Living on with autism after a devastating earthquake: experiences of children and adolescents in Turkey.

Introduction: The current study aimed to investigate the psychological impact of the Turkey 2023 earthquakes on children with autism spectrum disorder (ASD) and their parents residing in Hatay, Sanliurfa, and Ankara provinces, encompassing the periods both before and after the Turkey 2023 earthquakes. Method: This cross-sectional, multicenter study included 103 children and adolescents with ASD aged between 6 and 18. Participants were evaluated based on their residence in Ankara, Hatay, and Sanliurfa, three cities affected differently by the earthquake. Parent-report questionnaires were utilized to assess the children's autism symptoms and behavioural problems. The Childhood Autism Rating Scale was used to determine autism severity. The psychiatric problems of mothers were also assessed with self-report scales. Results: Significantly increased levels of core autism symptoms, irritability, and hyperactivity were found in Hatay and Sanliurfa participants after the earthquakes compared to before, while no differences were detected in children from the Ankara group. Scale score increases in the Hatay group, which had to take a more extended break from special education, were higher than in the Sanliurfa group. Participants with late-diagnosed ASD exhibited a more significant increase in their scale scores after the earthquake. Depression, stress and hopelessness scores were the highest, and the life satisfaction levels were the lowest in mothers of the Hatay and Sanliurfa groups. More pronounced increases were observed in aberrant behaviours among children of mothers with low educational levels following the earthquake. Discussion: Our findings demonstrate that the exacerbation of core ASD symptoms and behavioural deterioration after the earthquakes are associated with disruptions in specialized education services, exposure to earthquake-related trauma, and the educational level of mothers.

Impact of health and digital health literacy on quality of life following radical prostatectomy for prostate cancer: prospective single-center cohort study.

PURPOSE: The importance of health literacy (HL) and digital health literacy (e-HL) in promoting healthy behavior and informed decision making is becoming increasingly apparent. This study aimed to assess the effects of HL and e-HL on the quality of life (QoL) of men who underwent radical prostatectomy (RP) for localized prostate cancer. MATERIALS AND METHODS: This prospective observational study included 104 patients who underwent RP for localized prostate cancer. HL and e-HL were evaluated using the validated eHealth Literacy Scale and European Health Literacy Survey Questionnaire Short Form before RP. We evaluated patients' physical, psychological, social, and global QoL using the validated EORTC QLQ-C30 8 weeks after RP. The exclusion criterion was any difficulties in language and comprehension. We employed one-way ANOVA to compare continuous variables across groups in univariate analysis and used MANOVA for exploring relationships among multiple continuous variables and groups in the multivariate analysis. RESULTS: Multivariate analyses showed that poorer e-HL and HL were associated with being older (p = 0.019), having less education (p < 0.001), and not having access to the internet (p < 0.001). Logistic regression analysis revealed significant associations between improved e-HL (p = 0.043) and HL (p = 0.023), better global health status, and higher emotional functioning (p = 0.011). However, the symptom scales did not differ significantly between the e-HL and HL groups. CONCLUSION: Our study showed a positive association between self-reported HL/e-HL and QoL, marking the first report on the impact of HL/e-HL on the QoL in men who underwent RP for clinically localized prostate cancer.

Impact of anthro-metabolic indices and gestational weight gain on maternal and neonatal outcomes: a prospective observational study.

OBJECTIVE: The aim of this study was to examine the relationship of anthro-metabolic indices on maternal and neonatal outcomes. METHODS: This prospective observational study was conducted on healthy mother-baby pairs between January 1, 2023 and July 1, 2023. Detailed sociodemographic information was collected through an interview with the mother. Clinical, biochemical, obstetric, fetal, and neonatal outcomes were abstracted from hospital medical records. Anthropometric measurements were obtained from the examination of mother-baby pairs. RESULTS: A total of 336 healthy mothers-children pairs were included. Mothers of newborn ≥4000 g had higher gestational age (p=0.003), body mass index (p=0.003), gestational weight gain (p=0.016), waist circumferences (p=0.002), and hip circumferences (p=0.001). gestational weight gain was associated with the mode of delivery (p=0.023). waist-to-hip ratio (p=0.005), gestational weight gain (p=0.013), and a body shape index (p<0.001) were associated with longer length of hospital stay. Age (p<0.001) and inter-pregnancy interval (p=0.004) were higher in pre-pregnancy underweight/obese mothers. Receiver operating characteristic analysis revealed that maternal waist circumferences (AUC: 0.708, p=0.005), maternal weight (AUC: 0.690, p=0.010), and hip circumferences (AUC: 0.680, p=0.015) were sufficient to predict macrosomia (p<0.05). CONCLUSION: The study demonstrated a significant association between gestational weight gain and cesarean delivery, prolonged hospital stay, and macrosomia. It was also found that maternal body mass index, waist circumferences, and hip circumferences during pregnancy were associated with macrosomia. On the contrary, no significant relationship was found between maternal anthro-metabolic characteristics and maternal-fetal and birth outcomes.

Effect of mode of delivery on postpartum health-related quality of life.

OBJECTIVE: The aim of the study was to explore the impact of mode of delivery on health-related quality of life in mothers. METHODS: This cross-sectional study was conducted between May and August 2022 on healthy singleton pregnant women aged between 18 and 45 years. Data on socio-demographic variables, clinic features, pregnancy and birth characteristics, and neonatal outcomes were collected. Health-related quality of life was assessed by using EQ-5D-5L questionnaire. RESULTS: A total of 1,015 healthy pregnant women were included. The EQ-5D-5L index score was higher in those with regular sleep patterns (p<0.001), those who did physical activity (PA) during pregnancy (p<0.001), those who received spousal support (p<0.001), and those with very good and good perceived health (p<0.001). EQ-5D-5L index and EQ-5D-5L-VAS scores were lower in those with unplanned pregnancy, those who preferred cesarean section, those who had cesarean section, those who underwent episiotomy, and those who admitted to the intensive care unit (p<0.001). Emergency cesarean section and elective cesarean section had the lowest and second lowest health-related quality of life mean scores, while normal vaginal deliveries had the highest health-related quality of life mean scores, respectively (p<0.001). CONCLUSION: This study showed that health-related quality of life was higher after vaginal delivery than after cesarean section. In addition, spousal support, regular sleep pattern, and PA during pregnancy play an important role in maternal health-related quality of life.

Childhood Non-verbal Communication Scale (CNCS): Turkish Adaptation and Psychometric Properties.

Introduction: Nonverbal communication (NC) skills develop dramatically during the first year of life. Especially in children with Autism Spectrum Disorder (ASD), inadequacies in these skills in the early period negatively affect language development later. Therefore, early recognition of ASD symptoms is the first step in the diagnosis. The test to screen ASD at the earliest age is the Modified Checklist for Autism in Young Children/M-CHAT in Turkey. However, this test can be used for 18 months or later. In the present study, we aimed to adapt the Childhood Nonverbal Communication Scale (CNCS) to Turkish, which was developed in Iran to evaluate NC skills in children from birth to 18 months and determine psychometric properties. Methods: This cross-sectional and methodological study was conducted in 3 provinces and included 323 parents of children who are normally hearing and 3-18 months old. Sociodemographic form, Ankara Development Screening Inventory, CNCS-Turkish form, and LittleEARS Auditory Questionnaire were applied. Results: CNCS Turkish form consisting of 37 questions shows a two-factor structure. The reliability coefficient of the 37-item scale is highly reliable (KR-20=0.937). It also had good convergent validity based on a significant correlation between total scores and LittleEARS results (r=0.804, P<0.001). According to the normative curve plotted by the CNCS total score for age, NC skills progressed with a steep slope from 3 to 12 months and then progressed gradually until 18 months. Conclusions: Childhood Nonverbal Communication Scale (CNCS) is a promising tool showing good validity and reliability in Turkish.

Do Attitude, Awareness and Intention to Perform Female Genital Mutilation or Cutting for Their Daughters of Women Healthcare Providers Differ from Mothers in Somalia?

Aim: This study aimed to determine whether there were differences in attitude, awareness, and intention to perform female genital mutilation or cutting for their daughters in the future between female healthcare providers and mothers. Methods: A comparative cross-sectional study design was used. Results: A total of 508 women were included in the study. Of the participants, 68.7% (n = 349) were mothers (Group I) who visited the hospital and 31.3% (n = 159) were women healthcare professionals (Group II) [27% (n = 137) nurses and 4.3% (n = 22) doctors]. It was found that 8 (1.6%) of the participants did not have FGM/C and the FGM/C ratio was lower in group II (95%) than in group I (100%) (p < 0.001). In group I, 99.7% (n = 299) of the participants and 30.6% (n = 19) of those in group II reported intending to perform FGM for their daughters in the future (p < 0.001). The reasons for FGM/C most cited by participants were a traditional rite of passage into womanhood (78%), religious requirement (69.3%), and preservation of their virginity until marriage (59.3%). "Stop FGM" was given as a message on FGM/C by 60% of the participants (n = 79) who answered (n = 127, 100%) to open-ended questions. Conclusion: The results of this study show that female health professionals with higher education and monthly income had less positive perception of their FGM/C and less intention to allow their daughters to undergo FGM/C.

Long COVID in Hospitalized COVID-19 Patients: A Retrospective Cohort Study.

BACKGROUND: We aimed to evaluate the Long COVID frequency, and related factors in patients followed up after hospitalization. METHODS: This retrospective cohort study included 133 inpatients with COVID-19 PCR test positivity from Nigde Province, Turkey between 01.01.2021 and 28.02.2021. The characteristics of the patients were recorded by examining the files, and the symptom questioning was made by telephone interviewing with the patients approximately four months after the date of diagnosis. The presence of at least one symptom lasting more than four weeks was described as Long COVID. RESULTS: The frequency of Long COVID was 64.7%. The most common Long COVID symptoms were fatigue (45.9%), respiratory distress (25.6%), and muscle / joint pain (24.8%), respectively. In comparison analysis to identify factors associated with Long COVID; Long COVID was found to be more frequent among women (P=0.04); patients with severe COVID-19 (P<0.01), patients with prolonged hospital stay (P=0.03), patients with the comorbid disease (P=0.03), and Diabetes Mellitus patients (P=0.02). Additionally, the frequency of Long COVID increased as the depression score stated by the person increased after COVID-19 disease (P=0.02). CONCLUSION: The treatment of COVID-19 patients should not end when they are discharged from the hospital. On the contrary, these patients, especially high-risk patients, should be followed up in post-COVID clinics and rehabilitated physically and psychosocially with a multidisciplinary approach following the recovery period of the acute illness.

Is the course of COVID-19 associated with tuberculin skin test diameter? A retrospective study.

The pathogenesis of coronavirus disease 2019 (COVID-19) is still not fully understood. As severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) has a similar pathogenetic pathway to Mycobacterium tuberculosis, it has been reported that there may be a relationship between Bacille Calmette-Guérin (BCG) vaccination rate and COVID-19 severity. This study investigated the relationship between tuberculin skin test (TST) induration diameter and the clinical course of COVID-19. Of 1963 adult patients who underwent TST, 76 patients with SARS-COV-2 infection confirmed by RT-PCR analysis of respiratory tract samples were included in the study. Relationships between COVID-19 clinical severity and TST positivity, induration size, and other clinical parameters were analyzed. Of the 76 patients, TST results were negative for 53 patients (69.7%) and positive for 23 patients (30.3%). COVID-19 severity was mild in 47 patients (61.8%), moderate in 22 patients (28.9%), and severe in seven patients (9.3%). All TST-positive patients had mild disease. Patients with mild disease had a significantly higher TST positivity rate (p < 0.001) and larger induration diameter (p < 0.001). The area under the receiver operating characteristic (ROC) curve of TST induration size for the differentiation of mild with moderate and severe disease was 0.768 (p < 0.001). The maximum Youden J index value was 0.522 at an induration diameter of 6.5 mm, which had a sensitivity of 66.0% and specificity of 86.2%. COVID-19 patients with positive TST showed a significantly higher rate of mild disease than those with negative TST. TST positivity is favorably associated with the course of COVID-19.

Can preoperative modified systemic inflammation score (mSIS) be used to predict malignancy in persistent nondiagnostic thyroid nodules?

Background/aim: Despite the use of ultrasound guidance, a significant part of thyroid biopsies are nondiagnostic (ND). We aimed to investigate the utility of the preoperative modified systemic inflammation score (mSIS) to predict malignancies in patients with persistent ND thyroid nodules (TNs). Materials and methods: Records of 924 patients underwent thyroidectomy between September 2016 and May 2019 were retrospectively reviewed. The calculation of mSIS was as follows: mSIS 0 [patients with albumin (ALB) ≥ 4.0 g/dL and lymphocyte to monocyte ratio (LMR) ≥ 3.4], mSIS 1 [ALB < 4.0 g/dL or LMR < 3.4], and mSIS 2 [ALB < 4.0 g/dL and LMR < 3.4]. Results: One hundred and thirty-six patients were included in the study. Of the patients with a median age of 49 (21­81) years, 26 (19.1%) were male, and 110 (80.9%) were female. Besides low lymphocyte count (P = 0.03), and ALB levels (P < 0.01), higher BMI (P = 0.02) were also associated with malignancy. In patients classified as mSIS 2, 1 and 0; malignancy rates were 100%, 25.8%, and 16.1%, respectively. The association between preoperative mSIS and thyroid malignancies was statistically significant (P < 0.01). Conclusion: We recommend that when patients with persistent ND TNs are assigned to mSIS 2 or 1, surgery should not be delayed due to the risk of malignancy.

Diagnostic value of modified systemic inflammation score for prediction of malignancy in patients with indeterminate thyroid nodules.

BACKGROUND: Approximately 20% of the thyroid biopsies render an indeterminate (ID) cytology. We evaluated the diagnostic value of preoperative modified systemic inflammation score (mSIS) in predicting the malignancy of ID thyroid nodules (TNs). METHODS: Data of 162 patients with indeterminate TNs were examined retrospectively. The mSIS was calculated as follows: mSIS 0 [patients with albumin (ALB) ≥ 4.0 g/dL and lymphocyte-to-monocyte ratio (LMR) ≥ 3.4], mSIS 1 [ALB < 4.0 g/dL or LMR < 3.4], and mSIS 2 [ALB < 4.0 g/dL and LMR < 3.4]. RESULTS: Patients were classified into mSIS 0 (n = 105), mSIS 1 (n = 34) and mSIS 2 (n = 23) groups. The malignancy rates for the mSIS 0, 1 and 2 groups were 34.3%, 64.7% and 100% respectively. Preoperative mSIS was significantly associated with the presence of thyroid malignancy (p < 0.001). CONCLUSIONS: If the mSIS of patients with ID cytology is 1 or 2, appropriate surgical treatment should be performed without delay, due to the increased risk of malignancy.