INTRODUCTION: Adolescent pregnancies, which are undesirable situations, can adversely affect maternal and infant health. The aim of this study is to examine the effect of adolescent pregnancies on early neonatal outcomes.
METHODS: In this study, electronic files of adolescents (14-19 years old) and 20 years old mothers (control group) who gave birth and their babies in a tertiary hospital were retrospectively analyzed. Demographic and clinical data of the mother and baby were evaluated.
RESULTS: A total of 2638 patients, 1842 (69.82%) adolescents and 796 (30.17%) 20 years old mothers, were included in this study. While the birth weights of the babies of adolescent pregnant women were significantly lower than the control group; mean gestational ages, intrauterine growth retardation (IUGR), small for gestational age (SGA), and hypoglycemia rates were significantly higher (p<0.001, p=0.001, p=0.046, p=0.038, p=0.042, respectively). Adolescent mothers' body mass index was lower, preeclampsia and cesarean delivery rates were higher (p<0.001, p=0.048, p<0.001, respectively). The rates of admission to the neonatal intensive care unit and other neonatal morbidities were similar in both groups.
DISCUSSION AND CONCLUSION: Caesarean section rate is higher in adolescent pregnancies. Adolescent pregnancies are associated with negative neonatal outcomes like preeclampsia, IUGR, SGA and hypoglycemia. Social awareness should be provided to prevent adolescent pregnancies, which are still a problem. Regular follow-up of pregnant adolescents, especially in terms of preeclampsia and IUBG, is required. Close monitoring of infants of adolescent pregnant women is required for hypoglycemia is important.

INTRODUCTION: Helicobacter pylori (HP) is a gram-negative, microaerophilic bacterium that causes stomach infections. Gastroesophageal Reflux Disease (GERD) is one of the most common gastrointestinal disorders in the population, and its relationship with HP infection is still controversial. Although there are some articles in the literature that support the onset of esophagitis in patients with HP, a clear causal relationship between GERD and HP infection has not yet been established. The aim of this study is to evaluate the relationship between GERD and HP infection
METHODS: The files and gastroscopy reports of 1549 patients who underwent upper GIS endoscopy in the Gastroenterology Unit were evaluated. In addition to clinical features, 536 patients endoscopically diagnosed with GERD were included in the study. Endoscopy and pathology reports of 536 patients diagnosed with GERD were evaluated and analyzed for HP, esophagitis and intestinal metaplasia.
RESULTS: HP positivity was found in 229 (42,72%) of 536 patients diagnosed with GERD. Esophagitis was detected in 7,42% of patients with HP positive, and 13,35% of patients with HP negative had esophagitis. The frequency of esophagitis was found to be statistically significantly lower in those with positive HP (p=0,026).
DISCUSSION AND CONCLUSION: We found that patients with negative HP had significantly frequent reflux-esophagitis. This finding was consistent with the literature supporting the opposite relationship between HP and reflux-esophagitis. In the light of the knowledge obtained from the literature, it is thought that HP eradication in all patients with GERD will not reduce symptoms or may increase it.

INTRODUCTION: We aimed to determine the awareness of obese, overweight and normal-weight patients about the complications, causes and prevention of obesity.
METHODS: Patients who were admitted to our clinic during a four months period were included. Demographical features, familial histories of obesity, smoking, alcohol use, chronic diseases, medications, medical nutrition therapy and exercise habits were questioned. Patients were divided into groups as normal, overweight and obese according to the WHO criteria.
RESULTS: The median age of 352 patients was 45 (18-88), Of all, 282 (80.11%) were female, and 70 (19.89%) were male. Fifty-one patients (14.49%) were normal weight, 72 (20.45%) were overweight, and 229 (65.06%) were obese. The level of education was lower in obese patients, and the family history of obesity was higher (p<0.001). The percentage of patients who agreed that obesity was a risk factor for insulin resistance, type 2 diabetes, cardiovascular disease, hypertension, dyslipidemia, fatty liver, sleep apnea, asthma, gastrointestinal problems, depression and other mental problems, and death was changing between 65% and 92. Awareness of obesity risk factors was similar between groups. The rate of those who knew that eating 4-6 meals a day and not missing snacks was important for a healthy diet was highest in the obese group (p=0.043).
DISCUSSION AND CONCLUSION: Although awareness of some obesity-related complications was high in our study, awareness of risks such as cholelithiasis, pancreatitis and cancer development was low. For the prevention and effective treatment of obesity, it is necessary to increase the level of awareness of the disease.

INTRODUCTION: We aimed to evaluate the etiologic factors and pregnancy outcomes of pregnant women who applied to our antenatal outpatient clinics with the complaint of pruritus.
METHODS: A retrospective study was conducted to examine the age, gestational weeks, gravidity, parity, comorbidities, laboratory test results and obstetric outcomes of pregnant women who applied with the complaint of pruritus to the antenatal follow-up outpatient clinics of Ankara City Hospital between 01.01.2020 and 31.12.2020.
RESULTS: Medical records of 223 pregnant women who applied to our antenatal outpatient clinic with pruritus were evaluated, and the 181 pregnant with complete accessible data were enrolled in this study. The most common clinical diagnosis was pregnancy-specific dermatoses with a rate of 47.51% (n=86), and a specific diagnosis could not be determined in 80 pregnant women (44.19 %). Intrahepatic cholestasis (IHC) was found to be the most frequent diagnosis among the pregnancy-specific dermatoses with a percent of 25.41 (n=46). The incidence of IHC among specific dermatoses diagnosed ≥ 28 weeks of pregnancy was 30.76 %, and the most common dermatosis < 28 weeks was the atopic eruption of pregnancy (36.84 %).
DISCUSSION AND CONCLUSION: Pruritus is a common condition in pregnancy; considering the frequency, especially in the third trimester, IHC should be kept in mind in the differential diagnosis to prevent maternal-fetal morbidity and mortality.

INTRODUCTION: Recently, anti-vaccination has been rapidly spreading both around the world and in our country. Healthcare workers, including Family Physicians, must have knowledge of anti-vaccination. This study aimed to assess views, attitudes and behaviors of residents in Family Medicine clinics toward this issue.
METHODS: This cross-sectional study was performed between 15.06.2019 and 15.11.2019 and reached all Family Medicine clinics in Ankara. The study group consisted of 311 physicians. For data collection, participants received a questionnaire form questioning sociodemographic-occupational characteristics, knowledge of immunization and vaccines and views, attitudes and behaviors toward anti-vaccination. The value of p<0.05 was the cut-off point for statistical significance in all calculations.
RESULTS: The rate of those having encountered anti-vaccination was 59.50% (n=185). Residents of Contract Family Medicine (CFM) training, those who had been a resident for three years and more, and those with primary care experience had encountered more anti-vaccination cases. Of these participants, 85.40% (n=158) tried to convince individuals and 12.40% (n=23) respected their opinions. Of the participants, 94.90% (n=295) were against vaccine refusal and 82% (n=255) were against vaccine hesitancy while 0.30% (n=1) supported vaccine refusal. Of the participants, 23.20% (n=72) received training on anti-vaccination, and 59.70% (n=43) of those found the training received sufficient.
DISCUSSION AND CONCLUSION: The rate of participants supporting vaccine hesitancy or being unsure about it was considerable. Residents' training on anti-vaccination is insufficient. Therefore, training should be planned, necessary legal assessments should be performed, and health literacy should be increased to fight against anti-vaccination effectively and successfully.

INTRODUCTION: Pregnancy is a period with physical, emotional and social consequences. These results can be positive, such as joy and happiness, or negative, such as stress and anxiety. Negative consequences can cause fear of childbirth.
METHODS: The study was carried out in Samsun Education and Research Hospital, Gynecology and Pediatrics service building. In order to observe the effects of pregnancy, pregnant women at the 28th week and above in the third trimester were included in the study. The data obtained with the questionnaire, including questions questioning demographic characteristics and the Wijma birth expectancy scale, were interpreted through the SPSS package program. The study was conducted from April 1 to June 15, 2021.
RESULTS: The study was conducted with 1116 pregnant women. The mean age of the pregnant women participating in the study was found to be 27,86±5,44. The mean number of pregnant follow-ups in family medicine during pregnancy was 4,47±2,72. The mean W-DEQ score of the pregnant women participating in the study was found to be 75.89±24,67. Of the pregnant women, 33.69% were pregnant for the first time, 41.67% of the participants had previous experience of normal delivery, and 27.69% of them had previous cesarean delivery experience. In terms of having given birth before, having experienced normal birth before, and having had a previous cesarean delivery, the W-DEQ score does not differ statistically.
DISCUSSION AND CONCLUSION: The fact that pregnancy is a planned and desired pregnancy has a very significant effect on fear of childbirth reveals the importance of issues such as family planning and pregnancy timing. In this respect, free, effective and easily accessible primary care service; is the most important health step where materials for both counseling and contraception can be obtained.

INTRODUCTION: This study aimed to determine the frequency of headaches in COVID-19 related hospital admissions and whether they are specific to the disease.
METHODS: All patients over the age of 18 who applied to the COVID Outpatient Clinic were included in the cross-sectional descriptive study. Patients were asked to answer an 18-item questionnaire about the presence and characteristics of headache complaints. The ID Migraine scale and International Headache Society diagnostic criteria were used for classification, and the visual Pain Scale was used for pain intensity.
RESULTS: Of the 440 participants, 208 (47.27%) were women. Of the 273 first applicant patients, 44 (16.12%) had positive RT-PCR results. Of the 301 patients whose applications were based on any complaint, 179 (59.47%) had headaches. According to VAS, the pain intensity was 5.86 ± 2.72. Rates of headache presence or pain intensity did not differ in terms of RT-PCR test results. There was no significant difference in headache diagnostic groups according to RT-PCR test results.
DISCUSSION AND CONCLUSION: The headache is one of the most common complaints in COVID-19 patients. In our study, there was no difference in the frequency and characteristics of headaches according to RT-PCR test among patients who applied to the COVID-19 outpatient clinic with suspicion of the illness.

INTRODUCTION: With this study, it was aimed to determine the anxiety levels of individuals with end-stage lung disease during the COVID-19 outbreak.
METHODS: Adults with respiratory failure due to underlying lung disease and using long-term oxygen therapy were included in the study. State and trait anxiety levels of the participants were determined according to the STAI-1 and STAI-2 scores.
RESULTS: According to the STAI-1 evaluation, 64 (28,57) of the cases had mild, 142 (63,39) moderate, and 18 (8,03) severe anxiety, and according to the STAI-2 evaluation, 44 (19,64) had mild, 164 (73,21) moderate, and 16 (7.14) had severe anxiety. According to the STAI-2 evaluation, the anxiety level was statistically significantly higher in women (median; min-max: 50; 38-67) compared to men (42; 26-75) (p <0.001). Both STAI-1 and STAI-2 scores were higher in patients with psychiatric disease (52.5; 42-61 and 52.5; 43-66, respectively) than those without psychiatric disease (47; 21-67 and 43; 26-75, respectively) (p = 0.015 and p = 0.002, respectively). STAI-2 scores were higher in individuals who haven’t contracted COVID-19 (44; 34-75) than those who did (40; 34-75) (p <0.001). STAI-1 and STAI-2 scores were higher in participants who think that social measures taken against the epidemic are sufficient (50.5; 30-67 and 45.5; 34-75, respectively) compared to those who think insufficient (45; 21-60 and 43; 26-62, respectively) (p <0.001 and p = 0.008, respectively).
DISCUSSION AND CONCLUSION: Anxiety is observed in individuals with a diagnosis of end-stage lung disease.

INTRODUCTION: Depression, which is an important public health problem and a determinant of disease burden, is one of the most common mental disorders, especially in the elderly population. The current study was aimed to investigate the prevalence of geriatric depression and associated factors among elderly people who admitted to the family medicine outpatient clinic.
METHODS: A total of 195 elderly participants aged 60 years have enrolled in this study. Demographic characteristics, medical history, psychosocial factors, and physical health status of individuals that may be associated with depression were obtained with a questionnaire. Depressive symptoms were assessed using the 30-item Geriatric Depression Scale (GDS).
RESULTS: Total of the 166 participants included in the study, 49.09% (n=81) had no depression, 4.24% (n=7) had probable depression, and 46.67% (n=77) had depression. Depression questionnaire scores of participants 75 years and over-aged were statistically higher than other age groups (p=0.001). Ability to make own daily work (OR: 19.78, Cl: 1.23-317.83, p=0.035), have a hearing problem (OR: 2.74, CI: 1: 20 - 6: 27 p=0.017) and fair sleep quality (OR: 10.62, Cl: 2.37-42.70, p=0.002) or poor sleep quality (OR: 4.24, Cl: 1.78-10.06, p=0.001) were independent risk factors that affecting the depression status.
DISCUSSION AND CONCLUSION: This study provides an alarming signal for health professionals and family physicians about the high prevalence of geriatric depression. We found that geriatric depression is associated with household income, education level, physical health, hearing problem, sleep status and history of falls in the elderly population.

INTRODUCTION: Patients with chronic heart disease (CHD) have been defined in many guidelines as one of the priority groups for influenza vaccination. The purpose of this study was to evaluate influenza vaccination rates and related factors in patients with CHD.
METHODS: This cross-sectional survey study was conducted between May and August 2019. The questionnaire investigated socio-demographic characteristics, vaccination status in the 2018-19 influenza season, whether the influenza vaccine had been recommended, and vaccine acceptance or refusal reasons.
RESULTS: Of the 389 CHD patients participating in the study, 62.21% were male, and 45.24% were aged ≥65. The influenza vaccine uptake rate was 11.31%. Advanced age, vaccination recommendation by a physician, family members living with CHD patients having been previously vaccinated, emergency hospitalization for heart disease or respiratory disease, and knowing that the influenza vaccine was free of charge were factors that increased vaccination acceptance.
DISCUSSION AND CONCLUSION: The influenza vaccination rate among the CHD patients in this study was well below the expected level. The influenza vaccine not being recommended or not sufficiently encouraged, especially by physicians or other healthcare workers, seems to represent the greatest obstacle to influenza vaccination among CHD patients.

INTRODUCTION: The thiol-disulphide (TDH) homeostasis was investigated in a number of disorders. The aim of the present study is to investigate the dynamic thiol-disulphide homeostasis in patients diagnosed with obstructive jaundice and to compare the dynamic thiol-disulphide homeostasis with ischemia-modified albumin.
METHODS: A total of 146 participants who were admitted to the emergency department and who consisted of 69 patients and 77 healthy volunteers were included in the study. Detailed blood samples were obtained from the patients at the time of admission. Thiol/disulphide levels were examined using a brand-new method developed by Erel and Neselioglu on the patients diagnosed with obstructive jaundice during the admission. Data were evaluated in the computer system.

RESULTS: The levels of total thiol (p =0.025) and native thiol (p =0.023) were statistically significantly lower in the patient with obstructive jaundice than in the control group. It was observed that there was a significant negative correlation between the native thiol levels and the ALP (r =-0.262, p<0.01), urea (r =-0.313, p<0.01), total bilirubin (r =-0.388, p<0.01), direct bilirubin (r =-0.351, p<0.01) levels. At the same time, the level of disulphide (p = 0.235) was lower in the patient group than in the control group but not statistically significant. It was found that the ischemia modified albumin (IMA) values were lower in the control group than the obstructive jaundice group (p = 0.03).
DISCUSSION AND CONCLUSION: Total thiol and native thiol levels decrease in obstructive jaundice pathogenesis. Thiol-disulphide homeostasis may be a new biomarker of oxidative stress in obstructive jaundice.

INTRODUCTION: Family Medicine is an academic discipline with a curriculum, foundation and peer-reviewed journals. The monitoring and evaluation of the contents of the scientific journal become difficult considering the increasing publication's number. So, we evaluated scientific journals about 'Primary Health Care' (PHC) to help in the follow-up of academic data.
METHODS: On 09/11/2021, we evaluated 27 journals on the Web of Science (WoS) database in the 'PHC' category. Article Processing Charges (APC), Open Access (OA) states, origins, annual publication numbers, frequencies and types, publication languages, Journal Citation Indicators (JCI), SCImago Journal Rankings (SJR), Publons data, were examined as H-indexes including the terminology 'COVID-19'. p<0.05 was significant. Spearman correlation analysis was used.
RESULTS: In WoS, there were 18 SCIE (Science Citation Index Expanded) and 9 ESCI (Emerging Sources Citation Index) journals within PHC. Also seen that APCs ranged from 0-4545 USD, the annual number of journals ranged from 1-24, H-Index ranged from 8-120, SJR ranged between 0.17-1.92, all ESCI journals, as Twenty, were found to be OA. It was determined that the JCI, H-Index and SJR values of SCIE journals were higher. The number of publications containing the terminology "COVID-19" in the title and the impact factors of the journal was inversely proportional.
DISCUSSION AND CONCLUSION: The differences between SCIE-ESCI journals are in the journals in the PHC category, and this situation is reflected as H-Index, SJR 2020, JCI 2019 and 2020. It is noteworthy that all ESCI journals are OA. It is thought that PHC journals avoid 'COVID-19' related content in terms of their fields.

INTRODUCTION: This study was conducted in order to determine the frequency and severity of hypoglycemia and factors affecting hypoglycemia in diabetic patients.
METHODS: The patients hospitalized in the endocrinology ward or admitted to our outpatient clinics were included. All patients were above 18 years of age and had diabetes who were receiving insulin treatment. A total of 1038 patients were enrolled.
RESULTS: According to our findings, the patients in the study group were mostly female and relatively older. Most patients had low education levels and social status, and they were mostly living in the city suburbs. Most female patients in that group were housewives, and the most common accompanying comorbidities were hypertension and hyperlipidemia. The patients had a long duration of diabetes history and had received "diabetes and insulin education" before. Despite education, they didn't make the appropriate lifestyle changes such as diet and exercise. The mean insulin usage time was two years, and premixed insulins were the most common ones that were being used. Although hypoglycemia was frequent, the rate of severe attacks was low. Almost all cases had glucometer at home and were making self blood glucose monitoring. Moreover, almost all patients were injecting insulin to themselves, and the most common needle diameter was 8 mm. In our study, the enrolled patients' mean BMI, FPG, PPG were above the target range.
DISCUSSION AND CONCLUSION: In the analysis made in the research, occupation, diabetes type, insulin type, retinopathy, glucose follow-up, duration of diabetes, the duration of insulin treatment were found to be significant in terms of the presence of hypoglycemia; age and duration of insulin treatment were found to be significant in terms of frequency of hypoglycemia; duration of insulin treatment was significant in terms of severity of hypoglycemia.

SARS-Cov-2 infection, which we define as Covid-19, caused the death of almost 5,2 million people in the world until the end of 2021. The spread and lethality of the disease through various variants continue. The importance of the disease in obstetrics is due to the more severe clinical course in pregnant women compared to non-pregnant women and the higher morbidity/mortality rates in pregnant women in the presence of additional diseases. As in all epidemics, the way to find a global solution to the disease is through the vaccine. However, the fact that the epidemic deeply affected the whole world made it necessary to skip some steps of vaccine development studies that normally exceed ten years. A few of the dozens of vaccines that are tried to be developed with the introduction of modern techniques have been approved for emergency use by global health organizations since December 2020. Vaccines have been shown to provide high immunity in adults with slight differences between populations. In addition to the fact that no vaccine study also had a pregnant arm, reported results from pregnant animals are also limited. Therefore, the issue of whether pregnant women will be vaccinated is based on the recommendations of national and international organizations and the volunteers of the pregnant woman who is informed by health care providers. The purpose of this article is to present the general characteristics of Covid-19 vaccines and the latest data and recommendations regarding pregnant women in the world and in our country to health care providers.

Although the pathophysiology of thyroid hormone changes observed in acute or chronic diseases is not clearly understood, it has been known for about the last 50 years that the body has an adaptive metabolic response. On the other hand, it has also been shown in many studies that it can make inferences about the prognosis of the primary underlying disease. The most known of this thyroid hormone change pattern, defined as a non-thyroid disease, are low triiodothyronine (T3) and increased reverse T3 (rT3) levels. Although many pathogenetic mechanisms are thought to lead to these changes, the most known are changes in deiodinase activity, thyrotropin (TSH) secretion, and serum carrier proteins and/or cellular carrier receptors. Changes in thyroid hormones can vary at different stages of the primary underlying disease. In addition, in different clinical conditions or pathologies, thyroid hormones are affected in different ways, causing difficulty in the differential diagnosis. Many drugs used in the clinic are also known to affect thyroid hormones at different levels and directions. Current conditions should be taken into account when evaluating, and if possible, a full panel of thyroid hormones, especially TSH with free thyroxine (sT4), should be seen. The need for treatment should be decided by taking into account laboratory findings as well as the patient's clinical presentation and history. In many studies, routine thyroid hormone replacement is not recommended, as it does not give a positive or negative net result.