Quality of Life and Psychometric Characteristics of Syrian Refugee Physicians Who Migrated to Turkey: A Cross-Sectional Study

Background

The concept of migration comes with various problems, affecting the quality of life and psychological state of immigrants. This study aimed to investigate the quality of life and depression and anxiety states of physicians who immigrated to Turkey after the civil war that started in Syria in 2011.

Methods

In this cross-sectional study, a sociodemographic questionnaire form, the short version of the World Health Organization's quality of life assessment tool (WHOQOL-BREF), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were applied to Syrian doctors who received integration training to work in refugee health centers established for immigrants in Turkey.

Results

A total of 570 participants were included in the study. The median scores of WHOQOL-BREF domains of the participants were 75 for DOM1 (min: 25, max: 100, IQR: 18), 69 for DOM2 (min: 6, max: 100, IQR: 25), 69 for DOM3 (min: 0, max: 100, IQR: 19), and 63 for DOM4 (min: 0, max: 94, IQR: 19). The median BDI score of the participants was 7 (min: 0, max: 41, IQR: 8), and the median BAI score was 5 (min: 0, max: 50, IQR: 8). Having primary care experience, having knowledge about the Turkish healthcare system, believing that they can adapt to work in refugee health centers, and not having a plan to return to their country were found to be associated with a higher score in at least one of the WHOQOL-BREF subdomains. Planning to turn back their country was significantly associated with higher BAI scores.

Conclusions

The overall quality of life of most refugee physicians in Turkey was high, and the BDI and BAI scores were also below the threshold values. Further qualitative studies that allow in-depth analyses may reveal underlying factors for this situation.

Can the Smoke-Free Ratio be a Novel Indicator of the Cardiovascular and Metabolic Risk Reduction of Former Smokers? A Cross-Sectional Study

OBJECTIVE

The association of smoking with many diseases is well known, as well as are the benefits of smoking cessation. While mentioning these benefits, the duration that passes after quitting smoking is always stressed. However, former smokers' history of smoking exposure is usually ignored. This study aimed to investigate the possible effect of the pack-years history on several cardiovascular health parameters.

METHODS

A cross-sectional study was conducted on 160 ex smoker participants. A novel index was described and named the "smoke-free ratio" (SFR), which is the number of smoke-free years divided by the number of pack-years. The associations between the SFR and various laboratory values, as well as anthropometric and vital measurements, were investigated.

RESULTS

The SFR was negatively correlated with body mass index, diastolic blood pressure, and pulse in women with diabetes. In the healthy sub-group, fasting plasma glucose was negatively and high-density lipoprotein cholesterol positively correlated with the SFR. A Mann-Whitney U test revealed that the cohort with metabolic syndrome had significantly lower SFR scores (Z = -2.11; P = .035). In binary grouping, the participants with low SFR scores had higher rates of metabolic syndrome.

DISCUSSION

This study revealed some impressive features about the SFR, which is proposed as a novel tool for estimating metabolic and cardiovascular risk reduction in former smokers. Nevertheless, the actual clinical significance of this entity remains unclear.

Thiol levels in mild or moderate COVID-19 patients: A comparison of variant and classic COVID-19 cases

BACKGROUND

Various variants of the COVID-19 have started to attract attention recently. The clinical course of these variants and possible predictive parameters are being investigated. This study aimed to examine the relationship between thiol levels, which are indicators of oxidative stress, and variant COVID-19 types.

METHODS

In this cross-sectional study, patients with a diagnosis of classic COVID-19 and patients with a diagnosis of variant COVID-19 with mild and moderate symptoms followed in the clinical observatory of Ankara city hospital were included in the study group. The patients were divided into two groups according to the COVID-19 type as a variant and classic COVID-19, and a healthy control group was added for comparison. A complete blood count and thiol analysis were performed from the venous blood samples. Obtained results were compared between groups, and the ROC analysis was performed.

RESULTS

Thiol levels were significantly lower in patients with a diagnosis of COVID-19 compared with the control group. In terms of WBC, lymphocyte, neutrophil, NLR, ferritin and thiol parameters, patients with variant COVID-19 differed significantly from patients with a classic COVID-19 diagnosis. Thiol levels' cut-off values to distinguish between variant COVID-19 patients and control group from classical COVID-19 patients were almost identical (423 and 422 µmol/L, respectively).

CONCLUSIONS

It seems possible to use thiol as a sensitive, specific and cost-effective marker to suspect variant COVID-19 cases. Since this study is probably the first example in this subject, it would form a basis for further studies.

Organ Donation in Turkey: The Knowledge, Approaches and Opinions of Family Physicians

Background:

Considering the gap between organ donors and receivers, it can be assumed that family physicians may play an important role in organ donation. Thus, we aimed to investigate the family physicians’ approaches to organ donation in Turkey.

Methods:

In this cross-sectional study, an online survey was sent to all family physicians working in Family Health Centers in Turkey Between Jul – Sep 2018. The survey questioned the knowledge, approaches, and opinions about organ donation issues, besides the socio-demographic characteristics.

Results:

Most physicians stated that they had given information to their patients on this subject at least occasionally (59.19%, n=998). Among participants, the most common reason for refusing consent for organ donation was the fear of commercial abuse (19.66%, n=244). Most participants (52.61%, n=887) stated that they had been positively affected by the media about organ donation. Some physicians were uncertain about the reliability of the brain death diagnosis (18.39%, n=310). A minor group stated that organ donation might be religiously inappropriate (10.50%, n=177).

Conclusion:

Although most of the family physicians had a positive manner about organ donation, there was still some wrong knowledge of the participants about legal and medical aspects of organ donation, as well as some other concerns like organ trafficking and reliability of brain death diagnoses, whereas religious concerns were not significant.

Evaluation of obstructive sleep apnea prevalence in mothers of infants with low birth weight and its relationship with serum uric acid levels as a hypoxia marker

OBJECTIVE

Serum uric acid level, which is an oxidative stress marker, may increase in some conditions that lay the ground for the hypoxia. However, recent literature lacks studies with large series on this subject. We aimed to examine the incidence of OSAS in mothers who delivered a low birth weight baby and its association with serum uric acid levels as a hypoxia marker.

METHODS

We enrolled 143 pregnant women, 44 of whom delivered a low birth weight (LBW) baby. We made a face-to-face interview in which we asked the questions in the patient follow-up form, comprising three sections. The form included questions regarding the sociodemographic features and obstetric history of the participant women, besides the Berlin Questionnaire and the Epworth Sleepiness Scale. We recorded the blood test parameters that are obtained from patient records in the last section.

RESULTS

Mean uric acid (UA) levels of mothers with a LBW baby (n = 44, birth weight below 2500 g) were 4.51 ± 1.23 mg/dL (min-max = 2.7-8.0) while the UA levels in mothers of normal weighted (NBW) babies (n = 99, birth weight is 2500 g or above) were 4.08 ± 0.75 (min-max = 2.6-6.1 mg/dL). The UA levels of mothers who delivered LBW infants were significantly higher compared with the mothers of NBW babies (p = .010).

CONCLUSION

Uric acid levels can be used as a prognostic parameter for the closer monitoring of pregnant women who have been diagnosed with small-for-gestational-age babies during pregnancy.