Objective: Nosocomial infections are the main problems rising morbidity and mortality in health care settings. Hand hygiene is the most effective method for preventing these infections. In this study, we aimed to investigate the factors related with hand hygiene adherence at a private hospital in Turkey. Materials and Methods:This study was conducted between March and June 2010 at a private hospital in Turkey. During the observation period, employees were informed about training, then posters and images were hanged in specific places of the hospital. After the initial observation, training on nosocomial infections and hand hygiene was provided to the hospital staff in March 2010. Contacts were classified according to occupational groups and whether invasive or not. These observations were evaluated in terms of compatibility with hand hygiene guidelines. Results:Hand hygiene adherence rate of trained doctors was higher than untrained ones before patient contact and after environment contact [48% (35/73) versus 82% (92/113) p<0.05 and 23% (5/22) versus 76% (37/49) p<0.05 respectively]. Hand hygiene adherence rate of trained nurses was higher than untrained ones before patient contact [63% (50/79) versus 76% (37/49) p<0.05]. Hand hygiene adherence rate of trained assistant health personnel was higher than untrained ones before asepsis [20% (2/10) versus 73% (16/22) p<0.05]. In addition, it was seen that hand antiseptics were used when hand washing was not possible. Conclusion:The increase at the rate of hand washing after training reveals the importance of feedback of the observations, as well as the training. One of the most important ways of preventing nosocomial infections is hand hygiene training that should be continued with feedbacks. Sonuç: Eğitim sonrası el yıkama oranlarındaki artış gözlemlerin geribildiriminin yanı sıra, eğitimin önemini ortaya koymaktadır. Hastane enfeksiyonlarını önlemede en önemli yollardan biri geri bildirimler ile sürdürülmesi gereken el hijyeni eğitimidir.

Aim Systemic inflammation has a crucial role in the pathogenesis and mortality of Coronavirus disease 2019 (COVID-19). Multi-inflammatory index (MII) is a novel index related with systemic inflammation. In this study, we investigated the relationship between MII and in-hospital mortality in COVID-19 patients admitted to the intensive care unit (ICU). Methods We retrospectively analyzed the medical records of COVID-19 patients followed-up in the ICU of our institution between 01.04.2020 and 01.10.2021. Patients were classified into two groups according to mortality status as survivors and non-survivors. Various inflammatory parameters of the groups were compared and their efficacy in predicting mortality was investigated. Results Out of 348 study patients, 86 cases (24.7%) were in the survived group and 262 cases (75.3%) were in the dead group. The median age of the mortal group was significantly higher than that of the survived group (65.5 vs 76, P < .001). Multiple logistic regression analysis revealed that among all the included inflammatory parameters, MII showed the best efficacy for predicting mortality (OR: 0.999; 95% CI: 0.9991-0.9998; P = .003). Conclusion MII, a new combination of Neutrophil to lymphocyte ratio (NLR) and C-reactive protein (CRP), is a simple and practical biomarker that can help us in the prediction of mortality in COVID-19 patients followed-up in the ICU.

Background Crimean-Congo hemorrhagic fever (CCHF) is an endemic zoonosis in Kastamonu, Turkey. Clinical and laboratory findings may not be specific in the early phase of the disease, hence bringing a challenge to the clinician. Objective We aimed to distinguish CCHF cases among all suspected cases by comparing them with non-CCHF cases with respect to characteristics during admission. Methods Cases with a presumptive diagnosis of CCHF at a secondary care hospital in Kastamonu in between 2014–2017 were evaluated, retrospectively. CCHF and non-CCHF cases were compared with respect to their clinical, laboratory and epidemiological characteristics during admission. Results Among 76 suspected patients, CCHF was found in 46.1% of them. Four-year fatality rate was 9.6% in CCHF cases. The frequency of headache, nausea/vomiting, leukopenia, thrombocytopenia less than 50x109/L, AST-ALT and LDH elevation, tick bites and contact with blood or body fluids of animals in CCHF cases were significantly higher than in non-CCHF cases (p<0.05). Conclusion Headache and nausea/vomiting accompanied with leukopenia, thrombocytopenia less than 50x109/L, AST-ALT and LDH elevations raise the possibility of CCHF in endemic regions especially when there is a history of tick bite and contact with blood or body fluids of animals.

OBJECTIVE: This study investigates whether C-reactive protein, platelet-lymphocyte ratio, and neutrophil-lymphocyte ratio could be useful to predict mortality in COVID-19.METHODS: Data of 635 patients with COVID-19 followed up in Sinop Ataturk State Hospital from February to May 2020 were evaluated retrospectively. Diagnosis of COVID-19 was made according to the interim guidance of the World Health Organization. Patients were grouped into two groups based on mortality as survived and non-survived patients. Age, gender, neutrophil-lymphocyte ratio, plateletlymphocyte ratio, and C-reactive protein of the groups were investigated and compared. RESULTS:The mean age of the participants was 55.8±22.3 years. Among the patients, 584 survived and 51 patients died. Age was significantly different between the groups, 54.2±22.3 in the survived group and 75.6±11.1 in the dead group (p=0.000). In addition, neutrophil, C-reactive protein, and neutrophil-lymphocyte ratio values were significantly higher in the dead group (p=0.000). plateletlymphocyte ratio was slightly higher in the dead group, but this difference was not significant (p=0.42). The area under the curve values for age, lymphocyte, platelet, C-reactive protein, and neutrophil-lymphocyte ratio are 0.797, 0.424, 0.485, 0.778, and 0.729, respectively. CONCLUSIONS: Our results showed that neutrophil-lymphocyte ratio and C-reactive protein are significantly higher in patients leading to death and could be effective biomarkers in predicting COVID-19 fatality. Furthermore, C-reactive protein could be used as an independent biomarker to predict death in patients with COVID-19, regardless of gender and age (p=0.000).

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