In this study, we compare the predictive value of clinical scoring systems that are already in use in patients with Coronavirus disease 2019 (COVID-19), including the Brescia-COVID Respiratory Severity Scale (BCRSS), Quick SOFA (qSOFA), Sequential Organ Failure Assessment (SOFA), Multilobular infiltration, hypo-Lymphocytosis, Bacterial coinfection, Smoking history, hyper-Tension, and Age (MuLBSTA) and scoring system for reactive hemophagocytic syndrome (HScore), for determining the severity of the disease. Our aim in this study is to determine which scoring system is most useful in determining disease severity and to guide clinicians. We classified the patients into two groups according to the stage of the disease (severe and non-severe) and adopted interim guidance of the World Health Organization. Severe cases were divided into a group of surviving patients and a deceased group according to the prognosis. According to admission values, the BCRSS, qSOFA, SOFA, MuLBSTA, and HScore were evaluated at admission using the worst parameters available in the first 24 h. Of the 417 patients included in our study, 46 (11%) were in the severe group, while 371 (89%) were in the non-severe group. Of these 417 patients, 230 (55.2%) were men. The median (IQR) age of all patients was 44 (25) years. In multivariate logistic regression analyses, BRCSS in the highest tertile (HR 6.1, 95% CI 2.105–17.674, p = 0.001) was determined as an independent predictor of severe disease in cases of COVID-19. In multivariate analyses, qSOFA was also found to be an independent predictor of severe COVID-19 (HR 4.757, 95% CI 1.438–15.730, p = 0.011). The area under the curve (AUC) of the BRCSS, qSOFA, SOFA, MuLBSTA, and HScore was 0.977, 0.961, 0.958, 0.860, and 0.698, respectively. Calculation of the BRCSS and qSOFA at the time of hospital admission can predict critical clinical outcomes in patients with COVID-19, and their predictive value is superior to that of HScore, MuLBSTA, and SOFA. Our prediction is that early interventions for high-risk patients, with early identification of high-risk group using BRCSS and qSOFA, may improve clinical outcomes in COVID-19.

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Background: We aimed to examine the relationship of mean platelet volume (MPV) / albumin ratio (MAR) with disease and disease severity in patients with acute cholangitis. Material and Method: Cases older than 18 years of age, who applied to the emergency department and were diagnosed with acute cholangitis after detailed evaluation were included in the study.Tokyo 2018 criteria are used to determine the severity of acute cholangitis. Result: There was a positive correlation between MAR levels and Tokyo severity,and increased MAR levels were determined as an independent predictor for each risk group.The cut-off value of the MAR level in predicting moderate risk compared to the mild risk group was found to be >20.9% with 73.3% sensitivity and 70.6% specificity (AUC±SE=0.785±0.03; +PV= 51.3%, -PV= 86.2%; p< 0.001). The cut-off value of the MAR level in predicting severe risk compared to the moderate risk group was found to be >23.2% with 77.2% sensitivity and 59.1% specificity (AUC±SE=0.744±0.03; +PV= 64.5%, -PV= 72.9%; p<0.001).Mean MAR levels were found to be higher in patients admitted to the ICU compared to those who were not admitted (25.2±6.0 vs 21.3±4.6; p<0.001) and increased MAR levels were a potential risk factor for mortality (HR= 1.09; p<0.001). Conclusion: We found that the MAR level is a very good marker in determining the severity of acute cholangitis.

Objective: Thiol/disulfide (T/DS) homeostasis represents a promising new approach to evaluate oxidative stress. Therefore, we aimed to examine T/DS homeostasis in vitamin D (VitD)-deficient patients.Methods: We enrolled 154 patients with VitD deficiency and 154 healthy control subjects in the study. For both groups, native thiol, total thiol, and disulfide values were measured. Additionally, considering the obtained 25-hydroxycholecalciferol [25(OH)D] levels, the patient group was further divided into two subgroups (Group 1: <10 ng/mL, Group 2: 10-20 ng/mL), which were compared in more depth according to the specified parameters.Results: Values of native thiol, total thiol, and disulfide measured in the combination of Groups 1 and 2, comprising individuals with VitD deficiency, proved to be higher in comparison to the control group with statistical significance (p=0.007, p=0.028, and p<0.001, respectively). When subgroups were considered according to VitD classifications, native thiol and total thiol were again higher in Group 1 in comparison to the values obtained for control subjects (p=0.022; p<0.001). While the total thiol level of Group 2 was higher than that of controls (p<0.001), no difference with statistical significance was obtained in the comparison of disulfide levels among the indviduals of Group 1, Group 2, and the controls (p=0.081). Conclusion:In this study, among patients with VitD deficiency, we have confirmed that values of native thiol and total thiol were increased, while the T/DS balance was found to have shifted in favor of the thiol level.

Background Irritable bowel syndrome (IBS) is a functional bowel disease that is characterized by abdominal pain, discomfort, and changes in the frequency and form of stool without any organic pathology. In this study, the factors that affect the herbal treatment choices of IBS patients and their results were investigated. Methods Included in the study were 248 IBS patients who were over the age of 18. A questionnaire that comprised 25 questions was applied to the participants. Survey questions were asked to the participants regarding their age, place of birth, gender, educational status, demographic details, social standing, socioeconomic status and job, place of residence, and marital status. In addition, The participants were asked about which IBS symptoms they had, from whom they had received the recommendation for use of herbal products, whether the media had an effect on their selection of herbal products, and whether they had benefited from herbal products. Results It was observed that 41.1% of the patients with IBS who participated in the study used herbal medicine, 9.8% of whom used them regularly. It was found that the IBS patients participating in the study made their decision to use herbal products mostly based on the recommendations that they were given by acquaintances (57%) and the media (34%). When the patients were evaluated according to their gender, IBS was found to be more common in unemployed women who had a low level of education, while it was more common in working men (p = 0.015, P < 0.001, respectively). The IBS patients who were single used more herbal products that those who were married (P = 0.036). While the use of herbal herbs and oils was predominant in patients whose recommendation content comprised the media/internet and acquaintances, the herbal treatment content recommended by healthcare professionals consisted of traditional treatments and mixtures (P = 0.012). It was determined that a higher percentage of those who used herbal treatments lived in city centers when compared to those who did not (P < 0.001). In addition, it was determined that patients with constipation used herbal products more than those without (P < 0.001). Among the IBS patients, those who had diarrhea and those who were receiving medical treatment preferred to use significantly less herbal products (P = 0.007 and P = 0.041, respectively). It was found that the patients who visited the Gastroenterology Outpatient Clinic mostly used herbal therapy, while those who visited a family doctor used herbal therapy the least (P = 0.029 and P < 0.001, respectively). Conclusion The IBS patients revealed whose recommendations they followed when purchasing herbal products, which of the products they preferred, and how useful/beneficial they felt that these products were. In this regard, the addition of training curricula related to herbal treatment for professional healthcare workers will further raise awareness on this topic.