The Wolff-Chaikoff effect is a well-known phenomenon characterized by the transient suppression of thyroid hormone synthesis following an abrupt increase in iodine intake. Herein, we present a case of a 70-year-old man who presented with increased fatigue over several months, ultimately diagnosed with thyroid dysfunction induced by the chronic use of Lugol's solution. Despite having no significant medical history, his daily ingestion of two drops of 2% Lugol's solution (approximately 5 mg of total iodine per day) during the COVID-19 pandemic led to elevated thyroid-stimulating hormone (TSH) levels of 29 µIU/mL and low free thyroxine (fT4) levels of 0.6 ng/dL. Based on this information, the patient was started on levothyroxine 50 mcg daily and scheduled for a follow-up visit in two months. This case underscores the importance of recognizing and managing the Wolff–Chaikoff effect in clinical practice. Keywords: hypothyroidism, thyroid function tests, primary care, case report
Aimː The protective role of physical activity on cardiovascular and pulmonary health is well established; however, comparative evidence between yoga and aerobic exercise remains limited. This study aimed to compare their effectiveness in improving cardiovascular and pulmonary function. Methods: This parallel-group randomized controlled trial was conducted between March and August 2024 at a tertiary care teaching institute in southern Uttar Pradesh, India. Of 450 enrolled MBBS students aged 18–25 years, 360 participants completed the study. Participants were randomized to yoga or aerobic exercise, and outcome assessors were blinded. Both groups had supervised 45-minute daily sessions for 12 weeks. Cardiovascular and pulmonary parameters were assessed at baseline and after the intervention. Results: Both exercises significantly improved cardiovascular and pulmonary parameters after 12 weeks. Compared with aerobic exercise, yoga resulted in greater improvements in resting heart rate and blood pressure. Pulmonary parameters improved significantly in both groups; however, aerobic exercise was associated with greater improvements in dynamic pulmonary function, particularly FEV1 and PEFR. No significant between-group differences were observed for respiratory rate and FVC. Conclusion: Both interventions significantly improved cardiovascular and pulmonary function, with yoga showing greater cardiovascular benefits and aerobic exercise providing superior improvements in dynamic pulmonary function. Keywords: yoga, aerobic exercise, medical students, randomized controlled trial
Aimː Urinary incontinence is a prevalent geriatric syndrome that impairs quality of life, yet data on those aged ≥80 are limited. This study aimed to determine urinary incontinence prevalence, associated risk factors, and its relationship with depression in the very old population of eastern Türkiye. Methods: In this cross-sectional study, 400 individuals aged ≥80 registered at our Advanced Age Unit were interviewed face-to-face. Urinary incontinence was assessed with the International Consultation on Incontinence Questionnaire‑Short Form and depression with the Yesavage Geriatric Depression Scale. Associations were analyzed using chi‑square tests and Spearman correlation. Results: Mean age was 84.8±4.0 years; 60.8% were female. Urinary incontinence prevalence was 49.3% (n=197) and depression prevalence 27.3% (n=109). Urinary incontinence was significantly more frequent in women, those aged ≥90, with low education, higher BMI, smokers (p=0.003), those with history of falls, and those who had chronic disease. Depression occurred in 41.1% of participants with urinary incontinence versus 13.8% without. Incontinence Questionnaire‑Short Form scores correlated strongly with Yesavage scores and moderately with number of chronic diseases and number of medications. Conclusion: Urinary incontinence is common among those aged ≥80, and is strongly associated with depression. Integrated, multidisciplinary assessment and interventions targeting modifiable risk factors are essential to improve quality of life in this vulnerable population. Keywords: depression, quality of life, urinary incontinence
Aimː This study aimed to determine the prevalence of cyberloafing behaviors and perceived stress among medical students and to examine the relationship between these variables. Methods: A total of 252 participants were included in this study. This is a cross-sectional study. We used a personal information form, Cyberloafing Scale, and Perceived Stress Scale in our study. Results: The mean Cyberloafing Scale scores of the participants were 84.16±11.91. The Perceived Stress Scale mean score was 28.94±7.70. Access to the internet during the class, 69.8% (n: 176) of students indicated that they used the internet for personal and lecture purposes during class. Sharing was statistically significant in girls and playing games was statistically significant in boys. Conclusion: Our study results have shown that cyberloafing behaviors are common among medical students. Furthermore, sharing content was more common among female students, while gaming was more common among male students. Keywords: psychological stress, medical students, addiction
Aimː This study aimed to compare smoking cessation outcomes between cardiovascular risk assessment-based advice and the 5A-5R approach. Methods: This intervention study was conducted between June and July 2023 at the Family Medicine Clinic of Karadeniz Technical University. Volunteer participants aged 18–40 years, who had smoked at least 10 cigarettes per day for at least one year and had a lipid profile available within the preceding six months, were included. A total of 164 participants were allocated in a 1:1 ratio. Both groups completed a face-to-face questionnaire assessing sociodemographic characteristics and smoking habits. The control group received counseling based on the 5A-5R strategy, whereas the intervention group received smoking cessation advice guided by the 2019 ESC/EAS guidelines, including a 10-year cardiovascular risk estimation for young adults. Smoking status was assessed at six months via telephone or face-to-face follow-up interviews. Results: The median age of participants was 33 years (interquartile range: 25–37). Overall, 61.6% (n=101) of participants had not been asked about smoking during their last outpatient visit, and 36% (n=59) had never received advice to quit. After six months, at least one quit attempt was reported by 29.3% (n=24) of the control group and 42.7% (n=35) of the intervention group. Conclusion: Smoking cessation advice based on cardiovascular risk assessment resulted in a comparable number of quit attempts relative to the 5A-5R strategy. Keywords: tobacco use, preventive health services, primary health care, smoking cessation
Aimː To evaluate the performance of Generative Pre-trained Transformer-4o (GPT-4o) in generating mammography reports from complete four-image mammograms. Methods: This retrospective comparative study used previously reported 510 anonymized mammograms from Kırklareli Training and Research Hospital. Four JPEG images per patient were combined into a single composite input for GPT-4o, which generated structured reports in Turkish. Three radiologists independently evaluated the AI-generated reports by using the original mammography reports as reference. A custom interface and a Likert scale (0-5) for each section were used. Breast Imaging-Reporting and Data System (BI-RADS) classification performance was measured via accuracy, Cohen's Kappa, confusion matrix, and class-based metrics. Intraclass correlation coefficients are calculated for inter-rater reliability assesment. Results: GPT-4o demonstrated high performance in detecting normal findings (Lymph Node Evaluation: 4.97/5; Skin/Subcutaneous Tissues: 4.93/5) and some pathological features (Suspicious Calcifications: 4.53/5; Structural Distortion: 4.44/5). However, it achieved critically low performance in clinical decision-making: BI-RADS Category classification scored 2.48/5 with 9.6% overall accuracy and Cohen's Kappa of 0.017 (near-chance agreement), and Recommendations scored 2.50/5. The model systematically misclassified cases as BI-RADS 1 while failing to recognize BI-RADS 3 (1% recall), creating both false reassurance and inappropriate clinical escalation. Conclusion: GPT-4o, despite showing some success in identifying specific mammographic features, currently lacks the reliability required for independent BI-RADS classification and recommendation generation. The model's tendency towards misclassification and inappropriate escalation raises significant concerns regarding its clinical safety when used autonomously. Keywords: generative artificial intelligence, large language models, breast, mammography
Climate change is a pressing reality that continues unabated due to environmentally harmful human activities and a lack of sufficient political will to address the issue. The consequences of climate change have lasting negative effects on all living beings and plant life on our planet. Vulnerable populations, including children, the elderly, individuals with respiratory conditions, and those from lower socio-economic backgrounds with limited access to adequate healthcare, are likely to suffer the most. Climate change has far-reaching and serious impacts on the environment, agriculture, public health, social dynamics, and the economy of a region. This article aims to highlight the acute and chronic consequences of the climate crisis on children and their overall well-being. Keywords: climate change, global warming, child health, greenhouse gases
In this report, changes in the lipid profile of a 45-year-old female patient who regularly consumed Aronia melanocarpa (Aronia) fruit for one year were examined on a case-by-case basis. It was determined that the patient, who had no chronic diseases or medication use, consumed 30-40 grams of fresh frozen aronia berries in smoothie form five days a week for 12 months. The HDL-cholesterol (HDL-C) level was initially 74 mg/dL; it increased to 88 mg/dL after 6 months and reached 94 mg/dL at the end of 12 months. Concurrently, triglyceride levels, which had a baseline of 173 mg/dL, decreased to 83 mg/dL, while LDL and total cholesterol levels experienced slight fluctuations. This case illustrates a possible association between Aronia intake and changes in the lipid profile, particularly HDL‑C, in a single individual. However, given the observational nature of the report, potential confounders, and the inconsistency with higher‑level evidence, these findings should be viewed as hypothesis‑generating rather than as a basis for clinical recommendations. Keywords: aronia melanocarpa, HDL cholesterol, triglycerides
Aimː To examine medical students’ perspectives on the relationship between climate change–health, their ability to recognize climate-sensitive diseases, and their interest in receiving education on this topic. Methods: This descriptive, cross-sectional study was conducted among first- and sixth-year medical students at Marmara University during the 2024–2025 academic year. Data were collected via a 16-item online questionnaire between April and June 2025 covering socio-demographic characteristics, perceptions of climate-related health threats, awareness of climate-sensitive diseases, and views on curriculum integration. Results: Of the 217 respondents (response rate: 46.6%), 66.8% were female. Most participants stated that climate change threatens human, animal, and environmental health and increases pandemic risk. Moderate climate anxiety was reported by 69.1%. Students most frequently associated climate change with skin cancers, respiratory and infectious diseases, and injuries/deaths due to extreme weather events, while cardiovascular diseases and malnutrition were less recognized. Among vector-borne diseases, malaria, Crimean-Congo haemorrhagic fever, and West Nile virus infection were the most identified. Sixth-year students more often recognized certain low-endemic diseases. Female students reported higher climate anxiety while male students were less willing to receive training. Of the participants, 76.9% expressed interest in climate change–health education, and 57.1% preferred mandatory integration into the curriculum. Conclusion: Climate change–health education that reflects national risks and does not impose additional burden on the existing curriculum should be integrated into medical education. Family medicine academics can play a leading role in this process. Keywords: climate change, family practice, medical education, curriculum, medical students, vector-borne diseases
Aimː This study evaluated public awareness and knowledge of Human Papillomavirus (HPV) across Generations X, Y, and Z. Methods: An analytical cross-sectional design was used. A total of 390 participants completed a questionnaire including sociodemographic characteristics and the HPV Knowledge Level Scale. Participants were evenly distributed among Generation X (1965–1976), Generation Y (1977–1995), and Generation Z (1996–2007). Data were analyzed using descriptive statistics. Group differences were examined with the Kruskal–Wallis test followed by Mann–Whitney U test with Bonferroni correction. Statistical significance was set at p<0.05. Results: The mean age was 34.33±11.58 years, and 61.8% of participants were female. Generation Z demonstrated higher correct response rates for general HPV knowledge and vaccine-related items, whereas Generation Y showed higher rates for HPV test-related items. Mean HPV knowledge scores were 9.26±6.43 for Generation X, 9.18±6.62 for Generation Y, and 10.72±6.89 for Generation Z. No statistically significant differences were observed between generations. However, HPV knowledge levels differed significantly according to gender, employment status, and income level. Conclusion: Findings indicate the need for comprehensive, generation-sensitive, and sociodemographically tailored strategies to improve public awareness and knowledge about HPV. Keywords: human papillomaviruses, generation gap, knowledge, awareness
Aimː The aim of this research was to compare hepcidin values between children with celiac disease and healthy children and to investigate the relation of these values with iron findings. Methods: This case-control study included forty-six pediatric celiac patients and forty-four healthy children. Iron metabolism indicators, erythrocyte sedimentation rate, C-reactive protein and hepcidin levels were examined. The relationship between hepcidin levels and other parameters was evaluated. Results: Hepcidin, iron, ferritin, hemoglobin and mean corpuscular volume levels were lower, while total iron binding capacity, platelet count, red blood cell distribution width and erythrocyte sedimentation rate values were higher in the celiac group compared to the control group. Hepcidin values showed positive correlation with serum iron levels in both the celiac group and the control group. In the celiac group, hepcidin levels showed positive correlation with ferritin and mean platelet volume and negative correlation with red blood cell distribution width and platelet count. These correlations were not observed in the control group. Conclusionː In addition to the relation between hepcidin values and iron values, it is also noteworthy that hepcidin is associated with platelet production and activation, particularly in pediatric celiac disease patients, and is linked to impaired erythrocyte morphology accompanying decreased iron stores. Keywords: hepcidin, iron, ferritin, celiac disease, mean platelet volume, blood platelets
Aim: In the study, the stage of chronic obstructive pulmonary disease and its relationship with sleep disorders were determined, as well as the degree of sleep problems and daytime sleepiness of patients with chronic obstructive pulmonary disease, which can be diagnosed in the chest diseases outpatient clinic. It was aimed to investigate the relationship between the severity of chronic obstructive pulmonary disease and sleep disorders. Methods: A total of 95 patients, 83 men and 12 women, diagnosed with stable chronic obstructive pulmonary disease were included in this descriptive study. The demographic characteristics of the patients, any accompanying diseases, smoking status, and disease duration were recorded. To evaluate sleep quality, Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale were evaluated in patients. In the survey evaluation, the relationships between chronic obstructive pulmonary disease stage and sleep quality and sleep characteristics were evaluated. Results: A total of 95 patients, 83 (87.43%) males and 12 (12.6%) females, aged 66.0±9.5 (min:45- max:89) were included in the study. The Epworth Sleepiness Scale scores of the patients without Pittsburgh Sleep Quality Index was 6.66±2.66 and 8.64±2.65. 68% of patients had additional siblings. A significant relationship was detected between age and sleep quality scores. A significant relationship was observed between snoring and Pittsburgh Sleep Quality Index. A significant relationship was found between excessive daytime sleepiness and Pittsburgh Sleep Quality Index. Likewise, a significant relationship was seen between body mass index and Pittsburgh Sleep Quality Index. Conclusion: Although the prolongation of sleep latency in chronic obstructive pulmonary disease patients indicates daytime sleep disturbance, drowsiness and impaired sleep freedom during the day, no significant difference was detected.
Aim: Nonadherence to self-management in type 2 diabetes mellitus remains a major challenge in primary care. Although family involvement is widely recognized as important, the relational mechanisms through which families influence adherence are not fully understood. This study explored strategies used by families to support adherence to type 2 diabetes mellitus management and the challenges encountered in daily caregiving. Methods: A qualitative descriptive design was conducted in a primary care setting in East Java, Indonesia. Primary caregivers of adults with type 2 diabetes mellitus were purposively recruited. Data were collected through in-depth semi-structured interviews and analyzed using thematic analysis to identify patterns of family-based regulation, relational dynamics, and barriers to adherence. Results: Family support operated through structured regulation of daily practices, including medication scheduling, dietary monitoring, and reminder systems. Emotional persuasion and warning-based communication were also used to reinforce perceived disease severity. Support extended beyond the household through peer and community networks. However, families reported persistent challenges, particularly dietary resistance, concealment of unhealthy behaviors, inconsistent lifestyle modification, and caregiver emotional fatigue. Fear-based strategies sometimes generated compliance pressure but also contributed to relational strain and hidden nonadherence. Conclusion: Family involvement in type 2 diabetes mellitus management is a dynamic and negotiated process shaped by communication patterns, social context, and emotional resilience. Interventions should move beyond supervision-based models toward autonomy-supportive, family-centered approaches within primary care.
Aim: The purpose of the current study was to investigate the differences of perceived stress levels and body perception between patients scheduled to undergo upper blepharoplasty and control participants. Methods: Patients scheduled for blepharoplasty (as well as the control group) and unscheduled patients hospitalized to the university hospital's ophthalmology outpatient clinic were included. The subjects were given the Perceived Stress Scale and the Body Perception Scale in-person interviews. Software called IBM SPSS Data Package Program (25.0) was used to examine the data. Results: The research included 67 control patients (mean age 38.7±9.1 years, 80.6% female) and 40 blepharoplasty patients (mean age 42.5±10.2 years, 80% female). A statistically significant difference was seen between the mean Perceived Stress Scale scores of the patients scheduled for blepharoplasty and the control patients. The control group's mean Body Perception Scale score was found to be statistically significant, whereas the planned blepharoplasty patients' mean score was 148.2±16.5. Conclusion: Patients undergoing upper blepharoplasty had increased levels of perceived stress and lower body perception scores compared to controls. This can be explained as a finding rather than a cause-and-effect relationship, as the study was cross-sectional in nature and all the data were collected preoperatively.
Aim: To evaluate levothyroxine-related knowledge, medication-use practices, and adherence among adults with hypothyroidism attending a primary care outpatient clinic. Methods: This cross-sectional descriptive study included 213 hypothyroid patients using levothyroxine who attended the Pamukkale University Faculty of Medicine Family Medicine Outpatient Clinic between 1 August and 30 November 2024. Adherence was assessed using the 6-item Modified Morisky Scale. Participation was voluntary, and completion of the anonymous questionnaire implied consent. Data were analyzed using IBM SPSS Statistics for Windows, Version 25.0 (IBM Corp., Armonk, NY, USA), used under a valid license. Results: The mean age was 41.1±14.6 years and 86.9% were female. Most participants reported taking levothyroxine in the morning (99.5%) and on an empty stomach (98.6%); however, only 30.5% knew it should be separated from interacting drugs or supplements by ≥4 hours. High motivation and high knowledge domain score were observed in 65.7% and 87.3%, respectively. Knowledge scores were higher in younger and more educated participants and lower in those with comorbidities. Conclusion: Although overall levothyroxine intake timing was appropriate, important knowledge gaps remain regarding drug–drug/drug–supplement interactions. Targeted education and reinforcement at follow-up may improve adherence and treatment outcomes.
Hypertension is increasingly recognized as a chronic low-grade inflammatory condition rather than solely a hemodynamic disorder. Hematologic indices such as neutrophil-to-lymphocyte ratio, plateletto-lymphocyte ratio, systemic immune-inflammation index, systemic inflammatory response index, and aggregate index of systemic inflammation have emerged as accessible markers of systemic inflammation. Elevated levels of these indices are linked to cardiovascular risk, target organ damage, and non-dipper blood pressure patterns. Their simplicity and availability make them promising tools for early detection and risk stratification in primary care. However, standardized cutoff values and implementation strategies are still needed. This review summarizes current findings on the inflammatory basis of hypertension and the clinical utility of these biomarkers in routine practice.
Aim: To explore the applicability of the Quality-of-Life in Children with Chronic Gastroduodenal Pathology scale in assessing health-related quality of life in children, both before and after treatment and during recovery. Methods: A specialized questionnaire, the Quality-of-Life in Children with Chronic Gastroduodenal Pathology, was designed to assess the quality of life in children with chronic gastroduodenal pathology. The questionnaire incorporates a minimal number of questions, targeting the primary clinical symptoms of the condition. The efficacy of the questionnaire in evaluating health improvement tactics was assessed through standard clinical studies involving this patient population. Results: The Quality-of-Life in Children with Chronic Gastroduodenal Pathology questionnaire was validated for reliability and effectiveness. Using standard treatments for chronic inflammatory diseases, patients demonstrated an 18.5% higher quality of life compared to those with peptic ulcer disease. Incorporating rehabilitation techniques, such as enteral oxygen therapy, further enhanced quality of life, resulting in a 7.4% improvement (30.65% versus 23.27% at the start of treatment). Conclusion: Clinical research has confirmed the validity and utility of the Quality-of-Life in Children with Chronic Gastroduodenal Pathology questionnaire in outpatient settings for children with chronic gastroduodenal pathology. This tool enables family physicians to quickly and effectively assess the quality of life in pediatric patients, facilitating informed decisions regarding treatment and rehabilitation strategies.
Aim: The aim of this study is to investigate the effect of an educational intervention that creates selfawareness through role playing and reflection on intern physicians' attitudes towards the elderly. Methods: For the ageing game, 217 intern physicians took part in this study, whose eyes were covered with transparent tape and blurred with glasses, cotton wool was stuffed in their ears, and small stones were placed under their shoes so that they could hardly walk and could not hear. They went grocery shopping, to the doctor's office, and made phone calls in their aged versions. The UCLA Geriatric Attitude and Kogan Attitudes Toward the Elderly Scales were administered to the group before and after the game. Results: The mean age was 24.01±1.28 years, and 55.8% (n=121) were female. For male and female interns, the mean UCLA Geriatric Attitude_Pre score was 41.75±5.91 and 41.83±6.11 respectively, while the mean UCLA Geriatric Attitude_Post score was 43.43±5.23 and 43.68±4.78. Males had 90.14±14.42 and 90.04±14.33 points on The Kogan Attitudes Toward Older People Scale_Pre and The Kogan Attitudes Toward Older People Scale_Post, respectively, while female interns had 93.96±13.2 and 94.38±11.96 points on The Kogan Attitudes Toward Older People Scale_Pre and The Kogan Attitudes Toward Older People Scale_Post. Women and men differed in both pre- and post questionnaires. Conclusion: The scores of intern doctors who scored above average on both scales before playing the game remained the same afterwards, indicating that the game did not cause a sudden, detectable change in their attitudes. This study clearly demonstrates the difficulty of changing the attitudes of final-year medical students towards the elderly and the limitations of one-off, physically focused simulations
