PurposePolypharmacy (PP) is a clinical challenge in older adults. Therefore, assessment of daily drug consumption (DDC) and its relationships is important. First-line health services have a crucial role in monitoring and preventing PP. In this study, we aimed to assess DDC and investigate the risk factors for higher DDC among older adults in a primary care setting.Patients and methodsA total of 1,000 patients aged ≥65 years who visited Melek Hatun Family Practice Center between December 1, 2014, and August 1, 2017, were enrolled in the study. All patients were seen either at the center or in their homes, and informed consent was obtained. Comprehensive geriatric assessment was performed for each subject. Data were analyzed using SPSS software (version 17). The daily number of medicines that each patient used (DDC) regardless of whether they were prescribed was the dependent variable. Relationships between DDC and other continuous variables were examined using Pearson’s correlation. For between-group comparisons of DDC, Student’s t-tests were performed.ResultsUnivariate tests showed relationships between DDC and various demographic and clinical parameters. The variables that remained significant at the last step of a stepwise linear regression analysis were metabolic syndrome, chronic pain, incontinence, increased serum creatinine level, increased Geriatric Depression Scale scores, reported gastric disturbances, and neutrophil/lymphocyte ratio.ConclusionAlong with certain chronic conditions, depressive symptoms and an inflammatory marker (neutrophil/lymphocyte ratio) were significantly and independently related to higher DDC. Longitudinal and larger studies are needed to further explore the multifaceted relationships of PP.

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A 30-year-old male farmer presented to our emergency department (ED) with complaints of pain and redness in the bite site approximately 1 h after being stung on his left foot by a scorpion while he was working on his farm in the night. The patient had no chronic diseases, medical drug use, or allergy in his medical history. He was discharged a few hours after his examination, treatment, and follow-up at the observation unit because all the symptoms were relieved after treatment and there were no abnormal values from the laboratory examinations. He was re-admitted to the ED with complaints of widespread body pain, fatigue, and mild shortness of breath approximately 6 h after his discharge. During his physical examination, he was conscious, cooperative, oriented, and also mildly agitated. His vital signs were blood pressure, 180/100 mmHg; heart rate, 130/min; tempera-ABSTRACT Introduction: Scorpion stings continue to be a current public health problem in tropical regions of the world. Local effects are usually seen, but fatal cardiovascular complications may occur, albeit rarely, from scorpion stings. The purpose of this case is to emphasize that rhabdomyolysis and myocarditis can occur in patients admitted to a hospital with a scorpion sting. Case Report: A 30-year-old male patient presented to our emergency department (ED) with complaints of pain and redness in the bite site after being stung by a scorpion. His blood pressure was 180/100 mmHg and heart rate was 130/ min. Electrocardiography (ECG) showed a sinus tachycardia. Laboratory tests revealed the following values: creatinine: 1.71 mg/dL, creatinin kinase (CK): 2129 U/L, creatinin kinase-myocardial band (CK-MB): 43.24 ng/mL, and troponin: 22.59 ng/mL. After catheterization of the bladder, dark brown urine was seen. There were no pathological findings in coronary angiography, but the left ventricular ejection fraction was detected as 45%. The clinically stable patient was discharged on the fifth day of hospitalization. There were no abnormal findings in the latest tests of laboratory parameters. Conclusion: Scorpion stings can cause death due to toxic effects on the cardiovascular system. Observations for possible complications from a scorpion sting, such as the possibility of myocarditis, should be kept in mind in patients admitted to the ED with complaints of a scorpion sting.

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INTRODUCTIONVitamin D is a fat-soluble vitamin that is synthesized non-enzymatically in the skin and metabolized in the liver and kidneys. It arranges the immune response of the body, acts as a steroid hormone and plays a crucial role in mineral homeostasis and skeletal health. 1 Serum vitamin D levels in the range 30-60 ng/ml (75-150 nmol/l) are considered normal.Deficiency of vitamin D is associated with a variety of bone disorders (rickets, osteoporosis or osteomalacia), skin diseases and autoimmune disorders. 1,2 It also causes increased risk of cardiovascular diseases such as myocardial infarction (MI), heart failure and coronary artery disease. 2-5 Furthermore, deficiency of vitamin D has been reported in arterial diseases, including aortic aneurysm, peripheral arterial disease, arterial calcification and hypertension. [6][7][8][9] Deep vein thrombosis (DVT) is characterized by thrombus formation, usually in the lower-extremity deep venous system, which causes obstruction or occlusion of blood flow in veins. It is considered to be the third most common cardiovascular disease, after ischemic heart diseases and cerebrovascular events. 10 Although the medical and interventional treatment options for deep vein thrombosis have improved nowadays, it continues to pose a serious problem, especially in cases with inadequate treatment. It can lead to pulmonary thromboembolism, venous gangrene, chronic venous insufficiency and post-thrombotic syndrome. 11 The most well-known factors in the etiology of lower-extremity deep vein thrombosis are genetic predisposition, malignancy, history of surgical operation, immobilization, trauma, bone fractures, long journeys and oral contraceptive use. 12 Nevertheless, there may also be other factors that play a role in the etiopathogenesis of deep vein thrombosis.

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Introduction:The aim of the current study was to determine the self-efficacy and the medical adherence levels of the patients with type 2 diabetes and related factors in primary care. Methods: This was a descriptive study which was conducted in a family health center in Istanbul between February 2020 and May 2020. Information was collected from the patients over the age of 18 with a diagnosis of type 2 diabetes. A sociodemographic questionnaire form, Self-Efficacy Scale and Morisky Medication Adherence Scale were applied to participants face-to-face. Results: Two hundred and seven patients were included. Mean age of the participants was 59.05±10.74 years. Sixty percent of them were women, 85.0% were over 50 years, 69.9% had an additional disease, about half of them were diagnosed with diabetes for 10 years or more. It was found that individuals with diabetes had a median self-efficacy score of 72(64-79). The self-efficacy scores were higher in patients with normal BMI, those without additional disease and those with high physical activity level (p=0.004, p= 0.038, p=0.002 respectively). The medication adherence level was found medium in 174 (84.1%) of the patients. As the age increased medication adherence also tended to increase, and the adherence of people with normal BMI was higher (p=0.019 and p= 0.026 respectively). Conclusion:The self-efficacy and medical adherence of the diabetic patients participated in the current study were found to be at medium levels. It is understood that steps are needed to improve patients' self-efficacy levels and to increase their compliance with treatment.