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INTRODUCTION: The study aimed to determine how physicians' professional and institutional characteristics affect their treatment approaches for COVID-19 antiviral and supportive treatment, as well as their demographic characteristics and participation in COVID-19 trainings that may influence these orientations. METHODS: After researching the literature and conducting interviews with the experts, a questionnaire was prepared. The convenience sampling method was used to distribute the questionnaire online to 408 physicians across the nation in January 2021. Exploratory factor analysis was used to verify the research scale, and the Cronbach's Alpha test was used to confirm its reliability. During the data analysis, descriptive and inferential statistical tests were used. RESULTS: It was observed that the physicians were willing to give COVID-19 patients the antivirals but hesitant to provide and suggest supportive care. The training status for COVID-19 treatment was varied. Female physicians prescribed more antiviral drugs than male physicians, received more training, and scored higher across the scale than male physicians ( p = 0.001). The treatment approaches of physicians varied according to their specializations ( p = 0.002) all over the scale. CONCLUSION: The publication of current Ministry of Health guidelines on a variety of themes related to COVID-19 treatment, as seen in Turkey, is both beneficial and important. However, because all physicians, regardless of specialty, are affected by current and will be in the future pandemics, it is necessary to design and maintain a continuous training program on pandemics and their management for all physicians.

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BACKGROUND: Iron deficiency is a critical global health issue. One of the intriguing manifestations linked to iron deficiency is the presence of pica. The physiological relationship between the senses of smell and taste suggests that pica may be accompanied by an inclination towards the smell of earth (geosmin). The smell of geosmin is distinct and generally recognized as a pleasing scent. The objective of this study is to explore this potential association. The sign of liking the smell of earth will now be referred to as "geosminophilia", for the first time, in this study. METHODS: Patients aged 18 years and above who visited the Iron Deficiency Outpatient Clinic between September 2021 and August 2022 were chosen for this cross-sectional study. The dataset excluded those with ferritin concentrations over 100 mcg/L and transferrin saturation over 45%. Demographics, presence of pica, history of geosminophilia, and laboratory findings were documented in physical and digital patient data. The descriptive statistics, chi-square test, and independent group comparison tests were performed. RESULTS: With a mean age of 38.7±11.7 years, the study sample comprised 280 patients, of which 263 were female and 17 were male. Ninety-six patients (34.3%) had geosminophilia, while 29 patients (10.4%) had pica. The only factors that significantly distinguished the groups based on the presence of geosminophilia were gender (p=0.04) and age (p=0.02). Using the chi-square test to compare the presence of pica and geosminophilia, a statistically significant relationship was identified (p<0.001). Additionally, 72.4% of patients who presented with pica had geosminophilia. Pica was absent in 96% of patients who did not have geosminophilia. A total of 93.8% (15/16) of pica cases with geophagia subtype exhibited the presence of geosminophilia. A significant correlation (r=0.27, p<0.001) was also observed between geosminophilia and pica. CONCLUSION: In iron deficiency patients, geosminophilia and the presence of pica may accompany each other. Therefore, geosminophilia has the potential to be a new symptom of iron deficiency.

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There are few data on the effects of low hemoglobine levels on the left atrium (LA) in anemic patients. Our aim was to evaluate left atrial (LA) volume and functions in anemic patients using real time three-dimensional echocardiography (RT3DE) and also to investigate changes in variables of LA after the correction of anemia. In total, 55 iron-deficiency anemia patients without traditional cardiovascular (CV) risk factors and 30 age- and gender-matched controls were studied. Assessments included history, physical examination and echocardiography. Of the 55 patients with anemia enrolled, 50 (39 females and 11 males 40.3 years) were followed and underwent echocardiography after correction of the anemia. LA maximum volume (LAVmax), LA minimal volume (LAVmin), LAVmax index (LAVI), before atrial contraction volume (LAVpreA), LA total emptying fraction, LA active emptying volume were higher in anemic patients. LA passive emptying fraction was significantly lower in anemic patients. Following correction of anemia, LA volume and function parameters were observed to be significantly reduced. Moreover, significant increase was noted in LA passive emptying fraction. Correlation analysis was performed and a significant negative correlation was noted between the percentage change in hemoglobin level and percentage change in LAVI (r = - 0.382, p = 0.003). It was shown that volume and functions of LA are impaired in anemic patients. However impaired parameters were improved after correction of anemia. It may be thought that RT3DE LA parameters can be used as an important preclinical marker of disease pathogenesis before developing heart failure or atrial arrhythmia.

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BACKGROUND/AIMS: The cardiovascular system is one of the major targets of thyroid hormones. Subclinical hypothyroidism (SCH) is a common disease that can represent "early" thyroid failure. Our aim was to evaluate left atrial (LA) volume and functions in patients with SCH using real time three-dimensional echocardiography (RT3DE) and also to investigate changes in LA parameters after the levothyroxine treatment. METHODS: In total, 44 patients with SCH and 40 age- and gender-matched controls were studied. Assessments included history, physical examination and echocardiography. All patients with SCH were followed up with replacement therapy until the euthyroid status was achieved. RESULTS: In patients with SCH, LA total emptying volume, passive emptying volume, and passive ejection fraction were significantly reduced while LA minimal volume, active emptying volume, and active emptying fraction were significantly increased than in control group. Following the levothyroxine treatment, LA volume and function parameters were observed to be significantly improved. A negative correlation between the change of thyroid stimulating hormone (TSH) and change of LA active emptying volume and a positive correlation between the change of TSH level and change of LA passive emptying volume were found. CONCLUSION: It was shown that volume and functions of LA were impaired in patients with SCH. However, impaired parameters were improved after the levothyroxine treatment. These findings may be indicative of subclinical heart involvement that could lead to functional and structural changes in patients with SCH.

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BACKGROUND: Metabolic syndrome (MetS) is an endocrinological disease with both metabolic and physiological components. Previous studies have shown a relationship between MetS and left ventricular (LV) dysfunction. A fragmented QRS (fQRS) is a reliable electrocardiogram (ECG) finding with the importance of an indicator of myocardial fibrosis and scarring. In this study, we examined the utility of speckle tracking echocardiography (STE) in assessing LV function in MetS patients with fQRS. METHODS: The 164 consecutive MetS patients included in the study. They were separated into two groups; those with (n=33) and those without (n=131) fQRS. The two groups were compared by obtaining LV strain values with STE. RESULTS: Statistically significant differences between the fQRS (-) and fQRS (+) groups were identified for LV global longitudinal strain (LV-GLS) (p<0.001), maximum left atrial volume index (maxLAVI) (p≤0.001), strain rate during isovolumic relaxation period (SRivr) (p<0.001), and the E/SRivr ratio (p<0.001). In the multiple linear regression analysis, fQRS (ß=-1.456, p=0.003), diabetes mellitus (ß=-0.973, p=0.015), hypertension (ß=-0.820, p=0.015) and MaxLAVI (ß=-0.142, p=0.018) were independent predictors of LV-GLS. However, fQRS (ß=21.995, p<0.001), MaxLAVI (ß=3.090, p<0.001), and E/Em ratio (ß=3.326, p<0.001) were also independent predictors of E/SRivr. CONCLUSIONS: The results of this study showed that LV dysfunction was more common in MetS patients with fQRS. MetS patients, and especially those who are fQRS (+), should thus be closely monitored for subclinical LV systolic and diastolic dysfunction.

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