Hacettepe University Faculty Research Articles

Retrospective Assessment of Legal Capacity After Death: Experience of Hacettepe University Faculty of Medicine, Department of Forensic Medicine

Retrospective Assessment of Legal Capacity After Death: Experience of Hacettepe University Faculty of Medicine, Department of Forensic Medicine

Tested Instructions for the 1-Minute Laughie Laughter Prescription

This Brief Report presents tested instructions for facilitating the Laughie (Laugh Intentionally Everyday) Laughter Prescription in a group setting. The Laughie is a rapid, 1-minute prescriptive technique conceived to encourage participants to harness the positive outcomes associated with laughter. The Laughie was prescribed to Turkish earthquake survivors (N = 20) 3 times a day for 2 weeks in a laughter intervention that was delivered by the first author, a nurse faculty member at Hacettepe University Faculty of Nursing, Ankara, Türkiye. The report aims to describe tested instructions for how the Laughie prescription may be facilitated by nurses and health care workers to benefit participants within their communities.

#511 Inadequate diagnostic investigations and low treatment rates in CKD anemia: an inertia that can only change with long-term follow-up

Abstract Background and Aims Anemia is observed from the early stages in the course of chronic kidney disease (CKD), and as the stage progresses, the severity of anemia and its impact on quality of life increase. Early diagnosis of anemia in chronic kidney disease, assessments related to its etiology, and treatment are therefore crucial. There is no comprehensive and long-term study in Turkey addressing the diagnostic and therapeutic management of anemia seen in the course of chronic kidney disease. The aim of this study is to investigate the frequency of anemia in different stages of CKD in patients diagnosed with Stage 3 and more advanced stages, to evaluate the effectiveness of diagnostic approaches, and management of iron parameters and anemia, and to investigate the effect of anemia on patient survival. We aim to present “real-life” data from this study to guide clinical practice and correct errors or deficiencies in anemia management. Method This study is a single-center, observational-descriptive retrospective study. 1321 outpatients with Stage 3A and advanced CKD and anemia who admitted to Hacettepe University Faculty of Medicine Nephrology Clinic between 2014 and 2018 were included in the study. Data for demographics, CKD etiologies and stages, anemia severities, comorbid diseases were collected from electronic health system (Table 1). Diagnostic investigations for anemia evaluation and therapeutic interventions such as administration of iron, folic acid, vitamin B12, erythropoiesis stimulating agents (ESA) were assessed. The long-term yield of diagnostic and therapeutic approaches and their effects on survival were also evaluated. The study investigated whether the severity of anemia and improvement in anemia had an effect on survival. Results Ferritin is the most commonly performed test for the etiology of anemia (76.4%). Request rates for tests such as B12, folic acid, transferrin saturation and reticulocyte are below 20%. More than half of the patients with anemia (59.4%) have not received any form of anemia treatment. Even among those whose ferritin test was checked and the value was <100 µg/dL, only 41.4% were given iron treatment. As the clinical follow-up period of the patients increased, it was observed that anemia treatment was applied better and target values were reached more frequently (p < 0.001). More than one third of the patients (34.8%) died during follow-up. The overall survival in patients whose anemia improved was 79.8%, and it was 62.8% in patients whose anemia did not improve the overall survival was (p = 0.002) (Fig. 1). When examining the relationship between survival status and anemia severity for the non-dialysis-dependent CKD Stage 3-5 group, there was a statistically significant survival difference between the Hb group of 10-11.9 g/dL to Hb group of <10 g/dL (p = 0.004). Conclusion This study has shown that diagnostic tests for etiology of anemia were insufficiently ordered. It was also found that a significant majority of anemic patients who underwent etiological evaluation were not even adequately treated. Long-term follow up improved anemia treatment, and patients with improved anemia had better survival. In conclusion, we recommend an optimal evaluation of CKD patients with anemia and initiating treatment as early as possible.

Anadolu Öğretmen Lisesi Mirası: Türkiye'de Öğretmen Yetiştirme Kalitesinin ve Öneminin Mezun Bakış Açısıyla Değerlendirilmesi

This qualitative research aims to delve into the practices and influence of Anatolian Teacher High Schools, which play a critical role in Türkiye's teacher training process, from the perspective of graduates who are now teacher candidates. The research was conducted using a case study design, one of the qualitative research methods, and semi-structured interviews were conducted with ten students at Hacettepe University Faculty of Education, who are currently receiving pedagogical formation training and have previously studied at Anatolian Teacher High Schools. Interviews were carried out using 20 (6 unstructured closed-ended questions and 14 semi-structured open-ended questions) comprehensive questions pre-determined by the course instructor. These questions aimed to comprehend the students' experiences, opinions, and evaluations. The data collected were examined through content analysis, and the findings obtained were analyzed with the MAXQDA 2022 analysis program. The research findings highlight the positive impact and importance of Anatolian Teacher High Schools in Türkiye's teacher training process, as perceived by the graduates. The teacher candidates emphasized the significance of receiving education in these prestigious and quality schools and suggested that this experience should be recommended to other students aspiring to the teaching profession.

The utility of systemic immune inflammatory index in discriminating between gallbladder cancer and xanthogranulomatous cholecystitis: A single-tertiary center experience.

Xanthogranulomatous cholecystitis (XGC) and gallbladder carcinoma (GBC) are rare diseases with several similarities. This study aimed to evaluate the utility of the systemic immune inflammatory index (SII), a novel index that more accurately depicts inflammatory and immunological balance, in distinguishing between XGC and GBC. This retrospective study included 33 XGC, 22 GBC patients diagnosed according to histopathological findings and 33 age-sex-matched healthy controls at Hacettepe University Faculty of Medicine, General Surgery Department. The demographic, clinical and laboratory findings were recorded. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, monocyte to lymphocyte ratio and SII were calculated from preoperative complete blood count parameters. The receiver operating characteristic curve was performed to evaluate the utility of SII in differentiating GBC and XGC. A P value < .05 was accepted as statistically significant. The preoperative neutrophil to lymphocyte ratio, monocyte to lymphocyte ratio, platelet to lymphocyte ratio and SII were significantly higher in patients with GBC compared to XGC patients and healthy controls (P < .001, P = .001, P = .001, P < .001, respectively). When receiver operating characteristic analysis was made, the optimal cutoff value of SII was 640 for differential diagnosis of XGC and GBC preoperatively with a sensitivity of 77.3% and a specificity of 66.7%, among which the positive likelihood ratio was 2.32, and Youden index was 0.44 (P = .006). The positive predictive value was 60.7%, the negative predictive value was 81.5%, and the diagnostic accuracy was 79.9%. SII may be a valuable, practical, and affordable method to differentiate between XGC and GBC, in addition to clinical and radiological signs, prior to surgery. When supported by prospective trials with a larger study population, distinguishing GBC from XGC using SII preoperatively may lead to a change in the management practice of GBC.

Decrease in antibiotic prescription.

Journal Article Decrease in antibiotic prescription Get access Hilal Aksoy Hilal Aksoy Department of Family Medicine, Hacettepe University Faculty of Medicine, Ankara, Türkiye Corresponding author: Hilal Aksoy, Department of Family Medicine, Hacettepe University Faculty of Medicine, Ankara 06230, Türkiye. Email: hilal.aksoy35@gmail.com https://orcid.org/0000-0002-3330-9317 Search for other works by this author on: Oxford Academic PubMed Google Scholar Family Practice, cmad053, https://doi.org/10.1093/fampra/cmad053 Published: 06 May 2023

Experiences of Educators in Undergraduate and Postgraduate Medical Education in COVID-19 Pandemic: A Qualitative Study

Aim: Since the beginning of the COVID-19 pandemic, medical faculties have been trying to adapt their program, their students and educators, which are the main components of education, to new and rapidly changing conditions. For this reason, this study aims to investigate medical educators’ point of view about the effects of pandemic on undergraduate and graduate medical education, and their experiences during the pandemic.&#x0D; Methods: It is a basic qualitative study. The study was carried out with the participation of a total of 13 medical educators, 4 from basic sciences, 6 from internal sciences and 3 from surgical sciences, at Hacettepe and Akdeniz University Faculty of Medicine, between October and November 2020. In-depth individual interviews were conducted with the participants and the findings were evaluated with thematic analysis.&#x0D; Results: Participants most commonly shared negative opinions about the effect of the pandemic. Medical educators commonly think that the inability to continue face-to-face clinical education (Terms 4-5) in undergraduate education due to the pandemic negatively affects the acquisition of clinical competencies and professional attitudes and values. During the pandemic process, the negative effects of insufficient number and variety of patients and interventional practices, especially in clinical specialties, are reported in postgraduate education. Clinical teaching activities (visit, bedside discussion, etc.) were applied considering the risk of infection. Medical educators' online teaching experiences have included difficulties in planning/adapting teaching, preparing materials, providing online student participation, teacher-student interaction, motivation, and conducting reliable and methodically rich exams. Developing and increasing the accessibility of educational materials for distance education were evaluated as positive developments. While medical educators see the adaptation process to distance education as a challenge in terms of using technology and rapidly adapting teaching during the pandemic process, they also perceive it as an important gain. The negative effects of the lack of face-to-face interaction with the student in the social and psychological context were widely shared.&#x0D; Conclusions: The distance education experiences of medical educators in the COVID-19 pandemic draw attention to the importance of improving the technological infrastructure of medical faculties and supporting educators (use of technology, distance education-assessment methods). In addition, arrangements (social networks, feedback, etc.) that support medical educators socially and motivationally are recommended. In the context of carrying on face-to-face education in pandemic conditions, it is important to provide and maintain safe clinical and learning environments for educators, learners and patients. It is recommended to carry out studies to ensure equal opportunity at the national level, and to increase cooperation and sharing (educational materials and infrastructure) among medical faculties.

Developing the individual capacity, the sense of health responsibility of hacettepe university faculty of education undergraduate students in the novel coronavirus disease (covid-19) struggle

Developing the individual capacity, the sense of health responsibility of hacettepe university faculty of education undergraduate students in the novel coronavirus disease (covid-19) struggle

Evaluation of Pertussis Antibody Levels (Anti-PT IgG-Anti-FHA IgG) and Associated Factors in Maternal and Cord Blood

Pertussis has a very high mortality and morbidity rate in early infancy. There are many strategies to protect babies from pertussis, maternal immunization is one of them. In this study, it was aimed to evaluate pertussis toxin immunoglobulin G (anti-PT IgG) and filamentous hemagglutinin immunoglobulin G (anti-FHA IgG) levels of pertussis antibody in maternal and cord blood samples and also to evaluate the factors that may be associated with maternal antibody positivity. This descriptive study was conducted between 1 July and 31 October 2020. In the study, anti PT IgG and anti-FHA IgG levels were investigated by enzyme-linked immunosorbent assay (ELISA) method in 154 maternal and 154 cord blood samples. Microbiological analyzes were performed in Hacettepe University Faculty of Medicine Central Laboratory and results of 10 IU/mL and above were considered positive. Factors that could affect antibody positivity were questioned with the data collection form. "Package for Social Sciences (SPSS)" package program version 25.0 was used for statistical analysis of the data. Chi-square and Fisher's exact tests were used for statistical analysis of categorical variables. Continuous numerical variables were analyzed with the Pearson correlation test. Logistic regression analysis was used to evaluate the factors affecting positivity. The natural logarithm of the continuous variables was taken to ensure their conformity to the normal distribution, and conformity to the normal distribution was evaluated with the Kolmogorov-Smirnov test. The results were presented at a 95% confidence interval, at a significance level of p<0.05. The mean age of the mothers included in the study was 30. Of newborn babies, 52.6% were girls and 98.7% had normal birth weights. Of deliveries, 95.5% were term and 82.5% were cesarean section. Anti-PT IgG positivity and anti-FHA IgG positivity in maternal blood were 18.8% and 48.1%, respectively. Anti-PT IgG and anti-FHA IgG positivity in cord blood samples were 38.3% and 55.8%, respectively. Anti-PT IgG positivity was 2.6 times higher in mothers who had healthcare worker relatives compared to those who did not. Anti-FHA IgG positivity was 3.2 times higher in mothers aged 25 and younger than in mothers aged 26- 35. In addition, mothers aged 36 and over were 4.4 times more anti-FHA IgG positive than the mothers aged 26-35. Anti-FHA IgG antibody positivity was found 7.3 times more in those living in extended families than those living in nuclear families. Anti-PT IgG and anti-FHA IgG levels in maternal and cord blood samples were highly positively correlated. Mothers in the study had low pertussis antibody levels, indicating that newborns are at risk for infection. Maternal immunization with pertussis-containing vaccine is the most appropriate and cost-effective strategy to protect the newborn against pertussis. Many countries have been using pertussis-containing vaccines in maternal immunization safely for many years. Replacing the tetanus-diphtheria vaccine (Td), which is included in the routine pregnancy immunization program in Türkiye, with tetanus-diphtheria-pertussis (Tdap) may be appropriate to protect the mother and newborns from pertussis infection.

Administrative Judicial System Evaluation from Files Alleging Medical Malpractice: Experience of Hacettepe University Faculty of Medicine, Department of Forensic Medicine

Administrative Judicial System Evaluation from Files Alleging Medical Malpractice: Experience of Hacettepe University Faculty of Medicine, Department of Forensic Medicine

The impact of antiphospholipid antibodies in Takayasu arteritis.

The significance of antiphospholipid antibodies (aPL) is controversial in Takayasu arteritis (TA). This study was conducted to explore the frequency of aPL and their association with disease-related complications in TA. : This cross-sectional study was conducted to investigate the presence of anti-cardiolipin (aCL), anti-beta 2 glycoprotein- 1(aβ2G1) antibodies, and lupus anticoagulant (LA) in TA patients. TA patients admitted to the Department of Rheumatology of Hacettepe University Faculty of Medicine between December 2015 and September 2016 who fulfilled the American College of Rheumatology (ACR) classification criteria for TA were consecutively enrolled in the study. Patients were grouped according to aPL positivity and compared in terms of disease manifestations, type of vascular involvement at diagnosis, and vascular complications/interventions attributable to TA. Fifty-three TA (49 female) patients were enrolled in the study. We detected 9 (16.9%) patients with IgM and/or IgG aβ2G1 and/or LA positivity. There were no patients with positive aCL. All aβ2G1 titers were low. There were no differences in terms of symptoms, signs, type of vascular involvement, the number of patients with disease-related complications or vascular interventions/surgery between aPL (+) and aPL(-) groups (p > 0.05 for all). The number of patients with thrombotic lesions was similar between the groups (p > 0.05). There were no patients with a history of venous thrombosis or on anticoagulant treatment in the aPL(+) group. Only 1 patient with IgM aβ2G1 (+) had a history of pregnancy loss. Our results indicate that aPL positivity is not rare in TA. On the other hand, all aPL titers were low and no differences were found in the frequency of disease-related complications between aPL(+) and aPL(-) patient groups. Only TA patients with atypical manifestations with high suspicion of aPL-related complications should be considered to be investigated for aPL.

Evaluation of Risk Factors Affecting Progression in Primary Open-Angle Glaucoma and Exfoliation Glaucoma in a Turkish Population

Objective: To evaluate the effects of risk factors on progression in primary open-angle glaucoma (POAG) and exfoliation glaucoma (XFG). Materials and methods: The study included 139 patients with POAG and XFG followed up at Hacettepe University Faculty of Medicine, Department of Ophthalmology, Glaucoma Unit. A number of factors were evaluated through a cross-sectional design for all the patients, including age, sex, hypertension, diabetes, thyroid disease, cardiovascular disease, migraine, alcohol, smoking, family history, affected side, lens status, central corneal thickness (CCT), number of medications, body mass index (BMI), cup-to-disc (C/D) ratio, intraocular pressure (IOP), computerized automated visual field mean deviation (MD), and prior surgery. Results: The patients were divided into two groups, POAG and XFG, and further divided into the following two subgroups: progressive and non-progressive. Of the patients, 75 (53.9%) had POAG, and 64 (46.1%) had XFG. In the patients followed up, annual MD change was 0.96 ± 1.5 dB/year, baseline MD was −5.06 ± 5.61 dB, and IOP was 15.94 ± 1.93 mmHg. Potential risk factors for progression in the whole group were evaluated, but no significant difference was found between the groups with and without progression for all factors. Subgroup analysis revealed that in the POAG group, BMI was significantly higher in the non-progressive disease subgroup (p=0.01); furthermore, in the XFG group, IOP was significantly higher in the progressive disease subgroup (p=0.02). According to multiple logistic regression analysis, a 1-unit decrease in BMI in the POAG group increased the risk by 1.3 times (p=0.01), and smoking in the XFG group resulted in a 6-fold reduction in the risk of progression (p=0.04). Conclusion: Although mean IOP was higher in XFG group, the present study found BMI in POAG and smoking in XFG as independent factors that reduced progression in our series.

COVID-19 Pandemic Experiences of Residents: A Qualitative Study

Aim: The COVID-19 pandemic has had an unprecedented impact on the healthcare system and professionals worldwide. This study aims to explore the residents' experiences working in medical and surgical fields in Hacettepe University hospitals during the early months of the COVID-19 pandemic and investigate the effects of the pandemic on their lives and education.Methods: The research is designed as a Qualitative research. We obtained the data through in-depth interviews with nine residents working at the forefront of the pandemic, maintaining their postgraduate education at Hacettepe University Faculty of Medicine. We used content analysis to analyze the data.Results: Residents discussed the effects of the COVID-19 epidemic on their professional, psychosocial and educational lives with a broad perspective. They defined the modifications in working conditions, professional and institutional approaches, the professional conflicts caused by the pandemic, the effects of the pandemic on patient treatment/care, and the gains from experience as the effects of the COVID-19 epidemic on their professional lives. Besides family and friends' support, faculty members have an essential role in supporting residents. The residents stressed the importance of society's cooperation in managing the pandemic. They stated that the decision-makers and their institutions did not meet their expectations. They explained the pandemic's main psychosocial effect: the fear of infecting family members, social adaptation, and social stigma. The residents stated that the pandemic caused disruptions and changes in medical education. They indicated that undergraduate medical education was insufficient to prepare health professionals for extraordinary conditions. The residents suggested that the management of exceptional conditions topics such as epidemics, pandemics, and disasters should be included in medical education.Conclusions: COVID-19 has affected many aspects of residents' lives. Although this experience provided some gains, the pandemic experience revealed the weaknesses of medical education, university, hospital management and government. The pandemic caused changes in professional life, tensions in work environments, and psychosocial difficulties. It is worrying that undergraduate medical education programs are insufficient to prepare health professionals for crises in the health system. The pandemic caused disruptions in residency education. Academic, professional, and psychological support of faculty members has been critical in ensuring the residents' motivation during the pandemic. Stakeholders should consider the suggestions and needs of residents, and medical education programs should be reviewed to achieve competencies related to disaster/crisis management. This effort is the responsibility of all partners to the young physicians who witnessed the most memorable period of history and society, which is the subject of health service delivery.

Atelier experiences in interior architecture education: Zero waste approaches

Workshops, seminars, ateliers, and charrettes, which are vocational courses and extracurricular activities taken outside of the studio courses, support studio education to a great extent. The "learning by doing" model gains significance in 21st-century interior architecture education. In this context, the application model of two workshops/ateliers held at different times within the scope of the study will be reviewed. The first of these consists of the Zero Waste Approach in Design Education Training Workshop-1, which was held face-to-face and organized by the Hacettepe University Faculty of Fine Arts, Department of Interior Architecture and Environmental Design in 2019, and the second, the Zero Waste Approach in Design Education Training Workshop-2, held online in 2021. From the study, participation in workshops and ateliers in interior architecture education boosts students' awareness, supports group work, increases synergy and motivation, and strengthens their design skills. The cooperation of institutions, on the other hand, expands the interaction and provides important contributions to interior architecture education.&#x0D; &#x0D; Keywords: Atelier; Interior Architecture; Learning by Doing; Workshop; Zero Waste.

Treatment of childhood-onset Takayasu arteritis: switching between anti-TNF and anti-IL-6 agents.

Biologics are new treatment alternatives in Takayasu arteritis (TA), although data in childhood are limited. The aim of this study was to share our experience in seven childhood-onset TA patients who received a TNF-α inhibitor (adalimumab) or an IL-6 receptor inhibitor (tocilizumab) and the effect of switching therapy. We retrospectively evaluated the medical treatment records of seven patients with TA, followed between August 2005 and January 2021 at the Pediatric Rheumatology Department of Hacettepe University Faculty of Medicine. The median age of patients was 14 (IQR 4) years, and six were female. All of the patients had severe disease and high acute-phase reactants. The patients initially received only steroids or steroids+CYC. Prednisone was decreased, and biologic agents were started once the acute phase reactants decreased, and the Indian Takayasu Activity Score (ITAS) returned to normal. Initially, four patients received tocilizumab (TCZ) [median 25.5 (IQR 41) months] and three patients received adalimumab (ADA) [median 13 (IQR 31) months]. However, due to the progression of MR angiography findings or persistent elevation in acute-phase reactants, the biologic agents were switched from TCZ to ADA in four patients and from ADA to TCZ in three patients. The patients' median follow-up time after changing was 50 (IQR 77) months, and median ITAS was evaluated as '0' after 2 (IQR 4) months. In conclusion, both TNF-α and IL-6 inhibitors are effective alternatives in treating patients with childhood-onset TA. However, prospective randomized controlled trials are needed for the comparison of their effectiveness.

Isolated CNS Hemophagocytic Lymphohistiocytosis in Children:What We Know, What We Don't Know ?

The presence of central nervous system involvement has a profound impact on the prognosis, treatment, and clinical outcome of the primary hemophagocytic lymphohistiocytosis (pHLH). However, isolated CNS-HLH is a challenging disease with a high mortality and morbidity , possibly resulting from a spsecific neuroinflammation that leads to isolated disease only without systemic activation under some additional genetic modifiers. In this study, we retrospectively reviewed our isolated CNS-HLH cases and there were 73 patients (36 male, 37 female) with a median age of 20 months (range, 1- 226 months) diagnosed as primary hemophagocytic lymphohistiocytosis at Hacettepe University Faculty of Medicine, between January 2005 and June 2021. Among these, 39 (53%) patients had central nervous system involvement either on admission or during the recurrence. On admission, the number of patients who had both CNS and sytemic involvement was 19 (49%), moreover 2 had CNS infiltration both initially and during the course of relapse. 8 patient did show CNS involvement only during the relapse. Ten (25%) patients (5 male, 5 female) with isolated CNS involvement are the main subject of this study and none of them had infectious trigger. What we know is they were presented with mostly unexplained neurological findings and /or cranial nerve paralysis. In this group median age at presentation was 101 months ( range 6 - 180 months). They all had primary HLH associated patogenic mutation and in some of them diagnosed was also confirmed by brain biopsy. Neither family history and /or consanguinity nor HLH criteria are fullfilling in this devastating disorder. Cranial MRI gives many clues during admission in experienced hands. Two of our published cases were initially diagnosed as lymphomatoid granulomatosis and acute disseminated encephalomyelitis ; they were diagnosed as hemophagocytic lymphohistiocytosis after developing systemic symptoms 3 and 12 months later. Interestingly 6 of 10 patients in this group never developed systemic symptomps, 7 patients underwent allogeneic bone marrow transplantation. Spinal cord involvement was determined in 8 patients(20%), including 4 at diagnosis and 4 during follow up ; including one previously published case, 4 out of 8 had isolated cases did show spinal involvement as well. Even though few number of cases with isolated CNS-HLH has been reported in the recent years, we believe that the number of such cases is not limited to those who have been reported because it is rather difficult to diagnose patients with isolated CNS symptoms, which leads to misdiagnosis and/or mistreatment. What we don't know is how to specifically treat patients with CNS directed therapy, and exactly which mutations are associated with isolated CNS-HLH or whether there is a known tendency in this group and perhaps unknown mutations ? Does it have a facilitating effect ? DisclosuresNo relevant conflicts of interest to declare.

Impact of COVID-19 on eating habits, sleeping behaviour and physical activity status of final-year medical students in Ankara, Turkey.

The massive increase in COVID-19 cases led to the implementation of nationwide lockdown in Turkey. While enforced lockdown is an effective strategy to abate the transmission of the virus, it causes significant lifestyle changes in every part of the community. This study aims to assess the changes in eating habits, sleeping behaviour and physical activity status of final-year medical students (interns) whose education was suspended during the pandemic. In this cross-sectional epidemiological study, an online questionnaire was created. Interns were asked questions regarding socio-demographic status, eating habits, sleeping behaviour and physical activity status before and during COVID-19 pandemic. Changes in dietary habits and sleep quality were evaluated under the guidance of Turkey Dietary Guidelines, Determination of Nutritional Status Report, Turkey National Nutrition and Health Survey and Pittsburgh Sleep Quality Index. Hacettepe University Faculty of Medicine - Ankara, Turkey. Among 536 students, a total of 340 students (63·4 %) answered the questionnaire. After the beginning of lockdown, an increase in BMI was observed in both female (P = 0·002) and male students (P = 0·013). Students having healthy dietary habits increased by 18·8 % and unhealthy dietary habits decreased by 3·2 % during lockdown (P < 0·001). Overall, 63·2 % of students reported a decrease in physical activity, and 33·6 % reported a reduction in sleep quality, whereas 38·6 % reported an improvement in sleep quality. There was no significant difference in sleep quality between genders (P = 0·075). This study indicated that medical school suspension and enforced lockdown led to significant changes in interns' eating behaviour, physical activity and sleeping habits.

Electroclinical Presentations of Fixation-off Sensitivity in Adults With Symptomatic Epilepsy.

Fixation-off sensitivity (FOS) is a discharge pattern on EEG that occurs owing to the loss of central vision or fixation. Knowledge regarding the relationship between FOS and symptomatic epilepsy is limited. Therefore, we aimed to evaluate the electroclinical features of FOS in adult patients with symptomatic epilepsy. Outpatient video-EEG records of the Hacettepe University Faculty of Medicine were reviewed from 2009 to 2019. Patients aged >18 years with symptomatic epilepsy with a FOS pattern were included. Demographic, clinical, EEG, and neuroimaging data were retrospectively evaluated from an electronic database and patient files. Eight patients (50% female) were included in this study; seven (87%) had refractory epilepsy. Prominent risk factors were family history of epilepsy in five patients and prenatal/natal insult in four patients. Notable MRI signs included cortical developmental malformation, posterior gliosis, and frontoparietal porencephalic cyst. The FOS pattern was generalized with posterior emphasis in two patients and lateralized or localized in six patients: frontocentroparietal ( n = 1) and temporoparietooccipital ( n = 5). Fixation-off sensitivity discharges were found to be increased by hyperventilation and decreased by drowsiness and sleep in 50% of patients. Fixation-off sensitivity disappeared in one patient with good seizure control. In this study, the disappearance of FOS in an epileptic patient with a structural lesion and detection of FOS activity related to a frontoparietal porencephalic cyst were remarkable. Family history of epilepsy was also substantially high. Our results indicate that the underlying mechanism of FOS is much more complicated than previously thought.

Prof. Dr. Doğan Taner’s Role in The Foundation Years of Hacettepe University Faculty of Medicine and His Perspective on the Medical Education

Prof. Dr. Doğan Taner’s Role in The Foundation Years of Hacettepe University Faculty of Medicine and His Perspective on the Medical Education

Experiences of Hacettepe University Faculty of Medicine Amidst COVID-19 Pandemic

COVID-19 Salgını nedeniyle dijital ortamda eğitime geçilmesi sürecinde Hacettepe Üniversitesi Tıp Fakültesi’nde mezuniyet öncesi düzeyde yüzyüze yürütülen kuramsal ve uygulamalı eğitimler durdurulmuş ve yeni çözümler geliştirilmiştir. Acil uzaktan öğretim koşullarında öncelikle tüm kuramsal dersler (1494 ders) kayıt altına alınarak bir öğrenme yönetim sistemi üzerinden öğrencilere ulaştırılması için Tıp Fakültesi Destekleyici E-Öğrenme Programı tasarlanmıştır. Bu program içinde çeşitli çevrimiçi eğitim kaynakları da sağlanmıştır. Bir çevrimiçi sınav modülü satın alınarak bu dönemde 132 sınav gerçekleştirilmiştir. Mezuniyet sonrası düzeyde eğitimlerin sürmesi için her anabilim dalına bir sanal sınıf oluşturulmuştur. 2020-2021 akademik yılında uzaktan eğitim koşulları zenginleştirilerek uygulamalar sürdürülecektir. Bu dönemde kayıt altına alınan dersler artırılmış, eşzamanlı çevrimiçi küçük grup tartışmaları ve paneller planlanmış, standart hasta görüşmeleri ve çözümleme oturumları çevrimiçi olarak düzenlenmiş, hasta güvenliğine yönelik bir sanal gerçeklik eğitim modülü geliştirilmiş, ilk üç yıldaki öğrencilerin beceri eğitimlerinin çevrimiçi yürütülebilmesi için Bireysel Klinik Beceri Eğitimi Seti tasarlanmıştır.