Background: Crimean-Congo hemorrhagic fever (CCHF) is a severe viral illness with high mortality rates. Nosocomial transmission poses a significant risk to healthcare workers (HCWs). Materials/methods: In this study, we evaluated the effectiveness of ribavirin in post-exposure prophylaxis (PEP) among HCWs with high-risk contacts. Exposures are grouped into 3 categories. The high-risk group consisted of HCWs who were directly exposed to blood or bodily fluids. We also included HCWs who participated in CPR without wearing appropriate PPE to the high-risk group. The moderate-risk group consisted of HCWs without a visible exposure to blood or bodily fluids but handled patient without appropriate PPE. Results: At least 38 HCWs had contact with the index fatal patient. None of the HCWs who had contact with the patient had appropriate PPE. Patient’s PCR and IgM were positive for CCHF. Among all known contacts, all HCWs in high and moderate risk groups (n:24) received PEP with ribavirin. No moderate or severe side effects were observed due to ribavirin. None of the HCWs developed nosocomial CCHF. Conclusions: There are still life-threatening gaps in the compliance of the HCWs to standard precautions. Ribavirin seems an effective and well tolerated agent for PEP of nosocomial CCHF.

Background: Various variants of the covid-19 have started to attract attention recently. The clinical course of these variants and possible predictive parameters are being investigated. This study aimed to examine the relationship between thiol levels, which are indicators of oxidative stress, and variant covid-19 types. Methods: In this cross-sectional study, patients with a diagnosis of classic covid-19 and patients with a diagnosis of variant covid-19 with mild and moderate symptoms followed in the clinical observatory of Ankara city hospital were included in the study group. The patients were divided into two groups according to the covid-19 type as variant and classic covid-19, and a healthy control group is added for comparison. A complete blood count and thiol analysis are performed from the venous blood samples. Obtained results were compared between groups, and the ROC analysis is performed. Results: Thiol levels were significantly lower in patients with a diagnosis of Covid-19 compared to the control group. In terms of WBC, lymphocyte, neutrophil, NLR, ferritin and thiol parameters, patients with variant covid-19 differed significantly from patients with a classic covid-19 diagnosis. Thiol levels’ cut-off values to distinguish between variant covid-19 patients and control group from classical covid-19 patients were almost identical (423 and 422 µmol/L, respectively). Conclusions: It seems possible to use thiol as a sensitive, specific and cost-effective marker to suspect variant covid-19 cases. Since this study is probably the first example in this subject, it would form a basis for further studies. Keywords: Covid-19, SARS-CoV-2, variant covid-19, thiol, oxidative stress.

Introduction: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus (HCV) in the world. Aims: The aim of this study was to compare direct acting antivirals (DAAs) treatment of HCV for PWID and non-PWID in real life setting. Materials and methods: We performed a prospective, non-randomized, observational multi-center cohort study in 37 centers. All patients treated with DAAs therapy between April 1, 2017 to February 28, 2019 were included. In total, 2,713 patients were included in the study among which 250 were PWID and 2,463 were non-PWID. Besides patient characteristics, treatment response, follow-up and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: DAAs were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis.

Background There is neither a surveillance system nor a study to reveal the HD related infection rates in Turkey. We aimed to investigate the infection rate among HD outpatients and implement CDC’s surveillance system. Methods A multicenter prospective surveillance study is performed to investigate the infection rate among HD patients. CDC National Healthcare Safety Network dialysis event (DE) protocol is adopted for definitions and reporting. Results During April 2016–April 2018, 9 centers reported data. A total of 199 DEs reported in 10035 patient-months, and the overall DE rate was 1.98 per 100 patient-months. Risk of blood culture positivity is found to be 17.6 times higher when hemodialysis was through a tunneled catheter than through an arteriovenous fistula. DE rate was significantly lower in patients educated about the care of their vascular access site. Mean body mass index was significantly higher in patients with any DE. Staphylococcus aureus was the most causative microorganism among mortal patients. Outcomes of DEs were hospitalization (73%), loss of vascular access (18.2%), and death (7.7%). Conclusions This first surveillance study in Turkey gave insight into current DE status and will guide to generate a national surveillance system for maintaining much lower DE rates.

Objective: To investigate temporal bone findings in COVID-19 Design: Retrospective study Settings: Using the database of our tertiary pandemic hospital, patients with COVID-19 infection with a positive PCR test and temporal bone tomography imaging were evaluated. Participants: 42 PCR positive COVID-19 patients with temporal bone imaging. Main outcome measures: A grading system was created to evaluate effusion in the middle ear and mastoid air cells. Also any specific sign in temporal bone imaging. Results: Patients were divided into two groups according to their chest CT findings. Group 1 had specific chest CT findings and included 26 patients, group 2 had no findings in chest CT and included 16 patients. No obvious temporal bone involvement was observed in any of the patients. Temporal bone imaging findings were compared according to a grading system and there was no difference between the groups (p=0,50). Conclusion: The SARS-CoV-2 does not affect the temporal bone. There was no sign of effusion in mastoid air cells or the middle ear or any specific sign in the temporal bone in our study group.