Heat waves are one of the most common direct impacts of anthropogenic climate change and excess mortality their most apparent impact. While Turkey has experienced an increase in heat wave episodes between 1971 and 2016, no epidemiological studies have examined their potential impacts on public health so far. In this study excess mortality in Istanbul attributable to extreme heat wave episodes between 2013 and 2017 is presented. Total excess deaths were calculated using mortality rates across different categories, including age, sex, and cause of death. The analysis shows that three extreme heat waves in the summer months of 2015, 2016, and 2017, which covered 14 days in total, significantly increased the mortality rate and caused 419 excess deaths in 23 days of exposure. As climate simulations show that Turkey is one of the most vulnerable countries in the Europe region to the increased intensity of heat waves until the end of the 21st century, further studies about increased mortality and morbidity risks due to heat waves in Istanbul and other cities, as well as intervention studies, are necessary.

Healthcare workers are among risk groups in the COVID-19. Even if they are not infected with the disease, they witness the effects of the pandemic. The aim of the study is to determine the factors affecting COVID-19 vaccination status and reasons for vaccine hesitancy of healthcare personnel in our hospital. Firstly, the vaccination status and demographic characteristics of all healthcare personnel was evaluated. After that, a survey was applied to 408 vaccinated and 297 nonvaccinated personnel. Within the first month after the beginning of vaccination, 66% of 3937 healthcare personnel received a COVID-19 vaccine. The number of vaccinated personnel was higher among doctors, master graduates or higher educational levels and basic science-laboratory unit workers. In the surveyed group, being under the age of 50 (OR:1.85), being nondoctor healthcare personnel (nurse/midwife OR:1.78, administrative personnel OR:3.42, patient attendant/cleaning staff OR:4.11, security guard/other OR:2.96), having had the disease before (OR:2.36), not having the flu vaccine (OR:3.24) and hesitancy about other vaccines (OR:6.61) were found to be independent risk factors for not having a COVID-19 vaccine or having it late. The three most common reasons for not getting vaccinated were doubt on the efficacy of the vaccine, distrust of its content, and fear of side effects. Taking steps by considering the main factors of hesitancy among healthcare personnel will increase the vaccine acceptance.

Citation: Oba MC, Ozkoca D, Basara Sahin R, Senses Kazan D, Guldiken G, Kara Esen B. Factors Affecting Topical Treatment Success In Pediatric Scabies Cases: A Cross-Sectional Study. Dermatol Pract Concept. 2023;13(4):e2023307. DOI: https://doi.org/10.5826/dpc.1304a307 Accepted: September 20, 2023; Published: October 2023 Copyright: ©2023 Oba et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited. Funding: None. Competing Interests: None. Authorship: All authors have contributed significantly to this publication. Corresponding Author: Muazzez Cigdem Oba, MD, Department of Dermatology, Health Sciences University, Sancaktepe Sehit Prof. Dr. Ilhan Varank Research and Training Hospital, Istanbul, Turkey. Email: muazzez.oba@istanbul.edu.tr Introduction: Scabies is a common disease affecting the pediatric population. Treatment failure and relapses are frequent. Objectives: We aimed to define factors affecting topical treatment success in pediatric scabies patients. Methods: This multicenter cross-sectional study was performed between April and December 2022. Pediatric scabies cases were classified as treatment failure (TF) versus treatment success (TS). Results: We enrolled 170 patients in the study. In the TF group, the presence of symptomatic household members and referral from physicians other than dermatologists were more common (both p<0,001) and relapse rates and total symptom duration were higher (p=0,007, p<0,001 respectively). Permethrin 5% was more commonly used in the TF group (71.1% versus 25%) (p<0,001); however, the ratio of patients treated with sulfur preparations was significantly higher in the TS group (60.7% vs 16.9%) (p<0,001). Misapplication of topical therapy was significantly more common in the TF group (p<0,001), statistically significant errors being: (i) lack of treatment of close contacts (p<0,001); (ii) single application (p<0,001); and (iii) local application (p=0,027). In a multivariate analysis, treatment success was mainly associated with (i) presence of atopy (O.R.: 5,29, 95% CI:  1,22-25,57) ;(ii) absence of symptomatic household members (O.R.: 5,29, 95% CI: 1,72-16,27); (iii) presentation to dermatologists rather than other specialties (O.R.: 6,08, 95% CI: 1,9-19,51); whereas use of permethrin negatively affected treatment success (O.R: 0,22, 95% CI: 0,07-0,71). Conclusions: Pediatric scabies patients should be treated before other family members get affected and with topicals other than permethrin. Awareness of scabies disease needs to be increased among non-dermatologists. Keywords : children, , permethrin, scabies, sulfur, treatment This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

This study aimed to explore the impact of the coronavirus disease 2019 pandemic and lockdown period measures on patients’ visits to the psychiatric emergency department (PED) of a University Hospital in İstanbul. We compared the number and characteristics of patients during the initial lockdown with visits in the pre- and post-lockdown months. We also investigated the number of monthly PED visits and hospitalizations between March 11, 2020 and 2021 and compared it to the same period in 2019 and between March 2021 and 2022. PED visits in the initial lockdown period in our university increased by 109% compared to the prelockdown months in the previous year. Anxiety and depressive disorders were responsible for most of this increase. The decline in PED visits was 3.1% and 42% during the first and second year of the pandemic, respectively; however, among the major diagnostic categories, we found that the rates of anxiety, depressive disorders, and obsessive-compulsive disorder increased significantly in the first year, while psychotic disorders declined and bipolar disorders remained the same. In the second year, there was a trend toward prepandemic year ratios. These findings show that the pandemic affects PED admissions in different ways at different periods. These data may also help shaping the public policies necessary to meet the evolving needs in the field of mental health of society at different public crises in the future.