Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence data in Türkiye is limited. We aimed to determine the nationwide prevalence of MASLD and advanced hepatic fibrosis risk in subjects with cardiometabolic risk factors (CMRF). Despite recent international consensus redefining fatty liver disease terminology, no nationwide MASLD study has been reported in Türkiye. Methods: This cross-sectional study included 14,371 adults with ≥1 CMRF from 44 centers across 31 cities. MASLD was diagnosed using liver ultrasonography plus cardiometabolic criteria. Advanced fibrosis risk was assessed by fibrosis-4 (FIB-4) score (≥1.3 for ≤65 years; ≥2.0 for >65 years). Logistic regression was used to identify independent predictors of high FIB-4. Results: A total of 61.4% of participants were women, the mean age was 51.3 ± 14.4 years, and the mean BMI was 31.4 ± 6.0 kg/m². MASLD prevalence was 75.7% (n = 10,873), rising with the number of CMRFs (56.5% with one factor vs. 83.4% with all). The prevalence of high FIB-4 scores was 12.0% overall, being lower in MASLD patients than non-MASLD patients (11.2% vs. 14.4%, p < 0.001). FIB-4 scores decreased with increasing BMI (28.1% underweight vs. 8.7% class III obesity). Male sex, T2DM, and hypertension independently predicted high FIB-4 scores, while smoking, higher BMI, and MASLD were inversely associated. Conclusions: Three-quarters of Turkish adults with CMRF have MASLD. Standard FIB-4 thresholds may underestimate fibrosis risk in obese and smoking populations, underscoring the need for adjusted cut-offs or alternative tools. This study is the first to provide nationwide MASLD prevalence data in Türkiye.

Antimicrobial resistance can lead to morbidity and mortality in serious infections. Therefore, antimicrobial resistance has been accepted as a global public health problem in the 21st century. Unnecessary and excessive use of drugs is a serious problem in our country as well as in the rest of the world. Unnecessarily used drugs play an important role (...)

Background: Drugs that are used in COVID-19 infection, may interact with each other, as well as with the drugs for comorbidities, used concomitantly with COVID-19 treatment. Objectives: It is quite important to calculate and present the patients’ exposure to clinically important potential drug-drug interactions (pDDIs). We aimed to investigate the pDDIs and the burden of polypharmacy in COVID-19. Methods: The medical records of 126 consecutive inpatients with COVID-19 treatment were retrospectively analyzed. The Lexi-interact database was used to investigate pDDIs. Results: According to the Lexi-interact database, 605 pDDIs were detected. Of these pDDIs, 23 (3.8%) were A risk category interaction, 186 (30.7%) were B risk category interaction, 339 (56%) were C risk category interaction, 54 (8.9%) were D risk category interaction, and 3 (0.5%) were X risk category interaction. Sixty-five-point five percent of pDDIs (n=396) were clinically important pDDIs (C, D, and X categories), and 69 patients (54.8%) had at least one clinically important pDDIs. The most interacting drug was hydroxychloroquine (n=171, 28.3%). Hydroxychloroquine was also the most interacting drug in the C risk category (n=101, 29.8%) and had 19 pDDIs with metformin, 16 pDDIs with beta-blockers, 13 pDDIs with acetylsalicylic acid, and 10 pDDIs with insulin in the C risk category. Enoxaparin was the most interacting drug (n=25, 46.3%) in the D risk category and most of them were with acetylsalicylic acid (n=12). The most common possible clinical manifestations of pDDIs were QT prolongation, hypoglycemia, and hemorrhage. One hundred and eighteen patients (93.6%) used five or more drugs daily. There was a significant positive correlation between the number of drugs prescribed to patients and the number of clinically important pDDIs (r=0.80, p<0.001). Conclusions: Clinically important pDDIs are common among COVID-19 patients and the majority of pDDIs require monitoring of therapy. COVID-19 patients should be closely observed for QT prolongation, hypoglycemia, and hemorrhage due to pDDIs during treatment. Keywords: COVID-19; drug interactions; polypharmacy.

Background: Diabetes mellitus is a chronic disease. The aim of our study was to evaluate drug- drug interactions and polypharmacy in diabetic patients. Methods: Patients with type 2 diabetes attending our internal medicine and endocrinology policlinics from April 2019 to July 2019 were included to the study. It was designed as a prospective, descriptive and cross-sectional study. The socio-demographic characteristics of diabetic individuals, the drugs they use in the treatment of diabetes, and other accompanying diseases were evaluated according to the ATC classification. In this study, interactions between multiple drugs and polypharmacy were examined. Results: The study population consisted of 526 patients between the ages of 18-87/years (59 ± 11). 69.6% of the patients were women.83.8% of the patients had chronic diseases accompanying diabetes. The most common chronic diseases were hypertension (53.6%), hyperlipidemia (41.4%) and coronary artery disease (27.2%), respectively. 45.01% of the patients were using five or more drugs. The mean number of drugs was found to be 4.49 ± 1.93. Among the drugs used by the patients, 787 drug-drug interactions were found in a total of 429 (81.5%) patients. The average number of interactions was 3.89 ± 3.6 for interaction A 15.2% (n = 81), 16.2% (n = 85) for interaction B, 69.8% (n = 367) for interaction C was, 47.9% (n = 252) for interaction D, and 0.4% (n = 2) for interaction X. The most frequent interaction was found between acetylsalicylic acid and insulin and metformin and angiotensin converting enzyme inhibitors. Conclusions: Both the polypharmacy rate and drug-drug interaction rate are high in diabetic patients. The most common type of interaction is type C and type D drug-drug interaction. Attention should be paid to drug-drug interactions in the treatment of diabetes patients.