This prospective observational study describes the pharmacokinetic characteristics of favipiravir in adult patients hospitalized for mild to moderate COVID‐19 with a positive RT‐PCR test. Favipiravir was administered for 5 days, with a loading dose of 3200 mg and a maintenance dose of 1200 mg/day. Serial blood samples were collected on Day 2 and Day 4 of the therapy. Laboratory findings of the patients (n = 21) and in‐hospital mortality were recorded. Favipiravir concentrations exhibited substantial variability and a significant decrease during the treatment of COVID‐19. The median favipiravir trough concentration (C_0‐trough) on Day 2 was 21.26 (interquartile range [IQR], 8.37–30.78) μg/mL, whereas it decreased significantly to 1.61 (IQR, 0.00–6.41) μg/mL on Day 4, the area under the concentration–time curve decreased by 68.5%. Day 2 C_0‐trough of female patients was higher than male patients. Our findings indicate that favipiravir concentrations show significant variability during the treatment of COVID‐19 and therapeutic drug monitoring may be necessary to maintain targeted concentrations.

Introduction: The World Health Organization, within the scope of the Traditional Medicine Strategy for 2014-2023, recommends the development of integrated health policies, particularly in the area of primary healthcare. However, family physicians often report feeling insufficiently trained to effectively integrate these practices into patient care. This study aims to assess the views, understanding, and experiences of family physicians regarding the utilization of Traditional & Complementary Medicine (T&CM).Methods: The family physicians employed by the Istanbul Health Directorate Public Health Services were solicited to participate in an 18-question online survey to assess their level of education in T&CM methods, their views on integration of T&CM into family medicine, and the impact of these practices on patient care.Results: A total of 324 family physicians took part in the survey; 12.0% were specialists, 64.5% had worked in primary care for over 10 years, and 59.6% were in the age range of 31-50 years. Among the physicians, the majority (70.1%) reported a preference for integrating T&CM practices with conventional medicine (ConvM). The majority of the participants (71.6%) had no formal T&CM training, and 66.4% reported inquiring about T&CM in their patient consultations. Over half of the physicians (56.79%) believed that T&CM methods should be used in preventive medicine. The most widely recognized T&CM technique was cupping therapy (18.5%), which was also the most frequently recommended method by physicians.Conclusion: Most of the family physicians who participated in the study expressed a desire for integrative medicine, despite acknowledging limited formal education in this field. Offering physicians training in evidence-based complementary medicine therapies could provide them with additional non-invasive treatment options. However, patients' diffidence to inform their family physicians about T&CM practices they undergo may pose significant risks. As a result, incorporating education on integrative medicine into formal medical education and residency training may be necessary.Keywords: Family physician, complementary medicine, integrative medicine, traditional medicine

COVID-19 has now become a global pandemic. Understanding the routes of transmission is vital in the mitigation and suppression of the disease. İstanbul has become one of the disease’s epicenters. This study aims to describe the first COVID-19 case and contact tracing efforts around it in İstanbul. The descriptive study was conducted in İstanbul, Turkey. The first COVID-19 cases and those associated with them were investigated with contact tracing, and primary and secondary cases were described. The source case was an individual who returned to Turkey from international travel at the beginning of March and tested PCR (–). The index case is the brother of the source case and is considered the first PCR (+) case diagnosed in İstanbul. Contact tracing revealed 23 PCR (+) cases, 14 of which resulted in hospitalization and three deaths. This study described cases of the first COVID-19 cluster in İstanbul. Moreover, contact tracing was used in this first cluster. This contributed to contact tracing algorithms in Turkey.

After the declaration of the coronavirus-2019 (COVID-19) pandemic and the detection of the COVID-19 case in Turkey, a series of non-pharmaceutical measures were implemented to reduce the number of contacts at the national level. The aim of this study was to determine the change in the epidemic reproduction rate (R 0) with non-pharmaceutical interventions including curfews starting with the first reported case in Istanbul and to evaluate the effectiveness of interventions by estimating the number of cases and deaths using a dynamic compartmental model. While keeping transmission probability (beta) as 3% and incubation period as seven days, we developed five scenarios that represented non-pharmaceutical interventions The first scenario was "if nothing was done" and the last scenario was "curfew". The contact matrix of 16 age-groups created by Prem et al. was used in the study as the contact matrix of "if nothing was done" as scenario 1. For all other scenarios (2-5) contact matrices assumptions were created and R-0 values were calculated for the whole of Istanbul according to age groups for all five scenarios. For each scenario, "the number of cases and COVID-related deaths" for one year from the day the first case was detected were calculated with the mathematical modeling method. In the absence of any intervention, R-0 value was estimated as 2.86 in Istanbul. Among age-groups, the largest R-0 value was observed in ages 15-19, 10-14, 5-9, 20-24 and the values were 5.22, 4.37, 3.32, and 3.33; respectively. Due to school closings and flexible work hours, R 0 values decreased to 2.02, 1.84, 1.63 and 1.85 in the same age-groups. With the addition of a curfew for the population under the age of 20 to the above measures, the R 0 values for all age groups were reduced to less than one. When R-0 values for Istanbul was 2.86 and 1.55 based on our model results, the number of cases and deaths per year were determined as approximately 14 million and 2 million and 2.5 million and 327.000, respectively. School closures were determined as the most effective non-pharmaceutical intervention. Non-pharmaceutical measures with the addition of curfews under the age of 20 and over the age of 65 to the school closings and flexible working hours were identified as effective methods in controlling the COVID-19 epidemic in Istanbul. While the results of this study may not reflect real life data, it has the potential of helping public health policy makers to decide on which non-pharmaceutical interventions are the most effective.

Giriş: Göç, siyasi, ekonomik, dini ve toplumsal sebeplerle insanların yaşadıkları yerleşim yerlerini terk ederek başka bir yerleşim yerlerine gitme durumudur. Göç eden insanlar, ya hayatlarının geri kalan kısmını geçirmek ya da belli bir süre geçtikten sonra yeniden yerleşim yerlerine dönmek üzere yer değiştirirler. Bu durum göç edilen ülkede bir çok yönden yeni düzenlemeler gerektirdiği gibi, sağlık konusunda da önemli bir politika belirleyicisi olmuştur. Özellikle 2009 yılından sonra göç olayları artmış, Suriye Cumhuriyeti iç savaşı ile birlikte Türkiye ve diğer komşu ülkelere de göç akını başlamıştır. Bunlardan en önemlisi de göçmenlerin sağlık hizmeti alabilmeleridir. Bu amaçla ülkemizde Göçmen Sağlığı Merkezleri kurulmuştur. Bu çalışma, İstanbul ilinde aynı dili konuşan hekim ve sağlık çalışanlarından oluşan Göçmen sağlığı Merkezlerinden (GSM) hizmet alan göçmenlere yönelik verilen hizmetlerin değerlendirilmesi amacıyla yapılmıştır. Yöntem: Araştırma kesitsel, tanımlayıcı nitelikte olup analitik bir çalışmadır. Veriler SPSS 26.0 programında analiz edilmiştir. Tanımlayıcı istatistiklerinde ortalama, standart sapma, medyan en düşük en yüksek frekans ve oran değerleri kullanılmıştır. Bulgular: Göçmen Sağlığı Merkezlerine göçmenlerin % 63’ ü genel muayene için gelmektedir. %46,8’ı başka hiçbir sağlık kuruluşundan hizmet almamaktadır. Diğer birimlerden en fazla psikolojik danışmanlık hizmeti almaktadırlar(%52). Katılımcıların %55,1’i Suriyeli doktorlara muayene olmaktan , %50,9’u Suriyeli hemşirelerden hizmet almaktan çok memnun olduklarını belirtmişlerdir. Sonuç: Yapılan çalışma sonucuna göre, göçmen vatandaşlar sunulan hizmetlerden genellikle memnun olduğu görülmektedir. Bunda en çok kendi dillerini konuşan hekim ve hemşirelerin olması, merkezlerde tercümanların olmasının büyük payı vardır. Hastalar için anlaşılır olmak tedavi başarısında son derece önemlidir. Göçmen vatandaşların büyük çoğunluğunun, sadece göçmen sağlığı merkezlerinden sağlık hizmeti alıyor olmaları da memnuniyetin bir göstergesidir. Göçmen sağlığı merkezlerinin hayata geçirilmesi ile göçmen vatandaşların birinci basamak sağlık hizmetlerinden ücretsiz yararlanması sağlanmıştır.