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The Results Are Amusing

The condition that occurs with different clinical pictures in people who have been infected with COVID-19 is called post-COVID-19 syndrome or “prolonged COVID-19”.

Elderly people and people with many serious medical conditions are most likely to experience symptoms of COVID-19, but even young and healthy people can experience symptoms weeks or months after getting an infection. Especially, Tiredness, shortness of breath, cough, joint pain, chest pain, muscle pain or headache, fast or heavy heartbeat, loss of smell or taste, memory, concentration or sleep problems, rash or hair loss, stress syndrome, depression and anxiety.

COVID-19 may damage all organs. This organ damage can increase the risk of long-term health problems. Major organs that may be affected by COVID-19: Imaging tests performed months after recovery from COVID-19 have shown that even people who experience only mild symptoms of COVID-19 can have permanent damage at their heart muscle. This can increase the risk of heart failure or other heart complications in the future. COVID-19 can often cause long-term damage to the small air sacs (alveoli) in the lungs. The resulting scar tissue can cause respiratory problems in the long-term.

COVID-19 can cause diseases such as paralysis, seizures, and temporary paralysis.

COVID-19 may also increase the risk of developing Parkinson’s and Alzheimer’s disease.

COVID-19 can increase the possibility of coagulation. While large clots can lead to heart attacks and strokes, it is stated that most of the heart damage caused by COVID-19 is caused by very small clots that block small blood vessels in the heart muscle.

The lungs, legs, liver, and kidneys are other parts of the body that are affected by clots. On the other hand, COVID-19 can weaken blood vessels. This can cause long-term problems in the liver and kidneys. We started rehabilitation and antioxidant treatment after Covid-19 infection in our hospital’s FTR clinic. The results are amusing.

Breast Cancer which is seen among the women both in our country and world commonly, and the most common cause of death, arises with the uncontrolled cell proliferation in the breast tissue. Breast cancer is observed in the men more less frequently (less than 1% of all breast cancers) compared to women. The breast cancer is among the first ten most common cancers both in the world and our country. Breast cancer continues to be one of every 4 women’s cancers in our country. While the incidence of breast cancer is 47.8 per hundred thousand worldwide, it is 86.4 for Northern European countries, 43.0 for East Asia, 90.3 for the United States and 47.7 for our country.

Approximately 19.000 women are diagnosed as breast cancer in a year in our country. Breast cancer which was diagnosed at a further stage in the past, it can be diagnosed at an early stage by the effect of the screening programs carried out by our ministry and an increase in our early diagnosis rates can be achieved.

Breast cancers detected in the early stages are more successful in their treatment and their quality of life increases significantly. Because of that reason it is possible to detect cancer development at an early stage and to reduce the death rate due to breast cancer in women before clinical findings appear, in case of a possible cancer development in our women, through community-based screenings.

In our country community-based cancer screening has started by establishing Cancer Early Diagnosis, Screening and Education Centers (KETEM) then Family Health Centers (ASM) and Healthy Life Centers (SHM) are included to these screening program. Our people are being served free of charge by means of screening programs in accordance with European Union Quality Standards and our state-of-the-art digital mammography devices at the centers mentioned above. Public training and Self-Breast Examination are being given and brochure distribution is being done in these centers.

In our National Cancer Control Program; protection and prevention programs as well as the screening strategies, awareness raising activities of the public are carried out effectively.

Our women must be informed about risk factors, symptoms, diagnosis and treatment methods of breast cancer and they should be guided to healthy living conditions that will prevent cancer.

PROTECTION

As in all cancer types; the risk of breast cancer can be reduced by consuming foods rich in vegetables and fruits and prepared under appropriate conditions, establishing healthy eating habits, increasing physical activity, maintaining a healthy weight, avoiding smoking and alcohol use. It can be learned whether you are at a healthy weight by consulting your family doctor. Since there are many studies showing that breastfeeding protects against breast cancer, it is recommended that all mothers breastfeed their babies for at least 2 years.

Lifestyle-related and modifiable risk factors for breast cancer are as follows:

• Being overweight and obese
• Not doing physical activity (having a sedentary lifestyle)
• Have never given birth or have had their first birth after age of 30
• Using birth control pills and injection
• Having hormone treatment after menopause
• Having alcohol: In particular, consumption of more than 1 glass of alcohol (1 beer, 1 glass of wine, 1 double hard alcoholic beverage) per day increases the risk more.

Risk factors that cannot be changed for the breast cancer are as follows:

• Being a woman: Breast cancer is 100 times more common in women than men.
• Getting older: As age increases, the risk of breast cancer increases.
• Having certain inherited genes (especially BRCA1, BRCA2)
• Having breast cancer history in the family: Having breast cancer in first-degree relatives (mother, sister, daughter) doubles the risk. It is important to note that the majority of women with breast cancer (about 8 out of 10) do not have a family history of breast cancer.
• Having cancer at one breast of the person: This case increases the risk of cancer at the other breast or at the other parts of the same breast.
• Having an intense breast tissue.
• Presence of benign formations (such as fibroadenoma) in the breast
• Early menstruation (especially before the age of 12)
• Menopause after age of 55
• Having radiotherapy to breast.

SYMPTOMS OF BREAST CANCER

Knowing how your breasts normally look and feel is an important part of breast health. Diagnosing the breast cancer early provides a successful chance for the treatment. But knowing what to look for cannot substitute for regular mammograms and other screening tests. Screening tests help to diagnose the breast cancer in its early stages before any symptoms appear. The most common symptom of breast cancer; is the palpation and feeling of a painless, growing lump (mass) in the breast. In addition, the following symptoms can also be seen in breast cancer, whether there is a palpable lump (mass) or not:

• Swelling of all or part of one breast (even if you can feel a distinct lump)
• Pain at the breast or tit
• Inflammatory condition with itching and inflammation on the breast skin (eczema)
• Inverted nipple
• Orange peel appearance at the breast
• Irritation of breast skin
• Unilateral nipple discharge (especially bloody discharge)
• Swelling in part or all of the breast, change in breast shape
• Rubescence, crusting, thickening of the breast or nipple skin
• A lump (mass) in the armpit, sometimes before a lump in the breast is felt, cancer can cause swelling or a lump in the armpit or around the collarbone.

Although any of these symptoms can be caused by conditions other than breast cancer, it’s advised to be examined to a general surgeon to find the cause, when the listed symptoms are seen.

DIAGNOSIS:

            Breast cancer may not show any symptoms until it reaches advanced stages. Because of that reason, since the above symptoms are not sufficient to make a diagnosis, it is necessary to apply to the nearest health centers. Early diagnosis of breast cancer increases the chances of success in treatment and survival. For this reason, it is recommended that all women between the ages of 40-69 have a mammogram every 2 years. The most important factor in early diagnosis, the awareness of the person on this issue, the easy acceptance of the applied method by women, the success of screening methods with having few side effects, easy application, free and economical. The following methods are taught and applied to women in our screening centers, especially for early diagnosis.

BREAST SELF-EXAMINATION:

BSE is an examination method that women can easily perform at home at any time. In order to use BSE, it is necessary to receive adequate training on this subject and to apply what has been learned continuously, regularly and periodically. It is sufficient to apply to our centers to receive training.

Women should do breast self-examination every month after 20 years old. During the examination it is checked whether the image of both breasts is symmetrical by standing in front of the mirror. Nipple and skin collapse or recession, skin redness and edema are examined. With this examination, tumors close to the skin and nipples can be noticed by the woman herself at an early stage. A woman who examines herself regularly can distinguish a newly developing mass, a recession or discoloration of the breast skin or nipple, and an asymmetrical appearance. The masses that are suspicious of cancer are harder than other breast tissue (walnut-like), with indistinct borders, limited movement and usually painless. A woman who notices a mass in her breast should immediately consult her doctor. In addition, she should go to a doctor for a breast examination every two years.

Clinical Breast Examination:

            Women between the ages of 40-69 should do a breast self-exam once a month and go to the doctor for a breast exam once a year.

Taking a Mammogram:

Between 40-69 years old; It is performed for early diagnosis of breast cancer in women without complaints. It has performed every 2 years. During the scan, a standard film is taken for both breasts in two positions, one mediolateral oblique (MLO) and the other craniocaudal (CC). More comfortable service is offered to our women with the digital mammography devices used today.

Treatment:

The treatment of each patient differs; Multiple factors such as the location of the disease, the stage of the disease, the age of the patient and the presence of other health problems are effective in the decision of the treatment. Different treatment options such as surgery, radiation therapy (radiotherapy) and drug therapy (chemotherapy) are applied in breast cancer. You can access documents for breast cancer and other cancers from the Cancer Department’s Web site and be directed to the nearest screening center by using the “Which Screening is Right for Me?” link.

We have visited Mr. Cemal Yaman, President of Sakarya Chapter of Demiryol-İş Union and Provincial Representative of Turkish Confederation of Worker Unions, Türk-İş.
During our visit, we signed an institutional cooperation agreement, enabling unions and members of Türk-İş Confederation can use our hospital.
We thank them for receiving us and look forward to serving the members of Türk-İş Confederation.

A LIVING NUTRIENT: BREAST MILK AND COVID-19

Infant nutrition, a key area of medicine, has been the focus of many serious and comprehensive studies which led to decisive conclusions, based on long-term monitoring of infants fed cow’s milk or an infant formula vs those breastfed.

COMPARED TO BREASTFED INFANTS, INFANTS FED INFANT FORMULAS ARE AT HIGHER RISK FOR:

• Heart disease
• Diabetes mellitus
• Leukemia
• Sudden infant death
• Obesity
• Pneumonia
• Middle ear infection
• Allergies/asthma
• Severe diarrhea and chronic diarrhea
• Psychiatric disease
• Maternal estrangement
• Chronic bowel inflammation (Crohn’s Disease)
• Celiac disease.
ALSO,
• They have a shorter life expectancy, due to their becoming ill frequently and being at high risk for chronic disease.
• Their intelligence quotient (IQ) is lower.
• Economic studies have found that they earn a lower income in their future careers.

COMPARED TO A BREASTFEEDING MOTHER, A NON-BREASTFEEDING MOTHER IS AT HIGHER RISK FOR:

• conception while caring for her newborn
• anemia
• breast cancer
• ovarian cancer

Breast milk is produced by every mother specifically for her baby, differently for every meal. Its formula varies depending on whether the infant is low weight, or immature. How the infant sucks the breast milk at one meal sets up the composition of milk for the next meal. Despite the advanced in technology, it remains impossible to mimic the unique nature and composition of breast milk with any formula or other nutrient. This is because the milk is customized for the baby. Mimicking breast milk would only be possible if a formula can be produced individually for every infant for each meal in a composition equal to the breast milk. This remains an IMPOSSIBLE venture.

Inability to give or receive breast milk is a disease. Breast milk also works like an antibiotic. Studies have shown that 99.9% OF MOTHERS PRODUCE ENOUGH MILK TO FEED TWO INFANTS. There can be three reasons for the inability to give or receive breast milk: the mother is ill, the infant is ill, or the breastfeeding technique is flawed. There can be no other reason, and excuses of allegedly having insufficient or poor quality of milk have no scientific basis. If using an infant formula becomes necessary, it is imperative that a pediatrician is consulted and every effort must be made to establish the root cause of the problem and return to breastfeeding, until which point infant formulas can be used. Using an infant formula may only be indicated in infants with a daily weight gain of less than 20 grams and urinating less than 4 times a day, and even then on a temporary basis and under close physician oversight to identify and solve the underlying problem. Using an infant formula is unnecessary in all other cases. All infants, whether born on time or immaturely, must exclusively receive breast milk for the first 6 months, except as prescribed otherwise by a pediatrician.

Newborns are particularly at risk in serious and widespread outbreak conditions, such as the COVID-19 pandemic. Breast milk contains antibodies against respiratory tract infections and provides various immunologic benefits, including supporting the immune system and enveloping and protecting the intestinal flora.

A LIMITED NUMBER OF STUDIES CONDUCTED IN WOMEN WITH COVID-19 OR OTHER CORONAVIRUS INFECTION (E.G. SEVERE ACUTE RESPIRATORY SYNDROME, SARS-COV) HAVE FOUND NO VIRUS IN THE WOMEN’S BREAST MILK. IN A RECENT STUDY CONDUCTED IN WUHAN, CHINA, BREAST MILK SAMPLES WERE COLLECTED FROM SIX PATIENTS WITH A HISTORY OF COVID-19 INFECTION AT INITIAL BREASTFEEDING. ALL SAMPLES TESTED NEGATIVE FOR CORONAVIRUS. ACCORDING TO THE CURRENT WHO GUIDELINE, WOMEN WITH COVID-19 INFECTION MAY BREASTFEED THEIR INFANTS, PROVIDED THEY TAKE THE FOLLOWING PRECAUTIONS: 1. WEAR A MASK THAT COVERS NOSE AND MOUTH WHILE BREASTFEEDING AND ENSURE RESPIRATORY HYGIENE. 2. WASH HANDS WITH SOAP AND WATERS FOR AT LEAST 20 SECONDS BEFORE AND AFTER TOUCHING THE INFANT. 3. REGULARLY CLEAN AND DISINFECT ANY SURFACED TOUCHED. IF THE MOTHER FALLS TOO ILL WITH COVID-19 TO BREASTFEED, SHE SHOULD SEEK SUPPORT TO SAFELY FEED HER INFANT WITH BREAST MILK, BY HARVESTING BREAST MILK, RE-BREASTFEEDING (RESUMING BREAST FEEDING AFTER A PAUSE PERIOD), OR USE BREAST MILK DONATED TO RELIABLE BREAST MILK BANKS.

Breast milk saves the lives of millions of children every year, as it is the only nutrient that can remain uncontaminated during extraordinary circumstances such as war and natural calamities. Breast milk is a living nutrient; it is not fixed nor constant. It contains a complete diet of nutrients needed for organ, weight/height and intellectual development of the infant. “Epidermal growth factor” which speeds up growth occurs in very high concentrations in breast milk. It is non-allergic and economic, such that hiring a private breastfeeding nurse would cost less than the total amount you would have to spend on infant formulas for the first 6 months. It ensures the formation of a psychological bond between the mother and infant, and drives the feeling of motherhood and “having a mother.” Protein content of breast milk is of a higher quality than that in cow’s milk or infant formulas, and less straining on kidneys. Essential proteins that are crucial for intellectual development occur only in breast milk, and are produced specifically for that baby. Breast milk coats intestines from the first time, forming a protective shield for the infant and a more conducive environment for intestinal absorption of iron, protecting against diarrhea. Breast milk contains the enzyme lactase, which helps digest lactose and protects the infant from bloating pain. Lactose increases absorption of calcium needed for bones and drives the growth of benign bacteria in the intestines. It also reduces the risk of developing allergies in the future. Breast milk contains the enzyme lipase, which helps digest fats. It plays an important role in digesting or absorbing fats particularly in premature infants with an undeveloped digestive system. Lipase contained in breast milk also protects against parasitic disease. Fats are the main source of energy for newborns. They provide the essential fatty acids which are needed for brain development. Unsaturated fatty acids, needed for retinal functions, are available in high amounts in breast milk. Fats enter the cellular membrane structure and carry certain vitamins and hormones from the breast milk. The level of fat is low in the mornings, and increases later in the day. At the end of lactation, fat rate reach the saturation level, which allows the infant to be weaned without a risk of being overweight. The same sensation of satiation cannot be generated by fabricated products such as infant formulas, driving the risk of obesity. The renal burden of minerals in breast milk is lower than that of infant formulas or cow’s milk of same grade. While iron content of breast milk is lower, it has very high effectiveness and absorption which provides a greater benefit without causing as much burden. Breast milk is low in salt. The vitamin D content of breast milk is insufficient for infants, and therefore infants must be supplemented with vitamin D until the age of 1 year. Iron content of breast milk becomes insufficient after 4 months for infants born on time, and after 2 months for premature infants; supplementation is essential. Care must be taken to ensure that iron and vitamin D supplements recommended by primary care professionals are used as prescribed.

Infants born by cesarean start the life at a disadvantage. Their immune system is particularly weaker, but if they are breastfed they can make up for this deficiency by the second month. Cesarean does not preclude breastfeeding. Mothers who had cesarean should breastfeed like any other. Many infants are deprived of breast milk due to difficulties of the first week, which is quite unfortunate. Cesarean should be only used when medically indicated, and mothers should do away with the idea of “not breastfeeding.” In particular, the colostrum (golden milk) must be given to the baby. After cesarean, breastfeeding problems in the first week due to the colostrum being viscous and mammary ducts being not yet ready can be easily overcome. Just ask a breastfeeding nurse or pediatrician for help. Be sure to tell them “you want to breastfeed and are ready for it.”

Breast milk is life.

Cervical Cancer

Cervical cancer is a common type of cancer in women, and ranks in first place among gynecologic cancers in the world. Cervical cancer is a type of cancer that forms in the cervix, a neck-like segment connecting the uterus with the vagina. It is mainly caused by human papilloma virus (HPV) infection, a venereal disease that causes warts at the cervix.

Risk Factors for Cervical Cancer:

Human Papilloma Virus (HPV) infection
Venereal infections
First sexual intercourse at early age, i.e. when younger than 16 years
Tobacco use
A non-organic and irregular diet (low on fruits and vegetables)
A polygamous lifestyle

Signs of Cervical Cancer

Non-menstrual, sporadic vaginal bleeding
Plentiful and odorous vaginal discharge
Pain or bleeding during intercourse
Spotting or bleeding during menopause

Diagnostic Methods for Cervical Cancer:

Cervical cancer can be detected by screening and treated completely if detected early. It ranks low among cancer deaths. Screening for cervical cancer involves SMEAR testing. It is a painless procedure whereby a sample is collected from the cervix using a special brush during examination. It should be performed once a year. Additional testing may be required where indicated.

Therefore, we recommend a gynecologic checkup at least once a year, even if you have no complaints.

Treatment of Cervical Cancer:

There are two approaches to treating cervical cancer. In general, treatment is surgical if cancer was detected at early stage. If tumor propagated beyond cervix around uterus, radiotherapy is indicated. The larger the tumor, the higher the likelihood chemo-radiotherapy may be indicated.

Why Is Cervical Cancer Important?

Cervical cancer is preventable.
Cervical cancer can be treated 100% if detected early.
Death from cervical cancer is completely preventable.

There is no evidence that a particular nutrient or food supplements prevent coronavirus infection. But our immune system is our last line of defense against the virus, and a proper diet is key to keeping it strong.

Eat an adequate and balanced diet
Consume 5-6 servings a day of various fruits and vegetables rich in vitamin C.
Prefer natural foods and seasonal vegetables. Particularly in winter months, seasonal vegetables like lettuce, cauliflower, broccoli and leek which are rich in sulfur contain high amounts of antioxidants.
Be sure to include wholegrain products in your diet.
Legumes are a source of both proteins and fibers.
Sulfur compounds contained onion and garlic boosts the immune system.
Use ginger, turmeric and spices containing them in your recipes.
Include hard-shell nuts and their fatty seeds (e.g. walnut, hazelnut, almond) in your diet.
Drink at least 2 liters of water every day.
Consume tea of linden, rosehip and sage.
Having a regular and quality sleep is important. Be sure to sleep 6 to 8 hours every day and rest.

We wish you and us a rapid return to pre-corona healthy and peaceful days.