INTRODUCTION: Prolonged invasive mechanical ventilation (IMV) is the main cause of tracheal stenosis (TS). During the COVID-19 pandemic, the number of patients treated with long-term invasive mechanical ventilator support also increased. This study aimed to examine hospital presentations due to TS before and during the pandemic period.
METHODS: This retrospective observational study was planned over the 5-year period from October 2017 to October 2022. The data of all patients who presented to the hospital due to TS were screened through the hospital’s automation system. The age, gender, presentation unit and complaints, comorbidities, etiology of TS, intensive care admission, mechanical ventilation requirement and duration, the presence of a tracheostomy, the presence of previous surgical intervention, and treatment modalities were recorded in the data form. All variables were compared between the pre-pandemic and pandemic periods. SPSS version 25 statistical software package was used for statistical analyses. The significance level was taken as 0.05 for all tests.
RESULTS: The study included a total of 60 patients diagnosed with TS, of whom 21 presented to the hospital before and 39 during the pandemic. Forty of the patients were male and 20 were female, and their ages ranged from 3 to 77 years. The mean number of presentations was 5.25 before the pandemic and increased to 13 during the pandemic, indicating a 2.47-fold increase due to COVID-19. When the groups were examined, the mean age, the presence of diabetes mellitus and hypertension, the presence of stridor, tracheal dilatation, and stenting significantly increased during the pandemic period (p<0.05).
DISCUSSION AND CONCLUSION: According to our results, the increased requirement for IMV due to COVID-19 infection also increased the frequency of TS. Due to our findings, potential cases of TS can be predicted by inquiring about the patient’s history of COVID-19 infection and IMV.

INTRODUCTION: In our study, we aimed to compare the reliability of the Harmless Acute Pancreatitis Score (HAPS) score with the widespread, commonly used and reliable scoring system of the Ranson score in terms of prognosis prediction for non-biliary acute pancreatitis (AP) cases.
METHODS: The study included 73 patients with diagnosis of non-biliary AP with mean age 48 years, admitted for clinical follow-up from January 2016 to June 2021. The Ranson and HAPS scores and clinical progression were compared. For clinical progression, duration of admission, final outcome, and presence of local or systemic complications were assessed.
RESULTS: When HAPS and Ranson scores are compared, there was no statistically significant difference identified in the prognosis predictions for patients (p>0.05).
DISCUSSION AND CONCLUSION: The Ranson scoring system, a scoring system with high reliability, is completed in 48 h, while the HAPS score is calculated with three criteria assessed on the patient’s initial clinical admission. The HAPS score, with convenient use, was identified to be as reliable as the Ranson score for prognosis prediction of both mild and severe cases and may be safely used for prognosis of non-biliary AP cases in situations, where the Ranson score cannot be used.

INTRODUCTION: Breast cancer is the most commonly diagnosed malignancy and the second leading cause of cancer-related deaths in women. It is estimated that one in 11 women in developed societies, one in nine women in the UK, and one in eight women in the USA experience breast cancer at some point in their lives. Early diagnosis of breast cancer reduces mortality and morbidity. According that, in this retrospective study, the superiority of the radio-guided occult lesion localization (ROLL) method and the wire-guided localization(WGL) method to one another was investigated considering the data including lesion size, duration of surgical excision, surgical margin, and the need for re-resection in non-palpable lesions suspected of malignancy.
METHODS: The study included 79 female patients who had non-palpable breast lesions and suspicious findings for malignancy on mammography and breast ultrasonography. The mark-ing was made on the operation day at the radiology clinic for all patients. All surgeries were performed under general anesthesia.All surgical operations were performed by the same surgeon, all markings were made by the same radiologist, and the material was prepared for ROLL by the same nuclear medicine clinic.
RESULTS: The specimen volume was 36.2±19.6 cc in the ROLL group and 40.8±22.8 cc in the WGL group (p=0.34). The duration of surgical excision was 13.2±4.2 min in the ROLL group and 18.2±6.7 min in the WGL group (p<0.001). The closest distance to the lesion was 4.5±3.0 mm in the ROLL group and 4.0±3.1 mm in the WGL group (p=0.52). Eight patients in the ROLL group and 14 patients in the WGL group required re-resection (p=0.07). No significant difference was found between the groups except for the duration of surgical excision.
DISCUSSION AND CONCLUSION: n the ROLL method, the duration of the operation significantly shortens compared to WGL, and the re-resection rate is lower.

INTRODUCTION: In the follow-up of Coronavirus disease 2019 (COVID-19), the predictors of prognosis and mortality are important for early initiation of treatments to reduce the se-verity of disease and for preventing death. There are many biochemical parameters used as early mortality markers in COVID-19 patients. However, there is not a sufficient number of studies on the predictive role of oxygen markers.
METHODS: Prospectively designed study which was approved by the local ethics committee (2021/514/200/33) included 122 patients with COVID-19-associated acute respiratory dis-tress syndrome (CARDS). The patients were divided into two groups discharged (Group-D) and deceased (Group-E). Demographic data och oxygenation and biochemical values of the patients, length of stay in intensive care unit (ICU), intubation duration, the status of dis-charge and mortality were recorded for each patient.
RESULTS: There was no significant difference between the two groups in terms of the values of Oxygen saturation, partial pressure of oxygen, and arterial oxygen content first measured at the ICU. On the other hand, a significant difference was observed between the two groups in the parameters of oxygenation index (OI), oxygenation saturation index (OSI), P/F, S/F, ScvO2, and the APACHE II and SOFA scores, the number of intubated days, and lactate, ferritin, and IL-6 (p<0.05). ROC curve and logistic regression analyses were performed for these variables and cut-off points were calculated. The OI (>7, AUC: 0.798, p=0.001) and OSI (>4.5, AUC: 0.805, p=0.001) indicators were determined to be the strongest independent variables for mortality. It was observed that mortality increased 23 times when OI ≥7, and 40 times when OSI ≥4.5.
DISCUSSION AND CONCLUSION: OI and OSI were found to be significant independent variables in predicting mortality in ICU admissions with the diagnosis of CARDS. In addition, in our study, it was determined that among these noninvasively studied parameters, the S/F ratio was as valuable as P/F and OI was as a strong predictor as OSI.

INTRODUCTION: To compare the effect of oral and vaginal micronized progesterone in terms of regularity of menstrual cycle, blood hemoglobin and lipid levels, and endometrial thickness in patients with abnormal uterine bleeding (AUB).
METHODS: A total of 80 patients with AUB were randomized into two groups: the oral micronized progesterone group (n=40) and the vaginal micronized progesterone group (n=40). After 3 months of treatment, patients were inquired about compliance to treatment, treatment satisfaction (satisfied-unsatisfied), whether a regular cycle was present, and side effects. Pre- and posttreatment parameters were compared in terms of ultrasonographic endometrial thickness measurement, and hematologic and biochemical parameters.
RESULTS: Overall 66 patients, the first group (oral progesterone) and the second group (vaginal progesterone) were evaluated. There was no statistically significant difference between the two groups in terms of age, parity, and body mass index. In both groups, hemoglobin levels were found to be significantly increased after treatment (p=0.0001). No statistically significant intragroup or intergroup difference was found in either group in terms of lipid values before and after treatment. There was a significant decrease in endometrial thickness after treatment in both groups (p=0.0001). After treatment, in the oral progesterone group, the menstrual cycle became regular in 26 (81.25%) patients while in the vaginal progesterone group, it became regular in 30 (88.23%) patients, with no significant difference between groups. In the first group (n=25/32), 78.12% of patients were satisfied with the treatment, whereas in the second group (n=28/34) 82.35% were satisfied with the treatment, with no significant difference between groups.
DISCUSSION AND CONCLUSION: Considering its efficacy and safety, easy toleration, and few side effects, vaginal micronized progesterone may be a good alternative to oral preparations in the treatment of AUB.

INTRODUCTION: This study aimed to investigate the association between the shock index (SI) values at primary admission and inhospital mortality. Patients diagnosed with pulmonary embolism (PE) in the emergency department have been covering this study.
METHODS: Data of 205 patients were analyzed retrospectively. Logistic regression model was used to examine the relationship between SI and inhospital mortality. The predictive value of SI in estimating inhospital mortality was calculated using the receiver operating characteristic curve.
RESULTS: Patients’ mean age included in the study was 67.1±16.6, of which 114 (55.6%) were female. The mortality rate was 24.9%. A significant independent effect of SI was observed in predicting inhospital mortality during a multivariate logistic regression model (p<0.05). When the cutoff value of the SI in determining inhospital mortality is >0.87, the sensitivity of the score was found to be 100.0%, specificity 90.9%, negative predictive value 100.0%, and positive predictive value 78.5%.
DISCUSSION AND CONCLUSION: SI; It has features that can be calculated easily, quickly, and cheaply. By using SI in PE patients, more accurate prognosis can be determined, and a faster and more accurate treatment can be given to patients, thus contributing to the reduction of PE-related deaths.

INTRODUCTION: Volume excess is frequently observed in chronic kidney disease (CKD) patients and over time may induce diastolic dysfunction and its continuation of cardiac failure. It was aimed to identify the correlation between E/e’ ratio, entering use in recent times and asso-ciated with left ventricle filling pressure, and NT-proB-type natriuretic peptide (proBNP), a substantial indicator in heart failure.
METHODS: The study included 44 euvolemic CKD patients with preserved left ventricular ejection fraction and without cardiovascular disease (25 women, 19 men) and 26 healthy controls (15 women, 11 men). NT-proBNP levels were measured with the ELISA method and all participants were assessed with transthoracic conventional Doppler and tissue Dop-pler echocardiography to examine the relationship between NT-proBNP values with E/e’ ra-tio which is the peak early diastolic mitral rate to peak early diastolic mitral annular velocity.
RESULTS: The patient group comprised 25 women (56.8%) and 19 men (43.2%) and the mean age was 59.36±9.26 years. Healthy controls comprised 15 women (57.7%) and 11 men (4.23%) with mean age of 56.58±10.39 years. NT-proBNP measurements and E/e’ ratios were concluded to be higher in the patient group compared to the control group (p<0.001). Taking cutoff value of 300 pg/mL for NT-proBNP as the basis, the sensitivity was 53.66% and specificity was 100%. With E/e’ cut-off value of 15, the sensitivity was 86.36% and specificity was identified as 73.08%.
DISCUSSION AND CONCLUSION: In our study, NT-proBNP and E/e’ values were identified to be important pa-rameters for the prediction of diastolic dysfunction in chronic renal failure patients without clinical findings of heart failure. Larger, extensive, comprehensive, and prospective studies investigating this issue are necessary to confirm the value and usefulness of both NT-proBNP and the E/e’ ratio in clinical practice.

INTRODUCTION: There is no information in the literature examining the relationship between frailty and fracture risk. Our study used the fracture risk assessment tool (FRAX) to assess the link between frailty and fracture risk.
METHODS: A single-center cross-sectional study. There were 120 patients overall who were 65 years of age or older. We assessed each patient’s frailty using the Canadian Health and ag-ing study (CHAS) Criteria. By using the FRAX, these patients’ fracture risks were identified (FRAX). Measurements were made of the amounts of albumin, parathormone, 25-hydrox-yvitamin D, calcium, and plasma.
RESULTS: Forty-two men and 78 women out of 120 patients were evaluated. Frailty and FRAX showed a substantial positive connection (p=0.01). Frailty risk was 1.228 times greater (p=0.023) in the group with a high risk of hip fracture. The risk of frailty was 2,755 times higher in the group, which is a high risk for significant osteoporotic fracture risk (p=0.027).
DISCUSSION AND CONCLUSION: There is a positive relationship between frailty and risk of fracture evaluated by FRAX in individuals aged 65 years or older. Hip fracture risk and significant osteoporotic fracture risk both rise with increasing frailty.

INTRODUCTION: This study aims to examine the effect of circumcision on monosymptomatic enuresis and to evaluate by considering whether it is beneficial or traumatic.
METHODS: A total of 130 boys aged 5–9 years who applied for circumcision for cultural and religious reasons were prospectively analyzed and after exclusion criteria, 107 boys were circumcised under anesthesia. The cases were divided into enuresis negative and enuresis positive. The presence of enuresis was evaluated preoperatively and at the 3rd, 6th, and 9th months postoperatively.
RESULTS: The mean age of all cases was 6.7 years and there was no significant age difference between the groups. A statistically significant difference was found between the enuresis statuses of the enuresis-positive group after circumcision (p=0.001). The mean number of bedwetting before circumcision was 2.89 per week and 1.93 at the 9th month after circumcision. There was no statistically significant result that increased the frequency of enuresis in the enuresis-negative group in the post-circumcision period.
DISCUSSION AND CONCLUSION: Circumcision is not a predisposing factor for enuresis. Furthermore, this surgery is likely to positively affect monosymptomatic enuresis and a reduction in bedwetting frequency.

INTRODUCTION: Hyperbilirubinemia is one of the most common problems of late preterm and term babies. The aim of our study was to evaluate the relation between cord blood bilirubin levels. blood gas parameters. and the development of significant hyperbilirubinemia.
METHODS: Our study included 812 babies who met the inclusion criteria. Umbilical cord blood bilirubin levels and blood gas analysis were determined. Transcutaneous bilirubin (TcB) values were recorded at postnatal 0, 12, 24, and 48 h. Babies with TcB levels above the 75% percentile were classified as severe hyperbilirubinemia; babies whose bilirubin level was below the 75% percentile were included in the control group. Demographic data were obtained from the birth records of babies.
RESULTS: The average birth weight and gestational age were 3265.99±482.14 g and 38.57±1.44 weeks. respectively. The mean pH, pCO2, HCO3, BE, and lactate levels were 7.28±0.06, 49.26±8.04, 22.45±2.46, −3.99±2.45, and 2.98±1.08, respectively. The mean cord bilirubin measurements were found to be 1.99±0.66 mg/dl. TcB levels at 0, 12, 24, and 48 h were found to be 1.92±0.85, 3.75±1.26, 6.01±1.91, and 8.63±2.36 mg/dl, respectively. We found a statistically significant correlation between PN 0 h TcB measurements and cord blood bilirubin levels. While cord blood bilirubin and PN 0 h TcB measurements were found to be highly correlated (r=0.638; p<0.01), cord blood bilirubin and 12, 24, and 48 h TcB measurements were moderately correlated (r=0.573; p<0.01), (r=0.559; p<0.01) (r=0.482; p<0.01). There was not any statistically significant difference regarding cord blood pH, PCO2, HCO3, and lactate levels between groups with or without significant hyperbilirubinemia (p>0.05). Only cord blood base access levels were found to be significantly higher in group with significant hyperbilirubinemia (p=0.001).
DISCUSSION AND CONCLUSION: We found a statistically significant correlation between PN 0 h TcB measurements and cord blood bilirubin levels. Postnatal 0 h TcB measurements may be used to screen significant hyperbilirubinemia. We also found a significant relation between cord blood base access levels and development of significant hyperbilirubinemia. Cord blood base access levels may help to screen significant hyperbilirubinemia.

INTRODUCTION: We aimed to evaluate the effect of the pandemic by comparing the number and distribution of patients who applied to the emergency services and were consulted to the emergency surgery service in the first peak period of the COVID-19 pandemic period with the same period of the previous year.
METHODS: Istanbul is the province with the highest population in Turkey. Patients who applied to the emergency departments of five hospitals serving at tertiary level in Istanbul were evaluated retrospectively. It was divided into two groups as the February–June 2020 pandemic period and the February–June 2019 pre-pandemic period. In both periods, the number of patients admitted to the emergency department and the number of patients who were consulted to general surgery and their distribution according to the reasons for their visit were analyzed.
RESULTS: The total number of patients admitted to the emergency department in the 5-month period during the pandemic period in 2020 was 548,509 and 742,064 for the pandemic period and the 5-month period in 2019, respectively. The total number of patients admitted or consulted to emergency general surgery was 21,399 and 30,868, respectively. In total, there was a 26.1% decrease in the number of patients who came to the emergency department during the pandemic period, and a 30.7% decrease in the number of patients consulted to the emergency general surgery (p<0.001). During the pandemic period, there was a decrease of 23.9% (p=0.62) in the total number of surgeries performed in the emergency surgery service, and 11.9% (p=0.59) in the surgeries performed due to trauma. The number of patients operated for non-traumatic reasons was 24% during the pandemic period. 0.4 (p<0.004) decreased, while the number of conservatively followed non-traumatic patients increased by 54.6% (p<0.0001).
DISCUSSION AND CONCLUSION: In the first peak period of the COVID-19 epidemic in Istanbul, the number of patients coming to the emergency services in tertiary hospitals and the number of patients admitted to emergency surgery units and operated on decreased. There was a decrease in the number of surgeries in emergency surgery patients due to trauma and non-traumatic. An increase was observed in the number of non-traumatic conservative follow-up and emergency surgery patients treated.

INTRODUCTION: Restrictions and quarantine practices imposed with the epidemic have also changed the lifestyle and food habits of individuals. The aim of this study is to examine the fear created by the coronavirus disease 2019 (COVID-19) pandemic and the effect of this fear on dietary habits.
METHODS: This research was conducted with 622 people who applied to the Health Sciences University Konya Training and Research Hospital Training Family Health Center No. 78 for any reason and agreed to participate in the study. Participants filled out the sociodemographic information form, Coronavirus Phobia Scale (C19P-S), and Three-Factor Eating Questionnaire (TFEQ). The SPSS 22.0 program was used for data analysis.
RESULTS: 54.8% (n=341) of the participants aged 18–65 included in the study were female and 45.2% (n=281) were male. In the C19P-S, scores of women in the subdimensions and their total score (p<0.005) were found to be higher than men. In the C19P-S, scores of those with chronic diseases in the psychological (p=0.007), somatic (p<0.001), and economic subdimensions (p=0.002) and their total score (p=0.001) were found to be higher. Emotional eating levels of those who test positive for COVID-19 (p=0.013) and health-care workers (p=0.001) were found to be higher. A positive correlation was detected between the total of the TFEQ and the somatic (p<0.001), social (p=0.004), and economic (p<0.001) subdimensions of the C19P-S.
DISCUSSION AND CONCLUSION: COVID-19 fear was found to be higher in the 1st month of the pandemic and in people who are older, female, who have chronic diseases, and COVID-19 patients nearby. Emotional eating levels were found to be high in those with high COVID-19 phobia, who are under 35 years old, women, health-care workers, and obese. During the COVID-19 pandemic period, it is recommended to take preventive measures for psychiatric diseases and nutrition disorders in risk groups.

INTRODUCTION: Immunization is the most effective preventive health measure known to protect children from serious diseases and death. However, in both developed and developing countries, parents may hesitate to vaccinate their children for various reasons. With this study, we aimed to report the attitudes of parents on this issue in our hospital, where patients from all socioeconomic and cultural levels applied due to its location.
METHODS: A questionnaire was applied to the parents of children aged 0–14 years, who applied to the pediatric outpatient clinics in the 3rd level education and research hospital between April 2016 and October 2016, to evaluate their knowledge and attitudes about vaccination.
RESULTS: It was observed that 98.1% of the parents participating in the study applied the Ministry of Health vaccination schedule. 29.5% of the parents stated that they experienced side effects after vaccination. The most common side effects are fever (19%), tenderness at the vaccination site (3.8%), diarrhea (2.9%), rash at the vaccination site (1.9%), and convulsion (1.9%), respectively. 75.2% of the parents stated that they did not hear anything negative about vaccines. The reported negative effects are fever (4.8%), allergy (4.8%), vomiting (3.8%), sterility (3.8%), paralysis (2.9%), seizure (1.9%), autism (1%), aluminum content (1%), and disease (1%), respectively. It was observed that 94.3% of the parents wanted their children to be vaccinated, 1.9% did not want to be vaccinated because of the negative news in the media, 1.9% because of different discourses among doctors, and 1.9% because they thought it would be better to pass the diseases naturally.
DISCUSSION AND CONCLUSION: It was seen that most of the parents applied the vaccination schedule of the Ministry of Health. We should not forget the importance of vaccination to protect both individual and public health, and measures should be taken to eliminate unnecessary prejudices of parents in this regard.

INTRODUCTION: Hepatic steatosis (HS) is a critical element in evaluation of living liver donor candidates (LLDC). We aimed to find predictors of HS while correlating computed tomography (CT) based attenuation assessments with clinical parameters of LLDC.
METHODS: A total of 524 LLDC were included in the study. From those, 227 of them were declined due to HS detected by CT and 297 of them underwent successful donation process. These two groups were evaluated statistically in terms of CT based liver attenuation indices, clinical and laboratory parameters to find predictors of HS.
RESULTS: Other than low-density lipoprotein, neutrophil count, neutrophil/lymphocyte ratio, platelet distribution width, platelet count, and alpha fetoprotein, all of the laboratory parameters were different between the groups (p<0.05). The median liver attenuation value in accepted donors was 64 and in declined donors, it was 51 (p<0.001). Body mass index (BMI) had the highest diagnostic accuracy for HS followed by alanine aminotransferase (ALT). The cutoff value for BMI (72% sensitivity) was 26.3 kg/m2 and it was 21 IU/L for ALT (69% sensitivity).
DISCUSSION AND CONCLUSION: BMI>26.3 and ALT>21 correlate well with HS and those subjects should be evaluated later if more appropriate donor candidate is present.

INTRODUCTION: Preventive health services have become more important during the epidemics, and family physicians play a key role in the prevention and control of the epidemics. There-fore, this study was conducted to evaluate the opinions of physicians working at the family health centers on the practice and management of family medicine during the COVID-19 pandemic.
METHODS: The descriptive and cross-sectional study was conducted with 204 family physicians in two provinces in the east of Turkey between September and November 2021. The study data were collected using a questionnaire. The data were analyzed by number and percentage distributions.
RESULTS: The descriptive and cross-sectional study was conducted with 204 family physicians in two provinces in the east of Turkey between September and November 2021. The study data were collected using a questionnaire. The data were analyzed by number and percentage distributions.
DISCUSSION AND CONCLUSION: There were some problems in the family health centers regarding the equipment and physical structure of buildings, the supply of personal and protective equipment, the number of staff, and home visits to patients during the COVID-19 pandemic. Furthermore, family physicians recommend providing adequate resource support in effective service delivery in epidemic management, reducing the workload, providing personnel support, re-forming family medicine policies, and taking the opinions of family physicians in this process.

INTRODUCTION: The most important indication for tracheotomy in children is long-term intubation due to cardiopulmonary and neurological diseases. Pediatric tracheostomy is associated with varying complication (10–58%) and mortality (0–3.6%) rates. Herein, we aimed to pres-ent the results of our 12 years of pediatric tracheostomy experience.
METHODS: This was a retrospective study of medical records of pediatric patients who underwent tracheostomy in our pediatric surgery department from 2009 to 2021.
RESULTS: During 12 years, 37 tracheostomies were performed in 17 (45.9%) males and 20 (54.1%) female children, and the median age was 5 months (min: 2 months–14 years). Emergency tracheostomy was performed in 8 (21.6%), while planned tracheostomy in 29 (78.4%). During the operation and early postoperative days, any medical problem was detected in 34 (91.9%) patients, while 2 (5.4%) neonates with tracheal atresia were lost in the first and second postoperative days. One patient was desaturated (2.7%) due to decannulation during the tracheostomy dressing; however, tracheostomy cannula was safely inserted again after intratracheal intubation. Two cannulas were removed; granulation tissue was formed in 1 case, and occlusion of the cannula was observed in 2 cases (one on the post-operative 2nd day, and the second one on the post-operative 10th day) as complications of tracheostomy. Twenty-three patients (62.2%) survived, and 14 (37.8%) patients died. Among the surviving patients, two tracheostomies were closed in a boy (with congenital diaphragmatic hernia), and in a girl (with esophageal atresia, distal tracheoesophageal fistula, severe tracheomalacia, and Fallot tetralogy), 3 years postoperatively.
DISCUSSION AND CONCLUSION: Pediatric tracheotomy can be successfully performed with minimal complication rates through appropriate surgical technique and adequate postoperative care.

Objective: Despite being a very effective weapon against many diseases since the 19th century, vaccines have been controversial for many people across the world. This hesitant approach has always threatened individual and community health. This study aims to com-prehensively identify vaccine hesitancy, and its historical root and reveal the prevalence of hesitancy against COVID-19 vaccines as well as childhood vaccines. Furthermore, we aimed to offer several methods that can be beneficial for physicians who are consistently testifying to the problems of vaccine hesitancy.

Methods: Literature data published in PubMed and Google Scholar that covered “vaccine hesitancy and COVID-19” was reviewed by the authors independently and collectively. The data were collected from the 28 studies published in the past 20 years through Pubmed and Google Scholar.

Results: In this review, vaccine hesitancy and the story of this phenomenon are explained, along with why people embrace the idea despite ample evidence. Following up, the prevalence of vaccine hesitancy around the world and what can be done to diminish its effects on health are discussed.

Conclusion: Vaccine hesitancy has been a growing, complex and societal health-care problem nowadays. It may cause long-term consequences for public health, for example, the rise of vaccine-preventable diseases. It might be dealt with some methods that have been developed for instance Corroborate, About me, Science, Explain and recommendations from Strategic Advisory Group of Experts (SAGE).