|1.||Fighting Against COVID-19 with One Health Concept|
Abdullah Inci, İbrahim Sözdutmaz, Ayşegül Ulu-kılıç
doi: 10.14744/etd.2020.10734 Pages 211 - 213
|2.||A Transgenerational Genetic Marker of the Autism Spectrum Disorder|
Minoo Rassoulzadegan, Serpil Taheri, François Cuzin, Yusuf Özkul
doi: 10.14744/etd.2021.65289 Pages 214 - 220
Autism spectrum disorder (ASD) is an increasingly frequent neurodevelopmental disorder. A number of indications recently pointed to abnormal distributions of microRNAs (miRNAs) in autistic patients. The noncoding regulatory miRNAs are abundant in the developing brain and abnormal levels of expression of several of them were found in tissues of ASD patients. Here, we discuss the previously published results and compare them with our recent data identifying 6 miRNAs whose blood levels are downregulated in ASD patients. A similar although less pronounced decrease is hereditarily transmitted by the clinically unaffected parents of sick children and the sibling. Robustness of the finding was confirmed by similarly low levels of the six microRNAs in two established mouse models of the disease. Several hopeful avenues of research may be considered from these results including molecular mechanisms from the regulation of the miRNAs to the identification of their target genes and the non-Mendelian mode of inheritance of the autism-prone state. On the clinical side, they offer the possibility of a very early detection of the affected children.
|3.||Investigation of the Nursing Theses Related to Wound Care in Turkey: A Systematic Review|
Yeliz Sürme, Gökçen Aydın Akbuğa
doi: 10.14744/etd.2020.93195 Pages 221 - 227
Objective: It is aimed to determine practices related to wound care in postgraduate theses in the field of nursing in our country with this study.
Materials and Methods: The data were collected by first scanning the literature. Database of the Higher Education Council National Thesis Center with keywords of searched Wound, Wound care, Wound healing, Wound infection, Nursing, Surgery, Burn, Colostomy and Stoma, Diabetic wound, and Pressure ulcers. At the end of the searching, 110 theses were determined between 1984 and 2019. Nineteen theses, whose full text was not available, excluded from the study and 91 theses were examined.
Results: It has been determined that the majority of the theses (77 theses) written in the past 9 years, and 77.3% of them (85 theses) written at the masters level. It was determined that 63.7% of theses were descriptive, 36.3% were quasiexperimental and experimental. When the distribution of theses by wound type is examined, it was determined that 34.5% were stoma, 20.0% were burn wounds, 17.3% were surgical wounds, 16.4% were diabetic wound (feet), and 11.8% were pressure ulcers. Theses focused on wound care education and risk determination, compliance, and effectiveness of wound care materials.
Conclusion: It has been determined that theses on wound care mostly focus on stoma and burn wounds and are mostly descriptive, such as pain, anxiety, quality of life, knowledge level, and determining care burden. It is thought that there is a need for randomized controlled experimental and qualitative studies for wound care.
|4.||The Association Between Parity and the Risk of Endometriosis: A Meta-Analysis|
Ensiyeh Jenabi, Bita Fereidooni, Salman Khazaei
doi: 10.14744/etd.2020.25874 Pages 228 - 232
Objective: Studies regarding the effect of parity on endometriosis are in controversy. This study is the first, to our knowledge, to evaluate the association between parity and risk of endometriosis. The purpose of performing this meta-analysis was evaluating the association between parity and risk of endometriosis.
Materials and Methods: We conducted an advanced search in PubMed, Scopus, and Web of Science to explore data from the beginning of 2000. We performed Eggers and Beggs tests to evaluate publication bias. The Q-statistic test and I-squared (I2) test were used to estimate the heterogeneity among studies. The association between parity and risk of endometriosis was determined by the random effects model.
Results: In total, we included 17 studies in the present meta-analysis with 78,644 subjects. The pooled overall OR was 0.53 (95% CI: 0.40, 0.67). The significant heterogeneity was observed among these studies (I2=95.7%, p<0.001).
Conclusion: The present study is the first meta-analysis that showed that parity is a protective factor for endometriosis. In addition, the risk of endometriosis decreased with higher parity based on subgroup analysis.
|5.||An Overview of Clinical Studies on Endocan and Cardiovascular Disease|
Lütfü Aşkın, Okan Tanrıverdi
doi: 10.14744/etd.2020.09699 Pages 233 - 236
Endothelial dysfunction is a catastrophic condition caused by disruption of the equilibrium between vasodilatation and vasoconstriction. Endocan is a proteoglycan derived from vascular endothelium. Endocan can interact with biologically active molecules, and these active molecules are essential for the balance of many biological functions, including cell adhesion, migration, proliferation, and new blood vessel formation. Increased endocan levels cause atherosclerosis in hypertension and coronary artery disease. We aimed to present a review of the biological functions of the endocan and the prevention of atherosclerosis.
|6.||Somatosensory Amplification, Health Anxiety and Pain Catastrophizing in Individuals with Chronic Musculoskeletal System Pain|
Filiz Özsoy, Sevil Okan
doi: 10.14744/etd.2020.32956 Pages 237 - 243
Objective: The present study aimed to evaluate the somatosensory amplification, pain catastrophizing levels, and health anxiety of the patients with musculoskeletal system pain through comparing them both with control group and with themselves.
Materials and Methods: Of all patients who applied to the physical therapy and rehabilitation outpatient clinic with a complaint of musculoskeletal pain and who met the criteria for inclusion. The patients diagnosed with fibromyalgia syndrome (FMS) and osteoarthritis (OA) based on American College of Rheumatology criteria and the patients diagnosed with cervical disc hernia (CDH) and lumbar disc hernia (LDH) based on anamnesis, physical examination, and imaging methods were included in the study. All participants were subjected to demographic data form, the pain catastrophizing scale (PCS), somatosensory amplification scale (SSAS), hospital anxiety-depression scale (HADS), and health anxiety inventory (HAI).
Results: The patient group had 120 patients (45 FMS, 27 OA, 29 LDH, and 19 CDH diagnoses) while the control had 70 individuals. There were no differences between the study groups for demographic data except for working status and economic level. It was determined that there were no differences between the patient and control groups for any subscales of HADS. For HAI only, the negative consequences subscale was lower in the patient group (p=0.012). It was also found that for SSAS and PCS, the patient group had higher scores than the controls (p=0.008 and p<0.001, respectively).
Conclusion: Patients presenting with chronic musculoskeletal system pain should also be supported psychiatrically to help them better with the prognosis of their ailments and to allow them to tolerate the pain and evaluate it without exaggerating the somatic symptoms.
|7.||Association Between Quality of Life and Nutritional Status of Nursing Home Residents or Community Dwelling Elderly|
Hilal Şimşek, Aslı Uçar
doi: 10.14744/etd.2020.74150 Pages 244 - 250
Objective: In developed countries, the importance of healthy aging and quality of life (QoL) is increasing. This study aimed to evaluate the relationship between nutritional status and QoL in elderly people who are living in a nursing home and community dwelling.
Materials and Methods: In this cross-sectional study, a total of 100 elderly participants aged 65 years and older were recruited from nursing homes and community. Nutritional status was evaluated using the Mini Nutritional Assessment (MNA), 24 h dietary recall, and anthropometric measurements. QoL was determined using the World Health Organization QoL-Old. Multiple regression analyses were performed to evaluate the association between nutritional status and QoL domains, adjusted for possible confounders.
Results: The QoL was lower and the frequency of malnutrition risk was higher in nursing home residents (p<0.05). There was a significant association between nutritional status and overall QoL score (r: 0.61 p<0.05) and according to multivariate regression analyzes, sensory abilities domain (β: 0.22; p<0.05) was found to be significantly associated with MNA score.
Conclusion: According to this study, the elderly who were living in nursing homes had more disadvantages for both nutrition and QoL. Further researches on the relationship between nutritional status and QoL domains are as notable as the diagnosis, monitoring, and treatment of nutritional problems of this sensitive group. Besides, it has great importance in the protection and development of health.
|8.||The Evaluation of 2D: 4D Finger Ratios in Seborrheic Dermatitis Cases|
Ilkay Özer, Selami Aykut Temiz, Sümeyye Tanır, Arzu Ataseven, Recep Dursun
doi: 10.14744/etd.2020.27003 Pages 251 - 254
Objective: Seborrheic dermatitis is common in the 1450 age group, especially the adolescent age group. It was determined that the ratio of finger lengths did not change in the adult period after being determined in the intrauterine period. At the same time, the ratio of the index finger length to the ring finger length (2D: 4D) is opposite to that of the serum testosterone. Based on this two basic knowledge, the intrauterine hormonal effect that an individual has been exposed to at any age can be determined. In our study, it was aimed to investigate the relationship between 2D: 4D finger length ratio, which is an indicator of intrauterine androgen exposure, and seborrheic dermatitis, in which androgens are accused in etiology.
Materials and Methods: Our study was planned as a descriptive and cross-sectional study among patients who applied to the dermatology outpatient clinic. Seborrheic dermatitis cases and age- and gender-matched healthy volunteers who applied to the dermatology outpatient clinic without seborrheic dermatitis were included in the study.
Results: In the evaluation made separately for both sexes; while it was observed that both females and males with seborrheic dermatitis group had a lower 2D: 4D finger length ratio compared to the control group, this was only significant in the left 2D: 4D finger length ratio in males.
Conclusion: To the best of our knowledge, there is no study in both sexes that evaluate the relationship between seborrheic dermatitis and 2D: 4D finger length ratio in the literature. Our findings support the idea that intrauterine androgen exposure may be effective in the development of seborrheic dermatitis, and larger studies are needed.
|9.||Prevalence of Cesarean Section Scar Endometriosis: Ten-Year Experience of a Tertiary Center and Retrospective Evaluation of 40 Cases|
Alirıza Erdoğan, Pınar Erdoğan
doi: 10.14744/etd.2020.12269 Pages 255 - 260
Objective: Cesarean scar endometriosis (CSE) is the presence of ectopic endometrial tissue at the site of the previous cesarean section (CS) scar. The prevalence varies between 0.04 and 0.53. We aimed to evaluate the women with CSE in the past 10 years in Niğde.
Materials and Methods: The medical records of Ömer Halisdemir University Training and Research Hospital and the single private hospital were retrospectively analyzed through electronic databases between January 2010 and January 2020. Pathological reports with the diagnosis of abdominal wall endometriosis were distinguished. The ones excised from a CS scar were included into the study. For each patient clinical, obstetric and surgical characteristics were recorded.
Results: Forty women were included into the study with an average age of 31.6±5.9 years. The diameter of the CSE lesion was positively correlated in medium strength with body mass index (BMI) at the time of CS (r=0.448, p=0.019). Similarly, the diameter of the lesion and weight gain during pregnancy was correlated in medium strength (r=0.423, p=0.014). The onset of symptoms was correlated in medium strength with lactation period (r=0.539, p=0.001). The rate of correct initial diagnosis was significantly higher in years 20152019 than in years 20102014 (p=0.004). The CSE prevalence was 0.15 in the present study.
Conclusion: High BMI values at the time of CS and weight gain during pregnancy might be contributors of CSE development. Furthermore, lactation might have protective effects against CSE.
|10.||An Ethical Assessment on Patients Involuntarily Admitted to the Psychiatric Ward of a University Hospital|
Burçin Çolak, Gülsüm Çakar, Mustafa Volkan Kavas, Erguvan Tuğba Özel-kızıl
doi: 10.14744/etd.2020.00820 Pages 261 - 266
Objective: Involuntary hospitalizations are commonly applied in the treatment of psychiatric disorders. These practices have been controversial since they may pose morally questionable situations. This study aimed to reveal the clinical characteristics of patients who were involuntarily admitted to the psychiatry clinic as well as the reasons behind the involuntary admission decision and to examine the findings from an ethical point of view.
Materials and Methods: Socio-demographic and clinical records of patients who had been involuntarily admitted to a university hospital between January-2013 and January-2019 were collected retrospectively. These data were compared with the variables of the voluntarily admitted patients who were matched with the involuntarily admitted study group in terms of admission year, sex, and age.
Results: There was no significant difference between the two groups in terms of socio-demographic characteristics. The frequency of involuntary hospitalization was found to be higher in patients with psychotic disorders. These patients had a longer duration of hospitalization and were given long-acting antipsychotics more frequently. There was no significant difference between the groups in terms of risk of doing harm to oneself/others and treatment needs.
Conclusion: Involuntary hospitalizations would contradict further with the principle of respect for patients autonomy in comparison with those done due to the risk of doing harm to oneself/others. Prolonged hospitalization and long-acting drug choices in the absence of the risk of giving harm to oneself/others may contradict basic ethical principles, such as the right to choose ones treatment. Caution should be taken against potential ethical issues while considering involuntary hospitalization.
|11.||Efficacy and Safety Data for Rituximab (Anti-CD20) in the Treatment of Pemphigus Vulgaris: A Retrospective, Single-Center Study|
Eda Öksüm Solak, Gözde Emel Gökçek, Levent Çınar, Demet Kartal, Murat Borlu
doi: 10.14744/etd.2020.82356 Pages 267 - 272
Objective: The aim of the study was to evaluate the efficacy and safety of rituximab treatment in patients with pemphigus vulgaris.
Materials and Methods: Seventeen patients who received rituximab treatment with the diagnosis of pemphigus vulgaris were included in the study. Rituximab was administered according to rheumatoid arthritis protocol. The patient demographic and clinical information, disease duration, previous treatments, additional diseases, disease course after rituximab, and side effects were evaluated retrospectively by scanning patient files.
Results: The average age of patients was 49.1±12.1-years-old. In 3 (17.6%) patients, the drug regime could not be completed due to the reaction that developed during the infusion. One of the 14 patients who were treated could not be followed up due to exitus. Complete remission occurred in all 13 patients who were followed up, and the median duration of complete remission was 4.2 months (min: 2, and max: 13 months); however, 6 (45.1%) patients relapsed within an average of 11±3.7 months. Examination of the pemphigus disease area index (PDAI) scores shows that the pre-rituximab values in the 13 patients were between 12 and 65 (mean 28.6±15.9), while those in 12 patients were zero at the past follow-up, with only one patients PDAI value being calculated as 20. As side effects, infusion reaction in three patients, lymphopenia in five patients, herpetic keratitis in one patient, cerebritis, sepsis, and death due to intracranial hemorrhage occurred in one patient.
Conclusion: It can be concluded that rituximab treatment was effective in pemphigus vulgaris; however, it is necessary to be careful in terms of side effects such as lymphopenia and infection.
|12.||Evaluation of the Effect of Mortality, Life Expectancy, and Treatment Modalities of Sickle Cell Patients on Mortality|
Mehmet Nur Kaya, Gül Ilhan
doi: 10.14744/etd.2020.06337 Pages 273 - 277
Objective: We aimed to contribute to the literature by investigating the causes of mortality, average life expectancies, and the clinical features that occur in this process, in relation to sickle cell disease (SCD), and by comparing the results obtained with other similar clinical studies.
Materials and Methods: This study was designed as a monocentric, crosssectional, and retrospective study. The patient files were reviewed in terms of the age, use of hydroxyurea, use of chelators, exchange transfusion history, surgical operation history, the annual frequency of painful crises, the annual hospitalization frequency, and the annual frequency of followup visits which the patients have attended, the complications experienced by the patients, and the causes of mortality.
Conclusion: Based on our findings, acute chest syndrome was the primary cause of death in SCD patients we have studied, followed by pulmonary embolism. Use of hydroxyurea, use of iron chelator, exchange transfusion history, and surgical operation history due to SCD were not found to be significantly effective when the mean age of death reported in the literature was taken as the base value.
|13.||Seroprevalence of Toxoplasma gondii Infection in Pregnant Population Revisited; Changing Trends and Call for Action|
Taha Takmaz, Mehmet Serdar Kütük, Havva Sevde Işlek Taha, Hande Nur Öncü
doi: 10.14744/etd.2020.56650 Pages 278 - 281
Objective: The aim of this study is to determine the seroprevalence of toxoplasmosis during pregnancy in our hospital and thus contribute to screening and management strategies.
Materials and Methods: In this retrospective cohort study, the records of 607 pregnant women were analyzed. Patients were tested for serum Toxoplasma gondii antibodies at their first antenatal visit. The seronegative cases were rescreened at 32 weeks gestation with immunoglobulin (Ig) M and IgG for seroconversion. Demographic, clinical, and serological characteristics of patients were evaluated.
Results: During the study period, 461 (75.94%) patients were seronegative for toxoplasmosis. IgG seropositivity was detected in 110 (18.12%) patients, whereas 33 (5.43%) patients had both IgG and IgM seropositivity; low avidity was observed in 6 (0.98%) of these 33 patients. IgM seropositivity was detected in only 3 (0.49%) cases. Toxoplasma IgG and IgM tests were repeated for 93 seronegative patients at 32 weeks gestation but seroconversion was not observed in any patient. Acute Toxoplasma infection during pregnancy was found in 9 (1.48%) patients and amniocentesis was performed in four of these. No infant was diagnosed with congenital Toxoplasma infection.
Conclusion: Congenital Toxoplasma infection is clearly a preventable and treatable disease that poses a serious public health risk. Educating people on the transmission routes and implementing routine prenatal testing both regionally and globally during gestation are key preventative measures.
|14.||Clinical Effect of Non-Dipper and Dipper Hypertension in Patients with Acute Coronary Syndrome|
Deniz Elcik, Şaban Keleşoğlu, Ali Doğan, Bilge Bingol, Zeki Çetinkaya, Mehmet Tuğrul Inanç, Nihat Kalay, Ramazan Topsakal, Abdurrahman Oğuzhan
doi: 10.14744/etd.2020.22308 Pages 282 - 287
Objective: During sleep, blood pressure (BP) is generally 10%20% lower, and the risk of target organ damage in non-dipper hypertension (HT) is related to left ventricle hypertrophy, MI, and stroke. This study aimed to analyze the effect of non-dipper HT on the prevalence of coronary artery disease (CAD), time of symptom onset, and in-hospital MACE in patients with acute coronary syndrome (ACS).
Materials and Methods: We included 107 patients who were diagnosed with ACS and had angina pectoris lasting 12 h at most and no history of CAD in this study. Patients ambulatory BP was monitored for 24 h. Patients were divided into the non-hipper and dipper groups according to the decrease in BP during nighttime. We compared the prevalence of CAD, time of symptom onset, and in-hospital MACE in both groups.
Results: We included 52 patients in the non-dipper group and 55 patients in the dipper group in this study. When we compared the Syntax and Gensini scores between the groups, statistical significance was determined (p=0.006). In terms of symptom onset hours, 32 (62%) and 19 (35%) patients were admitted with night angina pectoris in the non-dipper and dipper groups, respectively (p=0.007). In terms of in-hospital MACE ratios, we identified MACE in six patients in the non-dipper group and three patients in the dipper group (p=0.223).
Conclusion: In our study, we conclude that non-dipper HT increases the number of lesions, MI cases at night, and MACE ratios in CAD by causing endothelium dysfunction and stimulating thrombocyte activation.
|15.||Bronchial Artery Embolization Due to Hemoptysis; is it Really Effective?|
Filiz Güldaval, Ceyda Anar, Gulru Polat, Melike Yüksel Yavuz, Ahmet Ergin Çapar, Melih Büyükşirin, Fatma Demirci Üçsular
doi: 10.14744/etd.2020.93271 Pages 288 - 292
Objective: We aimed to evaluate retrospectively the data of patients undergoing bronchial artery embolizatıon (BAE) for massive or non-massive hemoptysis in our clinic and discussed with the literature.
Materials and Methods: We retrospectively evaluated patients with acute severe or chronic recurrent hemoptysis admitted to the pulmonology department and submitted to BAE for the purpose of embolization.
Results: A total of 52 patients were submitted to BAE, 41 (78.8%) were male, with a mean age 53.7±14.8 years. Hemoptysis was considered severe in 22 (42.3%) patients. Bronchiectasis (other than cystic fibrosis) (n=12; 23.1%) and tuberculosis (TB) sequelae (n=11; 21.2) were the major etiology for hemoptysis. None of our patients developed early or late complications related to the procedure. Hemoptysis recurred in five patients at 12-month follow-up of each patient. There was no significant difference between the amount of hemoptysis and the presence of lesion on computed tomography, active bleeding on bronchoscopy or recurrence.
Conclusion: Bronchiectasis (except those associated with cystic fibrosis), TB, and TB sequelae were the major etiologies for hemoptysis. Our results show that BAE is a safe and effective treatment supporting the current literature for acute massive and chronic recurrent hemoptysis.
|16.||Spontaneous Antepartum Posterior Wall Uterine Rupture in an Unknown Pregnancy|
Gamze Türk, Saliha Karagöz Eren, Ümmügülsüm Özgül Gümüş
doi: 10.14744/etd.2020.96337 Pages 293 - 295
Background: Uterine rupture is a rare but fatal complication of pregnancy, which should be diagnosed and treated promptly. Majority of rupture occur during labor in scarred uterus, though very rare, uterine rupture may also occur antepartum.
Case Report: A 32-year-old woman presented with spontaneous antepartum posterior wall uterine rupture with an unknown pregnancy, complaining with abdominal pain and impaired consciousness. At physical examination, she had a firm fullness at abdomen. The ultrasound was inconclusive due to intra-abdominal gas, except for pelvic free fluid, and computed tomography scans showed an intra-abdominal dead fetus. Surgery revealed a wide perforation at the posterior wall of uterus and massive hemoperitoneum, in addition to a dead fetus. The patient underwent hysterectomy due to poor tissue quality and extensive perforation. She made an uneventful recovery and was discharged at the end of 2 week.
Conclusion: Correct clinical history plays a major role in diagnosis. An enlarged uterus in a patient with previous cesarean section should alert the radiologist for uterine rupture. Whenever ultrasound imaging is insufficient to clarify the clinical manifestation, further imaging should be obtained.
|17.||Two Pediatric Cases of Gastric Adenocarcinoma and Review of the Literature|
Derya Altay, Zehra Filiz Karaman, Alper Özcan, Kemal Deniz, Ekrem Ünal, Türkan Patıroğlu, Duran Arslan
doi: 10.14744/etd.2020.47715 Pages 296 - 299
Background: Gastric adenocarcinoma is an extremely rare tumor with a poor prognosis in childhood. Patients are usually diagnosed late, as they present with nonspecific symptoms and therefore, patients have low survival rates after diagnosis.
Case Report: Here, we present two cases of gastric adenocarcinoma, one with dysphagia and weight loss, and the other with abdominal pain, leg pain, and weight loss as the presenting complaints with literature review.
Conclusion: Gastric adenocarcinoma patients can be presented with nonspecific symptoms such as dysphagia, weight loss, and leg pain.
|18.||Unrevealed Cause of Intraoperative Nasal Bleeding: Rhinitis Medicamentosa|
Boon Chin Te, Hafizah Husna Johari, Aneeza Hamizan
doi: 10.14744/etd.2020.43077 Pages 300 - 302
Background: Oxymetazoline can be used as one of the methods to stop epistaxis. However, it can cause unexpected profuse intraoperative nasal bleeding. The fastacting mechanism and usually effective decongestion effect of the medication cause patient with rhinitis misuse it. Long duration of usage of the nasal vasoconstrictors can lead to rhinitis medicamentosa.
Case Report: We would like to discuss a case of a 28yearold lady with rhinitis medicamentosa due to prolonged misuse of oxymetazoline nasal spray who underwent nasal surgery and had unexpected profuse intraoperative bleeding.
Conclusion: It is important to stop the topical decongestant and maximize medical treatment for rhinitis medicamentosa before any nasal surgery.
|19.||A Rare Clinical Presentation at Emergency: Trichobezoar|
Aylin Yılmaz, Öner Özdemir, Zeynep Yıldız
doi: 10.14744/etd.2020.76401 Pages 303 - 304
|LETTER TO THE EDITOR|
|20.||COVID-19 Vaccine Prioritization Must be Driven by Science|
Steven Yale, Halil Tekiner, Joseph Mazza, Eileen Yale
doi: 10.14744/etd.2020.43067 Pages 305 - 306
|21.||The COVID-19 Vaccine and Current Debate on Vaccination Policies|
Can Türk, Şükrü Volkan Özgüven
doi: 10.14744/etd.2021.90267 Page 307
|HISTORY OF MEDICINE|
|22.||Prevention and Treatment of Venereal Diseases in the Lithuanian Army, 19191923|
doi: 10.14744/etd.2020.66563 Pages 308 - 313
In the early 20th century, many armies suffered from venereal diseases. Lithuanian army that participated in the Wars of Independence (19181920 ) was no exception. Although venereal diseases did not claim many lives, they forced small army to give up the services of many soldiers. Historical analysis of archival documents of the Lithuanian Ministry of National Defense, military periodicals, Statutes and medical books of the Lithuanian army from the period 19181923, has been conducted. The venereal disease that bothered the Lithuanian army the most was gonorrhea accounting for 78.4% of the overall incidence of venereal diseases in 1919. The Sanitation Department of the Lithuanian Ministry of National Defense took strict measures to stop the spread of gonorrhea and other venereal diseases. This institution paid attention to regular health examinations, registration of patients, disease traceability, education, preventive treatment, isolation, and prostitution. In case of illness, treatment was carried out in a special hospital named II Separate Infirmary. Until 1923, the treatment was compulsory even to soldiers who have completed their service. Difficulties were encountered in different areas because the soldiers avoided treatment, hid their illness, and visited uneducated doctors. There was a lack of laboratories to carry out the research, and the treatment of the patients was expensive and harmful. Despite all the difficulties, the fight against venereal diseases in the Lithuanian army was won. In 1923, the incidence of gonorrhea was twice as low. The incidence of other diseases has also decreased. Having carried out its main work the Sanitation Department narrowed its activities in 1923.