Among all the various existing skills needed in palliative end-of-life care, none is more important the ability to communicate effectively. Terminal ill experience is the time when patients were overwhelmed with several emotional and psychological symptoms, which need the maximum amount of care, through effective communication in the most appropriate way. Effective communication is the fundamental component to physician and patient quality relationship, which make clinician to be trusted by the patient, resulting in quality decision making for patient treatment and future diagnosis plan in the clinical practices. However, looking at the present scenario of Indian health care system, the absence of good communication is visible in most of the clinical practices, which becomes the underlying reason for terminal patient receiving unwanted life sustaining medical treatment, along with inappropriate care that goes against the patient’s choices. Moreover, effective communication also plays an important role in breaking the bad news to patient and family. Thus, seeing at the urgent needs of effective communication in the clinical practices, the present study is forms through fieldwork that is follow up by an analytical study. The aim of this particular research is to inquire, how important the effective communication is in terminal care, and what are the strategies for breaking bad news effectively without hurting the feelings of the dying individual’s.

INTRODUCTION: The aim of this study is to analyze the relationship between impairment and disability in individuals with Rheumatoid Arthritis.
METHODS: One hundred individuals with Rheumatoid Arthritis (86 women, 14 men; mean age=49.93±11.38 years; range: 20 to 65 years) were included in the study. Impairment was evaluated by use of Disease Activity Score 28 (DAS28). Disability was assessed by Disabilities of Arm, Shoulder and Hand Questionnaire (DASH), Michigan Hand Outcomes Questionnaire (MHQS) and Duruoz Hand Index (DHI). The presence of relationship between impairment and these disability scales was evaluated by Spearman correlation analysis.
RESULTS: DAS28 score was moderately and highly correlated with DASH, MHQS-total and other subscales and DHI scores (DASH; r=0.655, MHQS-total and other subscales; r=-0.708 to r=-0.570, DHI r=0.619) while DAS28 score was poorly correlated with MHQS-aesthetics subscale score (r=-0.323).
DISCUSSION AND CONCLUSION: In our study, it was concluded that impairment was an important indicator of disability by determined upper extremity scales in individuals with Rheumatoid Arthritis. Since upper extremity involvement is widespread in individuals with Rheumatoid Arthritis, upper extremity disability scales could use to determine disability.

INTRODUCTION: Immigrants are exposed to many health risks during and after immigration. The impact of immigration on women is greater. The impairment of the women’s mental health and barriers to accessing health services bring about many risks associated with pregnancy. In this study, it was aimed to reveal the state of using safe motherhood services among the women aged between 15-49 year old who immigrated from Syria.
METHODS: In this cross-sectional descriptive study, the data were obtained from Syrian women aged between 15-49 age living in Mardin city center and Kızıltepe in 2016 and agreeing to participate in the study. The sampling size was calculated 384, and the study was carried out among 363 women.
RESULTS: The average age of the participants is 28.06 ± 8.39 years and 38.0% is in the 25-34 age group. The rate of those who stated that they did not have any problems when applying to healthcare facilities is 42.3%. Out of 363, 180 (49.6%) women got pregnant after arriving in Turkey. While 162 (90.0%) pregnant women stated that they were examined by health personnel at least once during pregnancy, the rate of those who underwent adequate follow-up (≥4 follow-up) was 46.7%. Of the women, 47.2% who had pregnancy in Turkey were vaccinated against tetanus at least once.
DISCUSSION AND CONCLUSION: Although they found health services to be complicated, the level of benefiting from safe motherhood services was moderate. Despite these positive findings, it is suggested that health care facilities should be tailored for intercultural communication.

INTRODUCTION: Because of the usefulness of anthropometric measurements and indices, they are frequently recommended for prediction of diabetes in clinical practice. The aim of this study is to determine the relationship between HbA1c and fasting plasma glucose (FPG) and lipid parameters of diabetics and non-diabetics and 7 different indices, such as, waist circumference (WC), waist-to-hip ratio (WtHR), body mass index (BMI), Broca-Katsura index, Rohrer index, a body shape index (ABSI), and body roundness index (BRI).
METHODS: A total of 505 individuals were included in the study (type 2 DM, n=65; type 1 DM, n=265, and 171 controls). Anthropometric measurements were evaluated (weight, height and waist circumference) and from these measurements BMI, Broca-Katsura Index, Rohrer Index, ABSI and BRI were calculated. HbA1c, FPG, LDL-cholesterol, triglyceride and HDL-cholesterol levels were also measured. Data were analysed with SPSS 21.0 statistics program.
RESULTS: HbA1c levels and BMIs were significantly high in diabetic patients. None of the indices were significantly correlated with HbA1c, FPG levels, LDL-cholesterol and triglyceride levels in diabetic patients; but body weight, body mass, BMI, WC and BrocaKatsura index were positively correlated with HbA1c levels in controls. On the other hand, FPG levels of controls were positively correlated with body weight, BMI and Broca-Katsura index.
DISCUSSION AND CONCLUSION: Although much of the anthropometric measurements and indices correlated with the levels of HbA1c, FPG and LDLcholesterol, HDL-cholesterol and triglycerides in control group; none of the indices were correlated with HbA1c levels, FPG, LDLcholesterol and triglyceride in type 1 and type 2 diabetics. Anthropometric indices, especially recent ones, had limited capacity and usefulness for monitoring of diabetes and dyslipidemia in diabetic patients.

A dermoid cyst (mature cystic teratoma) is the most nonphysiological ovarian neoplasia diagnosed during the pregnancy. A 27year-old, gravidity 1, 39 weeks' gestation age woman with bilateral adnexal mass referred to our tertiary obstetrical center. The findings of the patient were consisted with bilateral dermoid cysts of the ovaries in a term pregnant woman. The patient was delivered by cesarean section and the bilateral dermoid cysts were extirpated during the surgery.