ISSN 1301 - 0883 | E-ISSN: 1309-3886
Eastern Journal Of Medicine - Eastern J Med: 27 (4)
Volume: 27  Issue: 4 - 2022

Page I

2.Serum Ischemia Modified Albumin and Oxidative Stress Levels in Patients with Gestational Diabetes Mellitus
Ayşe Arslan
doi: 10.5505/ejm.2022.75428  Pages 507 - 512
INTRODUCTION: Objective: Gestational Diabetes Mellitus is a metabolic condition that develops during pregnancy and is associated with complications. This studies aim was to evaluate and measure the oxidative stress markers and antioxidants levels in women with gestational diabetes and compare them with healthy pregnant women.

METHODS: There were 77 pregnant women who participated in this case-control study. Forty female patients diagnosed with GDM participated in the study as the case group and 37 healthy women as the control group. All biochemical analyzes (IMA, MDA, GSH, CAT) were performed using the spectrophotometric method.
RESULTS: When comparing the two groups, the patients group’s serum IMA levels (1.531±0.407 AbsU) were higher than those of the control group’s (0.863 ±0.092 AbsU) (p<0.001). Similarly, the patient group’s MDA levels (1.769 ±0.357 μmol/L ) were higher than the control group’s (1.025 ±0.018 μmol/L) (p<0.001). Conversly, the patient group’s GSH levels (0.023 ±0.014 mmol/g) were lower than those of the control group’s (0.186 ±0.012 mmol/g) (p<0.001). This study also found that both groups’ CAT activity levels had no significant statistical difference (GDM-0.072±0.019 and Control-0.075±0.013 U/L) (p<0.395).

DISCUSSION AND CONCLUSION: These results suggest that while the oxidative stress increased, the antioxidant defense levels decreased in women with GDM. It is recommended that patients with GDM are strictly monitored throughout pregnancy, which may help in the management of oxidative stress together with glycemic control.

3.Can platelet count, platelet mass index and mean platelet volume be parameters in retinopathy of prematurity?
İbrahim Deger, Sabahattin Ertuğrul, İrfan Kemal Kaya, Sibel Tanriverdi Yılmaz, ilyas yolbaş
doi: 10.5505/ejm.2022.34545  Pages 513 - 518
INTRODUCTION: Platelet parameters such as platelet count (PLT), mean platelet volume (MPV) and platelet mass index (PMI) are associated with physiological and pathological functions in various inflammatory diseases. The aim of the present study was to investigate whether platelet parameters were related to retinopathy of prematurity (ROP) in premature newborns.
METHODS: We retrospectively evaluated the platelet count, platelet mass index, and MPV parameters measured on the first day and 28th day, which belonged to patients, who were examined for retinopathy of prematurity at neonatal intensive var unit.
RESULTS: Among 343 patients enrolled by the study, 52.8 %(181) were male and 47.2 %(162) were female. The PLT level studied on the first day was 231.6±84(x1000/mm3) in the ROP group and 207.8±81.6(x1000/mm3) in the non ROP group, and the PLT level studied on the 28th day was 409.9±179.4(x1000/mm3) in the ROP group and 350.7±140.4(x1000/mm3) in the non ROP group. There was a significant difference between the two groups regarding both PLT levels(p=0.007, p=0.006, respectively). The PMI level studied on the first day was 1854.1±774.7 in the ROP group and 1638.2±753.3 in the non ROP group, and the PMI level studied on the 28th day was 3784.5±1797.4 in the ROP group and 3302.8±1452.9 in the non ROP group.
DISCUSSION AND CONCLUSION: This study showed that platelet count and platelet mass index measured on the first and 28th days are important parameters in patients who undergo ROP examination, and these parameters measured prior to examination will guide clinicians in diagnostic process.

4.In vitro anti-obesity effect of Aloe vera extract through transcription factors and lipolysis-associated genes
Oruc Yunusoglu, Ömer Türkmen, Mehmet Berkoz, Metin Yıldırım, Serap Yalın
doi: 10.5505/ejm.2022.13285  Pages 519 - 528
INTRODUCTION: In recent years, obesity has been associated with heart diseases, type 2 diabetes, obstructive sleep apnea, certain types of cancer and osteoarthritis, and become a global health problem. Therefore, researchers seek to find functional drugs against obesity. For the past few decades, medicinal plants have been examined to for their anti-obesity effects, including Aloe vera. In this study, it was aimed to elucidate the inhibitory effect of Aloe vera extract on adipogenesis.
METHODS: Firstly, 3T3-L1 pre-adipocytes were stimulated so as to differentiate into mature adipocyte using adipogenic differentiation cocktail consisting of 10 μg/mL insulin, 0.5 mM isobutylmethylxanthine, 0.25 mM dexamethasone, and 100 ng/mL biotin on day 0. Various concentrations (10-50 µg/mL) of Aloe vera extract with no cytotoxic effect were applied to differentiated 3T3-L1 cells. Glyceraldehyde-3-phosphate dehydrogenase (GPDH) activity, Oil red O staining, intracellular trigliceride levels, and gene expressions of transcription factors and lipolysis-associated genes were examined in order to investigate the effect of Aloe vera extract on adipocyte differentiation.
RESULTS: Aloe vera treatment caused a continuous decrease in cell size and intracellular triglyceride accumulation. Despite the fact that GPDH activity, mRNA levels of transcription factors and lipolysis-associated genes decreased in mature adipocytes treated with Aloe vera extract.
DISCUSSION AND CONCLUSION: These results suggest that Aloe vera may have a therapeutic effect in prevention and/or treatment of adipogenesis-related obesity.

5.Determining the Possible Effects of Blood Groups on Covid-19 Positivity in Humans
Feray Ferda Şenol
doi: 10.5505/ejm.2022.16680  Pages 529 - 533
INTRODUCTION: Since COVID-19 disease spreads very rapidly in society, the effect of genetic blood types on people catching the disease should be investigated. In this study, the aim was to investigate whether there is a relationship between ABO and Rh blood group systems and COVID-19 disease, severity and frequency.
METHODS: The blood groups of 16,913 patients treated with the diagnosis of COVID-19 between March 10, 2020 and March 31, 2021 and 23,141 control cases were compared retrospectively. The blood group distributions of the patients treated in the intensive care unit were examined.
RESULTS: Among the COVID-19 positive patients, the percentage of patients with blood group A (45.04%) was statistically significantly higher than the percentage of patients with blood group O (26.69%), blood group B (17.16%) and blood group AB (8.09%). The percentage of COVID-19 positive patients who were Rh positive (88.06%) was statistically significantly higher than the percentage who were Rh negative (11.93%). Among the COVID-19 patients, 7354 (43.48%) of 16913 patients were hospitalized and treated in the intensive care unit. The distribution of patients treated in the intensive care unit by blood group was blood group A 46.0%, blood group O 28.95%, blood group B 17.36%, and blood group AB 7.65%. In the intensive care unit, 6445 were Rh (+) (87.63%) and 909 were Rh (-) (12.36%).
DISCUSSION AND CONCLUSION: It was determined that the risk of COVID-19 disease is associated with ABO and Rh blood groups.We think that blood groups have an important role in the follow-up and treatment of covid -19 disease.

6.Evaluation Of Renal Colic Patients Attending The Emergency Department When The Covid 19 Pandemic Was First Announcement
Kasım Ertaş, Gizem Gizli, Murat Demir, MEHMET SEVİM, Recep Eryılmaz, Rahmi Aslan, Kerem Taken
doi: 10.5505/ejm.2022.90922  Pages 534 - 539
INTRODUCTION: Renal colic cases, which have an important place among patients presenting to the emergency department with pain complaints, have an important place in urological emergencies. In this study, patients who applied to the emergency department with suspected renal colic diagnosis during the Covid-19 pandemic were compared with those in the pre-pandemic period.
METHODS: Patients who applied to the Emergency Department with the colic type flank pain between March 2020 and May 2020 were included in the study. Diagnostic and treatment parameters of 1699 patients, including 199 pandemic and 1500 pre-pandemic control group, were evaluated in this study.
RESULTS: As a result of the evaluation made, it was seen that emergency physicians preferred USG less during the pandemic period, and mostly resorted to computer tomography method, and in this period, a decrease in the rate of observed kidney stones, an increase ureter stones were observed.. During the pandemic period, there has been a considerable decrease in the rate of hospital admissions
DISCUSSION AND CONCLUSION: As a result of postponing treatment of patients with urinary system stones, secondary pyonephrosis and pyelonephritis rates increased approximately 10 times compared to the pre-pandemic period.

7.Wolff-Parkinson-White syndrome in children: A single-center experience
Mehmet Gökhan Ramoğlu, Yasemin Nuran Dönmez, Zerrin Karakuş Epçaçan, Serdar Epçaçan
doi: 10.5505/ejm.2022.60437  Pages 540 - 548
INTRODUCTION: This study aims to evaluate the clinical characteristics and outcomes of children with intermittent and persistent Wolff-Parkinson-White (WPW) syndrome.
METHODS: Children followed up with the diagnosis of intermittent WPW and WPW syndrome between 2014 and 2022 were reviewed retrospectively. The age, gender, duration of follow-up, admission reasons, electrocardiography (ECG), echocardiography, and ambulatory ECG findings, electrophysiological study and ablation results were analyzed.
RESULTS: The study included 99 children with intermittent WPW and 38 children with WPW syndrome. The most common complaint on admission was palpitation (28.5%), murmur (22.6%), and chest pain (19%). Seven of the cases had a history of documented supraventricular tachycardia (SVT) and one of them had SVT on admission. On initial ECG 40.9% and 27.7% of the cases had intermittent and persistent WPW, respectively. Ninety-five (69.4%) cases had a structurally normal heart, whereas congenital heart disease, valvular disease, and mild septal hypertrophy were found in 25 (18.3%), 16 (11.7%), and 1 case, respectively. In the whole study group, 49 (35.8%) cases underwent electrophysiological study (EPS). Five cases had a diagnostic procedure and catheter ablation was performed in 39 (28.5%) cases. Five cases were lost from follow-up after referral for EPS. Recurrence was observed in only one case and none of the cases had any adverse event.
DISCUSSION AND CONCLUSION: Early diagnosis, risk stratification, and appropriate management of patients with WPW syndrome are crucial. The electrophysiological study is used as a risk stratification tool and catheter ablation is a safe curative procedure in high-risk patients.

8.Povidone-iodine antisepsis in lumbar disc surgery
Abdurrahim Taş, Nur Aycan, Abdurrahman Aycan, İrfan Zengin, Mehmet Edip Akyol
doi: 10.5505/ejm.2022.69077  Pages 549 - 551
INTRODUCTION: Postoperative surgical site infection still constitute a major concern in spinal surgery and related with poor outcome. We aimed to investigate the effect of povidone-iodine (PVP-I) on skin colonization in lumbar disc herniation (LDH) surgery.

METHODS: Adult patients scheduled for LDH surgery were included in the study. Three skin swab cultures were taken when lying on the operating table (culture 1), after PVP-I application (culture 2), and at the end of the operation (culture 3). The effect of PVP-I and other independent predictors on skin culture was analyzed.
RESULTS: A total of 62 [28 (45%) female, mean age 47±13 years] patients were included. Only male sex and taking shower before the surgery have been found to be independent factors for affecting culture 1 growth while adjusted to age, body mass index, smoking, preoperative hospital stay, and surgery site shaving [OR (95% CI): 7.8 (1.4-41.9), p=0.016; OR (95% CI): 0.34 (0.003-0.35), p=0.005]. After PVP-I, the growth frequency of culture 2 decreased significantly compared to culture 1 [8 (13%) vs. 43 (70%), p<0.001]. However, culture 3 positivity rate was similar to culture 2 (p=0.219).
DISCUSSION AND CONCLUSION: In preoperative sterilization of lumbar disc surgery, PVP-I significantly reduces skin colonization both immediately after application and at the end of the operation.

9.Carotid intima-media thickness and lipid profile in children patients with hypothyroidism
Mecnun Çetin, Aytul Eren, Eda Çelebi Bitkin, Eyyüp Yürektürk, Cemil Goya, Kamuran Karaman
doi: 10.5505/ejm.2022.10270  Pages 552 - 557
INTRODUCTION: Hypothyroidism is a condition where there is a decrease or absence of thyroid hormone production as a result of a disorder occurring anywhere in the hypothalamo-pituitary-thyroid axis. There are very few studies in the literature reporting on the effect of hypothyroidism on lipid metabolism and carotid intima-media thickness (CIMT) in children.
The present study was designed to determine whether hypothyroidism is associated with an increase in the CIMT and lipid levels in patients under thyroid hormone replacement therapy.

METHODS: The study included 30 children (under thyroid hormone replacement therapy) diagnosed with hypothyroidi and a control group comprising 30 healthy, euthyroid children. All the patients were examined for clinical characteristics, and the serum lipid levels and the CIMT were measured.
RESULTS: Mean age was 8.47 ± 5.22 years in the patient group and 8.82 ± 4.91 years in the control group. Patient group TSH value was significantly higher than control group (9.95 ± 18.43, 1.93 ± 1.04, p=0.021, respectively). The total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and TG values were similar in both group (p = 0.065, p = 0.429, p=0.219, and 0.391, respectively). CIMT values of the patient and control groups did not differ significantly (0.40 ± 0.08 and 0.39 ± 0.07, p=0.920, respectively)
DISCUSSION AND CONCLUSION: In this study, contrary to the rare studies in the children's age group in the literature, no significant changes in lipid profile and CIMT were detected in patients with hypothyroidism. Further prospective studies are needed to substantiate these findings in children with hypothyroidism.

10.“Microbiological study findings and their clinical predictors in culture-diagnosed septic knee arthritis patients in the Somali population”
Ebubekir Arslan
doi: 10.5505/ejm.2022.35545  Pages 558 - 565
INTRODUCTION: Septic arthritis (SA) is a serious orthopedic emergency. Waiting for aspiration and microbiological analysis results may cause therapeutic delay, resulting worsening of prognosis. In this study, it was aimed to determine the predictive value of clinical signs, laboratory and radiological examinations for the diagnosis of culture-proven SA and SA agents, and to create projections for early treatment.
METHODS: This 7-year retrospective cohort study included adult patients with suspected SA seen in a tertiary hospital emergency department. Patients with a positive culture aspiration confirming septic arthritis at one joint were analyzed, and then compared to a control group defined as 'Aseptic Arthritis' (ASA).
RESULTS: While Acute onset (P=0.038), history of crystal-induced arthritis (P=0.022) were significantly higher in the aseptic arthritis group, the presence of pain increasing with movement (P=0.042), previous septic arthritis history (P=0.028), higher than 0.5 ng/mL serum procalcitonin value (P=0.048), purulent appearance of synovial fluid (P=0.028) were found to be significantly higher in the septic arthritis group. However, septic arthritis patients significantly had a synovial fluid WBC count of over 20,000/μL and a PMNs ratio of over 75%. Pain that increases with movement Methicillin-resistant S. aureus was highly effective in differentiating from other bacteria (sensitivity 100, P=0.048).
DISCUSSION AND CONCLUSION: Although the definition of SA or its diagnostic criteria have not yet been determined, a few factors we found in our study results, the cutoff values we suggested, and the definition of “Aseptic Arthritis” that we used in our study design may be thought-provoking in terms of determining the diagnostic criteria for SA.

11.Effect of whitening mouthwashes on hybrid ceramic with different surface treatments
Merve Özarslan, Dilber Bilgili Can
doi: 10.5505/ejm.2022.82653  Pages 566 - 572
INTRODUCTION: The purpose of this study is to investigate the effects of three whitening mouthwashes with different contents on hybrid ceramics with three separate surface treatments in terms of color change.
METHODS: Samples of 7x5x1 mm dimensions were prepared from hybrid ceramic blocks (Vita Enamic- VE). The surfaces of the samples were standardized with silicon carbide papers. The samples were randomly divided into 3 groups (Group C: no additional polishing, Group L: VE technical kit and Group G: glaze was applied) (n=24). All samples were kept in coffee for seven days after the initial colors were recorded. Following the second color measurement (ΔE001), each group was divided into 3 subgroups and kept in whitening mouthwashes with different contents (Containing hydrogen peroxide, non-hydrogen peroxide and activated carbon) for 24 hours (n=8). The final color measurement was measured (ΔE002). Color changes were evaluated according to CIEDE2000. Shapiro-Wilk, One way ANOVA and post hoc Tukey tests were used for statistical analysis of the data (p˂0.05).
RESULTS: There was a significant difference in all groups for ΔE001, with the highest in Group C (Group L and Group G, respectively). The mouthwashes showed similar color changes on VE with different surface treatments (p≥ 0.05). Group C showed a significantly higher ΔE002 value than Group G in containing hydrogen peroxide mouthwash.
DISCUSSION AND CONCLUSION: Clinically acceptable color changes were observed in groups G and L after kept in coffee. After immersion in whitening mouthwash, all groups showed values below the threshold of perceptibility and acceptability (50: 50% acceptability ΔE= 1.8, perceptibility ΔE=0.8).

12.Evaluation of COVID-19-Related Pain Symptoms and Assessment of Neuropathic Pain
Sinan Pektaş, Canan Gürsoy, Özge Oral Tapan, Turhan Togan, Semra Gümüş Demirbilek
doi: 10.5505/ejm.2022.54280  Pages 573 - 578
INTRODUCTION: Myalgia, arthralgia, headache, chest pain, back pain, abdominal pain, sore-throat may be present in COVID-19. The purpose of this study is evaluating the frequency, intensity and the regional characteristics of pain related symptoms in hospitalized COVID-19 patients as long as neuropathic pain and its components.
METHODS: In this retrospective study, for the assessment of pain, myalgia, arthralgia, headache, sore-throat, chest pain, back pain and abdominal pain were questioned. Intensity of pain was evaluated by an 11-point Numerical Rating Scale. Neuropathic pain detection was performed by Identification Pain Questionnaire (ID-Pain).
RESULTS: The frequency of pain in hospitalized patients was 68.5%. The frequency of COVID-19-related symptoms were 53.4% myalgia, 39.7% arthralgia, 41.1% headache, 21.2% sore-throat, 21.9% chest pain, 28.1% back pain and 15.8% abdominal pain. A statistically significant relationship was observed between headache and hyposmia development (odds ratio= 6.53; 95% CI: 3.14-13.60; P<0.001). In neuropathic pain assessment, ID-Pain scores of 6 (4.1%) of patients were found ≥ 2. For neuropathic pain components, it was observed that hot/burning type was accompanying to pain in 12 (8.2%) of patients while pins and needles type was accompanying in 8 (5.5%) of the patients.
DISCUSSION AND CONCLUSION: In hospitalized COVID-19 patients, myalgia, arthralgia and headache are most frequent pain types. Headache was found to be related with hyposmia. Neuropathic pain or mixed pain with a neuropathic component is not a rare condition in COVID-19 disease. Finally, we suggest routine assessment of neuropathic pain in patients with COVID-19.

13.Predictive risk factors for Intensive Care Unit mortality in Acute Exacerbations of COPD requiring Invasive Mechanical Ventilation
Aysel Sunnetcioglu, Buket Mermit Çilingir, maşuk Çelikel, Serhat Bedirhanoğlu, Hilmi Demirkiran
doi: 10.5505/ejm.2022.70745  Pages 579 - 584
INTRODUCTION: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) frequently necessitate intensive care unit (ICU) admissions. The purpose of this study is to determine risk factors for ICU mortality in AECOPD who required invasive mechanical ventilation (IMV).
METHODS: Patients requiring IMV for AECOPD between January 2013 and March 2019 were retrospectively reviewed. Patients’ characteristics, comorbidities, and laboratory results were reviewed from the medical charts. Subjects’ acute physiology and chronic health evaluation (APACHE) II score, Glasgow Coma Scale (GCS), IMV (days), and mortality were recorded. As an output or dependent variable, ICU mortality was considered. Other variables were considered to independent factors or risk factors. Then, Logistic regression analysis was performed to determine risk factors for ICU mortality in AECOPD.
RESULTS: The study, 134 patients were included. The mean duration of IMV were 11.6 ± 12.2 days. The ICU mortality were 51.4 %. On admission to ICU, patients had APACHE-II scores of 23.0 ± 6.2. Nonsurvivors had lower blood Mg levels (1.8 ± 0.2 mmol/L, p = 0.002), lower blood Ca levels (8.0 ± 0.7 mg/dL, p = 0.005), higher Uric Acid, (8.5±3.8 mg/dl, p = 004), higher CRP levels (87.2 ± 71.8 mg/dl, p = 0.048), higher leukocyte count (14.7 ± 10.2 103L, p= 0.040), higher serum lactate (2.3 ± 1.7 mmol, p = 0.003) compared to survivors.
DISCUSSION AND CONCLUSION: APACHI score and uric acid level were found statististically significant risk factors for ICU mortality.

14.The relatıonship between women's contraceptive method choices and marital adjustment
nurdilan şener, Çiçek Ediz
doi: 10.5505/ejm.2022.29566  Pages 585 - 590
INTRODUCTION: Aim: This research aims to determine the relationship between women's contraceptive method (CM) choices and their marital adjustment.
METHODS: Materials and Methods: The sample of this descriptive study consisted of 747 women participants collected by snowball sampling from the Eastern and Southeastern Anatolia Region of Turkey. The research data were collected online with the personal information form, the contraceptive method choices form, and the Marriage Adjustment Scale (MAS). Data distribution normality was tested using the Kolmogorov-Smirnov test. The statistical evaluations were carried out using mean, standard deviation, numbers, percentile, and independent t-test. Statistical significance in the study was p<0.05.
RESULTS: Results: The mean age of the women in the study was 34.14±5.8. The study determined that condom use was the highest (34.6%) among maritally-adjusted-women. In terms of the CM, there was a statistically significant difference in non-prevention and withdrawal averages between maritally-adjusted-women and maladjusted-women (p<0.05). The marital adjustment of the women who were not protected and used the withdrawal method was high.
DISCUSSION AND CONCLUSION: Conclusion: The study determined that women who used the withdrawal method and did not use any CM had a higher marital adjustment.

15.Comparison of therapeutic and prophylactic cervical cerclages and their results
Gamze Nur Cimilli Senocak
doi: 10.5505/ejm.2022.67045  Pages 591 - 595
INTRODUCTION: Depending on the patient's history, cerclage procedure is called prophylactic cerclage in cases where the cervix has not been dilated or effaced yet. It is called therapeutic cerclage when performed after effacement and dilatation have occurred. Although there is literature arguing that therapeutic cerclages will be reduced with the spread of prophylactic cerclages, and pregnancy will be carried to further weeks; there are also researchers who argue that due to prophylactic cerclages, pregnant women who may not actually need cerclage are intervened and unnecessary procedure-related morbidity increases. In this study, we examined all cerclage procedures and indications performed in our clinic in two years. We tried to contribute to the literature by evaluating the contribution, frequency, and success of prophylactic and therapeutic cerclage procedures.
METHODS: Hospital records of 160 patients who underwent prophylactic and therapeutic cerclages were reviewed retrospectively.
RESULTS: Birth weeks of patients with a cervical length below 25mm (therapeutic cerclages) were found to be significantly lower than those with a cervical length of 25mm or above (prophylactic cerclages) (p=0.001). Birth weight of the babies of mothers with a cervical length below 25mm was found to be significantly lower (p=0.004).
DISCUSSION AND CONCLUSION: The success and pregnancy outcomes in therapeutic cerclages are worse than prophylactic cerclages.

16.Clinical evaluation of pulmonary thromboembolism in gynecologic oncology operations: Analysis of nine patients in a university hospital
Erbil Karaman, Burçhan Aydıner, Buket Mermit Çilingir, Latif Hacıoğlu
doi: 10.5505/ejm.2022.03780  Pages 596 - 600
INTRODUCTION: To investigate the cases of pulmonary thromboembolism(PTE) and analyze the risk factors in patients undergoing gynecologic oncology operations.
METHODS: The medical records of all patients who underwent gynecologic oncologic surgery from January 2015 to September 2022 were collected from the hospital’s database. Patients with the diagnosis of PTE were retrieved and analyzed retrospectively.
RESULTS: 9 cases of clinically apparent PTE cases were identified from the medical records. The mean age of the cases was 56.1±3.4. The mean BMI was 27.2±1.4. The majority of cases were advanced stage ovarian malignancy which underwent a major surgery including pelvic-paraaortic lymphadenectomy (5/9). Dyspnea and shortness of breath was the main complaint. Tachypnea was the main finding in all cases. The leukocytosis and thrombocytosis were notable in PTE cases.
DISCUSSION AND CONCLUSION: PTE remains as one of the fatal complications after gynecologic surgeries. In our case cohort, increasing age, obesity and the complexity of surgery are significant predictors of pulmonary embolism in gynecologic oncology operations. Further multicenter studies stratifying risk factors are warranted to reach a proper prophylactic strategy and prevent PTE.

17.The effect of age on clinical, functional and quality of life outcomes after arthroscopic rotator cuff repair in female patients
Sinan Oguzkaya, Gokay Eken, Ensar Turko, Erdal Uzun
doi: 10.5505/ejm.2022.69586  Pages 601 - 606
INTRODUCTION: In the literature, the effects of age and gender on rotator cuff repair (RCR) have been evaluated separately in many studies. In our study, we aimed to analyse the outcomes of female patients above and below the age of 60
METHODS: A total of 55 female patients who underwent arthroscopic rotator cuff repair (ARCR) between 2018 and 2020 were examined retrospectively. The patients were divided into two groups according to their age as Group 1 (<60 years) (n=21) and Group 2 (>60 years) (n=34). From the retrospective file information, the dominant side, the body mass index, whether the rupture was acute or chronic, and the duration of the symptoms were recorded. The American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley (CM) score, Visual Analog Scale (VAS), and SF-36 Health Survey (SF-36) score were used in the evaluation of clinical functional and quality of life measurements
RESULTS: Pre-operative and postoperative CM, VAS, and ASES scores did not differ between groups (P> 0.05). When the SF-36 scores of both groups were evaluated, the difference was insignificant pre-operatively (P> 0.05). A statistically significant difference was found in favor of Group 1 in role limitations arising from emotional problems postoperatively, Energy/fatigue assessment, social functionality, pain assessment, and health change (P <0.05)
DISCUSSION AND CONCLUSION: Clinical and functional outcomes are not affected by age, whereas some quality of life domains become worse in patients over 60 years of age

18.The Relationship Between The Demographic Data And Periodontal Health Awareness
Ahmet Cemil Talmaç, Nazli Zeynep Alpaslan Yayli
doi: 10.5505/ejm.2022.76094  Pages 607 - 614
INTRODUCTION: This study aims to determine the awareness levels of the individuals about gum health, gum diseases and periodontology and to correlate these values with their demographic and socio-economic characteristics.
METHODS: This cross-sectional epidemiological study included 428 volunteers, who were asked to participate in a specially designed online survey consisting of 6 multiple choice questions through a mobile application. The questionnaire evaluated the socio-demographic, and socio-economic profiles of the participants, their educational status, whether they had any systemic diseases, and their knowledge about periodontal diseases and periodontology. In addition, the patients' perceptions of self-care were also examined. Frequency tables and Chi-square analysis were used for the statistical analysis of the data, where the level of statistical significance was set at p<0.05.
RESULTS: A statistically significant relationship was found between gender and tooth brushing (p<0.01). While the prevalence of the habit of tooth brushing at least once a day was 92% in women, this rate was 83.4% for men.There was no statistically significant association between the number of dentist visits and gender, education, or income levels (p>0.05). Although this study demonstrates the presence of basic awareness of oral hygiene in the population with higher education and income levels; the knowledge regarding oral hygiene is still limited in the general population.
DISCUSSION AND CONCLUSION: Comprehensive training programs are needed to improve dental and gum health. Our results also show that it is necessary to ensure that the general population including individuals with higher education and income levels participate in these programs.

19.Characterization of Zn nanoparticles of Platonus orientalis plant, investigation of DPPH radical extinquishing and antimicrobial activity
Nuran Bazancir, İsmet Meydan
doi: 10.5505/ejm.2022.34392  Pages 615 - 619
INTRODUCTION: Zinc; It is one of the favorite elements because of its nano structures and properties. It is known to be involved in many tasks such as DNA protection, membrane stabilization, protein, ribosome and carbohydrate production. The aim of our present study is to examine some biochemical parameters directly related to human health as a result of the characterization of Platonus orientalis plant with Zn.
METHODS: The aim of our present study is to examine some biochemical parameters directly related to human health as a result of the characterization of Platonus orientalis plant with Zn. In our study, Zn particles were obtained with the green synthesis method using Platonus orientalis plant extract and Zn. Scanning electron microscopy was used for SEM, SEM / EDX images of synthesized Zn NPs. Characterization process was performed using UV visible spectrophotometer and fourier transformed infrared spectroscopy (FT-IR).The antimicrobial activity of synthesized metal nanoparticles against some pathogens causing disease in humans by disk diffusion method was investigated
RESULTS: It was determined that zinc nanostructures have an important antioxidant potential as a result of DPPH analysis. The antimicrobial activity of synthesized metal nanoparticles against some pathogens causing disease in humans by disk diffusion method was investigated. Zn NPs/Po has been found to have antibacterial effects against Bacillus subtilis ATCC 6633, Escherichia coli ATCC 25952, Pseudomonas aeruginosa ATCC 27853 microorganisms.
DISCUSSION AND CONCLUSION: According to the results of the study, the effects of Zn NPs/Po, we believe that this material will shed light on the scientific world, especially in the field of pharmacology.

20.The Effects of 4.5G Compatible Cell Phone Radiofrequency Radiation on Intraocular Pressure
Ülkü Çömelekoğlu, Erkin Özdemir, Evren Değirmenci, Begum Korunur Engiz
doi: 10.5505/ejm.2022.65021  Pages 620 - 626
INTRODUCTION: In recent years, mobile phone usage duration has increased rapidly and this has raised concerns about the toxic effects of exposure to radio frequency radiation. Many studies have shown that exposure to radiofrequency radiations may be associated with effects on the endocrine, nervous, ocular, cardiovascular and reproduction systems. The main aim of this study is to investigate the effect of 4.5 G compatible mobile phones radiation on intraocular pressure.
METHODS: A total of 32 Wistar albino male rats, 16 sham and 16 experimental groups, were used in the experiments. The rats in the experimental group were exposed to a 4.5G compatible mobile phone for 2 hours a day for 45 days. The rats in the Sham group were kept in the same environment for the same period of time with the mobile phone turned off. The specific absorption rate (SAR) value, skin temperature and intraocular pressure of rats were measured as analysis parameters. The maximum SAR value was calculated as 0.006 W/kg per 10 g of tissue.
RESULTS: No significant difference was observed between the sham and experimental groups in terms of body temperature. Intraocular pressure decreased significantly in the experimental group compared to the control group.
DISCUSSION AND CONCLUSION: As a result of the study, it was thought that the use of 4.5 G compatible smartphones may cause a decrease in intraocular pressure and may pose a significant risk for visual function.

21.Can Platelet Mass Index be used as a prognostic marker in the diagnosis of missed abortion patients?
Kazım uckan, İzzet Çeleğen, Yusuf BAŞKIRAN, Erhan Hanlıgil
doi: 10.5505/ejm.2022.45549  Pages 627 - 633
INTRODUCTION: The aim of this study is to evaluate the effectiveness of PCT (Platelet crit), NLR (Neutrophil-to-lymphocyte ratio), and PMI (Platelet Mass Index), which are among the complete blood count parameters, in predicting missed abortion (MA).
METHODS: The case-control study was conducted between January 1, 2020, and January 2022. A total of 926 pregnant women, including 474 MA and 452 normal patients, were included in the study.
RESULTS: There were no significant differences between the patient and control groups in terms of age, gestational week, body mass index (BMI), gravida and parity, and thyroid functions (p>0.05). PMI, PCT, and NLR values were significantly higher in the MA group (p<0.05). While there was a strong positive relationship between PMI and PCT, there was a negative relationship between PMI and NLR (p<0.05). In the ROC analysis, PCT>0.24, NLR>2.99, and PMI>2430.9 were significantly associated with an increased risk of missed abortion (P<0.05). Logistic regression analysis revealed that a one-unit increase in PCT resulted in a statistically significant 3.41-fold increase in the risk of missed abortion, a one-unit increase in NLR resulted in a 2.56-fold increase, and a one-unit increase in PMI resulted in a 1.004-fold increase (p< 0.05).
DISCUSSION AND CONCLUSION: We think that PMI, NLR, and PCT values obtained from complete blood count parameters are important predictors of missed abortion

22.A Comparison Study Between Four Different Pachymeters to Measure Corneal Thickness
Çağatay Çağlar
doi: 10.5505/ejm.2022.93763  Pages 634 - 640
INTRODUCTION: To compare the correlation and agreement between the central corneal thickness (CCT) measurements with ultrasound pachymeter and three different non-contact pachymeters and to analyze their influence on intraocular pressure (IOP) measurements.
METHODS: This prospective study included 102 healthy adults. Optical biometer (OB), scheimpflug corneal topographer (TOPO), non-contact pachytonometer (NCP), and ultrasound pachymeter (UP) were carried out to measure the corneal thickness. Pearson and Spearman correlation and a 95% limit of agreement were calculated.
RESULTS: In this prospective study, the CCT of 102 right eyes of 102 healthy volunteers were analyzed. CCT measured with optic biometer, corneal topography, ultrasound pachymeter and non-contact pachytonometer were 534.7 (438-629), 544.8 (444-634), 553.1 (449-674) and 562.9 (464-665 µm), respectively. There were strong correlations between all pachymeters by Pearson correlation analysis. The correlation of Pearson between all measurement methods were over 0.950. When the CCT was divided into the three groups according to corneal thickness ranges, the correlation was higher than 0.7 in all groups (r=0.72-0.91 for <510 µm, r=0.85-0.95 for 510-580 µm, r=0.82-0.93 for >580 µm) by Spearman correlation analysis. A significant positive correlation was observed between the IOP values and CCT obtained by all pachymeters with a trend toward increasing the IOP with increasing corneal thickness.
DISCUSSION AND CONCLUSION: The correlations between the pachymeters were high in normal corneal thickness, whereas it was slightly lower in the thick and thin cornea. A significant positive correlation was observed between IOP and CCT in all pachymeters.

23.ICU residents’ views on general ethical issues regarding the opt-in system of deceased organ donation in Turkey: a focus group study
Şükran Sevimli, Arzu Esen Tekeli
doi: 10.5505/ejm.2022.43402  Pages 641 - 648
INTRODUCTION: This descriptive study explores the views of resident physicians working in intensive care units (ICUs) concerning deceased organ donation and examines the various ethical issues surrounding organ donation encountered by residents.
METHODS: This was a qualitative, descriptive study utilizing solo interviews with participants together with focus group discussions. The participants' experiences and views were elicited via interviews and focus group discussions covering the following topics: ethical thoughts about deceased organ donation, barriers that impede or prevent organ donation, its effect on the next of kin, and its relationship with futile treatment. The discussions were reviewed using qualitative content analysis.
RESULTS: The residents commented that deceased organ donation is a complex and stressful process for the family of the potential donor as well as the transplant team, and still lacks wide acceptance in Turkish society. The opt-in system requires informed consent, thus creating a major barrier for both the patient’s family and the ICU team to overcome. The participants stated that new legal, ethical, and medical arrangements are needed to increase organ donation rates in Turkey.
DISCUSSION AND CONCLUSION: In order to increase rates of deceased organ donation and reduce cases of futile treatment, improved communication between the ICU, transplant team, and patient relatives is critical to ensure that ethical issues are properly managed. On a societal level, the subject of deceased organ donation needs to receive greater attention from public health authorities to increase public awareness. Residents can make valuable contributions to the deceased organ donation process as physicians and as psychosocial support for patients and their families.

24.Investigation of Antioxidant and Cytoprotective Effects of Allium Schoenoprasum L (Sirmo) Plant Ethanol Extract in Liver Damage Caused by Carbontetrachloride in Rats
Yılmaz Koçak, Ufuk Mercan Yücel
doi: 10.5505/ejm.2022.64614  Pages 649 - 656
INTRODUCTION: Liver diseases, morbidity and mortality rates are increasing in the world and existing drugs are insufficient for treatment. For this reason, there has been an increased interest in the discovery of new drugs against liver damage and the search for alternative therapies. This study aimed to determine the antioxidant and liver-protective effects of Allium schoenoprasum (AS) extract in a rat liver injury model created with carbon tetrachloride (CCl4).
METHODS: The in vivo experimental procedure was established as follows; Group 1, control (C) animals; Group 2, carboxymethylcellulose (CMC); Group 3, CCl4; Group 4, Legalon (LGL, silymarin); Groups 5, 6 and 7 were treated with AS (100, 200 and 400 mg kg-1) extract only. Groups 8,9 and 10 were administered AS+CCl4. On the 11th day of the experiment, the animals were sacrificed and analyzed.
RESULTS: According to the histopathological and biochemical analysis results; It was found that AS extract reduced tissue damage in a dose-dependent manner against CCl4 toxicity. When antioxidant and oxidative biomarkers were examined, positive effects of LGL and AS were observed in correcting the changed oxidant/antioxidant balance status due to oxidative stress caused by CCl4.
DISCUSSION AND CONCLUSION: The results showed that AS had a dose-dependent hepatoprotective effect against CCl4-induced liver toxicity, and it was evaluated that this effect might be due to its antioxidant activity.

25.Does Systemic Immune-Inflammation Index Predict Coronary Artery Disease Severity in Patients with ST-Elevated Myocardial Infarction Undergoing Percutaneous Coronary Intervention
dilay karabulut, cennet yildiz, fahrettin katkat, Umut Karabulut
doi: 10.5505/ejm.2022.94824  Pages 657 - 663
INTRODUCTION: Our aim was to assess value of systemic immune-inflammation index (SII) to predict coronary artery disease severity in patients with ST elevated myocardial infarction (STEMI) who underwent percutaneous coronary intervention (PCI).
METHODS: One hundred twenty six patients diagnosed as STEMI who underwent primary PCI were retrospectively analyzed. The severity of coronary stenosis was determined by the SYNTAX score (SxS). Patients with SxS<22 constituted group 0 and ≥22 constituted group 1. SII was obtained by multiplying number of platelets by neutrophil to lymphocyte ratio (SII = p × n/L ratio).
RESULTS: Lymphocyte count, ejection fraction and hematocrit was lower in patients with high SxS. Patients with higher SxS, had higher SIIs than those with lower SxS (1073.85 (147.28-6142.84) vs (778.88 (228.71-3179.78) p=0.044 respectively). SII had positive correlation with SxS, glucose, troponin T, creatinine, CK-MB levels and WBC count. SII was found to be predictor of high SxS (odds ratio: 1.001; 95% CI: 1.000-1.001; P = 0.018). SII with a cutoff value of 1124.7679 predicted the severity of coronary lesion with a sensitivity of 48% and specificity of 73.5% (AUC: 0.606, 95% CI: 0.507–0.705, p=0.46).
DISCUSSION AND CONCLUSION: Pre-procedural SII might provide an information about atherosclerotic burden in coronary artery in STEMI patients.

26.Is This Scarlet? Bacterial versus Viral Exanthem in Limited Resource Setting
Euginia Christa, Andreas Christian
doi: 10.5505/ejm.2022.46353  Pages 664 - 667
We report a case of a generalized bacterial-induced skin desquamation mimicking viral exanthem in a 10-year-old boy, providing insight for primary physicians on identifying tricky diagnostic cues in a type C general hospital with no attending dermatologist.
The patient presented with a chief complaint of high fever with generalized desquamation. Initial skin lesion was generalized erythematous skin rash, which evolved into vesicles and pustules, followed by a generalized desquamation. An initial diagnosis of bacterial infection was established. The patient was discharged after 8 days, with no fever but ongoing skin desquamation accompanied by mild sting and itch. Ten days after discharge, previously uninvolved areas of palms, soles, and intergluteal cleft started to exfoliate. Limited by the unavailability of specific supporting examinations, we eliminated differential diagnoses by relying on careful history taking and clinical symptoms, and pinpointed a more precise diagnosis of scarlet fever.

27.A Rare Known Specific Phobia "Turophobia": A Case Report
Doğancan Sönmez, İlknur Kiraz Avcı, Cicek Hocaoglu
doi: 10.5505/ejm.2022.89577  Pages 668 - 671
Specific phobia (SPs) is a type of disorder associated with persistent and pronounced fear of situations or objects other than those defined for social phobia and agoraphobia. It focuses on specific situations such as animals, altitude, storm, wind, darkness, confined spaces, airplane, swimming, dentist or seeing blood. Individuals with SPs experience extreme fear when they encounter a situation or object defined as a phobic stimulus. SP stands out as one of the most neglected clinical pictures based on clinical studies and scientific publications. Therefore, the subtypes, etiology, epidemiology and treatment of SP are not fully known. In this study, a 20-year-old female patient who was treated with the diagnosis of cheese phobia (turophobia) was presented in the light of the literature.

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