INTRODUCTION: Fibroadenomas are common benign breast tumors comprising 95% of all biopsied breast masses. Vitamin D has a strongly indicated ability to modify the histology of the breast.
Objective: To correlate histological alterations in breast tissue with deficient vitamin D in women clinically diagnosed to have fibroadenoma.
METHODS: Eighty women aged in a range between 25-45 year complaining from breast lump diagnosed as cases of fibroadenoma. Fifty women of them were agreed to undergo surgical excisional biopsy. Blood samples for testing 25(OH) D were collected from them before the operation.Excisional biopsies of the breast lumps were collected and tissue specimens were processed and prepared for examination by light microscope. The demographic data and histological findings were statistically analyzed for comparison between group A and B.
RESULTS: Histological examination of breast tissue from women of group B showed pericanalicular fibroadenoma in 70% of cases with more sever hyperplasia of the epithelial lining and showed intracanalicular fibroadenoma in 80% of cases with sever proliferation of stromal cells compressing the duct to be slit like spaces and lobulations expanded beyond the surrounding fibroblastic stroma in addition to sever adipose tissue deposition in 84% of cases and sever hyalinization of stroma.
DISCUSSION AND CONCLUSION: Conclusion: The study concludes a significant association of the histological appearance of breast fibroadenoma with deficiency of vitamin D indicated by suppressing the epithelial and stromal proliferation of breast lesions thus vitamin D supplement might arrest the progression of fibroadenoma towards breast cancer.

INTRODUCTION: Pathologic complete response (pCR) has a strong correlation with improved survival in breast cancer. Peripheral blood values such as neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and pan-immune-inflammation value (PIV) have prognostic value in triple-negative breast cancer (TNBC). In this study, we aimed to investigate the prediction of pCR by using the peripheral blood values prior to neoadjuvant chemotherapy in triple negative breast cancer.
METHODS: A total of 102 patients with locally and locally advanced TNBC treated with neoadjuvant chemotherapy (nChT) in four out-patients clinics of medical oncology were included. Hemogram parameters obtained within three weeks prior to neoadjuvant ChT were used. The relationship between pCR and these values was tested with Mann-Whitney U and Student t test, which were appropriate. Categorical variables were tested by Chi-squared test.
RESULTS: The median age was 42 years. One third of the patients received carboplatine along with the backbone chemotherapy. Patients who received carboplatine had a higher rate of pCR (65.7% vs. 31.3% of patients with or without carboplatine had pCR, respectively). The median values of NLR, PLR, and LMR were similar in the patients with and without pCR. Similarly, SII and PIV were not able to predict pCR in patients with TNBC who were treated with neoadjuvant ChT
DISCUSSION AND CONCLUSION: The addition of carboplatine to the neoadjuvant chemotherapy improved the pCR in TNBC. The pre-treatment peripheral blood values such as NLR, PLR, LMR, SII and PIV values could not predict the pCR.

INTRODUCTION: This study aimed whether S100A4 would be useful in predicting Erectile Dysfunction (ED) and ED severity.
METHODS: This prospective study included 88 male volunteers aged 18-80 years. The control group consisted of 44 healthy patients and the diabetic group consisted of 44 patients with type-2 diabetes (T2DM). Age, body mass index, smoking status, hypertension status, International Index of Erectile Function 1-5 scores of all the volunteers were evaluated, and also glucose, HbA1c, cholesterol, testosterone, prolactin and S100A4 levels were measured in the serum samples. The relationships between S100A4 and erectile functions were investigated with appropriate statistical analyzes.
RESULTS: The mean age of the T2DM group was 51.98 ±10.91 years, while the control group’s mean age was 53.77 ±12.46 years and there was no significant difference between them (p=0.31). Glucose, HbA1c, mean ED severity and S100A4 levels in the T2DM group were higher than in the control group, while testosterone level was lower than in the control (p≤0.05). In addition, it was found that S100A4 levels increased due to the increase in ED severity in both groups (p<0.001). In addition to ED severity, smoking and hypertension were seen as the factors that most affected S100A4.
DISCUSSION AND CONCLUSION: The results indicated that S100A4 may be a useful biomarker in determining ED and ED severity.

INTRODUCTION: Diethylnitrosamine (DENA) is known to have a carcinogenic effect on the liver by stimulating oxidative stress and inflammation. There are few studies on the negative effects of DENA on kidney tissue, and the therapeutic effect of Urtica dioica Seed Extract (UDSE) against the negative effects of DENA is investigated for the first time in this study. This study investigated the protective effect of UDSE on kidney tissues of rats administered DENA.
METHODS: The rats were divided into four groups (n=8): control, UDSE (one mL/kg/daily for 16 weeks), DENA (200 mg/kg/first day), DENA+UDSE (200 mg/kg/first-day single dose, and one mL/kg/daily for 16 weeks). At the end of the experiment, blood and kidney tissues were taken for biochemical and pathological analysis.
RESULTS: . DENA administration has been shown to increase oxidative stress in the kidneys and reduce antioxidant levels. Moreover, compared to the DENA group, DENA decreased the level of aquaporin (AQP)-1 in kidney tissue, while UDSE treatment increased both AQP-1 levels in kidney tissue and AQP-1 and 7 levels in serum samples. Histopathological examination of the kidney revealed significant coagulation necrosis, especially in proximal tubular epithelial cells, hyperemia in capillaries, mononuclear cell infiltration between tubular areas, atrophy in the glomerular cluster, and adhesions with Bowman's capsule. In addition, there was a decrease in both caspase-3 (immunohistochemically) expression and TOS levels in the DENA+UDSE group compared to the DENA group, while an increase was seen in antioxidant levels.
DISCUSSION AND CONCLUSION: These findings indicated that UDSE may be an essential therapeutic agent against DENA-induced kidney injury.

INTRODUCTION: This study aimed to evaluate the frequency and reasons for requesting Cone-beam computed tomography (CBCT) by endodontists in Turkey. 213 endodontists in Turkey participated in this survey research.
METHODS: Participants were asked 12 questions regarding their age, gender, the year since they completed their endodontic specialization or doctorate, the institution they work, their title and CBCT use cases. The descriptive statistics of the data are presented as percentages and numbers. The chi-square test was used for pairwise comparisons (p<0.05).
RESULTS: The rate of participants using a CBCT evaluation in their diagnosis and treatment was 77.9%. 81.7% of participants reported that the frequency of CBCT requests was less than 20% compared to the monthly total number of patients treated. 27.7% of participants indicated that the reason for requesting CBCT was to evaluate root resorption, and 36.6% indicated that they needed CBCT most frequently in the maxillary anterior region. It was determined that the majority of the participants, whose frequency of CBCT request was below 20%, did not have sufficient knowledge about CBCT.
DISCUSSION AND CONCLUSION: The majority of study participants use CBCT in their clinical practice. Although most participants have CBCT in their facility, they indicated that they do not have enough information about the use of CBCT. Most participants indicated that the frequency of CBCT use was lower than the number of cases studied. The reasons for using CBCT were complications in resorption and retreatment cases where two-dimensional imaging was inadequate for diagnosis and treatment.

INTRODUCTION: Reducing traffic-related deaths and injuries by 50% by 2030 is the main objective of the General Assembly of the United Nations in 2020. The current study aimed to investigate the characteristics of motor vehicle accidents (MVAs) that occurred between 2013 and 2022 in Turkey and the factors influencing the number of injuries and fatalities in these MVAs, to determine how close this target is.
METHODS: Crude data for the study was taken from the Turkish Statistical Institute's (TUIK) public website. To enable secure comparisons, these crude data were proportionately standardized for this study.
RESULTS: Both the number of MVAs per 1,000 registered vehicles and the number of injured and deceased victims per 100,000 people in Turkey decreased after peaking in 2015. Urban regions contributed to 76.2% of the MVAs which resulted in injuries and fatalities. Males accounted for 76.9% of all fatalities, 69.4% of all injured victims, 97.7% of dead drivers, and 92.5% of injured drivers. While most injuries and deaths occurred between the ages of 25 and 64, the highest risk of death was observed among individuals aged 65 and older in comparison with the 100,000 people. Most of the fatalities and injuries in MVAs happened in August, during weekends and daylight hours. Twilight MVAs had the highest fatality risk. Automobile MVAs were the most common cause of all MVAs, injuries, and deaths. Drivers were accountable for 88.5% of the faults that caused MVAs
DISCUSSION AND CONCLUSION: In Turkey, the frequency of MVAs, together with the number of injuries and fatalities sustained, continues to be comparatively high. Therefore, a road safety committee should be established, and an emergency action plan for safe road vehicle traffic in Turkey should be designed.

INTRODUCTION: Gum chewing improves the mood of individuals and also relieves stress and anxiety. Considering the vicious circle between anxiety and pain, gum chewing may help to break this circle and control the pain caused by invasive procedures. This study aims to investigate whether chewing gum can help relieving pain and anxiety associated with tube thoracostomy application.
METHODS: A pre-test / post-test control group design was used in this quasi-experimental study, which included 46 patients who were applied tube thoracostomy. The patients were assigned to the gum-chewing group and the control group. Patients' pain and anxiety levels were assessed at the 2nd hour following the analgesic application performed after tube thoracostomy and once again 30 minutes after this assessment. The data were analyzed using percentage, frequency, mean, independent and paired samples t-tests.
RESULTS: There was a difference between the chewing gum group and the control group in terms of changes in pain and anxiety. In the second evaluation made after chewing gum, it was determined that the pain and anxiety levels of the gum chewing group were significantly relieved.
DISCUSSION AND CONCLUSION: In management of the pain and the anxiety levels resulting from tube thoracostomy, chewing gum may help to eliminate the vicious circle between pain and anxiety and so reduce pain and anxiety. Chewing gum, as a simple and affordable nursing intervention contributing to pain and anxiety management, should be included in care practices for relieving pain and anxiety after thoracic invasive interventions.

INTRODUCTION: The physiological and anatomic changes in pregnancy create a series of difficulties in intubation for general anesthesia. Therefore, the aim of this study was to investigate the effects on the duration of intubation of the ramped and sniffing positions in the videolaryngoscopy guidelines in the cesarean section.
METHODS: A total of 60 patients undergoing elective cesarean section with general anaesthesia were randomly separated into 2 groups. Both groups were intubated with videolaryngoscopy; one group in the sniffing position with a pillow 7cm in height placed below the occiput, and the other group in the ramped position with specially designed pillows providing horizontal alignment of the external auditory meatus and sternal notch. The intubation times were compared between the groups.
RESULTS: The total intubation time was determined to be statistically significantly shorter in the ramped position (11.80 ± 2.30 s) than in the sniffing position (14.06 ± 1.86 s) (p<0.001). The laryngoscopy time was significantly shorter in the ramped position group (5.61±1.22 s) than in the sniffing position group (7.37±1.48 s) (p<0.001), and the tube insertion time was similar in botth groups (p>0.117).
DISCUSSION AND CONCLUSION: To be able to prevent desaturation which can develop rapidly in rapid intubation because of the reduced functional residual capacity and increased oxygen consumption in pregnancy, the ramped position may be a better option than the sniffing position in pregnant patients applied with tracheal intubation with videolaryngoscopy in cesarean section surgery.

INTRODUCTION: Although the instruments used during surgical intervention are an integral part of modern surgery, these instruments contain many harmful chemical gases, bacteria, viruses, etc. generates surgical smoke containing particles. Operating room workers are exposed to this harmful smoke in surgeries. No study was found in the literature comparing operating room personnel before and after working in the operating room.
METHODS: This study was conducted in a descriptive design. The study was performed in the operating room of Atatürk University Research Hospital between the dates January 2021 September 2021. The study was carried out with a total of 87 operating room personnel (surgeons, nurses, anesthesia technicians) who had worked in another clinic or outpatient clinic before working in the operating room.
RESULTS: In the study, it was determined that 44.8% of the operating room personnel were nurses, 65.5% were female, 51.7% worked in the operating room for 1-5 years, and 46.0% stayed in the surgical operation for 4-6 hours. It was reported that various symptoms related to surgical smoke such as headache (100%), fatigue (95.8%), nervousness (98.3%), muscle pain (98.4%), discomfort (100.0%), amnesia (95.5%), and respiratory tract problems were observed in operating room personnel, especially after working in the operating room.
DISCUSSION AND CONCLUSION: As a result of the study, it was revealed that the operating room personnel experienced various symptoms due to surgical smoke after working in the operating room. This study showed the adverse effects of surgical smoke on the health of operating room personnel.

INTRODUCTION: Effective stem cell mobilization is crucial for autologous hematopoietic stem cell transplantation (auto-HSCT), impacting engraftment time and patient outcomes. This study compared three mobilization regimens (G-CSF alone, G-CSF & plerixafor, and chemotherapy & G-CSF) to determine their optimal use for maximizing CD34+ cell yield and minimizing engraftment times.
METHODS: A retrospective analysis of 227 auto-HSCT patients was conducted. Mobilization groups, CD34+ cell counts, total nucleated cells (TNC), total mononuclear cells (TMNC), and platelet/neutrophil engraftment times were analyzed.
RESULTS: The average engraftment time was 11.6 days for platelets and 10.6 days for neutrophils. The chemotherapy & G-CSF arm yielded the highest CD34+ cells (p=0.001) and lowest TNC/TMNC (p=0.000). This arm also achieved the fastest platelet engraftment (p=0.017-0.001). Notably, age positively correlated with TNC count (p=0.022) and prolonged neutrophil engraftment (p=0.021). Gender did not significantly influence engraftment times.
DISCUSSION AND CONCLUSION: The chemotherapy & G-CSF regimen yielded the highest CD34+ cell count, lowest TNC/TMNC, and fastest platelet engraftment. However, neutrophil engraftment was positively associated with age, suggesting additional factors influence this outcome. Optimizing mobilization strategies and considering patient age are crucial for optimizing auto-HSCT outcomes.

INTRODUCTION: In our study, we evaluated the relationship between the duration of professional work in radiology technicians, the presence of thyroid nodules and hematological parameters.
METHODS: Patients who worked as radiology technicians in our clinic and underwent thyroid ultrasonography in the last 6 months were included in the study. The relationship between the presence of thyroid nodules, thyroid function tests and occupational working time in radiology technicians was statistically analyzed.
RESULTS: A total of 70 patients with a mean age of 39.1±8.5 years were included in the study. Regarding the duration of the study, 19 patients were in group 1 (less than 10 years) and 51 patients were in group 2 (10 years or more). The median age of the patients in group 1 was 30 years (26-47) and the median age of the patients in group 2 was 41 years (20-54). Twenty percent (14) were female and 80% (56) were male and there was no significant difference between the groups in terms of gender (p= 0.893). Thyroid nodules were found in 10.5% of cases in group 1 and 49% of cases in group 2 and this difference was statistically significant between the groups (p= 0.003).
DISCUSSION AND CONCLUSION: It was observed that there was a correlation between the duration of occupational work and the incidence of thyroid nodules in radiology technicians, and we recommend that sensitivity on radiation protection and preventive measures should be increased in the relevant units.

INTRODUCTION: In this study, the efficacy and safety of the caudal block technique for Trus-guided biopsy in patients with anorectal problems were investigated.
METHODS: A total of 31 consecutive patients with anal-rectal problems underwent prostate needle biopsy. All patients included in the study were examined by an experienced general surgeon, and the presence of anorectal problems was confirmed. The majority of patients (61%) were referred from the outer center to our clinic because a biopsy could not be performed due to severe pain felt during rectal probe insertion despite local anesthesia (topical prilocaine or lidocaine cream). A 12-core biopsy protocol was applied to all patients under the caudal block. Pain perception was separately assessed during caudal anesthesia, probe insertion, and sampling stages using a visual analog scale (VAS) score.
RESULTS: The mean age was 64.1 ± 9.1 years. The mean VAS score during caudal anesthesia was 1.8 ± 0.81. At probe insertion, the mean VAS score was 1,44 ± 012. During the needle penetration into prostate tissue and sampling, the mean VAS score was 2.44± 013. All of the patients did not state any bothersome pain at any stage. We did not find any complications related to the anesthesia method.
DISCUSSION AND CONCLUSION: Topical creams and/or PNB do not provide adequate analgesia in patients with anorectal disorders undergoing Trus-guided biopsy. Caudal block technique can be performed effectively and reliably in this selected patient group.

INTRODUCTION: The aim of our study was to evaluate the risk factors associated with mortality in COVID-19 patients who received tocilizumab therapy.
METHODS: During March 2020 to March 2022, 136 patients who were treated with tocilizumab in the service and intensive care unit due to Covid-19 pneumonia confirmed by Reverse-Transcriptase Polymerase Chain Reaction (RT-PCR) were retrospectively analyzed.
RESULTS: While the mean age of the surviving group (n: 70) was 54.4 years, for the dying group (n: 66) it was 67.4 years. There was no significant difference in terms of gender in the surviving and dying patient groups (p: 0.761). The time from hospitalization to tocilizumab treatment was significantly shorter among survivors (p=0.004), while patients who received tocilizumab in the intensive care unit exhibited a higher mortality rate. While the median Charlson Comorbidity Index (CCI) score was 0 in the surviving patients, it was 2 in the dying group. It was found that a 1-unit increase in CCI increased the mortality rate 1.416 times. Age, CCI, neutrophil, neutrophil-lymphocyte ratio (NLR), urea, and C reactive protein (CRP) were found to be independent risk factors for mortality. Patients with high white blood cell, lactate dehydrogenase, troponin, d-dimer, and low lymphocyte, total protein, albumin, and glomerular filtration rates had higher mortality rate.

DISCUSSION AND CONCLUSION: CCI, white blood cell, NLR, urea, LDH, troponin, d-dimer, CRP, lymphocyte, GFR, albumin and total protein basal values can be used as risk factors for death from Covid -19 disease.In addition, early initiation of tocilizumab therapy may reduce mortality rates.

INTRODUCTION: The aim of this study was to investigate the immediate effect of neural mobilization techniques, one of the manual therapy methods that can be used in the treatment of cervical radiculopathy(CR).
METHODS: Forty-four patients diagnosed with CR were assigned to the Control Group(CG, n=22) or Neural Mobilization Group(NMG, n=22) by simple randomization. CG received conventional physiotherapy and NMG received additional neural mobilization to conventional physiotherapy. Pain levels and characteristics of the patients were evaluated with the Numerical Pain Rating Scale(NPRS) and Neuropathic Pain Questionnaire(NPQ) at the beginning and end of the intervention, hand grip strength and pinch grip strength were evaluated with digital hand dynamometer(JAMAR Plus Digital Hand Dynamometer) and digital pinch gauge(JAMAR Plus Pinch Gauge).
RESULTS: Although there was a significant difference in the severity of neck pain and grip strength of both hands in both groups(p<0.05), there was no significant difference between the groups. While pinch grip strength increased in both groups, there was a greater increase in NMG than CG(p<0.05). In the comparison of the post-intervention pain characteristics of the two groups, the neural mobilization group showed a significant decrease in "unpleasant pain" and "overwhelming pain" values compared to the control group(p<0.05).
DISCUSSION AND CONCLUSION: The results showed that neural mobilization in CR was effective in acutely reducing pain and increasing hand grip and pinch strength. The addition of neural mobilization to the physiotherapy program may be considered for short-term goals in the treatment of CR, but its long-term effectiveness should be investigated.

INTRODUCTION: The relationship between diabetes and behavior is examined in retrospective studies in humans, as well as in animal models. In this study, it was aimed to present data to researchers working in this field by making a bibliometric analysis of worldwide trends in diabetes and behavior studies using animal models.
METHODS: This bibliometric study investigates studies of diabetes and behavior using animal models conducted between 1990 and 2023. As a result of searches made in the Web of Science (WOS) database using the keywords "Diabetes, animal, behavior", 2695 of 2710 studies were selected. The complete textual data underwent thorough analysis using VOSviewer software (version: 1.6.20) to ensure accuracy and reliability.
RESULTS: In this study, information was given about 2695 articles and 123666 citations to these articles taken from WOS database. The average number of citations per article is 54 and the H index is 158. Since 2002, both the number of articles and the number of citations have increased rapidly. Almost all of the articles were published in the fields of health sciences and the majority (25%) in the fields of neurosciences. USA, Germany and England are the countries that publish the most articles on this subject (74%). Most of the articles (50%) were published by Elsevier, Springer Nature and Wiley publishing houses, and a large proportion (95%) are in the SCI-Expanded category.
DISCUSSION AND CONCLUSION: The findings of our study show that many researchers are active in the field of diabetes and behavior using animal models and that research in this field is increasing.

INTRODUCTION: The aim of this study was to assess the potential of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) as diagnostic and prognostic parameters in predicting the malignancy potential of adrenal incidentalomas (AI).
METHODS: A retrospective analysis was conducted using data from a prospectively maintained database, including 66 patients with AI. The patients were categorized into two groups: Group M (malignancies) and Group B (benign conditions).
RESULTS: Postoperative pathological evaluation revealed adrenocortical cancer in eight patients (12.1%). No statistically significant differences were found between the groups in terms of NLR [Group M: 2.94 ± 1.78, Group B: 2.51 ± 1.08, p = 0.335] and PLR [Group M: 136.90 (98.7-354.05), Group B: 118.39 (28.5-315.32), p = 0.479]. However, analysis of adrenal mass size revealed a statistically significant difference, with Group M having a mean size of 80.5 mm (range: 40-146) and Group B having a mean size of 60.5 mm (range: 40-122) (p = 0.008).
DISCUSSION AND CONCLUSION: While NLR and PLR showed numerical increases in malignant adrenal masses, their utility in differentiating between benign and malignant masses was not significant. Further investigation of NLR and PLR in larger cohorts of patients with AI is recommended to better understand their diagnostic and prognostic value in this context.

Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide, affecting the majority of people at some point in their lives. The persistence of high-risk HPV is not only critical for the development of cervical cancer, but also contributes to the development of cancers in other anogenital areas, including the penis, vulva, vagina, anus and oropharynx. Prophylactic HPV vaccines have the potential to prevent HPV infection and thereby reduce the burden of HPV-related disease. The primary target population for HPV vaccination is individuals aged 9-14 years with no history of HPV infection. Vaccination is also recommended for those who are already infected, although efficacy may not be as robust as in the HPV-naive group. Many countries are implementing gender-neutral vaccination programmes, encouraging both males and females to receive the vaccine. This approach aims to reduce the risk of HPV-related cancers, prevent anogenital warts, and promote herd immunity. While routine single-dose vaccination is not the norm, it may be considered in resource-limited settings where access to multiple doses is difficult. Long-term data confirm that HPV vaccines significantly reduce the incidence of cancer and HPV-related diseases, and underscore their safety and efficacy.