INTRODUCTION: Objectives:
Preeclampsia is a condition of pregnancy linked with placental failure; it is described by low levels of nitric oxide, oxidative stress, and abnormal remodeling of the spiral arteries. N(ω)-nitro-L-arginine methyl ester (L-NAME) is administered to mimic these effects in animals. Protective antioxidants; Vitamin E and omega-3 fatty acids.
Aims:
The present study will try to show beneficial effects, to what degree, of Omega-3 and vitamin E consumption on the placental histopathology in an experimental rat induced preeclampsia.


METHODS: Materials and Methods:
To study the effects of L-NAME preeclampsia and the protective roles of omega-3; and vitamin E, forty pregnant Wistar rats were divided into five groups. Doppler ultrasound, histological evaluation, and biochemical analysis as well as statistical calculation were integrated to measure maternal blood pressure, placental histology, and oxidative stress assessment.

RESULTS: Results:
Lethargy, rising mean arterial blood pressure (MABP), and increased placental oxidative stress—as elevated malondialdehyde (MDA) levels and significant histological damage—were consequences of L-NAME-induced preeclampsia during the course of this study. Individual omega-3 or vitamin E treatments lowered MDA with an improvement in placental structure. However, it is the combination treatment that indicated a preventive synergistic effect against preeclampsia by markedly increasing maternal activity, decreasing MABP, oxidative stress, and restoring placental histology to near normal.

DISCUSSION AND CONCLUSION: Conclusion:
Placental damage and oxidative stress resulted from L-NAME-induced preeclampsia. Vitamin E and omega-3 therapies markedly ameliorated the markers of oxidative stress as well as the degree of tissue degeneration, which implies therapeutic protective potential.

INTRODUCTION: Magnesium is involved in immune-inflammatory processes, and hypomagnesemia is associated with type 2 diabetes mellitus (T2DM). Blood cells (BCs) and BCs-derived indices are popular subjects. However, the relationship between magnesium and BCs-derived indices has not been investigated in diabetes. The aim of this study was to compare hypomagnesemic and normomagnesemic patients with T2DM in terms of BCs and BCs-derived indices, and to investigate the correlation of magnesium with these parameters.
METHODS: The study included 204 patients with T2DM, 62 hypomagnesemic (<1.8 mg/dL) and 142 normomagnesemic (1.8-2.6 mg/dL). Hypomagnesemic and normomagnesemic cases with T2DM were compared in terms of BCs and BCs-derived indices including NLR (Neutrophil/Lymphocyte), MLR (Monocyte/Lymphocyte), PLR (Platelet/Lymphocyte), Systemic immune-inflammatory index, Systemic inflammatory response index, and Aggregate index of systemic inflammation. Also, correlation analysis was performed between serum magnesium and BCs and indices.
RESULTS: There was no significant difference between the groups in terms of demographic and clinical characteristics (p>0.05). The two groups were statistically similar with respect to BCs (p>0.05), except erythocytes. Hypomagnesemia group had significantly lower erythrocyte count than normomagnesemia group (p=0.042). The groups were not different statistically in terms of BCs-derived indices (p>0.05). No significant correlation was found between serum magnesium and BCs and BCs-derived indices (p>0.05), except NLR. There was significant negative correlation between serum magnesium and NLR (r: -0.152; p=0.030).
DISCUSSION AND CONCLUSION: No overall relationship was found between serum magnesium and BCs-derived indices. The lower erythrocyte count in hypomagnesemics and the negative correlation of magnesium with NLR may be related to hypomagnesemia in T2DM.

INTRODUCTION: Urinary incontinence (UI) is a common and important health problem in society. It has negative effects on individuals' daily life activities and quality of life.
Aim
Our study aims to assess the relationship between B12 vitamin and urinary incontinence.

METHODS: 109 patients (80 women, 29 men) diagnosed with urinary incontinence at Recep Tayyip Erdoðan University between January 2018 and December 2023 were retrospectively examined. As a control group, 100 healthy individuals (66 females, 34 males) of similar age to the patients were included. Vitamin B12 levels were measured using the Electrochemiluminescence Immunoassay (ECLIA) method. UI was assessed with specific questions regarding stress and urge incontinence.

RESULTS: When we compared the control and patient groups, there was no difference (44.76 and 43.6 years, respectively). B12 levels were lower in the control group compared to the patient group (p<0.001). When we compared the folate levels in the patient group, they were lower than in the control group (p=0.035).


DISCUSSION AND CONCLUSION: In our study, we found a significant association between vitamin B12 deficiency and urinary incontinence. B12 deficiency contributes to pelvic floor dysfunction through neurological and structural changes. These results suggest that treatment of vitamin B12 deficiency may play an important role in the management of urinary incontinence.

INTRODUCTION: This study aims to investigate the role of mitral annular plane systolic excursion (MAPSE) in evaluating left ventricular function in patients with chronic obstructive pulmonary disease (COPD).
METHODS: This study included 53 COPD patients and 51 healthy controls. All participants underwent echocardiographic evaluation, including tissue Doppler imaging. Lateral MAPSE was measured via M-mode in the apical four-chamber view.

RESULTS: The mean age of the study population was 63.5 ± 8.8 years, with 69.2% male. No significant differences were observed between the COPD (n=53) and control (n=51) groups regarding age, sex, heart rate, blood pressure, comorbidities, or laboratory findings, though smoking was more prevalent in the COPD group. Pulmonary function tests showed significantly lower FEV₁ and FEV₁/FVC in COPD patients (p<0.001). Conventional echocardiographic parameters including left ventricular dimensions and ejection fraction were similar between groups. However, the COPD group exhibited higher LAVi and e/E′ ratios, lower E′ velocities, and impaired right ventricular function indicated by reduced TAPSE and Sm-RV and elevated PAPs (all p<0.001). Importantly, MAPSE values were significantly decreased in COPD patients, reflecting impaired longitudinal left ventricular function [11.3 (9.6–13.8) vs. 13.7 (13.4–15.2), p<0.001].

DISCUSSION AND CONCLUSION: Reduced MAPSE in COPD patients may indicate early LV systolic dysfunction. MAPSE is a simple and reliable parameter that may aid in the early detection of cardiac involvement in COPD.

INTRODUCTION: This study aimed to investigate the distribution of oncology patients who underwent positron emission tomography-computed tomography (PET/CT) imaging using 2-[18F]-Fluoro-2-deoxy-D-glucose (FDG) radiopharmaceutical, according to cancer type.
METHODS: Our study included 2595 (F/M: 1367/1228) patients who were referred to our Nuclear Medicine department for oncological FDG PET/CT imaging in 2023. Patients are divided into groups according to their cancer type. The frequency of imaging number according to cancer types was obtained by proportioning the number of imaging types of cancer in each group to the total number of imaging.
RESULTS: The most common cancer type in FDG PET/CT imaging performed in our department is breast cancer (20.5%). The frequency of imaging for malignancies originating from the lung, stomach and esophagus was calculated as 19.6%, 10.5% and 7.6%. Oncological FDG PET/CT imaging performed for these four organs constitutes 58.2% of the FDG PET/CT imaging performed in our department.
DISCUSSION AND CONCLUSION: When the distribution of cancer types in our country is evaluated, lung and breast cancers are the most common cancers. It is known that stomach and esophageal cancers are less common and come after colorectal cancers. However, considering the number of imaging studies for esophageal and stomach malignancies in our patients referred to our unit, the incidences of these cancers in our region are higher than in the whole country.

INTRODUCTION: Today, peripheral nerve injuries are one of the clinically critical pathological conditions with a high prevalence and significantly reduce the quality of life of individuals. In peripheral nerve injuries, structural and functional deteriorations of varying rates and reversible or permanent nature are observed in sensory, motor, and autonomic nerve fibers. In peripheral nerve injuries, although the source varies, practical treatment approaches and chemical agents are needed to reverse the pathological processes that develop in the acute and chronic periods.
METHODS: In this study, the effects of trauma and neurotoxicity at the cellular level in the acute period were examined, and the role of these factors in neuronal survival was evaluated. Balb/C strain mice with high regeneration capacity, 6–8 weeks old, were used in the study. In vitro experiments were performed on dorsal root ganglion (DRG) neurons isolated from these animals. Three groups were formed in the experimental design: The control group, the axotomy (trauma) group, and the cisplatin-treated neurotoxicity group.
RESULTS: According to the obtained data, it was observed that the traumatic effect modeled with the axotomy method reduced neuronal survival more significantly compared to cisplatin-induced neurotoxicity (p<0.05).
DISCUSSION AND CONCLUSION: These findings indicate that preserving neuronal survival in the acute period is critical in managing nerve injury.

INTRODUCTION: To investigate the effect of renal artery Doppler (RAD) parameters on the increase in fetal urine production and identify potential associations with isolated polyhydramnios.
METHODS: This prospective case-control study was conducted at a single tertiary center. A total of 84 patients were included. Patients were grouped into patients with polyhydramnios and patients with normal AFI. RAD parameters were evaluated for each patient.. Spearman correlation coefficient was used. The “ROC” curve was used to determine the cut-off value for predicting isolated polyhydramnios.
RESULTS: A significant difference was observed in the systolic/diastolic ratio between the isolated polyhydramnios group and the control group (p=0.03). The cut-off value for renal artery S/D ratio in predicting isolated polyhydramnios was determined as 4.96 with 73% sensitivity and 58% specificity. In spearman correlation test, S/D ratio showed a moderate positive correlation with AFI.
DISCUSSION AND CONCLUSION: Isolated polyhydramnios is correlated with S/D, one of the RAD parameters. Based on the S/D ratio, we can say that isolated polyhydramnios is of renal origin.

INTRODUCTION: We aimed to determine the knowledge levels of women of reproductive age regarding healthy baby monitoring, assess their health literacy levels, identify the influencing factors, raise awareness on the topic, and address any deficiencies if present.
METHODS: Sociodemographic data, healthy baby monitoring survey questions, and Adult Health Literacy Scale results of women aged 18-49 appling to primary healthcare services were recorded. For group comparisons, the Mann-Whitney U test and Kruskal-Wallis test were used. Continuous data were expressed as mean ± standard deviation (SD) values and categorical data as number (n). A p-value of <0.05 was considered statistically significant.
RESULTS: The mean age of the participants (n=196) was 29.22±8.52. A total of 123 participants were married, and 105 had children. Twenty-seven mothers reported receiving support regarding infant care. The mean score for healthy baby monitoring was significantly higher among participants whose income exceeded their expenses, those aged 24–31 and 32 years or older, those who graduated from secondary school, civil servants, mothers, and among those with one child compared to others. The average AHLS score was higher and showed a significant difference among university graduates, civil servants, singles, those without children, and those with one child. A significant positive correlation was found between the healthy baby monitoring score and the AHLS score (r=0.538, p=0.00).
DISCUSSION AND CONCLUSION: Easily accessible and flexible educational programs should be offered to women aged 18-49 at the primary healthcare services. Additionally, responsibilities should be distributed among families, and interactive monitoring and vaccination programs should be established.

INTRODUCTION: Transfusion-dependent thalassemia patients neurological complications remained subclinical and were demonstrated only during neuropsychological, neurophysiological, or neuroimaging evaluation. The aim of this study was to investigate the incidence of peripheral and entrapment neuropathies in a patient group and determine whether these neurological complications correlate with liver and heart involvement.
METHODS: The study included 28 patients with transfusion-dependent thalassemia and 32 healthy controls. Nerve conduction studies were performed in the upper and lower extremities and the findings were evaluated in terms of entrapment neuropathy and polyneuropathy. Demographic data, laboratory parameters, radiological images of the patients were compared with the nerve conduction findings.
RESULTS: In the patient group, 64.29% had polyneuropathy, 10.71% had carpal tunnel syndrome, and 3.5% had ulnar neuropathy at elbow. Polyneuropathy was significantly more prevalent in the patient group. No correlation was found between polyneuropathy and age, gender, splenectomy, or ferritin. Hemoglobin was positively correlated with sural amplitude and tibialis amplitude. Liver MR T2 sequence was negatively correlated with PNP, ulnar sensory latency and was positively correlated with ulnar sensory amplitude, ulnar sensory velocity. We didn’t find relationship between heart MRI T2* and nerve conduction study.
DISCUSSION AND CONCLUSION: The findings obtained in the present study indicate that in patients with transfusion-dependent thalassemia, PNP is associated with iron overload in tissues. Furthermore, neurologic complications may be associated with other organ involvement.

INTRODUCTION: The aim of this study was to examine carotid intima-media thickness (CIMT) and other cardiometabolic indices in obese patients, compare to controls, and evaluate the relationships between CIMT and other indices in obese individuals.
METHODS: This cross-sectional study included patients diagnosed with obesity between September 2019 and January 2022 and a control group without obesity. A broad range of metabolic markers were measured, including fasting glucose, glycated hemoglobin (HbA1c), fasting insulin, and homeostasis model assessment for insulin resistance (HOMA-IR); lipid profile; C-reactive protein (CRP); and thyroid function tests. Several cardiovascular risk indices were calculated: atherogenic index of plasma (AIP), visceral adiposity index (VAI), lipid accumulation product (LAP), and triglyceride-glucose index (TyG index). CIMT was measured following standardized protocols.
RESULTS: Obese and control groups included 107 and 108 participants, respectively. Patients with obesity were significantly older (39 [29-43] vs. 33.5 [28-40], p = 0.040), while sex distribution did not differ (p = 0.089). Anthropometric results aligned with anticipated differences between the obese and normoweight groups. Cardiometabolic parameters, including glucose (p = 0.012), HbA1c, insulin, HOMA-IR, triglycerides, CRP, CIMT, AIP, VAI, LAP, and TyG index, were significantly elevated in the obese group (p < 0.001). CIMT had weak correlations with age (r = 0.362, p < 0.001), total cholesterol (r = 0.206, p = 0.034), and low-density lipoprotein cholesterol (r = 0.293, p = 0.002).
DISCUSSION AND CONCLUSION: Obese individuals had significantly higher CIMT, AIP, VAI, LAP, and TyG index values, but no statistically significant correlations were detected between CIMT and cardiometabolic indices.

INTRODUCTION: A class of traditional chemotherapy medications with a wide range of pharmacological activity is benzoimidazole. Imidazole compounds show anticancer activity both in vitro and in vivo, according to recent literature publications. Making a benzimidazole derivative and testing its anticancer properties in DLD-1 colon cancer cells was the study's goal.
METHODS: Hematoxylin eosin staining, caspase-3 activity, and the MTT assay were among the biological investigations.
RESULTS: A microplate reader was used to measure the impact of SL-9 on cell density in light of the MTT analysis data, and a logarithmic slope line was produced. The IC50 value of SL-9 was found to be 57.68 µM based on the logarithmic slope line. Over the course of treatment with 20 μM SL-9, a notable decline in cell viability was noted. Typical apoptotic alterations, particularly nuclear condensation and nuclear fragmentation, were noted in the cells with morphological parameters 24 hours after the start of treatment. These results imply that SL-9 caused cell death by apoptosis. When measured in terms of mitotic activity, the control group showed higher levels of mitotic activity than the treatment group.
DISCUSSION AND CONCLUSION: Therefore, it was discovered that the substance SL-9, a benzimidazole derivative, had a strong lethal impact when administered to colon cancer cells at varying concentrations. More thorough research should examine these beneficial effects of SL-9 treatment on colon cancer cells from a variety of angles.

INTRODUCTION: Bee allergies cause a significant health risk due to the potential for severe, life-threatening reactions and they negatively an individual's quality of life. We aimed to investigate prevalance and characteristics of bee and wasp sting allergies in *** province of *******.
METHODS: Patients who experienced allergic reactions after any bee stings between 2021 and 2024 were evaluated. The study assessed patients’, Apis-specific immunglobulinE (IgE), Vespula-specific IgE, total IgE andtryptase results, in addition to demographic characteristics such as age, gender, time of bee sting, and severity of allergic reaction.
RESULTS: A total of 139 patients with venom allergy were included. The median age was 33 years and53% of the patients were male.While 21% of the patients reported an allergy to honeybees, 62% reported an allergy to wasps, and 17% reported an allergy to both honeybees and wasp. Allergy tests were found negative in one of the four patients. Total IgE levels were significantly higher in those with positive allergy tests p deðerleri hepsine 0 dan sonra virgül koymaný istemiþ sen de hala nokta (p=0,001). Additionally, the positivity rate in allergy tests was found to be significantly higher for wasps than for honeybees (p=0,001).
DISCUSSION AND CONCLUSION: We found that the prevalence of wasp allergy in our geographical region is higher than honey bee allergy although beekeeping activities are widespread. This may be due to the strict adherence to protective measures in the beekeeping sector and the fact that the city center is concentrated in a small area within the rural region.

INTRODUCTION: If the severity of the stressor exceeds the threshold level of the body, this situation may disrupt homeostasis and cause some diseases. The aim of this study was to investigate the effects of exogenous oxytocin application on spatial learning performance of rats exposed to chronic cold stress.
METHODS: 39 male and 40 female adult Wistar albino rats were used. Rats were divided into CNT, OT, CS and CSO groups as male and female. Rats in CS and CSO groups were kept at +4 ºC for 2 hours for 21 days. Intranasal oxytocin (1 µg/µl; 2x10 µl) was applied bilaterally to rats in OT and CSO groups. Then, Morris Water Tank (MWM) experiments were performed. Hormone levels were measured in the blood samples taken and histopathological examinations were performed in brain tissue.
RESULTS: In MWM learning trials, the CSO group found the hidden platform later in both male and female rats. In the probe phase where memory performance was evaluated, it was observed that memory processes of all groups were preserved, however, in female rats, the CSO group spent less time in the target quadrant. Plasma corticosterone levels were found to be significantly higher in the CSO group in male and female rats. In male rats, the dentate gyrus granule cell layer was significantly thinner in the CSO group.
DISCUSSION AND CONCLUSION: Chronic cold stress impaired learning performance in male rats but did not cause any change in female rats. It was observed that intranasal oxytocin administration to stressed rats further deepened spatial learning impairment.

INTRODUCTION: To evaluate demographic profiles, surgical indications, and complication rates associated with laparoscopic gynecologic procedures for benign conditions, while identifying risk patterns across different surgical types.
METHODS: This retrospective study included 172 patients who underwent laparoscopic hysterectomy (n = 52), hysterectomy with oophorectomy (n = 48), or cystectomy/oophorectomy (n = 72) at a tertiary center. Data on demographics, indications, complications, and outcomes were analyzed. Postoperative complications were categorized using the Clavien-Dindo classification. Chi-square and t-tests or Mann–Whitney U tests were used for comparisons (SPSS v25.0, p < 0.05).
RESULTS: Patients in the hysterectomy with oophorectomy group were older (mean age 53.0 ± 7.0) and had higher comorbidity (70.8%) and medication use (61.5%). Uterine fibroids were the leading indication in hysterectomy groups, while ovarian cysts were predominant in the cystectomy/oophorectomy group. The hysterectomy with oophorectomy group showed significantly higher rates of bladder injury (4.2%, p = 0.032), ureter injury (6.2%, p = 0.043), and ICU admission (10.4%, p = 0.022). Grade IIIb and IV complications were also more frequent. Subgroup analysis of endometrioma cases (n = 32) confirmed elevated complication risk in extensive procedures.
DISCUSSION AND CONCLUSION: While laparoscopic surgery is effective for benign gynecologic conditions, complication rates vary by procedure type and patient complexity. Thorough preoperative evaluation and surgical expertise are vital, especially in advanced cases. vNOTES and other minimally invasive innovations may offer safer alternatives for select patients.

INTRODUCTION: This work aimed to research the actions of Epigallocatechin Gallate (EGCG) on heart tissue in diabetic rats.
METHODS: In the work, twenty-eight rats were taken and splited into 4 groups as control group, EGCG, Diabetes, and Diabetes + EGCG. A one dose of 45 mg/kg streptozotocin (STZ) was performed intraperitoneally to the groups to be described with diabetes. EGCG was given to the animals at 20 mg/kg/day for 14 days using an intragastric tube. The heart tissue was colored with Masson trichrome and Hematoxylin-Eosin (H&E). Heart tissue was evaluated by histopathological and immunohistochemical (Collagen type III) methods.
RESULTS: In the histological structure of the diabetic group, irregular heart muscle fibers, inflammatory cell infiltration, and necrotic myocytes in the myocardium and increased collagen type 3 expression were observed, and these findings were found to decrease in the Diabetes + EGCG group. It was found that the density of collagen content increased in the Diabetes group. This finding decreased in the Diabetes + EGCG group.
DISCUSSION AND CONCLUSION: The findings of our study suggest that EGCG may have ameliorative effects on induced cardiotoxicity in diabetic rats.

INTRODUCTION: Transforaminal epidural injection is increasingly recognized as a primary treatment for unilateral radiculopathy associated with lumbar disc pathology. This study retrospectively examines the imaging and clinical outcomes of patients who received transforaminal steroid injections for unilateral radiculopathies.
METHODS: This retrospective analysis included 100 patients who underwent transforaminal epidural injections at a single center, performed by the same surgeon between 2022 and 2023. Patients were selected based on specific inclusion criteria such as unilateral radicular leg pain, failure to respond to six weeks of conservative treatment, and a Visual Analog Score (VAS) score of 5 or higher. Magnetic resonance imaging (MRI) was used to confirm underlying pathologies, including lumbar disc herniation, spinal stenosis, or spondylolisthesis.
RESULTS: Treated patients, 76 (76%) experienced a significant reduction in VAS score by more than 50% within 15 days post-treatment. The analysis showed higher efficacy in patients treated at a single level (86.84% benefit) compared to those with multi-level pathologies (13.16% benefit). Additionally, patients with isolated lumbar disc pathology had better outcomes compared to those with concomitant stenosis or spondylolisthesis.
DISCUSSION AND CONCLUSION: Transforaminal epidural injections provide effective short-term pain relief in patients with lumbosacral radiculopathy primarily due to lumbar disc pathology. The procedure's success rate diminishes with increasing complexity of spinal involvement, highlighting the need for careful patient selection and targeted therapeutic approaches.

INTRODUCTION: In this study, it was aimed to retrospectively evaluate the epidemiological characteristics and long-term side effects related to hormon and bone metabolism in the follow-up of lymphoma patients between the ages of 0-18 years.
METHODS: 98 patients who were diagnosed with HL and NHL between 2007-2020 in the Van Yuzuncuyil University Pediatric Hematology Clinic were retrospectively scanned from the hospital database.
RESULTS: A total of 98 pediatric patients (55 HL, 43 NHL) were included, of whom 75.5% were male. The mean age at diagnosis was significantly higher in HL compared to NHL (106.7 ± 46.8 vs. 103 ± 50.3 months, p=0.032), while the mean updated age showed no significant difference (p=0.701). Among HL patients, mixed cellular type (49.1%) was the most common subtype, and 41.8% received RT in addition to CT. Growth retardation was observed in 2 patients, and puberty disorders in 7 patients (p>0.05). Vitamin D deficiency was frequent in both groups (HL: 38.2%, NHL: 23.3%). No significant differences were found in PTH, phosphorus, ALP, TSH, or fT4 levels. Hypothyroidism was present in 5 patients before and developed in 6 additional cases after CT-RT, without statistical significance. FSH levels were significantly higher in HL compared to NHL (p=0.037), whereas LH, estradiol, and testosterone showed no significant difference between groups.
DISCUSSION AND CONCLUSION: We conclude that it is important to evaluate patients regularly in terms of endocrinological and metabolic side effects related to CT and RT during the treatment process and long-term follow-up.

INTRODUCTION: This study aimed to investigate the seropositive rates of pregnant women against CMV infection and compare seroprevalence in different age groups in Van. This study aimed to investigate the seropositive rates of pregnant women against CMV infection and compare seroprevalence in different age groups in Van.
METHODS: The CMV serology results of 1665 women screened in the first trimester of pregnancy were evaluated between January 2022 and January 2024. The cohort's pregnant women were divided into three groups based on maternal age to make a comparison. Group 1 consisted of pregnant women aged 18-24, group 2 of pregnant women aged 25-35, group 3 of pregnant women over 35 years old. Categorical values were analysed by the chi-square test. A p-value <0.05 was considered statically significant.
RESULTS: The mean maternal age was 29.2±5.9 (range 18-43) years. CMV IgM was positive in 1.6%, 1.3% and 1.2% of women in group 1, group 2 and group 3 respectively. There was no significant difference in CMV IgM positive rates between age groups (p: 0.87). CMV IgG-positive women composed 95.8%, 96.3% and 97.8% of the population and it was similar among groups (p: 0.71). In our cohort 3.5% of women were seronegative and 96.5% were seropositive in CMV serology screening. CMV IgM, IgG were positive in 24 (1.4%) pregnant women CMV IgG avidity was high in 18, low in 4 and intermediate in 2 women.
DISCUSSION AND CONCLUSION: Our results demonstrate that CMV seropositive rate is very high in our region and seroprevalence is similar between young and older women.

INTRODUCTION: Morphological features such as cerebellar tonsillar descent, increased volume, and a peg-shaped configuration are frequently described in Chiari malformation type I (CMI); however, their presence in the normal population remains insufficiently characterized.To define normative anatomical parameters of cerebellar tonsil morphology and determine the prevalence of features commonly associated with CMI in structurally normal adult brains.
METHODS: Thirty formalin-fixed adult brain specimens were analyzed. Tonsils were categorized as round or peg-shaped. Bilateral tonsillar volumes were calculated using ellipsoid modeling, and spatial relationships to the obex, cerebellar vermis, and inferior cerebellar peduncle were recorded.
RESULTS: The right tonsil had significantly greater volume than the left (1199.8 ± 463.1 mm³ vs. 1060.5 ± 400.7 mm³; p = 0.023), primarily due to increased width (11.2 ± 2.3 mm vs. 9.8 ± 2.7 mm; p < 0.001). Round-shaped tonsils were larger than peg-shaped ones on the right (p = 0.048), and a similar trend was observed on the left (p = 0.061). Peg-shaped tonsils were present in 35% of all specimens examined. Only left tonsillar volume correlated with obex distance (r = –0.385, p = 0.035). No associations were observed between volume asymmetry or shape and spatial displacement.
DISCUSSION AND CONCLUSION: This study shows that features often associated with CMI—peg shape, descent below the obex, and right-sided dominance—can occur in anatomically normal brains. Without compression or CSF flow impairment, these findings may not justify tonsillar reduction, and surgery should be guided by clinical, imaging, and intraoperative assessment.

INTRODUCTION: Hypercalcemia is a significant electrolyte disorder and might be seen as the first finding of an occult disease. This study aimed to assess the clinical features of patients with hypercalcemia, to identify the underlying causes and to determine whether physicians undertook further diagnostic investigations to facilitate advanced diagnosis.
METHODS: Between July 2014 and June 2017, patients with total corrected calcium levels≥11 mg/dl, aged 18 and older were included in this study. The patients’ data collection was evaluated retrospectively.
RESULTS: 516 patients were evaluated for hypercalcemia. 35.9% had primary hyperparathyroidism (PHPT), 33.9% had hypercalcemia of malignancy (HCM) and 12.8% were found to have drug-induced hypercalcemia. Patients with HCM had significantly higher calcium levels than patients with PHPT, tertiary hyperparathyroidism, and drug-induced hypercalcemia (p=0.001, p=0.017, p=0.001, respectively). Multiple myeloma (27.4%) was the most frequent malignancy-caused hypercalcemia, followed by lung (18.9%) and breast cancer (9.1%).
DISCUSSION AND CONCLUSION: Our findings indicate that diagnostic tests may be inadequate, particularly in asymptomatic and/or mild-to-moderate cases. It is essential to evaluate clinical indicators and consider drug-induced hypercalcemia, which is notably prevalent in our study. Recognizing the possibility of multiple concurrent causes, including malignancy, drug use, and primary hyperparathyroidism (PHPT), is vital for effective management.

INTRODUCTION: This study aims to retrospectively evaluate obstetric cases admitted to the intensive care unit (ICU) due to complications during the antepartum period.
METHODS: A retrospective review was conducted on 114 obstetric cases admitted to the Intensive Care Unit of Diyarbakýr Gazi Yaþargil Training and Research Hospital for Gynecology and Obstetrics during the antepartum period between 2015 and 2017. The cases were evaluated for age, comorbidities, reason for admission, gestational age, and length of stay in the intensive care unit.
RESULTS: The mean age of the patients was 29.61 ± 6.71, and the mean gestational age was 26.69 ± 5.69. The average length of stay in the ICU was 1.56 ± 0.57 days. The most common reason for ICU admission was preeclampsia, with 26.31% (n=30) of patients admitted due to this condition. Abortus imminence was the second most common reason for admission (n=7, 10.3%). 81.57% of the patients had no comorbidities, and the most frequently observed comorbidity was anemia, at 8.77%.
DISCUSSION AND CONCLUSION: We found that the most common reasons for admission to the ICU during the antepartum period were preeclampsia, eclampsia, oligohydramnios, and anhydramnios, and that the most common comorbidity was anemia.

INTRODUCTION: The anterior clinoid process (ACP) is a critical anatomical landmark for skull base surgery due to its proximity to neurovascular structures such as the internal carotid artery and optic nerve. Pneumatization of the ACP can affect surgical planning and outcomes. Morphometric evaluation provides essential data for safer interventions.
METHODS: A total of 154 CT images from individuals aged 1–79 years were retrospectively analyzed. ACP pneumatization types (Type 0–3), bilateral height and width, and inter-ACP distance were evaluated. Morphometric values were stratified by age and gender. Statistical analysis included t-tests, ANOVA, chi-square tests, correlation analysis, and logistic regression.
RESULTS: Among 154 patients, 54.5% were female and 45.5% male. Pneumatization was more common in males, with statistically significant differences observed for both left (p < 0.001) and right (p = 0.021) sides. ACP widths showed a moderate positive correlation with age. Males had wider ACPs, whereas females had greater ACP heights. Logistic regression indicated male gender and younger age as predictors of ACP pneumatization.
DISCUSSION AND CONCLUSION: ACP pneumatization is significantly influenced by gender but not by age. Morphometric differences exist between sexes and age groups. Knowledge of these variations is essential for minimizing intraoperative complications during skull base surgeries.

INTRODUCTION: This study aimed to evaluate the relationship between uric acid level and urýc acide/albumin ratio (UAR) and stent thrombosis in patients with acute coronary syndrome (ACS).
METHODS: This study was conducted using a single-center retrospective cohort design. The study included 67 patients who underwent interventional treatment for acute coronary syndrome, followed by re-interventional treatment for stent thrombosis within one year, as well as 75 patients who were managed with medical therapy for one year and did not require re-intervention.


RESULTS: Stent thrombosis is significantly associated with diabetes and hyperlipidemia.(respectively p=0,001, p=0,002) Uric acid levels were significantly higher and UAR was significantly lower in the stent thrombosis group. (respectively p= 0,001, p=0,001) The development of no reflow and post-dilatation was more frequent in the stent thrombosis group. ROC analysis revealed that a uric acid cut-off value of 5.55 had a sensitivity of 59.7% and a specificity of 64% for predicting stent thrombosis.
DISCUSSION AND CONCLUSION: The relationship between uric acid levels, UAR, and stent thrombosis likely involves complex processes including inflammation and oxidative stress. Understanding these relationships may contribute to the development of targeted interventions to reduce the risk of stent thrombosis and improve the outcomes of ACS patients undergoing stent implantation.

INTRODUCTION: Urinary tract infection is one of the most common bacterial infections during pregnancy. However, not every pregnant woman presenting with lower urinary tract symptoms (LUTS) necessarily has an actual infection. Since urine culture, the gold standard for diagnosis, takes time to yield results, there is a need for rapid and practical
diagnostic tools. This study aims to evaluate the effectiveness of systemic inflammatory indices in predicting urine culture positivity.

METHODS: Pregnant women presenting with LUTS were retrospectively
evaluated. A total of 106 patients were included, with 53 positive and 53 negative urine cultures. Complete blood count parameters and C-reactive protein (CRP) levels at admission were analyzed. Inflammatory indices including the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), and aggregate systemic inflammation index (AISI)—were calculated and compared between the groups. Their predictive value for culture positivity was assessed.

RESULTS: Patients with positive cultures had significantly longer hospital stays (p = 0.015), higher rates of preterm birth (p = 0.020), and lower neonatal birth weight (p = 0.015). WBC, neutrophils, CRP, and all inflammatory indices were significantly higher in the culture-positive group (all p < 0.001). ROC analysis identified CRP as the most effective marker (AUC = 0.770; sensitivity: 76%, specificity: 70%), while SIRI was the most predictive inflammatory index (AUC = 0.742; sensitivity: 70%, specificity: 68%).
DISCUSSION AND CONCLUSION: Inflammatory indices are useful in predicting urine culture positivity in pregnant women with LUTS. The combined use of CRP and SIRI with WBC and neutrophil counts may enhance diagnostic efficiency.

INTRODUCTION: Acute sleep deprivation is associated with various adverse physiological consequences, such as dysregulation of the autonomic nervous system and adverse cardiovascular events. Markers of ventricular repolarisation are widely accepted in clinical practice to assess the risk of developing malignant ventricular arrhythmias. The aim of this study was to investigate the arrhythmogenic potential of acute sleep deprivation.


METHODS: This was a prospective, observational study conducted in a single centre to investigate the relationship between acute sleep deprivation and ECG parameters. The included subjects did not have any acute or chronic diseases and ECG abnormalities. A 12-lead ECG was performed after a sleepless period of 24 hours after the night shift and after seven days of normal sleep following the night shift. The 12-lead ECG was recorded using a Philips PageWriter TC20 at a rate of 50 mm/sec and ECG parameters evaluated included Tp-e/QT and Tp-e/QTc ratios, frontal QRS-T angle, PR, QT, QTc and Tp-e intervals.
RESULTS: Fifty-nine nurses were included in the study. Qt and QTc duration, mean Tp-e and corrected Tp-e intervals were prolonged after acute sleep deprivation. In addition, Tp-e/Qt ratio and Tp-e/QTc were found to be longer after acute sleep deprivation compared to after normal sleep.
DISCUSSION AND CONCLUSION: The results of our study suggest that acute sleep deprivation has a significant effect on ECG parameters, especially on repolarisation-related ECG parameters, but not on depolarisation parameters

INTRODUCTION: Anti-cyclic citrullinated peptides (anti-CCP) antibodies and rheumatoid factor (RF) represent the key biomarkers that harnessed to diagnose rheumatoid arthritis (RA). This work stands to appraise other less ascertain antibodies as Anti-Mutated Citrullinated Vimentin (Anti-MCV) or Anti-Carbamylated Protein (Anti-CarP) to be used for RA diagnosis.
METHODS: The current study was designed as a case-referent model including 60 RA patients and 30 controls. Sera levels of antibodies and RF were estimated via ELISA; and correlated with each other, and DAS28 score.
RESULTS: : Sera of 43.3% of patients own anti- MCV, while only 30% and 61.7% own anti-carp antibodies and RF respectively. Furthermore 66.7% tested positive for anti-CCP antibodies. Patients Anti-MCV was notably greater than among healthy controls (P value=0.0061). Statistically no significant difference between early, and established; or between seronegative, and seropositive patients. The sensitivity and specificity of anti-MCV for the diagnosis of RA were 43.3% and 96.7%. In regard to anti-CarP antibody, RA patients have significantly higher ODs than controls. Anti-CarP possessed a lower sensitivity (28.3%) and specificity (93.3%) in contrast to anti-MCV antibodies. The validity of anti-Carp antibodies to discriminate between early and established or between seronegative and seropositive RA seems to be low. Although both of anti- MCV and anti-CarP antibodies were correlated with each other, neither of them showed correlation with RF, anti-CCP or DAS 28 score.
DISCUSSION AND CONCLUSION: : Anti-MCV and anti-CarP antibodies are not superior to anti-ccp and RF as diagnostic indicators for RA, with limitation in discrimination between early, late, seronegative and seropositive RA.

A patient, diagnosed with two hydatid cysts in the right lung via thoracic computed tomography (CT) at a healthcare facility due to complaints of cough and dyspnea, was initiated on albendazole treatment. Two weeks after starting treatment, the patient presented to our Emergency Department with complaints of general malaise, severe respiratory distress, and chest pain. Following physical examination and radiodiagnostic evaluations, a diagnosis of tension pneumothorax was established, and urgent intrapleural air drainage was performed. After stabilization of the patient’s general condition, elective surgical treatment for the hydatid cyst was undertaken.

Type I and Type II Aortic Dissection is a condition that requires urgent surgical treatment. Because of its potential to affect all organs, these patients should be operated on without delay. Patients may experience other symptoms such as myocardial infarction (MI), abdominal pain, fainting, confusion, hemiparesis, hemiplegia, severe pain in the lower extremity, shortness of breath, or difficulty in swallowing. A 56-year-old male patient with no known diseases was admitted to the emergency department with a sudden onset of severe pain radiating to the back. In the first examination, he was conscious and cooperative, blood pressure was 190/100 mmHg, heart rate was 110/minute, and temperature was 37o C. There was no MI finding in the electrocardiogram of the patient. On echocardiography, the diameter of the ascending aorta was large and there was a flap inside. The patient was diagnosed with Type I aortic dissection after hemogram and CT angiography taken after biochemistry results. The Roper, Logan, and Tierney Model of Nursing has been implemented in this case report for the patient's diagnosis. The patient was discharged with full recovery on the 12th postoperative day after he was admitted to the cardiovascular surgery service.

Clozapine is a second-generation antipsychotic agent with established efficacy in patients with treatment-resistant schizophrenia. Among the most frequently reported adverse effects of clozapine are components of the metabolic syndrome, including central obesity, insulin resistance, impaired glucose metabolism, dyslipidemia and elevated blood pressure. It has been shown in several studies that clozapine use is associated with clinically relevant increases in serum triglyceride (TG) levels, ranging from 35% to nearly 100% over long-term treatment. In this case, an approximately twenty-fold increase in serum TG levels was observed following the initiation of clozapine therapy, rising from 73 mg/dL to 1686 mg/dL. Prior to clozapine administration, the patient was undergoing treatment for hyperlipidemia, and lipid parameters remained within normal limits. After initiating pharmacological treatment for hypertriglyceridemia, including statins, fibrates, and omega-3 fatty acids, clozapine was gradually tapered and replaced with aripiprazole. Subsequently, serum TG levels decreased to 604 mg/dL over a period of several months. The marked elevation in TG levels observed in our patient was considered to be associated with the patient's pre-existing history of hyperlipidemia. When evaluated in the light of the data obtained from this case, it can be suggested that the rate of lipid increase may be higher than expected in patients with a history of hyperlipidemia who are candidates for clozapine treatment; therefore, it may be recommended that lipid levels be monitored on a monthly basis during the early phase of treatment and at periodic intervals thereafter in such individuals.

INTRODUCTION: Laryngeal squamous cell carcinoma is one of the most common fatal cancers. The chemotherapeutic agent doxorubicin (DOX) has limited efficacy due to frequent side effects and the development of drug resistance during treatment. Therefore, we aimed to investigate whether Gallic acid (GA) has a synergistic effect on the chemotherapeutic effects of DOX and the mechanisms of its action.
METHODS: In order to do this, we looked at how GA stimulates the death of HEp-2 laryngeal cancer cells caused by DOX through the activation of TRPM2 channels. For the study, HEp-2 cells were divided into four groups: Control, GA, DOX, and GA+DOX. Cell viability, antioxidant and oxidant enzyme activity levels, inflammation markers, intracellular ROS levels, apoptosis markers, PARP-1 and TRPM2 expression values were evaluated.
RESULTS: DOX treatment caused cytotoxic effects in laryngeal cancer cells and increased apoptosis markers, intracellular ROS, inflammation markers, oxidant enzyme activity levels, PARP-1 and TRPM2 values, while decreasing cell viability and antioxidant enzyme activity values. The therapy was significantly more successful when GA and DOX were used together.
DISCUSSION AND CONCLUSION: In summary, this study discovered that TRPM2 activation caused the synergistic impact of GA+DOX combination therapy on cancer cell death.