INTRODUCTION: Aim: The study aims to identify factors influencing marital adjustment in pregnant women to inform supportive interventions that promote family stability and maternal health.


METHODS: Methods: A descriptive research design was used. The study sample consisted of volunteer pregnant women admitted to the Obstetrics and Gynecology outpatient clinics of a hospital in eastern. Sociodemographic Data Form and Near East Marital Adjustment Scale (NEMAS) were used for data collection. The study was completed with 370 pregnant women. The enter method of multiple linear regression analysis was used. Regression/decision tree analysis was performed with CHAID method.
RESULTS: Results: A statistically significant difference was found between all sub-dimensions and total scores of the NFLS according to age, working status, marriage type, number of children, previous stillbirth, gravidity, pregnancy planning status and gestational week (p<0.001). A statistically significant difference was found between the sub-dimensions of Marital Satisfaction (MS), Marital Communication (MC), Marital Empathy (ME) and the total scores of the NEMAS according to educational level and duration of marriage (p<0.001). According to family type, a statistically significant difference was found between the scores of pregnant women in the sub-dimension of Relationships with Families (FR)" (p<0.005)
DISCUSSION AND CONCLUSION: Conclusion: Nurses, are in a unique position to assess and monitor marital adjustment as part of routine prenatal care. Integrating marital and emotional well-being into antenatal care not only improves the health of pregnant women, but also contributes to family stability and better outcomes for both mothers and babies.

INTRODUCTION: This study aims to compare the clinical and radiological outcomes of arthroscopic rotator cuff repair (RCR) performed with versus without concomitant long head of the biceps tendon (LHBT) tenotomy, including a three-dimensional (3D) volumetric analysis of the subacromial space.
METHODS: This retrospective study included 43 patients who underwent unilateral arthroscopic single-row repair for small to medium supraspinatus tears between May 2021 and July 2023. Group I (n = 24) underwent RCR with LHBT tenotomy, while Group II (n = 19) underwent RCR alone. Clinical outcomes were assessed using the Visual Analog Scale (VAS) and the American Shoulder and Elbow Surgeons (ASES) score. Subacromial volume was evaluated using 3D MRI volumetric measurements obtained pre- and postoperatively.
RESULTS: In Group I, the mean VAS score decreased from 6.17 to 1.58 and the ASES score increased from 38.21 to 81.13 postoperatively. In Group II, the VAS score decreased from 5.95 to 1.37 and the ASES score increased from 42.32 to 82.47. Both groups showed significant postoperative improvements, but no intergroup difference was observed. Subacromial volume increased from 3.79 cm³ to 4.94 cm³ in Group I, and from 3.85 cm³ to 4.90 cm³ in Group II. Although both groups exhibited a significant postoperative increase in subacromial volume, no intergroup difference was observed in postoperative measurements.
DISCUSSION AND CONCLUSION: In this cohort, no statistically significant additional benefit of concomitant LHBT tenotomy was demonstrated in terms of pain relief, functional improvement, or 3D subacromial volume restoration compared with rotator cuff repair alone.

INTRODUCTION: This study aimed to evaluate lipid peroxidation and antioxidant status in different brain regions of epileptic rats subjected to chronic swimming exercise and vitamin C administration.
METHODS: A total of 48 rats were randomly divided into six equal groups: Control, Swimming, Swimming + Vitamin C, Swimming + Epilepsy, Swimming + Epilepsy + Vitamin C, and Epilepsy. Chronic swimming exercise was performed for 90 days (30 min/day). Vitamin C (ascorbic acid) was administered intraperitoneally at a dose of 100 mg/kg/day. Epilepsy was induced by injecting 500 IU penicillin into the left somatomotor cortex. At the end of the experimental period, brainstem, cerebellum, and brain tissue tissues were collected. Malondialdehyde (MDA, nmol/ml) levels were measured as an indicator of lipid peroxidation, while reduced glutathione (GSH, µmol/ml) levels were determined to assess antioxidant capacity.
RESULTS: In the epilepsy groups, a significant increase in MDA levels and a marked decrease in GSH concentrations were observed compared to the control and Swimming+Vitamin C groups (p<0.05). Combined exercise and vitamin C administration suppressed lipid peroxidation and partially improved antioxidant defense in brain tissue in epileptic rats (p<0.05).
DISCUSSION AND CONCLUSION: These findings suggest that epilepsy is associated with increased oxidative damage and impaired antioxidant defenses in multiple brain regions. Chronic swimming exercise together with vitamin C supplementation may exert protective effects by reducing lipid peroxidation and improving antioxidant capacity in the epileptic brain

INTRODUCTION: This studyaims to evaluate clinical, pathological, biochemical, and imaging differences among borderline ovarian tumors (BOTs) subtypes, serous, mucinous, and seromucinous, to improve preoperative diagnosis.
METHODS: A retrospective analysis was conducted at Kartal City Hospital between January 2018 and October 2023, including 59 patients with histologically confirmed BOTs. Patients were classified into serous (n=36), mucinous (n=18), and seromucinous (n=5) subtypes. Demographic data, tumor markers, inflammatory indices, imaging characteristics, intraoperative frozen section results, and final histopathology were compared.
RESULTS: A total of 59 patients with BOTs were analyzed: 36 (61.0%) serous, 18 (30.5%) mucinous, and 5 (8.5%) seromucinous. The mean age was similar across groups: serous 44.1 ± 12.2 years, mucinous 47.5 ± 19.5 years, seromucinous 45.2 ± 4.3 years (p=0.725). Mucinous tumors were larger (14.0 ± 8.8 cm) than serous (6.9 ± 2.4 cm) and seromucinous (7.7 ± 4.5 cm) (p=0.001). CA-125 and CA19-9 levels differed significantly (p=0.007 and p=0.017), with the highest levels in seromucinous tumors. Solid components on ultrasound were more frequent in serous (50%) and seromucinous (60%) tumors compared to mucinous (16.7%) (p=0.041). MRI septation was most common in mucinous tumors (66.7%, p=0.036). No significant differences were observed for menopausal status, comorbidities, tumor laterality, or frozen section results. AARPTI values differed significantly (p=0.001), highest in mucinous tumors (0.66 ± 0.33).
DISCUSSION AND CONCLUSION: This study revealed that mucinous BOTs are characterized by larger tumor size and higher AARPTI values, while seromucinous tumors exhibit elevated CA-125 and CA19-9 levels. Ultrasound and MRI findings also may aid in the differentiation among subtypes. These distinctions can enhance preoperative diagnosis and guide tailored surgical management.

INTRODUCTION: Growing evidence indicates a close interaction between the autonomic nervous system and inflammatory processes. Irisin, a myokine primarily released from skeletal muscle, has recently been associated with immune regulation; however, data regarding its role in autoimmune diseases are limited. This study aimed to compare serum irisin levels in patients with rheumatoid arthritis (RA) and multiple sclerosis (MS) with those of healthy individuals.
METHODS: The study included 45 patients with RA, 45 patients with MS, and 45 age- and sex-matched healthy controls. Blood samples were obtained and serum irisin concentrations were measured using a commercially available enzyme-linked immunosorbent assay (ELISA) according to the manufacturer’s protocol. Patients were included under stable treatment conditions and low disease activity (DAS-28 <3.2 for RA; EDSS 2.0–5.0 for MS). Physical activity levels were not directly assessed, and body composition parameters were not evaluated.
RESULTS: Mean serum irisin levels were 246.11±119.6 pg/mL in RA, 1898.5±187.6 pg/mL in MS, and 93.87±68.50 pg/mL in controls (p<0.01). Compared with healthy controls, both RA and MS patients exhibited elevated serum irisin concentrations. Moreover, irisin levels were significantly higher in patients with MS than in those with RA (p<0.01).
DISCUSSION AND CONCLUSION: The findings suggest that increased serum irisin levels may be associated with autoimmune inflammatory conditions such as RA and MS. This elevation may be associated with inflammatory processes and could reflect a potential adaptive response. Further longitudinal and mechanistic studies are needed to clarify whether irisin primarily exerts anti-inflammatory or neuroprotective effects in autoimmune diseases.

INTRODUCTION: This study aimed to compare the early and mid-term outcomes of patients diagnosed with acute and subacute deep vein thrombosis (DVT) treated with pharmacomechanical thrombectomy (PMT) only versus combined pharmacomechanical thrombectomy and catheter-directed thrombolysis (PMT+CDT).
METHODS: In this retrospective study conducted between January 2018 and January 2021, 60 patients diagnosed with acute or subacute iliofemoral DVT were included. Patients meeting the inclusion criteria underwent PMT alone or PMT combined with CDT. Thirty patients underwent PMT, while the other 30 received additional CDT following PMT. Demographic data, clinical findings, Doppler ultrasound results, Villalta scores, and complications were evaluated at 1, 6, and 12 months post-treatment.
RESULTS: The mean age was 61.2 years in the PMT group, comprising 14 males (46.6%) and 16 females (53.3%). At the 1-month follow-up, venous patency <70% was significantly more common in the PMT group (43.33%; p=0.032). At 6 and 12 months, patency rates ≥90% were significantly higher in the PMT+CDT group (63.34% and 66.67%, respectively; p=0.033). At 12 months, the rate of post-thrombotic syndrome (PTS) was significantly lower in the PMT+CDT group (33.33%; p=0.038). Although minor complications such as bleeding and transient renal dysfunction were observed in both groups, no significant differences were found regarding major complications or pulmonary embolism.
DISCUSSION AND CONCLUSION: The combination of PMT and CDT was more effective in maintaining venous patency and reducing the risk of PTS compared to PMT alone. Although minor bleeding risks were observed, the combined approach appears to offer superior clinical outcomes. Further multicenter, large-scale studies are warranted to validate these findings.

INTRODUCTION: In this study, a patient-specific cranial phantom (PSCP) was fabricated using 3D printing technology and its usability in individual quality control processes instead of commercially available 2D/3D phantoms was evaluated.
METHODS: Three patient-specific phantoms (PSCP1, PSCP2 and PSCP3) were modelled using computed tomography (CT) data from three different patients and fabricated using a plant-based biopolymer (STH). RTV2 silicone or paraffin wax were used to represent brain tissue. The quality and dosimetric reliability of the phantoms were analysed using point dose measurements with metal oxide silicon field effect transistor (MOSFET) and beryllium oxide (BeO) dosimetry systems on a Trilogy® radiotherapy machine and compared with treatment planning system (TPS) data.
RESULTS: The HU value of neurocranial bones fabricated with 100% infill STH filament was 141 ± 16.7. Silicone and paraffin wax brain tissue surrogates yielded HU values of 33 ± 6.4 and −56 ± 12.8, respectively, compared with 22 ± 4.4 for real brain tissue. In MOSFET measurements, dose differences ranged from 0.25% to 7.78%, while BeO dosimetry showed differences between 2.28% and 7.81%. Across both dosimetry systems, S-VMAT plans consistently produced lower measured doses, whereas higher values were observed with M-VMAT. Point dose analysis revealed a statistically significant difference between S-VMAT and M-VMAT techniques for both brain tissue materials, regardless of lesion number (p < 0.05), indicating a systematic planning-related effect.
DISCUSSION AND CONCLUSION: The obtained data demonstrate that the PSCP can be used as a mechanically stable and dosimetrically reliable model for patient-specific quality assurance by testing different planning techniques and dosimetry systems.

INTRODUCTION: Pulmonary Thromboembolism (PTE) is a clinical condition with a high mortality rate and various difficulties in diagnosis. The fact that scintigraphy, which may be necessary for diagnosis, and angiography, which is the gold standard for diagnosis, can only be performed in certain centers causes diagnostic efforts to be inadequate in some cases. New markers are needed for early diagnosis and prognostic process in this disease. The aim of this study is to determine the diagnostic value of plasma Fetuin-A test in patients with complaints, examinations and nonspecific laboratory findings suggesting PTE and to investigate its usability as a criterion in PTE disease diagnosis.
METHODS: This study was designed as a prospective, observational case-control study comprising 31 PTE patients and 30 controls.
RESULTS: It was determined that there was no significant difference between the patient and control groups in terms of age and gender (p=0.886, p=0.898). There were statistically significant results for white blood cell, albumin, sedimentation rate, C-reactive protein and Fetuin-A values among the groups in our study (p<0.05). It was observed that the difference in Fetuin-A levels in patients who exited due to PTE was not statistically significant (p=0.698).
DISCUSSION AND CONCLUSION: Fetuin-A levels were found to be low in patients with acute pulmonary embolism. This finding is consistent with the results of other studies defining Fetuin-A as a negative acute phase reactant. No significant correlation was found between Fetuin-A levels and mortality in patients with pulmonary embolism.

INTRODUCTION: Round pneumonia is characterized by round, well-circumscribed infiltrative lesions on computed tomography (CT) that can mimic malignant lung masses. This study aimed to evaluate distinguishing parameters between round pneumonia and primary malignant lung masses using histogram-based image analysis, and to investigate the diagnostic contribution of this method.
METHODS: In this retrospective study, 60 patients (30 with round pneumonia, 30 with primary malignant lung mass) diagnosed between 2020 and 2024 were included. Unenhanced thoracic CT images were analyzed; lesions were assessed by two radiologists, and a circular region of interest (ROI) was selected on an appropriate slice for each lesion.Histogram and texture analysis parameters obtained from these ROIs were compared between the two groups. The Mann-Whitney U test was used for two-group comparisons and Spearman’s rank test for correlation (p < 0.05).
RESULTS: Histogram-based analysis revealed many parameters with statistically significant differences between round pneumonia and malignant lung masses. In particular, features such as standard deviation, variance, entropy, range, interquartile range, and contrast provided significant separation between the two groups (p < 0.001). On receiver operating characteristic (ROC) analysis, histogram variance achieved the highest diagnostic performance, distinguishing pneumonia vs. tumor with 100% sensitivity and 100% specificity (AUC = 1.00, threshold ≈ 1.91 × 10³ HU²). No significant correlation was found between the standardized uptake value (SUV) and any histogram parameter in the tumor group.
DISCUSSION AND CONCLUSION: CT histogram analysis is a useful non-invasive tool for distinguishing round pneumonia from malignant lung lesions with similar imaging features, potentially reducing unnecessary invasive procedures.

INTRODUCTION: A healthy balance between the sympathetic and parasympathetic nervous systems is necessary
for normal heart rate variability (HRV), which is the fastest and least intrusive method for
examining data on autonomic modulation of the heart rate. This research aimed to evaluate autonomic cardiac profile changes in children with epilepsy using levetiracetam (LEV) and carbamazepine (CBZ) by analyzing heart rate variability.
METHODS: In this retrospective controlled study, children attempting to go to the pediatrics clinic between October 2020 and December 2022 were subjected to research and divided into three groups: epilepsy using LEV (n=39), using CBZ (n=39), and healthy controls (n=41). Echocardiogram, electroencephalogram, and 24-hour ambulatory electrocardiogram for HRV parameters were evaluated.
RESULTS: The HRV demonstrated no disparities between types of epilepsy, duration of epilepsy, or EEG abnormality. SDNN was considerably lower in children with epilepsy in comparison to healthy controls (p<0.05). The SDNN and pNN50 values of the children using CBZ were considerably lower than those of those using LEV and controls (p<0.05 and p<0.05).Healthy controls showed signs of higher sympathetic tone in cardiac autonomic function compared to children with epilepsy.
DISCUSSION AND CONCLUSION: The children on carbamazepine monotherapy resulted in a more pronounced decrease in parasympathetic tone compared to those treated with LEV or healthy controls. Children on LEV monotherapy don’t alter autonomic cardiovascular functions compared to children with epilepsy on CBZ monotherapy. The recommended use of Holter monitoring and electrocardiographic evaluation can achieve early detection of cardiac complications in high-risk children with epilepsy.

INTRODUCTION: This study aimed to evaluate the changes in oxidative stress markers in obese patients after bariatric surgery.


METHODS: The study included a total of 90 obese adults, divided into two groups: those who underwent bariatric surgery (case, n=45) and those who did not (control, n=45). Parameters such as 8-hydroxy-2-deoxyguanosine (8-OHdG; oxidative DNA damage), NADPH oxidase 2 (NOX2), NADPH oxidase 4 (NOX4), and thiol-disulfide homeostasis were compared in both groups.
RESULTS: 73.3% of the participants were female; age distribution was similar between groups (p=0.698). Body mass index (BMI) was lower in the case group compared to the control group (31.5±7.2 vs. 38.2±3.7 kg/m²; p<0.001). Native thiol levels were lower in the case group (135.9±55.6 vs. 154.3±38.0 µmol/L; p=0.014) and 8-OHdG was higher (7.6±1.8 vs. 6.5±2.1 ng/mL; p=0.015); NOX2 and NOX4 levels were similar (p>0.05). In the case group, those with a BMI change ≥13 kg/m² had higher native thiol levels (p=0.034) and lower 8-OHdG levels (p=0.045). A positive correlation was found between BMI change and native thiol levels (r=0.363; p=0.017). As the amount of weight loss increased, the disulfide/native thiol ratio decreased (r=−0.389; p=0.013) and the native/total thiol ratio increased (r=0.322; p=0.040).
DISCUSSION AND CONCLUSION: Although overall oxidative stress markers (high 8-OHdG, low native thiol) were observed in obese patients who underwent bariatric surgery, improvements in oxidative stress markers were detected in those with greater BMI reduction. The findings suggest that effective weight loss after surgery may increase antioxidant capacity and reduce DNA oxidative damage. Long-term prospective studies are needed to clarify this relationship.

INTRODUCTION: Hydatid cyst (CH) is a zoonotic infection caused by the parasite Echinococcus Granulosus. This study aims to determine the prevalence of hydatid disease presenting to our center and to present and discuss rare localized CH samples.
METHODS: A total of 1247 patients were evaluated in the study. All patients were noted as Type 1 through Type 5. In addition, cysts not included in the Gharbi classification and diagnosed with Echinococcus alveolaris were defined as Type 6, infected CH as Type 7, post-operative (PAIR and/or surgery) CH as Type 8, and ruptured CH as Type 9, for ease of lesion identification and classification.
RESULTS: A total of 936 patients were included in the study. The average hydatid cyst lesion size is 6.6±3.7 (min=0.6-max=47) cm. When the hydatid cyst lesions of the patients were examined, it was seen that 90.9% had one stage (type), 7.8% had two stages, and 1.3% had three stages. 28.5% of the patients had Type 1, 12.7% had Type 2, 12% had Type 3, 16.9% had Type 4, 22.8% had Type 5, 2.5% had Type 5. It was observed that 0.5% was Type 6, 0.5% was Type 7, 4.8% was Type 8, and 9.5% was Type 9.
DISCUSSION AND CONCLUSION: Since the condition or stage of the lesion is important in the treatment and follow-up of hydatid cysts, it would be logical and guiding to classify it as in our study.

INTRODUCTION: This study aims to identify the reasons why patients declined total knee arthroplasty (TKA) despite being advised to undergo the procedure in secondary-level public hospitals and to examine the relationship between these reasons and various demographic variables.
METHODS: A retrospective, cross-sectional study was conducted in 2024. The study included 50 patients who had previously been offered total knee arthroplasty (TKA) in a secondary-level public hospital but had declined the procedure and subsequently presented to a tertiary-level university hospital. Structured face-to-face surveys were administered at the tertiary hospital. The questionnaire evaluated sociodemographic characteristics, prior health experiences, and reasons for refusing surgery in the public hospital.


RESULTS: The most frequently cited reason for refusing surgery was distrust in the physician's experience (60%), followed by concerns about hospital hygiene (58%), and staff inattentiveness (16%). Female patients more frequently cited "long waiting times" as a reason (p = 0.012). Although statistical significance was not found for other reasons across education level, income, or occupation, subgroup analysis revealed that hygiene concerns and physician distrust were more prominent in low-income, low-education, and unemployed groups.


DISCUSSION AND CONCLUSION: Patient decisions to refuse THA in public hospitals are influenced not only by clinical concerns but also by perceptual and systemic factors. These findings can inform policies to improve patient-centered care in public healthcare institutions.

INTRODUCTION: The rising incidence of neurodegenerative diseases, particularly Alzheimer's disease (AD), has paralleled increased human life expectancy, severely affecting patient quality of life and imposing a burden on healthcare systems. Mitochondrial dysfunction has been recognized as a critical factor in AD pathogenesis.This study investigates the protective effects of MitoQ, a mitochondria-targeted antioxidant, on SH-SY5Y cells treated with amyloid-beta (Aβ42), mimicking AD pathology.
METHODS: SH-SY5Y neuroblastoma cells were exposed to Aβ42 to induce AD-like features, followed by MitoQ treatment. Markers of mitochondrial dysfunction were assessed, including reactive oxygen species (ROS) levels, mitochondrial membrane potential (MMP), and protein expression of antioxidant and mitochondrial-related genes (SODs, CAT, BACE2, ATPs, COIs, TRAKs, OPA1).
RESULTS: MitoQ significantly reduced ROS levels and restored MMP. It also upregulated antioxidant genes (SODs, CAT, BACE2) and OPA-1 expression, while downregulating ATPs, COIs, and TRAKs associated with mitochondrial stress.
DISCUSSION AND CONCLUSION: We successfully created an Alzheimer's model utilizing Aβ42 and studied the effect of the mitochondria-targeted antioxidant molecule, MitoQ, on oxidative stress and mitochondrial dysfunction in this work. We discovered substantial changes in gene and protein expression, as well as changes in mitochondrial membrane structure. These findings, together with MitoQ's possible therapeutic benefits, indicate the drug's potential as a treatment for Alzheimer's disease. Animal investigations are needed to corroborate these findings and get more accurate insights, especially in organs immediately impacted, such as the brain.

INTRODUCTION: Gastrointestinal anastomotic healing depends on collagen dynamics, microcirculation, and immune responses. The vagus nerve modulates these via the cholinergic anti-inflammatory pathway. This study evaluated the effects of truncal vagotomy on jejunal anastomotic healing in rats.
METHODS: Forty male Wistar Albino rats were divided into five groups: control, day 4 anastomosis, day 4 vagotomy + anastomosis, day 7 anastomosis, and day 7 vagotomy + anastomosis. Standard end-to-end jejunal anastomoses were performed; vagotomy groups underwent transection of anterior and posterior vagal trunks. Healing was assessed by bursting pressure (cm H₂O) and tissue hydroxyproline (µg/mg).
RESULTS: No mortality or macroscopic leakage occurred. Mean bursting pressures were 87.0 ± 4.75, 95.37 ± 7.72, 98.25 ± 9.37, 109.25 ± 12.66, and 123.37 ± 4.27 cm H₂O in Groups I–V, with a significant increase in the 7-day vagotomy group (p < 0.001). Hydroxyproline levels were 0.512 ± 0.223, 0.539 ± 0.025, 0.549 ± 0.023, 0.539 ± 0.025, and 0.584 ± 0.023 µg/mg; Group V was significantly higher than Groups IV and III (p < 0.001 and p = 0.038). At day 4, bursting pressure increased without a parallel rise in hydroxyproline, whereas both parameters increased significantly at day 7.
DISCUSSION AND CONCLUSION: Truncal vagotomy enhanced jejunal anastomotic healing at day 7 by increasing collagen deposition and mechanical strength. Disruption of vagal tone appears to modulate inflammatory and fibroblastic responses, influencing the temporal pattern of healing. Further mechanistic and clinical studies are warranted.

INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) is one of the most commonly performed bariatric procedures worldwide. While several studies have examined the relationship between gastric volume and weight loss, the correlation between resected gastric specimen weight and postoperative weight loss remains unclear. This study aimed to investigate the relationship between the weight of the resected gastric specimen and weight loss outcomes after LSG.
METHODS: A total of 50 patients (39 women, 11 men; mean age 38.52±10.36 years) who underwent LSG were retrospectively analyzed. Preoperative and postoperative (3rd, 6th, and 12th months) weight and BMI values were recorded. The correlation between resected stomach weight (full and empty) and postoperative weight loss was assessed.
RESULTS: A statistically significant weight loss was observed in all patients up to the 12th month (p<0.001). The resected stomach weight was moderately correlated with patient weight at all follow-up points (p<0.01). However, the correlation between resected gastric specimen weight and percentage of excess weight loss was only significant in the early period (3rd month). No significant association was found in the 6th and 12th months. Additionally, patients with lower initial BMI values experienced greater early weight loss.
DISCUSSION AND CONCLUSION: Resected gastric specimen weight may serve as a predictive factor for early postoperative weight loss following LSG. However, its predictive value for long-term weight loss remains limited. Larger prospective studies are needed to clarify its role in surgical planning and outcome prediction.

INTRODUCTION: To explore potential etiological factors in patients diagnosed with vaginismus, compare them with controls without lifelong vaginismus and/or painful sexual activity, and evaluate sexual satisfaction in both groups.
METHODS: The study included 12 patients with vaginismus and 12 controls. A demographic and clinical data form was completed, and the Structured Clinical Interview for DSM-IV – Axis I disorders (SCID-I) was conducted. All participants completed the Eysenck Personality Questionnaire Revised-Abbreviated Form (EPQR-A), Childhood Trauma Questionnaire-28 (CTQ-28), Experiences in Close Relationships-Revised (ECR-R), and Golombok Rust Inventory of Sexual Satisfaction (GRISS).
RESULTS: Vaginismus patients were more likely to live in rural areas and extended families (p<0,05), had less adequate sexual education (often from friends, p<0,05), and half associated intercourse with pain, unlike controls who viewed it as a necessity. The vaginismus group had higher EPQR-A lying subscale scores (p=0,033). No differences were found in attachment styles or childhood trauma. The vaginismus group scored higher on the GRISS vaginismus subscale and overall scores (p<0,05).
DISCUSSION AND CONCLUSION: Sexual experiences are shaped by sociocultural, psychological, and relational factors, underscoring the need for culturally sensitive, couple-focused interventions and comprehensive sexual health education. Routine assessment of sexual function during psychiatric evaluations, including psychological interventions and partner sexual health screening, is essential, as untreated sexual issues may persist in individuals without lifelong vaginismus.

INTRODUCTION: To quantitatively evaluate total posterior fossa volume and single-slice volume at the level of the internal acoustic canal on brain CT in patients with Chiari type II malformation and in controls.
METHODS: In this retrospective single-center study, consecutive patients who underwent brain CT between 2014 and 2018 were identified from the institutional archive using the term “Chiari type II.” Images of all identified cases were re-evaluated. Controls underwent brain CT during the same period and had no abnormality affecting posterior fossa anatomy. Total posterior fossa volume and single-slice internal acoustic canal-level volume were measured on axial noncontrast CT images by using a freehand volume-of-interest tool. Group comparisons, correlation analyses, age-restricted sensitivity analysis, receiver operating characteristic analysis, and age- and sex-adjusted multivariable models were performed.
RESULTS: Eighty participants were included (30 controls and 50 patients with Chiari type II malformation). The Chiari type II group was younger than the control group (median age, 5.5 months [interquartile range {IQR}, 1.0–12.0 months] vs 36.0 months [IQR, 24.0–48.0 months]; P < 0.001), whereas sex distribution did not differ (P = 1.000). Total posterior fossa volume was significantly lower in the Chiari type II group (34.78 cm³ [IQR, 26.59–58.80] vs 165.80 cm³ [IQR, 159.38–181.52]; P < 0.001), as was single-slice internal acoustic canal-level volume (IAC-level single-slice volume) (6.27 cm³ [IQR, 4.17–7.87] vs 9.79 cm³ [IQR, 8.23–11.63]; P < 0.001). Total posterior fossa volume correlated positively with age (ρ = 0.796, P < 0.001), remained significantly lower in the 1–5-year subgroup (P < 0.001), and showed an AUC of 1.000 (95% CI, 1.000–1.000). The corresponding AUC for single-slice internal acoustic canal volume was 0.823 (95% CI, 0.725–0.911). In age- and sex-adjusted models, Chiari type II malformation remained independently associated with lower total posterior fossa volume (adjusted ratio, 0.34; 95% CI, 0.27–0.43; P < 0.001) and lower IAC-level single-slice volume (adjusted ratio, 0.78; 95% CI, 0.61–0.99; P = 0.045).
DISCUSSION AND CONCLUSION: Total posterior fossa volume is markedly reduced in Chiari type II malformation and provides stronger group discrimination than single-slice internal acoustic canal-level volume on brain CT.

INTRODUCTION: Targeted colposcopic biopsy has imperfect sensitivity for cervical precancer, with a clinically important risk of missing CIN2 plus. This study compared a prespecified single primary targeted biopsy strategy with strategies that add systematic four quadrant biopsies and endocervical curettage.
METHODS: : This paired diagnostic accuracy study evaluated nested index strategies within the same patients. Strategy A was the prespecified primary targeted biopsy from the most suspicious lesion. Strategy B1 included all targeted biopsies plus systematic four quadrant biopsies. Strategy B2 included B1 plus endocervical curettage. Reference standard was excision histology or 12 month follow up verification. The primary endpoint was the paired sensitivity difference for CIN2 plus.
RESULTS: Among 268 reference standard evaluable patients, reference CIN2 plus prevalence was 61 of 268 (22.8%). Sensitivity for CIN2 plus was 75.4% for Strategy A (46 of 61), 91.8% for Strategy B1 (56 of 61), and 95.1% for Strategy B2 (58 of 61). Compared with Strategy A, sensitivity increased by 16.4 percentage points for Strategy B1 (p=0.00195) and by 19.7 percentage points for Strategy B2 (p=0.00049). Endocervical curettage contributed an additional 2 detections among reference positive patients (3.3 percentage points; p=0.50). Specificity for CIN2 minus was 99.5% for all strategies. Patient based number needed to sample was 26.2 for four quadrant biopsies and 67 for endocervical curettage.


DISCUSSION AND CONCLUSION: Adding systematic four quadrant biopsies to targeted biopsy substantially increased CIN2 plus detection without an observed specificity penalty in this dataset. Endocervical curettage provided a smaller incremental yield overall, supporting selective use in higher risk profiles.

INTRODUCTION: This study aimed to evaluate the clinical and hematological characteristics of 39 pediatric cases diagnosed with megaloblastic anemia who were investigated and treated at the Pediatric Hematology Clinic of Yüzüncü Yıl University Faculty of Medicine between 2020 and 2025.
METHODS: A retrospective review of patient files was performed. Bone marrow aspiration findings, peripheral blood smear results, serum vitamin B12, and folic acid levels were analyzed and evaluated for the diagnosis of megaloblastic anemia.

RESULTS: Results: Of the patients, 19 (48.7%) were female and 20 (51.3%) male, with a mean age of 37.8 months (range: 11–168). The most common presenting symptoms were loss of appetite, pallor, and fatigue. Folic acid deficiency was detected in 4 patients, and vitamin B12 deficiency in 35 patients. The mean hemoglobin concentration was 6.1 g/dL, mean MCV 97.2 fL, mean white blood cell count 8104/mm³, and mean RDW 23.8. Proteinuria was observed in 3 patients (7.7%). All patients were treated with parenteral vitamin B12 and oral folic acid, resulting in significant improvement in laboratory parameters. Post-treatment, iron deficiency anemia developed in 2 patients (5.1%). In 14 patients (35.9%), the initial MCV value was below 90 fL.

DISCUSSION AND CONCLUSION: By presenting these cases, we aimed to emphasize that megaloblastic anemia may present without macrocytosis and highlight the importance of adequate nutrition in infants and pregnant women in our region.

INTRODUCTION: In complete atrioventricular (AV) block, atrial contraction against closed AV valves may induce atrial pressure overload and early electrical remodeling. P-wave indices, such as P-wave area and dispersion, reflect atrial electrical heterogeneity, but the joint impact of AV block duration and baseline P-wave abnormalities on new-onset atrial fibrillation (AF) after dual-chamber pacing is unknown.
METHODS: We retrospectively studied 80 patients who received dual-chamber DDDR pacemakers for complete AV block. AV block duration was defined as the interval from the first documented complete AV block on ECG to implantation and was quantified in hours. Baseline P-wave indices (area, dispersion, and duration) were measured on pre-implant 12-lead ECGs. Patients were followed for 3 years if incident AF was confirmed by device interrogation or surface ECG. Predictors of AF were evaluated using ROC analysis, Kaplan–Meier curves, and Cox regression.
RESULTS: During follow-up, 14 patients (17.5%) developed AF. These patients had longer AV block duration and higher P-wave area and dispersion than those who remained in sinus rhythm (all p < 0.001). Optimal cutoffs were 38.5 hours for AV block duration, 5.150 µV·ms for P-wave area, and 39.5 ms for dispersion. AV block duration and P-wave indices showed excellent discrimination for incident AF and remained independent predictors in multivariable Cox models.
DISCUSSION AND CONCLUSION: Prolonged exposure to a complete AV block is associated with adverse P-wave remodeling and a higher risk of incident AF. AV block duration may represent a modifiable determinant of AF after pacemaker implantation, suggesting that earlier pacing could reduce atrial stress and arrhythmic risk.

INTRODUCTION: Pseudotumor cerebri(PTC) is characterized by increased intracranial pressure without the presence of any intracranial mass. PTC presents with symptoms such as headache, nausea, vomiting, and visual disturbances. The aim of this study is to retrospectively evaluate the clinical, laboratory, demographic, and radiological findings of pediatric patients followed with a diagnosis of PTC in our clinic.
METHODS: Cases diagnosed with PTC between the years 2015-2022 and followed for at least 6 months were included in the study. The patients' clinical features, laboratory results, cerebrospinal fluid(CSF) pressure measurements, brain magnetic resonance imaging(MRI) findings and ophthalmologic examination results were retrospectively evaluated.
RESULTS: The study population consist of 27(63%) female and 16(37%) male. The mean follow-up duration was 11.3±6.6(6-30) months. The symptoms of the cases included headache in 32(74%), nausea-vomiting in 14(32%), diplopia in 11(25%), cranial nerve involvement in 9 (20%), blurred vision in 8(19%), and photophobia in 7(16%). Papilledema was present in 37(86%) of the cases, with a mean CSF pressure of 36.1±10.3(26-67)cm H2O.When comparing the retinal nerve fiber layer(RNFL) thickness of the right and left eyes in 27 cases during diagnosis and follow-up, it was observed that RNFL values that were higher during diagnosis had significantly decreased during follow-up (respectively, p=0.001, p=0.001). The most commonly recommended treatment was acetazolamide.

DISCUSSION AND CONCLUSION: PTC is a disease that is relatively common in children, although not as much as in adults. To prevent the development of optic atrophy that can lead to visual impairment, cases should be promptly diagnosed, treated and interdisciplinary follow-up is required.

INTRODUCTION: The aim of this study was to evaluate the extent to which fractal dimension values obtained from panoramic radiographs correspond to those obtained manually by an oral and maxillofacial radiologist and to Generative Pre-trained Transformer (GPT) -based fractal analysis (FA) values, and to quantitatively examine the agreement between the two methods.
METHODS: Panoramic radiographs of 50 patients were examined in the study. Three regions of interest (ROIs) of 15x15 pixels were selected from each image. The oral and maxillofacial radiologist measurements were calculated in ImageJ 1.49x, and artificial intelligence measurements were calculated in the ChatGPT-4o environment. Intraclass correlation coefficient (ICC) was used for agreement, Pearson correlation was used for correlation, and Bland–Altman analysis was used for method differences.
RESULTS: The ICC, calculated using a two-way mixed model and absolute agreement definition, was found to be negative for both single measurements (ICC(A,1) = –0.06; p = 0.739) and average measurements (ICC(A,2) = –0.134; p = 0.708). The relationship between the measurements was assessed using Pearson correlation analysis. No significant linear relationship was found between the two methods (r = –0.099; p = 0.492).
DISCUSSION AND CONCLUSION: In its current form, ChatGPT-4o regarding FA does not provide acceptable agreement with radiologist measurements. It is anticipated that artificial intelligence (AI) assisted FA could become a helpful tool in the future with the stabilization of the algorithms/parameters, expansion of the training data, and software validation studies.