INTRODUCTION: The purpose of this study is to examine the protective effects of maresin 1 on testicular injury induced by ischemia reperfusion.

METHODS: 24 Sprague-Dawley male rats were divided into 3 groups. The groups are planned as follows; sham, ischemia reperfusion and ischemia reperfusion+maresin 1 groups. The spermatic cord was detected and clamped for 2 hours to establish the prompt. After 2 hours, the clamp was removed and testicular reperfusion was achieved for 2 hours. At the end of the reperfusion phase, testicular tissues were taken and total antioxidant capacity (TAC), total oxidant capacity (TOC), superoxide dismutase (SOD), malondialdehyde (MDA) and myeloperoxidase (MPO) levels were determined by spectrophotometric method.

RESULTS: In the ischemia-reperfusion group, TOS and MDA and MPO are increased, the levels of TAS and SOD molecules are decreased. TOS and SOD levels are increased and TAS, MDA and MPO levels are decreased in the Maresin-1 treatment group.

DISCUSSION AND CONCLUSION: These results show us that a single dose of maresin-1 application is effective against oxidative damage caused by ischemia reperfusion.

Objective: The aim of this research was to investigate the effects of subacute use of lithium carbonate (Li2CO3), on serum T3, T4, thyroid stimulating hormone (TSH), parathyroid hormone (PTH) and calcium (Ca) levels and thyroid tissue. In addition, this research is important as one of the rare studies in which thyroid tissue was subjected to histological examination.

Methods: Thirty-two male Sprague Dawley rats were assigned into groups consisting of eight animals each, based on weight; Group 1: Sham control, Group 2: Li2CO3+25 mg/kg, Group 3: Li2CO3+50 mg/kg and Group 4: Li2CO3+100 mg/kg. Li2CO3 was administered orally at varying concentrations, at 1 mL per day for 30 days. Serum samples were separated from blood obtained by intracardiac intervention. Serum T3, T4, TSH, PTH and Ca levels were measured by using an autoanalyzer and chemiluminescence. Thyroid tissue was examined under light microscopy after routine histopathological procedures.

Results: T3, T4, PTH and Ca levels increased in rats treated with high-dose Li2CO3, whereas TSH levels were very low in all groups. In addition, thyroid tissue exhibited concentration-dependent histological alterations.

Conclusion: Li2CO3, which was administered subacute high dose in rats, caused of increased T4 and T3 hormones levels, hyperparathyroidism and hypercalcemia in the early period. These results now need to be supported by further experimental and clinical studies.

INTRODUCTION: Low birth weight (LBW) is a worldwide public health problem, and in emerging countries in particular. In newborns, various maternal and socio-economical factors can lead to LBW. The purpose of this study is to evaluate the risk factors associated with LBW in term newborns.

METHODS: The study included 60 newborns with LBW (<2500 g) and 100 newborns with normal birth weight (2500−4000 g) as the control group. Father, mother and socio-economic factors were questioned by face-to-face interviews with mothers. Head circumference weight and height of all newborns were measured. Study and control group were compared in terms of socio-economical, neonatal, paternal and maternal factors.

RESULTS: Average head circumference, birth height and weight in LBW group were 33.03±1.29 cm, 47.22±1.72 cm and 2328±154.55 g respectively. There was no significant difference in female/male ratio between the 2 groups. Statistically significant differences were found between the 2 groups in number of antenatal care visits, smoking habits and presence of child mortalities under the age of 5 (p=0.04, p=0.014 and p=0.033 respectively). Socio-economic characteristics were not also found to be significantly different between the 2 groups.
DISCUSSION AND CONCLUSION: There are variety of factors leading to LBW, some of which can be prevented by ensuring a non-smoking pregnancy and high quality and sufficient number of antenatal care visits.

INTRODUCTION: A previously unknown contagious disease, which later turned out to be a worldwide pandemic originated from Wuhan, capital of Hubei province in China by the end of 2019. While this upheaval affected numerous countries tragically, mortality rate and necessity for ICU were relatively low in Turkey.

METHODS: A total of 166 patients (65 at ICU, 101 at pandemic service) were analyzed to uncover effect of radiological and laboratory parameters on prognosis in COVID-19. One hundred and one patients (60.8%) were treated in pandemic service and 65 (39.15%) were treated in ICU.

RESULTS: Mean age of the patients in pandemic service was 61.1±16.2 (23−93) and of patients in ICU was 64.6±15.7 (15−90) (p>0.05). Initial mean CRP value for pandemic service group was 68.14±6.5 mg/dL (3.11−271), whereas it was 117.07±11.5 mg/dL (0−360) for ICU (p<0.05). Mean D-dimer value for the patients in ICU was 5572.2±1075.6 ng/mL and for the patients in pandemic service it was 1904.9±290.7 ng/mL (p<0.05). There was a correlation between CRP and D-dimer values (p<0.05). Of 66 patients in ICU group, 30(49.2%) had early stage CT findings, 22 (36.1%) had progressing stage CT findings and 9 (14.8%) had severe stage CT findings. However, of 101 patients in pandemic service group, 67 (66.9%) had early stage CT findings, 32 (31.7%) had progressing stage CT findings and 2 (2%) had severe stage CT findings.

DISCUSSION AND CONCLUSION: CT staging is a substantial prognostic factor and may help clinicians decide treatment modality. Furthermore, CRP and D-dimer values are also prognostic during follow–up. Thus, the necessity of taking these parameters into consideration while implementing treatment algorithms has emerged. As a conclusion, CT stage, CRP and D-Dimer values should be adopted as crucial prognostic factors in order to provide efficient healthcare.

INTRODUCTION: The problem of the connection between theoretical knowledge and practical knowledge leads to the inadequate training of physicians that results in inaccurate prescriptions. Case-based learning (CBL) is a universal paradigm often used within the medical curriculum, and it encourages self-assessment while enabling the learner to generate analytical and diagnostic solutions to a real scenario. However, its applications are limited and more research is needed to test its compatibility with students with different learning styles.

METHODS: CBL-based pharmacology courses have been integrated into the 3rd year curriculum of Bahcesehir University Faculty of Medicine. A 15-question questionnaire was filled out by 67 students who were informed in advance to evaluate the CBL-based lessons. In addition, 37 of the participants were asked to complete an approved VARK questionnaire. In this way, traditional education systems were evaluated in terms of learning styles with CBL.
RESULTS: According to the majority of the students participating in the study, CBL is a very useful learning method compared to traditional learning methods by making it easier to direct real life cases. In addition, no significant difference was found between the answers of students with various preferences, such as multi-modal or single-modal learning styles, in terms of the evaluation of CBL.

DISCUSSION AND CONCLUSION: The students’ survey results showed that the CBL-based curriculum was a useful motivating method. This study shows that CBL is a teaching system that can be adapted to each type of student regardless of the learning style and it is a learning method that can be applied in other fields besides Clinical Pharmacology.

INTRODUCTION: The novel Coronavirus disease 2019 is a world-wide spreading disease emerged with increased perceived danger, uncertainty, and anxiety. In this study we aimed to conduct a survey evaluating attitudes of the patients who underwent rhinoplasty.

METHODS: An online form was sent to the patients who have undergone rhinoplasty in the last year. The online survey was conducted between the dates of 1-7 April 2020. All participants were asked to fill the survey within one week.

RESULTS: The link was sent to 201 patients. A total of 165 (82%) participants completed the questionnaire. The majority of the participants were aware of specific precautions, such as social distance and having personal hygiene. They were worried about possibility of having the disease. One-third of the patients reported that they took additional vitamin supplements.
DISCUSSION AND CONCLUSION: Patients with rhinoplasty had necessary information on preventing COVID-19 pandemics, but were anxious due to disruption of their follow-up.

INTRODUCTION: Spontaneous ascitic fluid infection (SAI) is one of the frequent and important complication of decompensated cirrhosis with high mortality. Mean platelet volume (MPV) is a parameter that shows the activity, stimulation and production of platelets. Changes in MPV are important indicators of platelet production, and are also an indicator of the severity of many diseases, such as sepsis, thrombosis, or even respiratory distress syndrome. In our study, we aimed to analyze the relationship between spontaneous ascites infection and mean platelet volume.

METHODS: 98 cirrhosis patients (42 females, 56 males) with various etiologies were participated to the study. The patients were divided into two groups as SAI positive group including patients with ascitic culture positive and/or ascites polymorphonuclear leukocyte count (PMNL) >250 mm3 and SAI negative group including patients with no bacterial reproduction in their ascites fluid culture and ascites PMNL count <250 mm3.

RESULTS: There were 52 patients as 19 females and 33 males, in SAI positive group and 46 patients as 23 females and 23 males, in SAI negative group. In spontaneous ascites infection- positive group, spontaneous ascites infection mean platelet volume (p<0.001) and leukocyte count (WBC) (p<0.001) were detected to be significantly different statistically compared to the negative group. There was no statistically significant difference between the mean platelet volume (p=0.795) and platelet distribution percentage (p=0.775) in SAI positive patients (p>0.05).

DISCUSSION AND CONCLUSION: Mean platelet volume in patients with spontaneous ascites infection who have developed, decompensated cirrhosis significantly increases. It is possible to use this test which is cheap, non-invasive and fast in the early diagnosis and treatment to follow-up of spontaneous ascites infection.

Objective: The frequency of detecting adrenal masses is increasing day by day. The basic approach is to evaluate whether these masses are hormonally active or not and to evaluate if they have malignant potential. There are doubts that most of these masses, which are known to be nonfunctional, produce some active metabolites. In this study, we aimed to investigate the cardiovascular risk factors of nonfunctional adrenal incidentalomas.

Methods: 305 patients who were admitted to the Endocrinology and Metabolic Diseases Polyclinics with an incidentally detected adrenal mass between January 2006 and 2011 were included. Demographic characteristics, co-morbidities, drugs, and laboratory parameters were analyzed retrospectively. It was divided into two groups. Our group with nonfunctional adrenal adenoma, were compared with a community-based study; Turkey Diabetes, Hypertension, Obesity and Endocrinology Diseases Prevalence Study-2 (TURDEP-2).

Results: Adrenal masses were divided into two groups as functional and non-functional. The patients in the first group were younger (46.2±12.1 years, p=0.0001), had larger masses with malignant appearance. The patients in the second group were compared with TURDEP-2. When the patients with non-functional adrenal adenoma compared with the general community, hypertension and obesity were observed more frequently in our patient group; 66.2%-31.3% and 61.8%-36%, respectively.

Conclusion: It is controversial whether non-functional adrenal incidentalomas increase cardiovascular risk or not. Subclinical Cushing Syndrome is the most common hormonal disorder. The insidious cortisol autonomy is thought to be responsible for this. In our study, cases with nonfunctional adrenal mass were found to be more obese and hypertensive compared to the general population.

Objective: We aimed to evaluate the etiology, traumatic pathology and treatment of thoracic trauma patients who were treated in thoracic surgery clinic.

Methods: Patients with thoracic trauma admitted to the thoracic surgery clinic between September 2017 and September 2019 were evaluated retrospectively in terms of age, gender, types of trauma, thoracic and extrathoracic injuries, treatments and hospitalization time.

Results: The mean age of 119 patients (92 males and 27 females) was 43.65 years. Eighteen (15.1%) patients were presented with penetrating trauma and 101 (84.9%) patients with blunt thoracic trauma. The most common pathologies in blunt traumas were rib fracture and contusion and in penetrating traumas were pneumothorax and hemothorax. Medical treatment was usually sufficient for patients with blunt thoracic trauma. The most common surgical method in penetrating injuries were tube thoracostomy.

Conclusion: Thoracic traumas must be treated quickly and effectively due to their high mortality rates.

INTRODUCTION: The prevalence of sleep problems increases with age. Both anxiety and depression symptoms can cause certain changes in sleep architecture. The aim of this study is to investigate the relationship of anxiety and depression levels with sleep quality and insomnia severity in geriatric patients with depression and concomitant anxiety symptoms.
METHODS: Fifty-three patients aged 60 and over were included in the study. Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), Insomnia Severity Index (ISI), Mini-Mental State Examination (MMSE) and Pittsburgh Sleep Quality Index (PSQI) were applied to the patients.

RESULTS: There was a positive and statistically significant relationships between the total GDS score and the mean PSQI Subjective sleep quality and Sleep latency scores, as well as between BAI and PSQI Subjective sleep quality, Sleep latency, Sleep disturbance, Daytime dysfunction and global PSQI score (p=0.018; p=0.006; p=0.043; p=0.009; p=0.012; p=0.045; p=0.049, respectively). There was positive and statistically significant relationships between total GDS, total ISI and ISI subscale scores, and there was positive and statistically significant relationships between BAI scores, total ISI, and ISI subscale scores (p=0.002; p=0.002; p=0.001; p=0.006, respectively).

DISCUSSION AND CONCLUSION: This study showed that sleep disorders were closely associated with anxiety and depression levels in the geriatric patients with depression. The deterioration in sleep quality and the increase in insomnia severity associated with the aging process may increase the incidence of new depressive disorders, while current anxiety and depression symptoms may cause sleep disorders.

INTRODUCTION: The aim of this study was to investigate the seroprevalence of Hepatitis A, Hepatitis B, Hepatitis C, HIV, Mumps, Measles and Chickenpox for all staff and trainee students working under SBU Fatih Sultan Mehmet EAH in 2018.
METHODS: A total of 1674 medical staff and trainee students' serum samples were screened retrospectively for Hepatitis A, Hepatitis B, Hepatitis C, HIV, Mumps, Measles and Chickenpox. The findings were analyzed by using IBM SPSS Statistics 22 (IBM SPSS, Turkey) program. Descriptive statistical methods, Chi Square and Fisher Freeman Halton tests were used in order to analyze of the data.
RESULTS: A total of 1674 people, 636 (38%) males and 1038 (62%) females were included in the study. Of these, 502 (30%) were internships in the health school. When examined in terms of total staff; AntiHBs (86%), Mumps IgG (97%), Measles IgG (94%) and VZV IgG (97%) were found to be highly positive. There were no health workers who were positive for anti HIV and measles IgM. There were 4 anti-HCV positive, 2 mumps IgM positive and 1 VZV IgM positive people.

DISCUSSION AND CONCLUSION: It is important to take preventive measures against vaccination preventable diseases and immunization of the personnel working in hospitals. The results obtained in our study were found to be consistent with similar studies conducted in our country.

INTRODUCTION: To compare the refractive measures of preterm and full-term children aged 1 year old.
METHODS: Fifty two eyes of 26 preterm children and 44 eyes of 22 term children were included in this study. Group 1 consisted of full-term subjects (mean GA 38.7 weeks), group 2 consisted of (mean GA 31.6 weeks) preterm subjects with no retinopathy of prematurity (ROP) and group 3 was included preterm subjects (mean GA 27.8 weeks) affected by ROP which required no treatment. All patients had undergone control examinations of autorefraction by Plusoptix S08 (PX) without cycloplegia and than fundoscopic evaluation at first year. The obtained refraction values were recorded as spherical equivalent (SE). The mean SE between the groups was compared statistically.

RESULTS: Mean SE of group 1 was statistically significant compared to group 2 and 3 (p<0.01), difference in SE between group 2 and 3 was weaker but also significant (p<0.05). The rate of myopia in ROP (+) group 3 (45%) was higher than group 1 (16%) and group 2 (38%) and the rate of hyperopia in group 1 (52%) was quite higher than group 2 (%13) and group 3 (%10). The percentage of astigmatism were significantly higher in group 2 (85%) and 3 (53%) than group 1 (25%).
DISCUSSION AND CONCLUSION: Refractive errors are more often in preterm infants even in the absence of ROP. Therefore screening for refractive errors in preterm children is important to prevent amblyopia.

INTRODUCTION: Most of the previous studies have shown good functional outcomes for most patients after in situ pinning or pinning with anatomical reduction of slipped capital femoral epiphyses (SCFE). We undertook a retrospective study to document comparative outcomes of both treated groups of 25 SCFE patients.
METHODS: Between 2005 and 2013, 21 patients (26 hips) with SCFE underwent in situ pinning or pinning with anatomical reduction at a tertiary referral center. Medical records and radiographs were reviewed for slip characteristics. Magnetic resonance imaging (MRI) was performed to all patients at final visits. Mean follow-up was 139 months (range, 64 to 179).

RESULTS: There was no significant difference between in situ group and reduction group regarding range of motion (ROM), Visual Analog Scale (VAS), and Harris Hip Score (HHS) of hip (p>0.05). Mean outcome scores were; HHS 80.4, and VAS 2.9 respectively.

DISCUSSION AND CONCLUSION: Especially in the anatomic reduction group, a decrease in hip ROM was observed (not statistically significant) compared to the in situ group. MRI revealed atrophy of the peri-hip musculature in the reduction group. This present study may suggest that patients with SCFE whether anatomically reduced or in situ pinned may not contribute to clinical outcomes.

INTRODUCTION: To assess the efficacy of double reversing Z plasty technique for stomaplasty in patients who had total laryngectomy.
METHODS: his was retrospective chart review of 20 patients having tracheostomal widening procedure`double reversing Z plasty` at our department between August 2016 and October 2019. Widest length of the stoma was measured in mm for each patient preoperatively and at postoperative 1st month respectively. The results were compared.

RESULTS: All 20 patients showed statistically significant widened tracheostoma without any complication. Mean diameter of the stoma was measured as 12±1.2 mm (range between10−14) and 21±1.3 (range between 19−24) mm preoperatively and postoperatively, respectively. The difference was statistically meaningful (p=0.01). 10 of patients (50%) had voice prosthesis in previous total laryngectomy procedure and their phonatory protshesis functioned well after the surgery. All patients were discharged at postoperative day 1. There was no need to wear laryngeal tube which shows successful amelioration of the disease in postoperative period.

DISCUSSION AND CONCLUSION: Double reversing stomaplasty is an effective technique to manage tracheastomal stenosis in total laryngectomized patients without any complication specific to the technique.

INTRODUCTION: We retrospectively examined extra-articular proximal phalangeal fractures excluding the thumb, for which fixation was applied using locked miniplates, with the aim to compare the results of the dorsal and midlateral approaches.
METHODS: 26 patients were operated via the dorsal approach (Group 1) and 20 patients were operated via the midlateral approach (Group 2). No graft was used in any patient. No splint was applied to any patient after the operation. Active finger movements were resumed on postoperative day 1.

RESULTS: The mean ages of patients in Groups 1 and 2 were 35.1 (range: 18–60) years and 33.8 (17–71) years, respectively. Union was achieved in all patients in the study. In Group 1, the mean total active movement (TAM) was 228° (range: 170–270°); according to the digital functional assessment, 18 patients had excellent, 7 patients had good, and 1 patient had fair results. In Group 2, mean TAM was 239° (range: 200–270°); according to the digital functional assessment, 14 patients had excellent and 6 patients had good results.

DISCUSSION AND CONCLUSION: We believe that both dorsal and midlateral approaches in extra-articular proximal phalangeal fractures are effective and reliable methods with similar clinical and functional results, and are thus a suitable alternative for each other.

INTRODUCTION: Hyperpigmentation is a condition characterized by the accumulation of pigment in the epidermis and dermis. Many dermatological diseases, such as primary cutaneous amyloidosis (PCA), postinflammatory hyperpigmentation (PIH), erythema discromicum perstans (EDP), notalgia paresthetica (NP), drug reaction (DR), may lead to acquired hyperpigmentation on the skin. The aim of this study is to investigate etiologic factors, clinical and demographic features, laboratory findings and treatment options in patients with generalized hyperpigmentation.
METHODS: Forty four patients who presented to our outpatient clinic with complaints of hyperpigmentation were evaluated retrospectively. Patients were examined in terms of age, duration and localization of lesions, accompanying symptoms or diseases, laboratory findings and treatment options.

RESULTS: When pigmentation-causing diseases are listed; PCA was detected in 50% of the cases. Of these, 72.7% (n=16) were macular amyloidosis, 22.7% (n=5) were lichen amyloidosis, and 4.6% (n=1) were biphasic amyloidosis. Others were 29.5% (n=13) PIH, 13.6% (n=6) EDP, 4.6% (n=2) NP, 2.3% (n=1) DR. The ages of the patients were generally between 20-69 years. The average age was mean 47.8 years (48.8 for females and 45.0 for males). The duration of pigmentation ranged from 3 months to 20 years (mean 6.8 years). 75% (n=33) of the patients had itching. About half of the lesions were located on the back. Half of the patients had a concomitant disease. As treatment options, 9 patients were treated with phototherapy, 9 with isotretinoin, 12 with depigmentation, and one with pregabalin and topical steroids.

DISCUSSION AND CONCLUSION: Knowing the conditions that cause hyperpigmentation facilitates the diagnosis of the disease. In this study, PCA was detected in half of the patients with clinically considered hyperpigmentation. Therefore, the diagnosis of PCA should be considered first in patients with pruritic and diffuse pigmentation.

INTRODUCTION: Serious Covid-19 disease is often complicated by coagulopathy. Most of Covid-19-related deaths have been shown to be caused by extensive intravascular coagulation disorders. Our aim in this study is to examine the importance of thromboprophylaxis in Covid-19 positive pregnant women.
METHODS: Pregnant women diagnosed with Covid-19 with the polymerase chain reaction test were retrospectively analyzed and treatment processes were evaluated.
RESULTS: A total of 18 pregnant women were followed up with the diagnosis of Covid-19. The mean age of the patients was 28.90±5.26 (18–41). Laboratory results revealed high CRP levels (11/18), lymphocytopenia (10/18) and increased neutrophil percentage (14/18). CT examinations were reported as widespread involvement findings (ground glass opacities - GGO) in 3 of 8 patients and mild fibrotic changes in 5 of the patients. Thromboprophylaxis was not applied in 4 outpatients however applied in 9/14 of the hospitalized patients. The average duration of drug use is 7.1 days (1–14). Average hospital stay is 3.3 days (2–16). The preferred dose is 40 mg 1x1/day. In a patient with suspected pulmonary embolism, 60 mg of 2x1/day enoxaparin was used. Maternal, fetal, and hemorrhagic complications were not observed.

DISCUSSION AND CONCLUSION: Since there is a tendency to hypercoagulation in pregnancy, thromboembolic events are more common. Therefore, starting LMWH treatment before Covid-19 infection progresses could be beneficial for preventing embolic complications that may be fatal.

Fecal impaction occurs because of hardened fecal matter retained in the colorectum which cannot be evacuated by peristaltic activity. Fecal impaction commonly occurs among nursing home residents, patients with neurological deficit, psychiatric disease or renal failure. Fecal impaction is usually treated by manual disimpaction, enemas and laxatives. Laparotomy is required only in the presence of complications. We herein report a case of a massive fecal impaction with megarectum in a 62-year-old woman who presented with large bowel obstruction. The aim of this report is to give a brief review of this entity and discuss the treatment options for these cases.

The novel coronavirus infection (SARS-CoV-2 infection), which appeared in the Wuhan region of China in late 2019, spread rapidly in a short time. A few months later, it was accepted as pandemic by the WHO (World Health Organization) and became an important threat to public health. The death rate in cases occurring in China was around 2%. Although it is thought that pregnancy is not a risk factor in the course of COVID-19 disease, it is often seen in which the cases were in the third trimester. It is striking that the maternal and neonatal implications of these infected cases during the late pregnancy period were quite good. Further studies examining more cases in the first and second trimesters, in order to determine long-term results and to clarify the risk of vertical transmission are needed.

Hereditary angioedema (HAE) is an autosomal dominant disorder, mostly due to C1 esterase inhibitor (C1-INH) deficiency, known by recurring angioedema attacks that are nonpruritic, not accompanying with urticaria, and involve the dermis, intestinal submucosa, and upper respiratory system. The angioedema attacks are not responsive to epinephrine, glucocorticoids, or antihistamine treatments. Whereas HAE patients formerly had a few therapeutic options accessible such as anabolic androgens and antifibrinolytics. Nowadays in many parts of the world there has been remarkable progress in HAE treatment for the last two decades and clinically confirmed medications are presented for prophylactic and attack treatment. Alternatives in attack therapy contain two plasma-derived C1-INH concentrates, a recombinant C1-INH product, a kallikrein inhibitor, and a bradykinin β2 receptor antagonist. Options in prophylactic therapy include other than two plasma-derived C1-INH concentrates, subcutaneous C1-INH replacement and newest subcutaneous plasma kallikrein inhibitor Lanadelumab. In spite of these progresses, HAE patients still run into some challenges of an arduous disorder that can yield to devastating angioedema attacks related with important expenses for patients and the public. Better education of HAE patients and implementation of the self-management policy for “on-demand” therapy will recuperate patients’ life quality and negative effects of the disease. Herein the existing and promising therapeutic options are reviewed in the HAE management.