INTRODUCTION: The main objective of present study was to determine the factors affecting dis-ease recurrence and overall survival in patients with high-grade endometrial cancer.
METHODS: The study retrospectively included women who underwent primary surgery be-tween January 2017 and December 2021 and were diagnosed with serous, clear cell, carci-nosarcoma, mixed type, grade 3 endometrioid or DE/undifferentiated endometrial cancer histology as documented in postoperative pathology reports. The data set was obtained from patient files and an electronic gynaecological oncology clinic database.
RESULTS: A total of 81 patients were included in the analysis. 26 (32.1%) patients had re-currence. Pelvic lymph node positivity, para-aortic lymph node positivity, disease stage and adjuvant treatment were associated with disease recurrence. P values were 0.005, 0.009, 0.019, 0.002 and 0.009, respectively. Overall survival duration was 39 months. In multivariate analysis, only histotype (DE/undifferentiated, Hazard ratio (HR): 4.028 Confidence interval (CI): 1.208-13.434; P=0.023) and positive peritoneal cytology (HR: 3.719; CI: 1.408-9.827; P=0.008) were significant independent prognostic factors for overall survival.
DISCUSSION AND CONCLUSION: Histotype and positive peritoneal cytology may be associated with a worse overall survival in high-grade endometrial cancers.

INTRODUCTION: This study investigates genetic factors contributing to hypospadias in patients from Eastern Anatolia, aiming to identify pathogenic variants and enhance diagnosis and personalised treatment strategies.
METHODS: An extensive evaluation was performed on 124 patients diagnosed with hypospadias, incorporating clinical examinations and family history reviews. Next-generation sequencing (NGS) was utilised to evaluate DNA samples, with a focus on 26 genes associated with 46,XY sexual development abnormalities. The genetic variations identified were then categorised according to the standards established by the American College of Medical Genetics (ACMG). This process involved a comparison with 124 healthy individuals who served as a control group.
RESULTS: It is notable that the investigation yielded several significant genetic discoveries, comprising probable deleterious mutations in genes such as SRD5A2, MAP3K1, and LHCGR. It is notable that 51 subjects exhibited the homozygous c.265C>G (p.Leu89Val) mutation in the SRD5A2 gene, while 19 patients presented with the heterozygous form. The investigation revealed that neither variant was present in the control group. The variant was thus categorised as a variant of unknown significance (VUS), on the basis of its possible pathogenicity. Furthermore, other VUSs were identified in the SOX9, DYNC2H1, and GATA4 genes.
DISCUSSION AND CONCLUSION: The development of hypospadias is significantly influenced by genetic factors. The present study identified SRD5A2 c.265C>G as a candidate for further functional research, emphasising the significance of genetic analysis in the diagnosis of sexual development abnormalities. Advances in genomic technologies, such as NGS, hold considerable potential in identifying therapeutic targets, thereby enhancing our understanding, diagnosis and treatment of hypospadias.

INTRODUCTION: To evaluate the relationship between the distance of pediatric distal tibial fractures to the physis and the fixation methods used, as well as their impact on weight-bearing times and complications.
METHODS: This retrospective study included patients with open physes who underwent surgical treatment for pediatric distal tibial metaphyseal fractures in two centers between 2019 and 2024. Patients were grouped based on the fixation method used: K-wire, titanium elastic nails (TEN), or plate-screw fixation. Data collected included patient demographics, fracture distance to the physis, the ratio of fracture distance to metaphyseal width (DP/MW), weight-bearing times, and complications such as infection and reduction loss. Statistical analyses were performed using non-parametric tests, with a significance threshold of p<0.05.
RESULTS: The study included 75 patients (52 males, 23 females) with a mean age of 9.7 years. Fixation methods included K-wire fixation (27 patients), TEN fixation (26 patients), and plate-screw fixation (22 patients). Pain-free weight-bearing was observed after a median of 8 weeks [7-9] in the K-wire fixation group, a median of 6 weeks [6-7] in the plate-screw fixation group, and a median of 6 weeks [5-6] in the TEN fixation group. The duration of pain-free weight-bearing was significantly longer in the K-wire group.A positive correlation was observed between the fracture’s distance to the physis and earlier weight-bearing (p=0.041). Superficial infection developed in three patients (11.11%) who were fixed with K-wires and in one patient (4.55%) in the plate-screw fixation group. While loss of reduction was reported in one patient (3.70%) in the K-wire fixation group, no loss of reduction was observed in the other groups. No statistically significant differences in complications were observed between the groups.
DISCUSSION AND CONCLUSION: The time to weight-bearing is longer in patients treated with K-wire fixation compared to TEN and plate-screw fixation. Additionally, fractures located farther from the physis allow for earlier weight-bearing. These findings underscore the critical role of fracture location and fixation method in informing treatment strategies. Further randomized controlled trials are essential to validate and strengthen these results.

INTRODUCTION: Obesity may influence postoperative pain and patient-reported outcomes after regional anesthesia through mechanisms beyond technical block success. This study evaluated the association between body mass index (BMI) categories and perioperative outcomes following ultrasound-guided infraclavicular brachial plexus block for upper extremity surgery.
METHODS: This retrospective observational cohort included 83 adult patients (≥18 years) undergoing hand, forearm, or elbow surgery with ultrasound-guided infraclavicular brachial plexus block as the primary anesthetic technique. Patients were stratified by BMI as <25 kg/m² (n=19), 25–30 kg/m² (n=46), and ≥30 kg/m² (n=18). Postoperative pain intensity was assessed using the Visual Analog Scale (VAS; 0–10) at 0, 6, 12, and 24 hours. Secondary outcomes included rescue analgesia, opioid consumption, and patient-reported outcome measures (PROMs), including satisfaction at 1 week and 1 month and subsequent preference for regional anesthesia at 1 month.
RESULTS: Demographic characteristics were similar across BMI groups (p>0.05). Postoperative VAS scores differed by BMI at 0, 12, and 24 hours, with higher pain levels observed in the BMI ≥30 group, most pronounced at 24 hours (3.11±1.89), while 6-hour scores were comparable between groups. Rescue analgesic use and opioid consumption did not differ between groups. Patient satisfaction and 1-month subsequent preference for regional anesthesia were significantly lower in the BMI ≥30 group compared with BMI <25 and BMI 25–30 (p<0.001).
DISCUSSION AND CONCLUSION: Higher BMI was associated with worse postoperative pain trajectories and lower patient-reported satisfaction after ultrasound-guided infraclavicular brachial plexus block, despite similar rescue analgesic use and opioid consumption across BMI categories. These findings suggest that BMI stratification may be relevant for individualized perioperative analgesic planning and patient-centered outcome optimization.

INTRODUCTION: To conduct a quantitative comparison of long-term sexual function and the severity of menopausal symptoms in premenopausal women who have undergone hysterectomy with ovarian conservation versus those who have undergone hysterectomy with bilateral salpingo-oophorectomy (BSO).
METHODS: This retrospective study encompassed 160 premenopausal women who had undergone hysterectomy for benign reasons at least one year prior. Participants were categorized into two cohorts: The Hysterectomy with Ovarian Conservation (HOC) group (n=80) and the Hysterectomy with Bilateral Salpingo-Oophorectomy (H-BSO) group (n=80). The study employed validated instruments, namely the Female Sexual Function Index (FSFI) and the Menopause Rating Scale (MRS), to gather data on sexual function and menopausal symptoms. Demographic and clinical information was extracted from patient records. Statistical analyses were conducted using independent samples t-tests and chi-square tests.
RESULTS: Both groups were comparable in terms of mean age, BMI, and primary indication for hysterectomy (p>0.05). The HOC group reported significantly higher (better) total FSFI scores compared to the H-BSO group (27.8±4.1 vs. 18.5±5.5; p<0.001). Significant differences were observed across all FSFI domains, including desire, arousal, lubrication, orgasm, satisfaction, and pain (all p<0.001). Conversely, the H-BSO group reported significantly higher (worse) total MRS scores (23.2±6.8 vs. 9.7±4.5; p<0.001), with pronounced differences in somatic, psychological, and urogenital subscales.
DISCUSSION AND CONCLUSION: Ovarian conservation at the time of hysterectomy in premenopausal women is strongly and significantly associated with preserved sexual function and a substantially lower burden of menopausal symptoms in the long term. These findings provide crucial quantitative evidence to support shared decision-making, advocating for ovarian conservation in appropriate candidates to protect long-term quality of life.

INTRODUCTION: This study aimed to identify the causes of conversion from laparoscopic cholecystectomy (LC) to open cholecystectomy (OC) and to determine the demographic characteristics, conversion rate, and associated risk factors.
METHODS: A total of 4,165 patients who underwent cholecystectomy for symptomatic cholelithiasis at our institution between January 2016 and December 2021 were retrospectively analyzed. Demographic characteristics, indications for conversion, and conversion rates were evaluated in 74 patients who required conversion from LC to OC.
RESULTS: Among the 4,165 patients, 74 (1.8%) required conversion from LC to OC. Of these, 33 (44.6%) were female and 41 (55.4%) were male. The mean age was 56 years (40–82), and the mean BMI was 30 kg/m² (25–43). Comorbidities were present in 44 patients (59.4%). The main reasons for conversion were adhesions and fibrosis due to prior surgery (n=41, 55.4%), acute cholecystitis (n=19, 25.7%), inability to clearly identify Calot’s triangle (n=3, 4.1%), bleeding from the cystic artery or gallbladder bed/liver (n=4, 5.4%), luminal organ injury (n=4, 5.4%), and biliary tract injury (n=3, 4.1%). Intraoperative complications occurred in 11 patients (14.9%), while postoperative complications occurred in 8 patients (10.2%). No patient required reoperation, and no mortality was observed. The mean length of hospital stay was 2.2 days (1–12).
DISCUSSION AND CONCLUSION: LC remains the preferred surgical approach for symptomatic gallstones. However, in patients with significant risk factors, persistent attempts to complete the procedure laparoscopically may increase morbidity. Timely conversion to OC and increasing surgical experience may help reduce complication rates.

INTRODUCTION: To investigate the impact of mini-Misa scleral contact lenses (SCLs, diameter: 16.5) on intraocular pressure (IOP), anterior chamber, and central corneal thickness (CCT)
METHODS: Patients diagnosed with keratoconus who had been using SCL for at least 6 months were included. The anterior chamber angle (ACA), anterior chamber volume (ACV), anterior chamber depth (ACD), and CCT were evaluated with Sirius corneal topography [(Sirius CT), CSO, Italy] before and after 5 hours of SCL wear, with the lens in place. Additionally, IOP was measured using a pneumotonometer (Canon TX-20P; Tokyo, Japan) both before lens wear and immediately after removal.
RESULTS: The SCL-corrected visual acuity was found to be 0.1 (0-1.3) LogMAR in twenty-four eyes of fourteen patients (4 females, 10 males), with a mean age of 37.9±10.4 years. After 5 hours of SCL wear, CCT values measured through the lens [478.5 (264-685) µm] were significantly higher than pre-wear values [417.0 (269-589) µm] (P<0.001). ACA [51 (38-68)° vs. 49 (38-66)°], ACD [3.74 (2.76-4.61) mm vs. 3.65 (2.57-4.25) mm], and ACV [210 (150-283) mm³ vs. 196 (132-255) mm³] with SCL were also higher than pre-wear values (P=0.001, P<0.001, P<0.001, respectively). After 5 hours of SCL wear, K1 significantly decreased from 48.46 D (44.21-51.47) to 41.64 D (40.12-45.49), and K2 significantly decreased from 56.24 D (50.53-57.12) to 41.83 D (41.10-45.85) (P=0.001 for both). IOP was unchanged between the initial measurement and after removing the SCL [10 (6–20) mmHg vs. 11 (6–21) mmHg, respectively, P>0.05].
DISCUSSION AND CONCLUSION: Besides not affecting IOP, SCLs were associated with an increase in CCT, ACA, ACD, and ACV after 5 hours of wear. These lenses do not appear to adversely affect IOP or narrow the iridocorneal angle.

INTRODUCTION: This study aimed to determine validity and reliability of the Turkish version of Balance Outcome Measure for Elderly Rehabilitation (BOOMER) and to evaluate its psychometric properties.
METHODS: The study included 60 elderly individuals (30 women, 30 men; mean age 72.03±7.86 years). Participants completed the four subtests of the BOOMER (Step Test, Timed Up and Go Test, Functional Reach Test, Timed Static Stand Test) and the Berg Balance Scale (BBS). Descriptive statistics were calculated, Cronbach’s alpha and Kendall’s W coefficient were used for internal consistency, and Spearman’s correlation was used to examine item-total relationships and correlations between the BOOMER and the BBS.
RESULTS: The total BOOMER score was found to be 12.52±0.95. Significant correlations were observed between the subtests and the total BOOMER score (r=0.414–0.565, p<0.01). The Cronbach’s alpha coefficient was low at 0.022, but the Kendall W coefficient showed moderate reliability at 0.339. For the BBS, the alpha was initially 0.304, but it increased to 0.548 after item-total correlation analysis. A positive and significant correlation was found between the BOOMER total score and the BBS total score (r=0.419, p=0.001).
DISCUSSION AND CONCLUSION: The BOOMER scale is a practical measure that can assess static, dynamic, and functional balance in older adults in a short time. Its significant correlation with the BBS supports the concurrent validity of the scale. However, considering the low internal consistency values, it is recommended that reliability findings be strengthened through further studies in different populations and with larger samples.

INTRODUCTION: This retrospective cross-sectional study aimed to investigate the incidence and trends of hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and rates of Hepatitis B surface antibody (anti-HBs) positivity among pregnant women attending an outpatient obstetrics clinic.
METHODS: Over a four-year period, data from 11,641 antenatal records were analyzed to determine the incidence and trends of anti-HBs, HBV, HCV, and HIV among pregnant women. Screening for anti-HBs, HBsAg, anti-HCV, and anti-HIV antibodies were categorized as positive or negative. People with multiple pregnancies were only counted once for their first positive. Descriptive statistics, chi-square tests for trend analysis, and Poisson distribution were utilized for data analysis.
RESULTS: The study revealed varying incidence rates of HBsAg, anti-HCV, and anti-HIV be-tween 1.6-9.2%, 0.2-1.2%, and 0-0.6%, respectively. Absence of HIV cases in 2020 and 2021 changed in 2022 with a 0.2% increase, escalating to 0.6% in 2023. The analysis of anti-HBs levels and HBsAg positivity supported the importance of maternal immunity and HBV infection.
DISCUSSION AND CONCLUSION: Routine screening for HBV, HCV, and HIV is crucial during pregnancy to prevent vertical transmission and improve maternal and infant health outcomes. Understanding the importance of maternal immunity and implementing targeted interventions and public health strategies to reduce transmission rates among pregnant women is essential for achieving this goal.

INTRODUCTION: Parental height is a key component of growth assessment in children; however, it is often self-reported. The accuracy of reported parental height and its potential clinical implications remain insufficiently studied.
METHODS: Parents of the first 100 children attending a tertiary pediatric endocrinology clinic for the first time were included. Parental height was first self-reported and subsequently measured using a standardized stadiometer. Height standard deviation scores (SDS) were calculated based on Neyzi reference data. Reporting error was defined as the difference between reported and measured height (Δ SDS). Agreement was assessed using Wilcoxon signed-rank tests and Bland–Altman analysis. Correlations were evaluated using Spearman’s rank test.
RESULTS: A total of 96 mothers and 58 fathers were included. Self-reported height was significantly higher than measured height in both mothers (159.3±6.1 vs. 157.3±5.6 cm, p<0.001) and fathers (174.8±5.3 vs. 172.7±4.6 cm, p<0.001). Over-reporting of ≥2 cm was observed in 51.0% of mothers and 58.6% of fathers. Bland–Altman analysis demonstrated a mean bias of 2.0 cm in mothers and 2.3 cm in fathers, with wide limits of agreement. No significant correlation was found between measured height SDS and reporting error in either group. Reporting accuracy was not influenced by parental stature, sex, or shared family behavior.
DISCUSSION AND CONCLUSION: Self-reported parental height frequently overestimates true height and shows substantial individual variability in a pediatric endocrinology setting. Whenever possible, direct measurement of parental height should be incorporated into routine clinical practice to ensure accurate growth assessment.

INTRODUCTION: This study aimed to examine the relationship between Attention Deficit Hyperactivity Disorder (ADHD) symptom severity and forgiveness behavior among individuals with Antisocial Personality Disorder (ASPD), both with and without comorbid ADHD, in comparison to a healthy control group.
METHODS: The sample consisted of 190 male participants divided into three groups: ASPD with ADHD symptoms (n=52), ASPD without ADHD symptoms (n=38), and a healthy control group (n=100). Diagnoses were established through structured clinical interviews based on DSM-V-TR criteria. Participants completed the Adult ADHD Symptom Scale and the Forgiveness Scale. Correlation analyses were conducted separately for each group to explore the association between ADHD symptom scores and forgiveness.
RESULTS: Sociodemographic variables were evenly distributed across all groups. A significant negative correlation was observed between ADHD symptoms and forgiveness in the ASPD without ADHD group (r=–0.418, p=0.008), indicating that increased ADHD symptoms in this group were associated with lower forgiveness. In contrast, a positive correlation was found in the ASPD with ADHD group (r=0.104, p=0.043) and the healthy control group (r=0.196, p=0.005), suggesting that higher ADHD symptoms may be related to increased forgiveness in these populations.
DISCUSSION AND CONCLUSION: The findings suggest that ADHD symptoms may modulate emotional responsiveness and forgiveness behavior, even in individuals with antisocial traits. The presence of forgiving behavior in antisocial individuals may reflect ADHD-related emotional variability rather than the absence of antisocial pathology. These results highlight the diagnostic complexity between ADHD and ASPD and underline the importance of multidimensional assessment in clinical practice.

INTRODUCTION: Autoimmune hepatitis (AIH) is a chronic liver disease characterized by inflammation of unknown origin. It is marked by high levels of immunoglobulin G (IgG) and autoantibodies in the blood. Pathologically, AIH shows infiltration of inflammatory cells, particularly plasma cells, and signs of interface hepatitis. The role of a specific type of CD4+ helper T cells, which produce interleukin (IL)-37, has been established in autoimmune diseases. However, their role in AIH is still not well understood. To shed light on this, our study aimed to investigate the gene and protein expression of IL-37 in liver biopsies of AIH patients and determine the involvement of tissue-resident IL-37-producing helper T cells in the development of AIH.
METHODS: We conducted a comparative study involving 20 patients diagnosed with AIH and 17 healthy individuals as controls. IL-37 gene expression was measured using quantitative real-time polymerase chain reaction (qRT-PCR), and immunofluorescence double staining was performed to identify IL-37+CD4+ helper T cells in the liver tissue. The ratio of IL-37+CD4+ helper T cells among total inflammatory cells was calculated to assess their abundance in AIH patients.
RESULTS: Our findings revealed a significant increase in the ratio of IL-37+CD4+ helper T cells in patients with AIH (p<0.05). Additionally, IL-37 gene expression was upregulated in AIH patients (p<0.01). Importantly, the ratio of IL-37+CD4+ Th cells showed a negative correlation with the severity of portal inflammation and Ishak scoring.
DISCUSSION AND CONCLUSION: Our results highlight IL-37-producing helper T cells may be potential therapeutic targets for autoimmune hepatitis. Further studies are warranted to elucidate their precise mechanisms and therapeutic implications.

INTRODUCTION: This study aimed to analyze and compare the early choroiad vascularity index (CVI) and choroidal Thickness (CT) values of newly diagnosed fibromyalgia (FM) patients and healthy subjects.
METHODS: The participants in this study consisted of 24 female FM patients (study group) and 30 similarly aged female healthy subjects (control group). Only newly diagnosed FM patients were included in the study group. FM was diagnosed according to the American College of Rheumatology (ACR) 2010 classification criteria.Fibromyalgia Impact Questionnaire (FIQ) was used to assess the disease severity. CT values were measured at five points: Subfoveal, 750 μm temporally, 1500 μm temporally, 750 μm nasally to the foveal center, 1500 μm nasally to the foveal center (1500-N). CVI values were measured using the public domain ImageJ software for subfoveal and total choroidal areas.
RESULTS: CT values in 1500 μm nasal and temporal were statistically lower in the FM group (p<0.05). While 750 μm nasal and temporal, subfoveal CT values were no statistically significant different (p>0.05). There was no statistically significant difference between the groups in terms of subfoveal-CVI, (p>0.05) but total-CVI values were significantly higher in the FM group (p<0.05).
DISCUSSION AND CONCLUSION: The thinner choroidal thickness in the nasal and temporal regions compared to the central area, preserved choroidal vascularity index in the subfoveal area, and overall increased CVI in these patients may indicate that choroidal vascular changes and thinning start from the peripheral choroidal area at early stages of FM.

INTRODUCTION: This study evaluated the utility of the Albumin-Bilirubin (ALBI) score as an indicator of liver dysfunction during pregnancy. The aim was to investigate the effectiveness of the ALBI score, which assesses liver function, in predicting the development of hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome.
METHODS: This retrospective case-control study was conducted at a tertiary center in Ankara between January 1, 2018, and January 1, 2022. Sixty-one patients diagnosed with HELLP syndrome and 122 healthy pregnant women, matched for age and gestational age, were included. Blood samples were collected at 20–28 weeks’ gestation, an average of six weeks before the development of HELLP syndrome findings. Demographic, clinical, and bio-chemical data for all participants were analyzed. The ALBI scores of patients with confirmed HELLP syndrome were compared with those of the control group using regression and receiver operating characteristic (ROC) curve anaylsis to assess predictive value.
RESULTS: Total bilirubin levels were significantly higher and albumin levels were significantly lower in the HELLP group (p<0.05). Consequently, ALBI scores were significantly higher (p=0.004). ROC showed that ALBI had discriminatory power in predicting HELLP syndrome (area under the curve=0.629; p=0.007). In both the HELLP group and the group including all participants, the ALBI score was not statistically significant in predicting poor composite neonatal outcome (p>0.05).
DISCUSSION AND CONCLUSION: Although the ALBI score is used in prognostication for liver diseases, it can also be used for early prediction of HELLP syndrome. Prospective multicenter studies are needed to confirm cutoff values and reliability.

INTRODUCTION: Gallbladder polyps (GPs) are increasingly detected with abdominal ultrasonography; although most are benign, differentiating benign from neoplastic lesions pre-operatively remains challenging. Current guidelines recommend cholecystectomy for polyps ≥10 mm, yet the true malignancy risk in smaller or symptomatic lesions is still debated.
METHODS: We performed a single-centre retrospective cohort study of adults (≥18 years) who underwent elective cholecystectomy for radiologically confirmed gallbladder polyps. Demographic, clinical, radiological and histopathological data were extracted from electronic records. The primary outcome was histopathological evidence of neoplasia. Categorical variables are presented as n (%), continuous variables as mean ± SD or median (IQR).
RESULTS: Fifty-seven patients were included (33 women, 24 men; mean age 45.4±14.8 years). Most (50/57, 87.7%) were symptomatic, commonly with right upper-quadrant pain or dyspepsia. Polyps were <10 mm in 43 patients (75.4%) and ≥10 mm in 14 (24.6%). Histology revealed cholesterol or other benign polyps in 55 cases (96.5%). Neoplastic change was identified in two patients (3.5%): One benign intraluminal papillary neoplasia and one high-grade intraepithelial neoplasia; both lesions occurred in polyps ≥10 mm. No neoplasia was found in polyps <10 mm. Sex, symptom status and polyp multiplicity were not associated with neoplastic transformation.
DISCUSSION AND CONCLUSION: In this cohort, neoplastic transformation was confined to polyps ≥10 mm, reinforcing the 10-mm threshold for prophylactic cholecystectomy. Polyps <10 mm—especially in asymptomatic patients—were uniformly benign, supporting conservative ultrasound surveillance. Larger, prospective studies are warranted to refine risk stratification for intermediate-sized lesions.

Longitudinally extensive transverse myelitis (LETM) generally present a destructive clinical syndrome which has come into focus for its association with neuromyelitis optica spectrum disease (NMOSD). In clinical practice, both LETM and NMO have a close relation so they thought to be synonymous with each other. Other causes of LETM are infective, neoplastic and connective tissue disorders. Similar symptoms and even similar CSF abnormalities can cause difficulties in differential diagnosis. In suspicious cases, beside more detailed history, tight observation of clinical progress and follow-up MRI, pathological evaluation can be helpful to certain diagnosis.

Burn victims consist a wide range of industrial accidents.The trauma arose from industrial burn accidents bring forth disability or even death. Not only the victim but also the family suffer from this situation. It is thought that the Nursing Model, which consists of five items (life time, daily life activities, factors those affecting daily life activities, independency-dependency system, individuality in life), collects data about the individual patient and apply it in a systematic direction with a holistic approach. The aim of this study is how to take care of the patients, those suffered from burn injury as a result of an industrial accident in accordance to the Nursing Model based on the daily life activities of Roper-Logan and Tierney.

Spina bifida (SB) is a congenital malformation in which the spinal column is split (bifid) as a result of failed closure of the embryonic neural tube, during the fourth week post-fertilization. The prevalence of spina bifida is 1-10 per 1000 births. Diagnosis of SB is usually made prenatally by measurement of alpha fetal protein in the maternal serum at 16 weeks of gestation or by ultrasound of the fetus at 18–20 weeks of gestation. Depending on the lesion, interruption of the spinal cord at the site of the defect causes paralysis of the legs, incontinence of urine and feces, anesthesia of the skin, and deformation of the hips, knees, and feet. Clinical presentation depends both on the level and type of the spinal lesion at the vertebral column. Early surgical repair of the spinal lesion is essential in preventing further deficits and neurological damage. Conventional approach dictates the surgical repair in 48 hours of birth. With the application of this principle, the rate of protection of the infant’s spinal cord and nerve roots has increased. Prenatal surgery which is a relatively new approach is proven to be more effective than postnatal surgery in lowering the occurrence of future complications. A child with the SB diagnosis is a life-long rehabilitation patient. Detailed clinical examination and setting age-appropriate goals is the first step for achieving the best possible outcome.