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Objective: Rheumatoid Arthritis (RA) is a chronic destructive inflammatory disorder. This study is aimed to investigate the effects of balneotherapy and aquatherapy in the treatment of RA patients. Materials and Methods: A total of 59 patients who fulfilled the American College of Rheumatology diagnostic criteria for RA were included this study. Patients were randomly assigned into three groups. Group 1 (n=20) received balneotherapy, group 2 (n=20) received an aquatic exercise program and group 3 (n=19) was accepted as control group. These programs were applied five times a week, over three weeks (15 sessions). Patients were evaluated for clinical and laboratory parameters. Clinical parameters included pain,duration of morning stiffness, number of swollen and tender joints, disease activity score (DAS28), Modified health assessment questionnaire (mHAQ), physician's and patient's global assessment and hand grip strength. Laboratory evaluation included erythrocyte sedimentation rate(ESR) and C-reactive protein (CRP). The assessment parameters were measured before, at the end of and after 3 months of the therapy. Results: The mean age of the patients was 54±10.7 (25-75) years and the mean disease duration was 122.3±98.1 (1-424) months. In aquatic exercise group we observed an improvement in DAS28 scores (p<0.001), in the number of tender joints (p<0.005), in VAS scores (p<0.005), mHAQ (p<0.05), physician's and patient's global assessments (p<0.05). Also there was a statistically significant decrease in ESR results in aquatherapy group compared to other groups (p<0.05). However no statistically significant difference was obtained between three groups (p>0.05). Conclusion: This study shows that aquatic exercise program is beneficial in the management of DAS28, pain, HAQ parameters and should be taken in to consideration in planning exercise therapy for RA patients. [ABSTRACT FROM AUTHOR]

Background and Design: Er: YAG lasers are precise ablation systems used in the treatment benign epidermal and dermal skin lesions. In this study, we retrospectively analysed the efficiency of Er: YAG laser therapy in the treatment of benign epidermal and dermal skin lesions. Materials and Methods: We retrospectively investigated the medical records of 116 patients treated with Er: YAG laser in our clinic between April 2011 and April 2013. The clinical data of 103 patients (47 men, 56 women) with xanthelasma, solar lentigo, epidermal nevus, seborrheic keratosis, nevus of ota, syringoma, cafe au lait macules (CALM) or other than these were included in the study. Treatment parameters, demographic features of the patients, and before and after photos of the lesions were investigated from patients’ records in order to evaluate the efficiency of Er: YAG laser therapy. Results: The patients included in the study were evaluated in 8 groups: xanthelasma (n=21), syringoma (n=17), solar lentigo (n=16), epidermal nevus (n=11), seborrheic keratosis (n=9), nevus of ota (n=5), CALM (n=3) and other than these (n=21). In the Er: YAG laser treatment, the average energy flow was 3-7 J/cm2, the average pulse duration was 300 ms, the average number of passes was 3-5 repeats, and the average pulse frequency was 3-7 Hz. While no improvement was observed in 4.9% of patients, 59.2% of subjects showed marked improvement, 26.2% showed moderate and 9.7% of patients showed mild improvement. Treatment responses in xanthelasma, syringoma, epidermal nevus, solar lentigo and CALM lesions were statistically significant. The observed side effects were hyperpigmentation in 4 patients, hypopigmentation in 3 patients, hypertrophic scar in 2 patients and persistent erythema in one patient. The treatment was well tolerated by all the subjects. Conclusion: Er: YAG laser is an effective and safe treatment option in the treatment of benign skin lesions especially in epidermal lesions. [ABSTRACT FROM AUTHOR]

Background and Design: Intense Pulsed Light (IPL) is a light system of 500-1200 nm wavelength which is used for hair removal and nonablative skin resurfacing as well as for the treatment of hyperpigmentation and superficial vascular lesions. The mechanism of action is thought to be the focal epidermal coagulation due to selective photothermolysis in the epidermal keratinocytes and melanocytes. A variety of laser systems can be used in the treatment of solar lentigo. The aim of this study was to investigate the effectiveness of IPL in solar lentigo. Materials and Methods: We retrospectively reviewed the medical records of patients with the diagnosis of solar lentigo in our Cosmetology Unit from March 2007 to November 2010. There were 139 files of patients who received clinical and dermoscopic diagnosis of solar lentigo and treated by IPL (L900 A&M). Informed consent was taken from all patients. Among them, 42 patients, who had attended regular follow-up visits and had pictures taken both before and after treatment, were included in the study. Results: A total of 52 lesions in 42 female and 1 male patients were included in the study. The mean age of the patients was 42±9.6 (33-88) years. Thirty-seven lesions (51.9%) were on the cheek, 7 lesions (13.5%) were on the zygoma, 6 lesions (11.5%) were on the chin, 4 lesions (7.7%) were on the hands, 4 lesions (7.7%) were on the forehead, 2 lesions (3.8%) were on the nose, and 2 lesions (3.8%) were on the forearm. The mean number of sessions was 3.28, ranging between 1 and 7. After treatment, more than 75% improvement was observed in 57.7% of the lesions, 50-75% in 17.3% of the lesions, 25-50% in 17.3% of the lesions, and less than 25% improvement was obtained in 7.7% of the lesions. Conclusion: According to the results of our work, IPL can be considered to be an effective, cheap and safe method in terms of its side effects in the treatment of solar lentigo. [ABSTRACT FROM AUTHOR]

Background and Design: Ultraviolet (UV) radiation can affect dermoscopic features of melanocytic nevi by inducing melanin synthesis or melanocyte proliferation. Despite widespread use of UV radiation in the treatment of several skin diseases, there have been only a few studies on its effects on the dermoscopic features of melanocytic nevi. The present study was designed to determine the effects of narrowband UVB, UVA1 and psoralen and UVA (PUVA) treatments on dermoscopic features of melanocytic nevi. Material and Method: A total of 55 patients, who were referred to our phototherapy unit for the treatment of various skin disorders, were enrolled in this prospective study. Twenty-one patients underwent narrowband UVB, 18 patients underwent UVA1 and 16 patients underwent PUVA treatment. Dermoscopic images of 233 nevi in narrowband UVB group, 233 nevi in UVA1 group and 229 nevi in PUVA group were evaluated for the alterations in dermoscopic structures at the end of three months. Total dermoscopic scores (TDSs) of melanocytic nevi were calculated according to the ABCD rule. Results: There was no statistically significant increase in the size of melanocytic nevi in the therapy groups. Narrowband UVB, UVA1, and PUVA resulted in statistically significant changes in the dermoscopic structures of melanocytic nevi. In narrowband UVB therapy group, de novo dot formation was documented (p=0.002). Only in narrowband UVB group, de novo dot formation was observed. There was no statistically significant change in the mean TDS. Conclusion: Narrowband UVB, UVA1 and PUVA therapies have significant effects on dermoscopic features of melanocytic nevi. [ABSTRACT FROM AUTHOR]

Objective: To compare the surgical and functional outcomes of open, laparoscopic and robotic dismembered pyeloplasty for the treatment of patients with ureteropelvic junction obstruction (UPJO). Material and methods: Between 2007 and 2012, a total of 56 patients underwent conventional open (Group 1; n=25), laparoscopic (Group 2; n=16), and robotic (Group 3; n=15) dismembered pyeloplasty operations. Preoperative evaluation was performed using urinalysis, urine culture, blood biochemistry, urinary ultrasound, intravenous pyelogram (IVP) (optional) and Mercaptoacetyltriglycine (MAG-3) renal scan. The mean operation time, estimated blood loss, drain removal time, narcotic analgesic requirements, length of hospital stay and functional outcomes were compared among groups. Statistical analyses were performed using SPSS Statistics v. 20 (IBM, Armonk, NY, USA) software, and statistically significant differences were determined using a p value <0.05. Results: The mean age of the patients was 30 years in Group 1, 34.3 years in Group 2 and 32.9 years in Group 3. The mean operation time was 127, 130 and 114 min (p=0.32), and the estimated blood loss was 105, 31 and 28 mL, respectively (p=0.001). The drain was removed after 4.36 (±1.3), 2.33 (±0.6) and 1.8 (±0.6) days after surgery (p<0.001), and the mean hospital stay was 4.14 (±1.8), 2.8 (±0.75) and 2 (±1) days, respectively (p<0.001). Narcotic analgesic requirement was significantly higher in Group 1 compared with Groups 2 and 3 (p=0.02). The radiographic and symptomatic success rates were 96% in Group 1, 93.75% in Group 2 and 93.3% in Group 3. Conclusion: Laparoscopic and robotic pyeloplasty are feasible, effective, reliable and minimally invasive treatment approaches for the treatment of UPJO as compared with open dismembered pyeloplasty. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to investigate the relationship between age and tumor characteristics and to evaluate oncologic results after radical cystectomy in bladder cancer with respect to age. Material and methods: We reviewed 460 patients retrospectively who underwent radical cystectomy. Patients were divided into two groups according to age: >70 (Group 1), and <70 (Group 2). We compared tumor's pathological characteristics and the results of long-term follow-up in both groups. The first group included 76 (16.7%), and the second group 379 (83.3%) patients. The mean age of the patients was 73.3±3.01 years (70-85) in Group 1 and 58.3±7.47 years (34-69) in Group 2. The American Society of Anesthesiologists (ASA) score was less than three in all of the patients, and there was no risk for major surgery. Results: Any statistically significant difference was not found between groups with respect to pathological T stage (p=0.567), lymph node involvement (p=0.179), or histological grade (p=0.567). Perioperative mortality rates were 3.9, and 3.4% for Groups 1, and 2, respectively (p=0.218). Perioperative complication rates were 14.7, and 17.5% for groups 1, and 2 respectively (p=0.578). Five-year disease-specific survival (DSS) rates were 57.0, and 51.6% Groups 1, and 2, respectively. The mean DSS periods were 82.05±4.88 and 71.68±8.53 months for Groups 1, and 2, respectively. Five-year overall survival rates were 43.9% for Group 1 and 45.9% for Group 2. The mean overall survival times were 54.02±8.47, and 69.25±4.97 months for Groups 1, and 2, respectively. In Cox regression analysis, tumor stage (p=0.012) and lymph node involvement (p<0.001) were significant factors that affected the survival in both groups. None of the patients received neoadjuvant radiotherapy or chemotherapy. Conclusion: We found that oncological outcomes of radical cystectomy performed with the indication of bladder tumor were comparable between young and elderly We believe that age per se should not constitute a contraindication for radical cystectomy operations. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effects of artificial tears on corneal higher order aberrations in dry eye patients. Materials and Methods: 30 right eyes of 30 newly diagnosed dry eye patients were evaluated in this prospective study. After routine ophthalmological examination, Schirmer test and tear break-up time (TBUT) test were performed in all patients. Anterior corneal aberrations were derived from conversion of the corneal elevation profile into corneal wavefront data with 6.0 mm pupil diameter using Zernike polynomails by corneal topography before and 5 minutes after instillation of artificial tear (Eyestil®). Corneal optical aberrations were compared before and after instillation of eyedrop. Results: The study included 17 women and 13 men; the average age of the patients was 44.36±13.22 years. Mean TBUT was 4.78±2.78 seconds and mean Schirmer value was 3.58±2.45 mm/5 minutes. After instillation of artificial tear, significant reductions in corneal total aberration from 1.120±0.35 μm to 0.960±0.34 μm, higher order aberration from 0.674±0.26 μm to 0.464±0.18 μm, coma-like aberration from 0.283±0.10 μm to 0.238±0.09 μm, and spherical-like aberration from 0.254±0.11 μm to 0.221±0.08 μm were detected (all, p<0.001). After eyedrop instillation, statistically significant increment was observed in Strehl ratio (p<0.001). Conclusion: As well as reducing the dry eye symptoms, artificial tears also cause increment in optical quality of the eye. Benefits of artificial tears on visual quality can be evaluated objectively via corneal wavefront aberrations. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the indications and outcomes of amniotic membrane transplantation (AMT). Materials and Methods: A total of 87 eyes who underwent amnion membrane transplantation in our clinic between February 2010 and April 2013 were included in this study. Mean follow-up period was 7.49±7.84 months (range 1-29 months). Amnion membrane defrosted at room temperature and washed three times with saline covered all over the cornea independent of the position and size of the lesion and was sutured to the peripheral cornea circumferentially by 10/0 monofilament suture. At the end of the operation, therapeutic contact lens was placed. All cases were evaluated with respect to duration of surface epithelial healing, visual acuity, presence of recurrence, and infection. Results: Forty-six of the 87 patients (52.8%) were men and 41 (47.1%) were women. The mean age was 57.02±19.74 years (range 31-89 years) in men and 66.69±16.56 years (range 8-88 years) in women. The indications were: ulcers in 27 eyes, keratitis in 24 eyes, topical anesthetic abuse in 10 eyes, bullous keratopathy in 7 eyes, conjunctival mass in 7 eyes, symblepharon in 3 eyes, chemical burns in 3 eyes, pterygium in 2 eyes, endophthalmitis in 2 eyes, dellen in 1 eye, and conjunctival laceration in 1 eye. After AMT, 12 patients required second AMT, and 2 cases required third AMT. 2 eyes were eviscerated, 1 eye was exenterated. At the final follow-up visit, except for patients who underwent evisceration and exenteration, improved visual acuity was observed in 45 of the 84 eyes (53.5%). The average of healing time was between 4 and 6 weeks. No infectious, inflammatory, immunologic, or toxic/allergic reactions related to AMT was observed. Conclusion: Amniotic membrane transplantation is a safe and effective technique in ocular surface diseases. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the indications, intra- and post-operative complications, and visual results of combined cataract surgery and pars plana vitrectomy. Materials and Methods: Medical records of patients who underwent combined surgery between January 2008 and January 2011 were retrospectively evaluated. Indications for surgery, complications, pre-operative and post-operative visual acuities were recorded. Results: Sixty-four eyes of 64 patients were included in the study. Thirty-fve (55%) of the patients were men and 29 (45%) were women; mean age was 53±21 (6-88) years. Mean follow-up time was 13±12 (1-51) months. The main indications for combined surgery were intravitreal hemorrhage in 19 patients (29.7%), epiretinal membrane in 12 (18.8%), intraocular foreign body in 11 (17.2%), retinal detachment in 9 (14.1%), and macular edema in 7 (11%) patients. Posterior capsule rupture in 3 cases and corneal edema in 2 cases were the complications encountered during surgery. Postoperatively, hypotonia occurred in 5 cases and corneal edema in 1. Intraocular pressure elevation was observed in 1 silicon-injected case and 1 propane gas-injected case. The average preoperative visual acuity was 1.90±1.9 (0.22 to 3.10) LogMAR. The average postoperative visual acuity at the last visit was 1.1±1.0 (0.00 to 4.00) LogMAR. The visual acuity increase was statistically signifcant (p<0.001). Conclusion: Combined surgery is a feasible option for patients with vitreoretinal diseases and cataract. Visual results and complications depend primarily on the underlying posterior segment pathology. [ABSTRACT FROM AUTHOR]

Objectives: To compare the outcomes of external dacryocystorhinostomy (DCR) and transcanalicular multidiode dacryocystorhinostomy (TC-DCR) operations in our clinic. Materials and Methods: This retrospective study included patients diagnosed with acquired nasolacrimal duct obstruction. The results of external DCR surgery performed in 15 eyes of 15 patients were compared with the results in 15 eyes of 13 patients who underwent TC-DCR surgery. The patients with external DCR were followed for an average of 9.7±3.2 months, and the cases that underwent TK-DSR were followed for an average of 8.3±2.9 months. Results: The surgical success rate was 53.3% in patients with TK-DCR, while it reached 87% in cases with external DCR. Mean operative time was 50.0±2.5 minutes in external DCR group and 30.0±2.0 minutes in TK-DCR group. There was no significant complication during operations in both groups. Conclusion: In dacryostenosis surgery, external DCR is the golden standard with high success rates. Even though success rate of TCDSR is less than that of external DSR, no need of skin incision, less damage to the lacrimal pump system, less bleeding, and a shorter duration of the operation are the main advantages of this method. [ABSTRACT FROM AUTHOR]

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Purpose: To present our results of limbal conjunctival autograft technique (LCAT) for recurrent pterygium which developed after different surgical techniques for primary pterygium. Material and Method: Cases, who underwent LCAT for the treatment of recurrent pterygium, were evaluated. The cases were divided into three groups based on the primary surgery performed. Recurrent pterygium developed after bare sclera technique in group 1, LCAT in group 2, and amniotic membrane graft technique in group 3. Corneal epithelization, recurrence rate, and postoperative complications were compared among groups. Results: Forty-two eyes of 42 patients were evaluated. Nineteen eyes of 19 patients formed group 1, 11 eyes of 11 patients - group 2, and 12 eyes of 12 patients - group 3. Mean age (years) was 45.38±12.22 (24-72) in group 1, 46.81±13.41 (25-73) in group 2, and 44.83±11.92 (27-66) in group 3. Follow-up (months) was 19.38±6.03 (9-32) in group 1, 21.37±7.41 (11-34) in group 2, and 20.93±7.26 (10-34) in group 3. Postoperative corneal epithelization was completed after 5.62±1.74 (2-7) days in group 1, 4.33±0.91 (2-7) days in group 2, and 4.79±1.39 (2-7) days in group 3 (p=0.035). Recurrence was detected in 4 eyes in group 1 (21%), 3 eyes in group 2 (27%), and 3 eyes in group 3 (25%) (p=0.092). Postoperative complications were not observed in neither of the groups. Discussion: LCAT seems to be an efficient treatment for recurrent pterygium with high success and low recurrence rates regardless of the primary surgery. Low recurrence rates in LCAT may be due to the limbal stem cells transplanted with conjunctival autograft to pterygium excision area. Early corneal epithelization in recurrences following LCOT may be an indication of the maintenance to a certain degree of activities of the limbal stem cells transplanted in the primary surgery. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of amniotic membrane transplantation (AMT) in the treatment of corneal ulcers resulting from herpetic keratitis (HK) and bacterial keratitis (BK). Material and Method: Forty-six patients (25 HK, 21 BK) treated with AMT for HK or BK-related corneal ulcers between January 2009 and September 2011 were followed prospectively. The visual acuities and ulcer characteristics (depth and localization) prior to AMT and epithelialization time, as well as final visual acuities after AMT, were evaluated. Results: The mean age was 51.9±17.0 years in HK and 53.3±22.0 years in BK and the mean follow-up time was 12.6±6.1 (5-33) months and 10.2±6.8 (3-27) months, respectively. The ulcers were mostly central in HK (72%) and paracentral in BK (52.4%) (p=0.03). Ulcer depth was deeper than 1/2 of the cornea in 14 (56%) HK and in 7 (33.3%) BK (p=0.290). Eight HK patients had scars from previous herpetic keratitis episodes. The mean epithelialization time was 22.3±8.5 (12-50) days in HK and 22.1±10.9 (8-45) days in BK (p=0.488). While epithelialization was achieved in all the patients with BK, 3 HK patients needed adjunctive surgeries (conjunctival flap, tectonic penetrating keratoplasty) in spite of three AMTs. Although visual acuities improved significantly in both groups, this improvement was more evident in BK cases (p=0.018 for HK and p<0.001 for BK). Discussion: Amniotic membrane transplantation is an effective and safe treatment for bacterial and herpetic corneal ulcers. The reason for the lower final visual acuities in the herpetic group was thought to be related to a more central location, deeper involvement and scars due to previous attacks [ABSTRACT FROM AUTHOR]

Purpose: To compare pain response of patients undergoing panretinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR) using 532 nm standard laser versus multispot pattern scan laser and to evaluate the relationship between pain response and patient characteristics. Material and Method: Thirty-five patients had PRP with the Pascal system in a single session, while other 35 patients had PRP with conventional laser in 2 sessions. Parameters used in conventional laser were as follows: spot size 200 μm, exposure time 0.2 s, and power sufficient to produce visible grey-white burns. We used same spot size, 20-30 ms exposure time, and higher levels of laser power in order to get a similar endpoint in the Pascal system. The patients were required to evaluate the severity of pain on a visual analog scale (VAS) and verbally 5 minutes after PRP with Pascal and 5 minutes after the first session of PRP with conventional laser. The relationship between pain experienced and patient characteristics was evaluated. Results: At baseline, both groups did not differ significantly (p >0.05, for all) with respect to sex, age, duration of diabetes, most recent HbA1c, treatment regimen, or patient experience. The patients in the Pascal group had a mean pain score of 0.55±0.70 on verbal scale and 1.54±1.22 on VAS compared to 2.17±1.18 and 5.54±3.28, respectively in the conventional laser group which was, statistically, significantly different in both scales (p<0.05). Discussion: Our study confirms that new generation pattern scanning photocoagulators satisfactorily decrease the pain by shortening the exposure time while increasing the laser power. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy and safety of 23-gauge (23G) pars plana vitrectomy (PPV) in dislocated intraocular lens (IOL) cases: In early- and late-term follow-up. Material and Method: In this retrospective study, the medical records of 17 patients who underwent 23 G PPV treatment for dislocated IOL between January 2009 and June 2011 were analyzed. Detailed ophthalmologic examination was performed in all patients; intraoperative and postoperative complications were recorded. Results: In this study, mean follow-up time was 9.0 (4-22) months and mean age was 60.8 (8-82) years. Mean time after cataract surgery was variable (mean of 28.3 (0-80) months). Four patients had trauma history, five patients had pseudoexfoliation syndrome, and two patients had pathologic myopia. Dislocated IOL was placed into the sulcus in nine patients (52.9%). In two cases (11.7%), the IOLs were removed, and the patients were left aphakic. In two cases out of other 6 (11.7%), the dislocated IOL was changed with scleral fixation lens, whereas in the other four cases (23.5%), IOL was changed with iris claw lens. One patient (5.8%) remained at the same level of vision, while twelve (70.5%) cases increased two or more lines in BCVA. The vision was decreased in two cases. Intraocular pressure elevation controlled by medication was observed in one case. For two days, hypotony was observed in one patient. Discussion: 23 G PPV technique is an effective and safe method for removing and repositioning of dislocated IOL in the vitreous. [ABSTRACT FROM AUTHOR]

Background and Design: Although gingival hyperpigmentation is not a medical problem, people who have moderate or severe gingival pigmentation, particularly patients having a gummy smile, frequently request cosmetic treatment. For gingival depigmentation, different treatment modalities have been reported such as surgical treatment, cryotherapy, electrosurgery, and laser therapy. Materials and Methods: Twenty-one patients with gingival melanin pigmentation were included in the study. We applied liquid nitrogen to the hyperpigmented area for 5-10 seconds using open spray technique with a cryogun. Clinical observations for intensity of pigmentation were recorded at baseline and 3 months after the treatment. Clinical parameters, such as bleeding, swelling, redness, and healing, were evaluated immediately after the cryotherapy and 24 hours, and 1 week after the treatment. We used a numeric pain scale to evaluate the pain level. Results: Three months after the treatment, the mean gingival melanin pigmentation score decreased from 41.62±16.58 to 19.28±11.85. The difference between pretreatment and posttreatment mean scores was found to be statistically significant.Discussion: Removal of gingival melanin pigmentation can be performed safely by open spray cryotherapy in dermatology clinics. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the intraoperative complications and postoperative visual outcomes of phacoemulsification surgery for the secondary cataract in vitrectomized eyes. Material and Method: We retrospectively evaluated 51 previously vitrectomized eyes of 51 patients who had undergone phacoemulsification and intraocular lens (PHACO+IOL) implantation surgery. PHACO+IOL surgery was performed in our clinic between October 2008 and May 2011. Intraoperative complications and postoperative best-corrected visual acuity (BCVA) outcomes were analyzed. Results: In this study, 31 out of 51 eyes had posterior subcapsular cataract. Cataract surgery was performed after a mean of 21.39±26.4 (6- 120, median 10.75) months following PPV. Mean preoperative and postoperative BCVA was measured to be 1.52±0.88 logMAR and 0.74±0.73 logMAR, respectively. In 25 eyes which had been filled with silicon oil, mean BCVA was 1.95±0.91 logMAR preoperatively and 1.15±0.84 logMAR postoperatively. In 18 (35.3%) eyes which had been filled with sulfur hexafluoride tamponade, mean BCVA was 1.17±0.47 logMAR preoperatively and 0.38±3.6 logMAR postoperatively. Peroperative zonular dialysis with instable deep anterior chamber occurred in two eyes, and posterior capsular tear occurred in one eye. Four eyes had Nd:YAG capsulotomy due to the posterior capsular opacity during the follow-up period. Discussion: Despite the well-known difficulties encountered in vitrectomized eyes such as zonular weakness, increased mobility of the lens-iris diaphragm, posterior capsular instability and posterior capsular plaques, phacoemulsification in vitrectomized eyes proved to be a safe surgery, and increase in visual acuity can be achieved. [ABSTRACT FROM AUTHOR]

Background and Design: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. Oral antibiotics and topical retinoids are effective in the treatment of acne. Materials and Methods: In this study, 60 patients with moderate acne vulgaris were evaluated; the patients were randomized into two equal groups. The groups were matched with respect to age, gender and clinical severity of acne. The patients in group 1 received oral azithromycin (500 mg daily on 3 consecutive days per week) and the patients in group 2 received doxycycline (100 mg daily) for 12 weeks. Topical adapalene gel was added to the systemic treatment in both groups. Clinical evaluation was performed at baseline and at the end of first, second and third months. Side effects were recorded. Quality of life in patients was measured with Skindex-29 and Acne Quality of Life Scale before treatment and at the end of third month. Results: At the end of the treatment, the patients in the two treatment groups had clinical improvement of more than 50%. Twenty-one patients in the azithromycin-adapalene group and 23 patients in the doxycycline-adapelene group had more than 80% clinical improvement. There was not any statistically significant difference in the clinical efficacy between the two combinations. Both treatment regimens were safe with minimal side effects. There was statistically significant difference in Skindex-29 and Acne Quality of Life Scale scores at baseline and at the end of the treatment (p< 0.05). There was not any statistically significant difference in the mean scale scores of both quality life scales between the two groups (p>0.05). Conclusion: Both treatments were efficient and safe. There was significant improvement in quality of life scale scores in both groups. [ABSTRACT FROM AUTHOR]

Aim: Minerals and trace elements affect bone formation and resorption through direct or indirect effects on bone cells or bone mineral. Strontium has several effects on bone cells and anabolic activity. Materials and Methods: The effects of strontium ranelate on pain and bone mineral density were assessed in an open, noncontrolled trial conducted in postmenopausal women. Oral strontium ranelate was given at a daily dose of 2 g for six months in 31 patients. All women received calcium and vitamin D supplements. Measurements of bone mineral density were performed before treatment and at the sixth month. Blood biochemistry analysis was performed at the beginning and at the 6th month. Results: Pain (visual analog scala) score was 6.12±1.05 at baseline and 4.25±0.92 at sixth month of treatment. Pain decreased significantly at 6th month (p<0.05). New fractures did not occur during the study. Strontium renalate treatment increased bone mineral density at 6th month at the total lumbar spine and the femoral total region. The changes were found to be statistically significant (p<0.05). There were no serious adverse events. None of the patients discontinued treatment due to adverse effects. The blood biochemistry was normal at baseline and end of the trial. Global efficacy was good in 64.5% of patients at sixth month. Tolerability was excellent during the study (80.6%). Conclusion: Treatment of postmenopausal osteoporosis with strontium ranelate can decrease pain, and increase bone mineral density beginning at six months following treatment. The results have to be considered as preliminary, the study was planned for a longer duration on a greater number of patients. (Turkish Journal of Osteoporosis 2012;18: 53-7) [ABSTRACT FROM AUTHOR]

Background and Design: There are numerous therapeutic methods for hair removal with various success rates. The aim of this study was to evaluate the efficacy of Intense Pulse Light (IPL) method for hair removal. Materials and Methods: Ninety patients, who applied for their unwanted hair, were included in the study. IPL was applied to the face, neck, axillary areas, bikini line, sternal area, periareolar areas, and upper and lower extremities. An IPL device (L900 A&M, France) was used for hair removal. The results were evaluated according to the clinical improvement (0-25%, 25-50%, 50-75%, 75% and more) and patients' satisfaction (very satisfied, satisfied, less satisfied, not satisfied). All results were analyzed using Chi-square test and statistical analysis was performed by SPSS 15.0 for Windows. Results: There were eighty-eight female (97.8%) and two male (2.2%) patients. The mean age of the patients was 33.62±11.11 (15-55) years. 13.3% of patients had polycystic ovary syndrome. The mean number of treatments was 6.5 (min-max= 2-11). 53.2% of patients had 50-75% clinical response and 53.2% of patients were satisfied. There were no side effects except mild erythema. Conclusion: We observed that IPL for hair removal was safe and moderately effective in our patients. (Turkderm 2012; 46: 94-7) [ABSTRACT FROM AUTHOR]

Background and Design: In this study, we aimed to evaluate the effects of a formula composed of millet extract, wheat germ oil, calcium pantothenate and L-cystine in women with diffuse alopecia by using Digital Phototrichogram (Trichoscan). Materials and methods: We evaluated female patients who presented to Gazi University Faculty of Medicine Department of Dermatology between January 2008 and November 2008 with the complaint of diffuse hair loss. Digital phototrichogram was performed in the frontal and occipital regions of the patients. Using this method, anagen:telogen ratios were determined. 53 female patients whose ages were between 18 and 50 and who were diagnosed as having telogen effluvium type diffuse alopecia were included in the study. The patients were given a capsule containing 140 mg millet extract, 271 mg wheat germ oil, 2 mg L-cystine and 10 mg calcium pantothenate three times a day for three months. The criteria for assessing the efficacy of the therapy included number of hair loss per day, hair pull test and digital phototrichogram. Results: The reduction of daily average hair loss after the treatment was statistically significant. Statistically significant difference was found between the pre- and post-treatment results of the hair pull test. Before the treatment, the average anagen ratio was determined to be 69.0±11.2 in the frontal region, and 72.3±9.4 in the occipital region. After the treatment, the anagen ratio increased to 76.4±11.2 in the frontal region and to 79.9±8.6 in the occipital region. The increase in the anagen hair rate in the frontal and occipital regions after the treatment was found to be statistically significant. Conclusion: As a result, it was found that the formula composed of millet extract, wheat germ oil, L-cystine and calcium pantothenate may be effective in the treatment of telogen effluvium. However, controlled studies including larger groups of diffuse alopecia patients and placebo groups are needed. (Turkderm 2012; 46: 78-83) [ABSTRACT FROM AUTHOR]

Objective: Double peak sensory responses elicited with submaximal stimulation is an electrophysiological method that has not been studied previously in pathological conditions. The second peak of the response was claimed to be produced by anodal stimulation and originated from the most distal regions of the nerve fibers. The objective of the study was to test double peak sensory responses in two groups of diabetic patients in two different stages of the disease. Methods: Conventional nerve conduction studies performed in 20 patients with impaired glucose tolerance (IGT), 14 with type 2 diabetes mellitus (DM), and in 25 healthy control subjects revealed normal results. Orthodromic double peak sensory responses with submaximal stimulation of the median nerve, sural/radial amplitude ratio and medial plantar nerve orthodromic sensory nerve action potentials (SNAP) were also studied in the non-dominant side. IGT and DM patients were evaluated with the Michigan Diabetic Neuropathy Scale (MDNS). Results: The mean median nerve sensory distal latency was prolonged and ulnar SNAP amplitude was significantly reduced in DM patients compared to the subjects in the other two groups. DM and IGT patients had higher stimulation thresholds and maximal stimulation intensities than the control subjects. The latencies of the first and second components of the double peak sensory responses were also prolonged in the DM group compared to the other groups. Conclusion: This study did not reveal any result indicating that double peak sensory responses with submaximal stimulation were superior to conventional nerve conduction studies in the detection of early diabetic polyneuropathy. However, the number of subjects included in our study is insufficient for a final decision on this matter, and further studies are needed to include diabetic patients having clinical signs and symptoms of polyneuropathy and normal nerve conduction studies. Stimulation threshold assessment might be a promising tool for the detection of early nerve involvement, if its reproducibility is achieved. This study showed once more that peripheral neuropathy may develop in individuals with diabetes even in early stage and with good glycemic control. [ABSTRACT FROM AUTHOR]

Objective: Although it is widely accepted that inpatient psychiatric treatment of children and adolescents is effective, it is also essential to evaluate its effectiveness by assessing the treatment compliance following discharge and the persistence of treatment effects in the long run. The aim of this study is to assess the effectiveness of inpatient treatment provided in one of the rare units in our country via evaluation of the achievement of treatment goals, changes in risk assessment scores, treatment compliance following discharge, and psychological functioning as reflected in the current relationships with the family, peers and school. Methods: This study was conducted in patients who had received at least 2 weeks of inpatient treatment in Dokuz Eylul University Hospital, the Child and Adolescent Mental Health Inpatient Unit between February 2008 and January 2009. Achievement of treatment goals, changes in risk assessment scores, treatment compliance following discharge, and the level of general functioning w ere assessed 1 year after the discharge. Socio-demographic variables, psychiatric diagnosis, and duration of hospital stay were recorded for each patient. Treatment goals questionnaire, risk assessment procedure, assessment of treatment compliance following discharge, relations with peers, family and school, and general functioning were assessed with the The Children's Global Assessment Scale (CGAS). Results: Forty-six patients with a mean (Standard Deviation, SD) age of 16.2 (1.6) years were included in the study. It was observed that 84.7% of patients had good compliance with the outpatient treatment plans. The mean (SD) CGAS scores calculated at admission, discharge and 1 year following the inpatient treatment were 40.6 (8.8), 60.7 (9.0) and 65.1 (1.7), respectively. The change in CGAS scores was found to be statistically significant (p=0.000). Additionally, the risk assessment scores were significantly lower 1 year following the discharge (p=0.000). Conclusion: Data obtained from the study display that the inpatient treatment of children and adolescents showed marked improvements in their psychiatric morbidities, peer, family and school functioning and outpatient treatment compliance. These findings could indicate the necessity of establishing and improving child and adolescent inpatient units in our country. [ABSTRACT FROM AUTHOR]

Objective: In this retrospective chart review study we aimed to investigate the effect of pimozide augmentation on schizophrenia patients with poor or partial response to clozapine therapy. Methods: Charts of 17 treatment resistant schizophrenia patients who had poor or partial response to at least one year clozapine therapy and whose treatment was augmented with pimozide were evaluated. Patients who had Clinical Global ImpressionSeverity (CGIS) scores ≥4 and Positive and Negative Syndrome Scale (PANSS) scores ≥72 were considered as poor or partial clozapine responders. The scores on the PANSS, CGI scale, and Extrapyramidal Symptom Rating Scale (ESRS) obtained in the first and the third months of follow-up were evaluated. Results: The mean age of the 8 female and 9 male (total 17) patients was 32.23±7.87 years, the mean age at onset of illness was 19.94±4.19 years, the mean duration of illness was 12.29±6.12 years, the mean clozapine dose was 500±58.63 mg/day, and the mean pimozide dose was 3.88±0.60 mg /day. The mean PANSS scores decreased from 99.70±13.91 to 3.64±1.27 and the mean CGIS scores decreased from 4.82±0.80 to 3.64±1.27. ESRS scores did not change significantly after the addition of pimozide to the treatment. Conclusion: Pimozide augmentation of clozapine was found to be effective and safe in treatment resistant schizophrenia patients with poor or partial response to clozapine therapy. [ABSTRACT FROM AUTHOR]

Otosclerosis is primary distrophic disease of the otic capsule.Surgical management of otosclerosis are stapes mobilization, anterior crurotomy, stapedectomy and stapedotomy. Our study included hearing and balance results of forty two otosclerosis patients operated in a private ear-nose and throat center in Diyarbakır between 2005-2010. [ABSTRACT FROM AUTHOR]

Objective: In this study we aimed to evaluate the results of pathology that patients undergoing laparoscopic and open appendectomy with suspected appendicitis from August 2012 to August 2014. Material and Method: In this study data from 131 patients undergoing laparoscopic and open appendectomy between August 2012 and August 2014 in Van Training and Research Hospital were examined retrospectively for demographic characteristics. Results: In the laparoscopic appendectomy group handmade endoloop technique was used for closing the base of the appendix. Mc Burney's incision was used for open appendectomy. 47% of patients was female (n=61), 53% of patients were male (n=69). The average age of the patients was 27.7 years. According to surgical technique, open appendectomy was performed 15% (n=20), laparoscopic appendectomy was performed 85% (n=110). Postoperative drainage tube was put to 15% of patients (n=20). Wound infection was seen in 4 open appendectomy performed patients (20%). Laparoscopic appendectomy was associated with a shorter hospital stay (2.2 days vs 2.8 days). When the pathology results are analyzed, 2 malignancies are revealed (1,5%), 1 carcinoid tumor, 1 neuroendocrine tumor. After pathology results hemicolectomy was performed. Conclusion: Appendectomy is the most frequently performed surgery, even if macroscopic pathology is not present the risk of malignancy can not be underestimated. [ABSTRACT FROM AUTHOR]