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BACKGROUND: The Modified Early Obstetric Warning System (MEOWS) is a score-based or color-coded system that detects changes in physiological parameters and enables earlier diagnosis and care of worsening obstetric patients. The aim of this study is to evaluate the tool's performance and contribute to its use in Türkiye by translating MEOWS into Turkish. METHODS: This prospective and descriptive study, approved by the local ethics committee, included 350 obstetric in-patients who gave birth at Samsun Training and Research Hospital, Gynecology and Children's Hospital between April and August 2022. The study involved patients with a gestational week greater than 28 weeks and up to six weeks postpartum. RESULTS: The average age of the patients was 28.9±5.9 (18-40) years, with trigger values occurring in 34.6% (n=121) and morbidity occurring in 30.9% (n=108) of the cases. The most common trigger among the individual physiological indicators was high systolic blood pressure (28.3%). When the performance of MEOWS was evaluated, a statistically significant correlation was found between trigger and morbidity (Kappa=0.605; p<0.001). The sensitivity of MEOWS in estimating morbidity was 77.78% (95% confidence interval [CI]: 68.76-85.21%), specificity was 84.71% (95% CI: 79.55-89.00%), Positive Predictive Value (PPV) was 69.42% (95% CI: 62.40-75.64%), Negative Predictive Value (NPV) was 89.52% (95% CI: 85.67-92.43%), and accuracy was 82.57% (95% CI: 78.18-86.40%). CONCLUSION: MEOWS was found to be an effective screening tool for predicting morbidity in this study and performs well in Turkish with sufficient sensitivity, specificity, and accuracy. However, the inclusion of long-term results would provide a more comprehensive understanding of the effectiveness of MEOWS. [ABSTRACT FROM AUTHOR]

Introduction: One of the most common comorbid conditions in heart failure is iron deficiency and anemia. Because the patients are mostly elderly and have comorbidities, many examinations cannot be performed for the etiology of anemia, and it is accepted as chronic disease anemia caused by chronic diseases. However, iron deficiency can occur frequently in these patients with or without anemia. We conducted this study to investigate this frequency in heart failure patients hospitalized in the internal medicine service. Methods: This retrospective study comprised one hundred patients with decompensated heart failure (72.2±10.4 years; F/M: 41/59). Measurements of serum iron, ferritin, folic acid, vitamin B12, lactate dehydrogenase, bilirubin, reticulocyte, hemogram parameters, creatinine, ejection fraction, and cardiothoracic index of these patients were recorded from patients' files. The ESC 2016 guideline was used for the diagnosis of heart failure and diagnosis of iron deficiency in patients with heart failure. Results: A total of 26 patients were NYHA III (26%), 74 patients were NYHA IV (74%), 16 patients were stage C (16%), and 84 patients were stage D (84%). Anemia was detected in 62 patients (62%), iron deficiency anemia in 45 patients (45%), and anemia of chronic disease in 56 patients (56%). Iron deficiency was present in 70% of all patients. Iron deficiency was found to be statistically significant in patients with coronary artery bypass graft (p<0.05). Discussion and Conclusion: Considering that the functional capacities and quality of life of patients with intravenous iron therapy increase in patients with chronic heart failure, we suggest that more attention should be paid to the investigation and treatment of the etiology of anemia in this patient group. [ABSTRACT FROM AUTHOR]

Introduction: Necrotizing enterocolitis (NEC) is a fatal disease with up to 20% mortality rates. Identifying risk factors for NEC may reduce NEC incidences. This study aims to investigate NEC-related risk factors in preterm infants. Methods: We included 27 preterm infants with NEC and 35 infants without NEC among the preterm newborns (n=1669) hospitalized in the Duzce University School of Medicine neonatal intensive care unit between 2009 and 2021. Parametric numeric data were calculated using the independent sample's t-test. Two-sample comparisons of nonparametric data were performed using the Mann-Whitney test. Pearson chi-square, Yates correction, and Fisher's exact test were also used to evaluate the categorical data. Results: Our results agree with previous studies regarding some of these findings: birth weight is lower in the NEC group (1.37±0.49 kg) than in the non-NEC group (18.3±6.5 kg) (p=0.009), with statistically similar gestational age. We couldn't show the association between NEC and multiple gestations, chorioamnionitis, preeclampsia, Apgar scores, patent ductus arteriosus, mechanical ventilation, pre-NEC red blood cell, or fresh frozen plasma transfusions. In the NEC group, thrombocyte levels before NEC were significantly lower (98 [9-2253]) (/x10³ mm³) than in the control group (222 [17-345]) (/x10³ mm³) (p=0.012). In addition, mortality rates (22.2% vs. 2.9%, respectively) (p=0.037), use of vasopressors (29.6% vs. 2.9%, respectively) (p=0.008) were markedly higher in the NEC group than in the non-NEC group. Additionally, lower birth weight (NEC group: 1367.25±493.62 vs. non-NEC group: 1831.71±651.62) (p=0.009), prolonged use of antibiotics (NEC group: 24% vs. non-NEC group: 0%) (p=0.004), and poor circulation (NEC group: 84% vs. non-NEC group: 3%) (p<0.001) were statistically significant variables. Discussion and Conclusion: NEC increases the mortality rates in preterm infants. The use of vasopressors, low birth weight, poor circulation, and antibiotics are significant risk factors for NEC, and low thrombocyte levels can lead to the prediction of NEC. [ABSTRACT FROM AUTHOR]

Introduction: The goal of this study is to compare computed tomography (CT) and ultrasonography (USG) in transthoracic biopsies as a guide method. Methods: A total of 152 patients, consisting of 121 men and 31 women, underwent a 20-Gauge (20-G) fine needle aspiration biopsy. CT in 83 patients and USG in 69 patients were chosen as the guide method. The mean age of the patients was 66±10 (CT guidance group was 67±9, USG guidance group was 64±11), and the median lesion size was 65 mm (interquartile range [IQR] 45-80 mm). All lesions were chosen pleural-based and larger than 2 cm. Thus, the risks of major complications, especially pneumothorax and hemorrhage, and the difficulties in reaching the lesion were minimized, and it was aimed to investigate the contribution of the chosen guide method to the diagnosis. The advantages and disadvantages of both techniques were investigated. Results: While CT-guided biopsies had a diagnostic accuracy rate of 87.9%, a sensitivity of 87.3%, and a specificity of 100%, USG-guided biopsies had a diagnostic accuracy rate of 82.6%, a sensitivity of 82.1%, and a specificity of 100%. Discussion and Conclusion: The necrosis content of the lesion is the primary factor reducing the success rate of both techniques. It causes more failures under ultrasonography guidance. [ABSTRACT FROM AUTHOR]

Introduction: Covid-19 presents with a wide variety of clinical manifestations, and these patients are also admitted to intensive care units (ICU). Long ICU stays, gastrointestinal involvement, and prolonged hospital stays can result in hypomotility and ischemia of the intestines, which may further result in increased mortality. In severe ARDS cases, the prone position is applied to the patients. In patients in the prone position, deep sedation with muscle relaxants and parenteral nutrition is generally preferred. We aimed to evaluate the Nutritional Risk Screening (NRS 2002) score at first hospitalization, the nutritional status of the patients, and their relationship with mortality in patients followed up for Covid-19. Methods: In this study, after the approval of the ethics committee (FSMEAH-KAEK2021/28), patients aged 18 years and over who had Covid-19 PCR test positivity and who were hospitalized in the ICU for more than 24 hours between 01.03.2020-28.02.2022 were included. Demographic data, APACHE II, SOFA, SAPS II, NRS 2002 scores, comorbidities, need for mechanical ventilation (MV), non-invasive MV or high-flow oxygen therapy, length of stay, enteral, parenteral, or oral nutrition and durations, need for prone positioning, time of first nutrition, inotrope requirement, discharge from the ICU, and mortality were recorded. SPSS v20.0 was used for statistical analysis. Results: Sixty-nine patients were studied in the study (35 male (50.7%), 34 female (49.3%)). The mean age of the patients was 72.2±12.3. The prone position was applied in 87% of patients on invasive mechanical ventilators, 30.4% of patients on non-invasive mechanical ventilators, and 7.2% of patients on high-flow oxygen therapy. Enteral nutrition rate was 89.9%, parenteral nutrition rate was 43.5%. Time to first nutrition was 1.4±0.6 days, and time to first enteral nutrition was 1.7±1.0 days. The number of patients who used vasopressor agents was 52 (75.4%), and the mortality rate was 69.6%. The mean NRS 2002 score was 4.2±0.9. SOFA score, IMV, NIMV, prone positioning, and vasopressor agent use were high in the mortality group. Discussion and Conclusion: The presence of extrapulmonary involvement, associated dysmotility, deep sedation, the use of muscle relaxants, and the resulting intolerance affect the complications of ICU admissions and ICU discharge in Covid-19 disease. Therefore, ICU management and the nutritional state of Covid-19 patients can influence ICU discharge and mortality. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Determining the risks in terms of preventing the formation of pressure sores and the progression of existing wounds is very important in reducing mortality. In our study, we aimed to determine the factors affecting the formation of pressure ulcers and the stage of the wound in patients hospitalized in a palliative care center. Methods: The material of our cross-sectional and retrospective study consisted of patients hospitalized in a palliative care center between January 2017 and February 2018. The age, gender, primary diagnosis, comorbidities, hemoglobin, hematocrit, lymphocyte, neutrophil, C-reactive protein, albumin, and prealbumin values, and NRS 2002 scores of the patients were recorded; and the relationship of these variables with pressure ulcer information was analyzed. Results: Of the patients participating in our study, 277 (55.1%) were female, and 226 (44.9%) were male. According to the results of our study, the risk of pressure ulcers increases in patients over 65 years of age and in female patients. Having a cerebrovascular accident or dementia/Alzheimer's disease increases the risk of advanced wounds. The presence of hypertension or cardiovascular disease increases the risk of pressure ulcers. Diabetes and chronic kidney disease have not been found to be associated with wounds. Low albumin, hemoglobin, and hematocrit, and high lymphocyte levels are associated with advanced wounds. There was no statistically significant relationship between prealbumin, CRP, neutrophil levels, and the neutrophil/lymphocyte ratio and pressure ulcers. Discussion and Conclusion: There is a strong relationship between the formation and progression of pressure ulcers and the diagnosis, nutritional status, presence of anemia, and hypertension. Taking precautions by being aware of the risks in elderly patients with chronic diseases and in need of care is of great importance in terms of preventing pressure ulcers, which increase morbidity and mortality. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to reflect the oncofertility practice in Turkey as a developing country, by investigating young breast cancer patients' fertilization preservation attitudes and their post-treatment fertility status. Methods: Young breast cancer patients(<42 years) examined for breast cancer follow-up at the medical oncology outpatient clinic were consecutively included in the study. Patients with metastatic, infertile, or no menstrual cycle at the time of diagnosis and women who were less than 3 years from their last chemotherapy cycle were excluded. A questionnaire on the desire for childbearing in the future, the fertility preservation preferences at the time of diagnosis, reproductive history was surveyed with patients. Results: 123 patients were enrolled in the study. 23.5% of the patients reported that they had a desire to give birth in the future at the time of diagnosis. For fertility preservation; 6 patients used embryo or oocyte cryopreservation, and 16 patients used LHRHa during chemotherapy. Nulliparous patients were more likely than others who had at least one child to pursue fertility preservation (p=0.001) and to be interested in having children in the future (p<0.001). Conclusion: This study revealed that oncofertility practices should be encouraged to improve the quality of life of survivors along with cancer treatment in developing countries. Even with fertility preservation, the chances of a successful pregnancy are significantly low. Physicians should offer protection options to all patients regardless of their previous childbearing status, and fertilization counseling should also be discussed during all the post-treatment visits as well as pre-treatment settings. [ABSTRACT FROM AUTHOR]

Copyright of Bosphorus Medical Journal / Boğaziçi Tıp Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Hypertension targets many organs. This study investigates left ventricular hypertrophy (LVH), which can lead to conduction disorders, arrhythmias, and heart failure. Endothelial dysfunction (ED) was assessed using serum asymmetric dimethyl-arginine (ADMA) levels. Methods: The study included a total of 90 voluntary participants: 30 patients with hypertension and left ventricular hypertrophy, 30 hypertensive patients without hypertrophy, and 30 normotensive healthy controls. Serum ADMA levels were used to detect endothelial dysfunction. Results: The results showed that serum ADMA levels were significantly higher in the patient group compared to the control group. However, there was no significant difference in serum ADMA levels between the two subgroups of patients, with or without left ventricular hypertrophy (LVH). A correlation analysis was performed, revealing no correlation between serum ADMA levels and the left ventricular mass index (LVMI). Discussion and Conclusion: There appears to be no direct relationship between LVH and endothelial dysfunction. Furthermore, inflammatory processes seem to contribute to the development of LVH rather than endothelial dysfunction. The duration of exposure to high blood pressure and the stage of hypertension are also believed to impact this process. [ABSTRACT FROM AUTHOR]

Introduction: Complete blood count parameters are associated with the inflammatory process in the diagnosis and prognosis of several types of cancer; thus, they have been studied as markers. In this study, the preoperative complete blood count parameters in patients with and without endometrioid type endometrial cancer were evaluated and the relationship of these biomarkers with prognostic factors in the cancer group was investigated. Methods: This study is retrospective in design. All the patients with endometrial cancer were of the endometrioid type. The cancer group involved 94 pathologically confirmed cases, and the control group comprised 96 women diagnosed with dysfunctional uterine bleeding with no signs of organic gynecological pathology. The clinicopathological features and preoperative complete blood count results of all the patients were evaluated. Results: In comparison with the controls (p<0.05), in the cancer group, hemoglobin, leucocyte, and platelet measurements were higher, whereas lymphocytes, monocytes, and mean platelet volume were lower. When subjects with endometrial cancer performed self-evaluation, the monocyte/lymphocyte ratio was higher in cases with lymph node metastasis in comparison with early-stage cases (p=0.006). Age was the only consistent factor in predictive of prognostic factors such as myometrial invasion depth, lymph node metastases, advanced stage, and grade. Discussion and Conclusion: Complete blood count parameters can be simple, readily available, and low-cost markers in endometrial cancer. Moreover, increasing monocyte/lymphocyte ratios may help predict an advanced disease. Nevertheless, to determine the actual predictive potential of these biomarkers, molecular studies that precisely examine the expression of secretory factors (cytokine/interleukin secretion of lymphocytes/macrophages, immunoglobulin secretion of plasma cells) are required. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the incidence and risk factors of pressure ulcers (PU) in the intensive care unit (ICU). Methods: Patients who developed PU in the ICU between January and June 2019 were retrospectively investigated. Patients who were treated in the ICU for longer than 72 h were included. Patient demographics, length of stay, cause of admission, risk scores at ICU admission, comorbidities, time to PU development, PU stage, Braden Scale at admission and discharge, invasive mechanical ventilation (IMV) duration, use of sedatives of vasopressors, laboratory results, and mode of discharge were recorded for patients with PU. Patient factors were compared between age groups. Results: Among the 411 patients admitted to the ICU, there were PU in 60 patients (14.5%). The median age was 72 years and the median length of ICU stay was 39.5 days for the patients with PU. 96.7% of patients with PU were under IMV, 83.3% were under sedatives, and 68.3% were administered vasopressors. The median time to PU development was 14 days. The most frequent PU stages were stage 1 and stage 2. PU were most frequently located in the sacrum and the heel. The rate of PU was higher in patients aged 65 or above. Discussion and Conclusion: Multiple factors contribute to PU development. A comprehensive PU management plan is necessary for the prevention of PU in the ICU. [ABSTRACT FROM AUTHOR]

Introduction: The most common musculoskeletal problems associated with pregnancy are low back pain (LBP) and pelvic girdle pain. The belief that LBP is a problem that occurs during the normal course of pregnancy and it will go away after delivery impairs women's quality of life. In this study, we aimed to determine the prevalence of LBP and the factors associated with LBP in pregnant women in Türkiye. It also aims to increase health-care professionals' awareness of this situation. Methods: This cross-sectional study involved 147 pregnant women who applied to the obstetric clinic of Haydarpasa Numune Training and Research Hospital between September 2020 and December 2020 during the COVID-19 pandemic. All questionnaires were filled in by a single midwife during face-to-face interviews. Functional disability was measured by the Turkish version of the Oswestry Disability Index. Results: The prevalence of pregnancy-related low back pain (PRLBP) was 86%. The prevalence of a history of LBP is 44%. Pregnant with a history of LBP had higher PRLBP during pregnancy (94.2%, p<0.001). Age, gestational week, and weight gain during pregnancy were the risk factors related to PRLBP (p<0.05). Women with PRLBP had significantly increased Oswestry score, maternal age, gestational age, and weight gain compared to pregnant without LBP (p<0.05). Discussion and Conclusion: A significant increase in the prevalence of PRLBP was observed in pregnant women during the COVID-19 pandemic period. Especially, young pregnant with excess weight gain during pregnancy and LBP history are candidates for PRLBP. [ABSTRACT FROM AUTHOR]

Objectives: Recent reports showed an association between tumor progression and systemic inflammatory response. It was suggested that increased neutrophil lymphocyte ratio were associated with reduced pathological complete response rates after neoadjuvant chemotherapy. We aimed to investigate the relationship between pretreatment NLR and pathological response rates in nonmetastatic breast cancer patients who received neoadjuvant chemotherapy. Methods: We retrospectively reviewed 67 patients who were diagnosed with breast cancer and received neoadjuvant chemotherapy at Kayseri City Hospital. NLR was calculated before neoadjuvant chemotherapy and we determined a cut off value. Low and high NLR were compared according to general characteristics. And the factors that predict complete response analysed using logistic regression analysis. Results: There were no statistically significant difference among NLR low and high groups according to general characteristics. Both the univariate and multivariate analyses revealed that histological subtype, grade, hormone receptor status, HER2 status were correlated with complete response. Conclusion: In this study there were no relationship between NLR and pathological complete response rate. As expected we showed that the histological subtype, grade, hormone receptor status, HER2 status were independent markers to predict complete response. [ABSTRACT FROM AUTHOR]

Objectives: Due to a lack of similar research, this retrospective analysis of patients indicated the blood parameters of pre-treatment inflammatory markers to assess the diagnostic accuracy of the protein nutritional index (PNI), platelet albumin ratio (PAR) and red cell distribution width (RDW) in patients with brain metastasis (BM) and glioblastome multiforme (GBM). Methods: Clinical and laboratory data were retrospectively collected from a group of 244 patients and randomly divided into GBM (142 patients) and BM (102 patients). PNI, PAR and RDW values were calculated 3 weeks before from a chosen pre-treatment modality (preoperative or pre-radiotherapy). Results: The neutrophil and trombocyte counts were higher, while the lymphocyte count was lower in patients with GBM and BM. A lower PNI value (p=0.019), higher PAR value (p=0.027) and higher RDW value (p=0.008) were independent diagnostic factors for brain metastasis. Although both PNI and PAR were diagnostically accurate, RDW had proven the highest accuracy of them all. Conclusion: Our study shows that the retrospective analysis provided a robust and independent diganostic value for pretreatment. The RDW ≥14.3%, PNI ≤ 49.1%, and Plt/alb ≥ 61.6 ratios also support this diagnostic index for differentiating between GBM and BM. [ABSTRACT FROM AUTHOR]

Introduction: Studies have found that sexual minorities, including gay and bisexual men, have more mental health problems than the heterosexual population. The aim of this study is to examine the prevalence of depression in gay and bisexual men and its relationship with some socio-demographic variables. Methods: Participants were recruited from groups on social media such as "Facebook," "Instagram," and an LGBT app. Only homosexual and bisexual men were included in the study. Each participant completed the personal information form and the Beck Depression Inventory. Results: It was found that 28.7% of the 418 homosexual and bisexual men included in the study had mild depression, 29.7% had moderate depression, and 9.1% had severe depression. No statistically significant difference was found between the depression rates of homosexual and bisexual men. Discussion and Conclusion: At the end of the study, it was determined that the rate of depression in homosexual and bisexual men was higher than in the general population. Smoking, alcohol, and substance abuse rates are also higher in this group than in the general population. The limitations of this study are that only gay and bisexual men were included in the study, and there was no control group. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the study was to investigate associations between hepatosteatosis (HS) with computed tomography severity score (CT-SS) and survival of coronavirus disease 2019 (COVID-19) patients attending the hospital. Methods: Our study was a retrospective analysis of 435 reverse transcription polymerase-chain reaction-positive COVID-19 patients (aged = 18 years) who attended our hospital between September and December 2021. The patient's chest CT parenchymal findings and CT-SSs were reported. For quantitative analysis, HS was defined if hepatic-to-splenic attenuation ratio (CTL/S)<1. In very fatty livers, we defined the hyperdense appearance of vascular structures compared to liver parenchyma as "pseudocontrast sign (PCS)." We divided patients into three groups based on the hepatic attenuation comparison of vascular attenuation. Group 1: no HS, Group 2: HS without PCS, and Group 3: HS with PCS. Results: 210/435 (48.3%) patients were included in Group 1, 184/435 (42.3%) in Group 2, and 41/435 (9.4%) in Group 3. The Mean CTL/S of Group 3 was 0.56±0.14, which was significantly lower than the other two groups (p<0.001). There was a very significant (p<0.001) negative correlation between CT-SS and CTL/S. There was no significant difference between HS groups with intensive care unit (ICU) admission (p=0.27) and mortality (p=0.64). In multivariate Cox regression analysis, HS with PCS was an 11-fold (p<0.001) risk factor for shortening the time from hospital admission to death and 3-fold (p=0.035) for shortening the time from ICU admission to death. Discussion and Conclusion: In our study, HS with the PCS was significantly associated with CT-SS but not with overall mortality. Consequently, this sign may be an independent indicator of shorter survival times among patients who died. However, multicenter studies are needed in a large patient population. [ABSTRACT FROM AUTHOR]

Introduction: One of the ways to reduce deaths due to Coronavirus-19 disease is to identify the factors that increase the mortality of the disease. Deficiency of vitamin D, which supports the immune system, and corticosteroids administered to suppress excessive inflammatory response may be risk factors that may affect mortality. Methods: In our study, we evaluated serum vitamin D and cortisol levels in Covid-19 patients during their admission to the intensive care unit, together with the demographic data and comorbidities of the patients, and examined their effect on mortality and their relationship with intensive care unit (ICU) scoring systems. Results: In the study, 101 Covid-19 patients were examined. Serum vitamin D and cortisol levels did not affect mortality statistically. Intensive care unit admission was more common in patients with low vitamin D levels. Cortisol levels were also higher in patients who died. Discussion and Conclusion: Vitamin D deficiency increased the risk of admission to the intensive care unit, and serum vitamin D and cortisol levels during admission to the intensive care unit had no effect on the prediction of mortality. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The aim of this study is to compare the results of plication and resection techniques in patients who underwent horizontal strabismus surgery. Methods: The records of patients who were operated due to horizontal strabismus in the Department of Ophthalmology of Health Sciences University Haydarpaşa Numune Training and Research Hospital between 2011 and 2017, were reviewed retrospectively. Those who underwent resection and those who underwent plication were divided into two groups. The amount of deviation at postoperative 1st day, 1st month and at the last control visit, were compared. Postoperative = 8 PD deviation was considered successful. Results: Twenty-two patients underwent horizontal rectus plication combined with antagonist muscle recession surgery. Eight of the patients were operated for esotropia and 14 for exotropia, and their mean age was 14.59±10.27 years. Twenty-four patients underwent horizontal rectus resection combined with antagonist muscle recession surgery. Nine of the patients were operated for esotropia and 15 for exotropia, and their mean age was 19.67±13.38 years. The mean amount of preoperative deviation was 30.79±7.29 PD in the plication group, and 39.89 ±10.72 PD in the resection group. Mean followup time was 12.82±7.47 months in the plication group and 9.75±8.63 months in the resection group. There was no statistically significant difference between the success rates of the two groups according to their final control follow-up (p>0.05). Discussion and Conclusion: Plication surgery, which is a fast, easy-to-apply and safe muscle strengthening technique, is as effective as resection surgery in the treatment of horizontal strabismus. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus disease 2019 (COVID-19) pandemic, which began in December 2019, is associated with high transmission and mortality rates. It is now known that COVID-19 increases the risk of venous thromboembolism due to microvascular inflammation. We aimed to explore the rate of pulmonary thromboembolism (PTE) in ongoing symptomatic COVID-19 patients and the association between D-dimer levels and PTE. Methods: A total of 2020 patients were retrospectively screened. Of these, 332 eligible patients over 18 years of age with a laboratory-confirmed diagnosis of COVID-19 and who underwent pulmonary computed tomography (CT) angiography due to suspected PTE 14-90 days after COVID-19 positivity were included. Over 500 µg/L was considered abnormally high for D-dimer. Results: The mean age was 57 years, and 55.4% (n=184) were females. Of the total patients, 58 patients had PTE. Males were found to have a significantly higher risk for PTE (M/F: 33/25). A significant relationship between advanced age and PTE risk was observed as well. PTE occurred mostly in the segmental arteries in 10.8%. The use of low-molecular- weight heparin was not associated with a significant preventive effect for PTE. In a multivariate logistic regression analysis of independent variables, including age, gender, D-dimer level, and timing of pulmonary CT angiography, D-dimer level was found to have the highest predictive value for PTE. The sensitivity and negative predictive value for a cutoff of 745 µg/L were 89.7% (78.8-96.1) and 93.4% (86.7-96.9), respectively. Discussion and Conclusion: PTE continues to pose a serious risk in these patients, and it remains unclear who was at risk for PTE. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the mortality rate and mortality-related factors for patients with oncological malignancies (cancer patients) hospitalized for Covid-19 infection. Methods: Demographic characteristics, hematological and biochemical parameters, lung CT Severity Scores (CT-SS), and Charlson Comorbidity Indices (CCI) of living and dead oncology patients were compared. Statistical analyses of possible factors that may impact mortality were performed. Results: The overall mortality rate of 2650 patients hospitalized for Covid-19 was 21%. Among these, 410 patients had active oncological malignancy. The mortality rate of the oncology patients was significantly higher than those without any malignancy (54% vs. 7.2%, p<0.0001). Logistic regression analyses revealed that CT-SS, neutrophil count, hemoglobin, and CCI had meaningful independent effects on mortality in patients with oncological malignancies. The mean CTSS was significantly higher in the ex-group than the alive group (17.6±5.5 vs. 15.3±4.8, p<0.0001). On the other hand, the mean neutrophil count (2100±830 vs. 4350±660 p <0.0001) and hemoglobin level (8.4±3.2 vs. 10.7±2.8, p<0.0001) were statistically lower. Conclusion: Covid-19 (+) oncology patients suffering from profound anemia, neutropenia, and substantial lung involvement have markedly high mortality and should be treated intensely and meticulously. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to determine the frequency of drug allergy and the risk factors associated with drug allergy with a standard questionnaire to be answered by the participants. Methods: In this study, we prepared and administered a questionnaire to inquire about drug allergy, recurrence of allergy, clinical findings, treatment for allergy, and accompanying comorbidities in outpatients admitted to the internal medicine clinic. Results: A total of 261 (138 men and 123 women) participants were included in this study. The prevalence of drug allergy was 36.8% in the study. It was observed that the most common cause of drug allergy was antibiotics (22.7%), acetylsalicylic acid (antipyretic drugs) (14.4%), and gastric protectors (10.3%). Among the allergic symptoms, urticaria (24.7%) stands first, angioedema (23.7%) second, and hematological problems third (15.5%). The fourth and the fifth are eye findings (13.4%) and skin findings (12.4%), respectively. The history of asthma and drug allergy in first-degree relatives was significantly higher in the group with drug allergy (p<0.001). Male gender, latex allergy, asthma, atopic dermatitis, allergic rhinitis, chronic sinusitis, diabetes, and recurrent urinary tract infection were risk factors associated with drug allergy. Discussion and Conclusion: In this study, the prevalence of drug allergy was found to be 36.8% in patients who applied to the Internal Medicine Clinic. It has been observed that male gender may be associated with drug allergy along with some chronic diseases. [ABSTRACT FROM AUTHOR]

Introduction: Total body irradiation (TBI) with megavolt photon energy is a treatment that can be applied before bone marrow transplantation (BMT) in many hematologic diseases. Two-dimensional TBI (2D-TBI) is one of the oldest RT techniques. We performed a retrospective study to evaluate the radiotherapy (RT)-related acute adverse events in pediatric patients with TBI. Methods: Patients who received TBI between January 1, 2021, and December 30, 2021, in the Radiation Oncology Clinic of Ankara City Hospital were evaluated retrospectively. The primary endpoint of the study was the assessment of RT-related acute adverse events (RT-AE). The Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 was used for RT-AE. Results: Twenty-one pediatric patients treated with 2D-TBI between February 20, 2021, and October 10, 2021, have been retrospectively analyzed. The median follow-up period is 7 (range 1-14) months. The median age of the patients is 11 (range 2-17) years. The median time to BMT following TBI is 4 (range 3-13) days. A total of 12 Gy was applied to 15 (71.4%) patients diagnosed with acute lymphoblastic leukemia and acute myeloid leukemia. A total of 3 Gy was applied to 5 (23.8%) patients due to aplastic anemia and thalassemia major. A total of 4 Gy was applied to 1 (4.8%) patient who had anaplastic large cell lymphoma. In the first week after TBI, all 21 (100%) patients were neutropenic in grade 3 or higher. One day after TBI, there was a 23.4% increase in grade 3 or higher leukopenia [p=0.042; OR (95% CI) 0.278 (0.132-0.585)]. Discussion and Conclusion: The 2D-TBI is applied with acceptable toxicity. TBI-related pneumonia was not observed in any of the patients in our treatment technique with a dose/rate of 0.053 Gy/min. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to compare the sociodemographic and abuse-related data of the children who have presented to the Antalya and Diyarbakir University hospitals due to sexual abuse. Method: The patient files of 172 children between the ages of 4-17 presented to the Akdeniz University, Department of Child and Adolescent Psychiatric Health and Diseases (CAPHD) Clinic within the year 2010, and of 167 children between the ages of 4-17 presented to the Dicle University CAPHD Clinic during the year 2012 were scanned and the sociodemographic and abuse-related data of the patients were recorded. Results: In the Diyarbakir group, the total years of education of the child, the total years of education of the mother, and the total years of education of the father were significantly lower, while the mean number of the siblings was significantly higher. The number of the male abuse survivors in the Diyarbakir group was significantly higher. The family structure where the parents are alive and living together was significantly more frequent in the Diyarbakir group. No difference in terms of the occurrence of penetration and relationship with the abuser was observed between the groups. Conclusion: Within the framework of this study, the characteristics of the survivors of abuse between two socioculturally, economically and ethnically different regions of Turkey (the Mediterranean region and the south-east Anatolian region) have been investigated. This study has demonstrated that some of the sociodemographic and abuse-related characteristics of sexual abuse in Turkey differs between these regions. We are of the opinion that efforts to prevent sexual abuse should be restructured in the light of these results. For instance, prevention of child labour, increasing the literacy rate of the individuals and promoting family planning efforts in south-east Anatolia should be the primary focus of these efforts. [ABSTRACT FROM AUTHOR]

Objective: In the family physician system, depression and anxiety disorders are frequently encountered and antidepressant medications are often prescribed in recent years. Therefore, we aimed to investigate the factors affecting the prescription of antidepressants by family physicians. Methods: In our study, 120 family physicians working at six districts in Istanbul were contacted and the data were collected by administering a 30-item questionnaire prepared by the investigators. Results: Eighty point eight percent of the participating family physicians reported that they had sufficient education and practice for diagnosing depression. Forty seven point five percent of them found their education inadequate for the treatment of patients. Only 1.5% of them were able to define all of the symptoms of depression. Eighty nine point two percent pointed out that they needed regular training about the use of antidepressants in treatment. We found that 81.7% of the physicians preferred prescribing the same antidepressant molecule as their primary option. Sixty six point seven percent stated that they believed the antidepressants could cause dependency and 72.2% believed that a large number of patients would recover without any medication. Conclusion: With the introduction of family physician practice across the country as of the end of 2010, we entered a new era in terms of the management of psychiatric disorders in primary care. We can suggest that new measures and arrangements are needed to improve the knowledge and attitudes of family physicians about the diagnosis and treatment of psychiatric disorders. [ABSTRACT FROM AUTHOR]

Objective: Violence against doctors and health professionals in the healthcare environment is thought to have increased in recent years. Although physical and verbal assaults in the health care system have been evaluated in many different aspects, a limited amount of research has been done in this field in our country. For this reason, we aimed to investigate assaults towards doctors working at the Çanakkale State Hospital and Çanakkale Onsekiz Mart University in Turkey. Method: A questionnaire was prepared by researchers assessing assaults within the last year on doctors working in the state and university hospitals. Data from 130 doctors who agreed to participation in the study were analysed with SPSS version 16. Descriptive statistics, independent sample T-test for normally distributed variables and Mann-Whitney U test for non-normally distributed variables were used to compare the groups. Results: We found that 59.2% (n=77) of the doctors were verbally and/or physically assaulted at least once during the past year. The majority of attackers consisted of relatives of patients (40.8% verbal attack, n=31). The verbal assaults mostly occurred in outpatient clinics (61.5%), with half of the physical assaults occurring in the emergency department. The vast majority of doctors considered that poor health policies were the most important reason for assaults (83.3%, n=65), and nearly all of them thought that violence towards doctors has increased in recent years (97.4%). Conclusion: The fact that most of the doctors exposed to assaults, regardless of gender, institution, or work position, perceived health policies as being responsible for this violent atmosphere, is very striking. We believe that larger sample-size and comprehensive countrywide studies in this area would help to provide solutions for this problem. [ABSTRACT FROM AUTHOR]

Association of delivery type with postpartum depression, perceived social support and maternal attachment Objective: There are contradictory findings in the literature about the effects of delivery type on postpartum depression and mother-infant interaction. The aim of this study was to investigate the relationship between delivery mode and postpartum depression, perceived social support, and maternal attachment. Method: Forty females, who had vaginal delivery (VD) and 40 females, who had cesarean delivery (CD) were recruited to participate in the study. Edinburgh Postpartum Depression Scale (EPDS) was used to screen depressive symptoms and Maternal Attachment Scale (MAS) was used to detect maternal attachment Social support was assessed by using Multidimensional Scale of Perceived Social Support (MSPSS). Results: We found no significant differences in postpartum depression and perceived social support scores between the two groups. On the other hand, MAS scores were significantly lower in CD women. Discussion: Our findings support that delivery mode had no impact on the development of postpartum depression. However CD may have negative effect on maternal attachment. [ABSTRACT FROM AUTHOR]

Objective: Inappropriate procedures or settings may cause secondary traumas in children and adolescents who are involved in justice systems. For improving the quality of assessments and preventing court-induced traumas, it is necessary to determine the existing problems. The aim of this study was to examine the problems with forensic assessments of children and adolescents, their causes, and possible solutions from the prosecutors' and judges' points of view. We also aimed to determine the collaboration problems from the legal authorities' perspective. Method: The present study was conducted in the City of Erzurum, which is one of the metropolitan cities of Turkey. Thirty-five prosecutors and 14 judges filled out a questionnaire assessing their problems in child assessments. Results: The results indicate that 87.8% of the prosecutors and judges had difficulties at child assessments but none of the participants had an education on child evaluation in law school while only 18.4% participated a post-graduate education program. 61.2% of the respondents indicated that there were problems in the application of the current law. Conclusion: Court induced trauma is a challenging issue for child and adolescent psychiatry. The skills of legal authorities on child evaluations and their cooperation with mental health professionals may directly influence the quality of legal processes. Vocational training programs, creation of direct channels to reach the mental health specialists, and reorganizing the faculty of law education programs may be useful in terms of prevention. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to determine the frequency of metabolic syndrome (MetS) in schizophrenia patients who are receiving treatment with antipsychotic drugs and also the sociodemographic and clinical characteristics of schizophrenia patients with MetS. Methods: 111 schizophrenia patients diagnosed on the basis of DSM-IV diagnostic criteria and receiving antipsychotic therapy for at least 3 months were included In the study. MetS was diagnosed on the basis of Intemational Diabetes Fedaration (IDF) diagnostic criteria. Schizophrenia patient groups with and without diagnosed MetS were compared In terms of sociodemographic and clinical characteristics. Results: MetS was determined In 27% of the patients. The most commonly determined parameter was elevated waist circumference (65.8%). The least common parameter was elevated blood pressure (10.8%). The waist circumference parameter In women and the blood pressure parameter In men were more frequently determined. No difference was determined between schizophrenia patients with or without MetS in terms of sociodemographic characteristics, schizophrenia subtypes and symptoms or other clinical characteristics. Conclusion: MetS is a significant problem In schizophrenia patients receiving antipsychotic therapy. Elevated waist circumference is an important parameter In monitoring. The findings in the literature regarding the relationship between MetS and sociodemographic and clinical characteristics are contradictory. No correlation was determined In our study. Further studies are now needed to shed light on this subject. There would seem to be no correlation between MetS and schizophrenia subtypes and symptoms. [ABSTRACT FROM AUTHOR]

Objective: In this study, sexual abuse was investigated in the case of the children who were criminals or victims. Sociodemographic characteristics (age, gender, educational level, family background, etc.), reasons of referral, diagnoses and report results were evaluated particularly. Methods: Personal files of all of the children-adolescents who were referred to Karadeniz Technical University Medical Faculty Child and Adolescent's Psychiatry Outpatient Clinic between January 1, 2008 and December 31, 2010 have been examined retrospectively. Data of the cases sent by legal authorities or detected as the victim or defendant of a sexual abuse event after psychiatric evaluation were analyzed by using SPSS 13.0 and required statistics were applied. Results: There were 118 cases in total; 88.1% (n=104) were victims and 11.8% (n=14) were defendants. Average age of victims was 10.8±3.3 and 82 of them (78.8%) were girl and 22 of them (21.2%) were boy. On the other hand, average age of the defendants was 14.3±1.0 and all defendants were boys (100%). It was found that the most frequent (48.8%) sexual abuse type in girls was stroking directly or over clothes (n=40) while in boys it was anal-genital contact (59.1%, n=13). Among victim children and adolescents, most of the cases were 12 years old or older. Also in this group, depressive disorder was the most common diagnosis (30.2%) and this was the only group with drug users. According to the forensic reports of the defendants, 85.8% of all perpetrators had mental competency. Conclusion: Children's sexual abuse is an important public health issue. When the long and short terms results are considered, it is a serious crime both legally and psychosocially. Our aim should be effective treatment after abuse and at the same time, preventing that kind of incidents. In this regard, it is proposed that some programs which inform children and their families about sexual abuse in more details must be developed with contributions of physicians, judicial departments, ministry of education and media. [ABSTRACT FROM AUTHOR]