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The surge in recommended vaccinations for child's has spurred the development of combination vaccines, notably hexavalent vaccines, which provide multiple immunizations in a single dose. These vaccines offer various advantages, such as streamlining vaccination schedules, minimizing injection-related pain and exposure to preservatives, expanding vaccine coverage, and reducing administration costs. However, the intricate and expensive development of these vaccines presents substantial challenges, requiring increased investment and healthcare provider education to optimize their utilization and sustain high vaccination rates. Turkey, known for its robust vaccine coverage, strategic geographic location, and the influx of refugees, is at a critical juncture for integrating hexavalent vaccines into national programs. This transition is especially relevant given the rising vaccine hesitancy and the potential resurgence of vaccine-preventable diseases. This review assesses the deployment of hexavalent vaccines, examining their benefits and challenges through clinical trials and global experiences, with a specific emphasis on Turkiye's public health context.

İntroduction: The pathophysiology of heart failure with preserved ejection fraction has not been clearly elucidated. Therefore, there is not enough information about the prediction of poor prognosis in these patients. Our aim is to investigate whether the pulmonary artery pulsatile index, derived from right heart catheterisation parameters, is associated with mortality in these patients., Materials and Methods: The study was designed retrospectively. Patients who underwent right heart catheterisation between 2016 and 2023 and were diagnosed with heart failure with preserved ejection fraction were included in the study. The patients were divided into 2 groups. Dead patients were included in the first group, and surviving patients were included in the second group. Basic characteristics, right heart catheterisation results, pre-catheter blood and echocardiography parameters, and pulmonary artery pulsatile index were compared between both groups., Results: Pulmonary artery pulsatile index, mean pulmonary artery pressure, and body mass index were found to be independent predictors of mortality in heart failure patients with preserved ejection fraction. A PAPi value of <2.84 was found to have 76.2% sensitivity and 77% specificity in predicting mortality in heart failure patients with preserved ejection fraction., Conclusion: This study shows how important the pulmonary artery pulsatile index is in predicting mortality in heart failure patients with preserved ejection fraction. Since low levels of pulmonary artery pulsatile index at the time of diagnosis may predict poor prognosis, importance should be given to follow-up and treatment in these patients. Routine use of this index may contribute to reducing mortality and morbidity in patients.

Introduction: In this study, we aimed to investigate the effect of HbA1C/C-peptide ratio on short-term mortality (this period is defined as 30 days after diagnosis) in the patients with myocardial infarction. Materials & Methods: Around 3245 patients who were admitted due to ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction underwent primary percutaneous coronary intervention between October 2020 and 2024 were included in this study. Results: In the receiver operating characteristic analysis, the predictive power of the HCR score for mortality in ST-elevation myocardial infarction patients was determined to be 83% sensitivity and 81% specificity. In non-ST-elevation myocardial infarction, this was determined to be 78% sensitivity and 75% specificity. Conclusion: The HbA1C/C-peptide ratio score can predict poor clinical outcomes early, reducing mortality and morbidity in patients with myocardial infarction.

Neurosteroids (NSs) are endogenous steroid hormones, which are synthesised and metabolised within the central nervous system (CNS). NSs aid myelination and glial differentiation and modulate cognitive functions. Herein, we aim to investigate the relationship between NS levels, 5-alpha-dihydroxyprogesterone (5-α-DHP) and allopregnanolone (ALPG), and their relationship with cognitive changes in relapsing remitting MS patients.A total of 43 cases with well controlled, relapsing remitting MS composed the study group. The control group included 21 age and gender matched healthy controls (HC). MS patients were assessed by calculating Expanded Disability Status Scale (EDSS) scores, and the Brief Repeatable Battery of Neuropsychological Tests (BRBNT) was performed in both MS group and HC. Levels of 5-α-DHP and ALPG levels were also evaluated for each participant.The median level of 5-α-DHP was 48 [IQR: 39.2-144.2] pg/mcgL in the MS group and 68.4 [IQR: 57.1-365.9] pg/mcgL in HC ( p  = 0.02). The median ALPG level was found to be 56.5 [IQR: 37.7-75.4] pg/mcgL in the MS group and 43.9 [IQR: 29.4-70.2] pg/mcgL in HC ( p  = 0.1). In both groups 5-α-DHP levels were positively correlated with Symbol Digit Modalities Test (SDMT) scores (HC: p = 0.01, r  = 0.3 and MS: p  = 0.03, r  = 0.3). In the MS group, higher EDSS scores were associated with lower scores on Spatial Recall Test (SPART)-Delayed ( p  = 0.009, r = -0.4) and SDMT ( p  = 0.01, r = -0.4). The disease duration was negatively correlated with the scores on SPART-Immediate, SPART-Delayed and SDMT ( p  = 0.02, r = -0.4; p  = 0.005, r = -0.4 and p  = 0.05, r = -0.3).5-α-DHP may be lower even in well-controlled cases. 5-α-DHP may contribute to better perceptual processing and attention in cases with MS.

Aim: Our aim was to investigate the differences between healthy people and COVID-19 patients in terms of some immunological biomolecules, especially including those related to the inflammation process. Materials & methods: A total of 180 participants (90 healthy controls and 90 COVID-19 patients) were included. The expression levels of eight different inflammation-related biomolecules were measured by the ELISA technique. Results: The mean levels of ACE2, ANG1-7, GAL3, GAL9, SCUBE1, SCUBE2 and SCUBE3 were elevated in COVID-19 patients when compared with healthy controls, while the mean level of GAL2 was lower in COVID-19 patients than controls. Conclusion: To understand the cytokine storm mechanism and related parameters, more detailed studies should be performed investigating more related biomolecules and related signaling pathways.

Although adriamycin (ADR) is used to treat many cancers, it can be toxic to healthy organs including the testis. We investigated the effects of ADR on pluripotency in rat testis. Testicular damage was induced by either cumulative or single dose single dose administration of ADR in Wistar albino rats. Rats were divided randomly into three groups: untreated control, cumulative dose ADR group (2 mg/kg ADR every three days for 30 days) and single dose ADR group (15 mg/kg, single dose ADR). Testicular damage was evaluated and seminiferous tubule diameters were measured using light microscopy. Expression levels of Oct4, Sox2, Klf4, c-Myc, Utf1 and Dazl were assessed by immunohistochemistry and real time PCR. Serum testosterone levels were measured using ELISA assay. Histopathologic scores were lower and mean seminiferous tubule diameters were less compared to the ADR groups. Oct4, Sox2, Klf4 and Utf1 expressions were decreased significantly in spermatogenic cells of both cumulative and single dose ADR groups compared to the control group. We found that c-Myc expression in spermatogenic and Leydig cells were increased significantly in both ADR groups compared to the control group. Dazl expression was decreased in the cumulative adriamycin group compared to the control group, but increased in the single dose ADR group compared to both the control and cumulative ADR groups. Serum testosterone levels were decreased in both ADR groups compared to the control group. Our findings suggest that ADR is detrimental to regulation and maintenance of pluripotency in rat testis.

Introduction: Safe thyroid surgery depends on a deep knowledge of human neck anatomy, including the recurrent laryngeal nerve (RLN). Anatomic variations such as extra-laryngeal terminal branching (ETB) are common., Patients and Methods: We studied the ETB pattern of 1001 RLNs at risk in 596 patients. We identified and exposed the location of division points on the cervical part of bifid RLN. The function of nerve branches was assessed through intraoperative nerve monitoring (IONM)., Results: Bifid RLNs was identified in 39.6% of patients. The nerve-based prevalence of ETB was 28.5%. The prevalence of ETB for the right and left RLN was 21.8% and 35.5%, respectively ( p  < 0.001). The location of the division point was found in the middle, distal, and proximal segments in 48.8%, 33.3%, and 18% of bifid RLNs, respectively. Electrophysiological monitoring revealed motor functions in all anterior and in 7% of posterior branches. The rate of injury was 0.4%, and 1.1% in single trunk and bifid nerves, respectively ( p  = 0.360), and 3.9% in nerves with proximal branching ( p  = 0.084)., Conclusions: The ETB prevalence is high and showing division points in different cervical segments of the RLN. All anterior branches and some posterior branches contain motor fibers. Knowledge and awareness of these anatomic and functional variations are mandatory for every thyroid surgeon to avoid misidentification and misinterpretation of human RLN anatomy.

Aim: To determine the unmet needs and challenges in management, diagnosis, treatment, follow-up and patient-physician communication in acute leukemia (AL). Materials & methods: The study was based on a modified Delphi approach. A questionnaire including the major potential obstacles was circulated twice among 13 hematologists. Results: The obstacles in AL management were limited access to the novel treatments and genetic tests, limited bed capacity, insufficient level of knowledge among allied health personnel, limited availability of psycho-oncological support and low levels of awareness in the population about the importance of stem cell donation. Conclusion: The challenges in the management of AL are critical to guide the efforts to improve the quality of healthcare delivery and the evidence-based decision making at treatment of AL patients.

Objectives: While there is a large body of research on falls and their consequences in older adults, little is known about how older adults remember them. We addressed this gap by inviting older adults to remember falls and control memories., Methods: We analyzed specificity of memories and invited participants to rate emotional valence, mental time travel, visual imagery, importance, and rehearsal, as experienced during retrieval., Results: Although analysis demonstrated no significant differences between memories of falls and control memories regarding specificity, participants rated memories of falls as more negative than control memories. Furthermore, they rated memories of falls as triggering higher mental time travel, higher visual imagery, higher importance, and higher rehearsal than control memories., Conclusions: The negative emotional valence of memories of falls, as well as their ability to trigger significant levels of mental time travel, visual imagery, importance, and rehearsal, demonstrate how these memories are different from other memories in older adults., Clinical Implications: The findings demonstrate how falls can modulate memory of personal events in older adults.

Objectives: Chronic graft versus host disease (chronic GVHD) still remains the leading cause of late morbidity and mortality for allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients. In this retrospective study, 53 consecutive allo-HSCT patients with chronic GVHD refractory to corticosteroids were treated with extracorporeal photopheresis (ECP)., Methods: This study was performed as a retrospective single-center study. Medical records of a total of 59 patients treated with ECP for chronic GVHD were reviewed., Results: Best organ responses to ECP were observed in skin, mouth mucosa, eyes and liver. Overall response rate (ORR) to ECP was 81.2% (CR 17% and PR 64.2%). Overall survival (OS) was 84.9% and 36.7%, at 1 and 3 years, respectively. Female sex appears to have an advantage on ORR. Patients achieving ORR were able to maintain their responses with a prolonged continuation of treatments for +6 and +12 months indicating the benefits of longer ECP treatment., Discussion: We found that patients with chronic GVHD who were treated with ECP for 12 months or longer had a higher response rate. Our findings in line with the data reported previously suggest that patients responding to ECP should continue longer therapy schedules to achieve a better and sustained response. In our cohort, long-term ECP therapy was safe and well-tolerated with no significant adverse effects. Best responses were observed in the patients with skin, eye, liver and oral involvement. The ECP procedure offers the advantage relative to the problems with typical immunosuppressive agents. The female sex appeared to have an advantage based on the cumulative probability of the OR after ECP for chronic GVHD.

Protective neutralizing antibody titers reduce in time after COVID-19 vaccinations, as in individuals who have had COVID-19. This study aimed to evaluate the safety and immunogenicity of CoronaVac and TURKOVAC vaccines used as a booster dose after CoronaVac primary vaccination. This double-blind, randomized, controlled, phase II, multicenter study included healthy male and female adults (18-60 years) who were vaccinated with two doses of CoronaVac vaccine and did not exceed the duration of at least 90 days and a maximum of 270 days from the second dose of vaccination. Among 236 eligible volunteers, 222 were recruited for randomization between July 12, 2021 and September 10, 2021; 108 and 114 were randomized to the TURKOVAC and CoronaVac arms, respectively. The primary endpoint was adverse events (AEs) (ClinicalTrials.gov; Identifier: NCT04979949). On day 28, at the neutralizing antibody threshold of 1/6, the positivity rate reached 100% from 46.2% to 98.2% from 52.6% in the TURKOVAC and CoronaVac arms, respectively, against the Wuhan variant and the positivity rate reached 80.6% from 8.7% in the TURKOVAC arm vs. 71.9% from 14.0% in the CoronaVac arm against the Delta variant. IgG spike antibody positivity rate increased from 57.3% to 98.1% and from 57.9% to 97.4% in the TURKOVAC and CoronaVac arms, respectively. The TURKOVAC and CoronaVac arms were comparable regarding the frequency of overall AEs. Both vaccines administered as booster yielded higher antibody titers with acceptable safety profiles.

Doxorubicin (DOX) is used as an anticancer drug despite its many side effects. Thymoquinone (THQ) is a plant-derived substance that exhibits antioxidant and anti-inflammatory properties. We investigated the protective effects of THQ on DOX induced nephrotoxicity in rats. Rats were divided into five groups of eight: group 1, untreated control; group 2, olive oil group given olive oil intraperitoneally (i.p.) for 14 days; group 3, THQ group given 10 mg/kg THQ i.p. for 14 days; group 4, DOX group given a single dose of 15 mg/kg DOX i.p. on day 7 of experiment; group 5, DOX + THQ given 10 mg/kg THQ i.p. for 14 days and 15 mg/kg DOX i.p. on day 7. Kidney tissues were evaluated for histopathology. Caspase-3, IL-17, GRP78 and TNF-α immunostaining was used to determine the expression levels of these proteins among the groups. The TUNEL method was used to determine the apoptotic index. Total antioxidant status (TAS), total oxidant status (TOS), and TNF-α and TGF-β1 levels in kidney tissue were measured using ELISA assay. Histopathologic damage, caspase-3, IL-17, GRP78 and TNF-α immunoreactivity, TUNEL positive cells, TOS, TNF-α and TGF-β1 levels were increased in group 4 compared to group 1. The TAS of group 4 decreased compared to group 1. We found decreased caspase-3, IL-17, GRP78 and TNF-α expressions and TUNEL positive cells in group 5 compared to group 4. In rats given DOX, THQ reduced kidney damage by suppressing endoplasmic reticulum stress, inflammation and apoptosis pathways.

The association of glutathione S-transferase (GST) enzymes with vitiligo is inconclusive. To evaluate tissue expressions of GST isoenzymes in vitiligo patients and to compare these expressions with healthy controls, we used 26 active depigmented patches on the trunk of vitiligo patients and 20 healthy sex and age matched controls. Punch biopsies were taken from the lesioned or normal skin. Tissue expression of GST isoenzymes were analyzed immunohistochemically. Tissue expression of GSTT1, GSTA1 and GSTP1 was significantly higher in the patient group than controls. Tissue expression of GSTM1 was not significantly different between the two groups. The increased tissue expression of GSTT1, GSTA1 and GSTP1 may represent a response to excess free radical formation in vitiligo and may support the role of oxidative stress in the pathogenesis of vitiligo.

Aim: This study aimed to identify patient characteristics, treatment patterns and outcomes and to evaluate the effects of presence of comorbidities at diagnosis in chronic phase (CP)-chronic myeloid leukemia (CML) patients in Turkey., Materials & Methods: Hospital records between 2005 and 2018 were retrospectively reviewed., Results: Of 861 CP-CML patients included, 31% had at least one comorbidity at diagnosis. Sex, cardiovascular disease status at diagnosis and molecular (at least major) and cytogenetic (partial and complete) responses were the independent predictors of survival., Conclusion: The response rates of CP-CML patients to the tyrosine kinase inhibitors were satisfactory. In addition to tolerability and side effect profiles of drugs, comorbidity status of patients should also be considered in treatment choice in CML patients., (© 2022 Guray Saydam.)

Background: Motor function of the external branch of superior laryngeal nerve (EBSLN) is vital for voice quality. We studied the rate of EBSLN identification and integrity in the era of intraoperative neuromonitoring (IONM)., Methods: Anatomic and functional identification of 515 EBSLNs-at-risk was performed under the guidance of IONM that motor integrity was electrophysiologically checked. The functional integrity was assessed with crico-thyroid muscle (CTM) twitches and/or recordable waveform amplitude. We tried to establish the systematic classification of EBSLN identification and integrity., Results: Visual, electrophysiological and total identification rates were 64.3%, 31.6% and 95.9%, respectively. We could identify 4.1% of EBSLNs neither anatomically nor electrophysiologically. We recorded CTM twitches alone or both CTM twitches and wave amplitude in 203(39.4%) and 291(56.5%) branches respectively. Identification features of EBSLNs were systematically classified under three main types: Visualized-monitored (1), non-visualized-monitored (2), unidentified (3), and electrophysiological integrity of EBSLNs under two subtypes: CTM twitches alone (a) and CTM twitches and wave amplitude (b)., Conclusion: Dedicated thyroid surgeon could visually identify EBSLNs. IONM contribution significantly increases the identification rate. Systematic classification of identification and electrophysiological integrity of EBSLNs may increase comprehensive knowledge about its motor function that is crucial for complication-free thyroidectomy.

Methotrexate (MTX) is an anti-neoplastic drug that also causes testicular damage. Vitamin B12 (Vit B12) is a water soluble vitamin that is required for normal metabolism. We investigated Vit B12 as a possible protective agent against testicular damage caused by MTX treatment. We divided rats into four groups: control group, Vit B12 group treated with Vit B12 daily for 15 days, MTX group treated with MTX on day 8, MTX + Vit B12 group treated with MTX on day 8 + Vit B12 for 15 days. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone were measured. We also measured proliferating cell nuclear antigen (PCNA), connexin43 (Cx43) and the growth arrest- and DNA damage-inducible gene, 153 ( GADD153 ), using immunohistochemical staining. Apoptosis was assessed using TUNEL staining. The MTX group exhibited degeneration of seminiferous tubules; decreased serum testosterone, LH and FSH levels; fewer PCNA positive cells; increased Cx43 expression; and increased GADD153 and TUNEL stained cells compared to the control group. These pathologic findings were substantially reversed In the MTX + Vit B12 group. MTX caused increased endoplasmic reticulum stress and apoptosis via GADD153 . Consequently, Vit B12 potentially is a protective agent against damage caused by MTX.

Purpose: Laparoscopic cholecystectomy causes moderate to severe pain despite its minimally invasive nature. This study was performed to compare the efficacy of the bilateral erector spinae plane block (ESPB) and the subcostal transversus abdominis plane block (STAPB) under ultrasound guidance., Methods: 64 patients were included in this prospective, randomized study. The patients were allocated into two groups as those receiving ESPB ( n  = 32) and those receiving STAPB ( n  = 32). Pain scores at rest and during movement, fentanyl requirement, postoperative walking time, and duration of hospital stay were compared. The complications which related to block were also recorded., Results: In the ESPB group, the Numeric Rating Scale (NRS) scores at rest were lower at hour 0 [at the time of post-anesthetic care unit (PACU) admission] and postoperative hours 2, 4, 6, and 12 ( p  < 0.05). In the same group, the NRS scores at movement were lower at hours 0, 2, 4, 6, 12, and 24 ( p  < 0.05). In the ESPB group, the time to first analgesic need was longer ( p  < 0.05), intraoperative and postoperative Fentanyl requirement ( p  < 0.0001 for both) and PACU rescue analgesic requirement were lower ( p  < 0.05), the lengths of PACU and hospital stay were shorter ( p  < 0.0001), and unassisted walking time was shorter ( p  < 0.0001). There were no complications related to the block in either group., Conclusion: Bilateral ultrasound-guided ESPB provides superior analgesia after laparoscopic cholecystectomy surgery compared to STAPB and further reduces unaided walking time and hospital stay.

Aims: We present the sequence and single-nucleotide polymorphism (SNP) analysis for 47 complete genomes for SARS-CoV-2 isolates on Turkish patients. Methods: The Illumina MiSeq platform was used for sequencing the libraries. The SNPs were detected by using Genome Analysis Toolkit - HaplotypeCaller v.3.8.0 and were inspected on GenomeBrowse v2.1.2. Results: All viral genome sequences of our isolates were located in lineage B under the different clusters, such as B.1 (n = 3), B.1.1 (n = 28) and B.1.9 (n = 16). According to the Global Initiative on Sharing All Influenza Data nomenclature, all of our complete genomes were placed in G, GR and GH clades. In our study, 549 total and 53 unique SNPs were detected. Conclusion: The results indicate that the SARS-CoV-2 sequences of our isolates have great similarity with all Turkish and European sequences.

Aim: COVID-19, caused by SARS-CoV-2, started in December 2019 and has spread across the world. Materials & methods: We analyzed real-time PCR results of 10,000 samples from 2 April to 30 May 2020 in three neighbor cities located in the East of Turkey. The final study population was 7853 cases, after excluding screening tests. Results:  Real-time PCR was performed to detect the SARS-CoV-2-specific RNA-dependent-RNA-polymerase gene fragment. The number of total positive samples out of 7853 were 487; however, the number of nonrepeating positive patient was 373 (4.8%). Cough and fever were the most common symptoms in positive cases. Conclusion: Epidemiologic studies should be performed about the prevalence of SARS-CoV-2 infection to better understand the effect of the virus across the world.

We investigated the efficacy of activated cannabinoid 2 receptors for alleviating ovarian ischemia-reperfusion injury in rats. Female Wistar albino rats were divided randomly into six groups: ischemia-reperfusion (IRG); ischemia-reperfusion + 0.2 mg/kg JWH-133 (JIRG1), ischemia-reperfusion + 1 mg/kg JWH-133 (JIRG2); ischemia-reperfusion + 5 mg/kg JWH-133 (JIRG3); solvent control, and sham control. Ovarian ischemia was established for 3 h followed by reperfusion for 3 h. Ovarian tissue was investigated using histology, immunohistochemistry and biochemistry. Administration of JWH-133 synthetic cannabinoid reduced nuclear factor kappa-B immunoreactivity as well as TUNEL positivity scores and malondialdehyde levels. These reductions were significant in all cases except for the malondialdehyde levels in the 1 mg/kg JWH-133 group. Activation of cannabinoid 2 receptors by JWH-133 reduced ovarian ischemia-reperfusion injury due to its antioxidant and anti-inflammatory effects.

Background: We investigated the postsurgical effects of splenectomy with additional curcumin therapy, as an antioxidant, anti-inflammatory substance among the lipid profile and histopathological changes., Materials and Methods: 32 rats were randomly divided into four groups: control group (L): laparotomy, sham group: splenectomy (S), splenectomy group treated with curcumin (SC) and splenectomy group treated with corn oil (SCO) for 28 days. The primary outcomes; total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), oxidized LDL (ox-LDL) very-low-density lipoprotein (VLDL) and lectin-type oxidized LDL receptor 1 (LOX-1), secondary outcomes: nuclear factor kappa B (NF-кB), malondialdehyde (MDA), glutathione peroxidase (GPx), superoxide dismutase (SOD) were measured. Histopathological changes were examined in vascular, intestinal and lung tissues. The analysis was performed by ANOVA., Results: TG, LDL, ox-LDL, and LOX-1 elevated in S group while reduced by curcumin compared with L group (p < 0.05). Serum and tissue levels of NF-кB and MDA were higher in S group and lower in SC group than L group (p < 0.05). Serum and intestinal levels of SOD and GPx increased in L group while reduced by curcumin (p < 0.05). Total histopathological scores of intestinal tissues were higher in S and SCO groups compared to L and SC groups (p < 0.05). No major changes in vascular and lung tissues were observed except the lymphoid follicles which was higher in S and SCO groups compared to L and SC groups (p < 0.05)., Conclusions: Curcumin partially improved the lipid profile dysfunction by modulating NF-кB, MDA, SOD, and GPx in splenectomized rats while less likely improving any vascular and alveolar regeneration.

Aim: The photoreceptors in retinitis pigmentosa (RP) remain in dormant status for a while with a decrease in the growth factors in their microenvironment before apoptosis. Growth factors reduce retinal degeneration and apoptosis in animal models. Materials & methods: The data of 188 eyes of 94 patients who were injected with autologous platelet-rich plasma (PRP) into the subtenon space three-times every 2 weeks were evaluated retrospectively. Results: Statistically significant improvements in visual acuity, visual field and fixation stability were detected after treatment. When the treatment response of the patients' better-seeing eye compared with the response of the other eye, there was no statistically significant difference. Conclusion: The PRP treatment has a favorable effect on visual functions in patients with RP. This approach is promising as it is safe and easy.

This study aimed to synthesize zinc nanoparticles with antimicrobial and antioxidant activities using alternan (ZnNPs-Alt) produced by Lactobacillus reuteri E81 as the stabilizing agent. For the characterization of the ZnNPs-Alt, UV-vis spectroscopy, SEM, TEM and EDX analysis, XRD, FTIR and DSC analysis were applied. The functional role of ZnNPs-Alt was tested by determination of their antioxidant activities by DPPH and CUPRAC methodologies and their antibacterial and antifungal activities. Results of this study demonstrated that alternan was utilized as a successful stabilizer to produce crystalline, thermally stabile ZnNPs-Alt with a particle size of ∼ 100 nm. Importantly, strong antioxidant and antimicrobial activities were observed for ZnNPs-Alt in a concentration dependent manner. These findings confirmed the role of alternan as a stabilizing agent for the production of ZnNPs-Alt with functional roles.

Objective: To compare the efficacy of statins and ɑ blockers drug therapies for benign prostatic hyperplasia (BPH) in patients with metabolic syndrome (MetS)., Materials and Method: A total of three hundred patients were randomly distributed into three groups of one hundred patients each. Group 1 received only ɑ-adrenoceptor antagonist (ɑ-blocker, AB) (Tamsulosin), group 2 received only statin (atorvastatin), and group 3 received AB plus statin (Tamsulosin + Atorvastatin). The efficacy measurement was assessed by analyzing the changes from baseline in the total International Prostate Symptom Score (IPSS), disease-specific QoL question score and maximum urinary flow rate at the end of 6 months in each group and between the three groups., Results: Pre-treatment and post-treatment value of triglycerides (TG), high-density lipoprotein (HDL), and prostate volüme (PV) were not significantly different in AB group, while TG and PV were significantly lower in patients taking statin and combined therapy. The significant decrease was demonstrated in maximum urinary flow rate ( Q max ) in three groups. However, the most significant decrease was observed in the combination therapy group. IPSS, postvoid residual urine volüme (PVR), and Quality of Life score (QoL) significantly changed in three groups., Conclusion: We recommend of the use of statins in those men with BPH accompanied by MetS in which AB is ineffective alone.

Introduction: Although there are studies about sepsis treatment in different age groups, data on immunoglobulin-M (IgM)-enriched intravenous immunoglobulin use in pediatric intensive care units (PICUs) are limited. The aim of this study was to evaluate the clinical features and prognoses of children receiving IgM-enriched intravenous immunoglobulin to treat sepsis, septic shock, and multi-organ failure., Method: We extracted data from the medical records of 254 children who received IgM-enriched intravenous immunoglobulin infusion (104 children for 3 days, 150 children for 5 days) in addition to standard treatment between 2010 and 2017., Results: When the 5-day vs. 3-day IgM-enriched immunoglobulin treatments were compared, the mortality rate was shown to be lower in patients who received the longer duration of treatment ( p < .001). Better outcomes were observed among children with septic shock ( p < .01 )., Conclusion: Our clinical work with 5-days IgM-enriched intravenous immunoglobulin may reveal a survival benefit of this treatment for children with septic shock.

Background: To evaluate whether subtenon injection of platelet-rich plasma (PRP) with retinal electromagnetic stimulation (rEMS) is effective in therapy-resistant chronic central serous chorioretinopathy (CSCR). Design: Prospective, sequential. Materials & methods: The study included 22 eyes with resistant chronic CSCR. Cases receiving micropulse laser or additional photodynamic therapy, subtenon PRP, and subtenon PRP + rEMS were classified as times 1, 2 and 3, respectively. Results: At time 3, the mean best-corrected visual acuity was 85.7 and 97.0 letters before and after the procedures, respectively (p = 0.01). Submacular thickness improved by 17, 27 and 51% at times 1, 2 and 3 respectively. Conclusion: For treating resistant CSCR, subtenon PRP + rEMS should be considered as an effective and safe option. Trial Registration: ClinicalTrials.gov ID: NCT04224831.

Purpose/Aim of the study : The main purpose of the colonoscopy is screening for colorectal cancers and diagnosis of colorectal disease The cost-effectiveness of colonoscopy directly depend on the adequate bowel preparation. Inadequate colonoscopy is recommended to be re-scheduled within 1 year. Re-scheduling is an economic and patient burden. Thus instead of re-scheduling, another strategy may be attempted. The purpose of this study was to examine the usefulness and effect of the same day repeat colonoscopy after administration of an additional laxative dose. Materials and Methods: Patients with inadequate colonoscopy were enrolled in the study. The patients eligible for the enrollment were instructed to consume an additional laxative and scheduled in afternoon. The demographic data of the patient, the details of the index and repeat procedures were obtained by a questionnaire. Results: A total of 60 patients were enrolled in the study. The rate of adequate colonoscopy was 80%. Cecum intubation rate was 83.3%. There were no complications due to colonoscopy itself and additional laxatives. The polyp detection rate was 26.6%. The withdrawal time was 6.7 ± 1.34 min. Conclusion: The results of the present study showed that same day repeat colonoscopy with additional laxative dose can be a safe and effective method for repeat procedure of an inadequate colonoscopy. The patients tolerated and were satisfied with the same day protocol. Quality indicators of colonoscopy such as adenoma detection rate and cecum intubation rate were achieved. Same day bowel cleansing method may be considered as an alternative way rather than re-scheduling inadequate colonoscopy for a later time.

We compared the expression profiles of antimicrobial peptides (AMPs) in psoriatic skin before and after narrow band ultraviolet B (nb-UVB) phototherapy and compared the levels to healthy controls. We studied 15 male and 12 female patients with psoriasis vulgaris, and 11 female and nine male control individuals. The patient group was treated with 24-36 sessions of nb-UVB phototherapy. Immunohistochemical staining for human beta defensin 1 (hBD-1) and human beta defensin 2 (hBD-2) expression of lesioned and control skin was performed prior to and following phototherapy. After phototherapy, the psoriatic area and severity index (PASI) decreased significantly in the treated patients compared to controls. The hBD-1 level was significantly higher in psoriasis patients than healthy controls. We found no statistically significant difference in hBD-1 and hBD 2 levels before and after phototherapy in the patient group. Although hBD-1 plays a role in psoriasis, levels of human beta defensin 1 and 2 are not affected significantly by phototherapy.

Aim: The objective of this study was to evaluate the possible protective effects of probiotic bacteria, especially Bifidobacterium and Lactobacillus strains, on 4,4'-dichlorodiphenyltrichloroethane (DDT)-induced toxicity. For this reason, we evaluated the relationship between probiotics and toxicity by checking immunological and immunohistochemical parameters. Materials & methods: Probiotic pretreatment was applied to 36 Wistar albino rats for 12 consecutive days. Serum aspartate aminotransferase and alanine aminotransferase levels were detected. CD3 and NF-κB staining methods were then performed by immunohistochemistry. Finally, pro- and anti-inflammatory cytokines were measured by ELISA. Results: DDT caused a serious increase/decrease in some cytokine parameters. The effective dose was 1 × 10 11  colony-forming unit probiotic treatment. CD3 and NF-κB positivity were intense in DDT group whereas the intensity was reduced in probiotic treatment groups. Discussion: The probiotic mixture has a potential to prevent inflammatory and oxidative stress related organ injuries. Further studies should be performed to explain the possible mechanisms.

Objectives: To investigate the prevalence and severity of varicocele in adult population over the age of 40. We also measured testicular size, consistency, and total testosterone levels with an aim to observe the effect of varicocele on testis as men age. Methods: Two hundred twenty-four patients with varicocele, 241 patients without varicocele who admitted to our clinic were enrolled in the study. We stratified participants by four age groups (40-49, 50-59, 60-69, >70 yr). Patients were grouped according to varicocele grade and laterality. The morning testosterone level was drawn. The subgroups were compared with each other. Results: Overall, varicocele prevalence was 48%. Of the patients, 104 had unilateral, 120 had bilateral varicocele. Of the patients with varicocele, 62 (13.30%) were found as grade 3, 99 (21.10%) were grade 2, and 63 (13.60%) were grade 1. The percentages of smaller testes in grade 1, grade 2, and grade 3 varicocele group were 20.60, 79.80, and 88.70 and a significant association was detected. Age stratification of the data revealed the smaller and soft testis prevalence as well as higher grade varicocele prevalance increased in older age groups. Conclusions: Varicocele presence is associated with lower testicular size, softer testicular consistency, and lower testosterone levels, especially in older patients with bilateral and high-grade varicocele.

Purpose: Non-opioid medications as a part of multimodal analgesia has been increasingly suggested in the management of acute post-surgical pain. The present study was planned to compare the efficacy of the combination of pregabalin plus ıv ibuprofen., Methods: 58 patients were included in this prospective, randomized, double-blinded study. The pregabalin group (Group P, n = 29) received 150 mg pregabalin, the pregabalin plus ibuprofen group (Gropu PI, n = 29) received 150 mg pregabalin and 400mg ıv ibuprofen before surgery. Postoperative fentanyl consumption, additional analgesia requirements and PACU stay were recorded. Postoperative analgesia was performed with patient-controlled IV fentanyl., Results: VAS scores in the group PI were statistically lower at PACU, 1and 2 hours at rest, at PACU, 1, 2, 4, 12 and 24 hours on movement compared to the group P (P < 0.05). Opioid consumption was statistically significantly higher in the group P compared to the group PI (130.17 ± 60.27 vs 78.45 ± 60.40 μq, respectively, P < 0.001) and reduced in the 4th 24 hours by 55% in group PI. Rescue analgesia usage was statistically significantly higher in the group P than in the group PI (16/29 vs 7/29, respectively, P < 0.001). Four patient in the group PI did not need any opioid drug. Besides, PACU stay was shorter in the group PI than the group P (10.62 ± 2.38 vs 15.59 ± 2.11 min, respectively, P < 0.001)., Conclusion: Preemptive pregabalin plus ıv ibuprofen in laparoscopic cholecystectomy reduced postoperative opioid consumption. This multimodal analgesic aproach generated lower pain scores in the postoperative period.

Purpose: Beside recurrent laryngeal nerve (RLN), protection of the external branch of the superior laryngeal nerve (EBSLN) is required for complication-free thyroid surgery. This study investigates the contribution of intraoperative neuromonitoring (IONM) to identification and motor integrity of the EBSLN., Methods: This prospective study was performed on 245 EBSLNs in 147 patients with thyroid surgery. The rate of visual identification, contribution of IONM to functional localization, the rate and levels of recordable waveform amplitude from vocal cord (VC) movement were determined during surgery., Results: 164 (66.9%) EBSLNs were visually identified and additional 74 branches were functionally identified by IONM. Additional identification rate of IONM was 30.2%. Seven (2.9%) EBSLNs could not be identified during surgery. Cricothyroid muscle (CTM) twitch established functional integrity in 97.1% of EBSLNs. Electrophysiological stimulation of 151 (63.4%) EBSLNs created waveform amplitude >100 µV that mean amplitude level was calculated as 186 µV, and an amplitude >300 µV was recorded in 19 of 151 (12.6%) EBSLNs., Conclusions: In addition to visual identification, surgeons can functionally localize the EBSLN with the assistance of IONM that CTM twitch is a reliable evience for functional integrity of the EBSLN. In the majority of patients, stimulation of the EBSLN creates recordable waveform amplitude thus the EBSLN appears to be a second source of motor innervations for intrinsic laryngeal muscles.

Objective: Visceral adiposity index (VAI) is a novel indicator for the assessment of visceral obesity. In this study, we aimed to evaluate the relationship between VAI and premature ejaculation (PE)., Materials and Method: A total of 300 men were included in the study. Hundred and fifty men with PE and 150 men without PE (control). All men were evaluated for PE by premature ejaculation diagnostic tool (PEDT). VAI levels were calculated using body mass index (BMI), high density lipoprotein and triglyceride (TG) levels., Results: Mean age of the study groups was 34.3 ± 5.2 (30-60) years and the mean age of the controls were 35.9 ± 5.3 (30-60) years. The men with PE had lower BMI, TG levels, waist circumference (WC) and higher high-density lipoprotein-cholesterol (HDL-C) levels. Mean VAI level was 4.13 ± 0.7 in study group and 5.72 ± 1.6 in control group, respectively. VAI levels were statistically higher in men without PE (p < .001)., Discussion: Our cross-sectional study demonstrated a negative correlation between VAI and PE. VAI is superior index for the evaluation and calculation the relationship between obesity and PE.

Objective: Visceral adipose index (VAI) is a novel parameter for the evaluation of visceral obesity. As we know that obesity is a risk factor for erectile dysfunction (ED). So, in this study, we compared the VAI levels between the men with ED and without ED., Materials and Method: A total of 177 men were included in the study. Ninety-five men with ED and 82 men without ED (control). All men were evaluated for ED by Index of Erectile Function-5 items (IIEF-5). VAI levels were calculated using body mass index, high density lipoprotein and tryglyceride levels., Results: Mean age was 53.5 (38-69) in men who have ED and 53.1 (34-69) in control. The men with ED had higher body mass index (BMI), triglyceride (TG) levels, higher waist circumference (WC) and lower high-density lipoprotein-cholesterol (HDL-C) levels. Mean VAI level was 5.18 ± 2.50 in study group and 3.47 ± 1.76 in control goup, respectively. VAI levels were statistically higher in men with ED (p < .001)., Discussion: The simplicity of WC and BMI measurement and TG and HDL assessment, make VAI an easily applicable index for the evaluation of visceral fat dysfunction. VAI can be useful index for the evaluation and calculation of erectile dysfunction risk.

Objective: To evaluate the association between visceral adiposity index (VAI) - a novel indicator for the assessment of visceral adipose tissue and prostate enlargement in non diabetic patients., Material and Methods: Four hundred patients who were admitted to the Urology clinic between January and December 2014 with complaints of BPH(benign prostatic hyperplasia )/LUTS(male lower urinary tract symptoms)were enrolled in this cross-sectional study. Patients were divided into two groups according to their prostate volume and international prostate symptom score (IPSS) value. They were compared in terms of age, body mass index (BMI), VAI, prostate volume, PSA, post micturional residual volume (PMRV), uroflowmetry Q max value, triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and fasting blood sugar (FBS)., Results: Although univariate analyses reveal that age, BMI, waist circumference (WC), FBS, TG, HDL-C level and TG/HDL ratio were correlated with prostate volume, only age [1.125 OR (1.088-1.164), p = .00001], BMI [1.119 OR (1.040-1.204), p = .003], TG [1.043 OR (1.016-1.071), p = .002], HDL-C [0.923 OR (0.860-0.990), p = .025] and VAI [1.194 OR (1.110-1.305), p = .011] were statistically significant in multivariate analysis. A positive correlation was found between VAI value and prostate volume in the Spearman correlation test (r = 0.29, p = .00001). The calculated area under the curve (AUC) for prostate volumes of 30, 40 and 50 ml were 0.680 (0.621-0.738), 0.625 (0.570-0.681) and 0.590 (0.528-0.652), respectively., Conclusion: Our study revealed a positive correlation between VAI and prostate volume. Our results are needed to be tested with well-designed randomized prospective cohort studies.

Mild traumatic brain injury (mTBI) in children is a common and serious public health problem. Traditional neuroimaging findings in children who sustain mTBI are often normal, putting them at risk for repeated mTBI (rmTBI). There is a need for more sensitive imaging techniques capable of detecting subtle neurophysiological alterations after injury. We examined neurochemical and white matter changes using diffusion tensor imaging of the whole brain and proton magnetic resonance spectroscopy of the hippocampi at 7 Tesla in 18-day-old male rats at 7 days after mTBI and rmTBI. Traumatic axonal injury was assessed by beta-amyloid precursor protein accumulation using immunohistochemistry. A significant decrease in fractional anisotropy and increase in axial and radial diffusivity were observed in several brain regions, especially in white matter regions, after a single mTBI versus sham and more prominently after rmTBI. In addition, we observed accumulation of beta-amyloid precursor protein in the external capsule after mTBI and rmTBI. mTBI and rmTBI reduced the N-acetylaspartate/creatine ratio (NAA/Cr) and increased the myoinositol/creatine ratio (Ins/Cr) versus sham. rmTBI exacerbated the reduction in NAA/Cr versus mTBI. The choline/creatine (Cho/Cr) and (lipid/Macro Molecule 1)/creatine (Lip/Cr) ratios were also decreased after rmTBI versus sham. Diffusion tensor imaging findings along with the decrease in Cho and Lip after rmTBI may reflect damage to axonal membrane. NAA and Ins are altered at 7 days after mTBI and rmTBI likely reflecting neuro-axonal damage and glial response, respectively. These findings may be relevant to understanding the extent of disability following mTBI and rmTBI in the immature brain and may identify possible therapeutic targets.

Objectives: To assess the association between triglyceride (TG)/high density lipoprotein (HDL) ratio and benign prostate hyperplasia/lower urinary tract symptoms (BPH/LUTS)., Methods: Four hundred patients who were admitted to the Urology Clinic between January and December 2014 with complaints of BPH/LUTS were enrolled in this cross-sectional study. Patients were divided into two groups according to their International Prostate Symptom Score and prostate volume (PV). They were compared in terms of age, body mass index (BMI), PV, PSA, post micturional residual volume, uroflowmetry Q max value, fasting blood sugar, TG and high density lipoprotein-cholesterol (HDL-C) level and TG/HDL ratio., Results: Although univariate analyses reveal that age, BMI, waist circumference (WC), FBS, TG, HDL-C level, and TG/HDL ratio were correlated with PV, only age [1.125 OR (1.088-1.164), p = .00001], BMI [1.119 OR (1.040-1.204), p = .003], TG [(1.043 OR (1.016-1.071), p = .002], HDL-C [(0.923 OR (0.860-0.990), p = .025], and TG/HDL ratio [(1.224 OR (1.130-1.315), p = .014] were statistically significant in multivariate analysis. The calculated area under the curve (AUC) for PV of 30 ml, 40 ml, and 50 ml was 0.668 (0.608-0.727), 0.617 (0.561-0.673), and 0.592 (0.530-0.654), respectively., Conclusions: Our results indicate that the TG/HDL ratio correlates with enhancement in PV. Further studies are warranted to better evaluate this relationship.

Tetrahydropyrimidine thiones, which are cyclic thiocarbamides derivatives, were synthesised from thiourea, β-diketones and substituted benzaldehydes. A tautomeric form of these derivatives incorporates the thiol functionality, which is known to interact with metal ions from metalloenzymes active sites, such as the carbonic anhydrases (CAs, EC 4.2.1.1) among others. This is a superfamily of widespread enzymes, which catalyses a crucial biochemical reaction, the reversible hydration of carbon dioxide to bicarbonate and protons (H(+)). The newly synthesised N-alkyl (aril)-tetrahydropyrimidine thiones were tested for inhibition of the cytosolic human isoforms I and II (hCA I and II). Both isoforms were effectively inhibited by the newly synthesised thiones. Ki values were in the range of 218.5 ± 23.9-261.0 ± 41.5 pM for hCA I, and of 181.8 ± 41.9-273.6 ± 41.4 pM for hCA II, respectively. This under-investigated class of derivatives may bring interesting insights in the field of non-sulphonamide CA inhibitors.

2-(Methacryloyloxy)ethyl 6-methyl-2-oxo-4-phenyl-1,2,3,4-tetrahydropyrimidine-5-carboxylate, is a cyclic urea derivative synthesized from urea, 2-(methacryloyloxy) ethyl acetoacetate and substituted benzaldehyde, and tested in terms of the inhibition of two physiologically relevant carbonic anhydrase (CA) isozymes I and II. Acetylcholinesterase (AChE) is found in high concentrations in the red blood cells and brain. Butyrylcholinesterase (BChE) is another enzyme abundantly present in the liver and released into blood in a soluble form. Also, they were tested for the inhibition of AChE and BChE enzymes and demonstrated effective inhibition profiles with Ki values in the range of 429.24-530.80 nM against hCA I, 391.86-530.80 nM against hCA II, 68.48-97.19 nM against AChE and 104.70-214.15 nM against BChE. On the other hand, acetazolamide clinically used as CA inhibitor, showed Ki value of 281.33 nM against hCA I, and 202.70 nM against hCA II. Also, Tacrine inhibited AChE and BChE showed Ki values of 396.03 and 209.21 nM, respectively.

Objectives: The purpose of this study was to investigate oxidative stress in children with attention deficit hyperactivity disorder (ADHD)., Methods: Total oxidant status (TOS), total antioxidant status (TAS), paraxonase-1 (PON-1) and arylesterase (ARE) activity were measured in 76 children (44 boys, 32 girls) diagnosed with ADHD according to the DSM-IV and 78 healthy children (46 boys, 32 girls)., Results: Age and sex were similar between the groups (P > 0.05). TOS and the oxidative stress index (OSI) were higher in the patient group than the control group (P < 0.001). PON-1 (P = 0.002), ARE (P = 0.010) activity and TAS (P < 0.001) were lower in the patient group than the control group., Discussion: We found decreased PON-1, ARE activity and TAS, and increased TOS and OSI in children with ADHD. Our study showed that there is significantly increased oxidative stress in children with ADHD.

Objective: The aim of this study was to investigate the effects of lycopene (Lyc) on methotrexate (Mtx)-induced intestinal damage in rats., Method: Twenty-eight male Sprague Dawley rats were divided into four equal groups: control, Mtx, Lyc, and Mtx-L., Control Group: Rats were given only the vehicle. Lyc group: Rats were given Lyc (10 mg/kg) with corn oil by oral gavage for 10 days. Mtx group: Rats were injected intraperitoneally with a single dose of 20 mg/kg of Mtx and given corn oil by oral gavage. Mtx-L group: Rats were treated with Lyc (10 mg/kg) for 10 days after a single dose of Mtx (20 mg/kg). All of the rats were euthanized using terminal anesthesia, and the intestinal tissues were removed for histological examination and for pro-inflammatory cytokine measurement (tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β)), total oxidative status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI)., Results: Mtx administration increased histopathological damage and increased TNF-α, IL-1β, TOS, TAC, and OSI levels in the small intestine tissues. Lyc therapy applied to the Mtx-L group provided significant improvement in all parameters of histopathological damage to the small intestine and significantly reduced the levels of IL-1β, TOS, and OSI in the intestinal tissues., Conclusions: The results of this study indicate that Lyc might be useful for protecting intestinal damage induced by Mtx in rats by reducing the increased oxidative stress and pro-inflammatory cytokine (IL-1β) levels.

β-Lactam antibiotics are a broad class of antibiotics, consisting of all antibiotic agents that contain a β-lactam ring in their molecular structures. Synthesis of β-lactam analogs, which are containing dichloride atoms and N-methyl, N-aromatic rings, was achieved by Schiff bases and dichloroketene compounds. All the synthesized imines and β-lactam analogs were tested against two physiologically relevant carbonic anhydrase isozymes (hCA I and II) and acetylcholinesterase (AChE). They demponstrated effective inhibitory profiles with K i values in ranging of 3.22-11.18 nM against hCA I, 3.74-10.41 nM against hCA II, and 0.50-1.57 nM against AChE. On the other hand, acetazolamide and dorzolamide clinically used as CA inhibitors, showed K i value of 170.34 and 129.26 nM against hCA I, and 115.43 and 135.67 nM against hCA II, respectively. Also, tacrine used as standard AChE inhibitor showed K i value of 5.70 nM against AChE.

A series of tetrahydropyrimidinethiones were synthesized from thiourea, β-diketones and aromatic aldehydes, such as p-tolualdehyde, p-anisaldehyde, o-tolualdehyde, salicylaldehyde and benzaldehyde. These cyclic thioureas showed good inhibitory action against acetylcholine esterase (AChE), butyrylcholine esterase (BChE), and human (h) carbonic anhydrase (CA) isoforms I and II. AChE and BChE inhibitions were in the range of 6.11-16.13 and 6.76-15.68 nM, respectively. hCA I and II were effectively inhibited by these compounds, with K i values in the range of 47.40-76.06 nM for hCA I, and of 30.63-76.06 nM for hCA II, respectively. The antioxidant activity of the cyclic thioureas was investigated by using different in vitro antioxidant assays, including 1,1-diphenyl-2-picrylhydrazyl (DPPH·) radical scavenging, Cu 2+  and Fe 3+  reducing, and Fe 2+  chelating activities.

Background: Our aim was to investigate the impact of allergic rhinoconjunctivitis on corneal and lenticular optical densitometry, pachymetry and anterior chamber depth in children., Methods: Fifty-four patients who had allergic rhinoconjunctivitis (study group) and 54 age-matched healthy children (control group) were recruited in this cross-sectional and comparative study. Corneal and lenticular optical densitometry, pachymetry, corneal volume and anterior chamber depth measurements were taken with the Scheimpflug imaging system., Results: The lens density and anterior chamber depth were similar between the groups (p > 0.05), while corneal density and thickness were significantly higher in the study group (p < 0.05). Although the corneal volume was higher in children with allergic rhinoconjunctivitis, the difference was not statistically significant (p = 0.07)., Conclusions: The cornea is affected in allergic rhinoconjunctivitis in respect to optical density and thickness, while the anterior chamber and lens are not influenced., (© 2016 Optometry Australia.)

Objectives: The Agean is one of the regions in Turkey where thalassemias and abnormal hemoglobins (Hbs) are prevalent. Combined heterozygosity of thalassemia mutations with a variety of structural Hb variants lead to an extremely wide spectrum of clinical and hematological phenotypes which is of importance for prenatal diagnosis., Methods: One hundred and seventeen patients and carriers diagnosed by hemoglobin electrophoresis (HPLC), at risk for abnormal hemoglobinopathies were screened for mutational analysis of the beta-globin gene. The full coding the 5' UTR, and the 3' UTR sequences of beta-globin gene (GenBank accession no. U01317) were amplified and sequenced., Results: In this study, a total of 118 (12.24%) structural Hb variant alleles were identified in 1341 mutated beta-chain alleles in Medical Genetics Department of Ege University between January 2006 and November 2013., Discussion: Here, we report the mutation spectrum of abnormal Hbs associated with the beta-globin gene in Aegean region of Turkey., Conclusion: In the present study, the Hb Hinsdale and Hb Andrew-Minneapolis variants are demonstrated for the first time in the Turkish population.