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Early prediction and diagnosis of perforation in acute appendicitis allow surgeons to choose the most appropriate treatment. The purpose of this study is to evaluate whether pre-operative routine laboratory examinations have a role in predicting complicated acute appendicitis.In the study, 783 patients operated with the diagnosis of acute appendicitis between the years 2014 and 2019 were analyzed retrospectively. Among the patients with non-perforated and perforated acute appendicitis, pre-operative laboratory tests include leukocyte (WBC), neutrophil, lymphocyte, platelet (PLT), mean platelet volume (MPV), platelet distribution width (PDW), C-reactive protein (CRP), and neutrophil-to-lymphocyte rate (NLR) parameters were compared.Appendicitis was not detected histopathologically in 81 cases. In the study, 89.9% (n=631) of the 702 patients were non-perforated and 10.1% (n=71) were perforated acute appendicitis cases. Perforation rate was higher in elderly patients (p0.01). It was seen that lymphocyte count was significantly lower in the perforated group, and CRP and NLR were significantly higher (p=0.048, p=0.001, p=0.028, respectively). In the diagnosis of perforated acute appendicitis, cutoff values were 44.0 mg/dL for CRP, 7.65 for NLR and 1.7/mm3 for lymphocytes. There was no statistical difference between the groups in terms of WBC, neutrophil, PLT, MPV, and PDW values.Low lymphocyte count, high CRP, and high NLR were found to be reliable and strong predictive parameters in the diagnosis of complicated acute appendicitis.

Bu tezin esas amacı, Rusya-Suriye ilişkilerinin geçmişten günümüze evrimine ve yakın geleceğine realizmin (gerçekçilik) sunduğu kuramsal pencereden ışık tutmaktır. Bu çerçevede, bilhassa uluslararası ilişkiler camiası nazarında modası geçtiği kabul edilerek ekseriyetle bir kenara itilen gerçekçi yaklaşımın ilke ve öğretilerinden ana hatlarıyla faydalanılmaktadır. Bir yandan İkinci Dünya Savaşı'nın bitiminden günümüze değin Rusya-Suriye ilişkilerinin gelişimine yön veren hâkim eğilimler, pratik gereklilikler, müşterek çıkarlar ve paylaşılan tehdit algıları saptanırken; diğer yandan da ikili ilişkilerin tezahür ettiği bölgesel ve küresel konjonktürdeki dönemsel dalgalanmalara, incelenen her bir dönemin jeopolitik değişkenleri arasındaki karmaşık etkileşim de hesaba katılarak tatmin edici ve tutarlı bir açıklama getirilmeye çalışılmaktadır. Bunu yaparken Moskova'nın Genişletilmiş Orta Doğu coğrafyasına yönelik uzun dönemli stratejilerini tayin eden birtakım etmen ve kanaatlere özel önem atfedilmektedir. Zira Suriye içerisinde ve çevresinde cereyan eden amansız vekalet savaşının zaman içerisinde jeopolitik bir girdaba dönüşerek başta Esad rejiminin kendisi olmak üzere ortaya çıkan keşmekeşte dahli olan tüm aktörler açısından yarattığı had safhada yıkıcı akıbet; gelinen aşama itibarıyla süratli ve kalıcı bir çözüme duyulan ihtiyacı hiç olmadığı kadar şiddetli hale getirmiştir. Ne var ki pratikte uygulanabilir bir çarede karar kılınabilmesi için, öncelikle karşı karşıya bulunulan soruna soğukkanlı ve akılcı bir teşhis konulması icap etmektedir. The primary aim of this thesis is to shed light on the past, present, and near future of Russian-Syrian relations from a broadly realist perspective, the particular variants of which had been labeled as `old-fashioned` and therefore swept aside without a second thought until recently for their perceived inability to offer a reliable account of contemporary international relations. While trying to reveal the persistent trends, practical necessities, mutual interests, and shared threats underlying the historical evolution of this key bilateral relationship from 1945 till date; the following chapters further explore major fluctuations in the larger international context and the complex interplay between the geopolitical variables of each successive phase under scrutiny. Within this framework, particular attention is paid to the lasting – and apparently, still highly determinative – influence of certain considerations in shaping Russian strategies towards the Greater Middle East. The main reason for this is to bring a convincing answer to widespread questions as to the dynamics behind the transformation of the ongoing Syrian crisis into a geopolitical black hole with utterly destructive repercussions for all parties involved, particularly Syria itself and those countries that lie in its immediate neighborhood. Such an academic inquiry is deemed essential at this stage in time, for the Syrian imbroglio is yet to be resolved. Whereas one needs to diagnose the disease accurately, in as rational a manner as possible, before searching for practical ways to cure it. 275