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Işın Güneş,1 Nuran Süngü,2 Aydan Kılıçarslan,2 Volkan Şıvgın,3 Metin Alkan,3 Ayşegül Küçük,4 Hakan Boyunağa,5 Yusuf Ünal,3 Mustafa Arslan3 1Department of Anaesthesiology and Reanimation, Erciyes University Medical Faculty, Kayseri, Turkey; 2Department of Pathology, Yıldırım Beyazıt University Medical Faculty, Ankara, Turkey; 3Department of Anaesthesiology and Reanimation, Gazi University Medical Faculty, Ankara, Turkey; 4Department of Physiology, Dumlupinar University Medical Faculty, Kütahya, Turkey; 5Department of Biochemistry, Kirikkale University Medical Faculty, Kirikkale, Turkey Objective: This study was conducted since the effects of colloid solutions on the renal system remain controversial and need to be adequately studied in animals. We aimed to evaluate the effects of hydroxyethyl starch (Voluven) on the kidney tissue of rats with late renal failure due to ureteral obstruction. Materials and methods: Rats were divided into four groups: Group C, control; Group HES, hydroxyethyl starch solution (HES) 130/0.4 (Voluven®); Group UUO, unilateral ureteral obstruction (UUO); and Group UUO-HES, UUO-HES 130/0.4 (Voluven®). In the groups with ureteral obstruction, the distal part of the right ureter was accessed and sutured through a lower abdominal incision under ketamine anesthesia. Any signs of late-stage renal failure were evaluated after three weeks. Rats in the HES group and the renal failure-HES group were administered with HES 130/0.4 as a single intravenous dose of 20 mL/kg. After a follow-up of 24 hours, intra-abdominal blood sample was collected, and the rats were sacrificed. Biochemical and histopathological parameters were then evaluated. Results: Ureteral obstruction significantly increased urea and creatinine levels. In addition, when the UUO-HES and HES groups were compared, the administration of HES increased urea and creatinine levels in the UUO-HES group. Nitric oxide enzyme activity and malondialdehyde levels have significantly increased in the UUO groups. In addition, HES significantly increased nitric oxide activity and malondialdehyde levels in the UUO-HES group, in comparison with the HES group. The activity of caspases 3 and 8 was significantly increased in the UUO groups. In addition, HES significantly increased the activity of caspases 3 and 8 in the UUO-HES group, in comparison with the HES group. Light microscopy revealed significant changes in the UUO groups, especially in the obstructed kidneys. Conclusion: If indicated, HES should be used with caution in cases of UUO, but not in the cases of bilateral ureteral obstruction. Other aspects of these findings, including the clinical significance and practical applications, merit further experimental and clinical investigation. Keywords: unilateral ureteral obstruction, hydroxyethyl starch solution 130/0.4, caspase 3, caspase 8, malondialdehyde, nitric oxide

Şaban Cem Sezen,1 Aysegul Kucuk,2 Abdullah Özer,3 Yiğit Kılıç,4 Barış Mardin,3 Metin Alkan,5 Fatmanur Duruk Erkent,5 Mustafa Arslan,5 Yusuf Ünal,5 Gürsel Levent Oktar,3 Murat Tosun6 1Department of Histology and Embryology, Kirikkale University Medical Faculty, Kirikkale, Turkey; 2Department of Physiology, Dumlupinar University Medical Faculty, Kutahya, Turkey; 3Department of Cardiovascular Surgery, Gazi University Medical Faculty, Ankara, Turkey; 4Pediatric Cardiovascular Surgery Clinic, Dr Siyami Ersek Cardiovascular and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey; 5Department of Anaesthesiology and Reanimation, Gazi University Medical Faculty, Ankara, Turkey; 6Department of Histology and Embryology, Afyon Kocatepe University Medical Faculty, Afyonkarahisar, Turkey Aim: The aim of this study was to investigate the effects of levosimendan and thymoquinone (TQ) on lung injury after myocardial ischemia/reperfusion (I/R). Materials and methods: Twenty-four Wistar albino rats were included in the study. The animals were randomly assigned to 1 of 4 experimental groups. In Group C (control group), left anterior descending artery was not occluded or reperfused. Myocardial I/R was induced by ligation of the left anterior descending artery for 30 min, followed by 2 h of reperfusion in the I/R, I/R-levosimendan (24 μg/kg) (IRL) group, and I/R-thymoquinone (0.2 mL/kg) (IRTQ) group. Tissue samples taken from the lungs of rats were histochemically stained with H&E and immunohistochemically stained with p53, Bcl 2, Bax, and caspase 3 primer antibodies. Results: Increased expression of p53 and Bax was observed (4+), especially in the I/R group. In IRTQ and IRL groups, expression was also observed at various locations (2+, 3+). H&E staining revealed that that the lungs were severely damaged and the walls of the alveoli were too thick, the number of areas examined was increased during the evaluation. Caspase 3 expression was observed to be at an (1+, 2+) intensity that was usually weak and diffuse in multiple areas. Bcl 2 was not found to be expressed in any of the tissues. H&E staining revealed that that the lungs were severely damaged in the I/R group, with the walls of the channels and alveoli thickened and edematous, and also an intense inflammatory cell migration was observed. Immunohistochemical staining was more prominent in inflammatory areas and structures around the terminal bronchioles. Conclusion: The findings in our study have shown that administration of levosimendan and TQ during I/R increases expression of caspase 3, p53, and Bax in lung tissue and has a protective effect on lung as distant organ. We suggest that findings of this study be elucidated with further large-scale clinical studies. Keywords: ischemia reperfusion, levosimendan, thymoquinone, lung, caspase 3, p53

The pole mass and width of the Delta resonance are calculated in the relativistic chiral effective field theory approach. We choose a systematic power-counting procedure by applying the complex-mass scheme (CMS).

Recto–vaginal fistula (RVF) associated with atresia ani (AA) are congenital anomalies in which fecal and urinary output occurs through the vulvar region. In this study, 17 ruminants (lamb n=9, calf n=8) constituting type II AA–associated RVF cases were included. The cases were evaluated clinically, radiographically and ultrasonographically. Clinical findings included tenesmus, feces in the perivulval area, abdominal distension, partial perineal swelling and hematochezia. The abdomen and pelvis were evaluated by direct radiography and gaseous distension, dilated colon, moderate or severe megacolon were diagnosed. Using radiographic assessment of the distance between the rectum blind pouch and perineum, AA was typed and all cases were diagnosed as Type II AA. Ultrasonography was used to classify RVF and recto–lower fistula was diagnosed in all cases evaluated. All operations were performed by anoplasty using the rectal–pull through technique. No complications were encountered during the postoperative follow–up period. The aim of this study was to provide information about the diagnosis, treatment and use of radiography and ultrasonography in Type II AA with RVF in lambs and calves.

Bilinenden yola çıkarak bilinmeyene ulaşma yöntemi olarak tanımlanan mantık ilminin Müslümanlar tarafından benimsenmesi ve İslâmî ilimlerde kullanılması tarihî bir dönüşüm sürecinden geçmiştir. Fıkıh usûlüne dair ilk çalışmaların lügat ve nahiv ilimleri perspektifinde şekillendiği ve lafız-mânâ ilişkileri ortaya konulurken ihtiyaç duyulan mantık ilkelerinin zaten kullanıldığı söylenebilir. Bununla beraber Gazzâlî dönemine gelinceye kadar İslâm âlimlerinin bir kısmı, felsefenin bir parçası olarak görülen ve gayrimüslimlerin kendi inançlarını yaymak için kullandıkları bir meşgale olarak algılanan mantık ilmine karşı menfî bir tavır ortaya koymuşlardır. Zaman içinde mantığın felsefeden ayrılması ve ahkâmı şerʻiyyeyi yayma, kıyas ile yeni meselelerde hüküm çıkarma ve aklî deliller çerçevesinde kâinata ibret nazarıyla bakma gibi gerekçelerle mantık ilmine karşı müspet bir bakış açısı ortaya çıkmıştır. Bu süreçte mantık ilminin Grek geleneğinden gelen biçimi İslâm düşüncesi ile yeniden şekillendirilmiş ve buna dair ilkeler geliştirilmiştir. Gelinen noktada şerʻî deliller ile fıkhî meseleleri çözümleme yöntemi olarak ifade edilen usûl-i fıkh açısından kesin, doğru ve tutarlı hükümler çıkarabilmek için mantık ilmi gerekli kabul edilmekte ve müçtehidin içtihada konu olan meselelerde bu ilmin metotlarına başvurması lüzumlu görülmektedir. Bu bağlamda çalışmada İslâm âlemine girdikten sonra müçtehitlerin farklı yaklaşımlarının söz konusu olduğu mantık ilminin İslâm fıkhındaki yeri, müçtehit ile ilişkisi ve müçtehit açısından gerekliliği ortaya konulmaya çalışılacaktır.

Bilinenden yola çıkarak bilinmeyene ulaşma yöntemi olarak tanımlanan mantık ilminin Müslümanlar tarafından benimsenmesi ve İslâmî ilimlerde kullanılması tarihî bir dönüşüm sürecinden geçmiştir. Fıkıh usûlüne dair ilk çalışmaların lügat ve nahiv ilimleri perspektifinde şekillendiği ve lafız-mânâ ilişkileri ortaya konulurken ihtiyaç duyulan mantık ilkelerinin zaten kullanıldığı söylenebilir. Bununla beraber Gazzâlî dönemine gelinceye kadar İslâm âlimlerinin bir kısmı, felsefenin bir parçası olarak görülen ve gayrimüslimlerin kendi inançlarını yaymak için kullandıkları bir meşgale olarak algılanan mantık ilmine karşı menfî bir tavır ortaya koymuşlardır. Zaman içinde mantığın felsefeden ayrılması ve ahkâmı şerʻiyyeyi yayma, kıyas ile yeni meselelerde hüküm çıkarma ve aklî deliller çerçevesinde kâinata ibret nazarıyla bakma gibi gerekçelerle mantık ilmine karşı müspet bir bakış açısı ortaya çıkmıştır. Bu süreçte mantık ilminin Grek geleneğinden gelen biçimi İslâm düşüncesi ile yeniden şekillendirilmiş ve buna dair ilkeler geliştirilmiştir. Gelinen noktada şerʻî deliller ile fıkhî meseleleri çözümleme yöntemi olarak ifade edilen usûl-i fıkh açısından kesin, doğru ve tutarlı hükümler çıkarabilmek için mantık ilmi gerekli kabul edilmekte ve müçtehidin içtihada konu olan meselelerde bu ilmin metotlarına başvurması lüzumlu görülmektedir. Bu bağlamda çalışmada İslâm âlemine girdikten sonra müçtehitlerin farklı yaklaşımlarının söz konusu olduğu mantık ilminin İslâm fıkhındaki yeri, müçtehit ile ilişkisi ve müçtehit açısından gerekliliği ortaya konulmaya çalışılacaktır.

Canine Coronavirus (CCV) is an important pathogen of dogs within the scope of canine enteritis complex, especially in puppies and young dogs, which may result in intestinal position changes such as invagination and/or intussusception. In this report, a 3-month-old male mixed breed dog with non-specific complaints such as loss of appetite, vomiting, hemorrhagic diarrhea, and suspected intestinal intussusception as a result of abdominal palpation was presented. Clinical examinations included physical, laboratory, radiographic, and ultrasonographic examinations. As a result of laboratory and ultrasonographic examinations, metabolic acidosis, hyperlactatemia, severe hypochloremia, anemia, and ileocecocolic intussusception were determined. Also, rapid diagnostic test results were negative for Canine Parvovirus (CPV) and Giardia but positive for CCV. In order to confirm the diagnosis of ileocecocolic intussusception, an exploratory laparotomy was performed. After the preparation and appropriate disinfection and sterilization procedures of the abdominal region, jejunocolic entero-anastomosis was performed as a surgical intervention. The dog was re-evaluated after 12 hours of hospitalization period after the operation. It was determined that vital and blood parameters were within reference ranges. As a result, it was concluded that clinicians should be vigilant of possible CCV infections where CPV has been ruled out and life-threatening conditions such as intestinal intussusceptions can occur as a result of CCV infection.

This study is focused on the evaluation of macro and trace elements concentration including sodium (Na), potassium (K), calcium (Ca), magnesium (Mg), iron (Fe), copper (Cu), zinc (Zn), selenium (Se), nickel (Ni), titanium (Ti), manganese (Mn), cobalt (Co), and chromium (Cr) of the serum, saliva, tears, and hair samples in Kilis goats. The study involved 33 goats without clinical signs of disease. Individual serum, saliva, tears, and hair samples from each goat were collected for element quantifications through the inductively coupled plasma mass spectrometry (ICP-MS) method after acid digestion in a microwave system. Element concentrations varied and depended on the sample type. The most predominant element in serum and saliva samples was Na (3559±55.2 and 3265±53.6 mg/L, respectively), followed by K>Ca>Mg. Potassium was the most abundant element analyzed in tears and hair samples (3506±305 and 4664±100.5 mg/L, respectively). The major trace element was Fe in all sample types except hair samples. Nickel was detected only in serum samples (83.9±6.35 μg/L) and Mn was detected only in hair samples (12903±3142 μg/L). In all samples, Co was below the detection limit. There was a significant correlation of some elements between serum and hair (Na, K, Mg, Cu), tears and hair (K, Mg, Fe), serum and tears (K) samples. Trace elements concentration did not pose a risk for deficiency or excess. It was concluded that tears and saliva are potential alternative materials for element analysis and simultaneous tears, saliva, and hair along with serum could be useful in predicting the inorganic metabolic status of goats.

The aim of this study was to investigate the effects of flumazenil antagonism after midazolam administration on sedative and cardiopulmonary variables in ewes. Six Awassi ewes were studied at least 14 days apart. The ewes were randomly divided into two groups as midazolam/saline (MDS) and midazolam/flumazenil (MDF). Hemodynamic values, blood gas, metabolic and electrolyte variables and reflex values were determined in both groups before midazolam (0.6 mg/kg, IV) administration (baseline) and after the 5th (T5) and 25th min (T25) of administration. At T25, saline was injected into the MDS and flumazenil (0.02 mg/kg, IV) into the MDF. The same measurements were repeated at the 5th min (T30), 35th min (T60), and 65th min (T90) of saline and flumazenil applications. Midazolam produced deep sedation and a significant increase in reflex scores in both groups at the indicated times (P

A dynamic voltage compensator (DVC) technique is presented for the minimizing of the capacitance value of the interleaved power factor corrected (PFC) boost converter for the battery charger in electric vehicles. This technique is based on eliminating the ripple on the capacitor by creating a voltage in the opposite direction as well as the amount of ripple on the capacitor. With the proposed method, the capacitance value is reduced by approximately five times. Reducing the size of the capacitor also provides the use of film-capacitors with a longer life. The other contribution of this study is designing a faster and more stable fully-digital control system, instead of the commonly used analogue controller of interleaved PFC boost converter. A 3.3 kW interleaved PFC boost converter is designed to verify the effect of the designed dynamic voltage compensator and digital controller.

Klasik Hanefî hukuk terminolojisinde önemli bir yeri olan teaddî kelimesi, günümüzde genellikle hukuka aykırılık olarak anlaşılmakta ve aktarılmaktadır. Hukuka aykırılığın, fâilin fiile dönük iradesinden bağımsız objektif bir unsur olması ve Mecelle’nin mübâşeret ve tesebbüb sorumluluğunu düzenleyen ilgili maddelerinde (müteaddî yerine) müteammid kelimesinin kullanılması, teaddîliğin hukuka aykırılığa indirgenip indirgenemeyeceği sorununu karşımıza çıkarmaktadır. Klasik Hanefî literatürün ilgili kısımları incelendiğinde, teaddî kelimesinin, hukuka aykırı ve aynı zamanda fâilinin iradesi sonucu (veya en azından özen yükümlülüğünün ihmali sonucu) açığa çıkmış davranışı temsil etmek üzere kullanıldığı görülmektedir. Bir diğer ifadeyle teaddî kelimesi, teammüd anlamını da kapsayacak bir içerikte kullanılmaktadır. Esasen Mecelle’de, müteaddî yerine müteammid kelimesinin kullanılmış olması da bu tespiti destekler niteliktedir.

Aim: The aim of this study was to determine the vulnerability levels of Turkey in terms of natural disasters and to guide decision makers and strategists in this field. In the study, disaster data obtained for 1987–2011 were used, and the disaster of type was most observed in our country.Materials and Methods: Data vulnerability indices against the disasters were calculated using a Data Envelopment Analysis Program (DEAP) 2.1 program with a Data envelopment analysis-based output-oriented Malmquist Total Factor Productivity Index method.Results: The regions of Turkey, which have the highest vulnerability index for the disasters, were TRA2 (0.323), TRB2 (0.305), and TRB1 (0.287) regions. In addition, it was seen that in the Black Sea region, the TR82 (0.267) region was more vulnerable than the other places of the region. In this study, a picture of the whole country over a period of 25 years in terms of disasters was captured.Conclusion:In the picture, it is seen that economic and social costs endured due to disasters are separated into two regions starting from the region of Eastern Anatolia and the north branch extends across the Black Sea region and the other south branch reaches to the Mediterranean.

In this study, the normal and abnormal proportions of the flexor tendons of forelimbs of healty and tendinitis throughbred horses were measured ultrasonographically. Dimensions, circumferences and cross-sectional areas of the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), check ligament (CL) and suspensory ligament (SL) were measured. The determination of the physiological boundaries of those tendons were aimed. The horse which are used in the study are 2-4 years old, in healty 19 and 6 horses with tendinitis throughbreds these measurements were applicated. Throughbred english horse area 2 for circumferences values of the MFDS were 0.869 + 0.453 cm2, MFDD values were 1,062 + 0.510 cm2, IC values were 1,324 + 0.647 cm2 and the horses with tendinitis values of the MFDS (0.625 + 0.181), MFDD (0.830 + 0.285) and LA (0.687 + 0.220) cm2 were estimated. There are no differences between two groups by statistically. Area 2 for lenght values of the MFDS were 1.615 + 0.649 cm, MFDD values were 1.698 + 0.600 cm, IC values were 2.078 + 0.665 cm, the horses with tendinitis values of the MFDS (1.213 + 0.335) cm, MFDD (1.303 + 0.160), ve LA (1.413 + 0.349) cm were evaluated. Especially, MFDD tendon and LA tendon show statistically differences between compared to normal one concern about lenght of tendon. As a conclusion, healty thoroughbred English horses and horses with tendinitis of flexor tendons of forelimbs were determined of morphometric measurements by ultrasonographically. The standard measurements were compared to tendinitis group and other breeds.

In Türkiye, anti-tobacco legislation (Law No. 4207 on the Prevention and Control of Harms of Tobacco Products) aims to ensure a "tobacco-free" life for current and future generations. However, there are observations of violations in the hospitality sector. In this study, we aimed to observe the hospitality venues' violation status regarding the Law in 11 different cities in Türkiye. In this descriptive study, 772 hospitality venues in Ankara, Burdur, Diyarbakır, Giresun, Hatay, Istanbul, İzmir, Kars, Kayseri, Samsun, and Zonguldak cities were observed between August 1 and October 10, 2023. Google Forms®, Microsoft Excel® and SPSS® 23.0 programs were used for data collection, entry, and analysis. A logistic regression model was performed to understand the associations between the noncompliance and the characteristics of the venues. During the observation of the indoor spaces, tobacco products were used in 282 venues (37.1%). Noncompliance in bars-pubs, traditional coffee houses, and hookah cafes was statistically significantly higher than in other venue types (OR = 3.031, 95% CI 1.699 to 5.408, P < .001). Having a retractable roof and/or side wall (OR = 5.362, 95% CI 3.518 to 8.173, P < .001), later hour observations (OR = 2.120, 95% CI 1.399 to 3.212, P < 0.001), existence of outdoor venues where smoking is permitted (OR = 3.165, 95% CI 2.170 to 4.617, P < .001) also increased indoor violations. The study findings provided scientific evidence that violations of the Turkish anti-tobacco legislation exist in hospitality venues. The public authority is recommended to play its vital role in the prevention of violations in indoor spaces.

Objective: HALP score is a scoring system consisting of hemoglobin, albumin, lymphocyte and platelet. It is different from other prognostic markers because it provides information about both inflammation and immunonutrition status. This study aims to evaluate the severity of the disease and the level of prognosis in patients diagnosed with acute diverticulitis., Material Methods: 190 patients diagnosed with acute diverticulitis between January 2017 and June 2023 were included in the study. The patients were divided into two separate groups according to the Hinchey classification. The prognostic effect of inflammatory markers and HALP score was examined., Result: The median values of C-reactive protein, white blood cell count, neutrophil count, HALP score, and hospitalization duration were significantly higher in patients diagnosed with complicated diverticulitis than in those diagnosed with uncomplicated diverticulitis. (p < 0.001, p = 0.045, p = 0.004, p < 0.001 and p < 0.001, respectively). The distinguishing feature of the HALP score in predicting the complexity of the diagnosis of diverticulitis was evaluated using ROC analysis. Area Under Curve (AUC) value was found to be 0.723 (p < 0.001). According to the ROC curve, the sensitivity and specificity for the cut-off value of HALP score ≤44.1 were 66.7 % and 75.0 %, respectively., Conclusion: HALP score is an inexpensive parameter that can be used safely to determine the severity and prognosis of acute diverticulitis., Competing Interests: Declaration of competing interest There is no conflict of interest between authors., (Copyright © 2024 Asian Surgical Association and Taiwan Society of Coloproctology. Published by Elsevier B.V. All rights reserved.)

Background and Objectives : Cisplatin is a chemotherapeutic drug that is frequently used with hyperthermic intraperitoneal chemotherapy (HIPEC). Cisplatin-induced gonadotoxicity leads to a depletion of the ovarian reserve, causing premature ovarian insufficiency. This study aimed to investigate the impact of hyperthermia on cisplatin-induced ovarian toxicity and to determine whether sevoflurane or desflurane could be a more appropriate choice of anesthetic for reducing ovarian toxicity in HIPEC procedures. Materials and Methods : A total of 24 New Zealand rabbits were randomly divided into 4 groups as follows: Group H: HIPEC (cisplatin 7 mg/kg), Group HS: HIPEC (cisplatin 7 mg/kg) + 3% sevoflurane (2 h), Group HD: HIPEC (cisplatin 7 mg/kg) + 6% desflurane (2 h), and Group C: Control (Saline). Two catheters were placed in the abdominal cavity, the upper and lower quadrants. The perfusate was heated to 42 °C and given intraperitoneally for 90 min at a rate of 4 mL/min by catheters. Ovarian tissues were collected for Hematoxylin and Eosin staining and immunohistochemical analysis. Results : The primary follicle number was significantly decreased in Group H and HD compared to the C group ( p < 0.05). Bax expression was high in Group H, according to all groups ( p < 0.0001). Bax expression significantly decreased after sevoflurane, compared to group H ( p = 0.012). The bcl-2 expression decreased in all groups compared to the C group. Bcl-2 expression was increased with sevoflurane compared to the H group ( p = 0.001). Caspase 3 and p53 expression increased in all groups compared to the C group. p53 expression was decreased with sevoflurane and desflurane compared to the H group ( p = 0.002, p = 0.008, respectively). Conclusions : The application of cisplatin with the intraoperative HIPEC method caused ovarian damage. According to our results, sevoflurane anesthesia could be a better option in mitigating cell death I the n ovarian reserve (follicle count) and apoptosis in the HIPEC procedures. We think that our findings should be supported by large series of clinical and experimental studies.

Background: Acute colonic diverticulitis has recently become a significant cause of hospital admissions. Complicated colonic diverticulitis, a severe form of the disease, necessitates medical and surgical intervention. Prompt diagnosis in these patients is crucial. This study aims to assess the role of infectious parameters in the early diagnosis of complicated colonic diverticulitis., Methods: This retrospective study analyzed 82 adult patients diagnosed with acute diverticulitis. Recorded data included patient demographics, hospital stay duration, disease location, and surgical procedures. Infectious parameters such as white blood cell count (WBC), C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), percentage of immature granulocytes (IG%), and systemic immune-inflammatory index (SII) were calculated and noted. Patients underwent abdominal computed tomography upon admission, and based on these results, they were categorized into uncomplicated or complicated diverticulitis groups. Statistical analysis was performed to identify differences between these groups., Results: CRP, NLR, and SII were significantly more predictive of complicated acute colonic diverticulitis. However, no statistical differences in WBC and IG% values were observed between the groups., Conclusion: The study found that the percentage of immature granulocytes, previously deemed a reliable marker in many studies, did not significantly predict complicated colonic diverticulitis. Further comprehensive studies are necessary to explore inflammatory markers in colonic diverticulitis more thoroughly.

Background: Secondary infections are the leading cause of death in burn patients. The purpose of this study is to evaluate the effects of open and closed burn dressings on the development of secondary infections., Methods: Tissue cultures were obtained from the burn sites of 56 patients between the ages of 18 and 65 who were admitted to our burn unit between December 2022 and January 2023, on days 3 and 7. The impact of the demographic features of the patients, the characteristics of the burn wound, the dressing type, and the first intervention strategies given to the burn wound on the development of wound infection were evaluated., Results: There was no statistically significant difference between the open- and closed-dressing groups in terms of cultural positiv-ity (P>0.05). A statistically significant difference (P=0.019) was found between the groups in terms of culture positivity among those whose wounds were cleansed with warm water as the initial intervention after a burn and those whose wounds were not., Conclusion: Even though the main impacts of the patient's variables on the development of a wound infection are recognized, it has been found that the appropriate and successful first intervention in a burn wound is also quite important.

Background: Acute cholecystitis (AC) is an acute inflammatory disease of gallbladder and it is one of the most common causes of acute abdominal pain. Determining the severity of AC at hospital admission is extremely important to choose the most effective treatment method and predict vital prognosis. The aim of this study was to investigate the effectiveness of immature granulocyte percentage (IG%) in grading AC severity., Methods: This retrospective study was carried out on 528 patients hospitalized due to AC diagnosis. Demographic data, white blood cell (WBC) count, neutrophil lymphocyte ratio (NLR), IG%, C-reactive protein (CRP) levels, and imaging results of patients were recorded. Furthermore, patients' length of hospital stay was determined. Tokyo Guidelines were used to grade AC severity. According to this grading, patients were classified into three groups as grade 1 (mild), grade 2 (moderate), and grade 3 (severe) AC. Differences among groups were analyzed statistically., Results: There were 386 patients (73.1%) in the mild AC group, 102 patients (19.3%) in the moderate AC group, and 40 patients (7.6%) in the severe AC group. WBC, NLR, CRP and IG% were significant parameters in discriminating mild AC from moderate and severe AC. However, only IG% was a significant parameter in discriminating moderate AC from severe AC. Moreover, the power of IG% to discriminate between patients with mild and moderate AC and those with severe AC was dramatically higher than the other parameters., Conclusion: Increased IG% is seen as an effective and reliable predictor in the early determination of AC severity.

This study was conducted to examine the effects of the coronavirus disease 2019 (COVID-19) pandemic on the epidemiological characteristics and causes of burns in patients admitted to burns services. A total of 629 patients who applied to the burn center of our hospital on March 11 to June 11, 2019, and March 11 to June 11, 2020, were included in this single-center, retrospective study. The demographic information of the patients, causes of burns, burn degrees, affected anatomical areas, admission times and burn surface areas were recorded retrospectively according to patient records. The findings of our study suggest that gender, age, causes of burns, affected anatomical areas and application times did not differ before and after the COVID-19 pandemic. The number of cases has significantly decreased during the COVID-19 pandemic compared with that of the previous year. As a result, burn trauma is an emergency; it is preventable and cannot be ignored. The COVID-19 pandemic has had many effects on social, cultural and economic fields, as well as on the field of health., (© 2022 The Authors. International Wound Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd.)

Objective: The aim of this study was to investigate the effectiveness of immature granulocyte count, immature granulocyte percentage, and total bilirubin value in predicting complicated and perforated appendicitis in patients aged 65 years and older with a diagnosis of appendicitis., Methods: In this study, 84 patients, aged 65 years and older, who had appendectomy demographic information, preoperative white blood cell count, neutrophil/lymphocyte ratio, immature granulocyte count and immature granulocyte percentage, operation findings, and pathology results were collected retrospectively. They were grouped into 4 categories: complicated, non-complicated, perforated, and non-perforated, according to the data and surgical findings., Results: Total bilirubin and immature granulocyte count were found to be statistically significant in predicting complicated and perforated appendicitis in patients aged 65 years and older with a diagnosis of appendicitis. The total bilirubin was found to have the following values in differentiating complicated appendicitis: area under the curve=0.883, sensitivity=78.3%, and specificity=88.5%. Total bilirubin had the highest discrimination power with area under the curve=0.804 in differentiating perforation., Conclusion: The immature granulocyte percentage and total bilirubin count are the fast, inexpensive, and reliable parameters that can be used to predict complicated and perforated appendicitis in patients aged 65 years and older.

Background/aims: To evaluate the potential protective effects of Ankaferd blood stopper (ABS) in an experimental obstructive jaundice (OJ) model., Materials and Methods: The study included 26 female rats, which were divided into 3 groups. The sham group, consisting of 10 rats, (group 1) only received solely laparotomy. In the control group, consisting of 8 rats, (group 2), ligation was applied to the biliary tract and no treatment was implemented. In the treatment group, consisting of 8 rats, (group 3), following ligation of biliary tract, 0.5 mL/day ABS was given for 10 days. Liver tissue and blood samples were taken for histopathological and biochemical examination., Results: Compared to group 2, group 3 had higher aspartate aminotransferase (AST), total oxidant status (TOS) malondialdehyde (MDA), fluorescent oxidant products (FOP), and lower expression of albumin and total antioxidant status (TAS) (P < 0.05). In histopathological analysis, the mean scores of all histopathological parameters (fibrosis, portal inflammation, confluent necrosis, interphase activity, bile duct proliferation) have statistical significance between group 2 and group 3 (P < 005)., Conclusions: ABS has promising results in the treatment of experimental OJ because of its antioxidant and antiinflammatory properties. It may be used in clinical practice after more extensive studies about the effects of ABS on OJ., Competing Interests: The authors have no conflict of interests to declare., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Background: This study aims to evaluate the effect of amantadine on lung tissue of after lower limb ischemia/reperfusion injury in rats., Methods: A total of 24 Wistar rats were divided into four equal groups including six rats in each: sham group (Group S), amantadine group (Group A), ischemia/reperfusion group (Group I/R), and ischemia/reperfusion + amantadine group (Group I/R-A). All groups underwent a midline abdominal incision. In Groups I/R and I/R-A, the infrarenal abdominal aorta was clamped for 120 min and, then, reperfused for 120 min after removal of the clamp. Amantadine hydrochloride 45 mg/kg was administered intraperitoneally to the rats of Groups A and Group I/R-A 15 min before surgery. At the end of reperfusion period (240 min), all rats were sacrificed, and their lung tissues were obtained. Lung tissue catalase and superoxide dismutase activities and glutathione S-transferase and malondialdehyde levels were analyzed. Lung tissues were examined histopathologically., Results: Catalase activity was lower in Groups A, I/R, and I/R-A compared to Group S. Superoxide dismutase activity was higher in Group I/R than Group S. Superoxide dismutase activity in Groups I/R-A and A decreased, compared to Groups S and I/R. Glutathione S-transferase levels decreased in Groups I/R and A, compared to Group S. Glutathione S-transferase levels in Group I/R-A were higher than Groups I/R and A. The highest level of malondialdehyde was found in Group I/R and the lowest level was found in Group I/R-A. According to histopathological examination, infiltration scores were significantly lower in Group S than Groups I/R and I/R-A (p=0.009 and p=0.011, respectively). The alveolar wall thickening scores in Group I/R were also significantly higher than Groups S and Group A (p=0.001 and p=0.001, respectively)., Conclusion: Lung tissue can be affected histopathologically by ischemia/ reperfusion injury and this injury can be reversed by amantadine administration., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2021, Turkish Society of Cardiovascular Surgery.)

Background/aim: To investigate possible protective effects of Ankaferd Blood Stopper® (ABS) in an experimental liver ischemia reperfusion injury (IRI) model., Materials and Methods: The study was carried out on 30 female rats separated into 3 groups as sham, control (IRI), and treatment (IRI + ABS) groups. In the IRI + ABS group, 0.5 mL/day ABS was given for 7 days before surgery. In the IRI and IRI + ABS groups, the hepatic pedicle was clamped for 30 min to apply ischemia. Then, after opening the clamp, 90-min reperfusion of the liver was provided. Blood and liver tissue samples were taken for biochemical and histopathological analyses., Results: Compared to the sham group, the IRI group had significantly higher levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total oxidant status (TOS), malondialdehyde (MDA), fluorescent oxidant products (FOP) and lower expression of albumin and total antioxidant status (TAS) (P < 0.05). Compared to the IRI group, the IRI+ABS group showed lower expression of AST, ALT, TOS, MDA and FOP and higher expression of albumin and TAS (P < 0.05). In the histopathological analysis, congestion scores were statistically significantly lower in the IRI + ABS group than in the IRI group., Conclusions: ABS has a strong hepatoprotective effect due to its antioxidant and antiinflammatory effects and could therefore be used as a potential therapeutic agent for IRI., Competing Interests: All authors confirmed that they have no conflicts of interest., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Multiple sclerosis is a chronic disease that usually occurs with exacerbations and remissions in young adults, affects the central nervous system white matter in multiple localization, and is thought to be the result of complex interactions of genetic and environmental factors, the most common form is relapsing-remitting MS. Forkhead transcription factors O class (FOXO) are responsible for the regulation of various cellular processes including cell cycle, apoptosis, DNA repair, cellular resistance and metabolism. DNA methylation is such an epigenetic change and has been shown to be associated with almost any biological process. The aim of our study to show the relation between the genetic variants of FOXO3a (rs2253310 rs4966936) and FOXO1 (rs3900833, rs4581585) and global DNA methylation in RRMS. We analyzed DNA obtained from 79 RRMS patients and 104 healthy individuals by PCR-RFLP method for the detection of genetic variants. For the determination of global DNA methylation, results were obtained using ELISA method. The data were evaluated statistically. As a result of our analysis; global DNA methylation is higher in RRMS patients compared to control individuals and it can be effective on the disease. In addition, it has been determined that variants of FOXO3a (rs2253310, rs4966936) and FOXO1 (rs3900833), which have been genotyped, may be effective in disease pathogenesis. These results suggest that DNAmethylation and FOXO gene variants may be effective in neuronal loss in RRMS., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background/aim: Recovery after coronary artery bypass graft surgery (CABG) can be complicated, leading to postoperative morbidity. The roles of hematologic and surgery-related parameters are important. The main purpose of this study is to determine the role of preoperative and postcardiopulmonary bypass neutrophil/lymphocyte ratio (NLR) on postoperative recovery. Materials and methods: Sixty-two patients aged between 41 and 80 years, scheduled for elective CABG surgery with ASA I-II risk and without a history of preoperative blood transfusion, were included in the study. Three patients were excluded due to their need for additional surgical procedures other than CABG. The patients were divided into two groups that were formed depending on preoperative NLR cut-off values below (Group 1, n = 37) and above 4 (Group 2, n = 22). Postoperative data such as length of stay in the hospital and in the intensive care unit (ICU), chest tube drainage, and incidence of atrial fibrillation were recorded for all patients. Results: Preoperative NLR was significantly lower in Group 1 (P < 0.0001), and there was no significant difference between the groups in terms of postoperative NLR (P = 0.217) when the two groups were compared. The patients in Group 2 had a longer length of stay in the ICU (P = 0.035) and in the hospital (P = 0.034). There was a positive correlation between preoperative NLR and length of stay in the ICU (P = 0.017) and the hospital (P = 0.014). No statistically significant differences in postoperative drainage or incidence of postoperative atrial fibrillation were detected between the two groups. Conclusion: The results of our study demonstrate that the postoperative NLR may be useful to predict the length of hospital and ICU stays and help the management of follow-up and treatment processes in patients undergoing CABG surgery., (CC-BY 4.0)

Background/aim: This study was undertaken to evaluate the effects of positive end-expiratory pressure (PEEP) levels on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) and to determine the appropriate PEEP level during steep Trendelenburg position combined with pneumoperitoneum.Materials and methods: Ten pigs were included in this study. Pneumoperitoneum and Trendelenburg position were maintained and PEEP titration was initiated. Arterial pressure, heart rate, arterial blood gas, ICP, and CPP were recorded at the following time points: baseline (T0), 30 min after positioning and pneumoperitoneum (T1), PEEP 5 (T2), PEEP 10 (T3), PEEP 15 (T4), and PEEP 20 (T5).Results: MAP significantly increased at T1 compared to T0 and decreased at T4 and T5 compared to T1. ICP was 9.5 mmHg and CPP was 69.3 mmHg at T0. CO2 insufflation and steep Trendelenburg position did not cause any significant difference in ICP and CPP. ICP increased and CPP decreased significantly at T4 and T5 compared to both T0 and T1. PaO2 and PaO2/FiO2 decreased significantly at T1 and T2 compared to T0, while both increased significantly at T3, T4, and T5 compared to T1.Conclusion: PEEP of 10 cmH2O was effective for providing oxygenation while preserving hemodynamic stability, ICP, and CPP in this model.

Objective: Stroke is the second most common cause of death and the leading cause of adult disability. Both stroke patients and their family can therefore experience increased traumatic stress level., Methods: The participants are close relatives of patients (n=65) who had a first time stroke (CRPWS) hospitalized. A control group (CG) (n=61), who had no history of chronic illness in their family and had at least one traumatic life event experience. The National Institutes of Health Stroke Scale, Modified Rankin Scale, Personal Information Form, Life Events Checklist, Traumatic Stress Symptom Scale, and Multidimensional Scale of Perceived Social Support, were used in the study., Results: We found no significant association between NIHSS and MRS of patients and traumatic stress level of the family member. The traumatic stress level was significantly higher in the CRPWS group than in the CG group. Traumatic stress level was higher in women than men and was not associated with perceived social support in the CRPWS group., Conclusion: The traumatic stress level of the relatives was not associated with the clinical features of the stroke patients. In the early phase, after the diagnosis of stroke, psychological support may be important to prevent CRPWS from PTSD.

Visceral artery pseudoaneurysm and arteriovenous fistula following penetrating abdominal injuries is a rarely observed complication. Presently described is the case of a 44-year-old male admitted to the hospital after having previously experienced penetrating abdominal trauma. The patient had developed a pseudoaneurysm in the superior mesenteric artery and an arteriovenous fistula between the superior mesenteric artery and vein following surgery. The patient underwent successful coil embolization procedure and he was discharged 1 day after intervention.

Background/aim: This study aimed to define the frequency of a primitive reflex, the buccopalpebral reflex (BPR), and its association with the clinical situation in patients with Parkinson disease., Materials and Methods: Between May 2010 and May 2011, 222 patients, 115 with Parkinson disease and 107 patients without any sign of neurodegenerative disease, were included in the study. All included patients were examined for BPR and snout reflex and were also evaluated with the Mini Mental State Examination. All patients with Parkinson disease were classified with the Unified Parkinson's Disease Rating Scale (UPDRS) and the Hoehn and Yahr Score to determine their clinical severity., Results: Sixteen patients with Parkinson disease (13.9%) had a BPR (+) and 4 patients in the control group (3.7%) (P < 0.001). The UPDRS score, UPDRS daily life activities score, and UPDRS motor system score were all higher in the group with BPR (+). All patients with a BPR also had a positive snout reflex., Conclusion: BPR is more frequent in patients with Parkinson disease than in patients without a neurodegenerative disease.

Purpose: Seroma is among the most common complications of laparoscopic total extraperitoneal (TEP) for especially large indirect inguinal hernia, and may be regarded as a recurrence by some patients. A potential area localized behind the mesh and extending from the inguinal cord into the scrotum may be one of the major etiological factors of this complication. Our aim is to describe a novel technique in preventing pseudorecurrence by using fibrin sealant to close that potential dead space., Methods: Forty male patients who underwent laparoscopic TEP for indirect inguinal hernia with at least 100-mL volume were included in this prospective clinical study. While fibrin sealant was used to close the potential dead space in the study group, nothing was used in the control group. The volume of postoperative fluid collection on ultrasound was compared between the groups., Results: Patient characteristics and the volumes of hernia sac were similar between the 2 groups. The mean volume of postoperative fluid collection was found as 120.2 mL in the control group and 53.7 mL in the study group, indicating a statistical significance (P < 0.001)., Conclusion: Minimizing the potential dead space with a fibrin sealant can reduce the amount of postoperative fluid collection, namely the incidence of pseudorecurrence., Competing Interests: No potential conflict of interest relevant to this article was reported.

Background/aim: There are limited data in the literature investigating the effects of anesthetic agents on cardiac output used in the chest-knee position. The aim of this study is to compare the effects of inhalation and total intravenous anesthesia on cardiac output in patients undergoing lumbar discectomy in the chest-knee position., Materials and Methods: Forty patients undergoing discectomy in the chest-knee position were allocated to 2 groups. The first group (GrS, n = 20) received sevoflurane after thiopental induction, while the second group (GrP, n = 20) received propofol induction and infusion. Heart rate (HR), mean arterial pressure (MAP), peripheral oxygen saturation, cardiac output (CO), and cardiac index (CI) were recorded., Results: Groups were comparable in terms of HR and MAP. The differences related to anesthetic technique and position were statistically significant within each group. Cardiac output and CI were similar between the groups. Cardiac output and CI of GrP were found to be decreased in the chest-knee position and significantly elevated in the supine position after surgery (P < 0.05). There were significant decreases in the mean CO and CI values recorded after the chest-knee position in GrP., Conclusion: Sevoflurane is found to be superior when compared to propofol in patients undergoing surgery in the chest-knee position in terms of perioperative hemodynamic stability. Therefore, sevoflurane may be the anesthetic of choice, especially in patients operated on in the chest-knee position with suspected hemodynamic instability.