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This study aimed to compare the anterolateral and posterior localized renal masses in laparoscopic partial nephrectomy with the retroperitoneal approach in terms of operative, functional, and oncological outcomes. Patients who underwent retroperitoneal laparoscopic partial nephrectomy by a single surgeon between January 2013 and January 2021 were included in the study. A one-to-one propensity score matching (PSM) analysis was conducted to obtain two balanced groups. The patients were divided into two groups as posterior and anterolateral according to the localization of the mass. A total of 239 patients were included in the PSM analysis, with 65 patients allocated to each group. The mean operative time was 79.2 ± 11.2 min in the posterior group, while it was 90.0 ± 11.6 min in the anterolateral group (P < 0.001). Warm ischemia time was 15.9 ± 2.4 min in the posterior group and 18.6 ± 2.7 min in the anterolateral group (P < 0.001). The median decrease in eGFR at 1 year was 4.8 (IQR, 2.9–6.9) mL/min in the posterior group and 5.0 (IQR, 2.8–11) mL/min in the anterolateral group (P = 0.219). The warm ischemia time and clamping technique were found to be significant factors for predicting eGFR change after surgery (β:0.693, 95% CI: 0.39–0.99, P < 0.001; β:6.43, 95% CI: 1.1–11.7, P = 0.017, respectively). We report that retroperitoneal laparoscopic partial nephrectomy provided longer warm ischemia and operative time for anterolateral renal masses than posterior masses. However, long-term oncological and functional results were similar for both localizations.

Aim:Although the 26F resectoscope is frequently used in transurethral prostatectomy, there are some concerns with high-caliber shafts. We compared 24F and 26F resectoscope used for Holmium Laser Enucleation of the Prostate (HoLEP) in terms of effects on postoperative urethral complications and perioperative outcomes.Methods:Data from patients undergoing HoLEP from 2017 to 2021 was retrospectively analyzed. All surgeries were completed by a single surgeon. The patients were divided into one of two groups according to the resectoscope diameter (24F or 26F). All patients were followed up for urethral complications for 12 months. Perioperative outcomes and urethral complications were compared between the groups.Results:The study included 301 patients. The mean age of patients was 68.5±8.3 and 69.1±8.6 for the 26F group (n=180) and the 24F group (n=121), respectively (p=0.608). A total of seven in the 26F group (3.8%) and 3 patients in the 24F group (2.4%) had postoperative urethral stricture (US) (p=0.503). Besides, 2 patients (26F) and 1 patient (24F) had postoperative bladder neck contracture (BNC) (p=0.807). The operation efficiency was 1.25 g/min in the 26F group and 1.17 g/min in the 24F group (p=0.005).Conclusion:The use of 24F or 26F RS was not shown to cause statistically significant differences in the incidence of US and BNC during the 12-month follow-up. The use of the 24F RS significantly reduces surgical and morcellation efficiency.

Background and Objectives: The most common kidney stones are calcium stones and calcium oxalate (CaOx) stones are the most common type of calcium stones. Hyperoxaluria is an essential risk factor for the formation of these stones. Quercetin is a polyphenol with antioxidant, anti-inflammatory, and many other physiological effects. The aim of this study was to investigate the protective effect of quercetin in hyperoxaluria-induced nephrolithiasis. Materials and Methods: Male Wistar-Albino rats weighing 250–300 g (n = 24) were randomized into three groups: Control (n = 8), ethylene glycol (EG) (n = 8), and EG + quercetin (n = 8). One percent EG-water solution was given to all rats except for the control group as drinking water for five weeks. Quercetin-water solution was given to the EG + quercetin group by oral gavage at a dose of 10 mg/kg/day. Malondialdehyde (MDA), catalase (CAT), urea, calcium, and oxalate levels were analyzed in blood and urine samples. Histopathological assessments and immunohistochemical analyses for oxidative stress and inflammation indicators p38 mitogen-activated protein kinase (p38-MAPK) and nuclear factor kappa B (NF-kB) were performed on renal tissues. Results: The MDA levels were significantly lower in the quercetin-treated group than in the EG-treated group (p = 0.001). Although CAT levels were higher in the quercetin-treated group than the EG-administered group, they were not significantly different between these groups. The expression of p38 MAPK was significantly less in the quercetin-treated group than the EG group (p < 0.004). There was no statistically significant difference between the quercetin and EG groups in terms of NF-kB expression. Conclusions: We conclude that hyperoxaluria activated the signaling pathways, which facilitate the oxidative processes leading to oxalate stone formation in the kidneys. Our findings indicated that quercetin reduced damage due to hyperoxaluria. These results imply that quercetin can be considered a therapeutic agent for decreasing oxalate stone formation, especially in patients with recurrent stones due to hyperoxaluria.

Pathological upgrading poses a significant challenge in treatment decision-making, particularly for patients considered for active surveillance (AS). This study aimed to devise a novel scoring system to predict the risk of upgrading in patients with biopsy Gleason grade group 1 prostate cancer. We conducted a retrospective review of 235 patients who underwent radical prostatectomy between February 2014 and June 2022. Data on patient age, prostate-specific antigen (PSA) level, body mass index, clinical T-stage, prior biopsy history, Prostate Imaging-Reporting and Data System (PIRADS) score, time interval from biopsy to surgery, and pathological outcomes were collected. After a comprehensive review of the literature, multivariate analyses identified seven factors associated with upgrading in prostate cancer patients after radical prostatectomy: uninformative prior biopsy sample, PSA level, greatest percentage of tumor involvement, radiological PIRADS score, age, delay from biopsy to surgery and extension of positive cores. These factors were integrated into our devised U.P.G.R.A.D.E. model to form a scoring system. The U.P.G.R.A.D.E. score was calculated based on the cumulative score of these variables. The predictive performance of the U.P.G.R.A.D.E. scoring system was assessed, revealing a cohort with a mean age of 64.22 ± 5.88 years and a mean PSA value of 8.92 ± 5.05 ng/mL. The pathological samples of 95 patients (40.6%) were upgraded, and the upgraded patients exhibited significantly higher U.P.G.R.A.D.E. scores (p < 0.001). The area under the receiver operating characteristic (AUROC) curve for the U.P.G.R.A.D.E. scoring system demonstrated robust predictive ability for upgrading (AUROC = 0.952; 95% Confidence interval (CI): 0.926–0.978; p < 0.001). In addition, a higher U.P.G.R.A.D.E. score was strongly associated with an increased risk of upgrading in biopsy Gleason grade group 1 patients, suggesting potential limitations for active surveillance eligibility in these individuals. Further validation studies are warranted to confirm these initial findings.

Purpose: To determine the factors affecting morcellation efficiency in holmium laser enucleation of the prostate (HoLEP) surgery. Materials and Methods: Patients who underwent HoLEP surgery by a single surgeon between 2018 and 2022 were included in the study. Our primary outcome of interest in this study was morcellation efficiency. The effect of preoperative and perioperative variables on morcellation efficiency was evaluated with linear regression analysis. Results: A total of 410 patients were included in the study. The mean morcellation efficiency was 6.95±1.70 g/min. Univariable and multivariable linear regression analysis was performed to identify factors affecting morcellation efficiency. Presence of the “beach ball” effect (small, round prostatic tissue fragments that are fibrotic and difficult to morcellate), the learning curve, resectoscope sheath type, prostate-specific antigen (PSA) density, morcellated tissue weight, and the presence of prostate calcification were found to be independent predictive factors (β=-1.107, 95% CI: -1.59 to -0.55, p

Backgroud: Epilepsy is a chronic medical condition requiring long term or even lifelong therapy. Various researches have shown that epilepsy patients have vascular risk factors such as abnormal lipids, insulin, elevated oxidative stress, chronic inflammation, and subclinical atherosclerosis. Objectives: The purpose of the present study was to determine serum prolidase enzyme activity as a biomarker in children taking antiepileptic drug treatment through comparison with control cases. Materials and Methods: The present study group consists of 61 children (20 females, 41 males) with epilepsy and a control group was formed of 32 healthy individuals (14 females, 18 males). Aspectrophotometric method was used to measure serum prolidase enzyme activity. Results: The epilepsy group demonstrated statistically significantly higher prolidase enzyme activity values when compared with the control group (P = 0.003). It was measured that the serum TOS and OSI values were significantly elevated in patients with epilepsy compared to controls (P < 0.001). However, serum TAS values were significantly lower in the epilepsy group than in the control group (P = 0.032). Conclusions: These results supported that epileptic patients taking the antiepileptic treatment had increased serum prolidase enzyme activity, suggesting that it may show an increased risk of subclinical vascular damage related to both chronic inflammation and fibrotic process associated with degenerated collagen turnover. Therefore, serum prolidase enzyme activity could be considered a useful biomarker for evaluation of the subclinical vascular damage in children with epilepsy on some antiepileptic drugs.

This study aimed to evaluate the prevalence of toxoplasmosis in pregnant women, as well as the general characteristics, clinical and laboratory findings, and pregnancy and fetal outcomes of pregnant women diagnosed with acute toxoplasma infection (ATI). The toxoplasma IgM, IgG, and IgG avidity test results of pregnant women who applied to our referral hospital between January 2016 and June 2022, and among them, those diagnosed with ATI, were analyzed. The 119 patients diagnosed with ATI during this time period were included for further analysis. The prevalence of toxoplasmosis in pregnant women was found to be 46.2%, and the rate of ATI was 4%. The total mother-to-child transmission rate was 5% (5/101). Congenital toxoplasmosis (CT) was observed in 1 (1.1%) child of the 87 pregnant women who received spiramycin prophylaxis, though it was found in 4 (30.8%) of the children of the 13 untreated mothers. With respect to prenatal treatment, CT rates were significantly higher in the children born to untreated mothers (p = 0.001). In conclusion, although toxoplasma seroprevalence was found to be high in our region, there was a paucity in diagnosis, follow-up, and treatment. Our findings support that prenatal spiramycin prophylaxis is effective in preventing the transmission of parasites from mother to child.

Ötelerde mekânlar muhtelif biliyorum Hak Teâla’dan Cennet-i A’la diliyorum Müsaadenle gözyaşımı siliyorum Unutulman çok zor herkes bilir, Önkal Hocam

In this study, fiscal decentralization in Turkey was first considered in terms of the size of local governments within the general government at the macro level, and then the differentiation of fiscal decentralization among the local governments on the basis of selected provinces was examined. The revenue and expenditures of local governments in Turkey have increased as a proportion of GDP, while the level of fiscal decentralization has shown a distinctive structure, especially since the 2000s. Results indicate that there is no efficient calculation methodology for achieving vertical equality. The objective for achieving horizontal equalization in the transfer system remains also limited. Fiscal decentralization rates differ between provinces. Intergovernmental revenue sharing system and differentiation in own-source revenues mainly resulting from the income levels of the regions clearly shows that there has been an inadequate vertical and horizontal imbalances and current sharing system somehow increases inequalities among provinces.

Aim: To investigate whether serum surfactant protein D (SP-D) level is an applicable indicator in differentiating bacterial and viral pneumonia and determining clinical severity in cases with community-acquired pneumonia (CAP).Materials and Methods: A total of 67 subjects were analyzed prospectively; of these, 32 were patients (aged 1 month–18 years) with a diagnosis of CAP and 35 were healthy control subjects.Results: The median age of the patients was 17.5 months (1.5–156 months). The serum SP-D levels of the patient group were significantly higher than those of the control group (p

Büyük bir mütefekkir, büyük bir şair, büyük bir mürşit olan Mevlâna çok yönlü, çok boyutlu bir fikir adamı olarak dikkat çeker. Mükemmel bir şekilde yetişmiş, devamlı surette mükemmel insan (insan-ı kâmil) yetiştirmenin gayretini vermiştir. Yaşadığı devirden günümüze kadar örnek yaşantısıyla, evrensel fikirleriyle insanlığa rehber olmuştur. O, içinde yaşadığı toplumun sorunlarını çok iyi tespit etmiş, yerinde ve zamanında çözümler sunmuştur. Mevlâna, insanlarla ilişkilerinde toplumun hiçbir kesimini dışlamamış, hepsini kucaklamış, kılıç, kalem ve kelâm ehlini birbirine kenetlemeye, birlik beraberlik içinde yaşamaya, kardeş olmaya çağırmıştır. Selçuklu sultanları başta olmak üzere, vezir ve emirlerle, ulema ve mutasavvıflarla sıkı dialog kurarken, toplumun diğer kesimlerini ihmal etmemiş, onlarla da ilişkilerini sürdürmüştür. Mevlâna’nın tesiri sadece yaşadığı dönemle sınırlı kalmamış, örnek yaşantısının, her dem tazeliğini koruyan fikir ve eserlerinin tesiri çok geniş bir zaman ve mekâna yayılmıştır. İnsanlık XIII. asırdan günümüze kadar büyük bir tecessüsle onu daha da yakından tanımaya, anlamaya çalışmaktadır. Mevlâna; Yunus’tan Şeyh Galib’e; İkbal’den Goethe’ye kadar birçok kalem erbabına ilham vermiş, Türk İslâm medeniyetine, Doğu ve Batı Dünyasına ışık olmuştur. Eserleri, 200’den çoğu İngilizce olmak üzere onlarca dile çevrilmiş, insanlığın bu ışıktan istifade etmesine imkân sağlanmıştır. Mevlâna’yı kendisini yetiştiren hocalarından, çağdaşları olan ulema ve mutasavvıflardan, çağlar boyunca insanlığa rehberlik eden toplum önderlerinden farklı kılan önemli sebepler vardır. Bu sebeplerin tespiti Mevlâna’nın tesir gücünün, etki alanının belirlenmesinde önemli ipuçları vermektedir

During this period the Rightly Guided Caliphs it has been followed the same line that the Prophet applied in public relations. The public relations that were based on the principles of Qur’an and the Sunna, were set up as regard for human’s worth. In other words, the Caliphs paid attention to universal worths such as human rights, freedom of religion and conscience, love, respect, tolerance, justice and administered in accordance with Islam and humanistic principles

Seçkin sahâbîlerden birisi olan Ebû Zerr el-Ğıfârî’nin Hz. Osman döneminde Rebeze’ye gönderilmesi, Halife’ye yapılan ciddî tenkitler arasında yer alır. İlk iki Halife ve Hz. Os-man’ın ilk altı yıllık dönemlerinde iktidarla en ufak bir sorun yaşamayan Ebû Zerr, Hz. Osman’ın ikinci altı yıllık döneminde önce Şam valisi Muâviye’ye, sonra da Halife’ye muhalefet etmiştir. İstismara açık bir hüviyete sahip olan bu konunun tahlîl edilmesi gereken bir arka plânından söz edilebilir. Ebû Zerr’in tepkisi o dönemde görülen zengin fakir arasındaki ekonomik dengesizliklere karşı olmuştur. Bu bağlamda Ebû Zerr, zenginlerin, nafakalarının dışında kalan mallarını fakirlere dağıtması gerektiğini dillendirmiş, gerekçe olarak da Tevbe sûresi 34. âyeti göstermiştir. Onun sosyal içerikli bu davranışı, toplumdaki zengin kesimi rahatsız etmiş, bu durum Şam valisi Muâviye tarafından Halife’ye bildirilmiştir. Ebû Zerr’in savunduğu fikirler kendisine başkaları tarafından dayatılan fikirler olmayıp, tamamen kendi fikirleridir ve diğer seçkin sahâbîler tarafından da destek görmemiştir. Toplumda meydana gelebilecek sınıf çatışmasını önlemek için Hz. Osman onunla istişare ederek onu Rebeze’ye göndermiştir. Sahâbîlerin Medîne dışına çıkmalarına yönelik Hz. Ömer’in koyduğu yasağı kaldırması ve toplumda bariz bir şekilde görülen ekonomik dağılımdaki dengesizlikler, problemin Hz. Osman’la ilgili kısmını teşkil etmektedir.

Diclofenac, a widely used nonsteroidal anti-inflammatory drug, has been reported to cause fatal drug-induced rhabdomyolysis very rarely . We report a case of a 13-month-old girl who developed fatal rhabdomyolysis after administration of intramuscular diclofenac for relief of pain caused by a scalding burn injury. Rhabdomyolysis due to diclofenac has not been reported in children. Here, we present the first case report to demonstrate rhabdomylysis secondary to diclofenac administration.