Search

Non-terrestrial networks (NTNs) will become an indispensable part of future wireless networks. Integration with terrestrial networks will provide new opportunities for both satellite and terrestrial telecommunication industries and therefore there is a need to harmonize them in a unified technological framework. Among different NTNs, low earth orbit (LEO) satellites have gained increasing attention in recent years and several companies have filed federal communication commission (FCC) proposals to deploy their LEO constellation in space. This is mainly due to several desired features such as large capacity and low latency. In addition, recent successful LEO network deployments such as Starlink have motivated other companies. In the past satellite and terrestrial wireless networks have been evolving separately but now they are joining forces to enhance coverage and connectivity experience in the future wireless networks. The 3rd Generation Partnership Project (3GPP) is one of the dominating standardization bodies that is working on various technical aspects to provide ubiquitous access to the 5G networks with the aid of NTNs. Initial steps have been taken to adopt 5G state of the art technologies and concepts and harmonized them with the conditions met in non-terrestrial networks. In this article, we review some of the important technical considerations in 5G NTNs with emphasis on the radio access network (RAN) part and provide some simulation based results to assess the required modifications and shed light on the design considerations.

The gender division of labour is a phenomenon that projects masculine domination that pervades society. The gendering of occupations is essentially different from society to society. However, most cultures see music is seen as a male occupation At this point, “bayan orchestras”, musical practices that are done by women-only musicians and for women-only audience subvert social presumptions about the gender of conservative communities, which is both a result and reproduction of masculine domination. There “bayan orchestras” in conservative communities are results of banning women to dance in the presence of men. In this context; It is also not welcome for women to dance in entertainment with male orchestras. However, this situation is resolved by women performing music in the public sphere, which may not be welcomed, either. Thus, DJs and musicians who call themselves “bayan orchestra” emerge in response to the need for musicians in women-only entertainments, especially in conservative communities, such as henna nights. In this context, DJ Cannur, who provides bayan orchestra service” to mostly conservative groups in the Kemalpaşa district of İzmir, is our case study. This study aims to examine the “bayan” orchestra practice in the context of gender division of labour. In this context, first, gender division of labour and gender division of labour in music are examined. Afterwards, henna night as a gendered entertainment practice and the role of this ritual in the emergence of “bayan orchestras” are emphasized. Finally, an analysis based on interviews is presented.

Although Geostationary-Equatorial-Orbit (GEO) satellites have achieved significant success in conducting space missions, they cannot meet the 5G latency requirements due to the far distance from the earth surface. Therefore, Low-Earth-Orbit (LEO) satellites arise as a potential solution for the latency problem. Nevertheless, integrating the 5G terrestrial networks with LEO satellites puts an increased burden on the satellites’ limited budget, which stems from their miniature sizes, restricted weights, and the small available surface for solar harvesting in the presence of additional required equipment. This paper aims to design the Electrical Power System (EPS) for 5G LEO satellites and investigate altitudes that meet the latency and capacity requirements of 5G applications. In this regard, accurate solar irradiance determination for the nadir-orientation scenario, Multi-Junction (MJ) solar cells modeling, backup batteries type and number, and designing highly-efficient converters are addressed. Accordingly, the power budgeting of the 5G LEO satellite can be achieved based on defining the maximum generated power and determining the satellite’s subsystem power requirements for 5G missions. In the sequel, the measured and simulated values of the electrical V-I characteristics of an MJ solar panel are compared to validate the model by using a Clyde Space solar panel that reaches a maximum power generation of approximately $1~W$ at ( $I_{MPP}=0.426\,\,A$ , $V_{MPP}=2.35\,\,V$ ). Moreover, a synchronous boost converter circuit is designed based on commercial off-the-shelf elements.

A rapid and specific method was developed for simultaneous quantification of hydrocortisone 21 acetate (HCA), dexamethasone (DEX), and fluocinolone acetonide (FCA) in whitening cream formulations using reversed-phase high-performance liquid chromatography. The effect of the composition of the mobile phase, analysis temperature, and detection wavelength was investigated to optimize the separation of studied components. The analytes were finally well separated using ACE Excel 2, C18 AR column having 150 mm length, 3 mm internal diameter, and 2 µm particle size at 35°C using methanol with 1% formic acid and double-distilled deionized water in the ratio of 60:40 (v/v), respectively, as the mobile phase in isocratic mode. Ten microliters of sample were injected with a flow rate of 0.5 mL/min. The specificity, linearity, accuracy, precision, recovery, limit of detection (LOD), limit of quantification (LOQ), and robustness were determined to validate the method as per International Conference on Harmonization guidelines. All the analytes were simultaneously separated within 8 min, and observed retention times of HCA, DEX, and FCA were 4.5, 5.5, and 6.9 min, respectively. The proposed method showed good linearity with the correlation coefficient, R 2 = 0.999 over the range of 1–150 µg/mL for all standards. The linear regression equations were y = 12.7x + 118.7 (r = 0.999) for HCA, y = 12.9x + 106.8 (r = 0.999) for DEX, and y = 12.9x + 96.8 (r = 0.999) for FCA. The LOD was 0.25, 0.20, and 0.08 µg/mL for HCA, FCA, and DEX and LOQ was 2.06, 1.83, and 1.55 µg/mL for HCA, FCA, and DEX, respectively. The recovery values of HCA, DEX, and FCA ranged from 100.7–101.3, 102.0–102.6, and 100.2–102.0%, respectively, and the relative standard deviation for precision (intra- and interday) was less than 2, which indicated repeatability and reproducibility. The novelty of the method was described by forced degradation experimentation of all analytes in the combined form under acidic, basic, oxidative, and thermal stress. The proposed method was found to be simple, rapid, and reliable for the simultaneous determination of HCA, DEX, and FCA in cosmetics.

A detailed analysis of ground-based CCD UBV photometry and space-based Gaia Data Release 3 (DR3) data for the open clusters King 6 and NGC 1605 was performed. Using the pyUPMASK algorithm on Gaia astrometric data to estimate cluster membership probabilities, we have identified 112 stars in King 6 and 160 stars in NGC 1605 as the statistically most likely members of each cluster. We calculated reddening and metallicity separately using UBV two-color diagrams to estimate parameter values via independent methods. The color excess E ( B − V ) and photometric metallicity [Fe/H] for King 6 are 0.515 ± 0.030 mag and 0.02 ± 0.20 dex, respectively. For NGC 1605, they are 0.840 ± 0.054 mag and 0.01 ± 0.20 dex, respectively. With reddening and metallicity kept constant, we have estimated the distances and cluster ages by fitting PARSEC isochrones to color–magnitude diagrams based on the Gaia and UBV data. The photometric distances are 723 ± 34 pc for King 6 and 3054 ± 243 pc for NGC 1605. The cluster ages are 200 ± 20 Myr and 400 ± 50 Myr for King 6 and NGC 1605, respectively. The mass function slopes were found to be 1.29 ± 0.18 and 1.63 ± 0.36 for King 6 and NGC 1605, respectively. These values are in good agreement with the value of Salpeter. The relaxation times were estimated as 5.8 Myr for King 6 and 60 Myr for NGC 1605. These indicate that both clusters are dynamically relaxed since these times are less than the estimated cluster ages. A Galactic orbit analysis shows that both clusters formed outside the solar circle and are members of the young thin-disk population.

Our understanding of the kinematic properties of multiple stellar populations (mPOPs) in Galactic globular clusters (GCs) is still limited compared to what we know about their chemical and photometric characteristics. Such limitation arises from the lack of a comprehensive observational investigation of this topic. Here we present the first homogeneous kinematic analysis of mPOPs in 56 GCs based on high-precision proper motions computed with Hubble Space Telescope data. We focused on red-giant-branch stars, for which the mPOP tagging is clearer, and measured the velocity dispersion of stars belonging to first (1G) and second generations (2G). We find that 1G stars are generally kinematically isotropic even at the half-light radius, whereas 2G stars are isotropic at the center and become radially anisotropic before the half-light radius. The radial anisotropy is induced by a lower tangential velocity dispersion of 2G stars with respect to the 1G population, while the radial component of the motion is comparable. We also show possible evidence that the kinematic properties of mPOPs are affected by the Galactic tidal field, corroborating previous observational and theoretical results suggesting a relation between the strength of the external tidal field and some properties of mPOPs. Although limited to the GCs’ central regions, our analysis leads to new insights into the mPOP phenomenon, and provides the motivation for future observational studies of the internal kinematics of mPOPs.

Introduction: Streptococcus pneumoniae is one of the major pathogens responsible for respiratory tract infections, meningitis, and bacteremia. In most countries around the world, an increase in the emergence of macrolide-resistant S. pneumoniae isolates has become a serious problem. Therefore, this study was conducted to investigate the association of erythromycin resistance with the mefA and ermB genes among clinical isolates of S. pneumoniae in Tehran City (Tehran Province, Iran). Materials and Methods: In this cross-sectional study, 62 erythromycin-resistant S. pneumoniae (ERSP) isolates were obtained from patients in four hospitals in Tehran city during 2013-2015. The macrolide resistance genes mefA and ermB were detected in ERSP isolates using polymerase chain reaction (PCR) assays. Furthermore, the copy number and expression level of the mefA gene were determined by real-time PCR. Results: In the present study, the overall resistance to erythromycin in S. pneumoniae isolates was 84.93% (62 isolates out of 73). Either mefA or ermB was identified in 10 (16.13%) and 36 (58.06%) ERSP isolates, respectively, and 7 (11.29%) ERSP isolates harbored both genes. Comparison of the mean relative expression of the mefA gene in ERSP isolates with different erythromycin minimal inhibitory concentration (MIC) values indicated that the expression level was increased approximately twofold for each doubling of the MIC value. Conclusion: Our findings highlighted the dominance of ribosomal methylation encoded by ermB as the most common mechanism of macrolide resistance in clinical S. pneumoniae isolates from Iran. Furthermore, in the present study, the expression levels of the mefA gene showed a significant increase in the ERSP isolates with higher erythromycin MIC values.

Callus culture is necessary for production of suspension cell culture in plant breeding programs. Regarding to the application of Papaver bracteatum as an important medicinal plant in production of benzophenantridine alkaloids, this study was performed to find the most suitable hormone combination and explant type for achieving to high percentage of callus induction fresh weight and somatic embryogenesis in this plant. For this purpose, hypocotyl explants were cultured in ½MS media containing active charcoal (2 and 4 mgL-1) in combination of different concentrations of NAA, 2,4-D (0, 1, 2, 3 and 5 mgL-1) and BA (0, 0.1 and 0.5 mgL-1). The seed explants were cultured in same treatments without active charcoal. Also, somatic embryogesis induction using seed explants in ½MS media containing different concentrations of NAA and 2,4-D (0, 0.5, 1 and 2 mgL-1) with BA 0.5 mgL-1 were investigated. The results showed that the highest percentage of callus induction (43.6%, 54%) in hypocotyls explants were obtained in the ½MS media containing 2 mgL-1 active charcoal and 2 mgL-1 2,4-D and 5 mgL-1 NAA in companion with BA 0.5 mgL-1 respectively. The maximum callus induction (84%) was obtained in ½MS medium with 1 mgL-1 2,4-D without active charcoal. The highest callus fresh weight (0.35%) was obtained in MS media with 0.5 mgL-1 2,4-D andthe maximum rate of somatic embryogenesis induction (77%) was observed in ½MS media containing 1 mgL-1 2,4-D with 0.5 mgL-1 BA.

Objectives: The aim of this study is to examine the effect of fibromyalgia (FM) treatment on mastalgia by performing fibromyalgia screening in patients who applied for mastalgia and whose underlying cause could not be found., Methods: Patients who applied to Kocaeli University General Surgery Outpatient Clinic between November 2017 and November 2020 with breast pain were included (n=120). Patients without cancer, systemic disease, previous breast surgery, and breast mass larger than 3 cm (n=30) were referred to the Physical Therapy and Rehabilitation Outpatient Clinic. A total of 13 patients (43%) were diagnosed with FMS. Twelve of them were given selective serotonin-noradrenaline reuptake inhibitor (duloxetine) treatment for 3 months. Turkish version of the Short Form - 36 (SF-36) quality of life scores, Visual Analog Scale (VAS), Cardiff breast pain score before and after treatment were compared. The remaining 17 patients were followed as only mastalgia., Results: Patients with fibromyalgia and mastalgia had similar demographic results. At the end of the 3rd month, the complaints of breast pain completely regressed in all of the patients. Statistically significant changes were detected in VAS score, the number of trigger points, and SF-36 quality of life scores, Cardiff breast pain score after duloxetine treatment., Conclusion: In the presence of unexplained mastalgia, fibromyalgia should be kept in mind. Duloxetine treatment improved the breast pain and quality of life in patients with mastalgia and fibromyalgia.

Background: This study presents the diagnosis and treatment of rare small bowel tumors through clinical cases., Methods: Patients treated between 2000 and 2023 were included in the study. The clinical records of the patients were analyzed retrospectively., Results: A total of 34 patients were included in the study. Of these patients, 26 (75.5%) were male and eight (23.5%) were female. The mean age of the patients was 62.1 years. The most common symptoms and signs were abdominal pain (76.4%), bloating (38.2%), and nausea and vomiting (17.6%). Diagnostic methods included computed tomography (CT) (82.3%), upper gastrointestinal double balloon enteroscopy (35.2%), and capsule endoscopy (5.8%). Diagnoses included adenocarcinoma in 13 cases, gastrointestinal stromal tumors (GISTs) in 12 cases, and neuroendocrine tumors (NETs) in two cases., Conclusion: Small bowel tumors frequently present with abdominal pain, bloating, and nausea and vomiting. CT and endoscopic procedures are the primary diagnostic tools. Small bowel cancers are often diagnosed late due to subtle clinical findings and the limitations of endoscopic imaging. Targeted screening strategies may be beneficial for certain at-risk and symptomatic patient groups. Early surgical intervention offers significant advantages for diagnosed patients.

Objectives: The involvement of axillary lymph nodes plays a key role in breast cancer staging. Positron emission tomography is a promising modality for detecting axillary lymph node metastasis. In addition, nomograms are used to predict the status of axillary lymph nodes. In this study, the role of positron emission tomography in determining axillary metastasis and its correlation with the nomogram was evaluated., Material and Methods: The axillary maximum standard uptake value (SUVmax) values of the patients in the preoperative period, the features in the perioperative and postoperative specimen and Memorial Sloan Kettering Cancer Center nomogram data were evaluated., Results: As axillary SUVmax detected by Positron emission tomography in the preoperative period increased, so did the likelihood of lymph node involvement. Axillary SUVmax value were compared with Memorial Sloan Kettering Cancer Center nomogram data but no correlation was found. Age, lymph node number, histopathology results, mass diameter, presence or absence of lymphovascular invasion and/or perineural invasion, tumor type, estrogen receptor status, Ki67 and Cerb-B2 statuses were not correlated. However, axillary SUVmax was inversely correlated with grade and progesterone receptor status., Conclusion: Results from positron emission tomography of axillary lymph nodes in breasts cancer patients showed that SUVmax was only inversely related to cancer grade and progesterone receptor status while not correlating with other accepted parameters for tumor assessment. Thus there is insufficient reliability for the use of axillary SUVmax alone for accurate assessment of tumor characteristics at present., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare., (Copyright © 2023, Turkish Surgical Society.)

Breast cancer is a global health concern, with increasing disease burden and disparities in access to healthcare. Late diagnosis and limited treatment options in underserved areas contribute to poor outcomes. In response to this challenge, we developed a novel family of 2-substituted-quinoxaline analogues, combining coumarin and quinoxaline scaffolds known for their anticancer properties. Through a versatile synthetic approach, we designed, synthesized, and characterized a set of 2-substituted quinoxaline derivatives. The antiproliferative activity of the synthesized compounds was assessed toward the MCF-7 breast cancer cells. Our investigations showed that the synthesized compounds exhibit considerable antiproliferative activity toward MCF-7 cells. Notably, compound 3b, among examined compounds, displayed a superior inhibitory effect (IC 50 = 1.85 ± 0.11 μM) toward the growth of MCF-7 cells compared to the conventional anticancer drug staurosporine (IC 50 = 6.77 ± 0.41 μM) and showed minimal impact on normal cells (MCF-10A cell lines, IC 50 = 33.7 ± 2.04 μM). Mechanistic studies revealed that compound 3b induced cell cycle arrest at the G1 transition and triggered apoptosis in MCF-7 cells, as evidenced by increasing the percentage of cells arrested in the G2/M and pre-G1 phases utilizing flow cytometric analysis and Annexin V-FITC/PI analysis. Moreover, compound 3b was found to substantially suppress topoisomerase enzyme activity in MCF-7 cells. Molecular modeling studies further supported the potential of compound 3b as a therapeutic candidate by demonstrating significant binding affinity to the active sites of both topoisomerase II and EGFR proteins. Taken together, the presented 2-substituted-quinoxaline analogues, especially compound 3b, show promise as potential candidates for the development of effective anti-breast cancer drugs., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

In this research work, a novel design of an electro-Fenton reactor for the treatment of polluted water was investigated. In addition to the reactor with iron electrodes, a ceramic filter was also used. An electrical circuit was designed to change the cathodes and anodes every 24 s via an electrical relay between the electrodes. The untreated water was sucked into the reactor with an air pump and entered the electrocoagulation chamber after filtration with a ceramic filter. Then, it flows to the polyethylene filter to separate the coagulated particles from the fresh water. To produce 12 L of clean water, the system consumed 100 W of energy. Analysis of a river sample showed a reduction in nephelometric turbidity units (NTUs), total suspended solids (TSS), biochemical oxygen demand (BOD), and chemical oxygen demand (COD). Turbidity reduction studies have shown that the system can improve water transparency by 95%, thereby improving water quality to acceptable levels. Further, this system reduced TSS by more than 86%. In addition, BOD was reduced by more than 84% and COD by more than 88%, as shown by the change in the ratio of BOD to COD from 0.44 to 0.625, indicating improved water quality. According to the results, the treatment system can clean polluted waters, particularly during floods and when industries discharge their effluents into rivers., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Regional anesthesia techniques constitute an important part of successful analgesia strategies in the perioperative care of patients undergoing breast surgery. The advent of ultrasound-guided regional anesthesia has led to the development of fascial plane blocks. The large array of blocks available for postoperative analgesia in breast surgery has increased the accessibility of regional anesthesia but has also created a dilemma of choice. This study compared the analgesic efficacy of the ultrasound-guided modified pectoral nerve (PECS) block and erector spinae plane block (ESPB) in patients undergoing radical mastectomy., Methods: Seventy women were enrolled in this prospective, double-blind, randomized control trial. After exclusion, 67 female patients who underwent radical mastectomy were finally analyzed. Ultrasound-guided PECS blocks and ESPBs were performed with 30 ml 0.25% bupivacaine. Postoperative morphine and pain scores were compared between the groups., Results: Postoperative total morphine consumption in the first 24 h was significantly higher in the PECS group (P < 0.001). The ESPB group exhibited significantly reduced morphine consumption at all postoperative time points. Numeric rating scale scores were lower in the ESPB group at 6, 12, and 24 h postoperatively at rest and when coughing., Conclusions: Ultrasound-guided bi-level ESPBs provided better postoperative analgesia than PECS blocks after radical mastectomy surgery.

Background/aim: To investigate the metabolic response and body mass index reduction according to the remaining stomach volume between 6-12 months after the operation in patients who underwent sleeve gastrectomy surgery for obesity and to determine the relationship between the remaining stomach volume and metabolic improvement. Materials and Methods: Patients underwent sleeve gastrectomy in a single center by the same team and with the same standardized method. Residual gastric volumes were calculated from three-dimensional computed tomography images obtained 6-12 months postoperatively. BMI, excess weight loss (EWL), total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), very low density lipoprotein (VLDL), triglyceride, hemoglobin A1c (HbA1c), total protein, albumin values were recorded preoperatively and at the time of residual volume measurement. Results: There were 49 subjects with a mean SD preoperative BMI of 47.26+-6.21 kg/m2 and mean age 37.51+-10.88 years. Mean residual volume was 155.36+-56.71 cc. Residual volume was associated with postoperative mean BMI (28.44+-3.23 kg/m2; p 0.001) and postperative mean EWL%(29.27+-7.66; p=0.001). Residual gastric volume was also negative correlated with postoperative mean HbA1c (p=0.004). HbA1c (p=0.828), LDL (p=0.661), HDL (p=0.848), triglycerides (p=0.641), VLDL (p=0.794), total protein relation (p=0.539) and albumin (p=0.824) were analyzed before and after surgery and were not correlated with residual gastric volume., Conclusion: The smaller the residual gastric volume after laparoscopic sleeve gastrectomy, the higher the %EWL and the greater the decrease in HbA1c. This study show that laparoscopic sleeve gastrectomy is an effective surgical procedure in patients with Type 2 diabetes mellitus., (Celsius.)

Introduction: The first case of novel SARS-COV-2 (COVID-19) in Pakistan was detected on 26 February 2020. Pharmacological and non-pharmacological strategies have been tried to lessen the mortality and morbidity burden. Various vaccines have been approved. The Drug Regulatory Authority of Pakistan gave emergency approval for Sinopharm (BBIBP-CorV) COVID-19 vaccine in December 2021. The phase 3 trial of BBIBP-CorV included only 612 participants aged 60 years and above. The primary aim of this study was to assess the safety and efficacy of BBIBPP-CorV (Sinopharm) vaccine within the Pakistani adult population aged 60 or above. The study was carried out in the Faisalabad district of Pakistan., Methods: A test negative case-control study design was used to assess safety and efficacy of BBIBP-CorV in individuals aged 60 and above against symptomatic infection, hospitalisations and mortality due to SARS-CoV-2 among vaccinated and unvaccinated individuals. ORs were calculated using logistic regression model at 95% CI. ORs were used to calculate the vaccine efficacy (VE) by using the following formula.VE= (1-OR) ×100., Results: 3426 individuals with symptoms of COVID-19 were PCR tested between 5 May 2021 and 31 July 2021. The results showed that Sinopharm vaccine 14 days after the second dose was efficient in reducing the risk of symptomatic COVID-19 infection, hospitalisations and mortality by 94.3%, 60.5% and 98.6%, respectively, among vaccinated individuals with a significant p value of 0.001., Conclusion: Our study showed that BBIBP-CorV vaccine is highly effective in preventing infection, hospitalisations and mortality due to COVID-19., (© The Author(s) 2022. Published by Oxford University Press on behalf of Postgraduate Medical Journal. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

This study used the gas-blowing method to develop a nanoporous hydrogel using poly (3-sulfopropyl acrylate-co-acrylic acid-co-acrylamide) grafted onto salep. The synthesis of the nanoporous hydrogel was optimized by various parameters for maximum swelling capacity. The nanoporous hydrogel was characterized using FT-IR, TGA, XRD, TEM, and SEM analyses. Images from SEM showed numerous pores and channels in the hydrogel with an average size of about 80 nm, forming a honeycomb-like shape. The change in surface charge was investigated by zeta potential and revealed that the surface charge of the hydrogel ranged from 20 mV at acidic conditions to -25 mV at basic conditions. The swelling behavior of optimum superabsorbent hydrogel was determined under different environmental conditions, such as different pH values, ionic strengths of the environment, and solvents. In addition, the swelling kinetics and the absorbance under loading of the hydrogel sample in different environments were investigated. Moreover, Methyl Orange (MO) dye was removed from aqueous solutions using the nanoporous hydrogel as an adsorbent. The adsorption behavior of the hydrogel was examined under various conditions, and the adsorption capacity of the hydrogel was found tobe 400 mg g -1 . The maximum water uptake was obtained under the following conditions: Salep weight = 0.01 g, AA = 60 μL, MBA = 300 μL, APS = 60 μL, TEMED = 90 μL, AAm = 600 μL, and SPAK = 90 μL. Lastly, the adsorption kinetics was studied by employing pseudo-first-order, pseudo-second-order, and intra-particle diffusion models., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Inc.)

The low water solubility of an active pharmaceutical ingredient (aripiprazole) is one of the most critical challenges in pharmaceutical research and development. This antipsychotic drug has an inadequate therapeutic impact because of its minimal and idiosyncratic oral bioavailability to treat schizophrenia. The main objective of this study was to improve the solubility and stability of the antipsychotic drug aripiprazole (ARP) via forming binary as well as ternary inclusion complexes with hydroxypropyl-β-cyclodextrin (HPβCD) and L-Arginine (LA) as solubility enhancers. Physical mixing and lyophilization were used in different molar ratios. The developed formulations were analyzed by saturation solubility analysis, and dissolution studies were performed using the pedal method. The formulations were characterized by FTIR, XRD, DSC, SEM, and TGA. The results showcased that the addition of HPβCD and LA inclusion complexes enhanced the stability, in contrast to the binary formulations and ternary formulations prepared by physical mixing and solvent evaporation. Ternary formulation HLY47 improved dissolution rates by six times in simulated gastric fluid (SGF). However, the effect of LA on the solubility enhancement was concentration-dependent and showed optimal enhancement at the ratio of 1:1:0.27. FTIR spectra showed the bond shifting, which confirmed the formation of new complexes. The surface morphology of complexes in SEM studies showed the rough surface of lyophilization and solvent evaporation products, while physical mixing revealed a comparatively crystalline surface. The exothermic peaks in DSC diffractograms showed diminished peaks previously observed in the diffractogram of pure drug and LA. Lyophilized ternary complexes displayed significantly enhanced thermal stability, as observed from the thermograms of TGA. In conclusion, it was observed that the preparation method and a specific drug-to-polymer and amino acid ratio are critical for achieving high drug solubility and stability. These complexes seem to be promising candidates for novel drug delivery systems development.

Background: Preliminary data suggest that the prevalence of pulmonary hypertension (PH) in patients with COVID-19 is around 13%, but its prognostic role remains unclear. Approximately 3% of patients develop chronic thrombo-embolic pulmonary hypertension (CTEPH) following diagnosis of acute pulmonary embolism (PE). It is recommended that patients are screened for CTEPH if they remain symptomatic 3 months following diagnosis of PE. The primary aim of the study was to assess the chances of persistent PH following PE secondary to COVID-19., Methods: We conducted a retrospective cohort study at a District General Hospital (DGH) in the United Kingdom. All patients diagnosed with COVID-19 and PE between April 2020 and October 2021 were examined. Patients were divided into two groups:·COVID-19 and PE with comorbidities (excluding pre-existing PH) and·COVID-19 and PE without comorbidities. We compared the ECHO features suggestive of PH between the two groups at the time of diagnosis of PE and at 3 months following treatment., Results: 80 patients were included in the study (49 with comorbidities and 31 with no comorbidities). Average age of comorbidities and no comorbidities groups were 73 years and 70 years, respectively. Average PaO 2 /FiO 2 ratio for comorbidities and no comorbidities groups were 170 and 195, respectively. Fourteen patients (13 with comorbidities and 1 with no comorbidities) died in total. Results showed that risk of persistent PH and subsequent mortality following PE in COVID-19 is 4.17 times and 1.32 times more in comorbidity group as compared to no comorbidity group, respectively ( p < 0.001)., Conclusion: Patients with comorbidities are at high risk of persistent PH and mortality due to PE secondary to COVID-19.

Idiopathic Granulomatous Mastitis (IGM) is a disease that clinically mimics breast cancers with symptoms of pain, edema, erythema, nipple discharge, nipple retraction, and fistula. Although IGM is considered to be formed by autoimmune responses or infections, the molecular mechanism behind formation and progress is unknown. Therefore, in this study, we aimed to investigate molecular mechanisms underlying IGM formation, progress, and recurrence by monitoring the changes at the proteome level. Protein extracts prepared from IGM (n = 15) and within-control tissues (n = 15) were subjected to nHPLC followed by LC-MS/MS proteomic analysis. Label-free quantitation analysis revealed that sixty differentially regulated between the two groups. Those proteins were classified based on their role in metabolic pathways using bioinformatics tools. Based on DAVID analysis, 16 of the differently regulated proteins were associated with the immune system, while 17 proteins were involved in cancer metabolism. STRING analysis showed that five of the differentially regulated proteins were associated with combined immune deficiency which were PNP, TAP1, ITGAL, PRKDC, and PTPRC while the other proteins were involved in insulin response and neutrophil degranulation. This study is one of the very few studies that investigated the changes in protein expressions of IGM tissues compared to controls. For the first time, we have shown the relationship of IGM with the immune system at the protein level and also underlined the cancer-like behavior of the disease. Furthermore, the proteins that were pointed out as combined immune deficiency-related proteins may have value as diagnostic markers for idiopathic granulomatous mastitis although further studies are needed to shed more light on the pathogenesis of the disease., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Pakistan has vaccinated over 122 million people. The two vaccines in widespread use are inactivated (BBIBP-CorV & Sinovac) and mRNA forms (BNT162b2 & mRNA-1273). The primary aim of this study was to compare these two forms of vaccines against unvaccinated individuals collectively and then to see which one is more efficacious., Methods: Case-control study design was used to compare the efficacy of inactivated and mRNA vaccines against symptomatic infection, hospitalisations and mortality due to Severe Acute Respiratory Syndrome Coronavirus 2 between vaccinated and unvaccinated individuals. We derived recovery time from illness for both vaccines. Furthermore, we also compared the vaccines against similar parameters (symptomatic disease, hospitalisations and mortality). We calculated crude odds ratios for each dependent variable. p value of 0.05 or below was considered significant., Results: Vaccinated individuals were significantly protected from hospitalisations and mortality compared to unvaccinated individuals ( p  < 0.001). There was no difference in protection from symptomatic disease ( p  = 0.28), hospitalisations ( p  = 0.59) and mortality ( p  = 0.53) between two forms of vaccines. mRNA vaccine had better recovery time than all other vaccines ( p  < 0.001)., Discussion: Our study showed that vaccinated individuals are at low risk of hospitalisations and mortality even without a booster and both vaccine forms are equally effective at preventing hospitalisations and mortality.

Obesity is associated with endothelial dysfunction and this relationship is probably mediated in part by inflammation. Objective: The current study evaluated the effects of etanercept, a tumor necrosis factor-alpha (TNF-α) inhibitor, on endothelial and vascular reactivity, endothelial nitric oxide synthase (eNOS) immunoreactivity, and serum and aortic concentrations of TNF-α in a diet-induced rat model. Design and results: Male weanling Wistar rats were exposed to a standard diet and cafeteria diet (CD) for 12 weeks and etanercept was administered during CD treatment. Isolated aortas of the rats were used for isometric tension recording. Carbachol-induced relaxant responses were impaired in CD-fed rats, while etanercept treatment improved these endothelium-dependent relaxations. No significant change was observed in papaverine- and sodium nitroprusside (SNP)-induced relaxant responses. eNOS expression decreased in CD-fed rats, but no change was observed between etanercept-treated CD-fed rats and control rats. CD significantly increased both the serum and the aortic levels of TNF-α, while etanercept treatment suppressed these elevated levels. CD resulted in a significant increase in the body weight of the rats. Etanercept-treated (ETA) CD-fed rats gained less weight than both CD-fed and control rats.

Background: Primary hyperparathyroidism (pHPT) caused by a single benign parathyroid adenoma is a common endocrine disorder that is affected by regional differences. Living in different geographical regions reveals differences in the laboratory results and pathological findings, but studies on this subject are not sufficient. The article focuses on biochemical and pathological effects of geographical differences in parathyroid adenoma. In addition, the present study seeks to elaborate on treatment methods and effectiveness of screening in geographical area of Bulgaria and Turkey., Method: In this prospective study, 159 patients were included from 16 centres. Demographic characteristics, symptoms, biochemical markers and pathologic characteristics were analysed and compared between 8 different regions., Results: Patients from Turkish Black Sea had the highest median serum calcium (Ca) level, whereas patients from Eastern Turkey had the lowest median serum phosphorus (P) level. On the other hand, there was no significant difference between Ca, parathormone (PTH) and P levels according to regions. Patients from Eastern Turkey had the highest adenoma weight, while patients from Bulgaria had the lowest adenoma weight. The weight of adenoma showed statistically significant differences between regions (p < 0.001). There was a correlation between adenoma weight and serum PTH level (p = 0.05) and Ca level (p = 0.035)., Conclusion: This study has provided a deeper insight into the effect of the regional differences upon clinicopathological changing and biochemical values of pHTP patients with adenoma. Awareness of regional differences will assist in biochemical screening and treatment of this patient group., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interests. Availability of data and material (data transparency):, (Copyright © 2021. Published by Elsevier Taiwan LLC.)

Objectives: COVID-19 disease, which rapidly became a pandemic, led to significant changes in the provision of health services. This included radical changes to the supply and delivery of routine services to release resources for emergency care. During this process, a range of restrictions were imposed including the recommended rules to be followed before, during and after surgery. Health services provided for breast cancer diagnosis, treatment and follow-up have also undergone enforced changes meaning the diagnosis, treatment, and follow-up of patients with priority has come to the fore. In this study, the effect of the COVID-19 pandemic in Turkey, between March 11, 2020 and May 31, 2020 was assessed in comparison to pre-pandemic practice in terms of divided into two periods, and breast cancer diagnosis, treatment, and follow-up., Material and Methods: Surgeons dealing with breast cancer treatment and registered to SENATURK (Turkish Senology Academy) were contacted online. The period was divided into two, between March 11 th and April 30 th and May 1 st to May 31 st , 2020. Surgeons were requested to complete two electronic evaluation forms, one for each period, investigating change in practice. Only complete responses for both periods were included in the analysis., Results: There were 93 respondents. Except for less multidisciplinary breast councils, there was no delay in radiological and pathological diagnoses. The number of breast cancer surgeries increased in Period 2, and more COVID-19 positive breast cancer patients were operated in Period 2. Benign breast patients were delayed less frequently in Period 2. In the statistical analysis performed between the two groups, it was found that only a significant difference was in the number of outpatients with benign breasts., Conclusion: With sufficient awareness of the risks of COVID-19 and with individual protection, breast cancer treatment was not affected during the assessed period of active pandemic in Turkey., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare., (Copyright © 2021, Turkish Surgical Society.)

A new series of 2,4-disubstituted benzo[ g ]quinoxaline molecules have been synthesized, using naphthalene-2,3-diamine and 1,4-dibromonaphthalene-2,3-diamine as the key starting materials. The structures of the new compounds were confirmed by spectral data along with elemental microanalyses. The cytotoxic activity of all synthesized benzo[ g ]quinoxaline derivatives was assessed in vitro against the breast MCF-7 cancer cell line. The tested molecules revealed good cytotoxicity toward the breast MCF-7 cancer cell line, especially compound 3 . The results of topoisomerase IIβ inhibition assay revealed that compound 3 exhibits potent inhibitory activity in submicromolar concentration. Additionally, compound 3 was found to cause pre-G1 apoptosis, and slightly increase the cell population at G1 and S phases of the cell cycle profile in MCF-7 cells. Finally, compound 3 induces apoptosis via Bax activation and downregulation of Bcl2, as revealed by ELISA assay.

Purpose: The COVID-19 pandemic has changed the way many health institutions approach their workload. Physicians managing patients with cancer now have to deal not only with the disease but also the restrictions and limitations imposed because of the global pandemic. We aimed to determine how surgical preferences in breast cancer management were affected globally using a questionnaire-based survey., Methods: Under the auspices of the Turkish Senology Society (SENATURK) we asked 122 surgeons from 27 countries to reply to a 26-question survey designed to measure the impact of COVID-19 on their surgical practice when treating patients with breast cancer., Results: The characteristics of participant surgeons were statistically similar when comparing the participants' answers from Turkey and other countries. From the responses given to our questionnaire, it was understood that breast cancer surgery decreased by 25% (p<0.05) in institutions all over the world, including Turkey, but there was no change in the approach technique to the axilla., Conclusions: Globally breast surgeons have adapted to the new normal due to the COVID-19 pandemic. Many surgical approaches and some follow up protocols have been changed, although the degree of change has varied from country to country. In addition, the availability of multidisciplinary case conferences has been reduced in some centers which may affect the quality of services provided to patients.

Medical visual documentation is an especially important source of information for medicine. Medical photography has become the main method of medical visual documentation. In breast surgery, as in all other medical branches, medical photography has a major role in education and patient follow-up. The published literature was reviewed for medical photography techniques. In co-operation with the University fine arts faculty photography unit, standards for clinical, intra-operative and specimen photography in breast surgery were analyzed and identified. As a result, we have made recommendations for obtaining high quality and academically more effective medical photographs in breast surgery., (Celsius.)

Background and objectives: Sentinel lymph node biopsy is important for metastasis surveillance in the management of a number of human cancers. Identification of sentinel lymph nodes may be facilitated by the use of several methods including methylene blue injection. However tissue necrosis is a known effect of methylene blue application. This study aimed to investigate the effects of methylene blue injection on skin flaps using a rodent model. Methods: Modified McFarlane flaps were prepared using Wistar Albino rats. Local injection of methylene blue was given to one group while saline was injected into the control group. A third group received systemic methylene blue via intraperitoneal injection. Observational and histological comparison was made between the groups to investigate the necrotic effects of methylene blue on skip flaps. Results: The control group's surviving flap areas were significantly larger than local methylene blue group's surviving flap area. However, there was no significant difference in skin flap survival area between the control group and the systemic methylene blue group. Furthermore, there is no significant difference between local and systemic methylene blue group's surviving flap areas. Conclusions: Local methylene blue injection increases skin necrosis and decreases rates of surviving flap areas in an experimental rat models.

The objective of this study was to assess the levels of contamination by toxic metals (Pb, Al, Ni, Cd and As) that may be present in 25 infant pharmaceutical herbal products and 15 traditional herbs in Jordan. Both products and medicinal herbs are currently prescribed by paediatricians. They are available as over-the-counter medicines and are sold the in herbal market, ensuring easy accessibility for parents. Inductively coupled plasma-optical emission spectroscopy (ICP-OES), with limit of detections (LODs) of 0.10, 1.00, 0.20, 0.15 and 2.00 mg.kg -1 for Pb, Al, Ni, Cd and As respectively, was employed to measure the levels of toxic metals in the samples. Pb, Al and Ni were detected in 88, 76 and 4% of the analysed samples of pharmaceutical herbal products and in 93, 87 and 13% of the analysed samples of traditional herbs, respectively. Neither Cd or As were detected in all analysed samples. The data obtained were subsequently compared by referral to the acceptable limits of toxic heavy metals according to World Health Organisation (WHO) standards. Largely, the results showed acceptable toxic metal levels in the finished pharmaceutical products and the traditional medicinal herbs for infants. One exception to this was Persian Thyme (Satureja thymbra) with Pb content of 41.18 mg.kg -1 . Also, the daily intake of detected metals through pharmaceutical herbal products was found to be lower than the daily tolerable intake limit set by the regulatory bodies, except of 8% of products that exceeded the tolerable daily intake of Pb set by US FDA, as compared to traditional medicinal herbs, where the tolerable daily intake for Pb, Al and Ni were exceeded in 40, 60 and 8% of the analysed herbs, respectively. The results obtained revealed that the excessive use of medicinal plants as alternative medicine should be used with caution keeping in mind the safety factor in infants.

N,N`-Bis[(1,2-didehydro-1-hydroxy-2-thioxopyrid-4-yl)-carbonyl]- L-lysine (HTPL) is a novel newly synthesized compound intended to be used for the chelation of lead in intoxicated animals. Subchronic lead intoxication experiments were carried out on Wistar male rats; these rats were intoxicated with lead and then treated with HTPL. Results were compared with those obtained with known compounds used for lead chelation therapy, such as disodium ethylnediaminetetraacetic acid (CaNa 2 EDTA) and meso-2,3-dimercaptosuccininc acid (DMSA), using different routes of administration. Biological samples of whole blood and urine were collected and analyzed for urinary proporphyrins, δ-aminolevulinic acid dehydratase, and zinc protoporphyrin. Results revealed that HTPL can remarkably reverse the toxic effects of lead intoxication at biochemical levels. Additionally, results showed that this agent is as good or even more potent than calcium disodium ethylnediaminetetraacetic acid (CaNa 2 EDTA) and meso-2,3-dimercaptosuccininc acid (DMSA) in reversing the toxic effect of lead. More importantly, HTPL was found effective when administrated intraperitoneally and orally., (Copyright © 2018 Elsevier GmbH. All rights reserved.)

Objective: Aim of this prospective study was to determine the complications of different treatment modalities for breast cancer and assess their impact on patients' quality-of-life and psychological status., Materials and Methods: Patients surgically treated for early-stage breast cancer were enrolled in the study. Complications after treatment and quality-of-life parameters were measured and recorded., Results: 218 patients, all female with a median age of 48 (19-82) years, were included in the study. In early period, significant limitation of shoulder movements, increased pain and decreased in functional capacity were observed, whereas in mid-term, all shoulder movements, as well as pain and functional capacity returned normal. In both early period and mid-terms, anxiety scores were significantly decreased, whereas depression scores were significantly increased. In early period, there was a significant decrease in physical and mental area scores. Social area scores were significantly increased, whereas environmental, mental and physical area scores were significantly decreased in mid-term and late period., Conclusion: Overall, patients' quality-of-life was found to be significantly deteriorated in both early period and mid-term and returned to pre-treatment period at long term follow up., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare.

Objectives: Constipation is the most commonly seen defecation problem related to several environmental factors. Defecation is learned in the childhood anal period in which anal characteristic features appear. Problems in the childhood anal period may affect not only characters but also defecation function. This study aimed to evaluate the relationship between constipation and anal characteristic features of participants with functional constipation., Material and Methods: Patients with functional constipation were included into the study according to the ROME III criteria. Patients with irritable bowel disease, slow transit constipation, outlet obstruction constipation, malignancy, and psychiatric diseases were excluded from the study. Patients filled out Personality Belief Questionnaire, Hospital Anxiety and Depression Scale, and Obsessive Belief Questionnaire. The results were compared with healthy individuals., Results: A total of 47 patients with functional constipation were included in the study. Avoidant, obsessive-compulsive, antisocial, narcissistic, and paranoid personality traits were found to be higher in patients with constipation than in the control group. Perfectionism/certainty, importance and control, and hospital anxiety scores were found to be higher in patients with constipation than in the control group., Conclusion: Constipation may be related to several factors, such as socioeconomic environment, emotional stress, age, and diet, among others. Here, it was found that anal-retentive behavior features are prominent in functional constipation. Biofeedback, which can be regarded as psychotherapy of defecation control, can be used for treatment., Competing Interests: Conflict of Interest: The authors have no conflicts os interest to declare., (Copyright © 2019, Turkish Surgical Society.)

Objectives: Constipation is the most commonly seen defecation problem and related with several environmental factors. Learning defecation is learned in the childhood anal period in which anal characteristic features appear. Problems in the anal period of childhood may affect not only the characters but also the defecation function. We aimed to evaluate the relationship between constipation and anal characteristic features of participants with functional constipation., Material and Methods: Patients with functional constipation were included in the study according to the ROME III criteria. Patients with irritable bowel disease, slow transit constipation, outlet obstruction constipation, malignancy, and psychiatric diseases were excluded from the study. Patients filled out the Personality Belief Questionnaire, Hospital Anxiety and Depression Scale, and Obsessive Belief Questionnaire. The results were compared with healthy individuals., Results: A total of 47 patients with functional constipation were included in the study. The avoidant, obsessive-compulsive, antisocial, narcissistic, and paranoid personality beliefs were found to be higher in patients with constipation than in the control group. Perfectionism/certainty, importance and control, and hospital anxiety scores were found to be higher in patients with constipation than in the control group., Conclusion: Constipation may be related to several factors, such as socioeconomic environment, emotional stress, age, and diet, among others. Here we found that anal-retentive behavior features are prominent in functional constipation. Biofeedback, which can be regarded as psychotherapy of defecation control, can be used for treatment.

Objective: Hyperthermic preconditioning has been shown to protect against different insults in experimental studies. However, clinical studies assessing its effects remain limited. The aim of this study was to investigate the effects of hyperthermic preconditioning on the rate of surgical site infection and inflammatory reaction in patients undergoing elective colorectal cancer surgery., Material and Methods: Patients with colorectal cancer, scheduled to undergo elective surgery were enrolled in this prospective randomized study. Patients were randomly assigned to either the hyperthermic preconditioning group or control group. Postoperative superficial and deep surgical site infection were recorded. Blood samples were collected from all the patients in the hyperthermic preconditioning group prior to the application of hyperthermia 12 h before surgery, immediately prior to surgery, and 4 h and 24 h postoperatively. For the control group, blood samples were obtained within the same periods without the application of hyperthermia. Levels of interleukin-1, IL-6, and tumor necrosis factor-α were measured from blood samples., Results: Twenty patients were randomized to the hyperthermic preconditioning group and 21 to the control group. No significant difference was found in deep or superficial surgical site infection between the groups. No significant difference in the tumor necrosis factor-α, interleukin-1, and IL-6 levels was found in serum samples collected before hyperthermia, during the operation, and postoperatively., Conclusion: This study showed that hyperthermic preconditioning has no effect on the surgical site infection and cytokine response in patients undergoing elective surgical intervention for colorectal cancer.

Objectives: An increase in the prevelance of obesity is a worldwide problem. It many serious health problems, especially cardiovascular diseases and type-2 diabetes mellitus. Conservative therapies such as diet modification and exercise are the most preferable obesity treatments. Bariatric surgery is the most appropriate treatment in suitable patients. Several studies showed that a very low number of patients prefer bariatric surgery even though it would be appropriate. This study aimed to assess and raise awareness about the obesity level, its complications, and treatment methods, especially bariatric surgery among obese patients in Kocaeli, which is one of the most socio-economically developed cities, as well as the leading industrial city in Turkey., Material and Methods: A survey was designed to assess the knowledge about obesity, its complications, and bariatric surgery in the Kocaeli province. It was administered to 232 adult patients with a body mass index greater than 30 in different outpatient clinics where patients suffering obesity were treated., Results: It has been seen that although the contribution factors and complications of obesity are well known, awareness of the body mass index was insufficient. Most of patients have tried to lose weight at least once and most patients have heard of bariatric surgery before. However, the details were not well known. The gastric band method is the most known method, and the most known risk of surgery was death. The main source of knowledge about bariatric surgery was television. The increasing body mass index affects patients' attitudes toward the surgery positively., Conclusion: Knowledge of bariatric surgery is inadequate in the Kocaeli province, which is one of the most socio-economically developed cities, as well as the leading industrial city in Turkey. More social responsibility projects and more objective elucidating via television and social media are also needed to increase the awareness of bariatric surgery.

Objective: Idiopathic granulomatous mastitis is a breast disease without a definitive etiology. There are no definitive classifications, scoring systems or certitudes. The aim of this study is to define the factors related to the recurrence and design a scoring system., Material and Methods: Patients who were admitted to the general surgery department with symptoms of granulomatous mastitis were evaluated by ultrasonography and underwent antibiotic therapy. Granulomatous mastitis is diagnosed by core biopsy and treated with steroid therapy. Patients without improvement underwent surgery and were included in the study. In total, 53 patients were included in the study. There were 8 recurrent cases. Factors related with recurrences were defined., Results: Number of births over 2, duration of lactation more than 18 months, body mass index greater than 31, having fistula in physical examination, abscess collection in ultrasonographic examination, and luminal inflammation score over 2 were scored as 1. Severity score in recurrent cases were 5.1±0.6 whereas 1.9±1.0 in nonrecurrent cases., Conclusion: Granulomatous mastitis score is a tool targeted at predicting the risk of recurrences. The patients with these factors are more prone for recurrences., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Objective: Breast cancer is a heterogeneous disease with different histological types. Ductal breast cancer constitutes the vast majority of the breast cancers. However limited data are present in the rest of breast cancers called special or rare type breast cancers. Here in this study, we tried to describe the clinical features of special type breast cancers in our center., Materials and Methods: Retrospective descriptive study was performed in Kocaeli University School of Medicine, Department of General Surgery between January 2000 and January 2016. Women diagnosed with primary breast cancer other than ductal carcinoma were included to the study. In total, 101 patients were evaluated according to histologic types, molecular types, Tumor Node Metastasis (TNM) stages, and grades. Survival of the patients was also evaluated., Results: Medullary and metaplastic types showed basal type; tubular, mucinous, micropapillary carcinoma, cribriform, lobular and apocrine tumors showed luminal type molecular pattern. Neither the existence of ductal carcinoma nor any histologic types had any effects on survival. Apocrine tumors were presented in younger ages., Conclusion: Histologic types of breast cancer are closely related with the molecular types of the breast cancer. Tumor size, grade, stage of the disease can show differences among histological types which might be due to the genetic background, late onset or limited number of patients. In order to achieve more significant results, multicenter national studies are needed., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

A number of new mono- and dihydroxypyridinethione ligands have been synthesized via reaction of dimethylamine and amino acid esters with the active amide obtained from the reaction of 1-hydroxy-2-pyridinethione-4-carboxylic acid (1) and 1,1'-carbonyldiimidazole in DMF. Moreover, the lead complexes of these new ligands were also prepared. Structures of the newly synthesized compounds have been confirmed by different spectroscopic methods such as IR, 1 H NMR, and 13 C NMR, and by elemental analysis. The effect of these synthesized ligands on the excretion of lead, iron, and zinc, and their distribution in kidneys, liver, and bones in acutely intoxicated rats was investigated and results, for lead, were compared with those of the known drug meso-2,3-dimercaptosuccinic acid (DMSA). Results obtained revealed that compound 5 exhibits remarkable ability in total fecal and urinary excretion of lead and was superior to DMSA. In addition, results show that the concentration of lead in soft tissues and bones was lower in rats treated with HTPL than those treated with DMSA. Furthermore, the concentration of lead in liver tissues obtained from sub-chronic lead-intoxicated rats treated with HTPL was lower than those treated with DMSA and calcium disodium ethylenediaminetetraacetic acid (CaNa 2 EDTA)., (Copyright © 2017 Elsevier GmbH. All rights reserved.)

Background/aim: To unveil the pathophysiology of primary hyperparathyroidism, molecular details of parathyroid hyperplasia and adenoma have to be revealed. Such details will provide the tools necessary for differentiation of these two look-alike diseases. Therefore, in the present study, a comparative proteomic study using postoperative tissue samples from the parathyroid adenoma and parathyroid hyperplasia patients was performed., Materials and Methods: Protein extracts were prepared from tissue samples (n=8 per group). Protein pools were created for each group and subjected to DIGE and conventional 2DE. Following image analysis, spots representing the differentially regulated proteins were excised from the and used for identification via MALDI-TOF/TOF analysis., Results: The identities of 40 differentially-expressed proteins were revealed. Fourteen of these proteins were over-expressed in the hyperplasia while 26 of them were over-expressed in the adenoma., Conclusion: Most proteins found to be over-expressed in the hyperplasia samples were mitochondrial, underlying the importance of the mitochondrial activity as a potential biomarker for differentiation of parathyroid hyperplasia from adenoma., (Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Objective: The aim of this present study was to assess the impact of COX-2 over-expression on breast cancer survival., Material and Methods: Non-metastatic invasive breast cancer patients who received adequate loco-regional and systemic treatments were evaluated. Patients' demographic, clinical, pathologic, and treatment-related and survival data were retrieved from their hospital files. COX-2, estrogen/progesterone receptor (ER/PR), HER-2/neu expression and Ki67 index of the tumors were determined immunohistochemically. As the primary objective, COX-2 positive and negative patients were compared in terms of overall (OS), disease-free (DFS) and breast cancer-specific survival (BCSS). Secondary objectives were to assess the independent prognostic factors for survival. In addition, the correlation of COX-2 expression with conventional prognostic and predictive factors of breast cancer was assessed., Results: Two hundred and seventeen patients who underwent adequate breast cancer treatment between November 2004 and December 2013 were included in the study. The median follow-up was 37 months (range: 5-107). Eighty-one (37%) patients were COX-2 positive. OS, DFS, and BCSS were similar in COX-2 positive and negative patients. Ki67 index and age were significantly correlated with COX-2 expression (r=-0.116; p=0.02; r=0.159; p=0.02). PR expression was found to be the only independent factor for predicting OS, tumor size and molecular subtype classification were found to be the only independent factors for predicting DFS, and PR expression was found to be the only independent factor for predicting BCSS., Conclusion: Among the independent predictive and prognostic factors of breast cancer, COX-2 over-expression was only correlated with Ki67 index and age.

Multidisciplinary approach is recommended for the diagnosis and treatment of cancer, in order to optimize quality of life and survival. Multidisciplinary cancer teams that are used for this purpose enable communication between professionals. Multidisciplinary cancer meetings are pre-programmed regular meetings where cancer patients are evaluated on an individual basis, and where the multidisciplinary treatment of patients is planned based on evidence. Currently, application of appropriate treatment in a timely manner carries as great significance as early diagnosis. For this purpose, standards of multidisciplinary approach are significant. Disease specific multidisciplinary breast cancer meetings are essential in the treatment of breast cancer. The standards and organization of these teams have been scientifically determined. It is recommended that these multidisciplinary breast cancer meetings should be held regularly and the required infrastructure should be provided.

Breast health is a subject of increasing importance. The statistical increase in the frequency of breast cancer and the consequent increase in death rate increase the importance of quality of services to be provided for breast health. For these reasons, the minimum standards and optimum quality metrics of breast care provided to the community are determined. The quality parameters for breast care service include the results, the structure and the operation of services. Within this group, the results of breast health services are determined according to clinical results, patient satisfaction and financial condition. The structure of quality services should include interdisciplinary meetings, written standards for specific procedures and the existence of standardized reporting systems. Establishing breast centers that adopt integrated multidisciplinary working principles and their cost-effective maintenance are important in terms of operation of breast health services. The importance of using a "reviewing/auditing" procedure that checks if all of these functions existing in the health system are carried out at the desired level and an "accreditation" system indicating that the working breast units/centers provide minimum quality adequacy in all aspects, is undeniable. Currently, the accreditation system for breast centers is being used in the European Union and the United States for the last 5-10 years. This system is thought to provide standardization in breast care services, and is accepted as one of the important factors that resulted in reduction in mortality associated with breast cancer., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Medical education, both graduate and postgraduate, is given at medical schools and affiliated teaching hospitals. The training at these institutions is necessary and valuable. In each field of the medical profession, the relevant science is being developed and changed constantly. Training of medical staff and auxilliary professionals must be adaptable to changes in the field. Also, the development of standards for the diagnosis and treatment of diseases is important. Independent institutions, called academies, serve an extremely useful task in the continuing further training that needs to be adjusted according to individual needs. Academies are independent and free from bureaucracies. Standardized records are uniform and comparable at these institutions. Both patients and medical staff receive training from these institutions. In this way, a high standard is provided in medicine, error rates are decreased and patient satisfaction is increased. Breast cancer, the most common tumor in women, is a serious cause of morbidity and mortality. The European Institute of Oncology (EIO) in Milan, Italy and the European Academy of Senology in Duesseldorf, Germany play important roles in establishing the standards of breast care. They provide substantial training for physicians to achieve high quality in breast cancer management. SENATURK (Senoloji Akademisi, Turkish Academy of Senology) was established in 2010 in Istanbul, Turkey. Both national and international scientists and physicians including eminent senologists are currently faculty members of this young organization. SENATURK collaborates with other institutions in Europe. Its missions include developing training programs for each level of the profession, as well as developing data recording systems and electronic learning tools for breast cancer prevention, diagnosis, treatment, rehabilitation and palliation. Briefly, SENATURK plays a significant role as the opinion leader on every aspect of health care related to conditions and diseases of the breast.

Adult intussusception, which is a rare condition, generally requires surgical treatment. A 25-year-old-male with abdominal pain was diagnosed as ileal intussusception with computerized tomography. The patient underwent diagnostic laparoscopy, laparoscopic small bowel resection and anastomosis. The pathologic evaluation revealed heterotopic gastric mucosa. Heterotopic gastric mucosa is rarely seen in ileum and is difficult to diagnose preoperatively. Excision is the choice of treatment. Laparoscopic treatment can be preferred in adult intussusception even in urgent cases.

Background: Pharmacist-patient association is a decisive component in improving health care system. To offer patient centred services, the pharmacists need to fully understand patients' perspectives and views to meet their needs and expectations., Purpose: To evaluate patients' perception of pharmacist and pharmacy practice in Pakistan., Methods: A cross sectional study was conducted between July and September 2012 on patients attended out-patient clinic in a teaching hospital of Pakistan. By using raosoft sample size calculator, questionnaires were distributed to a sample of 376 patients. Questionnaire included different section which evaluated the demographic information, frequency and reason of interaction, perception and choice of pharmacy. Statistical analysis was done by using SPSS (v.17)., Results: A total of 301, out of 376, surveys returned giving a response rate of 80%. 51.8% (n = 156) participants interacted with pharmacist on regular basis. The major reasons of interaction were drug alternative and drug availability queries (41.5%, n = 125 and 26.2%, n = 79). The finding also showed that 84.1% (n = 253) of participants agreed that pharmacists are important part of health care system. Interestingly, all the patients (n = 301) either agreed or strongly agreed that discount was the major influencing factor on their choice of pharmacy., Conclusion: The patients' perception of pharmacist in Pakistan was generally positive but their understanding is very primitive as majority of the patients are unaware of pharmaceutical care services. However, they are more devoted to witness such services being practiced in Pakistan. This transition in practice could be brought into certainty by proactive involvement of pharmacists in community setup.