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Introduction In 2020, the UK government established a large-scale testing programme to rapidly identify individuals in England who were infected with SARS-CoV-2 and had COVID-19. This comprised part of the UK government’s COVID-19 response strategy, to protect those at risk of severe COVID-19 disease and death and to reduce the burden on the health system. To assess the success of this approach, the UK Health Security Agency (UKHSA) commissioned an independent evaluation of the activities delivered by the National Health System testing programme in England. The primary purpose of this evaluation will be to capture key learnings from the roll-out of testing to different target populations via various testing services between October 2020 and March 2022 and to use these insights to formulate recommendations for future pandemic preparedness strategy. In this protocol, we detail the rationale, approach and study design.Methods and analysis The proposed study involves a stepwise mixed-methods approach, aligned with established methods for the evaluation of complex interventions in health, to retrospectively assess the combined impact of key asymptomatic and symptomatic testing services nationally. The research team will first develop a theory of change, formulated in collaboration with testing service stakeholders, to understand the causal pathways and intended and unintended outcomes of each testing service and explore contextual impacts on each testing service’s intended outcomes. Insights gained will help identify indicators to evaluate how the combined aims of the testing programme were achieved, using a mixed-methods approach.Ethics and dissemination The study protocol was granted ethics approval by the UKHSA Research Ethics and Governance Group (reference NR0347). All relevant ethics guidelines will be followed throughout. Findings arising from this evaluation will be used to inform lessons learnt and recommendations for UKHSA on appropriate pandemic preparedness testing programme designs; findings will also be disseminated in peer-reviewed journals, a publicly available report to be published online and at academic conferences. The final report of findings from the evaluation will be used as part of a portfolio of evidence produced for the independent COVID-19 government inquiry in the UK.Transparency declaration The lead author (the manuscript’s guarantor) affirms that the manuscript is an honest, accurate and transparent account of the study being reported; no important aspects of the study have been omitted, and any discrepancies from the study as planned have been explained.

Objective: In this study we aimed to investigate the relationship between acute exposure to air pollution and suicide attempts in children. Method: In this study, we retrospectively investigated over a 10-year period the likely relationship between suicide attempts in children, two air pollutants (PM10 and SO2), and meteorological factors affecting their life-endangering behavior. Results: We have determined that every one-unit increase in air pollution level of PM10 increased the risk of suicide attemps 1,002 times in all cases (p=0.016). One unit increase in air pressure, relative humidity, and wind speed increased the risk of suicide attemps in all cases 1,064 (p=0.014), 1,012 (p=0.045), 1,400 (p

Giriş ve Amaç: Tiroid fonksiyon bozukluğu, Hashimoto tiroiditi (HT) hastalarında kardiyovasküler hastalık (KVH) riskini artırdığı bilinmektedir. Ancak henüz tiroid fonksiyon bozukluğu gelişmemiş ötiroid HT hastalarında KVH riski ile ilgili veriler yetersizdir. Biz çalışmamızda asimetrik dimetilarjinin (ADMA), simetrik dimetil arjinin (SDMA), N-monometil-L-arjinin (L-NMMA), Arginine and Citrulline düzeylerinin bu riskin erken belirteçleri olarak kullanılıp kullanılamayacağını araştırmayı amaçladık. Gereç ve Yöntemler: Tiroid antikor pozitifliği ve ultrasonografik bulgularla HT tanısı alan, tiroid fonksiyon bozukluğu olmayan 65 pubertal kadın hasta ve 70 sağlıklı kontrol çalışmamıza dahil edildi. Gruplar arasında kan basıncı düzeyleri, tiroid fonksiyon testi verileri, tiroid antikor düzeyleri ve inflamatuar parametreler ile ADMA, SDMA, L-NMMA, Arjinin ve Sitrüllin düzeyleri karşılaştırıldı ve ADMA, SDMA, L-NMMA, Arjinin ve Sitrüllin düzeylerinin diğer KVH belirteçleriyle ilişkileri belirlendi. Bulgular : Hasta grubunda TSH, anti-TPO, anti-Tg ve ADMA değerleri yüksek saptanırken; sitrülin, arjinin ve arjinin/ADMA değerleri düşük olarak saptandı. Hasta grubunda ADMA ile SDMA, L-NMMA, sT3, total kolesterol, LDL, trigliserit, bel çevresi/kalça çevresi ve VKİ SSS değerleri arasında anlamlı pozitif korelasyon gözlenirken, arjinin/ADMA değerleri ile anlamlı negatif korelasyon saptandı. Sonuç: Çalışmamızda ötiroid Hashimoto tiroiditli hastalarda; erken dönemde, ADMA düzeylerinde artış saptandı. ADMA’nın antropometrik ölçümler, metabolik parametreler, SDMA ve L-NMMA ile olan ilişkileri nedeni ile ötiroid HT’li hastalarda KVH risk belirteci olarak kullanılabilir. Ancak daha büyük örneklem büyüklüğüne sahip ileri çalışmalara ihtiyaç vardır.

The adsorption properties of microporous carbon materials modified with iron citrate were investigated. The carbon materials were produced based on resorcinol-formaldehyde resin, treated in a microwave assisted solvothermal reactor, and next carbonized in the tube furnace at a temperature of 700 °C under argon atmosphere. Iron citrate was applied as a modifier, added to the material precursor before the synthesis in the reactor, in the quantity enabling to obtain the nanocomposites with C:Fe mass ratio equal to 10:1. Some samples were additionally activated using potassium oxalate or potassium hydroxide. The phase composition of the produced nanocomposites was determined using the X-ray diffraction method. Scanning and transmission electron microscopy was applied to characterize the changes in samples’ morphology resulting from the activation process and/or the introduction of iron into the carbon matrix. The adsorption of nitrogen from gas phase and dyes (methylene blue and congo red) from water solution on the obtained materials was investigated. In the case of methylene blue, the adsorption equilibrium isotherms followed the Langmuir isotherm model. However, in the case of congo red, a linear dependency of adsorption and concentration in a broad equilibrium concentration range was found and well-described using the Henry equation. The most efficient adsorption of methylene blue was noticed for the sample activated with potassium hydroxide and modified with iron citrate, and a maximum adsorption capacity of 696 mg/g was achieved. The highest congo red adsorption was noticed for the non-activated sample modified with iron citrate, and the partition coefficient for this material equaled 171 dm3/g.

All viruses, including SARS-CoV-2, the virus responsible for COVID-19, continue to evolve, which can lead to new variants. The objective of this study is to assess the agreement between real-world clinical data and an algorithm that utilizes laboratory markers and age to predict the progression of disease severity in COVID-19 patients during the pre-Omicron and Omicron variant periods. The study evaluated the performance of a deep learning (DL) algorithm in predicting disease severity scores for COVID-19 patients using data from the USA, Spain, and Turkey (Ankara City Hospital (ACH) data set). The algorithm was developed and validated using pre-Omicron era data and was tested on both pre-Omicron and Omicron-era data. The predictions were compared to the actual clinical outcomes using a multidisciplinary approach. The concordance index values for all datasets ranged from 0.71 to 0.81. In the ACH cohort, a negative predictive value (NPV) of 0.78 or higher was observed for severe patients in both the pre-Omicron and Omicron eras, which is consistent with the algorithm's performance in the development cohort.

This study aimed to evaluate the subjective Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms with self-reported ratings and objective neurocognitive tests among medical students. Also, we examined to identify the psychological factors that predict ADHD reporting among medical students. Medical students (N=57) completed self-report questionnaires, and neurocognitive tests were conducted for attention measures. Participants had a mean age of 20.3 years, and 69.0% were female. High levels of perceived stress, state-trait anxiety, and current and childhood ADHD symptoms were possible risk factors; however, only higher perceived stress was a risk factor for the possibility of reporting themselves as ADHD in medical school students [odds ratio [OR] =1.184, 95% confidence interval [CI] = [1.015; 1.381]]. Higher perceived stress levels, the more reported ADHD subjectively in medical students. Objective attention measures had no impact on reporting ADHD subjectively. Screening for perceived stress is necessary for medical students, especially those with subjective ADHD symptoms.

PURPOSETo evaluate the frequency of abdominal computed tomography (CT) findings in patients with coronavirus disease-2019 (COVID-19) and interrogate the relationship between abdominal CT findings and patient demographic features, clinical findings, and laboratory test results as well as the CT atherosclerosis score in the abdominal aorta.METHODSThis study was designed as a multicenter retrospective study. The abdominal CT findings of 1.181 patients with positive abdominal symptoms from 26 tertiary medical centers with a positive polymerase chain-reaction test for severe acute respiratory syndrome coronavirus 2 were reviewed. The frequency of ischemic and non-ischemic CT findings as well as the association between CT findings, clinical features, and abdominal aortic calcific atherosclerosis score (AA-CAS) were recorded.RESULTSIschemic and non-ischemic abdominal CT findings were detected in 240 (20.3%) and 328 (27.7%) patients, respectively. In 147 patients (12.4%), intra-abdominal malignancy was present. The most frequent ischemic abdominal CT findings were bowel wall thickening (n = 120; 10.2%) and perivascular infiltration (n = 40; 3.4%). As for non-ischemic findings, colitis (n = 91; 7.7%) and small bowel inflammation (n = 73; 6.2%) constituted the most frequent disease processes. The duration of hospital stay was found to be higher in patients with abdominal CT findings than in patients without any positive findings (13.8 ± 13 vs. 10.4 ± 12.8 days, P < 0.001). The frequency of abdominal CT findings was significantly higher in patients who did not survive the infection than in patients who were discharged after recovery (41.7% vs. 27.4%, P < 0.001). Increased AA-CAS was found to be associated with a higher risk of ischemic conditions in abdominal CT examinations.CONCLUSIONAbdominal symptoms in patients with COVID-19 are usually associated with positive CT findings. The presence of ischemic findings on CT correlates with poor COVID-19 outcomes. A high AA-CAS is associated with abdominal ischemic findings in patients with COVID-19.

Foreign bodies in the heart is rare and can be life threatening. Early diagnosis and removal are very important. X-ray, computed tomography and echocardiography are the main diagnostic methods. In this article, a 14-year-old male patient who had chest pain for ten days, whose pain increased when lying down for the last two days, and who was found to have a foreign body needle in the heart in the pediatric emergency service is presented. It was learned that the needle was voluntarily inserted by our patient, who was diagnosed with attention deficit hyperactivity syndrome seven years ago and did not follow-up regularly. It was learned that the chest X-ray taken at another hospital 2 days before applying to our hospital was evaluated as normal. The needle that caused lung contusion, right pleural effusion, right ventricular contusion, right coronary artery injury and pericardial effusion was successfully removed by open heart surgery. It is presented to draw attention to the rarity of cases with a foreign body in the heart in the literature and the careful evaluation of the X-rays.

The purpose of this article is to review the business management field evolution from 2000 up to date and to map the conceptual, social, and intellectual structure of the research in this field. Data were collected from the WoS database, comprising 12,145 articles published between 2000 and 2022. Several bibliometric techniques were applied, including analysis of co-words, co-citation, bibliographic coupling, and co-authorship networks in addition to performance analysis. VosViewer and the Bibliometrix/Biblioshiny packages were used to perform the analyses. Besides revealing the evolution of the business management field, the results identify the most active and influential authors, articles, journals, and topics in this field.

Objective: Metoclopramide is a dopamine receptor antagonist. It is not routinely recommended in children, particularly because of its extrapyramidal side effects. In this study, it was aimed to examine the reasons for the use of metoclopramide and their response to emergency treatment in children who developed acute extrapyramidal symptoms due to metoclopramide use. Methods: Patients who applied to the pediatric emergency service between 01.06.2019 and 31.05.2020 because of side effects related to the use of metoclopramide were included in the study. All the patients were treated with biperidene lactate. Results: Twenty patients without chronic disease, who were not taking any medication other than metoclopramide, and had an acute dystonic reaction due to metoclopramide for the first time were evaluated (median: 33.5 months, 55% male). Seventeen of the patients had taken the medication for acute gastroenteritis, two for motion sickness and one for a suicide attempt. In 16 patients, the drug was given by their mothers without a doctor's recommendation. Side effects in the normal dose range occurred in 16 of the patients. Findings occurred within a median of 4 h after metoclopramide ingestion. The median response to biperiden lactate treatment was 15 min. A positive and significant correlation was found between the metoclopramide dose taken and the clinical response time to biperiden lactate administered in the emergency department (r: 0.514; p=0.018). Conclusion: Metoclopramide causes an acute dystonic reaction in children, even in the normal dose range. Biperiden lactate is an effective and rapid treatment option. As the metoclopramide dose increases, clinical improvement occurs later.

It is important to be aware of and prepare for the possible consequences of disasters. In the event of any disaster, disaster triage is to do what is most beneficial for the large number of injured by using the limited resources. After the disaster, the injured victims are classified according to their injury status with an effective and fast triage. When available resources are used optimally under triage guidance, mortality and morbidity are reduced. Every country must have a disaster management plan. Children's anatomical and physiological characteristics are different from adults and they are vulnerable to disasters. Although one-third of the disaster victims were children, pediatric issues were not adequately addressed in the planning. In this article, it is aimed to provide information about the triage systems determined and accepted to be used for child victims aged 0-8 in disasters.

Jusqu’à l’avènement de la République turque en 1923, l’emprise de la religion dans l’exercice de la fonction de juge était un facteur d’exclusion des femmes. Dans cette configuration, tous les rites principaux musulmans écartaient la femme de la fonction, sauf quelques rares exceptions. C’est pourquoi, l’accès des femmes turques à la magistrature interviendra dans un contexte de rupture avec le droit musulman et de sécularisation de la société portée par la révolution d’Atatürk, créateur de la République. C’est ainsi qu’à la fin des années vingt, les premières femmes deviennent magistrates, avant même qu’elles obtiennent le droit de vote qui interviendra en 1934 et bien avant les femmes françaises. Toutefois, passé le symbole, la féminisation de la magistrature est un phénomène relativement récent. C’est principalement à partir des années 2000 qu’elle connaît une accélération sensible. Aujourd’hui, sur 22820 juges dans toute la Turquie, 8326 sont des femmes. Ces dernières représentent 36,5 % alors qu’en 2012, on comptait seulement 3020 femmes dans la magistrature sur 12201 (c’est-à-dire 24, 2 %). Leur nombre a donc plus que doublé en une décennie. Cette progression de la féminisation de la magistrature turque, due à de multiples facteurs dont la féminisation des études de droit et la création de nombreux postes de magistrats qui a ouvert de nouvelles opportunités pour les femmes, suscite encore aujourd’hui des réactions assez paradoxales. D’un côté, la présence de femmes ne devrait, en théorie, pas poser de problème en raison de la neutralité même du juge, symbolisée par le port de la robe. D’un autre côté, l’emprise des mœurs dans un pays fortement marqué par la religion explique que, dans la justice, il y a des fonctions implicitement réservées aux femmes et surtout compatibles avec leurs obligations familiales. C’est ainsi qu’à peine 16 % des procureurs sont des femmes et les postes hiérarchiques sont généralement exercés par les hommes. L’étude de la manière dont les femmes ont pris leur place dans la magistrature turque et des stratégies d’exercice qu’elles ont pu développer face à une société imprégnée de codes patriarcaux doit permettre de mieux cerner cette ambivalence entre une banalisation de la place occupée par les magistrates aujourd’hui et ses particularités. Ce sujet, qui n’en est qu’à ses prémices, mérite certainement des études complémentaires et plus régulières.

A fourteen years-old girl was admitted to the emergency department by 112 ambulances due to syncope. The patient was treated according to the syncope algorithm. Conversion was considered because initial findings were normal. In the follow-up, high fever and focal seizure were observed. Frontal sinusitis and abscess were detected in cranial magnetic resonance. In this case report, we wanted to emphasize the importance of algorithmic approach in children with syncope in the emergency department.

Munchausen syndrome by proxy (MBP) is a form of child abuse in which the perpetrator induces, exaggerates, or fabricates illness in his/her child. symptoms are highly variable. Diagnosis is essential because of the high associated morbidity and mortality. A ten-year-old, nine-month-old girl presented to our emergency department with complaints of seizures and nosebleeds. MBP was considered in the patient without any complaints during hospitalization and due to the normal test examination. In complaints without an etiological cause, MBP should be considered in the differential diagnosis.

In spite of threatening external factors such as uncertain environmental structure and market pitfalls, the companies struggling with the difficulty of retaining the current customer and finding the potential ones should first realize the existence of “Achilles Tendons” within themselves. To prevent this potential problem, they should focus on the labor which can be a very substantial weak point and an important asset as well. Regarding serious problems arisen from labor force, this study proposes a new term called as “Achilles Tendon Syndrome” to be used in organizational behavior literature. Various theories from different disciplines such as medicine, psychology, physics, economics and sociology support development process of the term. Similarities and differences with other close concepts are also provided throughout the paper. The current study aims to inspire future studies by filling an important gap in the organization and management literature.

Objective: Acute gastroenteritis (AGE) is one of the most common infections among children. Oral rehydration is the first-line treatment. In this study, it was aimed to compare the efficacy of probiotics, zinc, and combined therapies in children admitted with AGE. Methods: The study included 132 patients with a diagnosis of AGE in the Pediatric Emergency Service between October 2020 and April 2021, in a comparative study, prospective, placebo-controlled manner. Only appropriate dietary recommendations were given to the first (control) group, probiotics (Bifidobacterium breve, Bifidobacterium bifidum, Bifidobacterium infantis, Bifidobacterium longum) to the second group, zinc to the third group, and probiotics and zinc to the fourth group.1. Results: A total of 132 participants (27.5 ± 3.6 months, 59.8% male) were included in the study. The mean duration time of the termination of diarrhea was 84.5 ± 10.7 hours (range; 79-89) in group1, 73.05±6.8 hours (range; 70.5-75.4) in group 2, 80.1 ± 10.3 hours (range; 76-84) in group 3, and 43.5±9.6 hours (range; 46-48) in group 4. When all groups were compared, the duration of the termination of diarrhea was shorter in group 4 with a statistically significant level (p

We planned this study to research the effect of freeze-thaw number and storage temperatures on the tests of thiol-disulfide homeostasis. Dynamic thiol-disulfide homeostasis has a crucial role in antioxidant defense reactions. Thiol disulfide homeostasis is detected in serum samples. To gauge the steadiness at different storage temperatures, sera stored at -20°C and -80°C for 1, 2, 3, 6, and 12 months. To work out the effect of the freeze-thaw cycle, sera were frozen at -80°C and subjected to ten freeze-thaw cycles at 24-hour intervals. According to our results, native thiol, total thiol, and disulfide levels in human serum samples were stable at -20°C for three months and at -80°C for 12 months. After the third month at -20°C, native thiol and total thiol levels decreased while disulfide levels increased. Additionally, as the number of freeze-thaw cycles increased, native thiol and total thiol levels decreased, and disulfide levels increased. Our results show that storage at -20°C and an increasing number of freeze-thaw processes affect thiols levels. To get the most accurate results, repeated freeze-thaw cycles should be avoided the maximum amount possible. Also, samples should be frozen at -80°C if long storage times are required. [Med-Science 2021; 10(2.000): 450-4]

Hint coğrafyasına İslâm’ın girişi hicretin ilk yıllarına kadar uzanmaktadır. İlk asırlardan itibaren Müslümanlar bölgeye çok sayıda sefer düzenlemiş, böylece bölgenin İslâmlaşma süreci hızlanmıştır. İslâm’ın gelişi ile birlikte Hint coğrafyasında siyasî dengeler değişmiş, dinî ve kültürel alanda birtakım farklılıklar meydana gelmiştir. Mezhepler Tarihi açısından bakıldığında ise bölgede çok sayıda farklı düşünce ekollerinin yer aldığı görülmektedir. Hint coğrafyasındaki bu ekollerin farklı eğilimler gösterdiği söylenebilir. Çalışmamızın asıl konusu olan Şiîliğin bölgeye girişi ve yayılışı ile ilgili birçok iddia öne sürülmüştür. Bu iddiaların merkezinde Hz. Ali döneminde bölgeye seferler düzenlenmesi, Hz. Ali taraftarları olarak bilinen kişilerin bölgeye göç etmiş olmaları, ayrıca Emevîler ve Abbasîler döneminde Hâşimîlere yapılan baskı ve zulümlerden dolayı Hint bölgesine giden Ali oğulları ile ilgili rivayetler yer almaktadır. Makalede Şiîlik ve alt kolları olan Zeydiyye, İsmâilîyye, Karmatîlik ve İsnâaşeriyye’nin bölgeye ne zaman ve nasıl girdikleri, aynı zamanda hangi bölgelere yayıldıkları bilimsel verilere dayandırılarak objektif bir şekilde değerlendirilmeye çalışılmıştır.

Avec l’allongement de la durée de la vie, l’âge de la transmission successorale d’un patrimoine est de plus en plus tardif, retardant d’autant le transfert intergénérationnel et la capacité des générations suivantes à utiliser ce patrimoine. L’anticipation successorale, en d’autres termes, la possibilité de transmettre avant l’heure ses biens, devient ainsi une préoccupation des aînés d’aujourd’hui. Cette évolution doit néanmoins se conjuguer avec la crainte de ne pas être en capacité de faire face à la perte d’autonomie en raison du vieillissement. L’anticipation successorale et la transmission d’un patrimoine doivent donc prendre en considération la protection du disposant face à sa propre dépendance mais aussi la maintenance de son partenaire de vie en cas de décès. Un équilibre doit être trouvé entre l’aspiration légitime de nos ainés à profiter de leur patrimoine, la protection face aux risques de spoliation ou de dépendance et cette équité intergénérationnelle. À cet effet, le droit successoral français comporte de multiples techniques, parfois peu explorées, qui doivent permettre de satisfaire cette ambition, tout en respectant la limite de la réserve héréditaire bénéficiant notamment aux descendants.

Television tip-over injury is a home accident that can cause severe head trauma, especially in young children. In this study, three cases of television-related head trauma were presented. The first case was a 16-month-old girl. When she was playing at home, a cathode ray tube television rolled. A Skull fracture and intracranial injury developed. The children underwent emergency neurosurgery operation. He was hospitalized for 13 days and discharged. The second case was a 4-year-old male. He was found unconscious at home beside the overturned the cathode ray tube television. Subarachnoid hemorrhage was detected on tomography. He was hospitalized for 2 days and discharged. The third case was a 12-month-old boy. His mother accidentally dropped the cathode ray tube television on her child. Skull fracture and subgaleal hematoma were determined. In the follow-up, acute anemia developed and blood transfusion was performed in the emergency department. He was hospitalized for 2 days and discharged. In conclusion, television tip-over can lead to severe head trauma in children. Basic home preventive measures and adult supervision of young children may prevent television related-related injury.

Objective:Malaria is an infection disease caused by plamodium parasite. Sporadic cases have not been observed since 2011, but imported cases still present owing to travel. In this study, we aimed to evaluate labotauary and clinical findings patients with malaria who were hospitalized and treated in our hospital.Methods:Between January 2012-November 2018, a total of 31 adult patients was evaluated retrospectively, in terms of their epidemiological, physical examination and laboratory findings, complaints, countries they traveled to, prophylaxis and treatment that they received. Data of the patients were taken from the hospital’s database.Results:A total of 31 cases were diagnosed as having malaria. The causative microorganism was P. falciparum in 54.83% (17/31) of the patients, P. vivax in 32.25% (10/31), and P. falciparum-P. vivax co-infection in 12.9% (4/31) of the patients. Co-infections were excluded from the study. None of the cases had used prophylactic drugs for prevention of malaria. All of the cases suffered from chills with fever. The most frequently encountered pathologic laboratory findings were thrombocytopenia and leucopenia. Antibiotics had been initiated in 51.85% (14/27) of the patients with non-specific diagnoses. Rapid antigen test was used in 8148% (22/27) of cases. None of cases needed intensive care.Conclusion:It is important to inform persons who plan to visit malaria endemic areas about malaria and to make them take appropriate prophylaxis against malaria. Although P. falciparum which has a high mortality rate may be considered in the first plan, P. vivax, treatment of which is different due to risk of relapse, should not be overlooked.

The adsorption properties of microporous spherical carbon materials obtained from the resorcinol-formaldehyde resin, treated in a solvothermal reactor heated with microwaves and then subjected to carbonization, are presented. The potassium-based activation of carbon spheres was carried out in two ways: solution-based and solid-based methods. The effect of various factors, such as chemical agent selection, chemical activating agent content, and the temperature or time of activation, was investigated. The influence of microwave treatment on the adsorption properties was also investigated and described. The adsorption performance of carbon spheres was evaluated in detail by examining CO2 adsorption from the gas phase.

Cemâat-i İslâmî’ye göre siyaset, dini ikame etmek için yerine getirilmesi gereken bir araçtır. Bu amaçla Hindistan’da kurulan Cemâat-i İslâmî, Hz. Muhammed’in oluşturduğu toplum modelinde yeni bir cemaat oluşturmayı gaye edinmiştir. Bu anlayış ve metot çerçevesinde bireyler öncelikle zihni ve ahlaki yönden yetiştirilmeliydi. Bireylerde gerçekleşen bu değişim ve yenilik örnek bir Müslüman toplumun gerçekleşmesine vesile olacaktı. Ancak Cemâat-i İslâmî Pakistan’a geçtiğinde hareket metodunu değiştirdi. Cemâat’in bu yeni metodu Cemâat içerisinde birçok tartışma ve itirazlara konu oldu. Cemâat-i İslâmî’nin siyasete girmesi etik bulunmadı ve onun, daha çok ahlaki eğitim üzerinde yoğunlaşması gerektiği şeklinde düşünüldü. Cemâat-i İslâmî içerisinde yapılan bu münazaraları değerlendirmek, onun siyaset anlayışını ortaya koymak bakımından önemli bir yer teşkil etmektedir. Bu makalede Cemâat-i İslâmî’nin siyaset anlayışı, Pakistan’da Cemâat-i İslâmî’nin metot ve yönteminde yapılan bu değişikliklere yöneltilen eleştirilere karşı, Mevdûdî’nin müdafaası ile birlikte değerlendirilerek ele alınmıştır

Objectives: We described the clinical outcomes of the diabetic patients who had foot infections with multidrug resistant organisms. Methods: We included the patients with diabetic foot infections (DFI) from 19 centers, between May 2011 and December 2015. Infection was defined according to IDSA DFI guidelines. Patients with severe infection, complicated moderate infection were hospitalized. The patients were followed-up for 6 months after discharge. Results: In total, 791 patients with DFI were included, 531(67%) were male, median age was 62 (19–90). Severe infection was diagnosed in 85 (11%) patients. Osteomyelitis was diagnosed in 291(36.8%) patients. 536 microorganisms were isolated, the most common microorganisms were S. aureus (20%), P. aeruginosa (19%) and E. coli (12%). Methicillin resistance (MR) rate among Staphylococcus aureus isolates was 31%. Multidrug resistant bacteria were detected in 21% of P. aeruginosa isolates. ESBL (+) Gram negative bacteria (GNB) was detected in 38% of E. coli and Klebsiella isolates. Sixty three patients (8%) were re-hospitalized. Of the 791 patiens, 127 (16%) had major amputation, and 24 (3%) patients died. In multivariate analysis, significant predictors for fatality were; dialysis (OR: 8.3, CI: 1.82–38.15, p = 0.006), isolation of Klebsiella spp. (OR:7.7, CI: 1.24–47.96, p = 0.028), and chronic heart failure (OR: 3, CI: 1.01–9.04, p = 0.05). MR Staphylococcus was detected in 21% of the rehospitalized patients, as the most common microorganism (p

Intraventricular papillary neoplasms originating from the choroid plexus epithelium are called choroid plexus tumors (CPT). In pediatric patients. The most common findings in CPT are seizures, subarachnoid hemorrhage, focal neurological deficits, hydrocephalus and symptoms of increased intracranial pressure. A 4.5-month-old, previously healthy girl was admitted to our Pediatric Emergency Department with complaints of inadequate nutrition, vomiting and drowsiness in the last 2 days. The patient was admitted to the pediatric intensive care unit and saline loading treatment was initiated due to presumed dehydration caused by inadequate nutrition. As dehydration-related pathology was not detected, brain tomography scan was performed for possible cranial pathology and it revealed increased bilateral lateral ventricular diameters. As a result of magnetic resonance imaging results, the patient was diagnosed as having choroid plexus papilloma. After the shunt was inserted, the patient regained consciousness and an elective surgery was planned. Inadequate nutrition and drowsiness are the most common causes of admissions to pediatric emergency department, and these symptoms are usually due to dehydration. Cranial pathologies should be considered in patients who do not respond to fluid loading treatments and whose laboratory findings and vital signs are stable. As in our patient, the patients with choroid plexus papilloma should be evaluated clinically and shunt surgery should be performed firstly. Timing of surgery should be decided according to the effect and clinical status.

Introduction: The aim of this study was to determine theprevalence of rotavirus and adenovirus in patients who applied with the complaintof acute gastroenteritis to the emergency department of our tertiary health careprovider hospitals.Methods: 1712patients with the complaint of acute gastroenteritis were included in the studyand the study was done retrospectively from patient records.Results: Stool(faeces) samples have been sent from 1712 patients who applied to emergency serviceswith the complaint of acute gastroenteritis for 3 years. Of these, 17.5% (n=301)rotavirus antigen and 3.5% (n=61) adenovirus antigen were detected as positive.It was observed that 56% (n=203) of the positive cases were male and 44% (n=159)were female. The rotavirus antigen was statistically significantly higher inthe 0-4 age group than the other age groups.Conclusion: Acute gastroenteritisis an important health problem in children. Especially, the frequency ofrotavirus was observed to be higher in children under 4 years of age and inthis age group patients the use of rotavirus rapid diagnostic tests rather thanviral culture methods may be helpful to early diagnosis thus to reduce unnecessaryantibiotic use.

AIM: To investigate whether single-dose intravitreal injections of bevacizumab and ranibizumab transfer into milk. METHODS: This study included lactating 12 sheep and a single 3-month old suckling lamb of each sheep. Two groups consisting of 6 sheep and their lambs were constituted; the ranibizumab group and the bevacizumab group before the administration of intravitreal injections, blood and milk samples were obtained from all sheep and, following the injections, blood and milk samples of all sheep and blood samples of all lambs were collected at regular time points. Serum and milk concentrations of bevacizumab and ranibizumab were measured using an enzyme-linked immunosorbent assay (ELISA) kit. The limit of determination was 0.9 ng/mL for bevacizumab and 0.62 ng/mL for ranibizumab. RESULTS: At 6h after intravitreal injections, bevacizumab concentration was above the limit of determination in the blood of all sheep. At 3wk, when the study was terminated, bevacizumab concentrations were high in 4 sheep. Even though bevacizumab concentrations in milk showed fluctuations, the drug transferred into the milk of all sheep at detectable concentrations. Ranibizumab drug concentrations in the blood and milk of sheep and those in the blood of lambs were below the limit of determination by the ELISA kit. CONCLUSION: This sheep model study demonstrate that intravitreal injection of ranibizumab, which did not transfer into the milk of sheep and suckling lambs, is safer than bevacizumab during lactation period.

Introduction: Circumcision is a surgical procedureperformed by many societies for religious, medical and cultural purposes. Oneof the agents used during this procedure is prilocaine, a commonly used localanesthetic. In the literature, cases of methemoglobinemia which can bedeveloped with the application of prilocaine in normal dose have been reported.Oxidation of hemoglobin with various oxidative stresses is calledmethemoglobinemia when the divalent iron in its content is converted into itstrivalent form. This reactionleads to hypoxaemia in the tissueand a clinical picture of cyanosis occurs at varying degrees.Case Report: Two-and-a-half-month-old patient was referred to my hospital by aphysician because of the complaint of bruising after local anesthesia withprilocaine and the measured oxygen saturation was 79%. Physical examinationrevealed cyanosis in the peroral region, hands and feet. It was decided thatmethylene blue should be administered considering the fact that the patient wasgiven prilocaine as a local anesthetic, due to the inability to find anunderlying respiratory and cardiac cause, and because of the high value of methemoglobinin blood gas. Methylene blue 2 mg/kg was given orally. About an hour later,cyanosis disappeared. The control methhemoglobin level was found to be 2.7%.Conclusion: Methemoglobinemia should be considered in thedifferential diagnosis of cyanosis after local anesthetic application and localanesthetics with less side effects should be preferred in early infancy. Inthis case report, it was aimed to discuss the differential diagnosis andtreatment methods of methemoglobinemia after local anesthesia with prilocaine.

Late bilinguals who spend (part of) their adult lives in an environment where a language other than the one they learned in childhood is spoken typically experience a range of language development phenomena. Most obviously, they will acquire some level of receptive and/or productive knowledge of the new, or second, language (L2). How basic or advanced that level will be is determined by a range of environmental, experiential, attitudinal and individual factors. Secondly, they will most likely find the knowledge of their native language (L1) beginning to diverge from that of monolingual speakers in their country of origin, a process known as language attrition. In the course of this developmental process, some L2 skills may eventually match or even overtake the corresponding skill in the L1. This shift in the balance between L1 and L2 is the focus of investigations of language dominance. The present study explores language dominance in four migrant populations (Germans in the Netherlands and Canada, Turks and Moroccans in the Netherlands). Investigating both the development of formal/controlled skills and more automatic aspects of lexical access and fluency, we aim to attain an understanding of how extralinguistic factors contribute to the development of both languages. We argue that an integrated perspective can contribute more profound insights into the predictors of this complex process of bilingual development. In particular, our findings show that statistical models based on linear relationships fall short of capturing the full picture. We propose an alternative method of analysing data, namely discriminant function analysis, based on a categorisation of the populations, and demonstrate how this can enhance our understanding. Our findings suggest that different aspects of the bilingual experience contribute differently to language development, regardless of language combination and type of skill measured. Contrary to what previous research suggests, measures relating to the intensity of informal use of both the L1 and the L2 in daily life are important in determining whether someone is a good or a poor L1 maintainer, while high vs. low success in acquisition appears to be predominantly associated with personal factors such as educational level.

Bu çalışmada burun yapısal bozukluğu bulunan bireylerde akustik rinometri ve ses analizi verilerinin değerlendirilmesi amaçlanmıştır. Çalışmaya Selçuk Üniversitesi Ahmet Keleşoğlu Eğitim Fakültesi Güzel Sanatlar Eğitimi Bölümü Müzik Eğitimi Anabilim Dalı’ında eğitim gören 40 birinci sınıf öğrencisi dâhil edildi ve Selçuklu Tıp Fakültesi K.B.B. Anabilim Dalı’nda doktor muayenesi sonucunda 12 öğrenciye septum deviasyonu, 6 öğrenciye konka hipertrofisi ve 7 öğrenciye de septum deviasyonu ve konka hipertrofisi tanısıkonuldu. Ayrıca burunda yapısal bozukluk saptanmayan 15 öğrenci tespit edildi. Tüm öğrencilerden veriler elde etmek için kişisel bilgi formu, nazal obstrüksiyon değerlendirme skalası NOSE doldurmalarıistendi. İlgili uzmanlar tarafından öğrencilerin nazal kavite kesit alanıve hacminin ölçülmesi için akustik rinometri ile fonatuar yetenek ölçümleri ve akustik ses analizi uygulandı. Verilerin analizinde tanıtıcıistatistik yöntemleri ortalama, standart sapma ve Mann-Whitney U testi kullanıldı. Yapılan istatistiksel değerlendirme sonuçlarına göre; burun yapısal bozukluğu bulunan öğrencilerin akustik rinometri değerlerinin düşük olmasıve NOSE puanlarının yüksek olmasınedeniyle; nazal solunumun ve fonatuar yetenek ölçümlerinin olumsuz etkilendiği sonucuna varıldı. Sesin akustik özelliklerinden olan temel frekans F0 ve formant frekanslarıF1, F2, F3, F4, F5 değerlerinde farklılık tespit edilmedi. Tüm öğrencilerin şarkıcıformantını F3 oluşturabildikleri gözlendi.

Amaç: D vitamini, kalsiyum absorbsiyonu ve kemik metabolizmasında etkilidir. Ayrıca düşük D vitamini düzeyleri DM, HT, kanser ve otoimmun hastalıkların yer aldığı çoğu kronik hastalık ile de ilişkilidir. Bu çalışmada laboratuvarımızda 2012 yılı Ocak-Aralık ayları arasında çalışılan D vitamini düzeylerinin incelenmesi amaçlandı.Materyal ve Metod: 2012 yılında Ocak-Aralık ayları arasındaki 4168 hasta değerlendirildi ve yaş, cinsiyet ve D vitamini düzeyleri aylara göre gruplara ayrıldı.Bulgular: Çalışmamızda 3242 (% 77,8) kadın ve 926 (%22,2) erkek yer aldı. Hastaların D vitamini düzeyleri ortalaması 22,80±13,27 ng/mL, kadınlarda 22,49±13,88 ng/mL, erkeklerde 23,75±10,57 ng/mL idi. Hastaların % 47’inde (kadınlarda % 50, erkeklerde %38) < 20 ng/mL D vitamini seviyeleri vardı (D vitamin yetersizliği için cut-off). D vitamini yetersizliğinde mevsimsel değişiklikleri incelemek için ortalama D vitamini düzeyleri karşılaştırıldığında tüm gruplar arasında istatiksel olarak anlamlı fark bulundu ( p

Amaç: Perkütan endoskopik gastrostomi ( PEG ) gastrostomi yöntemleri içinde en sık ve en basit uygulanan minimal invaziv yötemdir. Çalışmamızda PEG uygulanan hastaların sonuçları ve reflü hastalığı ile ilişkisi değerlendirildi.Gereç ve Yöntem: Ocak 2010 – Ocak 2012 tarihleri arasında iki çocuk cerrahisi merkezinde perkutan endoskopik gastrostomi kateteri takılan 13 hastanın dosyası geriye dönük incelendi.Bulgular: Hastaların 6'sı erkek ( % 46 ), 7'si kız ( % 54 ) idi. Yaş ortalaması 3,5 yıl idi. Hastaların ortalama hastane yatış süresi 3 ± 1 gündü. Hastaların beslemeye başlama süreleri ortalama 31 ± 8 saat, operasyon süreleri ise ortalama 45 ± 15 dakika idi. Kız ve erkek hastalarda beslemeye başlama süreleri açısından fark yoktu. PEG takılma endikasyonları 1 hastada özefagus atrezisi onarımı sonrası yutma disfonksiyonu gelişmesi ve 12 hastada da santral sinir sistemini patolojilerine bağlı yutma disfonksiyonuydu. Olgularımızda başlangıçta gastroözofagial reflü araştırması yapıldı. Hipoksik iskemik ensefalopati tanılı, PEG sonrasında sık aspirasyon pnömonisi geçiren 2 hastaya ve özefagus atrezisi onarımı yapılmış 1 hastaya daha sonra antireflü ameliyatı yapıldı. Diğer 10 hasta operasyon sonrası komplikasyonsuz olarak PEG ile beslenmeye devam etmektedir.Sonuç: PEG işlemi kolay uygulanabilir bir yöntemdir. Herhangi bir nedenle gastrostomi takılması gereken olgularda gastrostomi öncesi invaziv araştırma ve cerrahi yapmadan minimal invaziv yöntem olan PEG yöntemi ile gastrostomi açılıp daha sonra gerekirse detaylı inceleme ve invaziv cerrahi yapılabilir.

Suicide is a public health issue that impacts an average of six family members and up to 135 community members. Persons bereaved by suicide may feel guilt, stigma, shame, and rejection. In Türkiye, suicide survivors may face additional challenges due to Islamic taboos and sanctions placed on suicide. This study explores the experiences and support needs of Turkish suicide survivors through an online survey. Using NVivo software for thematic analysis, we examined responses from 73 participants and identified three predominant themes: (1) the impact of suicide, (2) support experiences and perceptions, and (3) recommendations for appropriate support provision. Each theme contained several subthemes. Our findings indicated a lack of available services and an unmet need for support.

Congenital myasthenic syndromes (CMS) are a group of hereditary disorders affecting the neuromuscular junction. Here, we present clinical, electrophysiological and genetic findings of 69 patients from 51 unrelated kinships from Turkey. Genetic tests of 60 patients were performed at Mayo Clinic. Median follow-up time was 9.8 years (range 1-22 years). The most common CMS was primary acetylcholine receptor (AChR) deficiency (31/51) and the most common mutations in AChR were c.1219 + 2T > G (12/51) and c.1327delG (6/51) in CHRNE. Four of our 5 kinships with AChE deficiency carried p.W148X that truncates the collagen domain of COLQ, and was previously reported only in patients from Turkey. These were followed by GFPT1 deficiency (4/51), DOK7 deficiency (3/51), slow channel CMS (3/51), fast channel CMS (3/51), choline acetyltransferase deficiency (1/51) and a CMS associated with desmin deficiency (1/51). Distribution of muscle weakness was sometimes useful in giving a clue to the CMS subtype. Presence of repetitive compound muscle action potentials pointed to AChE deficiency or slow channel CMS. Our experience confirms that one needs to be cautious using pyridostigmine, since it can worsen some types of CMS. Ephedrine/salbutamol were very effective in AChE and DOK7 deficiencies and were useful as adjuncts in other types of CMS. Long follow-up gave us a chance to assess progression of the disease, and to witness 12 mainly uneventful pregnancies in 8 patients. In this study, we describe some new phenotypes and detail the clinical features of the well-known CMS., (Copyright © 2017 Elsevier B.V. All rights reserved.)