Makale Arama

 

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In this study, it was investigated whether Rh sen-sitization occurred in Rh(-) newborns and aclults from Rh(+) mothers. Rh sensitization was found to be 8% of the cases. It has been discussed whether it was ne-cessary to administer anti-D to these newborn girls. It was estimated that if anti-D administered one of the causes of the Rh hemolytic disease might be abolished.

In order to investigate the relation hetween the thyroid radionuclide scanning and the histopathological findings, we reviewed 125 patients operaled on from 1984 to 1988 in Korkuteli State Hospital. Sixty seven point five percent of patients had multinodular and 32.5% uninodular goiter. One hundred sir patients underwent thyroid radionuclide scanning and 85.8% revealed hypoactive, 6.6% hypoactive and normoactive, 3.8% hyperactive nodules and 3.8% other pathologies. Ali of the 125 patients were euthyroid at the time of operation. Mnety seven point six percent of the patients underwent unilateral or bilateral subtotal thyroidectomy. In 100 patients who had histopathologic exarnination had 131 hislopathologic diagnosis. In 81 patients who had hypoactive nodules determined with radionuclide scanning, 68.8% were diagnosed as multinodular goiter, 16.5% follicular edenoma, 7.4% chronic thyroiditis, 5.5% malig,nant thyroid disease and 1.8% colloidal cyst histopathologically. All cases with malignant thyroid disease had hypoactive nodules, five of them were multinodular and one solitary nodule.

Fractures of the clavic!e are common and make up a high percentage among the skeletal system tra-uma. They are well managed by conservative met-hods. 496 clavicular fractures of 493 patients were diagnosed between 1993 and 1997 in our dinle 357 of thern were men and 136 women. Average age was 38.5 (18-78). Years in 207 of them right side was affected and in 289 left. 3 of the cases had bi-lateral involvement. Conservative treatment included velpeau dressing or figure of eight bandage. 82 of the patients were lost to follow-up after the first exa-mination. Remaining 414 fractures of 411 cases were followed up at least 1.5 months 3 nonunions (%0.7) were detected_ Conservative treatment re-sulted in % 99.3 of union.

The purpose of this study was to evaluate the fear, vvorry and axieties of patients about anesthesia and surgery preoperatively by using a questionaire, and to measure their anxiety by using visual analogue scale (VAS). Five hundred and thirty six patients (>19 yr of age) were questioned about their worries, fears and request of Infor­ mation by means of a questionaire. The ansvvers were analysed with chi-square and correlation tests and p<0.05 was considered as significant. Fear from surgery was higher in the less educated patients (p<0.05). VVomen feared from anesthesia and surgery more than men (p=0.0001). Men prefered local anesthesia more than vvomen (p=0.00165). Fear and request of Information increased with increased income (p=0.01). VAS scores vvere high­ er in vvomen, illeterate and primary school graduates, and patients vvithout previous surgical or anesthesia expe- rience (p<0.05). No correlation was present betvveen VAS scores and income or increase or decrease of Informa­ tion requests (p>0.05). İt was concluded that not ali but some patients feared of surgery or anesthesia or vvanted Information. Informing these patients on the consequences of anesthesia and surgery may be usefull in alleviating their fears or vvorries. Positive correlation betvveen the results of the questionaire and VAS scores, leads us to con- sider that VAS scores may be usefull for measuring preoperative anxiety.

Aim: The clinical course of COVID-19 cases and the severity of symptoms vary according to the case.
However, it has been seen in the cases examined that it poses a greater risk for those with chronic
diseases and elderly individuals. In order to protect elderly individuals from COVID-19, governments
have introduced some restrictions. It is thought that the wrong evaluation of these restrictions may lead
to attitudes of ageism. This study aimed to determine the relationship between society's fear of COVID-19
and attitudes towards ageism.
Patients and Methods: This work is designed in descriptive type. This study was conducted with
volunteers between the ages of 18-65 683 people. The data of the study were collected using the Fraboni
Scale of Ageism and COVID-19 Fear Scale. Data were collected on 1-20 Jun e 2020.
Results: The mean Fraboni Scale of Ageism and COVID-19 Fear Scale scores were 67.87±6.15 and
18.81±6.16, respectively. The results showed a weak and negative correlation between COVID19 fear
and ageism.
Conclusion: In general, individuals had a positive attitude towards the elderly and had low levels of
COVID-19 fear.

Trichotillomania characterized by recurrent chronic hair pulling is an impulse control disorder which is associated with comorbid conditions. In most cases trichotillomania results in a total or partial scalp alopecia. The psychiatric comorbidity is usually seen with trichotillomania in adults. The most common psychiatric comorbidities are affective disorders, anxiety disorders, addiction disorders. The effect of trichotillomania can be quite large and serious. It has many negative effects such as either on relationships between people or causing avoid social activities. The treatment of trichotillomania usually involves participation of both psychiatrists and dermatologists. In this article, a case of a young female patient, who has applied only dermatology policlinic for many years with diagnosis of alopesia totalis and not believing being treated in result, is presented. This case has been prepared as a good example of that trichotillomania causes the depresion and the decrease on the quality of life.

Purpose: to evaluate the ocular and periorbital anthropometric measurments in young adults and adults. Methods: Our study were enrolled two different age groups, first group (young adults) was consisted of 200 medical students aged between 18 to 21(19.73±1.6) years, and second group (adults) consisted of 150 patients aged between 42 to 65 (52.48±9.2) years who were examined in department of opthalmology. Cases with history of trauma and congenital anomaly were excluded from the study. In all cases the intercanthal distance (ICD), the outercanthal distance (OCD), the interpupillary distance (IPD), the palpebral fissure height (PFH) and the palpebral fissure distance (PFD) were measured. Measurments were performed by the same examiner using a single electronic compass instrument. In both groups the measurments between males and females as well as the measurments of the same gender between the both groups were compared. Results: In the evaluation of the measurments, in ICD, OCD and IPD there was statistically significant differencess between the genders (ie male/female) in same group (p<0.05), while there was no statistically significant differencess between the gender in the same group, while there was statistically significant differencess in between the two groups (p<0.05), and in PFH there was statistically significant differencess between the genders in the first group (p<0.05), however there was no such defferencess in the second group (p>0.05). Conclusion: Our results on one hand and the contrary results of other studies on the other hand, arise the need for further studies including different ages and ethnics groups to set standarts for ocular and periorbital anthropometric measurments. These measurments in healthy subjects may be useful guide for early identification of some dysmorphological abnormalities and of planning surgical intervention.

Meckel’s diverticulum is a rare cause of mechanical intestinal obstruction in adults. Due to non-specific symptoms and preoperative diagnosis of this rare condition, surgeons should keep in mind. A 28-year-old male patient was admitted to our emergency department with abdominal pain, nausea and vomiting for about 8 hours before onset. The patient was diagnosed as acute small bowel obstruction and underwent emergency surgery. At operation a torsioned ileum due to Meckel’s diverticulum 60 cm proximal to ileocecal valve and small bowel distention proximal to this site was seen. Ileum was detorsioned and Meckel’s diverticulum resection was performed. The patient was discharged on postoperative day 3. Histopathologic specimen were reported as Meckel’s diverticulum in 3x2x1cm size.

Aim: The aim of this study is to evaluate the association between hematologic diseases and SARS-CoV-2
infection in patients who have been been diagnosed with a hemat ologic disease after COVID-19 infection.
Patients and Methods: The ones who had a previously history of COVID-19 infection among the patients
diagnosed with any malign or autoimmune hematologic disease were evaluated between April 1, 2020 – April
1, 2021, retrospectively. The Patients who had the COVID-19 infection and the patients who had not were
compared.
Results: Twenty-four (7.8%) patients of 305 newly diagnosed who had a previously history of COVID-19
infection were determined. The most common diagnosis was non-Hodgkin Lymphoma in both of the groups.
Although it was not statistically significant, frequency of NHL and aggressive NHL were most common in
the patients with history of COVID-19 (25.1% vs 23.1%; p=0.143 and 66.6% vs 56.9%, p=0.094). The basic
hematologic parameters were similar between the two groups. The median time between COVID-19 infection
and the hematologic diagnosis was 4.1 (0.6-11.8) month; the minimum duration was in the patient with
Immune Thrombocytopenic Purpura and the maximum was the one with Multiple Myeloma. The median time
up until the diagnosis was longer in the malign group (4.5 vs 2.5 months; p=0.070).
Conclusions: As a result of the study, it has been emphasized that COVID-19 may have an etiological factor
for malign and hematologic diseases with autoimmune pathogenesi s.

This study aimed to research dietary quality in adults and to compare using different parameters (body mass index, education statues, gender and age). The cross-sectional study was conducted on randomly selected 421 adults (275 females, 146 males) living in Ankara. Dietary intakes of individuals aging between 20 and 50 years (mean±SD, 32.7±9.096 years) were collected by using 24-hour recall method. Mean adequacy ratio scores calculated by using nutrient adequacy ratio were used for dietary quality assessment. According to mean adequacy ratio scores, 56% of individuals’ dietary nutrient content found to be inadequate. In the study, there was no significant difference in mean adequacy ratio scores according to education, age, body weight; whereas, male mean adequacy ratio scores were higher than female. There is a need for improving diets according to mean adequacy ratio scores assessment in Turkey. Dietary quality can be affected by different variables such as gender, body mass index, age and education statues. Improving dietary quality should be aimed using plan and policies, developed taking into consideration these variables by governments.

Single coronary artery is observed in approximately 2-4% of all coronary artery anomalies. In our case, 48 years old female patient had exercise-induced angina pectoris and fatigue. After her exercise electrocardiogram revealed ST depression during 9 mets, we demonstrated a single coronary artery as an extremely rare anomaly of coronary artery in which there was no original left main artery as well as right coronary artery, left anterior descending and circumflex arteries were originated from right sinus Valsalva. On medical treatment with beta blocker, her symptoms had recovered. This type of coronary anomalies is very infrequent and may be a reason of sudden death.

Aim: The aim of this review is to evaluate recent literature regarding effects of nutrition on fetal development. Main findings: Previous studies show that maternal factors such as age, nutrition, and stress are able to have negative effects on fetal development during pregnancy. The role of maternal nutrition on human pregnancy is still unclear but undoubtedly crucial. The dietary recommendations for pregnant women before and during pregnancy are similar to those for other adults, with a few exceptions. The main recommendation is to keep a healthy and balanced diet; however, there are some specific recommendations related to daily supplementation of minerals and vitamins during pregnancy to reduce the risk of birth defects. Maternal nutritional status during the period of conception is an important determinant of fetal growth and development. The relationship between maternal nutrition and low birth weight, intrauterine growth retardation, and spontaneous abortus are reported in the literature. Furthermore, maternal nutritional factors associated with different kinds of birth defects such as neural tube defects, oral cleft, cardiovascular, central neural, respiratory, and urinary system defects. Result: Therefore, further researchs are need for the effects of maternal nutrition on fetal growth

Serum selenium levels were investigated in both 65 cases who are living where white muscle disease of lambs were often observed and 33 cases where the disease seen rarely. The selenium level was 60.425±11.727 in first group and 70.849±12.868 pıgli, in the second and statistically significant difference was observed between the two groups (p<0.01). Particulary in the first group the selenium level was lower (han the values which reported as normal (78-320 !mit) selenium levels. Epidemiological and clinical studies indicate that low selenium levels can be an etiological cause for cardiovascular disease. Therefor it may be suggested that determination of coronary risk factors, incidance of coronary heart disease and fulfilling of prospective studies relatid with the subject would be usefil.

In this research, the levels of iptal lipid, total cholesterol and phospholipids of 150 cord obtained from healthy newborns. Total lipid: 378.39 ± 88.02 mg % Total cholesterol: 106.48 ± 23.05 mg % Phospholipids: 139.67 ± 39.82 mg % These results vere compared with the other results belong to healthy adults and discussed.

Aim: To determine the course and the variations of radial nerve and its muscular branches in human fetuses. Material and Method: Radial nerve dissections were made on the 200 arms and forearms of 100 fetuses (50 males and 50 females). Length, thickness and distance measurements were taken by the same person using a 0.01 mm sensitive digital compass. Results: In all arms, primarily, the medial branch of muscular branch was separating from radial nerve. This branch was originating from posterior superior part of radial nerve in 153 arms (76.5%) and anterior superior part of radial nerve in 47 arms (23.5%). On forearms it was observed that the first branches of radial nerve reached to the brachioradialis muscle and extensor carpi radialis longus muscle. It was found that the motor branch which innervates extensor carpi radialis brevis muscle exit from deep branch in 48% of the arms, from radial nerve (separating location of the deep and superficial branches) in 42% of the arms, and from superficial branch in 10% of the arms. Also it was observed, in 26% of the cases, that a muscular branch originated from radial nerve and reached to the inferolateral segment of brachial muscle. It was found that there was no relationship between radial nerve and humerus body’s upper (superiorly 0.18) and lover (inferiorly 0.17) parts. Conclusion: The course, muscular branches, innervation patterns and variations of radial nerve should be well known by the specialists especially dealing with the local surgery of this region. In the fetuses, the knowledge of the spiral course of the radial nerve on the posterior face of humerus is crucial to determine the operation approach point, and this area is less safer than adults in the fetuses, according to our results.

Aim: To compare patients applied with tracheotomy because of prolonged intubation before the COVID-19
pandemic and during the pandemic.
Patients and Methods: A retrospective examination was made of the records of 179 patients with a tracheotomy
opened following prolonged intubation in the Intensive Care Unit of Karaman Training and Research Hospital
between September 2018 and August 2021. The patients were separated into two groups as group 1 (n:80)
of patients with tracheotomy in the 18-month period before the COVID-19 pandemic (September 2018 –
February 2020) and group 2 (n:99) of patients with tracheotomy during the COVID-19 pandemic (March
2020-August 2021). The two groups were compared in respect of demographic characteristics, duration of
intubation, early and late complications associated with tracheotomy, and patient outcomes (exitus, discharge
to home, transfer to palliative and other wards).
Results: Group 1 comprised 45% females and 55% males and group 2 comprised 51% females and 49%
males, with no statistically significant difference determined between the groups in respect of gender. A
statistically significant difference was determined between the groups in respect of age and the duration
of intubation (p<0.05). Tracheotomy-related complications were not determined to be significantly different
between the groups (p>0.05).
Conclusion: The patients in this study with a tracheotomy opened during the COVID-19 pandemic were
observed to be younger than patients with tracheotomy applied before the pandemic. In addition, the duration
of intubation was determined to be longer during the pandemic t han in the pre-pandemic period.

Hypersensitivity pneumonia is an inflammatory interstitial lung disease caused by immune response due to inhalation of various organic and chemical substances. Bird fancier’s lung disease is a hypersensitivity pneumonia which develops in response to organic bird products. Hypersensitivity pneumonitis is caused by many birds, especially pigeon. In the current case, the diagnosis was subacute hypersensitivity pneumonitis. Thirty two year-old male was admitted to chest diseases outpatient clinic due to two months of effort dyspnea, dry cough, fever, sweating, fatigue and weight loss. The patient has a history of pigeon feeding. The patient was diagnosed as pigeon fancier’s lung disease by the help of the history, physical examination, pulmonary function tests, chest radiography and highresolution computed tomography findings, and he had prednisolone therapy. As a result, an early diagnosis and then early treatment after the necessary precautions are very important to avoid chronic progress of these diseases.

Aim: In this study, it was aimed whether biochemical parameters, vital signs and neutrophil-lymphocyte ratio
(NLR) values could be used in determining the indication for intensive care hospitalization in COVID-19
patients.
Patients and Methods: This retrospective observational study was conducted in the emergency department
of a university hospital. Patients with positive SARS-CoV-2 PCR test who applied to our hospital on 1-31 July
2020 were included in the study. Laboratory results, demographic findings and clinical results of the patients
were collected electronically. The patients were divided into 3 groups as discharged, admitted to the service
or intensive care unit. The incidence and severity of symptoms, comorbidities, laboratory values, and NLR
values were compared between the groups.
Results: A total of 489 patients were included in the study. The mean age of the included patients was 48.69
+ 17.25 years, of which 260 (53.16%) were female. While 248 (50.9%) of these patients were discharged,
207 (42.3%) were taken to the service and 33 (6.7%) to the intensive care units. Age, heart rate, urea,
creatinine, CRP, D-dimer and NLR values of the patients admitted to the intensive care unit were higher
than the other groups, while oxygen saturation was statistically significantly lower in this group. Concomitant
systemic diseases such as Diabetes Mellitus, Essential Hypertension, Chronic Obstructive Pulmonary
Disease were more common in those hospitalized in the intensive care unit. In multivariable analysis, oxygen
saturation (OR:0.803) and neutrophil-lymphocyte ratio (OR:1.09) were found to be independent predictors of
the indication for hospitalization in the intensive care unit.
Conclusion: As a result of our study, we think that especially low oxygen saturation and high neutrophillymphocyte
ratio can be used in determining the indication for intensive care hospitalization in patients who
apply to the emergency department due to COVID-19.

In this study: the effect of and tolerability to long actinz Verapamil SR 240 mg treatment on ',ordu, mild, moderate and malignant hypenension were in-vestigated.7'he drug was giyen orally once a day. If there was a necessity, a Jose o f 360 mg was used. At the end of Iliis study Verapamil SR 240 mg was found effective in most of thepaıients. Afier theVe-rapamil SR 240 mg treatınent, the patients diastolic blood pressure was ender 90 mın lig. Cardiac and ex-tracardiac tolercllıility to Verapamil SR 240 mg iher-apı. was excelknt. AV-block wasn't seen. In some of the patients, there were Side ellects such as headache, fiıtigue. flushing, nausea, vomiting and dizziness.

Acute myeloid leukemia is the most common type seen in adults with 3-4/100000 incidence and accounting for %20 newly diagnosed patients each year. Patient may present with a broad variety of symptoms including low-grade fever, easy bruising, anemia, weakness in immune system. Cytogenetic analysis is a key component in diagnostic of acute myeloid leukemia. Chromosomal abnormality is present in the majority of malignant cells in acute myeloid leukemia patients. We presented a rare acute myeloid leukemia case with 46, XX del11q(13) karyotype organization.

Aim: In this pre-and post- study, we aimed to compare changes in urological consultations and emergencies
between before and after the pandemic at the same time period o f 2019 and 2020 as two groups.
Patients and Methods: Patient files were retrospectively screened and numbers of consultations, surgeries
and admissions were evaluated. The two groups compared in terms of triage color codes, and final decisions.
Patients’ demographic data such as age and gender, triage color code, consultation order clinic, type of visit
(regular vs control), and operational data (type of surgery, prophylaxis status, place of OR etc) were recorded.
Results: A total of 89,674 patients presented to the emergency department in the 50-day period in 2019 and
53,745 patients in the same period of time in 2020. The number of patients presenting to the emergency
department decreased by 40.07% within the same period compared to the previous year. The percentage of
patients with the green triage code was decreased in 2020 by 30% compared to 2019, while the percentage
of yellow triage code was increased in 2020 by 28.9% compared to 2019. There was a dramatic fall in urology
visits in 2020 by 85.91%.
Conclusion: The COVID-19 pandemic is still ongoing, and it seems likely to continue for some time, despite
all efforts including vaccination programs and novel drugs that will also become available in a short time. The
number of patients cosulted with urology outpatient clinic has decreased during the pandemic.

Aim

This study aims to determine the prevalence of falls and associated risk factors among elderly living in Sinop, Turkey.

Materials and methods

The universe of this cross-sectional study consists of 32506 people older than 65 years old whom are registered to the family physicians’ information system and live in Sinop. After stratification for sex and age (65-74, 75 and over) a sample size of 2463 and 92.1% were reached. Data about some of the socio-demographic characteristics, falling status, daily living activity functionalities, depression status and awareness about falls of the participants were collected via a structuralized questionnaire. Relations between falls and associated risk factors were assessed by four different logistic regression models.

Results

The mean of falling prevalence after age 65 among elderly was 36.4%. Not being graduated from any school, having low scores for current health conditions, using more than one drug daily, not being able to walk without support and being positive for depression are found to be risk factors for falling among both sex and age groups. Having a chronic disease, living alone, having fear of falling, having low awareness about falls, being dependent in daily living activities and having inadequate knowledge about prevention from falls are found to be risk factors for at least two of the sex and age groups. There were no statistically significant relations between falling risk and previous or current employment status.

Conclusion

Falls are important public health concerns among elderly and the variability of risk factors depending on determinants such as age and sex should be considered while planning further implementations targeting fall prevention and control of risk factors for elderly.

Quantitative assessment of ventricular function in patients with congenital heart disease is often challenging due to distorted ventricular geometry. A myocardial performance index (MPI) has been reported in adults and children that is a Doppler-derived non-geometric measure of ventricular function. The MPI measures the ratio of isovolumic time intervals to ventricular ejection time. The effects of altered ventricular preload or afterload on the MPI have yet to be determined. This study was designed to determine the impact of altered preload on left and right ventricular MPI nin the clinical setting of atrial septal defect (ASD). The left and right ventricular MPI were measured in 17 patients with ASD (ages 6 to 148 months, median 24 months) and 24 normal children (ages 3 to 160 months, median 17 months). In patients with ASD and control groups, the left ventricular MPI was 0.38±0.16 and 0.32±0.09 and the right ventricular MPI was 0.24±0.15 and 0.20±0.08 respectively. No significant change in the left and right ventricular MPI was seen in patients with atrial septal defect and control groups. This study documents that the MPI is a quantitative measure of ventricular function that is appears to be relatively independent of changes in preload.

A 9 - year - old girl and a 69 - year - old male with xanthofranulo-matous pyelonephritis vere presented. A 9 - year - old girl had an abdo-minal mass, which, was suspected of being a Willm's Tumor. xanthogranu-iomatous Pyelonephritis occurs in patients of al/ ages. Patients usually have a large non - functioning kidneys with, ealeuli. The females are pre-dominant. Xanthogranu/omatous Pyelonephritis in the ehildren is a rare phenomenon. xanthorganu/omatous Pyelonephritis is always associated with infee-tino (usually proteus) and there are some signs of obstruction. There has never been reported bilaterally.

Tuberculosis remains to be a serious public health problem in our country and all over the world. Extrapulmonary tuberculosis causes major clinical problems because of difficulties encountered in the differential diagnosis. In this case report, we aimed to discuss a case of tuberculous lymphadenitis mimicking mediastinal tumor in chest CT and PET-CT examination. Eighty years old female patient with right paratracheal enlargement in the chest radiography was admitted to our hospital. Thorax CT and MR imaging was supporting this expansion as concordant with the mediastinal tumor. The PETCT showed increased FDG uptake in favor of malignant masses. However, mediastinoscopic biopsy was reported as tuberculous lymphadenitis and antituberculous therapy was started. It should be kept in mind that even in adults patients, tuberculous lymphadenitis should be thought in differential diagnosis of mediastinal masses suspecting malignancy with imaging techniques and also it should not be forgotten that tuberculous lymphadenitis may be presented with elevated FDG uptake at PET-BT.

Adult respiratory distress syndrome is an advanced degree of distressing respiratory failure in adults. Various factors play a role in this clinical picture. Although respiratory failure associated with trauma and shock has been reported since the beginning of the twentieth century, the definition of respiratory distress seen in adults is very recent. In 1967, Asbaugh et al. Described this entity with its clinical and physiopathological features.

Doctors Commisions report: of the Konya State Hospital from 1979 to 1989 have been reviewed. Among these reports that have been prepared the cause of the disability were studied. And the causes of the disabilities were investigated in adults. Our findings showed that musculoskeletal System was the most effected part in disabilities.

Aim: The aim of the study was to evaluate the clinical features and consultation process of the patients who
were consulted from the pediatric emergency department to the surgical departments during the pandemic
period, and to compare the findings with the data before the pa ndemic.
Patients and Methods: The research was conducted between 11.03.2020-11.03.2021 in the pediatric
emergency department of our hospital. The enrolled patients at 0-18 years of age were retrospectively
evaluated in terms of gender, age, diagnosis, consultation result, consultation response time. Our study was
compared with the prepandemic data between 01.01.2019 and 31.12 .2019.
Results: Of the patients; 42,4% were female and 57,6% were male. The mean age was 6,9±4,9 years. It
was determined that 27,3% of our patients were consulted to one of the surgical clinics with the diagnosis of
foreign body, 22,2% acute abdomen, 10.6% foreign body aspiration. It was found that 38,5% of the patients
were consulted to the pediatric surgery department, 33,9% to the otolaryngology department and 11,4% to the
thoracic surgery department. The mean consultation response time was 72,2±48,8 minutes. The distribution
of diagnoses, consultation response time, consulted surgical departments, consultation results by age groups,
and distribution of the consultation response times by surgical departments during the pandemic were found
to be statistically significant compared to the pre-pandemic pe riod (p<0,05).
Conclusion: In our study, it was found that the number of patients admitted to the pediatric emergency
department decreased during the pandemic period, the number of hospitalizations increased, the diagnoses
associated with trauma and close physical contact decreased, and the diagnosis of epididymorchitis increased.
In addition consultation response times were observed to be con siderably longer.

 Moyamoya disease is an entity, which is caused by obstruction or stenosis in the area between the internal carotid artery, and anterior and middle cerebral arteries, identified angiographically, and does not have an exactly known etiology. The most frequent symptoms of onset are hemorrhage in adults and ischemia in children. In this paper, we present a case of Moyamoya disease which was diagnosed with a 21 year old male patient who was admitted to our emergency department with headache, nausea vomiting and left hemiparasi complaints and whose radiological findings showed right basal ganglia hemorrhage.

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Introduction and Objective

Brucellosis is a zoonotic infection seen as an endemic in Turkey and is a public health problem at the same time. The objective of this study was to evaluate demographic/epidemiologic, clinic, laboratory features, complications and treatments in brucellosis patients followed-up in our clinic.

Material & Methods

In this study, features of patients followed-up between 01/01/2010 and 31/12/2018 in our clinic were retrospectively evaluated. Descriptive data were expressed as number and percentage. Categorical variables were analyzed with Chi-square test and numerical variables with Student’s t test.

Results

Of the total of 365 brucellosis patients, 159 (43.56%) were female and 206 (56.44%) were male. The mean age of the patients was 45.9±14.51 (18-82) years. The most common time of presentation was summer season with 137 (37.5%) patients. The most common transmission route of the disease was a history of animal husbandry with 252 (69%) patients. Of all cases 168 (46%) were acute, 96 (26.3%) were subacute, and 101 (27.7%) were chronic brucellosis. The most common complaint of the patients was fatigue in 302 (82.7%) patients with being higher in acute brucellosis (p=0.0015). Anemia was found in 53 (33.3%) male and 114 (55.3%) female patients with being significantly higher in female patients (p=0.0283). Leukopenia was found in 7.9%, leukocytosis in 16.2%, thrombocytopenia in 9.6%, neutropenia in 4.1%, neutrophilia in 9% and lymphomonocytosis in 12% of the patients. Wright agglutination test was performed in 26 (7.1%) and brucella immunocapture agglutination test in 361 (98.9%) patients and all results were positive. Of all patients, 172 (47.1%) developed complications with spondylodiscitis being the most commonly found in 58 (15.9%) patients. Sixty-one (31.8%) of patients developed relapse.

Conclusion: Since brucellosis is endemic in our country, it should be considered in presumed diagnosis of patients presenting with complaints such as fatigue, articular pain and fever.

Aim: The aim of this study is to examine whether the timing of surgery in our elderly patients with a
diagnosis of hip fracture changed before and after the pandemic, and whether this situation caused an
increase in mortality .
Patients and Methods: The patients who were operated with the diagnosis of hip fracture between March
2019 and March 2020 in our hospital database were accepted as in the pre-pandemic period, and the
patients who were operated with the diagnosis of hip fracture between April 2020 and April 2021 were
considered as in pandemic period. Both groups were statistically compared in terms of age, gender,
waiting time for surgery , length of hospital stay and one year mortality .
Results: When the factors af fecting mortality were examined, the time elapsed until surgery significantly
increased mortality. While the mean waiting time for surgery was 27.6±19.4 hours in all patients, it was
25.7±19.1 hours in Group 1 and 29.6±19.6 hours in Group 2 and there was a significant difference between
the two groups (p=0.043). The cut-off value of the waiting time for surgery, which caused mortality, was
determined as “23.35” hours. While no significant increase in mortality was found in Group 1 (p=0.340),
the increased delay for surgery in Group 2 affected mortality significantly (p=0.027).
Conclusion: In this study, it was found that the increase in the delay of admission for surgery over 23.35
hours in the elderly population after hip fractures was directly associated with one year of mortality
and also we think that the waiting time for surgery in the pandemic conditions is one of the factors that
negatively af fect mortality in these patients.

The disease was first described by Scheuermann as the dorsal kyphosis of juveniles in 1920. Scheuermann's disease is the most common cause of thoracic hyperkyphosis in adolescence. There are two sub-types: thoracic and thoracolumbar / lumbar. Histologically, when the irregularities in the vertebral end plates are examined, collagen fibrils are seen to decrease or vanish. As a result, end-plate continuity deteriorates and Schmorl nodules appear when the disc material protrudes into the corpus. Deformations cause wedging in the vertebral corpus, resulting in narrow angled kyphotic deformity. In the large series, the prevalence is up to 8%, and the genetic transition and mechanical stress come into prominence in the epidemiology of the disease. Pain can be accompanied by deformity in symptomatic state. Classical radiological features include irregular vertebral endplates and kyphosis more than 45 degrees with 5 degrees of wedging in 3 or more vertebrae. In some cases, minimal scoliosis may accompany to kyphosis. Periodic radiologic follow-up is recommended for patients below 50 degrees of kyphosis. Bracing is appropriate in uncompleted skeletal maturation with kyphosis up to 75 degrees. In cases above 75 degrees, it is appropriate to perform surgical treatment when bracing is unsuccessful in adolescence and presence of exceeding pain despite the conventional methods and obvious deformity in adults. 

Bronchial carcinoid tumors constitute approximately 5 percent of all lung tumors. They occur with about equal frequency in both sexes. Most patients are young or middle aged adults. These tumors are not related to cigarette smoking or other known pulmonary carcinogenic factors. Dependent upon the location of the tumor within the lung clinical presentation and morphologic appearance, these tumors are four variants. These variants are the central carcinoid, the peripheral carcinoid, atypical carcinoid, tumorlet type bronchial carcinoid. In this study, two cases diagnosed as bronchial carcinoid turner in Pathology Depart-ment of Medical School of Selçuk University between May 1987 -April 1988 were presented and discusseJ.

Bronchial carcinoid tumors constitute approximately 5 percent of all lung tumors. They occur with about equal frequency in both sexes. Most patients are young or middle aged adults. These tumors are not related to cigarette smoking or other known pulmonary carcinogenic factors. Dependent upon the location of the tumor within the lung clinical presentation and morphologic appearance, these tumors are four variants. These variants are the central carcinoid, the peripheral carcinoid, atypical carcinoid, tumorlet type bronchial carcinoid. In this study, two cases diagnosed as bronchial carcinoid turner in Pathology Depart-ment of Medical School of Selçuk University between May 1987 -April 1988 were presented and discusseJ.

Aim: This study was aimed to determine the demography of family caregiver of dependent older adults and their attitude related to care and relationship between attitude and short time education. Material and Method: The study carried out as quasi-experimental design. Forty-eight family caregivers of dependent older adults were included from a randomly selected health center area in Karaman city center. The family caregiving questionnaire was applied by interviewing. The family caregivers were educated by co-researcher about care of elderly. The questionnaire was applied again after eight weeks of education. Results: The mean age of the family caregivers was 49±16, 71% of them were married and 35% were uneducated. Almost all of them were women and were not working elsewhere. In 26 items the average of positive attitude score of the family caregivers was 59±27 on 100 points. The attitude scores was not significantly different according to demographic features. The scores were higher in post-training compared to pre-training. Conclusion: It is concluded that education of family caregivers by public health nurses positively affect the quality of care of dependent older adults.

Between 1983 and 1996 splenic surgerv was peıfonned irr a tatar` of 47 .children in the Research Hospital of Medical Faculty of Selçuk Unive•sity. The age• of the patients were betıveen one and 16 vc'ars. Of the patients 38 under•ent splenectomy. of. which 17 were pelforıned general sur.,!:;eons be-Pre 1991_ Pediatric surgeons have been performin these procedures since rhen. When these two periods are coınpared It is frJldlrfl that. the most U)/i dication.v for ,splenectomy are trannut and he-motological diseases before 1991 aml cıfıer tlıen. respectivelv. Wc' suppusod that. the ı-eason of the (lif-frrence between tvı,o periods is the impo•tance of- the jımetions of the spleen is not elem- in adults as iır (.-hildren and therefrre. .fi)r the menagemenı of the trattmatic children, the methocl used hrgenaral sur-geons i.s different from ılıaı (ıf pedian-k:surgeons_

Castleman’s disease is a rare lymphoproliferative disorder of unknown etiology exactly. Although the disease most commonly appears in the mediastinal lymph nodes, it can be occur in cervical, retroperitoneal, axillary and other regions lymph nodes. There is no gender predominance and often occurs in young adults. Two histological variants as hyaline-vascular and plasma cell type have been described. Clinically it is also divided in two types: a localized type, which is usually asymtomatic and presented as a mass or swelling. Systemic (multicentric) type is characterized nonspecific symptoms such as fever, anaemia, generalized lymphadenopathy and hepatosplenomegaly Complete surgical excision is curative for localized form. Although systemic type is usually treated with radiation therapy, corticosteroids and chemotherapy, there is no certain treatment. We herein reported a neck mass diagnosed as hyaline vascular type Castleman’s disease.

Nearly all of the reports about pneumomediastinum associated with pneumonia have been conducted in adults as pneumomediastinum was uncommon in pediatric age group. This case report is described an infant with pneumonia complicated with pneumomediastinum and epidural emphysema. Her original disease is a severe combine immunedeficiency (SCID). Another reason to provide this case report is that epidural emphysema or pneumorachis associated with pneumonia and pneumomediastinum is a rare condition.

Since the identification of SARS-CoV-2, a multisystem inflammatory syndrome (MIS-C) that appears in
children after COVID-19 disease and mimics Kawasaki disease was reported in the UK in April 2020,
while it is associated with Covid-19 in adults. Multisystem inflammatory syndrome (MIS-A) was reported
in June 2020. MIS-A patients have been reported to be up to 50 years of age in the literature and are more
likely to have some underlying health condition and have recently had an identifiable respiratory disease
compared to MIS-C. On the other hand, MIS-A patients and MIS-C patients have many overlapping clinical
features, but the severity of cardiac dysfunction, incidence of thrombosis, and MIS-A mortality may be
higher in MIS-A. While it is clear that neutrophilia, lymphopenia, and thrombocytopenia are common in
MIS-C/A, these features, together with elevations in troponin and BNP/NT-proBNP, have been considered
measures of disease activity .

The latex allergy has been increasingly recognised in recent years in both adultsand children. After anaphylactic type reactions due to latex has been shown as case reports, latex allergy became an important problem especially in medical practice. The majör risk factors in latex allergy are intense exposure to latex allergens (surgical gloves, catheters, etc.), atopy hand eczema, female gender, history of multiple operations and dental interventions. Some occupational groups such as health-care workers and workers in latex industry are under greater risk due to their possible frequent contact with latex. An association between latex allergy and allergy to various fruits (banana, avocado, pineapple, kiwi, etc) has been reported. Latex allergy is responsible for a wide spectrum of clinical symptoms ranging from a mild dermatitis to severe anaphylaxis in both adults and children. There fore an allergologic investigation for latex allergy should be considered for those from high-risk groups. Then, it will be possible to take precautions in order to prevent life-threatining allergic reactions by exposure to latex

The aim of this study is exploring the effects of childbirth education, physiotherapy and psychotherapy-based interventions on fears and worries about childbirth and labour. Expectant mothers in the last trimester of gestation those did not have a delivery before were taken to the study. At first the participants were examined by a psychiatrist than sociodemographic data form Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), Beck Depression and Beck Anxiety Inventories (BDI, BAI) were applied. Then 3 sessions each taking 60 minutes on possible physical and mental problems before birth were done, an exercise plan and recommendations for facilitating delivery were given to participants, information about possible physical and psychological problems after childbirth were given and their questions on these issue were answered. In results mean age of the group was found as 27.2±3.6. The mean gestational age was 35.7±2.3. Socio-demographic characteristics (age, education level, income level, etc.) was not found significantly correlated with the W-DEQ scores. W-DEQ 1 scores were positively correlated with BAI scores. In Wilcoxon test analyses W-DEQ 1 and W-DEQ 2 scores including all the subscales were significantly different p<0.001. As a conclusion on expectant mothers having their third trimester of pregnancy, education before childbirth was found helpful in reducing fears and negative thoughts related to childbirth.

Aim: Renal biopsy is performed for the diagnosis and the decision of treatment of renal parenchymal diseases. The aim of this study was to evauate the clinicopathological findings of kidney biopsies. Material and Method: 78 percutan renal biopsies were performed by ultrasonography in our institution during the period between January 2000 and December 2006. Results: The most common renal biopsy indication was nephrotic syndrome (n:39, 50%). Other indications were association of nephrotic and nephritic syndrome (n:14, 18%) and nephritic syndrome (n:7, 9%). The most mikroskocommon nephropathy was mesangial proliferative glomerulonephritis (n:15, 19%) which was followed by Henoch Schonlein purpura nephritis (n:14, 18%), focal segmental glomerulosclerosis (n:8, 10%) and lupus nephritis (n:8, 10%). Primary glomerular diseases (n:48, 62%) is more frequent than secondary glomeruler diseases (n:30, 38%). Conclusion: The present study which evaluated 78 renal biopsies showed that nephrotic syndrome was the most common indication for renal biopsy. Histopathologically, the most frequent nephropathy was mesangial proliferative glomerulonephritis. These results suggest that renal biyopsy results in children can show regional variances and have a fairly different distrubition from those of the adults.

Angiomatoid Fibrous Histiocytoma (AFH) is a rare soft tissue tumour of indeterminate differentiation usually occurring in children and young adults with low rate of metastasis and recurrence. AFH continues to be revised with various studies reporting recurrences but up till now, the diagnostic criterion remains unclear with pathologists relying mainly on Enzinger’s description and immunohistochemistry. Adding to the fact that it is a rare tumour, diagnosis usually is delayed. We present a case of a 10 year old male with AFH with atypical histology, immunoprofile and genetic testing. Opinions were sought from Heidelberg hospital Germany and Children Hospital of Philadelphia which had contrasting views regarding the diagnosis, which was finally confirmed by Brigham and Women’s hospital, Boston. We review literature and discuss the possible differential diagnosis.

German measles (rubella) is a viral disease characterized by rash, fever and lymphadenopathy in children and adults. This disease is passed with mild symptoms in childhood, if the virus passes to the fetus during pregnancy, it leads to congenital rubella syndrome and can lead to many anomalies. The purpose of this study was to determine the seroprevalence of rubella IgG antibodies in women of marriage-age. In this study, Rubella IgG antibodies were investigated in the serum of marriage-age women who had attended to step one health care provider for premarital tests, prospectively. Tests were performed by Electrochemiluminescence immunoassay (Cobas, Roche, Almanya) according to the manufacturer’s recommendations. 963 women who were between18-25 years old in marriage age were included in this study. Rubella IgG antibodies were positive in 929 (96.5%) and were negative in 34(3.5%) of them.The seroprevalence of rubella have been found to be high in Konya. Immunity continues during lifetime in individuals who suffered from infection but women in marriage age who had not been infected and unvaccinated are at risk. Vaccination of women attended for premarital tests may reduce morbidity and mortality associated with congenital rubella syndrome.

STUDY AIM: In this study, it was aimed to identify the accurate and inaccurate conceptions among the society on COVID-19 disease, which is considered as a public health problem and has a high risk of transmission. 

METHODS: The research was performed online at https://docs.google.com/forms in May 2020. The questionnaire form was composed of 40 queries, which were on sociodemographic characteristics and COVID-19. Following the study, the answers obtained from the questionnaire were analyzed by inserting related data to the software of SPSS. 

RESULTS: Of 580 participants involved in the study, 363 (62.6%) were female. The median age of the participants was 34.0 (18.0-77.0). Of the individuals who completed the questionnaire, 342 (59.0%) were married and 438 (75.5%) were university graduated and / or postgraduated. Of the individuals included in the study, 497 (85.6%) stated that they watched television / news channels to be informed about COVID-19. Most of the questions related to COVID-19 were answered accurately by the participants. The percentage of the premise, which was answered most accurately, was 577 (99.5%), whereas the lowest percentage of the accurately answered premise was 137 (23.6%). It was found that there was a statistically significant difference among the genders in terms of the percentage of accurate responses to the conceptions (p<0.05).

CONCLUSION: It was determined that the vast majority of the participants utilized from at least one news resource on COVID-19. Participants typically have accurate knowledge about COVID-19. Educational programs can be planned to enhance the awareness of the society about the conceptions, which were answered mostly inaccurately.

Tracheobronchial foreign body aspiration is a common and lifethreatening problem in childhood and adulthood and an important cause of childhood morbidity and mortality. Recurrent respiratory tract infections may be due to foreign body aspiration. Aspirates includes frequently; toys, coins, beans, nuts, peanut, kernel, dried legumes, and sugars in children and; food, awn, turban pins, metallic objects and dental prosthesis in the adults, respectively. If foreign body aspiration may caused to complete or nearly total occlusion, in this time the object have to be removed urgently. Although flexible bronchoscopy can be used to remove of foreign bodies in children and adults, rigid bronchoscopy remains the gold standard all the time.

Insulin receptor binding and levels on circulating lymphocytes in 13 healthy children. Their ages were changing between 9-17 years. The insülin binding rate(insulin receptor level) was found between 9,10 percent and 11,81 percent. The finding results were higher than in adults.

 Today an increasing prevalence of obesity, which is one of major health problems is associated with many chronic diseases such as diabetes, cardiovascular disease, stroke, cancer, asthma obstructive sleep apnea syndrome. Therefore, treatment of obesity contribute to  prevention of many chronic diseases risk. Recent years, it has started to consider on effects on the gastrointestinal system in treatment of obesity as well as adequate and balanced diet, increasing  physical activity and lifestyle changes. Especially it was seen that gut microbiota has been associated with obesity. Many studies showed that gut microbiota may be vary with eating habits and obesity. It is discussed changed microbiota might be associated with obesity and many obesity-related diseases. It is thought that long term-controlled studies in this area   will create a new approach to the treatment of obesity and come into prominence in the fight against obesity. In this review,it was aimed to evaluate the relationship between body weight and the gut microbiota.
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Aim: Hypoxemia is a vital criterion used to determine prognosis in coronavirus disease (COVID-19)
cases. This study thus examined the effectiveness of capillary refill time (CRT) in defining hypoxiadependent
disease severity in COVID-19 patients.
Patients and Methods: This prospective study was conducted with COVID-19 patients and an agematched
healthy group. The optimum test ambiance was provided, and a stable smartphone platform
was used to record the measurements (in ms) to standardize our method. The captured videos were then
evaluated using a video processing program.
Results: In total, 39 patients with COVID-19 and 40 control groups participated in this study. The patients
were further divided into the moderate (n = 25) or severe group (n = 14) according to disease severity.
The mean oxygen saturation of both moderate/severe groups was above 94%. Per disease severity, the
CRT measurements were higher in the severe group than in the moderate group (p = 0.009). In patients
without lymphopenia (n = 18), CRT values were found to be increased in the severe group (p = 0.008).
The use of CRT in patients with Covid-19 was practicable (AUC: 0.91; 95% CI 0.848-0.978; P = 0.001).
Conclusions: Our results show that CRT prolongation can occur in patients with COVID-19. In patients
without lymphopenia and with normal O2 levels, detecting CRT prolongation may be a criterion for early
admission to ICU.

Although the dental urch is generally symmetric, some cases of both mathematically and morp-hologieally deviated Pons have been reported. Irı our study,we aimed ta investigate the morphological pattern of dental ardı in adult maks and females. Using plaster casts, we peıformed our examination on 50 peoplc (25 males and 25 females, ranging from 17 to 35 years of ages), who had no anomalies or disorders of maxilla and mandible, and had no previous or CUITC111 dental treatmems. The results revealed that the width of the first intermolars in mandibles was significantly different between sexes (the value of the first intetınolar width in mandibles was largeı in males, p(0.05). There vere no sig-nificant differences in the other nıorphological .fe-atures examined.We. therefore believe that both the quantitative and qualitative analysis of the size and shape of the dental arch is especially important j'or the diagnosis, treatment and determination of the developnıental differences in dentistry.

Although the dental urch is generally symmetric, some cases of both mathematically and morp-hologieally deviated Pons have been reported. Irı our study,we aimed ta investigate the morphological pattern of dental ardı in adult maks and females. Using plaster casts, we peıformed our examination on 50 peoplc (25 males and 25 females, ranging from 17 to 35 years of ages), who had no anomalies or disorders of maxilla and mandible, and had no previous or CUITC111 dental treatmems. The results revealed that the width of the first intermolars in mandibles was significantly different between sexes (the value of the first intetınolar width in mandibles was largeı- in males, p<0..05). There vere no sig-nificant differences in the other nıorphological .fe-atures examined.We. therefore believe that both the quantitative and qualitative analysis of the size and shape of the dental arch is especially important j'or the diagnosis, treatment and determination of the developnıental differences in dentistry.

A case report of endocarditis patient due to Brucellosis who had gaye to open heart surgery and had an aortic walve replacement.

Bölgemizde oldukça yaygın olarak görülen Brusellosisin en korkulan ve en az görülen komplikasyonu endokarditisdir.

Invagination is the condition whereby a segment of intestine becomes drawn into the lumen of the proximal bowel. İnvagination in adults is a rare situation and the causes are different from childhood group. A 33 years old female patient admitted to emergency service with abdominal pain , nousea and vomiting. In ultrasonography and abdominal computed tomography suspected from invagination so the patient was operated urgently.In operation a masswas palpated and segmental resection was applied. Post-operative 7 th day , the patient was discharged from hospital without any complication. In pathological evaluation well-differentiated adenocarcinoma was detected in all polyps. Although invagination is a rare condition in adult patients when suspected from invagination the possibility of malign tumor should be considered. According to this , wide segmental resection is advised.

Essential thrombocythemia (ET) is ophically a disorder of adults in sixth or seventh decade of life and is characterised by frequent thrombohemorogic complications. E T is seen rarely in young people. Our case ►cars a young man so we decide to mff( this case.

Introduction: İn this study, we presented the results of smooth pinning which is a less aggressive surgical procedure with pelvipedal cast application in fractures of the neck of the femur in children. Materials and Methods: This study covers the results of surgically treated 48 hips of 49 children with fractured neck of femur who were admitted to our clinic betvveen 1986-1998. The mean age was 6.2 years (range 2-9 years). According to Colonna classification, four hips were type I, 27 hips were type II, 16 hips were type III, and two hips were type IV. İn ali patients, closed reduction with three or four percutaneus or öpen surgical smooth pins of two or three millimeters in diameter was applied using image intensifier and traction table. Pelvipedal cast was applied postoperatively. Results: Patients were follovved for 43 months (range 27-163 months) and the results were assessed using Ratliff’s criteria. Thirty-nine (79.6%) hips had good, nine (18.4%) hips had fair, one (2%) hip had poor results. Complications included avascular necrosis in 10 hips, prematüre closure of the epiphyseal plate in 3 hips, non-union in 3 hips, varus deformity in five hips, pin loosening in three hips. Conclusion: We realized that smooth pins were advantageous as their damages on epiphyseal plate were less, their percutaneus applications were easier and removing them by minör surgical procedures was possible. Unlike in adults, the femoral fractures in children are healed easily vvithout using compressive systems. İn relation to this, we observed that smooth pins had no negative effects in fracture union. The complication rates in this study were not higher than other studies reported in the literatüre.

Two patients have been operated tor pulmonary arteriovenous fistula at the Department of Thoracic Surgery, School of Medicine, University of Selçuk, Konya. The patients were adults, 49 and 62 years-old. Fistules were localized in the right lower lobe in first one and in the right upper lobe in second. The type of the operation was lobectomy in both cases. Among our patients with pulmonary arteriovenous fistulas, hereditary hemorrhagic telengiectasia was not observed. İn this article, the pathogenesis, clinical features, pathophysiologic changes, and treatment of pulmonary arteriovenous fistulas are discussed.

The human parvovirus B19 has been identified as the causative agent in several diseases, including erythema infectiosum, aplastic crisis,hydrops fetalis and a polyarthralgia that occurs in adults. The major pathophysiologk effect of infection seems to be cessation seems to be cessation of erythropoiesis a result of cytolitic infection of red cell precursors. Except for the potential of neonatal death due to fetal hydrops, the prognosis of patients with par-vovirus infection is generally good. The diagnosis of B19 infection may be established on clinical ob-servations but often requires cofirmation with serum antibody testing. Treatment strategies may include supportive care, analgesic medications, transfusions with red blood cells or administration of intravenous inuniunglobulinidepending on the clinical cir-cumstances.

Systemic Lupus Erythematous, autoimmune character, is a inflammative disease holding many systems. The disease can sometimes follow insidiously with symptoms of fever, asthenia and prostration for years. Central nervous system is common. It is the clinical variable and may be very mild or very severe. In most patients, the age of onset is between 16-55 years old and is found in cases diagnosed in advanced age. Here, it is presented an elderly patient developed dizziness and right side prostration when she was 80 and diagnosed lupus when she was 85. We thought as worth for presenting because of that both the patient is elder and that the lesions have similar features with demyelinating plaques. The lupus should not be forgotten in the central nervous system involvement in advanced age cases and separator diagnosis.

Towards the end of 2019, new coronavirus causing acute respiratory distress syndrome in patients was detected in Wuhan Province, China . This virus was called serious acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the International Virus Taxonomy Committee. The disease caused by this new coronavirus was called coronavirus disease-2019 (COVID-19) by the World Health Organization. This virus was found to be in the subclass of Betakoronavirus caused by bats. The role of viral proteins such as envelopes, membranes, nucleocapsids and spike proteins responsible for viral infectivity in immunopathogenesis is being investigated in studies. It has been emphasized in studies in which multiple organ failure develops due to the development of cytokine storm, especially in the advanced stages of the disease. An effective host immune response, including natural and adaptive immunity to SARS-Cov-2, is essential for controlling and treating viral infection. Although there is no effective treatment for the disease today, the benefits of various immunosuppressive and immunomodulatory drugs have been shown in studies. In this article, the immunopathogenesis of SARS-CoV-2 and the treatment models that can be effective on immunopathogenesis are reviewed in the light of current literature.

Asthma is one ofthe commonest diseases in children and adults İn many countries. The prevalence of asthma has dramatically increased in recent years. The development of asthma depend on an interaction between genetic factors, environmental exposure to allergens, and nonspesific adjuvant factors such as tobacco smoke, air pollu- tion, and vira! infections. These factors initiates a series of immunological changes, resulting in airvvay inflamma- tion. The airvvay inflammatory process is characterized by chronic eosinophilic and Th2 type lymphocytic infiltra- tion. Although the knovvledge about asthma pathogenesis has increased, the prevalence of asthma has not decreased. Therefore, the asthma stili is a threat for the society’s health at the beginning of the 21 st century.

Aim: This study aimed to evaluate the incidence of hypermetabolic axillary lymph nodes due to COVID-19
vaccines and the factors affecting hypermetabolic axillary lymph nodes in F18-fluorodeoxyglucose (FDG)
positron emission tomography/computed tomography (PET/CT) in on cology patients.
Patients and Methods: Among the patients who underwent FDG PET/CT in our institution between
January 15, 2021, and June 15, 2021, those who received one or two doses of COVID-19 vaccine
(CoronaVac or Biontech) were included in the study. Presence and number of ipsilateral hypermetabolic
axillary lymph nodes, FDG uptake, and whether there was a difference between these data after the 1st
and 2nd vaccination were investigated.
Results: Unilateral hypermetabolic axillary lymph nodes was observed in 9.9% (18/182) of the patients
[9.6% (9/94) after 1st dose, 10.2% (9/88) after 2nd dose] vaccinated with CoronaVac; It was detected in
37.5% (9/24) of the patients [35% (7/20) after 1st dose, 50% (2/4) after 2nd dose] who vaccinated with
Biontech. A negative correlation was found between the presence of hypermetabolic axillary lymph nodes
and age in patients who vaccinated with CoronaV ac.
Conclusion: The frequency of hipermetabolik aksiller lenf nodu after CoronaVac was lower than that
observed after mRNA vaccines, a small group of patients in our study, and lower than reported in the
literature. However, the statistical difference could not be evaluated due to the insufficient number of
patients in the Biontech group. A brief history of vaccination is recommended before FDG PET/CT to
reduce false positives. The potential role of FDG PET/CT in comparing the efficacy of vaccines produced
with dif ferent biotechnologies should be searched in studies with large r patient populations.

167 vascular reconstructive operations have been performed in our clinic using a prosthetic vas-cular graft (Dacron or PTFE) and/or autogenous vein graft between the dates of January 1988 -March 1996. During their follow up in this period 6 graft infection (%3.56) have been developed. Our major treatment protocol in graft infections was to remove the infected graft totally and to use app-ropriate antibiotics according to culture results. Our morbidity was I amputation . In different series incidence of graft infections is reported to he between 1.3 - 6%.

Aim: The literature revealed that group of COVID-19 patients who experience anosmia and ageusia
symptoms is younger, is predominantly female, and experiences a milder course of the disease. This
study aimed to evaluate the relationship of the presence of anosmia and ageusia symptoms with the
severity of pneumonia and laboratory test results in hospitaliz ed patients with COVID-19.
Patients and Methods: A retrospective evaluation was made of patients who were hospitalized by
the Department of Pulmonology between October 2020-March 2021 and underwent thorax computed
tomography (CT). Thorax CT findings of the patients were scored with a severity score for each lobe and
a total score was obtained. Pneumonia was classified according to the shape, distribution and appearance
of the lesions, and laboratory test results were obtained. These findings were compared according to the
presence of anosmia and ageusia symptoms.
Results: Evaluation was made of a total of 177 patients, comprising 89(50.2%) males and 88(49.8%)
females with a mean age of 53.0±14.5 years (range, 18-89 years). The number of patients who experienced
at least one of the symptoms of anosmia and ageusia (Group 1) was 67(37.9%) and the rest (Group 2)
did not experience any of these symptoms. The Group 1 patients who experienced these symptoms was
younger (p=0.009). No difference was determined between groups regarding the total pneumonia score
and involvement patterns (p> 0.05). The groups were similar in terms of laboratory results(p> 0.05) .
Conclusion: The prevalence of anosmia and ageusia in hospitalized patients is not a small number and
is more common in the younger population. No association was seen between the presence of these
symptoms and milder pneumonia severity and laboratory results. These symptoms do not have prognostic
value for the severity of the disease in hospitalized patients.

The result of 67 adult patients in whorn 68 fractures of the femoral shaft had been treated by Küntscher nailing and plate were reviewed. Küntscher nailing and plates were used in 40 and 27 patients, respectively. There were 56 male and 11 fernale patients. There average age of the patients was 33.6 years (range 18 to 85 years). There were five postoperative infection, but all fractures eompletely healed.

In the mental problems of young adolescents and young adults in university age, the physician should pay attention to whether the problem is an expected reaction to stress or early signs of a neurotic or psychological condition (1).

Objective: To determine the effect of COVID-19 infection on anxiety level in pregnant women.

Material and Methods: In this study, a questionnaire and Beck anxiety scale were applied to pregnant women who referred to outpatient clinic for routine pregnancy control in June 2020 to determine their concerns that may be related to COVID-19. Pregnant women admitted with obstetric emergencies and obstetric risk were not included in the study.

Results: 177 pregnant women were included in the study and the pregnant women were divided into four groups according to their score on Beck anxiety scale. Anxiety level of pregnant women was 44.6%. The possibility of not being with his family at the time of birth and the fear of death due to COVID-19 were statistically significantly associated with higher anxiety levels.

Conclusions: In this process, it is important to provide psychosocial support in addition to the follow-up of pregnant women by a multidisciplinary team consisting of perinatology, newborn and intensive care specialists.

Acute pancreatitis is an important cause of acute abdominal pain in children and requires prompt treatment because it may become life-threatening. The incidence of acute pediatric pancreatitis is increasing. Although epidemiology of acute pancreatitis, clinical manifestations and acute pancreatitis course in children are generally different than in adults, information about etiology, management and results are obtained on the basis of adult studies. In most cases, inflammation may limit itself, but in some cases acute pancreatitis, acute recurrent pancreatitis or chronic pancreatitis may progress. It is necessary to provide optimal management in the acute period of pancreatitis in children, as this may prevent secondary conplications. In this review we summarise the epidemiology of acute pancreatitis, role of imaging and imaging findings in the diagnosis of acute pancreatitis, treatment methods and management and complications of acute pancreatitis.

Exercise induced proteinuria was studied on 44 healthy players of the Amateur Foothall Tc-urnament Leaque. Their ages ranged from 16 to 25 years. Urine samples were collerted from the players before and after the ganıes, 44 samples were obtained from healty players and analyzedjor urine proteins electrophoreticly. Compared to va-lues obtained from the control pregam• values, the urine protein content increased sigmfirantly con-taining mainly alhumin, fl-globulin, and y globulins. Bul the values for a-globuliğıs did not change significantly. Urine proteins seperated biz nitrocellulose films were also qualitated from the proportions of the densitometric values (!f the peaks on the graphes. The values found in Iliis study and the values cited elsewhere indicated that exercise induced proteinuria is nonselective pro-teinuria and is due to increased permeability of glomerulus and, to impared reabsorption of normal amounts of protein from the glomerular filtrate or ta tubular excretion. Therefore, proteinuria ap-pearing after physical activity can be classified as glomerulo-tubular type.

In recent years, after it became clear that smoking poses a threat to human health by causing cancer and some other diseases, anti-smoking campaigns have intensified in many countries and the smoking rate has decreased significantly in these countries. Unfortunately, the amount of cigarettes consumed and imported in our country is gradually increasing. This means the number of people who will be harmed by smoking. Those who will suffer are not only actively smoking adults, but also the fetus, babies, and children in the mother's abdomen. In this article, some of the effects of smoking on child health will be discussed. This article has been prepared as part of a booklet that will also include other effects of smoking.

The Coronary heart disease and üs risk factors were investigated in Konya, which is placed in the central pan of Central Anatolia in Turkey. In 'his study 280 asymptomatic people, who are middle aged and over (.40), were selected randomize from Bozkır, a small town of Kon" ya, which shows a ho-mogen structure of population. All of the cases which were investigated, cardio-vascular system was examined. ECG and teleradiog-raphy were taken. In 54 cases (19.3%) hypertension, 11 cases (3.9%) hyperglisemia and 58 male cases (59.8%) smoking were found. Obesite was seen 17% of male and 27% of female. Ilypercholesterolarnia in 12% of cases and hypertrigliseridemia in 7.4% of cases were also seen. In 40 cases, coronary heart dis-ease was deterrnined. Incidence of hypefrtension was increasing with age, but the rale of cigarette-smoking was not changed. With the understanding of posiıive results of struggle -withreversible major risk factors periodic examinations in cases with high risk; furthermore investigation of risk factors medical and preventive treatment procedures were pointed out clearly as important issues which mut be followed by physidans.

Between 1983 and 1990, 182 patients with 189 tibial shaft fracture were diagnosed al the Department of Orthopaeclics and Traumatology in the Faculty of Medicine of Selçuk University. The mean age was 36 years with a range of 13 to 84 years. A hundred and seventy five patients had unilateral and 7 patient bilateral tibial shaft fracture. 165 tibial shaft fracture in 158 patients had been folowed and evaluated for treatment results. nese patients were followed at least a duration until the fracture were healed clinically and radiographically. A highly satisfacwry results were obtained with opera and closed treatment.