INTRODUCTION: The objective of this study was to retrospectively compare clinical features and prognostic values between the patients who were referred to the general surgery clinic of our hospital with the presumed diagnosis of acute appendicitis and underwent positive or negative appendectomy.
METHODS:
Patients were divided into two groups as positive (n: 362) and negative appendectomy (n: 284) and the data obtained were compared between these two groups. Laboratory investigations were performed in all patients, and white blood cell, mean platelet volume (MPV), neutrophils count, neutrophils (%) (NEU%), C-reactive protein and total bilirubin (TBIL) values were studied.
RESULTS: The mean CRP value was found as 57.68 in positive appendectomy (PA) group and 41.43 in negative appendectomy (NA) group, and the mean CRP value was statistically significantly higher in PA group, compared to NA group. The mean TBIL value was 0.97 mg/dl in PA group and 0.69 mg/dl in NA group, and the mean TBIL value was statistically significantly higher in PA group. The other parameters were similar between the groups.
DISCUSSION AND CONCLUSION: According to the results of our study, CRP and TBIL values significantly differ between positive and negative appendectomy patients. Therefore, these values may be used as specific biomarkers in predicting positive acute appendicitis.

INTRODUCTION: In our randomized prospective study, in applications of outpatient anesthesia we aimed to compare hemodynamic profile, duration of the procedure and hospitalization, patients’ and operators’ satisfaction and safety with or without the aid of an anesthesiologist.
METHODS: A total of 226 outpatient anesthesia patients were included in this study. The patients were included in two groups as those underwent procedures [percutaneous transhepatic cholangiography (PTC), gastroscopy and/or colonoscopy, endoscopic retrograde pancreotocholangiography (ERCP), hepatic biopsy] performed with (Group 1) and without (Group 2) the aid of an anesthesiologist. Single or combined midazolam, propofol, fentanyl, and pethidine were applied to all patients, leaving to the preference of the practitioner. At the end of the application, anexate was performed in some patients depending on their weights. Demographic characteristics, hemodynamic profile, cognitive functions, duration of the procedure and hospitalization, patients’ and operators’ satisfaction and complications with or without the aid of an anesthesiologist were compared.
RESULTS: Any intergroup difference was not detected as for the distribution of demographic data and procedures performed. Statistically different results were detected regarding to systolic artery pressures(SAP), diastolic artery pressures (DAP), mean arterial pressures (MAP), heart rates (HR) and partial oxygen pressures(SpO2). No intergroup difference was found as for VAS, Ramsey Sedation Scale and Aldrete recovery scores. There was a significant difference in drug preferences and processing times among the groups. Patient and doctor satisfaction was significantly higher in Group I than in Group II.
DISCUSSION AND CONCLUSION: It will be safer to perform operations outside the operating room under the supervision of an anesthesiologist.

INTRODUCTION: Limb injuries have an important place in traffic accidents. Although it has been identified among the most frequently injured areas in hand, wrist and forearm in traffic accidents; often neglected due to more severe injuries. In our study, it was aimed to evaluate the cases with hand, wrist and forearm fractures after traffic accidents, to define the age and gender distribution of the injured people, to compare the location and types of fractures in and out of the vehicle.
METHODS: In this study, the medical files of patients who applied to the Emergency Department of the Medical Faculty and the Forensic Medicine Outpatient Clinic after a traffic accident in the 7-year period between 01.01.2013 and 31.12.2019 were included in the study.
RESULTS: In our study, ulna-radius diaphysis fractures, which usually occur as a result of a direct blow to the forearm, were seen in more than 70% of all cases in the presented series with forearm, wrist and hand bone fractures due to traffic accidents. Direct mechanisms were effective in 65.9% of the fractures, and direct fractures were prominent especially in pedestrians and passengers.
DISCUSSION AND CONCLUSION: In our study, the founding of radius-ulna fractures, which usually occur as a result of a direct blow to the forearm in more than 70% of the cases in the presented series, the detection of effect of direct mechanisms in 65.9% of the fractures, and the seeing of in the foreground of direct fractures in pedestrians and passengers have been accepted as important indicators revealing that primary injuries are at the forefront rather than secondary injuries in traffic accidents.

INTRODUCTION: Aim: Cholecystitis is a common surgical emergency case, and the progress of simple cholecystitis to severe cholecystitis results in preoperative inflammatory and metabolic complications and a longer hospital stay. We aimed to determine whether the neutrophil-lymphocyte ratio (NLR) could help discriminate between simple and severe cholecystitis in emergency department (ED) admissions.
METHODS: Materials and Methods: All patients who were aged 18 or older, were diagnosed with cholecystitis, and presented to ED were included in our retrospective study. Blood laboratory values of patients who were diagnosed with cholecystitis in ED and whose preoperative diagnosis was confirmed were taken. Patients with secondary changes associated with cholecystitis, such as gangrenous cholecystitis and gallbladder perforation, were included in the severe cholecystitis group.
RESULTS: Results: The study consisted of 54 patients, including 45 (83.33%) with simple cholecystitis and 9 (16.67%) with severe cholecystitis. Of the 54 patients, 28 (51.85%) were male, 26 (48.15%) were female, and the median age was 71 years (minimum-maximum: 27-94). NLR was found significantly higher in the severe cholecystitis group compared to the simple cholecystitis group (p <0.001). Besides, there was a significant difference between the two groups in terms of CRP, WBC, neutrophil, and lymphocyte values.
DISCUSSION AND CONCLUSION: Conclusion: Early discrimination of simple and severe cholecystitis in patients presenting to the emergency department with right upper quadrant pain is important in terms of patient management. We think it may be useful to utilize the NLR ratio to discriminate between simple and severe cholecystitis.

INTRODUCTION: This study was determined the incidence of synostosis of vertebrae at various regions and to compare the increase in synostosis level with increased pain and decreased range of motion
METHODS: Seventy-eight adult vertebral columns were used to establish the incidence of congenital vertebral fusion in different spinal regions.The fusion was completed involving the bodies of the vertebrae without the vertebral arch.
RESULTS: The incidence of congenital vertebral fusion was seen at the maximum in the cervical region(61.53%), then in the lumbar (21.79%) and thoracic regions(16.66%) in decreasing order.Visual analog scale scores in the cervical region were seen as 4.9±1.3, then in the lumbar and thoracic regions as 4.5±1.3 and 2.3±1.4, respectively. Congenital vertebral fusion in the cervical, thoracal, and lumbar region, respectively, was most common between C2-C3 and C3-C4,T10-T11 and T11-T12, and the L4-L5 intervertebral bodies. In the cervical region, statistically significant changes were observed between single-level fusion and 2 or more fusions in terms of movement and visual analog scale scores;however, in the thoracic and lumbar regions, no statistically significant difference was observed.There was a statistically significant change in the range of motion in the thoracic and lumbar regions, except in lumbar extension. No patient underwent surgery.
DISCUSSION AND CONCLUSION: We found that the frequency of congenital vertebral fusion was most common in the cervical region.We observed that as the number of intervertebral congenital vertebral fusions increased in all cervical,thoracic and lumbar regions, the pain increased and the range of motion decreased.Congenital vertebral fusion causes resistant back pain and decreases the range of motion.

INTRODUCTION: Epstein Barr virus (EBV) is a type of virus associated with many types of cancer in humans. The relation between EBV and breast cancer varies in different studies. We also studied the presence of EBV in breast cancers, in our region.
METHODS: In this study, breast biopsy samples from 57 patients embedded in paraffin blocks were used. Twenty of these patients were diagnosed with fibroadenoma and were used as a control group. Thirty-seven of the patients were diagnosed with invasive ductal carcinoma. Out of the 37 invasive ductal carcinoma patients, 13 were graded as grade 1, 12 as grade 2 and 12 as grade 3 based on the Nottingham modification of the Bloom Richardson system. Epstein-Barr Virus Early RNA (EBER) in situ hybridization method was applied to all biopsies to research the presence of EBV.
RESULTS: The EBER in situ hybridization method shows, positive staining in 5 of 20 fibroadenomas, 4 of 13 Grade 1 invasive ductal carcinomas and 2 of 12 Grade 2 invasive ductal carcinomas. All cases with grade 3 invasive ductal carcinoma were negative.
DISCUSSION AND CONCLUSION: Although there was no statistically significant difference in our study, we believe further studies which are more sensitive on demonstrating the presence of EBV are needed, since staining was observed in some tumor cells.

INTRODUCTION: Aim of this study is evaluate the knowledge, attitudes and behaviors related to Covid-19 among physicians who are experts in child health and diseases in Turkey.
METHODS: In this study with a cross-sectional prospective design, a 20-question survey about Covid-19 was created using an online program. A total of 324 child health and disease experts were included in the study. There were two questions about the disease scored as 4 and 5 points, respectively. The factors affecting a high score were determined by the logistic regression analysis.
RESULTS: Study designed when the Covid-19 first broke out. Physicians, 43.8% considered that they had either low or moderate knowledge about the subject. Physicians' anxiety about being infected was over 95%. The mean score of the physicians in the two disease-related questions was 4.42±2.3. High scores were obtained from respondents over 35 years old [OR: 2.069 (CI: 1.224-3.497)], those with chronic diseases [OR: 2.105 (CI: 1.042-4.25)], those that followed the official websites of health authorities [OR: 5.40 (CI: 2.616) -11.148], and those that attended informative meetings at their workplace [OR: 2.25 (CI: 1.434-3.540].
DISCUSSION AND CONCLUSION: We consider that it is necessary to increase the awareness of pediatricians, increase the participation of young pediatricians in informative meetings, develop methods for coping with anxiety and to encourage pediatricians to acquire more knowledge about the pandemic considering that pediatric cases may be helpful in shedding light on the treatment of the disease.

INTRODUCTION: The antibiotic resistance problem in the world has emerged as multiple antibiotic resistance in recent years. Despite the limited options in the treatment of infections, the inability of producing new antibiotics also keeps the problem current. In our study, it was aimed to investigate daptomycin susceptibility, which is an important option in the treatment of MRSA and VRE infections.
METHODS: 81 MRSA and 11 VRE strains were included in our study that isolated from various specimens between October 2011 and June 2013. The susceptibility of these strains to daptomycin was determined by the E-test method with CLSI recommendations.
RESULTS: The susceptibility of S. aureus strains to daptomycin and linezolid was 100%. On the other hand it was over 90% in vancomycin, teicoplanin, nitrofurantoin, quinupristin-dalfopristin and trimethoprim-sulfamethoxazole. Also we found lower rates in tetracycline (22%), norfloxacin (21%) and gentamicin (25%). Enterococcus were 100% susceptible to daptomycin and 82% to linezolid, while 100% resistant to ampicillin, penicillin, erythromycin, nitrofurantoin, rifampin, and teicoplanin.
DISCUSSION AND CONCLUSION: Daptomycin may be as an alternative agent in MRSA and VRE infections. Although it is effective in gram positives, resistance is increasing. There is a need for new agents which are more effective and have appropriate pharmacokinetic and safety profiles.

INTRODUCTION: Obesity is an energy metabolism disorder that occurs with excessive fat storage in the body and can cause physical and mental problems. In this study; It was aimed to investigate the relationship between anthropometric findings and hormonal values in obese and overweight children.
METHODS: The data was retrospectively collected by reviewing the files of 742 children with obesity and overweight diagnoses who were followed up in Pediatric Endocrinology Clinic between 2010-2011. For all cases age, gender and anthropometric measurements are recorded. Fasting blood glucose, insulin, c-peptite, total cholesterol, trigliseride, LDL-cholesterol, VLDL cholesterol, HDL cholesterol, IGF-1 and IGFBP3 values are evaluated. Insulin resistance is calculated by HOMA-IR
RESULTS: Of those included in the study, 534 were obese and 208 were overweight. In pubertal period, an increase in HOMA-IR and fasting insulin levels was observed in obese group compared to overweight group. In the prepubertal period, no significant difference was observed between obese and overweight groups in terms of bone age, while in the obese group, bone age was significantly higher in the pubertal period than in overweight group. At the same time the bone age in obese children with BMI and body weight were found to be significantly correlated in a positive direction.


DISCUSSION AND CONCLUSION: Considering that obesity and overweight increase growth rate and bone maturation, decrease growth rate in puberty, short target length, dyslipidemia and future cardiovascular complications, it is very important to prevent childhood obesity in the early period.

INTRODUCTION: This study was conducted to examine the use of dietary supplements by nursing department students of a foundation university during the COVID-19 pandemic.

METHODS: The sample group of this cross-sectional study consisted of 216 first-year nursing students who were studying at a foundation university between November and December 2020. The data were collected socio-demographic characteristics and concern form for the COVID-19 pandemic, habits of using dietary supplements questionnaire, and the Nutrition Behavior Scale.
RESULTS: While 68.5% of the students did not use dietary supplements before the COVID-19 pandemic, 45.4% of them stated that they used dietary supplements from the beginning of the pandemic. It was found that 32.4% of the students useddietary supplements to be resistant to diseases, and the most vitamin and mineral supplements were used with a rate of 31.5%. While 19% of the students accessed dietary supplements by researching themselves, 39.8% of them stated that they were affected by the advertisements in the media. 67.1% of the students think that they eat healthy, 60.2% of them stated that they skip meals during the day. The mean score obtained by the participants from the nutritional behavior scale with the highest score of 24 was found to be 12.47 ± 3.61.
DISCUSSION AND CONCLUSION: It was determined that the use of unconscious dietary supplements increased and the level of healthy eating behaviors was low due to the COVID-19 pandemic.

INTRODUCTION: Ischemic stroke is characterized by loss of focal cerebral function due to impaired of brain-blood flow. Environmental factors and genetic factors may be effective together in the pathogenesis of ischemic stroke. Trace elements are important components of the biological structure, and toxic effects may occur when these trace elements are taken in more than the amount required for biological functions. The risk of neurological diseases such as ischemic stroke may increase as a result of imbalances in trace element levels. Therefore, the aim of this study is to investigate the effects of serum iron and copper levels in the development of ischemic stroke disease.
METHODS: Our study consisted of 20 ischemic stroke patients and 36 healthy controls. Serum iron and copper levels measurements were performed using atomic absorption spectrophotometer method.
RESULTS: Serum iron and copper levels were detected significantly lower in the patient group with ischemic stroke compared to the healthy control group (p<0.05). However, the significant difference was not determined in comparison of serum copper and iron levels according to gender between patient with ischemic stroke and healthy control groups (p>0.05).
DISCUSSION AND CONCLUSION: In our study, it was determined that serum iron and copper levels may be effective risk factors for ischemic stroke disease. Thus, it was concluded that serum iron and copper trace element levels may be important biomarkers that may be evaluated in the diagnosis, prognosis and treatment of ischemic stroke

INTRODUCTION: The aim of this study was to evaluate the effect of exposure of bulk-fill composite resin to 2 different acidic beverages for 1 day, 7 days and 30 days on the refractive index value.
METHODS: A total of 36 specimens made from standardized disc shaped SDR Plus (Dentsply Sirona, Konstanz, Germany) universal bulk-fill composite resin was prepared. Samples were divided into three groups as distilled water (control), coke and orange juice (n = 12). Refractive index (nD) measurements were made with an Abbe refractometer. After the first measurement, samples were kept in an oven at 37 ° C in bottles for the relevant beverages in distilled water, coke and orange juice groups on the 1st day, 7th day and 30th day. nD values were tested by generalized analysis of variance.
RESULTS: The average value obtained in n30 was obtained lower than the others. There is no difference between the average values in the first 3-time period. Group and time interaction was statistically significant. The mean value of n30 in the control group was lower than at other times. In the coke group, the average value obtained in n30 was obtained lower than other times. There is also a statistical difference between n7 and n1. There is also a difference between nilk and n30 and n7 in the orange group.
DISCUSSION AND CONCLUSION: Acidic beverages decrease the refractive index value of bulk-fill composite resins at the end of the 30th day. This decrease occurs most often in samples exposed to coke.

INTRODUCTION: Arterial hypertension, which has a high prevalence, is a significant risk factor for developing cardiovascular diseases. Left ventricular hypertrophy (LVH) is the most common structural damage in hypertensive target organ damage. LVH is an independent risk factor for evaluating cardiovascular events such as sudden cardiac death, coronary heart disease, myocardial dysfunction, heart failure, and stroke. This study investigated the effect of gender on the left ventricular mass of hypertension duration
METHODS: 210 patients between December 2019 and March 2020 were included in the study. The demographic data, blood parameters, echocardiographic data of the patients, and hypertension duration were examined.
RESULTS: Of the patients included in the study, 112 (53%) were male, and 98 (47%) were female. The mean age of the patients was 56.8.6 ± 15.2 years. The mean follow-up period of the patients until the time of data collection when they were diagnosed with hypertension was 9.7 ± 7.2 years. There was a positive correlation between hypertension duration and the left ventricular muscle mass index (LVMI) calculated echocardiographically (r: 0.265; p: 0.004). In the correlation analysis performed according to gender, a statistically significant positive correlation was found with LVM (r: 0.413) and LVMI (r: 0.477) in women, but no significant correlation was found between LVM and LVMI in men and duration of hypertension.
DISCUSSION AND CONCLUSION: In our study suggested that in the absence of other factors affecting LVMI, the length of the hypertension duration is useful in increasing LVMI in hypertensive patients, and the predominantly female gender is more affected by this increase.

INTRODUCTION: Glutathione S-transferase (GST; EC 2.5.1.18), which is a member of the family of transferase enzymes, is an enzyme that has a very important role in maintaining the internal and external balance of the body by catalyzing the first stage of the formation reactions. mercapturic acid, the end product of detoxification metabolism. In this study, it was aimed to investigate the in vitro inhibition effect of pyrimidine derivatives on the GST enzyme.
METHODS: TThe GST enzyme was purified by affinity chromatography technique. It was determined that pyrimidine derivatives strongly inhibited the GST enzyme at µM level. IC50 and KI values were calculated for the derivative compounds.
RESULTS: All of the compounds whose effect was examined showed a noncompetitive inhibition effect on the GST enzyme. Moreover, 4-amino-2-chloropyrimidine showed the most effective inhibitory effect with its noncompetitive inhibition type.
DISCUSSION AND CONCLUSION: It can be considered that pyrimidine derivatives may be effective on GST. The findings from this study make several contributions to the literature.

INTRODUCTION: Osteoarthritis is a disease characterized by joint cartilage damage, changes in surrounding bone structures and joint inflammation.Musculoskeletal ultrasonography is frequently used to evaluate soft tissue and joint in many rheumatologic diseases.We aimed tostudy the relationship between ultrasonographic findings and disease severity and quality of life in patients with knee osteoarthritis.
METHODS: The knee joint of the patients included in the study was evaluated by ultrasonography.Womac index and EQ-5D questionnaire were used to evaluate the quality of life of the patients.The relationship between ultrasonography findings and womac and EQ-5D questionnaire was compared.
RESULTS: Twenty-four patients were included in the study. 3 patients were male and 21 patients were female.There was no significant difference in synovial hypertrophy, effusion, baker cyst, calcification and womac score, VAS and EQ-5D score.A significant difference was found in the womac sub-parameter, stiffness parameter, in patients with osteophyte (p = 0.046).There was no significant correlation between Womac score and cartilage thickness.There was a negative correlation between womac and EQ-5D score (p = 0.006, r = -545).There was a negative correlation between VAS score and cartilage thickness (p = 0.017, r = -483).
DISCUSSION AND CONCLUSION: In our study, no relation was found between USG findings and clinical complaints and quality of life. This may be related to the low number of patients. However, musculoskeletal ultrasonography is one of the most effective and inexpensive methods to show structural pathologies in the joint. The use of ultrasonography will continue to detect structural problems associated with osteoarthritis.

INTRODUCTION: Introduction: Palpitations are the most common and most important symptoms of patients with rhythm disturbances. Rhythm disturbances may not be detected by electrocardiography.

Objective: The aim of our study is to evaluate the results of electrocardiography and 24-hour holter electrocardiography monitoring in children presenting with the complaint of palpitations, to determine the rhythm disturbances and their frequency, and to emphasize the role of holter in diagnosis and treatment.

METHODS: Material and Methods: Electrocardiography, 24-hour holter monitoring and echocardiography data of 320 children admitted to our hospital with the complaint of palpitations were evaluated.
RESULTS: Results: One hundred-sixty three of the patients were female (50.9%). Isolated palpitations in 246 (76.9%) patients, palpitations and chest pain in 55 (17.2%), palpitations and syncope in 18 (5.6%), one patient had (0.3%) palpitations and shortness of breath. The most common arrhythmias were supraventricular extrasystole in 63 patients (19.7%) and ventricular extrasystole in 58 patients (18.2%) in holter. Severe arrhythmia was detected in 63 of the patients. The rate of severe arrhythmia in patients presenting with isolated palpitations was found to be statistically significantly higher than the other groups (p˂0.05).
DISCUSSION AND CONCLUSION: Conclusion: Detection of arrhythmias in the holters of pediatric patients with normal electrocardiography shows that the arrhythmias of the patients can be overlooked only with electrocardiography. The higher rate of serious arrhythmias in patients presenting with isolated palpitations compared to patients with other complaints may indicate that we should be more careful in terms of arrhythmia in patients presenting with isolated palpitations.

INTRODUCTION: In this study, it was aimed to investigate the physical, psychological and familial problems of the healthcare provider working in emergency health care services that develop due to their work and working conditions.
METHODS: 297 people working in emergency health services in three different cities were included in the study. The study was carried out between November 15 and December 15, 2020 by conducting an online questionnaire. The participants in the study were asked questions about their physiological and psychological health conditions through the questionnaire. The answers received were evaluated statistically.
RESULTS: In this study conducted with 297 people working in emergency health services (EHS), 189 (63.6%) people had health problems, 249 (83.8%) people worked even though they were ill, 186 (62.6%) people did not go to regular check-ups about their diseases, 282 (94.9%) were found to be under occupational stress and 141 (47.5%) of them needed psychological support. It has been determined that women have more health problems than men, are constantly using medication and need psychological support more (p=0.002, p=0.001, p=0.001). The health status of EHS employees who worked on duty was worse than those working overtime. This situation was statistically significant (p=0.002).
DISCUSSION AND CONCLUSION: It is observed that emergency health care workers have some physical and mental problems. All stressful situations on healthcare provider should be identified and working conditions should be improved.

INTRODUCTION: Stroke is a public health problem as it is the second most common cause of death and the first most common cause of morbidity in the population over 60 years of age. Hypertension, diabetes, smoking, and obesity are known as the most critical risk factors. However, investigation of preventable and treatable unknown risk factors continues. Recent studies have reported that vitamin D reduces the risk of cardiovascular diseases. This study aimed to examine the relationship between risk factors and vitaminD levels in patients with ischemic stroke.
METHODS: 54 patients were included in the study. The sociodemographic characteristics of the patients and the results of the examinations for the etiology of stroke were retrospectively analyzed from the hospital information system. VitaminD levels of patients were compared with those with and without recurrent stroke, pre-stroke treatment, hypertension, diabetes mellitus, coronary artery disease, atrial fibrillation, normal doppler USG, cardiac tests results.
RESULTS: 24 of the 54 patients were female, 30 were male. There was no significant difference in vitaminD levels between those who had antiaggregant/anticoagulant treatment before the stroke and those who did not. VitaminD level was found to be lower in the group with hypertension compared to the group with no hypertension. VitaminD level was found to be statistically significantly higher in the group with normal carotid Doppler ultrasonography results. Correlation analysis revealed a positive correlation between HDL level and vitamin D level.
DISCUSSION AND CONCLUSION: When the results of this study is considered, we can say that vitaminD deficiency and insufficiency are important cardiovascular risk factors.

INTRODUCTION: Objective: Suicide attempt is a major cause of morbidity and mortality in young people. The aim is to investigate sociodemographic features and clinical variables of suicide in cases of suicide attempts, especially in women.
METHODS: Materials and Methods: In this study, cases of suicide attempts admitted to the emergency department between 2017 and 2018 were retrospectively examined. Sociodemographic characteristics, mental states, methods and causes of suicide attempts were recorded and analyzed in pre-prepared forms.
RESULTS: Results: Of the 133 patients included in the study, 48 were male (36%), 85 were female (64%), and the mean age was 27.7 ± 7.6. The most common cause of suicide attempt was interpersonal discussions with 81.9%. The most common place where arguments occurred was in the family, with 49.6%. Women attempted suicide more often, with a rate of 63.9%. The most preferred method was the intake of high-dose drugs or toxic substances (76.7%). The most common findings according to the characteristics of the cases who attempted suicide; The ones whose marital status were single (52.6%), education levels were primary school (33.1%) and secondary school (34.5%), and the unemployed (27.8%) by employment and employment status. As a result of the psychiatric evaluation of the cases, their mental state was normal (50.3%) and depressive (42.9%).
DISCUSSION AND CONCLUSION: Conclusion: Most of the patients who attempted suicide were in the young age group, and it was more common in women. The most common reason was interpersonal discussions. At the beginning of these were domestic unrest and quarrels.

INTRODUCTION: Because there is more than one hidden layer between the input and output layers in the neural network algorithm, it is called "Deep Neural Networks". In the study, the Deep Neural Networks algorithm; different input (number of layers, epoch, error rate) and evaluation of the performance of the model being practised an application is intended.
METHODS: The most important feature that distinguishes the deep neural network method from the classical neural networks is the number of layers that provide good results in complex problems. Wart treatment results of patients who used immunotherapy were used as data set in the study.
RESULTS: According to this; the simple-layer (1 hidden layer) artificial neural network model was classified with 87.5% overall accuracy and 29.74% MAPE, whereas the deep neural network model was classified with 99.8% overall accuracy and 25.19% MAPE ratio. The study showed that the model of deep neural networks had a higher accuracy rate.
DISCUSSION AND CONCLUSION: As a result of the application performed in this study; it is seen that the multi-layered (deep) neural network model provides classification with higher Accuracy and lower error rate than the single layer (classical) neural network model. In other words, according to the results of this study; it has been found that the deep neural network model has a better (optimum) classification rate than the classical neural network model.

INTRODUCTION: Chronic active otitis media(without cholesteatoma)and cholesteatoma are common ear pathologies that progress with a chronic inflammatory process, often causing damage, functional and anatomical loss. Differential diagnosis; provides foresight in determining the treatment to be applied and in terms of possible losses. Our study investigated the use of platelet indices, Neutrophil/Lymphocyte ratios, and Platelet/Lymphocyte ratios as auxiliary components in the differential diagnosis.
METHODS: A total of 457 subjects were included in the study and the subjects were divided into three groups.The first group is the Cholesteatoma group consisting of 197 people(n =197),the second group is the Chronic Otitis Media Without Cholestatoma group,consisting of 140(n2=140) people,and the third group is the control group, consisting of 120(n3=120) people.The data of the subjects were evaluated statistically.
RESULTS: In our study; The mean platelet volume in the cholesteatoma group(n1) was statistically significant compared to the other groups(p<0,033**). Neutrophil/lymphocyte ratios in the cholesteatoma group(n1) were statistically significant compared to the other groups(p<0,0024**).
DISCUSSION AND CONCLUSION: In our study, we found that MPV and NLR values were significant in differentiating cases with cholesteatoma from chronic active otitis media. However, when compared with the literature, we found that NLR rates were more stable and determinative in cases with cholesteatoma.

Bullet embolism of pulmonary artery is a vascular traumatic entity that is a very rare but with serious complications. The bullet can lead to vascular embolism by entering directly into the intravascular area or by migration. In pulmonary artery bullet embolism, complications with high mortality such as thrombosis, sepsis, endocarditis, cerebral stroke may be encountered. Observation and follow-up are sufficient in asymptomatic venous bullet embolism cases. In this case report, we aimed to share our experience with a patient who developed a bullet embolism of pulmonary artery as a result of gunshot injury from the right iliac region.

Patient comorbidity indexes are one of the important parameters in evaluating the outcomes of laparoscopic partial nephrectomy surgery.