INTRODUCTION: In this study, we aimed to investigation of the relationship between MTHFR C677T gene variation and serum copper levels in patients diagnosed with Parkinson's.
METHODS: For our study, patient and control groups were formed including 63 Parkinson's patients and 32 healthy controls. Genotype distributions for MTHFR gene variation were determined and serum copper levels were measured. In these processes PCR, RFLP and atomic absorption spectrophotometer methods were applied.
RESULTS: Serum Cu levels of Parkinson's patients were found to be significantly higher than healthy controls. Although the significant difference was not found between the patient and control groups in terms of genotype distributions of the MTHFR C677T gene variation, CC homozygote genotype of this gene variation was observed significantly more than other genotypes in the patient group. In addition, the C allele frequency of this gene variation was determined significantly different from the Hardy-Weinberg distribution in Parkinson's patients. Serum copper levels of Parkinson's patients carrying CT and TT genotypes were detected significantly higher than the serum copper levels of controls carrying the same genotypes.
DISCUSSION AND CONCLUSION: In our study, in Thrace population, it was determined that the relationship between MTHFR C677T gene variation and serum copper levels may be an important factor for Parkinson's disease. In conclusion, the evaluation of MTHFR C677T gene variation genotype distributions and serum copper levels together is extremely important for prognosis of Parkinson's disease.

INTRODUCTION: Melanomas are neoplasms that usually develop on the skin with a high prevalence and a mortality rate that is increasing year by year. Studies reflecting the data of this neoplasm, which has a very high mortality rate in our country, are still limited today. Our aim in our study was to retrospectively evaluate the skin melanoma cases treated in our hospital and to compare them with other studies.
METHODS: The clinical and histopathological features of 57 patients diagnosed with skin melanoma in the pathology clinic of our hospital between 2010 and 2019 were examined.

RESULTS: The mean age (1956) of patients was 63.18±16.54 years. The lesions were located in the head and neck in 21 patients (36.8%), in the lower extremities in 16 patients (28.1%), in the upper extremities in 11 patients (19.3%) and in the trunk in 9 patients (15.8%). Metastasis developed in 9 (15.8%) patients during a minimum 1-year and maximum 10-year follow-up of our cases. In the present study, 40 patients (70.2%) were diagnosed with nodular melanoma, 8 (14%) with superficial melanoma, 2 (3.5%) with lentigo and 7 (12.3%) with acral melanoma.

DISCUSSION AND CONCLUSION: As a result, most of our melanoma cases appeared as nodular type in the head and neck region due to sun exposure. Our study showed that these patients applied to the health institution in the late stage. In melanoma, early diagnosis seriously affects the prognosis.

INTRODUCTION: Vitamin B12, folate, and iron deficiencies both in early life and later can affect brain development and maintenance via potential mechanisms causing impaired synaptogenesis, myelination and neurotransmission, and increased neurotoxicity and oxidative stress, resulting in neuropsychiatric disorders like cognitive impairment, depression and anxiety. This study aimed to compare serum vitamin B12, folate, and ferritin levels between children and adolescents with anxiety disorders and healthy controls.
METHODS: The patient group consisted of 40 children aged 8-17 years who were newly diagnosed with anxiety disorders, had no physical or mental illness other than anxiety disorders, and whose serum vitamin B12, folate, and ferritin levels were measured in the last six months for any reason. As the control group, 40 subjects matched to the patient group for age and sex were selected from mentally and physically healthy children and adolescents. A semi-structured psychiatric interview was used for the diagnosis. Serum vitamin B12, folate, and ferritin levels were obtained from medical records.
RESULTS: Serum ferritin and folate levels in the patient group were found to be statistically significantly lower than the controls (34.0 ng/ml versus 46.9 ng/ml, 8.5±2.2 ng/mL versus 10.4±2.8 ng/mL, respectively), unlike serum vitamin B12 levels.
DISCUSSION AND CONCLUSION: Our initial findings may be scientifically important for further studies, which will show that low ferritin and folate levels are associated with childhood anxiety disorders. Whether there is a causal relationship between childhood-onset anxiety disorders and nutritional deficiencies should be investigated in longitudinal studies with larger samples.

INTRODUCTION: Although GLP-1 agonists have been shown to reduce cardiovascular events, their effect on the progression of subclinical atherosclerosis is not clear. In this respect, it was planned to evaluate cardiovascular risk markers in obese and diabetic patients receiving exenatide therapy.
METHODS: This retrospective study included 56 patients with Type 2 Diabetes Mellitus (DM) with a body mass index (BMI) >35. Demographic, anthropometric and clinic characteristics before and after six-month treatment with exenatide were screened. Cardiovascular risk marker Atherogenic Index of Plasma (AIP), uric acid, carotis intima media thickness (CIMT), HbA1c, fasting blood glucose (FBS) and postprandial blood glucose (TCG) levels were evaluated.
RESULTS: Eleven of the fifty-six patients had discontinued exenatide due to side effects, etc. 45 patients (35 females, 10 males; age 50 ± 9.5 years) completed the study. AIP, HbA1c, uric acid, fasting plasma glucose, postprandial glucose, waist circumference, hip circumference, body mass index (BMI), total cholesterol, and triglyceride levels were improved with exenatide treatment. However, no change was detected in CIMT, blood pressure, spot urine albumin/creatinine ratio, LDL, and HDL levels.
DISCUSSION AND CONCLUSION: Glycemic parameters, AIP and uric acid levels, which are biochemical predictors of subclinical atherosclerosis, were improved with GLP-1 agonist exetide treatment. However, no change was observed in CIMT measurements. These findings can be interpreted as exenatide therapy, can slow down the progression of subclinical atherosclerosis, but has no effect on existing atherosclerotic plaque.

INTRODUCTION: While non-alcoholic fatty liver disease (NAFLD) is linked to other metabolic dysfunction, it may also occur alone. In our study, we investigate the factors associated with NAFLD in subjects that do not have metabolic syndrome.
METHODS: The files of the patients that applied to our check-up outpatient clinic were evaluated retrospectively, and patients who met the criteria for admission to the study were divided into those with and without NAFLD (n=277 and n=280, respectively) with the age variable being adjusted. Anthropometric and biochemical values, fibrosis scores, cardiovascular and metabolic risk indices were compared between groups.
RESULTS: Between individuals with and without NAFLD there were statistically significant differences in terms of waist circumference (WC), waist-hip ratio (WHR), body mass index (BMI), ALT, AST/ALT, uric acid, smoking status, lipid levels, Triglyceride/HDL, hemoglobin, homeostasis model assessment insulin resistance (HOMA-IR), triglyceride-glucose index (TyG), visceral adiposity index (VAI) parameters (p<0.005). When people with BMI<25 kg/m2 were considered, the difference between smoking, total and LDL cholesterol, ALT, AST/ALT, and HOMA-IR values lost their significance. In the group with BMI≥25 kg/m2, significant differences remained only in terms of WC, WHR and BMI. It has been observed that hepatosteatosis has a positive correlation with the values of VAI, TyG, Triglyceride/HDL and AST-platelet ratio index and a negative correlation with AST/ALT.
DISCUSSION AND CONCLUSION: While cardiovascular and metabolic risk indicators were significantly increased in lean individuals with NAFLD, the increase in those risks in overweight individuals was independent of fatty liver.

INTRODUCTION: The internet is increasingly becoming important in daily life and healthcare services do not resist this change and keep evolving accordingly. In this study it was aimed to evaluate the awareness of pediatric urology, use of the internet for medical purposes by the parents of pediatric urology patients.
METHODS: A well-prepared 12-question anonymous questionnaire was administered to randomly selected 139 parents. Parents were questioned on whether they sought on the web information about the urologic problem of their child before presenting to the outpatient clinic, if so from which websites, whether the search results were useful, how it affected their relationship with the physician, whether they had knowledge about the pediatric urology subspecialty before presenting to outpatient clinic.
RESULTS: Percentages of internet access increased parallel to the increased level of education. In the educational status analysis of the parents who performed an internet search, the ratio of the graduates of the university and above (90.9%) were statistically higher than primary school graduates (62.5%). The average age of children whose parents performed internet search was significantly lower than whose parents did not (6.3±3.9 vs 8.4±5.1 years respectively). The sources used for the internet search were statistically different across different levels of education.
DISCUSSION AND CONCLUSION: Significant use of the internet among those attending pediatric urology outpatient clinic is demonstrated and that there was less awareness of the pediatric urology.

INTRODUCTION: It has been reported that short-term and low-dose intravenous corticosteroids prevent the progression of the disease and reduce mortality during the hyperinflammation period caused by the virus in COVID-19 disease. The aim of our study is to evaluate the clinical course, hospital readmission and mortality rates of patients with mild to moderate COVID-19 pneumonia, who do not need oxygen and for whom we started outpatient corticosteroid treatment.
METHODS: Patients over the age of 18 who applied to our hospital with the diagnosis of mild-to-moderate COVID-19 pneumonia and were treated with outpatient oral systemic corticosteroid were included in the study.Inclusion criteria were pneumonia finding consistent with mild to moderate COVID-19 involvement in lung computerized tomography, seven days or more from symptom onset, and oxygen saturation of 93 and above. The patients were given dexamethasone 8 milligrams (mg) methylprednisolone 32 mg, methylprednisolone 40 mg as oral systemic corticosteroid.
RESULTS: The median age (min-max) of the patients was 49.24 (22-91), and 60% of them were male. The median steroid duration was 6.6 (1-10) days. Due to ongoing symptoms, 56% of the patients were admitted to the hospital again, 12% were hospitalized due to clinical and laboratory deterioration, the intensive care hospitalization rate was 3% and the mortality rate was 2% (2/100).
DISCUSSION AND CONCLUSION: As a result, the effectiveness of oral corticosteroids on mortality and morbidity has not been demonstrated in mild to moderate COVID-19 pneumonia. Well-designed randomized controlled studies are needed on this subject.

INTRODUCTION: The aim of the study was to determine the importance and reliability of IL-6, IL8, TNF-α and C-reactive protein (CRP) levels in terms of diagnosis and prognosis in neonatal sepsis.
METHODS: Thirty newborns who were followed up and treated with the prediagnosis of neonatal sepsis in Neonatal Intensive Care Unit and 20 healthy newborns born to mothers without any disease were included in the study. Gender, gestational age, postnatal age, place and type of birth, birth weight, IL-6, IL-8, TNF-α and CRP levels of the cases were recorded.
RESULTS: Of the 30 cases diagnosed clinically as sepsis, 16 (53.3%) were male and 14 (46.7%) were female. Of the 20 cases in the control group, 11 (55%) were male and 9 (45%) were female. Eight (26.6%) of 30 sepsis cases were accepted as early-onset and 22 (73.4%) late-onset neonatal sepsis While the mortality rate in early-onset sepsis was 25%, this rate was 36.3% in late-onset sepsis cases. C-reactive protein, Interleukin-6, and Interleukin-8 were found to be statistically significantly higher in the group of cases than in the control group. Tumor necrosis factor-α levels were statistically similar in both groups. IL-6 (p: 0.001) and IL-8 (p: 0.007) levels were found to be statistically significantly higher in deceased cases.
DISCUSSION AND CONCLUSION: C-reactive protein, Interleukin-6, Interleukin-8 levels in the diagnosis of neonatal sepsis found as parameters that can be used, TNF-α was not found to have diagnostic value. IL-6 and IL-8 levels were found to be significant in neonatal sepsis prognosis.

INTRODUCTION: It is seen that there are changes in the number and profile of patients who applied to the emergency services during the pandemic period. This study was carried out to examine the patient burden who applied to the emergency department before and during the pandemic, and to determine the demographic characteristics of the patients and their complaints.
METHODS: Patient applications to the Emergency Department between April 1, 2019 and April 30, 2019 and between April 1 and April 30, 2020 were retrospectively analyzed. Demographic characteristics of the patients and complaints of admission to the emergency department were evaluated.
RESULTS: While the number of patients admitted to the emergency department was 36617 in the pre-pandemic period, it was 10907 during the pandemic period. When the pandemic period and the pre-pandemic period are compared; It was determined that there was a significant decrease in the number of patients followed in the green area, trauma patients, total inpatients, inpatients in the cardiology service, inpatients in the neurology service, inpatients in the chest diseases service, and patients admitted to the emergency service by ambulance during the pandemic period.
DISCUSSION AND CONCLUSION: During the pandemic period, compared to the pre-pandemic period, the total number of patients in the emergency room and the number of patients receiving it (green, yellow) decreased significantly. This may lead to increased mortality and morbidity. For this reason, it is very important to inform the public in detail about emergency diseases that require hospitalization.

INTRODUCTION: It was aimed to examine the diagnostic performance of the ionized calcium levels calculated by the Zeisler, Butler and Hanna method on the evaluation of hypocalcemia.
METHODS: Whole blood ionized calcium and serum total calcium levels of 500 individuals aged between 20-60 years were retrospectively screened.Individuals were divided into hypoalbuminemia and normoalbuminemia groups according to their serum albumin concentrations.In these groups, the diagnostic performance of total calcium and ionized calcium concentrations calculated by Zeisler,ButlerandHanna methods in terms of hypocalcemia were examined. While determining hypocalcemia, ionized calcium level was accepted as a reference.The difference and correlation between directly measured ionized calcium and calculated ionized calcium were analyzed by Wilcoxon signed ranks and Spearman correlation analysis.
RESULTS: The ionized calcium levels calculated by the Zeisler,Butler, Hanna methods were higher than the directly measured ionized calcium level(p<0.001).The method with the highest sensitivity and accuracy in terms of hypocalcemia was the Zeisler method.However, the specificity and negative predictive values were low.There was no correlation between directly measured ionized calcium and calculated ionized calcium levels in the hypoalbuminemia group(p>0.05). A significant correlation was observed between ionized calcium and calcium levels calculated by the Zeisler and Hanna methods in the normoalbuminemia group,but this correlation was low(p=0.010;r=-0.269,p=0.014;r=-0.254).No correlation was observed between ionized calcium and calcium calculated by Butler's method(p>0.05).
DISCUSSION AND CONCLUSION: The results of the study limit the use of the Zeisler,Butler and Hanna methods in estimating ionized calcium.We believe that it would not be reliable to comment on the level of ionized calcium with these methods.

INTRODUCTION: In developed countries,there is database for Rh subgroups as well as AB0 and Rh blood grouping. There is no study conducted on the distribution of Rh subgroups in our country. We aimed to examine the distribution of AB0, Rh blood group and Rh subgroup in our province.
METHODS: The blood groups of 58,000 patients, donors and healthy individuals who applied to our hospital between 2012 and 2018, and the subgroups of 103 people were analyzed retrospectively. Blood groups were studied by microcolumn agglutination method.
RESULTS: 58000 people were included in our study. 18607(%32.08) people blood type A(+), 1996(%3.44) people blood type A(-), 11133(%19.19) people blood type B(+), 1029(%1.77) people 77 people's blood type is B(-), 18850(%32.50) people's blood type is 0(+), 1878 (%3.24) people's blood type is 0(-), 4082(%7.03) people's blood type is AB(+), blood group of 425 (%0.73) people was determined as AB(-). In Rh subgroups, 90 (%87.37) of 103 people were D(+), 102 (%99) e(+) and Kell(+) 6(%5.82).
DISCUSSION AND CONCLUSION: According to the AB0 grouping system, the maximum 0(35.74%) group, the highest Rh (+) 92% and the most e(+) Rh subrgroup were detected. We think that the data we obtained will contribute to the blood group database of our country.

INTRODUCTION: Pulmonary lesions in peripheral lung are considered as Peripheral pulmonary lesions(PPL).Diagnosis of PPL is important because it can be malignant nature.Diagnosis of PPL has limited sensitivity in the absence of a target-guiding tool in the bronchial labyrinth.Multiplanar reconstruction images created with thin multi-slice imaging of computed tomography(CT) have started to be used as an alternative guide for bronchoscopy of PPL.In this study, we aimed to examine the diagnostic efficiency of the guidance of multiplanar reconstruction images for PPL diagnosis.
METHODS: Patients have PPL who underwent a bronchoscopic brush biopsy by gidance of multiplanar reconstruction thin images on thorax CT scans were retrospectively analyzed.The distance of the lesion to the distal bronchus,presence of bronchial association and location and size of PPL were recorded from hospital image archive system.The diagnostic rate was recorded from the procedure record unit.
RESULTS: The study was conducted with 92 cases.The mean size of PPL was 40±21 mm, and the average distal bronchial lesion distance was 27±19 mm.Bronchial association was found in 49(53.3%) patients. The diagnostic yield of the method was 48.9%.Diagnostic rate in patients with bronchial association(67.3%) was found to be significantly higher than those without(26.7%)(p=0.001).In logistic regression analysis, the factors affecting the diagnosis were distal bronchial lesion distance, presence of bronchial association and localization of the lesion.
DISCUSSION AND CONCLUSION: The guidance of thin multi-slice CT reconstruction images for PPL diagnosis can be easily performed in patients with PPL that over 20 mm and have bronchial association in centers where there is no interventional radiology unit and other guidance tools.

INTRODUCTION: In this study, our aim is to evaluate the usefulness of YouTube videos about epiretinal membrane surgery in the retina.
METHODS: When it was scanned by typing 'epiretinal membrane surgery' in the YouTube search engine, the first 100 videos on this subject were evaluated. Then, these videos were analyzed and scored with DISCERN, Journal of the American Medical Association (JAMA) and Global Quality (GQ) scoring systems.
RESULTS: DISCERN score of the evaluated videos was 30.0±7.8; JAMA score 1.5±0.6; the GQ score was found to be 1.8±0.6. When the results of epiretinal membrane surgery are evaluated according to the quality scoring of these three scoring systems, the DISCERN score is weak; the JAMA score was assessed as low quality and the GQ scoring as poor quality.
DISCUSSION AND CONCLUSION: Although there are many videos about epiretinal membrane surgery on Youtube, it has been determined that these videos are low usefulness as a source and poor quality.

INTRODUCTION: Coronovirus 2019 ( Covid-19) infection has been related to increased mortality amongst patients with lung disease. In this study it was aimed to showed the mortality rate and possible prognostic factors related to Covid-19 in connective tissue disease related interstitial lung disease patients (CTD-ILD)

METHODS: In a tertiary referral center,patients with previously diagnosed CTD-ILD retrospectively reviewed. Between 1th April 2020 to 1 th April 2021 patients data related to ILD disease, Covid-19 infection and mortality obtained from electronic records retrospectively. The primary outcome was death at day 30 of COVID-19 infection


RESULTS: There were 271patients diagnosed with CTD-ILD. 74 patients had Covid-19 infection, which was confirmed by polymerase chain reaction. 29 patients were dead during the followed-up period of whom 13 patients had Covid-19 infection-related mortality (17.5% vs 8.1%, p: 0.045). Covid-19 infection related to mortality was more frequently seen in patients with decreased forced vital capacity, smoking history, extended disease and rheumatoid arthritis. On multivariate regression analysis, only decreased forced vital capacity were related to poor outcomes.

DISCUSSION AND CONCLUSION: Covid-19 infection is related to increased risk of mortality in CTD-ILD patients. Decreased forced vital capacity is a poor prognostic risk factor

INTRODUCTION: Breast cancer is the most common cancer and major cause of cancer death in women worldwide. The importance of usage positron emission tomography (PET)/computed tomography (CT) in oncology is increasing. In our study, we planned to investigate the relationship between 18 F-fluoro-2-deoxy-D-glucose (18 F-FDG) uptake and characteristics of the tumor.
METHODS: The medical records of 414 patients who applied to our oncology clinic with the diagnosis of breast cancer and underwent PET/CT were analyzed retrospectively. Patients with breast cancer aged between 18-90 years were included in the study. Patients with secondary malignancy, mentally unstable, younger than 18 years of age and older than 90 years of age were excluded from the study. FDG uptake was investigated according to molecular subtypes, tumor sizes, body mass index and proliferation indices.
RESULTS: The mean age of 414 patients included in the study was 48.8 years. The vast majority of patients had invasive ductal carcinoma. While 86 patients were in the metastatic stage at the time of diagnosis, 327 patients had local or locally advanced disease. In the study, there was a correlation between the increase in Ki-67 and the increase in FDG uptake and it was statistically significant (p <0.01).
DISCUSSION AND CONCLUSION: In the study, those with larger tumor size had more FDG uptake. Likewise, increased proliferation index and invasive ductal carcinoma had higher FDG uptake. The relationship between tumor characteristics and FDG uptake can be used as a predictive marker for individualized treatment in the future.

INTRODUCTION: Glutamate is an essential excitatory neurotransmitter in the brain, causing neuronal cell loss by overactivation in high concentrations. Suberoylanilide hydroxamic acid (SAHA) is a well-known histone deacetylase inhibitor for its antitumor and anti-inflammatory properties. Therefore, in this study, we aimed to investigate the neuroprotective effect of SAHA against glutamate-induced oxidative stress in HT-22 hippocampal cells.
METHODS: Cell viability was determined by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay after administration of glutamate and SAHA to HT-22 cells. The neuroprotective effect of SAHA was evaluated by measuring the oxidative stress parameters like reduced glutathione (GSH) level, and antioxidant enzyme activities of glutathione reductase (GR) and glutathione peroxide (GPx) by Enzyme-like immunosorbent assay (ELISA).
RESULTS: SAHA has reduced glutamate-induced neuron death in HT-22 cells. Moreover, SAHA alleviated glutamate-induced oxidative stress by increasing GSH levels, and the activities of the antioxidant enzymes GR and GPx.
DISCUSSION AND CONCLUSION: These results demonstrated that SAHA has antioxidant activity, reduces glutamate-induced oxidative stress, and confers protection against glutamate-induced neuronal death.

In patients admitted to the intensive care unit, malnutrition is very common. Enteral nutrition is preferred primarily for malnourished patients, whereas parenteral nutrition is preferred in patients who cannot receive oral intake. Omega-3 (n-3) polyunsaturated fatty acids (PUFA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) inhibit the production of pro-inflammatory cytokines such as TNF-α, IL-1β and IL-6, and are an anti-inflammatory agent. It modulates the production of the cytokine IL-10. In recent years, many studies have investigated whether omega-3-supplemented diets are beneficial after acute respiratory distress syndrome and major abdominal surgery in clinical conditions characterized by a high inflammatory response such as sepsis in intensive care patients. While many studies conducted in intensive care patients argue that omega-3 consumption positively affects the overall mortality, morbidity and duration of intensive care stay, there are also studies arguing that it has no effect. In the light of all this information, it was aimed to determine the effects of omega-3 use in intensive care patients and to present information to researchers for future studies. Regarding to the data obtained and the recommendations of the health authorities, the use of omega-3 in parenteral nutrition is supported, while bolus feeding and high dose feeding methods are not recommended in enteral nutrition.

Aim: This study aimed to introduce a patient with a rarely encountered case of recurrent dark discoloration.
Case: A 12-year-old girl.Her headaches started 2 weeks ago.When she has headache,a rash followed by darkening and then bruising around her both eyes appear.When her headache wears off the bruising disappears.She has nausea but does not vomit.In her family,her uncle has a history of migraine.No history of kin marriage between her mother and dad.No history of hospitalization.She had dark discoloration 5 times in 2 weeks and presented to the emergency department.
Headache has no localization.She feels the pain all over her head and it lasts whole day.No history of alcohol or drug abuse.Her headache is not triggered by any food or drink.When the bruising occurs her vision becomes blurry.She has photophobia and phonophobia.She cannot sleep because of her headache and sleeplessness increases her complaints.She has missed several days of school.She spends too much time on phone and computer.She has stress and crying spells.
Her neurological examination is normal.Fundus examination is natural and there is no papilledema.She does not have opsoclonus,myoclonus or nystagmus.The EEG,brain MRG and MR venography are normal.She does not have anemia and the labs are normal.Pseudotumor cerebri,neuroblastoma or allergic reaction were not considered.Propranolol and fluoxetine was commenced for migraine prophylactic treatment and the patient’s headache improved And she is still followed-up.
Conclusion: Co-occurrence of dark discoloration and headache are reported with trigeminal autonomic cephalgia,neuroblastoma, sinus vein thrombosis,idiopathic intracranial hypertension,amyloidosis and aplastic anemia in the literature.However,these recurrent symptoms are predominantly associated with migraine.