INTRODUCTION: Pica is one of the symptoms of iron deficiency and a pathology that exacerbates the condition. In this study, we sought to identify the biomarkers associated with pica in iron-deficient patients.
METHODS: The study included female iron deficient clinic applicants from April 2021 to August 2022. The main iron deficit inclusion criterion was ferritin <30 ug/L. Patients' demographics, hemograms, iron parameters, c-reactive protein levels, and presence and types of pica were recorded. Independent sample tests and logistic regression tests were used to analyze the data.
RESULTS: There were a total of 381 patients who met the study's eligibility requirements (mean age 38.67+10.10). Fifty-three (13.9%) patients described pica. One hundred four of 381 patients (27.3%) showed non-anemic iron deficiency, while 277 (72.7%) had anemia. Pica was found in 9 (8.7%) non-anemic iron deficient individuals and 44 (15.9%) iron deficiency anemia patients. Pica subtypes geophagia (39.6%) and pagophagia (28.2%) were most common. Among the laboratory values, unsaturated iron binding capacity (UIBC), total iron binding capacity (TIBC) and transferrin saturation differed significantly between groups with and without pica (p=0.029, p=0.045 and, p=0.030, respectively). UIBC and TIBC were significant again with univariate logistic regression.
DISCUSSION AND CONCLUSION: Elevated UIBC and TIBC values and decreased transferrin saturation appear to be associated with pica in iron-deficient patients.

INTRODUCTION: Facet joint syndrome is one of the leading causes of low back pain, which can result in disability and loss of workforce. In this study, the effect of combined nutrition therapy in the treatment of lumbar facet joint syndrome was investigated.
METHODS: A total of 28 patients aged 25-50 years, who received combined treatment for at least 3 months with the diagnosis of lumbar facet joint syndrome after evaluation of MRI, were included in the study. Patients were invited to their last check-up and their pre-and post-treatment VAS scores and Roland-Morris scores were evaluated and compared.
RESULTS: Of the total 28 patients included in the study, 15 were male and 13 were female. The mean age of male patients was 39.9±1.5 and the mean age of female patients was 42.6±1. The mean VAS score of all patients was 7.7±0.8 before treatment and 2.60±0.8 after treatment. A significant difference was found when the mean VAS scores of all patients were compared before and after treatment (p=0.000). The mean pre-treatment Roland-Morris(RM) score of all patients was 18.7±2 and it was 4.6±2.8 after treatment. A significant difference was found when the RM score of all patients was compared before and after treatment (p=0.000).
DISCUSSION AND CONCLUSION: Combined supportive therapies seem to be effective in the treatment of lumbar facet joint syndrome.

INTRODUCTION: We aimed to investigate the role of transcerebellar diameter (TCD) on obstetric ultrasound for calculating the fetal gestational age
METHODS: The women with a pregnancy of 18-25 weeks (according to date of the last menstrual period(LMP)) who underwent a obstetric ultrasound were included in the study. The biparietal diameter (BPD), femur lenght (FL) and trans-cerebellar diameter (TCD) were calculated and their correlation with the getastional age were examined with statistical analysis.
RESULTS: Our study was conducted on 114 pregnant women. The mean age was 27 (±5-17) and approximately 54% of them were between 21-22 weeks. The value of TCD in millimeters in transabdominal ultrasonography showed a strong positive correlation with LMP(r=0.916, p<0.001), BPD(r=0.939, p<0.001) and FL(r=0.880, p<0.001) at 18-25 weeks in indicating gestational age. As the gestational age increased, TCD also increased. In addition, the value of TCD in millimeters was the same as the gestational age in approximately 80% of all patients, especially when compared with BPD.
DISCUSSION AND CONCLUSION: Because TCD calculation on obstetric ultrasound between 18-25 week of gestation is a safe and easy method for evaluating the general condition of fetüs, it may be added to BPD, FL calculation in the routine practise.

INTRODUCTION: With 7 primary genotypes and more than 100 subgroups, the hepatitis C virus (HCV) exhibits considerable genetic variability. Due to changes in genotype rates brought on by population migrations, epidemiology data must be updated regularly. This article's aims are to present HCV genotype data, investigate the link between age and gender, and establish the genotype distribution in relation to risk variables.
METHODS: Between 2017 and 2021, 95 HCV patients were included in this retrospective, single-center investigation. Anti HCV, HCV RNA polymerase chain reaction results (PCR) and HCV genotype status of the patients were recorded. Abbott Real Time HCV Genotype II genotyping kit was used for HCV genotyping of patients with positive HCV RNA PCR test.
RESULTS: 56 (59%) male and 39 (41%) female patients were included in the study. When both genders were examined, it was discovered that genotype 1b (65.3%) was the most common genotype. The least frequent genotypes among the patients were genotype 2 (2.1%) and genotype 4 (2.1%). Regarding HCV genotype type and gender, no statistically meaningful variation was found. However, the evaluation made in terms of genotype type and age showed a statistically significant difference (p 0.001). The most common possible transmission route of the patients was the presence of surgical operation (45.3%), and genotype 1b was the most common in this group.
DISCUSSION AND CONCLUSION: Determination of HCV genotypes and transmission routes and regular reporting of regional data will contribute to epidemiological data. This will guide the development of health policies for HCV and the elimination of HCV.

INTRODUCTION: Brucellosis is a chronic infectious disease with osteoarticular (OA) manifestations. It is difficult to distinguish between brucellosis and rheumatologic diseases in endemic areas. In this study, we aimed to report the clinical findings and autoantibody results of patients diagnosed with brucellosis in the rheumatology department.
METHODS: In this study, 92 patients over the age of 18 with the diagnosis of "Brucellosis" were included. All patients' systemic and joint examinations were performed. In the presence of clinical signs, those with a detected value of ≥1: 160 on the standard tube agglutination test were considered to be active brucellosis. Those with arthritis, arthralgia, tenosynovitis-bursitis, spondylodiscitis and sacroiliitis were detected on examination or magnetic resonance imaging, and those with low back or hip pain were recorded. Complete blood count,C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) and RF, anti-CCP, ANA and anti-DNA results were evaluated.
RESULTS: The mean age of ninety-two patients (Female: 54, 58.7%) was 39.3±13 years. In the OA findings; arthralgia was detected with a ratio of 90.2%, arthritis with 33.7%, myalgia with 28.2%, sacroiliitis with 25% and spondylodiscitis with 6.5%. CRP and ESR means were 19 mm/h with 2.1 mg\dL. RF was positive in 12 (13%), Anti-CCP in 5 (5.4%), ANA in 7 (7.6%).There were no patients with anti-DNA positivity. The median treatment duration was 12 weeks.
DISCUSSION AND CONCLUSION: The anti-CCP positivity was lower than in the literature, and RF and ANA positivity were similar. Symmetrical involvement of small joints, higher CRP and high titer autoantibody positivity were at a higher risk of developing rheumatologic disease.

INTRODUCTION: In the present study, different femoral osteotomy levels applied in the combined surgical treatment of the patients aged over 2 years with developmental dysplasia of hip (DDH) were compared. It was aimed to determine the advantages and disadvantages of the osteotomies performed at the shaft and subtrochanteric regions of the femur and to evaluate their radiological and clinical impact on hip development.
METHODS: The study included the patients aged over 2 years with DDH who were applied open reduction, Pemberton pericapsular osteotomy and femoral osteotomy. The demographic information, clinical evaluations and radiographic results of the patients were applied from the medical records. In addition, radiation exposure (the number of fluoroscopic images), operation duration and present of complications were evaluated. The hips were divided into two groups based on the level of femoral osteotomy as shaft (group 1) and subtrochanteric (group 2) groups. The Tönnis Classification System was used to assess the grade of preoperative hip dysplasia. Radiological evaluation was performed according to Severin’s criteria while modified McKay’s criteria was applied for clinical evaluation. Kalamachi and MacEwen’s criteria were preferred for evaluation of avascular necrosis (AVN).
RESULTS: Of the 46 hips, 21 hips were in the body group and 25 hips were in the subthoracanteric group. No statistically significant difference was present between the groups in terms of age, Tönnis type of hip dysplasia, preoperative acetabular index, postoperative acetabular index, preoperative collo-diaphyseal angle, postoperative collo-diaphyseal angle and derotation grade (p>0.05). The difference between the follow-up durations of the groups was statistically significant. The follow-up duration of the group 1 was shorter than the group 2. Although, clinical results in the group 1 were proportionally better than the group 2, no statistically significant difference was determined between the groups (p= 0.1264). A statistically significant difference was detected between the groups in terms of radiological results (p= 0.0008). AVN was found in none of the hips in the group 1 whereas 8 hips were detected with AVN in the group 2. The difference between the groups regarding femoral head AVN was statistically significant (p=0.0043). There was a statistically significant difference between the groups in terms of operation duration and radiation exposure (p<0.0001). Subluxation or redislocation developed in none of the cases.
DISCUSSION AND CONCLUSION: Femoral osteotomy performed for femoral shortening and derotation at the region of femoral shaft can be used as an alternative surgical procedure without increasing the risk for AVN in the pediatric patients aged over 2 years with DDH.

INTRODUCTION: The aim of this study is to determine the clinical characteristics of convicted patients admitted to the emergency department and to compare the similar and different aspects of emergency services offered to convicted patients between secondary and tertiary hospitals.
METHODS: This study was designed as a multicenter, retrospective cross-sectional. Convicted patients aged 18 and over who applied to the emergency departments of the hospitals mentioned in 2021-2022 were included in the study. The medical records of the cases were examined, and demographic characteristics, time of admission to the emergency department, emergency triage code, admission complaint, diagnosis, consultations, clinical outcomes, and any re-admissions to the emergency department within 24 hours were recorded.
RESULTS: Of the cases, 1415 (81.2%) were treated in the secondary care hospital and 327 (18.8%) were treated in the tertiary hospital. The cases with green code (62.4%) in the secondary hospital, and the cases with yellow (64.2%) and red codes (26.6%) in the tertiary hospital were more common (p=0.001,p=0.001,p=0.001, respectively). The most common complaint in both hospitals was physical assault (19.7%-30%). Consultation requests, ward hospitalizations, intensive care unit admissions, and emergency surgeries were more frequent in the tertiary hospital compared to the secondary hospital (p=0.001 for all comparisons).
DISCUSSION AND CONCLUSION: Trauma emerged as the primary reason for convicted patients seeking care at both hospitals, with a significant portion of cases being related to violent behaviors. Nonetheless, clinical differences exist between convicted patients admitted to secondary and tertiary hospitals, encompassing factors like emergency triage code, admission complaints, diagnoses, consultations, and patient outcomes.

INTRODUCTION: We aimed to evaluate the maternal and obstetric outcomes of pregnant women with and without COVID-19 infection in any period of their pregnancy.
METHODS: Maternal and neonatal results of all pregnant women who gave birth in Karaman Training and Research Hospital Gynecology and Obstetrics clinic for 1.5 years from the beginning of the COVID-19 pandemic were collected from the hospital data recording system.Pregnant women with or without COVID-19 infection were divided into groups and their results were compared.
RESULTS: A total of 2,989 pregnant women gave birth,of which 2,918(97.6%) tested negative for COVID-19, and 71 (2.49%)tested positive.The rate of low birth weight newborn (2500g and below) was 13.1% in COVID-19 negative pregnant,while it was 42.2% in COVID-19 positive pregnant (59.3% in the 3rd trimester).The rate of preterm births (37 weeks and below) was 13.3% in COVID-19 negative pregnant,while it was 22.5% in COVID-19 positive pregnant.The need for neonatal intensive care,Intrauterine ex rate and cesarean delivery rates were higher in COVID-19 positive pregnant women,and they were highest in the third trimester.While the rate of cesarean section due to fetal distress is 27.1% in COVID-19 negative pregnant women,34.6% in COVID-19 positive pregnant women and the highest cesarean delivery rate due to fetal distress was in third trimester pregnant.
DISCUSSION AND CONCLUSION: Although the COVID-19 pandemic seems to be over,COVID-19-like symptoms in pregnant women still make obstetricians nervous.Despite the increase in vaccination status,there are still unvaccinated pregnant women.Due to severe neonatal and maternal adverse outcomes,especially in the third trimester,the presence of COVID-19 should be considered.

INTRODUCTION: In this study, the aim was to investigate the relationship between immunological parameters, specifically the fibrinogen/albumin ratio, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and the widely used acute physiology and chronic health assessment (APACHE) II scoring system in critically ill patients in the intensive care unit.
METHODS: The retrospective analysis included 166 patients admitted between January 2023 and July 2023, evaluating their 28-day mortality. The patients were categorised into groups: Group M (mortality), with 53 patients and Group S (survival) with 113 patients. The immunological parameters of the patients between the groups were analyzed statistically.
RESULTS: APACHE II score, fibrinogen, lactate, and fibrinogen/albumin ratio were identified as independent parameters associated with mortality. The ROC analysis determined the optimal cutoff points for predicting mortality for APACHE II score, fibrinogen, lactate, and fibrinogen/albumin ratio.

DISCUSSION AND CONCLUSION: This study revealed a significant correlation between APACHE II score and immunological parameters, including fibrinogen, lactate, and fibrinogen/albumin ratio. These findings can be used to predict mortality.

INTRODUCTION: The profile of carbapenem-resistant Enterobacterales (CRE), antibiotic susceptibilities were analyzed in our hospital providing a wide range of healthcare services in Southeastern Anatolia.
METHODS: This retrospective study included carbapenem-resistant Klebsiella pneumoniae (CRKP, 1022 isolates) and carbapenem-resistant E. coli (CREC, 700 isolates) isolated from patients admitted to xxxxxx Hospital between 2019 and 2022. Isolate typing and antibiotic susceptibility profiles were determined using the BD Phoenix automated system (Becton Dickinson, USA), and the Diagnostics MIC-COL test kit (Diagnostics, Slovakia) was used to determine colistin susceptibility.
RESULTS: Out of the total 1022 CRKP isolates, 663 (64.9%) were obtained from intensive care units, 207 (20.2%) from inpatient clinics, and 152 (14.9%) from outpatient clinics. The most sensitive antibiotics for CRKP isolates were found to be ceftazidime-avibactam (CZA) (57%), gentamicin (51%), and amikacin (40%), respectively. Statistically significant changes in susceptibilities to CZA, colistin, trimethoprim-sulfamethoxazole (SXT), tobramycin, meropenem, imipenem, and levofloxacin were observed over the years (p<0.05). Among the total 700 CREC isolates, 258 (36.9%) were obtained from inpatient clinics, 229 (32.7%) from intensive care units, and 213 (30.4%) from outpatient clinics. Statistically significant changes in susceptibilities to imipenem, tobramycin, SXT, levofloxacin, cefepime, ampicillin-sulbactam (AMP-SM), and cefuroxime were observed over the years (p<0.05). Over 80% of the isolates were susceptible to amikacin, and over 60% were susceptible to gentamicin, imipenem, colistin, and CZA.
DISCUSSION AND CONCLUSION: Presentation of regional data on carbapenem resistance in health centers and understanding of antibiotic resistance/susceptibility specific to CSI are vital to guide empirical treatment decisions as well as provide important regional epidemiological data.

INTRODUCTION: Patients with severe coronavirus disease 2019 (COVID-19) infections are at risk of developing neurological complications. Critical illness neuromyopathy is one of the most important neurological complications in the long term and a serious cause of morbidity. Our study aimed to characterize critical illness neuromyopathy's clinical and electrophysiological features in COVID-19 patients.


METHODS: Patients admitted to the neurophysiology laboratory of Erzurum City Hospital between October 2020 and December 2022 due to the development of intensive care unit-acquired weakness after COVID-19 infection were evaluated retrospectively. The relationship between electrophysiological findings, patients' total muscle strength, and Barthel index of daily living scores was compared.
RESULTS: Twenty-two patients diagnosed with critical illness were included in the study. Eight patients had critical illness neuropathy, four had critical illness myopathy, and ten had electrophysiological findings of critical illness neuromyopathy. Muscle strength and Barthell scores of patients with critical illness neuromyopathy at the time of first diagnosis were statistically lower than those with critical illness neuropathy or myopathy. As the degree of polyneuropathy worsened and the number of myopathic muscles increased in electromyography, a statistically significant decrease was observed in the muscle strength and Barthell scores of the patients at the first diagnosis, 1st, and 6th months.
DISCUSSION AND CONCLUSION: Electrophysiological findings of critical illness neuromyopathy in COVID-19 patients provide information on functional outcomes in the short and medium term. Therefore, early electrophysiological study should be performed in patients with suspected critical illness, the severity of the disease should be determined, and rehabilitation should be started immediately after diagnosis.

INTRODUCTION: Postoperative cognitive dysfunction contributes to cognitive impairments following surgeries.Despite the potential of anesthesia methods causing cognitive dysfunction,conclusive evidence remains elusive.This study aims to compare the effects of general and spinal anesthesia on postoperative cognitive functions in patients undergoing urological surgeries.
METHODS: 108 patients aged 18 to 75 years, who underwent elective surgeries,were included in this study.Regardless of the anesthesia method chosen for surgery, the Mini-Mental State Test (MMST) was administered by a clinician at 24 hours preoperatively to assess cognitive functions in a blinded manner. At postoperative 24 hours, the same independent clinician repeated the MMST assessment. Preoperative and postoperative MMST scores were recorded. Patients were categorized into two groups: Group G received general anesthesia,and Group S underwent spinal anesthesia.Demographic data,surgery durations,and MMST values of the included cases were compared between the groups.
RESULTS: Of the 108 included patients, 80 were male (74.1%) and 28 were female (25.9%). Forty-eight patients received general anesthesia (Group G), while 60 patients received spinal anesthesia (Group S).No significant differences were observed between the groups in terms of age,ASA classification,and comorbidities.The female-to-male ratio was statistically significantly higher in Group G,while the male-to-female ratio was higher in Group S (p=0.014). The average surgery duration in Group G (87.56±28.15 minutes) was significantly longer than that in Group S (61±18.91 minutes) (p=0.001).When comparing preoperative and postoperative 24-hour MMST scores in both groups,no statistically significant differences were observed.
DISCUSSION AND CONCLUSION: No significant differences were found in terms of postoperative cognitive dysfunction between the general and spinal anesthesia methods used in patients undergoing urological surgeries

INTRODUCTION: With the current consensus approach, the definition of non-alcoholic fatty liver disease has been changed to “fatty liver disease associated with metabolic dysfunction” (MAFLD). This study aimed to investigate the company of MAFLD in isolated AntiHBC Ig G positive hepatitis B patients who need immunosuppressive therapy for various reasons.
METHODS: The presence of MAFLD was prospectively investigated before starting treatment in 150 patients with isolated AntiHBC IgG positivity who needed immunosuppressive therapy for a reason such as a rheumatological disease or tumor. All patients were scanned with Fibroscan M530 before immunosuppressive therapy and CAP value was determined. Simultaneously, blood lipid level, HOMA score, fasting insulin and fasting blood glucose were measured.
RESULTS: Oral antiviral therapy was started in all patients who needed immunosuppressive therapy and had isolated AntiHBc IgG positivity. CAP was measured with fibroscan M530 in all patients included in this study.This situation is accepted as F: 0-1 according to metavir. The patients' average CAP value was 235.2 dB/m with the exact measurement. In this case, although the mean value was <248 dB/m, MAFLD was detected in 28.1% of the cases.
DISCUSSION AND CONCLUSION: In this study, MAFLD was found in 28.1% of patients with low liver fibrosis but isolated AntiHBc IgG positivity requiring immunosuppressive treatment and to be started oral antiviral to prevent HBV reactivation.

INTRODUCTION: In this study, it was aimed to evaluate non-invasive, effective and low-cost diagnostic methods of bladder filling and voiding abnormalities in male patients.
METHODS: Visual Prostate Symptom Score (VPSS) and the International Prostate Symptom Score (IPSS) were completed by the patients. Patients’ intravesical prostatic protrusion (IPP), prostate volume, and post voiding residual urine (PVR) were measured by suprapubic ultrasound. Bladder Outlet Obstruction Number (BOON) was used to calculate urethral resistance. Patients with a BOON value above -20 were considered obstructive.
RESULTS: This study included 219 male patients aged 50 years and over.The number of patients with a BOON value over -20 were 34 (obstructed) and below -20 were 61 (non-obstructed). There was a significant difference between these two groups in terms of PSA, prostate volume, IPP, Qmax, PVR, IPSS, and VPSS. It was observed that IPSS and VPSS were correlated (r=0.786, p=0.001). Obstructive (r=0.779, p=0.000) and irritative symptoms (r=0.813, p=0.000) of IPSS and VPSS were also observed to be correlated.
DISCUSSION AND CONCLUSION: VPSS was found to be equivalent to IPSS in the diagnosis of lower urinary tract symptoms (p=0.001). IPP is an important, practical, and non-invasive method that correlates with IPSS, VPSS, and BOON.

INTRODUCTION: Asthma is a prevalent disease that can cause different clinical features due to various underlying mechanisms. Detecting different types of asthma is important in disease management. We aimed to compare the features of allergic and non-allergic patients and to assess the clinical characteristics of patients with asthma in ***.
METHODS: We included 302 adult patients with asthma with compatible history, physical examination and pulmonary function tests. We evaluated the demographic features and allergy test results in addition to clinical and laboratory findings on patients with asthma. The characteristics of the patients allocated into two groups with allergic and non-allergic, asthma were compared.
RESULTS: Among the patients, 80% were women and the median age was 35 years. Allergy tests indicated that the most frequently observed inhalant agents were pollens (59%), followed by house dusts (55%), molds (6%) and animal epitheliums (3%). More than half (57%) of the patients exhibited allergic asthma. Non-allergic asthma was correlated with longer disease duration and more severe disease while the presence of a family history of an allergic disease was higher in patients with allergic asthma (p=0,001, p=0,001 and p=0,001, respectively). Total IgE levels were significantly higher in allergic asthma, although there was no significant difference concerning eosinophil counts (p=0,001 and p=0,936, respectively).
DISCUSSION AND CONCLUSION: This study demonstrated that the majority of patients with asthma were allergic in ***, with pollen allergy being the most common. These findings can aid doctors in distinguishing asthma phenotypes. As a result, more successful treatments will be provided in managing patients with asthma.

INTRODUCTION: It is important to detect endometrial cancer (EC) in endometrial intraepithelial neoplasia (EIN) patients. It was aimed to determine the role of systemic immune inflammation index (SII) in predicting concurrent EC in women with EIN.
METHODS: In this retrospective study, 429 women with EIN divided into three groups according to final histopathologic results: benign(n=151), EIN(n=152), and EC(n=126). Demographic and clinical data, pathologic and laboratory result were collected. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and SII index were calculated and compared among groups.
RESULTS: The SII, PLR and NLR values of benign, EIN and EC groups were compared and all values of EC group were the highest. The ROC analysis showed that although all markers had statistical significance, the AUC of SII was the highest. The SII score>0.67 (95%CI: 7.17-37.3) had a 16.35-fold, preoperative platelet count > 287 (95%CI: 1.91-6.2) had a 3.45-fold and age >49 years (95%CI: 1.97-5.92) had 3.42-fold increased risk for EC.
DISCUSSION AND CONCLUSION: Although age and preoperative platelet count were found independent risk factors, SII was the strongest predictor for EC in women with EIN. SII can be used as a predictive marker for identifying concurrent EC or having risk for developing EC in women with EIN.

INTRODUCTION: Pulmonary embolism is an urgent health problem and causes high morbidity and mortality when diagnosis is delayed. In addition, detecting the severity of the disease early and starting appropriate treatment prevents complications and mortality due to pulmonary embolism. In recent years, efforts to determine the severity of pulmonary embolism with hemogram parameters that can be easily performed anywhere and anytime, instead of time-consuming and costly examinations, have increased. Right ventricular dysfunction, which indicates the severity of pulmonary embolism, is determined by echocardiography. In this study, we investigated the relationship between inflammatory parameters in the hemogram and immature granulocytes, a new parameter, with right ventricular dysfunction in order to screen for the necessity of echocardiography in pulmonary embolism.
METHODS: 57 patients admitted to the university hospital between January 1, 2018 and July 1, 2023 and diagnosed with pulmonary embolism by computed tomography pulmonary angiography were included in the study. Demographic, echocardiographic, radiological and laboratory data of the cases were obtained from hospital records and the results were analyzed retrospectively
RESULTS: Of the 57 patients included in the study, 36 (63.2%) were male and 21 (36.8%) were female. There were 18 (31.6%) patients with right ventricular dysfunction and 39 (68.4%) patients without. Mean age was 52.39±15.56. A significant correlation was found between right ventricular dysfunction and immature granulocyte count (p<0.05). In multivariate logistic regression analysis, immature granulocyte value was found to be a significant and independent variable in predicting right ventricular dysfunction (p˂ 0.05).
DISCUSSION AND CONCLUSION: As a result, the relationship between immature granulocytes measured in complete blood count and pulmonary embolism was examined. For the first time, the increase in immature granulocytes was found to be a significant and independent variable in predicting right ventricular dysfunction in pulmonary embolism. We believe that this result may have prognostic value for estimating the severity of pulmonary embolism and the need to screen for right ventricular dysfunction.

INTRODUCTION: In recent years, anesthesiologists have used Postoperative pain management more frequently due to its effects on early mobilization and discharge. In this study, we aimed to investigate the factors affecting anesthetists' preference for regional techniques and especially plane blocks in postoperative analgesia.
METHODS: Anesthesiologists were asked to answer a survey consisting of 20 questions electronically. Two hundred fifteen physicians fully replied to our survey digitally. The answers given to our survey, which consisted of questions to determine whether the demographic characteristics of the participants, the institution they work for, their working conditions, and the training they received impacted their preferences, were evaluated.
RESULTS: It has been determined that the participants' professional background, age, whether they have received USG training, and their titles affected their analgesia preferences.The plane block application rate was 61.4% higher in those who received USG training significantly (P = 0.003). 88.4% of the physicians said they used opioids, 84.2% used nonsteroidal anti-inflammatory drugs (NSAIDs), and 82.3% used regional analgesia methods. They also pointed out that they mostly applied lumbar epidural block procedure among the regional block methods,.(88.8%). The limiting reasons for using regional analgesia were 49% intensity, 6.8% the risk of complications.
DISCUSSION AND CONCLUSION: Opioids, NSAIDs, and regional methods were commonly used for postoperative analgesia. An epidural block is the most preferred method among the regional methods. Age, professional years, whether they have received USG training, their titles, intensity, and physical factors also determine analgesia preferences.

INTRODUCTION: Anterior clinoid process (ACP) and posterior clinoid process (PCP) are usually excised for access to lesions in the surgery of sellar and parasellar tumors or aneurysms. Anatomical variations of these structures should be well known for a safe clinoidectomy. This study aimed to investigate the variations in pneumatization of ACP, PCP, and the sphenoid sinus.
METHODS: The study was conducted by evaluating the images acquired by axial, coronal, and sagittal plane reconstructions of cranial computed tomography (CT) of 500 (245 female and 255 male) patients aged 15-93 years. Evaluating ACP, PCP, and sphenoid sinus pneumatization and pneumatization patterns, the concurrent occurrence of these variations was examined.
RESULTS: ACP pneumatization was identified in 24% of the patients, with 8.8% being on the right, 6.4% on the left, and 8.8% bilaterally. PCP pneumatization was observed in 7% of the patients, with 2.2% being on the right, 2.2% on the left, and 2.6% bilaterally. The prevalence of concurrent CP and PCP pneumatization was 5.8%. ACP and PCP pneumatization was most frequently noted in patients with postsellar sphenoid sinus pneumatization, with rates of 19.2% and 6.6%, respectively.
DISCUSSION AND CONCLUSION: The knowledge of variations in pneumatization of ACP, PCP and sphenoid sinus prevents neurovascular injuries that may occur during clinoidectomy and the formation of post-clinoidectomy cerebrospinal fluid (CSF) fistulas. These structures should be evaluated with preoperative cranial CT. Clinoidectomy should be avoided in order to prevent the formation of CSF fistulas, especially in cases of type 3 ACP and PCP pneumatization.

Solvent inhalation is still an important public health problem that is responsible morbidity and mortality of young people worldwide and has adverse effects on society. In Turkey, solvent inhalation is the most common substance abuse following smoking and alcohol addiction, and butane and propane have been reported to be the most frequently inhaled substances. In this study, the crime scene information is presented, with the pathology and toxicology analysis results of two cases of death due to inhalation of n-butane, one as suicide and the other accidentally. Although clinical findings were described in detail in cases hospitalized due to butane gas inhalation and in death cases, the number of articles describing crime scene and autopsy findings is limited. In this case report, it is aimed to describe of the findings that they may encounter during the crime scene and death examination, especially for general practitioners and autopsy findings of cases.
Consequently, it is important for the general practitioners participating in the corpse examination to be careful about the crime scene and the findings on the corpse, for accurate toxicological analyzes and accurate determination of the cause of death. These physicians should give clues to forensic experts about signs such as thinner, glue, or gas source near the corpse, a plastic bag placed on the head of the corpse, vomit stains near the corpse or on their clothing.

Heel pain is one of the common clinical conditions of musculoskeletal diseases. Heel pain can occur with infectious, inflammatory, mechanical and vascular causes. Haglund's deformity, one of the causes of heel pain, is an abnormal bone formation located in the posterosuperior part of the calcaneus. Achilles enthesopathy, Haglund deformity and lesions in the posterior heel are considered Haglund Syndrome. The diagnosis of Haglund Syndrome is made clinically and radiologically. In the diagnosis of Haglund syndrome, direct radiography and magnetic resonance imaging are used in radiological examination. The bony prominence on the lateral radiograph of the foot supports the diagnosis. The differential diagnosis of Haglund Syndrome with rheumatic diseases such as gout and seronegative spondyloarthritis should be made. Gout is an inflammatory rheumatic disease characterized by the accumulation of monosodium urate crystals in tissues caused by hyperuricemia. In this article, a case diagnosed with gout accompanying bilateral Haglund Syndrome is presented in the light of current literature.