INTRODUCTION: Azygos lobe is a rare anatomical variation in the upper lobe of the right lung. It is visible on chest radiography or computed tomography (CT) scans. In this study, we aimed to investigate the prevalence and sex distribution of the right azygos lobe in patients undergoing thoracic CT in a local region of the Eastern Black Sea in 2020.
METHODS: In this study, we retrospectively examined the images of 10,271 patients with thorax CT scans between 2020 and 2021. The ages and sex of the patients were recorded. The azygos fissure was identified as a convex line in the paramediastinal portion of the upper lobe of the right lung. The presence or absence of the right azygos lobe and fissure and the presence of a lung mass or nodule inside the azygos lobe were examined in patients undergoing thoracic CT.
RESULTS: The azygos lobe was found in 51 (1%) females and 73 (1.4%) males out of 10,271 patients examined. Azygos lobe was found in 124 patients (1.2%). The study results indicated that males had a higher prevalence of azygos lobe variation than females. However, there was no statistically significant relationship between the presence of azygos lobe variation and sex (p = 0.13). This study revealed no masses or nodules in the azygos lobe.
DISCUSSION AND CONCLUSION: The present study reports on the prevalence and sex distribution of the azygos lobe in a large representative sample of the Eastern Black Sea region, highlighting the importance of accurately detecting the azygos lobe in imaging studies.

INTRODUCTION: Today, with the development of technology, the variety of information sources has increased. It is now possible to access information obtained from encyclopedias in seconds with a few clicks of a button. Rapid developments in artificial intelligence (AI) and the widespread use of large language models (LLMs) such as ChatGPT, Gemini, and Perplexity have revolutionized access to medical information. However, the accuracy and readability of the answers provided by these models are critical, especially in the healthcare domain. This study evaluates the performance of ChatGPT, Gemini, and Perplexity in addressing frequently asked questions about tinnitus, a common symptom in otolaryngology practice.
METHODS: Twenty frequently asked questions about tinnitus were posed to the models and their responses were evaluated by two otolaryngologists using global quality (GQS) and Likert scales for accuracy and reliability and the Gunning-Fog Index (GFI) for readability.
RESULTS: The findings reveal no significant difference in the reliability and quality of information between the models (median: 5.00, p=0.159), but it was observed that Gemini came out ahead in readability (p=0.001) and ChatGPT in accuracy (p=0.007). However, Perplexity lagged in both metrics. These results highlight the varying strengths and weaknesses of LLMs, emphasizing the importance of model selection based on user needs. For example, ChatGPT is ideal for complex medical information, while Gemini is more accessible to wider audiences.
DISCUSSION AND CONCLUSION: This study demonstrates the potential of AI-enabled systems in healthcare; however, we suggest that future improvements should increase both accuracy and accessibility.

INTRODUCTION: Hypoxia and ischemia occurring after ovarian transplantation lead to significant follicular losses.The aim of this study was to prevent follicular losses during ovarian tissue transplantation through periovarian adipose tissue, without the need for any scaffold, bioengineering applications, or vascular anastomosis.
METHODS: In our study, fresh ovaries (maintaining their structural integrity) were transplanted into the dorsal muscles of the rat along with periovarian adipose tissue.
RESULTS: Our findings indicate that paracrine factors secreted by fibroblasts in the tunica albuginea and fibrous sheath, along with adipocytes and mesenchymal stem cells in periovarian adipose tissue, effectively prevent ischemia in ovarian tissue and accelerate angiogenesis.
DISCUSSION AND CONCLUSION: Based on our findings, periovarian adipose tissue effectively prevents ischemia in ovarian tissue and plays a crucial role in preserving the ovarian follicle reserve, without the need for scaffolds, bioengineering applications, or vascular anastomosis

INTRODUCTION: Osteochondroma is the most common benign bone tumor in children and young adults, typically localized in the metaphyseal regions of long bones. Osteochondromas rarely undergo malignant transformation, and cartilage cap thickness is an important factor in assessing this risk. This study aims to investigate the prevalence, clinical and radiological characteristics, necessity for surgical intervention, and malignant transformation potential of osteochondroma cases in the pediatric population.
METHODS: This retrospective observational study included pediatric patients diagnosed with osteochondroma between 2015 and 2024. Demographic data, tumor localization, size, number of lesions, clinical symptoms, treatment methods, and follow-up outcomes were retrospectively analyzed.
RESULTS: A total of 67 patients were included in the study, with a median age of 11.4 years. The most common age range for diagnosis was 10–14 years. Osteochondroma was more prevalent in males (62.7%). The most frequently affected sites were the distal femur (26.9%) and proximal tibia (26.9%). The mean long axis of the tumors was 27.7 mm, and the mean short axis was 15.3 mm. The majority of cases (89.5%) were solitary. The mean cartilage cap thickness was measured as 4.95 mm.
DISCUSSION AND CONCLUSION: The findings of this study are consistent with the literature, highlighting the significance of age, sex, localization, tumor size, and cartilage cap thickness in the diagnosis and follow-up of osteochondroma. The critical role of cartilage cap thickness in assessing malignant transformation risk has been confirmed. These data are expected to guide clinical management.

INTRODUCTION: Rising ambient temperature is increasingly recognized as a potential risk factor for suicide, yet long-term, nationwide evidence from developing countries remains limited. This study investigates the association between temperature and suicide rates in Turkey over a 24-year period.
METHODS: Monthly suicide data were obtained from the Turkish Statistical Institute (2000–2023), while average temperature was derived from the ERA5-Land reanalysis dataset. A Seasonal Autoregressive Integrated Moving Average with Exogenous Regressors (SARIMAX) model accounted for seasonality, autocorrelation, and temperature as a covariate.
RESULTS: All three SARIMAX models showed a statistically significant positive relationship between temperature and suicide rates (p < 0.001). For each 1°C increase, the suicide rate rose by 0.0038 per 100,000 population in the total group, 0.0043 per 100,000 among males, and 0.0025 per 100,000 among females. Model diagnostics (e.g., Ljung-Box, Jarque-Bera) suggested good overall fit. Despite limitations such as the lack of daily data and additional covariates, these findings underscore the robust link between ambient temperature and suicide.
DISCUSSION AND CONCLUSION: This nationwide analysis highlights temperature as an important environmental factor influencing suicide. In light of climate change, public health strategies should consider the implications of rising temperatures. Future work incorporating more covariates and higher-resolution data could further elucidate the complex relationship between temperature and suicidal behavior.

INTRODUCTION: Prostate cancer (PC) is the most common malignancy among men and remains a major cause of cancer-related mortality worldwide. Cisplatin is a widely used chemotherapeutic agent in cancer treatment. Vitamin B12 has been shown to play a role in enhancing the efficacy of certain cancer drugs when used in combination therapies. This study investigates the antitumor effects and mechanisms of action of B12 and Cisplatin combination therapy in prostate cancer cells.
METHODS: The clonogenic assay was used to determine the fraction of surviving cells after treatment. The MTS assay and flow cytometry were performed to assess the impact of B12 and Cisplatin on cell proliferation and apoptosis, while Western blot analysis was used to examine the expression of key signaling proteins involved in these processes.
RESULTS: Our results revealed that the combination treatment of B12 and Cispalatin significantly inhibited the proliferation and viability of the PC cell line. Also, clonogenic assay indicated that B12 and Cisplatin combination treatment inhibited the colony formation. In the B12 and cisplatin co-treated groups, our results showed a significant increase in P38 and PARP-1 protein expression compared to the control group. Moreover, B12 combined with cisplatin also downregulated MAPK/ERK1-2 and Bcl-2 protein expression.
DISCUSSION AND CONCLUSION: Our findings suggest that the combination of B12 and Cisplatin enhances the antitumor effects of Cisplatin by promoting apoptosis and modulating key signaling pathways, including P38, PARP-1, and MAPK/ERK1-2. This combination therapy represents a promising approach for improving prostate cancer treatment.

INTRODUCTION: The Mpox outbreak in Africa has emerged as a significant public health challenge, necessitating a deeper understanding of its transmission dynamics, intervention strategies, and socio-cultural determinants. This study focuses on six African countries—Nigeria, the Democratic Republic of Congo (DRC), Cameroon, Ghana, Côte d'Ivoire, and the Republic of Congo—to evaluate the effectiveness of community engagement strategies tailored to local contexts.

METHODS: This study employs a descriptive-analytical retrospective design, integrating quantitative metrics (e.g., cases, fatality rates) with qualitative insights into socio-cultural challenges and healthcare limitations. Data were collected from verified secondary sources. Advanced statistical techniques, such as multivariate regression analysis and Bayesian modeling, were used to examine relationships between variables like healthcare access, digital literacy, and intervention outcomes.

RESULTS: Results reveal significant disparities in case distribution and intervention effectiveness across the six countries. For instance, Nigeria achieved 85% effectiveness through mass education campaigns, while Ghana reached 90% success using real-time reporting apps despite limited digital literacy. Challenges such as stigma, logistical barriers, and human-wildlife interactions persist, particularly in the DRC and Cameroon. The study underscores the importance of culturally appropriate interventions and robust healthcare systems in reducing Mpox transmission and mortality.

DISCUSSION AND CONCLUSION: This study provides a comprehensive analysis of Mpox outbreaks, emphasizing the critical role of localized strategies and technological innovations in mitigating transmission. These findings contribute to the growing body of knowledge on zoonotic disease management and provide actionable recommendations for addressing emerging infectious disease threats in resource-limited settings.

INTRODUCTION: Vasopressor agents stimulate endothelial cells and platelets via the sympathetic nervous system and affect the coagulation cascade through various mediators. This study aimed to investigate the effects of epinephrine, norepinephrine, and dopamine on hemogram and coagulation parameters.
METHODS: A total of 28 healthy Wistar albino rats weighing 250-300 grams were used in this study. The rats were randomly divided into four groups, with 7 in each group. 0.9 % serum physiologic (group C, n=7), epinephrine (group E, n=7), norepinephrine (group NE, n= 7), dopamine (group D, n=7) were intraperitoneally perfused to the rats under sedation. Blood samples were drawn from the rats 30 minutes after perfusion. Hemogram and coagulation parameters were compared between the groups.
RESULTS: Granulocyte values were lower in the dopamine group (p=0.014). Platelet cluster count was higher in the dopamine group (p=0.001). The highest hemoglobin and hematocrit values measured among the groups were observed in Group E, and its values were higher than those in the norepinephrine and control groups (p=0.047 and 0.030, respectively).
DISCUSSION AND CONCLUSION: It has been determined that vasopressor drugs affect hemogram values and platelet aggregation in different ways, but do not cause any changes in coagulation parameters.

INTRODUCTION: In this study, the relationship between maxillary sinus retention cysts (RCMs) and nasal septum deviation types was evaluated. In addition, their association with osteomeatal unit obstructions, conchal structural variations, and the presence of an accessory ostium was evaluated using paranasal sinus computed tomography (PNsCT).
METHODS: A total of 439 patients were included in the study, 399 of whom underwent septoplasty, and 40 underwent rhinoplasty without septum pathology (control group). Paranasal CT scans were retrospectively analyzed for the presence of RCMs, osteomeatal complex obstruction, conchal pathologies, and accessory ostium. Statistical analyses included Fisher's exact test, Chi-square test, logistic regression analysis, and McNemar's test. P-values less than 0.05 were considered statistically significant.
RESULTS: The prevalence of RCMs was significantly higher in the septoplasty group (29.3%) compared to the control group (5.0%). A significant correlation was found between the type of septal deviation and RCM formation, with in deviations at the level of the middle turbinate showing the highest prevalence (49.1%). Additionally, a strong association was observed between osteomeatal complex obstruction and RCM presence (p = 0.008), as well as between the side of deviation and the side of the cyst (p < 0.001). Females were significantly more likely to develop RCMs than males (p = 0.006). No significant relationships were identified between retention cysts and accessory ostium (p = 0.700) or conchal pathology (p = 0.183).
DISCUSSION AND CONCLUSION: Septal deviation may be associated with RCMs formation. This relationship is especially evident in deformities close to the middle turbinate.

INTRODUCTION: This study aimed to determine the relationship between post-earthquake traumatic stress disorder level and disability, quality of life, and headache severity in patients with migraine. This study also aimed to reveal the relationship between migraine and post-earthquake traumatic stress disorder levels.
METHODS: The study was conducted prospectively. A total of 150 patients aged 18 65 years who were diagnosed with migraine by a neurologist according to the International Headache Society criteria and who were treated at the Neurology Clinic, between July 2023 and September 2023, 6 months after the earthquake were included in the study. A total of 150 patients with similar demographic characteristics and no migraines were included in the control group. All participants were questioned and recorded regarding physical-demographic information, dizziness, the floor they were on during the earthquake, and symptoms accompanying migraines.
RESULTS: Migraine scores such as the Migraine Disability Assessment Scale (MIDAS), Headache Impact Test (HIT-6), and Visual Analog Scale (VAS) were significantly higher in patients with high Post-Earthquake Trauma Level (PETL). The PETL was higher in the migraine group than in the control group. There was a positive correlation between PETL and the VAS, MIDAS, Hospital Anxiety and Depression Scale (HADS-A), and HIT-6.
DISCUSSION AND CONCLUSION: High PETL in migraine patients is associated with more severe disability, lower quality of life, more severe headaches, and greater frequency of anxiety. The PETL was higher in patients with migraine than in healthy controls. This study revealed that patients with migraine are severely affected by devastating natural disasters such as earthquakes.

INTRODUCTION: This study aimed to evaluate the distribution of anesthesia methods and complication rates in pediatric patients aged 0–18 years who underwent orthopedic surgery at the Department of Anesthesiology and Reanimation, Van Yüzüncü Yıl University Faculty of Medicine, between 2019 and 2021.

METHODS: The study was designed as a retrospective, cross-sectional, and descriptive study. A total of 1468 pediatric patients aged 0–18 years classified as ASA I–II who underwent orthopedic surgery were included. Patient data including age, sex, type of surgery, anesthesia method applied, and anesthesia-related complications were recorded and analyzed.
RESULTS: Of the 1468 patients included in the study, general anesthesia was administered to 70.8%, peripheral nerve blocks to 16%, and spinal anesthesia to 12.6%. A significant increase was observed in the rates of general and spinal anesthesia in 2021, while the rate of peripheral nerve blocks decreased (p<0.05). The most common complication was tachycardia, observed at a rate of 3.5% in 2019. Complication rates decreased significantly in subsequent years.
DISCUSSION AND CONCLUSION: General anesthesia remains the most preferred method in pediatric orthopedic surgeries. However, regional anesthesia techniques are increasingly used and demonstrate safety. These findings suggest that regional techniques can be effectively and widely applied in pediatric populations with appropriate patient selection.

INTRODUCTION: Internet addiction (IA) is a clinical phenomenon characterized by excessive and compulsive internet use, which impairs daily functioning and is often accompanied by withdrawal and tolerance symptoms when access is limited. IA adversely affects quality of life and mental well-being. Recent studies have shown a strong association between IA and psychiatric disorders. This study aimed to examine the relationship between internet addiction, depression, circadian preferences, and coping strategies.
METHODS: The study included 200 healthy volunteers. Participants completed the Sociodemographic Information Form, Young Internet Addiction Test-Short Form (YIAT-SF), Morningness-Eveningness Questionnaire (MEQ), Coping Orientation to Problems Experienced (COPE) Inventory, and Beck Depression Inventory (BDI).
RESULTS: A statistically significant correlation was found between total scores on the Young Internet Addiction Test-Short Form (YIAT-SF) and the Beck Depression Inventory (BDI) (p = 0.006). Regarding coping strategies assessed through the COPE Inventory, individuals with higher internet addiction scores were found to use certain maladaptive strategies significantly more frequently, including mental disengagement (p = 0.001), denial (p < 0.001), humor (p = 0.03), behavioral disengagement (p < 0.001), restraint-coping (p = 0.015), substance use (p < 0.001), and acceptance (p = 0.001). Furthermore, individuals classified as moderate evening type exhibited significantly higher YIAT-SF scores compared to all other chronotypes (p < 0.001).
DISCUSSION AND CONCLUSION: This study highlights the role of chronotype and coping strategies in the psychological effects of internet addiction. Moderate evening-type individuals and those using maladaptive coping methods appear at greater risk. Addressing these factors may be critical for developing targeted preventive and therapeutic interventions.

INTRODUCTION: This study aimed to evaluate the clinical, obstetric, and perinatal outcomes of pregnant women with epilepsy and to investigate the impact of antiepileptic drug (AED) regimens (monotherapy versus polytherapy) on these outcomes.
METHODS: This retrospective study included 98 singleton pregnancies with epilepsy who delivered at a tertiary referral center between October 2022 and May 2025. Patients were grouped based on AED use: monotherapy or polytherapy. Composite adverse perinatal outcome (CAPO), including preterm birth, NICU admission, low Apgar scores, and neonatal complications, was the primary outcome. Univariate and multivariate logistic regression analyses were performed to identify factors associated with CAPO.
RESULTS: Among the participants, 76 (77.6%) received antiepileptic treatment; 60 (61.2%) received monotherapy and 16 (16.3%) received polytherapy. CAPO occurred in 37.8% of all cases, with a significantly higher rate in the polytherapy group compared to the monotherapy group (p = 0.017). Seizure during pregnancy (p=0.030), cesarean delivery due to fetal distress (p=0.047), and lower birth weight (p = 0.032) were more frequent in the polytherapy group. In multivariate analysis, polytherapy was identified as an independent predictor of CAPO (aOR: 10.609; 95% CI: 1.617-69.604; p=0.014), while higher gestational age at delivery was protective (p=0.004).
DISCUSSION AND CONCLUSION: This study revealed that cases of polytherapy resulted in significantly elevated incidence of seizures during pregnancy, cesarean sections due to fetal distress, low birth weight, and CAPO compared to monotherapy. The data suggest that the use of multiple antiepileptic drugs may adversely affect perinatal outcomes by increasing fetal exposure.

INTRODUCTION: Perianal fistulas are defined as abnormal, epithelialized connections in the anorectal region. In this study, we aimed to present the treatment outcomes of patients undergoing treatment with an elastic cutting seton (hybrid seton) for transsphincteric fistulas.
METHODS: A total of 92 cases diagnosed with high and complex anal fistulas in our hospital's general surgery clinic between 2023-2024 were included in the study. Patients had fistulas involving more than one-third of the sphincter muscles or transsphincteric fistulas in the anterior region. Demographic data, operation duration, treatment plans, visual analog scores, anal incontinence scores, recurrence rates, and complications were evaluated.
RESULTS: All patients presented with complaints of malodorous discharge, pain, swelling, and pruritus ani in the perianal region. During examination under anesthesia, the fistula tract was identified with a stylet, and the wrist portion of a size 8 glove was placed as a seton. The seton either fell off spontaneously or was removed with a fistulotomy within an average of 45 days. Over an average 12-month follow-up period, no recurrence or incontinence was observed in any of the cases.
DISCUSSION AND CONCLUSION: The hybrid seton technique does not cause incontinence as it gradually cuts through sphincter tissue without causing acute damage. Additionally, the lack of seton revisions and quality-of-life deterioration in follow-up makes hybrid seton a preferred treatment option.

INTRODUCTION: The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing globally, ranging from simple steatosis to cirrhosis. This study evaluates the correlation between serum noninvasive fibrosis markers and histopathological and FibroScan fibrosis data, identifying potential risk factors for fibrosis progression in MASLD and metabolic dysfunction-associated steatohepatitis (MASH) patients.
METHODS: We included 40 biopsy-confirmed MASLD and MASH patients. Serum levels of hyaluronic acid, fibroblast growth factor 21 (FGF21), collagen type IV, and YKL-40 were measured using ELISA. Patients were stratified into mild and advanced fibrosis groups based on liver biopsy and FibroScan results.
RESULTS: Patients with advanced fibrosis had significantly higher HOMA-IR, fasting insulin, and BMI (p=0.027, p=0.041, p=0.025). Hyaluronic acid, FGF21, collagen type IV, and YKL-40 were significantly elevated in the advanced fibrosis group (p<0.01 for all). Linear regression showed BMI influenced HOMA-IR (β=0.036, p=0.008), but not triglycerides or HDL. ROC analysis identified hyaluronic acid as a significant fibrosis marker (AUROC=0.73). Multivariate regression revealed FGF21 and hyaluronic acid as independent risk factors for fibrosis progression (OR=1.001, 95% CI: 0.99–1.003; OR=1.004, 95% CI: 0.99–1.01). Fibrosis severity was higher in patients with elevated AST and GGT (p<0.01), but not ALT (p=0.204).
DISCUSSION AND CONCLUSION: Conclusion: Insulin resistance, obesity, elevated serum levels of AST (aspartate aminotransferase) and gamma-glutamyl transferase (GGT) key risk factors for advanced fibrosis in MASLD. Elevated FGF21 and hyaluronic acid levels may serve as noninvasive fibrosis markers.

INTRODUCTION: Our aim was to explore the potential of monocyte to albumin ratio (MAR), neutrophil to albumin ratio (NAR), platelet to albumin ratio (PAR), C-reactive protein to albumin ratio (CAR), neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR) and platelet/monocyte ratio (PMR) as biomarkers of disease activity in rheumatoid arthritis (RA).
METHODS: Cases with RA and healthy controls were included in this cross-sectional study. Demographic features, disease duration current medications, RA disease activity scores (DAS28-ESH, DAS28-CRP, Simplified Disease Activity Index; SDAI, Clinical Disease Activity Index; CDAI) were recorded. Complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum albumin levels were obtained. MAR, NAR, PAR, CAR, NLR, MLR, PLR, PMR were calculated. These parameters were compared between patient and controls, correlations between these parameters and disease activity and their discriminatory ability were analyzed.
RESULTS: Fifty-four RA patients and 57 controls were included. Significantly higher levels of CAR, MAR, NAR, and MLR were observed in patients than controls (p=0.001, 0.004, <0.001, 0.006, 0.004, 0.001, 0.032, respectively). There was a significant difference between active and inactive patients in terms of ESR, CRP and CAR according to DAS28-ESH (p=0.004, 0.018, 0.014, respectively), while no difference was detected between other parameters. CAR and NAR exhibited notable correlations with clinical disease activity scores.
DISCUSSION AND CONCLUSION: Higher CAR, MAR, NAR, and MLR in patients with RA, and their correlations with disease activity were determined. By demonstrating their discriminatory potential, they could serve as biomarkers to complement clinical assessments in RA.