INTRODUCTION: In this study, we were aimed to determine the clinical-pathological features by retrospectively evaluating the patients diagnosed with benign Gestation Traphoblastic Disease(GTD) in our clinic.
METHODS: This study retrospectively analyzed 11,319 pregnant patients who were admitted to our hospital between 2015 and 2019. 61 patients who were diagnosed with benign GTD, treated and followed up were included in the study. The patient’s ages, hospital admission complaints, ultrasound findings, serum B-HCG values, blood groups, gravidity, parity, number of miscarriages, histological GTD type and treatments were analyzed.
RESULTS: In GTD cases, 11.5% were aged below 21 years, while 23% were above 35 years. 68.9% of the patients applied to our clinic with the complaint of vaginal bleeding, and 26% of the patient’s received diagnosis during follow-up visits. The blood group distribution of GTD patients didn't significantly differ from general population, indicating that blood group A may not be an independent risk factor.
DISCUSSION AND CONCLUSION: Although there are many studies in the literature on the etiology and incidence of GTD, differences are observed in the data obtained since most of the studies are clinic-based. There is a need to increase community-based studies on this issue. Upon initial admission, 78.7% of patients were clinically suspected of having GTD. Thanks to advances in diagnostic methods, earlier diagnosis of the disease has become possible, contributing to a reduction in complications arising from the disease. Raising public awareness about the importance of earlier medical consultations during pregnancy or in cases of pregnancy suspicion is crucial

INTRODUCTION: Portal biliopathy (PB) refers to biliary strictures that develop as a result of chronic extrahepatic portal vein thrombosis (EHPVT), most commonly due to compression by collateral venous structures such as the epicholedochal and paracholedochal plexuses. On imaging, PB can mimic both benign and malignant biliary conditions, potentially leading to diagnostic uncertainty and unnecessary invasive procedures. Accurate radiologic recognition is essential for appropriate clinical management. This study aims to evaluate the radiologic and biochemical features of PB and identify imaging findings that may facilitate early and non-invasive diagnosis.
METHODS: This retrospective study included 15 patients clinically and radiologically diagnosed with PB secondary to chronic EHPVT between January 2018 and December 2024. Imaging was reviewed by an abdominal radiologist with 5 years of experience. Biliary changes, collateral vessel distribution, and lesion characteristics were evaluated using ultrasound, Doppler ultrasound, Computed Tomography (CT), and Magnetic Resonance Imaging (MRI). Biochemical parameters and clinical records were also assessed.
RESULTS: All patients had biliary strictures due to peribiliary collateral compression. Collateral types were varicoid in 8 (53.3%), fibrotic in 3 (20%), and mixed in 4 (26.7%). Two patients (13.3%) had MFPB with T1-weighted hyperintense, T2-weighted hypointense lesions showing delayed enhancement without diffusion restriction. ALP and GGT were elevated in 80% of cases; bilirubin in 46.7%. ERCP was performed in 5 patients (33.3%) for symptomatic relief; others were treated conservatively.
DISCUSSION AND CONCLUSION: PB can be identified by characteristic radiologic findings. Awareness of peribiliary collaterals and mass-forming changes is essential. Accurate imaging diagnosis may prevent unnecessary interventions and guide appropriate management.

INTRODUCTION: Pregnancies in the adolescent age group have shown an increasing trend in Türkiye, particularly with the rising issue of migration, constituting a significant public health concern. Factors such as lack of knowledge, social stigma, and financial constraints lead to delayed initiation of antenatal care and lack of follow-up. This study aims to examine the outcomes of adolescent pregnancies.
METHODS: The pregnancy outcomes of 74 adolescents who presented to the obstetrics and gynecology clinic of a rural district state hospital for delivery between 2020 and 2021 were retrospectively analyzed.
RESULTS: In this study, gravida, parity numbers, comorbidities, and maternal and neonatal outcomes of adolescents under 18 were examined. The mean age was 17.4 ± 1 years, the mean gravida was 1.3 ± 0.6, parity was 0.3 ± 0.6, and the mean number of abortions was 0.01 ± 0.1. Normal spontaneous vaginal delivery was observed in 67 participants (90.5%), with episiotomy performed in 54 (73.0%) of these cases. The mean gestational age was 38.5 ± 1.5 weeks, with a mean fetal weight of 3008 ± 481 g and a mean fetal length of 49.7 ± 3.2 cm. The mean 1-minute Apgar score was 7.8 ± 1.3, and the 5-minute score was 8.9 ± 1.1. Only one delivery occurred at 29 weeks of gestation, with all others classified as term deliveries.
DISCUSSION AND CONCLUSION: To prevent adolescent pregnancies, which constitute a societal issue, comprehensive education programs should be provided to both adolescents and their families. Adequate medical support must also be ensured for adolescent mothers

INTRODUCTION: Thyroid hormone plays an essential role in brain development and fetal, neonatal, and adult brain function and may influence neuronal recovery after hypoxia and traumatic brain injury. We aimed to see whether there is a relationship between the effects of hypoxia at the cellular level and the stages of the disease.
METHODS: After ethics committee approval and informing the families, demographic characteristics, laboratory parameters, diffusion MRI images, and TSH and free T4 levels from thyroid function tests on postnatal days 5 and 21 were recorded retrospectively in newborns who were hospitalized with the diagnosis of hypoxic-ischemic encephalopathy in the neonatal intensive care unit of our hospital in the last two years. 81 HIE babies over 37 gestational weeks and 50 control babies of the same age participated in the study. Sarnat staging was performed according to the patient's clinical status.
RESULTS: There were no statistically significant differences between HIE and healthy babies regarding gender, mode of delivery, birth weight, and birth week. According to Sarnat scoring, while healthy infants had lower TSH levels on postnatal day 5 compared to all types of hypoxic infants, moderate HIE newborns had higher TSH measurements compared with healthy, mild, and severe HIE neonates (p=0.001). fT4 level was statistically significantly higher in moderate HIE babies than in healthy, mild, and severe newborns (p=0.001).
DISCUSSION AND CONCLUSION: We demonstrated that thyroid hormones, known to have significant effects on energy catabolism and central nervous system development, varied over time in HIE infants at various stages.

INTRODUCTION: Prostate-specific antigen (PSA) is a standard laboratory assay employed in the diagnosis of benign prostatic hyperplasia (BPH). Nonetheless, alternative diagnostic biomarkers are under investigation. This study aimed to examine the possibility of blood levels of galectin-3 (Gal-3) and glucagon-like peptide-1 (GLP-1) (9-36) amide as alternative diagnostic indicators for BPH.
METHODS: A control group comprising 42 healthy individuals without complaints and 42 individuals diagnosed with BPH, aged over 40, exhibiting prostate-related lower urinary tract symptoms for a minimum of 6 months, an IPSS score exceeding 13, a peak urine flow rate of 4-15 ml/s, and a total PSA level below 3 ng/mL, was incorporated into the study as the patient cohort.
RESULTS: GGal-3 levels were markedly higher in the patient group than in the control group (median values 7.6 ng/dL vs. 5.17 ng/dL; p = 0.015). Nonetheless, GLP-1 levels did not differ significantly between the two groups (median values 15.96 pmol/L vs. 13.58 pmol/L; p = 0.424). Free PSA levels (f-PSA) and the f-PSA-to-total PSA (t-PSA) ratio (f-PSA/t-PSA) were significantly increased in the BPH group compared to the controls (p = 0.0001 and p = 0.002, respectively), while t-PSA levels did not differ significantly between the groups (p = 0.092).
DISCUSSION AND CONCLUSION: In summary, increased Gal-3 levels in BPH may significantly contribute to disease pathogenesis. This study is significant as it represents the first investigation into the importance of both parameters in patients diagnosed with benign prostatic hyperplasia.

INTRODUCTION: Desmopressin is a common first-line treatment for monosymptomatic nocturnal enuresis (MNE), but relapse after cessation is frequent. The most effective withdrawal strategy remains unclear.
METHODS: This retrospective multicenter study included children with MNE who achieved full response to desmopressin. Patients were grouped based on withdrawal method: abrupt cessation, dose reduction, or time-extended tapering. Relapse was defined as more than one wet night per month within 12 weeks after stopping treatment. Relapse rates were compared among groups.
RESULTS: Among 286 children included, relapse occurred in 55.7% of those with abrupt cessation, 42.7% with dose reduction, and 38.7% with tapering (p = 0.039). Structured strategies resulted in significantly lower relapse rates.
DISCUSSION AND CONCLUSION: Gradual desmopressin withdrawal strategies, including dose reduction and tapering, are more effective than abrupt cessation in reducing relapse rates in children with MNE. These approaches may enhance long-term treatment success.

INTRODUCTION: Multiple myeloma (MM) is a blood cancer involving the abnormal growth of clonal plasma cells in the bone marrow. Traditional models for prognosis such as the Revised International Staging System (R-ISS) primarily considers tumor burden and cytogenetic abnormalities, yet it fails to comprehensively capture patients' immune competence and nutritional condition. The CONUT (Controlling Nutritional Status) score is an immuno-nutritional metric derived from measurements of serum albumin, cholesterol concentration, and lymphocyte levels. Our study aimed to investigate the effect of the CONUT score on prognosis in patients with MM.


METHODS: Ninety-one patients with a confirmed diagnosis of MM were included in this retrospective analysis. Individuals were assigned to low (score ≤4), moderate (score 5–8), or high (score ≥9) risk groups based on their CONUT assessment. The relationship between the CONUT score and the R-ISS stage and the presence of plasmacytoma was evaluated using the chi-square test.
RESULTS: According to the CONUT scores, the mean survival time of the patients was 4202 days in the low-risk group, 3665 days in the moderate-risk group, and 987 days in the high-risk group, with the difference between these durations being statistically significant (p=0.002). The presence of plasmacytoma was identified as a factor negatively affecting survival (p=0.037).
DISCUSSION AND CONCLUSION: The CONUT score appears to be a simple and objective parameter that can predict survival in multiple myeloma independently of traditional staging systems. The assessment of nutritional and immunological status, when integrated into risk classification, may contribute to individualized treatment strategies.

INTRODUCTION: This study aims to compare LigaSure hemorrhoidectomy and direct current electrotherapy in the treatment of grade 2 and grade 3 internal hemorrhoids.
METHODS: This study was designed as a retrospective analysis including patients with symptomatic grade 2 and 3 internal hemorrhoids unresponsive to medical treatment. A total of 50 patients with complete follow-up data were divided into two groups of 25 each. In the galvanization group, hemorrhoidal columns were coagulated using electrotherapy with a current probe set between 2 and 16 mA. LigaSure hemorrhoidectomy was performed as a routine open surgical procedure in the other group. Operation time, postoperative pain, hospital stay, and clinical stage were recorded. Patients were followed up regularly for 3 months to assess healing, late complications, and recurrence.
RESULTS: Patients underwent rectoscopy at the 3rd postoperative month. Patients with grade 2 or 3 hemorrhoids, as confirmed by endoscopy and physical examination, were classified as having a recurrence. The LigaSure method showed a statistically significant difference in recurrence rates (p < 0.05). The mean operative time for the galvanization method was 26 minutes, and this difference was also statistically significant (p < 0.05). Pain scores were significantly lower with direct current electrotherapy compared to other methods (p < 0.05).
DISCUSSION AND CONCLUSION: Hemorrhoidal coagulation with galvanic electrotherapy reduces operative time and hospitalization duration. Additionally, the relapse rate and postoperative pain, as measured by VAS scores, are lower with this procedure compared to LigaSure hemorrhoidectomy. However, late complications and the intensity of late postoperative pain may be comparable between the two surgical methods.

INTRODUCTION: This study aimed to compare the postoperative analgesic effect of modified-thoracoabdominal nerves block through perichondrial approach (M-TAPA) and transversus abdominis plane (TAP) block in patients who underwent open hysterectomy with bilateral salpingo-oophorectomy.
METHODS: This study is a single-center, open label, prospective, randomized-controlled trial. Patients were divided into three groups: Group Control (n=15), Group M-TAPA (n=15) and Group TAP (n=15). Group M-TAPA and Group TAP patients received a bilateral M-TAPA and bilateral lateral-TAP blocks under ultrasound guidance with the use of bupivacaine 0.25% with a standard dose of 20 ml for each side. The primary outcome was the numerical rating scale (NRS) scores of the patients. Secondary outcome was total tramadol consumption by the patients followed up for postoperative 24 hours.
RESULTS: When the groups were compared in terms of static and dynamic NRS scores, there was a statistically significant difference between Group Control and the other groups (p<0.05). There was no statistically significant difference between Group M-TAPA and Group TAP in terms of NRS scores at all times (p>0.05). Total tramadol consumption was higher in Group Control (p<0.05) while there was no statistically significant difference between Group M-TAPA and Group TAP (p>0.05).
DISCUSSION AND CONCLUSION: In this study, although no statistically significant difference in analgesic efficacy was found between M-TAPA and TAP blocks after open TAH+BSO surgeries, both techniques provided clinically acceptable analgesia compared to the control group.

INTRODUCTION: Paracetamol is one of the most popular and frequently used analgesic and antipyretic medications in the world. It was aimed at investigating the effects of paracetamol on angiogenesis and oxidative stress markers in the in vivo chorioallantoic membrane model (CAM).


METHODS: METHODS: The 40 fertilized chick eggs were used in the experiment. The four groups were the control group (n = 10), 10-6 M bevacizumab group (n = 10), 10-4 M paracetamol group (n = 10) and 10-5 M paracetamol group (n = 10). Stereoscopic microscopy was used to assess angiogenesis on the window that was opened on the eggshell. Total oxidant capacity (TOS), total antioxidant capacity (TAS), and oxidative stress index (OSI) were analyzed in albumen specimens. The scoring methodology described in earlier research publications was used to determine and compare the average score values. One-way analysis of variance and the post hoc Tukey test were performed to assess oxidative stress markers between the groups.

RESULTS: The bevacizumab group demonstrated a strong anti-angiogenic effect, but the control group and both paracetamol groups showed no anti-angiogenic effect. Paracetamol increased TAC values at a 10-4 M concentration (p = 0.04). The bevacizumab group's T0C and OSI values were significantly higher compared to the control group (p<0.05).


DISCUSSION AND CONCLUSION: Paracetamol is used by a lot of people; healthy blood vessel growth and the balance between oxidants and antioxidants are important. The important result of this study is that paracetamol has strong antioxidant effects and no anti-angiogenic effects.

INTRODUCTION: This study aimed to compare the clinical and radiological outcomes of emergency and elective carotid artery stenting (CAS) in symptomatic carotid artery stenosis.
METHODS: A retrospective analysis was conducted on 115 patients who underwent CAS for internal carotid artery (ICA) stenosis in our center between January 2020 and May 2023. Patients were categorized as emergency or elective CAS. Data on demographics, comorbidities, symptomatic status, acute ischemic infarction history, stenosis degree, plaque characteristics, procedural details, intensive care need(>48 hours), hospital stay, and mortality rate were recorded.
RESULTS: Of 115 patients, 68(59.1%) were male, with a mean age of 69.87±9.17 years. Hypertension (73.9%) was the most common comorbidity. Elective CAS was performed in 96 patients (83.5%) and emergency CAS in 19(16.5%). Emergency CAS patients had higher rates of ulcerated plaques (47.4% vs. 13.5%, p<0.001), cerebral infarction (84.2% vs. 3.1%, p<0.001), dissection (26.3% vs. 0%, p<0.001), and plaque thrombus (26.3% vs. 1%, p<0.001). Hospital stay was longer in the emergency CAS group (4.74±2.07 vs. 3.63±2.05 days, p=0.033). Myocardial infarction (0% vs. 1%, p=0.946), extracranial complications (5.3% vs. 1%, p=0.835), and mortality (10.5% vs. 3.1%, p=0.190) did not differ significantly. In patients with severe stenosis (≥90%), the rate of tandem lesions was higher (p=0.010), periprocedural mortality (p=0.037) and prolonged intensive care duration (p=0.017) and the rate of predilatation application (p=0.002) were significantly higher compared to the other groups.
DISCUSSION AND CONCLUSION: Emergency CAS is feasible and effective in selected high-risk patients with symptomatic carotid stenosis. However, given the higher risk profile, careful patient selection and perioperative management are crucial.

INTRODUCTION: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. In this study, it was planned to determine the correlation of electrophysiological findings with the functional limitation detected after the complaints described by the patients and neurological examinations.
METHODS: A total of 180 patients with idiopathic carpal tunnel syndrome with electrophysiologically diagnosed CTS were included in the study. A neurologic examination was performed and Tinel and Phalen's sign, numbness, pain and awakening from sleep at night were noted.
RESULTS: 23.3% of the cases were male and 76.7% were female. In addition, correlations were found between electrophysiologic staging and BMI, VAS scale, BDI and BAI scales. VAS scores, BDI and BAI scores were found to be statistically significantly higher in patients with right hand CTS involvement than in patients with Stage 4 and Stage 5 CTS. Similarly, BDI and VAS scores and BMI were found to be statistically higher in cases with Stage 4 and Stage 5 left hand CTS involvement. Among the provocation tests, Tinel's test was found to be positive in 77 cases and Phalen's test in 45 cases, while Tinel's test was statistically significantly more positive in women. There was no statistically significant difference between female and male patients in terms of BMI, Beck Depression, Anxiety and VAS measurements (p>0.05).
DISCUSSION AND CONCLUSION: In this study, high levels of anxiety and depressive mood were found in patients with carpal tunnel syndrome. Anxiety and depressive mood should not be ignored in the diagnosis and treatment of patients with carpal tunnel syndrome.

INTRODUCTION: Severe non-ketotic hyperglycinemia may present with clinical signs such as lethargy, hypotonia, apnea, hiccups and persistent convulsions in the newborn period.
METHODS: Eight patients with severe non-ketotic hyperglycinemia who were followed between January 2016 and November 2024 were included in the study. Initial clinical findings, laboratory results, EEG findings, MRI and MRS findings, molecular genetic analyses, drugs, dietary treatments, treatment results and prognosis were evaluated from patient hospital files.
RESULTS: Levels of plasma and cerebrospinal fluid glycine were 868.3 ± 259.0 μmol/l and 137.7 ± 36.0 μmol/l, respectively. The ratio between cerebrospinal fluid and plasma glycine was above 0.08 in all eight patients. Cerebrospinal fluid/plasma glycine ratio was measured after treatment in three patients. Although a decrease in cerebrospinal fluid glycine levels was observed in two patients, no decrease was detected in cerebrospinal fluid/plasma glycine ratio after treatment.
Seizure frequency decreased during periods of mild elevated glycine levels in seven patients. Although plasma glycine levels remained normal in one patient, seizures continued in this patient.
The c.1784dupT mutation was identified as a novel mutation in GLDC gene.

DISCUSSION AND CONCLUSION: Non-ketotic hyperglycinemia is a life-threatening inborn error of amino acid metabolism. Although CSF and plasma glycine levels are reduced with medication, unfortunately seizures decrease but continue. We observed that seizures may continue even when plasma glycine levels are normal. Currently, there is no specific treatment for non-ketotic hyperglycinemia. However, new potential curative therapies should be explored for this debilitating disorder, particularly for its severe form.

INTRODUCTION: This study explores the role of Resolvin D1 (RvD1) in neuroinflammation and vasospasm following aneurysmal subarachnoid hemorrhage (SAH). Vasospasm, a major determinant of morbidity and mortality in SAH patients, is linked to increased neuroinflammation and elevated inflammatory markers, such as C-reactive protein (CRP), which worsen clinical outcomes. RvD1 is hypothesized to protect neurons by reducing apoptosis and neuroinflammation. The study aims to assess changes in RvD1 levels in cerebrospinal fluid (CSF) after SAH and their relationship with vasospasm, inflammatory markers, and clinical parameters, including Glasgow Coma Scale (GCS) scores.


METHODS: The study included 39 patients with spontaneous aneurysmal SAH between 2021 and May 2023. RvD1 levels in CSF were measured on the 1st and 3rd days of bleeding and compared with clinical vasospasm, GCS, and CRP values.
RESULTS: RvD1 levels were significantly higher in patients with radiological vasospasm on the first day. Similarly, elevated RvD1 levels were observed in patients with clinical vasospasm on subsequent days. Serum CRP levels were also significantly higher in the early days of bleeding in the vasospasm group.


DISCUSSION AND CONCLUSION: The findings suggest that RvD1, known for its neuroprotective and anti-inflammatory effects, is elevated in patients with clinical vasospasm, highlighting the role of inflammation in vasospasm pathogenesis after SAH. RvD1 could be used as a potential biomarker for predicting clinical vasospasm.

INTRODUCTION: This study aimed to evaluate the effects of the herbal compound, Cystolyberin, on the treatment of bacterial cystitis in a rat model.
METHODS: Twenty-eight male Sprague-Dawley rats were divided into four groups. Group 1 was the sham group, Group 2 served as the control, Group 3 received a short course of Cystolyberin, and Group 4 received an extended course. Bladder tissues and urine samples were collected after treatment. Urine culture results and histopathological findings were compared between the groups to assess the therapeutic effects of Cystolyberin.
RESULTS: Urine cultures showed no E. coli in Groups 1 and 4, while 100% of Group 2 and 42.86% of Group 3 had persistent infection (p = 0.001). Histopathological analysis revealed a significant reduction in bladder inflammation in Group 4 compared to Group 2 (p = 0.004). Additionally, there was a significant difference in lamina propria thickness across the groups (p = 0.025). No significant differences were found for edema (p = 0.208), vascular congestion (p = 0.15), epithelial modification (p = 0.272), urothelial integrity (p = 0.106), or lymphocyte presence (p = 0.252).
DISCUSSION AND CONCLUSION: : A 14-day course of Cystolyberin led to the eradication of E. coli in the rat model, demonstrating its potential as a treatment for bacterial cystitis. Further studies are needed to confirm these findings.

INTRODUCTION: Early maternal separation is a significant stressor with potential long-term consequences for mental health. It is known that early maternal separation affects adult attachment styles as well as psychopathologies such as depression and anxiety.
METHODS: This study investigated the relationship between early maternal separation experiences and adult psychopathology, focusing on attachment styles, depression, and anxiety symptoms. Sixty-one patients presenting with depression and/or anxiety symptoms, and who had experienced maternal separation within the first three years of life, were included and the data was collected retrospectively. Two distinct patterns of early maternal separation were identified: long-term continuous separation and repeated short-term separations. Clinical assessment included the Beck Depression Inventory, Beck Anxiety Inventory and Adult Attachment Scale (secure, avoidant, anxious-ambivalent).
RESULTS: Maternal separation during the first year of life was associated with significantly higher depression scores. Patients with avoidant attachment showed the highest depression scores, while those with secure attachment demonstrated the lowest. Long-term separation was predominantly associated with avoidant attachment and higher depression scores, while repeated short-term separations correlated with anxious-ambivalent attachment and higher anxiety scores.
DISCUSSION AND CONCLUSION: These findings suggest that the timing, duration, and pattern of early maternal separation significantly influence adult psychopathology and attachment styles, highlighting the importance of early mother-child bonding for mental health outcomes. Further longitudinal research with larger samples is needed to confirm these findings and elucidate the underlying mechanisms.

Objective:
Intraoperative damage to the pilot balloon inflation line of an endotracheal tube (ETT) can result in cuff deflation, leading to ineffective ventilation and increased aspiration risk. This case report describes a practical repair technique that allowed continued safe ventilation without tube replacement.
Case Presentation:
A 70-year-old woman underwent elective coronary artery bypass grafting. During central venous catheter placement, the anesthesia machine displayed low EtCO₂ and ventilator failure alarms. Diminished bilateral breath sounds were noted, and the pilot balloon was found severed. As the patient's hemodynamics remained stable, a 20G intravenous catheter steel needle tip was inserted directly into the inflation line, carefully positioned to avoid further damage. The cuff was reinflated using a syringe, and appropriate pressure was maintained with a three-way stopcock and cuff manometer. The air leak resolved, and surgery proceeded without requiring tube exchange.
Conclusion:
Pilot balloon damage can be safely managed intraoperatively using readily available equipment. This practical approach may serve as a valuable alternative to endotracheal tube replacement, especially in cases involving a difficult airway. Familiarity with such repair methods can enhance airway safety during surgery.