bluuebunny/crossref_metadata_2025 huggingface dataset:
Unveiling Asymptomatic Miliary-Type Osteoma Cutis Incidentally Detected in Craniocervical Computed Tomography Angiography: Two Case Reports
Authors: Zohrabova Albina , Gemici Aylin , Camkiran Elifsu , Midi İpek
Published: February 2025

Objective: Osteoma cutis (OC) is a benign disorder characterised by the formation of nodules resulting from cutaneous ossification in the dermis and subcutaneous tissue. It is categorised into two main forms: the less common primary form (15-20%) and the more prevalent secondary form (80-85%), which arises as a consequence of an underlying condition. Given the scarcity of OC cases in the existing literature, we present two cases of asymptomatic miliary-type OC that were incidentally detected during craniocervical computed tomography angiography (CTA), with one case also compared to sinus CT findings.
Case 1: A 53-year-old male with left main coronary artery (LMCA) stenosis was admitted to the cardiovascular surgery clinic for a coronary artery bypass graft (CABG) operation. His craniocervical CTA revealed cutaneous ossifications in the maxillofacial region and forehead.
Case 2: A 53-year-old female patient with systemic arterial hypertension and diabetes presented to the hospital with complaints of dizziness and speech impairment. Her craniocervical CTA exhibited distinct cutaneous ossifications in the maxillofacial region.
Conclusion: Despite being classified as rare, OC is frequently overlooked due to its benign and asymptomatic nature, highlighting the importance of bringing this condition to the attention of clinicians.
Aldehyde dehydrogenase-1 expression and prognosis in triple-negative breast cancer
Authors: Murrja Edvin , Turna Zeynep Hande , Ozturk Mehmet Akif , Cinkaya Ahmet , Ozturk Tulin
Published: February 2025

Objective: Understanding of other biological characteristics of Triple-negative breast cancer, the development of new therapeutical approaches and identification of new markers is necessary due to the lack of biological markers like ER, PR and HER2. The purpose of this study was to investigate the prognostic effect of the expression of aldehyde dehydrogenase-1 (ALDH1) in TNBC and its relationship with the clinico-pathological features
Methods: In this study 87 patient files were searched for clinico-pathological data obtained from the files and paraffin blocks. The prognostic value of these clinical data and ALDH1 positivity were evaluated by determining disease-free survival.
Results: TNM stage I vs III (p=0.03), vascular invasion (p=0.05), chemotherapy indication (p=0.02) were significantly associated with DFS. Multivariable analyses didn't demonstrate any statistically significant relationship between ALDH1 (p=0.61) and DFS.
Conclusions: We didn’t find any statistically significant relationship between ALDH1 positivity and DFS. There was no correlation between ALDH1 expression and tumor’s pathological features.
Anaplastic Childhood Meningioma in a 16-Year-Old Boy
Authors: Pala Emel Ebru , Kucuk Ulku , Cakir Ebru Arabaci , Binatli Ozcan
Published: February 2025

Meningiomas account for 0.4-4.6% of all primary brain tumors in children. Childhood meningiomas have several different characteristics than those occurring in adults. Case: Here we report a 16 year old male presented with long-standing headache and incipient weakness on the left side. Magnetic resonance images revealed a 65x47x37 mm sized, right sided frontoparietal parasagittal extra-axial mass. Histopathologic examination showed monotonous, small cells with oval/round nucleus forming whorl-like structures. The tumor showed high mitotic index and Ki67 proliferation rate around 30%. Immunohistochemically tumor cells were positive with EMA, vimentin, BCL-2, progesterone receptor. The final diagnosis according to histopathological, radiological and immunohistochemical findings was anaplastic meningioma. Conclusion: High-grade meningiomas are rare in children. Appropriate grading is important, as high grade tumors with high proliferation index are associated with less favorable clinical outcomes and warrant more radical treatment.
Documentation of the Salivary Gland Tumors: An Institutional Data From Turkey
Authors: Kucuk Ulku , Akoz Gamze , Cakır Ebru , Pala Emel , Bayol Umit , Gumussoy Murat , Cukurova Ibrahim
Published: February 2025

Objective: World-wide series show some differences in the incidence and clinicopathologic features of salivary gland tumors.
Methods: A total of 248 cases of SGTs diagnosed in our hospital between 1998 and2013 were reviewed with respect to their clinicopathologic features.
Results: There were 128 male and 116 female patients with a mean age of 49.2. Of these 248 tumors 214 were benign and 34 were malignant. The mean age of the patients with benign tumors was 48.6 years and with malignancies was 55.3 years. The most common site was the parotid gland (83.5%) followed by submandibular and minor ones.  Pleomorphic adenoma (50.4%) was the most common benign tumor and affected female patients more frequently. It is followed by Warthin’s tumor that favored parotid gland. Adenoid cystic carcinoma was the most frequent malignant tumor followed by mucoepidemid carcinoma and carcinoma ex pleomorphic adenoma and the majorities were located in the submandibular gland.
Conclusion: In the present study, epidemiological data was compared with other worldwide series. Our retrospective study revealed that; benign tumors were more frequent, major salivary glands were more affected by both benign and malignant tumors than minor salivary glands and the parotid gland was the most affected site. Epidemiological data in the various parts of the world can be helpful for a better understanding of SGT's biology and characteristics.
Tumor Mimicking Bladder Endometriosis
Authors: Kucuk Ulku , Pala Emel , Pala Halil Gursoy , Cakir Ebru , Divrik Rauf Taner
Published: February 2025

Endometriosis is described as the presence of endometrial tissue outside the uterine corpus. Though urinary tract endometriosis is uncommon, the bladder is the most common localization amongst them. Here we present three cases admitted to our hospital with similar complaints such as dysuria and abdominal pain. All of the patients had previous cesarean section history. And radiological examination of the bladder revealed solid masses located on the bladder wall. One of the case additionally had a protruding, polipoid luminal mass. Two of the cases were treated with transurethral resection and one with partial cystectomy. We noted similar histological findings such as endometrial stroma and glands within the smooth muscle fibers.  The stromal components were positive with CD10, epithelial components were positive with both estrogen and progesterone receptor immunohistochemically.
As a result bladder endometriosis should be kept in mind in the differential diagnosis of mass forming urinary tract  lesions.
Kikuchi-fujimoto disease: histopathological and clinical review of a case
Authors: Pehlivan Belma , Karagoz Muammer , Belli Seyda , Tokat Fatma , Saglican Yesim
Published: February 2025

Kikuchi-Fujimoto disease (KFD) or histiocytic necrotizing lymphadenitis is an idiopathic, benign, self-limited, rare disease. This disease is mostly encountered in Asia and in young adult. Cervical lymph node involvement is the most common symptom. In addition, fever, fatigue, increase in erythrocyte sedimentation rate, and leukocytopenia may also occur. A specific diagnosis and treatment for this disease has not been defined. The diagnosis of this disease however can be diagnosed with excision of lymph node and histopathological examination. KFD can often resolve spontaneously. If there is no spontaneous regression, oral corticosteroid therapy can be applied.              In this case report, we were referred a rare case of Kikuchi-Fujimoto disease, presented with the cervical lymphadenopathy, increased erythrocyte sedimentation rate, and fever.
Unilateral Ureterocele Presenting With Multiple Stones In An Old Lady: Endoscopic Incision and Stone Extraction
Authors: Yuksel Mehmet
Published: February 2025

In this video supported case report, we aimed to present our step-by-step technique of endoscopic incision of ureterocele and stone extraction in a 66 years old female  patient with a large ureretocele containing multiple urinary stones. The patient was with the complaints of flank pain and disuria. The patient  was prepared under spinal anesthesia and positioned in lithotomy position. Under direct visualisation of cystoscopic view, the ureterocele and other ureteral orifice of the duplicated urinary system have been detected. A ureteral catheter was placed into the other ureter for safety. Subsequently, a transverse endoscopic incision was performed by using a 26 F standard resectoscope with an electrical loop of TUIP at the inferior lateral border, and an artificial secondary ureteral orifice has been created. Though this new orifice, the resectoscope was inserted into the ureter, and multiple ureteral stones were seen inside the ureterocele and dilated ureter. These stones were extracted by using stone forceps and directly irrigation and decompression of the ureteral lumen. No stone fragmentation was required in this operation. After the elimination of all of the stones, a 4.8 F DJ stent was inserted into the ureter and the procedure has been completed without any complication. At the postoperative follow up period, no complication was occurred and all of the complaints were improved.
Nephrotic Syndrome Associated with Breast Cancer; When should it be treated?
Authors: Yenigun Ezgi Coskun , Turgut Didem , Alaguney Erdem , Ozturk Ramazan , Piskinpasa Serhan , Dede Fatih
Published: February 2025

We hereby describe a 46-year woman with nephrotic syndrome and new-onset breast cancer. This patient admitted to our hospital with peripheral edema and a mass in her right breast. Membranous glomerulonephritis (MGN) was the etiology of nephrotic syndrome. MGN has been reported in association with a wide variety of solid neoplastic diseases, although rarely occurs as a complication of breast carcinoma. We report a rare and a resistant case of MGN, who was concomitant diagnosed with breast cancer and there was no improvement in proteinuria although breast cancer was under-controlled with cheomotheraphy and surgery.
Ultrasound-guided lateral sagittal infraclavicular block in patient with flexion contracture
Authors: Palabiyik Onur
Published: February 2025

Ultrasound (US)-guided lateral sagittal infraclavicular block (LSIB) is a technique of regional anesthesia that is used for anesthesia and analgesia in lower arm surgery. US emerges as an essential source for peripheral nerve block in cases of the nerve stimulator is not to possible to use. We presented that US-guided LSIB was successfully applied for finger amputation in a 80-years female patient with flexion contracture in the left hand due to previous cerebrovascular disease, because this was not reported previously in the literature.
Relationship Between HDLc, NonHDLc/ HDLc Ratio and Gilbert's Syndrome
Authors: Ozenc Salim , Sarlak Hakan , Iscen Sinan
Published: February 2025

Objective: We investigated the relationship between HDL-cholesterol levels that is indirect marker of ApoA-I production in liver, Non-HDL-cholesterol that is indirect marker of ApoB and GS
Methods: HDLc, NonHDLc/ HDLc Ratio levels were investigated in subjects with GS (n=148) and compared to healthy controls (n=148).
Results: Age and BMI distributions were similar between the two groups. HDLc levels were lower in GS than the healthy controls (p=0.012). However, TC, Non-HDLc, Non-HDLc/HDLc levels were higher in GS than the healthy controls (p=0.002, p=0.001, p<0.001, respectively). In correlation analysis, UB were negatively mildly correlated with HDLc (r=−0.191, p=0.001) and positively correlated with TC (r=0.436, p<0.001), Non-HDLc (r=0.511, p<0.001) and Non-HDLc/HDLc (r=0.512, p<0.001) in the whole group.
Conclusions: The contrary of previously studies, we would like to suggest that bilirubin is a only antioxidant agent that protects from cardiovascular disease, but not physiological hypolipidemic agent.
Anomalous origin of Left Coronary Artery from Pulmonary Artery; Congenital Anomaly Presenting with Dyspnea. A rare Case Study
Authors: Anvari Shahriar , Negargar Sohrab , Khosroshahi Ahmad Jamei
Published: February 2025

Anomalous origin of left coronary artery from pulmonary artery (ALCAPA) is rare congenital anomaly. Most of these patients die is infancy. Presentation in adulthood is very rare. Clinical manifestation in teenagers or young adult contains arrhythmia, myocardial perfusion likely causes significant chest pain and these symptoms of myocardial ischemia may be misinterpreted as routine infantile colic and sudden death.
Evaluation of some tumor markers, acute phase proteins, sialic acid and lipid bound sialic acid before and after chemotherapy in stomach cancer
Authors: Cebi Aysegul , Mert Handan , Mert Nihat
Published: February 2025

Objective:  It was aimed to compare the some tumor markers, acute phase proteins, sialic acid and lipid bound sialic acid levels in patients with stomach cancer before and after chemotherapy to the healthy controls.
Material and Methods:  Forty-eight patients with stomach adenocarcinoma and 20 healthy controls, totally 68 subjects were used. Blood samples were taken from all patients before and after chemotherapy and controls to analyse the levels of tumor markers (CA 125, CA 15-3, CA 19-9, CEA), acute phase proteins (CRP and fibrinogen) and SA (sialic acid), LSA (lipid bound sialic acid).
Results:  Before chemotherapy the serum levels of CA 125, CA 15-3, CA 19-9, CEA SA, LSA, CRP and fibrinogen (107.30 U/ml, 65.74 U/ml, 295.86 U/ml, 108.57 ng/ml, 199.60 mg/dl, 41.89 mg/dl, 86.03 mg/l and 469.42 mg/dl ) were higher than after chemotherapy group (36.46 U/ml, 34.00 U/ml, 100.18 U/ml, 20.20 ng/ml, 87.67 mg/dl, 31.06 mg/dl, 57.04 mg/l and 379.04 mg/dl) and the controls (8.64 U/ml, 21.65 U/ml, 21.52 U/ml, 2.77 ng/ml, 73.75 mg/dl, 27.47 mg/dl, 2.37 mg/l, 303.5 mg/dl).
Conclusion:  The serum levels of SA and LSA may be considered the indicators of poor/good prognosis of stomach cancer. CRP and fibrinogen are suggested as available biomarkers for diagnosis and prognosis in patients with stomach cancer.
Analysis of adult intoxication cases treated in ICU: A sample from Adıyaman Region of Turkey
Authors: Duran Mehmet , Uludag Oznur , Yuzkat Nureddin
Published: February 2025

Objective: We determined the patient profile and aim to look into the distribution of age and sex, intoxication route, the duration of the stay in ICU and prognosis of the cases we accepted to our ICU presenting with intoxication.
Material and Methods: Before the research, approval was granted by the Ethical Committee. 259 intoxication patients, accepted and treated in the ICU of Adıyaman University Hospital between the dates of 2012-2014, were included in the research.
Results: Total of 259 as 83 male, 176 female patients were examined. 75.7% of the cases were below age of 30. 92% of the cases received in ICU were suicidal and 8% of them were accidental intoxication cases. When the causes were observed, 85.7% of the cases were intoxicated by drug intake. Most frequently used drugs were antidepressants (43.6%). The mean number of the days in intensive care unit was 2.02 days.
Conclusion: As a result, most of the intoxication cases in intensive care unit were made up by young age cases who received antidepressants with suicidal intentions. Acute drug intoxications have better response to intensive care treatments and shorter duration of stays while non-pharmacological intoxications have longer duration of stays.
Acute myeloid leukemia under lenalidomide therapy in a patient with multiple myeloma
Authors: Eser Ali , Tanrikulu Funda Pepedil , Tuglular Ayse Tulin Firatli
Published: February 2025

A 53-year-old patient who had a 7 year history of multiple myeloma was diagnosed with high risk myelodysplastic syndrome while on lenalidomide treatment. Progression to acute myeloid leukemia has occurred during the following 4 months. Like our case, secondary primary malignancies (SPMs) can rarely complicate treatment of multiple myeloma. Although possible association between SPMs in patients receiving lenalidomide can be attributed to previous melphalan use, potential SPM risk with lenalidomide cannot still be ruled out safely
Vesicoperitoneal Fistula: A Rare Late Complication of Laparoscopic Removal of Intrauterine Device
Authors: Ucer Oktay , Yuksel Mehmet Bilgehan , Temeltas Gokhan , Muezzinoglu Talha
Published: February 2025

We present a case of vesicoperitoneal fistula occurring 12 years after laparoscopic removal of the intrauterine device.
A 30-year-old primiparous woman presented with acute abdominal pain. On examination, there were sensitivity and painful of all the abdomen quadrants on gentle palpation. The diagnostic workup included transabdominal ultrasonography and contrast computed tomography that revealed leakage of contrast into the peritoneal cavity from the bladder. At laparotomy, the fistula tract was excised.
Vesicoperitoneal fistula is a rare major complication of laparoscopic surgeries and occurs in early postoperative period. We observed the vesicoperitoneal fistula as a late complication of laparoscopic approach in the present case. This may be due to the thinning of a urachal diverticulum wall in the bladder during the laparoscopic procedure.
Factors affecting the burden on caregivers of stroke survivors in Turkey
Authors: Gorgulu Umit , Polat Ulku , Kahraman Burcu Bayrak , Ozen Sukru , Arslan Ersin
Published: February 2025

Purpose: Caring for stroke patients leads to caregiver strain. Caregiver burden following stroke is increasingly recognised as a significant health care concern.  This study was conducted to determine factors affecting the burden on caregivers of stroke survivors.
Design: This was a descriptive study.
Methods: Eighty caregivers of stroke patients hospitalized in the intensive and intermediate intensive care clinics of the Neurology Department of the Gazi University Health Research and Application Centre were included in the study. The Caregiver Introductory Form, the Barthel Index, the National Institutes of Health Stroke Scale, the Pittsburgh Sleep Quality Index and the Caregiver Burden Scale were used to collect the data.
Findings: In our study, a significant negative relationship (r=-0.854, p=0.000) was determined between the mean Barthel Index scores (24.55±7.69) and the mean Caregiver Burden Scale scores (57.52±14.35) and a significant positive relationship was determined between the mean Caregiver Burden Scale and the mean Pittsburgh Sleep Quality Index daytime dysfunction sub-component scores (1.30±1,42; r=0.223; p=0.046). 
Conclusions: Our study has demonstrated that caregiver burden increased as the level of independence of stroke patients decreased and the daytime dysfunction sleep disorder became more prevalent as the caregivers’ burden increased.
Clinical Relevance: The burden of care could become as excessive as to impact. Negatively on the caregivers' sleep quality. To reduce the negative impact of burden of care influential factors should determine.
Effects of aminoguanidine treatment on endothelial nitric oxide synthase expression and nitric oxide levels in streptozotocin induced diabetic rats
Authors: Parmaksiz Ilker , Sirikci Onder , Bilsel Serpil , Akdeniz Humeyra Turan , Yavuz Dilek Gogas
Published: February 2025

Objective: Formation of advanced glycation end products (AGE) in Diabetes Mellitus contribute to endothelial dysfunction by permanent modifications of proteins and decrease NO concentration which regulate vascular tonicity and thus endothelial functions. We investigated the effects of AGE inhibitor aminoguanidine (AG) treatment on endothelial nitric oxide synthase (eNOS) expression and NO levels in streptozotocin induced diabetic rats.
Material and method: 38 male Sprague-Dawley rats were separated into 4 groups. Group 1 was healthy controls without any intervention (HC group). Group 2 received AG in drinking water (HC+AG group). Third and fourth groups received 65 mg/kg streptozotocin intraperitoneally to induce diabetes. Group 3 was followed without further intervention (DM group). Group 4 received aminoguanidine in drinking water (DM+AG group). After 12 weeks, glucose, HbA1c, NO levels an eNOS expressions were determined.
Results: NO levels were significantly lower in DM and HC+AG groups compared to HC group. There was no significant difference between the NO levels of DM and DM+AG groups. eNOS protein levels in heart tissues were significantly lower in DM group than the HC group. eNOS levels were significantly higher in DM+AG than DM group. There was no significant difference in eNOS levels in kidney tissues among the groups.
Conclusion: Decreased NO levels in DM group was consistent with the literature. eNOS expression in heart tissues were decreased in DM group, their concentration were increased with AG therapy. Further studies are needed to elaboate the effects of AG in tissues and the side effects observed in some studies.
The evaluation of diagnostic performance of some enzymes for diagnosis and detection of breast cancer by ROC curve
Authors: Demir Halit , Keskin Sıddık , Demir Canan , Gokyer Halis
Published: February 2025

Objective: In this study, it was aimed to examine the performance of Arylesterase (ARE), Paraoxonase-1 (PON-1) and Adenosine deaminase (ADA) enzymes to identify cancer patients and their stages with ROC curve in serum samples taken from patients diagnosed as breast cancer in the Medical Oncology services at Yüzüncü Yıl University.
Material and Methods: The 25 healthy controls and 25 breast cancer patients are included in this study. 8 patients are in stage-1, 9 patients are in stage-2 and 8 patients are in stage-3. Adenosine deaminase (ADA), Paraoxonase-1 (PON-1) and Arylesterase (ARE) activities were detected in serums with Spectrophotometric method. Descriptive statistics for the traits studied were presented as median, mean, standard deviation, minimum and maximum value. In terms of these traits, Kruskal-Wallis test was performed to find out whether there are no differences between stages and control group. In addition, ROC analysis was performed to evaluate the performances of enzymes to classify patient and control group.
Results: The differences between stage-1, stage-2, stage-3 and control group for Adenosine deaminase (ADA) enzyme activities were found statistically significant (p<0.01). Besides, the difference between stage-2 and stage-3 was found insignificant for Paraoxonase-1 (PON-1) and Arylesterase (ARE) enzyme activity. Last, the difference between them and stage-1 and control group was found statistically significant.
Conclusion: It can be inferred that sensitivity and specificity values of the enzymes are favorable high and they have outstanding performance to identify tumor stage as well as patient and control group. Therefore, these enzymes should be suggested as a “diagnostic test” to classify patients with breast cancer and control group.
Effect of a carbohydrate rich diet in vas deferens contractility in rats
Authors: Akdeniz Ekrem , Bilge Suleyman Sirri , Bolat Mustafa Suat , Firat Fatih , Agri Arzu Erdal , Alici Omer , Cinar Onder , Erdemir Fikret
Published: February 2025

Objective: We aimed to investigate the effects of a Carbohydrate-rich diet on vas deferens contractility and histology.
Materials and Methods: Twenty mature male rats were subjected into two groups. The control group received regular food and water and the study group received regular food and a carbohydrate-rich liquid diet mixture of 37–40% fructose, 30–36% sucrose and 27–30% glucose instead of water and prepared stock diet was diluted with 50% water. Animals were weighted and sacrificed after six weeks and the vas deferens has been evaluated with in vitro studies. Five rats from both the control and study groups, were separated into subgroups for dapoxetine administration 4 hours before they were sacrificed.
Results: At the beginning of this study, the mean body weights were 228.6±6.7 g (range: 205-237) and 231.4±9.6 g (range: 202-243) in control and study groups, respectively. The mean body weights were 247.1±4.8 g (236-252) in the control group and 318.8±9.3 g (314-326) in the study group (p<0.001). Weight gain was more distinct in the study group when compared to control group (p<0.001) (9% vs 27.4%). Contractile responses were recorded in each group, including the dapoxetine subgroups, to various noradrenaline concentrations; all groups had similar results (p>0.05). Responses to Adenosine Three Phosphate (ATP) were also not significant (p>0.05). The contractile responses at the same frequencies of electrical field stimulation (EFS) were similar in both groups (p>0.05). Histological examinations showed no abnormalities in either group.
Conclusion: Carbohydrate-rich diet caused no increase in fibrotic activity, and pharmacological and histological properties remained stable, but caused significant weight gain over a short time period. Furthermore, dapoxetine had no effect on the contractility of the vas deferens.
The Extent to which Patients Hospitalized in a Certain Region of Turkey are Aware of the Defined Duties of Nurses
Authors: Kockar Cigdem , Genc Fatma , Yabaci Ayse , Ugur Arif
Published: February 2025

Objective:   Aim: This study was conducted to determine the extent to which patients hospitalized in a certain region of Turkey are aware of the defined duties of nurses. Material and Methods: The population of this descriptive study consisted of inpatients who were hospitalized in Giresun State Hospital between January-May 2015. The study included 207 patients. The study data were collected using this nursing practices perception form prepared by the investigators. The data were assessed through numeric and percentage analyses.
Results: Of the patients who took part in the study, 44.4% were between 59 and 79 years of age. A large majority of the patients responded to the questions asked them regarding nursing practices stating that nurses are engaged in treatments and measure temperature-heart rate-blood pressure (99.5% and 98.1%). 85.4% of the patients stated that they saw care giving as a duty of nurses. Approximately 97.1% of the participating patients stated that they administer first aid treatment in emergency cases and 59.9% that they help patients in exercising. Some 71% of the participating patients said that nurses arrange the diets of patients. 
Conclusion: Based on the data obtained from the patients included in the study, it was concluded that a large majority of the inpatients were aware of the defined duties of nurses, but they thought that the practices of other healthcare professionals were also carried out by nurses.
Chronic myeloid leukemia in a pediatric population in the Congo
Authors: Ngolet Lydie Ocini , Ova Jenny Guelongo Okouango , Dokekias Alexis Elira
Published: February 2025

Objective: Chronic myeloid leukemia is a rare hematological malignant disorder among children and adolescents for which data are scare in Africa. The aim of the study is to report clinical, biological feature of children with chronic myeloid leukemia. Additionally, describing cytogenetic response to imatinib and adherence of children to the drug.
Patients and Methods: A retrospective study was carried out from January 2007 to December 2016 (10 years) in the department of Hematology at the Teaching Hospital in Brazzaville.  Four of 52 patients admitted during the period for chronic myeloid leukemia, were children. We collected data from these children’s medical records for analysis.
Results: They were four adolescents (2 boys and 2 girls) with a median age of 13.75 years at the time of diagnosis (range 11.2 and 16 years) that presented at the chronic phase of the  the chronic myeloid leukemia. Delay diagnosis was 4 months. All adolescents presented with a voluminous splenomegaly (median size: 16.75 cm) and high white blood cells count: 133.37G/L (range: 60.7 and 219 G/L). The response to imatinib was poor. None patient was adherent to the treatment.
Conclusion: Chronic myeloid leukemia in children in the Congo is rare. Abdominal pain and voluminous splenomegaly are the main finding symptoms of the malignancy. Despite the delayed diagnosis of the disease, children present at chronic phase. The response to imatinib is poor as children are not adherent to the treatment.
Evoked potentials and other guiding factors of conversion from radiologically isolated syndrome to definite multiple sclerosis
Authors: Demir Serkan , Duzgun Eyup , Kafadar Cahit , Togrol Erdem Rifat , Senol Guney Mehmet , Cakir Akin
Published: February 2025

Objective: Radiologically Isolated Syndrome (RIS) has become a popular subject recently with quite a number of follow-up and other clinical studies being done. A consensus on the approach to the patient with RIS is being tried to be established. The aim of our study was to assess the role of visual evoked potential (VEP) and somatosensory evoked potential (SEP) as a guiding factor for the conversion from Radiologically Isolated Syndrome (RIS) to definite Multiple Sclerosis (MS).
Material and methods: 49 RIS patients who were referred to GATA Haydarpasa Training Hospital Neurology Department between 2011-2015. All of the patients fullfillied the 2009 Okuda criteria for RIS and other differential diagnosis were excluded accordingly. VEP and SEP examinations made during the pre-MS RIS period were scanned retrospectively. For the VEP examination, the P100 latency and amplitudes, for the SEP examination, the P40 latency and amplitude was analysed.
Results: 49 patients were included in this study, the mean time of follow-up was 21,8 months. 63% of patients were female, while 37% were male. The mean age was 31,2 years. Among the four patients with abnormal SEPs, MS developed in three of them (75%) over time. This is statistically significant (p = 0.011). VEP and/or SEP was abnormal in 8 patients and MS developed in 4 (50%) of those (p=0.017). The following factors have a positive statistically significant correlation with conversion to MS: Presence of active plaques (r=0.461, p<0.001), presence of more than 9 plaques (r=0.287, p=0.046), VEP and/or SEP pathologies (r=0.402, p=0.004) and number of plaques (r=0.309, p=0.031). The most important factor for the transformation is the presence of active plaque which increases the risk 8.1-fold. The second important factor seems to be the presence of VEP and/or SEP abnormality, but this factor does not reach statistical significance. 
Conclusion: In the conversion to MS risk from RIS, VEP- SEP examinations are important and should take its place in the follow-up of these patients.
Examination of Clinical and Demographic Characteristics of 14 Cases with Frontal Fibrosing Alopecia
Authors: Akbas Ayse , Kilinc Fadime
Published: February 2025

Objective: Frontal fibrosing alopecia (FFA) is a rare type of cicatricial alopecia seen in postmenopausal women characterized with band-type frontal/frontotemporal hair traction and/or significant or complete loss of the eyebrows. We aimed to present the demographic, clinical and laboratory characteristics of female patients diagnosed and followed-up with FFA in our clinic by comparing these with the literature data.
Method: A total of 14 patients who admitted to our outpatient clinic with alopecia on the frontotemporal/frontal hairline and were clinically and/or histopathologically diagnosed with FFA between 2011 and 2016 were evaluated in a retrospective manner. The patients were reviewed in terms of the age of lesion onset, localization, accompanying symptom or disease, and treatment options.
Results: The ages of the patients who were followed-up in our outpatient clinic with FFA were between 52 and 73 (mean 2 years). Eight patients (57%) had total eyebrow loss,. Laboratory tests were in normal limits or negative. Comorbidities included thyroid disease, hypertension and coronary artery disease diabetes mellitus. For treatment, all patients were given systemic, intralesional and topical steroid, and topical minoxidil at various times. Four patients received hydroxychloroquine, 2 patients acitretin, 2 patients Vitamin E, 1 patient itraconazole, and 1 patient topical tacrolimus.
Conclusion: FFA should be considered in middle aged and elderly postmenopausal women presenting with hair loss complaints and were detected to have frontal hairline traction and cicatricial alopecia, and the diagnosis should be supported by biopsy. Thereby, the disease progression may be prevented or delayed with early diagnosis and proper treatment..
Compensation of MRI findings in asymptomatic patients with chronic low back pain
Authors: Levent Adiyeke  , Suavi Aydogmus  , Ozge Yapici Ugurlar  , Tahir Mutlu Duymus
Published: February 2025

Objective: Chronic low back pain can originate from a number of constructs. It has a range of pathologies depending on multifactorial causes. In this study, we aimed to investigate in asymptomatic patients who compensation complaint of chronic low back pain in our outpatient clinic and demonstrate its for functionality in treatment planning.
Material and Methods: Magnetic Resonance Imaging (MRI) results of 78 asymptomatic patients (46 males, 32 females) who complained of low back pain for at least 12 weeks atMarch 2016 - January 2017 were examined. During MRI assessments, T1 and T2 weighted sagittal plane and transaxial images of the lumbar region (L1-S1) and radiology reports of these images were obtained for all patients.  Degenerative disc disease, Bulging protrusion, Spinal canal stenosis and Nerve root compression re-evaluated and patient findings were assessed.
Results: There was no abnormality in the MRI results of 16 patients (20%) examined within the study criteria.  Nerve root compression was detected in 17 patients (22%), spinal stenosis in 24 patients (30%) and disc degeneration or bulging in 57 patients (78%). There was no statistically significant difference in the incidence of pathologies by asymptomatic patient findings.
Conclusion: Chronic back pain is a disease that involves a wide range of pathologies. MRI scan provides detailed images to the clinician, it is difficult to make a specific diagnosis in the majority of patients with low back pain. Difficulty should be taken into account that the findings obtained by the clinician during assessment can also be seen in asymptomatic individuals
Thoracoabdominal asynchrony correlates with peripheral vascular resistance changes in a cohort of obese children
Authors: Marco Zaffanello  , Franco Antoniazzi  , Laura Tenero  , Michele Piazza  , Giuseppe Lippi  , Emma Gasperi  , Giorgio Piacentini
Published: February 2025

Objective: The purpose of this study was to assess the relationship between the thoracoabdominal asynchrony (phase angle), as an index of inspiratory airflow resistance, pulse transit time arousal index (PTT Ar/I), as changes in peripheral vascular resistance and intrathoracic pressure, and obstructive apnea index (OA), Oxygen Desaturation Index (ODI), snoring (% estimated Total Sleep Time - eTST) and apnea-hypopnea index (AHI) in a cohort of exogenous obese children.
Material and Methods: Body mass index (BMI) and BMI z-scores were calculated according to age and sex in 36 consecutive obese children. Nasal patency, tonsil size, Friedman palate position scoring were also recorded. An overnight sleep respiratory recording was performed using an polygraphic ambulatory device.
Results:  Subjects studies had normal to mild sleep respiratory involvement (assessed by respiratory polysomnographic scoring). Phase angle correlated significantly with PTT Ar/I, but not with AHI (n/hr), OA (n/hr), ODI (n/hr) and snoring (% eTST), even adjusting for nasal patency, tonsil hypertrophy, palate position and BMI (z-score).
Conclusion: Thoracoabdominal asynchrony (phase angle) is correlated with peripheral vascular resistance changes (PTT Ar/I), suggesting a subclinical upper respiratory airflow anomaly with autonomic activation in obese subjects
A rare cause of ptosis in emergency medicine practice: acute sinusitis case report
Authors: Eraybar Suna , Atmaca Serhat , Nennicioglu Yasemin , Sir Nazli , Kaya Halil
Published: February 2025

Objective: Paranasal sinus infections are one of the most frequent causes of emergency service admissions. With increased incidence, complications are often local and classified according to the effecting side. Early identification of complication leads to reduce mortality and morbidity.
Case: A 22 year old male patient was admitted to our emergency department with ptosis on his right eyelid. Firstly he was admitted to the family doctor and received oral cephalosporin treatment for upper respiratory tract infection. Within three days, the ptosis was progressively occurred. No additional systemic sign was detected. The eyelid has slightly edema, not have redness, conjunctival hyperemia and loss of brow not observed. Eye movements were naturally, display pain in the outward view. For differential diagnosis central nervous system imaging was performed. Patient referred to otorhinolaryngology surgeon with prediagnosis of orbital cellulite and acute sinusitis. The patient was admitted to the otorhinolaryngology clinic for operation because of complicated sinusitis.
Conclusion: In the presence of acute sinusitis, infections may enter the orbital periosteum and spread to neighboring tissues. Computed tomography is a highly effective imaging modality for the evaluation of both paranasal infections and their complications. Patients with orbital complications must be hospitalized and immediate intravenous antibiotic therapy should be started.
Rat brain synaptosomes: In vitro neuroprotective effects of betaine against fluoride toxicity
Authors: Hacioglu Ceyhan , Kar Fatih , Kanbak Gungor
Published: February 2025

Objective: Fluoride increases the production of reactive oxygen and nitrogen derivatives, causing oxidative stress and cellular damage. Betaine, an antioxidant and an important methyl donor, has been reported to have potential protective effects on cardiovascular and neurodegenerative diseases in recent years. In this study, we aimed to investigate the neuroprotective effects of betaine treatment against cellular damage caused by fluoride exposure on rat synaptosomes.
Material and Methods: In the experimental period, 8 Wistar albino rats were decapitated and then their frontal cortices removed and divided into 4 equal cuts (total-32 cuts). Subsequently, an appropriate experimental procedure was applied to obtain the synaptosomal fractions. The determined doses of sodium fluoride (NaF) and betaine were administered in vitro at 37°C for 30 min. Synaptosomal glutathione (GSH), malondialdehyde (MDA) and nitricoxide (NO) levels, and also catalase (CAT) and Ca+2/Mg+2 ATPase activities were measured spectrophotometrically.
Results: According to our results, NaF exposure caused a decrease in GSH levels, CAT and Ca+2/Mg+2 ATPase activities, and also an increase in MDA and NO levels, significantly. MDA levels, NO levels and CAT activities were closed to the control group depends on the betain doses. The best recovery in terms of synaptosomal GSH levels and Ca+2/Mg+2 ATPase activities was found at 0.5 mM betaine concentration (P <0.001).
Conclusion: Our results showed that betaine could be a potential neuroprotective therapeutic agent against synaptosomal fluoride toxicity.
Investigation of antioxidant and antimicrobial activities of medicinal plants grown in the eastern black sea region of Turkey
Authors: Ceylan Sule , Harsit Burhan , Saral Ozlem , Ozcan Mehmet , Sonmez Emine
Published: February 2025

Objective: The aim of this study was to screen various extracts of plant of Gentian (Gentiana pyrenaicaL.), Tarragon (Artemisia dracunculus L.), Persimmon (Diospyros kaki), Raspberry (Rubus ideaus) to display potent antimikrobial, antifungal and antioxidant activity in vitro, total phenolic and flavonoid contents in order to find possible sources for future novel antioxidants in food and pharmaceutical formulations.
Material and Methods: The antioxidant properties of 12 different samples of medicinal and aromatic plants such as leaves, flowers and scapus were investigated by DPPH, FRAP and CUPRAC assays. Totalphenolic, total flavonoid content and the antimicrobial properties of extracts from these plants were also determined. Antibacterial and antifungal activities were investigated by microdilution method and agar diffusion method respectively.
Results: According to the determination of antioxidant results, dried leaves of Persimmon (Diospyros kaki) (obtained from Trabzon) plant had the best antioxidant activity that was carried out in all analyzes (except the analysis of total polyphenol). In accordance with analysis of total polyphenol, activity of purple flower of Gentian (Gentiana pyrenaica L.) plant was measured at 31,303±0,274 mg GAE /g dry sample and thus this plant had the highest total phenolic content. Antimicrobial activity tests were carried out using disc diffusion methods with 12 microbial species and most of them displayed good-moderate antimicrobial activity.
Conclusion: Due to their antimicrobial, antifungal and antioxidant properties, the extracts some of these plants might be used as potential sources of natural antioxidant and antimicrobial agents.
Work-related fatigue and related factors among nurses working at the Adnan Menderes University Hospital
Authors: Ozvurmaz Safiye , Mandiracioglu Aliye
Published: February 2025

Objective:   Work-related fatigue is a common health problem among nurses. The objective of this study is to determine the level of fatigue among nurses working at the Adnan Menderes University Hospital in Turkey.
Material and Methods: This cross-sectional study has been carried out in Turkey in 2016. A total of 463 nurses from Adnan Menderes University Hospital in Aydin have agreed and completed the data collection form. They have provided information on sociodemographic characteristics, work place, number of shifts worked, work year and weekly working hours. The visual analogue scale was used to measure levels of energy and fatigue. Linear regression analysis was performed to highlight any significant changes.
Results: In total, 85.3% of the nurses who participated were females. 60.3% were single, 53.6% worked in intensive care units and 26.1% worked only in the day shift, 17.9% worked for more than 45h a week. According to univariate analyses, nurses who were over 40 years of age, married, worked in internal medicine and surgery clinics for over 15 years and constantly worked in the day shift for 40 h a week had lower energy scores and higher fatigue scores. According to the univariate analysis, all the personal and working characteristics are related fatigue and energy subscale scores. Linear regression analysis revealed that age was the only variable affecting energy scores.
Conclusion: It can be stated that factors affecting fatigue among nurses in our study group are associated with age and gender. Prevention and supporting programs may focus on firstly vulnerable nurses (female and older age group).
Evaluation of thiol/disulfide homeostasis in patients with a first episode of major depressive disorder
Authors: Karaaslan Ozgul , Hacımusalar Yunus , Bal Ceylan , Ercan Müjgan
Published: February 2025

Objective: The aim of this study was to investigate the role of dynamic thiol-disulfide homeostasis as a new oxidative stress parameter in patients with major depressive disorder (MDD).
Material and Methods: Sixty-three patients with their first episode of untreated MDD, and 61 healthy volunteers were included in the study. Serum thiol/disulfide levels were measured in fasting blood samples. The data were compared between the two groups.
Results: No significant difference was observed between the two groups in terms of age, gender distribution, or body mass index. Plasma native and total thiol levels were lower in the MDD group compared to those in the controls (p=0.004, p=0.001). No significant differences were observed between the groups in terms of disulfide, the disulfide/native thiol, the disulfide/total thiol or the native thiol/total thiol ratio (p>0.05). No relationship was detected between these parameters.
Conclusion: As far as we know, this is the first study to evaluate changes in thiol/disulfide homeostasis in male and female patients with MDD. Our data show that thiol levels decrease during the first episode of untreated depression. Thiol/disulfide homeostasis may be useful as a biomarker for depression after long-term follow-up and treatment studies.
Potential Effects of EGFR Exon 21 L858R Mutations in Lung Cancer
Authors: Eker Ebru Derici , Arıcan Ali , Arpacı Rabia Bozdoğan , Nayır Erdinç , Ata Alper , Eras Nazan , Yıldırım Didem Derici , Akbaş Etem
Published: February 2025

Objective: The mainly significant reason in the etiology of lung cancer is smoking, which is important in other environmental pollutants and genetic susceptibility. Lung cancer is separated two major groups as mainly non-small cell and small cell according to the growth rate, spread, timing of metastasis, response to chemotherapy and radiotherapy. Epidermal growth factor receptor (EGFR) constitutes the highest rate with 50-80% in gene mutations which are prognostic value in lung cancer. Many studies have shown that EGFR is overexpressed in lung cancer. In our study, we aimed to investigate the relationship between EGFR gene exon 21 L858R mutations in lung cancer.
Material and Methods: Our sample consisted of a healthy group of 190 healthy volunteers with the same age and gender characteristics as the patient group of 178 patients who were diagnosed as lung cancer in the Mersin University Medical Faculty Oncology clinic. The DNAs were obtained according to the standard salt precipitation method. Mutation detection and genotyping analyzes were identified by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analyzes.
Results: Smoking was one of the other risk factors for lung cancer, 130 (68.33%) in the control group and 156 (87.5%) in the lung cancer group. 27 person of the lung cancer (15%) were female and 151 (85%) were male. In the control group, 92 people (48.33%) were in the wild genotype and 98 persons were in the mutant genotype (51.66%). In the lung cancer group 80 (45%) were wild-type and 98 (55%) were mutant genotypes. According to the histopathological types of lung cancer, EGFR-21 mutation heterozygous or homozygous carriers are proportionally compatible (p = 0.90).
Conclusion: According to our findings, the EGFR-21 mutation is not associated with histopathological types of lung cancer.
Can serum C-Reactive Protein and Procalcitonin levels associate with carpal tunnel syndrome?
Authors: Altun Yaşar , Tak Ali Zeynal Abidin
Published: February 2025

Objective: The purpose of this study was to examine whether an increase occurs in serum C-reactive protein (CRP) and procalcitonin (PCT) levels in patients with carpal tunnel syndrome (CTS).
Material and Methods: Thirty-six patients who have CTS due to electrophysiological tests and 40 healthy individuals were included the study. Boston Questionnaire (BQ) was used to assess the functional and clinical status of the patients. Also, CRP and PCT levels were investigated. Correlations between such parameters (electrophysiological findings, BQ results, and clinical findings) were evaluated.
Results: CTS and control subjects had similar CRP levels, whereas there was significant elevation in PCT among CTS patients. Serum PCT activity did not correlate with subunits of BQ (p> 0.05).
Conclusion: The results of this small study showed significant PCT increases in patients with CTS. Further studies in this regard may help to clarify the diagnostic and or follow-up value of PCT in patients with CTS.