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Öğe Ocular Pathologies in Children with Mental Retardation: A Prospective Study(2020) Arıcan, Nurdan; Tunç, MuratAim: The aim of this study is to investigate the ocular pathologies in mentally retardedpediatric patients without Down syndrome or any certain chromosomal-genetic anomaly.Material and Methods: A total of 189 patients, including 79 mental retarded and 110 healthychildren, were included in this study between 2010 and 2011. Demographic factors (age,gender) of the patients, and affected side, visual acuity, esotropia, exotropia, anterior segmentpathologies and posterior segment pathologies were evaluated. All pediatric patients in studygroup were divided as IQ level <34, 35-49, 50-69, and >70 according to Wechsler IntelligenceScale for Children-Revised Form.Results: The mean age of the children with mental retardation was 11.85±6.19 (3-17) years,while the mean age of healthy children was 10.73±3.35 (3-15) years. While visual impairmentwas present in 8 of the 74 patients whose vision was evaluated, there was no impairment in thehealthy group (p=0.001 and p=0.004 for right and left, respectively). Anterior segmentpathology was detected in 2 (2.5%) cases, and posterior segment pathology in 3 (3.8%) casesin children with low IQ. While strabismus was detected in 7 (8.9%) patients with low IQ, nostrabismus was found in healthy children. Five (6.3%) of the cases with mental retardation hadexotropia and 2 (2.5%) had esotropia. Exotropia was found significantly higher in childrenwith mental retardation compared to the control group (p=0.012).Conclusion: Visual impairment, anterior-posterior segment pathology, exotropia had a highprevalence in children with mental retardation, and all ocular pathologies were related to lowintellectual disability.Öğe Mortality Outcomes of Single-staged versus Multi-staged Complete Coronary Revascularization in Multivessel Non-ST Elevation Myocardial Infarction Patients(2021) Yıldırım, Abdullah; Quısı, Alaa; Allahverdiyev, Samir; Genç, Ömer; Harbalıoğlu, Hazar; Alıcı, Gökhan; Gür, MustafaAim: The aim of this study was to compare the short-term and long-term mortality results of single-stage percutaneous coronary intervention (SS-PCI) and multi-stage percutaneous coronary intervention (MS-PCI) strategies in patients diagnosed with non-ST segment elevation myocardial infarction (NSTEMI) with multivessel disease. Material and Methods: A total of 298 consecutive patients diagnosed with multivessel NSTEMI (71 (23.8%) patients in the SS-PCI group and 227 (76.2%) patients in the MS-PCI group) were included in this study. Data regarding mortality were obtained from the health information system of our institute and national health registry. Results: Although in-hospital mortality rates were found to be significantly higher in univariate analysis in the SS-PCI group compared to the MS-PCI group (14.1% (n=10) vs 4.0% (n=9); p=0.005), it was not independently associated with total mortality in multiple model. Among the parameters predicted mortality determinants, low hemoglobin (odds ratio (OR)=0.485, 95% confidence interval (CI)=0.332-0.708; p=0.002), No-reflow occurrence (OR=6.194, 95% CI=1.310-29.300, p=0.021), not using post dilatation (OR=0.287, 95% CI=0.085-0.970, p=0.045) were independently associated with total mortality. Conclusion: There was no statistical difference in overall mortality between the two study groups in multivessel NSTEMI patients who underwent complete coronary revascularization with the SS-PCI and MS-PCI strategy, while low hemoglobin, No-reflow phenomenon, and not using post-dilatation were found as independent predictors of mortality.Öğe Ellagic Acid Inhibits TGF?1/Smad-Induced Renal Fibrosis in Diabetic Kidney Injury(2022) Yıldız, Halime Tozak; Sarıbaş, Gülistan Sanem; None, OzkanAim: Free radical formation increases due to hyperglycemia occurring in the pathogenesis of diabetes mellitus (DM), and as a result, oxidative stress occurs. Hyperglycemia-mediated oxidative stress plays an important role in the pathogenesis of diabetic nephropathy. The antihyperglycemic, antioxidative, anti-apoptotic, and anti-inflammatory effects of ellagic acid (EA) have been demonstrated by many studies. In this study, it was aimed to demonstrate the antifibrotic effect of EA on TGF?1/Smad signaling in rats with streptozotocin induced diabetic nephropathy. Material and Methods: A total of 24 male Sprague Dawley rats, weighing 200-250 g, were used in this study. The animals were divided into four groups as control, EA, DM, and DM+EA. The kidney tissues were used for histological and immunohistochemical procedures. While the collagen density in kidney tissues was revealed by Masson's trichrome staining, the expression levels of fibrotic markers TGF?1, p-Smad3, and ?SMA were determined by the immunocytochemical method. Results: It was shown that the collagen density in the renal tissue of the DM group increased significantly in the intertubular area, while the collagen density in the EA-treated DM group was statistically significantly decreased. When TGF?1, p-Smad3, and ?SMA immunopositivity in kidney tissue sections of all groups were evaluated, the highest staining intensity was in the DM group, while the intensity of staining was close to the control group in the treatment group. It was observed that ?SMA, TGF?1, and p-Smad3 protein expression were down-regulated with EA treatment. Conclusion: EA reduced fibrosis in diabetic nephropathy by returning profibrotic parameters to normal levels.Öğe Enquiring into Experiences of Fear, Posttraumatic Stress and Nutritional Habits of Medical Students during the COVID-19 Pandemic(2022) Kocaay, Funda; Şanlıer, Nevin; Ayyıldız, PınarAim: This study aimed to determine the effects of fear of coronavirus disease 2019 (COVID-19) and post-traumatic stress disorder on eating disorders and eating habits. Material and Methods: A cross-sectional descriptive study employed 562 (167 males, and 395 females) medical students, utilizing the fear of COVID-19 scale, COVID-19 peritraumatic distress index (CPDI), SCOFF (REZZY) eating disorders scale and Mediterranean diet adherence screener (MEDAS) scale. Results: Of the participants, 292 (52.0%) had an adequate/balanced diet, and 339 (60.3%) students had an average sleep time of <8 hours. The REZZY scale score showed 198 (35.2%) students had an eating disorder risk, and MEDAS scores exhibited 320 (56.9%) students had incompatible diets. A significant correlation was detected between the REZZY score and the fear of COVID-19 scale score (p=0.003) and CPDI score (p<0.001). The CPDI scores of the underweight participants and those with normal body mass index (BMI) class were significantly higher (p=0.009). A significant difference was spotted in respecting REZZY scores according to BMI classes (p<0.001). The ones with normal BMI class had significantly higher MEDAS score (p=0.031). Females were 2.315 times more likely to develop eating disorders. BMI value affected the risk of eating disorders (p<0.001). When BMI (kg/m2) increased by 1 unit, the risk of eating disorders would increase by 1.220 times. Adequate and balanced nutrition had a significant impact on the risk of eating disorders (p=0.018). Conclusion: Assuring adequate and balanced nutrition and eliminating fears and stresses experienced during epidemics are essential.Öğe Synchronous Bilateral Flexure Tumor Causing Ileus and Requiring Surgical Treatment(2022) Kartal, Murat; Fakirullahoğlu, Mesud; Kalaycı, Tolga; Özerdem, YaseminThis case report presented a simultaneous right colon tumor detected perioperatively in a patient who developed ileus due to a metastatic left colon tumor in the preoperative period. A seventy-six-year-old man was admitted with epigastric pain, nausea, and vomiting. There was tenderness and defense on deep palpation on the epigastrium. On computed tomography, there were multiple hypodense lesions on the liver, a mass at the level of the splenic flexure that obliterates the lumen. In addition, there were numerous air-fluid levels due to tumoral mass on splenic flexure. Emergency surgery was performed, and during surgery, there were tumoral masses at the hepatic flexure and splenic flexure. Palliative total abdominal colectomy with end ileostomy was performed due to megacolon. The patient died due to sudden cardiac arrest on the 1st postoperative day.Öğe Evaluation of Anti-Mullerian Hormone in Predicting In Vitro Fertilization Cycle Outcomes(2022) Şanlıer, Nazlı; Güvey, Huri; Kahyaoğlu, İnci; Üstün, Yaprak Engin; Dilbaz, Serdar; Erdoğan, KadriyeAim: This study was conducted to explore the effect of serum anti-Mullerian hormone (AMH) level on in vitro fertilization (IVF) cycle outcomes. Material and Methods: A total of 142 patients included in this study, were divided into three groups according to their serum AMH levels as Group 1: AMH level 5-10 ng/ml (n=108), Group 2: AMH level 10-15 ng/ml (n=20), and Group 3: AMH level >15 ng/ml (n=14). Demographic characteristics were recorded. The duration of infertility and stimulation, the number of cycles, initial, final, and total doses of gonadotropins, and estradiol (E2) and progesterone levels on the day of trigger, oocyte pick up (OPU) and embryo transfer (ET), the total number of oocytes retrieved, the number of mature oocytes, the number and quality of the embryo, and also endometrial thickness on the day of trigger, OPU and ET, the distance of embryo-fundus, the day of ET, and pregnancy outcomes were all recorded. Results: While the IVF treatment indications and pregnancy outcomes were similar between the groups, body mass index (BMI) was significantly higher in Group 2 and Group 3 than in Group 1 (p<0.001). The total doses of gonadotropin were significantly higher in Group 2 than in Group 1 and Group 3, and the total oocyte count was also significantly higher in Group 3 than in Group 1 (p=0.006, and p=0.015, respectively) Conclusion: AMH levels were associated with BMI and total oocyte count, but not with mature oocyte count, oocyte quality, and pregnancy outcomes.Öğe Hypomagnesemia as a Predictor of Early Liver Dysfunction in Critically Ill Patients with Sepsis(2022) Ilban, Omur; İlban, AyşegülAim: Liver dysfunction is an early finding caused by the inflammation and hypoperfusion developed in sepsis. Magnesium deficiency may contribute to an excessive response to immune stress and inflammatory tissue damage in sepsis. This study aimed to evaluate the relationship between serum magnesium levels and early liver dysfunction (ELD) in patients with sepsis. Material and Methods: 142 patients who developed sepsis were divided into two groups according to their liver function, as sequential organ failure assessment (SOFA) hepatic subscore <2 (Non-ELD, n=72) and SOFA hepatic subscore ?2 (ELD, n=70). The disease severity, including the acute physiology and chronic health evaluation (APACHE) II score and the SOFA score, biochemical determination, and microbiological cultures were evaluated. Results: ELD patients presented APACHE II and total SOFA scores higher than Non-ELD patients, while PaO2/FiO2 ratios were significantly lower (both p<0.001). Hypomagnesemia and hypoalbuminemia were independently associated with ELD (OR: 6.55, 95% CI: 2.62-16.36, and OR: 4.62, 95% CI: 1.35-15.84, respectively). To predict ELD, the area under the curve was 0.81 (95% CI: 0.74-0.89, p<0.001) and 0.70 (95% CI, 0.61-0.79; p<0.001) for serum magnesium and albumin, respectively. The mortality rate in all septic patients was 35.0% for hypomagnesemia and 25.6% for normomagnesemia (p=0.065). The mortality rate in ELD patients was 34.1% for hypomagnesemia and 30.7% for normomagnesemia (p=0.415). Conclusion: The reduction of magnesium levels was associated with increased rates of ELD in critically ill patients with sepsis. Admission hypomagnesemia did not adversely affect mortality neither in all sepsis patients nor in those who developed ELD.Öğe Maternal and Fetal Outcomes of Gestational Thrombocytopenia(2022) Taş, Bahar; Günenç, OğuzhanAim: The study aimed to evaluate maternal and fetal outcomes of gestational thrombocytopenia according to platelet levels. Material and Methods: The cases who were followed up in our clinic between January 2017 and December 2018, who had no additional diseases, who had term deliveries, and who had gestational thrombocytopenia, were screened retrospectively. The pregnant women included in the study were divided into two groups according to their platelet values, ?70 x103/mm3 and >70 x103/mm3, and the subgroups were analyzed among themselves. The demographic, clinical, and laboratory data of the patients were also compared between the groups. Results: Among the patients with gestational thrombocytopenia, it was found that the birth week was significantly earlier in the group with platelet ?70 x103/mm3 (p=0.002). When perinatal characteristics were compared between the groups, the birth weight of the infants in the group with platelet ?70 x103/mm3 was found to be significantly lower than in the other group (p=0.033). APGAR 1st-minute score was found to be significantly decreased in the group with platelet ?70 x103/mm3 when compared to the other group (p=0.039). Single and multiple regression analyzes were performed on pregnant women with gestational thrombocytopenia. No risk factors that were associated with adverse maternal and perinatal outcomes were detected in the group with platelet values ?70 x103/mm3. Conclusion: Fetal growth retardation is seen in patients diagnosed with gestational thrombocytopenia and with platelet values below 70 x103/mm3 and their APGAR scores are lower. The premature birth rate is higher in the same patient group.Öğe The Relationship Between Body Mass Index and Mononeuropathies(2022) Buturak, Şencan; Yıldız, Mehmet; Fidancı, İzzet; Buyuksural, Ayse Begum; Fidancı, Halit; Öztürk, İlker; Arlıer, ZülfikarAim: The study aimed to find out whether there is a relationship between the mononeuropathies of the median, ulnar, radial, peroneal, and sciatic nerves and body mass index (BMI). Material and Methods: Patients whose clinical and electrodiagnostic findings were compatible with carpal tunnel syndrome (CTS), ulnar neuropathy at the elbow (UNE), radial neuropathy at the spiral groove (RNS), peroneal neuropathy at the fibular head (PNFH), and sciatic injury due to intramuscular injection (SNIII) were included in this retrospective cohort study. In addition, controls whose clinical and electrodiagnostic features were not compatible with mononeuropathy were included in the study. The BMI values of all participants were analyzed. Results: One hundred thirty-one CTS patients, 53 UNE patients, 6 RNS patients, 25 PNFH patients, 72 SNIII patients, and 53 controls were included in the study. The BMI of CTS patients was higher than the BMI of controls (p<0.001), PNFH patients (p<0.001), and SNIII patients (p<0.001). The BMI of SNIII patients was lower than the BMI of controls (p<0.001), CTS patients (p<0.001), and UNE patients (p<0.001). The BMI of PNFH patients was lower than that of CTS patients (p<0.001) and UNE patients (p=0.004). No significant correlation was found between BMI values and electrodiagnostic classification of mononeuropathies in the groups. Conclusion: This study showed that high BMI is a risk factor for CTS and low BMI is a risk factor for SNIII. There may also be a relationship between BMI and PNFH, but this should be confirmed by further studies.Öğe Clinical Comparison of Patients Undergoing Anterior Cruciate Ligament Reconstruction Using an Allograft or Autograft(2022) Şahin, Ercan; Güzel, Ismail; Arı, Bünyamin; Gürger, Murat; İnceoğlu, FeyzaAim: The purpose of this study was to examine the clinical results of individuals who underwent an autograft or allograft repair of the anterior cruciate ligament (ACL). Material and Methods: Retrospective analysis was done on the patient files of patients who underwent ACL reconstruction between 2014 and 2020 using semitendinosus-gracilis tendon autografts (SGT-A) and tibialis anterior tendon allografts (TAT-A). In this study, the data of 30 patients in each group were included. Knee laxity tests, the Lysholm knee grading system, the Tegner activity score, and the International Knee Documentation Committee (IKDC) score were used to compare patient results. Results: While there was no significant difference in the Tegner activity score between the preoperative and the final measurement (p=0.241), the IKDC scores and the Lysholm knee ratings changed statistically significantly between the preoperative measurement and the last control visit (p=0.020, and p=0.038, respectively) for both groups in this study. The SGT-A group’s Lysholm knee score had a preoperative value of 60.97% and a final control value of 90.48%. The preoperative Lysholm knee score for the TAT-A group was 61.31%, and the final control value was 95.03%. The anterior drawer and Lachman test findings showed statistically significant intergroup (autograft and allograft) alterations in both the autograft and allograft groups (both p<0.001). Conclusion: In terms of knee function and laxity, this study achieved a better clinical outcome in the allograft group compared to the autograft group.Öğe Fixed-Bearing versus Mobile-Bearing Unicondylar Knee Arthroplasty: Comparison of Patients with Similar Component and Mechanical Axis Alignment(2022) Ergün, Selim; Saylık, Murat; Güneş, TanerAim: Unicondylar knee arthroplasty (UKA) is among the treatment options for patients with arthritis limited to one compartment of the knee. Fixed-bearing (FB) and mobile-bearing (MB) inserts are present. This study aimed to compare functional and clinical outcomes and revision rates of patients operated with FB-UKA and MB-UKA. Material and Methods: A total of 131 knees of 118 patients underwent cemented UKA, with a mean follow-up period of 80.58±31.31 months for FB-UKA and 97.66±29.24 months for MB-UKA. Clinical and functional evaluation was performed by the Knee Society Score (KSS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, at the last follow-up visit. The factors affecting the radiological and functional results, complication, and revision rates were examined under three main titles; i) surgeon-related, ii) patient-related, and iii) component alignment-related factors. Results: There was no significant difference between the groups in terms of age, gender, body mass index, and side. Regarding the KSS scores, 9 (6.87%) knees were within acceptable limits, 62 (47.32%) knees were found to be good, and 60 (45.80%) knees were found to be excellent. No statistically significant difference was found between groups (p=0.497). Regarding the WOMAC scores, the MB-UKA group had significantly lower pain (p=0.049) and stiffness (p=0.014), but similar functional (p=0.591) scores. There was no statistically significant difference regarding revision rates (p=0.931). Conclusion: Similar clinical, functional, and radiological results and low revision rates were found. In terms of pain and joint stiffness, a significant difference was found between groups, in favor of MB-UKA.Öğe Effect of Hysteroscopic Surgery Before Frozen Embryo Transfer on Patients with Previous Implantation Failure(2022) Cetin, Caglar; Gözükara, İlkay; Çetin, Cihan; Tok, Abdullah; Kaplanoğlu, Dilek; Çetin, Turan M.; Karasu, Ayşe Filiz GökmenAim: The aim of this study was to evaluate the benefit of hysteroscopy (HS) before single frozen-thawed embryo transfer (sFET) on patients with previous implantation failure. Material and Methods: A total of 1352 infertile women with a previous implantation failure who underwent their first sFET treatment between January 2015 and December 2017 were included in this study. The patients were classified into two main groups in which HS was omitted (Group 1), and who underwent HS (Group 2). Furthermore, Group 2 was classified into two subgroups as patients without any intrauterine pathology (Group 2a), and those with intrauterine pathology (Group 2b). sFET was performed on all patients within 50 days of hysteroscopy. The major outcome measure was the clinical pregnancy rate. Results: The mean number of mature oocytes and fertilization rates were similar between groups. The clinical pregnancy rate was found to be 33.3% (n=70) in Group 1. Comparatively this rate was statistically significantly higher in patients in Group 2. The clinical pregnancy rate was 44.2% (n=378) in Group 2a, and 44.4% (n=127) in Group 2b (p=0.014). There was a significant difference between Group 1 and Group 2a (OR: 1.58, 95% CI: 1.15-2.17, p=0.004), and also Group 2b (OR: 1.59, 95% CI: 1.10-2.31, p=0.013). However, no significant difference was observed between Group 2a and Group 2b (p=0.896). Conclusion: Our findings demonstrate that HS surgery increases the probability of pregnancy rate at least by 1.58 times in patients having previous implantation failure when the hysteroscopic procedure is followed by sFET.Öğe Evaluation of Patients Presenting to the Pediatric Emergency Department with Carbon Monoxide Poisoning(2022) Tekeli, Aysun; Ünay, Bülent; Bolat, AhmetAim: Carbon monoxide poisoning is one of the significant causes of intoxication and presentation to pediatric emergency departments, especially in winter. The primary aim of this study was to evaluate the demographic characteristics, and clinical and laboratory findings of pediatric patients who presented to the pediatric emergency department with carbon monoxide poisoning, and the secondary aim was to examine the laboratory values of the patients with impaired consciousness. Material and Methods: The demographic and clinical characteristics and laboratory values of 162 patients presented to the pediatric emergency department due to carbon monoxide poisoning between 2017 and 2020 were retrospectively analyzed. The laboratory parameters of the patients with and without symptoms of impaired consciousness were compared. Results: The mean age of the patients was 8.94±5.33 years, and the gender distribution was homogenous. The highest frequency of presentation was during winter. Nausea, vomiting, and headache were the most common symptoms. Fifteen of the patients had impaired consciousness. While the laboratory values of the patients were generally within normal ranges, patients with high carboxyhemoglobin, lactate, and troponin values, and low pH were encountered. The carboxyhemoglobin and lactate levels of patients with impaired consciousness were found to be significantly higher than the patients without impaired consciousness (p<0.001 and p=0.019, respectively). Conclusion: Elevated carboxyhemoglobin and lactate levels were associated with impaired consciousness. Although carboxyhemoglobin levels are important for diagnosis and clinical follow-up, they should not be used as the only marker. High lactate and troponin levels, and low pH should also be taken into account.Öğe Comparison of Two Different Concentrations for Foot and Ankle Surgeries During Intravenous Regional Anesthesia (IVRA): A Randomized Cohort Study(2022) Göksu, Sıtkı; Şen, Elzem; Mendes, Ergun; Gocergil, Huseyin; Cesur, Mehmet; Emeli, YusufAim: Intravenous regional anesthesia (IVRA) is not commonly preferred in the lower extremity because of the toxic risks of high-dose local anesthetics. This study aimed to compare the use of two different concentrations of anesthetics with additional tourniquet application to reduce local anesthetics amount during the IVRA method for short-term foot and ankle surgeries. Material and Methods: In this prospective study, 40 patients were allocated to two groups with different concentration formulations of 200 mg lidocaine hydrochloride (Group 30 and Group 20). The groups were compared in terms of demographic data, tourniquet pain, operation time, hemodynamic indicators, and sedo-analgesia needs. Results: Demographic data were similar in the two groups. The mean tourniquet pain time was 41.66±6.61 minutes in Group 20 (n=9) and 36.76±7.17 minutes in Group 30 (n=13) (p=0.120). Perioperative sedo-analgesia consumptions were similar between the groups: weight-adjusted before/after tourniquet pain (p=0.390, p=0.207, p=0.536, and p=0.176), weight-adjusted/none total amount (p=0.425, p=0.578, p=0.268, and p=0.612), per minute before/after tourniquet pain (p=0.075, p=0.506, p=0.354, and p=0.055), for propofol and remifentanil, respectively. There was a significant difference between the propofol and remifentanil consumption per minute before and after the tourniquet pain in both groups: 5.61±1.67 and 14.58±6.62 mg/min propofol (p=0.001), and 4.79±1.69 and 7.86±1.55 mcg/min remifentanil (p=0.001), respectively. No patient had signs of local anesthetic toxicity. Conclusion: Low-dose sedo-analgesia can be used by a modified IVRA method in the management of tourniquet discomfort that may occur until the tourniquet pain develops.Öğe 17-year-old Selective Mutism Case without Treatment for A Long Time(2022) Bodur, Sahin; Congologlu, Mehmet Ayhan; Gulesen, Oya; Sönmez, Süeda AybikeSelective mutism is a rare childhood anxiety disorder characterized by the inability to speak in certain social situations in which speech is expected, despite speaking fluently in other situations. The average age of onset for selective mutism is 2 to 5 years old, but symptoms may not be noticed until starting school. The cause is still not known and the prevalence varies between 0.03% and 1%. Psychopharmacology and psychotherapeutic approaches are recommended in the treatment. Although the treatment is difficult, early diagnosis is one of the good prognostic factors. In this case report, we aimed to discuss the psychiatric and sociocultural functionality of a 17-year-old adolescent with selective mutism. Our case is remarkable as she has not been treated for many years. Her treatment continues with psychopharmacological and psychotherapeutic interventions. Recognition of selective mutism and getting support on this issue will help to solve the problem.Öğe Can Inflammatory Indices be Used to Predict Adverse Pregnancy Outcomes in Pregnant Women with Recurrent Urinary Tract Infection?(2022) Obut, Mehmet; Çelen, Şevki; Çağlar, Ali Turhan; Keleş, Ayşe; Dağdeviren, Gülşah; Öztürk, Azize Cemre; Çelik, Özge YücelAim: This study aimed to investigate the utility of inflammatory indices in predicting adverse maternal and neonatal outcomes in pregnant women with recurrent urinary tract infections. Material and Methods: This retrospective study was conducted on pregnant women treated for symptomatic urinary tract infection (UTI) between 2017 and 2021. Pregnant women with two or more episodes of symptomatic UTI were included in the study group. Pregnant women with one UTI were included in the control group. The study group consisted of 91 (46.9%) patients and the control group consisted of 103 (53.1%) patients. The groups were compared in terms of clinical characteristics, adverse outcomes, and inflammatory indices. Results: It was found that more adverse maternal and neonatal outcomes occurred in the study group compared to the control group (p=0.021, and p<0.001, respectively). The cut-off values for platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) to predict adverse maternal outcomes were found 185.00 (p=0.015, area under the curve (AUC)=0.604, 95% confidence interval (CI)=0.558-0.782,), 4.34 (p=0.051, AUC=0.584, 95% CI=0.514-0.746), and 1210.48 (p=0.008, AUC=0.614, 95% CI=0.547-0.771), respectively. The cut-off values for PLR, NLR, and SII for predicting negative neonatal outcomes were found 192.98 (p=0.001, AUC=0.692, 95% CI=0.572-0.812), 4.67 (p=0.166, AUC=0.583, 95% CI=0.475-0.740), and 1339.47 (p=0.006, AUC=0.666, 95% CI=0.526-0.777), respectively. Conclusion: Although the success of discrimination is weak, PLR and SII may be useful to predict adverse maternal and neonatal outcomes in pregnant women with recurrent UTI.Öğe Effect of Tocilizumab Use on Mortality in COVID-19 Patients Admitted to Intensive Care Unit(2022) Tosun, Mustafa; Ölmez, HasanAim: Coronavirus disease 2019 (COVID-19) mostly proceeds with mild respiratory symptoms, but sometimes severe pneumonia, cytokine storm, and acute respiratory distress syndrome can develop. Anti-cytokine treatments are being tried for cytokine storm. In this study, we aimed to examine the effect of tocilizumab on mortality associated with COVID-19. Material and Methods: The study included 146 patients with moderate-to-severe acute respiratory distress syndrome diagnosed with COVID-19. The patients were divided into two groups, receiving only standard treatment (ST group, n=44), and tocilizumab treatment in addition to standard treatment (TCZ group, n=102). Groups were compared in terms of demographic, clinic, and laboratory data. Also, mortality rates were determined to detect the effect of tocilizumab on mortality. Results: Overall, 36.3% (n=53) of the patients were female, 63.7% (n=93) were male, and the mean age was 69.5±14.2 years. The mortality rate was 29.4% (n=30) in the TCZ group and 52.3% (n=23) in the ST group (p=0.009). While C-reactive protein, fibrinogen, and lactate levels on admission to the intensive care unit (ICU) were similar across the groups, the TCZ group had higher ferritin levels (p=0.006). On discharge from ICU, the TCZ group had a significant decrease in C-reactive protein (p<0.001), while their ferritin levels decreased to levels in the ST group (p=0.134). The absence of tocilizumab in the treatment regimen was associated with a 2.63-fold increase in the mortality risk. Conclusion: Tocilizumab reduces the mortality in COVID-19 patients in ICU. However, further studies are warranted to better elucidate the efficacy and side effects of tocilizumab.Öğe The Effect of Preoperative Anemia on Hiatal Hernia Surgery and Postoperative Complications(2022) Tazeoğlu, Deniz; Arslan, Bilal; Edizsoy, Akay; Esmer, Ahmet Cem; Gökçeimam, Mehmet; Sağlam, FazılAim: Anemia is associated with increased mortality and morbidity in all patients undergoing surgery. This study aimed to reveal to what extent anemia caused postoperative complications before hiatal hernia surgery. Material and Methods: One hundred and ninety-two patients operated for hiatal hernia in our clinic between 2015 and 2019 were analyzed retrospectively. Patients were compared according to demographics, preoperative laboratory values, preoperative Charlson comorbidity index score, hiatal hernia type, postoperative intensive care requirement, presence of postoperative complications, Clavien-Dindo score, blood transfusion need, and length of hospital stay. Results: Of the patients, 109 were female and 83 were male. The mean age was 50.1±9.1 years. Fifty-four (28.2%) of the patients were in the anemic group, and 138 (71.8%) were in the non-anemic group. There was no statistically significant difference between the groups in terms of gender distribution (p=0.663). When the groups were compared in terms of age distribution, it was found that the anemic group was older than the non-anemic group and the difference was statistically significant (p<0.001). There was a significant difference between the groups in terms of the postoperative complications rate and it was more common in the anemic group (p<0.001). There was a significant difference between the groups in terms of the need for intensive care and blood transfusion in the postoperative period (p=0.020, p<0.001, respectively). Conclusion: Preoperative anemia increases postoperative complications in hiatal hernia surgery. Therefore, the presence of anemia should be investigated before hiatal hernia surgery and patients with anemia should be followed up closely postoperatively.Öğe Comparison of Asymptomatic Bacteriuria Agents and Antimicrobial Susceptibility in Term and Preterm Pregnancies(2022) Aydın, Özlem; Ayhan, Ihsan; Ergen, Pınar; Güney, Damla Dökmeci; Bılır, Reyhan Ayaz; Emecen, Ahmet NaciAim: The aim of this study was to compare the resistance to asymptomatic bacteriuria (ABU) between term and preterm pregnancies. Material and Methods: Pregnant women aged 17-41 years who were followed up in the obstetrics department of our hospital and whose urine cultures were sent to the laboratory for analysis and reported as ABU were included in the study. Patients were divided into two groups according to gestational weeks as preterm (<37 weeks) and term (?37 weeks). The results were compared between the two groups. Results: From among a total of 123 pregnant women, 29 (23.6%) delivered at preterm and 94 (76.4%) at term. The most frequently identified pathogen throughout the study group was 52.0% (n=64) Escherichia coli (E. coli), followed by 16.3% (n=20) Streptococcus agalactiae (S. agalactiae). There was no statistically significant difference in terms of the distribution of E. coli and S. agalactiae between the term and preterm groups (p=0.698 and p=0.930). E. coli was resistant to ampicillin 56.3% (n=36), to cefuroxime 40.6% (n=26). While fosfomycin resistance was 1.6% (n=1), nitrofurantoin resistance was not found. Extended-spectrum beta-lactamase positivity was 23.4% (n=15) in E. coli strains. No statistically significant difference was found in antibiotic resistance rates of E. coli strains between the term and preterm groups. Conclusion: The most commonly isolated pathogen was E. coli which was highly resistant to beta-lactams. Screening of pregnant women for ABU and treatment with appropriate antibiotics; is the most effective way to prevent both maternal and fetal complications and antimicrobial resistance.Öğe The Effect of Combination of Aerobic and Strengthening Exercise on Muscle Strength, Balance, and Sleep Quality in Individuals with Type 2 Diabetes(2022) Menek, Merve Yılmaz; Budak, MirayAim: The aim of this study was to determine the effects of aerobic and strengthening exercise combination on glycosylated hemoglobin (HbA1c), muscle strength, balance, and sleep quality in individuals diagnosed with type 2 diabetes mellitus (DM). Material and Methods: Fifty individuals aged between 30 and 65 years and diagnosed with type 2 DM were included in this study. Anthropometric measurements, HbA1c, quadriceps and hamstring muscle strength, balance, and sleep quality of the included individuals were evaluated. Aerobic and strengthening exercises were applied to the participants 3 days a week for 12 weeks. All evaluation measurements were repeated at the end of 12 weeks. Results: Of the 50 individuals included in this study and diagnosed with type 2 DM, 64% (n=32) were male and 36% (n=18) were female. The mean age of the participants was 50.12±10.81 years, the mean body mass index was 29.97±3.12 kg/m2, the waist/hip ratio was 0.91±0.08, and the mean HbA1c was 9.19±2.39. When the pre and post-treatment HbA1c, muscle strength, balance, and sleep quality measurements of all participants were compared, there were statistically significant differences (p<0.001). Conclusion: It was determined that the combination of long-term aerobic and strengthening exercise decreased the HbA1c value and also significantly improved muscle strength, balance, and sleep quality in individuals with type 2 DM. A structured exercise program that includes strengthening and aerobic exercises would be beneficial in developing the most effective and appropriate exercise prescriptions in terms of exercise efficiency and sustainability for individuals with type 2 DM.
