INTRODUCTION: COVID-19 is a new infection causing severe acute respiratory failure. It is known that Diabetes Mellitus is associated with poor prognosis in Coronavirus infection. Showing the presence of a relation between fasting blood glucose level and prognosis might affect the course of the disease. The aim of our study was to investigate the relation between fasting blood glucose level at admission and prognosis in patients hospitalized with COVID-19 pneumonia.
METHODS: For this retrospective study, we enrolled all patients diagnosed as confirmed or probable COVID-19. The age, gender, smoking history, and comorbidities of the patients, laboratory values (d-dimer, ferritin, C-Reactive Protein, Lactate Dehydrogenase, lymphocyte, fasting blood glucose level) were recorded. The data about radiological involvement, steroid/pulse steroid need, need for intensive care unit and mortality were also recorded.
RESULTS: A total of 574 patients constituted the Study Group. The median age was 60(20-99); and 326(56.8%) of the patients were male. In patients with fasting blood glucose level>159 mg/dL, the risk of pulse steroid need is 3 times; in patients with fasting blood glucose level>138 mg/dL, the risk of need for intensive care unit is 2 times; and the risk of mortality in patients with fasting blood glucose level>136 mg/dL was found to be 2.5 times higher. Also, the risk of poor prognosis was found to be 2.5 times higher in patients with fasting blood glucose level>136 mg/dL.
DISCUSSION AND CONCLUSION: It was shown that when fasting blood glucose level is>136 mg/dL (7.6 mmol/L), it increases the risk of poor prognosis.

INTRODUCTION: Our aim in this study is to determine whether there is any difference in radiological findings according to age in children followed up for Mycoplasma pneumonia.
METHODS: In our study, 78 cases aged 0-18 were included into our study among 460 children who were admitted to a tertiary research and training hospital pediatrics service between 01.01.2018-01.08.2020 due to pneumonia, diagnosed as Mycoplasma Pneumonia pneumonia by indirect fluorescent antibody test, and who didn't have co-infection with any viral, bacterial agent. The cases were divided into two groups: age five and under and over five. The radiological findings, symptoms, findings, laboratory parameters of the cases were evaluated.
RESULTS: When we compared the clinical findings according to age groups in our study, tachypnea was higher in the group of five years and younger, and a statistically significant difference was observed in the evaluation (p = 0.016). In the evaluation of the laboratory data, the difference between the lymphocyte count and polymorphonuclear leukocytes / Lymphocyte ratio was statistically significant (p <0.05). In the evaluation of radiological findings, we found that paracardiac infiltration and diffuse infiltration were proportionally higher in the group above five years of age, and lobar consolidation and reticular infitration in the group aged five and under five, but we found no statistically significant difference between groups (p = 0.401).
DISCUSSION AND CONCLUSION: In our study, we found that there was no statistically significant difference in radiological findings between the age of five years and under five years group and the group above five years of age.

INTRODUCTION: Primary hyperparathyroidism is a common calcium metabolism disorder. Patients with primary hyperparathyroidism are at risk for skeletal and renal damage.The presence of vitamin D deficiency may lead to difficulty in making a clear diagnosis. We reviewed the clinical charecteristics and laboratory findings of parathyroid adenoma patients in our center and tried to find a possible hallmark for parathyroid adenoma diagnosis regardless of vitamin D status of the patients.
METHODS: Patients who applied to the endocrinology and metabolism clinic with hypercalcemia and were diagnosed with primary hyperparathyroidism in the biochemical tests were included in the study.
RESULTS: The mean age of the 71 parathyroid adenoma patients was 52.1 ± 13.4 years. 87.3% of the patients were female (n=62) and 12.7% were male (n=9). 35.2% (n=25) of patients were asymptomatic. There was a positive correlation between serum intact PTH level and Ca/P ratio in parathyroid adenoma patients before the surgery. (p = 0,038, r = 0,258) Positive correlation between serum intact PTH levels and Ca/P before surgery was also present in patients with parathyroid adenoma also in the presence of vitamin D deficiency (p = 0,037, r = 0,339).
DISCUSSION AND CONCLUSION: The positive correlation between PTH and Ca/P ratio in patients with parathyroid adenoma may remain intact. This correlation may not be impaired in the case of vitamin D deficiency.

INTRODUCTION: Recently, an increasing number of publications in the literature have reported a series of prolonged neurological, cardiovascular, psychiatric and musculoskeletal symptoms after recovering from COVID-19, including particularly fatigue. This study seeks to evaluate fatigue symptoms in those infected by COVID-19.
METHODS: 82 volunteering and consecutive patients presenting to our clinic for follow-up checks after COVID-19 infection underwent evaluations for clinical and laboratory parameters, and received FAS (fatigue assessment scale).
RESULTS: The study included a total of 82 patients who had been infected by COVID-19, of whom 45 were male (54.9%) and 37 female (45.1%), with an average age of 55±15 years (min 22- max 87 age). In 35.4% of the cases, the disease had followed a severe/critical course, and in 64.6% mild/moderate. At the follow-up check, 65.9% (54 cases) were found to have mild fatigue and 18.3% (15 cases) severe fatigue according to the FAS fatigue scale. Severe fatigue was significantly more common in women than in men (29.7% vs. 8.9%, p=0.015). Those who were found to have fatigue at the follow-up check had significantly lower median hemoglobin levels (13.3 d/dl) at the time of presentation compared to the median hemoglobin levels of those without fatigue (14.2 g/dL). Fatigue was significantly more common in patients who had used low-molecular-weight heparin (LMWH) for treatment than those who never received LMWH.
DISCUSSION AND CONCLUSION: This study shown that; patients with COVID-19 infection may complain of fatigue regardless of the severity of the disease and other co-morbidities.

INTRODUCTION: The aim of the current study was to investigate the impact of guideline updates for the management of dyslipidemias by comparing the performance of 2019 and 2016 ESC/EAS guidelines in determining individuals who are eligible for statin as a primary prevention therapy.
METHODS: We enrolled consecutive patients diagnosed with first episode of acute coronary syndrome (ACS) between 2014 and 2020. Statin treatment indications of the patients were calculated based on 2016 and updated 2019 ESC/EAS Dyslipidemia Guidelines.
RESULTS: A total of 920 patients were included in the study. 83% of the patients were male. The mean age was 57 ± 13 years (56 ± 12 years for men; 63 ± 15 years for women, p <0.001). The Concomitant statin therapy (CST) recommendations was appropriate for 57 % (n: 522) of the patients according to the 2019 guideline, while this rate was 47% according to the 2016 guideline (n: 433). The overall statin therapy (OST) recommendations rate increased from 86.2% to 88.6% with the 2019 update.
The 2019 ESC / EAS Guidelines have extended the age range to recommend statin up to 75 years. However, the study shows that 15.5% of the patients had their first ACS attack outside this age range.
DISCUSSION AND CONCLUSION: The 2019 guideline update has increased the success of the guideline to classify very high-risk patients in this risk group, and the scope of statin therapy recommendations has also increased in these patients. Lipid treatment guidelines need to be improved, especially in individuals calculated in the intermediate cardiovascular (CV) risk group.

INTRODUCTION: Although liver biopsy is the gold standard diagnostic method for fibrosis, it is seen disadvantageous for risk of complications, high cost, and pathology result not reflecting the whole liver. Hence, the need to develop noninvasive methods to detect fibrosis has arisen. The aim is evaluate the power of scores developed using laboratory tests in predicting the severity of fibrosis in hepatitis B patients.
METHODS: In this study 171 patients diagnosed with Chronic Hepatitis B, had liver biopsy and had simultaneous laboratory tests were evaluated. To evaluate the difference between the variables, patients were divided into two groups as those with mild fibrosis (fibrosis score <2) and those with advanced fibrosis (fibrosis score ≥ 2). Between these two groups, Aspartate Aminotransferase - Alanine Aminotransferase ratio (AAR), AST Platelet Ratio Index (APRI), Fibrosis 4 Score (FIB-4), Age-Platelet Index (API), University of Goteborg cirrhosis index (GUCI), Cirrhosis Discriminant Score (CDS) and King Score were compared.
RESULTS: The median age of the patients is 31 in fibrosis 0-1 and 33 in fibrosis 2-3-4-5. There were 74 patients (43.2%) with mild fibrosis and 97 patients (56.7%) with advanced fibrosis. There was no significant difference between the two groups in terms of FIB-4, AAR, API, APRI, CDS, GUCI and King scores. DNA levels of HBV were significantly higher in advanced fibrosis.
DISCUSSION AND CONCLUSION: AAR, APRI, FIB-4, API, GUCI, CDS and King's scores were not sufficient to predict the severity of fibrosis in patients with HBV infection; however, serum HBV DNA levels were better in predicting fibrosis compared to these scores.

INTRODUCTION: Vitamin D is a steroid hormone and 1,25 dihidroxy vitamin D3 is the active form. Vitamin D acts via it’s spesific reseptor VDR( vitamin D receptor). This receptor has also been identified in reproductive organs such as the ovary, endometrium, testis and pituitary. This has increased the interest in investigating the role of vitamin D in human reproductive health.Vitamin D plays important role in oogenesis, antimullerian hormone(AMH) production and endometrial reseptivity.In this study,it was aimed to determine the role of vitamin D in fertility.
METHODS: Between January 2020- June 2020 months in Kocaeli Provincial Directorate of Health Sciences University Derince Education and Research Hospital,this research was carried out by retrospective screening of the data of 100 primary infertility and 100 fertile patients.Vitamin D levels in both groups were mutually examine.The necessary ethics committee permission has been obtained for the study.
RESULTS: : In the study,the blood vitamin D levels of 20-40 years old patients who applied to the outpatient clinic due to primary infertility were able to conceive 1 or more spontaneously and were compared with the fertile group between the ages 20-40.When vitamin D levels of fertile and infertile women participating in the study were compared,no significiant difference was found between the two groups.
DISCUSSION AND CONCLUSION: Although vitamin D is involved in the physiology of various organ systems,its role in ovarian function and reproductive physiology has not been fully elucidated yet. According to the results of current studies, vitamin D level does not have a direct effect on fertility. More prospective studies are needed to explain the role of vitamin D on ovarian function, especially in the infertil patient group.

INTRODUCTION: Sugammadex is a new generation cyclodextine ring with high affinity for steroidal normuscular blockers. Its effect on plasma steroid hormone levels has been the subject of some studies. In this study, the effects of high-dose sugammadex administration on both steroid hormones and growth hormone were investigated.
METHODS: For our experimental animal study, winstar albino rats administered 0mg/kg, 4mg/kg and 16mg/kg sugammadex under anesthesia were divided into 3 groups. Plasma estrogen, progesterone, total and free testosterone, cortisol and growth hormone levels were measured at the 15th minute after sugammadex administration in rats and compared between groups.
RESULTS: In the high-dose sugammadex group, plasma progesterone (p<0.05) and cortisol levels (p<0.05), were lower, growth hormone (p<0.05) and free testosterone levels (p<0.05 were higher, and estrogen (p>0.05) and total testosterone levels (p>0.05) were statistically similar to the other groups.
DISCUSSION AND CONCLUSION: There are different findings in the literature regarding the effects of sugammadex on steroid hormone levels. Sugammadex administered at high doses provides a more effective change in hormone levels. It also revealed the idea that the change in growth hormone levels may have an effect on the plasma proteins of sugammadex. Our finding regarding the decrease in cortisol levels with high-dose sugammadex is remarkable in terms of stress response to surgery.
Sugammadex administered at high doses affected both steroid and non-steroidal hormone levels in rats. High-dose sugammadex increased plasma free growth hormone in rats. Our findings suggest that sugammadex also affects hormone-binding proteins. The clinical significance of the findings should be supported by further studies

INTRODUCTION: Obesity is a major cardiovascular risk factor (CVRF). Metabolic disorders such as hypertension, insulin resistance, dyslipidemia, and atherosclerosis are associated with CVRFs, Although kidney transplantation reduces the risk of death and cardiovascular events associated with dialysis, cardiovascular disease remains one of the leading causes of death in kidney transplant recipients.
METHODS: Five patients with a BMI ≥40 from 47 living donor renal transplant recipients were included in the study. 2.5 mg/kg of antithymocyte globulin (ATG) in induction and tacrolimus, steroid and mycophenolate mofetil (MMF) as maintenance therapy were given to all patients.. Operation times, end-stage renal disease etiologies, posttransplant early graft functions and hospital stay of the patients were evaluated.
RESULTS: Four patients were male and 1 was female. The kidneys of all patients were placed in to the right iliac fossa. The mean operative time was 3 hours, and the mean hospital stay was 10 days. Acute humoral rejection was observed in 1 patient in the biopsy performed due to elevated creatinine levels on the 7th postoperative day. The mean exit creatinine value was found to be 1.2 mg/dl. Lymphocele requiring drainage was detected in 2 of 5 patients in the early postoperative period.
DISCUSSION AND CONCLUSION: Obesity is a risk factor for the development of complications in kidney transplant patients. Kidney transplantation has a survival advantage in obese patients compared with the patients on dialysis. A public health campaign is needed to raise awareness and to emphasize the importance of self-care, increased exercise, healthy eating and weight loss in kidney transplant candidates.

INTRODUCTION: The gold standard for the diagnosis of neuropathic pain is clinicians’ opinion, but inappropriate treatment methods are frequently encountered. In this study, it was aimed to determine the prevalence of neuropathic pain and which treatment methods were used in patients who applied to the neurology outpatient clinic.
METHODS: Five hundred-four outpatients who applied to the University of Health Sciences Kocaeli Derince Training and Research Hospital Neurology Outpatient Clinic in January 2023 were included in the study. Neuropathic pain symptoms were questioned in all patients, and 45 patients with a DN4 score of 4 and above, a PainDETECT score of 13 and above were accepted as patients with neuropathic pain. The prevalence of neuropathic pain was detected; the demographic data of the patients, diagnosis and the treatments they used were compared.

RESULTS: In this study, the prevalence of neuropathic pain in patients who applied to the neurology outpatient clinic was found to be 8.9%. The most common causes of neuropathic pain were diabetic neuropathy and discopathy/radiculopathy. While 35.6% of the patients did not use any medication for neuropathic pain, the most commonly used drug was pregabalin.
DISCUSSION AND CONCLUSION: The prevalence found in this study was consistent with the literature. The number of patients with ineffective/inappropriate treatment was small. It was thought that the high pain score in patients that using neuropathic pain medication may be due to inappropriate treatment doses.

INTRODUCTION: In this study, we aimed to compare the menstrual cycle changes with a copper intrauterine device (Cu-IUD) to that of an etonogestrel subdermal implant one year after insertion.
METHODS: The research included women aged 18 to 45 who sought contraception at a tertiary women's hospital in Turkey between January 2020 and December 2021. The groups were examined in terms of mean menstrual blood loss, dysmenorrhea, and dyspareunia, defined by the duration and frequency of menstruation, and the number of pads used on the second day of menstruation. p<0.05 was accepted as the level of significance.
RESULTS: After the contraceptive method use the duration of menstruation (7.00 ± 3.52) and the number of pads used on the 2nd day of the cycle (3.66 ± 1.53) were significantly higher in the patients in the 'Cu-IUD' group compared to the patients in the 'Implant' group (4.36 ± 3.26, 2.33 ± 1.55, respectively) (p<.001 and p<.001, respectively).
DISCUSSION AND CONCLUSION: Intermenstrual period was longer, and menstrual bleeding was lower in the implant group when compared with the Cu-IUD. Etonogestrel-bearing subdermal contraceptive implant can be favorable choice in women who prefer to have lighter and less frequent menstruation.

INTRODUCTION: The management of coronavirüs 2019 (COVID-19) infection in pregnancy is different from the normal population. Therefore, it is important to evaluate prognostic factors and inflammatory markers that may affect the clinical course of COVID-19 infection during pregnancy. Our aim in this study is to investigate inflammatory markers such as procalcitonin, ferritin, D-Dimer and fibrinogen that may affect the clinical outcomes of COVID-19 infected pregnant women who need intensive care unit (ICU).
METHODS: 53 pregnant women who needed ICU due to acute respiratory failure because of COVID-19 infection were included in our study. Pregnant patients followed up in the ICU were divided into two groups according to whether they were intubated or not. These two patient groups were compared according to lymphocyte count, C-reactive protein (CRP), D-Dimer, ferritin, fibrinogen, procalcitonin values and descriptive features.
RESULTS: The CRP results of the intubated group were higher (p=0.001; p<0.01). Lymphocyte count of the two groups were compared, the results of the intubated group were lower and this difference was statistically significant (p=0.002; p<0.01). A statistically significant difference was found between procalcitonin values (p=0.001; p<0.01) and ferritin values (p=0.033; p<0.05) in the intubated and non-intubated groups. Both laboratory parameters were higher in the intubated group. Fibrinogen results were high in intubated group but this was no statistically significant difference between the two groups (p=0.081; p>0.05).
DISCUSSION AND CONCLUSION: In conclusion, inflammatory parameters in pregnant patients may reflect the severity of the COVID-19 infection to some extent. Therefore, these markers can be used in the clinical management of the disease.

INTRODUCTION: The aim of this study was to evaluate lung tissue histopathologic changes and to find whether aspiration has an over effect on the lung tissue histopathologic changes with the increase of abdominal pressure.
METHODS: The study rats were randomly assigned into the following five groups: a sham-operated group and groups 1, 2, 3, and 4, in which the intra-abdominal pressure was increased to 15, 20, 25, and 30 mmHg for 60 min, respectively. Half of the rats of all groups were fed 2 cc methylene blue with the help of a feeding tube 30 sec before the process Lungs were harvested for histopathologic changes.
RESULTS: Total scores of lung histopathologic findings were concordant with the degree of IAB. When the total scores of histopathologic findings in lungs were compared for each applied IAB with the control group, the scores were higher in fed animals than in unfed animals. Necrosis was increased in accordance with the pressure level, especially 15 mmHg or over this value which was accepted as a cut-off value. The comparison of the scores of histopathologic findings in two groups in which the applied IAB was lower than the cut-off value was not significantly different from the control group. However, the comparison of the scores of histopathologic findings equal to or above 18 mmHg was significantly higher than the control group.
DISCUSSION AND CONCLUSION: The available findings suggest that intraabdominal pressure greater than 15 mmHg could irreversibly damage pulmonary cells. The scores of histopathologic findings were significantly higher in fed animals and pulmonary aspiration related to passive regurgitation in ACS has a substantial influence on histopathologic findings seen in this disorder.

INTRODUCTION: Open tension-free mesh repair (Lichtenstein) and laparoscopic totally extraperitoneal (TEP) repair are the most preferred techniques for inguinal hernia surgery. This study aimed to compare these two techniques' early and long-term results.
METHODS: One hundred two patients were randomly divided into two groups (TEP, n=51; Lichtenstein, n=51). The groups were compared regarding complications (early, late), postoperative pain status, time to return to work and recurrence.
RESULTS: The TEP group had a lower early postoperative visual analogue scale score (2 vs 5.27; p<0.001), less requirement for postoperative analgesia use (31.4% vs 70.6%; p<0.001), and earlier time to return to work (4.2 vs 20.4; p<0.001). Both groups had similar results regarding early and late postoperative complications. The mean follow-up period was 72,8±17.9 months. There was no difference between the groups regarding recurrence (TEP vs Lichtenstein; 2% vs 2%, p: 0.999).
DISCUSSION AND CONCLUSION: Both techniques are effective in inguinal hernia repair with low long-term recurrence and complication rates. Among the two approaches, the most significant advantages highlighting the TEP procedure are less postoperative pain and a shorter time to return to work.

INTRODUCTION: COVID-19 has a high risk of transmission for healthcare professionals working multidisciplinary in many departments of emergency medicine, infectious diseases, pulmonology, other internal and surgical departments. In healthcare workers infected with the Covid 19 virus, the disease can vary from URTI to mild, moderate, and severe pneumonia.
METHODS: In the follow-up patients, the cases of URTI, mild, moderate, severe pneumonia clinics, outpatient or inpatient or ICU hospitalization of healthcare workers diagnosed with Covid-19 laboratory and/or clinically were evaluated. Healthcare workers who have Covid-19 PCR (Polymerase Chane Reaction) positivity or whose imaging features are compatible with Covid-19 will be included in the study. It is planned to evaluate the course of the disease in healthcare workers of the Covid 19 pandemic, Covid-19 virus.
RESULTS: In the follow-up patients, the cases of mild, moderate, severe pneumonia clinics, outpatient or inpatient or ICU hospitalization of healthcare workers diagnosed with covid19 laboratory and/or clinically were evaluated. Healthcare workers who have Covid-19 PCR positivity or whose imaging features are compatible with Covid-19 will be included in the study. It is planned to evaluate the course of the disease in healthcare workers of the Covid-19 pandemic. It is planned to examine the Covid-19 PCR test, Covid-19 vaccine status, outpatient and hospitalization status of the patients.
DISCUSSION AND CONCLUSION: The use of personal protective equipment such as masks, gloves, goggles, and gowns to create droplet and contact isolation with patients helps prevent the transmission of Covid-19 infection in healthcare workers

INTRODUCTION: Urinary system stone disease is one of the most common and frequently recurring urological diseases. In this study, we investigated the effect of previous ESWL on bleeding during PNL.
METHODS: The data of 403 patients who underwent PNL in our clinic between 2015 and 2023 were retrospectively analyzed. The patients were divided into 2 groups as the group that had ESWL before and the group that did not. The operative times, scopy times, stone loads, hemoglobin decrease levels, blood transfusion rates, hospital stay, intraoperative and postoperative complications were compared statistically.
RESULTS: 112 patients who underwent ESWL before PCNL were named Group 1, and 277 patients who did not undergo ESWL were named Group 2. There was no statistically significant difference between the operative data in terms of stone size, operation time, stone-free rates, wetting cessation time and hospital stay. While the mean decrease in hemoglobin was 1.44 ± 1.09 g/dl in Group 1, it was 1.53 ± 1.09 g/dl in Group 2, and there was no statistically significant difference between the two groups in terms of bleeding (p=0.085). While the blood transfusion rate was 6% in Group 1, the blood transfusion rate was 7% in Group 2 (p=0.138).
DISCUSSION AND CONCLUSION: PNL operation can be performed effectively and reliably in experienced centers in patients who have undergone ESWL before.

INTRODUCTION: Investigation of the histopathological features in core biopsies can predict the chemotherapy responses and thus provide information about the prognosis of breast cancer patients. Tumor-infiltrating lymphocytes (TILs) have been reported as a prognostic factor in many tumors. We investigated the relationship between TILs and clinicopathological parameters and patients’ survival status.
METHODS: 74 breast cancer patients who underwent core biopsy between 2010 and 2021 and were operated on after neoadjuvant chemotherapy were included in our study. The relationship between TIL in core biopsy materials of the cases and pathological response to treatment in resection materials and clinicopathological features of the cases were evaluated.
RESULTS: No significant relationship was found between TIL and treatment response. TIL was low in cases with high ER expression (p: 0.012). Most of the cases with low TIL were in the Luminal A+B groups (p: 0.013). Low TIL was associated with short disease-free survival (DFS), and TIL was a prognostic factor for DFS in multivariate analysis.
DISCUSSION AND CONCLUSION: Breast cancer is an immunogenic tumor, and TIL before neoadjuvant therapy has predictive value on disease prognosis.

INTRODUCTION: The aim of this study was to investigate the predictive importance of neutrophil-lymphocyte ratio (NLR), C-reactive protein/albumin ratio (CAR), and prognostic nutritional index (PNI) on treatment response in triple-negative breast cancer (TNBC) patients receiving neoadjuvant chemotherapy (NACT).
METHODS: Data of TNBC patients treated with standard NACT protocol were analyzed retrospectively. ROC-curve analyzes were used for cutt-off determination. Binary logistic regression analysis was used for predictive markers.
RESULTS: 55 patients were included in the study. The cut-off value, which was thought to be ideal for CAR, was 9.86 [sensitivity: 66.7%, specificity: 71.4%, AUC=0.696 (95% CI 0.556-0.836, p=0.013). ROC analysis for NLR and PNI was not statistically significant. Patients with a CAR above 9.86 had an approximately 3.1-fold greater pathological complete response (PCR) than patients with a CAR below 9.86 (OR: 3.167 95% CI: 1.039-9.654, p=0.043). NLR and PNI were not predictive markers for PCR. (OR: 1.096, 95% CI: 0.941-1.276, p=0.23, and OR: 0.981, 95% CI: 0.91-1.057, p=0.610, respectively). Age (OR: 1.023 95% CI: 0.969-1.079, p=0.411), body mass index (1.074 95% CI: 0.938-1.229, p=0.304) and clinical T-stage (OR: 1.014 95% CI: 0.43- 2.394, p=0.975) did not predict PCR. When the results were evaluated with multivariate analysis, it was observed that only ki-67 retained its predictive significance (OR: 1.046, 95% CI: 1.015-1.079, p=0.004). CAR was not significantly predictive against ki-67 (p=0.263).
DISCUSSION AND CONCLUSION: In this study, it was concluded that CAR may be a predictive marker for neoadjuvant chemotherapy response in triple negative breast cancer patients, but it is a weaker marker when evaluated together with ki-67.

INTRODUCTION: Chronic shoulder pain is a common condition that may affect daily living activities and psychological status. Ultrasound (US)-guided deep supraspinatus muscle plane block (DSMPB) is a recently defined plane block and used for acute and chronic shoulder pain. The aim of this study was to investigate the effectiveness of US-guided DSMPB for chronic shoulder pain due to rotator cuff pathology.
METHODS: This study was designed as a retrospective observational study. A total of 40 patients with chronic shoulder pain due to rotator cuff pathology were included. The patients received US-guided DSMPB. The pain intensity as a primary outcome was assessed using a visual analogue scale (VAS) score at pretreatment, immediately after the intervention, at weeks 4 and 12. The short form-36, shoulder pain and disability index, pain medication consumption, patient satisfaction and complications were also recorded.

RESULTS: There was a statistically significant decrease in average VAS scores immediately after treatment, at week 4 and 12 compared to the baseline (p < 0.001). Patients experienced significant improvement in functional disability, patient satisfaction and quality of life up to 12 weeks after the treatment (p < 0.001). Throughout the duration of the follow-up period, there was a statistically significant decrease observed in pain medication consumption among the patients (p < 0.001).
DISCUSSION AND CONCLUSION: The US-guided DSMPB could be an alternative treatment modality in patients with chronic shoulder pain due to rotator cuff pathology. It provides improvement in pain scores, functional disability and quality of life and decreases pain medication consumption.

INTRODUCTION: The purpose of this study was to compare the stability of self-tapping and self drilling orthodontic micro implants throughout canine distalisation in permanent first premolar extraction cases.
METHODS: 34 patients (19 girls, 15 boys) with mean age 16.47±2.3 years who were to be treated with extraction of permanent first premolars in the maxilla, mandible or both were recruited. 1.5×8 mm micro implants were placed between the roots of the second premolar and the first molar teeth within a split-mouth approach. 43 self-tapping and 43 self-drilling micro implants with a total of 86 micro implants (BioMaterials Korea Inc.) were inserted and 72 micro implants were included in the study owing to the the failure of 14 implants. The stability measurements of the micro implants were made at the 0th,1st,2nd,3rd and 4th months. Mean periotest values were compared by independent samples t-test. Comparisons among monthly measurements were made by repeated measurements of ANOVA.
RESULTS: The mean mesial and occlusal periotest values of self-tapping micro implants were 1.36±2.39/2.19±1.54, 11.94±8.62/11.06±7.84, 14.50±7.17/12.93±6.04, 15.43±6.07/13.83±5.51, 16.07±5.81/13.41±5.61 respectively and the mean mesial and occlusal periotest values of self-drilling micro implants were -0.11±2.55/-0.22±2.97, 14.81±7.94/12.71±8.15, 15.00±6.23/12.77±6.51, 13.37±5.32/11.27±5.62, 12.41±5.07/10.33±4.85 respectively. Statistically significant difference was found between the stability of self-tapping and self-drilling micro implants at the initial and 4th month measurements.
DISCUSSION AND CONCLUSION: The stability of both ST and SD micro implants were higher at the 0th month. Self-drilling micro implants exhibited higher primary stability than self-tapping micro implants but both of them failed to retain their primary stability values in the consequent months.

The differential diagnosis of thyroid neuroendocrine tumors includes very different disease groups. Especially in calcitonin negative cases, other neuroendocrine tumors should be included in the differential diagnosis. Ewing sarcoma is one of the rare tumors in the thyroid tissue, and it is important in terms of being among the differential diagnoses of neuroendocrine tumors of the thyroid, especially in calcitonin negative cases. Here, we aimed to present a rare case of Thyroid Ewing's sarcoma and succesful rectal levothyroxine administration for thyroid hormone replacement.

Background: Transverse testicular ectopia (TTE) is a rare pathology resulting from the migration of both testicles into the same scrotal compartment. Although rare some cardiac anomalies had been reported with TTE but coexistence of TTE and coarctation of aorta (CoA) has not been reported before.
Case Report: Here we describe a 6-month old patient with TTE who presented with swelling in the left inguinal region, left undescended testicle, and impalpable testicle on the right side. The prenatal diagnosis of cardiac enlargement and clinical findings let us diagnose severe CoA that had to be managed immediately. The ultrasound examination showed the presence of two testicles in the left inguinal area and a laparoscopic procedure, trans-septal orchiopexy, was applied. In our patient, the right testicle had an ectopic location, while undescended testis, hernia and ectopic testis were on the left side.
Conclusion: Although rare, TTE should be considered in differential diagnosis of cryptorchidism and it might be present with other congenital abnormalities.