INTRODUCTION: We aimed to investigate the associated factors, treatment modalities, algorithm and the importance of anamnesis in children with chronic cough.
METHODS: Patients diagnosed with chronic cough in the Pediatrics unit were questioned about their medical history, symptoms and findings. All information was recorded. At the end of the study, the medications prescribed to the patients, diagnoses and investigations were reviewed.
RESULTS: In a total of 94 cases, 51(54.3%) males and 43(45.7%) females, mean age was 4.8±3.1 years, history of normal delivery was 59(62.8%), mean gestational age was 37.9±2.1 weeks, and duration of breastfeeding was 17.5(min: 0-max: 67) months. Seventy percent of the patients had chronic cough in the first three years of life, 80(85.1%) patients had exposure to allergenic agents, 38(40.4%) patients had atopic family history, and 53(56.4%) patients had evidence of reactive airway disease. Asthma was diagnosed in 15(15.9%) patients, 18(19.1%) patients were not started on any medication, 35(37.2%) patients were started on antibiotics, 45(47.8%) patients were started on montelukast-antihistamine and were followed up, 37(39.4%) patients were using alternative medicine methods when they were admitted.
DISCUSSION AND CONCLUSION: The cause, follow-up and treatment of chronic cough are important. Chronic cough in children is most commonly seen at a young age, exposure to allergenic agents, mode of birth, birth week are all important factors. As the duration of the disease prolongs, families seek remedies in traditional and alternative medicine methods. Taking the correct anamnesis with the appropriate algorithm in the outpatient clinic can facilitate the work of the physician and provide a faster and more accurate diagnosis.

INTRODUCTION: In the literature, there are studies related to the fact that the use of progesterone in the first trimester increases the Nuchal Translucency (NT) measurement. We aimed to investigate the effect of progesterone use on NT measurement in the first trimester and Nuchal Fold (NF) measurement in the second trimester due to threatened abortion.
METHODS: In this retrospective study, it was determined that 35 of them used vaginal progesterone due to the threatened abortion. NT and NF thicknesses of 130 pregnant women were compared with those who used progesterone (n = 35) and those who did not (n = 95). In addition, demographic data such as age, body mass index (BMI), NT, NT MoM, free beta human chorionic gonadotropin (free B-hCG), pregnancy associated plasma protein-A (PAPP-A) values in the first trimester aneuploidy screening and alpha fetoprotein (AFP) values in the second trimester aneuploidy screening, B-hCG, Estradiol (E2) values were also recorded.
RESULTS: There was no statistically significant difference between the NT values in the first trimester of the pregnant women who used progesterone due to threatened abortion and those who did not use progesterone (p = 0.1142). Considering the NF measurements, it was found that the NF thickness was significantly less in pregnant women using progesterone in the first trimester (p = 0.0268).
DISCUSSION AND CONCLUSION: Although the use of progesterone in the first trimester due to threatened abortion does not affect NT values, it may be associated with lower NF values measured in the second trimester.

INTRODUCTION: This study was conducted to determine the effects of physical symptoms experienced by mothers in the postpartum period on depression and mother-infant attachment.
METHODS: The population of the study consisted of women who applied to the Family Health Centers in Osmaniye city center in the 4th-6th week after delivery between the dates of the study. The sample consisted of 198 women who met the research criteria. Data were collected with a descriptive information form, Postpartum Physical Symptom Severity Scale, Postpartum Attachment Scale (WHO) and Edinburgh Postpartum Depression Scale.
RESULTS: In the study, postpartum physical symptom severity was found to be statistically higher in mothers who were illiterate, whose income was equal to expenditure, who gave birth by emergency cesarean section, who were discharged on the 1st postpartum day and who did not receive discharge training.In the study, it was observed that there was a strong and positive relationship between the risk of postpartum depression and the postpartum attachment scale, and attachment problems increased as the risk of depression increased.
DISCUSSION AND CONCLUSION: Educational status of mothers, type of delivery, number of births, planned pregnancy, postpartum discharge education and feeding style of the baby affect postpartum physical symptoms, postpartum depression and mother-infant attachment. In this respect, it is important to provide midwife support in reducing the severity of physical symptoms experienced by postpartum mothers, preventing depression and increasing attachment.

INTRODUCTION: The children with myelomeningocele are at an increased risk of recurrent urinary tract infection (RUTI) and renal damage due to neurogenic bladder. We aimed to evaluate of the relationship between recurrent urinary tract infection, renal damage and urodynamic findings in children with myelomeningocele who were referred late.
METHODS: We retrospectively evaluated the data from patients with myelomeningocele. RUTI was defined as two or more episodes of febrile urinary tract infection. The differential function <40% or the presence of renal scarring and/or atrophy were considered renal damage.
RESULTS: The median age of 75 patients was 7.4 years. The median age at first admission was 16 months (6-27 months). RUTI was observed in 48 patients. A cox regression analysis showed that vesicoureteral reflux (VUR), increased post voiding residual urine, reduced bladder capacity, trabeculated and hypocompliant bladder were risk factors for RUTI (p=0.028, p=0.036, p=0.005, p=0.042, respectively). Renal damage was determined in 30 patients. There were significant associations between renal damage and severe VUR, trabeculated bladder, hypocompliant bladder and clean intermittent catheterization (CIC) (hazard ratio: 1.724, p=0.011, hazard ratio: 1.934, p=0.038, hazard ratio: 1.452, p=0.025, hazard ratio: 3.691, p=0.014). Detrusor leakpoint pressure (DLPP) had a predictive value for renal damage (cut-off value: 29.8 cmH2O, p=0.021).
DISCUSSION AND CONCLUSION: The presence of VUR and the changes in bladder dynamics were important risk factors for recurrence of UTI in children with myelomeningocele who were referred late. Severe VUR, DLPP >29.8 cm H2O, trabeculated and hypocompliant bladder were associated with renal damage.

INTRODUCTION: In this study, we aimed to review the pneumothorax incidence and results of patients receiving treatment due to COVID-19 infection.
METHODS: A total of 41,525 cases who were admitted to the emergency department between 01 April 2020 and 01 January 2021 with COVID-19 symptoms were reviewed. Of these patients 14,611 were hospitalized. Clinical and laboratory features of patients who had been diagnosed with spontaneous pneumothorax with PA chest radiography were evaluated and included in the study.
RESULTS: A total of 11 cases who were diagnosed with spontaneous pneumothorax and had a positive PCR test were included in the study. Of these cases, 8 were male and 3 were female. The age distribution was 50-84 and the mean age was 66.5 years. None of our cases had received invasive or non-invasive mechanical ventilation before diagnosis. The most common comorbidities were chronic obstructive pulmonary disease (6/11) and hypertension (2/11). Pneumothorax was right-sided in six cases and left-sided in four cases. It was concurrently bilateral in one case.
DISCUSSION AND CONCLUSION: Spontaneous pneumothorax is a rarely encountered condition in COVID-19 patients and its pathophysiological mechanisms are still unknown. The incidence of spontaneous pneumothorax in non-intubated COVID-19 patients is approximately 10-fold more frequent then normal population. This result demonstrates that spontaneous pneumothorax incidence secondary to COVID-19 infection is much higher than expected.

INTRODUCTION: To examine hemogram markers related to inflammation in patients with pterygium.
METHODS: In this retrospective study, 59 patients with primary pterygium, 50 age- and gender-matched healthy individuals were included. Leukocyte, neutrophil-leukocyte ratio (NLO), red cell distribution width (RDW), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV), neutrophil count, lymphocyte count, hemoglobin (HGB), hematocrit, platelet count (PLT), red blood cell count (RBC) were examined and compared with healthy individuals.
RESULTS: Patients with pterygium had higher leukocyte,PLT, lymphocyte, RDW, MPV values compared to healthy controls group (p<0.001, p=0.001, p<0.001, p=0.020, p=0.001, respectively). NLR and PLR values were significantly lower in the pterygium group compared to the control group (p=0.019, p=0.046, respectively). There was no significant difference between the groups in other hematological values.
DISCUSSION AND CONCLUSION: It can be thought that local and systemic inflammation coexist in patients with pterygium and that increased lymphocytic inflammation in patients with pterygium occurs due to viral infections.

INTRODUCTION: COVID-19 (coronavirus disease 2019) infection occurs asymptomatically/symptomatically in vaccinated/unvaccinated individuals. This research aimed to evaluate the differences between thoracic CT (computed tomography) severity and laboratory findings in patients with CoronaVac/BNT162b2 mRNA vaccine, according to the time elapsed after the second dose of vaccine.
METHODS: Between March 2021 and December 2021, 221 SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) PCR positive/thoracic CT compatible patients over the age of 40 hospitalized in the COVID-19 services of Mersin City Training and Research Hospital were included. Patients included in the study were grouped as ≤1 month, 1-3 months, 3-6 months, and ≥6 months after receiving the second dose of CoronaVac/BNT162b2 mRNA vaccine. Patient information, thoracic CT and laboratory values at the first admission were obtained retrospectively from patient files and hospital information system.
RESULTS: The median time to develop positivity after the second dose of vaccine in all patients was 111 (CI: 93-132) days. In the BNT162b2 mRNA-vaccinated group, no significant difference was found between the groups in terms of thoracic CT and laboratory values (p>0.05). In the CoronaVac-vaccinated group, a very weak positive correlation was found between the development time of positivity after vaccination and the thoracic CT total severity score (r=0.148, p=0.048).
DISCUSSION AND CONCLUSION: It has been shown that as the time after the second dose increases in CoronaVac vaccinated patients, the degree of lung involvement increases, and there is no difference as the duration increases in BNT162b2 vaccinated patients

INTRODUCTION: Although it has been reported in the literature that non-invasive mechanical ventilation (NIMV) is effective on hypoxemia in some respiratory failure patients, the effect of this practice on peripheral perfusion of patients is not clear. In this study, the aim is to research changes in and the relation between perfusion index and pulse pressure in patients who have applied to the emergency department and been subject to NIMV.
METHODS: The study was planned as a prospective and cross-sectional research. It is conducted on 33 patients who have been treated with NIMV within two months in 2015 at Istanbul Training and Research Hospital. Perfusion index, blood pressure, heart rate, oxygen saturation are analysed being simultaneously measured within time periods determined before or during NIMV.
RESULTS: The study includes a total of 33 patients with the average age of 70.4±8.3, consisting of 15 (45.5%) males and 18 (54.5%) females. It is detected that there is an increase in oxygen saturation of the patients who are treated with NIMV (p<0.001) and a decrease in their average of heart rate (p: 0.023), which are statistically significant. There is no significant change has been observed throughout the process of NIMV treatment in patients’ blood pressure, pulse pressure and perfusion index (p>0.05).
DISCUSSION AND CONCLUSION: Whereas NIMV treatment that is applied in acute respiratory failure shows positive effect on patient’s hypoxemia, there is no positive or negative effect has been found on patients pulse pressure and peripheral perfusion.

INTRODUCTION: The COVID-19 pandemic is an important global public health crisis that is known to adversely affect the health and well-being of older adults. This study was conducted to determine pandemic awareness and its predictors among community-dwelling older adults.
METHODS: This was a descriptive-cross-sectional study. The data were collected face-to-face from 188 older adults via a questionnaire and the Pandemic Awareness Scale. The data were analyzed with descriptive statistics, independent samples t-test, One-Way ANOVA, and multiple linear regression analysis.
RESULTS: The total mean score of the Pandemic Awareness Scale was 33.08 ± 3.58. The pandemic awareness was significantly higher among older adults, those who were married, had graduated from secondary school and above, who had higher income, who were workers and had been vaccinated against COVID-19 (p < 0.05). In the multiple regression analysis, the total mean score of the Pandemic Awareness Scale was found higher in women (β = 0.282, 95% CI = 0.451-3.590), those who were secondary school graduates (β = 0.459, 95% CI = 1.464-5.883), and those who had higher income (β = 0.182, 95% CI = 0.216-2.438) (p < 0.05).
DISCUSSION AND CONCLUSION: The pandemic awareness level of older adults was above moderate. Gender, graduation, and socioeconomic status were the predictors of the pandemic awareness level of older adults. The results of the study showed that male gender, lower education, and lower income level should be given more importance in preventive healthcare services, which target to increase the knowledge and awareness of older adults about pandemics.

INTRODUCTION: The aim of this study is to compare the results of using rFSH, rFSH+rLH and HP-HMG in assisted reproductive technology (ART) applications in obese or overweight patients without polycystic ovary syndrome (PCOS).
METHODS: This retrospective cohort study was conducted with women without PCOS but with a body mass index greater than 25 who underwent ovarian stimulation with the GnRH antagonist protocol during ART. Appropriate cycles of these patients were divided into three groups as rFSH, rFSH+rLH and HP-HMG according to the type of gonadotropin used. ART outcomes were compared between these three groups.
RESULTS: Ongoing pregnancy rate and grade 1 embryo rate were statistically higher in the rFSH+rLH group (41.2% and 71.7%, respectively) than in the rFSH group (14.3% and 47.2%, respectively). There was no statistical difference between the group that received rFSH and the group that received HP-HMG, and between the group that received rFSH+rLH and the group that received HP-HMG in terms of ongoing pregnancy rate and grade 1 embryo ratio. In addition, the endometrial thickness on the day of HCG was statistically significantly higher in the rFSH+rLH group compared to the HP-HMG group.
DISCUSSION AND CONCLUSION: The rFSH+rLH combination has a superior effect over rFSH alone on embryo quality and ongoing pregnancy in obese or overweight patients without PCOS. In addition, it is seen that the endometrium of these patients on the hCG day is thicker when rFSH+rLH is used than when HP-HMG is used.

INTRODUCTION: This study aimed to determine the relationship between Stress, COVID-19 risk perception, and care behaviours of surgical nurses during the second year of the pandemic.


METHODS: This descriptive and cross-sectional study was conducted with 230 nurses in a training and research hospital. The data were collected using the Personal Information Form, Perceived COVID -19 Risk Scale, Nurse Stress Scale, and Caring Behaviours Scale-30 IBM SPSS Statistics 22 program was used for the study's statistical analysis.
RESULTS: In the second year of the pandemic, nurses' Stress, COVID -19 risk perception, and care behaviours were higher than the average. It was determined that there was a significant positive correlation between nurses' stress levels and COVÝD-19 risk perceptions and between care behaviours and COVÝD-19 risk perceptions.
DISCUSSION AND CONCLUSION: The findings indicated that nurses working in intensive care and pandemic clinics, especially those who had previously contracted COVID-19 and possessed sufficient knowledge about the virus, exhibited higher care behaviors. In addition, as nurses' COVID-19 risk perception and stress levels increased, their care behaviours also increased.

INTRODUCTION: Determining the prognosis in lung cancer, which is one of the main causes of cancer related deaths, is critical. The cytokine, chemokine and growth factors secreted by inflammatory cells play an important role in tumor progression and metastasis. In this study, it was aimed to investigate the relationship between hemogram parameters affected by inflammation such as hemoglobin level, neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) with overall survival (OS) and progression-free survival (PFS) in patients with stage IV non-small cell lung cancer (NSCLC).
METHODS: The sociodemographic and disease-related clinical features of 212 patients diagnosed with stage IV NSCLC were reviewed retrospectively by scanning the hospital database system and patient files.
RESULTS: In univariate analysis, leukocytosis (>10 000/mm³), neutrophilia (>7700/mm³), lymphopenia (<1000/mm³), thrombocytosis (≥450 000/mm³), high NLR (≥3.38), high PLR (≥138) were associated with poor OS and PFS. In addition, the presence of anemia (hemoglobin <12 g/dL in women,<13 g/dL in men) and low MPV (≤9 fl) were associated with poor OS. In the multivariate analysis, male gender, concomitant coronary artery disease, presence of anemia were independent poor prognostic factors for only OS. Undifferentiated tumor histopathology, adrenal metastasis, monitoring without treatment, anemia and high NLR were independent prognostic factors for both OS and PFS.
DISCUSSION AND CONCLUSION: Hemogram parameters such as NLR and hemoglobin are economic tests that can be repeated and easily measured. these parameters can be used as a useful prognostic marker in clinical practice to determine the prognosis of stage IV NSCLC patients. Larger prospective studies are required to confirm these findings.

INTRODUCTION: Ileus is a common surgical emergency and tends to recur like other gastrointestinal tract pathologies. Recurrent episodes of ileus cause morbidity and mortality. The aim of this study was to evaluate the clinical characteristics, outcomes, and laboratory parameters of patients who presented with initial and recurrent episodes of ileus.
METHODS: A retrospective observational study at a tertiary care hospital examined adult patients (≥18 years) diagnosed with ileus in the emergency department from January 2018 to March 2021.
RESULTS: This study was performed on 393 ileus patients in the emergency department. Of the patients, 312 (79.4%) were in the initial admission group and 81 (20.6%) were in the recurrent admission group. 144 patients (36.6%) were found to have comorbid diseases and the rate of comorbid patients in the initial group (23.7%, n=74) was significantly lower than in the recurrent group (50.7%, n=41) (p<0.001). Among 337 patients (85.8%) who were followed up on the ward and 56 patients (14.2%) who were followed up in the intensive care unit, the rate of follow-up in the intensive care unit was significantly higher for the initial group (16%, n=50) than for the recurrent group (7.4%, n=6) (p=0.048). In-hospital mortality was 11.5%, and there was no significant difference between the groups (p=0.776). WBC, CRP, CRP/albumin, and RDW/albumin ratios were lower in recurrent admissions, and a statistically significant difference was found between the groups (p=0.034, p<0.001, p=0.001, p=0.013, respectively).
DISCUSSION AND CONCLUSION: In managing patients with recurrent ileus episodes, clinicians may benefit from the findings of this study.

INTRODUCTION: Two devastating earthquakes occurred in Turkey on February 6, 2023. This study was conducted with the aim of examining in depth the experiences of earthquake survivor nurses affected by these major earthquakes in caring for earthquake survivor patients.
METHODS: The study was conducted in a qualitative study design with a phenomenological type. Data were collected in March-April 2023. The interviews were completed online and lasted between 29 and 40 minutes. The audio recordings of the data obtained were manually transcribed by researchers trained in qualitative research, and the MAXQDA program was used to create codes and themes. The Consolidated Criteria for Reporting Qualitative Research (COREQ) was used as a guide for reporting this study.
RESULTS: Nine earthquake survivor nurses were included in the study. The average age of the nurses was 29.6 years, 55% were female, 44% had 1-5 years of working experience, and 55% worked in emergency services, intensive care and operating rooms. As a result of in-depth interviews with nurses; 1- are we safe? 2- expressions of the moment of the earthquake, 3- differences in care 4- working as an earthquake survivor nurse, four main themes and thirteen sub-themes were formed.
DISCUSSION AND CONCLUSION: The self-sacrificing efforts of earthquake survivor nurses to provide care to earthquake survivor patients are in line with the literature. It is thought that the readiness of nurses for a major disaster will provide competence and competence in intervention in this situation.

INTRODUCTION: Acute appendicitis is one of the common causes of acute abdominal pain and is the most common cause of emergency abdominal surgery worldwide. The neutrophil-to-lymphocyte ratio (NLR) is a systemic inflammatory variable that provides information about two different immune and inflammatory pathways. In this study, according to histopathology results, we aimed to evaluate the predictive value of NLR in the differential diagnosis of complicated and uncomplicated appendicitis.
METHODS: We included patients who underwent appendectomy surgery in our clinic between September 2016 and September 2022. The white blood cell (WBC), neutrophil, and lymphocyte count of the patients before the surgery were analyzed and the neutrophil-lymphocyte ratios were calculated. Patients with perforation and gangrenous appendicitis on pathology were considered complicated. Patients were divided into complicated and uncomplicated appendicitis groups and were compared.
RESULTS: 171 patients with complicated appendicitis and 1309 patients with uncomplicated appendicitis were compared. In the complicated appendicitis group, preoperative WBC, neutrophil count and NLR values were found to be statistically significantly higher, while the lymphocyte count was lower. There was a significant difference between complicated and uncomplicated appendicitis in terms of NLR values, 8.78 ± 5.87 and 6.33 ± 4.34, respectively, p<0.001.
DISCUSSION AND CONCLUSION: To predict a complication such as perforation or gangrene in acute appendicitis, the surgeon can benefit from personal experience, radiological imaging methods, and laboratory parameters. NLR, neutrophil, and lymphocyte counts seem to be very helpful in this regard.

INTRODUCTION: This research was conducted to examine the relationship between nursing students' smartphone addiction and smartphone in-class cyberloafing levels.
METHODS: The study is a descriptive, correlational research. The study sample consisted of state university nursing students (n= 370). The data was collected with descriptive information form, The Smartphone Addiction Scale-Short Version (SAS-SV), and The Smartphone Cyberloafing Scale in Classes (SPCSC) between 25.11.2022 and 15.12.2022.
RESULTS: It was determined that 49.4% of students spent five to seven hours on a smartphone a day, 80.1% expressed the purpose of using a smartphone in a face-to-face lesson as having fun; 54.9% of them used their smartphones during face-to-face lessons for purposes other than the lesson, 74.4% did not know the meaning of the word cyberloafing. The SAS-SV total score average of the nursing students was 30.61±10.96, SPCSC total score average was 42.41±18.19. There was a low-level positive correlation between SAS-SV total score and SPCSC total score and all SPCSC subdomains.
DISCUSSION AND CONCLUSION: It was found that half of the students spent five to seven hours a day on smartphones and were interested in smartphones out of class during face-to-face lessons. Most of them stated that they used smartphones for entertainment, most did not know the meaning of cyberloafing. It was concluded that the levels of smartphone addiction risk and smartphone cyberloafing in classes were at a moderate level, there was a low-level positive correlation between SAS-SV and SPCSC, and an increase in smartphone addiction risk would increase the level of smartphone cyberloafing in classes.

We present a case of phacocele that developed in an 83-year-old male patient with vision loss after discharge from the intensive care unit. The patient's initial examination revealed severe conjunctival chemosis and aphakia. In the posterior segment examination, vitreous hemorrhage was observed, and the lens could not be localized. In the second control of the patient, it was observed that chemosis decreased, perilimbal scleral perforation was observed between 11 and 13 oclock, and the iris tissue occluded the perforation. The crystalline lens was clearly visible in the nasal subconjunctival area. In the treatment, subconjunctival crystal lens was removed, scleral perforation was repaired, and iol implantation was performed with scleral fixation.

Lymphangioleiomyomatosis is a low-grade metastatic malignancy caused by defects in the TSC1 and TSC2 tumor suppressor genes, which activate a signaling pathway known as mammalian target of rapamycin (mTOR) in atypical cells. Sirolimus, an antibiotic, inhibits the mTOR pathway and stabilizes the disease, but cannot cure it. Sirolimus should be started as a first-line treatment option in patients with abnormal pulmonary function tests, pleural or chylous complications, or who require oxygen therapy, according to recommended guidelines. The effectiveness of sirolimus may be increased by the use of losartan, loratadine, zoledronic acid, simvastatin, and chloroquine. The side effects of sirolimus are generally mild and include nausea, diarrhea, stomatitis, acne, and hyperlipidemia. In end-stage lung disease, a lung transplant is an appropriate course of action.