INTRODUCTION: Increased stress levels associated with COVID-19 can lead to irregularities which can increase emotional eating or overeating symptoms before and after bariatric surgery. The aim of this study was to investigate the mental health effects of the COVID-19 pandemic on changes in amounts and eating plans, and levels of physical activity in bariatric surgery patients. Evaluations were also made of the interaction of these changes with work programs and social experiences.
METHODS: Data were collected from an online questionnaire delivered to 75 patients who underwent surgery because of obesity between July 2018 and March 2020. Evaluation was made of sociodemographic characteristics, and a 30-item questionnaire which included the Coronavirus Anxiety Scale (CAS), the International Physical Activity Scale – Short Form (IPAS-SF) and the Moorehead-Ardelt Quality of Life Scale II (MA-II)
RESULTS: The patients comprised 44 (58.6%) females. The CAS levels indicated a high level of anxiety in only 3 patients. The most common physical activity was reported to be walking. According to the MA II test, 5 (6.7%) patients reported poor quality of life.
DISCUSSION AND CONCLUSION: It is important to determine the levels at which postoperative bariatric surgery patients are affected by pandemic measures such as curfews and quarantine to be able to establish support strategies that can be delivered remotely online.

INTRODUCTION: In this study,the effectiveness and side effects were compared between the standard (long contact) and short contact use of clindamycin+tretinoin combination in the treatment of mild to moderate acne vulgaris.
METHODS: The study was approved by the hospital’s nonclinical Ethics Committee.A total of 480 subjects were enrolled in the study and each group contained 240 subjects who were diagnosed with mild to moderate acne and treated with the combination of clindamycin+tretinoin between 01.09.2020-31.03.2021.Short contact users rinsed away the drug after 1 hour while standard users applied the drug at night,kept it until the next morning and then rinsed off.
RESULTS: There was a statistically significant difference between the groups in terms of ISGA score and percentage reduction in the score (p 0.013).The average ISGA score was lower and percentage improvement in ISGA score was higher in the standard group.Number of lesions showed greater improvement in the standard use group (p <0.001).There was a difference between the two groups in terms of side effects by the end of 1st month (p <0.001).Side effects were higher in standard application group.
DISCUSSION AND CONCLUSION: The fact that the standard application was found to be more effective than the short contact application,that the side effects were more common in the standard group at the end of the first month,and that they decreased and equalized with the other group in the following months,suggests that starting the treatment with a short contact application and then returning to the standard application would be more efficient in terms of effectiveness and side effects.

INTRODUCTION: Postoperative pancreatic fistula (POPF) after pancreatectomy can cause major complications. The aim of this study is to evaluate the risk factors affecting POPF after distal pancreatectomy (DP) and to discuss its clinical significance.
METHODS: Thirty-seven patients who underwent distal pancreatectomy between January 2015 and January 2021 at Sakarya University Training and Research Hospital were retrospectively analyzed. Demographic characteristics and clinical parameters of the patients were evaluated using analyzes to determine the risk factors causing POPF. p< 0.05 was considered statistically significant.
RESULTS: POPF was observed in 20 (54.05%) of 37 patients, while POPF was not observed in 17 (45.94%) patients. No effect of the patient's gender, age, preoperative serum-based inflammatory indicators, subcutaneous adipose tissue size, perinephric adipose tissue size, and psoas muscle area on POPF was observed. It was determined that pancreatic duct diameter greater than 2 mm increased POPF (p=0,009).
DISCUSSION AND CONCLUSION: POPF is a common complication after distal pancreatectomy. Pancreatic duct diameter greater than 2 mm may increase the risk of POPF.

INTRODUCTION: Identifying the stroke risk factors and controlling them with treatment at an early stage reduce the risk of stroke. In case of recurrent stroke, disability and mortality rates increase significantly. Our aim in this study is to evaluate the risk factors and awareness of risk factors in stroke patients.

METHODS: This study enrolled 96 patients with a history of stroke, who presented to the Harran University Faculty of Medicine Department of Neurology between October 2017 and March 2018. A questionnaire was applied to question the patients’ age, gender, risk factors (hypertension (HT), diabetes mellitus (DM), cardiovascular disease (CVD), atrial fibrillation (AF), dyslipidaemia, family history of stroke), regular outpatient follow-up, medication use, comorbid diseases, awareness of risk factors and the knowledge about the disease.

RESULTS: 96 stroke patients were included in the study. HT, smoking, DM, CVD, hyperlipidemia, family history of stroke, and AF were determined as risk factors, respectively. Forty-eight (50%) of the patients were not aware of their stroke risk factors, 42(43.75%) did not go to a regular neurologist for control, 42(43.75%) did not use preventive treatment for stroke regularly. It was learned that 28(29.17%) of the patients had recurrent stroke attacks.

DISCUSSION AND CONCLUSION: We can say that healthcare professionals should take a more active role in the education of patients with a high risk of stroke. Awareness campaigns are needed to highlight the relevance of stroke symptoms to disease, the need for treatment of modifiable risk factors, and how preventing delays in hospital admission is associated with a more favorable prognosis.

INTRODUCTION: Primary spontaneous pneumothorax (PSP) is the most common type of pneumothorax seen in adolescents. The aim of this study was to evaluate the results of PSP treatment in the adolescent age group in our clinic.
METHODS: In this study, the records of patients aged 14-18 years who were diagnosed with PSP at our center between March 2012 and March 2022 were retrospectively reviewed for age, sex, presenting complaints, diagnostic methods, pneumothorax rates, treatment methods, duration of stay, tube length of hospital stay, and outcomes.
RESULTS: : Of the 82 patients who were followed up, 72 (87.8%) were male and 10 (12.2%) were female. Conservative treatment was administered to 48 patients in all cases. Tubes were inserted in 34 (41.5%) patients. A chest tube was inserted once in 21 of the 34 patients, twice in 11 patients, and 3 times in 2 patients. Length of stay was recorded as chest tube for less than 3 days in 12 patients, 4-7 days in 16 patients, and more than 8 days in 6 patients. Video-assisted thoracic surgery (VATS) was performed in one patient. Open surgery was performed in 4 patients. Recurrence was observed in 32 (39.0%) of the 82 patients.
DISCUSSION AND CONCLUSION: Tube thoracostomy, which is both easy and effective, may be the first choice for the treatment of primary spontaneous pneumothorax. The choice of video-assisted thoracic surgery and open surgery should be based on the experience of clinicians and selected cases. We also believe that guidelines should be established as a standardized approach for the treatment of PSP

INTRODUCTION: Staged extubation sets are used as a current extubation strategy in difficult airway cases. Although useful for airway safety, it cannot be used when patients have symptoms of intolerance. We aimed to compare the efficiency and patient compliance of using the Cook staged extubation set, intubation catheter, and extubation wire separately in the extubation of the morbid obese patients having laparoscopic surgery.
METHODS: This study was performed on 30 patients who were planned for elective laparoscopic bariatric surgery. Patients were divided into two groups, where re-intubation catheter was used for the first (Group C) and extubation wire for the second (Group W). The heart rate (HR), mean arterial pressure (MAP), SpO2, end-tidal CO2 (ETCO2), pH, pO2, Parsiyel Arteriyel Oksijen Basýncý(PaCO2), and symptoms indicating patients’ intolerance, such as coughing and straining, were recorded.
RESULTS: The 0 and 15th minute SpO2, heart rate, and rate of coughing, the pH and PaCO2 values at the 0 and 15th minutes were found to be comparable, Although the 0 minute strain rate of the groups was similar, the 15th minute strain rate was found to be significantly lower in the catheter group. The 0 and 15th minute PaO2 values were found to be significantly higher in the catheter group (p: 0.011, p: 0.03, respectively).
DISCUSSION AND CONCLUSION: In the extubation of patients undergoing morbid obesity surgery, the re-intubation catheter of the Cook staged extubation set was found to be more advantageous in terms of patient compliance and hemodynamic response compared to the extubation wire.

INTRODUCTION: In this study, it was aimed to define the morphometric features of cerebral arteries in Alzheimer's patients and to reveal whether there is a difference between them and healthy individuals.
METHODS: MR angiography images of 30 Alzheimer's patients' and 30 healthy individuals' internal carotid artery length, internal carotid artery diameter, anterior cerebral artery length, anterior cerebral artery diameter, middle cerebral artery length, middle cerebral artery diameter were measured for the right and left sides. Statistical analysis of the obtained morphometric measurements was performed.
RESULTS: We found that right and left side internal carotid artery diameter, right side internal carotid artery length, right and left side middle cerebral artery length and diameter, right side anterior cerebral artery diameter measurements were smaller in Alzheimer's patients compared to the control group. There was no significant difference between the groups in the measurements of left side carotis interna length, right and left side anterior cerebral artery length, and left side anterior cerebral artery diameter.
DISCUSSION AND CONCLUSION: The morphometric data obtained will shed light on the early diagnosis of Alzheimer's Disease, which has no definitive treatment, and thus help take measures to prevent the progression of the disease, and will guide the treatment methods to be applied.

INTRODUCTION: In the literature, oral isotretinoin treatment has been reported to cause many ocular side effects. The aim of this study was to evaluate the effect of oral isotretinoin treatment on the central macular thickness (CMT), choroidal thickness, and retinal nerve fiber layer (RNFL) thickness by using the spectral domain optical coherence tomography (SD-OCT) device.
METHODS: A total of 45 patients receiving oral isotretinoin therapy were included in this prospective single-center study. The CMT, choroidal thickness, and RNFL thickness were measured with the SD-OCT device at baseline and at the end of the third month of oral isotretinoin treatment. Choroidal thickness measurements were performed at the subfoveal location and nasal and temporal to the fovea at a distance of 500, 1000, and 1500 µm.
RESULTS: No statistically significant difference was observed between the baseline and the third month of follow-up for the CMT and the subfoveal, and nasal and temporal 500, 1000, and 1500 µm choroidal thickness measurements (p=0.489, p=0.703, p=0.068, p=0.057, p=0.657, p=0.069, p=0.734, p=0.376, respectively). No statistically significant difference was present between the baseline and the third month follow-up in terms of the mean, superior, inferior, nasal, and temporal RNFL thickness values (p=0.453, p=0.446, p=0.670, p=0.379, p=0.086, respectively). No statistically significant relationship was found between the mean daily oral isotretinoin dose (24±4.96 mg/day) and the change in CMT, choroidal thickness, and RNFL thickness (p> 0.05).
DISCUSSION AND CONCLUSION: No toxic effects of 3-month oral isotretinoin treatment were observed on the CMT, choroidal thickness, and RNFL thickness.

INTRODUCTION: Invasive lobular carcinoma of the breast is a type of cancer with specific pathogenesis, clinical biology and growth pattern. In this study, we aimed to compare the survival rates between breast conserving surgeries (BCS) and mastectomy in invasive lobular carcinomas and to investigate the reliability of BCS.
METHODS: Data of patients who underwent breast surgery for invasive lobular carcinoma between January 2003 and October 2012 were analyzed retrospectively. The patients were divided into two groups: BCS and mastectomy. Disease-free survival and overall survival rates were compared.
RESULTS: 112 patients were included in the study. Total mastectomy was performed in 79 (70.5%) and BCS in 33 (29.5%). The mean age of the patients in the BCS group was 53.42±8.66 years and 55.23±12.19 in the mastectomy group (p: 0.002). Lymphovascular invasion was detected as a poor prognostic factor for disease-free survival and Ki-67 for overall survival. (p: 0.018 and p: 0.014, respectively). No statistically significant difference was detected between the groups in disease-free and overall survival.
DISCUSSION AND CONCLUSION: We suggest that breast conserving surgery with negative surgical margins and adjuvant radiotherapy can be safely performed in patients with invasive lobular cancer.

INTRODUCTION: Some patients with severe asthma experience frequent exacerbations associated with eosinophilic inflammation despite continuous treatment with high-dose inhaled corticosteroids (ICS) with or without oral corticocetroids (OCS). We wanted to analyse the effect of Mepolizumab, a humanised monoclonal antibody that binds to and inactivates interleukin (IL)-5, on asthma control test (ACT), peripheral blood eosinophil level (PBEV) and asthma attack in patients with severe eosinophilic asthma.
METHODS: Baseline clinical and demographic characteristics of 27 patients who were administered 100 mg mepolizumab subcutaneously (sc) every 4 weeks for at least 12 months for severe asthma were recorded. The annual number of asthma exacerbations PBEV and ACT changes before and after treatment were compared.
RESULTS: PBEV decreased significantly from a median of 910 (IQR: 885) cells/μL to 90 (IQR: 245), [p<0.001], asthma exacerbation decreased significantly from a median of 4 (IQR: 4) to 0 (IQR: 1) [p<0.001]) and ACT increased significantly from a median of 11 (IQR: 7) to 24 (IQR: 2) [p<0.001]. Mepolizumab led to a statistically significant reduction in PBEV and asthma exacerbations and an increase in ACT in all patients.
DISCUSSION AND CONCLUSION: Mepolizumab, which is used in the treatment of severe asthma with type 2 inflammation, is highly effective in reducing PEBV and asthma exacerbations as well as providing asthma control.

Kyphoscoliosis may be the reason for various difficulties in terms of both general and regional anesthesia. In this case report, the anesthesia method applied to a pregnant patient with advanced thoracolumbar kyphoscoliosis is presented. Spinal anesthesia was successfully applied to a pregnant patient with severe kyphoscoliosis in the thoracolumbar region by ultrasound guidance, who was scheduled for an elective cesarean section operation. Sensory block was obtained at the T-6 level in the patient who was placed in the supine position. No complications occurred during the intraoperative and postoperative periods. In conclusion, ultrasound guided spinal anesthesia may be a good option in kyphoscoliosis.