INTRODUCTION: Pain management before and after surgery is crucial for patients undergoing breast surgery. The erector spinae plane block (ESPB) is applied for postoperative analgesia in thoracic and abdominal surgical procedures. This study aimed to evaluate the effect of ESPB on postoperative pain and intravenous (IV) opioid consumption in patients undergoing breast cancer surgery.
METHODS: This retrospective cohort study was conducted following ethics committee approval. Data from patients who underwent breast cancer surgery between October 15, 2020, and April 30, 2022, were analyzed. Patients who received ESPB along with IV patient-controlled analgesia (PCA) were classified as Group 1, while those who received only IV PCA were classified as Group 2. IV morphine consumption and pain scores at postoperative 1st, 6th, 12th, and 24th hours were recorded in each group.
RESULTS: A total of 172 patients were included in the study. Morphine consumption at postoperative 1st, 6th, 12th, and 24th hours was significantly lower in Group 1 (1st hour p=0.042; 6th, 12th, and 24th hours p<0.001). Postoperative pain scores at postoperative 1st, 6th, 12th, and 24th hours were 4.68 ± 2.18, 3.79 ± 2.00, 3.51 ± 1.88, and 2.65 ± 1.68 in Group 1, compared with 6.09 ± 1.91, 4.78 ± 1.58, 4.14 ± 1.53, and 3.19 ± 1.36 in Group 2, respectively. Pain scores were significantly lower in Group 1 (1st and 6th hours p<0.001; 12th hour p=0.017; 24th hour p=0.006).
DISCUSSION AND CONCLUSION: ESPB significantly reduced postoperative opioid consumption and lowered postoperative pain scores compared to IV PCA in patients undergoing breast cancer surgery.

INTRODUCTION: Optimal patient positioning is critical for successful spinal anesthesia in cesarean deliveries. The cross-legged sitting position (CLSP) may enhance lumbar flexion and procedural success, yet its impact on maternal hemodynamics and neonatal outcomes remains underexplored.
METHODS: This retrospective cohort study evaluated 138 parturients who underwent elective cesarean section under spinal anesthesia in either CLSP (n=63) or traditional sitting position (TSP) (n=75). Demographic and obstetric variables, first-attempt success rate, conversion to general anesthesia, intraoperative hypotension, ephedrine use, and umbilical artery blood gas parameters were compared.
RESULTS: The first-attempt success rate was significantly higher in the CLSP group (100% vs 89.3%, p=0.018). Conversion to general anesthesia was observed only in the TSP group (2.7%). Rates of hypotension (34.9% vs 37.3%) and ephedrine use (30.1% vs 32.0%) were comparable (p>0.05). Neonatal Apgar scores and umbilical artery pH and lactate levels showed no significant differences between groups.
DISCUSSION AND CONCLUSION: The CLSP offers a procedural advantage by improving first-attempt success without compromising maternal hemodynamic stability or neonatal outcomes. Although maternal comfort was not objectively assessed, the lack of conversion to general anesthesia and higher technical success suggest that CLSP may provide a smoother anesthetic experience. These findings support the consideration of CLSP as a feasible alternative for enhancing spinal anesthesia success in obstetric practice. Further prospective studies evaluating maternal satisfaction and procedural ergonomics are warranted to confirm these benefits.

INTRODUCTION: Despite the use of numerous anesthetic methods during carotid endarterectomy operations, there is a lack of proven data regarding the superiority of any particular method. The purpose of this retrospective study was to evaluate the various types of anesthesia used in patients who underwent carotid endarterectomy for atherosclerotic carotid artery stenosis.
METHODS: After obtaining Ethics Committee approval, the data of 83 patients who underwent carotid endarterectomy operation between December 2012 and December 2020 were retrospectively analyzed. The patients were divided into three groups for evaluation: Group GA, Group RA and Group SA. The groups were compared in respect of age, gender, height, weight, American Society of Anesthesiology(ASA) score, type of anaesthesia, operation side, operation time, carotid clamping time, postoperative visual analog scale (VAS) scores, additional analgesic requirement, and one-month mortality.
RESULTS: No statistically significant difference was determined between the groups in respect of age, weight, height, ASA scores, operation side, carotid artery lumen stenosis grades, operation time, and length of hospital stay (p>0.05). Carotid clamping time was found to be significantly longer in Group GA than in Group SA (p=0.006). A significant difference was observed between the groups in the 6, 12, and 24-hour VAS scores, with scores being statistically significantly higher in Group SA compared to Group RA (p=0.030, p=0.030, and p=0.029, respectively).
DISCUSSION AND CONCLUSION: The results of this study demonstrated that in carotid endarterectomy operations, carotid clamping time was longer in patients under general anaesthesia, and more effective postoperative pain control was provided by regional anaesthesia than sedoanalgesia.

INTRODUCTION: Labiaplasty has become increasingly popular among women in recent years due to both aesthetic and functional expectations. This study aimed to evaluate patient satisfaction, sexual function, and complication rates following wedge labiaplasty.
METHODS: In this prospective study, 88 patients who underwent wedge labiaplasty by the same surgical team were included. Demographic data, surgical technique, and complications were recorded. All patients completed the Female Sexual Function Index (FSFI) and the Female Genital Self-Image Scale (FGSIS) before surgery and at 3 months postoperatively. Data were analyzed using SPSS version 25, with a significance level set at p<0.05.
RESULTS: The mean age of the patients was 37.8 ± 6.9 years. Aesthetic concerns were the primary motivation for surgery in 94.3% of cases. The wedge resection technique was used in 57.9% of patients. The most common complication was infection (5.7%). Postoperative FGSIS scores significantly improved (from 10.9 to 25.8, p<0.001). FSFI total scores increased from 15.8 to 28.2 (p<0.001), with statistically significant improvement across all FSFI subdomains.
DISCUSSION AND CONCLUSION: Wedge labiaplasty led to significant improvements in women's sexual function, genital self-image, and overall satisfaction. The low rate of complications and high satisfaction support the safety and efficacy of this surgical technique when appropriately indicated.

INTRODUCTION: Firearm injuries (FI) are the second leading cause of trauma-related deaths worldwide. Computed tomography (CT) is the preferred imaging modality for assessing trauma patients, including those with FI. Identifying pathological findings on CT and evaluating their prognostic value may help guide clinical management. This study aimed to investigate the prognostic significance of CT findings in patients presenting to the emergency department (ED) due to FI.
METHODS: This retrospective observational study included patients who presented to the ED of a tertiary hospital with FI. Patients without CT imaging, those under 18 years, with non-firearm trauma, missing data, or unavailable follow-up were excluded. Demographic data, injury characteristics, mode of ED presentation, laboratory parameters, and CT findings were recorded. Clinical outcomes including hospital admission, intensive care unit (ICU) admission, surgical intervention, and in-hospital mortality were assessed. Associations between CT findings and these outcomes were analyzed using appropriate statistical methods.
RESULTS: Logistic regression analysis was performed to identify CT findings independently associated with these clinical outcomes. Intracranial hemorrhage (OR 348.41, p < 0.001), hemothorax (OR 66.94, p = 0.011), and pneumoperitoneum (OR 24.06, p = 0.022) were independent predictors of in-hospital mortality. Pneumoperitoneum, extremity bone fracture, and extremity arterial injury predicted surgical intervention, while skull fracture, pneumoperitoneum, and extremity arterial injury predicted ICU admission.
DISCUSSION AND CONCLUSION: Pathological CT findings, particularly pneumoperitoneum, intracranial hemorrhage, and hemothorax are strong prognostic indicators in FI patients. Awareness of these findings can aid clinicians in risk stratification and guide timely decisions for surgical management and intensive care.

INTRODUCTION: Preeclampsia affects 3-8% of pregnancies, leading to serious maternal and fetal morbidity. The clinical significance and course of isolated gestational proteinuria (IGP) are unclear. The aim of this study was to determine the incidence of preeclampsia in pregnant women with IGP and to compare maternal and perinatal outcomes.
METHODS: Pregnant women with normotensive blood pressure admitted to our hospital due to IGP were followed until delivery and divided into two groups based on whether they developed preeclampsia. Patients with preeclampsia were subgrouped as severe or non-severe. Maternal characteristics, clinical and laboratory findings, and pregnancy outcomes were analyzed.
RESULTS: Of 117 women with IGP, 41 (35.0%) developed preeclampsia. Median 24-hour proteinuria was higher in the preeclampsia group (525 mg vs. 393 mg), but the difference was minimal (p = 0.067). Although severe maternal outcomes were similar, preeclampsia cases had significantly higher rates of preterm delivery, fetal growth restriction, low birth weight, and Neonatal Intensive Care Unit (NICU) admission (all p < 0.01). Fourteen of 41 preeclamptic patients (34%) met the severe criteria. Severe preeclampsia cases had the highest 24-hour proteinuria (p = 0.003) and the lowest gestational age and birth weight. NICU length of stay was also significantly longer.
DISCUSSION AND CONCLUSION: Although serious maternal complications are not significantly higher, neonatal outcomes are significantly worse in those who progressed to preeclampsia. Therefore, IGP should be considered a high-risk condition and requires close monitoring.

INTRODUCTION: Theaimofthisstudyistoevaluatehealth-relatedqualityoflife(HRQoL) inpatientswithacutelymphoblastic leukemia(ALL).
METHODS: Thisstudywasperformedduringout-patientvisitsofALLpatients,inJuly2013-November2017.ForassessmentofHRQoLofpatientsPedsQL4.0andSF36v2questionnaireswereused.Inadditiontocross-sectionalanalysesincludingoneobservationperparticipant,longitudinalwithin-subjectcomparisonswereconductedin33patientswhocompletedHRQoLassessmentsattwodistincttreatmenttimepoints.HighscoresshowedgoodHRQoL.Patientsinthemaintenance,survivorsinthefive-yearperiodaftertreatmentandlongersurvivorswereclassifiedasgroup I,IIandIIIrespectively.
RESULTS: A total of 111 patients were included in the study. Thirty-two patients participated in the study twice at different time points and were evaluated in different groups. The mean ages in Groups I, II, and III were 6.81 ± 5.00, 8.73 ± 5.05, and 14.73 ± 4.50 years, respectively. When the total PedsQL 4.0 scores of different age groups (5–7 years and 13–18 years) were compared with those of the healthy Turkish population, similar results were observed (74.63 vs. 70.5 and 76.95 vs. 79.94). However, parents’ scores were lower than those of both healthy adults and patients (65.35 vs. 80.86 and 62.43 vs. 82.5). Comparison of all PedsQL 4.0 subscale scores for patients and parents in Groups I, II, and III revealed no statistically significant differences. SF-36 v2 scores according to sexdidnotdiffersignificantlyfromthoseofthehealthyTurkishpopulation;however,mental health scores were lower in males compared to the healthy population (54.79 vs. 71), whereas physical functioning scores were higher in females (95 vs. 80.6). No significant differences in quality of life scores were observed among risk groups. When parents and patients were compared, no differences were found in the standard- and high-risk groups; however, in the medium-risk group, parents had lower social and school functioning scores than patients.
DISCUSSION AND CONCLUSION: This study shows that ALL patients in the maintenance treatment and survivors in the first remission have quite good HRQoL. But parents’ perception of their children’s HRQoL is impaired compared to patients/survivors. Psychological and social support for parents is required during and after treatment.

Alzheimer's disease (AD), the most common form of dementia, is rapidly increasing in prevalence worldwide due to aging. It is one of the leading serious health problems today, causing a decrease in the quality of life and loss of cognitive function. Impairments in glucose metabolism, which occur in the brain's energy production process, play a key role in the pathogenesis of Alzheimer's. In Alzheimer's disease, decreased expression or impaired function of GLUT-1 proteins limits neurons glucose uptake, leading to energy deficiency and synaptic dysfunction. This leads to beta amyloid accumulation and disruption of the tau mechanism, leading to the rapid progression of Alzheimer's. In this context, the potential importance of the ketogenic diet, which can provide an alternative energy source, emerges. While there is currently no definitive and approved treatment for Alzheimer's disease, approaches targeting modifiable risk factors are thought to have the potetial to slow the course of the disease. This review will address the potential effects of an individual's lifestyle, and particularly their eating habits, on the development of Alzheimer's disease. Additionally, the role of ketogenic nutrition in Alzheimer's disease will be examined due to its possible effects on brain-energy metabolism and cognitive functioning.

Changes in taste and smell due to medication use are frequently reported by patients and are frequently encountered in clinical practice. Infections, coronavirüs 2019 (COVID-19), medications or vitamin deficiencies, neurological disorders, tumors or problems with the central nervous system, psychosis, diseases such as Sjögren's syndrome, aging, and habits such as smoking are common causes of taste changes. This non-life-threatening side effect is often overlooked. Ageusia, which negatively impacts quality of life and eating behaviors, can also occur with psychotropic medications. No specific taste or smell changes associated with sertraline have been reported in the literature. This case report aims to highlight the possible alterations in taste that can occur with sertraline use.