INTRODUCTION: An increased number of complications and adverse obstetric outcomes have been linked to excessive or inadequate gestational weight gain (GWG). Our goal is to evaluate perinatal outcomes in different groups of GWG.
METHODS: A retrospective analysis was conducted on a total of 547 women delivered between May 2022 and February 2023. The study focused on various outcomes including, gestational hypertension (GHT), preeclampsia, gestational diabetes (GDM), oligohydramnios, polyhydramnios, low birth weight (LBW), macrosomia, placental abruption, preterm birth, premature rupture of membranes, low APGAR scores, acute fetal distress, amniotic fluid with meconium, and cholestasis of pregnancy.
RESULTS: The occurrence of gestational hypertension, preeclampsia and macrosomia was found to be significantly higher in cases where excessive GWG was observed (p=0.009, p=0.014, p=0.002, respectively). Conversely, inadequate GWG was associated with LBW, placental abruption, and acute fetal distress (p=0.046, p=0.029, p=0.044 respectively). GWG below the guideline recommendations had an adverse impact on the APGAR score at the 5th minute (p=0.039).
DISCUSSION AND CONCLUSION: The findings of our research underscores the importance of monitoring GWG, as the risk of unfavorable perinatal outcomes significantly rises with extremes of GWG. These negative outcomes can be reduced by informing pregnant women about their ideal weight gain during followup.

INTRODUCTION: Freiberg’s disease is a rare osteochondrosis of the second or third metatarsal head causing pain, swelling, and stiffness. Although early-stage disease may respond to conservative treatment, advanced stages often require surgery. This study compared the radiological, clinical, and functional outcomes of dorsal wedge osteotomy (DWO) fixed with absorbable bio-pins (ABp) or headless compression screws (HCS).
METHODS: This retrospective study included patients with Smilie stage 3 or higher Freiberg’s disease who underwent DWO between 2018 and 2023. Thirty patients (31 metatarsals) were analyzed. Patients with prior surgery, metabolic bone disease, or inadequate follow-up were excluded. Assessments included direct radiographs, MRI, Visual Analog Scale (VAS), European Foot and Ankle Society score (EFAS), SF-36, and range of motion (ROM). Statistical analysis was performed using non-parametric tests.
RESULTS: ABp fixation was used in 14 patients and HCS fixation in 17. The ABp group showed better postoperative ROM at 3, 6, and 12 months (p<0.05). SF-36 scores at 3 months were significantly higher in the HCS group (p<0.05). No significant between-group differences were found in VAS or EFAS. Complications included five superficial infections, one synovitis, and one nonunion requiring revision surgery. Patients with Smilie stage 4 had better postoperative ROM and EFAS improvement than those with stage 5.
DISCUSSION AND CONCLUSION: Both ABp and HCS provided effective fixation in DWO. ABp was associated with better postoperative ROM, whereas HCS showed earlier improvement in SF-36. Larger prospective studies are needed to determine the optimal fixation method.

INTRODUCTION: Syncope is an important health problem and the most common cause is vasovagal syncope. In our study, we evaluated if it is possible to make a certain diagnose by identifying the autonomic dysfunction with the non-invasive test (COMPASS-31) in patients with vasovagal syncope without using further examination techniques.
METHODS: Tilt-table test was performed in 47 patients with syncope included in the study. The COMPASS-31 questionnaire was administered before the tilt-table test, and the scores were recorded. The COMPASS-31 scores were then compared between patients with positive and negative tilt-table test results.
RESULTS: Tilt table test was positive in 34 patients (%72) and negative in 13 patients (%28). COMPASS-31 scores were higher in tilt table test positive group but the difference wasn't significant statistically [29.34 (18.33-41.86) - 22.62 (9.98-36.53)] (p=0,175). Difference, even it was still non-significant, was closer to the statistically significance after exclusion of postural orthostatic tachycardia syndrome (POTS) patients (n: 3) from tilt table negative group [29.34 (18.33-41.86) - 21.33 (7.31-29.62)] (p=0,058). In this analyse, pupilomotor dysfunction score was significantly higher in tilt table test positive group [2 (1-2.64) - 1 (0.75–1.4)] (p=0,047).
DISCUSSION AND CONCLUSION: The non-significant difference of COMPASS-31 scores between the two groups were thought to be due to the limitation of the enrolled patient number in our study. But we think that our study will be an origin for further and extensive studies for the use of COMPASS-31 as a tool of diagnose in patients with vasovagal syncope.

INTRODUCTION: The aim of our study is to identify hyperlipidemia cases in children, to make the differential diagnosis of primary and secondary hyperlipidemia, evaluating mutations detected in primary hyperlipidemia cases examined genetically.
METHODS: A retrospective study was conducted on 283 patients diagnosed with hyperlipidemia who were followed up in the pediatric metabolism clinic between 2009 and 2016.
RESULTS: Among the 283 patients, the mean age was 8.6 ± 3.7 years, and 52.6% were male. 50.9% of the patients had primary hyperlipidemia. The most frequent primary diagnoses were familial combined hyperlipidemia (43.8%) and heterozygous familial hypercholesterolemia (4.6%). Genetic mutations were detected predominantly in the LDLR gene, while APOB and PCSK9 variants were rare. The most secondary causes included obesity, hypothyroidism, and insulin resistance. HDL levels were found to be significantly lower in obese patients (p<0.001). Primary hyperlipidemia was more common between the ages of 0-4, while secondary hyperlipidemia was more common between the ages of 5-14.
DISCUSSION AND CONCLUSION: Primary hyperlipidemia constitutes a significant portion of childhood dyslipidemia. Genetic testing, particularly for LDLR variants, supports accurate diagnosis and early treatment. Differentiating it from secondary causes is vital in clinical practice.

INTRODUCTION: To retrospectively evaluate medicolegal deaths in Samsun in 2024, analyzing causes, demographic distribution, and seasonal variation to inform forensic and public health approaches.
METHODS: A total of 482 autopsy cases performed between January 1 and December 31, 2024, were reviewed. Data from official forensic reports included demographics, type of incident, type of death, and definitive cause. Statistical analysis was conducted using SPSS 21.0. Nonparametric tests compared continuous variables; Pearson’s chi-square test (with Yates correction when needed) assessed categorical variables. Significance was set at p<0.05.
RESULTS: Median age was 40 years (0–95); 77.8% were male. Natural deaths comprised 32.6% of cases; 67.4% were due to external causes. Most frequent incidents were sudden illness (24.5%), traffic accidents (22.6%), and unwitnessed deaths (21.8%). Traumatic causes led (47.1%), followed by cardiovascular diseases (25.7%) and asphyxia (15.6%). Multiple blunt trauma (28.0%) was the most common traumatic cause. External-cause deaths were significantly more frequent among males (p=0.002). Natural deaths predominated in winter (p=0.011), while traumatic and asphyxial deaths peaked in summer (p=0.002). Median age was higher in natural deaths (58 years) versus external-cause deaths (33 years) (p<0.001).
DISCUSSION AND CONCLUSION: Most medicolegal deaths in Samsun in 2024 were from external causes, especially traumatic injuries, with clear seasonal and demographic patterns. Findings underline the need for targeted preventive measures, including enhanced traffic safety and seasonal risk reduction strategies.

INTRODUCTION: To compare the diagnostic accuracy of transvaginal ultrasonography (TVUS) and diagnostic hysteroscopy (DH) in detecting endometrial pathologies, including polyps, myomas, and intrauterine adhesions.
METHODS: This retrospective cohort study included 300 women aged 20–65 years who underwent DH for suspected endometrial pathologies between January 2015 and March 2017. Patients with both hysteroscopic and histopathological diagnoses were analyzed. TVUS was performed in outpatient settings, and DH was conducted under general anesthesia with biopsy as needed. Sensitivity, specificity, positive likelihood ratio (LR+), and negative likelihood ratio (LR−) were calculated for each method.
RESULTS: DH demonstrated superior diagnostic accuracy compared to TVUS. Sensitivity and specificity for abnormal findings were 92.78% and 67.50% for DH, versus 88.57% and 41.74% for TVUS. For detecting endometrial polyps, DH had a sensitivity of 88.97% and specificity of 69.03%, compared to 61.54% and 64.63% for TVUS. DH also showed 100% sensitivity for intrauterine adhesions, significantly outperforming TVUS (33.33%). Complications associated with DH were minimal, and its ability to enable biopsy provided added diagnostic confirmation.
DISCUSSION AND CONCLUSION: While TVUS is a valuable non-invasive tool for initial evaluation, DH offers superior diagnostic performance, particularly for specific conditions like intrauterine adhesions and polyps. A combined approach, utilizing TVUS for initial screening and DH for inconclusive or complex cases, may optimize patient outcomes and resource allocation.

Heterotopic pregnancy is a rare condition following spontaneous conception, characterized by the simultaneous presence of intrauterine and extrauterine pregnancies. This report describes a case of spontaneous heterotopic pregnancy in a patient with no identifiable risk factors and highlights the diagnostic challenges of this unusual presentation. A patient admitted with acute abdominal pain and vaginal bleeding was found to have a 7-week intrauterine pregnancy with fetal cardiac activity, as well as an adnexal ectopic pregnancy and free pelvic fluid on ultrasound. Emergency laparotomy revealed a ruptured fallopian tube, and a left salpingectomy was performed; the diagnosis was confirmed histologically. The occurrence of a ruptured heterotopic pregnancy without risk factors and the misleading clinical presentation in this patient underscore the importance of maintaining clinical suspicion even in natural conceptions. Early recognition and thorough ultrasonographic evaluation are essential to prevent life-threatening complications.

Deep sternal wound infections (DSWI) after cardiac surgery are difficult-to-treat complications of median sternotomy that significantly increase mortality. The presence of diabetes mellitus as one of the underlying causes of DSWI makes its treatment even more difficult. In the challenging management of its treatment, beyond the combination of antibiotic therapy, open dressing and surgical interventions, new treatment technologies such as negative pressure wound therapy (NPWT) and autologous whole blood clot (WBC) provide promising results. In the literature, there are only a few studies and case reports regarding the use of NPWT and autologous WBC in mediastinal and thoracic wounds, indicating that they allow for faster wound healing and earlier rehabilitation, and reduces mortality in the long term. This case report describes the successful treatment of sternal dehiscence and DSWI that occurs after coronary artery bypass surgery in a patient with high comorbidities, mortality and morbidity risk.