INTRODUCTION: In this study, we aimed to compare the audiological results of patients who underwent bone cement (BC) and incus transposition (IT) to repair of incus long process (ILP) defects secondary to chronic otitis media (COM).
METHODS: The medical records of 130 patients who were operated due to COM and underwent ossicular reconstruction were analyzed. A total of 59 patients were enrolled in the study, including 23 patients who underwent BC and 36 patients who underwent IT, due to the ILP defect. BC was used for defects smaller than 2/3 of the length of ILP, while IT was preferred for larger defects.
RESULTS: The demographic data of two groups were similar (P>0.05). There was no significant difference between the two groups in terms of pre- and postoperative bone conduction thresholds (BCT), preoperative air conduction threshold (ACT), and air-bone gap (ABG). The postoperative ACT and ABG parameters were significantly better in the BC group (P=0.000). Additionally, postoperative hearing gain was significantly better in the BC group (P=0.042). The differences between the ABG values of both groups before and after surgery were statistically significant (P=0.001).
DISCUSSION AND CONCLUSION: Ossiculoplasty still appears to be a challenging problem for otological surgeons. Whatever technique is used, the functional condition of the middle ear is as important as the features of the material used in hearing gain to be obtained after surgery. In this study, the use of BC for repairing of ILP defects was found better than IT in terms of postoperative ACT, ABG and hearing gain.

INTRODUCTION: Autologous stem cell transplantation (ASCT) is an effective treatment option in patients with Multiple Myeloma (MM). There is a concern about development of cardiac complications following ASCT because of the chemotherapeutics which are used. In this study we aimed to evaluate late cardiac effects of ASCT in patients with MM.
METHODS: The patients who presented to the our institution with diagnosis of MM and underwent ASCT were studied retrospectively. Thirty cases who had routine pretransplant and posttransplant first year echocardiographic examinations were examined. The data of left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF), E wave, A wave and E/A index were collected.
RESULTS: The increase in posttransplant LVEF (mean±SD, 66.66±8.5 %) as a marker of left ventricular systolic function compared with pretransplant LVEF (62.46±4.51 %) was statistically significant (p=.013). In subgroup analyses, the increase in LVEF was greater in patients who underwent tandem ASCT (5.25±5.2 %) compared with did not (4.72±8.68 %), but the difference was not statistically significant (p=.872). There were significant decreases in posttransplant LVEDD (45.4±5.8 mm) and LVESD (27.3±4.9 mm) which was evidence of the amelioration of left ventricular diastolic dysfunction, compared with pretransplant LVEDD (48.9±4.1 mm) and LVESD (31.1±4.1 mm) (p=.044, p=.041, respectively).
DISCUSSION AND CONCLUSION: This is the first study in literature that demonstrated improved systolic and diastolic cardiac functions at late-term of ASCT in patients with MM. These results are important in terms of showing the systemic effect of stem cell during the course of ASCT.

INTRODUCTION: Renal transplantation is the optimal treatment in end-stage renal disease (ESRD). Even after succesfull renal transplantation, the health related quality of life (HRQoL) might be affected adversely by the long term complications of the primary disease. Additionally, immunosupressive treatment itself, adverse effects of the drugs have effect on HRQoLof patients, causing stress. HRQoL measurements in transplant patients are important in reflecting the success of immunosupressive treatment, patient compliance and graft function. The main objective of this study is to assess HRQoL in renal transplant patients and to determine the variables affecting it.
METHODS: This study was performed in nephrology department. 80 renal transplant patients, 42 hemodialysis patients and 35 healthy volunteers were included in the study. The patients were evaluated by KDQoL–SF questionnaire consisting of 38 questions answered by patients on their own. The healthy volunteers were evaluated with SF–36 health quality questionnaire.
RESULTS: There was a statistically significant correlation between the quality of life scores and younger age, adequate social support, comorbid factors, hospital admissions within last six months, number of medications used, serum albumin, haemoglobin levels and the duration of dialysis treatment. Good graft function was considered to be the most important parameter influencing the HRQoL scores.
DISCUSSION AND CONCLUSION: Younger age, adequate social support, higher albumin and haemoglobin levels are positive predictives of better HRQoL scores. Presence of comorbid factors, hospital admissions, polypharmacy, longer duration of dialysis treatment are negative predictives of lower HRQoL scores. Periodic assesment of HRQoL should be included in the follow-up protocols of transplant patients.

INTRODUCTION: In chronic kidney disease (CKD) patients, serum levels of ischemia-modified albumin (IMA), are found to be higher compared to the normal population. As oxidative stress increases, nitric oxide (NO) production reduces linked to endothelial dysfunction. Magnesium (Mg) increases NO production by endothelium. The aim of the study was to compare serum IMA, NO, and Mg levels in patients with CKD (stage 1-4).
METHODS: The study included 29 CKD patients with stage 1-4. Additionally, a control group comprised 40 healthy volunteers. Serum IMA, NO, and Mg testing was performed in both groups. Serum Mg was analyzed with the colorimetric method, IMA was analyzed with the rapid colorimetric method, while NO was analyzed with ELISA. Statistical significance was accepted as p < 0.05.
RESULTS: Serum IMA levels were significantly higher in the patient group than in the control group. (p=0.023), while there were no differences between the groups in terms of serum NO and Mg (p>0.05). In the patient group a statistically significant and positive correlation was identified between serum IMA and NO (p=0.023, r=0.421). There was no statistically significant correlation between serum IMA and Mg (p=0.96). There was a statistically significant and negative correlation between serum NO and Mg (p=0.02, r=-0.43).
DISCUSSION AND CONCLUSION: Examination of the serum NO and Mg levels in CKD patients (stage 1-4) was not found to be beneficial to predict oxidative stress.

INTRODUCTION: The aim of this study is to determine Diffusion Tensor Imaging (DTI) findings of normal-appearing brain anatomic localizations in Multiple sclerosis (MS) patients. Additionally, volumetric analysis of white and gray matter and correlation with EDDS were performed to interpret structural, functional, and clinical damage in MS patients.

METHODS: 32 patients with relapsing remitting MS diagnosis according to McDonald 2010 criteria and 24 healthy volunteers as the control group were included. 3T DTI-tractography and volumetric Magnetic resonance imaging (MRI) were performed in each group and conventional cranial MRI in MS group as well. Mean diffusivity (MD), fractional anisotropy (FA) values of tractography measurements of from various anatomic locations were obtained. EDSS were recorded in MS patients and correlated with DTI parameters and volumetric analysis.
RESULTS: FA and MD measurements from corpus callosum genu, body and splenium, fornix, bilateral forceps major, forceps minor, inferior longitudinal fasciculus, prefrontal cortex, thalamus areas revealed that FA values were decreased and MD values were increased in MS patients compared with that of the healthy control group. Grey and white matter volume values were significantly lower in MS patients group. Volumetric analysis and FA values from DTI analysis were not significantly correlated with EDSS in MS group. There was a significant correlation between MD values and EDSS in bilateral forceps major, prefrontal cortex, globus pallidus.

DISCUSSION AND CONCLUSION: Advanced MRI techniques such as DTI-tractography and volumetric MRI seem to make remarkable contributions to the evaluation of axonal degeneration in MS.

INTRODUCTION: The aim of this study was to evaluate the effects of angiotensin-converting enzyme inhibitor (ACEI) therapy on mortality and morbidity in patients undergoing coronary artery bypass grafting (CABG) operation
METHODS: Hospital records of patients undergoing CABG surgery were evaluated retrospectively. Demographic characteristics, comorbidities, functional classification and post-operative complications of patients were recorded
RESULTS: 42 women and 101 men, totally 143 patients were included in the study. There were 65 cases, mean aged 59.8 ± 8.86 years in non-user group and 78 cases, mean aged 58.15 ± 8.59 years in ACEI user group. When pre-operative specialties of groups were evaluated; there were no statistically significant difference of diabetes mellitus, hyperlipidemia, smoking habits, pre-operative and recent myocardial infarction, chronic obstructive pulmonary disease and New York Heart Association classification between groups (p>0.05). Hypertension and unstable angina pectoris frequency were statistically significant high in ACEI group (p>0.05). There was no statistically significant difference of post-operative complications and mortality between groups (p>0.05), but post-operative major events were higher in ACEI groups than non-users (p=0.007). Duration of stay in intensive care unit was long in 50% of patients in ACEI group. There was a statistically significant difference for duration of intensive care unit among groups (p=0.012).
DISCUSSION AND CONCLUSION: Pre-operative therapy with ACEI is associated with a prolonged stay in intensive care unit even though there is no statistically significant difference of mortality and morbidity between ACEI user and non-user groups.

INTRODUCTION: Starting from the first months of 2020, Covid19 pandemia caused devastating burden on health systems through out the World casuing restrictions on treatment of chronic disesases and redirection of resources to the treatment of pandemia. For this reason the treatment of obesity and comorbidities has been hindered and follow-up of patients were not bein managed optimally. During and after the pandemia to prevent the weight recevidism and to manage the optimal follow-up patients the current situation should be determined.
METHODS: Here in this study we aimed to determine the pycho-social status, eaiting patterns and exercise protocols of post-bariatric surgery patients in social isolation who has been at least followed-up for 1 years.
RESULTS: We have studied the parameters from the two group of bariatric patients who underwent Roux-en-y gastric bypass (n=15) and sleeve gastrectomy (n=20) in Istanbul University Cerrahpasa-Cerrahpasa Medical Faculty where two different types of execise protocols ( aerobic exercise versus aerobic combined with progressive resistance training) has been applied. Thirty-five patients has been followed up for 8 weeks after the start of pandemia by telemedicine modallities and statistical calculations were made.
DISCUSSION AND CONCLUSION: Our preliminary resluts suggest that social isolation measures resulted in excess calorie intake and changed the eating behaviours of the post-bariatric patients mainly due to emotional stress. The use of telemedicine to determine the current situation is curicial to determine current situation and to prevent eaiting disorders and weight recevidism in post-bariatric patients.

INTRODUCTION: Laparoscopic Nissen fundoplication was the gold standard for gastroesophageal reflux disease but nowadays, robotic surgery is also safe and effective method too. No consensus currently exists regarding the use of robotic or laparoscopic surgery in.
The aim of the present study was to compare standard laparoscopic NF with the robotic NF approach in terms of the advantages and disadvantages of using each procedure.

METHODS: A patient group of 42 candidates for Nissen fundoplication. Of these, 28 were treated by traditional laparoscopy (Group I) and 14 by robotic surgery (Group II). The synchronization was provided in the two groups about age, gender and body mass index.
RESULTS: All patients underwent Hiatus hernioplasty and Nissen fundoplication. There were no conversions to open procedures and no in-hospital deaths. Mean operation time was 127.46± 42.04 minutes in group I and 253.57±42.48 minutes in group II. There were statistically significant differences in this parameter from groups I and II (p<0.001).
DISCUSSION AND CONCLUSION: RNF shows similar perioperative and postoperative outcomes compared with conventional laparoscopic NF in our study. This study has demonstrated that RNF is safe and effective method for treating GERD, but it prolongs the operation time.

INTRODUCTION: This study aims to evaluate the orthopedic forensic cases admitted to the emergency department (ED).
METHODS: Forensic cases admitted to the ED were analyzed retrospectively between June 01st, 2018 and June 30th, 2018 in a tertiary care setting. Patients who were not consulted to the Orthopedics clinic and with insufficient data were excluded. Age groups (0-18 years, 19-64 years, >64 years), gender (male, female), trauma etiology (traffic accidents, physical assault, penetrating injuries, falls, gunshot injuries, electrical injuries, dent injuries), surgical intervention requirement, presence of fracture, affected body part, hospitalization and mortality status were recorded from hospital information system, forensic reports, and patient charts.
RESULTS: A total of 3732 forensic cases were analyzed and 500 orthopedic cases were included in the study. Admission causes were as follows: traffic accidents (n=301, 60.2%), physical assault (n=136, 27.2%), penetrating injuries (n=15, 3.0%), falls (n=25, 5.0%), gunshot injuries (n=21, 4.2%), electrical injuries (n=1, 0.2%), dent injury (n=1, 0.2%). Reported injury sites were as follows: upper extremity (n=195, 39.0%), lower extremity (n=174, 34.8%), spinal colon (n=1, 0.2%), pelvis (n=21, 4.2%), multiple trauma (n=109, 21.8%). A total of 41 (8.2%) patients required hospitalization mortality was positive in 4 (0.8%) patients. Surgical intervention and fracture rates were statistically significant between patients over and under 65 years old (p=0.015 and 0.005, respectively; Chi-square test).
DISCUSSION AND CONCLUSION: The current study showed that the only factor related to fracture and surgical intervention was the age among forensic cases with a complaint of orthopedic injury.

INTRODUCTION: Publication rates, number of citations, and quality of journals publishing presentations in a congress are considered among important factors which defines the value of the congress. The purpose of this study is to evaluate publication rates and characteristics of oral and poster presentations of the first National Pediatric Orthopedics Congress in Turkey.
METHODS: We reached abstracts of oral and poster presentations of first National Pediatric Orthopedics Congress through the official web site of the Pediatric Orthopedic Society. Presentations were searched via scientific databases using author names. Studies; were evaluated in the context of the journal, time between congress and publishing, impact factor, Scimago point, and index of journal, number of citations, and first authors institution.


RESULTS: Between congress and time of this study, 36,7% of presented papers were published. Journals published oral presentations had an average impact factor of 1,524 (0,39-4,154) and Scimago point of 0,75 (0,265-1,57) at the time of the study. These values were for poster presentations; 1,051 (0,39-2,383) and 0,663 (0,355-1,129) respectively. Oral and poster presentations were published an average of 20,9 and 23,75 months after congress respectively. At the end of the four years, the number of citations of oral presentations were 0-25 and poster presentations 0-8. Affiliation of first authors of papers were 32 university hospital, 18 research hospital, 6 general state hospital, 5 private hospitals.

DISCUSSION AND CONCLUSION: A high percentage of orally presented papers and also posters progressed to original articles. Although the time from the presentation to publication was somewhat long, they appeared in high-quality journals.

INTRODUCTION: Headache is common in the world and the most common type is tension type headache (TTH). One of the three most common symptoms in patients with temporomandibular dysfunction (TMD). Painful TMD; it is strongly associated with other painful conditions such as primary headaches. In our study; TMD features and effects of TMD cognitive treatment on TTH were investigated.
METHODS: 50 patients of TTH were included in the study, 29 of them had painful TMD. In boths cases, they were asked to rate their pain with a visual analog scale (VAS). Cognitive behavioral therapy was recommended for 4 weeks. The effects of this treatment on pain control due to TMD and TTH were evaluated.
RESULTS: Decreases in TMD VAS measurements after TMD treatment were found to be statistically significant (p=0.002;p<001, p=0.001;p<0.01), in both episodic and chronic type TTH cases. Decreases in TTH VAS measurements after treatment were found to be statistically significant (p=0.007; p<0.01, p=0.016;p<0.05), in both episodic and chronic type TTH cases.
DISCUSSION AND CONCLUSION: In our study, the common pathophysiological basis of these two painful diseases, TMD’s cognitive treatment, both in the disease itself and the TTH shows that the improvement in severity

INTRODUCTION: We present the data for pediatric patients who were hospitalized, treated, and followed-up in a tertiary center for burn treatment for three years.
METHODS: The cases were examined for age, gender, causes of burns, the environment where the injury occurred, total burn surface area, the infection rate and agent, intensive care requirements, the number and types of operations and mortality rates.
RESULTS: Of the 145 children, 77 were female, and 68 were male. Second-degree burns were present in 131 patients (88%). Intensive care was required in 60% of the cases and surgical treatment was required in 88%. Infection was documented in 36 patients (24.8%). The most frequently isolated agent was Acinetobacter baumannii. A total of 1,192 operations were performed and split-thickness skin grafts were the most common operation. Three of the patients died.
DISCUSSION AND CONCLUSION: The study represents a detailed analysis of one of the largest samples of burn cases for this age group in the literature. Scalding with hot water at home was the most common cause of burns, which suggests that simple preventive measures and training programs can prevent most of the pediatric burns. The need for intensive care in 60% of the cases and for surgical treatment in 88% of the cases revealed that treatment and follow-up after burns should be done in specialized centers. It was concluded that increasing the number of healthcare centers equipped for caring burns may reduce the morbidity and mortality related to burns.

INTRODUCTION: The incidence of preoperative anemia in cardiac surgery patients was found to be 26% on average, up to a maximum of 30%. In this study, we aimed to evaluate the relationship between preoperative anemia incidence, mortality and perioperative complications in patients undergoing cardiac surgery.
METHODS: Adult patients undergoing coronary bypass surgery due to ischemic heart disease were included. Patient demographics, cardiac reserves, preoperative and postoperative Hemotocrit values, transfusion volume, complications and mortality rates were recorded. Other laboratory tests, type of surgery, re-exploration frequency, intensive care and hospital stay were recorded.
RESULTS: The data of 333 patients were evaluated in this study. The incidence of anemia was 43%. Eighty percent of patients received transfusion and 75% of blood transfusions were in anemic group. Perioperative bleeding amount was 715.7±452.3 mL, and the mean amount of bleeding was significantly higher in anemic group (p=0.000). Nine patients were reexplored. The use of Fresh Frozen Plasm in anemic group was higher (p=0.019). There was no difference between groups in terms of mortality, drainage, hospital stay and mortality.
DISCUSSION AND CONCLUSION: The incidence of anemia in the preoperative period was found high. Although our study did not lead to an increase in complications, the risks associated with blood transfusion exists. We believe that the awareness of preoperative anemia should be increased.

INTRODUCTION: Our aim is to determine the incidence of thrombotic complications that may be associated with discontinuation of preoperative anticoagulants in patients undergoing open heart surgery.
METHODS: The data of 512 adult patients undergoing elective open hearth surgery were evaluated. Patients treated with dual antiplatelet therapy were included and divided into two groups. Group 1 patients (n=255) have suspended their aspirin therapy prior to surgery. Group 2 patients (n=257) have not suspended. Demographics, cardiac reserves, preoperative and postoperative Htc levels, the types of anticoagulants, the transfusion of blood products, possible complications and mortality rates were recorded.
RESULTS: The demographics, the duration of surgery, hospital and internal care unit (ICU) stay, cardiopulmonary bypass (CPB) time, mortality rate, reexploration rate, the need for transfusion did not differ between groups. The amount of platelet suspension in antithrombotic group was significantly higher than in group without antithrombotic agent (p ˂ 0.05).
DISCUSSION AND CONCLUSION: Neither reexploration nor transfusion rates were different for cardiac patients on aspirin therapy. Therefore, aspirin did not increase the incidence of postoperative complications even for cardiac surgery, where heparinization and extra corporeal circulation are necessary. As aspirin has not a negative effect on patient outcomes, should not be discontinued in patients undergoing major surgery.

INTRODUCTION: In this study, we aimed to compare longitudinal incision versus transverse incision in surgical treatment of De Quervain’s tenosynovitis.
METHODS: Between December 2017 and May 2019, a total of 17 patients who were operated for De Quervain’s tenosynovitis were included. The patients were divided into two groups as Group 1 (n=9) undergoing longitudinal incision and as Group 2 (n=8) undergoing transverse incision. The recurrence rate and patient satisfaction were recorded. Postoperative complications including vessel and nerve damage, wound infection, scar formation, and limited range of motion of the joint were evaluated.
RESULTS: Of the patients, 12 (70.6%) were females and five (29.4%) were males with a mean age of 41.2 (range, 22 to 69) years. There were seven females and two males in Group 1 and there were five females and three males in Group 2. The mean follow-up was 10 (range, 8 to 14) months. No recurrence was observed in any of the patient groups. The rate of patient satisfaction was 100% in both groups. No significant surgery-related complication was seen. An evident scar formation was observed in only one patient in Group 2 (p=0.03).
DISCUSSION AND CONCLUSION: Surgical treatment of De Quervain’s tenosynovitis is an effective and safe method without recurrence or postoperative complications in experienced hands. Our study results suggest no significant difference between the longitudinal incision and transverse incision, except for hypertrophic scar formation through the transverse incision.

INTRODUCTION: Acute gastroenteritis is an inflammatory disease. Neutrophil / lymphocyte ratio (NLR), one of the inflammation biomarkers, may be compatible with the severity of the disease in patients with acute gastroenteritis. In this study, we aimed to determine whether NLR in the blood has an effect on hospitalization in children with acute gastroenteritis with rota and / or adenovirus antigen positivity in the stool.
METHODS: Between January 2018 and January 2019, 438 children admitted to the emergency department due to acute gastroenteritis and who were found to have rota and / or adenovirus antigen positivity were examined retrospectively.
RESULTS: 438 children with rota and / or adenovirus antigen positive in their stool were included in the study. There was a statistically significant difference between NLO and hospitalization of patients as well as between groups (p <0.001). NLR of inpatients was 2.60±3.73 and neutrophil lymphocyte ratio of outpatients was 4.23±5.37.
DISCUSSION AND CONCLUSION: In pediatric admissions due to acute gastroenteritis, there was a statistically significant difference in terms of hospitalization in NLR between the adeno and rotavirus antigen positivity in the stool and adenovirus antigen patients with antigen positivity.

INTRODUCTION: There is a broad spectrum of action against most coronaviruses and especially viruses, including SARS-CoV-2. While the hydroxychloroquine treatment recommendation in the national treatment guidelines was 5 days at the beginning of the pandemic, it was recommended as 10 days in cases where the clinic deteriorated under hydroxychloroquine treatment since 14 April.
In this retrospective, observational, single-center study, it was aimed to reveal the effect of hydroxychloroquine treatment duration on the day of hospitalization, mechanical ventilation requirement, duration, survival and cost in patients with COVID-19 in intensive care unit.
METHODS: Following the approval of the Ethics Committee, the data of the first 50 patients (Group 1) who received hydroxychloroquine for 5 days and the first 50 patients (Group 2) who received 10 days were included in the study. Patients' age, gender, additional diseases, COVID-19 testings, hydroxychloroquine treatment days, invasive mechanical ventilator requirement and duration, intensive care hospitalization day, mortality and costs were recorded.
RESULTS: The duration of hospitalization in patients in group 2 was longer than group 1 (9,4 days vs 13,8 days, p=0<0001). There was no difference between the groups in terms of mortality (68%, 62%, respectively, p=0.383). The cost of intensive care unit hospitalization was higher in Group 2.
DISCUSSION AND CONCLUSION: In this retrospective observational study, it was found that 10 days of treatment intake did not affect the need for mechanical ventilator and mortality, while extending the intensive care hospitalization period and significantly increasing its cost.

Celiac disease (CD) is a chronic, immune-mediated, autoinflammatory disorder that occurs in relation to intake of gluten in genetically predisposed patients. Celiac crisis (CC) is a medical emergency characterized by severe watery diarrhea, dehydration, electrolyte disturbances and metabolic acidosis. A 3-year-old boy was brought to our emergency department with poor general condition, profuse diarrhea and abdominal distention. Acute celiac crisis was diagnosed based on history, physical examination and laboratory tests. Intravenous fluids, magnesium, calcium, phosphorus and methylprednisolone therapy were administered. The use of steroid therapy should be considered in patients with persistent symptoms despite supportive measures. We aimed to draw attention to the potential risk of death associated with celiac crisis if not diagnosed and treated at an early stage, although it is a very rare occurrence.