How much information regarding gingival enlargement can we get from TikTok and YouTube?

AIMS: This study aimed to evaluate and compare the reliability and quality of the information about gingival enlargements on YouTube and TikTok. METHODS: Two popular video sites, YouTube and TikTok, were searched for gingival enlargement and gingival hyperplasia. The reliability and quality of the first 300 videos for each search term, which is 1200 videos in total, were evaluated by social media video content evaluation tools: Global Quality Score (GQS) for quality and modified DISCERN for reliability. RESULTS: Health professionals uploaded 68.6% of the videos on YouTube and 54.5% on TikTok. It was observed that 50% of TikTok videos and 65.9% of YouTube videos were educational. In terms of quality, 2.7% of the videos on YouTube are of excellent quality, while in TikTok there are no videos of perfect quality. TikTok videos had considerably more views, likes, viewing rates, and interaction index scores than YouTube videos (P < 0.01). CONCLUSIONS: The videos and pieces of information on YouTube are more reliable and accurate in terms of gingival enlargement when compared to TikTok. Nevertheless, it was discovered that videos on both platforms were of poor reliability and quality in general.

The relationship between the presence of scapula fracture and mortality and morbidity in cases with blunt thoracic trauma.

BACKGROUND: Scapula fractures (SFs) occur as a result of high-energy trauma and are significant in terms of life-threatening injuries. There are few studies showing the relationship between SFs and mortality and morbidity in patients with blunt thoracic trauma (BTT). Our study aims to investigate the relationship between SF and mortality and morbidity in BTT. METHODS: Adult patients admitted to the emergency department of Kahramanmaras Sutcu Imam University, School of Medicine with BTT between January 2019 and April 2021 were retrospectively scanned from hospital records. Patients' age, gender, trauma mechanism, additional organ injuries, need for intensive care, length of hospital stay, morbidity, and mortality rates were recorded. Statistical results were expressed as frequency, percentage, and mean±standard deviation (min-max). In comparisons between groups, p<0.05 was accepted as the significance level. RESULTS: Two hundred and thirty-eight cases were included in our study. The scapular fracture was present in 86 cases (36.1%). About 43% of the cases with SFs were falling from a height. Intrathoracic injuries accompanying SF were determined as rib fracture, lung contusion, pneumothorax, hemothorax, and sternum fracture, respectively (91.9%, 80.2%, 41.9%, 37.2%, and 15.1%). Extrathoracic injuries associated with SF were vertebral fractures, intracranial injuries, clavicle fractures, extremity fractures, and intra-abdominal injuries (18.6%, 16.3%, 12.8%, 10.5%, and 5.8%), respectively. When the groups with and without SF were compared, a statistically significant relationship was found between SF and the number of rib fractures, lung contusion, pneumothorax, and hemothorax (p<0.001, p=0.001, p=0.001, p=0.001). In extrathoracic injuries, there was a significant relationship between SFs and vertebral fractures, intra-cranial injuries, and clavicle fractures (p=0.004, p<0.001, p=0.005). There was no difference observed between the groups regarding sternum fractures, extremity fractures, and intra-abdominal organ injuries (p=0.288, p=0.682, p=0.261). In cases with accompanying SF, there was a significant difference in terms of length of hospital stay, need for intensive care, and mortality (p<0.001, p=0.001, p=0.002). CONCLUSION: The most common intrathoracic injuries accompanying SFs were rib fractures and lung contusion, and the most common extrathoracic injuries were vertebral fractures and intracranial injuries. Moreover, it was found that SF was highly correlated with length of hospital stay, need for intensive care, and mortality. The most common cause of mortality was found to be intracranial hemorrhage. Imaging of other systems is important in cases with SFs. Particular attention should be paid to head-and-neck injuries.

The Utility of Immature Granulocyte Count and Percentage on the Prediction of Acute Appendicitis in the Suspected Acute Appendicitis According to the Alvarado Scoring System: A Retrospective Cohort Study.

BACKGROUND: This study aimed to investigate the utility of immature granulocyte count and percentage on the prediction of suspected acute appendicitis according to the Alvarado scoring system and its effect on the need for computed tomography scanning. METHODS: Adult patients who had an Alvarado scoring system between 4 and 7 with the first imaging technique computed tomography were included and retrospectively analyzed. The immature granulocyte count and granulocyte percentage were obtained from the blood samples taken at the time of the patient's first admission to the hospital. RESULTS: A total of 652 patients were evaluated and 186 patients were included in the study. Acute appendicitis was not detected in computed tomography imaging of 121 (65%) patients (group N) and detected in 65 (35%) patients (group P). The mean immature granulocyte percentage in group N and group P were 0.314 ± 0.188 (0.00-1.40) and 0.364 ± 0.205 (0.05-1.00), respectively. The mean immature granulocyte percentage was similar between groups (P = .095). The mean immature granulocyte count was 33 ± 46/µL (0-50) in group N and 60 ± 85/µL (10-690) in group P. Immature granulocyte count was significantly higher in group P (P = .005). Univariate analysis results revealed that age and immature granulocyte percentage were not predictive factors for the presence of acute appen- dicitis in suspected cases (P > .05). On the other hand white blood cell, neutrophil-lymphocyte ratio, C-reactive protein, and immature granulocyte count were determined as predictive factors in univariate analysis and multivariate analysis. Receiver operating character- istic curve analysis of preoperative immature granulocyte percentage and immature granulocyte count values in the diagnosis of acute appendicitis: the cut-off value of immature granulocyte percentage was ≥0.35 and its sensitivity, specificity, positive predictive value, and negative predictive value were 44.1%, 72.1%, 71.1%, and 41.5%, respectively (area under the curve: 0.588; CI: 0.484-0.682). The cut-off value of immature granulocyte count was ≥35/µL and its sensitivity, specificity, positive predictive value, and negative predictive value were 66.1%, 73.6%, 71.9%, and 67.7%, respectively (area under the curve: 0.743; CI: 0.659-0.827) Conclusion: Immature granulocyte count is a predictive factor for acute appendicitis in patients with the middle-risk group according to the Alvarado score and may be useful for the selective use of tomography.

Are the immature granulocyte count and percentage important in continue medical treatment in acute appendicitis? A prospective, randomized, and controlled study.

BACKGROUND: Although appendectomy is still a curative therapy for acute appendicitis, medical treatment has come to the fore in uncomplicated cases. This study aimed to determine the importance of immature granulocyte (IG) count and percentage for the role of medical treatment success in uncomplicated acute appendicitis. METHODS: Acute appendicitis cases were prospectively registered between July 2019 and April 2020. Using ball drawing, patients were divided into two groups as medical treatment (Group M) and undergo appendectomy (Group A). Group M was divided into two subgroups as those who responded to medical treatment medically responded (MR) and failed medical treatment (MF) within 24 h of follow-up. Changes in IG count and percentage, C-reactive protein levels, neutrophil-lymphocyte ratio, and white blood cell count between initial administration and 24th h of follow-up were examined. RESULTS: Sixty-four patients who met the inclusion criteria were followed as 31 patients in Group A and 33 in Group M. At Sub-group MF 11 patients and Subgroup MR 22 patients were followed up. At the 24th h of the follow-up, the IG count and percentage were higher in the Group MF (for IG count: Between Group A and MF, p=0.002; between Group A and Group MR, p=0.111; and between Group MR and MF, p<0.001) (for IG percentage: Between Group A and MF, p=0.001; between Group A and MR, p=0.809; and between Group MF and MR, p=0.001). This decrease in the IG count and percentage suggests that the response to medical treatment was effective [for IG count: F (148.862) = 61, p≤0.001, η2=0.707] [for IG percentage: F (10.157) = 0.252, p≤0.001, η2=0.504]. CONCLUSION: IG count and percentage are effective for evaluating the success of medical treatment of uncomplicated acute ap-pendicitis and they guide in the decision to continue medical treatment of uncomplicated acute appendicitis.

Effect of the presence of rib fracture on mortality and morbidity in blunt thoracic traumas.

BACKGROUND: The aim of this study was to determine the effect of the presence of rib fracture on mortality and morbidity in blunt thoracic trauma (BTT). METHODS: Records of patients aged over 18 and admitted with BTT between January 2017 and October 2019 dates were ret-rospectively evaluated. Only patients with both BTT and rib fracture were included in the study. Age, gender, trauma mechanism, additional organ injuries, and need for intensive care unit of patients were identified. The total length of hospital stay, length of stay in the intensive care unit, treatment modalities, need for mechanical ventilator; blood and blood products, complications, and mortality rates for patients were recorded. RESULTS: One hundred eighty-six (73.8%) and 66 (26.2%) of 252 included patients were male and female, respectively. The most commonly seen trauma mechanism was motor vehicle accidents (51.4%). The mean age of patients was 52±12 (18-91). We identified that there was a significant association between hemothorax and non-thoracic additional organ injuries (p=0.024). There was no significant association between pneumothorax and additional organ injuries (p=0.067). The number of fractured ribs was significantly different between cases with and without hemothorax (p<0.001). There was also a significant difference between cases with and without pneumothorax in terms of the number of broken ribs (p<0.039). There was a significant difference between cases undergone thoracotomy and cases who did not undergo thoracotomy in terms of mean length of stay in the hospital (p<0.001). There was a positive correlation between the number of broken ribs and length of stay in the hospital (r=320, p<0.001). CONCLUSION: Increased number of rib fracture in BTTs increases morbidity and length of stay in the hospital.

Timeline of critically ill 2019 SARS-CoV-2 cases after onset of illness: Intensive care data from Turkey.

Introduction: This study aimed to evaluate the epidemiological, clinical, laboratory characteristics and treatment and clinical outcomes of severe COVID19 cases from a 3rd degree intensive care unit in Turkey. Materials and Methods: The study was conducted in a level three, 16-bed COVID intensive care unit. The investigation was planned as a retrospective and observational study. Patients who were admitted with COVID-19 pneumonia and respiratory failure in the intensive care unit between March 2020 and March 2021 and followed up due to critical illness were evaluated. Result: A total of 213 patients that were admitted to the intensive care unit with the diagnosis of COVID-19 pneumonia were included in the study. Median age of the patients was 66 (IQR 56.5-74) years, and 134 (62.9%) were males. One hundred and sixty-six (77.9%) of the patients had at least one comorbidity. Patients were followed up mainly with invasive mechanical ventilation [104 (48.8%)] and high flow nasal cannula [67 (31.5%)]. Median number of days was 7 (IQR 4-10) and included the first symptom onset to intensive care admission. The time to intubation was 9 (IQR 4-15) days, and the median day to intensive care discharge was 16 (IQR 11-23). After the symptoms started, first tocilizumab 9 (IQR 5-11) and pulse steroid treatment 8 (IQR 3-11) were found to be close to each other. In total, 95 (44.6%) of the 213 patients died. Conclusions: SARS-CoV-2 associated viral disease can progress after simple symptoms to hospital admission in a median of four days and to intensive care admission requiring intubation in a median of nine days. We believe that a better understanding of the clinical course of COVID-19 and its change between centers can be revealed through sharing information from different countries and centers.

Investigation of the Correlation between Meteorin-Like Protein (Metrnl) and Thiol Balance in COVID-19 Patients.

BACKGROUND: The aim of this study is to investigate the correlation between serum meteorin-like protein levels and thiol/disulfide balance in patients with COVID-19. METHODS: This is a prospective case-control study including 52 PCR-confirmed COVID-19 patients (group 1) and 34 controls (group 2). The present study included patients aged 18 and older who were admitted to the emergency department with symptoms of COVID-19. Meteorin-like protein levels were analyzed using the YL Biont ELISA Kits protocol. Thiol/disulfide balance was studied using the spectrophotometric method. RESULTS: There were 35 males and 17 females in group 1, and 20 males and 14 females in group 2. The groups were similar in terms of gender and age (p > 0.05 and p > 0.05, respectively). Meteorin-like protein was significantly lower in group 1 (p < 0.001). There was no difference between the two groups in terms of total thiol level (p > 0.05). Disulfide, disulfide/native thiol ratio, and disulfide/total thiol ratio were significantly higher in group 1 (p < 0.001, p < 0.001, and p < 0.001, respectively). Native thiol was higher in group 2 (p = 0.002). Native thiol/total thiol ratio was significantly higher in group 2 (p < 0.001). Disulfide, SS/SH%, SS/TT%, and SH/TT% parameters had remarkably high sensitivity (98.1% for them all) and specificity (85.3% for disulfide and 100% for SS/SH%, SS/TT%, and SH/TT%) in differentiating patients and healthy subjects. CONCLUSIONS: In this study, thiol/disulfide balance, which is an indicator of oxidative stress, was disturbed in the disulfide direction and meteorin-like protein was significantly lower in patients with COVID-19. Thiol/disulfide balance and metrnl may play a role in the pathogenesis of COVID-19.

A Diagnostic Dilemma for Acute Abdomen: Sclerosing Encapsulating Peritonitis (Abdominal Cocoon Syndrome); A Retrospective Cohort Study.

BACKGROUND: Sclerosing encapsulating peritonitis (SEP) is a rare cause of acute abdomen and can be easily misdiagnosed. Preoperative diagnosis of the SEP can be performed with preoperative imaging studies. We aimed to evaluate the clinical features of ileus cases who were diagnosed with primary or secondary SEP in the last five years. METHODS: This retrospective cohort study evaluated the patients who were admitted with ileus or acute abdomen symptoms to the Emergency Department of Elazig Training and Research Hospital and underwent surgery by the same surgical team of General Surgery Department between January 2014 and January 2019. Patients who were diagnosed with primary or secondary SEP were included. The demographic data, clinical presentation, whether the disease was primary or secondary, the treatment options performed and mortality rates were evaluated. RESULTS: SEP was observed in 11 of the patients. Ten patients underwent surgery (90.9%), and one patient (9.1%) was treated conservatively. Of the patients, six had secondary SEP (54.5%) and five had primary SEP (45.5%). In total, five patients were female (45.5%) and six were male (54.5%). The median age of the patients was 35 years (24-69). The median age of the patients with primary disease was 48 (29-69) years, while the median age of patients with secondary disease was 34.5 (24-64) years. One patient expired in the postoperative 8th hour. CONCLUSION: SEP should be considered in the case of recurrent abdominal pain attacks, especially in patients undergoing peritoneal dialysis, and it should be known that the mortality rate is high when misdiagnosed.

Early effects of viper envenomation on retina and optic nerve blood flow: An optical coherence tomography angiography study.

In this study, the early retinal and optic nerve blood flows of patients exposed to Viper bite were evaluated with non-invasive optical coherence tomography angiography (OCTA) and compared with healthy controls. The retinal and optic disc OCTA data of 31 victims of viper bite (group S) without systemic envenomation clinical symptoms and 31 healthy controls (group C) were compared. Only patients with early signs of envenomation were included in the study. Optical coherence tomography angiographies were performed with RTVue XR Avanti with AngioVue software. Vascular densities in the whole image, foveal, parafoveal regions at the superficial and the deep capillary plexus segments were acquired and statistically analyzed. The flow area parameters were measured in the superficial retinal capillary plexus, deep retinal capillary plexus, outer retinal capillary plexus, and choriocapillaris layers of the macula in 1-mm and 3-mm diameter areas. The peripapillary flow areas were measured for the optic nerve head, vitreous, radial peripapillary capillary (RPC), and choroid in a 4.50-mm diameter area. Foveal and parafoveal thicknesses were also measured and compared. The average hospital admission time of the patients in group S was 1.24 ± 0.75 (0.50-3.00) hours. Age (p = 0.103) and gender (p = 0.714) were similar in both groups. Superficial (p = 0.010), deep flow areas (p = 0.034), and superficial parafoveal vascular density (p = 0.001) were significantly reduced in group S compared to group C. The outer retinal flow area (p < 0.001) increased significantly in group S. Nerve head flow area (p = 0.035), one of the optic disc flow areas, was found to be decreased in group S. Notably, foveal (p < 0.001) and parafoveal (p = 0.003) thicknesses and superficial (p = 0.001) and deep (p < 0.001) foveal vascular densities were greater in group S. Compared to group C, the superficial (p = 0.009) and deep (p = 0.009) foveal flow areas in the central foveal area with a diameter of 1 mm increased significantly in group S. Viper venom may cause blood flow changes in the retina and optic disc and an increase in retinal thickness in the early period although there are no signs of systemic envenomation.

The effects of active warming on perioperative inadvertent hypothermia in patients undergoing vitreoretinal surgery under local anesthesia.

Purpose: Perioperative inadvertent hypothermia (PIH) is the decrease in core temperature below 36°C. We aimed to assess whether PIH develops in patients operated under local anesthesia (ULA) for vitreoretinal surgery in the operating room and investigate active warming efficacy. Methods: Seventy-two patients were divided into two groups: Group 1 contained unwarmed patients (n = 36), and Group 2, warmed patients (n = 36). The core temperatures, heart rate (HR), and mean arterial pressure (MAP) of the patients were measured at the beginning of surgery, after 20 min, 40 min, 1 h, at the end of the operation, and during the postoperative period. Results: PIH incidence was 44.6% in Group 1, whereas no hypothermia was observed in Group 2. Patient temperatures at 20 min (P = 0.001), 40 min (P < 0.001), 1 h (P < 0.001), the end of the operation (P < 0.001), and the postoperative period (P < 0.001) were significantly higher in Group 2 than in Group 1. Patient HRs at the end of the operation and during the postoperative period were significantly lower in Group 2 (P = 0.005) than in Group 1 (P < 0.001). The intraoperative 40th (P = 0.044) and 60th (P < 0.001) minutes, end of operation (P < 0.001), and postoperative MAP (P < 0.001) values of Group 1 were significantly higher than those of Group 2. Conclusion: PIH may develop in patients operated ULA, especially with a low ambient temperature. Actively warming may help prevent the harmful effects of PIH.

Serum amphiregulin and cerebellin-1 levels in severe preeclampsia.

PURPOSE: Preeclampsia is a form of hypertensive disorders of pregnancy and defined as the presence of new-onset hypertension and proteinuria or other end organ damage occurring after 20-week gestation. Preeclampsia can be a destructive process that can cause maternal and infant mortality. The exact etiopathogenesis of preeclampsia is still undefined. We aimed to compare serum amphiregulin and cerebellin-1 levels of severe preeclampsia patients with healthy pregnant women and healthy control subjects. MATERIALS AND METHODS: A total of 88 women were enrolled in this study. Patients diagnosed with severe preeclampsia were group 1 (n = 28), healthy non-pregnant normotensive women group 2 (n = 30), and healthy pregnant women group 3 (n = 30). The participants in each group were matched for age. Pregnant women in groups 1 and 3 were also matched for gestational age. Serum amphiregulin and cerebellin-1 levels were measured using ELISA. RESULTS: Serum amphiregulin levels were 3413 ± 1.38 ng/ml (1748-7739), 8510 ± 7213 ng/ml (2019-24,000), and 6580 ± 5360 ng/ml (2484-24,000) in preeclampsia patients, controls and healthy pregnant women, respectively. Amphiregulin levels were significantly lower in preeclampsia patients than healthy pregnant women (p=.008) and controls (p = .015). Amphiregulin levels were similar between healthy controls and healthy pregnant women (p = 1.00). Cerebellin-1 levels were 222.039 ± 92.681 pg/ml (138,580-557,757) in preeclamptic patients, 537.043 ± 525.117 pg/ml (150,432-1,600,000) in controls and 415.091 ± 436.580 pg/ml (137,284-1,600,000) in healthy pregnant women. Cerebellin-1 levels were similar among groups (p = .272). Serum amphiregulin and cerebellin-1 levels were significantly and positively correlated with each other in preeclampsia patients (r = 0.693, p < .001), controls (r = 0.882, p < .001), and healthy pregnant women (r = 0.591, p = .001). Serum level of amphiregulin ≤3590 pg/ml had a sensitivity of 67.9% and specificity of 63.3% in the diagnosis of preeclampsia (AUC: 0.751; p = .001). CONCLUSIONS: Serum amphiregulin decreases in severe preeclampsia patients.

Changes and disruptions in diagnosis, treatment and follow-up of breast cancer during two periods of the COVID-19 pandemic in Turkey.

OBJECTIVES: COVID-19 disease, which rapidly became a pandemic, led to significant changes in the provision of health services. This included radical changes to the supply and delivery of routine services to release resources for emergency care. During this process, a range of restrictions were imposed including the recommended rules to be followed before, during and after surgery. Health services provided for breast cancer diagnosis, treatment and follow-up have also undergone enforced changes meaning the diagnosis, treatment, and follow-up of patients with priority has come to the fore. In this study, the effect of the COVID-19 pandemic in Turkey, between March 11, 2020 and May 31, 2020 was assessed in comparison to pre-pandemic practice in terms of divided into two periods, and breast cancer diagnosis, treatment, and follow-up. MATERIAL AND METHODS: Surgeons dealing with breast cancer treatment and registered to SENATURK (Turkish Senology Academy) were contacted online. The period was divided into two, between March 11th and April 30th and May 1st to May 31st, 2020. Surgeons were requested to complete two electronic evaluation forms, one for each period, investigating change in practice. Only complete responses for both periods were included in the analysis. RESULTS: There were 93 respondents. Except for less multidisciplinary breast councils, there was no delay in radiological and pathological diagnoses. The number of breast cancer surgeries increased in Period 2, and more COVID-19 positive breast cancer patients were operated in Period 2. Benign breast patients were delayed less frequently in Period 2. In the statistical analysis performed between the two groups, it was found that only a significant difference was in the number of outpatients with benign breasts. CONCLUSION: With sufficient awareness of the risks of COVID-19 and with individual protection, breast cancer treatment was not affected during the assessed period of active pandemic in Turkey.

Are Retinal and Peripapillary Blood Flows Affected during Migraine Attack?

Migraine pathophysiology is complex and partially includes the vasculature. This study compared retinal and peripapillary blood flow parameters in migraine patients during an attack with healthy controls using optical coherence tomography angiography (OCTA). A prospective clinical study was conducted including 52 eyes from 26 migraineurs and 48 eyes from 24 healthy controls. OCTAs were performed with RTVue XR Avanti using AngioVue software. OCTA imaging was performed during the attack period in migraineurs before any treatment for the attack. Vascular densities in the whole image, fovea, superior hemisphere, inferior hemisphere, and temporal, superior, nasal, and inferior regions of the parafoveal area and in the superficial and deep capillary plexuses were acquired and statistically analysed. The flow density parameters were measured in the superficial retinal capillary plexus, deep retinal capillary plexus, outer retinal capillary plexus, and choriocapillaris layers of the macula in a 3-mm diameter area. The peripapillary flow densities were measured for the optic nerve head, vitreous, radial peripapillary capillaries, and choroid in a 4.50-mm diameter area around the optic disc. Vascular density measurements in the superficial plexus were similar between migraineurs and controls (p > .05). Vascular densities in the deep capillary plexus were similar between groups (p > .05), except in the deep superior area (p = .05). Flow areas in the nerve head, vitreous, peripapillary capillary, and choroid segments were similar between migraineurs and controls (p > .05). Macular thickness parameters were also similar between groups (p > .05). The results suggest that an acute migraine attack does not affect retinal or peripapillary blood flow.

Effect of initial antifungal therapy on mortality among patients with bloodstream infections with different Candida species and resistance to antifungal agents: A multicentre observational study by the Turkish Fungal Infections Study Group.

This study aimed to describe the effect of initial antifungal therapy on patient mortality and to detail the current distribution and resistance patterns of Candida spp. among patients with candidaemia. A prospective observational study was performed among consecutive patients with candidaemia from 10 Turkish medical centres between January 2015 and November 2018. The primary outcome was 10-day mortality. Species were identified using MALDI-TOF/MS. A total of 342 patients with candidaemia were included, of which 175 (51.2%) were male and 68 (19.9%) were aged <18 years. The most common species were Candida albicans (47.4%), Candida parapsilosis (26.6%), Candida tropicalis (9.6%) and Candida glabrata (7.6%). Among all Candida spp., the 10-day case fatality rate (CFR) was 32.2%. The CFR was highest in patients with C. albicans (57.3%) and lowest in patients with C. parapsilosis (21.8%). The resistance rate to fluconazole was 13% in C. parapsilosis, with no significant effect on mortality. No resistance to echinocandins was detected. In the multivariate analysis, being in the ICU [OR = 2.1 (95% CI 1.32-3.57); P = 0.002], renal failure [OR = 2.4 (1.41-3.97); P = 0.001], total parenteral nutrition [OR = 2 (1.22-3.47); P = 0.006], C. albicans infection [OR = 1.7 (1.06-2.82); P = 0.027] and echinocandin as primary agent [OR = 0.6 (0.36-0.99); P = 0.047] were significantly associated with mortality. Candidaemia is a deadly infection. Fluconazole resistance is emerging, although it was not significantly related to mortality. Using an echinocandin as the primary agent could be life-saving.

The value of ischemia-modified albumin and oxidative stress markers in the diagnosis of acute appendicitis in adults.

INTRODUCTION: The present study evaluates the predictive value of such markers as ischemia-modified albumin (IMA), malondialdehyde (MDA) and glutathione peroxide (GSH-Px), in addition to parameters associated with inflammation, oxidative stress and ischemia, playing roles in the pathology of acute appendicitis (AA), including c-reactive protein (CRP), procalcitonin (PCT) and complete blood count (CBC) parameters and their ratios, for the diagnosis of AA in adults. MATERIAL AND METHODS: The study included 51 patients with histologically confirmed appendicitis and 45 healthy controls who referred to the emergency care unit between January and June 2018. The appendicitis cases were classified into two groups, as complicated and non-complicated, based on postoperative pathological investigations. RESULTS: Of all the appendicitis cases, 68.5% (n = 35) were non-complicated and 31.4% (n = 16) were complicated. IMA (positive LR = 3.0, negative LR = 0.1), GSH-Px (positive LR = 0.5, negative LR = 1.8), MDA (positive LR = 1.8, negative LR = 0.6), CRP (positive LR = 7.2, negative LR = 0.2), PCT (positive LR = 0.7, negative LR = 1.3), WBC (positive LR = 2.9, negative LR = 0.3), neutrophil-lymphocyte ratio (positive LR = 3.2, negative LR = 0.1) thrombocyte lymphocyte ratio (positive LR = 1.6, negative LR = 0.5) and IMA/albumin ratio (positive LR = 3.3, negative LR = 0.1) levels in the appendicitis cases were evaluated by a characteristic receiver operating characteristic (ROC) curve. In addition, IMA levels were significantly higher in the complicated cases (0.40 ±â€¯0.05 AbsU) than in the non-complicated cases (0.29 ±â€¯0.04 AbsU) (p < 0.0001). CONCLUSION: Our results showed that IMA (negative LR = 0.1), CRP (positive LR = 7.2, negative LR = 0.2), NLR (negative LR = 0.1) and IMA/albumin ratio (negative LR = 0.1) can serve as important diagnostic biomarkers for AA patients. We therefore believe that before clinically confirming an AA diagnosis, these parameters may be used as diagnostic tools in addition to CBC parameters, CRP levels and radiological imaging studies.

A case of ectopic cilia.

Ectopic cilia are the most rare of cilial anomalies. We report a 27-year-old man who presents with tarsal conjunctival symptomatic ectopic cilia. On slit-lamp examination eversion of the lower eyelid demonstrated that several black-white cilia were protruding from the conjunctiva.

A novel DAX1 gene mutation in a Turkish infant with X-linked adrenal hypoplasia congenita.

Adrenal hypoplasia congenita (AHC) is a rare inherited disorder of the adrenal cortex commonly manifested as an early onset adrenal insufficiency syndrome. A novel DAX1 (NR0B1) gene mutation was detected in a Turkish newborn boy presenting with primary adrenal insufficiency. He was from a family with a history of unexplained death of three male siblings in the neonatal period. This report highlights the value of mutational analysis of the DAX1 gene for definitive diagnosis of AHC as well as for genetic counselling because this disorder shows an X-linked genetic pattern of transmission, providing the possibility of finding new cases even in presymptomatic individuals.

Meningitis due to Gemella haemolysans in a pediatric case.

Gemella haemolysans is a rare pathogen in cases of bacterial meningitis. We present a case of meningitis due to G. haemolysans in a 17-month-old boy. This is the first reported case of Gemella meningitis in a child. The patient completely recovered following intravenous therapy with linezolid and chloramphenicol.