INTRODUCTION: Systemic immune-inflammation index (SII) is an indicator of the inflammatory process. In this study we aimed to determine whether there is a relationship between the level of hearing loss and SII in patients diagnosed with idiopathic sudden sensorineural hearing loss (ISSHL), and to reveal whether SII has an indicator in the rate of improvement in hearing loss after treatment.
METHODS: Patients with ISSHL were included in the study. According to the audiometry performed before the initial treatment, the patients were divided into 3 groups (250, 500, 1000, 2000, 4000, 8000 Hz pure tone averages) below 40 dB defined as mild, between 40 and 80 dB defined as moderate and above 80 dB defined as severe.
RESULTS: In total 201 patients, 64 were in the mild hearing loss group, 115 in the moderate hearing loss group, and 22 in the severe hearing loss group. Multivariable logistic regression analysis revealed that higher SII [OR=1.002, 95% CI (1.001-1.003); p<0.001] associated with the severity of hearing loss. A statistically significant difference was found between the mean SII of the three groups (p<0.001). A negative correlation was found between improvement in hearing loss after treatment and SII levels. (R=-0.195, p<0.001). In addition, a negative correlation was found between the improvement in hearing loss and SII (R=-0.195, p<0.001).
DISCUSSION AND CONCLUSION: SII is an easily available and relatively cheap marker, was associated with the severity of hearing loss. In addition, it was also associated with the recovery of hearing loss.

INTRODUCTION: In this study, it was aimed to evaluate the relationship between the use of two different sodium glucose transporter 2 (SGLT-2) inhibitors, dapagliflozin and empagliflozin, and renal tubular injury, with type 2 diabetes mellitus patients obtaining levels of neutrophil gelatinase-associated lipocalin (NGAL) in serum and arylesterase in urine.

METHODS: Sixty patients diagnosed type 2 diabetes mellitus were enrolled in the study; 30 of these patients used dapagliflozin and 30 patients used empagliflozin. The serum NGAL levels of the patients were measured by sandwich ELISA method while urine arylesterase levels were studied by centrifugation.

RESULTS: No significant relationship was found between the considered SGLT-2 inhibitors and the occurrence of acute tubular damage. There was no significant difference in serum NGAL levels or urinary arylesterase levels between the dapagliflozin and empagliflozin groups. The levels of microalbuminuria were significantly decreased in both groups.
DISCUSSION AND CONCLUSION: It can be said that there is no significant relationship between SGLT-2 inhibitors and renal tubular damage, with no significant difference found between dapagliflozin and empagliflozin.

INTRODUCTION: We aim to evaluate fetal cardiac function and umbilical cord blood pro-BNP (pro-brain natriuretic peptide) levels in ICP (intrahepatic cholestasis of pregnancy).
METHODS: The study included 41 ICP cases and 41 controls. All participants were evaluated after 34 weeks of gestation. The pro-BNP levels in umbilical cord blood were assayed, and perinatal outcomes were compared between the groups.
RESULTS: In the ICP group SBA (serum bile acid) and pro-BNP levels were higher than the control group (p<0.001 and p=0.001). The left MPI (myocardial performance index) of ICP group was higher among the control group (p=0.043). A positive correlation was evaluated between the pro-BNP levels and MPI values (p<0.001).
DISCUSSION AND CONCLUSION: Both the high MPI values obtained via ultrasonography and the high pro-BNP levels detected in umbilical cord blood may be attributable to the adverse fetal cardiac effects of ICP.

INTRODUCTION: We aimed to investigate the relationship between serum HMGB-1 levels and the clinical course of COVID-19 disease.
METHODS: A total of 86 patients, 43 patients in each group, were included in the study. According to the Ministry of Health's COVID-19 Diagnostic Guide, patients were divided into 2 groups as mild/moderate pneumonia and severe pneumonia. In addition to routine tests, blood samples were taken for serum HMGB-1 level analysis. At the time of blood draw, all patients were within the first 14 days of symptom onset.
RESULTS: HMGB-1 (High mobility group box protein 1) level of the patients in the mild Covid-19 pneumonia group was 4233.84 pg/ml, and the serum HMGB-1 level of the patients in the moderate-severe pneumonia group was 4804.35 pg/ml. There was no significant difference between the two groups (P=0.146).
DISCUSSION AND CONCLUSION: We did not find a significant difference between the two groups in blood samples taken in the first 14 days from the onset of symptoms in COVID-19 patients.

INTRODUCTION: Famotidine has been suggested as a potential treatment for coronavirus disease 2019 (COVID-19). We compared the incidence of COVID-19 outcomes (i.e. death and need for oxygen therapy or intensive service use) among hospitalized patients who received famotidine therapy and those who did not.

METHODS: We conducted a retrospective cohort study using data from COVID-19 Ankara Bilkent City Hospital electronic health records. The study population was COVID-19 hospitalized patients aged 18 years or older.


RESULTS: A total of 99 patients, 52 male and 47 female, aged between 20 and 93, were included in the study. All patients received standard of care (SOC) medications (favipiravir, hydroxychloroquine, low molecular weight heparin, acetylsalicylic acid or dipyridamole). 63 patients received famotidine treatment.36 patients did not receive famotidine.47 patients had decreased saturation and needed oxygen therapy. 38 patients who received famotidine needed anti-inflammatory treatment.There were 53 patients with fever, 49 with headache, 52 with dyspnea, 65 with cough, and 31 with decreased taste. Compared to the patients who were not treated with famotidine, the oxygen requirement was found to be lower in the patients treated with famotidine (p1: 0.001), but the eosinophil value increased after the treatment (p1: 0.025).
While there were 10 patients who needed ICU (Intensive Care Unit), mortality developed in 8 patients. The mean hospital stay was 10.89±6.6 days.

DISCUSSION AND CONCLUSION: According to our study, treatment with famotidine achieved a better clinical outcome compared to the control group in severe COVID-19 illness, although no significant survival benefit was found. The eosinophil level was found to be increased after treatment with famotidine.There are studies in the literature showing that eosinophilia increases thromboembolism. We do not recommend the use of famotidine treatment in patients with COVID-19 who have high eosinophil levels, as this may further aggravate the clinical picture in COVID-19 patients.

INTRODUCTION: Pelvic floor disorders (PFD) are more frequently seen in women and impairs quality of life. The aim of this study was to find agreement between the clinical examination and magnetic resonance defecography (MRD) findings of female patients with PFD related symptoms and to discuss the findings of MRD in PFD.
METHODS: Seventy-six female patients with complaints of PFD and undergone MRD were included in the study. The pubococcygeal line was used as the reference line for pelvic organ prolapse evaluation in MRD. MRD and clinical examination findings were compared.
RESULTS: Agreement between the MRD and clinical examination findings concerning the presence of cystoceles, rectoceles, entero/peritoneocele was 75%, 50%, and 60.52% respectively. However, the agreement was weaker in terms of pelvic organ prolapse grading (44% for cystoceles, 32% for rectoceles). Since there was no uterine prolapse detected on clinical examination an agreement test for uterine prolapse could not be performed.
DISCUSSION AND CONCLUSION: MRD is complementary to clinical examination in terms of its ability to comprehensively evaluate all compartments simultaneously. MRD provides additional information to the clinical examination in patients with symptoms related to PFD and should be utilized, in symptomatic cases, if the clinical examination findings are negative or if multicompartmental pathologies are suspected.

INTRODUCTION: Autoinflammation and increase in free oxygen radicals due to maternal familial mediterranean fever (FMF) may affect fetal lung maturation and cause changes in fetal pulmonary artery Doppler parameters. We aimed to investigate the fetal pulmonary artery acceleration time/ejection time (PATET) ratio in the pregnancies complicated with familial mediterranean fever (FMF).
METHODS: This cross-sectional study included 32 pregnant women with FMF, and 64 gestational ages matched healthy pregnant women, between the 29-30 gestational weeks. Maternal characteristics and fetal ultrasonographic information were recorded. Fetal pulmonary artery acceleration time (AT) and ejection time (ET) were measured manually and PATET ratio were calculated in the study groups. The duration of the disease and the AT and PATET measurements were analyzed with the Pearson correlation test.
RESULTS: The study groups were similar in terms of maternal characteristics, gravidity, parity and gestational week at the time of examination. AT and ET values were found to be significantly shorter and PATET (AT/ET) was found to be significantly lower in pregnant women complicated with FMF. A moderately significant negative correlation was found between the time elapsed since FMF diagnosis and fetal pulmonary artery acceleration time. (r=-.566, p=.001) and PATET (r=-.533, p=.002)
DISCUSSION AND CONCLUSION: This is the first study to investigate the fetal pulmonary artery Doppler indices in the pregnancies with FMF. In the presented study, it was shown that FMF significantly shortened the fetal pulmonary acceleration and ejection time and significantly reduced the PATET ratio. In addition, as the time elapsed from the diagnosis of the disease increased, it was shown that the shortening in AT and the decrease in PATET were higher, with a significant moderate negative correlation between the duration of the disease and these values.

INTRODUCTION: First dorsal metacarpal artery flap (FDMAF) is thin, pliable, sensate flap which is useful in the restoration of the contour and sensation of the thumb. Although FDMAF stands out with many positive aspects, venous congestion and related flap losses are frequently reported in the literature. In this study, we evaluated the clinical results of our modification, which prevents venous congestion and facilitates the inset of the flap to the defect area, with retrospective patient analyzes. We aimed to share surgical anatomy, surgical technique, tips and key points to get good results.
METHODS: Between May 2016 and December 2019, 37 patients (32 males, 5 females) with thumb defects were included in the study. All patients were evaluated for flap size, defect size, sensory return, two-point discrimination(2PD), operation time, metacarpophalangeal (MCP) and interphalangeal (IP) range of motion.
RESULTS: All 37 flaps survived complately. Venous congestion was not observed in the other flaps. Semmes-Weinstein sensory test score: 4,36 (range, 3,84-5,1) in the flap, 4,62 range, 3,9-4,92) in the donor site. Mean two-point discrimination (2PD): 8.8 mm (range, 7-22 mm) in the flap, 12 mm in the donor area (range 10-14 mm). MCP range of motion of the operated thumbs was 82o (range, 70o-86o) and IP range of motion was 84o (range, 15o-88o).
DISCUSSION AND CONCLUSION: Modified kite flap is technically simple, and the learning curve is fast, even it may be performed with local anesthesia. Also it is a useful, reliable and sensory option for the thumb reconstruction. Our clinical results are encouraging.

INTRODUCTION: Reconstruction of soft tissue defects of the lower extremities is a major challenge for plastic surgeons, and reconstruction options are limited. In this study, we aimed to evaluated the results of reconstructing plantar defects with the medial plantar artery flap, which is a safe and simple method for reconstruction.
METHODS: This study included patients who underwent reconstruction with a medial plantar artery flap in 15 patients with plantar defects between February 2019 and June 2021.Anatomical landmarks were marked. The flap was elevated and the dissection was extended proximally to prevent tension.
RESULTS: All defects were successfully reconstructed without complications except in one of 15 patients (12 males, 3 females).Due to the dehiscence of both flaps, the patient underwent a second operation for successful reconstruction. All harvest sites were reconstructed with a split thickness skin graft from the thigh. The necrotized flap area was reconstructed with a split-thickness skin graft from the thigh, which was vacuum-assisted closed after debridement.
DISCUSSION AND CONCLUSION: All defects were successfully reconstructed without complications except in one of 15 patients (12 males, 3 females).Due to the dehiscence of both flaps, the patient underwent a second operation for successful reconstruction. All harvest sites were reconstructed with a split thickness skin graft from the thigh. The necrotized flap area was reconstructed with a split-thickness skin graft from the thigh, which was vacuum-assisted closed after debridement.

INTRODUCTION: The aim was to evaluate changes in sexual function and satisfaction after therapy in couples who applied with a provisional diagnosis of vaginismus.
METHODS: From December 2017 to December 2018, couples who applied with a provisional diagnosis of vaginismus at the Sexual Dysfunction Polyclinic of Hospital were assessed before and after therapy with the Female Sexual Function Scale (FSFI), the International Erectile Function Form (IIEF), and the Golombok-Rust Sexual Satisfaction Scale (GRISS), as well as the Beck Depression and Anxiety Form, and the results were recorded.
RESULTS: Forty-one couples who presented to the sexual dysfunction outpatient clinic with a diagnosis of vaginismus participated in the study. After treatment, there was significant improvement in GRISS scores in men and women, FSFI scores in women, and IIEF scores in men. Beck's depression scores decreased significantly in both men and women. In addition, Beck anxiety scores decreased significantly in women (p < 0.01, p < 0.01, p < 0.01, p < 0.01, p < 0.01, p < 0.01, respectively).
DISCUSSION AND CONCLUSION: After sex therapy, there was a significant improvement in GRISS scores in both men and women, FSFI scores in women, and IIEF scores in men. Depression scores decreased significantly in both men and women. In addition, anxiety scores decreased significantly in females. The improvement in male sexual function in sex therapy during vaginismus treatment compared to pretreatment is new information in the literature.

INTRODUCTION: The systemic immune-inflammation (SII) index provides information about the inflammatory status. Therefore, in the present study, we aimed to show the role of the SII index in patients with OSAS.
METHODS: Patients who were taken to a tertiary center for apnea, excessive daytime sleepiness, or snoring between May 2019 and December 2022 were analyzed. The SII index was calculated as follows: (neutrophil × platelet) / lymphocyte.
RESULTS: The study included 300 OSAS patients with an apnea-hypopnea index (AHI) of over 5 according to PSG.A control group of 106 people with an AHI of less than 5 was also part of the study. OSAS patients were separated into three groups according to their AHI: mild (5 ≥ AHI < 15), moderate (15 ≥ AHI < 30), and severe (AHI ≥ 30). The SII index had a larger area under the ROC curve for the presence and severity of OSAS than other CBC parameters (AUC for AHI 5 = 0.733 and AHI 30 = 0.699). After adjustment, multivariable logistic regression analyses revealed that the SII index, age, and BMI were independent predictors of OSAS [ORs (CI 95%) = 1.053 (1.030-1.076); p<0.001, 1.009 (1.006-1.012); p<0.001 and 1.360 (1.244-1.487); p<0.001], respectively.
DISCUSSION AND CONCLUSION: In our study, we showed that an increased SII index was associated with the presence and severity of OSAS. We believe that it can be used as a novel and important marker since the higher SII index provided relevant information regarding the presence and severity of OSAS patients.

Rhinoplasty is one of the most frequently performed cosmetic surgeries and it may cause serious complications. Although it is a non-sterile operation, infection develops in less than 1% of the cases due to the facial abundant blood flow. Herein, we present a case diagnosed with preseptal cellulitis accompanied with progressive edema and tenderness that developed in the nasal tip and nasal dorsum one week after the rhinoplasty operation. Group A ß hemolytic streptococcus was detected in the abscess culture, and the infection was treated successfully with antibiotics. Vital sequels and complications were prevented by early diagnosis and appropriate antibiotic treatment. The patient was discharged without any complications.