Reduction of the femoral head to acetabulum for healthy development of dysplastic hip joint constitutes the basic principle of treatment. Success of concentric joint reduction and time without treatment determine the prognosis of the disease. The more delayed of the diagnosis causes to the lower potential for acetabular and femoral remodelization. This leads to difficulties in treatment and increased complications. In the early period, developmental dysplasia of the hip (DDH) is treated with cheap and easily applicable conservative methods. On the other hand, delayed cases are treated with methods that can progress to serious surgical procedures, have less chance of success and have higher risk of complications and costs. Therefore, it should not be forgotten that the most important step in the treatment of DDH is early diagnosis.

INTRODUCTION: Intensive care unit (ICU) nurses have an important role regarding brain death (BD) diagnosis and follow-up after this diagnosis and donor-related issues. The study aims to present the results of the assessment through survey on the knowledge, attitude and practices of ICU nurses about the BD in Turkey.
METHODS: Between 05.09.2015 and 05.12.2015, a survey was conducted to assess the knowledge, attitude and practices of ICU nurses regarding BD in Turkey. Survey data is obtained by respondents' filling the printed survey forms as well as collecting the electronic data forms. Survey data is assessed on the basis of frequency and percentage.
RESULTS: BD is defined as irreversible damage of the whole functions of brain, brainstem and cerebellum and this definition is known by 75.8% of the participant ICU nurses. The rate of witnessing patients with BD for ICU nurses is 31.05%. Rate of ICU nurses not participating apnea test before in the ICU is found to be 48.01%. 53.43% of the ICU nurses states that patients with BD are now death.
DISCUSSION AND CONCLUSION: The knowledge of ICU nurses about BD, donor care and organ donation are not sufficient and not up-to-date. It is necessary to educate ICU nurses with current information on the diagnosis of brain death and donor care. More efforts are needed to stimulate organ donation desires. Consciously work of the team working in ICU until the diagnosis of brain death, donor care and organ donation can benefit the increase in organ donation in our country.

INTRODUCTION: Although at least half of the medical students are women, neurosurgery specialty is not preferred much by women, and the number of women neurosurgeons taking place in academic platform is too small as well. In this study, we aimed to determine the position of women neurosurgeons in Turkish Neurosurgical Society (TNS) and how more they are supported in national congresses.
METHODS: We analyzed the rates of the women neurosurgeons participated in conferences, panels, and seminars as speaker and as moderator at annual national congresses for the years 2005 to 2019 and of the women members in education and training groups of TNS.
RESULTS: As of the year 2019, 92 (5.5%) of the 1680 neurosurgeons registered in the TNS are women. The highest rate among education and training groups was 10.3% (7/68) in the Pediatric Neurosurgery group while the least was 2.4 % (8/329) in the Spinal and Peripheral Nerve Surgery group. The rate of women neurosurgeons in executive board of TNS and the education - training groups was 2.5% and there was no significant difference statistically (1/40, P=0.721). When the placement as speakers and as moderators in the congresses were evaluated together, there was no statistical difference between women and men (P=0.591).
DISCUSSION AND CONCLUSION: Recently, the number of women neurosurgeons has increased in Turkey despite current challenges. In this field of expertise, it is necessary to increase the role-models by supporting women who want to pursue an academic career in order to gain successful and enthusiastic female medical students into our field.

INTRODUCTION: In this study, we aimed to present the clinical results of articular resurfacing prosthesis cases applied to cartilage problems of active patients who cannot be treated conservative and biological surgical methods.
METHODS: From April 2007 to March 2014, 32 patients were treated with femoral resurfacing using the HemiCAP implant. Indication for treatment with HemiCAP implant was symptomatic cartilage lesion at the medial femoral condyle demonstrated by MRI or arthroscopy, which was ICRS grade 3–4 and size less than 4 cm2. Patients were evaluated according to VAS score, American Knee Society Score, clinical improvement.
RESULTS: 32 patients ( 8 males, 24 females) evaluated in this study. Mean age was 53.1 ± 3.2 years. 18 ( %56.3 ) patients were operated from right knee while 14 ( %43.7) of patients from left. Follow-up time was between 24 and 30 months ( 26.6 ±1.9 ). The decrease in postoperative VAS compared to preoperative VAS was statistically significant ( p<0.01 ). A statistically significant increase was observed in postoperative American Knee Society Score compared to preoperative knee scores ( p<0.01 ). Preoperative function score was 46.5 ± 9.1, postoperative function score was 77.3 ± 7.7. A statistically significant increase was observed in postoperative knee function scores compared to preoperative knee function scores ( p<0.01 ).
DISCUSSION AND CONCLUSION: The femoral resurfacing treatment in active patients with local cartilage damage clinically reduces symptoms and improves knee function in the early period.

INTRODUCTION: The primary purpose of this study is to compare two different needle-free connectors to show that when used correctly the needle-free connectors port does not cause pathogenic surface colonization. The secondary objective is to determine whether there is a difference in catheter or blood stream infection between two kind of needle-free connectors.
METHODS: Aged 18-99, 199 patients, who were inserted central venous catheters follwed-up in intensive care unit were included to the study. The patients were divided into two groups as GroupA (n: 99) and GroupB (n: 100) according to the needle-free connector type used. During this study manipulation number of devices will be reported. Two blood culture samples, one from the central venous catheter and the other from the peripheral vein, were taken from the patient before removing the catheters.
RESULTS: There was no statistically significant difference between age, day of ICU stay, fever, number of medications, number of connector changes and length of longest connector stay. In GroupA, 7 patients and In GroupB, 23 patients had colonization in catheter culture and it was statistically significant. Colonization was detected 14 patients in GroupA, and 28 patients in GroupB in blood culture, and it was statistically significant.
DISCUSSION AND CONCLUSION: Hub contamination can lead to sepsis, which can lead to life-threatening consequences and suitable hub selection has an effect on sepsis control. Suitable needle-free connector selection has an effect on sepsis control. We thought that, GroupA free connector is better at avoiding sepsis then other connector when standard disinfection technique is used.

INTRODUCTION: Objective: Peroneal nerve injury is one of the common peripheral nerve lesions of the lower extremity. Peroneal nerve may be damaged due to trauma, neurogenic cyst, intranural ganglion, habitual leg crossing, heavy lifting and surgical procedures. In this study, we aimed to evaluate the surgical results of traumatic and non-traumatic peroneal nerve injury.

METHODS: Method: Twenty-three consecutive patients admitted to our clinic between 2014-2018 for peroneal nerve injury at knee level were evaluated retrospectively. Ankle dorsiflexion muscle strength levels of the patients were evaluated preoperatively and 6 months after the surgery.

RESULTS: Results: Of the 23 patients [6 (23%) female and 17 (77%) male] with peroneal nerve injury, 10 were evaluated in the traumatic group and 13 in the non-traumatic group. Preoperative and postoperative ABDF muscle strength improvement was statistically significant in both groups. In the traumatic patient group, median preoperative ABDF muscle strength was 0/5 (min.0/5-max.3/5) whereas the median postoperative postoperative 3,5/5 (min.0/5-max.5/5). (p=0.017) The median preoperative ABDF muscle strength was 2/5 (min.0/5-max.3/5) in the non-traumatic patient group, whereas it was 5/5 (min.4/5-max.5/5) (p = 0.001) postoperatively.

DISCUSSION AND CONCLUSION: Conclusion: The results of our study show that peroneal nerve decompression is a valid and effective method. Although we achieved better results in the non-traumatic patient group, motor function improved significantly after decompression in both patient populations.

INTRODUCTION: The aim of this study is to determine the types of tumors seen in the paratesticular region, to discuss the most prominent histopathological features and differential diagnoses of rare tumors among our cases as well as to compare the findings with the literatüre.
METHODS: The patients operated in Bezmialem Vakıf University for inguinal hernia and paratesticular tumor between 2014-2019 and diagnosed as paratesticular tumor were added to our study. Diagnosis, clinical findings and demographic data of the cases were recorded
RESULTS: We had a series of 21 paratesticular tumors with a mean age of 58.8 years. The most common; benign tumor was lipoma and malignant tumor was liposarcoma. Hemangioma, ovarian type serous carcinoma and mesothelioma were also rarely seen in the literature.
DISCUSSION AND CONCLUSION: Paratesticular tumors are composed of tumors originating from rete testis, epididymis and tunica vaginalis, soft tissue tumors and metastatic tumors. The most common epithelial tumors are adenomatoid tumors The most common benign and malignant mesenchymal tumors are lipoma and liposarcoma, respectively. Histomorphological appearance may be difficult especially in malignant epithelial tumors. Although immunohistochemical markers are helpful in differentiation, the transition between the lesion and non-neoplastic epithelium is important. Paratesticular tumors are quite rare. For this reason,at this location both primary tumors -especially malignant- and metastasis can be challenging..They should be kept in mind for differential diagnosis

INTRODUCTION: Cervical disc arthroplasty aims preservation of motion at the operated level while minimizing degenerative disease at adjacent levels. This study aimed to examine the long-term functional outcomes of patients with cervical disc pathology who were operated with arthroplasty technique.
METHODS: Sixty-eight patients who underwent cervical disc prosthesis implantation for disc herniation or spondylosis were included. Functional outcomes over time were evaluated using Neck Disability Index (NDI) and visual analogue scale (VAS) at baseline and 6 months, 1 year, 2 years, 4 years and 7 years after surgery.

RESULTS: Mean duration of follow-up was 5.4±1.8 years (median, 7 y; range, 1-7 y). At the last follow-up visit, VAS and NDI scores were significantly lower compared to baseline (1.2±0.9 vs. 7.7±1.2, p<0.001 and 5.5±5.0 vs. 40.4±5.8, p<0.001, respectively). VAS and NDI scores were improved at all measured time points compared to baseline (p<0.001 for all comparisons). A plateau was reached at 2 years and at 1 year for VAS and NDI scores, respectively. The overall predefined surgical success rate was 86.8% at the last follow-up.

DISCUSSION AND CONCLUSION: Findings of this study supports the benefit of cervical dynamic disc systems in cervical disc surgery in terms of functional outcomes both in the short-term after surgery and in the long term.

INTRODUCTION: We aimed to evaluate clinical characteristics and comorbidities of children applied to child psychiatry department via medical board for special need report and to compare differences between diagnosis and their disability rates according to new regulations and old regulations.
METHODS: Between 1 March-1 September 2019, records of all children applied to Kanuni Sultan Süleyman Training and Research Hospital Medical Board and directed to child psychiatrists were analyzed restrospectively.
RESULTS: 1061 cases were evaluated. 347 of this cases were female (%32.7). The mean age was 8±4. The most common psychiatric diagnosis were learning disorder (%27) and mild delay in cognitive development (%18.2) respectively. Comorbidities were detected in 271 cases (%25.5). The most common comorbidity was from physical therapy and rehabilitation department. 526 cases already had a psychiatric diagnosis before application to our medical board, the most common diagnosis was mild delay in cognitive development (%29.6). According to new offical regulations, disability rates of autism spectrum disorder and moderate delay in cognitive development diagnosis were increased. Suggested special need domains were child and adolescent psychiatry (%41.1, n=436), cognitive development (%40.5, n=430) and language, speech, communication (%25.4, n=269) respectively. These 3 domains were examined by child psychiatrists. The rate of cases who did not take any diagnosis after clinical examinations were %7.78 (n=40).
DISCUSSION AND CONCLUSION: Examination of cognitive development by the child psychiatrists is critical as in all psychiatric disorders, when patients applied to medical board for special need reports are evaluated. Our study is important in terms of update and adjustment needs of new official regulations.

INTRODUCTION: To determine the frequency of dysplastic lesions in Endocervicalcurettage(ECC) specimens of women with ASC-US (Atypical Squamous Cells of Undetermined Significance ) and to evaluate possible factors associated with high-grade dysplasia in these ECC specimens.


METHODS: The patients who had ASC-US result in Pap smear between January 2017 and June 2019 and who underwent ECC during colposcopic examination were retrospectively analyzed. Demographic data and pathology results of the patients were evaluated. Histopathological data were categorized into two categories as less than CIN 2 (cervicitis, atrophy, cervical polyp, metaplasia and CIN 1) and CIN2 + (CIN 2/3 / CIS (carcinoma in sutu) and invasive / microinvasive cancer) lesions. Risk ratios were calculated to evaluate CIN 2+ risk factors.

RESULTS: A total of 901 patients were included in the study. CIN 2+ lesions were detected in 7.4% of patients with inadequate colposcopic examination. There was a statistically significant difference in endocervical canal dysplasia between the patients with and without sufficient coloscopic examination (p = 0.005). There was a statistically significant difference in the presence of CIN 2+ lesion in the endocervix of patients with CIN2 + cervical biopsy (p=0.001). In patients with inadequate colposcopy and positive cervical biopsy, the risk of CIN 2+ in the endocervical canal was 24 and 139 times higher, respectively.

DISCUSSION AND CONCLUSION: Women with ASC-US cytology in Pap smear have a low incidence of high-grade CIN in the endocervical canal. High-grade ectocervical dysplasia and insufficient colposcopy can be used as predictors of high-grade dysplasia in the endocervical canal and ECC may be acceptable in these patients.

INTRODUCTION: Dermatologists manage numerous chronic skin diseases in daily clinic practice. It is difficult to manage chronic skin diseases in very intensive outpatient clinics which have to accept great number of patients.
METHODS: Clinic of Dermatology in University of Health Sciences (UHS), Kayseri Health Training and Research Center (KHTRC) has one education unit and chronic skin diseases unit (CSDU) exist in outpatient clinic. Specialists and academicians may refer patients with psoriasis, chronic urticaria and Behçet’s Disease to CSDU. Every day, two internal counseling are performed in outpatient clinic by dermatologist and academicians.
RESULTS: From 01.06.2015 to 01.06.2016, in one-year period, 158775 patients were accepted to the KHTRC dermatology outpatient clinic. 645 of 158775 (0,4%) patients were referred to CSDU consisted of; 370 psoriasis, 200 chronic urticaria and 75 Behçet’s Disease. Referring rates to CSDU consisted; 18% of psoriasis patients, 7,3 % of patients with chronic urticaria and 11,4 % of patients with Behçet’s Disease. 1387 patients included to the internal counseling. The most frequent reason for receiving patients to internal counseling was; “difficulty in diagnosis”. 5 specialists did not refer any patient to CSDU and three specialists neither received cases nor attended to internal counseling.
DISCUSSION AND CONCLUSION: CSDU and IC of outpatient patients in day time is beneficial for management of chronic skin diseases and collaboration of dermatologists lead confidence to make diagnosis and planning treatment.

INTRODUCTION: To investigate the long term prognosis of late term prognosis in neurologic and developmental areas in preschool period
METHODS: Moderate preterm (320/7 – 336/7 gestational week), late preterm (340/7 – 366/7 gestational week) and early preterm (<32 gestational week) infants who were followed-up in the II-III level intensive care unit of our hospital were included in the study. Age of the subjects during the study varied between 37 and 45 months (mean 42±3 month).
RESULTS: A total of 240 late and 163 early preterm infants included in the study. The mean gestational age and birth weight were found as 35.32±1.13 week and 1865±403 g in late preterm infants and 30.38±1.73 weeks and 1253±310 g in early preterm infants, respectively. The cases were evaluated in 42 months on average. The incidence of major neurologic sequelae was significantly lower in late preterm compared to early preterm infants (p=0.001). Cerebral palsy and epilepsy ranked first. According to the results of the Denver Developmental Screening Test, developmental delay was found in 10.8% of late preterm and 18.4% of early preterm infants, and the difference was significant (p=0.001). In the socio-economic cultural scoring, no statistically significant correlation was found between parents’ educational level, income level and delayed Denver II score.
DISCUSSION AND CONCLUSION: Delivering late preterm infants with considering them term infants should be avoided if there is no definitive indication, and the delivered infants should be followed-up for a long time to give a chance for early treatment and rehabilitation.

INTRODUCTION: The role of amniotic fluid volume, as a potential factor that may affect the estimated fetal weight measurements remains controversial. The objective of our study was to investigate the effect of oligohydramnios on the accuracy of fetal weight estimation in term pregnancies with oligohydramnios.
METHODS: The data of 207 pregnants diagnosed with oligohydramnios and 610 pregnants with a normal amniotic fluid volume in between January 2018 and June 2019 were compared retrospectively.Amniotic fluid volume and estimated fetal weight measurements were performed via ultrasonographic examination in all pregnants up to 48 hours before birth. Hadlock-4 Formula was used as the estimated fetal weight scale. After picking the estimated fetal weights and actual birthweights in two groups, absolute error, absolute error rates, rates of pregnancies with a higher and a lesser fetal weight estimations were compared.
RESULTS: The mean estimated fetal weights were 3110 (550) g in Group 1 (oligohydramnios) and 3420 (665) g in Group 2 (normal amniotic fluid volume). The actual birth weights were 3130 (620) g and 3410 (660)g for Group 1 and 2, respectively. Both values in Group 1 were detected as lower significantly, when their estimated and actual fetal birthweights compared with Group 2. The error between estimated fetal weights and actual birthweights was 240 (160)g, error rate was 7.3 (4.5)% in Group 1. The error and error rates were 230 (200)g and 6.9 (6.0)% in Group 2, respectively. When the error and error rates compared in groups, any significant difference was not detected.
DISCUSSION AND CONCLUSION: There is no any relation between oligohydramnios and estimated fetal birthweight in term pregnancies.There seems a tendency to measure estimated fetal weights higher in oligohydramniotic pregnancies.

INTRODUCTION: Diabetic foot (DF) wound causes long hospitalization and rehabilitation periods and puts a burden on the patient and the national economy. The aim is to present the mechanism of diagnosis and treatment of DF injury throughout the province and to emphasize the necessity of introducing a new application model.
METHODS: Quantitative data were evaluated retrospectively from January until April 2018 in five research and education hospitals with DF commission. A number of factors is evaluated, such as whether there are DF, wound policlinics or wound councils in the investigated hospitals, number of patients and the distribution of clinics where patients are admitted for treatment.
RESULTS: It was determined that three of the DF councils are organized by the Infectious Diseases Clinic and the other two are organized by the Underwater Medicine and Hyperbaric Medicine clinics. In case of required inpatient treatment, the patients were admitted to different departments in each hospital. The number of council patients and council frequency is given in Table 1 and the recommended treatment methods in Table 2 and Graphic 1.
DISCUSSION AND CONCLUSION: Because DF patients are admitted to different clinics the follow-up procedures cannot be controlled. If DF patients would be admitted to certain clinics and if the treatment processes and follow-up procedures would be followed by these clinics, all processes could be controlled. A multidisciplinary evaluation and treatment of the patients will not only increase limb salvage treatment success but also decrease costs.

INTRODUCTION: The parahippocampal gyrus and the uncus located in the mediobasal region of the temporal lobe are related to the limbic system. In this anatomical study, we aimed to provide a contribution to surgical success by describing the parahippocampal gyrus and the uncus with the definitions of the related surrounding structures.
METHODS: The topographic anatomy of the parahippocampal gyrus and the uncus was studied in seventeen formalin-fixed adult human brain specimens (34 hemispheres). Klingler’s fiber dissection technique was used in eight brains. Histological examination of the parahippocampal gyrus and the uncus with surroundings were evaluated in two brains.

RESULTS: The parahippocampal gyrus has an anterior segment that deviates medially to form the uncus and a posterior segment that continues superiorly to the cingulate gyrus through the isthmus, and inferiorly as the lingual gyrus. A thick white matter bundle connecting the medial frontal and parietal areas with the mediobasal temporal region is located in the cingulate gyrus and can be seen under the radiation of the cingulum that is revealed when the cortex of the parahippocampal gyrus is removed. The parahippocampal gyrus is made up of dysgranular, paralimbic type association cortex. The uncus has an allocortical structure that is made up of granular cell type.
DISCUSSION AND CONCLUSION: A detailed microsurgical anatomy of the parahippocampal gyrus and the uncus is described in this study. We consider that the knowledge gained from the results of this study can guide for more effective and successful neurosurgical approaches and can contribute for better understanding the region.

INTRODUCTION: Staphylococcus infections are important in terms of mortality and morbidity and that are encountered more and and more in the society and in hospitals. Their leading place among nosocomial infections spreading of resistance against methicillie are causing serious problems in treatments.
METHODS: Two hundered and ten strains of Staphylococcus aureus were included in this study isolated from various clinic specimens
Resistance of all these strains to various antimicrobials were examined with agar disc diffusion method ccording to NCCLS. In this determining the sensitivities of Staphyococci with society and hospital origin.

RESULTS: Resistance against vancomycin and theicoplanin was not observed at all any of the strains isolated. Resistance of low level was found for MRSA and MSSA against fucidic acid with 8.2% and 1.9% respectively and againts TMP/SXT with 16.5% and 6.9 %respectively. In our study, we found resistance of 100% against penicillin, 83.4% against gentamycin, 82.5% against ciprofloxacin, 75.2%agints levofloxacin, 72.4%against clindamycin, 71.5% against erythromycin and 61.4% against rifampicin in MRSA strainst. We found resistance of 65.3% against penicillin, 21.7% gentamicin and ciprofloxacin, 19.8% against rifampicin, 11.8% against levofloxacin and clindamycin, in MSSA strains. Mupirocine used in the eradication of hospital acquired MRSA has maintained its importance with a resistance of 3.6% resistance in MRSA strains, and zero resistance against MSSA strains.
DISCUSSION AND CONCLUSION: : It was found Vancomycin or teicoplanin resistance was not found in MRSA and MSSA. While ciprofloxacin, levofloxacin, clindamycin, gentamicin resistance increased for both MRSA and MRSA,The prevalence and antimicrobial resistance profile of MRSA and MSSA should be closely monitored.

Herpetic whitlow is a skin infection characterized by painful, non-purulent,vesicular involving distal phalanges of fingers and rarely toes. Here in, we report a ten-month old girl who presented to the emergency deparment with ongoing redness and swellingon the fore finger despite local drainage and oral antibiotherapy. Detailed history revealed herpes labialis in her brother. With herpetic stomatitis lesions in physical examination, she was diagnosed herpetic whitlow. Oral and digital lesions resolved rapidly after acyclovir treatment.Herpetic whitlow is an important skin infection in that it is rarely seen and 65% of the cases are initially misdiagnosed resulting with unnecessary local drainage. In addition, family contact with herpes labialis may result with a range of infections from herpetic whitlow to herpetic encephalitis which may cause morbidity and mortality. Therefore, isolation measures should be explained to families once again.

Anti–N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a form of autoimmune and paraneoplastic encephalitis that is commonly encountered in young women with ovarian teratoma. As an encephalopathy with possible epileptic, extrapyramidal and psychiatric manifestations, the treatment requires both tumor resection and immunosuppression. However, the rarity of the disease and lack of knowledge most often cause the accurate diagnosis to be late for the optimal patient outcome. Herein, we report a case of a 33 year-old female with anti-NMDAR encephalitis that interestingly developed after the surgical resection of ovarian teratoma.