INTRODUCTION: The aim of this study was to evaluate the level of knowledge of the public about human papilloma virus (HPV) and the HPV vaccine, and to determine their attitudes towards HPV vaccination and the obstacles they encounter.
METHODS: In this descriptive study, a structured questionnaire including questions about HPV infection, vaccine types, vaccination age ranges, and vaccine efficacy was applied to the participants. In addition, the effect of factors such as their attitudes towards vaccination, information sources, and the cost of vaccination were also evaluated.
RESULTS: The results showed that there is a serious lack of knowledge about HPV and the HPV vaccine in the community. Most of the participants were not sufficiently familiar with the vaccine, did not know what HPV infection was, and had doubts about the protection of the vaccine. Lack of information, cost, lack of confidence, and inadequacies in the health system were the main reasons for not getting vaccinated.
DISCUSSION AND CONCLUSION: Our study revealed that public awareness of HPV vaccination is low, and the cost of the vaccine is an important barrier. In order to implement an effective HPV vaccination programme, health policies should be established to raise public awareness, the cost of the vaccine should be reduced, and educational activities should be increased through health professionals.

INTRODUCTION: Identifying poisoning and suicidal characteristics in a country or specific region is crucial for determining risks, implementing necessary precautions, and managing affected individuals. This study aimed to examine the demographic, etiologic, and clinical features of patients with acute poisoning and identify factors associated with suicide attempts by poisoning.
METHODS: One hundred thirty-eight patients with acute poisoning who were admitted to the emergency department of Tokat-Turhal State Hospital between July 2021 and June 2023 were retrospectively included in this study. The patients were divided into two groups based on suicidal intent.
RESULTS: The incidence of poisoning over the study period was 0.048%. The median age was 28.5 (range: 15–47) years, and 81 (58.7%) patients were female. Poisoning cases were most frequent during summer, particularly in June. Thirty patients (21.74%) presented following suicide attempts by poisoning. The most common causes of poisoning were mushrooms (34.26%) and corrosive agents (32.41%) in the non-suicidal group. In contrast, 80% of suicide attempts involved drug poisoning (p<0.001), primarily analgesics and psychiatric drugs. Patients in the suicide attempt group had higher rates of psychiatric history (p<0.001), poorer health status (p=0.009), and more frequent ICU admissions (p<0.001).
DISCUSSION AND CONCLUSION: Suicide attempts mostly occurred via drug overdose, especially among individuals with psychiatric illness, resulting in poorer outcomes and greater need for intensive care. Early intervention, follow-up, and increased public awareness may help improve prognosis and reduce complications.

INTRODUCTION: Fermented foods, such as yogurt and kefir, provide health benefits. This study explores how fermented food consumption during pregnancy and breastfeeding may affect the development of egg allergy in children.
METHODS: The study included mothers of 50 children diagnosed with egg allergy and a control group of mothers of 52 healthy children of the same age group. Retrospective analysis was performed on data such as the mothers’ consumption of fermented foods during pregnancy and breastfeeding, sociodemographic characteristics, and family history of allergies.
RESULTS: It was observed that the case and control groups were similar in terms of age, gender, gestational age, maternal weight gain during pregnancy, and mode of delivery (p>0.05). However, the mean age of mothers in the case group was significantly lower than that in the control group (p=0.008). There was a significant difference in maternal education level between the groups (p=0.044). No statistically significant differences were found between the groups in terms of fermented food consumption, including yogurt, cheese, kefir, tarhana, pickles, and fermented sausage (sucuk), during pregnancy and breastfeeding (p>0.05).
DISCUSSION AND CONCLUSION: The findings indicate that the fermented food consumption habits of mothers of children with egg allergy during pregnancy and breastfeeding were not different from those of mothers in the control group. These results suggest no relationship between fermented food consumption and the development of egg allergy in children. However, further extensive studies are needed on this subject.

INTRODUCTION: To investigate the impact of using United Kingdom (UK) or United States (US) criteria instead of Turkish criteria for retinopathy of prematurity (ROP) screening on infants who require ROP treatment.
METHODS: Four hundred and twenty-two infants underwent ROP screening. ROP screening was performed in all infants with a gestational age of less than 34 weeks or a birth weight of less than 1,700 g. Gestational age, birth weight, stages of ROP, treatments administered, and treatment outcomes were documented.
RESULTS: ROP was diagnosed in 136 (32.2%) of 422 infants. Of these, 60 (14.2%) required treatment due to either type 1 ROP or aggressive ROP (A-ROP). If the UK screening criteria had been used, only 245 infants would have been screened, resulting in a 41.9% reduction compared to the screening criteria used in Türkiye. Thirteen (9.5%) cases of ROP developed in the 167 infants who were excluded from screening. Of these cases, five (8.3%) required treatment. If the screening criteria used in the US had been applied, the number of screened infants would have been reduced by 49.3% compared to the screening criteria used in Türkiye. Of the 208 infants who were not screened, 20 (14.7%) developed ROP, with 8 (13.3%) requiring treatment.
DISCUSSION AND CONCLUSION: The use of the US or UK screening criteria for ROP in our center has led to the underdiagnosis and undertreatment of ROP. Increased awareness of ROP in intensive care units may lead to further standardization of screening criteria in the future.

INTRODUCTION: Musculoskeletal system diseases are a significant global health burden, frequently requiring long-term pharmacological management. While conventional databases offer reliable drug consumption data, they often fail to reflect dynamic public interest. Google Trends, as a real-time digital surveillance tool, can provide complementary insights by capturing health-related online search behaviors. This study aimed to evaluate the association between national pharmaceutical consumption and public interest in musculoskeletal and nervous system drugs in Türkiye between 2015 and 2022.
METHODS: This retrospective descriptive study integrated OECD pharmaceutical consumption statistics with Google Trends data for selected keywords. Drug use was assessed via per capita expenditure and percentage of total pharmaceutical sales. Relative search volume values were extracted and normalized for keywords such as “painkiller,” “muscle relaxant,” and “osteoarthritis.”
RESULTS: Strong positive correlations were identified between analgesic consumption and RSVs for keywords including “painkiller” and “muscle relaxant” (r = 0.922, p = 0.001), “muscle pain” (r = 0.898, p = 0.002), and “joint pain” (r = 0.826, p = 0.011). No significant associations were found for musculoskeletal or anti-inflammatory drugs. In turnover-based analyses, certain keywords—especially “joint rheumatism” and “osteoarthritis”—were associated with specific drug categories. Negative correlations between musculoskeletal drug sales and general pain-related searches may suggest a public inclination toward symptom-based treatment.
DISCUSSION AND CONCLUSION: Google Trends data closely mirror analgesic consumption patterns, indicating their potential as digital proxies for pharmaceutical demand. Integrating such digital tools with traditional data sources may enhance public health surveillance and guide policy decisions.

INTRODUCTION: Altered lipid metabolism is increasingly recognized as a hallmark of cancer progression and may serve as a prognostic biomarker. While individual lipid components such as total cholesterol, LDLc, HDLc, and triglyceride have been evaluated in various malignancies, their prognostic relevance in gastroin-testinal (GI) cancers remains unclear. This study aimed to assess the association between baseline lipid profiles and overall survival (OS) in GI cancer patients.
METHODS: A retrospective analysis was conducted on 103 patients with histologically confirmed gastric, colorectal, rectal, or esophageal cancer treated between January 2024 and March 2025. Pre-treatment fasting lipid profiles, including total cholesterol, LDLc, HDLc, and triglyceride, were recorded. Optimal cut-off values were determined by receiver operating characteristic analysis, and OS was analyzed using Kaplan–Meier survival curves and log-rank tests.
RESULTS: At a median follow-up of 22 months, 26 patients (25.2%) had died. Low baseline total cholesterol (<135 mg/dL), LDLc (<76.5 mg/dL), and HDLc (<40 mg/dL) were each significantly associated with reduced median OS (all p<0.01). Triglyceride levels did not significantly correlate with survival (p=0.400). Cancer type, stage, liver metastasis, sex, and diabetes status showed no significant association with OS.
DISCUSSION AND CONCLUSION: Lower baseline total cholesterol, LDLc, and HDLc levels predict worse survival in GI cancer patients, highlighting the prognostic relevance of lipid metabolism. Routine lipid profiling may serve as an accessible tool for risk stratification in oncology. Prospective studies are warranted to validate these findings and explore lipid modulation as a therapeutic adjunct.

INTRODUCTION: This study aimed to evaluate the impact of optimal timing of enterostomy (particularly ileostomy) and colostomy closures on postoperative complications. The goal was to compare early versus late closures to inform surgical strategies and improve patient outcomes.
METHODS: Data from 474 patients who underwent ostomy closure between 2008 and 2023 were retrospectively analyzed. Based on prior literature, enterostomy patients were grouped as early (<12 weeks) or late (>12 weeks), and colostomy patients as early (<12 weeks), intermediate (13–20 weeks), or late (>20 weeks). Only patients with complete clinical records were included.
RESULTS: Among 366 patients with enterostomy closure, 27.5% (n=101) underwent closure within 12 weeks, while 72.4% (n=265) had closure after 12 weeks. Overall complication rate was 8.4%, with serosal injury (58.1%) and perforation (38.7%) being the most frequent. Late closure was significantly associated with malignant indications (OR = 7.208), preoperative rectoscopy (OR=2.063), and adjuvant therapy (OR=1.735). In 108 patients with colostomy closure, the complication rate was 23.2%, with serosal damage (52.0%) and perforation (40.0%) being most common. Malignancy was less common in patients closed within 12 weeks, but significantly higher in the >20-week group (p<0.001). Malignancy increased the risk of delayed closure by 4.9 times according to logistic regression.
DISCUSSION AND CONCLUSION: Optimal timing of ostomy closure is critical, especially in malignancy-related cases. Delayed closure is linked to increased complication rates. When early closure is applied to selected low-risk patients, outcomes may improve. Surgical timing should be guided by comorbidities, underlying disease, and oncologic treatment history.

INTRODUCTION: Congenital heart disease (CHD) is one of the most common congenital anomalies worldwide, necessitating detailed imaging for accurate diagnosis and surgical planning. While transthoracic echocardiography (TTE) serves as the first-line imaging modality, it may be insufficient in evaluating complex intracardiac and extracardiac structures. Cardiac computed tomography angiography (CTA) has emerged as a valuable complementary technique in pediatric patients, offering high-resolution anatomical visualization with relatively low radiation exposure. This study aims to retrospectively assess the role of cardiac CTA in the anatomical evaluation and clinical management of pediatric patients diagnosed with CHD at a tertiary care center.

METHODS: Pediatric patients who underwent cardiac CTA between January 1, 2021, and September 1, 2025, were retrospectively analyzed. Demographic data, clinical findings, radiation dose, and contrast volume were evaluated. Both intracardiac and extracardiac anomalies were examined in detail.
RESULTS: A total of 1,337 pediatric patients (mean age: 3.89 years; 56% male) were evaluated using cardiac CTA. The most common diagnoses were coarctation of the aorta (7.87%), Tetralogy of Fallot (7.5%), and double outlet right ventricle (6.38%). CTA demonstrated high diagnostic accuracy in assessing critical anatomical features such as the spatial relationships of the great vessels, coronary anomalies, and abnormal venous connections.
DISCUSSION AND CONCLUSION: Cardiac CTA facilitates detailed anatomical assessment in pediatric CHD patients, supporting surgical planning and improving clinical outcomes.

INTRODUCTION: Postpartum hemorrhage (PPH) is one of the most common causes of maternal death. Our objective was to determine whether an association exists between maternal obesity and increased risk of PPH.
METHODS: Women who underwent cesarean delivery between July 2022 and June 2023 were evaluated retrospectively. The patients were divided into two groups according to their body mass index (BMI): Group 1 had a BMI ≥30 kg/m² (n=82), and Group 2 had a BMI <30 kg/m² (n=109). Demographic features, duration and mode of placental separation, and amount of PPH were recorded. To measure blood loss, the weight of surgical gauze sponges used during the procedure and the volume of blood aspirated via surgical suction were recorded.
RESULTS: Postpartum blood loss was compared between the groups, but the difference was not statistically significant. Obesity is often considered a risk factor for PPH. Our study did not provide supporting data regarding the increased risk of obesity. Risk assessment scores for PPH have been proposed, but many women who experience severe hemorrhage have scores indicating a low risk.
DISCUSSION AND CONCLUSION: Obesity is a risk factor for many obstetric complications; therefore, clinicians should be more alert. Nevertheless, obstetricians should be prepared for PPH regardless of the BMI of the pregnant individual.

INTRODUCTION: Localized scleroderma is a rare disease that can cause significant morbidity. Due to its rarity, data are limited, and no standardized treatment exists for patients resistant to first-line therapies. This study aims to evaluate clinical and treatment features based on a referral pediatric rheumatology center’s experience.

METHODS: The medical files of 36 included pediatric localized scleroderma patients were retrospectively reviewed, and demographic, clinical, laboratory, treatment, and outcome data were recorded.
RESULTS: Of the patients, 30 (83.3%) were female, the median age at diagnosis was 6.37 years (IQR: 4.04), and the median follow-up duration was 25.5 months (IQR: 56). The most common subtype was linear scleroderma (n=15, 41.67%), followed by circumscribed morphea (n=14, 38.89%). Among patients with linear scleroderma, 6 had craniofacial involvement. ANA positivity was observed in 38.9% of patients. Extracutaneous findings in the form of joint contractures were present in three patients. Systemic treatment was administered to 94% of patients, with methotrexate (MTX) used in 33 (91.67%) and corticosteroids in 26 (72.22%). MTX was effective in 58%, though some patients required additional or alternative therapies such as mycophenolate mofetil (n=14, 38.89%), intravenous immunoglobulin (n=9, 25.0%), or tocilizumab (n=2, 5.56%). Relapses occurred in 19%, and complete clinical response was achieved in 61%. Side effects were mostly mild and mainly related to MTX.
DISCUSSION AND CONCLUSION: Pediatric localized scleroderma shows diverse clinical presentations and often requires systemic treatment, primarily MTX. While most patients respond well, a subset needs additional therapies. Early diagnosis and tailored treatment are essential to improve outcomes and reduce morbidity.

INTRODUCTION: The aim of this study was to evaluate the radiological, clinical, and pathological responses before and after neoadjuvant chemotherapy (NAC) in patients with breast cancer, to examine the reliability of imaging modalities, and to compare treatment responses according to pathological subtypes.
METHODS: Forty breast cancer patients who underwent neoadjuvant chemotherapy followed by surgery between June 2020 and 2025 were retrospectively analyzed. Tumor diameters before and after treatment were measured using positron emission tomography-computed tomography (PET-CT). Axillary lymph node metastases were compared clinically, radiologically, and pathologically. In addition, treatment responses were analyzed according to pathological subtypes.
RESULTS: A significant reduction in tumor size was observed following NAC (p<0.001). Among the 20 patients who demonstrated a complete response on PET-CT, only 8 had a complete pathological response. The sensitivity, specificity, positive predictive value, and negative predictive value of PET-CT in detecting complete response were 100%, 62.5%, 40%, and 100%, respectively. A statistically significant downstaging after NAC was observed (p<0.001). Higher response rates were found in human epidermal growth factor receptor 2 (HER2)-positive and triple-negative subtypes.
DISCUSSION AND CONCLUSION: Neoadjuvant chemotherapy significantly reduces tumor size and axillary involvement, enabling more conservative surgical approaches. Although PET-CT has high sensitivity in detecting complete response, its low positive predictive value highlights the need for complementary evaluation methods. Pathological subtypes are predictive of treatment response and should be taken into account during treatment planning.

INTRODUCTION: Emergency gastrointestinal surgery carries high postoperative complication and mortality rates, particularly in geriatric patients. Unlike elective procedures, limited preoperative optimization and frequent intraoperative contamination contribute to poorer outcomes. With the global increase in the geriatric population, understanding age-related risks is essential. This study aimed to compare early postoperative outcomes and etiological factors between adult and geriatric patients undergoing emergency laparotomy or laparoscopy.
METHODS: We retrospectively reviewed adult patients undergoing emergency general surgery between November 2021 and May 2025. Trauma cases, acute appendicitis, cholecystitis, and negative explorations were excluded. Demographics, comorbidities, preoperative laboratory values, surgical indications, techniques, ICU needs, complications, length of stay, and 30-day mortality were recorded. Patients were divided into adults (18–64 years) and geriatrics (≥65 years). Postoperative complications were evaluated using Clavien–Dindo and Comprehensive Complication Index (CCI) scores. Multivariate logistic regression was used to identify predictors of 30-day mortality.
RESULTS: Sixty patients were included (39 geriatric). Geriatric patients had higher ASA scores, more comorbidities, and lower preoperative albumin levels. Surgical indications, techniques, complication rates, and length of stay were similar between groups. Thirty-day mortality occurred in nine geriatric patients (15%), with low albumin identified as the only independent predictor.
DISCUSSION AND CONCLUSION: Advanced age alone did not independently influence postoperative outcomes, while low serum albumin significantly affected 30-day mortality. Emergency surgical care should focus on individualized management considering patient comorbidities, nutritional status, and etiology rather than age. Future multicenter studies are needed to refine risk stratification and optimize postoperative care.

INTRODUCTION: Germ cell tumors (GCTs) arise from primordial germ cells and vary greatly in clinical behavior, histology, and location. This study reviews the clinical and prognostic features of cranial/extracranial GCTs in the pediatric population through our clinical trial study and literature review.
METHODS: This study is a retrospective analysis of hospital system data on children ages 0–17 with germ cell tumors. A total of 26 patients who were diagnosed and treated for germ cell tumors in the pediatric hematology and oncology department of our university hospital between 2019 and 2023 were included in this study. Patients diagnosed with both intracranial and extracranial germ cell tumors were included. Within the scope of the study, 30 studies were scanned from PubMed and the National Cancer Institute (NCI) data system, and 7 of these were found to be related to the subject and summarized in a table.

RESULTS: The mean age of the 26 patients with GCT was 10.3 years (range: 5 months–17 years). Fifteen patients were girls (58%) and eleven were boys (42%). Three GCTs were located intracranially (3/26, 11%) and 23 extracranially (23/26, 89%). Nineteen patients (73%) received chemotherapy, and 7 patients (26%) had surgery-based treatment with no additional chemotherapy. All 3 patients with intracranial GCTs had chemotherapy plus radiotherapy (11%). In total, 2 patients (7%) died because of chemotherapy-refractory disease.
DISCUSSION AND CONCLUSION: GCTs are highly responsive to treatment, including surgery and chemotherapy. With new studies, treatment options will be defined with a flow chart, allowing the selection of the best surgery, radiotherapy, and chemotherapy for optimal prognosis.

INTRODUCTION: Piriformis syndrome is a neuromuscular condition characterized by sciatic nerve compression by the piriformis muscle, resulting in buttock pain radiating to the posterior thigh. While physical therapy and corticosteroid injections are commonly used, treatment-refractory cases remain challenging. Dextrose prolotherapy is a regenerative technique gaining interest, but its efficacy in piriformis syndrome is not well established.
METHODS: This retrospective study included 43 patients diagnosed with piriformis syndrome based on clinical criteria, including a positive FAIR test and at least one additional provocative maneuver. Patients received three sessions of ultrasound-guided injections of 5% dextrose (1 mL per site, 5 mL total) targeting the piriformis musculotendinous junction at 3-week intervals. Pain and functional status were assessed at baseline, 1-month, and 3-month follow-ups using the visual analog scale (VAS) and oswestry disability index (ODI). Patient satisfaction and adverse events were also recorded.
RESULTS: Mean VAS scores decreased from 7.6 to 2.3 (p<0.001), and median ODI scores improved from 48 to 20 over three months (p<0.001). Eighty-eight percent of patients reported satisfaction with the treatment. No major complications were observed; minor adverse events were mild and self-limiting.
DISCUSSION AND CONCLUSION: Ultrasound-guided dextrose prolotherapy significantly reduced pain and improved function in patients with refractory piriformis syndrome. These findings support its role as a minimally invasive treatment option, warranting further prospective studies.

INTRODUCTION: Excessive daytime sleepiness (EDS) is a key symptom in obstructive sleep apnoea syndrome (OSAS). The relationship between EDS and polysomnographic parameters across different OSAS phenotypes has not been fully elucidated. This study evaluated demographic characteristics, polysomnographic findings, and EDS severity among OSAS clinical phenotypes (classical OSAS, REM [rapid eye movement]-related OSAS, positional OSAS [P-OSAS], and REM+positional OSAS) and subgroups defined according to Epworth Sleepiness Scale (ESS) scores.
METHODS: A retrospective analysis was conducted on patients with OSAS diagnosed by polysomnography. Participants were categorised into clinical phenotypes and stratified into the EDS (ESS score >10) and non-EDS (ESS score ≤10) groups. Demographic data, apnoea–hypopnea index (AHI), oxygen desaturation index (ODI), minimum oxygen saturation, and heart rate (HR) parameters were compared between the EDS and non-EDS groups.
RESULTS: EDS was associated with male sex, the presence of comorbidities (particularly hypertension), and higher AHI, BMI, and body weight values (p<0.05). The highest EDS prevalence was observed in the classical OSAS group, followed by the P-OSAS group (p<0.05). Patients with EDS showed lower mean and minimum oxygen saturation levels and higher ODI values (p<0.05). No significant difference was observed in HR values among the OSAS phenotypes or between the ESS-based subgroups
DISCUSSION AND CONCLUSION: EDS was associated with OSAS disease severity. Among the clinical phenotypes, the risk of EDS was observed to be highest in patients with classical OSAS and P-OSAS. The early identification of OSAS subtypes, particularly the REM- and position-dependent forms, is essential for personalised treatment and improved clinical outcomes.

Peripheral nerve blocks are frequently preferred in orthopedic upper extremity surgeries because they provide adequate postoperative analgesia, reduce the need for general anesthesia, and accelerate recovery. The integration of ultrasound (USG) guidance into these techniques has improved block success rates and significantly reduced complications. USG-guided nerve blocks allow real-time visualization of neural structures and surrounding anatomy. The brachial plexus supplies most of the innervation of the upper extremity. In clinical practice, the four most commonly performed brachial plexus blocks are the interscalene, supraclavicular, infraclavicular, and axillary approaches. In addition, terminal nerves can be selectively blocked along their course. For example, in clavicular surgeries, the interscalene block is often combined with a cervical plexus block; in rotator cuff repair and shoulder arthroscopy, the interscalene block is preferred; in humeral shaft fractures and elbow arthroplasty, supraclavicular or infraclavicular blocks are commonly used; and in distal radius fracture fixation, wrist arthrodesis, and metacarpal fracture surgeries, the axillary block is frequently chosen. Median nerve blocks are useful in carpal tunnel release and tenosynovitis; ulnar nerve blocks are employed in Dupuytren’s contracture and flexor tendon repair of the fourth and fifth fingers; while radial nerve blocks are beneficial in de Quervain’s tenosynovitis, scaphoid fracture surgery, and dorsal hand lesions. This review discusses the anatomical basis, techniques, indications, and complications of cervical and brachial plexus blocks, as well as distal nerve blocks, which are widely utilized in orthopedic upper extremity surgery.

Porcelain gallbladder is a rare condition, defined as calcification of the gallbladder wall. Its etiology is still not well established, but a relationship with gallstones of up to 95% is suggested, which causes an obstructive effect that triggers an inflammatory process with subsequent irritation and fibrosis of the gallbladder wall, either focal (affecting only the muscle layer) or transmural. It often has an asymptomatic course but may present as a case of chronic cholecystitis. It is a relevant pathology because a relationship with gallbladder cancer of up to 6% has been demonstrated, and in this regard, the role of prophylactic cholecystectomy is still debated. This article presents the case of a 51-year-old woman who consulted for abdominal pain in the right hypochondrium. An ultrasound was performed, diagnosing cholelithiasis with cholecystitis and a gallbladder with a thickened wall and mobile stones inside. A laparoscopic cholecystectomy was performed, with samples taken for pathology, and malignancy was ruled out.