Objective: Ever since its identification in December 2019, the novel coronavirus SARS-CoV-2 has rapidly disseminated worldwide, giving rise to the COVID-19 (coronavirus disease-19) pandemic. The male reproductive system is susceptible to the effects of COVID-19, leading to potential alterations in semen parameters. In this study, we conducted a comparison between patients who have previously contracted COVID-19 and those who have not, specifically focusing on the sperm deformity index (SDI) as a parameter for assessing sperm morphology. Material and Method: 134 patients over the age of 18 who applied to Hospital Andrology Laboratory between 29 November 2022 and 29 December 2022 were included in the study. Of these, 44 were patients who have had COVID-19, and 90 were patients who have not had COVID-19. These patients were compared in terms of SDI parameter and other semen parameters (ejaculate volume, sperm concentration, total sperm count, total motility, progressive motility and percentage of normal morphology sperm). The calculation of the SDI was performed by dividing the total number of observed deformities by the total count of sperm. Results: A noteworthy distinction was observed in the SDI values between the two groups, with a statistically significant difference (p0.05). Conclusion: SDI, one of the semen parameters, was found to be significantly different in both groups. Further comprehensive studies are warranted to thoroughly investigate the impact of COVID-19 on semen parameters.

OBJECTIVE:To evaluate the analgaesic efficacy of tenoxicam and dexketoprofen in patients admitted to the Emergency Medicine (EM) Clinic with severe acute pain due to primary dysmenorrhea (PD). STUDY DESIGN:Randomised-controlled trial. Place and Duration of the Study: Emergency Medicine Clinic, Health Sciences University, Adana City Training and Research Hospital, Adana, Turkiye, from January to December 2022. METHODOLOGY:Patients presenting with PD, were divided into two groups of 60 each, administered 50 mg dexketoprofen and 20 mg tenoxicam intravenously. Visual analogue scale (VAS) scores were recorded at the 15th, 30th, 60th, and 120th minutes. VAS scores and ΔVAS scores were compared with the effectiveness of drugs, the need for rescue drugs and its side-effects. RESULTS:Intravenous (IV) dexketoprofen was administered to 60 of the patients and IV tenoxicam was administered to another 60. At the time of admission, mean VAS scores of the patients were 8.8 ± 0.9 for the dexketoprofen group and 8.6 ± 0.8 for the tenoxicam group. The VAS scores of the dexketoprofen group were found to be statistically significantly lower after 30 minutes with lower need for rescue analgaesics. ΔVAS scores of the dexketoprofen group were statistically significantly higher from the 30th minute. CONCLUSION:According to the VAS scoring, IV dexketoprofen was a more effective drug than IV tenoxicam in patients who were admitted to the EM clinic with severe pain due to PD. KEY WORDS:Dexketoprofen, Primary dysmenorrhea, VAS score.

Objective: To determine the demographic characteristics of patients undergoing nephrectomy at a tertiary care hospital and to analyze the spectrum of renal tumors based on histopathological findings of nephrectomy specimens by current literature. Material and Method: The results of nephrectomy materials admitted to the pathology clinic between January 2019 and December 2023 were included in the study. The demographic characteristics of the included patients, presenting complaints, reasons for nephrectomy, surgical method, nephrectomy area, tumor dimension, and histopathological reports were recorded in a standard data form. Results: A total of 325 nephrectomy materials were included in the study. 61.5% of the patients were male. The mean age of the patients was 54.5±20.2 years (min:3 max:91). The most common presenting complaints were flank pain (28.3%). The most commonly observed pathological malignancy was clear cell carcinoma (32%), and it was found to be significantly higher in male patients (38.5%) (p=0.001). The most frequently detected pathological TNM grade of the patients was grade 1, and the histological WHO/ISUP grade was 2. 28.9% of the patients (n:94) received a diagnosis incidentally. Among those incidentally diagnosed patients, 87.2% (n:82) were histopathologically malignant. When benign pathological diagnoses were examined, the most common diagnosis was pyelonephritis, followed by oncocytoma, benign cystic disease, and angiomyolipoma, respectively. Conclusion: According to our study results, malignant tumors are more commonly observed than benign neoplasms. Despite advancements in imaging technologies, the histopathological diagnosis of renal masses cannot be determined preoperatively, and surgical intervention is required for diagnosis

Objective: This study aims to evaluate the effects of stress due to war in Syrians exposed to after migration to Turkey on sperm parameters. Material and Method: Syrian migrant patients who underwent spermiogram due to infertility were included in the study. The patients were divided into two groups according to the period when the migration started and the stress was felt intensely, and the period when the immigrants had settled down and had less stress. Sexual abstinence duration, age, ejaculate volume, sperm concentration, total motility, progressive motility, morphology according to Kruger Strict criteria, were evaluated. Results: There were 300 patients in group 1 and 902 patients in group 2. There was a statistically significant relationship between the marital status of the refugee patients and the years. There was no statistically significant difference between the groups in terms of ejaculate volume, concentration, morphology and sexual abstinence parameters. The total motility values of the patients in group 2 were statistically significantly higher than the patients in group 1. The progressive motility values of the patients in group 2 were statistically significantly higher than the patients in group 1. Conclusion: The heavy psychosocial stress created by the war and post-war migration affects both sperm motility and progressive motility.

OBJECTIVE: Hypertriglyceridemia (HTG) is the third-most common cause of acute pancreatitis. Plasmapheresis is an extracorporeal treatment method used for treatment. This study aimed to investigate the efficacy of medical treatment and plasmapheresis in patients with acute pancreatitis due to HTG. METHODS: This was a retrospective cross-sectional study. The patients were divided into two groups according to the treatment they received as those who received only medical treatment and those who performed plasmapheresis with medical treatment. According to the treatment received by the patients; clinical, demographic, and laboratory data, Ranson scores, and bedside index of severity in acute pancreatitis (BISAP) scores, decrease in triglyceride levels in 24 h, length of hospital stay, and outcomes were recorded. RESULTS: Forty-seven patients were included in the study. The level of triglyceride decreases at the 24th h was 59.7% ±17.3% in those who received medical treatment and was 70.4% ±15.1% in those who received plasmapheresis (P = 0.032). Receiver operating characteristic curve analysis was performed to predict the need for plasmapheresis treatment, area under the curve (AUC) value of the triglyceride level was the highest (AUC: 0.822, 95% confidence interval: [0.703–0.940]; P < 0.001), the sensitivity and specificity were 83.3% and 72.4%, respectively, and the cut-off value of triglyceride was accepted as 3079.5 mg/dL. CONCLUSION: Plasma triglyceride levels and BISAP score on admission may help physicians to predict the need for plasmapheresis. Plasmapheresis helps to rapidly reduce triglyceride levels in patients with HTG-associated acute pancreatitis.

Background:Perfusion index (PI) has use to monitor sympathetic response changes to pain. In this study, we aimed to evaluate the utility of using perfusion index as an objective marker of pain relief and of the need for rescue analgesia in ED patients with documented renal colic. Methods:We conducted a prospective observational study between January 2020 and December 2020. The demographic characteristics of the patients, their complaints, nephrolithiasis histories, vital signs, PI, and VAS scores (on admission and after treatment) were recorded. Results:A total of 144 patients were included. All patients were administered 20 mg of Tenoxicam on admission. There was a statistically significant difference between the PI (<0.001) and VAS scores (<0.001) on admission and after the administration of Tenoxicam. 43.1% (n = 62) of the patients needed rescue analgesia. Accordingly to ROC curve, the ability of both PI2 (AUC: 0.615, 95%CI 0.519-0.711, p = 0.018) and ΔPI (AUC: 0.601, 95%CI 0.508-0.694, p = 0.039) indices were determined as statistically significant. The cutoff value of the PI2 level for the prediction of the needed rescue analgesia was 4.65 and the cutoff value for ΔPI (PI2-PI1) was 2. All patients had a pain VAS score of <3 and a mean PI of 5.7 ± 2.9 at discharge from the emergency department. Conclusion:In patients presenting to the emergency department with renal colic, the PI value on admission and after analgesic therapy can be helpful in assessing the severity of pain and predict the need for rescue analgesia.

Purpose: The aim of this study is to investigate the power of disease severity scores to predict the development of Severe Acute Pancreatitis (SAP) and mortality in the early period over 65 years old diagnosed with acute pancreatitis in the emergency department. Materials and Methods: We calculated RANSON (on admission) and Computed Tomography Severity Index (CTSI) in addition to Bedside Index for Severity in Acute Pancreatitis (BISAP) score on admission to the emergency department. Results: One hundred and sixty patients (46.9% over 80 years of age) were included in the study. We observed statistically higher length of hospitalization, longer duration of stay in the intensive care unit, SAP and higher mortality in patients over 80 years of age. When we examined the ROC curve, we determined that the AUC values of the BISAP score were highest in both SAP and mortality estimation (AUC: 0.911, 95% CI 0.861-0.962; AUC: 0.918, 95% CI 0.864-0.9722, respectively). Binary logistic analysis indicated a 4.7-fold increased risk for SAP and a 12.3-fold increased mortality for each unit increase in BISAP score value. Conclusion: BISAP may be a good predictor for SAP and mortality estimation on admission to the emergency department in patients over 65 years of age with acute pancreatitis.

Pain after soft tissue injuries in and around the ankle is a troublesome process in terms of patient comfort and mobilization. The aim of this study was to compare the analgesic efficacy of intravenous ibuprofen and intravenous tenoxicam in patients with acute musculoskeletal pain due to ankle injury. We conducted a prospective, double-blind, randomized controlled study in a tertiary hospital. The patients were divided into two groups as those administered IV 400 mg ibuprofen and IV 20 mg tenoxicam. After the treatment of the patients, visual analog scale (VAS) scores were recorded at 15, 30, 60, and 120 min. VAS scores were compared with the effectiveness of drugs, their side effects, and the need for rescue drugs. One hundred and twenty-four patients were included in the study. There were 62 patients in the tenoxicam group and 62 patients in the ibuprofen group. When VAS scores were compared, it was found that the VAS scores of the ibuprofen group were statistically significantly lower (p < 0.001). When the ΔVAS scores were compared, it was observed that the ΔVAS scores of the ibuprofen group were statistically significantly higher from 30 min (p < 0.001). There was a statistically significant difference in favor of ibuprofen between the two drug groups in terms of the need for rescue analgesics (p < 0.001). Conclusıon. The analgesic efficacy of intravenous ibuprofen and tenoxicam is equal after an ankle injury. However, after 30 min of drug administration, ibuprofen provides more effective analgesia than tenoxicam.

Abstract The aim of this study is to reveal the predictive power of biomarkers and SYNTAX (SX) score for short-term mortality in patients diagnosed with non-ST-segment elevation myocardial infarction (NSTEMI) in the emergency department. This is prospective observational cohort study. Demographic characteristics of the patients, laboratory parameters on admission, left ventricular ejection fraction (LVEF) percentages, affected vessels in angiography (CAG) and the treatment strategy [medical therapy, percutaneous transluminal coronary angioplasty (PTCA), coronary angio by-pass graft] and SX scores were recorded on the data collection form. ROC curve was used to investigate the predictivity of blood urea nitrogen/albumin ratio (BAR), procalcitonin, C-reactive protein (CRP), high sensitivity cardiac troponin I (Hs-cTnI), CRP to serum albumin ratio (CAR), neutrophil to lymphocyte ratio (NLR) and SX scores in mortality. Multivariate analysis of biomarkers and SX score was performed to estimate the patients’ 30-day mortality. Of the 415 patients were included in the study. ROC analysis of BAR, CAR, CRP, Procalcitonin, Hs-cTnI, NLR and SX score to predict mortality was statistically significant. BAR (OR: 1.280, 95% CI: 1.113–1.472, p = .001) and SX score (OR: 1.071, 95% CI: 1.018–1.126, p = .007) were found to be independent predictors of 30 days mortality. LVEF reduction, SX score, the number of affected vessels and the frequency of LMCA lesions increase were found to be statistically significant in patients with BAR ≥4.8. BAR, which can be calculated easily and quickly on admission to the emergency department and in clinical practice, may be used to predict mortality in patients with NSTEMI.

Background/aim: This study aimed to compare the levonorgestrel intrauterine system (LNG-IUS) with abdominal hysterectomy (TAH) and total laparoscopic hysterectomy (TLH) as first-line treatments for heavy menstrual bleeding (HMB). Materials and methods: Ninety-eight patients aged 20-55 years who complained of regular heavy menstrual bleeding were enrolled in the study. The TAH group included 29 patients, the LNG-IUS group included 34, and the TLH group included 35. These groups were compared in terms of quality of life and the cost-effectiveness of the selected methods. Quality of life was assessed using the 36-Item Short Form (SF-36), and cost-effectiveness was assessed according to the current cost of each approach. Results: The quality of life parameters, with the exception of mental health, improved significantly in the LNG-IUS, TAH, and TLH groups. The mean costs of the LNG-IUS, TAH, and TLH procedures were $99.15 ± 4.90, $538.82 ± 193.00 and $1617.05 ± 258.44, respectively (P < 0.05). Overall, LNG-IUS was the most cost-effective treatment option. Conclusion: The outcome measures of the SF-36 revealed that after 6 months, these treatments were equal in terms of quality of life, except for mental health. LNG-IUS was the most cost-effective approach.

Objectives: We aimed to determine if naloxone has any additive effect in the treatment of amitraz poisoning and clinical and laboratory findings of the toxicity in our study. Methods: In the experiment 60 adult female Wistar Albino rats of which mean weight 220- 260 gr were used. The rats were divided to four groups. Eight hundred mg/kg amitraz was administered to groups 1. 3. and 4. by orogastric route while group 2 was control. The change in respiratory and heart rates of four groups were recorded every twenty minutes. When toxicity symptoms in groups 3 and 4 were observed, the treatment was initiated. As treatment 20 ml/kg normal saline and 0,1 mg/kg atropine was administered when heart rate decreased under 250 beats/minutes intraperitonealy. 0.3 mg/kg naloxone was given additionally to group 4. All of the rats were sacrified under general anesthesia by obtaining intracardiac blood samples for hematological and biochemical analyses. Complete blood count (CBC) which contains white blood cell (Wbc), red blood cell (Rbc), hemoglobin (Hgb), hematocrit (Hct) and platelet (Plt) values as biochemical analyses blood urea nitrogen (BUN), creatine (crea), sodyum (Na+), calcium (Ca+), glucose (Glu), serum glutamic oxalasetic transaminase (SGOT), serum glutamic piruvic transaminase (SGPT) values were asseyed. The data were evaluated by SPSS 13.0. Results: In hematological evaluation there was statisticaly significant difference between groups for the values of Wbc, Rbc, Hct, Hgb as well as in the biochemical evaluation for BUN, crea, Glu, Na, SGOT, SGPT (p<0.05). Naloxone treatment was not superior to supportive treatment statisticaly. Conclusion: In conclusion hematological and biochemical values varies in amitraz poisoning and this can be cured by supportive treatment. Naloxone has no additive effect to the treatment. CAYD 2015;2(2):71-6.

OBJECTIVE:In our study, we aimed to investigate histopathological effects of chronic methyl parathion exposure on ovaries at electron microscopic level.MATERIALS AND METHODS:In this study, Wistar albino type, adult, female rats with an average weight of 190-250 g were used. 30 female rats, included in this study, were divided into 3 groups. Group I received only saline and was evaluated as the control group, whereas Group II received 1/50 percent of LD50 dose of methyl parathion and Group III received 1/20 percent of LD50 dose of methyl parathion every day at 130 pm orally by gavages during two estrus cycles (8 days). The rats at proestrus stage on the morning of 9th day of the study underwent bilateral ovariectomy. Ovarian tissues of the control and drug groups were examined under the electron microscope; primordial and growing follicles were included in the evaluation, however, corpora lutea were excluded taking into account the presence of remaining regressive corpora lutea from the previous cycles.RESULTS:Following examination of ovarian tissues of rats exposed to 1/50 and 1/20 percent of LD50 dose of Methyl parathion at electron microscopic level, it was detected that significant structural changes had occurred in developing follicles and ovarian stroma in both drug groups, and that primordial follicles had not been affected significantly from methyl parathion but necrosis had been developed in oocyte and granulosa cells of developing follicles, and that in 1/20 group in addition to these changes, apoptotic changes had been found in granulosa cells of developing follicles.CONCLUSIONS:As a result of chronic exposure to methyl parathion, rat ovaries are significantly affected and follicular development is impaired. This state may explain the cause of infertility due to chronic pesticide exposure.

İnfertilite, üreme fonksiyonunun yerine getirilememesi olarak tanımlanabilir. İstatistiksel olarak üreme çağındaki evli çiftlerin %15\'sini etkileyen bir sorundur. Çiftlerin % 30-40'ında erkek, % 40-50'sinde ise kadın infertiliteden sorumludur. Erkek infertilitesinde tanıda ilk basamak spermiyogram tetkikidir. Semen analizi erkeğin fertilite değerlendirmesinde en önemli tetkiktir. Bu derleme Dünya Sağlık Örgütünün uluslararası standardizasyonu sağlamaya çalıştığı semen analizi konusunda güncel bilgileri kapsamaktadır.

Objective. The purpose of this experimental rat model study is to evaluate the changes in the ovarian environment after excision of the rudimentary horn. Methods. Ten female Wistar albino rats were used in this study. One cm of right uterine horn length was excised in the first operation. Two months after the first operation, all animals were sacrificed to obtain ovaries for histological examination. Mann-Whitney U test and Student's t-test were used for statistical analysis purposes. Statistical significance was defined as P < 0.005. Results. The number of primordial follicles (P = 0.415), primary follicles (P = 0.959), preantral follicles (P = 0.645), antral follicles (P = 0.328), and Graafian follicles (P = 0.721) was decreased and the number of atretic follicles (P = 0.374) increased in the right ovarian side. Howeve,r this difference was not found to be statistically significant. Conclusion. The results of this experimental rat model study suggest that the excision of rudimentary horn could have negative effects on ipsilateral ovarian functions.

UNLABELLED:To assess the effects of the natural progesterone on the endometriosis in a rat model.MATERIALS AND METHODS:Endometriosis was surgically induced in 20 rats by transplanting an autologous fragment of endometrial tissue onto the inner surface of the abdominal wall. Rats in control group had no medication but 2.5 mg/kg/weekly natural progesterone was administered to rats in study group for four weeks. After that, all rats were sacrificed and dimensions of endometriosis were measured and they were evaluated morphologically and histologically. Scoring systems were used to evaluate preservation of epithelia.RESULTS:Two rats in the study group and one rat in the control group died of complications related to surgery. At the end of the treatment, there was a reduction in the size of the endometriotic lesions in the study group (p < 0.01). According to histological evaluation, the study group had lower score than control goup which was statistically significant (p = 0.014).CONCLUSIONS:Natural progesterone is effective against endometriosis in rat model.

Aims: The study was aimed to clarify whether toxic effects of organophosphorus compounds on ultrastructural changes in the testis tissue are reversible with antidotal treatment or not. Materials and methods: In this prospective, controlled, electron microscopic animal study, Wistar albino adult male rats were divided into 3 groups. 1st group received only isotonic sodium chloride. 2nd and 3rd groups received lethal dose of [ILD50) = 30 mg I kg] Methamidophos. 3rd group was treated with atropine and pralidoxime after cholinergic signs had evolved. Results: In testicular tissue samples of rats in 2nd group, we have found structural degenerative changes. The giant lipid droplets, dense mitochondria, agranider endoplasmic reticulum vacuolization have been observed. The thickness of membrana propria and electron density of Sertoli have been increased. Also findings of cytoplasmic lysis in most of the tubules, arrest in spermatogenic cells, hnmature release to lumen and apoptotic changes have been detected. In samples of 3rd group, degenerative changes in testicular tissue were similar to the 2nd group, and no significant structural improvement was proved after treatment. Conclusion: Our study revealed that acute exposure to Methamidophos causes important degenerative changes in all elements of testicular tissue; and those structural degenerative changes are not reversible with pharmacological drug treatment in the acute phase.

Postmenopausal adnexal masses are important to make diferentiation of benign-malign disorders. A 59 year–old postmenopausal woman presented with a mass in lower abdomen clinically suspicious of malignancy. Investigations failed to identify the nature. On laparotomy, excision of the mass was done. Histopathological examination identified the lesion as hydatid cyst arising from the mesentery of rectum. The patient had no history of liver or lung involvement. A significant clinical suspicion is necessary in the differential diagnosis of pelvic masses to identify such a rare entity.

Infertility may be defined as failure to meet the reproductive function. Statistically, affects 15 % of married couples of reproductive age. Of the 30-40 % males and 40-50 % females are responsible for infertility. The first step in diagnosis of male infertility is semen analysis. Semen analysis is the most important examination in the evaluation of male fertility. This review includes up to date information about the semen analysis in which The World Health Organization is trying to provide international standardization work. [Archives Medical Review Journal 2013; 22(4.000): 532-542]

BACKGROUND: Organophosphate (OP) insecticides are widely used in both agricultural and landscape pest control, and the potential for human exposure to these compounds is significant.OBJECTIVES: The aims-is Of this Study were to investigate the effects of acute poisoning with the OP methamidophos and the effects of antidotal therapy with atropine and pralidoxime on rat thyroid tissue .METHODS: In this single-blind, ex vivo study, male Wistar albino rats weighing 220 to 230 g were divided into 4 treatment groups. Group I received a median lethal close of methamidophos (30 mg/kg) via oral gavage. Group 2 received saline via oral gavage and served as the control group for group L Group 3 received methamidophos (30 mg/kg) via oral gavage, and after 8 minutes atropine 0.05 mg/kg and pralidoxime chloride (2-PAM) (40 mg/kg) were administered intraperitoneally (IP). Atropine was titrated to reverse signs of cholinergic excess. Group 4 received saline via oral gavage followed by IP injections and served as the control for group 3. Rat thyroid tissues were examined using electron microscopy, and the histologic changes were examined by a histopathologist who was blinded to treatment. All rats were euthanized by intracardiac blood collection. The rats in groups I and 2 were euthanized 8 minutes after treatment. The rats In groups 3 and 4 were euthanized 96 hours after treatment.RESULTS: Thirty-four mate rats (aged 16 weeks) were included in the study. The rats were grouped accordingly: group 1 (n = 10); group 2 (n = 7); group 3 (n = 1.0); and group 4 (n = 7). The mean (SD) pseudocholinesterase (PCE) activity was sign methamidophos-treated rats (group 1.) compared with the corresponding control group (group 2) (32.6 [17.0] vs 579.4 [59.0] U/L, respectively; P < 0.001). PCE activity was significantly higher in rats treated with atropine and 2-PAM (group 3) (392.5 [39-4] U/L; P < 0.001) compared with those not receiving antidotal therapy (group 1.). Group 1. experienced changes in thyrocytes and organelles that were not detected in the antidote-created rats in group 3. These changes included follicular cell nuclei exhibiting all increase in chromatin content, pyknotic nuclei, mitochondrial degeneration, dilated granular endoplasmic reticulum cisternae, reduced microvilli, and intraluminal cellular debris. Within follicular cells, formation of vacuoles Filled with fine granular material was noted.CONCLUSION: Acute OP poisoning was associated with histopathologic effects in rat thyroid tissue that appeared to be mitigated by antidotal therapy in this small animal Study. More extensive studies using immunohistochemical methods are needed.

This study was conducted to determine the probability of adhesion formation with certain materials after abdominopelvic surgery, and to assess the effectiveness of adhesion-preventing agents. The study included 2 phases. In the first phase of the study, 50 rats that had been divided into 5 groups were examined. Group 1 served as the control group. In group 2, 2 mL blood was taken from the femoral vein of the rat; in group 3, 0.0625 g talcum powder was mixed with 2 mL saline; in group 4, 2 mL ileal content was identified; and in group 5, 2 mL cecal content had spilled into the peritoneum. In the second phase of the study, 50 rats that had been divided into 5 groups were examined. Ileal content was the leading cause of intraperitoneal adhesions in the first phase; in the second phase, in group 1, 2 mL ileal content and 5 mL povidone-iodine (10%) were used; in group 2, 2 mL ileal content and 5000 units aprotinin were mixed with 5 mL saline; in group 3, 2 mL ileal content and 25 IU heparin (5000 IU/L) were mixed with 5 mL saline; in group 4, 2 mL ileal content and 5 mL 32% dextran 70 were combined; and in group 5, 2 mL ileal content was used together with 5 mL Ringer's lactate. On postoperative day 14, the rats were killed with the use of high-dose intramuscular ketamine, and necropsies were performed on all rats. Adhesions were most often established because of ileal and cecal contents. Blood and talcum powder produced less adhesion formation. Heparin and 32% dextran 70 were significantly more effective at preventing adhesion formation due to ileal contents. Intraperitoneal heparin and 32% dextran 70 may be particularly valuable for the prevention of adhesions due to intestinal content in cases with no contraindications.