Objective: This study aimed to evaluate and compare the therapeutic effects of fluoroscopy-guided triple shoulder injections with steroids and, a combination of steroids and ozone. Methods: Data were retrospectively collected from the files of 70 patients diagnosed with non-specific chronic shoulder pain and received triple shoulder injections. The patients were divided into two groups. One group included triple shoulder injections with steroids under fluoroscopic guidance, while the other group included combination of steroids and ozone. Pain intensity was evaluated with the Visual Analog Scale (VAS), the patient's quality of life and functionality were assessed using the Shoulder Pain and Disability Index (SPADI), and the active range of motion (ROM) of shoulder abduction, external rotation, and flexion were measured by goniometry. Beck Depression Inventory (BDI) was used to measure the severity of depression before the procedure. All measurements were recorded at baseline and 1, 3, and 6 months after the procedure. Results: Baseline characteristics were similar in both groups. There was no statistical difference in VAS scores between the two groups at baseline, 1st, and 3rd months. However, in the 6th months, the VAS scores of patients treated with steroids plus ozone were significantly lower than those of patients treated with steroids (P<0.001). Both groups showed significant improvements in SPADI pain, disability, and total subscores compared to pre-treatment values (P < 0.001). There was a significant improvement in the ROM of the shoulder joint in both groups (p<0.001). However, patients who received ozone and steroid treatments showed a significantly greater increase in SPADI and ROM of shoulder joints in the 6th months (p<0.001). There was a positive correlation between BDI score and pain duration, and the severity of depression had no statistically significant effect on VAS scores. Conclusion: Results of this study revealed that triple shoulder injection with steroids or a combination of steroids and ozone proved to be an effective therapeutic approach for patients suffering from shoulder pain and limited mobility. The combination of ozone with steroids may lead to better results than using steroids alone. Furthermore, a long duration of pain increases the risk of chronic depression in patients.

Objective: Circumcision is a significant issue for child health and parents, and the reliability and quality of information published on platforms like YouTube can affect patients' access to accurate information. This study aimed to evaluate the quality and reliability of Turkish YouTube videos as a source of information about circumcision. Methods: In this cross-sectional study, a search was conducted on YouTube using the keyword "circumcision" on June 1, 2024. After applying exclusion criteria, the 45 most viewed Turkish videos (more than 10,000 views) were included in the study. Videos that were irrelevant, contained advertisements, personal experiences, or were in languages other than Turkish were excluded. The duration, view count, likes, dislikes, number of comments, and upload date of the videos were recorded. The Video Power Index (VPI) was calculated to measure video popularity. Two pediatric surgeons independently assessed the quality and reliability of the videos using the Modified DISCERN (mDISCERN), Journal of the American Medical Association (JAMA), and Global Quality Scale (GQS) scores. Scale scores were compared between groups based on the purpose and publisher of the video using the Mann-Whitney U test. Correlations between video characteristics and scale scores were evaluated with the Spearman correlation coefficient, and inter-observer agreement was assessed with the intraclass correlation coefficient (ICC). Results: According to the inclusion and exclusion criteria, 39 (86.7%) of the 45 videos were informational, and 6 (13.3%) were surgical. The average length of the videos was 213.5 ± 206 (35 - 1164) seconds. The average duration since the videos were published until June 1, 2024, was 1653 ± 980 (350 - 3985) days. The average view count of the videos was 73,862 ± 114,210 (11,736 – 679,985). The average Video Power Index of the videos was 39.9 ± 40.85 (3.69 - 247.1). The average mDISCERN score was 2.87 ± 1.24, the JAMA score was 2.71 ± 0.7, and the GQS score was 3.38 ± 1.19. According to the GQS scale, 22.3% (n=10) of the 45 videos were of low quality, 33.3% (n=15) were of medium quality, and 44.4% (n=20) were of high quality. All scale scores of informational videos were statistically significantly greater compared to the surgical videos (P=0.008, P=0.041, P=0.024, respectively). Conclusion: YouTube is a significant source of information with the potential to influence the knowledge and behavior of a wide audience regarding circumcision. Patients and their relatives should consider videos uploaded by expert physicians. There is a need for more high-quality educational surgical circumcision videos and short, clear, unbiased, high-quality informational videos addressing controversial issues and containing necessary resources created by expert physicians. This will help increase the accurate knowledge of families about circumcision and consequently reduce unnecessary anxiety and expectations.

Objective: To evaluate demographic, laboratory, biopsy, and imaging variables as potential predictors of microbial identification in patients with suspected vertebral osteomyelitis, aiming to enhance diagnostic accuracy and optimize patient care. Methods: This retrospective cohort study analyzed 83 patients who underwent image-guided percutaneous disc-space sampling between June 2020 and December 2023. Inclusion criteria were adults aged ≥18 years with imaging-based evidence of vertebral osteomyelitis and clinical suspicion of infection. Exclusion criteria were presence of known malignancy and non-infective causes. Demographics, clinical history, imaging, biopsy, and microbiology data were collected. Logistic regression analysis was used to identify predictors of positive microbiological yield. Results: Microorganisms were identified in 32 of 83 cases (38.6%), with Mycobacterium tuberculosis being the most common pathogen identified (21.9%). Elevated C-reactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), and paravertebral signal changes on MRI were associated with a positive culture yield. Multivariate analysis identified CRP as an independent predictor of positive microbiological results. CT-guided percutaneous biopsy was found to be safe, with no major complications reported. Conclusion: CT-guided percutaneous biopsy is a reliable and safe diagnostic tool for identifying the causative pathogens in vertebral osteomyelitis. Elevated CRP levels were independently associated with positive microbiological yield, highlighting its role as a crucial predictor in clinical practice. These findings underscore the importance of incorporating CRP levels into the diagnostic process, potentially guiding the selection of patients for biopsy to improve the detection of infection.

Objective: There is growing evidence that Cognitive Disengagement Syndrome (CDS) is a distinct construct, supported by both empirical research and clinical differentiation. CDS demonstrates a stronger association with the inattentive type of Attention Deficit Hyperactivity Disorder (ADHD-IA), compared to its correlation with hyperactivity/impulsivity symptoms. Several studies have identified a significant positive relationship between CDS and internalizing symptoms such as anxiety and depression. To our knowledge, no study has explored CDS in children with major depression (MD). In the present study, we compared children with MD but without ADHD to children with ADHD but without depression in terms of CDS. We examined whether children with MD would have greater CDS when compared to children with ADHD. Methods: Thirty-six adolescents with ADHD, and twenty-five adolescents with MD, aged 12 to 18 years old, were administered the Barkley Child Attention Scale (BCAS), Turgay's DSM-IV Based ADHD and Disruptive Behavior Disorders Screening Scale, and the Children’s Depression Rating Scale-Revised (CDRS-R). Results: The majority of the ADHD and MD groups were boys. The MD group had significantly higher BCAS scores than the ADHD group (U=287.0, p=0.016). In the ADHD group, the severity of BCAS scores was inversely correlated with ADHD-Hyperactivity/impulsivity scores (r=-0.681, p<0.001). In the MD group, there was a significant positive relationship between BCAS and CDRS scores (r= 0.493, p=0.012). Conclusions: The findings of this study highlight the transdiagnostic relevance of CDS by demonstrating its association with depression, independent of ADHD. This underscores the importance of considering CDS in the assessment and treatment of depression across various clinical contexts.

Background/aim: Diabetes is manifested by endothelial dysfunction and an imbalance between vasoconstriction and vasodilation. The aim of our study is to examine the effect of vitK2 application on vascular and rheological parameters in a rat diabetes model. Materials and methods: A total of 60 male Wistar Albino rats were used to examine vascular responses and hemorheological parameters. A total of 6 groups were: control (C), control+vehicle (Cv), control+vitK2 administered (C + K2), diabetes (D), diabetes+vehicle (Dv), and diabetes+vitK2 (D + K2) group. After the animals were sacrificed, blood and vascular samples were taken and the contraction and relaxation responses of the aorta and erythrocyte deformability and aggregation were examined. Results: When KCl dose-response curves are evaluated; Increased vasoconstriction response was found in the Dv group compared to the Cv group. The increase in vasoconstriction observed in the Dv group decreased with the application of vit K2. D+vitK2 group thoracic aorta contraction responses returned to Cv group levels. In response to increasing cumulative doses of Phe, a significant increase in vasoconstriction response was observed in the Dv group compared to the Cv group. VitK2 application reduced the Phe-mediated contractile response, which was increased in the Dv group, and returned the contraction response to Cv conditions except for two intermediate Phe doses. In the Dv + K2 group, a significant decrease was observed in the aggregation index, which was tended to increase. Conclusion: Considering the cardiovascular complications frequently observed in diabetes, it can be suggested that vitK2 therapy may yield positive outcomes in diabetes.

Objective: The aim of this study was to investigate the clinical features, psychiatric comorbidities, and treatments of childhood obsessive-compulsive disorder (OCD), with consideration given to OCD severity, gender and age. Method: The study included 104 children and adolescents between the ages of 6 and 17 who were diagnosed with OCD and followed up in Child and Adolescent Psychiatry outpatient clinics between 2016 and 2023. The study examined the sociodemographic characteristics, clinical features, comorbid psychiatric disorders, and treatment approaches of children and adolescents with OCD. Results: The sample had a mean age of 13.1 ± 2.7 years, and the mean age at onset of OCD was 11.9 ± 2.7 years (range: 5-17 years). Those with mild OCD had a significantly lower mean age at presentation and onset of OCD compared to those with moderate and severe OCD (p=0.012, p=0.02, respectively). Patients with severe OCD had longer illness duration (p=0.009) and outpatient follow-up (p=0.004) compared to those with moderate OCD. Boys had significantly higher rates of family history of psychiatric disorders (p=0.006), attention-deficit/hyperactivity disorder/oppositional defiant disorder (p=0.003), and tic disorder (p=0.035) comorbidity rates than girls, while girls had higher rates of anxiety disorders (p=0.022) comorbidity. The study found that repeating and counting compulsions were more common in adolescents than in preadolescents (p=0.003, all). Conclusion: These results suggest that clinical presentation and comorbidity may vary with disease severity, gender and age, in children and adolescents with OCD. Early intervention is crucial to prevent clinical progression, worsening, and mental health sequelae.

Objective: This study aimed to retrospectively compare the results of microdissection testicular sperm extraction (microTESE) and Intracytoplasmic sperm injection (ICSI) treatments in nonobstructive azoospermia (NOA) patients with different aetiologies. Determinants (clinical characteristics) for microTESE outcomes were compared between patients with successful sperm retrieval (SSR) and sperm retrieval failure (SRF). Methods: A total of 510 NOA patients who underwent microTESE between January 2015 and January 2024 were included in this study. Patients were classified according to the cause of NOA and SSR, fertilisation rate, clinical pregnancy, and overall live birth rate were evaluated. Results: The SSR rate was 44.1% in the whole population. The idiopathic patient group had the lowest SSR rate (X2: 34.81; p<0.01). There was no difference between the groups in terms of fertilisation rate, clinical pregnancy and overall live birth rate. There was a negative correlation between age and SSR rates in patients with idiopathic NOA (t:-0.27; p<0.01). SSR rates were higher in patients with cryptorchidism (right: t:0.8; P:0.003; left: t:0.72; p:0.002) and mumps orchitis (right: t:0.76; P<0.01; left: t:0.76; p=0.003). Conclusion: Etiology has a significant role in terms of SSR in patients with NOA. SSR was found to be significantly less in patients with idiopathic NOA compared to other causes. In addition, age and testicular volume were significant predictive factors for SSR in patients with idiopathic and acquired NOA.

Objective: The objective of this study was to evaluate the dimensions and the morphology of the sella turcica, as well as maxillary cephalometric landmarks, in patients with and without clefts. Methods: Lateral cephalometric radiographs of 55 cleft patients and 55 non-cleft (control) patients were included in the study. The morphology of the sella turcica, including its shape, height, width, and diameter was evaluated. Additionally, maxillary cephalometric measurements, comprising four lengths and two angles, were assessed on the radiographs. The chi-squared test was employed to compare sella turcica shapes between the cleft and non-cleft groups. Independent samples t-tests were conducted to analyze dimensional parameters between groups and genders. Results: Significant relationship was found between groups with cleft and non-cleft for sella shapes (p=0.032). There was no statistical association for sella dimensions according to the cleft presence (p>0.05). All maxillary cephalometric measurements were significantly greater in individuals of the non-cleft group compared to those in the cleft group (ANS-PNS, A-PNS, S-N-ANS , S-N-A, N-A) except R-PNS. Conclusion: Patients with clefts more frequently exhibited a flattened sella shape, whereas those without clefts tended to have a round sella shape. Maxillary cephalometric dimensions were lower in the individuals of cleft group.

Objective: Body dysmorphic disorder (BDD) is a mental health disorder in which a person believes that their actual physical features appear worse than they truly are. The aim of this study is to examine the presence of BDD and its comorbidity with anxiety, depression, and obsessive-compulsive disorder (OCD) in patients with planned orthognathic surgery for dentofacial deformities. Methods: In this study conducted on patients scheduled for orthognathic surgery, the presence of BDD, OCD, depression, anxiety, and stress was determined by administering the Florida Obsessive-Compulsive Inventory (FOCI), Depression, Anxiety, and Stress Scale-21 (DASS-21), and Body Image Disturbance Questionnaire (BIDQ) prior to the surgery. An independent samples t-test evaluated differences between group means, Pearson's correlation coefficient demonstrated the linear relationship between two variables, and the chi-square test assessed the relationship between two categorical variables. A p-value below 0.05 was deemed statistically significant. A total of 108 patients were included in the study, with 54 patients Class 2 and 54 patients Class 3. Results: BIDQ, FOCI, depression, anxiety, and stress, males showed statistically significant higher results compared to females (p <0.05). There were no statistically significant differences in BIDQ, FOCI, depression, and stress between Class 2 and Class 3 patients (p>0.05). Of the 108 patients included in the study, a total of 20.4% (n=22) were found to be BDD positive. Among the female patients, 10% (n=6) were BDD positive, while among the male patients, 33.3% (n=16) were BDD positive. When evaluated in terms of skeletal classification, 14.8% (n=8) of Class 2 patients were BDD positive, while 25.9% (n=14) of Class 3 patients were BDD positive. Conclusions: Surgeons performing orthognathic surgery should be familiar with common and often severe body image disturbances. When evaluating patients seeking orthognathic surgery, their psychological conditions should be carefully considered.