Istanbul Medeniyet University Research Articles

Comparison of Sentinel Lymph Node Sampling with Positron Emission Tomography in the Evaluation of Axillary Lymph Node Involvement in Breast Cancer Patients

Objectives Axillary lymph node status is the most important prognostic factor in breast cancer patients.: This study was carried out to evaluate the diagnostic accuracy of FDG-PET/CT as a noninvasive technique and intraoperative frozen biopsy of sentinel lymphadenectomy (SLNB) in detecting axillary lymph node metastasis. Materials and Methods This study was carried out retrospectively on 44 patients diagnosed with breast cancer, who underwent preoperative FDGPET/ CT imaging and intraoperative SLNB, at the General Surgery Clinic of Istanbul Medeniyet University Göztepe Training and Research Hospital. The axilla was clinically negative in all patients. Preopative FDG-PET/CT imaging and intraoperative SLNB were performed. FDG-PET/CT results were compared with the histopathological results of SLNB and axillary lymph node dissection (ALND). Results According to the pathology results of axillary dissection, metastatic nodes were detected in 22 of 44 cases, and FDG-PET/ CT imaging gave false-negative results in 10. The number of false negative cases of SLNB was 3; Axillary involvement was detected as a result of pathology in one of them, while the others were evaluated as skip metastases. The sensitivity of SLNB and FDG-PET/CT imaging was measured as 86.3% and 54.5%. The specificity values were 95.4% and 100%. FDG-PET/CT imaging has low sensitivity; specificity and positive predictive value were at acceptable levels Conclusion: The sensitivity of FDG-PET/CT imaging is low in detecting axillary involvement, and SLNB is needed in those with negative axillary involvement in FDG-PET/ CT imaging. In our study, SLNB examination was superior to FDG-PET/CT imaging in detecting axillary nodal status. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1083-1094

Association of interleukin-1 and interleukin-6 levels in lateralized temporal epilepsy patients.

To explore the clinical significance of interleukin-1 and interleukin-6 in the development of lateralized temporal epilepsy. The prospective study was conducted from January to April of 2022 at the Neurology Department of Training and Research Hospital, Istanbul Medeniyet University, Turkey, and comprised patients with lateralized temporal epilepsy aged 18-86 years who were in the interictal period in group A and healthy controls in group B. The levels of interleukin-1 and interleukin-6 of patients in both groups were compared. Data was analysed using SPSS 25. Of the 92 subjects, 60(65.2%) were in group A; 35(58.3%) were males and 25(41.7%) were females with a median age of 37.5 years (interquartile range: 2.2-42.7 years). There were 32(34.8%) subjects in group B; 19(40.6%) females and 13(40.6%) males with a median age of 40.5 years (interquartile range: 25-50 years) (p>0.05). Within group A, 41(68.3%) patients had left-sided epilepsy and 19(31.7%) had right-sided epilepsy (p<0.001). Both interleukin-1 and interleukin-6 levels were lower in group A than in group B (p<0.001). Both interleukin levels did not significantly differ between right and leftlateralised temporal seizures (p=0.44). In the left-lateralized temporal seizures, interleukin-1 levels correlated with epilepsy duration (p<0.006), lower onset age (p<0.050), and presence of prenatal risk (p<0.028). Interleukin-1 and interleukin-6 levels were positively correlated with each other for lateralized temporal epileptic hemispheres (p<0.001). Interleukin-1 level was correlated with epilepsy duration, lower onset age, and presence of prenatal risk in the left-lateralized temporal epilepsy.

Factors Affecting Turkish Medical Students' Pursuit of a Career in Neurosurgery: A Single Center Survey Study

Statistics show that over the past 2 decades, even in high-income countries, fewer and fewer students have listed neurosurgery as their top career option. Literature on medical students' pursuit of neurosurgical careers in middle- and low-income countries are scarce. The aim of this research, conducted in Turkey with a middle-income economy, was to contribute insights relevant to medical education and neurosurgery across the world. A survey was conducted with a target sample of fourth-year (167 students), fifth-year (169 students), and sixth-year (140 students) medical students (476 in total) from the Medical School at Istanbul Medeniyet University in Turkey. The response rates of the fourth-, fifth-, and sixth-year students were 62% (104/167), 53% (90/169), and 50% (70/140), respectively (in total, 266, including 147 female and 119 male). In terms of the genuine intention, only 2.5% of men and 2.7% of women were committed to specializing in neurosurgery. This study further revealed that possible reasons for these students' low motivation to specialize in neurosurgery were their beliefs that in neurosurgery, the physical and psychological demands were high, and the night shifts were intense, meaning they would not have a social life or spare time for their hobbies; that morbidity/mortality were high; and that financial incentives were insufficient, especially in public institutions. Turkish medical students did not rank neurosurgery at the top of their career choices. Possible reasons for this are socioeconomic factors and the inadequate introduction of neurosurgery to medical students.

Effects of Ambient Temperature and Magnitude of the Vibration on the Dynamics of Pre-Stressed Precast Isolated Pedestrian Bridges

The dynamic properties of structures are known as inherent properties dependent on the mass and stiffness parameters. However, recent studies showed that the temperature and the magnitude of the vibration affect them. This study aims to reveal how the ambient temperature and human-induced vibrations alter the modal characteristics of pre-stressed precast isolated pedestrian bridges. For this aim, operational modal analyses have been applied to the Istanbul Medeniyet University pedestrian bridge. Three-bay pre-stressed precast and isolated bridge has been connecting the two campuses of the university for six years and its dynamic properties were investigated during its construction. In this study, the dominant frequencies of the bridge have been determined to see if they changed or not for its service life. Secondly, the dynamic response of the longest bay of the bridge has been evaluated under different temperatures and human-induced vibrations. Through a year, twelve acceleration measurements have been gathered in a temperature range of 5 – 33 °C and representing the different levels of human-induced vibrations, some jumping actions were applied and its response was recorded. While the performed analyses proved that, the dominant frequencies are dependent on the ambient temperature, no significant correlation was obtained between the amplitude of the vibration and the dominant frequencies of the bridge. High-amplitude vibrations have been used for the vibration serviceability check of the bridge, and it is seen that it satisfies the requirements set by different codes.

Does corneal tattooing affect the conjunctival microbiota?

Purpose This study aimed to investigate the effects of commercial tattoo inks used in corneal tattooing on conjunctival microbiota. Method This prospective case control study consisted of 125 participants divided in the following three groups: 35 patients with corneal tattoos, 40 patients with corneal leukoma, and 50 healthy subjects. Corneal tattooing was performed in all the cases in this study using a tattoo pen machine and commercial tattoo ink. A total of 500 cultures were taken from 250 eyes of 125 individuals on chocolate and sheep blood agar. Bacteriological samples were taken from the inferior eyelid conjunctiva using a sterile cotton swab. Without any contact elsewhere, the swabs were smeared on bedside chocolate agars and 5% sheep blood agar. Results In tattooed eyes, bacterial growth was detected in 42.9% of the chocolate and sheep blood agar samples. In other healthy eyes of patients with corneal tattoos, 54.5% bacterial growth on chocolate agar and 57.1% on sheep blood agar were detected. No statistical difference was detected in the conjunctival microbiota of chocolate and sheep blood agar (p = 0.254, p = 0.134, respectively) in the tattooed eyes compared to the other eye of the individual. No statistically significant difference was found in terms of bacterial growth in tattooed, leukoma, or healthy eyes on chocolate and sheep blood agar (p = 0.408, p = 0.349). The growth rate of Staphylococcus epidermidis decreased by 33.3% (from 12 to 8) on chocolate agar in 35 tattooed eyes, and it decreased by 28.5% (from 14 to 10) on sheep blood agar, while gram-negative bacteria Brevundimonas diminuta, Acinetobacter lwoffii, and Psychrobacter faecalis were detected in three patients. Conclusion Corneal tattooing using commercial dye does not affect conjunctival microbiota. In the past 3 years, 120 patients have been tattooed with commercial tattoo ink in Istanbul Medeniyet University Göztepe Training and Research Hospital. No complications related to infection were found in the 3-year follow-up. The gram-negative bacteria detected in the healthy control group and tattooed eyes were bacteria found on normal skin or in the respiratory tract. Although some gram-negative bacteria do not cause infection, careful eye examination, follow-up, and culture are required in suspicious cases.

Hearing Loss and the Affecting Factors in Patients with Fibromyalgia.

To find the frequency of hearing loss in newly diagnosed patients with fibromyalgia (FM), and the factors affecting it. Descriptive study. Place and Duration of the Study: Department of Physical Medicine and Rehabilitation and Department of Otorhinolaryngology Head and Neck Surgery, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Turkey, from March 2021 to November 2022. Patients with FM and gender/age matched controls were compared with pure-tone audiometric (PTA), and transient evoked otoacoustic emissions (TEOE) tests after standardised otorhinolaryngologic assessment The subjects were questioned for NSAID uptake and scored with ASAS-NSAID score. There were 33 patients with FM and 32 healthy volunteers. Subjective tinnitus, dizziness, and hearing loss rate in the FM group were 12%, 18%, and 15%, respectively. PTA air and bone conduction studies yielded significant differences between the control and FM group (p<0.05). The statistical difference was pronounced in higher frequencies. TEOE tests showed the FM group had significantly lower scores when compared to the control group at 3000 Hz and 4000 Hz (p<0.05). The median ASAS-NSAID scores were 0 for the control group and 7.78 for the FM group (p <0.001). Patients with FM had high rate of audiometric hearing loss of the sensorineural type. The abnormalities were more prominent in the high frequencies but also present in the low frequencies. Fibromyalgia syndrome, Hearing loss, Audiometry, Ototoxicity, Central sensitisation.

P-691 Does serum Kisspeptin levels discriminate between fertile and infertile women with polycystic ovary syndrome?

Abstract Study question Does serum Kisspeptin (KP) levels discriminate between fertile and infertile women with polycystic ovary syndrome (PCOS)? Summary answer Serum KP levels can be used as a potential discriminatory biomarker for infertility in women with PCOS. What is known already PCOS is the most common cause of anovulatory infertility and not fully elucidated pathology. A persistent rapid gonadotropin-releasing hormone (GnRH) pulse frequency in patients with PCOS exist throughout ovulatory cycle. KP is a neuropeptide that increases GnRH pulsatile release during ovulation. Therefore, KP may have a key role as a central regulator of fertility in PCOS patients. Although, recent studies showed that the KP concentration is higher in PCOS patients, the evidence is limited as to whether serum KP levels determine infertility in PCOS. Study design, size, duration This was a single center prospective cohort study conducted at Goztepe Prof. Dr. Suleyman Yalcin City Hospital Affiliated to Istanbul Medeniyet University, Istanbul, Turkey between January 2023 to February 2023. Our study enrolled 30 fertile and 30 infertile women with PCOS, who were aged between 18 and 45 years. PCOS was defined according to the criteria of the Rotterdam ESHRE- ASRM sponsored consensus group (2004). Participants/materials, setting, methods Venous blood samples from the participants were obtained after fasting and between 8 a.m. and 10 a.m. on days 2-5 of the menstrual cycle. Samples were thawed, and a human KISS1 (Kisspeptin 1) ELISA kit (Elabscience, USA,lot no:E-EL-H5618) was applied to measure KP serum concentrations. Patient characteristics and KP concentrations were compared among the two groups. Statistical analysis was performed by Mann-Whitney, Spearman correlations, and linear regression analysis. A p-value &amp;lt;0.05 was considered significant. Main results and the role of chance The mean age of the patients was 27.57±5.39 years in the fertile PCOS group and 26.80± 4.85 years in the infertile PCOS group (p = 0.63). There was no significant difference among the groups in terms of body mass index (BMI), duration of infertility, serum FSH, LH, LH-to-FSH ratio, E2, antimullerian hormone (AMH), TSH, prolactin, 17OHP, total testosterone, SHBG, HbA1c, HOMA-IR, neutrophil–lymphocyte ratio levels and antral follicle count (AFC). DHEA-S was significantly higher in the infertile PCOS group (306.73±94.869 mcg/ dL), compared to the fertile PCOS group (258.08±84.29 mcg/ dL, p = 0.037). The mean KP level was significantly higher in the infertile PCOS group (444.80±136.61 ng/ mL), compared to the fertile PCOS group (333.02±131.10 ng/ mL, p = 0.001). The KP level was positively correlated with AFC, AMH, and total testosterone levels (R = 0.495, R = 0.548, R = 0.362, p &amp;lt; 0.05, respectively) in the infertile PCOS group. Furthermore, ROC analysis showed that the optimal cut-point value was found to be 285.59. When this cut-off value of serum KP levels was taken, the sensitivity was 0.96 and the specificity was 0.50. Linear regression analysis revealed that AMH was positively associated with KP levels (p = 0.022). Limitations, reasons for caution Due to the limited number of women with available samples, we were not able to analyze KP serum levels according to specific PCOS phenotypes Wider implications of the findings Serum KP levels are higher in infertile women with PCOS compared to fertile women with PCOS. Infertility caused by PCOS can be predicted by serum KP levels. In the future identification, KP in PCOS may be applied to develop potential therapeutic agents. Trial registration number Not applicable

Trajectory of Anxiety, Depression and Quality of Life in Ankylosing Spondylitis: A Descriptive Study.

To investigate anxiety, depression, and health-related quality of life (HRQoL) over 15 years and associations between demographic, disease-related variables, anxiety and depression, and HRQoL in patients with AS. Descriptive study. Place and Duration of the Study: Istanbul Medeniyet University Goztepe Prof. Dr. Suleymsan Yalcin City Hospital, from June to December 2021. Seventy-five patients with AS, who were followed up in Physical Medicine and Rehabilitation outpatient clinic for 15 years, were included in this study, after their diagnosis was confirmed by the hospital system. The demographic information (gender, age, accommodation status, educational status, employment status, and time unemployed), diagnosis time, remission time, drugs used, usage of TNF-inhibitor drugs and duration of usage were recorded. Bath ankylosing spondylitis disease activity index (BASDAI) was used to the measure the disease activity, the hospital anxiety depression scale (HADS) was used for anxiety and depression screening and Short Form-36 (SF-36) was used for HRQoL. SF-36 physical component summary score, general health, social functioning, and role limitations due to physical health subscale scores improved significantly (p=0.004; p<0.000; p=0.024; p=0.002, respectively). It was observed that the effects of BASDAI, HADS anxiety and depression scores were significant on SF-36 (p=0.044; p=0.050; p=0.023), and time has a substantial impact on SF-36 (p=0.003). The effects of gender, education level, and occupation were not found statistically significant (p>0.05 for each). Within 15 years, quality of life increased, anxiety and depression decreased in AS patients. Along with disease activity, anxiety and depression were found to be the most important factors affecting the change in quality of life over time. Ankylosing spondylitis, Anxiety, Depression, Disease activity, Quality of life.

Total Lesion Glycolysis Obtained by FDG PET/CT in Diagnosing Solitary Pulmonary Nodules.

To evaluate the diagnostic performance of total lesion glycolysis (TLG) obtained by 18F-FDG PET/ CT to differentiate malignant solitary pulmonary nodules (SPNs) from benign ones. Observational study. Department of Nuclear Medicine, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey, from January 2018 to April 2022. Eighty patients, who were found to have SPNs and underwent PET/CT imaging, were enrolled in this retrospective study. Parameters of PET-CT such as metabolic, volumetric, and metabolovolumetric were assessed concerning diagnostic value. Moreover, maximum standard uptake value (SUVmax) and TLG were combined and compared to improve diagnostic accuracy. The number of the detected benign and malignant SPNs was 38 and 42, respectively. Compared to the benign lesions, the malignant nodules presented significantly higher values in terms of SUVmax, TLG, and the volumes of metabolic tumour (MTV) and CT. Considering all parameters, the highest area under the curve (AUC) was occupied by TLG and SUVmax. The values for the sensitivity, specificity, and accuracy of SUVmax, TLG, and SUVmax combined with TLG were as follows respectively: 97.6%, 63.2%, and 81.2%; 85.7%, 92.1%, and 88.7%; and 85.7%, 94.7%, and 90%. The conventional value of SUVmax does not yield satisfactory results in order to separate the malignant nodules from the benign ones. The SUVmax value could be more valuable if it is used with TLG measurement in diagnosing SPNs. 18F-FDG PET/CT, SUVmax, TLG, Pulmonary nodule.

Report on Osark 2022: A Congress Dedicated to Ottoman Studies

The third meeting of OSARK, an international Ottoman Studies conference founded by members of the Sakarya University History Department, was hosted and coordinated by Istanbul Medeniyet University between September 7 and 9, 2022. It was supported by TİKA (Turkish Cooperation and Coordination Agency), YTB (Presidency for Turks Abroad and Related Communities), the Üsküdar Municipality, and Turkish Airlines.

Evaluation of factors affecting smoking cessation in people treated with Varenicline

Objective: Aim of the study is to evaluate factors affecting treatment success among individuals receiving varenicline therapy for smoking cessation. Material and Methods: This research was carried out at Istanbul Medeniyet University Göztepe Training and Research Hospital between January 2018 and January 2019. A total of 209 patients in the smoking cessation outpatient clinic who were treated with varenicline Varenicline were constituted into the study group. The Fagerstrom Nicotine Dependence Level Test (FTND) was used to determine individuals' nicotine addiction levels, and the Hospital Anxiety and Depression Scale (HADS) was used to evaluate anxiety and depression levels. Results: There were 90 (43.1%) women and 119 (56.9%) men in the study group and mean age was 41.34 ± 10.93 (21-64) years. Overall, 63.2% (n=132) of varenicline recipients quit smoking. The frequency of quitting smoking due to physician advice was higher in those who quit than those who did not (p=0.011). Multiple logistic regression revealed that the independent factors associated with the lower likelihood of smoking cessation were higher number of cigarettes per day (p=0.008), higher HADS-Total score (p&lt;0.001), post-treatment nervousness (p=0.046), and post-treatment depressive mood (p=0.007), whereas being able to remain smoke-free for longer periods in previous quitting attempts was associated with higher likelihood of success (p=0.005). Conclusion: The success of smoking cessation with varenicline therapy is lower in the presence of the following factors: having high risk for anxiety and depression, smoking a greater number of cigarettes per day, shorter periods of remaining smoke-free in previous quitting attempts, and experiencing nervousness during withdrawal. Receiving physician advice to quit also appears to increase the chance of quitting smoking. Keywords: Smoking; Smoking Cessation; Smoking Cessation Agents; Varenicline; Anxiety; Depression

Relationship between the Properties of Paraspinal Muscles and Bone Mineral Density in Osteoporotic Patients.

To investigate the properties of paraspinal muscle structures in osteoporotic patients, lumbar computed tomography (CT) and their relationship with lumbar and femoral neck bone mineral density (BMD). A Descriptive study. Department of Radiology and Physical Medicine, Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey, between June 2020 and June 2021. Ninety patients with osteoporosis, who received lumbar spine CT and dual-energy X-ray absorptiometry (DEXA) examinations, were retrospectively included. Cross-sectional areas (CSA), densities, index values, and Hounsfield unit average calculation(HUAC) values were measured for psoas, multifidus, erector spinae, and quadratus lumborum muscles at the L3 level, and their associations with BMD were investigated. A total of 90 patients including 71 females were evaluated. The mean age was 63.31±11.90 years. A moderate correlation of lumbar spine (r=0.32, p<0.01) and femur neck BMD (r=0.28, p<0.05) with erector spinae CSA was defined. Small correlation between psoas CSA (r=0.28, p<0.05) and psoas muscle index (PMI, r=0.24, p<0.05) with lumbar spine BMD was found. The CSA of all the paraspinal muscles (p<0.01) and densities, except psoas muscle (p<0.05), were higher in males. In non-obese osteoporotic patients, the density and HUAC values of the paraspinal muscles, except the psoas muscle, were found to be significantly higher (p<0.05). The properties of the paraspinal muscles measured by the lumbar CT scan are found to be related to BMD. The psoas and erector spinae CSA and index values are the most significantly associated parameters with the lumbar spine BMD. Bone mineral density, Computed tomography, Osteoporosis, Paraspinal muscles, Psoas.

Yabancılara Türkçe öğretiminde kültürel farkındalık

Yabancı dil olarak Türkçenin eğitiminde, etkili öğrenmenin önemli bir yolu da kültür aktarımından geçer. Dilbilgisi ve kelime hazinesi, dilin matematiksel ve rasyonel yönünü temsil ederken, kültür aktarımı ise edebî, sanatsal ve soyut yanını temsil eder. Tıpkı kendi kültürüne vâkıf olmanın getirdiği zenginlikte olduğu gibi bir başka toplumun kültürüne hâkim olan öğrenci, dilinin de mantık sistemini, yapısal işleyişini, tarihsel gelişimini, günlük yaşamdaki akışını ve kurallarını kolaylıkla öğrenir. Dil ve kültür, arasındaki güçlü bağı kavrayan bir öğrencinin, dil öğrenmedeki içsel motivasyonu artar, dilin işleyişine dair sorularına yaşamın içinden cevaplar bulur. Kültürün taşıyıcısı olarak dilin, o toplumun sanatı, felsefesi, inanç sistemi ve edebiyatı ile ilgili üretimlerine daha derin bir bakış açısı ile yaklaşır. Tüm bu nedenlerle Türkçe öğrenmek amacıyla ülkemizde bulunan öğrencilere dilini öğrendikleri toplumun yaşamını, tarihsel bir süreçle şekillenen değerlerini, düşünce ve inanç sistemini, sanat ve edebiyat üretimini anlama fırsatı vermek için kültürel farkındalık çalışmaları uygulanmalıdır. Çalışmamızda Türkçe öğrenmek üzere ülkemizde bulunan yabancı öğrencilerin Türk toplumuna ve kültürüne dair farkındalık düzeylerini belirleyerek, sonuçlar doğrultusunda Türkçe öğretim müfredatlarına katkı sağlanması da amaçlanmıştır. Bu amaçla İstanbul Medeniyet Üniversitesi Türkçe Öğretim Merkezinde ve İstanbul Okan Üniversitesi Dil Merkezinde Türkçe eğitimi alan 30 öğrenciye demografik bilgileri de içeren sorular yöneltilmiştir. Türkçe Öğretim Merkezlerinde ders veren 6 öğretim üyesine de ayrıca ders verdikleri öğrencilerin kültürlerine yönelik sorular sorulmuştur. Araştırmamızda nitel araştırma yöntemlerinden durum çalışması kullanılmıştır. Durum çalışmalarının amacı, özel bir zaman ve parametrelerle sınırlandırılmış belirli bir durumu, konuyu, problemi en iyi şekilde anlamak, derinlemesine bir anlayış sunmaktır. Veri toplama yöntemi olarak demografik anket, açık uçlu sorular kullanılmıştır.

Validity and Reliability of the Anxiety Assessment Scale: A New Three-dimensional Perspective.

Objective:Anxiety is inseparable from life due to its survival value. Up-to-date and multidimensional assessment of anxiety is necessary to develop effective interventions to cope with high anxiety levels. This study was conducted to examine the psychometrics of the Anxiety Assessment Scale (AAS).Methods:Data were collected between January and April 2021 from 756 students (42.9% males and 57.1% females) studying medicine at Istanbul Medeniyet University. Seven experts evaluated the items to detect content validity in the final application form. Both exploratory and confirmatory factor analyses (EFA and CFA) were used for construct validity. The Beck Anxiety Inventory was also applied for concurrent validity. Test-retest reliabilities were calculated within four weeks. IBM SPSS 25 and AMOS 24 were used for statistical analyses.Results:Data were suitable for factor analyses (Kaiser-Meyer-Olkin=0.800, chi-square=3018.854, df=45). The EFA showed the three-factor structure with 10 items, and 70.1% of the variance was explained. Factor loads of the items varied between 0.61 and 0.87; data-model fit was suitable (CFI=0.92, TLI=0.93, RMSEA=0.059, SRMR=0.046, chi-square/df=1.556) according to CFA. Concurrent scale validity was also confirmed by the Pearson correlation (r=0.167, p<0.01). The test-retest reliabilities (r) were all >0.5 (p<0.001). The Cronbach a coefficients were 0.845 (AAS), 0.770 (Physiological Tension=PT), 0.822 (Worrying=W), and 0.838 (Feeling Unsafe=FU).Conclusions:AAS is a reliable and valid measurement instrument to assess anxiety levels in three dimensions. AAS can be applied for research, psychological assessment, and other appropriate application purposes.

Surgical residency training program in Somalia: Outcomes of 8 years

Objective Improving global surgery through postgraduate medical training in Africa is needed. In this context, implementing surgical residency programs into international developments for global surgery might play a great role to achieve successful results in low-income countries. The aim of this study is to provide insight about postgraduate surgical training program that was initiated in Somalia where there was no prior formal surgical residency program. Methodology General surgery residency program was initiated within the collaboration of Istanbul Medeniyet University and Benadir University. Medical doctors from Somalia, who were successful on enrollment exams, were selected for program. All residents completed a 3-year of theoretical and practical training, continuing 2 months at Istanbul Medeniyet University Department of General Surgery each year. Results Since 2013, 24 residents graduated from the program and 22 of them currently work as attending physicians in Somalia. Abdominal wall hernias, proctological diseases, cholelithiasis, thyroid diseases and breast diseases are the most common pathologies within the elective operations by graduated general surgeons. Also, appendectomy, infection-induced perforation or ischemia of colon and small bowel and acute mechanical intestinal obstruction due to tumors and adhesions are the most common emergency surgeries. Interventions due to blunt and penetrating trauma are frequently performed. Conclusions This surgical residency program provides surgical care and supports health systems in Somalia. We believe such programs are important to reduce global burden of surgical diseases.

An Evaluation of The Relationship Between Self-Reported Sleep/Awake Bruxism and The Chronotype Profiles of The Dental Students

Objectives: The aim of this study is to evaluate the possible relationship between the presence/absence of the self-reported sleep and/or awake bruxism and the chronotype profiles of dental students. Materials and Methods: The dental students at Istanbul Medipol University and Istanbul Medeniyet University in the fall semester of the 2020-2021 academic year participated in this study. Along with demographic data, an 11-item questionnaire evaluating sleep quality and self-reported sleep and awake bruxism, and a 19-question Morningness-Eveningness Questionnaire (MEQ) determining the chronotypes were applied. The significance level was set at P≤ 0.05 for statistical analysis. Results: 171 students (female:128, 74.9%; male:43, 25.1%) participated in the study. The mean age was 22.32.2. There was no statistical difference between the presence or absence of the bruxism types and the chronotype profiles of the students (P=0.815). The sleep quality in the students with the sleep bruxism was statistically lower than in other types of the bruxism (P&amp;lt;0.05). The participants with the sleep bruxism were statistically more likely to have difficulty concentrating on the daily activities than the participants with other types of the bruxism (P&amp;lt;0.05). Conclusions: There is no relationship between the presence or absence of the bruxism types and the chronotype profiles. However, the sleep bruxism negatively affects both the sleep quality and focusing on the daily activities.

Evaluation of the Association between Lumbar Spinal Stenosis and Lumbar Subcutaneous Fat Tissue Thickness by MRI: A Novel Perspective.

To evaluate whether lumbar subcutaneous fat tissue thickness (LSFTT) on midsagittal magnetic resonance imaging (MRI) is associated with lumbar spinal stenosis (LSS). Observational cross-sectional study. Department of Radiology and Neurosurgery, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey between January 2018 and December 2020. The study group included 79 patients, who had undergone surgery for lumbar spinal stenosis. The control group included MRI scans of 80 individuals without lumbar spinal stenosis. Association between LSFTT and LSS was analysed through a comparison of both the groups. The agreement between the two observers was found to be very good agreement with a two-way mixed intra-class correlation coefficient of 0.986 or higher (p <0.001). There was statistically significant differences between the LSS and non-LSS groups for both L5-S1 and L4-5 level measurements, p=0.001, and p=0.004, respectively. L5-S1 level measurements in the LSS group showed 29% increase in average with respect to the non-LSS group; and in L4-L5 level measurements, the increase was 40% in median. Females exhibited significantly higher values in both levels, (p <0.001 and p <0.001, respectively). Lumbar subcutaneous fat tissue thickness is significantly associated with lumbar spinal stenosis. Measuring LSFTT on mid-sagittal MRI is an easily applicable, reproducible alternative method for predicting LSS. Key Word: Lumbar, Spinal canal, Stenosis, Subcutaneous fat tissue, Magnetic resonance imaging.

Different types of dyslipidemia in type 2 diabetes and the associated factors

Aim: Diabetes and dyslipidemia are common diseases that can be seen together. In this study, we aimed to investigate factors affecting the type of dyslipidemia in diabetic patients.Methods: The cross-sectional study included a total of 596 patients with type 2 diabetes who visited the outpatient diabetes clinic of the Istanbul Medeniyet University between January 2017 and December 2019. Patient laboratory, clinical, and sociodemographic data were retrieved from medical records. Results: Of all patients, 52% were diagnosed with hypercholesterolemia (total cholesterol ≥200 mg/dL) and 56.4% had a history of hypertriglyceridemia. Four hundred and forty-four (74%) patients had abnormal low-density lipoprotein cholesterol (LDL-C) levels (≥100 mg/dL). Eighty percent of the female patients and 67.4% of the male patients had abnormal LDLC levels, and the difference between the two sexes was statistically significant (p&amp;lt;0.001). Triglyceride levels were higher in the patients with a hemoglobin A1c (HBA1c) level ≥7% (p&amp;lt;0.001). Smokers had significantly higher levels of LDL-C (p=0.03) and lower levels of high-density lipoprotein cholesterol (p=0.038) than non-smokers. The mean body mass index was higher for the group of non-smokers than for the smokers (p&amp;lt;0.001). The rates of hypertriglyceridemia and obesity were significantly higher in patients with hypertension than in those without (p=0.036 and p=0.013, respectively).Conclusion: Dyslipidemia is common in diabetic patients, especially women. A complete examination of the patient should include the consideration of conditions associated with dyslipidemia.

Empathy Assessment Scale.

OBJECTIVEEmpathy is a prosocial ability and communication skill to feel, understand, and respond to emotions of others; it includes affective and cognitive behavioral aspects of therapeutic communication. For instance, physicians should communicate empathically with their patients. Thus, empathy levels of medical students should be improved during their education. It is important to comparatively evaluate the dimensions of empathy to have a clearer picture of this ability. The aim of this study is to determine the validity and reliability of the Empathy Assessment Scale (EAS) and its subscales.METHODSData were collected between October and December in 2021 from 651 students studying medicine in Istanbul Medeniyet University. Item pool of the scale was developed by the researcher based on the literature review. Two counseling psychologists, two clinical psychologist, and two psychiatrists evaluated the items to detect the face and content validity in the final application form. Both explanatory and confirmatory factor analyses (EFA and CFA) were carried out. The Toronto Empathy Questionnaire was also applied for concurrent validity. IBM SPSS 25 and AMOS 24 were utilized to analyze the construct and concurrent validities, internal consistency, and test-retest reliabilities.RESULTSKMO and Bartlett’s sphericity tests showed that the dataset was suitable for factor analyses (KMO=0.812, Chi-square=5535.718, df=78). A three-factor structure with 13 items was confirmed by EFA, 67.1% of the variance was explained by these three factors. According to CFA, the factor loads of the items varied between 0.39 and 0.98 and data model fit was suitable according to the fit indices (CFI=0.95, TLI=0.91, RMSEA=0.049, SRMR=0.055, and Chi-square/df=1.316). Concurrent validity of the scale was also confirmed by the Pearson correlation (r=0.467, p<0.001). The test-retest reliability values (r) within four weeks interval were all above 0.60 at 0.01 significance level. Cronbach’s alpha coefficients were 0.845 (EAS total scale score, 13 items), 0.696 (social interaction subscale score, 4 items), 0.802 (cognitive behavior subscale score, 5 items), and 0.964 (emotional identification subscale score, 4 items).CONCLUSIONEAS is a valid and reliable measurement tool to assess the empathy levels of individuals in three dimensions: Social interaction, cognitive behavior, and emotional identification. EAS can be used to evaluate the empathy levels for research, educational, and other interventional purposes.

Abstract 9960: Soluble Low Density Lipoprotein Receptor-related Protein-1 Levels As A Potential Biomarker In Covid19

Introduction: Low density lipoprotein receptor-related protein 1 (LRP1), is a multifunctional receptor. Soluble form (sLRP1) is measurable as a novel biomarker of inflammation and atherosclerosis. We hypothesize that sLRP1 levels can be associated with Covid19 disease onset and severity. Methods: We measured sLRP1 levels in 180 PCR positive, Covid19 patients admitted to the hospital (mean age 60± 19, M/F = 51/49). Controls (n=61) were selected from outpatients without significant comobidities. Results: Covid19 patients display significantly lower sLRP1 levels compared to the controls (p&lt;0.001). Covid19 patients are stratified based on the severity of Covid19 such as emergency room (n=44), inpatient service (n=95) and intensive care (n=41). Median sLRP1 levels are 2.27, 1.26, 1.36, and 1.73 μg/ml for controls, emergency room, inpatient service and intensive care patients, respectively. sLRP1 levels rise as severity of Covid19 increases (p= 0.022) (Figure 1). Other biomarkers of inflammation such as CRP display similar trends (Figure 2). Median hsCRP levels are 8.2, 10.2 and 16.4 mg/L for emergency room, service and intensive care patients respectively (p&lt;0.001). Conclusions: Previous studies indicate that LRP1 can be a defense mechanism in acute viral infections. Eliminating LRP1 by siRNA knockdown increases intracellular cholesterol and the infectious virus yield. LRP1 displays a bidirectional course in Covid19. Low sLRP1 can be a risk factor for Covid19. On the other hand, sLRP1 levels increase with disease severity as a defense response to infection. This work was supported by the Research Fund of Istanbul Medeniyet University (project number 1358).