Nowadays, obesity is a very important public health problem due to its related comorbidities. Major treatment modalities include lifestyle modification, diet, and medical and surgical treatments. Bariatric surgery is the most successful treatment modality in obesity treatment. Owing to its ability to achieve weight loss and improve comorbidities accompanying obesity, it is now focused on metabolic control rather than weight loss. When choosing an operation method, the purpose of the surgery (weight loss and/or metabolic control) should be decided by taking into account the experience of the surgeon and the center, patient preference, and individual risk assessment results. In the past two decades, complication rates have gradually decreased because of the development of minimally invasive methods, increased experience, and adoption of a multidisciplinary approach in bariatric surgery. However, there are still complications requiring reoperation and hospitalization. Patients should be informed about the operation and postoperative diet and follow-up, realistic weight loss goals should be targeted, and operation and postoperative patient follow-up should be performed in experienced centers.

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INTRODUCTION: Adenoid tissue hypertrophy is a common problem in childhood. In addition, it can also cause obstructive sleep apnea syndrome (OSAS). The relationship between adenoid size and quality of life or psychological status has not been evaluated as an independent variable. Therefore, this study investigated the relationship between adenoid size, obstructive symptoms, and depression.
METHODS: In total, 180 children were included and divided into two groups: 92 children with OSAS and 88 without OSAS. The adenoid size was assessed by calculating the adenoid nasopharynx ratio, which is the maximum adenoid size to a line drawn from the posterosuperior hard palate to the spheno-occipital synchondrosis. The Turkish version of the pediatric depression scale was used to evaluate depression symptoms. The results of two evaluations were statistically compared to assess any correlation.
RESULTS: The mean age of the OSAS was 7.61 and the control group was 7.95 years. There were no statistical differences in sex and age between the groups. The adenoid nasopharynx ratio significantly differed p<0.001 (p=0.001) between the two groups, whereas the pediatric depression scale scores did not differ (p=0.472). There was no correlation between the adenoid nasopharynx ratio and depression.
DISCUSSION AND CONCLUSION: The adenoid nasopharynx ratio is not a significant predictor of depression in children with OSAS.

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INTRODUCTION: The purpose of this retrospective study was to examine cases with Bartholin gland excision due to Bartholin cyst or abscess.
METHODS: The files of 149 patients who underwent total excision of the Bartholin gland due to cyst or abscess in Istanbul Kanuni Sultan Süleyman Training and Research Hospital between January 2011 and December 2016 were retrospectively evaluated for demographic features, obstetric and medical history of the patients, location and size of the Bartholin cyst or abscess, complaints, duration of operation, and postoperative complications.
RESULTS: The mean age of the patients was 33.33±7.126 years. The gravida and parity mean values were 2.11 and 1.56, respectively. Of the patients, 35 were nulliparous, and 108 had vaginal delivery. The mean diameter of the cyst was found to be 3.18 cm. There were 20 patients with recurrent cases of Bartholin abscesses. The mean duration of operation was 22.42 min. The most common complaint was pain.
DISCUSSION AND CONCLUSION: Bartholin gland cyst or abscess is more prevalent in sexually active individuals in the reproductive age who has a history of surgical intervention in this region. In recurrent cases, total excision of the Bartholin gland is preferred despite the results, such as scarring and dyspareunia.

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INTRODUCTION: Emergency clinics encounter a wide range of patients. Therefore, the consultation request rate is high. A consultation system is the basic important factor that impacts the operations of emergency clinics. The objective of the present study was to evaluate the consultations requested by the emergency clinic and how they were replied.
METHODS: The consultations requested by the emergency clinic in the Okmeydani Training and Research Hospital between January 1, 2014 and December 31, 2015 were screened retrospectively through the database of the hospital’s Information Management System.
RESULTS: : In our hospital, the percentage of patient admission to the emergency clinic was 31.9%. A consultation was requested in 15.5% of all emergency clinic admissions. Regarding the distribution of the consultation requests to the departments, the Internal Medicine Department had the highest percentage with 67.1%. Of the consultation requests, 91.4% were replied on the system. The median reply time was 96 min. The rate of the consultations requested from more than one clinic for the same patient was 11.7%, and the reconsultation request rate from the same clinic within 24 h was 11.8%. There was a statistically significant correlation between the reconsultation requests within 24 h and multiple consultations (p=0.001). We determined that no record was kept in 82% of the consultation requests related to the outcome of the admissions to the emergency clinic.
DISCUSSION AND CONCLUSION: To our knowledge, this is the first study that focused on the consultation system of the hospital, where the study was conducted. Data related to the quality and quantity of the consultations were obtained during the study. The evaluation of all data including the consultation systems, which are performed to support the development of the emergency care services and emergency departments in Turkey, can only be done with a regular recording and analysis of the data.

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INTRODUCTION: We aimed to examine the influence of hyaluronic acid (HA) and basement membrane (BM) thickness alterations on biochemical properties of vocal fold lesions including vocal fold polyps, sulcus vocalis lesions, vocal fold cysts, and Reinke’s edema.
METHODS: Archival material of 56 laryngoscopic vocal fold biopsies from 49 patients reported between July 1, 2005 and February 27, 2007 were retrospectively evaluated. Hematoxylin-eosin, alcian blue pH 2.5, and Periodic acid–Schiff (PAS) stainings were histochemically performed.
RESULTS: We detected that the HA component in the extracellular matrix and BM thickness had increased in vocal fold polyps, sulcus vocalis lesions, vocal fold cysts, and Reinke’s edema compared with those in the control group.
DISCUSSION AND CONCLUSION: We believe that HA plays an important role in determining the biochemical properties of vocal fold lesions including vocal fold polyps, sulcus vocalis lesions, vocal fold cysts, and Reinke’s edema. Especially the increase in the HA component in all these lesions indicates that it plays a role in reparative processes.

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INTRODUCTION: To investigate whether combination therapy is more effective than either monotherapy in reducing the relative risk for benign prostate hyperplasia (BPH)-related surgery in patients with acute urinary retention (AUR).
METHODS: We retrospectively reviewed recorded data of patients who were randomized into two groups according to medical treatment as tamsulosin monotherapy and tamsulosin with dutasteride combination therapy between June 2002 and February 2008. A total of 150 patients who were initially admitted to the emergency department for BPH-associated AUR were selected. The urethral catheters were removed at the end of 3 days, and 96 patients who had a post-void residual urine volume of <150 mL were included in the study. Patients were followed up in an interval of 3 months; the primary endpoint was time to BPH-related surgery. Logistic regression was used to determine factors that contribute to BPH-related surgery. Furthermore, we compared the groups in terms of post-treatment variables.
RESULTS: Of the patients, 26 (27%) were diagnosed with prostate cancer and excluded from the study. A total of 70 patients, 38 in the monotherapy and 32 in the combination groups, participated in the study and were followed up for 1 year. The comparison of the monotherapy group and the combination group showed that the BPH-related surgery ratio (p=0.005) and serum total prostate-specific antigen (PSA) level (p=0.013) were lower in the combination group. By multivariate logistic regression analysis, we found that older age, higher serum PSA level, and higher prostate volume were independently associated with BPH-related surgery.
DISCUSSION AND CONCLUSION: Of all the factors analyzed, prostate volume, age, and serum PSA level were the most accurate predictors of BPH-related surgery. Moreover, combination treatment was found to be more effective treatment choice for prevention of BPH-related surgery.

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Adnexal torsion (AT) is usually unilateral and traditionally treated by oophorectomy. We present a case of bilateral AT, developed consequent to ovarian hyperstimulation syndrome (OHSS), managed by detorsion of the ovaries without oophorectomy. A 27-year-old female patient who underwent in vitro fertilization was hospitalized with acute abdomen. On ultrasonography, multifollicular ovaries, displaying continuity with each other on both sides with a size of 25×12 cm, which are consistent with OHSS and no apparent blood flow in the right adnexal area, were observed. In laparotomy, the right ovary (10×8 cm), left ovary (16×14 cm), and adnexa were bilaterally torsioned. Adnexa was detorsioned. Although it is assumed that blood flow did not improve in the ovaries, considering the patient’s fertility desire, oophorectomy was not performed. On sonography at 6 months, the size of the ovaries and blood flow were normal. Conservative surgery should be the first choice of treatment in AT to preserve fertility in patients who underwent artificial reproductive technologies.

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Small round cell malignant tumors are the general term given to tumors that are small, round, and usually develop from undifferentiated cells. Tumors included in this group are: Ewing sarcoma (peripheral neuroectodermal tumor), primitive neuroectodermal tumor, rhabdomyosarcoma, synovial sarcoma, non-Hodgkin lymphoma, cutaneous neuroendocrine carcinoma (Merkel cell carcinoma), retinoblastoma, peripheral neuroblastoma, hepatoblastoma, and nephroblastoma or Wilms’ tumor. In histopathological examinations, positive markers, such as cytokeratin, epithelial membrane antigen, desmin, vimentin, neuron-specific enolase, and CD15, can be found. The patient consulted our clinic with a diagnosis of neuroectodermal small round cell malignant tumor after an excisional biopsy was performed at an external center following a complaint of a mass in the thigh. A 40-year-old female patient with a complaint of a mass in the right femoral posterior region for over 1 year had excisional biopsy performed at an external center with a diagnosis of malignant tumor infiltration. Biopsy material was evaluated by our hospital’s pathology clinic. The result was found to be small round cell malignant tumor. The patient was admitted to our clinic for re-excision. Re-excision was made from the previous incision line on the posterolateral of the right thigh with a 2 mm surgical border. Small round cell tumors are a heterogeneous group of tumors composed of malignant neoplasia. Even though they are often observed in childhood, some primitive neuroectodermal variants may be seen in adults. Owing to their low surveys, early diagnosis and aggressive treatment are significant in these cases.

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Spontaneous pneumomediastinum is an uncommon clinical form of pneumomediastinum with no relationship to trauma or surgical procedures. Head and neck manifestations are predominant and may be confused with symptoms of acute parotitis. We report a case of spontaneous pneumomediastinum mimicking bilateral parotitis in a 23-year-old male patient. The symptoms and findings, swelling, and pain, secondary to air passing through the deep fascial planes in the head and neck region, were dominant at the beginning of clinical history. The aim of this case report was to outline the risk of misdiagnosing spontaneous pneumomediastinum as an acute parotitis.

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Cervical cancer is the second most common gynecologic cancer in women. However, the incidence showed a decline in the gynecologic cancer rates with the effective use of screening tests. The primary treatment at an early stage is either surgery or radiotherapy. Unfortunately, with the increasing use of radiotherapy, radiation enteritis has become an increasing problem. To avoid the radiation side effects, many technical and/or medical strategies have been described. For example, surgical placement of absorbable mesh slings and silicone prostheses have been described as a pelvic obliteration technique to keep the small intestine away from the adjuvant boost field. In this case report, we placed a PermacolTM surgical implant to displace the loops of the bowel out of the pelvis for the purpose of reducing the bowel injury due to external beam radiotherapy.

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