Sivas State Hospital

Obesity is a significant health problem with increasing prevalence worldwide and is associated with numerous comorbidities. In this prospective controlled study, the relationship between changes in platelet-to-lymphocyte ratio(PLR), neutrophil-to-lymphocyte ratio(NLR), and pan-immune-inflammation value(PIV)-calculated from complete blood count parameters on the preoperative day and the first postoperative day-and early major surgical complications following laparoscopic sleeve gastrectomy(LSG) was investigated. Patients scheduled for LSG due to morbid obesity at the Department of General Surgery, Kahramanmaraş Sütçü İmam University, and Elazig Private Eastern Anatolia Hospital were prospectively included in the study. Preoperative and postoperative (24-hour) complete blood count (CBC) parameters were recorded, including white blood cell count (WBC), neutrophil count, lymphocyte count, monocyte count, and platelet count. PLR, NLR, and PIV were manually calculated. Patients were divided into two groups based on whether postoperative complications developed. In the preoperative period, significant differences were observed in WBC count, neutrophil count, and PIV values between patients with and without complications (p = 0.001, p < 0.001, and p < 0.001, respectively). In the postoperative period, significant differences were found between the two groups in WBC count, neutrophil count, platelet count, PLR, NLR, and PIV (p = 0.001, p < 0.001, p < 0.001, p = 0.047, p = 0.001, and p < 0.001, respectively). When preoperative and postoperative values were compared, NLR, PLR, and PIV showed a statistically significant increase (p = 0.001, p < 0.001, and p < 0.001, respectively). Our study demonstrated that among inflammatory markers calculated from CBC parameters, the PIV-assessing the overall immune-inflammatory response-provides higher specificity and sensitivity than NLR and PLR in predicting early postoperative major complications following LSG. The primary keypoint to assess whether the changes in preoperative and postoperative PIV, NLR, and PLR values could predict early major postoperative complications following LSG. The Secondary keypoint included evaluation of perioperative major complication rates, reoperation rates, and mortality rates.

Schizophrenia is a chronic mental disorder and one of the leading causes of disability worldwide, with greater levels of disability being associated with lower general self-efficacy. Reducing disability and enhancing self-sufficiency in individuals diagnosed with schizophrenia are among the primary goals of treatment and care. This study aimed to examine the effects of alexithymia and metacognitive beliefs on self-efficacy levels and disability in individuals diagnosed with schizophrenia. The study was conducted with 145 individuals under the age of 30 (67 individuals diagnosed with schizophrenia and 78 healthy controls) using a descriptive and correlational design. Data were collected using a sociodemographic data form, the Toronto Alexithymia Scale (TAS-20), the Metacognition Questionnaire (MCQ-30), the General Self-Efficacy Scale (GSES) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Compared to the control group, the patient group demonstrated significantly higher TAS-20, MCQ-30 and WHODAS 2.0 scores, and significantly lower GSES scores (p < 0.05). The patients' total MCQ-30 scores were significantly associated with both WHODAS 2.0 and GSES scores (p < 0.05); however, TAS-20 did not mediate the relationship between MCQ-30 and WHODAS 2.0 (p > 0.05), whereas it showed a significant mediating effect in the relationship between MCQ-30 and GSES (p < 0.05). Patients exhibited higher disability and lower general self-efficacy than the control group. Cognitive-behavioural and metacognitive therapeutic approaches targeting alexithymia may contribute to improved functioning and reduced disability in individuals with schizophrenia. The findings improve understanding of factors related to disability and diminished general self-efficacy in individuals with schizophrenia and may inform the development of targeted psychosocial interventions. Self-efficacy and disability are key determinants of recovery in schizophrenia. By demonstrating the roles of alexithymia and metacognitive beliefs, this study provides a conceptual framework to guide clinical practice and supportive care strategies.

To determine genome-wide transcriptional coverage of well-characterized genes, gene candidates, and splice variants associated with invasive process on bladder carcinogenesis (BC), we investigated the whole-genome gene expression profile of high-grade Turkish BC patients. We collected high-grade bladder tumours (n = 12) and paired standard tissue samples (n = 12). To find differentially expressed genes related to bladder cancer’s metastatic pattern, we performed the human whole-genome expression profiling through the Illumina Human HT-12 Expression Beadchip system. Ingenuity Pathway Systems (IPA), i-Pathway Guide and Cytoscape software were used to determine statistically significant genes, networks, biological pathways between tumour and control groups. Cyclin A2 (CCNA2), CDC20, CDC45, MMP1, MMP3, MMP9, MMP10, STAT1, STAT2, TNFRSF1A, TNFSF10, and TUBB3 were significantly upregulated in bladder cancer cases. We showed that biological reactions, including the degradation of collagen and extracellular matrix and matrix metalloproteinases activation reactions, were found the most statistically significant pathways in BC. We also determined that inflammation and cytokine signalling could be related to the progression of bladder carcinogenesis. The genes differentially expressed could be molecular indicators for early prediction of bladder carcinogenesis.

Cu₂ZnSnS₄ (CZTS), well-known for its use in photovoltaic and photocatalytic systems, has been studied as a solid-state hydrogen storage material. At 10 bar hydrogen pressure, structural and spectroscopic analysis revealed unambiguous lattice changes in the form of enhanced lattice parameters (a = 5.41 Å, c = 10.754 Å), a reduction in crystallite size from 66.37 nm to 56.70 nm. Raman and FTIR spectra confirmed hydrogen incorporation through vibrational mode changes and S–H stretching band emergence. A-mode near 336 cm⁻¹, including intensity changes and slight shifts, reflecting hydrogen-induced strain and defect interactions within the lattice. Through the emergence of an S–H stretching band around 2369 cm⁻¹, which was absent in the pristine sample. The material was observed with a high specific surface area, enhancing the adsorption kinetics for hydrogen. Storage capacity was 0.9 wt%, and the rate of desorption was 0.0108 m³/h at 200 °C. TGA demonstrated enhanced mass loss behavior in hydrogenated samples, suggesting modified thermal stability after hydrogen treatment. Gas chromatography analysis confirmed clean and selective hydrogen release. These findings make CZTS a low-cost and structurally versatile material with a promising reversible hydrogen storage solution in energy conversion applications.

This study aimed to investigate the relationship between preoperative and postoperative inflammatory parameters—including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII)—and early clinical outcomes in patients undergoing isolated coronary artery bypass graft (CABG) surgery. In this single-center, retrospective clinical study, data from 500 adult patients who underwent elective, isolated on-pump CABG surgery between 2018 and 2023 were analyzed. Preoperative and postoperative (day 1 and day 7) complete blood count parameters, as well as early postoperative clinical outcomes (including mortality, atrial fibrillation, length of ICU and hospital stay, and other complications), were systematically evaluated. Multivariate logistic regression was used to identify independent predictors of early mortality. Patients who experienced early mortality had significantly higher preoperative NLR, PLR, SII, blood urea nitrogen, creatinine, and older age, as well as longer cardiopulmonary bypass and cross-clamp times. Postoperative day 7 values for NLR, PLR, SII, and neutrophil count were also significantly elevated in the mortality group, while lymphocyte and platelet counts were lower. Both preoperative and postoperative inflammatory markers were positively correlated with prolonged extubation time, length of ICU and hospital stay, and the occurrence of atrial fibrillation. In multivariate analysis, preoperative NLR, PLR, SII, and postoperative day 7 NLR and SII emerged as independent predictors of early mortality. Elevated preoperative and postoperative inflammatory markers (NLR, PLR, and SII) are significantly associated with adverse early clinical outcomes after CABG surgery. Monitoring these parameters may facilitate early risk stratification and improve postoperative patient management.

BACKGROUND Neural tube defects (NTDs) are among the most common congenital malformations and arise from disruption of early neurulation. Phosphoric acid is a widely used food additive; however, its potential effects on early neural tube development have not previously been evaluated in experimental neurulation models. This proof-of-concept study aimed to investigate the embryotoxic and teratogenic effects of phosphoric acid on neural tube development in a chick-embryo model of neurulation, at a single tested concentration. MATERIAL AND METHODS Fertilized pathogen-free chicken eggs (n=30) were randomly allocated into 2 groups. Control embryos (n=15) received no injection, whereas embryos in the experimental group (n=15) were injected beneath the embryonic disc with 0.25 mM phosphoric acid, at Hamburger-Hamilton stage 9. Embryos were incubated for 72 hours, after which survival was recorded and neural tube development was evaluated macroscopically and histopathologically. Statistical comparisons were performed using Fisher's exact test. RESULTS All control embryos survived (15/15, 100%) and exhibited normal neural tube closure. In the phosphoric acid-treated group, survival was significantly reduced (10/15, 66.7%; P=0.0421). Among surviving treated embryos, 80% (8/10) demonstrated NTDs, including cranial and caudal closure abnormalities (P<0.001). Histopathological examination confirmed incomplete neural fold closure, irregular notochord morphology, and disrupted somite organization in affected embryos. CONCLUSIONS Phosphoric acid exposure at the tested concentration and developmental stage markedly reduced embryo survival and induced a high incidence of neural tube closure defects in a chick-embryo model. These findings provide the first experimental proof-of-concept evidence that phosphoric acid can directly disrupt early neurulation in a vertebrate neurulation model. However, vehicle-controlled replication, dose-response analyses, and exposure-bridging studies are required to distinguish teratogenic specificity from general embryotoxicity and to assess potential relevance to human embryogenesis.

This study aimed to evaluate the effect of refractive correction on ocular deviation in children with exotropia and high hyperopia, and to compare treatment outcomes between partial and full hyperopic correction. The main objective was to evaluate if complete hyperopic correction leads to worsening ofexotropia in comparison to partial correction. This retrospective study included 43 patients diagnosed with high hyperopia (≥+ 3.00 D) and exotropia (≥10 prism diopters). Patients were categorized into two groups based on the level of spectacle correction: Group 1 received partial correction and Group 2 received full correction. Statistical analysis was conducted to compare best-corrected visual acuity (BCVA), amblyopia, and the degree of exotropia deviation. The average age at first admission and the follow-up duration were 6.3 (±3.1) years and 3.7 (±3.0) years, respectively. Before spectacle correction, the mean visual acuity was 0.45±0.28; it increased to 0.63±0.31 after treatment (p < 0.001). Additionally, the number of patients diagnosed with amblyopia significantly decreased (p = 0.001). Twenty-seven patients received partial correction, while sixteen were treated with full correction. Although a slight reduction in exodeviation was observed, there were no statistically significant differences in the overall population or within any of the subtypes (constant exotropia and intermittent exotropia) when comparing deviation angles between the partial and full correction groups before and after treatment (p > 0.05). Refractive correction is essential for improving visual acuity and reducing amblyopia in children with exotropia and significant hyperopia. Our results suggest that the use of high hyperopic spectacle correction did not demonstrate worsening of exotropia in this cohort.

The aim of this study is to assess the effects of the 45° lateral decubitus positioning and CO2 pneumoperitoneum pressure increases on the intracranial pressure via sonographically measured optic nerve sheath diameter (ONSD) in patients undergoing laparoscopic partial nephrectomy (LPN). In this prospective observational study, all patients underwent an LPN procedure. By using ocular ultrasonography, vertical and horizontal ONSDs were measured for each eye in the supine position preoperatively (T0), 10 min after the anesthesia induction in the supine position (T1), before the insufflation in the 45° lateral decubitus position (T2), after the insufflation with incremental pressures during the procedure (T3-T4-T5-T6-T7), and before awakening from anesthesia in the supine position (T8). Between the T3 and T7 measurement points, the pneumoperitoneum pressures were gradually increased from the level of 12 mmHg up to 20 mmHg by 2 mmHg in each step. A total of 103 patients, whose ages ranged from 25 to 69 years, were included in the study. A significant increase in the ONSDs was found in each measurement point from T0 to T7 (p < 0.05). The mean ONSDs were 4.4, 5.7, and 5.8 mm in T0, T6, and T7, respectively. However, as a result of a decrease in T8, the mean ONSD was similar to that in T2 (p > 0.05). Our study demonstrated that in the 45° lateral decubitus position, pneumoperitoneum pressures of 18-20 mmHg during LPN caused ONSD values to approach the threshold for elevated intracranial pressure.