Purpose: To evaluate the refractive and visual outcome of lens extraction or cataract surgery combined with limbal relaxing insicion in keratoconic eyes
Method: This study included 18 keratoconic eyes of 12 patients who underwent lens extraction or cataract surgery combined with limbal relaxing insicion. Changes in the uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), and cylindrical error were assessed.
Results: The preoperative mean SE was -8.87 ± 6.97 diopters (D) and this number improved to -2.27 ± 1.48 D at the last visit. The refractive astigmatisms were significantly reduced from -4.65 ± 1.68 D to -2.40 ± 1.8 D (p < 0.001). The mean surgically induced astigmatism, calculated by a vector analysis, was 1.93 ± 1.57 D. The mean preoperative steepest meridian keratometry reading (K1) value was 52.97 ± 5.1 D, which decreased to 50.96 ± 4.5 D at the last visit (p < 0.001). The mean logMAR CDVA improved from 0.71 ± 0.39 to 0.24 ± 0.18 (p < 0.001). The CDVA was achieved with spectacles, and no patients needed to return to rigid contact lenses.
Conclusion: Limbal relaxing insicion combined with lens extraction or cataract surgery can be used effectively to decrease irregular astigmatism. This technique improves corrected and uncorrected visual acuity by decreasing both spherical and cylindrical error in keratoconic eyes, and thus reduces dependency on contact lenses.

The aim of this study is to evaluate the occurance rate of depression and anxiety in the first trimester those affecting both mother and baby and leading to serious problems, and to assess the association with obstetric history. After obtaining Clinical Research Ethics Committee approval, a total of 197 pregnants whose admitted to the outpatient unit of Obstetrics and Gynecology Department in the gestational weeks of 11-14 between April 2014 and July 2014 were included. A history or the presence of affective or anxiety disorder, presence of chronic systemic disease, pregnancy after assisted reproductive techniques, presence of malfomations diagnosed by ultrasonography, presence of hyperemesis gravidarum and presence of multiple pregnancy were excluded. Gestational weeks were detected by ultrasonography. Beck Depression Inventory (BDE) and Beck Anxiety Inventory (BAE) were used for evaluating the level of depression and anxiety of the subjects. The demographic values including age, parity, gravida, number of abortus and live births of the patients were recorded. The BAE and BDE values were compared after the patients were grouped according to the presence of abortus, gravida, and the number of live births. A total of 49 (%25,1) patients required medical treatment for depression according to a cut-off value of 17 for Beck Depression Inventory. The mean BAE score of all enrolled patients was 11,91±9,47. Anxiety disorder was found in 49.2% of pregnants. In conclusion; the negative effect of depression and anixety during pregnancy on fetal and maternal health have been indicated in the literature. It is suggested that an efficient examination in the first trimester of pregnancy may provide to diagnose of affective disorders in early stages, thus leads to an appropriate treatment preventing negative effects on fetal and maternal health.

Rib fractures are painful injuries that need intensive care which may prolong the patient's stay in hospital. The management consists of either a conservative approach or surgery. It is controversial that which methods and materials will be chosen in surgical techniques. Between April and December 2007, 14 multiple rib fractures were treated multidisciplinary with open surgical reduction and plate-screw fixation. Average 1.5 days intensive care stay and 5 days hospitalization time were obtained. These ratios were found to be quite low compared with our general practice. No wound problems were observed. Pain control could be established with a single painkiller. We think that the entire process dealed with multidisciplinary approach, improvement in surgical success, lower pulmonary complications and hospital stay with diminished cost and an increase in patient satisfaction
can be achieved.

The purpose of the study is to determine the prevalence of women with preeclampsia and to evaluate the maternal and the fetal adverse outcomes in the severe and the early onset preeclampsia subgroups.116 pregnant women with preclampsia that gave birth in an academic tertiary centre were included in this study.The preeclampsia rate was 1.4 per 100 singleton births in three years;1.5 in 2012 and 1.3 in both 2013 and 2014 in this study. The rates of severe and early onset preeclampsia were found as 0.5 and 0.4 per 100 singleton births in this three years period. Maternal adverse outcomes occurred in 18 cases. Maternal mortality occurred in 1 case. In severe preeclampsia (PE), the mean gestational age, birth weight and apgar score at 5th minute at delivery were found as 33 w, 1935 g and 6.8 scores respectively. The admission to Neonatal Intensive Care Unit (NICU) and neonatal death were 67 % and 24% respectively in severe PE. In early onset preeclampsia, the mean birth weight and apgar score 5th minute at delivery were found as 1454 g and 5.4 scores. The admission to NICU and neonatal death were 91% and %30 in early onset PE. The rate of severe PE in early onset PE was 59%. The women with severe preeclampsia had the highest anti hypertensive drug prescribing rate (41%) at discharge. The women with preeclampsia, particularly early onset and severe preeclampsia require special attention of the healthcare providers.

In recent years,single-port VATS (video-assisted thoracoscopic surgery) applications have become widespread in the surgical treatment of spontaneous pneumothorax. In this study, the results of 16 patients with spontaneous pneumothorax who were treated by single-port VATS in our clinic have been reported.
Materials and Methods: The records of 16 patients with spontaneous pneumothorax who were treated by single-port VATS were analyzed retrospectively. 14 (87.5%) of the patients were male, 2 (12.5%) of the patients were female, the average age of the patients was 28.50(minimum: 18, maximum 63). All patients were evaluated according to the affected side of the chest,preoperative clinical characteristics, surgical procedures, postoperative clinical characteristics and recurrence rates in the follow-up.
Findings: 56.3% (n=9) of the patients had a right pneumothorax and 43.82% (n = 7) of the patients had a left pneumothorax.The mean operation time was 38.75 minutes, the mean size of the surgical incision was 2.5 cm, the average amount of drainage was 185.25 ml, the mean duration of stay of postoperative drain was 4.13 days,the mean postoperative hospital stay was 5.13 days. The mild pain was present in 62.5% of the patients, moderate pain was present in 12.5% of the patients, severe pain was present in 25% of the patients according to visual analogue scale (VAS) pain score in the first 24-hour. There was no recurrencein any patients duringmean 12.50 month postoperative follow-up period.
Discussion: Single-port VATS applications in the treatment of pneumothorax will become commonly used with shorter port incision length, shorter operation time, smaller amount of drainage, shorter drainage time and shorter hospital length of stay by development of new surgical equipment and increased experience in the future.

Use of shock wave therapy in urological field coincides during 1970-1980. Experimental studies for ureteral stones in the 1970s showed osteoblastic activity changes in ilium, and revived ability of shock waves in the treatment of musculoskeletal system. Treatment with shock waves got popular in recent decades. Sometimes as first choice or as supportive treatment is also commonly used for plantar fasciitis, calcaneal spur, lateral epicondylitis and in calcific tendonitis of the shoulder. Shock wave applications recently begun to be tested in the treatment of various diseases have been reporting positive results. The purpose of this review is to summarize the use of shock wave therapy in terms of dose and duration of application regarding dental treatment, myocardial ischemia, spasticity, and tendonitis.

In this paper, an interesting and a very rare case of primary spinal cord malignant melanoma which was diagnosed according to clinical, neuroradiological and histopathological criteria was presented. Surgical resection is the preferred treatment for these tumors and leads to the regression of neurological symptoms and improvement of the quality of life. The prognosis is related to the patient’s age, well-defined borders of the tumor and the absence of dissemination or local extension at the time of diagnosis. In our case, the tumor was resected totally. During follow- up period, he developed pneumonia and died one month after the surgery.

Herpes Zoster is a subgroup of herpesviredea consisting of a double-stranted DNA virus. It is a worldwide common clinical problem and has an important mortality and morbidity rate among immunsuppresed patients. HZ infections are oftenly seen in adults, however its incidence is 0.45/1.000 in 0-14 years-old children. Here, we present two children with different clinical presentations. Our aim is to emphasize important complications of HZ infections and prevent them with early diagnosis and appropriate treatment.

Malign mesenchymoma is infrequent among the mesenchymal neoplasies of the kidney in which the latter was also about 10 % within the renal malignancies. Malign mesenchymoma is characterized by the two accompanied sarcomas and with underlying spindle cells. We report a novel case of this rare tumor with literature review.

Macrotia is one of the rare congenital external ear deformities. This deformity occurs when the measurements of the ear exceeds the standard values. However, expansion of ear may occur by other causes and have clinical implications like true macrotia. In this report, we present an adult who had previously unilateral, slight auricular asymmetry on his left ear and then growing left ear spontaneously for last four years without genetic, dermatological and rheumatological pathologies. We recommend considering other possibilities in the differential diagnosis and making comprehensive research before surgical intervention to the deformity.