Most Viewed Articles

Science is the art of systematic and reproducible measurements, ultimately leading to knowledge supported by a holistic logic. Besides serendipity, there are 6 ways in general to obtain knowledge: authoritarianism; mysticism; rationalism, empiricism; pragmatism; and scepticism. Over the last 100 years, a canonical mythology – cortical spreading depression (CSD) – has prevailed in migraine pathophysiology. Conversely, a well-defined adaptive/protective role has evolved for CSD in locusts, Drosophila, and mammals. Additionally, an elaborate but entirely symptomatic nosologic system has arbitrarily evolved in migraine / primary headache. While the so-called systematic but symptomatic classification system of migraine / primary headache keeps on advancing the data-bank exponentially, the cause-effect nexus continues to obscure the most important systematic and insightful components of the knowledge of primary headache. The first step in advancing the cause-effect mystery of migraine / primary headache is to create a conceptual, consistent, and important adaptive-pathogenetic divide in the massive and disparate data-linked pathophysiology of the disorder. Once certain definitive principles (not laboratory/neuroimaging / genetic/epidemiologic data) emerge in the science of migraine / primary headache, we become empowered to understand the complex but key phenotypic blueprint as well as the neuro-pathophysiology / neuropsychiatry of the entity, including the visual (nasal visual-field sparing digitally-displaceable and eyeball-movement-synchronous scintillating scotomata), the lateralizing fronto-temporal-nuchal headache exclusively involving the ophthalmic division of the trigeminal nerve, and the associated features such as ‘stress’, ‘post-stress’, ‘autonomic storm’, ‘protean’ and ‘spontaneous’ onset and offset, and headache-aborting nausea-vomiting. In this manner, we have also evolved principles to begin to understand the most complex female predominance of migraine patients in adults [F:M=3:1] as well as the decline of prevalence in migraine attacks following menopause and advancing age. The Laws of the Pathophysiology of Migraine encompass the invaluable neurological / neuro-ophthalmological shift in pathophysiology from the brain to the eye.

A 56-year-old man was admitted to our hospital because of sudden onset of right-sided thoracic pain. The ECG showed inferior ST segment elevations. He has been treated with aspirin, clopidogrel, unfractionated heparin and tenecteplase, and his symptoms resolved after 30 minutes. About half an hour later, the patient developed again left-sided thoracic pain and the signs of an anterior myocardial ST-segment elevation infarction. 90 minutes after receiving the initial medications, the performed coronary angiography revealed a long dissection of a large ramus circumflexus. Furthermore, the left anterior descending coronary artery was occluded at about the mid-level. The left ventriculography showed a reduced ventricular function and a Stanford type A aortic dissection. Immediate patient transfer for emergency surgical intervention was arranged. However, ventricular fibrillation occurred during transport and he required endotracheal intubation and prolonged cardiopulmonary resuscitation. Unfortunately, he died during further transport. In a patient with massive thoracic pain of initially uncommon localization in combination with fluctuation of ST-segment elevations, aortic dissection should be seriously taken into the differential diagnosis as well as into therapeutic management decisions (in particular antiplatelet and thrombolytic therapy).

Ms X is a 34 year old para 1 woman who presented at 26+5 weeks’ gestation with fever, neurological symptoms and history of a viral illness. She was treated empirically for bacterial meningitis and transferred to a tertiary maternity hospital. Cerebrospinal fluid (CSF) polymerase chain reaction (PCR) was positive for enteroviral ribonucleic acid (RNA), confirming viral meningitis. Ms X improved clinically and was discharged after six days. A high index of suspicion is required for diagnosis of meningitis in pregnancy. Thorough history, examination and workup is vital for timely treatment. Prognosis in viral meningitis is excellent with no clear adverse fetal or neonatal outcomes.

Luteinizing Hormone (LH) like exposure in the mid cycle for inducing the oocyte maturation is the very crucial step in the success of ICSI treatment. Introduction of LH surge endogenously by GnRH-agonist for final oocyte maturation induction, may be more physiological compared with the administration of HCG. Since GnRH agonist would induce FSH surge also along with LH surge, as happens in natural cycle. However, the effects of giving HCG trigger for inducing only LH surge and giving GnRH agonist trigger for inducing both LH and FSH surge, in patients treated for ICSI with GnRH antagonists need more research. Sub fertile patients planned for ICSI, meeting the requirement of inclusion criteria, were started with recombinant FSH from day 2 of menstrual cycle. GnRH antagonists were started from day 6 of stimulation. FSH dose was adjusted according to the individual response. Trigger was planned when the lead follicle reaches 24 mm. For triggering, 100 patients were randomized to receive Recombinant HCG trigger and Triptorelin acetate trigger. Oocyte retrieval was done 36 hours after Recombinant hCG Trigger and 35 hours after Triptorelin acetate trigger. The oocyte maturity rate was assessed by the number of metaphase II oocytes retrieved.

A 27-year-old man presented to our hospital for abdominal pain and a cheesy discharge from the umbilicus which lasted for a few days. He was afebrile. The physical examination revealed periumbilical tenderness and discharge from the umbilicus. There were no signs of general infection. Otherwise, he had neither specific symptoms nor a palpable abdominal mass. Pelvic computerized tomographic (CT) scanning) confirmed the presence of a cyst in the midline of the abdominal wall, with communication with the bladder and peripheral calcification. The mass was infiltrated to the perivesical fat (Figure 1). The patient was prepared for surgery. During laparotomy, a urachal cyst with the cuff of the bladder dome were removed (Figure 2). Recovery was unremarkable. The resected specimen was a partial cystectomy specimen with perivesical fat and the median umbilical ligament

Cadmium is naturally present in the mineral cadmium sulfide which is a rare form of this element and the highest amount of cadmium is obtained from the extraction process of other minerals such as lead, copper and zinc. The release of this metal into the environment leads to widespread epidemiological effects. Therefore, measuring small amounts of this metal is also of particular importance. Small amount measuring methods of this metal are such as,preconcentration using solid phase extraction system using adsorbents. The main part of the preconcentration process is achieved by adsorption processes. In this study, the behavior of Freundlich and Langmuir adsorption isotherms for the capacity of TMON and IMNM adsorbents in cadmium adsorption has been evaluated by Power and Rational statistical distributions. At the end of the study, the constant coefficients of the Freundlich and Langmuir models were compared in both linear and non-linear modes. The results showed; the linearization method for the Kf coefficient of the Freundlich isotherm can cause errors equal to 41.6% in TMON adsorbent and 39.3% in IMNM adsorbent. Also, in parameter b, errors of 66.66% are obtained in TMON adsorbent and 32.45% in IMNM adsorbent.

Boron and their derived molecules have prevention or treatment potential against prostate cancer. In this study, we aim to investigate the effects of Boric acid (BA) and Disodium Pentaborate Dechydrate (DPD) in metastatic prostate cancer cells such as DU-145 which is brain metastatic prostate cancer, and PC3 which is bone metastatic prostate cancer.Metastatic human prostate cancer cell lines, PC-3 and DU-145, were used to show whether inhibition effects of BA and DPD on prostate cancer cells in this study. BA and DPD were applied for 24 hours to the cells. Cell viability determination was performed using WST-1 assay. Apoptotic cell death was evaluated with Annexin-V/PI flow cytometric analysis and caspase-3 expression immunohistochemically. A wound healing assay was also used to measure cancer cell migration after exposure to BA and DPD.Applying BA and DPD made inhibition of cell proliferation in both BA (1 mM) and DPD (7 mM) at 24 h. The results of Annexin-V/PI showed that DPD induced higher levels of apoptosis than BA in both prostate cancer cells. Caspase-3 expressions were also higher than BA with DPD in both metastatic prostate cancer cells. We evaluated cell migration using a wound healing assay and the result showed that cell migration was inhibited with BA and DPD in both cells. Both BA and DPD inhibited the cell viability of metastatic prostate cancer cells. Apoptotic cell death with applying DPP had a higher rate than BA treatment. Moreover, BA and DPD inhibited cell migration in both cells when we compared them with control. This study’s results showed that BA and DPD of boron derivates significantly induced cells to apoptosis and the migration was inhibited by the derived form of boron in metastatic prostate cancer cells.

The plastic pollution is threatening the environment because it has very slow degradation rate and high usage in regular activities. The present study aims at the isolation of novel microorganisms that would assist faster degradation process of polyethylene. The waste samples were collected from different landfills and dumpsites. Out of forty samples, eight samples were found to degrade polythene strips in liquid medium. Further screening of these samples showed that two strains of microbes had high potential for polythene degradation. Biochemical tests and ribotyping were performed for characterization of isolated bacteria. Resultantly, two novel bacterial strains were identified named; Bacillus wudalianchiensis_UMT (2A) and Pseudomonas aeruginosa_UMT (6). Analysis of these microbes further revealed that Bacillus wudalianchiensis_UMT and Pseudomonas aeruginosa_UMT have capability to degrade 6.6% and 4.8% polyethylene respectively. So, the results disclosed that these bacteria have great potential to degrade polythene in less time as compare to natural degradation process and can contribute to reduce pollution from our environment.

Oxygen therapy is the main supportive treatment in hypoxemic respiratory failure and has traditionally been delivered using low and high flow devices. However, the maximal flow rates that these devices can deliver are limited because of the insufficient heat and humidity provided to the gas administered. Low flow devices such as the nasal cannula, conventional face mask and reservoir bag deliver a flow rate of up to 15 L/min by administering more variable oxygen fractions (FiO2), depending on the patient’s respiratory pattern, peak inspiratory flow and characteristics of the devices. Conventional high flow devices, such as venturi type masks, utilize a constant flow of oxygen through precisely sized ports, entraining the ambient air, using the Bernoulli principle, providing a more constant inspired oxygen fraction. However, they are less tolerated than nasal cannulas because they are less comfortable and the insufficient humidification and heating of the gas delivered [1]. In the last two decades, new devices have been developed to administer high humidified and heated flow through a nasal cannula (HFNC) that also allows the delivery of oxygen with a known FiO2 up to 100%. In the literature, this technique has also been called mini CPAP (continuous positive airway pressure), transnasal insufflation, high nasal flow ventilation, high flow oxygen therapy, and high flow nasal cannula oxygen therapy [2]. It is considered that high flow nasal cannula has certain benefits compared to those of oxygen therapy previously detailed. HFNC manages a flow of more than 30 L/min, which is able to surpass the peak inspiratory flow of the patient, being able to reach values ​​between 60-80 L/min depending on the flow used. The gas source, which may be delivered by an air/oxygen blender, fans, or a flow generating turbine, is connected by an active humidifier to a nasal cannula and the FiO2 can be adjusted independently of the flow. From a clinical point of view, there is some confusion between venturi and high flow nasal cannula devices. In the literature, both have been considered as high flow oxygen therapy devices. In our opinion this is not appropriate because the high nasal cannula flow is much more than a simple system for administering oxygen therapy [3]. Venturi-type masks provide the patient with a gas mixture with a controlled FiO2, but do not exert additional benefits on the ventilator mechanics of the patient. Nevertheless, HFNC allows the delivery of a high flow, which can also add oxygen therapy, providing a series of physiological effects that imply an active treatment to respiratory failure. Effects related to HFNC include the following: 1. Delivery of higher and more stable FiO2 values, ​​because the flow delivered is greater than the patient’s inspiratory demand. 2. The anatomical dead space decreases by washing the nasopharynx, consequently increases alveolar ventilation. This improves the thoracoabdominal synchrony. 3. Respiratory work decreases because it acts as a mechanical stent in the airway and markedly attenuates inspiratory resistance. 4. The gas administered is warmed and humidified, improving mucociliar clearance, reducing the risk of atelectasis, improving ventilation perfusion and oxygenation ratio. 5. There is a CPAP-like effect. The dynamic positive espiratory airway pressure generated by HFNC reaches a value between 6-8cmH2o depending on the flow and the size of the cannula. This positive pressure distends the lungs and ensures their recruitment. 6. Pulmonary end-expiratory volume is higher with HFCN than with conventional high-flow oxygen therapy. 7. In addition, the technique is considered easy and simple for the medical staff and nurses, and can be used in different areas (emergency, hospitalization, critical care unit, weaning centers) and even at home [4]. Currently available evidence has demonstrated that HFNC therapy is an alternative for the treatment of acute hypoxemic respiratory failure, hypercapnic respiratory failure, acute heart failure, as rescue therapy preventive therapy in post-extubation respiratory failure and in specific conditions such as bronchoscopy [5]. We believe that high-flow nasal cannula treatment should not be confused with high flow oxygen therapy of venturi masks. According to detailed mechanisms of action, HFNC is not limited to being only an oxygen therapy system but also behaves as a true treatment that can be used in different clinical scenarios, generating physiological benefits that result in the reduction of respiratory work. In addition, in venturi type masks, the air is not humidified and complications such as dryness and nasal pain are common, generating a poor tolerance to oxygen therapy. The benefits of proper humidification and heating of the gas delivered with HFNC therapy allow better comfort and tolerance of the patient with easy adherence to the treatment. All this contributes to making HFNC be considered a technique of choice in patients with hypoxemic respiratory failure. The growth in its use associated with easy acceptance for patients and the expansion in its application show us that HFNC is a promising therapy.

Information regarding the effects of the novel coronavirus on human reproduction is currently limited. The objective of our work was to assess whether, in women who have passed the disease, there was a variation in the ovarian reserve through the determination of AMH levels. During May-June 2020, women performing an Assisted Reproductive treatment and who had a positive IgG for SARS-CoV-2 were included in the study; this group of women had a previous AMH determination of no more than 6 months. Women were stratified into two groups, according to their previous AMH levels: low responders (AMH<1 ng/ml) or normal-high responders (AMH ≥ 1 ng/ml) Statistical analyses were performed using the Statistical Package for Social Sciences 19.0 (IBM Corporation, Armonk, NY, USA). A total of 46 patients were included in the study; 16 women were diagnosed as having low ovarian reserve (AMH < 1 ng/ml), with an average age of 38.6 years, whereas 30 were classified as having normal ovarian reserve (AMH ≥ 1 ng/ml), with an average age of 34.7 years. Generally, the data show no variation in AMH levels before and after SARS-CoV-2 infection (1.73 ng/ml vs. 1.61 ng/ml, respectively). However, when we analyzed these differences according to the study groups, the results were consistent with the patient's ovarian status. It is possible to conclude that the fact of having passed the disease does not affect the ovarian reserve status but the degree of the variation of AMH levels depending on the patient was a low or high responder.