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Background/aim: Acetaminophen (APAP), used in the composition of thousands of preparations, is the most commonly used analgesic and antipyretic drug. The present study aimed to investigate the potential protective effects of the betulinic acid (BA) treatment through an APAP-induced hepatotoxicity rat model, using inflammatory, biochemical, and histopathological parameters., Materials and Methods: The study consisted of four groups: control group, APAP group, BA group, and APAP+BA group. Experimental studies continued for fifteen days. Serum samples were analysed for glucose, total cholesterol (TChol), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), aspartate amino transferase (AST), malondialdehyde (MDA), toll-like receptor-9 (TLR-9), nuclear factor kappa B (NF-κB), and interleukin-18 (IL-18)., Results: TLR9, IL-18, NF-κB, and MDA levels increased significantly in liver injury groups. These increases considerably decreased by the BA treatment. All groups showed immunopositivity for 8-hydroxy-2’–deoxyguanosine (8-OHdG) and interleukin (IL-1β) in the hepatocytes, inflammatory cells, and epithelial cells of bile ducts., Conclusion: BA can be used as an effective agent in the prevention and treatment of acute liver diseases due to its inhibitory properties in multiple pathways and its potent antioxidant effects., Competing Interests: The authors declare that there is no conflict of interest., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Background/aim: The Zurich Chronic Middle Ear Questionnaire (ZCMEI-21) is a newly-developed German-language questionnaire. The purpose of this study was to analyze the quality of life (QoL) of chronic otitis media (COM) patients and translate, transculturally adapt, and validate the ZCMEI-21 into Turkish., Materials and Methods: Based on internationally accepted guidelines, the ZCMEI-21 was translated into Turkish. To assess its validity, the total score of the ZCMEI-21-Tur was compared to the scores taken from the original validation study and a question that was directly related to the health-related QoL (HRQoL), as well as the general criterion EQ-5D-5L. Questionnaires were completed by healthy volunteers and the results were evaluated statistically., Results: A total of 80 COM patients and 40 healthy volunteers were prospectively enrolled in this study. Regarding internal consistency, the questionnaire showed a Cronbach α of 0.94, which indicated high internal consistency. Moreover, internal consistency was also determined to be excellent for the Cronbach α of the individual subscales, as follows: ear sign symptoms, 0.79; hearing, 0.83; psychosocial impact, 0.91, and medical resources, 0.84., Conclusions: The ZCMEI-21 was translated into Turkish and validated. Therefore, the ZCMEI-21-Tur was suitable for use in assessing HRQoL in adult patients with COM., Competing Interests: The authors have no funding, financial relationships, or conflicts of interest to disclose, (This work is licensed under a Creative Commons Attribution 4.0 International License.)

The aim of this review is to summarize current studies on the relationship between melatonin and aging. Nowadays, age-related diseases come into prominence, and identifying age-related changes and developing proper therapeutic approaches are counted as some of the major issues regarding community health. Melatonin is the main hormone of the pineal gland. Melatonin is known to influence many biological processes in the body, including circadian rhythms, the immune system, and neuroendocrine and cardiovascular functions.Melatoninrhythms also reflect the biological process of aging. Aging is an extremely complex and multifactorial process. Melatonin levels decline considerably with aging and its decline is associated with several age-related diseases. Aging is closely associated with oxidative damage and mitochondrial dysfunction. Free radical reactions initiated by the mitochondria constitute the inherent aging process. Melatonin plays a pivotal role in preventing age-related oxidative stress. Coronavirus disease 2019 (COVID-19) fatality rates increase with chronic diseases and age, where melatonin levels decrease. For this reason, melatonin supplementation in elderly could be beneficial in COVID-19 treatment. Therefore, studies on the usage of melatonin in COVID-19 treatment are needed., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Background/aim: Myocarditis in the acute phase usually presents with sinus tachycardia but many other arrhythmias might be seen as well. In this study we aimed to investigate repolarization abnormalities in baseline ECG of patients with myocarditis for the first time.Materials and methods: Thirty patients diagnosed with myocarditis and 25 healthy age-matched controls were included. Two different cardiologists measured corrected QT (QTc), QT dispersion (QTd), QT peak (QTp), T wave peak to T wave end (TpTe), TpTe/QT ratio, and TpTe/QTc ratio in 12-lead ECG.Results: When compared with the control group, QTp (P: 0.021), QT (P: 0.003), TpTe (P < 0.001), TpTe/QTc ratio (P < 0.001), and TpTe/QT ratio (P: 0.005) were significantly higher in patients with myocarditis. A comparison of receiver operating characteristic (ROC) curves was conducted using the Hanley and McNeil method. The area under the curve (AUC) of the electrocardiographic characteristics QT (AUC: 0.736; 95% CI [0.600-0.846]), QTP (AUC: 0.680; 95% CI [0.540-0.799]), and TpTe (AUC: 0.771; 95% CI [0.638-873]) and TpTe/QTc (AUC: 0.774; 95% CI [0.641-0.876]) and TpTe/QT (AUC: 0.726; 95% CI [0.589-0.838]) in myocarditis were not significantly different from each other but all of them were different from 0.5.Conclusion: Baseline ECGs of patients with myocarditis were associated with repolarization abnormalities. These novel findings may be one of the reasons underlying arrhythmic events in patients with myocarditis.

Background/aim: The aim of this study was to evaluate the reliability and validity of the Turkish version of the Vulnerability to Abuse Screening Scale (VASS). Materials and methods: This was a methodological study. The sample included 140 elderly individuals. Data were collected by using a questionnaire form, the VASS, and the Geriatric Depression Scale (GDS). The Cronbach alpha value was calculated and test?retest reliability was tested for the reliability analyses. Results: The Cronbach alpha value calculated for the VASS (12 items) was 0.819. There was no difference between test and retest mean scores of the VASS. A statistically significantly positive and strong relationship was found between the test and retest scores of the individuals. A statistically significantly positive and moderate relationship was found between the VASS and GDS scores. Factor analysis revealed that a total of four factors accounted for 63.66% of the total variance with an eigenvalue of >1. These results show that the Turkish version of the VASS is a valid and reliable scale. Conclusion: This study showed that the adoption of the translated VASS in Turkey is reliable and valid to evaluate the risk of abuse in adults over the age of 65.

Background/aim: The aim of this study is to identify the copeptin levels in patients presenting with carbon monoxide (CO) poisoning to the emergency department and to investigate its correlation with the neurological effects., Materials and Methods: The study group consisted of patients presenting with CO poisoning and carboxyhemoglobin levels >10%. Blood samples for copeptin levels were obtained twice, first at presentation then at the fourth hour of observation. The data were analyzed using SPSS 16 for Windows., Results: The median copeptin levels of the patient group were identified as 0.63 (0.39-1.06) ng/mL at hour 0 and 0.41 (0.31-0.49) at hour 4. The copeptin levels of the control group were 0.34 (0.25-0.42) ng/mL and were significantly lower than those of the patient group (P < 0.000). According to our results, 0.345 ng/mL for plasma copeptin level as the best cut-off level may be used with sensitivity of 94.0% and specificity of 60%. The copeptin levels at hour 0 were statistically significantly higher in the neurologically affected patients than those not affected (P < 0.001)., Conclusion: In this study it was shown that blood copeptin levels increase in patients presenting to the emergency department with CO poisoning.

Background/aim: Reduction mammoplasty is a common surgical procedure. We report the incidence of nonproliferative and proliferative breast lesions in breast reduction specimens from a single institution over a 6-year period., Materials and Methods: The histopathology reports of all patients were analyzed. The clinical and histopathological findings of the patients were recorded., Results: Between 2004 and 2010, 106 patients underwent breast reduction. Fifty-six patients (52.8%) had proliferative breast lesions, 84 patients (79.2%) had nonproliferative lesions, 8 patients (7.5%) had columnar cell lesions without atypia, 61 patients (57.5%) had columnar cell lesions with atypia, 5 patients (4.7%) had atypical ductal hyperplasia, and 6 patients (5.6%) had lobular carcinoma in situ. No invasive breast cancer was identified., Conclusion: In Turkey, there is limited evidence regarding the role of histopathological analysis in reduction mammoplasty. Moreover, none of the previous studies determined columnar cell lesion rates in reduction mammoplasty patients. The detection of significantly elevated columnar cell lesions, with or without atypia, especially in patients under the age of 40, increases the importance of screening tests, especially in Turkey, which has a high incidence of breast cancer in early ages, and addresses the need to starting screening tests early in these patients.