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Behçet’s disease (BD) is a disease that is characterized by recurrent oral aphthae and has various involvements especially in eye, skin and vascular structures. It was presented to the modern medical community by Hulusi Behçet in 1937. Although the prevalence of BD varies according to the population, it is mostly diagnosed in Türkiye. BD in patients with recurrent oral aphthae (at least three times in one year) plus two of the following clinical features: recurrent genital aphthae, eye lesions, skin lesions and a positive pathergy test. In the literature, data on BD diagnosed during pregnancy could not be reached. Our case was referred to the dentist at the 17th week of her pregnancy because of the wounds in her mouth. Then, after evaluation with a multidisciplinary approach, BD was diagnosed and treatment was started. In the literature, the effect of pregnancy on the disease or the effect of the disease on pregnancy has been investigated. Our case is the first in the literature to be diagnosed during pregnancy, a period when the disease is generally in remission.

Objective: The aim of this study was to determine a current approach to en bloc para-aortic lymphadenectomy and to compare the results of this new approach performed by way of laparotomy and endoscopically. Methods: This study was conducted on 191 patients with endometrial cancer (EC) who had undergone para-aortic lymph node (PaLN) dissection with the current method (en. bloc paraaortic lymphadenectomy; protect inferior mesenteric artery and superior hypogastric plexus) between January 2015 and September 2019. A description of the paraaortic lymphadenectomy technique was made in this study. Harvested lymph node counts, operational information, pathological features, postoperative complications, recurrence were presented. Results: A total of 191 EC patients were analyzed in two separate groups with regard to surgical approach. Open and minimally invasive surgery was composed of 141 and 50 patients, respectively. There was no difference between the groups in respect of age, body mass index, menopausal status, anesthesia time, chylous ascites, the presence of recurrence. We found in open surgery group that pre-operative CA125 level, amount of intraoperative bleeding, erythrocyte suspension transfusion, number of PaLNs, metastatic PaLN counts, and early postoperative complications were significantly higher than the other group. Conclusion: The current method has some advantages such as protecting normal body structures, resulting in the same lymph node counts with published articles by other authors previously, and having lower recurrence rates. Two approaches of the current technique are feasible, easy to perform and effective.

Introduction: Decreased renal function is a significant public health issue, increasing the risk of various adverse outcomes. Thus, identifying potentially modifiable factors associated with the onset of chronic kidney disease (CKD) is imperative. Although CKD has been demonstrated to impact thyroid function through various mechanisms; there remains insufficient and contentious data regarding the association between albuminuria and thyroid function in patients diagnosed with CKD. This study aimed to elucidate the association between albuminuria and thyroid function tests in patients with CKD. Methods: We conducted a cross-sectional analysis involving 232 patients with CKD. Patients were categorized on the basis of albuminuria levels, measured by the urinary albumin/creatinine ratio (ACR), following the KDIGO 2012 criteria: ACR1 300 mg/gr. Thyroid stimulating hormone (TSH), free thyroxine (free T4), and free triiodothyronine (free T3) levels were measured to assess thyroid function. Results: The ACR among subjects ranged from 1.0 mg/g to 10260.0 mg/g, with a mean urinary ACR of 485.7±1250.9 mg/g. Among the patients, 47.4% (n=110) had an ACR 300 mg/g. TSH levels ranged from 0.3 to 14 mU/L, free T3 ranged between 0.6 and 4.8 ng/L, and free T4 ranged from 5.5 to 17.8 ng/L. No significant differences were observed in TSH, free T4, and free T3 values among the ACR1, ACR2, and ACR3 groups (p>0.05). A significant positive correlation was found between glomerular filtration rate and free T3 (r=0.395, p

Introduction: Coronavirus diseases-2019 (COVID-19) have been ongoing for more than two years. Despite the scientific research conducted in this process, there is still no widely accepted definitive treatment for the disease. For treating COVID-19, using antiviral agents previously used for the treatment of other RNA-virus infections has been seen as a fast way to a solution, and favipiravir is one of the leading agents. This prospective, multicenter, observational study was designed to investigate the safety of favipiravir in 500 patients treated with favipravir for favipravir. Methods: This study was conducted as a multicenter prospective study. Eight different sites from four cities participated, and 500 patients were included in the study. Follow-up of laboratory parameters, adverse events (AEs), and amelioration of fever, dyspnea, and cough symptoms of the patients was recorded in a case report form. Results: A total of 475 patients from eight centers completed the study. A total of 401 AEs were reported in 206 (51.4%) patients, which were mild-to-moderate in the majority of cases. Serious AEs occurred in 5 patients and death occurred in 4 patients. From the first to the last measurement, serum alanine aminotransferase levels (31.9±27.7 vs. 47.2±49.7 U/L, p37.8 for 6.6% on day 3, 3.2% on day 5, and 0.6% on day 10), dyspnea (for 56.4% on day 5, 62.4% on day 7, and 81.2% on day 10), and cough (46.0% on day 5, 73.0% on day 7, and 87.3% on day 10) were noted in an increasingly higher percentage of patients with continued therapy. Conclusion: The current study provides real-life data of favipiravir, which is a unique option in Turkey for treating COVID-19 patients. The results revealed that favipiravir is a well-tolerated agent with a low side-effect profile. However, it needs to be evaluated with well-designed, dose-compared, randomized controlled studies for the evaluation of efficacy.

Objective: This study examined the clinical consequences of pregnancy coexisting with severe acute respiratory syndrome coronavirus 2 in the intensive care unit (ICU). Materials and Methods: The study was designed as a retrospective observational study. After the ethical approval of the local ethics committee, the study was conducted for a period when the number of young coronavirus disease-2019 (COVID-19) cases increased in our country. The patients enrolled in the study were pregnant/puerperal patients followed up in our third-level ICU. Results: The mean age of 35 pregnant women included in the study was 29.57±4.36 years. Twenty-one of the births (80.8%) were preterm births. Twelve (34.3%) patients received invasive mechanical ventilation (IMV), and 5 (41.7%) of these patients were deceased. Twenty-six (74.3%) underwent a cesarean section (C/S). There were 5 (14.3%) patients who needed extracorporeal membrane oxygenation and 3 (8.5%) patients who needed continuous renal replacement therapy. The 28-day neonatal mortality rate for 26 births was 3.8%. The maternal mortality rate in the ICU was 14.3%. Conclusion: The preterm birth rate was high in our pregnant patients followed up in the ICU with a diagnosis of COVID-19. Because of clinical and radiological progression in pregnant women, it is difficult to indicate any gestational week in which maternal outcomes are better to undergo C/S. IMV mortality is not higher than in non-pregnant patients, so endotracheal intubation should not be avoided in appropriate patients, whether pregnancy continues or not. The absence of fully vaccinated patients in the study group revealed the protective effect of vaccination during pregnancy.

Objective: To determine the demographic characteristics of pregnant women that have a history of drug use and categorize the drugs according to the Anatomic Therapeutic Chemical Classification (ATC) system. Methods: This study was designed as a retrospective cohort study. The data obtained from the hospital database were evaluated. The drugs used by pregnant women who were found to use drugs during pregnancy were categorized according to the ATC system. At the same time, demographic data, educational status, income levels, alcohol and cigarette use and obstetric results of the pregnant women were evaluated. Results: Ninety-nine pregnant women evaluated in Tepecik Training and Research Hospital Perinatology Department Council were included. Mean age of pregnant women was 31.7 [18-47, standard deviation (SD)=5.880], mean gravida was 2.81 (1-8, SD=1.452), mean parity was 1.4 (0-5, SD=0.988) and mean gestational week at presentation was 11.27 (5-30, SD=4.692). It was determined that the mean duration of drug use was 66.56 days. It was found that drugs related to the nervous system were used most frequently with a rate of 29.33%, followed by drugs related to the digestive system with a rate of 15.03%. Congenital anomalies were observed in only 5 of 100 pregnant women exposed to the drug. Conclusion: The demographic data of pregnant women and the distribution of the drugs they are exposed to are similar to the literature. However, unlike previous studies, the preference for optional curettage is lower and the incidence of congenital anomaly is not higher than expected.

Objective:This study aimed to present the impact of coronavirus disease-2019 pandemic on seeking treatment in patients with erectile dysfunction (ED) and compare the clinical characteristics, demographics, and laboratory analysis of patients with ED during and before the pandemic period.Materials and Methods:The clinical and demographic characteristics and laboratory analysis of patients with ED were compared between the time interval of March 9, 2020, to June 1, 2020, and the previous 3 months from the pandemics. The International Index of Erectile Function-5 questionnaire was used to assess ED and the results from two groups were compared.Results:A 76.4% decreased total number of outpatient clinics and a 70.9% decreased number of patients with ED was observed; however a significant increase was detected in the ratio of patients with ED to the total number of patients during the pandemic period (1.7% vs. 2.1%, p=0.008). The median age of patients was smaller in the pandemic period. Mild ED was significantly higher in the pandemic period and moderate ED was detected higher in the period before the pandemic.Conclusion:The admission rate of patients with ED has increased in the pandemic period. The patients presenting with ED during the pandemic period were younger, with milder ED symptoms.

The detection of seasonal effects is essential in economic forecasting. However, the lack of indicators produced referencing calendars other than the Gregorian system makes it hard to observe the impact of the cultural, national, and religious days that annually shift in the Gregorian calendar, on the economy. Ramadan, the ninth month of the lunar-based Hijri calendar, has an impact on many issues, namely the Ramadan effect, due to the changes in the daily practices of the fasting Muslim people. We checked the existence of the Ramadan effect on consumer prices and industrial production in Turkey by reconstructing the monthly indicators in the Hijri calendar and testing the significance of the differences between their increase rates in Ramadan and other months. We observed that the Food Price Index and prices of some goods increase, and production decrease in Ramadan, significantly more than in other months. Considering the Ramadan effect would improve the accuracy of the inflation forecasting and seasonal adjustment models.

Introduction:To examine the indications for termination due to fetal anomalies performed in our clinic between January 2015 and October 2020 and to determine the differences between years.Methods:This study is a retrospective, observational study involving 385 patients who underwent termination before the 24th week due to fetal anomalies at Karadeniz Technical University, Farabi Hospital, Clinic of Perinatology. Termination data were analyzed by dividing the sample into two groups: terminations performed between 11 and 14 weeks (first trimester) and those between 15 and 24 weeks (second trimester) of gestation.Results:Structural malformations constituted 81.3% of termination of pregnancy (TOP) cases, chromosomal anomalies 14.5%, and genetic diseases 4.2%. Central nervous system (CNS) anomalies, at 43.4%, were the most common cause of termination. Aneuploidy was present in 56 (34.8%) of 161 cases for which karyotype analysis was available. The number of terminations that took place in both the first and the second trimesters was the highest in 2019. A continuous increase was observed in the number of terminations over the years evaluated. When the systems were evaluated individually, it was observed that the number of cases in the second trimester with CNS and face and neck anomalies was statistically significantly higher than that in the first trimester (p=0.002, p=0.037, respectively). In all, 28.3% of terminations were performed in the first trimester and 71.7% in the second trimester.Conclusion:When the distribution of TOP indications over the years was examined, it was observed that the number of cases related to chromosomal anomalies, cardiovascular system anomalies, and genetic diseases had increased gradually.

Objective:To investigate the effect of preoperative non-contrast computed tomography (NCCT) findings and peroperative laser probe selection on total laser time, energy level and ureterorenoscopy (URS) time for distal ureteral stones.Materials and Methods:We prospectively evaluated 72 patients with single distal ureteral stone measuring 5-25 mm in diameter on NCCT, who were treated with ureteroscopic lithotripsy (URSL) between June 2015 and October 2016. The patients were divided into two groups according to probe selection as 365 μm and 550 μm groups. Stone diameters, stone volume and Hounsfield units (HU) measured on NCCT, and URSL findings were noted at the end of the treatment. These findings were compared between the groups. Also the possible predictive value of NCCT findings was evaluated for URSL data.Results:There were 17 patients in the 365 μm and 55 patients in the 550 μm groups. There was no significant difference in URSL success rate and other predictive data between the groups. However, among the peroperative data, laser time, laser energy level and laser energy/time ratio were significantly lower in the 365 μm group compared to the 550 μm group (p

Myelolipoma is a rare benign tumor which is generally detected incidentally. The tumor consists of mature fat tissue and hematopoietic cells that resemble bone marrow. The coexistence of myelolipoma and non-functional adrenocortical adenoma in the same gland is exceedingly rare. We herein present two cases of adrenal myelolipoma in association with non-functional adrenocortical adenoma in left adrenal gland of a 62-year-old woman and non-functional adrenocortical adenoma combined with myelolipoma and endothelial cyst, in right adrenal gland of a 73-years-old man. Microscopically, in the central of the tumor, there was a myelolipomatous area composed of adipocytes and hematopoietic cells surrounded by sheets of adenoma cells. The histopathological diagnosis was “myelolipomatous changes within a non-functional adrenocortical adenoma”. The cases are presented here with their rarity and pathological differential diagnosis.

Objective:We aimed to evaluate the prevalence and possible risk factors of overactive bladder symptoms (OABS) among women living in a western city of Turkiye, İzmir.Materials and Methods:A questionnaire and the validated Overactive Bladder Symptom Score were filled by urologists with face-to-face interview. The prevalence of OABS and independent possible risk factors of OABS such as age, obesity, systemic diseases, educational level, marital status and number of births were analyzed. The participants with OABS and without OABS were compared in terms of possible risk factors.Results:A total of 719 women were included and the prevalence of OABS was 42.8% in our study. The prevalence of OABS with urinary incontinence (UI) (OABwet) was 69.2% and the prevalence of OABS without UI (OABdry) was 30.8% and nocturia was the most common OABS besides urgency. There was a statistically significant association between OABS and presence of nocturia and UI types (r=0.363, p

Objective: This study aims to increase awareness of nocturia when evaluating and treating patients with Obstructive Sleep Apnea syndrome (OSAS). Materials and Methods: A total of 324 patients, who attended our sleep center with the suspected diagnosis of OSAS between June 2012 and December 2015, participated in our research. The patients were divided into 4 groups according to age distribution. Demographic variables, comorbid conditions and severity of OSAS were evaluated retrospectively for their association with the nocturia. Results: In this study, 176 patients had nocturia and 148 patients did not have. There was a statistically significant difference in the presence of nocturia between patients with and without OSAS (p≤0.001). We found that the prevalence of nocturia was higher in the severe OSAS group than in the moderate and the mild OSAS and normal groups (p≤0.001). We demonstrated that there were statistically significant differences in the frequency of nocturia and total apnea-hypopnea index between OSAS groups and age groups (p≤0.001). There was a statistically significant but weak correlation between nocturia and severity of OSAS and between frequency of nocturia and OSAS severity (r=0.310, p≤0.001 and r=0.276, p≤0.001). This relationship was more significant in women than in men and more significant in patients below age 40 than in the other age groups. However, we could not find any significant difference in the presence of nocturia between patients with and without comorbid diseases. Conclusion: The frequency of nocturia increases as the severity of OSAS increases and especially patients with OSAS below age 40 years should be evaluated for nocturia.

Perivascular epithelioid cell tumors are rare mesenchymal tumors composed of histologically and immunohistochemically distinctive perivascular epithelioid cells. They are mostly benign, however, malignant tumors with aggressive behavior and distant metastasis can also occur. The standard treatment is surgical excision. Here, we report a case of a 25-year-old male with a 4 cm-mass located in the inferior pole of the left kidney, treated by surgical excision.

Aim of this study is to compare the effects of partial nephrectomy (PN) and radical nephrectomy (RN) for stage I renal cell carcinoma (RCC) on renal functions in patients with diabetes mellitus (DM) and/or hypertension (HT). Charts of patients who underwent surgery for stage I RCC in our department were retrospectively reviewed and patients with DM and/or HT were enrolled. Preoperative and postoperative estimated glomerular filtration rates (eGFR) were calculated according to the Modification of Diet in Renal Disease (MDRD) formulation for both RN and PN groups. Groups were compared for patient demographics, preoperative eGFR, postoperative eGFR and ΔeGFR [(preoperative eGFR) – (postoperative eGFR)] which reflects the renal functional loss. There were 85 patients in the RN and 33 patients in the PN groups. Demographic data were similar but the patients in the PN group had smaller tumor size compared to RN group (32.2 ± 11.8 mm vs 47.1 ± 15.2 mm, p

Purpose: Patients receiving treatment for benign prostate hyperplasia may have persistent storage symptoms. There has been increasing debate on the precision and accuracy of the International Prostate Symptom Score questionnaires over other questionnaires in evaluating all the complaints of lower urinary tract symptoms (LUTS). The aim of this study was to perform the validity and reliability analysis of the Turkish version of the Internatinal Consultation on Incontinence Questionnaire-Male LUTS (ICIQ-MLUTS). Methods: Linguistic validation was studied (i.e., translation and back translation). Intelligibility was completed between October 2013 and November 2013. Data was collected between November 2013 and March 2014. The stability and reliability of the form were measured with the Cronbach test. Results: In total, 117 male patients were included in the study. At the first visit, the mean age of the patients was 59 years (range, 18–84 years). For reliability, the Cronbach alpha value was 0.798, demonstrating the internal consistency of the form (r>0.7). The internal consistency of each question was examined separately and found to be over 0.7. For the evaluation of test-retest reliability, the test was administered to 116 patients for a second time with an interval of 2–4 weeks. The first and second test scores for each question were found to be correlated (r=0.741). Conclusions: ICIQ-MLUTS is a new questionnaire, which can be used for evaluating male LUTS in Turkey. We believe that the Turkish version of the ICIQ-MLUTS is an important breakthrough in our country.

Objective Partial nephrectomy represents the gold standard surgical procedure for the treatment of small renal cortical tumors. Tumor resection may be performed with the following techniques: on-clamp (warm or cold ischemia) and off-clamp (zero-ischemia). We aimed to share our experience with these two techniques and compare treatment outcomes in the present study. Materials and Methods Patients who have undergone open partial nephrectomy for clinical stage I renal cell carcinoma in our department between 2008 and 2012 were enrolled. Group 1 comprised patients with off-clamp technique and group 2 with on-clamp technique. Demographic data, length of operation, length of hospitalization, preoperative estimated glomerular filtration rate (eGFR) and postoperative eGFR on the last visit, complications and requirement of additional procedures, pathologic stage, and surgical margin status were compared between the groups retrospectively. Results A total of 73 patients, 40 in group 1 and 33 in group 2, were included in the study. Mean age, rate of comorbidities, R.E.N.A.L. nephrometry scores, preoperative eGFR, length of operation, length of hospitalization, complications, surgical margin status and additional procedure requirement did not differ significantly between the groups. Transfusion requirement was higher in group 1, however, it did not reach statistical significance (0.7±1.2 U vs. 0.2±0.5 U, p=0.066). After a median follow-up of 27 months for group 1 and 33 months for group 2, postoperative eGFR values were also similar (72.6±31.0 ml/min/1.73 m2 vs. 78.3±22.3 ml/min/1.73 m2, p=0.651). Conclusion Both surgical techniques, on-clamp and off-clamp partial nephrectomy, can be performed according to the surgeons’ preferences safely with similar outcomes.

The use of instructional videos is rampant in education; however, their interaction is limited by weak instructional design. Gagne has never insisted on using his renowned 9 Events of Instruction slavishly in situations as a viable paradigm for utilization in video design. Connecting grade level, video length, and interaction, this study seeks to determine the relevance of Gagne's prescribed 9 event sequence in instructional mathematics videos. We scrutinized 50 instructional mathematics videos on YouTube geared towards middle school pupils ranging between 5th and 8th grades. We used quantitative media content analysis for video analysis. In data analysis, partial least squares were used. Bayesian estimation was also resorted to for cross checking. The data revealed that one-third of Gagne's instructional design steps were not always present: "activating prior knowledge," "eliciting performance," and finally "providing feedback." A mediation analysis between grade level and video length revealed that 6 events fully mediated the association between the two. We also elicited the impact of these variables on affective and behavioral interactions in videos. This study assists in creating an idiosyncratic instructional design model, called "Birgili's 8 steps for instructional video design," and in infusing this with a melange of four theories. In contrast with the status quo attesting that the literature abounds with scholarly works touting "the shorter is the better" mantra, the results substantiated that longer may be better in leveraging video interactions provided that the length is judiciously used to conform to instructional design principles.

Hounsfield units (HU) provides a quantitative assessment of stone density in the urogenital tract on non-contrast computed tomography (NCCT) and has the ability to predict treatment success. The difference in HU (HUdiff) value was measured on NCCT in two patients. Our opinion is that HUdiff can predict stone composition before treatment.

Purpose: To determine the proportion of patients with undetected symptoms of overactive bladder by using the overactive bladder-validated 8 (OAB-V8) screening questionnaire and investigate these symptoms were undetected in female patients who were hospitalized. Methods: We invited 2,250 female patients hospitalized in the Aegean region of Turkey to answer a self-administered questionnaire. The questionnaire included questions on evidence of lower urinary tract symptoms (OAB-V8), relevant medical history, and demographic data. Patients with a total OAB-V8 score≥8 were defined as having OAB symptoms. Results: The proportion of patients with OAB symptoms in this study was 40.6%. Nearly 57% of the patients with OAB symptoms had not been previously admitted to any hospital for lower urinary tract symptoms (LUTS). The two most common reasons why women with OAB symptoms did not admit themselves to a hospital because of LUTS were as follows: “I did not think I had a disease” and “The symptoms did not bother me,” with a response rate of 74.7%. The mean OAB-V8 scores of the patients with these two responses were significantly lower than those of the other patients (P

Objective In this study, we aimed to present clinical characteristics and repair outcomes in patients who had sexual intercourse-induced penile trauma and underwent early surgical repair in our clinic. Materials and Methods We retrospectively evaluated records of patients who underwent early surgical repair due to penile trauma between 2004 and 2014 in our clinic. Preoperative, peroperative and postoperative data were analyzed. Patient characteristics, penile trauma characteristics, pre-trauma and postoperative International Index of Erectile Function-Erectile Function Domain Scores (IIEF-ED), and operation features were evaluated. Results Twenty-six male patients who were admitted to the emergency room with penile trauma and underwent early surgical repair were investigated. Four patients had only dorsal vein laceration and twenty-two had corpus cavernosum rupture. Postoperative erectile dysfunction was observed in three patients (the patients were older than 45 years of age, a patients had bilateral corpus cavernosum rupture and two patients had concomitant urethral trauma). Early repair was successful (86.4%) in the remaining 19 patients. The average erection hardness grade and IIEF-ED value were 4.75 and 28.6 before penile fracture; postoperative mean erection hardness grade and IIEF-ED value were found to be 4.2 and 24.9, respectively (p>0.05). Conclusion As a result, in sexual intercourse-induced penile fracture, early repair with degloving approach is effective method in postoperative erectile success in young patients and patients with isolated unilateral fractures.

Ureteral jet dynamics, which have been shown in recent studies to indicate stone formation mechanism in adults and children, provide information about ureteral peristaltism. The dynamics were measured with Doppler ultrasonography and included ureteral jet flows and ureteral jet patterns. In this paper, we present radiographic images of a non-obstructive lower pole stone in the right kidney and a non-obstructive upper pole stone in the left kidney measuring

Objective In this study, the effect of cystocele repair performed simultaneously with transobturator tape (TOT) on the results of operation was evaluated in patients with stress urinary incontinance (SUI) and pelvis organ prolapsus (POP). Materials and Methods The data of 103 patients who had SUI and cystocele between 2006 and 2012 were evaluated retrospectively. The patients who underwent only TOT was classified as group 1 and the patients who underwent cystocele repair simulatenously with TOT were classified as group 2. The patients in group 2 were divided as group 2a (low grade cystocele (grade 1 and 2)) and group 2b (high grade (grade 3) cystocele ). The age, number of normal deliveries, pad test, cystocele grade, post-operative complications and preop International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) forms were evaluated from the patient files. All patients were questioned by ICIQ-SF in terms of the final continence status. The groups were compared in terms of the above-mentioned parameters. Results It was observed that there was no significant difference between group 1 and group 2 in terms of preoperative ICIQ-SF scores (16.06±0.34 and 16.82±0.42, respectively) and demographic data at the baseline. It was observed that the postoperative ICIQ-SF scores decreased markedly in both groups (3.28±0.78 and 5.41±1.21, respectively, p

Demonstration of the intra-vaginal ejaculation latency time (IELT) distribution in male subjects and its clinical expressions among couples in the Aegean region of the Turkey. Materials and Methods Subjects were recruited to the study from six different urologic centers in the Aegean region. During the enrollment period subjects were recruited in to two group according to presence of premature ejaculation (PE). PE diagnosis was made according to DSM-4 definition. Subjects and their partners were evaluated with patient reported outcome measures (PRO) related to the ejaculation-based questionnaire (Premature ejaculation patient profile questionnaire -PEPQ). Stopwatch measurements were also asked from each couple to record intravaginal ejaculation latency time (IELT). Couples who completed two clinical visits with 4 wk interval were recruited to the data analysis. Results Among 141 eligible subjects, mean age was 36.5±9.7 years and mean partner age was 32.9±9.8 years. Following the initial evaluation 80 subjects recruited to group 1(PE) and 41 subjects recruited to the group 2 (non-PE). Geometric mean IELT of the subjects was significantly differed between PE and non- PE group (64.7±66.8 vs. 521.5±414.7 seconds, p

The FATIH project was the largest K-12 level ed-tech integration project in Turkey. Its aim was to enhance the quality of education by improving technology in classrooms. To determine the outcome of the project a systematic literature review was carried out and the perspectives of in-service teachers were considered. The literature was searched for information between the years 2014 and 2022. A total of 22 studies were thematically coded, which yielded 170 codes. The results indicate that the project revolved around hardware and that the e-content was unsatisfactory. They also showed that the teachers were not prepared, that there were sustainability problems, and that classroom practice was disrupted. The underlying reasons for these issues were the sudden top-down start of the project and the recalcitrance of teachers towards it. As a result, it is recommended that ed-tech integration literature is referred to before launching such an initiative.

Female genital mutilation (FGM) is a horrible procedure which may have detrimental physical and pyschological effects on women and mostly performed in the Middle East and African regions. FGM has four different types described in various regions. Total urinary incontinence due to type 3 FGM is described in a 21-year-old female in the present article.

Prostatic urethral lift (PUL) has been recently introduced as a minimally invasive procedure for relieving benign prostatic hyperplasia (BPH) associated lower urinary tract symptoms (LUTS) while preserving sexual functions. BPH6 study is the first prospective, randomized study comparing PUL with transurethral resection of the prostate (TURP) which still represents the standard surgical procedure for BPH. The authors proposed a novel evaluation method for comparing treatment outcomes which they named BPH6 composed of 6 items including symptom relief, high-quality recovery, erectile functions, ejaculatory functions, continence and high-grade complications. The study included 80 patients (45 PUL, 35 TURP) with a follow-up period of 12 months. With similar baseline characteristics, the authors reported significantly higher rate of achieving the BPH6 recovery endpoint by 1 month in the PUL group compared to TURP group. Discharge from hospital and returning to preoperative activity level were in favor of PUL group. Despite significant improvement concerning the International Prostate Symptom Score (IPSS), IPSS-Quality of Life (IPSS-QoL), BPH-II and the peak urinary flow rate (Qmax) in both treatment arms compared to baseline; TURP was much better than PUL. Erectile functions evaluated by the Sexual Health Inventory for Men (SHIM) were preserved in both treatment arms. The authors reported improved ejaculatory functions (MSHQ-EjD) for the PUL group, whereas there was a significant decline in TURP group. Continence preservation was comparable between the groups. None of the patients in the PUL group required surgical intervention for any adverse event, however, 2 patients in the TURP group required endoscopic intervention. PUL seems to have no significant effect on sexual functions while improving LUTS in short-term follow-up, however, further trials with long-term follow-up are required.

Languages have various forms of expressing implications ofimminency and non-actuality. While a variety of constructions such asimperfectives, proximatives or adverbs like almost crosslinguistically imply thecounterfactuality of the event in question, some languages like French andTurkish have exclusive morphemes expressing imminence while at the sametime logically asserting the non-actuality of an event. This study has a particularfocus on the Turkish morpheme -(y)Ayaz, which when combined with apredicate indicates that the event expressed by the predicate has not beenactualized although it was close to be so. We argue that this is part of what-(y)Ayaz asserts, and provide a compositional semantics for sentences involvingthis morpheme. Finally, we show that our semantics sheds light on thecombinatorial restrictions concerning lexical aspect and outer aspect.