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Cauliflower is one of the vegetables for consumers. The demand for cauliflower was rising so it must be scaled up with fertilizer. The purpose of this study was to study the effect of chicken manure and NPK fertilizer on the growth and yield of cauliflower. The study was conducted in Sukasenang Village, Banyuresmi Sub-district, Garut Regency from July to August 2019. The study used a Randomized Block Design (RBD) in two factors each of the 3 rates with 2 replications. The first factor was the rates of chicken manure which consisted of 0, 10 and 20 tons ha-1; the second factor was NPK fertilizer which consists of 0, 100 and 200 kg ha-1. The parameter of this research was plant height, number of leaves, leaf area, weight and diameter crud. The results showed that there was no interaction between the chicken manure and NPK fertilizer. The treatment of 20 tons ha-1 chicken manure affected the variable plant height, the number of leaves and leaf area. The rates of 200 kg ha-1 NPK fertilizer had affected plant height, number of leaves, weight and diameter crud.

Introduction: Vitiligo is characterized as melanocyte loss in skin and mucous membranes, the pathogenesis of which has not yet been clarified. Calprotectin is a protein secreted from neutrophils, monocytes, and dendritic cells which has an effect on cytokine receptor regulation and the production of reactive oxygen radicals. It has been the subject of research in various inflammatory and autoimmune diseases, yet not investigated in vitiligo., Objective: The aim of our study was to investigate the role of calprotectin in the etiopathogenesis of vitiligo and its relationship with clinical subtypes and disease scores., Methods: Forty-four vitiligo patients with lack of autoimmune disease and 36 age- and sex-matched healthy controls were involved in the study. Serum calprotectin levels were measured by ELISA. The results were compared with the control group, and the relationship between patients' demographic characteristics, skin phototypes, disease type, disease scores (Vitiligo Area Scoring Index and Vitiligo Disease Activity Score), disease duration, and age at onset were evaluated., Results: The median serum calprotectin level was 454.08 pg/ml (41.19-873.41) in the patient group, and the median serum calprotectin level was 223.17 pg/ml (44.88-1044.43) in the control group. Serum calprotectin level was significantly higher in the patient group than in the control group (P = 0.016). No correlation was found between serum calprotectin level and disease scores, disease duration, age, or age of onset of disease (P > 0.05)., Conclusions: In our study, serum calprotectin levels in the patient group were found to be significantly higher than in the control group. Our findings and the existing literature on calprotectin suggest its potential involvement in the pathogenesis of vitiligo, independent of disease progression and patient characteristics.

Background and objective Emotional factors can affect stomach secretions, acid expression, and stomach motor functions. The coronavirus disease 2019 (COVID-19) pandemic was an emotionally difficult time for many individuals as the whole world faced a life-threatening disease for which definitive treatment is still not fully established. In light of this, the aim of this study was to compare the results of gastroscopies performed among individuals before and after the pandemic. Methods The study included patients who underwent gastroscopy at Bursa Çekirge State Hospital in the following four different time frames: March-June 2019 (Group 1), March-June 2020 (Group 2), March-June 2021 (Group 3), and March-June 2022 (Group 4). All gastroscopy procedures were performed under anesthesia in the endoscopy unit. During the COVID-19 pandemic, all patients underwent a polymerase chain reaction (PCR) test, and gastroscopy was performed on those with negative results. Biopsies were taken from the antrum in all cases. Patient data were collected retrospectively and the groups were examined and compared in terms of age, gender, COVID-19 history, histopathology examination results, and diagnoses. Results A total of 803 patients were evaluated: 201 in Group 1, 200 in Group 2, 201 in Group 3, and 201 in Group 4. Group 1 comprised 66 (32.8%) males and 135 (67.2%) females, Group 2 consisted of 76 (38%) males and 124 (62%) females, Group 3 had 76 (37.8%) males and 125 (62.2%) females, and Group 4 comprised 86 (42.8%) males and 115 (57.2%) females. The mean age was 52.77 ±14.92 years in Group 1, 52.5 ±14.49 years in Group 2, 50.08 ±15.71 years in Group 3, and 52.83 ±13.20 years in Group 4. Helicobacter pylori (HP) positivity was found in 84 (41.8%) patients in Group 1, 146 (73%) in Group 2, 107 (53.2%) in Group 3, and 70 (34.8%) in Group 4. The HP infection was mild in 47 (23.4%) patients in Group 1, 26 (13%) in Group 2, 49 (24.4%) in Group 3, and 72 (35.8%) in Group 4. Moderate severity of HP infection was found in 16 (8%) patients in Group 1, 18 (9%) in Group 2, 25 (12.4%) in Group 3, and 25 (12.4%) in Group 4. Very severe HP infection was noted in 21 (10.4%) patients in Group 1, nine (4.5%) in Group 2, 20 (10%) in Group 3, and 34 (16.9%) in Group 4. With regard to mild HP infection, the highest rate was seen in Group 4 (35.8%). As for patients with very severe HP infection, a statistically significant difference was found between Group 2 and Group 4. In 2020 (Group 2), the rate was 4.5%, increasing to 16.9% in 2022 (Group 4). Regarding the comparison among groups based on histopathological examination findings, the frequency of chronic antral gastritis was determined to be highest in Group 4, at a statistically significant level (p<0.001). Conclusion The COVID-19 pandemic has caused physical and emotional hardships for several people worldwide. The possibility of transmission of the disease, unknown facts about the disease, and anxiety due to the condition being potentially fatal have had a drastic impact on the emotional states of many people. It is a condition that affects the lives of many people in the short term, and we believe that its effects reflected in the chronic period can be better evaluated through further studies conducted over the long term., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Atak et al.)

Abstract: Circumscribed palmar or plantar hypokeratosis (CPPH) is a new dermatologic disorder that firstly defined Pérez A et al in 2002. Since that time, further cases of CPPH have been reported by different authors in different countries. We report a 69-year-old Turkish woman who presented with asymptomatic, erythematous patches on the thenar region of the left hand and on the second left finger. Skin biopsy showed histological features of CPPH. In this article, it was emphasized that CPPH may be seen more frequently than expected and the clinical and pathological features of this disease with suspected malignant transformation should be known., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Acute appendicitis is the leading emergency condition among surgical abdominal diseases. The treatment of choice for appendicitis is open or laparoscopic appendectomy. There are different methods for appendiceal stump closure. Laparoscopic ap-pendectomy became more applicable with hand-made endo-loop applications to close the appendiceal stump, especially in state hospi-tals where the resources were limited. This article aims to evaluate the outcomes of patients undergoing laparoscopic appendectomy with the appendiceal stump closure using a hand-made endo-loop., Methods: Fifty patients undergoing laparoscopic appendectomy with the appendiceal stump closure using a hand-made endo-loop in the General Surgery Department of our hospital between June 2014 and December 2018 were evaluated. The ages, genders, length of stay in the hospital, complications, and histopathological investigation results of the patients were gathered retrospectively. Lapa-roscopic appendectomy was performed with three ports. The appendiceal stump was closed using two hand-made endo-loops. The loop was made with a modification of Roeder's loop whose safety was proven in the literature. The first port was introduced to the abdomen with the open method. SPSS 26.0 statistical program was used for statistical analysis., Results: Thirty-one (62%) of patients were males and 19 (38%) of them were females. The mean age was 32.2±11.9 years. The age ranged between 19 and 74 years. The median length of stay in the hospital of the patients was 1.12±0.47 days. One of the patients was 21 weeks pregnant. A surgical site infection occurred in one patient during the post-operative period. Recovery was obtained with antibiotherapy. No leakage through the base of the appendix or cecal fistula was determined in none of the patients., Conclusion: One of the most important parameters in the cost of laparoscopic appendectomy is the closure technique of the stump. The cost comes into question much more especially in state hospitals where the resources are limited. Appendiceal stump closure using a hand-made endo-loop is an easy, safe, and cost-effective method.

Poliomyelitis was a disease feared worldwide, striking suddenly and paralysing mainly children for life. Monitoring of suspected cases of poliomyelitis is carried out with Acute Flaccid Paralysis (AFP) surveillance in Turkey. This study examines national data of AFP surveillance and the epidemiology of enteroviruses (EV) in Turkey from 2000 to 2019 and gives an overview of the detected serotypes of EVs. A total of 13,640 samples collected from patients with 5216 AFP pre-diagnosed cases (2 samples from each patient) and 3,208 contacts, during a 20-year period (2000-2019) were investigated. All isolated polioviruses were tested for their wild or vaccine origin according to the WHO recommended protocol by PCR and sequencing analysis were performed. Enterovirus positivity was detected in a total of 915 cases, which were identified as 204 Sabin-like polio virus (SLPV) and 711 non-polio enterovirus (NPEV). Of the 204 SLPV, 141 (69.1%) AFP were detected in patients and 63 (30.9%) were detected in samples taken from their contacts. Of the 711 NPEVs, 516 (72.5%) were from AFP cases and 195 (27.5%) were detected in samples taken from their contacts. It is concluded that the reason for the higher detection rate of NPEV in samples from AFP pre-diagnosed cases is attributed to the polio vaccination rates reaching 97% between 2008 and 2019 in Turkey. The most frequently detected NPEV serotypes were Coxackie A24, B3, and Echo 30. This retrospective study is the first comprehensive study in Turkey to evaluate the results of the AFP surveillance in the last 20 years.

Introduction: Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory breast disease that can clinically and radiographically mimic breast carcinoma and bacterial mastitis. The aim of this study is to investigate the importance of levels of the inflammation markers, interleukin-33 (IL-33), soluble ST2 receptor of IL-33 (sST2), procalcitonin (PCT), and CRP on differential diagnosis of IGM and breast cancer (BC)., Methods: 25 patients with IGM and 32 patients with primary BC who applied to General Surgery Clinic, and 30 healthy volunteer women with similar demographic condition were enrolled in the study. While the IL-33, sST2, and PCT levels were measured with ELISA method, other biochemical parameters were studied with autoanalyzer., Results: IL-33, sST2 levels were significantly higher in both BC and IGM groups than in control (p < 0.001). More importantly, the IL-33 levels of IGM group were found to be significantly higher when compared to the group with BC (p < 0.001). Accordingly the sST2 levels of the patients with IGM were significantly lower than the patients with BC (p < 0.001). There was no statistical significance between PCT levels BC and IGM groups (p > 0.05)., Conclusion: The results of our study suggest that measurement of IL-33 and its receptor sST2 levels, alongside radiological studies can help distinguishing IGM from BC. Findings of our study need to be supported with additional studies.

Although adenoviruses (AdVs) generally cause upper respiratory tract infections, conjunctivitis/epidemic keratoconjunctivitis, gastroenteritis and pneumonia, they can lead to the involvement of central nervous system. Acute flaccid paralysis (AFP) is a type of seizure, characterized by rapid and sudden onset of extreme weakness in hands and feet, including (less frequently) weakness of respiratory and swallowing, representing with decreased muscle tone, especially in children below 15-year-old. The major viral cause of AFP is polioviruses, however non-polio enteroviruses, mumps virus, rabies virus and flaviviruses can also be responsible for AFP. The data of some recent studies have pointed out the probable aetiological role of AdVs in AFP. The aim of this study was to investigate the frequency of AdVs from stool samples of AFP-suspected patients and their contacts. A total of 6130 stool samples from patients (age range: 0-15 years) prediagnosed as AFP (n= 3185) and their contacts (n= 2945), which were sent to our laboratory from the health care centers located at different regions of Turkey for the monitorization of poliomyelitis as part of national AFP surveillance programme, between 2000-2014, have been retrospectively evaluated in terms of adenovirus isolation frequency. Samples were analyzed according to the algorithm recommended by World Health Organization and inoculated in Hep-2, RD, and L20B cell lines for cultivation. Apart from enteroviruses, in case of the presence of characteristic cytopathic effects for AdVs observed in L20B cells were confirmed by a commercial Adeno agglutination kit (Diarlex Adeno; Orion Diagnostica, Finland). It was noted that AdVs have been isolated from 1.6% (97/6130) of the samples, and out of positive samples 76.3% (74/97) were from AFP-suspected cases, while 23.7% (23/97) were from their contacts. Accordingly the frequencies of AdVs from AFP-suspected cases and their contacts were found as 2.3% (74/3185) and 0.8% (23/2945), respectively. The frequencies of Adenovirus positivity between the patients and their contacts were statistically significant (Z-Score 4.8347; p< 0.05). It was determined that 52.6% of the detected AdVs among AFP-suspected cases were between 1-4 age group and the positivity was 1.6 times more among males than the females. Although the data of this study are in agreement with the studies that support the relationship of AdVs with AFP, it is obvious that further molecular and clinical studies are needed.

Background: Idiopathic granulomatous mastitis (IGM) is a rare benign breast disease which often mimics breast carcinoma both clinically and radiologically. Confirmation of diagnosis is only made by histopathological analysis. This study aims to define clinical and demographic features of IGM patients and discuss the results of treatment modalities., Methods: Forty patients with IGM who were assigned in Istanbul Medeniyet University General Surgery Clinic between March 2008 and October 2013 were retrospectively analyzed., Results: Mean age was 39.07 ± 11.5. The most common complaint was breast mass (55%). Nipple retraction was present in 6 patients (15%) and 9 patients (22.5%) had fistulizing abscess. Two patients had erythema nodosum on the lower extremity. Breast ultrasonography (USG) (n:40), mammography (MG) (n:20), and magnetic resonance imaging (MRI) (n:20) were used for imaging. Selected treatment methods were antibiotics and anti-inflammatory agents (27.5%), steroids (15%), abscess drainage (40%), and surgical excision (17.5%). Fifteen patients had recurrence after their first line treatment protocol. Mean follow-up period was 24.85 ± 19.7 months., Conclusion: Surgical excision still seems to be the best treatment method for IGM patients. Administration of steroids for large lesions prior to surgery may help minimize the lesion size and obtain better cosmesis.

The aim of this study was to determine whether conventional hemostasis (CH) or the harmonic scalpel (HS) results in shorter operative times for thyroidectomy and to evaluate the incidence of postoperative complications with each approach. In this study, 85 consecutive patients undergone open thyroidectomy were randomized into two groups: group CH (conventional hemostasis with classic technique of tying and knots, resorbable ligature, bipolar diathermy) and group HS (harmonic scalpel). Demographics, pathological characteristics, thyroid size, operative time, blood loss, and complications using the Student's t-test and χ (2)-test. The two groups were similar regarding age and sex. There were no intraoperative complications. There was no difference between the two techniques regarding the amount of blood loss for different procedures. No significant differences were found between the two groups concerning mean thyroid weight and mean hospital stay (2.2 days in HS vs. 3.7 in CH; P > 0.05). The mean operative time was significantly shorter in the HS group (47.2 min vs. 79.2 min; P < 0.001). Two (4.7 %) transient recurrent laryngeal nerve palsies were observed in the CH group and no one (0 %) in the HS group. No patient developed permanent palsy. Postoperative transient hypocalcemia occurred more frequently in the CH group (21/43, 48 % vs. 7/42, 16 %). In patients undergoing thyroidectomy, HS is a reliable and safe tool. Comparing with CH techniques, its use reduces operative times, postoperative pain, drainage volume, and transient hypocalcemia.

Objective: Evaluation of diagnostic laparoscopy findings in 600 unexplained infertility cases., Materials and Methods: A total of 600 diagnostic laparoscopies performed between 1995 and 2008 were investigated. Laparoscopies were performed in the proliferative phase of the cycle, General anesthesia was performed in all cases., Results: Normal genital findings were determined in 47.50% of primary infertile cases and in 47% of secondary infertile cases. Pelvic adhesion was the most frequent finding encountered and it was seen at a rate of 20% in the primary infertility group and 18% in the secondary infertility group. Endometriosis was determined to have a rate of 15% in the primary infertility group and 11.5% in the secondary infertility group., Conclusion: Laparoscopy has an important place in the diagnosis and planning in the treatment of infertility. Planning the convenient treatment for patients will prevent both economic loss and time loss.

Aim: Laparoscopic adjustable gastric banding (LAGB) is a widely performed surgical procedure for the treatment of morbid obesity. Late complications mainly originate from either the injection port or the gastric band. Complications from the tube and band together are also described., Case Report: We here report a case of adjustable gastric band migrated subserosally into the stomach with its whole connecting tube, which was removed endoscopically using a band cutter., Conclusion: In selected patients endoscopic techniques in combination with minimally invasive procedures can safely be used in the treatment of complete gastric band migration., (Copyright © 2011 S. Karger AG, Basel.)

Objective: To evaluate the feasibility and surgical outcome of laparoscopy-assisted surgery for large adnexal cysts., Methods: From January 1998 to October 2007, 46 women underwent laparoscopy-assisted surgery for large adnexal cysts whose maximum diameter were between 10 and 20 cm, radiologic and laboratory features suggestive of benign disease. All the patients had a pre-operative ultrasound with or without computed tomography and CA-125 assessment. Patients' demographics, clinical and ultrasound features, CA-125 values, surgical procedures, operative and post-operative complications, estimated amount of blood loss (EBL), operative time, conversion to laparotomy and the pathological findings were recorded., Results: Fourty-six consecutive patients underwent laparoscopy-assisted surgery over 9 years. The mean and range of the patients' age and body mass index were 34.1 +/- 6.3 and (21-45) years and 27.4 +/- 5.9 and (22-40), respectively. In all the patients, except one with borderline ovarian tumor, laparoscopy-assisted surgery was successful. There were no operative or post-operative complications. The mean and range of the operative time, EBL and hospital stay were 48.4 +/- 7.3 and (35-65) min, 55.0 +/- 28.9 and (25-150) mL, 1.49 +/- 0.50 and (1-3) days, respectively. The mean and range of the extracorporeal cystectomy time were 10.2 +/- 2.7 and (8-14) min. The surgical procedures performed were: ovarian and paraovarian cystectomy (n = 45), unilateral salpingo-oophorectomy, pelvic-paraaortic lymphadenectomy and omentectomy (n = 1). Pathologic findings included serous cystadenoma (n = 26), mucinous cystadenoma (n = 7), dermoid (n = 6), endometriosis (n = 6), and borderline ovarian tumor (n = 1)., Conclusion: Laparoscopy-assisted surgery is feasible and safe for women with large benign adnexal cysts and result s in a short surgery time.

Enteroviruses have major clinical and public health importance and are one of the leading causes of aseptic meningitis. There are many diseases with similar clinical symptoms and cerebrospinal fluid (CSF) findings of aseptic meningitis, thus virus isolation and identification is crucial for definitive diagnosis. Virological diagnosis is nonetheless important to distinguish between induced meningitis and other treatable causes of disease with a similar clinical picture. A total of 249 samples obtained from 246 cases (age range: 0-15 years), prediagnosed as aseptic meningitis, were sent to Virology Laboratory of Refik Saydam Hygiene Center. The patients were followed at Department of Pediatric Infectious Diseases in the Social Security Hospital, Ankara, Turkey, between 2001 and 2004. Stool (n: 180), CSF (n: 54) and throat swab (n: 15) samples have been inoculated to RD (rhabdomyosarcoma), Hep-2 (human epithelioma) and L20B (transgenic mice) cell lines, and followed up for the presence of cytopathic effects. A total of 95 enterovirus strains were isolated from 85 (34.6%) cases, and serotyped by using RIVM (National Institute of Public and the Environment, Nederlands) antisera with microneutralization method. As a result, the most frequently isolated types were found as echovirus type 30 (n: 24) and coxsackievirus type B (n: 19), which were most frequently isolated between July to October. This is the first report from Turkey for aseptic meningitis cases due to echovirus type 25 (n:3), 18 (n:2), 14 (n:1), 13 (n:4), 11 (n:6), 9 (n:1), 6 (n:9), 5 (n:1), 4 (n:1) and coxsackievirus type A9 (n:1).

In the present study, the sensitivities of HEp-2 (human epithelioma), RD (rhabdomyosarcoma) and L20B (mouse cells, that have receptors for human polioviruses) cell cultures have been evaluated and compared, for the isolation and identification of enteroviruses from the stool and cerebrospinal fluid samples of patients with acute flask paralysis and aseptic meningitis, which were examined between the years 1999-2000, in Refik Saydam Institute of Hygiene Center, Virology, Tissue Culture and Enterovirus Laboratory. Of a total of 1663 samples, 131 viral strains were isolated, and 120 of them were identified as enteroviruses, and 11 as adenoviruses. The isolation rates of 48 Sabin-like polioviruses from HEp-2, RD and L20B cell lines were found similar, as 83.3%, 87.5% and 91.6%, respectively. All of 47 Echovirus strains were isolated from RD cells, all of 13 Coxsackie type B strains were isolated from HEp-2 cells, and all of 12 non-polio enteroviruses were isolated from RD cells. All of 11 adenovirus strains that have been grown in Hep-2 cells, were thought to be occasionally isolated due to the passage of viruses to gastrointestinal tract, and excreted via stool, thus having no clinical significance for these patients. As a result, it was concluded that, all of these three cell lines and especially L20B were sensitive for polioviruses, RD cell line being more sensitive for Echovirus, and HEp-2 cell line being more sensitive for Coxsackie type B virus strains.