Dear Editor,
In this article, I want to share my thoughts about the publication named “Can Electrophysiological Findings Predict Functional Outcomes in Critical illness Neuromyopathy due to COVID-19?”. In this study, Yıldız (1) concluded that the electrophysiological findings of critical illness neuromyopathy in patients diagnosed with coronavirus disease 2019 (COVID-19) provide information about short- and medium-term functional outcome (1). First of all, I would like to thank the author for this valuable contribution to science. I would like to bring a new perspective to this subject from the perspective of a physiatrist and share my knowledge.

INTRODUCTION: Purpose: To determine the antiadhesive effects of bemiparine sodium compared to hyaluronic acid based jel on a standard adhesion formation model of rat uterine horn.

METHODS: Twenty non-pregnant female Sprague Dawley rats weighing 180-220 g were used to inflict a standardized model of adhesion formation on a rat uterine horn. The rats were randomized into four groups. Control group (group 1), bemiparin group (group 2), HA (hyaluronic acid) group (group 3) and bemiparin+hyaluronic acid group (group 4). Ten standardized lesions were inflicted using bipolar cauterization. The uterine horns of 20 rats were evaluated macroscopically, microscopically and with immunohistochemistry. For macroscopic evaluation; “adhesion type”, “adhesion tenacity”, “extent of adhesions” and “total macroscopic adhesion score” were determined. For microscopic evaluation; inflammation and fibrosis formation was evaluated. Immunohistochemistry scoring was performed utilizing VEGF and TGF-β1 markers.

RESULTS: Results: Macroscopic adhesion scores, including “adhesion type”, “adhesion extent” and “total macroscopic adhesion score” in the bemiparin+HA group (group4) was significantly lower than those in the control group (group1) and group HA (group3) (p<0.05). Among these three categories;bemiparin +HA (group4) had a significantly lower score than group HA (group3) in terms of adhesion type (p<0,01) and bemiparin group (group2) had a lower score than HA group (group3) in in terms of adhesion extent (p<0,05). There were no statistical differences across all four groups for microscopic inflammation, fibrosis and immunohistochemistry staining.

DISCUSSION AND CONCLUSION: The combined use of bemiparin and HA may be effective in preventing macroscopic pelvic adhesion formation. Clinical trials on humans should be conducted for further recommendations.

INTRODUCTION: Inflammatory bowel disease (IBD) is a chronic disease that can involve various regions and layers of the gastrointestinal tract from the mouth to the anus, with exacerbations-remissions, genetic predisposition and extra intestinal symptoms. Although many activity indices have been used to show the activation of the disease, there is still no consensus on the determination of disease activation. The aim of this study was to investigate the utility of mean platelet volume (MPV), an inexpensive, easily accessible test, as a marker for clinical activation in IBD.
METHODS: 94 clinically active ulcerative colitis, 45 Crohn’s patients and 140 healthy individuals over 18 years of age, colonoscopically and histopathologically confirmed in our clinic, were included in the study. Demographic and clinical characteristics of the patients, laboratory results, colonoscopy and pathology reports were evaluated retrospectively.
RESULTS: While 87(62.6%) of the patients included in the study were male, 85(60.7%) of the control group were male. The mean ages of the patient and control groups were 45.7±16.5 years and 42.9±14.2 years, respectively. Infection in both active and remission periods of the IBD group, CRP, ESR and leukocyte values were statistically higher in IBD compared to the control group(p<0.0001).MPV was found to be lower in IBD compared to the control group(p<0.0001). In addition, MPV values were also lower in the active disease period compared to the remission period(p<0.0001).
DISCUSSION AND CONCLUSION: Inflammatory parameters are used in the diagnosis and activation of IBD. We suggest that MPV can also be used as an inflammation marker to show the activation of IBD.

INTRODUCTION: This study was conducted to assess kidney function tests in outpatient individuals with a diagnosis of chronic hepatitis B who were receiving treatment with Tenofovir Disoproxil Fumarate (TDF).
METHODS: Our study included patients who presented to the Infectious Diseases Polyclinic at XXX Hospital with a diagnosis of chronic hepatitis B (CHB) and were treated with Tenofovir Disoproxil Fumarate (TDF). The hospital data, available retrospectively since 2013, allowed us to examine patient follow-ups up to that year. As a result, we were able to analyze a maximum follow-up period of nine years. The study encompassed individuals over 18 years of age whose data were complete and who were regularly monitored in the outpatient clinic.
RESULTS: Among the subjects, 69% (n: 69) were male, and 31% (n: 31) were female. Significant reductions in glomerular filtration rates (GFR) were observed in the 4th and 6th years compared to GFR measurements before initiating TDF treatment (p<0.05). Furthermore, creatinine values at the 4th and 6th years were significantly lower compared to the pre-treatment values (p<0.05). No modifications were made to the patients' treatment during the follow-up period.
DISCUSSION AND CONCLUSION: Our findings reveal differences in GFR and creatinine values similar to those observed in most studies involving patients using TDF. It is evident that TDF can lead to renal impairment. Thus, it is essential to closely monitor patients and make necessary treatment adjustments when indicated. In cases of renal insufficiency, alternative treatment options should be considered at the initiation of therapy. This approach can contribute to the prevention of nephrotoxicity.

INTRODUCTION: Patients with brucellosis present with nonspecific symptoms originating from different organs. In this study, we aimed to investigate the symptoms related to the head and neck region in patients with brucellosis.
METHODS: The retrospective study analyzed 542 patients with a definitive diagnosis of brucellosis who were admitted to our hospital between January 2015 and April 2022 and received outpatient and/or inpatient care. Clinical symptoms localized to the ear-nose-throat and head and neck regions were evaluated.
RESULTS: A neck mass was detected in 52 out of 542 patients included in the study. The prevalence of cervical lymphadenopathy and/or abscess was 9.6%. Only lymphadenopathy was present in 30 (57.7%) patients, while both neck abscess and lymphadenopathy were detected in 22 (42.3%) patients. No significant difference was found between the two groups with regard to treatment regimens (p=0.37). Mean duration of treatment was 30 ± 22.1 (range, 14-70) days in the lymphadenopathy group and was 22 ± 14.7 (range, 14-60) days in the abscess group. No significant difference was found between the two groups with regard to the length of time to clinical recovery (p=0.34).
DISCUSSION AND CONCLUSION: Brucellosis affects many regions of the head and neck and can have a variety of imaging manifestations that mimic benign and malignant lesions. The diagnosis of brucellosis should be considered in the first-line differential diagnosis conducted based on imaging features in patients residing in endemic regions.

INTRODUCTION: Menstrual problems affected by mothers or learned from mothers may continue for a lifetime. Understanding these factors may enable symptoms to be controlled. We aimed to compare premenstrual symptoms of daughters with their mothers' previous premenstrual and menopausal complaints and thought it might be a useful contribution for managing menstrual periods.
METHODS: Postmenopausal women who applied to gynecology and obstetrics policlinic and their menstruating adult daughters were clinically evaluated with psychiatrist clinician interview. Menopause rating scale(MRS) and premenstrual syndrome scale(PMSS) for previous were applied to mothers, and PMSS to daughters. Sociodemographic characteristics were also evaluated. Results were compared in SPSS 26.0 program.
RESULTS: There were 55 mother-daughter couples participated in the study. The mean age of daughters was 25.54 ± 6.4 years, of mothers was 55.23 ± 8.31 years. Anxiety, depressive thoughts, sleep, bloating symptoms of PMSS in both groups were similar (p=0.366, p=0.532, p=0.104, p=0.096 respectively), however depressive mood, fatigue, appetite, pain symptoms were different (p=0.003, p=0.031, p=0.010, p=0.001 respectively). Anxiety and fatigue symptoms of daughters were positively correlated with psychological menopausal symptoms of mothers (r=.334*, p=.013 and r=.302*, p=.025 respectively), however daughters’ PMSS scores weren't correlated to mothers’ somatic menopausal symptoms. Daughters’ pain scores were correlated to mothers’ urogenital menopausal symptoms o(r=.307*, p=.023).
DISCUSSION AND CONCLUSION: Premenstrual symptoms of daughters were related to some of their mothers' previous premenstrual and current menopausal problems. The investigation of social relationship between PMS and menopause may play role in determining methods for managing menstruel periods. But long-term, large-populated prospective follow-up studies may provide more evidence.

INTRODUCTION: This study sought to monitor the anxiety and depression symptoms, cognition, functioning, and mortality of inpatients diagnosed with delirium and to compare the results with those of a control group comprised of inpatients without delirium.
METHODS: The study group consisted of 50 inpatients with delirium, while the control group comprised 50 inpatients from the same clinic who did not have delirium. A sociodemographic questionnaire and the Delirium Rating Scale (DRS), Hospital Anxiety and Depression Scale (HADS), Mini Mental State Examination (MMSE), and Global Assessment Scale (GAS) were used for data collection purposes.
RESULTS: The MMSE and GAS scores of the delirium group were significantly lower than those of the control group at the first assessment. In addition, the increase seen in the MMSE scores of the delirium group over time was significant. At the three- and six-month follow-up assessments, the mortality rate of the delirium group was higher than that of the control group. Moreover, the mean survival duration of the delirium group at the three- and six-month assessments was significantly shorter than that of the control group.
DISCUSSION AND CONCLUSION: The findings showed that the delirium patients experienced deterioration in their cognition and functioning in the short term. Furthermore, the findings revealed life expectancy to be shortened in the delirium patients. To verify and extend the present findings, longitudinal studies involving larger sample sizes and longer follow-up periods are required.

INTRODUCTION: A survey was administered to the families of children hospitalized due to lower respiratory tract infections in winter. Risk factors that may cause non-recurrent LRTI and recurrent LRTI in hospitalized children were compared.
METHODS: Survey questions were asked to the families of pediatric patients who were hospitalized with a diagnosis of LRTI in the training and research hospital during the winter period and did not have a known chronic disease. Patients were divided into two groups: children hospitalized due to recurrent LRTI and non-recurrent LRTI (first hospitalization). Factors that may cause LRTI were compared between the two groups.
RESULTS: 47 of 77 patients (61%) were male. There were 43 (55.8%) patients between 1 and 6 months. There were 25 (32.5%) patients living in crowded houses. The number of patients exposed to cigarette smoke was 61 (79.2%). 28 (36.4%) of the patients lived in a damp house. Five of the six patients with a history of premature birth had been recurrently hospitalized (p= 0.013). Among those with a family history of atopy, 80.6% had non-recurrent LRTI and 19.4% had recurrent LRTI (p=0.004). There was a positive relationship between household population and the number of smokers.
DISCUSSION AND CONCLUSION: Risk factors for LRTI include young age, male gender, atopic family history, low socioeconomic level, exposure to cigarette smoke and premature birth. History of premature birth, young age, and atopic family history are risk factors for recurrent LRTI.

INTRODUCTION: The link between depression and childhood traumas has been emphasized for many years. This study investigates the impact of childhood traumas on posttraumatic growth in patients with depression.
METHODS: A total of 120 participants who had experienced childhood trauma at least once in their lives (75 patients with depression and 45 healthy controls) were included in the study. Participants were administered sociodemographic information form, Beck Depression Inventory (BDI), Childhood Trauma Questionnaire 28 (CTQ-28) and Posttraumatic Growth Inventory (PTGI).
RESULTS: Childhood traumas and rates of posttraumatic growth were high in both the patient and control groups, and there was no statistically significant difference between them. (p=0.63, p=0.68). The statistical analysis revealed that participants in the depression group had significantly higher scores on the physical abuse subscale of the CTQ-28 compared to the control group (p<0.05). Furthermore, significant negative correlations were observed in the control group between physical abuse of the CTQ-28 and changes in relationships with others in the PTGI, as well as between sexual abuse of the CTQ-28 and changes in relationships with others in the PTGI. In the study, female gender and level of physical abuse were found to increase the likelihood of belonging to the depression group.
DISCUSSION AND CONCLUSION: This study found that childhood trauma associated with physical abuse was more frequent in patients with depression than controls. Traumatic experiences were found to be detrimental to communicating with others. It is appropriate to recommend interventions for social support and for the treatment of traumatic experiences in childhood in a variety of contexts.

INTRODUCTION: To evaluate the functional and radiological results of double-row arthroscopic rotator cuff repairs performed by the Knotted Suture Bridging method.
METHODS: The study included 36 patients. Before surgery, tear type, tear size, and muscle atrophy were examined by ultrasound (USG) and magnetic resonance imaging (MRI) in all patients. In the clinical evaluation, the preoperative and postoperative 2nd year results of the patients were compared by Visual Analogue Scale (VAS), scoring the University of California, Los Angeles (UCLA) and the shoulder index scoring of the American Shoulder and Elbow Surgeons (ASES). Sugaya MRI recovery analysis was used to evaluate the structural healing of the tendon.
RESULTS: A significant decrease was found in the patients' VAS scores in the postoperative period. While the preoperative UCLA (0-35) score was 19.1, the median value in the second postoperative year was 29.7. (p<0.001). The median preoperative ASES index (0-100) was 46.7 before and 85 after surgery. (p<0.001) Both scores show a significant improvement in patients in the second postoperative year. MRI imaging showed good rotator cuff healing in 29 patients (Sugaya type 1-2), Sugaya type 3 in 2 patients, type 4 lesions in 2 patients, and type 5 in 3 patients.
DISCUSSION AND CONCLUSION: Double-row arthroscopic rotator cuff repairs performed by the Knotted Suture Bridging method in medium and large rotator cuff tears are highly effective in the tendon's functional and adhesive healing.