Objective: To explore the possible effects of naringin on acrylamide-induced nephrotoxicity in rats. Methods: Sprague-Dawley rats weighing 200-250 g were randomly divided into five groups. The control group was given intragastric (i.g.) saline (1 mL) for 10 d. The acrylamide group was given i.g. acrylamide in saline (38.27 mg/kg titrated to 1 mL) for 10 d. The treatment groups were administered with naringin in saline (50 and 100 mg/kg, respectively) for 10 d and given i.g. acrylamide (38.27 mg/kg) 1 h after naringin injection. The naringin group was given i.g. naringin (100 mg/kg) alone for 10 d. On day 11, intracardiac blood samples were obtained from the rats when they were under anesthesia, after which they were euthanized. Urea and creatinine concentrations of blood serum samples were analyzed with an autoanalyzer. Enzyme-linked immunosorbent assay was used to quantify malondialdehyde, superoxide dismutase, glutathione, glutathione peroxidase, catalase, tumor necrosis factor-β, nuclear factor-κB, interleukin (IL)-33, IL-6, IL-1β, cyclooxygenase-2, kidney injury molecule-1, mitogen-activated protein kinase-1, and caspase-3 in kidney tissues. Renal tissues were also evaluated by histopathological and immunohistochemical examinations for 8-OHdG and Bcl-2. Results: Naringin attenuated acrylamide-induced nephrotoxicity by significantly decreasing serum urea and creatinine levels. Naringin increased superoxide dismutase, glutathione, glutathione peroxidase, and catalase activities and decreased malondialdehyde levels in kidney tissues. In addition, naringin reduced the levels of inflammatory and apoptotic parameters in kidney tissues. The histopathological assay showed that acrylamide caused histopathological changes and DNA damage, which were ameliorated by naringin. Conclusions: Naringin attenuated inflammation, apoptosis, oxidative stress, and oxidative DNA damage in acrylamide-induced nephrotoxicity in rats.

Aims: Recent reports indicate that many coagulase-negative staphylococci (CoNS) strains are resistant to most antimicrobials used against staphylococcal infections. This study was aimed to determine the species distribution of the CoNS isolates in Lokman Hekim Ankara Hospital and determine their antimicrobial resistance characteristics. Methodology and results: The study was conducted at Lokman Hekim University Ankara Hospital between February 2020 and August 2021. The 154 blood cultures included in the study were incubated in the BACTEC FX40 automated blood culture device. Identification and antimicrobial susceptibility tests of the samples with positive catalase tests were performed with the BD Phoenix Automated Microbiology Sensitivity System. The statistical significance level was accepted as p<0.05. Nineteen different types of methicillin-resistant coagulase-negative staphylococci (MRCoNS) isolated from different age groups were identified. Vancomycin resistance was observed in 20 samples (13%). Trimethoprim-sulfamethoxazole (TMP-SMX) resistance was seen in 44 of 152 samples (28.6%), linezolid resistance in 15 of 143 samples (10.5%) and daptomycin resistance in 16 of 146 blood samples (11%). Conclusion, significance and impact of study In our investigation, there has been a striking rise in the prevalence of vancomycin, TMP-SMX, linezolid and daptomycin resistance among infections with the MRCoNS. Identifying and classifying multidrug resistance on MRCoNS requires reliable epidemiological data to be collected and compared between healthcare facilities in different countries. The research finding reported in this paper will contribute to the determination of alternative antibiotics for treating MRCoNS.
Methicillin Resistance Staphylococcus aureus ; Staphylococcal Infections ; Drug Resistance, Bacterial ; Turkey

Introduction: Bone-patellar tendon-bone (BPTB) and semitendinosus–gracilis (STG) are the commonest grafts used for ACL reconstruction. However even after having been debated for years, there is no consensus about the ideal graft. Moreover, the literature is deficient about STG graft with preserved tibial insertion (STGPI) which preserves the proprioception. Our aim is to compare the outcome of BPTB, free STG and STGPI grafts after ACL reconstruction in professional sports persons. We compared the outcome in terms of mechanical stability, functional outcome, return to sports activity and degenerative changes. Materials and Methods: Professional sports persons aged between 16-50 years operated for ACL tear using BPTB, free STG and STGPI grafts with minimum follow-up of two years were identified from hospital records. Patients with associated knee injuries were excluded. Patients, divided in three groups according to graft used, were compared in terms of mechanical stability (arthrometric examination KT-1000 score), functional outcome (Lysholm Score), return to sports activity (Tegner score and difference in thigh circumference) and degenerative changes (KL grading). Results: BPTB graft group was found to be better than free STG and STGPI graft groups in terms of KT-1000 score. There was no statistically significant difference among the groups in terms of Lysholm score, Tegner score, difference in thigh circumference and KL grading. Conclusion: BPTB graft is better than free STG and STGPI grafts in terms of knee stability. When compared for patient reported outcome, return to sports activity, osteoarthritic changes and graft failure there is no significant difference among the three types of grafts.

Introduction: Vitamin D, which is known for its effects on calcium and bone metabolism, has recently been associated with haematological malignancies. We aimed to investigate the relationship between disease findings and vitamin D deficiency in essential thrombocythemia (ET) and polycythemia vera (PV). Material and Methods: This retrospective cohort study conducted in Turkey included 73 patients diagnosed with PV or ET according to WHO criteria between 2012 and 2018. Vitamin D deficiency was defined as 25-OH vitamin D < 20 ng/mL. Polymerase chain reaction (PCR) was used to detect the Janus kinase 2 (JAK2) V617F mutation. Results: Vitamin D deficiency was found in 66.7% of PV and 74.2% of ET patients. The median follow-up time of ET and PV patients was 48 months and 47 months, respectively. Patients with the JAK2 mutation had a higher prevalence of a history of thrombosis and age older than 65 years. There was a significant relationship between JAK2 positivity and vitamin D deficiency. Conclusion: There was a remarkably higher prevalence of vitamin D deficiency in JAK2 mutation-positive ET and PV patients. These patients should be carefully evaluated for vitamin D deficiency. More studies are required to further investigate the association between JAK2 and vitamin D.

Background: Migraine is associated with atherosclerosis and white matter hyperintensities. This study aims to evaluate the relationship between white matter hyperintensities and carotid intima-media thickness in patients who have migraines without auras. Methods: The study enrolled 105 patients; of these, 43 patients had migraine without white matter hyperintensity (WMH) and 32 had migraine with WMH. There were also 30 healthy control subjects. The patients were divided into two groups according to whether or not they had WMHs on their brain magnetic resonance imaging (MRI). All subjects, including the control group, underwent brain MRI and carotid ultrasonographic examination to evaluate WMH and carotid intima-media thickness (CIMT), respectively. Results: The groups did not differ with regard to demographics and clinical findings. The CIMT was significantly greater in patients who had migraine without WMH than in the control group (p < 0.001) and in those who had migraine with WMH than in those who had migraine without WMH (p = 0.004) Conclusion: CIMT values were higher in migraine patients with WMH than in migraine patients without WMH. Migraine patients with WMH may be at a greater risk of developing future vascular events.

The coracoid process is a bony projection arising from the antero-lateral aspect of the scapula. The variation in the height and length of the coracoid process are responsible for altered size and shape of the space between the coracoacromial arch and the rotator cuff. The study was conducted on sixty-four dry adult human scapulae of unknown age and sex with a view to elucidate the morphological and osteometric details. The length of coracoid process on right side was 41.01±3.55 mm and it was found to be 40.88±3.83 mm on left sided. The breadth of coracoid process was observed as 13.93±1.13 mm and 13.25±1.26 mm on right and left side respectively and the difference between the two sides was statistically significant (p=0.026). Thickness of the coracoid process was 8.59±1.32 mm and 8.01±1.16 mm in right and left sided scapulae. The acromiocoracoid distance was found to be 38.48±4.03 mm on right side and 35.51±3.83 mm on left sided scapulae and the difference between to the two sides showed high statistically significance (p=0.004). Mean coracoglenoid distance was noted 26.23±3.05 mm and 24.94±2.75 mm on right and left sided scapulae respectively. Values of the thickness of coracoid process recorded in the present study are at appreciable variance with the result of previous study. The coracoid process constitutes an important component of the scapular glenoid construct and is involved in many surgical interventions on the glenohumeral joint. Comprehension of standard morphometric details of the coracoid process is vital in traumatic cases, surgical interventions and replacement surgeries in the shoulder region.
Coracoid ; process ; scapula ; osteometric ; clinical

Frequent variations are reported in muscles and ligaments of lower limb suggesting that these muscles are yet to achieve the evolutionary fate. Extensor Hallucis longus (EHL) is one such muscle exhibiting anomalies which prove to be of importance while explaining functional anatomy and clinical correlations of the foot. The current study reports unilateral presence of variant EHL tendon encountered during cadaveric dissection of dorsum of foot for undergraduate teaching. The tendon bifurcated into two slips (medial and lateral) at the base of first metatarsal. The main tendinous slip (lateral) was found to be inserted as usual on the dorsal aspect of the terminal phalanx of great toe. The thin medial slip was attached to the medial half of dorsal aspect of base of proximal phalanx of the great toe medial to the insertion of extensor hallucis brevis. An attempt is made to discuss the clinical implications of the variation in the light of available anatomical literature. The results of current study are of clinical relevance to orthopedicians and reconstructive surgeons.
Accessory tendon ; Hallux valgus ; Extensor hallucis longus ; Reconstructive surgery ; Tendon repair

Signet ring cell adenocarcinomas may be encountered in various parts of gastrointestinal tract but are almost unheard of in the region of ampulla of vater. In the region of ampulla of vater even if we come across an adenocarcinoma, it is usually a well differentiated variant. A 56-year-old female with features of obstructive jaundice on evaluation was diagnosed to have a peri-ampullary carcinoma.The patient was subjected to a laparotomy. On exploration patient was found to have a malrotation of gut. Patient was subjected to a pylorus preserving pancreatico-duodenectomy. Histopathology of the resected specimen revealed a signet ring morphology which is a rare variant in periampullary region.
Adenocarcinoma ; Carcinoma, Signet Ring Cell

Lumbricals are important small intrinsic muscles of the hand, which arise from the tendons of the flexor digitorum profundus in the palm distal to the flexor retinaculum and are inserted on to the dorsal digital expansion. Variations in the unipinnate/bipinnate pattern of lumbricals, absence of one or more muscles, origin from the superficial flexor tendons and flexor retinaculum have been reported earlier. In the present case, all four lumbricals were arising from the tendons of the flexor digitorum profundus, proximal to the flexor retinaculum in the anterior part of the forearm and extending into the palm through the carpal tunnel. However, there was no variation found with regard to their normal unipinnate (first two) and bipinnate (last two) pattern of origin. In the palm all the four lumbricals were found to be bulkier than their normal size, first one being the bulkiest. The bulky and high origin of lumbricals within the carpal tunnel makes the tunnel a compact space. Therefore, such variation is one of the predisposing factors for the carpal tunnel syndrome. Thus, the knowledge of such variant origin of lumbricals is helpful not only during carpal tunnel release but also during the magnetic resonance imaging (MRI) and ultrasound based diagnosis of carpal tunnel and during the flexor tendon repair and reconstruction.

Objective: This prospective study aimed to study the prognostic value of routine haematological and biochemical parameters in patients of acute hypertensive intracerebral hemorrhage (ICH) on fatality occurring during fi rst 30 days, and to estimate its case fatality rate, demographic and clinical correlates. Methods: One hundred and eleven consecutive patients with proved hypertensive ICH within 72 hours of symptom onset were studied. After clinical evaluation and neuroimaging, blood investigations including hemoglobin, total leukocyte count, platelet count, erythrocyte sedimentation rate, random blood sugar, urea, creatinine, sodium, potassium, serum bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), albumin estimations were performed. The patients were followed up for a maximum period of 30 days from the onset of stroke. Results: Logistic regression analysis demonstrated that a low Glasgow Coma Scale (GCS) score (Odd`s ratio (OR) 17.54, p=0.001); high serum bilirubin (OR=7.97, p=0.021), and low serum albumin (OR=13.31, p=0.001) correlated signifi cantly with death. Conclusions: Our study shows that low GCS, raised serum bilirubin, and low serum albumin are marker of poor outcome in ICH.