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Orbital cellulitis is a serious infection of the fat and muscle tissue outside the eyeball. Preseptal cellulitis is a generally mild infection of the tissues in the front of the eyelid. Although both conditions can cause eye pain, eyelid swelling and erythema, they can be confused with each other, but their clinical effects are very different. Preseptal cellulitis is a mild condition that rarely leads to serious complications, whereas orbital cellulitis can cause vision loss and even death. The most common underlying cause of both conditions is the spread of infection from nearby tissues (acute sinusitis, etc.) to the orbit through the surrounding tissues. One of the most important and serious complications of orbital cellulitis is orbital abscess. When orbital abscess is detected by clinical findings and radiologic examinations, intravenous broad-spectrum antibiotic treatment and emergency surgical intervention are required immediately. In this article, we will present a case that progressed from preseptal cellulitis to orbital cellulitis and orbital abscess and required surgical treatment. In conclusion, if there is no response to treatment in orbital infections, serious complications (orbital abscess, etc.) should be considered. Differential diagnosis should be made quickly with radiologic imaging. If necessary, surgery should be performed. Management of the disease should be planned and followed in a multidisciplinary manner with joint opinions from pediatrics, ophthalmology and otolaryngology branches.

Spontaneous spinal epidural abscess (SEA) is an uncommon but potentially fatal and shattering infectious disease. Generally treatment strategy for SEA is antibiotics and surgical decompression. In this report we present a SEA which was located at cervicothoracic region and highlight the importance of correct diagnosis and surgical timing for neurological functional recovery. We report a 65-year-old woman who presented to the emergency department of our hospital with progressive weakness in the arms and legs. The patient's spontaneous breathing had stopped immediately after the emergency admission and she was comatose with quadriplegia. Craniospinal axis magnetic resonance imaging revealed an extradural lesion at the C4-Th2 level with significant compression of the spinal cord. The patient was operated with left C5-Th1 hemilaminectomy and pus-like fluid drained from the epidural space. Empirical ceftriaxone and teicoplanin treatment was given. Spontaneous breathing started after the operation and quadriplegia improved and 4/5 upper and 2/5 lower extremity quadriparesis was achieved in the early postoperative period. Spinal epidural abscess is a rare disease.Delays in correct diagnosis of SEA might be cause irreversible neurological deficits and potentially fatal. Suspicion and careful clinical evaluation with detailed history and physical and neurological examination is essential in SEA patients.

Türkiye- Kahramanmaraş depreminde sahra hastaneleri ve işlevleri: Hatay Örneği Deprem sonrası binaların yıkılması ile özellikle sağlık hizmetleri veren kurumların işlevini kaybetmesi problemleri daha da artırmaktadır. Hastanelerin tahliye edilmesinin ardından tam teşekküllü birimlerin kurularak sağlık hizmeti devam etmelidir. Bölgede bulunan diğer hastanelerdeki büyük yıkım nedeniyle Hatay Mustafa Kemal Üniversitesi Araştırma Hastanesi depremin ilk saatlerinden itibaren aktif olarak çalıştı. 6 Şubat 2023 deki 7,7 şiddetindeki ilk depremin ardından 20 Şubat 2023 tarihinde meydana gelen 6,5 şiddetindeki deprem nedeniyle hastane tedbir amaçlı tahliye edildi. Türkiye Cumhuriyeti Sağlık Bakanlığı tarafından kara, hava ve deniz yolu ile hastaların tahliyesi sağlandı. Sağlık bakımının devam etmesi amacıyla 11 ili ilgilendiren deprem bölgesinde ilk planda 28 ülke tarafından 30 sahra hastanesi kurulurken bu sayı bir ay içerisinde 77 ye ulaştı (1,2). Bu sahra hastanelerinden biri de Amerika Birleşik Devletleri (ABD) Hava ve Deniz kuvvetleri personelince Hatay Sağlık Uygulama ve Araştırma Hastanesinin bahçesine kuruldu. Hatay Mustafa Kemal Üniversitesi’ne devredilen 20 çadırdan oluşan sahra hastanesinde iki operasyon odası, 75'i servis, 25'i yoğun bakım olan 100 yatak mevcuttu(Resim1-4). Hastane bünyesinde çadırlar acil müdahale alanı ortopedi, travma, dahiliye, kardiyoloji, aile hekimliği, diğer hekim ve personeli olan bolümlere ayrıldı. Acil görüntüleme, ultrasonografi, laboratuar için ayrı alanlar oluşturuldu. Laboratuar cihazlarında ve elektrik sistemlerinde aksamaların olması tetkik sonuçlarına ulaşımı zorlaştırdı. Vardiya usulu çalışma, kalınacak yerlerin olumsuz şartlar içermesi de çalışmalarda ve hizmetlerde sıkıntılara neden oldu (Resim 5-8). Şehirdeki kalacak yer ve temiz suya erişim sıkıntıları nedeniyle personel vardiya usulü çalıştı. Merkez ve çevre ilçelerden günlük 400 civarı ayaktan hasta kabul edilmekteydi. Bu hastaların %50 si dahili hastalardan oluşurken, %25 travma, %15 çocuk ve %10 kadın doğum hastalarından oluşmaktaydı. Hastalara acil müdahale, primer bakı, alçı atel, sütürasyon ve gereken hastalara 3-4 saatlik takipler yapıldı. Sahra hastanesinde çalıştığımız 4 aylık dönemde acil serviste 45 adet entübasyon, 13 adet resusitasyon, 6 adet katater, 391 adet kesi sütürasyonu ve 320 adet atel işlemi yapıldı. Tomografi ve ileri tetkik gerektiren hastalar sevk edildi. Özveri ile çalışan akademik-idari birimler, hekim, hemşire, teknik ekip ile bölge halkına ve depremzede yakınlarına sağlık hizmeti sunumunda kalıcı binaların inşası sağlanana kadar hizmet vermeye devam etti. Dileğimiz bu acıların tekrar yaşanmamasıdır. Sahra hastaneleri alınacak tedbirlerle depremin ilk saatlerinde vakit kaybedilmeden kurulmalı, içerisinde; acil müdahale odaları, laboratuvar, görüntüleme ve ameliyathane üniteleri mutlak olmalı gerekli ekip ve ekipman acilen temin edilmelidir. Özellikle yatay mimari ile planlanan kalıcı hastaneler mevcut hastanelerin bünyesinde riskli olan afet bölgelerinde mutlaka inşa edilmelidir (3). *Resim1-4. ABD Sahra hastanesi dış-iç görünüm (Fotoğraflar xxx arşivinden alınmıştır) Resim 5-8. ABD Sahra hastanesi müdahale alanları (Fotoğraflar xxx arşivinden alınmıştır) Kaynaklar: 1.https://t24.com.tr/haber/abd-nin-hatay-da-kurdugu-sahra-hastanesi-saglik-bakanligina-devredildi,1096527 2.https://medimagazin.com.tr/guncel/abd-antakyada-sahra-hastanesi-kuruyor-104419 3.Eren V. İnterdisipliner Yaklaşimla Hatay’da Afet Deneyimi: 6 Şubat 2023 Depremini Tarihe Not Düşmek Editör: Prof. Dr. Aci Bir Tecrübe: Hatay Depremi Deneyimi Karakuş A. ,Polat M. Nobel Akademik Yayincilik Eğitim Danişmanlik Tic. Ltd. Şti, Ankara, Eylül 2023, 447-455.

Introduction: The incidence of fungal infections, particularly those caused by Candida species, has been increasing globally. These infections are especially prevalent in nosocomial settings, affecting patients with predisposing conditions such as chronic illness, recent invasive procedures, admission to intensive care units (ICUs), and exposure to broad-spectrum antibiotics. This study aims to characterize the clinical presentation, laboratory findings, and risk factors associated with candiduria in a pediatric population. Materials and Methods: This retrospective study analyzed data from pediatric patients aged 1 month to 18 years diagnosed with candiduria at our institution between January 2017 and June 2024. Results: The study cohort comprised 58 pediatric patients (22 females, 36 males) with confirmed Candida species isolated from urine cultures. The mean age was 6.2 ± 2.9 years. Candida albicans was the most prevalent species, identified in 43 (74.1%) patients, followed by C. parapsilosis (13.7%), C. tropicalis (6.8%), C. lusitaniae (1.7%), C. lipolytica (1.7%), and C. krusei (1.7%). Clinical manifestations during candiduria episodes included fever (55.1%), dysuria (46.5%), flank pain (15.5%), suprapubic tenderness (13.7%), urinary frequency (12%), and urgency (6.8%). The most frequently observed risk factors among these patients were urinary catheterization (63.7%), ICU admission (60.3%), prolonged antibiotic use (58.6%), and the presence of a central venous catheter (56.8%). Laboratory findings revealed a mean leukocyte count of 12,964 ± 8,448/mm³, a neutrophil count of 8,297 ± 6,495/mm³, a urea level of 29.3 ± 26.3 mg/dL, a creatinine level of 0.49 ± 0.29 mg/dL, and a C-reactive protein level of 34.2 ± 25.3 mg/L. Antifungal therapy consisted of fluconazole in 57 patients and caspofungin in 1 patient. Conclusion: Effective management of candiduria requires a thorough understanding of local epidemiological trends and patient-specific risk factors. In pediatric patients, candiduria, particularly when accompanied by multiple risk factors, necessitates careful clinical evaluation and tailored treatment strategies.

Objective: The frequency of nonalcoholic fatty liver disease ( NAFLD ) is not known clearly because there are not enough clinical studies in our country. The disease is a finding that may occur incidentally when an abdominal ultrasound is performed in patients who do not have any complaints or apply to the hospital for different clinical reasons. Studies have shown that at least 25 percent of American adults have fatty liver. Our aim is to detect the frequency of NAFLD in Erzurum and its surroundings and to determine the change in our region over a ten-year period. Methods: In this study, 60000 patients who were admitted to our hospital between 2009 and 2019 and underwent ultrasonography for any reason were examined retrospectively. Prevalence was analyzed according to ultrasound findings, age, gender and body mass index (BMI). Results: NAFLD was detected in 42.1 % of the patients who participated in the study. This rate was determined as 43 % for men and 41.6 % for women. The highest rate was seen in those over 60 years of age ( 43.8 % ), in male gender ( 43 % ), and in those with BMI >25 kg/m2 ( 45 % ). Multivariate analysis showed that male gender, serum alanine aminotransferase level, older age, BMI, type II diabetes, hypertension, and dyslipidemia were independent factors associated with NAFLD. Conclusion: NAFLD is a disease that affects nearly half of the people living in our region and is about to become a public health problem. All asymptomatic individuals who are overweight or obese and have risk factors should be investigated for NAFLD.

Introduction: This study aims to describe the clinical, demographic, and laboratory characteristics of patients with abdominal venous thrombosis (AVT) and investigate the presence of paroxysmal nocturnal hemoglobinuria (PNH) clones. AVT is a rare but significant condition that affects various anatomical regions, including portal vein thrombosis (PVT), renal vein thrombosis (RVT), mesenteric vein thrombosis (MVT), and splenic vein thrombosis (SVT). Understanding the role of hematological diseases, including PNH, in the development of AVT may provide insight into its underlying mechanisms. Method: This retrospective case series was conducted at a tertiary research hospital. The study cohort consisted of adult patients diagnosed with and treated for intra-abdominal venous thrombosis. Data were collected from hospital information management system records. Demographic and clinical variables such as age, sex, thrombosis location, comorbidities, prothrombotic conditions, and genetic mutations were recorded. PNH clone presence was assessed for each patient using flow cytometry. Results: Data from 32 patients were analyzed. The mean age was 45 ± 15.6 years. Isolated PVT was observed in 21 patients (65.6%), while 4 (12.5%) had both PVT and RVT. MVT was observed in 1 patient (3.1%), and SVT in 2 patients (6.3%). Of the 3 patients with Budd-Chiari syndrome, 2 had SVT. Comorbidities included cirrhosis (6 patients), polycythemia vera (1), Factor V Leiden mutation (1), and protein C deficiency (2). No patient had a prior history of malignancy. Conclusion: There was no significant difference between male and female patients regarding risk factors, comorbidities, and multi-vessel thrombosis. No PNH clones were detected in any patient, suggesting a limited role for PNH in AVT pathogenesis. Further studies with larger cohorts are required to confirm these findings.

Purpose:Vitamin D deficiency and insufficiency remains an important health problem affecting the whole society. In our country, 400 IU/day of vitamin D3 has been provided free of charge to all newborns in primary health care since 2005. This has been effective in reducing the incidence of rickets. However, there is a lack of studies to determine the prevalence of vitamin D deficiency and insufficiency, especially in children over 3 years of age. In our study, we aimed to increase vitamin D awareness by performing a drama show for kindergarten and primary school children. Methods:Between February 2024 and March 2024, a theater performance was held in a private kindergarten and primary school in Konya province to increase the knowledge level of vitamin D. The parents of the students who participated in the drama performance were asked the specified questionnaire questions before and after the drama performance and their knowledge levels were examined. Results:59 parents were included in the study. Of the parents, 36 had children between 48-60 months and 23 had children between 61-84 months. Forty-eight (81.3%) of the children had informed their parents about the drama show. Before the drama, 44 (74.5%) parents reported having information about vitamin D. Before the drama, 27 parents used vitamin D supplements. After the drama, 12 more parents were considering using vitamin D supplements. Of the 16 parents who did not think they had enough knowledge about vitamin D, 14 of them said they had knowledge about vitamin D after the drama. Conclusion:There is a need for further studies on the widespread use of vitamin D and encouraging the use of prophylaxis. We believe that vitamin D prophylaxis, which is successfully used in the first year of life in our country, should be extended and applied to other age and risk groups.

Orexins (hypocretins) have attracted the attention of the scientific community in different pathological mechanisms since their discovery in 1998. Orexin peptides consist of two types, orexin A and B, encoded by the hypocretin neuropeptide precursor gene and then produced from the same precursor, prepro-orexin. Orexin-producing neurones are located in the lateral, dorsomedial, posterior and perifornical regions of the hypothalamus. Orexin A and B signalling is mediated by two G protein-coupled receptors called orexin1 and orexin2 receptors. The signalling of orexin peptides has been investigated in various cells, such as neurons endogenously expressing orexin receptors. The orexin1 receptor is found mainly in regions controlling feeding, learning, memory and reward, whereas the orexin2 receptor is found mainly in regions controlling arousal. From the distribution of orexin neurons and receptors, the orexin system is thought to have multiple functions in physiological mechanisms. Recent evidence suggests that the central orexin system has an important regulatory role for the regulation of food intake and sleep in animal and human models. In addition to its activity in feeding behaviour, orexin also has an active role in energy regulation. Orexin, a hypothalamic neuropeptide that is active in maintaining wakefulness, plays an important role in the regulation of the sleep-wake cycle. Experimental studies with human and animal models in which the effects of orexin system can be analysed in detail may guide therapeutic approaches related to orexin. In this review, the role of orexin in the physiopathological mechanisms of neuropsychiatric disorders such as eating disorders, sleep disorders, addiction, schizophrenia, epilepsy, depression and anxiety is explained.