INTRODUCTION: The aim of this study was to evaluate a rapid and non-invasive method for estimating central venous pressure (CVP) by comparing ultrasound measurements of the internal jugular vein and common carotid artery to CVP measured by central venous catheter
METHODS: A portable ultrasound machine was used to determine cross-sectional areas of the internal jugular veins (IJV) and common carotid arteries (CCA). The measurements were performed on patients lying in the supine position at a 45 degree angle, with ratios of the IJV area to CCA area recorded as ratio 1(lying position) and ratio 2(45˚ position). The patients were categorized
into 3 groups according to CVP, specifically; group1: CVP<10mmHg, group2: CVP 10-20mmHg, and group3: CVP>20mmHg.
RESULTS: Forty intensive care unit patients who were mechanically ventilated with a central venous catheter in place were enrolled during the study period. No statistically significant differences detected in ratio 1. Ratio 2 showed a mean ratio of 1.18 for group 1(min-max 0.72-1.64),2.64 for group 2 (min-max 1.73-3.55) and 3.00 for group 3 (min-max 0.97-5.03). For ratio 2, it was observed that group 1 had a lower value than group 2 (p=0.020) and group 3 (p=0.021).
DISCUSSION AND CONCLUSION: Ultrasound measurement of internal jugular to common carotid area ratio at a position of 45 degrees showed that a low ratio was correlated with a low central venous pressure as measured by central venous catheter.

INTRODUCTION: To assess the outcomes in patients who underwent pars plana vitrectomy (PPV) due to primary and secondary epiretinal membrane (ERM), to determine the prognostic factors affecting the results.
METHODS: Fiftyone eyes of 50 patients with ERM diagnosis were included in the study. ERMs that are not associated with any ocular disease were grouped as primary (group 1), while those due to another disease were grouped as secondary (group 2). Preoperative and postoperatively central macular thickness (CMT), visual acuity and intraocular pressure (IOP) were recorded. Three-port PPV was performed to all patients during surgery.
RESULTS: Twent-five of the patients (50%) were male and 25 (50%) were female. The mean age was 69,5±9,6. Thirty-two eyes (62.7%) were in primary ERM group; 19 eyes (37.3%) were in the secondary ERM group. Mean preoperative best corrected visual acuity (BCVA) was 0.19±0.11 in group 1 and 0.13±0.11 in group 2. Mean preoperative best corrected visual acuity (BCVA) was significantly higher in primary group (p=0.025). Mean postoperative BCVA was 0.47±0.32 in group 1 and 0.42±0.32 in group 2. In both groups there were significantly increase, but there was no significant difference between the groups in terms of the final visual acuity (p=0.669). Preoperative CMT was found 379±112.1 μ in group 1 and 430.7±131.0 μ in group 2. Postoperative CMT mean was 264.9±105.0 μ in group 1 and 211,1±94,5μ in group 2.
According to the preoperative period a significant decrease in CMT was achieved in both groups after surgery.
Although the decline was more rapid in the secondary
group, there was no difference between the two groups in
terms of final CMT (p= 0.212).
DISCUSSION AND CONCLUSION: Prognosis of early surgery performed without visual acuity reduction is better. There is no significant difference in the final results of the groups.

INTRODUCTION: To compare the results in keratoconus patients who underwent penetrating keratoplasty (PK) using interrupted or single continuous suturing techniques in terms of postoperative astigmatism and visual outcome.
METHODS: Penetrating keratoplasties were performed in 61 eyes of 61 keratoconus patients between January 2012-December 2014. Single continuous running suture tecnique was used in 30 patients (group 1), and interrupted suture technique in 31 patients (group 2). The patients who had no comorbidities, who had no increase in intraocular pressure that may affect the transparency of the graft cornea after PK, who did not experience graft rejection, graft ulceration or graft detachment, and who tracked their follow-ups were included in the study. Patients’ age, gender, autorefractometeric measurements and best corrected visual acuity (with Snellen chart) were compared in these two groups. The autorefractometeric results were measured before the surgery, 1 month 3, 6, 12 months after surgery, and 3
months after removing sutures.
RESULTS: There was no statistically significant difference between the two groups in terms of preoperative astigmatism (P=0.217>0,001). There was no statistically significant difference between the mean astigmatisma values after the removal of the sutures, as well (P=0.1).
Preoperative mean visual acuity was 0.07±0.05 in group 1, and 0.1±0.06 in group 2. The preoperative visual acuity was statistically significantly lower in group 1 than group 2 (p=0.046<0.05), whereas there were no statistically significant difference between the groups in the final visual acuities after the removal of the sutures(P=0,217 >0,05).
DISCUSSION AND CONCLUSION: There is no significant difference between the interrupted and single continuous suturing techniques in terms of the refractive values and the visual outcome. We think that the choice of suturing technique is up to surgeon’s experience.

INTRODUCTION: The purpose of this study was to determine directed to the Fatih Sultan Mehmet Education and Research Hospital Diet Policlinic wanted to be operated sleeve gastrectomy obese people’s characteristics and to evaluate the compliance of the diets and to investigate the relation between the operation decision after the 3 month diet program.
METHODS: During October 2016 and January 2017, 100 consecutive patients who were referred to the diet polyclinic for 3 months were included in the study. This patients was educated by the dietician with medical nutrition treatment, which lasted 15 minutes. Patients were called for control every month. Data collection was done using face-to-face and telephone survey techniques. At the end of the 3.month, all patients were called to the policlinic and the questionnaires were completed. The relationship between age, gender, weight, BMI, occupational status, level of education of the patients, weight loss status and operation decision after 3 months from the dietary programs was examined. In addition, the Dutch Eating Habits Questionnaire (DEBQ) assessed the external, restrictive, and emotional eating averages. The data were evaluated in the SPSS 16.0 package program. Pearson’s chi square test was used in the analysis of the data.
RESULTS: 81% of the patients were female, 19% were male. 47% of the women were housewives. Sixty-five percent of patients were found not to exercise separately from their routine tasks. After 3 months of diet, 60% of the patients lost weight and 25% of them refused surgery. The weight loss was significantly higher in men (p<0.05). Full compliance to medical nutrition treatment was found to be 12%.
DISCUSSION AND CONCLUSION: It was seen that there was a great resistance to medical nutrition treatment and exercise on obese individuals. We think that the content of the trainings and ordering the treatments to be prepared by analyzing the characteristics of the obese individuals is more appopriate and there is a need for more extensive works.

INTRODUCTION: Detection of the importance of motivation tools for employees who are active in vital areas such as health are very important in terms of determining institutional policies. By thinking this way, with this study; We aim to determine the importance of motivation tools for health workers.
METHODS: In this study was done at Fatih Sultan Mehmet Education and Research Hospital in April 2014. Survey method was used in the study and 202 medical staff attended in total. The obtained data analyzed in the SPSS program (Statistical Package for Social Sciences) and face to-face interview method was applied for the questionnaire.
RESULTS: 67,8% of the health workers participating in the survey have undergraduate/graduate degree, 52,6% of whom working in high risk areas. Working over 5 years percentage is 64,4%. 54.3% of the employees thinks suitability for the job, 65.4% of them emphasize that strong friendship relations in the business environment, 60.9% of them consider high wage and 60.9% of them imply appreciation of the work done increases their motivation. 60% of the employees emphasize lack of equipment and required materials; 66,3% think inadequacy of physical factors as lighting, aeration and noisiness; 63,9% declare injustice of the wages rather than low wages reduce their motivation. 63,9% thinks that it reduces the motivation of the wage injustice beside the low wage.
DISCUSSION AND CONCLUSION: There are several factors that influence the motivation of healthcare personel who work in the institution. An administrator who wants to increase efficiency and patient satisfaction in health care organizations needs to use effectively employee motivation and motivation tools. It is recommended managers to consider health workers feedback on their motivation tools when they creating management systems and do corrective and preventive activities for increasing motivation.

Neurological findings such as paresthesia and paralysis are more likely clinical manifestations of hypopotassemia, whereas severe hyperpotasemia may rarely be presumed to be paralysis. Although Guillain-Barré syndrome is the first disease coming to mind in a patient presenting with ascending paralysis, hyperkalemia rarely causes ascending paralysis. Here we present a case of secondary hyperkalemic paralysis mimicking GBS because of its rarity. It should be kept in mind that there may be an electrolyte abnormality in a patient with ascending paralysis. To prevent mortal complications that may develop, electrolyte inbalance should be treated rapidly.

A fifty-one year old male, with altered mental status, who was diagnosed as carbon monoxide intoxication, with typical central nervous system diffusion MR lesions. Although carbon monoxide intoxication is a common clinical condition, the proportion of proven neurological findings is too low to be known. Here we report a case, who has bilateral globus pallidus infarction due to carbon monoxide intoxication in central nervous system imaging. carbon monoxide poisoning should be kept in mind in patients with central nervous system lesions.

Dermoid cyst is a subgroup of mature teratoma that contains mainly ectodermal elements. Dermoid cyst of the mesentery is a rarely encountered tumor in abdominal region and it should be considered in the differential diagnosis of the cystic masses of the mesentery. Herein, we aim to present the radiologic findings in a spontaneously infected mesenteric dermoid cyst and the reactive changes in surrounding mesentery over time during followup.

Today, in the treatment of depression, SSRI, which are powerful and effective drugs, preferred at the first, because of less side effect and easy tolerated. Escitalopram, which increases the amount of serotonin in the synaptic spacing, side effects are similar to other drugs in SSRI class. Nocturnal bruxism is a motor disorder containing; nonfunctional clenching of the teeth during sleep, involuntary jaw locking, teeth grinding and abrasion. Initiation mechanism of nocturnal bruxism has not been fully understood, yet but neurochemical mechanisms are emphasized. There are publications showing that SSRIs can create nocturnal bruxism with increased serotonergic activity. In this article, we aimed to present a patient using 10 mg / day essitolapram with bruxism and dental fracture.

Chronic liver diseases can manifest itself with neurological sign and symptoms. Wilson disease is a rare genetic disorder related to ceruloplasmin deficiency and best-known example of chronic liver diseases related neurological findings. Also other chronic liver pathologies can be responsible for clinical picture. Cranial MRI shows heavy metal deposits, especially manganese, at the level of basal ganglions. Here we present a 54-year-old female patient diagnosed with acquired (non-Wilsonian) hepatolenticular degeneration related to cryptogenic cirrhosis who has balance disorder, dysarthria, tremor at hands and involuntary movements.

Dissociation is characterized by a disconnection between psychological functions as thoughts, perception, emotion, motor control, identity, consciousness, memory, body representation and behavior. Dissociative disorders are one of the most common psychiatric disorders in the community with the least genetic effect in etiology in contrast to the greatest association with trauma and environmental factors. Dissociative psychosis in which psychotic and dissociative features coexist; is a psychosis caused by traumatic factors, which is characterized by dissociation of a sudden onset of completeness in behavior, thought, affection and cognitive functions, disorientation of reality, dissociative content and short-lived recovery. Sudden onset, auditory and visual hallucinations, delirium, depersonalization, disorganized behaviors, suicide attempts, memory loss, childlike behavior, great madness, screaming, catatonia, delirium, crying, self-harm and harming others can be observed in the dissociative psychosis table. This condition which is believed to have emerged after a severe trauma lasts from a few days up to several weeks, does not respond to antipsychotic drugs, and is believed to achieve full remission in a short period of time. Dissociative psychosis, which is more frequently seen in our country, may be called as a crisis period after a mental trauma and is usually seen in urgent applications. Here in we are presenting a case of trauma-induced dissociative psychosis.

Ankylosing spondylitis is a systemic chronic inflammatory disease that mainly affects the sacroiliac joint and spine. It is a type of spondyloarthritis. Symptoms
usually start at late adolescent or early adult period. Diagnosis is based on a combination of clinical, laboratory
and radiology findings. There is no specific diagnostic
laboratory test, but acute phase reactants indicate disease activity and classification criteria include HLA-B27
test. Laboratory findings of ankylosing spondylitis is
discussed in this article.