INTRODUCTION: This study proposes to elucidate the efficacy and side effects of Foley catheter balloon and dinoprostone in late-term pregnancy (LTP)
METHODS: A total of 70 women were included in this study. Patients were classified into two groups based on cervical ripening methods as Group 1, Foley balloon catheter (n=40), and Group 2, dinoprostone (n=30).
RESULTS: The rate of cesarean section was higher in the Foley catheter group (p<0.05). The most common indication for cesarean section in the Foley catheter group was non-progressive labor. There were no significant differences in the other variables.
DISCUSSION AND CONCLUSION: The intracervical Foley catheter balloon was found to be associated with an increased risk of cesarean delivery without inducing excess maternal or neonatal morbidity.

INTRODUCTION: Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by immune-mediated platelet destruction and, in some cases, impaired platelet production. While conventional therapies, such as corticosteroids, IVIg, and splenectomy, are effective for most patients, refractory ITP remains a significant clinical challenge. This study aimed to evaluate the demographic characteristics, clinical features, treatment responses, and outcomes of hospitalized ITP patients in a real-world setting.
METHODS: This retrospective study included 60 ITP patients treated in the Internal Medicine Clinics of Ankara Numune Training and Research Hospital between 2009 and 2013. Patients with platelet counts <30 × 109/L were analyzed for demographic data, clinical presentations, treatments received during hospitalization, and treatment responses. Statistical analyses were performed to identify factors associated with treatment outcomes.
RESULTS: The cohort comprised 43 females (72.7%) and 17 males (27.3%), with a mean age of 47.6±16.9 years. First-line steroid therapy achieved a 65% response rate, with non-responders more likely to experience major bleeding (p = 0.039). Second-line therapies included IVIg (66.7% response rate) and splenectomy (53.8% response rate), with lower responses observed in refractory cases. Rituximab, vincristine, and eltrombopag response rates were 33.3%, 20%, and 33.3%, respectively. Two patients were resistant to all treatments; one died due to major bleeding, yielding a 1.6% mortality rate over four years.
DISCUSSION AND CONCLUSION: Refractory ITP presents a significant treatment challenge, particularly in patients resistant to multiple therapies. While combination therapies and novel agents, such as TPO receptor agonists, hold promise, further randomized controlled trials are necessary to establish standardized treatment protocols and improve outcomes in refractory cases.

INTRODUCTION: The rates of EMS use due to fever and the characteristics of these patients have not been clearly evaluated in the literature. The aim of this study is to evaluate the demographic characteristics of patients who requested an ambulance with complaints of fever.
METHODS: Our study was conducted by retrospectively examining the data of patients over the age of 18 who requested an ambulance from Ankara EMS with complaints of fever between 01.01.2022 and 31.12.2022 and whose fever was detected as ≥38 °C by the ambulance teams.
RESULTS: Between 01.01.2022 and 31.12.2022, a total of 5430 (1.07%) people called Ankara EMS with complaints of fever and requested an ambulance, and 1874 (34.5%) were found to have a fever of ≥38 °C. Of these patients with fever, 61.1% were male, and their mean age was 63.4±21.5. The patients’ vital signs were as follows: fever levels=39(38–40) °C, systolic blood pressure=127.6±24.5 mmHg, and diastolic blood pressure=74.9±13.8 mmHg. Pulse and respiratory rates were 98 (18–146)/min and 18 (10–32)/min, respectively. While 20.1% of the patients had COVID-19, 7.4% had asthma-COPD, 6.4% had gastroenteritis, and 4.0% had upper respiratory tract infection.
DISCUSSION AND CONCLUSION: In our study, most of the patients (65.5%) who requested an ambulance with a fever complaint had no fever detected at the scene by the ambulance team.

Gynecological cancers, including cervical, endometrial, ovarian, vulvar, vaginal, and fallopian tube cancers, are among the leading causes of cancer-related morbidity and mortality worldwide. The care process for patients with these diseases presents significant challenges not only for the patients themselves but also for their caregivers, impacting their physical, psychological, social, and spiritual well-being. This review aims to synthesize the existing literature on the caregiving needs of individuals providing care to gynecological cancer patients. It examines the physical, psychological, social, and spiritual challenges faced by caregivers and highlights the role of healthcare professionals in addressing these needs. Caregivers often experience fatigue, musculoskeletal pain, and chronic health issues due to the physical demands of caregiving. Psychological issues such as stress, anxiety, depression, and burnout are common, exacerbated by inadequate social support and disrupted daily routines. Financial burdens, arising from medical expenses and income loss, add further strain to caregivers. Spiritual well-being serves as a coping mechanism, enhancing caregivers’ resilience in managing the caregiving burden. Caregivers of gynecological cancer patients face multifaceted challenges that require targeted interventions and comprehensive support systems. Holistically addressing caregivers’ needs can improve both their quality of life and the care provided to patients. Healthcare professionals play a critical role in recognizing and supporting the physical, psychological, social, and spiritual needs of caregivers.

Echinococcus granulosus, a common parasitic infection prevalent in endemic regions, causes hydatid cysts. Despite its generally benign nature, this disease can sometimes exhibit aggressive behavior, affecting vital organs and leading to severe complications. This case report highlights an unusual instance of a 58-year-old female who arrived at the emergency department with symptoms of fever, fatigue, cough, and pain in the chest and abdomen. Radiological examinations revealed a subdiaphragmatic hydatid cyst in the liver, which had penetrated the diaphragm and extended into the right hemithorax. This report aims to illustrate the imaging characteristics of a rare complication of hepatic hydatid cyst, specifically transdiaphragmatic pleural rupture.

Tetralogy of Fallot (TOF) consists of four main components: pulmonary stenosis, ventricular septal defect, right ventricular hypertrophy, and dextroposition and overriding of the aorta. In this presentation, we aim to present the perioperative anesthetic approach to a cesarean section performed under emergency conditions due to preterm labor in a 32-year-old pregnant woman who had undergone surgery for tetralogy of Fallot in childhood. We learned that our patient had surgery at the age of four for tetralogy of Fallot. A previous echocardiogram showed tricuspid annular plane systolic excursion of 18 mm and third-degree tricuspid insufficiency. The patient had severe pulmonary valve insufficiency, with a maximum gradient across the pulmonary valve of 39 mmHg. Spinal anesthesia was administered using 12.5 mg of 0.5% heavy bupivacaine. In addition to standard monitoring, invasive blood pressure monitoring from the left radial artery and central venous pressure monitoring from the left cephalic vein were initiated immediately after spinal anesthesia. No hemodynamic disturbances or adverse events were observed in our patient. In summary, neuraxial analgesia and anesthesia can be safely applied to patients with repaired TOF, and it was the preferred technique for labor analgesia and surgical anesthesia in our patient.

Pretibial edema associated with antipsychotics has been documented in the literature, however this side effect is very frequently under-recognized. Among the antipsychotics, risperidone stands out with its wide range of indications and antagonist effect on various receptors, but it should be used with caution due to its side effects such as extrapyramidal symptoms, dizziness, nausea and sedation. Pretibial edema associated with risperidone is uncommon. We found very few incidences of pretibial edema related to risperidone in our review of the literature. We report a case of pretibial edema that developed when risperidone was added to the existing treatment which resolved after the medication was discontinued. A 52-year-old female patient presented to the psychiatry outpatient clinic with moderate depressive disorder symptoms. Initial treatment with escitalopram 10 mg/day led to partial symptom relief, but persistent ruminative thoughts were noted during the mental examination. Risperidone 1 mg/day was added to her treatment, resulting in clinical improvement; however, pretibial edema developed. Risperidone was discontinued and pretibial edema completely resolved one week after discontinuation. The patient’s psychiatric complaints partially recurred, upon recurrence of complaints, at her own decision, the patient started taking risperidone at a dose of 0.5 mg per day, but the medication had to be discontinued due to re-development of edema. Aripiprazole 2.5 mg/day was then added to the medication during the follow-up exam, and the patient continued to be in remission without experiencing edema. Pretibial edema is one of the uncommon but potentially dangerous adverse effects of risperidone. During the course of treatment, clinicians should be aware of these adverse effects, manage them, and consider alternative treatment options if necessary.