Objective: Age brings about changes to the oxidant and antioxidant balance of male testis that give rise to loss of fertility. The Ferula elaeochytris root extract (FE), contents antioxidant and anti-inflammatory component, have been used to treat infertility by local people for centuries. The main objectives of this study were to determine whether FE was effective on sperm quality, spermatogenesis, apoptosis and oxidative stress in aged rat. Methods: Four groups were formed with 40 rats; young Control (YC), Aged Control (AC), Ferula elaeochytris administrated aged rat (A+FE) and vitamin E administrated aged rat (A+VE). Vitamin E and FE was administered orally for 8 weeks. Results: The administration of FE significantly increased serum TAS, testetorone levels and decreased testicular malondialdehyde (MDA) activity, that these changes were accompanied by the reduced serum TNF-α, and TOS levels. Also, the apoptosis germ cell, the tubular diameter, the germinal epithelium height and Johnson’s score a have been regulated after administration of FE (p < 0.05). Meanwhile, in the present context, in aged group the sperm count, motility, testicular weight declined significantly. FE showed showed significantly increased effect on the motility and sperm count. Conclusive: These findings support that aging induces stress oxidative and inflammation, and FE could protect the testis against these damaging effects via its anti-oxidative, anti-inflammatory action and modulate spermatogenesis. Keywords: Ferula elaeochytris, Aging, Antioxidant system, Spermatogenesis.

Objective: The exact volume of the bone cyst is fundamental for evaluation, treatment, and surgical management of the pathology related to any bone. The aim of this study was to introduce the stereological point-counting technique in bone cyst volume measurements on computed tomography images and to compare it with the planimetry technique. Methods: A total of 30 bone cyst volumes were estimated on CT images using stereological point-counting and the planimetry technique, which is based on the Cavalieri principle. The planimetric measurements were regarded as reference values. The stereological and planimetric volume estimations were performed by two independent observers twice. The estimation results of the two volumetric techniques were compared with the Wilcoxon signed-rank test. Intra-observer and inter-observer reliability of each volumetric technique was assessed. Results: For each bone cyst, 7-11 systematically sampled CT slices enabled reliable cyst volume estimations with a low coefficient of error (0.39%-3.12%). There was no significant difference between point counting and planimetry methods regarding volume measurements in both sessions (p>0.05), and these methods correlated well with each other. There was a significant inter-and intra-observer agreement for each volumetric method (ICC=0.9984 to 0.9988). The stereological approach was observed to take less time than the planimetric approach (mean 01:43±0.44 vs. 03.33±1:47 minutes) Conclusion: The stereological point-counting method can be well pertained to CT images for the reliable and reproducible assessment of bone cyst volume. Application of the point-counting method for volume estimation of bone cysts with different morphological features provides a great advantage in terms of both time-saving, applicability, and practicality in comparison with the planimetry technique. Keywords: Bone cyst, computed tomography, planimetry, stereology, volume measurement

Objective: The assessment of the degree of lumbar lordosis in patients with spinal disorders is essential to determine disease progression and the effectiveness of treatment. The aim of this study was to examine the reliability of the projection area per length squared (PAL) for measuring lumbar lordosis on lateral radiographs and to compare it with the Cobb method. Methods: Two independent investigators measured lumbar lordosis twice on 100 lateral radiographs using PAL and Cobb methods. Intra- and interobserver agreements of each radiological method were evaluated using intraclass correlation coefficients (ICC) and Bland–Altman plots. Correlations between the PAL estimations and Cobb angle measurements were tested using the Spearman rank correlation coefficient. Results: Intra- and interobserver agreements for PAL and Cobb methods were excellent with all ICC values>0.976. The Bland–Altman plots indicated strong intra-observer and interobserver concordance in the measurement of the lumbar lordosis using the PAL method. A strong correlation was determined between the PAL and Cobb angle values in the first and second measurements (r=0.825; p<0.001 and r=0.815; p<0.001, respectively). Conclusion: The PAL technique is easy to apply on digital images and provides quantitative information independent of the vertebral surface pathologies of the end vertebrae. It could be used as an alternative and potent diagnostic criterion for evaluating lumbar lordosis. Keywords: Cobb angle, length squared, lumbar lordosis, planimetry, radiography

SARS Cov-2 infection causes Multi-Inflammatory Syndrome in Children (MIS-C), a serious condition that affects children. We report an 18-year-old Turkish male who was diagnosed with MIS-C and successfully treated. He was diagnosed with MIS-C and required invasive mechanical ventilation due to cardiogenic shock, after what he recovered. With a high temperature, rash, and conjunctival hyperemia, the patient was taken to the emergency department. He had no symptomatic COVID-19 in his medical history, although he had had contact with a COVID-19 positive patient in the near past. Physical examination revealed an erythematous maculopapular rash on the back and neck, as well as hepatosplenomegaly. SARS-CoV-2 IgM and IgG positivity were detected in the rapid antibody test. Following the procedure, rectal bleeding and tachypnea developed. Inflammation indicators and pro-BNP levels both increased. With echocardiogenic examination, the ejection fraction decreased from 50-55 percent to 35%. He needed invasive mechanical ventilation. As a result, the case was classified as MIS-C with predominant cardiac and gastrointestinal involvement. The patient was discharged after a successful multidisciplinary approach. Although COVID-19 infection in children and adolescents is asymptomatic or minimally symptomatic, clinicians should be aware of post-infection autoimmune complications. Keywords: COVID 19, MIS-C, SARS-CoV 2, Cardiogenic Shock

Objective: Detection of the etiological agents in patients with acute diarrhea is challenging due to a wide variety of pathogens. The aim of this study is to evaluate the diagnostic performance of BD Max Enteric Bacterial Pathogens (EBP) PCR assay in patients with diarrheal illness. Methods: Between 1 January 2014 and 31 May 2015, stool samples from pediatric or adult patients with diarrhea submitted for routine analysis of bacterial stool pathogens were included in the study. We compared the BD Max EBP PCR assay to culture for the detection of Salmonella spp., Shigella spp., Campylobacter jejuni, and Campylobacter coli and an EIA for Shiga toxins 1 and 2. Discordant results were adjudicated by either antigen detection methods or Film array GI Panel. Results: When coinfections were excluded, the positive percent agreement values for the BD Max EBP assay (PPA) was 100% and negative percent agreement (NPA) was between 98.0%-99.7%, when compared with culture and EIA. After discrepant analysis, the PPA values for the BD Max EBP assay was 100% and NPA was between 99.5%-100%. Conclusion: The BD Max EBP assay showed a high correlation rate with conventional and molecular methods for the detection of stool pathogens. Key words: Osteoarthritis, knee joint, talocrural joint, transverse tarsal joint

Objective: The shoulder joint is considered the most unstable in the human body and this is due to the measurement relationships between the bone surfaces of its components. This joint is subject to frequent dislocations, which can result in acute fracture or gradual bone loss, which can lead to recurrent instability, additional injury and pain. In this study, it was aimed to carry out a study of the maximum height and width measurements of the glenoid cavity of dry scapulae, correlating them with sex and dimidium. Methods: Measurements of the maximum heights and widths of 90 dry scapulae glenoid cavities were performed using a 0.01 mm precision digital caliper, 54 were males and 36 were females, with a mean age of 51.9 years. Values of p0.05). When we correlated the mean height and width of the GC with respect to homologous sides and sexes, they were also higher in males, but this finding was statistically significant (p<0.05). Conclusion: The findings of these measurements of the glenoid cavity represent a contribution not only for anatomy, but especially for orthopedists, when planning shoulder arthroplasty procedures, as well as helping the industry to develop more accurate and functional joint prostheses for the Brazilian population. Keywords: Glenoid cavity; arthroplasty, replacement, shoulder; shoulder joint; surgery; anatomy; anthropometry

Objective: Extremity fractures (EF) are among the most common causes of admission to hospitals in children. We aimed to evaluate children treated for EFs by comparing them with the control group from a psychiatric perspective. Method: Thirty-six children aged between 3 and 17 years who administered to the Orthopedics and Traumatology clinic due to EF were included in the study. 36 children of similar age and gender with the study group were included as the control group. A child psychiatrist evaluated all children included in the study. A psychiatric diagnosis interview was conducted. The parents filled out the Conner’s Parent Rating Scale-Revised Short Form (CPRS-R:S). Results: Of the cases in the patient group, 66.7% were male. The ratio of rural residents in the patient group was higher compared to the control group. The most common fracture location was lower extremity (55.6%). The most common cause of the fracture was falling (52.8%). In the patient group, the ratio of the children who had previously experienced fracture was 36.1%. Psychopathology was detected to be at a higher level in the patient group. The most common was Attention Deficiency and Hyperactivity Disorder (ADHD). Children in the patient group scored higher on the CPRS-R:S than the control group. Conclusion: Children with EF exhibited more impulsive and hyperactive behaviours than controls and had more psychopathology. For this reason, it is essential to evaluate children who apply due to fracture in terms of psychopathology. Keywords: Extremity fracture, psychopathology, children

Objective: Osteoarthritis (OA) is the most common joint disease. In this study it was aimed to compare the general features of OA such as location, placement, severity and shape of the lesions in terms of radiological and morphological aspects and to determine their relationship with each other. Methods: In our study, the antero-posterior and lateral radiographies of knee talocrural and transverse tarsal joints of 20 cadavers by age between 30 and 50 years were taken. The results obtained from the radiological examination were graded according to the Kellgren and Lawrence scale. For each of the identified regions, the presence of degenerative changes was noted. Then samples were taken from these regions were examined by microscopic methods. The cartilage degeneration changes, presence of fibrillations, density, depth, chondrocyte aggregation, and necrotic changes were evaluated. Results: In the radiological examination OA was found in 35% in knee joint, 25% in the talocrural joint, 15% in the transverse tarsal joint. In the morphological examination OA was found in 31.5% knee joint, 25% ankle joint and 5% transverse tarsal joint. In the microscopic examination OA was found in 94.7% knee joint, in 94.7% ankle joint and in 100% transverse tarsal joint. Conclusion: Although radiological and macroscopic OA was detected in approximately 1/3 of cadavers aged between 30 and 50 years, degeneration of varying degrees was detected in all joints examined in microscopic examination. This shows that an advanced age disease OA, starts at a very early age. Key words: Osteoarthritis, Knee joint, Talocrural joint, Transverse tarsal joint

Objectives: The pineal gland is an important neuroendocrine organ accounting for the melatonin secretion and chronobiology that regulate circadian rhythm. This study was designed to compare pineal gland volume (PGV) with healthy controls and patients with fibromyalgia syndrome (FM), in which sleep quality and efficiency is reduced. Patient and Methods: In this cross-sectional study, PGV and functional pineal gland volume (FPGV) of FM patients with age- and sex-matched healthy controls were compared. All MR imaging studies were performed using a 3 Tesla scanner with a multi-channel phased array head coil. The volume of pineal glands and pineal cysts were calculated from 3D MP RAGE images using the formula: volume= AP x transverse x craniocaudal diameter x 0.523. Results: There was no significant difference in PGV and FPGV between the FM group and healthy controls (p=0.374 and p=0.421, respectively). In the correlation analysis, age was negatively correlated with PGV and FPGV in the FM group (r=-0.496, p=0.010; r=- 0.477, p=0.014, respectively). No significant correlation was detected between age, PGV and FPGV in the control group (r= 0.022, p=0.916; r= -0.019, p=0.925, respectively). Conclusions: Based on the results, there was no significant difference between the FM group and healthy controls regarding PGV and FPGV. However, PGV and FPGV were decreased by advancing age in the FM group in which melatonin therapy is offered as an option. Keywords: Fibromyalgia syndrome, pineal gland volume, functional pineal gland volume, pineal gland magnetic resonance imaging