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Öğe A 46, XX patient with 21-OHD diagnosed during the etiologic workup of male infertility(Karger, 2019) Bugrul, Fuat; Yildirak, Ekrem; Guran, Tulay[Abstract Not Available]Öğe Are HoLEP Surgical Videos on YouTube Biased and Misleading or Are They Leading the Industry?(Galenos Yayincilik, 2022) Koras, Omer; Gokalp, Fatih; Yildirak, Ekrem; Sigva, Hakan; Tamkac, Nezih; Porgali, Sefa Burak; Kulak, BilalObjective: In this study, we aimed to evaluate the content and quality of the most relevant YouTube videos related to holmium laser enucleation of the prostate (HoLEP) surgery. Materials and Methods: The keywords HOLEP, laser enucleation and prostate enucleation were used to perform a search on YouTube. NonEnglish language videos, videos with less than 4-minute duration, and repetitive videos were excluded. The reactions of the viewers to the videos were evaluated by recording the total views, views/month and likes and dislikes parameters. The data were divided into two groups based on the source of upload: Group 1 consisted of healthcare providers and group 2 comprised of commercial companies and for-profit organizations. Results: A total of 117 videos were included in the study. A significant portion of the videos (77.7%) had been uploaded by healthcare providers. There was no statistically significant difference between the uploading groups in terms of the DISCERN and the Global Quality score, scores (p=0.484 and p=0.108, respectively). However, Patient Education Materials Assessment Tool for Audiovisual Materials understandability and actionability scores were statistically significantly higher in group 2 (p=0.004 and p=0.022, respectively). In addition, when the misinformation scale was evaluated, there were significantly more videos with high-degree misinformation in group 2 (5.5% vs 33.3%, p=0.001). Conclusion: On video sharing platforms, such as YouTube, the number of reliable videos with accurate and appropriate guidance about diseases and treatments should be increased, and these videos should be allowed to be posted after they have been approved by relevant institutions, including healthcare associations and universities.Öğe Bariatric surgery has positive effects on patients' and their partners' sexual function: A prospective study(Wiley, 2021) Gokalp, Fatih; Koras, Omer; Ugur, Mustafa; Yildirak, Ekrem; Sigva, Hakan; Porgali, Sefa B.; Tamkac, NezihBackground Obesity has been associated with severe conditions and sexual dysfunction. Bariatric surgery has effects positively patients' sexual function. Objectives To assess the effect of bariatric surgery on sexual functions of couples. Materials and Methods The study included 57 obese patients and their sexually active partners. Male participations were assessed with the International Index of Erectile Function (IIEF) and Male Sexual Health Questionaries (MSHQ-4), and female participations were assessed with the Female Sexual Function Index (FSFI). Results There were 31 (54.4%) male patients and 26 (45.6%) female patients in the study. The median IIEF score of the male patients statistically increased postoperatively (p < 0.001). The IIEF subgroup areas were found to have increased after surgery. The median FSFI score of the female patients statistically increased postoperatively (p < 0.001). The median FSFI of male patients' partners significantly increased postoperatively (p < 0.001). All FSFI domains were statistically significantly increased (p < 0.001, all areas). The median IIEF value of the postoperative partners of the female patients also increased statistically significant (p < 0.001). In addition, the increases in the IIEF's subdomains in terms of sexual desire (p < 0.001), intercourse satisfaction (p < 0.001), and general satisfaction (p < 0.001) were statistically significant. Conclusion The sexual functions of both males and females and also their' partners were improved after bariatric surgery. Patients with preoperative poor sexual function achieve significant benefits over patients without sexual dysfunction.Öğe Comparison of the postoperative effects of the erector spinae plane block and local infiltration analgesia in patients operated with lumbotomy surgery incision: Randomized clinical study(Lippincott Williams & Wilkins, 2024) Hakimoglu, Sedat; Ozdemir, Taner; Comez, Mehmet Selim; Urfali, Senem; Yildirak, Ekrem; Gorur, Sadik; Turhanoglu, SelimBackground:Our aim was to observe the effects of local infiltration analgesia (LIA) or erector spinae plane block (ESPB) methods, which we applied preemptively in patients who were scheduled for surgery with a lumbotomy surgical incision and on intraoperative remifentanil consumption, and to compare the postoperative numerical rating scale (NRS), morphine demand, consumption, and pain degrees.Methods:Sixty American Society of Anesthesiologists I to III patients aged 18 to 75 years who were due to be operated on with a lumbotomy surgical incision were included in the study. The present study was conducted via prospective, randomized controlled, double-blind trials. After the induction of standard anesthesia, LIA was applied to 30 patients and ESPB was applied to 30 patients preemptively. The dose of remifentanil consumed in the intraoperative period was measured, and the hemodynamic parameters were measured every 5 minutes. Morphine bolus treatment with the postoperative patient-controlled analgesia and rescue analgesia with paracetamol were planned for the patients. Postoperative morphine and additional analgesia consumption, NRS, hemodynamic parameters, and complications were recorded for 48 hours.Results:There was no difference between the groups in terms of demographic and hemodynamic data. The mean consumption of remifentanil was measured as 455 +/- 165.23 mu g in the intraoperative ESPB group and 296.67 +/- 110.59 mu g in the LIA group, and a statistical difference was observed (P = .001). In the postoperative follow-ups, the ESPB group drug consumption and NRS score averages were significantly lower at all times (P = .01; patient-controlled analgesia-morphine, 41.93 +/- 14.47 mg vs 57.23 +/- 15.5 mg and additional analgesic-paracetamol: 2.1 +/- 1.06 vs 4.27 +/- 1.14 g). The mean duration of additional analgesic intake of the groups was 10.6 +/- 8.1 in the LIA group, while it was 19.33 +/- 8.87 in the ESPB group, a significant difference. The patient satisfaction questionnaire was also significantly in favor of ESPB (P = .05).Conclusions:In conclusion, it has been shown that the intraoperative LIA method is more effective in terms of remifentanil consumption and in controlling pain in operations performed with a flank incision, but the ESPB method provides longer and more effective pain control in postoperative follow-ups.Öğe Correlation of Multiparametric Prostate MRI with Prostate Biopsy and Radical Prostatectomy Histopathology(Galenos Publ House, 2024) Sigva, Hakan; Gorur, Sadik; Gokalp, Fatih; Tamkac, Nezih; Porgali, Sefa Burak; Yildirak, EkremObjective: Prostate cancer (PCa) is the most common cancer responsible for cancer deaths in men after lung cancer. In this study, we aimed to obtain information about the Gleason score of PCa by prostate image reporting and data system (PIRADS) scoring of multiparametric magnetic resonance imaging (mpMRI) by comparing mpMRI results with the histopathology of prostate biopsy and radical prostatectomy specimen. Materials and Methods: A total of 214 patients who applied to the outpatient clinic of Hatay Mustafa Kemal University Faculty of Medicine, Department of Urology between January 2019 and April 2021 with elevated prostate-specific antigen (PSA) levels were included in the study. All patients underwent mpMRI before the biopsy procedure. PIRADS scoring was performed by the same radiologist. Prostate biopsy was systematically performed by experienced urologists as 12 quadrant biopsies. Results: When the mpMRI results of the patients are evaluated; the most common patterns are seen as PIRADS 2 and PIRADS 4, followed by PIRADS 3 lesions, followed by PIRADS 5 lesions, and PIRADS 1 lesions, which were the least frequent. When the analysis was applied to predict PCa over the pyrans value, the receiver operating characteristics analysis result for the diagnosis of the disease showed statistically significant levels of area under the curve (0.860; p<0.001), with a sensitivity of 81% and a sensitivity of 3 and above PIRADS 3 and above. It can predict cancer with 75 specificity. In the correlation analysis, there was a low but significant correlation between PIRADS and PSA value (r=0.252; p<0.001). Conclusion: We found that patients presenting with elevated PSA levels and mpMRI had a high power in detecting PCa. We also found a strong relationship between ISUP rating and PIRADS. As a result, it is thought that the pathology of the patients can be predicted using mpMRI.
