20251211224517 20251211224517 Selcuk Medical Journal sinandemircioglumd@gmail.com Prof. Dr. Sinan DEMİRCİOĞLU Selcuk Medical Journal Selcuk Med J 2149-8059 1017-6616 12 11 2025 41 4 BERRİN OKKA 0000-0002-9442-4706 Bekir Şen 0009-0007-3480-0144 ALİ OSMAN GÜNDOĞAN 0000-0001-7305-3443 Objective: To compare the psychological status of patients with chronic central serous chorioretinopathy (CSCR) with healthy controls using the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Anxiety Sensitivity Index-3 (ASI-3). Materials and Methods: This cross-sectional clinical study included 25 patients aged 18-60 with chronic CSCR who were followed and treated at the Retina Unit of Necmettin Erbakan University Faculty of Medicine Hospital between November 2023 and June 2024. A control group of 25 age- and sex-matched individuals undergoing routine eye check-ups was also recruited. All participants underwent a complete ophthalmological examination, including best corrected visual acuity, intraocular pressure measurement, and detailed anterior segment and fundus examination. The ASI-3, BDI, and BAI were administered. Results: There were no statistically significant differences between the CSCR and control groups in terms of mean age and sex (p=0.336 and p=0.774, respectively). The CSCR group had significantly higher BDI and BAI scores compared to the control group (p<0.001 and p=0.013, respectively). The ASI-3 score was also significantly higher in the CSCR group (p=0.015). Conclusion: Patients with chronic CSCR exhibited higher levels of depression and anxiety compared to healthy individuals, suggesting an association between psychological factors and CSCR. Healthcare professionals should adopt a patient-centered, ethical, and constructive approach, incorporating the management of psychosocial issues alongside physical concerns in individualized care plans for CSCR patients. Ophthalmologists should consider referring these patients for psychosocial support or interventions. 12 11 2025 171 175 10.30733/std.2025.01766 https://selcukmedj.org/en-us/evaluation-of-depression-and-anxiety-in-patients-with-chronic-central-serous-chorioretinopathy/ https://app.selcukmedj.org/uploads/makale-pdf/evaluation-of-depression-and-anxiety-in-patients-with-chronic-central-serous-chorioretinop-PiWy4P.pdf HATİCE KÜÇÜKCERAN 0000-0002-0581-9934 Aynur Yalçıntaş Objective: Smoking status should be questioned in every clinical interview and smoking cessation should be recommended to patients who smoke. Family physicians are in a unique position in the fight against tobacco addiction because they are the first point of contact for patients, provide continuity of care and prioritise preventive health services. Our study aimed to investigate the factors affecting the prediction of smoking cessation success in patients applying to the family health centre. Materials and Methods: Patients registered in the Family Medicine Department of Konya Karatay were the population of the descriptive study. The data of the questionnaire form completed by 292 participants on a voluntary basis were analyzed. The questionnaire included sociodemographic characteristics, questions about smoking, Fagerström Nicotine Dependence Test (FNDT ) and Smoking Cessation Success Prediction Scale (SCSPS). Results: The mean age of the participants was 33.11±12.42 (min:18; max:72) years, 41.4% (n=121) were highly nicotine dependent and 57.5% (n=168) had been advised to quit smoking by a doctor. The mean total score of the SCSPS was 33.96±7.67 (min:13; max:50). Participants who were female, aged 45 years or older, married, had children, had low nicotine dependence, had tried to quit smoking before and had been advised to quit smoking by a doctor had statistically significantly higher mean scores in their categories compared to others (p<0.05). A moderate negative correlation was found between the total score of the SCSPS and the Fagerström score (r=-272; p=<0.001). Conclusion: Despite the moderate scores of the participants in predicting smoking cessation success, a significant finding indicates that patients who received prior medical advice to quit were more likely to achieve successful smoking cessation. It is important that primary health care services play an active role in tobacco control to increase smoking cessation rates. 12 11 2025 182 188 10.30733/std.2025.01816 https://selcukmedj.org/en-us/factors-affecting-the-prediction-of-smoking-cessation-success-in-patients-admitted-to-a-family-health-center/ https://app.selcukmedj.org/uploads/makale-pdf/factors-affecting-the-prediction-of-smoking-cessation-success-in-patients-admitted-to-a-fa-Fn8btx.pdf Mehmet PİŞKİN 0000-0002-0528-6699 Ömer Çavdar 0000-0002-1794-6367 Bilal Güneş 0009-0003-5478-8913 MEHMET ÖZKENT Muzaffer Kılınç 0000-0002-1024-3394 Objective: Our study aimed to investigate the effect of lower pole localization in solitary stones smaller than 2 cm on pediatric retrograde intrarenal surgery (RIRS) outcomes compared to other localizations. Materials and Methods: Data from patients who underwent RIRS in a university hospital between January 2021 and June 2024 were retrospectively analyzed. The study included 69 patients under 18 years of age with single stones less than 2 cm and whose data were available. Patients were divided into two groups according to kidney stone localization: lower pole (Group 1) and other localizations (Group 2). Demographic data, clinical characteristics, stone-related data, and perioperative and postoperative data of the patients were statistically compared in both groups. Results: The study enrolled 69 patients with a mean age of 7±4.4 (1-17) years and a mean stone size of 11±3.3 (5-20) mm. There were 21 patients in Group 1 and 48 patients in Group 2. The patient's demographic data and clinical characteristics in both groups were similar. The groups' stone size, side, and density were similar (p=0.58, 0.58, and 0.63, respectively). The prestenting rate was statistically significantly higher in Group 1 than in Group 2 (76.2% vs 50%, p=0.04). No statistically significant difference was detected between the groups in access sheath use, operation time, fluoroscopy time, the stone-free rate on 1st day and 3rd month, or auxiliary procedures (p=0.69, 0.95, 0.60, 0.97, 0.27, and 0.28, respectively). The complication rates were similar in both groups (p=0.28). No high-grade or anesthesiarelated complications were observed in any of the patients. Conclusion: The lower pole localization does not affect surgical parameters, except for the prestenting rate, in single stones smaller than 2 cm. Considering that prestenting is performed under general anesthesia in the pediatric population, lower pole stones may increase the number of anesthesia sessions, radiation exposure, and hospitalizations. 12 11 2025 176 181 10.30733/std.2025.01796 https://selcukmedj.org/en-us/comparison-of-pediatric-retrograde-intrarenal-surgery-outcomes-in-less-than-2-cm-single-stones-lower-pole-and-other-localizations/ https://app.selcukmedj.org/uploads/makale-pdf/comparison-of-pediatric-retrograde-intrarenal-surgery-outcomes-in-less-than-2-cm-single-st-myUwjZ.pdf Volkan Taban 0000-0002-0865-1356 SERKAN YILDIRIM Yalçın Günerhan 0000-0003-3104-7920 Yüksel DERELİ Abdullah Güner 0000-0002-5528-8270 Objective: There are several treatment modalities for chronic venous insufficiency(CVI) of the lower extremities. The aim of this study was to compare stripping, radiofrequency ablation(RFA) and endovenous laser ablation(EVLA) for the treatment of CVI in terms of recurrence, deep vein thrombosis(DVT) and phlebitis complications in the first postoperative year. Materials and Methods: Total of 442 patients with vena saphena magna(VSM) diameter over 5.5 mm and reflux duration over 0.5 s who were admitted to our clinic between 2018 and 2023 and underwent stripping, RFA or EVLA were retrospectively included in the study. Results of colour doppler ultrasound(CDUSG) were analysed in the first postoperative year. Patients under 18 years of age, pregnant and/or lactating patients, patients with a history of DVT, and patients with symptoms of peripheral vascular disease were excluded from the study. Results: The mean age of the patients included in the study was 46±12.3 years, 266 (60.2%) were female and 176 (39.8%) were male. Stripping procedure was performed in 143, RFA in 179 and EVLA in 120 patients. Although the incidence of phlebitis and DVT was higher in patients who underwent EVLA, this difference was not statistically significant (p=0.166, 0.252 respectively). When the recurrence rate detected on CDUSG was analysed according to the type of procedure at 1 year post-operatively, no statistically significant difference was found between RFA and EVLA, while a statistically lower recurrence rate was observed in the stripping procedure compared to RFA and EVLA (p=0.035, 0.002, respectively). Conclusion: This study did not find significant differences in DVT rates among the procedures, but the results reveal that stripping had lower phlebitis rates and significantly fewer recurrences compared to RFA and EVLA after one year. 12 11 2025 189 193 10.30733/std.2025.01791 https://selcukmedj.org/en-us/comparison-of-patients-undergoing-stripping-endovenous-laser-ablation-and-radiofrequency-ablation-for-chronic-venous-insufficiency/ https://app.selcukmedj.org/uploads/makale-pdf/comparison-of-patients-undergoing-stripping-endovenous-laser-ablation-and-radiofrequency-a-6yp6hy.pdf Selim Kutlu Yasin Çimen Objective: Morphine is an opiate frequently used in the management of acute and chronic pain. Sequential use of morphine increases dopamine levels in the nucleus accumbens (NAc) through activation of dopaminergic neurons in the ventral tegmental area. The aim of the study was to investigate dopaminergic signals in the NAc during morphine dependence and withdrawal using fiber photometry system with dopaminergic sensor (GRABDA). Materials and Methods: Male Wistar rats were divided into two groups as morphine (M) and morphine+naloxone (M+N). GRABDA was injected into the right NAc region. GRABDA contains a recognition domain based on the dopamine receptor 2 (DRD2) in its structure. When dopamine binds to this domain, the green fluorescent protein in the sensor is activated. The resulting fluorescence change reflects dopaminergic activity and signal transmission in the region. Afterwards, a fiber optic cable was fixed to NAc. After 15 days of rest, 10mg/kg morphine was injected intraperitoneally for 5 days. 3mg/kg naloxone was injected into the M+N group after the last injection. Average ΔF/F (%) values expressing dopaminergic signalling were calculated with Python after collecting fiber photometric records. The ΔF/F (%) value expresses the normalised level of dopamine binding to DRD2 receptors as a percentage. Statistical comparisons were made using a mixed-ANOVA test and post-hoc comparisons were made using estimated marginal means. Results: The ΔF/F (%) values of the M and M+N groups increased with morphine injection compared to baseline period (p<0.05). As a result of naloxone injections, the ΔF/F (%) values of the M+N group significantly decreased compared to the M group (p<0.05). Morphine addiction increases dopaminergic signalling in the NAc, while naloxone suppresses this effect. Conclusions: Fiber photometry with a novel biosensors enables more efficient detection of dopaminergic activity compared to older methods such as liquid chromatography. Further studies are needed for a better understanding of specific neuronal and regional processes. 12 11 2025 194 200 10.30733/std.2025.01831 https://selcukmedj.org/en-us/investigation-of-morphine-induced-dopamine-release-in-the-nucleus-accumbens-by-fiber-photometry/ https://app.selcukmedj.org/uploads/makale-pdf/investigation-of-morphine-induced-dopamine-release-in-the-nucleus-accumbens-by-fiber-photo-y6FF1h.pdf Gülsüm Civcan Esma Çınar Birgül Tok İlkay Çınar Özge Aydın Hülya Öksüz Kabadayı Kıvanç Yılmaz Demet Şengül Sevda Dalar Objective: While the majority of tumours in the genitourinary system originate from epithelial origin, non-epithelial tumours constitute only a minor subset. This study was conducted to improve diagnostic approaches for these rare tumours and to emphasize their impact on patient outcomes. Materials and Methods: The patient records of patients who underwent genitourinary system biopsy between 2021 and 2023 were accessed from the hospital database. Patients diagnosed as epithelial tumour or non-neoplastic tissue according to histopathological evaluation were excluded from the study. Demographic data of patients diagnosed with non-epithelial tumours were obtained from the hospital database and tumour-related data were obtained from pathology reports. Results: During the specified period, a total of 20 patients were identified, most of whom were male. The kidney was the most frequently affected site. Malignant tumours were diagnosed in 11 patients, and benign tumours in 9. Leiomyosarcoma was the most common malignant tumour, while angiomyolipoma was the most frequently observed benign tumour. Other malignant tumours included rhabdomyosarcoma, liposarcoma, undifferentiated pleomorphic sarcoma, paraganglioma, malignant solitary fibrous tumour, and diffuse large B-cell lymphoma. Benign tumours included angioleiomyoma, schwannoma, renomedullary interstitial cell tumour, leiomyoma, and angiofibroma. Surgical procedures varied depending on tumour type and included excisional biopsy, partial resection, and radical resection. During the follow-up period (ranging from 1 to 38 months), survival was achieved in all patients with benign tumours, whereas three patients with malignant tumours died. Conclusion: Non-epithelial tumours of the genitourinary system are rare and display significant histological heterogeneity. Definitive diagnosis relies on histopathological evaluation. Appropriate diagnostic and therapeutic strategies may significantly influence patient survival. 12 11 2025 205 210 10.30733/std.2025.01842 https://selcukmedj.org/en-us/clinical-and-pathological-analysis-of-non-epithelial-tumours-of-the-genitourinary-system-a-single-centre-experience/ https://app.selcukmedj.org/uploads/makale-pdf/clinical-and-pathological-analysis-of-non-epithelial-tumours-of-the-genitourinary-system-a-zzX5Sd.pdf Nida Akgül 0000-0002-9449-5715 Hülya Yılmaz Tekinhatun 0000-0001-5664-5893 ALİ DOĞAN Cengiz Demir 0000-0001-9856-184X Özlem Beyler 0000-0002-2032-8877 Objective: This study evaluated the real-world efficacy, safety, and survival outcomes of azacitidine-venetoclax (AZA-VEN) therapy in newly diagnosed acute myeloid leukemia (AML) patients ineligible for intensive chemotherapy. Materials and Methods: A retrospective analysis was conducted on 36 AML patients treated at two centers between 2022–2025. Data included demographics, treatment cycles, dose adjustments, response rates (complete remission, partial remission, refractory disease), hematologic recovery, side effects, and overall survival. Results: The median age was 66 years (range: 27–98), with 61.1% achieving CR. Median OS (Overall Survival) was 22 months (95% CI: 13.1–30.9), significantly longer in patients receiving ≥3 cycles (23.7 vs. 6.4 months; p=0.031) and those with early neutrophil recovery (>1000/μL by day 7: 29.4 vs. 13.7 months; p=0.009). Grade 3 toxicity (33.3% of patients) correlated with poorer survival (6.4 vs. 22 months for Grade 2; p=0.006). No invasive fungal infections occurred. Conclusion: AZA–VEN is effective and safe in chemotherapy-ineligible AML, providing survival outcomes that are comparable to, and in some aspects even consistent with, those observed in pivotal clinical trials. Our findings indicate that extended therapy, especially in patients who were able to continue for three or more cycles, was associated with a meaningful improvement in overall survival, thereby emphasizing the importance of maintaining treatment continuity whenever possible. The complete absence of invasive fungal infections in our cohort, in contrast to the variable rates reported in previous studies, suggests that our prophylaxis strategy may have contributed positively and could be of clinical relevance. In addition, the female survival advantage observed in our study, while noteworthy, should be interpreted with caution, considered as hypothesis-generating, and further validated in larger, well-designed studies. 12 11 2025 217 221 10.30733/std.2025.01863 https://selcukmedj.org/en-us/azacitidine-and-venetoclax-treatment-in-acute-myeloid-leukemia-real-life-experience/ https://app.selcukmedj.org/uploads/makale-pdf/azacitidine-and-venetoclax-treatment-in-acute-myeloid-leukemia-real-life-experience-1wa653.pdf Abdurrahman Koç 0000-0002-4462-0944 Tracheal diverticulum (TD) is a rare respiratory tract anomaly characterized by an outpouching from the posterolateral wall of the trachea. It is usually asymptomatic and often detected incidentally on imaging. However, in some cases, TD may lead to symptoms such as chronic cough, recurrent respiratory infections, or airway obstruction. In this case series, we present three adult patients who were evaluated for chronic cough and diagnosed with tracheal diverticulum. All patients underwent thoracic computed tomography (CT), and all of them also had bronchoscopy. The diverticula were located adjacent to the right posterolateral aspect of the trachea. Due to the mild nature of symptoms in all cases, a conservative treatment approach was preferred. Although TD is uncommon, it should be considered in the differential diagnosis of patients presenting with chronic cough, and the diagnosis should be confirmed using imaging methods such as CT and bronchoscopy. 12 11 2025 222 224 10.30733/std.2025.01843 https://selcukmedj.org/en-us/tracheal-diverticulum-a-case-series-of-three-patients-presenting-with-chronic-cough/ https://app.selcukmedj.org/uploads/makale-pdf/tracheal-diverticulum-a-case-series-of-three-patients-presenting-with-chronic-cough-fWsN1m.pdf Fatma Sıkı 0000-0002-4461-3464 SAİME UYGUN Objective: This study aims to compare the guideline compliance of two widely used AI-based chatbot systems, ChatGPT and Bing AI, with the clinical recommendations outlined in the Disorders of Sex Development (DSD) guideline published by the Turkish Neonatal Society. Materials and Methods: A standardized evaluation set comprising 40 questions based on the DSD guideline was utilized. The questions were grouped under six main categories reflecting clinical decision-making processes and were presented to both ChatGPT and Bing AI. Responses were scored on a 5-point Likert scale by two independent experts, assessing their alignment with the guideline. Mean scores were calculated for each category, and statistical comparisons were made using the Wilcoxon signed-rank test. Results: ChatGPT demonstrated high consistency with the guideline across all categories (mean score: 4.88), while Bing AI showed lower compliance in several areas (mean score: 3.25). The differences in scores between the two systems were statistically significant across all categories (p < 0.05), with Bing AI performing particularly poorly in the areas of diagnosis/laboratory testing and multidisciplinary approach. Conclusion: ChatGPT demonstrated higher accuracy and consistency than Bing AI in providing guideline-based clinical support regarding DSD. The use of AIsupported systems aligned with current guidelines holds significant potential in supporting complex, multidisciplinary decision-making processes. Therefore, the selection of AI tools in clinical settings should be informed by such systematic evaluations. 12 11 2025 201 204 10.30733/std.2025.01852 https://selcukmedj.org/en-us/a-comparative-analysis-of-large-language-models-in-managing-disorders-of-sex-development-evaluation-based-on-clinical-guidelines/ https://app.selcukmedj.org/uploads/makale-pdf/a-comparative-analysis-of-large-language-models-in-managing-disorders-of-sex-development-e-br5P99.pdf MUSTAFA ESEN 0000-0002-4736-9142 Abdullah Demirbaş Esin Diremsizoglu 0000-0001-9824-481X Objective: Hidradenitis Suppurativa (HS) is a chronic skin condition marked by inflammation and driven by diverse underlying mechanisms, including hormonal involvement. The second-to-fourth digit ratio (2D:4D) is an established marker of prenatal androgen exposure, which may contribute to HS susceptibility. The objective of this study was to explore the potential link between 2D:4D digit ratios and hidradenitis suppurativa, along with their correlation to disease severity. Materials and Methods: A total of 140 HS cases and 140 healthy subjects matched by age and gender were enrolled in this cross-sectional investigation. Clinical severity was assessed using Hurley staging, the Modified Sartorius Score, and the Physician Global Assessment (PGA). Finger lengths were measured using a digital caliper, and 2D:4D ratios were calculated separately for each hand. Results: HS patients had significantly lower 2D:4D ratios in both hands compared with controls (p < 0.001). In females, both left- and right-hand ratios were lower (p < 0.001), while in males only the left-hand ratio differed (p = 0.038). In female patients, the left-hand ratio correlated with disease severity measures, including Hurley stage, Modified Sartorius Score, and PGA (all p < 0.05). Conclusion: Lower 2D:4D ratios, particularly in female HS patients, may reflect higher prenatal androgen exposure and be linked to greater disease severity. These findings support a possible hormonal contribution to HS pathogenesis, though confirmation in prospective studies with direct hormonal assessment is warranted. Interpretation is limited by the cross-sectional design. Additionally, the single-center setting and absence of biochemical hormone measurements may partly limit generalizability and the strength of disease mechanism–related interpretations. 12 11 2025 211 216 10.30733/std.2025.01856 https://selcukmedj.org/en-us/the-role-of-second-to-fourth-digit-ratio-in-hidradenitis-suppurativa-a-potential-link-to-prenatal-hormonal-exposure/ https://app.selcukmedj.org/uploads/makale-pdf/the-role-of-second-to-fourth-digit-ratio-in-hidradenitis-suppurativa-a-potential-link-to-p-16BmxQ.pdf