This article is a review of the scientific literature. The purpose of this research was the systematization of the updatedinformation on potential herbal medicine in hyperoxaluria treatment. We analysed the English language scientificliterature Medline published from January 2008 to December 2018. Data in vitro, experimental and clinical studiesdemonstrated antiurolithiatic properties of many plant extracts. Reducing hyperoxaluria is mainly caused by theability of plants to inhibit nucleation and agglomeration of crystals by changing the ionic composition of urine anddue to diuretic, nephroprotective, antioxidant and antibacterial effects.

There are pieces of evidence indicating the important role of long noncoding RNAs (lncRNA) with transcription factorsand their effect on gene expression at transcription and epigenetic levels. The possible role of lncRNAs in humanshave been investigated the involvement of H19 in cancers, including leukemia. H19 inhibits the transcription of IGF2 receptor via miR-675 and thereby regulates IGF-2 signaling. In chronic myeloproliferative disorders (CMPD), bonemarrow cells of patients express H19 in significantly lower levels than healthy samples, and the reduced expression ofH19 through IGF-2 reinforces the growth signal. H19 plays a regulatory role in maintaining the proliferation and selfrenewal abilities of HSCs. This molecule also influences the pathogenesis of leukemia due to its role in increasing theproliferation and regulating the quiescence of stem cells. Accordingly, it may be possible to consider H19 as a prognostic biomarker for myeloid disorders. In this review, the probable regulatory role of H19 as a prognostic biomarker witha variable role dependent upon disease context will be discussed.

Breast cancer (BC) is the most common cancer type among women worldwide. Patients with BC and survivors of BCoften experience a plethora of undesirable, anticancer therapy-related symptoms, which deteriorate their quality of life(QoL). For this reason, the development of treatment strategies BC, which are effective, safe, and tolerable is certainlyneeded. Personalized medicine offers therapeutic options that are tailored to the individual needs of each patient. Inaddition to the development of modern target therapies, there is an important need to combat some common adverseeffects of standard therapies for BC.This article presents some recent research findings that identify selected genetic changes, which are associated withthe occurrence and severity of adverse effects of the BC therapies. It focuses on typical side effects of current anticancertreatments, which reduce the QoL of BC patients and survivors. In particular, it addresses pain [including chemotherapy(CHT)-induced peripheral neuropathy (CIPN) and lymphedema], depression, cognitive dysfunction, premature menopause, and CHT-induced menopause.It introduces some potential interventions [e.g., using nicotinamide riboside (NR) and melatonin], targeted for womenwith BC, who suffer from CIPN, as well as nutritional/exercise programs for necessary lifestyle modifications to reduceobesity and the risk of BC recurrence among BC survivors. As a consequence, the described approaches may be helpfulin planning personalized treatment, facilitate the patient’s tolerability of many currently available anticancer therapies,optimize the medication selection or dosage, and improve the patients QoL.

Breast cancer (BC) is the most common female cancer, the second most common cause of cancer death in women,and the main cause of death in women ages 40–59.The most common sites of BC metastases are liver, lung and bones.Metastases to the female genital tract from extragenital cancers are rare. Breasts and the gastrointestinal tract are themost common sites of the primary tumor.Several studies have carried out retrospective analyses comparing the ER, PR,and HER2 status of primary tumors and paired metastasis.We reported that HER2 discordance between primary andmetastatic lesion in a 70-years old, postmenopausal woman who was diagnosed as invasive ductal carcinoma (IDC)with bone and endometrial metastases at the time of diagnosis.

There are a wide range of special care patients in dentistry anesthesia. As a consequence of this condition, rare syndroms are encountered. Hurler-Scheie syndrome is an inherited disorder of mucopolysaccharide metabolism, which iscaused by a defect in genetically controlled pathways of lysosomal degradation. As a result, mucopolysaccharide accumulation occurs in various tissues and organs. Structural and functional deficits resulting from Hurler-Scheie Syndromecan lead to difficulties in providing safe airway, especially during anesthetic applications. There is limited data on theliterature about the deep sedation practice in patients with Hurler-Scheie syndrome. We aimed to describe our experience of deep sedation for dental treatment in a child with Hurler-Scheie syndrome.

Primary mucinous carcinoma is a rare tumor which behaves in a relatively benign or locally aggressive manner andusually arises on the head and neck region. In this study, we would like to present a patient who has primary mucinouscarcinoma of the skin, review the literature on this tumor. 63 years old male patient applied to our clinic with a palpableand painless mass at lower eyelid. Physical examination showed that it had irregular borders and 2.5x2 cm diameter.The incisional biopsy revealed mucinous carcinoma. According to statistics the primary mucinous tumor of skin wouldbe counted as a rare entity. Therefore, it is hard to understand and define this kind of tumors. The diagnosis and treatment modalities could be varied among clinics. Primary mucinous carcinoma is a rare tumor. Therefore we would liketo present our patient that we operated and share our experience with literature.

Course of dermatomyositis (DM) can be complicated by multi organ failure, by complex pathophysiological mechanisms involving auto antibodies. Pulmonary complications are the leading cause of mortality, accounting for 30%deaths. There is a strong association between DM and interstitial lung disease (ILD); clinically amyopathic dermatomyositis (CADM) has stronger association with ILD as compared to classic form of DM. ILD can be in the form of fibrosing alveolitis, interstitial pneumonia and desquamative interstitial pneumonia or diffuse alveolar hemorrhage. Autoantibodies linked to ILD are anti Jo-1, PL12, PL7, EJ, and OJ and anti Mi 2.Our case describes a fifty three years old woman who presented with symptoms of lower respiratory tract infection, diagnosed with CADM on the basis of typical skin rash and polyarthritis and anti-CADM 140 antibodies. Systemic steroidtherapy (initiated after ruling out sepsis) failed to provide improvement. Medical course was complicated by multisystem involvement (respiratory failure, cerebral edema, renal failure, coagulopathy, hepatic failure and thromboembolism).Transthoracic echocardiogram revealed thrombus in right ventricle which was the result of prothrombotic state.

Objectives: In this study, we aimed to undertake a systematic review of the literature in order to investigate whetherpreoperative biomarkers have diagnostic significance in determining post-implantation syndrome PIS possibility afterendovascular aneurysm repair (EVAR).Methods: Literature review was carried out in PubMed electronic database without any limitations of date. Includedwere studies that recorded the preoperative levels of inflammatory biomarkers in which PIS develops following EVARand that were published only in English. Results of the studies were evaluated based on either random or fixed effectmodel in accordance with the presence of heterogeneity (I2>25%). Statistical analysis were performed by Open metaAnalyst® software.Results: A total of 349 articles were found upon a database screening. After the article titles and abstracts were analysed, 6 articles were included in the meta-analysis that cover 891 patients and comply with inclusion criteria. It wasobserved in the studies that WBC, CRP, thrombocyte, IL-6, and fibrinogen levels were analysed. It was found from theconducted analysis that the preoperative levels of WBC (SMD: 0.70 95% CI: 0.55-0.86 and p<0.001), fibrinogen (SMD:0.27 95% CI: 0.03-0.51 and p=0.02), IL-6 (SMD: 1.04 95% CI: 0.64-1.44 and p<0.001), and thrombocyte (SMD: 0.91 95% CI:0.13-0.69 and p=0.02) were significant in determining the PIS development, however, CRP levels were not (SMD: 0.3795% CI: -0.20-0.96 and p=0.20).Conclusion: We concluded that WBC, thrombocyte, fibrinogen, and IL-6 levels were effective in predicting PIS developing after EVAR in preoperative period.

Objectives: The purpose of the present study is to compare dosimetrically IMRT, VMAT, HT techniques in endometriumcancer adjuvant radiotherapy practice.Methods: The 10 patients to whom we had applied Pelvic RT due to endometrium cancer previously were selectedretrospectively. All patients had received TAH+BSO+BPLND. Three different plans were made for the patients as IMRT,VMAT, and HT.Results: The rectum V40 was found to be 53%, 54%, 45% (p=0.002), respectively; and the bladder V45 was 27%, 26%,20% (p=0.002), respectively. Bowel V40 was found to be 15%,17%,12%, respectively (p=<0.001). Total monitor unit(MU) and beam-on times were found superior at VMAT (<0.001). Bone marrow V40 was found to be 27%, 26%, 33%,respectively (p<0.001).Conclusion: It was found that the three techniques were suitable in terms of planning criteria and OARs. HI and CI werefound to be superior at HT. In risky organs, in rectum, bowel and bladder, HT was found to be superior than the others;in terms of bone marrow, IMRT was found to be superior; and in terms of bone, VMAT was found to be superior. VMAThas the advantage of having short treatment time and low MU.

Objectives: Megestrol acetate (MA) can induce significant secondary adrenal suppression. We designed this study todetermine the extent of adrenal insufficiency in cancer patients receiving MA and whether ther was any predictivefactor for this.Methods: Thirty-one patients (aged 48–83 years) who were receiving MA took part in this study. Serum concentrationsof TSH, ACTH, free T4, cortisol were measuresd in samples obtained at 7 AM, at baseline and 1st month. Standart ACTH(250 mg) stimulation test was performed if cortisol levels were below 18 µg/dl at any time.Results: 1 month after drug initiation, 32% of patients were accepted as adrenal insufficient. There wasn’t any correlation between the basal cortisol, ACTH levels, any biochemical parameter and overall survival. There was negativecorrelation between 1 month cortisol levels and survival time (p=0.04) If cortisol levels were lower at month of theraphysurvival time was longer. Cox regression analysis showed that patients having lower cortisol levels at first month had98% lower risk of death compared to patients having higher cortisol levels (p=0.02: OR 0.12 (0.02-0.75)).Conclusion: It is important to evaluate adrenal functions especially during episodes of infection or after withdrawalof MA therapy since this may require prompt corticosteroid treatment.

Objectives: Philadelphia chromosome (Ph) is common cytogenetic abnormality in B-ALL. Patients with Ph-chromosome have resistance to chemotherapy treatment with shorter event free survival, however, tyrosine kinase inhibitor(imatinib mesylate) has shown to improve the survival of Ph-positive ALL patients. The aim of the study was to examineimmunophenotypic profile associated with BCR/ABL1 gene rearrangement and to put forward a model for gene rearrangement based on immunophenotypic analysis at diagnosis.Methods: We had carried out a retrospective analysis of 130 patients with B-ALL diagnosed at The Gujarat Cancer andResearch Institute. Immunophenotyping of leukemic blasts was carried out using flowcytometry and BCR/ABL1 fusiongene was detected by FISH analysis.Results: BCR/ABL1 fusion was observed in 24% of B-ALL. All patients with BCR/ABL1 gene rearrangement were positivefor CD10 and Tdt. BCR/ABL1-positive cases exhibited a greater MFI value of Tdt, CD10, CD34, CD13, CD33, but a lowerMFI value of CD22, CCD79a as compared to BCR/ABL1 negative cases. Multivariate logistic regression analysis showedthat high MFI of Tdt, CD10 and low MFI of CD22 and CCD79a predict the presence of BCR/ABL1 rearrangement.Conclusion: Immunophenotypic profile of B-ALL patients can be used as primary screening to predict occurrence ofBCR/ABL1 gene rearrangement.

Objectives: Neutrophile-lymphocyte ratio (NLR) is an inflammatory marker and has prognostic significance for manycancers.In this study, we evaluated the prognostic value of NLR ratio and its relation with clinicopathological featuresin gastric cancer.Methods: A retrospective review of 110 patients who underwent stomach cancer surgery between 2012 and 2014 wasperformed electronically.Results: The mean age was 63.7±11.6 years.Seventy percent of the patients were male and 43% underwent total and57% subtotal gastrectomies. According to TNM staging; 11% were in stage 1, 29% in stage 2 and 60% in stage 3. Metastatic/total lymph node ratio is below 0.3 in 59% of patients. Neutrophil/lymphocyte ratio was found to be greaterthan 2.5 in 50% of patients and greater than 3 in 33% of patients. The mean NLR value was 3.38±2.7 (1.09-19.1).Conclusion: In our study, while NLR was not detected as an effective factor on disease-free survival; stage, metastaticlymph node ratio, tumor size and localization were found as independent factors effective on overall survival. As a significant factor in multivariate analysis, NLR reflects the immune status of the organism, not the tumor aggressivenessor stage and it is an independent prognostic factor.

Objectives: There is a wide variability in the pharmacokinetics, pharmacodynamics and tolerance of anticancer drugsbased on ethnicity. GIST is a rare cancer, (~1% of GI cancers). Imatinib is used in the neo-adjuvant, adjuvant and metastatic setting.Methods: The purpose of this study was to report the difference in hematologic toxicities to imatinib among differentethnicities when treated for GIST either in the adjuvant or metastatic setting.Results: Among 57 patients (median age 61 years, M: F=41:16 (F); ethnicities: White 65%, African-American (AA 19%,Asian 12% and Hispanic 3%), neutropenia (Grade 3 & 4) was seen in 6 patients (10%): 5 AA and 1 Asian. 45% of all AApatients developed neutropenia. Median absolute neutrophil count (ANC) nadir was 700/µL, median duration on drugprior to onset of neutropenia was 4.5 weeks and median duration of neutropenia was 4 weeks. One patient developedfebrile neutropenia. Dose interruptions were needed in 3, dose-reductions in all patients, and 3 patients required pegfilgrastim. One patient had to discontinue imatinib, while one patient was escalated back to 400mg daily dose.Conclusion: This is the first study to examine ethnic variations in myelosuppression following imatinib in patients with GIST.

Objective: Primary gastrointestinal non-hodgkin lymphomas (PGI-NHL) are uncommon diseases with treatment modalities including chemotherapy, surgery, and radiotherapy. Our aim is to analyze the demographic and clinical features and treatment results of PGI-NHL.Materials and Methods: 286 patients diagnosed with lymphoma who referred to Ataturk University Medical Faculty Hospital between July 2001 and April 2014 were surveyed retrospectively and 22 (7.6%) PGI-NHL cases whose primary lesions were in gastrointestinal system were included.Results: Mean age was 47 (min.25- max.77) and 14 (63.6%) of them were men. The origin was determined as small intestines (50%), stomach (31.8%) and colon (18.2%), respectively. The most common complaint and pathologic subtype were abdominal pain (68.2%) and diffuse large B cell lymphoma (86.4%), respectively. The Lugano Classification was as follows: stage 1 (18.2%), stage 2 (59.1%), and stage 4 (22.7%). Surgery and chemotherapy were administered to 40.9% of patients. Complete and partial response and disease progression were established in 72.1%, 4.5% and 13.6% of the patients, respectively. Mean survival time was 99.6±16 months. Mean overall survival time was determined significantly longer in small bowel group than gastric group (119±15 vs. 50±24 months) (p=0.039). Age, gender, Eastern Cooperative Oncology Group performance status, International Prognostic Index, stage, histological type, tumor size, LDH level, albumin level, Hemoglobin level and treatment options were not associated with survival.Conclusion: Demographic and clinical characteristics of our series were similar with Middle Eastern and African countries. Optimal treatment options or prognostic factors for PGI-NHL are not clear. There is a need for randomized prospective studies including large number of patients and long follow-up period.

Objectives: Recovery of motor function after moderate to severe stroke is challenging given the paucity of therapeuticchoices; we propose an effective treatment with a new combination of drugs which protect neuronal mitochondriafrom oxidative stress, inflammation, and subsequent apoptosis; also decrease excitotoxicity mostly by modulating thebrain derived neurotrophic factor (BDNF), insulin growth factor-1 (IGF-1), and transforming growth factor-β (TGF-β).Methods: The new combination consists of medications approved for human use in multiple pathologies: glutathione,oxytocin, dimethylsulfoxide (DMSO), deproteinated veal serum (Actovegin), vitamins C, B1, B6, B12, which were administered intravenously in an open-label, pilot study. Motor function was evaluated with the National Institutes of HealthStroke Scale (NIHSS) in 15 consecutive hemiplegic patients initially and at 1 month after administering first intravenoustreatment, and subsequently.Results: When treatment was administered during days 10-35 post-stroke, motor improvement at 1 month evaluationpost-treatment (mean ΔNIHSS score=-3.6, n=5) was significantly better than when administered at 35-100 days poststroke (mean ΔNIHSS=-0.83, n=6, p=0.02), or when given after 3 months post-stroke (mean ΔNIHSS=0, n=4). Motorimprovements at 2 and 3 months post-treatment were seen only in the group treated at 10-35 days post-stroke, withone complete recovery of hemiplegia at 6 months.Conclusion: Excellent results were obtained in subacute stroke patients with hemorrhagic transformation of ischemic stroke, recommending it as a much needed addition to the current treatment options for stroke and moreample clinical trials.

The underlying aim of the study is to investigate the underlying reasons behinds the rapid growths of cancer populations and the cancer mortality rates in the present India. The study emphasis mainly on the cancerous factors,theunderlying barriers behind the unfruitfulness of the terminal diagnosis, and the propose solutions or preventivemeasures in traditional ways.The current study is an analytical study on the collected data and reports of the following reliable sources:• The Population-Based Cancer Registries Data’ of the Central and State Governments.• The Data from National Cancer Registry and Regional Cancer Centers,• National Family Health Survey of India (NFHS-3), NICPR-National Institute of Cancer Prevention and Research,ICMR-Indian Council of Medical Research, Indo-Asia News Service (IANS), and Zee Media Bureau. The study alsoutilized the available journals database, along with WHO database. The researcher also accesses to the government’s data and hospitals documents on cancer statistics and their reports.The modern turns out to be a cancer hub and the world largest contributor to cancer mortality rates. The numbersof cancer effected people increases every year, while the government had minimal inputs towards the preventivemeasures against cancer/terminal illness.

Transient receptor potential vanilloid 1 channels (TRPV1) which are playing an important role in conduction of painsignals to dorsal root ganglion (DRG), can be interacted by many external and internal factors. Food ingredients andherbal products have a great impact on these receptors. Topical application or oral consumption of these products areeffective in reducing pain signals with different mechanisms of action. TRPV1 is involved in a various processes including nociception, thermosensation and energy homeostasis. Role of capsaicin, unsaturated omega fatty acids, minerals,and herbal products in pain relief and molecular mechanisms are being discussed. However, some dietary supplementation with TRPV1 activity, such as capsaicin, show conflicting results. TRPV1 channels and their agonist elements mayplay a great impact in decreasing the risk of obesity and diabetes through different mechanisms including reducinginflammation. Therefore, TRPV1 could be dysregulated in obesity leading to the development of obesity, diabetes.Further, TRPV1 channels look like to be responsible in pancreatic insulin secretion. Hopefully, we could make it possibleto produce natural food supplements to reduce pain by focusing on the role of TRPV1 channels. This will further helpclinicians and surgeons to reduce pain post-surgical procedures just by modifying the patient’s diet.

Polymyalgia rheumatica (PMR) is a systemic autoimmune disease associated with widespread pain in the elderly. Theetiology of PMR has not been clearly determined. There are many different causes of PMR and stress and/or diet mightbe one of them. Unconscious diet can reveal psychological and physical stress in the body. In addition, dieting andstress may affect the inflammatory process in several ways. Here we presented a patient on an unconscious diet diagnosed with PMR. As a result of the case, we thought that unconscious diet and related/non-related stress may be riskfactors for autoimmune diseases such as PMR.

Coronary-pulmonary artery fistula (CPAF) is one of the coronary anomalies rarely encountered in coronary angiographyseries. CPAFs are usually congenital but uncommonly remain asymptomatic in the advanced ages. Herein, we aimed toreport our approach to a case of CPAF, which remained asymptomatic until advanced ages and was determined coincidentally in a patient undergoing percutaneous intervention for acute anterior myocardial infarction.A 70-year-old male patient, who was admitted to the Emergency Department with extensive chest pain, hypotension,cold sweating, and impaired general status, underwent coronary angiographic intervention after being diagnosed withacute anterior myocardial infarction. During the intervention, a plexiform fistula originated from the conus branch ofthe right coronary artery and extended to the pulmonary artery was detected coincidentally. The 64-section computedtomography of the thorax confirmed that fistula drained into the left pulmonary artery. Taking the clinical and demographic characteristics of the patient into account, we decided medical follow-up as the first treatment option.Nowadays, coronary fistulas are usually closed by coiling or surgery even they are asymptomatic. We are in the opinionthat conservative approach would be more reasonable for asymptomatic fistulas in advanced age patients havingadditional cardiac pathologies.

The essential treatment of choice for organ confined prostate cancer (PCa) is radical prostatectomy (RP). Complicationscan occur after RP, even extremely ones. However, surgical intervention is needed to fix most of the complications,some of them rarely may be self-healing. We here presented a RP case which rectal injury occurred during RP. However,rectal injury was operated properly, urorectal fistula occurred in follow-up. After the first administration of leuprolideatrigel 22.5mg was given, colostomy was performed. At the end of 2. administration of leuprolide atrigel 22.5 injection,there was not urorectal fistula. After removing urethral catheter, the patient was also continent.