Aspiration of meconium typically occurs after fetal hypoxic/ischemic stress leading to intestinal peristalsis, meconium contamination of the amniotic fluid, and gasping respirations that draw the noxious meconium-stained fluid deep into the lung. Meconium contamination of amniotic fluid occurs in 10–15% of all pregnancies, and 5–10% of these infants develop meconium aspiration syndrome and respiratory failure. This review presents the update data on clinical, diagnostic and treatment approach for MAS.

In our hospital the first open heart surgery was done in March 2015 and is still beeing processed successfully since. Open heart surgery is a major surgical procedure challenging the anesthesiologist to be skilled and carefully during every stage. In this review we aimed to summarize properties of anesthesia for cardiovascular surgery in adults.

Objective: Temporary hypocalcemia is the most common complication after thyroidectomy and is easily treated when it occurs. The main problem of the temporary hypocalcemia is the prolongation of hospital stay. The purpose of this study was to identify the risk factors of postoperative temporary hypocalcemia in a group of patients whom underwent thyroid surgery.
Material and Method: The retrospective data of the 177 patients of whom underwent total thyroidectomy between January 2012 and December 2013 were evaluated. Hypocalcemia is defined as total plasma calcium level below 8 mg/dl. Temporary hypocalcemia is defined as recovery of hypocalcemia in 6 months following total thyroidectomy. Gender, preoperative vitamin D deficiency, surgery for recurrent disease, presence of hyperthyroidism, extent of surgery, number of parathyroid glands identified and protected, parathyroid autotransplantation, presence of parathyroid glands in surgical specimen were analyzed as the risk the factors for temporary hypocalcemia. ‘’Nomial logistic regression analysis’’, ‘’Chi-Squared test’’ and ‘’Fisher’s exact test’’ were used for statistics.
Results: Temporary hypocalcemia occurred in 37 of 177 (150F, 27M) (20.9%) patients. In nominal regression analysis, only the presence of parathyroid glands in the surgical specimen was determined as independent variable factor of transient hypocalcemia (p=0.025).
Conclusion: The presence of parathyroid glands in the surgical specimen is responsible for the high rate of temporary hypocalcemia. Careful examination of the surgical specimen intraoperatively can minimalize the incidence of inadvertent parathyroidectomy during thyroidectomy.

Objective: The aim of the study is to determine invasive device- related nosocomial infection rates and corrective action plan on the subject of neonatal intensive care unit in our hospital.
Material and Method: Our study is retrospective and include all neonates who were hospitalized between January-December 2013 and kept under observation more than 48 hours in the Neonatal Intensive Care Unit. Patients included in the study evaluated according to birth weight as over 2500 grams and under 2500 grams. Number of invasive procedures applied and rates of infections were
recorded. Data were analysed by using SPSS 15 software.
Results: Between the dates specified, 700 patients were enrolled in the study. A total of 19 invasive device related infection detected. Total infection incidence dansity were found 2.35% and catheter related blood stream infection was 1.4% and ventilator-associated infection was 1.29%.
Conclusion: Invasive device associated infection incidence dansity in our clinic was determined to be in acceptable limits. The ventilator-associated pneumonia incidence dansity was found lower.

Objective: To evaluate the safety, feasibility and efficacy of laparascopic approach in management of patients undergoing nevre-sparing radical hysterectomy for early stage cervical cancer
Material and Method: 14 patients who had early stage (1A1-1B1) and undergone laparascopic nerve sparing radical hysterectomy were analysed retrospectively.
Results: Mean age of patients was 44 (min 26 max 53), mean BMI was 30 (min 23 max 47), mean gravida was 4.7 (min0 max 12), mean parity was 8 (min 0 max 8). Mean duration of surgery- both laparascopic nevre-sparing radical hysterectomy and pelvic lymph node dissection- was 228 minutes. Fifteen lymph nodes and 2.2 centimeters of vaginal tissue were extracted in average. Intestinal functions
had returned in one day after surgery. Bladder catheter and abdominal drain were removed after 2.5 days (min 1 max 5) and 3.3 days (min 2 max 7) respectively. Complete surgical resection was achieved in all patients. Mean follow up duration was 15 months. No recurrence or patient death were present during this time period.
Conclusion: In treatment of early stage cervical cancer, laparascopic nevre-sparing radical hysterectomy is as effective as other surgical techniques, and a superior approach for patient’s quality of life considering less altered bladder function.

Objective: Lower respiratory tract infections (LRTI) have high morbidity rates in children. They are
also related with high mortality especially in early infancy. We aimed to investigate of viral agents of
children, clinically diagnosed as LRTI, by immunofluorescent and immunochromatographic methods
Material and Method: In our study, nasopharyngeal swabs of 260 patients (1 month-5 years)
clinically diagnosed as LRTI, were investigated by immunofluorescent and immunochromatographic
techniques.
Results: In 122 (46.9%) of samples the virus was identified. RSV was the most common etiologic viral
agent in LRTI by a rate of 35.3% followed by influenza A virus 4.2%, influenza B virus 1.9%.
Conclusion: In pediatric population, rapid diagnosis of LRTIs will help us to protect children and to
choose appropriate treatment, avoidance of unnecessary antibiotic use and prevention of nosocomial
infections caused by these agents.

Objective: Our study aims at determining infection frequency in patients receiving or not receiving therapeutic hypothermia (TH) after cardiopulmonary resuscitation (CPR), detecting the microorganisms most frequently isolated, and measuring the effect of TH on mortality and morbidity.
Material and Method: We examined retrospectively the files of 44 patients receiving successful CPR. Patients were separated into two groups: the ones receiving (n=20) and not receiving (n=24) TH. Their leucocyte numbers and C- reactive protein (CRP) values were recorded in the 1st, 3rd, 5th, 7th and 9th day. Their demographic data, hospitalization period in intensive care unit (ICU), the first
day that culture positivity occurred, in which culture(s) reproduction occured, which microorganisms reproduced in these cultures, and discharge state of the patients from ICU were recorded.
Results: No significant difference was found in patients’ demographic data, and Glasgow coma score (GCS) averages. Culture positivity observed in the first 10 days after intensive care follow-ups, blood, deep tracheal aspiration (DTA), urine culture growth rate, and leukocyte numbers were not significantly different between the groups. Although there was no significant difference between the mortality
rates of the groups, hospitalization time in the ICU was significantly lower in the group receiving TH. No significant difference was observed between the groups in terms of leucocyte numbers in the 1st, 3rd, 5th, 7th and 9th day. The CRP value in the 1st day in the group receiving TH was significantly lower than those not receiving TH. There was no significant difference between the CRP values in other days.
Conclusion: Although mortality rates are not significantly affected, hospitalization period in ICU was found to be shorter in the group receiving TH. For this reason, we think that TH which was proved to have favorable neurologic advances, should be applied to post CPR patients in ICU practice.

Objective: In hypothyroidic patients obesity and hyperlipidemia is more often. In this study hypothroid patients followed by Haseki Hospital lipid polyclinic evaluated and hyperlipidemia-obesity relation investigated.
Material and Method: Files of 37 hypothyroidic patients followed up by lipid polyclinic of Haseki Hospital between 2003-2006 years are evaluated retrospectively. Patients divided into two groups as obese (case) and nonobese (control) according to their body mass indexes (BMI) (≥30=obese) at the time they refer. Age, sex, BMI, glucose, TSH, total-cholesterol, LDL, HDL, triglyceride values of patients evaluated.
Results: 19 were obese (case group), 18 were nonobese (control group) from 37 patients with hypothyroidism admitted to our study. Case group had 1 male, 18 female, control group had 6 male, 12 female patients. In case group, HDL was lower (p<0.01) and glucose was higher (p<0.01) than control group. Triglycerides of case group was higher than control group, but this difference wasn’t significant (p=0.31). There wasn’t difference between groups in the levels of total and LDL-cholesterol.
Conclusion: We evaluated hypothroidic patients by dividing them to obese and nonobese groups according to their BMI. Total and LDL cholesterol levels of groups showed no significant difference. Trigliceryde and glucose levels of obese group was high and HDL-cholesterol was low. During therapies of hypothyroidic patients, hyperlipidemia have to be investigated and also when beginning of an antihyperlipidemic treatment thyroid hormones have to be evaluated.

Objective: The work-related musculoskeletal disorders are one of the most common health problems in the community. The aim of the our study was to determine the incidence of work-related upper extremity problems and to asses the risk factors in order to protect the health of our hospital employees, to improve job satisfaction and to avoid situations that could lead to job.
Material and Method: A total of 125 hospital employees were included in our study. The personal characteristics of the participants, information about the work and the working environment were questioned by a questionnaire that was collected from the literature. The Nordic Musculoskeletal Questionnaire was used to identify areas of pain.
Results: 125 cases participated in the study, 74 (59.2%) were female and 51 (40.8%) were male. The mean age of patients was 31.56±7: 09 years. 53 participants (50.5%) were cleaning staff, 25 participants (23.8%) were secretary, 16 participants (15.2%) were technician and 11 participants (10.6%) were nurse. 61 employees (58.1%) had upper limb pain during business. When logistic analysis was performed we found that male gender is a risk factor for wrist pain; high BMI is a risk factor for back, elbow and wrist; less time spent at home is a risk factor for back and wrist pain.
Conclusion: To determine the work-related upper extremity problems and risk factors in hospital employees is important to improve work efficiency and protect the health of employees.

Objective: Posterior circulation stroke syndromes are known to have high risk of mortality and morbidity. The recognition of posterior circulation infarcts are important for decreasing this mortality and morbidity, and can make it possible to administer thrombolysis treatment. In this study, our goal was to evaluate distribution of cerebellar infarcts, and to determine the clinical, aetiological and functional characteristics.
Material and Method: 90 patients were included in our study. All recorded vascular risk factors, blood pressure measurements, electrocardiograms, signs and symptoms during the application, results of cranial imaging and the results of studies done to reveal aethiology such as transthoracic ecocardiography and bilateral doppler ultrasonography of carotid arteries, cervical computed tomography or magnetic resonance angiography imaginings were examined.
Results: The most common vascular territories were medial posterior inferior cerebellar artery (PICA), medial superior cerebellar artery (SCA) and lateral PICA. Nausea and vomiting were the most common symptom, except for anterior inferior cerebellar artery (AICA). At AICA infarcts, it was derangement. The most common finding in all vascular territories were ataxia, dysmetria-disdiadokinezia and hypotonia. The
most common risk factors were hypertension (HT), smoking and diabetes mellitus. Cardioembolism was found in 22.2% and vertebrobasillar atherosclerosis (VBA) was found in 61.1% of the cases as aetiological factors. VBA was more common in infarcts that involved the territories of AICA, medial PICA and Iateral PICA. Cardioembolism was the most common in infarcts that involved the territories of medial SCA, Iateral
SCA and Iateral PICA.
Conclusions: In our study we found that the most commonly affected territory was medial PICA. The most common signs were nausea and vomiting, and the most common symptom was ataxia. HT was the predominant risk factor and the most common aetiological factor was VBA.

Infantile hemangioma is the most common bening tumors of infancy. Common treatment indications include airway obstruction, ulceration, infection, visual impairment or feding difficulties. Besides the steroids were the first choice in treatment of infantile hemangiomas for years, propranolol was also used in recent years.. This report presents a 3-month-old patient with infantile hemangioma in the right side of her face has been treated with oral propranolol therapy, accompanied by brief review of literature with treatment options.

Wolf-Hirschhorn syndrome (WHS) is a rare well-known genetic condition resulting from a distal deletion of the short arm of chromosome 4, is usually associated with marked prenatal and postnatal growth retardation with psychomotor delay, profound mental deficiency, typical facial anomalies, midline defects, skeletal anomalies, hypotonia and seizures. We herein report a 16-month-old girl with severe intrauterin-growth-retardation, atypical facial anomalies, seizures and abnormal electroencephalography that was diagnosed with karyotype analysis.

The parenteral drug application is a routinely used method in all medical disciplines. Intramuscular, intraarticular, intravenous injections and infusions can cause local complications such as abscesses and articular infections. These local complications can lead to bacteraemia, sepsis and may lead to multiple organ failure associated with high morbidity and mortality. We present a patient with thigh abscess and wide paniculitis caused by Escherichia coli after intramuscular injections.

Retroperitoneal abscess associated with a posterior perforation of the duodenum due to peptic ulcer disease is extremely rare problem in clinical practice. There are scarce data about its clinical signs and symptoms in the literature. We report a case of retroperitoneal abscess associated with a posterior perforation of the duodenum due to peptic ulcer disease and review the literature.