Objective: The basis of the research is the application of fractal analysis (FA) to panoramic radiographs of patients with primary hyperparathyroidism (PHPT). In addition, the relationship between the relevant biochemistry parameters and fractal values of healthy controls and patients with PHPT will be evaluated. Materials and Methods: In the current study, FA was performed with ImageJ program on panoramic radiographs of 48 patients diagnosed with PHPT. Fractal dimension (FD) values of the patients and 48 healthy subjects were compared. In addition, biochemical [parathyroid hormone (PTH), serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), and vitamin D] parameters and FD values of both groups were analyzed with Mann–Whitney U-tests and Pearson correlation coefficient (P < .05). Results: FD values of four different angular areas were significantly lower in the patient group than in the healthy group (P < .05). There was no statistically significant difference between the patient and control groups in the measurements between the apexes of the right and left premolar and molar teeth. The mean PTH, Ca, P, and vitamin D values of the patients with PHPT and control group were highly significant, and all the parameters of the patient group showed higher values than the control group except for the P values (P < .001). In the patient group and control group, there was no significant difference between mean ALP values (P = .48). No correlation was found between the two groups. Conclusion: Bone biopsy is the gold standard method for the diagnosis of bone structure changes in patients with PHPT. However, it is not used routinely because it is an invasive method. The FA method applied to panoramic radiographs may be used as a noninvasive, easy-to-apply method to reveal the changes in the trabecular structure of the jaw bones of the patients. Cite this article as: Canturk F, Miloglu O, Gumussoy I, Dayanan R. The Investigation of radiographic findings of mandibles on of with primary hyperparathyroidism using fractal analysis. Eurasian J Med. 2021; 53 (3):185–191

Purpose: Sexual health is not only the absence of sexual dysfunction or disability, but also the presence of physical, emotional, mental, and social well-being related to sexuality. The current study aims to determine whether all adult patients who have applied for their regular health check-ups due to diabetes mellitus had ever voluntarily expressed their sexual problems to a specialist and whether they were asked about the presence of sexual dysfunction. It also aims to determine how the physicians attach importance to the issue. Patients and Methods: All patients aged 18– 65 years with type 1 and type 2 diabetes mellitus, who applied to our hospital between the years of January 2021 and 2022, were questioned by filling out a questionnaire for the presence of sexual problems in addition to screening for chronic complications of diabetes mellitus (retinopathy, nephropathy, and neuropathy) and routine history and physical examination. Results: The association between the presence of sexual problems and whether patients were questioned about the relevant issue in their previous controls and gender and age factors, educational background, presence of comorbidities, duration of marriage, and microvascular complications of diabetes mellitus were examined. In a population of 595 patients, 53.78% of the patients stated that they had sexual problems; however, 9.91% had been questioned about this issue by the physician. It was observed that 6.3% of female and 15.3% of male patients had previously consulted a doctor voluntarily due to their sexual problems. Conclusion: This study presents empirical findings that shed light on the inadequacies in healthcare providers’ approach to addressing sexual health concerns among individuals diagnosed with diabetes, as well as the shortcomings in patients’ effective communication of these concerns.

Introduction: The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and the systemic immune-inflammation index (SII) have been used as new inflammatory markers in certain autoimmune diseases to assess the severity of inflammation. The current study aimed to evaluate the changes in neutrophil and lymphocyte series in hyperthyroid patients and to investigate whether NLR, PLR, and SII may be markers of inflammation. Methods: This cross-sectional study was conducted with 207 Graves’ patients and 120 healthy controls between 2018-2022 years. Hematologic parameters, thyroid function tests, age and gender were recorded. The NLR, PLR and SII values of all subjects were calculated. Firstly, groups were composed as Graves' group and participants without thyroid disorder as control group. Secondly, Graves' patients composed as two groups before treatment and after antithyroid treatment. These groups were compared with each other in terms of descriptive data and hematological parameters. Results: The patient and control groups were similar in terms of gender (p=0.522) and age (p=0.051). Graves’ patients had a significantly lower NLR than the control group (p=0.004). There was no significant difference between the groups in terms of PLR (p=0.120) and SII (p=0.577). Patients’ baseline TSH-receptor antibodies (TRAb) levels had a significant positive correlation with fT3 (r:0.283, p<0.001), fT4 (r:0.252, p<0.001) and Thyroid stimulating immunoglobulin (TSI) (r:0.673, p<0.001). There was no significant correlation between TRAb and TSI levels, inflammatory markers, and hematological parameters. Conclusions: Graves’ patients had lower NLR compared to the control group. The patient and control groups did not have a significant difference with regard to PLR and SII. Thyroid autoantibody levels and inflammatory markers did not have a significant correlation. Keywords: Hyperthyroidism, inflammation, neutrophils, lymphocytes

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a prevalent and nonalcoholic progressive liver disorder associated with metabolic disturbance. This study aimed to compare the efficacy of wheat flour or baker's yeast-restricted diet with traditional calorie restriction in NAFLD patients.Material and methods: Analyzed data was obtained from 243 individuals with NAFLD who completed the study. Of these patients, 54 belonged to Group (1) (Standard Diet, SD); 104 belonged to Group (2) (Wheat Flour-Free Diet, WFFD); and 85 belonged to Group (3) (Yeast-Free Diet, YFD). The intervention period lasted 6 months, during which participants' dietary compliance was closely monitored.Results: At the end of the six-month trial, both the WFFD and HFD groups exhibited a noteworthy reduction in body mass index (BMI) and triglyceride (TG) levels when compared to a standard diet that only involved calorie restriction. Furthermore, a notable reduction in the severity of liver steatosis was seen in these groups (p<0.05). The SD group did not exhibit any significant changes in these metrics. The WFFD group experienced a notable reduction in HSI values (p<0.05). Cluster analysis revealed that the obese group had higher HSI, weight, and BMI values throughout the study period, indicating a more advanced stage of NAFLD.Conclusions: To summarize, this study highlights the significance of food constituents and dietary strategies in the treatment of NAFLD. It suggests that limiting the intake of wheat flour and baker's yeast specifically could have positive effects on liver well-being.

Aims: Celiac disease (CeD) is an immune-mediated enteropathy with multisystem involvement that is often underdiagnosed due to variable clinical manifestations. Identifying reliable, accessible, and noninvasive biomarkers is essential for timely diagnosis, particularly in resource-limited settings. This study aims to evaluate the diagnostic utility of inflammation and nutrition-related indices and scores calculated from routine laboratory tests in predicting CeD. Methods: This retrospective cross-sectional study included 79 biopsy-confirmed celiac patients and 60 healthy controls. Demographic, hematological, and biochemical data were collected. The platelet-to-lymphocyte ratio (PLR), triglycerideglucose index (TyG), hemoglobin, albumin, lymphocyte, and platelet (HALP) score, and other inflammation-related indices were calculated via validated formulas. Logistic regression analysis was performed to identify independent predictors of CeD. Receiver operating characteristic (ROC) curves were used to assess diagnostic performance. Results: Compared with controls, patients with CeD had significantly greater PLRs and lower TyG indices and HALP scores (p

Adrenal incidentaloma (AI) is being diagnosed more frequently due to the increase in use of imaging modalities. Inflammatory processes can play a role in the development and prognosis of numerous diseases. We aimed to investigate the clinical and endocrinological characteristics of adrenal adenoma and its relationship with inflammatory markers. The present study retrospectively analysed 111 patients with adrenal incidentaloma who underwent radiological and clinical examinations between January 2018 and January 2022. Patients diagnosed with Cushing’s syndrome, pheochromocytoma or primary aldosteronism were classified as functional. Inflammation was assessed using neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), glucose lymphocyte ratio (GLR), systemic immune-inflammation index (SII) and prognostic nutritional index (PNI). Of the 111 patients included, 76.6% (n=85) had nonfunctional adenomas and 23.4% (n=26) had functional adenomas. Of the patients with functional adenomas, 50% (n=13) had Cushing’s syndrome, 26.9% (n=7) had pheochromocytoma and 23% (n=6) had primary aldosteronism. The median duration of follow-up was 22.0 (2.0–60.0) months. During the follow-up, two (2.4%) of the 85 patients with non-functional adenomas gained functionality and were diagnosed with Cushing’s disease. Functionality was not significantly associated with NLR, PLR, GLR, SII and PNI levels. There was a negative correlation between cortisol level after the overnight 1 mg dexamethasone suppression test and PNI (r:-0.207, p=0.030). Inflammatory hemogram parameters levels were not significantly different between patients with functional and non-functional adenomas. There was a significant negative correlation between the PNI level and cortisol secretion. PNI, which can be easily calculated by serum albumin level and absolute lymphocyte count, can be a useful guide for clinicians in the follow-up for the prognosis of functional adenoma.