Background/aim: We aim to report the outcomes of circumcisions performed with Alisclamp and our experiences to reduce the complications. Material and methods: Complications among circumcised males with Alisclamp between 2015 and 2018 were retrospectively analyzed. Patients were divided into two groups: Group 1 (n = 1429); patients circumcised in 2015-2016 and Group 2 (n = 3304); patients circumcised in 2017-2018. The different technical approaches in Group 2 are as follows: 1) Prevention of bleeding: In Group 2, we didn't pull the ventral prepuce to reduce the risk of frenulum injury and the foreskin was excised approximately 1-2 mm above the base. 2) Prevention of secondary phimosis: In Group 2, regular manual pressure had been applied to mons pubis and we postponed some of the overweight children's circumcision. 3) Prevention of excessive foreskin: The clamp was placed carefully to prevent the glans from moving back and forth. Results: Secondary phimosis was significantly lower in Group 2 (p = 0.003). Total bleeding and bleeding requiring suturing were significantly lower in Group 2 (p = 0.001 and p = 0.026, respectively). Conclusion: Technique-specific complications of Alisclamp can reduce with technique-specific modifications.

Background/aim: To compare estrogen and betamethasone in the topical treatment of labial adhesions in prepubertal girls. Materials and methods: In this retrospective study, we evaluated 39 girls with labial adhesions covering at least 50% of the vaginal opening. Of the total patients, 20 were treated with a topical estrogen preparation, while the remaining 19 patients were treated with a combination of betamethasone cream and petroleum ointment (Vaseline) for 3 to 9 weeks. Results: Sixteen of 20 (80%) patients in the estrogen treatment group were treated successfully with topical estrogen cream only, and 17 of 19 (89.4%) patients in the second group were treated successfully with a combination of betamethasone cream and petroleum ointment. Two patients (2/20) in the estrogen treatment group underwent a surgical procedure for the manual separation of the labial adhesion. One patient (1/19) treated with betamethasone cream and petroleum ointment required a manual separation procedure. We observed a side effect of labial enlargement in 2 patients (10%) who were treated with estrogen only, while the only side effect of the betamethasone treatment was local irritation, which occurred in a single patient (5.2%). In addition, the success rate of the betamethasone treatment exceeded that of the topical estrogen (89.4% and 80%, respectively). Conclusion: Betamethasone cream with petroleum ointment is a safe and effective primary therapy for prepubertal labial adhesions.

Background: Accurate diagnosis of acute appendicitis in children remains challenging due to variable presentations and limitations of existing clinical scoring systems. While machine learning (ML) offers a promising approach to enhance diagnostic precision, most prior studies have been limited by small sample sizes, single-center data, or a lack of external validation. Methods: This prospective, multicenter study included 8586 pediatric patients to develop a machine learning-based diagnostic model using routinely available clinical and hematological parameters. A separate, prospectively collected external validation cohort of 3000 patients was used to assess model performance. The Random Forest algorithm was selected based on its superior performance during model comparison. Diagnostic accuracy, sensitivity, specificity, Area Under Curve (AUC), and calibration metrics were evaluated and compared with traditional scoring systems such as Pediatric Appendicitis Score (PAS), Alvarado, and Appendicitis Inflammatory Response Score (AIRS). Results: The ML model outperformed traditional clinical scores in both development and validation cohorts. In the external validation set, the Random Forest model achieved an AUC of 0.996, accuracy of 0.992, sensitivity of 0.998, and specificity of 0.993. Feature-importance analysis identified white blood cell count, red blood cell count, and mean platelet volume as key predictors. Conclusions: This large, prospectively validated study demonstrates that a machine learning-based scoring system using commonly accessible data can significantly improve the diagnosis of pediatric appendicitis. The model offers high accuracy and clinical interpretability and has the potential to reduce diagnostic delays and unnecessary imaging.

Aim: This study was aimed to determine the normal position of the anus using the anal position index (API) in an attempt to develop a more sensitive method for measuring API. To investigate API in a wide range of neonates, both term and preterm infants were included in the present study. Materials and Methods: API was determined by measuring the anus-fourchette (FA) and anus-coccyx (AC) distance in female neonates and the anus-scrotum and AC distance in male neonates. API is defined as the ratio of the FA (scrotum) distance to the AC distance. A digital caliper was used for all measurements. The FA or scrotum and coccyx-fourchette or -scrotum distances were measured using digital calipers. Results: A total of 267 neonates (females, 143; males 124) were included in this study. Of these, 36 were borderline premature infants (birth at 35-37 weeks gestation) and 231 were term infants (birth at 38-42 weeks gestation). The mean API was 1.06 ± 0.04 in female and 0.90 ± 0.08 in male neonates. When premature infants were analyzed separately, the mean API was 1.12 ± 0.08 in female and 0.99 ± 0.09 in male neonates. No significant difference in API values was observed between term and preterm neonates (P < 0.05). Conclusions: API values that differ from the previous studies were identified in the present study. We believe our modified method allows for more accurate measurements of the API in newborns. According to our method, the anus should be considered as anteriorly located if API is <1 in female and < 0.9 in male neonates. In addition, the present study is the first to measure API using digital calipers. Digital calipers were found to be convenient and are useful in determining the API with high accuracy (to within 0.01 cm).

Background: There is increasing evidence to suggest that curcumin has antioxidant efficacy in renal ischemia reperfusion injury (IRI). However, it has not been investigated whether this effect is dose-dependent or not. The aim of this study is to investigate the dose-dependent effect of curcumin on renal IRI in an experimental rat model.Methods: The rats (n=32) were separated into four groups: sham, I/R, I/R+CUR-50, I/R+CUR-100. Rats were subjected to renal ischemia by clamping bilateral renal pedicles for 60 min, and then reperfused for 3 h. Animals in treatment groups received 50 mg/kg/day and 100 mg/kg/day curcumin orally for 5 days before IRI, respectively. MDA, GSH, SOD, and CAT activities were determined in renal tissue. Renal tissue also evaluated histopathologically for mean histopathological damage score.Results: The mean MDA levels in the I/R+CUR-50 and I/R+CUR-100 groups were significantly decreased when compared with the I/R group (p=0.038 and p=0.016, respectively). SOD, CAT and GSH levels of all treatment groups were significantly increased in comparison to that of I/R group (p0.05). In histological examination, the rats treated with curcumin had nearly normal morphology of the kidney.Conclusions: Curcumin significantly ameliorates the damage of renal IRI by its antioxidant activity. We detected the highest intraperitoneal dose of curcumin reduced the IRI induced oxidative stress as 50 mg/kg per day.