Objective: In our study, we aim to evaluate in terms of patients the quality and reliability of the most relevant and most-watched videos uploaded on YouTube about pancreatic cancer. Method: Before starting the study, YouTube^TM search terms were determined by consensus by two General Surgeons. Then, on 10/10/2020, the terms such as “pancreatic cancer”, “diagnosis of pancreatic cancer” and “treatment of pancreatic cancer” were entered separately in the search bar of YouTube, “relevance” was selected among the filtering options and the most viewed videos were listed. The videos were evaluated with the Global Quality Scale (GQS), the DISCERN scoring system (Quality Criteria for Consumer Health Information, http://www.discern.org.uk), and video power index. Results: Among the 50 videos analysed, 19 videos were uploaded by hospital channels, 17 videos by health channels, seven videos by patients, four videos by blog channels, and three videos by doctors. The mean GQS score of the first researcher was 3.24 ± 0.99 and the mean GQS score of the second researcher was 3.18 ± 0.88 with a significantly high agreement between them (r= 0.628). The mean DISCERN score of the first researcher was 3.48 ± 0.77 and the mean DISCERN score of the second researcher was 3.46 ± 1.09 with a significantly high agreement between them (r= 0.814). Conclusion: In our study, the majority of the videos were found to be of moderate quality. Healthcare professionals should be encouraged to upload more videos with useful content. However, we think that the uploaded videos should definitely go through a professional peer-review process before they are published.

Background: Acute appendicitis is the most common non-gynecological emergency during pregnancy. The diagnosis of appendicitis during pregnancy is challenging due to changes in both physiological and laboratory variables. Guidelines suggest patients with suspected acute appendicitis should be stratified based on clinical scoring systems, to optimize the use of diagnostic imaging and prevent unnecessary surgery. Surgeons require additional information beyond that provided by imaging studies before deciding upon exploratory laparoscopy in patients with a high suspicion of appendicitis. Various scoring methods have been evaluated for the diagnosis of acute appendicitis. However, there is no consensus on a method to use during pregnancy, and a detailed comparison of existing scoring methods for this purpose has not yet been conducted. The purpose of this study was to evaluate the efficacy of the most popular scoring systems applied to diagnose acute appendicitis during pregnancy. Methods: This single-center retrospective study included 79 pregnant patients who were admitted to the emergency department with abdominal pain between May 2014 and May 2019. The patients were diagnosed with acute appendicitis and underwent an appendectomy. As a control group, the study also included 79 non-pregnant patients who underwent appendectomy within the last 1.5 years. To ensure that the groups were similar, women in the case group were stratified according to age, and the proportions of women in the strata were determined. The women in the control group were similarly stratified. Women were randomly selected from the strata to prevent bias. Both laboratory and examination findings required for each scoring method were obtained and assessed separately for each patient. Negative appendectomy rates were evaluated according to pathology results. Categorical variables were compared using the chi-square test. A p value < 0.05 was considered to indicate significance. Receiver operator characteristic curve analysis was used to identify the best threshold value and to assess the performance of the test scores in terms of diagnosing appendicitis. Results: Among all scoring systems, the Tzanakis score was most efficacious at predicting appendicitis in non-pregnant women. The positive predictive value (PPV) of the Tzanakis score was 90.6%, whereas the negative predictive value (NPV) was 46.7%. The RIPASA score performed the best among the scoring systems in pregnant women. It was associated with a PPV of 94.40%, NPV of 44%, and sensitivity and specificity of 78.46% and 78.57%, respectively. Conclusion: Although the RIPASA score can be used to efficaciously diagnose acute appendicitis in pregnant women, a specific scoring system is needed for diagnosis during the gestation period.

Endoscopic detorsion is the first-line recommended treatment modality in sigmoid volvulus patients who have no peritoneal irritation signs on admission. In this paper, we present the results of endoscopic detorsion procedures applied at the time of presentation with the diagnosis of sigmoid volvulus and review the current literature about this topic.

Background. Many scoring systems have been developed for acute appendicitis, which is the most common emergent disorder in surgical practice. Considering the physiological changes and chronic diseases occurring with advancing age, an applied scoring system may not produce the same score in similar patients in all age groups. Objectives. We aimed to compare the predictive values of scoring systems in different age groups. Methods. In this prospective study, the patients operated on in our clinic with a prediagnosis of acute appendicitis between March 2020 and March 2021 were included. We divided them into three age groups as 1845 years (group 1), 4665 years (group 2), and >65 years (group 3). We compared the scores of the nine acute appendicitis scoring systems most commonly used in the literature for these age groups. Results. A total of 203 patients were included in our study. The Alvarado scoring system yielded the most accurate results for group 1, whereas the FenyoLinberg scoring system was the most accurate system for group 2 and the Eskelinen scoring system for group 3. Conclusion. Age should be considered as a major parameter during the selection of the scoring system to be applied for patients with prediagnosis of acute appendicitis. Our study revealed the Alvarado and the FenyoLindberg scoring systems as the most accurate systems for the differential diagnosis of appendicitis in the 1845 and 4665 years age groups, respectively. Although we found the Eskelinen scoring system as the most accurate one in the >65 years age group, the confidence intervals indicated that it may not be appropriate for use alone in this group.

Background. Although laparoscopic appendectomy increases its popularity today, the answer to the question of whether to perform open or laparoscopic appendectomy during pregnancy is appropriate in many studies, and the choice of surgery depends on the surgeon. Herein, we aimed to evaluate the variables that affect undesirable pregnancy outcomes that occur as a result of appendicitis during pregnancy. Methods. Seventy-eight pregnant patients with acute appendicitis who underwent laparoscopic or open technique intervention enrolled in this retrospective study. In addition to the demographic structure of the patients, surgical technique, the number of pregnancies, multiple pregnancy status, surgical pathologies, laboratory values, radiological imaging methods, and length of hospital stay were evaluated. The severity of appendicitis was classified according to the pathology results. The patients were divided into two groups according to the outcomes of their pregnancy. Preterm delivery and abortion involved in the study as a single complication section. Results. The mean age of the pregnant patients was 28.6 ± 5. Of the 78 pregnant women with appendicitis, 47.4% had their first pregnancy, 37.2% had their second pregnancy, and 15.4% had 3 or more pregnancies. The preterm delivery and abortus were 19.5% in the open appendectomy (OA) group and 16.2% in the laparoscopic appendectomy (LA) group. No statistically significant difference was detected in this group in terms of appendicitis pathology triggering preterm delivery or abortion (p 0.075). When white blood count (WBC) and C-reactive protein (CRP) were evaluated by laboratory findings, CRP was found to be statistically significantly higher in patients with preterm birth (p 0.042). Conclusion. Consequently, acute appendicitis may cause serious intra-abdominal infection and inflammation in addition to the complexity of the diagnosis due to the nature of pregnancy, as well as undesired pregnancy outcomes with the surgical technique, or independently with other variables.

Introduction: Granulomatous mastitis (GM) is a rare chronic inflammatory breast disease, often resistant to standard treatments. The condition typically affects women of childbearing age and presents significant diagnostic and therapeutic challenges.Aim: This study aims to evaluate the efficacy of systemic and intralesional steroid therapies in patients with recurrent or treatment-resistant granulomatous mastitis.Materials and methods: This prospective, randomized controlled, single-center study was conducted at the General Surgery Clinic of Haseki Training and Research Hospital. A total of 66 patients presenting with recurrent or treatment-resistant granulomatous mastitis between June 2021 and June 2022 were included. Participants were randomly assigned to two equal groups: one group received systemic steroid therapy, and the other group received intralesional steroid therapy. Treatment responses and parameters influencing the treatment process were meticulously evaluated.Results: The study found that the outcomes of systemic steroid and intralesional steroid therapies were statistically similar. Additionally, statistical analysis revealed that smoking had a negative impact on treatment outcomes for both therapy methods.Conclusions: In patients with recurrent or treatment-resistant granulomatous mastitis, intralesional steroid therapy appears to be a viable alternative to systemic steroid therapy due to its similar statistical outcomes, ease of administration and monitoring, controlled dosage adjustments, absence of systemic side effects, and the lack of necessity for dose tapering upon discontinuation. Furthermore, to achieve optimal treatment response, it is recommended that patients cease smoking, as smoking has been found to adversely affect treatment outcomes in both therapy methods.