Sakarie Mustafe Hidig

Microcystic adnexal carcinoma is a local, slow-growing, aggressive, and cutaneous neoplasm which is extremely rare in the external auditory canal. Although benign, it invades locally and recurs frequently. Complete surgical excision and long-term follow-up are necessary. Misdiagnosis can be prevented with a deep biopsy. Due to possible hearing issues, radiotherapy should be eschewed.

Cholelithiasis, or gallstone disease, is a common gastrointestinal disorder with significant global health implications. Recent studies have suggested a potential association between Helicobacter pylori (H. pylori) infection and the development of cholelithiasis. This meta-analysis aims to synthesize the latest evidence on the role of H. pylori as a risk factor for cholelithiasis. A comprehensive literature search was conducted, and studies published between 2018 and 2023 were included. The results indicate a significant association between H. pylori infection and an increased risk of cholelithiasis, with potential mechanisms involving chronic inflammation, altered lipid metabolism, and bile composition changes. This analysis underscores the need for further research to elucidate the causal relationship and explore therapeutic implications.

Background & Aims: Hepatocellular carcinoma (HCC) is a major global health concern, ranking sixth among prevalent cancers worldwide and third in cancer-related deaths.Despite diagnostic advancements, prognosis remains challenging.Traditional methods rely on postoperative pathology, limiting preoperative decision-making.Radiomics offers a solution by extracting imaging data to predict outcomes before surgery, aiding personalized treatment decisions. Materials & Methods:A PubMed search spanning from May 2019 to June 2024 was conducted to identify relevant peer-reviewed articles using the keywords: "radiomics," "MRI," "hepatocellular carcinoma," "HCC," "radiomics features," "liver cancer imaging," "tumor segmentation," "treatment response," and "HCC prognosis."The search yielded a total of 850 articles.After an initial screening based on titles and abstracts, 150 full-text articles were reviewed, and 35 articles were selected for inclusion in this review.The review focused on highlighting the utility of radiomics features on MRI across various aspects of HCC management.Results: This review highlights MRI radiomics' extensive utility in managing HCC.It aids in diagnosis, treatment decision-making, and prognosis prediction by analyzing imaging data noninvasively.MRI radiomics informs differential diagnosis, histological grading, microvascular invasion assessment, gene expression prediction, therapeutic monitoring, and prognostic evaluation.Its transformative potential offers clinicians a comprehensive toolset for personalized care and improved patient outcomes in HCC management.Conclusion: MRI radiomics holds promise as a noninvasive tool for improving the diagnosis and treatment of HCC.Its ability to extract comprehensive imaging data enables clinicians to make personalized treatment decisions, potentially improving patient outcomes.Further research and clinical validation are warranted to fully integrate MRI radiomics into routine clinical practice for HCC management.

Pancreatic cancer, particularly pancreatic ductal adenocarcinoma (PDAC) and pancreatic neuroendocrine tumors (PNETs), remains one of the deadliest malignancies in gastrointestinal oncology. PDAC is characterized by late diagnosis, rapid progression, and limited resectability, with only 20% of cases eligible for surgery at diagnosis. Standard treatments involve surgical resection and adjuvant or neoadjuvant chemotherapy, yet metabolic reprogramming and oncogene interactions contribute to treatment resistance. Surgical innovations, including minimally invasive pancreatoduodenectomy (MIPD), fluorescence-guided resection, and robotic-assisted techniques, have improved perioperative outcomes but require further validation for long-term survival benefit. The functional PNETs also demand targeted resection, whereas the management of the non-functional tumor less than 2 cm is still debatable. ICG-surgical INDO fluorescence surgery is a promising way of enhancing visualization and cytectasis, although it is not as widely standardized. Systemic treatment has evolved with regimens such as FOLFIRINOX, gemcitabine combinations, and targeted therapies for patients with BRCA or KRAS mutations. The targeting and minimization of systemic toxicity is achieved through nanoparticle-based drug delivery systems and exosomes. Non-coding RNA-targeted and immunotherapy are also being implemented to eliminate resistance and enhance efficacy. Non-resectable tumors can be treated with ablation techniques (RFA, MWA, IRE, cryoablation) and brachytherapy, whereas intraoperative radiotherapy (IORT) provides better local control. Despite the gains made, the high rates of recurrence and drug resistance still need the use of treatment strategies that combine different methods and are tailored for each patient. The future of clinical practice re-quires using fluorescence navigation, novel ablation methods, and nanomedicine. Imaging techniques, surgical methods, and molecular advancements have improved precision, which is promising for better outcomes in this potentially lethal disease. Further randomized trials are needed to refine these approaches and optimize their impact on survival and quality of life in patients with pancreatic cancer.

According to increasing evidence, high-density lipoproteins (HDLs) may raise prostate-specific antigen (PSA) levels in the prostate. The link between HDL-cholesterol (C) and PSA, on the other hand, is debatable and challenging. Hence, the present study examined the relationship between HDL-C and PSA in men using the National Health and Nutrition Examination Survey (NHANES) database. NHANES data were extracted for five cycles from 2001 to 2010. The data used for analysis included PSA concentrations, sociodemographic and laboratory data. After the screening, 6,669 out of 52,195 participants were included in the present study. Participants were divided into four groups based on HDL-C quartiles. Categorical and continuous variables using weighted chi-square tests and linear regression models were analysed to compare differences between groups. A total of three weighted multivariate linear regression models were constructed and the association between HDL-C and PSA using a smoothed curve fit was assessed. In the present study, unadjusted and adjusted multivariate linear regression models revealed a significant positive association between PSA concentrations and serum HDL-C levels. Specifically, each unit increase in HDL-C ratio was associated with an increase in PSA concentration by 0.470 ng/ml (P<0.001) in the unadjusted model. In minimally adjusted models, accounting for socioeconomic and demographic factors, this association remained significant, with an increase of 0.408 ng/ml per unit increase in serum HDL-C (P<0.001). Furthermore, the stratified analysis revealed various impacts based on socioeconomic status and HDL-C levels, with a significant interaction between household income and HDL-C levels (P=0.037). Exclusion of subjects with low HDL-C levels strengthened the association, revealing a significant increase in PSA concentration with higher HDL-C levels (0.50 ng/ml per 1 mmol/l increase, P=0.009). The findings of the present study suggest a nuanced relationship between HDL-C levels, socioeconomic factors, and PSA concentrations, highlighting the potential importance of considering these factors in prostate cancer (Pca) screening and risk assessment. The present study found a positive association between serum HDL-C and PSA concentrations in adult men in the United States without a Pca diagnosis.

RATIONALE: Lipomatous tumors are rare in the pediatric population. Lipomatous tumors may develop at any location throughout the body; however, they are highly uncommon in the retroperitoneal area. Lipomatous tumors represent the predominant category of soft-tissue neoplasms. Only 3 cases of pediatric retroperitoneal lipoma have been reported since 1980. We report a benign retroperitoneal lipomatous tumor and the literature compilation of benign retroperitoneal lesions. PATIENT CONCERNS: A 2-year-old South Asian female presenting with 13 months of increasing abdominal distention and intermittent fever was referred to our hospital. The child had no trauma or gastrointestinal symptoms like vomiting, diarrhea, or constipation. DIAGNOSES: An abdominal ultrasound showed a large, echogenic mid-abdomen tumor. The tumor obscured the bowel without calcification or fat necrosis. A color Doppler scan indicated no blood flow in the lesion. The computed tomography scan of the neck, chest, and abdomen with IV contrast showed a well-circumscribed, non-enhancing, heterogeneous hypodense mass from the left hypochondrium to the pelvis on the left abdominal region. The mass measured 18.4 × 14.8 × 13.6 cm, and its Hounsfield units ranged from -66 to -90, indicating adipose tissue. Histopathology showed a benign lipoma made of mature fat cells and thinsultory fibrils with no malignancy, cellular atypia, or necrosis. INTERVENTIONS: The patient had surgical resection via laparotomy, achieving complete resection with negative margins. OUTCOMES: The patient was discharged on the 4th day after the procedure, after an uneventful recovery. After 6 weeks, the child was asymptomatic in follow-up. LESSONS: The long-term prognosis of the retroperitoneal lipoma among children remains inadequately characterized relative to adults due to a small number of cases. Current literature suggests magnetic resonance imaging, computed tomography scan, and FISH are the most suitable diagnostic options. Extended follow-up is essential in pediatric patients.

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Cholelithiasis, or gallstone disease, is a common gastrointestinal disorder with significant global health implications. Recent studies have suggested a potential association between Helicobacter pylori (H. pylori) infection and the development of cholelithiasis. This meta-analysis aims to synthesize the latest evidence on the role of H. pylori as a risk factor for cholelithiasis. A comprehensive literature search was conducted, and studies published between 2018 and 2023 were included. The results indicate a significant association between H. pylori infection and an increased risk of cholelithiasis, with potential mechanisms involving chronic inflammation, altered lipid metabolism, and bile composition changes. This analysis underscores the need for further research to elucidate the causal relationship and explore therapeutic implications.

Ovarian cancer is the deadliest and most common gynecological cancer, with a significant incidence and variety worldwide.It ranks eighth among the leading causes of cancer mortality, with 151900 deaths, and seventh among the leading cancer diagnoses among women, with 238700 new cases worldwide.The objective of this study is to identify the characteristics of ovarian cancer.The prognosis and clinical management of ovarian cancer depend on the cancer's stage.Approximately sixty percent of ovarian cancer patients have a metastatic illness by the time they are diagnosed; the early stages of the disease are often asymptomatic.The analysis involved three hundred clinical cases of ovarian cancer collected at the third affiliated hospital of Xinjiang Medical University in China.The analytical process entailed using the Statistical Package for the Social Sciences (SPSS) due to the large dataset.The study found that patients aged between forty and fifty-nine are the most vulnerable to ovarian cancer incidence.Malignant ovarian tumors (moderately differentiated adenocarcinoma) had the highest prevalence within the provided sample.

Letter to Editor: Unraveling the Complexity of Spleen Evaluation: A Critical Analysis of Ultrasonography Studies

Dear Editor, I would like to share my professional opinion on the case report authored by Emre Berat Akçay, Kadir Çorbacı, and Ali Sürmelioğlu (1), published in the Journal of Izmir Faculty of Medicine, 2024; 3(1): 61-65. Firstly, I want to thank the authors for their valuable contribution to the field. Their case report presents two instances of paraduodenal hernias (PDH), highlighting the challenges in diagnosing and managing this rare condition. The report underscores the importance of maintaining a high level of clinical suspicion, especially in patients with recurrent hospitalizations for unexplained abdominal pain or signs of intestinal obstruction.

Somalia, a country located in the Horn of Africa, has long grappled with significant healthcare challenges exacerbated by decades of conflict, instability, and underdevelopment. In 2024, despite ongoing efforts to rebuild its healthcare system, Somalia continues to face multifaceted healthcare issues that hinder the delivery of essential services to its population. This report aims to provide an in-depth analysis of the current state of healthcare in Somalia, focusing on challenges, recent advancements, and potential solutions. Somalia’s healthcare system is characterized by a fragile infrastructure, inadequate resources, and a shortage of skilled healthcare professionals. The country’s healthcare services are predominantly provided by non-governmental organizations (NGOs) and international agencies, with limited government capacity to deliver healthcare at the national level. Access to healthcare remains a significant challenge in Somalia, particularly in rural and conflict-affected areas. Factors such as geographic barriers, insecurity, and financial constraints impede individuals’ ability to seek and receive healthcare services.1 Somalia’s healthcare infrastructure is severely underdeveloped, with many healthcare facilities lacking essential resources such as medical equipment, medications, and trained personnel. The quality of healthcare services varies widely across regions, with urban areas generally having better-equipped facilities compared to rural areas. Infectious diseases such as malaria, cholera, and measles continue to pose significant public health threats in Somalia. Weak disease surveillance systems, inadequate access to clean water and sanitation facilities, and population displacement contribute to the spread of communicable diseases.2Somalia’s maternal and child health indicators are among the poorest globally, with high maternal and child mortality rates attributed to limited healthcare access, and cultural and socio-economic factors. Recent years have seen the emergence of telemedicine and mobile health initiatives in Somalia, leveraging technology to improve access to healthcare services, particularly in remote and underserved areas. Mobile health applications and teleconsultation services enable individuals to receive medical advice and consultations remotely, overcoming barriers to access. International partnerships and humanitarian assistance play a vital role in supporting healthcare delivery in Somalia. Organizations such as the World Health Organization (WHO), UNICEF, and Médecins Sans Frontières (MSF) provide essentialmedical supplies, healthcare training, and support for healthcare facilities in the country. Community-based healthcare initiatives, including community health workers and outreach programs, are instrumental in delivering healthcare services at the grassroots level.3These initiatives focus on health education, disease prevention, and maternal and child health, addressing healthcare needs within local communities. Investments in healthcare infrastructure, training, and capacity building are crucial for improving healthcare delivery in Somalia, including upgrading facilities, providing resources, and expanding coverage to underserved areas. Training programs in Somalia should enhance clinical skills, promote evidence-based practices, and strengthen healthcare management while empowering communities through health education, mobilization, and participatory decision-making processes. Engaging communities in healthcare planning and implementation ensures that interventions are culturally appropriate and responsive to local needs. Enhancing disease surveillance systems and improving outbreak response capacity are crucial for controlling infectious diseases in Somalia. This includes strengthening laboratory capacity, training healthcare workers in disease surveillance and reporting, and enhancing coordination among healthcare stakeholders. The healthcare challenges facing Somalia are complex and multifaceted, requiring coordinated efforts from the government, civil society, and the international community to address them effectively. By prioritizing investments in healthcare infrastructure, strengthening healthcare systems, and empowering communities, Somalia can make significant strides toward improving healthcare access and outcomes for its population.

Dear Editor, I would like to share my opinion on the article titled "Survival-effective Prognostic Factors of Rectal Cancer Patients Receiving Neoadjuvant Chemoradiotherapy," published in the Cerasus Medical Journal, Volume 1, Issue 2, pages 117-123, on June 14, 2024. The article was authored by Orhun Uzun et al [1]. Firstly, I want to thank the authors for their contribution to the field. The study's objective was clear: to identify survival-effective prognostic factors in this patient population. As mentioned by the researchers, they utilized a retrospective review of 102 patients who underwent surgery for rectal cancer at a single institution, ultimately including 84 patients in the analysis after applying exclusion criteria. While the study’s objective is well-defined, its design and scope present certain limitations that affect the strength and applicability of its conclusions.

Objective: This study examines the use of CP in Somaliland schools and the psychological and behavioral impact of this practice on students as well as the impact of the practice on the performance of the student. Methods: This study used a qualitative study design in which a structured questionnaire was used to collect the necessary data regarding the study subject matter, and the data were analyzed via SPSS version 20 (IBM SPSS Corp., Armonk, NY, USA) Results: This study revealed a shocking prevalence of corporal punishment among Somaliland students. The study also demonstrated a strong link and statistical significance between corporal punishment and the psychological state of the students, as well as a positive relationship between corporal punishment and the behavior of the student. However, regarding the performance of the student, the study failed to find a reasonable statistical significance between this parameter and corporal punishment. Conclusion: There is a strong correlation between corporal punishment and the adverse psychological effects discussed in this study. The study also revealed a strong relationship between corporal punishment and the possible behavior issues of the pupils. The study highlighted a drawback of corporal punishment and a shift to alternatives among schools in Somaliland. Such alternatives may include positive reinforcement, rewarding good behavior, guidance and counseling, involving parents, time-outs, detentions, suspensions, motivations, recognition and praise tactics, revoking or taking away privileges, use of assignments and additional tasks such as punishment, and many other known methods as alternatives to corporal punishment.

Ovarian cancer is the deadliest and most common gynecological cancer, with a significant incidence and variety worldwide.It ranks eighth among the leading causes of cancer mortality, with 151900 deaths, and seventh among the leading cancer diagnoses among women, with 238700 new cases worldwide.The objective of this study is to identify the characteristics of ovarian cancer.The prognosis and clinical management of ovarian cancer depend on the cancer's stage.Approximately sixty percent of ovarian cancer patients have a metastatic illness by the time they are diagnosed; the early stages of the disease are often asymptomatic.The analysis involved three hundred clinical cases of ovarian cancer collected at the third affiliated hospital of Xinjiang Medical University in China.The analytical process entailed using the Statistical Package for the Social Sciences (SPSS) due to the large dataset.The study found that patients aged between forty and fifty-nine are the most vulnerable to ovarian cancer incidence.Malignant ovarian tumors (moderately differentiated adenocarcinoma) had the highest prevalence within the provided sample.

In low-income healthcare settings, the implementation of informed consent faces significant challenges despite its pivotal role in upholding patient autonomy and dignity. A study conducted in southeastern Nigeria at the University of Nigeria Teaching Hospital sheds light on these challenges, particularly concerning patient satisfaction and recall of critical information post-consent. While many patients recalled details about their medical condition and planned procedures, there was notably lower recall of associated risks, emphasizing the complexity of conveying risk-related information effectively. Importantly, the study reveals a correlation between patient satisfaction with the consent process and their subsequent recall of information, underlining the intrinsic link between patient engagement, satisfaction, and comprehension. To bridge this gap, tailored communication methods and addressing patient concerns are essential. Systemic deficiencies in the consent process, including generic forms and linguistic barriers, call for interventions such as culturally sensitive consent materials and capacity building for healthcare providers. Looking forward, innovative approaches, including pictorial aids and mobile health applications, should be explored, alongside longitudinal studies to assess their impact. Ultimately, prioritizing patient satisfaction and comprehension in the consent process is crucial for upholding ethical standards in healthcare delivery, even amidst resource constraints.

Abstract Background: According to growing evidence, high-density lipoproteins (HDLs ) may raise PSA levels in the prostate. The link between HDL-C and PSA, on the other hand, is debatable and challenging. Hence, this research examined the relationship between HDL-C and PSA in men using the National Health and Nutrition Examination Survey (NHANES) database. Methods: We extracted NHANES data for five cycles from 2001 to 2010. The data used for analysis included PSA concentrations, sociodemographic data, and laboratory data. After the screening, 6,669 of 52,195 participants were included in the study. Participants were divided into 4 groups based on HDL-C quartiles. We analyzed categorical and continuous variables using weighted chi-square tests and linear regression models to compare differences between groups. We constructed 3 weighted multivariate linear regression models and assessed the association between HDL-C and PSA using a smoothed curve fit. Results: In our study, unadjusted and adjusted multivariate linear regression models revealed a significant positive association between prostate-specific antigen (PSA) concentrations and serum high-density lipoprotein cholesterol (HDL-C) levels. Specifically, each unit increase in HDL-C ratio was associated with an increase in PSA concentration by 0.470 ng/mL (P < 0.001) in the unadjusted model. In minimally adjusted models, accounting for socioeconomic and demographic factors, this correlation remained significant, with an increase of 0.408 ng/mL per unit increase in serum HDL-C (P < 0.001). Furthermore, the stratified analysis revealed various impacts based on socioeconomic status and HDL-C levels, with a significant interaction between household income and HDL-C levels (P = 0.037). Exclusion of subjects with low HDL-C levels strengthened the association, showing a significant increase in PSA concentration with higher HDL-C levels (0.50 ng/mL per 1 mmol/L increase, P = 0.009). Our findings suggest a nuanced relationship between HDL-C levels, socioeconomic factors, and PSA concentrations, highlighting the potential importance of considering these factors in prostate cancer screening and risk assessment. Conclusion: This study found a positive association between serum HDL-C and PSA concentrations in adult men in the United States without a prostate cancer diagnosis. Moreover, People with low HDL-C are more likely to be diagnosed with prostate cancer in the late stage of the disease. Hence, people with high levels of HDL-C should be tested for PSA to help early detection of prostate cancer.

In the bustling corridors of hospitals and the serene confines of clinics, healthcare professionals stand as pillars of strength and compassion, dedicated to healing others. Yet, behind the façade of white coats and stethoscopes lies a silent crisis that demands urgent attention the alarming prevalence of suicide among healthcare workers.

Dear Editor, I would like to share my opinions on the article “Exploring Perspectives on Cancer Screening in People Aged 30-70: A Comparative Study of Those with and Without Type 2 Diabetes,” published in the Konuralp Medical Journal (2024;16(1):26-31). First and foremost, I commend the authors for their significant contributions to the field, addressing a topic of critical importance to physicians engaged in cancer research. This study, which investigates attitudes and behaviors towards cancer screening in individuals with and without type 2 diabetes mellitus (T2DM), is particularly notable for its potential public health implications given the increased cancer risk associated with diabetes (1).

COVID-19 is a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that began in Wuhan, China, in late 2019 and has since spread globally, disrupting efforts to contain it. In Africa, the COVID-19 infection may be influenced by malaria coinfection. Global health is severely hampered by the co-infection of COVID-19 and malaria, especially in areas where both illnesses are endemic. Studies that have already been conducted indicate that those who have co-infection may have more severe symptoms and a higher risk of dying, even though there is little information on the prevalence and consequences of co-infection. More studies and focused initiatives are required to address this issue because of the difficulties in diagnosing the two diseases and the possibility that co-infection would worsen already existing health inequities. Methodology: This review follows the guidelines of PRISMA. In this article, we reviewed published articles from 2019 to May 2023 on COVID-19 and malaria co-infection that might influence the ontology of COVID-19. Results: Sub-Saharan African countries have fewer COVID-19 cases due to factors like young populations, warm weather, lack of proper diagnosis, malaria history, and antimalarial drug use. Population genetics also influence COVID-19 dynamics. Clinical and pathological similarities between malaria and COVID-19 have confused diagnosis and treatment in Africa. Conclusion: Understanding the dynamics of COVID-19 infection in Sub-Saharan Africa and how another endemic disease like malaria shapes it can provide insights into how to tailor successful diagnostic, intervention, and control plans that lower disease morbidity and mortality. Coinfection with COVID-19 and malaria is related to expanded all-cause in-hospital mortality compared to mono-infection with serious acute respiratory disorder coronavirus 2 (SARS-CoV-2).