The Impact of Cigarette Smoking, Water-Pipe Use on Hearing Loss/Hearing Impairment: A Cross-Sectional Study.

OBJECTIVE: The aim of the present study was to determine the association between cigarette smoking, waterpipe smoking, and co-morbidity diseases on hearing loss. METHODS: A cross-sectional study was conducted among 1015 patients [386 males (38%) and 629 females (62%)] who were aged are between 25 and 65 years. The study used clinical, physical examinations and Pure-Tone Audiometry (PTA) to assess hearing. Univariate and multivariate stepwise logistic regression analyses were used for the statistical analysis. RESULTS: Out of 1015 patients assessed, 199 were cigarette smokers with hearing loss (21.6%) and 111 waterpipe smokers with hearing loss (12%). There were statistically significant differences between cigarette smokers with hearing loss regarding (p<0.001), gender (p<0.001), BMI (p<0.001), hypertension (p<0.001), tinnitus (p<0.001), vertigo and/or dizziness (p<0.001), and migraine/headaches (p<0.001). Also there were statistically significant differences between waterpipe smokers with hearing loss, none smokers concerning age groups (p<0.001), BMI (p<0.001), using MP3 players (p=0.004), family history of hypertension (p=0.026), ATP III metabolic syndrome (p=0.010), IDF metabolic syndrome (p=0.012), tinnitus (p<0.001), vertigo/dizziness (p<0.001), and migraine/headaches (p=0.025). Multivariate stepwise logistic regression analysis indicated that tinnitus (p<0.001), dizziness (p<0.001), nausea (p=0.001), headaches and migraine (p<=0.003), fatigue (p=0.004), and vertigo (p=0.022) were considered as risk predictors risk hearing loss related cigarette smokers. Also, analysis revealed that tinnitus (p<0.001), nausea (p=0.001), headaches and migraines (p<0.001), Type 2 diabetes mellitus (p<0.001), and vertigo (p=0.021), were considered as risk predictors for hearing loss related waterpipe smokers. CONCLUSION: The present study suggests cigarette smoking and waterpipe smoking, life-style factors are possible risk factors for hearing loss among smoker participants.

Analysis of radiological measurement parameters that can predict the type of treatment to be applied in odontoid fractures: Clinical research.

Introduction: Although various conservative and surgical treatment methods have been proposed, treatment options for patients with odontoid fractures remain controversial. This study was conducted to determine some demographic and radiological measurement parameters that can predict treatment options in patients with odontoid fractures. Materials and Methods: The patients were separated into the surgery (-) group (n = 9) and the surgery (+) group (n = 10). Patient data were recorded of age, gender, type of odontoid fracture, morphological measurement results obtained from computed tomography images, treatment regimens, duration of stay in the hospital, and mortality rate. In the operating room, a halo-vest corset or Philadelphia-type cervical collar was applied to the surgery (-) patients after the reduction of the fracture under fluoroscopy. Anterior odontoid lag screw fixation was performed on surgery (+) patients. Results: The amount of displacement of the fractured odontoid, the distance between the C1 vertebra and the odontoid process, the angle between the posterior wall of the odontoid process and the posterior wall of the clivus, the slip angle, and the anterior to posterior width of the spinal canal were not different between the groups. No difference was determined between the groups in respect of the amount of lateral displacement of the odontoid process in the spinal canal in the axial plane and the angle of the fractured odontoid process with the C2 vertebral body. Conclusion: This preliminary study showed that the demographic data and radiological measurement parameters analyzed in the present study could not be used as predictive markers either in decision-making for treatment modality or mortality risk.

Investigation of the Efficacy of Bilateral Osteoligamentous Decompression via Hemilaminectomy in Cervical Spondylotic Myelopathy: A Clinical Study.

OBJECTIVE: Cervical stability may deteriorate and kyphotic spinal deformities may develop in cervical spondylotic myelopathy (CSM) after laminectomy or laminoplasty. This study aimed to investigate the therapeutic efficacy of the "bilateral osteoligamentous decompression via unilateral hemilaminectomy approach (UHBOLD)" technique in CSM patients. METHODS: The study included 34 adult patients who underwent UHBOLD surgery for CSM between 2016 and 2022. A record was made for all patients of age, gender, number of operated levels, preoperative and postoperative long-term follow-up VAS scores, Nurick grade values and mJOA scores, kyphosis angles measured on X-ray, and spinal canal areas measured on T2-weighted MR axial images. RESULTS: Preoperative VAS scores of the patients were 6 (4-9), Nurick grade values were 3 (2-5), mJOA scores were 10.50 ± 3.42, kyphosis angles were -13.34 ± 13.69° and spinal canal areas were 87.11 ± 28.30 mm2. In postoperative long-term follow-up of these patients, VAS scores were 2 (1-5), Nurick grade values were 1 (0-5), mJOA scores were 13.94 ± 3.09, kyphosis angles were -15.07 ± 12.78° and spinal canal areas were 149.65 ± 42.57 mm2. A statistically significant difference was determined between the preoperative and the postoperative long-term follow-up VAS scores, Nurick grade values, mJOA scores, and spinal canal areas (P < 0.001). Kyphosis angles were not different (P = 0.198), and no instability was observed in any patient in long-term follow-up. CONCLUSIONS: The UHBOLD technique performed in multilevel CSM patients did not cause any change in cervical lordosis angle in long-term follow-up, did not cause cervical kyphotic deformity or cervical instability, and significantly improved Nurick grade values, and VAS and mJOA scores.

Management of uncomplicated acute appendicitis during the COVID-19 pandemic: Appendectomy or non-surgical treatment?

BACKGROUND: This study aims to compare medical treatment and appendectomy in patients diagnosed with uncomplicated acute appendicitis during the COVID-19 pandemic. METHODS: Retrospectively analyzed were the data of 80 patients who received medical or surgical treatment for uncomplicated acute appendicitis between March 15, 2020, and August 31, 2020. The demographic characteristics of the patients, length of hospital stay, physical examination and radiology findings, laboratory results, and any complications were recorded. Patients were divided into two groups depending on the mode of treatment, as surgical and non-surgical. RESULTS: Forty patients were given medical treatment and 40 patients were directly operated on for appendicitis. Of the 40 patients who received medical treatment, 8 (20%) ended up requiring an operation due to recurrence. The mean duration of hospitalization was 2 days (range: 1-3), and the mean follow-up duration was 285.35±65.66 days (range: 101-379). The white blood cell count was significantly higher in the surgical group (p=0.004), and the length of hospital stay was longer in the non-surgical group (p<0.001). The prevalence of post-operative complications was similar for patients who underwent appendectomy directly on admission or after recurrence (p=1.000). Among the patients who received medical treatment, the most important predictors of requiring surgery were the red cell distribution width and increased appendix diameter in computed tomography (p<0.05). CONCLUSION: Medical treatment is an effective alternative in patients with uncomplicated appendicitis. Even in the case of a recurrence in follow-up, surgery due to a potential recurrence is not associated with an increased rate of complication compared to direct surgery.

Comparison of Handmade Endoloop Versus Polymeric Endoclip for Stump Closure in Laparoscopic Appendectomy.

Background Stump closure is an important stage of laparoscopic appendectomy. This study aimed to establish whether the handmade endoloop or polymeric endoclip method was more effective for stump closure in laparoscopic appendectomy. Methods The study included 76 patients who underwent laparoscopic appendectomy between October 2017 and January 2019. Patients' demographic characteristics, duration of surgery, length of hospital stay, and any complications were retrospectively recorded from files. Patients were divided into two groups according to stump closure method as polymeric endoclip and handmade endoloop. Results Among the patients, 59.2% (n = 45) were male and 40.8% (n = 31) were female. For stump closure, the polymeric endoclip method was used in 37 patients (48.7%) and the handmade endoloop method in 39 patients (51.3%). The two groups were not significantly different in terms of age and appendix diameter ( p=0.408, p=0.218). A total of four patients (5.3%) developed wound infection, including three from the handmade endoloop group and one from the polymeric endoclip group. One patient (1.3%) in the polymeric endoclip group developed ileus. The two groups were also not significantly different in terms of complications (p = 1.000). Conclusion We conclude that both stump closure methods are safe, and the more easily accessible handmade endoloop method can be performed reliably in all hospitals, including secondary healthcare facilities such as small hospitals.

A rarely encountered case: A neuroendocrine tumor in strangulated Littre's hernia.

Littre's hernia is a rare condition that involves Meckel's diverticulum in the hernia sac. Meckel's diverticulum is the true diverticulum of the small intestine. Neuroendocrine tumors may develop in it; however, there are very few reported cases. In this study, we present a case of neuroendocrine tumor in strangulated Littre's hernia, on which we did not find a study when we reviewed the relevant literature. A 71-year-old male patient presented to our outpatient clinic with complaints of left groin pain and swelling in the groin. Acute abdomen findings were also present in the abdominal examination of the patient. The patient was operated on immediately and it was observed during the operation that the herniated Meckel's diverticulum was perforated. Segmental small intestine resection was performed. The pathology results of the patient revealed a well-differentiated neuroendocrine tumor with mucosal and submucosal localization in Meckel's diverticulum. We believe that if Meckel's diverticulum is found in the hernia sac in incarcerated hernias, it must be completely resected as a neuroendocrine tumor may develop, even if only rarely.

Some specific microbiological parameters and prevalence of salmonella spp. in retail chicken meat from erzurum province, turkey and characterization of antibiotic resistance of isolates / Alguns parâmetros microbiológicos específicos e prevalência de SalmonellA spp. cortes de carne de frango da província de Erzurum, Turquia e caracterização da resistência aos antibióticos de isolados

Specific microbiological parameters and the presence of Salmonella spp. were investigated in 72 chicken meat samples (36 wings and 36 drumsticks) collected from markets and butcher shops. The specific microbiological parameters were determined using a conventional cultural method and the presence of Salmonella spp. in chicken samples was determined using conventional and immunomagnetic separation (IMS)-polymerase chain reaction (PCR) methods. In addition, antimicrobial susceptibility of the isolates was revealed using the Kirby-Bauer disc diffusion method. The results indicated that 30 of the 72 samples were positive for Salmonella spp. by the conventional method, and 42 of the 72 were positive by the IMS-PCR method. However, 30 of the 72 samples were positive for Salmonella spp. by both methods. The Salmonella spp. isolates were confirmed by the VITEK2 Compact System and PCR. The susceptibilities of the isolates against 10 antibiotics were determined. The results indicated that isolates (27/30) showed the highest susceptibility to gentamycin (90.00%), while the highest resistance was to nalidixic acid and tetracycline at the 100 and 93.34% levels, respectively. These results indicate a high prevalence of Salmonella spp. in poultry meat from Erzurum city, Turkey, and the antimicrobial resistance profile of these isolates should be considered for public health. The results also show that the IMS-PCR technique was superior to the conventional method for detecting Salmonella in poultry meat.KEYWORDS:Chicken meat. Salmonella. IMS. PCR. Antimicrobial. INTRODUCTION Chicken is one of the most popular food products worldwide, because of nutritional, sensorial and economic factors. Chicken is widely consumed in homes and fast-food establishments, but can become contaminated during processing. The contamination of poultry products with Salmonella and other microorganismsis due to unhygienic conditions during the production, processing, distribution, marketing and preparationstages (DOOKERAN et al., 2012). The genus Salmonella includes short rod-shaped, facultative anaerobe, Gram-negative bacteria. Warm-blooded animals and humans are natural hosts for Salmonella spp. Detecting Salmonella spp. during production and before consumption is important to prevent food-borne salmonellosis. A Salmonella infection in humans is usually caused by consuming undercooked meat or other cross-contaminated foods, such as vegetables,milk and eggs (HASSANEIN et al., 2011). According to a report published by the Centres for Disease Control and Prevention (CDC), it is estimated that about 1.2 million people in the US have been exposed to Salmonella infections, and that an average of 23.000 hospitalisations and 450 deaths occur from these infections. The prevalence rates of Salmonella spp. in chicken meat sold in Turkey are 34-68.75%. Not only in Turkey, but in most developing countries, the absence of an epidemiological surveillance system for salmonellosis cases makes it difficult to effectively assess prevalence (KÄFERSTEIN, 2003). However, Received: 09/05/18 Accepted: 05/12/18

Parâmetros microbiológicos específicos e a presença de Salmonella spp. foram investigados em 72 amostras de carne de frango (36 asas e 36 baquetas) coletadas em mercados e açougues. Os parâmetros microbiológicos específicos foram determinados utilizando um método cultural convencional e a presença de Salmonella spp. em amostras de frango foi determinada utilizando métodos de reação em cadeia da polimerase (PCR) por separação convencional e imunomagnética (IMS). Além disso, a suscetibilidade antimicrobiana dos isolados foi revelada pelo método de difusão do disco de Kirby-Bauer. Os resultadosindicaram que 30 das 72 amostras foram positivas para Salmonella spp. pelo método convencional, e 42 das 72 foram positivas pelo método IMS-PCR. No entanto, 30 das 72 amostras foram positivas para Salmonella spp. por ambos os métodos. Os isolados de Salmonella spp. foram confirmados pelo sistema VITEK2 Compact e PCR. As susceptibilidades dos isolados a 10 antibióticos foram determinadas. Os resultados indicaram que os isolados (27/30) apresentaram maior suscetibilidade à gentamicina (90,00%), enquanto a maior resistência foi ao ácido nalidíxico e à tetraciclina nos níveis de 100 e 93,34%, respectivamente. Estes resultados indicam uma alta prevalência de Salmonella spp. em carne de frango da cidade de Erzurum, Turquia, e o perfil de resistência antimicrobiana desses isolados deve ser considerado para a saúde pública. Os resultados também demonstram que a técnica de IMS-PCR foi superior ao método convencional para detecção de Salmonella em carne de frango.

Multifocal multiphoton volumetric imaging approach for high-speed time-resolved Förster resonance energy transfer imaging in vivo.

In this Letter, we will discuss the development of a multifocal multiphoton fluorescent lifetime imaging system where four individual fluorescent intensity and lifetime planes are acquired simultaneously, allowing us to obtain volumetric data without the need for sequential scanning at different axial depths. Using a phase-only spatial light modulator (SLM) with an appropriate algorithm to generate a holographic pattern, we project a beamlet array within a sample volume of a size, which can be preprogrammed by the user. We demonstrate the capabilities of the system to image live-cell interactions. While only four planes are shown, this technique can be rescaled to a large number of focal planes, enabling full 3D acquisition and reconstruction.

Efficacy of Hyperbaric Oxygen Therapy in Diabetic Foot Ulcers Based on Wagner Classification.

Diabetic foot ulcer is a common chronic complication of diabetes mellitus. In addition to conventional primary therapy, there are adjuvant therapy methods such as hyperbaric oxygen therapy for the healing of diabetic foot ulcer wounds. The present study aimed to determine the efficacy of hyperbaric oxygen therapy in diabetic foot ulcers based on Wagner classification. It was performed retrospectively from prospectively collected data. One hundred thirty patients with diabetic foot ulcers were assessed in 2 groups: 1 group received hyperbaric oxygen therapy; the other group did not. Patients were examined according to age, sex, ulcer grade based on Wagner classification; ulcer healing status; whether hyperbaric oxygen therapy was received; duration of diabetes in years; HbA1C, sedimentation, C-reactive protein levels; and presence of accompanying diseases, including peripheral arterial disease, chronic obstructive pulmonary disease, hypertension, chronic kidney disease, neuropathy, and retinopathy. The mean follow-up period was 19.5 ±â€¯4.45 months (range 12 to 28 months). Seventy-one (54.6%) patients received hyperbaric oxygen therapy, and 59 (45.4%) patients did not. All patients in Wagner grade 2 healed in both groups. In the group that received hyperbaric oxygen therapy for grade 3 and 4 patients, 35 (87.5%) and 11 (84.6%) healed, respectively. In total, 60 (84.5%) patients in the group that received hyperbaric oxygen therapy healed. The subgroup comparison conducted according to Wagner classification revealed no differences between the 2 groups of grades 2 and 5 patients. It also revealed that treatment had higher levels of efficacy in the healing of ulcers in grade 3 and 4 patients.

Cerebral ischaemia/reperfusion injury could be managed by using tramadol.

OBJECTIVES: No valid treatment modality that will repair stroke damage and provide neurological recovery has yet been identified in literature. Studies demonstrated that adequate quality of life could be provided if post-stroke pain could be treated sufficiently and timely. Besides its pain relief effects, tramadol has oedema-reducing and anti-inflammatory properties. With these in mind, this study investigated the influence of tramadol in acute and/or chronic ischaemia/reperfusion (I/R) injury. METHODS: Putting aside the Control group, 23 Wistar albino rats were distributed to four groups to investigate the acute (Sham-A, TR-A) and chronic (Sham-C, TR-C) periods of I/R injury, and temporary aneurysm clips were applied to their internal carotid arteries for 30 min. Four hours after clippage, tramadol was administered to animals of TR-A and TR-C groups intraperitoneally. After sacrificing all animals, pyknotic and necrotic neuronal cells in hippocampal cornu ammonis (CA)1, CA2, CA3 and parietal cortical regions were counted, and perivascular oedema, intercellular organization disorder (IOD) and inflammatory cell infiltration were scaled histopathologically. Additionally, tissue interleukin (IL)-1ß, IL-10, malondialdehyde, nitric oxide, tumour necrosis factor-α, caspase-3, beclin-1, Atg12, LC3II/LC3I levels were measured biochemically. RESULTS: Tramadol could minimize perivascular oedema, IOD, parietal and hippocampal neuronal necrosis, inflammatory cell infiltration in both periods of I/R injury histopathologically. Apart from inhibiting apoptosis and enhancing autophagy, tramadol had no influence on any other biochemical result. DISCUSSION: Tramadol can ameliorate the histopathological structure of ischaemic tissue in both periods of I/R injury in rat. We suggest further research investigating various dosages with different administration methods of tramadol in stroke should be conducted by adopting different explorative techniques.

Clinical course of incidental parathyroidectomy: Single center experience.

OBJECTIVE: Thyroidectomy is a very common surgical procedure. Regardless of surgeon experience, incidental parathyroidectomy is a complication of thyroidectomy. The aim of this study was to identify the clinical course of incidental parathyroidectomies after thyroidectomy. METHODS: Patients who underwent thyroidectomy between January 2010 and June 2014 were evaluated retrospectively. Pathology reports were reviewed for the presence of parathyroid tissue in the thyroidectomy pathology specimens. Information regarding demographic, laboratory variables, operative details, and postoperative complications were collected. RESULTS: Incidental parathyroidectomy was found in 178 out of 3022 patients who had thyroidectomy (5.8%). Types of surgeries performed for 178 patients were total thyroidectomy (TT) in 132(74.2%) cases, TT and central lymph node dissection(CLND) in 30 (16.9%) cases, lobectomy in seven cases (3.9%), completion thyroidectomy in five (2.8%) patients and modified cervical lymph node dissection in four (2.2%)patients. One and two parathyroid glands were accidentally removed in 152 (85.3%) and 26 (14.7%) patients, respectively. In the entire series, biochemical temporary postoperative hypocalcemia occurred in 75(42.1%) patients and permanent hypocalcemia occured in 12 (6.7%) patients with incidental parathyroidectomy. There was not a statistically significant difference regarding the occurrence of postoperative permanent hypocalcemia between the patients who had incidental parathyroidectomy of one gland and the patients with two incidental parathyroidectomies (p=0.114). CONCLUSION: Incidental parathyroidectomy is not uncommon during thyroidectomy. No association between inadvertent parathyroidectomy and postoperative permanent hypocalcemia was found.

Effects of Sulphasalazine in Cerebral Ischemia Reperfusion Injury in Rat.

BACKGROUND: Management of cerebral ischemia/reperfusion (I/R) injury is still difficult process today. AIMS OF THE STUDY: Aim of present study was to investigate therapeutic properties of sulfasalazine in cerebral transient I/R injury in rat. METHODS: Except Control group (n = 5), 20 Wistar albino rats were allocated for acute and chronic stage investigation of I/R injury, and temporary aneurysm clips were attempted to both internal carotid arteries for thirty min. Four hours later, 40 mg/kg once a day sulfasalazine was administered to animals of SL-A and SL-C groups, orally. Animals were decapitated, following which pyknotic and necrotic neuronal cells, perivascular edema, irregularities of intercellular organization (IIO) of hippocampal regions, and cortical necrotic neurons of parietal lobe were counted or scaled histopathologically. Tissue malonyldialdehyde (MDA), myeloperoxidation (MPO), total nitrite/nitrate (NO), interleukin 1-beta (IL-1ß), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) level values were evaluated biochemically. RESULTS: Sulfasalazine could reduce perivascular edema, IIO, cortical and hippocampal neuronal cell death in both stages. It could decrease MDA in acute stage, but not reduce IL-1ß, IL-6, MPO, NO, and TNFα levels. It could increase IL-1ß levels in chronic stage but not affect to IL-6, MPO, MDA, NO, TNF-α levels. CONCLUSION: Sulfasalazine could improve histopathological architecture of hypoxic tissue in both stages of I/R injury in rat. It could inhibit lipid peroxidation cascades just in acute stage. These results suggested that therapeutic mechanisms of sulfasalazine in cerebral I/R injury should be investigated by using more specific laboratory methods in future studies.

New high-speed centre of mass method incorporating background subtraction for accurate determination of fluorescence lifetime.

We demonstrate an implementation of a centre-of-mass method (CMM) incorporating background subtraction for use in multifocal fluorescence lifetime imaging microscopy to accurately determine fluorescence lifetime in live cell imaging using the Megaframe camera. The inclusion of background subtraction solves one of the major issues associated with centre-of-mass approaches, namely the sensitivity of the algorithm to background signal. The algorithm, which is predominantly implemented in hardware, provides real-time lifetime output and allows the user to effectively condense large amounts of photon data. Instead of requiring the transfer of thousands of photon arrival times, the lifetime is simply represented by one value which allows the system to collect data up to limit of pulse pile-up without any limitations on data transfer rates. In order to evaluate the performance of this new CMM algorithm with existing techniques (i.e. rapid lifetime determination and Levenburg-Marquardt), we imaged live MCF-7 human breast carcinoma cells transiently transfected with FRET standards. We show that, it offers significant advantages in terms of lifetime accuracy and insensitivity to variability in dark count rate (DCR) between Megaframe camera pixels. Unlike other algorithms no prior knowledge of the expected lifetime is required to perform lifetime determination. The ability of this technique to provide real-time lifetime readout makes it extremely useful for a number of applications.

Small Intestinal and Mesenteric Multiple Gastrointestinal Stromal Tumors Causing Occult Bleeding.

Gastrointestinal stromal tumors are the meseancymal neoplasms which may involve any part of gastrointestinal tract. C-Kit and platelet derived factor receptor alpha polypeptide are believed to be responsible for the genetic basis. This case presentation aimed to discuss the diagnostic and therapeutic modality of multiple small intestinal, omental, and mesenteric GISTs with different sizes which caused occult bleeding in a 43-year-old male patient.

Report of a rare case: Double recurrent laryngeal nerve.

One of the most important and feared complications of thyroid and parathyroid surgery is injury to the recurrent laryngeal nerve. The main reason for this type of injury is anatomical variations. Currently, nerve monitoring is being widely used to reduce complications due to the high variation rate. However, it is not being used extensively in our country, due to cost related issues. In this case, we present a left sided double recurrent laryngeal nerve.

High serum cancer antigen 125 level indicates perforation in acute appendicitis.

BACKGROUND: The diagnosis of acute appendicitis is sometimes challenging, and prompt evaluation is required because of the risk of complications if not treated appropriately. AIM: We aimed to evaluate whether cancer antigen 125 (CA-125) has diagnositic accuracy and predictor of the severity in acute appendicitis. RESULTS: Sixty patients with acute appendicitis were recruited prospectively in this study between May 2014 and March 2015. Blood samples were obtained to measure CA-125 levels before appendectomy. Of the 57 patients, 10 had perforated or gangrenous appendicitis intraoperatively. The CA-125 levels were significantly higher in patients with perforated or gangrenous appendicitis than patients with uncomplicated appendicitis (49.9 vs 10.5 U/mL, P=.000). CONCLUSIONS: Cancer antigen 125 levels in patients with highly suspected or confirmed appendicitis could help clinicians determine the severity of the disease.

Spontaneous Rectus Sheath Hematoma: an Overview of 4-Year Single Center Experience.

Rectus sheath hematoma is a clinical entity characterized by the presence of blood within rectus abdominis muscle sheath. The aim of this study was to analyze clinical characteristics, diagnostic approach, treatment strategy, and outcomes of patients with rectus sheath hematoma. Patients diagnosed and treated for spontaneous rectus sheath hematoma between March 2010 and March 2014 were included in the study. A total of 10 patients were diagnosed as spontaneous rectus sheath hematoma. The mean age was 66.5 ± 16.9 years, and the mean hospital stay was 4.4 ± 1.8 days. There was no mortality. Six patients were using anticoagulant or antiplatelet agents. Eight patients recovered after conservative treatment. Two patients underwent surgery. Spontaneous rectus sheath hematoma is associated with anticoagulant therapy. Cases with abdominal pain and a non-pulsatile abdominal mass particularly in elderly women should be kept in mind. Treatment is mostly based on supportive care to preserve hemodynamic stability.

Intrasellar epidermoid cyst presenting as pituitary apoplexy.

We herein present a patient with intrasellar epidermoid cyst presenting as pituitary apoplexy, who was operated upon with a trans-sphenoidal approach. The clinical presentation, radiological and histological differential diagnosis and type of surgical intervention for intrasellar epidermoid cysts are discussed.