We aimed to examine independent predictive factors for the severity and survival of COVID‐19 disease, from routine blood parameters, especially the blood urea nitrogen (BUN)/creatinine (Cr) ratio. A total of 139 patients with COVID‐19 were investigated at Siirt State Hospital. According to the disease severity, the patients were categorized as three groups (moderate: 85, severe: 54, and critical: 20). Then, patients were divided into two groups: nonsevere (moderate) and severe (severe and critical). Demographic, clinical data, and routine blood parameters were analyzed. In multivariate model adjusted for potential confounders BUN/Cr ratio (odds ratio [OR] = 1.70; 95% confidence interval [CI]: 1.20‐2.40; P = .002) and neutrophil to lymphocyte ratio (NLR) (OR = 2.21; 95% CI: 1.20‐4.30; P < .001) were independent predictive factors for disease severity. In multivariate Cox proportional hazard model BUN/Cr ratio (hazard ratio [HR] = 1.02; 95% CI: 1.01‐1.05; P = .030), and NLR (HR = 1.17; 95% CI: 1.06‐1.30; P = .020) were independent predictors for survival of COVID‐19 disease. The optimal thresholds of the BUN/Cr ratio at 33.5 and 51.7 had the superior possibility for severe disease and mortality, area under the curve (AUC) were 0.98 and 0.95, respectively. The optimal thresholds of NLR at 3.27 and 5.72 had a superior possibility for severe disease and mortality, AUC were 0.87 and 0.85, respectively. BUN/Cr and NLR are independent predictors for COVID‐19 patient severity and survival. Routine evaluation of BUN/Cr and NLR can help identify high‐risk cases with COVID‐19.

Background Dyspepsia is a common disorder in kidney transplant recipients, and the risk of post-transplant complications is increased in candidates with upper gastrointestinal disease. We evaluated gastrointestinal lesions of kidney transplant candidates on dialysis. Methods In this study, endoscopic and pathological findings in hemodialysis (HD) and peritoneal dialysis (PD) patients with gastrointestinal symptoms on the waiting list were compared. Results The most common non-ulcerous lesions in the endoscopic examination were gastritis (62.3%), erosive gastritis (38.7%), duodenal erosion or duodenitis (18.9%) and esophagitis (13.2%). The ulcerous lesion was present in only 3 patients. Gastroesophageal reflux disease, ulcerated lesion and non-ulcerated lesion rates were similar in both dialysis groups. Histopathological examination revealed Helicobacter pylori (HP) positivity in 28.3% of patients. HP positivity rate was significantly higher in PD patients than in HD patients (38.7% vs. 13.6%, p = 0.046). Chronic gastritis (75.5%) was the most common pathological finding. HP positivity rate was 37.5% in patients with chronic gastritis, but HP was negative in patients without chronic gastritis. In multivariate analysis, male gender, urea and albumin levels were associated with the presence of pathological chronic gastritis. The presence of gastritis, total cholesterol and ferritin levels were found significant for HP positivity. A total cholesterol > 243 mg/dL was significantly related to an increased risk of the presence of HP positivity. Conclusions Gastrointestinal lesions and HP infection are common in dialysis patients. Dialysis modality may affect the frequency of some lesions. It may be useful to have an endoscopic examination before entering the transplant waiting list for all candidates.

Introduction: This study aimed to determine the safety and efficacy of a modified technique for performing transurethral resection of the prostate (TURP) combined with percutaneous cystolithotripsy (PCCL). Methods: Clinical data from 24 patients with benign prostate hyperplasia (BPH) and aggregate stone sizes ≥3 cm were assessed retrospectively between June 2011 and January 2014. All stones fragmented via pneumatic lithotripter were removed. An 18-F Foley catheter was inserted into the Amplatz sheath, which was then removed from the bladder. The Foley catheter balloon was inflated with 15 ml of saline, and suprapubic traction was applied to prevent extravasation. Next, TURP was performed while a suprapubic Foley catheter provided continuous drainage. Results: The mean stone size was 46.25 ± 9.51 mm. The surgical duration for stone removal was 31.25 ± 8.46 min. All patients were stone-free at the first month follow-up. None of the patients experienced extravasation or urethral stricture. Conclusions: PCCL is a short-duration, minimally invasive surgery that avoids urethral stricture. In the presented technique, as the drainage catheter is fixed to the dome of bladder, it is not visualized in the surgical field and remains outside of the resection area, which facilitates prostate resection. It seems to be a safe and efficient technique.

BackgroundNeovaginal perforation can develop following sexual intercourse in patients that have undergone male to female gender reassignment surgery. In such cases urinary tract symptoms may mimic acute cystitis and acute pyelonephritis.Case presentationA 33-year old white transsexual patient presented to the emergency department with dysuria, hematuria, difficulty urinating, widespread groin pain, bilateral side pain, clear vaginal discharge, abdominal pain, and nausea 2-3 h after sexual intercourse. Abdominal tomography showed fluid around the vaginal cuff and air throughout the abdomen. Vaginography showed contrast leaking to the abdomen from the vaginal cuff. The patient was considered as vaginal perforation and admitted to clinic.ConclusionVaginal perforation should be considered in transsexual patients that develop urinary system symptoms following sexual intercourse. Such cases were treated medically without the need surgery.

In late 2019, a pneumonia epidemic began in Wuhan, China's Hubei Province, with a primarily unknown cause, which is now known to have spread significantly worldwide. 1 The virus that caused the disease was initially named the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and later the World Health Organization described this disease as coronavirus disease-2019 This disease usually affects individuals between the ages of 30 and 79 years. About half of those with COVID-19 have mild or indeterminate symptoms. Significant symptoms in symptomatic patients include fatigue, fever, cough, muscle pain and shortness of breath. 2,3 Sometimes, more critical conditions, such as acute respiratory distress syndrome (ARDS) and multi-organ failure can be observed.Patients with these severe conditions often have comorbid diseases, especially hypertension (HT), diabetes mellitus (DM) and heart diseases. 3 Neutrophilia and lymphopenia are the most common laboratory parameters. Abnormal liver function test findings at different rates have also been reported. Serum procalcitonin levels are generally at normal levels, while mild increases in C-reactive protein levels can be seen. Moreover, D-dimer levels are high in 30% of patients. 4,5 Coronaviruses are enveloped RNA viruses that consist of a single chain and have a positive polarity. Therefore, they do not have RNA-dependent RNA polymerase enzymes, but this enzyme code

We examined the effects of preoperative hormonal values on varicocelectomy success. A total of 136 patients who underwent varicocelectomy for infertility in our clinic were analysed retrospectively. Improvement in semen quality was defined as >50% increase in post‐operative total motile sperm count (TMSC) in those with preoperative TMSC >5 million and at least 100% increase in those with <5 million. The patients were divided into two groups as benefiting from the treatment (Group A) and no benefits (Group B). The best cut‐off value for follicle‐stimulating hormone (FSH) and the luteinising hormone/testosterone ratio (LTR) that can predict varicocelectomy success were 7.01 and 0.016 with an area under the curve of 0.844 and 0.856 respectively. The highest sensitivities and specificities of FSH and LTR were 0.845 and 0.788 and 0.821 and 0.846 respectively. Binary logistic regression analysis showed FSH (odds ratio [OR]: 3.7; p < .001) and LTR (OR: 5.2; p < .001) as independent predictive factors in predicting varicocelectomy success. Our study demonstrated that low FSH (7.01 IU/L) and LTR (<.016) can be a useful preoperative predictive tool to help identify men who benefit most from varicocelectomy in infertile patients with varicocele.

Background We aimed to examine the effects of pre‐operative blood values on varicocelectomy success. Materials and methods A total of 130 patients who underwent varicocelectomy in our clinic were retrospectively analyzed. Operation success was defined as the return of all semen parameters (concentration, progressive motility, and morphology) to normal values 6 months after surgery. The patients were separated as two groups as benefiting from the treatment (Group A) and not (Group B). Results The best cut‐off value for the neutrophil/lymphocyte ratio (NLR), which can predict varicocelectomy success, was assigned to be 2.27, with AUC of 0.859 (%95 CI 0.795–0.922). The highest sensitivity and specificity were 0.857 and 0.731 (p < 0.001). The best cut‐off value for the mean platelet volüme (MPV) value, which can predict varicocelectomy success, was assigned to be 9.45, with AUC of 0.729 (%95 CI 0.639–0.819). The highest sensitivity and specificity were 0.655 and 0.635 (p < 0.001). Binary logistic regression analysis showed NLR ratio (odds ratio (OR): 11.2, p < 0.001) and MPV (OR: 2.65, p = 0.002) parameters as independent predictive factors in predicting varicocelectomy success. Discussion and conclusion Our study showed that low NLR ratio (≤2.27) and high MPV (≥9.45) ratio levels may be a useful pre‐operative predictive tool in identifying men who benefit most from varicocelectomy in infertile patients with varicocoele.

First described in the 1800s, testicular torsion is a urological disease that requires urgent intervention (Yagmurdur et al., 2006). The disease is mostly seen in adolescence and childhood (Yagmurdur et al., 2006). The aetiology of ischaemic damage from testicular torsion includes oxidative stress and inflammation due to reactive oxygen species (ROS); this process is called the ischaemic injury period (Wu, 1997). The extent of testicular damage primarily depends on the reduction of oxygen in the testicle. After the torsion is corrected, reperfusion injury begins with the formation of ROS products (Wu, 1997). Nesfatin-1 was first found in the hypothalamus in 2006. It is a molecule consisting of 82 amino acids weighing 9.7 kDa (NUKB2; Oh-I et al., 2006). Nesfatin-1 is found not only in brain tissues but also in peripheral tissues, such as adipose tissue, stomach tissue, pancreatic islets, liver tissue and the testicles (Stengel et al., 2009; Zhang et al., 2010). Nesfatin-1 is an amino group terminal fragment derived from nucleobindin-2 (NUKB2; Oh-I et al., 2006). NUKB2, which contains proteins that play an important role in the regulation of appetite and metabolism, has been found in the paraventricular (PVN), arcuate (ARC) and supra-optic tractus solitarius nucleus of the hypothalamus and in the lateral hypothalamic area, dorsomedial hypothalamic nucleus and zona incerta, as well as the cell bodies of