The novel coronavirus is an infectious disease caused by severe acute respiratory syndrome coronavirus-2. The World Health Organization declared coronavirus disease-2019 (COVID-19) outbreak is a pandemic in 2020. Many people die of acute respiratory failure both in community and hospital. Therefore, there is an urgent need for a novel effective treatment or vaccine to combat the outbreak. To develop new vaccine, a wide variety of studies have been conducted in many countries. Some vaccines are approved by the Food and Drug Administration. They were developed by a vari-ety of techniques; mRNA, inactivated, recombinant and vector-based vaccines. Most of them are safe and effective, but some adverse reactions have been observed. COVID-19 vaccination prevented spread of the virus and halted the outbreak, by breaking the chain of the infection. Thus, the pan-demic has proven again that vaccination is essential for human health. In this article, we attempted to review the commonly used ones in clinical practice.

With the advent of the pandemic, the landscape of treatment options has undergone rapid transformations in response to evolving viral variants. Current guidelines advocate tailoring treatments based on disease severity and the distinction between outpatient and inpatient settings. Remdesivir is endorsed for hospitalized cases, whereas molnupiravir is recommended for managing mild to moderate coronavirus disease-2019 (COVID-19) in individuals at high risk of progressing to severe disease. Baricitinib holds Food and Drug Administration (FDA) approval in the United States for use in hospitalized adults requiring supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation. Furthermore, dexamethasone is indicated for severely ill COVID-19 patients who require supplemental oxygen or ventilator support. Notably, tocilizumab has demonstrated limited efficacy in reducing the risk of disease progression. The FDA has granted Emergency Use Authorization for bebtelovimab, specifically for the treatment of mild to moderate COVID-19. Tixagevimab and cilgavimab have received FDA authorization for emergency use as pre-exposure prophylaxis against COVID-19. Although there is a recommendation against the use of an intermediate dose of low-molecular-weight heparin in critically ill COVID-19 patients, supported by moderate-level evidence, this recommendation does not extend to outpatient settings. However, there is insufficient evidence to endorse or discourage the use of supplements for treating COVID-19, both in non-hospitalized and hospitalized patients.

Objective: In the report published by the Clinical Laboratory Standards Institute-European Committee on Antimicrobial Susceptibility Testing (EUCAST), Polymyxin Breakpoints Working Group, they recommended that laboratories using semi-automatic devices take into account the manufacturer’s recommendations and implement strict quality control (QC) studies when reporting the colistin result. In this study, we compared the one-year colistin susceptibility results with those of Sensititre FRCOL and Phoenix M50. Thus, we aimed to determine the reliability of Phoenix M50 for reporting colistin results.
Material and Methods: Extensively drug-resistant Gram-negative bacteria grown from clinical samples that arrived at the laboratory between June 2021 and June 2022 were included. MALDI- TOF Microflex LT/ SH Smart MS was used for bacterial identification, and Phoenix M50 and Sensititre FRCOL were used for colistin antibiotic susceptibility testing, according to the manufacturer’s recommendations. The results obtained were evaluated in line with the EUCAST criteria. QC was performed using Escherichia coli ATCC 25922 and NCTC 13846 strains in accordance with EUCAST recommendations.
Results: We studied 782 strains of K. pneumoniae (n=175), P. aeruginosa (n=99), and A. baumannii (n=508). Categorical agreements were 90.3%, 93.9%, and 94.5%. The very major error rate (VME) of Phoenix M50 was found to be 40.4%. Considering the VME for K. pneumoniae, A. baumannii, and P. aeruginosa, 17.7%, 75.0%, and 100.0% were found, respectively. The ME rates of K. pneumoniae, A. baumannii, and P. aeruginosa were 5.3%, 0.8%, and 1.1%, respectively.
Conclusion: The susceptible colistin results of these bacteria by Phoenix M50 should be confirmed by broth microdilution as the VME is above acceptable values. While the results of colistin detection resistant by Phoenix M50 could be reported for P. aeruginosa and A. baumannii, it needs to be confirmed with broth microdilution for K. pneumoniae.

Objective: Individuals with conotruncal heart disease (CHD) often exhibit a range of associated anomalies. Our study aimed to investigate the frequency of non-cardiac comorbidities in patients with CHD.
Material and Methods: Our study was a hospital-based, single-center, retrospective, observational study conducted at our clinic between August 1, 2020, and November 1, 2022. The study included 179 cases, both male and female, aged between 0 day and 6 months, with CHDs diagnosed. Data from each patient, including gender, complete blood count, biochemical and coagulation tests, abdominal ultrasound (USG), cranial USG, and serum immune globulin levels, were evaluated.
Results: In 14.5% of the 179 patients included in the study, abnormal renal function test results were detected. In 18.4% of the cases, abnormal liver function test results were detected. When evaluated according to the diagnosis group, among the 21 patients diagnosed with interrupted aortic arch (IAA), 7 (33.3%) had abnormal liver function test results. In 25.7% of the cases, the leukocyte count was abnormal. In 12.8% of the cases, the platelet count in the complete blood count was abnormal. In 10.6% of the cases, abnormal results were found in the coagulation tests. In 21.2% of the cases, abnormal results were found in the serum immunoglobulin (Ig) and Ig subgroups. When evaluated according to the diagnosis group, among the 21 patients diagnosed with IAA, 10 (47.6%) had abnormal results. In 19% of the cases, abdominal USG results were pathological, and in 9.5% of the cases, cranial USG results were pathological.
Conclusion: CHD in children may be accompanied by non-cardiac problems that cause hemodynamic and systemic problems and affect organ systems. Routine liver function tests, renal function tests, coagulation, complete blood count, immune screening, and abdominal USG evaluation may be useful to improve the quality of life of patients and reduce morbidity and mortality while waiting for necessary surgical interventions.

Head and neck cancers may lead to malnutrition in patients because of the natural course of the disease and treatment-related complications. A 36-year-old patient who experienced pain and nutritional difficulties due to mucositis after combined chemoradiotherapy for nasopharyngeal cancer was found to be at risk for malnutrition. To prevent the development of malnutrition, it was decided to feed him through a percutaneous endoscopic gastrostomy (PEG) tube, and sufficient calorie intake was provided. The PEG tube was removed after alleviation of symptoms and achieving adequate nutritional performance that could meet all calorie needs with oral nutrition. It should be kept in mind that early recognition of the malnutrition risk in patients with malignancy and a proactive approach to nutrition will contribute to the regression of existing complaints in a short time and the patients’ regaining their former performance.

Interferon (IFN) beta (β) is a potent anti-inflammatory and immunomodulatory agent that is used for treating patients with multiple sclerosis (MS). In this study, we present the case of a 15-year-old female patient diagnosed with MS and treated with IFN β-1a for six months who was referred to the emergency department with complaints of fatigue, fever, and coughing. She was diagnosed with pulmonary tuberculosis (TB). IFN β-1a therapy was stopped and anti-TB treatment was initiated. After nine months of therapy, she recovered from TB. This case presented with a rare side effect during the treatment of pediatric-onset MS with immunomodulatory drugs, demonstrating the importance of screening and close follow-up of patients with TB.

The foramen transversarium (FT) is frequently mentioned in the cervical spine, and the possibility of injury to the vertebral artery and vein passing through this structure is noted, particularly during surgical procedures. In this report, we present an atypically located FT at the level of the L5 vertebra, which was identified during the pre-operative three-dimensional computed tomography (CT) evaluation of a patient with congenital scoliosis in our clinic. A 33-year-old female patient with congenital scoliosis was admitted to our clinic because of cosmetic deformities and spinal pain. CT showed multiple bone formation abnormalities in the thoracic region and surprisingly, bilateral FT at the level of the L5 vertebra in the lumbar region of the spine with no accompanying vascular structures on digital CT angiography. The literature defining lumbar FT is sparse. We believe that knowledge of this rare variant can add to the relevant literature and that it is important to consider this variant in radiological imaging and surgical procedures in this region.

Heart tumors can be divided into primary and secondary tumors. Secondary tumors are more common than primary tumors. The majority of primary tumors are benign, and the most common type is myxoma. Myxomas are most commonly seen in the left atrium and rarely in the right atrium or ventricles. Surgical excision can be performed with conventional median sternotomy in giant myxomas, whereas minimally invasive methods are preferred in tumors of appropriate size and localization. In this article, we report the successful operation of a giant cardiac myxoma in the right atrium with minimally invasive surgery.