Regaining Legitimacy Through Performance Increases: The Case of Restructuring the Turkish Red Crescent

This study aims to examine the process of regaining organizational legitimacy by increasing performance through restructuring in non-profit organizations. In the study, the Turkish Red Crescent is taken as a characteristic case in terms of its position, influence on public opinion, size, and history. Using case study design in qualitative method, the restructuring process of the Turkish Red Crescent in the 2000s to overcome the performance-based legitimacy problem experienced in the late 1990s was studied. Findings descriptively present the regaining legitimacy of the Turkish Red Crescent as a result of performance increase through planned change in organizational structure, service infrastructure, financial resources, and human resources

Accessory Nerve Anatomy in Anterior and Posterior Cervical Triangle: A Fresh Cadaveric Study

Objective: To understand the variations and normal course of the accessory nerve (CNXI) to help more accurate and confident neck dissection.Methods: The course of the CNXI in the neck, its relationship to the surrounding anatomic structures and the factors affecting its course were investigated.Results: A total of 100 neck dissections were performed on 50 fresh cadavers. Eleven division variations were observed at the anterior triangle. The location of CNXI at the posterior border of the sternocleidomastoid muscle (PBSCM) was investigated and the ratio between the distance from the mastoid apex (MAA) to CNXI at the PBSCM and the distance from MAA to the posterior border where the PBSCM is attached to the clavicle increased as height of the subject increased (p<0.05).Conclusion: It must be kept in mind that it is better to search for CNXI in taller subjects more inferiorly at the posterior border of the sternocleidomastoid muscle

Real-World Outcomes of Anti-VEGF Treatment for Neovascular Age-Related Macular Degeneration in Turkey: A Multicenter Retrospective Study, Bosphorus Retina Study Group Report No: 1

Objectives: To evaluate the real-world outcomes of intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment in neovascular age-related macular degeneration (nAMD) patients. Materials and Methods: Multicenter, retrospective, interventional, non-comparative study. The records of nAMD patients treated with an anti-VEGF agent on a pro re nata treatment regimen basis between January 2013 and December 2015 were reviewed. The patients who completed a follow-up period of 12 months were included. Primary outcome measures of this study were the visit and injection numbers during the first year. Results: Eight hundred eighty eyes of 783 patients met the inclusion criteria for the study. Mean number of visits at month 12 was 6.9±2.5 (range: 1-15). Mean number of injections at month 12 was 4.1±1.9 (range: 1-11). Mean visual acuity at baseline and months 3, 6, and 12 was 0.90±0.63 LogMAR (range: 0.0-3.0), 0.79±0.57 LogMAR (range: 0.0-3.0), 0.76±0.57 LogMAR (range: 0.0-3.0), and 0.79±0.59 LogMAR (range: 0.0-3.0), respectively. Mean central retinal thickness at baseline and months 6 and 12 was 395±153 μm (range: 91-1582), 330±115 μm (range: 99-975), and 332±114 μm (range: 106-1191), respectively. Conclusion: The numbers of visits and injections were much lower than ideal and were insufficient with the pro re nata treatment regimen

Near Point of Convergence Break for Different Age Groups in Turkish Population with Normal Binocular Vision: Normative Data

Purpose: The purpose of this study was to evaluate the near point of convergence break in Turkish population with normal binocular vision and to obtain the normative data for the near point of convergence break in different age groups. Such database has not been previously reported. Material and Method: In this prospective study, 329 subjects with normal binocular vision (age range, 3-72 years) were evaluated. The near point of convergence break was measured 4 times repeatedly with an accommodative target. Mean values of near point of convergence break were provided for these age groups (≤10, 11-20, 21-30, 31-40, 41-50, 51-60, and >60 years old). A statistical comparison (one-way ANOVA and post-hoc test) of these values between age groups was performed. A correlation between the near point of convergence break and age was evaluated by Pearson’s correlation test. Results: The mean value for near point of convergence break was 2.46±1.88 (0.5-14) cm. Specifically, 95% of measurements in all subjects were <6 cm. There were statistically significant differences, which were found between the age groups of ≤10 years old and 21-30, 31-40, 41-50, 51-60, >60 year-old age groups in the near point of convergence break values (p=0.0001, p=0.0001, p=0.006, p=0.001, p= 0.004). A mild positive correlation was observed between the increase in near point of convergence break and increase of age (r=0.355) (p<0.001). Discussion: The values derived from a relatively large study population to establish a normative database for the near point of convergence break in the Turkish population with normal binocular vision are in relevance with age. This database has not been previously reported. (Turk J Ophthalmol 2013; 43: 402-

Nonarteritic Ischemic Optic Neuropathy Due to the Increased Intraocular Pressure During Cataract Surgery: A Case Report

A 46-year-old patient diagnosed with rheumatoid arthritis underwent cataract surgery for a subcapsular cataract. Perioperative intraocular pressure (IOP) increased after two sideport incisions. Despite administration of 300 cc of 20% mannitol, the elevated IOP persisted for 30 minutes. IOP decreased after pressing the posterior surface of the sideports with a 25 G cannula. The other steps of cataract surgery and intraocular lens implantation were performed uneventfully. On the first postoperative day, the diagnosis of nonarteritic ischemic optic neuropathy (NAION), which was thought to be the result of increased IOP in the perioperative period, was recorded. Cataract surgeons keep in mind and urgently perform simple maneuvers to lower IOP in order to prevent unexpected vision-threatening complications, such as NAION. In addition, for patients who have a crowded optic nerve head with a small cup-to-disc ratio or a previous episode of NAION in the other eye, perioperative and postoperative ocular pressure must be attentively managed

Delayed diagnosis of an intraorbital wooden foreign body

A 35-year-old male patient was presented with pain on his right upper eyelid. A piece of wood injured his orbital and supraorbital regions while working at a furniture factory 10 days prior to our hospital admission. It was learned that the patient was discharged following the primary would closure procedure. Subsequent to the craniofacial computed tomography, primary wound closure was performed in the emergency room of previous hospital. In our clinic, a skin suturing on the nasal side of the right eyebrow was inspected and a foreign body (FB) was palpated on the superonasal contiguity of the patients' right globe. A hyperdense FB measuring 30x10x5mm in size with smooth margins on superonasal contour of the globe was detected. Superonasal orbitotomy was performed and the FB was completely removed. Finally, visual acuity was 20/20 and a mild residual ptosis was observed

Assessment of retinal thickness as a marker of brain masculinization in children with congenital adrenal hyperplasia: A pilot study

To investigate the relationship between brain masculinization and retinal thickness in children with congenital adrenal hyperplasia (CAH). Forty-five patients with CAH aged between 4 and 18 years and 30 age-matched healthy controls were included in this prospective study. Macular area was examined with optical coherence tomography (OCT); central subfield thickness (CST), cube volume (CV) and macular retinal thickness (MT) were measured in each subject. A gender identity questionnaire (GIQ) was used for the evaluation of gender happiness index. Girls with CAH had a higher CV (p = 0.002) and MT (p = 0.003) than healthy girls. No significant difference was found between boys with CAH and healthy boys regarding the retinal thickness measurements. Mean CST, CV and MT were significantly higher in boys than in girls in the control group (p = 0.013, p < 0.001, respectively), but there was no significant difference in those parameters between girls and boys with CAH. The gender happiness index was not different between healthy boys and boys with CAH, but was significantly lower in girls with CAH than healthy girls (p = 0.01). As retina is part of the brain, our finding appears to be a morphological evidence of the excess androgen exposure on brain structures in girls with CAH. In addition, we suggest using retinal thickness measurements as a marker of prenatal excess androgen exposure in future studies