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s through training and into practice, and to assess effects of interventions on patient outcomes. Efforts to standardise assessment and evaluation of interpersonal skills will strengthen future research efforts.The genetic diversity of the Mediterranean swordfish (Xiphias gladius Linneus) has not been explored extensively at its easternmost range so far. In this study, modern X. gladius samples from the eastern part of the Mediterranean basin, north of the Aegean Sea (Aegean-2013, n = 26) and the Mediterranean coast of Turkey (N.Levantine-2013, n = 42) were studied genetically, along with ancient samples from Yenikapı excavation (n = 6). Partial mitochondrial DNA control region sequences (entire sequences, clade I and clade II) were evaluated spatially and temporally together with previously published sequences (Alvarado Bremer et al., Molecular Phylogenetics and Evolution, 2005, 36, 169-187; Viñas et al., ICES Journal of Marine Science, 2010, 67, 1222-1229; Righi et al., Diversity, 2020, 12, 170) from the rest of the Mediterranean Sea. Pair-wise FST and pair-wise AMOVA tests showed that, in general, groups of eastern populations and western Mediterranean populations have not genetically differed from each other sigt the Ne of X. gladius in the eastern was high in Byzantium times. Eight microsatellite loci were also genotyped in modern samples. The microsatellite-based present Ne estimate of the pooled Aegean-2013 and N.Levantine-2013 populations was lower than 1000 according to the upper limit of 95% c.i. and possibly even lower than 100 according to the mean of posterior distribution of the present Ne estimate calculated by the software package MSVAR. These alarming genetic signals for the sustainability of X. gladius on the coasts of Turkey are in agreement with the nearly collapsing X. gladius fisheries as depicted also in the fisheries statistics. Overall, congruent with the previous studies, the data presented here show that sustainability of the X. gladius population in Mediterranean is under major threat. Therefore, X. gladius around the Turkish coasts need an immediate stringent action and management plan.Chronic Fatigue Syndrome (CFS), also known as myalgic encephalomyelitis (ME), is a complicated disease characterized by extreme fatigue of at least six months duration. It is necessary to rule out the organic cause of CFS in the pediatric patient in order not to overlook the preventable or the treatable condition. In our case report we present a case of a patient with a surprising origin OF CFS/ME diagnosed by cardiopulmonary exercise testing.Since December 2019, the rapid spread of SARS CoV-2 across the border, shuffled into a world pandemic situation with an alarming rate of morbidity and mortality. Concerns are mounting as the reports indicate tangled circumstances among the COVID-19 patients due to blood coagulopathy followed by organ dysfunction. COVID-19 induced an alteration in coagulation function increase the risk of pulmonary embolism and deep vein thrombosis associated with poor prognosis as well as high mortality. An elevated level D-dimer and other fibrin degrading protein are documented among the patients with COVID-19; especially in severe cases. Differences in coagulopathy among severe and non-severe cases, required prompt attention to adopt a more effective management strategy.We describe the case of a 36-year-old male who presented to hospital with acute respiratory distress, and hemoptysis after intravenously injecting 20 milliliters of pure gasoline. Despite maximum supportive care he died without a definitive diagnosis 4 hours after presentation to the hospital. Postmortem examination confirmed diffuse pulmonary hemorrhage as a cause of death. Our case highlights the key clinical, and pathological features of this very rare poisoning with a volatile substance and reminds clinicians to consider it as a potential cause of hemoptysis and pulmonary hemorrhage.A 65 years old male, chronic smoker (30 pack years), presented with complaints of dyspnea (mMRC grade2), cough (dry in nature), loss of appetite, loss of weight ( > 5 kgs), weakness, bony pains, feverish feeling and easy fatigability for last 2-3 months.Contrast enhanced CT chest showed bilateral extensive paraseptal and centriacinar emphysematous changes, right upper lobe spiculated heterogeneously enhancing soft tissue lesion and significant conglomerate mediastinal lymphadenopathy encasing lower trachea and great vessels.As patient was high risk for development of pneumothorax related to image guided sampling of right upper lobe lesion in view of extensive emphysema; patient was referred to us for EBUS-TBNA (endobronchial ultrasound guided transbronchial needle aspiration) guided mediastinal lymph nodes sampling. But on head to toe examination revealed round, firm, non-tender, skin coloured, 2-3 cm size skin nodules (2 on left lateral chest wall, 1 on right lateral chest wall and 1 in proximity to umbilicus).Fine needle aspiration cytology (FNAC) was attempted from two of skin nodules which was suggestive of small cell lung cancerSkin metastasis as initial presentation is reported rarely in small cell lung cancer.The index case emphasize on importance of detailed physical examination in cases of lung cancer to look for any skin manifestation of the disease, although encountered rarely.Moreover detection of skin nodules helps in staging and prognosis of diseases.Carbapenemase-producing Klebsiella pneumoniae is an emerging threat worldwide. The appropriate therapy for infections due to these multidrug-resistant pathogens is not well defined and depends upon the susceptibilities of individual isolates, and the choices are often severely limited. selleck kinase inhibitor We report a case of a 8-year-old male child with ARDS with left-sided tubercular pleural effusion who developed ventilator-associated pneumonia due to multidrug-resistant Klebsiella pneumoniae treated successfully with a regimen comprising a combination of colistin and double carbapenem.Infant respiratory distress syndrome (IRDS) develops among premature infants due to structural immaturity of the lungs and insufficient production of pulmonary surfactant. Nowadays, treatment takes place under conditions of intensive care and includes oxygen therapy, mechanical ventilation, exogenous supplementation of pulmonary surfactant and antenatal corticosteroid therapy. The treatment of IRDS, especially mechanical ventilation, may lead to complications which can contribute to developing a severe dysfunction of the respiratory system. Unavailability of pharmacological treatment of IRDS and development of pulmonary barotrauma due to mechanical ventilation in our patient led to the forming of severe pulmonary interstitial emphysema. In this case report, lung transplantation was performed as an only successful therapeutic option.