The effect of metformin treatment to ovarian response in cases with PCOS

Objective. To examine the effect of metformin therapy on ovarian response in clomiphene-resistant PCOS patients. Design. Randomized prospective study. Setting. Zeynep Kamil Hospital IVF Center. Patients. Thirty-two female PCOS patients with clomiphene citrate resistance. Interventions. Test group A received 2×850 mg/day metformin therapy for 8 weeks, followed by gonadotropin induction. Only gonadotropin induction was applied to Control group B. Main outcome measures. Total gonadotropin dosage, duration of gonadotropin therapy, estradiol level on HCG-day, number of follicles with ≥16 mm diameter, number of cases with hyperstimulation development, number of cancelled cycles, endometrial thickness on HCG-day, pregnancy outcome, multiple pregnancy rate. Results. The total gonadotropin doses given to metformin-study group was significantly lower than the control group. In addition, duration of therapy, HCG level, plasma estradiol level on HCG-day in the study group was significantly lower than in the control group. Conclusions. Metformin therapy has led to a higher pregnancy outcome, as well as to a decrease in hyperstimulation risk, cycle cancellations, and multiple pregnancy rates with a lower gonadotropin dosage.     

Sexual dysfunction in patients with chronic hand eczema in the Turkish population

IntroductionHand eczema can cause considerable psychosocial disorders, such as anxiety, depression, and difficulties at work, and it may also cause sexual dysfunction.AimThe aim of this study was to investigate sexual function in patients with hand eczema and to find out whether concomitant depression has an additional negative effect on sexual function in these patients.Main Outcome MeasuresSexual functions were evaluated in hand eczema patients.MethodsNinety-one female (43 patients vs. 48 controls) and 79 male (45 patients vs. 34 controls) subjects were enrolled in the study. Hand eczema severity index was used to determine severity of hand eczema. The Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF) were used to assess sexual function. Quality of life was assessed with the Dermatology Life Quality Index. Diagnosis of depression was made based on the Structured Clinical Interview for the DSM-IV, while the Hamilton Depression Rate Scale was used for grading depression.ResultsAmong 43 female subjects with hand eczema, 26 had depression (60.46%); of the 45 male patients, 11 had depression (24.44%). FSFI total score was found to be significantly decreased in female patients with both eczema and depression compared with controls (20.84 ± 9.19 vs. 24.04 ± 3.40, P < 0.05). FSFI total score was found to be significantly decreased in female patients with both eczema and depression compared with those without depression (20.84 ± 9.19 vs. 22.23 ± 5.82, P < 0.05). IIEF total score was also found to be significantly decreased in male patients with or without depression compared with controls (52.36 ± 14.83 vs. 59.88 ± 5.65 vs. 62.03 ± 11.04, P < 0.05).ConclusionsThe results of the study demonstrated that patients with hand eczema had sexual dysfunction, and concomitant depression had an additional negative effect on sexual dysfunction. Patients with hand eczema should be evaluated with regard to sexual function and depression to provide a better quality of life. Ergün M, Türel Ermertcan A, Öztürkcan S, Temeltaş G, Deveci A, and Dinç G. Sexual dysfunction in patients with chronic hand eczema in the Turkish population.     

Evaluation of clinical and serological findings for diagnosis of cutaneous anthrax infection after an outbreak

Purpose: Anthrax, caused by the bacterium Bacillus anthracis, is one of the oldest documented infectious diseases in both livestock and humans. We aimed to evaluate clinical findings and risk factors of patients with cutaneous anthrax infection and report anti-lethal factor (LF) IgG and anti-protective antigen (PA) IgG titers in the serologic diagnosis of disease.

Methods: In this study, serum samples of 18 cutaneous anthrax patients were collected and anti-LF IgG and anti-PA IgG titers were measured by enzyme-linked immunosorbent assay (ELISA).

Results: Twelve (67%) males and 6 (33%) females, with a mean age of 36.06?±?16.58 years were included in the study. Risk factors identified in the patient population studied were slaughtering (28%), flaying (56%), chopping meat (67%), burying diseased animal corpses (17%) and milking (6%) livestock. Black eschar formation (94%), pruritus (78%) and painful lymphadenopathy (61%) were first three common clinical signs and symptoms, respectively. Fourteen (78%) patients produced a positive IgG response against PA, 11 (61%) patients produced against LF. Three (17%) patients had no response to either antigen.

Conclusions: A detailed history of contact with sick animals or animal products along with clinical findings should be taken at the first step for the diagnosis of cutaneous anthrax infection. Serologic detection of anti-LF IgG and anti-PA IgG with ELISA may be useful auxillary method for establishing the diagnosis.     

Effect of play-based educational programme on behavioral self-regulation skills of 48-60 month-old children

The present study was conducted in order to determine the effect of a training programme on behavioural self-regulation skills of preschool children. For this purpose, the research was carried out as an experimental study based on pre-test–post-test model with a control group. The study group consisted of 54 children. In this study, Head–Toes–Knees–Shoulders was used to determine the behavioural self-regulation skills and Child Behavior Rating Scale was used to find out teacher opinions. Since the sample group did not show normal distribution, non-parametric tests were used in the analysis of the data. In order to determine the effectiveness of the programme applied to experimental group, Mann–Whitney-U and Wilcoxon marked rank tests were used in the comparison of the pre-test and post-test scores. As a result of the study, significant differences were found between the experimental and control groups in favour of the experimental group children in terms of the post-test scores.     

Depression among unaccompanied minor refugees: the relative contribution of general and acculturation-specific daily hassles

Objectives. This study is designed to provide an empirical conceptualization of daily hassles among unaccompanied refugees, and whether they might affect mental health of young refugees after resettlement. First, we examined the underlying structure of daily hassles conceptualized as measuring general and acculturation-specific hassles. Second, we examined whether these two distinct categories of daily hassles significantly contribute to depression above and beyond the impact of premigration trauma.

Design. The study was based on self-report questionnaire data collected from 895 unaccompanied refugees who had been granted residence in Norway.

Results. Using structural equation modeling, the results confirmed the grouping of hassles in two general categories, which explained 43% of the variance in depression.

Conclusion. The findings underscore the importance of current life conditions for unaccompanied refugees' mental health.     

What are the requirements for patient-centered breast imaging? Communication preferences of mammography patients in Turkey

Abstract

We have investigated communication preferences of mammography results in 90 patients through a structured interview approach. About 81% of patients expressed that they wanted to get the results, and 18% expressed that getting the results does not help if they are incomprehensible. In patients who want to get the results, 80% preferred face-to-face interaction with physicians, whereas the others preferred other modes of communication to prevent loss of time. Majority of patients infavor of face-to-face interaction (57%) preferred both the referring physician and the radiologist. Comprehensibility and fast delivery of reports, plus direct communication with radiologists are the requirements in mammography patients while implementing patient-centered radiology.     

The development of giant lipoma on the BCG vaccine caused scar

Lipoma is the most common mesenchymal tumors that accounts for about 6% of all soft-tissue tumors in children. The lesion size is usually around 1-2?cm that rarely reaches the bigger diameter. A 14-month-old baby girl was brought to our clinic for a progressively growing lesion on the left shoulder. The lesion started 4 months ago, and then was rapidly growing that caused pain and movement restriction. On the same site, there was a scar of BCG vaccination. The clinical and histopathological findings of the lesion were consistent with lipoma. The lesion was totally resected with no recurrence within 12 months. There are several complications related to BCG vaccination. However, the occurrence of lipoma on BCG vaccine caused scar has not been reported in literature. We reported this case because of its rarity and to emphasize that lipoma can present as a giant lesion in child.     

The acute and chronic toxic effect of cypermethrin,propetamphos, and their combinations in rats

This study was aimed at determining the acute and chronic toxic effects of cypermethrin, propetamphos, and combined cypermethrin and propetamphos. Four groups, each comprising 10 animals, were established for the acute (a) and chronic (b) toxicity trials, and in total, 80 male Wistar albino rats were used. In the acute toxicity trial, the first group was maintained for control purposes, and groups 2a, 3a, and 4a were administered only once with 80 mg/kg.bw of cypermethrin, 25 mg/kg.bw of propetamphos and 80 mg/kg.bw of cypermethrin combined with 25 mg/kg.bw of propetamphos, respectively, by gavage directly into the stomach. In the chronic toxicity trial, the first group was also maintained for control purposes, while groups 2b, 3b, and 4b were administered daily with 12 mg/kg.bw of cypermethrin, 4 mg/kg.bw of propetamphos, and 12 mg/kg.bw of cypermethrin combined with 4 mg/kg.bw of propetamphos respectively, by gavage directly into the stomach for 60 days. Blood and tissue (liver, kidney, brain, spleen, and testis) samples were taken 24 h after pesticide administration in the acute toxicity trial and at the end of day 60 in the chronic toxicity trial. Oxidative stress (MDA, NO, SOD, CAT, GSH‐Px, and G6PD) parameters, serum biochemical parameters (glucose, triglyceride, cholesterol, HDL, LDL, BUN, creatinine, AST, ALT, ALP, protein, and albumin) and hepatic drug‐metabolizing parameters (CYP2E1, CYPB5, CYTC, GST, and GSH) were investigated in the samples. When administered either alone or in combination, both pesticides inhibited the antioxidant enzymes and increased MDA and NO levels. For the drug‐metabolizing parameters investigated, particularly in the chronic period, either increase (CYP2E1, CYPB5, and CYTC) or decrease (GST and GSH) was observed. Furthermore, some negative changes were detected in the serum biochemical parameters. In result, cypermethrin and propetamphos combinations and long‐term exposure to these combinations produced a greater toxic effect than the administration of these insecticides alone. © 2015 Wiley Periodicals, Inc. Environ Toxicol 31: 1415–1429, 2016.     

Equilibrium and Kinetics Characteristics of Copper (II) Sorption onto Gyttja

The sorption characteristics of gyttja to remove copper (Cu²⁺) ions from aqueous solutions were satisfactorily described with the Freundlich, Langmuir and Dubinin–Redushckevich (D–R) models. The sorption capacity (q _max) of gyttja was 11.76 mg g⁻¹. The D–R model indicated that the sorption of Cu²⁺ by gyttja was almost taken place by chemisorption. Thermodynamic parameters such as change in free energy (ΔG), enthalpy (ΔH), and entropy (ΔS) suggested that the adsorption process of Cu²⁺ by gyttja was feasible, spontaneous and endothermic in nature. Kinetic examination of the equilibrium data showed that the sorption processes of Cu²⁺ ions followed well pseudo-second-order kinetics model.