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.     

Anti-hyperglycemic and antigenotoxic potential of Ulva rigida ethanolic extract in the experimental diabetes mellitus

An increased reactive oxygen species (ROS) and insufficient antioxidant activity is known in diabetes mellitus (DM). Antioxidant compounds in the human foods or supplementary diets can be used to counteract several diseases. The analysis of micronuclei (MN) is a cytogenetic technique used to show chromosomal damage caused by clastogenic affects. The present study was designed to evaluate: (i) the effects of diabetes mellitus on bone marrow MN frequency, (ii) the effect of oral administration of Ulva rigida ethanolic extract (URE) on MN frequency produced by DM, and (iii) some hematological values in normal and streptozotocin-induced diabetic rats. Daily fluid and food consumptions, weekly body weights, blood glucose concentrations and serum insulin levels were also examined in the study groups during the two different administration periods. The blood glucose concentration and MN frequency have been significantly increased in diabetic rats compared with the normal rats (p < 0.0001). Especially, URE-30d group treatment in diabetic rats was significantly decreased blood glucose concentrations and MN frequency. This is the first report on the anti-hyperglycemic, anti-oxidative and genotoxic/antigenotoxic capacity of U. rigida in vivo. Our results suggest that URE shows strong anti-hyperglycemic and antigenotoxic effect on the genotoxicity produced by DM in rats.     

Asymmetric parasitic dicephalus conjoined twins

In this report, we describe the case of a 19-year-old primigravida pregnant woman who had been hospitalized for 2 days with bleeding and a diagnosis of imminent abortion. Sonographic examination revealed a single fetus of approximately 17 weeks' gestation that initially appeared normal except for a mass on its neck. Further evaluation of the mass identified it as an anencephalic fetal head that was joined to the body with deformed cervical vertebrae. We diagnosed asymmetric parasitic dicephalus conjoined twins. The parents elected to terminate the pregnancy. Labor was induced, and the patient delivered a 20-cm, 208-g male fetus. The fetus had 4 normal limbs and a normal abdomen. Both its heads had a cleft lip, and its spine was U shaped with closed spina bifida at the spinal union in the thoracolumbar area. The patterns of conjoined twins are infinitely varied, but they can be generally classified according to standardized terms based on the anatomic site of their union. Cases of conjoined twins occur so rarely that it is important to learn as much as possible from each case.     

Permanent transfemoral pacemaker implantation in a child with Maroteaux Lamy syndrome

Permanent transfemoral pacing has been described as an alternative route in patients in whom the superior venous approach is not feasible. This report describes the use of the femoral venous approach to insert a permanent pacemaker in a child with Maroteaux Lamy syndrome who has complete atrioventricular block and abnormal subclavian venous anatomy. Transfemoral pacing may be a suitable alternative in children with short stature.     

Incidental Findings in Routine Histopathological Examination of Appendectomy Specimens; Retrospective Analysis of 1970 Patients

Diseases and tumors of the appendix vermiformis are very rare, except for acute appendicitis. This study aimed to examine rare findings in the histopathologic examinations of specimens of patients undergoing appendectomy due to the diagnosis of acute appendicitis. The files of 1970 patients undergoing appendectomy due to the diagnosis of acute appendicitis between March 2012 and March 2016 were retrospectively investigated. Rare findings were found in 59 (3 %) patients, and these were evaluated in detail. Patients’ age, gender, pathology reports, and postoperation follow-ups were recorded. The rare histopathological findings of 59 patients were examined. Of these, 31 were female (52.5 %) and 28 were male (47.5 %). The average age was 33.1 ± 18.2 years. The unusual findings were as follows: 16 fibrous obliteration, 11 Enterobius vermicularis, 2 schistosomiasis, 3 appendiceal neuroma, 2 granulomatous appendicitis, 1 Crohn’s disease, 3 chronic appendicitis, 1 endometriosis, 2 hyperplastic polyps, 9 mucinous cystadenoma (+mucocele), 8 carcinoid tumors, and 1 lymphoma. All of the malignant tumors were localized in the distal end of the appendix, and all of the patients were treated with appendectomy. Patients with parasitic diseases also underwent anthelmintic treatment, while chemotherapy was administered to the patient with lymphoma. All of the patients diagnosed with malignancy were alive reported no problems at their follow-ups. Although all of the appendectomy samples were normal macroscopically, data from this study suggest that all specimens should be sent for routine investigation.     

Effects of honey as a scolicidal agent on the hepatobiliary system

AIM： To examine the effects of 10% diluted honey, which has been shown to be scolicidal, on the liver and biliary system and determine whether it could be used as a scolicidal agent in the presence of biliary-cystic communication. METHODS： Thirty Wistar-Albino rats were divided into two groups. Honey with 10% dilution in the study group and 0.9% saline （NaCI） in the control group were injected into the common bile ducts of rats through a 3-mm duodenotomy. The animals were sacrificed 6 mo alter the procedure. Histopathological, biochemical, and radiological examinations were performed for evaluation of side effects. RESULTS： At the end of the sixth month, liver function tests were found to be normal in both groups. The tissue samples of liver and ductus choledochus of the honey group showed no histomorphologic difference from the control group. No stricture on the biliary tree was detected on the retrograde cholangiograms. CONCLUSION： According to these results, we concluded that 10% diluted honey could be used as scolicidal agent safely in the presence of biliary-cystic communication.     

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.