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Purpose This study aimed to determine the factors affecting the ORTO-R scores in individuals with T2DM and to investigate their effect on diabetes self-management. Methods The study included 373 individuals with type 2 diabetes between the ages of 18–65 who applied to Akdeniz University Hospital Endocrinology and Metabolic Diseases Polyclinic between January and May 2022. A questionnaire including sociodemographic data, information about diabetes, and nutritional habits, and the ORTO-R and Type 2 Diabetes Self-Management Scales were used to collect data. Linear regression analysis was performed to determine the factors affecting ORTO-R. Results The linear regression analysis showed that age, gender, education level, and duration of diabetes affected ORTO-R scores in patients with type 2 diabetes. Body mass index, comorbidities (cardiovascular diseases, kidney diseases and hypertension), diabetes-related complications, diabetes treatment method and dieting had no significant contribution to the model (p > 0.05). We also found that education level, comorbidities, diabetes-related complications, diabetes treatment method, dieting, and BMI can affect diabetes self-management. Conclusion It should be kept in mind that type 2 diabetes are at risk of orthorexia nervosa (ON) in terms of various aspects such as age, gender, education level and duration of diabetes. Since the factors affecting the risk of ON and the factors affecting diabetes self-management are intertwined, orthorexic tendencies should be kept under control while trying to increase self-management in these patients. In this respect, developing individual recommendations according to the psychosocial characteristics of patients may be an effective approach. Level of evidence Level V, cross-sectional study.

Purpose This study was conducted to investigate the relationship between the presence of orthorexia nervosa and diabetes self-management in individuals with type 2 diabetes. Methods The study included 373 individuals with type 2 diabetes between the ages of 18–65 who applied to Akdeniz University Hospital Endocrinology and Metabolic Diseases Polyclinic between January 2022 and May 2022. In the study, a questionnaire including sociodemographic data, information about diabetes, nutritional habits, ORTO-R and "Type 2 Diabetes Self-Management Scale" was used as a data collection tool. In addition, height and weight measurements were taken and body mass index (BMI) were calculated. Biochemical parameters were evaluated by accessing from the hospital system. Results 46.1% of the participants were men, 53.9% were women and mean age was 57.5 ± 9.6 years. Low diabetes self-management is associated with an increase in fasting glucose (p

Purpose This prospective cross-sectional study aimed to compare uterine and ovarian arterial Doppler signals in regularly menstruating patients who had been using copper intrauterine devices (IUD) for different durations. Methods Four groups of participants were formed (n = 30 for each) depending on the duration of copper IUD use: less than 1 year (group 1), 1 to 3 years (group 2), and over 3 years (group 3). Women without IUDs formed the control group. All participants were called in on the fifth-eighth days of their menstrual cycle for Doppler blood flow assessment. The pulsatility index (PI) and resistance index (RI) values were recorded in uterine and ovarian arteries. Results The groups 2 and 3 had significantly higher uterine artery PI and RI values than groups 1 and 4. Furthermore, group 2 had uterine and ovarian artery PI and RI values similar to those of group 3. There was a positive relationship between uterine and ovarian arteries' PI and RI values with the duration of IUD use. Conclusions The presence of an IUD for over a year seems to cause changes in the uterine artery PI and RI values assessed by Doppler ultrasonography.

This article features strengths and challenges indicated by foreign-born counselor educators in programs accredited by the Council for Accreditation of Counseling and Related Educational Programs. To gain a deeper understanding of this topic, we utilized a convergent parallel mixed methods design with merged quantitative and qualitative findings. Quantitative results indicated that foreign-born faculty (FBF) experienced more strengths in the personal, spiritual, and health domains while facing more challenges in the social, political, and financial domains. In addition, a thematic analysis identified three overarching themes reflecting FBF's strengths, challenges, areas of support, and the impact of COVID-19: (a) adjustment as a foreign-born individual in the United States, (b) immigration status and procedures, and (c) working as a foreign-born faculty in counselor education. This article presents implications for FBF and stakeholders seeking to support this population, while also suggesting recommendations for future research.

Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of ovulation induction or controlled ovarian hyperstimulation. The OHSS frequently occurs due to the administration of human chorionic gonadotropin (hCG) in controlled ovarian hyperstimulation cycles. However, OHSS has been reported rarely in normal spontaneous pregnancy cases. In this paper, a case of mild OHSS at 10 weeks 5 days of gestation in a woman with singleton gestation, who conceived naturally after cessation of a long-term combined oral contraceptive use was reported. Patients using long-term oral contraceptive should be informed about the symptoms of OHSS for early diagnosis. Early diagnosis and appropriate supportive therapy are essential to avoid the potentially life-threatening complications of OHSS., Ovarian hiperstimülasyon sendromu (OHSS), ovulasyon indüksiyonunun veya kontrollü ovarian hiperstimülasyonun iatrojenik bir komplikasyonudur. Ovarian hiperstimülasyon sendromu, kontrollü ovarian hiperstimülasyon sikluslarında insan koryonik gonadotropin (hCG) uygulamasından dolayı sıklıkla meydana gelir. Ancak, normal spontan gebelik vakalarında OHSS nadir olarak bildirilmiştir. Bu yazıda, uzun süreli kombine oral kontraseptif kullanımının kesilmesinden sonra spontan gebe kalan, tekil gebeliği olan bir kadında, 10 hafta 5 günlük gebelik haftasında orta şiddette OHSS vakası bildirilmiştir. Uzun süreli oral kontraseptif kullanan hastalar erken tanı için OHSS semptomları hakkında bilgilendirilmelidir. Erken tanı ve uygun destek tedavisi, OHSS'nin yaşamı tehdit edici komplikasyonlarından kaçınmak için esastır.

Please fill up the following information accurately. (Please use Times New Roman, 12 pt. Attitudes and perceptions of gendarmerie non-commissioned officers vocational college students towards English instruction This study aimed at investigatingattitudes and perceptions of second year students studying at GendarmerieNon-Commissioned Officers Vocational College towards English instruction.Attitudes of students were examined by focusing on the levels of attitudes aslow, moderate, and high. The three dimensions of an attitude; importance,enjoyment, and anxiety which were extracted through factor analysis were alsoexplored. The students’ perceptions were studied in relation with thedimensions of General English courses namely; objectives, content, learningactivities, materials and evaluation procedures. The study also exploredwhether the learners’ perceptions differed according to their level ofattitudes. The sample of this study was consisted of 308 second year studentsstudying at Gendarmerie Non-Commissioned Officers Vocational College. The datawere collected through an attitude scale and a perception questionnaire andwere analyzed descriptively and through chi-square test by using IBM SPSS 22.0.The results of the study revealed that majority of the participants heldmoderately low attitudes towards English language learning and teachingprocess. The students also displayed moderately low attitudes regarding each ofthe three dimensions of attitude. The perceptions of the students revealed thatGeneral English courses need improvement. Furthermore, it was found out thatsome of the students’ perceptions varied according to their level of attitudes. In conclusion,based on the students’ preferences and perceptions, in alliance with theirattitudes, suggestions and recommendations were made to improve the GeneralEnglish courses in Gendarmerie Non-Commissioned Officers Vocational College. Information about Author(s)* Author 1 Author (Last name, First name) Aksoy, Nur Affiliated institution (University) Country Email address nur2634@gmail.com Department & Rank Corresponding author (Yes/No) Write only one corresponding author. Author 2 Author (Last name, First name) Meral Affiliated institution (University) Aksu Country Email address aksume@metu.edu.tr Department & Rank Corresponding author (Yes/No) Author 3 Author (Last name, First name) Affiliated institution (University) Country Email address Department & Rank Corresponding author (Yes/No) Author 4 Author (Last name, First name) Affiliated institution (University) Country Email address Department & Rank Corresponding author (Yes/No)

Polyphenols which are produced by plants are very important functional foods in our nutrition. Because of their diverse chemical structures, they are subject to main classification among them. The main groups of polyphenols are; flavanoids, lignans, stilbenes and phenolic acids. At the present time, the health effects of them have been investigated in several in vivo and in vitro studies. In addition to their antioxidant effects, they are known to have a pro-oxidant character. Polyphenols have important effects in protecting the body against external factors and the cleansing of reactive oxygen species which occur as a consequence of some diseases. Furthermore, polyphenols have effects on protection from specific diseases and stop their progression with certain mechanisms. In this review, various effects of polyphenols including antioxidant, pro-oxidant, cytotoxic, anti-inflammatory, antihypertensive, anti-diabetic are discussed which obtained from in vitro, in vivo experimental animal and clinical investigations.

Human Rights, Civics and Democracy Curriculum for 4th graders was began to be implemented in 2015-2016 academic year. In this study, we aim to evaluate this curriculum regarding the universality of human rights concept; the appropriateness of the curriculum with its educational goals, content, instructional material and methods in terms of students’ cognitive level and finally teacher competencies to teach this course. A qualitative intrinsic case study method was utilized. The data was collected through document analysis; eight-hours of classroom observation, and semi-structured interviews with seven elementary school teachers and six “experts”. Eisner’s Educational Connoisseurship and Criticism Model was used as an evaluation framework. Deductive content analysis was used to analyze the data and to illuminate specific details about the case under investigation. Results showed that attainments and content were consistent with the universality of human rights perspective; also, instruction and assessment methods were consistent with the philosophy (constructivism) of the curriculum. However, the course material, as regards to its aims, content and philosophy; and the practices applied inside the classroom were highly inconsistent with the goals of the curriculum.

Aim Longitudinally extensive transvers myelitis (LETM) is a rare and disabling condition in childhood. The aim of the present study was to share experiences from our center regarding the treatment features and clinical and radiologic course in our LETM patients in light of the literature data. Material and method The study was designed as cross-sectional and included children who followed for LETM at our pediatric neurology clinic between 2010 and 2019. ATM was diagnosed according to the diagnostic criteria report from the Transverse Myelitis Consortium Working Group. LETM was defined as the presence of spinal cord lesions spanning a length of 3 or more consecutive vertebral segments. The patients’ medical records were examined in terms of demographic characteristics, presenting symptoms, history of infection prior to and during LETM, prodromal history, neurological examination, laboratory and radiological findings, clinical course, and treatment. The Barthel Index was used to assess the physical independence in activities of daily living of patients with LETM who were followed for at least one year. Results A total of 15 (8 girl) patients were included in the study. The patients were between 1 and 17 years of age. Presenting symptoms included inability to walk in 12 patients, incontinence in 9 patients, low back pain in 4 patients, abdominal pain in 2 patients, and inability to use the arms in 2 patients. In Barthel Index assessment of physical independence in activities of daily living, 8 patients were evaluated as completely independent, 3 patients as moderately dependent, and 2 patients as slightly dependent. When the 4 patients with motor area impairment and moderate dependency according to the Barthel Index were examined, it was noted that all of them had been admitted 4 days after the onset of symptoms and that 2 (13.3%) had cervicothoracic involvement and 2 (13.3%) had involvement of the entire cord. Conclusion Shorter delay from symptom onset to initiation of immunomodulatory therapy as well as effective rehabilitation resulted in favorable outcomes, with the most noticeable improvement in the areas of motor function and incontinence.

Bu araştırmanın amacı, Erken Çocukluk Sınıf Ortamı Değerlendirme Ölçeği’nin (EÇSODÖ) geliştirilmesi ve geçerlik-güvenirlik çalışmasının yapılmasıdır. Araştırmanın çalışma grubunu maksimum çeşitlilik örnekleme yoluyla belirlenen toplam 312 okul öncesi öğretmeni oluşturmaktadır. Öncelikle Temel Bileşenler Analizi (TBA) daha sonra Doğrulayıcı Faktör Analizleri (DFA) yapılmıştır. Güvenirlik analizleri için de Cronbach alfa iç tutarlılık güvenirliği hesaplanmıştır. Analizler sonucunda ölçeğin 38 madde ve 5 faktörden oluştuğu belirlenmiştir. Faktörler toplamda %52.13 oranında ortak varyansı açıklamıştır. Analizler sonucunda ölçeğin uyum indeks değerleri (RMSEA=.076, S-RMR=.025, GFI=.67, AGFI=.63, NFI=.79, NNFI=.89, CFI=.90, IFI=.90) incelendiğinde GFI, AGFI, NFI değerleri zayıf uyuma karşılık gelirken NNFI, CFI, IFI’ nın iyi uyuma karşılık geldiği görülmektedir. Cronbach alfa iç tutarlık katsayıları sırasıyla .86, .84, .74, .66 ve .84 olarak belirlenmiştir. Bu doğrultuda geçerli ve güvenilir bir ölçek elde edilmiştir., The study's aim was to develop the Early Childhood Classroom Environment Assessment Scale (ECCEAS) to measure the quality of preschool classroom environments as well as the scale's validity and reliability. This study was conducted using a survey research design and the study sample consisted of 312 preschool teachers determined by maximum diversity sampling. First, Principal Components Analysis (PCA) and then Confirmatory Factor Analysis (CFA) was performed. Cronbach alpha internal consistency reliability was calculated for reliability analysis. As a result of the analysis, it was determined that the scale consisted of 38 items and 5 factors, and the factors explained a total common variance of 52.13%. As a result of the analysis, when the goodness of fit index values of the scale (RMSEA=.076, S-RMR=.025, GFI=.67, AGFI=.63, NFI=.79, NNFI=.89, CFI=.90, IFI=.90), It is seen that GFI, AGFI, NFI values corresponded to poor fit, whereas the NNFI, CFI, and IFI corresponded to a good fit. The Cronbach alpha were .86, .84, .74, .66, and .84, respectively. Thus, a valid and reliable scale was obtained.

This study aimed to compare the effects of high doses of ondansetron and granisetron before spinal anesthesia on hemodynamic parameters in patients undergoing elective cesarean section.A double-blinded randomized placebo-controlled trial.Operating room.A total of 120 parturients with term pregnancy undergoing elective cesarean section with combined spinal-epidural anesthesia were included.Three groups (n = 40 for each group) were formed by randomization. Five minutes before the anesthesia procedure, Group I received 8 mg intravenous (IV) ondansetron diluted in 10 ml normal saline, Group II received IV 3 mg granisetron diluted in 10 ml normal saline, and Group III received IV 10 ml normal saline.Following intrathecal drug administration, intraoperative hemodynamic changes were recorded every 2 min for 20 min and then every 5 min until the end of the operation.Twenty patients (50%) in Group I, 12 patients (30%) in Group II, and 29 patients (72.5%) in Group III had hypotension requiring treatment with IV ephedrine (P = 0.001). The ephedrine requirement in Group III was significantly higher than in Groups I (P = 0.033) and II (P 0.001). Also, the ephedrine requirement in Group II was lower than in Group I, but the difference was not statistically significant (P = 0.055). The mean arterial pressure for the three groups differed in the 10th, 18th, and 60th minutes. The number of patients with nausea or vomiting was lower in Groups I and II than in Group III (P 0.001). At 5 min, the Apgar scores were higher than 8 for all neonates. Postoperative scores for the visual analogue scale were similar for all groups.It was concluded that prophylactic IV administration of 3 mg of granisetron or 8 mg of ondansetron before spinal anesthesia results in a significantly lower ephedrine requirement compared to placebo.

Primary dysmenorrhea effects the life-quality of women negatively. The aim of this study was to evaluate heme oxygenase-1 (HO1) activity together with malondialdehyde (MDA) and nitric oxide (NO) levels in patients with primary dysmenorrhea. A total of 28 nulliparous women with the diagnosis of primary dysmenorrhea and 26 healthy controls were included in this study. On the first day of menstruation, all patients underwent ultrasound examination to exclude pelvic pathology and the visual analogue scale was applied to patients. Patient’s visual analogue scale (VAS) scores, age, body mass index (BMI), menstrual cycle length (day), length of bleeding (day) were recorded. In the same day, fasting blood samples were taken from each patient for biochemical analysis. Serum MDA, NO and HO1 levels were found to be higher in women with primary dysmenorrhea compared to healthy controls (p = 0.012, p = 0.009, p

Introduction: Postpartum hemorrhage (PPH) is one of the leading causes of maternal death in the world and it is reported to occur in 5% - 8% of pregnancies. Objective: This study aimed to present a single centre’s experience in treating PPH by balloon tamponade. Methods: During the time period between January 2013 and March 2016, 50 patients who had undergone balloon tamponade for postpartum hemorrhage in our clinic were evaluated retrospectively. The patients’ age, parity, type of delivery, birth weight, hemoglobin and platelet values, total blood loss from catheter, balloon’s staying time, blood and platelet transfusion status, the presence of placenta anomalies and the Bakri balloon hemostasis success rate were evaluated. Results: During the study period, there were 27,249 deliveries. The frequency of massive postpartum hemorrhage was 0.61% (n = 168). Among the 168 patients with massive postpartum hemorrhage, there were 50 patients in whom the Bakri balloon catheter was used. Bakri balloons were placed via cesarean section incision in 19 patients and via vagina in 31 patients. The mean staying time of Bakri balloon was 18 hours. In 8 patients, balloon tamponade failed. Two patients underwent hysterectomy; other two patients had surgical ligation of the hypogastric artery. Four cases were referred to a tertiary center. Placental invasion abnormalities were observed in five patients. The overall Bakri balloon hemostasis successful rate was found to be as 84% in all cases. Conclusion: Bakri balloon tamponade is an effective, safe and practical approach in the treatment of postpartum hemorrhage.

Objective: We hypothesized that maternal and fetal circulations may be affected by moderately high altitudes. Therefore, we compared the differences in maternal and fetal Doppler flow parameters in women with term pregnancy living at a moderately high altitude (1890 m in Erzurum) with those of women living at the sea level (31 m in İstanbul).Material and Methods: Eighty women (n=40, for each group) with full-term and singleton pregnancies underwent Doppler waveform analysis, and the pulsatility and resistance index values for the uterine, umbilical, and mid-cerebral arteries were recorded. Also, sex, birth, and placental weights during delivery were obtained from the medical records.Results: Similar mean placental weight values were found at the sea level compared with the moderately high altitude (p>0.05). The mean birth weight values were found to be lower at the moderately high altitude than those at the sea level (p0.05). However, the pulsatility and resistance index values for both the right and left uterine arteries were higher at the sea level than those at moderately high altitude (p

Objectives To examine associations between red blood cell distribution width (RDW) and organ involvement and disease activity in patients with Behçet’s disease. Methods Haematological and inflammatory parameters including RDW, high-sensitivity C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR) were examined in patients with Behçet’s disease and in healthy controls. Patients were divided into those with active or inactive disease. Results Data from 236 patients with Behçet’s disease (77 with active and 159 with inactive disease) and 72 controls were analysed. RDW, ESR and hsCRP were significantly higher in patients with Behçet’s disease than in controls, and in those with active disease compared with inactive disease or controls. In addition, ESR and hsCRP were significantly higher in those with inactive disease than controls. No correlations were found between hsCRP, ESR and RDW. No differences were observed in RDW, ESR or hsCRP between patients with or without ocular or vascular involvement. Multivariate logistic regression analysis revealed that RDW was significantly higher in active disease compared with inactive disease. Conclusions RDW was increased in active disease compared with inactive disease. No relationships were found between organ involvement and RDW. RDW may be a cost-effective, novel potential parameter to evaluate disease activity in Behçet’s disease.

Background Retinopathy of prematurity is a proliferative vascular disease affecting premature newborns and occurs during vessel development and maturation. The aim of this study was to evaluate the maternal iron deficiency anemia as possible risk factors associated with the development of retinopathy of prematurity among premature or very low birth weight infants. Methods In this study, mothers of 254 infants with retinopathy of prematurity were analyzed retrospectively, and their laboratory results of medical records during pregnancy were reviewed for possible iron deficiency anemia. Results In a cohort of 254 mothers of premature infants with retinopathy of prematurity, 187 (73.6%) had iron deficiency, while the remaining 67 (26.4%) mothers had no deficiency. Babies born to mothers with iron deficiency anemia with markedly decreased hemoglobin, hematocrit, mean corpuscular volume, serum iron, and ferritin levels were more likely to develop retinopathy of prematurity. Conclusions Our results are the first to suggest that maternal iron deficiency is a risk factor for the development of retinopathy of prematurity. Our data suggest that maternal iron supplementation therapy during pregnancy might lower the risk of retinopathy of prematurity.

Background/Aims: To investigate the importance of antioxidant activity in infertility caused by cisplatin in rats. Methods: Rats in cisplatin control (CG), Vitamin E + cisplatin (ECG), Vitamin C + cisplatin (CCG), Hippophae rhamnoides extract (HRE) + cisplatin (HRECG), and thiamine pyrophosphate (TPP) + cisplatin (TPPCG) groups were injected intraperitoneally (ip) with (100 mg/kg) Vitamin E, Vitamin C, HRE, and TPP, respectively. One hour later, ip cisplatin was administered (5 mg/kg), and then antioxidant medications were continued for 10 days. Cisplatin + Vitamin E (CEG-1), cisplatin + Vitamin C (CCG-1), cisplatin + HRE (CHREG-1), and cisplatin + TPP (TPPCG-1) rats received cisplatin (5 mg/kg, ip) and were kept for 10 days. At the end of that period, rats received antioxidant medications for 10 days. (n = 12, for each group). Six rats from each group were sacrificed. Ovaries were removed to measure malondialdehyde, total glutathione, glutathione S-transferase, and glutathione reductase levels. The remaining rats were kept in a suitable laboratory environment. Results: Cisplatin-induced oxidative stress was best prevented by HRE, Vitamin E, Vitamin C, and TPP, in that order. However, infertility caused by cisplatin was only prevented and treated by TPP. Conclusion: Oxidative stress is not a major component in the pathogenesis of cisplatin-associated infertility.

Background: Electromagnetic fields (EMF) created by mobile phones during communication have harmful effects on different organs. Objectives: It was aimed to investigate the effects of an EMF created by a mobile phone on serum iron level, ferritin, unsaturated iron binding capacity and total iron binding capacity within a rat experiment model. Methods: A total of 32 male Wistar albino rats were randomly divided into the control, sham, mobile phone speech (2h/day) and stand by (12 h/day) groups. The speech and stand by groups were subjected to the EMF for a total of 10 weeks. Results: No statistically significant difference was observed between the serum iron and ferritin values of the rats in the speech and stand by groups than the control and sham groups (p>0.05). The unsaturated iron binding capacity and total iron capacity values of the rats in the speech and stand by groups were significantly lower in comparison to the control group (p

Background/Aims: To evaluate the effects of sildenafil on antioxidant enzyme activities, lipid peroxidation and histopathological changes in ovarian tissue after ischemia-reperfusion (I/R) injury in a rat model. Methods: A total of 18 adult female Wistar albino rats weighing 200-250 g were studied as follows: (1) control group: sham operation, (2) I/R group: 3 h of reperfusion after 3 h of ischemia and (3) I/R + sildenafil group: 3 h of reperfusion after 3 h of ischemia; half an hour before reperfusion, sildenafil (1.4 mg·kg-1) was given by oral gavage. At the end of the reperfusion periods, the ovarian tissues were removed for histopathological examination and to determine malondialdehyde (MDA) levels and glutathione peroxidase, myeloperoxidase (MPO) and superoxide dismutase (SOD) activities. Results: The I/R group had higher ovarian tissue MDA levels than the control group and the IR + sildenafil group (p = 0.016 and p = 0.044, respectively). MPO activity was lower in the IR + sildenafil group compared with the I/R group (p = 0.022). SOD activity was lower in the I/R group compared with the control group and the I/R + sildenafil group (p = 0.030 and p = 0.015, respectively). The I/R + sildenafil group had improved histological appearance which was not different to the control group (p > 0.05). Conclusion: The biochemical and histopathological results of this experimental study demonstrated that I/R injury in the ovary is ameliorated by sildenafil treatment.

Objectives: To explore the protective effect of progesterone on inflammation and oxidative stress in a rat model of sepsis created by cecal ligation and puncture (CLP). Materials and Methods: Rats were randomly divided into 4 groups: Overiectomy group (OVX), sham operated (control), sepsis (CLP) group and progesterone-treated CLP group (CLP+ progesterone). The rats in CLP+ progesterone group received intraperitoneal progesterone (2 mg/kg). Cardiac blood samples were obtained for the measurement levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). Tissue samples, including liver, kidney and uterus of rats were prepared to determine activities of myeloperoxidase (MPO), glutathione peroxidase (GPx) and levels of malondialdehyde (MDA). Results: Increased serum IL-6 and TNF-α levels were found in the CLP group in comparison with the control group ( P = 0.01, P = 0.02; respectively). In CLP+ progesterone group, mean MDA concentration of kidney tissue was significantly lower than in CLP group ( P = 0.003). Liver MDA concentration of the CLP+ progesterone group was not significantly different from that of the control group. While there were no significant differences among groups regarding liver MPO; in the CLP group, MPO activity in kidney ( P = 0.02) and uterine tissues ( P = 0.03) were found to be significantly higher compared to the control group. In CLP+ progesterone group, mean MPO activities of all tissues were not different than those of control group. The uterine tissue GPx activity in the CLP+ progesterone group was not statistically significantly different from control group. Conclusions: We suggest that progesterone ameliorates sepsis syndrome by reduction of the inflammatory cytokines IL-6 and TNF-α, and by restoration of antioxidant enzyme activities in some tissues.

Aim The aim of this case–control study was to compare the efficacy of ethinyl estradiol/drospirenone and Fructus agni casti in women with severe primary dysmenorrhea measuring uterine artery blood flow via Doppler ultrasonography. Methods A total of 60 women with severe primary dysmenorrhea and 30 healthy women (control) were included in this study. Thirty patients were treated with ethinyl estradiol 0.03 mg/drospirenone (group 1) and another 30 were treated with Fructus agni casti (group 2) during three menstrual cycles. Before and at the end of third month of therapy visual analog scale (VAS) scores, pulsatility index (PI), resistance index (RI) of uterine artery were recorded before and after receiving therapy on the first day of the menstrual cycle. Results Mean PI and RI values in patients with severe primary dysmenorrhea were significantly higher than in the control groups on the first day of the menstrual cycle (P

Background: The correlation of S100A8/S100A9 with various inflammatory conditions, including autoimmune diseases have been reported. There is no study investigating the levels of S100A8/S100A9 in autoimmune thyroid diseases (AITD) Aims: We aimed to evaluate the level of serum S100A8/S100A9 in AITD. Study Design: Case control study. Methods: Fifty patients with AITD (25 Hashimoto’s thyroiditis (HT) and 25 Graves’ disease (GD)) were included in the study. Twenty seven healthy subjects participated as a control group. Blood samples were obtained in the 3 months after the initiation of medical treatment. Serum levels of total antioxidant status (TAS), total oxidative status (TOS), total free sulfhydryl (SH), lipid hydroperoxide (LOOH) and S100A8/S100A9 were analyzed. Results: The patients with AITD had significantly higher S100A8/S100A9, OSI, LOOH and TOS levels than the healthy control group. There was no significant difference between GD and HT patients in terms of S100A8/S100A9, TOS and OSI levels. S100A8/S100A9 level was positively correlated with LOOH, TOS and OSI levels but negatively correlated with –SH level in the patients with AITD. Conclusion: Serum S100A8/S100A9 levels were increased in patients with AITD and positively correlated with LOOH, TOS and OSI whereas negatively correlated with SH.

Amaç: Farklı Polikistik over sendromu (PKOS) fenotiplerinde klinik, biyokimyasal ve hormonal değerlerin karşılaştırılması.Gereç ve Yöntem: Çalışmaya Dumlupınar Üniversitesi Evliya Çelebi Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum polikliniğimize Temmuz 2015- Ocak 2016 tarihleri arasında başvurarak PKOS tanısı almış 87 hasta ve yaş – vücut kitle endeksi uyumlu, 34 sağlıklı gönüllü olmak üzere toplam 121 olgu dahil edildi. PKOS tanısı için revize Rotterdam Kriterleri kullanıldı. Hastaların tanımlayıcı verileri, biyokimyasal ve hormonal değerleri karşılaştırıldı. İstatistiksel analizler için SPPS 21.0 programı kullanıldı. P değerinin 0.05’den küçük olması istatistiksel olarak anlamlı kabul edildi.Bulgular: Çalışma grubunun 38’i fenotip 1 (%43.67), 6’sı fenotip 2 (%6.89), 22’si fenotip 3 (%25.28) ve 21’i fenotip 4 (%24.13) idi. PKOS ve kontrol grubunun ortalama yaşları sırasıyla 23,09 ± 4.90 ve 23.15 ± 6.40 idi (p>0.05). Vücut kitle endeksi fenotip 1 ve 2’de daha yüksek olmasına rağmen gruplar arasındaki fark istatistiksel olarak anlamlı değildi. Bel kalça oranında fenotipler arasında fark izlenmedi (p>0.05). Hastaların % 63.2’sinde insülin direnci bulundu. İnsülin direnci en sık fenotip 2’de izlendi. Serum C reaktif protein (CRP) düzeyi incelendiğinde gruplar arasında istatistiksel açıdan anlamlı bir fark görülmedi (p>0.05). Grupların Ferriman Gallwey skorlarına (FGS) bakıldığında fenotip 2 ve 1’in en yüksek skorlara sahip olduğu görüldü. Fenotip 1, 2 ve 3’ün FGS’leri kontrol grubu ve fenotip 4’e göre ileri derecede anlamlı yüksekti (p0.05).Sonuç: Çalışmamızda farklı PKOS fenotiplerinde FGS ve serum LH seviyesi dışında gruplar arasında bir farklılığın olmadığı görüldü. Bununla birlikte, fenotip 2’de insülin direnci ve CRP düzeylerinin istatistiksel olarak anlamlı olmasa da belirgin şekilde yüksek olduğu gözlendi. Bu grubun uzun dönem kardiyovasküler morbidite açısından nisbeten riskli grup olduğu düşünülerek yakın takip yapılması uygun olacaktır. Anahtar kelimeler: Anovulasyon, Fenotip, Hiperandrojenizm, Polikistik over sendromu

Objective Brain-derived neurotrophic factor (BDNF), a member of neurotrophins, plays a critical role in neuronal tissue. In this study, the effects of spinal or general anaesthesia on cord and maternal peripheral blood BDNF and malondialdehyde (MDA) levels were investigated in patients undergoing elective caesarean section. Methods Eighty patients with term pregnancy were included. General anaesthesia was induced with intravenous (IV) propofol 2 mg kg-1 in the general anaesthesia group (n=36). In the spinal anaesthesia group (n=35), hyperbaric bupivacaine 0.5%, 9 mg (1.8 mL) was injected intrathecally. Maternal blood samples were taken immediately after positioning the patient on the operating table (T1), before clamping the umbilical cord (T2) and 24 hours after the first sample was obtained (T3). Cord blood samples were drawn from the umbilical artery (T4). Results Maternal BDNF levels (pg mL-1) measured at T2 time point were higher in the general anaesthesia group compared to the spinal anaesthesia group (p

Aim: To evaluate a possible relationship between body mass index and fetomaternal blood flow parameters in women with term pregnancy.Material and Methods: This study was performed on pregnant women undergoing routine third trimester ultrasound scans. Women were divided into four groups [underweight ( 18.5 kg/m2), normal weight (18.5–24.9 kg/m2), overweight (25-29.9 kg/m2) and obese (≥30 kg/m2)]. The uterine artery (UtA), umbilical artery (UA) and middle cerebral artery (MCA) were examined using color Doppler according to the standard protocols. The systole/diastole (S/D) ratio, pulsatility index (PI), and resistance index (RI) values of UtA, UA and MCA were recorded.Results: All Doppler findings were found to be similar among normal weight, overweight and obese women. There was a positive correlation between UtA-RI and maternal BMI (r=0.350; p0.01). There was a positive association between both UA-PI and UA-RI values with maternal BMI (r=0.372; p0.01; r=0.289; p=0.001, respectively). Also, we observed a positive association between both MCA-RI and MCA-S/D values with maternal BMI (r=0.180; p=0.04; r=0.181; p=0.04, respectively). Conclusion: Normal weight, overweight and obese women with term pregnancy have similar maternal and fetal blood flow parameters. Obese women should be informed about the risks of obesity during pregnancy, and they should be supported to lose weight before conception.

Vitiligo is an acquired depigmentary disorder characterized by white areas of the skin due to loss of epidermal melanocytes. Oxidative stress and free radicals are suggested as important phenomena in the pathogenesis of vitiligo. Myeloperoxidase is a lysosomal enzyme of polymorphonuclear leukocytes and acts as a catalyst in the production of hypochlorous acid, a powerful oxidant. In this study we analysed enzyme activity and gene polymorphism of myeloperoxidase in patients with vitiligo. Fifty-four patients with vitiligo and 58 healthy controls were enrolled to this study. Patient groups were subdivided according to localization of the lesions; generalized, acrofacial and local. Plasma myeloperoxidase enzyme activity was determined with ELISA and G-463A gene (-463) polymorphism with the PCR-RFLP (AciI) method. The plasma MPO level was significantly lower in vitiligo patients than in the healthy controls (p = 0.005), however, it was not significantly different among subtypes of vitiligo (p = 0.8). A significant difference was not observed for G-463A genotype and allele distribution in patients with vitiligo. In conclusion, the present study is the first study investigating MPO G-463A polymorphism and enzyme levels, which warrants further studies with higher patient numbers and broader polymorphism panels.

In developing countries, rheumatic valve disease (RVD) is still prevalent. Management of RVD depends on symptomatology, physical examination and echocardiographic evaluation, all of which, however, might be inadequate. Reliable biomarkers to establish severity of RVD and predict complications would be highly beneficial. Urotensin II is regarded as a cardiovascular autacoid/hormone, and its role in cardiovascular diseases is emerging. We hypothesized urotensin II might have pathophysiological roles in RVD. We investigated 71 patients with RVD (mean age 40 +/- 12 years, 17 female patients) and 25 normal subjects (mean age 40 +/- 7 years, 8 female patients). We assessed their New York Heart Association (NYHA) functional class, RVD severity and pulmonary artery pressure (PAP), and measured plasma urotensin II levels. Mitral regurgitation (r = 0.226, p = 0.02), tricuspid regurgitation (r = 0.238, p = 0.02), PAP (r = 0.320, p = 0.01), and NYHA class (r = 0.213, p = 0.03) correlated positively with urotensin II levels. There was positive correlation between urotensin II levels and severity of mitral regurgitation (r = 0.248, p = 0.01) and tricuspid regurgitation (r = 0.326, p = 0.001). In linear regression analysis, only PAP was predictive of urotensin II (beta = 0.3; p = 0.02). In conclusion, this is the first study showing that plasma urotensin II is elevated in chronic RVD, associated with severe mitral and tricuspid valve regurgitation. Furthermore, urotensin II level is correlated with NYHA functional class, and the increase in PAP is predictive of plasma urotensin II.

Uvod: Vjerojatno je da upala, oksidativni stres i apoptoza imaju ulogu u sekundarnom neuspjehu liječenja sulfonilurejom, koji se povezuje s propadanjem beta-stanica i njihovom smanjenom funkcijom. Dušikov oksid (NO) stimulira otpuštanje inzulina, ima proupalne, apoptotičke učinke te djeluje kao slobodni radikal. Adenozin-deaminaza (ADA) regulira koncentraciju adenozina, koja utječe na otpuštanje inzulina i glukagona te na periferni metabolizam glukoze. Cilj ovoga istraživanja bio je ispitati aktivnost ADA i koncentraciju NO kao potencijalne posrednike intenzivne inzulinske terapije kod bolesnika sa sekundarnim neuspjehom liječenja sulfonilurejom. Materijali i metode: U istraživanje su bila uključena 24 bolesnika sa šećernom bolešću tipa 2 i sekundarnim neuspjehom liječenja sulfonilurejom. Koncentracije NO u serumu i aktivnosti ADA određene su u uzorcima krvi uzetim prije liječenja, nakon trodnevne inzulinske infuzije i nakon šestomjesečne višestruke supkutane primjene inzulina. Aktivnost ADA određena je metodom prema Giustiu. Koncentracija NO izmjerena je kolometrijskom metodom prema Griessu. Rezultati: Kod sekundarnog neuspjeha liječenja sulfonilurejom, bazalna je aktivnost ADA (17,0 [14,6-21,7] U/L) bila statistički značajno niža nego aktivnost ADA izmjerena trećeg dana (20,5 [16,2-23,4] U/L; P = 0,018) i u šestom mjesecu (21,2 [16,6-22,5] U/L; P = 0,010). Između vrijednosti NO određenih na početku (18,8 [11,6-28,4] μmol/L), trećeg dana (17,8 [9,7-33,6] μmol/L; P = 0,966) i u šestom mjesecu (21,7 [16,0-33,9] μmol/L; P = 0,230) nije bilo statistički značajne razlike. Zaključak: Prema našem je istraživanju aktivnost ADA bila povećana u objema fazama, ranoj i kasnoj fazi intenzivne inzulinske terapije kod sekundarnog neuspjeha liječenja sulfonilurejom. O ulozi NO kod pogoršanja funkcije beta-stanica nismo puno saznali na razini perferne krvi., Background: Inflammation, oxidative stress and apoptosis are suggested to take part in secondary sulfonylurea failure associated with β cell destruction and impaired β cell function. Nitric oxide (NO) stimulates insulin release, has proinflammatory, apoptotic and free radical effects. Adenosine deaminase (ADA) exerts control on adenosine levels, which affects insulin and glucagon release and peripheral glucose metabolism. In this study, we aimed to investigate ADA activity and NO levels as potential mediators of intensive insulin treatment in patients with secondary sulfonylurea failure. Materials and methods: Twenty-four patients with type 2 diabetes mellitus and secondary sulfonylurea failure were enrolled in the study. Serum NO levels and ADA activity were determined in blood samples obtained prior to treatment, after three-day insulin infusion and after six-month multiple subcutaneous insulin administration. ADA activities were estimated by the method of Giusti. Nitric oxide levels were measured with colorimetric assay by the method of Griess reaction. Results: In secondary sulfonylurea failure, baseline ADA activity (17.0 [14.6-21.7] U/L) was significantly lower than ADA activity measured on day 3 (20.5 [16.2-23.4] U/L; P = 0.018) and at 6 months (21.2 [16.6-22.5] U/L; P = 0.010). There was no statistically significant difference between NO levels determined before (18.8 [11.6-28.4] μmol/L), on day 3 (17.8 [9.7-33.6] μmol/L) and at 6 months (21.7 [16.0-33.9] μmol/L; P = 0.966 and P = 0.230, respectively). Conclusions: According to our study, ADA activity is increased both in the early and late periods of intensive insulin therapy in secondary sulfonylurea failure. The role of NO in amelioration of β cell function is not supported at the level of peripheral blood.

Purpose: To investigate whether there is any therapeutic effect of colchicine on a rat model of polycystic ovary syndrome (PCOS). Methods: Twenty-two Wistar-Albino rats were randomly assigned into four with 8 rats in each group: control group; PCOS only group; PCOS-metformin group and PCOS-colchicine group. PCOS was induced by gavage with letrozole once daily at the concentration of 1 mg/kg orally with 21 consecutive days. After PCOS model assessment, PCOS-metformin group was received metformin orally with 500 mg/kg and PCOS-colchicine group was received colchicine orally with 1 mg/kg for the 35 day. Histopathology of ovaries, circulating estrone (E1), estradiol (E2), total testosterone, androstenedione and c-reactive protein (CRP) levels were evaluated. Results: cystic and atretic follicle number was significantly decreased, but CRP and hormone parameters were not significantly changed with colchicine treatment. Conclusion: Colchicine has provided histopathological improvement compared with metformin in PCOS rat model. © 2015, Springer-Verlag Berlin Heidelberg.

Background In the present study, we aimed to investigate serum calprotectin levels in patients with diabetic peripheral neuropathy, and possible role of this molecule in the disease pathogenesis. Method Twenty nine patients with diabetic peripheral neuropathy, 30 type 2 diabetic patients without neuropathy, and 40 healthy controls were enrolled in the study. Fasting plasma glucose (FPG), high-density lipoprotein- cholesterol (HDL-C), low-density lipoprotein- cholesterol (LDL-C), total cholesterol, triglyceride, HbA1c, calprotectin and hsCRP levels were measured in diabetic and healthy control groups. Results Serum calprotectin and hsCRP levels were significantly higher in patients with and without neuropathy than healthy controls (p

Elevated plasma homocysteine is considered to be an independent risk factor forcardiovascular diseases. In the present study, relations between plasma homocysteineand demographics, lifestyle factors and blood vitamin concentrations wereinvestigated in a population-based sample. Homocysteine and vitamin concentrationswere measured in the 126 healthy people aged 31-73 year. All participantscompleted the questionnaires about factors including demographics and lifestylefactors, and dietary records. Homocysteine values were higher in men as comparedto women (11.8 vs. 10.6 μmol/L; p

OBJECTIVE This study sought to evaluate the potential prognostic usefulness of QT dispersion (QTd) in patients with unstable angina. METHODS AND RESULTS QTd was calculated and plasma troponin T (TnT) level was measured and rest perfusion imaging with Tc-99m sestamibi was performed in 62 patients admitted with chest pain at rest. All patients had a follow-up during one month in order to assess cardiac events. Cardiac events occurred in 41 patients (no deaths, 11 myocardial infarctions (MI), 4 urgent and 26 planned revascularizations). The mean QTd in patients with cardiac events was significantly higher than in those without cardiac events (68 +/- 28 vs. 54 +/- 14 ms; p = 0.01). When patients were divided into subgroups according to the cardiac events, the mean QTd in MI and revascularization were 90 +/- 25 ms and 60 +/- 25 ms, respectively. QTd in patients with MI was higher than in patients without cardiac events (p = 0.001). There was no significant difference in QTd between the revascularization subgroup and patients without cardiac events. Nineteen patients with elevated TnT had a greater QTd compared to patients with normal TnT (74 +/- 29 vs. 56 +/- 20 ms; p = 0.008). Additionally, the mean QTd in 46 patients with perfusion defects was slightly higher than in patients without (66 +/- 27 vs. 53 +/- 17 ms; p = 0.03). There was also a moderate correlation between QTd and the number of perfusion defects (r = 0.31, p = 0.01). On the other hand, most of the patients who had a MI or urgent revascularization had a QTd greater than 75 ms. CONCLUSION The measurement of QTd in patients with unstable angina may help to stratify patients at high risk for cardiac events, in particular MI and urgent revascularization.

Background/Aims: To investigate the effectiveness of controlled reperfusion (CR) on ovarian tissue malondialdehyde, total glutathione and 8-hydroxyguanine levels and infertility rates in a rat model of induced ischemia-reperfusion (I/R) injury with unilateral oophorectomy. Methods: A total of 135 adult female albino Wistar rats were divided into 9 groups (n = 15 for each group): unilateral ovariectomy + ovarian I/R (OIR), unilateral ovariectomy alone (OEG), a sham operation group (SG), and unilateral ovariectomy + CR performed at different intervals (the clips were released 10 times for 10, 8, 6, 4, 2 or 1 s and closed again 10 times for 10, 8, 6, 4, 2 or 1 s; OCR-1-6, respectively). Five rats from each group were sacrificed, and their ovaries were removed. Results: Higher ovarian tissue malondialdehyde and 8-hydroxyguanine levels and lower ovarian tissue total glutathione levels were found in the OIR group compared with the SG, OEG and OCR-4-6 groups. The number of rats giving birth during the study period was found to be similar among the SG (n = 8), OEG (n = 8) and OCR-6 (n = 7) groups. Conclusion: These results suggest that sterility and ovarian oxidative stress caused by I/R injury decreases in parallel to the shortening of CR duration.

Amaç: Spontan vajinal doğum eylemindeki kadınlarda maternal serum beyin kaynaklı nörotrofik faktör (BDNF) ve malondialdehit (MDA) seviyelerinde oluşan değişiklikleri ortaya koymak.Gereç ve Yöntem: Bu prospektif çalışma, spontan vaginal doğum eylemindeki term gebeliği olan 62 hastada yapıldı. Doğumun latent fazında (T1), göbek kordonu klemplenmeden hemen önce (T2) ve doğumdan 24 saat sonra (T3) maternal kan örnekleri; doğumda göbek kordonu klemplendikten hemen sonra umblikal arterden kord kanı örneği alındı. Alınan kan örneklerindeki MDA ve BDNF seviyeleri ölçüldü ve uygun istatistik testler kullanılarak sonuçlar karşılaştırıldı. Kord kanı BDNF ile kord kanı MDA seviyeleri ve maternal serum BDNF ile maternal serum MDA seviyeleri arasındaki ilişki araştırıldı.Bulgular: T3 zamanındaki maternal serum BDNF seviyeleri (pg/ml) (3729,92 ± 621,68) T1 (956,75 ± 291,47) ve T2 (985,50 ± 291,91)’ den yüksek bulundu (P, Objective: To reveal the changes in maternal serum brain-derived neurotrophic factor (BDNF) and malondialdehyde (MDA) levels in women undergoing spontaneous vaginal delivery.Material and Method: This prospective study was done in sixty-two patients with term pregnancy undergoing spontaneous vaginal delivery. Maternal blood samples in the latent phase of labor (T1), immediately before clamping the umbilical cord (T2) and 24 hours after birth (T3); and umbilical artery cord blood sample immediately after umbilical cord clamping at delivery were obtained. MDA and BDNF levels in collected blood samples were measured and results were compared using appropriate statistical tests. The relationship between cord blood levels of BDNF with cord blood MDA and maternal serum levels of BDNF with maternal serum MDA was investigated.Results: Maternal serum BDNF levels (pg/ml) were significantly higher in the blood sample collected at the T3 time point (3729.92 ± 621.68) compared to blood samples collected at T1 (956.75 ± 291.47) and T2 (985.50 ±291.91)time points (P

OBJECTIVE It has been reported that the loss of cell membrane integrity during severe reversible ischaemia results in elevation of plasma troponin T (TnT) in unstable angina. We investigated whether TnT is released into circulation during severe ischaemia (e.g. on treadmill exercise testing) in patients with chronic coronary artery disease (CAD). METHODS AND RESULTS The study comprised 54 patients who had angiographically documented CAD (22 of them had a prior history of myocardial infarction) and 18 normal subjects. All cases underwent exercise thallium (Tl)-201 SPECT myocardial perfusion imaging. Blood samples for TnT analysis were obtained for each patient at pre-exercise, immediately after and 12 hours after exercise. SPECT images were divided into 20 segments. Patients with redistribution defects > or = 5 were considered to have severe ischaemia. Sixteen patients had severe ischaemia on SPECT images. The mean TnT levels of the patients with severe ischaemia at pre-exercise, immediately after and 12 hours after exercise were 0.009 +/- 0.008, 0.012 +/- 0.009 and 0.010 +/- 0.010 ng/ml, respectively. In normal subjects the mean TnT levels were 0.012 +/- 0.009, 0.010 +/- 0.009, 0.010 +/- 0.010 ng/ml, respectively. There was no significant difference neither between the two groups nor within each group with respect to pre-exercise and post-exercise TnT results. All TnT levels were within normal limits (< 0.1 ng/dl). Additionally, when the patients were grouped according to other SPECT variables (patients with reversible defects vs. fixed defects; patients with increased lung uptake of Tl-201 vs. without lung uptake; patients with transient left ventricle dilatation vs. those without) and angiographic findings (patients with multivessel disease vs. normal subjects), there were no significant differences with respect to pre-exercise and post-exercise TnT results. CONCLUSION Severe ischaemia does not result in the elevation of the plasma TnT level in patients with chronic CAD.

Since myomectomy throughout cesarean deliv- ery may lead to hemorrhage and uterinal atony, it is not recommended. But, myomectomy has been reported during cesarean section in recent studies. We presented a patient with large in- tramural myoma who was diagnosed at 34 weeks of pregnancy and operated with an unavoidable cesarean-combined myomectomy. A 33-year-old unpursued primigravida was referred to emer- gency department with abdominal pain and amenorrhea of 34 weeks duration. A sonographic diagnosis of myoma in pregnancy was made. Cesarean section was required for fetal distress and alive 2300 g weighted male infant with Ap- gar score of 6 at one minute, was born. As uterine incision could not be closed because of the myoma, myomectomy was performed dur- ing cesarean section unavoidably. A single 970 g and 15 × 18 cm sized myoma was removed. The physical examinations were unremarkable in the postoperative period. Although there are case series that have demonstrated the safety of myomectomy during cesarean section, we con-cluded that myomectomy during cesarean section is not a safe procedure accept inevitable situa-tions.

This retrospective study aimed to compare the therapeutic response, including side effects, for oral baclofen versus oral tizanidine therapy with adjuvant botulinum toxin type A in a group of 64 pediatric patients diagnosed with static encephalopathy and spastic equinus foot deformity. Following botulinum toxin A treatment, clinical improvement led to the gradual reduction of baclofen or tizanidine dosing to one-third of the former dose. Gross Motor Functional Measure and Caregiver Health Questionnaire scores were markedly elevated post–botulinum toxin A treatment, with scores for the tizanidine (Gross Motor Functional Measure: 74.45 ± 3.72; Caregiver Health Questionnaire: 72.43 ± 4.29) group significantly higher than for the baclofen group (Gross Motor Functional Measure: 68.23 ± 2.66; Caregiver Health Questionnaire: 67.53 ± 2.67, P < .001). These findings suggest that the combined use of botulinum toxin A and a low dose of tizanidine in treating children with cerebral palsy appears to be more effective and has fewer side effects versus baclofen with adjuvant botulinum toxin A.

This study investigated the association between fear of childbirth (FOC) and women’s knowledge about painless childbirth methods. The study was performed on 900 multiparous women within the last month of pregnancy. Data was obtained through a questionnaire including the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) Turkish form A. FOC was defined as W-DEQ sum score ≥85. Women were questioned about their knowledge about painless childbirth and the most important source of this knowledge. Group 1 consists of participants with knowledge about painless childbirth. Group 2 consists of participants without knowledge about painless childbirth. Five hundred and twenty-four women (58.2%) had knowledge while 376 women (41.7%) had no knowledge about painless childbirth. Mean W-DEQ scores in group 1 (68.46±12.53) were found to be lower than group 2 (71.35±12.28) (P=0.001). FOC was associated with increased maternal request for elective caesarean section (OR 4.22, 95% CI 2.91–6.11). Better informed pregnant women about painless childbirth methods may reduce the number of women with FOC and the rate of preferred elective caesarean section.