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IntroductionThe health sector is a field where employees are frequently exposed to occupational injuries due to high-risk working conditions. This study aimed to examine the distribution and causes of occupational injuries experienced by healthcare workers in the last 5 years in Turkey.Materials and methodsIn this population-based and national-scale study, occupational injuries reported to the Ministry of Health from healthcare organizations in 81 provinces of Turkey between 01.01.2019 and 31.12.2023 were retrospectively analyzed. Variables such as age, gender, title, place of employment, types of injuries, causes, and outcomes of occupational injuries were evaluated.ResultsA total of 68,563 occupational injuries were reported between the years analyzed. 64.5% of the injuries affected female workers. Occupational injuries occurred most frequently during the summer months and in hospitals. According to age groups, the highest rate of occupational injuries was observed in the 20–29 age group with 39.3%. Among the types of occupational injuries, sharps injuries were the most common, with 55.3%. It was followed by slips, trips, and falls (13.2%). As a result of occupational injuries, 76.2% of healthcare workers were able to return to work without long-term absence. Over the 5 years, 61 healthcare workers lost their lives due to occupational injuries. Nurses and midwives were the occupational groups most exposed to injuries, followed by cleaning staff.ConclusionTurkey's healthcare workers have a high exposure rate to occupational injuries. Women and young workers are the most affected groups. Strengthening the occupational safety culture and providing safe working environments is necessary.

Background and Objectives: Heat shock proteins (HSPs) are stress proteins. The endogenous nitric oxide (NO) synthase inhibitor asymmetric dimethyl arginine (ADMA) is a mediator of endothelial dysfunction. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus causes endothelial dysfunction and coagulopathy through severe inflammation and oxidative stress. Using these markers, we analyzed the prognostic value of serum ADMA and HSP-90 levels for early prediction of severe coronavirus disease (COVID-19) patients. Materials and Methods: A total of 76 COVID-19 patients and 35 healthy control subjects were included in this case–control study. COVID-19 patients were divided into two groups: mild and severe. Results: Serum ADMA and HSP-90 levels were significantly higher in the COVID-19 patients compared to the control subjects (p < 0.001). Additionally, serum ADMA and HSP-90 levels were determined to be higher in a statistically significant way in severe COVID-19 compared to mild COVID-19 (p < 0.001). Univariable logistic regression analysis revealed that ADMA and HSP-90, respectively, were independent predictors of severe disease in COVID-19 patients (ADMA (OR = 1.099, 95% CI = 1.048–1.152, p < 0.001) and HSP-90 (OR = 5.296, 95% CI = 1.719–16.316, p = 0.004)). When the cut-off value for ADMA was determined as 208.94 for the prediction of the severity of COVID-19 patients, the sensitivity was 72.9% and the specificity was 100% (AUC = 0.938, 95%CI = 0.858–0.981, p < 0.001). When the cut-off value for HSP-90 was determined as 12.68 for the prediction of the severity of COVID-19 patients, the sensitivity was 88.1% and the specificity was 100% (AUC = 0.975, 95% CI= 0.910–0.997, p < 0.001). Conclusions: Increased levels of Heat shock proteins-90 (HSP-90) and ADMA were positively correlated with increased endothelial damage in COVID-19 patients, suggesting that treatments focused on preventing and improving endothelial dysfunction could significantly improve the outcomes and reduce the mortality rate of COVID-19. ADMA and HSP-90 might be simple, useful, and prognostic biomarkers that can be utilized to predict patients who are at high risk of severe disease due to COVID-19.

PurposeTo evaluate the impact of serum LH levels prior to progestin administration on the outcomes of programmed frozen-thawed embryo transfer (FET) cycles.MethodsRetrospective cohort study was conducted to compare the treatment outcomes between four groups based on the 25 percentiles of serum LH levels before progestin administration in 596 cycles of 518 patients undergoing artificial endometrial preparation protocols for FET. Primary outcome measures were ongoing and live birth rates. Secondary outcome measures were the pregnancy rates, clinical pregnancy rates, and pregnancy loss rates.ResultsThe trends in clinical pregnancy (CPR) and live birth rates (LBR) increased from the first to the fourth quartile (Q1 to Q4) of serum LH levels prior to progestin administration (37,0% to 48,3%, p = 0.042, and 22.6% to 39.5%, respectively, p = 0.003). Pregnancy loss rates (PLR) were higher in group Q1, although the difference was not statistically significant. Based on a multivariate logistic regression analysis, a low serum LH level before progestin initiation was found to be the most significant predictor associated with a negative effect on live birth (OR: 0,421, 95% CI 0,178 – 0,994, p=0,048). The day of estrogen initiation was significantly correlated with serum LH levels and quartiles of serum LH levels before progestin administration (r=0,200, p=0,015 and r=0,215, p=0,009, respectively).ConclusionThe serum LH level prior to progestin administration significantly affects pregnancy and live birth rates in patients undergoing an artificial endometrial preparation protocol for FET. LH monitoring should be incorporated into the follow-up, in addition to assessing endometrial thickness and morphology in artificial FET cycles.

Objective: This study aims to evaluate the clinical and radiological results of patients who were followed for at least 4 years after treatment with total hip arthroplasty, which was performed using a direct anterior approach and to compare the results with different surgical approaches in the literature. Materials and Methods: The study included 37 patients who underwent total hip replacement using the direct anterior approach. Harris hip scores and lower extremity functional scores were recorded. The correlations between the scores and gender, diagnosis, body mass index, time of walking time, length of hospital stay, and inclination angle were examined. Results: Of the cases,26(70.3%) were female and 11(29.7%) were male. The mean age was 51.2 (26-76) years. The patients were followed up for an average of 58 (48-72) months. No significant difference was determined between the improvement in Harris hip score and gender, age, body mass index, and length of hospital stay. Postoperative acetabular inclination was 40.8° (35 - 55). The early dislocation was observed in one of our patients. Serous discharge developed in three patients. In three patients, n.cutaneus femoralis lateralis injury developed. The periprosthetic fracture was observed during surgery in five patients. Conclusion: In our study, it was seen that patients have successful and fast functional results when total hip replacement using a direct anterior approach was performed. Compared to the literature, faster recovery is observed in the early period compared to other approaches; however, no difference is seen between the approaches in the mid- and long term. Keywords: Direct anterior approach, Total hip arthroplasty, mid-term results

Objectives: The most common work-related diseases are musculoskeletal system disease. This study aims to determine the prevalence of work-related musculoskeletal disorders (WMSDs) in a high-hazard factory and to determine sociodemographic, occupational, and ergonomic risks. Methods: The research is cross-sectional and was conducted in a high-hazard factory, in Hatay, in 2017. The research population was all factory employees (N=190), and it was aimed to reach the whole population. Of the (97.3%), 185 employees participated in the study. Anthropometric measurements, the Cornell Musculoskeletal Discomfort Scale, the observation-based Rapid Upper Limb Assessment (RULA) Ergonomic Risk Analysis Scale, and a questionnaire developed by the researchers are used for data collection. In the statistical analyses p lt;0,05was accepted as significant. Results According to the Cornell Scale, the frequency of WMSDs was 58.9%. The most common WMSDs were in the lumbar region (34.1%). According to the RULA Scale, 31.9% of the employees had 3rd and 4th-degree ergonomic risk. There were linear relationships between the Cornell Waist Score and each of the three RULA scores (p lt;0.001). The risk factors for WMSDs in the lumbar region were the presence of chronic disease (OR=5.35), hand tool use (OR=2.63), not having had a work accident (OR=0.04) and RULA scores (OR=1.61), Conclusion: Approximately one-third of the high-hazard factory employees had a high ergonomic risk. WMSDs existed in more than half of the employees. As the ergonomic risk increases, WMSDs increase.

İslâm vakıf hukukunda vakıf işlemleriyle ilgili en önemli problemlerden biri mütevellî ve onun tasarruflarıdır. Bu araştırmanın konusu vakfı yöneten kişi olarak mütevellînin mali tasarruflarıdır. Amacı ise onun tazmine konu olan ve olmayan tasarruflarını tespit etmektir. Vakfın mali yönetimine dair fıkhî hükümler fıkıh ve fetva türü eserlerden hareket edilerek tespit edilmiştir. Mütevellî; vakfın rakabesine nispetle vasî, vâkıfa ya da vakfın lehtarlarına nispetle vekil, vakfın gallesine nispetle ise mûdî’ (emanet bırakılan) ve yed-i emîn konumundadır. Mütevellî olmanın mülkiyet ve tazmini içermemesi, ilgili tasarrufların öncelikle tazmine konu olmamasını gerektirmektedir. Vakıf malları yetim malı mesabesinde görüldüğünden mütevellînin tayininde emin, takva ve istikamet sahibi kişilerden olmasına özen gösterilmiştir. Mütevellinin tasarrufları vâkıfın şartlarına, şer’î ilkelere ve kadr-ı ma’ruf ölçüsüne uygun olarak şekillenmektedir. Bu tasarrufların kasıt, kusur ve te’addî olmadığı ve emanet ilkelerine uygun olduğu sürece tazminle sonuçlanmadığı kayıtlarda yer almaktadır. Mütevellinin emanet ilkelerine uymayan; vakfiye şartlarına riayetsizlik, vakfın süslemesine yapılan harcamalar ve zaruri miktarı aşmak gibi tasarrufları tazminle sonuçlanmaktadır. Vakfın rakabesine zarar veren satım, istibdal, vakfın imaretinin ihmal edilmesi gibi durumların ise mütevellilikten’azl ile sonuçlandığı görülmüştür. Vakfın rakabesine yönelik tasarruflar, tevliyetten ’azil, icâre-i tavîle ve istibdâl ile ilgili hususlar ise genel olarak İslâm hâkiminin yetkisi dâhilinde olan konulardır. Mütevellinin vakıf mallarında tasarruf yetkisi hâkime göre öncelikli olduğu “Velâyet-i hâssa, velâyet-i ’âmmeden akvâdır.” kuralıyla ifade edilmektedir.

Background and Objectives: Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease characterized by acute exacerbations. Systemic inflammation and oxidative stress play an important role in the pathogenesis of COPD. Exacerbations in COPD reduce the quality of life and are associated with rapid disease progression. Galectin-3 is a beta-galactoside-binding lectin of approximately 30 kDa with pro-inflammatory and pro-fibrotic properties. This study aims to analyze the efficacy of serum galectin-3 in predicting exacerbations in COPD patients. Materials and Methods: Baseline demographic and clinical characteristics of all patients were recorded and blood samples were collected. A total of 58 consecutive COPD patients, including 28 patients (19 male and 9 female) with stable COPD and 30 patients (23 male and 7 female) with acute exacerbation of COPD (AECOPD), were included in the study. Results: Serum galectin-3 levels were significantly higher in the AECOPD group compared to the stable COPD group. A logistic regression analysis revealed that increased galectin-3 levels and disease duration were independent predictors of COPD exacerbation (OR = 5.322, 95% CI: 1.178–24.052, p = 0.03; and OR = 1.297, 95% CI: 1.028–1.635, p = 0.028; respectively). Conclusions: The results of our study demonstrated that Galectin-3 was a strong and independent predictor of exacerbations in COPD patients.

Homeobox proteins play critical roles in controlling processes such as morphogenesis and organogenesis in many organisms. Some of these proteins are known to aff ect the formation, development and regeneration of the liver. In this context, the present study was aimed at demonstrating the localization and expression intensity of some homeobox proteins in the bovine fetal liver during the diff erent stages of gestation, determining whether or not these proteins are found in the structural components of the liver, and identifying their potential physiological roles. Th e study material comprised of 27 clinically healthy bovine fetuses, which were obtained from slaughterhouses and belonged to diff erent stages of gestation. Th e fetuses were grouped according to their crown-rump length (CRL) measurements. Liver samples were taken from each study group and subjected to routine histological processing, followed by immunohistochemical staining. Th e staining results showed that, throughout gestation, the expression intensities of the homeobox proteins HOXA10, HOXA11, HOXB6, TLX1, Dlx-5 and HLX were stronger in the hepatocytes, compared to the hepatic artery, vena interlobularis and bile ducts. However, the expression intensity of HLX was determined to have significantly decreased during the second and third trimesters of gestation, compared to the first trimester. In conclusion, the expression of the investigated homeobox proteins at diff ering and similar levels in the hepatocytes, hepatic artery, vena interlobularis and bile ducts of the bovine fetal liver during gestation could be interpreted as an important indicator of these proteins being involved in the development and physiological activity of the fetal liver.

Aim: The most common metabolic disorder during pregnancy is gestational diabetes mellitus (GDM). GDM can occur in anywhere between 1.7 and 11.6 percent of people. In hypothyroidism, the rates of glucose oxidation and glycogen synthesis are reduced, and the peripheral tissues' consumption of glucose is also delayed. Patients with subclinical and overt hypothyroidism develop insulin resistance because insulin is unable to adequately maintain the muscles' use of glucose. According to the literature, hypothyroidism is linked to 6–15 percent of GDM pregnancies. Additionally, the chance of having GDM is 4.3 times higher in pregnant women who have hypothyroidism. This study aimed to reveal the relationship between first-trimester thyroid function tests and GDM. Material and Method: This retrospective cohort study was conducted between May 2021 and May 2022. 100 pregnant patients diagnosed with GDM and 500 healthy controls were included in the study. Using a 75 g glucose challenge test, GDM was identified. The trimester-specific recognized normal limits were used to evaluate the TSH and fT4 readings. Results: There was a statistically significant difference in terms of SCH between patients with and without GDM (p=0.04). TSH's performance in predicting GDM was evaluated using AUC and ROC (AUC=0.586 and p=0.006). To forecast GDM, the TSH level cut-off value was discovered to be 1.58. The AUC was found to be 0.586 (0.521-0.652). Furthermore, the selectivity is 58% and the sensitivity is 41% Conclusion: There are many studies in the literature investigating thyroid functions and the development of gestational diabetes mellitus. Our study also found a correlation between the diagnosis of subclinical hypothyroidism in the first trimester and GDM. The study adds to the literature the importance of being cautious and vigilant in terms of the development of gestational diabetes mellitus based on the results of the thyroid function test in the first trimester.

Aims: Gestational diabetes mellitus (GDM) is an inflammatory disorder. GDM raises the risk of pregnancy complications. Early recognition of GDM is critical to prevent complications. Systemic Immune-Inflammation Index (SII) is an index that shows the inflammatory response, we hypothesized that it might be associated to GDM. The purpose of this study was to determine the relationship between GDM and SII, as well as whether SII in the first trimester can predict GDM. Material and Method: This retrospective cohort study was conducted between January 2021 and January 2022. 100 pregnant women were included in the study. The study group included 50 pregnant women who had been diagnosed with GDM. The control group consisted of the remaining 50 pregnant women who had not been diagnosed with GDM. SII values were calculated from the hemogram values of the patients at the first visit in the first trimester. Results: There was a statistically significant difference between GDM and control groups in terms of SII, platelet, neutrophil, fT3, apgar 1 min and apgar 5 min measurements (p

Aim: In this study, it was aimed to compare two different periods in terms of surgical results in octogenarian patients who underwent open heart surgery. Material and method: In the present study, 218 patients aged 80 and over who had undergone open heart surgery in our clinic between January 2013 and December 2020 (group 1:115 patients) and between January 2000 and December 2007 (group 2:103 patients) were included and divided into two groups. The study was designed retrospectively, and the operative and postoperative data were statistically compared between the two groups. Results: There was no significant difference between groups in terms of mean age and gender distribution (p>0.05). Coronary artery bypass graft-beating heart prevalence in Group 2 (24.5%) was significantly higher than that in Group 1 (7.9%) (p:0.002; p

The structural and compressibility properties of the weft-knitted glass yarn fabrics from 1x1, 2x2, English, and fisherman rib architectures were investigated in this study. Due to their tight structures; 2x2 and fisherman rib fabric architectures exhibited higher loop density, and shorter loop length than 1x1 and English rib fabric architectures. English and fisherman rib fabric architectures displayed higher fiber volume fraction than 1x1 and 2x2 rib architectures in multi-layer compaction and recovery tests where the pressure was varied between 2 and 200 kPa. Number of layer increased the fiber content that pointed the nesting between the fabric layers. As a result of lack of complete recovery from compression; the fabrics exhibited lower thicknesses (i.e. higher fiber volume fractions) during the recovery periods than they did during the compression periods. A second order polynomial regression model with 0,89 R2 (coefficient of determination) was developed to estimate the fiber volume fraction by means of knit architecture, number of fabric layers, pressure, and measurement period.

PURPOSE:The reliability and reproducibility of T2-weighted imaging/ fluid-attenuated inversion recovery (T2/FLAIR) mismatch were investigated in the diagnosis of isocitrate dehydrogenase (IDH) mutant astrocytoma between WHO grade II and III diffuse hemispheric gliomas.METHODS:WHO grade II and grade III diffuse hemispheric gliomas (n=133) treated in our institute were included in the study. Pathological findings and molecular markers of the cases were reviewed with the criteria of WHO 2016. The finding of mismatch between T2-weighted and FLAIR images in preoperative magnetic resonance imaging (MRI) of the cases was evaluated by two different radiologists. The readers reviewed MRIs independently, blinded to the histopathologic diagnosis or molecular subset of tumors. The cases were classified as IDH-mutant astrocytoma, oligodendroglioma and IDH-wildtype (IDH-wt) astrocytoma according to molecular and genetic features.RESULTS:T2/FLAIR mismatch positivity was observed in 46 patients (34.6%). T2/FLAIR mismatch positivity was observed in 42 of 75 IDH-mutant astrocytomas (56%) and 4 of 43 oligodendrogliomas (9.30%), while it was not seen among IDH-wt astrocytomas (0/15, 0%). The T2/FLAIR mismatch ratio was significantly different between IDH-mutant astrocytomas (WHO grade II and grade III) and oligodendrogliomas (chi-square, p

Low birth weight (LBW) is a worldwide public health problem as it is the most important cause of infant deaths and contributes significantly to the burden of childhood problems. There are many studies that have investigated the relationship between LBW and lead exposure, but the mechanism underlying lead exposure and increased risk of LBW are still unknown. In our study, we aimed to determine the effect of lead on endothelial dysfunction by investigating the relationship between the severity of exposure, birth weight and methylated arginines in pregnant women. The study was carried with 165 pregnant women. Placental methylated arginines (ADMA, SDMA, L-NMMA), arginine, citrulline, homoarginine cadmium and lead levels were analyzed. Pb level was significantly higher in the 25% and below percentile group compared with other groups. There was a negative correlation between birth weight and Pb levels. A statistically significant correlation was found between Pb and birth length, Cd, ADMA and SDMA. It is possible to say that the underlying mechanism in fetal growth retardation due to lead exposure can be linked to placental endothelial dysfunction. [Med-Science 2021; 10(3.000): 1008-14]

Abstract: In addition to its many functions, the placenta is characterized by the intensity and characteristics of its hormonal functions. It has been reported that the development and vascularization of the placenta with normal fetal growth is regulated by many factors such as growth factors, transcriptional factors, and homeobox proteins. This study was conducted to determine the distribution and possible physiological roles of HOXA11 and HLX in the uterus and placenta of pregnant cows. In this study, 27 pregnant Holstein breed cow uteri and placentas obtained from private slaughterhouses were used as tissue samples. In order to determine the pregnancy period of the obtained uterus, the ages of the fetuses were calculated according to the age calculation formula. The uteri were classified under three different groups as the first (69-89 days), second (99-178 days), and third (190-269 days) periods of pregnancy so that there are 9 animals in each group. Tissue samples were then subjected to immunohistochemistry to demonstrate the presence of HOXA11 and HLX proteins. It was observed that HOXA11 and HLX immunoreactions occurred prominently in the luminal and glandular epithelial cells of the uterus during pregnancy, and the maternal epithelial cells of the placenta and UTC and TGC/BNCs. In addition, it was determined that HOXA11 immunoreaction also formed in some vascular endothelial cells. Immunohistochemical findings in this study suggested that Hoxa11 and HLX may affect the proliferation and differentiation of cells in the uterus and placenta during pregnancy in cows, and that these proteins may contribute to normal uterine physiology, placentation formation, and continuity of pregnancy in cows. Key words: Hox proteins; HOXA11; HLX; placenta IMUNOLOKALIZACIJA PROTEINOV HOXA11 IN HLX V POSTELJICI KRAVE MED BREJOSTJO Izvleček: Za posteljico so poleg številnih funkcij značilne intenzivnost in karakteristike njenih hormonskih funkcij. Poročali so,da razvoj in ožiljenost posteljice pri normalni rasti ploda uravnavajo številni dejavniki, kot so rastni dejavniki, transkripcijski djavniki in homeoboks proteini. Ta študija je bila izvedena z namenom določiti porazdelitev in morebitno fiziološko vlogo protnov HOXA11 in HLX v maternici in posteljici brejih krav. Za vzorce tkiv smo uporabili maternice in posteljice 27 krav pasem Holstein, pridobljenih v zasebnih klavnicah. Obdobje brejosti smo izračunali na podlagi starosti plodov po formuli. Maternice smoglede na obdobje brejosti uvrstili v tri skupine po 9 vzorcev: 1 (69-89 dni), 2 (99-178 dni) in 3 (190-269 dni). Prisotnost proteinoHOXA11 in HLX v vzorcih tkiv smo preverili z imunohistokemijo. Proteini HOXA11 in HLX so bili prisotni predvsem v luminalnihin žleznih epitelijskih celicah maternice ter v epitelijskih celicah maternalne posteljice, UTC in TGC/BNC. Prisotnost HOXA1je bila zaznavna tudi v nekaterih žilnih endotelijskih celicah. Rezultati imunohistokemije v tej študiji kažejo na morebiten vplivproteinov HOXA11 in HLX na proliferacijo in diferenciacijo celic v maternici in posteljici krav med brejostjo in na morebitno vlogoteh proteinov pri normalni fiziologiji maternice, nastanku posteljice in vztrajanju brejosti pri kravah. Ključne besede: proteini Hox; HOXA11; HLX; posteljica

Steroids are frequently used for symptom control in cases of asthma exacerbation. The aim of this study was to compare the effect of short-term and long-term oral steroid therapy on symptom control in patients with asthma exacerbation. Patients that received short-term (

INTRODUCTION: With this study, we aimed to identify the anxiety and depression status of children with T1DM and to determine its relationship with parents' coping attitudes and resilience levels and the effects on glycaemic control. METHODS: Our study included seventy-one patients of T1DM and their parents. We applied the Children's Depression Inventory (CDI) and the Screen for Child Anxiety Related Disorders (SCARED) to the children, and the COPE Inventory and the Family Resilience Scale (FRS) to the parents. All participants filled out the personal information form was filled out. The patients' glycaemic control levels were assessed based on the average glycosylated hemoglobin (HbA1c) levels of the previous year. RESULTS: The child's depression status decreased as the mother's resilience increased. In the mothers and fathers, the most frequently observed problem was problem-focused coping attitudes. When we evaluated the subscales of the coping attitudes, a negative statistically significant correlation was determined between the duration of diabetes and the mother's "mental disengagement," and the father's "active coping," "planning," and "using social support." Again, a positive statistically significant correlation was identified between the mother's "humor" coping attitude subscale and the child's depression status, and between "active coping" and the child's anxiety level. DISCUSSION AND CONCLUSION: Parents with children who have a chronic disease exhibit different coping attitudes. These attitudes cause various effects on the child. In conclusion, families using appropriate coping strategies will have a positive impact on their children. It is essential to guide families in this respect.

Purpose: This study seeks to examine Las Vegas visitors’ perception about security in Las Vegas and the perceived risks associated with traveling to Las Vegas following the One October mass shooting. It also aims to explore potential Las Vegas visitors ‘attitudes towards the proactive security measures implemented by Las Vegas resorts after the One October tragedy. Methods: The study is descriptive in nature. The data was collected through a web-based survey that comprised a national sample of 414 adults from the United States. Results: The results indicate that despite the tragic One October mass shooting in Las Vegas and the associated media coverage, security is not a major concern for visitors to Las Vegas. The findings of this study also suggest that Las Vegas visitors approve of existing and emerging security procedures. Implications: Findings point out to an opportunity to capitalize on the perceived enhanced security measures in Las Vegas and to put emphasis on addressing financial risk concerns via marketing and public relations campaigns.

Pb exposure is a well-known risk factor for inflammation including vessels. In our study, we aimed to investigate the relationship between Pb levels of exposed workers and the severity of inflammation/endothelial dysfunction. We analyzed the correlation between blood lead level and the markers of endothelial damage. There was a significant correlation between blood lead levels and vascular cell adhesion molecule-1 (VCAM-1). Elevated levels of blood lead also show correlation with soluble CD40 ligand (sCD40L). The strongest correlation was with sE-selectin. Association between lead exposure and markers of cardiovascular injury may help to predict cardiovascular effects of lead earlier and to protect workers who are exposed to lead. [Med-Science 2020; 9(2.000): 468-72]

Background and Objectives: Carbonic anhydrase (CA) enzymes are a family of metalloenzymes that contain a zinc ion in their active sites. CA enzymes have been implied in important situations such as CO2 transport, pH regulation, and oncogenesis. CA-IX is a transmembrane glycoprotein and stimulates the expression of hypoxia-inducible factor-1 (HIF-1) CA-IX. This study aimed to determine serum CA-IX levels in OSA patients in whom intermittent hypoxia is important and to investigate the relationship between serum CA-IX levels and disease severity. Materials and Methods: The study included 88 people who applied to Malatya Turgut Özal University Training and Research Hospital Sleep Disorders Center without a history of respiratory disease, malignancy, and smoking. Patients were divided into three groups: control (AHI < 5, n = 31), mild–moderate OSA (AHI = 5–30, n = 27) and severe OSA (AHI > 30, n = 30). The analysis of the data included in the research was carried out with the SPSS (IBM Statistics 25, NY, USA). The Shapiro–Wilk Test was used to check whether the data included in the study had a normal distribution. Comparisons were made with ANOVA in multivariate groups and the t-test in bivariate groups. ANCOVA was applied to determine the effect of the CA-IX parameter for OSA by controlling the effect of independent variables. The differentiation in CA-IX and OSA groups was analyzed regardless of BMI, age, gender, and laboratory variables. ROC analysis was applied to determine the parameter cut-off point. Sensitivity, specificity, and cut-off were calculated, and the area under the curve (AUC) value was calculated. Results: Serum CA-IX levels were 126.3 ± 24.5 pg/mL in the control group, 184.6 ± 59.1 pg/mL in the mild–moderate OSA group, and 332.0 ± 39.7 pg/mL in the severe OSA group. Serum CA-IX levels were found to be higher in the severe OSA group compared to the mild–moderate OSA group and control group and higher in the mild–moderate OSA group compared to the control group (p < 0.001, p < 0.001, p < 0.001, respectively). In addition, a negative correlation between CA-IX and minimum SaO2 and mean SaO2 (r = –0.371, p = 0.004; r = –0.319, p = 0.017, respectively). A positive correlation between CA-IX and desaturation index (CT90) was found (r = 0.369, p = 0.005). A positive correlation was found between CA-IX and CRP (r = 0.340, p = 0.010). When evaluated by ROC curve analysis, the area under the curve (AUC) value was determined as 0.940 (95% CI 0.322–0.557; p < 0.001). When the cut-off value for CA-IX was taken as 254.5 pg/mL, it was found to have 96.7% sensitivity and 94.8% specificity in demonstrating severe OSA. Conclusions: Our study found that serum CA-IX value was higher in OSA patients than in control patients, and this elevation was associated with hypoxemia and inflammation. CA-IX value can be a fast, precise, and useful biomarker to predict OSA.

The present study aimed to evaluate patients who were referred to adult allergy clinic due to allergic reactions after concomitant multiple intravenous-drug administrations in Emergency Department (ED). Between January 2017 and January 2019, patients admitted to our allergy clinic with hypersensitivity reactions to intravenous drugs administered in ED were included retrospectively. Fifty-seven patients who developed allergic reactions after intravenous drug administration in EDs were evaluated. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) were the most common cause of allergic reactions (n = 40, 70.2%). Skin Prick Tests (SPT) were positive in 6 (10.5%) patients. Drug Provocation Tests (DPT) were positive in 10 (17.5%) patients. No significant correlation was found between the total number of drugs in the intravenous fluid and the degree of allergic reaction (r = -0.145, p = 0.282). There was no statistically significant difference between the degree of allergic reaction and history of atopic disease (p = 0.579). In conclusion, concomitant administration of multiple drugs in intravenous fluids may increase the risk of allergic reactions.

Purpose: We aimed to investigate the effect of kinesiophobia on daily and sport activities. We compared Tampa scale of Kinesiophobia (TSK) with Tagner Activity score (TAS). We hypothesized that high level of Tampa scale of Kinesiophobia decreases Tagner Activity score. Materyal Methods:A total of 50 patients, with Anterior cruciate ligament (ACL) reconstruction surgery from January 2010 and December 2016 were included in this study. The patients completed the Lysholm Knee, TAS and TSK questionnaires postoperatively. KT-1000 arthrometer at 30 degrees knee flexion performed for both knees. The TSK score was compared with TAS and Lyshman knee score. Results:Mean age was 29.6 (18-50). Minimum follow-up was 12 months. Twenty of 50 patients (%40) had meniscal tears. The TAShad negative and significant correlation with TSK. Higher TSKled to lower TASand lower TSKled to higher TAS.There was no difference in Lysholm and TAS compared to TSKin patient with or without meniscal tear.Conclusion Our study showed that knee functions are not the only indicator to return preinjury daily and sport activities. Kinesiophobia may also play a significant role even if the Lyshman knee score is higher. The patients with Anterior cruciate ligamentinjury must be warned about the kinesiophobia. In our opinion, all the patients with Anterior cruciate ligamentruptures should have a kinesiophobia test. The patients who have high rate of kinesiophobia preoperatively, shouldhave a psychotherapy postoperatively in addition to their physical therapy.

Objective: Intrauterine insemination (IUI) is frequently used to treat patients with ovulation disorders, cervical factor, mild male infertility and unexplained infertility. The aim of this study was to investigate the impact of modified speculum application on the success of IUI in patients with unexplained infertility. Materials and methods: This prospective randomized study reviewed 219 women who had undergone controlled ovarian hyperstimulation (COH)-IUI treatment. In the modified speculum application group (109 patients with 124 cycles), the screw of the vaginal speculum was loosened after passing the internal os with catheter and the vaginal speculum remained in this position to ensure closure of the cervix during the procedure. In the conventional speculum application group (110 patients with 132 cycles), the screw of the vaginal speculum was not loosened to close the lips of cervix after passing the internal os with the catheter and the vaginal speculum was removed after withdrawal of the insemination catheter. The primary outcome was live birth rate. Results: The modified and conventional speculum application groups had statistically similar demographic and clinical characteristics. There were no significant differences between the study and the control groups in terms of the clinical pregnancy rate per cycle and per patient (24.1% vs 18.9% and 26.6% vs 22.7%, respectively), as well as the live birth rate per cycle and per patient (19.3% vs 15.1% and 22% vs 18.1% respectively). Conclusion: Applying gentle mechanical pressure on the portio vaginalis of the cervix using a vaginal speculum during IUI does not improve pregnancy and live birth rates in patients with unexplained infertility. Keywords: Intrauterine insemination, Controlled ovarian hyperstimulation, Speculum, Technique

INTRODUCTION: To evaluate the clinical and radiological results of adrenal masses of patients admitted to our center. METHODS: The demographic data of 139 patients admitted to Van YuzuncuYil University Dursun Odabasi Medikal Faculty Department of Endocrinology and Metabolism with adrenal incidental disease diagnosis from 01.01.2015 to 01.01.2017 were examined. The characteristics of adrenal incidentaloma, the right-left involvement, functional-nonfunctional hormones, and the pathology results and clinics of adrenalectomy patients were studied retrospectively. RESULTS: 69% of the cases were female (n: 95), 31% were male (n: 44). 99 of these patients were assessed with CT, 38 with MRI, and 2 with PET results. The surrenal involvement was in the right in 39.6%, in the left in 67.6% and bilateral in 7.2%. The mass diameter of adrenal incidentalomas was 1-90 mm. 23% of patients with adrenal insufficiency (n: 32) were operated. Incidentalomas according to pathology results were as follow: adrenal cortical adenoma in 14 (43.75%), pheochromocytoma in 8/139 (5,8%), bilateral adrenal hyperplasia in 4 (12,5%), adrenal cortical carcinoma in 2 (6,25%), lipomas in 1 (3,12%), mature cystic teratomas in 1 (3,12%), ganglioneuromas in 1 (3,12%) collision tumor in 1 (3,12%). Result of clinicopathological evaluation of patients with adrenal incidentaloma; there was hypertension in 46 of cases (33,1%), Diabetes Mellitus (along with hypertension) in 18 (12,9%), cushing syndrome (hypertension in 4, diabetes and hypertension in 3) in 16 (11,5%), pheochromocytoma in 8 (5,8%), hyperaldosteronism due to adrenal hyperplasia in 5 (3,5%) and Conn syndrome in 3 (2,1%). 2 of the 4 patients with cortical adrenal hyperplasia were diagnosed with Cushing's syndrome and one with primary hyperaldosteronism. 85.7% of patients with adrenal cortical adenoma were hormonally active. The lesion diameter of 18 patients with functional adrenal mass was less than 40 mm, and the mean diameter was 23,1 mm. The lesion diameters of the others were 44 mm and 60 mm. A 11-mm lesion with Conn's syndrome was detected as calcific on imaging. The diameters of the 2 nonfunctional cortical adenomas were 40 mm and 90 mm. Imaging revealed calcification in 4 patients. 2 of these patients were operated. As a result of pathology one was adenoma, the other was adrenal cancer. DISCUSSION AND CONCLUSION: Most of the adrenal incidental cases in our series are nonfunctional adenomas. Among the functional adenomas, Cushing's syndrome was the most common and the second was hyperaldosteronism. The factors that lead to the operation of the masses are function and size.

Purpose: To assess the results of a technique for pie crusting of the medial collateral ligament (MCL) and inside-out medial meniscal repair and perform a comparison with the literature. Methods: This retrospective study consisted of electronic data collection between 2012 and 2017 with a minimum of 2 years’ follow-up. The inclusion criteria were the presence of difficult medial meniscal tears with joint tightness requiring pie crusting and the presence of acute or chronic tears of zone I or II with or without anterior cruciate ligament reconstruction (ACLR) using hamstring autograft during the same session. The primary outcome of the study was the achievement of good results with the aforementioned technique. There was no control group. All patients underwent assessments at 1, 2, and 6 months in outpatient clinics. At 6 months, the Lysholm knee score was calculated. For statistical analysis, the Social Science Statistics online program was used to perform descriptive analysis and assess any associations between the variables. Results: This study included 53 patients from a single surgeon’s practice; of these patients, 31 underwent additional ACLR using hamstring autograft during the same session. The mean age was 29.43 years (range, 14-49 years), and the mean increase in the medial joint space width was 3.21 mm (range, 2-5 mm) with pie crusting. At 6 months, the average Lysholm score was 93 (range, 67-100) and the average visual analog scale score was 0.8 (range, 0-4). There was no meaningful association between age, tear pattern, chronicity of tear, joint space width obtained after pie crusting, and associated anterior cruciate ligament tear. Patients returned to their daily activity level at 4.5 months on average and returned to sporting activities at 7.4 months on average. Saphenous nerve symptoms were observed in 5 patients, but no infection or instability was documented in the follow-up period. Conclusions: In this study, we obtained good outcomes using arthroscopic inside-out medial meniscal repair combined with pie crusting for the release of the MCL, with or without ACLR. Level of Evidence: Level IV, therapeutic case series.

Background Volar finger defects where critical structures exposed are always challenging for plastic surgeons. In these types of defects, local flaps, cross finger flaps, abdominal flaps, and free flaps are used. Free dorsoulnar artery perforator (DUAP) flaps and superficial palmar branch of radial artery (SPBRA) flaps are also used. In this case, we present a patient who was scheduled to receive a DUAP flap to address defect on the second finger of right hand; however, we repaired the defect with a SPBRA flap because intraoperative absence of the ulnar artery was observed. Materials and Methods A 34-year-old male patient was admitted with a wound that exposed the tendon and neurovascular bundle on the volar side of the second finger of the right hand. A free DUAP flap was planned for the patient. A perforator was detected during the preoperative Doppler ultrasound examination. While dissecting the perforator, we noted the absence of an ulnar artery proximal to the perforator vessel. The elevated SPBRA flap from same extremity and the defect were closed. Results Postoperative computer tomography showed an absence of the ulnar artery distal to the right antecubital region. No complications were seen in the donor and recipient areas. Long-term motor movements were natural, and the patient's quality of life was good. Conclusion Determining the perforator site using Doppler alone may not be sufficient in preoperative evaluation of patients scheduled to receive DUAP flaps. Performing an Allen test and using advanced imaging methods can prevent surgeons from encountering a bad surprise.

SONUÇ: Rotator manşet yırtığının tedavinde hem artroskopi yardimlı mini açık ve hem de artroskopi, klinik ve radyolojik olarak başarılı sonuçlar vermektedir. Yöntemlerin arasinda ağrı, fonksiyon kapasitesi, hareket açıklığı, kuvvet skorları ve memnuniyet arasından anlamlı bir fark bulunmadi. Sonuçlar her iki yöntemin, ilgili ortopedistler için uygun olabilecegini göstermektedir. Group 1 ve 2 nin kiyaslamasinda UCLA p=0,94, Constant p= 0,356 bulundu. Iki grubun fizik muayene, radyolojik ve subjektif verileri arasinda anlamlı bir farklılık bulunmadi. Cerrahi sonrası fizik muayene, radyolojik ve subjektif verilerinde her iki grupta ameliyat öncesine göre belirgin olarak iyileşme gösterdiği görüldü (p lt;0,0001). Radyolojik Thomazeau atrofi ve yağlı dejenerasyon sınıflamasında, 11 grade 1, 25 grade 2, 4 grade 3 idi. Tendon bütünlüğü sağlam olarak değerlendirilen hastalarda yağlı dejenerasyon ve atrofide artma izlenmedi, yırtık olan 6 hastanın 3’ünde seviye artış gözlendi. Grup 2’ de, ortalama yaşı 53,1 idi. UCLA skorlaması ameliyat öncesi ortalama 11,12 sonrası 31,16. Constant Murley skorlaması ameliyat öncesi ortalama 31, sonrası 87,48 idi. BULGULAR: Grup 1’de, ortalama yaş 57,4 idi. UCLA skorlaması ameliyat öncesi ortalama 10,93, sonrası 32,46 idi. Constant Murley skorlaması ameliyat öncesi ortalama 31,6 sonrası 88,13 idi. GEREÇ VE YÖNTEMLER: 2014-2016 yılları arasında 40 hasta 2 grup halinde retrospektif olarak incelendi. 15 atroskopi yardımlı mini açık (grup 1), 25 artroskopik yöntemle (grup 2) tedavi edildi. Gruplar, yaş, cinsiyet, cerrahi öncesi ve sonrası muayene ve radyolojik bulgular, Constant Murley ve UCLA skorlamaları açısından değerlendirildi. AMAÇ: Rotator manşet yırtıklarının tamirinde uygulanan artroskopi yardımlı mini açık ve artroskopik yöntemlerinin klinik ve radyolojik olarak karşılaştırılması amaclanmistir.

Cancer is the second most important cause of mortality, and millions of people either have or have had the disease. Leukaemia is one of the most common forms of cancer. Autoantibodies that have developed against the organism’s self-antigens are detected in the sera of subjects with cancer. In recent years carbonic anhydrase (CA) autoantibodies have been determined in some autoimmune diseases and carcinomas, but the mechanisms underlying this immune response have not yet been fully explained. The purpose of this study was to determine CA I and II autoantibodies in subjects with chronic lymphocytic leukaemia (CLL) and to provide a novel perspective regarding the autoimmune basis of the disease. Autoantibody levels were investigated using enzyme-linked immunosorbent assay (ELISA) in serum samples from 37 patients with CLL and 37 healthy peers. Anti-CA I titres in the CLL group were significantly higher compared with the control group (p = 0.0001). However, there was no significant difference between CLL and control groups in terms of anti-CA II titres (p = 0.278). The prevalences of CA I and II autoantibodies in patients with CLL in this study were 27% and 24.3%, respectively. Our results suggest that these autoantibodies may be involved in the pathogenesis of CLL. More extensive studies are now needed to reveal the entire mechanism.

Objective: The aim of the present study was to investigate effects of resveratrol (RSV) over ovarian hyperstimulation syndrome (OHSS) in rat model. Materials and Methods: 24 female Wistar rats (22 days old) were divided into four groups. Group 1 (control group; n = 6) received 0.1 ml intraperitoneal (IP) saline from days 22–26; group 2 (mild-stimulated group; n = 6) received 10 IU pregnant mare serum gonadotropin (PMSG) on day 24 and 10 IU of hCG 48 h later (day 26); group 3 (OHSS group; n = 6) was given 10 IU of PMSG for 4 consecutive days from day 22 and 30 IU hCG on the fifth day to induce OHSS; group 4 (OHSS + RSV group; n = 6) was treated the same as group 3, but received 60 mg/kg RSV 2 h before PMSG injection for 4 consecutive days and 2 h before the hCG injection on the fifth day. Results: Weight gain was highest in the OHSS group. Ovarian weights were lower in the treatment group than OHSS group. Peritoneal fluid VEGF levels were lower for RSV group compared to group 2 and 3. Total VEGF immunoreactivity was higher in OHSS group than group 1, 2 and 4. Conclusion: These results indicate that RSV is beneficial for prevention of OHSS by reducing the increases in body and ovarian weight and VEGF activity. These effects may be mediated by anti-inflammatory, anti-oxidant and anti-angiogenic capacity of RSV.

The organic (ecologic-biologic) agricultural practices in Turkey began in 1985 with organic raisins and dried figs demand of European countries. As of 2015, 1829291 tons of organic products from 197 different products, which comprise grapes, in 515268 ha, are produced by 69967 farmers. Currently, the number of registered enterprises operating in organic agriculture is over 1500. As in the entire in world and in Turkey, the share of organic production in grape production is increasing. Organic grape production is carried out in 10645 ha area in Turkey. This amount constitutes approximately 2.3% of the total grape production area in Turkey. Organic grape is the second major product of Turkey export, and the export share of organic products in recent years is increased to 20-30%. The share of the organic table grape production in total organic grape production is an increasing trend and the studies in this direction are continuing.

Objectives: This study aimed to evaluate the serum concentrations of PAPP-A (pregnancy associated placental protein-A), a biomarker which is associated with cardiovascular disease, in patients with polycystic ovary syndrome (PCOS). Materials and Methods: A total of 62 women with PCOS, and 68 age and body mass index (BMI) matched controls were eligible for the study. Hirsutism scores, hormonal and metabolic profile as well as PAPP-A levels were assessed in each subject. Results: Women with PCOS and controls yielded similar median serum levels of PAPP-A (1.7 ng/ml versus 1.8 ng/ml, respectively, p = 0.328). However, when patients were compared based on BMI; subgroup analyses found that among women with BMI

The purpose of this study is to introduce a two-stage solution approach for a large-scale home healthcare routeing and scheduling problem (HHCRSP). In the first part of the two-stage solution approach, a cluster-assign algorithm is employed, based on the home location and the time to obtain feasible clusters. In the second stage, using these clusters, route construction heuristics start to create schedules and routes, taking the side constraints of the model into consideration. Using the novelty of this two-stage solution approach, higher diversification is achieved with a series of newly-developed cross movement strategies. The computational results show that our solution approach offers certain advantages, such as an increase in the efficient use of human resources, and a decrease in the working time of nurses.

Objective: The aim of this study is to determine the frequency of unintended pregnancies, induced abortions and associated risk factors in women who have been admitted to hospitals in Hatay. Method: The subjects of this cross-sectional study were women who had been admitted to hospitals for the purposes of delivery or abortion, during a month-long period. A structured questionnaire was taken by 635 women. Unintended pregnancy was dependent variable. The independent variables were: age, husband’s age, civil status, total number of pregnancies, employment, use of family planning methods and family planning consultation services. Chi-square and Student's t-test were used to analyze of data. Results:21.4% of women reported using a family planning method when they got pregnant and 15.1% of the women said they did not want to be this pregnant. Ages of the women and their husbands, as well as the total number of pregnancies, were higher among unintended pregnancies (p10.4% ended with spontaneous abortions and 4.25% were ended with induced abortions. The primary reason given for induced abortion was economic difficulties (44%). Conclusion: Unintended pregnancy rate is high in Hatay. It is estimated that almost half of all induced abortions are reported as spontaneous or therapeutic abortions.

Background: The time in therapeutic range values may vary between different geographical regions of Turkey in patients vitamin K antagonist therapy. Aims: To evaluate the time in therapeutic range percentages, efficacy, safety and awareness of warfarin according to the different geographical regions in patients who participated in the WARFARIN-TR study (The Awareness, Efficacy, Safety and Time in Therapeutic Range of Warfarin in the Turkish population) in Turkey. Study Design: Cross-sectional study. Methods: The WARFARIN-TR study includes 4987 patients using warfarin and involved regular international normalized ratio monitoring between January 1, 2014 and December 31, 2014. Patients attended follow-ups for 12 months. The sample size calculations were analysed according to the density of the regional population and according to Turkish Statistical Institute data. The time in therapeutic range was calculated according to F.R. Roosendaal’s algorithm. Awareness was evaluated based on the patients’ knowledge of the effect of warfarin and food-drug interactions with simple questions developed based on a literature review. Results: The Turkey-wide time in therapeutic range was reported as 49.5%±22.9 in the WARFARIN-TR study. There were statistically significant differences between regions in terms of time in therapeutic range (p

Amaç: Bu çalışma Hatay’da akraba evliliği sıklığını, nedenlerini ve bunların çocuk sağlığına, kadınların ilişkilerindeki mutluluk düzeyine ve yaşam doyumuna etkilerini değerlendirdi. Yöntem: Kesitsel nitelikteki araştırmada evreni, Hatay’da yaşayan evli, boşanmış ya da eşi ölmüş kadınlar oluşturdu. Çalışma örneklemi çok aşamalı örneklemle seçilen 584 kadın idi. Veriler yüz yüze anket formu ile Nisan-Mayıs 2014’te kadınların evlerinde toplandı. Ölçüm aracı olarak kullanılan soru kâğıdı ‘kişisel bilgiler, doğurganlık bilgileri, hastalık ve engellilik durumu, evlilik bilgileri, sosyal ve ekonomik faktörler, evlilik şekli üzerine düşünceler, ilişkilerde mutluluk ölçeği ve yaşam doyum ölçeği’ bölümlerini içerdi. Bulgular: Akraba evliliği sıklığı %34.4 idi ve düşük öğrenim düzeyi, düşük ekonomik durum ve düşük gelirle ilişkili idi (p0.05). Sonuç: Hatay’da akraba evliliği çok yaygındır; düşük ekonomik durum ve öğrenim düzeyiyle ilişkilidir. Çocuk sağlığı üzerine olumsuz etkileri vardır.Anahtar Kelimeler: Akraba evliliği, çocuk ölümleri, mutluluk, doyum, evlilik şekilleri

Abstract Objective: Transcatheter aortic valve implantation has recently been used in the treatment of severe aortic valve stenosis, particularly in patients with high mortality and morbidity rates for open surgery. The purpose of this study was to compare quality of life in patients over 70 years of age undergoing surgical or transcatheter aortic valve implantation, before the procedure and in the early post-procedural period. Methods: Seventy-nine patients were included in the study, 38 (48.1%) male and 41 (51.9%) female. Mean age of patients was 74.3±5.2 (70-91) years. The surgical aortic valve replacement group consisted of 51 (64.6%) patients and the transcatheter aortic valve replacement group of 28 (35.4%). Quality of life data before the procedure and at the 3rd month postoperatively in patients aged 70 years and older undergoing surgical or transcatheter aortic valve implantation were assessed using the 36-item Short Form Health Survey form. Results: Positive increases in physical task difficulty (13.2±9.8vs. 5.1±7.3) (P=0.001), emotional task difficulty (14.4±11.9 vs.8.5±6.4) (P=0.035), and mental health (0.4±10.4 vs. 9.6±15.1) (P=0.001; P

It is known that ghrelin, obestatin and leptin are involved in many biological processes such as appetite-energy regulation, growth hormone release and cell proliferation. In addition to these biological activities of in human and rodents, direct effects of these hormones on reproductive functions and regulation of smooth muscle contractions have gained importance in recent years. In mammals, gonadal functions are regulated by using a complex network of autocrine, paracrine and endocrine signals. The signals involved in the control of energy balance regulate reproductive functions by acting on different hypothalamic pituitary-gonadal axis. The underlying molecular mechanism of gonad is poorly understood and appears to be controlled on genetic, environmental, and hormonal factors. Ghrelin, obestatin and leptin, three recently discovered hormones, are especially coexpressed in endocrine cells. The purpose of this investigation was to examine the immunohistochemical expression and potential biological activity of bull and ram deferent ducts (DD) in relation to the tissue concentration of ghrelin, obestatin and leptin. Ghrelin, obestatin and leptin expression observed in the DD sections were restricted to the cytoplasm of the epithelial and muscle cells. Both ghrelin and leptin expressions were found in smooth muscle cells in muscular layer of DD and smooth muscle cells of blood vessels, and obestatin expression was found in the basal epithelial cells of the luminal epithelium. In conclusion, ghrelin, obestatin and leptin were expressed in varying concentrations in epithelial and muscle cells as well as blood vessels of the deferent ducts of both species. Given the multifunctional biological roles of these peptide hormones, we can suggest that these hormones function in the contraction and hypertrophy of smooth muscles, proliferation or apoptosis of epithelial and muscle cells in DD. Key words: deferent ducts; ghrelin; leptin; obestatin; ruminant; physiological function IZRAŽANJE IN BIOLOŠKA AKTIVNOST GRELINA, OBESTATINA IN LEPTINA V SEMENOVODU PRI BIKU IN OVNU Povzetek: Znano je, da so grelin, obestatin in leptin vključeni v številne biološke procese, kot so uravnavanje apetita, sproščanje rastnega hormona in spodbujanje delitev celic. Poleg omenjenih bioloških učinkov pri ljudeh in glodavcih so v zadnjih letih postali znani tudi njihovi neposredni učinki na delovanje spolnega sistema in uravnavanje kontrakcije gladkih mišic. Pri sesalcih je delovanje spolnih žlez uravnano z zapleteno mrežo avtokrinih, parakrinih in endokrinih sporočil. Sporočila, ki sodelujejo pri nadzoru energetskega ravnotežja v telesu pogosto vplivajo tudi na delovanje spolnega sistema z vplivom na hipotalamusno-hipofizno-spolno os. Osnovni molekularni mehanizem delovanja spolnih žlez je slabo raziskan, na njegovo delovanje pa vplivajo genetski, okoljski in hormonski dejavniki. Grelin, obestatin in leptin so trije hormoni, ki v telesu sodelujejo pri urejanju in ohranjanju energetskega ravnotežja. Namen raziskave je bil preučiti imunohistokemično izražanje in potencialno biološko aktivnost grelina, obestatina in leptina v semenovodu bikov in ovnov. Grelin, obestatin in leptin so izraženi v semenovodu in so bili omejeni na citoplazmo epitelijskih in mišičnih celic. Grelin in leptin sta bila izražena v gladkih mišičnih celicah mišične plasti semenovoda in gladkih mišičnih celicah krvnih žil. Obestatin je bil izražen v bazalnih epitelijskih celicah svetline semenovoda. Grelin, obestatin in leptin so torej izraženi v različnih koncentracijah v epitelnih in mišičnih celicah ter krvnih žilah v semenovodu pri biku in ovnu. Glede na raznolike biološke vloge teh peptidnih hormonov lahko predvidevamo, da ti hormoni morda sodelujejo pri krčenju in hipertrofiji gladkih mišic ter pri množenju ali apoptozi epitelijskih in mišičnih celic v semenovodu. Ključne besede: semenovod; grelin; leptin; obestatin; bik; oven; fiziološka funkcija

According to the Moslems, Mohammed, who is the messenger of Allah, is the Seal of the prophets who were sended by Allah to humanbeing to guardian or to rescue them from the error. His duty of prophethood continued for 23 years; 13 years at Mecca where is the place of birth of prophet Mohammad, and 10 years at Medina where is his emigrating place. For a man who believes in Islam, this short time is most important period in history of mankind, and it is divided two part. Because both of the period of Mecca and Medina have some notable characteristics. When we examine this time in the perspective of establishment of Islamic law, the term of Mecca is a period that creats the general principles, religious and ethical background of foundation of Islamic law. Therefore, the period of Mecca’s legislation charakteristics should be analysed by the scientific methods and new perspectives to understand the mental of Islamic jurisprudence

Background Our objective was to evaluate the effectiveness of clomiphene citrate (CC) vs. letrozole (L) plus human menopausal gonadotropin (hMG) in gonadotropin releasing hormone (GnRH) antagonist protocol in poor prognosis women with previous failed ovarian stimulation undergoing intracytoplasmic sperm injection (ICSI). Materials and Methods This retrospective cohort study included cycles with CC and L plus hMG/GnRH antagonist protocols of 32 poor responders who had failed to have ideal follicles to be retrieved during oocyte pick-up (OPU) or embryo transfer (ET) at least for 2 previous in vitro fertilization (IVF) cycles with microdose flare protocol or GnRH antagonist protocol from January 2006 to December 2009. Main outcome measures were implantation, clinical pregnancy and live birth rates per cycle. Duration of stimulation, mean gonadotropin dose used, endometrial thickness, number of mature follicles, serum estradiol (E2) and progesterone (P) levels on the day of human chorionic gonadotropin (hCG) administration, number of retrieved oocytes and fertilization rates were also evaluated. Results A total number of 42 cycles of 32 severe poor responders were evaluated. Total gonadotropin consumption was significantly lower (1491 ± 873 vs. 2808 ± 1581 IU, P=0.005) and mean E2 level on the day of hCG injection were significantly higher in CC group than L group (443.3 ± 255.2 vs. 255.4 ± 285.2 pg/mL, P=0.03). ET, overall pregnancy and live birth rates per cycle were significantly higher in CC than L protocol (27.2 vs. 15%, 13.6 vs. 0% and 4.5 vs. 0%, respectively, P < 0.05). Conclusion Severe poor responders who had previously failed to respond to microdose or GnRH antagonist protocols may benefit from CC plus hMG/GnRH antagonist protocol despite high cancellation rate.

Abstract Objective: This study aimed to show the effects of intra-operative diltiazem infusion on flow in arterial and venous grafts in coronary artery bypass graft surgery. Methods: Hundred fourty patients with a total of 361 grafts [205 (57%) arterial and 156 (43%) venous] underwent isolated coronary surgery. All the grafts were measured by intraoperative transit time flow meter intra-operatively. Group A (n=70) consisted of patients who received diltiazem infusion (dose of 2.5 microgram/kg/min), and Group B (n=70) didn't receive diltiazem infusion. Results: Mean graft flow values of left internal mammary artery were 53 ml/min in Group A and 40 ml/min in Group B (P

Objectives: The European Action on Primary and Secondary Prevention by Intervention to Reduce Events (EUROASPIRE III) Study in coronary artery disease had been undertaken between the years of 2006 and 2007, with the participation of 22 countries in Europe including Turkey (76 centers). In this study, the situation in the management of coronary artery disease in Kyrgyzstan was compared with EUROASPIRE III findings of Turkey and Europe. Study design: The results of 1067 patients with stable coronary artery disease admitted to 22 centers in Kyrgyzstan were studied retrospectively and compared with the European and Turkish findings in EUROASPIRE III. During the study, the patients were interviewed and examined in the first year after the initial coronary event and/or intervention. Results: The gender distribution of the 1067 patients in the study was 658 female (61.7%) and 409 male (38.3%), and the average age was 68+-14 years. The ratio of young patients (

Background: The aim of this study was to determine the relationship between marital violence and distress level among women with a diagnosis of infertility. Materials and Methods: In this prospective randomized study, a total of 180 patients were included in the study. Amongst these, pertubation of the uterine cavity was carried out in 79 patients prior to insemination. One patient in the pertubation group was later excluded because insemination could not be performed due to cycle cancellation. Results: There were no significant differences in demographic characteristics between the study and control groups. When the pregnancy rates of both groups were evaluated, 14(17.8%) patients in the study group achieved pregancy. Three (3.8%) had a biochemical pregnancy, 1(1.3%) miscarried and 10(12.7%) had live births. In the control group, a total of 24(23.8%) pregnancies were achieved, amongst which one (1%) had a biochemical pregnancy, 3(3%) miscarried and 20(19.8%) resulted in live births. There was no significant difference between groups in terms of total pregnancy and live birth rates (p > 0.05). There was a 21% total pregnancy loss rate. There was no significant difference between the control and study groups in terms of pregnancy loss rates (p > 0.05). Conclusion: This study on a homogenous group of unexplained infertile patients determined that the addition of pertubation to a controlled ovarian hyperstimulation plus intrauterine insemination (COH+IUI) treatment protocol did not affect pregnancy rates (Registration Number: NCT01999959).