The comparison of bone mineral density in primary hyperparathyroidim, vitamin D induced secondary hyperparathyroidism, and patients with both condition: a single center experience

Background: To compare bone mineral densities via dual energy X-ray absorptiometry method (DXA) between various hyperparathyroidism (HPT) types such as primary, vitamin D induced secondary, and both conditions.Methods: Participants who were aged between 18-45 years and had elevated parathyroid hormone levels were included. After initial evaluations, patients were divided into 3 groups according to diagnoses: primary HPT (pHPT), vitamin D induced secondary HPT (sHPT), and combined (primary+secondary) one. In addition to the bone mineral density (BMD), demographic and laboratory datas were recorded.Results: Of 166 patients, 147 of the patients were female, 19 were male, and average age was 38.10±7.24 years. Significant difference was found in terms of age (p=0.03) between pHPT and sHPT. Blood calcium, PTH, 25-OH vitamin D, and daily urine calcium excretion levels were significantly higher and phosphorus levels were lower in the pHPT group compared to the sHPT and combined disease group. Both T and Z scores of the pHPT group were significantly lower than the sHPT group especially in the lumbar region. However, no significant difference was noted between pHPT and combined disease group with respect to T and Z scores in all regions.Conclusions: The results of this study indicate that pHPT has a significantly worse impact on skeletal mineral density particularly in the lumbar region than sHPT. The addition of vitamin D deficiency to the clinical picture seems to have no significant influence on BMD in pHPT. To confirm and clarify these findings, prospective studies with larger number of participants are needed

Is BMI Sufficient to Evaluate the Association between Obesity and Ovarian Reserves?

Body fat content and distribution might have an effect on ovarian reserves. Here, we studied the effects of body fat distribution on the antral follicle count (AFC) of women who consulted for infertility. In this two-center study, the ovarian reserves of patients who came to the hospital for infertility treatment was evaluated based on their AFC and early follicular phase follicle-stimulating hormone (FSH) levels. In addition, adiposity was evaluated using their body mass index (BMI) and waist-to-hip ratios (WHRs), the subcutaneous tissue thickness of the bicipital and tricipital regions, and the body adiposity index (BAI). Body fat distribution was evaluated using bioelectrical impedance analysis (BIA). We evaluated 58 patients in this study. While we failed to show a relationship between BMI and WHR based on the AFC, there was a significant relationship between body fat percentage and the AFC. The AFC in patients with < 35% body fat and ≥ 35% body fat was 11.54 ± 4.27 and 9.00 ± 3.95, respectively (p = 0.029). There was no significant relationship between the AFC and the WHR, BAI, and bicipital and tricipital subcutaneous tissue thickness. BMI may not reflect the adiposity of every patient. When evaluating the ovarian reserves of patients, we must consider other measures of obesity that reflect body fatness. Further large studies must be conducted to investigate the relationship between body fat and infertility

WESTERNIZATION AS CULTURAL TRAUMA: EGYPTIAN RADICAL ISLAMIST DISCOURSE ON RELIGIOUS EDUCATION

In this article, the relation between the Westernization experience and the radical Islamists reaction in Egypt is examined. It is argued that it is necessary to focus on the historical imagination of Westernization to understand the Egyptian reaction as manifested in Islamist religious educational discourse. The historical imagination appears to be based on a traumatic experience which was triggered by a traumatic event, namely British colonialism. The religious educational discourse in Egypt, an opportune case to observe radical Islamist response to the trauma experience, is found to be a mediating structure between the historical experience and the Islamist reaction. The study indicates that emic categories and societal emotions play a significant role in this mediation

Efficiency analysis of Turkish natural gas distribution companies by using data envelopment analysis method

This paper analyzes the performance of 38 Turkish natural gas distribution companies by using a non-parametric method, Data Envelopment Analysis (DEA). The results are used to determine the most proper model specification, to detect the important criteria affecting the efficiency levels, and to find the common characteristics of the most inefficient firms. We find that public firms compared to private firms, non-tender firms compared to tender firms, large firms compared to small firms and firms operating in more developed areas compared to firms operating in underdeveloped areas that utilize resources and manage costs more efficiently. However, we cannot reach a certain conclusion about the comparison of old firms versus the new firms. Lastly, we try to detect the common characteristics of the most inefficient firms and find that most of these firms are immature and low scale companies. Therefore, we think these firms can increase efficiency level either by increasing their delivery amounts through higher penetration rates or by merging or doing both together

Arthroscopic treatment of femoroacetabular impingement: early outcomes

Objective: The aim of the study was to assess the early outcomes of the arthroscopic treatment of femoroacetabular impingement

Heterotopic bone formation following anterior cruciate ligament reconstruction with BPTB autograft

In this study, we present a 36-year-old male patient who developed heterotopic ossification after anterior cruciate ligament (ACL) reconstruction performed using bone-patellar tendon-bone autograft harvested from the 1/3 middle part of the patellar tendon. This ossified part, which restricted range of motion of the affected knee, was excised surgically 1 year after diagnosis. Physical examination, conducted 36 months later, revealed the achievement of full range of motion without any complaints or recurrences. Heterotopic ossification following ACL reconstruction is a very rare complication, which should be removed with open surgery