Evaluation of factors that affect skin to subarachnoid space distance

Introduction: Lumbar puncture is a procedure frequently used in anesthetic practice. For the success of the procedure, prediction of skin to subarachnoid space distance (SSD) is valuable. In this study, we aimed to evaluate the relationship between SSD with age and body mass index (BMI). Methods: Two hundred and fifty patients, ASA physical status I, II, and III scheduled to undergo elective surgery under spinal anesthesia, were studied. Spinal anesthesia was induced in the sitting position at the L3–4 vertebral level using a midline approach. Furthermore, the level of L3–L4 was identified by palpation, using Tuffier’s line as a guide. Following an intrathecal injection, the spinal needle was grasped between the thumb and the index finger during its removal from the patient’s back. From the grasping point, SSD was measured using rulers. Results: Mean values of SSD at the L3-4 interspace were 55.43±6.47 mm (range 35-74). Statistically significant correlations were observed between SSD with BMI and body weight (ρ=0.650, P<0.001 and ρ=0.651, P<0.001, respectively). Statistically significant correlation was not found between SSD with age, gender and body height (ρ=0.120, P=0.058; ρ=-0.047, P=0.4568 and ρ=0.089, P=0.159, respectively). Conclusions: SSD is affected by BMI and body weight but not by age, gender and body height

Evaluating the statistics courses in terms of the statistical literacy: Didactic pathways of pre-Service mathematics teachers

This study intends to determine the statistical literacy levels of pre-service mathematics teachers and to evaluate the contribution of the statistics courses in the elementary mathematics education curriculum to statistical literacy. A mixed methods research design was adopted. The study group consisted of 202 pre-service mathematics teachers enrolled in the Statistics and Probability course. In the data collection process, a pre-test and post-test was administered to determine the pre-service teachers' statistical literacy before and after the statistical course, and classroom observations were performed to identify the contribution of the statistics course to statistical literacy. The Rasch model was used for validity-reliability analyses, and one-way ANOVA tests were used to analyze the quantitative data. Content analysis was utilized in the analysis of qualitative data, which revealed that statistical literacy levels of pre-service teachers are generally low, generally influencing the competence of pre-service teachers. The pre-service teachers failed in the sample selection component in the pretest and data interpretation in the post- test, while they were more successful with table and graphs in the pre-test and sample selection in the post-test. The comparative analysis of revealed statistically significant differences in favor of U4 in the pre- test, but in favor of U1 in the post-test. It was concluded that practices included in the statistics lessons could be effective on these differences

İlköğretim 7. Sınıf Matematik Öğretmenlerinin Kullandıkları Problem Türlerinin Belirlenmesi

Designation of the problem types used by mathematics teachers and determination of the used problem types was studied. In this regard, according to the literature review, problems were classified into 3 categories, such as presentation, content and solution. In order to elaborate these problem compositions and to designate the problem types used by teachers, the lectures given by 4 different primary school mathematics teachers, selected from Trabzon province, are followed for a month. Sub-categories, towards the composition of problems designated by the help of observations, were formed. In terms of presentation, it was observed that the teachers prefer rather the problems that are verbal, short and not including much quantitative data. While the problems not including irrelevant and insufficient data, being curriculum-dependent and routine are dominant in terms of content; the problems rather being easy and requiring plenty of operations are preferred in terms of solution structure.There are some constrains for teachers such as a curriculum to be followed strictly and a placement test to be performed as requirements of the system. Even though these all constrains, it is thought to be important that teachers must become conscious about different question types and use them periodically in the classroom in order for students both to face different problem types and to increase their success in problem solving.Bu çalışma ile matematik öğretmenlerinin kullandıkları problem türlerinin belirlenmesi ve kullanılan problem türlerinin öğretmenlere bağlı olup olmadığının tespit edilmesi amaçlanmıştır. Bu çalışma kapsamında yapılan literatür çalışması sonucunda problemler sunuş, içerik ve çözüm olmak üzere 3 kategoride sınıflandırılmıştır. Bu problem yapılarını detaylandırmak ve öğretmenlerin kullandıkları problem türlerini belirlemek amacıyla Trabzon İli içerisinden seçilen 4 ilköğretim matematik öğretmeninin dersleri bir ay süreyle izlenmiştir. Gözlemler yardımıyla belirtilen problem yapılarına yönelik alt kategoriler oluşturulmuştur. Sunuş açısından öğretmenlerin daha çok sözel, kısa ve çok sayısal veri içermeyen problemleri tercih ettikleri görülmüştür. İçerik açısından ilgisiz ve eksik veri içermeyen, müfredata bağımlı ve rutin problemlerin baskın olduğu ortaya çıkarken; çözüm yapısında ise en çok kolay ve bol işlem içermeyen problem türleri tercih edilmektedir.Her ne kadar öğretmenlerin yetiştirmesi gereken bir müfredat ve sistem gereği yapılan bir seviye belirleme sınavı gibi engeller mevcut olsa da öğretmenlerin farklı problem türleri hakkında bilinçlenerek belirli aralıklarla sınıf ortamında kullanmalarının hem öğrencilerin farklı problem türlerini görmeleri hem de problem çözme başarılarını artırabilmeleri açısından önemli olacağı düşünülmektedir

Ortaokul Sekizinci Sınıf Öğrencilerinin İstatistiksel Süreçteki Deneyimlerinin İncelenmesi

This study aims at making 8th grade students go through a statistical process and gain experience in this matter and revealing their behaviors, experiences, and difficulties at each stage of this process. Activities were designed in a way allowing the students to experience a statistical process. Then the students were made to get involved in these activities through group work. Data were collected via statistical process activities, the reflection papers of the students concerning the process, and the video-recordings of classroom discussions. The activities were prepared based on Ben-Zvi and Arcavi (2001) as well as expert opinions. The students posed questions that could be directly answered by the help of relevant texts rather than problems that could be solved through data analysis. The groups formed their tables and charts by focusing on just one feature or variable though the data in the activities involved features of more than one variable. As making an inference by interpreting data requires experience, it is recommended in this study that activities be prepared in a way allowing the use of skills of this sort.Bu çalışmada ilköğretim 8. sınıf öğrencilerine istatistiksel süreç tam anlamıyla yaşatılarak bu konuda deneyim kazanmaları, her bir aşamada sergiledikleri davranışları, yaşadıkları deneyimleri ve zorlukları ortaya koymak amaçlanmıştır. Öğrencilere istatistiksel süreci yaşatacak şekilde etkinlikler tasarlanarak grup çalışması yardımıyla uygulanmıştır. Veri toplama araçlarını istatistiksel sürece yönelik etkinlikler, sürece dair öğrencilerin yansıtıcı yazıları, sınıf tartışmalarına yönelik video kayıtları oluşturmaktadır. Etkinlikler, Ben-Zvi ve Arcavi (2001)’nin çalışmasından ve uzman görüşlerinden yararlanılarak hazırlanmıştır. Öğrenciler verilerin analiz edilmesiyle cevaplanabilecek problemler yerine daha çok etkinliklerde yer alan bağlamı yansıtan, metin yardımıyla doğrudan cevaplandırılabilen sorular oluşturmayı tercih etmişlerdir. Etkinliklerdeki veriler birden fazla değişkene ait özellikler içerse de grupların çizimlerinde sadece bir özelliğe veya değişkene odaklanarak tablo ve grafiklerini oluşturdukları görülmüştür. Öğrencilerin veriler üzerinden yorumlar yaparak çıkarımda bulunmalarının deneyim gerektirdiği düşünülerek etkinliklerin bu tür becerileri ortaya çıkaracak şekilde hazırlanması önerilmektedir

Estrogen priming GnRH antagonist regimen is an efficient protocol in poor responders

International-Federation-of-Fertility-Societies 21st World Congress on Fertility and Sterility / 69th Annual Meeting of the American-Society-for-Reproductive-Medicine -- OCT 12-17, 2013 -- Boston, MAInt Federat Fertil Soc, Amer Soc Reprod Me

Ten years experience with poor responder patients fulfilling bologna criteria

70th Annual Meeting of the American-Society-for-Reproductive-Medicine -- OCT 18-22, 2014 -- Honolulu, HIAmerican Society for Reproductive Medicin

Evaluation of factors that affect skin to subarachnoid space distance

Introduction: Lumbar puncture is a procedure frequently used in anesthetic practice. For the success of the procedure, prediction of skin to subarachnoid space distance (SSD) is valuable. In this study, we aimed to evaluate the relationship between SSD with age and body mass index (BMI). Methods: Two hundred and fifty patients, ASA physical status I, II, and III scheduled to undergo elective surgery under spinal anesthesia, were studied. Spinal anesthesia was induced in the sitting position at the L3–4 vertebral level using a midline approach. Furthermore, the level of L3–L4 was identified by palpation, using Tuffier’s line as a guide. Following an intrathecal injection, the spinal needle was grasped between the thumb and the index finger during its removal from the patient’s back. From the grasping point, SSD was measured using rulers. Results: Mean values of SSD at the L3-4 interspace were 55.43±6.47 mm (range 35-74). Statistically significant correlations were observed between SSD with BMI and body weight (ρ=0.650, P<0.001 and ρ=0.651, P<0.001, respectively). Statistically significant correlation was not found between SSD with age, gender and body height (ρ=0.120, P=0.058; ρ=-0.047, P=0.4568 and ρ=0.089, P=0.159, respectively). Conclusions: SSD is affected by BMI and body weight but not by age, gender and body height

Migration of Ventriculoperitoneal Shunt Catheter into the Inguinal Hernia Sac in a Patient with Hydrocephalus

Literatürde ventriküloperitoneal (VP) şant kataterinin intestinal perforasyon, inguinal herni, peritonit gibi abdominal komplikasyonlara neden olabileceği bildirilmiştir. Hidrosefali nedeniyle VP şant takılmış 2 aylık erkek hastanın klinik takibinde, şant ameliyatından otuz gün sonra sol kasığında şişlik saptandı. Yapılan abdominal ultrasonografi ve direkt grafi tetkiklerinde hastanın sol skrotumu içerisinde VP şant kateterinin distal ucunun izlenmesi üzerine hasta Çocuk Cerrahisi Bölümü tarafından değerlendirildi. Hastaya sol inguinoskrotal herni tanısı koyularak ameliyat edildi. Kateter ucu karın içerisine redükte edilerek yüksek ligasyon ile inguinal herni onarımı yapıldı. Hastanın ameliyat sonrası üç aylık takibi sonunda nüks ve/veya komplikasyon izlenmedi. Sonuç olarak VP şant takılan hastalarda inguinoskrotal komplikasyonlar akılda tutulmalıdır. VP şant ameliyatı sonrası kasık bölgesindeki şişlikler inguinal herni açısından değerlendirilmeli ve erken tanı ve tedavi için aile bilgilendirilmelidir.Ventriculoperitoneal (VP) shunt devices can cause some abdominal complications such as intestinal perforation, inguinal hernia, peritonitis. A two-month-old male who had underwent VP shunt surgery thirty days ago was admitted for swelling in his left inguinal region. Abdominal ultrasonography and X-ray examination revealed that distal part of VP shunt catheter had migrated into the left scrotum and therefore the patient was consulted to the Pediatric Surgery Department. During operation, the shunt catheter was reimplanted into the abdomen and the inguinoscrotal hernia was repaired by using the high ligation technique. No recurrence and/ or complication was occured in the patient during his three-month follow-up. In conclusion, inguinoscrotal complications should be kept in mind for patients who have VP shunts and present with a swelling in the inguinal region. This swelling should be evaluated in terms of inguinal hernia and the family should be informed for early diagnosis and treatment

Factors associated with livebirth in couples undergoing their first in vitro fertilization cycle: An internally validated prediction model

Objective: The aim of the study is to create a new model to predict successful outcome in assisted reproductive techniques

Laparoscopy versus open surgery for the surgical management of tubo-ovarian abscess (TOA). Is there a beneficial impact of early endoscopic intervention in terms of fertility rates?

Objectives: To compare success rates and complications in women undergoing laparoscopic versus open surgical management of tubo-ovarian abscess. We further examined whether early laparoscopic intervention has any impact on pregnancy rates in a subgroup of infertile patients following frozen-thawed embryo transfer. Material and methods: Hospital records of 48 patients diagnosed with TOA between January 2015 and December 2020, who underwent surgical intervention or received only medical treatment were analyzed. All patients were hospitalized, and parenteral antibiotics were commenced on admission initially. Laparoscopic or open surgery was performed within 48 hours course of intravenous antibiotherapy (early intervention) or later according to the clinical findings and antibiotherapy response. Results: Of 48 patients with TOA, 18 (37.5%) underwent laparoscopic and 30 (62.5%) underwent open surgical intervention. The median postoperative hospital stay was shorter (4.5 days vs 7.5 days, respectively; p = 0.035), and postoperative opioid analgesic requirement was lesser in the laparoscopy group compared to open surgery group (22% vs 53%, respectively; p = 0.034). Intra- and post-operative complication rates were similar between the groups. Of these 48 patients, seven were diagnosed to have TOA following oocyte retrieval, and four of these conceived with frozen thawed embryo transfer all of whom underwent laparoscopic surgery within 48 hours of diagnosis. Conclusions: Minimal invasive surgery should be preferred even in the presence of severely adhesive and inflammatory TOA in order to improve postoperative outcomes. Moreover, early laparoscopic intervention may be considered in infertile patients with an aim to optimize pregnancy rates in a subsequent frozen-thawed embryo transfer