Combination of myasthenia gravis and HELLP Syndrome in pregnancy: case report and literature review

Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction. Preeclampsia/HELLP Syndrome is a potentially life-threatening pregnancy complication. The combination of HELLP Syndrome and MG is challenging because the preferred treatment regimens for both conditions generally contradict each other. Our aim is to describe the management options when these two diseases occur simultaneously. We present a case in which a woman with an established diagnosis of MG developed HELLP Syndrome at 31 weeks gestation. Magnesium sulfate prophylaxis was not utilized because of the patient’s MG diagnosis. A cesarean delivery was performed. Reported cases with combined diagnoses of MG and preeclampsia/HELLP Syndrome are reviewed and adjustments to treatment plans are discussed. Management of such patients should be done with a multidisciplinary approach in advanced medical centers with careful consideration of the medications used

A comparison of pelvic organ prolapse and sexual function after abdominal and laparoscopic hysterectomy

Objectives: Hysterectomy is one of the risk factors of pelvic organ prolapse (POP). There is no consensus on whether the route of hysterectomy affects the subsequent development of POP. The aim of the study was to assess POP and sexual function 1 year after a hysterectomy when comparing total abdominal hysterectomy (TAH) with total laparoscopic hysterectomy (TLH). The study applied the pelvic organ prolapse quantification (POP-Q) as the measure of POP and a short-form of the POP/Urinary Incontinence Sexual Function Questionnaire (PISQ-12).Material and methods: All patients that underwent either TAH or TLH due to benign causes between March 2016 and March 2017 at the tertiary hospital used for the study were included in our prospective cohort study. POP-Q measurements and PISQ-12 scores were assessed 1 year postoperatively.Results: We included 182 patients in the clinical examinations. There were no statistically significant differences in demographic characteristics between the TAH and TLH groups. Also, there we no differences observed in the objective POP measurements between the two study groups. Results of the two groups’ PISQ-12 scores were also similar. However, postoperative vaginal lengths were found to be significantly shorter in the patients who had undergone TAH compared with those who had undergone TLH.Conclusions: TAH and TLH are comparable regarding short-term objective pelvic organ prolapse. Although we foundstatistically a significant difference in vaginal lengths between the two groups, no clinical significance was found in terms of sexual function

Maternal age, education level and migration: Socioeconomic determinants for smoking during pregnancy in a field study from Turkey

WOS: 000279909900003PubMed ID: 20534133Background: Smoking during pregnancy has been associated with socioeconomic determinants and it is recognized as the most important preventable risk factor for an unsuccessful pregnancy outcome. Turkey has national data on the prevalance of smoking during pregnancy; however there is no data on the characteristics of the high-risk population. This is a field study that aims to identify socioeconomic determinants for smoking during pregnancy as well as differentiating the daily and occasional smokers. Method: Cross sectional study was conducted among women with 0-5 year old children living in the area served by Primary Health Care Center (PHCC) in Burhaniye, Turkey. Face-to-face interviews were conducted by the researchers during January-March 2008 at the home of the participants with 83.7% response rate (n = 256). The relation of "smoking during pregnacy" and "daily smoking during pregnancy" with the independent variables was determined with chi(2) tests. Women's age, educational level, number of previous births, place of origin, migration, partner's educational level, poverty, perceived income, social class were evaluated. Statistical significance was achieved when the p value was less than 0.05. The variables in relation with the dependent variables in the chi(2) tests were included in the forward-stepwise logistic analysis. Results: Prevalance of smoking during pregnancy was 22.7%. The majority (74.1%) were daily smokers. Young mothers (< 20), low educated women and migrants were at increased risk for smoking during pregnancy. Low education and being a migrant were risk factors for daily consumption (p < 0.05). Conclusions: Systematic attention should be paid to socioeconomic determinants in smoking for pregnant women, especially in countries like Turkey with high rates of infant and mother mortality and substantial health inequalities. Young mothers (< 20), low educated women and migrants are important groups to focus on

Antioxidant plants and diabetes mellitus

The incidence of diabetes mellitus (DM) is increasing rapidly and it is expected to increase by 2030. Other than currently available therapeutic options, there are a lot of herbal medicines, which have been recommended for its treatment. Herbal medicines have long been used for the treatment of DM because of the advantage usually having no or less side-effects. Most of these plants have antioxidant activities and hence, prevent or treat hard curable diseases, other than having the property of combating the toxicity of toxic or other drugs. In this review other than presenting new findings of DM, the plants, which are used and have been evaluated scientifically for the treatment of DM are introduced

Demographic, Epidemiologic and Clinical Analyses of Paediatric Patients Hospitalized with Henoch-Schonlein Purpura: A Retrospective Study

WOS:000617712200007Aim: Henoch-Schonlein purpura (HSP) is the most common systemic vasculitis in children. The purpose of this study was to assess the clinical, epidemiological, and laboratory features of 117 children diagnosed with HSP. Materials and Methods: This study was conducted to evaluate the data of 117 children with HSP, retrospectively. The presence of the cardinal clinical findings such as purpura, abdominal pain, and arthralgia; and the presence of increased erythrocyte sedimentation rate, decreased serum C3 levels, leukocytosis, blood in the stool, haematuria, and proteinuria were assessed in children with HSP. Results: of the 117 patients enrolled in the study, 68 were mates (58.1%) and 49 were females (41.9%). The median age was 85 (49) months. Purpuric skin lesions were detected in ninety-eight (97.9%) patients, arthritis/arthralgia in 71 (60.6%), gastrointestinal involvement in 52 (44.4%), and renal involvement in 27 (23%) patients. The median duration of hospitalization day was 6 (10) days. Non-palpable purpuric skin lesions mostly located on ankles were the most common involvement in the patients. Conclusion: Non-palpable purpuric skin lesions were the most common presentations followed by arthritis/arthralgia, and gastrointestinal involvement in our patients. Seasonal distributions, gender, and ages of the patients were concluded to be noncontradictory compared with the literature. Although variable clinical findings in the patients were found, the cardinal features of HSP were determined in almost all subjects in this study

Irritable bowel syndrome in childhood: Review

Irritable bowel syndrome (IBS), is also known spastic colon, is one of the functional bowel diseases. Etiology of IBS is unknown and is associated with symptoms such as diarrhea and constipation. It usually affects both adults and adolescents. Functional bowel differences, disordered defecation habits and chronic abdominal pain, which is the most common of the symptoms, is due to bowel disorder. The frequency of the pain varies from patient to patient and is usually observed on the around umblicus but the pain observed another places on the abdomen. Etiopathogenesis hasn't become definite yet. The second important symptom is disturbed defecation and the changes in defecation pattern. Constipation and diarrhea often follow each other. Patients need to defecate after each meal. Dyspeptic symptoms; especially postprandial abdominal tenderness, abdominal discomfort, bloating, gas, indigestion, loss of appetite, nausea are also common in IBS. Diagnostic criteria which named Rome III criteria based on recurrent abdominal pain or discomfort following; improvement with defecation or change in frequency of stool or stool appearance. We report here; irritable bowel syndrome, diagnosis and treatment of it in children. © 2015 by Türkiye Klinikleri