Giant endometrial polyp protruding from the external cervical os in a postmenopausal woman: magnetic resonance imaging and hysteroscopic findings

Endometrial polyps are most commonly seen in the postmenopausal women with uterine bleeding, although the giant polyps which originate from the uterine cavity and protruding from the cervical os are rare. Several cases which have been described in the literature are usually developed secondary to tamoxifen use, and the polyps do not extend or protrude from the external cervical os. Most of the polyps protruded from the cervical os can mimic a cervical neoplasia or endocervical polyp. We report the case of a giant endometrial polyp (8x4x3 cm in size) which was protruding from the external cervical os and that developed spontaneously without tamoxifen use in a multiparous 73 -year-old woman presenting with vaginal bleeding. Hysteroscopic polypectomy was performed and no recurrence was seen at 6 months after surgery. Diagnosis, management and outcome of this rare entity have been discussed according to the literature

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Evaluation of the Effects of Home-Based Deep Breathing Exercises in Parkinson's Disease Patients

Objectives: The aim of our study was to investigate the effects of home-based deep breathing exercises (DBEs) on pulmonary functions and fatigue in patients with mild and moderate stages of Parkinson's disease (PD)

The effect of supervised exercises on static and dynamic balance in Parkinson's disease patients

Background/Aim: The aim of the this study was to examine the effects of supervised exercises on measures of static and dynamic balance Parkinson's disease (PD) patients

The Effects of Home Exercise Program on Balance and Functional Capacity in Parkinsonian Patients

Objective: The aim of our study is to investigate the effects of home exercise program on balance, postural control, coordination and functional strengthening in parkinsonian patients

Factors Affecting Topical Treatment Success in Pediatric Scabies Cases: A Cross-Sectional Study

Introduction: Scabies is a common disease affecting the pediatric population. Treatment failure and relapses are frequent. Objectives: We aimed to define factors affecting topical treatment success in pediatric scabies patients. Methods: This multicenter cross-sectional study was performed between April and December 2022. Pediatric scabies cases were classified as treatment failure (TF) versus treatment success (TS). Results: We enrolled 170 patients in the study. In the TF group, the presence of symptomatic household members and referral from physicians other than dermatologists were more common (both p<0,001) and relapse rates and total symptom duration were higher (p=0,007, p<0,001 respectively). Permethrin 5% was more commonly used in the TF group (71.1% versus 25%) (p<0,001); however, the ratio of patients treated with sulfur preparations was significantly higher in the TS group (60.7% vs 16.9%) (p<0,001). Misapplication of topical therapy was significantly more common in the TF group (p<0,001), statistically significant errors being: (i) lack of treatment of close contacts (p<0,001); (ii) single application (p<0,001); and (iii) local application (p=0,027). In a multivariate analysis, treatment success was mainly associated with (i) presence of atopy (O.R.: 5,29, 95% CI:  1,22-25,57) ;(ii) absence of symptomatic household members (O.R.: 5,29, 95% CI:  1,72-16,27);  (iii) presentation to dermatologists rather than other specialties (O.R.: 6,08, 95% CI: 1,9-19,51); whereas use of permethrin negatively affected treatment success (O.R: 0,22, 95% CI: 0,07-0,71). Conclusions: Pediatric scabies patients should be treated before other family members get affected and with topicals other than permethrin. Awareness of scabies disease needs to be increased among non-dermatologists

Excess mortality in istanbul during extreme heat waves between 2013 and 2017

Heat waves are one of the most common direct impacts of anthropogenic climate change and excess mortality their most apparent impact. While Turkey has experienced an increase in heat wave episodes between 1971 and 2016, no epidemiological studies have examined their potential impacts on public health so far. In this study excess mortality in Istanbul attributable to extreme heat wave episodes between 2013 and 2017 is presented. Total excess deaths were calculated using mortality rates across different categories, including age, sex, and cause of death. The analysis shows that three extreme heat waves in the summer months of 2015, 2016, and 2017, which covered 14 days in total, significantly increased the mortality rate and caused 419 excess deaths in 23 days of exposure. As climate simulations show that Turkey is one of the most vulnerable countries in the Europe region to the increased intensity of heat waves until the end of the 21st century, further studies about increased mortality and morbidity risks due to heat waves in Istanbul and other cities, as well as intervention studies, are necessary.Scientific Research Projects Coordination Unit of Istanbul University-Cerrahpas