Theory of mind and related factors in parents of children diagnosed with autism spectrum disorders

Objective: Impairments constituting the basis of Autism Spectrum Disorder (ASD) are explained in terms of theory-of-mind (ToM). Our study aimed to investigate psychiatric disorders and sociodemographic characteristics potentially associated with ToM in the parents of children with ASD in the context of gender variation. Method: The study involved 84 families with a child diagnosed with ASD (mother, father and child with ASD - 252 participants). The Reading the Mind in the Eye Test (RMET) was applied to evaluate parental ToM. Parents were also assessed using a Sociodemographic Information Form, the Toronto Alexithymia Scale (TAS), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The Childhood Autism Rating Scale (CARS) was applied to assess severity of autism in children. The data obtained were subjected to statistical comparisons. Results:No statistically significant difference was determined between parents’ RMET, BAI, or TAS scores. Mothers’ BDI scores were significantly higher than those of fathers (p=0.009). Higher RMET scores were determined in pa-rents of children with mild ASD and no accompanying disease. Significant negative correlation was determined between children’s CARS scores and parental RMET scores (r=-0.528 p=<0.0001/r=- 0.473 p=<0.0001). Negative correlation was determined between parental TAS and RMET scores (r=-0.303 p=0.005/r=-0.327 p=0.002). Discussion: ToM disturbance in parents increased with severity of ASD in children, although no gender diffe-rence was determined. Further ToM studies involving parents of children with severe ASD are needed

Congenital asymmetric crying face: a case report

Congenital asymmetric crying face is an anomalia caused by unilateral absence or weakness of depressor anguli oris muscle The major finding of the disease is the absence or weakness in the outer and lower movement of the commissure during crying. The other expression muscles are normal and the face is symmetric at rest. The asymmetry in congenital asymmetric crying face is most evident during infancy but decreases by age. Congenital asymmetric crying face can be associated with cervicofacial, musclebone, respiratory, genitourinary and central nervous system anomalia. It is diagnosed by physical examination. This paper presents a six days old infant with Congenital asymmetric crying face and discusses the case in terms of diagnosis and disease features

Four Intoxication Cases Related to the Misuse of Sage Oil

Infantile colic is excessive crying of infants younger than 4 months. Families of children suffering from infantile colic attend to the emergency department frequently and the etiology is not well-known. However many families of chil­dren suffering from infantile colic try pharmacologic and non-pharmacologic treatment, they are sleepless and ex­hausted and are affected negatively. Sage oil is in volatile form and it is recommended to apply 1-2 drops on plantar and tummy region of the body by massage for the treat­ment of infantile colic. Most of drugs used for infantile colic are drops and used orally. Families who do not learn detailed usage information may use it orally or may pre­sumed another drug while suffering from sleepless and drowsiness. Herein we reported 4 cases of sage oil intoxi­cation because of wrong information of wrong application of sage oil. We aimed to reduce the prescribing of sage oil in the treatment of infantile colic and emphasize to give more information about proper use of sage oil

Determination of some physicochemical properties of honeys from Tokat region and their compliance with the Turkish Food Codex

Bu çalışmada; bitki çeşitliliğinin oldukça fazla olduğu Tokat ili ve ilçelerinden temin edilen balların bazı fiziksel ve kimyasal özellikleri belirlenmiştir. 2019 ve 2020 yıllarında 12 ilçeden temin edilen (toplam 24 adet) çiçek balı örneklerinin Türk Standartları (TS) 3036 Bal Standardı ve uluslararası standartlarda kabul görmüş analiz metotları ile yapılan bazı fizikokimyasal, pestisit ve mineral analizleri sonuçlarının Türk Gıda Kodeksi (TGK) Bal Tebliği’ne (2020/7) uygunlukları incelenmiştir. Bal örneklerinde nem miktarı %13,0-20,0; serbest asitlik 26±0,12-48±0,16 meq/kg; elektriksel iletkenlik 0,33-0,86 mS/cm; Hidroksimetilfurfural (HMF) miktarı 0,05-8,69 mg/kg; prolin değeri 422,56-1222,56 mg/kg; diastaz sayısı 0,0-10,9; protein ve ham bal Δ13 C farkı-0.84-1.23; C4 şeker oranı %0,0-5,26; sakkaroz miktarı %0,30- 1,96; früktoz+glikoz miktarı %62,54-76,67; früktoz/glikoz oranı 0,98-2,62 olarak belirlenmiştir. Bal örneklerinde toplam üç numunede pestisit tespit edilmiştir. Bunlar triamenol+triadimefon, metrafenone, cypermethrin, boscalid, deltamethrin, kresoxim methyl olup üç örnekte sınır değerleri aşılmış olup, diğer örneklerde ise limit değerleri aralığındadır. Balların mineral içerikleri (mg/kg); çinko (Zn) 0,0-24,306; nikel (Ni) 0,0-2,906; krom (Cr) 0,0- 3,850; mangan (Mn) 0,0-4,660; bakır (Cu) 0,0-17,099; kurşun (Pb) içeriği 0,314-2,729 aralığında tespit edilmiştir. Örneklerin toplam fenolik madde miktarları 254,14-776,94 μg GAE/g bal; serbest radikali giderme aktivitesi 129,47-587,37 μg TE/g bal; katyon radikali giderme aktivitesi 93,33-1187,78 μg TE/g bal aralıklarındadır.In this study; some physical and chemical properties of honey taken from the districts of Tokat province, where plant diversity is quite high, were determined. Results of some physicochemical, pesticide, and mineral analyses conducted with Turkish Standards (TS) 3036 Honey Standard and internationally accepted analysis methods of flower honey samples (24 in total) obtained from 12 districts in 2019 and 2020 Turkish Food Codex (TGK) Honey Communique (2020/7) has been investigated for compliance. Moisture content in honey samples is 13.0-20%; total acidity 26 }0.12- 48 }0.16 meq/kg; electrical conductivity 0.33-0.86 mS/cm; the amount of hydroxymethylfurfural (HMF) 0.05-8.69 mg/kg; proline value 422.56-1222.56 mg/kg; diastase number 0.0-10.9; protein and raw honey Δ13 C difference -0.84-1.23; C4 sugar content 0.0-5.26%; amount of sucrose 0.30-1.96%; fructose+glucose amount 62.54-76.67%; fructose/glucose ratio was determined as 0.98-2.62. Pesticides were detected in a total of three samples in honey samples. These are triamenol+triadimefon, metrafenone, cypermethrin, boscalid, deltamethrin, and kresoxim methyl. In three samples, the limit values are exceeded, and in the other samples, the limit values are in the range. Mineral content of honey (in mg/kg); zinc (Zn) 0.0-24.306; nickel (Ni) 0.0-2.906; chromium (Cr) 0.0-3.850; manganese (Mn) 0.0-4.660; copper (Cu) 0.0-17.099; lead (Pb) content was determined in the range of 0.314-2.729. The total phenolic content of the samples was 254.14-776.94 μg GAE/g honey; free radical scavenging activity was 129.47-587.37 μg TE/g honey; cation radical scavenging activity was in the range of 93.33-1187.78 μg TE/g honey

Evaluation of intraocular pressure and retinal nerve fiber layer thickness in patients with Helicobacter pylori

Objectives: High prevalence of Helicobacter pylori (HP) in the glaucoma patients was shown in recent studies. In our prospective study we aimed to compare the intraocular pressure (IOP) and the retinal nerve fiber layer thickness (RNFLT) in patients with HP positive and negative. Methods: In 91 patients with gastritis HP was investigated by urea breath test (UBT) and biopsy sample culture Following the full ophthalmologic examination the patients’ IOP was measured by Goldmann applanation tonometry and RNFLT was measured by spectral optic coherence tomography. The patients' demographic and clinical characteristics were compared with the χ² test for categorical variables and with the Mann Whitney U test for continuous variables. Results: Of the 90 patients who meet the including criteria, HP was detected in 74 patients (27 male, 47 female) positive, and in 16 patients (7 male, 9 female) negative. Median (minimum-maximum) age values were 46 (18-79) in HP positive group and 51 (18-67) in HP negative group. One hundred forty seven eyes in 74 HP positive patients and 31 eyes in 16 HP negative patients included in the study. Median IOP values were determined 14 (7-21) mmHg in HP positive group and 14 (8-18) mmHg in HP negative group. The measurements of RNFLT in superior, temporal, inferior and nasal quadrants found to be respectively 122(98-165), 68(50-101), 135(93-188), 79(51-120) micron in HP positive group and 120(94-161), 67(43-104), 129(94-166), 76(50-97) micron in HP negative group. No statistically significant difference was found when compared IOP and RNFLT measurements between the two groups (p<0.05). Conclusion: In this study found that the IOP and RNFLT measurements of HP positive group was not show statistically significant difference compared with HP negative group. In a large case series, randomized, case-controlled, histologic and serologic studies should be done to show the relationship between HP and glaucoma

Original Article Expression of fibroblast growth factor receptor 1, fibroblast growth factor 2, phosphatidyl inositol 3 phosphate kinase and their clinical and prognostic significance in early and advanced stage of squamous cell carcinoma of the lung

Abstract: Aim: Non-small cell lung carcinoma is the leading cause of cancer related to death in the world. Squamous cell lung carcinoma (SqCLC) is the second most frequent histological subtype of lung carcinomas. Recently, growth factors, growth factor receptors, and signal transduction system-related gene amplifications and mutations are extensively under investigation to estimate the prognosis and to develop individualized therapies in SqCLC. In this study, besides the signal transduction molecule phosphatidyl inositol-3-phosphate kinase (IP3K) p110α, we explored the expressions of fibroblast growth factor 2 (FGF2) and receptor-1 (FGFR1) in tumor tissue and also their clinical and prognostic significance in patients with early/advanced SqCLC. Materials and methods: From 2005 to 2013, 129 patients (23 early, 106 advanced disease) with a histopathological SqCLC diagnosis were selected from the hospital files of Cukurova University Medical Faculty for this study. Two independent pathologists evaluated FGFR1, FGF2, and PI3K (p110α) expressions in both tumor and stromal tissues from 99 of the patients with sufficient tissue samples, using immunohistochemistry. Considering survival analysis separately for patients with both early and advanced stage diseases, the relationship between the clinical features of the patients and expressions were evaluated by univariate and multivariate analyses. Results: FGFR1 expression was found to be low in 59 (60%) patients and high in 40 (40%) patients. For FGF2; 12 (12%) patients had high, 87 (88%) patients had low expression and for IP3K; 31 (32%) patients had high and 66 (68%) patients had low expressions. In univariate analysis, overall survival (OS) was significantly associated with stage of the disease and the performance status of the patient (P&lt;0.0001 and P&lt;0.001). There was no significant difference in OS of the patients with either low or high expressions of FGFR1, FGF2, and IP3K. When the patients with early or advanced stage disease were separately taken into consideration, the relationship did not differ, either. Any of FGFR1, FGF2 or IP3K expressions was not found predictive for the treatment of early or advanced staged patients. On the other hand, the expressions of both FGFR1 and FGF2 were significantly different with respect to smoking, scar of tuberculosis and scar of radiotherapy (P=0.002; P=0.06 and P=0.05, respectively). Discussion: There has not been identified an effective individualized treatment for SqCLC yet. Therefore, in order to be able to develop such a treatment in the future, it is essential to identify the genetic abnormalities that are responsible for the biological behaviors and carcinogenesis of SqCLC. Although we could not show the prognostic and predictive significance of FGFR1, FGF2 and IP3K expressions in SqCLC, we determined the expression rates of FGFR1, FGF2 and IP3K as a reference for Turkish patients. In conclusion, we want to put some emphasis on the fact that, pulmonary fibrosis which is a late complication of radiotherapy at stage III disease, and the scar of tuberculosis could be associated with FGFR1 and FGF2 expressions

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p &lt; 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely