Use of complementary and alternative medicines by a sample of Turkish women for infertility enhancement: a descriptive study

<p>Abstract</p> <p>Background</p> <p>Infertility patients are a vulnerable group that often seeks a non-medical solution for their failure to conceive. World-wide, women use CAM for productive health, but only a limited number of studies report on CAM use to enhance fertility. Little is known about traditional and religious forms of therapies that are used in relation to conventional medicine in Turkey. We investigated the prevalence and types of complementary and alternative medicine (CAM) used by infertile Turkish women for fertility enhancement.</p> <p>Methods</p> <p>A face-to-face questionnaire inquiring demographic information and types of CAM used for fertility enhancement were completed by hundred infertility patients admitted to a primary care family planning centre in Van, Turkey between January and July 2009.</p> <p>Results</p> <p>The vast majority of infertile women had used CAM at least once for infertility. CAM use included religious interventions, herbal products and recommendations of traditional "hodja's" (faith healers). Of these women, 87.8% were abused in the last 12 months, 36.6% felt not being supported by her partner and 80.5% had never spoken with a physician about CAM.</p> <p>Conclusions</p> <p>Infertile Turkish women use complementary medicine frequently for fertility enhancement and are in need of information about CAM. Religious and traditional therapies are used as an adjunct to, rather than a substitute for, conventional medical therapy. Physicians need to approach fertility patients with sensitivity and should be able to council their patients about CAM accordingly.</p

Images in Medicine - Split Hand-Foot Malformation: A Congenital Central Limb Ray Deficiency

A thirty five-year-old male had deformed hands and feet since birth. His growth, development and general health were unaffected except for his short stature (height-one hundred and thirty cms.) in comparison to other family members. There was no history of consanguinity, or mutagenic exposure in the mother during the antenatal period and there was no family history of similar deformity. Examination revealed bifid hands with two digits each and right and left foot with two and three toes respectively (Figure 1 and 2). Radiological examination of the hands revealed bilateral complete absence of second, third and fourth digital rays, presence of two carpal bones on the right side and only one carpal bone on the left side along with hypoplasia of radius and ulna and subluxation of inferior radio-ulnar and radio-carpal joints. X-ray feet showed absence of three lateral rays on right side and two lateral rays on left side, presence of calcaneum on the right side and calcaneum and talus on the left side, hypoplasia of phalanges and absence of both fibulae. X-rays of chest, spine and skull were normal. Examination of teeth, hair, nails, mucosae and eye did not reveal any abnormality. A skin biopsy showed normal sweat glands

Spot the Diagnosis

A 65-year-old male had a six-month history of alopecia and thickening of the scalp. He had no history of seizures or any significant past medical history. General physical examination was normal with proportionate length of trunk and limbs. There was no lymphadenopathy or organomegaly and his systemic examination was unremarkable. Scalp revealed bilaterally symmetrical longitudinal gyrate folds of skin involving the entire scalp with loss of scalp hair (Fig 1a and 1b). There was no erythema, papules, pustules or scarring of scalp. A detailed cutaneous examination revealed no caf\ue9-au-lait spots, ash leaf macules, axillary freckling or neurofibromas. The examination of nails, mucosae and eyes was normal. Investigations revealed normal hemogram, serum biochemistry, urine analysisand a chest radiograph. Psychiatric evaluation revealed an average intelligence (PQ 89, VQ 93) without any other abnormality. A skin biopsy showed hyperkeratosis, acanthosis and a mild lymphomononuclear cell infiltrate with hypertrophy of sebaceous glands

Caso para diagnóstico Case for diagnosis

As tubercúlides são reações cutâneas imunológicas à presença de tuberculose, que com freqüência se encontra oculta no organismo. Antigamente um grande número de lesões cutâneas era interpretado como tubercúlide. Atualmente, porém, apenas três entidades são consideradas verdadeiras tubercúlides: tubercúlide papulonecrótica, eritema indurado e o líquen scrofulosorum. Pacientes com líquen scrofulosorum apresentam forte reação ao teste de Mantoux e excelente resposta aos tuberculostáticos.<br>Tuberculids are cutaneous immunologic reactions to the presence of tuberculosis, which is often occult elsewhere in the body. A wide range of skin disorders has been interpreted as tuberculids in the past. Currently, however, only three entities are regarded as true tuberculids: papulonecrotic tuberculid, erythema induratum and lichen scrofulosorum. Patients with lichen scrofulosorum have a strongly positive tuberculin reaction and an excellent response to treatment with antituberculous drugs

Unusual case of traumatic neuroma of the orbit

Traumatic or amputation neuromas are neoformations developing after damage to a peripheral nerve. They are not proper tumors but rather a reactive process or a frustrated attempt of nerve regeneration. Traumatic neuromas are potentially found in every sensory peripheral nerve and often at the site of past surgical intervention, including orbital surgery. A 29-year-old Northern African migrant presented progressive exophthalmos and progressive loss of acuity in left eye, which had started about 6 months before after a cranio-facial trauma caused by a violent assault. MRI of the orbits showed a massive intra-orbital, intra-conical lesion, clearly compressing and dislocating the optic nerve and extending posteriorly to the orbital apex. Surgery was performed through lateral approach of Kroenlein and led to complete excision of the lesion. Histology revealed fibrotic, adipose and striated muscle tissues, a disordered, non-neoplastic overgrowth of small and large fascicles of nerves, inflammatory infiltrates, and fibrosis with sparse calcifications were diffusely observed in a background of fat, scar and striated muscle tissued. Patient was discharged on the fifth day in good health condition, without deficit of eye motion but without recovery of visual acuity. In conclusion, this case demonstrates that traumatic neuromas may arise in the orbit in patients with minor direct trauma to nerves and without previous surgical treatment