Assessment of Serotonin Metabolite 5-hydroxyindoleacetic Acid Levels in Urine Sample for Diagnosis and Treatment Efficacy in Children with Dysfunctional Voiding and Their Interaction with Biofeedback Therapy

Objective:Dysfunctional voiding (DV), which is explained as an incoordination between the external urethral sphincter and the bladder, is a situation developing in neurologically normal children. Serotonin has some effects on the lower urinary tract which cannot be fully explained. The selective 5-hydroxyindoleacetic acid (5-HIAA) agonist improves voiding efficacy in the rat model with voiding dysfunction as serotonin. Serotonin decomposes to 5-HIAA which excreted from urine. We considered that a problem in neuromodulator levels can lead to DV and evaluated the levels of 5-HIAA in urine.Materials and Methods:Our study included 130 children aged 5-15 years who were diagnosed with DV and 48 children with no urological complaints as controls. Urine samples were taken only once in control group, and 3 times [before and after the biofeedback treatment (sixth month and twelfth month)] in the study group to determine the difference and the interaction between 5-HIAA and biofeedback therapy.Results:Biofeedback therapy was found to be an effective method in the treatment of DV. However, there was no significant difference in the level of mean urine 5-HIAA/creatinine (u5-HIAA/Cr) between study (6.139±3.652) and control groups (6.374±4.329) (p=0.751). The mean u5-HIAA/Cr levels in the DV group at baseline and at the end of biofeedback therapy (6th month) were 6.249±4.132 and 6.19±4.715, respectively (p=0.951). The mean u5-HIAA/Cr levels in the DV group at baseline and at 12 months were 5.901±3.291 and 6.644±4.206, respectively (p=0.557). There was no significant difference in u5-HIAA/Cr levels between pre-treatment and post-treatment in the DV group.Conclusion:We still do not know if a problem at the level of neurotransmitter metabolite in the central nervous system plays a role in the etiology of DV. We evaluated this relationship, but we could not find a significant result. New studies are needed to get more information about the role of neuromodulators in the etiology and treatment of DV

TİMOLOL/BRİNZOLOMİD KOMBİNASYONU İLE TİMOLOL/DORZOLOMİD KOMBİNASYONUN GÖZ TANSİYONU AÇISINDAN KARŞILAŞTIRILMASI

Objective: The aim of this study is to compare the effect timolol/brinzolomid fixed-combination drugs on intraocular pressure. Materials and Methods: This is a retrospective study. The primary open angle glaucoma patients that were switched to fixed-combination drugs due to high intraocular pressure despite monotherapy were included to the study. The intraocular pressure records of 4.week and 4.month were compared. Results: The baseline intraocular pressure levels were timolol/dorzolamid group and 23,1±2,8 (17-28 mmHg) in timolol/brinzolamid group. After 4.weeks of combination treatment intraocular pressure levels were 15,3 ±2,3 mmHg (1120mmHg) in timolol/ dorzolomid and 15,8±2,7(1119mmHg) in timolol/brinzolomid. After 4.nmonths of combination treatment intraocular pressure levels were 15,8±3,1 (11-21mmHg) in timolol/dorzolamid group timolol/brinzolomid group. There statistically significant difference between the groups. Conclusion: Both fixed combination drugs decreased the intraocular pressure successfully but there was no statistically significant difference between intraocular pressure levels at 4.week and 4.month. Key dorzolami

TRAVMATİK HİFEMALI BİR ORAK HÜCRE TAŞIYICISINDA URRETS-ZAVALİA SENDROMU

Patients with sickle cell disease or trait are more susceptible to complications secondary to traumatic hyphema and incidence of optic nerve atrophy, recurrent hemorrhage is high in these patients. These complications could lead to permanent impairment of vision. Because of the nature of the disease it is difficult to control the elevate

Undescended testis and the presence of concurrent inguinal hernia: A review

Cryptorchidism is defined as testes nonpalpabl in thescrotum. And they are generally undescended or aplastic.Cryptorchidism usually occurs among infants withcongenital disorders and most cryptorchidic testicles areundescended. Between 2% and 5% of full-term and 30%of premature male infants are born with an undescendedtesticle. Approximately 10% of undescended testicle is bilateraland the most common location is just outside theexternal inguinal ring.Inguinal hernia that is characterized as patent prosesusvaginalis (PV) is the most common seen pathology concomitantto undescended testes. Primary inguinal herniais present 1-5% of all infants. But this ratio rises up to9-11% of premature babies. The patients are usually asymptomaticand the treatment needs surgical procedures.If urgent surgery is needed for incarcerated or strangulatedinguinal hernia, orchiopexy procedure should be madetogether. In other conditions inguinal hernia requirementmust be done during routine orchiopexy. The inguinalhernia with untreated undescended testes which is occultmay become symptomatic or complicated such as incarcerationor strangulation at any time.The incidence of inguinal hernia in the patients with undescendedtestes is controversial that different rates arereported in different series. According to our review of theliterature, we determined that the rate of inguinal herniaand patent PV accompanying to undescended testes is20% and 50%, respectively.Key words: Cryptorchidism, Inguinal hernia