Premarital screening of 466 Mediterranean women for serum ferritin, vitamin B12, and folate concentrations

Background/aim: Iron, folate, and vitamin B12 serum levels are closely related with dietary habits and have an essential role in the healthy development of a fetus. We aimed to investigate hemoglobin, ferritin, folate, and vitamin B12 levels in preconceptional women in an area where a plant-based diet referred to as Mediterranean cuisine is commonly used. Materials and methods: The study population included 466 women between the ages of 18 and 45 years admitted for thalassemia screening. Sociodemographic variables and history of menometrorrhagia, pica, and dietary habits were collected. Serum vitamin B12, folate, ferritin, and hemoglobin levels were measured. Ferritin of <12 μg/L, vitamin B12 of <200 pg/mL, and folate of <4 ng/mL were accepted as deficiencies. Hemoglobin level of <12 g/dL was classified as anemia. Results: Polymenorrhea was present in 11.7% and hypermenorrhea in 24.8% of women. Anemia was detected in 24.9% and thalassemia trait in 3.0% of women. Low ferritin levels were observed in 46.1%, vitamin B12 in 21.6%, and folate in 3.4% of women. In the group with low vitamin B12, decreased meat consumption was more prevalent (27.5% vs. 16.9%; P = 0.019). Conclusion: Vitamin B12 and iron are the main micronutrients depleted in our community. This necessitates implementing a public health program for women consuming a Mediterranean diet. © TÜBİTA

Frequency of the mdr‐1 C>T gene polymorphism in patients with COPD

BACKGROUND AND AIM: The multi-drug resistant-1 (MDR-1) gene is located on human chromosome 7 and encodes a glycosylated membrane protein that is a member of the ATP-binding cassette transporters superfamily. The aim of the study was to reveal the role of the C3435T MDR-1 gene polymorphism in chronic obstructive pulmonary disease. METHOD: DNA samples from 41 patients with chronic obstructive pulmonary disease and 50 healthy control participants were used to compare MDR-1 gene profiles. Genotyping assays were performed using the StripAssay technique that is based on reverse-hybridization. RESULTS: The T allele polymorphism in the MDR-1 gene located at position 3435 in exon 26 was shown to correlate with chronic obstructive pulmonary disease. CONCLUSION: These preliminary results suggest that the T allele polymorphism of the MDR-1 gene is associated with chronic obstructive pulmonary disease

Konya il merkezinde hizmet veren iki hastanenin tiroidektomi endikasyonlarının değerlendirilmesi

Amaç: Konya İl Merkezindeki iki farklı hastanenin Tiroidektomi uygulamalarını, endikasyonları bakımından karşılaştırmayı amaçladık. Yöntem: Ocak 2007 ile Aralık 2008 tarihleri arasında Konya’da farklı iki A ve B hastaneleri hastanede tiroidektomi ameliyatı geçiren hastaların dosyaları retrospektif olarak incelendi. Hastaların yaş, cins, tiroit fonksiyon testleri TFT , tiroit ultrasonografi USG bulguları, yapıldıysa tiroit ince iğne aspirasyon biyopsileri İİAB raporları ve tiroit ameliyat raporları bulunanlar çalışmaya alındı. İki hastanenin tiroidektomi ameliyatı yapılan hastaları ameliyat endikasyonları ve malignite tespiti bakımından birbiriyle karşılaştırıldı. Bulgular: İki yıllık süre içinde A hastanesinde 60, B hastanesinde 223 hastaya tiroidektomi ameliyatı yapılmıştı. Hastaların yaş ortalaması sırasıyla 53 , 49 idi. İki guruptaki vakalar cins, yaş ve dominant nodül çapları bakımından benzerdi. A hastanesinde tiroidektomi kararında klinik, USG ve İİAB ile belirlenen malignite riski öne çıkarken, B hastanesinde ise palpable nodül varlığı, USG’ de nodülün 1 cm den büyük olması ve USG ile malignite şüphesi tespit edilmiş olması yeterli idi. A hastanesinde basit nodüler guatrlı 53 hastanın 19 unda % 35.8 İİAB yapılmıştı. B hastanesinde hiç bir hastaya İİAB yapılmamıştı. A hastanesinde genel malignite oranı % 25, B hastanesinde ise % 13 idi p=0.028 . Sonuç: Nodüler guatrlarda, klinik, US ve İİAB’ nin birlikte kullanımı ile malignite riski daha iyi belirlenebilir. Ameliyat veya takip kararı buna göre verilmelidi

Steroid Cell Tumor of Ovary Diagnosed After Delivery; Case Report

Introduction: Steroid cell tumors (SCTs) constitute less than 0.1% of all ovarian tumors. They are divided into 3 categories according to cell of origin: Stromal Luteoma arising from stromal cells of the ovary, Leydig cell tumor arising from Leydig cells, and SCT not otherwise specified (NOS) when the origin of the tumor is not defined. Case Presentation: Herein is presented a case of SCT diagnosed one month after a caesarian section delivery of a female fetus with ambiguous genitalia. The patient was admitted to the emergency department with the findings of acute abdomen, and surgery was performed under emergency conditions. The patient had virilization and hoarsening of the voice before surgery. Intraoperatively, a 21-cm ovarian mass was detected and resected with unilateral salpingo-oophorectomy. Conclusion: A histopathological examination of the tumor showed a tumor with cystic degeneration, necrosis, hemorrhage, and tumoral embolism. The pathological examination revealed ovarian SCT. Virilization was resolved immediately after the surgery. In women with virilization who give birth to a fetus with ambiguous genitalia, SCTs should be kept in mind

Prognostic and Clinical Role of Contrast Enhancement on Magnetic Resonance Imaging in Patients with Bell’s Palsy

Objective:To investigate the prognostic value of the magnetic resonance imaging in Bell’s palsy patients.Methods:Patients who were diagnosed and treated with Bell’s palsy between October 2013 and March 2016 retrospectively selected. House–Brackmann grades, pre- and post-treatment pure tone audiograms, stapedial reflexes were analyzed and magnetic resonance imaging (MRI) scans with gadolinium-based contrast agents were evaluated. Contrast-enhanced segments of the facial nerve were determined. MRI findings were compared statistically with pre- and post-treatment grade, recurrence rate of Bell’s palsy, MRI scanning timing, presence of stapes reflexes and posttreatment recovery data.Results:No significant correlation was observed between pretreatment House–Brackmann grades and enhancement (p>0.05). Similarly, there was no significant correlation between clinical recovery and enhancement (p>0.05). Also, no significant correlation was observed between MRI scanning time, the recurrence rate of Bell’s palsy and MRI findings (p>0.05). None of the MRIs showed neoplastic contrast enhancement.Conclusion:The routine use of the contrast-enhanced temporal MRI is not recommended in the diagnosis and monitoring of Bell’s palsy patients, because the contrast enhancement pattern of the facial nerve has no effect on the prognosis of Bell’s palsy. MRI should be used in cases that do not heal despite treatment, for the differential diagnosis of facial nerve tumors and in patients who are candidates for surgical decompression

Diagnosis of comorbid migraine without aura in patients with idiopathic/genetic epilepsy based on the gray zone approach to the International Classification of Headache Disorders 3 criteria

BackgroundMigraine without aura (MwoA) is a very frequent and remarkable comorbidity in patients with idiopathic/genetic epilepsy (I/GE). Frequently in clinical practice, diagnosis of MwoA may be challenging despite the guidance of current diagnostic criteria of the International Classification of Headache Disorders 3 (ICHD-3). In this study, we aimed to disclose the diagnostic gaps in the diagnosis of comorbid MwoA, using a zone concept, in patients with I/GEs with headaches who were diagnosed by an experienced headache expert.MethodsIn this multicenter study including 809 consecutive patients with a diagnosis of I/GE with or without headache, 163 patients who were diagnosed by an experienced headache expert as having a comorbid MwoA were reevaluated. Eligible patients were divided into three subgroups, namely, full diagnosis, zone I, and zone II according to their status of fulfilling the ICHD-3 criteria. A Classification and Regression Tree (CART) analysis was performed to bring out the meaningful predictors when evaluating patients with I/GEs for MwoA comorbidity, using the variables that were significant in the univariate analysis.ResultsLonger headache duration (&lt;4 h) followed by throbbing pain, higher visual analog scale (VAS) scores, increase of pain by physical activity, nausea/vomiting, and photophobia and/or phonophobia are the main distinguishing clinical characteristics of comorbid MwoA in patients with I/GE, for being classified in the full diagnosis group. Despite being not a part of the main ICHD-3 criteria, the presence of associated symptoms mainly osmophobia and also vertigo/dizziness had the distinguishing capability of being classified into zone subgroups. The most common epilepsy syndromes fulfilling full diagnosis criteria (n = 62) in the CART analysis were 48.39% Juvenile myoclonic epilepsy followed by 25.81% epilepsy with generalized tonic-clonic seizures alone.ConclusionLonger headache duration, throbbing pain, increase of pain by physical activity, photophobia and/or phonophobia, presence of vertigo/dizziness, osmophobia, and higher VAS scores are the main supportive associated factors when applying the ICHD-3 criteria for the comorbid MwoA diagnosis in patients with I/GEs. Evaluating these characteristics could be helpful to close the diagnostic gaps in everyday clinical practice and fasten the diagnostic process of comorbid MwoA in patients with I/GEs

Üsküdar bölgesinde birinci basamağa kayıtlı 40 yaş ve üstü populasyonda multimorbidite prevalansı

ÖZETGiriş ve Amaç 21. yüzyılda kronik hastalıkların oluşturduğu küresel yük büyümeye devam etmektedir.Çok sayıda kronik hastalığa sahip olmak, hastanın işlevselliğini ve yaşam kalitesini azaltır, sağlık harcamalarını arttırır. Ayrıca, özgül sağlık bakımı gerektirebileceğinden hastanın yönetimini daha da zorlaştırır. Multimorbidite,kişide iki ya da daha fazla kronik durumun, hastalığın eşzamanlı olarak bulunmasıdır. Multimorbiditenin epidemiyolojisini anlamak; müdahale imkanlarını geliştirmek, hastalık yükünü azaltmak, önlemek ve sağlık hizmetlerini hastaların ihtiyaçları doğrultusunda düzenlemek açısından çok önemlidir .Ülkemizde spesifik bazı kronik hastalıklar için yapılmış prevalans çalışmaları olmakla birlikte bu araştırmalar toplumdaki multimorbidite sıklığını yansıtmamaktadır. Çalışmanın amacı İstanbul ili Üsküdar ilçesinde Aile Sağlığı Merkezlerine (ASM) kayıtlı 40 yaş ve üzeri bireylerde multimorbidite prevalansını saptamaktır. Yöntem Hastalar İstanbul ili Üsküdar ilçesi Aile Sağlığı Merkezlerine kayıtlı 40 yaş ve üzeri tüm bireylerden tabakalı örneklem yöntemiyle seçilmiştir. Hastaların sadece multimorbidite durumlarına ait bilgileri doktorlardan istenmiştir. Hastaların son bir senede gerçekleştirdikleri ASM ve hastane ziyaretleri, hastalara konulan teşhisler ve reçete edilen ilaç etken maddeleri kayıt altına alınmıştır. İlaç etken maddeleri, herhangi bir hastanın aldığı tanıya yönelik ilaç kullanımının olup olmadığını tespit amacıyla kayıt altına alınmıştır. Prevalans hesaplamasında; ilaç tedavisi teyit edilmiş olan tanılar dikkate alınmıştır. Bulgular Çalışmaya dahil olan 1187 bireyde multimorbidite prevalansı % 27,8 (n=330) bulunmuştur. Kadınlarda multimorbidite prevalansının erkeklerden istatiksel olarak anlamlı şekilde yüksek olduğu saptanmıştır. (E: % 19,5 n=115 , K: % 36,1 n=215 x2=40,81 py % 19,5 n=179, 65y % 19,5 n=179, 65<y % 55,9 n=151 x2=137,73 p<0,001 ). Hypertension (HT) is demonstrated to be the most prevalent condition with a percentage of 26.8 (n=318) of the population being treated for HT during the course of the study. There was an increased frequency of visits to family health centers and hospitals annually from multi-morbid patients compared to the rest of the population. (FHC: with multimorbidity; 7,01 n=292, without multimorbidity; 1,6 n= 818 t: 26,13 p<0,001) (Hospitals: with multimorbidity; 5,5 n=288, without multimorbidity; 2,1 n=807 t: 11,30 p<0,001). Results In this study, the prevalence of multimorbidity highlights that one in four people in the age group of 40 and over struggles with multimorbidity in the general population. This ratio is significantly higher for females and for the age group of 65 and over. Multimorbid patients visit family health centers more often than the hospitals

İzmir ve Eskişehir bitpazarlarında ekonomi ve kültür

xiv, 156 sayfatablo, şekil, fotoğraf, harita, grafik : 29 cm. 1 CDÖZETBitpazarları, diğer semt pazarlarından farklı olarak ikinci el eşyalar veya başka bir deyişle kullanılmış günlük ihtiyaç ürünlerinin kullanılmamış sıfır ürünlerden daha ucuz fiyata satıldığı ve genelde sıfır ürünleri alamayan bireylerin tercih ettiği bir alışveriş mekânıdır. Aynı zamanda içerisinde ikinci el kıyafet, antika değeri olan eşyalar, tablolar, ayakkabılar, el tamir aletleri ağırlıklı olmak üzere birçok ikinci el ürünü barındırmaktadır. Bitpazarları tarihsel olarak pazaryerlerinin ortaya çıktığı ilk dönemlerden günümüze süreklilik göstermektedir.Bu tez bitpazarını ağırlıklı olarak kullanan alt gelir gurubu veya yoksul kesimlerin tüketim pratikleri bağlamında internet ve bitpazarları arasındaki etkileşimin görünür kılınması, bir alışveriş mekânı olarak bitpazarı müşterilerinin vintage modası ve koleksiyonculuk amacı ile bitpazarını kullanarak orta sınıfa yaklaşma arzusu ile yapılan tüketim yönlü özelliklerinin irdelenmesi açısından önem taşımaktadır.ABSTRACTThe Flea Market, unlike the other district bazaars, is a commerce space where second hand commodities or in other words previously used daily necessaries are sold cheaper then brand new products by the individuals who cannot afford to buy it. This place at the same time contains a great many of second hand commodities mostly consist of second hand clothes, antique objects, paintings, books, shoes and hand repair tools. The flea markets historically shows a continuity since the beginning of marketplaces emergence to nowadays.This thesis have importance for revealing the interaction between internet and the flea market in terms of lower income or the poor groups consumption patterns who predominantly make use of the flea market and examining the consumption oriented features of the desire to move up the middle class by utilising flea market with an aim of vintage fashion or collecting purposes