Sexual and reproductive health of Syrian refugee women in Turkey: a scoping review within the framework of the MISP objectives.

BACKGROUND: Turkey hosts the world's largest community of Syrians displaced by the conflict. The Minimum Initial Service Package (MISP) is a coordinated set of priority reproductive health services. There is not any scoping review assessing the RH situation of Syrian refugees in Turkey within the framework of the MISP objectives. The objectives of this review is to identify the situation of sexual and reproductive health (SRH) among Syrian refugee women in Turkey, and document the health services provided for them in terms of the components of MISP. We hoped to show evidence of gaps and help guide future research to focus on priority areas to improve the range, quality, and access to SRH services and to recommend public health interventions. METHOD: The literature search was conducted in Turkish and English. Multiple electronic databases (Turkish Medline, Google Scholar, PubMed, Web of Science, Medline, Cochrane Database of Systematic Reviews, EBSCOHost, CINAHL, and Embase) were searched from January 2011 to May 2018. References published in the peer-reviewed literature, the grey-literature, and on websites were eligible for inclusion if they had conducted research on one or more of the following SRH topics specifically for Syrian women in Turkey: maternal and neonatal health/antenatal care, HIV and sexually transmitted infections, use of contraceptives, sexual violence, and services delivery and accessibility. References were excluded if any of the following criteria were relevant: not specific to Syrian women refugees in Turkey. Firstly, the titles and abstracts of the articles that were found were examined to determine if they met the eligibility criteria. Secondly, if the abstracts and titles met one or more of the eligibility criteria, the full text of the articles have been examined. Finally, standard forms were prepared and used to summarize the articles narratively. The results of the screening were recorded in Excel spreadsheets for comparison, and any disagreements among the researchers were resolved by consensus. The studies were grouped according to the MISP objectives. RESULTS: A total of 24 publications were eligible for inclusion in the review. Consanguineous marriage rate was 56%. The rate of marriage under age 18 were very high. Mean age at first marriage was found to be between 18 and 20. The rate of antenatal care was inadequate. The rate of using a modern contraceptive method was 24% among married and all age groups of Syrian women. The rates of unmet family planning needs were about 35%. Among patients admitted to gynecology outpatient clinics, about half of the applicants were reported to have abnormal vaginal discharge. The reported rates of sexual violence were about 8%. Only 20% of Syrian women had regular gynecological visits. CONCLUSION: Overall, we conclude that early marriage, low modern contraceptive use, unmet need for contraception, sexual and gender-based violence are the major SRH issues reported. There is a need for further studies to identify the barriers limiting service uptake as well as to document successful practices. Long term strategies to improve the SRH status of Syrian refugee women should be developed with participation of all stakeholders. This review is significant in terms of that it is the first scoping review assessing the RH situation of Syrian refugees in Turkey within the framework of the MISP objectives. Based on the data of this review, relevant policy makers should consider to improve the SRH status of Syrian women refugees in Turkey.

Cytotoxic, anti-proliferative and apoptotic effects of noscapine on human estrogen receptor positive (MCF-7) and negative (MDA-MB-231) breast cancer cell lines.

AIM: Noscapine, a naturally occurring alkaloid obtained from opium poppy, is a microtubule-targeting agent. This study is aimed to investigate the effects of noscapine on human breast cancer cell lines by comparing them with those of tamoxifen and docetaxel. METHODS: MCF-7 and MDA MB-23 cell lines were used to observe the effects of docetaxel, tamoxifen, and noscapine on cell proliferation. For each drug, cell blocks were prepared from cultured cells treated with IC50 dose of each drug and these were examined histologically. The expressions of Ki-67, Bcl-2, BAX, and cyclin-D1 were assessed immunohistochemically. RESULTS: Although noscapine showed cytotoxic effects on both cell lines in a time and dose dependent manner, MDA-MB-231 cells were more susceptible to its effects. Noscapine inhibited MCF-7 and MDA-MB-231 cells proliferation in vitro with IC50 value of 29 µM and 69 µM, respectively, which was comparable with IC50 of tamoxifen (40 µM and 50 µM) and docetaxel (43 nM and 32 nM). Noscapine showed anti-proliferative effects by decreasing Ki-67, cyclin-D1 and apoptotic effects by increasing BAX/Bcl-2 ratio in both breast cancer cells. Its effect was comparable with tamoxifen and docetaxel. CONCLUSION: Noscapine may be a good chemotherapeutic agent for the treatment of breast cancer, especially in estrogen receptor­negative breast cancer (Tab. 2, Fig. 7, Ref. 40).

Volatile compound profiling of Turkish Divle Cave cheese during production and ripening.

The formation of volatile compounds in Turkish Divle Cave cheese produced in 3 different dairy farms was determined during production and ripening, revealing 110 compounds including acids, alcohols, ketones, esters, and terpenes. The presence and concentration of these volatile compounds varied between specific phases of the production and the 120-d ripening process. Smaller differences were also detected between cheeses produced at different farms. Carboxylic acids were established as a major class at the end of ripening. The relative amounts of acids and ketones increased until d 90 of ripening, whereas alcohols increased for the first 30d and tailed off during the remaining part of the ripening process. The level of esters increased gradually until the end of ripening. Butanoic, acetic, and valeric acids, 2-butanol, 2-butanone, 2-heptanone, ethyl butanoate, α-pinene, and toluene were the most abundant compounds, likely contributing to the characteristic aroma of this traditional cheese.

Histopathological gallbladder morphometric measurements in geriatric patients with symptomatic chronic cholecystitis.

INTRODUCTION: Cholecystectomy for symptomatic cholecystitis is one of the common surgical procedures in the geriatric patients. Increased gallbladder wall thickness is expected due to acute cholecystitis and in some other clinical conditions. Routine histopathological evaluation of cholecystectomy materials are required to confirm the diagnosis and document other pathologies. The aim of this study was to evaluate age-related histopathological gallbladder morphometric measurements. METHODS: A retrospective chart review of 371 cholecystectomy materials was performed. Two groups were designed according to age (<65 and ≥65 years old, respectively). Age and gender analyses for histopathological gallbladder length, diameter and wall thickness were performed. In addition, pathologically confirmed acute inflammation rates were evaluated in this case-control study. RESULTS: Gallbladder morphometric measurements and pathologically confirmed acute inflammation rates were similar in males and females. Histopathological gallbladder diameter was higher with acute inflammatory changes, but no differences were observed in gallbladder length and wall thickness. Gallbladder wall thickness and pathologically confirmed acute inflammation rates were not comparable between the control and geriatric patients (2.8 ± 1.3 vs 2.6 ± 1.2 mm, and 30/281 (10.7 %) vs 10/74 (13.5 %), respectively, p > 0.05). However, higher gallbladder length and diameter were observed in geriatric group. CONCLUSION: Age is an independent factor on histopathological gallbladder length and diameter, but not for gallbladder wall thickness. In addition, pathologically confirmed acute inflammation rate is not higher in geriatric patients. Clinical significance of these findings merits further investigation.