Pregnant women's attitudes towards complementary and alternative medicine and the use of phytotherapy during the COVID-19 pandemic: A cross-sectional study.

BACKGROUND: Approximately 80% of individuals worldwide use various holistic complementary and alternative medicine (HCAM) methods, including herbal products, to prevent diseases and improve their general health. In this study, it was aimed to investigate complementary and alternative therapy (CAM) and the use of phytotherapy by pregnant women in the COVID-19 pandemic period. METHODS: This is a cross-sectional and descriptive study. The study included 381 women who applied to a public hospital in Türkiye and used herbal products during this pregnancy. Purposive sampling method was used. The study data were collected through "Identifying Information Form", "Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ)" and "Information Form on the Use of Phytotherapy". In the analysis of the study data, descriptive statistics, the one-way ANOVA and multinomial logistic regression analyses were used. RESULTS: The study was completed with 381 pregnant women. The average age, parity and gestational age of the pregnant women were 28.33±6.09, 2.17±0.95, 29.11±8.87, respectively. It was determined that 37.3% of pregnant women did not know the ingredients of the herbal products they used and 38.8% found them safer than the drugs. HCAMQ total mean score of the pregnant women was calculated as 34.62±16.22. It was found that the pregnant women used garlic the most (65.6%), followed by cumin (38.6%), curcuma (36.2%), and ginger (34.4%). HCAMQ total mean score was found to be lower in the pregnant women who found herbal products safer than drugs (p<0.001), who were not aware of the content of the herbal product they used (p<0.001), and who used herbal products so as to protect against COVID-19 (p = 0.041), to increase their physical resistance (p = 0.022), and to facilitate childbirth (p = 0.002). It was determined that among the pregnant women who knew the content of the herbal products they used (Odds Ratio (OR) 1.122; 1.095-1.149 95%CI; p<0.001) and who did not know (OR 1.114; 1.085-1.144 95%CI; p<0.001), as negative attitude towards HCAM increased, their status of finding traditional drugs safer increased. Among the pregnant women who used herbal products to protect against COVID-19 (OR 1.142; 1.111-1.174 95%CI; p<0.001) and to increase their physical resistance (OR 1.120; 1.094-1.147 95%CI; p<0.001), as negative attitude towards HCAM increased, their status of finding conventional drugs safer increased. CONCLUSION: In today's world where the use of herbal products and CAM has become widespread, it is important to raise the awareness of pregnant women about the benefits and harms of these practices about which there is inadequate evidence.

Is decreased tissue elasticity more important than histopathological changes in ruptures of ascending aortic aneurysms?

Background: In this study, we aimed to investigate the natural properties of ascending aortic aneurysms and to compare dilated aortic tissues of patients with ascending aortic aneurysms and the non-pathological aortic tissues of cadavers. Methods: Between January 2017 and January 2020, a total of 14 patients (12 males, 2 females; mean age: 66.6±8.4 years; range, 54 to 77 years) who underwent elective ascending aortic surgery without genetic disease or family history in the etiology were included in the study. Aortic tissues taken from the patients with ascending aortic aneurysms and cadavers without any aortic pathology were compared histopathologically and biomechanically. An experienced pathologist performed a histological evaluation with appropriate staining and scoring. In the biomechanical examination, stress-strain curves were created with the uniaxial tensile test. The instantaneous elastic modulus was calculated based on the first regions of the curves (Ei) and the slopes of the linear region close to rupturing (Es). Results: In the pathological examination, there was no statistically significant difference in the parameters of both the patient and control groups (p>0.05). In the biomechanical examination, Ei values were significantly higher in the patients with ascending aortic aneurysms, while Es values were comparable between the groups (p=0.028 and p=0.609, respectively). Conclusion: Our study results showed that the tissues of the ascending aortic aneurysm were much more rigid, although no significant histopathological changes were detected. These findings are meaningful in understanding the structure of normal and pathological aortic tissue.

The effect of kangaroo mother care or skin-to-skin contact on infant vital signs: A systematic review and meta-analysis.

BACKGROUND: It has been reported that kangaroo mother care/skin-to-skin contact immediately after birth facilitates the newborn's physiological and psychological adaptation to extrauterine life. OBJECTIVE: To examine the effect of kangaroo mother care/skin-to-skin contact on infants' body temperature, oxygen saturation, respiratory rate and heart rate. DESIGN: Systematic review and meta-analysis. METHODS: PubMed, ScienceDirect, SpringerLink, Wiley Online Library and Taylor & Francis Online were searched for the period 1 January 2015 to 30 November 2021 for studies published in the English language. The methodological quality of articles was assessed using the modified Jadad scale and the Newcastle-Ottawa scale. Effect size calculations were made using the fixed effects and random effects models. FINDINGS: This meta-analysis included 13 studies, with a total of 891 infants. Kangaroo mother care/skin-to-skin contact was effective for maintaining infants' body temperature (p = 0.000). Infants' heart rate decreased (p = 0.015) and oxygen saturation was higher (p = 0.040) following kangaroo mother care/skin-to-skin contact. Kangaroo mother care/skin-to-skin contact did not affect infants' respiratory rate (p = 0.896), but infants' respiratory rate decreased after kangaroo mother care/skin-to-skin contact (p = 0.047). KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Kangaroo mother care/skin-to-skin contact is effective for improving the vital signs of newborns. Kangaroo mother care/skin-to-skin contact is recommended for all neonates, and standardization of this approach would be beneficial.

Effectiveness of carotid council in the treatment of carotid artery disease: Early-term outcomes of the multidisciplinary approach.

OBJECTIVES: Carotid arterial stenosis could be treated by surgical or percutaneous stenting. In this study, we aimed to investigate the effectiveness of the carotid council on the outcomes of patients with carotid artery disease. METHODS: In this retrospective study, we analyzed the patients who had undergone carotid arterial revascularization from April 2014 to July 2022 in our hospital. All patients were evaluated in carotid council, which is constituted by neurologist, cardiologist and cardiovascular surgeon. Patient-specific treatment procedure was decided in the council. Demographics and early-term follow-up results of the patients were evaluated. RESULTS: Totally 95 procedures in 85 patients were analyzed during the study period. 27.4 % of the patients had significant contralateral carotid arterial stenosis. In 88 (92.6%) procedures, patients were treated by carotid endarterectomy, and 5 procedures were performed under regional anesthesia. Shunt usage was 6.0% during the surgery, and arteriotomy was repaired with primary sutures in 87.3%. Stent implantation was performed in 7 patients. There were 5 neurological adverse events after the carotid endarterectomy and 2 neurological events were after carotid arterial stenting. In each treatment group, one patient died after the procedure. In the follow-up period, restenosis was observed just in a patient who was treated with carotid endarterectomy and primary repair. CONCLUSION: Although carotid artery disease could be treated in accordance with the guidelines, treatment procedures should be patient-specific. Carotid councils might be helpful in giving patient-specific decisions, thereby providing the patient-based treatment procedure and improving the outcomes of the patients with carotid artery disease.

Does individualized care make a difference in postpartum discharge?: A block randomized controlled trial.

With this study, we aimed to determine the severity of physical symptoms displayed by mothers who received individualized care during the early postpartum period and their level of perceived readiness for discharge after birth. We conducted the study as a single-blind randomized controlled trial, assigning the mothers to the experimental (EG = 60) and control (CG = 60) groups using the permuted block randomization method. We administered the EG individualized care and the CG a routine care. Both groups received Postpartum Physical Symptom Severity Scale and Readiness for Hospital Discharge Scale-New Mother Form. The mean posttest scores the groups obtained from Postpartum Physical Symptom Severity Scale and Readiness for Hospital Discharge Scale-New Mother Form were significant in favor of the EG (p < 0.05). It is fair to state that individualized care is effective in reducing the physical complaints increasing the maternal health and improving the general health.

Investigation of the Relationship Between COVID-19 Anxiety and Perception of Risk in Pregnancy, Fears of Death and Losing Their Baby in the Pandemic.

The aim of the study was to determine Covid-19 anxiety, obsession, perception of risk and self-care agency levels of pregnant women during the pandemic and investigate the association between Covid-19 anxiety, obsession, perception of risk and self-care agency levels and the fears of death and losing their baby in the pregnant women. The study was a cross-sectional and descriptive study. Five hundred thirty-eight pregnant women were included in the study. "COVID-19 Anxiety Scale," "COVID-19 Obsession Scale," "Risk Perception in Pregnancy Scale," and "The Exercise of Self-Care Agency Scale" were used to collect data of the study. In this study, the total Cronbach's alpha reliability coefficients of the COVID-19 Anxiety Scale, COVID-19 Obsession Scale, The Perception of Pregnancy Risk Questionnaire, The Exercise of Self-Care Agency Scale were found to be 0.73, 0.70, 0.86 and 0.95 respectively. Statistical analysis of data in the study was conducted using SPSS (22.0, IBM Corp. Armonk, NY) statistical program. Statistically significant differences were identified between the mean score from COVID-19 anxiety scale and the mean scores from COVID-19 obsession scale, the perception of pregnancy risk questionnaire and the exercise of self-care agency scale. These results suggest that education and health policies that focus on the health of pregnant women and their fetus should be developed for antenatal care services.

Pediatric hydatid cyst with ventricular aneurysm and surgical treatment with dor procedure, case report.

BACKGROUND: Cardiac involvement of hydatid cyst disease (HCD) is a rare presentation but may lead to life-threatening complications such as cyst rupture and should be treated surgically. METHODS: A 10-year-old male patient with cranial and complicated cardiac HCD lesions that caused lower extremity peripheral arterial occlusion and aneurysmatic dilatation in the left ventricular apex is presented. RESULTS: Although the patient was in the pediatric age group, the Dor procedure was successfully applied to preserve the ventricular geometry. The Dor procedure for a ventricular aneurysm caused by a cardiac hydatid cyst (CHC) was rarely applied in the pediatric age group. CONCLUSION: In conclusion, this case differs from other CHCs previously reported in the literature due to the advanced stage of the disease, atypical clinical presentation, and rare complications despite the young age of the case. The surgical method used in treating the patient makes the subject more interesting.

A creative and practical approach to postpartum discharge education: Pecha Kucha training via smart phone.

In this study, we aim to determine the effect of discharge education provided with the Pecha Kucha method using smartphones on the levels of feeling of being ready for postpartum discharge and anxiety. This is a randomized controlled experimental study. ClinicalTrials.gov Identifier: NCT04696991. We assigned the participants to the experimental (70) and control (70) groups through the permuted block randomization method. We collected the data using Personal Information Form, State-Trait Anxiety Inventory (STAI) and the Readiness for Hospital Discharge Scale-New Mother Form (RHDS-NMF). The experimental group obtained significantly higher scores from the STAI and RHDS-NMF (p < 0.05). Today especially during the period of the pandemic in which contact tracing and social distancing are highly important, such a type of discharge education is also of importance for reducing the duration spent and the physical contact established by people indoors. According to the results of our research, this method can be a good alternative to routine discharge education.Supplemental data for this article is available online at https://doi.org/10.1080/07399332.2022.2043860 .

A Pseudocoarctation of the Aorta With a Left Subclavian Artery Aneurysm, A Case Report and A Review of the Literature.

Here we present a 47-year-old male diagnosed with a pseudocoarctation of the aorta and a funnel-like subclavian artery aneurysm with a large orifice and severe aortic valve insufficiency. The patient underwent a two-stage repair for both pathologies. After an aortic valve replacement, postcardiotomy pericardial effusion occurred and was medically managed. Six months later, the patient underwent a distal arcus aorta and subclavian artery replacement with a left posterolateral thoracotomy as the second stage. Due to the strict adhesions, pulmonary veins were not cannulated and an extracorporeal bypass between the pulmonary artery and femoral artery was used for distal body perfusion. The coincidence of subclavian aneurysms and a pseudocoarctation of the aorta is rare and a literature review was performed to identify treatment options for this pathology.

Risk factors related to the size and volume of femoral artery pseudoaneurysm after catheter angiography: a single-center study

Background/aim: Evaluate the risk factors associated with pseudoaneurysms' development after the percutaneous interventional procedures performed by cardiology, interventional radiology (IR), and the other clinics. Materials and methods: We retrospectively analyzed the ultrasound scans in the hospital database and picture archiving system (PACS) and enrolled a total of 132 patients during the period from October 2015 and December 2019. We evaluated the maximum diameter and volume of the pseudoaneurysm with the patient and procedure-related factors with univariate analysis. Results: We found that the patients with hypertension and without peripheric artery disease (PAD) had greater sac diameter (p = 0.010 and p = 0.016) and increased sac volume (p = 0.029 and p = 0.007). However, the sac volume increased in patients with diabetes than those without (p = 0.003). Both the increased maximum diameter and the volume of the pseudoaneurysm sac were in the patients in whom the procedure was applied in the common femoral artery (CFA) and with the venous intervention (p < 0.010 and p < 0.016; p = 0.004 and p = 0.001, respectively). We found that platelet count correlated negatively with the sac's maximum diameter and the volume (r = ­0.383, p < 0.001 and r = ­0.486, p < 0.001, respectively) duration of intervention correlated positively with the sac's maximum diameter and the volume (r = 0.205, p = 0.019 and r = 0.320, p < 0.001). Conclusion: Our study reveals that prolonged procedure duration, simultaneous arterial and venous accesses, peripheral artery disease, thrombocytopenia, and puncture site are the aggressive risk factors of pseudoaneurysms size after angiographic procedures.

On-pump coronary artery bypass with concomitant descending thoracic aorta-bi-iliac bypass: A case report.

The presence of critical coronary artery disease and concomitant critical limb ischemia represents a clinical challenge. Single-stage operations for cardiac and peripheral revascularization can be an option in such cases. The "Süzer technique" provides a more physiological extra-anatomical vascular reconstruction by using the descending thoracic aorta as the inflow source. This is an alternative to the more widely used technique of ascending aorta to bifemoral bypass and concomitant coronary revascularization. We report a case of critical limb ischemia with juxtrarenal aortic occlusion and left main coronary artery stenosis treated with concomitant coronary artery bypass grafting and descending thoracic aorto-bi-iliac bypass using a modification of the Süzer technique.

Relationship Between Maternal Characteristics and Postpartum Hemorrhage: A Meta-Analysis Study.

BACKGROUND: Postpartum hemorrhage (PPH) is a leading cause of maternal death in low-income countries and the primary cause of approximately one of every four maternal deaths worldwide. PURPOSE: The aim of this study was to determine the antenatal risk factors of PPH and its effects. METHODS: The literature from nine databases was reviewed, and studies published between 2000 and 2012 were analyzed using terms such as "postpartum hemorrhage," "prevention of postpartum hemorrhage," and "management of postpartum hemorrhage." The full text of 1,061 articles was reviewed, and 29 studies were selected according to the inclusion criteria. Studies that determined bias using the funnel plot test were excluded, and 20 studies were included in the meta-analysis. The data were analyzed using Microsoft Office Excel 2010 and comprehensive meta-analysis. RESULTS: The meta-analysis included five studies and 1,286,752 women for maternal age, six studies and 607,822 women for body mass index, and six studies and 1,118,490 women for parity. The results of the analysis showed that body mass index ≥ 25.00 kg/m (OR = 1.43, 95% CI [1.40, 1.47]), primiparity of mothers (OR = 1.37, 95% CI [1.35, 1.40]), and hypertensive disorder in mothers (OR = 1.52, 95% CI [1.43, 1.61]) are risk factors for the development of PPH. No rela-tionship was found between maternal age ≥ 35 years and PPH (OR = 1.02, 95% CI [0.99, 1.04]). CONCLUSIONS: Midwives, obstetric nurses, and obstetricians should carefully evaluate mothers for the risk factors of PPH during the antepartum, intrapartum, and postpartum periods. Moreover, at-risk pregnant women should give birth in a unit with emergency initiative options. Future studies should examine relevant personal characteristics of mothers, as familiarity with the risk factors facilitates the management and treatment of PPH. Finally, meta-analyses should review more studies to detect risk factors more comprehensively.