Fear of childbirth in women with normal pregnancy evolution.

PURPOSE OF INVESTIGATION: The authors aimed to research the prevalence of fear of childbirth (FOC) in women with a positive birth experience and some factors associated with FOC. MATERIALS AND METHODS: The study sample consisted of 817 women with positive birth experience within the last month of their pregnancy from February 2012 to May 2013. The data were collected with a questionnaire form including women's demographic-obstetric information and the Turkish form of Wijma Delivery Expectancy Questionnaire. Whether it was a planned pregnancy and their preferable delivery method for the current pregnancy were recorded. RESULTS: The total number of women with FOC was found to be 128 (15.6%). None of the patients had severe FOC. Fear of labour pain was found as the major cause for preferring cesarean section (73.5%). FOC was associated with preferring delivery methods (OR 5.91, 95% CI 3.96-8.84). FOC was associated with pregnancy planning status (OR 2.4, 95% CI 1.66-3.58). CONCLUSION: Fear of childbirth may be seen to some extent in women with a positive birth experience. However even with woman's positive birth experience, it is important to avoid severe FOC. The pregnancy planning status should be evaluated in the early stages of pregnancy and maternal education programs may be offered to reduce FOC level.

Ozone partially prevents diabetic neuropathy in rats.

Neuropathy is one of the most common complications of diabetes mellitus. Although the beneficial effects of good blood glucose control on diabetic neuropathy are known, this control cannot completely prevent the occurrence and progression of diabetic neuropathy. The aim of this study was to investigate whether ozone prevents diabetic neuropathy. 36 adult female Sprague-Dawley rats were randomly divided into 6 groups (n=6): control (C), ozone (O), diabetic (D), ozone-treated diabetic (DO), insulin-treated diabetic (DI), and ozone- and insulin-treated diabetic (DOI). Diabetes was induced by a single injection of streptozotocin (60 mg/kg, intraperitoneal [i.p.]), after which insulin was administered (3 IU, i.p.) to the DI and DOI groups for 28 days, and 1.1 mg/kg (50 µg/ml) ozone was given to the O, DO, and DOI groups for 15 days. 4 weeks after the induction of diabetes, the nerve conduction velocity (NCV), amplitude of the compound action potential (CAP), total oxidant status (TOS), and total antioxidant status (TAS) were measured, and the oxidative stress index (OSI) was calculated. The NCV, amplitude of CAP, and TAS of the DI and DOI groups were higher than those of the D group; the amplitudes of CAP and TAS of the DO group were higher than those of the D group; and the TOS and OSI of the DO, DI, and DOI groups were lower than those of the D group. These findings indicate that ozone partially prevents diabetic neuropathy in rats. It appears that the preventive effects of ozone are mediated through oxidant/antioxidant mechanisms.

Vitamin E treatment enhances erythrocyte deformability in aged rats.

The harmful effects of aging on blood rheology have been well known. These effects in the aging have been found to be associated with an increase in oxidative stress. The aim of this study was to seek whether treatment of vitamin E as a potent antioxidant could improve the age-related haemorheological abnormalities. For this purpose, male Wistar rats at the age of 3 and 24 months were used. The following parameters were evaluated: red blood cell (RBC) deformability, aggregation, plasma viscosity, vitamin E level, total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI), and the following results were obtained. First, aging was associated with a decrease in RBC deformability and increase in RBC aggregation and plasma viscosity. Second, compared with the young group, while plasma TOS levels and OSI were found to be significantly increased in aged rats, there was no significant change in their plasma TAS level. Third, vitamin E administration produced significant improvement in RBC deformability and decrement in TOS and OSI values in aged rats with respect to young and aged control groups. We did not find any significant effect of vitamin E treatment on RBC aggregation in both young and aged rats and finally, we found a significantly lower plasma vitamin E level in aged rats than in young rats. In conclusion, these findings suggest that blood rheology impairs with age and vitamin E has ameliorating effects on age-induced haemorheological abnormalities especially in RBC deformability, probably by reducing the increased oxidative stress in old age.

Hypospadias reoperations.

AIM: To retrospectively evaluate the experience of a single surgeon (YS) with hypospadias reoperations. PATIENTS AND METHOD: 105 hypospadias patients were reoperated by the same surgeon between 1994 - 2003. The patients were classified into three groups according to the surgical technique employed. Urethral plate tubularisation was performed in Group I. Repair with genital skin or mucosa was carried out in Group II and repair with extragenital tissues was performed in Group III. RESULTS: Mean age at operation was 6.5 years (range: 1.5 - 23 yrs). Mean number of operations performed was 2 (1 - 7). Group I consisted of 33, Group II of 64, Group III of 8 cases. Reasons for reoperation were complete or partial neourethral loss in 71 cases; big and multiple fistulas in 29; neourethral or meatal stenosis in 11 children. One had diverticula. Two had partial corpus cavernosal loss. Residual or secondary fibrotic ventral flexion was detected in 31/105. Complication rates were 15%, 25% and 0% in Group I, II and III, respectively. Overall complication rate was 20% (21/105). CONCLUSION: Severe complications can develop not only in proximal but also after distal hypospadias repairs. Local supportive tissues can be provided more easily in proximal reoperations. Repair with buccal mucosa had no complications in our series as it was only used in well selected cases. If urethral plate is present and wide enough, its tubularisation should lead to better results in reoperations. If it is absent or narrow, meatal based or onlay island flaps should be employed. Though the onlay island flap is known to be well vascularised theoretically, our results with meatal based flaps were better. We preferred using the tunica vaginalis when urethral plate was absent and penile skin was not appropriate. We suggest using the onlay technique for large penile defects of the shaft and not in the glanular area. But its use as local supportive tissue in reoperations can be very helpful.

Feminizing surgical management of intersex patients.

The study's objective was to evaluate the results of surgical modalities for children with ambiguous genitalia. The records of 55 patients who were reared as females between 1985 and 2001 were reviewed regarding diagnosis, age at surgery, operative procedures, and outcome. The mean age at surgery was 3.5 years, and the follow-up period averaged 4.1 years with a range of 2 months-17 years. The types of reconstructive surgical techniques were clitorovaginoplasty in 29, staging clitoral surgery and vaginoplasty in seven, clitoroplasty in five, total urogenital mobilization (TUM) in three, vaginal bowel substitution in two, clitoridectomy in one, and gonadectomy in six, and two are waiting for vaginal substitution surgery after gonadectomy. The main complications were vaginal stenosis in four patients. All of the TUM patients had good appearances of their urethral orifice and vagina, all of them were continent, and none of them had urinary tract infections. With our limited experience with the TUM procedure, we feel that it is possible to obtain a better cosmetic and functional result with an easier technique. Among the 10 patients of postpubertal age, none of them had had sexual experience. Eight of the postpubertal patients asked questions about their reproductive status. Patients with an intersex disorder should be informed about their problems, especially about their reproductivity.

Duplication of appendix vermiformis: a case in a child.

Appendiceal anomalies are extremely rare malformations that are usually found in adult population as an incidental finding during laparotomy due to another reason. When appendiceal duplications are detected in childhood, almost all the patients have serious associated intestinal, genito-urinary or vertebral malformations. Presented herein are a case of a huge (15 x 13 cm mass) appendiceal duplication in a child causing acute abdomen without an accompanying pathology, its differentiation from appendiceal and caecal diverticulum, and classification of appendiceal duplications with the review of literature.