The effect of hyperemesis gravidarum on voice and dysphagia: a comparative study.

OBJECTIVE: This study aims to determine the voice and gastrointestinal system changes of patients with hyperemesis gravidarum in the first trimester and to compare them with healthy pregnant women. PATIENTS AND METHODS: This study was conducted prospectively. Two groups were defined as hyperemesis and healthy pregnant women. All the participants in the groups are between 20-42 years old and 6-12 weeks pregnant. Voice evaluation of all participants was made with the voice handicap index-10 (VHI-10). The Eating Assessment Tool-10 (EAT-10) was used for Dysphagia evaluation. The groups were compared, and the significance level was determined as p<.05. RESULTS: In terms of mean age and week of gestation, both groups were matched. There was a statistically significant difference in total VHI-10 between the control and HG group. In terms of the EAT-10 on the other hand subjective swallowing problem, higher scores (more problematic) were observed in the HG group. There was no statistically significant correlation between age and VHI-10, VHI-10 sub-scores, or EAT-10. CONCLUSIONS: Compared to healthy pregnant women, hyperemesis gravidarum affects the voice quality negatively and increases gastrointestinal complaints. Although these are shown with subjective parameters in this study, there is a need for studies that will make an objective evaluation.

Effect of delivery mode on objective and subjective aspects of voice.

OBJECTIVE: This study aimed to compare the effect of delivery on both objective and subjective parameters of voice. PATIENTS AND METHODS: This is a prospective parallel-group randomized controlled trial. 105 women grouped in two; vaginal delivery (NG) and cesarean group (CG). The fundamental frequency (F0), jitter, shimmer, noise-to-harmonics ratio (NHR), number of voice breaks (VBn) and percentage of voice breaks (VB%) were determined in acoustic analysis. Voice Handicap Index 30 (VHI) was used for subjective analysis. RESULTS: In NG, a significant decrease in jit%, shim% and VB% was observed (p <.05). In CG, all parameters including F0 showed a significant decrease in early postpartum period (p <.05). CG had more significant improvement in F 0, jit%, shim%, shimdB, VB%, VBn according to test statistics values. VHI scores increased in both NG and CG. CONCLUSIONS: The change of objective parameters was more significant in CG. Vaginal delivery may cause vocal trauma which results in deterioration in objective acoustic measures as well as decrease in subjective voice quality.

Encephalocraniocutaneous lipomatosis, a rare neurocutaneous disorder: report of additional three cases.

PURPOSE: Encephalocraniocutaneous lipomatosis (ECCL) is a rare congenital neurocutaneous disorder. It was described by Haberland in 1970 and is also called Haberland syndrome. It is characterized by unilateral skin lesions such as lipomas, connective tissue nevi, and alopecia with ipsilateral ophthalmological and cerebral malformations with or without psychomotor and mental retardation and early-onset seizure. METHODS: We present three pediatric cases (two boys, one girl) with ECCL. All the patients' sociodemographic, clinical, and neuroradiological data was collected. RESULTS: We describe two male (5 and 1.3 years old) and one female (15 years old) cases. All patients have unilateral left-sided alopecia with ipsilateral ocular lesion and the cerebral lesion. All patients were born at term; their past history and family histories were unremarkable. Their electroencephalograms showed hemispheric asymmetry. All of the cases had right-sided mild to moderate hemiparesis. In addition, our second case is having optic glioma and this case is the fifth case with glioma associated with ECCL. CONCLUSIONS: We describe three additional cases with ECCL which is an extremely rare neurocutaneous syndrome. Also, case 2 has optic glioma and according to the literature this is the fifth case of low-grade gliomas with ECCL. We suggest that patients who have ocular lesion and ipsilateral skin lesion must be examined for ECCL, and the patients must be followed up with cerebral MRI once a year for low-grade gliomas.

Comparison of the effect of the rotation palatoplasty and V-Y pushback palatoplasty techniques on palate elongation with magnetic resonance imaging.

Most surgical techniques used in cleft palate repair require the extension of the palate to the pharynx. However, no adequate information exists regarding the extent to which this elongation obtained during operation continues in late postoperative period. In this study, we compared and measured palate elongation in patients with a cleft palate who underwent a V-Y pushback or rotation palatoplasty, by means of magnetic resonance images obtained before and 1 year after surgery. The hard palate, soft palate, and total palate lengths were measured for all of the patients, and the velopharyngeal opening area width was calculated. In patients who underwent the V-Y pushback technique (n=13), the total palate and soft palate lengths were shortened by an average of 0.10 and 0.14cm after surgery, respectively. However, the hard palate length was elongated by an average of 0.13cm. In the rotation palatoplasty group (n=13), the total palate, hard palate, and soft palate lengths were elongated by 0.57, 0.10, and 0.49cm, respectively. The velopharyngeal opening was narrowed by 0.06cm(2) using the V-Y pushback technique and by 0.29cm(2) using the rotational palatoplasty. This study demonstrated that the palate does not elongate during the V-Y pushback technique, as expected. However, rotational palatoplasty elongates the soft palate.

Impact of the intensity of microemboli on neurocognitive outcome following cardiopulmonary bypass.

BACKGROUND: This study aimed to determine whether there was any association between the intensity of intraoperative gaseous microembolic signals (GME), neuropsychological testing and clinical outcome in high-risk patients undergoing coronary artery surgery (CABG). METHODS: Over a 6-month period, GME activity was monitored in 102 Euroscore 6+ patients during cardiopulmonary bypass (CPB) with a conventional 32-micron arterial filter by non-invasive, real-time ultrasonic device. Cognitive tests; line bisection, the Stroop test, finger tapping, and the Rey Auditory Verbal Learning Test were performed at baseline, postoperative one week and postoperative one month. RESULTS: The distribution of GME activity showed that there were three groups of patients: >500 total emboli (n = 38); 250 to 500 emboli (n = 30) and <250 emboli (n = 34) at a detection level of 2% of the circuit diameter on the arterial side. Line bisection, the Stroop test and finger tapping were impaired significantly in >500 emboli patients versus control (<250 emboli) in postoperative week one, but resolved in one month. CONCLUSIONS: Correlation between intraoperative GME intensity and neurocognitive tests suggests that the level of GME might have a role in determining the psychological outcome after CABG with CPB.

Presence of accompanying head injury in patients with maxillofacial trauma.

BACKGROUND: Patients with maxillofacial fractures are at high risk of accompanying traumatic cranial injuries. Prompt determination of head injury in these patients is crucial for improving patient survival and recovery. METHODS: The records of 246 patients with maxillofacial fractures referred to the emergency department of our hospital between January 2006 and September 2009 were reviewed in this retrospective study. The patients' age and gender, cause, type and location of the maxillofacial fracture, and the cranial injuries were analyzed. RESULTS: The mean age of the patients was 23.61±16.75 years (83.3% males and 16.7% females). Cranial injury was observed in 38 patients with maxillofacial trauma. While the risk of head injury was found to be 3.44-fold lower among patients with single facial bone fracture (p<0.001), the risk of experiencing head injury significantly increased in patients with multiple facial bone fractures (p<0.001). The risk of head trauma significantly increased in patients with fractures of the nasal bone, maxillary bone, mandibular bone, and with frontal region fractures (p<0.05 in each group). CONCLUSION: The patients with multiple facial bone fractures should be investigated with regard to head injury even if they do not have clinical findings.

Kutlay technique for hypospadias repair.

OBJECTIVE: Although many techniques have been described, new techniques with a wide range of therapeutic options are needed. The Kutlay technique is a novel technique that is based on the reconstruction of the neourethra with two horizontal meatal-based skin flaps. In the present study, the data of 31 patients who underwent surgery with the Kutlay technique are presented. PATIENTS AND METHODS: Thirty-one patients with hypospadias with an average age of 5.6 years who did not have previous hypospadias repair were operated on with the Kutlay technique. Ten patients had chordee. Among those patients, three patients were circumcised. RESULTS: The patients were followed up for 4-13 months (average, 9.3 months). During the follow-up period, a fistula was observed in only one patient. None of the patients developed neourethral dehiscence, meatal stenosis, urethral stricture, wound infection, penile torsion, hematoma, or persistent or recurrent chordee. On uroflowmetry studies, the maximum flow rate of the patients was approximately 10.5 ml/s (range, 6-17 ml/s). The patients were observed to void with a single straight urinary stream in a forward direction. CONCLUSION: The Kutlay technique is a technique that is easily applied in patients with chordee and that provides a low risk of fistulas and acceptable functional and esthetic results. The factors that reduce the risk of fistula are the lack of the superposition of the suture lines of the skin and the urethra, the reconstruction of the urethra with well-vascularized flaps, and the replacement of the neourethra in its appropriate location through the tunnel created in the glans.

A rare case of fistula: nasocutaneous fistula.

A three-year-old male patient was brought to our clinic by his family with the complaint of a non-healing wound with discharge on his forehead and the nasal region. He had a history of a fall one-year ago. The patient had recurrent complaints of swelling and hyperemia following this trauma. He had undergone an operation with the pre-diagnosis of foreign body in soft tissue six months ago. However, no foreign body had been detected and the inflamed tissue had been excised and closed again. The swelling and purulent discharge in the region between nose and eye continued after this surgery. The patient underwent an operation and a circular defect 0.5 cm in diameter was detected on the dorsum of the nasal bone and a fistula tract was found to have developed between this defect and the skin between the nose and the eye. A subcutaneous forehead flap without skin tissue was removed including the periosteum from the left part of forehead after excision of the fistula tract. The flap was transferred to the nasal dorsum and the component of the forehead flap including the periosteum was used for reconstruction of the nasal mucosa. The wound healed without any problems and no fistula or infection developed again during the six-month follow-up.

Evaluation of temephos and chlorpyrifos-methyl against Culex pipiens (Diptera: Culicidae) larvae in septic tanks in Antalya, Turkey.

The larvicidal activity of chlorpyrifos-methyl and temephos was evaluated against Culex pipiens L. (Diptera: Culicidae) in septic tanks in Antalya, Turkey. Chlorpyrifos-methyl (Pyrifos MT 25 emulsifiable concentrate [EC] ) was evaluated at application rates of 0.04, 0.08, and 0.12 mg active ingredient (AI)/liter, and temephos (Temeguard 50 EC) was evaluated at 0.02, 0.04, and 0.06 mg (AI)/liter during a 21-d study. Generally, overall larval reduction in septic tanks from single- and multifamily dwellings treated with either larvicide was significantly greater than pretreatment levels and control tanks for the duration of the study. At 14 d posttreatment, duration of control was greatest in multifamily tanks treated with chlorpyrifos-methyl at the highest application rate with similar levels of control through 21 d for single-family dwellings (range 97-100%). Septic tanks from both types of family dwellings treated at the highest application rate of temephos resulted in >90% reduction through day 21 (range 91-100%). Laboratory bioassays of septic tank water treated at field application rates, without daily dilution, revealed that complete larval mortality was achieved for 21 d at each application rate and formulation. It is thought that daily addition of water and organic matter to the septic tanks in the single and multifamily dwellings influenced the duration of effectiveness of the larvicides.

Phenotypic and genetic parameter estimates for racing traits of Arabian horses in Turkey.

The racing records for Arabian horses used in the study were obtained from the Turkish Jockey Club. The traits used in the study were racing time, best racing time, rank, annual earnings, earnings per start, log annual earnings and log earnings per start. Genetic parameters were estimated by the restricted maximum likelihood (REML) procedure using the DFREML program. The effects of age, sex and origin of horse were significant for each trait. The effect of year was significant on time and earning traits, but not rank. The effect of month on time traits was also significant. Heritability estimates of the entire data set were 0.280, 0.281, 0.069, 0.139, 0.174, 0.152 and 0.171 for racing time, best racing time, rank, annual earnings, earnings per start, log annual earnings and log earnings per start respectively. Estimates of repeatability varied from 0.349 to 0.500 for racing time, from 0.430 to 0.524 for best racing time and from 0.129 to 0.171 for rank depending on the data set used in the analyses. Best racing time was the most appropriate trait for selection in this study, as this might lead to genetic improvement than other traits.

[The effects of malathion, fenitrothion and propoxur on the house fly, Musca domestica I. (Diptera: Muscidae), populations]. / Karasinek, mucsa domestica l., (diptera: muscidae), populasyonlarina malathion, fenitrohion ve propoxur'un etkisi.

The present work was carried out to determine the LD50 and LD90 of Malathion, Fenitrothion and Propoxur for the house fly, MUSCA DOMESTICA L., under laboratory conditions. The house fly populations were collected from the municipality garbage area of Ankara in September 1981, April and September, 1982. The resistance tests were applied on both sexes by means of Topical Application method. The highest resistance level for Malathion was observed in Ankara strains. The values of LD50 were 261.1, 302.1, 312,6 micrograms/female, respectively. The populations were not showed high resistance ratio to Fenitrothion (R/S 93.3, 126.6, 56.6 at LD50) and Propoxur (R/S 34.2, 31.4, 21.4 at LD50). It is clear that, Propoxur was more toxic to female and male flies than Fenitrothion. However the males were more susceptible to the applied insecticides than the females. It was concluded that susceptibility of houseflies to the insecticides varied widely by seasons in the same habitat. The results of the tests indicated that the resistance level of Malathion was very high. Therefore it should not be recommended for the control of houseflies in Ankara.