Development of a mobile monitoring program for anxiety and depression in pregnancy and evaluation of 3-month results.

BACKGROUND: The aims of this study were to develop a mobile mental health application (app) to scan the symptoms of anxiety, depression, and related factors during pregnancy; examine the effect of the app on pregnant women; and determine the factors related to using such an app. METHODS: A software platform called Perinatal Anxiety Depression Monitoring Platform (PADIP) was developed. This study included 320 pregnant women: 160 in the PADIP group and 160 in the control group. The PADIP group was screened monthly for 3 months for depression, anxiety, and sleep quality, and instant feedback was provided on scale scores. RESULTS: During the follow-up period, there was a significant decrease in depression and anxiety scale scores in the PADIP group but no significant difference in scale scores in the control group. The interface used for the app was important for scale scores. It was preferred by pregnant women with a high education level, higher Perinatal Anxiety Screening Scale scores, and lower sleep quality scores. CONCLUSIONS: PADIP use was associated with a decrease in depression and anxiety scores of pregnant women. It was more useful for patients with higher education levels and a history of a psychiatric disorder, but further research is needed to develop a more comprehensive model.

Detection of depression and anxiety in the perinatal period using Marine Predators Algorithm and kNN.

Undiagnosed prenatal anxiety and depression have the potential to worsen and have an adverse effect on both the mother and the infant. Although the diagnosis is made by specialist doctors, it is unclear which parameters are more effective. Especially in medicine, it is crucial to diagnose disease with high accuracy. For this reason, in this study, a questionnaire study was first conducted on pregnant women, and real original data were collected. Then, the Marine Predators Algorithm (MPA), one of the current metaheuristic algorithms inspired by nature, was combined with K-Nearest Neighbors (kNN) to determine high-priority features in the collected data. As a result, five of the 147 features selected by the proposed method were determined as high priority and approved by the doctors. In addition, the proposed method is compared with the Chi-square method, which is one of the filter-based feature selection methods. Thanks to the proposed feature selection method based on MPA and kNN, it has been observed that the classification gives more successful results in a shorter time with 98.11% success, and the model supports the diagnosis stage of the doctors.

The Effectiveness of Granulocyte Colony-Stimulating Factor (G-CSF) Against Experimental Ischemia-Reperfusion Injury in Rat Ovaries and Its Effect on In Vitro Fertilization Outcomes.

Local ischemic damage resulting from ovarian torsion is a common cause of decreased follicular activity and infertility. It was aimed to evaluate the effect of granulocyte colony-stimulating factor (G-CSF) protection on in vitro fertilization (IVF) results against experimental ischemic (I) and ischemic-reperfusion (I/R) injury in rat ovaries. The study consisted of 35 adult female Sprague-Dawley albino rats (sham, ischemia, I/R, I + G-CSF, and I/R + G-CSF) randomly assigned to 5 groups, each containing 7 rats. While bilateral adnexal torsion was applied to the ischemia groups for 3 h, detorsion was applied to the reperfusion groups. Intraperitoneal 100 IU/kg G-CSF was administered 30 min prior to ischemia (I + G-CSF) or reperfusion (I/R + G-CSF). After ovulation induction (intraperitoneal 150-300 IU/kg PMSG), the oocytes were collected and IVF was applied. Statistically significant differences were observed between the collected oocyte numbers in I and I + G-CSF, I/R, and I/R + G-CSF groups (P values were P = 0.001 for the I-I + G-SCF groups and P = 0.003 for I/R-IR + G-CSF, respectively). An increase in the number of MII oocytes obtained was observed in the I + G-CSF and I/R + G-CSF groups compared to the I and I/R groups. Grade 1 and grade 2 embryo numbers were statically different between the I/R and I/R + G-CSF groups (P values were P = 0.023 for grade 1 embryos and P = 0.045 for grade 2 embryos, respectively). G-CSF treatment was found to be effective in reducing I- and I/R-induced ovarian damage.

Hematological Parameters to Predict the Severity of Hyperemesis Gravidarum and Ketonuria.

OBJECTIVE: Hyperemesis gravidarum (HG) is a pregnancy complication that can progress with persistent nausea and vomiting. The aim of the present study is to evaluate the relationship between hematological parameters and HG. METHOD: A total of 532 pregnant women with HG who were admitted to the Department of Obstetrics and Gynecology between March 2019 and February 2021, and 534 healthy pregnant women with characteristics similar to those of the case group were included in the study. The hematological parameters of both groups were compared. In addition, the hematological parametersof patients with HG according to the severity of ketonuria were compared. RESULTS: The mean age of the HG group (n = 532) was 26.3 ± 4.1 years, and that of the control group (n = 534) was 25.9 ± 4.8 years. Among patients with HG, 46% (n = 249) had ketone (+), 33% (n = 174), ketone (++), and 21% (n = 109), ketone (++ + ). The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were higher in the HG group than in the control group: 3.8 (2.8-5.8)/3.2 (2.6-4.0); p < 0.001; and 135.2 ± 30.4/108.9 ± 62.2; p < 0.001 respectively. The neutrophil count, NLR, and PLR were higher in the group with ketone (++ + ) than in the groups with ketone (+) or ketone (++): 7.6 ± 1.9/5.5 ± 2.4; p < 0.001; 3.8(2.8-4.6)/2.9(2.3-3.6); p < 0.001; and 149.9 ± 48.0/135.9 ± 65.7; p < 0.001 respectively. The mean corpuscular hemoglobin (MCH) level, the NLR, and the PLR were identified as independent predictors of the presence of HG and the level of ketone positivity in HG patients. CONCLUSION: The NLR and PLR were high in patients with HG, suggesting the its inflammatory activity. They may be important markers associated with the presence and severity of HG.

OBJETIVO: A hiperêmese gravídica (HG) é uma complicação da gravidez que pode evoluir com náuseas e vômitos persistentes. O objetivo deste estudo é avaliar a relação entre os parâmetros hematológicos e a HG. MéTODO: Foram incluídas neste estudo 532 gestantes com HG internadas no Departamento de Obstetrícia e Ginecologia entre março de 2019 e fevereiro de 2021, e 534 gestantes saudáveis com características semelhantes às do grupo de caso. Os parâmetros hematológicos foram comparados entre gestantes com e sem HG. Além disso, os parâmetros hematológicos foram comparados entre as pacientes com HG de acordo com a gravidade da cetonúria. RESULTADOS: A média de idade do grupo GH (n = 532) foi de 26,3 ± 4,1 anos, e a do grupo de controle (n = 534) foi de 25,9 ± 4,8 anos. Entre as pacientes com HG, 46% (n = 249) tinham cetona(+), 33% (n = 174), cetona(++), e 21% (n = 109), cetona(+ + +). A razão de neutrófilos para linfócitos (RNL) e a razão de plaquetas para linfócitos (RPL) foram maiores no grupo HG do que no grupo de controle: 3,8 (2,8­5,8)/3,2 (2,6­4,0); p < 0,001; e 135,2 ± 30,4/108,9 ± 62,2; p < 0,001, respectivamente). A contagem de neutrófilos, a RNL e a RPL foram maiores no grupo com cetona(++ + ) do que nos grupos com cetona(+) e cetona(++): 7,6 ± 1,9/5,5 ± 2,4; p < 0,001; 3,8 (2,8­4,6)/2,9 (2,3­3,6); p < 0,001; e 149,9 ± 48,0/135,9 ± 65,7; p < 0,001, respectivamente. O nível médio de hemoglobina corpuscular (MHC), a RNL e a RPL foram identificados como preditores independentes da presença de HG e do nível de positividade de cetona em pacientes com HG. CONCLUSãO: A RNL e RPL estavam elevadas em pacientes com HG, o que sugere a sua atividade inflamatória. Elas podem ser marcadores importantes associados à presença e à gravidade da HG.

Can the neutrophil-to-lymphocyte ratio (NLR) predicts fetal loss in preeclampsia with severe features?

INTRODUCTION: Preeclampsia (PE) is one of the most common causes of major maternal and fetal adverse events including mortality and preterm birth Grill et al. (2009). The neutrophil-to-lymphocyte ratio (NLR) and other hematologic indexes of systemic inflammation have been investigated in patients with PE for the prediction of the severity or presence of the disease. Despite these studies, we found no trials investigating the relationship between NLR and fetal outcomes in PE patients. In this study, we aimed to investigate the relationship between NLR and fetal outcomes. METHODS: We retrospectively analyzed the demographic data and laboratory tests to determine the NLR of 175 pregnant women with severe PE admitted to our clinic between January 2015 and December 2018. RESULTS: NLR in the first (2.4 ± 1.1 vs 2.9 ± 1.4, P = 0.18) and second trimesters (3.6 ± 0.7 vs 3.8 ± 1.3, P = 0.25) were not different between the groups, but third trimester NLR was significantly higher in patients with fetal loss (6.5 ± 5.4 vs 4.2 ± 2.7, P = 0.009). The area under the receiver operating characteristic curve for NLR in the third trimester was 0.66 and NLR > 3.9 predicted fetal loss with a sensitivity of 75% and a specificity of 61% (0.684, 95% confidence interval 0.48-0.83, P = 0.05). CONCLUSION: We demonstrated that third trimester NLR is associated with fetal loss in patients with severe PE.

Does applied ultrasound prior to laparoscopy predict the existence of intra-abdominal adhesions?

BACKGROUND: The purpose of this study was to evaluate the efficacy of trans-abdominal ultrasonography (USG), a noninvasive diagnostic tool, in predicting the presence of intraabdominal adhesions, especially near the trocar entry area, to provide safe surgical access to the abdomen. METHODS: Fifty-nine women with a previous history of open abdominal surgery (group A) and a group of 91 women with no previous history of surgery (group B) underwent dynamic ultrasound evaluation of the abdominal fields before laparoscopic operations. The anterior abdominal wall was divided into six quadrants: right upper, right lower, left upper, left lower, suprapubic, and umbilical. Adhesions were evaluated by surgeons during the operation and by radiologists using USG prior to the operation. Visceral organ movements greater than 1 cm was defined as normal visceral slide (positive test), with less than 1 cm of movement defined as abnormal visceral slide (negative test). Sliding test measures movements of omental echogenicity or a stable echogenic focus that corresponds to intestine peritoneal echogenicity that underlies abdominal wall during exaggerated inspiration and expiration. Adhesions observed during surgery were evaluated on a four-point scale, with 0 indicating no adhesions present, 1 indicating the presence of a thin, filmy avascular adhesion, 2 indicating the presence of a dense and vascular adhesion, and 3 indicating adhesions that connect surrounding organs with the overlying peritoneal surfaces. The McNemar test was used to compare the results of USG and laparoscopy for each measure. RESULTS: We found that preoperative USG was successful in identifying adhesions [sensitivity, 96.39% (95% CI 89.8-99.2); specificity, 97.43%]. DISCUSSION: Preoperative ultrasound examination of the abdominal wall may enhance the safety of abdominal entry during laparoscopic operations.

How often do women use non-drug treatment methods for psyschiatric symptoms during pregnancy and postpartum periods?

The aim of this study was to determine the prevalence of complementary and alternative medical applications (CAM) and non-drug treatments of women during their pregnancies, postpartum periods and the changes between these periods. The Screening Form for Non-pharmacologic Methods Used during Pregnancy and Postpartum period was administered to the participants. Passiflora (Incarnata), Hypericum perforatum (St. John's Wort), omega 3 supplements, bright light treatment, transmagnetic stimulation, S-adenosyl- methionine, herbal teas, biofeedback/neurofeedback, amulets, exercise, acupuncture and psychotherapy were investigated. The ratio of the use of one of the CAM methods for psychiatric complaints during people's lifetime was found to be 33.3% (n=162). Herbal teas were the main practice used during pregnancy (58.8%) and the postpartum. The use of CAM according to the utilization periods of the participants statistically significantly decreased in those who were currently pregnant (Cochran's Q=298.007; P<0.05). The use of participants' non-drug treatments in the periodical follow-up decreased in those who are currently pregnant and increased during the postpartum period.

The Relation of Health-Related Practices of Pregnant Women, Fatigue and Prenatal Attachment.

OBJECTIVE: To examine the relation of the health-related practices of expectant mothers during pregnancy and fatigue in mother and prenatal attachment. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Sakarya Training and Research Hospital, Turkey, between February and April 2016. METHODOLOGY: The study sample consisted of pregnant women (at least 20-week gestation) aged 18 years or above (n=211) who applied to prenatal care services and agreed to participate in the study. The data were collected through a Personal Information Form, Brief Fatigue Inventory (BFI) and the Prenatal Attachment Inventory (PAI). RESULTS: The PAI medians of the participants were 55 [42-64], and the BFI medians were 30 [23-42], and a negative, statistically significant relationship was found between BFI and PAI (r= -0.184, p=0.007). CONCLUSION: Expectant mothers who develop positive health behaviors during pregnancy feel less fatigue and positively affect the prenatal attachment. It is important to evaluate prenatal attachment and identify the mother with low attachment scores.

The determination of infant feeding attitudes among Turkish mothers using the Iowa Infant Feeding Attitude Scale.

OBJECTIVE: To assess whether the Iowa Infant Feeding Attitude Scale is a valid and reliable scale for Turkish mothers, and to assess maternal attitudes toward various aspects of infant feeding. METHODS: This methodological, analytical study was conducted at the obstetrics and gynaecology department of Sakarya Training and Research Hospital, Sakarya, Turkey, from June to August 2015, and comprised mothers of newborn babies. Data was collected using the Turkish version of Iowa Infant Feeding Attitude Scale. SPSS 23 was used for data analysis. RESULTS: There were 391 participants in the study. Five items of the original Iowa Infant Feeding Attitude Scale were excluded due to the low correlation with the scale integrity (Cronbach's alpha=0.67). The total mean score of the mothers was 48.11±6.57. A statistically significant difference was found between the educational status, having social security, what the mothers having other children fed these children in the first 6 months and family types (p=0.05 each). Significant difference was also found between the mothers only breastfeeding and the mothers feeding with mother's milk and formula (p=0.008). CONCLUSIONS: The scale was found to be culturally acceptable, reliable and valid scale for Turkish mothers.

Does hormone replacement therapy have beneficial effects on renal functions in menopausal women?

BACKGROUND: The study was carried out to evaluate the possible effects of hormone replacement therapy (HRT) on renal functions in postmenopausal women. METHODS: A total of 85 postmenopausal women without a history of medical illness were enrolled in the study. They were divided into HRT users and control groups. After 30 weeks of HRT use, the changes in serum urea, creatinine, uric acid, urinary protein, urinary creatinine, urinary protein/creatinine ratio and glomerular filtration rate (GFR) (mL/min/1.73 m(2)) were evaluated. RESULTS: HRT was associated with statistically significant increases in glomerular filtration rate (p < 0.01), while serum urea, creatinine, uric acid, urinary protein, urinary creatinine and urinary protein/creatinine ratio did not change significantly in both groups. CONCLUSION: In our study, we suggested that usage of hormone replacement therapy appeared to affect renal functions in postmenopausal women. There were beneficial effects of HRT on GFR in our postmenopausal patients. HRT may have possible protective mechanisms for kidney against adverse effects of aging.

Is there any possible genotoxic effect in exfoliated bladder cells of rat under the exposure of 1800 MHz GSM-like modulated radio frequency radiation (RFR)?

People are exposed to many carcinogenic and mutagenic chemicals in their everyday lives. These include antineoplastic drugs, Polycyclic aromatic hydrocarbons (PAH)s, aromatic amines, nitrosamines, metals, and electromagnetic radiation. Based on the state of knowledge acquired during the last 50 years of research on possible biological effects of electromagnetic fields (EMF), the majority of the scientific community is convinced that exposure to EMF below the existing security limits does not cause a risk to the health of the general public. However, this position is questioned by others, who are of the opinion that the available research data are contradictory or inconsistent and, therefore, unreliable. In this study, we aimed to investigate if there is any effect of 1800 MHz GSM modulated radio frequency radiation (RFR) on the number of micronucleus in exfoliated bladder cells of rat which will be informative about the genotoxic damage. Exposure period was 20 min/day, 5 days/week during a month. Six female Wistar rats were used for two groups: Group I (n=6): controls; Group II (n=6): 1.8 GHz exposed animals. 1800 MHz RFR did not showed a significant MN frequencies in rat bladder cells when compared with the control group (p>0.05). 1800 MHz RFR-exposed animals did not produce any genotoxic effect when compared with the control group ( p>0.05). Kinetic studies are important for any biomarker, especially those in which tissue differentiation and maturation processes will heavily influence the time between induction of damage and collection of damaged cells for micronucleus analysis.