The Uptake of Pneumococcal and Seasonal Influenza Vaccinations Based on Perceptions and Attitudes Toward the COVID-19 Vaccine Among Patients With Diabetes.

Objective In this study, we aimed to assess the rates of pneumococcal and seasonal influenza vaccinations among elderly and nonelderly diabetes patients and examine their perceptions and attitudes toward the coronavirus disease 2019 (COVID-19) vaccine. Methods A single-center study was conducted among patients with diabetes, employing a structured survey encompassing sociodemographic data, vaccination records, and the COVID-19 vaccine perception and attitude scale. Results Among the 280 diabetes patients in our study, the vaccination rates for COVID-19, seasonal influenza, and pneumococcal vaccines were 96.1%, 16.8%, and 17.5%, respectively. A higher cumulative dosage of the COVID-19 vaccine was associated with older age (r = 0.463; p<0.001), increased safety score (r = 0.479; p<0.001), and lower conspiracy theory score (r = -0.336; p<0.001). Participants who had received COVID-19 and influenza vaccines were observed to have significantly higher safety scores related to COVID-19 vaccines (p<0.001; d = 2.381 and p = 0.008; d = 0.525, respectively). Notably, vaccination rates for influenza and pneumococcus were significantly different between nonelderly and elderly patients (8.7% vs. 29.6%; p<0.001 and 13.4% vs. 24.1%; p = 0.022). Elderly patients with diabetes were 3.3 times more likely to receive the influenza vaccine than nonelderly participants [odds ratio (OR) = 3.319; 95% confidence interval (CI) = 1.592 - 6.920; p = 0.001] and had a higher safety score related to COVID-19 vaccines (OR = 1.076; 95% CI = 1.011 - 1.146; p = 0.021). Conclusions Both influenza and pneumococcal vaccination rates were below the desired targets in this study. The vaccination rates among the nonelderly diabetes population suggest that this group may be more likely to neglect to receive vaccination compared to the elderly diabetes population. The association between vaccination rates and post-pandemic safety perceptions highlights the critical need to implement public health strategies specifically designed to address and improve safety-related information dissemination.

Comparison of the Oral Health-Related Quality of Life, Sleep Quality, and Oral Health Literacy in Sleep and Awake Bruxism: Results from Family Medicine Practice.

Objectives: Bruxism is a common oral behaviour. This study aimed to compare oral health-related quality of life, sleep quality, and oral health literacy in patients with and without possible sleep bruxism (SB) and awake bruxism (AB). Materials and Methods: A cross-sectional study including 249 volunteers was conducted in a family medicine clinic of a tertiary hospital in Istanbul, Turkey. The American Sleep Medicine Association Bruxism Diagnostic Criteria, Pittsburgh Sleep Quality Index (PSQI), Oral Health-Related Quality of Life (OHRQoL) tool, Decay Missing Filled Total Teeth (DMFT) score, and Health Literacy Dental Scale-Short Form (HeLD-14) were assessed by face-to-face interviews. Data were examined using Kruskal-Wallis and Mann-Whitney U tests, Spearman correlation, and logistic regression analysis. Results: The presence of SB and AB was detected as 41.4% and 21.7%, respectively, among 91 males and 158 females, with a mean age of 36.64 ± 11.60 years. Sleep and awake bruxers had a lower oral health-related quality of life (odds ratio (OR): 0.816, 95% confidence interval (CI) = 0.770-0.864 and OR: 0.923, 95% CI = 0.956-0.982, respectively). Poor sleep quality was detected 1.28 times higher in sleep bruxism (OR: 1.277, 95% CI = 1.152-1.415) and 1.14 times higher in awake bruxism (OR: 1.141, 95% CI = 1.230-1.058). The DMFT score was found to be 1.13 times higher in SB (OR: 1.129, 95% CI = 1.043-1.223). A higher HeLD-14 score was associated with a lower DMFT score (p < 0.001; r = -0.240). The oral health literacy score was lower in AB and SB groups than in patients without bruxism, but it was not statistically significant (p = 0.267, p = 0.376). Conclusion: A lower oral health-related quality of life and poor sleep quality would be expected in the presence of SB or AB. However, patients may not be aware of it unless asked by a physician regardless of oral health literacy level.

Did healthy life awareness affect the behavioral or cognitive avoidance attitude from COVID-19? An observational study.

Aim: This study purposed to evaluate the healthy life awareness (HLA) level versus the COVID-19 avoidance attitudes. Materials and Methods: A single-centered observational study was conducted in the Family Medicine Clinics of a tertiary hospital between April 30, 2021 and July 30, 2021. The HLA scale was used to determine the participants' HLA levels. In addition, the avoidance attitudes from the COVID-19 scale score assessed attitudes toward avoiding COVID-19. Data were analyzed with E-Picos (MediCRES) Statistical Programme. Results: Of the 311 participants aged 30.79 ± 8.37 years, 58.52% (n = 182) were female and 41.48% (n = 129) were male. A negative relationship between the HLA and cognitive avoidance scores (r = -0.255, P < 0.001) and a positive relationship between HLA and behavioral avoidance scores (r = 0.119, P = 0.036) have been indicated. The results of a binary logistic regression, taking the presence of a higher HLA score as the dependent variable, have shown that high awareness was observed in women, approximately 1.7 times more than in men [odds ratio (OR): 1.684, 95% confidence interval (CI) = 1.058-2.696; P = 0.030]. Participants with high HLA had 1.06 times higher behavioral avoidance scores than others (OR: 1.066, 95% CI = 1.012-1.455; P = 0.049). As the cognitive avoidance score increased, the presence of high HLA decreased by nearly 33%. (OR: 0.666, 95% CI = 0.512-0.867; P = 0.002). Conclusion: This study emphasized that a higher HLA was associated with increased behavioral avoidance and decreased cognitive avoidance from COVID-19. HLA has led to doing what needed to be done without being affected by negative discourses.

Screening of Hepatitis A and B Seropositivity among Turkish Healthcare Providers Admitted to Occupational Health Services.

This study aimed to determine the protection rates against hepatitis A virus (HAV) and hepatitis B virus (HBV), among healthcare providers (HCPs). The occupational health service data of Gaziosmanpasa Training and Research Hospital between January 2020 and December 2020 were evaluated for this retrospective observational study. Of the 1,722 participants aged 34.40 ± 9.16 years, 48.6% (n = 861) were male, and 55.0% (n = 975) were doctors and nurses. The anti-HBs seropositivity rate was 87.5% (n = 1,501). None of the participants had anti-HCV antibodies. Twelve participants were HBsAg positive. A level of anti-HBs titer ≥10 mIU/mL was maintained in 66.7% of the HCPs vaccinated in childhood, while 71.3% (n = 1,263) of the participants had anti-HAV IgG. HAV vaccination needs were higher in the doctor and nurse groups than in the other groups (60.5% and 39.5%, respectively, p = 0.003). HBV protection was higher among HCPs in polyclinics/wards and surgery/intensive care units than in those working in the emergency department (odds ratio (OR): 2.099, 95% confidence interval (CI) = 1.285-3.429; OR: 1.592, 95% CI = 1.037-2.443, respectively). HAV protection was higher in HCPs aged 31-50 years and over 50 years than in those aged 18-30 years (OR: 2.046, 95% CI = 1.647-2.541; OR: 3.615, 95% CI = 2.164-6.037, respectively). In this study, one out of every two HCPs aged 18-30 years admitted to the occupational health control services had not yet received the HAV vaccine. The low levels of HBV protection among HCPs in the emergency department highlight the need for occupational health screening and HBV vaccination for HCPs working in emergency services in hospitals.

Frequency and severity of irritable bowel syndrome in cigarette smokers, Turkey 2019.

INTRODUCTION: Cigarette smoking has recently been associated with several gastrointestinal symptoms, and smoking cessation has been recommended as a lifestyle change strategy for irritable bowel syndrome (IBS). This study assessed the prevalence of IBS in cigarette smokers based on the Rome IV criteria, the severity of nicotine dependence, and the effect of smoking cessation in smokers with IBS. METHODS: This prospective study included 371 smokers who attended smoking cessation treatment at family medicine clinics in a tertiary hospital between January and April 2019, in Turkey. Data on demographic characteristics, IBS status according to the Rome IV criteria, and Fagerström test for nicotine dependence (FTND) scores were collected during face-to-face interviews. RESULTS: The mean patient age was 40.7 ± 11.96 years. Out of the total patients, 29.4% were heavy smokers, and 18.1% had IBS. There was a significant difference in age (p=0.03), duration of smoking (p=0.05), FTND score (p=0.02), and sex (p<0.001) between those with and without IBS. Logistic regression analyses identified female sex as a predictor of IBS in smokers (adjusted odds ratio, AOR=1.78; 95% CI: 1.18-2.69; p=0.006). At follow-up at 1 year, IBS(+) smokers who had quit smoking showed decreased gastrointestinal symptoms (p=0.035). CONCLUSIONS: FTND score was higher in IBS(+) smokers than in IBS(-) smokers. Smoking cessation ameliorated gastrointestinal symptoms but did not affect IBS status.

Evaluation of the Rational Analgesic use in elderly adults: A cross-sectional study.

OBJECTIVES: To assess inappropriate analgesic use (IAU) by comparison of STOPP/START Version-2 and Beers 2019 criteria. METHODS: This is a cross-sectional study of 331 elderly patients admitted to family medicine clinics at a tertiary hospital between February and July 2018. Data were collected from face-to-face surveys, including informed patient consent and electronic drug monitoring databases. RESULTS: The presence of IAU by STOPP version2 was higher than the Beers criteria (19.6%, 14.5%, respectively; P<0.04; Z= -2.5) with a moderate agreement (Kappa= 0.458). The number of drugs and pain score were predictors of IAU. The most commonly caused IAU was diclofenac, although naproxen was the most used analgesic. Almost 39% of diclofenac use, 18.5% of naproxen use, and 33% of etodolac use were IAU. Most commonly, IAU reasons were; (i) NSAID use in hearth failure (Beers) (ii) NSAID use with an antiplatelet agent(s) without PPI (STOPP). CONCLUSIONS: The difference between criteria in terms of IAU was significant in favor of STOPP V2.

Association between post-cessation weight gain and eating behavior changes.

OBJECTIVE: Fear of post-cessation weight gain may be a barrier to cessation therapy or may lead to smoking relapse. This study aimed to evaluate the relationship between the change in eating behavior and post-cessation weight gain. METHODS: A prospective study that included 103 cigarette smokers, who visited the family medicine clinics of a training and research hospital for smoking cessation treatment between June 2018 and December 2018, was planned. A face to face survey (including Turkish version of Dutch Eating Behaviour Questionnaire-DEBQ and weight measures) was applied to all individuals at first and the final visits for the assessment of restrained, emotional, and external eating behaviors. Statistical analyses were completed using the IBM SPSS Statistics 22 program. RESULTS: Of 103 patients screened (M age=38.3 years SD=9.28), 58.3% were male, and 40.8% were in heavy nicotine dependence level (NDL) group. The mean weight increased by 4.74±2.63 kg in three months of smoking cessation. In the high NDL group, three subscales score (restrained p<0.001, emotional p=0.007, external p=0.005) of the DEBQ increased. Weight gain was significative associated with NDL (p=0.01). There was a positive correlation between Fagerstrom score and weight (kg) gain (r: 0.34; p=0.001). Weight change according to the emotional eating behavior was significantly different by gender (female p=0.005; male p=0.04). Women had a higher difference in emotional eating behavior score than men. Obese smokers had a higher initial restrained eating score than non-obese smokers (p=0.009). Weight gain of nicotine replacement therapy group had a similar result in the pharmacotherapy (varenicline) group (p=0.26). Both of treatment types concluded with a significant weight change (p=0.001). CONCLUSION: This study obtained that post-cessation weight gain is related to high nicotine dependence, and quit smoking causes increased scores of emotional, restrained, external eating behavior subscales. Post-cessation eating behavior is negatively affected by quit smoking.

What is the impact of short- and long-term supplementation of either cabergoline or clarithromycin on resolving rat ovarian hyperstimulation syndrome (OHSS) model?

This study aimed to evaluate the effects of coasting, cabergoline and clarithromycin in a rat ovarian hyperstimulation syndrome (OHSS) model. The 42 female Wistar rats were divided into seven groups: control, OHSS (was given 10 IU of pregnant mare serum gonadotropin for 4 consecutive days from day 22 and 30 IU hCG on the fifth day to induce OHSS ), coasting (hCG was applied on the 27th day after gonadotropin injections and the rats were decapitated on the 28th day), Cabergoline (100 mg/kg/d) and clarithromycin (100 mg/kg/d) were given (on the 26th day) with a short-term supplementation (on the 26th day) and long-term supplementation (from the 22nd to the 26th day) groups. The rats were decapitated on the 27th day. Cabergoline and clarithromycin significantly lowered VEGF-2 levels. Clarithromycin significantly reduced IL-1b and TNF-a and significantly increased IL-10 levels. Clarithromycin may be an effective drug for the treatment of OHSS. Impact statement What is already known on this subject? Ovarian hyper-stimulation syndrome (OHSS) is a self-limited disease, in which vascular endothelial growth factor (VEGF) plays the most important role and has a large clinical spectrum related with increased capillary permeability and fluid retention. Some treatment methods that block VEGF over-expression are used in treatment of OHSS. Clarithromycin is known to suppress the production of some pro-inflammatory molecules such as VEGF, IL-8, IL-1, IL-6 and TNF-a. In our study, we compared the efficacy of coasting, short- and long-term supplementation of clarithromycin and cabergoline on correcting OHSS parameters in an experimental study. What do the results of this study add? As a result of our study, we found that OHSS parameters improved better in early prophylactic treatment regimens. We have shown that clarithromycin may be a more effective treatment agent than coasting and cabergoline. What are the implications of these findings for clinical practice and/or further research? Although our study is important in that it is the first pilot study to show that clarithromycin is effective in the treatment of OHSS, there is a need for larger clinical trials.

Comparison of results of Bakri balloon tamponade and caesarean hysterectomy in management of placenta accreta and increta: a retrospective study.

The aim of this study was to compare the postoperative results of the patients who were treated with Bakri balloon tamponade or hysterectomy for placenta accreta and increta. Patients who were diagnosed with placenta accreta or increta preoperatively and intraoperatively and treated with Bakri balloon tamponade (Group 1) or caesarean hysterectomy (Group 2) were compared in regards to the postoperative results. Among the 36 patients diagnosed with placenta accreta or increta, 19 patients were treated with Bakri balloon tamponade while 17 cases were treated with hysterectomy. Intraoperative blood loss amount was 1794 ± 725 ml in G1, which was lower than that in G2 (2694 ± 893 ml). Blood transfusion amount was 2.7 ± 2.6 units in G1, lower than that in G2 (5.7 ± 2.4 units), too. Operation time was 64.5 ± 29 min and 140 ± 51 min in G1 and G2, respectively, showing significant differences between two groups. The success rate of Bakri balloon was determined as 84.21%. In conclusion, cases with placenta accreta/increta, with predicted placental detachment who are willing to preserve fertility, application of uterine balloon tamponade devices before the hysterectomy is encouraging with its advantages compared with the hysterectomy. Impact statement What is already known on this subject: Invasive placental anomalies are the most common indication of postpartum hysterectomy. Recently, uterine balloon tamponade was also included in the treatment modalities of postpartum haemorrhage.This study aimed to compare the postoperative results of UBT or hysterectomy for patients with placenta accreta and increta. What the results of this study add: In this study, the total amount of blood loss was higher in the caesarean hysterectomy group when compared with the Bakri balloon tamponade group. The mean transfusion requirement, mean operation time and hospitalisation period was significantly longer in the caesarean hysterectomy group. The success rate of the Bakri balloon was determined as 84.21%. Two patients who were treated with balloon application had a successful pregnancy and delivery later. Maternal mortality was reported in neither balloon nor hysterectomy groups. What the implications are of these findings for clinical practice and/or further research: In conclusion, patients diagnosed with placenta accreta/increta with ultrasound should be taken into the operation in elective conditions, if possible, on lithotomy position. In cases with predicted placental detachment that are willing to preserve fertility, application of uterine balloon tamponade devices before the hysterectomy has advantages compared with the hysterectomy.

Protective effects of vitamin C and vitamin E against hysterosalpingography-induced epithelial degeneration and proliferation in rat endometrium.

AIM: The aim of this study was to examine the protective effects of vitamin C (VC) and vitamin E (VE) against hysterosalpingography (HSG)-induced epithelial degeneration and proliferation in rat endometrium. MATERIALS AND METHODS: A total of 28 female Wistar albino rats were randomized into four groups: G1 (n=7; abdomen was opened and closed), G2 (n=7; 0.1 mL Lipiodol [ethiodized oil] was administered to each uterine horn in conjunction with X-ray irradiation), G3 (n=7; 50 mg/kg of intraperitoneal (ip) VC was administered, followed by the administration of 0.1 mL of ethiodized oil into the uterine horns after 15 minutes), and G4 (n=7; 50 mg/kg of ip VE was administered, followed by the administration of 0.1 mL of ethiodized oil into the uterine horns after 15 minutes). After abdominal closure, rats in G2, G3 and G4 groups were exposed to whole-body X-irradiation three times with 2-minute intervals at a total dose of 15-20 mrad. Three hours after exposure, abdominal cavities of all the rats were reopened and uterine horns were removed. The right uterine horns were embedded into paraffin blocks after fixing in 10% formaldehyde for histopathological and immunohistochemical examination. Uterine horns on the other side were rapidly excised and stored at -80°C for the examination of expression of microRNAs (miRNAs) and oxidant, antioxidant, apoptotic and antiapoptotic gene expression using real-time polymerase chain reaction (RT-PCR) method. RESULTS: No differences were observed in terms of expression of miRNAs and oxidant, antioxidant, apoptotic and anti-apoptotic gene expression between the study groups. Congestion, epithelial degeneration and malondialdehyde immunoreactivity were significantly lower in G3 and G4 groups than in G2 group; no differences were observed between G1, G3 and G4 groups. Ki-67 immunoreactivity score was significantly higher in G2 group when compared with G1, G3 and G4 groups. Caspase-3 immunoreactivity was not statistically different between the groups. CONCLUSION: VC and VE may confer cellular protection against radiation injury induced by HSG in endometrial epithelium.

Efficacies of vitamin D and omega-3 polyunsaturated fatty acids on experimental endometriosis.

OBJECTIVE: The aim of this study was to investigate the effects of 1,25-dihydroxyvitamin-D3 (vitamin D) and omega-3 polyunsaturated fatty acids (omega-3 PUFA) on experimentally induced endometriosis in a rat model. MATERIALS AND METHODS: A prospective, single-blind, randomized, controlled experimental study was performed on 30 Wistar female rats. Endometriosis was surgically induced by implanting endometrial tissue on the abdominal peritoneum. Four weeks later, a second laparotomy was performed to assess pre-treatment implant volumes and cytokine levels. The rats were randomized into three groups: vitamin D group (42 µg/kg/day), omega-3 PUFA group (450 mg/kg/day), and control group (saline 0.1 mL/rat/day). These treatments were administered for 4 weeks. At the end of treatment, a third laparotomy was performed for the assessment of cytokine levels, implant volumes (post-treatment) and implants were totally excised for histopathologic examination. Pre- and post-treatment volumes, cytokine levels within the groups, as well as stromal and glandular tissues between the groups were compared. RESULTS: The mean post-treatment volume was statistically significantly reduced in the omega-3 PUFA group (p=0.02) and the level of the interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), vascular endothelial growth factor (VEGF) in the peritoneal fluid were significantly decreased at the end of treatment in the omega-3 PUFA group (p=0.02, p=0.03, and p=0.03, respectively). In the vitamin D group, only IL-6 levels were significantly decreased. In the histopathologic examination, the glandular tissue and stromal tissue scores of the implants were significant lower in the omega-3 PUFA group (p=0.03 and p=0.02). CONCLUSION: Omega-3 PUFA caused significant regression of endometriotic implants. Vitamin D has not been as effective as omega-3 PUFA on endometriosis.

Investigation of the effects of unilateral total salpingectomy on ovarian proliferating cell nuclear antigen and follicular reserve: experimental study.

OBJECTIVE: We aimed to investigate the effects of unilateral total salpingectomy procedure on ovarian follicular reserve, apoptosis, and proliferating cell nuclear antigen (PCNA) staining in this study. STUDY DESIGN: Fourteen female Wistar Albino rats of 12 weeks were randomly divided into two groups. Abdomen midline incision was conducted under general anesthesia. Group 1(G1) (n=7): Group in which only the abdomen was opened and closed, Group 2(G2) (n=7): Group that underwent right total salpingectomy. After 1 month, abdomens of all rats were opened. Ovaries were macroscopically evaluated. Right ovarian tissue was quickly removed, fixed in 10% formaldehyde, and paraffin blocks were prepared.' The existence of fibrosis was identified with the usage of light microscope. Follicles were microscopically classified and counted. The prevalence of cytoplasmic immune staining and TUNEL staining was scored semi-quantitatively. STATISTICAL ANALYSIS: SPSS 17.0 software was used for the statistical analysis of data. First, Kruskal-Wallis variance analysis was conducted, and then Mann-Whitney U test was utilized for inter-group dual comparisons for parameters found as p<0.05. RESULTS: While the number of CL was found out dramatically high, secondary follicle count was found out to be significantly low in G2. Also in G2, although the number of atretic follicle and fibrosis were found out significantly increased, and the score of the angiogenesis was found to be significantly decreased in CL. When compared PCNA immunoreactivity in granulosa cells with the control group, there was a significant decrease in G2. When compared the malondialdehyde (MDA) immunoreactivity with G1 a significant increase was established in G2. Apoptosis score of ovarian follicles in granulosa cells was significantly higher in G2. CONCLUSIONS: In this experimental study, the decrease in the ovarian reserve and PCNA staning of granulosa cells, an increase in apoptosis, fibrosis and the number of atretic follicles in unilateral total salpingectomy operation were analyzed in rats. We found out significantly higher MDA staining rates in G2 in comparison to in G1. According to the study, the unilateral total salpingectomy procedure can damage to the same side ovarian tissue by means of the ischemia and reperfusion injury at the ovarian tissue.

Evaluation of vitamin C and vitamin E for prevention of postoperative adhesion: a rat uterine horn model study.

AIM: To investigate the effectiveness of intraperitoneal vitamin C (VC) and vitamin E (VE) in the prevention of postoperative adhesion formation in a rat uterine horn model. METHODS: Twenty-eight Wistar albino rats were divided into four groups in which: control group, the abdomen was opened and closed without any intervention; adhesion group, a 2-cm linear incision was performed on the uterine horn and closed; VC group, VC was administrated i.p., and 15 min later a 2-cm incision was performed on the uterine horn and closed; and VE group, VE was administrated i.p., and 15 min later a 2-cm incision was performed on the uterine horn and closed. Re-laparotomy was performed 15 days later. Right uterine horn adhesions were evaluated according to macromorphological characteristics and tissue sections were further examined for fibrosis, angiogenesis and vascular endothelial growth factor (VEGF), type I collagen and malondialdehyde (MDA) scoring. Kruskal-Wallis anova and Mann-Whitney U-test were utilized for statistical analysis. RESULTS: Adhesion area and also strength were significantly lower in the VC group and the VE group compared with the adhesion group. Fibrosis and angiogenesis scores were observed to be significantly higher in the adhesion group compared with the VC group and the VE group. MDA and VEGF immunoreactivity were also found to be significantly lower in the VC group and the VE group compared with the adhesion group. However, there was no significant difference between the VC group and the VE group with respect to all the above parameters. CONCLUSION: Administration of VC or VE i.p. was observed to be effective in the prevention of postoperative adhesion formation in an experimental model.

Complete tamponade system for management of severe postpartum vaginal haemorrhage due to uterine atony.

A 30-year-old, 39 weeks pregnant, multiparous woman with single fetus, attended our obstetric clinic with complete cervical dilation in intractable mentum anterior presentation. The fetus was delivered by caesarean section with vertical uterine incision under general anaesthesia and lithotomy position. After surgery, examination of the vagina revealed multiple, serious tears with severe haemorrhage. Vaginal bleeding could not be controlled by sutures and concurrently uterine atony developed, which could not be controlled with medical treatment. Owing to intractable bleeding from uterus and vagina, a complete tamponade system was used. After the instillation of the uterine balloon with 500 mL and vaginal balloon with 300 mL liquid, the bleeding was controlled. The estimated blood loss was 3200 mL. The vaginal wound healed well during the postoperative 2 weeks. A complete tamponade system may be an effective treatment method for treatment of postpartum haemorrhage owing to vaginal lacerations and uterine atony.

Expression changes of antioxidant, apoptotic, anti-apoptotic genes and miR-15b-34a-21-98 in over tissue by using erythromycin, quinacrine and tetracycline in non-surgical sterilization.

In the present study, effects on expression of antioxidant, apoptotic and anti-apoptotic genes (GSR, GRX3, SOD1, RAI-NOS, HSP7, BAX, Bcl-2, CASP3 and MDH1) of substances being used in non-surgical sterilization such as quinacrine, erythromycin and tetracycline were evaluated in over tissue. Moreover, expression of some specific mi-RNA (miR-15b, miR-21, miR34a and miR-98) that playing a role in apoptosis was determined in same tissue. Prospective comparative experimental study. Genetics and Histology laboratory. Total number of 28 Wistar albino 12-14 week old female rats with regular cycles and 200-220 grams in weight. Total RNA was isolated from tissues by using a RNA isolation kit. Gene expression levels were evaluated by Real-Time PCR method. Tubal passage and fibrosis induction in tissues was observed in the histochemical analysis. In the statistical analysis of data Kruskal-Wallis variance analysis and Mann-Whitney U test were used and p < 0.05 were accepted as significant. While the expressions of target genes found to be increased in quinacrine and erythromycin group when compared to control group, this increase was insignificant. In quinacrine group, increase in the SOD1 expression levels was only statistically significant (p < 0.05). Expression levels of miR-15b, miR-21, miR34a and miR-98 microRNAs were found to be up-regulated in all experimental groups, despite this, only the increased expression miR-34 was found as statistically significant when compared to control. Tubal blockage and fibrosis induction scores of quinacrine, erythromycin and tetracycline were significantly higher than control. Results of the present study suggest that the doses treated of quinacrine, erythromycin and tetracycline used in non-surgical sterilization effect poorly the expression of anti-oxidant, apoptotic and anti-apoptotic genes, but the expression of miR-34 playing the role in apoptosis increased after treatment of these substances.

Impact of intracystic ethanol instillation on ovarian cyst diameter and adjacent ovarian tissue.

OBJECTIVE: To investigate the regression level of simple ovarian cyst size after local ethanol application and the damage level of adjacent ovarian reserve in rats. STUDY DESIGN: This study was conducted at Firat University Animal Laboratory with 18 mature (12-14 weeks old) female Wistar albino rats weighing 200-220g, with regular cycles. Ovarian cyst induction was performed with unilateral salpingectomy. Fourteen rats with ovarian cysts after a second laparotomy were divided into two groups as follows: Group 1 (n=7): cyst aspiration group, and Group 2 (n=7): intracystic 95% ethanol application group. One month after the cyst aspiration procedure a third laparotomy was performed. The cyst number and size were recorded for each rat. Right ovariectomy was performed and formalin-fixed/paraffin-embedded tissues were sectioned at 5µm thickness. Under light microscopy, ovarian total follicle reserve and fibrosis were evaluated with Masson trichrome staining and apoptosis was evaluated with TUNEL staining. The groups were compared with the Mann-Whitney U test and Wilcoxon Rank test. p<0.05 was considered significant. RESULTS: Ovarian cyst formation was observed in 85% (15/18) of rats. The mean diameter of ovarian cysts in Groups 1 and 2 were, respectively, 10.3mm and 10.1mm. After aspiration, there was no significant reduction in the cyst diameter (10.3mm vs 8.1mm), but after ethanol application the diameter significantly reduced (10.1mm vs 3.4mm, p<0.05). Mean ovarian follicle count in Group 2 was significantly lower than in Group 1 (25 vs 42, p<0.05), and mean fibrosis and apoptosis scores in Group 2 were significantly higher than in Group 1 (2.5 vs 0.9, p<0.05). CONCLUSION: Local ethanol application reduces cyst diameter but concomitantly decreases ovarian reserve due to increased fibrosis in rats. In humans, intracystic ethanol application should be performed cautiously.

Lower extremity venous Doppler evaluation in patients undergoing laparoscopic gynecological operations.

BACKGROUND: Laparoscopy is established as a standard of care in a variety of gynecological pathologies. Pneumoperitoneum and reverse Trendelenburg positioning during laparoscopy have been claimed to increase thrombosis risk, albeit these proposals are still controversial. The aim of this study was to assess lower extremity venous blood flow by Doppler sonography in patients undergoing laparoscopic gynecological surgeries. PATIENTS AND METHODS: A prospective, nonrandomized, controlled study was designed to compare lower extremity venous Doppler measurements in patients undergoing diagnostic and operative gynecological laparoscopies. In the period from May 2010 to April 2011, in total, 96 patients operated on for various gynecological complaints excluding malignancy were enrolled in the study. Thirty-two of these patients underwent diagnostic laparoscopy, 34 underwent operative laparoscopy, and 30 underwent open surgery. Lower extremity venous blood flow was investigated by Doppler sonography in patients the day before surgery and 24 hours afterward. Preoperative and postoperative Doppler measurements were obtained from bilateral common and superficial femoral, bilateral great saphenous, and bilateral popliteal veins. RESULTS: Lower extremity venous Doppler measurements were similar in diagnostic and operative laparoscopy groups. Femoral venous blood flow measurements were observed to be similar, but great saphenous and popliteal blood flows were found to be significantly decreased in the open surgery group compared with laparoscopic operations. CONCLUSIONS: The laparoscopic approach in gynecological surgery is not associated with an adverse effect on lower extremity blood flow and seems not to bring an additional risk of thrombosis.