Assessing the impact of migraine on benign paroxysmal positional vertigo symptoms and recovery.

BACKGROUND: During episodes of benign paroxysmal positional vertigo (BPPV), individuals with migraine, compared with individuals without migraine, may experience more severe vestibular symptoms because of their hyperexcitable brain structures, more adverse effects on quality of life, and worse recovery processes from BPPV. METHODS: All patients with BPPV were assigned to the migraine group (MG, n = 64) and without migraine group (BPPV w/o MG, n = 64) and completed the Vertigo Symptom Scale (VSS), Vertigo Dizziness Imbalance Symptom Scale (VDI-SS), VDI Health-Related Quality of Life Scale (VDI-HRQoLS), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) at the time of BPPV diagnosis (baseline) and on the one-month follow-up. Headache Impact Test-6 and Migraine Disability Assessment Scale were used for an assessment of headache. Motion sickness was evaluated based on the statement of each patient as present or absent. RESULTS: Compared with the BPPV w/o MG, the MG had higher VSS scores at baseline [19.5 (10.7) vs. 11.3 (8.5); p < 0.001] and on one-month follow-up [10.9 (9.3) vs. 2.2 (2.7), p < 0.001]; experienced more severe dizziness and imbalance symptoms based on the VDI-SS at baseline (61.9% vs. 77.3%; p < 0.001) and after one month (78.9% vs. 93.7%, p < 0.001); and more significantly impaired quality of life according to the VDI-HRQoLS at baseline (77.4% vs. 91.8%, p < 0.001) and after one month (86.3% vs. 97.6%, p < 0.001). On the one-month follow-up, the subgroups of patients with moderate and severe scores of the BAI were higher in the MG (39.2%, n = 24) than in the BPPV w/o MG (21.8%, n = 14) and the number of patients who had normal scores of the BDI was lower in the MG than in the BPPV w/o MG (67.1% vs. 87.5%, p = 0.038). CONCLUSION: Clinicians are advised to inquire about migraine when evaluating patients with BPPV because it may lead to more intricate and severe clinical presentation. Further studies will be elaborated the genuine nature of the causal relationship between migraine and BPPV.

Subclinical hypothyroidism: Is it important in intracytoplasmic sperm injection cycles?

OBJECTIVE: To compare intracytoplasmic sperm injection (ICSI) outcomes of women with subclinical hypothyroidism with those of euthyroid women. MATERIALS AND METHODS: A retrospective case-control study was conducted. Out of 2529 ICSI cycles evaluated, 41 women with hypothyroidism, 28 women with hyperthyroidism, and 128 women with subclinical hyperthyroidism were excluded, and 2336 cycles were analyzed. Women were identified as having subclinical hypothyroidism (case group, n=105) in the presence of a thyroid-stimulating hormone level >4.5 mU/L and normal free T4 and compared with euthyroid controls (n=2231). RESULTS: The mean age, body mass index, day 3 follicle-stimulating hormone level, and antral follicle count of the study patients were similar to the control group (p>0.5). The cycle cancellation rate of the study group was similar to the control group (13.3% vs. 7.6%, p=0.1). The clinical pregnancy rate was 21.2% in the study group, which was significantly lower than the 35.8% in the control group (p=0.04). The take-home baby rate was also significantly lower in the study group compared with the control groups (13.5% vs. 31.4% respectively, p=0.01). CONCLUSION: Both the clinical pregnancy rate and the take-home baby rate is lower in women with subclinical hypothyroidism at the time of ICSI cycle.

High-Throughput Platform for Synthesis of Melamine-Formaldehyde Microcapsules.

The synthesis of microcapsules via in situ polymerization is a labor-intensive and time-consuming process, where many composition and process factors affect the microcapsule formation and its morphology. Herein, we report a novel combinatorial technique for the preparation of melamine-formaldehyde microcapsules, using a custom-made and automated high-throughput platform (HTP). After performing validation experiments for ensuring the accuracy and reproducibility of the novel platform, a design of experiment study was performed. The influence of different encapsulation parameters was investigated, such as the effect of the surfactant, surfactant type, surfactant concentration and core/shell ratio. As a result, this HTP-platform is suitable to be used for the synthesis of different types of microcapsules in an automated and controlled way, allowing the screening of different reaction parameters in a shorter time compared to the manual synthetic techniques.

Melamine-Formaldehyde Microcapsules: Micro- and Nanostructural Characterization with Electron Microscopy.

A systematic study has been carried out to compare the surface morphology, shell thickness, mechanical properties, and binding behavior of melamine-formaldehyde microcapsules of 5-30 µm diameter size with various amounts of core content by using scanning and transmission electron microscopy including electron tomography, in situ nanomechanical tensile testing, and electron energy-loss spectroscopy. It is found that porosities are present on the outside surface of the capsule shell, but not on the inner surface of the shell. Nanomechanical tensile tests on the capsule shells reveal that Young's modulus of the shell material is higher than that of bulk melamine-formaldehyde and that the shells exhibit a larger fracture strain compared with the bulk. Core-loss elemental analysis of microcapsules embedded in epoxy indicates that during the curing process, the microcapsule-matrix interface remains uniform and the epoxy matrix penetrates into the surface micro-porosities of the capsule shells.

Pregnancy outcomes after cold knife conization related to excised cone dimensions. A retrospective cohort study.

OBJECTIVE: To analyze the perinatal outcome of pregnancies following cold knife conization and investigate its relationship, if any, with the amount of tissue removed, and to assess risk factors of perinatal complications. STUDY DESIGN: A retrospective cohort study was designed to compare perinatal outcomes between a group of patients who had prior conization operation (study group) and a group of patients who did not have a conization operation (control group). RESULTS: The preterm delivery rate and preterm premature rupture of membranes (PPROM) rate were significantly higher in the study group as compared with the control group. The mean cone volume was significantly higher in the group of patients who delivered at <37 weeks as compared with the group of patients who delivered at >37 weeks. For the patients who were diagnosed with PPROM, the mean excised volume and height were higher than those of the group of patients who were not diagnosed with PPROM. In cases with preterm delivery the cutoff value of excised cervix tissue volume was measured as 2.27 cm3, and in cases with PPROM the cutoff value of excised cervix tissue volume was measured as 3.99 cm3. CONCLUSION: The perinatal complication frequency was higher for the group of patients who had undergone conization procedure. We found that the volume of excised cervix tissue is more important than the height of the excised cervix tissue in regards to the assessment of perinatal complications. Colposcopy and conization procedure must be performed by the same, experienced specialist. During the procedure unnecessary tissue excision must be avoided.

Fertility sparing surgery on placenta invasion anomalies and placenta previa.

BACKGROUND: Abnormal placental invasion has increased parallel with persistent rise in Caesarean delivery. Management relies on accurate diagnosis and delivery should be planned at an institution with appropriate expertise and resources for managing this condition. CASE: We present a case of a placenta invasion anomaly which is the major risk factors of peripartum deaths. In this case we try to explain our approach which reduces unnecessary hysterectomy rates. CONCLUSION: In order to avoid postpartum hemorrhage and hysterectomy protocols, our approach which consists bilateral hypogastric arterial ligation, Bakri balloon tamponade and if necessary methotrexate therapy can be applied succesfully.

Development of bladder stone after tension free vaginal tape procedure: a case report.

We present a case of a bladder stone which formed on the intravesical portion of tension free vaginal tape material secondary to bladder perforation. 8 years previously, a tension free vaginal tape (TVT) operation was performed. The patient was referred to hospital with persistent urinary infection and urinary incontinence. An intravesical stone that had formed on the TVT sling material was detected by cystoscopy and it was removed with the sling material by a supra pubic cystostomy approach. When evaulating patients presenting with urinary symptoms after a TVT procedure, bladder complications should be kept in mind.