Relation between mothers' types of labor, birth interventions, birth experiences and postpartum depression: A multicentre follow-up study.

AIM: This definitive and cross-sectional study was conducted to determine the relation between mothers' types of labor, birth interventions, birth experiences and postpartum depression. METHODS: A total of 1010 mothers who gave birth in four different provinces of Turkey were chosen to participate in the study via purposive sampling method Results: The Edinburgh Postpartum Depression Scale score was determined to be 13 and over in 36.4% of the women. In this study, it was determined that the Edinburgh Postpartum Depression Scale scores for women in the 18-24 age group who had a vaginal birth, did not have health insurance, experienced health problems during pregnancy and were not trained about type of labor during pregnancy were statistically higher. There was no significant correlation between the birth experiences and postpartum depression. The linear regression model showed that there was a statistically significant correlation between enema and amniotomy interventions practised during the birth and the Edinburgh Postpartum Depression Scale scores. CONCLUSION: In conclusion, it is thought that preparing the mothers for birth with birth preparation training in the antenatal period and imposing the necessary regulations in the delivery room for the mothers to have a positive birth experience are important in reducing postpartum depression risk.

The relationship between fatigue and breastfeeding self-efficacy.

BACKGROUND: Postpartum fatigue appears in the early weeks and after childbirth has a clear impact on maternal functioning and breastfeeding. AIM: This study aimed to examine the relationship between fatigue and breastfeeding self-efficacy. MATERIALS AND METHODS: This descriptive study was conducted at three family health centers (FHCs) in Izmir, Turkey, between June 2013 and March 2014. We used the Self-Description Form for Mothers, the Breastfeeding Self-Efficacy Scale Short Form (BSES-SF), and the Brief Fatigue Inventory (BFI) to collect data from 184 breastfeeding women during the postpartum period. RESULTS: At week 1 postpartum, 98.9% of the mothers in this study experienced fatigue; of those, 12.6% had minor fatigue, 48.3% had moderate fatigue, 36.8% had excessive fatigue, and 0.7% had the highest level of fatigue. At week 8 postpartum, 46.7% of the mothers experienced fatigue, 50.0% of whom experienced fatigue on a minor level, 16.2% on a moderate level, and 2.5% on an excessive level. The present study found that 55.4% and 1.1% of the mothers had BSES-SF mean scores below 50 at weeks 1 and 8 postpartum, respectively. The mean BSES-SF score was 51.21 ± 6.95 (min-max = 19.00-70.00) at week 1 postpartum, which increased to 64.54 ± 9.65 (min-max = 15.00-70.00) at week 8 postpartum. The statistical results indicated that there were no significant relationships between the BSES-SF and the BFI at week 1 postpartum (r = 0.007, P > 0.05) and week 8 postpartum (r = 0.111, P > 0.05). CONCLUSION: In this study, the mothers' fatigue during the postpartum period was not associated with breastfeeding self-efficacy. Many of the variables identified may be considered modifiable and amenable to interventions. Targeted interventions should be directed toward improved breastfeeding outcomes among Turkish women.

A morphological study of uterine alterations in mice due to exposure to cadmium.

We investigated the morphologic and molecular effects of exposure to cadmium (Cd) for 30 and 60 days on the uteri of mice. We assessed uterine morphometric measurements, eosinophilia, mast cell numbers, endometrial apoptosis, proliferation and estrogen receptor alpha (ERα) immunoreactivity. We examined vaginal smears that reflected the hormonal alterations in the female reproductive tract. Because the female reproductive tract exhibits different morphology at each stage of the estrous cycle, we sacrificed all animals at estrus to make appropriate comparisons. Female BALB/c mice were exposed to 200 ppm Cd in their drinking water for either 30 or 60 days. Cd exposure caused significant decreases in endometrial thickness and number of glands in estrus phase uteri. The endometrial eosinophilia in the groups exposed to Cd also decreased compared to controls. Cd exposure increased the number of mast cells. Luminal and glandular epithelia were examined using the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay and by immunostaining proliferating cell nuclear antigen (PCNA) and estrogen receptor α (ERα). Compared to controls, the apoptotic index increased with time in both Cd exposed groups, while the proliferation index decreased. ERα immunoreactivity was decreased in both Cd exposed groups compared to controls; the decrease was most apparent in the 30 day Cd group. We found that 60 day Cd exposure increased apoptosis in the endometrium, which may affect the receptivity of the uterus for implantation.

Violence experienced by nurses at six university hospitals in Turkey.

This research was conducted to analyse the violence experienced by nurses employed at six university hospitals. A descriptive and cross-sectional study was conducted. The research sample consisted of 441 nurses who worked in the emergency, intensive care and psychiatry units of six university hospitals in Turkey between June 2008 and June 2009 and who voluntarily agreed to participate. It was found that 60.8% of the nurses were subjected to verbal violence and/or physical violence from patients, visitors or health staff. Of the nurses who were subjected to workplace violence, 42.9% stated that their experience of verbal and/or physical violence had a negative impact on their physical and/or psychological health, and 42.9% stated that their work performance was negatively affected. Of these nurses, 1.8% stated that they received professional help, 13.6% stated that a report was made and 9.5% stated that they contacted the hospital police in some way. According to the findings of this research, similar to the situation worldwide, nurses in Turkey are subjected to verbal and/or physical violence from patients, visitors and health staff.

Morbidity following dental treatment of children under intubation general anaesthesia in a day-stay unit.

OBJECTIVES: To determine which variables were best related to the overall morbidity of a child undergoing dental general anaesthetic (GA) and then to use these variables to determine those factors that might influence the extent and severity of morbidity experienced by healthy children following dental GA. SAMPLE AND METHODS: Data were collected on anxiety, pain and morbidity, GA procedure and dental procedure from 121 children attending a day stay GA unit for dental treatment. Patients were interviewed preoperatively, postoperatively before discharge then four further times over the next 148 h. Data were analysed using multivariate regression. RESULTS: Thirty-one per cent of subjects had restorative work, 60% had at least one tooth extracted, 54% had a surgical procedure. Use of local analgesia reduced postoperative pain whilst an increase in the number of surgical procedures increased it. Increase in anaesthetic time was related to increased odds of feeling sleepy and nauseous, females were more likely to complain of sleepiness or weakness. Feelings of dizziness were increased if the patient was given local analgesia during the procedure. CONCLUSIONS: Pain following dental GA was the most prevalent and long lasting symptom of postoperative morbidity in this study. Reductions in operating time and improvement in pain control have the potential to reduce reported morbidity following dental GA.

The value of computed tomography in the diagnosis of acute necrotising pancreatitis in a renal transplant patient.

BACKGROUND: The incidence of acute pancreatitis after renal transplantation ranges around 1%, and the mortality rate is nearly 65%. Dynamic computed tomography (CT) scan and amylase levels are valuable in the diagnosis of this rare complication. CASE OUTLINE: A 29-year-old man was hospitalised with cytomegalovirus (CMV) pancreatitis after renal transplantation. An initial CT scan showed an enlarged pancreas with hypodense, heterogeneous consistency and with peripancreatic, perihepatic, mesenteric and pelvic fluid collections. After initial conservative management, follow-up CT revealed pancreatic necrosis and abscess formation. The patient underwent necrosectomy and repeated drainage of abscess facilitated by a Bogota bag, but he died 60 days after admission and five surgical procedures. DISCUSSION: CMV pancreatitis after renal transplantation is rare and frequently fatal. In the presence of an acute abdomen after renal transplantation, the diagnosis of pancreatitis should be considered. Dynamic CT scan and measurement of amylase levels are recommended.