Exercise training improves body composition, blood lipid profile and serum insulin levels in obese children.

AIM: Increasing prevalence of obesity and related diseases especially in children and adolescent has gained more scientific attention. The present study was conducted to determine the effects of regular exercise on childhood obesity often associated with clinical conditions such as hypertension, dyslipidemia and diabetes already at a young age. METHODS: The subjects were 40 obese children at 11 ± 1 years and with Body Mass Index (BMI) of at least 30 kg/m2 who volunteered to the study and randomly classified into exercising and non-exercising control group. Physical load of the exercising group was first determined by the Karvonen protocol after which to the subjects underwent a 12-week aerobic exercise training program primary consisting of walking and jogging exercise. Blood pressure, biochemical cardiovascular risk factors and body composition were assessed before and after the exercise-training period and compared to the non-exercising control group. RESULTS: In the exercising group, statistically significant changes were observed in the circumference of forearm, elbow, calf, knee, waist, chest and hip, as well as skin fold thickness of chest, subscapulae, calf, abdomen, suprailiac and leg. Similarly, total cholesterol, triglyceride, LDL, VLDL and insulin levels were found to be lower and HDL levels higher than in the non-exercising control group. CONCLUSION: While treating obesity in children, a major emphasis should be directed towards increasing regular physical activity and supported with dietary interventions. By this approach the risk of other chronic diseases often associated with obesity could be minimized thereby improving the quality of life.

Risperidone-associated transient diabetic ketoacidosis and diabetes mellitus type 1 in a patient treated with valproate and lithium.

UNLABELLED: A 37-year-old man treated with valproate and lithium for bipolar affective disorder since 1999 and with risperidone since March 2003 was admitted to our clinic due to metabolic acidosis. Serum glucose was 647 mg/dL and urine ketones were positive. The patient was accepted as diabetic ketoacidosis (DKA). Risperidone, valproate, and lithium were immediately stopped, and the patient was treated with insulin and i.v. fluid replacement. Serum insulin and C-peptide levels were too low, and islet cell antibody and anti-GAD antibody were positive. We accepted him as type 1 diabetes mellitus (DM type 1). After the intensive treatment of diabetes, insulin requirements decreased gradually and diabetes mellitus disappeared completely within three months. CONCLUSION: Risperidone may lead to transient DM type 1 and DKA.

Transurethral resection of the prostate and laser prostatectomy under local anesthesia.

OBJECTIVE: To perform transurethal resection of the prostate (TURP) and transurethral laser ablation prostatectomy (TULAP) under appropriate local anesthesia. PATIENTS AND METHODS: A total of 54 patients were examined in this study. We carried out TURP in 42 and TULAP in 12 of them under local anesthesia with lignocaine chloride. Patient's discomfort was recorded by means of a four-point descriptive pain scale. RESULTS: We had perfect pain control in the majority of the patients. Patient's acceptance was very high. No patient required conversion to general anesthesia. Complications due to local anesthesia were not observed. CONCLUSION: We believe that ours is a simple, safe and effective procedure.

Chlamydial infections and male infertility.

Chlamydial infections may be difficult to diagnose due to the silent symptoms and difficulty in culturing. An infectious process may impair fertility by adversely affecting sperm functions, resulting in testicular damage or causing obstruction of the genital tract. In our study, we tried to find Chlamydial antigen by using EIA (Enzyme Immune Assay) and to compare the Ag(+) and Ag(-) groups according to semen parameters. Except for semen volume, we found significant differences in density, morphology, motility and viability (intervolume p > 0.05, interdensity p < 0.01, intermorphology p < 0.001, intermotility p < 0.001 and interviability p < 0.001).

The effects of sodium hypochlorite and calcium hydroxide on tissue dissolution and root canal cleanliness.

In this in vitro study, we investigated the efficacy of sodium hypochlorite (NaOCl) and calcium hydroxide (Ca(OH)2) in dissolving necrotic tissue and cleaning root canals. In the first part of the study, 0.5% NaOCl solution and Ca(OH)2 paste and solution were tested with samples of necrotic bovine muscle in different treatment modes and for different periods. The necrotic tissue was weighed before and after the test and the percentage of weight change calculated. In the second part of the study, 40 extracted single-rooted human teeth were hand instrumented and then subjected to different irrigation regimens. The cleansing efficacy in root canals of 0.5% NaOCl with Ca(OH)2 pretreatments and ultrasonics was examined using scanning electron microscopy. A solution of 5% NaOCl was significantly more effective than 0.5% NaOCl as a solvent of necrotic tissue. Calcium hydroxide was an effective solvent for necrotic tissue as a paste but not as a solution. Pretreatment of necrotic tissue with Ca(OH)2 increased its solubility in 0.5% NaOCl. While 5% NaOCl plus ultrasonic irrigation produced cleaner root-canal walls at the middle and apical thirds, 0.5% NaOCl used with the same technique achieved no root-canal cleaning. However, pretreatment of root canals with Ca(OH)2 paste increased the effectiveness of 0.5% NaOCl plus ultrasonic irrigation, except in the coronal third of the root canal.

Renocolic fistula secondary to chronic pyelonephritis.

Renocolic fistula is very rare. Only slightly over 100 cases have been reported in the world literature. We present a case of renocolic fistula secondary to chronic pyelonephritis discovered intraoperatively and discuss its diagnosis and management in the light of published data.

[Comparison of symptoms and clinical and laboratory findings in the first and last weeks of typhoid fever]. / Tifonun ilk ve son haftalarinda semptom, klinik ve laboratuvar bulgularinin karsilastirilmasi.

In this study we examined the clinical and laboratory findings of 80 in-patients. There is an important difference between sexes (p greater than 0.05). Comparison of ages showed that 7-30 age is more vulnerable than the older group. We found clinical symptoms of fever, chills, headache, abdominal pain, disturbances in bowel function, nausea, vomiting, anorexia, and lassitude in the first two weeks more frequently when compared with the 3rd, 4th, 5th weeks of illness (p less than 0.001). Where physical finding of rose spots, discordant pulse rate are important in the first two weeks (p less than 0.001). Abdominal discomfort is an important symptom both in the first two and in the last three weeks (% 40.3 and % 36 respectively). Hepatomegaly and splenomegaly, were found more frequently in the last three weeks. According to laboratory findings of anemia, leukopenia, increased erythrocyte sedimentation rate and positive blood and feces cultures there is no important difference between the first two and last three weeks (p greater than 0.05). Increase in polynuclear leucocytes is important for the first two weeks, and increase in lymphocytes is important in the last three weeks (p less than 0.001). Positivity of group agglutination tests is 57%, in the first two weeks and 83% in the last three weeks. This difference is found to be important.

The penetration of smear material into dentinal tubules during instrumentation with surface-active reagents: a scanning electron microscopic study.

Thirty freshly extracted, single-rooted anterior teeth were used. They were divided into three groups and instrumented conventionally with #10 to 50 K files. During instrumentation, the K files in the first group were moistened with saline solution, in the second group with 50% sodium dodecylbenzenesulfonate solution, and in the third group with Sulfapon (sodium salt of sulfonated condensation product of ethylen oxide with a fatty acid) solution. After the experimental procedure the specimens were examined in a scanning electron microscope to observe packing of smear material into dentinal tubules. Results showed the surface-active reagents cause the deeper penetration of the smear material into the dentinal tubules. These findings support the hypothesis that the phenomenon of the packing of smear material into the dentinal tubules is by capillary action and fluid dynamics.

Subclinical amnionitis in patients with intact membranes in preterm labour.

Preterm delivery is the major obstetric and paediatric problem, being responsible for much perinatal morbidity and mortality. Subclinical amnionitis may cause preterm labour and delivery. The rate of subclinical bacterial infection of amniotic fluid was studied in 25 afebrile pregnant women with intact membranes in preterm labour. Specimens of amniotic fluid were collected by transabdominal amniocentesis. Serum and amniotic fluid lactic dehydrogenase (LDH) levels were assessed to determine their usefulness in making the diagnosis of subclinical amnionitis. Aerobic bacteria were isolated from 48% (12/25) of the specimens. Thus, subclinical amnionitis may play a substantial role in patients with intact membranes in preterm labour. However, transabdominal amniocentesis is not routinely indicated in similar asymptomatic patients because microbiological and especially LDH studies require further evaluation.