The effect of phototherapy treatment on serum melatonin levels in term newborns.

Background/aim: The aim of this study was to investigate the effect of phototherapy treatment on serum melatonin levels in term newborn infants. Material and methods: This study was planned as a single-center, prospective, observational, case-control study. Term infants (gestation week ≥37 weeks) who received at least 6 h of phototherapy due to jaundice constitute the phototherapy group, while the term infants without jaundice and who were exclusively breastfed constitute the control group. Melatonin levels were examined by taking blood samples from babies in both groups at 02:00 at night. Melatonin values were compared between groups. The effect of phototherapy on serum melatonin levels was investigated. The relationship between the duration of phototherapy and maximum serum bilirubin values on melatonin values was investigated. Results: Seventy term infants (64.3% girls) were included in the study. Mean gestational week was 38.3 ± 1.1 weeks, mean birth weight was 3295 ± 434 g. There was no statistically significant difference between the phototherapy group and the control group in terms of sex, type of delivery, gestational week, birth weight, height, and head circumference (all p > 0.05). Serum melatonin level was 20.3 ± 5.9 pg/mL (range: 8.7-36.6 pg/mL) in the phototherapy group and 19.9 ± 4.38 pg/mL (range: 9.9-26.3 pg/mL) in the control group. There was no significant difference between the two groups in terms of serum melatonin levels (p = 0.155). The mean total bilirubin value was 17.65 ± 1.48 mg/dL, and the average duration of phototherapy application was 13.94 ± 7.64 h in the babies in the phototherapy group. No correlation was found between the duration of phototherapy application and serum melatonin levels (p = 0.791). Conclusion: It was determined that there was no significant difference in serum melatonin levels in term newborn babies who received phototherapy for at least 6 h due to jaundice. No correlation was found between the duration of phototherapy application and the serum melatonin level of the maximum bilirubin values.

Evaluation of Etiological Causes and Factors Affect Length of Hospitalization in Neonates Hospitalized with Lower Respiratory Tract Infection.

Objectives: This study aims to determine the risk factors by examining the sociodemographic characteristics of infants hospitalized in the neonatal intensive care unit (NICU) due to lower respiratory tract infection (LRTI), to determine the factors that affect the duration of hospitalization, and to determine the underlying microbial factors and evaluate them in the light of the literature. Methods: This study evaluated the data of newborns hospitalized with LTRI between 01 October 2022 and 31 March 2023. Demographic characteristics of the patients detected viral agents, duration of hospitalization and risk factors were recorded in the study form. Babies divided viral LRTI and non-viral LRTI, and then compared with each other. Additionally, the facts that might affect the duration of hospitalization were investigated. Results: The study included 57 babies. Viral agent was detected in 50.9% of the babies, the most frequently viral agent was respiratory syncytial virus (RSV) (48.2%). Other viral factors, in order of frequency; Adenovirus, SARS-CoV-2, Influenza A and B. There is no demographic difference between the viral agent positive and negative groups. The patients were evaluated according to length of hospitalization, it was seen that the hospital stay was longer in babies who were found to be viral positive and needed oxygen therapy (p=0.02, p=0.03, respectively). The male gender ratio was higher in the group with longer hospital stays, but this difference was not statistically significant. Although the rate of exclusive breastfeeding was higher in the group with a short hospitalization period, this difference was not statistically significant (p>0.05). Conclusion: RSV is currently the most frequently detected viral agent in lower respiratory tract infections in newborns. The hospital stay of babies diagnosed with RSV is longer than those with non-RSV viral agents. So struggling with RSV is important in preventing lower respiratory tract infections in newborns. It is necessary to develop a vaccine or immunoglobulin application against RSV infection not only for preterm babies but also for all newborn babies.

The effects of progesterone on the healing of obstetric anal sphincter damage in female rats.

We aimed to evaluate the effects of postpartum progesterone on obstetric anal sphincter injury (OASI) healing in female rats using an experimental OASI model. Twenty-eight female rats were divided into four groups after birth: sham-30, sham-90, progesterone (P4)-30, and P4-90. Moreover, OASI model was established in all groups. Subsequently, except for the sham groups, medroxyprogesterone acetate (0.15 mg) was intramuscularly injected into the P4 groups. After 30 and 90 days, the rats were euthanized under general anesthesia after recording the data. The anal sphincter region was collected for histopathological examination. Progesterone and thiol/disulfide homeostasis studies were performed on blood samples. No significant differences were observed between the groups regarding the external anal sphincter (EAS), internal anal sphincter (IAS), or connective tissue thickness (p = 0.714, p = 0.135, and p = 0.314, respectively). No statistically significant differences in the total thiol, native thiol, disulfide, and progesterone levels were found between the groups (p = 0.917, p = 0.503, p = 0.361, and p = 0.294, respectively). The endometrial thickness was lower in the P4 groups than in the sham groups (p = 0.031). Postpartum progesterone administration did not affect IAS and EAS or connective tissue thickness or disrupt the thiol-disulfide balance. However, this administration led to endometrial thinning.

Effects of testosterone treatment on anal sphincter damage repair in ovariectomized rats.

BACKGROUND: Fecal incontinence (FI) generally occurs with anal sphincter damage caused by vaginal delivery in women, obvious FI can develop in the postmenopausal stage. This pelvic floor dysfunction has no rational medical therapeutic options. We investigated the effect of testosterone treatment on the anal sphincter structure, serum thiol/disulfide levels, uterine tissue, and body composition in female rats in an experimental menopause-FI model. METHODS: The animal experiments were performed between September and November 2020 at Experimental Animal Application and Research Center, Afyon Kocatepe University, Afyonkarahisar, Turkey. Thirty-two female rats were divided into four groups: sham, saline, 10 mg/kg testosterone undecanoate, 100 mg/kg testosterone undecanoate. Except for the sham group, all the other groups underwent ovariectomy (OVE) to create a menopause model. Two weeks after this procedure, the FI model was created under general anesthesia in all rat groups. At the end of the experiment, the rats were placed under general anesthesia, weighed, and euthanized after recording the data. The anal sphincter region and uterine tissue samples were collected for histopathological examinations, and blood samples were collected for total testosterone and thiol/disulfide homeostasis analyses. RESULTS: An increase in anal sphincter muscles and connective tissue thickness was observed in the testosterone-administered groups (p = 0.001). No difference was detected between the groups in the total thiol, native thiol, and disulfide balance (p = 0.087, p = 0.604, p = 0.092). The testosterone-treated groups did not have severe uterine epithelial degradation, hyperemia, or increased endometrial thickness (p = 0.186, p = 0.222, p = 0.630). The body weight of all rats increased (p < 0.05), but the omental weight did not increase (p = 0.061). DISCUSSION: Testosterone treatment increased the anal sphincter muscle and connective tissue thickness without causing any oxidative stress and did not result in a pathological change in the uterine tissue and body fat composition.

Comparison of postoperative pain after the use of different nickel titanium instrumentation systems: a randomized clinical trial.

Purpose: Postoperative pain is a common complication in endodontics contributed by multiple etiological factors, which consist canal preparation instruments and kinematics. The aim of this randomized clinical trial compare the postoperative pain in terms of intensity and incidence after the use of different nickel titanium (NiTi) file systems. Patients and methods: In this randomized clinical trial (NCT03791762), a total of 150 patients were root canal treated by 2 experienced endodontists according to a standardised protocol. The subjects were randomly assigned to 1 of the 3 groups according to preparation instrument used: ProTaper Next (Dentsply Sirona, Ballaigues, Switzerland), Reciproc Blue (VDW, Munich, Germany) and WaveOne Gold (Dentsply Sirona). Following preparation the teeth underwent standardized root canal treatment procedures in a single visit. The patients were contacted to gather information about the incidence of pain and intensity at 6th, 12th, 18th, 24th, 48th, and 72nd hours postoperatively. The data were analysed using chi-square, one-way analysis of variance and post hoc Tukey tests and logistic regression analysis with 5% significance threshold. Results: No significant difference was found among preparation groups in relation to the intensity of postoperative pain. The incidence of postoperative pain was significantly linked with the preoperative pain presence with odds ratio values ranging between 2.06 and 4.08 irrespective of the preparation technique (P<0.05). Conclusion: The effects of reciprocating and the continuous rotary systems on the intensity and incidence of postoperative pain were found to be similar.

Demographic and lifestyle risk factors of dry eye disease subtypes: A cross-sectional study.

PURPOSE: To evaluate demographic and lifestyle factors associated with aqueous deficient and evaporative dry eye disease. METHODS: A total of 1125 general public visitors (707 females, mean ± SD age, 33 ± 21, range 5-90 years) at the Royal Society Summer Science Exhibition were recruited in a cross-sectional study. A demographic and lifestyle factor questionnaire was administered, and dry eye symptomology (DEQ-5 score), ocular surface characteristics (conjunctival hyperaemia, and infrared meibography), and tear film parameters (tear meniscus height, non-invasive breakup time, and lipid layer grade) were evaluated for the left eye of each participant within a single session. The diagnostic criteria for dry eye disease subtypes were adapted from the rapid non-invasive dry eye assessment algorithm. RESULTS: Overall, 428 (38%) participants fulfilled the diagnostic criteria for dry eye disease, 161 (14%) with aqueous deficient dry eye disease, and 339 (30%) with evaporative dry eye disease. Multivariate logistic regression demonstrated that advancing age, female sex, reduced sleep duration, higher psychological stress, and poorer self-perceived health status were independently associated with aqueous deficient dry eye disease (all p < 0.05). Significant risk factors for evaporative dry eye disease included advancing age, East and South Asian ethnicity, contact lens wear, increased digital device screen exposure, higher psychological stress, and poorer self-perceived health status (all p < 0.05). CONCLUSIONS: Both subtypes of dry eye disease were associated with several unique and shared demographic and lifestyle factors. The findings of this study could inform future research design investigating the utility of targeted screening and risk factor modification for the prevention and management of dry eye disease.

The fracture strength of endocrowns manufactured from different hybrid blocks under axial and lateral forces.

AIM: This in vitro study was conducted to compare the fracture strength of endocrowns manufactured from different hybrid blocks under axial and lateral forces. MATERIAL AND METHODS: Following root-canal treatment, 100 permanent mandibular first molars were randomly distributed among 5 groups according to restoration material. Endocrown restorations were produced from IPS e.max CAD (IPS), Vita Enamic (VE), GC Cerasmart (GC), Shofu (SH), and Brilliant Crios (BC) using CAD/CAM technology. Specimens were cemented, subjected to artificial aging, and further divided into 2 subgroups (n = 10) per group for fracture testing. Each specimen was placed on a universal testing machine and subjected to axial or lateral forces applied at a crosshead speed of 1 mm/min. Fracture data were analyzed using one-way ANOVA, Tukey, Tamhane T2, and Weibull tests. RESULTS: Statistically significant differences in fracture-strength (FS) values under axial and lateral forces were observed among the groups (P < 0.05). Group BC had the highest FS value under axial forces, whereas group IPS had the highest FS value under lateral forces. According to Weibull analysis, VE exhibited the highest reliability under axial forces (7.62), whereas IPS exhibited the highest reliability under lateral forces (4.68). No statistically significant differences were detected in the distribution of failure types under either axial or lateral forces among the groups (P > 0.05). CONCLUSION: All of the hybrid blocks tested showed sufficient fracture strength for use as CAD/CAM-fabricated endocrowns. CLINICAL RELEVANCE: Hybrid blocks can be used as an alternative to lithium disilicate blocks in endocrown restorations.

Hemolytic Anemia Due To Anti-c Incompatibility in The Newborn Period: A Case Report.

Hemolytic disease of the fetus and newborn is a disease that is caused by maternal alloantibodies to the fetus. In the literature, the frequency of hemolytic disease of the newborn due to Rh (D) sensitization decreased inversely with the increase in the use of anti-D gammaglobulin. However, the importance of minor blood group incompatibilities has increased in the etiology. Clinical presentation in patients with minor blood group incompatibility may vary from subclinical hemolysis findings to active hemolysis and hyperbilirubinemia requiring blood exchange. In this case study, we present a patient with hemolytic anemia due to anti-c antibody incompatibility.

Current Overview of Neonatal Convulsions.

Neonatal convulsions are one of the most common emergency neurological events in the early period after birth. The frequency has been reported to be 1.5 to 3 in 1000 live births. It has been established that the convulsion threshold is lower in infants due to immature neonatal neurons and differences in neurotransmitters. Hypoxic ischemic encephalopathy is the most common etiology in neonatal convulsions. Other causes vary, and may be related to the level of development of the country. Convulsions are classified into 4 different types according to the clinical findings. The most common is the subtle (undefined) type of seizure; the other types are defined as clonic, tonic, and myoclonic seizures. Non-epileptic paroxysmal movements frequently seen in the neonatal period, should not be confused with seizures. The most common non-epileptic paroxysmal movements are jitteriness, benign neonatal sleep myoclonus, and hyperekplexia. A newborn that experiences convulsions should be hospitalized and monitored with continuous video electroencephalogram, if possible. If an initial rapid evaluation detects an acute metabolic disorder, treatment is provided, and, if warranted, it will be followed by a plan for further treatment with anticonvulsant drugs. Phenobarbital is still currently recommended as first-line therapy, though there are studies of other anticonvulsant drugs. Levetiracetam and phenytoin are commonly used as second-step anticonvulsant drugs. The aim of treatment should be not only to stop acute symptomatic seizures, but also to reduce the risk of brain damage and to minimize the possible negative effects of epilepsy and neurological deficits.

A Case Report: Neonatal Torsional Ovarian Cyst.

The majority of abdominal masses detected in the neonatal period are benign (85%) and usually originate in the urinary tract (50%), genital system (15%), gastrointestinal system (15%), or the hepatobiliary tract (5%). Ovarian cysts comprise one-third of the masses with a genital origin. Presently described is a case of an ovarian cyst that developed during the antenatal period and transformed into a hemorrhagic cystic mass as a result of torsion. A female infant born at 37 weeks of gestation with the prediagnosis of nephroma was admitted to the neonatal intensive care unit. Abdominal ultrasonography revealed a smooth cystic mass approximately 50x45x35 mm in size in the left upper quadrant that was not associated with the kidney. Magnetic resonance imaging revealed a 55x44x49-mm cystic mass in the left adnexal region containing multiple septations that were not enhanced with contrast material, and the mass was then interpreted as a hemorrhagic fetal ovarian cyst. The left ovary, compromised by 2 full torsions, was removed during a laparoscopy performed on the postnatal seventh day. The infant was subsequently discharged without complications. It should be kept in mind that cystic masses detected in the prenatal period may be of ovarian origin. An appropriate follow-up and treatment should be planned according to the size of the ovarian cyst and the clinical findings.

The evaluation of xenotransplantation of feline ovarian tissue vitrified by needle immersed vitrification technique into male immunodeficient mice.

In this study, the efficiency of the "Needle Immersed Vitrification" technique was tested on cryopreserved feline ovarian tissue. For vitrification, ovarian fragments (0.5-1.5 mm2) from each ovary were collected; the grafts were exposed to 7.5-15% ethylene glycol and 7.5-15% dimethyl sulfoxide at room temperature and stored in liquid nitrogen at least 1 week. Morphologic examinations, expression of genes such as B cell lymphoma 2, B-cell lymphoma-2-associated X protein, Bone morphogenetic protein 15, zone of polarizing activity, zona pellucida C protein and DNA (cytosine-5)-methyltransferase 1, ultrastructural analysis and viability tests were carried out from collected grafts. Light microscopy examinations revealed the percentage of morphologically normal primordial follicles in a fresh group which was significantly higher than the treatment groups (p < 0.001). Terminal deoxynucleotidyl transferase dUTP nick end labeling and anti-caspase-3 staining observed in oocytes, follicle cells, interstitial tissue showed higher rates of apoptosis for post-vitrification and -transplantation groups than freshly grafted ovarian tissues. Furthermore, we observed significant downregulation of zone of polarizing activity and zona pellucida C protein gene expression in vitrified ovarian tissue grafts than in the fresh grafts (p < 0.05). In conclusion, we suggest that the needle immersed vitrification method is a convenient, cheap, and feasible vitrification method for cat ovarian tissues. However, further studies need to be performed to determine more optimal vitrification solutions and equilibration times for the needle immersed vitrification method in order to adapt it for cat ovaries.

Novel liposome-based and in situ gelling artificial tear formulation for dry eye disease treatment.

PURPOSE: Artificial tears are widely used in the treatment of dry eye disease, although current formulations do not closely resemble natural tears. The purpose of this study was the design and characterization of a novel in situ gelling artificial tear formulation, containing both lipid and aqueous components, in order to resemble natural tears and replenish the tear film. METHODS: Liposomes, containing phosphatidylcholine, cholesterol, vitamins A and E, were prepared by the thin-film hydration method. The aqueous phase of the formulation was comprised of gellan gum, hydroxypropyl methylcellulose, levocarnitine, electrolytes (sodium chloride and potassium chloride), trehalose, and borates. The artificial tear was characterized in terms of liposome size, pH, surface tension, and viscosity. In vitro tolerance studies were performed in a human epithelial carcinoma cell line (HeLa) and a murine macrophage cell line (J774). In vivo tolerance was assessed in rabbits. RESULTS: Liposomes presented a unimodal distribution with a mean size of 200.1 ±â€¯4.4 nm. The resulting surface tension was 53.4 ±â€¯1.1 mN/m (at 33 °C) and the pH was 7.6 ±â€¯0.1. The viscosity of the formulation presented a mean value of 4.0 ±â€¯0.1 mPa s within the shear rate interval of 200-1000 s-1 at 33 °C. Cell viability remained higher than 90% in both cell lines. No discomfort or clinical signs were observed in rabbits. CONCLUSIONS: The liposome-based and in situ gelling artificial tear formulation presented good tolerance and suitable properties for topical ophthalmic administration. It may be beneficial in the treatment of dry eye disease.

How should we give vitamin D supplementation? evaluation of the pediatricians' knowledge in Turkey.

BACKGROUND: We aimed to determine the knowledge and attitudes of Turkish pediatricians concerning vitamin D supplement. METHODS: The study was planned cross-sectional to be carried out between April-May 2015 in Turkey. A questionnaire form that determined the participants' opinions and practices concerning vitamin D supplement was completed via face-to-face interview. RESULTS: A total of 107 pediatricians (49.3%) and 110 pediatric residents (50.7%) participated in the study. Of the physicians, 85.2% recommended vitamin D supplement for all infants and children regardless of diet, 13.4% recommended for the infants which are solely breastfed. Vitamin D supplement is recommended at a dose of 400 IU/day by 88.8% of pediatricians and by 90% of pediatric residents. Of the pediatricians and pediatric residents, 72% and 68.2%, respectively commence vitamin D supplement when the newborn is 15 days old. The rates of recommending vitamin D supplement until the age of one and two years were higher among pediatricians (48.6% and 41.1%, respectively) than pediatric residents (40.9% and 32.7%, respectively). The rate of starting vitamin D supplement for fontanelle closure was significantly higher among pediatric residents (15.5%) than pediatricians (3.7%) (p = 0.002). It was determined that the rate of prescribing vitamin D supplement until fontanelle closure was higher among pediatric residents (18.2%) than pediatricians (0.9%). CONCLUSIONS: The present study suggest that the knowledge of pediatricians about recommendation of vitamin D needs to be enhanced by education programs in addition to free vitamin D supplement provided by the Ministry of Health.

Assessment of the place of tubular reabsorption of phosphorus in the diagnosis of osteopenia of prematurity.

AIM: In this study, we aimed to investigate the utility of tubular reabsorption of phosphorus in the diagnosis of osteopenia of prematurity in addition to biochemical markers. MATERIALS AND METHOD: Premature babies with a gestational age of ≤32 weeks and/or a birth weight of ≤1 500 g who were hospitalized in the neonatal intensive care unit between June 2009 and March 2011 were included in the study. These babies were evaluated at the 40th gestational week and serum calcium, phosphorus, alkaline phosphatase, urea, creatinine, urinary calcium and phosphorus levels were measured and tubular reabsorption of phosphorus was determined. The subjects who had bone graphy findings and/or an alkaline phosphatase level of >400IU/L and a phosphorus value of <3.5 mg/dL were considered osteopenic. The levels of tubular reabsorption of phosphorus of the osteopenic patients were compared with the ones of the non-osteopenic patients. The study was initiated after obtaining ethics committee approval (date: 04.29.2009/213). RESULTS: During the study period, a total of 698 premature babies were hospitalized in our neonatology unit. A diagnosis of osteopenia of prematurity was made in 24 of 190 subjects who met the study criteria. The level of tubular reabsorption of phosphorus was compared with the serum calcium, phosphorus and alkaline phosphatase levels measured at the 40th gestational week and alkaline phosphatase was found to be significantly increased in the group with a high tubular reabsorption of phosphorus (≥%95). When the subjects with a phosphorus level of <3.5 mg/dL and an alkaline phosphatase level of >499 IU were compared with the newborns who were found to have a tubular reabsorption of phosphorus of ≥%95 for the objective of evaluating the specificity and sensitivity of tubular reabsorption of phosphorus, the sensitivity, specificity, positive predictive value and negative predictive value of tubular reabsorption of phosphorus in the diagnosis of osteopenia were found to be 27%, 82%, 17% and 89%, respectively. When the osteopenic and non-osteopenic patients were compared in terms of the levels of tubular reabsorption of phosphorus, no statistically significant difference was found. CONCLUSIONS: It was thought that it was not appropriate to use tubular reabsorption of phosphorus alone in the diagnosis of osteopenia of prematurity.

Antibodies to Schmallenberg virus in domestic livestock in Turkey.

This, partly retrospective study, was designed to determine the seroprevalence of Schmallenberg virus (SBV), a new Orthobunyavirus first reported in Germany in late 2011, in domestic ruminants from the Middle Black Sea, West, and Southeast regions of Turkey. An indirect enzyme-linked immunosorbent assay was used to screen serum samples collected from slaughterhouse animals between 2006 and 2013. The overall seroprevalence was 335/1,362 (24.5 %) with 325/816 (39.8 %), 5/307 (1.6 %), 3/109 (2.8 %), and 2/130 (1.5 %) recorded in cattle, sheep, goats, and Anatolian water buffalo, respectively. This is the first study to demonstrate the presence of antibodies to SBV in Turkish ruminants; it indicates that cattle are more susceptible to infection than sheep, goats, or buffalo and that exposure of domestic ruminants to SBV in Turkey may have occurred up to 5 years prior to the first recorded outbreak of the disease in 2011.

Effect of the stage of estrous cycle on follicular population, oocyte yield and quality, and biochemical composition of serum and follicular fluid in Anatolian water buffalo.

This study was designed to investigate the effects that the different stages of the estrous cycle had on the number of surface ovarian follicles and oocyte yield and quality of Anatolian water buffalo during peak breeding season. Assessments were made on the basis of ovarian morphology, serum and follicular fluid concentrations of variety of biochemical parameters. Following slaughter, blood samples were collected from each animal. The stage of estrous cycle was classified as either the luteal or follicular phase, and surface ovarian follicles were classified as small, medium, or large. The follicular fluid was aspirated, and oocytes were evaluated microscopically for classification into four categories. No statistical differences (p>0.05) were observed regarding the total number of follicles or quality of oocytes relative to the stage of the estrous cycle. Serum high-density lipoprotein cholesterol (HDL), alkaline phosphatase (ALP) and progesterone (P4) concentrations were significantly higher in the luteal phase than in the follicular phase (P<0.05). Significant correlations were observed in the luteal phase between the total number of oocytes and cholesterol (Cho), HDL, sodium (Na), chloride (Cl); A-quality oocytes and Na, Cl, Mg; C-quality oocytes and Cho, HDL, and Mg in follicular fluid. These results offer new information concerning Anatolian water buffalo reproductive physiology, which may be useful for improving oocyte quality in buffalo. This is the first study to describe the number of ovarian follicles, oocyte yield and quality, and a variety of biochemical parameters in the serum and follicular fluid of Anatolian water buffalo during peak breeding season in Turkey.

Ovarian remnant syndrome and uterine stump pyometra in three queens.

Ovarian remnant syndrome (ORS) is the presence of functional ovarian tissue with signs of oestrus as a complication after ovariohysterectomy (OHE) or ovariectomy. Stump pyometra is another complication that can be observed after OHE. However, there are few reports about ORS and stump pyometra in queens. In this report, three queens with recurrent oestrous behaviours after OHE are described. In two queens, ORS with stump pyometra was diagnosed and in one queen ORS alone was diagnosed by physical examination, medical history, vaginal cytology and ultrasonography. Remnant ovarian and uterine tissues were removed by laparotomy. Two queens recovered without any complications; however, one queen died 2 days after surgery. This study reveals that ORS and stump pyometra can result in severe disease and can be fatal.