Depression, anxiety, body image scores, and sexual dysfunction in patients with polycystic ovary syndrome according to phenotypes.

Background: Polycystic ovary syndrome (PCOS) has been linked to both mental and metabolic disturbances. The purpose of this research was to investigate psychological features such as anxiety and depression, body image, sexual dysfunction, and associated factors among the PCOS phenotypes and to compare these with healthy controls. Methods: The study involved 167 reproductive-age women with PCOS and 73 healthy controls. Standardized scales assessing depression (the Beck Depression Inventory [BDI]), depression and anxiety (the Hospital Anxiety and Depression Scale [HADS] and the General Health Questionnaire [GHQ]), and body image scale (the Body Cathexis Scale [BCS]) were administered to all participants. Hirsutism scores, serum androgen levels, and metabolic parameters were recorded. Results: Significantly higher BDI, HADS depression, and GHQ scores, and a more negative body image in terms of BCS scores were observed in the women with PCOS than in the healthy controls. BDI scores were significantly higher in phenotypes A, B, and D compared with the healthy controls. No significant difference was observed in BDI and HADS depression scores among the phenotypes. Significant differences were observed only between phenotype A and the control group in terms of HADS depression and GHQ scores. BCS scores were significantly higher in phenotypes A, B, and C than in the healthy controls. No significant difference was determined in Female Sexual Function Index (FSFI) scores between the PCOS phenotypes and the healthy controls. When all participants were divided into three groups based on body mass index (BMI), a statistically significant difference was observed only between the phenotype A lean group (BMI: 18.5-24.9 kg/m2) and the control group in terms of BDI, HADS depression, and BCS scores. Conclusions: BDI, HADS depression scores, and GHQ scores were all higher in patients with PCOS compared with the healthy controls. These features were more pronounced in phenotypes A and B, including hyperandrogenism and oligo-anovulation. Physicians should be aware of the high risk of these disorders in women with PCOS.

The level of depression, anxiety, and sleep quality in pregnancy during coronavirus disease 2019 pandemic.

AIM: We aimed to evaluate the mental health and sleep quality of pregnant women in different trimesters during coronavirus disease 2019 (COVID-19) pandemic and investigate the effect of quarantine and new lifestyle changes that come into our lives with pandemic with on this subject. METHODS: It was conducted on pregnant women (n = 149) who attended routine pregnancy prenatal visit during their pregnancy weeks. The data were collected using sociodemographic and clinical data form, Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) to evaluate maternal depression and anxiety. RESULTS: A significant correlation was observed between the week of gestation and depression, anxiety, and defective sleep scores (p < 0.001). A moderate positive correlation was found between the week of gestation and depression (r: 0.628). A high level of positive correlation was found between the week of gestation and defective sleep quality and anxiety scores (r: 0.858, r: 0.754). A statistically significant increase in depression, anxiety, and defective sleep quality was found in the group staying in home quarantine (p = 0.002). CONCLUSION: This study showed that the COVID-19 pandemic can cause depression, anxiety, and serious sleep disorders in pregnant women. The depression and anxiety scores of pregnant women in home quarantine were also found to be higher than the group not in quarantine. As the week of gestation progresses, mental health symptoms worsen and sleep quality deteriorates.

Investigating fear of childbirth in pregnant women and its relationship between anxiety sensitivity and somatosensory amplification.

The causes of fear of childbirth and the factors that affect it are not fully explained. The aim of this study was to investigate the relationship between fear of childbirth in pregnant women and anxiety sensitivity and somatosensory amplification. The study included 100 healthy pregnant women who were admitted to the Obstetrics and Gynaecology Department of a tertiary hospital in Turkey at 28-40 weeks of gestation. Sociodemographic Data Form, Anxiety Sensitivity Index (ASI), Somatosensory Amplification Scale (SSAS), Spielberger State and Trait Anxiety Inventory (STAI), Wijma Expectancy/Experience Scale (W-DEQ) were applied to all cases. The mean age of the pregnant women included in the study was 29.20 ± 6.17 years, and 82% of them had high fear of childbirth. It was determined that factors such as age, education status, occupation, prior pregnancy experience, the number of pregnancies, miscarriage history, and abortion experience had no significant effect on the fear of childbirth. It was observed that there was a weak positive correlation between the fear of childbirth and the anxiety sensitivity and the amplification of somatosensory symptoms. According to the findings of our study, as the fear of childbirth increases, anxiety sensitivity, and somatosensory amplification increase. For this reason, it is crucial to carefully monitor prenatal anxiety, somatosensory amplification and the fear of childbirth of pregnant women with state-related concerns.IMPACT STATEMENTWhat is already known on this subject? Fear of childbirth or what is historically referred to as tokophobia is generally defined as a fear of severe birth and fear of pathological birth. The causes of fear of childbirth are stated as biological reasons, psychological reasons and lack of social support. However, it is not possible to explain the causes of the fear of childbirth in pregnant women and the risk factors affecting them. Similarly, fear of childbirth in individuals with anxiety sensitivity and amplification of somatosensory symptoms has not been adequately investigated.What do the results of this study add? In this study, we aimed to contribute to the related literature by examining the relationship between fear of childbirth in pregnant women and anxiety sensitivity and amplification of somatosensory symptoms. It was observed that there was a weak positive correlation between the fear of childbirth and the sensitivity of anxiety and the amplification of somatosensory symptoms. According to the findings of our study, as the fear of childbirth increases, anxiety sensitivity, and somatosensory amplification increase.What are the implications of these findings for clinical practice and/or further research? For this reason, it is crucial to carefully monitor the pregnants who have prenatal anxiety sensitivity, somatosensory amplification, and state-continuous anxiety. Due to insufficient number of studies related to the subject, extensive sample studies on the subject are needed.

Saliva resistin as a screening marker of gestational diabetes mellitus.

OBJECTIVE: The aim of this study was to evaluate the resistin concentrations in saliva; which is a noninvasive and stress-free diagnostic sample, and to investigate the significance of salivary resistin concentrations in screening GDM. METHODS: This cross-sectional case-control study included 41 newly diagnosed GDM patients and 40 healthy pregnant. The participants were consecutively included in the study among eligible pregnant women; who were in the age range from 18 to 40 years of age and at the gestational age between 24 and 28 weeks. The levels of serum and salivary resistin were determined using an enzyme-linked immunosorbent assay method. RESULTS: Maternal serum resistin and salivary resistin concentrations were significantly higher in the patients with GDM compared to the individuals in the control group. The data were evaluated by the receiver-operator curve analysis; which revealed that serum and saliva resistin concentrations were moderately successful markers to differentiate subjects with GDM from healthy pregnant women. CONCLUSIONS: The results indicate that the determination of saliva resistin levels at the gestational age between 24 to 28 weeks may be used as an alternative, stress-free, and noninvasive technique that may be used in GDM screening.

Maternal Gestational Diabetes and Early Childhood Obesity: A Retrospective Cohort Study.

Background: Recently, childhood obesity has become one of the most serious public health problems in the world. Gestational diabetes mellitus (GDM) is considered a risk factor for childhood overweight and obesity. The study aimed at investigating the relationship between maternal GDM and childhood obesity in children aged from 1 to 3 years. Methods: In this retrospective cohort study, 237 GDM and 296 non-GDM mothers and their offspring who were followed up by Family Medicine Clinics in Rize province of Turkey were assessed. World Health Organization (WHO) criteria were used for the diagnosis of maternal GDM. Crude and adjusted logistic regression models were calculated for the association of gestational diabetes and childhood overweight/obesity. Gender and age-specific percentile tables were used for the categorization of BMI. Results: Statistical analysis carried out with adjustment for potential confounders (mother's age, educational status, smoking status, BMI, gestational weight gain, children's gender, and gestational birth weight) provided results with an odds ratio of 2.99; 95% CI 1.14-7.94 and 7.77; 95% CI 1.92-31.37 for the impact of gestational diabetes on childhood overweight and obesity at 2 and 3 years of age, respectively. Conclusions: This study found evidence for maternal GDM to cause the risk of early childhood obesity. Therefore, proper intervention strategies are required for this high-risk population.

Protective effects of nebivolol on ovarian ischemia-reperfusion injury in rat.

AIM: Ovarian torsion is a common gynecological emergency of reproductive ages, occurring at rates of 2.7-7.4%. This study aimed to evaluate the antioxidant effects of Nebivolol (NEB) and histopathological changes in experimental ischemic (I) and ischemic-reperfusion (I/R) injury in rat ovaries. METHODS: Forty-eight adult female rats were randomly separated into six groups as group 1 (control) receiving an oral saline solution for 3 days; group 2 (I) that underwent ischemia for 3 h with the application of atraumatic vascular clips; group 3 (I/R); group 4 (I + NEB) receiving 10 mg/kg NEB by oral gavage 30 min prior to the ischemia induction; group 5 (I/R + NEB) receiving 10 mg/kg NEB, and group 6 (control + NEB) receiving oral 10 mg/kg NEB for 3 days before ischemia induction followed by consequent reperfusion. Ovarian tissue damage was scored by histopathological analysis. Ovarian tissue malondialdehyde (MDA) and glutathione (GSH) levels were measured biochemically. RESULTS: The levels of MDA and tumor necrosis factor-alpha (TNF-α), and TUNEL assay positivity scores increased in the I and I/R groups. GSH levels decreased in all case groups (P < 0.05). The oral administration of NEB (10 mg/kg) to the I- and I/R-groups reduced the levels of MDA and TNF-α and TUNEL assay immunopositivity scores (P < 0.05). GSH levels increased in the treatment groups. CONCLUSION: The current experimental ovarian torsion study suggests a protective role for NEB against I and I/R injury in rat ovaries. NEB may be a novel agent for decreasing ovarian I/R injury.

Cystic Endometriosis in a Huge Degenerated Subserous Leiomyoma Mimicking Bilateral Multicystic Endometriomas in an Infertile Woman with Diminished Ovarian Reserve: A Rare Endometriotic Implantation.

Uterine leiomyomas are the most common pelvic tumor in women. Leiomyoma can show atypical locations and degenerations and may not be easily differentiated from adnexal masses. Uterine leiomyoma can undergo cystic degeneration and is said to be found in 4% of all types of degenerations. The commonest type of degeneration is hyaline seen in 60% of patients. Usually uterine leiomyoma does not present as clinical and radiological diagnostic challenge. However, when leiomyoma undergoes massive cystic degeneration they may become clinical and radiological diagnostic dilemmas. The MRI showed a huge cystic mass protruding up to the pelvis not differentiated from bilateral endometriomas and accompanying subserous myomas. Surgery revealed that the mass is not bilateral endometriomas but a huge pedunculated leiomyoma with cystic degeneration and cystic endometriosis. Endometriosis is a troubling gynecologic condition occurring in 10% to 15% of women of reproductive age and is associated with fertility problems. As a peritoneal disease, the locations of endometriotic lesions are predominantly the ovaries (96.4%), followed by the soft tissue (2.8%), gastrointestinal tract (0.3%), and urinary tract (0.2%) and other rare locations. The presented case is multiple sized cystic endometriosis (endometriomas) located in a huge pedunculated subserous leiomyoma in an infertile woman having a history of laparoscopic bilateral endometrioma surgery. Conclusion. To our knowledge, this is the first reported case for endometriotic cysts (endometriomas) located in a huge cystic degenerated leiomyoma. PubMed search revealed no report concerning endometriotic implantation in the leiomyomas.

Pemphigoid gestationis in a third trimester pregnancy.

Pemphigoid gestationis (PG) is a rare vesiculobullous dermatosis of pregnancy. It is commonly seen in second or third trimester. The diagnosis is frequently made with direct immunofluorescence studies of perilesional skin. Prompt recognition and appropriate management may reduce morbidity of this disease. Herein we present a case of pemphigoid gestationis occurring in a 33-year-old primigravida woman with symptoms of generalized pruritus.

Could platelet distribution width be a predictive marker for unexplained recurrent miscarriage?

PURPOSE: The aim of our study was to evaluate the platelet function in unexplained recurrent miscarriage and to investigate whether any hematologic changes detectable by simple complete blood count have a diagnostic value for the prediction of unexplained recurrent miscarriage. METHODS: A prospective study based on the comparison of 74 patients with unexplained recurrent first-trimester pregnancy loss with 208 control subjects matched for age. The two groups were compared in terms of platelet indices. RESULTS: There was a significant difference in platelet distribution width in patients with unexplained recurrent miscarriage compared to healthy control subjects. Platelet distribution width values in the patient group were statistically higher (P < 0.001) than the control group. CONCLUSION: Our study provides an evidence that platelet distribution width gradually increases in women with recurrent miscarriage compared to control group. Patients with unexplained recurrent miscarriage have significantly increased platelet aggregation. This data may provide an empirical rationale for the use of anticoagulants in the management of this clinical condition.

Alterations of natriuretic peptides amino-terminal pro B-type natriuretic peptide and amino-terminal pro C-type natriuretic peptide during the pregnancy.

OBJECTIVE: The aim of this study was to determine the plasma levels of natriuretic peptides amino-terminal pro B-type natriuretic peptide (NT proBNP) and amino-terminal pro C-type natriuretic peptide (NT proCNP) during pregnancy and any possible changes occurring in each trimester. METHODS: This was a prospective longitudinal case-control study conducted in a University Hospital antenatal outpatient clinic. Subjects were all healthy pregnant women without a history of previous cardiac disease, hypertension or preeclampsia, and each patient was assessed during every trimester, and blood samples were collected for the measurement of NT proBNP and NT proCNP levels. RESULTS: Twenty pregnant women were followed-up during pregnancy without any complications. We obtained longitudinal levels of natriuretic peptides in each trimester. The mean NT proBNP levels were 14.95 ± 16.8, 9.37 ± 10.76, 52.48 ± 126.65 pmol/ml and the mean NT proCNP levels were 44.64 ± 41.64, 45.70 ± 47.03, 47.22 ± 55.09 pmol/l, respectively. No statistically significant alteration of plasma levels of natriuretic peptides was detected between trimesters. CONCLUSION: This is the first study evaluating the longitudinal levels of NT proCNP during the pregnancy, and demonstrates that NT proCNP remained constant, but NT proBNP levels do not significantly alter during pregnancy.

Industrial symbiosis: high purity recovery of metals from Waelz sintering waste by aqueous SO2 solution.

Sintering operation in the production of Zn, Cd, and Pb by Waelz process produces a powdery waste containing mainly (about 70%) ZnO, CdO, and PbO. The waste may be referred to as Waelz sintering waste (WSW). The aim of this study is to develop a process for the separation and recovery of the metals from WSW with high purities. The process is based on the dissolution of the WSW in aqueous SO2 solution. The research reported here concentrated on the effect of some important operational parameters on dissolution process. The parameters investigated and their ranges were as follows: SO(2) gas flow rate (V); 38-590 ml/min, stirring speed (W); 100-1000 rpm, reaction temperature (T); 13-60 degrees C, reaction time (t); 1-16 min, and solid-liquid ratio (S/L); 0.1-0.5 g/ml. The results showed that the dissolution rate increased with increasing W, V, and S/L and decreasing T. The best dissolution conditions were found to be V=325 ml/min, W=600 rpm, t=6 min, T=21 degrees C, and S/L=0.1g/ml. Separation of Zn from Cd involved precipitation of ZnSO3 from a mixture solution. The best pH level for the precipitation was observed to be 6.