Mustafa Agah Tekindal

Acupressure at BL60 and K3 Points Before Heel Lancing in Preterm Infants

CONTEXT Acupressure is an ancient Chinese healing art. In this pain-relieving method, the fingers are used to press key acupuncture points on the skin surface that stimulates the body׳s regulatory processes. OBJECTIVE The aim of this study was to investigate the effect of acupressure at Kun Lun (UB60) and Taixi (K3) points for pain management in preterm infants prior to heel lancing for blood collection. DESIGN This was a prospective, randomized controlled study. SETTING The study setting was the neonatal intensive care unit at Baskent University Hospital in Turkey. PATIENTS A total of 32 preterm infants between 28 and 36 weeks׳ gestational age were randomly assigned to one of two groups: an acupressure group (n = 16) or a control group (n = 16). INTERVENTION In the acupressure group, immediately before the heel prick, acupressure was applied for three minutes at UB60 and K3 points. MAIN OUTCOME MEASURES A behavioral pain score was determined using the Premature Infant Pain Profile (PIPP) scale. RESULTS There were no significant differences between the groups with respect to gestational age, birth weight, sex, mode of delivery, age at time of procedure, weight at time of procedure, or PIPP score. Mean duration of procedure and mean duration of crying were both shorter in the acupressure group (both P = .001). CONCLUSIONS Applying acupressure at the BL60 and K3 points before heel lancing was associated with shorter procedural time and shorter duration of crying in preterm infants.

The Relationship between Balance, Muscles, and Anthropomorphic Features in Young Adults.

Posture can be defined as the form of the body when sitting, walking, or standing. There would be no problem if muscles interact in harmony with musculoskeletal system or nervous system. Posture analysis is crucial for clinical assessments in physical medicine and rehabilitation. However, studies into this issue are limited. In this study, the relationship between static standing balance and anthropomorphic features in healthy subjects was investigated. The study was carried out with a total of 240 students at Baskent University (116 females, 124 males) aged between 18 and 25 years. Type of balance of the subjects was determined with lateral posture analysis. Additionally, muscle shortness tests, subcutaneous fat thickness, and waist and thigh circumference were measured. As the results of lateral posture analysis, 107 subjects (71 males, 36 females) were detected to have anterior balance, 89 (41 males, 48 females) posterior balance, and 44 (12 males, 32 girls) neutral balance. Values of waist circumference, thigh circumference, and waist/thigh ratio were compared with all three balance types. A statistically significant difference was detected between these values in the subjects who had anterior balance (P < 0.05). In conclusion, a significant relationship was detected between muscle shortness, waist and thigh circumferences, and postural balance type.

Laser acupuncture before heel lancing for pain management in healthy term newborns: a randomised controlled trial

Background Healthy term newborns commonly undergo painful procedures during routine follow-up visits. Non-pharmacological strategies have currently become more important than pharmacological analgesic agents in neonatal pain management. Acupuncture is a new non-pharmacological method for preventing pain in newborns. Objective We aimed to investigate the effect of laser acupuncture (LA) at the Yintang point before heel lancing as a non-pharmacological intervention for procedural pain management in infants. Methods Forty-two term newborns, who were undergoing heel lancing between postnatal days 3 to 8 as part of routine neonatal screening, were randomly assigned to the LA group or the oral sucrose group. In the LA group, 2 min before the heel lancing, 0.3 J of energy was applied to the Yintang point using a Laser PREMIO-30 unit for 30 s. In the sucrose group, each infant received 0.5 mL of 24% sucrose orally via syringe 2 min before the heel lancing. Each babys behaviour was scored using the Neonatal Infant Pain Scale (NIPS), assessed blinded to group. Results There were no significant differences between the LA and oral sucrose groups with respect to means for gestational week of age at birth, birth weight, actual weight, or Apgar score. Mean procedure time was significantly shorter in the LA group; however, mean crying time was longer and NIPS score was lower compared to the oral sucrose group. Conclusions Our results indicate that 0.3 J of LA at the Yintang point before heel lancing is less effective than oral sucrose for reducing the discomfort of this procedure. Trial Registration Number KA14/09.

AMH levels at central precocious puberty and premature thelarche: is it a parameter?

Abstract Background: The possible difference of antimüllerian hormone (AMH) levels at central precocious puberty (CPP) and premature thelarche (PT) has not been properly evaluated. Objective/hypothesis: By evaluating AMH levels in girls with diagnosed CPP and PT, we aim to show the change of AMH levels at the pubertal onset. Subjects: Sixty-five girls who have breast development before the age of 8 years and 25 healthy girls were enrolled in the study. Methods: The subjects were divided into two groups as CPP and PT, according to results of GnRH test. AMH levels were determined in the two groups. Results: The mean AMH levels of the CPP group were significantly lower than those in the PT group (13.57±9.85 pmol/L and 58.42±12.78 pmol/L, respectively, p=0.022). Conclusion: These results suggest that the AMH levels decrease in the duration of the hypothalamus-pituitary-ovarian axis activation. We thought that AMH might/may be a marker for distinguishing between CPP and PT.

Effects of alendronate and pamidronate on apoptosis and cell proliferation in cultured primary human gingival fibroblasts

Data arising from the recent literature directed the researchers to study on the degree and extent of bisphosphonate toxicity on oral mucosa in further detail. The aim of this study is to determine the half maximal inhibitory concentration of pamidronate (PAM) and alendronate (ALN) on human gingival fibroblasts in vitro using 3-[4.5-thiazol-2-yl]-2.5-diphenyltetrazolium bromide (MTT) assay and to evaluate the effects of both agents on the proliferation and apoptotic indices. Cells used in the study were generated from human gingival specimens and divided into alendronate (n = 240), PAM (n = 240), and control groups (n = 60). Based on the MTT assay results, 10−4, 10−5, 10−6, and 10−7 M concentrations of both drugs were administered and the effects were evaluated for 6, 12, 24, 48, or 72 h periods. An indirect immunofluorescence technique was used to evaluate apoptotic (anti-caspase 3) and proliferation (anti-Ki67) indices. Toxicity of both PAM and ALN was found to be the most potent at 10−4–10−5 M range. The apoptotic index of PAM group was found to be significantly higher than ALN group for all concentrations especially at 24 h incubation time (p < 0.05). The decrease in the proliferation index was found similar in first 48 h for both drugs; however, after 72 h of incubation decrease in proliferation index in PAM group was found to be significantly higher (p < 0.05). Micromolar concentrations of not only PAM but also ALN rapidly affect cells generated from human oral gingival tissue by inducing apoptosis together with inhibition of proliferation. Cytotoxic effects of both ALN and PAM on primary human gingival fibroblasts, which cause significant changes in apoptotic and proliferative indices as shown in this in vitro study, suggests that the defective epithelialization of oral mucosa is possibly a major factor on the onset of bisphosphonate-related osteonecrosis of the jaw cases.

The association between coenzyme Q10 concentrations in follicular fluid with embryo morphokinetics and pregnancy rate in assisted reproductive techniques

PurposeThis study seeks to evaluate the association between follicular fluid (FF) coenzyme Q10 (CoQ10) levels, embryo morphokinetics, and pregnancy rate.MethodsSixty infertile patients who underwent intracytoplasmic sperm injection (ICSI) cycles were included in the study. For each patient, CoQ10 level of the follicular fluid was measured by high-performance liquid chromatography system. After the ICSI of each oocyte, the relationship between the level of CoQ10 content of each follicular fluid, the subsequent embryo quality, and embryo morphokinetics was investigated. The relationship between the level of CoQ10 content of each follicle and optimal time-lapse parameters for the embryos of these follicles including t5, s2, and cc2 was also analyzed. The embryos were further classified into four categories, namely, grades A, B, C, and D, according to morphokinetic parameters using t5–t2 and t5–t3 (cc3). Each follicular fluid analysis was performed for a single oocyte of a single embryo which was transferred to the patients. Additionally, follicular fluid CoQ10 levels and pregnancy rates were evaluated.ResultsFollicular fluid CoQ10 levels were significantly higher in grades A and B than grades C and D embryos (p < 0.05). The concentration of CoQ10 levels was significantly higher in the pregnant group (p < 0.05). There was no significant correlation between optimal t5 and s2 morphokinetic parameters and CoQ10 levels. However, CoQ10 levels were significantly higher in follicular fluid of embryos which had optimal cc2 (p < 0.05).ConclusionHigh follicular fluid CoQ10 level is associated with optimal embryo morphokinetic parameters and higher pregnancy rates.

OGTT results in obese adolescents with normal HOMA-IR values

Abstract Objective: To investigate insulin resistance (IR) with OGTT in obese adolescents who have normal fasting insulin and homeostasis model assessment for insulin resistance (HOMA-IR). Subjects: A total of 97 obese adolescents who had values of HOMA-IR <3.16 and insulin levels <18 μU/mL (125 pmol/L) were included in the study. Methods: Oral glucose tolerance test (OGTT) was performed on all cases. Subjects were divided into two groups: subjects with and without IR using an insulin peak of ≥150 μU/mL (1041.8 pmol/L) and/or ≥75 μU/mL (520.9 pmol/L) 120 min after glucose charge and the sum of insulin levels >2083.5 pmol/L (300 μU/mL) in OGTT. IR risk factors were defined as family history of diabetes mellitus, acanthosis nigricans (AN), and hepatic steatosis. Results: IR was detected in 61 (62.9%) patients. The IR group had significantly more frequent AN (p=0.0001). As the number of risk factors increased, the frequency of IR also increased (p=0.01). Conclusion: We advise to perform OGTT in obese adolescents with normal HOMA-IR, if they have risk factors for IR.

Distribution and number of Cajal-like cells in testis tissue with azoospermia

We investigated the number and distribution of Cajal‐like cells in patients with azoospermia. A total of 99 patients with non‐obstructive azoospermia were divided into subgroups [19 patientsin hypospermatogenesis group (S1), 40 patients in maturation arrest group (S2), 20 patients in a Sertoli cell‐only syndrome (S3), and 20 patients in a testicular atrophy and fibrosis group (S4)], and 20 patients with obstructive azoospermia group (S0). Sections stained with a c‐kit antibody were studied by light microscopy to determine the number and distribution of Cajal‐like cells in peritubular and perivascular areas of testis. The number of Cajal‐like cells were higher in all the non‐obstructive groups than in the obstructive group (S0: 2.43 cells/mm2, S1: 3.14 cells/mm2, S2: 4.00 cells/mm2, S3: 4.57 cells/mm2, S4: 3.86 cells/mm2) but statistically significantly different (p < 0.05) in the S2 and S3 subgroups only. Distribution of Cajal‐like cells were similar in all groups. The number and distribution of Cajal‐like cells in non‐obstructive groups suggest that these cells may affect spermatogenesis. This cellular type can be responsible for the regulation of cellular motility or spermatogenesis. Electrophysiological and electron microscopic studies are needed to better define morphology and function of Cajal‐like cells in the testis, especially totally the normal testis tissue.

A comparison of calisthenic and cycle exercise training in chronic obstructive pulmonary disease patients: a randomized controlled trial.

Aim: To compare the effects of calisthenic and cycle exercises with no exercise in chronic obstructive pulmonary disease patients. Method: Forty-seven participants were allocated to either a cycle or calisthenic exercise or control group. Outcome measures, including Saint George Respiratory Questionnaire, pulmonary functions, cardiopulmonary exercise testing, Fitness Testing, and Hospital Anxiety-Depression, Modified Medical Research Council Dyspnea, Fatigue Severity, Fatigue Impact Scales, were performed before and after the intervention. Results: The change in VE/VCO2 significantly differed (p = 0.01) between two exercise groups. Physical fitness, quality of life, anxiety-depression, dyspnea and fatigue changed significantly in exercise groups, with no between-group differences. There were no significant improvements in control group. Conclusion: Calisthenics are as safe and effective as cycle exercise and could be included in comprehensive treatment programs.

Can We Predict the Presence and Severity of Intra-Abdominal Adhesions before Cesarean Delivery

Aims: The study aimed to investigate whether we can predict the presence and severity of intra-abdominal adhesions before cesarean delivery using patient history, symptoms, and abdominal skin scar characteristics. Methods: In this prospective study, 143 pregnant women with history of previous abdominal surgery were included and they delivered by cesarean. Preoperative abdominal scar characteristics and symptoms as well as intraoperative abdominal adhesions were evaluated using the Manchester Scar Scale, a symptomatology questionnaire and the More Comprehensive Adhesion Scoring Method, respectively. Results: Patients with adhesions (n = 98) and without adhesions (n = 45) had similar baseline characteristics. In the adhesion group, abdominal scar scoring parameters were significantly increased. However, there was no significant correlation among total scar score, adhesion score, and symptom score. Conclusion: Despite the availability of many proposed methods, accurate prediction of the severity of surgery-related adhesions is beyond our current abilities. Therefore, as healthcare providers, obstetricians should avoid unnecessary use of the cesarean approach. This approach is more effective, beneficial, realizable, and reasonable than the prediction of surgery-related adhesions.