Sinan Beksaç

Premarital Screening of Hemoglobinopathies: A Pilot Study in Turkey

To identify premarital couples who are carriers for hemoglobinopathies, a screening study was conducted in one of the southern cities of Turkey. For 2,113 couples, total blood count, Hb A2 and Hb F levels were determined and hemoglobin electrophoresis was performed. The frequency of Hb S was 4.6% and beta thalassemia 2.3%. In 35 of 2,113 prospective families, both partners were found to be carriers. During the 4-year follow-up period, prenatal diagnosis was sought in 10 pregnancies of these at-risk families. This study indicated that premarital screening is a very useful tool for detecting carrier couples. The immediate beneficial effect of this study was the application of prenatal hemoglobinopathy diagnosis from the first pregnancy.

Comparison of different treatment protocols in the treatment of idiopathic detrusor overactivity: a randomized controlled trial

Objective: To investigate and compare the effectiveness of various treatment protocols for the treatment of women with idiopathic detrusor overactivity. Design: Prospective, randomized controlled trial. Setting: Departments of Physiotherapy and Rehabilitation and Obstetrics and Gynaecology, Hacettepe University. Subjects: Forty-six subjects were randomized to three groups. Interventions: The first group received only pharmacotherapy, the second group received only physiotherapy and in the third group pharmacotherapy was combined with physiotherapy (combined therapy group). Main measures: All patients were evaluated at the beginning and at the end of treatment. Assessment parameters were maximum cystometric capacity, electromyographic activity of pelvic floor muscles, voiding diary parameters, the amount of urine leakage and the quality of life score. Results: The maximum cystometric capacity and the electromyographic activity of pelvic floor muscles increased significantly and the number of voids/day and incontinence episodes/day, and the amount of urine leakage reduced significantly (P < 0.05) in both physiotherapy and combined therapy groups while there was no significant difference in the pharmacotherapy group. After treatment, the number of voids/day increased by 0.3 ± 3.4 in the pharmacotherapy group (P > 0.05) and decreased by 5.1 ± 5.5 and 4.7 ± 5.6 in the physiotherapy and combined therapy groups, respectively (P < 0.05). Statistically significant improvements were observed in all groups according to the number of voids/night and the quality of life scores at the end of the treatment. Conclusion: The physiotherapy protocol we introduced in the present study with or without anticholinergic therapy has a substantial positive impact on the treatment of female patients with idiopathic detrusor overactivity.

Validity and reliability of the Turkish version of the Pelvic Floor Distress Inventory-20

Introduction and hypothesisThe aim of this study was to investigate the reliability and validity of the Turkish version of the Pelvic Floor Distress Inventory-20 (PFDI-20).MethodsOne hundred and twenty-eight women with pelvic floor disorders, including pelvic organ prolapse, urinary incontinence, and anal incontinence were enrolled in the study. The Turkish version was developed using forward back translation. Construct validity was examined by correlation of clinical methods. Interclass correlation coefficients (ICC) compared the PFDI-20 and subscale scores. Cronbach’s alpha assessed the internal consistency of the Turkish version.ResultsThe PFDI-20 has three subscales. The test–retest reliability of the PFDI-20 and subscale was excellent (ICC 0.96 to 0.98, p < 0.001). Cronbach’s alpha value (0.79) was moderate for the PFDI-20. Construct validity demonstrated that the PFDI-20 and each subscale displayed significant correlation with other clinical methods used (p < 0.05).ConclusionsThe PFDI-20 is a valid and reliable condition-specific questionnaire for Turkish women with pelvic floor disorders.

Quantities of adult, fetal and embryonic globin chains in the blood of eighteen- to twenty-week-old human fetuses

The prenatal diagnostic program, established at Hacettepe University in Ankara for the purpose of detecting beta-thalassemia (beta-thal), sickle cell anemia (SS), and Hb S-beta-thal, offered the opportunity of evaluating the relative quantities of adult (beta A, beta S), fetal (G gamma, A gamma, A gamma T), and embryonic (epsilon, zeta) chains in 26 fetuses, aged 18-20 weeks. Methodology involved micro high-performance liquid chromatographic (HPLC) procedures and immunology using an mAb, specific for the embryonic epsilon chain. A good correlation was observed between the beta/gamma in vitro chain synthesis ratio and the level of beta A and/or beta S chains determined by reversed-phase HPLC; the combination of these two sets of data strengthens the prenatal diagnostic approach of detecting beta-thal major but not beta-thal trait. The levels of the different gamma chains were about as observed in newborn babies; the frequency of the A gamma T variant in the 26 fetuses was the same as observed for a larger group of Turkish newborn babies. The level of the embryonic zeta chain was higher than seen in full-term babies and varied between 0 and 1.3%; 5 of the 26 fetuses showed the complete absence of zeta. The embryonic epsilon chain was not detectable, not even in babies with beta-thal major. These data indicate that the synthesis of epsilon is completely turned off in fetuses at the age of 18-20 weeks, while that of zeta continues, albeit at a low level.

Robinow syndrome, vaginal atresia, hematocolpos, and extra middle finger

A 14-year-old girl with Robinow syndrome was admitted with severe abdominal pain that had recurred periodically during the last 6 months. She had been followed by us since age 2 months and she had not experienced menarche yet; hematocolpos related to vaginal atresia was diagnosed. She underwent vaginoplasty with cervical construction. Genital system abnormalities are common in Robinow syndrome, but this kind of malformation has not been reported previously.

Prenatal Diagnosis of Hemoglobinopathies in Turkey: Hacettepe Experience

Prenatal diagnosis of hemoglobinopathies was performed in 250 fetuses at risk for hemoglobinopathies. The main diagnostic procedures were in vitro hemoglobin synthesis analysis in fetal blood and analysis of DNA obtained from chorionic villus samples. Sixty-six percent of the fetuses were at risk for beta thalassemia major and 28% for sickle cell anemia. Beta thalassemia mutations were heterogenous, and 51 fetuses examined by the DNA technique were found to be at risk for at least 20 different combinations.

Reliability and validity of the Turkish King’s Health Questionnaire in women with urinary incontinence

Introduction and hypothesisThe aim of this study was to translate the King’s Health Questionnaire (KHQ) into Turkish and to test its reliability and validity among Turkish women with urinary incontinence (UI).MethodsThree hundred and thirty-five women with symptoms of UI completed the Turkish versions of the KHQ, short forms of the Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7), and the Incontinence Severity Index (ISI). Psychometric analysis of the KHQ included assessments of test–retest reliability, internal consistency, construct, and criterion validity. Factor analysis was used to explore the underlying structure of the KHQ.ResultsThe internal consistency (Cronbach’s alpha ≥0.68) and test–retest reliability of the KHQ were found to be high (p < 0.001). Interdomain correlation analysis showed good convergent validity among Role, Physical, and Social Limitations, with relatively higher correlations and divergent validity between Personal Relationships and other domains, with relatively lower correlations. Exploratory factor analysis identified three factors, namely, Daily Life and Emotions, Personal Relationship, and General Health Perception. The KHQ was also significantly correlated with IIQ-7, UDI-6, and ISI (p < 0.01).ConclusionsThe results suggest that the Turkish KHQ is a valid and reliable condition-specific quality of life instrument for Turkish women with UI.

Two patients with marginal symptoms showing hyperthecosis at the edge of malignancy: Presentation of two cases

It is important to define the aetiology of increased levels of androgens in women. Ovarian stromal hyperplasia (OSH) and ovarian hyperthecosis (OHT) are non-neoplastic pathologies. They show the excess of androgen production and have a wide clinical range like hirsutism, virilisation, abnormal menses, obesity, hypertension and insulin resistance. Ovarian stromal hyperplasia and hyperthecosis are commonly seen in postmenopausal women and generally involve both ovaries. Laboratory testing is the gateway; testosterone and dehydroepiandrosterone sulphate (DHEA-S) are the first hormones that should be measured. OSH and OHT could also be a reason for endometrial malignancy by unopposed oestrogenic status. Hyperthecosis must be differentiated from several other diseases, especially malignant conditions, and the treatment for postmenopausal women should be bilateral oophorectomy.

Stress-induced release of cortisol and prolactin during dilatation and curettage under general and local anesthesia

Comparison of the effect of general and local anesthesia on serum prolactin and cortisol concentrations in response to the stress of dilatation and curettage revealed that short surgical procedures under general anesthesia resulted in no significant change in mean serum cortisol and in a significant decrease in mean serum prolactin. By contrast, short surgical procedures under local anesthesia resulted in a significant increase in serum prolactin and cortisol concentrations. Our findings support the importance of using general anesthesia during dilatation and curettage.

Influence of Surgical Stress and General Anaesthesia on Serum Follicle Stimulating Hormone (FSH) Levels in Female Patients

Quite a number of antifungal agents have been released into the market within the recent decade for t.he topical treatment of superficial skin fungal infections. including tinea pedis (athletes foot). tinea cruris. tinea corporis caused by va.rious dermatophytes such as Trichophyton rubrum. Trichophyton mcntagrophytes, Epidermophyton floccosum and Microsporum canis; tinea versicolor (pityriasis versicolor) caused by Candida Albicans. Tables IA & B present a. summary of the old Bnd new preparations, from which some similarities and differences among them can be anticipated.Medicine, as it stands today, did not develop overnight. It is the culmination of efforts of millions of people, some we know and others we do not. The flame of civilization, including medicine, started thousands of years ago. The flame has been handed over from one generation to another, and from one country to the other. Depending on who took the sacred responsibility of hosting it, sometimes it got brighter and sometimes it got dimmer. However, it never died away, because if it did, it would have been too hard to start all over again.DOI: http://dx.doi.org/10.5915/10-3&4-5726 This paper reviews the cost of producing and manufacturing tobacco. This cost will be analyzed in terms of the amount of resources spent on tobacco with certain comparison with other commodities. This paper will also throw some light on the share of the Muslim world in the production and manufacturing of this commodity. At last, it will discuss the morals of commercializing this commodity from an Islamic point of view. This last discussion will indulge the paper in the price theory in the Islamic economy on the microeconomic level and its macroeconomic implications.DOI: http://dx.doi.org/10.5915/10-3&4-6507 This study was undertaken to investigate the effect of general anesthesia and surgical stress upon pituitary FSH secretion in females. In this study, anesthesia and surgical stress caused no change in the plasma concentrations of FSH in normally menstruating and pregnant women.A majority of the Muslim countries are the worst victims of grinding poverty. under-employment, malnourishment and disease. By and large they are part of the developing world and are at an early stage of development. Even though agriculture is the backbone of their economy and the principal occupation of most people. the management is grossly inefficient. its practices are primitive a nd the economic reward is barely at subsistence level. These countries do not have an organized food industry as commonly found in the West. The dairy food industry is conspicuous by its absence in most Muslim countries. The per capita production and consumption of milk and milk products is among the lowest in the world. The standard of human nutrition is well below the accepted nonns and this fact is reflected in high infant and adult mOrullity, low life expectancy, and a higher incidence of deficiency and wasting diseases. In this paper the author surveys the current status of the dairy food industry in Muslim counlries. their resource potential and ways and means of improving the level of human nutrition through increased supply of high quality fresh. fermented, or preserved dairy, non-<lairy, and speciallY products. A number of conventional, substitute or fabricated dairy food products have been Identified and their composition and componenlS explained. A plan of action for achieving these goals has also been recommended.