ObjectiveWe aimed to investigate whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) could be utilized to screen for gestational diabetes mellitus (GDM).Subjects and methodsNLR and PLR were assessed by retrospective analysis of 762 healthy and pregnant women with GDM. The patients were stratified into four groups, as follows: GDM (n=144), impaired glucose tolerance (n=76), only screen positive (n=238), and control (n=304).ResultsThe leukocyte, neutrophil, and lymphocyte counts were significantly higher in the study groups compared with the control group (P=0.001; P<0.01). There were no statistically significant differences between the groups with respect to the NLR and PLR (P>0.05).ConclusionWe do not recommend that blood NLR and PLR can be used to screen for GDM. However, increase in the leukocyte count is an important marker for GDM as it provides evidence of subclinical inflammation.

ObjectiveTo translate and validate the Michigan Incontinence Severity Index (M-ISI) for its use in Turkish-speaking women with urinary incontinence.MethodsThe translation and cross-cultural adaptation were based on international guidelines. Content validity by content validity ratio/content validity index, internal consistency by Cronbach’s alpha, test–retest reliability by Pearson’s correlation, and construct validity by using Spearman rank correlations to show the relationship between individual items and the relevant domains and subdomains were analyzed in 100 female participants with a chief complaint of urinary incontinence. Correlations between the relevant scores of M-ISI and The International Consultation on Incontinence Questionnaire – Short Form scores were analyzed to indicate convergent validity. The Varimax rotation method was used to conduct exploratory factor analysis in order to investigate the factor structures/distribution of M-ISI items.ResultsContent validity index and content validity ratio values increased to 0.97 and 1.00, respectively, showing sufficient content validity of the Turkish version of the M-ISI. The analysis formed three factors which was slightly different from original developers. In our proposed three-factor construct, all of the ten items demonstrated high correlations with their subdomains and lower correlations with the other domains, indicating good construct validity. Correlations between stress urinary incontinence and urge urinary incontinence (UUI) scores and The International Consultation on Incontinence Questionnaire – Short Form scores were found high, which indicated convergent validity (r: 0.953, P<0.001). Good internal consistency of the scores for each subdomain was observed (stress urinary incontinence, 0.787; UUI, 0.862; pad usage and bother, 0.832). Test–retest reliability was shown for each subdomain (stress urinary incontinence, 0.973; UUI, 0.973; pad usage and bother, 0.979).ConclusionThe translated and cross-culturally adapted M-ISI showed good validity, reproducibility, and reliability that allow its use in Turkish-speaking populations with urinary incontinence. Its comprehensive structure means that it has become a practical instrument that is available for utilization in the primary health care setting, clinical research, and epidemiological trials in Turkey.

INTRODUCTIONExtra-uterine pregnancy or Ectopic Pregnancy (EP) is a major health problem for pregnant women, presenting as a potentially life-threatening emergency in the first trimester [1]. EP occurs in approximately 1-2% of all pregnancies [2]. Serial beta b Human Chorionic Gonadotropin (b-HCG) measurements and advances in Transvaginal Ultrasonography (TVU) contribute to the early diagnosis of an EP before rupture occurs by providing increased clinical suspicion and by bearing the possibility in mind more frequently [3]. Early diagnosis provides the opportunity of more widespread use of medical therapy rather than surgery. There are three major options for the treatment of EP: expectant management, surgical treatment and medical management.Expectant management should only be considered for women with low (≤200 mIU/mL) and decreasing serum b-HCG levels [4].Laparoscopic surgery is the standard surgical approach for EP. Laparotomy can be preferable for patients who are haemodynamically unstable with intra-abdominal bleeding [5]. There are three choices of surgical approach for tubal pregnancy: salpingostomy, salpingotomy and salpingectomy [6]. Partial or total oophorectomy is commonly performed for ovarian EP [7].Medical treatment of an unruptured EP using intramuscular Methotrexate (MTX) was first attempted by Tanaka et al., in 1982 [8]. Since the first successful trial of MTX treatment, it has become increasingly popular worldwide. It is easier to apply and is more cost-effective compared to surgery. In addition, MTX treatment has shown comparable success rates, safety and fertility preservations with surgery since single-dose and multi-dose MTX therapy protocols have been developed. The optimal treatment protocol has been discussed repeatedly in the literature [9-11].The single-dose protocol is more popular and a more commonly used regimen worldwide, with success rates of 52-94% [12]. The other agents used for medical management protocols in EP are potassium chloride, hyperosmolar glucose, dactinomycin, prostaglandins and RU 486.Most of the previously published protocols for the treatment of EP have restricted the use of systemic MTX based on serum chorionic gonadotropin concentrations usually more than 5000 or 10,000 mIU/mL and in women with a gestational mass larger than 3 to 4cm in size [13,14]. These therapeutic limitations are determined based on the success rate. Absolute contraindications for MTX treatment are intrauterine pregnancy, immunodeficiency, moderate to severe anemia, leukopenia or thrombocytopenia, sensitivity to MTX, active pulmonary or peptic ulcer disease, clinically important hepatic or renal dysfunction and breast feeding [9]. Relative contraindications for MTX therapy are positive fetal cardiac activity, high initial b-HCG concentrations (>5,000 mIU/mL), gestational mass >4 cm size, refusal to accept blood transfusion and inability to participate in follow-up [9]. Atypical localization (interstitial, cervical, ovarian or cesarean section scar) is also a relative contraindication, parti...