Objective:Thyroid-stimulating hormone (TSH) level in neonates is recommended as an indicator for presence of iodine deficiency (ID) at a population level and as a monitoring tool in programs of iodine supplementation. The purpose of this study, based on data from the National Newborn Screening Program (NNSP) for congenital hypothyroidism (CH) in 2014, was to analyze neonatal TSH levels to predict the current status of iodine nutrition in Turkey.Methods:According to screening methodology, heel-prick blood samples of newborns were collected on filter paper cards usually on day 3-5 after birth (or shortly before discharge). Results of samples collected >48 h after birth were analyzed. The degree of severity of ID was assessed by using the epidemiologic criteria of the World Health Organization (WHO). Elevated TSH levels (>5 mIU/L) were processed and classified according to province, region, birth season, and sampling time.Results:A total of 1,298531 newborns were registered in the NNSP for the CH database. Of those, 1,270311 newborns had screening results collected >48 h after birth and were included in the statistical analyses. The national prevalence of elevated TSH was 7.2%. While the Gaziantep sub-region had the highest TSH elevation rate (15.9%), the Tekirdağ sub-region had the lowest rate (4.0%; p<0.001). Seasonal variations were also significant, and the elevated TSH prevalence rate was highest in winter (7.4%; p<0.001).Conclusion:National CH screening results suggest that Turkey may still be mildly iodine deficient. Nationwide studies should be performed for direct assessment and monitoring of iodine status in vulnerable populations to confirm accuracy of our results.

Background. Injury is the most common cause of preventable morbidity and mortality among children. The aim of this study was to determine the epidemiological characteristics and trends of injury-related mortality in children under five and to provide evidence for future preventive strategies. Methods. Our study was designed as a descriptive cross-sectional study. National under-five mortality data from the Death Notification System database, entered between January 1st, 2014, and December 31th, 2017, was included in the study. Results. Among all under-five deaths registered in the system, 2,560 injury-related death cases were included in the study. Overall, deaths related to injuries accounted for 4.1% of all deaths in children under five years old. Of all injury deaths, 59.9% of cases were male, 52.7% occurred at home or its close vicinity, and 80.3% were children aged 12-59 months. Injury-related under-five deaths were mainly attributed to traffic injuries (36.5%), falls (12.0%), and suffocation (10.2%). Traffic injuries were the most common cause of injury-related deaths both in infants 0-11 months and children 12-59 months old. The second and third most common causes of injury-related deaths among infants 0-11 months were suffocation and falls, while these were falls and drowning in children aged 12-59 months, respectively. The injury-related under-five mortality rate dropped from 11.3 per hundred thousand in 2014 to 9.1 in 2017. Causes of all unintentional injury-related deaths were associated with season except for other unintentional injuries and exposure to mechanical forces (p &lt; 0.001). Conclusions. The injury-related mortality rate among children under five years declined from 2014 to 2017, however it is still high. To prevent injuries in children under five, it is important to raise awareness and increase the supervision of children by their caregivers. At the national level, multisectorial cooperation with a holistic approach will be of key importance.

Infertility is a significant reproductive health condition that affects between 8% and 12% of couples of reproductive age globally (Inhorn & Patrizio, 2015). Male infertility accounts for almost half of all cases of infertility (Women as Wombs, 1993). Increased usage of intracytoplasmic sperm injection (ICSI) has highlighted the critical nature of improved sperm selection throughout the technique.Recently, there has been increased interest in the possible implications of sperm DNA damage on male infertility (Sakkas & Alvarez, 2010). Sperm DNA fragmentation occurs more frequently in infertile men who have anomalies in routine semen analysis criteria such as concentration, motility and morphology (Moskovtsev et al., 2009). Furthermore, up to 11% of normozoospermic infertile men exhibit considerable DNA damage, whereas 5% of infertile men with sperm parameter values greater than the 50%th percentile have significant DNA fragmentation. (Belloc et al., 2014;Zini et al., 2002). The current methods of sperm selection for assisted reproductive technology (ART) bypass natural selection barriers by focusing exclusively on motility and morphology, while ignoring other critical factors such as DNA integrity, ROS generation, membrane maturation and nonapoptotic presenting spermatozoa (Rappa et al., 2016). According to studies, centrifugation, pipetting and washing, all of which are routinely utilized in traditional procedures, generate ROS, impairing

Gebeliğinde major travma yaşayan kadınlarda hem maternal hem de fetal mortalite artmıştır. Ancak gebelikteki minör travma ile kötü perinatal sonuçlar arasında ilişki olup olmadığı bilinmemektedir. Bu çalışmada gebelikte minör travmaya maruz kalma sıklığı ve gebelikte minör travmaya maruziyetin gebelik sonuçlarına etkisi araştırıldı.Yöntemler: Ocak 2013-Aralık 2014 tarihleri arasında Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim Araştırma Hastanesi kadın doğum acil servisine başvuran 105727 hasta verisi incelendi. Hastalardan gebe olan ve gebeliğinde minör travma öyküsü olan 283 (%0,3) gebe çalışmaya dahil edildi. Gebelerin demografik özellikleri tanımlayıcı istatistiksel yöntemlerle belirlendi. Çalışma grubumuzdaki gebelerden hastanemizde takip edilen ve doğum yapan 188 hastanın bilgilerine ulaşıldı. Bu gebelerin antenatal komplikasyonlar ve gebelik sonuçları incelendi.Bulgular: Çalışma periyodunda hastanemiz acil servisine başvuran 105727 kadından 283'ü (%0,3) gebe ve acile başvuru nedeni minör travma idi. Sıklık sırasına göre minör travmalar ev içi kazalar (%81,3), aile içi şiddet (%9,9) ve trafik kazaları (%8,8) olarak bulundu. Bu gebelerden hastanemizde takip edilen ve doğuran 188 hastanın verileri incelendiğinde en sık saptanan komplikasyon preterm doğum olarak bulundu (%15,4). Sonuç: Ev içi kazalar ve aile içi şiddet gebelikte minör travmaların en sık nedenleridir. Gebelerde özellikle 2. trimesterde minör travma riski daha fazla bulunmuştur. Gebeliği sırasında minör travmaya maruz kalan gebelerde preterm doğum riski artmıştır. Bu gebeler preterm eylem ve doğum riski konusunda bilgilendirilmeli ve gebelik takiplerini daha dikkatli yaptırmaları önerilmelidir.

Objective: To present the reference range of the fetal thymus gland according to gestational age groups. Methods: In this prospective study, fetal thymus size was assessed in singleton, uncomplicated pregnancies between 19 and 38 weeks of gestation in our outpatient clinic between 2019 and 2020. Based on their monthly pregnancy follow-ups, fetal thymus measurement was divided into 5 gestational age groups (Group 1: 19–22 weeks, Group 2: 23–26 weeks, Group 3: 27–30 weeks, Group 4: 31–34 weeks, and Group 5: 35–38 weeks). Results: Fetal thymus measurements of 210 patients were performed over one year, and as a result, 184 pregnant patients were included for assessment. Fetal thymus could be visualized at a rate of 93.5%. The 5th percentile of thymus transverse diameter, antero-posterior diameter, perimeter, thymus anterior-posterior diameter to thoracic diameter, and thymus perimeter to thoracic circumference were 11.03 mm, 5.60 mm, 32.52 mm, 0.33, and 0.32 in Group 1; 13.53 mm, 7.66 mm, 43.67 mm, 0.34, and 0.32 in Group 2; 20.43 mm, 11.22 mm, 47.72 mm, 0.33, and 0.32 in Group 3; 27 mm, 12.98 mm, 55.88 mm, 0.32, and 0.30 in Group 4; 28 mm, 13.59 mm, 63.4 mm, 0.32, and 0.30 in Group 5; respectively. Spearman’s rho correlation coefficients for the thymic measurements were 0.879, 0.869, 0.846, 0.236, and 0.267 respectively, and all p-values were less than 0.001. As a result of linear regression analysis between thymus measurements and BPD; the equations for the optimal models are as follows: thymus transverse diameter= -3.49+0.4xBPD (mm) (r=0.826, R2=0.682, p<0.001), thymus anterior-posterior diameter= -2.48+0.22xBPD (mm) (r=0.808, R2=0.653, p<0.001), thymus perimeter= -14.37+1.21xBPD (mm) (r=0.814, R2=0.663, p<0.001), thymus anterior-posterior diameter /thoracic diameter= 0.38+7.76E-4xBPD (r=0.213, R2=0.045, p=0.004) and thymus perimeter/thoracic circumference= 0.35+1.02E-3xBPD (r=0.263, R2=0.069, p<0.001). Thymus transverse diameter, anterior-posterior diameter, and perimeter increased linearly with increasing biparietal diameter (BPD). Conclusion: We established the reference ranges of fetal thymus size. Thymus transverse diameter, antero-posterior diameter, and thymus perimeter have a strong relationship with gestational age and are easy and reproducible. Therefore, the knowledge of reference ranges of fetal thymus will enable the evaluation of thymic aplasia/hypoplasia.