3 Mart 2023 Cuma

Secondary infertility

 

secondary infertility

Since you've given birth before, it may not occur to you that you are suffering from infertility unless you become pregnant again. Those who have experienced secondary infertility learn that this can happen only when they consult a doctor.

There is a misconception that infertility is congenital and will not happen to women giving birth, but infertility is usually an afterthought. As you know, infertility is a very broad topic. However, today I will talk about a more subtle topic, secondary infertility.


What is Secondary Infertility?

Secondary infertility is the inability to get pregnant even if you have had a child before, even though you try to get pregnant again.

Just like primary infertility, secondary infertility can occur due to a problem at any point in the natural process necessary to get pregnant. Any problems with ovulation, fertilization, entry of the fertilized egg into the uterus, or the development of the fertilized egg may result in inability to become pregnant or the pregnancy terminated in miscarriage.


What Are the Causes of Secondary Infertility?

Primary and secondary infertility often share the same causes. I will explain them one by one for you.

Ovulation Disorders

In fact, 40 percent of women with infertility problems do not ovulate consistently. Therefore, the chance of getting pregnant decreases. Ovulation disorders can be caused by a variety of conditions and factors, such as:

  • Polycystic Ovary Syndrome (PCOS)
  • Primary Ovarian Insufficiency (POI)
  • Decreased egg production due to aging
  • Thyroid or other endocrine disorders that affect hormone production
  • Certain lifestyle factors, such as weight, diet, and alcohol or drug use        
One of the most common causes of infertility in women is PCOS, which causes the ovaries or adrenal glands to produce too many hormones that prevent the ovaries from releasing eggs. It can also cause cysts to develop in the ovaries, which can further inhibit ovulation.

But do not despair at this point. I have good news for you. 70 percent of women with PCOS do not have any problems getting pregnant after the necessary treatments.

Problems with the Uterus and Fallopian Tubes

Structural issues can affect your ability to get pregnant. For example, if there is a blockage in the fallopian tubes, the sperm and egg may not be able to come together. The uterus may also have a structural or tissue defect that prevents implantation. Some special conditions that affect the fallopian tubes or uterus include:
  • Endometriosis
  • uterine fibroids or polyps
  • uterine wound
  • Uterine-shaped abnormality, such as a unicornuate uterus            
  Secondary infertility due to endometriosis can occur after cesarean section or uterine surgery, when uterine cells are misplaced and symptoms begin or increase.


Scar in the Womb

If you had a cesarean delivery with a previous pregnancy, it's possible to have a scar on the uterus called an isthmocele. An isthmocele can lead to inflammation in the uterus that affects implantation. This causes problems in conceiving.


Infections

Infections, including sexually transmitted infections, can cause pelvic inflammatory disease. This can cause injury and blockage of the fallopian tubes. A human papillomavirus (HPV) infection (and its treatments) can also affect cervical mucus and reduce fertility.

I have to give important information about this. The sooner the infections are treated, the less impact it will have on fertility. This is an important example for you to see again the importance of regular gynecological examination.


Age

Age plays an important role in fertility. Biologically, fertility peaks around age 20 in women and begins to decline at age 30. Of course, this does not mean that a successful pregnancy cannot occur at a later maternal age. Just getting pregnant may take longer or be more challenging.


Other Causes

Causes such as stress, smoking and weight gain are also factors affecting fertility. Just like primary infertility, secondary infertility can also occur due to such conditions.



When Is Secondary Infertility Suspected?

If you can't get pregnant despite trying for the last year or if your pregnancies end in miscarriage, we start to suspect secondary infertility. For women over the age of 35, this period decreases to 6 months.



How Is Secondary Infertility Diagnosed?

When we suspect secondary infertility, we want to do an examination and some tests for diagnosis. These:

  • blood tests to look at your hormone levels
  • Ovulation tests
  • pelvic exam
  • X-rays to view your fallopian tubes
  • Transvaginal ultrasound
  • Other tests to view your uterus and cervix                           
         If your tests show no problems, we may recommend testing for male infertility.


How Is Secondary Infertility Treated?

Once we know the cause, we develop a treatment plan to increase the likelihood of conception. I have listed the most common ones for you below.

Medicines

Medications are often used to normalize hormones, or fertility-enhancing drugs are recommended to help stimulate ovulation.

Operation

In some cases, you may need to have surgery. There are several effective surgical procedures that can treat problems such as uterine fibroids, uterine scarring or advanced endometriosis. Most of these procedures are performed minimally invasively.

Hysteroscopy is used to diagnose and treat uterine abnormalities such as polyps and endometriosis.

Laparoscopy is a method to help diagnose infertility when other measures have failed and can be used in conjunction with hysteroscopy as an effective treatment.

Vaccination and IVF treatment are among the most preferred methods in the treatment of infertility.




Naegleria fowleri (Brain-eating amoeba)

 


In Naegleria fowleri disease, the single-celled amoeba infects the brain, and cases are often fatal. Single-celled Naegleria fowleri, which is mostly found in fresh waters such as lakes and rivers, is transmitted only through the nose and is not passed from person to person.

Amoebae entering the olfactory canal pass through the nasal mucosa and settle in the cerebrospinal fluid and brain via the olfactory nerve. They cause meningitis, which is a sudden fatal disease called Primary Amoebic Meningoencephalitis (PAM).


What Are the Symptoms of Brain-Eating Amoeba?

As the name suggests, the disease caused by this type of amoeba is mainly the inflammation of the brain tissue called meningoencephalitis and the membrane surrounding the brain. It usually starts with severe headache, fever, nausea and vomiting within 10 days of ingestion. In the following days, neck stiffness typically develops, seizures, and consciousness are impaired. The delusions we call hallucinations begin. Loss of interest in one's surroundings. Loss of balance develops. It deteriorates rapidly, with coma and death within about 5 days.


Is there a cure?

There is no known cure for this disease. It is 97% fatal. There are two survivors after a new drug called Miltefosine was tried. However, it is very difficult to cope with the excessive brain edema that occurs in this disease.

1 Mart 2023 Çarşamba

Elden Ring - Shadow of the Erdtree DLC Announced

 

elden ring shadow of the erdtree dlc



Elden Ring, which has surpassed 20 million sales worldwide in the past weeks, has turned into a great success story for developer studio FromSoftware. Legendary game director Hidetaka Miyazaki and Game of Thrones writer George R.R. The soulslike RPG, brought to life in partnership with Martin, impressed both critics and players.


FromSoftware introduced the first expansion pack for its first-year game. Elden Ring DLC ​​named Shadow of Erdtree was officially announced in the social media post. The tweet in question read, "Tarnished, let's stand up and walk together. Shadow of Erdtree, an upcoming expansion for Elden Ring, is currently in development. We hope you look forward to new adventures in Lands Between." statements were included.



When will Elden Ring DLC ​​be released?


No details have been announced about the new story yet, but it is possible to make some inferences from the promotional image. A man with long blond hair sits on a torrent-like mount. The character, which we're not sure about, but presumes to be Fia or Miquella, looks to a distant place in a countryside with spectral figures resembling tombstones.

Some players on social media think that the place in the image may be Haligtree. If that's really it, we're back in one of the wildest parts of The Lands Between. This could also be pointing to the Deathbed Companion, which takes place after Age of the Duskborn ends. Everything we say goes beyond speculation, as there are hardly any details about the DLC that is still in development.



Shadow of Erdtree in development

To predict a release date, we don't expect Elden Ring Shadow of Erdtree to arrive until at least November-December 2023. However, given the depth of the expansion, it wouldn't be surprising if the Elden Ring DLC ​​is out in the first months of 2024. We will likely see an expansion that follows in the footsteps of the story in the main game.

Lassa Fever

lassa fever infographics


What is Lassa Fever?

Lassa fever is an acute viral disease of rodent origin. It is transmitted to humans through contact with food and objects contaminated with rodent urine or feces. The virus is called Lassa after the first case was encountered in Lassa, Nigeria. According to sources, the first case occurred in 1969. Although Lassa fever is known to be endemic in West African countries such as Ghana, Guinea, Mali, Benin, Liberia, Sierra Leone, Togo and Nigeria, it is also thought to exist in other West African countries.


Diagnosis of the disease is important for early treatment. According to the World Health Organization (WHO) data, 80% of people exposed to Lassa virus do not have any symptoms. In addition, the virus seriously affects various organs such as the liver, spleen and kidney in 1 out of every 5 infections.


Where and when was Lassa fever first seen?

Lassa virus was discovered in 1969 after the death of two nurses working in Lassa, Nigeria.


How Is Lassa Fever Transmitted?

Lassa fever is a disease transmitted from animals to humans. It is a rodent known as Mastomys natalensis that carries the Lassa virus. Their frequent reproduction and easy settlement in living areas affect the rate of spread of the virus. Lassa virus is transmitted to humans through respiration and food. In addition, consuming these animals also causes the transmission of the disease.
Person-to-person transmission of the disease is also possible. Especially in cases where the necessary hygiene is not provided in health care equipment, the risk of transmission is high.


How Long Is the Incubation Period of Lassa Fever?

The incubation period of the disease varies between 6-21 days.


What Are the Symptoms of Lassa Fever?

Lassa virus usually presents with mild symptoms such as fever and headache. However, some people also experience significant symptoms such as bleeding and difficulty breathing. If we list the symptoms of the disease as follows:

  • slight fever
  • Weakness
  • Headache

Lassa fever produces more severe symptoms in about 20% of cases.

  • Bleeding in places such as the gums, eyes, or nose
  • difficulty breathing
  • severe vomiting
  • facial swelling
  • Pain in the chest, back and abdomen


How Is Lassa Fever Diagnosed?


In the early stage of Lassa fever, the disease is diagnosed with a swab taken from the person. Blood test also has an important place in the diagnosis of the disease.


How Is Lassa Fever Treated? Is There a Vaccine for Lassa Fever?

An antiviral drug is given for treatment. There is no vaccine yet for the treatment of Lassa fever.


Who is at Risk for Lassa Fever?

Visitors to countries in West Africa have a higher incidence of the disease than people living in countries outside the continent. If you are going to these countries, you can reduce the risk of transmission by following the safety precautions below. 

  •  Storing food in rodent-proof containers
  •  Paying attention to the cleanliness of the accommodation 
  •  Avoiding contact with rodents

28 Şubat 2023 Salı

Nonalcoholic fatty liver disease (NAFLD)

 

Nonalcoholic fatty liver disease



It is a disease caused by the accumulation of more than normal fat in the liver, in this disease the cause of excessive fat accumulation in the liver is not alcohol.


One of the variants of non-alcoholic fatty liver disease is NASH. NASH siroza ilerleyebilen bir hastalık olduğundan çok daha önemlidir.


What is NASH?


More than normal fat accumulation in the liver can be seen alone or together with inflammation (inflammation). If fatty liver is accompanied by inflammation, this disease is called NASH. NASH is actually the severe type of fatty liver disease. The name NASH is given by using the initials of the words Non-Alcoholic SteatoHepatitis. 'Steato' means fat, and 'hepatitis' means inflammation of the liver. In NASH disease, fat in your liver and hepatitis are associated with liver cell damage, which can lead to the formation of scar tissue in the liver, which we call fibrosis, over time. In NASH disease, cirrhosis occurs when this scar increases in parallel with the damage over the years. NASH is therefore a disease that can lead to cirrhosis and liver cancer.


What are the symptoms of fatty liver disease?

Fatty liver disease or NASH usually causes no symptoms. Rarely, it may cause weakness, feeling unwell, restlessness, fullness or mild pain in the upper right part of the abdomen. The cause of the pain here is the enlargement of the liver with excessive accumulation of fat in the liver, stretching the liver capsule. Symptoms usually appear years after cirrhosis develops, so NASH is considered an insidious disease. In advanced stages of cirrhosis, symptoms such as swelling, enlargement of the spleen, yellowing of the eyes, redness of the palms, shedding of chest hair in men and breast enlargement can be seen due to fluid accumulation in the abdomen.


Is fatty liver disease a serious disease?

Since fatty liver disease is a disease that can lead to cirrhosis, it is a disease that should definitely be taken seriously. Fortunately, we know that at least 80% of those with fatty liver do not develop any serious health problems. However, in 10-20% of cases, non-alcoholic steatohepatitis (NASH), a severe form of the disease, which occurs with inflammation of liver cells, may develop. NASH is more likely to occur in patients with fatty liver detected on ultrasound and elevated liver tests. NASH can lead to potentially fatal diseases such as irreversible liver damage, cirrhosis and even liver cancer. In the past, we could not find the cause of cirrhosis in a significant number of patients who were diagnosed with cirrhosis. Today, it has been understood that the most important cause of cirrhosis in these patients is fatty liver disease. If NASH has caused cirrhosis and cirrhosis has progressed to liver failure, a liver transplant may be needed to survive.

Cheetah

 

cheetah



Cheetah is a member of the feline family and is known to run faster than other mammals. Today, the majority of the species lives in Southern and Eastern Africa. A very small community also lives in the Khorasan region of Iran. Hunting cheetahs are seen in miniatures depicting hunting scenes of 15th, 16th and 17th centuries Sultans. He has spots on his body and black lines that go from under his eyes to his mouth and chin. These lines attract the sun's rays and thus, unlike other predators, they can hunt with a more comfortable sight even in the hottest hours of the day. It is the fastest running land animal in the world. Its name comes from the Sanskrit word "Chitraka" meaning spotted.

It is an animal that hunts by taking advantage of its high speed, instead of hunting in packs or hiding like lions. It can accelerate from zero to 108 km/h in just 3.1 seconds. When he runs more than 460 meters, his body temperature rises above 46 degrees, which can damage the cheetah's brain. That's why its run while hunting is usually less than a minute. Experts consider that there are less than 10,000 wild cheetahs in the world.


Female cheetahs reach puberty at the age of twenty to twenty-four months. Male cheetahs, on the other hand, reach this stage at the age of twelve months. In contrast, sexual intercourse rarely occurs before the age of three. The mortality rate in cheetah cubs is 90%. They are often attacked by hyenas and eagles. Cubs are usually separated from their mothers at 13-20 months of age. Although cheetahs can live longer than 20 years, they often live shorter because of their speed, which decreases with age.


Although cheetahs run fast, they only succeed in half of their hunting attempts. Cheetahs owe their fast running ability to their light, thin bones. For this reason, it has been seen that while cheetahs eat their prey in one place, if predators such as lions and hyenas come, they withdraw from that area and leave their prey there. Because hyenas have very strong jaws. The thin bones of the cheetah are more vulnerable to strong jaws. One of the reasons cheetahs run fast is because their tails are long. For cheetahs, the tail also helps during running. Cheetahs prey on herbivores such as gazelles and impalas. However, gazelles and impalas are the fastest maneuvering animals in the world. Despite their high speed, cheetahs can make sharp turns by using their tails as a rudder. When cheetahs reach maximum speed, the distance between each step can reach about 15 meters. These long strides are a factor that gives them speed.





27 Şubat 2023 Pazartesi

Shigella








It is a member of the Enterobacteriaceae family. It is a gram negative, non-motile, non-sporeless, non-encapsulated, facultative anaerobic, oxidative and fermentative metabolism bacillus that is pathogenic for humans. Bacteria of the genus Shigella (O) are divided into groups as A, B, C, D according to their somatic antigen structures and their effects on mannitol. These groups are; S. dysenteriae, S. flexneri, S. boydii, S. sonnei.

Mannit Negative Shigella s S. dysenteriae (Serogroup A)

Serovar A1 (S. dysenteriae = Shiga bacillus)

Serovar A2 (S. schmitzii)

Serovars A3-7 (in S. arabinotar)

Serovars A8-12

Mannit Positive Shigella s S. flexneri (Serogroup B, serovars; B 1-6,X, Y)

S. boydii (Serogroup C, serovar; C 1-18)

S. sonnei (Serogroup D, serovar; D)

Although Shigella are immobile, movement is seen only in Shigella flexneri with Type-1 fimbria. Shigella are distinguished from Salmonella by being inactive. They make bacteriocin (colisine), which acts on other gut bacteria. When the bacteria is lysed, the somatic antigen (O) is released, which is in lipoprotein structure and has endotoxin properties. Of the Shigella, only Shigella dysenteriae secretes exotoxin to the environment. Shigellas cause edema, profuse mucus secretion, abscesses and ulcerations in the large intestinal mucosal epithelium. While these bacteria can survive for a long time in watery, moist and sunless environments, they are not resistant to high heat, sunlight and antiseptics.


Its Diseases

Shigella bacterium appears with the appearance of abdominal pain, nasal congestion and bloody diarrhea after 12 hours or 2-6 days of incubation period after ingestion with food and drink. If Shigella is isolated with these findings, this disease is called Bacillary Dysentery.


Epidemiology and Prevention

Since the host of Basil Dysentery is human, preventive methods should be applied for people who are sick and carriers. For this; faeces and other wastes should be disposed of in appropriate sewer systems, drinking and utility water should be clean and controlled, food and beverages should be prepared in accordance with health conditions, porters (carriers) should be identified and treated, and they should not be employed in food-prepared sections.


Cure

It is done on antibiotics. Sick people need to be fed in a way to relieve pain and prevent water and electrolyte loss.

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