Background: Tramadol, a synthetic opioid analgesic, is associated with reproductive toxicity and testicular oxidative damage following prolonged exposure. Amaranthus viridis (green amaranth), a medicinally valued tropical vegetable, possesses antioxidant and anti-inflammatory properties that may offer protective effects. This study investigated the protective potential of Amaranthus viridis leaf extract against tramadol-induced testicular toxicity in adult male Wistar rats, focusing on oxidative stress biomarkers, reproductive hormones, and inflammatory cytokines. Method: Twenty-five adult male Wistar rats were randomly assigned into five groups (n=5). Group 1 received distilled water (control); Group 2 received 200 mg/kg tramadol (toxic control); Groups 3, 4, and 5 were administered combined doses of tramadol (150, 100, and 50 mg/kg, respectively) and Amaranthus viridis extract (100, 200, and 300 mg/kg, respectively) for 21 days via oral gavage. Testicular tissues and serum samples were evaluated for histology, oxidative stress markers (SOD, GPx, MDA), reproductive hormones (LH, FSH, testosterone), and inflammatory cytokines (IL-1, IL-6, TNF-α, TNF-β). Results: Tramadol administration significantly disrupted testicular histoarchitecture and caused a marked reduction in LH, FSH, testosterone, SOD, and GPx levels, along with elevated MDA and TNF-β levels (p<0.05). Co-treatment with A. viridis extract, especially at 300 mg/kg, significantly restored LH, FSH, testosterone, SOD, and GPx levels and suppressed TNF-β expression, although MDA levels remained elevated. Histologically, A. viridis treatment attenuated germ cell necrosis and improved seminiferous tubule integrity. Conclusion: A. viridis extract demonstrated a dose-dependent protective effect against tramadol-induced testicular toxicity by enhancing antioxidant defenses, restoring hormonal balance, and suppressing proinflammatory cytokines-highlighting its therapeutic potential in male reproductive health.
Papillon–Lefèvre syndrome (PLS) is a rare autosomal recessive genodermatosis caused by pathogenic variants in the CTSC gene. The condition is characterized by the coexistence of palmoplantar keratoderma and early-onset, rapidly progressive periodontitis. Here, we present a 21-year-old female patient in whom a previously unreported homozygous CTSC variant, c.872G>A, was identified.Since childhood, the patient had marked hyperkeratosis on the palmoplantar regions, early tooth loss, and the need for oral prostheses. A family history of individuals with similar dermatologic features and consanguinity between the parents supported an autosomal recessive inheritance pattern. The identified variant was evaluated in conjunction with the clinical phenotype and was classified as likely pathogenic according to the American College of Medical Genetics and Genomics (ACMG) criteria.Systemic retinoid therapy was recommended but could not be initiated due to patient preference. This case contributes to the expanding genetic spectrum of PLS and highlights the crucial importance of early diagnosis, a multidisciplinary approach, and treatment adherence in determining disease prognosis.
Effective communication in neonatal intensive care units (NICUs) is central to Family-Centered Care (FCC), shaping how parents understand their infant’s condition, engage in shared decision-making, and form therapeutic partnerships with the healthcare team. Grounded in communication theory, this narrative review explores the triadic interaction among families, healthcare professionals, and infants, emphasizing how information exchange, relational communication, and emotional attunement influence clinical processes and parental experiences. The review synthesizes international and national literature to highlight recurrent communication challenges, including fragmented information flow, limited parental inclusion in care discussions, and variability in professional communication skills. Drawing on FCC principles, we identify evidence-based strategies that strengthen communication effectiveness, such as structured communication tools, routine family meetings, digital information platforms, parent-reported experience measures, and nurse-led relational support. These interventions enhance parental empowerment, reduce anxiety, and contribute to improved continuity and quality of care. The Turkish NICU context is also considered, underscoring the cultural and systemic factors that shape family engagement and communication expectations. Overall, this review demonstrates that communication is not merely a clinical task but a relational process that underpins FCC and supports the emotional well-being of families navigating the NICU environment. Strengthening communication pathways can promote safer, more collaborative, and developmentally supportive neonatal care.
Objective: Although magnesium (Mg) is integral to numerous metabolic and immunological processes, its influence in Hashimoto’s thyroiditis (HT) has not been fully elucidated. The present study sought to examine the effects of oral Mg supplementation on thyroid function and thyroid autoantibody in hypomagnesemic, euthyroid individuals with HT who were receiving a stable levothyroxine (LT4) regimen.Methods: In this retrospective observational analysis, adult patients with HT who were euthyroid and had documented hypomagnesemia were evaluated after receiving oral Mg supplementation for a minimum of two months, during which LT4 dosing remained unchanged. Serum thyroid-stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG), and Mg levels were measured both prior to and following supplementation. Pre- and post-treatment values were compared using paired statistical methods.Results: A total of 45 patients (82% female, mean age 49.3 ± 15.7 years) were analyzed. All patients received oral Mg oxide equivalent to 365 mg elemental Mg daily. After two months of Mg supplementation, serum Mg levels increased significantly (p = 0.04). Serum TSH levels also showed a statistically significant increase (p = 0.03), while remaining within the euthyroid range. No significant changes were observed in fT4, fT3, anti-TPO, or anti-TG titers.Conclusion: In hypomagnesemic euthyroid patients with HT on stable LT4 therapy, short-term Mg supplementation was associated with a modest but significant increase in TSH without alterations in thyroid hormone levels or autoantibody titers. These findings suggest that Mg replacement may influence biochemical thyroid regulation without short-term effects on thyroid autoimmunity.
Cafe coronary syndrome is a term used to describe cases of sudden death during a meal in healthy individuals without any asphyxia, respiratory distress or neurologic symptoms. It is usually fatal without timely intervention. The causative factor in café coronary syndrome is almost always food. In most cases, predisposing factors such as fast eating, alcohol consumption, underlying neurologic diseases or senility are observed. In this case report, we aimed to present a case who was found dead alone in his home and autopsy revealed Cade coronary syndrome with food in the respiratory tract and to make a forensic and clinical evaluation.
