Single fetal death in a twin pregnancy in the late second or early third trimester is associated with significant morbidity and mortality rate in the surviving co-twin, especially in monochorionic twin pregnancies. The common causes are twin-to-twin transfusion syndrome, chromosomal abnormalities, and congenital anomalies of the fetus or anomalies of the umbilical cord-placenta. Here we report a case of monochorionic twin pregnancy in which one fetus had a single umbilical artery (SUA) while the co-twin had two umbilical arteries. The twin with SUA died in utero at the 30th week of gestation and the other fetus was delivered by cesarean section immediately due to fetal distress diagnosed by cardiotocography. Disseminated intravascular coagulation and multicystic encephalomalacia have been observed in the surviving neonate. This case and review of the literature suggest that neurologic complication rates are also increased in monochorionic twin pregnancies with single fetal demise despite the immediate delivery as in our case.

Aim: This study was conducted to investigate the association between internet addiction(IA), and social skills and loneliness levels in junior high school students and to determine the factors affecting their IA levels. Method: The population of the study consisted of students attending junior high schools in Kirklareli, in the 2017-2018 academic year(N=10,682).After minimum sample size was calculated as 668, 693 students were reached. In the study, the Internet Addiction Scale(IAS), Matson Evaluation and Social Skills with Youngsters(MESSY) and Children's Loneliness Scale(CLS) were used to collect the study data. Results: Of the students, 13.5% were moderate, 1.5% were severe internet addicts. The results of the adjusted Multivariate Linear Regression analysis indicated that while there was a positive association between IAS scores and the scores for the NegativeMESSY(β:0.345, 95%CI:0.252;0.439,p<0.001) and CLS(β:0.169, 95%CI:0.050;0.288,p0.05).The risk of IA was high in the male gender, >12 years of age, those who perceive their academic success poorly, whose monthly household income was >3000₺/500$ and those who do not have parental control in internet use(p<0.05). Conclusion: The students’ IA levels are affected by their socio-demographic and internet usage characteristics. Their levels of negative social skills and loneliness increase as their IA level increase.

OBJECTIVE: Implementation of strategies to prevent vertical transmission is highly important steps in reducing the global burden of chronic hepatitis B. We conducted this prospective study to observe the clinical course and outcomes of untreated and treated HBV in pregnant.STUDY DESIGN: HBsAg-positive pregnants were prospectively enrolled from 2013 to 2016 and antiviral therapy was administered to eligible patients. Pregnancy and neonatal outcomes were determined in the treated (n=29) and untreated group (n=136). Active-passive immunoprophylaxis was administered to infants and they were tested for HBsAg.RESULTS: The risk factors for transmission (HBeAg positivity, history of previously-born HBsAg-positive child) were significantly higher in the treated group. All participants under treatment had sufficient viral suppression. Half of the pregnant women for whom the treatment was withheld at the postpartum period, experienced increased viral load. The treated group had significantly higher pre- and postpartum alanine aminotransferase levels more than the untreated group, although there were no significant differences in other biochemical parameters. There were no significant differences regarding fetal outcomes between the two groups. All infants were HBsAg-negative at seven months postpartum.CONCLUSION: While the untreated group included inactive carriers, there were more patients at risk for transmission of HBV to their offsprings in the treated group. Half of the pregnant women for whom the treatment was withheld at the postpartum period, experienced increased viral load. Antiviral therapy did not adversely affect the outcomes of infants. As a result, we successfully prevented perinatal HBV transmission by close monitoring of participant pregnant women and starting antiviral therapy when needed.