Objective:To assess the anxiety and depression status of women with hyperemesis gravidarum (HG); the risk factors for developing both depression and anxiety in women with HG were evaluated.Materials and Methods:A total of 200 women, 100 diagnosed as having HG before the 20th week of gestation at a tertiary referral center and 100 gestational-age-matched controls were enrolled. The socio-demographic data and the depression and anxiety scores, as assessed using the Beck depression and anxiety inventory were compared between the two groups.Results:The median depression and anxiety scores were significantly higher in the HG group compared with controls (19.5 vs. 9.0 and 22.0 vs. 10.0). Women with HG have the highest relative risks for moderate depression and severe anxiety [relative risk (RR): 16.88 and RR: 20.50, respectively]. In the univariate analysis, having HG, low education level, low income and poor social relationships were significant predictors of depression and having HG. Moreover, poor social relationships significantly predicted the presence of anxiety disorder. However, having HG and poor social relationships were found as the only independent predictors of both depression and anxiety. Patients with HG were 5.5 and 6.7 times more prone to having depression and anxiety disorder compared with controls, respectively.Conclusion:Both depression and anxiety disorder were more frequent in women with HG who have weak family and social relationships, lower education and income levels. Therefore, the determination of the psychological status of women with HG should be an integral part of the evaluation.
SubjectiveThe aim of the present study was to investigate the prognostic significance of preoperative complete blood count inflammatory markers in women operated for invasive Epithelial Ovarian Cancer (EOC).MethodTwo hundred forty four patients that underwent operation with the diagnosis of invasive EOC between 2006 and 2014 were included in the study. The date of operation, date of recurrence and final mortality evaluations were performed for survival analysis. The sensitivity, specificity, PPV and NPV were separately calculated with ROC analysis. Survival analysis was carried out with Kaplan Meier-Log Rank Method.ResultsFive-years overall survival rate was 56, 9% and 5-year disease-free survival (DFS) rate was 45,5%. Advanced disease stage, moderate-poor tumor differentiation, and the presence of recurrence were determined to have significant inverse relation at mean survival and 5-year survival rates. Neutrophil/lymphocyte ratio (NLR) and Platelet lymphocyte ratio (PLR) had prognostic effect on both DFS and overall survival based upon the cut-off values determined in the study (PLR = 231, s36, NLR = 3,83). Histopathological subtypes were not found to have any prognostic value. In correlation analysis, PLR and NLR had positive correlation with each other and negative correlation with overall survival.ConclusionsInflammatory markers such as NLR and PLR have independent prognostic value for women who undergo surgery for invasive EOC.
Background: It is estimated that 41, 8% of pregnant women worldwide are anemic. At least half of this burden is assumed to be due to iron deficiency. Although iron deficiency anemia is very common in pregnancy, there has been limited research investigating glycosylated hemoglobin (HBA1c) levels in nondiabetic anaemic pregnant women and the effect of iron supplementation on HbA1c levels. We aimed to investigate HBA1c level changes in anemic pregnant women after anemia is corrected and to evaluate the relation of HBA1c with haemoglobin, haematocrit, ferritin and red blood cell indices. Materials and methods: Thirty seven pregnant women (16-30 weeks into their pregnancies) who had been diagnosed as having iron deficiency anemia (IDA) were enrolled in the study. IDA was corrected with iron supplementation. Haemoglobin, haematocrit, ferritin and red blood cell indices were analysed prior to and following (1 month) iron replacement therapy. Results: HBA1c values significantly decreased after iron supplementation when compared to those in a pre-supplementation state (5.01 ± 0.39 vs. 4.69 ± 0.38).
Aim: To investigate the effectiveness of myo-inositol and D-chiro-inositol (MI:DCI) (40:1) treatment in normal-weight polycystic ovary syndrome (PCOS) patients without insulin resistance. Methods: This retrospective case-control study included PCOS patients without insulin resistance who were diagnosed in the gynecology and obstetrics clinic of Bas¸kent University Konya Practice and Research Hospital between January 2016 and October 2019 and received at least 6 months of MI:DCI (40:1) treatment. The patients were divided into two groups according to body mass index (BMI). Twenty-nine anovulatory patients without insulin resistance with a BMI of 18-25 were included in group 1 (normal-weight group), whereas 17 patients without insulin resistance with BMI > 25 were included in group 2 (obese/overweight group). Ovulation status of both groups was compared after MI:DCI treatment. Results: Ovulation was detected in 23 of 29 patients in the normal-weight group, whereas it was detected only in 5 of 17 patients in the obese/overweight group; this difference was statistically significant (P < 0.001) (Table 2, Figure 1). Post-treatment progesterone levels of both groups were compared and in the normal-weight PCOS group was significantly higher than the obese/overweight group (P < 0.001) (Table 2, Figure 2). In addition, spontaneous pregnancy following treatment was observed in six of the seven (85.7%) patients in the normal-weight group who wanted to conceive, whereas it was observed in only two of the six (33.3%) patients in the obese/overweight group who wanted to conceive. Conclusion: Our results showed that MI:DCI (40:1) treatment may be a first-line treatment in normal-weight PCOS patients without insulin resistance.
Objective:To compare the accuracy of clinical and ultrasonographic (USG) estimation of fetal weight in non-complicated, term pregnancies.Materials and Methods:Two hundred term pregnant women were included in the study. We used three formulae for the estimation of fetal weight at term; the Hadlock formula for the USG method, and two different formulas for clinical methods, maternal symphysis-fundal height and abdominal circumference at the level of umbilicus. Accuracy was determined by mean percentage error, mean absolute percentage error and proportion of estimates within 10% of actual birth weight (birth weight ±10%). Patients were divided into two groups according to actual birth weight, the normal birth weight group (2500-3999 g) and high birth weight group (≥4000 g).Results:All three methods statistically overestimated birth weight for the high and normal birth weight groups (p<0.001, p=1.000, p=0.233) (p=0.037, p<0.001, and p<0.001). For both groups, the mean absolute percentage errors of USG were smaller than for the other two clinical methods and the number of estimates were within 10% of actual birth weight for USG was greater than for the clinical methods; the differences were statistically significant (p<0.001). No statistically significant difference of accuracy was observed for all three methods for the high birth weight group (p=0.365, p=0.768, and p=0.540). However, USG systematically underestimated birth weight in this group.Conclusion:For estimation of fetal birth weight in term pregnancies, ultrasonography is better than clinical methods. In the suspicion of macrosomia, it must be remembered that no method is better than any other. In addition, if ultrasonography is used, careful management is recommended because ultrasonography overestimates in this group.
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