Our study did not demonstrate a difference in pain perception among second trimester pregnancy termination cases using acetaminophen, diclofenac and HnBB.
Aim: COVID-19 pandemic causes stress between individuals, and this stress can affect the quality of couples' sexual relationships. This study aimed to examine the quality of women's sexual life during the COVID-19 pandemic. Material and Method: This prospective cross-sectional study was conducted at May-June 2020. 235 sexually active women aged 18 to 51 years participated in this study. The Female Sexual Function Index (FSFI) was used to examine women's sexuality from six different perspectives: desire, arousal, lubrication, orgasm, satisfaction, and pain. Due to quarantine restrictions, questionnaires were emailed to participants. Results: The participants' age range was 18 to 51, with an average of 29.6±6.08 years. The total FSFI score with a minimum of 1 and a maximum of 26.75 had an average of 18.12±6.23. Since the cut-off value for female sexual dysfunction is 26.0, it can be concluded that, on average, participants had poor function and quality of sexual intercourse in the previous four weeks during the lockdown. The values of the FSFI score were significantly different according to the age of the woman (p-value=0.003), the age of the man (p-value=0.005), and duration of marriage (p-value=0.006). The woman's age (Sig.=0.008), the man's age (Sig.=0.004), and duration of marriage (Sig.=0.02) had a significant and negative correlation with the total FSFI score. Conclusion:This study showed that the COVID-19 pandemic and lockdown reduced women's sex life quality. Our results also show that the older women and men are, the lower their sexual satisfaction will be, which may be due to the higher risk of COVID-19 for the elderly.
This study aimed to elucidate the diagnostic process, the associated anomalies and the perinatal outcomes of right aortic arch (RAA) in a group of low-risk patients. The obstetric imaging database and digital patient files were reviewed between January 2015 and June 2016. There were 12 RAA cases detected prenatally. Seven foetuses had an aberrant left subclavian artery and one foetus had mirror image branching. The prevalence of RAA was 1.8 in 1000. Invasive prenatal diagnosis was offered to patients and seven tests were performed. There was one associated cardiac anomaly (8.3%) and one extra-cardiac anomaly (8.3%) in the same foetus which cordocentesis revealed trisomy 21. There were also two 22q11.2 microdeletion cases with isolated RAA with aberrant left subclavian arteries. All patients have given live births except one patient has chosen a termination of pregnancy for 22q11.2 microdeletion. The median follow-up time of the newborns was 21 months. None of the babies required surgery for RAA during follow-up. All the babies are alive, except for the one with trisomy 21, who dead at 5 months due to the surgical complications of an oesophageal atresia operation. Patients with an RAA foetus should be offered for foetal karyotyping and analysis for 22q11.2 microdeletion. When isolated, RAA has usually a good prognosis and rarely requires cardiac surgery. Impact Statement What is already known on this subject? Prenatal diagnosis of RAA should prompt a detailed cardiac and extra-cardiac ultrasound examination. When isolated, RAA is associated with 22q11 deletion and aneuploidies in 4.6% and 5.1%, of cases respectively. What the results of this study add? Our study showed that 28.5% of isolated RAA cases are associated with 22q11.2 microdeletion. Cardiac surgery is rarely required when RAA is an isolated anomaly. What the implications are of these findings for clinical practice and/or further research? Invasive prenatal testing for karyotypes and 22q11.2 microdeletion should be offered to patients with RAA, even in the case of an isolated one. Further larger studies are needed to confirm this finding.
ÖZAmaç: Peripartum histerektomi sıklığı tüm dünyada giderek artmakta olan, obstetrik kanamaların tedavisinde son basamak olarak uygulanan hayat kurtarıcı bir cerrahi müdahaledir. Özellikle artan sezaryen hızları ile birlikte gelişen plasental anomaliler (plasenta previa ve invazyon anomalileri) peripartum histerektominin önemini artırmaktadır.Çalışmanın amacı, peripartum histerektominin bir üniversite kliniğindeki risk faktörlerini, insidansını endikasyonlarını, yönetim stratejilerini ve komplikasyonlarını incelemektir. Gereç ve Yöntemler:Bu retrospektif çalışmaya Mart 1997 ile Mart 2017 tarihleri arasında kliniğimizde doğum sonrası ilk 24 saat içinde peripartum histerektomi yapılan olguları dahil edilmiştir. Olguların demografik verileri, plasental anomali varlığı, histerektomi endikasyonları, yapıldı ise histerektomiye ek cerrahi müdahaleler, intraoperatif komplikasyonlar, transfüzyon ihtiyacı, verilen kan ürünü tipleri ve miktarları ile maternal ve perinatal mortaliteleri incelenmiştir. Bulgular:Kliniğimizde 20 yıl içinde 23 peripartum histerektomi yapılmış olup bu müdahale ‰ 1,7 sıklıkla uygulanmıştır. Peripartum histerektomi endikasyonları arasında en sık olarak plasenta invazyon anomalileri (n=8; %34,8), ikinci en sık olarak ise uterin atoni (n=7; %30,4) olarak yer almaktaydı. Plasental anomalilerin (plasenta previa ve invazyon anomalileri) toplam oranı %52,17 olarak tespit edilmişti. Hastaların tamamına eritrosit süspansiyonu verilmiş olup verilen ortalama eritrosit süspan-siyonu miktarı 11,52 (± 9,27) ünitedir. Perinatal mortalite hızı ‰ 120 iken maternal mortalite hızı ‰ 4,3 (n=1) olarak tespit edilmiştir.Sonuç: Çalışma plasental anomalilere (plasenta previa ve invazyon anomalileri) bağlı peripartum histerektomi sıklığının giderek artığını göstermektedir. Bu nedenle bu problemlerin antenatal dönemde tanısının konması ve bu hastaların doğum yönetiminin tecrübeli bir ekip tarafından multidisipliner yaklaşımla yapılması gerekmektedir.Anahtar Sözcükler: Peripartum histerektomi, Obstetrik kanama, Plasenta akreata, Uterin atoni, Plasenta previa ABSTRACT Objective: Peripartum hysterectomy is a lifesaving procedure that is performed as the last step in the management of massive obstetric hemorrhage. Its incidence is increasing worldwide. Placental abnormalities that are associated with high cesarean rates are of utmost importance in the concept of peripartum hysterectomy.The purpose of this study was to elucidate the risk factors, incidence indications, management strategies and complications of peripartum hysterectomy in a university setting. Material and Methods:This retrospective study included the patients who gave birth and underwent hysterectomy in the 24h after delivery at our clinic between March 1997 and March 2017. Demographic characteristics, the presence of placental abnormalities, indications of hysterectomy, surgical interventions other than hysterectomy, intraoperative complications, need of transfusion, types and amount of transfused blood products, and perinatal and maternal mortality were exam...
ÖZET: Amaç:Adölesan dönemde pelvik kitle ile başvuran imperfore himen olgusu sunumu Bulgular: İmperfore himen nedenli hematokolpos gelişmiş bir adölesan kız olgusu sunuldu. Bizim olgumuzda alt kadran ağrısı ve pelvik kitlenin primer amenore ile birlikte eş zamanlı görülebildiği gösterildi. Himenotomi sonrası annuler halka tarzında himen şeklinde restore edildi. Sonuç: Pelvik kitle ile başvuran primer amenoreik adölesanlarda altta yatan imperfore himen olasılığı göz önünde bulundurulmalıdır. ANAHTAR KELIMELER: Adolesan, Hematokolpos, İmperfore himen, Primer amenore SUMMARY: Study objective: To document an unusual cause of abdominal pain and pelvic mass in premenarcheal adolescent girl.Results: The case of hematocolpos in adolescent girl due to imperforate himen was reported. Our case manifested lower abdominal pain and pelvic mass concomittant with primary amenorrhea. Himenotomy was performed and the annular himen ring was restorated.Conclusion: We should bear in mind the probability of imperforated himen in primarily amenorrheic premenarcheal girls presented with abdominal mass
AMAÇ: Bu çalışmada, smear sonucu düşük dereceli servikal intraepitelyal lezyon (LSIL), yüksek dereceli servikal intraepiteliyal lezyon (HSIL), önemi belirsiz tipik olmayan yassı hücreler (ASCUS) tespit edilen, servikal muayenede erzoyon saptanan hastalar ve yapılan human papilloma virüs (HPV) testi pozitif olan takiben kolposkopik biyopsi uygulanan hastalarımızda HPV, smear ve biyopsi sonuçları karşılaştırılması amaçlanmıştır.GEREÇ VE YÖNTEM: Toplamda çalışma grubu olarak 186 hasta dahil edildi. Hastalardan alınan servikal smearlar değerlendirildi. Servikal smear sonucu; ASCUS, LSIL ve HSIL, olan hastalar ile HPV pozitif hastalar kolposkopiye yönlendirildi. HPV tiplerinden 16, 18, 31 ve 33 olanları yüksek riskli, diğerlerini düşük riskli olarak gruplandırdık. Buna göre HPV, smear ve biyopsi sonuçları karşılaştırıldı.BULGULAR: Çalışmaya dahil edilen 186 hastanın 74’ü (%39,7) menopozdaydı. Kolposkopi yapılan hastaların 103’ünde (%55,3) HPV testi sonucu pozitif saptanması nedenli kolposkopi yapıldı. Bu hastaların 82’si yüksek riskli HPV grubundaydı. ASCUS nedenli 35 (%18,8) olguya, servikal erozyon nedenli 33 hastaya (%17,7), LSIL nedenli 12 hastaya (%6,5) HSIL nedenli 3 hastaya (%1,6) kolposkopi yapıldı. Kolposkopi yapılan hastaların alınan biyopsilerinin patoloji sonuçlarına bakacak olursak 134’ü (%72) benign olarak geldi. Smear sonucu malignite izlenmedi olarak gelen 121 hastanın kolposkopik biyopsi sonuçları değerlendirildiğinde 19 hastada CIN1 (%15,7), 6 hastada CIN2(%5), 2 hastada CIN3(%1,7) saptandı. Smear sonucuna göre LSIL gelen hastaların %25’inde ileri düzeyde epitelyal anomali (CIN 2 ve 3) gözlenirken, HSIL olan hastalarda bu oran %50 olarak tespit edilmiştir. HPV tipleri ile kolposkopik biyopsi sonuçları karşılaştırıldığında yüksek riskli HPV tipleri ile %37,8 oranında CIN 1, 2 ve 3 tespit edilirken, düşük riskli grupta bu oran %9,5 olarak bulunmuştur (p<0.016).SONUÇ: Smear tarama testi olarak kullanılmalıdır ve LSIL veya HSIL varlığında mutlaka kolposkopik biyopsi ile tanının doğrulanması gereklidir. Ayrıca özellikle yüksek riskli HPV tiplerinin pozitifliği tespit edilen olgularda smear sonucundan bağımsız olarak da kolposkopik biyopsinin önemi anlaşılmaktadır.
Objective: The aim of this study was to evaluate the incidence of total laparoscopic hysterectomy (TLH) in our clinic during the first 6 months and the last 6 months by a single surgeon. Material and Methods: Eighty-one patients who underwent TLH between January 2016 and December 2016 due to benign diseases were evaluated retrospectively using age, parity, BMI, indications, length of hospitalization, blood loss, and duration of operation time. The cases were examined in 2 groups as the first 6 months (Group 1) and the last 6 months (Group 2). Analysis of the data was done using t test.
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