The aim of this study was to quantitatively investigate the antenatal care provided by healthcare physicians in a rural area of North East Anatolia, Turkey, and the effective factors. Patients who applied to a Second-tier health institution for delivery were asked how many times they went for a check-up during their pregnancy. In addition, the sociodemographic characteristics of the responding patients were recorded. In this study, the rate of pregnant women who received inadequate antenatal care was 41.0%. Examining the risk factors for inadequate antenatal care in pregnant women who attended fewer than four antenatal care visits revealed that the risk was 2,115 (confidence interval [CI] = 1.328–3.368) times higher for those receiving spousal education for <5. Longer years than those with ≥6 years of partner training. Pregnant women who received inadequate antenatal care in the North East Anatolia region preferred to visit Secondary and Tertiary healthcare institutions instead of visiting primary care physicians. In conclusion, it is necessary to establish a referral chain through health plans and expand Primary antenatal care services to reduce both maternal and neonatal mortality and morbidity.
Objectives: The rates of vaccination with human papillomavirus (HPV) vaccine, which can prevent many cancers, rank the last place when compared to other childhood vaccination rates. The purpose of the present study was to evaluate the knowledge levels of mothers living in our region about HPV vaccine and their perspectives regarding having the vaccine. Methods: The study was conducted between 15 July and 15 August 2022 in the Department of Obstetrics and Gynecology, Faculty of Medicine, Kafkas University with the mothers of 377 girls. The SPSS 21 program was used and p < 0.05 was accepted as significant. Results: No statistically significant differences were detected between the desire of the mother to have her child vaccinated against HPV and the age of her child (p = 0.740), income level of the household (p = 0.590) and the working status of the mother (p = 0.419). There were statistically significant differences between the desire of the mother to have her daughter vaccinated with HPV, the place where the mother lived (p = 0.001), age of the mother (p = 0.037), family type (p = 0.001), number of people living at home (p = 0.027), education year of the mother (p = 0.004), father’s approval for vaccination (p = 0.001), and mother’s hearing about the Smear Test (p = 0.001). Conclusions: Even if the HPV vaccine is given free of charge, there is resistance in mothers to the vaccine. It is necessary to inform mothers about HPV vaccination for their daughters and to make the vaccination more widespread.
OBJECTIVE: This study aims to investigate the prognostic value of the preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with epithelial ovarian cancer. STUDY DESIGN: Between January 2012 and December 2018, the data and preoperative levels of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio of 116 epithelial ovarian cancer patients were retrospectively collected. The association of these relevant markers with outcomes was analyzed. RESULTS: The difference was observed concerning optimal and suboptimal debulking in platelet-to-lymphocyte ratio ratios (p=0.04). Lymphovascular space involvement was significantly associated with higher platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio ratios (p<0.0001). Patients with ascites and lymph node involvement had a higher platelet-to-lymphocyte ratio ratio (p=0.007 and p=0.004). In recurrences, higher ratios of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio were observed (p=0.03 and p=0.02). The analysis revealed that platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio were not independent prognostic factors for recurrence (p=0.783 and p=0.391). Regarding mortality, platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio were not independently prognostic (p=0.621 and p=0.830). It was determined that neutrophil-to-lymphocyte ratio >2.45 (HR 0.714, CI 0.622-0.794, p<0.0001) and platelet-to-lymphocyte ratio >179.4 (HR 0.736, CI 0.646-0.814, p<0.0001) could predict the presence of recurrence with a certain sensitivity and specificity, and for predicting the death, a neutrophil-to-lymphocyte ratio of >2.45 had a sensitivity of 78.26% (95% CI: 56.3 to 92.5%) and a specificity of 54.84% (95%CI: 44.2 - 65.2) (p=0.03). CONCLUSION: The evaluation of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio is important in obtaining prognostic information before surgery. However, no significant association between the neutrophil-to-lymphocyte ratio or platelet-to-lymphocyte ratio with survival was identified.
To evaluate whether tubal sterilization (TS) has an adverse effect on menopausal age in a cohort of postmenopausal women. The medical records on TS were gathered from 1,228 postmenopausal women in menopause clinic at a tertiary hospital. The age at menarche, the parity, smoking and secondhand smoking status and mother’s age at menopause did not show any significant difference between the groups. Likewise, marital status, educational and yearly income levels were comparable (P > 0.01). Although the mean BMI (P = 0.06) and the rate of oral contraceptive use (P = 0.09) were tended to be higher in non-TS women than in TS group, the difference did not reach statistical significance. The ever use of intrauterine device rate was significantly lower in TS group than in non-TS group (P <0.001). The TS women, in comparison with the non-TS women had undergone earlier natural menopause (P <0.001). The age at menopause had an inverse correlation with TS, and positive correlation with mother’s age at menopause in univariate analyses. However, there was marginally significant correlation between secondhand smoking and age at menopause. Linear stepwise regression analyses revealed that TS and mother’s age at menopause were independent predictors of age at menopause (P < 0.05). We found an earlier age at menopause in women with TS in this study. In this regard, this is the first report about the age at menopause in women with TS, as far as we know.
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