Objectives: The aim of our study is the comparison of the results of conventional smear (CC) technique and liquidbased cytology (LBC) technique used as cervical cancer screening methods. Material and methods: Results: When considering the distribution within CC group, the results were as follows: intraepithelial cell abnormalities 2,0% (n=619), insufficient sample for analysis 2,1% (n=660), Atypical squamous cells of undetermined significance (ASC-US) 1.8% (n=554), Low grade squamous intraepithelial lesion (LGSIL) 0.1% (n=35), High grade squamous intraepithelial lesion (HGSIL) 0.1% (n=16), Atypical squamous cells -cannot exclude HGSIL (ASC-H) 0.029% (n=9), Atypical glandular cells-not other wise specified (AGC-NOS) 0.012% (n=4), squamous carcinoma 0.003% (n=1). When considering the distribution in LBC group, the results were as follows: intraepithelial cell abnormalities2.1% (n=357), insufficient sample for analysis 0.9% (n=144), ASC-US 1.8% (n=296), LGSIL 0.2% (n=38), HGSIL 0.1% (n=8), ASC-H 0.1% (n=10), AGC-NOS 0.017% (n=3), squamous carcinoma 0.011% (n=2). Conclusions
Background To date, only a limited number of studies have evaluated the importance of abdominal subcutaneous fat thickness (ASFT) on gestational diabetes mellitus (GDM) screening. The aim of this study was to investigate the effectiveness of ASFT measurement during routine obstetric ultrasound performed between 24 and 28 weeks of gestation in predicting cases with GDM. Methods This prospective comparative study was conducted on 50 cases with GDM and 50 cases without GDM in the GDM screening program at 24–28 gestational weeks between January 2018 and May 2018. The most accurate ASFT cut-off point values were determined for the prediction of cases with GDM by performing receiver operator characteristic (ROC) curve analysis. Results The ASFT was higher in those with GDM compared to those without GDM (P < 0.05). For an ASFT cut-off point value of 18.1 mm for the prediction of cases with GDM, the sensitivity, specificity, negative and positive predictive values were 72.0%, 60.0%, 64.2% and 68.1%, respectively. The risk of GDM increased 3.86-fold in those with ASFT level >18.1 mm (P = 0.001). Conclusion The ASFT value measured by routine obstetric ultrasound performed at 24–28 weeks of gestation was found to be significantly higher in patients with GDM in comparison to those without GDM. However, further multi-centered and comprehensive prospective studies are required to better demonstrate this relationship.
OBJECTIVES:The aim of this study was to compare the obstetric and neonatal outcomes of pregnant women who were screened with one or two-step screening programs for diagnosis of gestational diabetes mellitus. STUDY DESIGN:A retrospective evaluation was made of pregnant women who were screened with one step [75 g oral glucose tolerance test] or two-step screening programs [50 g oral glucose challenge test and 100 g oral glucose tolerance test] depending on the preference of the physician between September 2016 and August 2017. RESULTS:The one-step screening program was applied to 34.1% (n:1358) of the pregnancies and the remaining 65.9% (n=2623) were screened using the two-step program. The following results were obtained for the pregnant women applied with the one and two-step screening programs, respectively; mean age: 29.37±7.6 years and 28.1 ± 6.2 years, gestational diabetes mellitus: 8.8% and 4.8%, preterm birth:5.2% and 6.9%, term birth: 89.8% and 85.5%, post-term birth: 5% and 7.6%, vaginal delivery: 74.8% and 67.5%, caesarean section delivery: 25.2% and 32.5%, birth weight: 3389±432 gr and 3234.1 ± 415.9 gr, and mean 5-minute APGAR score: 9.1 ± 0.4 and 9.2 ± 0.7. Comparisons showed statistically significant differences between the groups. CONCLUSION:The study results showed a significantly higher rate of gestational diabetes mellitus diagnosis for the pregnant women screened with the one-step screening program than the two-step screening program. Although the mean maternal age was significantly higher in the pregnant women screened with the one-step screening program, these pregnancies were observed to have better outcomes (low rates of preterm birth, post-term birth, caesarean delivery and high rates of term birth, vaginal delivery). These results can be attributed to the early referral to a treatment program and follow-up, even though more cases of gestational diabetes mellitus were diagnosed with the one-step screening program.
Objective: This study aimed to investigate how gynecologic oncologists modified their patient management during Coronavirus disease-2019 (COVID-19) in Turkey. Material and Methods: An online survey was sent to gynecologic oncology specialists and fellows in Turkey. It included management questions about strategies for newly diagnosed or recurrent endometrial, cervical, ovarian and vulvar cancer during the pandemic. Participants were asked if treatment of these cancers can be delayed or not and, if yes, the duration of delay. Results: 32.9% of surgeons prescribed oral or intrauterine progesterone for early stage, low-grade endometrial cancer. Conversely, 65.7% and 45.7% of the most surgeons did not change their management for early stage high-grade and advanced stage endometrial cancers respectively, as they perform surgery. 58% and 67.1% of the surgeons continued to prefer standard surgical treatment for microinvasive and early stage cervical cancers, respectively. Radiotherapy was preferred administered with hypofractionated doses for locally advanced cervical cancer (57.1%). While 67.1% of surgeons operated early stage ovarian cancer patients, 50% administered neoadjuvant chemotherapy (NACT) to all advanced stage ovarian cancers and 50% administered more cycles of NACT in preference to interval debulking surgery. 93.7% of the surgeons responded that treatment should not be delayed beyond eight weeks. Conclusion: Most Turkish gynecologic oncologists modified their management of gynecologic cancers due to the COVID-19 pandemic. While chemotherapy was preferred for ovarian cancer, postponement of the surgery, with or without non-surgical options, was considered for early stage, low-grade endometrial cancer. Treatment of gynecologic cancers should be decided on a case by case basis, taking into account local COVID-19 infection rates and availability of health facilities. Prognosis is also an important consideration if delay is contemplated. Standard treatment and normal time-frames should be used if possible. If not, a postponement for a maximum of eight weeks or referral to another center were acceptable alternatives.
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Objectives: We sought to compare the surgical outcomes, safety, effectiveness, and mid-term outcomes in patients who had undergone laparoscopic hysterosacropexy and laparoscopic pectopexy due to apical prolapse. Materials and Methods: This prospective randomized study was conducted on a total of 62 women who underwent apical prolapse surgery (32 undergoing a pectopexy and 30 undergoing a sacrohysteropexy) between June 2015 and June 2017. Patients with symptomatic uterine or vaginal vault prolapse with stage 2 or worse were included in the sudy. Before and after the operation, we used the Pelvic Organ Prolapse Quantification System (POP-Q) and questionnaires, which are the Prolapse Quality of Life Questionnaire (P-QOL) and Female Sexual Function Index (FSFI), to evaluated cases. Baseline characteristics, perioperative and postoperative complications, and follow-up results at 12 months were also evaluated. Results: All domains of POP-Q, P-QOL, and FSFI scores improved significantly after surgery both in pectopexy and sacrohysteropexy group. The postoperative complications of both procedures were similar except for constipation after surgery (3.2% in the pectopexy group and 20% in the hysterosacropexy group [ P = 0.036]). Conclusion: Both sacrohysteropexy and pectopexy are effective surgical options for apical prolapse patients. The pectopexy is an acceptable alternative to laparoscopic sacrohysteropexy because of its less complexity and not reducing pelvic space for the rectum to exist. We suggest that the laparoscopic pectopexy may be widely used in clinical routine.
Öz Amaç: Bu çalışmada; gebelerde, Toxoplasma gondii, Rubella virüs ve Cytomegalovirus infeksiyonlarının bölgemizdeki seroprevalanslarının belirlemesi amaçlanmıştır. Yöntemler: Bu çalışmada hastanemize Eylül 2016 ile Haziran 2018 tarihleri arasında kadın hastalıkları ve doğum polikliniklerine ilk prenatal vizite gelen 18-45 yaş arası gebeler dahil edildi. Bu hastalardan Toxoplasma gondii, Rubella ve Cytomegalovirus virüs serolojisi çalışılanların test sonuçları retrospektif olarak incelendi. Bulgular: Toxoplasma gondii antikorları açısından 8175 hastanın 2853' inde (%34,9) anti toksoplazma gondii IgG antikorları, 91' inde (%1,1) anti Toxoplasma gondii IgM antikorları pozitif olarak saptandı. Cytomegalovirus antikorları açısından 2797 hastanın 2775' inde (%99,2) anti Cytomegalovirus IgG, 20' sinde (%0,7) anti Cytomegalovirus IgM pozitif olarak saptandı. Rubella virüs antikorları açısından 8158 hastanın 7677' sinde (%94,1) anti Rubellavirus IgG, 5' inde (%0,1) anti Rubellavirus IgM pozitif olarak saptandı. Sonuç: Bu çalışmada hastanemize başvuran gebelerin çoğunun toksoplazma seronegatif (%65,1) olduğu tespit edildi. Rubella seroprevalansı (%94,1) Türkiye verileri ile uyumludur. Gebelerin Cytomegalovirus seroprevalansı için seropozitiflik oranı (%99,2) dünya verileri ile uyumludur.
Purpose: The aim of this study was to research the relationship between types of birth and congenital nasolacrimal duct obstruction. Method: The study enrolled 665 infantile patients with prediagnosis of congenital nasolacrimal duct obstruction due to associated ophthalmic symptoms. Age, gender, family history, delivery type, and patient medical records were investigated. Patients were grouped and compared according to their birth type and whether it was the first birth. Results: The number of the infants with and without congenital nasolacrimal duct obstruction was 227 (34.1%) and 438 (65.9%), respectively. Comparison of the congenital nasolacrimal duct obstruction and non-congenital nasolacrimal duct obstruction groups according to the first births showed that ratio of cesarean section was significantly higher in the congenital nasolacrimal duct obstruction group than the non- congenital nasolacrimal duct obstruction group (58.7% and 20.7%, respectively). Number with positive family history also was significantly higher in the congenital nasolacrimal duct obstruction group. Conclusion: Cesarean section in first birth and positive family history of congenital nasolacrimal duct obstruction appear to be important risk factors in the etiopathogenesis of congenital nasolacrimal duct obstruction.
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