The Diagnostic Value of the Umbilical Cord Diameter Thickness in Second Trimester Congenital Anomaly Screening

OBJECTIVE: Diagnostic value of the umbilical cord thickness second trimester congenital anomaly screening. STUDY DESIGN: Eighty-three pregnant women in the study. Patients were examined by dividing them into 3 groups. The first group was comprised of 50 healthy individuals which exhibited no chromosomal or sonographic fetal anomaly. The second group consisted of 8 cases which displayed chromosomal anomaly by amniocentesis. The third group included 25 cases with fetal anomaly detected by USG. RESULTS: The first group mean cord diameter was 7.06±1.6 mm (4.50-11.80 mm). Second group was 8.32±2.2 mm (4.60-11.0 mm), third group was 7.24±1.5 mm (4.70-10.50). No significant difference was determined between the results (p>0.05). CONCLUSION: Umbilical cord diameter was not found to be a valuable sonographic finding in the congenital anomaly screening

Treatment Results of Vulvar Intraepithelial Neoplasia in 16 Women

OBJECTIVE: Clinical outcome after surgical treatment of vulvar intraepithelial neoplasia (VIN). STUDY DESIGN; 16 women with vulvar intraepithelial neoplasia were reviewed. Histologic diagnosis was based on classification of the International Society for the Study of Vulvovaginal Diseases (ISSVD). RESULTS: All cases had unifocal lesions in vulvar examination. In 13 cases (81,5%) lesions were white, in 2 cases (12,5%) lesions were papillary in apprereance and in a case ( 6%) there was an ulcerative lesion. In all cases diameter of the vulvar lesions were less than 2 cm. Local excision was performed for VIN 1 lesions. VIN2 and VIN3 lesions underwent simple vulvectomy. Imiquimod therapy was prefferred for a case with VIN3 lesion who refused surgery. In a case with VIN3 lesion squamous cell carcinoma in situ diagnosed after vulvectomy operation. Recurrence of disease has not yet been diagnosed during the follow up period. CONCLUSION: VIN lesions should be surgically treated and careful long term surveillence is mandatory

The effects of progesterone on the healing of obstetric anal sphincter damage in female rats

We aimed to evaluate the effects of postpartum progesterone on obstetric anal sphincter injury (OASI) healing in female rats using an experimental OASI model. Twenty-eight female rats were divided into four groups after birth: sham-30, sham-90, progesterone (P4)-30, and P4-90. Moreover, OASI model was established in all groups. Subsequently, except for the sham groups, medroxyprogesterone acetate (0.15 mg) was intramuscularly injected into the P4 groups. After 30 and 90 days, the rats were euthanized under general anesthesia after recording the data. The anal sphincter region was collected for histopathological examination. Progesterone and thiol/disulfide homeostasis studies were performed on blood samples. No significant differences were observed between the groups regarding the external anal sphincter (EAS), internal anal sphincter (IAS), or connective tissue thickness (p = 0.714, p = 0.135, and p = 0.314, respectively). No statistically significant differences in the total thiol, native thiol, disulfide, and progesterone levels were found between the groups (p = 0.917, p = 0.503, p = 0.361, and p = 0.294, respectively). The endometrial thickness was lower in the P4 groups than in the sham groups (p = 0.031). Postpartum progesterone administration did not affect IAS and EAS or connective tissue thickness or disrupt the thiol–disulfide balance. However, this administration led to endometrial thinning

Isolated Fetal Pyelectasis and Chromosomal Abnormalities

OBJECTIVES:Try to find out the frequency of isolated fetal pyelectasis and its association with abnormal fetal karyotypes in a high risk pregnant population STUDY DESING :759 pregnants with advanced maternal age or with increased risk for trisomy 21 in triple tests were enrolled into the study.Ultrasonographic examinations and amniocentesis were performed for all pregnants at 15-21 weeks of their gestations RESULTS:649 pregnants completed the study protocol.424 cases had advanced maternal age and 225 cases had increased risk for trisomy 21. There were 15 cases (2.31%) with isolated pyelectasis and these cases had normal karyotypes except a normal variance(46 XX inv9p11q13).There were 14 (3.30%) chromosomal abnormalities in advanced maternal age group and 7 (3.11%) in pregnants with increased risk in triple tests. CONCLUSION:Although inreased risk of Down’s Syndrome is not high in pregnants with isolated fetal pyelectasis, they should be followed and searched for other findings of aneuploidy

Investigation of the efficacy of kinesiological banding in pregnancy-related carpal tunnel syndrome

Karakoyun, Ahmet ( Aksaray, Yazar )Aim: The aim of this study was to investigate the effects of kinesiological banding on symptoms in carpal tunnel syndrome associated with pregnancy.Patients and Methods: Patients who were admitted to the Physical Therapy and Rehabilitation Clinic due to carpal tunnel syndrome and who were diagnosed with carpal tunnel syndrome by electromyography and who were able to reach the visuel analog score, Short Form-36, Boston Carpal Tunnel Questionnaire and Pittsburgh Sleep Quality Index values were included in the study.Results: In both groups, there was a significantly difference between the first visuel analog score day-night and the last visuel analog score day-night and first and last Pittsburgh Sleep Quality Index (p<0,05). While there was a significantly improvement in the Boston Symptom Severity Scale, there was no significantly difference in Boston Functional Capacity Scale. In the comparison between the groups, visuel analog score day, Short Form-36 pain parameter and decrease in Boston Symptom Severity Scale were found statistically significant.Conclusions: In our study, although the superiority of kinesiological banding on hand-wrist rest splint could not be clearly shown, decreased pain and symptoms and an increase in sleep quality were observed.The kinesiological banding should be in mind in patients who have no response to resting splint because of low treatment options during pregnanc.Amaç: Bu çalışmada gebelikle ilişkili karpal tünel sendromunda kinezyolojik bantlamanın semptomlar üzerine etkisinin araştırılması planlandı. Hastalar ve Yöntem: Çalışmaya karpal tünel sendromu nedeniyle Fizik Tedavi ve Rehabilitasyon Kliniğine başvuran ve elektromiyografi ile karpal tünel sendromu tanısı alan , kayıtlarında visuel ağrı skoru, Kısa Form-36, Boston Karpal Tünel Anketi ve Pittsburgh Uyku Kalite İndeksi değerlerine başvuru ve takip esnasında eksiksiz ulaşılabilen hastalar dahil edildi. Bulgular: Her iki grupta da ilk visuel ağrı skoru gündüz-gece ve son visuel ağrı skoru gündüz-gece ve ilk ve son Pittsburgh Uyku Kalite İndeksi arasında anlamlı fark saptandı (p<0,05). Her iki grupta da Boston Semptom Şiddeti Skalasında anlamlı düzelme saptanırken, Boston Fonksiyonel Kapasite Skalasında anlamlı fark saptanmadı. Gruplar arası karşılaştırmada ise kinezyolojik bantlama uygulanan hastalarda visuel ağrı skoru gündüz, Kısa Form-36 ağrı parametresi ve Boston Semptom Şiddeti Skalasındaki azalma istatistiksel olarak anlamlı saptandı. Sonuç: Çalışmamızda kinezyolojik bantlamanın el-el bilek istirahat splintine üstünlüğü net olarak gösterilememesine rağmen ağrı ve semptomlarda azalma ve uyku kalitesinde artış gözlenmiştir. Gebelikte tedavi seçeneklerinin az olması nedeniyle istirahat splintine yanıt alınamayan hastalarda kinezyolojik bantlama aklımızda bulunmalıdır

Skin Metastasis of Sarcomatoid Squamous Cell Carcinoma in Vulva A Case Report

Histopathologic results and clinical course of the sarcomatoid-type vulvar squamous cell carcinoma presenting skin metastasis which is an uncommon entity. Patient presented a nodular lesion of 1cm diameter in right labium minus. Pathology results revealed squamous cell carcinoma. Radical vulvectomy, bilateral inguinofemoral lymphadenectomy were applied to the case. Sarcomatoid squamous cell carcinoma and metastasis in the lymph nodes. Postoperative radiotherapy was applied. The patient again presented 4 months later due to a nodular lesion in the inguinal region. Squamous cell carcinoma displaying sarcomatoid alterations in the dermis. the case was subjected to extended field radiotherapy and cisplatin chemotherapy. The patient’s condition deteriorated postoperative 5th month. Survival rate for skin metastasis of sarcomatoid squamous cell carcinoma in vulva, is found to be poor

Leiomyoma of The Vagina

17 year old girl complaining of pelvic swelling mass and urinary frequency was reported. Ultrasonography and abdominal computed tomography showed a solid mass with size of 130x121x117 mm in left pelvis, normal sized uterus.At laparotomy there was solid mass under the bladder located at the left anterior part of the elevated uterus. With an incision at the anterior serosa of the uterus the bladder was removed. There was a vaginal myoma at the base seperate from the uterus. Second insicion was performed to the left anterior vaginal wall, mass enucleated from its base. Four units of blood was required intra and postoperatively. İn large vaginal leiomyomas located in the upper part of the vagina combined abdominovaginal approach may be prefferred for providing safer operation with less bleeding

ÜÇÜNCÜLERDE TRİMESTİRDE GEBELİKLE İLİŞKİLİ BEL AĞRISININ AZALTILMASI, YAŞAM VE UYKU KALİTESİNİ ARTTIRILMASINDA KİNESİO-TERAPİ VE EV EGZERSİZİNİN KARŞILAŞTIRILMASI

Amaç: Bu çalışmanın amacı gebeliğin 3. trimestirinde gebelikle ilişkili bel ağrısını azaltması, yaşam ve uyku kalitesini arttırılmasında Kinesio-terapi ile ev egzersizinin etkinliğinin karşılaştırılmasıdır. Gereç ve Yöntem: Retrospektif olarak kayıtları incelenen gebeliğin 3. trimestirinde bulunan 50 gebe hasta çalışma grubunu oluşturmuştur. Hastalar iki gruba ayrılmıştır. Bel ağrısı için bel bölgesine dört günde bir kez yeniden bantlanmak üzere 4 hafta boyunca ‘I’ şeklinde Kinesio-terapi uygulanan hastalar Kinesio-terapi tedavi grubunu (KTTG), bel ağrısı için her gün günde iki kez sekiz tekrar uygulanmak üzere oturma pozisyonunda ve ayakta pelvik tilt ev egzersiz programı verilerek 4 hafta boyunca takip edilen olgular ise egzersiz tedavi grubunu (ETG) oluşturmuştur. Her iki grup hastalar demografik özellikler ve sosyokültürel statü, VAS (Vizüel Analog Skala), SF36 (yaşam kalitesi ölçeği), PUKİ (Pittsburgh Uyku Kalite İndeksi), Oswestry Bel Ağrısı Engellilik Anketi skorları açısından karşılaştırılmıştır. Bulgular: VAS ve SF-36 skor değerleri her iki grup açısından karşılaştırıldığında istatistiksel olarak anlamlı bulunmamıştır (P0,05). PUKİ ve Oswestry skor değerleri egzersiz tedavi grubu için istatistiksel olarak anlamlı bulunmuştur (P0,05). Sonuç: Üçüncü trimestirde gebelikle ilişkili bel ağrısı tedavisinde Kinesio-terapi uygulamasının bel ağrısını azaltmada, yaşam ve uyku kalitesini arttırmada ev egzersizine üstünlüğü gösterilememiştir. Bel ağrısı ve uyku kalitesi üzerine olan etkisi açısından ev egzersizleri, Kinesio-terapiye göre üstün bulunmuştur.Aim: The aim of this study is to investigate the effect of Kinesio-therapy, which is a non-pharmacological method, versus home exercises in reducing pregnancy-related low back pain and increasing quality of life and sleep quality in the third trimester. Methods: As retrospectively fifty pregnant patient’s third trimester records were composed in this study group. Patients were separated into two groups. Patients who have been followed with ‘I' shape application once a week during 4 weeks were composed Kinesio-Tape Treatment Group (KTTG), patients who have been followed with sitting and standing daily pelvic tilt home exercises with twice a day eight again during 4 weeks were composed exercise treatment group (ETG). Two groups were compared with demographic features and socio-cultural status, VAS (Visual Analog Scale), Quality of life scale SF-36 (Short-form 36), PUKI (Pittsburgh sleep quality index) and Oswestry Disability Index (ODI). Results: There were no significant differences between KTTG and ETG in terms of VAS and SF-36 score (P0,05). There were significant differences in ETG for PUKI and Oswestry score (P0,05). Conclusions: Kinesio-Therapy wasn’t more effective than home exercises in terms of reducing pregnancy-related low back pain and increasing quality of life and sleep quality. But, home exercises were more effective than Kinesio-Therapy in terms of low back pain and sleep quality in the third-trimester pregnancy-related low back pain

Sağlıklı Gebelerde Kas İskelet Sistemi Ağrıları; Lokalizasyon, Şiddet ve Karakter Değerlendirilmesi: Kesitsel Çalışma

Giriş ve amaç: Bu kesitsel çalışmada gebelikte görülen özgül olmayan kas iskelet sistemi ağrılarının lokalizasyonunu ve yayılımını, şiddetini ve karakterini ortaya koymak amaçlanmıştır.Gereç ve yöntemler: Çalışmaya yaş aralığı 18-35 yaş arası olan ve çalışmaya katılmaya gönüllü olan gebeler dahil edildi. Gebelerden fiziyatrist eşliğinde, ayaklı 40x55 cm’ lik laminat yazı tahtası üzerine çizilmiş insan ön ve arka yüzü figürü üzerinde ağrının yerini hissettiği bölgelerde olduğu gibi boyaması istendi. Boyama esnasında ağrının şiddetini belirlemek üzere 5 farklı (siyah: çok şiddetli, kırmızı: şiddetli-orta düzeyde, mavi: orta düzeyde, yeşil: orta- hafif düzeyde, sarı: oldukça hafif düzeyde) renk kullanması istendi. Boyama işleminden sonra hastanın ağrılı bölgeler üzerinde ağrının karakterini künt / zonklayıcı / yanıcı / dondurucu / karıncalanma / elektriklenme veya elektrik çarpması gibi / batma veya iğnelenme gibi /gerilme kelimelerini kullanarak tanımlaması istendi.Bulgular: Çalışmaya katılan 250 gebenin ortalama yaşı 26.44.1 idi. Gebelerden %25,6(64)’ sı birinci, %32,8 (82)’ ikinci ve %41,6 (104)’ sı üçüncü trimesterda idi. En sık ağrı uyulan bölgeler sırasıyla bel, kalça ve sırt bölgesi olarak belirtilirken, ağrı şiddeti en yüksek olan bölgeler ise sırasıyla el-el bileği, kalça kuşağı & uyluk ve bel bölgesi olarak belirtildi. Nöropatik karakterde ağrıların en sık el bileği ve ellerde, ayak bilekleri ve ayaklarda ve sırt bölgesinde görüldüğü izlendi.Sonuç: Sağlıklı gebelerde sıklıkla kendini sınırlayıcı kas iskelet sistemi ağrılarının iyi tanımlanması ilerleyici ve sekel bırakıcı durumların ayırt edilebilmesi açısından önemlidir