Knowledge, behaviors and opinions of medical faculty students during the COVID-19 pandemic

Aim: The emergency of COVID-19 pandemic has severely affected medical students’ education and the possibility of being considered as health-care professionals has come to mind. We described knowledge, behaviours and opinions of medical students during the pandemic and separated into the continents and compared them with our country. Materials and Methods: The cross-sectional worldwide study including 26 items online questionnaire was conducted between March 24th and April 9th, 2020.Medical students were grouped according to their continent and Turkey as a separate group. Results: 1454 medical students studying in 64 countries from 4 continents including Asia, Europe, South America and Africa participated in study. Only 23.7% of all was adequately informed about approach to outbreak situations. This was the lowest in Europe and followed by Turkey (20.8%, 21.7% respectively).71.2% of all changed their hygiene habits; paying attention to social distance increased from 2% to 61.9%. In Africa, 58.6% of students feel qualified to work in hospitals voluntarily, whereas it was only 19.9% in Turkey and 29.2% in Europe (p<0.001).91.5% of Asian and 87.7% of European students would agree to volunteer in hospitals. In Turkey it was only 71.1% (p<0.001).75.9% of all support the view that they should be qualified to volunteer in hospitals when necessary. Conclusion: Medical students seem to want to volunteer, but have not been adequately informed about the approach to outbreak situations. An international consensus on medical students’ roles may improve medical school programs about the current COVID-19 Pandemic and future ones

Comparison of female sexual function and sexual function of their partners between groups of pregnant and non-pregnant women

Objectives: To compare the female sexual function index and sexual function of their partners between groups of pregnantand non-pregnant Turkish women.Material and methods: This was a cross-sectional study of 321 women, including 252 healthy pregnant and 69 healthynonpregnant women. Assessment of female sexual function index (FSFI), ARIZONA scores of their partners were comparedin relation to some of the sociodemographic characteristics and pregnancy trimesters.Results: Comparison of the groups revealed a significantly higher FSFI score in the non-pregnant group whereas the ARIZONAscore was significantly higher in the pregnant group (p &lt; 0.001). Age, gravidity, parity and smoking rate adjustedmean differences of scores remained statistically significant (p &lt; 0.001). Higher ARIZONA (&gt; 11) score rate was significantlyhigher in pregnant groups (55.6% vs 23.2%, p &lt; 0.001). Pregnancy was a risk factor for high ARIZONA score [OR: 4.1 (95%CI 2.2–7.6, p &lt; 0.001)]. Lower FSFI score rate was significantly higher in the pregnant group (26.4% vs 69.4%, p &lt; 0.001).Pregnancy was a risk factor for low FSFI score [OR: 6.4 (95% CI 3.5–11.7, p &lt; 0.001)].Conclusions: Both female sexual function index and ARIZONA scores of their partners were found to be significantly differentbetween groups of pregnant and nonpregnant Turkish women which indicated altered sexual function of couplesduring pregnancy

Oligo-Amenorrheic Polycystic Ovary Syndrome Patients Have Higher Risk For Cardiovascular Disease Compared to Hirsute Patients and Healthy Control

OBJECTIVE: To evaluate the clinical, endocrine and cardiovascular disease risk profile differences in polycystic ovary syndrome (PCOS) patients who complain of hirsutism or oligo-amenorrhea. STUDY DESIGN: A total of 129 consecutive women underwent the screening investigation at Dr. Sami Ulus Women’s Health Teaching and Research Hospital between December 2009 and June 2010. There were 48 PCOS patients with hirsutism while 49 PCOS patients with oligo-amenorrhea and 32 healthy women included in the study. Body mass index (BMI), Waist/hip ratio (WHR) serum follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone, free testosterone, glucose, low density lipoprotein (LDL), total cholesterol, high density lipoprotein (HDL), triglceride (TG), high sensitive C reactive protein (hs-CRP), insulin, insulin sensitivity and carotid intima thickness (CIMT) were compared in PCOS patients who complain of hirsutism or oligo-amenorrhea and control group. RESULTS: Mean ages were similar among groups. There were significant differences among groups in terms of BMI, WHR, total cholesterol, LDL, TG, LH, fasting glucose, hsCRP, CIMT (p<0.05) (table 1). BMI, waist-hip ratio (WHR), total cholesterol, LDL, TG, LH, estrodiol, fasting glucose adjusted mean CIMT values were 0.40±0.01 mm, 0.49±0.012mm, 0.34±0.012mm (p<0.001) in hirsute, oligo-amenorrheic and control groups respectively. CONCLUSION: PCOS patients with oligo-amenorrhea without hirsutism have higher risk for cardiovascular disease (CVD) and abnormal lipid profile than patients with hirsutism without oligo-amenorrhea

Ultrasonografik endometriyal kalınlık ölçümü atipisiz endometriyal hiperplazi tedavi cevabında öngörücüdür

Objective: We sought to determine the predictors of treatment response in simple endometrial hyperplasia without atypia. Material and Methods: We prospectively treated 67 women with simple endometrial hyperplasia without atypia who were administered cyclic oral medroxyprogesterone acetate 10 mg/day for 12 days of luteal phase for 3 months and underwent control endometrial sampling after treatment. All subjects were evaluated in terms of age, gravidity, parity, body mass index (BMI), menstrual cycle, endometrial thickness, uterine fibroids, ovarian cysts, serum CA 125 levels, systemic disorders and cigarette smoking. All parameters were used to predict treatment success. Results: Persistent hyperplasia was observed in 11 subjects. Endometrial thickness was significantly correlated with treatment failure (r=0.293, p=0.015). In ROC analysis, endometrial thickness was found to be predictive for persistent hyperplasia (area under curve: 0.724, P=0.019). Optimal cut off value was calculated to be 16.5 mm with 64% sensitivity, 72% specificity and 91% negative predictive value. The number of persistent hyperplasia in women with and without endometrial thickness greater than 16.5 mm was significantly different (7/23 vs. 4/45, p=0.029). Odds ratio of endometrial thickness higher than 16.5 mm for treatment failure was 4.4 (95% CI, 1.2-17.4, p=0.03). Conclusion: Results of this study suggest treatment modification according to the baseline endometrial thickness in patients with simple endometrial hyperplasia without atypia. © 2013 by the Turkish-German Gynecological Education and Research Foundation

Duktus venozus s/d oranına göre düzeltilmiş alfa fetoprotein düzeyinin yalancı pozitiflik oranını azaltması

AMAÇ: Fetal karaciğer çoğunlukla duktus venozus aracılığıy- la umbilikal venden beslenmektedir. Alfa Fetoprotein (AFP) fe- tal karaciğerde üretilip, salgılanmaktadır. Çalışmamızda, se- rum AFP düzeyine duktus venozus ve umbilikal kan akımının etkisi incelendi. GEREÇ VE YÖNTEM: Çalışmaya 16-20 hafta gebeliği olan 60 kadın alındı. Olgular AFP seviyeleri 2 MoM üzeri (n46) ve al- tı (n14) olarak ikiye ayrıldı. Tüm olgular serum AFP ölçümü ile Doppler görüntülemede duktus venozus ve umbilikal arter S/D oranı değerlendirmesine yönlendirildi. Duktus venozus ve umbilikal arter kan akımının serum AFP seviyesi üzerine olan etkisi araştırıldı. BULGULAR: Umbilikal arter ve duktus venozus kan akımının serum AFP seviyesi ile ilişkili olduğu saptandı (p0.05). Yüksek AFP seviyesi olan olgularda, umbilikal arter ve duktus venozus S/D oranları belirgin olarak düşüktü (p0.05). SONUÇ: Çalışmamızda duktus venozus ve umbilikal arter kan akımının serum AFP seviyesini etkileyebileceği ön görülmekte- dir. AFP düzeyinin bu faktörlere göre yeniden düzenlenmesi, Nöral Tüp Defekti teşhisinde prediktif değerini artırabilir.OBJECTIVE: Fetal liver is mostly perfused by umbilical vein via ductus venosus and AFP is synthesized and secreted from fetal liver. In this study we tried to determine the effect of ductus venosus and umbil- ical blood flow on serum AFP levels STUDY DESIGN: Sixty women with 16-20 weeks of gestation were enrolled for the study. Subjects were divided into two: AFP levels lower (n46) and higher than 2 MomS MoMs (n14). All participants un- derwent serum AFP, ductus venosus and umbilical artery Doppler Doppler S/D screening. Effect of duc- tus venosus and umbilical artery blood flow on serum AFP levels were analyzed. RESULTS: Ductus venosus (AUC0.945, P2 MoM be- came 1.98 MoM after adjustment. CONCLUSION: Our study revealed that Ductus venosus and umbilical artery S/D value adjusted serum AFP levels may have lower false positive rates

Ductus Venosus Doppler S/D Value Adjusted Alfa Fetoprotein Levels to Decrease False Positive Rates

OBJECTIVE: Fetal liver is mostly perfused by umbilical vein via ductus venosus and AFP is synthesized and secreted from fetal liver. In this study we tried to determine the effect of ductus venosus and umbilical blood flow on serum AFP levels STUDY DESIGN: Sixty women with 16-20 weeks of gestation were enrolled for the study. Subjects were divided into two: AFP levels lower (n=46) and higher than 2 MomS MoMs (n=14). All participants underwent serum AFP, ductus venosus and umbilical artery Doppler Doppler S/D screening. Effect of ductus venosus and umbilical artery blood flow on serum AFP levels were analyzed. RESULTS: Ductus venosus (AUC=0.945, P<0.001) and umbilical artery Doppler S/D (AUC=0.803, P=0.001) values were predictor for low AFP levels. In regression analysis, Ductus venosus Doppler S/D (Beta coefficient= -0.442, P<0.001) and umbilical artery S/D (Beta coefficient= -0.291, P=0.011) values were significantly associated with the AFP levels (R2=0.60). DV and umbilical artery Doppler S/D values adjusted serum AFP levels remained significant but mean value of AFP in group with AFP>2 MoM became 1.98 MoM after adjustment. CONCLUSION: Our study revealed that Ductus venosus and umbilical artery S/D value adjusted serum AFP levels may have lower false positive rates

Educational Status Number of Previous Contraceptive Failure Do not Effect the Women’s Contraceptive Preference After Surgical Abortion in Turkey

OBJECTIVE: The aim of this study was to investigate the determinants of the contraceptive preference of couples after surgical abortion result of contraceptive failure or no contraception. STUDY DESIGN: Study population consisted of 302 women who admitted to Dr. Sami Ulus Maternity and Women’s Health Teaching and Research Hospital family planning unit and underwent surgical abortion. All pregnancies were in their 5-10 th weeks of gestation. Gravida, parity, number of previous surgical abortions, living children number, last pregnancy status with current contraceptive method were recorded. RESULTS: Mean age, gravida, parity, number of previous surgical abortions and living children were 31.05±6.52 (19-46 years), 4.30±1.83 (1-11), 2.33±1.32 (0-7), 0.96±1.05 (0-5), 2.28±1.29 (0-7) respectively. There were 183 (60,6%) women with previous surgical abortions, mean number of surgical abortions were 1.59±0.6. Among these patients there were 82 (45%) patients using no contraceptive method and 55 (30%) women were using coitus interruptus. Condoms were being used only by 29 (16%) women. Oral contraceptives (OCS) were being used in 11 (6%) women. No association was observed between condom or OCS use and educational status (p=0.786) in these patients. Condom or OCS users a little bit younger but not reached statistical significance (p=0.071). Women with different contraceptive use were similar in terms of gravida, parity, interval from previous pregnancy (p=0.423, p=0.402, 0.467 respectively). No association was obtained between number of previous surgical abortion, current contraceptive use (p=0.386) and educational status (p=0.735). CONCLUSION: Our study suggests that educational status, number previous contraceptive failure or maternal age does not effect the contraceptive preference after surgical abortion

Nuchal Translucency Measurement Did Not Significantly Predict Trisomy Cases in Tertiary Referral Center

OBJECTIVE: We sought to determine the value of well defined screening method in predicting trisomy cases in our institution. STUDY DESIGN: Totally 300 amniocentesis cases were screened from prospectively collected database. Subjects were referred to amniocentesis according to the sequential results of first and second trimester screening tests. Each case had nuchal translucency measurement between 11th to 14th weeks of gestation. All values of NT measurement were analyzed to predict trisomy cases. RESUlTS:There were 7 trisomy cases , non of the screening methods significantly predicted trisomy cases (p>0.05) rather than the simply age (Area under curve 0.724, p=0.043). Mean NT did not differ between groups with normal and abnormal chromosomes(p>0.05). CONClUSION: This data led us to conclude that in our country there is still need for more accurate and standardized method to predict abnormal cases with higher sensitivity and specificiy to decrease invasive procedures

Doppler Study of the Fetal Renal Artery in Oligohydramnios with Post-term Pregnancy

The aim of the study was to investigate the fetal renal artery impedance and hemodynamics in the context of post-term pregnancy with oligohydramnios, using Doppler indices. Methods: This is a prospective study which took place between December 2011 and March 2013. Fetal renal artery Doppler was performed in women at gestational age between 40.1 weeks and 41.3 weeks with singleton pregnancies. The fetal renal artery Doppler resistance index (RI), pulsatility index (PI), systolic/diastolic ratio (S/D), acceleration time (AT), blood flow (BF), fetal renal volume, APGAR, and cesarean ratio were measured. Stepwise logistic regression and the two-tailed t test were used to determine whether the Doppler indices correlated with oligohydramnios (amniotic fluid index < 5 cm). Results: We studied 84 well-dated, singleton, post-term pregnancies, referenced from the high post-term pregnancy obstetric service. Forty-one patients (48.1%) had oligohydramnios. Patients with oligohydramnios had higher S/D, RI, and AT. The fetal renal artery BF (FRABF) was lower in patients with oligohydramnios than those without oligohydramnios (p = 0.037). Stepwise logistic regression using renal artery Doppler indices found FRABF to be the only significant predictor of oligohydramnios: p = 0.012, p < 0.005 [odds ratio = 0.821, 95% confidence interval (CI) = 0.769–0.912]. Conclusion: In oligohydramnios in the context of post-term pregnancies, there is an increased resistance in the fetal renal vascular bed. The reduced FRABF suggests that increased arterial impedance is an important factor in the development of oligohydramnios. This study supports the idea of increased vascular resistance in the fetal renal bed in patients in post-term pregnancies. We think that fetal renal artery Doppler measurement should be part of a routine daily clinical obstetric practice in post-term pregnancies with oligohydramnios