Does preparation for childbirth training reduce the cesarean rate?

Purpose: This study was conducted as experimental and prospective to determine the effect of birth preparation training on the birth route preparations of pregnant individuals. Methods: The study was conducted in three state hospitals which operate under Kocaeli State Hospitals Community. The study group included 110 pregnant individuals who attended the hospitals’ birth preparation training classes between 1 January – 30 June 2015 and the control group included 90 pregnant individuals from Kocaeli Maternity Hospital. The chi-squared test was used to measure the differences between groups in classified variables, and the t-test was used for parametric variables. P <0.05 was considered to be significant A survey form was used to identify individual demographic information, obstetric stories, and preferred birth route in order to collect relevant data. Findings: The survey reveals that 67% of the pregnant individuals prefer vaginal birth while 33% prefer cesarean birth. In choosing the birth route, 60% of the pregnant individuals make their own decisions, while 28.2% make the decision together with their partner, and 11.8% report the decision being made by their doctor. It is observed that—after attending the birth training—all of the individuals preferred vaginal birth. For the pregnant individuals, their birth route choices before and after the birth preparation training had been observed as highly statistically significant ( p<0, 005). However, when the choices of the pregnant individuals who participated in birth preparation training is compared to the control group’s choices, no statistical significance was found. Rates of cesarean were alike for both groups. Conclusions and Suggestions: In this study, for the individuals who participate in birth preparation training, the choice of the birth route is found to be affected by age, literacy, and former birth route experienced. However, no significant evidence was found regarding reducing the choice of cesarean. A pregnant individual’s birth route choice will be more healthy as she becomes qualified for, and receives sufficient treatment between the preconception stage to after birth, alternative birth routes, and consultancy for overcoming birth pain and relaxation methods

(E)-1-(4-Hydroxyphenyl)-3-(substituted-phenyl)prop-2-en-1-ones: Synthesis, In Vitro Cytotoxic Activity and Molecular Docking Studies

A series of chalcone compounds (2–11) were designed and synthesized to determine their cytotoxic effects. The structures of 2–11 were fully characterized by their physical and spectral data. The in vitro cytotoxic effects of 2–11 were evaluated against human ovarian cancer (A2780), breast cancer (MCF-7) and prostate cancer (PC-3 and LNCaP) cell lines. The activity potentials of compounds were further evaluated through molecular docking studies with AutoDock4 and Vina softwares. All the compounds (except compound 5) showed significant cytotoxic effects at high doses in all cancer cell lines. Among all the compounds studied, one compound i.e. compound 2 demonstrated dose-dependent activity, particularly against A2780/LNCaP cancer cell lines. The most effective compounds 8, 9, 10 and 11 reduced the cell viability of A2780, MCF-7, PC-3 and LNCaP cells by 50–98%, while other compounds 2, 4 and 7 reduced the cell viability of A2780 cells by 70–90% at concentrations of 50 and 100 µM

Empty Follicle or Not? A Case Report

Empty follicle syndrome is characterized by retrieving no oocytes in despite of achieving multiple follicle development in an IVF cycle. We report a case having a presumed empty follicle syndrome at 36th hour of human chorionic gonadotrophin (βhcg) administration and rescued by a second oocyte pick-up procedure performed at 42nd hour, without the need of a second dose of the drug. Intrauterine transfer of three good quality embryos resulted in a singleton pregnancy which ended with a healthy girl

Women self-reported G-spot existence and relation with sexual function and genital perception

Objective:Aim of study to determine the existence of the G-spot from the healthy women’s point of view and to assess the relationship with sexual function and genital perception.Materials and Methods:Sexually-active healthy polyclinic patients aged between 18 and 54 years (n=309) were classified into three groups as group 1 (do not agree, n=90, 29.1%), group 2 (neutral/do not know, n=61, 19.7%) and group 3 (agree, n=158, 51.1%) with regard to participants’ responses to a question of “does the G-spot exist.” The Female Sexual Function index (FSFI) and Female Genital Self-Image scale (FGSIS) were administered to the participants.Results:Half of the patients (51.1%, n=151) indicated that the G-spot exists. The groups were statistically homogeneous in terms of body mass index, parity, marital status, number of partners, and sexual orientation (p=0.41, p=0.06, p=0.12, p=0.19, p=0.25; respectively). Women with an education level of “less than high school” reported the absence of the G-spot significantly more often than others, whereas women with an education level of “university and higher” reported the presence of the G-spot more often (p≤0.001). Sexual dysfunction was found to be more frequent in group 1 when compared with group 3 (p=0.002, 67.8%, 45.6%). The orgasm subdomain scores of the FSFI and FGSIS total scores were significantly higher in group 3 than in group 1 (p<0.001, p=0.041).Conclusion:Half of healthy women in the Turkish population believe that the G-spot exists. Those women showed better scores in sexual functioning and genital perception

Patient’s Refusal of Early Treatment of a Cesarean Scar Pregnancy Resulting in Life - Saving Hysterectomy at 23 Weeks Gestation: Report of a Case

Cesarean scar pregnancy (CSP) is a rare life-threatening form of ectopic pregnancy embedded in the myometrium of a previous cesarean scar. Pathogenesis is suggested to be related with an existing scar defect or a microscopic dehiscent tract generated between the prior cesarean scar and the endometrial canal. The most common risk factor is a history of previous cesarean section. Sonography is the firstline diagnostic tool for the diagnosis of CSP. It is possible to make the diagnosis in the early weeks of pregnancy and early diagnosis would let the patient retain her future fertility. Treatment options prior to rupture include expectant management, dilatation&curettage, conservative medical treatment, hysteroscopic- laparoscopic-primary open surgical removal or hysterectomy. We herein present a case of Cesarean scar ectopic pregnancy complicated with uterine rupture at 23 weeks’ gestation

Previous Antibiotic Use and Its Influence on Antifungal Susceptibility of Candida Strains

Aim: Antifungal drug resistance of Candida strains is a cause ofrecurrent or persistent vulvovaginal candidiasis (VVC). In order toprevent patient discomfort and to diminish the treatment cost ofthe disease, it is essential to identify the causative strain, determine the drug resistance status, and understand the mechanismof resistance.Material and Method: Vaginal discharge specimens were collected from 300 patients. Sixty-five Candida albicans and thirtyfive non-albicans species were identified. The susceptibility tovoriconazole, fluconazole, and amphotericin-B was examined.Previous antibiotic use and its correlation with the antifungal drugresistance were studied.Results: Fluconazole, voriconazole and amphotericin-B susceptibilities of Candida albicans strains were 92.3%, 86.2%, and 100%respectively. The non-albicans group’s susceptibilities to these antifungals were 45.7%, 22.9%, and 85.7% respectively (p=0.00 for all).After nitroimidazole use, 92.8% of infections were caused by Candidaalbicans, and 7.2% of them non-albicans strains (p=0.01). All the infections occurred after macrolide use was non-albicans infections(100%). There were no detected candida albicans infections (p=0.01).Conclusion: Since resistance to voriconazole, fluconazole, andamphotericin-B was more frequent in the non-albicans group,physicians should suspect from non-albicans strains for treatmentresistant VVC cases. Previous antibiotic use have not increasedthe amphotericin B, fluconazole and voriconazole resistance ofboth candida albicans and non-albicans strains. Recurrent infections which have no response to amphotericin B, fluconazole orvoriconazole treatment may be due to a different mechanism otherthan antifungal resistance of Candida species. The decreasedamount of lactobacilli in vaginal flora might be the reason for recurrent VVC.Amaç: Candida suşlarının antifungal ilaç direnci, tekrarlayan veya inatçı vulvovajinal kandidiyazın (VVC) bir nedenidir. Hastanın rahatsızlığını ve tekrarlayan VVC’nin ekonomik maliyetini önlemek için, nedensel suşu belirlemek, ilaç direnci durumunu belirlemek ve direnç mekanizmasını anlamak önemlidir. Materyal ve Metot: Vajinal akıntı örnekleri 300 hastadan toplanmış, 65 Candida albicans ve 35 non albicans türü tespit edilmiş, vorikonazol, flukonazol ve amfoterisin B’ye duyarlılık araştırılmıştır. Önceki antibiyotik kullanımı ve suşların antifungal ilaç direnci ile ilişkisi araştırılmıştır. Bulgular: Candida albicans suşlarının flukonazol, vorikonazol ve amfoterisin B duyarlılıkları %92,3, %86,2 ve %100 iken, nonalbicans grubunun bu antifungallere olan duyarlılıkları %45,7, %22,9 ve %85,7 idi (hepsi için p=0,00). Nitroimidazol kullanımından sonra, enfeksiyonların %92,8’ine candida albicans, %7,2’sinin non-albicans suşları neden olmuştur (p=0,01). Makrolid kullanımından sonra ortaya çıkan tüm enfeksiyonların tamamında nonalbicans türleri enfeksiyona neden olurken (%100) ve candida albicans nedenli enfeksiyon saptanmadı (p=0,01). Sonuç: Non-albicans grubunda vorikonazole, flukonazol ve amfoterisin B direnci daha sık olduğu için olduğu için, tedaviye dirençli VVC olgularında klinisyenler non albicans suşlarından şüphelenmelidir. Önceki antibiyotik kullanımı, hem candida albicans hem de albicans olmayan suşların amfoterisin B, flukonazol ve vorikonazol direncini arttırmamaktadır. Amfoterisin B, flukonazol veya vorikonazol tedavisine cevap vermeyen tekrarlayan enfeksiyonlar, kandida türlerinin antifungal direncinden farklı bir mekanizmaya bağlı olabilir. Vajinal florada azalmış laktobasil miktarı rekürren VVC’nin nedeni olabilir

The effects of progesterone treatment on nuchal translucency in women with threatened miscarriage

This study aims to investigate the effects of progesterone on the possible changes in nuchal translucency (NT) levels for patients diagnosed with threatened miscarriage. The study group was composed of 125 patients diagnosed with threatened miscarriage and taking 400 mg/day micronized orally progesterone at least for two weeks, the control group was composed of 160 healthy pregnant women not taking any progesterone. Crown rump length (CRL) NT thickness, Pregnancy-associated plasma protein-A (PAPP-A), free beta human chorionic gonadotropin (Beta-HCG) levels of patients were measured for assessment of aneuploidy risk. Both of the groups were divided into four subgroups to determine the relationship between thickness of NT and progesterone use for specific CRL measurements. CRL in the first, second, third and fourth group was 45–55 mm, 55–65 mm, 65–75 mm, 75–84 mm, respectively. The two groups were age and BMI matched. In all groups of CRL there were no significant difference in Mom levels of NT thickness, PAPP-A and free Beta-HCG between the study and control groups. There havent been any relation between NT thickness and progesterone use.IMPACT STATEMENT What is already known about this subject? Recently some studies have claimed that progesterone use might have caused atypical blood flow pattern on foetal circulation, which could possibly increase NT. If the NT thickness is affected by the use of progesterone, then the false positive rate of detecting Down Syndrome screening tests would increase. What the results of this study add? In this study we did not found any relation between NT thickness and progesterone use. What the implications are of these findings for clinical practice and/or further research? Using orally progesterone due to threatened miscarriage do not change NT thickness levels. Further studies have to be done with a large number of participants

Üreme çağındaki polikistik over sendromlu hastalarda metabolik sendrom sıklığı ve farklı metabolik sendrom tanı ölçütlerinin karşılaştırılması

Amaç: Farklı tanı ölçütleri kullanarak polikistik over sendromlu (PKOS) hastalarda metabolik sendrom sıklığını (MetS) araştırmak. Materyal ve Metot: Rotterdam ölçütlerine göre PKOS tanısı konulmuş 182 kadın çalışma grubunu oluştururken, yaşa göre eşleştirilmiş 182 kadın da kontrol grubunu oluşturdu. Her iki grupta da MetS sıklığı Ulusal Kolesterol Eğitim programı (NCEP: National Cholesterol Education Program Expert Panel), Dünya Sağlık Örgütü (WHO: World Health Organization), Amerikan Kalp Derneği/Ulusal Kalp Akciğer Kan Enstitüsü (AHA/NCLBI: American Heart Association/National Heart Lung Blood Institute), Uluslararası Diyabet Federasyonu (IDF: International Diabetes Federation) ve Rotterdam MetS kriterleri kullanılarak araştırıldı. Sonuçlar: PKOS grubunda AHA/NCLBI dışındaki diğer tüm ölçütlerle MetS tanısı konulmuş hasta sıklığı kontrol grubundan fazlaydı. Bu fark, özellikle daha genç yaşlarda daha belirgindi. En yüksek MetS sıklığı tanısı %26 ile IDF ölçütlerine göre konuldu. Bel çevresi ve açlık kan glukozunda kullanılan düşük kesme değerleri IDF ölçütlerini MetS tanısında en ayırt edici ölçütler yapmaktadır. Bu ölçütler PKOS hastalarında riskli kadınların ayırt edilmesinde ve MetS’e bağlı ileride oluşacak etkilerin önlenmesinde kullanılabilir. Tartışma: IDF, NCEP ve Rotterdam ölçütleri göstermektedir ki, PKOS’lu kadınlarda MetS oluşumu daha genç yaşlarda başlayabilir. MetS’in gelecekteki kardiyovasküler etkilerinin tedavisi ve yönetimindeki en önemli strateji önleme olduğu için en ayırt edici ölçütler kullanılarak daha fazla kadını MetS olarak tanımlamak riskli kadınların MetS’in gelecekteki etkilerinden korunmalarını sağlayabilir.Objective: To investigate the frequency of the metabolic syndrome (MetS) by using different criteria in women with polycystic ovary syndrome (PCOS). Materials and Methods: The study group consisted of 182 patients diagnosed with PCOS according to the Rotterdam criteria and 182 age matched controls. MetS frequency was separately investigated in the two groups according to the National Cholesterol Education Program Expert Panel (NCEP), World Health Organization (WHO), American Heart Association/National Heart Lung Blood Institute (AHA/NCLBI), International Diabetes Federation (IDF) and the Rotterdam MetS criteria. Results: Except for the AHA/NCLBI criterion, all criteria showed significantly higher MetS prevalence in patients with PCOS as compared to the control group. This difference was more prominent especially at younger age. The highest frequency of MetS (26%) was observed according to the International Diabetes Federation (IDF) definition. The lower cutoff values of waist circumference and fasting glucose level in the IDF criteria has made it the most discriminative MetS definition for identifying risky individuals for MetS in patients with PCOS. Discussion: Development of MetS may begin at younger ages in PCOS patients by using IDF, NCEP and Rotterdam criteria. As the most important approach for treatment and management of MetS against future cardiovascular events is the preventive strategy, categorizing more women with MetS according to the most discriminative criteria can also be a useful method for identifying the individuals under greater risk to prevent the developmental effects of MetS in patients with PCOS