Risk of HSIL (CIN 2-3) on colposcopic biopsy is minimal in postmenopausal women with LSIL on cytology and a negative HRHPV test

BackgroundCurrent cervical cancer screening guidelines recommend a 1-year follow-up period for patients with a postmenopausal low-grade squamous intraepithelial lesion (LSIL) who are test negative for high-risk human papillomavirus (HrHPV). The aim of this study was to assess whether such patients had an increased immediate risk of high-grade squamous intraepithelial lesion. MethodsWe assessed 54 HrHPV-negative women with postmenopausal LSIL in the Department of Obstetrics and Gynecology of our hospital between 2012 and 2013. All patients underwent liquid-based cytology and reflex HrHPV testing (for human papillomavirus [HPV] types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68). Colposcopic examination and guided biopsy were performed by the same gynecologist (MO). ResultsThe average age of the patients was 53.13.2 years. There were 33 patients (61%) with cervical intraepithelial neoplasia (CIN) grade 1 and 21 who were non-dysplastic. None of the patients was positive for CIN 2 or any other lesions. ConclusionsIf the HPV test is negative, repeat cytology after 12 months is recommended by the American Society for Colposcopy and Cervical Pathology for cases of HrHPV-negative postmenopausal LSIL. We recommend reflex HPV testing as the best choice for patients who test positive for postmenopausal LSIL by Pap smear, in line with the literature. Diagn. Cytopathol. 2016;44:969-974. (c) 2016 Wiley Periodicals, Inc

Effects of pericervical tourniquet on intraoperative bleeding at abdominal myomectomy

Uterusun kanlanmasının temel kaynağı uterin arterlerdir. Uterin arterler, uterusun lateral isthmik seviyesinden uterusa girer ve ikiye ayrılır. Asendan dal, uterus korpusunu beslerken desendan dal, üst vajinal bölgeye dağılır. Asendan uterin arter akımının azaltılması veya kesilmesi, uterus korpusuna yapılacak olan cerrahi işlemlerde kanamayı azaltacaktır. Semptomatik leiomyomlarda en çok tercih edilen tedavi yöntemi cerrahidir. Bu çalışmada, abdominal myomektomide genellikle tercih edilen konvansiyonel yöntemle periservikal turnike uygulamasının etkinlik bakımından karşılaştırılması amaç- lanmıştır. Yöntem: Ocak 2013-Ocak 2014 tarihleri arasında abdominal myomektomi uygulanan 45 kadın iki gruba ayrıldı: (1) paraservikal turnike tekniği (15 hasta) ve (2) konvansiyonel teknik (30 hasta). Submüköz, subseröz ve parazitik myom tanısı olan hastalar çalışma dışı bırakıldı. Periservikal turnike yardımlı myomektomi için uterusun isthmik seviyesinin her iki yanından, uterin arter ve venin asendan dalının lateralinden ve ligamentum latum içinden 16F sonda çepeçevre sarılıp, anterior bölgede bağlanarak turnike uygulandı. Bulgular: Ortalama operasyon süresi periservikal turnike tekniği için 54.7 dakika ve konvansiyonel teknik için 54.6 dakikadır (p>0.05). Turnike uygulanan ve uygulanmayan gruplar, hastanede kalış süresi bakımından benzerdir (2.5 vs 2.6 gün, p>0.05). İki grup arasında, perioperatif komplikasyonlar açısından istatistiksel olarak anlamlı bir fark saptanmamıştır (p>0.05). Hemoglobin ve hematokrit değişiklikleri, turnike uygulanan grupta daha düşüktür ancak bu fark, istatistiksel olarak anlamlı değildir ( >0.05). Sonuç: Periservikal turnike yardımlı teknik, uygulanabilir ve etkili bir yöntemdir.Background: Uterine arteries are the major source of blood flow of the uterus. At the lateral isthmic level, uterine artery divides into two branches and enters the uterus. The ascending branch mainly nourishes uterine corpus while the descending branch provides blood supply for the upper vaginal area. Reduction or discontinuation of ascending uterine artery flow will reduce bleeding during surgical procedures. Surgery is the most preferred treatment in symptomatic leiomyomas. The present study aims to compare the efficacy of conventional and pericervical tourniquet assisted techniques in abdominal myomectomy. Method: Fourty-five women who underwent abdominal myomectomy between January 2013 and January 2014 were allocated into two groups: (1) pericervical tourniquet -assisted technique (15 patients) and (2) conventional technique (30 patients). The patients with submucous, subserosal and parasitic fibroids were excluded. For pericervical tourniquet assisted myomectomy, 16F catheter was strapped around the isthmic level on both sides of the uterus so that tourniquet was applied in front of the anterior region. Results: The mean hospital stay was 2.5 days for the pericervical tourniquet -assisted technique and 2.6 days for the conventional technique (p>0.05). The mean operation time was 54.7 minutes for the pericervical tourniquet -assisted technique and 54.6 minutes for the conventional technique (p>0.05). Both groups were statistically similar in aspect of perioperative complications as well as hemoglobin and hematocrit changes (p>0.05 for all). Conclusion: Pericervical tourniquet-assisted technique is a feasible and effective method for performing myomectomy

Yarı dolu mesane ile yapılan vajinal histerektomi

Yarı dolu mesane ile yapılan vajinal histerektom

Prenatal Diagnosis of Megacyst In Early Pregnancy: A Case Report

A case with an incidental ultrasonographic finding of a megacysty in the 14th week of pregnancy, leading to an early diagnosis of Trisomy 18 is presented. An 18-year-old primigravida attending to outpatient clinic for her routine antenatal check up at the 14th week of her pregnancy was observed to have a fetus with a 12 mm bladder. There were no other apperant major organ or system abnormalities. Under the guidance of current literature, the family was counseled by obstetrics and genetics departments, and a chorion villus sampling was adviced. The result of the CVS was reported as Trisomy 18. The family’s wish of termination of the pregnancy was evaluated and the medical abortion with misoprostol induction was achieved. When evaluating and screening an early pregnancy with ultrasound for fetal abnormalities, the size of the fetal bladder should be evaluated carefully and megacystic cases should be kept in mind with the possibility of chromosomal abnormalities

A New Etiologic Factor for Adnexal Torsion: Congenital Omental Fenestrum

Torsion seen in ovary, fallopian tube or in both organs is one of the gynecologic emergency pathologies in patients suffering from acute lower abdominal pain, and it constitutes approximately 2.7% of gynecologic emergencies. Delays in diagnosis and treatment can cause ischemic damage, in that way can cause the risk of ovary, fallopian tube or both organs loss. Thus, it can result in fertility problems in people who are desiring future fertility. Although the etiology is not totally known, it has been thought that torsion risk has been increasing in benign cystic teratomas and ovarian tumors. It can be also seen in congenital situations such as vitellointestinal duct anomaly and people who have undergone pelvic surgery. In this article, a case for adnexal torsion developed in congenital omental fenestrum which is considered as a new factor for torsion etiology, was explained

Üniversite Öğrencilerinin Bölüm Seçme Nedenleri

Bu araştırmada, üniversite öğrencilerinin, cinsiyetlerine, okudukları üniversitenin (kamu ya da vakıf) ve mezun oldukları lisenin türüne (genel, anadolu/fen ve meslek), anne ve babalarının eğitimi düzeyleri açısından bölüm seçme nedenleri ve bölümden memnuniyetleri arasında fark olup olmadığı araştırılmıştır. Bu amaçla araştırmacılar tarafından geliştirilen bir anket aracılığı ile 869 öğrenciden veri toplanmıştır. Ankette demografik soruların yanısıra meslek seçimini etkileyebilecek etmenler (25 madde) bireysel, sosyal, sistemik ve şans etmenleri biçiminde gruplanarak sorulmuş, ayrıca üniversite ve bölümden memnuniyetlerine ilişkin (7 madde) sorulara yer verilmiştir. Veriler SPSS 15 aracılığı ile frekans, yüzde ve kay kare testi kullanılarak analiz edilmiştir. Bölüm seçme nedenlerinin sıralanmasına bakıldığında en fazla  işaretlenenlerin bireysel ve sistemik etmenler olduğu, bunu sosyal etmenlerin izlediği ve en sonda da yüzde altı oranında şans etmeninin yer aldığı görülmektedir. Öğrencilerin genel olarak okudukları üniversite ve bölümden memnun oldukları görülmektedir. Sonuçlar bağımsız değişkenlerin hepsine göre öğrencilerin bölüm seçme nedenlerini farklılaştığını da göstermektedir. Sonuçlar alanyazın ışığında tartışılmış ve bazı öneriler sunulmuştur

The Evaluation of Multiple Birth Rates For Patients Who Had IVF-ET Procedure in Our Clinic

OBJECTIVE: We evaluated the multiple birth rates for the patients who had undergone IVF-ET procedure in our clinic. STUDY DESIGN: Total number of births and the amount of the births following assisted reproductive techniques (ART) in 2006 in Gulhane Military Medical Academy was investigated. We determined the multiple pregnancy rates among the total births, and our overall success rates, and compared those with the embryo transfer policies and the multiple pregnancy rates of other countries. RESULTS: 120 out of 1797 births (6.6%) in 2006 was the result of ART. A total of 345 embryo transfers made resulted in 176 pregnancies (51%). Live birth rate per embryo transfer was 35%, (120/345). Multiple births were 42 (2.5%), and all were the result of the ART. The ratio of multiples in ART pregnancies were 35%, (42/120). CONCLUSION: Elective single embryo transfer should be promoted by explaining the patients the possible complications of the multiple pregnancies in detail

A Rare Cause of Intrauterine Plagiocephaly within Twin Pregnancy: A Case Report

The word plagiocephaly is occurred from Greek for “slanted” (plagio) and “head” (kephale). Plagiocephaly describes a planar or multiplanar cranial asymmetry which can be occurred in prenatal or postnatal period. In prenatal period, the most reason for associated plagiocephaly is intrauterine pressure (multiple birth infants (especially dizygotic twins), amount of amniotic, small pelvis and uterine tumors etc.). It has been demonstrated in recent studies that the location of the fetuses within uterus, importantly their position and orientation in the uterus and also the number of fetuses play crucial roles in the development of plagiocephaly during pregnancy. In this report, it was reported that in the case of the dizygotic twin- pregnancy due to the location of the babies in the uterus, they are prone to develop plagiocephaly