Laparoscopy versus open surgery for the surgical management of tubo-ovarian abscess (TOA). Is there a beneficial impact of early endoscopic intervention in terms of fertility rates?

Objectives: To compare success rates and complications in women undergoing laparoscopic versus open surgical management of tubo-ovarian abscess. We further examined whether early laparoscopic intervention has any impact on pregnancy rates in a subgroup of infertile patients following frozen-thawed embryo transfer. Material and methods: Hospital records of 48 patients diagnosed with TOA between January 2015 and December 2020, who underwent surgical intervention or received only medical treatment were analyzed. All patients were hospitalized, and parenteral antibiotics were commenced on admission initially. Laparoscopic or open surgery was performed within 48 hours course of intravenous antibiotherapy (early intervention) or later according to the clinical findings and antibiotherapy response. Results: Of 48 patients with TOA, 18 (37.5%) underwent laparoscopic and 30 (62.5%) underwent open surgical intervention. The median postoperative hospital stay was shorter (4.5 days vs 7.5 days, respectively; p = 0.035), and postoperative opioid analgesic requirement was lesser in the laparoscopy group compared to open surgery group (22% vs 53%, respectively; p = 0.034). Intra- and post-operative complication rates were similar between the groups. Of these 48 patients, seven were diagnosed to have TOA following oocyte retrieval, and four of these conceived with frozen thawed embryo transfer all of whom underwent laparoscopic surgery within 48 hours of diagnosis. Conclusions: Minimal invasive surgery should be preferred even in the presence of severely adhesive and inflammatory TOA in order to improve postoperative outcomes. Moreover, early laparoscopic intervention may be considered in infertile patients with an aim to optimize pregnancy rates in a subsequent frozen-thawed embryo transfer

Recurrent Cystic Hygroma with Normal Karyotype in Two Consecutive Pregnancies

We herein describe a woman with two consecutive pregnancies affected by fetal nuchal cystic hygroma (CH) with a normal karyotype. A 33-year-old woman (gravidity 2, parity 1) was referred to us because of fetal hydrops. No consanguinity or Rh isoimmunization was involved in her current or previous pregnancy. First-trimester ultrasonography revealed nuchal CH, and chorion villus sampling was performed to exclude aneuploidy. In the first pregnancy, the CH had regressed and aortic coarctation was detected by second-trimester fetal echocardiography. In the current pregnancy, the CH had progressed and was complicated by the development of nonimmune hydrops. Termination of the pregnancy was performed at 21 weeks’ gestation. Recurrence of fetal CH in subsequent pregnancies is extremely rare. CH with a normal karyotype can be inherited as an autosomal recessive trait. This report describes a woman with recurrent CH with normal karyotypes and different prognose

The effects of gestationalweight gain and maternal body mass index discrepancy on all stages of labor

Objective: To investigate the effects of maternal body mass index (BMI) and total weight gain during the pregnancy (WGDP) on all stages of labor. Material and Methods: This is a prospective case-control study carried out at a tertiary referral hospital during 1-year period of time. We divided study population into 4 groups according to BMI and classified women according to WGDP; inadequate, optimum, excessive. Then we assessed the maternal characteristics, cesarean rate, all variables of labor stages, delivery complications, operative delivery rates, and interventions such as; induction rate and episiotomy. Results: A total of 523 women were included in the study [n=55 (10.5%) cesarean section and n=468 (89.5%) vaginal delivery]. There were 435 pregnant Turkish women and 88 Syrian Refugees in the study population. Younger maternal age and need for episiotomy was more common in low-weight group than others. All stages of labor except transition stages (duration between 7 and 10 cm of cervical dilatation) was longer in obese group (222.9±35.6 min, 195.8±29.6 min, 200.6±30.4 min, 255.8±38.2 min in group 1,2,3 and 4, respectively) (p<0.05). We found no statistically significant effect of weight gain on the duration of labor. Conclusion: Either low and high pre-gestational BMI are found to lead to increased risk of adverse labor results in compatible with literature. Therefore, professionals should support weight loss or gain to achieve optimal BMI in women planning pregnancy

Photoneutron Flux Measurement via Neutron Activation Analysis in a Radiotherapy Bunker with an 18 MV Linear Accelerator

In cancer treatment, high energy X-rays are used which are produced by linear accelerators (LINACs). If the energy of these beams is over 8 MeV, photonuclear reactions occur between the bremsstrahlung photons and the metallic parts of the LINAC. As a result of these interactions, neutrons are also produced as secondary radiation products (γ,n) which are called photoneutrons. The study aims to map the photoneutron flux distribution within the LINAC bunker via neutron activation analysis (NAA) using indium-cadmium foils. Irradiations made at different gantry angles (0°, 90°, 180° and 270°) with a total of 91 positions in the Philips SLI-25 linear accelerator treatment room and location-based distribution of thermal neutron flux was obtained. Gamma spectrum analysis was carried out with high purity germanium (HPGe) detector. Results of the analysis showed that the maximum neutron flux in the room occurred at just above of the LINAC head (1.2x105 neutrons/cm2.s) which is compatible with an americium-beryllium (Am-Be) neutron source. There was a 90% decrease of flux at the walls and at the start of the maze with respect to the maximum neutron flux. And, just in front of the LINAC door, inside the room, neutron flux was measured less than 1% of the maximum

Gömük alt yirmi yaş dişi cerrahisi sonrasında görülen erken dönem komplikasyonlar: Retrospektif değerlendirme

Bu çalışmada, alt gömük yirmi yaş dişlerinin çekimini takiben görülen erken dönem komplikasyonların değerlendirilmesi amaçlanmıştır. Araştırma, Ankara Üniversitesi Diş Hekimliği Fakültesi’nde alt gömük yirmi yaş dişine çekim endikasyonu koyulmuş ve cerrahisi gerçekleştirilmiş olan 68 hasta üzerinde yapılmıştır. Araştırmada ameliyat sonrası dönemde görülen ağrı, ödem, trismus, alveolit, dudak ve dilde his kaybı, kanama, yara yerinde açıklık ve yutkunma zorluğu gibi parametreler değerlendirilmiştir. İstatistiksel değerlendirmeler için veriler SPSS Statistical Package for Social Sciences 11,5 programında bilgisayara aktarılmış ve yüzde dağılımları elde edilmiştir. Araştırmaya 36 erkek ve 32 kadın hasta dâhil edilmiştir. 34 sağ ve 34 sol olmak üzere toplam 68 alt gömük yirmi yaş dişinin çekim sonrası 3. güne kadar meydana gelen komplikasyonları değerlendirilmiş ve %35’inde ağrı, %69’unda ödem, %75’inde trismus, %4’ünde dudakta his kaybı, %1’inde dilde his kaybı, %18’inde yutkunma zorluğu, %1’inde ikincil kanama ve % 6’sında alveolit görülmüştür. Sonuç olarak alt gömük yirmi yaş dişlerinin çekimi sonrasında oluşabilecek komplikasyonların fazla olması nedeniyle hekimin bu konuyla ilgili hangi komplikasyonun hangi durumda olabileceği konusunda yeterli bilgi ve tecrübeye sahip olması gerekmektedi

Photoneutron Flux Measurement via Neutron Activation Analysis in a Radiotherapy Bunker with an 18 MV Linear Accelerator

In cancer treatment, high energy X-rays are used which are produced by linear accelerators (LINACs). If the energy of these beams is over 8 MeV, photonuclear reactions occur between the bremsstrahlung photons and the metallic parts of the LINAC. As a result of these interactions, neutrons are also produced as secondary radiation products (γ,n) which are called photoneutrons. The study aims to map the photoneutron flux distribution within the LINAC bunker via neutron activation analysis (NAA) using indium-cadmium foils. Irradiations made at different gantry angles (0°, 90°, 180° and 270°) with a total of 91 positions in the Philips SLI-25 linear accelerator treatment room and location-based distribution of thermal neutron flux was obtained. Gamma spectrum analysis was carried out with high purity germanium (HPGe) detector. Results of the analysis showed that the maximum neutron flux in the room occurred at just above of the LINAC head (1.2x105 neutrons/cm2.s) which is compatible with an americium-beryllium (Am-Be) neutron source. There was a 90% decrease of flux at the walls and at the start of the maze with respect to the maximum neutron flux. And, just in front of the LINAC door, inside the room, neutron flux was measured less than 1% of the maximum