Związek wskaźnika anizocytozy płytek (PDW) oraz wskaźnika PCT ze stanem przedrzucawkowym

Objective: While the relationship between platelet crit (PCT), platelet distribution width (PDW) and hypertension has been well-documented, data on the association between PCT, PDW and preeclampsia are scant at best. In our study, we aimed to investigate the possible correlation of PCT and PDW with preeclampsia and disease severity. Material and methods: A total of 110 preeclamptic and 100 healthy pregnant women were included in the study. Baseline PCT and PDW were measured using an automatic blood counterin the entire study population. Results: While there were no significant differences between the preeclampsia group and the control group in terms of hemoglobin and platelet counts, the PDW, mean platelet volume (MPV), systolic and diastolic blood pressure, proteinuria, WBC and Hs-CRP levels were significantly higher in the preeclampsia group. In addition, PCT level was significantly lower in the preeclampsia group as compared to controls. Moreover, subgroup analysis revealed that PDW and MPV levels were significantly increased in severely preeclamptic patients when compared to mildly preeclamptic patients. Conclusions: Our study results revealed that PCT and PDW levels were associated with both, the presence and severity of preeclampsia.Cel pracy: Związek pomiędzy wskaźnikiem PCT, wskaźnikiem anizocytozy płytek krwi (PDW) a nadciśnieniem tętniczym jest dobrze udokumentowany, podczas gdy dane na temat zależności pomiędzy PCT i PDW a stanem przedrzucawkowym są skąpe. W naszym badaniu celem było zbadanie możliwych korelacji pomiędzy PCT i PDW a stanem przedrzucawkowym oraz ciężkością choroby. Materiał i metoda: Do badania włączono 110 kobiet ze stanem przedrzucawkowym i 100 zdrowych ciężarnych. Wyjściowe wartości PCT i PDW zmierzono przy pomocy automatycznego pomiaru krwi w całej badanej populacji. Wyniki: Nie znaleziono istotnych różnic pomiędzy grupą pacjentek ze stanem przedrzucawkowym a grupą kontrolną w odniesieniu do hemoglobiny i liczby płytek krwi, podczas gdy PDW, średnia objętość płytek (MPV), ciśnienie skurczowe i rozkurczowe, obecność białka w moczu, WBC i poziom Hs-CRP były istotnie wyższe w grupie ze stanem przedrzucawkowym. Dodatkowo, poziom PCT był istotnie niższy w grupie ze stanem przedrzucawkowym w porównaniu do grupy kontrolnej. Co więcej, analiza podgrup wykazała, że poziom PDW i PCT wzrastał istotnie wraz z ciężkością stanu przedrzucawkowego. Wnioski: Nasze badania wykazały, że poziom PCT i PDW jest związany zarówno z obecnością jak i ciężkością stanu przedrzucawkowego

Relation of inflammatory markers with both presence and severity of hyperemesis gravidarum

Objectives: The aim of our study is to determine the newly introduced systemic inflammation marker, neutrophil lymphocyte ratio (NLR) in hyperemesis gravidarum (HG) patients and to investigate the association between severity of the disease and NLR. Method: The study population consisted of 55 pregnant patients with HG and 50 pregnant women without complaints matched for gestational age as a control group. The HG patients were grouped as mild (n=16), moderate (n=19) and severe (n=20) according to Modified Pregnancy- Unique Quantification of Emesis and Nausea Scoring Index Questionnaire. Furthermore, hsCRP, neutrophils, lymphocytes, and NLR were evaluated with complete blood count. Results: The HG group had significantly higher NLR values compared to the control group (2.69±1.81 vs 1.97±1.34, p=0.004). HsCRP levels were significantly higher among HG patients compared to the control group (1.95±2.2 vs 0.56±0.30,

Does the presence of anhydramnios affect the duration of medical abortion?

Objectives: The aim of the study was to determine whether anhydramnios affected the duration of medical abortion in cases with various indications as compared to cases with normal amniotic fluid volume. Material and methods: Patients who were admitted to our clinic because of medical abortion between January 2010–December 2013 were included in this retrospective study. A total of 32 pregnant women with anhydramnios (study group) and 67 pregnant women with normal amniotic fluid volume but with fetal abnormality (control group) were included in the study. Patient age, gravidity, parity, gestational age, previous delivery route, and duration of the abortion were recorded. Results: Mean duration of the abortion in the study group was 71.93 ± 47.51 h as compared to 79.08 ± 52.62 h in the control group. There were no statistically significant differences between the two groups in terms of duration of the abortion (p = 0.516). Also, we found no statistically significant differences in duration of the abortion with regard to previous delivery route (p = 0.220). Conclusions: There were no statistically significant differences between the study group and controls in terms of duration of the abortion. In addition, neither parity nor previous delivery route affected the duration of the abortion

A rare syndrome, pentalogy of cantrell : case report

Cantrell pentalojisi, omfalosel ve torako-abdominal ön duvar defektiyle birlikte ektopia kordisin beraber görüldüğü nadir bir sendromdur. Etyopatogenezi net olarak bilinmeyen bu sendromlu fetusların prognozu kötüdür. Gebeliğin 25.haftasında kliniğe başvuran olgunun yapılan ultrasonografik muayenesinde Cantrell pentalojisinin tüm özellikleri saptanmıştır. Bu yazıda Cantrell pentalojisi güncel literatür eşliğinde tartışılmıştırPentalogy of Cantrell is a rare syndrome; characterized by ectopia cordis with omphalocele and anterior wall defect of thoraco-abdominal. Prognosis of fetuses with this syndrome which etiopathogenesis is unknown, is poor. The patient who admitted to our clinic at 25th week of gestation, had all signs of pentalogy of Cantrell in ultrasonography. In this article, we discussed the pentalogy of Cantrell with review of the literatur

PERİPARTUM DÖNEMDE SPLENİK ARTER ANEVRİZMA RÜPTÜRÜ: OLGU SUNUMU

Splenic artery aneurysm (SAA) is the most common type of aneurysm in the visceral artery aneurysms. If SAA is ruptured, the mortality is higher. SAA which is more common in women, has increased risk of rupture depending on the physiological events in pregnant women. SAA rupture in pregnant women is encountered with sudden syncope and shock in the clinic. In this article, we aimed to present the rupture of SAA ın pregnant wome

Rheumatoid arthritis and pregnancy : 15 case reports

Amaç: Romatoid artrit (RA), yetişkin populasyonun yaklaşık %1-2’sinde görülmekte olup, kadınlarda görülme sıklığı, erkeklerden fazladır. RA’lı kadınların önemli bir kısmı da reprodüktif çağdadır. RA’nın aktivitesi gebelikte genellikle azalırken, bir kısmında ise semptomlar daha da kötüleşir. RA tedavisinde kullanılan ilaçların, gebelik üzerine etkisi tam bilinmediğinden dolayı, gebelik sürecinde hastalığın tedavisi tartışmalıdır. Bu yazıda amacımız, kliniğimiz de gebelik ve RA tanıları ile takip edilen olguların antenatal ve postnatal dönemdeki klinik özelliklerinin irdelenmesidir. Gereç ve Yöntemler: Bu çalışmaya RA tanısıyla takip edilen 15 hasta dahil edilmiştir. Gebelik öncesi kullanılan tedavi kesilmiş ve hastalar sadece prednol ve parasetamol almıştır. Bu sürede gebelerin takibi aynı klinisyen tarafından yapılmıştır. Ultrasonografi ile seri fetal ölçümler ve 3. trimestırda non-reaktif stres (NST) testi yapıldı. Gebelik boyunca her ay RA açısından klinik muayene yapıldı. Ayrıca her ay laboratuvar testlerinden tam kan sayımı, biokimya ile eritrosit sedimentasyon hızı (ESH) ve C-reaktif protein (CRP) çalışıldı. İstatiksel analiz SPPS 17.0 programı ile yapıldı. Bulgular: Hastaların yaş ortalaması 26.7 ± 1.2 (20-32) idi. Onbeş, hastanın ondördünde gebelik öncesinde RA mevcut iken, sadece bir tanesi hamilelik döneminde yeni tanı almıştır. Oniki RA’lı gebede semptomlar düzelirken, ikisinde şiddetlendiği gözlenmiştir. Gebelikte yeni tanı alan RA hastasına perinatal dönemde prednol ve sadece ağrı kesici olarak parasetamol verilirken, postpartum dönemde sulfasalazin başlanmıştır. Postpartum dönemde onbir hastada semptomlar yeniden şiddetlendi ve bunlara sulfasalazin başlandı. RA semptomları gebelikte azalan olgularda laboratuvar bulgularının gebelik haftası ilerledikçe azaldığı görülürken, klinik bulguların da aynı şekilde gerilediği izlenmiştir. ESH ve CRP ile hassas eklem sayısı ve şiş eklem sayısı arasında pozitif korelasyon olduğu tespit edilmiştir (r= 0.678, p: 0.02). Sonuç: RA’sı olan hastalara gebelik öncesinde kullandıkları ilaçların gebelikte zararlı olabileceği ve gebelik döneminde semptomların değişebileceği hakkında danış- manlık verilmelidir. RA’sı olan gebeler, gebelik döneminde yakından takip edilerek semptomlara yönelik tedavi uygulanmalıdır. Postpartum dönemde semptomların yeniden şiddetlenebileceği akılda tutulmalı ve hastalar bu konuda uyarılmalıdır. Ayrıca gebelik öncesi metotreksat kullanan hastalara emzirme döneminde de bu ilacın kontrendike olduğu anlatılmalıdır ve bunun yerine diğer ilaçlar düşünülmelidir.Aim: Rheumatoid arthritis (RA) is seen approximately 1-2% of adult population and is more common in women than men. A significant number of these women with RA is in the reproductive age. While the activity of RA during pregnancy usually decreases, the symptoms are getting worse in a part. As the insufficient knowledge about whether the drugs for RA are safe in pregnancy, the treatment of this disease is difficult. In the present study, the prognosis of RA in patients before pregnancy, perinatal and postpartum period was reported.Material and Methods: A total of 15 patients with RA were included to this study. The treatment was stopped for RA before pregnacy and the patients received just prednol and paracetamol. At this time, the monitoring of pregnants was conducted by the same clinician. Serial ultrasonography and non-reactive stres test(NST) in the 3’rd trimestere were done. Clinical examination was done every month during pregnancy in term of RA. Moreover, the laboratory tests (complete blood count, biochemical, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) ) were studied. The statistical analyse was performed with SPSS 17.0 for windows Results: The mean age of patients was 26.7 ± 1.2 (range 20-32). While the RA was present ın fourteen of fifteen patients before pregnancy, just one of them has taken a new diagnosis. The symptoms of twelve pregnants with RA was decreased and was observed to be aggravated in two other of pregnants. The patient with RA who was diagnosed newly in pregnancy, received just analgesic (paracetamol) and prednol in the perinatal period and methotraxate (mtx) was started in the postpartum period. In the postpartum period, a total of eleven patients' symptoms were re-aggravated and thereby, methotrexate and sulfasalazine were given again to seven of them. While laboratory findings in cases of decreased RA symptoms in pregnancy were decreasing with increasing gestastional age, the clinical findings also were regressed. There was a positive correlation between ESH, CRP with tender joint count and swollen joint count (r= 0.678, p: 0.02). Conclusion: The patients with RA should be counseled before pregnancy and monitorized closely and treated for symptoms during pregnancy. Re-aggravation of symptoms in the postpartum period should be kept in mind and patients should be warned about this. In addition, the patients who received methotrexate before pregnancy, should be told that this drug is contraindicated during breast feeding period and other medications should be considered instead of this dru

Cesarean birth after vaginal delivery : a survey in healthcare proffesionals

Amaç: Çalışmadaki amacımız sağlık çalışanlarının sezaryen sonrası vajinal doğum hakkında bilgi düzeylerini ölçmek.Gereç ve Yöntemler: Tanımlayıcı tipteki bu çalışmada Mustafa Kemal Üniversitesi Tıp Fakültesinde görev yapan 100 sağlık personeline randomize anket formu dağıtılmış ve yanıtlanması istenmiştir. Anket formu Amerikan Obstetri ve Jinekoloji Derneği (ACOG) tarafından yayınlanmış SSVD hakkında hasta bilgilendirme formuna istinaden hazırlanmıştır.Bulgular: Çalışmaya dahil edilen 87 sağlık çalışanından'Sezaryen sonrası vajinal doğum yapılabilir mi?' sorusuna 63 (%72,4) kişi evet yanıtını verirken 24 (%27,6) kişi hayır cevabını verdi. Aynı sorunun cevabına meslek gruplarına göre bakıldığında ise gruplar arasında fark izlenmedi (p=0,3). Sezaryen sonrası vajinal doğuma evet cevabı veren katılımcılara SSVD yapılabilmesi için gerekli önceki doğuma ait kesi şekli ve sezaryen sayısı sorulduğunda 21( %33,3) kişi bilmiyorum, 30 (%47,6) kişi transvers ve 12 (%19) kişi vertikal olması gerektiğini belirtti. Aynı grubun SSVD için gerekli minimum geçirilmiş sezaryen sayısına cevabı değerlendirildiğinde 25 (%39,7) kişi bilmiyorum, 13 (%20,6) kişi 1, 13 (%20,6) kişi 2, 11 (%17,5) kişi 3 ve 1 (%1,6) kişi 4 olarak kaydedildi. 'Sezaryen sonrası normal doğum yapmanın riskleri nelerdir?' sorusuna katılımcıların cevaplarının dağılımları 29(%46) bilmiyorum, 30(%47,6) rüptür ve 4 (%6,3) yok olarak kaydedildi.Sonuç: Sonuç olarak özellikle geçirilmiş sezaryen olan hastalarda SSVD'nin bir seçenek olduğu günümüzde, SSVD'nin mümkün olduğu çoğu sağlık çalışanı tarafından bilinse de, şartları ve riskleri konusunda sağlık çalışanlarının yeterince bilgi sahibi olmadığı görüldü. Bu konuda uygun eğitim ve bilgilendirmenin sağlanması artan sezaryen oranlarının kontrolünde yardımcı olabilirAim: The aim of this study was to ascertain the knowledge for Vaginal Birth after Cesarian Section (VBAC) in people who are working in hospitalMaterial And Methods: This descriptive study was done in Mustafa Kemal University, Medical Faculty Hospital and a total of 100 surveys were randomized distrubuted. The surveys were prepared by using the patient aknowledgement form of American College of Obstetricians and Gynecologists (ACOG). Results: Eighty seven surveys were returned and evaluated. ‘ Is VBAC possible ?’ question was responded by 63 (72.4%) health care providers as ‘yes’ and 24(27.6%) as ‘no’. There were no difference between occupation groups for this question (p=0.3).’What should be the uterine incision scar in previous section to achieve VBAC?’ was asked to persons that said ‘yes’ for former question. Twenty one ( 33.3%) of them responded as ‘I don’t know’ , 30 (47.6%) as ‘transvers’ and 12 (19%) as ‘vertical’.Same group also responded of minimum previous cesarian section number for VBAC 25 (39.7%) as ‘I don’t know’, 13 (20.6%) people as 1, 13 (20.6%) as 2, 11 (17.5%) people as 3 and 1 (1.6%) person as 4. ‘What is the risk of VBAC?’ was asked and responded as ‘I don’t know’ from 29 (%46) people, as ‘uterine rupture’ from 30(%47,6) people and ‘no risk’ from 4 (%6,3) people.Conclusion: In conclusion even though VBAC is considered as an option in most of health care providers they have not sufficient knowledge about conditon and risks of VBAC. Informing of this group may help to decrease cesarian rate in the populatio

Maternal MTHFR C677T Gen Mutasyonu Varlığının Yenidoğan Doğum Ağırlığı Üzerine Etkisi

Aim: reductase) gene mutation may diminish MTHFR activity and result in an increased homocystein level. It is thought that MTHFR gene mutation may cause intrauterine growth restriction. The aim of this study is to evaluate the effect of maternal MTHFR gene mutatıon presence on neonatal birth weights. Materials and Methods: The study population consists of MTHFR gene mutation group (n=71) and control group (n=36). Neonatal birth weights were compared between groups. Results: 107 pregnant women applying to Mustafa Kemal University Hospital were included in this study. Neonatal birth weights were lower in MTHFR gene mutatıon group than in control group. Conclusion: Our study result showed that neonatal birth weights were lower in MTHFR gene mutation group than in control group. Neonatal care may be necessary for newborn of mothers having MTHFR gene mutation. Further studies are needed to investigate the relation between MTHFR gene mutation and neonatal birth weight. Key reductase, Mutation words: methylenetetrahydrofolate weight, neonatal birth Gen

Intraoperative ephedrine allergy in a patient who received chemotherapy and perioperative hypersensitivity reactions

Kemoterapi almış hastada intraoperatif efedrin alerjisi ve perioperatif hipersensitivite reaksiyonları anestezi, farmakolojik açıdan özgül bir durumu temsil eder ve bu süre boyunca çok sayıda yabancı maddelere maruz kalan hastalarda erken aşırı duyarlılık reaksiyonları veya anafilaksi gelişebilir. Otuz yedi yaşındaki, total abdominal histerektomi planlanan hastada intraoperatif hipotansiyon gelişmesi nedeniyle (5 mg) efedrin iv uygulandı. Uygulama sonrası aynı ekstremitenin iv kanülün yerleştirildiği ven trasesi hattında kızarıklık görüldü. Yaklaşık 15 dakika sonra her iki ekstremitede, batında yaygın ürtiker plakları gözlendi. İntravenöz kristalloid infüzyon hızı arttırılarak, metilprednisolon (100 mg+100 mg), Feniraminmaleat (45,5 mg) verildi. Postoperatif sorunsuz ekstübe edilerek postoperatif bakım ünitesinde gözleme alındı. Lezyonları postoperatif 60. dakikada tamamen ortadan kalkmasının ardından yaşamsal bulgularının da istikrarlı olması nedeniyle servise alındı. Cerrahi takibinde herhangi bir komplikasyon gelişmeyen hasta yatışının ikinci gününde taburcu edildi.Anaesthesia represents a specific set-up in respect to pharmacology, and during this time, early hypersensitivity reactions or anaphylaxis may occur in patients who are exposed to a great number of foreign substances. Intravenous ephedrine (5 mg) was applied to a 37-year-old patient due to the development of intraoperative hypotension in a total abdominal hysterectomy operation. After application, hyperaemia was seen in the track of the intravenous catheter of that extremity. Approximately 15 minutes later, urticarial plaques were observed extensively in the abdomen and in both extremities. Methylprednisolone (100 mg+100 mg) and pheniramine (45.5 mg) were given with an increasing infusion rate of intravenous crystalloid. The patient was extubated without any problem and removed to the recovery unit for observation. After the total disappearance of lesions at postoperative 60 minutes and because of the stability of vital signs, the patient was removed to the service. In the follow-up of surgery, no complication developed, and the patient was discharged on postoperative day 2

Üriner İnkontinans Tarifleyen Kadınlarda Aile ve Enürezis Nokturna Öyküsü

Aim: In this study, the relationship of urinary incontinence (UI) with family history and nocturnal enuresis history were investigated in women in the reproductive age that admitted to the outpatient clinics. Materials and Methods: Total of 520 female patients were included in the study that admitted to urology, gynecology, internal medicine and family medicine clinics between December 2013 - January 2014. General questionnaire containing sociodemographic characteristics and urinary incontinence history questionnaire was administered to these patients. Results: 520 women aged between 15-49 years were investigated and 35% (182) of them complained of urinary incontinence. More often had a complaint of incontinence in a little amount (42.9%). The most common type was urge 114 (22%) of had UI history in first-degree relatives. 31.4% of them suffered from urinary incontinence in childhood and; 28.4% of sad that they received treatment, 55% of was not treated, 16.6% of did not remember anything. Conclusion: UI is a common health problem and quite often in the female population. The most women see UI as a result of being a women and aging so they dont take medical advice. This disease should be awared and treated and in childhood. It is important to identify the problem and the risk factors of UI in patients admitted to outpatient clinic