İyatrojenik vajen darlığının emilebilir bir oksidize rejenere seluloz ile genişletilmesi

OBJECTIVE: Iatrogenic vaginal stenosis adversely affects the sexual life of couples. The definitive treatment of this condition is possible by redilatation of vagina. This study aims to investi- gate the outcomes of vaginal dilatation procedure performed using an absorbable oxidized regenerated cellulose. MATERIAL AND METHODS: 29 patients who could not have intercourse due to Iatrogenic vaginal stenosis underwent va- gina enlargement surgery using an absorbable oxidized rege- nerated cellulose in the period of April 2014 to August 2020. The results were analysed with the help of the standard ‘Patient Global Impression of Improvement Scale (PGI-I) which evalua- tes patient satisfaction in particular. RESULTS: The mean follow-up period was 16 monts (14 - 24 months). No major perioperative complication was detected except from perianal hemotoma treated with antibiotics and drainage in a case. At 6th month follow up visit, 27 patients re- ported pain free sexual intercourse. Two patients needed re-di- latation 4 and 6 months later respectively.Based on the scores of patients as “much better ‘’and ‘’very much better” on the PGI-I scale, satisfaction rate was 93% at 6th month follow up visit. CONCLUSIONS: Vaginal dilatation surgery with absorbable oxidized regenerated cellulose seems to be a safe and effecti- ve procedure with positive anatomical and functional results. However, many comparative studies are needed to fully the ef- ficiency and safety of this procedure.AMAÇ:Vajinanıniatrojenikolarakfazladaraltılması,çiftlerin cinsel hayatını olumsuz etkilemektedir. Bu durumun kesin tedavisi ise tekrar vajinanın genişletilmesi ile mümkündür. Bu çalışma, emi- lebilir oksidize rejenere seluloz kullanılarak uygulanan vajina ge- nişletme işleminin sonuçlarını değerlendirmeyi amaçlamaktadır. GEREÇ VE YÖNTEM: İatrojenik vajina darlığı nedeniyle ilişkiye giremeyen 29 hastaya, Nisan 2014 ile Ağustos 2020 tarihleri arasında, emilebilir oksidize rejenere seluloz kullanılarak vajina genişletme ameliyatı yapıldı. Bu ameliyatın sonuçları, özellikle hasta memnuniyetini değerlendiren standart ‘’Hasta Memnu- niyet Ölçeği’’ yardımıyla incelendi. BULGULAR: Hastalar, ortalama 16 ay (14 - 24 ay) takip edildi. Drenaj ve antibiyoterapi ile tedavi edilmiş bir perianal hemo - tom vakası dışında perioperatif dönemde kaydedilmiş majör komplikasyon saptanmadı. Altı haftanın sonunda, 27 hasta ağ- rısız cinsel ilişkiye girebildiğini belirtti. Iki hastada ise, sırasıyla 4 ve 6 ay sonra, vajina genişletme ameliyatı tekrar uygulandı. Cer- rahiden altı ay sonra, memnuniyet ölçeğindeki “daha iyi ‘’ve ‘’çok daha iyi” cevaplarına göre ameliyat sonrası hasta memnuniyet oranı %93 olarak saptandı. SONUÇ: Emilebilir oksidize rejenere seluloz kullanılarak yapılan vajina genişletme ameliyatı, olumlu anatomik ve fonksiyonel sonuçlara sahip etkili ve güvenilir bir işlem gibi görünmektedir. Ancak, bu yöntemin güvenilirliğinin ve etkinliğinin tam olarak değerlendirilebilmesi için çok sayıda karşılaştırmalı çalışmaya ihtiyaç vardır

Relationship between physical activity level and plantar sensitivity, balance in postmenopausal women

This research was planned to investigate the relationship between physical activity level and plantar sensitivity, static and dynamic balance in postmenopausal women. Forty women between the ages of 50 and 65, who had not had a menstrual period for at least 12 months, and who had undergone menopause due to hormonal, surgical or natural means were involved in the research. International Physical Activity Questionnaires Short Form (IPAQ-SF) was used to assess the level of physical activity. Light touch pressure threshold on soles of the individuals and two-point discrimination sense were evaluated bilaterally from 6 different regions of the sole of the foot. Single leg and tandem stance tests were used for static balance assessment. Dynamic balance was evaluated with Berg Balance Scale (BBS) and Timed Up and Go Test (TUG). As a result of the statistical analysis, a negative correlation was found between the total physical activity level of the participants and the light touch pressure of the right big toe. There was a significant negative correlation between total physical activity level and left big toe, and the 1st and 5th metatarsal heads of the left foot. A significant negative correlation between total physical activity level and TUG test was detected. However, no significant difference between total physical activity and BBS, static balance tests was found. As a result of this research, it was concluded that the level of physical activity affects the light touch sense of big toes of both feet, and the 1st and 5th metatarsal heads of left foot. During this study, it was seen that if total physical activity level decreases, then the score of TUG can increase. Physical activity level and related factors should be examined with a larger number of samples

A simple approach for relieving voiding dysfunction after tension-free vaginal tape: Safety stitch

Voiding dysfunction is one of the most common postoperative complications of the tension-free vaginal tape procedure. The aim of this study was to show the effectiveness of loosening the tape with a simple approach. A total of 84 women underwent a tension-free vaginal tape operation for stress urinary incontinence. While operation was performed, a prolene suture–safety stitch was inserted in the middle of the tape. Then vaginal incision was closed by extracting the prolene stitch outside. Thus prolene suture will be pulled with a clamp when patient complaint of voiding dysfunction at the postoperative period. A total of 18 patients (21.4%) experienced voiding dysfunction at the postoperative 1-month follow-up period. Sixteen patients (%19) were performed transvaginal tape mobilization within 3 days (range 1–5) after the primary procedure. No complications were observed with the mobilization. Two patients(2.3%) performed clean intermittent catheterization for a period of more than 1 day, with an average of 14.4 days (range 3–63). After tape mobilization, 15 women (93.7%) were recovered from voiding dysfunction and were continent. One woman was incontinent after mobilization. The incidence of voiding dysfunction requiring tape mobilization was 19%. Pulling the safety stitch without anesthesia and without reopening the vaginal incision is a simple, safe, and effective way for tape mobilization to relieve voiding dysfunction

The effects of different gonadotropin releasing hormone analogues in IVF cycles

Objective: To compare Triptorelin, Leuprolide acetate and Nafarelin sodium in women undergoing controlled ovarian hyperstimulation for in vitro fertilization cycles. Settings: Zeynep Kamil Women and Children's Hospital Reproductive Endocrinology - Infertility - IVFCenter. Material and Methods: Sixty patients were haphazardly distributed for each GnRH-a group. GnRH-a was administrated, starting on the 21st day of menstrual cycles for the long protocol: Triptorelin (Decapeptyl, 0.1 mg) as 0.1 mg/day SC, leuprolide (Lucrine, 5 mg flacon) as 0.5 mg/day SC and nafarelin (Synarel, 2 mg/mi nasal spray) as 200 micrograms to each nostril with a daily total dosage of 800 micrograms. The responses from each group were compared on the basis of duration of stimulation, total dosage of gonadotropin, E2 values on day 5, the down regulation duration, cyst formation, E2 values on the 1st day of stimulation and HCG, progesterone values and endometrial thickness on the HCG day, the number oocytes picked up, fertilization rates, the number of transferred embryos, pregnancy and implantation ratios. Results: Evaluating Triptorelin (T), Leuprolide (LA) and Nafarelin (NA) groups respectively, E2 values on the 1st day of menstrual cycles, measured to confirm the down regulation for each GnRH-a, were 24.67 pg/ml, 21.23 pg/ml, 29.62 pg/ml (p<0.05); the total gonadotropin usage (ampoules) were 47.15 ± 12.97, 39.45 ± 13.97, 36.72 ± 13.14 (p<0.05); the number of retrieved oocytes were 9,89 ± 5,98, 10,50 ± 3,69 and 9,19 ± 5,31 (p>0,05); the fertilization rates were 89%, 100% and 100% (p>0.05). The implantation and pregnancy rates, the two major parameters of the study were 5% and 15% in T, 16.5% and 40% in LA, 14.8% and 38.8% in NA groups respectively (p>0,05). Conclusions: Even though the success rates in Triptorelin group were somewhat lower, the results of every GnRH-a group were statistically similar; but to reach the same outcome we had to use more gonadotropins in this former group. Cost-effectivity analysis of the three GnRH-a makes Leuprolide and Nafarelin better choices than Triptorelin. However, we must state that our study has two major limitations to give a concrete conclusion, namely the study was not randomized and the number of patients was very small

Bir olgu sunumu: Olağandışı over lokalizasyonu ve müller kanalı anomalili hastada başarılı gebelik

In this article we aimed to describe the clinical findings in a patient with subhepatic right ovary and müllerian duct anomalies who was successfully treated with in vitro fertilization (IVF) due to male factor infertility. Ovarian maldescent is a rare condition, and ovary localization can be seen up to the subhepatic region. This unusual ovarian localization suggests ovarian maldescent can be anywhere between the liver and pelvic brim When required, transabdominal ultrasound-guided oocyte retrieval and IVF can be performed successfully.Sağ over lokalizasyonu subhepatik alanda izlenen ve Müller kanal anomalileri bulunan bu olguda male faktör sebebiyle ıvf uygulanmıştır. İnmemiş over lokalizasyonu nadir görülmekle birlikte , görüldüğünde sıklıkla pelvis giriminde olmaktadır. Bu olguda literaütrde ilk defa bu kadar yüksek seviyede yani subhepatik bölgede yerleşmiş bir over lokalizasyonu belirtilmiştir. Male faktör sebebiyle IVF uygulanan hastaya abdominal oosit toplama işlemi yapılmış, inmemiş over olgularında overin pelvik giriminden subhepatik alana kadar herhangi bir alanda olabileceği fikri savunulmuştur

Supplementation of docosahexaenoic acid (DHA) / Eicosapentaenoic acid (EPA) in a ratio of 1/1.3 during the last trimester of pregnancy results in EPA accumulation in cord blood

WOS: 000413616200005PubMed ID: 28987719Omega-3 fatty acids (n-3 FA), specifically DHA, are associated with fetal growth and development. We aimed to determine the levels of DHA and EPA in cord serum after n-3 FA supplementation during the last trimester of pregnancy. Among 55 women, 23 were administered daily one capsule of n-3 FA supplement, involving DHA/EPA in a ratio of 1/1.3. Twenty nine women were enrolled as control group. Blood samples were collected at 22-24 weeks of gestation and at delivery. Fatty acids were analyzed with the method of GC-MS. Cord DHA level increased and EPA level decreased in both groups between the days of 22-24 and delivery. However, decrease in cord EPA level was significant in control group (p 0.05). Supplementation of DHA/EPA in a ratio of 1/1.3 during the last trimester of pregnancy caused higher cord EPA level compared to control group indicating an accumulation in umbilical cord

Oxidative stress in maternal milk and cord blood in gestational diabetes mellitus: A prospective study

BACKGROUND: Reduced antioxidant defenses may reflect a poor protective response against oxidative stress and this may be implicated in progression of gestational diabetes mellitus (GDM). Oxidative stress induced by hyperglycemia plays a major role in micro and macrovascular complications, which imply endothelial dysfunction. OBJECTIVE: Our aim in this study was to investigate the association between GDM and oxidative stress markers measured in plasma, with regard to revealing changes to total antioxidant capacity (TAC) and total oxidant status (TOS) among mothers showing impairments in oral glucose tolerance tests (OGTTs). DESIGN AND SETTING: Prospective study at a university hospital in Turkey. METHODS: The study group consisted of 50 mothers with GDM, and 59 healthy mothers served as con-trols. Umbilical cord blood samples were taken from all mothers during delivery and breast milk samples on the fifth day after delivery. TAC, TOS, thiol and disulfide levels were measured. RESULTS: No statistically significant relationship between the blood and milk samples could be found. An analysis on correlations between TAC, TOS and certain parameters revealed that there were negative correlations between TOS and total thiol (r =-0.386; P < 0.001) and between TOS and disulfide (r =-0.388; P < 0.001) in milk in the control group. However, these findings were not observed in the study group. CONCLUSION: Our findings suggested that a compensatory mechanism of oxidative stress was expected to be present in gestational diabetes mellitus and that this might be ameliorated through good glycemic regulation and antioxidant supplementation

Predictive value of serum and follicular fluid chemerin concentrations during assisted reproductive cycles in women with polycystic ovary syndrome

Aims To evaluate the effect of serum and follicular fluid (ff) Chemerin levels on Assisted Reproductive Technology (ART) outcomes in lean patients with PCOS. Materials and methods The study included 76 infertile reproductive aged women, between 21-35 years who underwent intracytoplasmic sperm injection (ICSI) procedure. Serum and ff Chemerin levels were evaluated. Fertilization and clinical pregnancy rate were compared between the groups. Results Serum (13.32 ng/ml versus 29.82 ng/ml) and ff chemerin (35.90 ng/ml versus 87.60 ng/ml) levels were significantly higher in lean PCOS patients compared to controls (p < .01). Serum (24.5 ng/ml versus 18.4 ng/ml) and ff chemerin (71.7 ng/ml versus 52.8 ng/ml) levels were higher in subjects without clinical pregnancy compared to the subjects with clinical pregnancy (p < .05). A cutoff value of 36.2 ng/ml in the ff chemerin level was found to estimate clinical pregnancy with 83% sensitivity and 52% specificity (Area under the curve 0.66; 95% confidence interval, 0.53-0.79). A cutoff value of 12.7 ng/ml in the serum chemerin level was found to estimate clinical pregnancy with 91% sensitivity and 49% specificity (Area under the curve 0.65; 95% confidence interval, 0.52-0.78). Clinical pregnancy rates were significantly higher in group with lower serum chemerin levels (80.0% versus 30.4%, p < .001). High serum chemerin levels are associated with failure of assisted reproduction [OR:0.1(95% CI, 0.03-0.4, p < .001)]. Conclusions PCOS is associated with higher serum and ff chemerin levels and high serum chemerin level is a risk factor for failed ART cycle

Expression of WT1 gene in multiple myeloma patients at diagnosis: is WT1 gene expression a useful marker in multiple myeloma?

Monitoring patients with multiple myeloma during and after treatment for the presence of residual myeloma cells (minimal residual disease - MRD) has been shown to give a major insight into the effectiveness of treatment. It has been reported that Wilms' tumor gene (WT1) expression levels measured by real-time quantitative polymerase chain reaction was useful as an indicator of minimal residual disease in leukemia and myelodysplastic syndrome. The aim of this study was to measure levels of WT1 expression, in order to find a possible association between the expression of this gene and multiple myeloma at diagnosis. If an association was found, the WT1 gene could be evaluated as an MRD marker by comparison with other prognostic factors. We investigated peripheral blood WT1 expression level measured by real-time light cycler quantitative polymerase chain reaction in 50 newly diagnosed multiple myeloma patients. The normal WT1 gene copy number was found to be <23/mu l cDNA and all patients with myeloma were found to have normal WT1-mRNA levels. On this basis WT1 expression analyses is unlikely to be a useful genetic marker for routine clinical use in multiple myeloma patients at diagnosis