Levonorgestrel-releasing intrauterine device versus oral progesterone for treatment of simple endometrial hyperplasia without atypia

The aim of this study was to compare the efficacy and effect on the menstrual pattern of the levonorgestrel releasing intrauterine device versus oral progesterone for treatment in patient having simple endometrial hyperplasia (EH) without atypia. Patients who underwent endometrial sampling with abnormal uterine bleeding history and received simple EH without atypia were included in this study between 1 December 2015 and 31 March 2016, retrospectively. Twenty-two patients were treated with the levonorgestrel-releasing intrauterine device (LNG-IUD) and 47 with oral progesterone. Primary outcome measures were regression of hyperplasia after 3 months of therapy. Secondary outcome measures were effect on menstruel pattern during treatment, or rates of hysterectomy and recurrence within a 12 month period. After 3 months of treatment, regression of EH occurred in all of women in LNG-IUD group versus 93% of women in the oral progesterone group (p=0.226). Hb values were increased at the 3th month measurement in both of groups. Endometrial thickness was significantly decreased at the end of the 3th month (p< 0.001). Amenorrhea was more common in the LNG-IUD group (p [Med-Science 2018; 7(1.000): 21-24

Analysis of the effectiveness of ultrasound and clinical examination methods in fetal weight estimation for term pregnancies

Objective: To compare the accuracy of clinical and ultrasonographic (USG) estimation of fetal weight in non-complicated, term pregnancies. Materials and Methods: Two hundred term pregnant women were included in the study. We used three formulae for the estimation of fetal weight at term; the Hadlock formula for the USG method, and two different formulas for clinical methods, maternal symphysis-fundal height and abdominal circumference at the level of umbilicus. Accuracy was determined by mean percentage error, mean absolute percentage error and proportion of estimates within 10% of actual birth weight (birth weight +/- 10%). Patients were divided into two groups according to actual birth weight, the normal birth weight group (2500-3999 g) and high birth weight group (>= 4000 g). Results: All three methods statistically overestimated birth weight for the high and normal birth weight groups (p<0.001, p=1.000, p=0.233) (p=0.037, p<0.001, and p<0.001). For both groups, the mean absolute percentage errors of USG were smaller than for the other two clinical methods and the number of estimates were within 10% of actual birth weight for USG was greater than for the clinical methods; the differences were statistically significant (p<0.001). No statistically significant difference of accuracy was observed for all three methods for the high birth weight group (p=0.365, p=0.768, and p=0.540). However, USG systematically underestimated birth weight in this group. Conclusion: For estimation of fetal birth weight in term pregnancies, ultrasonography is better than clinical methods. In the suspicion of macrosomia, it must be remembered that no method is better than any other. In addition, if ultrasonography is used, careful management is recommended because ultrasonography overestimates in this group

Eyeliner in Bladder: A Case Report

Intravesical foreign objects in bladder are really seen rarely. Most of the time, the reasons of insertions of the foreign body are self-autoerotism to iatrogenic urological procedures, migration from surrounding organs or trauma. It can damage the bladder and may result in several urogenital and bowel complications. Herein, we present a case in a 42-year-old female with an eyeliner pencil self-introduced into the urethra with successfully removal of eyeliner from bladder despite to the anamnesis given involuntarily due to embarrassment, guilt and humiliation. [Cukurova Med J 2015; 40(1.000): 158-161

Malignancy Risk of Endometrial Polyps Among Geriatric Women

Summary: Background: The population of elderly women is increasing worldwide. Here we investigated the prevalence of malignant endometrial polyps in a population of geriatric women. Methods: This retrospective study was conducted at the gynaecology clinic of Zekai Tahir Burak Education and Research Hospital. Women who were aged >65 years and who were pathologically diagnosed with endometrial polyps between 2007 and 2016 were included. All patients with endometrial polyps underwent hysteroscopic resection. Patient characteristics, complaints and imaging and surgical findings were obtained from their medical records. Statistical data analysis was performed using SPSS software. Results: In total, 133 geriatric female patients were included. They had a mean age of 68.96 ± 4.20 (65–83) years. Among them, 114 (85.7%) patients had benign endometrial polyps, 7 (5.2%) had endometrial hyperplasia and 12 (9%) had endometrial cancer. Forty-eight women had been admitted because of postmenopausal bleeding. Eighty-five women presented with either non-specific symptoms, such as abdominal pain, dysuria and urinary incontinence, or had no symptoms and received incidental diagnosis via ultrasound scanning. The mean endometrial thickness was 9.3 ± 6.39 mm in benign cases and 16.44 ± 8.64 mm in premalignant/malignant cases. In multivariate Cox regression analysis, uterine bleeding and endometrial thickness were significantly and independently associated with premalignant or malignant polyps.All malignant polyps were found to be endometrioid adenocarcinoma. Conclusion: In our study, we detected an prevalence of endometrial cancer among 9% of geriatric women with endometrial polyps. Hence, it is important to conduct a pathological evaluation of endometrial polyps in such patients. Keywords: geriatrics, postmenopausal period, polyps, neoplasm

General health status and intelligence scores of children of mothers with acromegaly do not differ from those of healthy mothers

To determine the physical status and intelligence scores of children of acromegalic mothers and to compare them with those of children from mothers without acromegaly

Molecular Diagnosis of Monogenic Diabetes and Clinical/Laboratory Features in Turkish Children

Objective: Monogenic diabetes is a heterogeneous disease that causes functional problems in pancreatic beta cells and hyperglycemia. The aim of this study was to determine the clinical and laboratory features, the admission characteristics and distribution of monogenic form of diabetes in childhood in Turkey. Methods: Patients aged 0-18 years, who were molecularly diagnosed with monogenic diabetes, and consented to participate, were included in the study. Results: Seventy-seven (45.6%) female and 92 male cases with a mean age of 8.18 +/- 5.05 years at diagnosis were included. 52.7% of the cases were diagnosed with monogenic diabetes by random blood glucose measurement. The reason for genetic analysis in 95 (56.2%) of cases was having a family member diagnosed with diabetes under the age of 25. At the time of diagnosis, ketone was detected in urine in 16.6% of the cases. Mean hemoglobin A1c on admission, fasting blood glucose, fasting insulin, and c-peptide values were 7.3 +/- 2.1%, 184.9 +/- 128.9 mg/dL, 9.4 +/- 22.9 IU/L, 1.36 +/- 1.1 and ng/L respectively. GCK-MODY was found in 100 (59.2%), HNF1A-MODY in 31 (18.3%), and variants in ABCC8 in 6 (3.6%), KCNJ11 in 5 (3%), HNF4A in 2 (1.2%), and HNF1B in 2 (1.2%). Conclusion: Recent studies have indicated HNF1A-MODY is the most frequent of all the MODY-monogenic diabetes cases in the literature (50%), while GCK-MODY is the second most frequent (32%). In contrast to these reports, in our study, the most common form was GCK-MODY while less than 20% of cases were diagnosed with HNF1A-MODY