Transvaginal Sonographic Evaluation of the Cervix in Asymptomatic Singleton Pregnancy and Management Options in Short Cervix

Preterm delivery (PTD), defined as birth before 37 completed weeks of gestation, is the leading cause of perinatal morbidity and mortality. Evaluation of the cervical morphology and biometry with transvaginal ultrasonography at 16–24 weeks of gestation is a useful tool to predict the risk of preterm birth in low- and high-risk singleton pregnancies. For instance, a sonographic cervical length (CL) > 30 mm and present cervical gland area have a 96-97% negative predictive value for preterm delivery at <37 weeks. Available evidence supports the use of progesterone to women with cervical length ≤25 mm, irrespective of other risk factors. In women with prior spontaneous PTD with asymptomatic cervical shortening (CL ≤ 25 mm), prophylactic cerclage procedure must be performed and weekly to every two weeks follow-up is essential. This article reviews the evidence in support of the clinical introduction of transvaginal sonography for both the prediction and management of spontaneous preterm labour

Second trimester uterine artery pulsatility index and chorionicity in twins

Background: We aimed to compare the second trimester uterine artery Pulsatility Index (PI) measurement in twin pregnancies according to the chorionicity and determine its effect on twin pregnancy outcome in terms of fetal and birth weight.Methods: All medical records of twin pregnancies, whose fetal screening was done between May 1999 and January 2012, were evaluated retrospectively. All twin pregnancies without detected/suspicious anatomical or genetic fetal anomalies, biochemical abnormalities, and familial genetic diseases were included in the data analyses. Ones with missing PI measurements and ones with undetermined chorion types were excluded from the data analyses.Results: A total of 149 twin pregnancies were evaluated. The percentages of chorion types were diamniotic dichorionic in 89.9% (n=134) and diamniotic monochorionic 10.1% (n=15). Mean age of the mothers was 31.56 ± 4.9 years. Mean gestational week of PI measurement was 20.30 ± 2.23 weeks. Mean birth week was 35.5 ± 2.50 weeks. Mean birth weight was 2405 ±437 grams. Correlation analyses related to PI values and second trimester weight and birth weight parameters didn’t show any statistically significant correlation.  Mean maternal age, mean gestational week of PI measurements, mean birth week, mean fetal weights and birth weights were indifferent between chorionicity groups. Comparisons of second trimester PI, second trimester weight and birth weight and related parameters showed no statistically significant between groups.  Conclusions: Second trimester uterine artery pulsatility index measurements do not differ between chorionicity types. It has no effect on twin pregnancy outcome in terms of fetal weight and birth weight

Sonographically Diagnosed Vault Hematomas Following Vaginal Hysterectomy and Its Correlation with Postoperative Morbidity

Objective. Our aim is to investigate sonographically detectable vault hematomas after vaginal hysterectomy and its relation to postoperative morbidity. Methods. We studied a group of 103 women who had undergone vaginal hysterectomy for benign causes apart from uterovaginal prolapse. Transabdominal ultrasound examinations were carried out 24 to 72 hours after surgery to assess the presence of vault hematomas. Ultrasound findings were correlated with clinical data and postoperative morbidity. Results. The incidence of vault hematoma was found 19.4% in present study. In these patients, 40% (8/20) had fever while only 2.4% (2/83) of cases without vault hematoma suffered from fever. Out of all women having vault hematoma, 70% (14/20) had small-sized hematoma and 30% (6/20) had large-sized hematoma. Fifty percent of patients (3/6) with large-sized hematoma, as compared to only 35% (5/14) with small-sized hematoma, suffered from febrile morbidity. Large-sized hematomas drained by vaginally, while all small-sized pelvic hematomas managed by watchful expectancy successfully. The significant difference was found mean hemoglobin drop and postoperative stay in the hematoma group or without hematoma group. Conclusion. Sonographic detection of vaginal vault fluid collection is common after hysterectomy, but such a finding rarely indicates additional treatment. Though febrile morbidity was more in cases with vault hematoma, the number of such patients was too small to be significant. Vaginal ultrasound examination should not be performed routinely after hysterectomy

A decision support model proposal for privatization of public bus transportation: Eskisehir sample

Kentlerde ulaştırma hizmetleri genellikle yerel y&ouml;netimlerce ger&ccedil;ekleştirilmektedir. Yerel y&ouml;netimler&nbsp; &ccedil;eşitli sebeplerle kentliye sundukları taşıma hizmetinde yetersiz kalmışlardır. Başka sekt&ouml;rlerde olduğu gibi ulaştırma sekt&ouml;r&uuml;nde de &ouml;zelleştirme bir &ccedil;&ouml;z&uuml;m olarak ortaya &ccedil;ıkmıştır. Ulaştırmada &ouml;zelleştirme, ulaşım alt yapısının &ouml;zel işletmecilerle kullanılması olup b&uuml;y&uuml;k harcamalarla ger&ccedil;ekleştirilen altyapının verimli şekilde kullanılması yanında, yolcuların sunulan taşıma hizmetinden memnun kalmaları ve bunlarda s&uuml;rekliliğin sağlanmasının &ouml;nemi b&uuml;y&uuml;kt&uuml;r. &Ccedil;alışmada, kenti&ccedil;i toplu taşıma hizmetinin &ouml;zelleştirilmesi i&ccedil;in bir karar destek modeli ortaya konması ama&ccedil;lanmıştır. Bulanık mantık, istatistik y&ouml;ntem ve electre y&ouml;ntemi kullanılmıştır. Eskişehir ilindeki taşımalardan elde edilen veriler kullanılmıştır.Anahtar Kelimeler: &Ouml;zelleştirme, karar verme, model kurma.People have been very closely interested in transportation that is very important for their lives for a long time and they have used various vehicles for their transportation. On the otherhand, public transportation is generally carried out by local authorities in cities. However, they haven?t been able to accomplish the required duties that they present to their citizens. Therefore, privatization has appeared as a solution in the transportation sectors like the other sectors. However, privatization in transportation means using the substructure with private sectors and it is important to use the substructure which has been accomplished with great dispenses profitably. Besides, the appreciation of travellers and the continuity of this service is essential as well. In this study, a model about the privatization of public transportation service was proposed. Fuzzy logic method, statistical method and electre method were used for the model. The data obtained from transportation in Eskisehir where  privatization is practiced were used. Four groups were formed for participation decision making. These groups were formed from a user, an expert, an administrator and some non-governmental organizations. Final decisions of these groups were combined by using the span method. At the same time, the demand analysis was realised so as to determine the net income of the administrators. The data were collected by stated preferences method and the demand for buses was estimated.Keywords: Privatization, decision making, establishing model

The Effects of Different Types of Fly Ash on the Compressive Strength Properties of Briquettes

The aim of this study is to evaluate the effect of the different types of fly ash on the compressive strength properties of sintered briquettes. Thermal gravimetric (TG) analysis was carried out. The chemical composition and physical properties of the materials used were determined. Particle size distribution and microstructure elemental analyses of the materials used were carried out by a particle size analyzer (Mastersizer) and a scanning electron microscope (SEM-EDS). Following the characterization of the materials, briquettes were prepared by sintering at different temperatures. Compressive strength test results of the briquette samples indicated that briquettes with a compressive strength value of 47.45 N/mm2 can be produced. The results obtained exceed the Turkish standard (TS EN 771-1) requirements (9.8–23.54 N/mm2). SEM-EDS results showed that briquette samples made with Tunçbilek (T) fly ash had a higher percentage of the glassy phase than the other briquette samples. Due to this microstructure, it results in higher compressive strength value

COVID-19 during pregnancy and its impacts on perinatal health

n this review, we reviewed current literature on COVID-19 infection during pregnancy and provided up-to-date information and community/society recommendations. Although it has previous examples such as SARS and MERS and the infection findings appeared at an earlier period and have become known in China, the infection could not be limited and spread worldwide. Until June 8, 2020, a total of 6.8 million cases were reported and 397,000 cases died. As of the same date, the total case number in Turkey is 171,000 and total number of death is 4711. COVID-19 virus spread by droplets and its incubation period varies between 2 and 14 days. The rate of asymptomatic cases is 42% in non-pregnant patients while it is 44–89% in pregnant women. The disease progresses with mild-medium severity in about 80% of the patients, and it recovers by itself. A total of 17 maternal death cases has been reported. Although vertical transmission risk is very low according to a study investigating 265 pregnant women, there are cases showing fetal vertical transmission and we reviewed such cases in detail in this review

The Role of Patent Foramen Ovale in Cryptogenic Stroke Kriptojenik İnmede Patent Foramen Ovalenin Rolü

INTRODUCTION Approximately 40% of ischemic strokes with no clearly definable etiology are classified as cryptogenic stroke (1). The etiology of some cryptogenic strokes may be an embolus from the venous system traversing from the right to left atrium into the systemic circulation through a patent foramen ovale (PFO), a phenomenon known as paradoxical embolism (2). The first description regarding the association of PFO with stroke was in a young woman with cerebral arterial embolism by Cohnheim et al. (3) in 1877. At autopsy series of general population, the prevalence of PFO is 20−26% (4). However, PFO prevalence in cryptogenic strokes changes between 40% and 55.7% (5). A PFO located between the septum primum and septum secundum leads to the passage of fetal blood from the right atrium to the left atrium. In 75% of PFO cases, thi

Monocyte-to-HDL-cholesterol ratio is associated with Ascending Aorta Dilatation in Patients with Bicuspid Aortic Valve

Background: The importance of monocyte count-to-HDL-cholesterol ratio (MHR) in cardio- vascular diseases has been shown in various studies. Ascending aortic dilatation (AAD) is a common complication in the patients with bicuspid aortic valve. In this study, we aimed to investigate the relationship between MHR and the presence of aortic dilatation in the patients with bicuspid aortic valve. Methods: The study population included totally 347 patients with bicuspid aortic valve.169 patients with aortic dilatation (ascending aorta diameter 65 4.0 cm) and 178 patients with no aortic dilatation. Echocardiographic and laboratory measurement was done and compared between groups. Results: The mean age of the participants was 44.7 \ub1 15.4 years and average ascending aorta diameter was 3.2 \ub1 0.3 cm in dilatation negative group and 4.4 \ub1 0.4 cm in positive group. MHR was significantly increased in in patients with aortic dilatation. MHR and uric acid level was independently associated with the presence of aortic dilatation in the patients with bicuspid aortic valve. Conclusion: We found a significant relationship between MHR and aortic dilatation in the patients with bicuspid aortic valve