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Numerous studies have been conducted on the psychological effects of the COVID-19 pandemic. However, how the mental health of health workers will be affected among the number of peaks during the pandemic has not been evaluated yet. The study aims to investigate the effects of the first, second, and third peaks of COVID-19 on anxiety, depression, and stress symptoms in healthcare workers.The current study included 4031 healthcare workers, 1051 during the first peak period, 1409 during the second peak period, and 1571 during the third peak period. The Depression-anxiety-stress scale-21(DASS-21) was used to assess the participants' levels of anxiety, depression, and stress symptoms.The mean age of the participants was 33.74 ± 7.95, and 2634 (66.3 %) were female. 36.9 %(n = 1486) of the participants were physicians, 41.1 % (n = 1655) were nurses and 22.1 % (n = 890) were other healthcare workers. A statistically significant difference was documented in the DASS-21 anxiety (F(2:4028) = 502.893, p 2. Peak1. Peak), DASS-21 depression (F(2:4028) = 46.034, p 2. Peak1. Peak), DASS-21 stress (F(2:4028) = 65.548, p 1. Peak), and DASS-21 total scores (F(2:4028) = 156.860, p 2. Peak1. Peak) of healthcare workers during all three peak periods.Our findings show that as the peak number rises, so do the levels of anxiety and depression among healthcare workers. As a result, it is possible to assert that prolongation of the COVID-19 pandemic worsens mental problems (Tab. 2, Fig. 3, Ref. 35).

Research question: Can cannabidiol (CBD) be used in the treatment of endometriosis for its anti-inflammatory, antioxidative and antiangiogenic effects? Design: Endometrial implants were surgically induced in 36 female Wistar albino rats. After confirmation of endometriotic foci, the rats were randomized into four groups. In the leuprolide acetate group, rats were given a single 1 mg/kg s.c. leuprolide acetate injection. The other groups were 5 mg/kg CBD (CBD5), saline solution and 20 mg/kg CBD (CBD20); daily i.p. injections were administered for 7 days. After 21 days, the rats were euthanised, and total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-a) measurements in blood and peritoneal fluid samples, and immunohistochemical staining for TNF-a, IL-6 and vascular endothelial growth factor (VEGF) of endometriotic tissues were evaluated. Results: Significant reductions in the endometriotic implant surface area (P = 0.0213), serum TOS (P = 0.0491), OSI (P = 0.0056), IL-6 (P = 0.0236), TNF-a (P = 0.0083) and peritoneal fluid OSI (P = 0.0401), IL-6 (P = 0.0205) and TNF-a (P = 0.0045) concentrations were observed in the CBD5 group when compared with the saline solution group. Compared with the saline solution group, increased TAS concentrations in serum (P = 0.0012) and peritoneal fluid (P = 0.0145) were found in the CBD5 group. The CBD5 and leuprolide acetate groups were similar regarding inflammatory and oxidative stress parameters of serum and peritoneal fluid samples. The CBD5 group showed significantly lower mean intensity in both surface epithelium and stromal cells for VEGF (both P = 0.002) and only in surface epithelium cells for IL-6 (P = 0.0108), when compared with the leuprolide acetate group. Conclusion: Due to its anti-inflammatory, antioxidative and antiangiogenic effects, CBD might be a therapeutic agent candidate for endometriosis. Department of Biostatistics ; Reakiro Company ; Bezmialem Vakif University

Aim: To investigate the association between menstrual cycle regularity in healthcare providers and COVID-19 pandemic-related anxiety, depression, stress. Methods: A cross-sectional study was conducted by administrating online questionnaires to female healthcare workers in Turkey. Women aged 18–40 years with regular menstrual cycles for more than 1 year before the beginning of the pandemic were included in the study and they were divided into two groups according to menstrual cycle regularity during the pandemic. The questionnaires included sociodemographic characteristics, medical and reproductive history, lifestyle information of participants, COVID-19 Stress Scales (CSS), and a short version of the Depression Anxiety Stress Scale (DASS-21). Results: A total of 952 women were included in the study, 679 had regular menstrual cycles, and 273 had irregular menstrual cycles. The prevalence of irregular menses among Turkish women healthcare workers aged 18–40 years was 28.7%. The CSS subdimensions and total scores were significantly higher in the irregular menstruation group than in women with regular menstruation (p < 0.001). The DASS-21 depression, anxiety, and stress subdimensions were likewise significantly higher in women with irregular menstruation (p < 0.001). Besides, both the univariable and the multivariable logistic regression results showed the relationship between irregular menstruation and CSS total score. Conclusion: The current study showed the association between the COVID-19 pandemic-induced anxiety, perceived stress, depressive symptoms, and increased prevalence of menstrual cycle irregularity among healthcare providers.

Oral glucose tolerance testing (OGTT) is the recommended approach for the diagnosis of gestational diabetes mellitus (GDM). Leptin and chemerin are two examples of hormones from adipokine family, which mostly takes part in glucose metabolism and inflammatory processes. We aim to find a possible new and tolerable screening technique for GDM using salivary levels of leptin and chemerin.Saliva samples of pregnant patients, on their 24-28th weeks of gestation, are collectedELISA study for leptin showed an insignificant difference between patients with GDM and patients without where the values were 0.44 ± 0.33 and 0.34 ± 0.24 respectively (Leptin and chemerin can be detected in saliva. Chemerin levels are significantly higher in patients with GDM, thus this knowledge can be used to develop a new screening method for OGTT.

Purpose: The aim of this study is to understand the motives behind CS requests in nulliparous women in their late pregnancy better and to investigate if specific personality traits affect the maternal decision on mode of delivery. Material and method: This prospective study was conducted with 70 healthy, nulliparous parturient with singleton pregnancies. Women at their 28-32. weeks of gestation were asked to fill a socio-demographic data form and the questionnaires; Personality Belief Questionnaire - Short Form (PBQ-SF) and The Childbirth Attitudes Questionnaire (CAQ). After delivery, all the results of pre-filled questionnaires and women's mode of delivery were analyzed and compared. Results: There were significant differences in personality types; dependent (p = 0.033), passive-aggressive (p = 0.031), obsessive-compulsive (p = 0.001), antisocial (p = 0.014), narcissistic (p = 0.014) and borderline (p = 0.014) between vaginal delivery and CS groups. The CAQ scores of the mothers who requested CS were significantly higher (p:0.007). Weak but significant positive relation was found between total CAQ scores and avoidant (p = 0.022), dependent (p = 0.034), passive-aggressive (p = 0.040), narcissistic (p = 0,006), schizoid (p = 0.007), paranoid (p = 0.007) and borderline (p = 0.007) personality types. Conclusion: This is the first study that investigates the relationship between mode of delivery and personality traits according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) and cognitive behavioral perspective in the literature. These personality traits can be carried at a level that is not clinically significant to create an obvious pathology, yet they might play a role as the motives behind the apparent reasons for women who request CS. Understanding women's motives and attitudes for childbirth during their pregnancy may help healthcare providers to tailor women's approach to childbirth to avoid unnecessary CS.

Backgrounds: Although the psychological effects of the COVID-19 pandemic have been investigated, there is no study comparing the effects between the peaks. This study aims to compare the levels of anxiety, depression, and stress of healthcare workers struggling with pandemic between the first and second peaks. Methods: A total of 2460 healthcare workers, 1051 from the first peak period and 1409 from the second peak period, were included in the study. The first peak measurements of the participants were made between 07.04.2020 and 05.05.2020 and the second peak measurements were made between 22.11.2020 and 20.12.2020 according to the peak period in Turkey. Depression-Anxiety-Stress-21(DASS-21) scale was applied to the participants online by the purpose of the study. Results: The mean age of the participants was 32.63 ± 7.70, and 66.5% of them were female. A statistically significant difference was found between the income status (p < 0.001), lifestyle (p < 0.001) and COVID-19 test result (p < 0.001), DASS-21 Depression (p < 0.001, t = -5.311), Anxiety (p < 0.001, t = -8.244), Stress (p < 0.001, -10.056) and total(p < 0.001, t = -8.719) scores of the two groups. Conclusion: The present study results showed that healthcare workers meticulously struggling with the pandemic had increased anxiety, depression, and stress levels at the second peak of the pandemic compared to the first peak.

Leiomyomasare benign mesenchymal tumors mostly seen in uterus. Uterin leiomyomas are oneof the most common reasons of pelvic masses seen in women whereas ovarianleiomyomas are so rare that among allbenign ovarian tumours it accounts only 0,5-1 %. It’s mostly seen between agesof 20-65 which premenopausal women consist %85 of them. In this case we wanted to present a 14 years old girl who was admitted to ourclinic with a 6 months history of lower quadrant abdominal pain. In theultrasonographic evaluation, there was a solid mass with uterin echogenityextending from posterior of uterus towards left adnexia with diameters of 6 cmx 5,5 cm. The origin of the tumor was unknown and could not be revealed withultrasonography nor MRI until diagnostic laparoscopy was performed. Ovariantumor was removed and the final pathology was compatible with leiomyoma.When we checked the literature there were only 5 cases of ovarian leiomyomareported under age of 20 and mostly they had bilateral character. The youngestage reported was 13. Our case is the second youngest of all reported cases andit shows a unilateral character. The other important aspect of our case is thatsometimes the imaging techniques can’t be adequate for detecting the origin oftumor., Leiomyomlarsıklıkla uterusta rastlanan benin mezenkimal tümörlerdir. Uterin leiomyomlarkadınlarda görülen pelvik kitlelerin en sık nedenlerinden olsa da over kaynaklıleiomyomlar oldukça nadir görülmektedir. Ovaryan leiomyomlar o kadar nadirgörülmektedir ki bütün over kaynaklı benin tümörlerin yalnızca %0,5 ila %1’inioluşturmaktadır. Genellikle 20-65 yaş grubunda görülmekte olup %85’inipremenopozal dönemdeki kadınlar oluşturmaktadır.Bu olgudakliniğimize 6 aydır devam eden alt kadran karın ağrısı nedeniyle başvuran 14yaşındaki bir kız çocuğunu sunduk. Ultrasonografik görüntülemede uterus arkaduvar komşuluğundan sol adneksiyal bölgeye uzanım gösteren, uterin ekojenitesiolan solid görünümde 6x5.5 cm çaplarında kitle izlendi. Kitlenin kaynağınınayrımı ultrason ve mr ile net belirlenememesi üzerine diagnostik laparoskopiuygulandı. Over kaynaklı olduğu görülen kitle çıkarılıp patolojiyegönderildiğinde nihai patoloji sonucu leiomyom ile uyumlu çıktı.Bildirilen vakalariçinde 14 yaşında olarak en genç ikinci vaka olma özelliği, genelderastlanandan farklı olarak unilateral karakter taşıması ile özellikli bir olguolduğunu düşünüyoruz. Ayrıca bazen görüntüleme tekniklerinin kitlenin kaynağınıbelirleme açısından yetersiz kalabildiği de bu olguda karşımıza çıkmıştır.

dogan, ozan/0000-0002-0016-8749 WOS: 000438931800005 PubMed: 30084477 Objectives: Our aim is to evaluate the laboratory results arid proteinuria levels of preeclamptic women arid their relationships to maternal and fetal outcomes. Material and methods: One hundred preeclamptic pregnant women who gave birth in our clinic between 2013 and 2015 were included in our study retrospectively. The data collected from the patients included gestational week, age, gravidity, parity, abortus history, blood pressure, biochemical parameters, delivery method, maternal hospitalization time, cesarean indication, complications, blood products required, plasmapheresis use and dialysis need. The details about the newborns were recorded retrospectively. The relationships between preeclampsia signs and maternal and neonatal outcomes were analyzed. The protein amounts were analyzed via 24-hour collected urine analyses and spot urine analyses. Results: A statistically significant positive correlation was observed between neonatal intensive care unit needs and proteinuria levels. Fetal growth restriction, respiratory distress syndrome and sepsis were observed as the level of proteinuria increased, but the result was not statistically significant. Eclampsia was observed only in patients with massive proteinuria, and it was statistically significant. An increase in cesarean sections, placental abruptions, antihypertensive drug needs and blood product replacement rates was observed as the amount of proteinuria increased in preeclamptic women, but the results were not statistically significant. Conclusions: The severity of preeclampsia cannot be determined by the level of proteinuria. However, when massive proteinuria is detected, the clinician should be more cautious about maternal and fetal complications.

OBJECTIVE To document the neonatal outcomes of preterm birth in twin pregnancies and to investigate whether perinatal and obstetric parameters are associated with clinical outcomes. METHODS This retrospective trial was conducted on data gathered from 176 preterm twins delivered in the obstetrics and gynecology department of our tertiary care center. Data extracted from medical files of 88 pregnant women who gave preterm birth (at 26(0/7) to 36(6/7) gestational weeks) to twins were analyzed. Maternal/fetal descriptive and obstetric parameters, sonographic data, route of delivery, indication for cesarean section, birth weight, Apgar scores, head circumference, umbilical cord length and placental weight were noted. RESULTS The average age of the pregnant women was 28.8±6.4 years and ultrasonographic gestational age was 31.9±2.6 weeks. Apgar scores at 1(st) minute were affected significantly by fetal body weight (p=0.001), gestational age (p=0.001), height (p=0.004) and head circumference (p=0.011). None of these variables exhibited a noteworthy effect on Apgar scores at 5(th) minute. CONCLUSION Efforts must be made to achieve advancement of gestational age until delivery in the follow-up preterm of twins. A well-established algorithm with special emphasis to risk factors is necessary to standardize and popularize the appropriate management strategy.