Search

Objective: To present the reference range of the fetal thymus gland according to gestational age groups. Methods: In this prospective study, fetal thymus size was assessed in singleton, uncomplicated pregnancies between 19 and 38 weeks of gestation in our outpatient clinic between 2019 and 2020. Based on their monthly pregnancy follow-ups, fetal thymus measurement was divided into 5 gestational age groups (Group 1: 19–22 weeks, Group 2: 23–26 weeks, Group 3: 27–30 weeks, Group 4: 31–34 weeks, and Group 5: 35–38 weeks). Results: Fetal thymus measurements of 210 patients were performed over one year, and as a result, 184 pregnant patients were included for assessment. Fetal thymus could be visualized at a rate of 93.5%. The 5th percentile of thymus transverse diameter, antero-posterior diameter, perimeter, thymus anterior-posterior diameter to thoracic diameter, and thymus perimeter to thoracic circumference were 11.03 mm, 5.60 mm, 32.52 mm, 0.33, and 0.32 in Group 1; 13.53 mm, 7.66 mm, 43.67 mm, 0.34, and 0.32 in Group 2; 20.43 mm, 11.22 mm, 47.72 mm, 0.33, and 0.32 in Group 3; 27 mm, 12.98 mm, 55.88 mm, 0.32, and 0.30 in Group 4; 28 mm, 13.59 mm, 63.4 mm, 0.32, and 0.30 in Group 5; respectively. Spearman’s rho correlation coefficients for the thymic measurements were 0.879, 0.869, 0.846, 0.236, and 0.267 respectively, and all p-values were less than 0.001. As a result of linear regression analysis between thymus measurements and BPD; the equations for the optimal models are as follows: thymus transverse diameter= -3.49+0.4xBPD (mm) (r=0.826, R2=0.682, p

To investigate the effect of coffee consumption on bowel motility on postcaesarean patients. This study is designed as a prospective randomized trial. Patients who are operated between dates June 2017-July 2017 are assessed for eligibility. We included patients who are operated under elective conditions. Leading exclusion criterias were; emergency caesarean section , patients diagnosed with inflammatory bowel disease, chronic constipation, irritable bowel syndrome and who had previous bowel or endometriosis surgery. Simple randomization scheme is used. Patients allocated to intervention group drank 65 cc Turkish coffee at postoperative 4 th and 12 th hour; control group patients drank warm water starting from postoperative 4th hour. Time to first flatus, presence of stool passage and nausea, vomiting are questioned and recorded. Sixty five patients' data was available for final analysis. General characteristics of control and intervention group patients were similar regarding mean age, body mass index (BMI), operation time, type of anesthesia , postoperative analgesic requirement . Mean time to first flatus was 17.7±6.1 and 13.0±5.7 hours respectively for control and intervention group (p:0.004). Number of patients whose stool passage assured before discharge were 7 (22.6%) in control and 3 (8.8%) in intervention group (p:0.174). There was not any patient who had nausea and vomiting in both groups. Postoperative coffee consumption is a cheap, attainable and safe practice that can be utilized to expedite gastrointestinal motillity during postcaesarean period. [Med-Science 2022; 11(2.000): 651-5]

To investigate the postoperative pain intensity after laparoscopic gynecologic surgeries conducted with different pneumoperitoneal pressures. This study was designed as a single-blinded prospective randomized trial in a tertiary referral center. Patients who were scheduled to undergo laparoscopic surgery for benign gynecologic pathologies between dates August 2018 and December 2019 were included. Exclusion criterias were ; malign gynecologic diseases , lack of consent and conversion to laparotomy. Primary outcome measure was postoperative pain scores at 6th and 24th hour time point ; secondary outcome measures were shoulder tip pain and need for opioid type analgesic. The initial and intraoperative pressure for group 1 was 15 mm Hg, the initial pressure was 15 mm-Hg and intraoperative pressure was 12 mm Hg for group 2, and the initial and intraoperative pressure was 12 mm Hg for group 3. Visual analog score (VAS) surveys were performed in postoperative follow-ups for the 6th and 24th hours. The presence of shoulder tip pain and the postoperative opioid analgesic requirement was additionally evaluated. One hundred and seventy-one patients were investigated for per-protocol analysis. The mean 6th and 24th-hour VAS scores of the three study groups were 4.9;3.5; 5.0;4.1, and 5.3;4.3 respectively, for groups 1, 2, and 3 (p=0.506). The difference in shoulder tip pain rates was not statistically significant at each time point between the patient groups (p=0.829 and p=0.334, respectively). Opioid analgesic requirement was significantly higher in patients undergoing laparoscopic hysterectomy with 15 mm Hg intraabdominal pressure (p=0.004). Surgeons should take into account that high intraperitoneal pressures may cause more opioid analgesic requirement. Although pain scores and shoulder tip pain were comparable, opioid analgesic requirement is an important health issue. [Med-Science 2022; 11(2.000): 471-7]

To examine the histopathological features and treatment modalities in patients with uterine sarcoma according to subgroups (uterine leiomyosarcoma, low grade/high grade endometrial stromal sarcoma, adenosarcoma, undifferentiated uterine sarcoma) and to determine the factors affecting mortality rates. We retrospectively evaluated patients diagnosed with uterine sarcoma in our center between March 2012 and December 2019. We compared the clinicopathological characteristics and treatment modalities of the subgroups and investigated the factors affecting mortality rates using logistic regression analysis. There was no difference between the subgroups in terms of age, body mass index, menopausal status, comorbidity, presenting complaint, primary diagnosis, surgical treatment protocol, adnexal and lymph node involvement and tumor size (p> 0.01). However, there were higher rates of hormone therapy administration in the low grade endometrial stromal sarcoma group (p: 0.000). There were comparable rates of local and distant metastases between subgroups, however, no difference was found between chemotherapy and radiotherapy protocols (p> 0.01). It was found that in all US groups, stage was the only parameter which affected mortality rates (OR: 15.7 (95% CI 2.8-29.6) p = 0.002). Stage is the most important factor affecting mortality in all uterine sarcomas. Despite their different histopathological features, subgroups do not have distinctive features such as demographic features, presenting complaints, primary diagnosis and surgical treatment protocols. [Med-Science 2021; 10(3.000): 1020-5]

Objective Pregnancies after in vitro fertilization (IVF) are associated with a less favorable outcome compared to natural conception as consistently shown in various studies. However, etiologic factors behind this issue remain to be elucidated. We aimed to demonstrate whether the etiology of infertility has a role on poor pregnancy outcomes in IVF pregnancies. Methods In this retrospective case control study; IVF and spontaneous singleton pregnancies were investigated. The infertile patients were divided into six groups according to the etiology of their infertility (anovulation, male factor, tubal factor, endometriosis, unexplained infertility and poor ovarian reserve). The incidence of preeclampsia, gestational diabetes mellitus, intrahepatic cholestasis of pregnancy, preterm birth and birth weight discrepancies was examined between the groups and subgroups. After adjusting the confounding variables for each infertility subgroup such as demographic data, embryo stage in transfer (blastocyst against cleavage stage) and fresh and frozen embryo transfer status, the effect on pregnancy outcomes was investigated using multinomial logistic regression analysis. Results The study included 934 patients in the IVF group and 1009 patients in the control group. While adverse pregnancy outcomes were more frequent in the general infertility group in comparison to the control group, after elimination of the confounding variables, the direct effect of the etiology of infertility on these outcomes could not be shown. Conclusion In the IVF pregnancies, most of the increased risk of poor pregnancy outcomes appeared to be explained by maternal characteristics (such as age, body mass index) and by treatment protocols rather than infertility etiology. Physicians should consider these risks while counselling patients.

Objective This study evaluated the association between proteinuria levels and maternal, and perinatal outcomes of preeclampsia patients and determined the cutoff values for predicting severe complications. Methods We retrospectively evaluated the records of 412 patients with proteinuric preeclampsia. Results Median proteinuria levels were significantly higher in patients with severe maternal and adverse perinatal outcomes than in those without such outcomes, except in cases of placental abruption and late preterm delivery. Conclusion Proteinuria levels may aid in diagnosing preeclampsia and indicating early intervention. The revised guidelines do not suggest that proteinuria encountered during pregnancy is clinically insignificant.