OBJECTIVE: Dinoprostone is a drug of choice in our daily practice for the induction of labor. The aim of our study; to compare the use of oxytocin with dinoprostone (PGE2- Propess©) used in term multiparous pregnant women to ripen the cervix. STUDY DESIGN: A total of 507 patients were included in the study. Group A, consisted of 262 women with term multiparous pregnancy Bishop score ≤6 underwent induction of labor with a vaginal insert containing 10-mg timed-release dinoprostone (Propess© -prostaglandin E2). Group B, consisted of 245 cases of pregnancy with Bishop score ≤6 underwent induction of labor with iv oxytocin and was matched for the patient's age and parity. The following data were recorded: age, gestational age, body mass index, the time from the drug administration to the vaginal labor, delivery mode, indications of induction, cesarean indication, birth weight, Apgar score, and need of neonatal intensive care unit. RESULTS: The primary outcome of the in group B interval from induction to vaginal delivery was similar between the two groups. In group A, 41 patients and in group B, 23 patients had a cesarean section. Cesarean section rate was lower in the oxytocin group (cesarean rate 15.6% versus 9.3%, p<0.05). CONCLUSION: It appears; Dinoprostone ovule increases the cesarean rate in terms, multiparous cases with inappropriate cervical score and does not shorten the duration of delivery. Therefore, the use of oxytocin for cervical ripening in multiparous women may be a more appropriate option.
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Background/aim: Water immersion and epidural analgesia are the most preferred pain relief methods during the labor process. Adverse effects related to these methods, impact on the labor, and perception of pain is well studied in the literature. We aimed to investigate the cord blood level of copeptin, total serum oxidant (TOS), antioxidant (TAS), interleukin (IL)-1, IL-6, and oxytocin after the labor with water immersion, epidural analgesia, and vaginal birth without pain relief. Materials and methods: The study was conducted with 102 healthy pregnant women admitted to the obstetric delivery unit for noncomplicated term birth. Copeptin, oxytocin, TAS, TOS, IL-1, and IL-6 levels of cord blood and obstetric and neonatal results after vaginal birth were compared. Results: The study included a total of 102 patients (group 1 = 30, group 2 = 30, and group 3 = 42). We found no significant difference between the three groups in terms of BMI, age, gravidity, parity, birth week, birth weight, interventional birth, perineal trauma, breastfeeding, duration of labor, oxytocin, IL-1 and IL-6 levels (p > 0.05). Neonatal intensive care unit (NICU) need, TAS, TOS, and copeptin levels were higher. Apgar scores were lower in the epidural group (p = 0.011, p = 0.036, p = 0.027, p < 0.001, and p < 0.001 respectively). Conclusion: Epidural analgesia has deteriorated oxidative stress status and lower neonatal Apgar scores with higher NICU administration compared with water birth and vaginal birth without pain relief. Key words: Epidural analgesia, infection, neuroendocrine, oxidative stress, waterbirth
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OBJECTIVE: In this study, we aimed to determine the frequency of etiologic factors that causes postmenopausal bleeding.STUDY DESIGN: For the purpose, a total number of 200 women with postmenopausal bleeding wereincluded in the study. Medical records regarding history, physical examination, and endometrium biopsyof these cases were retrospectively analyzed. The frequency of etiologic factors and relevancy of pathological results with demographic factors were determined.RESULTS: Most frequent histopathologic diagnosis of the women with postmenopausal bleeding wereestablished as endometrial atrophy, endometrial polyp, inadequate material, cancer, proliferative endometrium, endometrial hyperplasia, and other disorders respectively. Contrarily the previous studies,our study showed that estrogen replacement therapy was not a reason for postmenopausal bleeding.CONCLUSION: Although endometrial atrophy is the most frequent cause, postmenopausal bleedingshould promptly be evaluated since endometrial hyperplasia and cancer are frequently the underlyingcause. We found that premalignant and malignant lesions were related to the patients’ BMI (body massindex), duration of postmenopause, the presence of diabetes, determination of thick endometrium by ultrasonography.
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Objective: To determine the levels of thyroid-stimulating hormone (TSH), thyroxin (T4), triiodothyronine (T3), anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG) and renal iodine excretion (RIE) in the first trimester of the pregnancy and to estimate the risk of developingGDM in these patients.Method: The levels of TSH, T3, T4, anti-TPO, anti-TG, and RIE were retrospectively evaluated. Atotal of 312 pregnant women were included in the study (GDM (-) group n=240, GDM (+) groupn=62). Diagnosis of GDM was made according to the recommendation of American DiabetesOrganization (ADA). The association between thyroid dysfunction and GDM was evaluated.Results: Our study included a total of 302 women. Sixty-two of these women were diagnosedas GDM (62/302=20.5%). When compared with the GDM (-) group the mean TSH level (2.02 vs4.13 p=0.019), anti-TPO positivity (8.3% vs 30.64% p=0.044), anti-TG positivity (8.3% vs 19.4%p=0.019) and RIE (156 vs 178 p=0.017) were significantly higher in the GDM (+) group. TSHlevels were statistically significantly higher in patients with positive anti-TPO levels (P=0.045).Conclusion: Elevated TSH levels , TPO and TG antibody positivity rates were more frequentamong the patients with GDM. These results may be a guide to perform routine thyroid functiontests for patients with increased risk of GDM, on the other hand, they will alert the physicians forGDM progression and ensure taking preventive attempts for the patients who have thyroid disorder, especially those with positive thyroid antibodies in the first trimester of the pregnancy
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Aim: The study aimed to evaluate the relationship between the caries frequency, which was determined using different caries indexesObjective: The aim of this study was to investigate the effect of in-office bleaching agents on the color and translucency of differentresin composites.Materials and Methods: Twenty-four disk-shaped specimens with 1 mm thickness and 8 mm diameter were fabricated from fivedifferent resin composites. The specimens were then divided into three subgroups, two office bleaching groups (40% OpalescenceBoost, 38% Whitesmile Power Whitening) and one control group (n=8). All specimens were polymerized for 40 s with a LED lightcuringunit. Color measurement was performed using a spectrophotometer. Bleaching agents were applied to the experimentalgroups in accordance with the manufacturer's instructions for 14 days, while the specimens in the control group were kept in distilledwater only. Translucency parameters of the specimens before and after bleaching and the color changes after bleaching werecalculated using CIE L*a*b* color coordinates. Data were analyzed using the paired sample t-test and ANOVA (α=0.05).Results: Statistically significant differences were found between the control group and the bleached groups according to color changevalues (p<0.05). The highest mean color change value was observed in the Ceram-X / Opalescence Boost group. The Ceram-X /Opalescence Boost, Majesty Esthetic / Opalescence Boost, and Ceram-X / Whitesmile Power specimens showed clinically nonacceptablecolor changes. Translucency parameter values in each group between baseline and the end of the 14th day revealed nostatistically significant difference (p>0.05).Conclusions: The office bleaching agents may affect the color and translucency parameters of composite resins depending on thestructural properties.
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Amaç: Hastanemiz İnfertilite Kliniği’nde yapılan laparoskopik ve histeroskopik operasyonların endikasyon dağılımını belirlemek ve minimalinvaziv operasyonların önemini saptamak.Gereç ve Yöntemler: Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi İnfertilite Kliniği’nde, Ocak 2010- Aralık 2015 yılları arasında primer/sekonder infertil olgulara yapılan laparoskopik/histeroskopikoperasyonlar retrospektif olarak incelenmiştir.Bulgular: İnfertilite nedeniyle retrospektif olarak incelenen 729 hastanın117’si (%16.1) tubal faktör, 244’ü (%33.5) endometriozis, 346’si (%47.4)endometrial polip, 21’i (% 2.9) submuköz myom ve 1 tanesi dermoid kistnedeniyle opere edilmiştir. Yapılan prosedürlere bakıldığında 188 adetlaparoskopik kist ekstirpasyonu, 31 adet kist aspirasyonu, 1 adet laparoskopik adezyolizis, 4 adet endometriotik odak koterizasyonu, 120 adetdiagnostik laparoskopi, 364 adet histeroskopik polipektomi ve 21 adethisteroskopik myomektomi operasyonu gerçekleştirilmiştir.Tubal faktör ön tanısıyla alınan 117 hastanın 76’sında geçiş izlenmişolup 41’inde geçiş tespit edilmemiştir. Bu bağlamda histerosalpingografinin pozitif prediktif değeri %35.4 olarak hesaplanırken, negatif prediktifdeğeri ise % 64.6 olarak hesaplanmıştır.Sonuç: Minimal invaziv cerrahi, günümüzde rutin uygulanımda yerinialmıştır. Özellikle infertilite alanında, hastaları değerlendirme kolaylığıaçısından altın standarttır. Bununla birlikte kullanımı tecrübe ve komplikasyonların üstesinden gelebilme yetisi gerektirmektedir.
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