E-ISSN 2757-8062
Volume : 45 Issue : 4 Year : 2022

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ZEYNEP KAMIL MEDICAL JOURNAL - Zeynep Kamil Med J: 45 (4)
Volume: 45  Issue: 4 - 2014
ORIGINAL RESEARCH
1.Pregnancy Rates After One and Conditional Two Embryo Transfer Policy in an IVF Unit
Şule Ayla, Gülden Tunalı, Naciye Körkoca, Beyhan Sağlam, Mehmet Ural, Kenan Sofuoğlu, Bahar Uslu, Tayfun Kutlu, Belgin Devranoğlu, Esra Esim Büyükbayrak, Sadık Şahin
Pages 156 - 159
GİRİŞ ve AMAÇ: Bu çalışmada tek ve şartlı iki embriyo transferi (ET) yönetmeliği sonrası Zeynep Kamil Kadın Hastalıkları ve Doğum Eğitim Araştırma Hastanesi Tüp Bebek ünitesinde in vitro fertilizasyon (IVF) yapılan hastalarda gebelik oranlarının belirlenmesi amaçlandı. Merkezimizde Mart 2010 ve Mart 2012 tarihleri arasında bir veya iki ET yapılan 1187 IVF siklus sonuçları retrospektif olarak değerlendirildi. Gebelik oranlarının tek embriyo transferi yapılan sikluslarda (n=891) %19,9, iki embriyo transferi yapılanla sikluslarda (n=250) ise % 30,4 olduğu gözlendi. Gebelik oranları iki embriyo transferi yapılan hastalarda tek embriyo transferine göre anlamlı derecede yüksek bulundu (p< 0,001).
YÖNTEM ve GEREÇLER:
BULGULAR:
TARTIŞMA ve SONUÇ:
INTRODUCTION: This study was conducted to determine the pregnancy rates of women who underwent IVF treatment at Zeynep Kamil Maternity and Children’s Hospital IVF Unit between March 2010 and 2012 after the regulations about Assisted Reproduction Technics and IVF(In Vitro Fertilization) Units. A total of embryo transfer (ET) of 1187 IVF cycle under going one or two embryos transfer were retrospectively analysed. The pregnancy rates following one or two embryos transfers were found to be (n=891) 19,9% and (n=250) 30,4%, respectively. The pregnancy rate was significantly higher than those under went one embryo transfer (p< 0,001).
METHODS:
RESULTS:
DISCUSSION AND CONCLUSION:

2.Comparison of Clinical Efficiancy Tolterodine or Trospium Chloride in Overactive Bladder Treatment
Ebru Çöğendez, Taylan Şenol, Meryem Eken, Mesut Polat, Arman Özdemir, Mustafa Eroğlu
Pages 160 - 164
INTRODUCTION: The aim of the study is to compare the efficiency of trospium cloride and tolterodine in overactive bladder treatment.
METHODS: The patients that applied to Zeynep Kamil Educational and Reseach Hospital Gynecology Clinic with one or more of following complains such as nocturia, poliuria (more than 8/ day) and urodinamically overactive bladder proved patients and the patients treated with trospium cloride or tolterodine have been called up at least 3 months after treatment and the day and night urinary frequency and wetness of underwear are investigated.
RESULTS: There is no significiant difference between the demographic characteristics of two groups. There is no istatistically differences between two groups in terms of symptoms.
DISCUSSION AND CONCLUSION: The efficiancy of trospiyum cloride and tolterodine are similar in terms of overactive bladder treatment.

CASE REPORT
3.Placental Chorioangioma: Case Report
Pınar Kumru, Cem Ardıç, Oya Demirci, Oya Pekin, Murat Muhcu, Semih Tuğrul, Cuma Yorgancı
Pages 165 - 170
Chorioangiomas are the most common benign tumors of placenta. In our case, a 30 years old woman, gravida 2, para 1 at 22 weeks of gestation was referred to our Perinatology Department due to high levels of maternal serum alpha-fetoprotein (MSAFP). Doppler ultrasonography showed that the placenta was attached to left-posterior wall of uterus and a 40x38 mm solid, vascularized mass was present in it. No fetal abnormality was detected. Patient was followed with preliminary diagnose of placental chorioangioma and at 32 weeks of gestation, it was detected that the size of the mass was 64x54 mm and accompanied by polihydroamnios. Patient was
hospitalized because of abnormal umbilical artery Doppler finding as absence of end diastolic flow. After applying corticosteroids and completion of fetal lung maturation, a caesarean section was performed due to previous cesarean delivery history.
Diagnose of placental choriangioma was confirmed after pathological examination. As a result, we suggest; detailed evaluation of
placenta should be performed in patients with elevated MSAFP levels. Patients with preliminary diagnose of placental chorioangioma should be followed closely for possible fetal and maternal complications.

4.Laparoscopic Excision of Ruptured Non-Communicating Rudimentary Horn Pregnancy
Hasan Onur Topçu, Ümit Taşdemir, Ali Irfan Güzel, Mahmut Kuntay Kokanalı, Özlem Evliyaoğlu, Melike Doğanay
Pages 171 - 174
Unicornuate uterus with rudimentary horn occurs due to failure of complete development of one of the mullerian ducts and incomplete fusion with the contralateral side. Pregnancy in a non-communicating rudimentary horn is extremely rare and usually terminates in rupture during first or second trimester of pregnancy. Diagnosis of rudimentary horn pregnancy and its rupture in a woman with prior vaginal delivery is difficult. It can be undiagnosed in routine ultrasound scan and in majority of cases it is detected after rupture.We report a case of G2P1 with ruptured rudimentary horn pregnancy at 9 weeks of gestation which was misdiagnosed as tubal ectopic pregnancy.

5.Laparoscopic Myomectomy of A Giant Myoma
Sema Ovalı, Cahit Gürkan Zorlu
Pages 175 - 177
Laparoscopic myomectomy of large myomas are rare and needs expertise. Myomas up to 12 cm in diameter have been managed by laparoscopy. We report a case in which a myoma 25 cm in diameter was excised successfully by laparoscopy. No complications were seen.

REVIEW ARTICLE
6.Comparison of Hemodialysis and Online Hemodiafiltration in Removal of Uremic Toxins
Seçil Conkar, Sevgi Mir
Pages 178 - 185
Hemodialysis (HD) treatment in recent years has extended the life span of patients with end stage renal disease. Standard or conventional HD is far from fully compensating normal renal functions. Inadequately cleaned uremic toxins lead to cardiovascular morbidity and mortality. In this review, different dialysis techniques improving the quality of life of patients and reducing morbidity and mortality will be discussed on the basis of various studies and scientific innovations.

ORIGINAL RESEARCH
7.Evaluation of Pediatric Patients with Non-Cystic Fibrosis Bronchiectasis
Mahmut Doğru, Tayfur Ginis, Emine Dibek Mısırlıoğlu, Handan Duman, Serap Özmen, Ilknur Bostancu
Pages 186 - 191
INTRODUCTION: To evaluate the clinical characteristics of patients with bronchiectasis, localization, pulmonary function tests, the etiologic factors and investigation of the relationship between localization- pulmonary function tests and etiology in our Pediatric Allergy-Immunology Clinic.
METHODS: We retrospectively evaluated the clinical, radiologic, and physiologic findings of 35 patients with non cystic fibrosis- bronchiectasis confirmed by high-resolution computed tomography (HRCT).
RESULTS: The mean age was 11.6 ± 3.3 (4.8-18) years, and 20 of them were males (57%). The age at onset of symptoms was 6.8 ± 3.8 (1-15) years, while the age of diagnosis was 10.4 ± 3.1 (4.2-15.8) years. The most common symptoms were cough (100%), sputum (54.3%) and wheezing (54.3%). Crepitant rale was the most frequent physical examination finding (45.7%). In evaluation of chest X-Ray findings; 8 (22.9%) of the patients had bronchiectasis and the most common finding was infiltration 12 (34.3%). Four of the (11.4%) patients had positive skin prick test. The most common involvements on HRCT were left lower lobe in 22 (62.8%), right lower
lobe in 21 (60%), right middle lobe in 16 (45.7%). The causes of the bronchiectasis were found to be as postinfectious in 12 patients (34.3%), asthma 7 (20%), immun deficiency 5 (14.3%), and primary ciliary dyskinesia 4 (11.4%). There was not an aetiological
cause in 7 (20%) of the patients.
DISCUSSION AND CONCLUSION: Infections in our country still maintain their importance in the etiology of bronchiectasis. Asthma with increasing frequency is another important factor in the development of bronchiectasis. Bronchiectasis should be investigated especially in patients with asthma who has ongoing complaints despite suitable treatment and/or those who has atypical symptoms for asthma despite normal chest radiography.

8.Investigation of the Factors Affecting the Formation of 6-18 Years School-Age Children Obesity
Almala Pınar Ulutaş, Pınar Atla, Züleyha Aysu Say, Erdal Sarı
Pages 192 - 196
INTRODUCTION: Obesity is becoming one of the important problems of the community and individual health because of different factors such as
false nutrition and low physical aktivity. Although incidence of obesity is higher in USA and EU compared to Turkey, nowadays it is increasing especially in cities. For healthy generation causes of obesity must be well studied and suggestions for the solution
must be developed. Unfortunately, obesity in childhood is ignored by their families but they must be made aware that obesity may be the cause of a serious illness in the future. Therefore, in this study we aimed to determine the causes of the childhood obesity.
METHODS: Patients visiting Hospital outpatient clinic aging between 6-18 without any known chronic metabolic disease were included to our
study. 109 obese as study group and 109 non-obese as control group were chosen. Obesity was described by using percentile curve developed for Turkish children depending on BMI, gender and age, over 95. percentile.
RESULTS: According to the results mean values of existence of obese member in the family, weight and BMI values of both parents, duration for eating, physical training, fastfood and vegetable consumption in a week, daily sleep time, feeding time and skipped meals were significantly different between two groups (p<0,05). Smoking during pregnancy, duration time on television-computer, parents education
and working status were statistically not significant between the groups (p>0,05).
DISCUSSION AND CONCLUSION: The incidence of obesity is increasing in our community, therefore to prevent it, we have to lean on child nutrition plus routine physical activity.

9.Evaluation of Patients with Atopic Dermatitis
Almala Pınar Ulutaş, Mehmet Reha Cengizlier, Ahmet Oğuzhan Özen, Coşkun Saf, Ayça Vitrinel
Pages 197 - 203
INTRODUCTION: Infants with Atopic Dermatitis (AD) are predisposed to develop allergic rhinitis (AR) and/or asthma later in childhood. We aimed to investigate clinical features, accompaning allergic diseases and laboratory findings of AD in childhood and analyze the risk factors for recurrent wheeze (RW) and other allergic diseases among these children.
METHODS: We have retrospectively evaluated medical records of 298 patients who had been followed-up for AD between 2006-2010 in Pediatric Allergy Clinic.
RESULTS: We studied 298 patients (108 female, 190 male) with a mean age at referral of 18.1±21.5 months. Atopic sensitization was detected in 148 children (51.6%). A hundred and four children (34.9%) had RW episodes and 13.1% AR. The leading site of initial involvement was face (60.4%), followed by arm (32%), trunk (9.4%) and leg (6.5%). A positive history of maternalatopy was 34.2% and
paternal atopy 28.5%. Risk factors associated with RW included recurrent respiratory infections, history of hospitalization, environmental tobacco smoke (ETS) and gastroesophageal reflux (GER). We detected no association between RW and breast-feeding, gender, high Ig E level, site of involvement or family history of atopy. Meanwhile, presence of atopy was associated with paternal atopy, recurrent infections, history of hospitalization and inhaled corticosteroid (ICS) use.
DISCUSSION AND CONCLUSION: Among a group of children with AD 51.6% were found to be atopic and 35% had RW. Risk factors for recurrence of wheeze included recurrent respiratory infections, history of hospitalization, ETS and GER. These risk factors should be considered in the management of children with AD who present with wheezing episodes.

CASE REPORT
10.Henoch-Schönlein Purpura Begin with Severe Gastrointestinal Involvement
Hayrünisa Kahraman Esen, Osman Esen
Pages 204 - 207
Henoch-Schönleinpurpura (HSP) is the most common vasculitis of childhood and is a multisystemic disease which is characterized by skin, joint, gastrointestinal (GI) and renal small vessels involvement.

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