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Volume : 46 Issue : 1 Year : 2022

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ZEYNEP KAMIL MEDICAL JOURNAL - Zeynep Kamil Med J: 46 (1)
Volume: 46  Issue: 1 - 2015
ORIGINAL RESEARCH
1.Self-Perceived Frequency of Urinary Incontinence by Women and Distribution Of Incontinence Types According to Age-Groups In Target Population of Mersin
Hüseyin Durukan, Ekrem Celalettin Tok, Devrim Tok, Hakan Aytan
Pages 1 - 5
INTRODUCTION: Determining the self-perceived frequency of urinary incontinence in women in Mersin province and evaluation of the data according to age groups and incontinence types.
METHODS: Study enrolled 1320 women. All participants were evaluated via questionnaire forms. Distribution of urinary incontinence types
and frequency among different age groups were determined.
RESULTS: Total urinary incontinence ratio perceived by women in this region was 21.3% (n=1320). Frequencies for stress incontinence, urge incontinence, and mixed incontinence types were 8.6% (n=114), 5.3% (n=70), and 7.4% (n=96), respectively. Urinary incontinence was observed to proportionally increase as advancing age.
DISCUSSION AND CONCLUSION: Urinary incontinence affects nearly one fifth of women in Mersin province. All three types of incontinence become more frequent as age
advances.

2.Investigating The Changes In Maternal Serum Brain-Derived Neurotrophic Factor Levels In Patients Undergoing Spontaneous Vaginal Delivery
Ayşe Nur Aksoy, Ilay Gözükara, Suna Kabil Kucur, Gonca Batmaz, Esra Laloğlu, Elif Bulut
Pages 6 - 12
INTRODUCTION: To reveal the changes in maternal serum brain-derived neurotrophic factor (BDNF) and malondialdehyde (MDA) levels in women undergoing spontaneous vaginal delivery.
METHODS: This prospective study was done in sixty-two patients with term pregnancy undergoing spontaneous vaginal delivery. Maternal blood samples in the latent phase of labor (T1), immediately before clamping the umbilical cord (T2) and 24 hours after birth (T3); and umbilical artery cord blood sample immediately after umbilical cord clamping at delivery were obtained. MDA and BDNF levels in collected blood samples were measured and results were compared using appropriate statistical tests. The relationship between cord blood levels of BDNF with cord blood MDA and maternal serum levels of BDNF with maternal serum MDA was investigated.
RESULTS: Maternal serum BDNF levels (pg/ml) were significantly higher in the blood sample collected at the T3 time point (3729.92 ± 621.68) compared to blood samples collected at T1 (956.75 ± 291.47) and T2 (985.50 ±291.91) time points (P<0.0001, for both). Cord blood
BDNF levels (834.91 ± 235.73) were significantly lower compared to maternal blood samples collected at T1, T2 and T3 time points (P=0.01, P=0.002, P<0.0001; retrospectively). Maternal serum MDA levels (μmol/ml) at T3 time point (6.42 ± 1.70) were found to be lower compared with those of collected blood samples at T1 (8.43 ± 2.67) and T2 (8.80 ± 3.11) time points (P<0.0001, for both).
Also, cord blood MDA levels (9.98 ± 1.70) were higher compared to maternal serum MDA levels collected at T1, T2 and T3 time points (P=0.001, for T2 and P<0.0001, for T1 and T3 time points). A negative association was found between both maternal and cord blood BDNF levels with maternal and cord blood MDA levels, respectively (r= -0.374, P<0.0001; r= -0.310, P=0.014; respectively).
DISCUSSION AND CONCLUSION: Changes in maternal BDNF and MDA levels occur in women undergoing spontaneous vaginal delivery. These changes may be associated with increased maternal oxidative stress during labor

3.Management of Adnexial Mass in Pregnancy: Case Report and Review
Elif Meşeci, Semra Kayataş Eser, Cem Öngüloğlu, Fuat Demirkıran
Pages 13 - 18
Adnexial masses during pregnancy which have a wide spectrum treatment from conservative follow-up to complicated surgery have no well established approach algorithm for management. Most of these masses are asymptomatic and thanks to rutin ultrasonography in early pregnancy these lesions can be determined easily. The majority of them are benign and disappear spontaneously as pregnancy grows. But, if the mass persist, it can be challenging for physician and patient in terms of management. For all these reasons, we wanted to review the diagnosis, follow-up and recent treatment options in the light of literature inspired by a case which has reffered to our clinic with the diagnosis of adnexal mass during pregnancy.

CASE REPORT
4.Absent Pulmonary Valve Syndrome: Case Series
Oya Demirci, Taner Yavuz, Emre Erdoğdu, Resul Arısoy, Pınar Kumru, Oya Pekin, Bülent Tandoğan
Pages 19 - 21
Absent pulmonary valve syndrome (APVS) is a variant of Tetralogy of Fallot (TOF). It shares the features of the classical form of TOF with
the addition of incompetent or absent pulmonary valve. It is associated with severe dilatation of the main and branch pulmonary arteries because of concurrent severe pulmonary stenosis and regurgitation

ORIGINAL RESEARCH
5.Comparison of The Effects of Fish Oil Containing Multicomponent And Standard Lipid Emulsion on Parenteral Nutrition Associated Cholestasis
Halil Değirmencioğlu, Mehmet Yekta Öncel, Erhan Çalışıcı, Yavuz Yılmaz, Şerife Suna Oğuz, Uğur Dilmen
Pages 22 - 27
INTRODUCTION: To compare the effect of a multicomponent parenteral lipid emulsion (PLE) with a standard PLE in case of cholestasis induced by longterm use of parenteral nutrition (PN) in infants who need surgical procedures.
METHODS: We conducted a retrospective study in neonatal intensive care unit (NICU) between January 2011 and February 2012. The patients
with surgical procedures and need for longterm PN (at least 2 weeks) at NICU were enrolled in the study. Group 1: given standard lipid emulsion, in addition to the standard treatment of cholestasis, Group 2: given multicomponent lipid emulsion (soybean oil, medium chain triglyceride, olive and lipid fish oil) in addition to the standard treatment of cholestasis. Period of cholestasis and prognosis data were compared during follow-up in NICU.
RESULTS: A total of 24 patients (Group 1 (n = 11) and Group 2 (n = 13)) were included in the study. Period of cholestasis were similar between groups. Despite the inequality between gestational age and birthweight among groups (gestational age 36±4.3 and 30.3±3.4 weeks and p=0,047, birth weight mean 2395±635 and 1404 ±670 g, p=0.03, respectively Group 1 and 2), total non-feeding time (Group 1: 10 ± 3.3 days; Group 2: 16.3 ± 10.6 days) and total duration of PN (group 1: 20 ± 4.6 days; Group 2: 25.8 ± 17 days) and mortality rates were compared between the groups and there was no statistically difference. There were no short-term adverse effects identified due to the use of multi-component PLE.
DISCUSSION AND CONCLUSION: No additional contribution of multicomponent PLE than standard PLE to the treatment of cholestasis could be shown at our study. We think that inequality among groups may effect these results.

6.Jacobsen Syndrome: A Cases
Ali Karaman, Hatip Aydın
Pages 28 - 31
INTRODUCTION: Jacobsen syndrome is a contiguous gene deletion syndrome caused by partial deletion of the long arm of chromosome 11. The characteristic features includes pre and postnatal growth retardation, psychomotor retardation, trigonocephaly, strabismus, epicanthus, broad nasal bridge, short nose with anteverted nostrils, carp-shaped upper lip, retrognathia, low-set dysmorphic ears, bilateral camptodactyly, hammer toes, and isoimmune thrombocytopenia.
METHODS: The present case was referred at the age of 18 months because of delayed psychomotor development, postnatal growth retardation and multiple congenital anomalies. Clinical examination showed trigonocephaly, strabismus, epicanthus, upslanting palpebral fissures, broad nasal bridge, short nose with anteverted nostrils, long philtrum, carp-shaped upper lip, retrognathia, low-set dysmorphic
ears, bilateral camptodactyly, hammer toes. His karyotype was 46,XY, del(11)(q23.3-->qter). Array CGH on peripheral blood lymphocyte DNA. Terminal deletion ranged from 120.725.596 to 135.006.516 bp in size (14.280.921 bp) and covered chromosome regions 11q23.3-qter.
RESULTS:
DISCUSSION AND CONCLUSION: As Jacobsen Syndrome presents with distinc clinical features, caryotype analysis and array CGH is valuable in suspected and uncertain cases.

CASE REPORT
7.Skeletal Dysplasia: Report of Four Cases
Bilge Demirel, Didem Arman, Hatip Aydın, Sevilay Topçuoğlu, Tuğba Gürsoy, Güner Karatekin, Fahri Ovalı
Pages 32 - 35
Our first and second cases, with an antenatal diagnosis of skeletal dysplasia, were admitted to neonatal intensive care unit due to respiratory distress. First infant was born to a 30 years old mother at term with a birth wight of 2800 grams. Second case was born to a 24 years old mother at the 33th gestational week with a birth weight of 1900 grams. In physical examination both had a coarse facies, large fontanelle, low nasal bridge, narrow thoracic cage and their extremities were extremely short. Genetic consultation yielded a diagnosis of TD. Infants succumbed to respiratory failure in the 4th and 8th days of life respectively. Third and fourth cases lacked antenatal visits. They were hospitalized due to severe respiratory distress. Both infants were term SGA. They had large heads compared to trunk. Fontanelles were large and multiple fractures were palpable in the skull. Genetic consultation yielded a diagnosis of OI type II. Infants succumbed to respiratory failure in the 4th and 3th days of life respectively.

8.Alagille Syndrome Presenting With Chronic Renal Failure: Case Report
Selahattin Akar, Sevilay Topçuoğlu, Dilek Yavuzcan Öztürk, Güner Karatekin, Fahri Ovalı
Pages 36 - 39
A female newborn with the antenatal diagnosis of right hypoplastic kidney was hospitalized following the birth. One of her siblings with Jagged 1 mutation has died because of renal and liver failure. Our case had total and direct hyperbilirubinemia. Renal ultrasonography revealed bilateral dysplastic kidney. Peripheral pulmonary stenosis was diagnosed with echocardiography. She has posterior embryotoxon on eye examination. Although liver biopsy could not be performed because of fungal peritonitis, Allagille syndrome with the renal failure secondary to bilateral dysplastic kidney was thought with the family history, clinical and laboratory findings.

REVIEW ARTICLE
9.Intravitreal Anti-Vegf Therapy In Retinopathy of Prematurity
Murat Günay, Gökhan Çelik
Pages 40 - 44
Retinopathy of prematurity (ROP) is the retinal vascular developmental disorder of the premature infants and it is a leading cause of childhood blindness. Hypoxia secondary to the immature retina with subsequent release of some mediators establish the characteristic feature of ‘progressive retinopathy’. The most promoter one among these mediators is vascular endothelial growth factor (VEGF). The screening and treatment criteria were identified in past literature and successful treatment results were revealed especially with anti-VEGF therapy in recent years. In this article, definition, screening, follow-up criteria and pathogenesis of ROP are summarized and current knowledge of anti- VEGF agent use in the treatment of the disease is reviewed.

ORIGINAL RESEARCH
10.Effecting Factors of The Mortality and Morbidity in The Jejunoileal Obstruction
Vedat Akçaer, Ayşenur Cerrah Celayir, Inanç Cici, Serdar Moralıoğlu
Pages 45 - 50
INTRODUCTION: Jejunoileal atresia and meconium ileus are seen common among major causes of intestinal obstructions of the newborns requiring emergency surgical treatment. The aim of this study is determined effecting factors of the mortality and morbidity in the jejunoileal obstruction in newborns.
METHODS: This study is designed as a retrospectively from all records of the neonates with jejunoileal obstructions hospitalised in between January
2004 and January 2013.
RESULTS:
DISCUSSION AND CONCLUSION: 44 newborns were opertated due jejunoileal obstruction during the 9 years period. 34 of them were intestinal atresia (77,2%), the others had meconium ileus. Prenatal diagnosis was suggestive of intestinal obstruction in 15 fetuses (44%). %41of 34 intestinal atresia was premature. At the time of surgery, 34 (77,2%) of the jejunoileal atresias were classified 6(17,6%) as type I(mucosal), 8(23,5 %) as type II(atretic fibrous cord), 5(14,2 %) as type IIIa(V-shaped mesenteric defect), 11(24,4%) as type IIIb(“apple peel” atresia), and 4(11,8%) as type IV(-multiple atresias). Other findings in operation had included malrotation in 9(20,4%), meconium peritonitis in 1(2,9%), Meckel diverticulum in 1(2,9%), and intrauterine intussusception in 1(2,9%). Operative management included resection of the atresia with primary bowel anastomosis in 28 neonates (82,3%), temporary ostomy in 2(5,8%), with intestinal resection in 30(88,1% of those), enterotomy with web excision in 1(2,9%). Ladd procedure was performed in those neonates with malrotation 9(20,4%) and Meckel diverticulectomy was performed in 1 neonate, and incidental appendectomy was performed in 4 neonates (11,6%). Following resection, 1 patients (2,9%) had resultant short-bowel syndrome. Mortality for neonates with with jejunoileal atresia was 7 cases (20,5%). Ten neonates (22,7 %) had cystic fibrosis documented by sweat chloride determinations. The long-term survival rate for children with jejunoileal atresia, 79,5%; and with meconium ileus 90%.

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