|1.||The Assessment of the Diagnostic Values of Hysterosalpingography and Transvaginal Ultrasonography in Primary and Secondary Infertile Patients Undergoing Hysteroscopy|
Gülhan Özüm, Özkan Özdamar, Ismet Gün, Kenan Sofuoğlu, Tayfun Kutlu, Gülden Tunalı
doi: 10.16948/zktb.08928 Pages 1 - 5
GİRİŞ ve AMAÇ: Histeroskopi (H/S) yapılan primer ve sekonder infertil IVF hastalarında, intrauterin patolojilerin saptanmasında
H/S ve patoloji sonuçlarını altın standart kabul ederek; transvajinal ultrasonografi (TVS) ve histerosalpingografinin (HSG) sensitivite, spesifite, pozitif ve negatif prediktif değerlerini hesaplamak ve intrauterin patolojilerin bu gruplardaki sıklığını belirlemektir.
YÖNTEM ve GEREÇLER: Bu çalışma Zeynep Kamil Eğitim ve Araştırma Hastanesi infertilite ve tüp bebek polikliniğine Ocak - Ağustos 2013 tarihleri arasında başvuran ve H/S yapılan, primer (Grup 1) ve sekonder (Grup 2) infertil 227 hasta ile yapılmış prospektif kesitsel tarzda bir çalışmadır.
H/S, TVS ve/veya HSGde patolojiden şüphelenilen ya da iki IVF başarısızlığı olan hastalara yapıldı. Çalışmanın birincil sonucu, H/S gold standart kabul edilerek TVS ve HSGnin primer ve sekonder infertil hasta gruplarında uterin patolojileri saptamadaki spesifite,
sensitivite, pozitif prediktif değer (PPD) ve negatif prediktif değerlerinin (NPD) hesaplanması ve ikincil sonucu, gruplarda H/S sonuçlarına göre intrauterin patoloji sıklığının belirlenmesidir.
BULGULAR: TVS ve HSG intrauterin patolojileri yakalamada birbirlerine yakın sensitivite ve spesiviteye sahiptir. Fakat TVSnin NPD, HSGnin ise PPD daha yüksektir. Total grup ve primer infertil grupta intrauterin lezyonların tanınmasında TVSnin tanısal bir araç olarak kullanımı istatistiksel olarak anlamlıdır.
TARTIŞMA ve SONUÇ: Grup 1de intrauterin patolojilerin tespit edilmesinde TVSnin sensitivite, spesifite, PPD ve NPD değerleri
sırasıyla %71, %47, %34 ve %81 (p=0.042) ve Grup 2de spesifite %69 ve PPDsi %16 (p=0.35) iken total hasta grubunda sırasıyla %72, %49, %33 ve %84 idi (p=0.014). Grup 1de uterin patolojilerin saptamasında HSGnin ölçüm parametreleri sırasıyla %57, %46,
%74 ve %29 (p=0.75) iken, Grup 2de %60, %36, %71, %25 (p=1) ve total grupta %55, %48, %74, %28 (p=0.8) idi. H/Sde primer infertil hastaların %56,25inde ve sekonder infertil hastaların %36,8inde intrauterin patolojilere rastlandı.
INTRODUCTION: To calculate sensitivity, specificity, positive and negative predictive values of transvaginal sonography
(TVS) and hysterosalpingography (HSG) in the detection of intrauterine lesions, assuming hysteroscopy (H/S) and pathology results as gold standart, and to investigate the prevalance of intrauterine pathologies in primary and secondary infertile IVF patients who underwent H/S.
METHODS: TThe present is a prospective cross-sectional study conducted with a total of 227 primary (Group 1) and secondary (Group 2) infertile patients who admitted to the Infertility and IVF clinic of Zeynep Kamil Training and Research Hospital between January and August 2013 and who underwent H/S. The procedure was performed in those with suspected intrauterine abnormalities or with two or more IVF failure. Primary outcome was to determine the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of TVS and HSG, assuming H/S as the gold standart test, in the detection of intrauterine abnormalities in primary and secondary infertile patient groups. Secondary outcome was to assess the prevalance of intrauterine pathologies based on the H/S results.
RESULTS: Sensitivity, specificity, PPV and NPV of TVS in the detection of intrauterine abnormalities in Group 1 were 71%, 47%, 34% and 81%, respectively (p=0.042) and in Group 2 specificity and PPV were 69% and 16%, respectively (p=0.35) while in total patient group 72%,
49%, 33% and 84% (p=0.014). Measurement parameters of HSG in Group 1 were 57%, 46%, 74% and 29%, respectively (p=0.75) while in Group 2 60%, 36%, 71% and 25% (p=1) and in total patient group 55%, 48%, 74% and 28% (p=0.8). In H/S, 56.25% of patients with primary infertility and 36.8% of patients with secondary infertility were detected to have intrauterine abnormalities.
DISCUSSION AND CONCLUSION: In detecting intrauterine abnormalities, TVS and HSG have similar sensitivity and spesificity values. However, NPV of TVS and PPV of HSG are higher. Use of TVS in the detection of intrauterine lesions as a diagnostic tool in total patient and primary infertile groups is statistically significant.
|2.||Factors Associated with Success of Induction of Labor with Dinoprostone Vaginal System and Outcomes|
Mehmet B. Şentürk, Mehmet Şükrü Budak, Yusuf Çakmak, Halit Ataç
doi: 10.16948/zktb.08796 Pages 6 - 10
INTRODUCTION: The aim of this study was to evaluate factors associated with success of induction of labor with dinoprostone vaginal system and assess maternal and fetal outcomes.
METHODS: One hundred and three patients were evaluated retrospectively. Primary outcomes were considered proportion of women achieving
vaginal delivery within 24 hours. Secondary outcome measures were assessed as tachysystole, hyper stimulation, oxytocin requirement, cesarean section rate, fetal distress, meconium stained liquor, postpartum hemorrhage, cervical-vaginal tears,
fetal death and vaginal birth achieved post hours, and side effects such as hyperprexia, vomiting, and diarrhea. The factors associated with success of dinoprostone use were evaluated comparing between vaginal birth and cesarean section groups, and fetal outcomes were also assessed.
RESULTS: The success rate of vaginal birth within 24 hours after induction was 28.2%. Age, parity and cervical opening were associated factors
with success of achieving vaginal birth within 24 hours (p<0.01). There were no differences between two groups in terms of maternal and fetal outcomes (p>0.05). Apgar scores also were not different between two groups. The maternal and fetal complications which might be attributed to dinoprostone use were rare.
DISCUSSION AND CONCLUSION: Age, parity and cervical opening were associated factors with success of induction of labor with dinoprostone with rare maternal and fetal
|3.||Ventriculoperitoneal Shunt and Pregnancy: a Case Report|
Hicran Acar Şirinoğlu, Oya Pekin, Deniz Şirinoğlu, Sevcan Arzu Arınkan, Gökhan Ünver
doi: 10.16948/zktb.42358 Pages 11 - 12
Hydrocephalic woman with cerebrospinal fluid shunts are now surviving to reproductive age. Both maternal intra-abdominal pressure and intracranial cerebrospinal fluid increase cause maternal and fetal complications due to cerebrospinal shunt. Therefore
gestation period must be followed carefully with brain surgery department. Any shunt unfunction must be diagnosed promptly and solved at on time. There is no enough literature about pregnancies in women with previously placed ventricular shunts for obstructive hydrocephalus.
Since there are doubts regarding the mode of delivery, analgesia and anesthesia. We present a case of labor in the 21 year-old woman with hydrocephalus and a ventriculoperitoneal shunt. It is considered that delivery mode of pregnant women with ventriculoperitoneal shunt without
any neurological problems is to allow progress naturally and interventions limited to obstetrical reasons alone.
|4.||Prenatal Diagnosis of Vein of Galen Aneurysmal Malformation by Color Doppler Ultrasonography and Management: A Case Report|
Hüseyin Durukan, Mürşide Çevikoğlu, Talat Umut Dilek, Faik Gürkan Yazıcı, Yalçın Çelik
doi: 10.16948/zktb.86210 Pages 13 - 16
Vein of Galen aneurysmal malformation is a rare form of commonly encountered symptomatic cerebrovascular malformations in the
neonatal period. High output congestive heart failure as a result of increased flow in intracerebral shunts, and pulmonary hypertension of different severity as a result of increased intravascular volume, are two important comorbidities that may coincide. Increased perinatal morbidity and mortality in the neonatal period are mostly attributed to high output congestive heart failure.
|5.||The Evaluation of Relationship Between Passive Smoking and Recurrent Episodes of Bronchiolitis in Children Under Two-years Old|
Ahu Paketçi, Abdulkadir Bozaykut, Cem Paketçi, Rabia Gönül Sezer
doi: 10.16948/zktb.87611 Pages 17 - 20
INTRODUCTION: Recurrent episodes of wheezing are more common in infants especially with low socioeconomic status who are exposed to smoking, who are not breastfed and lives in crowded families.
METHODS: This study was performed prospectively with infants diagnosed as first attack bronchiolitis from the outpatient clinics between 2009 to 2011.
RESULTS: The study included 500 infants aged between 1-24 months. Cigarette smoking was present in 46.6% (n=233) of the families. There was
a significant relationship between recurrent episodes of bronchiolitis and exposure to cigarette smoke
DISCUSSION AND CONCLUSION: In this study, exposure to cigarette smoke was detected as a risk factor for recurrent episodes of bronchiolitis. The decrease of smoking
in the population can prevent recurrence of bronchiolitis.
|6.||Nutrition Therapy Approach in Pediatric Obesity and Insulin Resistance|
Dilek Özçelik Ersü, Gül Kızıltan
doi: 10.16948/zktb.92281 Pages 21 - 26
Nowadays, obesity has became a major public health problem that is threatening this century. The incidence of obesity is increasing in
population of all ages. It is a serious disease which is seen with disease charactized by chronic comorboid and takes effect on not only adults but also children and adolescents. This is a global problem also has affects especially at urban areas of the lowand middle-income countries. Those who used to be overweight or obese in their childhood are likely to become obese indivisuals into adulthood. Obesity is
the most common pathophysiological cause of insulin resistance. Insulin resistance in children is significantly
related obesity and cardiometabolic risk. Living in a urbanization growth world and less physical activity choices cause less movement particularly for children and adolescents and eventually obesity rate increases. Development of practise and principles of weight management nutrition theraphy for children and adolescents are updating every day. Treatment of obesity and weight management is one of the important issues of this century. Therefore it is needed more comprehensive publications including variety of age groups.
|7.||Cerebro-Oculo-Facio-Skeletal (COFS) Syndrome: Case Report|
Ali Karaman, Hasan Kahveci, Selin Karaman, Hatip Aydın, Arda Çetinkaya
doi: 10.16948/zktb.29167 Pages 27 - 29
Cerebro-oculo-facio-skeletal (COFS) syndrome is a rare autosomal recessive disorder characterized by a wide range of dysmorphic features, including microcephaly, progressive neurologic disorder, optic atrophy, mental retardation, progressive joint contractures and growth failure.
|8.||Latex Sensitivity in Children With Recurrent Gastrointestinal Tract or Abdominal Surgical Interventions|
Mahmut Doğru, Derya Erdoğan, Ilknur Bostancı, Serap Özmen, Ibrahim Karaman, Handan Duman
doi: 10.16948/zktb.05694 Pages 30 - 34
INTRODUCTION: The frequency of latex allergy is increased for repeated surgical interventions. This effect was investigated especially in patients with spina bifida and urogenital anomalies. There is limited data about latex allergy in repeated surgical interventions that were done for other
reasons. It was aimed to determine the prevalence of latex allergy in children who underwent two or more interventions especially for gastrointestinal tract surgery.
METHODS: A total number of 27 children who underwent two or more surgical interventions in Dr. Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital Department of Pediatric Surgery before 2009, and 25 healthy children with no history of any
allergic complaints and surgical intervention were included in the study. Skin prik tests were performed with the same allergens for patient and control groups. Total immunoglobulin E was evaluated.
RESULTS: The mean age was 5.7 ± 4.5 (5 months to 18 years) years and 51.9 %(14) of the patients were male. The mean age was 5.9 ± 1.6 (2,7 to 8,4) years and 52 %(13) of the children in the control group. The most diagnoses of the patients were; eight (29.6%) patients with anal atresia, five (18.5%) patients with esophageal atresia and five (18.5%) patients with gastrointestinal damage due
to ingestion of caustic materials. The number of surgical procedures varied between 2 to 21 (mean±SD: 5.2 ± 4, median: 4). Seven (26%) patients underwent surgery more than five. Between two groups there was no significant difference for developing findings with contact to latex, family history of allergic disease, IgE elevation, eosinophilia and skin prik tests (p< 0.05). Latex allergy
was detected in any of the control group, while only one patient (3,7%) was allergic to latex in the patient group.
DISCUSSION AND CONCLUSION: Children who underwent more than one surgical intervention for gastrointestinal tract was not statistically differences in terms of latex allergy compared to controls. Especially those operated for malignancy patients should be monitored carefully because they have frequent contact with latex products.