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Volume : 48 Issue : 3 Year : 2022

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ZEYNEP KAMIL MEDICAL JOURNAL - Zeynep Kamil Med J: 48 (3)
Volume: 48  Issue: 3 - 2017
1.According to The Data of Our Hospital, The Rates of Abnormal Cervical Smear, Preinvasive Cervical Lesions and Cervical Cancer, Changes In The Years
Çiğdem Yayla Abide, Ahter Tanay Tayyar, Ateş Karateke
doi: 10.16948/zktipb.289616  Pages 73 - 79
GİRİŞ ve AMAÇ: Bu çalışma hastanemizdeki anormal servikal smear ve smearın preinvaziv servikal patoloji yakalama oranlarının yıllara göre azalıp azalmadığının, servikal kanser oranının, preinvaziv hastalık yakalama oranına bağlı olarak azalıp azalmadığının araştırıldığı epidemiyolojik bir çalışmadır. Ayrıca bu çalışmadaki diğer bir amacımız Türkiye’de ki epidemiyolojik verilere katkıda bulunmaktır.
YÖNTEM ve GEREÇLER: Bu çalışma retrospektif kohort bir çalışma olarak planlandı. Çalışmaya 01 Ocak 2005 ve 31 Aralık 2009 tarihleri arasında Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum kliniğine başvuran 18-70 yaş arasındaki hastalardan alınan servikal smearler, anormal smear sonucunda alınan ve dış merkezden hastanemize anormal smear sonucu ile refere edilen toplam 36.822 servikal smear incelendi.
BULGULAR: Yıllara göre anormal smear dağılımları arasında istatistiksel olarak anlamlı farklılık bulunmaktadır (p<0,01); 2008 yılında anormal smear görülme oranı diğer yıllardan anlamlı şekilde yüksektir. Anormal smear görülen olgularda ASCUS (önemi bilinmeyen atipik skuamöz hücreler) dağılımları yıllara göre istatistiksel olarak anlamlı düzeyde yükseliş göstermektedir (p<0,01). HSIL ( yüksek gradeli skuamöz epitel lezyonu) dağılımları arasında yıllara göre istatistiksel olarak anlamlı düşüş görülmektedir (p<0,01). Anormal smear görülen olgularda yıllara göre LSIL ( düşük gradeli skuamöz epitel lezyonu) ve HSIL dağılımları arasında istatistiksel olarak anlamlı
değişim görülmektedir (p<0,05). Yıllara göre anormal servikal smear sonucunda alınan servikal biyopsi ve ECC (endoservikal
küretaj) sayıları arasında istatistiksel olarak anlamlı farklılık görülmektedir (p<0,01). Alınan biyopsiler içerisinde; CIN (Servikal intraepitelyal neoplazi) 1 ve CIN 3 dağılımları yıllara göre istatistiksel olarak anlamlı yükseliş göstermektedir (p<0,01). preinvaziv lezyon oranları ile Ca oranları arasında negatif yönde (preinvaziv lezyon oranı artarken kanser oranı azalmakta) istatistiksel olarak anlamlı ilişki saptanmıştır.
TARTIŞMA ve SONUÇ: Servikal kanser tarama programlarının daha etkin bir şekilde yapılmasının, yıllar içersinde servikal epitelyal anormallik yakalama oranlarımıza artış şeklinde yansıdığını izledik. Bu artışın da ileride servikal kanser yakalama oranlarında azalma sağlayacağı düşüncesindeyiz.
INTRODUCTION: This epidemiological study is aimed to investigate the rate of abnormal smear findings and the success rate of
smear screening test in diagnosing the pre-invasive cervical pathologies by years. It was also investigated if the diagnosis of pre-invasive pathology helps the cervical cancer rate to decrease or not. Furthermore; we aimed to contribute to the epidemiological database in Turkey.
METHODS: This study was designed as a retrospective cohort study. A total of 36822 smear samples of patients aged between 18-70 who were admitted to obstetrics and gynecology department of Zeynep Kamil Gynecology, Obstetrics and Pediatrics Research and Teaching Hospital between January 1, 2005 and December 31, 2009; and the smear samples which were referred to our hospital with the diagnosis of abnormal smear findings were included in this study
RESULTS: There was a statistically significant relationship between the rate of the abnormal smear findings and years
(p<0.01). Abnormal smear rate was found as significantly increased in the year of 2008. There was a statistically significant increase in ACTUS (atypical squamous cells of undetermined significance) rate by years (p<0.01). There was a significant negative correlation between years and rate of HSIL (high-grade squamous intraepithelial lesion) (p<0.01). There was a statistically significant relationship between LSIL (low-grade squamous intraepithelial lesion) and HSIL in patients with abnormal smear findings by years (p<0.05). The number of cervical biopsies performed based on abnormal smear findings and ECC (endocervical curettage) were found
as significantly different by years (p<0.01). It was observed that CIN (cervical intraepithelial neoplasia) 1 and CIN3 significantly
increased by years (p<0.01). A statistically significant negative correlation was found between the rate of preinvasive lesions and rate of cancer presence.
DISCUSSION AND CONCLUSION: We can conclude that paying attention in cervical cancer screening tests resulted in an increase of cervical epithelial abnormality diagnosis. We assert that this result will lead to a decrease in the presence of cervical cancers.

ORIGINAL RESEARCH
2.Pediatric Burns and Characteristics in Konya Region
Metin Gündüz
doi: 10.16948/zktipb.281504  Pages 80 - 83
INTRODUCTION: We evaluated the etiology factors ant treatment modalities of pediatric burns.
METHODS: This retrospective study was carried out using data from Konya Education and Research Hospital Burn Unit. Patients those admitted to our hospital between September 2013 - April 2014 were evaluated.
RESULTS: Clinical data, including age and sex of the patient, depth of burn injury, TBSA (total body surface area) burned %, etiology
of burn and treatement were evaluated. The 48 study subjects included 26 (%54) male and 22 (%46) female pediatric patients
(mean age, 3.1 years 1-17). %38 percent of patients had second degree superficial, %48 of them had had second degree deep and
%2 had third degree burns. The mean percentage of TBSA was %8 (%3-55). Etiology of burn was tea %44, hot water %36, stove %8,
milk % 2, oil %2 scent bottle %2, pressure cooker explosion %2, gel candles %2, and bomb %2. 11 of 48 patients (%23) had wound
debridement under general anestesia, 4 (%8.3) patient were treated by autogrefting, parents of 6 patient refused treatment, 2 patients
used pressure dresing, and after escarotomy 1 patient was
transferred to burn center.
DISCUSSION AND CONCLUSION: In %80 of patients etiology is scalding. Most of them ocur due to tea. Parents must be educated. Vocational Training of pediatric surgeons and nurses is necessary for treating minor and moderate burn.

3.Investigation of the Relation with HLA and Esophageal Stricture Formation Following Corrosive Ingestion
Rahşan Özcan, Erkan Yılmaz, Günay Can, Mehmet Eliçevik, Sebuh Kuruğoğlu, Ergun Erdoğan
doi: 10.16948/zktipb.292426  Pages 84 - 88
INTRODUCTION: Development of esophageal stricture due to corrosive ingestion may be related with different factors. In this study it has been aimed to detect if there is a difference esophageal stricture according to Human Leucocyte Antigen (HLA) type.
METHODS: The patients who were diagnosed with grade 1 or higher esophageal burn has been evaluated retrospectively. Group 1, consisted of 10 cases who have developed esophageal stricture and group 2, consisted of 10 cases who have not. Blood samples were taken from all of the patients for HLA antigen typing and evaluated with statistical analysis.
RESULTS: Mean age was 4.75 (2-10) years. HLA-DRB1’11 was detected more common in group 1 and HLA-A3 in group 2. This difference was neither significant statistically for both.
DISCUSSION AND CONCLUSION: We did not find any significant difference in HLA antigen types between Group 1 and Group 2 about stricture development; however, this early report can predict a guide for further studies. With an increase in case number, we think that more precise information can be acquired about the role of HLA in diagnosis and treatment of esophageal strictures.

4.Comparison of Obstetric and Neonatal Outcomes in Adolescent, Reproductive and Old Age Pregnancies Delivery in a Tertiary Center
Sibel Sak, Adnan Incebıyık, Hacer Uyanıkoğlu, Ahmet Berkız Turp, Neşe Gül Hilali, M. Erdal Sak
doi: 10.16948/zktipb.300736  Pages 89 - 93
INTRODUCTION: In this study, we aimed to evulate obstetric neonatal outcomes of adolescent and old age pregnants who gave birth in our center.
METHODS: A total of 126 pregnant women which were consist of adolascent (14-18), reproductive (19-38) and advanced (39-50) maternal age pregnancies and gave birth in Harran University of Medicine Faculty of Obstetric and Gynecology Department were compared retrospectively. Maternal demographic datas, obstetric complications (preterm delivery, abnormalities of presantation, intrauterin growth restriction (IUGR), preeclampsia, gestational diabetes mellitus (GDM), abnormalities of placentia, duration of hospitalization, oligohidramnios, type of delivery, fetal outcomes (birth weights of infants, apgar scores, macrosomia, congenital malformations, iumf) were evulated.
RESULTS: Although the rates of birth weight infant, preterm labour, IUGR, amnion fluid abnormalities, GDM, macrosomia and preeclampsia were found similiar in adolescents of whom majority are nulliparous and reproductıve, advanced maternal age women, the rates of gestational week at birth were found to be lower and frequency of congenital anomalies and abnormalities of presantation was found to be higher than the other both groups. The rate of sectio, placenta previa totalis and placenta invasion abnormalities, duration of hospitalization were higher significantly in advanced age maternal women. The normal spontaneous vaginal deliveries rate was significantly higher in reproductive group than the other groups
DISCUSSION AND CONCLUSION: This study has shown that the adolescent and advanced maternal age women have some kind of charecteristıc high risks in respect to their age groups. For having the best maternal and neonatal outcomes in both groups, these women should be informed about maternal and fetal risks and provided regular perinatal follow ups and treatment. Also social support is needed.

5.4.5 Years’ Experiences in Cases with Testicular Torsion
Gökmen Kurt, Ayşenur Cerrrah Celayir, Ceyhan Şahin, Koray Pelin
doi: 10.16948/zktipb.293307  Pages 94 - 98
INTRODUCTION: Testicular torsion occurring as a result of the rotation of the vasculer pedicle is the most important cause of acute scrotum results in terms of. In this study, cases with testicular torsion who had operated at our department and it’s outcomes were discussed.
METHODS: Clinical records of all cases with testicular torsion who had operated at our department between January 2006 and July 2010 were evaluated as retrospectively in regard to age, history, side, symptoms, examination findings, surgical indications, operatively findings, histopathological results and outcome.
RESULTS: 25 testes torsion in 24 cases were operated at our department during 4.5 years period. Ages of patients ranged an
1 hour’s newborn to a 16 years old boy. 9 of patients (37.5%) were newborn; and 3 were adolescent (12.5%); the other 12 patients
remained between one and 11 years old (50%) one of these newborns had bilateral testes torsion. 14 testes underwent
orchiectomy (44%) and 11 testes of 10 patients underwent orchidopexy (56%). 16 of testes torsion were on left side (64%), and 9 were on right side (36%). One patient aged 7 years old had torsion of appendix testes on left side. Torsion degree was
changed between 360-720 degree; and bigger than 540 degree in most patients. All newborn torsions were extravaginal. Orchidopexy
was created in elder boys; three of them had a suspicious of trauma, and findings of the phisical examination were
unspesific for the torsion. In histopathologıc examinations of all orchidectomic testes were determined hemoragic infarctus.
Two of the three testis with orchiopexy in two neonates went to atrophy in the late period. Overall, testicular viability of 9
testes in 25 testes was preserved.
DISCUSSION AND CONCLUSION: Despite emerging technologies, testicular torsion is still continues to be a source of stress for families and pediatric surgeons both in terms of operation indication and recognize.

6.Endometrial Sampling Results: Investigatıon of 1403 Cases
Özgül Özgan Çelikel, Özlem Doğan, Dilek Benk Şilfeler
doi: 10.16948/zktipb.292821  Pages 99 - 102
INTRODUCTION: Probe curettage is a method commonly used in the diagnosis of endometrial disease. The aim of our work done in our clinic endometrial sampling indications, cases of the sample after the histopathological results, to compare the premenopausal and postmenopausal.
METHODS: Between January 2015-January 2016 endometrial samples done in our clinic, patients were evaluated retrospectively analyzed. Patients were divided into two groups premenopausal and postmenopausal. The age range of the patients, the cause and histopathological results were compared statistically.
RESULTS: In 969 premenopausal group (69.1%) patients and in post-menopausal group, 434 (30.9%) patients were available. Premenopausal mean age was 45.06 ± 3.4 years. The average age was 51.05 ± 8.6 years in postmenopausal group. Endometrial
sampling cause of otitis media visit commonly refer patients who, abnormal uterine bleeding in premenopausal women, 69.1%, and in postmenopausal women who were determined to come in order to control 16%of endometrial thickness.
DISCUSSION AND CONCLUSION: Abnormal uterine bleeding due to endometrial sampling performed widely used in diagnosis and treatment. In particular, it is important for early diagnosis in postmenopausal endometrial cancer. Premenopausal endometrial sampling should be selective when placing indication.

CASE REPORT
7.Sclerosing Stromal Tumor of the Ovary: A Case Report
Gonca Uğurlu Pakay, Kaan Pakay, Canan Kabaca Kocakuşak, Ateş Karateke, Özden Us, Hatice Öztürkmen, Ecmel Kaygusuz
doi: 10.16948/zktipb.272955  Pages 103 - 106
Overin sklerozan stromal tümörü (SST), over seks kord tümörleri içinde sınıflandırılan ve oldukça nadir görülen benign karakterli bir tümördür. Bu tümörler çoğunlukla 20-40 yaş aralığında görülürler, ancak az sayıda olguda postmenopozal dönemde ya
da çocukluk döneminde görülebilirler. 13 yaşında anormal uterin kanama ve dismenore yakınması ile başvuran adolesan kızda, alt batın
ultrasonografisi (USG) ve pelvik manyetik rezonans görüntülemede (MRG) unilateral heterojen kistik kitle tespit edilmiştir. Bu makalede benign sklerozan stromal tümör olgusunun, görüntüleme, operasyon, histopatolojik özellikleri ve ayırıcı tanısı sunulmuştur.

8.A Rare Cause of Wheezing in Asthmatic Child: Foreign Body Aspiration
Mahmut Doğru, Fatih Çiçek
doi: 10.16948/zktipb.304984  Pages 107 - 109
Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. Foreign body aspiration is one of the differential
diagnosis of this disease that is characterized by exacerbations. Similar complaints may ocur during asthma attacks as during foreign body aspiration. Here in, we presented a case with foreign body aspiration who was followed with a diagnosis of asthma
and admitted with complaints of cough and wheezing that did not improve despite treatment. In these
cases, history and physical examination should be done carefully and bronchoscopy should be performed for diagnosis and treatment in suspicious cases.

9.Post-Hemorrhagic Hydrocephalus Treated with Serial Lomber Puncture: A Case Report
Emre Dinçer, Abdülhamit Tüten, Selahattin Akar, Handan Hakeyemez Toptan, Güner Karatekin
doi: 10.16948/zktipb.304856  Pages 110 - 113
Intra-ventricular hemorrhage and posthemorrhagic hydrocephalus come across as a serious problem as survival rates of very low birth weight preterm babies increase in neonatal intensive care units. Although ventriculo-peritoneal shunting is the accepted treatment for post-hemorrhagic hydrocephalus, it cannot be performed in early stages of premature babies because of low birth weight.

10.Coexistence of Placental Site Nodule and Cervical Intraepithelial Lesion (Two Cases)
Hülya Yavuz, Ecmel Kaygusuz, Meryem Eken
doi: 10.16948/zktipb.266176  Pages 114 - 119
Placental site nodule (PSN) is a cellular proliferation formed by intermediate trophoblasts and has a benign clinical course. It usually diagnosed incidentally during the reproductive period. The most frequent localization of the PSN is endometrium and uterine cervix, respectively.
We herein present two cases of PSN that located at uterine cervix and accompanied to squamous intraepithelial lesion (SIL).

REVIEW ARTICLE
11.Zika Virus and Pregnancy
Çiğdem Bilge, Nevşn Hotun Şahin
doi: 10.16948/zktipb.303670  Pages 120 - 123
Zika virus, which has been firstly identified in the Zika Mountains of Uganda in 1947, threatens Brazil, America in particular and the entire world. The most common way of its infection is through mosquitoes and in addition to that it can be transmitted from mother to child and through sexual intercourse. The fact that microcephalia findings have increased in the regions where zika virus is active makes people think that the virus can cause congenital anomalies and neurological syndromes. Although the relationship between zika virus and microcephalia
and anomalies has not been clearly known yet, if there are microcephalia and intracranial calcifications in the baby of a mother who is potentially infected by a zika virus during pregnancy, it is suggested that the baby should be evaluated under the circumstance of zika virus infection. While new reports have been published everyday related to the epidemics caused by this virus, there has not been any case reported in Turkey. Healthcare personnel and nurses bear significant responsibilities on this issue. This compilation study aims at touching upon the process of zika virus infections in the light of contemporary information and presenting latest developments on the potential problems during pregnancy and protective precautions.

12.The Effects of Turkish Music on Pregnancy And Newborn
Fatma Coşar Çetin, Ali Tan, Yeliz Doğan Merih
doi: 10.16948/zktipb.283033  Pages 124 - 130
Music has played an important role in different cultures since time immemorial. It has profoundly affected human beings in their physical, mental, emotional and spiritual well being. Nowadays researchers point out that, there is a close relationship between music and health procedures and that it can be used in every area of health in a noninvasive, safe and cheap method that does not have any side
effects. Sufis have played music in history of Islamic civilization. They have expecially pointed out that Turkish music was effective in the treatment of psychological disorders. Turkish music makams have been used as a treatment of some kind to treat disorders from past to present. However, there isn’t any literature regarding the evaluation of pregnant women and babies. Althought pregnancy is a normal process, a lot of women experience stress because of the emotional, physical and social changes they undergo, just like anxiety over their baby’s physical health and pending lifestyle changes during this period. The music listened in pregnancy reduces stress as well as anxiety. Listening to music in the prenatal period affects the infant positively in the neonatal period. When the fetus hears the same voices
and sounds that she used to hear in her intrauterine life, it has a relief effect on the infant after birth. It decreases the stress of the infants, increases mother-infant attachment and brings about positive physiological and behavioral changes. Music therapy is important not only in terms of trearment of diseases but also brings about preventive health behaviors in healthy persons. Peoples are affected by their own cultural music and for this reason they could comminicate with each other more healthily by listening to this cultural music. Although there are a lot of reseaches examining music therapy of different cultures, there is no academic research in our culture evaluating Turkish music. The filling in this scientific gap is important for protection of individual health as well as our social and cultural values.

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