GİRİŞ ve AMAÇ: Intrauterin gelişme geriliği olan fetusların Doppler akımları ile doğumdaki kan pH değerlerinin perinatal ve neonatal sonuçlar açısından değerlendirilmesi amaçlandı.
YÖNTEM ve GEREÇLER: Mayıs 2014 ve Ocak 2015 tarihleri arasında intrauterin gelişme geriliği (IUGR) tanısı konan 32 hasta çalışmaya alındı. Hastalar umblikal arterde akım kaybı olmayan (17 hasta) ve umblikal arterde akım kaybı (11 hasta) veya ters akım olan (4 hasta) olmak üzere iki gruba ayrıldı. Ayrıca 3 hastada duktus venosusta ters a dalgası mevcuttu
BULGULAR: Umblikal arterde akım kaybı olmayan grupta neonatal mortalite görülmezken, umblikal arterde akım kaybı veya ters akım olan grupta %40 mortalite izlendi. Akım kaybı olmayan grubun doğum ağırlıkları ortalaması (2118 gr), patolojik akım grubundan (968 gr) istatistiksel olarak anlamlı düzeyde yüksek saptandı (p: 0.001). Akım kaybı olmayan grubun apgar 5.dk skor ortalaması (7,65), patolojik akım grubundan (6,27) istatistiksel olarak anlamlı düzeyde yüksek saptandı (p: 0.001). Akım kaybı olmayan grubun yeni doğan yoğun bakım ünitesine yatış süreleri (6,58 gün), patolojik akım grubundan (39,93 gün) istatistiksel olarak anlamlı düzeyde düşük bulundu (p: 0.001). Akım kaybı olmayan grupta baz açığı ortalaması(-0,75), patolojik akım grubundan (-5,76) istatistiksel olarak anlamlı düzeyde yüksek saptandı (p: 0.004). Akım kaybı olmayan grubun pH ortalaması (7,33), patolojik akım grubundan (7,24) yüksek saptandı (p: 0.016).
TARTIŞMA ve SONUÇ: İntrauterin gelişme geriliği olan fetusların takibinde ve doğum zamanlamasında Doppler ultrasonda umblikal arter ve ductus venosus ölçümleri güvenle kullanılabilir. İntrauterin gelişme geriliği olan fetuslar duktus venosusta a dalgası kaybı olmadan doğurtmak gerekmektedir.

INTRODUCTION: Assessment of pregnancy outcomes among intrauterine growth restricted fetuses with Doppler indices and cord blood gases.
METHODS: This study was conducted in May 2014 and January 2015. A total of 32 cases who had intrauterine growth restricted fetuses were included in this study. Cases were grouped as normal flow in the umblical artery (n=17) and absent or reversed end-diastolic flow in the umbilical artery (11 and 4 cases respectively). In addition to these cases, 3 cases had reversed a waveform in ductus venosus.
RESULTS: There was no neonatal mortality among the cases had normal flow in the umblical artery. However, mortality rate was %40 (n=6) among the cases had absent or reversed end-diastolic flow. The mean birth weights were 2118gr in the normal group and 968gr in the abnormal umblical artery Doppler group (p: 0.001). The mean Apgar score at 5 minutes was higher in the normal flow group (7,65) than the abnormal umblical artery Doppler group (6,27) and this difference was statistically significant (p: 0.001). The neonatal intensive care admissions were significantly increased in the abnormal group. The mean durations of hospitalization were 6,58 days in normal group and 39,93 days in abnormal group. The mean umbilical arterial pH and base excess were significantly higher in the normal group (p: 0.016, p: 0.004). The mean umblical arterial pH of normal group and abnormal group were 7,33 and 7,24 respectively.
DISCUSSION AND CONCLUSION: There is a strong relationship between pregnancy outcome in IUGR fetuses and abnormal uterine artery doppler waveform (absent or reversed) and ductus venosus waveform. Furthermore, Doppler examination can be safely used to management of these fetuses and to determine delivery time. Also, delivery of IUGR fetuses before detection of absent a wave in the ductus venosus should be considered.

GİRİŞ ve AMAÇ: Gestasyonel diyabet için erken tanı ve tedavi modalitelerinin geliştirilememesinin nedeni etiyopatolojilerinin aydınlatılamamış olmasıdır. Bu patolojilerde plasentanın rolünü tanımlamak önemlidir. Plasenta genetik ve epigenetik faktörlerin etkisinde fetal gelişimi belirler. DNA metilasyonu değiştirilebilir epigenetik mekanizmalardandır. Günümüzde tanı ve tedavi amaçlı kullanılmaktadır. Çalışmamızda GDM (Gestasyonel Diyabet) gebelerde, plasental anjiogenezde etkili genlerden VEGF (Vaskuler Endotelyal Büyüme Faktörü), PIGF (Plasental Büyüme Faktörü) ve sFLT-1 (soluble fms like tirozinkinaz)’nin DNA metilasyon değişiklikleri değerlendirilecektir.
YÖNTEM ve GEREÇLER: 2016-2017 tarihlerinde Süleyman Demirel Üniversitesi Kadın Hastalıkları ve Doğum Bölümü’nden takipli; 15 GDM tanılı ve 16 sağlıklı gebeden plasental örnekler alınmıştır. DNA metilasyon düzeyleri ‘Yeni Nesil Sekanslama’ ile belirlenmiştir. Verilerin dağılımlarına göre Manny Whitney U analizi; veriler arasındaki ilişkiler için Spearman korelasyon analizi kullanılmıştır.
BULGULAR: Genlerin metilasyon oranları ile yaş, gebelik haftası, bebeğin cinsiyet ve ağırlığı arasında ikililer arasında anlamlı ilişki saptanmamıştır (p>0.05). Plasenta ağırlığı artarken sFLT-1 geninin P92186.Pozisyondaki promoter metilasyon düzeyinin azaldığı görülmüştür. PIGF geninin metilasyon değerlerinde gruplar arasında anlamlı fark bulunmamaktadır. sFLT 1 geninin bölgesel analizlerine göre P92186., P92344., P92456. pozisyonlarındaki primer noktalarının hipometile; VEGF geninin bölgesel analizlerine göre P92668., P92710., P92863. pozisyonlarındaki primer noktalarının hipermetile olduğu saptanmıştır.
TARTIŞMA ve SONUÇ: Bulgularımız literatürle uyumludur ve anjiogenezde etkili genlerin bazı lokuslarındaki DNA metilasyon değişimlerinin GDM patogenezindeki yerine katkı sağlamıştır. Ancak prediktif değere ulaşılabilmesi için, geniş hasta gruplarıyla yapılacak genom çalışmaları ile ilgili gen bölgeleri netleştirilmelidir.

INTRODUCTION: The reason of absence preventive processes from GDM and early treatment modalities is unsettled ethiopathologies. Defining the role of the placenta is important for these pathologies. Fetal growth is adjusted due to placental genetic and epigenetic factors. DNA methylation which is an epigenetic mechanism, is modifiable and utiziable for diagnosis and treatment recently. DNA methylation changes of VEGF, sFLT-1, PIGF genes, have roles on placentation were evaluated according to GDM.
METHODS: All placental samples had taken from pregnants who routinely followed at Suleyman Demirel University Gynecology and Obstetrics Department, compatible with study criteria and diagnosed as GDM (n=15) and healthy pregnants (n=16). DNA Methylation levels were analysed by ‘New Generation DNA Sequencing’ method. Data collections analysed via SPSS 23 programme. Because of data distrubution Manny Whitney U tests are used for means; SPEARMAN correlation analysis is used to reveal relation between datas.
RESULTS: The methylation levels were not changed significantly due to demographic characteristics. The analyses that examine differences in methylation levels of PIGF were established no statistically significant difference. There was statistically significant difference in levels of methylation of sFLT-1 gene at the position of P92186., P92344., P92456. primer regions as hypomethylated and VEGF gene at the position of P92668., P92710., P92863. primer regions as hypermethylated.
DISCUSSION AND CONCLUSION: The findings of our study indicates changes of DNA methylation in some regions of VEGF, sFLT-1 genes and it is compatible with literature. But clarifying of related regions of genes via whole genom studies with a large population is necessary to reach predictive values.

GİRİŞ ve AMAÇ: Endometrial poliplerin patogenezi halen tam olarak bilinmemektedir. Bu araştırmada amacımız endometrial poliplerdeki steroid reseptörlerini incelemektir.
YÖNTEM ve GEREÇLER: Bu araştırmada Şubat 2008 ile Aralık 2011 tarihleri arasında hastanemizde histeroskopik polipektomi yapılan 28 hastanın poliplerine ve sağlam endometrium dokularına ait östrojen ve progesteron reseptörleri immunohistokimyasal olarak boyandı. Boyanma skorları kuvvetli boyananlar için 3 pozitif, orta boyananlar için 2 pozitif ve zayıf boyananlar için 1 pozitif olarak kaydedildi.
BULGULAR: Östrojen reseptörleri endometriyal polip glandında 1 (%3.6) hastada zayıf, 17 (%60.7) hastada kuvvetli boyandı. Stromasında ise 5 (%17.9) hastada zayıf, 12 (%52.8) hastada kuvvetli olarak boyandı. Polipin hemen yanındaki endometrial dokunun glandında 13 (%46.4) hastada zayıf, 5 (%17.6) hastada kuvvetli boyandı. Stromasında ise 14 (%50.0) hastada zayıf, 3 (%10.7) hastada kuvvetli boyandı. Progesteron reseptörleri için endometriyal polip glandında zayıf boyanma olmadı. Kuvvetli boyanma 27 (%96.4) hastada görüldü. Stromasında da zayıf boyanma olmadı. Kuvvetli boyanma 25 (%89.3) hastada görüldü. Endometriyal polipin hemen yanındaki endometrium dokusunun glandında 4 (%14.3) hastada zayıf, 18 (%64.3) hastada orta, 6 (%21.4) hastada kuvvetli boyandı. Stromasında ise 3 (%10.7) hastada zayıf, 18 (%64.3) hastada orta, 7 (%25.0) hastada kuvvetli boyandı
TARTIŞMA ve SONUÇ: Bulgularımız steroid reseptörlerinin endometrial poliplerin gelişimi üzerine olan önemini destekler niteliktedir. Bu reseptörlere yönelik geliştirilecek tedaviler hem poliplerin gelişiminin önlenmesinde, hem tedavisinde, hem de sebep olduğu şikâyetlerin engellenmesinde faydalı olabilecektir.

INTRODUCTION: The pathogenesis of endometrial polyps is still unknown. Our aim in this research is to examine steroid receptors in endometrial polyps.
METHODS: This study immunohistochemically stained estrogen and progesterone receptors of both polyp and intact endometrium tissues of 28 patients who underwent hysteroscopic polypectomy between February 2008 and December 2011 in our hospital.
RESULTS: The coloring scores were recorded as 3 positive for strong dyes, 2 positive for medium dyes and 1 positive for weak dyes. In endometrial polyp gland estrogen receptors were weak in 1 (3.6%) patient and strong in 17 (60.7%) patient. In the stroma, 5 (17.9%) patients were weak and 12 (52.8%) patients were strongly stained. The endometrial tissues adjacent to the polyp 13 (46.4%) patients were weak and 5 (17.6%) patients were strong stained. In the stroma, 14 (50.0%) patients were weak and 3 (10.7%) patients were strongly stained.Progesterone receptors did not show weak staining on the endometrial polyp gland. Strong staining was observed in 27 patients (96.4%). There was no weak staining in stroma. Strong staining was observed in 25 patients (89.3%). The gland of the endometrial tissue adjacent to polyp; 4 (14.3%) patients weak, 18 (64.3%) moderate, and 6 (21.4%) patients were strong stained. In the stroma, 3 (10.7%) patients weak, 18 (64.3%) patients moderate and 7 (%25.0) patients were strongly stained.
DISCUSSION AND CONCLUSION: Our findings support the importance of steroid receptors on the development of endometrial polyps. Therapeutic treatments for these receptors may be useful in preventing the development of polyps, as well as in treatment and prevention of complaints.

GİRİŞ ve AMAÇ: Bronkospazm, operasyonun ve anestezinin tüm aşamalarında ve istenmeyen bir fenomendir. Anestezi indüksiyonu sonrası trakeal entübasyon, sıklıkla bronkokonstriksiyona neden olan solunum sisteminin direncinde ölçülebilir bir artışa neden olur. Propofol ve tiyopental uzun yıllardan beri anestezi indüksiyonunda intravenöz anestezik ajan olarak kullanılmaktadır. Barbitüratlar, bronkospazmaya neden olan etkilerinden dolayı riskli hastalarda kullanılması tavsiye edilmez. Bronkodilatasyon ve kas gevşetici etkisi nedeniyle astım ve bronkospazm riski olan hastalarda genellikle propofol önerilir. Bu çalışmada, rat bronşlarında supramaksimal tonus oluşturulmuş bronkospazm modelinde propofolun thiopentale olan bu üstünlüğünü göstermeyi amaçladık.
YÖNTEM ve GEREÇLER: Toplam 30 erişkin erkek sıçan dört gruba ayrıldı. Çift-kör grup T1 supramaximal kontraksiyonda 1x10-5 M tiyopental aldı. Grup T2'de supramaksimal kontraksiyonda 1x10-6M tiyopental, supramaksimal kontraksiyonda Grup P1 1x10-1M propofol ve Grup P2'de 1x10-2M propofol uygulandı. Doku voltajları MAY GTA0303 GENIUS TRANSDUCER AMPLITUDE® ile ölçüldü ve Acqunowledge MP100® programına kaydedildi.
BULGULAR: Grup T1'de tonustaki azalma istatistiksel olarak anlamlı bulundu (tahmini ortalama fark, -0.41;% 95 güven aralığı [CI], -0.36 ile 1.18; p = 0.000. T2 grubunda tonus farkı istatistiksel olarak anlamlıydı (tahmini). ortalama fark, -0.20;% 95 güven aralığı [CI], -0.62 ile 1.03; p = 0.001). Uygulama öncesi ve sonrası P1 grubu ve grup P2'de tonus seviyeleri arasında istatistiksel olarak anlamlı bir fark bulunmadı.
TARTIŞMA ve SONUÇ: Çalışmamızda in vitro bronkospazm modelinde rat bronş dokusunda iki farklı tiyopental dozunda gevşeme etkisi gösterilmiştir. Propofolün iki ayrı dozunda ise herhangi bir gevşeme veya kasılma yanıtı saptanmamıştır. Şaşırtıcı olarak, bu çalışma propofolun doğrudan bronkodilatör etkisinin olmadığını ve tiyopentalin direkt olarak bronkodilatasyon sağladığını göstermektedir. Sonuç olarak, tiyopental doza bağımlı bronkodilatasyonun etkisinin literatürde iyi tartışma olmadığını fark ettik. Bu nedenle daha ileri klinik ve deneysel çalışmalarda tiyopental direkt bronkodilatasyon dozları belirlenmelidir.

INTRODUCTION: Bronchospasm is an undesirable phenomenon in all phases of operation and anesthesia.Tracheal intubation after induction of anesthesia causes a measurable increase in the resistance of the respiratory system, which often results in bronchoconstriction.Propofol and thiopental have been used as an intravenous anesthetic agent in induction of anesthesia for many years. Barbiturates are recommended not be used in patients with risks due to bronchospasm-causing effects. Propofol is generally recommended for patients with asthma and bronchospasm due to bronchodilatation and muscle relaxant effects. In our study, we aimed to demonstrate this superiority of propofol to thiopental in rat bronchi with supramaximal tonus in a bronchospasm model.
METHODS: A total of 30 adult male rats were divided into four groups. Double-blinded group T1 received 1x10-5 M thiopental at supramaximal contraction. In Group T2, 1x10-6M thiopental was applied at supramaximal contraction while in Group P1 1x10-1M propofol was applied at supramaximal contraction and in Group P2, 1x10-2M propofol was applied. Tissue voltages were measured with MAY GTA0303 GENIUS TRANSDUCER AMPLITUDE® and recorded in the Acknowledge MP100® program.
RESULTS: In Group T1, the reduction in tonus was statistically significant (estimated mean difference, -0.41; 95% confidence interval [CI], -0.36 to 1.18; p=0.000. In Group T2, the tonus difference was statistically significant (estimated mean difference, -0.20; 95% confidence interval [CI], -0.62 to 1.03; p=0.001).There was no statistically significance between tonus levels in neither group P1 nor group P2 before and after the implementation.
DISCUSSION AND CONCLUSION: In our study, relaxation effect in two different doses of thiopental was shown in rat bronchus tissue in in vitro bronchospasm model. Propofol did not show any relaxation or contraction responses in two separate doses. Surprisingly, Our results suggest that propofol has no direct bronchodilatation effect and thiopental directly provides bronchodilation. Consequently, we noticed that the effect of thiopental dose-dependent bronchodilatation is not well debate in the literature. For this reason, direct bronchodilatation doses of thiopental should be determined in further clinical and experimental studies.

GİRİŞ ve AMAÇ: Çocuklukta geçirilen idrar yolu enfeksiyonu (İYE), erişkin çağda böbrek yetmezliğinin en önemli sebeplerinden biridir. Zamanında tanınıp, uygun tedavi edilen enfeksiyon, renal hasar riskini azaltabilir. Çalışmamızda hastanemizde İYE tanısıyla tedavi edilen yenidoğanları retrospektif olarak değerlendirmeyi, tanı ve tedavi konusundaki verilerimizi klinik pratiğimizde yardımcı ve yol gösterici olarak kullanmayı amaçladık.
YÖNTEM ve GEREÇLER: Bu araştırmaya, Ocak 2009- Ekim 2012 tarihleri arasında Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi Yenidoğan Yoğun Bakım-2 Ünitesi’ne, idrar yolu enfeksiyonu tanısıyla yatırılan ya da yatırıldıktan sonra idrar yolu enfeksiyonu tanısı alan 137 yenidoğan hasta dâhil edildi. Tüm hastaların demografik özellikleri, fizik muayene bulguları, laboratuvar değerleri ve tedavi yöntemleri değerlendirildi.
BULGULAR: Çalışmamızdaki 137 hastanın %78,8’i erkek, %21,2’si kızdı. Hastaların başvuru semptomları sırasıyla; uzamış sarılık (%38,7), ateş (%28,5), emmeme (%28,5), kusma (%13,1), huzursuzluk (%10,2), dehidratasyon (%10,2), letarji (%6,6), kilo alamama (%4,4), idrar yaparken ağlama (%2,9), konvülziyon (%1,5), ishal (%1,5) ve batın distansiyonu (%0,7) idi. İdrar kültüründe üreyen en sık patojenler; E.coli (%54), Klebsiella spp. (%10,2), Enterobakteriacea spp (%9,5) ve ESBL(+) E.coli (%7,3) idi. En çok direnç geliştirilen antibiyotik ampisilindi. Ampisiline en fazla direnç gösteren patojen E.coli (%76,3)’ydi
TARTIŞMA ve SONUÇ: İdrar yolu enfeksiyonu, özellikle yenidoğan ve süt çocuklarında atlanmaması gereken ve ciddi sonuçları olan bir enfeksiyondur. Oluşabilecek komplikasyonların önüne geçilmesi, antibiyotik seçimi, uzun süreli izlem ve görüntüleme yöntemlerinin yönetimine bağlıdır.

INTRODUCTION: Childhood urinary tract infection (UTI) is one of the most important causes of renal failure in adult age. Fast and correct recognition and appropriate treatment of urinary tract infections during neonatal period may reduce the risk of renal damage. In our study; we aimed to evaluate newborns with UTI who were hospitalized in our neonatal ward retrospectively, and to use our findings in our clinical and treatment practice.
METHODS: We enrolled 137 neonates who were hospitalized with the diagnosis of UTI or diagnosed as UTI after hospitalization in Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital NICU-2 between January 2009 - October 2012. All patients’ demographic characteristics, physical examination findings, laboratory values, and treatment were evaluated retrospectively.
RESULTS: Of the 137 neonates included to the study 78,8 % were male and 21,2 % female. Presenting symptoms of patients was prolonged jaundice (38,7 %), fever (28,5 %), poor sucking (15,3 %), vomiting (13,1 %), restlessness (10,2 %), dehydration (10,2 %), lethargy (6,6 %), weight loss (4,4 %), crying during the voiding (2,9 %), convulsion (1,5 %), diarrhea (1,5 %), abdominal distantion (0,7 %) respectively. Most frequent pathogens cultured in urine was E. coli (54%), Klebsiella spp. (10.2%), Enterobacteriacea (9,5%), ESBL (+) E. coli (7,3%) respectively. The most common antibiotic resistance was to ampicilline. The most resistant pathogene to ampisiline was E.coli.
DISCUSSION AND CONCLUSION: Urinary tract infection is an infectious disease that should not be missed in newborns and infants and has serious consequences. Prevention of complications that may occur depends on the management of antibiotic selection, long-term follow-up and imaging methods.

GİRİŞ ve AMAÇ: Spontan vajinal doğum sonrasında plasental drenajın etkinliğini değerlendirmek.
YÖNTEM ve GEREÇLER: Bu randomize kontrollü çalışmaya, Aralık 2016 ve Temmuz 2017 tarihleri arasında Zeynep Kamil Kadın ve Çocuk Sağlığı Eğitim ve Araştırma Hastanesi'ne başvuran 222 gebe kadın dahil edildi. Spontan vajinal doğum sonrasında olgular çalışma (111) veya kontrol (111) grubu olarak randomize edildi. Çalışma grubunda; Göbek kordonun fetal yönü klemplendi, maternal tarafı akış duruncaya kadar kanı boşaltmak için açık bırakıldı. Kontrol grubunda umblikal kord her iki taraftan kleplendi.
BULGULAR: Doğumun üçüncü evresinin süresi çalışma grubunda 18,39 ± 6,85 dk, kontrol grubunda 22,78 ± 5,90 dk idi (p <0,0001). Çalışma grubunda ortalama kan kaybı 212,75 ± 12,1 olup kontrol grubunda 308,42 ± 18,4 ml idi (p <0,0001). Çalışma ve kontrol grubunda VAS skorları 5,65 ve 6,58'dir (p <0,0001).
TARTIŞMA ve SONUÇ: Plasental drenaj, doğumun üçüncü evresinin süresini, doğumun üçüncü evresindeki kan kaybını ve doğumun üçüncü evresindeki ağrıyı azaltmada etkili olabilir.

INTRODUCTION: To asses the effectiveness of placental blood drainage after spontaneous vaginal delivery in reducing the duration, the pain and blood loss during third stage of labour against no placental drainage.
METHODS: In this randomized controlled study, 222 pregnant women who admitted to Zeynep Kamil Women and Children’s Health Training and Research Hospital from December 2016 and July 2017 were included. They were randomized into study(111) or control(111) group when they delivered vaginally. In study group; umbilical cord was clamped from fetal side but unclamped from maternal side. After that unclamped side of umblical cord was left open to drain the blood until the flow stopped. In control group the umblical cord was clamped both sides.
RESULTS: The duration of third stage of labour was 18,39±6,85 min in the study group and 22,78±5,90 min in the control group(p<0,0001). The mean blood loss in study group was 212,75±12,1 and was 308,42±18,4 ml in the control group(p<0,0001). The mean respective visual analog scale (VAS) scores in study group and control group were 5,65 and 6,58 (p<0,0001).
DISCUSSION AND CONCLUSION: Placental blood drainage was effective in reducing the duration of the third stage of labour, the blood loss in the third stage of labour, and also the pain in the third stage of labour.

INTRODUCTION: To investigate the association between neutrophil / lymphocyte ratio (NLO) and platelet / lymphocyte ratio (PLO) values and prognostic factors (myometrial invasion, cervical invasion, lymph node involvement, and stage) in the complet blood count of patients with <40 mm grade I-II endometrioid type endometrial carcinoma (EEC).
METHODS: In this study, we retrospectively reviewed the records of patients who received EEC diagnosis and underwent hysterectomy and retroperitoneal lymphadenectomy in the gynecological clinic of Tepecik Training and Research Hospital between January 2013 and January 2016. Grade I-II patients with tumors size less than 40 mm were studied and included in the study. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off value of predictive prognostic factors in the EEC.
RESULTS: Patients with deep myometrial invasion, presence of cervical invasion, presence of lymph node metastasis and advanced stage tumors were found to be higher of NLO, PLO and CA125 values, and all results were found to be statistically significant. According to ROC curve analysis, NLO was found to be the factor with the highest area under curve for advanced stage, lymph node metastasis and deep myometrial invasion. However, the highest area under curve for cervical invasion was shown to have PLO value.
DISCUSSION AND CONCLUSION: In the grade I-II <4 cm tumors EEC patients who include advanced stage, lymph node metastasis, deep myometrial invasion and cervical stromal invasion were higher mean NLO, PLO and CA125 values. Systemic inflammation markers were found to be associated with poor prognosis in EEC patients with grade I-II tumor size <4 cm.

INTRODUCTION: Congenital hearing loss is found to be the most common congenital defect among newborns. After birth, newborn hearing screening program aims to detect congenital hearing loss as early as possible. The aim of this study was to evaluate and present our hospital’s newborn hearing screening program results including 8451 babies for a period of four years.
METHODS: Babies who were born in our hospital’s Obstetric Department between January 2013 and December 2016 and babies who were referred from other regional hospitals due to presence of a risk factor for hearing loss were included in the study. During working hours, babies were initially screened with TOAE test performed by an audiometrist before hospital discharge. Babies who failed TOAE test for 2 times and babies with risk factors or the ones referred from other hospitals were all evaluated by TABR as a secondary level screening. The results of the screening program and the records of the babies were evaluated.
RESULTS: A total of 8451 newborns were screened for congenital hearing loss during 4 years period. With first level screening, 4986 babies were evaluated with TOAE. Four thousand and seven babies with risk factors and the ones who were referred because of failure of TOAE for 2 times,were tested with TABR. Of the 4968 babies who were screened with TOAE, 4134(83,2%) passed the test. Of the 834 (16,7%) babies who were called for the second TOAE test, 524 (10,5%) passed the test, whereas 310 (6,2%) did not comefor a control test. Only 3652 (91,1%) babies passed the TABR test, whereas 355 (8,8%) were called for a second TABR test. Hundred and ten (2,7%) babies were not brought for control testing. Of the 245 (6,1%) babies who were brought for second TABR test, 98 (2,4%) of them were referred for tertiary level evaluation. Nineteen babies (0,22%) were found to have congenital hearing loss.
DISCUSSION AND CONCLUSION: With congenital hearing screening, the aim is to test every newborn in order to detect congenital hearing loss as early as possible after birth. Early identification and rehabilitation of the babies with congenital hearing loss will give an opportunity for optimum social, emotional and linguistic development.

INTRODUCTION: Recurrent urinary tract infection (RUTI) is an important public health problem in terms of disease management. Most frequently the agent is Escherichia coli. Protection methods include continous and post-coital prophylaxis, latter has similar efficiency with lesser drug dosage. In this study we aimed to investigate the efficiency of post-coital prophylaxis in prevention of RUTI.
METHODS: We retrospectively evaluated premenopausal, non-pregnant, and sexually active adult women whom were suggested to use single dose of 50 mg of nitrofurantion per oral in terms of post-coital prophylaxis for six months along with lifestyle modifications. Data of follow up examination after six months of therapy were also included.
RESULTS: Thirty nine patients were included. One patient couldn’t complete the prophylaxis due to gastrointestinal side effects. Data of thirty eight patients were statistically evaluated. There wasn’t any recurrence of RUTI and success rate was 100%. In terms of follow up examinations, one patient had a recurrent four months after the end of prophylaxis. Overall success rate for twelve months was 97.4%.
DISCUSSION AND CONCLUSION: Post-coital prophylaxis with low dose nitrofurantion was found both effective and safe for treatment of premenopausal, non-pregnant women with RUTI for both six months of treatment and six months of follow up period. This effect should be further evaluated with longitudinal prospective studies.

INTRODUCTION: The purpose of this study is to determine the timing of spontaneous separation of placenta after vaginal delivery and the factors affecting this time.
METHODS: Between 01.03.2016-01.01.2017 in the department of Obstetrics and Gynecology in İstanbul Dr. Lütfi Kırdar Kartal Education and Research Hospital.198 patients referred for vaginal delivery were included in our study. Following vaginal delivery, the placenta was expected to be spontaneously separated and checked at intervals of 5 minutes.
RESULTS: The separation time of the placenta was determined to be 11,69±6,09 minutes. It has been observed that the time for placental separation in induction-receiving and previously delivered patients is shortened. The placenta of 96% of the patients left within the first 20 minutes. In 5 of 198 patients the placenta did not spontaneously separate within 30 minutes and was taken by hand.
DISCUSSION AND CONCLUSION: In this study, the spontaneous separation time of the placenta was observed at intervals of 10-15 minutes. It was thought that 20 minutes should be determined as the threshold value for the spontaneous separation of the placenta. Taking induction and previously giving birth has been identified as a shortening factor.

INTRODUCTION: Breast cancer (BC) is the second most frequent malignancy in women. Fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) has become a major diagnostic tool for staging of the disease and predicting the prognosis. We aimed to evaluate the correlation between main quantitative 18F-FDG PET/CT parameters- primarily TLG (total lesion glycolysis), and CT density measurements as Hounsfield Unit (HU) of the primary BC masses in non-locally advanced BC (non-LABC) patients. And also we aimed to see whether there is a correlation between the volume and HU measurements of BC masses in non-LABC patients.
METHODS: In this retrospective study, we included 17 women with unilateral non-LABC having a mean age of 54.1±10.3 years who underwent 18F-FDG PET/CT before any treatment between 2016−2017. The mean volume, HU, maximum standardized uptake value (SUVmax) and TLG of the primary BC masses with their standard deviations and 95% confidence intervals (CI)s were calculated. Of the BC masses, the correlations between their mean TLG and mean HU, their mean SUVmax and mean HU, their mean volume and mean HU were statistically calculated.
RESULTS: The mean volume and HU of BC masses were 4.6±3.9 mL (95% CI: 2.6−6.6) and 42.5±4.1 HU (95% CI: 40.3−44.6), respectively. The mean SUVmax and TLG of BC masses were 6.4±5.6 g/mL (95% CI: 3.5−9.3) and 22.1±14.2 g/mLxmL (95% CI: 14.7−29.4), respectively. Of the BC masses, the correlations between their mean TLG and mean HU (r=-0.443, P=0.075), besides their mean SUVmax and mean HU (r=-0.368, P=0.146) were not statistically significant. The correlation between the mean volume and the mean HU of BC masses was also statistically insignificant (r=-0.214, P=0.410).
DISCUSSION AND CONCLUSION: In women with non-LABC, 18F-FDG PET/CT is a useful and reliable tool for obtaining the TLG of primary BC masses presenting with various CT densities

INTRODUCTION: Nausea and vomiting in pregnancy is the most common complication that observed in %50-80 of pregnant women. Approximately %1 of pregnant women experience severe nausea and vomiting during the first trimester and are diagnosed with hyperemesis gravidarum (HG). HG is the major reason for hospitalization before 20 gestational weeks. A relationship between insulin sensitivity, HG, and gestational diabetes mellitus (GDM) has been established. In this study, we aimed to assess the impact of HG on GDM and pregnancy outcomes.
METHODS: This retrospective study was conducted at Konya Akşehir State Hospital between 1st March 2015 and 30th September 2017.A total of 100 women included in this study (n: 46 hyperemesis, n: 54 control). Screening for GDM was performed once during pregnancy. GDM diagnosis was obtained with a 75-g OGTT, during the second trimester, from 24–28 weeks of gestation. Main outcomes were gestational diabetes, pregnancy-induced hypertension, fetal birth weight, preterm birth and fetal sex. Statistical analysis was performed using SPSS 15.0. p < 0.05 was considered as statistically significant.
RESULTS: At initial examination, no significant differences in maternal age and BMI were observed between the two groups. We found no statistical difference between the groups in the prevalence of GDM, pregnancy-induced hypertension, fetal birth weight, preterm birth and fetal sex.
DISCUSSION AND CONCLUSION: In the literature, there are many studies that shows negative effects of HG on maternal and fetal outcomes. In our study, it was found that HG is not associated with adverse pregnancy outcomes. The lack of this study is the small number of patients. More extensive studies are needed to define long term effects of HG.

INTRODUCTION: Our main goal was to present normal BMD measurements in pubertal males and females in order to make contribution to the the database of normative BMD values in our country.
METHODS: In this study 30 pubertal subjects (14 males, 16 females) with Tanner stage II-V having normal BMD values were enrolled. The mean ages of the male and female groups were 13.6±1.4 and 13.7±1.6 years, respectively (P>0.05). The BMD measurements of lumbar spine (L1-4) and femoral neck were done by dual x-ray absorptiometry (DXA). Lumbar and femoral BMD measurements of male and female subjects were compared. Lumbar and femoral neck BMD values were correlated with the age, weight, height and body mass index of the subjects within each gender groups.
RESULTS: There was no significant difference between mean ages, mean weight, mean height and mean BMI of male and females (P>0.05). The mean lumbar BMD value was statistically higher in pubertal females compared to males (P<0.05). There was significant correlation between the mean age and the mean lumbar BMD measurements in female group (P<0.05). There was significant correlation between the mean weight and the mean BMD measurements (lomber and femoral BMD) in male group (P<0.05).
DISCUSSION AND CONCLUSION: In conclusion, DXA is a useful, fast and accurate diagnostic tool for performing BMD measurements of lumbar spine (L1-4) and femoral neck in pubertal males and females.

INTRODUCTION: Maternal depressive changes in postpartum period are important for mother, infant and community health. The clinical use of screening tests developed for postpartum depression is recommended for prevention of disease, early diagnosis and treatment of patients.The aims of this study are to evaluate the effective risk factors on postpartum depressive emotional disorders in mothers and to evaluate the effects of depressive emotional disorders on breastfeeding.
METHODS: Between April 2018 and October 2018, mothers who gave birth in our hospital and who agreed to participate in the study and their babies were included. Approval was obtained from the local ethics committee for this study. Age of mothers, numbers of pregnancies and births, forms of birth, financial conditions, education levels, partner supports, genders of infants, birth weights and gestational weeks, the body weight of infants at the time of application, feeding patterns and whether or not hospitalizations were recorded. All mothers were screened for postpartum depression by EPDS test.
RESULTS: 100 mother-infant couples participated in the study. Median ages of mothers was 29 (19-39) and spontaneous vaginal birth rate was 48%. The median weight of the infants was 3300 g (1700 g - 4500 g) and gestational weeks were median 38 weeks (34 weeks - 41 weeks). There was a statistically significant positive correlation between the EPDS score of more than 10 and maternal age, feeding of breast milk, the history of loss of pregnancy and the hospitalization of the baby. It was found that 48 (82.7%) of 58 mothers with EPDS score less than 10 had only breast milk and 27 (64.2%) of 42 mothers with EPDS score of 10 or higher fed their babies only with breast milk. This difference was statistically significant (p = 0.035).
DISCUSSION AND CONCLUSION: The prediction of individuals at risk for postpartum depression is important for providing early and strong psychosocial support to these mothers. Prevention of postpartum depression will increase the feeding rate of infants with breast milk.

INTRODUCTION: To evaluate the incidence and risk factors of retinopathy of prematurity.
METHODS: Results of ROP screening of the four years period (from 1 January 2011 to 27 December 2014) were assessed retrospectively. Data of preterm newborns with and without intervention for ROP were compared with statistics of Student T and Ki square tests. Variables that are found significant for ROP with intervention were examined with logistic regression analysis in term of independent risk factors.
RESULTS: ROP was detected in 386 preterms with a mean gestational age of 28.6 ± 1.9 weeks and birth weight of 1085 ± 287 and patients without ROP with a mean gestational age of 30.3 ± 1.7 weeks and birth weight of 1413 ± 298, respectively. The overall incidence of ROP was 43.4 %. Patients with ROP were grouped into with and without intervention; 114 preterms with intervention (29.5 %) had a mean gestational age of 27.43 ± 2.03 weeks and birth weight 969 ± 276 g and 272 preterms without intervention (70.5 %) had a mean gestational age of 29.07 ± 1.73 weeks and birth weight 1134 ± 278 g. Male gender, the absence of antenatal steroid, chorioamnionitis, respiratory distress syndrome, inotrope use, erythrocyte transfusion, sepsis, patent ductus arteriosus, intraventricular hemorrhage, and total oxygen use were found significantly higher in the preterms with intervention than the preterms without intervention. On the contrary, gestational age and birthweight birth weight were found significantly lower in the preterms with intervention. Gestational age, male gender, and erythrocyte transfusion were identified as independent risk factors.
DISCUSSION AND CONCLUSION: ROP remains a crucial issue in excessively preterm newborns that have increased survival rates. Reduction of risk factors may decrease morbidity of ROP.

Idiopathic orbital myositis is a disease with unknown etiology, but it is thought to be an autoimmune disease, which is rarely seen among children. In most cases, corticosteroids provide a rapid and dramatic improvement. In this case report, we present an 11-year-old girl who admitted to our clinic with headache and orbital pain. Her neurologic examination revealed restriction of the outside glance on the right eye and restriction of the down glance on the left eye. Finally, she was diagnosed as idiopathic orbital myositis and improved with nonsteroidal anti-inflammatory treatment.

In recent years, psychosocial approaches in the treatment and care of infertility have become increasingly important. Although important developments are being made in this issue in our country, psychosocial approaches in institutions are not implemented systematically and in line with certain standards. Some institutions working with couples with fertility problems around the world have made similar nursing interventions supporting the treatment as institutional policy and have implemented each couple. In Royal College of Nursing, fertility nurses practice regular psychosocial support interventions for couples during the diagnosis and treatment. In Boston In Vitro Fertilization center, nurses have implemented brain-body program couples receiving fertility support to parallel treatment. In Canada, International Federation of Gynecologic and Obstetrics has developed systematic steps for health professionals to follow in couples with fertility problems. Nurses also apply methods such as hypnofertility and fertility yoga in some institutions. These standarts will allow couples to take individual care.