INTRODUCTION: We aimed to explore the clinical indicators necessitating insulin therapy and the factors affecting the amount of insulin used by pregnant women with diabetes diagnosed either during or before pregnancy.
METHODS: We reviewed all diabetes-related prenatal clinic visits from January 2015 to December 2017. A keyword search of electronic medical data identified cases of gestational, pregestational, type 1, and type 2 diabetes. Pregnant diabetics treated with insulin were included. Age, parity, consanguineous marriage, birthweight of prior children, first-degree relatives with diabetes, BMI before pregnancy, weight gain during pregnancy, and exercise compliance were recorded. Total insulin dose, as well as short-, intermediate-, and long-acting insulin doses, were documented separately. Hyperemesis in the first trimester, dietary changes, and ketonuria were also noted. HbA1c readings were obtained when gestational diabetes mellitus was diagnosed and when pregestational diabetes mellitus patients first visited our institution. Plasma lipid profiles were measured in all cases. Third-trimester fetal biometry was calculated using three ultrasonographic measurements.
RESULTS: A total of 202 diabetic patients were included in the study. The prevalence of pregestational diabetes mellitus was 52.5%, while diabetes diagnosed during pregnancy accounted for 47.5%. The combined effect of age and the discrepancy between the last menstrual period and abdominal circumference was found to be statistically significant in predicting insulin dosage. Specifically, total insulin requirements increased by 1.903 units for every additional year of age, and by 4.390 units for every unit increase in the Last Menstrual Period/Abdominal Circumference discrepancy.
DISCUSSION AND CONCLUSION: The global rise in diabetes prevalence has led to an increase in pregnancies complicated by diabetes. Our objective is to manage this condition optimally, enabling patients to continue therapy with minimal adverse effects and achieving the best possible outcomes for both mother and baby.

INTRODUCTION: This study aims to explore the contraceptive preferences, experiences, and attitudes of obstetricians and gynecologists, focusing on the alignment between their personal choices and professional practices in patient counseling.
METHODS: An online survey was conducted among 92 obstetricians and gynecologists from seven hospitals in Istanbul between September and October 2024. The survey consisted of three sections addressing demographic data, contraceptive preferences, and patient counseling practices. Data were analyzed to identify trends in contraceptive use, satisfaction, and perspectives on permanent methods such as tubal ligation and vasectomy.
RESULTS: The most commonly used contraceptive methods were condoms (47.8%) and oral contraceptive pills (32.6%), valued for their ease of use and secondary health benefits, respectively. Traditional methods, such as withdrawal and the calendar method, were associated with all reported unintended pregnancies (7.6%). Among respondents, 74% expressed positive views on tubal ligation and vasectomy, yet 42 did not discuss vasectomy with their patients. Physicians demonstrated high satisfaction with modern methods, though cultural and personal factors shaped their contraceptive choices and counseling practices.
DISCUSSION AND CONCLUSION: The study reveals that while obstetricians and gynecologists effectively utilize modern contraceptive methods, traditional methods remain in use and contribute to unintended pregnancies. Cultural and religious factors significantly impact attitudes towards permanent methods and patient counseling. These findings underscore the need for enhanced education and culturally sensitive counseling strategies to improve contraceptive adherence and patient outcomes.

INTRODUCTION: The aim of this study is to determine the changes in bowel habits and the associated factors that occur during pregnancy, thereby contributing to the existing literature.
METHODS: This descriptive study employed statistical methods and was conducted between June 1, 2022, and September 1, 2023, at a public hospital in Istanbul, involving 388 healthy pregnant women aged 18 to 45.
RESULTS: Before pregnancy, 90.6% of the participants reported having regular bowel habits. During pregnancy, 52.6% maintained regular bowel habits, while 47.4% experienced irregular bowel habits.
DISCUSSION AND CONCLUSION: The impact of pregnancy on the anal sphincter and pelvic floor organs as gestation progresses is not yet fully understood. The role of healthcare providers is crucial in preventing and treating these conditions, as well as in mitigating their adverse effects on women’s quality of life post-pregnancy. It is evident that further research is needed in this area.

INTRODUCTION: This study aimed to investigate the potential diagnostic value of endoplasmic reticulum (ER) stress-induced proteins, namely heat shock protein A5 (HSPA5) (also known as GRP78) and C/EBP homologous protein (CHOP), in maternal serum for identifying patients with intrahepatic cholestasis of pregnancy (ICP).
METHODS: A prospective case-control study was conducted with 37 pregnant women diagnosed with ICP and 36 healthy pregnant controls. Serum HSPA5 and CHOP levels were quantified using enzyme-linked immunosorbent assay (ELISA) kits.
RESULTS: While HSPA5 and CHOP levels were higher in the ICP group compared to the control group, the differences were not statistically significant (p-values of 0.164 and 0.310, respectively).
DISCUSSION AND CONCLUSION: The findings of this investigation did not yield sufficient evidence to validate the use of serum HSPA5 and CHOP levels for diagnosing ICP. Further research with larger sample sizes and exploration of placental tissue levels are warranted.

INTRODUCTION: The increasing cesarean section rates both in our country and worldwide have become a major public health concern. While cesarean sections are life-saving operations when performed under proper indications, they increase the risks of complications and place a significant economic burden on healthcare systems.
METHODS: This retrospective cohort study aimed to evaluate the effects of cervical dilation at hospital admission on cesarean section rates and hospital stay durations. Birth records from City Hospital between May 2020 and January 2021 were reviewed. Pregnant women between 37–41 weeks of gestation with no prior cesarean section and vertex presentation were included. Participants were divided into two groups based on cervical dilation at admission: early admission (EA) and late admission (LA). Statistical analyses were performed using SPSS 23.0, with a significance level of p<0.05.
RESULTS: A total of 550 pregnant women participated in the study. The cesarean section rate was significantly higher in the EA group (19.0%) compared to the LA group (2.5%) (p<0.001). The time between hospital admission and delivery was significantly longer in the EA group (p<0.001). The average hospital stay was 2.8±1.3 days for the EA group and 1.9±0.9 days for the LA group (p<0.001).
DISCUSSION AND CONCLUSION: Early admission is associated with higher cesarean section rates, prolonged labor durations, and extended hospital stays. These findings suggest that the timing of hospital admission plays a crucial role in maternal outcomes and that managing admission timing could improve delivery processes. Reducing early admissions, particularly for low-risk pregnancies, may help decrease unnecessary medical interventions and improve maternal outcomes.

INTRODUCTION: The objective of the present study was to ascertain the impact of the dysregulated immune response caused by the novel coronavirus (SARS-CoV-2) on the clearance of human papillomavirus (HPV) in infected patients.
METHODS: In this retrospective study, patients who were followed up at our centre between 2020 and 2022 due to positive test results for HPV 16 or 18 and who had a documented history of infection with the SARS-CoV-2 virus were included. Patients without a history of SARS-CoV-2 infection constituted the control group. To reduce the number of variables, patients who had received HPV or COVID-19 vaccination were excluded from the study.
RESULTS: The study included 105 patients with single HPV (16 or 18) positivity, of whom 55 (52.4%) were COVID-19 positive and 50 (47.6%) were COVID-19 negative. It was found that HPV clearance was statistically significantly lower in HPV-positive patients infected with COVID-19 compared to those who were not infected (p<0.001). Additionally, HPV clearance was found to be statistically significantly lower in the group with a history of smoking (p<0.001).
DISCUSSION AND CONCLUSION: This study demonstrated that the immune response to SARS-CoV-2, commonly referred to as “coronavirus”, may be associated with a reduction in the clearance of HPV types 16 and 18. Despite the modest number of cases included, the findings are significant in establishing a benchmark for future research with larger sample sizes.

INTRODUCTION: Immune thrombocytopenia (ITP) is an autoimmune disease. We aimed to examine the demographic, clinical, and laboratory features of ITP patients, identify the etiological factors, evaluate and compare treatment options, and analyze the effects of these parameters on the course of the disease.
METHODS: This retrospective study was conducted by reviewing the medical records of all patients under 18 years of age diagnosed with ITP at the Pediatric Hematology Department of a tertiary healthcare institution between January 2015 and December 2022. A total of 154 patients were divided into three groups according to age, initial thrombocyte count, and response to treatment. All groups were compared in terms of the course of the disease.
RESULTS: The mean age at diagnosis was 5±4.1 years. The most common findings at referral were ecchymosis (n=84; 54.5%) and petechiae (n=67; 43.5%). Sixty-two patients (40.3%) had an infectious disease prior to being diagnosed with ITP. The presence of triggering factors was significantly higher in the acute ITP group (p=0.031). Chronic disease was significantly more common in children aged 10 to 18 years (p<0.001). A ‘wait and watch’ strategy was followed for 40 patients, and these patients tended to develop a persistent (40%) or chronic (52.9%) course of disease (p<0.001). The rate of chronicity (70.6%) was higher in patients who received corticosteroids (p<0.001). The remission time was shorter among patients who received only IVIG therapy (p<0.001). Seventeen (11%) of the patients required second-line therapy.
DISCUSSION AND CONCLUSION: ITP is a benign disease with a very low mortality rate and tends to resolve spontaneously.

INTRODUCTION: Diagnosing measles, a highly contagious viral infection characterized by fever and a characteristic rash, can be challenging due to the similarity of the clinical presentation to other diseases. Confirmatory laboratory testing is critical to accurately identify measles cases, as different pathogens and medications can produce comparable symptoms. The objective of this study was to evaluate the predictive value of clinical findings and complete blood count parameters for the diagnosis of measles in pediatric patients presenting with fever and maculopapular rash.
METHODS: This study was conducted in our clinic between January 1, 2023, and October 1, 2023. Patients with fever and maculopapular rash were divided into two groups: the study group consisting of patients diagnosed with measles, and the control group consisting of patients without measles.
RESULTS: A total of 140 pediatric patients presenting with fever and maculopapular rash were included in the study. In the measles group, 34.4% (31/90) of patients had Koplik’s spots. In our study, vaccination rates were similar between the measles group (34%, 31/90) and the non-measles group (40%, 20/50) (p=0.513). However, vaccine refusal was significantly higher in the measles group (40%, 36/90) compared to the non-measles group (14%, 7/50) (p=0.001). Comparing symptoms between the groups, cough (p<0.001), conjunctivitis (p=0.004), coryza (p<0.001), and lymphadenopathy (p=0.02) were statistically significantly more common in the measles group. Cough significantly increased the likelihood of measles, with patients exhibiting this symptom being 8.94 times more likely to have the disease. A platelet-to-lymphocyte ratio cutoff of 89.2 yielded a sensitivity of 65% and a specificity of 72%. For the neutrophil-to-lymphocyte ratio, a cutoff of 0.28 demonstrated a sensitivity of 94% but a lower specificity of 40%.
DISCUSSION AND CONCLUSION: Clinical findings, particularly the presence of cough alongside fever and maculopapular rash, aid in strengthening measles diagnosis. However, we believe that markers derived from complete blood counts are not strong diagnostic tools for measles.

INTRODUCTION: Pain is a distressing experience for newborns and a significant source of stress that affects their overall health and development. This study was conducted to determine the effect of maternal heart sounds listened to by newborns during heel blood collection on pain level and crying time.
METHODS: This is a randomized two-group experimental study. The sample consisted of 60 newborns who presented for heel blood sampling. The newborns in the experimental group (n=30) listened to maternal heart sounds during the blood collection process. Routine heel blood was taken from newborns in the control group (n=30). An information form, the Neonatal Infant Pain Scale (NIPS), a hand Doppler device, a camera, and a voice recorder were used to collect data.
RESULTS: In the experimental group, mean pain scores during the heel blood collection procedure (control group: 5.850±1.3967; experimental group: 3.333±1.9623) and after the procedure (control group: 3.200±2.2992; experimental group: 0.967±1.4910) were found to be statistically significantly lower than those in the control group (p<0.05). Crying times during the procedure were also significantly shorter in the experimental group (control group: 155.87±111.462 sec; experimental group: 61.77±51.882 sec) (p<0.05).
DISCUSSION AND CONCLUSION: Newborns who listen to maternal heart sounds during heel blood collection experience less pain and have shorter crying times. Maternal heart sounds can be recommended as an effective method to reduce pain in newborns.

INTRODUCTION: To assess the effect of levetiracetam on cerebral oxygenation in the newborn period, whether it was used as first-line or add-on treatment for neonatal seizures.
METHODS: A prospective, cross-sectional study was performed. Neonates who were treated with levetiracetam because seizures were suspected clinically were included in the study. The included neonates were clinically stable and preparing for discharge during the study period. Baseline regional cerebral oxygenation (rSO2-C) and cerebral fractional oxygen extraction (FTOE) were recorded one hour before levetiracetam administration; three additional measurements of rSO2-C and FTOE were recorded during levetiracetam administration, and one and two hours after administration.
RESULTS: Eighty-one doses of levetiracetam were administered to 22 neonates, and nine (40.9%) of the neonates were receiving phenobarbital together with levetiracetam. The median gestational age and birth weight of the neonates were 37.5 (25–41) weeks and 2755 (720–3740) g, respectively. The levetiracetam dose ranged from 10 mg/kg to 60 mg/kg, with a median value of 20 mg/kg. There were no significant changes in the measurements of rSO2-C and FTOE associated with levetiracetam doses.
DISCUSSION AND CONCLUSION: The impact of levetiracetam on NIRS findings suggests that levetiracetam is safe in the neonatal period in terms of cerebral oxygen metabolism.