bluuebunny/crossref_metadata_2025 huggingface dataset:
Hematolojik hastalığı olan çocuklarda splenektominin endikasyonları ve etkinliği
Authors: Özden Önder , Kılıç Şeref Selçuk , Alkan Murat , İnce Banu
Published: April 2018

Amaç: Bu çalışmada çocuklarda hematolojik hastalıklar nedeniyle yapılan splenektominin faydasını ve endikasyonlarının araştırılması amaçlanmıştır.Gereç ve Yöntem: Hastanemizde 2009-2015 yılları arasında, 0-17 yaş aralığında, herhangi bir sebepten dolayı splenektomi yapılmış hastalar araştırıldı. Hastalarının yaşı, cinsiyeti, tanıları, postsplenektomi enfeksiyon olup olmadığı, portal venoz tromboz (PVT) olup olmadığı, ameliyat tipi, preoperatif ve postoperatif beyaz küre sayısı, hemotokrit ve trombosit sayısı, eşzamanlı kolesistektomi, dalak boyutu ve ameliyattan fayda görüp görmediği retrospektif olarak incelendi.Bulgular: Hastaların (n=58) yaş ortancası 8’di. % 41’i kız, % 59 ‘u erkekti.  Dört hastada splenektomi sonrası PVT gelişti. Hastaların 8’ine laparoskopik splenektomi yapıldı. 2 hasta ise ameliyata laparoskopik başlanmış ancak kanama sebebiyle açığa dönülmüştür. On dört hastaya eş zamanlı kolesistektomi yapıldı.  En çok orak hücreli anemi (n=20 %34,5) ,daha sonra talasemi major ( n=17 %29,3) ve immün trombositopenik purpura (n=6 %10,3) tanılarıyla splenektomi yapıldı. Dokuz (%15) hasta splenektomi sonrası enfeksiyon nedeniyle hastanemize yatışı yapıldı. Hastaların 17 ‘sinde splenektomiden fayda görüp görmediği veri yetersizliğinden dolayı değerlendirilemedi. Değerlendirilen hastaların %85’i (n=35) splenektomiden fayda gördü. 4 hasta eksitus olmuştur. Talasemi major ve İTP olan birer hasta splenektomiden fayda görmedi. Orak hücreli anemi olan hastaların hepsi splenektomiden fayda gördü.Sonuç: Splenektomi, hala birçok hematolojik hastalığın tedavisi için kullanılan etkili cerrahi bir işlemdir. Trombosit sayısını yükseltmek için yapılan ameliyatlarda hastanın yaşı, azda olsa önemlidir.
Laparoskopik kolesistektomi cerrahisi geçiren hastalarda neostigmin ve sugammadeks uygulamasının postoperatif bulantı kusma üzerine etkilerinin karşılaştırılması
Authors: Özbilen Fisun , Karacaer Feride , HATİPOĞLU Zehra , ÖZALEVLİ Mehmet , GÜNEŞ Yasemin
Published: April 2018

Amaç: Bu çalışmada laparoskopik kolesistektomi yapılan hastalarda sugammadeks ve neostigmin uygulamasının postoperatif bulantı kusma üzerine etkilerinin karşılaştırılması amaçlandı. Gereç ve Yöntem: Bu çalışmaya, ASA I-III statüsünde olan, öngörülen cerrahi süresi 150 dakikayı aşmayan, APFEL  Skoruna göre %40 ın üzerinde olan 60 hasta dahil edildi. Basit rasgele yöntemle randomize edilen hastalar neostigmin grubu (Grup I) ve sugammadeks grubu olmak üzere iki gruba ayrıldı. Anestezi indüksiyonunda tüm hastalara tiyopental 5-7 mg kg-1, rokuronyum 0,5 mg kg-1 intravenöz olarak uygulanarak endotrakeal entübasyon gerçekleştirildi. Oksijen (%33) + azot protoksit (%67) +desfluran ile anestezi idamesi sağlandı. Anestezi uygulamasının sonlandırılmasında son cilt dikişi atılırken iki grupta da desfluran ve N2O kesilerek %100 oksijene geçildi.  Eş zamanlı olarak kas gevşeticiyi antagonize etmek için grup I’e neostigmin, grup II’ye sugammadeks uygulandı. Ekstübasyon ve derlenme süresi, bulantı ve kusma ile diğer olası yan etkiler değerlendirildi.Bulgular: Postoperatif esktübasyon ve derlenme süresi sugammadeks grubunda nesotigmin grubundan daha kısa idi. Postoperatif bulantı ve kusma ilk 30 dakikada   sugammadeks grubunda nesotigmin grubundan daha az olmasına rağmen istatistiksel olarak anlamlı değildi. Sonuç: Bulantı ve kusma riski yüksek olgularda desfluran ile oluşturulan genel anestezide dekürarizasyon amacıyla neostigmin ya da sugammadeks uygulamasının bulantı kusma açısından birbirlerine üstünlükleri olmadığı kanısına varıldı.
Influence of total knee arthroplasty approaches on component positioning
Authors: Kaya Biçer Elcil , Sözbilen Murat Celal , Aydoğdu Semih , SUR Hakkı
Published: April 2018

Purpose: The aim of this study was to evaluate the influence of subvastus and medial parapatellar total knee arthroplasty approaches on component positioning and to explore the possible negative effects of potentially more restrictive approaches especially in highly deformed knees.Materials and Methods: 88 knees of 84 patients (46 knees operated with medial parapatellar approach (group 1), and 46 knees operated with subvastus approach (group 2)) who had undergone total knee arthroplasty. The patients were also regrouped according to their preoperative mechanical axis deviations. Postoperative femoral and tibial component positioning on frontal and sagittal planes were evaluated.Results: Frontal femoral (α) and tibial (β) component angles as well as sagittal femoral and tibial component angles were not significantly different between two groups (mean values of α of groups 1&2: 96.79±2.86° and 96.81±3.22°, respectively, of β 89.07°± 3.45° and 89.97°± 3.00° respectively, of sagittal femoral angle 4.85° ± 3.84° and 3.31° ± 3.58°, respectively, of sagittal tibial angle 5.10° ± 3.88° and 4.08 °± 3.18°, respectively). Postoperatively, posterior tibial slope was significantly decreased in both groups. Conclusion: None of the total knee arthroplasty approaches tested in this study found to exert a significant effect on component positioning even in highly deformed knees. The components can be placed properly utilizing both approaches.
İntrakranial kanamaların prognozunda biyokimyasal belirteçler
Authors: Yüksel Ulaş , Öğden Mustafa , Akkurt İbrahim , Bakar Bülent , Kısa Üçler , Özveren Mehmet Faik
Published: April 2018

Amaç: Bu çalışmada, intrakranial kanaması olan hastaların rutin laboratuvar bulgularını inceleyerek prognozu belirlemeye yönelik bir algoritma oluşturulması amaçlandı.Gereç ve Yöntem: İntrakranial kanama ile takip edilen ve cerrahi tedavi uygulanan hastalar spontan subaraknoid kanama, spontan intraserebral hematom ve subdural hematom grupları olarak üç gruba ayrıldı. Daha sonra cerrahi öncesi ve sonrası ölçülen serum sodyum, potasyum, C-reaktif protein değerleri ve kan lökosit ve nötrofil düzeyi sonuçları karşılaştırıldı. Bulgular: Yirmi sekiz hasta (10 kadın, 18 erkek) çalışma kapsamına alındı. Tüm parametreler açısından gruplar arasında fark görülmedi Ancak intraserebral hematom grubunda postoperatif lökosit sayılarının preoperatif değerden yüksek olduğu; subraknoid kanama grubunda postoperatif sodyum düzeyinin preoperatif değerden yüksek olduğu saptandı. Buna ek olarak, subaraknoid kanama grubunda Glasgow Çıkış Ölçeği puanları ile preoperatif, preoperatif ve postoperatif sodyum değerleri arasında negatif korelasyon bulundu. Subdural hematom grubunda Glasgow Çıkış Ölçeği ve preoperatif C-reaktif protein değerleri arasında negatif korelasyon olduğu tespit edildi.Sonuç: Sonuç olarak subaraknoid kanamalarda ameliyat öncesi ve sonrası ölçülen serum sodyum değerlerinin; spontan intraserebral hematomlarda ise yaş, Glasgow Koma Ölçeği, ameliyat öncesi ve sonrası ölçülen CRP değerlerinin ve subdural hematomlarda ameliyat öncesi ölçülen CRP değerlerinin ve prognozu belirlemede birer belirteç olabileceği düşünüldü.
Sonographic identification of isolated incompetent perforating veins and their correlation with age, sex, body mass index and CEAP classification
Authors: AKTÜRK Yeliz , KURT Aydın , İDİLMAN İlkay Sedakat
Published: April 2018

Purpose: Isolated incompetent perforating veins (IPVs) are poorly discussed in the literature and their importance and prevalence is unknown. This study aims to assess the prevalence and their relation with several factors; age, sex, location and body mass index (BMI). Materials and Methods: A total of 803 limbs of 485 patients were evaluated with duplex ultrasonography. The clinical severity of the affected limbs were assessed according to CEAP classification. Incompetent perforating veins were considered isolated if neither superficial nor deep venous system reflux were associated. Results: 617 legs were classified as CEAP 0-2, 186 legs were classified as CEAP 3 or higher. There was a significant correlation with age, sex, BMI, incompetent perforating veins and CEAP stage. 22 of 803 legs (2.7%) have been shown to have isolated incompetent perforating veins. Total of 25 isolated incompetent perforating veins were detected in these 22 legs (19 patients; 14 females, 5 males). All patients with isolated incompetent perforating veins had CEAP stage 0-2. The mean BMI of these patients was lower than the whole patients groups. Conclusion: The results of this study show that isolated IPVs may also be a cause of venous insufficiency. It may be inferred that the increase in the patients' weights or BMIs does not lead to development of isolated incompetent perforating veins because the BMI of the patients with isolated incompetent perforating veins are found to be lower.
Investigation of monoamine oxidase inhibitory activities of new chalcone derivatives
Authors: CAN Nafiz Öncü
Published: April 2018

Purpose: In the present study, it is aimed to investigate monoamine oxidase (MAO) enzyme inhibition potencies of some new chalcone derivatives. Materials and Methods: Nine novel chalcone derivatives were synthesized and structures of the synthesized compounds (2a-2i) were confirmed by spectroscopic methods. Inhibitory activities of the compounds against MAO-A and MAO-B enzymes have been determined via in-vitro fluorometric method. Effects of the compounds on substrate level were measured by an LC-MS/MS method. Enzyme kinetics studies were carried out for the most active compound 2i using Lineweaver–Burk plots.Results: Compounds 2c, 2e and 2i displayed notable inhibition against hMAO-B with lower IC50 values than 1 µM. The most active compound 2i displayed significant inhibition by IC50 of 0.13 µM. Results of substrate level quantification study were in an agreement with fluorometric enzyme inhibition assay. Competitive type of inhibition was determined for compound 2i as a result of enzyme kinetic studies. Conclusion: Synthesized compounds displayed more selectivity towards hMAO-B. In this study, the results of inhibitor effects of compounds 2c, 2f and 2i are promising for the synthesis of similar derivatives with enhanced MAO inhibitory activity and therefore for the development of new molecules which may be drug candidates against Parkinson's disease.
Meme, prostat, kolorektal ve akciğer kanserlerinde çevresel risk faktörleri ve risk düzeylerinin belirlenmesi: olgu-kontrol çalışması
Authors: Açıkgöz Ayla , Çımrın Dilek , Ergör Gül
Published: April 2018

Amaç: Bu çalışmanın amacı meme, prostat, kolorektal ve akciğer kanserini etkileyen çevresel risk faktörlerini belirlemek ve risk düzeyi belirleme programları kullanılarak tanı konmadan önceki risk düzeylerini değerlendirmektir. Gereç ve Yöntem: Bu çalışma İzmir’in Balçova ilçesinde yapılan olgu-kontrol araştırmasıdır. 2008-2013 yılları arasında akciğer, meme, kolorektal ve prostat kanseri tanısı alanlar araştırmanın olgu grubunu oluşturmuştur. Katılımcıların sosyodemografik özellikleri, yaşam tarzı ve beslenme alışkanlıkları anketle belirlenmiştir. Olgu ve kontrol gruplarının kanser risk düzeyleri hesaplanmıştır. Olgu grubunda 57 meme, 52 prostat, 22 kolorektal ve 42 akciğer kanseri olgusu bulunmaktadır. Meme kanseri olguları 216 kadın, prostat kanseri olguları 211 erkek, kolorektal ve akciğer kanseri olguları ise 427 kadın ve erkek kontrol ile karşılaştırılmıştır. Bulgular: Altmış yaşın altında olanlarda meme kanseri 2.36 kat fazladır. Fazla kilolu ya da şişman gruplarında meme kanseri daha az görülmüştür. Akciğer kanseri erkeklerde 2.04 kat, sigara içenlerde 4.10 kat, sigarayı bırakanlarda 2.19 kat fazladır. Sonuç: Yaş ve beden kütle indeksiyle meme kanseri; inflamatuar bağırsak hastalığıyla kolorektal kanserler; erkek cinsiyeti ve sigara içmeyle akciğer kanseri arasında ilişki bulunmuştur. Olgu ve kontrol grupları arasında hesaplanan kanser risk düzeyleri bakımından anlamlı fark saptanamaması olgu sayılarının az olmasından ya da kullanılan risk hesaplama programlarının Türk toplumuna uygun olmamasından kaynaklanabilir.
Stres üriner inkontinans tedavisinde transobturator tape ile gerilimsiz vajinal tapenin karşılaştırılması
Authors: Sukgen Gökmen , Altunkol Adem , Köse Gültekin , Tüfekçi Ertuğrul Can
Published: April 2018

Amaç: Stres üriner inkontinans tedavisinde gerilimsiz vajinal tape ve transobturator tape uygulamasının etkinliği,  güvenliği ve her iki yöntemin hayat kalitesini karşılaştırmayı amaçladık.Gereç ve Yöntem: Nisan 2006 ile Nisan 2008 tarihleri arasında stres üriner inkontinans nedeniyle transobturator tape uygulanan 45 hasta ile gerilimsiz vaginal tape uygulanmış 33 hastanın verileri karşılaştırıldı. Demografik özellikleri, başarı oranı, kısa dönemdeki komplikasyonlar ve operasyonun semptomlar ve yaşam kalitesi üzerine etkileri değerlendirildi.Bulgular: Total 78 hastanın ortalama yaşı 48.77±4.78 (34-79) olarak hesaplandı. Transobturator tape yapılan hastaların ortalama operasyon süresi sırasıyla 12.89±4.09 dakika idi. Gerilimsiz vaginal tape yapılan hastaların ortalama operasyon süresi 30.21±2.89 dakika idi. Ortalama operasyon süresi gerilimsiz vaginal tape yapılan gurpta istatistiksel olarak daha yüksekti. Urogenital distress inventory-6 anketinin analizinde her iki grubun kendi içinde postoperatif dönemde anlamlı derecede düzelme olduğu tespit edildi.Sonuç: Her iki prosedür güvenli ve etkili metodlardır. Aynı zamanda hayat kaliteleri üzerine istatistiksel olarak anlamlı derecede düzelmeler yaptığını tespit ettik. Yine de stres üriner inkontinansın tedavi modalitelerinin etkinliğini değerlendirmek için randomize kontrollü ve daha uzun takip süreleri olan çalışmalara ihtiyaç vardır.
Bipolar ötimik hastalarda uykunun genel özellikleri ve uyku bozuklukları
Authors: KESKİN Necla , TAMAM Lut
Published: April 2018

Amaç: Bu çalışmada ötimik dönemde olup, sorulunca uyku sorunu bildiren hastalarda uykunun genel özellikleri ile görülen uyku bozukluklarının belirlenmesi amaçlanmıştır.  Gereç ve Yöntem: Çalışmaya Çukurova Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı Bipolar Bozukluk Birimi’ne ayaktan başvuran ve “Genel olarak uyku düzeninizden memnun musunuz? Son 1 yıldır uyku düzeninizden memnun muydunuz?” sorularından en az birine “hayır” ve / veya “Başkalarının gözlemine göre uykunuzda sorun var mı?” sorusuna “evet” yanıtı veren 18-65 yaş arası 57 hasta alındı.Sosyodemografik Veri Formu ve Bipolar Bozukluk Veri Formu dolduruldu.  Genel Uyku Anketi (GUA) ile uykunun genel özellikleri ve uyku bozuklukları sorgulandı. Tüm hastalar Epworth Uykululuk Ölçeği (EUÖ)’ni doldurdu. Bulgular: Uykuyu başlatma, sürdürme ve sonlandırma evrelerinde sıklıkla sorun yaşadığı gözlenen hastaların %43.9’unun 10 saatten fazla uyuduğunu, %54.4’ünün horladığını, % 1.8’inin uyku apnesi yaşadığını bildirdiği gözlenmiştir. Hastaların %36.8’inin uyku sorunlarının mevsimsel özellik gösterdiği saptanmış, uyku sorunları çoğunlukla ikincil ve ruhsal kökenli olarak tanımlanmıştır. Sonuç: BPB’un ötimik dönemlerinde uyku bozuklukları oldukça sık görülen, tedavi için başvuru nedeni olmayan, gözden kaçan ve hastalık seyri, işlevsellik ve yaşam kalitesi üzerine etkileri iyi bilinen bozukluklar olup, BPB tanılı her hastanın uyku alışkanlıkları, yapısı ve bozuklukları açısından ayrıntılı olarak incelenmesi büyük önem taşımaktadır.
Effect of baricity of low dose diluted bupivacaine with fentanyl on the duration and quality of spinal block in transurethral prostatectomy
Authors: POLAT Reyhan , BUMİN AYDIN Gözde , AKTAY İNAL Meltem , Ergil Jülide , Topçu Gülöksüz Çiğdem , Baran İlkay
Published: April 2018

Purpose: In this prospective randomized controlled trial, we investigated whether density of low dose diluted bupivacaine with fentanyl effects the duration and quality of the spinal block for transurethral prostatectomy  (TURP) in elderly patients.Materials and Methods: Sixty patients requiring elective TURP were randomly allocated into two groups. Group H (n=30) received fentanyl 20 mcg+hyperbaric bupivacaine 0.5% (1.5 ml)+ saline 1.1 ml. Group I (n=30) received fentanyl 20 mcg+plain bupivacaine 0.5% (1.5 ml)+ saline 1.1 ml in total, bupivacaine 0.25% (3 ml) intrathecally. Onset, duration of the sensory block, the degree of motor block, perioperative anesthesia quality, side-effects, analgesic-free period were assessed.Results: The median peak level of the sensory block was significantly higher in Group H than in Group I. The time to the first analgesic request was longer in Group H). There were no differences between the groups for degree of the motor block, quality of anaesthesia, or adverse effects.Conclusion: Low-dose diluted hyperbaric bupivacaine  with fentanyl  provides adequate anaesthesia,  postoperative analgesia without haemodynamic instability or prolonging the recovery time for TURP in elderly patients.
Arabic gum acacia improves diabetic peripheral neuropathy in rats: a biochemical and histopathological evidence
Authors: Almohaimeed Hailah M. , Amin Hanan A. , Abd El-Aziz Gamal S. , Saleh Hamed A.
Published: April 2018

Background: Diabetic peripheral neuropathy (DPN) is a frequent complication of diabetes mellitus and unfortunately, its present therapeutic alternatives are exceptionally poor. Objectives of this study was to assess the antidiabetic, antioxidant and hypolipidemic action of Gum Arabic (GA) and its role in promoting the functional recovery from diabetic neuropathy developed in in an experimental model of diabetic neuropathy.Methods: Sixty adult male Sprague-Dawley rats were utilized and randomly assigned into six groups (n= 10); control, Arabic gum-treated, untreated diabetic, diabetic received metformin, diabetic received metformin and B12 vitamin and diabetic received metformin, B12 vitamin and AG. Locomotor activity and hyperalgesia were assed at the end of the study. Fasting and two hours post-prandial blood glucose, serum insulin levels, lipid Profile, oxidants/antioxidants parameters were assessed in the blood. Sciatic nerve was assessed histopathologically.Results: The locomotor activity of the untreated diabetic rats was significantly (p<0.001) reduced compared to the control group while it was significantly increased in all treated groups. The lipid profile and Malondialdehyde were significantly improved in all treated groups. Levels of CAT, GSH, SOD, GPx were significantly decreased in untreated diabetic group compared to the control while they were significantly increased in all treated groups compared to the untreated diabetic group. Sciatic nerve fibers of untreated diabetic rats showed degenerated axons with dilated myelin sheaths and degenerated Schwann cells. The nerve had significantly fewer fiber compared to the control. These changes were alleviated in all the treated groups specifically that received metformin, vitamin B12 and GA.Conclusions: It could be concluded that Arabic gum had hypoglycemic, antioxidant and hypolipidemic activity and had a protective effect on diabetic neuropathy. Based on this it is recommended that human clinical trials are necessary to prove this therapeutic effect.
Desire to practice postpartum contraception among antenatal women at Awka, Southeast Nigeria
Authors: Ezenyeaku Cyril C. , Ezebialu Ifeanyichukwu U. , Umeobika Joseph C. , Ikeako Lawrence C. , Ubboe Geoffrey I. , Ojiyi Chukwuemeka E. , Okeke Tochukwu C. , Ezenyeaku Chijioke A.
Published: April 2018

Background: Postpartum contraception enables the nursing woman recover from the effects of pregnancy and childbirth before embarking on another pregnancy. It also promotes child welfare. The assessment of the desire by pregnant women to take up postpartum contraceptive service will help the planning of good delivery of this service.Methods: A cross-sectional study of antenatal clinic attendees at Chukwuemeka Odumegwu Ojukwu Teaching Hospital, Awka was done using a pretested interviewer-administered questionnaire. Data was analyzed with IBM SPSS version 20 software and associations between variables were tested with Chi square. Level of significance was set at P ≤0.05.Results: A total of 262 antenatal women were interviewed. The mean age of the respondents was 29.1±6.1 years while the mean parity was 2.5±1.5. Two hundred and one of the study women (76.7%) had the desire to practice postpartum contraception after the index pregnancy while only 9 (3.4%) were unsure whether they had the desire or not. Multiparous women are more likely to desire postpartum contraception (P <0.01). Also, previous use of contraception (P<0.01), desired index pregnancy (P=0.01) and being married or single (P=0.02) are all significantly associated with the desire to practice postpartum contraception.Conclusions: There was a high level of desire to practice postpartum contraception among antenatal clinic attendees at Awka. Parity, marital status, desired index pregnancy and previous practice of contraception all influence this desire.
Awareness and perception of vasectomy among antenatal women in a tertiary health facility in southeast Nigeria
Authors: Ikeako Lawrence C. , Nnagbo Johnpaul E. , Umeh Uchenna A. , Ezegwui Hyginus U. , Chigbu Chibuike O. , Ajah Leonard , Onwudiwe E. N. , Okeke Tochukwu C.
Published: April 2018

Background: Vasectomy is a safe alternative to bilateral tubal ligation (BTL) in achieving permanent sterilization but not popular in developing countries. As part of the efforts to increase popularity as well as acceptance of vasectomy in the developing countries, its awareness among women needs to be assessed. The study was undertaken to determine the awareness and perceptions of vasectomy among antenatal attendees in a tertiary health institution southeast Nigeria.Methods: This was a questionnaire-based cross-sectional study in which pregnant women visiting University of Nigeria Teaching Hospital, Enugu (UNTH) antenatal clinic from 1st June – 30th November 2017 were recruited. Data was collected using structured questionnaire. Two hundred (200) self-administered questionnaires were completely filled and analyzed by means of descriptive and inferential statistics including means frequencies and x^2-tests at the 95% confidence level (CL).Results: Of the 200 respondents, 146(73%) were completely unaware of the existence of vasectomy while 54(27%) were aware. Of those who were aware, 41(75.9%) accepted its use as a family planning method for men. The commonest reason for acceptance was the fear of infidelity among their husbands, 17(41.5%). The intention to use was however low as 24(44.4%) of those who accepted vasectomy disapproved of its use by their husbands and the main reason for disapproval was “weakens husband’s sexual performance,” (33.3%). Tertiary level of education of the respondents was 5.3 times independently associated with the acceptance of vasectomy.Conclusions: The awareness is low and there are several misperceptions about vasectomy among the women in Enugu. Tertiary education of the women however improves the choice of vasectomy as a permanent contraceptive option. There is the need for educational programmes in line with the numerous advantages of vasectomy so as to counteract the misperceptions especially those regarding sexual relationship.
Comparison of Foley’s catheter with PGE2 gel and Foley’s catheter with PGE2 gel with extra amniotic saline infusion for labour induction
Authors: Bembalgi Shobha , . Lavanya , M. B. Vinutha
Published: April 2018

Background: Induction of labour is initiation of uterine contractions before the onset in order to vaginally deliver the foetoplacental unit. Common reasons for induction of labour are post-term and hypertensive disorders of pregnancy. The purpose of this study was to compare the efficacy of Foley catheter with intra cervical PGE2 gel and Foley catheter with PGE2 gel with extra amniotic saline infusion for induction of labour.Methods: The clinical trial was conducted from November 2016 to April 2017 at Karnataka Institute of Medical Sciences, Hubballi. 80 pregnant women which included both primigravidae and multigravidae were alternatively divided into two groups. Group 1 received Foley’s and PGE2 gel and group 2 received Foley’s, PGE2 gel and extra amniotic saline infusion for induction of labour.Results: Both groups were comparable with respect to maternal age, gestational age and indication for induction. There was no significant difference in the mean pre-induction Bishop score between two groups. In both the groups there was significant improvement in the Bishop score after 6 hours of induction. But progress in group 2 was greater than group 1(P <0.05). The mean time from induction to delivery in group 2 was shorter and was statistically significant(P<0.05). There was no difference in mode of delivery, neonatal and maternal morbidity and mortality between 2 groups.Conclusions: The present study showed that Foley’s with PGE2 gel with extra amniotic saline infusion is better for labour induction though both groups appear to be effective agents.
Obstetric outcome of teenage pregnancies in a tertiary care centre in Mangalore, Karnataka, India
Authors: Emani Anusha , Shetty K. Shraddha
Published: April 2018

Background: Teenage pregnancy is a social problem affecting maternal and child health. In India, teenage pregnancy is an important public-health problem, although the national policy of the Government of India advocates the minimum legal age of marriage for girls to be 18 years. The aim of the present study was to observe the obstetric outcome in Teenage pregnanciesMethods: A retrospective analysis of all Teenage pregnancies was done over a period of 1 year from August 2014 to July 2015. Case sheets of all teenage mothers delivered during that period were retrieved. Maternal and neonatal outcome were analyzed and compared with pregnant women ≥20 years of age.  Results: 5859 deliveries occurred during the study period, teenage deliveries were 457.The prevalence of teenage deliveries was 7.8%. Cesarean delivery rate was 56% vs 42% (p value<0.05) among teenagers compared to non teenage pregnant mothers. Preterm delivery rate was higher in teenagers 24% vs 14 % (p<0.05). 39(8.6%) teenage mothers had developed hypertension in pregnancy and 42(8.3%) among non-teenagers (p>0.05). Teenage mothers had increased Low birth weight rates 24% vs 10% (p<0.05).Conclusions: Teenage pregnancies has a negative impact on maternal and perinatal health. Hence strict laws should be enforced to prohibit teenage marriages. Adolescent girls should be educated about safe sex practices, contraception and complications of teenage pregnancies on maternal and child health.
Are Gynaecologists underutilising the open access technique for laparoscopic surgery?
Authors: Dhillon Atmajit Singh
Published: April 2018

Background: Open access technique for laparoscopic surgery is used by the surgeons routinely, for gaining intraabdominal access safely, but is somehow underutilised by gynaecologists. The most important and dangerous part of laparoscopic surgery is while gaining access to the abdominal cavity, especially in the obese, thin and in patients with previous abdominal scars. Various access techniques have been described including Hasson and Fielding technique, transvaginal or transuterine insufflation, alternative sites for introducing Veress needle abdominally and insufflations with an optical trocar. Open access technique can minimize visceral and vascular injuries and ensures quick and easy intra-abdominal access.Methods: 250 patients were taken up for laparoscopic surgery at tertiary care service hospitals for open access technique for laparoscopic surgery for a variety of indications. The spectrum of patients ranged from thin, obese, single and multiple transverse scarsResults: A total of 250 patients, were taken up for laparoscopic surgery with the open access method successfully. The median age of the patients was 32 years, there were 77 patients (31%), with previous transverse laparotomy incisions. Median time for access was 100 seconds, and in 102 patients, there was prolonged access time ranging from 150-300 seconds, 37 (36%) of these patients were those with previous multiple transverse laparotomies and 65 (64%), patients were obese. There were no intra-abdominal organ or vascular injuries. Skin incisions healed well.Conclusions: This study describes the open access technique in patients, with transverse laparotomy scars and especially useful in thin and obese women, and where the chances of vascular and visceral injuries can be high while gaining intra - abdominal access. It is safe, effective, easy to learn and requires minimal instrumentation and can be used in the vast majority of the gynaecological cases.
Comparative study of oral PGE 1 and intracervical PGE2 gel for pre-induction cervical ripening in prelabour rupture of membranes >37 weeks gestational age
Authors: Nadar Alka N. , P. S. R. N. S. Sirisha
Published: April 2018

Background: Active induction of labour in prelabour rupture of membranes resulted in a lower risk of maternal and fetal sepsis as compared to conservative management. Pre-induction cervical ripening helps in successful induction of labour.in this study we have compared the efficacy of low dose 25 mcg oral misoprostol versus intracervical PGE2 gel for cervical ripening in term PROM patients.Methods: Women with pregnancies between 37 and 41 weeks gestational age presenting with PROM at term and a Bishop score of 4 or less were randomly assigned to receive either a 25-mcg oral misoprostol every 4-hourly interval or 3 applications of intracervical PGE2 gel at a 6-hour interval for effective cervical ripening. Oxytocin was initiated if labor had not started after 6 hours of last effective dose of prostaglandin.Results: Fifty-three women (75.73%) (n = 70) in the oral misoprostol group with 2 doses, 4 hours apart had successful cervical ripening within 8 hours in comparison to sixty-two women (88.58%) (n = 70) in the intracervical PGE2 gel group with 2 doses, 6 hrs apart approximately 12 hrs for successful ripening. (p = 0.021). Oral misoprostol group needed shorter mean duration interval for the Bishop score <4 to >6 than intracervical PGE2 gel group, 7.84±3.64 hours and 9.39±4.20 hours respectively (p = 0.022). Similarly, the mean time duration interval from ruptured membranes to vaginal delivery in oral misoprostol was shorter i.e. 12.60±3.78 hours versus 14.66±4.08 hours (p = 0.005).Conclusions: Low dose 25 mcg oral misoprostol is a safe, efficacious and better tolerated alternative to intracervical PGE2 gel for pre-induction cervical ripening in especially in PROM patients at term.
Histopathological features of endometrium in those with symptoms suggestive of female genital tuberculosis
Authors: Sankareswari R. , Sundharam Ramya Sreevarshni Shunmugha
Published: April 2018

Background: Histological characteristics of endometrial biopsy material as assessed by light microscopy remain the diagnostic standard for the clinical diagnosis of endometrial pathology. Management of female genital TB is not complete without tissue diagnosis. The aim of the present study was to find out the histopathological pattern of theendometrium in those with symptoms suggestive of genital tuberculosis.Methods: A random sample of 200 female OPD patients with symptoms suggestive of FGTB attending to the Obstetrics and Gynaecology OPD in a tertiary care hospital at Ariyur, Puducherry were subjected to endometrial curettage and histological characteristics of endometrial biopsy material was assessed.Results: Endometrial histopathology revealed proliferative endometrium (60.5%, n=121), secretary endometrium (25.5%, n=51) and menstrual endometrium (9%, n=18) in majority. Chronic endometritis (3%, n=6), Simple hyperplasia without atypia (1%, n=2), atrophic (0.5%, n=1) and inert endometrium (0.5%, n=1) were other abnormalities reported.Conclusions: Histopathological features of endometrium in those with suggestive symptoms of female genital TB are variable and non-specific.
Analysis of ICU admissions in a tertiary care setting
Authors: Poovathi M. , Prasanna N.
Published: April 2018

Background: Management of the critically ill obstetric woman at an ICU is a unique challenge to ICU Physicians and obstetricians. Admission of obstetric patients occur approximately at 0.1-0.9% of the deliveries. The purpose of this study was to analysis of all critically ill obstetric patients admitted to a dedicated obstetric ICU to characterize the causes, clinical course, treatment any issues engendered by the presence of pregnant and postpartum women in a medical-surgical ICU.Methods: Details of all patients on the antepartum women or women less than six weeks postpartum admitted to the ICU from January 1, 2017 to December 31 ,2017 were reviewed. Obstetric data included gestational age at the time of admission and at delivery; type, indication, and location of delivery, and he ICU admitting diagnoses were categoried depending on the major system involved.Results: Out of a total of 10126 deliveries occurred in MGMGH, Trichy, in the past 1 year from January 2017 to December 2017 out of which the total number of ICU admissions were 141. The preclampsia/eclampsia related complications and Antepartum haemorrhage equally were responsible for the maximum number of obstetric ICU admissions and the number of ICU admissions for ventilator support and haemodynamic support were more.The leading cause of maternal death in the ICU admissions was pre-ecclampsia and eclampsia related complications .Ventilator support was required in 112 patients out of 141 ICU admissions , postpartum admissions were more than the antepartum admissions and nearly 73 of the ICU admissions were delivered by caesarean sections.Conclusions: The most common precipitants of ICU admission were obstetric hemorrhage and uncontrolled hypertension. Improved management strategies for these problems may signiﬁcantly reduce major maternal morbidity.
A comparative study of oral iron and intravenous iron in iron deficient antenatal mothers
Authors: G. Suganya , Vimala D.
Published: April 2018

Background: The aim of the study is to compare the efficacy, tolerance and compliance between oral iron and intravenous infusion of iron in iron deficient antenatal mother.Methods: This is a prospective randomised clinical and interventional study in the department of Obstetrics and Gynaecology in Vinayaka Mission Kirupananda Variyar Medical College and Hospital. The antenatal women attending the antenatal op were screened for Hb status. Those antenatal women of gestational age 16-34 weeks with Hb level between 7-10g% and diagnosed to have iron deficiency anemia by peripheral smear and serum ferritin were included in this study after getting informed consent. The total numbers of 100 mothers were allotted into two major groups, group A and group B of 50 subjects each. Group A: 50 pregnant women given oral iron supplementation (carbonyl iron 100 mg twice a day). Group B: 50 pregnant women given intravenous iron sucrose therapy after calculating the total iron requirement. The rise in hemoglobin in both the groups were comparedResults: In this study the mean rise of hemoglobin in carbonyl iron was 0.914±0.20 gm% whereas in iron sucrose group was 2.43±0.20gm%. This showed that iron sucrose (i.v) had better rise in Hb than carbonyl iron (oral).Conclusions: The present study revealed that intravenous iron sucrose therapy was bettertolerated with higher increase in mean haemoglobin compared to oral iron therapy. There were no serious side effects with intravenous iron sucrose therapy. Intravenous iron sucrose is a good substitute to oral iron therapy in moderate anaemia.
Comparative study to evaluate the effect of colloid coloading versus crystalloid coloading for prevention of spinal anaesthesia induced hypotension and effect on fetal Apgar score in patients undergoing elective lower segment caesarean section: a prospective observational study
Authors: Wani Sadia Ali , Pandit Basharat Hussain , Din Mehraj Ud , Ul Nissa Wakar , Ashraf Asia , Bashir Samreen , Mir Altaf Hussain
Published: April 2018

Background: Spinal anesthesia for LSCS has a high incidence of maternal hypotension which can be severe and disastrous for the fetus and the mother. Coloading in these patients is a physiologically more appropriate method for preventing spinal anesthesia induced hypotension.Methods: 100 ASA I patients for elective LSCS were randomly divided into two equal groups to either receive 1000ml colloid (6% Hetastarch) or 1000ml crystalloids (Ringer lactate) as coload. NIBP, heart rate SPO2 and incidence of nausea and vomiting and use of ephedrine to treat any hypotension was recorded. Fetal outcome was measured using APGAR score at 0, 1 and 5 minutes.Results: The incidence of hypotension was lesser with colloid coload group (41.7%) as compared to the crystalloid coload group (58.3%) but the difference between the two groups was statistically insignificant. Similarly, no statistically significant difference was noted in the incidence of nausea and vomiting and Fetal APGAR score between the two groups.Conclusions: Both Colloid and Crystalloid coloading is effective in decreasing the incidence of spinal anesthesia induced hypotension during LSCS with lesser incidence of hypotension and nausea vomiting with colloid coloading.
Ormeloxifene in the management of dysfunctional uterine bleeding
Authors: Devi L. Thulasi , Nimonkar Ravi
Published: April 2018

Background: Dysfunctional Uterine Bleeding (DUB), is the commonest cause of Abnormal Uterine Bleeding (AUB). It causes morbidity, anaemia, and unnecessary hysterectomies in women of fertile age group. This study attempts to study efficacy of medical management especially Selective Estrogen Receptor Modulator (SERM) namely Ormeloxefine (ORM) (Sevista®) in Perimenopausal women. Ormeloxifene was marketed in India for contraception under brand names Centron, Saheli, Choice-7, Novex and Novex-DS. It’s a benzopyran derivative also known as Centchroman which causes asynchronousity between ovulation and menstrual cycles possibly because of both estrogenic and anti-estrogenic actions. It has been known to cause delay in ovulation in clinical trials; however, majority have been unaffected. It causes delay in proliferation of endometrium thereby causing asynchronous cycles. It also improves motility of ciliary lining of Fallopian tubes thereby reducing the chances of implantation of fertilized egg.  Methods: This study is aimed at evaluation of subjective and objective stastical benefits and side effects in treatment of DUB in perimenopausal age group with ORM and commonly used 19 nortestosterone compound (progesterone); Norethisterone (NET).Results: Primary outcome were analyzed at the end of every 3 months and at the end of one year finally. Secondary outcomes of the study in each arm were also assessed. There was stastically significant increase in Hb and stastically significant decrease in ET. Data analysis was done for variables in each arm by t-test to estimate the mean, median, range P and t value for a conclusion. Differences were taken as significant when P<0.05.Conclusions: ORM is a safe, cost effective, non-steroidal, non-hormonal drug with convenient dosage and better compliance for medical management of perimenopausal DUB with minimum focal pathology. Side effects observed need more evaluation with larger sample size to be statistically significant.
Menstrual hygiene practices in young girls of urban India
Authors: Wagh Reena V. , Upadhye Aditi J. , Upadhye Jayshree J.
Published: April 2018

Background: Menstrual hygiene is an important aspect in the life of young girls.The present study aims at assessing the knowledge regarding menstruation and hygienic practices and perceptions during menstruation.Methods: It was a cross sectional study, conducted among 100 young girls of 20-22 years age to assess the awareness of menstrual hygiene. Data was collected by pre-tested questionnaire. Statistics was calculated in percentages.Results: Out of 100 girls, 71 (71%) knew about menstruation before menarche while 29 (29%) did not have any knowledge. 71 (71%) girls knew the cause of menstruation as physiological, 18 (18%) girls didn’t know the cause, 11 (11%) girls still believe it as curse of God. 68 (68%) girls knew the source of bleeding during menstruation as uterus, 20 (20%) girls thought it as vagina while 12 (12%) thought it as urethra. 64% girls use sanitary pads during menstruation, 19% girls used old cloth while 17% girls used new cloth during menstruation as adsorbent material. 9% girls dispose pads or used cloth in dustbin, 19% girls flush them in toilet while 12% girls throw them roadside. 96% girls avoid going to temple, 68% girls restrict their daily activities, 56% girls avoid going to functions, 50% girls avoid going to kitchen, 50% girls avoid going to kitchen while 45% girls avoid touching things at home.Conclusions: It is very important that young girls should be educated about the importance of maintaining hygiene during menstruation to prevent the risk of reproductive tract infections.
Effectiveness of intravenous iron sucrose over oral iron therapy for anaemia in pregnancy
Authors: Pitale Devdatt Laxman
Published: April 2018

Background: Anaemia in pregnancy is very common throughout our country impacting both mother and the newborn. The most common cause of anaemia in pregnancy is iron deficiency. The increased prevalence of iron deficiency anaemia amongst the pregnant women, especially in developing countries is a major cause of significant maternal morbidity and mortality. Intolerance to oral iron, inadequate absorption, and side effects leading to poor compliance are the major shortcomings in oral iron therapy. These factors are significant especially in anaemia near term. To overcome all these limiting factors associated with oral iron therapy, parenteral iron therapy is preferred. Aim of this study was to study effectiveness of intravenous iron sucrose over oral iron therapy for anaemia in pregnancy.Methods: This prospective study was taken up to compare the effectiveness of intravenous iron sucrose over oral iron therapy for anaemia in 30 antenatal women attending antenatal outpatient Department of Obstetrics and Gynaecology belonging to gestational age group of 28-34 weeks with anaemia in pregnancy.Results: Majority of pregnant women belonged to age group of 22-25 years.67% were primigravidas. The period of gestation varied from 28-34 weeks. In this study, the mean baseline haemoglobin was 8.4 g/dl before start of treatment and after iv iron sucrose treatment haemoglobin showed a mean value of 10.8g/dl. The mean baseline MCV was 70 fl/cell. Post treatment MCV after 4 weeks showed a significant mean rise of 12 fl/cell in the present study with no major side effects.Conclusions: Intravenous iron sucrose is highly effective over oral iron therapy for anaemia in pregnancy. It enables rapid correction of anaemia with minimal side effects.
Incidence and perinatal outcome of multiple pregnancy in a tertiary care centre in Central India
Authors: Yadav Nutan , Alwani Madhuri , Singh Ankita
Published: April 2018

Background: The incidence of multiple pregnancy is increasing all over the world because of assisted reproductive technology or spontaneously as a result of numerous risk factors. The objective of this study was to study the perinatal outcome of multiple pregnancy in a tertiary care centre in central IndiaMethods: It is a prospective study total 2289 pregnant woman were enrolled. Out of which 72 pregnant women were either a twin or triplet. 2217 pregnant women were singleton and had acted as controls. Perinatal outcomes including perinatal morbidity and mortality in relation to history regarding any complication in the present pregnancy were noted and analyzed.Results: In case of multiple pregnancy 90.2% were conceived between 20-30 years of age and 9.8% more than 30 years.13.9% cases of multiple pregnancy were less than 34 weeks at the time of delivery. The IUGR in multifetal pregnant patient was significantly higher. Oligohydromnios was seen in 3 out of 72 multifetal gestation which accounted for 4.1%. The proportion of singleton and multiple pregnant females who had anemia during pregnancy was 92.33% and 91.67%. Most common indication of LSCS in multifetal gestation is abnormal presentation during labour accounting for 41.7% of LSCS. The most common indication for NICU admission in case of multifetal pregnancy was 80.8%.Conclusions: Majority of the twin pregnancy is high risk one, and as such all twin preganancies should have mandatory hospital delivery. Early diagnosis, antenatal, intra-natal and post-partum cares are necessary to improve the outcome.
A study of management and outcome of tumors of ovary among women of reproductive age group
Authors: M. Priyadarshika
Published: April 2018

Background: Variety of presentations of each and every type of the tumor of the ovaries and their asymptomatic nature in the initial stages of the cancer brings out the disease in very late stages. In the late stages of the malignancy of the ovaries, even chemotherapy or even surgical management is of limited use. Objective of this study was to study of management and outcome of tumors of ovary among women of reproductive age groupMethods: Present study was follow-up study. Patients were followed from diagnosis to surgery till the six months post-surgery. A total of 56 eligible study subjects with any kind of tumor of ovary posted for surgery in the department of Obstetrics and Gynecology were included in the present study and studied in the present study which lasted for two years.Results: Maximum (64.3%) were managed by oophorectomy. 87.5% of tumors were benign and 10.7% were malignant. Maximum cases were of serous cystadenoma in 44.9% of the cases among benign tumors. Out of 22 cases of serous cystadenoma, maximum i.e. 16 underwent oophorectomy. One case of Dysgerminoma affecting one ovary was in stage Ia but not having metastatic nodules or ascites. Papillary mucinous cystadeno carcinoma in stage IIIc received Salvage CT with multi drug regimen with 3 Number of cycles of chemotherapy. Three cases died and one lost to follow up.Conclusions: Benign tumors of the ovary were the most common among women. Each case was unique histo-pathlogically and stage wise. This feature of tumors of the ovaries makes it difficult to diagnose easily and make management more difficult. Hence thorough study of each case is required to understand them properly.
Serum Beta HCG and uterine artery Doppler studies in second trimester to predict preeclampsia and eclampsia
Authors: Kulkarni Nitin , Bansal Radhika , Pawar Pankaj
Published: April 2018

Background: Hypertensive disorders during pregnancy remain amongst the most significant and intriguing unsolved problems in obstetrics. The study aims at testing the hypothesis that women with high serum beta hCG levels and alterations in waveforms in the uterine artery doppler in early second trimester have high risk of developing pre-eclampsia.Methods: Serum Beta hCG estimation was done by Sandwich chemiluminescence immunoassay method. All uterine artery waveforms were obtained using a Toshiba nemio ultrasound machine attached to a 3.5 MHz curvilinear transducer, with colour and pulsed Doppler abilities.Results: For prediction of preeclampsia or eclampsia uterine artery Doppler velocimetry alone shows specificity of 96.30%, sensitivity of 90%, positive predictive value of 94% and negative predictive value of 80%. When it is combined with serum beta HCG sensitivity and specificity are almost same, but alone serum beta HCG levels are showing sensitivity of 96% and specificity of just 76%.Conclusions: Abnormal waveforms on uterine Doppler studies are the better predictors for preeclampsia and eclampsia when done in early second trimester.