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Öğe Comparison of effects of low and high flow desflurane anaesthesia on hemogram parameters(2019) Yoldaş, Hamit; Karagoz, İbrahim; Ekici, Mustafa Ayhan; Eş, Abdulhamit; Yıldız, İsa; Demirhan, Abdullah; Bilgi, MuratObjectives: To compare the effects of low and high flow desflurane anaesthesia on hemogram parameters in lower abdominal surgeries. Methods: Sixty female patients who underwent lower abdominal surgery under general anaesthetic were included in this prospective study. Patients were randomly divided into two groups, as Group I (low flow) and Group II (high flow), and then compared with each other according to their demographic features and hemogram parameters. Results: Groups were statistically similar, and there were no significant differences in terms of demographic data between the groups (p>0.05). The comparisons of hemogram parameters within the groups showed that there were significant differences in plateletcrit, platelet-lymphocyte ratio and neutrophil-lymphocyte ratio values in Group I (p<0.05). The comparisons of hemogram parameters within Group II showed a statistically significance in plateletcrit and platelet-lymphocyte ratio values. A statistically significant difference was found for red cell distribution width, neutrophil- lymphocyte ratio, platelet-lymphocyte ratio and plateletcrit values between groups for the pre-operative and post-operative values of hemogram parameters (p<0.05). Conclusion: Our study showed that the administration of low flow anaesthesia led to a positive effect on the inflammatory response by lowering neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and red cell distribution width values, in comparison to high flow anaesthesia.Öğe Could Mean Platelet Volume and Red Cell Distribution Width be related with the progression and severity of gestational hypertensive disorders?(Kuwait Medical Assoc, 2022) Ekici, Mustafa Ayhan; Yis, Ozgur MehmetObjective: To evaluate the correlation between thrombocyte indices, red cell distribution width and the progression of gestational hypertensive disorders Design: Retrospective and cross-sectional study Setting: Abant Izzet Baysal University Hospital and Bolu State Hospital, Bolu, Turkey Subjects: Five hundred and one pregnant women were included in this study, which included 115 severe-preeclampsia (PE), 155 mild-PE, 105 gestational hypertension (GHT) and 126 healthy pregnant women (control group). Intervention: 2 ml blood samples were taken by using 19-G needles. Hematological parameters values were studied using a blood count analyzer. Main outcome measure(s): Comparison of hematological parameters before and after diagnosis of GHT, mild-PE and severe-PE. Results: Mean platelet volume (MPV) was found significantly higher in the severe-PE group than GHT, mild-PE and control groups (P=0.005). MPV was higher in the severe-PE group concerning mild-PE and GHT groups (P=0.043, P=0.014 respectively), and it was unchanged between mild-PE, GHT and control groups. Platelet distribution width, red cell distribution width (RDW), plateletcrit, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were found unchanged among four groups. Platelet count (PC) was significantly lower in the severe-PE group than mild-PE, GHT and control groups (P=0.021). PC was not found to be significantly different among GHT, mild-PE and control groups. Hematological parameters before and after diagnosis of GHT, mild-PE and severe-PE were compared and RDW was significantly higher after progression of the disease (P=0.009, P=0.006, P=0.0002 respectively). Conclusions: Elevation in RDW levels is associated with a progression of GHT, mild PE and severe PE. MPV levels are found higher and PC levels are found lower in severe-PE. However, there was no significant change observed according to the severity of gestational hypertensive disorders.Öğe A cross-sectional study of non-diabetic macrosomic infants(Sri Lanka College of Paediatricians, 2013) Bekdaş, Mervan; Demircioğlu, Fatih; Göksügür, Sevil Bilir; Ekici, Mustafa Ayhan; Kısmet, ErolObjective: To determine risk factors and short term outcomes in infants with fetal macrosomia independent of gestational diabetes. Method: Patient records of babies born in Bolu IzzetBaysal Obstetrics-Gynaecology and Paediatrics Hospital between 1st January 2007 and 31st December 2010 with weights of 4000g or more were assessed retrospectively. Data were analysed usingSPSS version 17.0. Babies born outside hospital and infants of diabetic mothers were excluded.Control group comprised 500 healthy infants weighing 2500-3999g, born during the same period. Chi-square test, student-t test, Mann-Whitney test and multiple regression analysis were the statistical tests used. Results: Of 10,898 babies delivered in our hospital during the 4 year study period, 509 (4.7%) weighed 4000g or more. Significantly more non-diabetic macrosomic babies were male compared to controls (p<0.001). Significantly more non-diabetic pregnant women older than 35 years delivered macrosomic infants compared to non-diabetic pregnant women 35 years or less (p<0.001). Significantly more non-diabetic pregnant women who delivered macrosomic infants were multipara compared to controls (p<0.001). No significant statistical differences were detected in mode of delivery between cases and controls (p>0.05). The 5th minute Apgar scores in the non-diabetic macrosomic group was significantly lower than in controls (p<0.001). Non-diabetic macrosomic babies had significantly more birth injuries than controls (p=0.009). Risk of developing hypoglycaemia and hypocalcaemia were significantly higher in non-diabetic macrosomic babies compared to controls (p<0.05). Conclusion: In our study the risk factors for nondiabetic fetal macrosomia were advanced age pregnancy, multiparity and male sex.Öğe Düşük doğum ağırlıklı bebeklerde morbidite ve mortaliteyi etkileyen faktörler(2013) Bekdaş, Mervan; Göksügür, Sevil Bilir; Küçükbayrak, Beyhan; Ekici, Mustafa AyhanAmaç: Hastanemizde doğan düşük doğum ağırlıklı bebeklerdeki kısa dönem morbidite ve mortalite sıklığını ve bunları etkileyen faktörleri incelemek. Yöntemler: 18 aylık dönem içinde hastanemizde doğan düşük doğum ağırlıklı 195 bebek ve aynı dönem içinde normal doğum ağırlıklı doğan 150 bebek kontrol grubu olarak seçildi. Bulgular: Söz konusu süre içinde hastanemizde doğan bebeklerin %4,4’ü (n=168) düşük doğum ağırlıklı, %0,7’si (n=27) çok düşük doğum ağırlıklı idi. Bu bebeklerde kontrol grubuna kıyasla çoğul gebelik ve asfiktik doğum anlamlı oranda yüksekti (sırasıyla p=0,029, p=0,011). Çok düşük doğum ağırlıklı bebeklerde asfiktik doğum (OR=14,2, 95% CI (6,6-30,7, p<0,001), yenidoğan yoğun bakım ünitesine yatırılma (OR=34,8, 95% CI (4,7-256,3, p<0,001) ve solunum güçlüğü sendromu tanısı alma (OR=11,5, 95% CI (4-33,5, p<0,001) oranları anlamlı oranda yüksekti. Bebeklerin tümünde geçici metabolik bozukluklar anlamlı oranda yüksek saptandı (p=0,045). Bebeklerin doğum kilosu ve gestasyonel yaşı düştüğü oranda fetal ve neonatal mortaliteleri artmaktadır (tümü için p<0,001). Sonuç: Bu çalışma düşük doğum ağırlıklı bebekleri etkileyen en önemli faktörün çoğul gebelik olduğunu gösterdi. Bebeklerin doğum kilosu ve gestasyonel yaşı, perinatal morbidite ve mortalite ile ters orantılı olarak ilişkili idiÖğe Herlyn-Werner-Wunderlich syndrome presented with amenorrhea: A rare urogenital anomaly in females(2019) Ekici, Mustafa Ayhan; Oyardı, Pelin; Dağıstanlı, Funda; Albayrak, Ömür; Çetin, ÇağlarA 13-year-old prepubertal girl had with primary amenorrhea and severe lower abdominal pain. Pelvic ultrasound showed double uterine cavity and a fluid collection in left uterine cavity with diffuse low level internal echoes, which appeared contiguous with the endocervix. Hymen could not be evaluated because the patient could not be taken to the gynecological table the patient was initially diagnosed as imperforate hymen, gynecologic examination was performed with sedation, and hymen has a normal patency. Magnetic resonance imaging (MRI) revealed two uterus and two cervix, normal right endometrial cavity and 17 mm fluid in the left endometrial cavity and compatible with hematometra. Hematocolpos was observed in the left half of the vagina. There was no left kidney and the right kidney was normal. Based on these findings, the patient was diagnosed as Herlyn-WernerWunderlich syndrome and vaginal septum resection was performed as treatment. Evaluation of the genital tract by means of MRI scanning or ultrasonography should be recommended in all girls with known renal abnormalities before the onset of menstruation.Öğe Hiperemezis Gravidarum'da yeme tutum davranışları ve sosyo-demografik özellikler arasındaki ilişkinin değerlendirilmesi(2018) Kurban, Yüksel; Uyar, İbrahim; Aydemir, Önder; Karaoba, Ali; Ekici, Mustafa AyhanHiperemezis Gravidarum tanısı almış gebelerin yeme tutum ve davranışlarının öğrenim durumu ve sosyo-demografik özellikleri arasındaki ilişkinin değerlendirilmesi. Materyal ve Metod: Çalışmaya Mayıs 2015 ve Haziran 2016 tarihleri arasında Keçiören Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniğine Hiperemezis Gravidarum(HG) tanısı ile yatırılan 48 hasta ile normal sağlıklı 42 gebe dahil edildi. HG tanısı klinik ve laboratuvar testleri ile doğrulandı. HG ve Kontrol grubu yaş, beden kitle indeksi (BKİ), yeme tutum testinden (YTT) aldıkları puanlar, öğrenim durumları ve yeme bozukluğu bulunması çısından karşılaştırıldı. Bulgular: HG ve Kontrol Grubu arasında yaş, öğrenim düzeyi, BKİ ve yeme bozukluğu bulunma durumu açısından istatistiksel olarak anlamlı fark saptanmadı (p>0.05). Ancak YTT skoru açısından istatistiksel olarak anlamlı fark saptandı (p=0.039). Buna göre HG hastalarının YTT skoru, kontrol grubundan anlamlı olarak yüksekti. HG olan hasta grubu kendi içerisinde öğrenim durumları ile YTT skoru açısından değerlendirildiğinde istatistiksel olarak anlamlı fark saptandı (p=0.037). Öğrenim durumu düşük olanlarda daha fazla yeme bozukluğu görüldü. Kontrol grubunda BKİ ve yeme bozuluğu açısından istatistiksel fark vardı (p=0.001). Yeme bozukluğu olanların BKİ daha düşüktü. Sonuç: Çalışmamızda HG ile kontrol grubu arasında YTT açısından fark vardı. Yeme tutum testinden alınan yüksek değerler HG'ye yatkınlığı gösterebilir. HG kliniği ile gelen hastalar değerlendirilirken diğer risk faktörlerinin yanında yeme bozukluğu ve eğitim durumu göz önüne alınmalıdır.Öğe Hiperemezis Gravidarumda Yeme Tutum Davranış- ları ve Sosyo-Demografik Özellikler Arasındaki İliş- kinin Değerlendirilmesi(2018) Kurban, Yüksel; Uyar, Ibrahim; Aydemir, Önder; Karaoba, Ali; Ekici, Mustafa Ayhan; Alan, MuratAmaç: Hiperemezis Gravidarum tanısı almış gebelerin yeme tutum ve davranışlarının öğrenim durumu ve sosyo-demografik özellikleri arasındaki ilişkinin değerlendirilmesi.Materyal ve Metod: Çalışmaya Mayıs 2015 ve Haziran 2016 tarihleri arasında Keçiören Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniğine Hiperemezis Gravidarum(HG) tanısı ile yatırılan 48 hasta ile normal sağlıklı 42 gebe dahil edildi. HG tanısı klinik ve laboratuvar testleri ile doğrulandı. HG ve Kontrol grubu yaş, beden kitle indeksi (BKİ), yeme tutum testinden (YTT) aldıkları puanlar, öğrenim durumları ve yeme bozukluğu bulunması çısından karşılaştırıldı. Bulgular: HG ve Kontrol Grubu arasında yaş, öğrenim düzeyi, BKİ ve yeme bozukluğu bulunma durumu açısından istatistiksel olarak anlamlı fark saptanmadı (p>0.05). Ancak YTT skoru açısından istatistiksel olarak anlamlı fark saptandı (p=0.039). Buna göre HG hastalarının YTT skoru, kontrol grubundan anlamlı olarak yüksekti. HG olan hasta grubu kendi içerisinde öğrenim durumları ile YTT skoru açısından değerlendirildiğinde istatistiksel olarak anlamlı fark saptandı (p=0.037). Öğrenim durumu düşük olanlarda daha fazla yeme bozukluğu görüldü. Kontrol grubunda BKİ ve yeme bozuluğu açısından istatistiksel fark vardı (p=0.001). Yeme bozukluğu olanların BKİ daha düşüktü. Sonuç: Çalışmamızda HG ile kontrol grubu arasında YTT açısından fark vardı. Yeme tutum testinden alınan yüksek değerler HG'ye yatkınlığı gösterebilir. HG kliniği ile gelen hastalar değerlendirilirken diğer risk faktörlerinin yanında yeme bozukluğu ve eğitim durumu göz önüne alınmalıdır.Öğe Is it necessary to perform an endometrial sampling prior to hysterectomies for benign conditions?(2019) Hanlıgil, Erhan; Ekici, Mustafa AyhanAim: Hysterectomy is one of the most prevalent surgical intervention in gynecological field. This study concerns the requirement and necessity of an endometrial sampling to exclude an unpredictable uterine malignancy risk before hysterectomy for benign conditions. Methods: This is a retrospective and cross-sectional study involving 307 patients who had hysterectomy for benign conditions between years 2014-2018. Prior to hysterectomy, in 162 cases, an endometrial sampling was performed ahead (biopsy group) and in 145 cases, hysterectomy was performed without obtaining an endometrial sampling earlier on (control group). Pre- and postsurgical pathological evaluation reports were collected and compared between the groups. Results: Features of the patients as mean age, number of previous pregnancies, being at postmenopausal status did not vary significantly between two groups. In the biopsy group, 51.2% of the patients were in the premenopausal period, 40.7% of the patients had postmenopausal bleeding and 52.5% had abnormal uterine bleeding symptoms and these three features were significantly higher than in the control group. In the control group, one case (0.7%) had leiomyosarcoma and another case (0.7%) had endometrial adenocarcinoma. In the biopsy group, endometrial adenocarcinoma was detected in 5 patients (3.1%) as significantly higher than in the control group. Conclusion: If there are no symptoms, clinical and radiological findings suggesting an endometrial malignancy in patients who planned to undergo a hysterectomy for benign conditions, it is unnecessary to perform a routine endometrial biopsy.Öğe Is there a relationship between polycystic ovary syndrome and the FABP1 gene rs2197076 single nucleotide polymorphism?(2019) Karakuz, Arzu Güler; Ekici, Mustafa Ayhan; Topçuoğlu, Mehmet Ata; Düzenli, Selma Gepdiremen; Öztabağ, Cansu KaraAim: Polycystic ovary syndrome (PCOS) is a multifactorial, endocrine, and metabolic disorder seenin 10%-20% of women of reproductive age. Due to the close relationship observed between theincreased risk of type 2 diabetes and insulin resistance and the polymorphism of the fatty acid bindingprotein 1 (FABP1) gene rs2197076 single nucleotide polymorphism (SNP), we investigated thefrequency of the FABP1 gene rs2197076 SNP in patients with PCOS.Methods: This is a prospective case-control study. The study included 151 women—75 patients withPCOS and 76 healthy women. A real-time polymerase chain reaction was performed for the FABP1rs2197076 polymorphism. Additionally, biochemical and hormonal levels of the patients werestudied.Results: Menstrual irregularities, the body mass index (BMI), hirsutism scores, the luteinizinghormone / follicular stimulating hormone ratio, dehydroepiandrosterone sulfate and testosteronelevels were significantly higher in the PCOS group than in the control. There was no significantdifference between the PCOS and control groups in terms of FABP1 rs2197076 genotype distributionand FABP1 rs2197076 allele frequency distribution.Conclusion: There was no increase in the genotype distribution and allelic frequency of the FABP1 geners2197076 SNP in PCOS patients. Further studies are needed on this subject.Öğe Likelihood of incidental finding of gynecological cancer in women undergoing hysterectomy for benign indications(Imr Press, 2020) Ekici, Mustafa Ayhan; Önal, Ali Can; Çetin, ÇağlarObjective: The aim of this study was to determine the incidence of unexpected gynecological malignancy (UGM) after hysterectomy performed for benign indications. Methods: We analysed patient sample data extracted from a medical database between 1 January 2007 and 10 August 2019 for 2740 women who underwent a hysterectomy for benign indications. The Kolmogorov-Smirnov test, KruskalWallis test and Chi-square test were performed. Statistical significance was reached if p < 0.05. Results : The most common primary indications for hysterectomy were leiomyomata (1403, 51%), abnormal uterine bleeding (784, 28.61%), and pelvic organ prolapse (504, 18.39%). A laparotomic, laparoscopic or vaginal hysterectomy was performed in 1452 (53%), 836 (30.5%) and 452 (16.5%) women, respectively. unexpected gynecological malignancy after hysterectomy was diagnosed in 22 (0.80%) women. The incidence of unexpected uterine malignancies (UUM), unexpected endometrial cancer, and unexpected uterine malignancies without endometrial cancer was 0.54%, 0.40% and 0.14% respectively. Mean ages were not significantly different for abdominal, laparoscopic and vaginal hysterectomy groups (51.75 +/- 9.83, 51.32 +/- 9.51, 51.39 +/- 10.04 years respectively, p = 0.299). No significant difference in the incidence of unexpected gynecological malignancy was noted between the groups [laparotomy 0.47%, laparoscopy 0.22%, vaginal 0.11%, p = 0.066]. The incidence of unexpected leiomyosarcoma [laparatomic 0.11%, laparascopic 0.03%, vaginal 0.0%] and unexpected endometrial carcinoma [laparatomic 0.26%, laparascopic 0.11%, vaginal 0.03%] was significantly higher in abdominal and laparascopic hysterectomy groups than the vaginal hysterectomy group and no significant difference was observed between the abdominal and laparoscopic hysterectomy groups (p = 0.037, p = 0.028, p = 0.108, respectively). Conclusion: The incidence of unexpected gynecological malignancy diagnosed after hysterectomy performed for benign conditions was very low, if the correct indications were selected.Öğe Platelet distribution width and neutrophil-lymphocyte ratio in progression to preeclampsia and severe preeclampsia(Carbone Editore, 2019) Ekici, Mustafa Ayhan; Ural, Ülkü MeteBackground and aim: Preeclampsia is a multisystemic, hypertensive disorder without a well-known etiology, affecting 3-9% of pregnancies. The aim of this study is to demonstrate the roles of hematological markers at prediction of PE by a comparison between their levels prior and following the disorder and at determine the usefulness of them at deciding the severity of PE. Material and methods: This research is a retrospective and cross-sectional study performed between January 2012 and March 2018. SPSS (Statistical Package for Social Sciences) version 15.0 (SPSS Inc., USA) is used for statistical analysis.. Kolmogorov-Smirnov, Anova, Kruskal-Wallis, Paired Samples and Wilcoxon tests are used for interpreting data. Test results are assesed within 95% confidence interval and statistical significance is considered if p<0.05. Results: Two hundred and sixty nine pregnant women were recruited into our study. 115 women delivered with severe preeclampsia (SPE), 105 with mild preeclampsia (MPE) and 49 with gestational hypertension (GHT). After the progression to severe preeclampsia, MPV, RDW and PDW were found higher (p=0.005, p=0.0002, p=0.032). RDW is significantly elevated after diagnosis of MPE (p=0.006). After the diagnosis of SPE, MPE and GHT, MPV was higher in SPE subgroup with respect to MPE and GHT subgroups (respectively p=0.043, p=0.014). PDW and NLR were significantly lower in gestational hypertension patients which were evolving to preeclampsia (p=0.015, p=0.010). Conclusion: Lower PDW and NLR levels were found to be related with developing preeclampsia in GHT patients. As preeclamp-sia becomes severe, MPV levels increase and platelet counts decrease.Öğe Plateletcrit Could Be A Marker of Inflammation in Cesarean Section(2019) Karagöz, Ibrahim; Ekici, Mustafa AyhanObjective: We aimed to compare preoperative andpostoperative values of novel inflammatory markers ofhemogram; especially neutrophil to lymphocyte ratio (NLR),mean platelet volume (MPV), red cell distribution width(RDW), MPV to platelet ratio (MPR), RDW to platelet ratio(RPR) and plateletcrit (PCT) in pregnant women undergonecesarean section by either general or spinal anesthesia.Material-Method: Patients who had elective caesarean sectionin our institution that had no contraindications for general andregional anesthesia, with a single fetus pregnancy, 18-40 yearsold women were included in the study. The subjects wererandomly divided into two groups. Group I (n=30) patientsunderwent general anesthesia and Group II (n=30) patientsunderwent spinal anesthesia. Preoperative and postoperativehemogram parameters were compared.Results: Postoperative PCT values of spinal and generalanesthesia groups were 0.16 (0.05)% and 0.19 (0.07)%,respectively. The difference in postoperative PCT wasstatistically significant (p=0.03).Conclusions: We suggest that PCT could be used as amarker of inflammation after cesarean section surgery. If notcontraindicated, spinal anesthesia should be preferred forthose pregnant women in cesarean delivery.Öğe Psikolojik yıldırma (mobing) ve çalışan motivasyonu arasındaki ilişkinin incelenmesi(2019) Uysal, Burhanettin; Ekici, Mustafa Ayhan; Önal, Ali Can; Kulakoğlu, EmelBu çalışma, sağlık çalışanları üzerinde psikolojik yıldırma (mobing) ile çalışan motivasyonu arasındaki ilişkiyi ortaya koymak amacıyla kamu sektöründe faaliyet gösteren bir işbirliği yapılan (afiliye) hastanede gerçekleştirilen kesitsel bir alan araştırmasıdır. Araştırmanın evrenini 1076 çalışan oluşturmuş olup araştırma 222 hastane çalışanı üzerinde uygulanmıştır. Araştırmadan elde edilen veriler SPSS 22.0 programı ile analiz edilerek yorumlanmıştır. Katılımcıların büyük çoğunluğu 45 yaşının altında ve kadındır. Çalışmanın sonucuna göre hastanedeki sağlık hizmetlerinin kadın ağırlıklı sağlık meslek mensupları tarafından verildiğini göstermektedir. Aynı zamanda katılımcıların yaklaşık 1/3’ü bekârdır. Araştırmaya katılan çalışanların %90,1’inin daha önce yöneticilik deneyimi yoktur. Eğitim durumuna bakıldığında en yüksek oranı lisans grubu oluşturmaktadır. Katılımcıların yaklaşık 1/3’ünü hemşire/ebeler oluşturmaktadır. Katılımcıların yarısına yakını gündüz; büyük çoğunluğu 40 saat üstü çalışmakta; büyük çoğunluğu 10 yılın altında görev yapmaktadır. Katılımcıların 2/3’ünün kadrosu Sağlık Bakanlığına bağlıdır. Korelasyon analizi sonucunda psikolojik yıldırma ile motivasyon araçları arasında istatistiksel olarak anlamlı bir ilişki bulunmamıştır (p>0,05). Regresyon analizine göre psikolojik yıldırma motivasyon araçlarını etkilemektedir ((F=3,954, R²=0,018; F=9,351, R²=0,041).Öğe The role of performing a routine four-quadrant cervical biopsy in patients with negative colposcopic findings in increasing the identification rate of cervical intraepithelial neoplasms(2019) Çetin, Çağlar; Serindağ, Sevinç Rabia; Topçuoğlu, Mehmet Ata; Ekici, Mustafa AyhanAim: In patients with high-risk human papilloma virus (HPV), there is no consensus on the inclusion of cervical biopsy for diagnostic purposes in cases whereas there is no pathological finding in colposcopy. In this study, we aimed to investigate the effect of simultaneous routine cervical biopsy in patients with normal colposcopic findings on the rate of cervical intraepithelial neoplasia diagnosis. Methods: This retrospective study included 119 patients with colposcopy indications who had no cervical pathology between January 2015 and March 2017 and the histopathological results were evaluated. Results: The mean age of the population was 45.75±9.52 years. The histopathological results obtained in our study patients are as follows; 38.7% (n=46) LSIL, 28.7% (n=33) chronic cervicitis, 15, 3 % (n=19) coilositosis, 9.2% (n=11) HSIL, 2.5% (n=5) adenocarcinoma, 1.7% (n=2) carcinoma in situ and 2.1% (n=3) squamous carcinoma. LSIL 33 (27.5%), HSIL and advanced lesion 11 (9.2%) were detected in patients with normal cervical cytology before colposcopy. LSIL 26 (21.7%), HSIL and advanced lesion were found to be 13 (10.8%) in patients with abnormal cervical cytology. There was no significant difference in terms of biopsy pathology results between normal and abnormal cervical cytology results. Conclusions: In patients with HPV positive and normal colposcopic findings, adding simultaneous routine four-quadrant cervical biopsy to the colposcopy might increase the detection rate of cervical intraepithelial lesions.Öğe Sonographic evaluation of pulmonary interstitial edema in patient with preeclampsia(Lippincott Williams & Wilkins, 2021) Gökkuş, Halil; Coşgun, Zeliha; Coşgun, Mehmet; Ekici, Mustafa Ayhan; Kalaycıoğlu, OyaThe aim of this study was to sonographically detect pulmonary edema, which is a major problem in pregnant women with preeclampsia, in the interstitial phase. We evaluated 41 preeclampsia patients and 21 control subjects prospectively. In the preeclampsia group, 26 patients had severe features, whereas the other 15 patients had none. To detect early fluid loading in lungs, sonographic B lines were counted from the intercostal space by using ultrasonography, and left ventricular loading findings were examined for corporation by using transthoracic echocardiography both before and after birth. In severe preeclampsia, the number of B lines before and after birth is statistically significant compared with the other groups. In addition, the total number of B lines calculated at 24 hours after delivery was significantly lower than that calculated before delivery (P < 0.018). In terms of prenatal E values, a statistically significant difference was found between all groups (P < 0.001). A strong positive and statistically significant relationship was found between B lines and prenatal E/e ' (r = 0.768; P < 0.001). The overall accuracy rate of the prenatal E/e ' and E value for estimation of the B line number classification is 0.791 (95% confidence interval, 0.674-0.908; P < 0.001) and 0.829 (95% confidence interval, 0.722-0.936; P < 0.001), respectively. Pulmonary edema is a serious complication in patients with severe preeclampsia and may be detected interstitially in some patients, even if it does not occur clinically.Öğe THROMBOCYTE INDICES RELATION WITH GESTATIONAL HYPERTENSIVE DISORDERS.(2020) Ekici, Mustafa Ayhan; Kayhan, MehmetThe aim of this study to evaluate relationship between thrombocyte indices, Red cell distribution width (RDW) and gestational hypertensive disorders.This study is a retrospective cross sectional study performed between 2009 - 2019.Total 583 pregnant women were included in this study; 123 severe preeclampsia (PE), 175 mild-PE, 73 gestational hypertension (GH), 41 chronic hypertension and 171 healthy pregnant women (control group). Statistical Package for Social Science version 23.0 is used for statistical analysis. Kolmogorov-Smirnov, Anova, Kruskal-Wallis and Mann Whitney U tests are used for interpretation of data. Statistical significance is considered if p < 0.05. Mean age and number of pregancies were indifferent among five groups. Mean Platelet Volume (MPV) was significantly higher in severe-PE group (p<0.001) and insignificantly different among mild-PE, GH, chronic hypertension and control groups (p=0.116) . Platelet count (PC) was found significantly lower in severe-PE group (p=0.01) and found indifferent among mildPE, GH, chronic hypertension and control groups (p=0.110). RDW was found significantly higher in severe-PE group than other groups (p=0.01)and significantly higher in mild-PE group than GH, chronic hypertension and control groups (p=0.01) but insignificantly different among GH, chronic hypertension and control groups (p=0.501). Platelet distribution width (PDW) was found significantly lower in control group than other groups (p<0.001) and found indifferent among mild-PE, GH, chronic hypertension and severe-PE groups (p=0.621). Neutrophil lymphocyte ratio (NLR), hemoglobin, Plateletcrit and Platelet lymphocyte ratio (PLR) were found unchanged among the groups. MPV, RDW, PDW, NLR, PC, Plateletcrit and PLR were indifferent among GH and chronic hypertension groups. MPV and RDW were found higher and PC was found lower in severe-PE. RDW levels elevation was found higher in accordance with the severity of preeclampsia.PDW was found higher in gestational hypertensive disorders than healthy pregnant women.Öğe Transvaginal round-infundibulopelvic ligament colposuspension after vaginal hysterectomy in high-grade uterovaginal prolapse: 11-year outcome(Elsevier, 2020) Ekici, Mustafa Ayhan; Çetin, Çaglar; Kayar, Batuhan; Albayrak, Ömür; Topçuoğlu, Mehmet Ata; Ural, Ülkü MeteObjective: To interpret the long-term outcomes of transvaginal round-infundibulopelvic ligament colposuspension after vaginal hysterectomy in patients with stage 3-4 uterovaginal prolapse. Study design: This retrospective case-control study from 2007 to 2016 analysed patients' medical records and evaluated gynaecological examinations over 11 years of follow-up. One hundred and forty-three patients who underwent transvaginal round-infundibulopelvic ligament colposuspension after vaginal hysterectomy were evaluated. The prespecified primary outcome evaluated at 11-year follow-up was apical prolapse of stage 2 or higher evaluated by the Pelvic Organ Prolapse Quantification System (POP Q), in combination with bothersome bulge symptoms or repeat surgery for recurrent apical prolapse. The secondary outcome was overall anatomical failure (recurrent prolapse of stage 2 or higher in apical, anterior or posterior compartment). The rate of recurrence of apical prolapse was compared between groups using the McNemar test. Results: The mean (+/- standard deviation) follow-up period was 88.15 +/- 2.519 months (95 % confidence interval 83.17-93.13). The pre-operative diagnoses were stage 3 uterovaginal prolapse in 23 (16.08 %) patients, stage 4 uterovaginal prolapse in 120 (83.91 %) patients, rectocele in 119 (83.21 %) patients, cystocele in 138 (96.50 %) patients and stress urinary incontinence in 53 (37.06 %) patients. Ten (8.33 %) patients with stage 4 uterovaginal prolapse developed postoperative apical prolapse, whereas none of the patients with stage 3 uterovaginal prolapse developed postoperative apical prolapse. Postoperatively, the POP-Q stages of apical prolapse were significantly lower compared with pre-operatively (p < 0.001). Postoperatively, the apical prolapse rate was 7.0 %, the recurrent cystocele rate was 2.07 %, the recurrent rectocele rate was 5.5 %, and the recurrent stress urinary incontinence rate was 18.87 %. Overall, postoperative anatomical failure occurred in 21 of 143 (14.68 %) women. One (0.69 %) patient developed perioperative bladder perforation, two (1.39 %) patients experienced voiding difficulty, and eight (5.59 %) patients experienced vaginal spotting. Conclusion: Transvaginal round-infundibulopelvic ligament colposuspension during vaginal hysterectomy is an effective and useful method that reduces the rate of postoperative apical prolapse in patients with high-grade uterovaginal prolapse. (C) 2020 Elsevier B.V. All rights reserved.Öğe Unexpected risk of gynecological malignant and premalignant disease in women undergoing hysterectomy for pelvic organ prolapse(2020) Ekici, Mustafa Ayhan; Önal, Ali CanAim: To investigate the incidence of unexpected malignant and premalignant gynecological pathological findings among women who underwent hysterectomy due to pelvic organ prolapse (POP). Methods: In this retrospective study, the medical reports of women who underwent hysterectomy for POP between 2007 and 2019 were investigated to reveal unexpected malignant and premalignant lesions. The possible relationship between pathological results and other variables was evaluated statistically. Results: The hysterectomy was performed by abdominal (160, 30.53%), laparoscopic (62%, 11.83%) and vaginal approaches (302, 57.63%) in 524 patients with POP indication. Thirty five patients (6.67%) had unexpected premalignant or malignant pathological findings found on hysterectomy specimens. Simple hyperplasia was found in 18 patients (3.44%), complex hyperplasia in two patients (0.38%); CIN-1 (LSIL) low grade cervical intraepithelial dysplasia in nine patients (1.7%), CIN-II, moderate dysplasia in two patients (0.38%); CIN-III, severe dysplasia in one patient (0.19%); vaginal carcinoma in two patients (0.38%) and endometrial carcinoma in one patient (0.19%). In the vaginal hysterectomy group, the incidence of unsuspected gynecological malignancy was founded at the rate of 0.57% (3/524) and the percentage of the group was significantly higher than laparotomic and laparoscopic hysterectomy groups. Statistically significant difference was not found between the groups with respect to unexpected uterine malignancy. Conclusion: Women without abnormal vaginal bleeding do not have high risk of premalignant or malignant pathological reporting after uterovaginal prolapse surgery, however it should not be neglected.Öğe Urinary incontinence in female university students(Springer London Ltd, 2021) Ural, Ülkü Mete; Gücük, Sebahat; Ekici, Mustafa Ayhan; Topçuoğlu, AtaIntroduction and hypothesis We aimed to determine the prevalence of urinary incontinence (UI) in nulliparous female university students and to provide an overview of risk factors associated with urinary continence. Methods A total of 1,397 female university students aged 18-28 years were enrolled into this cross-sectional questionnaire study. The self-administered questionnaires, the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Overactive Bladder V8 (OAB-V8), demographics, and general characteristics were recorded. The frequency, type, and severity of urinary incontinence and related factors were evaluated. Results The mean age of the students was 20.27 +/- 1.69 years. The prevalence of UI in female university students was 18.4% (n = 258). ICIQ-SF total score was 0.85 +/- 2.11 (0-14). OAB-V8 total score was 5.97 +/- 5.35 (0-40) and 27.0% of participants had scores of >= 8. Elevated BMI, childhood enuresis, constipation, exercising, positive family history for UI, accommodation in a dormitory, and holding urine at school are risk factors associated with UI in female university students. Conclusion We demonstrated that UI is a common condition among female university students. The identification of the associated risk factors will help to further raise the knowledge and awareness of the problem, and preventive strategies may be proposed to young women to improve the quality of life and psychological well-being.
