Gülsüm Uysal

Successful medical treatment of cesarean scar ectopic pregnancies with systemic multidose methotrexate: Single‐center experience

The aim of this study was to investigate the efficacy, and the safety of systemic multidose methotrexate (MTX) for the treatment of cesarean scar pregnancy (CSP).

Gestational diabetes mellitus is as innocent as you think

Gestational diabetes mellitus (GDM) is a common multisystemic disease affecting 6-7% pregnancies in western countries. GDM is a type of carbohydrate intolerance with onset or first diagnosed during pregnancy depending on the diagnostic criteria used. Pregestational diabetes (diabetes mellitus type 1 and 2) is also one of the common chronic metabolic disorders resulting with four times relative risk for fetal death and higher risks of complications such as hypertension, preeclampsia, genital trauma and cesarean delivery. Type 1 diabetes mellitus (DM) is a kind of pancreas β cell destruction while type 2 DM is characterized as insufficient insulin release leading insulin resistance. The antenatal follow-up in diabetic pregnant women is important to control blood glucose levels, treat chronic complications and to monitor the fetus. In addition to routine pregnancy antenatal follow up, glucose impairment is the most focused issue to manage and identify the complications of pregnancy in GDM patients.

Level of anxiety, depression, self-esteem and quality of life among the women with vaginitis

Background: Present aim is to evaluate anxiety, depression, quality of life and self-esteem in patients with vaginitis (not only specific to candidasis) and also to determine factors affecting vaginitis such as demographic, cultural and psychological causes. Methods: Each patient completed a self-administered questionnaire (Rosenberg’ Self-Esteem Scale, Short-Form 36, Quality of Life Scale, Beck Anxiety Inventory, and Beck Depression Inventory, Body Image Scale) and underwent a careful examination of the vulva and vagina. The cross-sectional study was carried out with two groups. The first group consisted of 107 women between the ages 18 and 45 years and had no physical disease but reccurrent vulvovaginitis (≥4 in a year). The comparison control group consisted of 94 healthy (no vaginitis symptoms in 12 months) age matched volunteer participants. Results: Women with vaginitis had significantly higher anxiety and depression scores. There was no statistically significant difference in body image scale. Regarding type of marriage, arranged type was statistically significantly higher in vaginitis group while flirting type was statistically higher in control group. University school degree and income was statistically significantly lower in vaginitis group. Living residence as rent and vaginal douch was statistically significantly higher in vaginitis group. Conclusions: A better detailed history should be taken into consideration for personal stress sources and treatment support should be provided for patients with vaginitis. Not only gynecologists but also a multidisciplinary team should take part in the treatment and follow up of the patients to cope with recurrency even in non-specific vaginitis.

Chorea Gravidarum Associated with Poor Perinatal Outcomes: Report of Two Cases

Chorea Gravidarum (CG) is a rare syndrome which usually presents in the first trimester of pregnancy with bilateral repetitive, brief, jerky, dance-like, involuntary movements and slurred speech. CG is a self-limiting condition which is probably caused by estrogen which enhances receptor sensitivity to dopamine. Prognosis of CG for pregnant women and fetuses are believed to be good. In this report, we present two cases of CG secondary to rheumatic fever that were associated with adverse fetal outcomes. Both cases had elevated antistreptolysin O titer and mitral valve disease. In both cases, pregnancy was associated with hypertension. In one case, the previous pregnancy was also complicated with CG and fetal demise. Contrary to widespread belief, CG may be associated with adverse fetal outcome.

ENDOMETRİAL KANSER SAPTANAN OLGULARDA OPERASYON SONUÇLARININ VE BAZI PROGNOSTİK FAKTÖRLERİN DEĞERLENDİRİLMESİ

Purpose: Endometrial cancer is the fourth leading cancer among women in the world and consists of nearly half of all gyneco logical cancers. Our aim was to report surgical results and prognosis of endometrial cancer diagnosed in our clinic.Methods: Fourty two endometrial cancer patients diagnosed and treated surgically between 2010 and 2013 were analyzed retrospectively. Clinical and surgical data of the patients, histopathological and prognostic parameters related to outcomes were evaluated. The patients undergone type 3 hysterectomy or the patients who couldn’t be differentially diagnosed from cervical cancer were excluded.Results: According to the American Joint Committee on Cancer classification, 29 patients (69%) were found to have in stage 1, 5 patients in stage 2 (12%), 4 patients in stage 3 (9%) and 4 patients (10%) in stage 4 respectively. Approximately half of the patients (n = 14) (48.2%) in stage 1 had endometrially limited tumor with myometrial invasion of <1/2, or grade 1 tumor and all were undergone TAH+BSO. The rest of patients in stage 1 were additionally undergone pelvic para-aortic lymph node dissection (PPLND), omentec tomy and appendectomy. Mean number of removed lymph nodes 41.14. Stromal lymphovascular invasion (LVS) were found in 14 patients (33.3%). Wound infec tion and evisceration was developed in one patient. Three wound infection, one atelectasis, one ureter injury and one pulmonary embolism were developed in patients with PPLND. Age of patients in the earlier stages was lower. The age distribution of patients was found to increase with increase in the stage of the tumor.Conclusion: Endometrial cancers can be diagnosed in earlier stages Due to early clinic symptoms compared to other gynecological cancers. Al though the treatment modalities can change in accordance with stage of tumor and patients’ health status, surgery appears as the standard treatment modality