Comparison of Depression and Anxiety Scores in Multi/Nulliparous Women who have Undergone Dilatation and Curettage.

AIM: To demonstrate the duration of negative psychological effects of elective curettage on both nulliparous and multiparous women and to determine the association between parity and post-abortion depression and anxiety. MATERIALS AND METHODS: A total of 168 women who applied to our reproductive health clinic for elective abortion were included in this prospective study. 84 nulliparous and 84 multiparous women were asked to fill out Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory (BAI-II) forms by a psychiatrist at their pre-abortion consultation and at 3 months follow-up. A thorough anamnesis with demographic data of each patient was recorded at initial consultation. RESULTS: Depression and anxiety measurements in both groups significantly decreased at the end of the 3 months follow-up. The mean depression value in nullipara group decreased from 24.2 ± 5.8 to 9.4 ± 3.3 and anxiety from 23.5 ± 3.7 to 8.8 ± 2.5. In the multipara group, the mean depression score decreased from 15.7 ± 4.0 to 7.3 ± 2.3, and anxiety from 15.9 ± 4.0 to 7.9 ± 2.3. A significant decrease in both depression and anxiety scores could be observed in both groups. CONCLUSION: Although the severity of depression and anxiety varies between multiparous and nulliparous individuals, this study showed that both depression and anxiety scores return to normal values by the end a 3 months follow-up period.

Evaluation of Oxidative Stress in Ectopic Pregnancies.

PURPOSE: The aim of the study is to show the relationship between oxidative stress and ectopic pregnancy. MATERIALS AND METHODS: A total of 62 patients, 31 in the ectopic pregnancy group (study group) and 31 in the first-trimester pregnancy (control group) were included in the study. Patients between 18-45 years of age who had tubal ectopic pregnancy diagnosed by transvaginal ultrasonography and serum ß-HCG values were included in the study group. Serum thiol- disulfide hemostasis were measured from venous blood. RESULTS: Between the control group and the ectopic pregnant group; there was no statistically significant difference in terms of age, total thiol, albumin, disulfide, index 1 (disulfide / total thiol), index 2 (disulfide / native thiol), and index 3 levels (p> 0.05). The area under the ROC curve for native thiol measurements was statistically significant in distinguishing the control group and the ectopic pregnant group [AUC = 0.657, 95% CI: 0.521-0.793, p = 0.034] Conclusion: This study shows that ectopic pregnancies may be associated with the presence of high oxidative stress. Especially in early stage suspected patients, demonstrating the presence of oxidative stress together with serial ß-HCG follow-up may be helpful in diagnosis.

Effectiveness of the world's first 1-Day online hands-on laparoscopic suturing training during COVID-19 pandemic.

We aimed to investigate the effectiveness of an online laparoscopic suturing training course conducted via an online meeting program. The mean needle loading, stitching, and knot-tying times were 77.3 s, 63.0 s, and 140.3 s, respectively on the initial test. Total laparoscopic suture time before the course was 273.8 s. After the course, time measures across all parameters decreased significantly (p < .001). The mean needle loading, suture passing, and knot tying times were 25.0 s, 31.0 s, and 34.6 s on the final test. The total intracorporeal suture time after the course was 90.0 s. The Objective and Structured Assessment of Technical Skills Scores significantly increased from 16.8 at the initial test to 25.4 at the final test (p < .001).IMPACT STATEMENTWhat is already known on this subject? Training models like box trainers and virtual reality simulators have frequently been shown to significantly improve laparoscopic skills.What the results of this study add? A 1-day online laparoscopic suturing course significantly reduces the intracorporeal suturing time.What the implications are of these findings for clinical practice and/or further research? Basis the results, online laparoscopic suturing training might become the new norm for training over conventional training given the benefits of cost and time savings.

Effect of analgesia with pethidine during labour on false positivity of newborn hearing screening test.

OBJECTIVES: Newborn hearing screening may fail due to some perinatal and neonatal factors. False positivity of newborn hearing screening increases costs, familial concerns and anxiety. The objective of this study was to determine the effects of pethidine administered in the mother for labor analgesia on the false positivity rates of the newborn hearing screening test. METHODS: This study was designed as a retrospective and cross-sectional study. A total of 75 pregnant women scheduled for vaginal delivery who received 50 mg intramuscular pethidine at the beginning of the active phase of the labor were included as the patient group and 68 pregnant women who did not receive pethidine as the control group. A total of 143 infants born with vaginal delivery were evaluated with otoacoustic emission (OAE) test before discharge. Perinatal and neonatal variables and test outcomes were recorded, and the correlation between false positivity rate and pethidine usage was evaluated. RESULTS: Initially, system records of 148 healthy term newborns were screened. Four patients who failed in both OAE tests and were referred to the Automated Auditory Brainstem Response (AABR) test and one patient who failed in all tests (first OAE, control OAE and AABR) and was referred to an upper center for further investigations and treatment were excluded from the study. No statistically significant difference was found between the groups in terms of birth features. First stage OAE test was reported as 'passed' in 8 (10.7%) and 58 (85.3%) newborns in the study and control groups, respectively; while OAE was reported as 'referred' and 'passed' in the second test in 67 (89.3%) and 10 (14.7%) newborns in the study and control groups, respectively. There was a statistically significant difference between both groups in terms of false positivity ratio (p < 0.5). CONCLUSION: Pethidine significantly decreases the duration of the active phase, providing a good analgesic effect for pain management during labor. Therefore, it seems that pethidine can be used as an acceptable agent during labor. However, it may have neonatal effects after the delivery, causing false positivity in newborn hearing screening tests. The results of this study support the opinion that the OAE test should be performed in postpartum later dates in order to increase OAE passing rates and minimize costs and parents' concerns.

The effect of dydrogesterone on sexual function in endometriosis.

Endometriosis is an oestrogen-dependent chronic disease, which is commonly regarded as a disease of reproductive-aged women. We aimed to evaluate the sexual function with Female Sexual Function Index (FSFI) in women with endometriosis who received dydrogesterone for 6 months. A total of 79 women with endometriomas were recruited in the study group and received 10 mg dydrogesterone tablets orally for 6 months. FSFI and visual analog scale (VAS) scores for each patient before and after treatment were recorded. When before treatment VAS scores and after treatment VAS scores (5.7 ± 1.27, 3.97 ± 1.01, respectively) were compared, a significant decrease was observed (p = .001). A significant increase in mean orgasm scores (3.23 ± 0.6 vs. 3.57 ± 0.65, p = .01) and means satisfaction scores (3.85 ± 0.48 vs. 4.10 ± 0.38, p < .001) were observed. In addition, means desire scores were also significantly higher following treatment (p = .01). In conclusion, this study showed that FSFI scores were increased after 6 months of dydrogesterone treatment in patients with endometriosis. Desire, satisfaction, orgasm and pain scores improved significantly, and sexual dysfunction decreased after treatment.Impact statementWhat is already known on this subject? Endometriosis is a chronic inflammatory disease associated with severe dysmenorrhoea, pelvic pain, dyspareunia, painful gastrointestinal symptoms and sub-fertility are among the symptoms. These symptoms can be responsible for a significant decrease in the quality of life scores of the patients. Dydrogesterone is a synthetic progesterone derivative, which suppresses oestrogen levels and ovulation. Dydrogesterone's effect on pain relief in endometriosis patients has already been shown, but it's role on the sexual dysfunction observed in women with endometriosis has not yet been questioned.What do the results of this study add? To the best of our knowledge this is the first study showing the effects of dydrogesterone on sexual function in patients with endometriosis.What are the implications of these findings for clinical practice and/or further research? Dydrogesterone can safely be used in medical treatment of endometriosis not only for pain relief but also patients with additional complaints such as sexual dysfunction can benefit from this treatment. Future studies with larger cohorts and long-term follow-ups are needed to validate our results.

Transition from pandemic to infodemic: an analysis of Turkishlanguage COVID-19 YouTube videos.

BACKGROUND: YouTube can be a powerful educational tool for the dissemination of health information. However, if uploaded health-related videos are inaccurate, it can mislead, create confusion and generate panic. AIMS: This study aimed to determine the success of the most-watched Turkish-language COVID-19 YouTube videos regarding information and guidance on the disease for the public. The secondary aim of this study was to evaluate the accuracy and quality of such video content. METHODS: The study was conducted during May 2020 and analysed 133 videos. The length of the videos, the number of likes and dislikes, comments and views, how long they have been on YouTube, Medical Information and Content Index (MICI) Score, mDISCERN scores, global quality scores, and the source and target audiences of the videos were all determined. RESULTS: The average MICI Scores of videos was 2.48±3.74 and the global quality scores was 1.27±0.64. When MICI Scores were compared between video sources, the scores of academic hospitals and government videos were significantly higher. The global quality scores of videos from news agencies and independent users was significantly lower ( < 0.001). The mDISCERN score of the videos uploaded by news agencies and categorized as useful was higher than the others (P < 0.001). Among the targeted videos, only the global quality scores of the videos made for health-care workers were found to be significantly higher. CONCLUSION: Health-care professionals should upload more videos to improve the quality of health-related video content available on YouTube. Accompanied by evidence-based information, the issues of diagnosis, ways of transmission, prevention and treatment of diseases should be emphasized.

Ovarian reserve in patients with ankylosing spondylitis.

PURPOSE: The aim of this study was to determine the autoimmune effects of ankylosing spondylitis (AS) on the fertility potential of women by evaluating ovarian reserves of AS patients. METHODS: A total of 104 patients, 52 in the AS group (study group) and 52 in the control group were included in the study. Ovarian reserve was evaluated by serum anti-Müllerian hormone (AMH) levels, antral follicle count (AFC) and baseline serum follicle-stimulating hormone (FSH) levels. RESULTS: The mean serum AMH levels were significantly lower in the study group when compared to the controls (2.203 ± 1.110 vs. 1.188 ± 0.891, p < 0.001). In addition, the mean AFC was also significantly lower in the study group. (10.67 ± 1.81 vs. 9.54 ± 2.50, p = 0.009). Mean FSH levels were calculated to be 6.72 ± 1.14 in the study group and 7.21 ± 1.22 in the control group. The difference was not statistically significant (p = 0.781). CONCLUSION: This study shows that AS like several other autoimmune conditions has an adverse effect on the female fertility potential. Therefore, an early start and long-term management of AS patients who have fertility desire is recommended. Serum AMH levels can be used in monitoring ovarian reserve and in early detection of reproductive decline of AS patients. CLINICALTRIAL NUMBER: NCT04209881.

Healthcare information on YouTube: Pregnancy and COVID-19.

OBJECTIVE: We aimed to analyze Turkish language videos on YouTube about Coronavirus and pregnancy. METHODS: YouTube was searched for the following keywords: "Coronavirus, gebelik," "Coronavirus, Hamilelik," "COVID-19, gebelik" and "COVID-19, hamilelik". All ranking data for each video was recorded, video sources and target audiences were analyzed. Videos were designated as "informative, "misleading" "personal experience" and "news update." The usefulness of the videos were analyzed by DISCERN score and the quality of the content was calculated by MICI score. RESULTS: Seventy-six videos had a total of 1.494.860 views, with 40.849 likes and 575 dislikes. The source of information in informative videos was physicians (73%), and news agencies (20%), and the majority of these targeted patients. The DISCERN score of videos was 2.9 ± 1, 1.6 ± 0.9, and 1.9 ± 0.9 respectively for respectively for the informative group, personal experience group, and news update group. The mean MICI score for informative videos was low and calculated as 5.3 ± 2.8. CONCLUSION: YouTube videos are easily accessible sources of COVID-19 information for pregnant women. The present study demonstrated that videos about pregnancy and COVID-19 have high view rates, but are generally low in quality and trustworthiness.

Is Vaginal Hysterectomy Safe for an Enlarged Uterus?

Objective The purpose of this study was to compare the surgical outcomes between two sets of women undergoing vaginal hysterectomy (VH) for benign gynecological conditions: those with moderately enlarged ( ≥12 weeks') uteruses and those with normal-sized uteruses. Materials and Methods The medical records of 84 women who underwent vaginal hysterectomies for benign gynecological conditions at Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey between 2013 and 2015 were reviewed. Age, uterine sizes, indications, duration of hospitalization, operation time, hematocrit (HCT) levels, and complications were analyzed. Results The most common indications for VH were uterine descensus. However, most women had presented with more than one indication. The mean age of the patients who underwent VH was 56.12. The maximum volume of the uterus was found to be 1244.74 ml, and the smallest volume was found to be 18.83 ml. The mean volume of the uterus was found as 122.6629 ml. The mean duration of operation was 159.70 minutes, whereas the mean duration of hospital stay was 3.79 days. The mean preoperative HCT and hemoglobin (Hgb) values were 37.098 (±3.64) gr/dl and 12.365 (±1.35) gr/dl respectively. Postoperative HCT and Hgb values were 31.363 (±3.94) gr/dl and 10.52 (±1.38) respectively. Conclusion VH is usually a simple procedure with low morbidity. It is important to choose the appropriate patient when deciding on the operation. In addition, having experienced surgeons in the field of VH increases the success of surgery.

Comparison of hepatitis B, hepatitis C, and HIV seropositivity of Syrian and Turkish pregnant women.

OBJECTIVE: In this study, we aimed to compare the seroprevalence of hepatitis B (HBV), hepatitis C (HCV), and human immunodeficieney viruse (HIV) in Syrian pregnant women and Turkish pregnant women in our hospital. MATERIALS AND METHODS: In our study, a total of 68,169 Turkish pregnant women who received HB surface antigen (HBsAg), HB surface antibody (anti-HBs), HCV antibody (anti-HCV), anti-HIV test, and a total of 11,015 Syrian pregnant patients who received HBsAg, anti-HBs, anti-HCV and anti-HIV tests were examined retrospectively between January 2012 and January-2018 in Universty of Health Sciences Kanuni Sultan Süleyman Training and Research Hospital, Obstetrics and Gynecology Clinic. RESULTS: In our study, the rates of HBsAg, anti-HCV, and anti-HIV seropositivity were 1.1%, 0.1%, and 0.03% in Syrian pregnant women between 2012 and 2018, respectively. In the other study group, in Turkish pregnant women, HBsAg, anti-HCV, and anti-HIV seropositivity rates for 2012 and 2018 were found as 1.8%, 0.2%, and 0.08%, respectively. CONCLUSION: Although there were no significant differences between the HBsAg, anti-HCV, and anti-HIV results of both groups, the anti-HBs positivity was higher at a significant level in Turkish pregnant women. The reason of the significantly higher anti-HBs positivity levels in pregnant women might stem from the fact that women are vaccinated and controlled regularly due to the policies in this regard in our country.