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Öğe CURRENT CHALLENGES OF THE GYNECOLOGY ASSISTANTS IN TURKEY(Galenos Yayincilik, 2013) Kafadar, Yusuf Taner; Gode, Funda; Demir, Cansun; Baloglu, AliObjective: To assess the working conditions and current challenges of the gynecology assistants in Turkey and to propose solutions within this context. Materials and methods: A survey on the problems of assistant doctors and the solution proposals they offered was executed with gynecology assistants who serve at the teaching, research and university hospitals in different regions of Turkey. Results: 60 gynecology assistants from 7 training institutions (university and teaching research hospitals) were included in the study. 75% of the participants (n:45) prefered gynecology as their first choice in the medical specialty exam. 51% of the survey participants(n:31) were satisfied with their existing conditions. The main problem was determined as severe working conditions by 43% of the participants. (n:26) Based on the answers of 42% of the participants(n:25), malpractice was observed as the leading concern following the specialty. Furthermore, setting rules on duty hours and daily leave after duty as well as arranging working hours were the common opinion of assistant doctors with regard to the solution proposals to the working conditions. Additionally, issuing assistant report cards and boosting participation in conferences and scientific research activities were other prevailing opinions of the assistant doctors when it comes to reducing training problems. Discussion: It is striking that under the current circumstances, assistant gynecologists are discontent with strenuous working environment and inadequate training. The common proposed solution is to initiate standardization in all training agencies across Turkey.Öğe Does Polycystic Ovary Syndrome Itself Have Additional Effect on Apelin Levels?(Hindawi Ltd, 2014) Silfeler, Dilek Benk; Gokce, Cumali; Kurt, Raziye Keskin; Atilgan, Nigar Yilmaz; Ozturk, Oktay Hasan; Turhan, Ebru; Baloglu, AliObjective. The present study was designed to compare serum levels of apelin between lean PCOS women and healthy women with regular menses. Study Design. A total of 30 lean patients with PCOS and 30 healthy subjects were included in this study. Serum apelin levels were compared between groups. Results. Serum apelin levels in lean PCOS patients were not significantly different from the control subjects. Conclusion. Our findings indicate that PCOS itself does not seem to change apelin levels. Further investigation on a large number of subjects will need to be conducted to prove the consistent or variable association in PCOS.Öğe The effect of Ramadan fasting on fetal development(Professional Medical Publications, 2015) Karateke, Atilla; Kaplanoglu, Mustafa; Avci, Fazil; Kurt, Raziye Keskin; Baloglu, AliObjective: To evaluate the effects of Ramadan fasting on fetal development and outcomes of pregnancy. Methods: We performed this study in Antakya State Hospital of Obstetrics and Child Care, between 28 June 2014 and 27 July 2014 (during the month of Ramadan). A total of two hundred forty healthy pregnant women who were fasting during Ramadan, were included in the groups. The three groups were divided according to the trimesters. The each group was consisted of 40 healthy pregnant women with fasting and 40 healthy pregnant women without fasting. For evaluating the effects of Ramadan on fetus, ultrasonography was performed on all pregnant women in the beginning and the end of Ramadan. We used the essential parameters for the following measurements: increase of fetal biparietal diameter (BPD), increase of fetal femur length (FL), increase of estimated fetal body weight (EFBW), fetal biophysical profile (BPP), amniotic fluid index (AFI), and umbilical artery systole/diastole (S/D) ratio. Results: No significant difference was found between the two groups for the fetal age, maternal weight gain (kilogram), estimated fetal weight gain (EFWG), fetal BPP, AFI, and umbilical artery S/D ratio. On the other hand, a statistically significant increase was observed in maternal weight in the second and third trimesters and a significant increase was observed in the amniotic fluid index in second trimester. Conclusion: In Ramadan there was no bad fetal outcome between pregnant women with fasting and pregnant women without fasting. Pregnant women who want to be with fast, should be examined by doctors, adequately get breakfast before starting to fast and after the fasting take essential calori and hydration. More comprehensive randomized studies are needed to explain the effects of fasting on the pregnancy and fetal outcomes.Öğe The effectiveness of the double B-lynch suture as a modification in the treatment of intractable postpartum haemorrhage(Taylor & Francis Inc, 2018) Sahin, Hanifi; Karapinar, Oya Soylu; Sahin, Eda Adeviye; Dolapcioglu, Kenan; Baloglu, AliA broader range of more effective compression techniques are needed in the patients who have an intractable postpartum haemorrhage due to uterine atony despite medical treatment and B-Lynch sutures. The aim of this study was to report the outcome of a series of patients with haemorrhage who were managed by double B-Lynch suture. Fourteen patients who were treated in a tertiary hospital between July 2010 and February 2015 were included in the study. The intractable haemorrhage rate was 0.35% over 5 years (14/4000 births). Bleeding was controlled in all the patients with a double B-Lynch suture. The mean age of the patients was 24 +/- 3.4years. The mean estimated blood loss was 1696 +/- 272.075mL, and the mean transfusion rate was 4.2 +/- 2.5 units. Pregnancy was observed in five patients at follow up. The double B-Lynch suture seems to be an effective and reliable solution to an intractable postpartum haemorrhage resulting from uterine atony and has no unfavourable impacts on fertility. It should be considered before the use of any aggressive surgical techniques such as a hypogastric artery ligation or a hysterectomy. This the first study to investigate the effectiveness of the double B-Lynch suture, and we showed that the hysterectomy and/or hypogastric artery ligation rate can be decreased by adding a second B-Lynch suture in cases where the medical treatment or a single B-Lynch has failed. IMPACT STATEMENT What is already known on the subject? Uterine atony is the most common cause of a primary postpartum haemorrhage. When a simple massage of the uterus and medication failed to manage this condition, various surgical solutions have been sought, including uterine compression sutures, uterine artery ligation, devascularisation of the uterus, internal iliac artery ligation and, ultimately, a hysterectomy. The B-Lynch suturing technique is particularly useful because of its simplicity of application, life-saving potential, relative safety and capacity for preserving the uterus and subsequent fertility. To-date, this suturing technique, when applied correctly, has been successful with no problems and no apparent complications. However in the cases of when it falls, usually a hysterectomy or a hipogastric artery ligation is preferred. What does this study add? A double B-Lynch suture seems to be an effective and reliable method in an intractable postpartum haemorrhage due to a uterine atony and has no unfavourable impact on fertility'. What are the implications of these findings for clinical practice? The double B-Lynch suture seems to be an effective, reliable and technically easy method. With this aspect, it might be considered before any aggressive surgical techniques, such as a hypogastric artery ligation and hysterectomy in selected cases.Öğe Evaluation of Mean Platelet Volume values in lean women with polycystic ovary syndrome(Professional Medical Publications, 2014) Silfeler, Dilek Benk; Kurt, Raziye Keskin; Yengil, Erhan; Un, Burak; Arica, Secil; Baloglu, AliObjective: Mean Platelet Volume (MPV) is an important indicator of platelet activation. It is known that MPV increases in patients with coronory artery disease, diabetes mellitus, atherosclerosis and Polycystic ovary syndrome (PCOS). Our aim was to measure the MPV in lean patients with polycystic ovary syndrome. Methods: The present study was designed to examine the platelet function by measuring MPV in non-obese women with PCOS. A total of 50 outpatients with PCOS were included. The control group consisted of 50 healthy subjects. Serum platelet, MPV, and white blood cell (WBC) levels were compared and evaluated retrospectively in all participants. These values were compared by statistical analysis. Results: There were no statistically significant difference in between groups regarding MPV (p=0.357), WBC (p=0.414) and platelet (p=0.666). Conclusion: There are studies implying MPV increase in PCOS patients, in our patients MPV levels did not correlate with PCOS except for patients with obesity. We think that PCOS itself has no effect on MPV levels and obesity changes MPV levels.Öğe Relation of platelet distribution width (PDW) and platelet crit (PCT) to preeclampsia(Via Medica, 2015) Karateka, Atilla; Kurt, Raziye Keskin; Baloglu, AliObjective: While the relationship between platelet crit (PCT), platelet distribution width (PDW) and hypertension has been well-documented, data on the association between PCT, PDW and preeclampsia are scant at best. In our study, we aimed to investigate the possible correlation of PCT and PDW with preeclampsia and disease severity. Material and methods: A total of 110 preeclamptic and 100 healthy pregnant women were included in the study. Baseline PCT and PDW were measured using an automatic blood counterin the entire study population. Results: While there were no significant differences between the preeclampsia group and the control group in terms of hemoglobin and platelet counts, the PDW, mean platelet volume (MPV), systolic and diastolic blood pressure, proteinuria, WBC and Hs-CRP levels were significantly higher in the preeclampsia group. In addition, PCT level was significantly lower in the preeclampsia group as compared to controls. Moreover, subgroup analysis revealed that PDW and MPV levels were significantly increased in severely preeclamptic patients when compared to mildly preeclamptic patients. Conclusions: Our study results revealed that PCT and PDW levels were associated with both, the presence and severity of preeclampsia.
