Background: Pregnancy-induced hormonal and physiologic changes increase the risk of musculoskeletal problems in pregnancy. The purpose of this report is to provide a comprehensive look at the musculoskeletal pain and symptoms experienced during pregnancy. Methods: A total of 184 women (mean age 30.9 ± 5.0 years) who gave birth in the obstetrics clinic of a tertiary hospital were included in the study. The participants who had given birth at 37–42 weeks of pregnancy (term pregnancy) and aged over 18 years were selected for participation. Basic demographic and clinical characteristics of the participants including age, body mass index, weight gained during pregnancy, education level, occupation, parity, sex of baby, and exercise habits were collected from the medical chart and face-to-face interviews. Musculoskeletal pain sites were defined as hand–wrist, elbow, shoulder, neck, back, low back, hip, knee, and ankle–foot in a diagram of the human body. The interviews with participants were performed to assess their musculoskeletal pain separately at each trimester follow-up visit. Results: The most frequent musculoskeletal complaints during pregnancy were low back pain ( n = 130, 70.7%), back pain ( n = 80, 43.5%), hand–wrist ( n = 61, 33.2%) and hip pain ( n = 59, 32.1%). The participants experienced musculoskeletal pain most in the third trimester except for elbow, shoulder and neck pain compared with the first and second trimesters ( p < 0.05). Conclusions: The results of the study suggest that numerous musculoskeletal problems may complicate pregnancy especially in the third trimester.

OBJECTIVE:To evaluate the possible association between progesterone use in the first trimester of pregnancy and fetal nuchal translucency (NT).MATERIAL AND METHODS:This is an observational case-control study, which was conducted with patients who underwent nuchal scans between March 2015 and February 2016 and consequently delivered live and healthy babies. The study group was composed of assisted reproductive technology pregnancies and used intravaginal progesterone 180 mg/day until gestational week 12. The control group comprised pregnant women who became pregnant spontaneously without using any progesterone preparation in the first trimester.RESULTS:One hundred sixty-four (57.5%) of 285 patients were in the control group and 121 (42.5%) were in the progesterone group. Age, bodyweight, gravidity, and parity number of previous births and abortus, gestational week, crown-rump lengths, free β-human chorionic gonadotropin, pregnancy-associated plasma protein A, and NT values of the progesterone and control groups were recorded and we investigated whether there was a statistically significant difference between the two groups in terms of these parameters; maternal weight was found to be higher in the progesterone group than in the control group and the difference between the groups was statistically significant (p=0.019 and p=0.025). Whether the difference in NT was caused by the effect of maternal weight was investigated using the covariance analysis test and maternal weight was not found to be statistically significant in the model (p=0.284).CONCLUSION:Fetal NT was increased in the progesterone group compared with the untreated group in healthy pregnancies.

Cesarean scar dehicence has the incidence of 1.2% after base transverse incisions. Beside causing a situation increasing morbidity and mortility for baby and mother and needing acute intervention in antenatal or intrapartum period by causing uterine rupture, it is an important complication that can cause sudden bleeding, infection and even uterine fistules in postpartum period. In our case, we will mention about the successful management of cyst caused by menstrual blood that develops dehiscence of cesarean scar. A female patient with the age of 40 (Gravida:2, parity:2 (2 C/S) applied to our policlinic because of amenorrhoea. A cystic mass, probably originated from cesarean incision scar, with intense content, smooth borders and the dimensions of 66x24 mm was observed by the help of transvaginal ultrasonography. The evacuation of the cyst content had been decided by performing vacuum aspiration from cervical ostium. Transabdominal ultrasonography guided karman cannula was placed into the cyst from cervical ostium. The content of the cyst had been aspired by negative pressure. Most of the complications after cesarean can be diagnosed by easy ultrasonographic observations and physical examinations, some needs expensive radiologic observations such as magnetic resonance imaging, computerized tomography, while for some of them, second- look procedures can be necessary that increase mortality and morbidity of the patient. The most important thing is how to treat these complications. Some of them can be treated by conservative approaches; while some of them needs severe surgical operations even histerectomy. As in our case, the cyst caused by menstrual blood after causing dehiscence of cesarean scar, was vacuum aspirated easily and treated by conservative approach.

The effects of material properties on bond strength between reinforcing bar and concrete exposed to high temperatures are investigated extensively using modified pullout tests. The specimen parameters include various bar diameters, rebar grades and concrete strengths. Three different concrete cubes with compressive strengths of 20, 34 and 44MPa, 12, 16 and 20mm rebar diameters and S220a, S420a and S500a rebar grades were utilized for the tests. In the experimental study, the tests were conducted on 150/300 cylinder specimens in which rebars are embedded vertically exposed to high temperatures (100, 200, 400, 600 and 800°C) and cooled down. Furthermore, 150mm cube and 100/100/300mm prism specimens were used to determine compressive and flexural strength of concrete. Bond strengths of these specimens were compared with each other and then with unheated specimens at 20°C. Experimental results indicated that residual bond strength between reinforcing bar and concrete decreases with increasing temperature. The first severe bond strength loss was observed for grade S220a at the range of 200–400°C and for grade S420a and S500a at the range of 400–600°C. The residual compressive strength is in tendency with the residual bond strength of S420a and S500a whereas the residual flexural strength corresponds agrees with the residual bond strength of S220a.

Objective: The aim of this study is to demonstrate if there is any difference in the presence of antiovarian antibody (AOA) in normal fertile women and the ones having poor ovarian response and to examine if serum AOA levels could be used as a marker to detect patients at risk for poor ovarian reserve. Materials and Methods: 51 premature ovarian insufficiency (POI) patients, 47 poor responder (POR) patients to in vitro fertilization (IVF) and 51 healthy controls were included in the study. The patients were examined for their basal hormone values and antral follicle counts. Venous blood sampling for the detection of AOA was applied and ELISA technique was used to detect AOA concentrations. Results: The AOA levels were detected as 7.91 ± 1.11 U/mL in POI group, 5.72 ± 1.00 U/mL in the fertile group and 8.30 ± 0.75 U/mL in the POR group. It was significantly elevated in the POI and POR groups when compared to the fertile group (p< 0.001). There was not any difference between the AOA levels of POI and POR groups (p=0.053). The cut off levels of AOA for diagnosis of POI was detected to be 6.58 U/mL and for POR it was 7.78 U/mL. When these cut off levels were used, the sensitivity ratio was calculated as 90.2% for POI, and 94.74% for POR groups; whereas the specificity was 86.27% for POI and 83.05% for POR groups. In multivariate regression analysis of the POR group, AOA level was demonstrated to be the only significant independent variable in predicting the patients. Conclusion: Antiovarian autoimmunity plays a role in the etiopathogenesis of POI and POR; but the exact mechanism still needs to be elucidated with more clinical trials. AOA can be used as serum marker to detect the POR patients and predict IVF results. Immunosuppressive treatment of these patients may enhance the pregnancy outcomes.

We read the article “Depression, Anxiety, and Anger in Patients with Polycystic Ovary Syndrome” by Balikci et al with great interest (1). The authors aimed to evaluate the relations of some biochemical parameters with anger, anxiety, and depression in patients with polycystic ovary syndrome (PCOS). They concluded that anxiety symptoms assessed based on anxiety scores were significantly correlated with serum levels of dehydroepiandrosterone sulfate (DHEAS). We would like to thank the authors for their contribution to the present study, which is successfully designed and documented. All

The word plagiocephaly is occurred from Greek for “slanted” (plagio) and “head” (kephale). Plagiocephaly describes a planar or multiplanar cranial asymmetry which can be occurred in prenatal or postnatal period. In prenatal period, the most reason for associated plagiocephaly is intrauterine pressure (multiple birth infants (especially dizygotic twins), amount of amniotic, small pelvis and uterine tumors etc.). It has been demonstrated in recent studies that the location of the fetuses within uterus, importantly their position and orientation in the uterus and also the number of fetuses play crucial roles in the development of plagiocephaly during pregnancy. In this report, it was reported that in the case of the dizygotic twin- pregnancy due to the location of the babies in the uterus, they are prone to develop plagiocephaly.

Giris: Anjiyomyofiblastomlar (AMFB), genital stromal tumorler icerisinde yer alan, nadir izlenen benign mezenkimal tumorlerdir. Cogunlukla orta yasli kadinlarda izlenmekle birlikte, ozellikle vulvayi nadiren de vajinayi tutabilmektedir. AMFB benzeri tumorler adi altinda, nadiren erkekler de gorulebilmektedir. Klinik olarak yerlesim yeri ve klinik prezentasyonu ile bartolin kistleri, alt genital tract lipomlari veya nadiren de agresif anjiyomiksomalar ile karisabilmektedir. Bu nadir tumorlerin tedavisi genellikle basit cerrahi eksizyondur. Olgu - Tartisma: Bu olguda, literatur bilgimize gore cocukluk caginda olan 11 yasinda ki kiz cocugunda ilk kez izlenen AMFB olgusundan bahsedildi.

Burkitt’s lymphoma (BL) occurs commonly in children and young adults, whereas bilateral ovarian involvement is extremely rare. We report a patient with unusual symptoms for BL, mimicking an ovarian neoplasm. Here, our aim was also to point out that BL can spread into the genital tract. A 60-year-old woman presented with the complaint of abdominal pain for a few months. Abdominal distension and sensibility were observed upon physical examination of the patient, but no common “B” symptoms associated with lymphoma were noted. Our imaging studies revealed bilateral adnexal masses suggesting an ovarian tumour with positive laboratory findings. We performed an exploratory laparotomy and a total hysterectomy, bilateral salpingo-oophorectomy and right hemicolectomy with appendectomy. The hemicolectomy process was needed to reduce the tumour burden and because of the risk of intestinal obstruction risk that could arise from the tumour mass in the ileocecal valve. Observation of a frozen specimen indicated BL, so the surgery was ended. Although BL involving the genital tract is a rare condition in patients who have pelvic masses, BL can be one of the diseases that should be considered for specific diagnosis.

A female patient with the age of 33 having gravida: 3, parity: 2 and D&C: 1, applied to our clinics by pelvic mass that she had. It had been comprehended from the anamnesis of the patient that she applied to a gynecologist because of ongoing inguinal pain and abdominal distension for about 4 months. In the physical examination, a mass that can be palpated in suprapubic region was observed. In transvaginal ultrasonographic examination, a giant leiomyom was determined having the dimensions of 9.5cm x 8.5 cm that was located at fundal uterus with subserous component and enlarged the uterus. Pfannenstiel incision was performed. In intraoperative examination, a fundal subserous located parasitic leiomyoma with around 10 cm diameter, supplied by a vascular structure about 30 cm in length from omentum was diagnosed.It was diagnosed that omentum adhered to leiomyoma partially. Firstly, omentum with its vascular structure was excised. Partial omentectomy was performed. Then, leiomyoma was excised by performing dissection and operation was ended up. Parasitic myomas are indicated as rarely seen myomas in literature. It is crucial to maintain specific diagnosis, careful imaging and serious planning in preoperative preparations.Although parasitic leiomyomas are rarely seen cases, because of abnormal vascularization and adhesion to other organs, one should be careful in preoperative examinations and sufficient blood supply should be maintained in case of bleeding. Additionally, surgical information has to be had for surgical exploration and pelvic anatomy.

Torsion seen in ovary, fallopian tube or in both organs is one of the gynecologic emergency pathologies in patients suffering from acute lower abdominal pain, and it constitutes approximately 2.7% of gynecologic emergencies. Delays in diagnosis and treatment can cause ischemic damage, in that way can cause the risk of ovary, fallopian tube or both organs loss. Thus, it can result in fertility problems in people who are desiring future fertility. Although the etiology is not totally known, it has been thought that torsion risk has been increasing in benign cystic teratomas and ovarian tumors. It can be also seen in congenital situations such as vitellointestinal duct anomaly and people who have undergone pelvic surgery. In this article, a case for adnexal torsion developed in congenital omental fenestrum which is considered as a new factor for torsion etiology, was explained.

Introduction: To determine whether controlled drilling, cyst excision, and removal in a bag can reduce the operative time and intraperitoneal spillage in dermoid cysts.Materials and Methods: Laparoscopic dermoid cyst excision was performed in 45 women using a different technique: controlled drilling of dermoid cysts in a bag, excision of these cysts, and their removal in the same bag.Results: The median age of the patients was 29.5 years (range, 18-42 years), the median size of the cysts was 55 mm (range, 30-100 mm), the median operative time was 40 minutes (range, 25-60 minutes), the median level of cancer antigen 19-9 was 28.5 U/mL (range, 1.2-127 U/mL), the median parity was 1 (range, 0-3), and the median hospitalization time was 1 day (range, 1-2 days). Twenty-five cysts were in the right ovary, and 20 were in the left ovary. In all cases, the dermoid cysts were ruptured with the controlled drilling. There was no intraperitoneal spillage of the cyst contents in the abdomen. No complication occurred intraoperatively or postoperatively. There was no recurrence 3 months after the operation.Conclusions: Controlled drilling, excision, and removal of a dermoid cyst inside the same bag seems to be a feasible method to prevent intraperitoneal spillage and to reduce the operative time.

Chancroid is a sexually transmitted infection caused by the Gram-negative bacteria Haemophilus ducreyi. The disease manifests as genital ulcerations, which may be accompanied by lymphoadenitis. It is widespread in low-resource countries in Africa and can co-occur with human immunodeficiency virus. We present a case of chancroid in patient with Candida glabrata vaginitis. There were two major genital ulcers, one of which was a painful ulcer in the left labia major and the other was a painless ulcer in the cervix uteri; she was also found upon examination to have bilateral inguinal lymphadenopathy. Candida glabrata was found in vaginal culture. We treated the patient with azithromycin 1 gram orally for 3 days, and fluconazole 150 mg oral and vaginally. This case is very typical of an H. ducreyi infection, and physicians should be aware of this type of infection when carrying out routine gynecological examinations.

Objective To determine the effect of dopamine agonists in a surgically induced endometriosis model on rats. Study design In this prospective randomized experimental study, surgical induction of endometriosis was performed by autotransplantation technique on 52 adult female Wistar-Albino rats. Endometriosis formation was confirmed by a second-look laparotomy ( n :48) 1 month later. Four study groups were randomly generated according to their treatment regimens: group 1 (leuprolide acetate, n = 12), group 2 (bromocriptine, n = 12), group 3 (cabergoline, n = 12) and group 4 (control, n = 12). Endometriotic implants were excised for histopathological examination after treatment at the setting of laparotomy. The mean surface areas and histopathological glandular tissue (GT) and stromal tissue (ST) scores of endometriotic implants were studied and compared among groups. Results After 30 days of treatment, the mean surface area of the endometriotic implants of leuprolide acetate, bromocriptine and cabergoline groups was significantly decreased. The regression of endometriotic foci size in comparison to control was highest in group 1, followed by group 2, then group 3. In the histopathological evaluation both the ST and GT scores of group 1, 2 and 3 were significantly decreased in comparison to controls without a statistically significant difference between the groups. Conclusion Dopamine agonists are as effective as GnRH agonists in the regression of experimental endometriotic implants in rats. Further trials are needed to elucidate the pathways affected by dopamine agonists.

Purpose of investigation: The aim of this study was to prospectively compare the diagnostic performances of nine gray-scale sonographic prediction models to detect ovarian malignancy. Materials and Methods: Clinical data of 322 women presenting with an adnexal mass were obtained and used in nine scoring systems. For each model a ROC curve demonstrating the capacity of the model to diagnose malignancy was constructed for all cases and for the subgroups of premenopause and postmenopause. The performance of each model was expressed as area under the ROC curve, sensitivity, and specificity. Results: The area under the ROC curve, sensitivity, and specificity of these models in the present study varied between 0.737 and 0.929,70.7% and 87.9%, 60.2% and 80.3%, respectively. Conclusions: This study has revealed the usefulness of morphological scoring systems to correctly discriminate between benign and malignant pelvic masses.

Background The aim of this study was to investigate the influence of body mass index (BMI) on the in vitro fertilization (IVF) treatment outcomes in a cohort of women undergoing their first IVF, using an intracytoplasmic sperm injection (ICSI). Methods This retrospective cohort study included 298 cycles from women younger than 38 years old undergoing IVF-ICSI at a university infertility clinic. The treatment cycles were divided into three groups according to the BMI of the women involved: normal weight (18.5 ≤ BMI < 25 kg/m 2 , 164 cycles), overweight (25 ≤ BMI < 30 kg/m 2 , 70 cycles), and obese (BMI ≥ 30 kg/m 2 , 64 cycles). The underweight women (BMI < 18.5 kg/m 2 ) were not included in the analysis due to small sample size ( n = 22). The patient characteristics and IVF-ICSI treatment outcomes were compared between the BMI groups. Results The total gonadotropin dose ( p <0.001) and duration of stimulation ( p = 0.008) were significantly higher in the obese group when compared to the normal BMI group. There were no significant differences across the BMI categories for the other IVF-ICSI cycle outcomes measured, including the number of retrieved oocytes, mature oocytes, embryos suitable for transfer, proportion of oocytes fertilized, and cycle cancellation rates ( p >0.05 for each). Additionally, clinical pregnancy, spontaneous abortion, and the ongoing pregnancy rates per transfer were found to be comparable between the normal weight, overweight, and obese women ( p >0.05 for each). Conclusion Obese women might require a significantly higher dose of gonadotropins and longer stimulation durations, without greatly affecting the pregnancy outcomes.

Introduction: Angiomyofibroblastoma (AMFB) is a rare seen mesenchymal tumor that is categorized as a genital stromal tumor.It is commonly seen in the middle-aged women usually affecting the vulva and rarely the vagina.A variant called AMFB-like tumors are also rarely seen in male patients.AMFB with its clinical presentation and location can be wrongly diagnosed as an aggressive angiomyxomas, bartholin cyst or lower genital tract lipomas.The treatment of this rare tumor is generally a simple surgical excision.Case-Discussion: In the following case, an AMFB that was seen in childhood for the first time according to the literature with it's clinical and histopathological characteristics, was explained.