Goal: 16 - Barış, Adalet ve Güçlü Kurumlar
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Barış, Adalet ve Güçlü Kurumlar
Sürdürülebilir kalkınma için barışçıl ve kapsayıcı toplumlar tesis etmek, herkes için adalete erişimi sağlamak ve her düzeyde etkili, hesap verebilir ve kapsayıcı kurumlar oluşturmak.
Barış, istikrar, insan hakları ve hukukun üstünlüğüne dayalı etkin yönetim olmadan, sürdürülebilir kalkınma olmasını bekleyemeyiz. Gittikçe artan ölçüde bölünmüş bir dünyada yaşıyoruz. Bazı bölgelerde barış, güvenlik ve refah sürekli iken, diğer bazı bölgelerde ise bitmek bilmeyen çatışma ve şiddet sarmalı var. Ancak bu, hiçbir şekilde kaçınılmaz sonuç değildir ve mutlaka çözümlenmelidir.
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Publication Metadata only Administration of rectal cytotec versus rectal buscopan before hysteroscopy(2020-06-01T00:00:00Z) GÖKMEN KARASU, AYŞE FİLİZ; AYDIN, SERDAR; ATEŞ, SEDA; TAKMAZ, TAHA; Comba, Cihan; GÖKMEN KARASU, AYŞE FİLİZ; AYDIN, SERDAR; ATEŞ, SEDA; TAKMAZ, TAHAIntroduction:Our objective was to compare the effect of rectal misoprostol (Cytotec) versus rectal hyoscine-n-butyl bromide (Buscopan) on patients undergoing hysteroscopy. We hypothesised that HBB may have a role in cervical priming. Material and methods:This trial was conducted at Bezmialem Vakif University Hospital. Women of reproductive age between 18-50 years who were scheduled for operative hysteroscopy indicated by type 1 submucous myoma or endometrial polyps were recruited for the study. Ninety patients were divided randomly into three groups. Group 1 received placebo treatment. Group 2 received rectal 200 mcg misoprostol and Group 3 received rectal 20 mg hyoscine-n-butyl bromide two hours before the procedure. Procedures were performed using a bipolar 26 F (9 mm) continuous-flow rigid resectoscope with a 30 degrees lens. The outcome measures included cervical dilation width and time, ease of cervical dilation, procedure time and operative complications. Postoperative self-rated pain was assessed one hour after the procedure. Results:Thirteen patients (43. 3%) in the placebo treatment group, 11 patients (36.7%) in the misoprostol group and four patients (13.3%) in the hyoscine-n-butyl bromide group needed analgesics postoperatively (p = .02). The mean duration of cervical dilation time was longest in Group 1 and shortest in Group 3, however this difference did not reach statistical significance (p=.11). There was no difference with regard to other studied parameters. Summary:HBB reduced the need for pain medication compared to placebo. Larger studies are needed to further investigate the role of HBB in facilitating pre-operative cervical priming.Publication Metadata only Total colpocleisis technique in huge neglected ulcerated uterovaginal prolapse(2020-06-01T00:00:00Z) AYDIN, SERDAR; Gorchiyeva, Irana; TANOĞLU, FATMA BAŞAK; AYDIN, SERDAR; TANOĞLU, FATMA BAŞAKIntroduction and hypothesis We present a video describing the technical considerations for performing a total colpocleisis in the management of significant, neglected, ulcerated, and symptomatic complete uterovaginal prolapse. Methods A 79-year-old debilitated woman presented with a large, ulcerated pelvic bulge. A previous attempt at pessary treatment failed because of a disproportion of the pessary with the prolapse size. She had a history of liver insufficiency and hypertension. Obliterative colpocleisis surgery was selected because the healing of a large ulcerated vagina was not likely within a short timeframe. Sharp dissection with scissors and de-epithelialisation of the remaining non-eroded vaginal mucosa with the friction of a sharp-edged surgical knife were performed. Closely located purse strings were used to obliterate potential spaces. Two mirror image triangles in the anterior and posterior vaginal walls were removed. After the formation of a new perineal body, the diamond-shaped vaginal incision was closed vertically to narrow introitus. Results The patient was discharged on the first postoperative day and an uncomplicated postoperative course ensued. At the 4-week follow-up, there was no evidence of infection, recurrent prolapse, de novo stress incontinence, or voiding with difficulty. Conclusions Total colpocleisis is an excellent surgical option in women with multiple, large cervicovaginal ulcers and multiple comorbidities with no desire for penetrative vaginal function.Publication Metadata only Thel Incidence of Concomitant Precancerous Lesions in Cases Who Underwent Hysterectomy for Prolapse(2016-09-01T00:00:00Z) AYDIN, SERDAR; BAKAR, Rabia Zehra; Mammadzade, Aygun; DANSUK, RAMAZAN; AYDIN, SERDAR; BAKAR, RABIA ZEHRA; DANSUK, RAMAZANThe aim of the study was is to assess the incidence of unexpected gynecological cancers and pre-cancerous lesions following hysterectomy for pelvic organ prolapse to better understand the risks of uterine sparing surgery. Material and Method: This was a retrospective analysis of histopathology findings after hysterectomy for uterine prolapse surgery who underwent preoperative diagnostic work including cervical cytology, transvaginal ultrasonography and endometrial histopathological examination for a high risk group (Postmenopausal women with an endometrial thickness of >= 5 mm and premenopausal women with abnormal bleeding). Patients with a history of endometrial, cervical and/or adnexal precancerous or cancerous pathological conditions and with incomplete medical records were excluded. Results: Results were taken from 106 women who underwent hysterectomy. The abdominal route was used in 22 cases (21.7 %), the vaginal route in 82 patients (77.4 %) and laparoscopic-assisted vaginal route in two (1.9 %) women. Oophorectomy was performed in 35 (33 %) cases. None of the patients had malignant histopathology specimens from hysterectomy. Total premalignant pathology incidence was 7.5 % (8/106). Six (5.7%) patients had simple endometrial hyperplasia and 2 patients (1.9 %) had cervical intraepithelial neoplasia. Discussion: The incidence of unexpected endometrial, cervical or ovarian malignancy among women who underwent hysterectomy after preoperative diagnostic workup including transvaginal ultrasonograhy, endometrial pathological examination to high risk cases was negligible. The inclusion of low risk endometrial and cervical precancerous lesions increased the incidences. Our results could provide precious data to extrapolate to similar populations with uterine prolapse who desire surgical correction sparing uterus.Publication Metadata only Age-Related Distribution of Basal Anti-Mullerian Hormone Levels in a Population of Infertile Women(2016-05-01) AYDIN, SERDAR; ÖZCAN, PINAR; AYDIN, SERDARAim: We aimed to constitute age-specific reference serum values for anti-Mullerian Hormone (AMH) in women, and to analyze the distribution of basal serum AMH levels in Turkish women of reproductive age attending an infertility clinic to provide a framework for expected values according to age. Material and Method: Retrospective analysis of prospectively collected data on cycle day 2-3 serum AMH measurements of 409 women attending a single infertility unit in Turkey through a 12-month-period was performed. Results: Concentrations of serum AMH were shown to decrease with advancing age of the female partner. The mean age of the women was 34.04 +/- 5.39 years and the mean AMH level of the women was 1.77 +/- 1.82. The AMH levels were grouped according to age as follows: 20-24, 25-29, 30-34,35-39, and >40 years. The median AMH values were 2.16 ng/ml, 2.15 ng/ml, 1.71 ng/ml, 0.80 ng/ml, and 0.47 ng/ml, respectively according to the age groups. Discussion: The present data provide a framework for age-specific serum AMH levels in a Turkish population of infertile women.Publication Metadata only Association between maternal vitamin D status in pregnant women and risk of gestational diabetes mellitus(2016-05-15T00:00:00Z) ATEŞ, SEDA; AYDIN, SERDAR; GÖKMEN KARASU, AYŞE FİLİZ; KILIÇ, GÖKHAN; KILIÇOĞLU DANE, PAKİZER BANU; ATEŞ, SEDA; AYDIN, SERDAR; GÖKMEN KARASU, AYŞE FİLİZ; KILIC, GÖKHAN; KILIÇOĞLU DANE, PAKİZER BANUPublication Metadata only Association between maternal vitamin D status in pregnant women and risk of gestational diabetes mellitus(2016-05-15) AYDIN, SERDAR; AYDIN, SERDARPublication Metadata only Dental health dispositions of pregnant women: A survey from a hospital clinic in Istanbul.(2017-08-01) Gokmen, Karasu; KUTUK, NÜKHET; Aydin, SERDAR; Adanir, I; Ates, SEDA; Bademler, N; GÖKMEN KARASU, AYŞE FİLİZ; KÜTÜK, NÜKHET; AYDIN, SERDAR; ADANIR, İLKNUR; ATEŞ, SEDAPublication Metadata only Association between maternal vitamin D status and risk of gestational diabetes mellitus in pregnant women(2017-03-01) ATEŞ, SEDA; AYDIN, SERDAR; GÖKMEN KARASU, AYŞE FİLİZ; KILIÇOĞLU DANE, PAKİZER BANU; ATEŞ, SEDA; AYDIN, SERDAR; GÖKMEN KARASU, AYŞE FİLİZ; KILIÇOĞLU DANE, PAKİZER BANUPublication Metadata only IMMEDIATE COLPOSCOPY FINDINGS AMONG WOMEN WITH HIGH RISK HPV OTHER THAN HVPV16/18 AND NORMAL CYTOLOGY(2019-11-01T00:00:00Z) Aydin, S.; Kayahan, H. N.; Arici, D. S.; AYDIN, SERDARPublication Metadata only The usual suspect: cross-sectional study of fundal pressure at second stage of delivery and the association with pelvic floor damage(2020-09-01T00:00:00Z) TAKMAZ, TAHA; AYDIN, SERDAR; Gorchiyeva, Irana; GÖKMEN KARASU, AYŞE FİLİZ; TAKMAZ, TAHA; AYDIN, SERDAR; GÖKMEN KARASU, AYŞE FİLİZIntroduction and hypothesis Uterine fundal pressure is applied to accelerate birth by increasing the expulsive force of the uterus in the second stage of delivery. The aim of the study was to evaluate the effect of using uterine fundal pressure during the second stage of delivery on the rate of pelvic floor damage among primiparous women using three-dimensional transperineal ultrasonography. Methods The women were divided into two groups: the fundal pressure group included women where the fundal pressure maneuver was applied (n = 39); the control group included women who delivered spontaneously without fundal pressure (n = 47). 3D-TPU was performed within 48 h of delivery, and LAM biometry, LAM defect and loss of tenting were determined. Results Anteroposterior hiatal dimensions on resting, maximal Valsalva and maximal PFMC were found to be higher in the fundal pressure group (p < 0.0001,p = 0.008,p = 0.007, respectively). The mean hiatal area at rest was larger in the fundal pressure group than in the control group (p = 0.04). The rate of LAM defect was significantly higher in the fundal pressure group (p = 0.001). The rate of loss of tenting was significantly higher in the fundal pressure group (p < 0.0001). According to multivariate regression models, the fundal pressure was the only independent factor associated with LAM defect (OR = 5.63; 95% CI = 12.01-15.74) and loss of tenting (OR = 8.74; 95% CI = 2.89-26.43). Conclusions Fundal pressure during the second stage of delivery is associated with a higher risk of LAM defect and loss of anterior vaginal wall support.