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 Short and middle-term outcomes of vaginally assisted laparoscopic sacropolpopexy.(2020-12-07T00:00:00Z) Gökmen Karasu, Ayşe Filiz; Aydın, Serdar; Ateş, SEDA; Arıoğlu, Çağrı; ATEŞ, SEDA; GÖKMEN KARASU, AYŞE FİLİZPublication Open Access Chronotype anc Sleep Quality Assessment of Patients with Polycystic Ovary Syndrome(2021-01-01T00:00:00Z) GÖKMEN KARASU, AYŞE FİLİZ; Sahbaz, Cigdem Dilek; Dogu, Zeynep Filiz Eren; TAKMAZ, TAHA; ÇALI, HALİME; Tanoglu, Basak; GÖKMEN KARASU, AYŞE FİLİZ; ŞAHBAZ, ÇIĞDEM DILEK; TAKMAZ, TAHA; ÇALI, HALİMEAim: Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder among women during the reproductive ages. The purpose of this study was to investigate the chronotype and sleep quality of PCOS patients.Publication Metadata only The role of clitoral topography in sexual arousal and orgasm: transperineal ultrasound study(2021-05-01T00:00:00Z) Aydin, Serdar; Bademler, Neslihan; Yardimci, Elif Asli Sarioglu; Arioglu, Cagri; GÖKMEN KARASU, AYŞE FİLİZ; GÖKMEN KARASU, AYŞE FİLİZIntroduction and hypothesis The clitoris has a critical pivotal role in female orgasm and arousal. The aim of this cross-sectional study was to evaluate topographic measurements of the clitoris, as well as to explore potential relationships between the clitoral complex and the orgasm domain of female sexual function, combining transperineal ultrasound with morphometric measurements. Methods In sexually active, heterosexual, premenopausal women, three-dimensional transperineal ultrasound imaging was used to measure the subpubic angle, the anterior triangle area (ATA) of the genital hiatus, the levator urethra gap, and the anteroposterior and transverse diameters of the genital hiatus. Mons pubis thickness, clitoris-urethra distance (CUD), clitoris-fourchette distance, and fourchette-perineal body distance were measured using a caliper. Comparison of measurements and correlation with orgasm score were performed. Results Among the 108 sexually active women, 30 (27.7 %) reported a low orgasm domain score. There were statistically significant differences between the low orgasm group and the control group in the ATA (4.05 vs 3.64 cm(2) respectively; p = 0.03), CUD (21 mm; p = 0.04 vs 16.1 mm; p = 0.04), and volume of the glans clitoris (947.7 mm(3) vs 1081 mm(3); p = 0.02). There was a moderate and inverse correlation between clitoris-urethra distance and orgasm (r = -0.53, p < 0.001), and arousal (r = -0.42 p < 0.001). Broader ATA (OR = 0.47; 95 % CI = 0.23-0.99; p = 0.04) and longer CUD (OR = 0.57; 95 % CI = 0.44-0.73; p < 0.001) were identified as the only independent predictors of orgasm problems. Conclusions Longer glans clitoris-urethra distance and broad space for the deep structures of the clitoris is related to difficulty in reaching orgasm and arousal problems.Publication 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.Publication Metadata only Are chronotype and subjective sleep quality associated with preeclampsia and preterm birth?(2020-02-20T04:00:00Z) TAKMAZ, TAHA; Unal, Busra; ÖZCAN, Pınar; ARICI HALICI, BELFİN NUR; Gorchiyeva, Irana; GÖKMEN KARASU, AYŞE FİLİZ; Sahbaz, Cigdem; TAKMAZ, TAHA; ÖZCAN, PINAR; ARICI HALICI, BELFİN NUR; GÖKMEN KARASU, AYŞE FİLİZ; ŞAHBAZ, ÇIĞDEM DILEKThe physiological and physical changes in pregnancy affect the sleep-wake cycle. Limited data exist to evaluate the effect of sleep quality and chronotype during pregnancy on adverse pregnancy outcomes. It is hypothesized that there could be a tendency for the evening chronotype and sleep disturbances to lead to the development of preeclampsia and preterm birth. A total of 313 pregnant women were included. Women were divided into three groups: Group A (control - problem-free), Group B (preeclampsia) and Group C (preterm birth). There were significant differences in the mean PSQI score between the groups (A vs C and A vs B) (p < 0.01). Women in the preterm and the preeclampsia groups reported significantly worse sleep quality. There was a significant difference in the mean MEQ scores between groups (A vs C and A vs B) (p < 0.01). The ratio of the evening-types was significantly higher for the preterm and preeclampsia groups (p < 0.01). Multivariate logistic regression analysis revealed that there is a negative association between preeclampsia/preterm birth and MEQ score, positive association between preeclampsia/preterm birth and PSQI score. Chronotype and sleep quality measurements could provide a simple and feasible way in the prediction of adverse pregnancy outcomes.Publication Open Access Association of intrinsic sphincter deficiency with urine flow acceleration measurement(2020-09-01T00:00:00Z) GÖKMEN KARASU, AYŞE FİLİZ; Aydin, Serdar; KALKAN, Senad; ERSÖZ, CEVPER; GÖKMEN KARASU, AYŞE FİLİZ; KALKAN, SENAD; ERSÖZ, CEVPERBackground Intrinsic sphincter deficiency (ISD) is associated with an inability to maintain mucosal coaptation either at rest or in the presence of stress resulting from damage to muscles or nerves that maintain tonus. The purpose of our trial was to determine the role of urodynamic measurements of flow such as maximum flow rate, flow time, and acceleration speed of flow to assess the urethral resistance on prediction of stress incontinence and ISD. Materials and Methods Our study was based on a retrospective analysis of urodynamic records of female patients performed for urinary incontinence. Mean flow rate, maximum flow rate, detrusor pressure at maximum flow, vesical pressure at maximum flow, maximum detrusor pressure, and flow rate at maximum detrusor pressure measurements were extracted from the voiding phase of urodynamic charts. The slope of the maximum flow was used to calculate acceleration of flow (Qacc). The urodynamic records of 142 women were reviewed and Qacc was measured. Results The mean age of the ISD group was 53.3 +/- 12.5 (24-78) and of the non-ISD group 53.7 +/- 12.5 (35-74). The mean Qacc (30.3 +/- 16.1 degrees [mL/s(2)]) in the ISD group was significantly higher than in the non-ISD group (21.6 +/- 9.6 degrees [mL/s(2)]). Urodynamic bladder capacity of the non-ISD group (432.3 +/- 90.4 mL) was higher than the ISD group (389.2 +/- 109) (P = .01). Conclusion The Valsalva leak point pressure and maximum urethral closure pressure measurements in assessing urethral function are not useful for predicting incontinence surgery failure. We demonstrated that Qacc is higher in ISD stress incontinent women than stress incontinent women. Qacc may demonstrate urethral resistance and tonus in a more reliable manner.