Pilomatrixoma

The Effects of Obesity and Bariatric Surgery on Fertility

Several disorders such as coronary system diseases, endocrine disorders, respiratory system diseases (sleep apnea, chronic obstructive pulmonary disease), digestive system diseases (hepatosteatosis, gallbladder diseases, reflux esophagitis), and genitourinary system disorders (erectile dysfunction, reproductive dysfunction) are caused due to excessive adipose tissue deposition. In addition, obese women are at a higher risk of developing colorectal cancer, endometrial cancer and postmenopausal breast cancer, as compared to the non-obese women.

Prenatal Diagnosis and Postnatal Management of a Large Hepatic Hemangioma

estimated to constitute 1–5% of total pediatric malignancies and listed as most commonly diagnosed tumors after hepatic hepatoblastoma in pediatric patients.1,2 While some of these tumors may be unrecognized due to a small size in clinical practice, a noticeably large sized tumor may cause severe coagulopathy due to thrombocyte depletion and abdominal hemorrhage. This condition is called as Kasabach Merritt Syndrome and results from the rupture of the tumor. Prenatal di-agnosis is often based on the presence of an abdominal mass with a high blood flow appearing in color Doppler ultrasonography. Although small sized tumors can be managed expectantly, large sized tumors may require medical therapy (corticosteroids), surgical intervention, such as ligation of feeding arteries, mass excision or hepatic transplantation. We present prenatal diagnosis and postnatal management of a case with a hepatic hemangioma.

Comparison of Laparoscopy and Laparotomy in Surgical Treatment of Ectopic Pregnancies: A 6-Year Experience at a Tertiary Center

Objective: To investigate laparotomy and laparoscopic approaches in patients diagnosed with ectopic pregnancy (EP) and who underwent surgical treatment in our clinic during the last six years. Material and Methods: This study included 202 patients who underwent laparoscopic surgery and laparotomy for EP between January 2012 and January 2018 in our clinic. A comparison was made among the patients for age, gravidity, parity, mean β human chorionic gonadotropin (HCG) levels on admission, risk factors for EP, and clinical findings. The contributions of these two treatments to the postoperative process were assessed. Results: The surgical intervention was performed on 202 patients who had an EP. Of these patients, 110 (54%) underwent laparotomy and 92 (46%) underwent laparoscopic surgery. No differences were found at a statistically significant level between the groups in age, gravidity, parity, curettage, gestational age at admission, mean β-HCG levels on admission, and preoperative and postoperative hemoglobin levels. Although the length of postoperative hospital stay was shorter at a statistically significant level in the laparoscopy group than in the laparotomy group, operation time was shorter at a statistically significant level in the laparotomy group than in the laparoscopy group. Conclusion: When surgical treatment is decided in patients with EP, laparoscopic surgery can be preferred more by considering the fact that it leads to less contamination, reduces hospital length of stay, and has a cost advantage over laparotomy. However, treatment methods can vary according to the facilities of clinics, availability of surgical instruments, and experience of physicians.

Diagnostic Accuracy of Ultrasonography and Magnetic Resonance Imaging in the Assessment of Placenta Previa Accreta

ing accreta, increta, and percreta, as well as cases of the clinically apparent morbidly adherent placenta.1 Placenta previa is more commonly associated with placenta accreta as the lower segment is an area of relatively poorer decidualization and is associated with a thin or absent decidua basalis.2 Placenta previa accreta is associated with significant maternal morbidity and mortality owing to bladder and rectum invasion, massive postpartum hemorrhage and its resultant coagulopathy, cesarean hysterectomy, and death.3 The risk of placenta accreta with placenta previa ranges from 3.3 to 67%; the risk increases with the number of previous cesarean deliveries.4,5 Placenta previs accreta has become an obstetric complication that an average obstetrician is likely to encounter several times. There has been a substantial increase in its occurrence over the past 50 years and it can no longer be considered as a rare obstetric pathology.6

The Effect of Non-Cavity-Distorting Myomas on the Outcomes of Stimulated Intrauterine Insemination in Unexplained Infertility

140 he definition of unexplained infertility includes all sperm or oocyte dysfunctions, or developmental disorders of fertilization, implantation, or embryogenesis, that cannot be diagnosed from standard fertility tests. Fifteen percent of all couples are diagnosed with unexplained infertility.1 Myomas may be detected in 20-40% of all women in the reproductive age and 5-10% of infertile women.2,3 However, in 1-2% of the women with infertility, myomas are the only abnormal finding.4 Abnormal bleeding, pain, and compression in adjacent organs constitute the majority of myoma-related complaints, while the effects of myomas on fertility are more difficult to identify. Most of the evidence regarding the impact of myomas on fertility arises from the studies comparing the prevalence of myomas in fertile and infertile women, and those comparing the fertility outcomes of women with unexplained infertility before and after myomectomy.4,5

The Effectiveness of Neuraltherapy in the Treatment of Vaginitis

Objective: In this study, we approached vaginitis, which we encounter so frequently in our daily practice, from a different point of view. Based on regulatory effects of neural therapy (NT), we applied NT to the patients with a complaint of vaginitis in order to regulate the perfusion and innervation of the vaginal mucosa and to improve lymphatic drainage. In this study, we intended to treat vaginitis with the immun system modulating effects of NT. However, we aimed to treat vaginitis by means of the immune system which is regulated with NT. Material and Methods: 25 patients who were admitted to our polyclinic due to vaginal discharge were included in the study. In the patients, procaine was injected intracutaneously into the T11-L2 and S2-S4 dermatomes (urogenital region sympathetic innervation from T11-L2 segments and parasympathetic innervation from S2-S4) segments (including the entire pelvic area as well as the vaginal area) over 3 sessions 1 week apart. Procaine was injected intracutaneously into the relevant site for stimulating the lymphatic system of the lower extremity. At the end of the 1st and 2nd months, the patients were called for check and were asked to give a vaginal culture. Results: When the patients were evaluated at the end of the 1st month, it was observed that the complaints of 23 patients (except for 2 patients) regressed and 17 patients were completely recovered. When the vaginal culture results of the patients were evaluated, it was determined that 16 patients had negative culture results. It was observed that mucosal hyperemia and fragility present in the patients were completely regressed and improved. When the patients were evaluated at the end of the 2nd month, it was determined that 19 patients had negative culture results. Conclusion: In conclusion, the treatment of vaginitis is vaginal flora regulation. In the lower urogenital tract where parasympathetic innervation is dominant, NT allows vaginal flora regulation and the treatment of vaginitis. The purpose of neural therapy is to regulate the perfusion and innervation of the vaginal mucosa and to provide lymphatic drainage. NT is a regulatory therapy. It may become an effective method in the treatment of vaginitis by regulating both the perfusion and innervation of the vaginal mucosa.

Place of Neural Therapy in Neuropathic Vulvar Neuralgia

The Impact of Anemia on Sleep Quality in 15-49 Years Old Women

Evaluation of Dry Eye Parameters and Meibomian Gland Morphology in Patients Who Underwent Transcutaneous Levator Resection

Objective: To evaluate dry eye parameters and meibomian gland morphology in patients who underwent transcutaneus levator resection. Material and Methods: Twenty one eyes of 11 patients who underwent transcutaneus levator resection between January 2015-March 2015 at Haydarpasa Numune Training and Research Hospital Ophthalmology Clinic were included in this prospective study. Patients younger than 18 years old, except for aponeurotic ptosis, past eyelid surgery or trauma cases were not included. In addition to routine ophthalmologic examination, Schirmer 1 test, tear break up time (TBUT) and meibography (Sirius CSO corneal topography) was performed preoperatively and postoperative 1th month. Results: Seven of the 11 patients were male (64%). Mean age was 56.10±8,03. Preoperative mean Schirmer 1 test was 18,76 ± 4,69 mm and postoperative 1th month was 15,90±4,07 mm. Preoperative mean TBUT was 5,57±1,89 sec and postoperative 1th month was 7.05±2.20 sec. The preoperative mean area loss in the upper eyelid meibography was 33.75±8.43%, whereas in the postoperative 1th month 34±9.67%. The preoperative mean area loss in the lower eyelid meibography was 22,05±5,05%, whereas in the postoperative 1th month 21,94±6,57%. Conclusion: Schirmer 1 test results were significantly lower at postoperative 1th month after transcutaneus levator resection. TBUT was <10 sec in both preoperative and postoperative 1th month. No significant changes was observed in the upper and lower eyelid meibomian gland area loss. Our study indicate that transcutaneus levator resection may cause dry eye without affecting meibomian gland morphology in the early postoperative period.