Browsing by Author "Karaman, Yasemin"

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Ovarian Torsion in the Normal Ovary: a Diagnostic Challenge in Postmenarchal Adolescent Girls in the Emergency Department
(int Scientific information, inc, 2017) Karaman, Erbil; Beger, Burhan; Cetin, Orkun; Melek, Mehmet; Karaman, Yasemin
Background: Ovarian torsion can be seen in the otherwise-normal ovary and is a challenging issue in the emergency department. The aims were (1) to evaluate and compare the surgically verified ovarian torsion cases in otherwise-normal ovaries and ovaries including a mass or cyst and (2) to investigate whether the normal-appearing ovaries on ultrasound examination affected the diagnosis of ovarian torsion or not. Material/Methods: A retrospective cohort study design was used. The medical records of all postmenarchal adolescent girls with surgically verified ovarian torsion treated in a university hospital from 2010 to 2016 were reviewed. Results: Twenty-nine post-menarchal girls were identified. The subjects were divided into two groups. Eight girls (group 1) had ovarian torsion in a normal ovary, and twenty-one girls (group 2) had ovarian torsion including a mass or cyst. The median ages of group 1 and 2 were 13 and 14 years, respectively. Abdominal pain was the main presenting symptom for all cases in both groups. Doppler flow studies were abnormal in 6/9 (66.6%) in group 1 and 12/21 (57.1%) in group 2. The time from first admission to the operation was statistically longer in group 1 than in group 2 (34.5 +/- 24.3 hours vs. 19.5 +/- 9.2 hours, respectively; p=0.001). The longitudinal axis of uterine size was significantly shorter in group 1 than in group 2 (34.3 +/- 2.9 mm vs. 47.6 +/- 4.5 mm, respectively; p=0.001). Conclusions: Ovarian torsion in adolescent girls can be seen within the otherwise-normal ovary. The normal-appearing ovaries on ultrasound in the emergency department may lead to delay in the diagnosis of ovarian torsion in adolescent girls.
Sonuçlara Etkisi: Bir Olgu Kontrol Çalışması
(2015) Yıldız, Ahmet; Talay, Hasan; Han, Ağahan; Karaman, Yasemin; Taşdemir, Deniz; Karaman, Erbil
Amaç: Bu çalışmada, vücut kitle indeksinin term gebelerde metarnal ve fetal sonuçlara etkisini belirlemeyi amaçladık.Gereç ve Yöntem: Çalışmaya prospektif olgu kontrol çalışması olarak, hastanemiz kadın hastalıkları ve doğum ünitesine başvurmuş ve doğumu hastanemizde gerçekleşmiş olan 37 hafta ve üzeri gebeler dâhil edildi. Çalışmada olgu grubunda vücut kitle indeksi (VKİ) 30 ve üzeri olan 142 gebe ile kontrol grubu olarak aynı gebelik haftalarındaki vücut kitle indeksi 30'un altı olan 158 sağlıklı gebe dâhil edildi. Gruplar, gestasyonel diyabet ve hipertansiyon sıklığı, sigara-alkol bağımlılığı, mekonyumlu amniyon, erken membran rüptürü, doğum şekli, sezaryen endikasyonları, post partum hemogram/hematokritte azalma, post partum enfeksiyon, bebek doğum ağırlığı, omuz distosisi, fetal APGAR skoru, ayrıca maternal fetal neonatal istenmeyen sonuçlar açısından karşılaştırıldı.Bulgular: Normal vücut kitle indeksi olan kadınlarla karşılaştırıldığı zaman, obez gebeler gestasyonel diyabet (p=0,044), hipertansiyon (p=0,0001), sezaryen sıklığı (p=0,001), sefalopelvik uygunsuzluk veya ilerlemeyen eylem nedeniyle sezaryen (p=0,001), hastanede kalış süresi (p=0,01), iri bebek (p=0,01), bebeklerin servis izlemine alınması (p=0,025) ve maternal-fetalneonatal istenmeyen sonuçlarda (p=0,001) istatiksel olarak anlamlı bir artışa sahipti. Her 2 grup arasında sigara/alkol bağımlılığı, erken membran rüptürü ve mekonyumlu amniyon, post partum hemoraji, düşük doğum ağırlıklı bebek doğurma sıklığı, yenidoğan APGAR skoru arasında istatistiksel olarak anlamlı fark bulunmadı.Sonuç: Çalışmamızdan elde ettiğimiz verilere göre maternal obezite gebelik komplikasyonlarının ve fetal-neonatal morbiditenin artmasında önemli bir faktör gibi gözükmektedir.
What Should the Optimal Intrauterine Pressure Be During Outpatient Diagnostic Hysteroscopy? a Randomized
(Wiley, 2017) Karaman, Erbil; Kolusari, Ali; Cetin, Orkun; Cim, Numan; Alkis, Ismet; Karaman, Yasemin; Guler, Seyithan
Aim: The aim of this study was to evaluate and compare lower and higher uterine filling pressures during outpatient diagnostic hysteroscopy. Methods: One hundred and seventy-five women eligible for outpatient diagnostic hysteroscopy were included in this randomized double blind comparative study. The subjects were randomized into two groups. Group 1 (n = 80) underwent surgery with lower intrauterine filling pressures (30, 40, and 50 mmHg) and group 2 (n = 81) underwent surgery with higher filling pressures (70, 80, and 100 mmHg). The primary outcome measure was adequate visibility during the procedure. The secondary outcome measure was pain perceived by the patient during and 30 min after the procedure. Results: In total, 161 patients completed the trial. Group 2 had significantly higher adequate visibility than group 1 (71/80, 88.75% in group 1 and 79/81, 97.5% in group 2, P = 0.008). There was a trend toward increase in pain scores with higher pressures during the procedure. However, there were no significant differences between the two groups in terms of visual analog scale pain scores measured 30 min after the procedure. Conclusion: Lower uterine filling pressure was associated with lower pain scores with a higher trend towards inadequate visibility. It appears that higher filling pressure can be used for performing office hysteroscopy, but it is associated with higher pain scores.