Background:In addition to the pain caused byuterine contractions during labour, continuous and severe back pain is observed in 33% of women. Several pharmacological and nonpharmacological methods are available for managing this pain. Sterile water injection is considered as alternative method for nonpharmacological pain management.Aims:To assess the satisfaction level and effectiveness of sterile water injection for back pain among women in labour.Study Design:Randomized controlled trial.Methods:A total of 168 term, healthy women with labour pain and severe back pain were randomized into the sterile water injection (study) and dry injection (placebo) groups. Injections were applied to the rhombus of Michaelis in the sacral area. Pain scores were assessed at 10, 30, 60, 120, and 180 min using a visual analogue scale. Additionally, the need for epidural analgesia, Apgar score, mode of delivery, time of delivery, maternal satisfaction, and breastfeeding score were assessed.Results:The mean back pain scores at 30 min after injections were significantly lower in the study group (study group: 31.66±11.38; placebo: 75±18.26, p<0.01). The mean decrease in pain scores after 30 min according to baseline was significantly higher in the study group (study group: 54.82±7.81; placebo: 13.33±12.05, p<0.01). The need for epidural analgesia, time of delivery, mode of delivery, and Apgar and breastfeeding scores were similar in both groups. Maternal satisfaction from the analgesic effect was significantly higher in the study group (study group: 84.5%; placebo: 35.7%, p<0.01).Conclusion:The application of sterile water injection is effective for relieving back pain in the first stage of labour and has a sufficient satisfaction level among women.

At laparotomy, a radical hysterectomy was performed. It was reported as ovarian leiomyoma on pathological evaluation. After 15 days of surgery, patient is discharged without any complications and also no more epileptic seizures.

Objective: The purpose of this study was to evaluate the prevalence and connection with hormonal changes of metabolic syndrome and its components in postmenopausal women based on a literature survey. Methods:The medical records of 138 postmenopausal patients were retrospectively reviewed between January 2013 and March 2014. Patients with surgical menopause and those who underwent hormone replacement therapy, chemotherapy, and radiotherapy were excluded. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Patients' demographic data, menopausal status, medical history, and physical examination and clinical laboratory data were analyzed. Data were evaluated statistically.Results: In total, 128 patients were included in this study. The menopausal age of patients in the metabolic syndrome group was 50.06±2.93 and that in the non-metabolic syndrome group was 45.16±4.4 years. The prevalence of metabolic syndrome was observed in 43.4% patients in this study. A statistically significant negative high correlation (p<0.05) was observed between waist circumference and the number of metabolic components with FSH-LH levels. Conclusion:The prevalence of metabolic syndrome among postmenopausal women is high, and abdominal obesity and low HDL levels are strong predictors. These components can lead to an increase in cardiovascular diseases. Thus, it is encouraging to adopt lifestyle changes that reduce the prevalence of metabolic syndrome. (JAREM 2016; 6: 35-9)

Objective: The purpose of this study was to evaluate the results of our experience with 83 patients who underwent total laparoscopic hysterectomy (TLH). Methods:The subjects included 83 patients operated in Gaziosmanpaşa Taksim Training and Research Hospital, Department of Obstetrics and Gynecology. Total laparoscopic hysterectomies were performed for various indications between January 2013 and October 2014. Indications of total laparoscopic hysterectomy, method of operation, intraoperative and postoperative complications, duration of the operation, length of hospital stay, and blood loss in patients who underwent total laparoscopic hysterectomies were retrospectively evaluated.Results: In total, 83 patients were included in our study. The mean age was 49.3 years. The most common indication for total laparoscopic hysterectomy was menorrhagia. The mean body mass index (BMI) was 28.7±4.3. The mean operation time was 132.16±48.5 min, mean hospital stay was 3.38±1.6 days, and mean blood loss was 2 g/dL. The overall complication rate was 6%. Conclusion:Total laparoscopic hysterectomy is a preferred method to abdominal hysterectomy because it is associated with a more favorable surgical outcome. The laparoscopic approach is an acceptable treatment modality in the current gynecological practice. Total laparoscopic hysterectomy is more beneficial to patients because of low estimated blood loss, less analgesia use, low intraoperative and postoperative complication rates, less postoperative pain, more rapid recovery, and short hospital stays. However, the percentage of total laparoscopic hysterectomies is still very low. The longer operation time in total laparoscopic hysterectomy, an unfavorable learning curve, and extensive training of surgeons and the whole surgical team are often cited as reasons. (JAREM 2015; 5: 10-3)