There is no clinically significant difference between extraperitoneal cesarean section and transperitoneal cesarean on fetal delivery time. Extraperitoneal cesarean reduces postoperative pain, analgesic requirements, and improves oral tolerability.
Objectives: In recent years, lidocaine infusion for pain management during long operations is becoming more widespread in anesthesiology practice. However, only a limited number of studies have reported the intravenous use of lidocaine for short-term interventions. The aim of this study was to investigate the effectiveness of intravenous lidocaine use in pain management during colposcopic cervical biopsy and endocervical curettage (ECC). Material and methods:Patients between the ages of 18 and 65 years with abnormal cytological findings or who were determined to be human papillomavirus (HPV)-positive were included in this randomized double-blind study. The lidocaine group (Group L, n = 30) was intravenously administered 50 mg dexketoprofen + 1.5 mg/kg lidocaine in 10 mL saline for 3 min 30 min before the procedure. The control group (Group C, n = 30) was intravenously administered 50 mg dexketoprofen in 10 mL saline for 3 min, 30 min before the procedure. During the procedure, pain scores were assessed using the visual analogue scale (VAS). In addition, patients, operator satisfaction and duration of procedure were assessed.Results: There were no differences in the demographic data of the groups. Pain scores during biopsy and ECC were significantly lower in Group L than in Group C (p < 0.001). The duration of the procedure was significantly shorter in Group L than in Group C (5.00 ± 0.78 vs 6.12 ± 1.16, respectively; p < 0.001). Patient and operator satisfaction were significantly higher in Group L than in Group C (p < 0.001). Conclusions:Intravenous lidocaine administration can be used as an alternative approach to reduce pain and increase operator and patient satisfaction during colposcopy-directed biopsy and ECC procedures in office settings.
Objective The aim of our study was to evaluate the effect of two different doses of lycopene, an antioxidant, on experimentally induced ovarian ischemia/reperfusion (IR) injury in rat model. Materials and Methods Twenty-four female rats were randomly divided into four groups: sham operation (group 1), 3-hour ischemia, 3-hour reperfusion (IR) (group 2), and IR + 100 mg/kg lycopene (PO) (group 3), IR + 200 mg/kg of lycopene (group 4). The rats’ superoxide dismutase (SOD), myeloperoxidase (MPO) activities, malondialdehyde (MDA), and glutathione (GSH) levels were calculated. Ovarian tissue damage was assessed using a histopathological scoring system. Results Serum parameter levels and histological scores showed that treatment with lycopene may be conservative approach to prevent IR injury after the ovarian detorsion procedure.The improvement with lycopene was higher at 200 mg than at 100 mg. The MPO and MDA values were significantly lower in groups 3 and 4 as compared with group 2 (p < 0.05), whereas the MPO and MDA values were lower in group 4 as compared with group 3.The SOD and GSH values were significantly higher in groups 3 and 4 as compared with group 2 (p < 0.05), whereas the SOD and GSH values were higher in group 4 as compared with group 3.Tissue damage scores were elevated in the IR group compared with the sham group, but the treatment with different lycopene doses after reperfusion improved the histopathological tissue damage scores. Conclusion The results showed that lycopene treatment reduced ovarian IR damage. Antioxidant activity was found to increase in a dose-dependent manner. Lycopene treatment may be conservative approach for ovarian torsion patients after the detorsion procedure to prevent IR damage.
We investigated the effects of stem cell therapy as an alternative to surgical methods and medical treatments in endometrial injuries in Asherman syndrome (AS). Materials and Methods: In this study, AS model was created chemically in rats. The bone marrow-derived mesenchymal stem cells isolated from the tibia and femoral bone of male individuals of the same species (BMDSC) were given to female rats with asherman syndrome and the changes in the endometrium were evaluated by histopathological parameters. Asherman + medium, Asherman + niche, Asherman + BMDSCs, Asherman + BMDSCs + niche were formed in four groups. Results: It was observed that increased endometrial thickness, gland count and vascularization and decreased fibrous areas and apoptotic cell death with regeneration in epithelium and lamina propria in treatment groups. No histopathologic changes were observed in the right uterine horns, which were evaluated as control group. . Conclusion: BMDSCs and Niche applications can contribute to the clinic by reducing the formation of adhesion within the mechanisms causing infertility. These positive results are promising in terms of transporting Asherman studies to the clinic.It has been shown that BMDSCs and Niche may contribute to the clinic by treatment with adhesion molecules in mechanisms that cause infertility. Amaç: Bu çalışmada Asherman sendromundaki (AS) endometriyal hasarlarda cerrahi yöntemlere ve medikal tedavilere alternatif olarak kök hücre tedavisinin etkileri araştırılmıştır. Gereç ve Yöntem: Bu çalışmada sıçanlarda AS modeli kimyasal olarak oluşturuldu. Aynı türün erkek bireylerinin tibia ve femur kemiğinden izole edilen kemik iliği kaynaklı mezenkimal kök hücreler (KİMKH) AS oluşturulan dişi sıçanlara verilerek endometriyumda meydana gelen değişiklikler histopatolojik parametrelerle değerlendirildi. Asherman+ besiyeri, Asherman+ niş, Asherman+ KİMKH, Asherman+ KİMKH+ niş olmak üzere toplam dört grup oluşturuldu. Bulgular: Tedavi gruplarında epitel ve lamina propriyadaki rejenerasyonla birilkte endometriyal kalınlığın, bez sayısının ve vaskülarizasyonun arttığı, fibröz alanların ve apoptotik hücre ölümünün azaldığı gözlenmiştir. Kontrol grubu olarak değerlendirilen sağ uterin hornlarda ise her hangi bir histopatolojik değişiklik görülmemiştir. Sonuç: KİMKH ve Niş uygulamalarının, infertiliteye neden olan mekanizmaların içerisinde yer alan adezyon oluşumunu azaltarakedavi ile kliniğe katkı sağlayabileceği gösterildi. Bu olumlu sonuçlar Asherman çalışmalarının kliniğe taşınabilmesi açısından ümit vericidir.
Development of ovarian hyperstimulation syndrome (OHSS) is very rare in a spontaneous ovulatory cycle and it is usually seen during pregnancy. In the etiology of OHSS, higher hCG (molar pregnancies or multiple pregnancies) and thyroid-stimulating hormone (TSH) levels have been accused. In recent years, some follicle-stimulating hormone (FSH) receptor (FSHR) gene mutations have been described in patients with OHSS in the first trimester with normal hCG levels. Herein, we report two cases of FSHR gene mutation during the investigation of the etiology of spontaneous OHSS. Although OHSS is typically associated with ovulation induction, it should be kept in mind that this condition may also develop in spontaneous pregnancies.
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