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Yavuz M.S.,Duatepe Polatli State Hospital | Kazanci D.,Turkiye Yuksek Ihtisas Education and Research Hospital | Turan S.,Turkiye Yuksek Ihtisas Education and Research Hospital | Aydinli B.,Turkiye Yuksek Ihtisas Education and Research Hospital | And 3 more authors.
BioMed Research International | Year: 2014

Introduction. Postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy operations still continue to be a serious problem. Intravenous fluid administration has been shown to reduce PONV. Some patients have higher risk for PONV described by APFEL score. In this study, our aim was to determine the effects of preoperative intravenous hydration on postoperative nausea and vomiting in high Apfel scored patients undergoing laparoscopic cholecystectomy surgery. Patients and Methods. This study is performed with 50 female patients who had APFEL score 3-4 after ethics committee approval and informed consent was taken from patients. The patients were divided into 2 groups: group 1 (P 1): propofol + preoperative hydration and group 2 (P2): propofol + no preoperative hydration. Results. When the total nausea VAS scores of groups P1 and P2 to which hydration was given or not given were compared, a statistically significant difference was detected at 8th and 12th hours (P=0.001 and P=0.041). It was observed that in group P 1, which was given hydration, the nausea VAS score was lower. When the total number of patients who had nausea and vomiting in P1 and P2, more patients suffered nausea in P2 group. Discussion. Preoperative hydration may be effective in high Apfel scored patients to prevent postoperative nausea. © 2014 M. Selçuk Yavuz et al. Source

Kerimoglu O.S.,Selcuk University | Ercan C.M.,Gulhane Military Medicine Faculty | Keskin U.,Gulhane Military Medicine Faculty | Korkmaz C.,Gulhane Military Medicine Faculty | And 2 more authors.
Archives of Gynecology and Obstetrics | Year: 2013

Purpose: This study aims to determine whether a low dose of the gonadotropin releasing hormone antagonist, cetrorelix, prevents a premature luteinizing hormone (LH) surge and affects in vitro fertilization (IVF) outcomes compared to the standard dose of 0.25 mg/day. Methods: In this study, 45 IVF/intracytoplasmic sperm injection patients were stimulated with recombinant follicle stimulation hormone from day 2 of the cycle. Cetrorelix was injected daily from day 6 of gonadotropin administration. Twenty-two patients received cetrorelix at a dose of 0.25 mg/day, whereas 23 participants received half dose. Results: The mean consumption of gonadotropins was significantly higher in patients receiving 0.25 mg/day of cetrorelix (2,213 vs. 1,350 U; p = 0.046). The clinical pregnancy rates were similar in both groups (31.8 vs. 47.8 %; p = 0.273). Premature LH surge was detected in 9.1 % of the patients receiving cetrorelix 0.25 mg/day and in 13 % of the patients receiving cetrorelix 0.125 mg/day (p > 0.05). The difference between two groups was not statistically significant (p > 0.05). ConclusIons: Our results suggest that there is no difference between a cetrorelix dose of 0.125 or 0.25 mg/day in preventing premature LH rise during ovarian stimulation for IVF. © 2013 Springer-Verlag Berlin Heidelberg. Source

Ercan C.M.,Gulhane Military Medicine Faculty | Kerimoglu O.S.,Selcuk University | Sakinci M.,Akdeniz University | Korkmaz C.,Gulhane Military Medicine Faculty | And 2 more authors.
European Journal of Obstetrics Gynecology and Reproductive Biology | Year: 2014

Objective: To present our in vitro fertilization outcomes after implementation of the Turkish government policy limiting the number of transferred embryos to one, in women under the age of 35, and two, in women over age 35; and to demonstrate the feasibility of this policy. Study design: We retrospectively reviewed the records of 423 patients who underwent ovarian stimulation, oocyte pick-up, intracytoplasmic sperm injection and embryo transfer due to primary or secondary infertility over a 22-month time interval. Clinical pregnancy was defined as a fetal heartbeat in the seventh gestational week. Embryo transfers were carried out on day 3 or 5. Descriptive statistics are given as the number of subjects and percentages. Results: A total of 353 embryo transfers were performed: 261 (73.9%) were single-embryo transfer (244 (69.1%) elective and 17 (4.8%) non-elective) and 92 (26.1%) were double-embryo transfer. Of the 244 elective single-embryo transfers, 6.6% (n = 16) were performed using frozen-thawed embryos. The average patient age was 29.6 ± 4.5 years in the single-embryo group and 36.5 ± 2.4 years in the double-embryo group. The cumulative pregnancy rates per oocyte pick-up were similar in both groups: 41% (n = 107) in the single-embryo group and 43.4% (n = 40) in the double-embryo group (p = 0.678). The cumulative live birth rate of the single-embryo group (32.1%) was not statistically different from the double-embryo group (35.8%) (p = 0.518). The twin pregnancy rate after single-embro transfer was significantly lower than with double-embryo transfer (2.8% (n = 3) vs. 32.5% (n = 13); p < 0.001) and 62.5% of the twin pregnancies occurred in women 35 years or older who underwent double-embryo transfer. No significant difference in the spontaneous abortion rates was recorded between the single- and double-embryo transfer groups (16 (6.1%) vs. 6 (6.5%); p = 0.894). Conclusion: Single-embryo transfer results in a pregnancy rate comparable to double-embryo transfer, with a significantly reduced multiple pregnancy rate. Double-embryo transfer in patients over age 35 should be reconsidered because of the resulting high rate of multiple pregnancy. © 2014 Elsevier Ireland Ltd. All rights reserved. Source

Gokcil Z.,Gulhane Military Medicine Faculty | Ipekdal H.I.,Gulhane Military Medicine Faculty | Ulas U.H.,Gulhane Military Medicine Faculty | Odabasi Z.,Gulhane Military Medicine Faculty
Neurologist | Year: 2010

Objectives: Hot water epilepsy (HWE) or bathing epilepsy is one of the reflex epilepsies induced by hot water pouring over the head, face, neck, or trunk during bathing. The aim of this study was to demonstrate the clinical and electroencephalographic features and the management alternatives of the patients with HWE. Methods: The age of seizure onset, duration of seizure, family history, interictal and postictal electroencephalography findings, triggering temperature of water, type of seizure, medication, and follow-up results were evaluated for each patient. Results: The mean age at seizure onset was 10.5 years. The mean duration of seizures was 10 years. Interictal EEG recordings showed focal abnormalities in 4 patients and generalized abnormalities in 3 patients. Only one patient had normal interictal EEG findings. Among the 8 patients with HWE, 6 had seizures only during hot bathing, whereas 2 had additional seizures. Seven patients had generalized tonic-clonic seizures and 1 patient had complex partial seizure during their hot bathings. The mean triggering temperature of water was calculated as 41.4°C. The mean duration of follow-up period was 23 months. Five patients became seizure-free during the follow-up period and seizures persisted in 3 patients. Antiepileptic drugs were given (800 mg/d carbamazepine for 2 patients and 600 mg/d phenytoin for 1 patient) to these 3 patients and they also became seizure-free during the follow-up period. Conclusions: Hot water epilepsy is a benign reflex epilepsy. Lowering water temperature must be the first step for the treatment. If needed, antiepileptic drugs should be considered as an additive treatment. Copyright © 2010 by Lippincott Williams & Wilkins. Source

Hacihamdioglu D.O.,Gulhane Military Medicine Faculty | Kibar Y.,Gulhane Military Medicine Faculty | Gul D.,Gulhane Military Medicine Faculty | Kocaoglu M.,Gulhane Military Medicine Faculty | Gok F.,Gulhane Military Medicine Faculty
Turk Uroloji Dergisi | Year: 2012

Herein, an 11-year-old boy is described with giant vesical diverticulum, unilateral renal agenesis and mental retardation. This combination does not fit any known syndromes, and to our knowledge, this is the first report of the association of these features. © 2012 by Turkish Association of Urology. Source

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