Notes

Searching for an optimal dosing regimen pertaining to OZ439/DSM265 mix treatments for treating simple falciparum malaria.
When physicians, nurse practitioners, and physician assistants transition from a community setting to a university-based academic environment during mid-career, it can be challenging. Strategic planning is needed to ensure success. Institutions can assist experienced providers making such a transition, and there are steps the provider can take to self-advocate. As a group of four medical professionals who began their careers in patient care community practices for up to 18 years before transitioning to an academic medical center, we have had to navigate an unfamiliar landscape. We collectively offer our tips for a successful mid-career transition to academic medicine.Female hypospadias is a very rare congenital anomaly and its impact on fertility has not yet been clearly defined. A 21-year-old woman with hypospadias was admitted with secondary infertility, dyspareunia, and urge symptoms. She was successfully treated with vaginal flap urethroplasty and broad spectrum antibiotics. Postoperatively, her symptoms resolved and she conceived spontaneously and aborted at her 17th gestational week following premature rupture of membranes suggesting infection. She then conceived spontaneously again and delivered a healthy term baby 30 months after the operation. Female hypospadias may cause chronic pelvic infections, urge symptoms, sexual dysfunction, hence infertility with time. After achieving normal anatomy by vaginal flap urethroplasty, treatment of chronic infections allows restoring normal urologic and sexual functions, and fertility.
Evidence for the use of lung ultrasound scan (LUS) examinations in coronavirus 2019 pneumonia is rapidly growing. The safe and non-ionizing nature of LUS drew attention, particularly for pregnant women. This study aimed to contribute to the interpretation of LUS findings in pregnant women for the obstetricians.

LUS was performed to pregnant women suspected of or diagnosed as having Severe Acute Respiratory syndrome coronavirus-2 (SARS-CoV-2) in the first 24 hours of admission. Fourteen areas (3 posterior, 2 lateral, and 2 anterior) were scanned per patient for at least 10 seconds along the indicated anatomical landmarks. The scan was performed in supine, right-sided and left-sided positions, respectively. Each area was given a score between 0 and 3 according to the specific pattern.

In this study, 21 still images and 21 videoclips that enabled dynamic and real-time evaluation were provided. Pleural line assessment, physiologic A-lines, pathologic B-lines, light beam pattern, white lung pattern, and specific patterns for quick recognition and evaluation are described.

The potential advantages and limitations of LUS and its areas of use for obstetricians are discussed. LUS is a promising supplementary imaging tool during the SARS-CoV-2 pandemic. It is easy to perform and may be feasible in the hands of obstetricians after a brief didactic course. It may be a firstline imaging modality for pregnant women.
The potential advantages and limitations of LUS and its areas of use for obstetricians are discussed. LUS is a promising supplementary imaging tool during the SARS-CoV-2 pandemic. It is easy to perform and may be feasible in the hands of obstetricians after a brief didactic course. It may be a firstline imaging modality for pregnant women.
Upper extremity complaints are frequently encountered in breast cancer. It was aimed to investigate the pain, extremity pain, and limitation of motion, lymphedema prevalence, severity, risk factors and quality of life in patients with breast cancer followed by mastectomy in our center.

The study included 67 patients with mastectomy. The presence of lymphedema, lymphedema duration, and grade of lymphedema were recorded. Grip strength was measured on both hands using a dynamometer; arm, shoulder and hand problems were evaluated using the disabilities of the arm, shoulder, and hand. Quality of life was assessed using the World Health Organization Quality of Life scale-short form.

The presence of lymphedema was 23.9%; the most common was international society of lymphology grade 1 (76.1%); the median lymphedema duration was 12 (range, 3-72) months. Radical/modified radical mastectomy (58.2%) was the most common type of surgery. Median pain score in the affected extremity according to the visual analogue scale was 2 (minimum 0/maximum 7); the presence of shoulder pain was 40.3%; shoulder movement limitation was 7.5%.

It was found that lymphedema had a negative effect on quality of life by affecting shoulder, arm, and hand functions even in the early stages. The recognition of risk factors and signs of upper extremity complications in breast cancer survivors will contribute to rehabilitation success.
It was found that lymphedema had a negative effect on quality of life by affecting shoulder, arm, and hand functions even in the early stages. The recognition of risk factors and signs of upper extremity complications in breast cancer survivors will contribute to rehabilitation success.
Morbid obesity is identified as patients with a body mass index more than 40 kg/m
. Obesity is known as a risk factor for endometrial cancer due to the increase of the deposited estrogen. This study was conducted to evaluate the effect of morbid obesity on the survival of endometrial cancer.

The archival records and pathologic reports of patients with endometrial cancer who underwent surgery and were followed up in Çukurova University Gynecologic Oncology Center between January 1996 and December 2018 were reviewed, retrospectively. Data regarding body mass index and survival was reported in 520 patients. These patients were stratified into two groups according to their body mass index, <40 and ≥40 kg/m
. The groups' clinic, pathologic features, and survival rates were compared.

There were 146 patients in the morbidly obese group and 374 patients in the obese group. The mean age of the groups was 58.5 and 56.2 years, respectively. The mean follow-up time was 51.6 months. Comorbidities were significa those who had body mass index less then 40 kg/m2. It is important to deal with the frequent comorbidities in this special group, which could be simply altered by lifestyle changes. Morbidly obese patients with endometrial cancer should be encouraged in lifestyle changes and consulted by dieticians and endocrinologists.
To estimate the exact incidence of trocar site hernia (TSH) through sonographic examination and to evaluate the predisposing risk factors of TSH.

Three hundred patients who underwent laparoscopic surgery for benign gynecologic indications were included in this study and called back for a follow-up visit. All patients underwent an ultrasound evaluation for the detection of TSH. Risk factors for TSH formation were investigated.

Twenty-five (8.3%) TSHs were diagnosed among 300 postoperative laparoscopies. selleckchem The highest rate of TSH development among the surgeries was found in tubal ligation cases with 19%. Parity ≥3 [odds ratio (OR), 3.13; 95% confidence interval (CI) 1.21-8.09; p=0.018], and not closing fascia (OR 6.74; 95% CI 2.72-16.70; p<0.001) were statistically significant risk factors for the development of TSH in multivariate analysis.

The prevalence of TSH is higher than previously reported, and ultrasonographic examination is adequate for detecting subclinical types of this complication.
The prevalence of TSH is higher than previously reported, and ultrasonographic examination is adequate for detecting subclinical types of this complication.
To reveal the characteristics and prevalence of dysmenorrhea and Premenstrual syndrome (PMS) among college students and to investigate their impact on their academic performance.

This cross-sectional study was conducted between December 2017 and January 2018 at Koç University, Turkey. An online survey that included multiple-choice and short paragraph questions was prepared. Female students aged between 18 and 27 years were invited with an email to provide online informed consent to proceed to the survey.

The final analysis included 352 students. The prevalence of dysmenorrhea was found as 90.1%. Fifty-six percent of the participants reported lower academic performance during menstruation. However, only 32.8% of the students with dysmenorrhea presented to the gynecology clinic. The prevalence of PMS alone and with dysmenorrhea was 71.3% and 65.9%, respectively. The most common symptom among those who reported affected academic performance was depression (prevalence of 27.5%). However, only 19.9% of students with PMS consulted a healthcare professional.

Symptoms of dysmenorrhea and PMS are generally neglected by students. Quality of life can be affected more than estimated. Considering the reluctance to disclose menstrual disorders, health care providers should be aware of them and ask women about their symptoms during routine visits.
Symptoms of dysmenorrhea and PMS are generally neglected by students. Quality of life can be affected more than estimated. Considering the reluctance to disclose menstrual disorders, health care providers should be aware of them and ask women about their symptoms during routine visits.
To compare spinal anesthesia (SA) with general anesthesia (GA) in gynecologic laparoscopic surgery regarding anesthetic parameters and patient satisfaction together with an assessment of total oxidant, antioxidant levels, and Oxidative Stress index (OSI).

Sixty patients who were planned to undergo gynecologic laparoscopy were randomized into group G (GA) and group S (SA). Demographics, adverse events and anesthetic parameters were recorded before induction, after induction, and at the 5
, 10
, 15
, 30
, 60
, 90
, and 120
minutes. Patients and surgeons completed questionnaires. Total antioxidant capacity (TAC), total oxidant level (TOL), and OSI were measured.

There was no difference between the groups in terms of hemodynamic parameters except heart rate at 30
minute and mean arteral pressure at 10
, 15
, 30
, and 60
minute (p<0.05). The postoperative arterial blood pH value was lower in group S (p=0.021). Intraoperative hypotension was lower in group S (p=0.038). There was more intraoperative hypotension in group S when compared with group G (p=0.038). Postoperative analgesic consumption was higher and onset of postoperative pain was shorter in group G (p=0.001 for both). There was no difference between the groups in terms of patient and surgeon satisfaction. There was no difference in terms of TAC, TOL, and OSI between the groups (p=0.862, p=0.940, and p=0.728, respectively).

SA may become a reliable alternative to GA in gynecologic laparoscopy when hemodynamic and respiratory parameters, patient and surgeon satisfaction, as well as total oxidant, antioxidant levels, and OSI are considered.
SA may become a reliable alternative to GA in gynecologic laparoscopy when hemodynamic and respiratory parameters, patient and surgeon satisfaction, as well as total oxidant, antioxidant levels, and OSI are considered.
Many reconstructive surgical procedures have been described for vaginal agenesis. Almost all are surgically challenging, multistage, time-consuming or leave permanent scars on the abdomen or skin removal areas. The aim of this study was to introduce a simple and cheaper approach for laparoscopic vaginal bead-pull through.

In this retrospective study, we report a total of six patients with congenital absence of vagina [Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome] who were treated with a laparoscopic vaginal bead pull-through technique between 2018 till 2019 with a dental prosthesis material.

Six patients with MRKH syndrome were treated with a laparoscopic vaginal bead pull-through technique. None of the women had any previous treatment. The mean age at the time of surgery was 18.7±3.1 years and mean body mass index was 25 (range, 19-38) kg/m
. None of the patients had any additional malformations. In all patients, normal external genitalia and complete vaginal agenesis were observed during examination.
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