ISSN 1301 - 0883 | E-ISSN: 1309-3886
Eastern Journal Of Medicine - Eastern J Med: 26 (4)
Volume: 26  Issue: 4 - 2021
1.Breast and Cervical Cancer Related Practices of Female Health Care Workers at a Tertiary Hospital in Gaziantep, Turkey
Hatice Tuba Akbayram
doi: 10.5505/ejm.2021.05579  Pages 497 - 503
INTRODUCTION: Breast and cervical cancer are common in women and they are largely preventable. This study was performed to determine the knowledge and practices of female health care workers (FHW) about breast and cervical cancers in a university hospital.
METHODS: This cross sectional study was conducted Gaziantep University Hospital. The data was collected with a questionnaire consisting of 21 questions. Chi-square and logistic regression analyses were used for statistical analyses.
RESULTS: A total 412 women were included in the study. The mean age of the participants was 31.2 ± 7.7 years and 21.4% were doctors, 32.5% were nurses and 46.1% were working in other fields.It was found that 25.5% of the participants did not do breast self-examination (BSE), while 42.2% of them did it irregularly and 32.3% of them did it monthly. “Forgetting, neglect, and not having enough time” (47.1%) were cited as the most frequent reasons for not doing the BSE. 19.7% of the women had clinical breast examinations, 22.1% had breast ultrasound and 8.3% had mammography at least once. The rate of patients who had a Pap smear test was 22.8%. “Finding it unnecessary” (47.6%) was cited as the most significant reason for not having a mammography or a Pap smear test. The percentage of those who had heard about the HPV vaccine was 64.1%, while the rate of those who had had the HPV vaccine was 5.1%.
DISCUSSION AND CONCLUSION: It was concluded that the knowledge and practices on breast and cervical cancer screening methods among FHW need to be improved.

2.The temperament, anxiety and depression status of hemoglobinopathy traits during first trimester of pregnancy
Erol Arslan, Fatma İşlek Uzay
doi: 10.5505/ejm.2021.80090  Pages 504 - 510
INTRODUCTION: To evaluate the temperament, depression, anxiety scores and pain level of first trimester pregnant women with a hemoglobinopathy trait undergoing chorionic villus sampling (CVS).
METHODS: This was a prospective study of pregnant women undergoing CVS between March 2020-January 2021. Sixty pregnant women without preexisting psychiatric illnesses were asked to fill the Temperament Evaluation of Memphis, Pisa, Paris and San Diego – autoquestionnaire (TEMPS-A), Hamilton Anxiety and Beck Depression Inventory. Scores were evaluated before procedure and compared with clinical features such as and parity, history of abortus, employment and education status.
RESULTS: The highest TEMPS-A scores belonged to hyperthymic personality (11.5 ± 3.9). The employed pregnant women had lower scores of depressive (2.6±1.9 vs. 5.6±2.9, p<0.005) and anxious temperament (3.8±2.1 vs. 7.7±4.7, p=0.01) compared with housewives. Likewise university graduated pregnant women had lower scores of depressive (3.3±1.8 vs. 5.6±2.8, p<0.05) and anxious temperament (5.4±4.2 and 7.7 ±4.4, p<0.05) compared with less educated ones. Nearly one of the third pregnant women had moderate to severe depression scores and the mean depression scores were lower in employed women compared with housewives (6.7±2.9 vs. 14.2±4.2, p<0.05) and in university graduated compared with less educated ones (7.3±3.7 vs. 14.6±6.3, p<0.05) respectively.
DISCUSSION AND CONCLUSION: The hyperthymic temperament had higher scores in pregnant women with a hemoglobinopathy trait over other temperament types and this was compatible with general pregnant population. Unemployment and less educated pregnant women required more psychological support since they had higher depression scores as well higher anxious and depressive temperament scores.

3.Interobserver reproducibility of intracranial anatomy assessment during second trimester sonographic scan
Erkan Kalafat, Tuncay Yüce, batuhan aslan, Esra Ozkavukcu, Acar Koc, Feride Söylemez
doi: 10.5505/ejm.2021.83788  Pages 511 - 514
INTRODUCTION: Objective: To evaluate the reproducibility of mid-trimester intracranial anatomy assessment
METHODS: Women undergoing mid-trimester scan (between 18th to 25th gestational weeks) for fetal anatomy assessment were included in the study. Measurements of lateral ventricle (LV), cisterna magna (CM) and transverse cerebellar diameter (TCD) were obtained for reproducibility analyses. Inter-observer reproducibility analysis was made with correlation coefficients.
RESULTS: A total of 162 women were included in the analysis while one woman was excluded from the study due to diagnosis of vermian agenesis. Correlation coefficient (CC) of cisterna magna measurements have shown weak to moderate interclass correlation (r=0.28, P=0.001). Measurements of lateral ventricle have shown moderate to strong interclass correlation (r=0.73, P<0.0001). Transverse cerebellar diameter measurements have shown the best interclass correlation (r=0.88, respectively P<0.0001). Mean difference between different observers were -0.4 mm (95% CI: -3.0 to 2.1 mm), 0.7mm (95% CI: -1.0 to 2.5 mm) and 0.53 mm (95% CI: -2.5 to 3.6 mm) for measurements of cerebellum, lateral ventricle and cisterna magna, respectively. When grouped according to BMI (Over 30 kg/m2 and lower than 25 kg/m2) and presentation (cephalic and breech), there were no differences between groups regarding the prevalence of an absolute difference greater than 1 mm between paired measurements by different observers.
DISCUSSION AND CONCLUSION: Measurements of TCD, LV and CM during mid-trimester scan have good interobserver reliability with the exception of CM measurements. Methods used for measuring these structures have shown good consistency between different BMI categories and different fetal presentations during ultrasound scans.

4.Torg ratio in normal ageing population: no risk of stenosis
Necat Koyun, Mehmet Ata Gökalp
doi: 10.5505/ejm.2021.78889  Pages 515 - 518
INTRODUCTION: Canal/ body or Torg’s ratio has been agreed as a reliable method to detect cervical spinal stenosis. Age changes of cervical canal diameter and the ratio have been seldom analyzed in the cohort of normal adults. Our objective is to undertake the age changes in decades from healthy young to the elderly subjects.
METHODS: Sagittal diameter (SD) of the spinal canal and anteroposterior diameter of the vertebral body (VB) were taken on the lateral cervical radiographs consisting of normal appearance from 104 males and 102 females.
RESULTS: SD showed significant gender differences and insignificant age changes. VB changed with age significantly in both sex, and showed sex difference. Torg ratio was found above 0.9 and changed with age. The ratio also indicated no difference between sexes.
DISCUSSION AND CONCLUSION: The male/female difference declared previously might not be a consistent finding. The present study suggested that bone cervical canal might diminish in normal ageing persons without existence of the cervical stenosis and/or risk of myelopathy. Our findings might be peculiar to our subject group, which need to be confirmed by the further studies.

5.The Effect of Age on Subfoveal Choroidal Thickness in Healthy Subjects
Kamil Yavuzer, Banu Bozkurt, Banu Turgut Ozturk, Suleyman Okudan
doi: 10.5505/ejm.2021.59489  Pages 519 - 525
INTRODUCTION: To assess the normative values of subfoveal choroidal thickness (SFCT) in healthy Turkish subjects using spectral-domain optical coherence tomography (SD-OCT, Spectralis®, Heidelberg Engineering, Germany) and its relationship with age and gender.
METHODS: One hundred sixty-nine emmetropic healthy subjects (84 men; 49.7%, 85 women 50.3%) underwent a detailed ophthalmological examination. The subjects were divided into 5 groups according to age; Group 1 (n = 42): 18-29 years, group 2 (n = 34): 30-39 years, group 3 (n = 33): 40-49 years, group 4 (n = 34): 50-59 years, group 5 (n = 26): 60 years and older.
RESULTS: There were statistically significant differences in mean SFCT values among different age groups (p <0.05). Mean SFCT was highest in subjects under 30 years (364.87 ± 71.24 µm) and lowest in subjects over 60 years (261.25 ± 52.39 µm). There was a statistically significant negative correlation between age and SFCT values (r= -0.52, p< 0.001). Slope of change in SFCT over time in the subjects was -2.59 µm per year. When all subjects were evaluated, the mean SFCT value was 322.73 ± 64.00 µm in men and 310.47 ± 60.11 µm in women (p= 0.34). Except group 4, SFCT did not differ between men and women (p>0.05).
DISCUSSION AND CONCLUSION: SFCT decreases with aging and sex does not seem to alter the measurements. Our normative data according to age groups and gender might be used to demonstrate SFCT changes in various retinal and choroidal diseases in Turkish population.

6.The Effect of Short v.s Long -Term Antibiotic Prophylaxis in Gynecologic Surgery
Ecem Kaya, Onur Kaya, Cemre Celik, Cem Dane
doi: 10.5505/ejm.2021.14042  Pages 526 - 532
INTRODUCTION: This study aimed to investigate the difference between the prophylaxis made with only one or two dose first-generation cephalosporin and at least 3 days first-generation cephalosporin use in the emergence of surgical site infections in patients with vertical abdominal incision.
METHODS: This study was completed retrospectively by examining the file, computer and laboratory results of 91 postoperative patients with median incision who showed a high risk for infection in Haseki Training and Research Hospital Department of Obstetrics and Gynecology between August 2014-May 2015.
RESULTS: In our study, surgical site infection in the short-term perioperative prophylaxis group is 57,1 percent of patients, while in long-term perioperative prophylaxis group this rate is 15,4 percent. In short-term perioperative prophylaxis group, surgical site infections rate were detected significantly higher p (<0,001) than long-term perioperative prophylaxis group.
DISCUSSION AND CONCLUSION: In our study, perioperative prophylaxis with only one or two doses of Cefazolin Na in gynecological or gyneco-oncological operations with median incision, contrary to what was suggested by the guide, were found to be significantly inadequate p (<0,001) versus to the at least three days prophylaxis with Cefazolin Na in the prevention of surgical site infections. However, it was found that perioperative prophylaxis of at least 3 days was sufficient.

7.Gender Mainstreaming Role Preferences and Perceptions of University Students Enrolled at Van School of Health
Selver Karaaslan, Hanim Guler Sahin, Reyhan Orhun, Nizamettin Gunbatar, Abdullah Yesilova, Cem Taylan Erden
doi: 10.5505/ejm.2021.06641  Pages 533 - 542
INTRODUCTION: Investigating university students’ perceptions on the gender roles attributed to men and women in social contexts is highly important for promoting an egalitarian perspective to these gender roles for future generations. This study aimed to investigate the perceptions of undergraduates majoring in midwifery and nursing in school of health on social gender roles.
METHODS: The universe of the cross-sectional study included all the 980 undergraduates enrolled in midwifery and nursing departments in school of health. of these, 648 students including 343 female and 305 male students who consented to participate in the study were included in the study, which accounted for 66.1% of the universe. Data were collected using a survey developed by the researchers.
RESULTS: The results indicated that the students’ views regarding social gender equality were not sufficiently egalitarian and male students held more traditional views compared to female students.
DISCUSSION AND CONCLUSION: As a result of the findings of the study it shows that university students should not only be equipped with basic knowledge about their profession but also their sensitivity about gender equality should be increased.

8.Evaluation of Calcium Hydroxide Removal Efficiency of Different Concentrations and Forms of Sodium Hypochlorite
Esin Özlek, Gizem Kadı
doi: 10.5505/ejm.2021.26989  Pages 543 - 549
INTRODUCTION: Calcium hydroxide could not be fully removed from the root canal regardless of the method or irrigation used. Calcium hydroxide residues remaining in the dentin tubules prevent the penetration of the sealer into the dentin, thereby reducing the bond strength and increasing microleakage. The aim of the present study was to compare different forms of sodium hypochlorite for the removal of calcium hydroxide from root canals.
METHODS: Sixty single-rooted mandibular premolars with single canals were prepared using ProTaper Next file up to size X3. Each root canal was filled with calcium hydroxide using #30 Lentulo (Dentsply, Mailifer, Switzerland) to the working length. Then, cotton pellets were placed over canal orifices and teeth were stored in 100% humidity at a temperature of 37 ̊C for 7 days. Afterwards, the teeth were divided into 4 groups according to the irrigation protocol to be used for the removal of calcium hydroxide (n=10): Group 1,2.5% NaOCI; Group 2,5.25% NaOCI; Group 3,NaOCI gel; Group 4,control. Samples were split longitudinally, photos of halves were taken at 10× magnification and were analyzed using the Corel DRAW Graphics Suite X4 v14.0 (Corel Corporation. CA, USA) software to calculate the percentage of surfaces with residual calcium hydroxide. Chi-square test was used for making comparisons among the groups at a significance level of p<0.05.
RESULTS: There were significant differences between the 2.5% NaOCI solution, 5.25% NaOCI solution, NaOCI gel groups and the control group (p<0.001).
DISCUSSION AND CONCLUSION: Gel form of NaOCI is an appropriate and effective method for removing Ca(OH)2 from the root canals.

9.Prevalence of Facial Dimples among the Ndokwa People in Delta State, Nigeria
ESE ANIBOR, Mabiaku Osaretin Yvonne, OKORO Ogheneyebrorue GODSWILL, Ejiroghene Frank Avwerosuo
doi: 10.5505/ejm.2021.21549  Pages 550 - 554
INTRODUCTION: Facial dimples are profoundly valued because the face is exceptionally visible, and it is a significant outlet for communicating thoughts and feelings.
METHODS: This study adopted an observational cross-sectional study design and was conducted at Obiaruku in Delta State and involved male and female Ndokwas of Delta State. 384 subjects were used and the cluster sampling technique was adopted. Data was collected with the aid of a questionnaire. The questionnaire included the following: age, gender, presence of facial dimples, the pattern of facial dimples, presence of facial dimples among parents of the respondents, pattern of facial dimples among parents of the respondents, and perception towards facial dimples. Data obtained were subjected to Statistical Package for the Social Sciences (SPSS). Chi-square was used to compare the prevalence of facial dimples between the sexes and a p-value lesser than 0.05 was considered to be statistically significant.
RESULTS: Most of the subjects in this study were females (n=196, 51%) while minorities were males (n=188, 49%) and aged 18-23years, followed by 24-29 years, 30-35 years, and 36-40years. The prevalence of facial dimple was 31.8% (n=122). Most of the facial dimples were located in the cheek, followed by the chin.
DISCUSSION AND CONCLUSION: This present study demonstrated a higher prevalence of facial dimples among females than males. Facial dimples can be inherited and the dominant gene is thus responsible for this inheritance pattern.

10.The Correlation Between Female Age and Ovarian Reserve Biomarkers (FSH & AMH) and Its' Effect on The Response to Controlled Ovarian Hyper-stimulation (COS) and Pregnancy Rate Following Intracytoplasm sperm injection ( ICSI )
Wasan Ghazi Alsafi
doi: 10.5505/ejm.2021.48303  Pages 555 - 560
INTRODUCTION: This study aimed to assess the association between female age, ovarian reserve biomarkers, response to controlled ovarian stimulation represented by the dose of gonadotropin stimulation, number and quality of retrieved oocytes, cycle cancellation rate and pregnancy rate in those who undergo ICSI.
METHODS: A total of 126 couples complained of sub-fertility have been evaluated and subjected to COS/ICSI and divided into two groups below and above 35 years old. Assessment of cycle day 2 FSH and AMH, response to COS, cycle cancellation rate, and the pregnancy rate has been performed, and the results compared between both.
RESULTS: The study showed that baseline serum level of FSH and AMH did not differ between groups. Women older than 35 years old needed significantly higher doses of gonadotropin stimulation(mean total dose of r-FSH 2179.4±1222.2 vs 1987.2±947.6, p-value=0.036 and mean total dose of HMG 3122.3±1456.8 vs 2468.7±1454.8, p-value=0.02), produced significantly lower number of oocytes (6.09±4.7 vs 9.8±6.4,p-value=0.0001), and mature oocytes (4.4±3.8 vs 6.7±5.1,p-value=0.005), higher rate of cycle cancellation(17.7% vs 4.6%) and insignificantly lower pregnancy rate(23.5% vs 37.7%, p-value=0.107) following ICSI in comparison with those younger than 35 years old.
DISCUSSION AND CONCLUSION: Age is a significant determinant factor that affects the ovarian reserve, can lead to ovarian aging, and lower the women's fertility rate. Older women exhibit a low response to ovarian stimulation with a higher cancellation rate, produce a small number of oocytes with low quality following COS despite their higher need for large doses of gonadotropin stimulation.

11.Factors Affecting Survıval Analysıs İn Non-Metastatıc Operated Gastric Cancer Patıents
Hayriye Tanin, Nurhan Önal Kalkan
doi: 10.5505/ejm.2021.02170  Pages 561 - 565
INTRODUCTION: To determine the factors that may have prognostic significance by evaluating the clinical data of patients with non-metastatic operated gastric cancer during diagnosis and to determine the effect of these prognostic factors on survival
METHODS: The records of 109 non-metastatic (Stage Ι-ΙΙΙ) and operated for gastric cancer between January 2013 and November 2017 were retrospectively reviewed. Gender, age, Eastern Cooperative Oncology Group performance score of patients (ECOG PS), tumor’s location, macroscopic appearance, histological subtype, invasion depth (pT), metastasis on the lymph node (pN), stage (TNM), and its lymphatic, perineural and vascular invasion conditions were evaluated in terms of prognostic significance and their effects on survival.
RESULTS: 68 of the cases were male, 41 of them were female and the mean age was 58.81 (24-81). In our patients’ clinical staging, there were 15 patients in Stage 1, 36 of them in Stage 2, 58 of them in Stage 3. The disease-free survival time was 79 months in Stage 1 cases, 27 months in Stage 2 cases and 17 months in Stage 3 cases. When the data of the patients were analyzed by univariate analysis, pT (p = 0.003), pN (p = 0.004), stage (TNM), (p = 0.002), ECOG (p = 0.001), perineural invasion (p = 0.010) were found to be independent prognostic factors
DISCUSSION AND CONCLUSION: Determining the prognostic factors in patients is very important to evaluate optimal treatment strategies in gastric cancer. We consider that the prognostic factors that we determined in our study may change the approach to treatment

12.Detection of incidental findings on chest CT scans in patients with suspected COVID-19 pneumonia
İlyas Dündar, Sercan Özkaçmaz, Fatma Durmaz, Leyla Turgut Çoban, Gökhan Aygün, Ramazan Yıldız, Muhammed Bilal Akıncı, Ensar Türko, Saim Türkoğlu
doi: 10.5505/ejm.2021.26428  Pages 566 - 574
INTRODUCTION: This study aimed to evaluate the chest Computed Tomography(CT) scans of COVID-19 suspected patients in the first period of the pandemic, to reveal the frequency of parenchymal-extraparenchymal incidental findings (IFs).
METHODS: Our single-center retrospective observational study was initiated with the approval of the ethics committee. Chest CT records taken during March-August 2020 due to the suspicion of COVID-19 pneumonia were scanned using the imaging archive of our center. The study was conducted with 1540 patients with non-contrast chest CT without prior CT imaging to detect IFs. Histopathological results and clinical-radiological follow-up data of the patients were scanned from medical records.
RESULTS: Of the 1540 patients in our study, 902(58.57%) were male and 638(41.43%) were female, with a mean age of 41.96±17.08(5-92) years. While 248(16.1%) patients had a typical appearance for COVID-19 pneumonia on thorax CT, no findings were found in 1180(76.6%) patients. Except for COVID-19 pneumonia, parenchymal IFs(primary malignant lung lesions, metastatic lesions, benign pathologies) were detected in 73 patients(4.74%) and extraparenchymal IFs(lymphadenopathy, breast lesions, thyroid nodule, bone, liver and kidney lesions...) in 280 patients(18.8%).
DISCUSSION AND CONCLUSION: Our study showed that the number of patients without any findings in terms of COVID-19 pneumonia on CT scans is high. It is understood that CT scans for pneumonia are unnecessary due to radiation exposure and should be used when clinically necessary. However, due to the ability of CT to detect incidental findings, it is also important to define IFs other than pneumonia in patients who underwent chest CT examination during the pandemic.

13.Impact of the First Six Months of the Covid-19 Pandemic on Orthopedic and Hand Trauma Surgery
Abbas Tokyay, Sezai Özkan, Necip Güven, Tülin Türközü, Cihan Adanaş, Mehmet Ata Gökalp, Mehmet Rauf Koç
doi: 10.5505/ejm.2021.60420  Pages 575 - 579
INTRODUCTION: Reduced mobility due to COVID-19 prevention measures caused major changes in the number and types of orthopedic trauma cases. This study aimed to compare the profile of trauma-related general orthopedic surgery and hand surgery cases between the first 6 months of the COVID-19 pandemic and the corresponding periods of previous years in order to determine strategies for managing orthopedic traumas in unusual circumstances such as pandemics.
METHODS: Patients over 18 years old who underwent orthopedic surgery due to trauma were grouped according to surgery date as pre-pandemic group 1 (G1, March 16–September 18, 2018), pre-pandemic group 2 (G2, March 18–September 20, 2019), and the pandemic group (G3, March 19–September 21, 2020).Between-group differences with p<0.05 were considered statistically significant.
RESULTS: The study included a total of 3522 patients: 1351 in G1, 1427 in G2, and 744 in G3. There was a significant decrease in the number of patients in G3 compared to the other groups (p≤0.001), while the number of hand surgeries did not differ significantly between the groups. As a result, the ratio of hand trauma surgeries to general orthopedic traumas was significantly higher in G3 (p <0.05).
DISCUSSION AND CONCLUSION: During the COVID-19 pandemic, there was a decrease in orthopedic trauma surgeries and an increase in hand trauma surgeries. In this period of increased hand traumas, hand surgeons should be encouraged to intervene remotely using technology (telemedicine).

14.Examining Periodic Differences of Suicide Cases with Circular Data Analysis
Yıldırım Demir
doi: 10.5505/ejm.2021.03779  Pages 580 - 588
INTRODUCTION: The aim of this study is to analyze suicide cases with circular data analysis and to compare them with the standard linear analysis method and to guide the implementation of long-term social protective programs.
METHODS: Circular data analysis was used as method. However, standard linear statistics method was also used to compare the results of circular data analysis.
RESULTS: Men constitute 74.91% of 15731 cases included in the study. Disease (39.84%) has been identified as the highest risk factor. Despite having a low concentration, the most suicide occurred in May (9.43%). Furthermore, a significant relationship was found between suicide causes and gender and suicide causes and months (p<0.05). In the analyses performed by circular data analysis, although the mean direction of suicides indicated May 29 (148.11°), suicides spread throughout the year according to circular variance (0.96). It was determined that the mean directions of suicide causes among from 1 April (90.02°) to 19 July (199.69°), so the concentration of suicide was in this interval.
DISCUSSION AND CONCLUSION: However, according to the distribution measures, all causes of suicide, except educational failure, showed a multimodal distribution. It can be stated that at least one sample distribution, mean direction, condensation parameter differs from other sample parameters in terms of itself species (p<0.05). Suicide cases were seen more common among men and during the spring-summer months. It is recommended to take preventive measures according to risk factors in order to prevent suicides, especially in periods determined.

15.Social Appearance Anxiety in Patients with Contact Dermatitis
Faruk Kurhan
doi: 10.5505/ejm.2021.52280  Pages 589 - 594
INTRODUCTION: Contact dermatitis is a dermatological disease that can cause skin lesions on visible and invisible parts of the body. Lesions in the visible parts of the body can negatively affect the body perception of people and cause them to worry about their appearance. The aim of this study was to evaluate the social appearance anxiety of individuals with contact dermatitis lesions on the visible parts of their bodies using the Social Appearance Anxiety Scale and to compare them with healthy controls.
METHODS: A total of 129 patients aged between 18-65 years with a diagnosis of contact dermatitis and 89 healthy controls were included in the study. Patients and healthy controls were asked to fill in Social Appearance Anxiety Scale (SAAS), Hospital Anxiety Depression (HAD) scales, and dermatological quality of life and visual analog scales were applied to the patient group.
RESULTS: In terms of the mean Social Appearance Anxiety Scale (SAAS) scores, the mean SSI score in the patient group was 57.11, while the mean SSI score in the control group was 19.27. Thus, the mean SDSS score of the patient group was found to be considerably higher than the control group (p<0.01). A significant positive correlation was found between SSQ score and VAS score (r=0.282, p<0.05).
DISCUSSION AND CONCLUSION: Lesions appearing in visible places in contact dermatitis patients cause anxiety in individuals due to their appearance. This situation revealed that those with contact dermatitis lesions should receive psychiatric treatment in addition to dermatological treatments.

16.The effectiveness of laparoscopic training box on learning curve in gynecology residents
Erbil Karaman, Hanım Güler Şahin
doi: 10.5505/ejm.2021.59455  Pages 595 - 599
INTRODUCTION: Laparoscopy poses a significant role in routine surgical operations recently. However, it needs a surgical skill and education programs to be applied safely and effectively. The aim of this study was to investigate the impact of laparoscopic training box practice on the learning curve in gynecology residents.
METHODS: The study was conducted over for 6 months at our hospital laparoscopic simulation room. Twenty gynecology residents; aged range of 26 to 35 years, of either sex, who had not to have senior experience on laparoscopy were attended the education program. Each participant was given a list of tasks to perform during the six months of a training program. Each resident were allowed to work on a training box every two days of the week for six months. The baseline and sixth months evaluation scores were recorded. The recommended tasks were as: task 1 (loops and wire), task 2 (pea on a peg), task 3 (post and sleeve), task 4 (wire chaser), task 5 (holding the needle), and task 6(suturing and knot tying). Each task’s time was measured from start to completion and the time was recorded at baseline and the sixth months of the training program.
RESULTS: The mean age of the participants was 28.3±1.8 and 12 were female and 8 were male residents. The mean scores of time taken to perform tasks at baseline evaluation were as follows: task 1 (32±8, second), task 2(34±6, second), task 3(50±10, second), task 4(34±5, second), task 5(60±12, second), task 6(300±100, second). The mean scores of time taken to perform tasks at 6th month of the evaluation were as follows: task 1 (22±4, second), task 2 (18±6, second), task 3 (34±8, second), task 4 (22±4, second), task 5 (40±8, second), task 6(250±50, second). When analyzing the improvement in surgical skill about concerning the time of task completion. There was a statistically significant difference between the baseline and at the 6th months of the training program (p<0.05).
DISCUSSION AND CONCLUSION: The present study confirmed that laparoscopic training box improved the surgical skills of gynecology residents and was found to be effective for improvement of learning curve in the education of minimally invasive surgery practice.

17.Amniocentesis Results of Van and Surrounding Provinces Between 2018 and 2020: a Tertiary Center Experience
Gökçe Naz Küçükbaş, Deniz Dirik, ONUR KARAASLAN, erbil karaman, Ali Kolusarı, Huri Sema Aymelek, ABDULAZİZ GÜL, hanım güler şahin
doi: 10.5505/ejm.2021.10438  Pages 600 - 605
INTRODUCTION: Amniocentesis is one of the safest procedures of prenatal diagnosis. This study aimed to show amniocentesis indications, rate of successful amniocyte culture, complications and outcomes of these pregnancies undergoing prenatal diagnosis in eastern part of Turkey, especially Van province and its nearby.
METHODS: Between 2018 and 2020, 253 patients were referred to our center for amniocentesis and 120 patients giving consent were enrolled from Van and its surrounding provinces. Parametric data was studied by student’s t-test. Mann–Whitney U-test was used in analyzing non-parametric data. Categorical variables were undergone chi-square test.
RESULTS: The most frequent indication was high risk in prenatal screening tests whereas the highest chromosomal abnormality was found in fetuses with abnormal ultrasonographic findings. Overall, 12.5% of fetuses had chromosomal anomaly. The most abundant chromosomal abnormality was Trisomy 21, followed by trisomy 18 and 13. Except one case with amniotic leakage no complications were found. Thirteen pregnancies were terminated whereas one fetus was born with Turner syndrome and one pregnancy resulted with stillbirth
DISCUSSION AND CONCLUSION: In conclusion, fetuses with abnormal ultrasound screening had higher chromosome anomaly diagnosed by amniocentesis and compatible with the literature, amniocentesis is a safe and succesful method of prenatal diagnosis of chromosomal abnormalities. Van and its surrounding provinces showed a high rate of chromosomal anomaly when prenatal diagnosis was done.

18.Exploring the Concurrent Use and Potential Interactions between Prescription Drugs and Health Supplement Products among Patients with Chronic Diseases
Shing Chyi Loo, Chee Ping Chong
doi: 10.5505/ejm.2021.62444  Pages 606 - 617
INTRODUCTION: The concurrent use of prescription drugs and health supplement products (HSP) is a concern among patients with chronic diseases. This study aimed to investigate the concurrent use of prescription drugs and HSP among patients with chronic diseases in suburban and rural area of Sarawak, Malaysia. The potential drug-HSP interactions were also assessed.
METHODS: This was a cross-sectional multicenter study involved seven government districts hospitals. Patients who prescribed with three or more chronic prescription drugs were recruited from the outpatient pharmacy of the hospitals by using convenient sampling. The patients’ perceptions and practices of HSP consumption were assessed by a questionnaire. The patients’ current used of prescription drugs and HSP were also assessed.
RESULTS: A total of 350 patients were recruited in this study and 84 patients (24.0%) found to have actively using HSP. Slightly more than half (55.7%) of the patients perceived that there were potential interactions between HSP and prescription drugs. Nevertheless, 56.0% of the patients never consult their healthcare providers regarding potential drug-HSP interaction. Besides, 54.0% of patients never search for information about the potential interaction. A total of 80 cases of potential drug-HSP interactions were identified. The interactions were mostly involved antihypertensive drugs (66.3%) and antidiabetic agents (17.5%). Vitamin B3 (niacin) (33.8%) and fish oil (omega-3) supplements (26.3%) were the most common HSP involved in the interactions.
DISCUSSION AND CONCLUSION: In conclusion, the patients have lack of awareness regarding potential drug-HSP interactions. Healthcare providers should be alert about the concurrent use of HSP and prescription drugs among the patients.

19.Depression, the severity of bone metastasis, and the number of radiotherapy episodes: are they interlinked?
Armin Hoveidaei, Mehrshad Fekri, Amir Human Hoveidaei
doi: 10.5505/ejm.2021.27167  Pages 618 - 619
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