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Öğe Meperidine versus valethamate bromide in shortening the duration of active labor(Elsevier Ireland Ltd, 2009) Yilmaz, Bulent; Kart, Cavit; Kelekci, Sefa; Gokturk, Umut; Sut, Necdet; Tarlan, Nurten; Mollamahmutoglu, LeylaObjective: To compare the efficacy and safety of meperidine hydrochloride and valethamate bromide against placebo in shortening the duration of active labor. Method: We randomly assigned 160 nulliparous women with a singleton pregnancy at term who needed induction of labor to one of 3 treatments: 50 mg of meperidine (n = 53), 16 mg of valethamate bromide (n = 53), or a normal saline solution as placebo (n = 54). All medications were given by slow intravenous infusion. Labor duration was the main outcome measure. Results: The intervals between infusion and complete cervical dilation and between infusion and delivery were significantly reduced (P<0.001 and P<0.01) in the meperidine group (103.0 +/- 64.5 minutes and 119.8 +/- 70.2 minutes), in contrast to the placebo group (173.9 +/- 74.8 minutes and 192.2 +/- 82.8 minutes). However, differences were not significant between the 2 treatment groups (139.6 +/- 63.1 minutes and 160.6 +/- 71.9 minutes), or between the valethamate bromide and the placebo group. Conclusion: Meperidine, but not valethamate bromide, significantly shortened the duration of active labor in nulliparous women with a singleton pregnancy at term. (C) 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.Öğe Metformin and atorvastatin reduce adhesion formation in a rat uterine horn model(Reproductive Healthcare Ltd, 2009) Yilmaz, Bulent; Aksakal, Orhan; Gungor, Tayfun; Sirvan, Levent; Sut, Necdet; Kelekci, Sefa; Soysal, SunullahThe aim of the present study was to determine whether atorvastatin and metformin are effective in preventing adhesions in a rat uterine horn model. A total of 40 non-pregnant, female Wistar albino rats, weighing 180-210 g, were used as a model for post-operative adhesion formation. The rats were randomized into four groups after seven standard lesions were inflicted in each uterine horn and lower abdominal sidewall using bipolar cauterization. The rats were given atorvastatin 2.5 mg/kg/day, p.o. (10 rats), atorvastatin 30 mg/kg/day, p.o. (10 rats), metformin 50 mg/kg/day, p.o. (10 rats) and no treatment was applied in the control group (10 rats). The animals were killed 2 weeks later and adhesions were scored both clinically and pathologically by authors blinded to groups. One rat in the control group died before the end of the 2 week period. Total clinical adhesion scores regarding extent, severity and degree of adhesions and histopathological findings including inflammation and fibrosis were significantly lower in the metformin (P < 0.001 and P < 0.01, respectively) and atorvastatin 30 mg/kg/day (P < 0.001 and P < 0.01, respectively) groups when compared with control group. Metformin and atorvastatin are both effective for prevention of adhesion formation in a rat uterine horn model.Öğe Moistening of misoprostol tablets with acetic acid prior to vaginal administration for mid-trimester termination of anomalous pregnancy: A randomised comparison of three regimens(Taylor & Francis Ltd, 2010) Yilmaz, Bulent; Ertas, Ibrahim Egemen; Kelekci, Sefa; Sut, Necdet; Mollamahmutoglu, Leyla; Danisman, NuriMethods A total of 118 women requiring second-trimester pregnancy termination were randomly assigned to one of three treatment groups: 400 mu g 3-hourly in group A (n = 39), 600 mu g 6-hourly in group B (n = 39), and 800 mu g 12-hourly in group C (n = 40). Misoprostol tablets moistened with 3 ml of 5% acetic acid were placed into the posterior vaginal fornix. Results The median induction-abortion times in groups A (8 h [range: 3-64]) and B (9 h [4-81]) were significantly shorter (p < 0.01 and p < 0.05, respectively) than in group C (12.5 [3-72]). Moreover, expulsion rates within 24 hours in groups A (92.3%) and B (92.3%) were significantly higher (p < 0.05 in both cases) than that of group C (75%). Expulsion rate within 48 hours, number of tablets used, number of patients with retained placenta and side effects did not differ between groups. Conclusions Misoprostol moistened with acetic acid is effective for second-trimester pregnancy termination when given vaginally 3-hourly, 6-hourly or 12-hourly. The former two regimens are significantly more effective than the latter.Öğe Pimecrolimus 1% cream for pruritus in postmenopausal diabetic women with vulvar lichen simplex chronicus: A prospective non-controlled case series(Taylor & Francis Ltd, 2008) Kelekci, Handan Kiymet; Uncu, Hikmet Gulsen; Yilmaz, Bulent; Ozdemir, Orcun; Sut, Necdet; Kelekci, SefaBackground: Pruritus vulvae may have a variety of causes, such as infections, dermatologic disorders or non-neoplastic/neoplastic vulvar diseases. Objectives: To investigate the efficacy and side effects of topical pimecrolimus 1% cream for pruritus vulvae. Methods: Twelve postmenopausal diabetic women with vulvar lichen simplex chronicus were enrolled in this trial. Each patient was treated with pimecrolimus 1% cream which was applied twice daily in a thin layer to the vulvae for 3 months. Clinical examination and recording of patients' symptoms using a scoring system was performed by the same physician before, after 4 weeks and after 3 months of therapy. Results: All of the patients completed the study. A substantial decrease in pruritus after treatment was reported by the patients at the 4th week (2.17 +/- 0.72, p < 0.01) and 3rd month of treatment (0.42 +/- 0.92, p < 0.001) when compared with the baseline score (3.75 +/- 0.45). Follow-up of the patients after 3 months of treatment showed that complete cure occurred in 10 patients (83.3%) and the pruritus was improved in two (16.7%) patients. Conclusions: Pimecrolimus 1% cream seems to be an effective and safe treatment modality for pruritus in postmenopausal women with vulvar lichen simplex chronicus.Öğe Prematurity: is it a risk factor for striae distensae?(Wiley, 2011) Kelekci, Kiymet Handan; Kelekci, Sefa; Destegul, Emre; Aksoy, Ayhan; Sut, Necdet; Yilmaz, BulentBackground Although the causes of striae distensae (SD) remain to be elucidated, the condition is known to relate to changes in the structures that provide the skin with its tensile strength and elasticity. Objective This study was conducted to evaluate whether premature birth is a risk factor for SD. Methods A total of 15,475 parous women ranging in age from 18-45 years were interviewed between January 2007 and June 2009. After exclusion criteria were applied, a total of 1336 women were included in the study. Group 1 consisted of 1231 women of reproductive age who had been born at term. Group 2 included 105 women of reproductive age who had been born prematurely. The main outcome measure was the prevalence of SD. Results The overall prevalence of SD was 34.6% (462/1336). Mild SD was significantly more common (P < 0.01) in women who had been born prematurely (49.5%) than in women who had been born at term (31.8%). A multivariate analysis using backward stepwise logistic regression analysis identified that height, weight, gravidity, parity and abortion were found to be significantly associated with SD. Conclusions Striae distensae was significantly more common in women who had been born prematurely than in women who had been born at term.