Zeynep Kamil Hospital

To identify the factors associated with postoperative ileus (POI) following Caesarean section. A descriptive study. Place and Duration of the Study: Department of Obstetrics and Gynaecology, Zeynep Kamil Women's and Children's Diseases Training and Research Hospital, Istanbul, Turkiye, between April 2021 and February 2025. A total of 293 women who underwent Caesarean section were evaluated postoperatively. POI was defined as the absence of the first flatus within 24 hours after surgery. Demographic and obstetric characteristics, as well as factors associated with POI, were compared between patients with and without POI. POI developed in 33 patients (11.3%). Multivariate binary logistic regression showed an increased risk of POI with each 1-unit decrease in preoperative haemoglobin level (RR 1.357, 95% CI = 1.029-1.791, p = 0.031) and with intraoperative drain placement (RR 6.433, 95% CI = 2.326-17.792, p <0.001). POI can delay postpartum recovery. Preoperative anaemia, history of POI, and intraoperative drain placement are significant risk factors for POI after Caesarean section. Caesarean section, Ileus, Maternal health, Postoperative complications, Postpartum women.

In cases of sepsis and an excessive inflammatory response, continuous renal replacement therapy (CRRT) has the potential to provide immunomodulation by removing cytokines and inflammatory mediators. This study aimed to evaluate the efficacy of the Oxiris filter, which has endotoxin and cytokine adsorption properties, in the pediatric population and compare it with conventional filters. This retrospective study examined 42 pediatric intensive care patients diagnosed with sepsis or multisystem inflammatory syndrome in children (MIS-C). The patients received CRRT with either Oxiris filters (n = 21) or conventional filters (n = 21). The study compared hemodynamic and laboratory parameters, as well as mortality. The two groups had similar baseline characteristics and disease severity scores (PRISM III, PELOD II, and OFI). Overall mortality rates were comparable between the Oxiris and conventional filter groups (52.4% vs. 57.1%; p = 0.757), whereas 28-day mortality was significantly lower in the Oxiris group (28.6% vs. 61.9%; p = 0.030). Within 24 h, both filters showed comparable improvements in VIS, heart rate, mean arterial pressure (MAP), lactate, bicarbonate, and albumin levels (all p > 0.05); no significant changes were observed in C-reactive protein (CRP) or procalcitonin levels. Subgroup analysis revealed a more pronounced VIS reduction (p = 0.013), less adequate acidosis correction (p = 0.022), and higher PELOD-II scores (p = 0.026) among non-survivors. Thrombocytopenia was the most common complication, with no difference between the two groups. In critically ill pediatric patients, Oxiris and conventional filters produced comparable short-term hemodynamic, metabolic, and inflammatory effects during CRRT. While overall mortality did not differ between the groups, 28-day mortality was lower in the Oxiris cohort. Further multicenter, prospective research is warranted to confirm these findings and to identify specific pediatric subgroups that may benefit from Oxiris therapy.

Letrozole and other aromatase inhibitors are increasingly recognized as first-line ovulation induction (OI) medications, offering an efficient and physiologic approach to ovarian stimulation that enhances outcomes in reproductive medicine. By selectively inhibiting aromatase and maintaining lower peripheral estrogen levels, letrozole supports mono- or bi-follicular development while reducing the risk of supraphysiologic estradiol exposure seen with traditional gonadotropin regimens. These pharmacological characteristics have contributed to its expanding use not only in OI but also in various assisted reproductive technologies. To evaluate the clinical benefits, effectiveness, and safety of using letrozole in in vitro fertilization (IVF), in vitro maturation (IVM), and OI, with particular attention to reproductive outcomes, ovarian response, endometrial effects, cycle characteristics, and treatment-related adverse events. A comprehensive systematic search covering the period from December 2000 to November 2025 was conducted across major electronic databases including PubMed, Embase, the Cochrane Library, and Google Scholar. The search strategy incorporated predefined keywords related to letrozole, aromatase inhibition, OI, IVF, and IVM. Studies involving randomized controlled trials, observational cohorts, and meta-analyses were included, while non-clinical and non-reproductive data were excluded. Relevant outcomes were extracted and synthesized qualitatively. Letrozole demonstrates broad clinical utility in reproductive medicine, spanning assisted reproductive techniques, ovarian stimulation strategies, and the management of ovarian hyperstimulation syndrome risk, ectopic pregnancy, and endometriosis-related infertility. Its targeted estrogen suppression, cost-effectiveness, and favorable safety profile make it a valuable component of individualized treatment protocols. Nonetheless, further high-quality research is required to refine optimal dosing strategies, identify ideal patient populations, and clarify long-term reproductive and obstetric safety.

Background and Objectives: To evaluate the impact of gonadotropin-releasing hormone agonist (GnRHa) triggering compared to human chorionic gonadotropin (hCG) triggering on frozen–thawed and fresh embryo transfer outcomes in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization (IVF). Materials and Methods: This retrospective cohort study analyzed 267 IVF cycles of 261 PCOS patients treated with GnRH antagonist protocols. Patients were divided into three groups: GnRHa-triggered frozen–thawed embryo transfer (ET) (n = 126), hCG-triggered frozen–thawed ET (n = 68), and hCG-triggered fresh ET (n = 73). Baseline characteristics, stimulation parameters, and cycle outcomes were compared between groups. A binary logistic regression analysis was established to identify independent predictors of clinical pregnancy. Results: The GnRHa-triggered group had significantly higher numbers of retrieved oocytes, mature (MII) oocytes, and fertilized oocytes compared to both hCG-triggered groups (p < 0.001). The number of obtained embryos and frozen embryos (good-quality embryos) was highest in the GnRHa group (p < 0.001). However, clinical pregnancy rates were comparable between the groups with a similar number and grade of transferred embryos (32.53%, 38.23%, and 32.87%, respectively). Multivariate regression analysis revealed that the grade of the transferred embryo was a significant predictor of clinical pregnancy (p = 0.034). Conclusions: This study provides insights into different triggering strategies for final oocyte maturation in PCOS patients. GnRH-agonist-triggered frozen–thawed cycles showed comparable clinical pregnancy outcomes to those of hCG-triggered cycles, with a potentially lower OHSS risk. The findings suggest that individualized triggering approaches based on patient characteristics and OHSS risk may be beneficial for PCOS patients undergoing IVF.

ABSTRACT Objective To evaluate indications, clinical response, outcomes, and tolerability of intravenous immunoglobulin (IVIG) therapy in patients with juvenile dermatomyositis (JDM) in a multicenter cohort. Methods This retrospective multicenter study included 29 patients with JDM who received IVIG. Demographic data, clinical features, laboratory parameters, and standardized disease activity scores were recorded at disease onset, before and after IVIG treatment, and at final follow-up. Treatment response and adverse events were analyzed. Results IVIG was initiated a median of 1.2 months (IQR: 0.1–18.9) after diagnosis and continued for a median of 8.2 months (IQR: 5.6–21.6). Indications included refractory muscle weakness, persistent skin disease, calcinosis, and interstitial lung disease (ILD). IVIG therapy was associated with significant improvements in disease activity measures and laboratory parameters (p < 0.001). Calcinosis partially or completely resolved in 3 of 6 patients, while no change was observed in the single ILD case. IVIG was well tolerated, with only mild adverse effects. Conclusion IVIG appears to be a safe and effective treatment option for JDM, particularly in refractory or skin-predominant disease. Although causal inferences are limited by the retrospective design and the absence of a control group, these real-world findings support the inclusion of IVIG in an individualized treatment approach.

Objective: To compare intraocular pressure (IOP) measurements obtained using the Easytone Transpalpebral Tonometer (ETT) with the Icare 200 (IC200), Tonopen AVIA (TPA), and Goldmann Applanation Tonometer (GAT) in healthy individuals. Methods: Fifty-eight right eyes of 58 healthy volunteers underwent IOP measurement with all four devices. Three consecutive readings were taken per device and averaged. Two masked observers performed all measurements. Agreement was assessed using intraclass correlation coefficients (ICCs) and Bland–Altman analysis, and repeated-measures ANOVA compared mean IOP values. Results: Mean IOP values were 15.18 ± 1.88 mmHg (ETT), 14.45 ± 2.24 mmHg (TPA), 13.38 ± 2.65 mmHg (IC200), and 14.33 ± 2.03 mmHg (GAT) (p < 0.001). ETT provided significantly higher values than IC200, TPA, and GAT, while IC200 underestimated IOP compared with TPA and GAT. No difference was observed between TPA and GAT. Inter-observer agreement was excellent (ICC 0.805–1.000). Agreement analysis showed weaker ICC values for ETT–TPA (0.642) and ETT–IC200 (0.615). Bland–Altman plots confirmed the closest agreement between GAT and TPA, and the poorest agreement between ETT and IC200. Conclusions: ETT tends to overestimate and IC200 to underestimate IOP compared with GAT. TPA demonstrated the closest agreement with GAT and may be the most reliable alternative in clinical practice. ETT can be useful when applanation is not feasible, but its limited agreement should be considered.

Abstract Background In this study, we aimed to present the imaging and surgical results of our pediatric UPJO patients and to discuss our findings in the context of the current literature. Methods All medical records of children who underwent open pyeloplasty due to UPJO were reviewed retrospectively. Obtained data included patient demographics, clinical symptoms, ultrasonographic and scintigraphic imaging, intraoperative details, length of hospital stay and complications. Results 114 patients underwent 124 open dismembered pyeloplasties for UPJO. Anderson-Hynes dismembered pyeloplasty technique was used except Y–V plasty in a recurrent patient. Significant changes in mean hydronephrosis degree, pelvic anterior–posterior diameter and parenchymal thickness were observed. The mean preoperative ipsilateral differential renal function was 37%, and it was calculated as 36% postoperatively. Pelviostomy catheter was used in 11 kidneys, double-J stent was used in 108 kidneys and no catheter was used in 5 kidneys. The mean operative time was 98 min. The mean length of hospital stay was 4.6 days. The mean postoperative follow-up period was 5.1 years. Recurrent UPJO was seen in 5 of 124 kidneys (4%). Conclusion Open dismembered pyeloplasty remains a highly successful and feasible surgical option in the treatment of pediatric UPJO, and our findings are consistent with outcomes reported in the current literature.

IntroductionJuvenile Systemic Lupus Erythematosus (jSLE) is a rare pediatric rheumatic disease characterized by systemic inflammation that can lead to organ damage. Compared to adults, it often has a more severe course in children. Both disease activity and treatments may result in temporary or permanent damage.ObjectivesTo evaluate risk factors associated with damage occurrence in patients with jSLE.MethodsThis multicenter, retrospective study included patients with jSLE followed for at least 12 months. Low-dose corticosteroid therapy was defined as prednisolone 0.01-0.03mg/kg/day (max 7.5mg/day). The annual cumulative steroid dose was calculated by dividing the total steroid intake by 365.25 times the number of follow-up years. Collected data included SLEDAI and SDI scores at initial and final visits, laboratory parameters, and flare characteristics.ResultsA total of 158 patients (86.7% female) from 17 centers were included. Median age at diagnosis was 13.8years, with a median follow-up of 35months. Organ damage was present in 14 patients at diagnosis and in 23 at final visit. Damage types included proteinuria, cognitive dysfunction (each 3.2%), and others such as cataracts, erosive arthritis, avascular necrosis, optic atrophy, and vertebral collapse. Patients with damage had significantly higher SLEDAI scores at both time points, delayed transition to low-dose steroids, and a lower rate of achieving Lupus Low Disease Activity State (LLDAS) (p = .006).ConclusionPersistent disease activity and delayed control are major contributors to organ damage in jSLE. Early and sustained disease suppression is critical to prevent long-term complications.

This study aims to analyze the use of chronological conjunctions and conjunctions of causality in the news text in TribunJatim.com February 2025 edition. Chronological conjunctions are used to express the sequence of time in an event, while the conjunction of causality connects the causal relationship in sentences. The analysis was carried out by qualitative descriptive method, with data collection techniques in the form of news text documentation published during that period. The results showed that the use of chronological conjunctions was more dominant in narrative news, while causality conjunctions were found in many news and opinion news. This finding is expected to be a reference in learning Indonesian, especially in understanding the role of conjunctions in written discourse. The method used is qualitative descriptive, with data collection through documentation of news texts published during the specified period. The analysis involves identifying the types of conjunctions, their functions, and the accuracy of their usage within the context of the news. The results show that chronological conjunctions are more dominantly found in narrative news that tells a sequence of events in order, while causal conjunctions are more frequently used in analytical and opinion news that emphasize cause-and-effect relationships. These findings provide a clear empirical overview of the patterns of conjunction usage in online news texts. This study is expected to serve as an important reference in Indonesian language learning, especially in understanding the role and function of conjunctions in constructing cohesive and communicative written discourse.

ABSTRACT Purpose To provide insights into the presentation and management of uveitis in children, enhancing understanding and improving treatment strategies. Methods A retrospective evaluation of medical records was conducted to gather data on children diagnosed with uveitis in Uveitis Department of a tertiary care hospital in Turkey. Results The study included 153 children with uveitis, of which 84 (54.9%) were female and 69 (45.1%) were male. The mean age was 10.17 ± 4.14 years (2–16 years). The mean follow-up period was 32.04 ± 17.47 months (12–72 months). Eighty-eight children (57.5%) had anterior uveitis, 32 (20.9%) had intermediate uveitis, 2 (1.3%) had posterior uveitis, and 31 (20.3%) had panuveitis. The most common diagnosis was juvenile idiopathic arthritis (JIA)-associated uveitis, which occurred in 59 children (38.5%). Out of 260 eyes assessed, 25.7% (67/260) had at least one ocular complication at presentation. Of the 145 children with noninfectious uveitis, methotrexate (MTX) was prescribed to 131 (90.3%), azathioprine (AZA) to 35 (24.1%), mycophenolate mofetil (MMF) to 6 (4.1%), cyclosporine (CSA) to 5 (3.4%), adalimumab (ADA) to 87 (60%), and infliximab (IFX) to 26 (17.9%). At the end of follow-up BCVA was found to be significantly improved in all anatomic localizations (p < 0.05). Conclusion In our study, the collaboration between our clinic and the pediatric rheumatology referral center may have contributed to the higher number of JIA uveitis and different results. Early and aggressive treatment strategies are important in early and long-term control of ocular inflammation thus resulting in better visual prognosis in pediatric uveitis.