Europeanatolia Health Sciences Journal

The Utilization Of Hysteroscopy In Clinical Practice - A Narrative Review

Ahmet Coşkan — Sun, 20 Apr 2025 00:00:00 +0300

Hysteroscopy is an endoscopic method used to evaluate the uterine cavity. It is a minimally invasive diagnosis and surgical management of endocervical and intrauterine pathologies and the gold standard in assessing and managing intrauterine pathologies. Hysteroscopy provides patient-doctor comfort, making it easier to apply. It is preferred because it can provide patient satisfaction, rapid recovery of the patient, and cost-effectiveness.

Hysteroscopy is ideal for patients with abnormal findings in tests such as hysterosalpingography and saline infusion sonography. Suspicion of an intracavitary lesion is one of them. It is also possible to intervene in polyps and myomas that may cause abnormal uterine bleeding. Submucosal and some intramural fibroids can be treated. Hysteroscopy can be performed for reasons such as abnormal endometrial thickness and postmenopausal bleeding. It is crucial to be able to treat abnormal uterine bleeding without the need for a hysterectomy. Myomectomy, polypectomy, and septoplasty can be performed hysteroscopically. Adhesiolysis can also be performed this way. It is also a suitable method for patients evaluated for infertility. On the other hand, it removes products of conception and intrauterine foreign bodies, and intrauterine devices remain in the cavity.

Hysteroscopy can also help evaluate those with abnormal or echo-like findings on imaging and those with chronic dense leukorrhea. It is an auxiliary tool in pregnancy complications and the treatment of persistent bleeding after pregnancy. This review aims to elucidate hysteroscopy's clinical utilization, indications, and complications to help physicians improve their techniques.

The Utilization of Laparoscopy In Clinical Practice - A Narrative Review

Ahmet Coşkan — Sun, 20 Apr 2025 00:00:00 +0300

Laparoscopic surgery (L/S) is a minimally invasive alternative to traditional laparotomy. It is a diagnostic and therapeutic modality for minor and major surgical procedures. Many procedures traditionally performed using open laparotomy can now be performed laparoscopically. L/S has numerous benefits, including smaller incisions, shorter hospital stays, and shorter recovery times. L/S also allows the surgeon to visualize and magnify the anatomy and existing pathology better.

Laparoscopic procedures during pregnancy have been viewed with controversy because of the idea that laparoscopic techniques may reduce maternal lung compliance, leading to hypoventilation, hypercarbia, fetal acidosis, aortocaval compression, and direct uterine and fetal trauma. The most common indications for laparoscopic surgery during pregnancy are cholelithiasis, appendicitis, persistent ovarian cysts, and adnexal torsion. The problems that the anesthesiologist will encounter in a pregnant patient undergoing laparoscopic surgery are not only maternal and fetal factors and prevention of premature labor but also the physiological and mechanical effects of CO₂ pneumoperitoneum and patient position.

The indications for laparoscopic surgery are the same as for open procedures. L/S aims to perform a surgical procedure similar to the standard technique without opening the peritoneal membrane. Laparoscopy has two absolute contraindications: the patient's inability to tolerate general anesthesia and the surgeon's inexperience and lack of skill in the specific procedure or technique. Laparoscopy reduces morbidity, reduces hospital stay, and improves cosmetic results.

Seroepidemiology Of Human Herpesvirus-6 In Different Age Groups In Istanbul

Süheyla Aykaç Yazıcıoğlu, Gülden Çelik (Yılmaz) — Sun, 20 Apr 2025 00:00:00 +0300

Objective: This research aimed to elucidate the HHV-6 IgM and HHV-6 IgG antibodies in febrile and healthy individuals using ELISA to determine the distribution rates of HHV-6 antibodies in Istanbul.

Method: This research has enrolled 149 individuals (Group 1) admitted to the hospital with fever and had at least two symptoms, such as sore throat, swollen lymph nodes, and increased leukocyte count together with fever, with suspicion of herpes infection and 121 healthy individuals (Group 2) who had no complaints or findings and were admitted to the hospital for routine check-ups—the presence of HHV-6 Ig M and HHV-6 Ig G antibodies in two different groups.

Results: According to the study, HHV-6 IgG antibody was detected in 86 (57%), and HHV-6 IgM antibody in 28 (19%) of 149 febrile individuals. HHV-6 IgM antibody was detected in febrile patients. HHV-6 IgG antibody was found in 48% of healthy individuals, and HHV-6 IgM antibody in 6%. HHV-6 IgM was not detected among healthy individuals in the 0-5 month group. The findings were consistent with the HHV-6 IgM and HHV-6 IgG rates reported in the literature. This study shows that HHV-6 was encountered in 48% of healthy individuals.

Conclusion: This study's results are consistent with the information in the literature. Based on the data, it was thought that organ transplant recipients and donors should be evaluated for HHV-6 infection and that HHV-6 infection should not be ignored in children admitted to the hospital with fever.

Investigation Of The Role Of Multifidus Muscles In The Development Of Recurrent Lumbar Disc Herniation

Mesut Çelik, Ahmet Karaoğlu, Melih Çekinmez, Gökhan Karataş — Sun, 20 Apr 2025 00:00:00 +0300

Introductıon: In our study, we used magnetic resonance imaging (MRI) to assess whether the atrophy of the multifidus muscle, which plays a crucial role in lumbar spine stabilization, could be prevented following a back exercise program after lumbar disc herniation surgery.

Objective: This research investigated the effect of multifidus muscles that undergo atrophy after lumbar disc herniation surgeries on the development of recurrent disc herniation.

Method: A total of 59 patients who underwent recurrent lumbar disc herniation surgeries were retrospectively examined. Multifidus muscle Cross-Sectional Area (CSA) and Muscle-Lamina Distance (MLD) of the patients before primary lumbar disc surgery and before recurrent surgery were measured radiologically using lumbar magnetic resonance imaging (MRI) images. Within the scope of these measurements, the effect of the multifidus muscle development exercise program application after lumbar disc herniation surgeries on the development of recurrent discs was statistically evaluated.

Results: The MLD measurement of the multifidus muscle before primary lumbar disc herniation surgery was not statistically significant between the exercise and non-exercise groups, while the MLD measurement of the multifidus muscle on the pathological disc side before lumbar recurrent disc surgery (p= 0.017) was statistically significant between the exercise and non-exercise groups. In the measurements taken by the first observer before lumbar recurrent disc herniation surgery, the mean MLD measurement of the multifidus muscle in the exercise group was 5.34. In contrast, the mean MLD measurement of the multifidus muscle in the non-exercise group was 6.83, which was statistically significant (p= 0.017). In addition, the first observer's measurement of the upper pathological disc distance before lumbar recurrent disc herniation surgery was statistically significant (p= 0.024). According to the evaluation made by the second observer, the mean MLD measurement of the multifidus muscle before lumbar recurrent disc herniation surgery was 5.56 in the exercise group. At the same time, it was 6.81 in the non-exercise group (p= 0.038), same result as the first observer.

Conclusion: Our study shows that exercise shortens the MLD distance and that an appropriate lumbar exercise program can prevent multifidus muscle atrophy.

Analysis Of Cases Operated With Open Spinal Dysraphism Diagnosis And Undergoing Additional Operation Due To Tensioned Spinal Cord Syndrome Developing In Their Follow-Ups

Abdullah Ertaş, Yusuf Tüzün, Elif Başaran Gündoğdu, Jason Ömer Holtclaw — Sun, 20 Apr 2025 00:00:00 +0300

Objective: The study was designed to elaborate on additional surgical needs, compare the morbidity and mortality of patients diagnosed with open spinal dysraphism, and statistically analyze the results obtained, thus concretizing both our and the families' expectations and predictions.

Method: This retrospective analysis examined open spinal dysraphism patients who underwent additional surgical intervention due to tethered cord syndrome that developed during their follow-up, as well as all the cases that were operated on due to closed spinal dysraphism during the same years. In total, 96 cases diagnosed with open spinal dysraphism and 42 cases diagnosed with closed spinal dysraphism were included in the study.

Results: Paraparesis was detected at 21.9% in the open group and 2.4% in the closed group. Paraplegia was found at 45.8% in the open group but not in the closed group. Monoparesis was seen at 4.2% in the open group and 19.0% in the closed group. In addition, when the open spinal dysraphism cases were examined within themselves, those who underwent additional TCS surgery had a higher rate of normal neurological examination (29.1%). In comparison, paraplegia was detected at a higher rate in those who did not undergo additional TCS surgery (68.3%). In addition, it was observed that hydrocephalus, shunt requirement, Chiari Malformation, scoliosis/kyphosis presence, urological problems, gastrointestinal problems, and mortality rates were higher in open spinal dysraphism cases (p<0.001).

Conclusion: These findings highlight the need for careful follow-up evaluation of patients with open spinal dysraphism and establishing precise long-term follow-up strategies post-surgery.

Effectiveness Of Chicken Embryo Amniotic Membrane In Preventing Post Laminectomy Epidural Fibrosis Development – A Rat Laminectomy Model

Sun, 20 Apr 2025 00:00:00 +0300

Objective: Amniotic membranes have been shown to enhance nerve regeneration and reduce perineural fibrosis after surgery. This study aimed to elucidate the effect of chicken amniotic membranes on preventing epidural fibrosis after laminectomy.

Method: In this study, 20 adult male Wistar albino rats weighing 300±50 g were used. The rats were randomly divided into two groups, each containing 10 rats. Group 1 (Control group, n=10): Rats underwent 3-distance laminectomy + primary closure. Group 2 (Experimental group, n=10): Rats underwent 3-distance laminectomy + chicken embryo amniotic membrane application followed by primary closure.

Results: In the group where the chicken embryo amniotic membrane was placed, the degree of macroscopic fibrosis varied between stage 1 and stage 3; 70% (n=7) of the subjects developed scar tissue that could be easily dissected in the dura mater (Rydell stage 1), two subjects (20%) developed scar tissue that caused structural deterioration in duramater and caused serious dissection difficulties but could be dissected (Rydell stage 2), while only one subject (10%) had scar tissue that was adherent to the dura mater and could not be dissected (Rydell stage 3). The difference between the groups was significant (p =0.001). Histopathologically, group 1 showed grade 2 and 3 scar tissue development, while group 2 showed grade 0 to 3 scar development, with a significant difference (p = 0.001).

Conclusion: The study results show that chicken embryo-derived amniotic membrane can be implanted as a physical barrier to reduce epidural fibrosis without affecting wound healing and causing infection the surgical area.