Coffee consumption for recovery of intestinal function after laparoscopic gynecological surgery: A randomized controlled trial.

BACKROUND: To investigate the effect of postoperative coffee consumption on bowel motility after laparoscopic gynecological surgery. MATERIALS AND METHODS: In this randomized controlled trial, patients were allocated postoperatively to 3 cups of either coffee or warm water at 6, 12, or 18 h after the operation. Total hysterectomy and bilateral salpingectomy were performed on all patients. In addition, a salpingo-oophorectomy and systematic pelvic with/without para-aortic lymphadenectomy were performed according to clinical indications. The primary endpoint was time to the first passage of flatus after surgery. RESULTS: A total of 96 patients were enrolled; 49 patients were assigned to the coffee group, and 47 were enrolled in the control group (warm water). The median time to flatus (19 [13-35] vs. 25 [15-42] h; hazard ratio [HR] 1.9, 95% confidence interval [CI], 1.2-2.9; P = 0.0009), median time to defecation (30 [22-54] vs. 38 [26-65] h, HR 2.4, 95% CI, 1.5-3.8; P < 0.0001), and mean time to tolerate food (2 [2-5] vs. 3 [2-8] days, HR 1.5, 95% CI, 1.02-2.3; P = 0.002) were decreased significantly in patients who consumed coffee compared with the control subjects. Postoperative ileus was observed in seven patients (14.9%) in the control group and one patient (2.0%) in the coffee group (P = 0.02). No adverse events were attributed to coffee consumption. CONCLUSION: Postoperative coffee intake after laparoscopic gynecological surgery hastened the recovery of gastrointestinal function by reducing the time to the first passage of flatus, time to the first defecation, and time to tolerate a solid diet. This simple, cheap, and well-tolerated treatment merits routine use alongside other existing enhanced recovery pathways in the postoperative setting.

An Interesting Relationship Between Maternal Adipose Tissue Thickness and Maternal Pelvicalyceal System Dilatation.

PURPOSE: To evaluate whether maternal body mass index (BMI), visceral adipose tissue (VAT) thickness, and sub-cutaneous adipose tissue (SAT) thickness have effects on maternal pelvicalyceal system dilatation, which develops during pregnancy. MATERIALS AND METHODS: Between April 2018 and November 2018, a total of 120 pregnant women aged between 18-35 years in their third trimester were included in this prospective observational study. For each pregnant wom-an, SAT and VAT thicknesses were measured and renal sonography was performed by the same radiologist and obstetric ultrasound was performed by the same obstetrician. Nine patients were excluded from the study because their maximal caliceal diameters were less than 5 mm. Ultimately, 111 patients were divided into three groups according to the maximal calyceal diameter (MCD). RESULTS: Asymptomatic hydronephrosis was diagnosed in 108/111 (97.3%) of the patients. There were 53 patients in group 1 (MCD of 5-10 mm), 39 patients in group 2 (MCD of 10-15 mm), and 19 patients in group 3 (MCD of >15 mm). There were statistically significant differences in terms of maternal SAT and VAT thickness between the groups (P = .001). There were also statistically significant differences between the groups for the estimated fetal weight and birth weight (P = .024, P = .003, respectively). In the correlation analysis, there was a negative correlation between maternal SAT thickness, VAT thicknesses, BMI, and maximal calyceal diameter (P = .001). CONCLUSION: In this study, relationships between maternal BMI, VAS thickness, SAT thickness, the estimated fetal weight, birth weight, and renal pelvicalyceal dilatation have been shown. Increasing maternal adipose tissue may have a protective effect of mechanical pressure of growing uterus on the ureters.

Massive Ascites and Pleural Effusion in Preeclampsia.

Preeclampsia is defined as new onset hypertension and proteinuria after 20 weeks of gestation and complicates approximately 2-8% of all pregnancies. Release of vasoconstrictive agents, endothelial damage, hyperpermeability of the capillaries and microangiopathic haemolysis involves the basic pathophysiology. It has variable clinical presentation. Here, we report a case of severe preeclampsia who developed postpartum massive ascites and pleural effusion. Primigravid patient was admitted to our clinic at 35 weeks of gestation with very high blood pressure. In biochemical analysis, Alanine aminotransferase (ALT) was 401 U/L, Aspartate aminotransferase (AST) was 292 U/L. An emergency caesarean section was performed because of fetal distress. On the 2nd post-operative day, abdominal distension and severe abdominal pain occurred. On the 3rd post-operative day, her abdominal distension increased and Ultrasonography (USG) revealed massive ascites. Abdominal drainage was performed and albumin infusion was administered. On postoperative day 4, she still had abdominal distension and concomitant respiratory distress. Computed Tomography (CT) showed ascites and bilateral pleural effusion. Her complaint regressed on the following days.

Bone loss & platelet-to-lymphocyte ratio.

AIM: The aim of the study is to assess the possible relation of platelet-to-lymphocyte ratio (PLR), neutrophil-to-platelet ratio and low-density lipoprotein cholesterol levels with low bone mineral density (BMD) in postmenopausal women. METHODOLOGY: In total, 211 postmenopausal women were divided into two groups according to their T-score results. The control group consisted of 32 and BMD group consisted of 179 patients. Electronic records of the patients were analyzed retrospectively. RESULT(S): PLR was statistically significantly higher in the BMD group. According to receiver operating characteristic analysis, PLR was found to be a discriminative factor for low BMD. CONCLUSION: PLR level may predict low BMD with baseline measurement in postmenopausal women.

Is There Any Impact of Copper Intrauterine Device on Female Sexual Functioning?

INTRODUCTION: Intrauterine Device (IUD) is the most preferred modern contraceptive method in Turkey. Female Sexual Dysfunction (FSD) is defined as lack of one or more of the components in the sexual response cycle which includes sexual desire, impaired arousal and inability achieving an orgasm or pain with intercourse. FSD has multi-factorial aetiology. Advanced age and menopause, fatigue and stress, psychiatric and neurologic disease, childbirth, pelvic floor or bladder dysfunction, endometriosis, uterine fibroids, hypertension obesity, medication and substances, hormonal contraceptives, relationship factors are known risk factors for FSD. AIM: To investigate if IUD has any impact on female sexual functioning. MATERIALS AND METHODS: In this cross-sectional study subjects were divided into two groups. Study group consisted of 92 IUD-users (mean 5.1±1.2 years) and the control group consisted of 83 women with no contraception. Female Sexual Function Index (FSFI) questionnaire was performed to both two groups. Women with a total score lower than 26.5 were considered as having sexual dysfunction. RESULTS: The prevalence of FSD was 57.1% among participants. IUD users had a lower total FSFI score comparing to control group but the difference was not statistically different (p=0.983). A positive correlation was found between total FSFI score and duration of IUD (p=0.003). CONCLUSION: No difference was found in terms of sexual dysfunction between IUD users and women with no contraception. The prevalence of FSD was very high in both groups which may be attributed to the socio-cultural factors such as embarrassment of women due to conservatism.

Impaired olfactory function in patients with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is an endocrine disorder which affects 6.6% of women of child-bearing age. Although olfactory dysfunction is frequent in the population and it negatively affects quality of life, neither physicians or patients consider this important. This case-control study included 30 patients diagnosed with PCOS, and 25 healthy age-matched controls. Sniffin' sticks tests (BurghartGmbH, Wedel, Germany) were used to analyze olfactory functions, and the Beck Depression Inventory was used to evaluate depressive symptoms. The total odor score was significantly lower in the PCOS group compared to the control group (p<0.005). The Beck depression score was higher in the PCOS group (p<0.005). There was a negative correlation between the total odor score and the Beck Depression Score. Patients with PCOS have impaired olfactory function. This might be related to depressive disorders that are also observed in those patients.

Maternal serum amyloid A levels in pregnancies complicated with preterm prelabour rupture of membranes.

OBJECTIVE: The aim of the study was to investigate a possible association between maternal serum amyloid A levels (SAA) and maternal and fetal parameters in pregnancies complicated with preterm prelabor rupture of membranes (PPROM). MATERIAL AND METHODS: A total of 88 pregnant women (PPROM group, n = 44 and control group, n = 44) were included into this prospective case control study Serum blood samples for SAA were obtained from both groups within 1 h since the rupture of the membranes and before administration of any medicine. The samples were kept frozen at -70 degrees C until the analysis. The recorded risk factors were: age, gravidity parity delivery mode, gender; fetal birth weight, APGAR scores, white blood cell count, microCRRF neutrophil/lymphocyte ratio (NLR), and maternal serum SAA levels. RESULTS: Demographic characteristics showed no statistically significant differences between the groups (p > 0.05). The mode of delivery mode was cesarean section: 41% and 43.2% in the study and the control group, respectively and this difference was statistically significant between the groups (p < 0.05). Fetal parameters also showed statistically significant differences (p < 0.05). There was a statistically significant difference between the groups in terms of micro CRP NLR and SAA. SAA levels were higher in the PPROM group (p < 0.005). SAA levels at a cut-off 95.63 ng/ml. CONCLUSION: We are of the opinion that second trimester maternal serum SAA level may be a predictive marker for PPROM. However further studies with more participants are required.