Examining the changes in women's lives after the hysterectomy operation: Experiences of women from Turkey.

PURPOSE: The aim of the study is to examine what kind of changes the operation has brought about in the social and psychological life of women. METHODS: The study was a hermeneutic-phenomenological research conducted using qualitative research methods. It took place between May and July 2023 at a university hospital located in Istanbul, Turkey. Following ethical approval, the study included a total of 24 women who had undergone a 'total abdominal hysterectomy, bilateral salpingo-oophorectomy.' These participants were selected using a combination of maximum diversity sampling and random sampling methods. Data collection was carried out using a semi-structured interview form. The interviews were conducted using face-to-face interview techniques and in-depth interview methods. Qualitative data analysis involved using the coding paradigm of Grounded Theory and Straus and Corbin's coding framework. For the analysis of quantitative data, SPSS version 28.0 was employed, while qualitative data were analyzed using MaxQDA Analytics Pro 2022. RESULTS: The study found that the participants had a mean age of 47 ± 7.53, and the majority, 66.7%, had not reached menopause before the operation. The qualitative analysis of the semi-structured interviews revealed five main themes, which were identified as follows: 'hysterectomy experiences', 'the impact of hysterectomy on sexual life', 'the significance attributed to the uterus', 'the significance attributed to femininity', and 'self-efficacy after hysterectomy'. CONCLUSIONS: The study revealed that women experienced changes in self-perception, body image, a sense of organ loss, and developed negative attitudes towards menopause following a hysterectomy. Additionally, there was a noticeable connection between the meanings attributed to the uterus and femininity, which was often influenced by cultural and social factors. In light of these findings, it is recommended that women receive counseling from healthcare professionals before undergoing a hysterectomy. This guidance can help women better understand and cope with the physical, emotional, and cultural aspects of the procedure.

Prevalence and correlates of premenstrual syndrome and premenstrual dysphoric disorder among women aged 18-25 in Turkey.

OBJECTIVE: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are experienced in the luteal phase among women of reproductive age and are known to affect quality of life. This study sought to determine the prevalence and correlates of PMS and PMDD in women aged 18-25 in Turkey. METHOD: A cross-sectional study was conducted between December 2022 and May 2023, which recruited 1125 female college students. A personal information form, the International Physical Activity Questionnaire, and the Premenstrual Syndrome Scale (PMSS) were administered. Participants who met criteria for PMS during three consecutive menstrual cycles based on the ACOG and PMSS scores were diagnosed as having PMS. Participants who met the criteria for PMDD during three consecutive menstrual cycles based on the DSM-V were diagnosed as having PMDD. Logistic regression analysis was used to determine correlates of PMS and PMDD. FINDINGS: PMS was found in 49.2% and PMDD in 48.0% of the participants. Women having a blood group type B compared to those with blood group type A were more likely to have PMS (OR = 151.8, 95% CI = 54.5-422.6). In addition, women with PMS were less likely to be physically active based on the metabolic equivalent of task score (OR = 0.99, 95% CI= 0.98-0.99). Menstrual cycle duration was also longer among those with PMDD (OR = 1.47, 95% CI= 1.25-1.72), as was daily caffeine intake (OR = 1.01, 95% CI= 1.00-1.01). PMDD score was also found to be associated with major depressive disorder (OR = 1.06,95% = 1.05-1.07). CONCLUSIONS: PMS and PMDD among young women in Turkey were associated with blood groups, MET scores, and other clinical characteristics that may help clinicians to identify these conditions.

Effect of maternal cortisol levels on fetal heart rate patterns in primiparous pregnant women in the third trimester.

OBJECTIVE: This study aimed to determine whether maternal cortisol levels affect fetal heart rate patterns in primiparous pregnant women in the third trimester. METHODS: This cross-sectional descriptive study included 400 primiparous pregnant women with uncomplicated pregnancies between November and December 2022. The study included primiparous pregnant women over 18 years old in the third trimester who had not exercised for at least 2 h before the fetal heart rate monitoring and had a healthy pregnancy without consuming any food or drink. Fetuses with decelerating heartbeats and pregnant women who showed uterine contraction and cervical dilation during the fetal heart rate monitoring were excluded from the study. Research data were collected with the data collection form. The fetal heart rate data were collected using a cardiotocograph. At least two accelerations during the 20-min nonstress test period were the basis for diagnosing a reactive nonstress test. About 5 mL of maternal saliva for cortisol measurements was collected before fetal heart rate monitoring. Research data were analyzed with IBM SPSS Statistics for Macintosh, Version 28.0. A p-value of <0.05 was considered significant. RESULTS: There were no significant differences in the comparison of the groups in terms of education and income status, family type, fetal gender, pregnancy planning status, BMI and age averages, or gestational week averages (p>0.05). The number of at least two accelerations required for the diagnosis of reactive NST was also higher in Group 1 (maternal salivary cortisol level ≤24.20). A moderately positive relationship between fetal heart rate and maternal salivary cortisol was observed (r=0.448, p=0.000). In total, 11.9% of the total change in fetal heart rate level is explained by maternal cortisol (R2=0.119). Maternal cortisol increases fetal heart rate level (ß=0.349). CONCLUSION: These findings suggest that stress in primiparous pregnant women with high cortisol levels may influence fetal heart rate patterns. It was revealed that the increase in cortisol level, considered a stress hormone, may be a harbinger of fetal tachycardia.

A techno-economical assessment of treatment by coagulation-flocculation with aluminum and iron-bases coagulants of landfill leachate membrane concentrates.

Landfill leachate treatment involved with the membrane bioreactor (MBR) combined with membrane treatment via nanofiltration (NF) and/or reverse osmosis (RO) is widely used in Turkey. This treatment produces landfill leachate membrane concentrates (LLMCs) with an undesirably high concentration of contaminants. In the study, two different nanofiltration concentrates of leachate were coagulated. Coagulant dosages from 0.10 to 5.0 g of Me3+/L (Me3+: Al3+ or Fe3+), and the pH values ranged from 4.0 to 8.0 and 3.0-9.0 for Al-based and Fe-based coagulants, respectively. The most efficient pH values were 5.0 and 4.0 for Al3+ and Fe3+, respectively. These pH values are lower than those known to be effective in coagulants. The reason for this is the presence of humic substances in the wastewater. The cost of Fe2(SO4)3.xH2O was the lowest than other coagulants at the end of the cost analyses obtained from Istanbul region landfill leachate NF concentrate (NFCL-1) and Kocaeli region landfill leachate NF concentrate (NFCL-2). Under optimum conditions, the costs for NFCL-1 and NFCL-2 were calculated as 0.55 and 0.46 $/removed kg COD, respectively.

Inactivated COVID-19 vaccine hesitancy among midwifery students: a prospective online survey.

Limited information on vaccines' reliability and lack of sufficient scientific data may cause suspicion among individuals concerning the Coronavirus Disease-2019 (COVID-19) vaccines. This study aimed to investigate the attitudes of midwifery students to an inactivated COVID-19 vaccine. This prospective online survey was conducted between 01 March and 01 May 2021 with 172 midwifery students. An anonymous online survey was developed by the researchers, taking into account the studies in the literature examining the attitudes of individuals towards the vaccine. The online survey included a total of 19 questions, covering five main topics. The study revealed that 118 (68%) of 172 midwifery students were hesitant to get vaccinated. There was a significant difference between the vaccine-hesitant and -accepting groups regarding the general attitude towards the vaccine (respectively; <0.001, 0.001). It was determined that 48.1% of the vaccine-accepting participants strongly agreed that this vaccination should be mandatory for all midwifery students working in a clinical practice internship. Higher vaccination willingness levels are expected in students who attend health curricula due to the high literacy level in health-related issues. In conclusion, healthcare professionals who are in contact with patients should be informed more accurately about newly developed vaccines.IMPACT STATEMENTWhat is already known on this subject? Limited information on vaccines' reliability and lack of sufficient scientific data caused suspicion about the COVID-19 vaccines among many people .What do the results of this study add? Almost half of the participants in both groups agreed that the vaccine could be ineffective if the virus is mutated. Nearly half of the hesitant group thought that the COVID-19 vaccine might not be effective and were concerned about serious side effects.What are the implications of these findings for clinical practice and/or further research? This study reveals that healthcare professionals who are in contact with patients should be informed more accurately about newly developed vaccines.

Statistical assessment of seasonal variations in water quality for different regions in Lake Van (Türkiye).

On earth, surface water bodies interact and change with the natural ecosystems. These surface waters and water quality may be adversely affected due to different factors. To analyze the effects, parameters indicating water pollution and quality and the possible causes of these parameters should be examined. In addition, environmental pollution issues should be controlled by taking measures. The most important surface water body in the province of Van, located in the east of Türkiye, is the biggest soda Lake Van. The population density around the lake, human polluting factors, unconscious beach use, inadequate wastewater treatment, agriculture and livestock activities, small-scale industrial areas, and chemicals used create a pollution effect. In the study, data were obtained during year of 2018 from six important sampling points around Lake Van and from the middle of the lake. Twenty-seven water quality parameters were analyzed separately and together. These variables' yearly values were evaluated with Turkish Surface Water Quality Regulation (TSWQR, 2015). As a result, these points were determined to have class I in terms of water parameters according to the seasonal data. The basic descriptive statistics were compared with the regulation, and max, mean, and min values were examined. Data analyzed were done with probability-normality, trend analysis, correlation, and regression methods. The results of this study are that general parameters were normal and the quality of the six points continued to be similar. Na+, Cl-, salinity, and TDS were highly correlated, while DO and F were high matrix value parameters. EC, TDS, and SS regression equations provided high correlation parameters.

Degradation of thiocyanate by electrochemical oxidation process in coke oven wastewater: Role of operative parameters and mechanistic study.

This study presents the removal of thiocyanate (SCN-) from coke oven wastewater by the electrooxidation (EO) process. Initially, the performances boron-doped diamond (BDD) and different DSA (Dimensionally stable anode) electrodes including Ti/IrO2, Ti/IrO2-RuO2, and Ti/IrO2-RuO2-TiO2 in SCN- removal were compared. BDD anode outperformed the Ti-based mixed metal oxide (MMO) anodes achieving 96.51% SCN- removal efficiency. The most favorable conditions for the removal of SCN- using BDD anode were determined as follows: pH = 9, current density = 43.10 A m-2, and the electrolyte concentration (Na2SO4) = 2.5 g L-1. The strong role of ⦁OH in the removal of SCN- was confirmed by the addition of radical quenching agents. The evolution of the intermediates as a result of the EO of SCN- was determined. Under the determined conditions, the EO process could remove 84.13% of SCN- and 94.67% of phenol from a real coke oven wastewater, which was comparable to that of the simulated solution. The electrical energy consumption cost of the process to remove 1 kg of SCN- was calculated as 0.208 US $. Overall, the study showed the EO using BDD anode is a cost-effective method for the removal of SCN- from a coke oven wastewater.

The effect of tubal sterilization with the Pomeroy technique and bipolar electrocauterization on the ovarian reserve and serum anti-Müllerian hormone levels in a rat model.

OBJECTIVE: To investigate the effects of tubal sterilization techniques on the ovarian reserve and serum anti-Müllerian hormone (AMH) levels in rats. STUDY DESIGN: Wistar Hannover rats (n=21) were assigned to the following 3 groups (7 rats/group): Pomeroy technique, bipolar electrocauterization, and control. Pre- and postoperative serum AMH levels, ovarian damage and ovarian follicle counts were assessed. RESULTS: Total ovarian damage was higher in the electrocauterization group than in the Pomeroy (p=0.008) and control (p<0.0001) groups. The large antral follicle count was higher in the Pomeroy group than in the electrocauterization (p=0.023) and control (p=0.003) groups. The electrocauterization group had a greater decrease in postoperative serum AMH levels than the Pomeroy and control groups (p=0.031). CONCLUSION: Bipolar electrocauterization may have a negative effect on the ovarian structure and ovarian reserve compared to the Pomeroy technique.

Effect of detorsion alone and in combination with enoxaparin therapy on ovarian reserve and serum antimüllerian hormone levels in a rat ovarian torsion model.

OBJECTIVE: To investigate the effect of enoxaparin on ovarian reserve and serum antimüllerian hormone (AMH) levels in a rat ovarian torsion model. DESIGN: Experimental study. SETTING: Experimental surgery laboratory in a training and research hospital. ANIMAL(S): Fourteen female Wistar Hannover rats. INTERVENTION(S): 1) Control group received no special treatment other than abdominal exposure; 2) detorsion-only group received bilateral adnexal torsion (3-hour ischemia), and then after 3-hour torsion period, detorsion (reperfusion) was performed; and 3) detorsion-enoxaparin group received 0.5 mg/kg enoxaparin subcutaneously 2 hours before the same surgery as the detorsion-only group and a second 0.5 mg/kg dose of enoxaparin 24 hours after the first surgeries. Apart from the surgeries, preoperative and postoperative 1-mL blood samples were drawn from the right jugular vein of each rat. MAIN OUTCOME MEASURE(S): Preoperative and postoperative serum AMH levels, histopathologic damage scores, and follicle counts in the ovarian tissue of the rats. RESULT(S): Vascular congestion and hemorrhage scores were higher in the detorsion-enoxaparin group than in the detorsion-only and control groups. The number of small antral follicles was smaller in the detorsion-only group than in the control group. The difference in the pre- and postoperative AMH levels was higher in the detorsion-only group than in the control and detorsion-enoxaparin groups. CONCLUSION(S): The combination of enoxaparin therapy with conventional ovarian detorsion is more effective in protecting the ovarian reserve than detorsion alone.