Background/aim: Laparoscopic surgery has become the preferred minimally invasive technique for both diagnostic and therapeutic procedures in gynecology. Although it is associated with lower overall complication rates compared to open surgery, most serious complications occur during the initial step of abdominal entry. Therefore, developing faster and safer entry methods is critical to improving surgical outcomes. This study aimed to compare the surgical results of the Median Umbilical Ligament Lift-Up (MULU) technique routinely used in our clinic with the commonly preferred Veress needle (VN) entry technique. Materials and methods: This randomized, controlled, prospective study included 124 patients: 64 underwent abdominal entry with the MULU technique and 60 with the VN technique. Demographic data such as age, BMI, obstetric and surgical history, and menopausal status were recorded. Key perioperative outcomes, including abdominal entry time, number of attempts, insufflation failure, vascular or visceral injury, bleeding at the trocar site, infection, hematoma, and hernia were documented and analyzed. Results: The VN group had a significantly higher mean age (50.03 years) compared to the MULU group (45.42 years) (p<0.05). No significant differences were observed in height, weight, or BMI. The MULU technique demonstrated a significantly shorter mean entry time (71.5 vs. 146.3 seconds; p<0.05). Extraperitoneal insufflation occurred in 6.7% of VN cases and was absent in the MULU group (p=0.036). Gastric or intestinal injury occurred in 3.3% of VN patients, with none observed in the MULU group. Omental injury was seen only in the MULU group (3.1%). No significant differences were found in vascular injury, bleeding, or prior surgical history. Conclusions: The MULU technique, based on anatomical guidance via the median umbilical ligament, is a safe and effective method for abdominal entry. It offers faster access and may reduce the risk of major complications, making it a viable alternative to conventional techniques.

Introduction: Understanding HPV and cervical cancer is vital for prevention, early diagnosis, and treatment. Nurses play a crucial role in implementing screening and are also at risk. This study examines nurses' knowledge and practices regarding HPV and cervical cancer screening in a tertiary center. Materials and Methods: It is a prospective survey study conducted with nurses. A total of 191 nurses participated in the three-part and 53-item survey that evaluated demographic data, HPV knowledge levels and cervical cancer screening awareness. Results: A total of 2895 nurses work at the hospital. The rate of participation in the research was 6.6% with 191 participants. The average age of the participants is 27.1. Majority of the participants are female (n: 171, 89.5%), only 20 (10.5%) are male. While 81.9% of the respondents had knowledge about sexually transmitted diseases, only 13.5% had gone to regular gynecological examinations. Despite 98.4% of the participants who had knowledge about cervical cancer and screening practices, only 11% (n:19) had undergone cervical cancer screening and 94.2% (n:180) had not received HPV vaccine. The most mis-answered question about HPV was whether current vaccines protect against both genital warts and cervical cancer. Conclusion: In conclusion, nurses' knowledge level and screening practices about HPV and cervical cancer need to be improved. It is also important to increase awareness of the HPV vaccine and encourage more people to receive it. This effort could positively impact health outcomes related to cervical cancer and HPV.

We aimed to evaluate D-dimer levels in pregnant women diagnosed with COVID-19. This single-center study was carried out in a tertiary center hospital serving as a pandemic hospital. 151 pregnant women with COVID-19 diagnosis were included as the study group, and 70 healthy pregnant women as the control group. The data were analyzed separately in 3 different trimesters of pregnancy. Of the 221 pregnant women included in the study, 151 had a diagnosis of COVID-19. 70 healthy pregnant women were taken as the control group. It was observed that D-dimer values in pregnancy increased as the trimesters progressed. No significant difference was observed when this was compared with pregnant women with COVID-19 (p = .428, .75, .927 according to the 1st, 2nd and 3rd trimesters, respectively). The diagnosis of pulmonary embolism is difficult due to the lack of reliable alternative D-dimer thresholds for pregnant patients. On the other hand, D-dimer elevation continues to be a sign of poor prognosis in patients with COVID-19. The situation remains uncertain in patients who are pregnant and have COVID-19. Maybe D-dimer value should be removed from being a poor prognosis criterion in pregnant women.

Purpose: To describe clinical and virologic outcomes after topical 5% imiquimod for VaIN (vaginal intraepithelial neoplasia) within routine clinical practice, including the assessment of available post-treatment high-risk HPV status, and to evaluate its relationship with treatment outcomes. Methods: In this retrospective-cohort study, twenty patients with histologically confirmed VaIN (low-grade VaIN = 10, high-grade VaIN = 10) were evaluated between October 2020 and October 2022. The treatment varied based on the initial VaIN grade. The primary endpoint was complete response, defined as negative cytology and/or benign follow-up biopsy. Secondary endpoints included partial response (downgrading from high-grade to low-grade), persistence/progression, adverse events, and available post-treatment high-risk HPV status. Results: Among seventeen evaluable patients, a complete response was observed in 69.2% (9/13) imiquimod-treated patients. In high-grade VaIN imiquimod-treated patients, complete response was observed in 66.7% (6/9), while 33.3% (3/9) downgraded to low-grade VaIN on biopsy as a secondary outcome, with no persistence over a median follow-up of 24 months. Low-grade VaIN showed 75% clearance with either imiquimod or observation at a median follow-up of 24 months. In one low-grade imiquimod-treated, persistent HPV16 was observed, and the lesion progressed to high-grade VaIN; however, no invasive cancers were observed during follow-up. Adverse events related to imiquimod were mild; there were no discontinuations. Among baseline high-risk HPV positive imiquimod-treated patients, post-treatment follow-up HPV testing was available in a limited subset group, and clearance was confirmed in 44% (4/9) among those with follow-up testing and presented descriptively as exploratory. Conclusions: In this single-center retrospective cohort, outcomes after topical 5% imiquimod are reported as observed findings. Complete and partial responses were observed in high-grade VaIN with acceptable tolerability and no invasive events at available intermediate follow-up (median 24 months). Post-treatment HPV testing provided complementary virologic information alongside clinical outcomes, consistent with recommendations incorporating HPV testing into VaIN follow-up, and longer surveillance is required to assess long-term oncologic outcomes.

Akademisyen Yayınevi yöneticileri, yaklaşık 30 yıllık yayın tecrübesini, kendi tüzel kişiliklerine aktararak uzun zamandan beri, ticarî faaliyetlerini sürdürmektedir. Anılan süre içinde, başta sağlık ve sosyal bilimler, kültürel ve sanatsal konular dahil 2000 kitabı yayımlamanın gururu içindedir. Uluslararası yayınevi olmanın alt yapısını tamamlayan Akademisyen, Türkçe ve yabancı dillerde yayın yapmanın yanında, küresel bir marka yaratmanın peşindedir.Bilimsel ve düşünsel çalışmaların kalıcı belgeleri sayılan kitaplar, bilgi kayıt ortamı olarak yüzlerce yılın tanıklarıdır. Matbaanın icadıyla varoluşunu sağlam temellere oturtan kitabın geleceği, her ne kadar yeni buluşların yörüngesine taşınmış olsa da, daha uzun süre hayatımızda yer edineceği muhakkaktır.

Human papillomavirus (HPV) has been associated with several adverse pregnancy outcomes, but its relationship with hydatidiform mole remains unclear. The ai