Aim: To evaluate cervicovaginal smear and breast examination results during last 10 months beginning from the date of first patient admission in 24.03.2008 until the date of 13.01.2009 in Van Cancer Early Diagnosis, Screening and Training Center. Method: Firstly, breast examination was performed to all sexually active women applying to our center for cervical and breast cancer screening and who were at 20-69 years of age. Breast ultrasonography and mammography were ordered for the women who had palpable breast masses and mammography was routinely ordered for every woman between 50-69 years of age. Then, these women had gynecologic exams and their Pap smear results were reported according to the Bethesda system. Then, colposcopy and biopsy were performed to the patients who needed these according to their results. The patients who needed further evaluation and the ones with cancer suspicion were referred to the tertiary health care center. Results: Breast examination was performed to all women applying to our center between the dates of 24.03.2008 and 13.01.2009. Among them, breast ultrasonography and mammography were ordered to 829 (19.03%) and 499 (11.45%) women respectively. Two women were referred to the upper level health care center with a prediagnosis of breast cancer and they were both operated for breast cancer. Pap smear test was performed to 1926 patients of whom 23 had cervical precancerous lesions, 11 underwent colposcopy and 2 underwent colposcopy and cervical biopsy. The distributions of squamous cell abnormalities were as follows: the most common diagnosis was ASC-US (atypical squamous cells of undetermined significance) seen in 69.56% (16) of patients. ASC-H (atypical squamous cells- cannot exclude high grade lesion), LSIL (low grade squamous intraepithelial lesion), HSIL (high grade squamous intraepithelial lesion) were seen in 13.04% (3), 13.04% (3), 4.36% (1) of the patients, respectively. The patient who had been diagnosed as HSIL was referred to tertiary care center and was operated for cervical cancer. One of the patients having the diagnosis of LSIL didn’t accept the colposcopic examination; colposcopy and biopsy were performed to the other one while the last patient didn’t come back to our center for further examination. Colposcopy guided cervical biopsy was performed to one of the patients who had been diagnosed as ASC-H and her pathological examination result was reported as CIN I (cervical intraepithelial neoplasia I). All of the patients having the diagnoses of ASC-H were referred to the tertiary health care center. Conclusion: It is possible to reach to early diagnoses in many women with the use of cervical and breast cancer screening programs. The importance of widely distribution of KETEM’s is proved by the screening of many women in our region within a relatively short period of time and obtaining favorable results.

Aim: We aimed to analyze the adolescent pregnancies and their outcomes at the Department of Obstetrics and Gynecology Yuzuncu Yil University School of Medicine between the years 2004-2008. Methods: Labors between the years 2004-2008 at our department were evaluated retrospectively and 102 adolescent labors (<19 years) were detected. The sociodemographic and clinical characteristics of these pregnancies were analyzed. Results: While the adolescent pregnancy rate in our clinic in 1999-2003 was 77/4072 (1.89%), it was determined as 102/7788 (1.30%) in 2004-2008. Decrease in this ratio was statistically significant (p<0.05). By the analysis of adolescent labor; mean age was 17.36 years, consanguineous marriage 7.83%, graduated elementary school 72.54%, mean parity 1.07, mean pregnancy term 35.23 weeks, cesarean ratio 15.68%, intrauterine fetal death ratio 0.98%, preterm labor ratio 52.94%, premature membrane rupture 1.96%, preterm premature membrane rupture 2.94% and preeclampsia 1.96% were determined. Conclusion: Decline of adolescent pregnancy ratio compared with previous five years can be explained by increased sociocultural level and/or effective contraception. More than half of the adolescent labor being preterm and neonatal mortality rates four times higher in this young patient group, we can conclude that the complications of labor and delivery are higher among adolescent pregnancies.

Aim: In this study, we aimed to investigate the seroprevalances of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), hepatitis C surface antibody (anti-HCV) and human immunodeficiency virus antibody (anti-HIV) among the women living in the province of Van. Method: In this study, 4870 women who applied to the outpatient clinics of Van Maternity and Children’s Hospital between 15 July 2008 and 15 January 2009 for antenatal follow up or other gynecologic complaints were included. The results of the blood samples of these women were evaluated retrospectively for HBsAg, anti-HBs, anti-HCV, anti-HIV antibodies. Results: It was observed that HBsAg had been studied all of the women included in the study, anti-HBs had been studied in 1878 women, anti HCV had been studied in 2397 women, anti-HIV had been studied in 1832 women. The seropositivity was detected in 75 out of 4870 (1.54%) patients, 290 out of 1878 (15.4%) patients and 13 out of 2397 (0.54%) patients who were investigated for HBsAg, anti-HBs antibody and anti-HCV antibody, respectively. Seropositivity was not detected in any of 1832 patients whose serums were investigated for anti-HIV antibody. Conclusion: The seropositivity rates detected for HBsAg and anti-HBs, anti-HCV, anti-HIV antibodies in our study were similar to rates found for the general population in our country. As a result; for pregnants and the women at reproductive age group, it may also be appropriate for public health to plan and perform effective screening and vaccination programs.

Aim: We aimed to evaluate the children diagnosed as sexual abuse and to determine the precautions against sexual abuse and to enhance the importance of this subject. Method: Among the children with the ages between 5-15 years who were admitted to Yuzuncu Yil University school of medicine Research Hospital Pediatric Emergency Room between March-2008 and August-2009 were included in the study. Clinic records were investigated retrospectively. On the cases of sexual abuse among child abuse cases were included in the study and physical or emotional abuses were excluded. Results: Eight children with sexual abuse were enrolled in the study. There were five boys and three girls. The younger aggrieved child was five years old and the elder was fifteen. Girl patients were examined by gynecologist for gyncologic examination and the boys examined by pediatric surgeon for anal sphyncter and rectal examination. Smears from anal region were taken and examined. Conclusion: The sexual abuse of children is an all-purpose subject. Maximum care must be taken before the exact diagnosis. İn suspicious cases the discrepancies between the history and clinical findings should be evaulatied fort the right diagnosis.

The home where people regard as the safest place hides many hazards. Our case is a fifteen months old female child. She was injured with a crush of television that fell down on her while playing at home. She was sent to hospital because of vomiting continuously. She died at home at night after discharging from hospital with medical treatment. At autopsy, echymosis as 1x2 cm in diameter on abdomen between xyphoid and umbilicus, and brown colored 1750 cc fluid mixed with blood and faeces in the abdominal cavity was found. Total rupture of small intestine via 20 cm. descent of stomach, each free edge of it participating with abdominal cavity, and perforation of mesentary were determined. In this study, taking preventive measures for home accidents, paying more attention to home safety, and to wound-care principles, involving patients in the medical decision-making process, and ensuring appropriate medical follow-up and medical malpractice were discussed.

Background: Purulent pericarditis is a rare entity in the developed countries. Coexistence of purulent pericarditis and thoracic empyema is rare. Here we report an adult patient with concomitant purulent pericarditis and thoracic empyema caused by Streptococcus pneumonia as an initial presentation of cardiac tamponade. Case presentation: A 20-year-old male patient was admitted with pleuritic chest pain and shortness of breath. Chest radiograph showed an enlarged cardiac silhouette and pleural effusion. An emergency echo-guided pericardiocentesis was performed and his condition rapidly improved. The day after admission he deteriorated clinically. Repeated echocardiography showed increased effusion with right atrial collapse, features consistent with tamponade. Right thoracotomy was performed and a pericardial window was created to relieve tamponade. The thickened parietal and visceral pleura were decorticated. Streptococcus pneumonia was isolated in the empyema culture. Postoperative recovery was uneventful. Approximately 15 days after discharge, he was hospitalized again due to recurrent chest pain and shortness of breath. Pericardiectomy was performed via median sternotomy. The postoperative recovery was uneventful. He was discharged from the hospital on postoperative day 15. Conclusion: Purulent pericarditis is a rare, life-threatening condition that is most often resulting from the contiguous spread of infection. If its origin is related to thoracic empyema, trapping lung may be developed in conjunction with effusive-constrictive pericarditis and cardiac tamponade, as in this case. The delay in an appropriate surgical procedure can cause complications leading to death.

Traumatic diaphragmatic rupture is reported to occur in 0,5% to 6% of cases of blunt trauma. The majority (80–90%) of blunt diaphragmatic ruptures occur on the left side. The preoperative diagnosis of traumatic diaphragmatic rupture is difficult. Patients with undiagnosed rupture of diaphragma can develop symptoms of such an injury after a delay of weeks, months, or even years. The patient, a 52-year-old male had a traffic accident while driving 4 years ago. He again consulted the doctor with complaints of dyspnea after an effort or while lying and pain 4 years after the traffic accident. Posterolateral thorax radiography showed air-fluid level in the left lower zone. The definite diagnosis was made by the thorax computerized tomography. During surgery, the colon, the stomach and the omentum were observed in the left hemithorax. The diaphragma was repaired primarily. The patient did not have any postoperative complications and was discharged on the 10th postoperative day. The most important point in the diagnosis of a such condition is the consideration of a possibility in the differantial diagnosis. The diagnosis is often difficult in the late phase since the history of trauma can easily be underestimated.

Thoracic trauma is relatively frequent in childhood and causes considerable mortality. Blunt trauma is the most frequent cause of chest injuries in children. Penetrating injuries are also increasing. Thoracic injuries serve as a reliable marker for injury severity in children, mandating careful evaluation of the child presenting with thoracic trauma. Children's chest injuries differ from adults' because of the pliant nature of a child's ribs. A simple injury may easily damage the intra-thoracic organs, in contrary to that in adults. The lung is the most commonly injured intrathoracic structure. Lung contusion and laceration cause parenchymal hemorrhage and consolidation sometimes accompanied by pneumothorax and/or hemothorax. Hemothorax is the presence of blood in the pleural space. Trauma is the most common etiology of hemothorax in children. In children, hemothorax is usually a consequence of blunt or penetrating trauma, with penetrating being more severe than blunt. A timely diagnosis of hemothorax is crucial to prevent hemorrhagic shock and respiratory compromise. Thoracic trauma in children can be managed conservatively in most of the cases.