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    Comparison of diclofenac sodium with indomethacin suppositories for mediolateral episiotomies
    (2012) Altungül A.Ç.; Sapmaz E.; Kale A.
    Objective: The study was carried out to compare the analgesic effect of diclofenac sodium and indomethacin suppositories for management of right mediolateral episiotomy repair. Method: A total of 70 patients who gave birth vaginally with right mediolateral episitomy were randomly assigned to receive 100 mg diclofenac sodium suppositories/day (G1, n = 35) or 100 mg indomethacin supposotories/day (G2, n = 35) after episiotomy repair and postpartum for three days. Pain ratings were recorded before, the first hour and 24 hours after medication. The verbal rating scale (VRS) and visual analog scale (VAS) were used for pain recording. The independent T test, Mann-Whitney U and Wilcoxon rank test were used for statistical analysis and Spearman correlation analysis was used for comparison between VRS and VAS. Results: Diclofenac sodium was a more effective analgesic than indomethacin suppositories for right mediolateral episiotomy pain. For G1 the first hour VRS was 2.6 ± 0.5 points and VAS 4.9 ± 0.8 points; for G2 the first hour VRS was 3.4 ± 0.6 points VAS 6.6 ± 1.2 points; this difference was statistically significant (p < 0.05, Mann-Whitney U test). For Gl at the 24 th hour VRS was 1.2 ± 0.4 points and VAS 2.4 ± 0.9 points; for G2 at the 24 th hour VRS was 2 ± 0.7 points and VAS was 3.4 ± 1.3 points; the difference was statistically significant (p < 0.05, Mann-Whitney U test). The first and 24 th hour pain scores (VAS1-VAS24, VRS1-VRS24) were decreased dramatically for both groups (p < 0.05, Wilcoxon rank test). A positive correlation was obtained between the first and 24 th hour VRS and VAS by Spearman correlation analysis (r s = 0.9, n = 70, p = 0.000). Conclusion: The two analgesics were effective after episiotomy repair, however diclofenac sodium suppositories may be the preferred choice because they were more effective.
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    Examination of the effect of melatonin use in Pomeroy method of tubal ligation on ovarian histology in rats
    (2012) Altungül A.Ç.; Kale A.; Sapmaz E.; Akpolat N.
    Objective: To examine the effects of melatonin use in the unilateral Pomeroy method of tubal ligation on ovarian histology in rats. Setting: Firat University Medical School, Obstetrics and Gynecology Department, Elazig. Material and Method: Thirty adult, female rats of Wistar albino species with regular cycles were randomly allocated to three groups in the estrus phase: G1 (n: 10): The abdomen was opened and closed. G2 (n: 10): The group where the abdomen was opened, and the Pomeroy method of tubal ligation was performed. G3 (n: 10): The group where the abdomen was opened, and Pomeroy method of tubal ligation was performed 15 min after 10 mg/kg/ip melatonin administration. Abdomens of all rats were opened six months later and left oophorectomy was performed. Samples of the left ovary were fixed in formaldehyde. The preparations were stained with hematoxylin eosin, and primordial, primary, secondary and tertiary follicles were counted. All the numbers were added up to determine the ovarian follicle reserve. An atretic follicle count was made. The corpus luteum and corpus albicans were counted, and the number of total corpuses were calculated. Regression of angiogenesis within the corpus luteum was examined. Presence of fibrosis on ovarian stroma was examined. An ordinal scale was formed for the regression of angiogenesis within the corpus luteum and presence of fibrosis (none: 0p, present: 1p, markedly present: 2). Follicle cysts in the ovary were counted. Kruskal Wallis variance analysis was used in the statistical analysis of data; p < 0.05 were considered significant. Results: The comparison between G1 and G3 showed that all values were similar (p > 0.05, Kruskal Wallis variance analysis). When G2 was compared with G1 and G3, regression of angiogenesis in the corpus luteum was found to be significantly lower (p < 0.05, Mann Whitney U test), while atretic follicle count and fibrosis were significantly higher in G2 (p < 0.05, Mann Whitney U test). Conclusion: The Pomeroy method of tubal ligation reduces regression of angiogenesis in the corpus luteum, and increases atretic follicles and fibrosis development. Melatonin use restores these harmful effects. Melatonin can be used to refrain from this negative effect of the Pomeroy method of tubal ligation on the ovary.