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When to Switch to Additional Food? *When sitting with support *When you want to eat while you eat *Exclusively breastfed - if healthy Whatever is in season should be given as vegetables and fruits! YOU should decide what to eat and your BABY to decide how much to eat! RULES 1) Must be hungry for at least 2-3 hours 2) Eat sitting down (with support) 3) Food must be fresh, daily and smooth. 4) Feed your baby while you are eating, that is, at the meal. 3 DAY RULE CAUTION!!! *rash-flushed *vomiting while waiting *Diarrhea-Constipation *Redness on the buttock *blood in poop If symptoms are seen, the mother should immediately stop whatever she started as supplementary food and consult a doctor. VEGETABLES Potatoes Carrot spinach Green pumpkin pumpkin Celery Artichoke Broccoli Chard Leek Green beans Cabbage Pea Whatever is in season, Hash is mashed with water and made into a puree. 1 teaspoon of olive oil can be added and given to the baby in a maximum of 1 tea glass. Avocado can be given as ripe directly without boiling, by mashing it with 1 teaspoon of olive oil.

BREAST BLEEDINGS Bleeding after the 20th week is seen between 2% and 5% of all pregnancies, except for bleeding in the first 20 weeks due to the risk of miscarriage. Reasons Placenta previa (baby's partner is ahead) It is seen in approximately 30% of prenatal hemorrhages. In most cases seen before 24 weeks of gestation, this will resolve after 24 weeks. Therefore, the diagnosis is made after the 24th week. In this case, which is among the most important causes of prenatal bleeding, delivery is usually performed by cesarean section (sometimes normal delivery can be made considering the distance of the baby's partner to the cervix and the conditions of both the baby and the mother). The risks created by this situation include premature birth, developmental delay in the baby, sudden infant death, and the baby not coming with the head. The predominance of the baby's spouse often presents itself with painless vaginal bleeding. The diagnosis is made by ultrasonography. The expectant mother with this diagnosis should be alert in terms of bleeding, if she is not hospitalized in terms of emergencies near the birth, she should not be admitted to the hospital where the birth is planned at the latest. They should live within 15-20 minutes, know their blood type, and their relatives who can give blood in an emergency should be prepared for this situation. Placental abruption (departure of the baby's partner before birth) It occurs in approximately 20% of prenatal hemorrhages. It can be seen before birth as well as during birth. The amount of bleeding can vary from an occult bleeding to overt bleeding. Intense uterine contractions (unability to relax the uterus) and pain accompanying bleeding are stimulating. Ultrasonography can help in the diagnosis although it does not provide 100% information. Risk factors include high blood pressure, multiple births, smoking, hypertension, and excess water in the baby. The way of delivery is decided according to the well-being of the mother and the baby. Cesarean section is preferred in cases where the lives of mother and baby are threatened. Except for these frequent cases; Engagement, infections of the cervix and vagina, trauma, genital varicose veins, genital masses, vasa previa (passing of the veins from the partner to the baby over the cervix) can be counted among the other causes of prenatal bleeding. As a result, regardless of the cause and amount, prenatal bleeding should be investigated. In such a case, the expectant mother should immediately apply to the hospital. Vaginal expulsion of pregnancy tissue and painful bleeding Painful bleeding with signs of blood loss Disappearance of pregnancy signs without bleeding About 20% of pregnancies have vaginal bleeding. This situation causes great uneasiness for the pregnant woman and her husband. Heavy bleeding in early pregnancy should never be ignored and should be investigated urgently. The amount of bleeding varies from mild to very intense. Painless bleeding is generally considered a threat of miscarriage. Patients seen in clinics mostly have painless bleeding. In most of these patients, bleeding is due to normal changes in the cervix. Pain occurs when tissue or blood clot causes the cervix to open or stretch. Pregnancy may continue normally after the patient has bleeding or pain, there may be a clinical pregnancy loss or this loss may be silent but can be detected on routine ultrasonography screening. It has been shown that 12% of pregnancies with bleeding end in miscarriage. In contrast, many pregnancies are lost before they are recognized. Risk factors The most important risk factor is chromosomal abnormalities in the fetus, other risk factors are advanced maternal age, previous miscarriage, maternal infections, medications and environmental factors, chronic diseases, immune system disorders, and structural abnormalities of the uterus and cervix. Spontaneous abortions are defined in five groups; Threat of Miscarriage (Abortus Imminens) By definition, it is bleeding without a cervix opening. It can be understood by pregnancy hormone (B-hCG) and ultrasound follow-ups that the pregnancy is located in the uterus and maintains healthy growth and development. Threatened miscarriage cases are approached as follow-up. At the threat of miscarriage, it is recommended to restrict their physical activities, bed rest, prohibition of sexual intercourse. In addition, drugs containing progesterone hormone can be used in cases where hormonal failure is considered as the cause of the threat of miscarriage. Despite all precautions, the threat of miscarriage may result in miscarriage, and the most common reason for this termination is that the fetus has a chromosomal anomaly. Anti-D immunoglobin should be administered to women with blood incompatibility who are at risk of miscarriage. If the bleeding is light and there is no pain, it should be considered that the pregnancy will continue. More than 50% of pregnancies with bleeding continue. Inevitable Miscarriage (Abortus Incipiens) The amount of bleeding is excessive, opening of the cervix and abdominal / groin pain may occur. Sometimes fetal parts can be seen in the cervix. If the fetal heart has stopped or the cervix has been opened, the treatment is abortion. blood incompatible

Cervicitis, which is known as a wound in the cervix among the people, is one of the most common gynecological problems. In general terms, cervicitis is inflammation of the cervix tissue. It is often due to an infection, but can sometimes occur after irritation or trauma. More than half of women will get this disease at some point in their lives. Any sexually active woman, regardless of age, is a suitable candidate for cervicitis. Most women with groin pain and vaginal discharge may have cervicitis alone or in combination with another disease. It is difficult for a person to suspect self-cervicitis because its symptoms are similar to many other diseases and do not cause specific complaints. It is usually noticed by a gynecological examination performed for another reason. Symptoms: The first symptom of cervicitis is vaginal discharge that occurs in the period following the end of menstrual bleeding. Other symptoms may include PAIN in the groin, abnormal vaginal bleeding, itching, burning in the vagina, pain during intercourse (dyspareunia), bleeding after intercourse, burning during urination, and lower back pain. In mild cases, there may be no symptoms, but as the event progresses, a foul-smelling and inflammatory discharge appears. A prolonged and untreated cervicitis resulting from cervical wounds can worsen the mucus (cervix secretion) structure, disrupting the entry of sperm into the cervical canal, and thus lead to infertility. Therefore, spontaneous pregnancies may occur in individuals with infertility problems with treatment in experienced hands. For this purpose, the first step of infertility treatment is to properly remove the infections in the cervix and vagina. Because one of the causes of infertility is cervical problems called cervical factor. Even if a woman with cervicitis becomes pregnant, there is a risk of miscarriage and premature birth. In addition, postnatal lung and eye infections are more common in babies born to such mothers. Diagnosis: Even just a gynecological examination is highly informative. The most common problems in the cervix; Cervicitis and Cervical “ectropion” are cases of external epithelium called. Cervicitis, that is, inflammation of the cervix, develops as a result of the body's normally functioning defense mechanisms. When there is injury, irritation or infection in any tissue, white blood cells, that is, white blood cells, migrate to that area and blood flow in this area increases. When this event occurs in the cervix, the normally light pink cervix becomes red and swollen. This can be seen as a wound on examination. Although the diagnosis of cervicitis is usually made by gynecological examination, some additional tests may be required to be sure of the diagnosis and to make a definitive diagnosis. It is very important to recognize the lesions on the cervix. As a matter of fact, sometimes cervical cancers can be confused with cervical wounds, especially in the early stages. Tests Used in the Diagnosis of Cervicitis: Smear: It is used to screen for cervical infection and early cervical cancer. Smear is an extremely simple yet important test that every woman should have once a year. During the examination, it includes the procedures of taking a swab from the cervical secretion with a thin brush and spreading it on a glass and performing the pathological examination. It is a painless and simple procedure. Biopsy: If the cervix looks extremely abnormal, a biopsy of the cervix (piece removal) can be performed from suspicious areas under local anesthesia. If a single area cannot be identified, a biopsy is taken at the 3, 6, 9 and 12 o'clock positions and sent for pathological examination. Colposcopy: It is the examination of the cervix and vagina under the light with the help of an optical instrument similar to a magnifying glass. In order to reveal suspicious areas more easily, the cervix is ​​wiped with some chemical substances before colposcopy and then painted. The place where the biopsy will be taken is determined according to the differences in dye retention of the tissue. With colposcopy, the structures of the capillaries in the cervix are also evaluated and it is determined whether there is abnormal vascularity. These vascular changes are important in distinguishing between cervicitis and malignant diseases. Cervicitis Causes: Successful treatment of cervicitis is related to identifying the underlying cause. If the cause is a simple irritant, not using this substance will solve the problem. If the underlying cause is an infection, appropriate antibiotic treatment will also solve the cervicitis problem. The three most important microorganisms causing cervicitis are chlamydia, gonorrhea and trichomonas. In addition, some allergic substances can cause this situation. Cervicitis Treatment: If the condition of cervicitis is prolonged or there is no regression despite the treatment of the underlying cause, some minor surgical interventions can be performed to destroy the abnormal cells in this area. The most commonly used are cauterization (burning), cryotherapy (freezing) and laser treatments. The purpose is the same in all three methods: to kill the inflammatory tissue. A tissue can be destroyed by burning or freezing. cauterization : Cauterization is destruction with the help of heat. in public

Childbirth is perhaps one of the most painful situations in life. Labor pains cause unnecessary pain and physiological stress to the mother, as well as cause the mother to become tired. Therefore, in recent years, the use of anesthetized pain relief techniques for labor and delivery has become very common. WHEN IS PAINLESS DELIVERY APPLIED? It is applied when uterine contractions become regular (birth pains settle), when the cervix thins by about 60-70% and its opening reaches 4 cm, that is, when the contractions begin to seriously disturb the mother. Application before it affects the contractions and delays the birth. If it is late, both the mother will suffer unnecessary pain and the pain will come more frequently, so the expectant mother cannot remain still during the procedure and epidural administration may become difficult. HOW TO MAKE PAINLESS BIRTH? It is performed by injecting pain relievers around the dura mater membrane (Epidural area) in the lumbar region. The expectant mother feels the pressure, the touch, she can even get up and walk, but she does not feel the pain. There are labor pains and contractions necessary for normal birth, but they do not bother. The process takes place in 3 stages: In the first stage, the area to be treated on the mother's back is wiped with an antiseptic liquid (Baticon) and covered with a sterile cover. This is to prevent infection. In the second stage, the skin and subcutaneous tissue are anesthetized with a very thin needle. In the third stage, a catheter is placed in the epidural area with the help of a blunt needle (tohy needle) and medication is given. Especially at this stage, it is very important for the mother to stand still for a few minutes. The catheter is a thin tube made of a soft material. When the effect of the first drug wears off, it is placed so that additional drugs can be made. The outside part of the catheter is adhered to the shoulder with a special non-allergic plaster. From here, medication can be given from time to time as needed, or a certain dose of medication can be given continuously with pre-programmed automatic pumps. When the expectant mother feels the need, she can make an additional dose to herself by pressing a button connected to this pump. This is called Patient Controlled Analgesia (PCA). This catheter is easily removed without any pain when the mother is no longer in pain after delivery. Since the purpose of applying epidural anesthesia in normal birth is to relieve pain only, strong painkillers are also given to the epidural space with local anesthetics in lower doses compared to cesarean section surgeries. In this way, since the motor will not be lost, the expectant mother can feel the touch and move her legs even though she does not feel pain. By keeping the amount of local anesthetic very low, the expectant mother can even walk during normal labor.

Diagnostic hysteroscopy is a method applied to diagnose pathologies such as polyps, fibroids, adhesions, and septum. This method allows the inside of the uterus to be observed by examining the inner layer of the uterus after filling the uterus with an optical instrument with a cold light source, and allows intrauterine operations to be performed with the help of small instruments. Hysteroscopy method is used in the detection and treatment of recurrent miscarriages, abnormal menstrual bleeding and all intrauterine pathologies. There are two types of this method. These two types are called Diagnostic (Diagnostic) Hysteroscopy and Operative (Surgical) Hysteroscopy. At this stage, it is necessary to give the details of the methods by answering the question What is Diagnostic and Operative Hysteroscopy. What is Diagnostic Hysteroscopy? Diagnostic hysteroscopy, most commonly known as "Office Hysteroscopy", is performed with the aim of examining the inside of the uterus. Because it is applicable during the examination, it is more commonly called office hysteroscopy. Diagnostic hysteroscopy is performed through a lighted optical system called a telescope, as in the laparoscopy method. However, the diameter of this system is quite thin. The diameter of the systems used for diagnostic purposes is 5 mm on average. Intervention is performed without enlarging the cervix, that is, dilatation. This procedure is performed in the gynecological examination position. What is Diagnostic and Operative Hysteroscopy? In diagnostic hysteroscopy, some special fluids are given through the cervix. Thus, the uterine walls are separated from each other during the procedure. After the liquid filling, the structures in the enlarged uterus can be directly visualized by the hysteroscopy method. Thus, all intrauterine pathologies can be easily evaluated. Diagnostic hysteroscopy is usually performed without the need for anesthesia. This method, which is performed without the need for local anesthesia and hospitalization, is performed in a certain period. It is usually performed a few days after the menstrual bleeding ends, so that the inside of the uterus can be evaluated more clearly and easily. During this period, the entire uterus is suitable for detailed examination, both structurally and functionally. All intrauterine pathologies such as uterine fibroids, polyps and adhesions can be detected directly through diagnostic, that is, office hysteroscopy. After hysteroscopy, the diagnosis is made and appropriate methods and preparations for treatment are started if necessary. What is Operative (Surgical) Hysteroscopy? Many abnormalities diagnosed during diagnostic hysteroscopy can be treated with "Operative (Surgical) Hysteroscopy", that is, surgically as the name suggests. In particular, polyps in the uterus (growing parts), septum (the part that causes the uterus to divide), adhesion (adhesion) and intrauterine fibroids can be treated surgically by this method. What is Diagnostic and Operative Hysteroscopy? At this point, where the subject is explained in detail, we can say that the instruments to be used in the operation are allowed to pass through the uterus through the channels in the hysteroscope used in hysteroscopy. Surgical instruments to be used during the procedure can easily pass through these channels in the hysteroscope. After the technique designed in this system, surgical intervention is started. Adhesions, fibroids and polyps that can be seen in the uterus are treated during surgery, that is, operative hysteroscopy. If there is a congenital abnormality or if there is a septum dividing the uterus completely or partially, it is corrected by hysteroscopy. After this intervention, a special anti-adhesion gel is applied to the uterus in order to prevent the uterine walls from sticking together. After the end of the entire intervention, some hormone drugs and antibiotics are used and the risk of infection is minimized. In addition, hormonal drugs can provide a faster healing of the intrauterine membrane. What Are the Risks of Diagnostic and Operative Hysteroscopy? The complication rate of diagnostic hysteroscopy is quite low. This rate is the same in operative hysteroscopy. However, perforation of the uterus is the most common complication in both of these methods. The resulting holes usually heal on their own without the need for a surgical intervention. Other complications are caused by the fluids used at the beginning of the procedure and injected into the uterus to expand the uterus. These fluids can cause allergic reactions in patients. Complications due to these drugs, which have side effects such as decreased body temperature, blood coagulation problems, respiratory difficulties and fluid accumulation in the lungs, are rarely encountered in diagnostic and operative hysteroscopy. Except for perforation of the uterus during the operative hysteroscopy procedure,

In vitro fertilization is a form of treatment for women who cannot become pregnant naturally. It was first introduced in England in 1978. In vitro fertilization method is based on the discipline of taking the sperm cell of the man and the egg cell of the woman, combining them in the laboratory environment and fertilizing them at a certain temperature. The embryo formed as a result of fusion is placed into the uterus with the help of a thin catheter. In order for the treatment to be successful, there are some points that couples should pay attention to during the preparation process for IVF treatment. Paying attention to lifestyle before IVF treatment significantly increases the success rate of the treatment. The factors that will affect the success of IVF treatment can be listed as follows; Cigarettes and alcohol Mothers and fathers who decide on IVF treatment should definitely stay away from smoking and alcohol. Smoking affects egg quality and the health of the uterine wall in women. In men, it impairs sperm quality. According to studies, the success rate of IVF treatment in smokers is significantly lower. In the case of passive smoking, the same disadvantages exist. In the preparation process for IVF treatment, smoking and alcohol should be stopped 3 months before the treatment starts. Not Being in Hot Environments Hot environments such as baths, spas and saunas reduce the quality of sperm in men and egg quality in women. It is recommended not to be in such environments at least 3 months before IVF treatment. Weight Control - Obesity Obesity, which requires treatment, negatively affects all body functions, and in women, the ovulation pattern is also negatively affected by obesity. In obese women, menstrual periods are irregular and the number and quality of eggs are low. Obesity causes an increase in the testosterone hormone level in the woman's body, causing a decline in female functions. Expectant mothers should be at their ideal weight before starting IVF treatment. According to studies, the success rate of IVF treatment in obese individuals is significantly lower. Even if pregnancy is achieved, the risk of miscarriage is high. Initiation of in vitro fertilization by obese women will lead to drug loading to increase the number and quality of eggs. Despite all this, if in vitro fertilization treatment is started in obese women, the follicles are insufficient and egg development is weak. Expectant mothers should lose weight under the control of a dietitian during the preparation process for IVF treatment. Obesity is also an important factor affecting the success of IVF treatment for men. This problem; It causes infertility and low sperm quality in men. It is observed that the sperm count in obese men is 20% less than in men of ideal weight. Importance of Nutrition in IVF Treatment Couples who decide on IVF treatment should also regulate their nutrition in a conscious and disciplined way. • Containing vitamin E; foods such as cereals, soy products, legumes, broccoli should be consumed. • Containing vitamin A; Vegetables such as black cabbage and cauliflower should be consumed. • Milk and dairy products with vitamin C and D content, such as orange juice, should be consumed. • Foods containing calcium, iron and zinc should be consumed. • Care should be taken to get Omega 3 and Omega 6 from food. • It is very important to start taking folic acid vitamin, which is valid for every pregnant woman, before pregnancy. This vitamin can be taken from green leafy vegetables, unground grains, foods such as soy, or it can be taken in pill form when necessary. Behaviors to be Followed by the Father-to-be During the Preparation Process Before IVF Treatment Before IVF treatment, the man should pay attention to some issues for sperm quality; • If you are being treated for another ailment and taking medication, the doctor must be informed. • Smoking and alcohol should not be used in the last 3 months before the application. • If heavy sports are done, it should be stopped during the preparation period (last 3 months) before IVF treatment. • Avoid hot environments such as baths and spas. Heat affects sperm quality. • Febrile diseases affect the success of treatment by reducing sperm quality. If there is a febrile illness within 2 months before starting the treatment, the doctor should be informed. • Loose and comfortable underwear should be preferred. Tight clothes should not be worn. • If there is any disease in the genital area, the doctor must be informed. • You should not have sexual intercourse for the last three days before the treatment and for at least 10 days after the application. Behaviors to be followed by expectant mothers before IVF • If you are being treated for another ailment and taking medication, the doctor must be informed. • The doctor should be informed about past or ongoing genital disorders.

The most obvious cause of vaginal enlargement is childbirth. Vaginal width is around 2 cm on average. This width reaches up to 15 cm at birth. It is possible to say that all muscle tissues around the vagina are deformed and torn after this expansion. For this reason, we can first explain that there are normal births under the question title of What are the Causes of Vaginal Enlargement. After the tears in the muscle tissue during normal delivery, the vagina does not return to its former structure and tightness and cannot reach its former stenosis. However, depending on the increase in the number of sexual intercourse, vaginal enlargement occurs. However, this situation has some effect on vaginal enlargement, although not much. During birth, incisions called episiotomy are made in order to facilitate the birth of the baby during the exit of the baby from the vaginal canal and to prevent the formation of tears extending towards the anus. This incision is closed by suturing after the baby is released. If this suture is not placed properly, infections or problems in the healing process may occur. In these cases, enlargement of the vagina is observed. Another reason affecting the expansion is; is age. With the advancing age, loosening is observed in all body tissues. In addition, stretching may occur with relaxation in the muscle tissues and connective tissues around the vagina. After the flexibility of the muscles and connective tissues, enlargements are seen in the vagina. Some women may have collagen tissue differences. Indirect textures from these differences are very flexible. For this reason, vaginal enlargement is more common in such people. In addition, these enlargements, which cause a big problem at earlier ages, lead to treatment for vaginal enlargement in the 20s. As a result of vaginal enlargement, some sexual problems are experienced and this problem is disturbing and causes a picture for many women. What are the Causes of Vagina Enlargement? These problems, accompanied by both aesthetic and functional deterioration, are eliminated by vaginal tightening surgeries. Risk Factors Causing Vagina Enlargement: There are a number of risk factors other than the factors mentioned above in the title of What are the Causes of Vaginal Enlargement. Especially menopause is an important risk factor for this vaginal enlargement. Estrogen hormone, which is actively secreted during the fertile period, helps to strengthen the muscle and connective tissues in the pelvic structures. However, due to the decrease in estrogen levels after the menopause period, the strength in this pelvic region is lost. As a result, vaginal enlargement is observed, accompanied by loosening of the muscle and connective tissues in the vaginal region. As it is known, the uterus, that is, the uterus, is in the support structure located on the upper part of the vagina. Hysterectomy also refers to the surgical removal and removal of the uterus. In cases where the uterus is removed, the upper part of the vagina may fall into the vaginal opening. In this case, sagging of the vaginal dome occurs and causes enlargement. Considering all the reasons and risk factors mentioned above, it is possible to summarize the factors that cause vaginal enlargement. Birth Age Menopause Race Obesity Deformations of tissues and muscles Dysfunctions in nerves and tissues Past pelvic surgeries Apart from all these risk factors and reasons, vaginal enlargement is also seen during menstrual periods. In order to ensure blood flow through the vagina during the menstrual period, there are enlargements of 1-2 cm in diameter. However, these enlargements narrow after the end of menstrual bleeding and the vagina returns to its former narrowness. However, the wrong information in the title of What are the Causes of Vagina Enlargement should also be corrected. It is thought by many that there are enlargements in the vagina during sexual intercourse or depending on the number of sexual intercourse. This has a very small effect on the enlargement of the vagina. In other words, since the vagina has an elastic structure, it has a structure that can stretch both during intercourse and during childbirth. Therefore, changes in the vagina during arousal and sexual intercourse should be perceived as completely normal. In other words, we can say that the vagina, which is suitable to expand up to 15 cm in diameter during childbirth, will not expand after sexual intercourse or depending on the number of them, which causes discomfort and deformation. At this point, it is recommended that patients who think that they have vaginal enlargement should have a comprehensive physical examination. Vaginal narrowing is diagnosed with the patient's history and physical examination. The treatment method to be applied after the diagnosis of enlargement varies according to the type of enlargement or sagging. For this situation, the physician examines each area of ​​the vagina in detail and performs a number of tests.

“Cancer” is a disease that can be treated today, thanks to being conscious about its symptoms and being able to diagnose it at an early stage. Preventing cancer and living a healthy life is possible by paying attention to the small changes that may occur in the body. If the swelling in the abdomen lasts longer than 2 weeks… Persistent abdominal swelling lasting 2 weeks or longer should be taken seriously. Abdominal swelling or enlargement may be an early and sometimes the only sign of ovarian cancer. Abdominal swelling can also be a symptom of colorectal cancers, which are common in both men and women, with a high risk of death. If you have digestive difficulties after a small amount of food… Feeling full even after a small meal can be a sign of ovarian, pancreatic or stomach cancer. Pancreatic cancer is the most difficult to treat and must be detected at the earliest possible stage. Other common symptoms of pancreatic cancer in both men and women are; loss of appetite, involuntary weight loss, yellow eyes and/or skin (jaundice), and pale, large, slippery and floating stools. If you urinate frequently and defecation habits change… Frequent urination or inability to urinate despite frequent urination is one of the insidious symptoms of bladder cancer. In this disease, which mostly affects older men, reddish yellow or dark red urine is seen. Frequent urge to urinate is one of the prominent symptoms of ovarian cancer. Changes in defecation habits that last longer than a few days (diarrhea, constipation, etc.) or symptoms such as the feeling of defecation and inability to relax after defecation may also be indicators of colorectal cancer. If a palpable mass and changes are seen in the breast… Although a breast mass is one of the most common symptoms of breast cancer, there are also more noticeable symptoms. Swelling of all or part of the breast, redness or discoloration of the skin of the breast can be signs of inflammatory (inflammatory) breast cancer, which is rare but very aggressive and carries a risk of loss of life. These symptoms are not only for women, but also for men, which should be considered in breast cancer. If you are losing weight unintentionally… If weight loss happens unintentionally, it may be a sign of cancer. unexplained weight loss; It is a common symptom in stomach, pancreatic, lung and sometimes kidney cancers. Involuntary weight loss is when a person experiences weight loss despite having a good appetite and eating well. In addition, some people may experience symptoms of nausea, vomiting, and weakness. If the hoarseness lasts for a long time… hoarseness; it can be evaluated as a cold, allergy or a simple voice disorder. However, attention should be paid to the ongoing hoarseness. It allows smokers to consult a doctor in ongoing hoarseness, which allows for earlier diagnosis of possible laryngeal or lung cancer and a more effective treatment. Also, hoarseness can be a sign of esophageal, stomach, or thyroid cancer. If there are lines on the nails… Dark streaks on your toe or fingernails may not be a cause for concern, or they may be a sign of skin cancer (melanoma), one of the cancers with the highest risk of loss of life. These symptoms should not be ignored. In addition, it should not be forgotten that chronic wounds, skin tuberculosis, scars, chemicals containing some carcinogenic substances, and moles (large moles with different colors and shapes) may play an active role in skin cancer.

One of the biggest problems experienced after full response cancer treatments is the risk of recurrence (recurrence) after many years. So what is the factor that causes cancer to reappear after many years? Tumor dormancy is when cancer cells "sleep" undiagnosed for long periods of time. These types of cells bypass standard treatments and begin to divide again after many years, causing the cancer to recur. Cancer types in which tumor sleep is frequently observed; -breast cancer, -prostate cancer, - skin cancer (malignant melanoma) and It is B cell lymphoma. Sleeping cancer cells have 4 main features: 1. Growth at a slow rate, 2. Resistance to standard cancer treatments, 3. Bypassing the immune system and 4. Self-renewal The control of cell growth is done by an advanced manager. They do not reproduce until the environmental conditions are suitable. There are 3 types of tumor sleep mechanisms: 1) Cellular sleep: Cells are constantly kept at the G0 checkpoint. For this reason, they do not divide and do not reproduce. 2) Angiogenic sleep: Since cancer cells grow very quickly, they need to form vessels to provide nutrients after a while. However, some cells cannot form enough blood vessels. Growth rates stop, a constant balance occurs in the number of dying cells and growing cells. This balance is called angiogenic sleep. 3) Immunogenic sleep: Our immune system approaches tumors in 3 ways. They are elimination (destruction), Equilibrium (equilibrium) and escape sections. Some tumor cells learn and adapt to appear "friendly" to our immune system. In this way, it stays dormant for years. Standard cancer treatments and environmental factors can cause these cells to wake up and divide aggressively. Why and how tumor cells fall asleep has not yet been answered. Recent studies show that epigenetic (genetic and environmental relationship) factors are effective. The fact that these cells are the same type of cells can be successful against tumor dormancy in targeted therapies developed against cancer stem cells. Another problem is whether dormant cancer cells are still present in all patients who have been successfully treated for cancer. In recent years, it has been discussed how a strategy should be developed against tumor sleep in cancer research. There are basically two options; 1. Developing treatments that awaken dormant cancer cells or 2. Treatments that keep the tumor dormant? In recent clinical studies, it has been observed that treatments that awaken the tumor from sleep cause the cancer cell to begin to divide more aggressively, and cancer cells with multi-drug resistance begin to develop. For this reason, the generally accepted view is to develop treatments that will keep the tumor dormant. Drugs targeting epigenetic factors show promise for this purpose. Sağlıklı ve mutlu kalın...

In the treatment of botox in chronic migraine, toxin injections are made to 7 different areas and 31 points. More injections can be made into the areas where the pain is more intense. The trigger area is usually right or left forehead, temple or nape. This treatment is applied every 3 months. It is applied in cures ranging from 3-5 cures. After botox treatment in migraine, 70% of the patients had a 50% reduction. In addition, significant improvements are observed in the quality of life and the amount of disability related to headaches in these patients. As a result of Botox treatment, significant improvements occur in the vitality, psychological state and general life of the patients. How long after Botox injection takes effect? The effect begins to be seen 2 to 7 days after the injection. One month after the injection, the patient is examined again. What are the most common side effects of Botox injection? Botox injections have few obvious side effects. However, temporary side effects such as swelling, redness and tenderness at the injection site, pain in the face and head, drooping of the eyebrows (ptosis), flu-like complaints, hematoma at the injection site, flushing, dry mouth, and muscle weakness may be observed. Doing sports, massaging, rubbing the injection sites, playing, tilting the head forward, lying down immediately after the application and taking a hot bath should be avoided for the first 4 hours after the Botox application. If your headaches that you have been suffering for years do not go away, Botox injection may be an option for you. The effect of Botox on migraine was unknown until recently. This treatment was discovered by chance, when it was noticed that migraine attacks improved after botox injection in patients with migraine who received botox injection to correct wrinkles in the facial area. The underlying cause of most of the migraine headaches is the tension of the muscles in the head area. If the tension of the muscles causing the migraine attacks is removed, that is, if the muscles are relaxed, the factor causing migraine pain will be eliminated. Many pain relievers are used in the treatment of migraine. However, the biggest advantage of botox is that botox does not relieve pain, it prevents the emergence of pain. 80-90% of migraine patients benefit from botox. The effect of Botox in the treatment of migraine lasts for about 4 months. In other words, after a botox application, its effect starts within 7-10 days and you experience a pain-free period for 4 months. When the effect starts to wear off at the end of the 4th month, a new application is required. How is Botox injection done? Botox is administered as a drug injection. It is not a painful procedure. Injection is done with a very fine-tipped needle. At the time of the injection, you may feel a slight pain due to the needle prick, the only pain you will feel is this. If Botox is to be applied for migraine treatment, it should be applied inside the muscles causing tension, inside the muscles causing wrinkles if it is desired to be corrected, and under the skin in the area with sweating complaint if sweating treatment is to be applied. It's a 5-10 minute process in total. How long is the effect of Botox? The effect of Botox becomes sufficient 1 week after the injection application, the effect increases day by day and becomes established at the end of 1 month. It stays at this level for 2-3 months and then starts to decrease gradually, after 5-6 months its effect completely disappears. With repeated injections, the duration of action is longer. When the effect of Botox wears off, it can be applied repeatedly without any inconvenience.

Although tarsal tunnel syndrome, which is one of the causes of pain in the ankle and sole of the foot, is known as a rare entrapment neuropathy, it is one of the entrapment neuropathies we encounter frequently in our neurology outpatient clinic. It is an entrapment neuropathy characterized by pain, numbness and loss of strength that can start from the inner part of the ankle and spread to the entire sole of the foot. It occurs as a result of compression of the posterior tibial nerve, which comes from the leg and goes to the toes, as it passes through the canal called the tarsal tunnel in the inner part of the ankle. Causes of tarsal tunnel syndrome Traumas of the ankle, cysts in the wrist, vascular anomalies, tumors, infections can cause tarsal tunnel syndrome. However, in our outpatient clinic, we encounter more often overweight women who stand a lot and do not wear suitable and comfortable shoes. The nerve is easily compressed in the tarsal tunnel, which is also narrowed by continuous and excessive load on the ankle and weight gain. The pain hits the soles of the feet as well as the upper legs. In most patients, because the pain spreads over a wide area, the person cannot recognize the focal point where the pain starts. For this reason, heel spurs are confused with other causes of pain such as rheumatic diseases, sciatica, and it becomes difficult to make an accurate diagnosis. The definitive diagnosis of the disease is made by MRI examination of the ankle and EMG examination. Treatment in Tarsal Tunnel Syndrome If there is an underlying cause such as infection, edema, cyst, tumor, these causes should be eliminated. First of all, the condition causing tarsal tunnel syndrome should be eliminated. Such as losing weight, not standing too long, using suitable and comfortable shoes. Analgesic and anti-inflammatory drugs can be used in neuropathic pain in consultation with a neurologist. In patients who do not respond adequately with these measures, local cortisone injection can be applied to this area under the control of a neurologist. If there is no response despite all these treatments, the treatment is surgery.

TREMOR Tremor: It means tremor in Turkish. It is a movement disorder that occurs with short-term contraction of the muscles. It is frequently seen in Turkey and all over the world. Not every tremor (tremor) is a symptom of disease. There are also physiological tremors, that is, tremors that are not related to a pathology in the brain, and they are seen quite frequently (4%) over the age of 40. It is one of the most common movement disorders. essential tremor; It is also known as benign, familial or hereditary tremor. It is among the most common movement disorders. It begins in adulthood and progresses with aging. It is in the form of postural and kinetic tremor. That is, they occur in a certain position (when the hands are extended forward) or during movement (while holding a glass, spoon or writing). It is most common in the hands. Then it occurs in the head and neck, legs, voice (larynx) and trunk. They generally do not initially affect the patient's daily work. However, in the future, it can become a situation that seriously affects the quality of life, mostly in hyper-adrenergic conditions (excitement-stress). The tremors of people with tremor increase in cases of stress, insomnia and excessive caffeine consumption. The patient does not have any other neurological symptoms. There is no pathology in imaging methods and blood analysis. Shivering can sometimes occur in thyroid dysfunctions. These types of tremors are usually hereditary. It is necessary to distinguish essential tremor from Parkinson's disease tremor. The incidence of essential tremor is 10 times more common than Parkinson's disease. Parkinson's tremor is static tremor. Contrary to essential tremor, it occurs at rest, when the hands are in a relaxed position, and decreases with movement. There are other neurological findings that are not seen in patients with essential tremor in Parkinson's disease. These are findings such as slowing down in movements, walking with small steps, walking with the head and trunk tilted forward, decrease in facial expressions, stiffness in the muscles we call rigidity. Although it is not as frequent as essential tremor, one of the tremors that should not be confused is cerebellar (in cerebellar lesions) tremor. It is a kinetic (occurring with movement) tremor like essential tremor. It is more severe than essential tremor. The tremor increases as the hands get closer to the target. As the glass gets closer to the mouth, it increases and starts to pour out while drinking the full water. In addition, patients with cerebellar pathology may have other examination findings such as instability while walking and sitting, which are not seen in essential tremor. ET does not shorten your lifespan. The tremor may increase over time, but change is usually slow and occurs over years. As a result, some patients may experience some disability, such as difficulty in writing, eating and drinking, and even social embarrassment. Mild tremors do not need to be treated, and early treatment does not stop or slow the natural course of the disease. Treatment of essential tremor; If tremors reduce the patient's quality of life, drug therapy is started when he begins to have difficulty performing daily activities. Propranolol is one of the most used drugs. However, care should be taken to ensure that the patient's blood pressure and pulse are not low. Another drug is primidone; It is an anti-epileptic drug. It is necessary to start with very low doses and increase. Drugs such as benzodiazepine, gabapetin, topiramate are also used. In addition, botulinum toxin injection can be applied to the affected muscle groups. It has been observed that it is more effective especially in head-neck tremors. There are surgical treatment methods for patients with severe tremor who cannot get results with drug therapy. These are: • Thalamatomy; It is a brain surgery performed by damaging the thalamus region of the brain. • Deep brain stimulation (DBS); In another thalamus surgery, a wire called an electrode is placed in the thalamus area and connected to a battery-like device that is placed under the skin on the chest.