Publications by authors named "Adnan Incebiyik"

36 Publications

Recurrent pregnancy loss and metabolic syndrome.

Ginekol Pol 2020;91(6):320-323

Sanliurfa Eyyubiye Government Hospital, Sanliurfa, Turkey.

Objectives: The aim of this study was to evaluate the frequency of metabolic syndrome (MetS) and its components in patients with unexplained recurrent pregnancy loss (RPL).

Material And Methods: A cross-sectional study was held including 115 patients with unexplained RPL who were referred to a tertiary center between December 2018 and December 2019. In the study, MetS was classified according to The National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria on the basis of metabolic risk factors. Frequency of MetS in the patients with unexplained RPL was investigated. The relationship between miscarriage rate and metabolic risk factors was also evaluated.

Results: According to our study the percentage of MetS in patients with unexplained RPL was 24.4%. When evaluated according to different age groups, it was 18.4% in patients aged 20-29 years, and it was 27.8% in patients aged 30-39 years. At least having one of its components were high (82.6%) in all patients with unexplained RPL.

Conclusions: The percentage of MetS or of at least having one of its components were high in patients with unexplained RPL. Increased number of having MetS components were associated with increased miscarriage rate.
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http://dx.doi.org/10.5603/GP.a2020.0063DOI Listing
January 2020

The Effects of Rocuronium-sugammadex on Fetomaternal Outcomes in Pregnancy Undergoing Electroconvulsive Therapy: A Retrospective Case Series and Literature Review.

Cureus 2019 Jun 3;11(6):e4820. Epub 2019 Jun 3.

Anesthesiology and Critical Care, University of Harran, Sanliurfa, TUR.

Introduction The aim of this study was to evaluate the anesthesia management of pregnant patients who received electroconvulsive therapy (ECT) at our hospital and to examine the effects of this procedure on mothers and fetuses. Methods This study was conducted with 15 pregnant patients who underwent the ECT procedure who did not benefit from medical treatment or who did not want medical treatment. We evaluated the psychiatric, obstetric, and especially anesthesiology records of these patients. All of the patients received 1 mg/kg propofol with 0.6 mg/kg rocuronium. Eight mg/kg sugammadex was used to terminate the effects of the non-depolarizing neuromuscular blocking agents. Their demographic characteristics, history of diagnosis, total ECT sessions, duration of hospitalization, discharge status, neonatal outcomes, short- and long-term maternal or fetal complications, anesthetic management, and recovery parameters were retrospectively reviewed. Results Fifteen pregnant patients received a total of 95 ECT treatments. No anesthesia-related maternal complications developed. In terms of the recovery parameters of the patients, the mean duration of the motor seizure was 28.7 ± 6.3 seconds, the mean time to spontaneous respiration was 224 ± 21.8 secs, the mean time to opening the eyes was 403.6 ± 21.1 secs, and the mean time to command compliance was 415.24 ± 81.15 secs. The mean gestational week was 14.06 ± 6.65, and the mean number of pregnancies was 2.87 ± 2.29. Seven (46,7%) patients were in the first trimester of pregnancy, six (40%) were in the second trimester, and two (13.3%) were in the third trimester. Spontaneous abortion occurred in four patients, six patients gave birth by spontaneous vaginal delivery, and five patients delivered by cesarean section. Neonatal respiratory distress developed in only one fetus. Conclusion Anesthesia management during ECT can be provided safely by using propofol and rocuronium-sugammadex in pregnancy in the postoperative period. However, there is a risk of abortion and neonatal respiratory distress in the use of ECT, especially in the first trimester period. It is advisable to inform the patient's family in detail before this procedure outcome.
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http://dx.doi.org/10.7759/cureus.4820DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682383PMC
June 2019

Effect of spinal anesthesia on the QT interval in term and post-term pregnancies scheduled for elective cesarean section: a prospective study.

J Matern Fetal Neonatal Med 2020 Sep 27;33(18):3147-3151. Epub 2019 Jan 27.

Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey.

In this study, we aimed to investigate the effects of spinal anesthesia on the QT interval in patients with term and post-term pregnancy that were scheduled for elective cesarean section. Forty pregnant women scheduled for elective cesarean section under spinal anesthesia were assigned into two groups: Post-term group (Group P) ( = 20) and Term group (Group T) ( = 20). After entering the operation room, standard monitoring [electrocardiography (ECG), noninvasive blood pressure, heart rate, respiratory rate, and peripheral oxygen saturation] was performed. The patient was placed in the sitting position and spinal anesthesia was performed with a median approach at the L3-L4a level using a 25G Quincke-type spinal needle. After cerebrospinal fluid was viewed, 12.5 mg (2.5 mL) hyperbaric bupivacaine was administered intrathecally over 1 min. Other ECG records were made at min 1 (T1), 5 (T2), and 10 (T3) after the induction of spinal anesthesia and after skin closure (T4). QT and QT dispersion were measured from ECG. Heart rate-corrected QT (QTc) and QT dispersion (QTcd) values were calculated using the Bazett formula. Demographic characteristics of the patients were similar in both groups. Postoperative QTc, QTd, and QTcd values were significantly increased in Group P compared to those in Group T ( < .05). Spinal anesthesia led to increased postoperative QTc, QTd, and QTcd values in the patients with a gestational age of ≥42 weeks who underwent cesarean section. Accordingly, it is advisable to perform postoperative strict cardiac monitoring particularly in post-term pregnant women undergoing spinal anesthesia.
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http://dx.doi.org/10.1080/14767058.2019.1569620DOI Listing
September 2020

Cytogenetic screening in couples with Habitual Abortions.

J Gynecol Obstet Hum Reprod 2019 Mar 6;48(3):155-158. Epub 2018 Nov 6.

Harran University, Faculty of Medicine, Department of Obstetrics and Gynecology, Sanliurfa, Turkey.

Objective: Habitual abortion (HA) is defined at least three consecutive pregnancy losses. One of the etiologic causes is parental chromosomal anomalies. In this study, we aimed to that investigate the effect of parental chromosomal abnormalities on HA.

Methods: The cytogenetic results of patients with at least three abortions referred to our university hospital between January 2010 - March 2017 were evaluated. A total of 1154 couples with HA were analysed. Peripheral lymphocyte cultures incubated for 72 h were used for karyotype analysis via the Giemsa banding technique.

Results: Of a total 1154 couples (2308 patients) 37 female (3.2%) and 17 male (1.47%) had abnormal karyotypes. Reciprocal translocation carriage (n = 26; 1.12%) was the most commonly detected structural anomaly, followed by X chromosome mosaicism (n = 16; 0.69%),Robertsoniantranslocation (n = 9; 0.38%), Chromosomal inversion (n = 6; 0.26%). Chromosomal polymorphisms, which are considered minor chromosomal changes, were detected in 221 (9.57%) individuals.

Conclusion: Our study exhibits that chromosomal analysis in patient with HA is an appropriate approach to elucidate the aetiology of HA. Data from cytogenetic screening can be used in guiding couples planning future pregnancies and in prenatal diagnosis of chromosomal anomalies in the foetus.
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http://dx.doi.org/10.1016/j.jogoh.2018.10.021DOI Listing
March 2019

Associations of serum fetuin-A and oxidative stress parameters with polycystic ovary syndrome.

Clin Exp Reprod Med 2018 Sep 3;45(3):116-121. Epub 2018 Sep 3.

Department of Obstetrics and Gynaecology, Faculty of Medicine, Harran University, Sanliurfa, Turkey.

Objective: The aim of this study was to compare serum fetuin-A levels and oxidative stress markers, as indicators of insulin resistance, in women with polycystic ovary syndrome (PCOS) and in healthy controls.

Methods: This prospective case-control study included 46 patients with PCOS and 48 age- and body mass index-matched control women. Levels of serum hormones, fetuin-A, and oxidative stress markers were measured in blood samples taken during the early follicular period from each participant.

Results: Follicle-stimulating hormone (FSH), luteinising hormone (LH), total testosterone levels, and the LH/FSH ratio were found to be significantly higher in women with PCOS than in controls. Serum total antioxidant status, total oxidant status, and oxidative stress index parameters all indicated significantly higher levels of oxidative stress in PCOS patients than in controls. Serum fetuin-A levels, which were analyzed as an indicator of insulin resistance, were higher in the PCOS group than in the control group (210.26±65.06 µg/mL and 182.68±51.20 µg/mL, respectively; =0.024).

Conclusion: The data obtained from the present study suggest that higher levels of both serum fetuin-A and oxidative stress markers might be related with PCOS.
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http://dx.doi.org/10.5653/cerm.2018.45.3.116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125147PMC
September 2018

Copper and ceruloplasmin levels are closely related to the severity of preeclampsia.

J Matern Fetal Neonatal Med 2020 Jan 18;33(1):96-102. Epub 2018 Jul 18.

Harran University School of Medicine, Sanliurfa, Turkey.

The aim of this study was to investigate the maternal serum concentrations of copper (Cu) and ceruloplasmin (CP) in patients with mild preeclampsia, severe preeclampsia, hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome, and to determine their association with the severity of the disease. This study was carried out at the largest tertiary care health center in the southeast region in Turkey and Department of Obstetrics and Gynecology, Dicle University Hospital. A total of 179 pregnant women, including 58 healthy pregnant women and 71 mild preeclampsia, 26 severe preeclampsia, and 24 HELLP syndrome cases classified according to the American College of Obstetricians and Gynecologists' 2013 guidelines were included in this prospective study. Blood samples were taken from all the pregnant women to evaluate the serum Cu and CP levels. The Cu level was determined atomic absorption/emission spectroscopy, while the serum CP level was assessed with a nephelometric assay using an automatic image analyzer. Spearman's rank correlation tests were used to determine the correlations between the serum levels of the antioxidative markers and the preeclampsia severity. The mean ± SD of the Cu was 81.2 ± 11.84 µg/dl in the mild preeclampsia cases and 160.2 ± 20.89 µg/dl in the severe preeclampsia cases ( < .001). The mean ± SD of the CP was 33.0 ± 4.81 mg/dl in the mild preeclampsia cases and 65.3 ± 9.17 mg/dl in the severe preeclampsia cases ( < .001). The Cu and CP levels were significantly higher in the patients with HELLP syndrome, which is an advanced and more severe form of severe preeclampsia, than in the mild and severe preeclampsia patients ( < .001 and  < .001, respectively). Therefore, the serum Cu and CP levels were correlated with the severity of preeclampsia ( = 859,  < .001 and  = 786,  < .001, respectively). In addition, there was a positive correlation between the serum Cu and CP levels and the systolic and diastolic blood pressure values and aspartate amino transferase levels (AST), and a negative correlation between the serum Cu and CP levels and the platelet count. This was the first study in which the ceruloplasmin and Cu levels were investigated in HELLP syndrome patients. When considering the results obtained in the present study, there were significant relationships between the Cu, CP levels which are the markers of oxidative stress and the preeclampsia severity.
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http://dx.doi.org/10.1080/14767058.2018.1487934DOI Listing
January 2020

Serum ischemia modified albumin level and its relationship with the thiol/disulfide balance in placenta percreta patients.

J Obstet Gynaecol 2018 Nov 8;38(8):1073-1077. Epub 2018 Jun 8.

d Department of Clinical Biochemistry, Faculty of Medicine , Harran University , Sanliurfa , Turkey.

The pathogenesis of placenta percreta (PP) is not very well known. This study was designed to analyse the oxidative stress (OS), the thiol/disulphide balance, and ischaemia-modified albumin (IMA) the women with PP. The study included 38 pregnant women with PP and 40 similarly aged healthy pregnant women in their third trimester of gestation. We measured the IMA, native and total thiols, and disulphide concentrations in the maternal sera of all of the participating women. The IMA levels were higher and the native and total thiols were lower in the PP group than in the control group. However, there was no statistical significance with respect to the thiol/disulphide balance between the two groups. The results of this study suggest that an increase in the ischaemia and OS and a decrease in the antioxidant status may contribute to the pathogenesis of PP. Impact statement What is already known on this subject? Placenta percreta (PP) is a serious complication of pregnancy. Although there are several studies investigating the pathophysiological mechanism of PP, whether the pathology results from a lack of decidua or from the over-invasiveness of trophoblasts remains controversial. The pathology of PP is poorly understood. What do the results of this study add? This prospective study has shown an increased ischaemia modified albumin (IMA) and a decreased antioxidant capacity in the patients with placenta percreta. The results from 38 women with PP suggest that the serum concentrations of IMA and the oxidative stress parameters may be able to predict PP in cases of uncertainty. What are the implications of these findings for clinical practice and/or further research? The implication of these findings shed light on understanding the pathogenesis of PP for further research.
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http://dx.doi.org/10.1080/01443615.2018.1450369DOI Listing
November 2018

The clinical characteristics and surgical approach of scar endometriosis: A case series of 14 women.

Bosn J Basic Med Sci 2018 Aug 1;18(3):275-278. Epub 2018 Aug 1.

Department of General Surgery, Faculty of Medicine, Harran University, Sanliurfa, Turkey.

Scar endometriosis, also referred to as abdominal wall endometriosis (AWE), is a rare form of endometriosis that usually develops in the scar after obstetric or gynecological surgeries, including cesarean section (CS). Recently, the occurrence of scar endometriosis has been increasing together with the increase of CS incidence. Scar endometriosis can be clinically misdiagnosed as hernia, lipoma, or hematoma. Here we retrospectively analyzed the clinical aspects of scar endometriosis and surgical approach in 14 patients from a tertiary hospital, who were treated by surgery, between 2012 and 2017. The mean age was 32.71 ± 8.61 years (range: 19-45). Palpable mass and cyclic pain at the scar site were the most common complaints. Twelve patients had previously undergone CS, and two patients had undergone a surgery of ovarian endometrioma. The preoperative diagnosis was determined with ultrasonography (US), magnetic resonance imaging (MRI), or computed tomography (CT). Preoperatively, scar endometriosis was diagnosed in 12/14 patients (85.7%), while 2 patients (14.3%) were diagnosed with inguinal hernia. The treatment was surgical excision in all patients; in addition, mesh repair surgery was performed in 1 patient with recurrent scar endometriosis. Postoperatively, endometriosis was confirmed by histology in all patients. The average size of endometriomas was 24.71 ± 6.67 mm (range: 11-35). No woman had concurrent pelvic endometriosis. In the follow-up period (mean: 9 months) the recurrence of endometriosis was not observed. Scar endometriosis should be considered in all women of reproductive age presenting with cyclic pain and swelling in their abdominal incision sites.
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http://dx.doi.org/10.17305/bjbms.2018.2659DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6087557PMC
August 2018

A comparison of treatment results of the different treatment protocols in patients with poor ovarian response.

Gynecol Endocrinol 2018 Jun 19;34(6):524-527. Epub 2017 Dec 19.

c Department of Gynecology and Obstetrics , Harran University, Faculty of Medicine , Sanliurfa , Turkey.

To compare the effect of the different protocols in patients receiving in vitro fertilization treatment due to poor ovarian response. Seventy-seven of the patients included in the study were treated with gonadotropin (450 IU) + GnRH antagonist (group 1), 84 of the patients were treated with gonadotropin (450 IU) + microdose GnRH analog (group 2), and 53 of the patients were treated with clomiphene citrate (100 mg/day) + gonadotropin (300 IU) + GnRH antagonist (Group 3). In assessing total gonadotropin dosage, patients in Group 3 detected significantly less gonadotropin as compared to the other two groups (p < .001). Group 1 were superior to the other two groups with respect to retrieved oocytes, meiosis II oocytes and number of embryos obtained at the end of the treatment. As for the evaluation of clinical pregnancy, although the highest pregnancy rate was in Group 3, this finding was not of statistical significance. Although increasing the dosage of gonadotropins for ovarian hyper stimulation treatment in patients with poor ovarian response is beneficial with respect to retrieved oocytes, meiosis II oocytes and number of embryos, the increased dosage does not provide a statistically significant increase in clinical pregnancy rates.
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http://dx.doi.org/10.1080/09513590.2017.1416464DOI Listing
June 2018

Comparison of sVCAM-1 and sICAM-1 levels in maternal serum and vaginal secretion between pregnant women with preterm prelabour ruptures of membranes and healthy pregnant women.

J Matern Fetal Neonatal Med 2019 Mar 2;32(6):910-915. Epub 2017 Nov 2.

a Department of Obstetrics and Gynecology , Harran University School of Medicine , Sanliurfa , Turkey.

Objective: The study aims to evaluate the maternal serum and the vaginal fluid levels of soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intercellular adhesion molecular (sICAM-1) in pregnant women complicated by preterm prelabour ruptures of membranes (PPROM).

Materials And Methods: The prospective case control study included 34 pregnant women with PPROM and 34 healthy pregnant women. Patients with additional diseases, a smoking habit and vaginal bleeding, as well as those using antibiotics, during the study period were not included in the study. Cervicovaginal fluid and serum samples were taken during the patients' admission. The demographic data, maternal serum and vaginal fluid sVCAM-1 and sICAM-1, C reactive protein (CRP) and leukocyte counts were noted for all pregnant women included in the study. The sVCAM-1 and sICAM-1 levels were measured by enzyme-linked immunosorbent assay kits.

Results: In pregnant women with PPROM, the serum leukocyte (mean ± SD =11.41 ± 1.067 versus 9.18 ± 1.56, p < .0001), serum sVCAM-1 (median 771.20 versus 704.60 ng/ml, p < .001), sICAM-1 (mean ± SD 213.10 ± 35.59 ng/ml versus 188.11 ± 37.35 ng/ml, p = .06), vaginal sVCAM-1 (median 208.00 versus 140.20 ng/ml, p = .014) and sICAM-1 (mean ± SD 32.32 ± 6.49 ng/ml versus 24.87 ± 6.79 ng/ml, p < .001) values were found to be significantly higher in pregnant women with PPROM than in healthy pregnant women. A positive and significant correlation was observed between the leukocyte count and the vaginal sVCAM-1 level (r = 0.850; p < .001).

Conclusion: To the best of our knowledge, this is the first study evaluating the levels of sICAM-1 in maternal serum in pregnant women with PPROM. The maternal serum and vaginal fluid sVCAM-1 and sICAM-1 levels can be used as biochemical markers supporting the PPROM diagnosis because of the increase in both maternal serum and vaginal fluid sVCAM-1 and sICAM-1 levels in pregnant women with PPROM.
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http://dx.doi.org/10.1080/14767058.2017.1395016DOI Listing
March 2019

Management of peripartum hysterectomies performed on patients with placenta percreta in a tertiary central hospital.

J Matern Fetal Neonatal Med 2019 Mar 2;32(6):883-888. Epub 2017 Nov 2.

a Harran University School of Medicine , Department of Obstetrics and Gynecology , Sanliurfa , Turkey.

Objective: The main objective of this study is to analyse the circumstances and management of peripartum hysterectomies performed on patients with placenta percreta.

Methods: This study included 37 patients who were diagnosed with placenta percreta, a condition in which the placenta invades the uterine wall, and who therefore underwent a peripartum hysterectomy. Their demographic characteristics, history of past caesareans, uterine surgery and curettage, duration of hospitalization, admission to an intensive care unit, neonatal outcomes, skin and uterus incision type, hypogastric artery ligation (HAL), complications, quantities of transfused ES (erythrocyte suspensions), and FFP (fresh frozen plasma), maternal morbidity and mortality and postoperative pathology results were retrospectively reviewed.

Results: All pregnant patients who underwent a caesarean hysterectomy due to placenta percreta had a history of caesarean section and also of placenta praevia totalis. Bilateral HAL was performed in two patients (5.4%), owing to uncontrollable bleeding during the bladder dissection. The complications most frequently observed were bladder injury (13.5%), followed by infection (8.1%) and relaparotomy (5.4%). There was no mortality. Twenty-three (62.2%) of the patients had ES and 11 patients (29.7%) had FFP transfusions. According to the histopathology findings, 33 of the 37 patients (89.1%) reportedly had placenta percreta, three patients had placenta increta, and one patient had placenta accreta. Analysis of the neonatal status at birth showed that the gestational age was, on average, the 35th week. The birth weight was normal in relation to the gestational week, but the first and fifth minute Apgar score, which measures the physical condition of an infant, was found to be lower than the normal range.

Conclusions: If a pregnant patient undergoes uterine surgery or has a history of a caesarean with placenta praevia, she is likely to have placenta percreta. In placenta percreta cases with bladder invasion; careful suturing of the high-volume vessels on the posterior wall of the bladder, through the bladder serosa is important in reducing the amount of bleeding and preventing future fistula formation.
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http://dx.doi.org/10.1080/14767058.2017.1394289DOI Listing
March 2019

Serum Angiogenic and Anti-angiogenic Markers in Pregnant Women with Placenta Percreta.

Balkan Med J 2018 01 13;35(1):55-60. Epub 2017 Sep 13.

Department of Obstetrics and Gynecology, Harran University School of Medicine, Şanlıurfa, Turkey.

Background: Placenta percreta is the morbidly adherent form of all the placental invasion abnormalities. The pathology that underlies placenta percreta is poorly understood.

Aims: To compare the levels of circulating vascular endothelial growth factor, placental growth factor and soluble fms-like tyrosine kinase 1 in pregnant women with placenta percreta to a control group.

Study Design: Case-control study.

Methods: Twenty-two women who underwent caesarean section due to placenta percreta and 22 women who underwent caesarean section for other obstetric reasons were included in this study. The diagnosis of placenta percreta was defined as extreme trophoblastic invasion involving serosa of the uterus. Venous blood samples were collected for biochemical comparison of circulating vascular endothelial growth factor, placental growth factor and soluble fms-like tyrosine kinase 1 from all pregnant women.

Results: Women with placenta percreta were significantly older, had higher gravidity, received more frequent antenatal steroids and blood transfusions and delivered at an earlier gestational age when compared to the control group. In women with placenta percreta, preoperative circulating levels of vascular endothelial growth factor, placental growth factor and soluble fms-like tyrosine kinase 1 were lower than the controls (p<0.001, p<0.001 and p<0.05, respectively). While the postoperative levels of vascular endothelial growth factorand soluble fms-like tyrosine kinase 1 levels were higher in placenta percreta (p=0.001 and p<0.001, respectively), placental growth factor levels were similar in both groups.

Conclusion: The findings of this study suggest that a decrease in vascular endothelial growth factor, placental growth factor and soluble fms-like tyrosine kinase 1 levels may be related to placenta percreta etiopathogenesis.
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http://dx.doi.org/10.4274/balkanmedj.2016.1890DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820448PMC
January 2018

Serum endothelin-1 and placental alkaline phosphatase levels in placenta percreta and normal pregnancies.

J Matern Fetal Neonatal Med 2018 Mar 8;31(6):777-782. Epub 2017 Mar 8.

a Department of Obstetrics and Gynecology , Harran University Medical Faculty , Sanliurfa , Turkey.

Purpose: To evaluate the circulatory levels of endothelin 1 (ET-1) and the placental alkaline phosphatase (ALP) in pregnant women with placenta percreta (PP) and a control group.

Methods: This study was carried out in the Obstetrics and Gynecology and in the Biochemistry Departments of Harran University Medical School. Forty-four women who underwent cesarean section (CS) due to PP and 44 women who underwent CS for other obstetric reasons were included in this study. The PP diagnosis was made by a pathologic examination that showed an extreme trophoblastic invasion involving the uterine serosa.The levels of circulating ET-1 and placental ALP were measured by an enzyme-linked immunosorbent assay (ELISA).

Results: Women with PP more frequently received antenatal steroids and blood transfusions and they delivered at an earlier gestational age compared to controls. In women with PP, preoperative circulating ET-1 and placental ALP levels were lower than in the controls (p < .05 for both).

Conclusions: The findings suggest that a decrease in ET-1 and placental ALP levels might play a role in the pathogenesis of PP.
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http://dx.doi.org/10.1080/14767058.2017.1297412DOI Listing
March 2018

Does apoptotic activity have a role in the development of the placental abruption?

J Matern Fetal Neonatal Med 2017 Dec 6;30(23):2871-2875. Epub 2017 Feb 6.

a Department of Gynecology and Obstetrics, Faculty of Medicine , Harran University , Sanliurfa , Turkey.

Objective: The purpose of the present study is to analyses the role of apoptotic activity in placental abruption (PA) development by evaluating the level of plasma M30-M65.

Methods: The study group included 46 pregnant women who underwent caesarean sections (CS) because of PA, and the control group included 48 pregnant women who underwent CS because of obstetric causes. Venous blood samples were received from all expectants before starting the CS for the purpose of evaluating the M30-M65 levels, which are indicators of apoptotic activity in maternal plasma.

Results: The plasma M30-M65 levels were determined to be statistically significantly higher in with PA group. The sensitivity and specificity of the test were determined to be 71.7% and 64.6%, respectively in identifying the expectants with PA when the cut-off value was taken as 163.50 U/L for the plasma M30 value. The sensitivity and specificity of the test were determined to be 76.1% and 66.7%, respectively in identifying the PA when the cut-off value was taken as 295.50 U/L for the M65 value.

Conclusions: The increase of apoptotic activity induced by thrombin resulting from decidual bleeding may have a role in the development of PA.
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http://dx.doi.org/10.1080/14767058.2016.1265936DOI Listing
December 2017

Surgical management of 58 patients with placenta praevia percreta.

Wien Klin Wochenschr 2016 May 25;128(9-10):360-6. Epub 2016 Feb 25.

Department of Obstetrics & Gynaecology, School of Medicine, Mugla Sitki Kocman University, 48000, Mugla, Turkey.

Objective: The aim of this study is to present our experience with surgical management of placenta praevia percreta.

Methods: This study was conducted from January 2009 through March 2014 at Harran University Hospital and was a chart review of all patients who underwent caesarean hysterectomy with the placenta left in situ for placenta praevia percreta.

Results: The study group comprised 58 patients. All of the patients underwent ultrasound mapping of the placental area before surgery. Emergent caesarean hysterectomy was only performed in 9 patients; 49 patients underwent planned caesarean hysterectomy. Bilateral internal iliac artery ligation was performed in all cases. Four patients (6.9 %) had bladder damage, one patient (1.7 %) required cystotomy, and one patient (1.7 %) required re-operation because of postoperative hemorrhage. The mean operative time was 141.6 (range: 95-355) minutes. Only 17 (29.3 %) patients were administered more than four units of red blood cells. There was no ureteral damage or maternal death. Furthermore, there were no complications in 42 (72.4 %) patients.

Conclusions: Caesarean hysterectomy for placenta praevia percreta is associated with increased maternal morbidity. However, preoperative diagnosis of placenta praevia percreta, ultrasound mapping of the placenta, and the presence of a multidisciplinary experienced team may decrease maternal morbidity and mortality. Moreover, the urinary system may be protected in the patients with placenta praevia percreta without serious morbidity.
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http://dx.doi.org/10.1007/s00508-016-0962-4DOI Listing
May 2016

Assessment of Apoptotic Activity Dysregulation and Oxidative Stress in the Development of Epithelial Ovarian Cancer: A Case-Controlled Descriptive Analysis.

Gynecol Obstet Invest 2016 4;81(1):71-7. Epub 2015 Jun 4.

Department of Gynaecology and Obstetrics, Harran University, Sanliurfa, Turkey.

Aim: In the present study, we aimed to assess whether oxidative stress and apoptotic activity play a role in the development of epithelial ovarian cancer (EOC).

Methods: The study group included patients with EOC (n = 26) and benign ovarian tumour (BOT) (n = 25), while 30 healthy women were employed as a control group. Venous blood samples were drawn to evaluate oxidative stress parameters and serum M30/M65 antigen levels before surgery. In addition, blood samples were taken for the second time on postoperative day 8 to analyse whether the postoperative tumour load was decreased.

Results: When the groups were assessed regarding oxidative stress, the highest values were detected in patients with EOC. Serum M30/M65 levels were found to be higher in patients with EOC when compared to the other groups (p < 0.001). A significant decrease was determined in the M30/M65 levels of serum samples taken on postoperative day 8 from the patients in the EOC and BOT groups (p < 0.001).

Conclusion: Our results suggest that dysregulation of apoptotic activity could be effective in the development of ovarian tumoural tissue, whereas oxidative stress could be effective in malignant transformation.
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http://dx.doi.org/10.1159/000381774DOI Listing
December 2016

Can circulating M30 and M65 levels be beneficial markers in the diagnosis and management of patients with complete hydatidiform mole?

Wien Klin Wochenschr 2016 Dec 14;128(Suppl 8):566-571. Epub 2015 Apr 14.

Faculty of Medicine, Department of Biochemistry, Harran University, Sanliurfa, Turkey.

Objective: The objective of this study is to evaluate the prognostic value of M30 and M65 levels as markers of apoptotic activity and maternal serum oxidative stress in patients with complete hydatidiform mole (CHM).

Methods: In total, 68 pregnant women were included in the study. The study group included 34 pregnant with CHM, while 34 healthy pregnant were employed as a control group. Venous blood samples were drawn to assess the maternal serum oxidative stress and M30-M65 levels. In addition, a second blood sample was drawn from patients with CHM on day 8 after dilatation evacuation.

Results: Maternal serum oxidative stress and M30-M65 levels were found to be significantly higher in patients with CHM as compared with the control group. It was found that serum β-subunit of human chorionic gonadotropin (β-hCG) level had a significant positive correlation with M30-M65 levels in patients with CHM. In addition, serum M65 level was found to be as effective as β-hCG in the identification of the patients with CHM.

Conclusion: Our results indicated that oxidative stress and apoptosis may play significant roles in CHM development. In addition, it seems that serum M30-M65 levels can presumably be an ancillary laboratory test to β-hCG in the diagnosis and follow-up of the patients with CHM.
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http://dx.doi.org/10.1007/s00508-015-0735-5DOI Listing
December 2016

Diffusion-weighted MRI in the differential diagnosis of uterine endometrial cavity tumors.

Wien Klin Wochenschr 2015 Apr 24;127(7-8):266-73. Epub 2015 Feb 24.

Faculty of Medicine, Department of Radiology, Harran University, Yenisehir Campus, 63300, Sanliurfa, Turkey,

Background: This study aimed to investigate the efficacy of quantitative apparent diffusion coefficient (ADC) measurement in the differential diagnosis of the uterine endometrial cavity tumors (UECT).

Methods: This study included consecutive 36 female patients with UECT. The groups were formed as follows: group 1, patients with endometrial carcinoma; group 2, patients with endometrial polyp; group 3, patients with submucosal leiomyoma; and additionally group A, patients with malignant lesion; group B patients with benign lesion. Tumoral and outer myometrial ADC values were measured and the tumor-myometrium ADC ratios were calculated in all patients. Kolmogorov-Smirnov tests were used to test the normality of the data distributions. The data were not normally distributed, and therefore, nonparametric tests were performed. The cut-off values, sensitivity, and specificity were determined by the receiver operating characteristic analysis.

Results: The mean ADC value and ratio of group 1 were lower than that of group 2 and 3, and the mean ADC value and ratio of group 3 were lower than that of group 2. The sensitivity and specificity for group 1, 2, and 3 were as follows: 90, 100, and 66.7 %; and 81.8, 88, and 58.8 %, respectively, in terms of the ADC values; 90, 100 and 67 %; and 77.3, 96, and 64.7 % in terms of the ADC ratios. Statistically significant differences were demonstrated between group A and B in terms of mean tumoral ADC values and ratios. Sensitivity and specificity were found to be 90 and 81.8 %, respectively, in terms of the ADC values. The sensitivity and specificity were found to be 90 and 77.3 %, respectively, in terms of the ADC ratios.

Conclusions: ADC values and ratios represent a promising parameter in the determination of the tumoral lesions in patients with UECT.
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http://dx.doi.org/10.1007/s00508-015-0709-7DOI Listing
April 2015

What is the role of matrix metalloproteinase-2 in placenta percreta?

J Obstet Gynaecol Res 2015 Jul 6;41(7):1018-22. Epub 2015 Feb 6.

Department of Pathology, School of Medicine, Kocatepe University, Afyon, Turkey.

Aim: This study compared the placental expression of the matrix metalloproteinase-2 (MMP-2) enzyme, which is thought to play a key role in the penetration of trophoblastic cells, in third-trimester placenta percreta (PP) patients with that of women with normal pregnancies.

Methods: Twenty-five pregnant subjects who underwent cesarean section due to PP and 25 term pregnant subjects who underwent cesarean section for obstetric reasons were included in the study. Demographic data, pathology reports, and histopathological samples were examined. Blocks containing samples of placenta underwent immunohistochemical analysis using the MMP-2 antibody. Immunohistochemical expression of placental samples obtained from both groups was examined and compared.

Results: There were no statistically significant differences in the demographic data (P > 0.05). With regard to immunohistochemistry, cytoplasmic staining of trophoblastic cells was considered immunohistochemically positive. In the PP tissue samples, positive MMP-2 staining was detected as follows: 0 immunoreactivity, one patient (4%); 1(+), six patients (24%); 2(+), seven patients (28%); and 3(+), 11 patients (44%). In the term pregnant placental tissue samples, positive MMP-2 staining was detected in five patients (20%) at 0 immunoreactivity, 12 (48%) at 1(+) immunoreactivity, five (20%) at 2(+) immunoreactivity, and three patients (12%) at 3(+) immunoreactivity. Immunohistochemical expression was significantly different between the PP and normal term pregnancy placental tissues (P = 0.02).

Conclusion: The stronger expression of the MMP-2 enzyme in the PP as compared to the normal placental tissue suggests that this enzyme may be an effective mediator in the pathogenesis of PP.
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http://dx.doi.org/10.1111/jog.12667DOI Listing
July 2015

Laparoscopic retroperitoneal radical nephrectomy in a pregnant woman with retrocaval artery.

Int Urol Nephrol 2015 Mar 20;47(3):469-71. Epub 2015 Jan 20.

Department of Urology, Harran University School of Medicine, 63100, Sanliurfa, Turkey,

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http://dx.doi.org/10.1007/s11255-014-0906-8DOI Listing
March 2015

Trophoblastic E-cadherin and TGF-beta expression in placenta percreta and normal pregnancies.

J Matern Fetal Neonatal Med 2016 16;29(1):126-9. Epub 2014 Dec 16.

a Department of Gynecology and Obstetrics , and.

Objective: This study aimed to evaluate whether trophoblastic transforming growth factor beta (TGF-β) and E-cadherin expression levels have a role in placenta percreta (PP) aetiopathogenesis.

Methods: This study was carried out in the Obstetrics & Gynecology and Pathology Departments of Harran University Medicine School. Forty-four women who underwent caesarean section for PP and other obstetric reasons were included in this study. PP was defined as the detection of placental invasion during the histopathological examination of the hysterectomy specimen, which passes the uterine wall as a whole layer and involves the uterine serosa. Placental tissue samples were collected from all pregnant patients to evaluate TGF-β and E-cadherin expression levels.

Results: No significant difference was found in demographic features, including age, gestational week, number of pregnancies and body mass index, among the groups. Immunohistochemical staining against E-cadherin, a cell adhesion molecule, showed significantly reduced staining in PP patients (p = 0.048). TGF-β staining was also low in PP patients, but this difference was not significant (p = 0.107).

Conclusions: The findings of this study suggest that a decrease in trophoblastic E-cadherin expression may have an important role in PP aetiopathogenesis.
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http://dx.doi.org/10.3109/14767058.2014.989203DOI Listing
September 2016

Prevalence of thromogenic gene mutations in women with recurrent miscarriage: A retrospective study of 1,507 patients.

Obstet Gynecol Sci 2014 Nov 20;57(6):513-7. Epub 2014 Nov 20.

Department of Gynecology and Obstetrics, Harran University Faculty of Medicine, Sanliurfa, Turkey.

Objective: Thromogenic gene mutations has been thought to be associated with recurrent pregnancy loss in women in Turkey. The aim of this study was to investigate the prevalence of thromogenic gene mutations such as factor V Leiden (FVL, G1691T), prothrombin (G20210A), and the methylene tetrahydrofolate reductase (MTHFR, C677T) mutation in women with recurrent pregnancy loss.

Methods: This descriptive study was carried out in the Department of Obstetrics and Gynaecology, Harran University School of Medicine, and included a total of 1,507 women with histories of recurrent pregnancy loss between January 2010 and June 2013. The mutations were assessed by using the polymerase chain reaction.

Results: The homozygous mutation frequencies of FVL, prothrombin, and MTHFR were found to be 3 (0.20%), 0 and 125 (8.29%), and the heterozygous mutation frequencies were 83 (5.51%), 61 (4.05%), and 612 (40.61%), respectively. Among the 86 FVL mutation patients, 38 also had accompanying prothrombin and MTHFR mutations.

Conclusion: Since the homozygous forms of the FVL-prothrombin gene mutations have low incidences and MTHFR mutation is similar to a healthy population, preconceptional thromogenic gene mutations screening seems to be controversial.
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http://dx.doi.org/10.5468/ogs.2014.57.6.513DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245346PMC
November 2014

Does sildenafil have protective effects against ovarian ischemia-reperfusion injury in rats?

Arch Gynecol Obstet 2015 Jun 22;291(6):1283-8. Epub 2014 Nov 22.

Department of Gynecology and Obstetrics, Harran University School of Medicine, Yenisehir Campus, 63300, Sanlıurfa, Turkey,

Purpose: The aim of this study was to evaluate the protective activity of sildenafil treatment against ischemia-reperfusion damage created experimentally in rat ovaries.

Methods: For this study, 42 female Wistar rats were used, and the rats were separated randomly into six groups consisting of seven rats each: sham, torsion, torsion-detorsion, torsion-detorsion + saline, torsion-detorsion + sildenafil 0.7 mg/kg and torsion-detorsion + sildenafil 1.4 mg/kg. With the exception of the sham group, an ovarian torsion procedure was implemented in all other groups for 2 h. Then, a detorsion procedure was implemented to the groups for 2 h, with the exception of the torsion group. Medications were given intraperitoneally, one-half hour before the detorsion procedure in the saline, 0.7 and 1.4 mg/kg sildenafil groups. Finally, 2 ml of blood samples was drawn for markers of oxidative stress, while the ovaries which were torsioned for the histological examination were extracted from all rats.

Results: According to the histopathological damage scores, the least damage was seen in the sham group and the most damage was seen in the torsion-detorsion group. The sildenafil treatment appeared to be effective in decreasing tissue damage; however, there were no differences between the dosages. Additionally, it was determined that the oxidative stress levels were higher in the torsion-detorsion group, while the sildenafil treatment caused a significant decrease in the oxidative stress levels.

Conclusions: The results of the current study showed that the sildenafil treatment can be effective in preventing tissue damage and oxidative stress induced by the ischemia-reperfusion created in rat ovaries.
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http://dx.doi.org/10.1007/s00404-014-3554-4DOI Listing
June 2015

Prevalence of β-thalassemia trait and abnormal hemoglobins in Sanliurfa Province in southeast Turkey.

Hemoglobin 2014 ;38(6):402-4

Department of Obstetrics and Gynaecology , Harran University, School of Medicine , Sanliurfa , Turkey .

Thalassemia is one of the most common hereditary disorders in Turkey, especially in the Mediterranean region of the country. The purpose of this study was to determine the frequency of the β-thalassemia (β-thal) trait and abnormal hemoglobins (Hbs) in couples who applied for premarital screening in Sanliurfa Province, in the southeastern region of Turkey, a province with the first reported incidence of β-thal and abnormal Hbs. In the present study, in order to detect the prevalence of the β-thal trait and abnormal Hbs in Sanliurfa Province, Turkey, a total of 37,962 couples who applied for premarital screening were analyzed. From January 2011 through March 2014, red blood cell (RBC) counts and Hb fractionation were carried out by a cell counter and high performance liquid chromatography (HPLC), respectively. The prevalence of β-thal with high Hb A2 (>3.5%) values was found at rates of 2.44% (n = 1853) in Sanliurfa Province. Additionally, the abnormal Hb rate was 1.57% (1193/75,924), and Hb S (HBB: c.20T > A), Hb C (HBB: c.19G > A) and Hb D-Punjab (HBB: c.364G > C) were reported as 0.50, 0.38 and 0.69, respectively. This study is the first to establish the frequency of β-thal and abnormal Hbs in Sanliurfa Province, which has the highest birth frequency. We report that the frequency of the β-thal trait is at a high-risk level compared to other cities in Turkey. Due to the high risk of β-thal in Sanliurfa Province, a premarital screening program would be of great value in informing parents about offspring with β-thal.
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http://dx.doi.org/10.3109/03630269.2014.978008DOI Listing
July 2015

Ki-67 proliferation index in patients with placenta previa percreta in the third trimester.

Wien Klin Wochenschr 2015 Feb 15;127(3-4):98-102. Epub 2014 Nov 15.

Faculty of Medicine, Department of Gynecology and Obstetrics, Harran University School of Medicine, Yenisehir Campus, 63300, Sanliurfa, Turkey,

Aim: The purpose of this study was to investigate proliferative capacity of placenta previa percreta in the third trimester via evaluating Ki-67 proliferating index.

Methods: The paraffin blocks of placental tissues, which were obtained from the patients who underwent hysterectomy for placenta previa percreta (n = 12, gestational age > 28 weeks), from legal abortions (n = 12, gestational age < 10 weeks), and of cesarean deliveries with the indication of previous cesarean section, without any complication (n = 12, gestational age > 38 weeks), between January 2011 and April 2013, were included into the study. The paraffin blocks of the patients were stained with Ki-67 (proliferating cell marker) immunohistochemically, and Ki-67 proliferation index levels were calculated.

Results: Ki-67 proliferation index levels were higher in patients with legal abortions than patients with placenta percreta or noncomplicated cesarean delivery group. However, any statistically significant difference was not detected between the percreta and noncomplicated groups (p > 0.05).

Conclusion: The tissue samples of the patients with placenta previa percreta exhibited low proliferative capacity similar to the samples of normal placentation group.
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http://dx.doi.org/10.1007/s00508-014-0634-1DOI Listing
February 2015

Comparison of tissue prolidase enzyme activity and serum oxidative stress level between pregnant women with placental abruption and those with a healthy pregnancy.

Arch Gynecol Obstet 2015 Apr 21;291(4):805-9. Epub 2014 Sep 21.

Department of Gynecology and Obstetrics, Faculty of Medicine, Harran University, Yenisehir Campus, 63300, Sanliurfa, Turkey,

Purpose: Although placental abruption is an acute condition, it is thought that the underlying pathology is chronic vasculopathy. Collagen is one of the important components of vascular structure, and there is a correlation between collagen turnover and prolidase enzyme activity (PEA). Thus, our aim was to assess whether there is a difference in serum oxidative stress level and PEA between pregnant women with placental abruption and those with a healthy pregnancy.

Methods: The study group consisted of 36 pregnant women who underwent caesarean section with a diagnosis of placental abruption, while the control group comprised 36 pregnant women who underwent caesarean section due to obstetric reasons. Venous blood samples were drawn from all patients before caesarean section. In addition, tissue samples were obtained during caesarean section to evaluate tissue PEA.

Results: No significant differences in demographic characteristics were detected between groups (p > 0.05). Oxidative stress parameters, such as total oxidant status and oxidative stress index, were found to be significantly higher in the study group (p < 0.001). Placental tissue PEA was found to be significantly higher in pregnant women with placental abruption (557.21 ± 135.41 vs. 426.68 ± 131.57 U/g, p < 0.001). In addition, a significant positive correlation was detected between PEA and oxidative stress parameters (r = 0.332, p = 0.004).

Conclusions: Our results indicated that elevated tissue PEA and serum oxidative stress levels are closely related to placental abruption. Thus, we think that increased collagen turnover may have a significant role in the aetiopathogenesis of placental abruption.
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http://dx.doi.org/10.1007/s00404-014-3481-4DOI Listing
April 2015

Is catechol-o-methyltransferase gene polymorphism a risk factor in the development of premenstrual syndrome?

Clin Exp Reprod Med 2014 Jun 30;41(2):62-7. Epub 2014 Jun 30.

Department of Gynecology and Obstetrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey.

Objective: The objective of this study was to investigate whether there was a correlation between catechol-o-methyltransferase (COMT) gene polymorphism, which is believed to play a role in the etiology of psychotic disorders, and premenstrual syndrome (PMS).

Methods: Fifty-three women with regular menstrual cycles, aged between 18 and 46 years and diagnosed with PMS according to the American Congress of Obstetrics and Gynecology criteria were included in this study as the study group, and 53 healthy women having no health problems were selected as the controls. Venous blood was collected from all patients included in the study and kept at -18℃ prior to analysis.

Results: There was no significant difference between the groups in terms of demographic features such as age, body mass index, number of pregnancies, parity, and number of children. No statistically significant difference was observed in terms of COMT gene polymorphism (p=0.61) between women in the PMS and the control groups. However, a significant difference was found between arthralgia, which is an indicator of PMS, and low-enzyme activity COMT gene (Met/Met) polymorphism (p=0.04).

Conclusion: These results suggested that there was no significant relationship between PMS and COMT gene polymorphism. Since we could not find a direct correlation between the COMT gene polymorphism and PMS, further studies including alternative neurotransmitter pathways are needed to find an effective treatment for this disease.
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http://dx.doi.org/10.5653/cerm.2014.41.2.62DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4102691PMC
June 2014

Plasma D-dimer level in the diagnosis of adnexal torsion.

J Matern Fetal Neonatal Med 2015 Jun 28;28(9):1073-6. Epub 2014 Jul 28.

Department of Gynecology and Obstetrics, Harran University School of Medicine , Sanlıurfa , Turkey and.

Objective: To date, there is no clinical or laboratory examination particular to adnexal torsion (AT); therefore, the objective of this study was to evaluate whether the plasma D-dimer level has any merit in establishing a diagnosis in AT patients.

Materials And Methods: In total, 34 women who underwent laparoscopic surgery due to adnexal mass were incorporated into our study. While the study group consisted of 14 women operated on due to AT, the control group comprised of 20 patients operated on due to benign ovarian cysts. In order to study the plasma D-dimer level during the pre-operative period, venous blood samples were obtained from all the women who participated in this study.

Results: The plasma D-dimer level in the AT group was seen to be significantly higher than that of the control group (2.20 ± 1.71 µg/ml, 0.43 ± 0.21 µg/ml, p = 0.002, respectively). When the cut-off value for the D-dimer level was taken as 0.65 µg/ml, the sensitivity in determining the AT was found to be 71.4%, whereas the specificity was 85%.

Conclusions: The results obtained from our present study suggest that the plasma D-dimer level could be a supplementary laboratory examination in establishing diagnoses in AT patients.
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http://dx.doi.org/10.3109/14767058.2014.942636DOI Listing
June 2015

May mean platelet volume levels be a predictor in the diagnosis of pelvic inflammatory disease?

Wien Klin Wochenschr 2014 Jul 24;126(13-14):422-6. Epub 2014 Jun 24.

Faculty of Medicine, Department of Gynecology and Obstetrics, Harran University, Yenisehir Campus, 63300, Sanlıurfa, Turkey,

Background: Our aim in this study was to investigate whether mean platelet volume (MPV) value could be used as an early marker to predict pelvic inflammatory disease (PID).

Methods: Overall, 44 patients with PID and 44 healthy women were included in the study. The control group consisted of 44 women who applied to the clinic for a routine gynaecological check-up, without chronic disease or a history of medication use. Owing to the fact that it would affect thrombocyte function, women who have the following conditions were excluded from the study: women who were taking anticoagulant therapy, oral contraceptives, nonsteroid anti-inflammatory medications and who had chronic diseases. The leukocyte count, platelet count, neutrophil ratio and MPV values were collected from PID and the control group. C reactive protein values of patients with PID were also noted.

Results: MPV values in patients with PID were lower than those in the control group. This reduction in MPV is statistically significant when the PID patient group is compared with the control group (p < 0.001). A negative correlation was discovered between platelet count and MPV values (p = 0.019, r = - 0.425). Receiver-operating curve analysis pointed out that MPV has greater area under curve value than neutrophil rate, leukocyte and platelet count (0.73, 0.64, 0.72 and 0.49 respectively).

Conclusion: Since the MPV value was significantly decreased in patients with PID, it may serve as an additional and even more valuable marker than leukocyte count in the diagnosis of PID.
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http://dx.doi.org/10.1007/s00508-014-0560-2DOI Listing
July 2014

Supplemental oxygen in elective cesarean section under spinal anesthesia: Handle the sword with care.

Braz J Anesthesiol 2013 Sep-Oct;63(5):393-7. Epub 2013 Nov 19.

Department of Clinical Biochemistry, School of Medicine, Harran University, Sanliurfa, Turkey.

Background And Objectives: We aimed to investigate the effect of 21% and 40% oxygen supplementation on maternal and neonatal oxidative stress in elective cesarean section (CS) under spinal anesthesia.

Methods: Eighty term parturients undergoing elective CS under spinal anesthesia were enrolled in the study. We allocated patients randomly to breathe 21% (air group) or 40% (oxygen group) oxygen from the time of skin incision until the end of the operation. We collected maternal pre- and post-operative and umbilical artery (UA) blood samples. Total antioxidant capacity (TAC), total oxidant status (TOS) and the oxidative stress index (OSI) were measured.

Results: Age, weight, height, parity, gestation week, spinal-skin incision time, skin incision-delivery time, delivery time, operation time, 1(st) and 5(th) minutes Apgar scores, and birth weight were similar between the groups (p > 0.05 for all comparisons). There were no differences in preoperative TAC, TOS, or OSI levels between the groups (p > 0.05 for all comparisons). Postoperative maternal TAC, TOS and OSI levels significantly increased in the oxygen group (p = 0.047, < 0.001 and 0.038, respectively); umbilical artery TAC levels significantly increased in the oxygen group (p = 0.003); and umbilical artery TOS and OSI levels significantly increased in the air group (p = 0.02 and < 0.001, respectively).

Conclusions: The difference in impact on maternal and fetal oxidative stress of supplemental 40% compared to 21% oxygen mandates further large-scale studies that investigate the role of oxygen supplementation during elective CS under spinal anesthesia.
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http://dx.doi.org/10.1016/j.bjane.2013.04.006DOI Listing
April 2015
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