Publications by authors named "Mehmet Nafi Sakar"

6 Publications

  • Page 1 of 1

Letrozole is superior to clomiphene citrate in ovulation induction in patients with polycystic ovary syndrome.

Pak J Med Sci 2020 Nov-Dec;36(7):1460-1465

Suleyman Cemil Oglak, Department of Obstetrics and Gynecology, University of Health Sciences, Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey.

Objective: This study was aimed to compare the clinical outcomes of ovulation induction (OI) by timed intercourse with letrozole (LTZ) and clomiphene citrate (CC).

Methods: Three hundred and twenty-three patients with polycystic ovary syndrome (PCOS) who underwent OI with LTZ or CC between February 2017 and November 2018 were included in this retrospective study. The patients were divided into two groups as the CC group (n=148) and the LTZ group (n=175). Endometrial thickness, follicular development, ovulation, clinical pregnancy, abortion, and live birth rates of the groups were analyzed.

Results: The mean endometrium thickness of the CC group was 7.1±1.7 mm, and the LTZ group was 8.6±1.8 mm (p<0.001). The ovulation rate per cycle was higher in the LTZ group (93.1%) in comparison with the CC group (83.8%) (p=0.013). Clinical pregnancy rates were 52% in the LTZ group, and 41.2% in the CC group (p=0.047). LTZ with 44% of live birth rate was superior to CC with a 33% live birth rate (p=0.029).

Conclusions: LTZ is an effective OI agent in PCOS patients. LTZ is superior to CC in terms of pregnancy rates and live birth rates. As a result, we recommend that LTZ should be the first-line treatment agent in patients with PCOS.
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http://dx.doi.org/10.12669/pjms.36.7.3345DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7674913PMC
November 2020

Low antimullerian hormone levels may be associated with cardiovascular risk markers in women with diminished ovarian reserve.

Gynecol Endocrinol 2016 27;32(4):302-5. Epub 2015 Nov 27.

b Department of Obstetrics & Gynecology , Diyarbakir Gazi Yasargil Training and Research Hospital , Diyarbakir , Turkey.

There is growing evidence that diminished ovarian reserve (DOR) may be associated with cardiovascular disease (CVD). The aim of the study was to investigate whether there was any relationship between antimullerian hormone (AMH) and CVD risk markers in the study. Ninety women with DOR and 90 women with normal ovarian reserve (NOR) attending the infertility unit at XXXX, were enrolled in the study. CVD risk markers such as insulin resistance [defined by the homeostasis model assessment ratio (HOMA-IR)], C-reactive protein (CRP), low density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), and triglyceride (TG) were assessed. HOMA-IR, CRP, TG, LDL levels were higher and HDL and AMH were lower among patients with DOR compared with controls (p < 0.05, for all). There were positive associations between low AMH and HOMA-IR, CRP, TG, LDL levels and a negative correlation with HDL (p < 0.05, for all). However, multivariate logistic regression analysis showed that HOMA-IR, CRP, TG and HDL were independent variables that were associated with low AMH. There was a close relationship between low AMH and CVD risk markers in the study. Further studies with larger groups are needed to investigate the nature of this link in these patients.
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http://dx.doi.org/10.3109/09513590.2015.1116065DOI Listing
January 2017

The effect of total hysterectomy on sexual function and depression.

Pak J Med Sci 2015 ;31(3):700-5

Sabiha Caglayan, Medipol University Hospital, Istanbul, Turkey.

Background & Objectives: To investigate whether the operations of Type 1 hysterectomy and bilateral salpingo-oophorectomy performed for benign reasons have any effect on sexual life and levels of depression.

Method: This is a multi-center, comparative, prospective study. Healthy, sexual active patients aged between 40 and 60 were included into the study. Data was collected with the technique of face-to-face meeting held three months before and after the operation by using the demographic data form developed by the researchers i.e. the Female Sexual Function Index (FSFI) and the Beck Depression Scale (BDS).

Results: In the post-operative third month, there was an improvement in dysuria in terms of symptomatology (34% and 17%, P<0.001), while in FSFI (41.47±25.46 to 34.20±26.67, P<0.001) and BDS (12.87±11.19 to 14.27±10.95, P=0.015) there was a deterioration. For FSFI, 50-60 age range, extended family structure; and for BDS, educational status, not working and extended family structure were statistically important confounding factors for increased risk in the post-operative period.

Conclusion: While hysterectomy and bilateral salpingo-oophorectomy performed for benign reasons brought about short-term improvement in urinary problems after the operation for sexually active and healthy women, they resulted in sexual dysfunction and increase in depression. The age, educational status, working condition and family structure is also important.
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http://dx.doi.org/10.12669/pjms.313.7368DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485298PMC
July 2015

Association of endothelial nitric oxide synthase gene G894T polymorphism and serum nitric oxide levels in patients with preeclampsia and gestational hypertension.

J Matern Fetal Neonatal Med 2015 Nov 20;28(16):1907-11. Epub 2014 Oct 20.

a Department of Obstetrics and Gynecology , Suleymaniye Maternity Education and Research Hospital , Istanbul , Turkey .

Objective: Pregnancy-induced hypertension is one of the most important cause of maternal-fetal morbidity and mortality. Pregnancy-related hypertensive disorders are usually associated with diminished nitric oxide (NO) levels. We aimed to evaluate the role of serum NO levels and eNOS gene G894T polymorphism on hypertensive disorders of pregnancy.

Methods: Eighty patients with gestational hypertension or preeclampsia, and 80 healthy pregnants were enrolled to analyze serum NO levels and G894T polymorphism of the eNOS gene. NO level was analyzed by high-performance liquid chromatography (HPLC) method. The G894T polymorphism of the eNOS gene was determined by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP).

Results: There was no significant difference between groups in terms of G894T/eNOS genotype and allele frequencies (p > 0.05). Serum NO levels were significantly lower in the patients group. In the control group, subjects with thymine-thymine (TT) genotype had significantly lower NO levels when compared to subjects with guanine-guanine (GG) or guanine-thymine (GT) genotype (p < 0.05).

Conclusions: We failed to demonstrate an association between eNOS gene G894T polymorphism and serum NO levels in patients with pregnancy-induced hypertensive disorders. We established a relation between pregnancy-induced hypertension and low NO levels.
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http://dx.doi.org/10.3109/14767058.2014.971748DOI Listing
November 2015

Ramadan fasting and pregnancy: implications for fetal development in summer season.

J Perinat Med 2015 May;43(3):319-23

Aims: In the Islamic religion, Ramadan is a month in the year that is passed by fasting. Healthy adult individuals are prohibited to eat, drink, and smoke from sunrise to sunset. In the present study, our aim was to assess the relation of Ramadan fasting with fetal development and maternal-fetal Doppler indices in pregnant women.

Methods: This is a prospective case-control study carried out in the month of Ramadan in 2013 (9 July-7 August). One hundred and six pregnant women at the second and third trimesters of pregnancy were enrolled into the study. The sample size of the fasting group was 83 and the non-fasting group sample size was also 83. Fetal biometric measurements, such as biparietal diameter, head circumference, abdominal circumference, femur length, estimated fetal weight, amniotic fluid index, and Doppler indices of both uterine and umbilical arteries were evaluated by gray scala and color Doppler ultrasound at the beginning and end of Ramadan.

Results: At the end of the Ramadan, increase in biparietal diameter, head circumference, and femur length showed a statistically significant difference from initial measurements (P<0.05). When fasting and non-fasting groups were compared separately, an increase in amniotic fluid index was statistically significant in the non-fasting group (P<0.05).

Conclusion: We demonstrated some adverse effects of Ramadan fasting on fetal development. In the Islamic religion, pregnant individuals have the privilege of not fasting; therefore, they should consider postponing fasting to the postpartum period, especially in the summer season. If they are willing to do so, an appropriate nutritional program should be recommended.
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http://dx.doi.org/10.1515/jpm-2013-0289DOI Listing
May 2015

The association of endothelial nitric oxide synthase gene G894T polymorphism and serum nitric oxide concentration with microalbuminuria in patients with gestational diabetes.

Clin Nephrol 2014 Feb;81(2):105-11

Department of Internal Medicine, Bagcılar Education and Research Hospital, Istanbul, Department of Medical Biology, Medical School of Harran University, Sanlıurfa, Department of Physiology, Medical School of Mustafa Kemal University, Hatay, Department of Obstetrics and Gynecology, Suleymaniye Education and Research Hospital, Istanbul, Department of Obstetrics and Gynecology, Medical Faculty of Harran University, Sanlıurfa, and Department of Medical Biology and Genetics, Medical Faculty of Dicle University, Diyarbakir, Turkey.

Aim: Gestational diabetes mellitus (GDM) is a glucose intolerant condition that affects 14% of all pregnancies. Diabetes mellitus (DM) occurs in 30 - 70% of patients with GDM after delivery. DM and GDM are associated with structural and functional deterioration of the renovascular system. Our aim is to investigate the association Glu- 298Asp polymorphism of the endothelial nitric oxide synthase (eNOS) gene with serum nitric oxide levels and microalbuminuria in patients with GDM and healthy pregnancies.

Material And Methods: Serum nitric oxide (NO) levels, urinary excretion of albumin and Glu298Asp polymorphism of the eNOS gene were analyzed in 68 patients with GDM and 73 healthy controls. High performance liquid chromatography (HPLC-Griess) method was used to analyze serum NO levels. Microalbuminuria was evaluated by rate nephelometry method. The Glu298Asp polymorphism of the eNOS gene was determined by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP).

Results: Nitric oxide, glucose, creatinine, and microalbuminuria were significantly different between the patients and the control subjects (p = 0.001, p = 0.001, p = 0.002, and p = 0.005, respectively). There was a significant difference between groups in terms of the ratio of GG/GT+TT of eNOS gene Glu- 298Asp (p = 0.02). The patients with GT+TT genotype had significantly higher microalbuminuria levels and lower NO concentrations (22.16 vs. 9.51, p = 0.005, and 10.56 vs. 12.73, p = 0.021, respectively). The presence of T allele of eNOS gene is an independent predictor of microalbuminuria (OR: 2.346, 95% confidence interval: 1.247 - 5.238, p = 0.02) as well as serum glucose and NO concentration.

Conclusion: The G894T polymorphism of eNOS gene and decreased NO concentration seem to be independent predictors of increased urinary excretion of albumin in patients with GDM. Determining the frequency of eNOS gene G894T polymorphism may help to identify pregnancies at increased risk of microalbuminuria.
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http://dx.doi.org/10.5414/cn108138DOI Listing
February 2014