Publications by authors named "Nese Gul Hilali"

26 Publications

  • Page 1 of 1

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

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

A new biomarker for the early diagnosis of ovarian torsion: SCUBE-1.

Clin Exp Reprod Med 2018 Jun 29;45(2):94-99. Epub 2018 Jun 29.

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

Objective: Prompt diagnosis and management are essential for saving the adnexal organs from infarction in cases of ovarian torsion (OT). This study aimed to determine the diagnostic significance of signal peptide, complement C1r/C1s, Uegf, and Bmp1 (CUB), and epidermal growth factor-like domain-containing protein-1 (SCUBE-1) levels in cases of OT, an emergent ischemic condition, and the relationship of SCUBE-1 with oxidative stress parameters.

Methods: This prospective study was conducted among 15 OT patients and 20 age- and gravidity-matched healthy women. SCUBE-1 serum concentrations were determined by using enzyme-linked immunosorbent assays. In addition, oxidative stress was evaluated by measuring the serum levels of advanced oxidation protein products (AOPP), ferric reducing ability of plasma (FRAP), and glutathione (GSH).

Results: The SCUBE-1 titers were significantly higher in the patients with OT than in the controls (=0.008). In addition, serum FRAP and GSH levels were significantly lower in the OT patients than in the controls (<0.001 for both). Serum AOPP levels were higher in the OT patients, but this trend was not statistically significant (>0.05). Furthermore, there were no correlations between SCUBE-1 levels and age, gravidity, parity, cyst size, and AOPP, FRAP, or GSH levels (>0.05).

Conclusion: We believe that SCUBE-1 may be a promising biomarker for the early diagnosis of OT.
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http://dx.doi.org/10.5653/cerm.2018.45.2.94DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6030614PMC
June 2018

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

A community-based survey on Syrian refugee women's health and its predictors in Şanliurfa, Turkey.

Women Health 2018 07 12;58(6):617-631. Epub 2017 May 12.

d United Nations Population Fund , Ankara , Turkey.

Reproductive characteristics, mental health symptoms, micronutrient deficiencies, and symptoms of sexually transmitted infections (STIs) were determined among married Syrian refugee women aged 15-49 years who were living outside of camps in 2015, using probability sampling. Of the 458 participants, 51.3 percent married before the age of 18 years. Early-age marriages and number of desired children increased after the war. In multivariable analyses, education (adjusted odds ratio [aOR] = 1.2; 95% confidence interval [CI] = 1.2-1.3) and length of stay in Şanlıurfa (aOR = 1.2; 95% CI = 1.1-1.2) were independently associated with early marriage. Approximately 16 percent of women were pregnant, and 26.7 percent of them had not received prenatal care; 47.7 percent had had a pregnancy loss; 50.8 percent reported symptoms of STIs. Of those who were sexually active, 37.8 percent were not using contraception. The prevalence of iron, B, and folic acid deficiencies was 50 percent, 45.6 percent, and 10.5 percent, respectively. Early marriage (aOR = 2.2; 95% CI = 1.4-3.5) and number of desired children (aOR = 5.03; 95% CI = 3.2-7.9) were associated with not using contraception. Most (89.7 percent) women reported at least two mental health symptoms; lack of social support (aOR = 2.6; 95% CI = 1.3-5.3), language barrier (aOR = 2.3; 95% CI = 1.01-5.2), and B deficiency (aOR = 1.8; 95% CI = 1.01-3.4) were associated with such symptoms. The findings demonstrate the need for reproductive health and psychosocial services.
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http://dx.doi.org/10.1080/03630242.2017.1321609DOI Listing
July 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

[Investigation of the prevalence of Trichomonas vaginalis among female Syrian refugees with the complaints of vaginitis aged between 15-49 years].

Mikrobiyol Bul 2016 Oct;50(4):590-597

Harran University Vocational School of Health Services, Medical Laboratory Programme, Medical Microbiology, Sanliurfa, Turkey.

Since the Syrian civil war began in 2011, most of the Syrian refugees have immigrated to Turkey due to its open gate policy and the width of the border. By the end of 2015, it was estimated that there were 2.5 million Syrian refugees in Turkey. Many of the Syrian refugees live in Sanliurfa due to its location on the border with Syria. Trichomonas vaginalis, apart from viral agents is the most common parasite among sexually transmitted infection agents. The aim of this study was to determine the prevalence of T.vaginalis among female married Syrian refugees living outside of the camps in Sanliurfa city center, aged between 15-49 years with complaints of vaginitis. This multi-purpose survey was carried out between February and March of 2015, in collaboration with the United Nations Population Fund and Harran University. This study was approved under the heading of "General Health Status of Female Syrian Refugees" by the Ethics Committee of Harran University Faculty of Medicine. A total of 460 Syrian refugees house were selected using the probability cluster sampling method, with a 95% confidence level and a 5% confidence interval with a design effect. Two women refused to participate in the study, and the response rate was 99.6%. Two Syrian nurses, one laboratory technician, and one interpreter who knew Kurdish and Arabic were hired for the field survey. A structured questionnaire written in Turkish was translated to Arabic and used to collect the sociodemographic data during face to face interviews. According to the questionnaire data, the women with the complaints of vaginal discharge, unusual vaginal bleeding and/or dyspareunia were invited to the Gynecology Department of Harran University Research and Training Hospital for a medical examination. During gynecological examination, swab samples obtained from posterior fornix were evaluated by direct microscopy and Giemsa staining methods for the presence of T.vaginalis trophozoites. Of 458 women who have participated the questionnaire survey, 232 (50.6%) have declared that they had vaginitis complaints. Accordingly, 157 symptomatic and non-pregnant women were invited to the hospital, however only 89 (56.7%) accepted the invitation. T.vaginalis infection was detected in 19 (21.3%) by direct microscopy, and in 32 (36%) by Giemsa staining of the samples taken during the examination of those 89 women (mean age: 31.6 ± 8.7 years). In the gynecological examination, 56.2% (50/89) of the women were clinically diagnosed as vaginitis. A statistically significant association was detected between T.vaginalis positivity and the cases with or without the clinical vaginitis diagnosis (p< 0.001). Our data indicated that the prevalence of T.vaginalis (36%) detected in the female Syrian refugees is higher than the prevalence (3-13%) of our general population, but it is close to the prevalence (40%) in groups with risky behaviors (sex workers). In conclusion, health screening studies and health educations about safe sex life for Syrian refugees would be useful in the prevention of sexually transmitted diseases.
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http://dx.doi.org/10.5578/mb.28173DOI Listing
October 2016

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

Changes of intraocular pressure in different trimesters of pregnancy among Syrian refugees in Turkey: A cross-sectional study.

Turk J Obstet Gynecol 2016 Jun 15;13(2):67-70. Epub 2016 Jun 15.

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

Objective: To evaluate the physiologic changes in intraocular pressure associated with pregnancy in healthy Syrian refugee women in Turkey.

Materials And Methods: In this cross-sectional study, intraocular pressures were measured using a Goldmann tonometer in 235 patients in the first, second, and third trimester of pregnancy and puerperium among Syrian refugees in Turkey.

Results: Mean intraocular pressures values of the right eye were 15.5±2.5 mmHg, 14.4±1.4 mmHg, 13.9±1.6 and 14.7±1.9 mmHg in the three trimesters and puerperium, respectively. Mean intraocular pressures values of the left eye were 15.3±1.6 mmHg, 14.3±1.4 mmHg, 13.9±1.6 and 15.3±2.2 mmHg in the three trimesters and puerperium, respectively. The mean intraocular pressures values measured from both eyes were significantly higher in first trimester and puerperal period than in the third trimester (p<0.001).

Conclusion: Changes in the intraocular pressure in pregnancy are common and temporary. This study shows the baseline changes in the intraocular pressure during pregnancy in healthy women. Therefore, we cannot extrapolate the results to the whole eye. A decrease in intraocular pressures was shown in healthy pregnant women.
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http://dx.doi.org/10.4274/tjod.40221DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5558340PMC
June 2016

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

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

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

Does a risky outcome of antenatal screening test indicate oxidative stress?

J Matern Fetal Neonatal Med 2014 Jul 17;27(10):1033-7. Epub 2013 Oct 17.

Gynecology and Obstetrics Clinic and.

Objective: The study aimed to investigate a possible relationship between second trimester aneuploidiy screening results and oxidative stress in foetal amnion and maternal serum.

Methods: Concerning the outcome of the second-trimester screening test, 50 pregnant women of high risk were included in the experimental group, whereas 50 pregnant women with normal scores who wished to proceed with the amniocentesis procedure due to advanced maternal age and counselling were included in the control group. The biochemical parameters of total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI) were measured in the amniotic fluid samples and maternal serum samples.

Results: OSI in the maternal serum samples, as well as TAS and TOS in the amniotic fluid, was significantly higher in the control group compared to the experimental group (p < 0.001, p = 0.047, p = 0.005, respectively). There was no significant difference in the TAS and TOS in the maternal serum samples or the OSI in the amniotic fluid between the groups.

Conclusions: The results indicate that the positivity of the screening test is not significantly correlated with oxidative stress, a factor regarded as a pathological mechanism in various diseases. Potential maternal anxiety could underlie the elevated oxidative stress in the control group.
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http://dx.doi.org/10.3109/14767058.2013.847421DOI Listing
July 2014

Myomectomy during caesarean: a retrospective evaluation of 16 cases.

Arch Gynecol Obstet 2014 Mar 8;289(3):569-73. Epub 2013 Sep 8.

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

Aim: To evaluate the results and complications of myomectomy carried out during caesarean section.

Materials And Method: A retrospective study of 16 patients who underwent myomectomy concurrently with caesarean section in our clinic between January 2009 and September 2012 was conducted. The pre- and postoperative haemoglobin values, number, size and total volume of excised fibroid nodules, location of fibroids, duration of operation, and duration of hospital stay of all patients were retrospectively investigated.

Results: While the most common leiomyoma was transmural myoma, with ten cases encountered, the most common location was in the corpus anterior, where transmural myomas were seen in five patients. The volume of the excised leiomyomata ranged from 84 to 3.300 cm³. The average preoperative haemoglobin value of our patients was 11.4 g/dl, while the postoperative value was 10.3 g/dl. Of 16 patients included in the study, two required blood transfusions due to excessive bleeding. Uterine defects caused by the myomectomy were closed without problems in all patients, and no patient required a hysterectomy. The average time for the myomectomy and caesarean section procedure was 56.1 min. All patients were discharged without problems an average of 3.25 days after the operation.

Conclusion: Myomectomy carried out during caesarean section is a trusted surgical intervention regardless of the size of leiomyomata.
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http://dx.doi.org/10.1007/s00404-013-3019-1DOI Listing
March 2014

Increased insulin resistance and C-reactive protein in women with complete hydatidiform mole.

Gynecol Endocrinol 2011 Oct 4;27(10):840-3. Epub 2011 Jan 4.

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

Objective: To evaluate (i) insulin resistance and C-reactive protein (CRP) levels in women with complete hydatidiform mole (CHM) and (ii) whether there were any correlations between these parameters and CHM.

Methods: Thirty-two women with CHM and 30 healthy pregnant women were enrolled in the study. Fasting serum glucose and insulin levels, low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), and triglyceride (TG) and C-reactive protein (CRP) were measured. Insulin resistance was calculated by the homeostasis model assessment ratio (HOMA-IR).

Results: Fasting glucose, insulin, HOMA-IR, CRP, and TG levels were higher, and HDL was lower among patients with CHM compared with healthy pregnant group (p < 0.05 for all). There were positive associations between CHM status and glucose, insulin, HOMA-IR, CRP, TG levels and had a negative correlation with HDL (p < 0.05 for all). The receiver operating characteristic curve (ROC) analysis value for HOMA-IR in CHM was 0.96 (95% confidence interval (CI) = 0.92-1.00), sensitivity = 94%, and specificity = 87%. The area under ROC curve value for CRP was 0.72 (95% confidence interval (CI) = 0.58-0.84), sensitivity = 82%, and specificity = 60% in CHM.

Conclusions: Insulin resistance and CRP were found to be higher among patients with CHM. These parameters were also closely associated with CHM. Further studies are needed to investigate the nature of this link in this group.
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http://dx.doi.org/10.3109/09513590.2010.538096DOI Listing
October 2011
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