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    Evaluation of adolescent pregnancies: 10-year experience of a hospital in rural Turkey
    (I R O G Canada, Inc, 2011) Demir, B.; Guzel, A. I.; Celik, Y.; Demir, S.; Demir, F.
    Purpose: To evaluate the characteristics of adolescent pregnancies admitted to our clinic. Materials and Methods: This retrospective and descriptive study was performed at Ergani State Hospital from January 2000 to December 2010. This is an outpatient gynecology and obstetrics at government hospital in Southern Eastern Region of Turkey. A total of 15,210 pregnancies were delivered during the study period, of whom 711 of them were adolescent pregnancies. Statistical analyses were carried out using the statistical packages for SPSS 15.0 for Windows (SPSS Inc., Chicago, IL, USA). Results: During the study period, of the total of 15,210 deliveries 711(4.6%) were adolescent pregnancies (age range 14-19 years). The mean age (95% CI) of the patients was 17.90 +/- 1.12 (17.82-17.98) years old. Most of the patients were nulliparous (n = 559, 78.60%). Mean gestational weeks, fetal birth weight and fetal birth length and 95% Cl values were as follows: 37.11 +/- 2.53 (36.93-37.30), 3045.73 +/- 51.70 (3007.65-3083.79) and 48.68 +/- 2.31 (48.51-48.85), respectively. Six hundred and twenty (87.20%) of the patients delivered spontaneously by the vaginal route, while 91 (12.80%) were delivered by cesarean section. Although the age range of the patients was not wide, there was a significant correlation between maternal age, gestational age, fetal birth weight and fetal birth length (p < .01). Conclusion: According to this study, the ratio of adolescent pregnancies was found to be 4.6% which was lower than other regions of Turkey. The majority of the patients were nulliparous and most delivered spontaneously by the vaginal route. There was a significant correlation between maternal age, gestational age, fetal birth weight and fetal birth length.
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    Hirsutism Score and the Severity of Hyperandrogenism Associated with Polycystic Ovary Syndrome in the South-eastern Region of Turkey
    (Sage Publications Ltd, 2011) Demir, B.; Pasa, S.; Demir, S.; Tumer, C.; Atay, A. E.; Gul, T.; Atamer, Y.
    This study investigated the severity of hirsutism and its correlation with serum total testosterone (tT) levels in 87 patients with polycystic ovary syndrome (PCOS) and 85 healthy control subjects from the south-eastern region of Turkey. A wide range of variability exists in both hirsutism and modified Ferriman-Gallwey (mFG) scores. Similar mFG scores and serum tT levels were found compared with previous studies of general populations, but lower scores than those previously reported from Turkey. The incidence of hirsutism was lower in hyperandrogenic PCOS patients compared with nonhyperandrogenic PCOS patients. There was no correlation between serum tT levels and the rate of hirsutism in patients with PCOS. Heritability, testosterone receptor sensitivity, 5 alpha reductase activity or environmental/socioeconomic factors may play a role in the development of clinical hirsutism. Larger scale studies are needed to clarify which other factors may be responsible and to confirm these results.
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    Morphologic and functional vascular alterations in patients with polycystic ovary syndrome
    (I R O G Canada, Inc, 2011) Demir, B.; Pasa, S.; Demir, S.; Buyukkaya, R.; Atay, A. E.; Atamer, Y.; Gul, T.
    Background: We aimed to investigate morphologic and functional alterations of common carotid arteries (CCA) and femoral arteries and the anteroposterior diameter of the abdominal aorta in patients with polycystic ovary syndrome (PCOS). Materials and Methods: Fifty consecutive females with the complaint of oligoamenorrhea, infertility or hirsutismus, diagnosed with PCOS and 50 healthy females admitted to the Department of Gynecology and Obstetrics, Ergani State Hospital between January 2010 and January 2011 were included in the study. Results: The mean BMI of 50 patients with PCOS was higher than control subjects (CS) (25.89 +/- 3.3 vs 22.52 +/- 2.7 kg/m(2), p < 0.0001). The mean arterial blood pressure was 88.93 +/- 6.4 mmHg in the patient group and was it 85.73 +/- 7.6 mmHg in CS (p = 0.02). The mean plasma glucose level (74.04 +/- 6.7 vs 70.5 +/- 6.4 mg/dl), total cholesterol level (167.88 +/- 30.1 vs 153.38 +/- 27.8 mg/di), low density lipoprotein level (101.28 +/- 27.0 vs 79.56 +/- 25.5 mg/dl) and triglyceride level (121.22 +/- 49.2 vs 102.54 +/- 36.6 mg/di) were higher; also the mean high density lipoprotein level (44.56 +/- 8.1 vs 50.90 +/- 12.3 mg/dl) was lower in patients with PCOS than CS (p = 0.009, p = 0.014, p < 0.0001, p = 0.034 and p = 0.003, respectively). CCA-IMT (0.63 +/- 0.2 vs 0.52 +/- 0.1 mm), and CCA-PI (1.44 +/- 0.3 vs 1.28 +/- 0.22) were higher in patients with PCOS (p = 0.018 and p = 0.005, respectively). Femoral-IMT (0.62 +/- 0.6 vs 0.41 +/- 0.1 mm) and anteroposterior diameter of the infrarenal aorta (12.34 +/- 1.5 vs 11.4 +/- 1.0 mm) were higher in patients with PCOS (p = 0.024 and p = 0.001, respectively). Conclusion: The present study showed that IMT and PI of CCA, and anteroposterior diameter of the infrarenal abdominal aorta and femoral-IMT were higher in patients with PCOS. These results are probably related with increased androgens, their effects on insulin resistance and lipid profile, increased BMI and blood pressure. Detection of these functional and/or structural abnormalities are important in predicting prognosis. Larger scale prospective studies are needed to determine the effects of PCOS on the mortality and morbidity, and to clarify the relation between the duration of the disease and development of these alterations.
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    Outcomes of pregnancies in women with parity ten or more: a case control study
    (I R O G Canada, Inc, 2012) Demir, B.; Guzel, A. I.; Demir, S.; Demir, F.; Celik, Y.
    Purpose: To determine the outcomes of pregnancies in women with parity ten and more. Materials and Methods: We designed this study in a government hospital in rural Turkey. Pregnant women with parity of ten or more (n = 126) were evaluated and compared with pregnant women with parity lower than ten (n = 90). The risk factors recorded were maternal age, parity, gestational age (weeks), delivery mode, fetal birth weight and Apgar scores. Statistical analyses were carried out using the statistical packages for SPSS 15.0 for Windows (SPSS Inc., Chicago, IL, USA). Results: During the study period, a total of 12,551 deliveries were delivered at the current clinic. One hundred and twenty-six mothers were delivered with parity ten or more with a ratio of 1.01%. There was a statistically significant difference between the study and control group by means of maternal age, parity, fetal birth weight and 1- and 5-min Apgar scores (p < 0.05). There was no difference in delivery mode between the groups. Conclusion: According to this study, pregnant women with parity ten or more showed no adverse clinical characteristics when compared with pregnant women with parity lower than ten.
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    The role of homocysteine, asymmetric dimethylarginine and nitric oxide in pre-eclampsia
    (Taylor & Francis Inc, 2012) Demir, B.; Demir, S.; Pasa, S.; Guven, S.; Atamer, Y.; Atamer, A.; Kocyigit, Y.
    Nitric oxide (NO) contributes to vasodilatation that is observed during normal pregnancy. Hyperhomocysteinaemia (HHcy) is a vascular risk factor associated with placental microvascular diseases and pre-eclampsia. Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of endothelial nitric oxide synthase (NOS) has been linked to endothelial dysfunction. Maternal ADMA has been reported to be higher in women with pre-eclampsia and HHcy leads to accumulation of ADMA. The aim of this presented study is to evaluate the alterations of plasma homocysteine, ADMA and NO levels in mild pre-eclampsia. A total of 40 pre-eclamptic women and 40 healthy controls were included into the study. Mean systolic and diastolic blood pressure, mean serum homocysteine and ADMA levels were significantly higher and NO level was lower in patients. Serum homocysteine, ADMA and NO levels found to be correlated among them and with blood pressure. In conclusion, we found that homocysteine and ADMA levels were increased and NO levels decreased in pre-eclampsia.
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    Serum Levels of Lipids, Lipoproteins and Paraoxonase Activity in Pre-eclampsia
    (Sage Publications Ltd, 2011) Demir, B.; Demir, S.; Atamer, Y.; Guven, S.; Atamer, A.; Kocyigit, Y.; Hekimoglu, A.
    Serum paraoxonase 1 (PON1) activity and the oxidation of lipoproteins were investigated in 35 women with preeclampsia and in 35 healthy control women with normal pregnancies. Blood pressure, body mass index (BMI), serum levels of total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB) and lipoprotein (a) (Lp[a]), and PON1 activity were assessed. There were no significant between-group differences in subject age, gestational age at diagnosis of preeclampsia, BMI, serum total cholesterol, triglycerides, LDL and ApoB levels. Mean systolic and diastolic blood pressures and serum Lp(a) were significantly higher in subjects with pre-eclampsia than in controls. Mean serum HDL, ApoA1 and PON1 activity were significantly lower in subjects with pre-eclampsia compared with controls. In conclusion, lipids and oxidized lipoproteins may play important roles in the pathogenesis of preeclampsia.
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    Weber's gland immune/histopathology in pediatric recurrent tonsillitis and obstructive tonsillar hypertrophy cases
    (Verduci Publisher, 2022) Sizer, B.; Deveci, E.; Demir, S.; Yorgancilar, A. E.
    OBJECTIVE: Recurrent tonsillitis and obstructive tonsillar hypertrophy are very common in childhood and constitute the two major causes of tonsillectomy in this age group. There is no study in the literature on the immune/histopathological changes in the recurrent and obstructive tonsillar hypertrophy of Weber's glands. In this study, we aimed to histopathologically and immunohistochemically examine the Weber's glands of pediatric patients with recurrent. PATIENTS AND METHODS: A total of 63 patients, with 31 patients aged 6-9 who had surgery for recurrent tonsillitis, and 32 patients aged 6-11 years who had surgery for obstructive tonsillar hypertrophy, were included in the study. The removed Weber's glands were included in the obstructive tonsillar hypertrophy or recurrent tonsillitis group according to the patient's clinical diagnosis. All specimens were coded with a numbering method, where only the surgeon knew which patient was in which group. All specimens were evaluated in the same histology center and by the same histologist, unaware of the clinical diagnosis of the patients (blind). RESULTS: The comparison of Weber's gland immunohistochemical parameter scores of the groups revealed that the scores of the RT group were significantly higher for all three parameters (VEGF: t=6.777; p<0.001), (EGFR: t=4.386; p<0.001), (IL-6: t=5.072; p<0.001). The comparison of the groups in terms of inflammation, basement membrane thickening, myoepithelial cell and glycoprotein accumulation revealed significantly higher Weber's gland evaluation scores in the RT group for all four parameters. (inflammation: t=7.794; p<0.001), (basement membrane thickening: t=6.582; p<0.001), [myoepithelial cell: t=3.693; p<0.001), (glycoprotein accumulation: t=5.287; p<0.001)]. CONCLUSIONS: Histopathological and immunohistochemical examination of Weber's gland in pediatric recurrent tonsillitis and obstructive tonsillar hypertrophy cases revealed inflammatory changes in both disease groups. As expected, inflammatory manifestations were more common in the recurrent tonsillitis group. Besides, inflammatory changes detected in Weber's glands of obstructive tonsillar hypertrophy cases without a history of tonsillitis may contribute to the Weber's gland hypothesis, which attempts to explain the etiology of peritonsillar abscess.