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Öğe Bilateral hypogastric artery ligation: A tertiary center experience(Harran Üniversitesi Tıp Fakültesi, 2019) Peker, Nurullah; Yavuz, Mustafa; Aydın, Edip; Ege, Serhat; Bademkıran, Muhammet Hanifi; Turan, Gökçe; Karaçor, Talip; Gül, TalipBackground: The aim of this study was to evaluate the obstetric characteristics and maternal outcomes of patients undergoing bilateral hypogastric artery ligation (BHGAL) for primary postpartum hemorrhage (PPH). Materials and Methods: Digital records and hospital archives of patients who underwent BHGAL in the postpartum period after vaginal delivery (VD) or during or after cesarean section (C/S) in a tertiary center between May 2005 and May 2018 were reviewed retrospectively. Demographic characteristics, parity, gestational week, duration of operation, hospitalisation time, estimated blood loss, laboratory values, transfused blood volume, previous C/S history, and intensive care requirement of the patients were evaluated. The efficacy of BHGAL in controlling bleeding, indications, concomitant surgeries, and intraoperative and postoperative complications were evaluated. Results: There were 276.008 deliveries in our hospital in the specified period. Of the patients with PPH, 41 patients underwent BHGAL after VD and 19 patients underwent BHGAL during or after C/S. In 25 of 28 patients with PPH due to atony, bleeding was controlled by BHGAL, while 3 patients underwent hysterectomy together with BHGAL. While the effectiveness of BHGAL in uterine atony was 89.2%, the success rate was 33.3% when all cases were considered. The most common cause of indication for BHGAL was atony and disseminated intravascular coagulation (DIC) was the most common complication in patients undergoing BHGAL. Iliac vein injury was detected in one patient due to the procedure itself. Conclusions: BHGAL is more effective on controlling PPH due to atony compared to the control of other PPH causes. Most of the complications in these patients are not related to the procedure but are due to the complications of PPH. Therefore, BHGAL continues to be a life-saving method when applied by centers with adequate surgical knowledge and equipment.Öğe Can clomiphene citrate resistance be predicted by RDW-CV levels in infertile women with PCOS?(Wolters Kluwer Medknow Publications, 2019) Peker, Nurullah; Ege, Serhat; Bademkiran, Muhammet Hanifi; Aydin, Edip; Karacor, Talip; Obut, Mehmet; Arac, EsrefObjective: To identify whether red blood cell distribution width coefficient of variation (RDW-CV) and mean platelet volume (MPV) levels can predict clomiphene citrate resistance (CC-R) in infertile, anovulatory females with polycystic ovarian syndrome (PCOS). Methods: A total of 89 infertile patients who were admitted to a tertiary center diagnosed with non-obese PCOS were included in this study. The patients were divided into two groups: the first group comprised 53 non-obese patients with PCOS and CC-R, and the second group included 36 non-obese patients with PCOS and CC-S. RDW-CV, RDW-SD, and MPV values, along with routine whole blood count parameters were compared between the groups. Results: RDW-CV values were found to be significantly higher in the patients with CC-R compared to those with CC-S (P < 0.05). The sensitivity, specificity, positive, and negative predictive values were found to be 69%, 58.1%, 34.5%, and 12.5%, respectively, at an RDW-CV level of 12.85. The odds ratio was calculated as 3.077 (95% CI 1.245-7.603) in terms of the cut-off point. Conclusion: We think that RDW-CV which is a marker of inflammation is a simple, cheap, and accessible marker for the prediction of CC resistance.Öğe A comparison between a combination of letrozole and clomiphene citrate versus gonadotropins for ovulation induction in infertile patients with clomiphene citrate - A resistant polycystic ovary syndrome-A retrospective study(Via Medica, 2020) Ege, Serhat; Bademkıran, Muhammed Hanifi; Peker, Nurullah; Tahaoǧlu, Ali Emre; Çaça, Fatma Nur Hançer; Özçelik, Serap MutluObjectives: The aim of this study was to compare a combination treatment with CC plus letrozole versus gonadotropins in CC-resistant polycystic ovary syndrome (PCOS) patients with regard to ovulation and clinical pregnancy rate. Material and methods: One hundred sixteen CC-resistant infertile PCOS patients were evaluated retrospectively. The patients were divided into two groups. Group 1 (n = 73) received CC plus letrozole, and Group 2 (n = 43) received gonadotropins. Results: The ovulation rate in Group 1 was 65/73 (89%), the pregnancy rate was 13/73 (18%), the twin foetuses rate was 1/73 (1.3%) and the miscarriage rate was 2/73 (2.7%). In Group 2, the ovulation rate was 41/43 (95%), and the pregnancy rate was 8/43 (19%) the rate of the twin foetuses was 1/43 (2.3%) and the miscarriage rate was 1/43 (2.3%). There was no statistically significant difference in the ovulation (p = 0.25), pregnancy (p = 0.91), twin foetuses (p = 0.89) and miscarriage p = 0.89) rates between two groups. Conclusions: This new drug combination suggests that it may be a lower cost, lower risk alternative treatment that increases the rate of ovulation. Larger randomized clinical trials are needed to provide information on live birth rates of this combination.Öğe Comparison of The Efficacy of Letrozole and Gonadotropin Combination Versus Gonadotropin Alone In Intrauterine Insemination Cycles In Patients With Unexplained Infertility(2020) Oğlak, Süleyman Cemil; Ege, Serhat; Otçu, Serap Mutlu Özçelik; Obut, Mehmet; Kahveci, Bekir; Yıldız, İsmail; Sakar, Mehmet NafiThis study aimed to determine the outcomes of combined treatment of letrozole (LTZ) with recombinant follicle -stimulating hormone (rFSH) in comparison with rFSH alone in intrauterine insemination (IUI) cycles.This study consisted of 86 patients who experienced 106 IUI cycle s. Patients were classified into two treatment groups:group I underwent a combination of LTZ plus rFSH, and group II received rFSH alone. Ovulation was triggered withhuman chorionic gonadotropin (hCG), and IUI performed 36 hours later. The number of follicles ?18 mm, endometrialthickness, required dose of FSH, duration of ovulation induction (OI), clinical pregnancy rates, multiple pregnancy rates,spontaneous abortion rates, and live birth rates were evaluated.The total required rFSH dose during the OI was significantly lower in the LTZ-rFSH combination group than the rFSHalone group (401.2±177.1 IU and 770.1±345.8 IU, respectively, p<0.001). The days of stimulation with rFSH were alsolower in the LTZ co-treatment group than the rFSH-alone group (5.2±1.3 days and 10.1±3.0 days, respectively, p<0.001).Clinical pregnancy rate was 17.0% in LTZ-rFSH group, and 15.2% in rFSH group (p>0.05).The combined use of LTZ with rFSH resulted in a lower required dose of rFSH, a similar and ac ceptable endometrialthickness at the day of hCG administration, and comparable pregnancy rate compared with rFSH aloneÖğe Does ischaemia-modified albumin level predict clomiphene citrate resistant polycystic ovary syndrome patients?(Taylor & Francis Inc, 2021) Ege, Serhat; Bademkiran, Muhammet Hanifi; Peker, Nurullah; Erdem, Selami; Koceroglu, Rusen; Erel, OzcanThis study aims to examine the role of ischaemic-modified albumin (IMA) in predicting clomiphene citrate (CC) resistance in patients with CC-resistant and CC-sensitive infertile polycystic ovary syndrome (PCOS). Sixty women patients admitted to the infertility clinic were evaluated. The patients were divided into two groups. Group 1 comprised 30 infertile PCOS patients with CC resistance; group 2 was the control group comprising 30 infertile PCOS patients with CC sensitivity. Serum IMA levels of PCOS patients with CC resistance were significantly higher than CC sensitivity patients (p < .001). The independent variables BMI and age effects were adjusted according to the logistic regression method with groups. Significant differences were observed between the two groups in the levels of IMA (p = .0005), HOMA-IR (p = .0045), insulin (p = .022), free testosterone (p = .0001) and total testosterone (p = .03) values. By using ROC curve analysis for IMA between study and control groups, cut off point of IMA was calculated as 0.505 U/mL, sensitivity was 80% and specificity was 63%. The area under the curve was 0.926. This shows us that more oxidative stress (OS) occurs in the CC-resistant group. As a reflection of OS in the follicular endocrine, microenvironment may be linked with impaired oocyte developmental competence and embryo quality in association with increased IMA, free testosterone, total testosterone, insulin and HOMA-IR levels.Impact statement What is already known on this subject?In previous studies, IMA was compared between PCOS and control groups. In this study, serum IMA levels were measured in infertile PCOS patients resistant to CC for the first time. What the results of this study add?Serum IMA levels were significantly higher in resistant infertile PCOS patients compared to the control group. This shows us that more OS occurs in the CC-resistant group. What the implications are of these findings for clinical practice and/or further research?IMA will be a guide for PCOS management in patients with CC-resistant PCOS.Öğe The effect of clomiphene citrate on oxidative stress parameters in polycystic ovarian syndrome(Taylor & Francis Inc, 2021) Peker, Nurullah; Turan, Gokce; Ege, Serhat; Bademkiran, Muhammet Hanifi; Karacor, Talip; Erel, OzcanThis study aimed to examine the possible association between the oxidative stress parameters and clomiphene citrate resistance in polycystic ovary syndrome. The demographic data, hormone profiles and oxidant and antioxidant values of 50 clomiphene citrate-resistant polycystic ovary syndrome patients (Group 1), 32 clomiphene citrate-sensitive polycystic ovary syndrome patients (Group 2) and 87 non-polycystic ovary syndrome patients (Group 3) were compared. The average age, follicle-stimulating hormone, oestradiol, thyroid-stimulating hormone and prolactin values of the three groups were found to be homogeneous. Ferroxidase, catalase and myeloperoxidase levels were determined to be lower in the clomiphene citrate-resistant group compared to clomiphene citrate-sensitive and non-polycystic ovary syndrome groups (p < .001). As a result, Polycystic ovary syndrome patients with clomiphene resistance had lower antioxidant (catalase and ferroxidase) levels compared to those who were sensitive to clomiphene and who did not have polycystic ovary syndrome. The myeloperoxidase levels also demonstrated the same trend, which might be due to a compensation mechanism.Impact Statement What is already known on this subject? In the literature, there are many studies evaluating the association between PCOS and oxidative stress. No research related to antioxidants in clomiphene citrate-sensitive and clomiphene citrate-resistant PCOS patients was found in the relevant literature. What do the results of this study add? In this study, the antioxidants catalase and ferroxidase were found to be lower in PCOS women compared to non-PCOS; however, they were the lowest in clomiphene citrate-resistant PCOS women. Interestingly, myeloperoxidase, which is a part of oxidative stress, was also found to be higher in the non-PCOS group.Öğe Evaluation and Management of Patients with Hematoma After Gynecologic and Obstetric Surgery(2021) Uzundere, Osman; Ege, Serhat; Kahveci, Bekir; Budak, Mehmet Sukru; Kahveci, Gaye; Peker, Nurullah; Sucu, MeteOBJECTIVE: Postoperative hematoma following abdominal surgery is relatively rare and mainly depends on the type of surgery. Specific treatment including surgery or interventional radiology is sometimes necessary. The aim of this study is to evaluate the cases of postoperative hematoma after gynecologic and obstetric surgery.STUDY DESIGN: This is a retrospective cohort study of 30 patients with hematoma developed after gynecologic and obstetric surgery. We included the patients who hospitalized with the diagnosis of a postoperative hematoma between June 2017 and April 2019 at Gazi Yasargil Training and ResearchHospital of Health Sciences University. Hematomas occurring after endoscopic surgery and episiotomywere not included. The diagnosed cases were divided into three groups as wound hematoma, rectussheath hematoma and intra-abdominal hematoma (intraperitoneal and retroperitoneal). All cases wereassessed by patient demographics and clinical findings, hematoma of characteristics, treatment methods and results.RESULTS: A total of 30 patients were included in the study with a mean age of 33.0±8.6 years.Incidence of hematoma account for 0.2%. The mean c-reactive protein was 37.9±47.4 mg/dL at admission and 14.6±25.8 mg/dL at discharge, respectively. The decrease was statistically significant (p <0.001). The mean hemoglobin was 10.6±2.1 g/dL at admission and 10.7±1.5 g/dL at discharge. Feverwas detected in 7 (23.3%) patients. Only 12 patients (40%) were followed up by observation and symptom management. In 10 (33.3%) patients, antibiotics were included in the treatment due to infection. Inaddition, 4 patients (13.3%) had relaparotomy, 5 patients (16.7%) underwent percutaneous radiologicaldrainage and 8 (26.7%) received blood transfusion. The mean time of resorption of the hematoma was4.6 ± 2.0 days. The evaluation of the hematoma locations revealed that 14 patients (46.7%) had woundhematoma, 7 patients (23.3%) had rectus sheath hematoma (Type I: 2 cases, type II: 3 cases, type III:2 cases), 8 patients (26.7%) had pelvic hematoma and 2 patients (6.7%) had a retroperitonealhematoma. The mean hematoma size was 68.1±15.18 mm.CONCLUSIONS: In cases of hematoma resistant to antibiotic treatment and non-resorbable hematoma,we can consider percutaneous catheter drainage as an alternative to surgical interventionÖğe Evaluation of catalase, myeloperoxidase and ferroxidase values in pregnant women with hyperemesis gravidarum(Via Medica, 2019) Ege, Serhat; Bademkıran, Muhammed Hanifi; Peker, Nurullah; Erdem, Selami; Bağlı, İhsan; Köçeroǧlu, Ruşen; Kahveci, Bekir; Yıldızhan, Recep; Erel, Özcan; Araç, EşrefObjectives: To investigate maternal serum catalase, myeloperoxidase and ferroxidase levels in pregnant women with Hyperemesis Gravidarum and to compare the results with healthy pregnancies. Material and methods: In this study, 60 female patients admitted to the Health Sciences University, Gazi Yasargil Training and Research Hospital, Gynecology and Obstetrics Department were evaluated. The patients were divided into two groups: Group 1 included 30 pregnant women with hyperemesis gravidarum; Group 2 included 30 healthy pregnant women. Pregnancies over 14 weeks were excluded from the study. Results: The laboratory and laboratory characteristics of both groups are shown in Table 1. No significant differences were found between the groups in terms of the maternal age, gestational age, gravidity, parity, fasting glucose level, and BMI. The maternal blood CAT levels were significantly higher in the HG group (219.6 ± 111.3 kU/L) when compared to the control group (71.5 ± 52.5 kU/L) (p < 0.001). The maternal blood MPO levels were lower in the control group (121.5 ± 36.3 U/L) than in the study group (90.9 ± 56.4 U/L) (p = 0.016). However, the ferroxidase levels were similar between the two groups. The independent variables BMI, age, parity, gravidity and gestational week effects were adjusted according to the logistic regression method with groups. Significant differences were observed between the two groups in the levels of CAT (0.001), MPO (0.005) values. Conclusions: This study suggests that antioxidants in response to oxidative stress gave different reactions with different mechanisms; Also, we believe that insufficient food intake suppresses the immune system and this has an important role on antioxidants.Öğe Excessive Weight Gain During Pregnancy Increased Ponoxarase 1 Level in Neonatal Cord Blood(Mdpi, 2025) Ege, Serhat; Akduman, Hasan; Asir, Aysegul; Korak, TugcanMaternal obesity is increasingly recognized as a risk factor for adverse fetal outcomes, primarily through its association with heightened oxidative stress. This study aimed to evaluate oxidative stress markers in umbilical cord blood of neonates born to obese mothers. Sixty-three pregnant women, who were of normal weight at the start of pregnancy but classified as obese at term, were included. Umbilical cord blood samples were collected immediately post-delivery and analyzed for serum oxidative stress markers (total oxidant status (TOS), total antioxidant status (TAS), paraoxanase (PON), aryl esterase, thiol, and catalase activities). Protein interaction networks were generated using Cytoscape (v3.10.3), and the overlapping proteins were further analyzed for functional annotations with ShinyGO (0.80). The top ten significantly enriched pathways were identified with a false discovery rate (FDR) threshold of <0.05. Significant associations were found between maternal BMI change and paraoxonase 1 (PON1) levels in umbilical cord blood, while no correlation was observed with other oxidative (total oxidant status) and antioxidant markers (total antioxidant status, aryl esterase, thiol, and catalase). Additionally, the correlation analysis showed a significant relationship between BMI change and fetal gestational age, but not with other demographic or clinical features. A total of 24 common protein interactors associated with PON1, obesity, and oxidative stress were identified. Functional annotation analysis revealed significant enrichment in antioxidant and oxidoreductase activities, along with pathways involved in insulin resistance, AGE-RAGE signaling, and atherosclerosis. Maternal obesity may specifically affect PON1 activity, potentially serving as a compensatory response to oxidative stress in neonates, suggesting PON1 as a possible biomarker for oxidative stress-related metabolic disturbances in neonates of obese mothers, with implications for monitoring and managing pregnancy outcomes in obese populations.Öğe Factors Affecting Successful Vaginal Birth Following Dinoprostone Administration in Post-term Pregnancies(Turkiye Klinikleri, 2020) Bademkiran, Muhammed Hanifi; Bademkiran, Cihan; Ege, Serhat; Peker, Nurullah; Oglak, Suleyman CemilObjective: This study will determine the success rates of the predictive factors of vaginal birth in the post-term labor induction of the cervical ripening slow-release insert dinoprostone. Material and Methods: All patients who underwent labor induction were post-term pregnant patients. Post-term pregnancy was defined as lasting >= 42+0 weeks of gestation. Dinoprostone insertion into the posterior fornix was performed according to the Bishop score (<= 6) and maintained for a maximum of 24 hours. Parity, Bishop score, maternal age, fetal gender, and induction time were identified as candidate predictors. The traditional logistic regression method was used to examine the relationship between the outcome and candidate predictors. Discrimination in the model was evaluated by calculating the c-index. Results: Of the 25,678 deliveries that occurred during the study period, 361 (1.4%) women underwent post-term delivery; of these, 293 (81%) succeeded, and 68 (19%) failed to achieve cervical ripening using the dinoprostone slow-release vaginal insert. Three predictors were strongly associated with dinoprostone vaginal delivery success: multiparity (2.88[1.38-6.01]), fetal gender (1.69[0.9-3.0]), and Bishop score (OR: 1.59 [1.45-1.70]). Conclusion: The success of vaginal delivery can be predicted by evaluating factors, including fetal gender, parity, and the Bishop score in post-term pregnancies. Including these factors in the management protocol for labor induction with cervical ripening could improve care quality.Öğe Factors associated with complications of vaginal hysterectomy in patients with pelvic organ prolapse - a single centre's experience(Via Medica, 2019) Peker, Nurullah; Aydın, Edip; Yavuz, Mustafa; Bademkıran, Muhammed Hanifi; Ege, Serhat; Karaçor, Talip; Ağaçayak, ElifObjectives: The study aimed to examine the predisposing factors that play a role in the development of complications in patients undergoing vaginal hysterectomy. Material and methods: This retrospective analysis was performed on data provided from 239 patients who underwent vaginal hysterectomy due to uterine prolapse at a single centre between January 2008 and August 2018. Complications were defined according to Clavien-Dindo classification of complications. The patients were divided into two groups: with and without complications. We built a model using multivariable logistic regression to examine the relationships between complications and five candidate predictors. Results: Intra/postoperative complications developed in 30 patients, and the complication rate was found to be 12.5%. 87.2% of the reported complications were classified as Grade ≤2 according to Clavien-Dindo system. It was found that complications were associated with factors such as intraoperative concurrent salpingo-oophorectomy [Odds ratio (OR): 1.24 (1.1.1.4)], low preoperative haemoglobin [OR: 0.96 (0.94.0.98)], uterine weight [OR: 2.69 (2.62.2.76)], and long operation time [OR: 1.04 (1.02.1.07)]. History of pelvic surgery was not found to increase complication rate [OR: 1.11 (0.96.1.27), p = 0.13]. Our multiple logistic regression model correctly classified 74% of participants within the Receiver Operating Characteristic (ROC) curve. Conclusions: Preoperative anaemia, large uterus and concomitant adnexectomy were found to be factors associated with complications during and after vaginal hysterectomy for pelvic organ prolapse.Öğe Ghrelin does not change in hyperemesis gravidarum(Via Medica, 2019) Ege, Serhat; Kolusarı, Ali; Buğdaycı, Güler; Çim, Numan; Bademkıran, Muhammed Hanifi; Peker, Nurullah; Erdem, Selami; Özgökçe, Çaǧdaş; Yıldızhan, Recepbjectives: Ghrelin levels can play an important role in maintaining the energy balance of pregnant women. Therefore, we investigated the relationship between HG and Ghrelin. Material and methods: 50 female patients admitted to the VAN Yüzüncü Yýl University, Gynecology and Obstetrics Department were evaluated. The patients were divided into two groups: Group 1 included 25 pregnant women with HG, Group 2 included 25 healthy pregnant women. Results: The two groups showed similarities in terms of age, gravidity, B-HCG and gestational age. There was no statistically significant difference between the two groups in terms of the Ghrelin levels (p = 0.867). Conclusions: This study shows that there is no difference between Ghrelin levels and HG during pregnancy. Increased Ghrelin in previous studies was attributed to low oral intake. Another study reported lower Ghrelin levels are not the result of, but are rather the cause of, reduced oral intake during. The balancing of these two conditions does not lead to a change in the level of Ghrelin.Öğe Increased oxidative stress is associated with thiol/disulphide homeostasis in clomiphene citrate resistant polycystic ovary syndrome(Taylor & Francis Inc, 2021) Ege, Serhat; Bademkiran, Muhammet Hanifi; Peker, Nurullah; Ozgun, Zinet; Bagli, Ihsan; Erdem, Selami; Erel, OzcanThe purpose of this study was to evaluate the relation CC resistant PCOS and the thiol/disulphide homeostasis, used as a marker of OS, by measuring that exchange using a novel technique. Sixty women patients admitted to the infertility clinic were evaluated. The patients were divided into two groups. Group 1 comprised 30 infertile PCOS patients with CC resistance; Group 2 was the control group comprising 30 infertile PCOS patients with CC sensitivity. Serum total thiol (p = .024), native thiol (p = .0052), disulphide (p = .003), index 1 (p = .001), index 2 (p = .001) and index 3 (p = .001), HOMA-IR (p < .001) and free testosterone (p < .001) were statistically significant. The independent variables BMI and age effects were adjusted according to the logistic regression method with groups. Significant differences were observed between the two groups in the levels of native thiol (p* = .0042), total thiol (p* = .024), disulphide (p* = .0003), index 1 (p* = .0001) index 2 (p*= .0001), index 3 (p* = .0001), HOMA-IR (p* = .0044), insulin (p*= .032) and free testosterone (p* = .0001) values. The thiol/disulphide homeostasis viewed in favour of OS. Like a reflection of OS in the follicular endocrine microenvironment may be linked with increased thiol/disulphide homeostasis, free testosterone, insulin and HOMA-IR levels.Impact statement What is already known about this subject?In previous studies, thiol/disulphide homeostasis was compared between PCOS and control groups. In this study, serum thiol/disulphide homeostasis was measured in infertile PCOS patients resistant to CC for the first time. What do the results of this study add?Disulphide concentrations were significantly higher in patients with CC resistant patients thanthe control group. This shows us that more OS occurs in the CC-resistant group. What are the implications of these findings for clinical practice and further research?Thiol/disulphide homeostasis will be a guide for PCOS management in patients with CC-resistant PCOS.Öğe Investigation of Aquaporin Molecules in the Placentas of Pregnant Women with Premature Rupture of Membranes(Tıbbi Kayıtlar Derneği, 2024) Kaplan, Özge; Başaran, Süreyya Özdemir; Pala, Ayşegül; Korak, Tuğcan; Aşır, Fırat; Kaplan, Serdar; Ege, SerhatAim: This study aimed to investigate the immunohistochemical expression of Aquaporin 3 (AQP3) in placentas of pregnant women with premature rupture of membrane (PROM) and to explore AQP3-related interactors and signaling pathways using in silico approaches. Material and Method: Placental samples from 21 healthy (control) pregnant women and 21 pregnant women diagnosed with PROM were processed for routine histological tissue preparation. Sections were immunostained with AQP3 and analyzed under light microscope via ImageJ software. Protein-protein interaction (PPI) network of AQP3 was constructed with Cytoscape (version 3.10.2). Nodal centrality indexes (degree, closeness and betweenness) were computed through CentiScaPe plugin. The Enrichr tool was utilized to perform pathway enrichment analysis for 15 central genes. Results: AQP3 immune activity was significantly decreased in the plasma membrane of the trophoblastic cell layer of the PROM group compared to control group. According to network centrality analysis, AQP subfamily proteins predominantly play central roles in the AQP3 network; Major Intrinsic Protein of Lens Fiber (MIP), Glycerol-3-Phosphate Dehydrogenase 2 (GPD2), Glyceraldehyde-3-Phosphate Dehydrogenase (GAPDH), Glycerol Kinase 2 (GK2), GK, and Actin Beta (ACTB) with additional central interactors including proteins. Peroxisome proliferator-activated receptors (PPAR) signaling pathway was obtained as the most significantly enriched pathway. Conclusion: Alterations in AQP3 expression level in the PROM group compared with the control group may contribute to disturbances in water transport and cellular homeostasis in placental tissues and in silico potential interaction between AQP3 expression and PPAR signaling suggest the role of AQP3 in cell metabolism in PROM.Öğe Investigation of Aquaporin Molecules in the Placentas of Pregnant Women with Premature Rupture of Membranes(2024) Kaplan, Özge; Başaran, Süreyya Özdemir; Aşır, Ayşegül; Korak, Tuğcan; Aşır, Fırat; Kaplan, Serdar; Ege, SerhatAim: This study aimed to investigate the immunohistochemical expression of Aquaporin 3 (AQP3) in placentas of pregnant women with premature rupture of membrane (PROM) and to explore AQP3-related interactors and signaling pathways using in silico approaches. Material and Method: Placental samples from 21 healthy (control) pregnant women and 21 pregnant women diagnosed with PROM were processed for routine histological tissue preparation. Sections were immunostained with AQP3 and analyzed under light microscope via ImageJ software. Protein-protein interaction (PPI) network of AQP3 was constructed with Cytoscape (version 3.10.2). Nodal centrality indexes (degree, closeness and betweenness) were computed through CentiScaPe plugin. The Enrichr tool was utilized to perform pathway enrichment analysis for 15 central genes. Results: AQP3 immune activity was significantly decreased in the plasma membrane of the trophoblastic cell layer of the PROM group compared to control group. According to network centrality analysis, AQP subfamily proteins predominantly play central roles in the AQP3 network; Major Intrinsic Protein of Lens Fiber (MIP), Glycerol-3-Phosphate Dehydrogenase 2 (GPD2), Glyceraldehyde-3-Phosphate Dehydrogenase (GAPDH), Glycerol Kinase 2 (GK2), GK, and Actin Beta (ACTB) with additional central interactors including proteins. Peroxisome proliferator-activated receptors (PPAR) signaling pathway was obtained as the most significantly enriched pathway. Conclusion: Alterations in AQP3 expression level in the PROM group compared with the control group may contribute to disturbances in water transport and cellular homeostasis in placental tissues and in silico potential interaction between AQP3 expression and PPAR signaling suggest the role of AQP3 in cell metabolism in PROM.Öğe Maternal serum thiol/disulfide homeostasis in pregnancies complicated by fetal hypoxia(Taylor & Francis Inc, 2021) Ege, Serhat; Akduman, Hasan; Bademkiran, Muhammet Hanifi; Peker, Nurullah; Erdem, Selami; Bagli, Ihsan; Ozmen, ErdalWe aimed to evaluate maternal serum thiol/disulphide homeostasis in pregnancies complicated by fetal distress (FD). A total of 100 patients beyond the 34th week of pregnancy were included in this study, and they were divided into two groups. The study group included 50 patients who had been diagnosed with FD; the control group was composed of 50 patients who had shown no signs of FD and who had undergone an elective (previous) caesarean section (CS). The native thiol, total thiol and native thiol/total thiol (%) concentrations were lower in Group 1 patients than Group 2 patients (p < .001). The disulphide, disulphide/native thiol (%) and disulphide/total thiol (%) concentrations were higher in Group 1 patients than Group 2 patients (p < .001). This study suggests that maternal thiol/disulphide homeostasis is impaired in pregnancies complicated by FD.IMPACT STATEMENT What is already known about this subject? Oxidative stress (OS) has previously been investigated in FD. This study reports for the first time a new novel and automatic measurement method. What do the results of this study add? This study shows that the thiol balance shifts in the direction of disulphide in the cases of FD.Öğe PALM-COEIN classification system of FIGO vs the classic terminology in patients with abnormal uterine bleeding(Via Medica, 2021) Kahveci, Bekir; Budak, Mehmet Şükrü; Ege, Serhat; Obut, Mehmet; Bağlı, İhsan; Oğlak, Süleyman Cemil; Vardar, Mehmet AliObjectives: To evaluate the FIGO's novel classification system versus the classic terminology in patients with abnormal uterine bleeding. Material and methods: A retrospective study was carried out between August 2015 and September 2019 in the Health Sciences University Gazi Yasargil Training and Research Hospital. The pathology reports of the patients were classified according to the PALM-COEIN method and were compared with classical terminology. The operated patients with fibroids reported in the pathology results were classified as subgroups of fibroids. Results: Evaluation was made of a total of 515 women with abnormal uterine bleeding. According to the classical terminology, 137 (26.6%) patients were defined with hypermenorrhea, 74 (14.4%) with menorrhagia, 57 (11.1%) with metrorrhagia, and 246 (47.8%) with menometrorrhagia. In the PALM-COEIN classification system, polyps were determined in 84 (16.3%) cases, adenomyosis in 228 [diffuse adenomyosis:196 (38.1%), local adenomyosis:32 (6.2%)], leiomyoma in 386 [submucous:161 (31.1%), other types: 225 (43.9%)], and malignancy and hyperplasia in 47 (9.1%). Conclusions: The classical terminology for abnormal uterine bleeding is insufficient in terms of etiological pathologies in non-pregnant women of reproductive age. The widespread use of this novel system for the abnormal uterine bleeding classification will provide a more useful communication between physicians and researchers.Öğe The prevalence of uterine anomalies in infertile patients with polycystic ovary syndrome: A retrospective study in a tertiary center in Southeastern Turkey(Galenos Yayınevi, 2019) Ege, Serhat; Peker, Nurullah; Bademkıran, Muhammed HanifiObjective: To evaluate the prevalence of uterine anomalies in infertile patients with polycystic ovary syndrome (PCOS) admitted to our tertiary hospital inSoutheastern Turkey.Materials and Methods: The files of 3033 patients with infertility who presented to the infertility polyclinics were retrospectively analyzed, and uterine anomalieswere detected in 131 patients. Seven hundred ten of these patients were evaluated as having PCOS, 55 of whom had uterine anomalies. Patients with PCOS werealso divided into two subgroups as those with primary and secondary infertility.Results: Of the 3033 patients with infertility who were evaluated, 57 (8%) of 710 infertile patients with PCOS, and 74 (3%) of 2323 non-PCOS patients withinfertility had uterine anomalies. A statistically significant difference was found between the two groups (p<0.001), and no significant difference was found betweenthe primary and secondary infertile PCOS subgroups (p=0.3). Septate uteri and arcuate uteri had a high prevalence in the PCOS group, and no t-shaped orhypoplastic uteruses were observed in this group.Conclusion: To or knowledge, this is the first study in our region to examine the relation between PCOS and Müllerian anomalies. We demonstrated uterineanomalies and their prevalence in patients with infertility. A more careful examination is required in order to determine the incidence of uterine anomalies in patientswith PCOS.Öğe Risk factors for relaparotomy after cesarean section due to hemorrhage: a tertiary center experience(Taylor & Francis Ltd, 2020) Peker, Nurullah; Yavuz, Mustafa; Aydin, Edip; Ege, Serhat; Bademkiran, Muhammed Hanifi; Karacor, TalipAim: This study aimed to examine the risk factors for relaparotomy after cesarean section (RLACS) due to bleeding. Material and methods: In this retrospective descriptive case-control study, women who underwent RLACS only for bleeding between 2008 and 2019 at a single tertiary center were examined (the center oversees approximately 25,000 deliveries per year). Maternal characteristics, postoperative findings, and surgical features were compared with a control group that included non-complicated cesarean sections (CS). Multivariable logistic regression analysis was used to identify the risk factors for relaparotomy. Results: Relaparotomy complicated 0.07% (n?=?40) of CS during the study period (n?=?58,095). When compared with the control group, age, parity, estimated blood loss (EBL), postoperative pulse, blood replacement, and length of hospital stay were statistically higher in patients undergoing relaparotomy, whereas their postoperative systolic and diastolic blood pressure were found to be low. A history of pelvic surgery, the need for intensive care, and complications were more frequent in patients undergoing relaparotomy. When CSs were grouped according to 8-h periods of the day, it emerged that relaparotomies were mostly performed on the patients who underwent CS after working hours. Time interval during the day of the CS [OR: 2.59 (1.10?6.12)] and high postoperative pulse rate [OR: 1.58 (1.28?1.96)] were found to be independent risk indicators for RLACS (AUC: 0.97). Conclusions: Monitoring vital signs in the postoperative period and increasing the number of physicians and nurses during off-hours in hospitals working with on-call duty procedures as determined by the Ministry of Health will reduce the incidence rate of relaparotomy, maternal morbidity, and mortality due to hemorrhage.Öğe SPERM PARAMETERS' PREDICTIVE VALUE IN INTRAUTERINE INSEMINATION SUCCESS: A SINGLE-CENTER EXPERIENCE(Bilal GÜMÜŞ, 2023) Afşin, Muhamet; Nursal, Ayşe Feyda; Otcu, Serap Mutlu Özçelik; Yavuz, Dilek; Ege, SerhatAlthough intrauterine insemination is a widely used assisted reproductive technique there is no consensus on sperm parameters that affect the probability of pregnancy. Therefore, the purpose of this study was to determine whether semen parameters affect intrauterine insemination success. A total of 403 couples (345 negative pregnancies, and 58 positive pregnancy) that underwent 549 intrauterine insemination treatment cycles for heterogenous indications were included in the study. Clomiphen citrate, letrazole and/or gonadotropins were used for ovarian stimulation in women in this study. The spermiogram tests of the spouse of receiving IUI tretment were examined. Clinical pregnancy occurred in 58 of 549 intrauterine insemination (10.56%). Unexplained infertility, polycystic ovary syndrome, and cervical-tubal factors were higher in positive pregnancy group compared to negative pregnancy group while male factor was more prevalant in negative pregnancy group comparison to positive pregnancy group (p=0.03). There was no statistical difference between women with positive and negative pregnancy in terms of age (? 35 and > 35), body mass index, infertility type, infertility time, endometrial thickness on HCG day, stimulation protocol, cycle numbers, number of insemination, estradiol, prolactin, LH, FSH, and TSH levels (p>0.05). The sperm characteristics in males [ejaculate volum, sperm concentration, total sperm count, motility, immotility, and total progressive motile sperm count] did not significantly differed between positive and negative pregnancy groups (p>0.05). Briefly, the present study found that the conception probability of intrauterine insemination did not correlate with the spermiogram parameters.