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Öğe Abdominal wall endometriosis: a case series and review of the literature(Old City Publishing Inc, 2016) Basaranoglu, Serdar; Agacayak, Elif; Deregozu, Aysegul; Yilmaz, Deniz; Acet, Mustafa; Tunc, Senem Yaman; Evsen, Mehmet Siddik[Abstract Not Available]Öğe The Biochemical and Histologic Effects of Adnexal Torsion and Early Surgical Intervention to Unwind Detorsion on Ovarian Reserve: An Experimental Study(Sage Publications Inc, 2013) Ozler, Ali; Turgut, Abdulkadir; Soydinc, Hatice Ender; Sak, Muhammet Erdal; Evsen, Mehmet Siddik; Alabalik, Ulas; Basarali, Mustafa KemalObjective: The aim of the present study was to determine to what extent ovarian reserves are affected by ischemia-reperfusion injury, evaluating the number of growing follicles and the serum levels of the ovarian hormones. Study Design: Thirty female fertile adult Wistar albino rats, weighing 200 to 220 g, were previously numbered to randomization, and then randomly divided into 3 equal groups (n = 10): sham, torsion, and detorsion groups. In torsion and detorsion groups, bilateral adnexal torsion (3-hour ischemia) was carried out. Bilateral adnexal detorsion (3-hour reperfusion) was performed in the detorsion group. Results: The mean number of preantral and small antral follicles in detorsion group were lower than those of the sham group (P < .01). After torsion, anti-Mullerian hormone (AMH), estradiol, and inhibin B levels decreased significantly compared to the preoperative and postoperative periods (P = .003, P = .032, and P = .014, respectively). In detorsion group, only AMH levels were found to decrease significantly following the 3-hour ischemia and 3-hour reperfusion (P < .05). Conclusion: After adnexal torsion, a significant decrease in ovarian reserve has been detected for the first time in this study. Additionally, the results of this study suggest that conservative surgery alone is insufficient to protect ovarian reserve.Öğe Cesarean Scar Pregnancy Mimicking Malignant Tumor A Case Report(Sci Printers & Publ Inc, 2011) Soydinc, Hatice Ender; Evsen, Mehmet Siddik; Sak, Muhammet Erdal; Gul, TalipBACKGROUND: Ectopic pregnancy in cesarean scar is rare, however it is occurring with increasing frequency. These ectopic pregnancies can cause serious complications such as severe bleeding, uterine rupture, disseminated intravascular coagulation and maternal death. We present a case of cesarean scar pregnancy diagnosed during laparotomy with frozen section. CASE: A 26-year-old woman, gravida 3, para 3, was admitted to our gynecology clinic because of a 6-week history of irregular vaginal bleeding and anemia. A solid mass originating from the cervix was detected on ultrasound examination. Doppler ultrasound revealed an increase in blood supply. The case was managed by laparotomy. The solid mass was removed and the uterus preserved. CONCLUSION: Although ultrasound is useful in the detection of a typical scar pregnancy, ultrasound images can lead to a misdiagnosis, such as sarcoma or myoma, in some cases. Cesarean scar pregnancy should be considered in the differential diagnosis when an extremely vascularized and exophytic mass located in the isthmic region is detected. (J Reprod Med 2011;56:518-520)Öğe Circadian Variation of Blood Pressure Is Impaired in Normotensive Pregnant Women with Gestational Diabetes Mellitus(Taylor & Francis Inc, 2013) Soydinc, Hatice Ender; Davutoglu, Vedat; Sak, Muhammet Erdal; Ercan, Suleyman; Evsen, Mehmet Siddik; Kaya, Hasan; Oylumlu, MuhammedData about circadian blood pressure (BP) in normotensive patients with gestational diabetes mellitus (GDM) are lacking. Thus, we sought to compare dipper and nondipper circadian variation of BP profile between normotensive women complicated with GDM and normal pregnant women. Forty-two women with GDM and 33 normal uncomplicated pregnant women who met the entry criteria for the study were enrolled in the study. Twenty-four-hour noninvasive ambulatory blood pressure monitoring and echocardiography to measure the left ventricle mass index and diastolic parameters were performed. Nocturnal blood pressure dipping was calculated as follows: (awake BP - sleep BP) x 100/awake BP. Patients with a nocturnal reduction in average daytime systolic BP and diastolic BP of less than 10% were classified as nondippers. Left ventricle mass index was higher in normotensive pregnant women with GDM group than in normal pregnant subjects (101.98 +/- 24 g/m(2) vs. 90.67 +/- 15 g/m(2), P < .018). Significant nocturnal systolic and diastolic nondippings were observed in GDM groups compared with normal subjects. From diastolic variables, the mitral E velocity and isovolumetric relaxation time were compatible with diastolic dysfunction relaxation abnormalities (P = .003 and P = .015, respectively) in nondipper group. From all confounding factors, only E velocity (P = .002) and diagnosis of GDM (P < .001) were predictive of nondipper circadian variation. This study shows that (i) circadian BP is impaired in normotensive pregnant subjects with GDM, (ii) the left ventricle mass index is higher in pregnant subjects with GDM than in normal pregnant subjects who despite a 24-hour BP are within normal limits, and (iii) in nocturnal nondipper group, the tendency to having diastolic relaxation abnormalities is noted.Öğe Effect of Caffeic Acid Phenethyl Ester on Intra-Abdominal Adhesion in Rats(Karger, 2013) Turgut, Abdulkadir; Sak, Muhammet Erdal; Turkcu, Gul; Ozler, Ali; Soydinc, Hatice Ender; Evsen, Mehmet Siddik; Evliyaoglu, OsmanBackground: To determine the impact of caffeic acid phenethyl ester (CAPE) on abdominal adhesion formation after laparotomy. Methods: Forty female rats were allocated into four distinct groups on which laparotomy alone; laparotonny with traumatization of the uterine horns; laparotomy, traumatization of the uterine horns and intraperitoneal irrigation with saline, and laparotomy, traumatization of the uterine horns and intraperitoneal irrigation with CAPE were performed. After sacrifying the animals on the 14th postoperative day, histopathological examination and biochemical analysis were conducted to evaluate the formation of abdominal adhesions and antioxidant status. Results: In the CAPE group, total adhesion scores were significantly lower than in the control and saline groups. The CAPE group displayed less inflammation, giant cell formation, fibrosis and fibroblastic activity than the control group. On the other hand, the control group displayed higher total adhesion scores. Conclusion:The results of this study indicate that the administration of CAPE may have beneficial effects for the prevention of abdominal adhesion formation after laparotomy. Further clinical studies are mandatory to explore the actual therapeutic potential of CAPE. Copyright (C) 2013 S. Karger AG, BaselÖğe Effects of Malathion in Fetal Kidney Tissues in Pregnant Rats: Teratogenic Effects Induced by Different Doses(Kafkas Univ, Veteriner Fakultesi Dergisi, 2012) Alp, Harun; Sak, Muhammet Erdal; Evsen, Mehmet Siddik; Firat, Ugur; Evliyaoglu, Osman; Penbegül, Necmettin; Sancaktutar, Ahmet AliThe aim of this study was to investigate the teratogenic effects of Malathion (ML) induced by different doses on fetal kidney tissues in pregnant rats. A total of 28 Sprague-Dawley pregnant rats were randomly divided into 4 groups of 7 rats each. Depending on ML dose, four groups were formed, including (I) control, (II) ML 2.5 (ML 2.5 mg/kg/day, orally), (III) ML 5 (5 mg/kg/day, orally), and (IV) ML 10 (10 mg/kg/day, orally). ML application started when the male and female were put together (when mating started). Daily ML application was continued until birth. It was determined that in parallel with dose of ML, ML resulted in toxic effects on serum enzymes (acetyl-cholinesterase (AChE), amylase and lipase) and kidney tissues of pregnant rats, and also -regardless of ML dose in fetal kidneys-it led to teratogenic effects in all the doses. Biochemical data wasconfirmed by histopathologic data. We concluded that ML leads to kidney damage in both pregnant and fetal rats as a result of its teratogenic and toxic effects.Öğe Evaluation of obstetrical patients with disseminated intravascular coagulopathy - tertiary center experience(Taylor & Francis Ltd, 2016) Basaranoglu, Serdar; Evsen, Mehmet Siddik; Agacayak, Elif; Tunc, Senem Yaman; Yilmaz, Zulfikar; Yildirim, Yasar; Deregozu, AvSequiObjective: The purpose of the present study is twofold: (a) to investigate the etiology of disseminated intravascular coagulopathy (DIC) caused by obstetrical conditions and (b) to present parameters that can be used in predicting DIC-related mortality in obstetrical patients. Material and method: Obstetrical patients who had a delivery at or were referred (after delivery) to Obstetrics and Gynecology Clinic of Dicle University between July 2006 and December 2013 were retrospectively analyzed in this study. Those patients diagnosed with DIC were included in the study. Results: Fifty-six obstetrical patients carrying the diagnosis of DIC were included in this study. The overall mortality rate was 25% among these patients. More specifically, the mortality rate was 10.7% among patients with a DIC score <= 5 and 40.7% among those with a DIC score >5. Multiple logistic regression analysis resulted in the finding that international normalized ratio (INR) and urea were among those factors affecting mortality in obstetrical DIC [OR: 8.44 (CI: 1.9-36.8), OR: 1.05 (CI: 1.0-1.1), respectively]. Conclusion: DIC is a syndrome that might be caused by obstetrical conditions. It is associated with high mortality and morbidity rates. In obstetrical DIC, urea is the most important factor affecting mortality. In addition, we are of the opinion that DIC score might guide mortality predictions as a determinant of prognosis.Öğe Evaluation of the relationship between insulin resistance and recurrent pregnancy loss(Via Medica, 2011) Celik, Nazan; Evsen, Mehmet Siddik; Sak, Muhammet Erdal; Soydinc, Ender; Gul, TalipObjective: To investigate insulin resistance in patients with recurrent pregnancy loss (RPL). Design: Single center, case-control, prospective study. Methods: The study was performed at the Obstetrics and Gynecology Clinic at the Dicle University Medical Faculty from May to October 2009. 64 study subjects who had RPL were compared to 64 controls. Both groups were compared with fasting glucose, fasting insulin, fasting glucose/fasting insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) index values to assess insulin resistance. Results: No significant differences in age and BMI index were found between the study and control subjects (p>0.005). The mean number of abortions was 3.04 in the study and 0.2 in the control group (p<0.001). The mean fasting glucose value was 100.84 in the study group, and 89.67 in the control group (p<0.001). Also, the mean fasting insulin value was 15.51 in the study group and 7.17 in the control group (p =0.001). The mean glucose/ insulin ratio was 12.24 in the study group and 28.27 in the control group (p =0.017), and the mean HOMA-IR value was 4.16 in the study group and 1.62 in the control group (p =0.002). Conclusion: Compared with the control group, patients with RPL were more likely to have insulin resistance.Öğe Expression of Beta Human Chorionic Gonadotropin in the Placenta of Gestational Diabetic Mothers An Immunohistochemistry and Ultrastructural Study(Sci Printers & Publ Inc, 2013) Sak, Muhammed Erdal; Deveci, Engin; Evsen, Mehmet Siddik; Kalkanli, Sevgi; Baran, Ozlem; Ozekinci, Selver; Seker, UgurOBJECTIVE: To investigate morphologic differences of the placenta in pregnancies complicated by gestational diabetes compared to nondiabetic pregnancies. STUDY DESIGN: This was a comparative morphological study of the placentas from 20 women with gestational diabetes and 20 healthy pregnancies at 28-35 weeks of gestation. RESULTS: The presence of lesions such as fibrinoid necrosis, villous edema, syncytial knot and vascular lesions like chorangiosis was apparent, mainly in the diabetes group. There was an apparent decrease in the intensity of the human chorionic gonadotropin (hCG) immunostaining in the syncytiotrophoblast from the 28th to 35th weeks of gestation in the placentas of the healthy control group. No hCG immunostaining was observed in the vinous or intervillous areas of any of the placentas. In diabetic placentas the expression of hCG was homogeneous with a moderate to intense immunoreactivity in the syncytiotrophoblast. Several syncytiotrophoblast cells showed dilations of both rough and smooth endoplasmic reticulum and loss and alteration of microvilli, and large vacuoles were observed just below the plasma membrane, as well as irregularities in the mitochondria. CONCLUSION: Syncytial cells play an important role in the placental transition. Increased expression of beta-hCG, deterioration, degeneration of organelles and cell structure and the basal membrane disorder in chorionic vessels were seen in placentas with gestational diabetes. These changes can affect placental transfer. However, further studies are needed to clarify this issue. (Anal Quant Cytopathol Histopathol 2013;35:52-56)Öğe Factors Affecting ICU Stay and Length of Stay in the ICU in Patients with HELLP Syndrome in a Tertiary Referral Hospital(Hindawi Ltd, 2022) Agacayak, Elif; Bugday, Rezan; Peker, Nurullah; Deger, Ugur; Kavak, Gonul Olmez; Evsen, Mehmet Siddik; Gul, TalipObjective. The study aimed to compare patients with HELLP syndrome who require intensive care and who do not require intensive care and evaluate the factors affecting the length of stay in the intensive care unit. Methods. Patients were divided into two groups as follows: requiring intensive care (group 1) and not requiring intensive care (group 2). The data of both groups were compared in terms of demographic characteristics, transfusion amounts, length of stay in the intensive care unit, maternal complications, and mortality. Results. 14032 births in a tertiary center between 2011 and 2018 were evaluated in this study. During the study period, 342 patients were diagnosed with HELLP, and 32 (9.4%) of these were followed up in the intensive care unit. The length of stay in the intensive care unit was determined as 8.1 (7.2) days on average. Fresh frozen plasma, erythrocyte suspension, apheresis, and random thrombocyte transfusion were observed to be significantly more in group 1 patients. In the regression analysis, the most effective factor was found to be erythrocyte suspension and the length of stay in the intensive care unit was significantly longer in patients who had erythrocyte suspension transfusion. The receiver operating characteristic curve showed that the area under the curve value for erythrocyte transfusion was 70.6%. When the cutoff value of erythrocyte suspension was 450 (95% CI: 365-681) ml, the sensitivity was 43.8% and the specificity was 91.6%. Conclusion. We think that physicians should be careful that maternal morbidity and mortality may increase as the need for erythrocyte suspension transfusion increases in patients with HELLP syndrome. Minimum transfusion to hemodynamically stable patients can be more suitable in terms of morbidity and mortality in managing patients with HELLP syndrome requiring erythrocyte suspension transfusion. Precautions and measures should be taken in this regard.Öğe Human Placental Macrophages (Hofbauer Cells) in Severe Preeclampsia Complicated by HELLP Syndrome Immunohistochemistry of Chorionic Villi(Sci Printers & Publ Inc, 2013) Evsen, Mehmet Siddik; Kalkanli, Sevgi; Deveci, Engin; Sak, Muhammet Erdal; Ozler, Ali; Baran, Ozlem; Erdem, ElifOBJECTIVE: To evaluate Hofbauer cells in the placentas of women diagnosed with HELLP syndrome. STUDY DESIGN: The present study compared 20 patients with HELLP syndrome and 20 control patients with respect to demographics, hematological parameters and the presence of Hofbauer cells in placental samples. CD-68 antibody was used for immunohistochemical examination. The total number and size of Hofbauer cells were measured in the placental villi, and the proportion of Hofbauer cells relative to the vascular structure was also compared between groups. RESULT: The patient and control groups were similar according to baseline obstetric characteristics. White blood cell counts in patients with HELLP syndrome and the control group were 15,139 4,169 and 10,806 2,888, respectively, and were significantly increased among patients with HELLP syndrome (p < 0.001). Hofbauer cell numbers in the placental villi of patients with HELLP syndrome were significantly elevated in comparison to normotensive controls (p = 0.046). The proportion of Hofbauer cells in the placental villi according to proximity to the vascular structure were 3.85 +/- 1.66 in the HELLP group and 1.75 +/- 1.12 in controls (p < 0.001). Sizes of the Hofbauer cells were not statistically different between groups. CONCLUSION: Increased Hofbauer cells may be associated with increased inflammation or may have an adaptive mechanism at the fetal site of the placenta in patients with HELLP syndrome.Öğe Hypogastric artery ligation in postpartum haemorrhage: a ten-year experience at a tertiary care centre(Taylor & Francis Inc, 2021) Icen, Mehmet Sait; Findik, Fatih Mehmet; Akin Evsen, Gamze; Agacayak, Elif; Yaman Tunc, Senem; Evsen, Mehmet Siddik; Gul, TalipThis study investigated patients who underwent bilateral hypogastric artery ligation (BHAL) due to postpartum haemorrhage (PPH). Patients who underwent BHAL because of PPH following a conservative treatment were included in this study. Placental abnormalities were referred to as placenta accreta. A total of 130 BHAL procedures took place at the study hospital as a result of PPH. Of these, 39 (30%) were referred to the hospital. The rate of BHAL requirement was 62 out of 10,000 births. Among the 130 patients, the most frequent indication for BHAL was placenta accreta (58.5%). Haematological parameters were poorer among the referral patients. Four of the exitus patients (80%) were referral patients. The mortality rate among the referral patients was 10.25%, whereas this rate was only 1.01% among the patients who gave birth at the hospital. PPH is a life-threatening condition that requires immediate medical attention. BHAL, with its fertility-preserving features, is a good option that can be employed in all PPH patients. BHAL not only preserves patients' fertility, but it also gives them a higher chance of survival.IMPACT STATEMENT What is already known on this subject?PPH is a life-threatening condition. Due to the worldwide increase in caesarean sections, placenta accreta has also increased. BHAL is a vital treatment method for PPH. What do the results of this study add?Placenta accreta is one of the most common causes of PPH. Traditional hysterectomy rates can be reduced by replacing this treatment with BHAL in this group of patients. Without early intervention in PPH, a patient's mortality risk can increase by up to 10 times. As research and surgeons' experience grows, PPH can be controlled with treatments with less complex modalities without the need for BHAL. What are the implications of these findings for clinical practice and/or further research?The need for BHAL should be kept in mind when addressing PPH, especially in cases of placenta accreta. The need for hypogastric artery ligation, which is a more aggressive treatment for the surgical correction of the pathology, can be reduced as surgeons' experience increases. Early intervention and/or referral in cases of PPH is of great importance.Öğe Immune mechanisms and the role of oxidative stress in intrahepatic cholestasis of pregnancy(Termedia Publishing House Ltd, 2014) Ozler, Ali; Ucmak, Derya; Evsen, Mehmet Siddik; Kaplan, Ibrahim; Elbey, Bilal; Arica, Mustafa; Kaya, MuhsinIntroduction: The purpose of this study was to investigate levels of inflammatory cytokines such as interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha) and neopterin and oxidative stress status in patients with intrahepatic cholestasis of pregnancy (ICP) as well as their potential role in the pathophysiology. Material and methods: Thirty patients with ICP (Group 1) and 30 healthy pregnant women (Group 2) were included in this prospective case-control study. Levels of IL-6, TNF-alpha and neopterin were determined in both of the groups. Total anti-oxidant status (TAS) and total oxidative stress (TOS) levels were determined by means of a fully automated Erel method. Oxidative stress index (OSI) was calculated as the ratio of TOS to TAS. Results: There was no significant difference between the groups in IL-6 and TNF-alpha levels (p = = 0.105 and p = 0.722, respectively). The mean neopterin level was significantly higher in Group 1 compared to Group 2 (2.34 +/- 0.77 and 1.57 +/- 0.38, respectively, p = 0.001). In addition, TAS, TOS and OSI levels were significantly higher in Group I (p = 0.004, p = 0.001 and p = 0.001, respectively) compared to Group 2. Discussion: Intrahepatic cholestasis of pregnancy is an inflammatory disorder in which maternal immune reaction may play a role. Interleukin 6 and TNF-alpha, which are some of the markers of humoral reaction, act as an indicator of abnormal reaction rather than acute-phase reaction in ICP. Further clinical trials and supportive placental findings are needed on the role of cytokines in cellular and humoral immune reactions during the symptomatic period and delivery to better understand the role of immune mechanisms in the aetiology of ICP.Öğe Imperforate Hymen with Elevated Serum CA 125 and CA 19-9 Levels(Sci Printers & Publ Inc, 2013) Sak, Muhammet Erdal; Evsen, Mehmet Siddik; Soydinc, Hatice Ender; Sak, Sibel; Yalinkaya, AhmetOBJECTIVE: To report the clinical characteristics of 14 patients with imperforate hymen and their levels of tumor markers (CA 19-9 and CA 125). STUDY DESIGN: Fourteen patients with imperforate hymen who followed-up between September 2006 and September 2010 in the Department of Obstetrics and Gynecology, Dicle University School of Medicine, Diyarbakir, Turkey, were evaluated retrospectively. The clinical features and the management of the patients are discussed. RESULTS: The mean age of the patients was 13.8 years. All patients had primary amenorrhea and pelvic pain. The most common clinical symptoms were cryptomenorrhea in 14 patients, pelvic pain in 11, palpable abdominal mass in 6, voiding difficulties in 7, and defecation problems in 2. In 6 patients with palpable pelvic mass, the mean +/- standard deviation values of tumor markers were as follows: CA 125, 84.0 +/- 23.7 and CA 19-9, 162 +/- 189. One week after surgery we measured CA 125 and CA 19-9 levels once again. The postoperative mean CA 125 level was 13.8 +/- 3.6, and the mean postoperative CA 19-9 level was 17.5 +/- 3.5. Preoperative leziels of CA 125 and CA 19-9 were significantly higher than those of the postoperative period (p < 0.001 for both comparisons). Six patients were treated by T-shaped incision and 8 patients by a central surgical incision through the hymenal membrane. CONCLUSION: Diagnosis of imperforate hymen is very important before undergoing surgery in a different clinic. Many patients have seen several doctors before receiving a clear diagnosis and have had tumor markers evaluated because the presence of pelvic mass in patients suggests the possibility of a gynecologic malignancy. Imperforate hymen is one of the benign conditions that increase serum CA 125 and CA 19-9 levels and which is not listed in the classical medical textbooks. These markers are not needed for the diagnosis. (J Reprod Med 2013;58:47-50)Öğe Increased psychological trauma and decreased desire to have children after a complicated pregnancy(Galenos Yayincilik, 2013) Tan, Pinar; Evsen, Mehmet Siddik; Soydinc, Hatice Ender; Sak, Muhammet Erdal; Ozler, Ali; Turgut, Abdulkadir; Bez, YasinObjective: Information about fertility desire and psychological sequelae after high-risk pregnancies are scarce in the literature. The aim of the present study is to investigate the psychological effects of high-risk pregnancies. Material and Methods: The patients who had a history of severe preeclampsia, eclampsia or major hemorrhage during the peripartum period were enrolled as the study group and compared with the control subjects with respect to fear about new pregnancy, anxiety/depression and post-traumatic stress disorder (PTSD) scores. The study was carried out by submitting a questionnaire form to the participants. Numbers of planned children before and after the last delivery were evaluated in both groups. Results: Fear about a new pregnancy was found to be significantly higher in the study group compared with the controls. There were no statistically significant difference between the two groups in terms of anxiety and depression. In terms of re-experience and avoidance in PTSD was significantly higher in the study group, however no significant difference was found for hyper-arousal. Conclusion: Fear regarding new pregnancy is high and planning more children is decreased after high-risk pregnancies and PTSD symptom scores were higher after high-risk pregnancies.Öğe Intrauterine blood transfusion in immune hydrops fetalis, corrects middle cerebral artery Doppler velocimetry very quickly(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2012) Yalinkaya, Ahmet; Evsen, Mehmet Siddik; Celik, Yusuf; Sak, Muhammet Erdal; Soydinc, Hatice Ender; Taner, Mehmet ZekiThe aim of our study was to evaluate the middle cerebral artery velocimetry before and after intrauterine blood transfusion in immune hydrops fetalis. The current study was conducted in a tertiary research hospital, from February 2009 to January 2011. Nineteen intrauterine blood transfusions performed during the study period. The factors recorded were age of the mothers, gestational weeks, pre-transfusion fetal hematocrit and post-transfusion fetal hematocrit, and also middle cerebral artery peak systolic velocimetry (MCA-PSV) was detected and recorded before and after intrauterine transfusion. A control group of twenty two cases for normal MCA doppler velocimetry was also included to the study. During the study, a total of eleven rhesus isoimmunized pregnancies underwent intrauterine blood transfusions at our perinatal diagnose unit. Before transfusion seventeen severe and two moderate anemias were detected and mean MoM of MCA-PSV was 1.76 +/- 0.38 MoM. Post transfusion mean MoM of MCA-PSV in the patient group and control group were 1.08 +/- 0.22 MoM and 0.96 +/- 0.21 MoM, respectively. The mean MCA-PSV values were higher in RI fetuses than post transfusion and control group. In current study, we found that MCA-PSV is a valuable parameter in detecting fetal anemia requiring intrauterine transfusion and mean MCA-PSV values is higher than 1.5 MoM in fetuses with anemia. And also decrease in MCA-PSV just after transfusion in anemic fetuses showed the quick response of the fetus to correction of anemia. (C) 2012 Association of Basic Medical Sciences of FBIH. All rights reservedÖğe A new technique in laparoscopic abdominal access (Evsen Method, Modified Veress Technique)(Via Medica, 2018) Evsen, Mehmet Siddik; Icen, Mehmet Salt; Findik, Fatih Mehmet; Tunc, Senem Yaman; Magacayak, Elif; Gul, TalipObjectives: The most important step in laparoscopic surgery is to safely establish the pneumoperitoneum, especially since approximately half of the complications occur during the initial entry into the abdomen. There is a distinct need to modify the available methods to reduce therate of adverse events in laparoscopic entry. In this study, a modified Veress technique (MVT) or Evsen method is introduced. The aim of this article was to present a modified Veress technique for establishing the pneumoperitoneum. Material and methods: The study was conducted at the Dicle University, Faculty of Medicine, Department of Obstetrics and Gynecology, from September 2016 to May 2017. A new laparoscopic entry technique was introduced and compared with the classical Veress technique. A total of 40 cases were included in the study. MVT and the classical Veress method were applied to 26 and 14 patients, respectively. Results: The pneumoperitoneum was established at the first attempt in 23 (88.5%) MVT patients and in 7 (50%) patients from the classical Veress method group. The number of insufflation attempts to establish a successful pneumoperitoneum was lower using MVT and the difference was statistically significant (p: 0.022). As far as time is concerned, a comparison between the groups revealed that the pneumoperitoneum was established in a statistically significantly shorter time using MVT (p < 0.00). Conclusions: The modified Veress technique proved to be superior to the classical Veress method for establishing the pneumoperitoneum. Using the new method, the pneumoperitoneum was established after fewer attempts and in a shorter time.Öğe Platelet profile in patients with gestational diabetes: a retrospective study(Galenos Yayincilik, 2012) Sak, Muhammet Erdal; Soydinc, Hatice Ender; Ozler, Ali; Evsen, Mehmet Siddik; Turgut, Abdulkadir; Sak, Sibel; Gul, TalipObjective: To assess and compare alterations in the morphology and function of platelets occurring in gestational diabetes and healthy pregnancies. Material and Methods: A retrospective study was performed of 77 pregnant women: 42 cases with gestational diabetes and 35 healthy controls. The two groups were compared in terms of demographics and platelet parameters derived from complete blood counts. Results: The mean platelet volume (p=0.001) and HbA1c (p<0.001) were significantly increased in the patients with gestational diabetes. The mean platelet volume was well correlated with the platelet distribution width (rs=0.404, p<0.001) and the platelet count (rs=0.355, p=0.002) Conclusion: The mean platelet volume and other platelet parameters may significantly aid the identification of diabetic pregnants at risk for vascular complications. The role and possible clinical relevance of these changes during diabetic pregnancy need to be investigated in further studies.Öğe Pregnancy and H1N1 infection in Southeast Turkey(J Infection Developing Countries, 2012) Soydinc, Hatice Ender; Celen, Mustafa Kemal; Yildiz, Bahri; Sak, Muhammet Erdal; Evsen, Mehmet Siddik; Gul, TalipIntroduction: H1N1 Influenza made a great impact a worldwide, as well as in Turkey, in 2009. Clinical experiences have shown that it had a more serious prognosis in pregnant women. In this report, we summarize the cases of 16 pregnant women with H1N1 Influenza. Methodology: The study included 16 pregnant women hospitalized in Dicle University Hospital with complaints of fever, sore throat, cough and myalgia between October and December 2009. The diagnosis of pandemic H1N1 Influenza was confirmed on nasopharyngeal specimens using real-time reverse-transcriptase polymerase chain reaction (RT-PCR) in all patients. Patients who had the same complaints but were not diagnosed as H1N1 Influenza were excluded. The epidemiological, clinical, diagnostic, and outcome features of the patients were recorded. Results: The median age of the patients was 27 years (range 18-41 years). The mean gestational age was 25.4 weeks (range 5-38 weeks). Two cases were twin pregnancy. Two cases had co-morbid diseases including asthma and anemia. The most frequent admission symptoms were fever in 13 cases (81%), cough in 12 cases (75%) and dyspnea in 6 cases (37,5%). Antiviral treatment (oseltamivir 75 mg p.o. bid) was applied in 15 cases. Four cases needed intensive care monitoring and two of them died (12.5%) because of severe respiratory insufficiency. Conclusion: Patients with late gestational age, the presence of co-morbid disease, and multiple pregnancy have poor prognosis. Immediate intervention with antiviral treatment is associated with reduced severity of the disease and duration of hospital stay.Öğe Prolidase, Matrix Metalloproteinases 1 and 13 Activity, Oxidative-Antioxidative Status as a Marker of Preterm Premature Rupture of Membranes and Chorioamnionitis in Maternal Vaginal Washing Fluids(Ivyspring Int Publ, 2013) Soydinc, Hatice Ender; Sak, Muhammet Erdal; Evliyaoglu, Osman; Evsen, Mehmet Siddik; Turgut, Abdulkadir; Ozler, Ali; Yildiz, IsmailObjective: Etiology of premature preterm rupture of membranes (PPROM) is not yet completely known and chorioamnionitis is one of the most important complications of its. We aimed to evaluate whether prolidase, matrix metalloproteinases, oxidative-antioxidative status, and inflammation markers in vaginal washing fluid (VWF) were associated with etiology of PPROM and whether these markers could be used to predict chorioamnionitis in PPROM. Study Design: This prospective case control study enrolled fifty pregnant women with PPROM and 50 healthy pregnant women. The VWF samples were taken at the time of admission in the PPROM group and patients were followed for chorioamnionitis. Prolidase, matrix metalloproteinases, oxidative-antioxidative status, and inflammation markers in VWF were assayed. Results: VWF levels of prolidase, matrix metalloproteinases 1-13 (p<0.001), oxidative stress parameters, total oxidative stress (TOS) (p < 0.001) and oxidative stress index (OSI) (p = 0.002), and hs-CRP (p = 0.045) were significantly higher in the PPROM group than in the controls. Antioxidative status parameters, levels of paroxanase (PON-1) (p < 0.001) and total antioxidant capacity (TAC) (p < 0.001), were significantly lower in the PPROM group than in the controls. Mean VWF levels of prolidase (p < 0.001), metalloproteinases (p<0.05), and oxidative-antioxidative status parameters (p<0.05) were significantly different in women with versus women without chorioamnionitis in the PPROM group. Prolidase, MMP-13, TOS, TAC, and PON-1 were found as important predictors for chorioamnionitis in the PPROM group by the multivariate logistic regression analysis. When the ROC curve analysis for prolidase, MMP-13, TOS, TAC, and PON-1 were performed, all of them were statistically significant for area under the curve (areas under the curve were 0.94, 0.90, 0.80, 0.25, and 0.19, respectively). Conclusions: This study showed that collagen turnover mediators, especially prolidase, and increased oxidative stress are significantly associated with PPROM. Also, chorioamnionitis can be predicted with prolidase, MMP-13, TOS, TAC, and PON-1 in PPROM patients.
