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    Amniotic fluid paraoxonase-1 activity, thyroid hormone concentration and oxidant status in neural tube defects
    (Wiley-Blackwell, 2016) Sak, Sibel; Agacayak, Elif; Tunc, Senem Yaman; Icen, Mehmet Sait; Findik, Fatih Mehmet; Sak, Muhammet Erdal; Yalinkaya, Ahmet
    AimThe aim of this study was to investigate the potential association between neural tube defects and paraoxonase-1 activity in amniotic fluid. We studied total oxidant status, total antioxidant capacity, paraoxonase-1 activity and thyroid hormone amniotic fluid concentration in fetuses with neural tube defects. MethodsThe present study was performed at the Department of Obstetrics and Gynaecology and the Department of Clinical Biochemistry of Dicle University between September 2011 and June 2013. The study group included 37 amniotic fluid samples from pregnant women (16-20 weeks of gestation) with fetuses affected by neural tube defects. The control group consisted of 36 pregnant women who were diagnosed with a high-risk pregnancy according to first or second trimester aneuploidy screening and were later confirmed on amniocentesis to have genetically normal fetuses. ResultsAmniotic fluid paraoxonase-1 activity and total oxidant status were significantly higher (P = 0.023, P = 0.029, respectively) whereas free T4 was significantly lower (P = 0.022) in fetuses with neural tube defects compared with control subjects. In fetuses with neural tube defects, amniotic fluid paraoxonase-1 activity correlated positively with total oxidant status (r = 0.424**, P = 0.010), and amniotic fluid total antioxidant capacity correlated positively with free t4 (r = 0.381*, P=0.022). ConclusionThis is the first study in the literature to show an association between paraoxonase-1 activity and thyroid hormone concentration and neural tube defects.
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    Honokiol Decreases intra-Abdominal Adhesion Formation in a Rat Model
    (Karger, 2015) Agacayak, Elif; Tunc, Senem Yaman; Icen, Mehmet Sait; Alabalik, Ulas; Findik, Fatih Mehmet; Yuksel, Hatice; Gul, Talip
    Aim: The purpose of this study was to investigate the effectiveness of honokiol, a natural molecule that was shown to have antioxidant effects, in prevention of intra-abdominal adhesion formation in a rat model. Material and Method: This study was conducted on a total of 40 non-pregnant Sprague-Dawley rats, which were divided into 4 groups as follows: sham, control, saline, and honokiol groups. Both uterine horns of the rats in control, saline, and honokiol groups were exposed and a 2-cm segment of the anti-mesenteric surface of both uterine horns was traumatized by a scalpel. The saline group was administered 2 ml of saline/day intraperitoneally for 5 days after the operation. The honokiol group, on the other hand, was administered honokiol intraperitoneally at a dose of 1 mg/kg/day for 5 days after the operation. On postoperative day 14, 3 ml of intracardiac blood sample was taken from the rats for biochemical analyses, and the rats were sacrificed this way. Results: Adhesion and inflammation scores were significantly lower in the honokiol group compared with the saline and control groups (p < 0.008). Similarly, fibrosis score was significantly lower in the honokiol group compared with the saline group (p < 0.008). Conclusion: Honokiol was found to be effective in prevention of intra-abdominal adhesion formation in a rat model. However, larger studies are needed to shed light on the exact role of honokiol in intra-abdominal adhesion formation and to determine the molecular aspects of the promising results found in this study. (C) 2015 S. Karger AG, Basel
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    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, Talip
    This 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.
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    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, Talip
    Objectives: 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.
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    Oxidant/antioxidant status, paraoxonase activity, and lipid profile in plasma of ovariectomized rats under the influence of estrogen, estrogen combined with progesterone, and genistein
    (Dove Medical Press Ltd, 2015) Agacayak, Elif; Basaranoglu, Serdar; Tunc, Senem Yaman; Icen, Mehmet Sait; Findik, Fatih Mehmet; Kaplan, Ibrahim; Evliyaoglu, Osman
    Introduction: The aim of this study was to investigate whether estradiol (E2), E2 combined with progesterone (Prog) (E2/Prog), and genistein (Gen) treatment had antioxidative and anti-hyperlipidemic effects in the plasma of ovariectomized (OVX) rats. Materials and methods: Adult female Sprague-Dawley rats were divided into five groups. Rats in all groups, except for those in a sham group, underwent bilateral ovariectomy under general anesthesia. The groups were as follows: sham group; control OVX group; group treated with estrogen (0.014 mg/kg 17-beta E2); group treated with a combination of E2 and Prog (0.014 mg/kg 17-beta E2 plus 0.028 mg/kg drospirenone), and group treated with Gen (10 mg/kg/day). Plasma of rats of each treatment group was analyzed to determine the total antioxidant status, total oxidant status, paraoxonase activity, lipid profile, high-density lipoprotein (HDL-chol), low-density lipoprotein (LDL-chol), total cholesterol (Total-C), triacylglycerols, lipoprotein (a), and oxidative stress index. Results: Plasma Total-C levels and body weight increased in all the OVX groups compared with the sham group (P < 0.005). The group treated with E2 had significantly elevated total oxidant status, oxidative stress index, LDL-chol, and Total-C compared with the control group (P < 0.005). Gen treatment might lead to lower LDL-chol and Total-C levels compared with E2 treatment. Conclusions: Gen treatment might be preferred to E2 treatment for treatment of menopausal symptoms in patients at risk for cardiovascular diseases. However, considering the small sample size of this study, larger studies are needed in this area.
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    The role of maternal blood elabela levels in the prediction of placenta previa and accreta☆
    (W B Saunders Co Ltd, 2025) Demir, Omer; Ozalp, Mirac; Yaman, Huseyin; Findik, Fatih Mehmet
    Introduction: Placenta previa and Placenta Accreta Spectrum are life-threatening obstetric conditions that are challenging to diagnose accurately. Currently, there is no biochemical parameter available for their diagnosis. The aim of our study is to investigate the potential of Elabela as a laboratory marker that could predict placenta previa and placenta accreta, both of which can lead to severe, life-threatening complications for the mother. Methods: In this study, which was conducted prospectively in two tertiary centers between 2020 and 2022, Elabela levels were examined in patient groups with placental insertion and invasion anomalies. SPSS program was used for comparative statistical analysis between groups. Results: Of the 67 analyzed patients, 32 were in the control group, 12 were in the previa group, and 23 were in the accreta group. There was no statistically significant difference between the groups regarding age, BMI, number of curettages, presence of previous cesarean section, and smoking status. The Elabela level was measured at 135.6 +/- 72.1 in the control group, 988.3 +/- 925.5 in the previa group, and 376 +/- 364.6 in the accreta group, with a statistically significant difference between the groups. The cut-off value of Elabela levels in the previa group was determined to be 304, with a sensitivity of 83.30 % and a specificity of 83.60 % (AUC = 0.909). In the accreta group, the cut-off value was 195.5, with a sensitivity of 60.90 % and a specificity of 61.40 % (AUC = 0.658). Discussion: By showing that the prediction of placenta previa and placenta acreata can be made with a biochemical parameter in our study, young researchers will focus more on this subject and thus make many contributions to science.
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    Serum levels of neopterin, inflammatory markers and oxidative stress indicators in hyperemesis gravidarum
    (Wiley-Blackwell, 2016) Tunc, Senem Yaman; Agacayak, Elif; Budak, Sukru; Tunc, Nurettin; Icen, Mehmet Sait; Findik, Fatih Mehmet; Ekinci, Aysun
    Aim: To investigate whether serum levels of neopterin and inflammatory markers including C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and oxidative status indicators were altered in patients with hyperemesis gravidarum (HG) compared to asymptomatic pregnant women. Methods: This cross-sectional study was performed including 30 pregnant women with HG (mean age: 30.67 +/- 6.68) and 30 asymptomatic pregnant women (mean age: 28.00 +/- 5.30). Demographic features, obstetric history, and the Pregnancy Unique Quantification of Emesis/Nausea (PUQE) index were noted. Complete blood count, serum biochemical assay and measurement of CRP, TNF-alpha, IL-6, total antioxidant status and total oxidative status (TOS) levels were taken and compared between groups. Results: White blood cell count (P = 0.013), platelet count (P = 0.015), TOS (P < 0.001), and PUQE score (P < 0.001) were remarkably higher in HG pregnancies. On the other hand, serum levels of lactate dehydrogenase, (P < 0.001), sodium (P < 0.001), potassium (P < 0.001), chloride (P < 0.001) and TAS (P < 0.001) were higher in the control group. There was no difference in the levels of neopterin, CRP, TNF-alpha and IL-6. In patients with HG, a positive correlation was detected between TOS and serum levels of lactate dehydrogenase, while TNF-alpha, IL-6 and neopterin were positively correlated with hemoglobin levels. Conclusion: Our results demonstrated no association between inflammation and HG. Elucidation of the pathophysiology and complex interaction between various inflammatory processes in HG necessitates further trials on larger series.
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    Single intrauterine demise in twin pregnancies: Analysis of 29 cases
    (Galenos Yayincilik, 2015) Tunc, Senem Yaman; Agacayak, Elif; Goruk, Neval Yaman; Icen, Mehmet Sait; Findik, Fatih Mehmet; Evsen, Mehmet Siddik; Turgut, Abdulkadir
    Objective: To evaluate the maternal and fetal demographic features and clinical aspects of twin pregnancies with single intrauterine demise. Materials and Methods: This retrospective study was conducted in Dicle University Faculty of Medicine, Department of Gynecology and Obstetrics between January 2008 and December 2013. There were a total of 594 twin deliveries in our hospital between the given dates. Twenty-nine of these cases were referred to our hospital by another health center because of a preliminary diagnosis of single intrauterine demise. Maternal age, parity, chorionicity, week of fetal death, gestational week at delivery, mode of delivery, birth weight, Activity, pulse, grimace, appearance, respiration scores, maternal fibrinogen levels at delivery and during pregnancy, stay in the neonatal intensive care unit, and obstetric complications were explored in these 29 cases of single intrauterine demise. Results: The mean age of the 29 patients who were provided antenatal follow-up and delivery services in our hospital was 29.9 +/- 6.5 years. Thirteen (44.8%) of the patients were monochorionic, whereas 16 (55.2%) were dichorionic. Intrauterine fetal death occurred in the first trimester in 6 pateints and in the second or third trimester in 23. In addition, 20 (69%) patients underwent cesarean section, whereas 9 (31%) had spontaneous vaginal delivery. Lastly, none of the patients had a maternal coagulation disorder. Conclusion: Twin pregnancies with single intrauterine death can lead to various complications for both the surviving fetus and the mother. Close maternal and fetal monitoring, and proper care and management can minimize complications.
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    Vaginal Birth After Repeated Cesrean Section: A Case Report
    (Aras Part Medical Int Press, 2016) Arslan, Necmi; Kibrisli, Erkan; Findik, Fatih Mehmet; Yilmaz, Ahmet; Aslanhan, Hamza
    Introduction: Cesarean section is a risky procedure. In most of the world, trial of vaginal birth after cesarean section (VBAC) is suggested and performed. In this case report, we aimed to show the possibility of vaginal labor in a patient who underwent repeated cesarean section and to review the risk of cesarean section. Case Presentation: A female patient aged 32 years, who had cesarean section three times (gravida 5, parity 3, abortion 1) with 3 children, came to the delivery service when she went into final labor pain. On examination, it was seen that there was full dilatation of cervix and the fetus was in the vertex position. With episiotomy given and normal spontaneous vaginal delivery, a live baby boy of 3280 grams, 50 cm and Apgar score of 6-8 (at first and fifth minutes) was delivered. Having normal vital findings, the patient was discharged from the hospital on these conditions postpartum day 1. Conclusion: Cesarean section increases maternal, prenatal mortality and morbidity. In health centers which have operative conditions, the option of normal spontaneous delivery should not be ignored for appropriate pregnant women.