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Öğe 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, AhmetAimThe 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.Öğe Evaluation of maternal and fetal outcomes in pregnant women with gestational thrombocytopenia(Bayrakol Medical Publisher, 2024) Sunar, Nebahat; Sizer, Mulaim; Gunsel, Hamdin; Tekes, Guelten Cirkin; Donmez, Dicle Akkilic; Icen, Mehmet SaitAim: Investigate the relationship between gestational thrombocytopenia (GT) and adverse maternal and fetal outcomes in pregnant women. Material and Methods: 97 patients who were diagnosed with gestational thrombocytopenia during pregnancy, had no other disease that causes thrombocytopenia and delivered in our clinic were included in the study. The patients were divided into two groups according to their platelet values. Group-1 platelet count was <70.000/mm3 and Group-2 platelet count was 70.000- 150.000/mm3. In the analysis of negative perinatal outcomes, logistic regression analysis was performed. P <0.05 was considered significant in the analysis results. Results: From the laboratory data of the patients diagnosed with gestational thrombocytopenia, the mean platelet count was 85.28 +/- 27.08 (min -max: 22-142) and mean hematocrit was 35.91 +/- 3.63 (min -max: 21-45). When the groups were evaluated considering their hematocrit values; the mean hematocrit value of the patients in Group-2 (36.42 +/- 3.22) was higher than the mean hematocrit value (34.26 +/- 4.39) of the patients in Group-1, and a significant difference was found between them (p:0.03). This significant difference was also present when the platelet value was taken as the limit of 110,000 (p:0.039). Discussion: Apgar scores are lower in patients diagnosed with gestational thrombocytopenia and with platelet values below 70,000, and the need for blood transfusion (erythrocyte suspension, FFP (Fresh Frozen Plasma) and platelet product) is higher. The need for erythrocyte transfusion continues even when the platelet limit is 80,000, and the need for platelet transfusion is 100,000.Öğe Evaluation of predisposing factors, diagnostic and treatment methods in patients with translocation of intrauterine devices(Wiley, 2015) Agacayak, Elif; Tunc, Senem Yaman; Icen, Mehmet Sait; Oguz, Abdullah; Ozler, Ali; Turgut, Abdulkadr; Basaranoglu, SerdarAimThe purpose of this study was to evaluate the diagnostic methods, predisposing risk factors and surgical treatment options in patients with translocation of intrauterine devices (IUD). Material and MethodsDiagnosis, predisposing factors and treatment of 34 patients with translocation of IUD was evaluated in this retrospective study. ResultsComplaints of pain during insertion and history of cesarean section were present in 70.5% and 58.8% of patients, respectively. IUD-related complications were detected in 52.8% of patients. Transvaginal ultrasonography was used to detect translocation of IUD in 55.8% of cases. Laparoscopy was performed in 55.8% of patients. ConclusionThere were high rates of history of cesarean section, insertion in the puerperal period and insertion by midwives in patients with translocated IUD. These may be predisposing factors for IUD translocation. The clinician who inserts the IUD should be experienced in this area and obtain sufficient information from the pelvic examination prior to insertion of the device. Gynecological examination should be conducted for a proper diagnosis of translocation of IUD. In the event that the IUD string is not visible in the gynecological examination, transvaginal ultrasonography should be performed. If the IUD is still not visible, then abdominal radiography should be performed. As soon as diagnosis of translocation of IUD has been established, surgical treatment should be planned. First treatment of choice should be laparoscopy.Öğe THE FREQUENCY AND THE TYPE OF DIFFERENT ETIOLOGICAL FACTORS IN PRIMARY AMENORRHEA(Carbone Editore, 2014) Agacayak, Elif; Icen, Mehmet Sait; Tunc, Senem Yaman; Evsen, M. Siddik; Kalkanli, Sevgi; Basaranoglu, SerdarAim: Primary anzenorrhea (PA) is defined as the absence of menarche by the age of 14 without the development of secondary sexual characteristics or lack of menstruation by the age of 16 despite the existence of normal growth with the appearance of secondary sexual characteristics. We carried out a retrospective study, with the purpose of establishing the frequency and the type of different etiological factors among patients with primary amenorrhea. Material and method: A total of 108 subjects, age ranged from 14 to 33 years were included in the study. A complete physical examination, blood tests for hormonal profile, pelvic ultrasonography and magnetic resonance imaging were performed to all patients. Besides, genotypic evaluations were also performed for the patients who got the indication. Results: Out of the 108 patients presenting with primary amenorrhea, 40 (37,0%) had gonadal dysgenesis, 25 (23,1%) had Mullerian agenesis and 14 (12,9%) patients had hypogonadotropic hypogonadism. The genotypic evaluation revealed that 77.5 % (n=31) of cases had normal chromosome composition whereas 22.5% (n=9) had chromosomal abnormalities. Conclusion: In conclusion, we have determined the 3 most common causes of primary amenorrhea are ovarian dysgenesis, Mullerian agenesis and hypogonadotropic hypogonadism; this data is compatible with the literature. Abnormalities in chromosomal analysis were determined in 22,5% of patients, which is also compatible with the literature. Determining etiology, in this large range of diseases may be confusing in clinical practice. During evaluation of patients with primary amenorrhea; these results should be kept in mind in order to establish an algorithm.Öğe 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, TalipAim: 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, BaselÖğe 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 The Most Important Factors in Prognosis Of Obstetric Patients with Disseminated Intravascular Coagulation: A Tertiary Center Study(2020) Karacor, Talip; Dırıcan, Emre; Peker, Nurullah; Agacayak, Elif; Evsen, Gamze Akın; Icen, Mehmet Sait; Gul, TalipObjective: The aim of this study was to investigate the underlying causes of obstetrical disseminated intravascular coagulation (DIC) and to evaluate the laboratory and clinical signs affecting DIC-related morbidity and mortality in women diagnosed with obstetrical DIC in a tertiary referral hospital. Method: The retrospective study included women with DIC who either had a delivery at Dicle University Medical School Gynecology and Obstetrics Department or were referred to this department prior to delivery between May 2006 and May 2016. DIC scoring was performed using the DIC scoring system developed by the International Society of Thrombosis and Hemostasis (ISTH) in 2001. Results: A total of 82 women with obstetrical DIC were included in the study. The incidence of obstetrical DIC in our department was 0.41%. Overall mortality rate was 24% and mortality occurred in 8% of the patients with a DIC score of ?5 and in 12% of the patients with a score of >5 (p=0.043). Multiple logistic regression analysis indicated that increased INR (International Normalized Ratio) and ALT (Alanin Aminotransferaz) levels led to a significant increase in DIC-related mortality [OR: 1.803 (CI: 1.027-3.167), OR: 1.003 (CI: 1.001-1.005), respectively]. Conclusions: Obstetrical DIC may result in high mortality and morbidity. DIC scoring can be useful for predicting the prognosis and DIC-related mortality. INR and ALT is the most important laboratory parameter in DIC and also can affect mortality.Öğe 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, OsmanIntroduction: 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.Öğe Protective effects of honokiol on ischemia/reperfusion injury of rat ovary: an experimental study(Dove Medical Press Ltd, 2016) Tunc, Senem Yaman; Agacayak, Elif; Goruk, Neval Yaman; Icen, Mehmet Sait; Turgut, Abdulkadir; Alabalik, Ulas; Togrul, CihanAim: The purpose of this study was to investigate the protective effect of honokiol on experimental ischemia/reperfusion injury of rat ovary. Materials and methods: A total of 40 female Wistar albino rats were used in this study. The rats were divided into five groups as follows: sham (Group I), torsion (Group II), torsion + detorsion (Group III), torsion + detorsion + saline (Group IV), and torsion + detorsion + honokiol (Group V). Bilateral adnexa in all the rats except for those in the sham group were exposed to torsion for 3 hours. The rats in Group IV were administered saline, whereas the rats in Group V were administered honokiol by intraperitoneal route 30 minutes before detorsion. Tissue and plasma concentrations of malondialdehyde and nitric oxide were determined. Ovarian tissue was histologically evaluated. Data analyses were performed by means of Kruskal Wallis test and Mann-Whitney U-test (Bonferroni correction) in SPSS 15.0 (Statistical Package for Social Sciences; SPSS Inc., Chicago, IL, USA). Results: The torsion and detorsion groups had higher scores in vascular congestion, hemorrhage, and inflammatory cell infiltration compared with the sham group (P<0.005). In addition, total histopathological scores were significantly higher in the torsion and detorsion groups compared with the sham group (P<0.005). A significant reduction was observed in hemorrhage, inflammatory cell infiltration, and cellular degeneration scores, of all histopathological scores, in the honokiol group (P<0.005). Ovarian tissue concentrations of malondialdehyde were significantly higher in the torsion and detorsion groups compared with the sham and honokiol groups (P<0.005). Ovarian tissue concentrations of nitric oxide, on the other hand, were significantly higher in the torsion group compared with the sham, saline, and honokiol groups (P<0.005). Conclusion: Honokiol has a beneficial effect on ovarian torsion-related ischemia/reperfusion injury.Öğe Role of inflammation and oxidative stress in the etiology of primary ovarian insufficiency(Galenos Yayincilik, 2016) Agacayak, Elif; Goruk, Neval Yaman; Kusen, Hakan; Tunc, Senem Yaman; Basaranoglu, Serdar; Icen, Mehmet Sait; Yildizbakan, AhmetObjective: The aim of this study was to elucidate the etiology and treatment of primary ovarian insufficiency, which is of unknown cause in 95% of the cases. Materials and Methods: Thirty patients aged 18-40 years who presented to Dicle University Faculty of Medicine Clinic of Obstetrics and Gynecology between June 2012 and January 2014 and were diagnosed as having primary ovarian insufficiency based on their clinical and endocrinologic data, and 30 healthy controls were included in this study. Results: No significant differences were found between patients with primary ovarian insufficiency and control subjects in demographic data and lipid profile levels, thyroid-stimulating hormone, prolactin, and glucose. However, the neutrophil to lymphocyte ratio and levels of follicle-stimulating hormone, luteinizing hormone, total antioxidant status, total oxidant status, and oxidative stress index were significantly higher in patients with primary ovarian insufficiency than in control subjects. In the correlation analysis, follicle-stimulating hormone exhibited a positive correlation with total oxidant status, oxidative stress index, and the neutrophil to lymphocyte ratio (r=0.573** p < 0.001, r=0.584** p < 0.001, r=0.541 p < 0.001, respectively) and correlated negatively with total antioxidant status (r=-0.437** p < 0.001). Conclusion: The neutrophil to lymphocyte ratio, total oxidant status, and oxidative stress index levels are elevated in primary ovarian insufficiency. Therefore, anti-oxidative and anti-inflammatory treatment might be administered to patients in the early stage of primary ovarian insufficiency. However, larger studies are needed to clarify whether these elevated levels are a cause or a consequence of primary ovarian insufficiency.Öğe 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, AysunAim: 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.Öğe 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, AbdulkadirObjective: 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.Öğe Uterocutaneous fistula: a rare complication after relaparotomy performed due to postpartum haemorrhage(Taylor & Francis Inc, 2022) Gunduz, Reyhan; Icen, Mehmet Sait[Abstract Not Available]
