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Öğe Alteration of peripheral blood cells in tubal ectopic pregnancy(Studio K, 2013) Turgut, Abdulkadir; Sak, Muhammet Erdal; Ozler, Ali; Soydinc, Hatice Ender; Karacor, Talip; Gul, TalipObjectives: To investigate whether mean platelet volumes and leukocyte counts are altered significantly in patients with tubal ectopic pregnancy (TEP). Materials and Methods: Retrospective analysis of mean platelet volumes and leukocyte counts of 138 TEP patients, diagnosed between 2005 and 2012, and the control group consisting of 72 pregnants was performed. Patients with TEP were further subdivided into 2 subgroups composed of 72 ruptured and 66 non-ruptured cases. Statistical analysis was performed using the Kruskal-Wallis and the Mann-Whitney U tests. Results: Mean platelet volume was found to be larger in patients with TEP (whether ruptured or non-ruptured) when compared to controls (p=0.007). However, no significant difference could be observed between the ruptured or non-ruptured cases (p=0.89). With respect to leukocytosis, the TEP group with tubal rupture had significantly higher white blood cell numbers when compared to the non-ruptured TEP and the control groups (p=0.022 and p<0.001, respectively). Conclusions: Mean platelet volume seems to be higher in ectopic pregnancy and this finding evokes a possible role of increased platelet activity in the pathophysiology. Leukocytosis may occur more apparently in EP cases with tubal rupture. However, further prospective, controlled and with a larger sample size studies must be conducted to find clues on the correlation between the clinical entities and laboratory findings.Öğe Assessment of oxidative stress markers in cord blood of newborns to patients with oxytocin-induced labor(Wiley, 2017) Karacor, Talip; Sak, Sibel; Basaranoglu, Serdar; Peker, Nurullah; Agacayak, Elif; Sak, Muhammet Erdal; Turgut, AbdulkadirAim: We aimed to measure the extent of oxidative stress experienced during labor by the neonates of pregnant women undergoing induced or spontaneous birth and to compare the effects of induced labor on fetalwell-being. Methods: Sixty-four healthy pregnant women referring to the Department of Gynecology and Obstetrics, Dicle University Medical Faculty between October 2010 and May 2011 were included in this comparative study. Pregnant women undergoing induced labor by oxytocin were group 1 and those without labor induction were group 2. Post-partum Apgar score was calculated at 1 and 5 min and measurements of weight and height of the neonateswere carried out. After the fetal cordwas clamped, 5 cm(3) blood was drawn into a plain tube without anticoagulant. The samples were centrifuged at 5000 r.p.m. for 5 min. Separated sera were transferred to Eppendorf tubes and were stored at -80 C degrees until the analysis time. Results: The complete blood counts and biochemistry results indicated that there were no statistically significant differences in regards to diseases between the two groups. Nitric oxide and asymmetrical dimethylarginine values of the two groups were not significantly different; however, there were statistically significant differences in the malondialdehyde, paraoxonase, total antioxidative status, and total oxidative status values of the two groups (respectively, P = 0.005, P = 0.006, P = 0.008, and P = 0.007). Conclusion: We observed that oxytocin-induced labor increases stress markers but does not affect Apgar scores. Oxidative stress in pregnant women may trigger antioxidative mechanisms. Prospective studies in larger cohorts are needed to better understand the impact of oxytocin-induced labor on pregnant women and neonates.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 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 Intrauterine pregnancies conceived in the presence of intrauterine devices (IUD): a single center experience(E-Century Publishing Corp, 2018) Karacor, Talip; Basaranoglu, Serdar; Peker, Nurullah; Guler, Oguz; Aydin, Edip; Deregozu, Aysegul; Gul, TalipAim: This study aims to investigate the clinical and perinatal outcomes of pregnancies occurring in the presence of an intrauterine device (IUD). Material and Method: A total of 132 women diagnosed as having pregnancies complicated by IUDs in situ with visible strings were retrospectively examined during a period of six years. Twenty-nine women who chose to keep their IUDs in situ during pregnancy were included in Group 1 whereas 103 women who had their IUDs removed during pregnancy were included in Group 2. Results: Age, parity, frequency of IUD insertion at a maternity hospital and frequency of IUDs located within the uterine corpus were significantly higher in women who retained their IUDs compared to women who had their IUDs removed (p=0.02, p=0.04, p=0.02 and p=0.01, respectively). Although women who retained their IUDs had a significantly higher frequency of perinatal complications, they had a higher gestational week at delivery as well as higher Apgar scores at both 1 and 5 minutes (p=0.01, p=0.02 and p=0.02, respectively). Gestational age at preterm delivery was significantly lower in women who retained their IUDs during pregnancy (31.4 +/- 6 weeks vs. 33.0 +/- 4 weeks, p=0.01). Conclusion: Although removing IUDs with visible strings during pregnancy may increase the abortion risk, retaining them is also associated with adverse perinatal outcomes such as preterm premature rupture of membranes and preterm delivery. If an IUD located within the uterine cavity is retained during pregnancy, it may act as a filter allowing pregnancies to reach term.Öğe Misoprostol-induced termination of second-trimester pregnancy in women with a history of cesarean section: A retrospective analysis of 56 cases(Studio K, 2013) Turgut, Abdulkadir; Ozler, Ali; Goruk, Neval Yaman; Karacor, Talip; Yalinkaya, AhmetObjective: To assess the effectivity and safety of misoprostol induced termination of pregnancy in the second trimester in women with a history of previous caesarean section. Materials and Methods: Retrospective analysis of case records from the obstetrics and gynecology department of a tertiary care center between January 2009 and February 2012 was performed. Data derived from 219 women, who underwent a second trimester termination of pregnancy was analyzed in terms of demographics, clinical findings, laboratory and procedural data. The study group consisted of 56 women with a previous caesarean section and the control group was composed of 163 women without such a history Termination of pregnancies was conducted by administration of misoprostol at doses of 50-600 mcg intravaginally or by surgical evacuation in cases of failure of medical measures. Results: There was no statistically significant difference between two groups in terms of demographics such as age, menarche, number of pregnancies or live births, smoking habit and co-morbidities. Necessity for blood transfusion (p=0.05) and additional procedure for abortion (p=0.056) were found to be similar in both groups. However, laparotomy (p=0.004), uterine rupture (p=0.016), hysterotomy (p<0.001) were performed more frequently in the study group; while abortion was more likely to occur within 24 hours in the control group (p=0.031). Conclusion: Medical abortion must be carefully used for the termination of second trimester pregnancies in women with a history of CS. Increased possibility of uterine rupture and requirement of interventions such as laparotomy or hysterotomy is more likely in these patients.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 PREDISPOSING FACTORS IN THE OCCURRENCE OF COMPLICATIONS AFTER VAGINAL HYSTERECTOMY(Galenos Yayincilik, 2013) Sak, Muhammet Erdal; Ozler, Ali; Sak, Sibel; Goruk, Neval Yaman; Karacor, Talip; Gul, TalipObjective: To investigate the predisposing risk factors in the occurrence of complications after vaginal hysterectomy. Material and methods: The data obtained from 223 patients, admitted to tertiary care center that underwent vaginal hysterectomy due to benign pathology between January 2006 and March 2012 were retrospectively analyzed. Chisquare test was used to evaluate variables in categorized groups. Results: Group variables occurred age, number of pregnancies and abortion, parity, stage according to pelvic organ prolapse classification (POP-Q), periods of hospitalization and urinary catheterization. The main complications were hemorrhage, febrile morbidity and vaginal vault prolapse. Advanced age (> 60), pelvic prolapse, long-term hospitalization and urinary catheterization, were predisposing factors for the presence of complications. Conclusion: Vaginal hysterectomy is a safe and effective method, although not completely devoid of intraoperative or postoperative complications. Advanced age (> 60), POP-Q stage 3-4 pelvic prolapse, prolonged hospitalization and urinary catheterization were seem to be predisposing conditions for the existence of complications. Appropriate preoperative planning and meticulous postoperative care may be helpful to reduce the rate of complications.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 Uterine rupture revisited: Predisposing factors, clinical features, management and outcomes from a tertiary care center in Turkey(Professional Medical Publications, 2013) Turgut, Abdulkadir; Ozler, Ali; Evsen, Mehmet Siddik; Soydinc, Hatice Ender; Goruk, Neval Yaman; Karacor, Talip; Gul, TalipObjective: To determine the predisposing factors, modes of clinical presentation, management modalities and fetomaternal outcomes of uterine rupture cases at a tertiary care center in Turkey. Methodology: A 14-year retrospective analysis of 61 gravid ( >20 weeks of gestation) uterine rupture cases between January 1998 to March 2012 was carried out. Results: The incidence of ruptured uteri was calculated to be 0.116%. Persistence for vaginal delivery after cesarean was the most common cause of uterine rupture (31.1%). Ablatio placenta was the most common co-existent obstetric pathology (4.9%). Bleeding was the main symptom at presentation (44.3%) and complete type of uterine rupture (93.4%) was more likely to occur. Isthmus was the most vulnerable part of uterus (39.3%) for rupture. The longer the interval between rupture and surgical intervention, the longer the duration of hospitalization was. Older patients with increased number of previous pregnancies were likely to have longer hospitalization periods. Conclusion: Rupture of gravid uterus brings about potentially hazardous risks. Regular antenatal care, hospital deliveries and vigilance during labor with quick referral to a well-equipped center may reduce the incidence of this condition.