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    Adenomyomatous polyp causing acute urinary retention in a postmenopausal woman
    (Modestum Publishing Ltd., 2011) Evsen, Mehmet Sıddık; Sak, Muhammet Erdal; Soydinç, Hatice Ender; Gümüş, Hatice; Özekinci, Selver; Gül, Talip
    A case of adenomyomatous polyp (AP) causig acute urinary retention in postmenopausal period is presented. A 65-year-old, G8P8 women admitted to our clinic with the complaint of vaginal bleeding and vaginal mass was identified. During preoperative hospitalization she complained about not able to urinate. Serum urea and creatinine levels increased [66 mg/dL (range= 10-45) and 2,49 mg/dL (range= 0. 6-1.3) respectively]. Emergent abdominopelvic tomography showed vaginal mass and overdistended bladder. Mass was removed by vaginal route and abdominal hysterectomy was also performed. Pathologic examination revealed non-malignant AP with massive necrosis. A variety of female reproductive tract diseases can cause urinary obstruction. Treatment choice depends on reproductive expectance of the patient. J Clin Exp Invest 2011; 2 (3): 312-314.
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    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, Talip
    Objectives: 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.
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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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    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, Abdulkadir
    Aim: 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.
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    Bacterial profile and drug susceptibility pattern of urinary tract infection in pregnant women with ureteral stones and hydronephrosis
    (Academic Journals, 2012) Atar, Murat; Bozkurt, Yasar; Sancaktutar, Ahmet Ali; Soylemez, Haluk; Penbegül, Necmettin; Sak, Muhammet Erdal; Tekin, Recep
    The aim of this study is to identify bacterial agents and their antibiotic susceptibility patterns isolated from pregnant women with symptomatic ureterolithiasis. Seventeen patients who had proven ureteral stones, positive urine cultures and underwent intervention for ureterolithiasis treatment between January, 2008 to December, 2011 were included in this study. Bacteriuria was defined as accounts of 10(5) cfu/ml in urine culture. The mean age and gestational period was 24.5 years and 25.5 weeks. The major symptoms were renal colic, hematuria and fever-chills. The overall prevalence of urinary tract infection (UTI) in pregnancy with ureteral stones was 17/65 (26.2%). Escherichia coli are the most common etiological agent (64.7%), followed by Klebsiella and Staphylococcus. The rate of resistance of E. coli to amoxicillin-clavulanate, ampicilin, cefotaxime, ciprofloxacin, trimethoprim/sulfamethoxazol, ceftriaxone, piperacillin/ tazobactam and imipenem were 50, 45.5, 100, 18, 36.4, 28.6, 36.4, 0%, respectively. The rate of resistance of Klebsiella to Ampicilin were 80% and Amoxicillin-Clavulanate, Cefazolin, Cefepime, Ceftazidim were 60%. There were no resistance of Klebsiella to ciprofloxacin, gentamicin, meropenem and amikacin. Significant bacteriuria was observed in these patients and we recommend urine cultures in all pregnant women with ureteral stones during pregnancy. Ceftriaxone is recommended for the patients who have UTI with ureteral stones during pregnancy because of its high specificity and sensitivity.
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    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 Kemal
    Objective: 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.
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    Cesarean Scar Pregnancy Mimicking Malignant Tumor A Case Report
    (Sci Printers & Publ Inc, 2011) Soydinc, Hatice Ender; Evsen, Mehmet Siddik; Sak, Muhammet Erdal; Gul, Talip
    BACKGROUND: 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)
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    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, Muhammed
    Data 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.
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    Continuous amnioinfusion via an epidural catheter following spontaneous membrane rupture: A case report
    (Galenos Yayincilik, 2013) Turgut, Abdulkadir; Katar, Selahattin; Sak, Muhammet Erdal; Turgut, Fethiye Gulden; Sahin, Alparslan; Basaranoglu, Serdar; Yalinkaya, Ahmet
    Preterm premature rupture of membranes (PPROM) is seen in 3% of all pregnancies, and is a frequent cause of preterm birth, neonatal mortality and morbidity. The most important complications are maternal and foetal infection, prematurity, umbilical cord compression, hypoxia or asphyxia due to cord prolapse, pulmonary hypoplasia and extremity deformities. The basic approach to PPROM therapy aims to prevent premature birth and the development of foetal distress, and decrease the risk of maternal and foetal infection, and amniotic fluid loss. In compliance with these objectives, alternatives of PPROM therapy demonstrate a wide spectrum, including watchful waiting, amniopatch application, recurrent amnioinfusions and emergency birth. However, repeated amnioinfusions in cases of fluid loss, especially within 6 hours of therapy, provides only minimal benefit. In this case presentation, we attempted to describe a different and cost-effective continuous amnioinfusion technique performed to confer survival benefit for an immature anhydramniotic foetus affected by PPROM at the border of viability.
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    Cytogenetic screening in couples with Habitual Abortions
    (Elsevier Masson, Corporation Office, 2019) Sak, Sibel; Incebiyik, Adnan; Hilali, Nese Gul; Agacayak, Elif; Uyanikoglu, Hacer; Akbas, Halit; Sak, Muhammet Erdal
    Objective: Habitual abortion (HA) is defined at least three consecutive pregnancy losses. One of the etiologic causes is parental chromosomal anomalies. In this study, we aimed to that investigate the effect of parental chromosomal abnormalities on HA. Methods: The cytogenetic results of patients with at least three abortions referred to our university hospital between January 2010 - March 2017 were evaluated. A total of 1154 couples with HA were analysed. Peripheral lymphocyte cultures incubated for 72 h were used for karyotype analysis via the Giemsa banding technique. Results: Of a total 1154 couples (2308 patients) 37 female (3.2%) and 17 male (1.47%) had abnormal karyotypes. Reciprocal translocation carriage (n = 26; 1.12%) was the most commonly detected structural anomaly, followed by X chromosome mosaicism (n = 16; 0.69%), Robertsoniantransiocation (n = 9; 0.38%), Chromosomal inversion (n = 6; 0.26%). Chromosomal polymorphisms, which are considered minor chromosomal changes, were detected in 221 (9.57%) individuals. Conclusion: Our study exhibits that chromosomal analysis in patient with HA is an appropriate approach to elucidate the aetiology of HA. Data from cytogenetic screening can be used in guiding couples planning future pregnancies and in prenatal diagnosis of chromosomal anomalies in the foetus. (C) 2018 Published by Elsevier Masson SAS.
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    Diagnostic Dilemma in Rudimentary Horn Pregnancies: Report of the Eight Cases and a Literature Review
    (2013) Özler, Ali; Görük, Neval Yaman; Turgut, Abdulkadir; Evsen, Mehmet Sıddık; Soydinç, Hatice Ender; Sak, Muhammet Erdal; Yalınkaya, Ahmet
    AMAÇ: Rudimenter horn gebelikleri (RHP) son derece nadir olmasına rağmen, tehlikeli olabilirler. Bu çalışmanın amacı, literatür incelemesi eşliğinde RHP olan 8 hasta ile ilgili klinik deneyimimizi sunmaktır. GEREÇ VE YÖNTEM: Türkiye'nin Güneydoğu bölgesinde tersiyer referans bir hastanede Ocak 2008 ve Aralık 2011 tarihleri arasında tedavi edilen RHP hastaların kayıtları geriye dönük olarak incelendi. Çalışma süresi boyunca RHP'li sekiz olgu tespit edildi. BULGULAR: Hastaların ortalama yaşı 23±3,9 yıldı ve ortalama gebelik haftası 14,8±4,8 hafta idi.Rudimenter horn 8 hastanın 6'sında (%75) sol tarafta lokalize idi. Dört (%50) olgu horn rüptür sonrası diğer hastanelerden kliniğimize sevk edilmişti. İlginç olarak iki olguda malprezentasyon nedeniyle sezaryen öyküsü olmasına rağmen Müllerian anomali varlığı konusunda herhangi bir bilgileri yoktu. Dört olgu masif intra-abdominal kanama ile şok tablosunda dış merkezlerden kliniğimize refere edildi. Maternal mortalite görülmedi. SONUÇ: Unicornuat uterus olgularına, rudimenter horn gebelikleri ve rüptür riski nedeni ile kadın hastalıkları ve doğum eğitiminde daha fazla önem verilmelidir.
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    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, Osman
    Background: 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, Basel
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    EFFECTS OF GENISTEIN, ESTROGEN AND PROGESTERONE THERAPIES ON BLADDER MORPHOLOGY AND M2, M3 RECEPTOR EXPRESSIONS IN OOPHORECTOMIZED RATS
    (Carbone Editore, 2014) Turgut, Abdulkadir; Goruk, Neval Yaman; Sak, Muhammet Erdal; Deveci, Engin; Akdemir, Fatih; Keles, Ayse Nur; Nergiz, Yusuf
    Aims: Investigating the effects of estrogen, estrogen/progesterone combination and genistein therapy on the expression of M2 and M3 receptors located on bladder walls and comparing the morphological and degenerative changes exerted on bladder walls. Materials and methods: A total of 50 adult Sprague-Dawley female rats were randomly divided into five groups. Rats other than the sham group were ovariectomized. OVX group (control group) received water, OVX+G group received 10 mg/kg genistein, OVX+E group received 0.014 mg/kg 17-beta estradiol, OVX+E+P group received 0.014 mg/kg 17-beta estradiol plus 0.028 mg/kg drospirenone per day. Results: When compared with the sham group, in the OVX group higher collagen fibre (CF): smooth muscle (SM) ratio, relatively increased fibrosis, oedema, space between detrusor smooth muscle fascicles, cytoplasmic vacuoles, and total M2, and M3 expression were observed. Relative to the OVX group, decreased CF: SM ratio and fibrosis in the OVX+G, OVX+E, and OVX+E+P groups, decreased oedema, spaces between detrusor muscle fascicles and cytoplasmic vacuoles in the OVX+G group and lesser total M2, and M3 expression in the OVX+G, OVX+E and OVX+E+P groups were observed. Conclusion: Genistein therapy regresses unfavourable morphological changes effecting postmenopausal bladder and increases in M2 and M3 receptor expression more effectively than estrogen and estrogen/progesterone combination. Besides, genistein therapy almost completely regresses degenerative changes; however, estrogen and estrogen/progesterone combination therapies do not improve these degenerative changes except for fibrosis. We think that genistein will favourably contribute both to the conduction of more comprehensive studies in the future concerning its use in postmenopausal urinary incontinence where estrogen and estrogen/progesterone combination therapies do not provide any improvement and etiopathogenesis of urinary incontinence.
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    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 Ali
    The 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.
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    Effects of malathion in fetal kidney tissues in pregnant rats: teratogenic effects ınduced by different doses
    (2012) Sak, Muhammet Erdal; Sancaktutar, Ahmet Ali; Penbegül, Necmettin; Evsen, Mehmet Sıddık; Fırat, Uğur; Söylemez, Haluk; Evliyaoğlu, Osman
    Bu çalışmanın amacı gebe ratlara düşük dozlarda subakut uygulanan Malathion (ML)’un fetüs böbrek dokusu üzerine teratojeniketkisini araştırmaktır. Toplam 28 Sprague-Dawley gebe rat randomize olarak her grupta 7 adet gebe rat olacak şekilde 4 gruba ayrıldı.ML’un dozuna bağlı olarak, gruplar; kontrol, ML 2.5 (2.5 mg/kg/gün dozunda oral yoldan (p.o) ML uygulandı), ML 5 (5 mg/kg/gün, p.o) veML 10 (10 mg/kg/gün, p.o) olmak üzere 4 gruba ayrıldı. ML uygulamsı erkekler ve dişilerin aynı ortama konulmasından itibaren başladı(çiftleşmeden itibaren). Günlük ML uygulamasına doğuma kadar devam edildi. ML’un, dozuna paralel bir şekilde gebe ratlarda böbrekdokusu ve serum enzimleri (asetilkolinesteraz (AChE), lipaz, amilaz) üzerine toksik etkiler oluşturduğu, ayrıca yavru rat böbreklerindeise ML’un dozuna bağlı olmayarak, tüm dozlarda teratojenik etkiye neden olduğu belirlendi. Histopatolojik veriler biyokimyasal verileridoğruladı. ML’un düşük dozlarının bile hem anne hem de yavru böbrekleri üzerine toksik ve teratojenik böbrek hasarına neden olduğusonucuna varıldı.
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    The efficacy and safety of ureteroscopy for ureteral calculi in pregnancy: our experience in 32 patients
    (Springer, 2012) Bozkurt, Yasar; Penbegül, Necmettin; Soylemez, Haluk; Atar, Murat; Sancaktutar, Ahmet Ali; Yildirim, Kadir; Sak, Muhammet Erdal
    The aim of this study was to investigate the efficacy and safety of ureteroscopy (URS) in pregnant women. A retrospective analysis was performed on 32 pregnant patients referred to our center between April 2005 and November 2010 with hydronephrosis requiring surgical intervention. A semirigid URS of 9.5 F was used in all patients. The mean age of patients was 27.8 years (range 20-39), and the mean gestation duration was 24 weeks (15-34). The ultrasound findings were diagnostic of obstructive ureteral calculi in 16 (50%) patients and the mean stone diameter was 8 mm. Spinal anaesthesia was performed in 22 (68.8%) patients, while general anaesthesia was performed in 7 (21.8%) patients. Ureteric stones were found in 27 (84.3%) patients during endoscopy, 10 being distal, 9 middle and 8 proximal. There were no stones in five patients. The stones were fragmented with pneumatic lithotripsy in 8 patients and with holmium laser in 17 patients and the fragments were retracted with forceps. Of the 32 patients, 19 (59.4%) required JJ stent insertion peroperatively. There was no serious complication intraoperatively, while urinary tract infection developed in four and renal colic in two patients postoperatively. In one patient, sepsis developed postoperatively, and improved with appropriate treatment. All babies were born normally. Semirigid ureteroscopy for diagnosing and treating ureteral calculi by intracorporeal pneumatic or holmium laser lithotripsy is a safe and reasonable treatment option for pregnant patients.
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    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, Talip
    Objective: 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.
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    Gebelik anemisinin perinatal sonuçlara etkisi
    (Dicle Üniversitesi Tıp Fakültesi, 2009) Sak, Muhammet Erdal; Özkul, Özgür; Evsen, Mehmet Sıddık; Sak, Sibel; Evliyaoğlu, Osman
    Gebelikte tedavi edilmemiş aneminin yenidoğanda komplikasyonlar ile ilişkili olabileceği bildirilmektedir. Çalışmamızın amacı gebelikte maternal anemi tespit edilen hastalardaki perinatal sonuçları değerlendirmektir. Çalışmaya ikinci trimesterde hemoglobin (Hb) düzeyi 8 g/dl’nin altında olan 29 anemik gebe kadın (Grup 1) ile Hb düzeyi 10 g/dl’nin üzerinde olan 30 gebe kadın (Grup 2) dahil edildi. Her iki grup için preterm doğum, intrauterin gelişme geriliği (IUGG) ve yeni doğan ünitesine sevkedilme oranları incelendi. Grup 1 de ortalama Hb konsantrasyonu 7.2±0.4 gr/dl, Grup 2 de 12.1±0.9 olarak saptandı (P<0.001). Preterm doğum oranı Grup 1 de %34.4 iken Grup 2 de %13.3 olarak bulundu (P=0.05). Grup 1 ile grup 2 arasında IUGG açısından anlamlı fark izlenmezken (P>0.05), yeni doğan ünitesine sevk oranı anemik grupta anlamlı yüksek bulundu (sırasıyla %44.8 ve %166, P=0.019). Gebelik anemisinin antenatal takipler sırasında belirlenmesi ve tedavisi perinatal komplikasyonların azaltılması bakımından önemlidir. Maternal aneminin perinatal sonuçlara etkileri açısından daha ileri çalışmalara ihtiyaç vardır.
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    Gebelikte adneksiyel kitle: Olgu sunumu ve literatür verilerinin değerlendirilmesi
    (Dicle Üniversitesi Tıp Fakültesi, 2009) Sak, Muhammet Erdal; Koplay, Mustafa; Özkul, Özgür; Evsen, Mehmet Sıddık; Sak, Sibel
    Ultrasonografi nin (USG) yaygın olarak kullanımını takiben, adneksiyel kitleler gebelerde daha sık saptanır hale gelmiştir. Bu çalışmada, antenatal takip sırasında saptanan adneksiyel kitlenin takip ve tedavi protokolü literatür bulgularıyla birlikte değerlendirildi. Gebelikte tespit edilen adneksiyel kitlelerin yönetimi; gebelik haftası, semptomatolojisi, ultrasonografi ve muayene bulguları doğrultusunda düşünülen ön tanıya göre, ailenin de görüşü alınarak şekillendirilir. Gebelik esnasında cerrahi girişimin komplikasyonları da göz önüne alınarak, gebelerde adneksiyel kitleye yaklaşım için uygun tedavi protokoller oluşturulması gerekliliği açıktır. Sonuç olarak, obstetrik USG’de adneksler mutlaka değerlendirilmeli, gebelerde abdominal cerrahi endikasyonu konurken çok dikkatli olunmalıdır
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    Öğe
    Gebelikte asitin nadir sebebi: Spontan ovaryan hiperstimülasyon sendromu
    (2012) Gül, Talip; Sak, Muhammet Erdal; Soydinç, Hatice Ender; Evsen, Mehmet Sıdık
    Ovaryan hiperstimülasyon sendromu (OHSS), ovulasyon indüksiyonu yapılan hastalarda sık rastlanan bir komplikasyondur. Spontan gebeliklerde oldukça nadir olmakla birlikte ortaya çıkabilir. Makalemizde 13 haftalık gebe olan ve spontan OHSS tespit edilen olgunun yönetimini sunmayı amaçladık. 35 yaşında hasta karın şişliği, nefes darlığı, bulantı, kusma ve el-ayakta şişme şikayetleriyle polikliniğimize başvurdu. Daha önce invitro fertilizasyonla (İVF) gebe kaldığı ve o gebelikte OHSS geliştiği öğrenildi. Muayene, laboratuar ve ultrasonografik incelemeler sonrası spontan OHSS tanısı konuldu. Konservatif tedavi yapıldı. 38 haftanın bitiminde sağlıklı kız bebek doğurtuldu. Daha önce İVF ile oluşan gebeliğinde OHSS geçiren hastaların, daha sonraki gebelikleri spontan olsa dahi OHSS gelişme riski akılda tutulmalıdır.