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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 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 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 postoperative sexual function in patients after trans-obturator-tape operation(Aves Press Ltd, 2016) Agacayak, Elif; Basaranoglu, Serdar; Yavuz, Mustafa; Tunc, Senem Yaman; Sak, Sibel; Turgut, Abdulkadir; Deregozu, AysegulIntroduction: In this study, we aimed to evaluate postoperative sexual function of patients, who had undergone colporraphy anterior and transobturator tape operation due to cystocele and stress urinary incontinence. Materials and Methods: In our study, 52 patients with cystocele and stress urinary incontinence that were admitted to Dicle University, School of Medicine, Department of Obstetrics arid Gynecology between January 2009 and January 2014, were included in the study. Patients with previous hysterectomy, patients who had rectocele repair during operation, patients in menopause were excluded from the study. Patients completed the Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire-12 before and after under going surgery. Results: Mean age of the patients in our study was 42.04 +/- 7.50, average body mass index of the patients was 30.1 +/- 3.7 kg/m(2). Average follow-up time was 31.5 +/- 11.3 months. 22 (42.3%) patients did not completely recovery the postoperative complaints. 2 (3.8%) patients had increased postoperative complaints. The positive correlation between postoperative complaints with dyspareunia was observed (r= 0.355 **p: 0.010). 5 (9.6%) patients developed postoperative complications. These complications, urinary comfortable inability in 2 (%3.8) patients, mesh erosion in 1(%1.9) patient, developed de novo urinary incontinence in 2 (%1.9) patients. The total result according to Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire-12 was observed significant improvement in sexual function (p= 0.000). Conclusion: Urinary incontinence negatively affects the sexual life of women. We observed improvement in sexual function of women that had went transobturator tape operation for urinary incontinence.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 İkinci trimester amniyosentez olgularının değerlendirilmesi: Tersiyer bir merkezin10 yıllık deneyimi(2021) Gündüz, Reyhan; Oral, Diclehan; Tekeş, Selahaddin; Tunc, Senem Yaman; Yalınkaya, Ahmet; Buğday, RezanAmaç: Kliniğimizdeki amniyosentez uygulanan olguların retrospektif analizini yapmak ve bu konudaki deneyimimizi paylaşarak literatüre katkı sunmaktır.Yöntem: Çalışmamıza ikinci trimesterde amniyosentez uygulanan 632 olgu dahil edildi. Olguların demografik özellikleri, gebelik haftaları, amniyosentez endikasyonları, işleme bağlı komplikasyonları, kültür başarısı, sitogenetik sonuçları, kromozom anomalisi saptanan olguların sonuçları ve endikasyonları değerlendirildi. Kromozom anomalisi, komlikasyonları, kültür başarısızlığı oranları ve en sık amniyosentez endikasyonları belirtildi. Kromozom anomalisi olan olguların sonuçları sayısal ve yapısal anomi olarak belirtildi.Bulgular: Çalışmamıza dahil edilen tüm olguların yaş ortalamaları 33.7±6.8 yıl, gebelik haftaları 17.5±1.0 hafta olarak tespit edildi. Amniyosentez sonucu kromozom anomalisi tespit edilen olgu oranı%22.4, kültür başarısızlığı oranı %2.1 ve komplikasyon oranı %0.5bulundu. En sık amniyosentez endikasyonları ve kromozom anomalisi tespit edilen olgularda amniyosentez endikasyonları aynı olupbunlar sırasıyla; kombine testin yüksek riskli olması, üçlü tarama testinin yüksek riskli olması ve ultrasonografide (USG) anomali olmasıdır. Kromozom anomalisi tespit etme oranı birden fazla endikasyonun birlikte görülüp amniyosentez uygulanan olgularda dahayüksek bulundu.Sonuç: Prenatal tanı için USG ve serum tarama testleri yaygınolarak kullanılmakla birlikte yüksek riskli hastalara kesin tanı içinamniyosentez gibi invazif testlere ihtiyaç vardır. Tarama testlerinde birden fazla kromozom anomalisi riski taşıyan olgularda, prenatal tanı için amniyosentezin daha önemli olduğu sonucuna varıldı.Öğe The impact of the stage and tumor size on brain metastasis of cervical cancer.(Amer Soc Clinical Oncology, 2015) Teke, Fatma; Tunc, Senem Yaman; Teke, Memik; Turan, Yahya; Urakci, Zuhat; Altin, Suleyman; Eren, Bekir[Abstract Not Available]Öğe Multiple repeat caesarean deliveries: do they increase maternal and neonatal morbidity?(Taylor & Francis Ltd, 2017) Tunc, Senem Yaman; Agacayak, Elif; Sak, Sibel; Basaranoglu, Serdar; Goruk, Neval Yaman; Turgut, Abdulkadir; Tay, HayrettinObjective: The aim of the present study is to evaluate the effects of the increased number of caesarean deliveries (CDs) in cases of multiple repeat caesarean deliveries (MRCDs) on maternal and neonatal morbidity. Methods: MRCDs admitted to our hospital between January 2013 and September 2014 were analysed retrospectively. A total number of 1133 women were included in the study and were divided into 4 groups. Group 1: second CDs (n=329); Group 2: third CDs (n=225); Group 3: fourth CDs (n=447); Group 4: fifth CDs (n=132). The clinical, demographic, intraoperative and postoperative data of the patients were registered upon the review of patient files. Results: The differences among the groups were found to be statistically significant in terms of mean maternal age, gravida, APGAR (Activity, Pulse, Grimace, Appearance, Respiration) scores, hospital stay and operation time. In addition, the difference was also statistically significant for severe adhesion, bladder injury and premature birth. No statistically significant difference was observed among the groups with respect to placenta previa, placenta accreta, caesarean hysterectomy, uterine scar rupture. Conclusions: According to our findings, MRCDs seem to increasing the maternal and neonatal morbidity even though they are not life-threatening.Öğe 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 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 A Prospective Study to Evaluate the Predictivity of Risk Malignancy Index in Adnexal Masses(2021) Tunc, Senem Yaman; Elmastaş, Narin Yar; Obut, MehmetOBJECTIVE: To evaluate the efficiency of CA-125, menopausal status, ultrasound features and risk malignancy index in predicting malignancy in patients with an adnexal mass. STUDY DESIGN: This study was designed prospectively and 212 patients who applied to our hospital and met the study criteria were included. Preoperatively RMI value was calculated for the differentiation of benign from malignant patients. The diagnosis was confirmed by histopathology. KolmogorovSmirnov, Yates correction, Pearson Chi-Square and Student's t-test were used for statistical analysis. ROC curves were drawn as diagnostic tests and the test results were presented. RESULTS: Of 212 patients included in our study, 174 (82%) patients’ were reported as benign, 6 (3%) borderline and 32 (15%) malignant. In predicting malignancy, the malignity risk index with 200 cutoff value the sensitivity and specivity was 87% and 80% respectively. However, when the cutoff value of malignity risk index taken as 112, the sensitivity was unchanged but the specificity increased to 90%. Similarly, when CA-125's cutoff value was taken as 46U/mL, the sensitivity did not change but the specificity increased from 68% to 72%. CONCLUSION: Malignancy risk index is a method that has high sensitivity and specificity. Preoperativeop RMI calculation can provide accurate predictions for the establishment of an appropriate surgical plan for pelvic masses or referral to tertiary centers.Öğe Protective Effect of L-Glutamine as an Antioxidant Against the Toxic Effects of the Pesticide Deltamethrin in the Rat Ovary(Sci Printers & Publ Inc, 2016) Agacayak, Elif; Tunc, Senem Yaman; Goruk, Neval Yaman; Ekinci, Aysun; Basaranoglu, Serdar; Ekinci, Cenap; Deveci, EnginOBJECTIVE: To investigate the potential protective effect of L-glutamine as an antioxidant against the toxic effects of the pesticide deltamethrin (DLM) by examining biochemical and histopathological parameters in the rat ovary. STUDY DESIGN: The rats included in this study were divided into 4 groups (n= 10) as follows: Group I, controls (distilled water, 10 mL/kg, p.o.); Group II, Lglutamine (1.5 g/kg, p.o.); Group III, DLM ( 35 mg/kg, p.o.); and Group IV, DLM (35 mg/kg, p.o.)+ Lglutamine (1.5 g/kg, p. o.). Biochemical measurements were taken and apoptotic changes were determined in ovarian tissue. Immunohistochemical expression of proliferating cell nuclear antigen and CD34 were assessed. RESULTS: Histopathological examination revealed germinal epithelial thinning and degeneration in antral follicles as well as apoptotic changes in the DLM group. The same examination showed significantly elevated estradiol (E2) levels and decreased total oxidant status levels in the DLM+ L-glutamine group as compared to the control group ( p= 0.047 and p= 0.048, respectively). Bivariate analysis resulted in the observation that E2 levels correlated negatively with follicular degeneration and vascular hemorrhage (r=-0.471* [ p= 0.036] and r=-0.482* [ p= 0.031], respectively) as well as with CD34 expression in pre-antral and antral follicles (r=0.537** [ p= 0.005]). CONCLUSION: L-glutamine as an antioxidant might alleviate the toxic effect of the pesticide DLM. (Anal Quant Cytopathol Histpathol 2016; 38: 331-342)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 The role of vitamin B1-B2 and plasma lipid profile in intrahepatic cholestasis of pregnancy(Walter De Gruyter Gmbh, 2017) Basaranoglu, Serdar; Agacayak, Elif; Ucmak, Feyzullah; Tunc, Senem Yaman; Deregozu, Aysegul; Akkurt, Zeynep Meltem; Peker, NurullahAim: The present study aimed to determine the levels of total cholesterol, triglycerides (TG), low-density lipoproteins (LDL), high-density lipoproteins (HDL), and vitamins B1 and B2 in intrahepatic cholestasis of pregnancy (ICP) patients, and to evaluate if these were involved in the pathophysiology of the disease. Methods: The prospective randomized study included 35 pregnant patients who were admitted to the Gynecology and Obstetrics Polyclinic, Faculty of Medicine at Dicle University and who were diagnosed with ICP (Group 1), and 40 healthy pregnant women who were admitted in the same period and who had no systemic diseases that might complicate the pregnancy during the pregnancy follow-up (Group 2). Serum lipid levels and vitamins B1 and B2 were determined and compared, and statistical comparisons of the groups were made. Results: There was no difference between the TG levels of the two groups (P=0.631). Total cholesterol, LDL, HDL, and vitamin B1 and B2 levels were higher in Group 1 than in Group 2 (P=0.001, P=0.001, P=0.001, P=0.001, and P=0.032, respectively). Conclusions: Increased levels of vitamins B1 and B2 may indicate a need for increased energy metabolism at the fetus. So we believe that new studies are required, which will be supported by the placental analyses of the pyruvate and lactate levels in maternal blood at delivery and fetal cord blood in order to develop a better understanding on the fetal effects of energy metabolism.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.
