Browsing by Author "Şahin, H.G."

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Amniocentesis Results of Van and Surrounding Provinces Between 2018 and 2020: a Tertiary Center Experience
(Yuzuncu Yil Universitesi Tip Fakultesi, 2021) Küçükbaş, G.N.; Dirik, D.; Karaaslan, O.; Karaman, E.; Kolusari, A.; Aymelek, H.S.; Şahin, H.G.
Amniocentesis is one of the safest procedures of prenatal diagnosis. This study aimed to show amniocentesis indications, rate of successful amniocyte culture, complications and outcomes of these pregnancies undergoing prenatal diagnosis in eastern part of Turkey, especially Van province and its nearby. Between 2018 and 2020, 253 patients were referred to our center for amniocentesis and 120 patients giving consent were enrolled from Van and its surrounding provinces. The most frequent indication was high risk in prenatal screening tests whereas the highest chromosomal abnormality was found in fetuses with abnormal ultrasonographic findings. Overall, 11.6% of fetuses had chromosomal anomaly. The most abundant chromosomal abnormality was Trisomy 21, followed by trisomy 18 and 13. Except one case with amniotic leakage no complications were found. Eleven pregnancies were terminated whereas one fetus was born with Turner syndrome and two pregnancies resulted with stillbirth. In conclusion, fetuses with abnormal ultrasound screening had higher chromosome anomaly diagnosed by amniocentesis and compatible with the literature, amniocentesis is a safe and successful method of prenatal diagnosis of chromosomal abnormalities. Van and its surrounding provinces showed a high rate of chromosomal anomaly when prenatal diagnosis was done. © 2021, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Delivery Methods, Perinatal Mortality and Obstetric Complications in Multiple Pregnancies
(2004) Kamaci, M.; Zeteroǧlu, Ş.; Şahin, H.G.; Şengül, M.; Gülümser, S.; Bolluk, G.
OBJECTIVE: To evaluate the outcome of multiple pregnancies, which were in the high- risk pregnancy groups and to investigate the factors playing role at perinatal mortality. STUDY DESIGN: Ninety-six cases with multiple pregnancies delivered at Gynecology and Obstetrics Clinic of Research and Training Hospital of The Medical Faculty of Yüzüncü Yil University between January 1997-January 2004 were included in this study. Ninety-four twin pregnancies and 2 triplet pregnancies were reviewed retrospectively and then mortality rates, congenital anomalies, complications and delivery characteristics of these cases were analyzed. The statistical analysis was performed by SPPS (The Statistical Computer Software, version 9.05, Chicago, Illinois). RESULT(s): The incidence was 1.66% (94/5,632) for twin pregnancies; and 0.035% (2/5,632) for triplet pregnancies. The antenatal follow-up rate for the pregnant women during this study was 26.36%. The mean age of pregnant women was 28.3±5.65 and mean gestational age was 35.18±5.35 weeks. Fifty-three of these cases (55.2%) were delivered vaginally, while 42 cases (43.75%) were delivered by cesarean section. In one case, first fetus was delivered vaginally and the second fetus by cesarean section. Apgar scores (1-5 minutes) in 16 newborns were 0-0, in 56 newborns were below 7 and in 124 newborns were above 7. Birth weights were below 1000 gr. in 30 (15.5%) newborns, were between 1000 and 2499 gr. in 88 newborns (45.4%), and were above 2500 gr. in 76 newborns. Perinatal and neonatal mortality was highest among the babies with birth weights below 1500 gr. and gestational age under 27 weeks. Perinatal mortality rate was found to be 0.82% and neonatal mortality rate to be 0.98% among multiple pregnancies. CONCLUSION(s): The frequency of multiple pregnancies was consistent but the perinatal mortality rate was higher than the literature. Immaturity and prematurity were determined as the important factors increasing perinatal mortality.
The Effectiveness of Laparoscopic Training Box on Learning Curve in Gynecology Residents
(Yuzuncu Yil Universitesi Tip Fakultesi, 2021) Karaman, E.; Şahin, H.G.
Laparoscopy poses a significant role in routine surgical operations recently. However, it needs a surgical skill and educatio n programs to be applied safely and effectively. The aim of this study was to investigate the impact of laparoscopic training box practice on the learning curve in gynecology residents. The study was conducted over for 6 months at our hospital laparoscopic simulation room. Twenty gynecology reside nts; aged range of 26 to 35 years, of either sex, who had not to have senior experience on laparoscopy were attended the education program. Each participant was given a list of tasks to perform during the six months of a training program. Each resident were allowed to work on a training box every two days of the week for six months. The baseline and sixth months evaluation scores were recorded. The recommended tasks were as: task 1 (loops and wire), task 2 (pea on a peg), task 3 (post and sleeve), task 4 (wire chaser), task 5 (holding the needle), and task 6(suturing and knot tying). Each task’s time was measured from start to completion and the time was recorded at baseline and the sixth months of the training program. The mean age of the participants was 28.3±1.8 and 12 were female and 8 were male residents. The mean scores of time taken to perform tasks at baseline evaluation were as follows: task 1 (32±8, second), task 2(34±6, second), task 3(50±10, second), task 4(34±5, second), task 5(60±12, second), task 6(300±100, second). The mean scores of time taken to perform tasks at 6th month of the evaluation were as follows: task 1 (22±4, second), task 2 (18±6, second), task 3 (34±8, second), task 4 (22±4, second), task 5 (40±8, second), task 6(250±50, second). When analyzing the improvement in surgical skill about concerning the time of task completion. There was a statistically significant difference between the baseline and at the 6th months of the training program (p<0.05). The present study confirmed that laparoscopic training box improved the surgical skills of gynecology residents and was found to be effective for improvement of learning curve in the education of minimally invasive surgery practice. © 2021, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Evaluation of Fetal Central Nervous System Anomalies Diagnosed Prenatally: Prenatal and Postnatal Outcomes
(Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Bağcı, M.; Uçkan, K.; Şahin, H.G.; Karaaslan, O.; Karaman, E.; Başkıran, Y.
Introduction: The aim of this study is to examine the diagnosis types and rates of patients with central nervous system (CNS) anomalies detected in the prenatal period between 2021-2022 in our perinatology clinic and to contribute to the literature. Materials and Methods: Our study included 191 patients with CNS anomaly and whose pregnancy results were reached. Demographic characteristics of the patients, additional detected anomalies, fetal Magnetic Resonance Imaging (MRI) and genetic results, o bstetric and neonatal results were evaluated if requested. Results: Neural tube defects (NTD) were found most frequently at 75.3%, and among these, acrania was found most frequently at 27.2%. While 74.3% of the detected CNS anomalies were isolated anomalies, it was found that 5.2% were accompanied by additional CNS anomalies and 21.9% were accompanied by additional extracranial anomalies. Abnormal karyotype was obtained in 12.1% of the pa tients who wanted to have a prenatal diagnosis test. It was found that 11% of the patients requested fetal MRI and ventriculomegaly was the most common fetal MRI indication. While the pregnancies of 56.5% of the patients were terminated, 37.7% of them gave live bir ths. The rate of surgical intervention in live-born babies with CNS anomalies was found to be 56.9%. A total mortality rate of 43% was found in live-born babies. Conclusion: Since CNS anomalies are associated with serious morbidity and mortality; Prenatal diagnosis is very important so that families can be offered a pregnancy termination option and those who will continue to be pregnant should be informed about the treatment and rehabilitation processes of their babies. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Evaluation of Maternal Thyroid Autoimmune Status in Gestational Trophoblastic Disorders
(Yuzuncu Yil Universitesi Tip Fakultesi, 2016) Karaman, E.; Çetin, O.; Çim, N.; Kolusarı, A.; Güler, S.; Yıldızhan, R.; Şahin, H.G.
To investigate the maternal autoimmune status of patients with molar pregnancies. The study was conducted at Yuzuncu Yil University, Department of Obstetrics and Gynecology between January 2012 and June 2016. The medical records of patients who were diagnosed and followed for complete and partial molar pregnancies were reviewed retrospectively. The data of patients who were studied for maternal thyroid auto-antibodies including AntiThyroid peroxidase (TPO) and Anti-Tyroglobulin (Tg) were included in the study. The mean maternal age of complete molar pregnancies were significantly higher than partial molar pregnancies (p=0.010). There were no significant differences between two groups in terms of beta-hCG, TSH, and free T4 (p=0.815, p=0.204, and p=0.072, respectively). None of the patients were anti-TPO positive in the study. There was no significant difference in anti-thyroglobulin positivity between the two groups (p=0.950). Maternal thyroid autoantibody status did not show any difference between the partial and complete molar pregnancies. Thyroid dysfunction seen in molar pregnancies seems to be due to the stimulation of follicular cell receptors with hCG rather than auto-antibodies against thyroid gland. © 2016, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Hypopharyngeal Cancer in Pregnancy: Case Report
(OrtadogÂ u Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2015) Kamaci, M.; Şahin, H.G.; Kolusari, A.; Adali, E.; Kurdoʇlu, Z.; Kurdoʇlu, M.; Adali, F.
Hypopharyngeal cancer is very rarely seen in pregnancy. The patients may apply with the symptoms and signs of difficulty in swallowing, sore throat or hemoptysis. A thirty nine years old G:5, P:3, A:2 pregnant woman whose fetal biometric measures were consisted with 32 weeks of gestation applied with difficulty in swallowing and sore throat. On the magnetic resonance imaging, a vegetative mass with 6.5x3.5x3.5 cm dimensions was detected at the hypopharyngeal location and the biopsy was reported as "well differentiated squamous cell carcinoma". The patient was regarded as stage IV (T4N1M0) inoperable by the Department of Otolaryngology. The patient whose chemoradiotherapy was delayed to the postpartum period upon the desire of the family was delivered at 37th gestational week by cesarean section under spinal anesthesia. It was learned that the patient was given a chemoradiotherapy in another center, 2 weeks after the delivery. In this case presentation, the management of a pregnant woman with hypopharengeal cancer which is a very rare condition in pregnancy is presented. Copyright © 2015 by Türkiye Klinikleri.
Investigation of Matrix Metalloproteinas Levels in Preeclamptic/Eclamptic Pregnancy
(Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Özmen, E.; Şahin, H.G.
The present research was designed to investigate levels of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), and their respective tissue inhibitors, tissue matrix metalloproteinase inhibitor-1 (TIMP-1) and tissue matrix metalloproteinase inhibitor-2 (TIMP-2), in eclamptic and preeclamptic pregnant women. In this work, undertaken in the Obstetrics and Gynecology Department of the Yüzüncü Yıl University Faculty of Medicine Health Practice and Research Hospital, eclamptic (n=28), preeclamptic (n=28), and healthy pregnant women (n=24) were enrolled and their levels of MMP-2, MMP-9, TIMP-1, and TIMP-2 were studied by micro-ELISA method. No statistically meaningful differences were identified between the study groups for MMP-2 (p=0.786). When the ratios of MMP-2 to TIMP-2 of the three groups were examined, again, no statistically meaningful differences were noted (p=0.788). While a meaningful difference was not seen between the preeclamptic and eclamptic groups for MMP-9 and TIMP-1, significantly lower values of MMP-9 and TIMP-1 were obtained in both groups upon comparison to the control group (p=0.001 for MMP-9, p<0.000 for TIMP-1). When the MMP-9/TIMP-1 ratios of the groups were evaluated, a statistically meaningful difference did not exist between women with preeclampsia and controls; however, this ratio was higher among women with eclampsia in comparison to the preeclampsia and control groups and this finding was statistically significantly (p=0.011). Imbalanced levels of MMP-9 and TIMP-1 could be used as a marker in efforts to predict preeclampsia and especially eclampsia. However, larger clinical studies are needed to reveal these interactions in more detail. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Maternal Serum Ischemia Modified Albumin Level Does Not Change in the Presence of Intrauterine Growth Restriction
(Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Çetin, O.; Karaman, E.; Tolunay, H.E.; Boza, B.; Cim, N.; Alisik, M.; Şahin, H.G.
Maternal vascular hypoperfusion is the most common cause of fetal growth restrict ion. Maternal oxidative status features are identifiable on placental pathology, and antepartum diagnostic methods are rapidly evolving. The current study was constructed to determine the maternal oxidative status by measuring serum ischemia modified album in (IMA) levels in pregnancies complicated with idiopathic intrauterine growth restriction (IUGR). The current study was designed as a descriptive and cohort trial. A total of 87 pregnant women; 45 healthy controls and 42 pregnancies complicated with idiopathic IUGR were included to the study population. Maternal serum IMA concentration was measured prior to the administration of any medication. The perinatal outcomes of patie nts were also recorded. Maternal serum IMA concentration in pregnancies complicated by idiopathic IUGR was higher than in healthy controls. There was no significant difference between the groups (0.54±0.04 versus 0.55±0.06 ABSU, p: 0.314). IUGR is a significant pregnancy complication. Elevated oxidative stress which leads to an ischemic microenvironment is associated with IUGR. Maternal serum IMA which is a possible marker for oxidative stress is not increase in pregnancies complicated with idiopathic IUGR. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Ovarian Torsion During Pregnancy: a Case of Malignant Ovarian Cancer
(Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Hacıoğlu, L.; Karaman, E.; Dirik, D.; Karaaslan, O.; Kolusarı, A.; Şahin, H.G.; Gül, A.
Ovarian torsion is an acute and emergency condition during pregnancy. It is caused mainly by the benign cystic mass in the ovary. However, ovarian cancer may be seen as a cause which is very rare during pregnancy. Here, we aim to present a case of pregnant women with ovarian torsion and diagnosed with malignant ovarian tumor. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Prenatal Diagnosis of Urethropelvic Obstruction and Assesment of Fetal Renal Function: Case Report
(2006) Erdemoglu, E.; Kolusari, A.; Şahin, H.G.; Kamaci, M.
Fetal obstructive renal anomalies ar the most common urinary anomaly. Obstuction is particularly is encountered in ureteropelvic junction, vesicoureteral juction or urethra. Accurate localisation of obstruction and status of fetal kidneys are of utmost importance in prognosis and intrauterin management. Thirtythree years old, G6P5A0 women at 20th gestational weeks was refered for anhidroamnios and urinary to deparment of Obstetrics and Gynecology, Yuzüncü Yil Univeristy Medical Faculty. B-mod ultrasonographic examination was likely a posterior urethral valve however, color doppler and pulse doppler examination revealed obstruction cranial to fetal bladder. Pyelourethrocenetsis to evaluate renal function and amnioinfusion was performed. Right renal cortex was thin and hiperechogenic, collecting tubules were dilated. Collecting tubules of right kidney was minimally dilated. Biochemical analysis of aspirated fluid and anhidroamniosis gave irreversible renal damage and pregnancy was terminated. There was left renal duplication and right grade 4 hydronephrosis due to ureteopelvic obstruction. Bladder and urethra was normal. Color doppler and pulse doppler examiation should be incorporated to B-mod examination to assess localisation of urinary obstruction. Uretherocentesis and amniotic fluid index should be examined in order to evaluate prognosis of fetal kidneys.
A Rare Case of Pelvic Castleman’s Disease Mimicking an Adnexal Tumor
(Yuzuncu Yil Universitesi Tip Fakultesi, 2018) Karaman, E.; Ateş, Ç.; Kolusarı, A.; Alkış, İ.; Şahin, H.G.; Gül, A.; Demir, F.
Castleman’s disease (CD) is described as a nodal lympho-follicular hyperplasia and mostly seen in thoracic cavity. The occurrence in pelvic cavity is very rare. It is usually mimicking the pelvic adnexal solid-heterogenous tumoral mass. So the preoperative diagnosis is mostly difficult. We now present a case of pelvic CD in a woman who complaint from pelvic pain. The patient underwent laparotomy with suspicious of adnexal tumor. However, the diagnosis was made at histopathologic examination postoperatively. The surgery was curative in this case and no recu rrence was observed in the patient. © 2018, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Recurrent Spontaneous Ohss in a 10 Week Pregnant: a Case Report
(Yuzuncu Yil Universitesi Tip Fakultesi, 2018) Çim, N.; Tolunay, H.E.; Boza, B.; Sayan, S.; Şahin, H.G.; Yıldızhan, R.
Ovarian hyperstimulation syndrome (OHSS) most often occurs in the context of assisted conception like in-vitro fertilization (IVF). OHSS can be a reason of acute abdomen. USG is very important in the diagnosis of OHSS. Severe complications can be seen in OHSS. Incidence of OHSS is increasing in recent years, so this situation should be kept in mind and the early diagnosis of OHSS is very important. © 2018, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Relationships Between Somatosensory Amplification, Health Anxiety and Low Back Pain Among Pregnant Women
(Yuzuncu Yil Universitesi Tip Fakultesi, 2019) Yıldırım, A.; Boysan, M.; Karaman, E.; Çetin, O.; Şahin, H.G.
Introduction: A great proportion of pregnant women experience low back pain during pregnancy. The aim of this study was to uncover potential psychological mechanisms underlying pregnancy-related back pain. Method: Fifty two women with low back pain and forty seven women without low back pain were volunteered to participate in the study. A battery set containing the Health Anxiety Inventory (HAI), Hospital Anxiety and Depression Scale (HADS), Somatosensory Amplification Scale (SSAS), and Visual Analog Scale (VAS) was completed by all participants. Group comparisons were conducted using logistic regression analysis. Relationships of psychological symptoms with pain as measured by the VAS were assessed using regression analysis. Results: Regression models showed that somatosensory amplification satisfactorily explained the group difference between pregnant women with and without low back pain. A tendency to anomalous somatic sensation was associated with the individual differences on scores of the VAS. Conclusion: We concluded that pregnant women high in somatosensory amplification were at greater risk of development of low back pain during pregnancy. © 2019, Yuzuncu Yil Universitesi Tip Fakultesi. All Rights Reserved.
Should We Use Urinary Catheter Routinely at Cesarean Delivery
(2007) Kolusari, A.; Zeteroǧlu, Ş.; Şahin, H.G.; Ramazan, S.; Kamaci, M.
OBJECTIVE: The aim of the study was to compare intraoperative complications and postoperative morbidity of patients to whom urinary catheter were performed or not in cesarean deliveries. STUDY DESING: This study was designed as a prospective randomised study. Fifty patients (Group 1) who delivered with cesarean section after spontaneous mixture were compared with fifty patients (Group 2) to whom Foley urinary catheter were performed before the opertaion for intraoperative complications and postoperative morbidity. FINDINGS: There were no significant differences between the groups for age, gravity, parity, cesarean indications, factors those could increase postoperative infectious risks and operative time. No intraoperative complications were noticed in both groups. Postoperative mobilization was significantly earlier in Group 1 (6.58±1.69 hours vs 12.52±4.48 hours). The average time to first void was 5.24±3.53 hours in Group 1. In Group 2, two patients (% 4) who had glob vesicate required urinary catheter drainage (Both of them had epidural anesthesia). Urinary catheter was removed at 12.08±4.42 hours in Group 2 patients. There were no urinary tract infections in group 1, four in group 2 patients which reached statistical significance. CONCLUSION: Use of urinary catheter at cesarean delivery increases postoperative urinary tract infections. We think that use of urinary catheter at cesarean delivery is ineffective.
Telemedicine
(2003) Şahin, H.A.; Şahin, H.G.; Onbaşi, K.T.; Şahin, I.
Advances in telecommunication and computer industry are turning the concept of a global community into a reality. In the medical industry, telemedicine would be useful in improving health care quality, creating alternatives for transportation of patients and health care professionals. It would allow the exchange of data and radiographs before the transfer of patients between referring and receiving hospitals, increase self-diagnostics and home monitoring, allow real-time video teleconferencing between remotely located users over computer systems, provide rehabilitation and long-term support to the people with disabilities, thus saving lives and reducing medical costs due to early detection of serious pathology. Telemedicine offers new possibilities for multidisciplinary care of patients, allowing direct communications between different, complementary and geographically distant specialists. Thus, it is possible to form committees in small hospitals where all specialties are not represented. New and enhanced telecommunication links between community and academic hospitals show promise for reducing isolation and enhance lifelong learning opportunities for rural health care providers, reduce unnecessary referrals to specialists, and consequent savings to the patients, accompanied by more efficient usage of specialists' time.