Browsing by Author "Adali, E."

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A Case Report of Patient With Uterine Torsion and Glob Vesicale Mimicking Twin Pregnancy
(2012) Kamaci, M.; Aksin, Ş.; Kolusari, A.; Kurdoǧlu, M.; Coşkun Erol, Ü.; Adali, E.
The patient who was 35-year-old, gravidity 8, parity 7 and who had followed for a long time by the active phase of labor was referred to our clinic urgently due to cephalopelvic disproportion and fetal shoulder dystocia by helicopter ambulance. After the ultrasonographic examination, a fetus with bradicardia and whose measurement was 38th gestational week was noted and patient was taken up for emergency cesarean section. Intraoperatively, glob vesicale and uterine torsion were noted. The patient might be evaluated as a twin pregnant woman due to the pressure to urethra and bladder neck by fetal head with a severe uterine contraction and torsion of the pregnant uterus. We aimed to present the management of the patient with glob vesicale and torsion of the pregnant uterus on the light of the literature. Copyright © 2012 by Türkiye Klinikleri.
Catalase Activity, Serum Trace Element and Heavy Metal Concentrations, and Vitamin A, D and E Levels in Pre-Eclampsia
(Sage Publications Ltd, 2008) Kolusari, A.; Kurdoglu, M.; Yildizhan, R.; Adali, E.; Edirne, T.; Cebi, A.; Yoruk, I. H.
Catalase (antioxidant enzyme) activity in erythrocytes and serum levels of trace elements (copper, iron, zinc), heavy metals (cadmium, cobalt) and vitamins A (retinol), D (cholecalciferol) and E (alpha-tocopherol) were measured in 145 subjects comprising 47 pre-eclamptic pregnant women (PE), 48 healthy pregnant women (HP) and 50 healthy non-pregnant controls (NP). Catalase, vitamins A, D and E and levels of cobalt were significantly lower in the PE group compared with the HP and NP groups, whereas levels of copper, iron and cadmium were significantly higher in the PE group than in the HP and NP groups. Levels of zinc were significantly lower in both the PE and HP groups compared with the NP group. This assessment of oxidant/antioxidant imbalance in pregnant women could be useful in the early identification of pre-eclampsia and antioxidant supplementation in the early weeks of gestation might be useful.
Catalase Activity, Serum Trace Element and Heavy Metal Concentrations, Vitamin A, Vitamin D and Vitamin E Levels in Hydatidiform Mole
(Imr Press, 2009) Kolusari, A.; Adali, E.; Kurdoglu, M.; Yildizhan, R.; Cebi, A.; Edirne, T.; Yoruk, I. H.
Purpose of investigation: In this study we aimed to measure the activity of catalase, which is an antioxidant enzyme, the concentrations of some trace elements and heavy metals, and vitamin A, D and E levels in serum samples of patients with hydatidiform mole, normal pregnancies and healthy non pregnant women. Methods: Seventy-two women were enrolled in this study. Of these, 24 were healthy women in the first trimester of pregnancy (HP), 24 were healthy non-pregnant women (NP) and 24 were patients with complete hydatidiform mole (CHM). Results: Serum levels of catalase, Zn, Co, vitamin A, D and E were significantly lower in the CHM group when compared with the HP and NP groups (p < 0.001). Serum levels of Cu, Fe, and Cd were significantly higher in the CHM group when compared with the HP and NP groups (p < 0.001). Conclusion: The assessment of oxidant/antioxidant imbalance in pregnant women could be useful in the early determination of molar pregnancy and supplementation with antioxidants may be useful in the treatment of CHM, and may prevent recurrent molar pregnancy.
Delayed Diagnosis of an Atypical Rupture of an Unscarred Uterus Due To Assisted Fundal Pressure: a Case Report
(2009) Kurdoglu, M.; Kolusari, A.; Yildizhan, R.; Adali, E.; Sahin, H.G.
Introduction: Although rare, rupture of an unscarred uterus is one of the most dangerous obstetric complications, resulting in maternal and fetal jeopardy. Case presentation: A 30-year-old grand multiparous Turkish woman without any history of uterine surgery gave birth vaginally at 37 weeks of gestation with fundal pressure applied in the second stage of labor. Transabdominal sonography performed 32 hours after delivery due to postural hypotension and a drop in hemoglobin values in the postpartum period revealed massive intraabdominal free fluid. On emergency laparotomy, serosal rupture of the uterus on the left posterior side was observed. She underwent a subtotal hysterectomy and did well postoperatively. Conclusion: Postural hypotension in postpartum patients without any evident vaginal bleeding may be an early sign of possible uterine rupture, even if the vital signs are stable. Early diagnosis is important if maternal morbidity and mortality are to be decreased. © 2009 Kurdoglu et al; licensee Cases Network Ltd.
Fetal Death Due To Upper Airway Compromise Complicated by Thyroid Storm in a Mother With Uncontrolled Graves' Disease: a Case Report
(2009) Yildizhan, R.; Kurdoglu, M.; Adali, E.; Kolusari, A.
Introduction. We report an unusual case of upper airway compromise complicated by thyroid storm in a pregnant woman with Graves' disease, ending with the in utero death of the fetus. This complication might have developed due to upper airway edema as a result of poorly controlled hyperthyroidism. Case presentation. A 41-year-old Turkish woman at 27 weeks' gestation suffering from Graves' disease was referred to our emergency department with a diagnosis of respiratory arrest. She was unconscious and had been intubated. Her laboratory results were compatible with thyrotoxicosis. The patient had suffered from respiratory difficulty for a long time and had stopped using her antithyroid medications after the first trimester of pregnancy. One day before, she had visited an obstetrician because her respiratory distress had increased. At that time, her fetus was still alive. She was given oxygen therapy and then sent home. With a presumptive diagnosis of thyroid storm, she was admitted to the intensive care unit and treated with aggressive medical therapy. The baby was found to be no longer alive and was delivered vaginally after labor induction. The mother was discharged 10 days later with maintenance therapy. Conclusion. Hyperthyroidism during pregnancy warrants very close attention and should almost always be treated with appropriate antithyroid medications. Maternal respiratory distress in such patients can be an early sign of impending upper airway compromise and thyroid storm, which can endanger the mother and fetus unless prompt and aggressive therapy is initiated. © 2009 Yildizhan et al; licensee Cases Network Ltd.
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.
Leiomyosarcoma of the Broad Ligament: a Case Report and Review of the Literature
(I R O G Canada, inc, 2009) Kolusari, A.; Ugurluer, G.; Kosem, M.; Kurdoglu, M.; Yildizhan, R.; Adali, E.
Leiomyosarcoma of the broad ligament is a rare turnout, since only 15 cases have been reported thus far in the English literature. We describe the case of a 35-year-old patient with primary leiomyosarcoma of the broad ligament. The histologic diagnosis and management of this rapidly progressive and highly malignant tumour are also discussed. The tumor had high mitotic activity and more than ten mitotic figures were found for ten high-power fields. The treatment consisted of total abdominal hysterectomy, bilateral salpingo-oophorectomy and pelvic lymph node dissection. The patient received pelvic radiotherapy and chemotherapy considering the high grade of malignancy. No evidence of metastasis has been noted after a follow-up of 12 months.
Ovarian Stimulation in Obese and Non-Obese Polycystic Ovary Syndrome Using a Low-Dose Step-Up Regimen With Two Different Starting Doses of Recombinant Follicle-Stimulating Hormone
(Sage Publications Ltd, 2008) Yildizhan, R.; Adali, E.; Kolusari, A.; Kurdoglu, M.; Yildizhan, B.; Sahin, H. G.; Kamaci, M.
Sixty-seven infertile women with polycystic ovary syndrome (PCOS) were divided into two groups, obese and non-obese, according to their body mass index. Waist-to-hip ratio, insulin resistance, total testosterone and dehydroepiandrosterone sulphate levels were significantly elevated in obese, compared with non-obese, patients. Both groups were treated with a low-dose step-up protocol of recombinant follicle-stimulating hormone (rFSH) with a starting dose of 50 IU/day and, every third day, a 25-IU increase in the dose until the appropriate dose was achieved for each individual, up to a maximum of 175 IU/day. In the obese group only, repeat therapy commenced in the second ovulatory cycle in women who had not become pregnant, however a starting dose of 75 IU/day was then used, with incremental and maximum dose as before. The results of the starting dose of 75 IU/day rFSH were compared with the results of a 50 IU/day rFSH starting dose in the obese group. A starting dose of 50 IU/day rFSH in a low-dose step-up regimen was found to be effective, safe and well-tolerated for inducing follicular development in non-obese infertile women with PCOS. However, for obese PCOS patients, a starting dose of 75 IU/day rFSH is recommended.
Primary Abdominal Ectopic Pregnancy: a Case Report
(2009) Yildizhan, R.; Kolusari, A.; Adali, F.; Adali, E.; Kurdoglu, M.; Ozgokce, C.; Cim, N.
Introduction: We present a case of a 13-week abdominal pregnancy evaluated with ultrasound and magnetic resonance imaging. Case presentation: A 34-year-old woman, (gravida 2, para 1) suffering from lower abdominal pain and slight vaginal bleeding was transferred to our hospital. A transabdominal ultrasound and magnetic resonance imaging were performed. The diagnosis of primary abdominal pregnancy was confirmed according to Studdiford's criteria. A laparatomy was carried out. The placenta was attached to the mesentery of sigmoid colon and to the left abdominal sidewall. The placenta was dissected away completely and safely. No postoperative complications were observed. Conclusion: Ultrasound examination is the usual diagnostic procedure of choice. In addition magnetic resonance imaging can be useful to show the localization of the placenta preoperatively. © 2009 Yildizhan et al.; licensee Cases Network Ltd.
The Relation Between Pelvic Varicose Veins and Lower Extremity Venous Insufficiency in Women With Chronic Pelvic Pain
(Assoc Royal Soc Scientifiques Medicales Belges, 2012) Bora, A.; Avcu, S.; Arslan, H.; Adali, E.; Bulut, M. D.
Purpose: To determine the relation between pelvic varicose veins and lower extremity venous insufficiency in women with chronic pelvic pain. Methods and Materials: This study was done in Yuzuncu Yil University Faculty of Medicine, Department of Radiology, with patients who were referred for abdominal and pelvic imaging between January 2007 and April 2008. A total of 1029 women with pelvic imaging study were included in the study. The presence of venous dilatations (diameter > 5 mm) in parauterine and paraovarian localizations were accepted as pelvic varicose veins. In all patients, endometrial thickness was measured and lower extremity venous system was examined with Doppler ultrasonography to assess possible associated venous insufficiency. All patients were undergone questionnaire for frequency of delivery, age, and chronic pelvic pain. Results: Pelvic varicose veins were discovered with transabdominal ultrasound and computerized tomography in 56 of 1029 patients. Various degrees of associated lower extremity venous insufficiency were also discovered in 44 of 56 patients (78,6%) with pelvic venous dilatation. Of the 44 patients with lower extremity venous insufficiency, 21 were bilateral, 9 were right-sided, and 14 were left-sided. Endometrial thickness was significantly increased in patients with pelvic venous dilatation. Conclusion:The presence of pelvic varicose veins is significantly associated with lower extremity venous insufficiency. Since the diagnosis of lower extremity venous insufficiency plays an important role in deciding the course of treatment, lower extremity Doppler ultrasonography examination would be useful to include in the evaluation of pelvic varicose veins.
The Relationship Between Clinico-Biochemical Characteristics and Psychiatric Distress in Young Women With Polycystic Ovary Syndrome
(Sage Publications Ltd, 2008) Adali, E.; Yildizhan, R.; Kurdoglu, M.; Kolusari, A.; Edirne, T.; Sahin, H. G.; Kamaci, M.
The relationship between clinico-biochemical characteristics and self-reported psychological parameters in 42 women with polycystic ovary syndrome (PCOS) and 42 age-matched healthy controls was examined. The General Health Questionnaire was used (GHQ-12) to ascertain emotional distress and the Beck Depression Inventory (BDI) to determine depressive symptoms. Emotional distress, depressive symptoms, hirsutism score, body mass index (BMI), waist-to-hip ratio (WHR), luteinizing hormone/follicle-stimulating hormone ratio, serum total testosterone, dehydroepiandrosterone sulphate levels and the insulin resistance index were significantly greater in women with PCOS than in healthy women. The BDI and GHQ-12 scores of the women with PCOS were significantly higher than those of the control group (BDI, 11.69 +/- 9.49 vs 5.80 +/- 4.58; GHQ-12, 3.38 +/- 3.38 vs 1.54 +/- 1.97, respectively), and BMI and WHR were positively correlated with the BDI and GHQ-12 scores. Clinicians should be aware of the increased risk of emotional distress and depression in women with PCOS, especially those who are obese, and of the need to screen these patients for such symptoms.
Reversible Acute Cortical Blindness Associated With Eclampsia in Complete Hydatidiform Mole
(Springer London Ltd, 2011) Adali, E.; Kurdoglu, M.; Avcu, S.; Yildizhan, R.; Adali, F.; Kolusari, A.
Eclampsia is rare in molar pregnancy. Sudden cortical blindness in eclampsia is an uncommon but very dramatic experience for the patient. Because of its rarity, blindness associated with eclampsia may pose a significant problem for the obstetrician. We describe cortical blindness and posterior reversible encephalopathy syndrome (PRES) complicating molar pregnancy-related eclampsia. The clinical presentation in our patient was consistent with PRES associated with eclampsia together with magnetic resonance imaging (MRI) findings. Preeclampsia and eclampsia are regarded as common causes of PRES, which is considered to be the result of vasogenic brain edema caused by a rapid raise in blood pressure. Clinical and imaging findings are usually reversible. Early diagnosis and elimination of possible causes are important in order to avoid permanent visual or brain injury. Imaging (especially MRI) should be carried out in eclamptic patients with visual disturbance in order to exclude other causes of blindness.
Serum Retinol-Binding Protein 4, Leptin, and Plasma Asymmetric Dimethylarginine Levels in Obese and Nonobese Young Women With Polycystic Ovary Syndrome
(2011) Yildizhan, R.; Ilhan, G.A.; Yildizhan, B.; Kolusari, A.; Adali, E.; Bugdayci, G.
Objective: To evaluate retinol-binding protein 4 (RBP4), leptin, and asymmetric dimethylarginine (ADMA) levels in young women with polycystic ovary syndrome (PCOS) and to investigate their relationship with each other and with clinical, metabolic, and hormonal parameters. Design: Clinical study. Setting: University hospital. Patient(s): Fifty-seven young women with PCOS (obese [n = 27] and nonobese [n = 30]) and 27 age-matched healthy controls. Intervention(s): History and physical examination, peripheral venous blood sampling. Main Outcome Measure(s): Asymmetric dimethylarginine, RBP4, leptin, LH, FSH, DHEAS, total T, E2, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglyceride (TG), and homeostasis model assessment insulin resistance index (HOMA-IR). Result(s): Obese women with PCOS had significantly higher HOMA-IR, DHEAS, leptin, RBP4, and ADMA levels. Leptin levels were significantly increased in nonobese subjects with PCOS. Leptin and ADMA levels were positively correlated with HOMA-IR in PCOS. There was no correlation between RBP4 and HOMA-IR. Leptin, RBP4, and ADMA levels are positively correlated in PCOS. Conclusion(s): [1] Young obese women with PCOS have increased ADMA, RBP4, and leptin levels, and they are positively correlated with each other. [2] The increased levels of leptin are independent of obesity, and leptin seems to have an association with IR. [3] Levels of RBP4 may not reflect IR in PCOS. © 2011 by American Society for Reproductive Medicine.
Sigmoid Volvulus in Pregnancy and Puerperium: a Case Series
(2009) Kolusari, A.; Kurdoglu, M.; Adali, E.; Yildizhan, R.; Sahin, H.G.; Kotan, C.
Intestinal obstruction due to sigmoid volvulus during pregnancy is rare. The presenting signs/symptoms seen in these patients are the same as with non-pregnant patients. Fetal and maternal mortality rates are higher during pregnancy due to delays in diagnosis. We aimed to present four patients diagnosed with sigmoid volvulus during pregnancy and puerperium in our clinic. Diagnosis requires a high index of suspicion in a patient who presents with complaints of abdominal pain and evidence of bowel obstruction. Prompt intervention is necessary to minimize maternal and fetal morbidity and mortality. © 2009 Kolusari et al.; licensee Cases Network Ltd.