Browsing by Author "Alkis, Ismet"

Now showing 1 - 18 of 18

Accurately Localizing the Thyroid Tissue in Mature Cystic Teratoma of Ovary by Single-Photon Emission Computerized Tomography/Computerized Tomography
(Wolters Kluwer Medknow Publications, 2015) Demir, Yusuf; Ucler, Rifki; Alkis, Ismet; Bulut, Gulay
A 30-year-old woman with hyperthyroidism was admitted to hospital. Although increased thyroid function was found, the gland was normal in ultrasonography (USG). Additionally, thyroid iodine uptake and Tc-99m pertechnetate scintigraphy was normal. Abdomen USG detected a cystic pelvic mass in left ovary. A whole-body scan was performed 48 hours after oral ingestion of 29.6 MBq (0.8 mCi) 1-131 (iodine-131) revealed a round structure located to the left lower abdomen. Iodine uptake was detected in this cyst which was compatible with functional thyroid tissue demonstrated by SPECT/CT. The patient was underwent surgical operation and histopathology confirmed mature cystic teratoma. Accurate localization and depiction of thyroid tissue in ovary mass was provided with SPECT/CT.
Biomechanical Effects of Menopause in Ovariectomized Rats' Femurs
(informa Healthcare, 2014) Okyay, Ayse Guler; Kavak, Servet; Turktas, Ugur; Alkis, Ismet; Guner, Savas; Aksakal, Bunyamin
Objective: To demonstrate the biomechanical changes in rat bones occurred by surgical menopause and to search for correlation between biomechanical test results and bone mineral density (BMD) measurements. Methods: Thirty female Wistar-albino rats aged 6 months and weighed 250-300 g were randomized into ovariectomy, sham and control groups. After 6 months, rats were sacrificed and right femurs were extracted. BMD measurements and three point bending biomechanical tests were made in femurs. Results: The difference among the mean BMD measurements of three groups were found to be statistically significant (Pr>F value <0.0001). Mean elastic module, maximum elongation and femoral diameters were also found to be statistically significantly different (Pr>F value <0.05). Ovariectomised and sham-operated groups were significantly different in terms of elastic modulus. Ultimate force did not differ among the groups significantly. The difference between ultimate strain and maximum elongation of the ovariectomy and sham operated group was statistically significant. Conclusions: Bone quality was deteriorated and fragility was increased in rats 6 months after surgical menopause. Sole BMD measurement might not be reliable in evaluation of osteoporosis and fracture risk. Biomechanical quality of bone is more important than its mineral content in determining fragility.
Biomechanical Effects of Menopause in Ovariectomized Rats' Femurs (Vol 30, Pg 62, 2014)
(informa Healthcare, 2014) Okyay, Ayse Guler; Kavak, Servet; Turktas, Ugur; Alkis, Ismet; Guner, Savas; Aksakal, Bunyamin
Comparison of Topical Lidocaine Spray With Forced Coughing in Pain Relief During Colposcopic Biopsy Procedure: a Randomised Trial
(Taylor & Francis inc, 2019) Karaman, Erbil; Kolusari, Ali; Alkis, Ismet; Cetin, Orkun
Our objective was to compare the effectiveness of local lidocaine spray (LS) compared to forced coughing (FC) for relieving the pain during colposcopically guided cervical biopsies (CGBs). The study was a randomised study, which included patients with abnormal cervical cytologic results requiring a colposcopic biopsy procedure. The patients were randomly assigned to either the 10% LS or the FC groups before the biopsy procedure. As a primary outcome, the pain was assessed by using a 10cm visual analogue scale at the different steps during the procedure. Forty-four and 42 patients had CGBs using LS and FC, respectively. The age, parity, body mass index, history of previous curettage and vaginal delivery, smoking status and the number of biopsies were similar in both groups. The meanSD pain scores after the cervical biopsy were 3.251.4 and 4.41.3 in the LS and FC groups, respectively (p<.05). The operative time was longer in the LS than in the FC group (7.6 +/- 1.4 vs. 5.2 +/- 0.8, p: .004). No complication or adverse effect was observed in both groups. The present study showed that LS use can be recommended for pain relief during colposcopically directed cervical biopsy procedure with a superiority to the FC in the terms of pain and absence of any adverse reactions.Impact StatementWhat is already known on this subject? A colposcopic-guided cervical biopsy is a painful procedure and different techniques have been proposed to relieve this pain with conflicting results. Studies have demonstrated that a forced coughing is a good and easy method for relieving pain with some disadvantages. Local lidocaine spray (LS) is another option for pain relief during the biopsy procedure. However, no randomised study has compared these two methods yet.What the results of this study add? The results from this randomised study suggest that LS has superiority in terms of pain relief during the colposcopic biopsy procedure and has no adverse reactions.What the implications are of these findings for clinical practice and/or further research? The evidence from different studies showed some conflicting results regarding the pain relief methods during the colposcopic biopsy procedure. The local LS can be used in this procedure in routine clinical practice. However, further studies with larger samples and comparison of different methods are needed.
Conservative Management of Postpartum Hemorrhage
(Elsevier Taiwan, 2015) Karaman, Erbil; Alkis, Ismet; Han, Agahan; Ark, Hasan Cemal; Buyukkaya, Betul
The Effect of Drospirenone/Estradiol Treatment on Catalase and Carbonic Anhydrase Enzyme Activities, and Some Mineral Concentrations in Ovariectomized Rats
(Parlar Scientific Publications (p S P), 2011) Alkis, Ismet; Kavak, Servet; Meral, Ismail; Oto, Gokhan; Demir, Halit
This study was designed to investigate the effect of drospirenone/estradiol (Angeliq (R)) on erythrocyte CAT and CA enzyme activities, and serum Fe, Mg, Co, Cu, Zn, Pb, Mn and Cd concentrations in ovariectomized- and drospirenone/estradiol-treated rats. Forty Female Wistar-albino rats were divided randomly into four groups, each consisting of ten rats. The animals in the first group were not treated, and served as control. The animals in the second group were operated but not ovariectomized and served as sham group. The animals in the third group were operated, ovariectomized but not treated with drospirenone/estradiol and served as ovariectomized group. The animals in the fourth group were operated, ovariectomized and treated with 0.01 mg/kg 17 beta-estradiol and 0.02 mg/kg drospirenone daily, p.o. for four weeks. Blood samples were collected at the end of the application period for the determination of the erythrocyte catalase (CAT) and carbonic anhydrase (CA) enzyme activities as well as serum Fe, Mg, Co, Cu, Zn, Pb, Mn and Cd concentrations. It was found that although erythrocyte CAT enzyme activity decreased in sham group, CA enzyme activity increased in angeliq group. Serum Pb levels of angeliq group and serum Mg levels of sham, ovariectomized and angeliq groups decreased. Serum Co, Cu, Mn and Fe levels increased in angeliq group. There was no significant difference among groups with regard to the serum Cd or Zn levels. It was concluded that hormonal replacement therapy might provide beneficial effects on blood antioxidant enzyme activity, heavy metal and some trace element levels in menopause. However, more studies are needed to verify and clarify the relationship between the hormonal replacement therapy and blood antioxidant status and trace element levels in menopause.
The Effect of Patient Position During Mid-Urethral Sling Operations on the Postoperative Outcomes of Sling Success: a Randomized Clinical Study
(Karger, 2016) Han, Agahan; Karaman, Erbil; Alkis, Ismet; Ark, Hasan Cemal; Akca, Aysu; Numanoglu, Ceyhun; Tunca, Aysun Fendal
Aims: To determine and compare the effectiveness, peri- and postoperative outcomes of mid-urethral sling (MUS) operations for urinary incontinence, using 2 different patient positions during surgery. Methods: In this study, 146 patients underwent MUS surgery in a urogynecology clinic. Of them, 72 patients underwent the intraoperative surgical procedure of reverse trendelenburg patient positioning for tape adjustment (group 1) and the remaining 74 patients had the routine surgical procedure of MUS surgery (group 2). The primary outcome was the evaluation of postoperative urine leaks, using the stress test, and secondary outcomes were quality of life, using the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF, Turkish version) and complication rates. Results: There were no significant differences in demographic variables between the 2 groups. The overall cure rates for incontinence in the lithotomy position was 97.22 and 85.13% for groups 1 and 2, respectively, in which group 1 had a statistically significant decrease in urine leak postoperatively (p < 0.05; OR 3.08, 95% CI 2.78-22.14). The postoperative ICQ-SF scores showed no significant difference between the 2 groups (p = 0.19). Conclusion: Applying a 45-degree reverse trendelenburg position for tape adjusting during MUS operation results in a greater objective cure rate compared with the typical dorsolithotomy position; however, there was no difference in the subjective outcome. (C) 2015 S. Karger AG, Basel
Evaluation of Mean Platelet Volume in Unruptured Ectopic Pregnancy: a Retrospective Analysis
(Taylor & Francis inc, 2016) Karaman, Erbil; Cim, Numan; Alkis, Ismet; Yildizhan, Recep; Elci, Gulhan
We aimed to investigate and compare the mean platelet volume (MPV) levels in ectopic and viable intrauterine pregnancy (IUP). The medical records of 78 unruptured tubal ectopic pregnancy patients (TEP, Group 1) and 150 patients with viable IUP (Group 2) served as control group between May 2014 and February 2015 in our clinic were retrospectively analysed. The demographic characteristics including age, parity, gravida, abortus, haemoglobin levels and leucocyte counts showed no statistically difference between two groups. The mean MPV level was significantly lower in TEP group compared to IUP group (8.69 +/- 1.14 and 10.06 +/- 1.46, p<0.001). The platelet (PLT) distribution width was higher in TEP group, however, there was no statistical difference between the two groups (p=0.078). The early diagnosis of TEP is crucial in order to prevent maternal morbidity and mortality. Our results showed that MPV is lower in TEP than IUP and it seems to be related with the possible inflammation at implantation site of tuba uterina. However, there is need for further studies for employing PLT indices in the diagnosis of TEP.
Evaluation of the Protective Effect of Chlorogenic Acid and Rhabdosciadium Anatolyi Against Cyclophosphamide-Induced Ovarian Toxicity in the Rat With Histopathological and Immunohistochemical Findings
(Kafkas Univ, veteriner Fakultesi dergisi, 2020) Alkis, Ismet; Ekin, Suat; Yildirim, Serkan; Bakir, Ahmet; Eser, Gizem; Firat, Mehmet
Cyclophosphamide (CD) has a range of adverse effects on ovarian tissue in humans. It is widely an anticancer drug and used in autoimmune disorders. Also, CD produces reactive oxygen species. In the current study, we evaluated possible protective roles of Rhabdosciadium anatolyi (RA) and chlorogenic acid (CA) on histopathological alterations and immunohistochemical assessment of 8-OHdG in the ovarian tissues of female rats given cyclophosphamide. Female Wistar albino rats were divided into six experimental groups, each consisted of eight rats: control group, CD (200 mg/kg) with i.p. for the first day as single dose, CA (100 mg/kg), RA (300 mg/kg) for each day, RA (300 mg/kg) + CD (200 mg/kg) and CA(100 mg/kg) + CD (200 mg/kg) groups. The rats were administered treatments lasted 7 days for all groups. CA and RA treatment is associated with positive the ovary action CD-induced ovotoxicity in rats. CA and RA could ameliorate the histopathological and immunohistochemical finding restoring which may show moderate levels of primordial follicle, primary, secondary, tertiary and graafian follicles were observed degeneration in germinative cells.Therefore, our results suggest that chlorogenic acid and Rhabdosciadium anatolyi might be a protective effect for CD-induced ovotoxicity.
The Fertility Sparing Management of Postpartum Hemorrhage: a Series of 47 Cases of Bakri Balloon Tamponade
(Elsevier Taiwan, 2015) Alkis, Ismet; Karaman, Erbil; Han, Agahan; Ark, Hasan Cemal; Buyukkaya, Betul
Objective: To evaluate the success rate of Bakri balloon tamponade (BBT) for managing postpartum hemorrhage (PPH), intractable to conservative medical treatment, as a fertility sparing intervention. Materials and methods: We evaluated 47 women treated with BBT who had severe postpartum hemorrhage and uncontrollable bleeding due to failed treatment with uterotonic agents. The main outcome measure was successful management and preservation of the uterus. Results: Forty-seven women were identified for BBT treatment due to severe PPH. BBT was used to successfully manage hemorrhage in 43 patients, and there was no need for hysterectomy. Four patients required an additional surgical procedure. Of the four failures, a subtotal hysterectomy was performed in two patients, and the other two patients underwent a total hysterectomy. The overall success rate was 91.4%, which was comparable to rates reported earlier. The main cause of PPH was uterine atony (43%). Conclusion: Uterine preservation is an important issue when managing PPH. BBT is an effective, easy to use, and safe procedure for massive PPH that can minimize recourse to hysterectomy after failed medical treatment. Copyright (C) 2015, Taiwan Association of Obstetrics & Gynecology. Published by Elsevier Taiwan LLC. All rights reserved.
Local Resection May Be a Strong Alternative To Cesarean Hysterectomy in Conservative Surgical Management of Placenta Percreta: Experiences From a Tertiary Hospital
(Taylor & Francis Ltd, 2017) Karaman, Erbil; Kolusari, Ali; Cetin, Orkun; Cim, Numan; Alkis, Ismet; Yildizhan, Recep; Gul, Abdulaziz
Objective: To evaluate and describe a surgical approach for uterine preservation and management of postpartum hemorrhage in placenta percreta. Methods: We analyzed the data of patients who were diagnosed with placenta percreta prenatally and subsequently underwent cesarean section in which local resection technique was used to manage postpartum hemorrhage and uterine preservation at our tertiary care center between 2013 and 2016. The technique includes local resection of placental invasion site and suturing the new uterine edges. Results: The technique of local resection described above was successful in preserving the uterus and stopping the bleeding in 8 of 12 cases. The diagnosis of placenta percreta in all cases was confirmed intraoperatively and postoperatively by histological examinations. Four cases were resorted to hysterectomy. The mean number of transfused erythrocyte suspension was 4.82.6. One complication of bladder injury was encountered in which treated conservatively. Conclusion: Local resection of percreta site is an effective, safe and fertility preserving approach that can be applied to manage the postpartum hemorrhage and preservation of uterus in patients with placenta percreta.
Long Term Suppression of Oestrus and Prevention of Pregnancy by Deslorelin Implant in Rats
(Natl veterinary Research inst, 2011) Alkis, Ismet; Cetin, Yunus; Sendag, Sait; Wehrend, Axel
The experiments were designed to test the possibility to induce a down-regulation of pituitary GnRH-receptors and hence a suppression of oestrus by application of a long term deslorelin implant in female rats. Sixteen non pregnant female rats were randomly divided into two equal groups. The eight rats of the implant group (DESL) were subcutaneously implanted with long acting deslorelin implant, an analog of GnRH, at the dose of 4.7 mg, to inhibit oestrus. No treatment was applied to control group (CON). One adult male rat was added per cage of DESL and CON females after six weeks. Conceptions were diagnosed by inspection, palpation, and ultrasonography for one year. Conception rates were 0% and 100% in DESL group and CON group, respectively (P<0.001). An influence of the deslorelin insertion on the concentrations of progesterone and oestradiol - 17 beta was determined. Average hormone concentrations were statistically different between groups (P<0.01). In conclusion, the subcutaneous implantation of 4.7 mg of deslorelin is a practicable method for suppressing oestrus in rats. Further investigative studies will be required to determine upper time limit of down-regulation duration by deslorelin.
The Outcome of Manchester-Fotergill Operation for Uterine Decensus Repair: a Single Center Experience
(Springer Heidelberg, 2014) Alkis, Ismet; Karaman, Erbil; Han, Agahan; Gulac, Bekir; Ark, Hasan Cemal
The aim of this study was to evaluate the clinical characteristics, peri- and post-operative outcomes, and clinical effectiveness of the Manchester-Fothergill (MF) procedure for uterine descensus as a uterine-sparing surgery. In this study, 49 patients underwent the MF procedure as a uterine-sparing surgery for uterine descensus during 2008-2012 in the Department of Urogynecology at Kanuni Sultan Suleyman Research and Teaching Hospital, Istanbul, Turkey. Medical records and follow-up data were collected from 24 of the 49 patients (48.9 %). The mean age was 49.3 +/- A 9.1 years, and parity 3.6 +/- A 1.5; 41.6 % were post-menopausal; 6 patients (25 %) had grade II, and 18 (75 %) had grade III uterine prolapse; 95.8 % had associated cystoceles, and 79.1 % had associated rectoceles; 66.6 % complained of urinary incontinence. On follow-up examination, the cervical stumps were satisfactorily situated in 23 of 24 patients, and recurrent prolapse was seen in 1 patient (4.1 %). Bladder perforation was repaired at the time of the operation in 1 patient, and one complained of post-operative urinary retention. The MF procedure is a viable option to surgically correct uterine descent while preserving the uterus to treat recurrent prolapse with a low complication rate and low morbidity.
Rectal Indomethacin Use in Pain Relief During Hysterosalpingography: a Randomized Placebo Controlled Trial
(Wiley, 2016) Karaman, Erbil; Cim, Numan; Alkis, Ismet; Yildirim, Abdullah; Yildizhan, Recep
AimTo evaluate the effectiveness of a rectal nonsteroidal anti-inflammatory drug (indomethacin) for pain relief during a hysterosalpingography (HSG). Materials and MethodsThis prospective, randomized study included 82 women divided randomly into two groups. The study group received self-administered rectal indomethacin, while the control group received a placebo before the procedure. Degrees of pain were evaluated using the visual analog scale (VAS) at four different steps during the procedure and 30 min afterwards. The anxiety-depression status of the patients was evaluated using a validated Turkish version of the Beck anxiety-depression form before the procedure. ResultsThere were no statistically significant differences in the demographic characteristics of patients. The mean pain scores during tenaculum application (step 2), cervical traction (step 3), contrast injection (step 4) and 30 min after the procedure, were significantly lower in the study than the control group (P < 0.05). Step 4 was the most painful in both groups (VAS scores 3.2 0.6 study vs 5.3 +/- 1.1 control). The mean pain score in step 4 for patients with abnormal HSG results was significantly higher than in patients with normal HSG results (P < 0.05). The mean anxiety and depression scores immediately before the procedure were not statistically different between the groups (P = 0.610 and P = 0.129, respectively). ConclusionOur study demonstrated a significant reduction in pain in patients who received a single rectal dose of indomethacin; therefore, we recommend the use of rectal indomethacin for reducing pain during a HSG procedure.
Recurrent Gliosarcoma in Pregnancy
(Hindawi Ltd, 2014) Gulsen, Ismail; Ak, Hakan; Yilmaz, Tevfik; Bulut, Mehmet Deniz; Alkis, Ismet; Bayram, Irfan
Gliosarcoma is a rare tumor of the central nervous system and it constitutes about 1 to 8% of all malignant gliomas. In this report we are presenting a recurrent gliosarcoma case during a pregnancy in a 30-year-old woman. This is the first report presenting gliosarcoma in the pregnancy.
The Role of Trace Element, Mineral, Vitamin and Total Antioxidant Status in Women With Habitual Abortion
(Taylor & Francis Ltd, 2021) Sami, Awaz Sayfallah; Suat, Ekin; Alkis, Ismet; Karakus, Yagmur; Guler, Seyithan
Objective: In this study, women with habitual abortus (HA) and healthy control groups were determined for zinc (Zn), copper (Cu), manganese (Mn), selenium (Se), iron (Fe), cobalt (Co), chromium (Cr), nickel (Ni), lead (Pb), magnesium (Mg), calcium (Ca), sodium (Na), potassium (K), retinol, cholecalciferol, alpha-tocopherol, phylloquinone, total antioxidant (TAS) and total oxidation status (TOS) levels, also, and the relationships of these variables with HA were evaluated. Material and methods: The study included 39 women with HA and 39 healthy control subjects. In this study, trace element and mineral analyses by ICP-OES and vitamin analyses were determined using HPLC method. Results: Statistical analysis found that in the HA group was significantly lower than the control group with regarding cholecalciferol, phylloquinone, TAS, Se, Zn, Cu, Mg, K and Na levels (p < .05, p < .01, p < .01, p < .001, p < .05, p < .05, p < .01, p < .01 and p < .05). However, HA group was also significantly higher than control group regards to TOS, OSI and Ca forward slash Mg levels (p < .05, p < .001, p < .05). In the HA group, significantly positive correlations were observed between phylloquinone and Ca (r = 0.495; p = .027), also, indicates negative significant correlation between cholecalciferol and Co (r = -0.598; p = .031). Conclusion: Our findings indicate that the results could be helpful in the monitoring of women with HA in terms of deficiency. It is important that in terms of the evaluation of phylloquinone, cholecalciferol Se, Zn, Cu, Mg and Ca/Mg ratio is required to consider.
Tuberculosis Peritonitis-Related Ascites and Malign Ascites: How Can We Discrimate Them With a Simplier Way
(derman Medical Publ, 2016) Dulger, Ahmet Cumhur; Gonullu, Hayriye; Alkis, Ismet
What Should the Optimal Intrauterine Pressure Be During Outpatient Diagnostic Hysteroscopy? a Randomized
(Wiley, 2017) Karaman, Erbil; Kolusari, Ali; Cetin, Orkun; Cim, Numan; Alkis, Ismet; Karaman, Yasemin; Guler, Seyithan
Aim: The aim of this study was to evaluate and compare lower and higher uterine filling pressures during outpatient diagnostic hysteroscopy. Methods: One hundred and seventy-five women eligible for outpatient diagnostic hysteroscopy were included in this randomized double blind comparative study. The subjects were randomized into two groups. Group 1 (n = 80) underwent surgery with lower intrauterine filling pressures (30, 40, and 50 mmHg) and group 2 (n = 81) underwent surgery with higher filling pressures (70, 80, and 100 mmHg). The primary outcome measure was adequate visibility during the procedure. The secondary outcome measure was pain perceived by the patient during and 30 min after the procedure. Results: In total, 161 patients completed the trial. Group 2 had significantly higher adequate visibility than group 1 (71/80, 88.75% in group 1 and 79/81, 97.5% in group 2, P = 0.008). There was a trend toward increase in pain scores with higher pressures during the procedure. However, there were no significant differences between the two groups in terms of visual analog scale pain scores measured 30 min after the procedure. Conclusion: Lower uterine filling pressure was associated with lower pain scores with a higher trend towards inadequate visibility. It appears that higher filling pressure can be used for performing office hysteroscopy, but it is associated with higher pain scores.