Browsing by Author "Gul, Murat"

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Association Between Parathyroid Hormone Levels and the Extensiveness of Coronary Artery Disease
(Kare Publ, 2016) Alsancak, Yakup; Kiziltunc, Emrullah; Sezenoz, Burak; Ozkan, Selcuk; Alsancak, Aybuke Demir; Gul, Murat; Cengel, Atiye
Objective: Previous studies have suggested that there is a relationship between coronary artery disease (CAD) and parathyroid hormone (PTH) levels. Here, we aimed to evaluate the association between PTH levels and severity of CAD. Methods: Patients were divided into two groups based on their serum PTH values. Patients with PTH levels = 72 pg/mL were accepted as Group 1 (n=568) and >72 pg/mL as Group 2 (n=87). Gensini score system and > 50% stenosis in any coronary artery with conventional coronary angiography were used to determine the extensiveness of CAD. This study was designed as a prospective and cross-sectional study. Results: Baseline characteristics except for age, gender, and blood pressure were similar between groups. Mean serum PTH levels of the entire cohort was 43.4 +/- 29.5 pg/mL. Median Gensini score was 19.5 in Group 1 and 14.5 in Group 2 (p=0.75). On the other hand, PTH levels were weakly correlated with Gensini score (Spearman's Rho=0.11, p=0.003). Additionally, we did not observe a statistically significant difference between PTH levels and the number of stenotic vessels (p=0.14). This study was designed as a prospective and cross-sectional study. Conclusion: There is no association between serum PTH levels and extensiveness of CAD.
Exploring the Impact of Sexual Positions on Ejaculation: Insights From a Survey Study by the Andrology Working Group of the Society of Urological Surgery in Turkey
(Wiley, 2024) Gul, Murat; Sahin, Ali; Dogan, Cagri; Ceker, Gokhan; Altintas, Emre; Deliktas, Hasan; Gul, Umit
Background: Sexual position is one of the several aspects that affects ejaculation control, which is essential for sexual pleasure. Still little is known, nevertheless, about the connection between sexual positions and ejaculation duration. Objective: To investigate the impact of various sexual positions on the duration of ejaculation and gain a deeper understanding of the elements that influence the ability to control ejaculation. Method: An online survey was carried out on a sample of 1904 heterosexual men between the ages of 18-65 years. Premature ejaculation (PE) diagnostic tool was used to define PE. Demographic, behavioral, and physiological traits that are linked to PE and non-PE groups were collected. The participants listed their preferred sexual positions and the ones they changed to during ejaculating. Also, analyses were performed between male/female active or deep/shallow thrust positions and PE status. Results: Although there were no appreciable variations in age or circumcision between PE and non-PE groups, the age of first sexual experience was associated with PE status. Groups also varied in the number of weekly ejaculations, the duration of the favored ejaculations, and the characteristics of the erection. The most preferred sexual posture was the doggy style regardless of the group. When the non-PE group felt to ejaculate, they preferred to change the position significantly more than the PE group (74% vs 67.2%; p < 0.05). However, when participants felt ejaculate, non-PE participants tended to switch to shallow thrusting positions significantly more than PE participants, who preferred deeper positions (27.1% vs. 18%; p < 0.05). Conclusion: This study underlines the relevance of considering sexual positions in controlling PE. Modifying positions during sexual intercourse may offer a non-pharmacological therapeutic alternative for improving ejaculation control. Future studies in this field might help to create tailored PE treatment strategies.
Massive Pulmonary Embolism and a Cardiac Mass: Thrombus or Metastasis
(Turkish Soc Cardiology, 2016) Gul, Murat; Babat, Naci; Ucar, Fatih Mehmet; Kuyumcu, Mevlut Serdar; Ozeke, Ozcan
Cardiac mass can be described as an abnormal structure within or directly contiguous to the heart. Tumors and thrombi are the most common types of cardiac masses. Intracardiac thrombi have been encountered in various clinical settings and can result in severe morbidity and mortality due to embolic events. Cardiac neoplasms are extremely rare, and are usually metastatic tumors. The major primary malignancies associated with cardiac metastases include cancers of the lung, breast, stomach, and liver, and lymphoma, leukemia, and melanoma. Osteosarcoma (OS) is the most common type of bone malignancy, and is almost always highly malignant. A previous study demonstrated that OS very rarely metastasizes to the heart. Presently reported is an unusual case of OS with intracaval, right atrial, and right ventricular extension that was misdiagnosed as venous thrombus.
Turkish Physicians Approach To Lesbian, Gay, Bisexual, Transgender, and Other Gender and Sexual Minority Individuals and Their Sexual Health
(Oxford Univ Press, 2025) Ceker, Gokhan; Arda, Ersan; Cakici, Ozer Ural; Gul, Murat; Ibis, Muhammed Arif; Kutman, Kerem Gencer; Bal, Harun
Background: Lesbian, gay, bisexual, transgender, and other gender and sexual minority (LGBT+) individuals often face healthcare disparities, and physicians' knowledge, attitudes, and clinical preparedness significantly impact access to competent care. Aim: This study evaluated Turkish physicians' perspectives, knowledge, and clinical approaches to LGBT+ sexual health, highlighting educational and clinical gaps. Methods: A nationwide cross-sectional survey was conducted among physicians from 10 specialties involved in LGBT+ sexual health. The survey, administered anonymously via Google Forms between June 4, 2024, and February 1, 2025, included sociodemographic questions and items assessing attitudes, clinical experience, and guideline familiarity. Statistical analyses included descriptive statistics, chi-square, Fisher's exact tests, and binary logistic regression to identify predictors of physician attitudes and perceived competence. Outcomes The primary outcome was to assess physicians' perspectives, competency, and willingness to provide LGBT+ healthcare, including gender-affirming procedures. Results: Among 745 participants, 58.8% considered LGBT+ identities normal, while 22.9% classified them as psychiatric disorders. Perceiving LGBT+ identities as normal was significantly associated with being female (OR = 3.12, 95% CI: 1.96-4.96, P < .001), prior experience treating LGBT+ patients (OR = 2.22, 95% CI: 1.60-3.07, P < .001), and physician specialty. This view was most common among psychiatrists (P = .012) and child and adolescent psychiatrists (P = .015). Physicians' views were primarily shaped by education (43.2%) and socio-cultural environment (40.9%). Although 63.9% had treated LGBT+ patients, only 28.2% felt competent, and 11.5% were aware of relevant guidelines. Only 18% of surgical specialists supported gender-affirming procedures. The most commonly cited reason for reluctance was lack of surgical experience (44.8%), along with concerns related to religious beliefs, absence of a surgical team, and potential surgical complications. Ethical dilemmas were evident, as 58.3% believed LGBT+ patients face discrimination in healthcare, and 21.9% supported a physician's right to refuse care based on personal beliefs. Clinical Implications: Enhancing physicians' education and competency in LGBT+ healthcare through structured training and standardized guidelines is crucial to improving equitable healthcare delivery. Strengths and Limitations: This study provides novel insights into physicians' attitudes and practices regarding LGBT+ healthcare in Turkey. However, self-reported data may introduce response bias, and findings may not be fully generalizable to other regions. Conclusion: Significant educational and clinical gaps persist in LGBT+ healthcare. Addressing these through structured training programs, standardized protocols, and multidisciplinary collaboration is essential to ensuring competent, inclusive, and ethical medical care.