Browsing by Author "Guler, Ayse"

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Abnormal Liver Function Test in Hydatidiform Moles: a Retrospective Study Comparing the Hyperthyroid State and the Euthyroid State
(informa Healthcare, 2014) Kucukoglu, Mehmet Emin; Dulger, Ahmet Cumhur; Aslan, Mehmet; Olmez, Sehmus; Guler, Ayse; Aldemir, Mehmet Naci; Demirkiran, Davut
Introduction: The effect of a hyperthyroid or euthyroid state on liver function tests in patients with hydatidiform moles (HM) is not known. The aim of this study was to determine the effect of hyperthyroidism on liver transaminases in HM. Patients and methods: We retrospectively reviewed aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in 80 patients with HM (23 complete moles and 57 partial moles). Results: Of the 80 HM patients, 52 (65%) were euthyroid and 28 (35%) were hyperthyroid. The number of gravida and the levels of serum beta-human chorionic gonadotropin (beta-HCG), AST, and ALT were significantly higher in the hyperthyroid state than in the euthyroid state (p = 0.033, p = 0.001, p = 0.001 and p = 0.001; respectively). Number of gravida, serum TSH and total T4 were significantly higher in complete HM than partial HM (p < 0.05, p < 0.001, p < 0.05; respectively). Conclusions: Our results demonstrated that HM-related beta-HCG may activate thyroid cells via TSH-related signalling, resulting in the release of high levels of FT4, FT3, TT3 and TT4, and a subsequent decrease in TSH.
Approach To Scorpion Stings During Pregnancy: Two Cases
(Galenos Yayincilik, 2011) Guler, Ayse; Karadas, Sevdegul; Kurdoglu, Zehra
Introduction: Although there are many studies in the literature about scorpion stings and scorpion venoms, data on maternal and fetal effects during gestation is very little. In this paper, we presented two pregnant cases who applied to our clinic because of scorpion sting and discussed the management of scorpion envenomation with literature. Cases: Two pregnant women at 32 and 24th gestational weeks admitted to the emergency department with the complaint of scorpion sting. Physical, ultrasonographic examinations and laboratory results were normal. Clinical staging of the scorpion sting was stage I in both patients. No gestational complications occured during follow of the patients who were offered hospitalisation and managed with supportive treatment. Both patients delivered healthy babies vaginally at term. Conclusion: In management of scorpion stings during pregnancy, observation and supportive treatment are sufficient when the patient is at stage I.
Are Consanguineous Marriage and Swaddling the Risk Factors of Developmental Dysplasia of the Hip
(Springer, 2013) Guner, Sukriye Ilkay; Guner, Savas; Peker, Erdal; Ceylan, Mehmet Fethi; Guler, Ayse; Turktas, Ugur; Kaki, Baris
The purpose of this study was to investigate prospectively the effects of swaddling and consanguineous marriage on developmental dysplasia of the hip and associated risk factors. We screened by ultrasound 265 infants using the Graf method. The Pediatrics Department referred all newborn infants with suspected instability or a recognized risk factor to the orthopedic clinic. Risk factors of developmental dysplasia of the hip were searched and noted in these patients. Swaddling and consanguineous marriage were also determined and noted. We observed 164 of 265 infants (61.9 %) who had been swaddled and that 64 of 265 infants' parents were in a consanguineous marriage (24.2 %). In the statistical analysis that was conducted for swaddling and consanguineous marriage, highly significant differences were found. Our study showed that the rate of developmental dysplasia of the hip is very high, 11.7 %, in our region, eastern Turkey. Also, we commonly see improper swaddling and consanguineous marriage in our region, which affects many infants.
Clinical and Echocardiographic Follow-Up in Pregnant Patients With Valvular Heart Disease
(Turkish Soc Cardiology, 2013) Gumrukcuoglu, Hasan Ali; Guler, Ayse; Odabasi, Dolunay; Simsek, Hakki; Sahin, Musa; Akdag, Serkan; Tuncer, Mustafa
Objectives: Pregnancy associated cardiovascular changes may result in a significant hemodynamic burden and can lead to morbidity and even mortality in women with cardiac disease. The present study aimed to evaluate clinical and echocardiographic follow-up in pregnant patients with valvular heart disease (VHD). Study design: The medical records of pregnant patients diagnosed with VHD from January 2004 to January 2011 were screened. Demographic characteristics including history of cardiac intervention performed during pregnancy, pulmonary edema, and maternal and fetal mortality, and cesarean section (C/S) history were collected from the hospital database and clinical records of the cardiology and obstetrics departments. The echocardiographic examination was carried out at presentation, 3rd trimester, and 1 month after delivery. The outcomes evaluated were cardiac intervention, pulmonary edema, and both fetal and maternal mortality during pregnancy and C/S. Results: We evaluated the outcomes of 884 pregnant patients with VHD. Adverse clinical outcomes including death, pulmonary edema, and valvular interventions were frequent among patients with severe VHD, whereas no adverse clinical outcome was observed in patients with mild-moderate VHD (n=49, 5.5% vs. n=0, 0%, p<0.001). In patients with severe VHD, clinical outcomes were frequent among patients with valve stenosis, but lower among patients with regurgitation [death 4 (0.45%) vs. 0 (0%); pulmonary edema (15 (1.7%) vs. 13 (1.5%); valvular intervention 11 (1.2%) vs. 6 (0.7%); respectively). Conclusion: Valvular heart disease is associated with fetal/maternal morbidity and mortality. Pregnant with severe VHD constitute a high-risk group in which life-threatening complications are likely to occur in the course of pregnancy.
Comparison of the Efficacy of Intrauterine Lidocaine, Paracervical Block and Oral Etodolac for Decreasing Pain in Endometrial Biopsy
(Galenos Yayincilik, 2010) Guler, Ayse; Sahin, H. Guler; Kucukaydin, Zehra; Erdemoglu, Evrim
Objective: To compare the effectiveness of paracervical block, intrauterine lidocaine and oral etodolac in decreasing the pain caused by pipelle endometrial sampling. A secondary goal of this study was to determine the adverse effects and compare possible effects of these methods on pulse and blood pressure. Material and Methods: The study was performed between April 2006 and October 2006 in the Obstetrics and Gynecology Department of Van Yriziincji Yil University Research Hospital. One-hundred twenty patients were randomized into four groups: 1. Group: Paracervical block was performed with 3 ml 2% prilocaine solution. 2. Group: Five ml of 2% lidocaine solution was instilled through the endocervix into the uterine cavity. 3. Group: Subjects received 400 mg oral etodolac tablet 1-1.5 hour before the procedure. 4. Group: No method of anesthesia was used in the control group. Endometrial sampling was performed with pipelle. Severity of pain during the procedure was scored by the subjects according to the "6-point Verbal Rating Scale (VRS)". Blood pressure and pulse rate were measured before, during and 30 minutes after the procedure. Results: Pain scores in intrauterine lidocaine group (2"d group) were found statistically significantly lower than the other three groups (p<0.05). Conclusion: Intrauterine lidocaine anesthesia technique decreases pain in endometrial sampling with pipelle more efficiently than paracervical block or oral etodolac. While indication of menorrhagia and endometrial thickness more than 5 mm increased pain scores, intrauterine lidocaine application or paracervical block decreased tyre scores significantly (p<0.05).
Ectopic Intrauterine Device in the Bladder of a Pregnant Woman
(Hindawi Ltd, 2010) Kurdoglu, Zehra; Ceylan, Kadir; Kurdoglu, Mertihan; Guler, Ayse; Sahin, Hanim Guler
Background. Uterine perforation and transvesical migration of an intrauterine device are rare complications. Case. A 28-year-old woman who had an intrauterine device was admitted to our outpatient clinic with complaints of amenorrhea lasting 5 weeks and pelvic pain lasting a year. Transvaginal ultrasonography revealed embedding of the intrauterine device in the bladder. The misplaced device was removed by laparotomy. Conclusion. The followup of intrauterine device localization with transvaginal ultrasonography is essential for early detection of possible serious complications.
Evaluation of Sexually Abused Cases in Childhood in Eastern Turkey
(Galenos Yayincilik, 2010) Kurdoglu, Mertihan; Kurdoglu, Zehra; Guler, Ayse; Ozgokce, Cagdas
Objective: To evaluate the cases who were consulted to Department of Obstetrics and Gynecology in Yuzuncu Yil University Faculty of Medicine for sexual abuse. Design: A retrospective study. Setting: Yuzuncu Yil University Faculty of Medicine, Department of Obstetrics and Gynecology, Van. Patients: Sexually abused children in the 4-14 age group. Interventions: None Main Outcome Measures: Demographic characteristics and physical findings of sexually abused children. Results: When the records between January 2007 and July 2009 were examined, it was determined that 52 children in the 4-14 age group had been sexually abused. Of these, 42 (80.77) were girls and 10 (19.23%) were boys. Of girls, hymen defloration was detected in twelve (28.57 %), anal abuse in 7 (16.67 %), and both in 4 cases (9.52%). Of boys, anal abuse was detected in 6 (60%) while signs of physical violence were observed in 7 cases (70%). It was understood that, while four (9.52%) girls and 2 (20%) boys were abused by more than one person at the same time; 3 of girls (7.14%) and 1of boys (10%) were repeatedly abused by the same individual or individuals. Conclusions: Since child sexual abuse in our region is often hidden due to ethnic and cultural values, we think that sexually abused children are actually much more than we have detected.
Is Time of Childbirth Affected by Chronotype of the Mother
(Taylor & Francis Ltd, 2013) Guler, Ayse; Aydin, Adem; Selvi, Yavuz; Dalbudak, Tuna
We have investigated if biological rhythms, which affect many physiological and pathological events, influence the time of birth. Two hundred and sixty-three cases who were hospitalized with a diagnosis of active labor and who delivered vaginally were enrolled in the study. Information about the age, gravidity, parity, gestational age on admission, and time of onset of labor and birth was registered. A Morningness-Eveningness Questionnaire (MEQ) was administered for determining the patients' chronotypes and dividing them into a morning- or evening-type group. While 20 (35%) of the morning-types delivered between 18:00 and 24:00h, only 11 (19%) of them delivered between 06:00 and 12:00h. From the evening types, 6 (33%) delivered between 18:00 and 24:00h and 3 (17%) between 06:00 and 12:00h. We conclude that there was no statistically significant difference between the chronotypes in terms of delivery time.
A Retrospective Analysis of Acute Poisoning During Pregnancy
(Galenos Yayincilik, 2011) Karads, Sevdegul; Guler, Ayse; Aydin, Irfan
Objective: The aim of this study is to investigate and analyse pregnant women who were admitted to our emergency service due to acute poisoning. Material and Methods: All cases were retrospectively collected from our computer records and emergency record book between 01.01.2006 and 01.01.2010; the registration data on age, gravidity, gestational week, whether the poisoning was deliberate or accidental, causative agent, admission time, treatment results and mortality outcome were collected and analyzed. Results: Eighty eight women admitted with acute poisoning were known to be pregnant and the poisoning was accidental in 23% of the cases, while 77% were suicidal intoxications. 74% of patients were in the 21-34 age group. Accidental intoxications were due to carbon monoxide, foods and cleaning products. 75.4% of the suicidal poisonings were caused by medical drugs, with analgesics, multiple drugs and psychiatric drugs being the top culprits and accounted for 53%, 31% and 16% of drug poisonings respectively. In terms of gestational week, 47.4% of suicidal poisonings were within the first trimester and the relationship between suicidal attempt and gestational week was found to be statistically significant (p<0.015). However, the relationship between gravidity and the rate of suicidal attempts was not statistically significant (p=0.214). All patients were followed up and treated in the emergency service and no mortality was observed in the study. Conclusion: Most cases of acute poisonings during pregnancy were suicidal. Pregnant women attempted suicide mostly within the first trimester of gestation. The most common agents used for suicidal attempt were medical drugs.
Serum Advanced Oxidation Protein Products, Myeloperoxidase and Ascorbic Acid in Pre-Eclampsia and Eclampsia
(Wiley, 2006) Noyan, Tevfik; Guler, Ayse; Sekeroglu, Mehmet Ramazan; Kamaci, Mansur
Background: Activation products from neutrophils and the complement system might cause endothelial dysfunction, which is central to the aetiology of pre-eclampsia. This study aimed to investigate the activity of myeloperoxidase (MPO), and its association with advanced oxidation protein products (AOPP), in women with pre-eclampsia and eclampsia. Materials and method: Twenty-one pregnant women with pre-eclampsia, 11 pregnant women with eclampsia and 19 healthy pregnant women were studied. Serum levels of malondialdehyde (MDA), AOPP, ascorbic acid (AA) and activities of MPO and catalase (CAT) were measured using a colorimetric method. Results: The MDA level was significantly higher in the pre-eclampsia (3.15 +/- 0.28 nmol/mL) and eclampsia (4.01 +/- 0.66 nmol/mL) groups than in controls (1.85 +/- 0.18 nmol/mL); the difference between MDA levels in the pre-eclampsia and eclampsia groups was not statistically significant. MPO activity was significantly higher in the eclampsia (347.59 +/- 88.06 U/L) group than in the pre-eclampsia (196.17 +/- 30.8) and control (93.22 +/- 9.52) groups, and there was also no significant difference in these levels between the pre-eclampsia and control groups. CAT activity was significantly higher in the pre-eclampsia (166.35 +/- 31.75 U/L) and eclampsia (166.98 +/- 40.31 U/L) groups than in controls (81.28 +/- 7.41 U/L), and AA level was significantly higher in the pre-eclampsia (0.54 +/- 0.15 mg/dL) group than in controls (0.18 +/- 0.01 mg/dL); the differences in AA and CAT activity between the pre-eclampsia and eclampsia groups were not statistically significant. AOPP levels did not change significantly among the control, pre-eclampsia and eclampsia groups (106.88 +/- 5.62, 98.89 +/- 6.47, 111.89 +/- 6.8 mu mol/L, respectively). Conclusions: We suggest that increased oxidative stress might contribute to the pathophysiological mechanisms of pre-eclampsia and eclampsia, and that AA and CAT might have a protective role via free radical-scavenging properties. However, further study is needed.
Transcervical Intrauterine Levobupivacaine Infusion or Paracervical Block for Pain Control During Endometrial Biopsy
(Spandidos Publ Ltd, 2012) Kosus, Nermin; Kosus, Aydin; Guler, Ayse; Simavli, Serap A.; Turhan, Nilgun O.
The aim of this study was to determine pain during endometrial biopsy by comparing the use of intrauterine instillation of levobupivacaine or paracervical block with a placebo in a randomized, double-masked trial in premenopausal and postmenopausal women. A total of 90 women were enrolled in the study. Patients were allocated to either the control or case groups. Group 1 consisted of 30 cases with intrauterine anesthesia with 5 ml 0.5% levobupivacaine. Group 2 consisted of 30 patients who underwent paracervical block with lidocaine. No analgesic agent was given to the remaining 30 patients; these cases comprised the control group. The primary outcome measures were pain or discomfort experienced during the procedure. When the pain scores of the different groups were compared, the scores in the intrauterine levobupivacaine and paracervical block groups were found to be significantly lower compared to those in the control group. There was no difference between the levobupivacaine and paracervical block groups in terms of pain scores. There was a marked positive correlation between biopsy indications and pain scores. Pain scores were lower in cases with the indication of polymenorrhea, hypermenorrhea and metrorraghia compared to those in the cases with other indications. In conclusion, the transcervical intrauterine instillation of levobupivacaine or paracervical block with lidocaine brings about pain relief during and after endometrial biopsy.
Türkiye'nin Doğusunda Çocukluk Çağındaki Cinsel İstismar Olgularının Değerlendirilmesi
(2010) Kurdoğlu, Mertihan; Özgökçe, Çağdaş; Kurdoğlu, Zehra; Guler, Ayse
Amaç: Yüzüncü Yıl Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Bölümü’ ne cinsel istismar nedeniyle konsülte edilen olguları değerlendirmek. Planlama: Retrospektif çalışma Ortam: YYÜ Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniği, Van Hastalar: Cinsel istismara uğrayan 4-14 yaş grubundaki çocuklar Girişim: Yok Değerlendirme Parametreleri: Cinsel istismara uğrayan çocukların demografik özellikleri, muayene bulguları. Sonuç: Ocak-2007 ile Temmuz-2009 tarihleri arasındaki kayıtlar incelendiğinde, 4-14 yaş grubunda 52 çocuğun cinsel istismara uğradığı tespit edilmiştir. Bunlardan 42’sini kız ( % 80.77) 10’ unu erkek (%19.23) çocuklar oluşturmaktadır. Kız çocuklardan 12’ sinde (%28.57) hymen deflorasyonu, 7’ sinde (%16.67) anal livata, 4’ ünde (%9.52) her iki durum da tespit edilmiştir. Erkek çocukların 6’sında ( %60) anal livata, 7’sinde (%70) fiziksel darp hali görülmüştür. Dört kız (%9.52) ve 2 erkek (%20) çocuğunun aynı anda birden fazla kişi tarafından istismara uğrarken kızlardan 3’ ünün (%7.14) erkeklerden 1’ inin (%10) aynı kişi veya kişiler tarafından defalarca istismar edildiği anlaşılmıştır. Yorum: Bölgemizde çocuğa cinsel istismar, çoğu kez etnik ve kültürel değerler nedeniyle gizlendiği için cinsel istismara uğrayan çocukların gerçekte daha fazla olduğunu düşünmekteyiz.