Browsing by Author "Sahin, H. Guler"

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Chemerin Level in Pregnancies Complicated by Preeclampsia and Its Relation With Disease Severity and Neonatal Outcomes
(Taylor & Francis inc, 2017) Cetin, Orkun; Kurdoglu, Zehra; Kurdoglu, Mertihan; Sahin, H. Guler
The aims of this prospective study were to detect maternal serum chemerin level in patients with preeclampsia and investigate its association with disease severity and neonatal outcomes. Maternal serum chemerin levels were significantly elevated in severe preeclamptic women (394.72 +/- 100.01ng/ml) compared to mild preeclamptic women (322.11 +/- 37.60ng/ml) and healthy pregnant women (199.96 +/- 28.05ng/ml) (p=.001). Maternal serum chemerin levels were positively correlated with systolic and diastolic blood pressure, C-reactive protein levels, homeostasis model assessment of insulin resistance, proteinuria, AST, ALT, and duration of hospitalisation. Gestational week at delivery, birthweight, and APGAR scores at 1 and 5min were negatively correlated with maternal serum chemerin level. A maternal serum chemerin level of >252.0ng/ml indicated preeclampsia with 95.5% sensitivity and 95.7% specificity. There was a positive correlation between maternal serum chemerin level and severity of preeclampsia. Additionally, adverse neonatal outcomes were significantly associated with high maternal serum chemerin levels.
Clinical and Perinatal Outcomes in Eclamptic Women With Posterior Reversible Encephalopathy Syndrome
(Springer Heidelberg, 2015) Kurdoglu, Zehra; Cetin, Orkun; Sayin, Refah; Dirik, Deniz; Kurdoglu, Mertihan; Kolusari, Ali; Sahin, H. Guler
Purpose To compare the clinical and perinatal outcomes in eclamptic women with and without posterior reversible encephalopathy syndrome (PRES). Methods This single-center, retrospective, cohort study was conducted between 2008 and 2013. The clinical and perinatal outcomes of eclamptic patients were obtained from hospital records. Magnetic resonance imaging was used for the diagnosis of PRES. Eighty-one eclamptic women were divided into two groups: 45 and 36 patients were included in the PRES and non-PRES groups, respectively. Results In the PRES group, headache and visual impairment together (60.0 %) were the most common presenting symptoms. In the non-PRES group, only headache was the most common (50 %) presenting symptom. Occipital and parietal lobes were the most frequently affected areas in the PRES group. Women in the PRES group had a higher body mass index value (p = 0.005), longer hospitalization time (p = 0.001), and higher level of proteinuria (p = 0.012) than those in the non-PRES group. Women in the non-PRES group had higher Apgar scores (p = 0.002) than those in the PRES group. Conclusions This study indicates that PRES manifests predominantly with headache and visual impairment together. Adverse neonatal outcomes are also common in these patients.
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).
The Effect of Oxytocin Infusion and Misoprostol on Neonatal Bilirubin Levels
(Springer Heidelberg, 2010) Sahin, H. Guler; Kolusari, Ali; Kamaci, Mansur; Kaynak, Canev; Tuncel, Hatice
To investigate the association of neonatal bilirubin levels with oxytocin and misoprostol use for labour induction. A total of 100 neonates were included in the study. The first group consisted of 50 healthy babies of women who had received oxytocin infusion and the second group consisted of 50 healthy babies of women who had received 25 mu g misoprostol every 4 h placed in the posterior fornix for labour induction. Bilirubin and haematocrit levels were measured in all on days 1 and 4 of the neonatal period. The levels of bilirubin in the oxytocin group were significantly higher than those in the misoprostol group on day 1 [4.42 +/- A 0.27 mg/dl versus 3.55 +/- A 0.28 mg/dl (P = 0.035)] while they were higher also on day 4 but was not significantly so [7.47 +/- A 0.63 mg/dl versus 6.86 +/- A 0.65 mg/dl (P = 0.525)]. The mean haematocrit levels on day 1 were 50.62 +/- A 1.23 and 58.04 +/- A 1.30 in groups 1 and 2, respectively, with a significant difference between them. The levels were 52.31 +/- A 1.27 and 58.96 +/- A 1.14 on day 4 and the difference was again significant. P < 0.05 indicated statistical significance. Labour induction with misoprostol and oxytocin does not seem to have harmful effects on bilirubin levels in the neonate.
Expression of Laminin Receptor 1 in Gestational Trophoblastic Diseases and Normal Placenta and Its Relationship With the Development of Postmolar Tumors
(Academic Press inc Elsevier Science, 2009) Kurdoglu, Mertihan; Bayram, Irfan; Kolusari, Ali; Erten, Remzi; Adali, Ertan; Bulut, Gulay; Sahin, H. Guler
Objectives. To investigate the expression of laminin receptor 1 (LR1), a non-integrin-type laminin receptor, in gestational trophoblastic diseases and normal first-trimester placenta, since it may play a role in controlling trophoblast invasion in normal and molar pregnancies. Methods. Paraffin sections from 24 gestational age controlled normal first-trimester placentas, 47 partial moles, 56 complete moles, 3 invasive moles, 4 gestational choriocarcinomas, and 1 placental-site trophoblastic tumor were studied immunohistochemically for expression of LR1. Results. In complete and partial moles, decidual cells showed significantly stronger LR1 protein staining compared to the normal placenta (p<0.01). When compared to the partial moles, weak staining in less than 33% of decidual cells was also more prominent in the normal placenta (p<0.05). Complete and partial moles, invasive moles, choriocarcinomas, and placental-site tumors did not differ from each other with respect to staining intensity. Strong immunostaining for LR1 in decidual cells, cytotrophoblasts, syncytiotrophoblasts, and extracellular matrix cells of partial and complete moles was not significantly correlated with the development of persistent postmolar gestational trophoblastic tumors. Conclusions. LR1 may be important in the pathogenesis of gestational trophoblastic diseases. The increased expression of LR1 in decidual cells of partial and complete moles may not influence the development of persistent gestational trophoblastic tumor. Since they are seen rarely, multicentric studies should be planned to study LR1 expression in invasive moles and gestational trophoblastic neoplasms. (C) 2009 Elsevier Inc. All rights reserved.
Ileal Penetration and Tubo-Ovarian Abscess in the Presence of an Intrauterine Device
(informa Healthcare, 2009) Kolusari, A.; Deveci, A.; Sahin, H. Guler
Increased Plasma Thrombin-Activatable Fibrinolysis Inhibitor Levels in Young Obese Women With Polycystic Ovary Syndrome
(Elsevier Science inc, 2010) Adali, Ertan; Yildizhan, Recep; Kurdoglu, Mertihan; Bugdayci, Guler; Kolusari, Ali; Sahin, H. Guler
Objective: To evaluate carotid intima-media thickness and thrombin-activatable fibrinolysis inhibitor levels in young women with polycystic ovary syndrome (PCOS) and age-matched healthy controls, and to investigate their relationship with each other and with clinical, metabolic, and hormonal parameters. Design: Clinical study. Setting: University hospital. Patient(s): Fifty young women with PCOS (overweight or obese [n = 24] and nonobese [n = 26]) and 25 age-matched healthy controls. Intervention(s): History and physical examination, peripheral venous blood sampling, carotid ultrasonography. Main Outcome Measure(s): Plasma thrombin-activatable fibrinolysis inhibitor, serum FSH, LH, DHEAS, total T, E-2, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, insulin resistance defined by the homeostasis model assessment insulin resistance index, and carotid intima-media thickness. Result(s): Plasma thrombin-activatable fibrinolysis inhibitor levels in the overweight or obese PCOS group were significantly higher than those in the nonobese PCOS and control groups. Carotid intima-media thickness did not significantly differ between the groups. Obesity and insulin resistance were associated positively with plasma thrombin-activatable fibrinolysis inhibitor levels, but there was no association between carotid intima-media thickness and thrombin-activatable fibrinolysis inhibitor. Conclusion(s): Young overweight or obese women with PCOS have increased plasma thrombin-activatable fibrinolysis inhibitor levels. Impaired fibrinolysis may be responsible for the increased risk of cardiovascular diseases in women with PCOS. (Fertil Steril (R) 2010;94:666-72. (C) 2010 by American Society for Reproductive Medicine.)
Management of Haemangiopericytoma Located in the Spinal Cord Diagnosed During Pregnancy
(Taylor & Francis inc, 2015) Kurdoglu, Z.; Cetin, O.; Bulut, G.; Erten, R.; Gulsen, I.; Sahin, H. Guler
Protective Effect of Erythropoietin on Ischemia-Reperfusion Model in Rat Ovary
(Ortadogu Ad Pres & Publ Co, 2010) Kolusari, Ali; Kamaci, Mansur; Zeteroglu, Sahin; Altunay, Hikmet; Sahin, H. Guler
Objective: In this study, the purpose was to investigate the effects of erythropoietin (EPO) on ischemia-reperfusion model that was made by experimental ovarian torsion- detorsion. Material and Methods: Twenty five Wister albino type rats were used in the study. They were randomly divided into three groups. Ten rats consisted the group that received no erythropoietin after the detorsion performed on 24th hour after ovarian torsion (group 1); 10 rats consisted the group that received intraperitoneal EPO after the detorsion that was performed at the 24th hour of ovarian torsion (group 2) and five rats consisted the sham group (group 3). After the surgical operation, right ovaries of all groups were excised on 7th day and blood samples were taken. Histopathologic findings and blood parameters of three groups were compared. Statistical analyses were made by SPSS package. One way ANOVA and t-test for independent samples were used. Results: Histopathologic findings of the group that received EPO were statistically different from the group that did not received EPO. In the group that did not receive EPO, tissue integrity deteriorated with partial necrosis and in some, there was near to total necrosis. In the group that received EPO, no necrosis was seen. After the treatment in the EPO administered group, the blood hemoglobin, hematocrit and red blood cell count were high and the differences were statistically significant. Conclusion: In ischemia-reperfusion model that was performed by ovarian torsion-detorsion, the histopathologic findings of the group that received EPO were different from the other groups, and the difference was statistically significant. In the cases of surgical detorsion that was made after ovarian torsion, intraperitoneal EPO injection had positive effects on tissue life.
Short-Term Results of Posterior Intravaginal Slingplasty in Grade 4 Uterine Prolapse
(Springer Heidelberg, 2010) Kolusari, Ali; Yildizhan, Recep; Adali, Ertan; Kurdoglu, Mertihan; Sahin, H. Guler; Kamaci, Mansur; Sivaslioglu, Akin
The purpose of this study was to evaluate the short-term efficacy and complication rates of posterior intravaginal slingplasty (IVS) procedures. Thirty-four patients who had advanced (grade 4) uterine prolapse were recruited. All patients underwent vaginal hysterectomy and the cuff was suspended with a posterior IVS operation. The mean follow-up duration was 12 months (range 3-20 months). Thirty-three patients (97.1%) had satisfactory level I support defined objectively as stage 0 or I for point C as described in the pelvic organ prolapse quantification system. There were no rectal, vesical, ureteric, or vascular injuries in this series. During the postoperative period no complications, including tape erosion, were seen. Posterior IVS is a minimally invasive procedure for grade 4 genital prolapse with a high success rate.
Side Effects and Acceptability of Implanon®
(Parthenon Publishing Group, 2007) Yildizbas, Beyhan; Sahin, H. Guler; Kolusari, Ali; Zeteroglu, Salim; Kamaci, Mansur
Objective To assess side effects during the first 6 months of use of Implanon (R). Design and methods The study was conducted in eastern Turkey between June 2004 and May 2005. Forty-one healthy women, aged 18-40 years who chose to use Irriplarion (R) participated in the study. The implant was inserted between days 1 and 5 of the menstrual cycle. Findings were recorded before and during 6 months following insertion. Statistical analyses were performed using SPSS package programme including paired samples t-test. Results No pregnancy occurred during the study. Ninety days after initiation of therapy, three of the 41 patients (7.3%) had regular periods, 14 (34.1%) were amenorrhoeic and the remaining 24 (58.5%) had some type of abnormal bleeding. Dysmenorrhoea affected significantly less women (1/41, i.e. 2.4%) than before treatment (17/41, i.e. 41.5%), but mastalgia increased significantly as it was reported by five previously unaffected participants (12.2%). Mood changes appeared in seven patients (17.1%) and acne in 11 of them (26.8%). The circulating levels of protein C, total cholesterol and oestradiol dropped significantly. Endometrial thickness decreased significantly. At completion of the study period, removal of the implant was requested by eight of the 41 patients (19.5%) because of irregular bleeding (six women), depressive symptoms requiring treatment (one woman) or weight gain (one woman). Conclusions Mainly because of irregular bleeding, the discontinuation rate of Implanon(9 at 6 months among the women in this region is high (19.5%).
Umbilical Artery Erythropoietin Levels in Preeclamptic Pregnancies
(Galenos Yayincilik, 2006) Sahin, H. Guler; Surucu, Ramazan; Zeteroglu, Fiahin; Ustun, Y. Engin; Ustun, Yusuf; Kamaci, Mansur; Kolusari, Ali
Objective: The aim of this study was to determine the levels of umbilical artery erythropoietin (EPO) levels and to evaluate its relation with clinical findings. Material and Methods: In this prospective study, 26 normal (Group I), 25 mild preeclamptic (Group II) and 17 severe preeclamptic (Group III) pregnant women whose gestational ages were between 37-42 weeks were enrolled. After the delivery, blood samples were taken from the umbilical artery of double clamped umbilical cord and umbilical artery EPO levels and blood gas parameters were analyzed. Sociodemographic findings, labor properties and physical examination of neonates were recorded. The blood gas parameters, EPO levels, their relationships with clinical findings of the groups were evaluated. Statistical analyses were performed by SPSS 9.05 statistical package program. Results: There were no statistical differences between gravidity, parity and gestational ages of the groups (p> 0.05). Maternal ages were significantly higher in the second group when compared with the others (p< 0.05). Systolic and diastolic blood pressures were statistically different in the groups (p< 0.05), and the highest levels were found in the third group. Birth weights were; 3480.76 +/- 431.75, 3373.20 +/- 846.83 and 2497.05 +/- 859.83 grams in group I, group II and group III, respectively (p< 0.05). First minute Apgar scores were 8 (ranges between 7-10) in the first group, 8 (ranges between 3-9) in the second group and 6 (ranges between 3-9) in the third group (p< 0.05). Umbilical cord pH levels were 7.35 +/- 0.06, 7.25 +/- 0.11 and 7.19 +/- 0.09; base excess (BE) levels were -4,71 +/- 2,02, -6.53 +/- 3.98 and -9.29 +/- 3.82 mmol/L; EPO levels were 30.0 (9.2-122), 62.5 (11.0-549) and 167.4 (10.1-908) mU/ml, respectively, and the differences between the groups were statistically significant (p< 0.05). In the Spearman bivariate correlation analysis, there was no significant relation between maternal age and EPO levels. There was significant positive correlation between EPO levels and systolic, diastolic blood pressures, pCO2 levels, and, significant negative correlation between first, fifth minute Apgar scores, birth weight, umbilical cord blood pH and BE levels. Conclusions: After delivery umbilical artery EPO levels showed significant correlation with severity of preeclampsia and, clinical and biochemical determinants of perinatal hypoxia. Our results support that erythropoietin can be used as a biochemical determinant of chronic fetal hypoxia that is caused by preeclampsia.
Uterine Rupture: a Twelve-Year Clinical Analysis
(informa Healthcare, 2008) Sahin, H. Guler; Kolusari, Ali; Yildizhan, Recep; Kurdoglu, Mertihan; Adali, Ertan; Kamaci, Mansur
Objective. To review the experience of uterine rupture at a tertiary obstetric unit in Eastern Turkey and to propose preventive measures. Methods. All uterine rupture cases managed from November 1995 to March 2007 at the Department of Obstetrics and Gynecology of the Medical School of Yuzuncu Yil University, Van, Turkey, were analyzed retrospectively. Results. There were 33 cases of uterine rupture with an incidence of 1/287 deliveries. Of these, 72.72% had complete and 27.27% had incomplete uterine rupture. Of the patients, 39.39% had a scarred uterus, 90.90% received no antenatal care, 60.60% were referred after various interventions had been attempted, and 42.42% required subtotal or total hysterectomy. The maternal mortality rate was 15.15% and the perinatal mortality rate was 42.42%. Conclusions. Improvements in antenatal care, reduction in cesarean rates, the place where the birth occurs, and skilled attendants are important factors in reducing uterine rupture.