Browsing by Author "Yildizhan, R."

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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.
Evaluation of Maternal Mortality Ratio and Causes in a University Hospital in Eastern Turkey
(S.O.G. CANADA Inc., 2015) Kurdoglu, Z.; Dalbudak, T.; Kurdoglu, M.; Yildizhan, R.; Sahin, H.G.
Aim: To investigate the maternal mortality ratio (MMR) and causes of maternal death in order to decrease these deaths. Materials and Methods: The number of live births, maternal deaths, and the causes of deaths in Yuzuncu Yil University were recorded between 2004 and 2013. Results: The MMR was 268 per 100,000. Forty-nine maternal deaths were examined in terms of cause. The most frequent cause of death is eclampsia (33%) and associated intracerebral complications. The antenatal follow-up rate was 23.3%. The majority of patients had low income (92.3%), 72.2% were from rural areas, and 95.5% were illiterate. Conclusion: The high MMR may arise from the high incidence of pregnancy complications in eastern Turkey, the rareness of antenatal follow-ups, and the present hospital being a referral hospital. The most frequent cause of maternal mortality is eclampsia and associated complications, followed by bleeding.
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.
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.
Management of Gastric Cancer With Liver Metastasis in a Pregnant Woman
(Yuzuncu Yil Universitesi Tip Fakultesi, 2017) Cim, N.; Karaman, E.; Toktas, O.; Gunes, G.; Elci, E.; Andıc, E.; Yildizhan, R.
The complaints and symptoms of gastric cancer are non-specific and many of these symptoms are frequently masked by factors related to normal pregnancy. A 38 year-old woman with G10P8A1 and at 31 weeks of pregnancy was admitted to a maternity outpatients’ clinic complaining of nausea, vomiting and constipation during the previous 4 days. On palpation a solid lesion of 1.5 cm was palpable in the subxiphoid region. A solid nodule with largest diameter of 5 cm was observed on the liver and suspected to indicate metastasis. Under endoscopic examination, ulcerovegetan, fragile and malignant mass that surrounded and narrowed the gastric antrum and extended to an angular notch was seen. The biopsy that was taken from lesion was revealed to be the result of a malignant epithelial tumor of poorly differentiated adenocarcinoma. During the explorative laparotomy, a tumoral mass with multiple peripheral lymphadenopathies was observed in the posterior gastric antrum, pancreas and colon median entry-invasive artery. Multiple metastases were present in the omentum and liver with a large amount of acid in the abdomen. The patient was considered inoperable due to the gastric cancer being in a terminal stage and adjuvant chemotherapy was planned. Early diagnosis and treatment is important for the prognosis of gastric cancer. The complaints and symptoms of gastric cancer are non-specific and many of these symptoms are similar to those seen during a normal pregnancy. If the same symptoms recur during pregnancy or there is a failure to respond to therapy, the gastrointestinal system should be evaluated endoscopically. © 2017, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Maternal and Fetal Outcomes in Caesarean Sections Repeated Fourth and Fifth Times
(Univ West indies Faculty Medical Sciences, 2021) Karaman, E.; Cim, N.; Cetin, O.; Oruc, H.; Gunes, G.; Yildizhan, R.
Objective: To evaluate the maternal and fetal outcomes associated with caesarean sections (CS) repeated fourth and fifth times. Methods: We performed a retrospective study of 110 patients undergoing CS repeated fourth and fifth times between May 2014 and May 2015. The patients were divided into two groups: group 1 had CS repeated four times (n = 90) and group 2 had CS repeated five times (n = 20), and the maternal and fetal outcomes of the groups were retrospectively evaluated. Results: There were no statistically significant differences between fourth and fifth CS groups with regard to the maternal age, gravida, body mass index, gestational age at birth, birth-weight, and Apgar scores at 5 minutes (p > 0.05). We found no significant differences between the fourth and fifth CS groups in terms of injury to peripheral organs, intra-abdominal adhesions, caesarean hysterectomy, uterine dehiscence or rupture, time during operation, length of hospital stay, and need for blood transfusions (p > 0.05). Compared with the elective cases, perioperative complications and length of hospital stay were significantly higher in the urgent group (p = 0.034 and p = 0.005). Conclusion: Women with CS repeated four or five times have increased risks for perioperative complications. Placenta previa with or without accreta and intra-abdominal adhesions seem to be the major causes of increased morbidity.
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 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.
The Role of Lipoproteins in Stages of Women Life
(Nova Science Publishers, Inc, 2011) Yildizhan, R.; Yildizhan, B.P.; Anik, G.; Yildizhan, G.
Cardiovascular disease, especially atherosclerosis is a consequence of multiple metabolic disorders. Polycystic ovary syndrome (PCOS) is the most common hormonal disorder of reproductive aged women, affecting 5-10% of this population. PCOS traditionally a reproductive disorder showing hyperandrogenism, infertility and chronic anovulation is now considered as a multifaceted disease with metabolic and cardiovascular long term consequences. Dyslipidemia, hypertension, endothelial dysfunction, low grade chronic inflammation are risk factors for cardivascular problems. Dyslipidaemia is very common in patients with polycystic ovary syndrome. It has been suggested that atherogenic lipoprotein abnormalities may be found in one third of women with PCOS who have normal lipid profile. Determination of high risk population may be important for preventive therapy and may provide reduction of cardiovascular risks. Lifestyle interventions play an important role in the prevention of metabolic complications. Moderate-intensity exercise without significant weight loss was found to have beneficial effects on lipoprotein profiles of women with PCOS. Metabolic syndrome is associated with increased risk for cardiovascular disease and type 2 diabetes mellitus. The role of lipoproteins is important in the management of the syndrome. Many combinations of drugs have been studied to treat dyslipidemia and reduce cardiovascular risk. Aging and menopause are the main causes that lead to an adverse lipid profile in women. The incidence of coronary heart disease increases after menopause and obesity may exaggerate the unfavorable lipid profile. Diet and lifestyle changes should be recommended as first line therapy. Treatment should be individualised for each patient and if the lipid profile can not be improved drug therapy should be added. The importance of the lipoproteins should be kept in mind to lower coronary heart disease in stages of women life. © 2010 Nova Science Publishers, Inc.
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.
Transvaginal Ultrasonography and Saline Infusion Sonohysterography for the Detection of Intra-Uterine Lesions in Pre- and Post-Menopausal Women With Abnormal Uterine Bleeding
(Sage Publications Ltd, 2008) Yildizhan, B.; Yildizhan, R.; Ozkesici, B.; Suer, N.
This prospective study investigated 79 pre- and 25 post-menopausal women with abnormal uterine bleeding who underwent conventional transvaginal ultrasonography (TVS) and saline infusion sonohysterography (SIS) and compared the results with histopathological findings obtained by dilatation and curettage, hysteroscopy or hysterectomy. Histological examination revealed normal endometrial histology in 28 patients, intracavitary polyps in 46 patients, submucosal fibroids in 18 patients, intramural fibroids in six patients and endometrial hyperplasia in six patients. The sensitivity and specificity of TVS in detecting endometrial polyps were 65.2% and 87.9%, respectively, compared with 91.3% and 93.1% for SIS. The sensitivity and specificity of TVS in detecting uterine fibroids were 95.8% and 95.0%, respectively, versus 91.6% and 98.7% for SIS. These results show that SIS is a satisfactory method of identifying lesions and that it is easy and cost-effective, and improves on the diagnostic utility of TVS. SIS is also a less invasive alternative to hysteroscopy, so should result in less morbidity in the evaluation of abnormal uterine bleeding in women.
Two Markers in Predicting the Cardiovascular Events in Patients With Polycystic Ovary Syndrome: Increased P-Wave and Qt Dispersion
(verduci Publisher, 2015) Akdag, S.; Cim, N.; Yildizhan, R.; Akyol, A.; Ozturk, F.; Babat, N.
OBJECTIVE: Polycystic ovary syndrome (PCOS) is a prevalent disease with many potential long-term cardiovascular risks. P-wave dispersion (Pdis) and QT dispersion (QTdis) have been shown to be noninvasive electrocardiographic predictors for development of cardiac arrhythmias. In this study we aimed to search Pdis and QTdis parameters in patients with PCOS. PATIENTS AND METHODS: The study included 82 patients with PCOS and 74 age-and sex-matched healthy controls. Baseline 12-lead electrocardiographic and transthoracic echocardiographic measurements were evaluated. P-wave maximum duration (Pmax), P-wave minimum duration (Pmin), Pdis, QT interval, heart rate-corrected QT dispersion and QTdis were calculated by two cardiologists. RESULTS: Patients wirh PCOS had significantly higher QT dispersion (49.5 +/- 14.1 vs. 37.9 +/- 12.6 ms, p < 0.001), and P wave dispersion (54.2 +/- 11.4 vs. 45.9 +/- 10.1 ms, p < 0.001) than the controls. Serum testosterone and estradiol levels was correlated with the Pdis (r = 0.677, p < 0.001 and r = 0.415, p < 0.001 respectively) and QTdis (r = 0.326, p < 0.001 and r = 0.321, p < 0.001 respectively). CONCLUSIONS: Pdis and QTdis are simple and useful electrocardiographic markers which may be used in the prediction of the risk of adverse cardiovascular events in PCOS patients.