Browsing by Author "Yildizhan, Recep"

Now showing 1 - 20 of 55

Acoustic Radiation Force Impulse Elastosonography of Placenta in Maternal Red Blood Cell Alloimmunization: a Preliminary and Descriptive Study
(Soc Romana Ultrasonografe Medicina Biologie-srumb, 2017) Cetin, Orkun; Karaman, Erbil; Arslan, Harun; Akbudak, Ibrahim; Yildizhan, Recep; Kolusari, Ali
Aims: Maternal red blood cell alloimmunization is an important cause of fetal morbidity and mortality in the perinatal period, despite well-organized prophylaxis programs. The objective of the study was to evaluate placental elasticity by using Acoustic Radiation Force Impulse (ARFI) in Rhesus (Rh) alloimmunized pregnant women with hydropic and nonhydropic fetuses and to compare those with healthy pregnant women. Material and methods: This case-control and descriptive study comprised twenty-eight healthy pregnant women, 14 Rh alloimmunized pregnant women with nonhydropic fetuses, and 16 Rh alloimmunized pregnant women with hydropic fetuses in the third trimester of pregnancy. Placental elasticity measurements were performed by ARFI elastosonography at the day of delivery. The maternal characteristics and neonatal outcomes of the patients were also noted. Results: The highest mean placental ARFI scores were observed in Rh alloimmunized pregnant women with hydropic fetuses (1.13 m/s) (p= 0.001). Healthy controls and Rh alloimmunized pregnant women with nonhydropic fetuses had similar mean placenta ARFI scores (0.84 m/s, 0.88 m/s, respectively) (p< 0.05). Conclusions: Based on the present findings, the placenta becomes stiffer in Rh alloimmunized pregnancies complicated with hydrops fetalis. The increased placental ARFI scores may be a supplemental marker for adverse pregnancy outcomes, additional to Doppler evaluation of middle cerebral artery. This data should be confirmed with a large sample size and prospective studies by using serial measurements of ARFI elastosonography in maternal red blood cell alloimmunization.
Analysis of Uterine Rupture Cases at a Tertiary Referral Center: a Retrospective Study
(2016) Karaman, Erbil; Çim, Numan; Çetin, Orkun; Güler, Hnım Şahin; Alkis, İsmet; Kolusarı, Ali; Yildizhan, Recep
Amaç: Komplet veya inkomplet uterin rüptür gelişen vakaların risk faktörlerini, perioperatif maternal-fetal sonuçlarını ve yönetim şekillerini retrospektif olarak belirlemektir. Gereç ve Yöntem: Bu çalışmada 2012 ile 2016 yalları arasında kliniğimizde uterin rüptür tanısı alan 28 hasta retrospektif olarak incelendi. Analiz için demografik bilgileri, risk faktörlerinin detayları, rüptürün tipi, yönetim şekli ve perioperatif maternal-fetal sonuçları ele alındı. Verilerin analizi için SPSS (ver: 20) istatistik programı kullanıldı. Bulgular: Çalışma döneminde %0.86 oranında 28 uterin rüptür vakası olduğu görüldü. Vakaların yirmisi (%71) inkomplet rüptür iken sekizi (%29) komplet rüptür idi. Vakalardan sadece 8'i kliniğimizde gelişen rüptür vakaları iken geri kalan 20 vaka kliniğimize dışarıdan refere edilen hastalardan oluşmaktaydı. Önceki uterus cerrahisi 22 hastada (%78.5) en sık görülen sebep idi. Bu hastalardan 18'inde 2 yada daha fazla geçirilmiş sezeryan öyküsü vardı. Grandmultiparite ikinci en sık görülen sebep idi(8 hasta). Uterin rüptür bölgesinin primer onarımı en sık yapılan cerrahi girişim idi (28 hastanın 25'inde, %89.2). Ana perioperatif komplikasyon 4 hastada (%14.2) görülen mesane yaralanması idi. Maternal mortalite görülmedi. Komplet rüptür grubunda kan transfüzyon ihtiyacı, ortalama hastanede kalış süresi, önceki sezeryanla doğum fetal ölüm ve mesane yaralanması inkomplet rüptür grubuna göre daha fazla görülmekteydi (p<0.05). Sonuç: Bu çalışma obstetrisyenlerin geçirilmiş uterin cerrahi yada grand multiparite gibi risk faktörleri olan hastalarda uterin rüptür gelişebileceği konusunda dikkatli olmaları gerektiğinin doğrulamaktadır. Uterin rüptür yönetiminde hızlı tanı, erken transport, yeterli kan ürünü transfüzyonu ve tecrübeli cerrahi ekibin varlığı çok önemlidir
An Analysis on the Roles of Angiogenesis-Related Factors Including Serum Vitamin D, Soluble Endoglin (Seng), Soluble Fms-Like Tyrosine Kinase 1 (Sflt1), and Vascular Endothelial Growth Factor (Vegf) in the Diagnosis and Severity of Late-Onset Preeclampsia
(Taylor & Francis Ltd, 2017) Cim, Numan; Kurdoglu, Mertihan; Ege, Serhat; Yoruk, Ibrahim; Yaman, Gorkem; Yildizhan, Recep
Aim: The aim of this study was to evaluate the roles of proangiogenic factors including serum vitamin D and vascular endothelial growth factor (VEGF) and anti-angiogenic factors including soluble endoglin (sEng) and soluble fms-like tyrosine kinase 1 (sFlt1) in the diagnosis and severity of late-onset preeclampsia. Materials and methods: The study was conducted at Yuzuncu Yil University Research and Education Hospital Department of Gynecology and Obstetrics. The study included a patient group of 40 women with late-onset preeclampsia who were pregnant at >= 32 weeks of gestation according to the last menstrual period (LMP) or ultrasonographic fetal biometric measurement and a control group of 40 healthy pregnant women who presented to our clinic for routine pregnancy examination and were at the same age and gestational period with those in the patient group. The two groups were compared in terms of maternal age, gravida, parity, week of gestation, systolic/diastolic blood pressure, total protein in spot urine sample, 24-h urine protein, white blood cell (WBC), hemoglobin (Hgb), platelet count, urea, creatinine, liver function tests (AST, ALT, LDH), vitamin D-3, 25(OH) vitamin D-3, 1,25(OH) vitamin D-3, sEng, sFlt1, and VEGF levels, mode of delivery, the infant APGAR score at 1 and 5 min after delivery, and infant weight at delivery. Results: The groups were similar in terms of age, gravida, parity, week of gestation, serum vitamin D-3, 25(OH) vitamin D-3, 1,25(OH)(2) vitamin D-3 and VEGF levels, and infant weight at delivery (p > 0.05). Systolic/diastolic blood pressure, total protein in spot urine sample, 24-h urine protein, WBC, Hgb, serum urea, creatine, AST, ALT, and LDH were significantly higher in the preeclamptic group compared to the healthy group (p < 0.05). However, thrombocyte level and the APGAR score at 1 and 5 min after delivery were significantly lower in the preeclamptic group compared to the healthy group (p < 0.05). No significant correlation was found between serum sEng, sFlt1, VEGF, vitamin D-3, 25(OH) vitamin D-3, and 1,25(OH)(2) vitamin D-3 levels. The sEng level was higher in the women with severe preeclampsia compared to the women with mild preeclampsia (p < 0.05) and no significant difference was observed in serum sFlt1, VEGF, vitamin D-3, 25(OH) vitamin D-3, and 1,25(OH)(2) vitamin D-3 levels between the subgroups of preeclampsia (p > 0.05). Conclusion: Both sEng and sFlt1 levels are remarkably high in patients with late-onset preeclampsia; however, only sEng may be a useful tool in the determination of the severity of preeclampsia.
Are the Skin Scar Characteristics and Closure of the Parietal Peritoneum Associated With Pelvic Adhesions
(Galenos Yayincilik, 2018) Cim, Numan; Elci, Erkan; Elci, Gulhan Gunes; Almah, Necat; Yildizhan, Recep
Objective: To assess whether the abdominal scar characteristics and closure of the peritoneum were associated with pelvic adhesions. Materials and Methods: Patients who had undergone cesarean section between December 2015 and February 2016 were assessed prospectively in terms of age, gravida, body mass index, number of living children, number of cesarean sections, time passed since the last cesarean section, closure status of the peritoneum in the last cesarean section, presence of other diseases, smoking status, location of incision in the abdomen (medial, pfannenstiel) scar dimensions (length, width), scar status with respect to skin (hypertrophic, flat, depressive), scar color [color change/no color change (hyperpigmented/hypopigmented)], adhesion of bowel-omentum-uterus, omentum-anterior abdominal wall, uterus-anterior abdominal wall, uterus-bladder, bladder-anterior abdominal wall, fixed uterus, and uterus-omentum-anterior abdominal wall in abdominal exploration. Results: One hundred five pregnant women who had undergone previous ceserean section surgery by the same physician, were at least in their 30th gestational week, had surgery notes about their previous operation, and had no chronic diseases were included in the study. Age, gravida, body mass index, number of children, number of cesarean sections, time passed since the previous cesarean section, closure/non-closure of peritoneum in the previous cesarean section, and smoking status had no effect on pelvic adhesions. Intraabdominal adhesion was not found to be associated with scar length [odds ratio (OR): 1.54, 95% confidence interval (CI): 1.1-2.2; p= 0.02], depressive scar (OR: 9.3, 95% CI: 3.2-27.2; p< 0.001), or hypopigmented scar [OR: 0.01, 95% CI: 0.003-0.11; p< 0.001]. Conclusion: Adhesions following surgical operations are of great importance due to complications for the patient, complications in relaparotomy, and high costs. Depressive and hypopigmented abdominal scars may be associated with pelvic adhesions. We believe that closure or non-closure of the parietal peritoneum is not associated with pelvic adhesions.
Brucellosis in Pregnancy: a 6-Year Clinical Analysis
(Springer Heidelberg, 2010) Kurdoglu, Mertihan; Adali, Ertan; Kurdoglu, Zehra; Karahocagil, Mustafa Kasim; Kolusari, Ali; Yildizhan, Recep; Akdeniz, Hayrettin
To review our experience with brucellosis in pregnancy and to characterize the risk factors, clinical presentations, the rates of possible perinatal complications, and the effect of hospitalization on pregnancy outcomes. We reviewed the medical records of 21 pregnant women at a tertiary care hospital and 12 at a maternity hospital, who presented with acute, subacute, chronic, or relapsing brucellosis. Their risk factors and clinical presentations were defined. The reproductive outcomes of 29 cases were compared within themselves according to the hospitals they were managed and with the outcomes for all women followed in the maternity hospital for the period from January 2008 through December 2008. Consumption of unpasteurized dairy products had occurred in 92.3% of the cases. Spontaneous abortion, intrauterine fetal death, and preterm delivery rates were 24.14, 3.45, and 6.9%, respectively. Only spontaneous abortion rate substantially exceeded that among the general population of pregnant women in our maternity hospital (P < 0.05). Hospitalization did not affect pregnancy outcomes significantly (P > 0.05). Brucellosis in pregnancy is associated with increased incidence of spontaneous abortion without an association with the magnitude of serum agglutination titer, the clinical type of brucellosis and hospitalization. In endemic areas with habitants of low socioeconomic class and low educational level, educating women of childbearing age about brucellosis may help to prevent the disease and its complications in pregnancy.
Comparison of the Effects of Chlormadinone Acetate Versus Drospirenone Containing Oral Contraceptives on Metabolic and Hormonal Parameters in Women With Pcos for a Period of Two-Year Follow-Up
(Taylor & Francis Ltd, 2015) Yildizhan, Recep; Gokce, Anik Ilhan; Yildizhan, Begum; Cim, Numan
Objective: A randomized trial to compare the effects of two oral contraceptive pills containing either chlormadinone acetate or drospirenone as the progestogen, in women with PCOS for a period of two-year follow-up. Methods: Group A received ethinyl-estradiol 0.03 mg + drospirenone 3 mg (EE+DRSP; n=56) and Group B received ethinyl-estradiol 0.03 mg + chlormadinone acetate 2 mg (EE+CMA; n=50). Clinical, hormonal and biochemical parameters were compared at baseline, 6 months, 12 months and 24 months. Results: The increase in total cholesterol and hsCRP levels was statistically significantly higher at 6, 12 and 24 months in Group B when compared with Group A. The change in the high-density lipoprotein cholesterol level at the 24 months of treatment was statistically significantly higher in Group A. Group A has a significantly higher reduction in FAI at 6 and 24 months, in FGS at 6, 12 and 24 months and in HOMA-IR index at 12 and 24 months when compared with Group B. Conclusions: Drospirenone containing combined oral contraceptive (COC) is found to have more favorable effects on lipid profiles, hsCRP levels, insulin resistance and hyperandrogenism when compared with the CMA containing COC and appears to be more beneficial for the long-term cardiovascular and metabolic aspects of PCOS.
Comparison of the Efficacy of Diclofenac and Indomethacin Suppositories in Treating Perineal Pain After Episiotomy or Laceration: a Prospective, Randomized, Double-Blind Clinical Trial
(Springer Heidelberg, 2009) Yildizhan, Recep; Yildizhan, Begum; Sahin, Sadik; Suer, Necdet
To compare the results in terms of effectiveness, side effects, and patient satisfaction when diclofenac and indomethacin suppositories were used for the relief of perineal pain after episiotomy or tearing during childbirth. A total of 200 women who had undergone mediolateral episiotomy or suffered lacerations while giving birth vaginally were randomly assigned to receive either rectal diclofenac or indomethacin. Pain ratings were recorded before the administration of drugs and at 1, 3, 6, 9, 12, and 24 h after the first dose on a 10 cm visual analog scale. Side effects and overall opinion on the two treatments were assessed at 24 h. The prophylactic use of diclofenac suppositories reduced perineal pain more than the use of indomethacin suppositories, although the difference was not significant. Overall additional analgesia requirement was correspondingly lower in the diclofenac group. There were no significant differences in overall patient satisfaction between the two groups. Since the two analgesics were rated similarly and gave satisfactory pain relief, diclofenac may be preferred because it is administered in a single dose and requires less nursing time to dispense and is a substantially less costly alternative to the new pain treatment technologies currently in use.
Does Residual Amniotic Fluid After Preterm Premature Rupture of Membranes Have an Effect on Perinatal Outcomes? 12 Years Experience of a Tertiary Care Center
(Springer Heidelberg, 2010) Kurdoglu, Mertihan; Kolusari, Ali; Adali, Ertan; Yildizhan, Recep; Kurdoglu, Zehra; Kucukaydin, Zehra; Kamaci, Mansur
To review our experience with preterm premature rupture of membranes at a tertiary-care hospital in Turkey to determine whether the amount of residual amniotic fluid after rupture has prognostic value for adverse maternal and fetal outcomes. We reviewed the medical records of 191 pregnant women with gestational ages between 24 and 34 weeks at the time of rupture of the amniotic membrane and of their babies delivered in our hospital between January 1996 and September 2008. On the basis of amniotic fluid index (AFI) values recorded at the time of admission, patients were categorized into two groups: those with an AFI < 50 mm (n = 119) and those with an AFI > 50 mm (n = 72). The patients with high gravidity (4-8) were more prevalent in the group with an AFI < 50 mm (37 vs. 23.6%), while nulliparous women were more common in the group with an AFI > 50 mm (44.4 vs. 30.2%) (P < 0.05). Seventy-two percent of the cesarean sections performed due to nonreassuring fetal status were in the group with an AFI < 50 mm (P < 0.01). In 71.4% of the cases with a 5 min Apgar score a parts per thousand currency sign 7, AFI was less than 50 mm (P < 0.01). AFI < 50 mm was present in 65, 70.8, 76.7, and 73.1% of the pregnancies complicated by chorioamnionitis, respiratory distress syndrome, composite neonatal morbidity, and neonatal death, respectively (P < 0.05). A residual AFI < 50 mm after preterm PROM between 24 and 34 weeks of gestation, which is mostly seen in grand multiparous women in Eastern Turkey, may be a valuable prognostic variable for anticipating adverse maternal and neonatal outcomes.
Domestic Violence Against Infertile Women in a Turkish Setting
(Elsevier Ireland Ltd, 2009) Yildizhan, Recep; Adali, Ertan; Kolusari, Ali; Kurdoglu, Mertihan; Yildizhan, Begum; Sahin, Guler
Objective: To investigate the prevalence of domestic violence against infertile women in a Turkish setting. Methods: A total of 122 women with primary infertility attending an obstetrics and gynecology outpatient clinic were interviewed using the Abuse Assessment Screen questionnaire to investigate their experiences of domestic violence. Results: In total, 41 (33.6%) women had experienced domestic violence because of their infertility. Of these women, 32 (78%) had experienced domestic violence for the first time in the relationship with the current partner following diagnosis of female factor infertility. The percentage of nonabused and abused infertile women who were mostly satisfied with their sexual lives was 56.87% and 29.2%, respectively (P<0.05). Conclusion: Routine screening for domestic violence in infertility clinics is necessary to give affected women an opportunity to access appropriate health care and support services. (C) 2008 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Doppler Analysis of Uterine Perfusion and Ovarian Stromal Blood Flow in Polycystic Ovary Syndrome
(Wiley, 2009) Adali, Ertan; Kolusari, Ali; Adali, Fulya; Yildizhan, Recep; Kurdoglu, Mertihan; Sahin, Hanim Guler
Objective: To investigate blood flow velocity in the ovarian stromal artery and uterine artery in women with polycystic ovary syndrome (PCOS) and to correlate these velocities with clinical and biochemical parameters. Methods: A prospective study was carried out in 55 patients with PCOS and 42 age-matched women who did not have PCOS. Clinical, biochemical, and hormonal characteristics, and utero-ovarian Doppler ultrasound blood flow parameters were determined, and correlations between the parameters were evaluated. Results: Ovarian stromal blood flow was higher (P<0.01) and uterine perfusion was lower (P<0.01) in women with PCOS compared with women who did not have PCOS. Ovarian stromal artery pulsatility index (PI) was inversely correlated with levels of dehydroepiandrosterone sulfate (DHEAS) and insulin-like growth factor-1, and with the luteinizing hormone/follicle-stimulating hormone ratio. There was a positive correlation between uterine artery PI and DHEAS level. Conclusion: Doppler analysis of the uterine and intraovarian arteries may provide additional information about the etiopathogenesis of PCOS and partly explain the clinical implications of the condition. (C) 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Early Prenatal Diagnosis of Conjoined Twins: Case Series
(Aras Part Medical int Press, 2015) Cetin, Orkun; Kurdoglu, Zehra; Cim, Numan; Yildizhan, Recep; Sahin, Guler; Kurdoglu, Mertihan
Introduction: Conjoined twins are complicated and unusual form of monozygotic twins. We present early prenatal diagnosis of three cases of conjoined twins by 2-dimensional (2D) ultrasound between 9-10 weeks of gestation. Case presentation: In the first case, we prenatally diagnosed parapagus dicephalus dibrachus dipus with 2-dimensional ultrasound at gestational age of 10 weeks 4 days. In the second case, we detected parapagus dicephalus at the 10 weeks 2 days gestation. In the third case, we diagnosed thoracopagus at the 9 weeks 6 days of gestation, using 2D ultrasound. After proper counselling, all of the patients opted early pregnancy termination due to the poor prognosis of conjoined twins. Conclusion: Early prenatal detection of conjoined twinning is important for the gestational course. Conjoined twinning could be identified in early first trimester with cautious and comprehensive view by experienced sonographers. Early and accurate prenatal diagnosis of conjoined twinning allows preferable counselling of the parents and gives a chance for early termination of pregnancy.
Effects of Two Combined Oral Contraceptives Containing Ethinyl Estradiol 30 Μg Combined With Either Gestodene or Drospirenone on Hemostatic Parameters, Lipid Profiles and Blood Pressure
(Springer Heidelberg, 2009) Yildizhan, Recep; Yildizhan, Begum; Adali, Ertan; Yoruk, Pinar; Birol, Fatih; Suer, Necdet
The aim of this study is to compare the effect of ethinyl estradiol 0.03 mg/gestodene 0.075 mg (EE/GSD) with ethinylestradiol 0.03 mg/drospirenone 3 mg (EE/DRSP) administered according to conventional 21/7 regimen on body mass index (BMI), blood pressure (BP), lipid metabolism and hemostatic parameters. In this study, 160 healthy women were randomized to EE/GSD mg or EE/DRSP for 12 months. Mean differences in BMI, high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C), total cholesterol (TC) levels and BP compared to baseline were assessed. One hundred and forty-five (89%) of the women completed all 12 treatment cycles. The subjects randomly assigned into two treatment groups. Group EE/GSD (n = 71) and group EE/DRSP (n = 72). In group B, BMI values were significantly lower than baseline at the sixth cycle. DRSP/EE had more favorable effects on BP than GSD/EE with the mean systolic and diastolic BPs remaining lower in the DRSP/EE group. The difference between the two preparations was not statistically significant at the end of the study. TC levels remained similar in both groups throughout the study period. In both groups LDL-C levels decreased, triglyceride and HDL-C levels significantly increased from baseline levels. These changes result in increasing HDL-C/LDL-C ratio, demonstrating anti-atherogenic effect. Menstrual cycle patterns and the incidence of adverse events were similar between groups. The duration of withdrawal bleeding decreased during the study for both groups and was similar. The EE/DRSP regimen provides good cycle control with reliable contraceptive efficacy and low incidence of adverse events. Compared with the EE/GSD preparation, the EE/DRSP preparation demonstrated a more favorable effect on BMI and BP with the mean BMI and mean BP remaining lower than baseline mean. The new formulation may be especially beneficial for women susceptible to body weight gain and rise in BP.
Ektopik Gebelik Tedavi Yaklaşımında Laboratuvar Mı? Fertilite mi
(2017) Elçi, Gülhan Güneş; Elçi, Erkan; Yildizhan, Recep; Çim, Numan
Amaç: Bu çalışmanın amacı kliniğimizde son üç yılda ektopik gebelik tanısı ile tedavi edilen olguların tanı ve tedavi yaklaşımlarının irdelenerek tedavi başarı oranlarımızın belirlenmesidir.Yöntem ve Gereçler: Haziran 2013- Kasım 2016tarihleri arasında ektopik gebelik nedeniyle tedavi edilen140 olgunun bilgilerine ulaşılabilen 111 olgu yaş, gravida,yaşayan çocuk sayısı, önceki gebeliği, kontrasepsiyonyöntemi, pelvik cerrahi öyküsü, hemodinamik stabilite,başlangıç ?-hCG düzeyi, ultrasonografide batında serbestsıvı bulunup-bulunmadığı, adneksial alanda bulgu varlığı,bekle-gör yöntemi, methotrexate (MTX) ve cerrahi tedaviedilen olgu sayısı retrospektif olarak değerlendirildi.Bulgular: Olguların yaş ortalaması 29±5,6, obstetriköykülerinde; önceki gebelikleri abortus %12,6 (n=14),sezaryen ile doğum %12,6 (n=14), vajinal yol ile doğum%39,6 (n=44) idi. Daha önceki gebeliğinde ektopikcerrahisi geçirme oranı %3,6 (n=4) ve olguların%17,1'inde (n=19) geçirilmiş pelvik cerrahi öyküsü vardı.İlk başvuruda olguların %21,6'sında (n=24) hipovolemikbulgular mevcuttu, %78,4 olgunun (n=87) hemodinamisistabil ve ektopik gebelik rüptür bulguları yoktu. Buolguların ilk yaklaşımlarında ise, %23,4'ü (26) sadeceizlenirken (bekle-gör), %55'ine (n=61) medikal tedavi,%21,6'sına (n=24) cerrahi tedavi uygulandı. Bekle-göryaklaşımında bulunulan olgularda başarı oranı %77, tekdoz MTX tedavisinin başarı oranı %64 bulundu.Methotrexate tedavisi alan 2 olguda 2.doz MTX ile başarıelde edilemeyince cerrahi tedavi uygulandı. Cerrahi tedaviuygulanan 52 olgudan %75'ine (n=39) salpenjektomi,%19,2'sine (n=10) salpingostomi, %2'sine (n=1)salpingotomi ve %3,8'ine (n=2) overyal wedge rezeksiyonyapıldı.Sonuç: Rüptür bulguları olmayan, genel durumu stabilhastalarda methotrexate ve bekle-gör tedavisi ilk seçenekolarak önerilebilir. Cerrahi tedavi genellikle genel durumve fertilite durumu düşünülerek tercih edilmeli vetedavide organ koruyucu cerrahi ön planda tutulmalıdır.
Energy Drinks May Affect the Ovarian Reserve and Serum Anti-Mullerian Hormone Levels in a Rat Model
(Galenos Yayincilik, 2021) Elci, Erkan; Elci, Gulhan Gunes; Cim, Numan; Aras, Ibrahim; Sayan, Sena; Yildizhan, Recep
Objective: Energy drinks have an impact on concentration levels, physical performance, speed of reaction, and focus, but these drinks cause many adverse effects and intoxication symptoms. The main goal of this study was to determine the effect of energy drink consumption on ovarian reserve and serum anti-mullerian hormone (AMH) levels. Materials and Methods: Female Wistar albino rats (n=16) were included and randomized into two groups (n=8). Serum AMH levels were checked before and after energy drinks were given. Eight weeks later, the ovaries and uteruses of the rats were analyzed histopathologically. The number of follicles in the ovaries was counted. Results: The total number of the preantral plus small antral follicles, which show the ovarian reserve, was decreased at the end of eight weeks in both the control group and the energy drink group. There was a statistical difference between them (p=0.021). Also, there was a statistically significant difference in the initial/final AMH (ng/mL) reduction levels between the control group and the energy drink group (p=0.002). AMH levels were decreased more in the energy drink group. Conclusion: The consumption of energy drinks can lead to a decrease in ovarian reserve and AMH values and may cause weight gain.
Epilepsinin Gebelik Sonuçları Üzerine Etkisi
(2018) Çim, Numan; Alkis, İsmet; Yildizhan, Recep; Aksin, Şerif; Tolunay, Harun Egemen; Boza, Barış; Karaman, Erbil
Amaç: Epilepsili olguların yaklaşık %25’i reprodüktifçağdadır. Günümüzdeki anti-epileptik ilaçlarla nöbetlerkontrol altına alınmakta ve bu olgularda artmış orandagebelik tercihi olmaktadır. Bu çalışmada epilepsili gebeolguların gebelik sonuçlarının incelenmesi amaçlandı.Gereç ve Yöntem: Bu çalışma epilepsi tanısı olangebelerin dosya kayıtları üzerinden retrospektif olarakyapıldı. Ocak 2009- Nisan 2014 tarihleri arasında toplam43 epilepsi tanısı olan gebe kaydına ulaşıldı. Aynı tariharalığında başvuran, sistemik hastalığı ve ilaç kullanımıolmayan, tekiz canlı gebeliği olan, benzer yaş ve gebelikhaftadaki dosya kaydı tam olan 87 olgu ise kontrolgrubunu oluşturdu. Her iki grup demografik özellikler,gebelik haftası, doğum şekli, bebek 1. ve 5. dk Apgarskoru, doğum kilosu, epilepsi tanı süresi, nöbet sıklığı,kullandığı anti-epileptik ilaç, maternal komplikasyon,gebelik komplikasyonu yönünden istatistiksel olarakkarşılaştırıldı.Bulgular: Demografik yönden ve perinatal sonuçlaryönünden gruplar arasında fark yoktu (p>0,05), fakatabortus sayısı epilepsi tanılı gebe grubunda sağlıklı gebegrubuna göre anlamlı olarak daha yüksekti (p:0,035).Gruplar gebelik komplikasyonları bakımındankarşılaştırıldığında, epileptik grupta oligohidroamnioz,preterm eylem, preeklampsi ve eklampsi oranları kontrolgrubuna göre daha yüksekti (p:0,001). Her iki gruptasezaryen ile doğum oranı yüksekti (% 68,4 ve %62,4).Epilepsili gebe olgularda en sık geçirilen nöbet türüjeneralize tonik-klonik nöbetti (%81,6). Epileptik nöbetsayısı arttıkça 5. dk Apgar skoru düşmekteydi. Olguların%26,3’ü ilaç kullanmazken, % 55,3’ü monoterapi,%18,4’ü ise politerapi almaktaydı.Sonuç: Epilepsili gebelerde gebelikle ilişkilikomplikasyonlar ve kötü perinatal sonuçlar dahayüksektir. Gebelikteki nöbet sayısı arttıkça, gebeliksonuçları olumsuz olarak etkilenmektedir. Bu olgularagebelik öncesi iyi bir danışmanlık verilmeli ve nöbetsizdönemde gebelik önerilmelidir.
Evaluation of Cardiac Risk Marker Levels in Obese and Non-Obese Patients With Polycystic Ovaries
(Taylor & Francis Ltd, 2017) Elci, Erkan; Kaya, Cihan; Cim, Numan; Yildizhan, Recep; Elci, Gulhan Gunes
Objective: To compare cardiac risk markers such as asymmetric dimethyl arginine (ADMA), C-reactive protein (CRP), homocystein (Hcy), plasminogen activator inhibitor-1 (PAI-1), vascular endothelial growth factor (VEGF), angiopoietin-related growth factor 6 (ANGPTL6) in obese and non-obese patients with polycystic ovary syndrome (PCOS). Study design: Thirty obese (BMI>30kg/m(2)) and 30 non-obese (BMI<30kg/m(2)) patients diagnosed with PCOS and 30 age-matched healthy controls were included in the study. The ages of subjects were varying between 18 and 30 years. Serum ADMA, CRP, Hcy, PAI-1, VEGF and ANGPTL6 levels were analyzed for each subject. Results: Serum ADMA, CRP, Hcy, PAI-1, VEGF and ANGPTL6 levels were significantly elevated in obese and non-obese women with PCOS in comparison to control subjects (p<0.05). This elevation was more obvious in the obese PCOS group than in the other group. Conclusions: Cardiovascular risk markers such as ADMA, CRP, Hcy, PAI-1, VEGF and ANGPTL6 levels are elevated in women with PCOS.
Evaluation of Maternal Liver Elasticity by Acoustic Radiation Force Impulse Elastosonography in Hypertensive Disorders of Pregnancy: a Preliminary Descriptive Study
(Taylor & Francis Ltd, 2017) Cetin, Orkun; Karaman, Erbil; Arslan, Harun; Kolusari, Ali; Yildizhan, Recep; Ozgokce, Mesut; Akbudak, Ibrahim
Purpose: To compare maternal liver elasticity scores by Acoustic Radiation Force Impulse (ARFI) elastosonography in healthy and preeclamptic pregnancies and its association with the severity of the disease.Materials and methods: Forty-two healthy, 33 mild, 33 severe preeclamptic and 28 pregnant women with Hemolysis, Elevated Liver enzymes and Low Platelets (HELLP) syndrome were included into the study. Maternal liver elasticity was measured by ARFI elastosonography at the first day of puerperium. The maternal and neonatal outcomes of the patients were retrieved from the medical records.Results: The ARFI-Mean liver elastosonography scores of controls and mild preeclamptic women were lower than severe preeclamptic and HELLP syndrome women (p: 0.001). The mean ARFI elastosonography score >1.22 m/s indicated the effect of severe preeclampsia on maternal liver elasticity with 72.7% sensitivity and 74.7% specificity (Area under curve [AUC], 0.835, 95% confidence interval [CI], 0.757-0.913). The mean ARFI elastosonography score >1.31 m/s indicated the effect of HELLP syndrome on maternal liver elasticity with 78.6% sensitivity and 75.9% specificity (AUC, 0.794, 95% CI, 0.695-0.892).Conclusions: The maternal liver becomes stiffer in severe preeclampsia and HELLP syndrome measured by ARFI elastosonography. The increased maternal liver ARFI scores may alert the obstetrician about the possible maternal puerperal morbidity.
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.
A Five-Year Audit of Cases With Ectopic Pregnancy in Our Clinic
(Galenos Yayincilik, 2010) Adali, Ertan; Kurdoglu, Mertihan; Kolusari, Ali; Yildizhan, Recep; Cim, Numan; Sahin, Hanim Guler; Kamaci, Mansur
Objective: The aim of this study was to review the ectopic pregnancy cases that were administered to our clinic in the last five years. Materials and methods: According to the dermographic features, risk factors, clinical signs and treatment approaches, ninetyone cases with ectopic pregnancies were evaluated retrospectively between 2004-2009. For statistical analysis, SPSS was used. Results: The average age of the patients were 28,38 +/- 6,47 years and ectopic pregnancies were mostly seen between the ages of 26-35. The mean gravida and parity were 3,86 +/- 2,55 and 2,34 +/- 2,16, respectively. The mean serum beta-hCG level of the patients on admission to our clinic was 3085,41 +/- 6346,84 mIU/L. The risk factors in the order of frequencies were previous abdomino-pelvic surgery (16 %), the use of intrauterine device (12 %), previous ectopic pregnancies (7 %) and previous pelvic inflammatory disease (2 %). The most common complaint on admission were abdominal pain (40 %) and following that in the order of frequencies were vaginal bleeding with pain (38 %) and only vaginal bleeding (15 %). As a treatment option, surgery, methotrexate and expectant management were applied to 66 %, 20% and 10% of the patients respectively. Conclusion: Ectopic pregnancies are important health problems since they may interfere with fertility capability of the patient in her future life and may even cause maternal mortality. Especially, women who had abdomino-pelvic surgery before are at risk. Early diagnosis enables conservative management approaches.
Gebelikte Miyastenia Gravis: Olgu Sunumu
(2015) Çim, Numan; Çetin, Orkun; Kurdoğlu, Zehra; Yildizhan, Recep; Güneş, Gülhan
Miyastenia Gravis (MG)'in reprodüktif yaştaki kadınlarda insidansı 1/10.000- 1/50.000'dir. MG nöromüsküler kavşakta postsinaptik Asetil Kolin reseptörlerine karşı antikor gelişimi ile karekterizedir. Çalışmamızda; MG tanısı ile takip edilen 28 yaşındaki gebe olgunun obstetrik yönetimini literatür bilgisi ışığında tartıştık. MG'nin gebelikteki seyri değişken olabilir. MG olguları nörolog ve obstetrisyen işbirliği ile takip edilmelidir. Doğum şekline obstetrik endikasyona göre karar verilmelidir