Ali Ulvi Hakverdi

Distribution of Candida species in women with vulvovaginal symptoms and their association with different ages and contraceptive methods

The aim of this study was to determine the frequency and distribution of Candida spp. within different age groups and different contraceptive methods users in women with vulvovaginal symptoms. The study included 569 female outpatients who had visited the Education and Research Hospital of Mustafa Kemal University, Turkey, between Jaunary 2004 and June 2005. Among 569 women with symptoms of vulvovaginitis, 240 (42.2%) were positive for Candida spp., of which 106 (44.2%) were C. albicans and 134 (55.8%) were non-albicans spp. The age group 26–30 y had the highest frequency of Candida spp. (23.7%). Candida spp. were isolated from 44.2% of contraceptive method users, and 37.9% of non-contraceptive users (p>0.05). The isolation rate of C. albicans was higher among oral-contraceptive users (57.5%) than IUCD users (38.5%), coitus interruptus (48.5%) and condom users (42.8%). These results indicate that factors associated with age and contraceptive method used may influence the occurrence and distribution of Candida spp. in women with vulvovaginal symptoms.

Prevalence, management and outcome in eclampsia.

Objective: To review the management of eclampsia in our institution. Method: The prevalence, management and outcome of women with eclampsia over a period of 8 years were reviewed at our referral medical center. There were 444 patients with eclampsia among 5757 deliveries (1 in 12.96 deliveries or 7.71% of deliveries). Most of the cases were uneducated and had received no antenatal care. One hundred eighty‐one cases were nulliparous (40.77%). High parities of more than five were observed in 27.93% of cases. A standard magnesium sulfate regimen, similar to Prichards intramuscular regimen, was used. Results: Magnesium sulfate effectively controlled the convulsions. The incidence of abdominal delivery among 397 cases with ante‐ and intrapartum eclampsia was 50.12%. Perinatal mortality was very high (591.47%0) for all cases. Maternal complications were serious and led to maternal death in 42 women (9.46%). Conclusion: Eclampsia is still a serious obstetric complication particularly in uneducated women who do not receive antenatal care.

Increased density of Demodex folliculorum mites in pregnancies with gestational diabetes.

Objective: To investigate the presence of Demodex in patients with gestational diabetes and the impact of glucose regulation on Demodex density in gestational diabetes. Subjects and Methods: The study population consisted of 33 patients with gestational diabetes and 30 pregnant women without gestational diabetes (control group). The age, parity, gestational age, and BMI of the study group were recorded and the patients were divided into 2 groups, i.e. those with regulated and unregulated glucose levels, according to their postprandial 1st- and 2nd-hour glucose values. A standardized skin surface biopsy method was used to determine if patients had Demodex folliculorum infestation (>5 mites/cm2 of skin). Results: Patients with gestational diabetes had a statistically significantly higher Demodex density compared to the control group (24.2 vs. 3.3%; p < 0.001). Furthermore, a significantly higher proportion of gestational diabetes patients with unregulated glucose levels had a higher Demodex density compared to those in the regulated subgroup (6/19 vs. 2/14; p = 0.001). Conclusion: Our study revealed that the Demodex density was increased in gestational diabetes patients. Further, poor glucose regulation could be the mechanism responsible for the increased Demodex density in gestational diabetes patients with unregulated glucose levels compared to those with regulated glucose levels.

Evaluation of fetal autopsy findings in the Hatay region: 274 cases.

OBJECTIVE The aim of this study was to present the incidence of fetal anomalies in our region of Hatay, Turkey in order to determine the efficiency of prenatal diagnosis through fetal autopsy, and to compare our statistical data with other national and international studies. MATERIAL AND METHOD This study was conducted on 274 fetuses from terminated pregnancies due to abnormal prenatal findings and intrauterine deaths from 2005 to September 2010. Fetuses were evaluated through postmortem examination, external measurements, X-rays, Magnetic Resonance Images, Multislice Computerized Tomography and photographs. The autopsy was completed by the histological examination of each organ. RESULTS Autopsy was conducted on 274 fetuses. A fetal anomaly was detected in 160 (58.39%) cases. The central nervous system contained the most frequent structural defects (79 cases, 49.38%), followed by malformations in the musculoskeletal system in 36 cases (22.5%). The most frequent multiple system anomalies were central nervous system defect and bilateral adrenal agenesis, musculoskeletal system malformations and urinary system defects. Fetal autopsy provided additional findings in 43 cases (26.88%). CONCLUSION Fetal autopsy is a very important procedure and an integral part of the general prenatal management. New findings through this method may suggest invaluable data for parents about potential risks in future pregnancies.

Chromosome imbalances and alterations in the p53 gene in uterine myomas from the same family members: familial leiomyomatosis in Turkey.

Uterine leiomyomas (UL) are extremely common neoplasms in women of reproductive age, and are associated with a variety of characteristic choromosomal aberrations (CAs). The p53 gene has been reported to play a crucial role in suppressing the growth of a variety of cancer cells. Therefore, the present study investigated the effects of CAs and the p53 gene on ULs. We performed cytogenetic analysis by G-banding in 10 cases undergoing myomectomy or hysterectomy. Fluorescence in situ hybridization (FISH) with a p53 gene probe was also used on interphase nuclei to screen for deletions. In patients, CAs were found in 23.4% of 500 cells analysed, significantly more frequent than in the control group (p<0.001). In the patients, 76% of the abnormalities were structural aberrations (deletions, translocations and breaks), and only 24% were numerical. Deletions were the most common structural aberration observed in CAs. Among these CAs, specific changes in five loci 1q11, 1q42, 2p23, 5q31 and Xp22 have been found in our patients and these changes were not reported previously in UL. The chromosome breaks were more frequent in cases, from high to low, 1, 2, 6, 9, 3, 5, 10 and 12. Chromosome 22, X, 3, 17 and 18 aneuploidy was observed to be the most frequent among all numerical aberrations. We observed a low frequency of p53 losses (2-11%) in our cases. The increased incidence of autosomal deletions, translocations, chromatid breaks and aneuploidy, could contribute to the progression of the disease along with other chromosomal alterations.

Detection of Trichomonas Vaginalis in Vaginal Speciemens from Women by Wet Mount, Culture and PCR

1 Gülnaz Çulha1, Arif Gungoren3, Cemil Demır4, Ali Ulvi Hakverdı3, Nizami Duran2 1Medical Faculty, Department of Parasitology, Mustafa Kemal University, Hatay, 2Medical Faculty, Department of Microbiology, Mustafa Kemal University, Hatay, 3Medical Faculty, Department of Gynecology, Mustafa Kemal University, Hatay, 4Vocational School of Health Services, Department of the Medical Documentation and Secretarial, Mardin Artuklu University, Mardin, Turkey Trichomonas Vaginalis Tanısında Mikroskopi, Kültür ve PCR / Diagnosis of Trichomonas Vaginalis Microscopy, Culture and PCR Detection of Trichomonas Vaginalis in Vaginal Speciemens from Women by Wet Mount, Culture and PCR

Incomplete androgen insensitivity (testicular feminization) syndrome : two case reports

A 18 year old phenotypically female patient was presented because of primary amenorrhea and genital ambiguity. She was the third child in a family of four and born by normal delivery. At birth normal female external genitalia was observed and in childhood psychological orientation was female. She had two elder sisters whose fertility potential were normal. She had one sister who was 11 years old and her karyotype was 46 XX. At physical examination she had eunuchoidal body appearance (Fig. 1). Her height was 171 cm and weight was 42 kg. She had normal axillary and pubic hair but insufficient breast development. Physical examination, routine labaratory tests and echocardiography and intravenous pyelography did not show any abnormal finding. In gynecologic examination she had ambiguous external genitalia. The phallus length was 4.0 cm (Fig. 2). The urethral opening, labia majora and minora were normal. The depth of vagina was 4.0 cm. Uterus and ovaries were not palpable. There was no mass in either inguinal canals or in labia majora. Cytogenetic studies demonstrated the absence of X chromatine body in buccal smear. A normal 46 XY karyogram was defined. Baseline serum gonadotropins levels were; LH = 20.5, FSH = 5.7 mIU/ ml. Serum testosterone level ( 2.2 ng/ml ) was higher than females, but a little bit lower than those observed in normal adult males ( normal range in female = 0.1 0.8, in male = 2.8 8.8 ng/ml ). Serum DHEA-S leves were in normal range of male values. In diagnostic laparoscopy major findings were absence of Miillerian structures and presence of two gonads located near the pelvic wall and above the fossa ovaries. Gonads were measured 3x3x3.5 cm diameters and one of them had a well developed vas deferens. Gonads were removed and cliteroplasty was performed. Histological examination revealed immature seminiferous tubules with thickened basement membrane, absence of germinal epithelium and scarce number of Sertoli cells in the tubular lumen. There was no spermatogenesis. Interstitial spaces were occupied by hyperplastic Leydig cells ( Fig. 3). After the operation she was given hormone replacement therapy.

Does the presence of anhydramnios affect the duration of medical abortion

OBJECTIVES The aim of the study was to determine whether anhydramnios affected the duration of medical abortion in cases with various indications as compared to cases with normal amniotic fluid volume. MATERIAL AND METHODS Patients who were admitted to our clinic because of medical abortion between January 2010-December 2013 were included in this retrospective study. A total of 32 pregnant women with anhydramnios (study group) and 67 pregnant women with normal amniotic fluid volume but with fetal abnormality (control group) were included in the study. Patient age, gravidity, parity, gestational age, previous delivery route, and duration of the abortion were recorded. RESULTS Mean duration of the abortion in the study group was 71.93 ± 47.51 h as compared to 79.08 ± 52.62 h in the control group. There were no statistically significant differences between the two groups in terms of duration of the abortion (p = 0.516). Also, we found no statistically significant differences in duration of the abortion with regard to previous delivery route (p = 0.220). CONCLUSIONS There were no statistically significant differences between the study group and controls in terms of duration of the abortion. In addition, neither parity nor previous delivery route affected the duration of the abortion.