Aygen Çelik

Evaluation of cervical cytological abnormalities in Turkish population

INTRODUCTION Cervical cancer is one of the most common female malignancy with high mortality rates in developing countries. Our purpose was to determine the prevalence of cervical cytologic abnormalities in population (strict Islamic religious area) and the detection rate of epithelial abnormalities by cervical cytology (CC). MATERIALS AND METHODS A total of 32,026 conventional pap smear tests collected between January 2006 and January 2010 from three hospitals are retrospectively analyzed. RESULTS Total of 900 (2.8%) cases had epithelial abnormalities. The numbers and rates of epithelial abnormalities were as the followings: Atypical squamous cell of undetermined significance (ASCUS; n=615 [1.9%]); atypical squamous cell suspicious for high-grade squamous intraepithelial lesion (ASC-H; n=27 [0.1%]); atypical glandular cell of undetermined significance (AGUS; n=73 [0.2%]); low- grade squamous intraepitelial lesion (LSIL; n=147 [0.5%]); high- grade squamous intraepithelial lesion (HSIL; n=35 [0.1%]); and squamous cell carinoma (SCC; n=3 [0.0%]). CONCLUSION The prevalence of cervical cytological abnormality in our study was 2.8%. Recently, some conflicting results from the same population were published. More prospective studies with larger numbers are needed.

Voice and Speech Changes in Various Phases of Menstrual Cycle

BACKGROUND The reproductive system in females undergoes a regular cyclic change known as the menstrual cycle. Laryngeal changes are evident and fluctuate systematically during the reproductive years with the menstrual cycle. The impact of estrogens in concert with progesterone produces the characteristics of the female voice, with a fundamental frequency (F(0)) higher than that of male. OBJECTIVE To characterize changes in voice and speech in adolescent females in different phases of the menstrual cycle--during menstruation, after menstruation, mid-menstrual cycle, and premenstruation. MATERIALS AND METHODS Sixteen adult females who were nonusers of oral contraceptives participated in a cross-sectional study of menstrual cycle influences on voicing and speaking tasks. Acoustic analysis (F(0), intensity, perturbation measurements [jitter and shimmer], and harmonic-to-noise ratio), maximum phonation time (MPT), s/z ratio, and perceptual assessments (grade [G], roughness [R], breathiness [B], asthenia [A], and strain [S] [GRBAS] and Voice Handicap Index-10 [VHI-10]) scales were performed during all phases. RESULTS None of the acoustic analysis parameters and MPT and s/z ratio measurements revealed statistically significant difference (P > 0.05). Perceptual voice assessment scales either clinician based or patients self-evaluated showed significant differences among phases (P < 0.05). CONCLUSIONS The objective voice analysis methods, such as acoustic analysis, MPT, and s/z ratio, determined no difference; however, the subjective voice analysis methods, such as clinician-based perceptual assessment (GRBAS) and patients self-evaluation (VHI-10) scales, demonstrated significant changes during different phases of menstrual cycle.

Effects of Spirulina on Cyclophosphamide-Induced Ovarian Toxicity in Rats: Biochemical and Histomorphometric Evaluation of the Ovary

Cyclophosphamide (Cyc) is known to cause ovotoxicity and infertility in women. Our aim is to investigate the possible ovotoxic effects of Cyc and possible antioxidant and protective effects of blue-green algae, Spirulina (Sp), in rat ovaries. Eighteen rats were given: group I (n = 6, control); group II (n = 6, CP), a single dose Cyc; group III (n = 6, Sp+Cyc), 7 days Sp+single dose Cyc. Tissue malondialdehyde (MDA) levels, superoxide dismutase (SOD), and catalase (CAT) activities are assessed biochemically. Normal and atretic primordial and primary follicle counts for all sections obtained for each ovary are calculated. Mean number of follicle counts for each group are compared. In Sp+Cyc group, tissue MDA levels were significantly lower than those in the CP and higher than those in the C group (CP > Sp+Cyc > C). Tissue SOD activity was significantly higher in Sp+Cyc group than that in the CP group and lower than that in the C group (C > Sp+Cyc > C). No statistically significant difference was found between the ovarian CAT activities in any group. Histomorphometrically, there was also no significant difference between the mean numbers of normal and atretic small follicle counts. Our results suggest that single dose Cyc has adverse effects on oxidant status of the ovaries and Sp has protective effects in Cyc-induced ovotoxicity.

Comparison of uterine artery blood flow with levonorgestrel intrauterine system and copper intrauterine device

BACKGROUND As a contraceptive method, we investigated whether the levonorgestrel-releasing intrauterine system (LNG-IUS) has any effect on uterine artery blood flow when compared with copper intrauterine device (IUD). STUDY DESIGN Sixty women with copper IUD and 60 women with LNG-IUS were included in the study. The age, gravidity, parity, body mass index (BMI) and menstrual flow pattern using a pictorial chart were recorded. All women were assessed by ultrasonography at the preinsertion period and 1 year after insertion. The pulsatility and resistance indices (PI and RI, respectively) of the uterine artery and endometrial thickness were evaluated in the preinsertion and postinsertion periods. RESULTS In copper IUD users, preinsertion and postinsertion ultrasonographic assessments were not significantly different. However, postinsertion RI was significantly higher compared with preinsertion RI in LNG-IUS users (p=.001). The PI was also increased 1 year after insertion, but it did not reach statistically significant levels (p=.08). Endometrial thickness was also significantly decreased in the postinsertion period in women with LNG-IUS (p=.04). CONCLUSION The significant increase in uterine artery RI in LNG-IUS users 1 year after insertion might be due to its local progestational effects. It might also indicate the mechanism of the LNG-IUS in reducing menstrual blood flow.

Negative correlation between D-dimer and homocysteine levels during pregnancy and the postpartum period: a prospective study

OBJECTIVE There have been conflicting data about the role of increased levels of homocysteine (Hcy) on haemostatic system. We aim to investigate prospectively the relation between serum Hcy levels and changes in haemostatic system in pregnancy and postpartum period. STUDY DESIGN Sixty-eight healthy pregnant women were included in the study. Blood samples were obtained in the 11th gestational week, 25th gestational week, 32nd gestational week and postpartum 4th week. The haemoglobin levels, white blood cell count (WBC), platelet count, activated partial thromboplastin time (aPTT), prothrombin time (PT), fibrinogen, D-dimer, Hcy, vitamin B12, and folate levels were measured. RESULTS Serum Hcy levels were negatively correlated with D-dimer levels (r = -0.57, p < 0.0001). The highest levels of D-dimer (1046.62 ± 322.01 ng/ml) were achieved in the third trimester and the lowest levels of serum Hcy (4.45 ± 1.23 mmol/l) were detected in the same trimester. In postpartum fourth week, D-dimer levels were decreased to normal levels (238.27 ± 198.59 ng/ml) while the serum Hcy levels were reached to the highest levels (7.99 ± 1.36 mmol/l). CONCLUSION The negative correlation between Hcy and D-dimer levels may be a compensatory mechanism to maintain the normal haemostatic balance in pregnancy. Hence, possible advantage of low Hcy levels in pregnancy may be to prevent undesired thrombosis.

Laparoscopic surgery of interstitial (cornual) pregnancy, a case report

We report a successful laparoscopic management of an interstitial pregnancy of a 24- year-old single woman, treated by cornuostomy. The patient was first managed with methotrexate treatment. After the 2. methotrexate administration, the patient suffered from low abdominal pain, and intraabdominal bleeding signs were reported by transvaginal ultrasonograpy. The hemoglobin level was decreased from 12.8 gr/dl to 11.8 gr/dl and the beta hCG level was increased from 8,314 mIU/l to 11,541 mIU/l. The laparoscopic approach to interstitial pregnancy was presented and other management strategies such as medical treatment and laparotomy have been reviewed.

Fluid intake and voiding parameters in asymptomatic Turkish women

Introduction and hypothesisFor an accurate evaluation of bladder diaries, we aim to investigate normal urinary habits and determining factors on functional bladder capacity, frequency, and 24-h volume in the bladder diaries of asymptomatic women.MethodsOne-hundred and fifteen asymptomatic women who recorded a 24-h bladder diary were included in the study. Linear regression analyses were used to explore associations between diary values and patient characteristics.ResultsTotal number of voids was related to age, body mass index, total voided volume, total fluid intake, total diuresis rate, and maximum fluid intake in one go. Maximum, average, and minimum volumes per void were found to be related to body mass index, total voided volume, total fluid intake, total diuresis rate, and maximum fluid intake. When we used multiple regression analysis, only maximum fluid intake was found to be related to the total number of voids, maximum, average, and minimum volumes per void.ConclusionsMaximum fluid intake rather than total voided volume seems to be an important determinant factor for total number of voids and functional bladder capacity.

Doğal ve cerrahi menopoz olgularındaki hormonal değişimin kemik döngüsüne etkisi

Objective: In surgical and natural menopause, bone turnover alterations due to estrogen deficiency result in osteoporosis. In the present study, the effect of hormonal alterations on bone turnover markers in women with surgical and natural menopause was planned. Material and Methods: Sixty women with natural menopause and 60 women with surgical menopause applied to menopause clinic of Maltepe Medical Faculty were included study. Serum follicle stimulating hormone (FSH), estradiol (E2), dehydroepiandrosterone sulphate (DHEAS), cortisole, bone-spesific alkaline phosphatase (BAP), paratyroid hormone (PTH), collagen C-telopeptite (CTX) and calcium (Ca) levels were measured. Results: Serum PTH, CTX, E2 and DHEAS levels were higher in women with natural menopause. In women with surgical menopause, serum BAP, cortisole and Ca levels were higher than those with natural menopause. However, these differences were not statistically significant. Serum BAP levels were positively correlated with age, serum cortisole and CTX (r=0.308p=0.004; r=0.301 p=0.023; r=0.302p=0.005; respectively). Serum CTX levels were positively correlated with serum PTH levels (r=0.271 p=0. Oil). While serum PTH levels were positively correlated with age and years since menopause (r=0.381 p=00001; r=0.318p=0.015; respectively), it was negatively correlated with BMI (r=-2.33 p=0.032). Serum DHEAS levels were negatively correlated with age and years since menopause (r=-0.220 p=0.041; r—-0.291 p=0.030; respectively). Conclusion: We concluded that, except estrogen deficiency, there may be various factors for osteoporosis in cases with natural and surgical menopause.