Bekir Serdar Ünlü

Comparison of Four Different Pain Relief Methods during Hysterosalpingography: A Randomized Controlled Study

Hysterosalpingography is an important technique for the diagnosis of infertility, and involves injection of contrast medium into the uterus to visualize the anatomy of the reproductive system. Unfortunately, the procedure can be painful, although multiple pain management techniques are available. This study was conducted to determine which of four pain management techniques is the most effective for pain relief during hysterosalpingectomy. The most painful parts of the procedure were also assessed.

Adrenal gland volume assessed by magnetic resonance imaging in women with polycystic ovary syndrome.

PURPOSE To determine adrenal gland volume (AGV) in women with polycystic ovary syndrome (PCOS) by comparison with healthy control subjects and to investigate the relationship between AGV and hormonal status. PATIENTS AND METHODS AGV was measured on transverse sections of T1-weighted MRI imaging data in 27 PCOS patients and 40 age-matched control subjects for this prospectively designed study. A comparative analysis of AGV in PCOS and controls was performed and possible correlations between AGV and hormonal parameters were evaluated. RESULTS PCOS patients had significantly larger AGV compared to controls ((11.7±4.4 cm(3), 7.2±1.9 cm(3), respectively, P<0.001). A significant positive correlation was found between total AGV and dehydroepiandrosterone sulfate, 17-OH progesterone, and total and free testosterone levels in the PCOS group (r=+0.51, +0.48, +0.43, +0.62, respectively; P values<0.05). In addition, AGV was significantly negatively correlated with LH and LH/FSH ratio in the PCOS group (r= -0.55, P=0.02; r=-0.51, P=0.01, respectively). CONCLUSIONS PCOS patients have significantly increased AGV as well as a positive correlation of AGV and androgens. We conclude that the assessment of AGV with MRI shows a significant correlation with the androgenic activity of the gland, and that hypertrophy of the adrenal gland may be involved in the pathogenesis of PCOS.

Alterations in pituitary gland volume in Polycystic Ovary Syndrome: A structural magnetic resonance imaging study.

The purpose of this prospectively designed cross-sectional observational study was to evaluate the effect of polycystic ovary syndrome (PCOS) on pituitary gland volume (PGV) under the hypothesis that endocrinologic changes may lead to morphologic changes of the pituitary gland. Twenty-six PCOS patients and 31 control subjects underwent magnetic resonance imaging (MRI) of the pituitary. Informed consent was obtained from all subjects. PGV was significantly larger in PCOS patients than in control subjects. Luteinizing hormone/follicle-stimulating hormone ratio was the only predictor of PGV. The association between pituitary gland enlargement and PCOS should be kept in mind when pituitary hypertrophy is detected on MRI.

Placental Blood Drainage Shortens Duration of the Third Stage of Labor in Women Slowly Administered 20 IU Oxytocin

Objective: Prolongation of the third stage of labor may cause serious postpartum complications. Thus, timely expulsion of the placenta is essential for preventing complications of the third stage of labor. We conducted a prospective cohort study to determine the effect of placental cord drainage on the duration of the TSL in women administered intravenous oxytocin during this stage. Study Design: This was a prospective cohort study in which 112 low risk pregnant women were allocated to the study. There were 53 women in the placental cord drainage group, and 59 women in the cord clamping group without drainage. Immediately after fetal delivery, intravenous infusion of 20 IU oxytocin in 500 mL Ringers’ Lactate was started and infused within 2 hours in women in both groups. Outcome measures were the third stage duration and hemoglobin differences between admission and the postpartum sixth hour. Results: There were no significant differences between the two groups with regard to duration of stages 1 and 2 of labor, hemoglobin level on admission, and at the postpartum sixth hour, and hemoglobin differences between admission and the postpartum sixth hour. The median third stage duration in the study group was 3.40 (range: 0.35-16.20) minutes, and 5.10 (range: 2.30-11.00) minutes in the control group. This difference between the groups was statistically significant (p<0.01). Conclusion: Placental cord drainage reduces the third stage duration following vaginal deliveries in patients receiving intravenous oxytocin. Placental cord drainage is simple, does not require additional cost, and is applicable for every delivery.

Brain Diffusion Changes in Polycystic Ovary Syndrome

Department of Radiology, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA Department of Radiology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey Clinic of Obstetrics and Gynecology, Ilgin State Hospital, Konya, Turkey Department of Obstetrics and Gynecology, School of Medicine, Kirikkale University, Kirikkale, Turkey Department of Obstetrics and Gynecology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey

Gebeliğin 3. Trimesterinde Over Torsiyonu: Vaka Takdimi

Otuz alti yasinda, gebeliginin 35. haftasinda olan bir hasta merkezimize ciddi sag alt kadran agrisi ile basvurdu. Torsiyone 12 cm sag over kisti tanisi koyuldu. Hastaya epidural anestezi altinda laparatomi uygulandi ve kist basarili sekilde intakt olarak cikarildi. Bebek sezaryen ile dogurtuldu. Histopatolojik incelemede; Intestinal tip Borderline musinoz tumor bulundu. Postoperatif 4.ayinda cerrahi evreleme uygulandi. Hasta klinik olarak takip edildi. Antepartum cerrahi mudahale guvenli kabul edildigi halde, abdominal cerrahi hamile bir kadin ve karnindaki fetus icin bazi riskler tasir. Bu yuzden yonetim secimi adneksiyal kitlenin karakteri ve gebelik yasina gore karar verilmelidir

Comparison of serum granulocyte colony-stimulating factor levels between preterm and term births.

OBJECTIVE Preterm birth (PTB) is the major obstetric problem in developed countries, accounting for the majority of neonatal mortality and morbidity. Granulocyte colony-stimulating factor (G-CSF) is a hematopoietic cytokine that mediates the increase in leukocytes in pregnancy and may play a role in placentation. We aimed to investigate the differences of serum G-CSF levels between subsequent spontaneous PTB and term-delivered healthy pregnant women. MATERIAL AND METHODS Serum samples, collected from total of 600 singleton otherwise healthy pregnants at 24-28 weeks of gestation during a routine antenatal visit, were used to assess G-CSF levels; 40 of the total pregnants who delivered their infants spontaneously after preterm labor before 37 weeks of gestation were selected as the study group. Also, 120 pregnants were selected as a control group using a 1/3 ratio. Students t-test, chi-square test, Mann-Whitney U-tests, and ROC curve analysis for prediction of PTB were used for the comparison of groups. P<0.05 was accepted as statistically significant. RESULTS There was no significant difference in maternal serum G-CSF levels between the study and control groups (p=0.28) but maternal white blood cell (WBC) count was significantly different between them (p=0.00). In addition, G-CSF was insufficient in the prediction of PTB (AUC=0.419). In the preterm and term groups, no correlation was found between WBC and G-CSF (p=0.165 vs. p=0.703). CONCLUSION There were no differences in serum levels of G-CSF between term- and preterm-delivered pregnants. There was no predictive role for serum G-CSF in PTB.

Platelet values measurement. What we know about it

1 In this paragraph, the authors should have specified which blood samples were collected in which collecting tube (this is achieved with either ethylenediaminetetraacetic acid [EDTA] or sodium citrate as standard substances-EDTA cause more swelling on platelets than sodium citrate; e.g. Na-EDTA as an anticoagulant results in less pronounced swelling than K-EDTA). 2 At this point, platelets undergo swelling when stored in EDTA and, to a lesser extent, in citrate-containing solutions. This makes determination of MPV timedependent. Over time, platelet swelling can increase the measured volume by an additional 20–25%. Suggestions for using time-dependent reference ranges or alternative anticoagulants for MPV determination have been made to resolve this issue. But the authors did not specify the study time of MPV. 3 There are four different principles of platelet counting and MPV measurement: (i) manual counting by phase contrast microscopy; (ii) impedance counting; (iii) optical light scatter counting; and (iv) immunological flow cytometry techniques.