Cenk Nayki

Uterine Rupture during Second Trimester Abortion with Misoprostol

Background: Data are limited regarding the use of misoprostol in the midtrimester, therefore few cases with uterine rupture during the second trimester with a previous uterine scar have been reported in the literature. Case Report: A 23-year-old woman with a prior low transverse cesarean section presented at 26 weeks’ gestation for pregnancy termination for a fetal abnormality. She was given 200 µg misoprostol intravaginally every 3 h until regular contractions began. After the fourth dose, she had vaginal bleeding and severe contractions. She aborted completely 2 h later after the last dose. Uterine rupture was diagnosed at the previous cesarean section scar by manual vaginal examination. She underwent emergency laparotomy and the uterus was repaired. Conclusion: Misoprostol use in the second trimester in a woman with a uterine scar can trigger severe contractions that can lead to uterine rupture.

Abdominal and pelvic hydatid disease during pregnancy

BackgroundHydatid disease is an infection of sheep and cattle. Affected human beings are only chance intermediate hosts. It is a rare condition in pregnancy.Case report We present a 15-week pregnant patient with cysts in the liver and in the right adnexa identified by ultrasonography and magnetic resonance imaging. Diagnosis of hydatid disease was confirmed by an indirect hemagglutination test.OutcomeThe patient underwent laparotomy and a healthy baby was delivered at term.

Surgical removal of intra‐abdominal intrauterine devices at one center in a 20‐year period

To review 20 years of experience of the removal of intra‐abdominal intrauterine devices (IUDs) and to compare the surgical methods used.

Oxidative and antioxidative status in the endometrium of patients with benign gynecological disorders

AIM Oxidative stress and impaired antioxidative system are implicated in the development of many disease states including gynecological diseases. In the present study, we aimed to investigate the oxidative-antioxidative status in endometrium of patients diagnosed with benign gynecological disorders. METHODS Samples of endometria and blood were obtained from 65 patients admitted to our center for abnormal uterine bleeding or postmenopausal bleeding. Endometrial biopsy was performed for the evaluation of histopathology and oxidative-antioxidative status in endometrial tissue. Based on histological examination, subjects were divided into groups as follows: normal controls (n=15); patients with endometrial polyps (n=20); patients with uterine myoma (n=10) patients with chronic endometritis (n=10), and patients with atrophic endometrium (n=10). Activities of superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GR) and total antioxidant status (TOS), total oxidant status (TAS) were assessed. RESULTS Compared to the normal controls, nonsignificant changes (decrease or increase) were detected in antioxidant enzyme activities, TAS and TOS in the examined groups. Additionally, between TAS and TOS, we also found a strong positive correlation in normal and chronic endomethritis groups and a moderate positive correlation uterine myoma, endometrial polyps and endometrial atrophy groups. CONCLUSION Even though, our results do not allow to conclude how oxidative and antioxidative status are influenced in benign gynecological disorders, these findings may provide a basis for the further researches.

Prognostic Factors, Treatment and Outcome in a Turkish Population with Endometrial Stromal Sarcoma

PURPOSE To analyze treatment modalities and prognostic factors in patients with Stage I-II endometrial stromal sarcoma (ESS). MATERIALS AND METHODS Twenty four patients (nineteen with low-grade ESS [LGESS] and five with high-grade ESS [HGESS]) were assessed retrospectively in terms of general characteristics, prognostic factors, treatment methods and survival. RESULTS Twenty patients were at Stage I and three were at Stage II. The stage of one patient could not be determined. With respect to age and comorbidity, no statistically significant difference was found among disease-free survival (DFS) (p=0.990; p=0.995). However, DFS was significantly shorter in Stage II than Stage I patients (p=0.002). It was also significantly shorter in HGESS patients than in LGESS patients (p=0.000). There was no statistically significant differences among the overall survival (OVS) times of patients with respect to age at diagnosis and comorbid disease (p=0.905; p=0.979) but OVS was significantly shorter in patients with HGESS (p=0.00) and Stage II disease (p=0.001). No statistically significant difference was found with respect to OVS between patients who received radiotherapy (RT) and those who did not receive RT (p=0.055). It was not statistically possible to include other treatment modalities in the analysis because of the small sample size. CONCLUSIONS Grade and stage of a tumour were found to be the most important prognostic factors. It was not possible to determine the optimal surgical method and the effect of adjuvant treatment since the number of cases was insufficient.

Assessment of smoking for low bone mineral density in postmenopausal Turkish women

SummaryObjectiveTo investigate the effect of cigarette smoking on bone mineral density (BMD) in postmenopausal Turkish women.Study designA total of 175 postmenopausal Turkish women admitted to Tepecik Training and Research Hospital for a routine menopausal checkup were included in this study. All participants completed a questionnaire regarding their age, educational status, parity, number of abortus, time since menopause, caffeine intake, tobacco use, alcohol consumption, history of a previous fracture related to trauma, and taking any medication for menopause and osteoporosis. Of all subjects, 23.3 % (n = 39) were smokers and 77.7 % (n = 136) were nonsmokers. T-scores and Z-scores of vertebra and femur neck were assessed using dual energy X-ray absorptiometry (DXA). For analyzing the results, Student t-test, one-way ANOVA, Mann–Whitney U test, Pearson correlation, and Kruskal–Wallis test were performed.ResultsFemur T-scores (− 0.78 ± 1.07 vs. − 0.32 ± 1.56) and vertebra T-scores (− 2.26 ± 1.23 vs. − 1.82 ± 1.04) were significantly lower in smoking women than nonsmoking women (p < 0.05). However, there were no significant difference between duration of smoking, number of cigarettes consumed per day, and BMD (p > 0.05)ConclusionCigarette smoking is one of the modifiable risk factors influencing bone density in postmenopausal Turkish women. “Cessation of cigarette” should be recommended for lifestyle modifications to prevent postmenopausal osteoporosis.

Effect of Kineret® on ovarian ischemia reperfusion injury in a rat model.

To investigate the effect of Kineret® on ischemia reperfusion (IR) injury in rat ovaries.

The effect of melatonin on oxidative stress and apoptosis in experimental diabetes mellitus-related ovarian injury.

Abstract We aimed to evaluate the effect of melatonin on oxidative stress and ovarian injury in rats. Twenty-four Sprague–Dawley albino rats were divided into three groups: Group 1 as nondiabetic healthy controls (n = 8), group 2 as nontreated diabetic rats (n = 8) and group 3 as melatonin-treated diabetic rats (n = 8). After overt diabetes was produced by intraperitoneal injection of streptozosin, 20 mg/kg/day of melatonin was given intraperitoneally to group 3 for a week. NF–kB and caspase-3 immunoexpressions, lipid peroxidation, the activities of antioxidative enzymes, total oxidant capacity and total antioxidant capacity were assessed. Immunoexpressions of NF–kB and caspase-3 were significantly lower in group 3 than group 2. There was a significant decrease in superoxide dismutase activity in group 2 than group 1 and a significant increase in group 3 compared with group 2. We observed a nonsignificant decrease in catalase activity between group 1 and group 2 and a nonsignificant increase between group 2 and group 3. There was a nonsignificant increase in the plasma level of total oxidant status in group 2 than group 1, but a significant decrease was observed in group 3 compared to group 2. Total antioxidant status was significantly lower in group 2 compared with group 1 and group 3. In conclusion, melatonin ameliorates the negative effects of oxidative stress on DM-related ovarian injury.

The Effects of Diabetes Mellitus on Ovarian Injury and Reserve: An Experimental Study.

Objective: The study aims to investigate the effects of diabetes mellitus (DM) on ovarian injury and reserve in a rat model. Study Design: In this prospective experimental study, 16 female Sprague-Dawley albino rats (12 weeks, 220-240 g) were randomly divided into 2 groups. Group 1 included 8 normal healthy rats as controls. No drug was administered to the controls. Group 2 included the other 8 rats in which diabetes was induced by intraperitoneal injections of streptozotocin (STZ). After overt DM occurred (blood glucose >250 mg/dl), all the animals were euthanized and blood samples were collected by cardiac puncture for biochemical analysis. Bilateral oophorectomy was performed for histopathological examination. Immunoexpressions of nuclear factor-kappa B (NF-kB) and caspase-3 as well as anti-Müllerian hormone (AMH) levels were assessed. Values were analyzed by t test. Results: Immunoexpressions of NF-kB and caspase-3 were significantly higher in non-treated diabetic rats than in the control group (p = 0.011 and p = 0.010, respectively). In healthy control group, AMH levels (3.22 ± 0.58 ng/ml) were significantly higher than in the non-treated diabetic group (1.41 ± 0.25 ng/dl; p = 0.024). Conclusion: Hyperglycemia causes severe ovarian injury via NF-kB pathway and caspase-3 apoptotic pathway, leading to the decrease in ovarian reserve in STZ-induced diabetic rats.

Primary Uterine Hydatid Cyst: A Case Report

Echinococcosis, which is caused by echinococcus granulosus, is also known as cystic hydatid disease, unilocular echinococcosis or cystic echinococcosis. Cystic echinococcosis is an alarming public health problem in some countries. Although the liver and lung are the organs involved most commonly by the disease, it may appear rarely in other tissues as a primary disease. Here, we present a 66-year-old patient who is invoved in farm work work. A Uterine multiseptate hydatid cyst was found on radiological investigations and the patient underwent surgery. A total hysterectomy was carried out. There were no postoperative complications.