Emre Karasahin

Lidocaine 10% spray reduces pain during hysterosalpingography: A randomized controlled trial

Aim:  The aim of this study was to evaluate whether the use of lidocaine 10% spray was effective in pain control during hysterosalpingography (HSG).

Can serum gamma-glutamyltransferase levels be useful at diagnosing gestational diabetes mellitus?

Objective: The aim of this study was to evaluate plasma gamma-glutamyltransferase (GGT) in gestational diabetes mellitus (GDM) in pregnant women at oral glucose tolerance test (OGTT) and the diagnosis of GDM and to explore whether this activity is associated with metabolic parameters. Method: This prospective control study included 37 women with GDM and 42 women with normal glucose tolerance in pregnancy (control group). In the study group (GDM), blood was taken for analyzing 100 g OGTT from women who have abnormal 50 g glucose challenge test (GCT). Results: Compared with the controls, the GDM group had significantly higher mean values for serum fasting glucose, insulin, homeostasis model assessment-insulin resistance (HOMA-IR), triglyceride and GGT. Within the GDM group, GGT levels were only negatively correlated with high-density lipoprotein (r = −0.41, p = 0.01). GGT was determined to be an independent metabolic parameter for GDM. While performing analyses receiver operational curve analysis, GGT cutoff set was set at 16 IU/L, the sensitivity was calculated as 86%, and specificity was as 37%. Conclusion: The increase at GGT level is an independent risk factor for GDM and identified as high-risk women for diagnosis of GDM.

Comparison of four malignancy risk indices in the detection of malignant ovarian masses

Objective The aim of this study was to evaluate the ability of four risk of malignancy indices (RMI) to detect malignant ovarian tumors. Methods This is a prospective study of 100 women admitted to the Department of Obstetrics and Gynecology of Gulhane Military Medicine Academy for surgical exploration of pelvic masses. To diagnose malignant ovarian tumors, the sensitivity, specificity, negative and positive predictive values and diagnostic accuracy of four RMIs (RMI 1, RMI 2, RMI 3, and RMI 4) were obtained. Results In our study we found that there is no statistically significant difference in the performance of four different RMIs in discriminating malignancy. We think that malignancy risk indices is more reliable than the menopausal status, serum CA-125 levels, ultrasound features and tumor size separately in detecting malignancy. Conclusion We concluded that any of the four malignancy risk indices described can be used for selection of cases for optimal therapy. These methods are simple techniques that can be used even in less-specialized gynecology clinics to facilitate the selection of cases for referral to an oncological unit.

Anticipated and perceived pain from midtrimester amniocentesis.

To evaluate the anticipated and perceived pain and determine the factors contributing to pain perception in women undergoing midtrimester amniocentesis.

Comparison of risk of malignancy index (RMI), CA125, CA 19-9, ultrasound score, and menopausal status in borderline ovarian tumor.

Objective: The aim of this study was to assess the prognostic values of risk of malignancy index (RMI IV), ultrasound score, menopausal status, and serum CA125 and CA19-9 level in patients with borderline ovarian tumor (BOT). Methods: Fifty women having borderline ovarian tumor (BOT) and 5O individuals with benign adnexal mass were enrolled in this retrospective study. The sensitivity, specificity, positive predictive values, negative predictive values and diagnostic accuracy of preoperative serum levels of the CA125 and CA19-9, ultrasound findings and menopausal status, and RMI IV were calculated for prediction of discrimination between BOTs and benign adnexal masses and the results were compared. Results: The RMI IV was the best method for discrimination between BOTs and benign adnexal masses and was more accurate than the other parameters. When Receiver Operator Characteristic area under the curves for menopausal status was analyzed, serum CA 125 and CA19-9 level, ultrasound score, RMI IV(CA125), and RMI IV(CA19-9) were, 0.580, 0.625, 0.548, 0.694, 0.734 and 0.711, respectively. The best RMI IV cut-off was found to be 200 for discrimination of benign and BOT lesions. In the RMI formulation, replacing CA125 with CA19-9 didn’t affect RMI IV sensitivity and specificity for discrimination. Conclusion: Compared to ultrasound, menopausal status, CA-125, CA19-9, the RMI IV was found to be the best predictive method for differentiation of BOTs from benign adnexal masses. RMI IV cut–off value of 200 is suitable for differentiation of benign and BOT’s.

Herniation of fallopian tube through perforated uterine wall during previous first trimester surgical abortion in an infertile patient

A unique case of fallopian tube herniation into the endometrial cavity after dilatation and curettage is presented. A 28‐year‐old patient who had secondary infertility for 2 years following dilatation and curettage without any other specific complaint was evaluated by laparoscopy and hysteroscopy. During these procedures, herniation of the right tube and infundibulopelvic ligament into the uterine cavity were observed. The herniation was repaired through a minilaparotomy incision.

Continuous vaginal and bilateral thoracic fluid drainage for management of severe ovarian hyperstimulation syndrome.

Severe ovarian hyperstimulation syndrome (OHSS) is a serious and potentially fatal complication of ovarian stimulation. A 29-year-old nulligravid patient with anovulatory infertility was treated with in vitro fertilization. Six days after embryo transfer, the patient presented with complaint of abdominal bloating, nausea, vomiting and shortness of breath. Severe late-onset OHSS, with massive ascites and pleural effusion, was diagnosed. Posterior colpotomy was performed under general anesthesia, a Foley catheter was inserted into the posterior cul-de-sac, and bilateral chest drainage tubes were left for continuous drainage. In total, 13.2 liters of ascites and 6.1 liters of pleural fluid were drained in 8 days. Continuous drainage of ascites and pleural effusion improved the patients comfort without need for repeated transvaginal and thoracic aspirations.

Using narrow‐band imaging with conventional hysteroscopy increases the detection of chronic endometritis in abnormal uterine bleeding and postmenopausal bleeding

A preliminary study was designed to evaluate whether a narrow‐band imaging (NBI) endoscopic light source could detect chronic endometritis that was not identifiable with a white light hysteroscope.

Chitotriosidase levels in patients with severe endometriosis.

Objective: To study the levels of chitotriosidase activity in the peritoneal fluid and the plasma of patients with severe endometriosis and control subjects. Materials and methods: Twenty-five women with laparoscopically and histopathologically confirmed endometriosis (study group) and 27 control patients who had undergone laparoscopic surgery were included. Peritoneal fluid and peripheral blood were obtained from all the patients before the surgery. Chitotriosidase activities were measured. Results: Analysis of chitotriosidase activity in the peritoneal fluid of patients with endometriosis showed that there was no significant difference between endometriosis and control group, respectively (32.04 ± 64.20 vs. 15.25 ± 31.17 nmol/mL/h; p > 0.05). Analysis of chitotriosidase activity in plasma of patients with endometriosis showed significantly increased levels of chitotriosidase levels compared with the control group (74.81 ± 60.54 vs. 14.10 ± 26.17; p < 0.001), respectively. Conclusion: We found that the activity of chitotriosidase in plasma was statistically higher in severe endometriosis patients than women without endometriosis.

Comment to "The prognosis of pregnancy conceived despite the presence of an intrauterine device (IUD)".

No abstract available