Mehmet Can Nacar

The Effect of Maternity Support Belts on Postural Balance in Pregnancy

The purpose of this study was to evaluate the effect of maternity support belts (MSB) on postural balance during pregnancy.

Neutrophil-lymphocyte and platelet-lymphocyte ratios in endometrial hyperplasia

Objective The purpose of present study was to evaluate association between neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) and endometrial hyperplasia (EH). Methods One hundred and ten women with abnormal uterine bleeding were included into the study. Blood samples were drawn from all patients to obtain complete blood cell counts, neutrophil-leukocyte ratio and platelet-leukocyte ratio before endometrial curettage procedure initiated. The patients were divided into three groups due to their pathological results: group 1, patients with EH without atypia (n=40); group 2, patients with EH with atypia (n=15); and group 3, patients with neither hyperplasia nor cancer as control group (n=55). Blood cell counts, NLRs and PLRs were compared among these groups. Results Based on hemoglobin and platelet counts, there was no significant difference among these groups (P>0.05). Leukocyte and neutrophil counts were higher in group 2 (EH with atypia) than group 1 and group 3 (P<0.01). NLR of group 2 was significantly elevated when compared to group 1 and group 3 (P=0.004). PLR was higher in group 1 and group 2 than control group (P=0.024). Conclusion Non-specific inflammatory markers such as NLR and PLR were elevated in women with atypical EH. These markers may be used as a predictor of atypical EH in patients with abnormal uterine bleeding.

Regression of experimental endometriotic implants in a rat model with the angiotensin II receptor blocker losartan.

Endometriosis is a common disease in women of reproductive age, and many different treatments have been developed, although none has provided a cure. In this study, the efficacy of losartan, an angiotensin II type 1 receptor blocker and an antiangiogenic and anti‐inflammatory agent, on regression of experimental endometriotic implants in a rat model was investigated.

Mature cystic teratomas: Relationship between histopathological contents and clinical features

AIMS The aim of this study was to evaluate the relationship between pathological findings and clinical features in patients with ovarian mature cystic teratomas (MCTs). MATERIALS AND METHODS We reviewed and compared the demographic and clinical features of 32 patients confirmed pathologically as having MCT at a university hospital from 2009 to 2014, with MCT contents such as skin, hair, sebum, and cartilage. RESULTS The mean age of the patients was 33.7 ± 13.4 years. The mean tumor diameter was 7.1 ± 3.3 cm (range: 2-15 cm). The mean serum CA-19.9 level was 37.5 ± 79.5 IU/ml and the mean serum CA-125 level was 29.1 ± 33.0 IU/ml. The postmenopausal and pregnancy status rates of participants were 18.8, and 15.6%, respectively. The mean age, postmenopausal and pregnancy status, tumor size, symptoms related to MCT and laterality of the tumor did not differ among the patients according to the MCT contents. CONCLUSIONS Our findings suggest no relationship between the clinical features and histopathological contents of MCTs.

Postural balance in pregnancies complicated by hyperemesis gravidarum

Abstract Objective: To assess postural balance in females with pregnancies complicated by hyperemesis gravidarum (HG). Methods: In this observational study, postural balance during the first trimester was measured using the Biodex Balance System (BBS) in 41 pregnant females (20 females with pregnancies complicated by HG and 21 healthy controls). The overall stability index (OA), anterior-posterior stability index (APSI), medial-lateral stability index (MLSI) and fall risk test (FRT) scores were obtained from the mean scores of three trials on the BSS. The four measurements obtained from the BBS (OA, APSI, MLSI and FRT) were compared between healthy pregnant females and those with pregnancies complicated by HG (HG group). Results: The mean OA and APSI scores were significantly higher in the HG group compared to healthy pregnant controls (p < 0.01). There was no significant difference in the MLSI between the two groups (p > 0.05). The FRT scores of HG patients were higher than healthy pregnant females (p = 0.001). Conclusions: Pregnant females with HG have poor postural stability/balance and high fall risk test scores. HG causes decreased postural equilibrium in the first trimester of pregnancy.

Incidence of gestational trophoblastic disease in Tokat province, Turkey

OBJECTIVE This study investigated the incidence of gestational trophoblastic disease (GTD) in Tokat province, Turkey. MATERIAL AND METHODS The medical records of patients who had been diagnosed and treated at one university hospital, six government hospitals, and one specialist hospital in Tokat province between January 2005 and December 2012 were evaluated retrospectively. RESULTS During the study period, there were 59,754 births and GTD was diagnosed in 73 cases. The calculated GTD incidence was 1.22/1000. The mean age of the patients diagnosed with GTD was 28.6±7.3 (range 17-51) years. In GTD, complete moles occurred in 26%, partial moles in 74%, and no invasive moles, choriocarcinomas, or placental site trophoblastic tumours were found. Only two patients received chemotherapy (methotrexate). There was no mortality associated with the disease during follow-up. CONCLUSION The incidence of GTD in Tokat province was 1.2 per 1000 births. Early diagnosis, treatment, and follow-up play a critical role in preventing the morbidity and mortality associated with disease. The incidence of GTD, which has a high recovery rate with adequate treatment and follow-up, can be determined from regional and community-based research.

Late Postpartum HELLP Syndrome 60 Hours after Delivery Associated with Mild Pre-eclampsia

The purpose of this report is to present a case of mild Pre-eclampsia which was complicated with postpartum HELLP syndrome. A 25-years-old pregnant woman with mild Pre-eclampsia at 36 weeks of gestation was admitted to our clinic with uterine contractions. A caesarean section was performed, due to her previous caesarean section history. Postpartum period was uneventful until the 2nd day after the caesarean section. Epigastric pain, nausea and vomiting appeared two days after her delivery. In evaluation of the case, laboratory findings which were associated with HELLP syndrome were found to include haemolysis, elevated liver enzymes and low platelet counts. The general condition and laboratory findings of the case returned to normal with supportive and steroid treatment after 3 days. It should be noted that HELLP syndrome can develop in the postpartum period. Therefore, caution should be exercised in patients with pre-eclampsia, for the development of the postpartum HELLP syndrome.

The Evaluation of IL6 and ESR1 Gene Polymorphisms in Primary Dysmenorrhea.

ABSTRACT Primary dysmenorrhea is the most common gynecological complaint with painful menstrual cramps in pelvis without any pathology. It affects about half of menstruating women, and it causes significant disruption in quality of life. We investigated the association between IL6 gene promoter and ESR1 gene XbaI and PvuII polymorphisms and primary dysmenorrhea. In this case–control study, 152 unrelated young women with primary dysmenorrhea and 150 unrelated healthy age-matched controls participated. Genomic DNA was isolated and IL6 and ESR1 gene polymorphisms were genotyped using PCR-based RFLP assay. The distribution of genotype and allele frequencies of IL6 gene promoter and ESR1 gene XbaI polymorphisms were not statistically different between patients and controls (p > 0.05). However, the genotype and allele frequencies of ESR1 gene PvuII polymorphism showed statistically significant differences between primary dysmenorrhea patients and controls (p = 0.009 and p = 0.021, respectively). Statistically significant associations were also observed between age and married status of primary dysmenorrhea patients and ESR1 gene PvuII polymorphism (p = 0.044 and p = 0.023, respectively). In combined genotype analyses, AG at ESR1 XbaI and TC at ESR1 PvuII loci encoded a p-value of 0.027. Thus, individuals who are heterozygote at both loci have a lower risk of developing primary dysmenorrhea. Our study suggests no strong association between IL6 gene promoter and ESR1 gene XbaI polymorphisms and primary dysmenorrhea in Turkish women. However, ESR1 gene PvuII polymorphism showed statistically significant differences between primary dysmenorrhea patients and controls. The potential association between ESR1 gene PvuII polymorphism and age and married status of dysmenorrhea patients deserves further consideration.

Underage mothers in Turkey

Background All individuals under the age of 18 are considered as children by the Convention on the Rights of Children. Underage mothers are a pediatric-age group of children that become pregnant and give birth. It may be unfamiliar in Western countries, but in Middle-Eastern countries ruled by religious laws and old-fashioned traditions, it is common for an older man to marry a girl. The aim of this study was to describe the status of underage mothers within the framework of children’s rights and to draw attention to this issue. We presented this study to increase awareness and sensitivity, and to scrutinize and discuss these topics. Material/Methods We retrospectively investigated cases of underaged pregnant girls who applied to Forensic Science Department outpatient clinics and Obstetrics and Gynecology Department outpatient clinics of Gaziosmanpasa University Faculty of Medicine between 2003 and 2013. Results We accessed records of 163 underage mothers (≤18 age). Mean age was 16.9±0.83 (14–18 years). Gravida and parity rates increased proportionately with increasing age. Most of our cases were 16 and 17 years of age (n: 117, 71.8%). Conclusions Underage motherhood is not only a medical issue; it is a multi-dimensional problem with social, economic, traditional, religious, and legal aspects.

MTHFR and IL-4 Gene Polymorphisms Are Not Associated with Primary Dysmenorrhea in Young Adults

Abstract Primary dysmenorrhea is one of the most common conditions among young adult females. The purpose of the present study was to investigate possible associations between the functional MTHFR gene C677T and IL-4 gene intron 3 VNTR polymorphisms with primary dysmenorrhea susceptibility in a Turkish population. One hundred and fifty-nine unrelated young women with primary dysmenorrhea and 135 unrelated healthy age-matched controls. Genomic DNA were isolated and MTHFR gene C677T polymorphism genotyped using polymerase chain reaction (PCR)-based restriction fragment length polymorphism (RFLP) assay and IL-4 gene intron 3 VNTR polymorphism genotyped by using PCR with specific primers. The distribution of genotype and allele frequencies was not statistically different between the primary dysmenorrhea patients and healthy controls (p>0.05). According to the findings of first study of intron 3 VNTR polymorphism in the IL-4 gene and C677T polymorphism in MTHFR gene, these polymorphisms do not lead to increased susceptibility to primary dysmenorrhea.