Nese Gul Hilali

Increased prolidase activity and oxidative stress in PCOS.

Matrix metalloproteinases (MMPs) have been considered to have a role in various pathological processes, including inflammatory response, cardiovascular disease and recently also in ovarian dysfunction. Since prolidase could be accepted as a matrix metalloproteinase, on the biochemical level, we aimed to evaluate serum prolidase activity and oxidative–antioxidative status in patients with polycystic ovary syndrome (PCOS) and healthy individuals.

DNA damage and oxidative stress in patients with mild preeclampsia and offspring

OBJECTIVE Oxidative stress has been shown to play an important role in the pathogenesis of pre-eclampsia, and DNA damage frequently occurs in cells exposed to such stress. The aim of the present study was to investigate DNA damage and oxidative stress in mildly pre-eclamptic women and their offspring. STUDY DESIGN We studied 25 mildly pre-eclamptic mothers, 20 healthy controls, and their infants. Mononuclear leukocyte DNA damage, total antioxidant status (TAS), and total oxidant status (TOS) were determined and the oxidative stress index (OSI) was calculated. RESULTS DNA damage, and TOS and OSI levels were significantly increased, and TAS levels significantly decreased, in maternal and cord blood samples of the mildly pre-eclamptic group. A positive correlation between the extent of DNA damage and diastolic blood pressure was evident in pre-eclamptic mothers and there was a negative correlation between the extent of DNA damage and TOS. CONCLUSION Both oxidative stress and DNA damage are elevated in mildly pre-eclamptic patients and their offspring. Increased oxidative stress may be important in inducing DNA damage in pre-eclamptic patients.

May mean platelet volume levels be a predictor in the diagnosis of pelvic inflammatory disease

SummaryBackgroundOur aim in this study was to investigate whether mean platelet volume (MPV) value could be used as an early marker to predict pelvic inflammatory disease (PID).MethodsOverall, 44 patients with PID and 44 healthy women were included in the study. The control group consisted of 44 women who applied to the clinic for a routine gynaecological check-up, without chronic disease or a history of medication use. Owing to the fact that it would affect thrombocyte function, women who have the following conditions were excluded from the study: women who were taking anticoagulant therapy, oral contraceptives, nonsteroid anti-inflammatory medications and who had chronic diseases. The leukocyte count, platelet count, neutrophil ratio and MPV values were collected from PID and the control group. C reactive protein values of patients with PID were also noted.ResultsMPV values in patients with PID were lower than those in the control group. This reduction in MPV is statistically significant when the PID patient group is compared with the control group (p < 0.001). A negative correlation was discovered between platelet count and MPV values (p = 0.019, r = − 0.425). Receiver-operating curve analysis pointed out that MPV has greater area under curve value than neutrophil rate, leukocyte and platelet count (0.73, 0.64, 0.72 and 0.49 respectively).ConclusionSince the MPV value was significantly decreased in patients with PID, it may serve as an additional and even more valuable marker than leukocyte count in the diagnosis of PID.ZusammenfassungGrundlagenZiel dieser Studie war es zu untersuchen, ob das mittlere Thrombozytenvolumen (MPV) als früher Marker einer Erkennung von Entzündungen im Beckenbereich verwendet werden kann.Methodik44 Patienten mit Entzündungen im Becken und 44 gesunde Frauen wurden in die Studie aufgenommen. Die Kontrollgruppe waren Frauen, die die Ambulanz der Klinik zur gynäkologischen Routineuntersuchung aufgesucht hatten. Um andere Einflüsse auf die Thrombozytenfunktion zu vermeiden, wurden Frauen, die unter oraler Antikoagulationstherapie standen, die orale Kontrazeptiva und/oder nicht-steroidale antiinflammatorische Medikamente nahmen oder die eine chronische Erkrankung hatten, nicht in die Studie aufgenommen. Die Leukozytenzahl, die Thrombozytenzahl, der Neutrophilen Quotient und die MPV Werte wurden bei beiden Gruppen erhoben. Bei der Patientengruppe wurden zusätzlich die CRP Werte gemessen.ErgebnisseDie MPV Werte bei den Patientinnen waren niedriger als in der Kontrollgruppe (p < 0,001). Es bestand eine negative Korrelation zwischen der Thrombozytenzahl und den MPV Werten (p = 0,019, r = − 0,425). ROC Analysen ergaben, dass die MPV eine größere Fläche unter der Kurve hatte als die Neutrophilen Rate, oder die Leukozyten- beziehungsweise die Thrombozytenzahl (0,73, 0,64, 0,72 und 0,49 respektive).SchlussfolgerungDa das MPV bei Patientinnen mit Entzündungen im Beckenbereich signifikant erniedrigt war, kann dieser Parameter als ein zusätzlicher und im Vergleich zur Leukozytenzahl sogar wertvollerer Marker bei der Diagnose von Entzündungen im Beckenbereich dienen.

Surgical management of 58 patients with placenta praevia percreta

SummaryObjectiveThe aim of this study is to present our experience with surgical management of placenta praevia percreta.MethodsThis study was conducted from January 2009 through March 2014 at Harran University Hospital and was a chart review of all patients who underwent caesarean hysterectomy with the placenta left in situ for placenta praevia percreta.ResultsThe study group comprised 58 patients. All of the patients underwent ultrasound mapping of the placental area before surgery. Emergent caesarean hysterectomy was only performed in 9 patients; 49 patients underwent planned caesarean hysterectomy. Bilateral internal iliac artery ligation was performed in all cases. Four patients (6.9 %) had bladder damage, one patient (1.7 %) required cystotomy, and one patient (1.7 %) required re-operation because of postoperative hemorrhage. The mean operative time was 141.6 (range: 95–355) minutes. Only 17 (29.3 %) patients were administered more than four units of red blood cells. There was no ureteral damage or maternal death. Furthermore, there were no complications in 42 (72.4 %) patients.ConclusionsCaesarean hysterectomy for placenta praevia percreta is associated with increased maternal morbidity. However, preoperative diagnosis of placenta praevia percreta, ultrasound mapping of the placenta, and the presence of a multidisciplinary experienced team may decrease maternal morbidity and mortality. Moreover, the urinary system may be protected in the patients with placenta praevia percreta without serious morbidity.

Does a risky outcome of antenatal screening test indicate oxidative stress

Abstract Objective: The study aimed to investigate a possible relationship between second trimester aneuploidiy screening results and oxidative stress in foetal amnion and maternal serum. Methods: Concerning the outcome of the second-trimester screening test, 50 pregnant women of high risk were included in the experimental group, whereas 50 pregnant women with normal scores who wished to proceed with the amniocentesis procedure due to advanced maternal age and counselling were included in the control group. The biochemical parameters of total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI) were measured in the amniotic fluid samples and maternal serum samples. Results: OSI in the maternal serum samples, as well as TAS and TOS in the amniotic fluid, was significantly higher in the control group compared to the experimental group (p < 0.001, p = 0.047, p = 0.005, respectively). There was no significant difference in the TAS and TOS in the maternal serum samples or the OSI in the amniotic fluid between the groups. Conclusions: The results indicate that the positivity of the screening test is not significantly correlated with oxidative stress, a factor regarded as a pathological mechanism in various diseases. Potential maternal anxiety could underlie the elevated oxidative stress in the control group.

A Community-Based Survey on Syrian Refugee Women’s Health and Its Predictors in Şanliurfa, Turkey

ABSTRACT Reproductive characteristics, mental health symptoms, micronutrient deficiencies, and symptoms of sexually transmitted infections (STIs) were determined among married Syrian refugee women aged 15–49 years who were living outside of camps in 2015, using probability sampling. Of the 458 participants, 51.3 percent married before the age of 18 years. Early-age marriages and number of desired children increased after the war. In multivariable analyses, education (adjusted odds ratio [aOR] = 1.2; 95% confidence interval [CI] = 1.2–1.3) and length of stay in Şanlıurfa (aOR = 1.2; 95% CI = 1.1–1.2) were independently associated with early marriage. Approximately 16 percent of women were pregnant, and 26.7 percent of them had not received prenatal care; 47.7 percent had had a pregnancy loss; 50.8 percent reported symptoms of STIs. Of those who were sexually active, 37.8 percent were not using contraception. The prevalence of iron, B12, and folic acid deficiencies was 50 percent, 45.6 percent, and 10.5 percent, respectively. Early marriage (aOR = 2.2; 95% CI = 1.4–3.5) and number of desired children (aOR = 5.03; 95% CI = 3.2–7.9) were associated with not using contraception. Most (89.7 percent) women reported at least two mental health symptoms; lack of social support (aOR = 2.6; 95% CI = 1.3–5.3), language barrier (aOR = 2.3; 95% CI = 1.01–5.2), and B12 deficiency (aOR = 1.8; 95% CI = 1.01–3.4) were associated with such symptoms. The findings demonstrate the need for reproductive health and psychosocial services.

Trophoblastic E-cadherin and TGF-beta expression in placenta percreta and normal pregnancies

Abstract Objective: This study aimed to evaluate whether trophoblastic transforming growth factor beta (TGF-β) and E-cadherin expression levels have a role in placenta percreta (PP) aetiopathogenesis. Methods: This study was carried out in the Obstetrics & Gynecology and Pathology Departments of Harran University Medicine School. Forty-four women who underwent caesarean section for PP and other obstetric reasons were included in this study. PP was defined as the detection of placental invasion during the histopathological examination of the hysterectomy specimen, which passes the uterine wall as a whole layer and involves the uterine serosa. Placental tissue samples were collected from all pregnant patients to evaluate TGF-β and E-cadherin expression levels. Results: No significant difference was found in demographic features, including age, gestational week, number of pregnancies and body mass index, among the groups. Immunohistochemical staining against E-cadherin, a cell adhesion molecule, showed significantly reduced staining in PP patients (p = 0.048). TGF-β staining was also low in PP patients, but this difference was not significant (p = 0.107). Conclusions: The findings of this study suggest that a decrease in trophoblastic E-cadherin expression may have an important role in PP aetiopathogenesis.

Assessment of Apoptotic Activity Dysregulation and Oxidative Stress in the Development of Epithelial Ovarian Cancer: A Case-Controlled Descriptive Analysis

Aim: In the present study, we aimed to assess whether oxidative stress and apoptotic activity play a role in the development of epithelial ovarian cancer (EOC). Methods: The study group included patients with EOC (n = 26) and benign ovarian tumour (BOT) (n = 25), while 30 healthy women were employed as a control group. Venous blood samples were drawn to evaluate oxidative stress parameters and serum M30/M65 antigen levels before surgery. In addition, blood samples were taken for the second time on postoperative day 8 to analyse whether the postoperative tumour load was decreased. Results: When the groups were assessed regarding oxidative stress, the highest values were detected in patients with EOC. Serum M30/M65 levels were found to be higher in patients with EOC when compared to the other groups (p < 0.001). A significant decrease was determined in the M30/M65 levels of serum samples taken on postoperative day 8 from the patients in the EOC and BOT groups (p < 0.001). Conclusion: Our results suggest that dysregulation of apoptotic activity could be effective in the development of ovarian tumoural tissue, whereas oxidative stress could be effective in malignant transformation.

Prevalence of β-Thalassemia Trait and Abnormal Hemoglobins in Sanliurfa Province in Southeast Turkey

Abstract Thalassemia is one of the most common hereditary disorders in Turkey, especially in the Mediterranean region of the country. The purpose of this study was to determine the frequency of the β-thalassemia (β-thal) trait and abnormal hemoglobins (Hbs) in couples who applied for premarital screening in Sanliurfa Province, in the southeastern region of Turkey, a province with the first reported incidence of β-thal and abnormal Hbs. In the present study, in order to detect the prevalence of the β-thal trait and abnormal Hbs in Sanliurfa Province, Turkey, a total of 37,962 couples who applied for premarital screening were analyzed. From January 2011 through March 2014, red blood cell (RBC) counts and Hb fractionation were carried out by a cell counter and high performance liquid chromatography (HPLC), respectively. The prevalence of β-thal with high Hb A2 (>3.5%) values was found at rates of 2.44% (n = 1853) in Sanliurfa Province. Additionally, the abnormal Hb rate was 1.57% (1193/75,924), and Hb S (HBB: c.20T > A), Hb C (HBB: c.19G > A) and Hb D-Punjab (HBB: c.364G > C) were reported as 0.50, 0.38 and 0.69, respectively. This study is the first to establish the frequency of β-thal and abnormal Hbs in Sanliurfa Province, which has the highest birth frequency. We report that the frequency of the β-thal trait is at a high-risk level compared to other cities in Turkey. Due to the high risk of β-thal in Sanliurfa Province, a premarital screening program would be of great value in informing parents about offspring with β-thal.

Can circulating M30 and M65 levels be beneficial markers in the diagnosis and management of patients with complete hydatidiform mole

ObjectiveThe objective of this study is to evaluate the prognostic value of M30 and M65 levels as markers of apoptotic activity and maternal serum oxidative stress in patients with complete hydatidiform mole (CHM).MethodsIn total, 68 pregnant women were included in the study. The study group included 34 pregnant with CHM, while 34 healthy pregnant were employed as a control group. Venous blood samples were drawn to assess the maternal serum oxidative stress and M30–M65 levels. In addition, a second blood sample was drawn from patients with CHM on day 8 after dilatation evacuation.ResultsMaternal serum oxidative stress and M30–M65 levels were found to be significantly higher in patients with CHM as compared with the control group. It was found that serum β-subunit of human chorionic gonadotropin (β-hCG) level had a significant positive correlation with M30–M65 levels in patients with CHM. In addition, serum M65 level was found to be as effective as β-hCG in the identification of the patients with CHM.ConclusionOur results indicated that oxidative stress and apoptosis may play significant roles in CHM development. In addition, it seems that serum M30–M65 levels can presumably be an ancillary laboratory test to β-hCG in the diagnosis and follow-up of the patients with CHM.