Pasa Ulug

Evaluation of the effects of single or multiple dose methotrexate administration, salpingectomy on ovarian reserve of rat with the measurement of anti-Müllerian hormone (AMH) levels and histological analysis

OBJECTIVE To evaluate the effects of single, multiple dose methotrexate (MTX) administration and salpingectomy on ovarian reserve in a rat model. STUDY DESIGN In this prospective controlled experimental study, forty female Wistar-albino rats were randomly divided into four groups; healthy control group (group 1), one month after single dose (50mg/m(2)) MTX administration group (group 2), multiple (1mg/kg, 1, 3, 5, 7 days) dose MTX administration group (group 3), and unilateral salpingectomy applied group (group 4). Ovarian reserves were assessed with anti-Müllerian hormone (AMH) and ovarian follicles including primordial, primary, secondary, tertiary and total follicle counts. SETTING Kobay and Duzen experimental research laboratory. RESULTS Serum AMH levels decreased significantly in the single and multiple dose MTX administration group and salpingectomy group compared with control group. Primordial follicle counts were comparable between single dose MTX group and control group whereas all type of follicle counts in single and multiple dose MTX and salpingectomy group were significantly reduced compared with control. The least affected ovarian reserve in the treatment groups was single dose MTX group. CONCLUSIONS Ovarian reserve markers including follicle counts and AMH levels were decreased after single, multiple dose MTX administration, and salpingectomy. Single dose MTX was the least detrimental method on ovarian reserve for the treatment of ectopic pregnancy.

Evaluation of ovarian reserve tests in women with systemic lupus erythematosus.

Impact of systemic lupus erythematosus (SLE) on fertility may be negative, and ovarian function can be also reduced by autoimmune oophoritis. In this article, we evaluated the ovarian reserve of pre‐menopausal women firstly diagnosed with systemic lupus erythematosus (SLE).

Maternal magnesium level effect on preterm labor treatment.

Abstract Objective: To compare the initial serum magnesium levels between preterm labor (PL) and control groups and to evaluate MgSO4 treatment response in preterm labor group according to their initial serum magnesium levels. Methods: Hundred women diagnosed as preterm labor between 28 and 33 weeks of gestation and 100 non-complicated pregnant women were enrolled in this prospective study. Total basal serum magnesium levels were measured in both the groups. After a 6 g intravenous bolus of MgSO4, a dose of 2 g/h was given as an infusion in the preterm labor group. Results: Serum magnesium levels were significantly lower in preterm labor group (p < 0.001). The active contractions stopped in 69 (73,4%) preterm patients. The basal Mg level was significantly lower in this preterm group (1.6 versus 1.9, respectively, p < 0.001). Predictive value of basal magnesium level measurement for magnesium tocolysis response was calculated by receiver operating characteristic analyses with 95% confidence interval. Positive predictive and negative predictive values were found as 64.5% and 92.5%, respectively, with 83% accuracy, when cut-off magnesium value was taken as a <1.75 mg/dl (sensitivity = 80%, specificity = 84,1%). Conclusions: Basal magnesium levels in preterm labor had a predictive value in evaluating MgSO4 tocolysis response. It may help to select patients who are appropriate for MgSO4 tocolysis.

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.

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.

A systemic review of randomized controlled studies about prevention with pharmacologic agents of adhesion formation in the rat uterine horn model

Introduction Evaluation of treatment attempts in postoperative adhesion formation is pivotal for the prevention of several morbidities including infertility, pelvic pain, bowel obstruction, and subsequent intraoperative complications. The purpose of this systemic review was to assess the literature on the rat uterine horn model for adhesion formation and treatment modalities to prevent adhesion in the most frequently used experimental animal model. Material and methods We performed a systemic review of publications from January 1st 2000 to December 31st 2013 via a PubMed search. A high number of agents were evaluated for the prevention of postoperative adhesion formation in the rat uterine horn model. Results According to most of the studies, adjuvants such as antiinflamatuars, antiestrogens, antioxidants were effective to prevent adhesion formation. Conclusions Prevention of adhesion formation is pivotal and numerous types of agents were described in the literature were summarized in this review.

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.

Ovarian reserve markers in unexplained infertility patients treated with clomiphene citrate during intrauterine insemination

Introduction The aim of this retrospective case control study was to identify predictors of ovarian response and pregnancy outcomes in intrauterine insemination (IUI). Material and methods One hundred women undergoing IUI cycles with clomiphene citrate were enrolled. The number of antral follicles and the total ovarian volume by ultrasound, and the basal levels of follicle-stimulating hormone (FSH), estradiol, and inhibin B on cycle day 3 were measured in groups that were divided according to ovarian response. The tests were also evaluated according to ovarian response and pregnancy outcomes. All analyses were performed using the Statistical Package for the Social Sciences, version 15.0 (SPSS, Chicago, IL, USA). Results The antral follicle count (AFC) was the best single predictor for ovarian response and pregnancy outcomes. The sensitivity and specificity for prediction of ovarian response were 81% and 78% for AFC at an optimum cutoff value of ≤ 13.1. Age was negatively correlated with ovarian volume (r = –0.280, p = 0.021) and AFC (r = –0.358, p = 0.003). Increasing FSH was associated with a reduction in AFC (r = –0.273, p = 0.025). The AFC was significantly correlated with ovarian volume (r = 0.660, p < 0.0001) and FSH (r = –0.273, p = 0.03). Conclusions Our data demonstrate that the AFC provides better prognostic information on the occurrence of ovarian response during clomiphene citrate stimulation for IUI.

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.

Relationship between mean platelet volume and recurrent miscarriage: a preliminary study.

Introduction The aim of the study was to examine the relationship between mean platelet volume (MPV) and recurrent miscarriage in order to illuminate the etiopathogenesis of recurrent miscarriage. Material and methods We retrospectively investigated the data of 120 patients with unexplained recurrent miscarriage (group 1), and compared them with the data of 120 match-paired patients in the control group (group 2). The definition of recurrent miscarriage was accepted as two or more failed clinical pregnancies which were documented by ultrasonography or histopathologic examination. All patients in the recurrent miscarriage group were evaluated with diagnostic tests for the etiology of recurrent miscarriage. Total blood count parameters, including hemoglobin, mean corpuscular volume, red cell distribution width, white blood cells, platelets, and mean platelet volume, were compared. Results The average patient age at the time of examination was 29.07 ±2.81 years in group I and 28.53 ±3.5 years in group II (p > 0.05). Mean body mass index (BMI) was similar between group 1 and group 2, 22.54 ±3.17 and 22.99 ±2.38, respectively (p > 0.05). Mean hemoglobin, mean corpuscular volume, red cell distribution width, and white blood cell and platelet levels were similar in both groups (p > 0.05). Mean platelet volume levels were significantly higher in group I (9.45 ±1.09 fl) than in group II (7.63 ±0.52 fl) (p = 0.001). Conclusions Higher MPV values in the study group suggest and support the importance of thromboembolic events in the etiology of recurrent miscarriage.