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    Correlations of maternal neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) with birth weight
    (Taylor & Francis Ltd, 2017) Akgun, Nilufer; Kalem, Muberra Namli; Yuce, Ebru; Kalem, Ziya; Aktas, Hatice
    Objective: The aim of this study is to investigate the possible correlation of hemogram parameters including neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) with birth weight and gestational week.Materials and methods: This prospective study has been conducted with 783 patients. The maternal age, parity, gestational age, type of delivery, values of complete blood count (CBC) variables and the weight of newborn were recorded. We analyzed the statistical differences between the NLR, PLR, hemoglobin (HGB), platelet distribution width (PDW), red cell distribution width (RDW), mean platelet volume (MPV), platelet, neutrophil, lymphocyte and white blood cells (WBC) in terms of the birth weight.Results: There was no statistically significant difference in the NLR in terms of the birth weight (p=0.097), whereas there was a statistically significant difference in the PLR (p<0.001). In correlation analyses, a linear, negative, weak and statistically significant correlation was detected between NLR and PLR with the birth weight of infant and gestational week (p=0.011 and p<0.001, respectively).Conclusion: This prospective study is the first in the literature which investigates the correlation of NLR and PLR with the week of birth and birth weight of the infant. Our study suggested that the maternal NLR and PLR are negatively correlated with the week of birth and birth weight of the infant.
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    Electrocardiographic P-Wave Duration, QT Interval, T Peak to End Interval and Tp-e/QT Ratio in Pregnancy with Respect to Trimesters
    (Wiley, 2016) Tanindi, Asli; Akgun, Nilufer; Pabuccu, Emre Goksan; Gursoy, Asli Yarci; Yuce, Ebru; Tore, Hasan Fehmi; Duvan, Candan Iltemir
    Background: P-wave duration helps to determine the risk of atrial arrhythmia, especially atrial fibrillation. QT interval, T peak to end interval (Tp-e), and Tp-e/QT ratio are electrocardiographic indices related to ventricular repolarization which are used to determine the risk of ventricular arrhythmias. We search for any alterations in electrocardiographic indices of arrhythmia in the pregnancy period with respect to trimesters. Methods: We enrolled 154 pregnant and 62 nonpregnant, healthy women into this cross-sectional study. Maximum and minimum P-wave durations (Pmax, Pmin), and QT intervals (QTmax, QTmin) were measured from 12 leads. QT measurements were corrected using Fridericia (QTc-Fr) and Bazett's (QTc-Bz) correction. Tp-e interval was obtained from the difference between QT interval, and QT peak interval (QTp) measured from the beginning of the QRS until the peak of the T wave. Tp-e/QT ratio was calculated using these measurements. Results: Pmax were 93.0 +/- 9.1, 93.9 +/- 8.9, 97.9 +/- 5.6, 99.0 +/- 6.1 in nonpregnant women, first, second, third trimesters of pregnancy, respectively (P = 0.001); whereas Pmin values were not significantly different. QTc-Fr max were 407.4 +/- 14.2, 408.5 +/- 16.1, 410.1 +/- 13.1, 415.1 +/- 10.1 (P = 0.007); Tp-e were 72.7 +/- 6.2, 73.2 +/- 6.5, 77.2 +/- 8.9, 87.2 +/- 9.6 (P < 0.001); and Tp-e/QT were 0.17 (0.14-0.20), 0.17 (0.14-0.20), 0.18 (0.15-0.23), 0.20 (0.16-0.25) in nonpregnant women, first, second, and third trimesters of pregnancy respectively (P < 0.001). None of the participants experienced any arrhythmic event. Conclusions: P-wave duration is prolonged in the second trimester, and resumes a plateau thereafter. Maximum QTc interval, Tp-e interval and Tp-e/QT ratio are increased in the late pregnancy. Although these indices are altered during the course of pregnancy, they all remain in the normal ranges.
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    Misdiagnosis of macroamylasemia in pregnancy as pancreatitis
    (Walter De Gruyter Gmbh, 2015) Eser, Ayla; Akgun, Nilufer; Yuce, Ebru; Kafali, Hasan
    Background: While elevated serum amylase in the presence of abdominal pain can be indicative of pancreatitis, differential diagnosis of macroamylasemia depends on additional assessment of serum lipase and urinary amylase. The present report concerns misdiagnosis of pancreatitis in a pregnant woman with elevated serum amylase but normal lipase. Highlights: The patient was a nulligravid woman on her first pregnancy diagnosed with pancreatitis in her 32nd week plus 3 days of gestation, on the basis of elevated serum amylase and abdominal pain, after treatment for premature contractions and antepartum vaginal bleeding with ritodrine HCl and nifedipine. She was started on painful and invasive intravenous hydration; oral intake was stopped. Repeat elevated serum amylase suggested that the patient might in fact have macroamylasemia, not pancreatitis. Conclusions: Normal serum lipase levels should be considered as a likely indication of an alternative cause of elevated serum amylase to pancreatitis, and urinary amylase should be routinely checked to assist in differential diagnosis to avoid unnecessary and invasive treatment and stress to pregnant women.
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    The relationship between postmenopausal women's sclerostin levels and their bone density, age, body mass index, hormonal status, and smoking and consumption of coffee and dairy products
    (Springer Heidelberg, 2017) Kalem, Muberra Namli; Kalem, Ziya; Akgun, Nilufer; Bakirarar, Batuhan
    To investigate the relationship between postmenopausal women's sclerostin levels and bone density and the factors that may affect this relationship. 135 postmenopausal patients' ages, BMIs, hormonal statuses, BMD values, and smoking, and consumption of coffee and dairy products were compared with their sclerostin levels. No statistical relationship was found between sclerostin level and age in the group with osteoporosis (p = 0.204, r = -0.305). There was a positive, high-level relationship between sclerostin levels and BMI in the osteoporosis group and it was found to be statistically significant (p < 0.001, r = 0.786). No statistical relationship was found between sclerostin level and age in the non-osteoporosis group with (p = 0.496, r = -0.88). There was a positive, moderate relationship between sclerostin levels and BMI in the non-osteoporosis group and it was found to be statistically significant (p < 0.001, r = 0.505). No statistically significant relationship could be found between sclerostin levels and vitamin D (p = 0.723), PTH (p = 0.112), FSH (p = 0.795), E-2 (p = 0.627), TSH (p = 0.517), T-3 (p = 0.788), and T-4 (p = 0.664) blood levels. No significant difference was found among the groups formed by smoking, consumption of coffee and milk, and dairy products, either (p = 0.405; p = 0.626; p = 0.234, respectively). It was monitored that sclerostin's negative effect observed on BMD scores was independent from age; however, it had a positive correlation with BMI. As blood sclerostin levels increase, bone mineral density decreases. This negative effect of sclerostin on bone density increases as BMI increases, too. Effects of sclerostin levels on bone density are independent from age, and they are not affect by levels of vitamin D: PTH, FSH, E-2 and thyroid hormones, and daily activities, such as smoking and consumption of coffee and milk and dairy products, either.