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Öğe Bakri balloon application in postpartum haemorrhage(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2015) Eser, Ayla Açar; Koş???us, Aydin; Aslaner, Sevgi Yildirim; İnegöl Gümüş, İlknur; Kaygusuz, İkbal Cekmen; Köşüş, Nermin; Hizli, DenizObjective: To evaluate effectiveness of Bakri Balloon in post-partum haemorrhage treatment. Post-partum haemorrhage is the most common cause of maternal death in the world. It is potentially fatal complication of both vaginal and caesarean deliveries. In situations where medical interventions are unsuccessful in achieving haemostasis in cases of post-partum haemorrhage, either conservative or invasive surgical therapies are needed. Ultimately hysterectomy may be required. Invasive surgical interventions are associated with co-morbidities and potential implications for future fertility. Among the more conservative interventions are intrauterine balloon tamponade such as the Bakri balloon. Material and Methods: In this retrospective, observational study, records of 25 patients who were treated for post-partum haemorrhage in the Obstetrics and Gynecology Clinic of Turgut Ozal University Hospital, between January 2009 and August 2014 were examined. Frequency and efficacy of interventions were investigated in terms of haemostasis achievement without recourse to hysterectomy. Results: In 12 women who underwent Bakri balloon placement, haemostasis was achieved in all patients without subsequent hysterectomy. By contrast, of 9 women who underwent arterial ligation, 77.8% required hysterectomy as opposed to 31.3% of the 16 women who did not undergo arterial ligation. Use of combinations of surgical techniques was also significantly associated with higher risk of hysterectomy when compared to single techniques. Conclusion: Use of Bakri balloon is a highly effective method in achieving haemostasis in post-partum haemorrhage without necessity of hysterectomy. © 2021 Elsevier B.V., All rights reserved.Öğe Can either oral glucose challenge test or oral glucose tolerance test parameters predict gestational diabetes mellitus?(Springer India, 2017) Yildirim, Melahat; Kosus, Aydin; Kosus, Nermin; Hizli, Deniz; Akcal, Banu; Kosger, HaticeThis study aims to evaluate the relationship between the glucose challenge test (GCT) levels and any of the oral glucose tolerance test (OGTT) parameters (fasting plasma glucose (FPG), 1-, 2-, or 3-h plasma glucose levels) and their effect on predicting gestational diabetes mellitus (GDM). This analysis was carried out as a retrospective study at Obstetrics and Gynecology Clinic of Turgut A-zal University Hospital. Oral GCT were conducted on patients who are at 24-29 weeks' gestation. The study participants with positive GCT results underwent a 3-h, 100-g OGTT, and the resulting values were evaluated using Carpenter and Coustan diagnostic criteria to determine the gestational glucose tolerance status of patients. The data obtained from both tests (GCT, FPG, 1-, 2-, 3-h OGTT values) were analyzed to observe the effect of each group on predicting GDM. Although all of the GCT and OGTT values were found to be statistically significant (p < 0.001) in determining GDM, the 2-h values of OGTT detected almost all GDM cases with a very high sensitivity level (94.5 %). The 1-h values on the other hand identified 87.6 % of GDM (p < 0.001). The GCT value with the highest sensitivity and specificity for predicting GDM was calculated as 154.50 mg/dl (sensitivity and specificity rates were 79.2 and 72.8 %, respectively). A 2-h OGTT glucose level can detect GDM with 94.5 % sensitivity. This result can guide clinicians to evaluate the patients with GDM.Öğe Does vitamin E prevent tubal damage caused by smoking? A light microscopy and animal study(Elsevier Science Bv, 2014) Duran, Muzeyyen; Ustunyurt, Emin; Kosus, Aydin; Kosus, Nermin; Turhan, Nilgun; Hizli, Deniz; Sarac, Gulce NazObjective: To assess the histomorphological effects of smoking on the cilia of fallopian tubes in mice and the effect of vitamin E on the negative effects of smoke. Study design: Eighteen 12-14 week-old Swiss albino type female mice were randomly divided into three groups, each consisting of six mice: Group A: control group; Group B: mice exposed to cigarette smoke; Group C: mice exposed to cigarette smoke together with vitamin E. Groups B and C were exposed to cigarette smoke for 10 weeks. After 10 weeks, tubal excision was performed in all animals. Histopathologic examination of excised tubal tissue was conducted under light microscopy. Results: The number of cilia was significantly lower in Group B. Although not statistically significant, the median number of cilia in Group C was measured to be higher than in Group B but lower than in Group A. Conclusion: Based on the results, it can be concluded that smoking decreases tubal cilia numbers. Supplementation by vitamin E may treat or at least help to slow down the decrease in number of cilia caused by smoking; therefore it could be used therapeutically in the treatment of smoking-related tubal damage. Crown Copyright (C) 2014 Published by Elsevier Ireland Ltd. All rights reserved.Öğe Effect of combined oral contraceptive use on serum 25-hydroxy vitamin D levels and ultrasound parameters in patients with polycystic ovary syndrome(Taylor & Francis Ltd, 2016) Kalem, Mueberra Namli; Hizli, Deniz; Kamalak, Zeynep; Kosus, Aydin; Kosus, Nermin; Turhan, Nilgun; Kafali, HasanPurpose: To investigate if there is an effect of combined oral contraceptive (COC) use on serum 25-hydroxy vitamin D [25(OH)D] levels in patients with polycystic ovary syndrome (PCOS). Methods: PCOS was defined by the 2003 Rotterdam criteria. All patients with PCOS were treated with a COC containing 0.035 mg ethinylestradiol and 2 mg cyproterone acetate for 6 months. Serum 25(OH)D levels, HOMA-IR, ovarian volume and antral follicule count were measured before and after the treatment. Results: The median 25(OH)D levels were 9.40 (range 4.40-24.50) mu g/l and 7.00 (5.00-13.50) mu g/l before and after COC use, respectively. Serum 25(OH)D levels decreased after the treatment; however, the difference was not statistically significant (p = 0.055). Conclusion: This study seems to be the first prospective trial revealing the effect of COC use on serum 25(OH)D levels in women with PCOS. Although the decrease in serum 25(OH)D levels in patients with PCOS with the use of COC alone, did not reach to statistically significance level after 6 months treatment with COC.Öğe Effects of curcumin on ovarian ischemia-reperfusion injury in a rat model(Spandidos Publ Ltd, 2015) Eser, Ayla; Hizli, Deniz; Haltas, Hacer; Namuslu, Mehmet; Kosus, Aydin; Kosus, Nermin; Kafali, HasanIschemia-reperfusion injury is a significant problem following reperfusion treatment for ovarian torsion. It is generally caused by reactive oxygen species-induced damage. Antioxidant agents, such as curcumin, may protect ovaries from this adverse effect. The aim of the present randomized, controlled study was to evaluate the short-term protective effect of curcumin on a rat model of ovarian ischemia-reperfusion injury. A total of 30 female Wistar albino rats, weighing 160-230 g, were divided into 2 groups depending upon the time of unilateral, left ovary ischemia/reperfusion (group 1, 2 h ischemia/2 h reperfusion and group 2, 4 h ischemia/4 h reperfusion). These groups were subdivided into 3 subgroups (sham, control and curcumin). The sham subgroups were not subjected to ischemia/reperfusion. Control and curcumin subgroups were performed under ischemia for 2 h plus 2 h reperfusion or 4 h ischemia plus 4 h reperfusion. Curcumin, 200 mg/kg, was intraperitoneally administered simultaneously with reperfusion to the curcumin subgroups. Serum nitric oxide (NO), NO synthase (NOS), xanthine oxidase (XO), total antioxidant status (TAS), total oxidant status (TOS) and histological scores were measured and compared between subgroups. For group 1, no significant differences were observed between NO, NOS, XO, TAS or TOS. The left ovary histological grade was significantly higher in the control and curcumin subgroups compared with the sham subgroup (P=0.036). For group 2, TOS was significantly higher in the control group compared with the sham and curcumin groups (P=0.023). However, TAS was also significantly higher in the control subgroup compared with the other 2 subgroups (P=0.005). Left ovary histological grade was significantly higher in the control and curcumin subgroups compared with the sham subgroup (P=0.038). No significant differences were observed between NO, NOS or XO between the group 2 subgroups. The results showed that curcumin exerted no major significant protective effect on ischemia-reperfusion injury in the rat ovary.Öğe Gut satiety hormones and hyperemesis gravidarum(Springer Heidelberg, 2015) Kosus, Aydin; Kosus, Nermin; Usluogullari, Betul; Hizli, Deniz; Namuslu, Mehmet; Ayyildiz, AbdullahHyperemesis gravidarum (HG) is described as unexplained excessive nausea and vomiting during pregnancy. Some gut hormones that regulate appetite may have important role in etiopathogenesis of HG and weight changes during pregnancy. In this study, levels of gut satiety hormones were evaluated in pregnant women with HG. Methods This prospective case-control study was conducted in 30 women with HG and 30 healthy pregnant women without symptoms of HG. Fasting venous blood samples were taken from all subjects for measurement of plasma gut hormone levels; obestatin (pg/mL), peptide YY (PYY), pancreatic polypeptide (PP) and cholecystokinin (CCK). Results Plasma PYY and PP levels were significantly higher in HG group. The most important parameter in diagnosis of HG was plasma PP level. Simple use of PP level led to the diagnosis 91.1 % of HG cases correctly. The single most important parameter in the prediction of HG was also PP level. Conclusion Anorexigenic gut hormones might have important role in etiopathogenesis of hyperemesis gravidarum and weight changes during pregnancy.Öğe Hyperemesis gravidarum and its relation with maternal body fat composition(Taylor & Francis Inc, 2016) Kosus, Aydin; Eser, Ayla; Kosus, Nermin; Usluogullari, Betul; Hizli, DenizThe objective of this study was to determine if maternal body fat composition and body mass index were associated with hyperemesis gravidarum (HG) in the first trimester of pregnancy. Healthy pregnant women (n=30) without nausea and vomiting (control group) and women with HG (n=54; study group), all with singleton pregnancy at 6-14weeks gestational age, were included. Body mass index was measured before and during pregnancy. Visceral adipose tissue (VAT) and subcutaneous fat thickness were measured during pregnancy. Comparison of the groups revealed that VAT and pre-pregnancy body mass index but not subcutaneous fat thickness were significantly higher in the HG group versus controls. VAT and pre-pregnancy body mass index predicted 83.8% and 67.1% of HG cases, respectively. VAT and pre-pregnancy body mass index were correlated with the development of hyperemesis gravidrum and hence could be considered as predictive markers for HG.Öğe Is there any effect of demographic features on development of hyperemesis gravidarum in the Turkish population?(Tubitak Scientific & Technological Research Council Turkey, 2013) Kamalak, Zeynep; Kosus, Nermin; Kosus, Aydm; Hizli, Deniz; Ayrim, Aylin; Kurt, GoncaAim: To assess the effect of maternal demographic variables on development of hyperemesis gravidarum (HG) in pregnant Turkish women. Materials and methods: Two hundred consecutive women with HG were defined as the study group, and 200 consecutive pregnant women without any signs or symptoms of HG matched for age, parity, and gestational age were defined as the control group. Personal information, including lifestyle, educational level, occupation, and economic status were obtained via questionnaire. Results: The number of abortions was higher but parity was lower in the HG group. The time interval between 2 pregnancies was significantly shorter in the HG group than in the control group. HG developed in all women who had HG in a previous pregnancy. HG was significantly higher in women who graduated from high school or university. Level of monthly income and communication within the family have an effect on development of HG. Logistic regression analysis showed that the most important parameters for prediction of HG were education level, age at marriage, and previous history of abortus. Conclusion: Living conditions, life standards, communication, and experiences in previous pregnancies might affect development of HG.Öğe Sleep deprivation in the last trimester of pregnancy and inadequate vitamin D: Is there a relationship?(Lippincott Williams & Wilkins, 2016) Gunduz, Suzan; Kosger, Hatice; Aldemir, Secil; Akcal, Banu; Tevrizci, Hatice; Hizli, Deniz; Celik, Huseyin TugrulBackground: Disturbed sleep is a significant health issue for pregnant women. Inadequate vitamin D intake is common among pregnant women and can affect many bodily systems. The purpose of this cross-sectional study was to test the hypothesis that serum vitamin D levels are low in pregnant women who have poor sleep quality in their last trimester. Methods: We enrolled 92 pregnant women who were admitted to the Maternity Clinic of Turgut Ozal University (Ankara, Turkey) in their last trimester. Venous blood sampling was performed to determine serum 25-hydroxyvitamin D levels. Sleep quality was measured by the Pittsburgh Sleep Questionnaire. The Student t test and Chi-square test were used to evaluate the relationships between variables. Logistic regression analysis was used to identify independent predictors of the vitamin D level. Results: The median score of the Pittsburgh Sleep Questionnaire was 6.2 +/- 3.3 (range, 1-17). We determined that 43.5% (40) of participants had poor sleep quality. The mean number of sleep hours at night was 8.6 +/- 1 hours (range, 6.30-11 hours), and the mean sleep latency was 20.3 +/- 12.7 minutes (range, 5-60 minutes). Vitamin D levels were measured for 87 participants; the median serum level of 25 (OH) vitamin D was 22.9 +/- 16.2 ng/mL (range, 4.9-99 ng/mL). Among all patients, we did not determine any significance between the vitamin D-deficient group and the non vitamin D-deficient group with regard to the Pittsburgh Sleep Questionnaire Inventory (PSQI) total score and subcomponents scores of the questionnaire (p > 0.05). Among 37 patients with poor sleep quality and for whom the vitamin D level was measured, 56.8% (21) women had vitamin D deficiency, and 81% (30) women had vitamin D insufficiency. However, we did not find any significance between participants with poor sleep and participants with good sleep quality with regard to age, occupational status, relationship with her partner, prepregnancy body mass index (BMI), weight gain during pregnancy, being primiparus, length of labor, and mode of delivery. Our findings further showed that being in a low income family was associated with poor sleep quality. Conclusion: Inadequate vitamin D and poor sleep quality are prevalent in pregnant women, but low levels of vitamin D are not associated with poor sleep quality. Further studies with larger sample sizes and studies that include preterm deliveries and special sleep disorders should be performed to understand this issue better. Copyright (C) 2015 Elsevier Taiwan LLC and the Chinese Medical Association. All rights reserved.Öğe The Effect of Body Mass Index on Acne, Hirsutism and Menstrual Irregularity Symptoms in Turkish Adolescent Girls(Gazi Univ, Fac Med, 2013) Hizli, Deniz; Kosger, Hatice; Hacivelioglu, Servet; Kosus, Nermin; Kosus, Aydin; Kamalak, Zeynep; Akcal, BanuPurpose: The aim of the present study was to determine whether body mass index (BMI) influences polycystic ovary syndrome (PCOS) related symptoms such as acne, hirsutism and menstrual irregularity in a large healthy adolescent population. Methods: Self-administered questionnaires were distributed to all volunteer female students at 15 different secondary schools. The subjects' BMI, birthweight, age at menarche, pattern of menstrual cycle and presence of acne or hirsutism complaints were recorded. Subjects with BMI of = 18.4 kg/m 2, 18.5-24.9 kg/m(2), 25-29.9 kg/m(2) and > 30 kg/m(2) were defined as group 1, group 2, group 3 and group 4, respectively. The relation between BMI and the symptoms of acne, hirsutism and menstrual irregularity was analyzed. Results: A total of 1309 students filled the questionnaires properly and included in the study. Of these students, 314 were in group 1, 899 in group 2, 81 in group 3 and 15 in group 4. The median ages of participants were 16 years (range 13-20 years) and median age at menarche was 13 years (range of 11-16 years). A total of 106 (8.1%) participants reported various menstrual irregularity. Underweighed girls had significantly less acne (p= 0.001) and hirsutism problems (p<0.001) compared to normo weighed girls. Hirsutism incidence was significantly higher in overweighed girls than in normo weighed subjects (p<0.001). Conclusion: The present study provided the prevalence of PCOS related symptoms in population, including menstrual irregularity, acne and hirsutism according to BMI in a large adolescent population. Our results showed that menstrual irregularity was not significantly increased as BMI increased, however acne and hirsutism problems were significantly increased as BMI increased.
