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    Öğe
    Abdominal sakroservikopeksi operasyonunun yaşam kalitesi ve cinsel sağlık skorları üzerine etkisi
    (2023) Aksin, Şerif; Balsak, Deniz; Yılmaz, Mehmet; Aboalhasan, Yasmin
    Amaç: Pelvik organ prolapsusu (POP) cerrahisinde çeşitli yöntemler kullanılmaktadır. Bu yöntemlerden biri olan abdominal sakroservikopeksi başarı oranları bilinmesine rağmen yaşam kalitesi ile ilgili veriler yetersizdir. Çalışmamızın amacı abdominal sakroservikopeksi operasyonunun yaşam kalitesi ve cinsel sağlık ile ilgili sonuçlarını araştırmaktır. Yöntemler: Çalışmamız, Diyarbakır Gazi Yaşargil Eğitim ve Araştırma hastanesinde 01.05.2008 ile 31.12.2012 tarihleri arasında POP tanısı ile abdominal sacrocervicopexy operasyonu yapılan 72 hastayı içeren retrospektif kohort çalışmasıdır. Operasyon sonrası bu hastalar ortalama 29.68 ± 6.55 ( 20-49 ) ay takip edildiler. Hastalar, demografik, klinik operasyonel özellikler, cerrahi başarı oranları, vajinal semptom skoru, seksüel semptom skoru (FSFI), (POP Q) quality life skoru, komplikasyonlar, de novo şikayetler açısından değerlendirildi. Bulgular: Çalışmamızda yaş ortalaması 37.77 ± 9.18 yıl, parite 5.07 ± 1.83, operasyon süreleri 55.25 ± 8.55 ( 38-72 dk ) dakika idi. Hastaların hastanede kalış süresi 39.51 ± 7.03 ( 30-72) saati buldu. Mesh erezyonu hiçbir hastada saptanmadı. En sık görülen komplikasyonun sırt ağrısı olduğu izlendi.( %18,1 ). Ortalama 30 aylık bir izlem sonrası hastalarımızın vajinal semptom skorlarının ( p?0.001 ) ve seksüel semptom skorlarının ( p?0.001 ) belirgin derecede anlamlı bir şekilde düzeldiği sonucuna varılmıştır. Yine bu hastaların Prolaps ilişkili yaşam kalitesi (P-QoL) skorlarında anlamlı düzelme olduğu belirlendi. ( p?0.001 ) . Sonuç: Abdominal sakroservikopeksi; yaşam kalitesi, cinsel sağlık ve pelvik organ prolapsusu başarısı konusunda uygulanabilir, etkili ve güvenli bir cerrahi prosedürdür.
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    Öğe
    Angiogenic factors and evaluation of vascular status in preeclampsia
    (Bayrakol Medical Publisher, 2021) Aksin, Serif; Cim, Numan; Sahin, Hanim Guler; Balsak, Deniz
    Aim: The aim of this study was to measure serum levels of the angiogenic factors nitric oxide (NO), soluble endoglin (s Eng), soluble fms-like tyrosine kinase-1 (s Flt-1), placental-derived growth factor (PIGF) and vascular endothelial growth factor (VEGF) and to measure uterine and umbilical arterial blood flow using Doppler ultrasonography to investigate the physiopathology of preeclampsia and endovascular dysfunction by comparing brachial artery dilatation and the thickness of the carotid artery with normal pregnant women. Material and Methods: Forty pregnant women with preeclampsia and 40 healthy pregnant women (control group) were recruited for the study in April 2011 and October 2011 at Van Yuzuncu Yil University. Systolic and diastolic blood pressure, urinary protein in spot urine samples, complete blood counts, aspartate transaminase (AST), alanine aminotransferase (ALT) levels of sEng, sFlt-1, VEGF, PIGF and NO, and APGAR scores at one and five minutes after birth were recorded and compared in all patients. Intima-media thickness of the carotid artery, brachial artery dilatation and umbilical artery Doppler parameters of all pregnant women were assessed and recorded. Results: When compared to the control group, systolic and diastolic blood pressures urinary protein in spot and 24-hour urine collection, levels of AST, ALT and sFlt-1, and uterine artery Doppler parameters were significantly higher, whereas VEGF, platelet count and APGAR scores at one and five minutes after birth were lower in the preeclampsia group (p<0.001). Brachial artery dilatation before obstruction was found to be insignificant in both groups, while post obstructive dilatation was found to be significantly higher in the control group. Discussion: Uterine artery Doppler evaluation, assessment of brachial artery dilatation and measurement of VEGF and sFlt-1 levels seem to be useful in preeclampsia.
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    Comparison of orexigenic and anorexigenic neuropeptide levels in hyperemesis gravidarum patients with normal pregnant women: A prospective cohort study
    (Lippincott Williams & Wilkins, 2024) Yilmaz, Mehmet; Aksin, Serif; Balsak, Deniz; Aboalhasan, Yasmin; Batmaz, Ibrahim
    Background: The aim of this study was to determine whether orexigenic neuropeptides, orexin and galanin, and anorexigenic neuropeptides, alpha-melanocyte-stimulating hormone (alpha-MSH) and cocaine- and amphetamine-regulated transcript (CART), are implicated in hyperemesis gravidarum (HG). Methods: Fifty pregnant women who had been diagnosed with HG between April 2022 and February 2023 at the Siirt University Faculty of Medicine Training and Research Hospital (tertiary center) were recruited for this study. An equal number of pregnant women without an HG diagnosis were included in the study as the control group. Participants' age, pregnancy history, medical history, thyroid function test results, complete blood count results, and electrolyte levels were recorded, and their orexin, galanin, alpha-MSH, and CART serum levels were analyzed using an enzyme-linked immunosorbent assay. Results: No statistically significant differences in orexigenic neuropeptides (orexin and galanin) were observed between the HG and control groups. A statistical difference was found between an anorexigenic neuropeptide (alpha-MSH) and the control group (P = .012). Based on a receiver operating characteristic analysis, the alpha-MSH parameter was statistically significant for distinguishing between participants with an HG diagnosis and those without, with a sensitivity of 63.6%, specificity of 65.9%, and cutoff value of 11769.3 pg/mL (P = .012, area under curve: 0.655). Based on the severity classification of ketonuria (ketonuria levels of +1 or +2 were classified as mild, whereas levels of +3 or +4 were classified as moderate to severe), the anorexigenic CART neuropeptide was found to be a statistically significant diagnostic indicator of severe ketonuria (P = .020). Conclusion: alpha-MSH and CART levels were found to be related in HG patients and in HG patients with severe ketonuria.
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    Comparison of Perinatal, Newborn, and Audiometry Results of COVID-19 Pregnant Women
    (Wiley, 2022) Yilmaz, Mehmet; Aksin, Serif; Balsak, Deniz; Avci, Fazil; Ozdogru, Osman; Helvacioglu, Bekir; Erdemoglu, Mahmut
    Objective. There are studies on the perinatal outcomes of COVID-19, but the audiometric effects of the maternal immune system against COVID-19 in the newborn are not clear. In this study, we aimed to investigate the relationship between the perinatal outcomes of COVID-19 positive pregnant women and the audiological outcomes of newborns. Materials and Methods. This retrospective, single-center cohort study was conducted with 65 polymerase chain reaction (PCR) positive pregnant women and newborns and 66 normal pregnant women and newborns who were admitted between January 2020-December 2021. Pregnancy data, perinatal outcomes, and newborn hearing test results of pregnant women and newborns were recorded and compared. Results. A total of 131 patients were enrolled in the study. The number of normal pregnant women was 66 (50.4%) and the number of pregnant women who had COVID-19 disease was 65 (49.6%). In general, gestational week, age, parity, biochemical parameters, duration of hospital stay, week of delivery, fetal weight, and apgar scores were compared between pregnant women with COVID-19 and normal. White blood cell (WBC), neutrophil, aspartate aminotransferase (AST), and C-reactive protein (CRP) parameters were found to be significantly higher, and lymphocyte and neutrophil/lymphocyte (N/L) ratios were significantly lower (p < 0.05). There was no statistically significant difference between the two groups (chi(2)=0.001; p=1,000). The normal delivery status, the normal delivery rate in patients with COVID-19 was found to be statistically significantly higher than the cesarean section delivery status (p=0.012). In the statistical comparison between the COVID-19 and normal pregnant groups in the cesarean section group, the gestational week, delivery week, and apgar1 scores of the pregnant women with COVID-19 were found to be significantly higher. There was no statistically significant difference between the distributions of the rate of infants with hearing impairment in the comparison with hearing tests in pregnant women with COVID-19 (n=1) and normal pregnant women (n=1) (chi(2)=0.001; p=1,000). Conclusion. Although the negative effects of COVID-19 on pregnancy outcomes are rare, it was determined that there was no increased audiological risk factor, and the most important predictor of COVID-19 was lymphopenia.
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    Pregnancy outcomes after abdominal sacrocervicopexy
    (Springer London Ltd, 2022) Balsak, Deniz; Aksin, Serif; Yilmaz, Mehmet; Aboalhasan, Yasemin
    Introduction and hypothesis Various methods are used in pelvic organ prolapse (POP) surgery. Organ-preserving methods are gaining importance and popularity. Although the success rates of abdominal sacrocervicopexy, which is one of these methods, are known, data on pregnancy outcomes are insufficient. The aim of this study was to investigate pregnancy outcomes after abdominal sacrocervicopexy. Methods This study included 72 patients with a diagnosis of POP who underwent abdominal sacrocervicopexy with monofilament polypropylene mesh in Diyarbakir Gazi Yasargil Training and Research Hospital between 2008 and 2016. Anterior and posterior colporrhaphy operations were performed. Postoperatively, these patients were followed up for a mean of 29.68 +/- 6.55 (20-49) months. Pregnancy and recurrence outcomes of those who became pregnant were recorded and analyzed. Results On average, pregnancies occurred 23.2 (18-30) months after the operation. During follow-up, eight patients became pregnant and gave birth without any issues or complications. One had a normal vaginal delivery, and seven gave birth by cesarean section. One of the pregnant women had a twin pregnancy. When 24 patients who underwent bilateral tubal ligation and postmenopausal (n = 2) were excluded, the pregnancy rate was found to be 17.3%. The weeks of the deliveries were 35 weeks (twin pregnancy), 38 weeks (n = 2), 39 weeks (n = 3), and 40 weeks (n = 1), for an average of 38.5 weeks. Conclusions Eight patients who had undergone abdominal sacrocervicopexy had healthy pregnancies and deliveries.
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    Thyroid Function Tests and Thyroid Antibody Tests in Ectopic Pregnancies: A Prospective Cohort Study
    (Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Aksin, Şerif; Yilmaz, Mehmet; Balsak, Deniz; Aboalhasan, Yasmin; Yoldaş, Adem; Batmaz, İbrahim
    Thyroid hormone levels have been observed to induce structural changes in different regions of the fallopian tube. This study aimed to investigate the impact of thyroid hormones on ectopic pregnancy. In pursuit of this objective, 31 patients with ectopic pregnancy were monitored at Siirt University Training and Research Hospital between July 2022 and December 2022. Additionally, a total of 31 patients with normal first-trimester pregnancies, matched for age, parity, and gestational week, were included in th e control group. Various parameters, including patient age, pregnancy history, medical history, treatment methods, clinical and demographic data, TSH, fT3, fT4, TT3, TT4, Thyroglobulin, Anti-thyroglobulin Antibody, TSH receptor antibody (TrAB), Anti-Peroxidase Antibody, Anti-Tyroglobulin Antibody, hemogram, biochemistry, CRP, and sedimentation values, were compared.Clinical Trials no: NCT05446012 Statistically significant differences were noted in Free T3 (p = 0.011) and thyroglobulin (p = 0.018) values bet ween the ectopic pregnancy and control groups. Subsequent ROC analysis was conducted for the significant parameters, determining the AUC (Lower and Upper Bound), sensitivity, specificity, and cut-off values for each parameter. Multivariate logistic regression analysis followed, wherein the "backward stepwise model" was applied to the Free T3 parameter. The apparent parameter indicating an increased risk in the disease was Free T3, with a 4.2-fold increase and a 95% CI of [1.3-13.5]. Lower Free T3 levels were associated with an elevated risk of ectopic pregnancy. The assessment of Free T3 levels during pre-pregnancy counseling may aid in identifying pregnant women at risk of ectopic pregnancy. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.