The relationship between primary ovarian insufficiency and gene variations: a prospective case-control study.

Around 70 percent of cases of Primary Ovarian Insufficiency (POI) etiology remain unexplained. The aim of our study is to contribute to the etiology and genetic background of POI. A total of 37 POI patients and 30 women in the reproductive period were included in this prospective, case-control study between August 2020 and December 2021. The women were examined for 36 genes with next-generation sequencing (NGS) panel. Gene variations were detected in 59.5 percent of the patients in the case group. FSHR p.S680N (rs6166, c.2039 G>A) and FSHR p.A307T (rs6165, c.919 G>A) gene variants, which are most frequently located in exon 10 of the FSHR gene, were detected in both groups. Although it was not found that these gene variants were significantly different between the groups, it was also found that they were significantly different in POI patients under 30 years of age and in those with a family history of POI. Variations were detected in 12 genes in POI patients. Two gene variants (FGFR1 [c.386A>C, rs765615419] and KISS1 [c.58 G>A, rs12998]) were detected in both groups, and the remaining gene variants were detected only in POI patients. No differences were detected between the groups in terms of gene variations. However, the gene variations detected only in POI patients may play a role in the etiology of POI.

Repeated application of luteal phase oestradiol/GnRH antagonist priming increases IVF success for poor ovarian reserve patients.

We aimed to compare repeated LPP (luteal phase oestradiol LPP/GnRH antagonists protocol) treatment with different protocol results with poor ovarian response (POR) patients. Two hundred and ninety-three cycles with poor ovarian reserve who underwent LPP, microdose flare up protocol and antagonist protocol were included in the study. Of these, 38 patients were applied LPP in the first cycle and LPP in the second cycle. After the microdose or antagonist protocol applied in the first cycle, LPP was applied to 29 patients in the second cycle. There are 128 patients who received LPP only once and 31 patients who received microdose flare up only once. The clinical pregnancy rate was monitored higher in LPP application group in the second cycle than the patients who received only LPP and patients who received LPP after different protocols (p = .035). b-hCG positivity per embryo and clinical pregnancy rate were found to be significantly higher with the LPP application in the second protocol (p = .000, p = .001). Repeated LPP may be the first choice protocol for low ovarian reserve patients.

What is already known on this subject? There is no standard treatment protocol applied to patients with low ovarian reserve. In this patient group, the rate of lack of response to stimulation and cycle cancellation is high. Increasing FSH level in patients with poor ovarian reserve causes the formation of larger follicles by increasing the sensitisation of follicles in the late luteal phase.What do the results of this study add? Our study was conducted for the first time in the literature. We compared the results of second cycle LPP (luteal phase oestradiol LPP/GnRH antagonists protocol) application in patients with low ovarian reserve who resulted in failed IVF after commonly used LPP, microdose flare up protocol and antagonist protocols.What are the implications of these findings for clinical practice and/or further research? Luteal phase oestrogen LPP/GnRH antagonist may be the first choice in patients with poor ovarian reserve patients. In unsuccessful cases, the LPP protocol should be considered in the retreatment for the second time.

OHVIRA syndrome presenting with acute abdomen findings treated with minimally invasive method: three case reports.

BACKGROUND: One of the least common forms of Müllerian anomalies is Herlyn-Werner-Wunderlich syndrome (HWWS), characterized by uterus didelphys, obstructed hemi-vagina, and ipsilateral renal agenesis (OHVIRA). HWWS is also known as OHVIRA syndrome. Patients with OHVIRA syndrome generally present with increasing pelvic pain, dysmenorrhoea, and pelvic mass during puberty, shortly after menarche. These patients may be treated successfully with a minimally invasive method. CASE REPORT: We present three previously asymptomatic patients with OHVIRA syndrome who presented with acute abdomen shortly after menarche. These patients were treated with a minimally invasive method. CONCLUSION: Patients with OHVIRA syndrome may be treated with minimally invasive method after definitive diagnosis and, laparoscopy and laparotomy should be avoided as much as possible. Minimally invasive treatment modality is not only cost-effective, but also provides symptomatic relief and preserves fertility.

Hypogastric artery ligation in postpartum haemorrhage: a ten-year experience at a tertiary care centre.

This study investigated patients who underwent bilateral hypogastric artery ligation (BHAL) due to postpartum haemorrhage (PPH). Patients who underwent BHAL because of PPH following a conservative treatment were included in this study. Placental abnormalities were referred to as placenta accreta. A total of 130 BHAL procedures took place at the study hospital as a result of PPH. Of these, 39 (30%) were referred to the hospital. The rate of BHAL requirement was 62 out of 10,000 births. Among the 130 patients, the most frequent indication for BHAL was placenta accreta (58.5%). Haematological parameters were poorer among the referral patients. Four of the exitus patients (80%) were referral patients. The mortality rate among the referral patients was 10.25%, whereas this rate was only 1.01% among the patients who gave birth at the hospital. PPH is a life-threatening condition that requires immediate medical attention. BHAL, with its fertility-preserving features, is a good option that can be employed in all PPH patients. BHAL not only preserves patients' fertility, but it also gives them a higher chance of survival.IMPACT STATEMENTWhat is already known on this subject? PPH is a life-threatening condition. Due to the worldwide increase in caesarean sections, placenta accreta has also increased. BHAL is a vital treatment method for PPH.What do the results of this study add? Placenta accreta is one of the most common causes of PPH. Traditional hysterectomy rates can be reduced by replacing this treatment with BHAL in this group of patients. Without early intervention in PPH, a patient's mortality risk can increase by up to 10 times. As research and surgeons' experience grows, PPH can be controlled with treatments with less complex modalities without the need for BHAL.What are the implications of these findings for clinical practice and/or further research? The need for BHAL should be kept in mind when addressing PPH, especially in cases of placenta accreta. The need for hypogastric artery ligation, which is a more aggressive treatment for the surgical correction of the pathology, can be reduced as surgeons' experience increases. Early intervention and/or referral in cases of PPH is of great importance.

Investigation of transfer results of human embryos that were vitrified and thawed at the cleavage, morula and blastocyst stages.

The objective of this study was to compare the rates of clinical pregnancy after the transfer of vitrified and thawed human embryos on days 3, 4 and 5 of embryonic development. In this retrospective study, the results of 148 embryo transfer cycles, using embryos frozen and thawed over the 3-year period between January 2016 and December 2018 at the Gülhane Training and Research Hospital Department of Gynecology and Obsterics Reproductive Medical Center of the University of Health Sciences, Ankara, Turkey were examined. Following embryo transfer - including 29 dissolved embryos frozen on day 3, 80 frozen on day 4, and 39 frozen on day 5 - results were examined in terms of clinical pregnancy rates. In this study, across all three groups, no significant differences were observed in terms of patient age, the number of oocytes collected, infertility reasons, the number of embryos dissolved, transfer day, or the number of embryos transferred. According to the transfer day, the rates of clinical pregnancy and ongoing pregnancy were significantly higher for embryos frozen on day 4 and transferred on day 5. Significantly higher rates of pregnancy and live birth were determined during in vitro fertilization (IVF) treatment with the freezing of human embryos on day 4 and the transfer of those embryos on day 5.

A New Comorbidity in Female Patients With Ankylosing Spondylitis: Pelvic Organ Prolapse.

AIM: The aim of this study was to investigate whether increased intra-abdominal pressure caused by pelvic inflammation and frequent use of the Valsalva maneuver increases the incidence of pelvic organ prolapse (POP) among female patients with ankylosing spondylitis (AS). METHODS: Thirty-nine patients diagnosed as having AS through the use of the modified New York criteria, 47 patients with chronic low-back pain (CLBP), and 38 healthy controls (HCs) were included in this study. All the patients and the HCs underwent thorough physical and gynecological examinations. Pelvic organ prolapse was graded blindly by a gynecologist. Presence or absence of cystocele (CS), rectocele (RC), and uterine prolapse (UP) was noted. RESULTS: The incidences of CS, RC, and UD were significantly higher among the AS patients compared with the HCs (p = 0.001, 0.026, and 0002, respectively). The incidences of CS (p = 0.042) and UD (p = 0.017) were significantly higher among the AS patients compared with the CLBP patients. CONCLUSIONS: The incidence of POP is higher among patients with AS compared with normal population. These patients should be questioned about the symptoms of POP and recommended, if necessary, regular gynecological examinations, as well as specific exercises including those targeting AS.

Can clomiphene citrate resistance be predicted by RDW-CV levels in infertile women with PCOS?

OBJECTIVE: To identify whether red blood cell distribution width coefficient of variation (RDW-CV) and mean platelet volume (MPV) levels can predict clomiphene citrate resistance (CC-R) in infertile, anovulatory females with polycystic ovarian syndrome (PCOS). METHODS: A total of 89 infertile patients who were admitted to a tertiary center diagnosed with non-obese PCOS were included in this study. The patients were divided into two groups: the first group comprised 53 non-obese patients with PCOS and CC-R, and the second group included 36 non-obese patients with PCOS and CC-S. RDW-CV, RDW-SD, and MPV values, along with routine whole blood count parameters were compared between the groups. RESULTS: RDW-CV values were found to be significantly higher in the patients with CC-R compared to those with CC-S (P < 0.05). The sensitivity, specificity, positive, and negative predictive values were found to be 69%, 58.1%, 34.5%, and 12.5%, respectively, at an RDW-CV level of 12.85. The odds ratio was calculated as 3.077 (95% CI 1.245-7.603) in terms of the cut-off point. CONCLUSION: We think that RDW-CV which is a marker of inflammation is a simple, cheap, and accessible marker for the prediction of CC resistance.

Evaluation of Sexual Function in Women with Hypogonadotropic Hypogonadism Using the Female Sexual Function Index (FSFI) and the Beck Depression Inventory (BDI).

BACKGROUND Hypogonadotropic hypogonadism (HH), or secondary hypogonadism, results from reduced secretion of gonadotropins, including follicle-stimulating hormone (FSH) and luteinizing hormone (LH), by the pituitary gland, resulting in lack of production of sex steroids. The aim of this study was to evaluate self-reported sexual function in sexually active women with and without HH using two evaluation methods, the Female Sexual Function Index (FSFI) and the Beck Depression Inventory (BDI). MATERIAL AND METHODS The study recruited 88 women who attended an outpatient in vitro fertilization (IVF) clinic in Turkey for primary infertility, between August 2013 and August 2016. All patients were sexually active with an age that ranged from 20-41 years. Following an initial examination, including measurement of FSH and LH levels, all study participants were asked to complete the FSFI and BDI self-reporting questionnaires. Patients were divided into Group 1 (with HH) (N=42) and Group 2 (the control group) (N=46). RESULTS Analysis of the patient responses to questions regarding their sexual function in the FSFI and BDI showed that of the 42 patients in Group 1 (the HH group), 27 patients (64.28%) reported sexual dysfunction; of the 46 patients in Group 2 (the control group) 14 patients (30.34%) reported sexual dysfunction. Analysis of the FSFI lubrication scores and orgasm scores showed a statistically significant difference between the two groups (both, p<0.01). CONCLUSIONS Women with HH require both physical and psychological support to improve their sexual function, self-esteem, mental health, and quality of life.

Thrombophilia and Recurrent Pregnancy Loss: The Enigma Continues.

BACKGROUND Thrombophilic gene polymorphism is known to be a risk factor for recurrent pregnancy loss (RPL), but few studies have confirmed a possible role of thrombophilic genes polymorphism in RPL risk. This study was conducted to understand the relationship of the mutations of some thrombophilia-associated gene polymorphism (heterozygous/homozygous) with RPL. We compared patients with 2 abortions to patients with 3 or more abortions among Turkish women. MATERIAL AND METHODS In this study, patients previously diagnosed with habitual abortus at Obstetrics and Gynecology outpatient clinics in Turkey between 2012 and 2016 were included. In their peripheral blood, we detected factor V Leiden H1299R, prothrombin G20210A, MTHFR C677T, MTHFR A1298C, PAI-1 4G/5G, and PAI-1 4G/4G gene mutations. RESULTS In this study, we have observed statistically meaningful data (P<0.01) related to the relationship between RPL and thrombophilia-associated gene polymorphisms such as heterozygous factor V Leiden H1299R, heterozygous prothrombin G20210A, PAI-1 4G/5G, and PAI-1 4G/4G. CONCLUSIONS We found that diagnosis of thrombophilic genes polymorphism is useful to determine the causes of RPL, recognizing that this multifactorial disease can also be influenced by various acquired factors, including reproduction-associated risk factors and prolonged immobilization.

A new technique in laparoscopic abdominal access (Evsen Method, Modified Veress Technique).

OBJECTIVES: The most important step in laparoscopic surgery is to safely establish the pneumoperitoneum, especially since approximately half of the complications occur during the initial entry into the abdomen. There is a distinct need to modify the available methods to reduce therate of adverse events in laparoscopic entry. In this study, a modified Veress technique (MVT) or Evsen method is introduced.The aim of this article was to present a modified Veress technique for establishing the pneumoperitoneum. MATERIAL AND METHODS: The study was conducted at the Dicle University, Faculty of Medicine, Department of Obstetrics and Gynecology, from September 2016 to May 2017. A new laparoscopic entry technique was introduced and compared with the classical Veress technique. A total of 40 cases were included in the study. MVT and the classical Veress method were applied to 26 and 14 patients, respectively. RESULTS: The pneumoperitoneum was established at the first attempt in 23 (88.5%) MVT patients and in 7 (50%) patients from the classical Veress method group. The number of insufflation attempts to establish a successful pneumoperitoneum was lower using MVT and the difference was statistically significant (p: 0.022). As far as time is concerned, a comparison between the groups revealed that the pneumoperitoneum was established in a statistically significantly shorter time using MVT (p < 0.00). CONCLUSIONS: The modified Veress technique proved to be superior to the classical Veress method for establishing the pneumoperitoneum. Using the new method, the pneumoperitoneum was established after fewer attempts and in a shorter time.

Evaluation of protein levels of autophagy markers (Beclin 1 and SQSTM1/p62) and phosphorylation of cyclin E in the placenta of women with preeclampsia.

Preeclampsia is a severe multisystem disorder, and its pathophysiology is still not completely understood. Autophagy, a recycling process that maintains cellular homoeostasis during differentiation and development, is controversial regarding increased or decreased autophagic activity in preeclampsia. The aim of this study was to determine whether autophagy is increased in the placentas of women with preeclampsia by examining the protein levels of autophagy markers (Beclin 1 and SQSTM1/p62) and phosphorylation of cyclin E. For this purpose, placentas from preeclampsia (n=10) and control (n=10) pregnancies were included in this study. The protein expression of autophagy-related markers Beclin1, SQSTM1/p62 and phosphorylation status of cyclin E were detected by Western blot. Our data showed that the protein levels of both Beclin 1 and SQSTM1/p62 were significantly increased, while the phosphorylation level of cyclin E was significantly decreased in placentas with preeclampsia compared to those derived from controls. The results of this study suggest that the autophagic activity is perpetually increased in preeclampsia and cyclin E protein stabilisation might be involved in the induction of autophagy.

The role of vitamin B1-B2 and plasma lipid profile in intrahepatic cholestasis of pregnancy.

AIM: The present study aimed to determine the levels of total cholesterol, triglycerides (TG), low-density lipoproteins (LDL), high-density lipoproteins (HDL), and vitamins B1 and B2 in intrahepatic cholestasis of pregnancy (ICP) patients, and to evaluate if these were involved in the pathophysiology of the disease. METHODS: The prospective randomized study included 35 pregnant patients who were admitted to the Gynecology and Obstetrics Polyclinic, Faculty of Medicine at Dicle University and who were diagnosed with ICP (Group 1), and 40 healthy pregnant women who were admitted in the same period and who had no systemic diseases that might complicate the pregnancy during the pregnancy follow-up (Group 2). Serum lipid levels and vitamins B1 and B2 were determined and compared, and statistical comparisons of the groups were made. RESULTS: There was no difference between the TG levels of the two groups (P=0.631). Total cholesterol, LDL, HDL, and vitamin B1 and B2 levels were higher in Group 1 than in Group 2 (P=0.001, P=0.001, P=0.001, P=0.001, and P=0.032, respectively). CONCLUSIONS: Increased levels of vitamins B1 and B2 may indicate a need for increased energy metabolism at the fetus. So we believe that new studies are required, which will be supported by the placental analyses of the pyruvate and lactate levels in maternal blood at delivery and fetal cord blood in order to develop a better understanding on the fetal effects of energy metabolism.

Assessment of oxidative stress markers in cord blood of newborns to patients with oxytocin-induced labor.

AIM: We aimed to measure the extent of oxidative stress experienced during labor by the neonates of pregnant women undergoing induced or spontaneous birth and to compare the effects of induced labor on fetal well-being. METHODS: Sixty-four healthy pregnant women referring to the Department of Gynecology and Obstetrics, Dicle University Medical Faculty between October 2010 and May 2011 were included in this comparative study. Pregnant women undergoing induced labor by oxytocin were group 1 and those without labor induction were group 2. Post-partum Apgar score was calculated at 1 and 5 min and measurements of weight and height of the neonates were carried out. After the fetal cord was clamped, 5 cm3 blood was drawn into a plain tube without anticoagulant. The samples were centrifuged at 5000 r.p.m. for 5 min. Separated sera were transferred to Eppendorf tubes and were stored at -80 C° until the analysis time. RESULTS: The complete blood counts and biochemistry results indicated that there were no statistically significant differences in regards to diseases between the two groups. Nitric oxide and asymmetrical dimethylarginine values of the two groups were not significantly different; however, there were statistically significant differences in the malondialdehyde, paraoxonase, total antioxidative status, and total oxidative status values of the two groups (respectively, P = 0.005, P = 0.006, P = 0.008, and P = 0.007). CONCLUSION: We observed that oxytocin-induced labor increases stress markers but does not affect Apgar scores. Oxidative stress in pregnant women may trigger antioxidative mechanisms. Prospective studies in larger cohorts are needed to better understand the impact of oxytocin-induced labor on pregnant women and neonates.

There is a Positive Correlation Between Socioeconomic Status and Ovarian Reserve in Women of Reproductive Age.

BACKGROUND The purpose of this study was to investigate the potential association between socioeconomic status and ovarian reserve, anti-Mullerian hormone level, antral follicle count, and follicle stimulating hormone level in women of reproductive age. MATERIAL AND METHODS A total of 101 married women between 20-35 years of age who presented to the Department of Obstetrics and Gynecology, Health Research System In Vitro Fertilization (HRS IVF) Center between October 2014 and November 2015 and met the inclusion criteria were included in this study. The participants were divided into three socioeconomic groups using Kuppuswamy's socioeconomic status scale. Thirty-one participants were assigned to the low socioeconomic status group, 37 to the middle socioeconomic status group, and 33 to the high socioeconomic status group. On days 3-6 of the menstrual cycle, 10 mL of blood was collected from the participants for follicle stimulating hormone and anti-Mullerian hormone measurements. Transvaginal ultrasonography was performed for both ovaries for the purpose of counting antral follicles measuring 2-10 mm in diameter. RESULTS Both ovarian reserve parameters, namely anti-Mullerian hormone level and antral follicle count, exhibited a significant association with socioeconomic status (p=0.000 and p=0.000, respectively). The association between follicle stimulating hormone level and socioeconomic status was also significant (p=0.000). CONCLUSIONS A low socioeconomic status aggravated by sources of stress such as undernutrition and financial hardships affects ovarian reserve, which should be remembered in approaching infertile patients.

Serum levels of neopterin, inflammatory markers and oxidative stress indicators in hyperemesis gravidarum.

AIM: To investigate whether serum levels of neopterin and inflammatory markers including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and oxidative status indicators were altered in patients with hyperemesis gravidarum (HG) compared to asymptomatic pregnant women. METHODS: This cross-sectional study was performed including 30 pregnant women with HG (mean age: 30.67 ± 6.68) and 30 asymptomatic pregnant women (mean age: 28.00 ± 5.30). Demographic features, obstetric history, and the Pregnancy Unique Quantification of Emesis/Nausea (PUQE) index were noted. Complete blood count, serum biochemical assay and measurement of CRP, TNF-α, IL-6, total antioxidant status and total oxidative status (TOS) levels were taken and compared between groups. RESULTS: White blood cell count (P = 0.013), platelet count (P = 0.015), TOS (P < 0.001), and PUQE score (P < 0.001) were remarkably higher in HG pregnancies. On the other hand, serum levels of lactate dehydrogenase, (P < 0.001), sodium (P < 0.001), potassium (P < 0.001), chloride (P < 0.001) and TAS (P < 0.001) were higher in the control group. There was no difference in the levels of neopterin, CRP, TNF-α and IL-6. In patients with HG, a positive correlation was detected between TOS and serum levels of lactate dehydrogenase, while TNF-α, IL-6 and neopterin were positively correlated with hemoglobin levels. CONCLUSION: Our results demonstrated no association between inflammation and HG. Elucidation of the pathophysiology and complex interaction between various inflammatory processes in HG necessitates further trials on larger series.

Amniotic fluid paraoxonase-1 activity, thyroid hormone concentration and oxidant status in neural tube defects.

AIM: The aim of this study was to investigate the potential association between neural tube defects and paraoxonase-1 activity in amniotic fluid. We studied total oxidant status, total antioxidant capacity, paraoxonase-1 activity and thyroid hormone amniotic fluid concentration in fetuses with neural tube defects. METHODS: The present study was performed at the Department of Obstetrics and Gynaecology and the Department of Clinical Biochemistry of Dicle University between September 2011 and June 2013. The study group included 37 amniotic fluid samples from pregnant women (16-20 weeks of gestation) with fetuses affected by neural tube defects. The control group consisted of 36 pregnant women who were diagnosed with a high-risk pregnancy according to first or second trimester aneuploidy screening and were later confirmed on amniocentesis to have genetically normal fetuses. RESULTS: Amniotic fluid paraoxonase-1 activity and total oxidant status were significantly higher (P = 0.023, P = 0.029, respectively) whereas free T4 was significantly lower (P = 0.022) in fetuses with neural tube defects compared with control subjects. In fetuses with neural tube defects, amniotic fluid paraoxonase-1 activity correlated positively with total oxidant status (r = 0.424**, P = 0.010), and amniotic fluid total antioxidant capacity correlated positively with free t4 (r = 0.381*, P = 0.022). CONCLUSION: This is the first study in the literature to show an association between paraoxonase-1 activity and thyroid hormone concentration and neural tube defects.

Peripartum cardiomyopathy in Turkey: Experience of three tertiary centres.

We conducted this study to determine demographic details, and clinical presentations in patients with peripartum cardiomyopathy (PPCMP) of Turkish origin. The study population consisted of 58 patients with PPCMP treated at 3 major hospitals in Turkey, retrospectively. In this study, demographic details and initial echocardiographic data were recorded and long-term clinical status was evaluated. The mean age for the patient cohort was 31.47 ± 6.31 years. Thirty-eight patients (73.1%) were multigravida and seven patients had multifetal pregnancy (13.7%). The mean follow-up left ventricular (LV) ejection fraction increased from 31 ± 7 to 38 ± 19. A minority of patients were defined as improvers according to our pre-specified criteria. The average survival period after diagnosis of PPCMP was 20.66 ± 14.44 months. Initial values for LV end-diastolic diameter and urea were higher in the deceased patients compared with the surviving patients, respectively. Twenty-eight (48%) patients with PPCMP showed improvement in the follow-up period. Of the 58 PPCMP patients, 9 (15%) died during a mean follow-up of 32 ± 22 months.

Analysis of Sensitivity, Specificity, and Positive and Negative Predictive Values of Smear and Colposcopy in Diagnosis of Premalignant and Malignant Cervical Lesions.

BACKGROUND This study aimed to examine the positive and negative predictive value in the diagnosis of premalignant and malignant lesions of cervical colposcopy, the sensitivity and specificity of smear, and to evaluate the correlation with histopathology of abnormal cytology and colposcopy. MATERIAL AND METHODS The criteria for inclusion of patients with unhealthy cervix in the study were: Erosion, Chronic cervicitis, and Healed lacerations, Hypertrophied cervix, bleeding on touch, suspicious growth/ulcer/polyp on the cervix, and abnormal discharges from the cervix. Women with frank carcinoma cervix, pregnant females, patients with bleeding per vaginum at the time of examination, and those who had used vaginal medications, vaginal contraceptives or douches in the last 48 h of examination were excluded from the study. Demographic analysis was performed for 450 patients who were admitted to the clinic. Sensitivity, specificity, positive predictive value and negative predictive values of patients to identify cervical pathologies of smear and colposcopy were histopathologically calculated. The statistical software package SPSS 15.0 (SPSS Inc., Chicago, IL, USA) and Spearman's and Chi-Square tests were used for statistical analysis. RESULTS Sensitivity, specificity, PPD and NDP of smear were 0.57%, 0.76%, 0.26%, 0.92% respectively. Sensitivity, specificity, PPD and NDP of colposcopy were 0.92%, 0.67%, 0.52%, 0.96% respectively. A statistically significant correlation was found between abnormal cytology and histopathology, and abnormal colposcopy finding and histopathology. CONCLUSIONS Women with clinical diagnosis of unhealthy cervix should be evaluated by cytology to detect any premalignant or malignant lesions. It was concluded that Pap smear, colposcopy and histopathology should be collectively evaluated to evaluate cervical findings in low socio-economic regions.

Levels of Neopterin and other Inflammatory Markers in Obese and Non-Obese Patients with Polycystic Ovary Syndrome.

BACKGROUND: We aimed to measure the levels of inflammatory markers and neopterin in obese and non-obese patients with PCOS by using 2 separate control groups with matching body mass index (BMI). MATERIAL AND METHODS: A total of 60 women of reproductive age with (n=30) and without (n=30) PCOS were included in this study. Based on their BMI, patients with PCOS were divided into 2 groups as obese (n=15) and non-obese (n=15) PCOS groups. In addition, 2 BMI-matched control groups were formed. Neopterin, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (N/L ratio), and vitamin B12 were assessed by complete blood count. RESULTS: No significant difference was found between patients with PCOS and control subjects in neopterin, IL-6, TNF-α, and CRP levels. However, N/L ratio levels were significantly higher (p 0.045) and vitamin B12 levels were significantly lower (p 0.033) in patients with PCOS compared to control subjects. No statistically significant difference was found between obese and non-obese patients with PCOS and control subjects in neopterin, IL-6, TNF-α, and N/L ratio levels. However, CRP levels were significantly higher in obese patients with PCOS compared to obese control subjects (p 0.007). CONCLUSIONS: It can be concluded that inflammatory activity is increased in patients with PCOS, can lead to an increased risk for atherosclerosis, and this increase is not caused by obesity but rather by the polycystic ovary syndrome itself. However, studies with larger sample sizes are needed in this area.

Honokiol decreases intra-abdominal adhesion formation in a rat model.

AIM: The purpose of this study was to investigate the effectiveness of honokiol, a natural molecule that was shown to have antioxidant effects, in prevention of intra-abdominal adhesion formation in a rat model. MATERIAL AND METHOD: This study was conducted on a total of 40 non-pregnant Sprague-Dawley rats, which were divided into 4 groups as follows: sham, control, saline, and honokiol groups. Both uterine horns of the rats in control, saline, and honokiol groups were exposed and a 2-cm segment of the anti-mesenteric surface of both uterine horns was traumatized by a scalpel. The saline group was administered 2 ml of saline/day intraperitoneally for 5 days after the operation. The honokiol group, on the other hand, was administered honokiol intraperitoneally at a dose of 1 mg/kg/day for 5 days after the operation. On postoperative day 14, 3 ml of intracardiac blood sample was taken from the rats for biochemical analyses, and the rats were sacrificed this way. RESULTS: Adhesion and inflammation scores were significantly lower in the honokiol group compared with the saline and control groups (p < 0.008). Similarly, fibrosis score was significantly lower in the honokiol group compared with the saline group (p < 0.008). CONCLUSION: Honokiol was found to be effective in prevention of intra-abdominal adhesion formation in a rat model. However, larger studies are needed to shed light on the exact role of honokiol in intra-abdominal adhesion formation and to determine the molecular aspects of the promising results found in this study.