Role of Vitamin B12 and Vitamin D levels in intrahepatic cholestasis of pregnancy and correlation with total bile acid.

This study aimed to evaluate the relationship between intrahepatic cholestasis of pregnancy (ICP) and Vitamin D and B12 levels. The study was a retrospective, cross-sectional, case-control study that evaluated 92 ICP cases and 102 pregnant women without any additional disease. ICP cases were grouped as mild and severe according to their total bile acid (TBA) levels, and their relationship with Vitamin D and B12 levels and perinatal outcomes was evaluated. Vitamin D and B12 levels of the ICP group were significantly lower than those of the control group. There was a moderate negative correlation between TBA and Vitamin D levels and a low negative correlation between TBA and Vitamin B12 levels. Adverse neonatal outcomes were significantly higher in the severe ICP group than in the mild ICP group. IMPACT STATEMENTWhat is already known on this subject? The pathophysiology of ICP, which can lead to adverse perinatal outcomes, is not yet fully understood, and there is no preventive treatment.What do the results of this study add? This study showed that Vitamins B12 and D levels were low in women with ICP and that TBA levels were negatively correlated with Vitamin D and B12 levels.What are the implications of these findings for clinical practice and/or further research? This study may guide future studies in terms of explaining the etiopathogenesis of ICP and developing treatment options.

Genetic Polymorphisms of COL1A1 Promoter Region (rs1800012) and TGFB1 Signal Peptide (rs1800471): Role in Cervical Insufficiency Susceptibility?

A structural or functional cervix problem prevents a woman from carrying a full-term pregnancy, which leads to the disease known as cervical insufficiency. Cervical insufficiency is partially inherited, and in certain situations, variations in genes related to connective tissue metabolism may be involved. The main objective of this investigation was to describe the collagen type I alpha 1 chain (COL1A1) gene rs1800012 polymorphism and the transforming growth factor beta 1 (TGFB1) gene rs1800471 polymorphism in a cohort of patients suffering from cervical insufficiency. Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) assays have been used to analyze the DNAs of 93 patients with cervical insufficiency and 103 healthy controls. The chi-square test was used for statistical analysis. There were significant differences in the genotype frequencies of the COL1A1 gene rs1800012 (G > T) and TGFB1 gene rs1800471 (G > C) polymorphisms between the patient and the control groups (p = 0.049 and p = 0.049, respectively). Also, the C allele of the TGFB1 rs1800471 polymorphism was significantly higher in the patient group than the control group (p = 0.016). Following clinical assessment, the COL1A1 rs1800012 polymorphism was found to be connected to the history of cerclage (p = 0.010). Additionally, the frequency of the TT/GG composite genotype of COL1A1 rs1800012/TGFB1 rs1800471 polymorphisms was significantly lower in the patient group than the control group (p = 0.049). The TT genotype of COL1A1 rs1800012 polymorphism was found to be protective against cervical insufficiency, while the C allele of TGFB1 rs1800471 polymorphism was found to predispose to the disease. It appears that the TT/GG composite genotype of COL1A1 rs1800012/TGFB1 rs1800471 polymorphisms protects against cervical insufficiency.

Association between lower urinary tract symptoms and polycystic ovary syndrome.

OBJECTIVE: The aim of this study was to analyze the association between lower urinary tract symptoms and polycystic ovary syndrome. METHODS: A total of 180 women were enrolled in this prospective study. Demographic data, body mass index, waist circumference, modified Ferriman-Gallwey scores, biochemical parameters, ultrasonographic findings, and maximum urinary flow rate (Q max) were analyzed. In addition, the Beck Depression Inventory, Beck Anxiety Inventory, and Bristol Female Lower Urinary Tract Symptom Scored Form questionnaires were evaluated for each subject. RESULTS: The mean age of patients was calculated as 23.78±3.04 years, which was similar for both groups (p=0.340). Body mass index, waist circumference, Beck Depression Inventory, Beck Anxiety Inventory, Bristol Female Lower Urinary Tract Symptom Scored Form, and modified Ferriman-Gallwey scores were significantly higher in group 2 (p<<0.001). Hyperandrogenism, lipid profile, and glucose metabolism disorders were more frequent in group 2 (p<<0.05). Bladder capacity (Q max), bladder wall thickness, and post-void residual volume values were similar in both groups (p>>0.05). CONCLUSION: In our study, a close relationship was observed between polycystic ovary syndrome and lower urinary tract symptoms. In this context, we think that a detailed urinary system evaluation of women with polycystic ovary syndrome is extremely important.

Evaluation of first- and third-trimester afamin levels in preeclampsia.

OBJECTIVE: The aim of this study was to investigate serum afamin levels in the first and third trimesters in preeclampsia. METHODS: Serum samples from 118 patients in the first and third trimesters were analyzed. Serum samples were collected from pregnant women who had enrolled in the first trimester. Blood was then collected from pregnant women who had developed preeclampsia and from healthy controls in the third trimester. The collected blood samples were resolved for analysis, and serum afamin concentrations were measured in the first and third trimesters. Preeclampsia and healthy controls were compared. RESULTS: There was no significant difference between the control and preeclampsia groups in terms of age, body mass index, and smoking. Afamin levels in the first and third trimesters were higher in the preeclampsia group than in the control group (p<0.05). In the subgroup analysis of the preeclampsia group, afamin levels were higher in the early-onset preeclampsia group than in the late-onset preeclampsia group in the first and third trimesters (p<0.05). In the receiver operating characteristic analysis afamin levels were 96.23 ng/mL in the first trimester and 123.57 ng/mL in the third trimester as cut-off values for preeclampsia. CONCLUSION: Serum afamin levels are useful for predicting preeclampsia in the first trimester in pregnant women and can be used in clinical practice as a supportive biomarker for the diagnosis of preeclampsia in the third trimester. Meta-analyzes are needed to investigate the effect of afamin levels in the prediction and diagnosis of preeclampsia and to determine the cut-off value.

Evaluation of blood transfusion rate in obstetric patients.

OBJECTIVES: The aim of this study was to analyse the obstetric patients who underwent transfusion in the gynecology and obstetrics clinic. MATERIAL AND METHODS: Obstetric patients who underwent a blood transfusion in the peripartum period were included in the study. A total of 213 patients who needed blood transfusion were identified. Patients' age, gravida, parity, gestational week, delivery types, blood transfusion indication and time, transfusion rate, blood products used, number of transfusions, peripartum hysterectomy status, neonatal APGAR scores and hemoglobin (Hb), hematocrit (Hct), red blood cell (RBC), platelet (Plt) values which counted before and after transfusion were recorded by scanning patient files from the hospital registry system. RESULTS: The overall blood transfusion rate of the patients who gave birth in our clinic was 2.51%. Uterine atony (50.7%) and chronic anemia (32.9%) were found as the most frequent indications of blood transfusion in the patients included in the study. Antenatal mean Hb of all transfusion patients was 9.8; postpartum mean Hb was 8.2. Pre-transfusion mean Hb, RBC, Hct, Plt values calculated as 7, 3.9, 30.3, 245.2, respectively; post-transfusion mean Hb, RBC, Hct, Plt values were 9, 3.52, 27.5, 215.1, respectively. CONCLUSIONS: Due to blood replacement, supply difficulties and transfusion complications, the profit-loss relationship should be individualized and clearly demonstrated before it is applied to the patient. In unpredictable obstetric situations that cause bleeding, staying up to date on current guidelines on pharmacological, hematological and surgical interventions and having an active blood transfusion center in the healthcare provider is very important in reducing maternal mortality and morbidity rates.

Total cholesterol/high-density lipoprotein and inflammatory parameters in patients with polycystic ovary syndrome.

OBJECTIVE: In this study, the hormone profile, lipid profile, and inflammatory parameters of patients with polycystic ovary syndrome were compared with those of non-polycystic ovary syndrome patients to determine predictive markers in young polycystic ovary syndrome patients who have not yet had children. METHODS: Patients' age, height, weight, body mass index, waist circumference, degree of hirsutism, and ultrasound findings were recorded. Hormone profile, lipid levels, ratio of complete blood count parameters, monocyte/high-density lipoprotein ratio, and total cholesterol/high-density lipoprotein ratio were compared between groups. RESULTS: No statistically significant differences were found between groups in terms of age, weight, waist circumference, body mass index, and dysmenorrhea (p>0.05). A significant relationship was found between the height and the degree of hirsutism in the groups (p<0.05). It was found that prolactin, total testosterone, and dehydroepiandrosterone sulfate levels were statistically significantly higher in the polycystic ovary syndrome group compared to the control group. The polycystic ovary syndrome group had hemoglobin, leukocytes, lymphocytes, neutrophils, platelets, and statistically higher ratios of total cholesterol/high-density lipoprotein, Low-density lipoprotein/high-density lipoprotein, and triglycerides/high-density lipoprotein. No statistically significant relationships were found between homeostatic model assessment insulin resistance, neutrophil-to-lymphocyte ratio, and monocyte-to-high-density lipoprotein ratio between the groups (p<0.05). There was no significant difference in systemic immune inflammation index values between the groups. CONCLUSION: Polycystic ovary syndrome patients are at risk for short- and long-term complications, and the use of the total cholesterol/high-density lipoprotein, Low-density lipoprotein/high-density lipoprotein, and triglycerides/high-density lipoprotein ratios in clinical practice during the follow-up of these patients may allow easy follow-up for patients. The health status of polycystic ovary syndrome patients can be objectively determined by tracking these outcomes at regular intervals.

Warm distension fluid reduces pain severity in office hysteroscopy: a randomized controlled trial.

BACKGROUND: Abnormal uterine bleeding (AUB) affects approximately 14% to 25% of women of reproductive age. The most common use of office hysteroscopy is to evaluate pathologies related to AUB and reproductive health, but office hysteroscopy can also be used for the diagnosis and treatment of other intrauterine pathologies. OBJECTIVE: Investigate the effects of the temperature of the distension fluid on pain severity in patients undergoing diagnostic office hysteroscopy due to AUB. DESIGN: Randomized controlled clinical trial. SETTING: Tertiary care center in Turkey. PATIENTS AND METHODS: One hundred perimenopausal patients with AUB were randomly allocated according to the temperature of the distension fluid used in office hysteroscopy (37°C or 25°C). Pain intensity was assessed using a visual analog scale (VAS). Six VAS measurements were compared over the course of the hysteroscopy: pre-treatment (VAS-1), at vaginal entry (VAS-2), at the cervical ostium transition (VAS-3), while in the cavity (VAS-4), at the end of the procedure (VAS-5), and 30 minutes after the end of the procedure (VAS-6). MAIN OUTCOME MEASURE: VAS SAMPLE SIZE: Fifty in each group enrolled, one drop out. RESULTS: The VAS-3, VAS-4, and VAS-5 scores were significantly lower for patients in the warm fluid group than in the room temperature group (P<.05), whereas the VAS-1, VAS-2, and VAS-6 scores were similar in both groups. CONCLUSION: The application of warm distension fluid in office hysteroscopy reduces pain severity compared with the application of an unheated fluid. LIMITATIONS: The main limitations of the study were that a subgroup analysis could not be performed due to an insufficient number of cases, and we were unable to evaluate vasovagal symptoms. CONFLICT OF INTEREST: None.

Association between lower urinary tract symptoms and polycystic ovary syndrome

SUMMARY OBJECTIVE: The aim of this study was to analyze the association between lower urinary tract symptoms and polycystic ovary syndrome. METHODS: A total of 180 women were enrolled in this prospective study. Demographic data, body mass index, waist circumference, modified Ferriman-Gallwey scores, biochemical parameters, ultrasonographic findings, and maximum urinary flow rate (Q max) were analyzed. In addition, the Beck Depression Inventory, Beck Anxiety Inventory, and Bristol Female Lower Urinary Tract Symptom Scored Form questionnaires were evaluated for each subject. RESULTS: The mean age of patients was calculated as 23.78±3.04 years, which was similar for both groups (p=0.340). Body mass index, waist circumference, Beck Depression Inventory, Beck Anxiety Inventory, Bristol Female Lower Urinary Tract Symptom Scored Form, and modified Ferriman-Gallwey scores were significantly higher in group 2 (p<<0.001). Hyperandrogenism, lipid profile, and glucose metabolism disorders were more frequent in group 2 (p<<0.05). Bladder capacity (Q max), bladder wall thickness, and post-void residual volume values were similar in both groups (p>>0.05). CONCLUSION: In our study, a close relationship was observed between polycystic ovary syndrome and lower urinary tract symptoms. In this context, we think that a detailed urinary system evaluation of women with polycystic ovary syndrome is extremely important.

Evaluation of first- and third-trimester afamin levels in preeclampsia

SUMMARY OBJECTIVE: The aim of this study was to investigate serum afamin levels in the first and third trimesters in preeclampsia. METHODS: Serum samples from 118 patients in the first and third trimesters were analyzed. Serum samples were collected from pregnant women who had enrolled in the first trimester. Blood was then collected from pregnant women who had developed preeclampsia and from healthy controls in the third trimester. The collected blood samples were resolved for analysis, and serum afamin concentrations were measured in the first and third trimesters. Preeclampsia and healthy controls were compared. RESULTS: There was no significant difference between the control and preeclampsia groups in terms of age, body mass index, and smoking. Afamin levels in the first and third trimesters were higher in the preeclampsia group than in the control group (p<0.05). In the subgroup analysis of the preeclampsia group, afamin levels were higher in the early-onset preeclampsia group than in the late-onset preeclampsia group in the first and third trimesters (p<0.05). In the receiver operating characteristic analysis afamin levels were 96.23 ng/mL in the first trimester and 123.57 ng/mL in the third trimester as cut-off values for preeclampsia. CONCLUSION: Serum afamin levels are useful for predicting preeclampsia in the first trimester in pregnant women and can be used in clinical practice as a supportive biomarker for the diagnosis of preeclampsia in the third trimester. Meta-analyzes are needed to investigate the effect of afamin levels in the prediction and diagnosis of preeclampsia and to determine the cut-off value.

Total cholesterol/high-density lipoprotein and inflammatory parameters in patients with polycystic ovary syndrome

SUMMARY OBJECTIVE: In this study, the hormone profile, lipid profile, and inflammatory parameters of patients with polycystic ovary syndrome were compared with those of non-polycystic ovary syndrome patients to determine predictive markers in young polycystic ovary syndrome patients who have not yet had children. METHODS: Patients' age, height, weight, body mass index, waist circumference, degree of hirsutism, and ultrasound findings were recorded. Hormone profile, lipid levels, ratio of complete blood count parameters, monocyte/high-density lipoprotein ratio, and total cholesterol/high-density lipoprotein ratio were compared between groups. RESULTS: No statistically significant differences were found between groups in terms of age, weight, waist circumference, body mass index, and dysmenorrhea (p>0.05). A significant relationship was found between the height and the degree of hirsutism in the groups (p<0.05). It was found that prolactin, total testosterone, and dehydroepiandrosterone sulfate levels were statistically significantly higher in the polycystic ovary syndrome group compared to the control group. The polycystic ovary syndrome group had hemoglobin, leukocytes, lymphocytes, neutrophils, platelets, and statistically higher ratios of total cholesterol/high-density lipoprotein, Low-density lipoprotein/high-density lipoprotein, and triglycerides/high-density lipoprotein. No statistically significant relationships were found between homeostatic model assessment insulin resistance, neutrophil-to-lymphocyte ratio, and monocyte-to-high-density lipoprotein ratio between the groups (p<0.05). There was no significant difference in systemic immune inflammation index values between the groups. CONCLUSION: Polycystic ovary syndrome patients are at risk for short- and long-term complications, and the use of the total cholesterol/high-density lipoprotein, Low-density lipoprotein/high-density lipoprotein, and triglycerides/high-density lipoprotein ratios in clinical practice during the follow-up of these patients may allow easy follow-up for patients. The health status of polycystic ovary syndrome patients can be objectively determined by tracking these outcomes at regular intervals.

Neutrophil-lymphocyte and platelet-lymphocyte ratios in endometrial hyperplasia.

OBJECTIVE: The purpose of present study was to evaluate association between neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) and endometrial hyperplasia (EH). METHODS: One hundred and ten women with abnormal uterine bleeding were included into the study. Blood samples were drawn from all patients to obtain complete blood cell counts, neutrophil-leukocyte ratio and platelet-leukocyte ratio before endometrial curettage procedure initiated. The patients were divided into three groups due to their pathological results: group 1, patients with EH without atypia (n=40); group 2, patients with EH with atypia (n=15); and group 3, patients with neither hyperplasia nor cancer as control group (n=55). Blood cell counts, NLRs and PLRs were compared among these groups. RESULTS: Based on hemoglobin and platelet counts, there was no significant difference among these groups (P>0.05). Leukocyte and neutrophil counts were higher in group 2 (EH with atypia) than group 1 and group 3 (P<0.01). NLR of group 2 was significantly elevated when compared to group 1 and group 3 (P=0.004). PLR was higher in group 1 and group 2 than control group (P=0.024). CONCLUSION: Non-specific inflammatory markers such as NLR and PLR were elevated in women with atypical EH. These markers may be used as a predictor of atypical EH in patients with abnormal uterine bleeding.