Risk factors for empty follicle syndrome in diminished ovarian reserve patients undergoing intracytoplasmic sperm injection cycles: A retrospective observational analysis.

The aim of this study is to evaluate the risk factors for empty follicle syndrome (EFS) in patients with diminished ovarian reserve (DOR) undergoing an intracytoplasmic sperm injection cycle. In this retrospective study, patients with DOR were divided into 2 groups according to the presence of empty follicles on the day of oocyte retrieval. Patient age, body mass index (BMI), anti-Müllerian hormone (AMH), baseline follicle stimulating hormone (FSH) and estradiol (E2) levels, basal antral follicle count (AFC), total gonadotropin dose, and day of stimulation were recorded as risk factors. The association between EFS and these variables was assessed using the logistic regression method and ROC curve analysis. Increased BMI, low AMH, higher baseline FSH, low baseline AFC, higher gonadotropin dose, and longer day of ovulation induction were independent risk factors for EFS in patients with DOR. ROC curve analysis showed that BMI, AMH, baseline FSH, baseline AFC, higher gonadotropin dose, and longer ovulation induction days were predictive parameters in this group. According to the current study, higher BMI, lower AMH, higher baseline FSH, lower baseline AFC, higher gonadotropin dose and longer ovulation induction days were independent risk factors for EFS in patients with reduced ovarian reserve.

Targeting the anaphase-promoting complex/cyclosome (APC/C) enhanced antiproliferative and apoptotic response in bladder cancer.

Improving the chemotherapy sensitivity of bladder cancer is a current clinical challenge. It is critical to seek out effective combination therapies that include low doses of cisplatin due to its dose-limiting toxicity. This study aims to investigate the cytotoxic effects of the combination therapy including proTAME, a small molecule inhibitor, targeting Cdc-20 and to determine the expression levels of several APC/C pathway-related genes that may play a role in the chemotherapy response of RT-4 (bladder cancer) and ARPE-19 (normal epithelial) cells. The IC20 and IC50 values were determined by MTS assay. The expression levels of apoptosis-associated (Bax and Bcl-2) and APC/C-associated (Cdc-20, Cyclin-B1, Securin, and Cdh-1) genes were assessed by qRT-PCR. Cell colonization ability and apoptosis were examined by clonogenic survival experiment and Annexin V/PI staining, respectively. Low-dose combination therapy showed a superior inhibition effect on RT-4 cells by increasing cell death and inhibiting colony formation. Triple-agent combination therapy further increased the percentage of late apoptotic and necrotic cells compared to the doublet-therapy with gemcitabine and cisplatin. ProTAME-containing combination therapies resulted in an elevation in Bax/Bcl-2 ratio in RT-4 cells, while a significant decrease was observed in proTAME-treated ARPE-19 cells. Cdc-20 expression in proTAME combined treatment groups were found to be decreased compared to their control groups. Low-dose triple-agent combination induced cytotoxicity and apoptosis in RT-4 cells effectively. It is essential to evaluate the role of APC/C pathway-associated potential biomarkers as therapeutic targets and define new combination therapy regimens to achieve improved tolerability in bladder cancer patients in the future.

Pelvic Radiation-Induced Testicular Damage: An Experimental Study at 1 Gray.

Therapeutic radiation of the pelvic region has been shown to cause damage to testicular germ cells. In this study we aimed to evaluate the effects of a low therapeutic dose of 1 Gy on the induction of cellular and histological damage in early-stage testicular germ cells and the impact of this radiation on offspring sex ratio. Unirradiated and irradiated male rats were mated with unirradiated female rats. Female rats were followed and the sex of the offspring was determined. The male rats were sacrificed at the end of the second week, and the testicular germ cells were subjected to genetic analysis along with cytological and histopathological examination. Sperm DNA was amplified with primers specific to testis-specific Y-linked protein, rat actin beta and testis-specific X-linked genes. The resulting products were separated by capillary electrophoresis. Histopathological changes were investigated by light microscopy along with the TUNEL assay and immunohistochemical staining for caspase-3. There was no significant difference between the two groups for sex ratio and size of offspring. The number of sperm cells bearing X or Y chromosomes' did not differ significantly between these two groups. However, a 1 Gy dose of radiation caused significant cytopathological and histopathological changes in the testicular tissue. In the irradiated group, edematous regions were evident. The number of caspase-3 positive cells in the germinal epithelium of the seminiferous tubules was also significantly higher in the irradiated group. Our results showed that low-dose radiation induced apoptosis and caused significant cyto- and histopathological changes in the testicular tissue. Further research is required to fully elucidate their contribution to apoptosis and if low-dose radiation may potentially lead to long-term effects in the offspring. These results may also lead us to develop a new technique using the caspase-3 staining to monitor the susceptibility to low dose radiation.

Association of paraoxonase-1 L55M and Q192R polymorphisms with PCOS risk and potential risk factors for atherosclerosis.

AIM: To examine the PON1-L55M and -Q192R polymorphisms for polycystic ovary syndrome (PCOS) risk in relation with atherosclerosis risk markers. METHODS: Blood samples were collected from 203 women (PCOS [n = 151], control [n = 52]). Genomic DNA was extracted and RFLP method was performed following the amplifications of the target regions. RESULTS: Individuals with 192QR/192RR genotypes had a 2.5-fold increased risk of representing PCOS compared with the individuals with 192QQ genotype. Q192R was more strongly associated with PCOS than previously suggested atherosclerosis risk markers. Q192R status and body mass index values in combination were established to be a significant predictor of PCOS (AUC: 0.655, p = 0.001). CONCLUSION: This is one of the first studies suggesting the use of combination biomarkers to better predict the risk of developing PCOS.

Chronic subdural hematoma following spinal anesthesia for cesarean section.

OBJECTIVE: Intracranial subdural hematoma after spinal anesthesia is a rare and life-threatening complication of spinal anesthesia. The most common complication of spinal anesthesia is the postdural puncture headache. When severe and persistent headache after spinal anesthesia occur, differential diagnosis can be explored. In this report, we aimed to evaluate a patient with persistent headache following spinal anesthesia for cesarean section in a 31-year-old woman ,and emphasize a rare complication of spinal anesthesia which is subdural hematoma.

Effect of Obesity on Clinical Parameters and Pregnancy Rates in Women with Polycystic Ovary Syndrome Undergoing Ovulation Induction Cycles.

OBJECTIVE: To evaluate the effect of obesity on clinical parameters and pregnancy rates in infertile women with polycystic ovary syndrome (PCOS), who have undergone ovulation induction. STUDY DESIGN: This retrospective study included 177 women with PCOS who presented to our gynecological endocrinology outpatient clinic for diagnosed infertility. All of the patients initially received clomiphene citrate (CC), and if CC resistance was noted, gonadotropins were used. The patients were classified into 2 groups according to BMI (<30 kg/m2=control group and ≥30 kg/m2=study group). Pregnancy was assessed by ß-hCG levels and a visible gestational sac in the endometrium. RESULTS: The demographic and hormonal parameters were similar between the groups. The mean duration of infertility was longer in the study group (p<0.05). In the study group, cycle cancellation due to CC resistance (p=0.039) and mean baseline LH levels (p=0.026) was statistically more likely than in the control group. On follow-up, 4 (9.3%) patients in the study group had conceived and 26 (19.4%) patients in the control group had conceived (p=0.041). CONCLUSION: Obesity adversely affects pregnancy rates in women with PCOS who undergo ovulation induction cycles. Clinicians should recommend weight loss in these patients before ovulation induction.

Association of clinical outcomes and complications with obesity in patients who have undergone abdominal myomectomy.

BACKGROUND: This study aimed to evaluate the association between complications and clinical parameters with obesity in 273 women who have undergone abdominal myomectomy during the study period. METHODS: The patients were classified into two groups according to body mass index (BMI) (≤30 kg/m(2) and >30 kg/m(2)). Demographic, preoperative and postoperative clinical parameters were evaluated. RESULTS: Demographic, preoperative and postoperative clinical parameters were evaluated. The results showed statistically significant differences between the obese and non-obese groups in terms of age, gravidity, diameter of fibroid (DOF), postoperative hemoglobin, duration of hospital stay, and complications. Patients in the obese group had greater DOF and complications such as hemorrhage, postoperative fever, wound infection and ileus (p < 0.05). CONCLUSION: Based on our results, we conclude that obesity adversely affects the clinical outcomes of patients who undergo abdominal myomectomy.

The Predictive Role of Serum Cystatin C Levels in Polycystic Ovary Syndrome in Adolescents.

STUDY OBJECTIVE: To evaluate the correlation between serum cystatin levels and clinical parameters in adolescents with polycystic ovary syndrome (PCOS). DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: This prospective case-control study included 89 adolescents with PCOS. Demographic characteristics and hormonal and biochemical parameters were compared between study (89 patients with PCOS) and control (84 subjects without PCOS) groups. Risk factors recorded were age, body mass index (BMI), waist to hip ratio (WHR), Ferriman-Gallwey score, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein (LDL), high-sensitivity C-reactive protein, cystatin C, follicle stimulating hormone, luteinizing hormone, estradiol, dehydroepiandrosterone sulfate, homeostatic model assessment insulin resistance index, free testosterone, and progesterone levels. RESULTS: BMI, WHR, Ferriman-Gallwey score, and triglyceride, LDL, total cholesterol, estradiol, dehydroepiandrosterone sulfate, free testosterone, luteinizing hormone, high-sensitivity C-reactive protein, and cystatin C levels, and homeostatic model assessment insulin resistance index scores were significantly higher, and high-density lipoprotein levels were lower in the PCOS patients compared with healthy subjects (P < .05). We also found positive correlations between the cystatin C levels and BMI, WHR, estradiol, high-sensitivity C-reactive protein, and LDL levels in the study group. CONCLUSION: The serum cystatin C level is a promising marker for diagnosing adolescent patients with PCOS and suggests an inflammatory etiology for these patients. Further studies with more participants should examine this potential association with inflammation.

The association between clinical parameters and uterine fibroid size in patients who underwent abdominal myomectomy.

OBJECTIVES: To evaluate if there is an association between neutrophil lymphocyte ratio and tumor markers in patients with uterine fibroids. METHODS: A total of three hundred and fifty seven patients who operated for myomectomy were enrolled this retrospective case control study. Risk factors evaluated were; age, uterine fibroid type, body mass index (BMI), gravidity, parity, preoperative and postoperative hemoglobin difference, neutrophil/lymphocyte ratio (NLR), alpha fetoprotein (AFP), cancer antigen 125 (CA 125), cancer antigen 19-9 (CA 19-9), cancer antigen 15-3 (CA 15-3), carsino embryonic antigen (CEA) levels. Patients divided two groups with regard to the diameter size of the removed fibroids. Group 1 (n=211) determined as the patients whose diameter size of the removed fibroids ≤ 5 cm and group 2 (n=146) determined as patients with > 5 cm diameter size. Groups were compared in terms of their age, bmi, gravidity, parity, preoperative and postoperative hemoglobin difference, nlr, afp, ca 125, ca 19-9, ca 15-3, cea levels. RESULTS: The mean age of the patients in group 1 (n=211) were 38.02 ± 5.38 years and in group 2 were (n=146) 37.80 ± 6.06 years (p = .751). There were no statistically significant differences between groups in terms of age, bmi, uterine fibroid types, cea and afp levels (p > 0.05). Gravidity, parity, preoperative and postoperative hemoglobin differences, nlr, ca 125, ca 19-9, ca 15-3 levels were statically significantly different between groups. CONCLUSIONS: According to this study, we think that multiple parameters affect developing uterine fibroids.

Maternal serum vitamin D levels in pregnancies complicated by neural tube defects.

OBJECTIVE: The association between vitamin D deficiency and abnormal neural development has been proposed previously. We aimed to evaluate maternal serum vitamin D levels in pregnancies complicated by neural tube defects (NTDs) and compared them with healthy pregnant women. METHODS: A total of 60 pregnant women were included in this controlled cross-sectional study. Thirty of the patients whose pregnancies were complicated by meningocele, meningomyelocele, encephalocele, anencephaly and fetal acrania constituted the study group, whereas 30 normal pregnant women constituted the control group. The main parameters recorded for each woman were as follows: age, body mass index (BMI), gestational week (GW), gravidity, abortion, co-morbidities, dressing style, consumption of milk and dairy products and serum levels of 25(OH)VitD3, calcium, albumin and total protein. RESULTS: The mean maternal serum 25(OH)VitD3 level was 6.2 ± 5.0 ng/ml in the study group and 9.1 ± 7.3 ng/ml in the control group (p: 0.071). The mean maternal serum calcium level was statistically significantly higher in the control group, and calcium-rich dietary intake was also more common in this group (p < 0.05). There was no statistically significant difference between groups in terms of age, BMI, GW, dressing style and serum levels of albumin and total protein. CONCLUSIONS: Vitamin D deficiency is common among pregnant women, and maternal serum calcium levels were lower in pregnancies complicated by NTD than healthy pregnant women. Larger further studies are required to evaluate the effects of calcium-rich dietary sources or vitamin D and calcium in the development of NTDs.

Krukenberg carcinoma metastasized from stomach resembling mucinous cystadenocarcinoma of the ovary.

The ovaries are common site of metastasis in a variety of primary neoplasms. Multiple tumors such as breast, lung, and pancreas have been reported to metastasize to the ovary, however; the colon and stomach are the most common primary cancer sites that of ovarian metastasis. An ovarian mass mostly originates from its self-tissue, but sometimes it can be a metastasis of a gastrointestinal system tumor. Such cases are often misdiagnosed as primary ovarian cancers. A 42-year-old woman was admitted to our hospital with pelvic pain. She had a history of her complaints for two months. Bilateral large ovarian mass was detected in transvaginal ultrasound. Laparotomy was performed, the pathologist suggested inspection of the stomach after the frozen section analysis; therefore, an irregular mass on the stomach was detected. The general surgeon was attended to the operation, and an inoperative stomach tumor was reported by the general surgeon. After that due to the partial obstruction of jejunum, a gastrojejunostomy was performed. It is in fact difficult to distinguish between metastatic mucinous carcinomas and primary mucinous carcinomas of the ovary, due to the similar appearance of as cystic tumors on gross examination. The clinicians should be aware of the likely concomitant gastrointestinal system tumor when a large and bilaterally mass was detected on physical examination. This case also reminds that a systemic examination is necessary even if the large ovarian tumors suspicious of primary malignancy were noticed.

Unilateral angiokeratoma of vulva: a rare clinic entity.

The aim of this study is to present a very rare dermatologic condition of the vulva. Angiokeratoma is a benign dilation of ectatic thin-walled blood vessels and congested capillaries in the superficial dermal layer of skin. It occurs predominantly in men and extremely rare in women. Angiokeratoma presents as single or multiple papular lesions on the vulva with smooth or verrucous surface. These lesions are easily confused with infectious disease, inflammatory lesions, and epithelial tumors. In this report, we presented a 42 year old unmarried woman who was admitted to our clinic with complaints of two papuler lesions of the right labium majus with vaginal discharge, vulvar pruritis, and vulvar edema. She had been previously treated with different local or systemic antiinfectious agents and her screening tests for sexually transmitted disease were negative. The genital examination showed a very thinned, hyperemic and edematous vulvar skin with two lesions measured 0,5-1 cm in diameter on the right labium majus. The surface of the lesions was partly uneven and partly veined. A local excision was performed. Histological examination showed hyperkeratosis, papillomatosis and acanthosis with dilated vascular areas in the dermis and the specimen revealed angiokeratoma. In conclusion, we should be aware of this clinical entity to make the differential diagnosis of a lesion on the vulva.

Clinical significance of serum follistatin levels in the diagnosis of ovarian endometrioma and benign ovarian cysts.

OBJECTIVE: To determine the clinical significance of serum follistatin levels in women with an ovarian endometrioma. MATERIALS AND METHODS: This is a prospective study of 89 women, 56 with an ovarian endometrioma (endometrioma group) and 33 with a benign ovarian cyst (control group) who underwent laparoscopic excision. Age, parity, body mass index, serum CA-125, serum CA 19-9, and serum follistatin levels were determined for all participants and evaluated as potential prognostic factors prior to laparoscopic cystectomy. RESULTS: There were no significant differences in demographic factors between the endometrioma group and the control group. However, serum follistatin levels were significantly higher in the endometrioma group (9350 ± 895 pg/mL vs. control group 725 ± 72 pg/mL, p < 0.05). The optimal diagnostic cut-off values (sensitivity and specificity) of CA-125, CA 19-9, and follistatin for ovarian endometrioma were 23.2 IU/mL (82.14% and 72.73%), 30.14 IU/mL (45.28% and 87.50%), and 2350 pg/mL (53.7% and 60.61%), respectively. CONCLUSION: Despite the increased serum follistatin levels in patients with ovarian endometrioma, CA-125 was determined to be a more sensitive and specific marker than follistatin for the diagnosis of ovarian endometrioma and endometriosis.

The effect of preprocedure anxiety levels on postprocedure pain scores in women undergoing hysterosalpingography.

BACKGROUND: Hysterosalpingography (HSG) is an invasive, uncomfortable, and painful procedure. Patients often experience considerable anxiety and stress before the procedure. In this study, we aimed to evaluate the effect of preprocedure anxiety on postprocedure pain scores and clinical outcomes in women undergoing HSG. METHODS: This study was designed as a prospective randomized study. Women undergoing HSG were asked to complete the Beck Anxiety Inventory before the procedure. Patients were classified into two groups according to the anxiety score (Group 1: anxiety score ≤ 25; n = 84 and Group 2: anxiety score > 25, n = 25). All of the patients were asked to state the severity of their pain during the procedure using a visual analogue scale immediately after the procedure. Then, postprocedure pain scores and clinical features were evaluated. Data analyzed were: age, gravidity, parity, durations of marriage and infertility, body mass index, procedure time, amount of contrast media used, operator sex, history of surgery, educational level, and HSG results. RESULTS: A total of 109 women were enrolled into this prospective study. There was no statistically significant difference between the groups in terms of age, body mass index, durations of marriage and infertility, procedure time, amount of contrast media used, operator sex, history of surgery, educational level, and patency of the one and/or two fallopian tubes (p > 0.05). The median parity and pain scores after the procedure were lower in Group 1 (p < 0.05). There was also a positive correlation between anxiety scores and postprocedure pain scores (r = 0.289, p = 0.002). Receiver operator characteristics curve analysis demonstrated that operator sex was an important risk factor for postprocedure pain in patients with a preprocedure Beck Anxiety Inventory > 25. Logistic regression method demonstrated that higher parity, preprocedure anxiety score > 25, and male operator were risk factors for increased postprocedure visual analogue scale scores. CONCLUSION: According to this study, preprocedure anxiety levels have an effect on postoperative pain scores in women undergoing HSG procedure. Multiparity, male operator, and higher preprocedure anxiety scores also may have an effect on postoperative pain scores.

Plasma Visfatin Levels in Adolescents with Polycystic Ovary Syndrome: A Prospective Case-Control Study.

STUDY OBJECTIVE: We evaluated the plasma visfatin levels in hirsute female adolescents with polycystic ovary syndrome. DESIGN, SETTING, AND PARTICIPANTS: This prospective case-control study included 87 female patients who were seen in our adolescence department. Demographic characteristics and hormonal and biochemical parameters were evaluated between patients with and without polycystic ovary syndrome. Next, we divided the patients with polycystic ovary syndrome into the following subgroups: overweight or obese (body mass index [BMI] ≥ 25 kg/m(2)) vs normal weight (BMI < 25 kg/m(2)) and hirsute vs nonhirsute. RESULTS: There were statistically significant differences in the BMI, serum androgen levels, homeostasis model assessment-insulin resistance (HOMA-IR) levels, and insulin levels between patients with and without polycystic ovary syndrome (P < .05). The mean visfatin levels showed no statistically significant difference between these 2 groups (P > .05). The serum visfatin levels were similar between the 2 subgroups classified by BMI (P > .05). However, there were statistically significant differences in the total and free testosterone levels, 17-hydroxylase progesterone level, HOMA-IR level, and visfatin level between the 2 subgroups classified by hirsutism (P < .05). The plasma visfatin level was higher in hirsute PCOS than in nonhirsute PCOS patients. CONCLUSION: Significantly higher visfatin levels were found in hirsute than in nonhirsute adolescents with PCOS. According to these results, plasma visfatin levels may be a useful marker in hirsute adolescents with PCOS.

The association between endometrial polyps and metabolic syndrome: a case-control study.

BACKGROUND: Endometrial polyps are common benign gynaecologic disorders. The etiopathogenesis of this condition remains unclear, however obesity is an important risk factor for the development of endometrial polyps. AIM: The aim of the study was to evaluate a possible association between endometrial polyps and clinical parameters of metabolic syndrome (MetS). MATERIALS AND METHODS: Forty-five women with endometrial polyps (study group) and 45 without (control group) were included in this cross-sectional study. The main parameters evaluated between the groups were age, BMI (body mass index), waist circumference (WC), blood pressure, serum lipid profiles, fasting glucose levels and homeostatic model assessment of insulin resistance (HOMA-IR). RESULTS: There was a significant difference between the groups in terms of BMI, WC, insulin levels and HOMA-IR (P < 0.05). The MetS was present in 32 (71.1%) of women in the study group and in 6 (13.3%) in the control group (P < 0.001). Logistic regression demonstrated that MetS was a significant risk factor for endometrial polyps. ROC curve analysis also showed that MetS was the most significant discriminative risk factor in the study group with an AUC of 0.789 (0.691-0.887; CI 95%). CONCLUSION: Our study suggests that there may be a relationship between endometrial polyps, MetS and insulin resistance. Further studies are required to explain the role of this relationship in the pathogenesis of the disease.

Urinary Incontinence Due to Urethral Coitus in a Multiparous Woman.

Urethral coitus in women with a normal vagina and introitus has very rarely been reported. We report the case of a 48-year-old gravida 5, para 5 woman with a history of urethral coitus complaining of urinary incontinence. To the best of our knowledge, our patient is the fifth reported case of urethral coitus with normal genitalia, and it might be accepted as the first reported case of urethral coitus in a multiparous woman.

Risk factors for adenomyosis, leiomyoma and concurrent adenomyosis and leiomyoma.

AIM: To evaluate the risk factors for adenomyosis, leiomyoma and concomitant adenomyosis and leiomyoma in patients with treatment-resistant menometrorrhagia. METHODS: A retrospective study was conducted on 129 women who underwent abdominal hysterectomy for treatment-resistant menometrorrhagia. The patients were divided into four groups according to the postoperative histopathology: concomitant adenomyosis and leiomyoma (n = 33), adenomyosis only (n = 26), leiomyoma only (n = 48) and controls (n = 22). Patients without any organic uterine pathology constituted the control group. RESULTS: Age at menarche was higher in the concomitant adenomyosis and leiomyoma group compared to the adenomyosis only group (P = 0.006). The mean age (P = 0.007), age at menarche (P = 0.001) and gravidity (P = 0.001) were higher in the concomitant adenomyosis and leiomyoma group compared to the leiomyoma only group. Preoperative hemoglobin was lower in the concomitant adenomyosis and leiomyoma, adenomyosis only, and leiomyoma only groups than the control group (P < 0.008). On receiver operating characteristic analysis, hemoglobin <10.9 mg/dL had a sensitivity and specificity of 77% and 70%, respectively, in discrimination of any uterine organic pathology, including adenomyosis only, leiomyoma only, and concomitant adenomyosis and leiomyoma, from the control group. Patients in the adenomyosis group were older (OR, 1.20; 95%CI: 1.05-1.50) and had a lower age at menarche (OR, 0.42; 95%CI: 0.19-0.89) than the other groups. CONCLUSIONS: Preoperative anemia may be a useful predictor of adenomyosis. Older patients, and patients who had a lower age at menarche, were also more likely to have adenomyosis.

Associations between adipocyte fatty acid-binding protein and clinical parameters in polycystic ovary syndrome.

PURPOSE: We evaluated a possible association between serum adipocyte fatty acid-binding protein (A-FABP) levels and clinical parameters in women with polycystic ovary syndrome (PCOS). METHODS: Our study included 86 women: 49 with PCOS (study group), 37 with non-PCOS (control group). We recorded and analyzed age, body mass index [BMI = weight (kg)/height (m)(2)], waist circumference, and blood pressure and follicle-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH, free testosterone (fT), dehydroepiandrosterone sulfate, 17-OH progesterone, insulin, glucose, triglyceride, high-density lipoprotein, low-density lipoprotein, very low density lipoprotein, HOMA-IR, and A-FABP levels. RESULTS: The mean BMI, waist circumference, and levels of serum LH, fT, LH/FSH, fasting insulin, and HOMA-IR were significantly higher in PCOS patients (p < 0.05). Pearson correlation analysis showed positive correlations of A-FABP levels with BMI and HOMA-IR levels and a negative correlation between A-FABP and fT levels. A ROC curve analysis found that BMI, waist circumference, and levels of fT, A-FABP, and HOMA-IR were discriminative parameters. CONCLUSION: Serum A-FABP levels may be a good prognostic marker in predicting metabolic syndrome and cardiovascular diseases in PCOS patients.

Pain experienced during and after office hysteroscopy with and without intracervical anesthesia.

We designed this study to evaluate if intracervical anesthesia reduces pain experienced during and after office hysteroscopy (OH). Two hundred women undergoing OH were randomized into two groups. Group I received intracervical anesthesia (10 ml %2 prilocaine), group II did not receive any anesthesia before procedure. The intensity of pain during procedure, 30 and 60 minutes later on visual analog scale (VAS) was assessed. Groups were similar in age, parity, previous number of vaginal delivery, or presence of menopausal status. The mean of pain scores during OH was less in group I (0.82 ± 0.11) than in group II (0.86 ± 0.09) and the difference was statistically significant (p = 0.04). But, the difference of mean pain scores 30 and 60 minutes after procedure between the groups were not statistially significant. In conclusion, intracervical anesthesia reduces pain experienced during OH, but this effect does not last longer.