The effect of lavender foot baths on postoperative pain and sleep quality in comparison with foot baths with warm water only-A prospective randomized controlled study.

INTRODUCTION: The aim of the study was to investigate the effect of warm water (WW) foot bath with or without lavender oil for pain and sleep quality in the patients who undergone abdominal surgeries. MATERIALS AND METHOD: This study was designed as a prospective randomized controlled. The three study groups were defined as the control group (n = 44), the WW foot bath group (n = 46), WW foot bath with the lavender group (n = 40). Foot baths were done for 20 min with 40 °C every night for 3 days after surgery. Visual Analogue Scale and Richard-Campbell Sleep Questionnaire were used during data collection. RESULTS: A total of 130 patients, mean age 55.99 ±  ± 13.05 years, 66 male (51 %), 103 of whom underwent abdominal surgery, were included in the study. When the patients during the postoperative three days were evaluated, decreased pain score and increased sleep quality both the WW and WW foot bath with lavender groups (p < 0.001). Noise-related sleep quality was detected to be lesser in the control group patients on the 3rd day (p < 0.001). CONCLUSION: WW foot bath with or without lavender oil is an uncomplicated, economical, and effective complementary therapy to reduce postoperative pain and improve sleep quality. WW foot baths with essential oils are optionally available in clinics and can be used according to patients' preferences.

Does cabergoline administration affect endometrial VEGFR-2 expression in a rat model of ovarian hyperstimulation syndrome?

OBJECTIVE: To assess the effect of cabergoline on endometrial vascular endothelial growth factor receptor-2 (VEGFR-2) immunoexpression in an ovarian hyperstimulation syndrome (OHSS) rat model. MATERIAL AND METHODS: Twenty-one immature female Wistar rats were assigned into three groups: group 1, the control group; group 2, stimulated with gonadotropins to mimic OHSS; and group 3, in which an OHSS protocol was induced and thereafter treated with cabergoline (100 µg/kg/day). Body weight, ovarian volume, corpora lutea numbers, and endometrial VEGFR-2 expression were compared between the groups. RESULTS: Weight gain and ovarian volume were highest in the OHSS-placebo group, while cabergoline administration significantly reversed those effects (p = 0.001 and p = 0.001, respectively). VEGFR-2 stained cells were significantly lower in groups 2 and 3 compared to group 1 (p = 0.002). Although VEGFR-2 expression was lowest in group 3, the difference was not statistically significant. Corpora lutea numbers were also similar (p = 0.465). CONCLUSION: While successful implantation requires a vascularized receptive endometrium, impaired expression of VEGFR-2 and disrupted endometrial angiogenesis due to cabergoline administration may be associated with IVF failure in fresh OHSS cycles. The insignificant decrease in endometrial VEGFR-2 expression observed in this research needs to be investigated by further studies involving additional techniques such as immunoblotting and/or RT-PCR analyses.

Immunomodulatory and anti-inflammatory therapeutic potential of gingerols and their nanoformulations.

Ginger (Zingiber officinale Roscoe), a member of the Zingiberaceae family, is one of the most popular spices worldwide, known since ancient times, and used both as a spice and a medicinal plant. The phenolic compounds found in ginger are predominantly gingerols, shogaols, and paradols. Gingerols are the major phenolic compounds found in fresh ginger and contain mainly 6-gingerol as well as 4-, 5-, 8-, 10-, and 12-gingerols. Gingerols possess a wide array of bioactivities, such as antioxidant and anticancer, among others. Regarding the different array of biological activities and published data on the mechanisms underlying its action, the complex interaction between three key events, including inflammation, oxidative stress, and immunity, appears to contribute to a plethora of pharmacological activities of this compound. Among these, the immunomodulatory properties of these compounds, which attract attention due to their effects on the immune system, have been the focus of many studies. Gingerols can alleviate inflammation given their ability to inhibit the activation of protein kinase B (Akt) and nuclear factor kappa B (NF-κB) signaling pathways, causing a decrease in proinflammatory and an increase in anti-inflammatory cytokines. However, given their low bioavailability, it is necessary to develop new and more effective strategies for treatment with gingerols. In order to overcome this problem, recent studies have addressed new drug delivery systems containing gingerols. In this review, the immunomodulatory activities of gingerol and its underlying mechanisms of action combined with the contributions of developed nanodrug delivery systems to this activity will be examined.

Herbal Ingredients in the Prevention of Breast Cancer: Comprehensive Review of Potential Molecular Targets and Role of Natural Products.

Among various cancers, breast cancer is the most prevalent type in women throughout the world. Breast cancer treatment is challenging due to complex nature of the etiology of disease. Cell division cycle alterations are often encountered in a variety of cancer types including breast cancer. Common treatments include chemotherapy, surgery, radiotherapy, and hormonal therapy; however, adverse effects and multidrug resistance lead to complications and noncompliance. Accordingly, there is an increasing demand for natural products from medicinal plants and foods. This review summarizes molecular mechanisms of signaling pathways in breast cancer and identifies mechanisms by which natural compounds may exert their efficacy in the treatment of breast cancer.

Placenta specific protein-1 in recurrent pregnancy loss and in In Vitro Fertilisation failure: a prospective observational case-control study.

Observations from studies have provided evidence that Placenta-specific protein1 (PLAC1) is important for the establishment and maintenance of pregnancy and suggest it as a potential biomarker for gestational pathologies. The aim of this study is to investigate whether maternal serum PLAC1 levels have any impact on etiopathogenesis of recurrent pregnancy loss (RPL) and repeated implantation failure after In Vitro Fertilisation (RIF). We conducted a prospective observational case-control study in a Research Hospital. Twenty-eight patients with RPL (group 1), 30 patients with unexplained infertility and RIF (group 2), 29 fertile patients (group 3) were included. The demographic features and serum PLAC1 levels were compared. There was a significant difference in PLAC1 levels between the groups (group 1 = 19.71 + 16.55 ng/ml; group 2 = 4.82 + 1.44 ng/ml; group 3 = 0.89 + 0.62 ng/ml, respectively) (p=.001). Positive correlation was found between serum PLAC1 levels and abortion rates (r = 0.64; p=.001), a negative correlation was found between serum PLAC1 levels and live birth rates (r = -0.69; p=.001). PLAC1 might have a negative effect on implantation in RPL and RIF. There may be a subgroup of PLAC with different bioactivity. There are no relevant studies conducted among these populations, further large-scale studies are needed to assess the molecular role of PLAC1 on implantation.IMPACT STATEMENTWhat is already known about this subject? PLAC1 (placenta-specific protein-1) gene is located on the X chromosome which encodes for a protein that is thought to be important for placental development although its role has not been clearly defined. Studies in the literature have provided evidence that PLAC1 has an important role in the establishment and maintenance of pregnancy and suggest it as a potential biomarker for gestational pathologies. Several reports over the past few years have demonstrated PLAC1 expression in a variety of human tumours including lung cancers, breast cancer, hepatocellular and colorectal cancers, gastric cancers and uterine cancers.What do the results of this study add? There have been no previous studies conducted among patients with recurrent pregnancy loss (RPL) or repeated implantation failure after In Vitro Fertilisation (RIF) that have searched for any association between PLAC1 levels and implantation failure. This study has demonstrated higher PLAC1 levels in infertile women with RIF and RPL for the first time; suggesting that it could have a negative effect on implantation in these populations. PLAC1 could be detected in the serum as a biomarker that is associated with RIF and RPL. What are the implications of these findings for clinical practice and/or further research? Defining the precise role of PLAC1 during implantation will provide new insight into understanding of poor reproductive outcomes such as RIF and RPL and help in developing treatment strategies. Further large-scale studies with more patients are needed to uncover the clinical value of PLAC1 as a biomarker to predict repeated implantation failure and RPL.

Assessment of circulating betatrophin levels in intrahepatic cholestasis of pregnancy.

Objective: To investigate maternal serum levels of betatrophin and their relationship with total bile acid (TBA) levels in patients with intrahepatic cholestasis of pregnancy (ICP).Materials and methods: Fifty-nine pregnant women with ICP (31 patients with severe and 28 patients with mild disease classifications) and 23 healthy women with uncomplicated pregnancies as the control group included the study. The maternal betatrophin, fasting blood glucose, fasting insulin (FI), and homeostatic model assessment of insulin resistance (HOMA-IR) levels of the groups were compared.Results: Serum betatrophin levels were significantly higher in the ICP groups than in the control group (p = .04 and p < .001, respectively). The FI levels and HOMA-IR values were significantly higher in the severe ICP group than in the control group (p = .006 and p = .001, respectively). While a significant positive correlation was found between betatrophin levels and fasting and postprandial TBA levels, there was no significant correlation among betatrophin and HOMA-IR or FI levels.Conclusions: Betatrophin levels were shown to correlate with TBA levels, it provides a model for future studies to understand the physiopathology of ICP, a complex metabolic disease. Changes in betatrophin levels may shed light on the pathogenesis of ICP.

Protective effect of omega 3 and vitamin D in preventing lung-tissue damage of newborn rats exposed to cigarette smoke during intrauterine period / Efecto protector de omega 3 y vitamina D en la prevención del daño en el tejido pulmonar de ratas recién nacidas expuestas al humo del cigarrillo durante el período intrauterino

SUMMARY: This study aimed to investigate the toxic effects of cigarette smoke exposure on lung and the protective role of Omega 3 and Vitamin D against these toxic effects biochemically and histologically. 28 pregnant Wistar Albino rats were divided into four groups. The first group was control group; the second group was exposed to smoke of 10 cigarette by puff device 2 hours/day after pregnancy; the third group was exposed to cigarette smoke together with Omega 3 (0.5 mg/kg/day) and the fourth group was exposed to cigarette smoke together with vitamin D (42 microgram/kg/day). Finally, lung tissue sections of the newborn rats were stained with Hemotoxilen eosine and Masson tricromite. Malondialdehyde (MDA) and Fluorescent Oxidation Products (FOU) levels were measured. Fetal weights and the number of fetuses were significantly lower in the group received only cigarette smoke (both p<0.001). Histopathologically, pulmonary volume, number of developed alveols and parenchyma elasticity decreased significantly, meanwhile interstitial tissue increased, elastin and collagen did not develop adequately. Histopathologic changes significantly decreased in the group given Omega 3 and Vitamin D. Statistically, MDA and FOU levels were found to be higher in the group exposed to cigarette smoke compared to the control group, and MDA and FOU levels were lower in the group given Omega 3 along with cigarette smoke (p<0.001). Cigarette smoke caused histologically significant damage to fetal lung tissue, oxidative stress and increased MDA and FOU levels. This damage was significantly reduced with Omega 3 and Vitamine D supplementation. Omega 3 is an important antioxidant; vitamin D has no significant antioxidant effect.

RESUMEN: Este estudio tuvo como objetivo investigar los efectos tóxicos de la exposición al humo de cigarrillo en el pulmón, y el papel protector de Omega 3 y la Vitamina D contra esos efectos. 28 ratas Wistar albino preñadas fueron separadas en cuatro grupos. El primer grupo grupo control; el segundo grupo estuvo expuesto al humo de 10 cigarrillos por dispositivo de inhalación 2 horas / día después de la preñez; el tercer grupo se expuso al humo del cigarrillo junto con Omega 3 (0,5 mg / kg / día) y el cuarto grupo se expuso al humo del cigarrillo junto con vitamina D (42 microgramos / kg / día). Secciones de tejido pulmonar de las ratas recién nacidas se tiñeron con Hematoxilina Eosina y tricrómico de Masson. Se midieron los niveles de malondialdehído (MDA) y productos de oxidación fluorescente (POF). Los pesos fetales y el número de fetos fueron significativamente más bajos en el grupo que recibió solamente humo de cigarrillo (ambos p <0,001). Histopatológicamente, el volumen pulmonar, el número de alveolos desarrollados y la elasticidad del parénquima disminuyeron significativamente; mientras que el tejido intersticial aumentó y la elastina y el colágeno no se desarrollaron adecuadamente. Los cambios histopatológicos disminuyeron significativamente en el grupo que recibió Omega 3 y Vitamina D. Estadísticamente, se encontró que los niveles de MDA y POF eran más altos en el grupo expuesto al humo de cigarrillo en comparación con el grupo control, además los niveles de MDA y POF fueron más bajos en el grupo que recibió Omega 3 junto con el humo del cigarrillo (p <0,001). El humo del cigarrillo causó daños histológicamente significativos en el tejido pulmonar fetal, el estrés oxidativo y el aumento de los niveles de MDA y FOU. Este daño se redujo significativamente con los suplementos de Omega 3 y Vitamina D. El omega 3 es un importante antioxidante; la vitamina D no tiene ningún efecto antioxidante significativo.

Ginger (zingiber officinale) might improve female fertility: A rat model.

BACKGROUND: Ginger (Zingiber officinale) is a well known and extensively used antioxidant in traditional remedies. In this study, we aimed to investigate the effects of ginger powder on ovarian folliculogenesis and implantation in rats. METHODS: There were two study groups. In the 5-day treatment group (one estrous cycle), 100 mg ginger powder, 200 mg ginger powder or distilled water was given for 5 days to the three subgroups each containing seven rats. In the 10-day treatment group, same doses were given for 10 days (two estrous cycle) to the three subgroups each containing seven rats. At the end of the 5th and 10th days, ovarian volumes, ovarian weights, primordial follicles, antral follicles, atretic follicles, and corpus luteum counts were assessed. To evaluate the angiogenic effects of ginger, vascular endothelial growth factor (VEGF) and for the antioxidant effects of ginger endothelial nitric oxide synthase (eNOS) were examined in the ovaries and in the endometrium immunohistochemically. RESULTS: In the 5-day treatment group, antral follicle count and ovarian stromal VEGF were significantly high in the 100 mg ginger subgroup in comparison to the control group (p < 0.05). In the 10-day treatment group, endometrial VEGF and ovarian stromal eNOS were significantly high in the 100 mg ginger subgroup in comparison to the control group (p < 0.05). There was no statistically significant difference at 200 mg ginger dose both in 5-day and 10-day treatment groups. CONCLUSION: The increases in the antral follicle count and ovarian stromal VEGF in the 100 mg/5-day treatment subgroup indicate that ginger have positive effects on folliculogenesis in short term with low dose. Additionally, ginger may enhance implantation in rats in long term with low dose.

The Influence of Maternal Obesity on Pregnancy Complications and Neonatal Outcomes in Diabetic and Nondiabetic Women.

INTRODUCTION: This study aimed to investigate the influence of obesity on pregnancy complications and neonatal outcomes in diabetic and nondiabetic women. MATERIALS AND METHODS: This retrospective case control study was conducted on 1193 pregnant women and their neonates at a tertiary level maternity hospital between March 2007 and 2011. The pregnant women were classified into 2 groups according to the presence of diabetes mellitus. Six hundred and seven patients with gestational diabetes or pregestational diabetes formed the diabetic group (study group) and 586 patients were in the nondiabetic group (control group). Demographic characteristics, body mass index, gestational weight gain, obstetric history, smoking status, type of delivery, gestational ages, pregnancy complications, neonatal outcomes were recorded for each patient. Multivariable logistic regression analysis was performed to evaluate the effect of obesity and diabetes on the pregnancy complications and neonatal outcomes. RESULTS: The mean age and pre-pregnancy body mass indices of women with diabetes mellitus were significantly higher than the control group's (p < 0.001). Gestational weight gain and number of smokers were similar among the groups. Multiparity and obesity were more prevalent in the diabetic group compared to controls (both p < 0.001). Although gestational age at birth was earlier in the diabetic group, birth weights were higher in this group than in the control group (both p < 0.001). Cesarean delivery rates, the incidence of macrosomia, and neonatal intensive care unit admission rates were significantly higher in the diabetes group both with normal and increased body mass index (all p < 0.001). However, adverse pregnancy outcomes were comparable between the groups (p = 0.279). Multivariable logistic regression analysis showed that obesity is a significant risk factor for pregnancy complications (OR = 1.772 [95% CI, 1.283 - 2.449], p = 0.001) but not for adverse neonatal outcomes (OR = 1.068 [95% CI, 0.683 - 1.669], p = 0.773). CONCLUSION: While obesity increases risk of developing a pregnancy complication, diabetes worsens neonatal outcomes.

Serum betatrophin/angiopoietin-like protein 8 (ANGPTL8) levels in pregnancies affected by hyperemesis gravidarum.

OBJECTIVE: The association between serum betatrophin levels and hyperemesis gravidarum (HEG) remains unknown. The aim of this study was to determine and understand the alterations in serum betatrophin levels in pregnancies complicated by HEG compared with unaffected normal pregnancies. STUDY DESIGN: A cohort study was carried out to evaluate serum betatrophin levels in patients with HEG. Serum betatrophin concentrations were measured with other metabolic markers for lipids and glucose metabolism in 40 singleton pregnancies affected by HEG and 40 gestational age- and body mass index-matched controls. RESULTS: The serum betatrophin concentrations were significantly higher in pregnant women with HEG than in the controls (1000 [600-1100] vs. 900 [500-1000] pg/ml, p = 0.003). The serum total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) levels were significantly higher in patients with HEG than in the healthy counterparts at the first trimester of pregnancy (158.5 ±â€¯29.4 vs. 143.8 ±â€¯29.7 mg/dl and 47.3 ±â€¯14.2 vs. 40.1 ±â€¯8.6 mg/dl, p = 0.031 and p = 0.007, respectively). Receiver operating characteristic (ROC) analyses demonstrated that the area under the curve (AUC) indicative of the betatrophin value for discriminating HEG patients was 0.690 (95% CI: 0.574-0.806, p = 0.003). The optimal cutoff value was 976 pg/ml with a sensitivity of 50% (95% CI: 33.80-66.20%) and a specificity of 82.5% (95% CI: 67.22-92.66%). We also found a positive correlation between betatrophin levels and HDL-C (r = 0.311; p = 0.005). Logistic regression analyses demonstrated that increased levels of betatrophin and HDL-C were risk factors for HEG with odds ratios (95% confidence interval) of 4.884 (1.589-15.009) and 5.346 (1.044-27.366), respectively. CONCLUSION: We conclude that serum betatrophin concentrations were increased in pregnancies affected by HEG. Furthermore, HDL-C levels seem to be associated with alterations in serum betatrophin levels.

Pregnancy outcome of laparoscopic tubal reanastomosis: retrospective results from a single clinical centre.

Objective Tubal sterilization is a widespread method of contraception. Post-sterilization regret is encountered, despite careful consideration prior to the procedure. Two treatment options are available for women after having had tubal sterilization: microsurgical reversal and IVF treatment. Recent improvements in laparoscopy have allowed tubal reanastomosis to be performed. This study aimed to evaluate the reproductive outcome after laparoscopic tubal reanastomosis and surgical features of the patients. Methods From June 2007 to January 2010, 27 patients with bilateral tubal ligation who underwent laparoscopic tubal reanastomosis were evaluated retrospectively. Tubal sterilization was performed by Pomeroy's technique during caesarean section in all of the patients. Before surgery, all of the patients were evaluated for possible other causes of infertility and the results of the evaluation were normal. Results The mean age of the patients was 31.8 years (range, 27-38 years). The mean interval between sterilization and reversal was 5.1 years (range, 1-14 years). Bilateral reversal was achieved in 24 patients. The operation time ranged from 85 to 140 minutes with a mean time of 105 minutes. All of the patients were discharged on the next day. There were no postoperative complications. Overall pregnancy, intrauterine pregnancy, and ectopic pregnancy rates were 55.5% (15/27), 51.8% (14/27), and 3.7% (1/27), respectively. Of the 14 intrauterine pregnancies, one ended with abortion at 6 weeks' gestation (1/14). The mean interval from surgery to pregnancy was 270 days (range, 147-420 days). Conclusion Laparoscopic tubal reanastomosis has the advantages of fewer complications, less postoperative discomfort, a smaller incisional scar, a shorter recovery time, and earlier resumption of normal activities. This technique has a satisfactory pregnancy rate in selected patients who desire reversal of tubal sterilization.

Levels of serum vitamin D and calcium in pregnancies complicated with fetal congenital diaphragmatic hernia and normal pregnancies.

OBJECTIVE: Vitamin D (VD) deficiency is a common public health problem worldwide in all age groups. Receptors and enzymes related to VD metabolism have been shown in many cells and tissues of the body. VD plays a crucial role in cellular growth and differentiation during embryogenesis. It has been suggested that VD deficiency may be associated with various diseases, and that lower maternal serum levels may be associated with adverse perinatal outcomes. In this study, we aimed to compare serum VD levels of pregnant women whose pregnancies complicated by congenital diaphragmatic hernia (CDH) with healthy pregnant women. We also evaluated perinatal outcomes of these pregnancies. METHODS: Total of 77 patients was included in this prospective and cross-sectional case-controlled study. 24 pregnant women having a fetus with CDH diagnosed prenatally formed the study group, and 53 healthy pregnants were eligible for the control group. Demographics and clinical characteristics of the cases with some laboratory parameters were recorded. Perinatal outcomes were also investigated. RESULTS: No significant differences were observed between two groups in terms of demographics and clinical features. Mean maternal serum VD levels were significantly lower in the study group than in the controls (p: 0.019). Ionized calcium and corrected calcium levels were also found to be lower in pregnant women with CDH (p < 0.001). Moreover, the calcium-rich dietary habits were also more common in the control group. Four (16.7%) patients chose termination and one (4.2%) experienced a stillbirth. Fourteen (58.3%) infants died in the early neonatal period; although some had undergone surgical interventions, only 5 (20.8%) were still alive after surgery. CONCLUSIONS: Maternal serum VD and calcium levels were significantly lower in pregnancies complicated by CDH than healthy pregnant women. Hipovitaminosis D may play a vital role in the pathogenesis of CDH.

Helicobacter pylori infection and polycystic ovary syndrome in adolescent and young adult patients.

AIM: Polycystic ovary syndrome (PCOS) is the most common cause of infertility among women of reproductive age. Chronic systemic inflammation has been considered to play a role in the development of PCOS. Helicobacter pylori has been shown to lead to both local gastric and chronic systemic inflammation. In the light of this, the aim of the present study was to investigate a possible link between H. pylori and PCOS. METHODS: A total of 167 nullipar and single adolescent and young adults (AYA) were recruited for the study: 86 (51.5%) had PCOS and 81 (48.5%) were age-matched controls. The average age was 18.57 ± 2.40 (range, 14-24 years). The recent Amsterdam European Society of Human Reproduction and Embryology/American Society for Reproductive Medicine (ESHRE/ASRM) guidelines including all three of the Rotterdam criteria were used to diagnose PCOS, and enzyme-linked immunosorbent assay kit was used to measure H. pylori IgG. RESULTS: There was no significant association between the PCOS and non-PCOS groups with regard to the presence of H. pylori IgG (P = 0.924), white blood count or C-reactive protein (P = 0.064; P = 0.383, respectively). CONCLUSION: The prevalence of H. pylori was not different with regard to PCOS status in AYA. More studies are needed to investigate a possible link between PCOS and H. pylori.

Obstetric Outcomes in Non-Gynecologic Cancer Patients in Remission.

OBJECTIVE: The aim of the present study was to evaluate the obstetric and perinatal outcomes in treated women who were diagnosed with non-gynecologic cancer and to compare these findings with pregnant women with no history of cancer. MATERIALS AND METHODS: This retrospective study was conducted on 21 pregnant women with non-gynecologic cancer who were in remission (study group) and 63 pregnant women with no history of cancer (control group). The women were admitted to the high-risk pregnancy clinic of Zekai Tahir Burak Women's Health Training and Research Hospital with a diagnosis of pregnancy and cancer between January 2010 and January 2015. Obstetric outcomes and demographic characteristics of the patients were recorded. Age, gravida, parity, abortus, body mass index (BMI), gestational week, smoking, mode of delivery, gestational weight, and perinatal outcomes were examined for each woman. RESULTS: The most common cancer types were thyroid (28.5%) and breast cancers (23.8%), which constituted just over half of the non-gynecologic cancer cases during pregnancy. The time elapsed after the diagnosis was 3.8±2.2 (1-9) years. No statistically significant differences were found between the two groups with regard to age, obstetric history, BMI, gestational week, smoking, and obstetric and perinatal outcomes (p>0.05). CONCLUSION: Negative perinatal outcomes in non-gynecologic cancer patients in remission were found to be within acceptable levels.

Is Xanthine oxidase activity in polycystic ovary syndrome associated with inflammatory and cardiovascular risk factors?

The aim of this study is to examine women with polycystic ovary syndrome (PCOS) to determine the relationship between xanthine oxidase (XO) and oxidative stress, inflammatory status, and various clinical and biochemical parameters. In this cross-sectional study a total of 83 women including 45 PCOS patients and 38 healthy women were enrolled. We collected blood samples for XO and superoxide dismutase (SOD) activity, hormone levels, cholesterol values, and inflammatory markers. Body mass index (BMI) , waist-to-hip ratio (WHR), and blood pressure were assessed. Blood samples were taken for hormonal levels, cholesterol levels, fasting plasma glucose (FPG), fasting plasma insulin (FPI), homeostatic model assessment-insulin resistance (HOMA-IR) index, quantitative insulin sensitivity check index (QUICKI), C-reactive protein (CRP), white blood cell and neutrophil counts, XO and SOD activities. The basal hormone levels, triglyceride (TG) levels, TG/HDL-C (high density lipoprotein-cholesterol) ratios FPG, FPI and HOMA-IR levels were higher in PCOS patients compared to controls (p<0.05). Platelet and plateletcrit (PCT) values, CRP, and XO activity were significantly increased, however SOD activity was decreased in PCOS patients (p<0.001). XO activity was positively correlated with LH/FSH and TG/HDL ratios, CRP, PCT, FPG, FPI, and HOMA-IR, and negatively correlated with QUICKI levels. In conclusion, XO is a useful marker to assess oxidative stress in PCOS patients. Positive correlations between XO and inflammatory markers and cardiovascular disease risk factors suggest that XO plays an important role in the pathogenesis of PCOS and its metabolic complications.

Association between anti-Mullerian hormone and insulin resistance in non-obese adolescent females with polycystic ovary syndrome.

OBJECTIVE: The present study was designed to evaluate the association between anti-Mullerian hormone (AMH) and insulin resistance (IR) in non-obese adolescent females with polycystic ovary syndrome (PCOS) with and without IR. METHODS: Seventy-seven consecutive non-obese patients were recruited and distributed into three groups according to diagnoses of PCOS and IR. Group I included 27 females diagnosed with PCOS and IR, group II included 18 females diagnosed with PCOS but without IR, and group III included 32 controls without PCOS. RESULTS: Group I had significantly higher AMH levels compared to group II and group III (p < 0.012 and p < 0.000, respectively). ROC curve analyses demonstrated that the AUC, indicative of the AMH value for discriminating PCOS with IR, was 0.763, with a confidence interval of 0.607-0.920 (p = 0.004). There was a significant positive correlation between serum AMH and HOMA-IR levels in adolescent females with PCOS (p = 0.003). CONCLUSION: We found that serum AMH levels were higher in non-obese adolescent females with PCOS and IR than in PCOS patients without IR and the healthy controls. There was a significant positive correlation between AMH levels and IR in non-obese adolescent females with PCOS.

Serum angiogenic profile in abnormal placentation.

OBJECTIVE: To evaluate the circulating soluble fms-like tyrosine kinase 1 (sFlt1), placental growth factor (PlGF) and vascular endothelial growth factor (VEGF) levels in women with abnormal placentation and to compare the data with the results of women with normal pregnancy. MATERIAL AND METHODS: Serum biomarkers of angiogenesis and maternal and perinatal characteristics of 68 pregnant women, all in the third trimester, who were diagnosed to have vaginal bleeding due to complete placenta previa with and without concomitant placenta accreta, increta and percreta as the study group and 30 pregnant women without any placentation abnormality who eventually delivered at ≥37 weeks of gestational age as the control group were evaluated. RESULTS: There was no statistical difference in the maternal serum values of sFlt1, PlGF, sFlt1/PlGF ratio and VEGF in groups with placental abnormality as compared to controls. Not even a single case of preeclampsia and intrauterine fetal growth restriction was encountered in the study group. CONCLUSION: We demonstrated that regardless of the localization and the degree of the myometrial invasion of the placenta in the uterus, the circulatory biomarkers of angiogenesis and vascularization were comparable.

Diagnostic value of CA 19-9 in pregnancies complicated by spinal neural tube defects: a preliminary study.

OBJECTIVES: Various physiological and pathological conditions can induce significant variations in plasma concentrations of tumor markers, such as CA 19-9, which is present in the serum and amniotic fluid of pregnant women. Herein, we aimed to determine the clinical importance of maternal serum CA 19-9 levels in the diagnosis of neural tube defects (NTDs). MATERIAL AND METHODS: A total of 100 women were included in this controlled cross-sectional study. Thirty-three patients whose pregnancies were complicated by isolated meningocele or meningomyelocele constituted the study group, whereas 33 normal, healthy pregnant women constituted the control group, and 34 age- and body mass index (BMI)-matched non-pregnant women were chosen for the validation group. RESULTS: The mean maternal serum CA 19-9 levels were 17.2 ± 17.0 IU/mL, 7.1 ± 5.9 IU/mL, and 4.7 ± 3.6 IU/mL in the study, control, and validation groups, respectively (p < 0.001). ROC analyses showed that elevated CA 19-9 values may predict NTDs (p < 0.001). The cut-off value for CA 19-9 was found to be 9.6 IU/mL at 70% (51%-84%, 95% CI) sensitivity and 84% (74%-92%, 95% CI) specificity. CONCLUSIONS: CA 19-9 may be a promising noninvasive marker for NTDs. Further studies are needed to reveal the clinical applicability and diagnostic potential of maternal serum CA 19-9 levels in the identification of NTDs.

A rare case of leiomyosarcoma originating from the left round ligament of the uterus.

Uterine leiomyosarcomas (LMS) are rare malignancies with a poor prognosis. The incidence is reported to be 3-7/100.000 per year. Preoperative and intraoperative differentiation between LMS and large leiomyoma is always challenging. Therefore, LMS are often diagnosed during postoperative histologic evaluation of hysterectomy or myomectomy specimens. LMS of the round ligament of the uterus which can represent as an inguinal or pelvic mass is extremely rare. To our knowledge, there is only one case report of LMS arising from the round ligament available in the literature. Herein, we aimed to present the second case of LMS originating from the left round ligament of the uterus in a premenopausal woman initially misdiagnosed as an ovarian tumor.

Factors That Affect Perinatal Outcomes of the Second Pregnancy of Adolescents.

STUDY OBJECTIVE: We assessed factors that might affect perinatal outcomes in second pregnancies in adolescents. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, MAIN OUTCOME MEASURES: This longitudinal retrospective study was carried out on 66 adolescents who experienced 2 deliveries during their adolescence. Data were collected for the first and second pregnancies. Odds ratios (ORs) and 95% confidence intervals (CIs) for adverse perinatal outcomes in the second pregnancy were calculated using a logistic regression model and SPSS software (version 17.0 for Windows; SPSS Inc, Chicago, IL). A P value < .05 was considered to indicate statistical significance. RESULTS: Body mass index, number of antenatal care visits, weight gain during pregnancy, incidence of anemia, smoking status, gestational week at delivery, cesarean section rate, and birth weight were similar between the first and second pregnancies of these adolescents. Neonatal intensive care unit admission rate, preeclampsia rate, low neonatal birth weight rate, and 5-minute Apgar scores <7 were significantly higher in the first than in the second pregnancy (P < .001). Age of 16 years or younger at the time of first pregnancy (OR = 1.5; 95% CI, 0.9-2.1; P < .01), less than an 18-month interval between births (OR = 1.4; 95% CI, 0.2-1.7; P < .04), presence of gestational complications in the first pregnancy (OR = 1.9; 95% CI, 1.0-3.4; P < .01), and the presence of perinatal complications in the first pregnancy (OR = 1.3; 95% CI, 1.0-1.9; P < .01) were found to be significant indicators for adverse neonatal outcomes in second pregnancies of adolescents. CONCLUSION: We found that the second pregnancies of adolescents were associated with fewer adverse perinatal outcomes than were their first pregnancies. However, some factors regarding the presence of perinatal complications in the first pregnancy, such as maternal age of 16 years or younger at the time of the first pregnancy and interval between first and second pregnancy of less than 18 months, were found to increase the risk of adverse perinatal outcomes for the second births.