Role of the systemic immune-inflammation index in threatened abortion patients and predicting of abortion.

PURPOSE: Our study aimed to compare the systemic immune inflammation index (SII), one of the hematological inflammation parameters, between pregnant women diagnosed with threatened abortion (TA) and healthy pregnant women, and to evaluate the prediction of abortion in pregnant women with TA. METHODS: This retrospective study compared 150 patients with TA group and 150 age- and gestational week-matched healthy pregnant women (control group). Complete blood count parameters were assessed. SII, white blood cells (WBC), neutrophil to lymphocyte ratio (NLR), red cell distribution width (RDW), plateletcrit (PCT), platelet distribution width and monocyte to lymphocyte ratio (MLR) values were calculated. The SII value was calculated as follows: platelet count × (neutrophil/lymphocyte). RESULTS: SII, NLR, MLR, WBC, RDW, and PCT values were significantly higher in the TA group compared to the control group (923 ± 683 vs. 579 ± 364 [p < 0.001], 3.3 ± 2.0 vs. 2.1 ± 1.1 [p < 0.001], 0.3 ± 0.1 vs. 0.2 ± 0.2 [p < 0.001], 9.84 ± 2.87 vs. 8.6 ± 1.6 [p < 0.001], 13.9 ± 1.9 vs. 14.4 ± 2.3 [p = 0.032] and 0.3 ± 0.1 vs. 0.2 ± 0.0 [p < 0.001], respectively). Using receiver operating characteristics curve analysis to predict abortion in AI patients, the highest area under the curve was found for SII (0.727 for SII and 0.666 for NLR). CONCLUSION: SII, NLR, MLR, RDW, and platelet to lymphocyte ratio (PLR) levels were significantly increased in patients with TA. This study supports the idea that several inflammatory pathways may play an important role in the pathogenesis of this disorder. SII may be a much better marker than NLR and PLR for predicting the inflammatory status of the disease and abortion in an ongoing pregnancy.

Effect of the Covid 19 pandemic on depression and mother-infant bonding in uninfected postpartum women in a rural region.

BACKGROUND: Postpartum depression and maternal-infant attachment scores were examined in uninfected women during the COVID 19 pandemic in Kutahya, a rural province in Turkey's North Aegean region. METHODS: This cohort study was conducted in the Kutahya Health Sciences University Hospital obstetrics unit between April 2021 and August 2021. 178 low-risk term pregnant women who gave birth were given the surveys Edinburgh Postpartum Depression Scale and Mother-to-Infant Bonding Scale (MIBQ) 6 weeks after birth. The Edinburgh Postpartum Depression Scale was used to determine postpartum depression and the Mother-to-Infant Bonding Scale was used to determine maternal attachment. RESULTS: In this study, the postpartum depression rate was calculated as 17.4%. When depressed and non-depressed patients were compared, education level, maternal age, BMI, MIBQ score, history of previous pregnancies, route of delivery, previous operation history, economic status, employment status and pregnancy follow-up information were found to be similar (p > 0.05). The ratings on the Mother-to-Infant Bonding Scale were found to be similar in depressed and non-depressed patients (p > 0.05). The odds of maternal depression for patients who received guests at home was 3.068 (95%CI [1.149-8.191]) times the odds of patients who did not receive guests at home. CONCLUSIONS: Although a relationship has been found between accepting guests in the postpartum period and postpartum depression, it is necessary to investigate in further studies whether there is a causal relationship.

First trimester screening of serum advanced glycation end products levels of pregnant women who have risk factors for gestational diabetes and their obstetric outcomes: a preliminary case-control study.

Advanced glycation end-products (AGE) are complex compounds formed by nonenzymatic glycosylation of proteins, nucleic acids, and lipids with glucose in the blood. We aimed to investigate whether there was a difference in first-trimester serum AGE levels of pregnant women with and without risk factors for gestational diabetes mellitus (GDM) and their obstetric outcomes. There were 44 women in study group who have risk factors for GDM and 44 as controls. Demographic features, serum AGE levels, adverse perinatal and neonatal outcomes were compared between groups. Five patients (11.4%) in the study group and one patient (2.3%) in the control group were diagnosed as GDM (p = .2). The serum AGE values were not statistically different between the study and control groups. There were no statistical differences between groups in terms of adverse perinatal and neonatal outcomes. However, in the group with adverse perinatal outcome (n = 25), AGE values were higher than the control group. The results of our preliminary study suggested that high-risk women for GDM did not have increased serum levels of AGE in the first trimester. Nevertheless, a high first-trimester serum AGE level was found to be associated with adverse perinatal outcomes. IMPACT STATEMENTWhat is already known on this subject? Advanced glycation end products (AGE) are markers that are associated with diabetes and its complications. For pregnant women, a high third trimester serum AGEs levels were found in women who had gestational diabetes.What do the results of this study add? The results of our study revealed that first trimester screening of serum AGE levels of women who had risk factors for gestational diabetes was not discriminate. Nevertheless, a high first trimester serum AGE levels was associated with adverse perinatal outcome.What are the implications of these findings for clinical practice and/or further research? Whether reducing exogenous sources of AGE (western-style diet, smoking) before pregnancy will be associated with better pregnancy outcomes should be investigated in future studies.

Comparison of the different PCOS phenotypes based on monocyte to HDL cholesterol ratio.

In this study, we aimed to evaluate the degree of inflammation in polycystic ovary syndrome (PCOS) phenotypes by comparing the monocyte-to- High-density lipoprotein (HDL) ratios showing inflammatory and oxidative stress among different phenotypes of PCOS. In this case-control study, we studied 186 women with PCOS and 59 age-matched healthy women. PCOS women were prospectively classified into four phenotypes based on NIH Expert Panel criteria. The degree of inflammation between the non-PCOS control group and four PCOS phenotypes was compared by measuring monocyte-to high-density lipoprotein ratio (MHR). The prevalence of phenotypes A, B, C and D were 29%, 22%, 26% and 23%, respectively. MHR was found to be the highest in phenotype A (13.7 ± 4.9) among the PCOS phenotypes and the lowest level was found in phenotype D (9.0 ± 1.9), which is the non-androgenic phenotype. MHR were significantly different across the four PCOS phenotypes; with the highest value were present with phenotype A. As an easily accessible simple marker, the monocyte/HDL ratio may be promising for detecting at-risk metabolic phenotypes in PCOS.IMPACT STATEMENTWhat is already known on this subject? Polycystic ovary syndrome (PCOS) is a syndrome that progresses with chronic inflammation and has long-term effects such as diabetes and cardiovascular risk. The inflammatory process in PCOS has been demonstrated by many parameters.What do the results of this study add? The level of inflammation among PCOS phenotypes in Turkish women was evaluated by the monocyte-to high-density lipoprotein ratio (MHR). Inflammatory cytokines have been studied extensively in the literature comparing PCOS and non-PCOS patients, but studies of inflammatory levels between PCOS phenotypes are rare.What are the implications of these findings for clinical practice and/or further research? Inflammatory status in PCOS is important in terms of disease severity and long-term complications. It is now important to apply a clinical approach, knowing that PCOS is no longer a single syndrome but a difference in phenotypes. In future studies, it is necessary to investigate the phenotypes of patients with PCOS with different inflammatory markers.

Evaluation of Fetal Serum Thiol/Disulfide Homeostasis and Ischemia-Modified Albumin Levels in Fetal Distress.

Aim: We investigated the association of fetal serum thiol/disulfide homeostasis and ischemia-modified albumin (IMA) levels with fetal distress (FD). Methods: Umbilical cord blood for native thiol, total thiol, disulfide, albumin, and IMA analysis was obtained from 44 pregnant women over 34 weeks gestation undergoing cesarean section due to non-acute FD, and from 61 healthy pregnant women who underwent elective cesarean section Results: Native thiol and total thiol levels were significantly lower in the FD group (p = 0.02 and p = 0.014, respectively). Although disulfide/native thiol and disulfide/total thiol ratios were higher in the FD group, the difference was statistically insignificant (p = 0.805). The IMA levels were significantly higher in the FD group (p = 0.013). Conclusion: The thiol-disulfide homeostasis shifts toward the oxidant direction during the FD pathogenesis and the increased IMA levels may be the best indicator of an underlying non-acute ischemic condition.

Do follicular fluid advanced glycation end products levels affect the ovarian response in unexplained infertility?

OBJECTIVE: To compare the advanced glycation end products (AGEs) levels in follicular fluid according to the different ovarian responses of women who underwent controlled ovarian stimulation due to unexplained infertility and to examine the relationship between these levels and pregnancy outcomes. METHODS: Sixty-three women who underwent fresh IVF/ICSI cycles with GNRH antagonist protocol were divided into 3 groups according to the number of retrieved oocytes as suboptimal (4-9 oocytes), optimal (10-15 oocytes) and high (>15 oocytes) responders. AGEs levels in follicular fluid were measured by ELISA method. RESULTS: AGEs levels were 6.81 ± 2.20 µg/ml, 5.30 ± 2.01 and 6.44 ± 1.43 µg/ml in suboptimal, optimal and high response group, respectively. AGEs level was significantly higher in suboptimal response group than in optimal response group. The cutoff level of 6.19 µg/ml had a sensitivity of 59.3% and a specificity of 66.7% in distinguishing the suboptimal response group from the optimal response group. However, there were no statistically significant difference between AGEs levels and clinical pregnancy and live birth rates. CONCLUSION: Increased AGEs level in follicular fluid may be associated with decreased ovarian response during controlled ovarian stimulation in unexplained infertility case, however, it does not provide information about pregnancy outcomes.

The Relationship Between Breast Density, Bone Mineral Density, and Metabolic Syndrome Among Postmenopausal Turkish Women.

The relationship between metabolic syndrome (MetS) and menopause remains unclear. The effects of MetS on breast and bone density in this group of women are also not fully elucidated. Herein, we aimed to investigate the relationship between components of the MetS, mammographic breast density (MBD), and vertebral/femoral bone mineral density (BMD) in postmenopausal Turkish women. The study group consisted of postmenopausal women with MetS whereas controls postmenopausal women without MetS. All consecutive women who applied to our center for routine postmenopausal follow up and met the inclusion criteria, between July 2013 and October 2015 were included in the study. Menopause was defined as the cessation of menstruation for at least 1 year, and we used the definition of the MetS suggested by a joint interim statement. BMD of the spine and femur was measured by dual energy X-ray absorptiometry. The medical records of 390 postmenopausal were retrospectively reviewed. No significant differences were observed between the groups in terms of age, menopause type, and menopause duration (p > 0.05). Decreased MBD (for grade 1-2 and 3-4 densities) was associated with increased MetS risk (p = 0.017). Total femoral BMD, total lumber BMD, femoral neck BMD were significantly higher in postmenopausal women with MetS (p < 0,005). This study is the first report focusing on the relationship between MetS and breast/bone density. According to the results of our study, the presence of MetS in postmenopausal periods has a positive effect on both MBD and BMD.

Effect of Prolonged Fasting Duration on 50 Gram Oral Glucose Challenge Test in the Diagnosis of Gestational Diabetes Mellitus.

The aim of this study was to investigate the association between fasting duration before screening with 50 g glucose challenge test (GCT) and the test outcome. For this cross-sectional study, we enrolled 508 low-risk pregnant women who underwent 50 g GCT between the 24 and 28 weeks of gestation. We excluded women with pregestational diabetes, multiple gestations or a history of gestational diabetes mellitus (GDM), and macrosomia. We evaluated fasting durations, GCT results, and demographic features. A significant positive correlation was found between fasting duration and 50 g GCT values (r=0.122; p=0.006), and the best cut-off value was found to be 6.5 h, with 85.85% sensitivity and 38.61% specificity (relative risk, 2.73; 95% CI, 1.893-3.936; p<0.0001). Further, we divided the patients into two groups: study (fasting, <6.5 h; n=146) and control (fasting,>6.5 h; n=362) groups. Notably, the mean glucose levels, number of patients with GCT>140 mg/dl, and rates of unnecessary 100 g loadings were significantly higher in the study group. We found no significant differences between the groups in terms of the fasting plasma glucose levels and GDM prevalence. According to our findings, fasting duration of>6.5 h resulted in 2.7 times more unnecessary 100 g glucose tolerance tests (GTT). We recommend that patients having fasted for>6.5 h receive a one-step 75 g GTT after completing 8-h fasting.

25-Hydroxy vitamin D levels in premenopausal Turkish women with uterine leiomyoma.

We aimed to evaluate the relationship between serum 25-hydroxy vitamin D levels and the risk of uterine fibroids in premenopausal women in Turkish population in this prospective observational cross-sectional study. Sixty-eight women with at least one uterine leiomyoma ≥10 mm were compared with 56 healthy controls. Serum 25-(OH) vitamin D3 levels were measured by electrochemiluminescence immunoassay. The groups were similar in terms of age, BMI, gravidity and parity numbers. The mean level of 25-(OH) D3 were 7.28 ± 4.94 ng/ml and 78% of patients (n = 97) had severe vitamin D deficiency ( < 10 ng/mL). Vitamin D levels were significantly lower in the study group (6.54 ± 4.66 ng/ml vs. 8.18 ± 5.16 ng/ml, respectively; p = .009). Vitamin D levels were not correlated with size, volume, localization and number of leiomyomas. Traditional covered clothing style, low education level and being housewife were risk factors for Vitamin D deficiency. This is the first study that investigates the vitamin D levels in women with leiomyomas in Turkish population. Influence of vitamin D on uterine leiomyoma formation to may lead to new preventive strategies in the future.

The impact of nuchal cord on umbilical cord blood gas analysis and ischaemia-modified albumin levels in elective C-section.

This study was designed to evaluate umbilical cord ischaemia-modified albumin (IMA) levels and the cord blood gas parameters of foetuses with or without nuchal cords, at the time of elective C-section. The cross-sectional study population consisted of the patients who were admitted to the Tertiary Care Center between February and June 2015. Women with uncomplicated single term gestations between 37 and 40 completed weeks and scheduled for elective C-sections were included in the study. Fifty cases with a nuchal cord and 50 cases without a nuchal cord were recruited. Nuchal cord blood gas analysis and the IMA levels were evaluated. The IMA levels in umbilical artery of foetuses both in the study and control groups were similar (0.714 ± 0.150 vs. 0.689 ± 0.107 ABSU, p = .340, respectively). The umbilical artery pH values of the study group were significantly lower than that in the control group (7.31 ± 0.04 vs. 7.32 ± 0.03, p = .042; respectively). The results of the current study indicate that the nuchal cord has an impact on the foetal cord blood gas parameters to some extent before the initiation of labour. Fortunately, this impact does not end up with foetal tissue ischaemia, as confirmed by the IMA levels. Impact statement What is already known on this subject? The impact of nuchal cord on perinatal outcomes has been the subject of research for many years. Although the accumulated data has pointed out some unfavourable perinatal effects, the heterogeneity of the study groups both including a vaginal delivery and C-section and the inability to adjust the interfering factors ended up with some controversies. This is why there is not much known about the effects of the nuchal cord in women who are not in the labour process. What do the results of this study add? The current study aimed to exclude the interfering effects such as the active stage of labour. In this study, elective caesarean sections were selected as the study population to evaluate the effects of the nuchal cord on cord blood gas parameters and the IMA values. pH analysis in cord blood is used to detect hypoxia and the IMA is a new ischaemia marker. The results revealed that the in utero nuchal cord is associated with a significantly higher pCO2 and lower pH values and similar IMA values. What are the implications of these findings for clinical practice and/or further research? The final outcome supports that the nuchal cord causes alterations in cord blood gas analysis but this does not reach critical levels. Therefore, the results show that there is no need to change clinical practice when the nuchal cord is detected by ultrasound in a term gestation.

Is Striae Gravidarum related to Cesarean Scar and Peritoneal Adhesions?

OBJECTIVE: To evaluate the relationship between striae gravidarum (SG) score and abdominal scar characteristics together with intraperitoneal adhesion (IPA) grades of patients who were hospitalized for second cesarean delivery. METHODS: A total of 145 consecutive women undergoing scheduled cesarean section (CS) in a tertiary level maternity hospital between November 2013 and January 2014 were included in the study. All women had transverse suprapubic skin incision due to the previous CS and none of them had a history of vaginal delivery. Patients were classified according to the SG status, as women with no SG: Group-1(n=53), mild SG: Group-2(n=27) and severe SG: Group 3(n=65). Groups were compared between themselves with regard to various sociodemographic properties, cesarean scar characteristics and IPA scores. RESULTS: No significant difference in the length, width and color of the scar was detected among groups. While flat scar was the most prominent form of scar, the elevated scar was significantly more frequent in Group-1 compared to other groups (p=0.009). IPA grades were 0 or 1 in 77.3% of Group-1, 81.3% of Group-2 and 76% of Group-3. There was no significant difference in IPA scores between groups (p=0.884). After combining CS scar characteristics (flat, depressed and elevated) and SG status [SG (+) or SG (-)], we found no significant difference between the groups in terms of IPA severity. CONCLUSION: Striae gravidarum (SG) was found to be associated with scar characteristics, but not associated with the severity of intraperitoneal adhesion (IPA).

Comparing neonatal respiratory morbidity in neonates delivered after 34 weeks of gestation with and without antenatal corticosteroid.

OBJECTIVE: To investigate the effect of antenatal corticosteroid prophylaxis on neonatal respiratory morbidity between 34 and 37 weeks of gestation. METHODS: This retrospective study evaluated the neonatal respiratory complications of 683 low risk singleton pregnancies delivered at 34-37 weeks of gestation in a tertiary care center between Jan 2012 and Sept 2015. Group-I (n=294) comprised data of woman who did not receive betamethasone and Group-II(n=396) comprised those who received betamethasone after 34 weeks of gestation for cases at risk of preterm birth. Primary outcome was neonatal respiratory morbidity (NRM). NRM was defined as any respiratory disease that required medical support including supplemental oxygen, nasal continuous positive airway pressure, endotracheal intubation, or exogenous surfactant, with more than 25% oxygen for > 10 minute to maintain neonate oxygen saturation >90% Demographic characteristics, mode of delivery, fetal birth weight and neonatal respiratory complications was compared between the two groups. RESULTS: There was no statistically significant difference for neonatal respiratory morbidity development rate between patients who received betamethasone or those who did not receive it. The incidence of neonatal respiratory morbidity was similar (15.3% in the control group and 14.9% in the intervention group; p=0.88). CONCLUSION: We found no improvement with betamethasone administration empirically in late preterm birth as regards prevention of Neonatal Respiratory Morbidity(NRM).

Controlled ovarian hyperstimulation with sequential letrozole co-treatment in normo/high responders.

OBJECTIVE: To investigate the effect of co-administration of letrozole in an ovarian stimulation protocol using recombinant FSH and GnRH antagonists for ICSI in normo/high responders. METHODS: Computerized data of 320 antagonist ICSI/ET cycles with or without letrozole were retrospectively analyzed. In 105 cases, letrozole (5 mg/day) was started at the second day of the cycle continued for 5 days. At the second day of letrozole, gonadotropins were added. The remaining 215 cases were stimulated with recombinant FSH only. In all cases on day 6, GnRH antagonist was started. Ovarian stimulation protocols with or without letrozole were compared for cycle outcome parameters. RESULTS: In cycles with letrozole, significantly lower gonadotropin consumption and lower peak estradiol levels were found. In cycles with letrozole, mean number of metaphase II and fertilized oocytes retrieved were significantly higher compared to cycles without letrozole. The pregnancy and clinical pregnancy rates were similar. CONCLUSION: Should the number of oocytes retrieved being higher in letrozole group might indicate that letrozole might contribute to successful ovarian stimulation with a lower dosage of gonadotropins. Despite the lower peak estradiol levels, pregnancy rates being similar to other group also support the idea that letrozole can contribute to normal potential of implantation.

The prognostic value of first-trimester cystatin C levels for gestational complications.

AIMS: This study is designed to evaluate predictive value of first-trimester cystatin C levels for long-term pregnancy complications. METHODS: The cross-sectional study population consisted of patients who admitted to outpatient clinic of a Maternity Hospital between September 2013 and December 2014. Among the 203 participants who accepted to participate in the study, 174 subjects who continued antenatal follow-up in the same clinic were included in the final analyses. Cystatin C, blood urea nitrogen, Creatinine levels and estimated glomerular filtration rates were evaluated in the first-trimester routine antenatal visit. Mode of delivery and gestational complications were noted. RESULTS: First-trimester cystatin C levels were significantly higher in cases complicated with preterm delivery and premature rupture of membrane (PROM) compared to uncomplicated ones (0.58±0.07 vs. 0.55±0.07, P=0.041, and 0.58±0.07 vs. 0.55±0.07, P=0.036). With a cutoff value of 0.505 mg/L, sensitivity of cystatin C for preterm delivery and PROM was 91.9% and specificity was 27.7% with a negative predictive value of 92.3% and a positive predictive value of 26.6%. CONCLUSION: Detection of cystatin C levels in the first trimester of pregnancy for the prediction of preterm/PROM seems as a promising preliminary data. The relatively higher first-trimester cystatin C levels in complicated pregnancies are conspicuous. The results imply that in pregnancy cystatin C might be more than a marker for renal function.

Ocular surface changes following oral anticholinergic use for overactive bladder.

OBJECTIVE: To investigate the effect of oral solifenacin succinate on Schirmer I test results, tear break-up time (TBUT) and Ocular Surface Disease Index (OSDI) scores in overactive bladder (OAB) patients and to compare these results with those of healthy control subjects. MATERIALS AND METHODS: The female OAB patients who were prescribed oral solifenacin succinate 5 mg/day (Group I, N = 80) and age-matched healthy female subjects (Group II, N = 40) were recruited for the study and underwent ophthalmological examination prior to oral treatment and after 4 weeks. They completed the OSDI questionnaire and underwent ocular surface tests including Schirmer I test and TBUT. RESULTS: The statistical analysis of the Schirmer I test and TBUT revealed no significant difference between the baseline and 4th week values in both groups (Group I, p = 0.506 and p = 0.070 consecutively) (Group II, p = 0.810 and p = 0.823 consecutively). OSDI scores were found to be significantly increased in group I (21.8 ± 4.2 vs 23.1 ± 4.6, p = 0.020) and remained unchanged in group II (20.5 ± 7.0 vs 20.7 ± 7.0, p = 0.805). CONCLUSIONS: Short-term solifenacin succinate treatment has no effect on the Schirmer I test results and TBUT, but ocular surface symptoms appeared to be exacerbated in respect with increased OSDI scores. However, the clinical significance needs to be further evaluated with larger studies.

Does progesterone therapy increase nuchal translucency in women with threatened miscarriage?

OBJECTIVES: The effect of exogenous progesterone on fetal nuchal translucency (NT) has been proposed recently. In this study, we aimed to compare the thickness of NT of patients receiving and not receiving progesterone for threatened miscarriage. MATERIAL AND METHODS: This study was designed as a retrospective comparative study. Ninety five women treated with progesterone constituted the study group whereas 97 women who were not treated with progesterone constituted the control group. An ultrasonographic examination was performed on all of the women to measure NT. All patients were treated with oral micronized progesterone in the study group. The main parameters recorded for each woman were; age, body mass index (BMI), obstetrical characteristics, and gestational age at first examination, treatment duration of progesterone therapy, and results of combined and triple tests. RESULTS: A total of 192 pregnant women with threatened miscarriage were included in this study. The mean NT thickness was statistically significantly higher in the study group (p < 0.001), and mean serum level of human chorionic gonadotropin (hCG) was also higher in this group (p < 0.05). There was no statistically significant difference between groups in terms of age, BMI, and gestational age at first examination. ROC curve analysis demonstrated that only increased NT (area under the curve: 0.634, p = 0.005, 95% CI: 0.541-0.727) was a discriminative factor for women receiving progesterone for threatened miscarriage. Also there was a positive correlation between NT and treatment duration (r = 0.269; p < 0.001). CONCLUSIONS: We think that oral progesterone therapy may increase NT depending on treatment duration without causing abnormal prenatal screening test results.

The effect of oral solifenacin succinate treatment on intraocular pressure: glaucoma paradox during overactive bladder treatment.

INTRODUCTION AND HYPOTHESIS: Anticholinergic medication is the mainstay of pharmacotherapy for overactive bladder (OAB). The aim of the study is to investigate the effect of oral solifenacin succinate on intraocular pressure (IOP) in female OAB patients and to discuss the ocular drawbacks during treatment. METHODS: The female patients with a clinical diagnosis of OAB in whom use of oral solifenacin succinate 5 mg/day (group I) and age-matched healthy female subjects (group II) underwent complete ophthalmological examination, including IOP measurement at the beginning of the oral treatment and after 4 weeks. The patients with a history of previous ocular surgery and those with ocular diseases besides refraction disorders and presbyopia were excluded. RESULTS: The data from the right eyes of 60 consecutive patients in group I and 30 consecutive patients in group II were used for analysis. No statistically significant change was detected in the IOP (from 16.05 ± 2.30 mmHg to 16.30 ± 2.25 mmHg at the 4th week in group I, p = 0.160; from 15.60 ± 2.14 mmHg to 15.60 ± 2.09 mmHg at the 4th week in group II, p = 0.864) of the eyes in both groups. CONCLUSIONS: Since the power of the study is not enough to draw a clear conclusion, a 4-week course of solifenacin succinate treatment in women with OAB seemed to have no clinically significant effect on IOP values. Further larger studies are needed to determine the effect of anticholinergics on anterior chamber parameters and to evaluate their safety in glaucoma patients.

Comparison of the efficacy of micronized progesterone and lynestrenol in treatment of simple endometrial hyperplasia without atypia.

PURPOSE: To evaluate the treatment of simple endometrial hyperplasia without atypia with different gestagens. METHODS: Sixty premenopausal women with histologically documented endometrial hyperplasia without atypia were included in this prospective controlled study. Patients were randomized into two groups: Group I included 30 patients who received lynestrenol (LYN) in a dose of 15 mg/d, while Group II included 30 patients who received micronized progesterone (MP) 200 mg/d for 12 days per cycle for 3 months. Patients were reevaluated with endometrial curettage after treatment. MP and LYN regimens were compared to regression, resolution or persistence rates and metabolic parameters. RESULTS: After 3 months of treatment in both groups, none of the cases progressed. In LYN group, the rate of resolution was observed to be higher compared to MP group (p = 0.045). LYN was found more effective inducing resolution in patients more than 45 years compared to MP (p = 0.036). When we compare both groups after 3 months of treatment, there was no statistically significant difference in BMI, total cholesterol, HDL, LDL and fibrinogen level between two groups. The rate of patients without any side effects was found to be similar in both groups (p = 0.5). CONCLUSION: LYN which is a synthetic progestin ensures better endometrial control compared to MP in simple hyperplasia without atypia in the patients of premenopausal age especially in ages more than 45 years.

The changes in fear of childbirth in pregnancy during and before the COVID-19 pandemic.

We aimed to investigate how factors such as age, education level, planned delivery method and fear of childbirth were affected in pregnant women before and during the pandemic. This cross-sectional study compared a pre-pandemic pregnant group (July 2019 and December 2019) and a pandemic group (November 2020 and May 2021) of patients at Kütahya Health Sciences University Evliya Çelebi Training and Research Hospital. A total of 696 pregnant women in their second trimester were included in the study. All of them were literate and voluntarily agreed to participate in the study. Data were collected with the Wijma delivery expectancy/experience questionnaire (WDEQ-A), and the outpatient doctor asked the questions face-to-face. The mean age of the pregnant women participating in the study was 31.6 ± 6.8 years. While the total Wijma score was 62.1 ± 25.1 in the pre-pandemic group, it was 61.3 ± 26.4 in the pandemic group, and there was no significant difference between the two groups (p = 0.738). Upon analyzing the fear of childbirth among groups based on education level, no statistically significant differences were observed between the pre-pandemic and pandemic periods within any of the groups. While 25.7% (n = 179) of all participants had a normal fear of childbirth, 22% (n = 153) had a mild fear of childbirth, 27% (n = 188) had a moderate fear of childbirth, and 25.3% (n = 176) had a severe fear of childbirth (Wijma score of 85 and above). When the pre-pandemic and the pandemic period were compared, the fear of childbirth was unchanged in pregnant women at all education levels (p = 0.079, p = 0.957, p = 0.626, p = 0.539, p = 0.202). When comparing fear of childbirth before and after the pandemic, it was found that patients with a high school education level have a significantly higher fear of childbirth. To alleviate the fear of childbirth in pregnant women who have completed high school, training or psychosocial support interventions may be prioritized.

Myo-inositol oxygenese activity in second trimester of pregnancy: altered myoinositol catabolism in gestational diabetes mellitus.

OBJECTIVE: We aimed to determine myo-inositol oxygenase (MIOX) activity in gestational diabetes mellitus (GDM). MATERIAL AND METHODS: The insulin, HbA1c, and MIOX levels of 80 pregnant women were analysed after 75 g OGTT. Group I included patients with no risk factor for GDM, Group II: patients with high risk for GDM, and Group III: GDM patients. RESULTS: Fasting plasma glucose and Homeostatic Model Assessment for Insulin Resistance index were significantly higher in GDM cases (Group 3). Regarding the MIOX levels, significantly higher levels were recorded at 0-h in Group 3 compared to Groups 1 and 2. Significant alteration in MIOX activity was found between 0- and 2-h in Group 3 compared to Groups 1 and 2 (p < .029). CONCLUSIONS: MIOX levels were higher in GDM cases so, it may be have a role in myo-inositol catabolism.