MEFV gene pathogenic variants: a risk factor for dysmenorrhea in the Turkish population.

BACKGROUND/AIM: The Mediterranean fever (MEFV) gene codes for protein pyrin, which is among the modulators of inflammasome activity in innate immune cells. It was suggested that there is a relation between MEFV variations and inflammatory diseases. The aim of this study was to investigate MEFV gene variations in the patients with primary dysmenorrhea. METHODS: The prevalence of common MEFV gene variations (M694V, M680I, V726A, E148Q and R202Q) was investigated in 145 young women with primary dysmenorrhea and 135 unrelated healthy controls. MEFV gene variations were genotyped using PCR-based RFLP assay. RESULTS: Number of childbirth and marriage were significantly lower in the study group than the controls, respectvely (p < 0.001, p = 0.001). Family history was statistically higher in the patient group (p < 0.001). In total, MEFV genotype and allele frequencies were significantly higher in patients than controls, respectively (p = 0.008 and p = 0.005, respectively). It was found that MEFV gene E148Q allele was more common in patient group (p = 0.039). MEFV R202Q A allele was higher in the patients than the controls (p = 0.045). A significant association was observed when the patients were compared with the controls according to R202Q variant AA versus GG+GA genotypes (p=0.020). CONCLUSION: Our findings suggest that MEFV variations may be a risk factor for patients with dysmenorrhea in a Turkish cohort.HighlightsThere are very few studies in the literature regarding the relationship between pathological variants of MEFV and dysmenorrhea disease.The common MEFV mutations/variants were evaluated in primary dysmenorrhea patients.Family history was statistically higher in the patient group (p <.001).MEFV gene variations were found 52 (35.9%) in patients and 29 (21.5%2) in controls.MEFV gene allele frequency was significantly higher in-patient group than control (p =.005).

Analysis of estrogen and progesterone receptor gene polymorphisms in leiomyoma.

BACKGROUND: Leiomyoma, one of the most common benign tumors, causes morbidity during the reproductive years in women. The molecular pathogenesis of the disease is not clear. Leiomyomas are hormone-sensitive tumors affecting around 20%-25% of women. Gene polymorphism studies could be important and explaining in the evaluation of multifactorial diseases such as leiomyoma. Polymorphisms involving genes responsible for the synthesis and signalization of steroid hormones could be used as genetic markers for hormone-related conditions. The purpose of this study was to analyze the effect of ERα-351 XbaI A/G, ERα-397 PvuII T/C, and progesterone receptor (PGR) PROGINS polymorphisms on the development of leiomyomas. MATERIAL AND METHODS: In this study, 213 samples (103 leiomyoma patients and 110 healthy controls) participated. The ERα-351 XbaI A/G and ERα-397 PvuII T/C gene polymorphisms were analyzed using PCR-RFLP method. PGR PROGINS polymorphism was analyzed by PCR method with specific primers. RESULTS: The genotype distribution and allele frequency of the ERα-351 XbaI A/G, ERα-397 PvuII T/C, and PGR PROGINS polymorphisms were not statistically different between leiomyoma patient and control groups (p > 0.05). CONCLUSION: This study reflects that ERα and PGR PROGINS polymorphisms may not be one of the many genetic factors for leiomyoma susceptibility.

Comparison of Reflexology and Connective Tissue Manipulation in Participants with Primary Dysmenorrhea.

OBJECTIVE: The aim of this interventional correlational study is to compare the effects of foot reflexology (FR) and connective tissue manipulation (CTM) in subjects with primary dysmenorrhea. DESIGN: A total of 30 participants having primary dysmenorrhea completed the study. Data, including demographics (age, body-mass index), menstrual cycle (age at menarche, menstrual cycle duration, time since menarche, bleeding duration), and menstrual pain characteristics (intensity and duration of pain, type and amount of analgesics), were recorded. Effect of dysmenorrhea on participants' concentration in lessons and in sports and social activities was assessed by using the visual analog scale. Participants rated their menstruation-related symptom intensity through the Likert-type scale. FR was applied to 15 participants for 3 days a week and CTM was performed on 15 participants for 5 days a week. Treatments were performed during one cycle, which started at the third or fourth day of menstruation and continued till the onset of next menstruation. Assessments were performed before treatment (first menstruation), then after termination of the treatment because of the next menstruation's onset (second menstruation), and ∼1 month after at the consecutive menstrual period (third menstrual cycle). RESULTS: Time-dependent changes in duration and intensity of pain along with analgesic amount show that both treatments provided significant improvements (p < 0.05) and no superiority existed between the groups (p > 0.05). A similar result was obtained in terms of time-dependent changes in concentration in lessons and difficulty in sports and social activities due to dysmenorrhea. Menstruation-related symptoms were found to be decreased after treatment and in the following cycle with both treatments (p < 0.05) where no difference existed between the groups (p > 0.05). CONCLUSION: Both FR and CTM can be used in the treatment of primary dysmenorrhea and menstruation-related symptoms as these methods are free from the potentially adverse effects of analgesics, noninvasive, and easy to perform.

Role of first trimester total testosterone in prediction of subsequent gestational diabetes mellitus.

AIM: To assess the role of first trimester maternal testosterone and dehydroepiandrosterone sulfate (DHEA-S) levels in prediction of development of gestational diabetes mellitus (GDM). METHODS: Four hundred and fifty pregnant women were included in this prospective cohort study. All pregnant women with a singleton pregnancy who were not diabetic, had no family history of diabetes, had no history of previous GDM, were of white race and non-smokers were enrolled. Total testosterone and DHEA-S were measured at 11-14 weeks of gestation. The patients were called for routine pregnancy visits and followed accordingly. Forty-two patients did not come to their visits and were excluded. During gestational weeks 24-28, the remaining 408 patients were screened for GDM. The total testosterone and DHEA-S levels were compared between patients with and without GDM. Regression and receiver-operator curve analysis were performed. RESULTS: GDM developed in 22 women (5.7%). Compared with women without GDM, first trimester total testosterone levels were higher among women in whom GDM subsequently developed. The DHEA-S level did not differ. Age, total testosterone and body mass index were found to be independent predictors of GDM development. A total testosterone value of 0.45 ng/mL was found to predict development of GDM with a sensitivity of 63.6% and a specificity of 62.7%. CONCLUSION: First trimester total testosterone has a low testing power for GDM screening with low sensitivity and specificity values and cannot be used as a marker alone. It may have a role in combination with other markers.

Evaluation of postural equilibrium and fall risk during pregnancy.

OBJECTIVE: The hormonal, anatomical and physiological states change during pregnancy. Due to these alterations, pregnant women are at increased risk of falling throughout this period. The aim of this study is to evaluate postural equilibrium and risk of falls during pregnancy by comparing dynamic postural stability between pregnant and non-pregnant control women. METHODS: Eighty pregnant women (the first, second and third trimester of pregnancy; 25, 30 and 25, respectively) and thirty nonpregnant control women were evaluated and compared in terms of dynamic postural stability using the Biodex Balance System. Overall (OA), anterior-posterior (AP), medial-lateral (ML) stability index and fall risk test (FRT) scores were obtained from the mean scores of the three trials at platform stability of level 8. RESULTS: No significant differences for OA, APSI and MLSI were found among the pregnant women in the first and second trimester and nonpregnant control subjects. Overall, anteroposterior and mediolateral index scores were significantly higher in pregnant women in the third trimester than nonpregnant controls (p<0.05). Fall risk test scores of third trimester patients were found to be significantly higher than the first and second trimester and nonpregnant control women (p<0.001). CONCLUSIONS: Pregnancy has a negative effect on postural stability. Postural equilibrium decreases during pregnancy, particularly in the third trimester. Using postural stability tests may detect pregnant women with a high fall risk.

[Comparing efficiencies of diclofenac sodium and paracetamol in patients with primary dysmenorrhea pain by using Visual Analog Scale]. / Primer dismenore agrili hastalarda diklofenak sodyum ve parasetamol tedavi etkinliklerinin Vizüel Analog Skala kullanilarak karsilastirilmasi

OBJECTIVES: The aim of this study was to compare the efficiency of diclofenac sodium to paracetamol using a visual analog scale in the patients presenting to the emergency room with primary dysmenorrhea. METHODS: Group I (n=40) patients were diagnosed with primary dysmenorrhea and treated with paracetamol (1 gr intravenous) and Group II (n=40) patients were diagnosed with primary dysmenorrhea and treated with diclofenac sodium (75 mg intramuscular). In both groups, patients were 19-30 years old. In all groups, the intensity of the pain was ranked from 0 (no pain) to 10 (intolerable) using VAS. The VAS scores were compared between treatment groups. RESULTS: Between two groups, there was no statistically significant difference in age, mean arterial pressure and pulse values. The initial VAS values of the first group were higher than that of 2nd group. Following treatment, in the 10th and 30th minutes, the VAS values were lower in Group I than Group II (p=0.00). The VAS values of each group were significantly different from each other on the 10th and 30th minutes. VAS values at the 10th and 30th minutes were lower compared to the initial values and the values in the 30th minute were lower relative to the 10th minute (p=0.00) in both treatment groups. CONCLUSION: We can suggest that paracetamol is more efficient than diclofenac sodium in the treatment of primary dysmenorrhea.

Relationship between maternal thyroid hormones and the biochemical markers of the first trimester aneuploidy screening.

PURPOSE: The role of thyroid function in biochemical markers of first trimester screening has not been assessed. The aim of the present study was to investigate if there were any relation between maternal thyroid hormones and free-beta subunit of human chorionic gonadotropin (fß-hCG) and pregnancy-associated plasma protein A (PAPP-A) levels as the biochemical markers of the combined first trimester aneuploidy screening. METHODS: 375 pregnant women between 11 and 14 weeks of gestation who were offered routine first trimester prenatal aneuploidy screening and whose thyroid hormone levels (Thyroid stimulating hormone (TSH), free and total thyroxine, free and total triiodothyronine, anti thyroid peroxidase antibody) were measured were assessed. Correlation of free-ß-hCG and PAPP-A with maternal thyroid hormones was analyzed. RESULTS: There was no statistically significant correlation between maternal TSH, free and total thyroxine, free and total triiodothyronine, anti-thyroid peroxidase antibodies and free-ß-hCG and PAPP-A as biochemical markers of first trimester aneuploidy screening. CONCLUSION: Maternal thyroid function does not seem to affect secretion of fß-hCG and PAPP-A.

Polymorphism of catechol-o-methyltransferase and uterine leiomyoma.

Uterine leiomyoma (ULM) is the most common gynecological benign tumor that is affecting around 20-50 % of women over the age of 30. Although its molecular pathogenesis is still unknown, ULM has a multifactorial etiology determined by both genetics and environmental factors. The present study was designed to find out whether Val158Met polymorphism in the catechol-o-methyltransferase (COMT) gene is associated with the risk of ULM. We analyzed COMT Val158Met polymorphism in 105 ULMs patients and 105 healthy subjects using a polymerase chain reaction-based restriction fragment length polymorphism assay. We found remarkably similar frequencies in ULM compared with controls for COMT Val158Met genotypes and alleles, and no association was found between ULM and this polymorphism (p = 0.46). The COMT 158 Met allele in patients with large (≥5 cm) fibroids was higher than in patients with small (<5 cm) fibroids, and significant association was found between fibroid size and COMT 158 Met allele (p = 0.011, OR 0.50, 95 %CI 0.28-0.90). Our results reflect that COMT Val158Met polymorphism is not associated with an increased risk of ULMs, but Val158Met polymorphism may be a risk factor for development of large fibroids in Turkish patients with ULM.

Pain levels associated with renal colic and primary dysmenorrhea: a prospective controlled study with objective and subjective outcomes.

OBJECTIVES: To evaluate the degree of pain associated with renal colic and primary dysmenorrhea using objective and subjective measurements. METHODS: In total, 60 subjects participated in this study. There were 20 subjects in the renal colic group (average age 24.45 ± 2.35 years), 20 subjects in the primary dysmenorrhea group (average age 23.75 ± 1.86 years), and 20 subjects in the control group (average age 24.20 ± 2.57 years). The serum chromogranin A (CgA) values were determined by an enzyme-linked immunosorbent assay and the mean pain score was assessed by means of a Visual Analog Scale (VAS) for each individual. RESULTS: The serum CgA level was 19.83 ± 19.61 ng/ml for the renal colic group, 13.45 ± 8.52 ng/ml for the primary dysmenorrhea group and 12.45 ± 7.76 ng/ml for the control group. The mean VAS score for pain was 7.95 ± 1.54 for the renal colic group and 7.05 ± 1.50 for the primary dysmenorrhea group. CONCLUSIONS: Primary dysmenorrheic pain is as intense as renal colic pain. Emergency room physicians should display the same degree of care and attention for the treatment of patients with primary dysmenorrhea as they do for patients with renal colic, and rapidly initiate an effective treatment for these patients.

A preliminary retrospective study about the relationship between ductus venosus Doppler indices, nuchal translucency (NT) and biochemical markers in the first and second trimester screening tests.

In our study, we tried to assess the relation between ductus venosus Doppler indices [pulsatility index (PI), resistance index (RI) and S/D] and first-trimester screening markers (MoM of serum pregnancy-associated plasma protein A, pappalysin 1 (PAPP-A), MoM of serum free ß-human chorionic gonadotrophin (ß-hCG), and nuchal translucency (NT) and second trimester screening markers (MoM of serum α-fetoprotein, MoM of serum total ß-hCG and MoM of serum estriol). We analyzed the data of 121 singleton pregnancies. Roche cobas e 601ECLIA (electrochemiluminescence immunoassay) was used to measure MoM of serum PAPP-A and Roche cobas e 602 ECLIA (electrochemiluminescence immunoassay) was used to measure MoM of serum free ß-hCG in the first trimester. Beckman Coulter Access 2 Immunoassay was used to measure MoM of serum α-fetoprotein, MoM of serum total ß-hCG and MoM of serum estriol in the second trimester. The first author performed all ultrasound screenings and ductus venosus Doppler studies. What we found new in our study is presented as following; MoM of serum α-fetoprotein had a negative correlation with RI of ductus venosus Doppler, MoM of serum estriol had a negative correlation with RI of ductus venosus Doppler and MoM of serum estriol had a negative correlation with S/D of ductus venosus doppler. The results of our study suggest that ductus venosus Doppler can be used to increase the effectiveness of the second trimester screening test.

Altered expression of COP9 signalosome proteins in preeclampsia.

OBJECTIVE: The presumptive factors that are released by the preeclamptic placenta to cause maternal disease are less well known. The constitutive photomorphogenic-9 (COP9) signalosome (CSN) complex, a multifunctional protein complex involved in modulating signal transduction, gene transcription, and protein stability in cells. Although the roles of most CSN components in early embryonic development have been studied, their role in preeclamptic human placentas is not known. Thus, this study was aimed to show the localization and the protein expression of CSN1 and CSN5 in normal and preeclamptic placenta. STUDY DESIGN: The distribution and the protein expression of CSN1 and CSN5 were analyzed in normal (n: 15) and preeclamptic (n: 15) human placenta by using immunohistochemistry (IHC) and Western blotting. RESULTS: CSN1 and CSN5 were mainly localized in the vascular endothelium, syncytiotrophoblast, stromal and Hofbauer cells in normal and preeclamptic placentas. However, a stronger immunoreactivity and protein expression for CSN1 and CSN5 were observed in preeclamptic placentas compared to normal term placentas. Western blotting of the tissue extracts confirmed the IHC results. CONCLUSIONS: Our results suggest that an increased level of CSN1 and CSN5 as an important part of the ubiquitin proteasome system (UPS) might be associated with the pathophysiology of preeclampsia.

[Obturatory abscess and pelvic pain caused by Brucella melitensis]. / Brucella melitensis'in neden oldugu obturator apse ve pelvik agri.

Brucellosis which is a systemic infection, is seen endemically in Turkey. Although there a lot of complications related to brucellosis, soft tissue involvement is rare. In this case report a patient with mature cystic teratoma and a Brucella related obturatory abscess, was presented. A 21-year-old female patient with bilateral pelvic pain was admitted to the hospital with complaints of weakness, backache and ab- dominal swelling. Pelvic examination revealed bilateral adnexial sensitive masses. There were no history of systemic complaints or other organ involvement. The patient had no history of contact with infected animals, intramuscular injections or consumption of non-pasteurized foods. A mass of 56 x 63 mm with regular margins and hyperechogenic segments at the left side was detected at ultrasonographic examination. Left ovarian cystectomy and mass excision at the left side were performed during laparotomy. Histopathological examination of the mass revealed chronic granulomatous inflammation characterized by central necrosis, histiocyte and lymphocyte infiltration and formation of giant cells, compatible with brucellosis. Brucella melitensis was isolated from the capsule of pelvic mass on the fifth day of culture in BacT/ALERT Selectlink (Organon Teknika, U.S.A.) system. Brucella Wright agglutination titer which was 1:80 at the admittance, rose to 1:2560 at the sixth week of the follow-up. The patient was treated successfully with the excision of the abscess and 6 weeks course of oral doxycycline and rifampicin. Brucellosis should be considered in the differential diagnosis of pelvic pain and obturatory abscess, especially in endemic areas for brucellosis.

A novel antibiotic, linezolid, reduces intraperitoneal adhesion formation in the rat uterine horn model.

OBJECTIVE: To examine the effects of linezolid in prevention of adhesion formation in a rat uterine horn model. DESIGN: Prospective randomized study. SETTING: University Experimental Animal Research Laboratory Center. SAMPLE: Ninety female Wistar albino rats. METHODS: A dose response study was first conducted with 60 Wistar albino rats that were randomly assigned to six equal groups by administering vehicle (control), 5 mg/kg (Group 1), 15 mg/kg (Group 2), 50 mg/kg (Group 3), 100 mg/kg (Group 4), and 150 mg/kg (Group 5) linezolid starting three days before the adhesion inducing operation and continuing for 14 days postoperatively. Adhesion was scored clinically with a scoring system. The minimum effective dose was found to be 100 mg/kg/day. With this dose time response (starting three days before the operation and continuing for seven days), only preoperative and postoperative administration studies were conducted. MAIN OUTCOME MEASURES: Extent and severity of adhesions. RESULTS: Total adhesion scores in the control and Groups 1 and 2 were significantly higher when compared with Groups 4 and 5, but not with Group 3. There were no significant differences in the adhesion scores between Groups 3, 4, and 5. In time response arm a total of 10 days treatment was not as effective as 17 days treatment. In postoperative and preoperative arms of the study, it was found that administration of linezolid only postoperatively or preoperatively did not affect adhesion formation significantly when compared with the control group. CONCLUSION: Linezolid was found to reduce intraperitoneal adhesion formation.

Interferential current versus biofeedback results in urinary stress incontinence.

BACKGROUND: Urinary stress incontinence is a common, disruptive and potentially disabling condition in which the subject complains of involuntary leakage on effort or exertion or on sneezing or coughing. AIM: This study was performed in order to compare the effects of interferential current and biofeedback applications on incontinence severity in patients with urinary stress incontinence. In addition, pelvic muscle strength and quality of life as important parameters in these subjects were investigated. METHODS: In this prospective, randomised, controlled study, forty women with moderate intensity of urinary stress incontinence as determined by one-hour pad test were included. Pelvic muscle strength was evaluated by a biofeedback device and quality of life was assessed by a 28-itemed questionnaire. All of the parameters were evaluated before and after the treatments. Twenty cases underwent interferential current therapy, while pelvic floor exercises via biofeedback were applied in the remaining cases. The treatments lasted 15 minutes per session, three times a week for a total of 15 sessions. RESULTS: All of the parameters improved after the treatments in each group (p <0.05) and both treatment modalities seemed to have similar effects on pad test (95% CI: -1.48 - 4.59), pelvic muscle strength (95% CI: -9.29 -1.78) and quality of life (95% CI: -11.91 - 5.31) outcomes. CONCLUSIONS: Physical therapy modalities used in this trial are applied easily and non invasive. Also, when the finding that no adverse effects were observed during the study period is taken into consideration, it can be concluded that both methods can be used effectively in patients with urinary stress incontinence.

Cervical partial hydatidiform molar pregnancy.

BACKGROUND: Cervical hydatidiform molar pregnancy is an exceedingly rare occurrence that has been reported only twice before. CASE: We report a 25-year-old, G4P1D&C2 woman with a positive pregnancy test and vaginal bleeding. A cervical pregnancy with hydatidiform mole was detected on transvaginal ultrasound and color Doppler examinations. Magnetic resonance imaging was used to localize the lesion. Dilatation and curettage was performed and bleeding that was initially brisk ceased after bimanual pressure. Histopathological examination revealed a partial hydatidiform molar pregnancy. Serial beta-hCG measurements showed a decline without need for adjuvant chemotherapy. CONCLUSION: Conservative fertility-sparing management was successful in this potentially fatal rare case.

Effectiveness of transcutaneous electrical nerve stimulation and interferential current in primary dysmenorrhea.

OBJECTIVE: To compare the effectiveness of transcutaneous electrical nerve stimulation and interferential current in primary dysmenorrhea. DESIGN: A prospective, randomized, and controlled study. SETTING: Hacettepe University School of Physical Therapy and Rehabilitation. PATIENTS: Thirty-four volunteer subjects with primary dysmenorrhea (mean age: 21.35 +/- 1.70 years) were included. Statistical analyses were performed in 32 subjects who completed all measures. INTERVENTIONS: Fifteen subjects received interferential current application for 20 minutes and 17 subjects received transcutaneous electrical nerve stimulation for 20 minutes when they were experiencing dysmenorrhea. OUTCOME MEASURES: Physical characteristics, years since menarche, length of menstrual cycle (days), and duration of menstruation (days) were recorded. Visual analog scale ( VAS) intensities of menstrual pain, referred lower limb pain, and low back pain were recorded before treatment, and immediately, 8 hours, and 24 hours after treatment. RESULTS: Intensities of the evaluated parameters decreased beginning from just after the applications in both groups (P<0.05). Intensity of referring low back pain in first three measurement times was different between the groups (P<0.05), but this difference is thought to be due to the baseline values of the groups. So, it can be said that no superiority existed between the methods (P>0.05). CONCLUSION: Both transcutaneous electrical nerve stimulation and interferential current appear to be effective in primary dysmenorrhea. As they are free from the potentially adverse effects of analgesics, and no adverse effects are reported in the literature nor observed in this study, a clinical trial of their effectiveness in comparison with untreated and placebo-treated control groups is warranted.

Peroxisome proliferator-activated receptor-gamma agonist rosiglitazone reduces the size of experimental endometriosis in the rat model.

BACKGROUND: The effect of rosiglitazone, an activator of peroxisome proliferator-activated receptor-gamma, on the growth of ectopic uterine tissue was assessed. METHODS: Endometriosis was surgically induced in 28 rats by transplanting an autologous fragment of endometrial tissue onto the inner surface of the abdominal wall. Four weeks later, rats were randomly grouped and a second laparatomy was performed. The length, width, height and volume of the explants were measured. Rosiglitazone at 0.2 mg/kg/day was orally administered to one group, while vehicle treatment was given to the control group. Four weeks later, rats were sacrificed and ectopic uterine tissues were re-evaluated morphologically and histologically. Scoring system was used to evaluate the preservation of epithelia. RESULTS: One rat in the study group and two rats in the control group died as a result of complications related to surgery. There was a significant difference in post-treatment length, width, height, and spherical volumes between control and rosiglitazone-treated groups. The epithelia were found to be preserved significantly better in the control group when compared with the rosiglitazone-treated group. CONCLUSION: Rosiglitazone was found to cause regression of experimental endometriosis in rats.

Comparison of the use of electrothermal bipolar vessel sealer with harmonic scalpel in total laparoscopic hysterectomy.

AIM: The aim of the present study was to compare the use of electrothermal bipolar vessel sealer (EBVS) with harmonic scalpel (HS) during total laparoscopic hysterectomy with respect to operation time, estimated blood loss and related complications. METHODS: A retrospective study was conducted in the university hospital. Forty patients who underwent total laparoscopic hysterectomy and bilateral salpingo-oophorectomy were enrolled. Nineteen hysterectomies were performed with HS and in 21 patients the same surgeons used EBVS. Data about the characteristics of the patients, operation time, estimated blood loss, uterine weights, related complications and length of hospital stay were registered and compared. RESULTS: Mean procedure time and estimated blood loss were significantly less in the EBVS arm (59.57 +/- 3.71 vs 90.95 +/- 5.73 min, P < 0.001; 87.76 +/- 25.48 vs 152.63 +/- 60.90 mL; P < 0.001, respectively). The change in hemoglobin and hematocrit values was found to be more significant in the HS group. CONCLUSION: EBVS was found to be less time-consuming and caused less bleeding when compared with HS.

Corneal topographic changes in premenopausal and postmenopausal women.

BACKGROUND: To asses the effect of menopause on the corneal curvature changes using corneal computerized videokeratography (CVK) in premenopausal and postmenopausal healthy women. METHODS: Thirty-six postmenopausal women with mean ages of 49.2 (range 39 to 57) were enrolled in this randomized, prospective study, comparing with 26 healthy controls with mean ages of 38.5 +/- 4.9 (range 32 to 49). Subjects were determined to be postmenopausal, by the Gynecology and Obstetrics Department, based on blood Follicular Stimulating Hormone (FSH), Luteinizing Hormone (LH), Estradiol, Progesterone levels and clinical complaints. Complete ophthalmic examination and CVK using Haag-Streit System was performed in both premenopausal and postmenopausal women. RESULTS: Mean horizontal curvature and vertical curvature of central corneal power in premenopausal women were 43.5 +/- 1.25 Diopter (D), and 44.1 +/- 1.53 D. Mean horizontal curvature and vertical curvature of central corneal power in postmenopausal women were 43.9 +/- 1.4 D, and 44.6 +/- 1.3 D. The mean keratometric astigmatisms of premenopausal and postmenopausal women were 0.81 +/- 0.57 D (4-179 degrees), 0.74 degrees +/- 0.5 D (1-180 degrees) respectively. No significant corneal curvature changes were detected between premenopausal and postmenopausal groups (P > 0.05). On the other hand, we only found negative but significant correlation between horizontal corneal curvature and estrogen level of postmenopausal women (r = -0.346, p = 0.038). CONCLUSION: Menopause is physiologic process and may also affect corneal topographic changes. In postmenopausal women, corneal steeping was observed minimally compared to premenopausal women. The results suggest that changes in estrogen level of women with menopause are associated with slightly alteration of horizontal curvature of cornea.

Effects of ovarian drilling in middle Black Sea region Turkish women with polycystic ovary syndrome having normal and high body mass indices.

AIM: To assess the effectiveness of laparoscopic ovarian drilling (LOD) in women with polycystic ovary syndrome (PCOS) with normal and high body mass indices (BMIs). METHODS: We investigated the effects of LOD process on two different groups of Turkish women with normal (n = 13) and high (n = 12) body mass indices. Three-puncture laparoscopy was performed under general anesthesia. Luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone-sulfate (DHEAS) and total testosterone (total T) levels were measured one menstrual cycle before the operation (in early follicular phase defined as day 3 of the menstrual cycle) and one menstrual cycle after the operation (in early follicular phase defined as day 3 of the menstrual cycle). RESULTS: Ovarian drilling had a positive effect on FSH increase and DHEAS, total testosterone and LH/FSH ratio decrease; but BMI levels had no effect on these hormonal changes, respectively (F = 0.343, P = 0564) (F = 0.790, P = 0383) (F = 0.083, P = 0776) and (F = 0.816, P = 0376). Ovarian drilling had a positive effect on LH decrease and BMIs were effective on this change (F = 6.946, P < 0.05). LH decrease in the group with normal BMI was significantly higher than the obese group with high BMI. Ten of 13 women with normal BMI (76.9%) and eight of 12 women with high BMI (66.6%) started to see regular menses 2 to 3 months after the procedure. CONCLUSION: Ovarian drilling is an effective procedure on PCOS. Women with lower BMI may benefit more from the procedure.