Skin closure at cesarean section, polypropylene versus polyglactin 910: a randomized controlled study.

AIM: To compare the rates of surgical wound infection in women who have undergone cesarean delivery with subcuticular skin closure with polyglactin 910 or polypropylene. METHODS: Between April 2018 and October 2018, patients who had undergone a cesarean delivery for any reason were randomized with polyglactin 910 or polypropylene for subcuticular skin closure. Participants were evaluated for wound complications on day 7 and 30 postoperatively. The primary outcome was surgical site infection within the first 30 days following delivery. In addition, factors affecting surgical site infections were analyzed by binary regression. RESULTS: A total of 220 women who had undergone cesarean delivery were randomized and 213 were included in the final analysis. The groups were similar in terms of demographic characteristics and perioperative features. No statistically significant difference was observed between the groups in terms of wound complications or superficial site infections (8.3% in the polypropylene group versus 10.6% in the polyglactin 910 group, p = .642). Similarly, no difference was observed between the groups in terms of other wound complications. A binary logistic regression analysis indicated that superficial wound site infection was not affected by gravidity, BMI, duration of operation, repeated or unplanned cesarean delivery. CONCLUSION: It was observed that surgical site infections and other wound complications in skin closures with polyglactin 910 were similar to those with polypropylene.

A novel biochemical marker -OKL38- with its apoptotic and antioxidant properties for the development of PCOS and its related clinical implications.

Aim: To investigate the role of serum OKL38 levels in the development of polycystic ovary syndrome (PCOS) and clinical implications related to PCOS.Method: PCOS (n = 33) and ovulatory controls (n = 48) were recruited for the study. Anthropometric measurements were recorded, and blood samples for hormonal and biochemical parameters including serum OKL38 levels were obtained. The potential role of OKL38 on the development of PCOS, metabolic syndrome and cardiovascular disease (CVD) were investigated. Framingham risk score (FRS) was used for the determination of CVD risk.Results: Mean Ferriman-Gallway (FG) score, insulin, low-density lipoprotein (LDL), total cholesterol (TC) levels, and the homeostasis model assessment of insulin resistance index (HOMA-IR) were significantly increased (p < .05) in women with PCOS compared to controls. PCOS group had lower mean OKL38 level compared to controls (p < .0001) and OKL38 was negatively predictive for the diagnosis of PCOS after adjustment of variables that were significantly different between two groups. A negative association between OKL38 and metabolic syndrome in PCOS women was evident after adjustment for age, obesity, and abdominal obesity. OKL38 level was also negatively correlated with body mass index, waist-to-hip-ratio, fat composition, serum TC, LDL, free testosterone levels, FRS, and FG scores.Conclusion: OKL38 may have a partial role in the etiopathogenesis of PCOS and may protect development of metabolic syndrome and CVD in women with PCOS.

Testis spectroscopy may predict sperm retrieval rate in men with non-obstructive azoospermia undergoing micro-TESE: A pilot study

Objective: To investigate whether prior testis magnetic resonance spectroscopy predicts the success or failure of micro-dissection testicular sperm extraction (micro-TESE) in patients with non-obstructive azoospermia (NOA). Material and Methods: Nine men with NOA who were scheduled for micro-TESE for the first time, 9 NOA men with a history of previous micro-TESE and 5 fertile men were enrolled. All NOA patients and fertile controls underwent testis spectroscopy. A multi-voxel spectroscopy sequence was used. Testicular signals of choline (Cho), creatine (Cr), myo-inositol (MI), lactate, and lipids were analyzed quantitatively and compared with the results of the micro-TESEs. Results: The most prominent peaks were Cho and Cr in the fertile controls and NOA subjects with positive sperm retrieval in the micro-TESE. A high Cho peak was detected in 87% of the NOA men with positive sperm retrieval. NOA men without sperm at the previous micro-TESE showed a marked decrease in Cho and Cr signals. For positive sperm retrieval in micro-TESE, the cut-off value of Cho was 1.46 ppm, the cut-off value of Cr was 1.43 ppm, and the cut-off value of MI was 0.79 ppm. Conclusion: Testis spectroscopy can be used as a non-invasive screening method to predict the success or failure of micro-TESE.

Increased pancreatic-derived factor (PANDER) levels in gestational diabetes mellitus.

The aim of the study was to investigate the pancreatic-derived factor (PANDER) levels in healthy pregnant women and in pregnant women with gestational diabetes mellitus (GDM). A total of 50 women consecutively diagnosed with GDM and 30 randomly selected age-matched and gestational-age-matched healthy pregnant women were included in this cross-sectional study. Serum PANDER levels and other variables were analyzed. The age, the gestational age at the time, the blood sample was obtained and the hemoglobin A1c (HbA1c) levels of the GDM and control groups were similar. The body mass index (BMI), fasting blood glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), and serum PANDER levels were significantly higher in the GDM group than the control group. The optimal PANDER cutoff value was 227.2 ng/ml, and the ratios above this value were 100 and 86.6% for sensitivity and specificity, respectively (p=.0001). Serum PANDER levels were higher in women with GDM compared to the control group and were positively correlated with insulin, HOMA-IR, and HbA1c levels. These results suggest that PANDER might be considered a new biomarker for GDM.

Gremlin-1 and gremlin-2 levels in polycystic ovary syndrome and their clinical correlations.

Objective: Gremlin 1 and 2 regulate oocyte primordial follicle transition in animal models. The main objective of this study is to measure the blood levels of Gremlin 1 and 2 in the women with Polycystic Ovary Syndrome (PCOS). We also aimed to evaluate the association of these markers with hormonal and biochemical parameters of PCOS as interrupted folliculogenesis in those women is related to metabolic dysfunction. Material and methods: Fifty women with PCOS were diagnosed according to Rotterdam criteria, and thirty age-matched female controls were included in this prospective study. Gremlin 1 and 2 levels along with hormonal and metabolic parameters were compared between PCOS and control groups. Results: Serum Gremlin 1 levels were significantly higher in the PCOS group than in the control group (p = .001). Gremlin 2 levels were similar between the groups. Besides, there was a significant positive correlation between Gremlin 1 and insulin levels, Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) and waist to hip ratio (WHR) (r = 0.305; r = 0.297; r = 0.303, respectively). Conclusion: Our data suggest that Gremlin 1 may be the key regulator in the pathogenesis of PCOS. In future, Gremlin 1 may be a novel therapeutic target for the treatment of PCOS.

Increased levels of the novel hepatokine fetuin B in patients with intrahepatic cholestasis of pregnancy.

OBJECTIVES: To investigate liver-derived plasma protein fetuin B levels in healthy pregnant women and pregnant women with intrahepatic cholestasis of pregnancy (ICP). MATERIALS AND METHODS: Forty women with ICP and 40 healthy pregnant women were included in this cross-sectional study. The serum fetuin B levels of these patients were analyzed. The patients were followed up to delivery. RESULTS: Maternal age, gravida, parity, BMI at assessment, and gestational age at blood sampling were similar between the ICP and control groups (p > .05). However, the gestational age at delivery and the birth weight were significantly lower in the ICP group (p < .05). Total bile acid (TBA) levels and liver function tests were significantly higher in the ICP group than in the control group (p < .0001 and < .0001, respectively). In addition, serum fetuin B concentrations were significantly higher in the ICP group than in the control group (p < .0001). The best cutoff for fetuin B serum concentration was 5540.2 pg/mL. Serum values greater than this threshold had 80% sensitivity and 65% specificity for the diagnosis of ICP. CONCLUSIONS: Serum fetuin B was higher in patients with ICP compared to healthy pregnant women and might be a new biomarker.

Role of ischemia-modified albumin in the evaluation of oxidative stress in intrahepatic cholestasis of pregnancy.

Objective: The objective of this study is to investigate the ischemia-modified albumin (IMA) level, and the IMA/albumin ratio (IMAR) in healthy pregnant women, and pregnant women with intrahepatic cholestasis of pregnancy (ICP). Material and method: This cross-sectional study included 53 women with ICP and 52 healthy pregnant women. Their serum IMA and albumin levels were analyzed, and the women were followed up to delivery. Results: No significant intergroup differences were identified in maternal age, body mass index, and gestational age at the time that the blood samples were taken. The gestational age at delivery and the serum albumin level was significantly lower (p = .002 and p < .0001, respectively) in the ICP group than in the healthy pregnant women. Although no differences in IMA levels were shown between the groups, IMA/albumin levels were higher in the ICP group than in the healthy pregnant women (p = .004). Conclusion: Serum IMA levels did not differ between pregnant women with ICP and healthy pregnant women, while the IMAR was significantly higher in the ICP group versus the healthy pregnant women.

A comparison of pelvic organ prolapse and sexual function after abdominal and laparoscopic hysterectomy.

OBJECTIVES: Hysterectomy is one of the risk factors of pelvic organ prolapse (POP). There is no consensus on whether the route of hysterectomy affects the subsequent development of POP. The aim of the study was to assess POP and sexual function 1 year after a hysterectomy when comparing total abdominal hysterectomy (TAH) with total laparoscopic hysterectomy (TLH). The study applied the pelvic organ prolapse quantification (POP-Q) as the measure of POP and a short-form of the POP/Urinary Incontinence Sexual Function Questionnaire (PISQ-12). MATERIAL AND METHODS: All patients that underwent either TAH or TLH due to benign causes between March 2016 and March 2017 at the tertiary hospital used for the study were included in our prospective cohort study. POP-Q measurements and PISQ-12 scores were assessed 1 year postoperatively. RESULTS: We included 182 patients in the clinical examinations. There were no statistically significant differences in demographic characteristics between the TAH and TLH groups. Also, there we no differences observed in the objective POP measurements between the two study groups. Results of the two groups' PISQ-12 scores were also similar. However, postoperative vaginal lengths were found to be significantly shorter in the patients who had undergone TAH compared with those who had undergone TLH. CONCLUSIONS: TAH and TLH are comparable regarding short-term objective pelvic organ prolapse. Although we found statistically a significant difference in vaginal lengths between the two groups, no clinical significance was found in terms of sexual function.

Maternal levels of growth differentiation factor-15 in patients with preeclampsia.

OBJECTIVE: Growth differentiation factor-15 (GDF-15) is a stress-induced cytokine and related to the prognosis of cardiovascular diseases. Our purpose is to measure the maternal levels of GDF-15 in patients with early-onset preeclampsia (EOPE) and late-onset preeclampsia (LOPE). METHODS: This cross-sectional study was conducted including 72 pregnant women, 23 with normal pregnancies and 49 with preeclampsia (26 with EOPE and 23 with LOPE). Maternal serum levels of GDF-15 were measured by using enzyme-linked immunosorbent assay kits. RESULTS: The median serum GDF-15 level was found to be the highest in the EOPE group (EOPE: 441.7 pg/ml). The median serum GDF-15 levels were higher in women with preeclampsia than in the control group (309.7 pg/ml vs. 436.6 pg/ml, p: 0.009). CONCLUSION: Our findings suggest GDF-15 increased as a response to endothelial injury caused by cytokines triggered by preeclampsia.

The Relations Between HSG Proven Tubal Occlusion, Stimulated Intrauterine Insemination and Pregnancy Rate.

BACKGROUND: Tubal factor infertility is one of the main causes of female infertility. Although its sensitivity is low, hysterosalpingography (HSG) is remains the first-line method for evaluating tubal patency. AIMS: To compare pregnancy rates in patients with HSG proven proximal or distal unilateral tubal occlusion, and unexplained infertility undergoing both controlled ovarian stimulation (COS) and intrauterine insemination (IUI). STUDY DESIGN: Case control study. METHODS: In total, 237 patients undergoing ovulation induction (OI) with gonadotropins and IUI were divided into two groups and evaluated. Study group consisted 59 patients with HSG proven unilateral tubal pathology, and 178 patients with unexplained infertility taken as control subjects. Cumulative pregnancy rate was the primary endpoint. RESULTS: Cumulative pregnancy rates after three cycles of OI and IUI were 15.25% in study group and 20.79% in control group. Pregnancy rates between two groups were not statistically significant. Although, pregnancy rates in patients with proximal tubal occlusion (21.8%) were higher than in those with distal tubal occlusion (7.4%), the difference was not statistically significant. CONCLUSION: Our study data shows that, regardless of the HCG proven occlusion area, COS and IUI might be a preferred treatment modality in patient with unilateral tubal occlusion.