The effect of rectus reapproximation on postoperative muscle strength and core endurance in cesarean section: A prospective case-control study.

AIM: The necessity of the reapproximation technique of the rectus abdominis muscle in the cesarean section (CS) is a controversial issue. We aimed to investigate the effect of the approximation of the rectus abdominis muscle in CS on postoperative pain intensity, muscle strength, and core endurance. METHODS: Thirty-eight women whose rectus muscle was reapproximated in CS and 36 women whose muscles were not reapproximated were included in the study. All women were called in for evaluation in the postoperative period twice, in the 8th-10th and 24-26th weeks. While muscle strength was assessed by manual muscle test (MMT), core endurance was assessed by core stability tests [trunk flexion test (TFT), trunk extensor endurance test (TEET), lateral right/left bridge test (LRBT/LLBT)]. The distance between inter-rectus diastasis (IRD) and rectus abdominis muscle thickness were evaluated by ultrasonography. RESULTS: In the first evaluation; in the rectus muscle reapproximation (RMR) group, lower and upper IRD values were less than the control group, while muscle strength, TFT, TEET, LRBT, and LLBT times were higher (p < 0.001, <0.001, 0.014, <0.001, <0.001, 0.002, and <0.001, respectively). In the second evaluation; in the RMR group, lower and upper IRD values were lower than the control group, while upper rectus abdominis muscle thickness, TFT, TEET, and LRBT times were higher (p < 0.001, <0.001, 0.046, <0.001, 0.032, and 0.010, respectively). CONCLUSION: RMR in CS increases muscle strength and core endurance in the early postoperative period. RMR can facilitate the daily work of mother by increasing their physical fitness, especially in the early postoperative period.

Short-Term Effects of Connective Tissue Massage After Hysterectomy: A Randomized Controlled Study.

OBJECTIVE: The aim of this study was to investigate the effects of connective tissue massage (CTM) on postoperative pain severity, first passage of flatus and the first defecation, and functionality in patients after total laparoscopic hysterectomy (TLH) or total abdominal hysterectomy (TAH). METHODS: A total of 60 patients who underwent TLH or TAH were included in the study. Patients who underwent TLH were randomly grouped as TLH-CTM (n = 15) and TLH control (n = 16), and those who underwent TAH were randomly grouped as TAH-CTM (n = 14) and TAH control (n = 15). CTM was applied twice postoperatively at the third hour and after 24 hours. The pain severity scores and functional activity limitation levels of the patients were evaluated with the visual analog scale. The number of analgesics use and first passage of flatus and the first defecation were recorded. RESULTS: The first passage of flatus and the first defecation after surgery were shorter in the TLH-CTM and TAH-CTM groups compared with the TLH and TAH control groups (P < 0.001). The first passage of flatus and the first defecation, pain intensity, and analgesics use of the TLH-CTM group were the lowest among all groups (P < 0.05). The improvement in functionality level in the TLH-CTM group was higher than those in the other groups (P < 0.05). CONCLUSION: This study showed that CTM reduced postoperative pain severity, use of analgesics, first passage of flatus, and first defecation after TAH or TLH.

The protective effect of JZL184 on ovarian ischemia reperfusion injury and ovarian reserve in rats.

AIM: Ovarian torsion is a gynecopathology that requires emergency surgery in women. However, ischemia reperfusion injury (IRI) occurs after treatment with detorsion. This study aimed to evaluate the effects of monoacylglycerol lipase inhibitor JZL184 on ovarian IRI and ovarian reserve. METHODS: Forty-eight female Wistar albino rats were divided into six groups. Group 1: Sham, Group 2: Ischemia, Group 3: ischemia/reperfusion (IR), Group 4: IR + JZL184 4 mg/kg, Group 5: IR + JZL184 16 mg/kg, Group 6: IR + vehicle (dimethyl sulfoxide). Three hours of ischemia followed by 3 h of reperfusion. Two different doses of JZL184 (4 and 16 mg/kg) were administered intraperitoneally in Group 4 and 5, 30 min before reperfusion. Ovarian IRI and ovarian reserve were evaluated in serum and tissue by using histopathological and biochemical parameters. RESULTS: Treatment with JZL184 was associated with a significant increase in ovarian 2-arachidonoylglycerol and improved serum anti-Mullerian hormone, Inhibin B, primordial follicle count, and ovarian histopathological damage score (p < 0.05). JZL184 treatment significantly decreased the level of malondialdehyde, and increased superoxide dismutase enzyme activity and glutathione (GSH) levels (p < 0.05). The increased phosphorile nuclear factor-κB (Phospho-NF-κB-p65), tumor necrosis factor alpha (TNF-α), interleukin-1beta (IL-1ß), transforming growth factor beta 1 (TGF-ß1), and TUNEL assay immunopositivity scores in ovarian I/R injury were decreased after treatment with JZL184 (p < 0.05). CONCLUSIONS: JZL184 showed significant ameliorative effects on ovarian IRI and ovarian reserve caused by IR through acting as an antioxidant, anti-inflammatory, and antiapoptotic agent. Thus, JZL184 may be a novel therapeutic agent for ovarian IRI.

Plantar sensation, proprioception, and balance levels in pregnant women with gestational diabetes mellitus.

BACKGROUND: The aim of the study was to compare plantar sensation, proprioception, and balance levels between pregnant women with Gestational Diabetes Mellitus and healthy pregnant women. Also, we aimed to investigate the relationship between parameters that were found to be different and sensory sensitivity, balance, and position sense. METHODS: Seventy-two pregnant women (35 with Gestational Diabetes Mellitus and 37 controls) were included in this case-control study. Plantar sensory levels of the ankle joint (Semmes-Weinstein Monofilament-Test), position sense (digital inclinometer), and balance levels (Berg Balance Scale) were evaluated. FINDINGS: The Gestational Diabetes Mellitus group could not detect small filament thickness in the heel region compared to the control group (p < 0.05). In the ankle proprioception measurements of the Gestational Diabetes Mellitus group, deviation angle values were higher (p < 0.05) and the balance level was lower compared to the control group (p < 0.001). In addition, there was a positive correlation between glucose metabolism parameters and plantar sense and proprioception and a negative correlation with balance level (p < 0.05). INTERPRETATION: Plantar sense in the heel area, ankle joint position, and balance level of pregnant women with Gestational Diabetes Mellitus were lower than those of the healthy pregnant women. Disruption of glucose metabolite levels, which causes Gestational Diabetes Mellitus, is related to poorer balance, ankle position sense, and plantar sense in the heel. We recommend evaluating position sense and plantar sense for postural instability and risk of falling in pregnant women with Gestational Diabetes Mellitus.

The effects of incontinence on functionality, disability, and quality of life in male and female patients with multiple sclerosis.

PURPOSE: To determine the effects of incontinence on male and female patients with multiple sclerosis in terms of functionality, disability, and quality of life. METHODS: The study included 90 patients (45 male, 45 female) with multiple sclerosis (MS) with a median age of 37 years. After recording the sociodemographic characteristics, urinary incontinence was evaluated in terms of quality of life with the International Consultation of Incontinence Questionnaire-Short Form (ICIQ-SF), overactive bladder symptoms with Overactive Bladder Questionnaire-V8 (OAB-V8), quality of life with Multiple Sclerosis Quality of Life Questionnaire-54 (MSQOL-54), and function was evaluated with the Lower Extremity Functional Scale (LEFS). RESULTS: The demographic and clinical features, types of incontinence, total and sub-dimensions of ICIQ-SF, LEFS, OAB-V8, MSQOL-54 were determined to be similar in both males and females with MS (p>0.05). The education level of males was higher than that of females (p<0.05). A positive correlation was found between the mean LEFS score and MSQOL-total, MSQOL-PHC(physical health composite) and MSQOL-MHC(mental health composite) scores, and a negative correlation was found between the mean LEFS score and the ICIQ-SF and OAB-V8 scores (p<0.05). CONCLUSION: Urinary incontinence, overactive bladder and lower extremity functionality may be similar in males and females with MS. It should not be ignored that lower extremity functionality may negatively affect incontinence symptoms.

Brucellosis in pregnancy and its response to the changing immunoglobulin A: A prospective controlled study.

Objective: This study aimed to define the rare Brucella infection in pregnancy and its effects on immunoglobulins (Ig). Materials and Methods: This prospective study has conducted Brucella screening using the Rose Bengal test on pregnant and non-pregnant outpatients who did not show any specific Brucella symptoms. The immunoglobulin levels were measured using the enzyme-linked immunosorbent assay. The study group consisted of pregnant women who were at 20 weeks or below gestation and applied to our hospital outpatient clinic for routine check-ups. The control group consisted of healthy patients who applied for routine controls. Results: This study included a total of 584 participants, 293 of whom were controls and 291 were the study (pregnant) participants. The study revealed a 1.5% incidence of Brucella during pregnancy. In acute and chronic Brucella infection, lower levels of IgA response were observed in pregnant cases compared to the control group. Conclusion: Brucella infection is a disease that can cause fetal problems, especially in endemic areas. The role of the altered IgA response in pathologies that are associated with Brucella infection stands out as a new target for disease pathophysiology.

Maternal Serum Delta-Like 1 and Nesfatin-1 Levels in Gestational Diabetes Mellitus: A Prospective Case-Control Study.

Objective Delta-like 1 (DLK1) and nesfatin-1 are adipokines that have been shown to affect glucose metabolism. We aimed to search serum DLK1 and nesfatin-1 concentrations at 24-28 weeks of pregnancy in women newly defined with gestational diabetes mellitus (GDM) and investigate the relationship of these adipokines with various metabolic parameters. Methods Serum levels of DLK1 and nesfatin-1 were evaluated in 44 women with GDM, and in 40 healthy pregnant women by enzyme-linked immunosorbent assay (ELISA) kits. While performing oral glucose tolerance test (OGTT) for GDM diagnosis at 24-28 weeks of pregnancy, homeostasis model assessment of insulin resistance (HOMA-IR), lipid profiles, glycosylated hemoglobin (HbA1c) were also measured. Results Maternal serum DLK1 and nesfatin-1 concentrations were found lower in pregnant women with GDM compared with healthy pregnant women (418.4±282.6 vs. 586.7±303 ng/L, p=0.002; 12.2±7.6 vs. 26.7±16.4 ng/ml, p<0.001, respectively). Maternal serum DLK1 levels correlated positively with HOMA-IR and fasting insulin (r=0.395, p=0.008; r=0.374, p=0.012, respectively). Conclusion We determined that DLK1 and nesfatin-1 levels were lower in GDM. Based on this study, it may be considered that DLK1 could be culpable for metabolic disorders in GDM.

Does polycystic ovary syndrome with phenotype D affect the cardiovascular endurance, core endurance, body awareness, and the quality of life? A prospective, controlled study

Objective: This study evaluates cardiovascular endurance, core endurance, body awareness, and the quality of life in normal-weight women with polycystic ovary syndrome. Materials and Methods: This study included a total of 101 normal-weight women (51 with and 50 without polycystic ovary syndrome). Cardiovascular endurance was evaluated with the 20-meter Shuttle Run test, and maximum oxygen consumption was calculated. Core endurance was evaluated with core stability tests, body awareness with the body awareness questionnaire, and the quality of life with short form-36. Blood lipids, glucose, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), hormonal profile, and high-density and low-density lipoprotein cholesterols were measured. Results: Maximum oxygen consumption, core endurance, body awareness questionnaire, and short form-36 results were lower in women with polycystic ovary syndrome than healthy women (p<0.05). There was a significant correlation between core endurance tests, high-density lipoprotein cholesterol, maximum oxygen consumption, and homeostatic model assessment for insulin resistance scores (p<0.05). Conclusion: When normal-weight women with polycystic ovary syndrome and control groups with similar androgen levels and body mass index profiles were compared, women with polycystic ovary syndrome had lower aerobic capacity and muscle endurance. This suggests that the adverse metabolic profile of polycystic ovary syndrome can limit physical function.

Behaviors and Attitudes of Obstetricians in Turkey Related to Cord Clamping, Cord Milking, and Skin-To-Skin Contact.

Objective This study was planned to evaluate obstetricians' practices of umbilical cord clamping, milking, and skin-to-skin contact applications and to determine the related variables. Material and methods A total of 522 obstetricians participated in the study. Participants were reached via the internet and a 15-item questionnaire was applied about umbilical cord clamping, cord milking, and skin-to-skin contact. Mann-Whitney U test and Student's t-test were used for continuous data and Chi-square test or Fisher's exact test for categorical data in determining the difference between groups. For the multivariate analysis, the possible factors identified with univariate analyses were entered into the logistic regression analysis to determine further independent predictors of delayed clamping. Statistical analysis was performed using the SPSS software (version 20, IBM Corp, Armonk, USA). Results It was determined that 234 (44.8%) of the participants clamped the umbilical cord early whereas 288 (55.2%) clamped it late. It was found that the delayed clamping rates of physicians working in public hospitals were significantly lower than those working in private (p<0.001). It was observed that 132 of the participants (25.3%) did not milk the cord and 180 (34.5%) of them applied it continuously, and no significant difference was found between physicians working in the public and private sectors (p=0.130). It was observed that 384 (73.6%) physicians applied skin-to-skin contact. In the multivariate regression analysis, it was determined that working status in a private hospital with a 3.6 odds ratio (OR) (95% CI = 2.0-6.3) and a low number of patients examined daily with a 1.2 OR (95%CI= 1.0-1.4) were the most important independent factors affecting the choice of delayed clamping. Conclusion It is seen that the most important parameter affecting the birth practices of physicians in our country is the employment status in public or private institutions. The age and professional experience of the physicians who clamp the umbilical cord late were found to be higher. Obstetricians are at the key point in obstetrics practice, and the experience of physicians and the type of institution they work with affect these practices.

Concordance of HPV, conventional smear, colposcopy, and conization results in cervical dysplasia.

BACKGROUND: Cervical cancer screening algorithms are increasingly focused on Human Papillomavirus (HPV)-based screening while the accuracy of using abnormal cytological findings to detect dysplastic lesions still remains important. This retrospective study correlated the results of conventional cervical cytology, colposcopy guided biopsy, and cold knife conization (CKC) procedures performed in a tertiary center. MATERIALS AND METHODS: Data from 9399 patients who underwent screening with conventional cervical cytology between 2010 and 2019 was obtained from the hospital registry. Abnormal cervical cytology and high-risk HPV DNA genotypes were recorded and their colposcopic and CKC pathology was determined. RESULTS: Two hundred and ninety two patients underwent colposcopy for abnormal cervical cytology and/or high-risk HPV positivity. One hundred and twenty three patients were positive for High-risk HPV. Abnormal cervical cytology was detected in 216 patients. The most common cytological anomaly was atypical squamous cells of undetermined significance (ASCUS) found in 9399 patients (1.39%). It was determined that conventional cytology had a sensitivity of 70.8% and a specificity of 62.2% for the detection of low-grade lesions, while it had a sensitivity of 72.4% and a specificity of 86.0% for the detection of high-grade lesions. CKC was applied to 68 patients who were diagnosed with high-grade squamous intraepithelial lesions (HSIL) as a result of the colposcopy. As a result of CKC, a high-grade lesion was detected in 73.5% of these patients. CONCLUSION: Conventional cervical cytology and colposcopy exhibited higher accuracy as the severity of lesions increased. Detection of HPV may prevent unnecessary surgical procedures, especially with ASCUS.

The Relationship Between Heavy Metal Exposure, Trace Element Level, and Monocyte to HDL Cholesterol Ratio with Gestational Diabetes Mellitus.

The objective of this study is to assess the levels of heavy metals (cadmium, lead, antimony, mercury, and arsenic), which are also called endocrine-disrupting chemicals, and trace elements (chromium-III, chromium-VI, zinc, copper, and selenium) vs. monocyte to HDL ratio among pregnant women with gestational diabetes mellitus (GDM). A total of 112 pregnant women (60 with GDM and 52 healthy women) were included in this case-control study. Analysis of heavy metals and trace elements were performed in inductively coupled plasma mass spectrometer. Heavy metals (cadmium, lead, antimony, mercury, and arsenic), trace elements (chromium-III, chromium-VI, zinc, copper, and selenium), and metabolic parameters were assessed in both groups. It was determined that the levels of cadmium, lead, antimony, and copper were higher (p < 0.05) and levels of chromium-III, zinc, and selenium were lower (p < 0.05) among the GDM group compared to the control group, whereas there was a statistically insignificant difference between the two groups, regarding the levels of copper, mercury, and arsenic (p > 0.05). Moreover, the monocyte to HDL ratio was higher in the GDM group (p < 0.05), and the insulin resistance was significantly higher as well (p < 0.05). The results of our study demonstrated that environmental factors could be effective in the etiology of GDM. Toxic heavy metals, through inducing Cu, OS, and chronic inflammation, and other trace elements, either directly by impacting insulin secretion or through weakening the body's antioxidant defense system, could play a role in the occurrence of GDM.

DLK1 and Nesfatin-1 levels and the relationship with metabolic parameters in polycystic ovary syndrome: Prospective, controlled study

Objective: Delta-like 1 (DLK1) is known to inhibit adipocyte differentiation and nesfatin-1 is a neuropeptide that plays a role in the regulation of nutrition and metabolism. We aimed to assess both the levels of DLK1 and nesfatin-1 in polycystic ovary syndrome (PCOS) and determine the association of DLK1 and nesfatin-1 with metabolic parameters. Materials and Methods: Forty-four patients with PCOS and 40 healthy women as the control group were included in this study. Venous blood samples of the participants were collected, and hormonal, metabolic parameters, DLK1 and nesfatin-1 blood levels were determined. Anthropometric parameters were also determined. For a double comparison, the Mann-Whitney U test was used for non-parametric numerical data, and Student's t-test was used for parametric numerical data. Bivariate correlations were investigated using Spearman's correlation analysis. The diagnostic performance of the parameters was evaluated using receiver operating characteristic curve analysis. Results: The findings showed that DLK1 and nesfatin-1 levels were lower among the PCOS group, and the differences in these values were found to be statistically significant. A significant negative correlation was found between DLK1 levels and body mass index (BMI), waist/hip ratio, visceral adiposity index (VAI), fasting serum insulin (FSI), homeostasis model of assessment-insulin resistance (HOMA-IR) and triglyceride levels. A significant negative correlation was found between nesfatin-1 levels and BMI, VAI, FSI, HOMA-IR and triglyceride. Conclusion: The findings showed that DLK1 and nesfatin-1 levels were lower in PCOS. Based on this study, DLK1 may be culpable for metabolic disorders in PCOS and can be a novel marker for PCOS in the future.

Activation of cannabinoid 2 receptors by JWH-133 protects against ovarian ischemia-reperfusion injury in rats.

We investigated the efficacy of activated cannabinoid 2 receptors for alleviating ovarian ischemia-reperfusion injury in rats. Female Wistar albino rats were divided randomly into six groups: ischemia-reperfusion (IRG); ischemia-reperfusion + 0.2 mg/kg JWH-133 (JIRG1), ischemia-reperfusion + 1 mg/kg JWH-133 (JIRG2); ischemia-reperfusion + 5 mg/kg JWH-133 (JIRG3); solvent control, and sham control. Ovarian ischemia was established for 3 h followed by reperfusion for 3 h. Ovarian tissue was investigated using histology, immunohistochemistry and biochemistry. Administration of JWH-133 synthetic cannabinoid reduced nuclear factor kappa-B immunoreactivity as well as TUNEL positivity scores and malondialdehyde levels. These reductions were significant in all cases except for the malondialdehyde levels in the 1 mg/kg JWH-133 group. Activation of cannabinoid 2 receptors by JWH-133 reduced ovarian ischemia-reperfusion injury due to its antioxidant and anti-inflammatory effects.

The effect of placental angiogenic and anti-angiogenic factors on pregnancy outcome in patients with early onset preeclampsia

Objective: The aim was to evaluate the possible effects of anti-angiogenic factors including soluble endoglin (sEng), placental growth factor (Pgf), and soluble fms-like tyrosine kinase 1 (sFlt-1) in both normotensive pregnant patients and preeclampsia (PE) patients. Material and Methods: The study was carried out at the Departments of Gynecology and Obstetrics and Biochemistry of Yozgat Bozok University Training and Research Hospital. Eighteen women with PE who were pregnant for at least 20 weeks comprised the study group. The control group consisted of 33 pregnant women with no complications and with similar demographic features. In the study, laboratory parameters, demographic characteristics, sEng, sFlt-1, and Pgf levels, delivery type, APGAR scores of the infants, and birthweight were determined and a comparison was made between the groups. Results: It was found that the sEng level was significantly lower in the PE group compared to the control group (p<0.05). In addition, the Pgf, birthweight, and 1st and 5th-minute APGAR scores were significantly lower in the PE group compared to the control group (p<0.05). Conclusion: The decrease in Pgf may have an effect on the pathogenesis of PE and can be utilized for the determination of PE.

Quality of life and sexuality after bilateral sacrospinous fixation with vaginal hysterectomy for treatment of primary pelvic organ prolapse.

OBJECTIVE: To investigate the quality of life (QoL) and sexuality in women affected by pelvic organ prolapse (POP) and treated by bilateral sacrospinous ligament fixation (SSLF) with vaginal hysterectomy. METHODS: This is a prospective observational study carried out at Isparta City Hospital from July 2017 to December 2018. A total of 26 sexually active women with symptomatic uterine prolapse POP-Q (Pelvic Organ Prolapse Quantification) stage II or higher requiring surgery were included in the study. Short Form Health Survey (SF-36) was used preoperatively and at 6 months to examine the impacts of vaginal reconstruction on QoL. To assess sexual functioning, the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) was used preoperatively and at 6 months. RESULTS: A significant improvement of POP-Q landmarks was found between pre- and posttreatment at 6 months of follow-up. The patients reported QoL improvement at the follow-up for all the categories of physical functioning, bodily pain, physical health, general health, vitality, social activity, emotional state, and mental health with respect to the baseline values (P < .001). The results of PISQ-12 demonstrated a significant improvement for all the three fields: behavioral emotive factor, physical factor, and partner-related factor, and the total score at 6 months after surgery (P < .001). CONCLUSION: This study clearly demonstrates that bilateral SSLF is able to significantly improve both QoL and sexual function in patients with POP. Improvement in sexuality and QoL after surgery may be explained by correction of avoidance of sexual intercourse due to prolapse and physical recovery.

Sexual function and depression in polycystic ovary syndrome: Is it associated with inflammation and neuromodulators?

Numerous studies have been carried out on depression and sexual dysfunction concomitant with polycystic ovary syndrome (PCOS). Increasing evidence has revealed the importance of inflammation in the etiology of PCOS. In addition, it has been known that some neuromodulators affect depression and sexual function. However, their effects on PCOS are not known. This study aimed to evaluate the relationship of depression and sexual function with cytokines and neuromodulators in PCOS patients. The present study included 20 fertile and 30 infertile patients diagnosed with PCOS and 30 healthy volunteers. Metabolic and endocrine parameters, interleukin (IL)-1ß, IL-6, TNFα, γ-aminobutyric acid (GABA), Glutamate, Brain-derived neurotrophic factor (BDNF) serum levels, Beck Depression Index (BDI) and Female Sexual Function Index (FSFI) scores of the patients were compared between the groups. TNFα, IL-1ß, IL-6, glutamate, GABA, and BDI scores were found to be significantly higher (p < 0.05) in the PCOS group (p < 0.05). Glutamate, TNFα, IL-1ß, and IL-6 values were higher whereas GABA and BDNF values were lower in pateints with moderate and severe depression (p < 0.05). There were no statistically significant relationships between these parameters and the FSFI scores (p > 0.05). Multivariate logistic regression analysis was conducted with potential factors that may affect sexual dysfunction. The results indicated that high waist-to-hip ratio (WHR) (> 0.80) with an odds ratio of 1.81 in PCOS patients, and body mass index (BMI) with an odds ratio of 2.3 and high WHR (> 0.80) with an odds ratio of 1.97 in all patients were found to be independent risk factors affecting sexual dysfunction. The results of the present study suggested that chronic low-dose inflammation seen in PCOS may interact with some neuromodulators, leading to the development of depression. However, no relationship was found between these parameters and sexual function.

The relationship between oxidative stress and preeclampsia. The serum ischemia-modified albumin levels and thiol/disulfide homeostasis.

OBJECTIVE: Preeclampsia (PE) is a dangerous complication of pregnancy and still a major cause of maternal-fetal morbidity and mortality. Its etiology remains largely unknown, but researchers have suggested oxidative stress-mediated inflammation for the same. The purpose of this study is to investigate the relationship between oxidative stress and PE as well as the usability of oxidative stress indicators such as serum ischemia-modified albumin (IMA) levels and thiol/disulfide balance in the prediction of PE. MATERIALS AND METHODS: The study included 47 pregnant women with PE and 57 healthy pregnant women. We measured their serum IMA, native thiol, total thiol, and disulfide levels. Additionally, we determined the optimal cutoff values via the receiver operating characteristic curve analysis. RESULTS: There were no differences between the two groups with respect to the maternal age, body mass index, gravida, and parity. The native and total thiol levels were found to be low when the disulfide and IMA levels were high in the patients with PE (p<0.05). When the IMA level was corrected by the albumin level (IMAR), the significant difference between the two groups disappeared. We also found that the native and total thiol concentrations were correlated with the systolic and diastolic blood pressures. The optimal cut-off values calculated for the prediction of PE were as follows: 178.45 µmol/L (with sensitivity of 72% and specificity of 83%) for native thiol, 232.55 µ mol/L (with a sensitivity of 75% and specificity of 85%) for total thiol, and 29.05 µmol/L (with sensitivity of 65% and specificity of 72%) for disulfide. CONCLUSION: The balance of thiol/disulfide may play a role in the pathogenesis of PE and could be used as a biological marker for PE.

Awareness of women about cervical smear, human papilloma virus and human papilloma virus vaccine.

OBJECTIVE: The aim of this study was to assess the awareness level of women about cervical smears, human papilloma virus (HPV), and HPV vaccine in a rural city in the central part of Anatolia. MATERIALS AND METHODS: A total of 553 patients were included in the study. A 16 item questionnaire developed by our group was completed by all participants. The first part of the questionnaire collected the demographic and socioeconomic information of the participants. In the second part, it was questioned whether this information had a relationship with HPV, HPV vaccine awareness, and cervical screening tests. In the third part, the participants were asked questions related to the acceptance of an HPV vaccine for themselves and their willingness to give consent to have their children vaccinated. RESULTS: In our study, it was found that HPV awareness significantly increased with the level of education, occupational status and total monthly family income (p<0.001). There was a significant increase in HPV vaccine awareness as the parity (p=0.016), level of education (p=0.025), and occupational status (p=0.001) increased. Having a Pap smear significantly increased with age, income, and number of parity (p<0.001). CONCLUSION: Our study revealed that only 9.8% of the women had knowledge about HPV, the majority of the women reported that they would accept vaccination for themselves and for their children. These results indicate that physicians should pay attention to increasing the awareness about HPV.