Aysun Altinok Karabulut - Academia.edu (original) (raw)

Papers by Aysun Altinok Karabulut

Research paper thumbnail of Serum Vitamin B12 and Folate Concentrations and the Effect of the Mediterranean Diet on Vulnerable Populations

Pediatric Hematology-Oncology, 2014

Low vitamin B12 and folate levels in expectant mothers may lead to low stores in babies. The aim ... more Low vitamin B12 and folate levels in expectant mothers may lead to low stores in babies. The aim of this study was to determine the frequencies of vitamin B12 and folate deficiencies in pregnant women and neonates, and to assess the effect of maternal vitamin status on babies' vitamin levels in the Aegean region of Turkey, where the Mediterranean diet (mainly fresh fruits and vegetables) is adopted. We studied 72 pregnant women and their singleton-term babies. Venous blood samples of expectant mothers were collected 1 h before delivery and cord blood of babies were obtained at birth. The mean vitamin B12 in maternal and cord blood serum was 163.1 ± 72.0 pg/mL and 146.2 ± 102.5 pg/mL, and the mean folate, 9.8 ± 4.8 ng/mL and 15.8 ± 3.8 ng/mL, respectively. There were statistically significant correlation between maternal and cord blood serum vitamin B12 (r = 0.61, P = .04) and folate levels (r = 0.65, P < .001). 70.8% of the mothers and 83.9% of the babies were vitamin B12 deficient (<200 pg/mL). Neither group showed folate deficiency. The mean level of vitamin B12 in mothers significantly varied by the type of diet (241.6 (72.1) pg/mL versus 155.9 (68.2) pg/mL; P = .012). Vitamin B12 deficiency in pregnant women and neonates may be a public health problem in our community. The Mediterranean diet in these vulnerable groups may be an aggravating factor for vitamin B12 deficiency. Prenatal screening of all expectant mothers, prenatal supplementation of vitamin B12, and an increase in animal-source food intake may improve expectant mother's vitamin B12 level.

Research paper thumbnail of The effects of human umbilical cord blood transplantation in rats with experimentally induced spinal cord injury

Journal of Neurosurgery: Spine, 2010

Even though there have been many efforts to recover neuronal dysfunction following spinal cord in... more Even though there have been many efforts to recover neuronal dysfunction following spinal cord injuries, there are limitations to the treatment of these injuries. The purpose of this laboratory investigation was to determine the clinical and neurophysiological effects of human umbilical cord blood (HUCB) transplantation in a rat hemisection model of spinal cord injury. In this study, experimental hemisection of the thoracic spinal cord was performed in rats. The rats were divided into 4 groups (6 rats in each group). One group of rats (Group 1) underwent thoracic laminectomy only. Rats in Group 2 underwent laminectomy and right hemisection of the thoracic spinal cord. Rats in Group 3 underwent right hemisection and implantation of freshly obtained HUCB on Day 0 postinjury. Rats in Group 4 underwent hemisection and implantation of freshly obtained HUCB on Day 4 postinjury. Clinical evaluations of rat motor function included the following: neurological examination, Rotarod performance, and inclined plane tests. Rats also underwent reflex evaluation. The neurological examinations revealed that the frequency of plegic rats was 70.8% at the beginning of the study across all 4 groups; this value decreased to 20.8% by the end of the study. The percentage of rats with a normal examination increased from 25% to 50%. The results of Rotarod performance and 8-week inclined plane performance tests showed statistical significance (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) in an overall group comparison across all time points. At the end of the 8 weeks, a statistically significant difference was found in the inclined plane test results between rats in Groups 1 and 2. There were no statistically significant differences between Groups 1, 3, and 4 (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). When the reflex responses of the hemisectioned sides were compared, statistically significant differences were detected between groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). All groups were significantly different with regard to the right-side reflex response score (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Spinal cord preparations of rats in all groups were examined for histopathological changes. Human umbilical cord blood is stem cell rich and easily available, and it carries less risk of inducing a graft-versus-host reaction in the recipient. Human umbilical cord blood serum is also noted to contain stem cell–promoting factors, which is why cell isolation was not used in this study. Freshly obtained cord blood was also used because storage of cord blood has been reported to have some negative effects on stem cells. Transplantation of freshly obtained HUCB into the hemisectioned spinal cord experimental model demonstrated clinical and neurophysiological improvement.

Research paper thumbnail of Stromal Tumor of the Sex Cord in a Woman with Testicular Feminization Syndrome: Imaging Features

American Journal of Roentgenology, 2002

Research paper thumbnail of Effects of menopause, diabetes mellitus and steroid use on type I mesh-induced tissue reaction in a rat model

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2014

Research paper thumbnail of Predictors of fertility quality of life (FertiQoL) in infertile women: analysis of confounding factors

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2013

Research paper thumbnail of Premarital screening of 466 Mediterranean women for serum ferritin,vitamin B12, and folate concentrations

TURKISH JOURNAL OF MEDICAL SCIENCES, 2015

Iron, folate, and vitamin B12 serum levels are closely related with dietary habits and have an es... more Iron, folate, and vitamin B12 serum levels are closely related with dietary habits and have an essential role in the healthy development of a fetus. We aimed to investigate hemoglobin, ferritin, folate, and vitamin B12 levels in preconceptional women in an area where a plant-based diet referred to as Mediterranean cuisine is commonly used. The study population included 466 women between the ages of 18 and 45 years admitted for thalassemia screening. Sociodemographic variables and history of menometrorrhagia, pica, and dietary habits were collected. Serum vitamin B12, folate, ferritin, and hemoglobin levels were measured. Ferritin of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;12µg/L, vitamin B12 of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;200 pg/mL, and folate of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;4 ng/mL were accepted as deficiencies. Hemoglobin level of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;12 g/dL was classified as anemia. Polymenorrhea was present in 11.7% and hypermenorrhea in 24.8% of women. Anemia was detected in 24.9% and thalassemia trait in 3.0% of women. Low ferritin levels were observed in 46.1%, vitamin B12 in 21.6%, and folate in 3.4% of women. In the group with low vitamin B12, decreased meat consumption was more prevalent (27.5% vs. 16.9%; P = 0.019). Vitamin B12 and iron are the main micronutrients depleted in our community. This necessitates implementing a public health program for women consuming a Mediterranean diet.

Research paper thumbnail of A late complication of transobturator tape procedure: vaginocutaneous fistula formation with vaginal mesh erosion

International Urogynecology Journal, 2014

Transobturator tape procedures are a common treatment modality in patients with stress urinary in... more Transobturator tape procedures are a common treatment modality in patients with stress urinary incontinence (SUI). Various complications have been reported related to this procedure. We present a rare case of vaginocutaneous fistula formation 5 years after transobturator tape surgery. A 56-year-old woman presented with complaints of increased vaginal discharge, difficulty in coitus, and serosanguineous discharge from the left groin 5 years after transobturator tape surgery for SUI. Pelvic examination revealed 2-3 cm of extruded mesh at the anterior vaginal wall. The vaginocutaneous fistula was detected at surgery. The suburethral tape was removed, and the fistula tract was excised and repaired primarily. Postoperative period was uneventful, and the patient was still continent 6 weeks postoperatively. With widespread use of mesh for treating SUI, we will likely see a variety of complications in the long term.

Research paper thumbnail of Non-immune hydrops fetalis without anemia due to parvovirus B19

International Journal of Gynecology & Obstetrics, 2014

Research paper thumbnail of Evaluation of cervical screening results in a population at normal risk

International Journal of Gynecology & Obstetrics, 2010

Objective: To evaluate the frequency of dysplasia and other cervical conditions in a population a... more Objective: To evaluate the frequency of dysplasia and other cervical conditions in a population at normal risk, and compare demographic characteristics of the women with normal and abnormal results. Methods: Characteristics such as gravidity, parity, age at marriage, and smoking status were obtained from a questionnaire completed from January 2004 through July 2005 at Denizli State Hospital, Denizli, Turkey, by the 19 639 participants before they were screened. The results were analyzed. Results: The dysplasias detected in 107 smears (0.54%) included ASCUS (0.31%), LSIL (0.15%), and HSIL (0.07%); there were also 1 case of AGUS and 1 of squamous cell carcinoma. Age, age at marriage, number of pregnancies, number of deliveries, and smoking habit were similar for participants with and without dysplasia (P N 0.05). Bacterial vaginosis was seen in 1633 smears (8.3%), candidiasis in 1346 (6.9%), Actinomyces sp. in 648 (3.3%), and Trichomonas vaginalis in 143 (0.7%). Conclusion: Cytologic abnormalities in a cervical smear can point to precancerous or cancerous processes or to other conditions. The prevalence of dysplasia was lower for our participants than in Western populations, which could be explained by a conservative lifestyle and a lower prevalence of HPV in Turkey.

Research paper thumbnail of Evaluation of confounding factors interfering with sexual function in women with minimal pelvic organ prolapse

International Journal of Gynecology & Obstetrics, 2014

Objective: To evaluate the effects of confounding factors on sexual function in women with minima... more Objective: To evaluate the effects of confounding factors on sexual function in women with minimal pelvic organ prolapse (POP). Methods: A cross-sectional study was conducted at a cervical cancer screening center in Turkey between December 1, 2012, and March 31, 2013. Symptom-free women with stage I or II POP were enrolled to evaluate the association between sexual function and sociodemographic variables, POP, POP-related quality of life, stress incontinence, and overactive bladder. Results: Of 243 volunteers (mean age 46.0 ± 9.1 years), 188 (77.4%) had a low Female Sexual Function Index score. Women with better sexual function tended to be younger, have a higher salary, not be in the menopause, and have no chronic illness (P b 0.05 for all). There was no difference between the groups in terms of POP Quantification measurements (P N 0.05), apart from transvaginal length (P = 0.011). Overactive bladder was more common (P = 0.005) and more severe (P = 0.002) in women with sexual dysfunction, and their POP-related quality of life was worse (P b 0.05). In a linear regression analysis, high salary had a positive effect and overactive bladder had a negative effect on sexual function. Conclusion: Sexual dysfunction is highly prevalent in women with minimal POP. Overactive bladder and low income are the major factors adversely affecting sexual function.

Research paper thumbnail of An Unusual Form of Unicornuate Uterus with Noncommunicating Rudimentary Horn: Case Report and Review of the Literature

Journal of Gynecologic Surgery, 2012

Research paper thumbnail of Gonadal dysfunction and pelvic sonographic findings in females with thalassaemia major

Gynecological Endocrinology, 2010

To investigate pubertal and menstrual problems and evaluate pelvic sonographic findings in patien... more To investigate pubertal and menstrual problems and evaluate pelvic sonographic findings in patients with beta-thalassaemia major. Twenty-five female patients followed for thalassaemia major constituted the study population. Sexual maturation and hormonal status were assessed. Pubertal and menstrual problems were investigated. There was one patient with delayed puberty and five patients with arrested puberty. Mean ferritin level in this group of patients was slightly but not significantly higher than patients with normal pubertal maturation (2620 +/- 994 ng/ml vs. 2409 +/- 1348 ng/ml, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). There were 10 patients with primary amenorrhoea, three with secondary amenorrhoea, five with oligomenorrhoea and irregular menstruation and one with regular menstruation. Compared to menstruating patients, the mean uterine size was smaller (4.1 +/- 3.5 cm(3) vs. 52.8 +/- 14.5 cm(3)) in all patients with delayed and arrested puberty (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Ten patients were taking hormone replacement therapy (HRT). The mean uterine size in these patients was larger than that in patients with amenorrhoea who were not taking HRT, but smaller than that in menstruating patients (9.1 +/- 15.9 cm(3), 2.7 +/- 1.3 cm(3) and 52.8 +/- 14.5 cm(3), respectively) (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Thalassaemia major has important side effects on the hypothaloma-pituitary-gonadal axis resulting in pubertal and menstrual abnormalities. HRT should be given to provide normal sexual maturation in these patients.

Research paper thumbnail of Angiotensin converting enzyme gene insertion/deletion polymorphism in patients with polycystic ovary syndrome

Gynecological Endocrinology, 2010

Research paper thumbnail of Maternal serum interleukin 6 levels in preterm labor: prediction of admission-to-delivery interval

Journal of Perinatal Medicine, 2000

To evaluate the diagnostic value of maternal serum interleukin 6 (IL-6), C-reactive protein (CRP)... more To evaluate the diagnostic value of maternal serum interleukin 6 (IL-6), C-reactive protein (CRP) levels and white blood cell (WBC) count for the prediction of preterm labor and length of admission-to-delivery interval in patients with preterm labor. Maternal serum IL-6, CRP and WBC count were prospectively determined in eighty-two patients in preterm labor and 21 controls. Data was analyzed in study and control groups, and for the assessment of clinical and laboratory risk factors in the prediction of admission-to-delivery interval in the study group. Maternal serum IL-6 levels were significantly higher in the study group than controls. The IL-6 value associated with the highest percent of true positives and true negatives for the prediction of preterm labor was 5 pg/ml. The area under curve of maternal IL-6 was significantly higher than the area under curve of of CRP and WBC count. In the study group maternal serum IL-6 levels were significantly higher in patients delivered within 2 and 7 days than the nondelivering ones and a cut off value of 8.3 pg/ml was determined for estimation of preterm delivery. Maternal serum IL-6 is a reliable marker in the prediction and management of preterm labor and delivery.

Research paper thumbnail of Ovarian sclerosing stromal tumour with elevated CA19-9 levels

Journal of Obstetrics & Gynaecology, 2015

Research paper thumbnail of Evaluation of body fat distribution in PCOS and its association with carotid atherosclerosis and insulin resistance

Gynecological Endocrinology, 2012

The aim of this study was to compare body fat distribution in PCOS with healthy controls and to i... more The aim of this study was to compare body fat distribution in PCOS with healthy controls and to investigate the factors associated with carotid artery intima media thickness (IMT) and insulin resistance. A case control study was conducted in 46 women with PCOS and 43 age matched controls. Anthropometrical measurements, hormonal levels, lipid and glucose profile were evaluated. Body fat thickness in four regions and carotid IMT were measured. Body fat distribution was compared between groups. Correlation of these parameters with carotid artery IMT and insulin resistance was investigated. Visceral and subcutaneous fat thickness and the mean carotid artery IMT were significantly higher in PCOS subjects (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). In correlation analysis, age, body mass index (BMI) and waist hip ratio (WHR) showed correlation with carotid artery IMT (r = 0,55, p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0,001; r = 0.41, p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.008 and r = 0.34 p = 0.03, respectively), whereas visceral fat thickness presented a correlation with HOMA-IR index as a sign of insulin resistance. Fat accumulation is more prominent in visceral and subcutaneous regions in PCOS. Increased BMI and abdominal type of obesity are closely related to the increased carotid artery IMT and insulin resistance. Weight control and regional weight loss are important part of the treatment for the future health of women with PCOS.

Research paper thumbnail of Effects of ethinyl estradiol-cyproterone acetate treatment on metabolic syndrome, fat distribution and carotid intima media thickness in polycystic ovary syndrome

Gynecological Endocrinology, 2012

To evaluate the effects of ethinyl estradiol-cyproterone acetate (EE-CA) treatment on metabolic a... more To evaluate the effects of ethinyl estradiol-cyproterone acetate (EE-CA) treatment on metabolic and cardiovascular risk factors, and body fat distribution in polycystic ovary syndrome (PCOS) after 6-month treatment. Thirty women with PCOS were evaluated before and after 6 months of EE-CA treatment. Anthropometrical measurements, hormonal levels, lipid and glucose profile were evaluated. Body fat thickness in four regions and carotid intima media thickness (IMT) were measured. Interval change in antropometric measurements, glucose and lipid profile, carotid IMT and body fat distribution was evaluated before and after 6-month EE-CA treatment. Ferriman-Gallwey score and serum testosterone levels were significantly decreased after EE-CA treatment (p &amp;amp;amp;amp;amp;amp;lt; 0.01). No significant effect was detected on insulin resistance, lipid profile and carotid artery IMT. The visceral, subcutaneous and preperitoneal fat thicknesses decreased, and mid-thigh fat thickness increased after treatment period. However, only the alteration in subcutaneous fat thickness achieved a statistical significance (p &amp;amp;amp;amp;amp;amp;lt; 0.01). The EE-CA is an effective regimen in treatment of hirsutism and menstrual regulation. Although it provides significant decrease in subcutaneous fat thickness after 6-month treatment, it has no beneficial effect with respect to visceral fat thickness, metabolic and cardiovascular risk factors.

Research paper thumbnail of Comparison of aerobic conjunctival bacterial flora in pregnant, reproductive-aged and postmenopausal women

International journal of ophthalmology, 2012

To evaluate the effect of hormonal status on aerobic conjunctival flora in women. One hundred fif... more To evaluate the effect of hormonal status on aerobic conjunctival flora in women. One hundred fifty-eight women [reproductive-aged (n=55), pregnant (n=51), and postmenopausal (n=52)] who admitted to outpatient clinic of Obstetrics and Gynecology Department of Denizli State Hospital were enrolled. Age, body-mass index (BMI), obstetric history, cigarette smoking, drug usage, presence of systemic disease, and intraocular pressure (IOP) were recorded for each patient. The samples were taken from the lower fornix with two culture swabs and directly incubated in culture containing 5% sheep blood, eosin-methylene blue and chocolate agar. The other swab specimen was Gram stained. All growths and microscopic results were analyzed. The coagulase-negative Staphylococcus was the predominant organism isolated in the conjunctival samples in both three groups. The aerobic microorganism growth rate for all isolated aerobic organisms revealed no significant change in the three groups (P >0.05). T...

Research paper thumbnail of Evaluation of risk factors and effect of physical activity in caesarean section in nulliparous women

Journal of Maternal-Fetal and Neonatal Medicine, 2012

The aim of this study was to evaluate risk factors for caesarean section (CS) in nulliparous wome... more The aim of this study was to evaluate risk factors for caesarean section (CS) in nulliparous women and to determine the effect of physical activity on ease of labour. A prospective observational study, including 282 nulliparous women at 37-41 gestational weeks was conducted. Maternal demographic characteristics, obstetric history and Modified Grimby scale for evaluation of physical activity were noted. Patients were classified into spontaneous labour and induction group. Multiple logistic regression model was used to assess independent risk factors for type of delivery. Caesarean rate was increasing with higher educational status (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Maternal height, maternal and paternal age were higher, whereas dilatation on admission was lower in CS group (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Maternal age, weight gain and CS rate were higher in induction group (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Fetal distress as a cause of CS was detected higher in induction group (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Physical activity has no significant effect on mode of delivery (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). Maternal height (p = 0.011), and cervical dilatation on admission (p = 0.004) were identified as predictor factors for CS. Cervical dilatation is the most important negative predictive factor for CS, whereas, moderate physical activity has no effect on mode of delivery. Fetal distress was the most frequent cause of CS in induction group.

Research paper thumbnail of H1N1 infection in Pregnancy: clinical course in two women

Journal of the Turkish German Gynecological Association, 2011

Pregnant women are one of the major risk groups for disease related morbidity and mortality from ... more Pregnant women are one of the major risk groups for disease related morbidity and mortality from influenza A (H1N1, swine flu) pandemic. Healthy pregnant women are supposed to have 4 to 5 fold increased rate of serious illness and hospitalization compared to non-pregnant subjects. Herein, the clinical course of novel influenza A (H1N1) infection in two pregnant women was presented. One woman expired due to delay in treatment, while the other one was discharged on day six after prompt treatment. We would like to emphasize that obstetricians should be aware of the clinical and radiological manifestations of influenza A for prompt diagnosis and treatment. Obstetricians also should prepare themselves to provide adequate care for pregnancy related complications encountered by pregnant women with H1N1 infection. (J Turkish-German Gynecol Assoc 2011; 12: 118-20)

Research paper thumbnail of Serum Vitamin B12 and Folate Concentrations and the Effect of the Mediterranean Diet on Vulnerable Populations

Pediatric Hematology-Oncology, 2014

Low vitamin B12 and folate levels in expectant mothers may lead to low stores in babies. The aim ... more Low vitamin B12 and folate levels in expectant mothers may lead to low stores in babies. The aim of this study was to determine the frequencies of vitamin B12 and folate deficiencies in pregnant women and neonates, and to assess the effect of maternal vitamin status on babies' vitamin levels in the Aegean region of Turkey, where the Mediterranean diet (mainly fresh fruits and vegetables) is adopted. We studied 72 pregnant women and their singleton-term babies. Venous blood samples of expectant mothers were collected 1 h before delivery and cord blood of babies were obtained at birth. The mean vitamin B12 in maternal and cord blood serum was 163.1 ± 72.0 pg/mL and 146.2 ± 102.5 pg/mL, and the mean folate, 9.8 ± 4.8 ng/mL and 15.8 ± 3.8 ng/mL, respectively. There were statistically significant correlation between maternal and cord blood serum vitamin B12 (r = 0.61, P = .04) and folate levels (r = 0.65, P < .001). 70.8% of the mothers and 83.9% of the babies were vitamin B12 deficient (<200 pg/mL). Neither group showed folate deficiency. The mean level of vitamin B12 in mothers significantly varied by the type of diet (241.6 (72.1) pg/mL versus 155.9 (68.2) pg/mL; P = .012). Vitamin B12 deficiency in pregnant women and neonates may be a public health problem in our community. The Mediterranean diet in these vulnerable groups may be an aggravating factor for vitamin B12 deficiency. Prenatal screening of all expectant mothers, prenatal supplementation of vitamin B12, and an increase in animal-source food intake may improve expectant mother's vitamin B12 level.

Research paper thumbnail of The effects of human umbilical cord blood transplantation in rats with experimentally induced spinal cord injury

Journal of Neurosurgery: Spine, 2010

Even though there have been many efforts to recover neuronal dysfunction following spinal cord in... more Even though there have been many efforts to recover neuronal dysfunction following spinal cord injuries, there are limitations to the treatment of these injuries. The purpose of this laboratory investigation was to determine the clinical and neurophysiological effects of human umbilical cord blood (HUCB) transplantation in a rat hemisection model of spinal cord injury. In this study, experimental hemisection of the thoracic spinal cord was performed in rats. The rats were divided into 4 groups (6 rats in each group). One group of rats (Group 1) underwent thoracic laminectomy only. Rats in Group 2 underwent laminectomy and right hemisection of the thoracic spinal cord. Rats in Group 3 underwent right hemisection and implantation of freshly obtained HUCB on Day 0 postinjury. Rats in Group 4 underwent hemisection and implantation of freshly obtained HUCB on Day 4 postinjury. Clinical evaluations of rat motor function included the following: neurological examination, Rotarod performance, and inclined plane tests. Rats also underwent reflex evaluation. The neurological examinations revealed that the frequency of plegic rats was 70.8% at the beginning of the study across all 4 groups; this value decreased to 20.8% by the end of the study. The percentage of rats with a normal examination increased from 25% to 50%. The results of Rotarod performance and 8-week inclined plane performance tests showed statistical significance (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) in an overall group comparison across all time points. At the end of the 8 weeks, a statistically significant difference was found in the inclined plane test results between rats in Groups 1 and 2. There were no statistically significant differences between Groups 1, 3, and 4 (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). When the reflex responses of the hemisectioned sides were compared, statistically significant differences were detected between groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). All groups were significantly different with regard to the right-side reflex response score (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Spinal cord preparations of rats in all groups were examined for histopathological changes. Human umbilical cord blood is stem cell rich and easily available, and it carries less risk of inducing a graft-versus-host reaction in the recipient. Human umbilical cord blood serum is also noted to contain stem cell–promoting factors, which is why cell isolation was not used in this study. Freshly obtained cord blood was also used because storage of cord blood has been reported to have some negative effects on stem cells. Transplantation of freshly obtained HUCB into the hemisectioned spinal cord experimental model demonstrated clinical and neurophysiological improvement.

Research paper thumbnail of Stromal Tumor of the Sex Cord in a Woman with Testicular Feminization Syndrome: Imaging Features

American Journal of Roentgenology, 2002

Research paper thumbnail of Effects of menopause, diabetes mellitus and steroid use on type I mesh-induced tissue reaction in a rat model

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2014

Research paper thumbnail of Predictors of fertility quality of life (FertiQoL) in infertile women: analysis of confounding factors

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2013

Research paper thumbnail of Premarital screening of 466 Mediterranean women for serum ferritin,vitamin B12, and folate concentrations

TURKISH JOURNAL OF MEDICAL SCIENCES, 2015

Iron, folate, and vitamin B12 serum levels are closely related with dietary habits and have an es... more Iron, folate, and vitamin B12 serum levels are closely related with dietary habits and have an essential role in the healthy development of a fetus. We aimed to investigate hemoglobin, ferritin, folate, and vitamin B12 levels in preconceptional women in an area where a plant-based diet referred to as Mediterranean cuisine is commonly used. The study population included 466 women between the ages of 18 and 45 years admitted for thalassemia screening. Sociodemographic variables and history of menometrorrhagia, pica, and dietary habits were collected. Serum vitamin B12, folate, ferritin, and hemoglobin levels were measured. Ferritin of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;12µg/L, vitamin B12 of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;200 pg/mL, and folate of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;4 ng/mL were accepted as deficiencies. Hemoglobin level of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;12 g/dL was classified as anemia. Polymenorrhea was present in 11.7% and hypermenorrhea in 24.8% of women. Anemia was detected in 24.9% and thalassemia trait in 3.0% of women. Low ferritin levels were observed in 46.1%, vitamin B12 in 21.6%, and folate in 3.4% of women. In the group with low vitamin B12, decreased meat consumption was more prevalent (27.5% vs. 16.9%; P = 0.019). Vitamin B12 and iron are the main micronutrients depleted in our community. This necessitates implementing a public health program for women consuming a Mediterranean diet.

Research paper thumbnail of A late complication of transobturator tape procedure: vaginocutaneous fistula formation with vaginal mesh erosion

International Urogynecology Journal, 2014

Transobturator tape procedures are a common treatment modality in patients with stress urinary in... more Transobturator tape procedures are a common treatment modality in patients with stress urinary incontinence (SUI). Various complications have been reported related to this procedure. We present a rare case of vaginocutaneous fistula formation 5 years after transobturator tape surgery. A 56-year-old woman presented with complaints of increased vaginal discharge, difficulty in coitus, and serosanguineous discharge from the left groin 5 years after transobturator tape surgery for SUI. Pelvic examination revealed 2-3 cm of extruded mesh at the anterior vaginal wall. The vaginocutaneous fistula was detected at surgery. The suburethral tape was removed, and the fistula tract was excised and repaired primarily. Postoperative period was uneventful, and the patient was still continent 6 weeks postoperatively. With widespread use of mesh for treating SUI, we will likely see a variety of complications in the long term.

Research paper thumbnail of Non-immune hydrops fetalis without anemia due to parvovirus B19

International Journal of Gynecology & Obstetrics, 2014

Research paper thumbnail of Evaluation of cervical screening results in a population at normal risk

International Journal of Gynecology & Obstetrics, 2010

Objective: To evaluate the frequency of dysplasia and other cervical conditions in a population a... more Objective: To evaluate the frequency of dysplasia and other cervical conditions in a population at normal risk, and compare demographic characteristics of the women with normal and abnormal results. Methods: Characteristics such as gravidity, parity, age at marriage, and smoking status were obtained from a questionnaire completed from January 2004 through July 2005 at Denizli State Hospital, Denizli, Turkey, by the 19 639 participants before they were screened. The results were analyzed. Results: The dysplasias detected in 107 smears (0.54%) included ASCUS (0.31%), LSIL (0.15%), and HSIL (0.07%); there were also 1 case of AGUS and 1 of squamous cell carcinoma. Age, age at marriage, number of pregnancies, number of deliveries, and smoking habit were similar for participants with and without dysplasia (P N 0.05). Bacterial vaginosis was seen in 1633 smears (8.3%), candidiasis in 1346 (6.9%), Actinomyces sp. in 648 (3.3%), and Trichomonas vaginalis in 143 (0.7%). Conclusion: Cytologic abnormalities in a cervical smear can point to precancerous or cancerous processes or to other conditions. The prevalence of dysplasia was lower for our participants than in Western populations, which could be explained by a conservative lifestyle and a lower prevalence of HPV in Turkey.

Research paper thumbnail of Evaluation of confounding factors interfering with sexual function in women with minimal pelvic organ prolapse

International Journal of Gynecology & Obstetrics, 2014

Objective: To evaluate the effects of confounding factors on sexual function in women with minima... more Objective: To evaluate the effects of confounding factors on sexual function in women with minimal pelvic organ prolapse (POP). Methods: A cross-sectional study was conducted at a cervical cancer screening center in Turkey between December 1, 2012, and March 31, 2013. Symptom-free women with stage I or II POP were enrolled to evaluate the association between sexual function and sociodemographic variables, POP, POP-related quality of life, stress incontinence, and overactive bladder. Results: Of 243 volunteers (mean age 46.0 ± 9.1 years), 188 (77.4%) had a low Female Sexual Function Index score. Women with better sexual function tended to be younger, have a higher salary, not be in the menopause, and have no chronic illness (P b 0.05 for all). There was no difference between the groups in terms of POP Quantification measurements (P N 0.05), apart from transvaginal length (P = 0.011). Overactive bladder was more common (P = 0.005) and more severe (P = 0.002) in women with sexual dysfunction, and their POP-related quality of life was worse (P b 0.05). In a linear regression analysis, high salary had a positive effect and overactive bladder had a negative effect on sexual function. Conclusion: Sexual dysfunction is highly prevalent in women with minimal POP. Overactive bladder and low income are the major factors adversely affecting sexual function.

Research paper thumbnail of An Unusual Form of Unicornuate Uterus with Noncommunicating Rudimentary Horn: Case Report and Review of the Literature

Journal of Gynecologic Surgery, 2012

Research paper thumbnail of Gonadal dysfunction and pelvic sonographic findings in females with thalassaemia major

Gynecological Endocrinology, 2010

To investigate pubertal and menstrual problems and evaluate pelvic sonographic findings in patien... more To investigate pubertal and menstrual problems and evaluate pelvic sonographic findings in patients with beta-thalassaemia major. Twenty-five female patients followed for thalassaemia major constituted the study population. Sexual maturation and hormonal status were assessed. Pubertal and menstrual problems were investigated. There was one patient with delayed puberty and five patients with arrested puberty. Mean ferritin level in this group of patients was slightly but not significantly higher than patients with normal pubertal maturation (2620 +/- 994 ng/ml vs. 2409 +/- 1348 ng/ml, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). There were 10 patients with primary amenorrhoea, three with secondary amenorrhoea, five with oligomenorrhoea and irregular menstruation and one with regular menstruation. Compared to menstruating patients, the mean uterine size was smaller (4.1 +/- 3.5 cm(3) vs. 52.8 +/- 14.5 cm(3)) in all patients with delayed and arrested puberty (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Ten patients were taking hormone replacement therapy (HRT). The mean uterine size in these patients was larger than that in patients with amenorrhoea who were not taking HRT, but smaller than that in menstruating patients (9.1 +/- 15.9 cm(3), 2.7 +/- 1.3 cm(3) and 52.8 +/- 14.5 cm(3), respectively) (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Thalassaemia major has important side effects on the hypothaloma-pituitary-gonadal axis resulting in pubertal and menstrual abnormalities. HRT should be given to provide normal sexual maturation in these patients.

Research paper thumbnail of Angiotensin converting enzyme gene insertion/deletion polymorphism in patients with polycystic ovary syndrome

Gynecological Endocrinology, 2010

Research paper thumbnail of Maternal serum interleukin 6 levels in preterm labor: prediction of admission-to-delivery interval

Journal of Perinatal Medicine, 2000

To evaluate the diagnostic value of maternal serum interleukin 6 (IL-6), C-reactive protein (CRP)... more To evaluate the diagnostic value of maternal serum interleukin 6 (IL-6), C-reactive protein (CRP) levels and white blood cell (WBC) count for the prediction of preterm labor and length of admission-to-delivery interval in patients with preterm labor. Maternal serum IL-6, CRP and WBC count were prospectively determined in eighty-two patients in preterm labor and 21 controls. Data was analyzed in study and control groups, and for the assessment of clinical and laboratory risk factors in the prediction of admission-to-delivery interval in the study group. Maternal serum IL-6 levels were significantly higher in the study group than controls. The IL-6 value associated with the highest percent of true positives and true negatives for the prediction of preterm labor was 5 pg/ml. The area under curve of maternal IL-6 was significantly higher than the area under curve of of CRP and WBC count. In the study group maternal serum IL-6 levels were significantly higher in patients delivered within 2 and 7 days than the nondelivering ones and a cut off value of 8.3 pg/ml was determined for estimation of preterm delivery. Maternal serum IL-6 is a reliable marker in the prediction and management of preterm labor and delivery.

Research paper thumbnail of Ovarian sclerosing stromal tumour with elevated CA19-9 levels

Journal of Obstetrics & Gynaecology, 2015

Research paper thumbnail of Evaluation of body fat distribution in PCOS and its association with carotid atherosclerosis and insulin resistance

Gynecological Endocrinology, 2012

The aim of this study was to compare body fat distribution in PCOS with healthy controls and to i... more The aim of this study was to compare body fat distribution in PCOS with healthy controls and to investigate the factors associated with carotid artery intima media thickness (IMT) and insulin resistance. A case control study was conducted in 46 women with PCOS and 43 age matched controls. Anthropometrical measurements, hormonal levels, lipid and glucose profile were evaluated. Body fat thickness in four regions and carotid IMT were measured. Body fat distribution was compared between groups. Correlation of these parameters with carotid artery IMT and insulin resistance was investigated. Visceral and subcutaneous fat thickness and the mean carotid artery IMT were significantly higher in PCOS subjects (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). In correlation analysis, age, body mass index (BMI) and waist hip ratio (WHR) showed correlation with carotid artery IMT (r = 0,55, p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0,001; r = 0.41, p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.008 and r = 0.34 p = 0.03, respectively), whereas visceral fat thickness presented a correlation with HOMA-IR index as a sign of insulin resistance. Fat accumulation is more prominent in visceral and subcutaneous regions in PCOS. Increased BMI and abdominal type of obesity are closely related to the increased carotid artery IMT and insulin resistance. Weight control and regional weight loss are important part of the treatment for the future health of women with PCOS.

Research paper thumbnail of Effects of ethinyl estradiol-cyproterone acetate treatment on metabolic syndrome, fat distribution and carotid intima media thickness in polycystic ovary syndrome

Gynecological Endocrinology, 2012

To evaluate the effects of ethinyl estradiol-cyproterone acetate (EE-CA) treatment on metabolic a... more To evaluate the effects of ethinyl estradiol-cyproterone acetate (EE-CA) treatment on metabolic and cardiovascular risk factors, and body fat distribution in polycystic ovary syndrome (PCOS) after 6-month treatment. Thirty women with PCOS were evaluated before and after 6 months of EE-CA treatment. Anthropometrical measurements, hormonal levels, lipid and glucose profile were evaluated. Body fat thickness in four regions and carotid intima media thickness (IMT) were measured. Interval change in antropometric measurements, glucose and lipid profile, carotid IMT and body fat distribution was evaluated before and after 6-month EE-CA treatment. Ferriman-Gallwey score and serum testosterone levels were significantly decreased after EE-CA treatment (p &amp;amp;amp;amp;amp;amp;lt; 0.01). No significant effect was detected on insulin resistance, lipid profile and carotid artery IMT. The visceral, subcutaneous and preperitoneal fat thicknesses decreased, and mid-thigh fat thickness increased after treatment period. However, only the alteration in subcutaneous fat thickness achieved a statistical significance (p &amp;amp;amp;amp;amp;amp;lt; 0.01). The EE-CA is an effective regimen in treatment of hirsutism and menstrual regulation. Although it provides significant decrease in subcutaneous fat thickness after 6-month treatment, it has no beneficial effect with respect to visceral fat thickness, metabolic and cardiovascular risk factors.

Research paper thumbnail of Comparison of aerobic conjunctival bacterial flora in pregnant, reproductive-aged and postmenopausal women

International journal of ophthalmology, 2012

To evaluate the effect of hormonal status on aerobic conjunctival flora in women. One hundred fif... more To evaluate the effect of hormonal status on aerobic conjunctival flora in women. One hundred fifty-eight women [reproductive-aged (n=55), pregnant (n=51), and postmenopausal (n=52)] who admitted to outpatient clinic of Obstetrics and Gynecology Department of Denizli State Hospital were enrolled. Age, body-mass index (BMI), obstetric history, cigarette smoking, drug usage, presence of systemic disease, and intraocular pressure (IOP) were recorded for each patient. The samples were taken from the lower fornix with two culture swabs and directly incubated in culture containing 5% sheep blood, eosin-methylene blue and chocolate agar. The other swab specimen was Gram stained. All growths and microscopic results were analyzed. The coagulase-negative Staphylococcus was the predominant organism isolated in the conjunctival samples in both three groups. The aerobic microorganism growth rate for all isolated aerobic organisms revealed no significant change in the three groups (P >0.05). T...

Research paper thumbnail of Evaluation of risk factors and effect of physical activity in caesarean section in nulliparous women

Journal of Maternal-Fetal and Neonatal Medicine, 2012

The aim of this study was to evaluate risk factors for caesarean section (CS) in nulliparous wome... more The aim of this study was to evaluate risk factors for caesarean section (CS) in nulliparous women and to determine the effect of physical activity on ease of labour. A prospective observational study, including 282 nulliparous women at 37-41 gestational weeks was conducted. Maternal demographic characteristics, obstetric history and Modified Grimby scale for evaluation of physical activity were noted. Patients were classified into spontaneous labour and induction group. Multiple logistic regression model was used to assess independent risk factors for type of delivery. Caesarean rate was increasing with higher educational status (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Maternal height, maternal and paternal age were higher, whereas dilatation on admission was lower in CS group (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Maternal age, weight gain and CS rate were higher in induction group (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Fetal distress as a cause of CS was detected higher in induction group (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Physical activity has no significant effect on mode of delivery (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). Maternal height (p = 0.011), and cervical dilatation on admission (p = 0.004) were identified as predictor factors for CS. Cervical dilatation is the most important negative predictive factor for CS, whereas, moderate physical activity has no effect on mode of delivery. Fetal distress was the most frequent cause of CS in induction group.

Research paper thumbnail of H1N1 infection in Pregnancy: clinical course in two women

Journal of the Turkish German Gynecological Association, 2011

Pregnant women are one of the major risk groups for disease related morbidity and mortality from ... more Pregnant women are one of the major risk groups for disease related morbidity and mortality from influenza A (H1N1, swine flu) pandemic. Healthy pregnant women are supposed to have 4 to 5 fold increased rate of serious illness and hospitalization compared to non-pregnant subjects. Herein, the clinical course of novel influenza A (H1N1) infection in two pregnant women was presented. One woman expired due to delay in treatment, while the other one was discharged on day six after prompt treatment. We would like to emphasize that obstetricians should be aware of the clinical and radiological manifestations of influenza A for prompt diagnosis and treatment. Obstetricians also should prepare themselves to provide adequate care for pregnancy related complications encountered by pregnant women with H1N1 infection. (J Turkish-German Gynecol Assoc 2011; 12: 118-20)