Macronutrient Composition of Colostrum in Mothers with Gestational Diabetes Mellitus

Background: Infants fed breast milk are known to have lower rates of childhood obesity. However, there is evidence suggesting an increased risk of obesity in infants who receive milk from a diabetic mother. The aim of this study was to investigate the calorie and macronutrient content of colostrum in mothers with gestational diabetes mellitus (GDM). Methods: This prospective, controlled study included mothers who had diagnosis of GDM and a control group of mothers without GDM who delivered at term. Colostrum samples were analyzed for macronutrients (fat, protein, and carbohydrate) and calorie content using a human milk analyzer (Miris, Uppsala, Sweden). Results: A total of 92 colostrum samples were analyzed, 31 in the GDM group and 61 in the non-GDM group. The carbohydrate content of colostrum in the GDM group was higher compared with the non-GDM group (p = 0.004). The calorie, fat, and protein contents of colostrum were similar between the groups (p > 0.05). Multiple regression analysis indicated that having GDM was significantly related to carbohydrate content. Conclusion: The colostrum of GDM mothers had higher carbohydrate content. This might be one of the factors explaining the relationship between diabetic breast milk and infantile obesity.

The effectiveness of Teucrium chamaedrys L. extracts on endometriotic implant regression in rat endometriosis model

The aim of the present study was to investigate the therapeutic effects of Teucrium chamaedrys L. (Lamiaceae) in the experimentally induced endometriosis in rats. Endometrial tissue was implanted into the abdominal wall of thirty Sprague Dawley rats; the rats with endometriosis were randomized into five groups and treatment procedure was performed for three weeks. The treatment groups were orally treated with three different extracts of Teucrium chamaedrys. Buserelin acetate (20.00 mg) was given as a reference drug. Vehicle was administered alone to the control group. All rats were sacrified at the end of the experiment. The endometriotic implants were measured, intra-abdominal adhesions were scored and the tissue samples were histopathologically investigated. After the treatment procedure, the volumes of endometrial implant and adhesions were detected to be significantly decreased in the T. chamaedrys extracts treated groups compared to the control group. Therapeutic effect of the T. chamaedrys extracts could be attributed to the both nonpolar and polar secondary metabolites. The study conceived that the different polarity extracts of T. chamaedrys could be beneficial in the treatment of endometriosis.

Polycystic ovary syndrome in adolescents: Q-TOF LC/MS analysis of human plasma metabolome

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone levels. Metabolomics provide information on early biochemical changes in patients. Our aim was to find potential biomarkers on metabolome level to notice PCOS in adolescents and propose treatment opportunities based on our findings on metabolome level. In this study, Q-TOF LC/MS based analysis of the plasma samples of 15 healthy adolescents as control group (Group C) were compared with the plasma samples of 15 adolescents having PCOS (Group T). Raw chromatograms were processed on XCMS using Isotopologue Parameter Optimization (IPO) to optimize XCMS parameters. Finally, 2288 peaks were found but 84 of them had fold changes >1.5 based on normalized peak areas and they were statistically different (p < 0.05) between the groups. These peaks were subjected to MetaboAnalyst 4.0 - MS Peaks to Pathways utility for putative identification. The final list based on putative identification were evaluated through a clinical perspective and the statistically proved variation on the metabolite profiles of Group T and Group C presented that PCOS directly affected the lipid metabolism in the body or occurred as a result of a deformation in the lipid metabolism. Lower amount of Gamma-Tocopherol and higher amount of Coenzyme Q9, which is a product of incomplete Coenzyme Q10 biosynthesis, in the plasma samples of adolescent PCOS patients encouraged us to suggest larger randomized placebo controlled studies for Gamma-Tocopherol and Coenzyme Q10 supplements on the disease situation since our findings on metabolome level were in an accordance with the previous clinical findings.

The impact of Loop Electrosurgical Excision Procedure and cold-knife conization training model on the surgical skills and confidence level

Objective

The purpose of this study is to evaluate the impact of loop electrosurgical excision procedure (LEEP) and cold-knife conization (CKC) active training model on the surgical education and confidence levels of gynecologists.

Materials and Methods

The LEEP and CKC hands-on training model consists of sausage, which is 2.5 cm in diameter, as cervix; plastic cup as vagina; foam rubber as posterior and anterior fornices; and cotton plate as the leukoplakia area. In total, 34 participants performed LEEP and CKC procedures on the training model under the guidance of mentors after theoretical lessons about the transformation zone, indications, and surgical techniques of LEEP and CKC. Afterward, a web-based survey was conducted to measure the effectiveness of this surgical model, and participants graded their learning and confidence levels on the same.

Results

We evaluated the educational levels of the course, which were based on the basic surgical steps of LEEP and CKC procedures, and the confidence levels of the participants with regard to the previous practice or expertise of LEEP and CKC. Importantly, participants in each group had similar learning gains irrespective of previous practice or expertise. Despite a significantly higher pre-course confidence level of participants who had previously performed LEEP (p<0.001) and CKC (p<0.001) against their non-practitioner counterparts, the post-course confidence levels were similar in each group (p=0.127 and p=0.845, respectively). In both groups, the participants had increased mean confidence scores, which were statistically significant for participants who had not previously performed the procedures (p=0.003, LEEP and p=0.002, CKC, respectively).

Conclusion

This surgical training model on LEEP and CKC can impart a better level of education in participants, irrespective of their previous expertise/practice.

Identifying strategies to reduce cesarean section rates by using Robson ten-group classification

OBJECTIVE

To assess the cesarean section (CS) rates using Robson ten-group classification system (RTGCS) and the interventions combined with RTGCS which may reduce the CS rates.

METHODS

A total of 100,326 deliveries at Zekai Tahir Burak Research and Training Hospital in Ankara, Turkey between 2012 and 2018 were included in this study. Interventions including free mobilization of pregnant women, CS decision with the signature of three obstetricians, re-evaluate the CS decision, strictly obeying the failed induction algorithm to reduce the CS rates were started to be applied in 2017. The CS rates between 2012 and 2017 and in 2017 were compared to evaluate the effects of the interventions on CS rate regarding the Robson groups.

RESULTS

The overall CS rates in between 2012 and 2017 significantly reduced from 37,703/84,279 (44.7%) to 6738/16,047 (42.0%) in 2017, p < .001. Cephalopelvic disproportion and suspected macrosomia rates reduced from 4992/37,703 (13.3%) to 683/6738 (10.0%), p < .001 and from 668/37,703 (1.8%) to 96/6738 (1.4%), p = .030, respectively.

CONCLUSIONS

To the best of our knowledge, this study is the first that gives the birth data from Turkey using RTGCS and showed that some interventions combined with RTGCS to reduce CS rates should be properly used.

Serum levels of phthalates and bisphenol-A in patients with primary ovarian insufficiency

OBJECTIVES

Phthalates and bisphenol-A (BPA) may pose a risk for human reproduction. Adverse effects of endocrine disturbing chemicals on animal ovaries have been proposed previously. This study was designed to measure the concentrations of phthalate diesters or their metabolites in serum to evaluate their relevance with primary ovarian insufficiency (POI).

METHODS

This study was designed as a cross sectional and case-control study. The study group consisted of 30 women diagnosed with POI whereas 30 healthy fertile women without any systemic diseases were recruited as a control group. The two groups were matched with respect to age and body mass index and tobacco smoking. Serum phthalate diesters and BPA levels were measured in both groups.

RESULTS

The mean serum level of mono-buthyl phthalate (MBP) was statistically significantly higher in POI group than in control group (8.45 ± 4.2 vs. 5.0 ± 3.47 ng/mL, p < .001). Other serum phthalate metabolites and BPA concentrations were similar among the groups.

CONCLUSIONS

Serum levels of BPA and phthalate metabolites are increased in women diagnosed with POI. However, MBP is the most significant one among them. MBP may be a contributing risk factor in the development of POI.

The role of oxidative stress markers in development of endometrial polyp

OBJECTIVE

To evaluate the association of the oxidative stress markers in patients with endometrial polyp.

METHODS

A total of forty nine patients between 28-47 years of ages who have a suspect evidence of endometrial polyp on transvaginal sonography were enrolled for the study. Hysterosonography was applied all of the patients and patients then were divided into two groups in terms of their hysteroscopic findings. Group 1(control group, n=27) defined who has no endometrial pathology and group 2 (study group, n=22) defined has one or more endometrial polyp on hysteroscopy with guided biopsy. The diagnosis was established by histopathological examination polyps. The parameters compared between groups were; age, body mass index, catalase (CAT), xsantine oxidase (XO), malondialdehyde (MDA) levels.

RESULTS

There were no statistically significant differences between groups in terms of age and BMI. Catalase, xsantine oxidase and malondialdehyde levels were statically significantly different between the groups (p < 0,05). The mean of polyp diameter size were 17.95 ±0.45 mm and the number of the polyp per patient was 1.54 ± 0.67.

CONCLUSION

According to our study, serum catalase, xsantine oxidase and malondialdehyde levels may be discriminative parameters for patients with endometrial polyp.