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Bozoklu Akkar O, Sancakdar E, Karakus S, Yildiz C, Akkar I, Arslan M, Sahin IO, Imir Yenicesu AG, Cetin A. Evaluation of Maternal Serum 25-Hydroxyvitamin D, Paraoxonase 1 Levels, and Neutrophil-to-Lymphocyte Ratio in Spontaneous Preterm Birth. Med Sci Monit 2016; 22:1238-43. [PMID: 27072780 PMCID: PMC4832961 DOI: 10.12659/msm.897983] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The aim of this study was to evaluate the association of maternal serum 25-hydroxyvitamin D, paraoxonase 1, and neutrophil-to-lymphocyte ratio in women having early spontaneous preterm birth without clinical chorioamnionitis. Material/Methods This study was prospectively administered in women referred to our obstetrics service with preterm labor that resulted in preterm birth (n=35) and term labor that ended in term birth (n=44). The maternal serum levels of 25-hydroxyvitamin D and paraoxonase 1 were measured and neutrophil-to-lymphocyte ratio was calculated. Results The 25-hydroxyvitamin D and paraoxonase 1 levels of the preterm group were significantly lower than those of the term group (p<0.05). The neutrophil-to-lymphocyte ratio value of the preterm group was significantly higher than that of the term group (p<0.05). There was a significant but small positive correlation between the serum levels of 25-hydroxyvitamin D and paraoxonase 1 in the preterm group (r=0.35; p=0.021). Conclusions Decreased maternal serum 25-hydroxyvitamin D and paraoxonase 1 levels and increased neutrophil-to-lymphocyte ratio may have a role in the etiology of spontaneous preterm birth.
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Affiliation(s)
- Ozlem Bozoklu Akkar
- Department of Obstetrics and Gynecology, Cumhuriyet University, Sivas, Turkey
| | - Enver Sancakdar
- Department of Medical Biochemistry, Cumhuriyet University, Sivas, Turkey
| | - Savas Karakus
- Department of Obstetrics and Gynecology, Cumhuriyet University, Sivas, Turkey
| | - Caglar Yildiz
- Department of Obstetrics and Gynecology, Cumhuriyet University, Sivas, Turkey
| | - Ismail Akkar
- Department of Pediatrics, Sivas State Hospital, Sivas, Turkey
| | - Murat Arslan
- Department of Obstetrics and Gynecology, Sivas State Hospital, Sivas, Turkey
| | | | | | - Ali Cetin
- Department of Obstetrics and Gynecology, Cumhuriyet University, Sivas, Turkey
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Karakus S, Akkar OB, Yildiz C, Yenicesu GI, Cetin M, Cetin A. Comparison of Effectiveness of Laminaria versus Vaginal Misoprostol for Cervical Preparation Before Operative Hysteroscopy in Women of Reproductive Age: A Prospective Randomized Trial. J Minim Invasive Gynecol 2016; 23:46-52. [PMID: 26272687 DOI: 10.1016/j.jmig.2015.08.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 08/05/2015] [Accepted: 08/06/2015] [Indexed: 11/20/2022]
Abstract
STUDY OBJECTIVE To compare the effectiveness and safety of intracervical laminaria dilator versus intravaginal misoprostol administered before surgery to facilitate cervical dilation before operative hysteroscopy. DESIGN A prospective randomized study (Canadian Task Force classification 1). SETTING A university hospital. PATIENTS A total of 150 women were assigned at random to the following groups: laminaria dilation (n = 50), misoprostol dilation (n = 50), and mechanical dilation (n = 50). INTERVENTIONS Hysteroscopic surgery of intrauterine lesions. MEASUREMENTS AND MAIN RESULTS In this study, 150 women were assigned at random to receive cervical priming with an intracervical laminaria dilator, 200 μg of intravaginal misoprostol, or a mechanical dilator before operative hysteroscopy. Cervical response, surgical outcome, and complications of operative hysteroscopy were assessed. Visual analog scale (VAS) pain scores were recorded in the misoprostol and laminaria dilation groups. Demographic variables of the study groups were comparable (p = .278-.988). The duration of cervical pretreatment was similar with the intracervical laminaria dilator and intravaginal misoprostol (p = .803); however, intravaginal misoprostol was associated with more adverse effects (p = .031). Compared with the misoprostol dilation group, in which all patients required additional cervical dilation, notably fewer patients in the laminaria dilation group required additional cervical dilation after cervical preparation (p = .001). VAS pain scores were significantly higher in the laminaria dilation group, however (p = .001). CONCLUSION Cervical priming with an intracervical laminaria dilator before operative hysteroscopy reduces the need for cervical dilation and better facilitates hysteroscopic surgery compared with intravaginal misoprostol. Oral analgesic use may be required before the use of this device.
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Affiliation(s)
- Savas Karakus
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey.
| | - Ozlem Bozoklu Akkar
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Caglar Yildiz
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Gonca Imir Yenicesu
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Meral Cetin
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Ali Cetin
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey
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Kula A, Akkar OB, Gulturk S, Cetin M, Cetin A. Combination of paracetamol or ketamine with meperidine enhances antinociception. Hum Exp Toxicol 2015; 35:887-92. [PMID: 26429929 DOI: 10.1177/0960327115608245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Dealing with pain is one of the most important issues of medicine. All of the studies aim to find a drug or combination of drugs in order to have more effective analgesia and less side effects. In this study, we aimed to investigate the antinociceptive effects of combination of paracetamol or ketamine with meperidine. METHODS In this study, we evaluated the systemic antinociceptive effects of meperidine, paracetamol, and ketamine one by one with their combinations. We used 50 mice (weighing 25-30 g), which were divided into 5 groups with each group consisting of 10 mice. Meperidine was applied to animals with increasing doses and their tail flick latencies (TFL) were noted at 20, 40, 60, 90, 120, 180, and 240 min. The same protocol was repeated after the combination of meperidine with paracetamol or ketamine. RESULTS There was no analgesic effect on low doses of ketamine and paracetamol at TFL measurements. But the combination of low doses of these drugs with meperidine significantly increased TFL (p < 0.05). CONCLUSION It was observed that meperidine + ketamine and meperidine + paracetamol combinations have potent analgesic effect.
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Affiliation(s)
- A Kula
- Malatya State Hospital, Malatya, Turkey
| | - O B Akkar
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - S Gulturk
- Department of Physiology, Faculty of Medicine; Cumhuriyet University, Sivas, Turkey
| | - M Cetin
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - A Cetin
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
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Karakus S, Bozoklu Akkar O, Yildiz C, Sancakdar E, Cetin M, Cetin A. Serum levels of ET-1, M30, and angiopoietins-1 and -2 in HELLP syndrome and preeclampsia compared to controls. Arch Gynecol Obstet 2015; 293:351-9. [PMID: 26138305 DOI: 10.1007/s00404-015-3803-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 06/23/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE We aimed to compare the serum levels of ET-1, M30, and Angs-1 and -2 in patients with preeclampsia or HELLP syndrome, and normal controls. METHODS In this cross-sectional study of 74 pregnant women, serum levels of ET-1, M30, and Angs-1 and -2 were measured in preeclamptic patients with or without HELLP syndrome. 74 pregnant women; 37 had healthy pregnancies, 25 had preeclampsia (PE), and 12 had HELLP syndrome. RESULTS The age, body mass index, gravidity, and parity of patients with normal pregnancy, PE, and HELLP syndrome were comparable (p > 0.05). In HELLP syndrome, compared to healthy or preeclamptic pregnancies, platelet count was lower (p < 0.05) and the values of hepatic function tests were higher (p < 0.05). In HELLP syndrome, ET-1, M30, and Ang-2 were higher compared to healthy or preeclamptic pregnancies (p < 0.05); however, they increased in preeclamptic pregnancies compared to healthy pregnancies though not significant (p > 0.05). In PE or HELLP syndrome, Ang-1 was higher compared to a healthy pregnancy (p < 0.05); however, in HELLP syndrome, it was also higher than in PE though not significant (p > 0.05). We found no significant correlation among these biomarkers and hematological and biochemical parameters (p > 0.05). CONCLUSION For the diagnosis of HELLP syndrome, increased levels of ET-1, M30, and Angs-1 and -2 appear as promising biomarkers after determination of their standardized threshold levels after further studies. As an apoptosis-related biomarker, serum M30 level has a merit to be the most promising test for prediction or differential diagnosis of HELLP syndrome in PE patients.
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Affiliation(s)
- Savas Karakus
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, 58140, Sivas, Turkey.
| | - Ozlem Bozoklu Akkar
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, 58140, Sivas, Turkey.
| | - Caglar Yildiz
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, 58140, Sivas, Turkey.
| | - Enver Sancakdar
- Department of Biochemistry, Cumhuriyet University School of Medicine, 58140, Sivas, Turkey.
| | - Meral Cetin
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, 58140, Sivas, Turkey.
| | - Ali Cetin
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, 58140, Sivas, Turkey.
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Yildiz C, Kacan T, Akkar OB, Karakus S, Kacan SB, Ozer H, Cetin A. Effects of Pazopanib, Sunitinib, and Sorafenib, Anti-VEGF Agents, on the Growth of Experimental Endometriosis in Rats. Reprod Sci 2015; 22:1445-51. [DOI: 10.1177/1933719115584448] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Caglar Yildiz
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Turgut Kacan
- Department of Medical Oncology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Ozlem Bozoklu Akkar
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Savas Karakus
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | | | - Hatice Ozer
- Department of Pathology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Ali Cetin
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey
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Akkar OB, Yildiz C, Karakus S, Akkar I, Cetin A, Yanik A, Yenicesu AGI, Boztosun A. Antenatal counseling against passive smoking may improve birth weight for gestational age. CLIN EXP OBSTET GYN 2015; 42:805-809. [PMID: 26753491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM The authors determined the impact of antenatal counseling against exposure to environmental cigarette smoke on the prevention of reduced neonatal birth weight according to gestational age. MATERIALS AND METHODS A cross-sectional study was conducted in pregnant women, with 77 passive smokers and 88 non-smokers. During motivational interviews, passive smoking status was monitored and additional follow-up visits were arranged to increase the knowledge regarding perinatal risks of passive smoking, including intrauterine growth restriction and low birth weight. The authors aimed to increase the woman's motivation to avoid second-hand tobacco smoke exposure. RESULTS The demographic and clinical findings of the study groups were found considerably similar, in this context, and the authors found positive and strong correlations between the gestational age and neonatal birth weight (r = 0.80 and r = 0.76, respectively; p < 0.05). CONCLUSIONS During antenatal care of women, regular counseling against second-hand smoke exposure may prevent negative effect of passive smoking on neonatal birth weight according to gestational age. This promising finding needs to be supported by further studies with larger sample size considering covariates relevant to passive smoking.
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Gozel MG, Elaldi N, Engin A, Akkar OB, Bolat F, Celik C. Favorable outcomes for both mother and baby are possible in pregnant women with Crimean-Congo hemorrhagic fever disease: a case series and literature review. Gynecol Obstet Invest 2014; 77:266-71. [PMID: 24732981 DOI: 10.1159/000360699] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 02/17/2014] [Indexed: 11/19/2022]
Abstract
To assess the impact of Crimean-Congo hemorrhagic fever (CCHF) infection during pregnancy on maternal and fetal outcomes, we present the clinical and laboratory findings and outcomes of 5 pregnant women with CCHF infection as well as fetal outcomes. We also reviewed previously reported cases with CCHF infection in pregnant women. All pregnant women with CCHF infection who had been hospitalized between August 2007 and September 2011 were included. The gestational ages at the time of CCHF infection were 8, 18, 20, 21 and 32 weeks. CCHF infection was acquired during the 1st trimester in only 1 case and resulted in spontaneous abortion. The other 4 pregnant women completely recovered, all reached a healthy full-term gestation and 4 term babies were born. All infants had normal birth weight and were found to be healthy on their first examination and follow-up. In the literature concerning CCHF infection in pregnancy, 8 published articles including case reports or case series and 1 poster presentation including 1 case could be accessed. In conclusion, there is a risk of vertical transmission of CCHF infection, and infections acquired early in gestation had a poor prognosis for the fetus.
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Affiliation(s)
- Mustafa Gokhan Gozel
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
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Ozer H, Boztosun A, Açmaz G, Atilgan R, Akkar OB, Kosar MI. The efficacy of bevacizumab, sorafenib, and retinoic acid on rat endometriosis model. Reprod Sci 2012; 20:26-32. [PMID: 22895024 DOI: 10.1177/1933719112452941] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Blood vessels are necessary for development and maintenance of the endometriosis and blood flow supplies oxygen and essential nutrient to the disease. Local angiogenesis is regulated by vascular endothelial growth factor (VEGF) and inhibitors of VEGF may be a novel therapeutic approach. We inducted endometriosis in 43 rats and they were randomly allocated into 4 groups. The rats in group I (control n = 11) were given no medication. The rats in group II (n = 11) were given bevacizumab. The rats in group III (n = 11) were given Sorafenib, and the rats in group IV (n = 10) were given retinoic acid (RA). Then groups were compared for microvessel density, VEGF, soluble tyrosine-kinase receptor, ovarian reserve, and treatment effectivity. All these medications were effective on endometriosis and we detected that volume of endometriotic implants were significantly decreased. Ovarian reserve was not affected from the medication, in addition RA have induced reproductive capacity.
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Affiliation(s)
- Hatice Ozer
- Department of Pathology, Cumhuriyet University School of Medicine, Sivas, Turkey
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