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Syed RU, Afsar S, Aboshouk NAM, Salem Alanzi S, Abdalla RAH, Khalifa AAS, Enrera JA, Elafandy NM, Abdalla RAH, Ali OHH, Satheesh Kumar G, Alshammari MD. LncRNAs in necroptosis: Deciphering their role in cancer pathogenesis and therapy. Pathol Res Pract 2024; 256:155252. [PMID: 38479121 DOI: 10.1016/j.prp.2024.155252] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 03/02/2024] [Accepted: 03/04/2024] [Indexed: 04/14/2024]
Abstract
Necroptosis, a controlled type of cell death that is different from apoptosis, has become a key figure in the aetiology of cancer and offers a possible target for treatment. A growing number of biological activities, including necroptosis, have been linked to long noncoding RNAs (lncRNAs), a varied family of RNA molecules with limited capacity to code for proteins. The complex interactions between LncRNAs and important molecular effectors of necroptosis, including mixed lineage kinase domain-like pseudokinase (MLKL) and receptor-interacting protein kinase 3 (RIPK3), will be investigated. We will explore the many methods that LncRNAs use to affect necroptosis, including protein-protein interactions, transcriptional control, and post-transcriptional modification. Additionally, the deregulation of certain LncRNAs in different forms of cancer will be discussed, highlighting their dual function in influencing necroptotic processes as tumour suppressors and oncogenes. The goal of this study is to thoroughly examine the complex role that LncRNAs play in controlling necroptotic pathways and how that regulation affects the onset and spread of cancer. In the necroptosis for cancer treatment, this review will also provide insight into the possible therapeutic uses of targeting LncRNAs. Techniques utilising LncRNA-based medicines show promise in controlling necroptotic pathways to prevent cancer from spreading and improve the effectiveness of treatment.
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Affiliation(s)
- Rahamat Unissa Syed
- Department of Pharmaceutics, College of Pharmacy, University of Ha'il, Hail 81442, Saudi Arabia.
| | - S Afsar
- Department of Virology, Sri Venkateswara University, Tirupathi, Andhra Pradesh 517502, India.
| | - Nayla Ahmed Mohammed Aboshouk
- Department of Clinical laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail 81442, Saudi Arabia
| | | | | | - Amna Abakar Suleiman Khalifa
- Department of Clinical laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail 81442, Saudi Arabia
| | - Jerlyn Apatan Enrera
- Department of Clinical laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail 81442, Saudi Arabia
| | - Nancy Mohammad Elafandy
- Department of Clinical laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail 81442, Saudi Arabia
| | - Randa Abdeen Husien Abdalla
- Department of Clinical laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail 81442, Saudi Arabia
| | - Omar Hafiz Haj Ali
- Department of Clinical laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail 81442, Saudi Arabia
| | - G Satheesh Kumar
- Department of Pharmaceutical Chemistry, College of Pharmacy, Seven Hills College of Pharmacy, Venkataramapuram, Tirupati, India
| | - Maali D Alshammari
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of Hail, Hail 81442, Saudi Arabia
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Khojali WMA, Khalifa NE, Alshammari F, Afsar S, Aboshouk NAM, Khalifa AAS, Enrera JA, Elafandy NM, Abdalla RAH, Ali OHH, Syed RU, Nagaraju P. Pyroptosis-related non-coding RNAs emerging players in atherosclerosis pathology. Pathol Res Pract 2024; 255:155219. [PMID: 38401375 DOI: 10.1016/j.prp.2024.155219] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 02/26/2024]
Abstract
Globally, atherosclerosis a persistent inflammatory condition of the artery walls continues to be the primary cause of cardiovascular illness and death. The ncRNAs are important regulators of important signalling pathways that affect pyroptosis and the inflammatory environment in atherosclerotic plaques. Comprehending the complex interaction between pyroptosis and non-coding RNAs (ncRNAs) offers fresh perspectives on putative therapeutic targets for ameliorating cardiovascular problems linked to atherosclerosis. The discovery of particular non-coding RNA signatures linked to the advancement of atherosclerosis could lead to the creation of novel biomarkers for risk assessment and customised treatment approaches. A thorough investigation of the regulatory networks regulated by these non-coding RNAs has been made possible by the combination of cutting-edge molecular methods and bioinformatics tools. Studying pyroptosis-related ncRNAs in detail appears to be a promising way to advance our understanding of disease pathophysiology and develop focused therapeutic methods as we work to unravel the complex molecular tapestry of atherosclerosis. This review explores the emerging significance of non-coding RNAs (ncRNAs) in the regulation of pyroptosis and their consequential impact on atherosclerosis pathology.
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Affiliation(s)
- Weam M A Khojali
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of Hail, Hail 81442, Saudi Arabia; Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Omdurman Islamic University, Omdurman 14415, Republic of the Sudan
| | - Nasrin E Khalifa
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail 81442, Saudi Arabia; Department of Pharmaceutics, Faculty of Pharmacy, University of Khartoum, Khartoum 11115, Republic of the Sudan
| | - Farhan Alshammari
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail 81442, Saudi Arabia
| | - S Afsar
- Department of Virology, Sri Venkateswara University, Tirupathi, Andhra Pradesh 517502, India.
| | - Nayla Ahmed Mohammed Aboshouk
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail 81442, Saudi Arabia
| | - Amna Abakar Suleiman Khalifa
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail 81442, Saudi Arabia
| | - Jerlyn Apatan Enrera
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail 81442, Saudi Arabia
| | - Nancy Mohammad Elafandy
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail 81442, Saudi Arabia
| | - Randa Abdeen Husien Abdalla
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail 81442, Saudi Arabia
| | - Omar Hafiz Haj Ali
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail 81442, Saudi Arabia
| | - Rahamat Unissa Syed
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail 81442, Saudi Arabia.
| | - Potnuri Nagaraju
- Department of Pharmaceutics, Mandesh Institute of Pharmaceutical Science and Research Center, Maharashtra, India
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Camili FE, Akis M, Adali E, Hismiogullari AA, Taskin MI, Guney G, Afsar S. Oncostatin M Is Related to Polycystic Ovary Syndrome-Case Control Study. Biomedicines 2024; 12:355. [PMID: 38397957 PMCID: PMC10886802 DOI: 10.3390/biomedicines12020355] [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] [Received: 12/12/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Oncostatin M, a novel adipokine, plays a role in oogenesis, lipogenesis, and inflammation and may contribute to polycystic ovary syndrome pathogenesis and related metabolic problems. Adipokines are believed to contribute to developing polycystic ovary syndrome and its accompanying metabolic parameters, such as dyslipidemia, insulin resistance, and cardiovascular diseases. Methods: In this case-control study, the patients were grouped in a 1:1 ratio into either the polycystic ovary syndrome (n = 32) or the control group (n = 32). Serum levels of fasting glucose, insulin, C-reactive protein, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, white blood cell count, thyroid-stimulating hormone, luteinizing hormone, follicle-stimulating hormone, total testosterone, prolactin, estradiol, homeostasis model assessment of insulin resistance, and oncostatin M were analyzed. Results: Oncostatin M levels were significantly lower, but C-reactive protein levels were substantially higher in the polycystic ovary syndrome group than in the control group (p = 0.002, p = 0.001, respectively). Oncostatin M was inversely correlated with total cholesterol, non-high-density lipoprotein cholesterol, fasting glucose, and the luteinizing hormone/follicle-stimulating hormone ratio (ρ = -0.329, p =0.017; ρ = -0.386, p = 0.005; ρ = -0.440, p = 0.001; ρ = -0.316, p = 0.023, respectively). Conversely, there was no correlation between oncostatin M and total testosterone level (ρ = 0.220; p = 0.118). In the context of inflammation and metabolic parameters, oncostatin M was inversely correlated with C-reactive protein, homeostatic model assessment for insulin resistance score, and low-density lipoprotein cholesterol (ρ = -0.353, p = 0.019; ρ = -0.275, p = 0.048; ρ = -0.470, p < 0.001, respectively). Conclusions: Plasma oncostatin M levels were considerably lower in patients with polycystic ovary syndrome than in the control group, and this was inversely correlated with the hormonal and metabolic parameters of polycystic ovary syndrome. Thus, oncostatin M may be a novel therapeutic target for polycystic ovary syndrome and its metabolic parameters.
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Affiliation(s)
- Figen Efe Camili
- Department of Obstetrics and Gynecology, School of Medicine, Balikesir University, 10145 Balikesir, Türkiye; (F.E.C.); (E.A.); (M.I.T.); (G.G.)
| | - Merve Akis
- Department of Medical Biochemistry, School of Medicine, Balikesir University, 10145 Balikesir, Türkiye; (M.A.); (A.A.H.)
| | - Ertan Adali
- Department of Obstetrics and Gynecology, School of Medicine, Balikesir University, 10145 Balikesir, Türkiye; (F.E.C.); (E.A.); (M.I.T.); (G.G.)
| | - Adnan Adil Hismiogullari
- Department of Medical Biochemistry, School of Medicine, Balikesir University, 10145 Balikesir, Türkiye; (M.A.); (A.A.H.)
| | - Mine Islimye Taskin
- Department of Obstetrics and Gynecology, School of Medicine, Balikesir University, 10145 Balikesir, Türkiye; (F.E.C.); (E.A.); (M.I.T.); (G.G.)
| | - Gurhan Guney
- Department of Obstetrics and Gynecology, School of Medicine, Balikesir University, 10145 Balikesir, Türkiye; (F.E.C.); (E.A.); (M.I.T.); (G.G.)
| | - Selim Afsar
- Department of Obstetrics and Gynecology, School of Medicine, Balikesir University, 10145 Balikesir, Türkiye; (F.E.C.); (E.A.); (M.I.T.); (G.G.)
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Talmac MA, Yuksek SC, Afsar S, Bestel A, Gunay I, Ozdemir I. How do contraception preferences change over time? Eight years of experience in a tertiary hospital. Saudi Med J 2024; 45:93-97. [PMID: 38220240 PMCID: PMC10807679 DOI: 10.15537/smj.2024.45.1.20230348] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/06/2023] [Indexed: 01/16/2024] Open
Abstract
OBJECTIVES To examine the contraceptive preferences of women based on their age and to track changes in these preferences over time. METHODS This was an observational, retrospective cross-sectional study. Data from 2742 patients were evaluated for this study. The patient group of the first 4 years was classified as Group I (n=1371) and the last 4 years was classified as Group II (n=1371). The preferred contraception methods between the groups and their changes across the years were examined. RESULTS Coitus interruptus was found to be the prevailing contraceptive method across all age groups, with 304 (70.9%) in 18-24 age group; 1314 (65.4%) in 25-40 age group; and 148 (48.8%) in 41-53 age group using this method. Breastfeeding rates were also analyzed across age groups, revealing that 11% of patients aged 18-24 years, 5% of patients aged 25-40 years, and 1.7% of patients aged 41-53 years were breastfeeding. Among these patients, 114 (74.5%) were not using any contraception method, while coitus interruptus remained the most popular choice. CONCLUSION It was determined that there are many couples who do not have sufficient knowledge regarding family planning and birth control in our country. At the same time, the use of birth control methods has increased due to the increase in the education level of women and easier access to sexual health services.
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Affiliation(s)
- Merve A. Talmac
- From the Department of Gynecological Oncology (Talmac, Afsar); from the
Department of Obstetrics and Gynecology (Gunay), Basaksehir Cam and Sakura
State Hospital, University of Health Sciences, and from the Department of
Obstetrics and Gynecology (Yuksek, Bestel, Ozdemir), Kanuni Sultan Suleyman
Training and Research Hospital, University of Health Sciences, Istanbul,
Turkey.
| | - Seyma C. Yuksek
- From the Department of Gynecological Oncology (Talmac, Afsar); from the
Department of Obstetrics and Gynecology (Gunay), Basaksehir Cam and Sakura
State Hospital, University of Health Sciences, and from the Department of
Obstetrics and Gynecology (Yuksek, Bestel, Ozdemir), Kanuni Sultan Suleyman
Training and Research Hospital, University of Health Sciences, Istanbul,
Turkey.
| | - Selim Afsar
- From the Department of Gynecological Oncology (Talmac, Afsar); from the
Department of Obstetrics and Gynecology (Gunay), Basaksehir Cam and Sakura
State Hospital, University of Health Sciences, and from the Department of
Obstetrics and Gynecology (Yuksek, Bestel, Ozdemir), Kanuni Sultan Suleyman
Training and Research Hospital, University of Health Sciences, Istanbul,
Turkey.
| | - Aysegul Bestel
- From the Department of Gynecological Oncology (Talmac, Afsar); from the
Department of Obstetrics and Gynecology (Gunay), Basaksehir Cam and Sakura
State Hospital, University of Health Sciences, and from the Department of
Obstetrics and Gynecology (Yuksek, Bestel, Ozdemir), Kanuni Sultan Suleyman
Training and Research Hospital, University of Health Sciences, Istanbul,
Turkey.
| | - Izel Gunay
- From the Department of Gynecological Oncology (Talmac, Afsar); from the
Department of Obstetrics and Gynecology (Gunay), Basaksehir Cam and Sakura
State Hospital, University of Health Sciences, and from the Department of
Obstetrics and Gynecology (Yuksek, Bestel, Ozdemir), Kanuni Sultan Suleyman
Training and Research Hospital, University of Health Sciences, Istanbul,
Turkey.
| | - Ismail Ozdemir
- From the Department of Gynecological Oncology (Talmac, Afsar); from the
Department of Obstetrics and Gynecology (Gunay), Basaksehir Cam and Sakura
State Hospital, University of Health Sciences, and from the Department of
Obstetrics and Gynecology (Yuksek, Bestel, Ozdemir), Kanuni Sultan Suleyman
Training and Research Hospital, University of Health Sciences, Istanbul,
Turkey.
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Afsar S, Syed RU, Bin Break MK, Alsukaybi RH, Alanzi RA, Alshobrmi AM, Alshagdali NM, Alshammari AD, Alharbi FM, Alshammari AM, Algharbi WF, Albrykan KM, Alshammari FN. The dual role of MiR-210 in the aetiology of cancer: A focus on hypoxia-inducible factor signalling. Pathol Res Pract 2024; 253:155018. [PMID: 38070222 DOI: 10.1016/j.prp.2023.155018] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 01/24/2024]
Abstract
Tumorigenesis exemplifies the complex process of neoplasm origination, which is characterised by somatic genetic alterations and abnormal cellular growth. This multidimensional phenomenon transforms previously dormant cells into malignant equivalents, resulting in uncontrollable proliferation and clonal expansion. Various elements, including random mutations, harmful environmental substances, and genetic predispositions, influence tumorigenesis's aetiology. MicroRNAs (miRNAs) are now recognised as crucial determinants of gene expression and key players in several biological methods, including oncogenesis. A well-known hypoxia-inducible miRNA is MiR-210, which is of particular interest because of its complicated role in the aetiology of cancer and a variation of physiological and pathological situations. MiR-210 significantly impacts cancer by controlling the hypoxia-inducible factor (HIF) signalling pathway. By supporting angiogenesis, metabolic reprogramming, and cellular survival in hypoxic microenvironments, HIF signalling orchestrates adaptive responses, accelerating the unstoppable development of tumorous growth. Targeting several components of this cascade, including HIF-1, HIF-3, and FIH-1, MiR-210 plays a vital role in modifying HIF signalling and carefully controlling the HIF-mediated response and cellular fates in hypoxic environments. To understand the complexities of this relationship, careful investigation is required at the intersection of MiR-210 and HIF signalling. Understanding this relationship is crucial for uncovering the mechanisms underlying cancer aetiology and developing cutting-edge therapeutic approaches. The current review emphasises MiR-210's significance as a vital regulator of the HIF signalling cascade, with substantial implications spanning a range of tumor pathogenesis.
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Affiliation(s)
- S Afsar
- Department of Virology, Sri Venkateswara University, Tirupathi, Andhra Pradesh 517502, India
| | - Rahamat Unissa Syed
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail 81442, Saudi Arabia.
| | - Mohammed Khaled Bin Break
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of Hail, Hail 81442, Saudi Arabia; Medical and Diagnostic Research Centre, University of Hail, Hail 55473, Saudi Arabia
| | | | - Reem A Alanzi
- College of Pharmacy, University of Hail, Hail 81442, Saudi Arabia
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Subaiea GM, Syed RU, Afsar S, Alhaidan TMS, Alzammay SA, Alrashidi AA, Alrowaili SF, Alshelaly DA, Alenezi AMSRA. Non-coding RNAs (ncRNAs) and multidrug resistance in glioblastoma: Therapeutic challenges and opportunities. Pathol Res Pract 2024; 253:155022. [PMID: 38086292 DOI: 10.1016/j.prp.2023.155022] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 01/24/2024]
Abstract
Non-coding RNAs (ncRNAs) have been recognized as pivotal regulators of transcriptional and post-transcriptional gene modulation, exerting a profound influence on a diverse array of biological and pathological cascades, including the intricate mechanisms underlying tumorigenesis and the acquisition of drug resistance in neoplastic cells. Glioblastoma (GBM), recognized as the foremost and most aggressive neoplasm originating in the brain, is distinguished by its formidable resistance to the cytotoxic effects of chemotherapeutic agents and ionizing radiation. Recent years have witnessed an escalating interest in comprehending the involvement of ncRNAs, particularly lncRNAs, in GBM chemoresistance. LncRNAs, a subclass of ncRNAs, have been demonstrated as dynamic modulators of gene expression at the epigenetic, transcriptional, and post-transcriptional levels. Disruption in the regulation of lncRNAs has been observed across various human malignancies, including GBM, and has been linked with developing multidrug resistance (MDR) against standard chemotherapeutic agents. The potential of targeting specific ncRNAs or their downstream effectors to surmount chemoresistance is also critically evaluated, specifically focusing on ongoing preclinical and clinical investigations exploring ncRNA-based therapeutic strategies for glioblastoma. Nonetheless, targeting lncRNAs for therapeutic objectives presents hurdles, including overcoming the blood-brain barrier and the brief lifespan of oligonucleotide RNA molecules. Understanding the complex relationship between ncRNAs and the chemoresistance characteristic in glioblastoma provides valuable insights into the fundamental molecular mechanisms. It opens the path for the progression of innovative and effective therapeutic approaches to counter the therapeutic challenges posed by this aggressive brain tumor. This comprehensive review highlights the complex functions of diverse ncRNAs, including miRNAs, circRNAs, and lncRNAs, in mediating glioblastoma's chemoresistance.
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Affiliation(s)
- Gehad Mohammed Subaiea
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Hail, Hail 81442, Saudi Arabia
| | - Rahamat Unissa Syed
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail 81442, Saudi Arabia.
| | - S Afsar
- Department of Virology, Sri Venkateswara University, Tirupathi, Andhra Pradesh 517502, India.
| | | | - Seham Ahmed Alzammay
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Afsar S, Turan G, Sonmez AY, Usta CS, Usta A. Fetal vascular malperfusion score is linked with developing preeclampsia in women with gestational diabetes mellitus: a retrospective cohort study. Rev Assoc Med Bras (1992) 2023; 69:e20230795. [PMID: 37971131 PMCID: PMC10645183 DOI: 10.1590/1806-9282.20230795] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 08/27/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Fetal vascular malperfusion is associated with poor perinatal outcomes in women with preeclampsia and gestational diabetes mellitus. The aim of this study was to determine the association between fetal vascular malperfusion score and syncytiotrophoblast basement membrane thickness and clinicopathological variables, such as developing preeclampsia in women with gestational diabetes mellitus. METHODS This retrospective cohort study included 65 pregnant participants (34 with gestational diabetes mellitus and 31 controls) between January 2019 and January 2022. Gestational diabetes mellitus was diagnosed as ≥2 of 4 elevated values on a 3-h, 100-g oral glucose tolerance test. The fetal vascular malperfusion score was evaluated by endothelial CD34 positivity in the villous stroma of the placenta. The association between fetal vascular malperfusion score and syncytiotrophoblast basement membrane thickness with clinicopathological variables in women with gestational diabetes mellitus was evaluated. RESULTS It was revealed that the gestational diabetes mellitus group had greater fetal vascular malperfusion scores than the control group (gestational diabetes mellitus group fetal vascular malperfusion score: 34.2±9.1 and control group fetal vascular malperfusion score: 26.5±8.7, respectively, p=0.0009). Syncytiotrophoblast basement membrane thickness was correlated with the development of preeclampsia, trophoblast proliferation, and fetal vascular malperfusions (0.3952, p=0.0129; 0.3487, p=0.0211; and 0.4331, p=0.0082, respectively). On the contrary, fetal vascular malperfusions were correlated with the development of preeclampsia, villous edema, and trophoblast proliferation (0.3154, p=0.0343; 0.2922, p=0.4123; and 0.3142, p=0.0355, respectively). CONCLUSION The gestational diabetes mellitus group displayed significantly higher fetal vascular malperfusion scores and thickening of the syncytiotrophoblast basement membrane than the control group. There is a correlation between developing preeclampsia and the fetal vascular malperfusion scores and the syncytiotrophoblast basement membrane thickness.
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Affiliation(s)
- Selim Afsar
- Balikesir University, School of Medicine, Department of Obstetrics and Gynecology – Balikesir, Turkey
| | - Gulay Turan
- Balikesir University, School of Medicine, Department of Pathology – Balikesir, Turkey
| | - Ayse Yigit Sonmez
- Adana Yuregir State Hospital, Department of Obstetrics and Gynecology – Adana, Turkey
| | - Ceyda Sancakli Usta
- Balikesir University, School of Medicine, Department of Obstetrics and Gynecology – Balikesir, Turkey
| | - Akın Usta
- Balikesir University, School of Medicine, Department of Obstetrics and Gynecology – Balikesir, Turkey
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Afsar S, Usta CS, Usta A, Lafcı D, Gunay I, Karabudak CB. Teres lift-up technique: a retrospective comparative study for an alternative route for laparoscopic entry in gynecologic and oncologic surgery. Arch Gynecol Obstet 2023; 308:1549-1554. [PMID: 37650933 DOI: 10.1007/s00404-023-07191-6] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/13/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE Laparoscopic surgery is the favored method for the surgical treatment of gynecologic diseases and malignancies. We have defined an anatomic landmark-based, easy-to-perform, and an alternative way of open laparoscopic entry technique named the ligamentum teres lift-up technique (TLU) that can be used in obese or normal-weight women to tackle the risks of the closed laparoscopic entry technique, namely, Veress needle entry (VNE). STUDY DESIGN In this retrospective comparative study, the participants were equally distributed to either the TLU group (n = 36) or the VNE group (n = 36) in a 1:1 ratio. The participants were stratified according to their BMI as follows: BMI between 20-25 kg/m2 (average weight), 25-30 kg/m2 (overweight), 30-35 kg/m2 (class I obesity), and 35-40 kg/m2 (class II obesity). Both laparoscopic access techniques were compared according to the entry time, vascular or visceral injuries, insufflation failures, trocar-related complications, and omental damage. RESULTS The TLU group had a considerably shorter entry time than the VNE group (74.43 ± 21.45 s versus 192.73 ± 37.93 s; p < 0.001). Only one failed insufflation occurred in the VNE group (p = 0.32); however, that case was successfully insufflated with the TLU technique. Only one intestinal injury was seen in the VNE group, encountered during trocar site closure (p = 0.32). The subgroup analyses of the TLU and VNE groups based on BMI strata revealed a continuation of the statistical significance of entry time between BMI-matched groups. CONCLUSION The current study reveals that the new alternative TLU technique supplies an alternative, validated, and rapid access to the abdominal cavity in normal-weight and obese women. This new approach offers an easy-to-teach and easy-to-perform technique for surgical mentors and residents in gynecologic and oncologic surgeries.
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Affiliation(s)
- Selim Afsar
- Department of Obstetrics and Gynecology, School of Medicine, Faculty of Medicine, Balıkesir University, Cagis Yerleskesi, Bigadic yolu 17 km, 10145, Balikesir, Turkey.
| | - Ceyda Sancaklı Usta
- Department of Obstetrics and Gynecology, School of Medicine, Faculty of Medicine, Balıkesir University, Cagis Yerleskesi, Bigadic yolu 17 km, 10145, Balikesir, Turkey
| | - Akın Usta
- Department of Obstetrics and Gynecology, School of Medicine, Faculty of Medicine, Balıkesir University, Cagis Yerleskesi, Bigadic yolu 17 km, 10145, Balikesir, Turkey
| | - Duygu Lafcı
- Department of Obstetrics and Gynecology, School of Medicine, Faculty of Medicine, Balıkesir University, Cagis Yerleskesi, Bigadic yolu 17 km, 10145, Balikesir, Turkey
| | - Izel Gunay
- Deptment of Obstetrics and Gynecology, Health Sciences University, Istanbul, Turkey
| | - Can Berk Karabudak
- Deptment of Obstetrics and Gynecology, Health Sciences University, Istanbul, Turkey
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Afsar S, Turan G, Guney G, Sahin G, Talmac MA, Afsar CU. The Relationship between Furin and Chronic Inflammation in the Progression of Cervical Intraepithelial Neoplasia to Cancer: A Cross-Sectional Study. Cancers (Basel) 2023; 15:4878. [PMID: 37835572 PMCID: PMC10571943 DOI: 10.3390/cancers15194878] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/22/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVE The current study aimed to delineate the relationship between furin and chronic inflammation while cervical intraepithelial neoplasia progresses to cancer. STUDY DESIGN This cross-sectional study included 81 women who required colposcopic examinations. The study groups were formed based on pathological results: Group I included women with cervical intraepithelial neoplasia (CIN) I (n = 30); Group II included women with CIN II-III (n = 28); and Group III included women with cervical cancer (CC) (n = 23). Furin, ki-67, and p16 levels were evaluated based on immunostaining intensity. The inflammatory indices were calculated in parallel with the literature from routine blood samples retrieved within one week before the procedure. RESULTS Furin expression gradually increased from CIN I to CIN II-III and from CIN II-III to CC, respectively (p < 0.001, p = 0.005). NLR, MLR, PLR, and SII were significantly higher in the CC group (p < 0.001). ROC curve analysis unveiled that NLR, MLR, PLR, and SII predicted the presence of CC with a cutoff value of 2.39 for NLR (sensitivity: 91.3%, specificity: 63.8%, AUROC: 0.79, p < 0.001); a cutoff value of 0.27 for MLR (sensitivity: 78.3%, specificity: 72.4%, AUROC: 0.77, p = 0.009); a cutoff value of 123 for PLR (sensitivity: 100%, specificity: 41.4%, AUROC: 0.70, p = 0.04); and a cutoff value of 747 for SII (sensitivity: 69.6%, specificity: 90.7%, AUROC: 0.71, p = 0.014). CONCLUSION Furin expression increased gradually in parallel with the severity of cervical intraepithelial neoplasia. The inflammatory indices were higher in the presence of CC and denoted a good discrimination ability for predicting cervical cancer.
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Affiliation(s)
- Selim Afsar
- Department of Obstetrics & Gynecology, School of Medicine, Balıkesir University, Cagis Yerleskesi, Bigadic Yolu 17. km, Balikesir 10145, Turkey;
| | - Gulay Turan
- Department of Pathology, School of Medicine, Balıkesir University, Balıkesir 10145, Turkey;
| | - Gurhan Guney
- Department of Obstetrics & Gynecology, School of Medicine, Balıkesir University, Cagis Yerleskesi, Bigadic Yolu 17. km, Balikesir 10145, Turkey;
| | - Gozde Sahin
- Department of Gynecologic Oncology, Health Sciences University, Istanbul 34668, Turkey; (G.S.); (M.A.T.)
| | - Merve Aldıkactıoglu Talmac
- Department of Gynecologic Oncology, Health Sciences University, Istanbul 34668, Turkey; (G.S.); (M.A.T.)
| | - Cigdem Usul Afsar
- Department of Medical Oncology, Health Sciences University, Istanbul 34668, Turkey;
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Abstract
Gynecologic malignancies are one of the most frequent cancers amongst
women. Biomarkers are crucial for the differential diagnosis of adnexal masses;
however, their potential for diagnosis is limited. In the era of difficulty in ovarian
cancer screening, novel biomarkers are defined, but CA125 still remains the most
valuable one. Circulating tumor DNAs, DNA hypermethylation, metabolites,
microRNAs, and kallikreins have recently turned out as ovarian cancer biomarkers and
are being applied to clinical practice. For uterine cancer, genomic classification has
now been described, it will be used as a prognostic tool. In this chapter, we describe
ovarian, endometrial, and cervical cancer biomarkers in detail.
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Affiliation(s)
- Selim Afsar
- Department of Obstetrics and Gynecology, Balıkesir University Medical Faculty, Balikesir,
Turkey
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11
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Afsar S, Yigit A, Ozcaglayan R, Usta CS, Bulbul CB, Turan G. Fetuin-A expression in human umbilical vein endothelial cells and amnion cells of patients with gestational diabetes mellitus. Saudi Med J 2022; 43:694-699. [PMID: 35831000 PMCID: PMC9749698 DOI: 10.15537/smj.2022.43.7.20220283] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To elucidate the link between fetuin-A expression in human umbilical vein endothelial cells (HUVECs) and amnion cells (ACs) and clinicopathological changes in patients with gestational diabetes mellitus (GDM) and newborns. METHODS This retrospective cohort study included 82 pregnant patients (40 with GDM and 42 controls) between January 2019 and January 2022. The patients underwent a one-hour, 50 gram glucose challenge test (GCT) during the 24-28th weeks of pregnancy. Patients with positive GCTs immediately underwent a 3-hour, 100 gram oral glucose tolerance test. The expression level of fetuin-A in UVECs and ACs was evaluated by immunohistochemistry (IHC) and scored based on IHC staining in randomly selected slides. The IHC staining intensity was evaluated by the number of dots, which reflects the expression level of fetuin-A in both HUVECs and ACs. RESULTS The GDM group displayed significantly higher fetuin-A expression in both HUVECs (p<0.0001) and ACs (p=0.0001) when compared with the control group. Fetuin-A expression in HUVECs was correlated with fetal macrosomia, neonatal hypoglycemia, and placental weight. However, there was no correlation with fetuin-A expression in ACs. CONCLUSION There is a correlation between fetal macrosomia, neonatal hypoglycemia, placental weight, and fetuin-A expression of HUVECs in patients with GDM.
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Affiliation(s)
- Selim Afsar
- From the Department of Obstetrics and Gynecology (Afsar, Usta, Bulbul); from the Department of Internal Medicine (Ozcaglayan); from the Department of Pathology (Turan), School of Medicine, Balikesir University, Balikesir, and from the Department of Obstetrics and Gynecology (Yigit), Adana Yuregir Devlet Hastanesi, Adana, Turkey.
- Address correspondence and reprint request to: Dr. Selim Afsar, Department of Obstetrics and Gynecology, Faculty of Medicine, Balıkesir University, Balikesir, Turkey. E-mail: ORCID ID: https://orcid.org/0000-0002-2757-1765
| | - Ayse Yigit
- From the Department of Obstetrics and Gynecology (Afsar, Usta, Bulbul); from the Department of Internal Medicine (Ozcaglayan); from the Department of Pathology (Turan), School of Medicine, Balikesir University, Balikesir, and from the Department of Obstetrics and Gynecology (Yigit), Adana Yuregir Devlet Hastanesi, Adana, Turkey.
| | - Ruhsen Ozcaglayan
- From the Department of Obstetrics and Gynecology (Afsar, Usta, Bulbul); from the Department of Internal Medicine (Ozcaglayan); from the Department of Pathology (Turan), School of Medicine, Balikesir University, Balikesir, and from the Department of Obstetrics and Gynecology (Yigit), Adana Yuregir Devlet Hastanesi, Adana, Turkey.
| | - Ceyda S. Usta
- From the Department of Obstetrics and Gynecology (Afsar, Usta, Bulbul); from the Department of Internal Medicine (Ozcaglayan); from the Department of Pathology (Turan), School of Medicine, Balikesir University, Balikesir, and from the Department of Obstetrics and Gynecology (Yigit), Adana Yuregir Devlet Hastanesi, Adana, Turkey.
| | - Cagla B. Bulbul
- From the Department of Obstetrics and Gynecology (Afsar, Usta, Bulbul); from the Department of Internal Medicine (Ozcaglayan); from the Department of Pathology (Turan), School of Medicine, Balikesir University, Balikesir, and from the Department of Obstetrics and Gynecology (Yigit), Adana Yuregir Devlet Hastanesi, Adana, Turkey.
| | - Gulay Turan
- From the Department of Obstetrics and Gynecology (Afsar, Usta, Bulbul); from the Department of Internal Medicine (Ozcaglayan); from the Department of Pathology (Turan), School of Medicine, Balikesir University, Balikesir, and from the Department of Obstetrics and Gynecology (Yigit), Adana Yuregir Devlet Hastanesi, Adana, Turkey.
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Comba C, Ozdemir IA, Demirayak G, Erdogan SV, Demir O, Özlem Yıldız G, Bulut H, Karakas S, Gulseren V, Afsar S, Gungorduk K. The effect of omentectomy on the blood levels of adipokines in obese patients with endometrial cancer. Obes Res Clin Pract 2022; 16:242-248. [PMID: 35701296 DOI: 10.1016/j.orcp.2022.06.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 04/18/2022] [Accepted: 06/01/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the blood levels of adipokines in obese patients with endometrial cancer who have and have not undergone omentectomy. METHODS Between September 2017 and September 2019, the study recruited 54 patients with endometrial cancer. Measurements were taken of blood levels of human leptin, perilipin-1, adiponectin, adipolin, resistin, visfatin, and estrone preoperatively and postoperatively before adjuvant therapy or at the end of one month. The serum samples were separated by centrifugation for 10 mins at 3,000 revolutions/min, then stored at -80 °C until assay. RESULTS In this prospective study, a total of 54 endometrial cancer patients were analyzed in two separate groups according to the omentectomy status. Comprehensive staging surgery with omentectomy and without omentectomy was performed in 26 patients and 28 patients, respectively. The age, body mass index, body fat index, waist circumference, and skin thickness values of the patients with and without omentectomy were found to be similar. No statistically significant difference was determined between the patients with and without omentectomy in respect of the blood level of the adipokines measured preoperatively. A strong statistically significant correlation was determined between the pre and postoperative levels of Human Leptin (p = 0.002), perilipin-1(p = 0.001), adipolin (p < 0.001), adiponectin (p < 0.001), resistin (p = 0.001), visfatin (p < 0.001), and estrone (p = 0.004) (r = -0.43, -0.47, 0.75, 0.84, -0.47, - 0.58, -0.41, respectively) CONCLUSIONS: Omentectomy affected the postoperative blood levels of adipokines in obese patients with endometrial cancer. As omentectomy may have some positive effects on metabolism in these patients, it may be considered during endometrial cancer surgery due to the possible positive metabolic effects.
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Affiliation(s)
- Cihan Comba
- Department of Gynecologic Oncology, Istanbul Aydin University VM Medical Park Hospital, Istanbul, Turkey.
| | - Isa Aykut Ozdemir
- Department of Gynecologic Oncology, Medipol University Hospital, Istanbul, Turkey.
| | - Gokhan Demirayak
- Department of Gynecologic Oncology, Memorial Sisli Hospital, İstanbul, Turkey.
| | - Sakir Volkan Erdogan
- Department of Obstetrics and Gynecology, Memorial Sisli Hospital, İstanbul, Turkey.
| | - Omer Demir
- Department of Obstetrics and Gynecology, Karadeniz Technical University Hospital, Trabzon, Turkey.
| | - Güneş Özlem Yıldız
- Department of Anesthesiology, Bakırköy Dr Sadi Konuk Training and Research Hospital, University of Health Sciences, İstanbul, Turkey.
| | - Huri Bulut
- Department of Medical Biology, Istinye University Hospital, Istanbul, Turkey.
| | - Sema Karakas
- Department of Gynecologic Oncology, Bakırköy Dr Sadi Konuk Training and Research Hospital, University of Health Sciences, İstanbul, Turkey.
| | - Varol Gulseren
- Department of Gynecologic Oncology, Erciyes University, Kayseri, Turkey.
| | - Selim Afsar
- Department of Gynecologic Oncology, Balikesir University Hospital, Balikesir, Turkey.
| | - Kemal Gungorduk
- Department of Gynecologic Oncology, Muğla Sıtkı Koçman University, Education and Research Hospital, Muğla, Turkey.
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Afsar CU, Afsar S. SARS-CoV-2 (Covid-19): Interferon-epsilon may be responsible of decreased mortality in females. J Reprod Immunol 2020; 141:103154. [PMID: 32521376 PMCID: PMC7265849 DOI: 10.1016/j.jri.2020.103154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/15/2020] [Accepted: 05/29/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Cigdem Usul Afsar
- Balıkesir University Medical Faculty, Department of Internal Medicine and Medical Oncology, Turkey.
| | - Selim Afsar
- Balıkesir Ataturk City Hospital, Department of Gynecologic Oncology, Turkey
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Sancakli Usta C, Altun E, Afsar S, Bulbul CB, Usta A, Adalı E. Overexpression of programmed cell death ligand 1 in patients with CIN and its correlation with human papillomavirus infection and CIN persistence. Infect Agent Cancer 2020; 15:47. [PMID: 32695218 PMCID: PMC7367318 DOI: 10.1186/s13027-020-00312-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/12/2020] [Indexed: 01/07/2023] Open
Abstract
Backround HPV causes specific cell-mediated immunity in the cervix. Mononuclear cells such as helper T cells (CD4+), cytotoxic T cells (CD8+), and dendritic cells play a critical role in the initiation of the HPV-specific immune response and destruction of virus-infected cervical epithelial cells. The programmed cell death ligand 1 (PD-L1) gene encodes an immune inhibitory receptor ligand and overexpression of PD-L1 inhibits T-cell activation and cytokine production. The aim of this study was to investigate the expression of PD-L1 in cervical tissue and its correlation with clinicopathological findings. Methods In this cross-sectional study, a total of 94 women who were referred for colposcopy due to abnormal Papanicolaou (PAP) test results and/or HPV positivity were evaluated. The presence of HR-HPV-DNA was analyzed using type- and gene-specific primers along with commercial real-time polymerase chain reaction. The cervical examination was done with a colposcope. Cervical biopsies were obtained from the areas that were evaluated as abnormal during the colposcopy. Histopathological result of cervical biopsies were defined as no intraepithelial neoplasia (CIN 0), mild CIN (CIN I), and moderate-to-high CIN (CIN II-III). All women were classified into four groups based on their HR-HPV positivity and cervical biopsy results: Group I (controls; n = 29), HR-HPV (-) CIN 0; Group II (n = 21), HR-HPV (+) CIN 0; Group III (n = 20), HR-HPV (+) CIN I; and Group IV (n = 24), HR-HPV (+) CIN II-III. A semi-quantitative scoring system was used to evaluate the degree of Ki-67, p16, and PD-L1 immunoreactivity in the cervical tissue samples. Results We found that PD-L1 expression in both mononuclear cells and in cervical epithelial cells gradually increases from the HR-HPV (-), CIN 0 group to the HR-HPV (+), CIN II-III group (p = 0.0003 and p = 0.0394, respectively) and mononuclear PD-L1 expression was correlated with HPV type, initial Pap test results, HPV persistence, and CIN persistence or recurrence (p = 0.0180, p = 0.0109, p = 0.0042, and p = 0.0189, respectively). Moreover, mononuclear PD-L1 expression was also correlated with Ki-67 and p16 immunoreactivity (p = 0.0432 and p = 0.0166, respectively). Epithelial PD-L1 expression was only correlated with HPV type and the presence of HPV persistence (p = 0.0122 and p = 0.0292, respectively). Conclusion During the initial evaluation of the cervical histology results, the assessment of PD-L1 expression-especially in mononuclear cells in cervical tissue samples-may provide more information on the progression of HR-HPV infection and its persistence.
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Affiliation(s)
- Ceyda Sancakli Usta
- Department of Obstetrics and Gynecology, School of Medicine, Balikesir University, Cagis Yerleskesi, Bigadic yolu 17. km pc:10345, Balikesir, Türkiye
| | - Eren Altun
- Department of Pathology, School of Medicine, Balikesir University, Balikesir, Turkey
| | - Selim Afsar
- Department of Obstetrics and Gynecology, Balikesir Ataturk State Hospital, Balikesir, Turkey
| | - Cagla Bahar Bulbul
- Department of Obstetrics and Gynecology, School of Medicine, Balikesir University, Cagis Yerleskesi, Bigadic yolu 17. km pc:10345, Balikesir, Türkiye
| | - Akin Usta
- Department of Obstetrics and Gynecology, School of Medicine, Balikesir University, Cagis Yerleskesi, Bigadic yolu 17. km pc:10345, Balikesir, Türkiye
| | - Ertan Adalı
- Department of Obstetrics and Gynecology, School of Medicine, Balikesir University, Cagis Yerleskesi, Bigadic yolu 17. km pc:10345, Balikesir, Türkiye
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Özdemir İA, Comba C, Demirayak G, Gülseren V, Erdogan SV, Aslanova F, Afsar S, Gungorduk K. Impact of pre-operative walking on post-operative bowel function in patients with gynecologic cancer. Int J Gynecol Cancer 2019; 29:1311-1316. [PMID: 31326951 DOI: 10.1136/ijgc-2019-000633] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/19/2019] [Accepted: 06/24/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND There is a paucity of data on whether pre-operative walking and functional capacity has a direct association with post-operative gastrointestinal function in patients who have undergone surgery to treat gynecologic cancers. OBJECTIVE To explore the relationship between pre-operative walking and post-operative recovery of bowel function. METHODS This randomized trial was performed from January 1, 2018 to August 31, 2018. All patients had a diagnosis of endometrial or ovarian cancer and were scheduled for comprehensive staging. Group A served as the control group who did not walk regularly on the last night before surgery. Patients in group B walked for 30 min at an average speed of 3 km/h from 20.00 to 20.30 and 21.30. to 22.00 on the last night before surgery under the supervision of a nurse or doctor. The study was registered with clinicaltrials.gov (no: NCT03553121). RESULTS A total of 85 patients were enrolled: 43 patients were assigned to the walking group and 42 to the control group. There were no significant differences in demographics between the groups. Median age was 57.3±8.5 in the control and 59.9±9.1 in the walking group. In addition, 28 patients had endometrial cancer and 14 had ovarian cancer in the control group. 33 patients and 10 patients in the walking group had endometrial and ovarian cancer, respectively. The mean time to first flatus was shorter in the walking group than in the control group (32.5±10.4 vs 40.6±16.9 hours, respectively; p=0.010). In addition, the time to first defecation was significantly shorter in the walking group (62.8±26.7 vs 91.4±51.8 hours; p=0.002). Patients who walked before surgery were less likely to have post-operative paralytic ileus (25.0% vs 60.7%; p=0.003). Walking before the operative period and laparoscopic surgery independently protected against the development of post-operative paralytic ileus. CONCLUSION Walking before surgery expedited time to bowel motility and ability to tolerate food. In addition, this method significantly decreased the risk of post-operative paralytic ileus.We consider that walking before surgery may be integrated into the pre-operative management of patients under going surgery for gynecologic cancers. CLINICAL TRIAL REGISTRATION clinicaltrial.org record number: NCT03553121.
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Affiliation(s)
- İsa Aykut Özdemir
- Bakirkoy Dr Sadi Konuk Training and Research Hospital, Gynecologic Oncology, University of Health Sciences, Istanbul, Turkey
| | - Cihan Comba
- Bakirkoy Dr Sadi Konuk Training and Research Hospital, Gynecologic Oncology, University of Health Sciences, Istanbul, Turkey
| | - Gokhan Demirayak
- Bakirkoy Dr Sadi Konuk Training and Research Hospital, Gynecologic Oncology, University of Health Sciences, Istanbul, Turkey
| | | | - Sakir Volkan Erdogan
- Sadi Konuk Training and Research Hospital, Gynecology and Obstetrics, University of Health Sciences, Istanbul, Turkey
| | - Fidan Aslanova
- Sadi Konuk Training and Research Hospital, Gynecology and Obstetrics, University of Health Sciences, Istanbul, Turkey
| | - Selim Afsar
- Bakirkoy Dr Sadi Konuk Training and Research Hospital, Gynecologic Oncology, University of Health Sciences, Istanbul, Turkey
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Gungor M, Takmaz O, Afsar S, Ozbasli E, Gundogan S. Single-port Robotic Pelvic Bulky Lymph Node Resection: A Case Report. J Minim Invasive Gynecol 2016; 23:1030-1031. [PMID: 27311875 DOI: 10.1016/j.jmig.2016.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 05/25/2016] [Accepted: 05/27/2016] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVE To report the feasibility of bulky pelvic lymph node resection with robotic-assisted single-port laparoscopy in a patient with cervical cancer before chemoradiation therapy. DESIGN Resection of pelvic bulky lymph nodes with a narrated video of da Vinci single-port platform surgery (Intuitive Surgical, Sunnyvale, CA) (Canadian Task Force classification III). SETTING Although not enough evidence exists to reveal that single-site surgery is better than traditional endoscopic surgery, several studies have suggested that single-site robotic surgery has certain advantages such as less postoperative analgesic use, shorter hospital stay, and quicker recovery. Furthermore, robotic single-site surgery has evolved single-site procedures. Compared with the single-port laparoendoscopic procedure, the robotic-assisted single-port laparoscopic procedure offers some advantages to minimally invasive surgery such as greater dexterity, 3-dimensional visualization, and fewer instrument clashes. These advantages make robotic single-port surgery more preferable; nevertheless, the lack of articulating instruments and the low quality of optical exposure are still challenges. Robotic single-port pelvic lymphadenectomy was first described by Tateo et al [1] in an endometrial carcinoma patient. We present a robotic single-port pelvic bulky lymph node resection in an advanced cervical cancer patient. Even though current data are controversial about removing bulky lymph nodes in patients with advanced cervical cancer, some studies have recommended that debulking of tumor-involved lymph nodes before chemoradiation may be benefical for these patients (Leblanc et al [2], Marnitz et al [3]). In our case, the patient underwent robotic-assisted single-port laparoscopy using the da Vinci Single-Site platform. The abdominal cavity was insufflated from a 3-cm umblical incision, and a 5-lumen single port was inserted. Then, an 8.5-mm 3-dimensional camera was inserted through the port, and for dissection and resection 5-mm bipolar fenestrated forceps and a monopolar hook were used. After resection, the bulky lymph nodes were taken out with an endoscopic bag through the assistant port lumen. Additionally, it is important to remember that single-site procedures are not approved by the Food and Drug Administration for lymphadenectomy. PATIENTS A 46-year-old patient diagnosed with advanced-stage cervical cancer (Fédération Internationale de Gynécologie et d'Obstétrique stage IIIB) presented with bilateral pelvic lymph node metastasis revealed by pelvic magnetic resonance imaging. The patient had no history of prior surgery or comorbidity. We decided to perform resection of the pelvic lymph nodes with a robotic-assisted single-site laparoscopic procedure before chemoradiation threapy. INTERVENTIONS Excision of pelvic bulky lymph nodes using robotic-assisted single-port laparoscopy. MEASUREMENTS AND MAIN RESULTS The total operating time was 170 minutes (from docking to the end of the extubation), the estimated blood loss was 30 mL, and no complications occurred. The patient was discharged the day after surgery. The histopathologic examination revealed squamous cell carcinoma metastasis. CONCLUSION Robotic-assisted single-port surgery seems to be an applicable and alternative technique to perform the resection of bulky pelvic lymph nodes in patients with advanced cervical cancer before chemoradiation therapy.
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Affiliation(s)
- Mete Gungor
- Department of Gynecology and Obstetrics, Acibadem University Maslak Hospital, Istanbul, Turkey
| | - Ozguc Takmaz
- Department of Gynecology and Obstetrics, Acibadem University Maslak Hospital, Istanbul, Turkey.
| | - Selim Afsar
- Department of Gynecology and Obstetrics, Acibadem University Maslak Hospital, Istanbul, Turkey
| | - Esra Ozbasli
- Department of Gynecology and Obstetrics, Acibadem University Maslak Hospital, Istanbul, Turkey
| | - Savas Gundogan
- Department of Gynecology and Obstetrics, Acibadem University Maslak Hospital, Istanbul, Turkey
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Afsar S, Hemsinli D, Ozyazgan S, Akkan AG, Arslan C. The Effects of Potassium Channels in Human Internal Mammary Artery. Pharmacology 2015; 97:72-7. [DOI: 10.1159/000442528] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 11/13/2015] [Indexed: 11/19/2022]
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18
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Safarpour MA, Omrani A, Afsar S, Zare-Hossein-Abadi D. Study of cure kinetics of epoxy/DDS/nanosized (SiO2
/TiO2
) system by dynamic differential scanning calorimetry. POLYM ADVAN TECHNOL 2011. [DOI: 10.1002/pat.1571] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Zare-Hossein-abadi D, Ershad-Langroudi A, Rahimi A, Afsar S. Photo-Generated Activities of Nanocrystalline TiO2 Thin Films. J Inorg Organomet Polym Mater 2010. [DOI: 10.1007/s10904-010-9334-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Ganglioneuroma is a rare benign neurogenic tumor originating from the sempathoadrenal nervous system and is considered the benign counterpart of neuroblastoma, lacking the immature neuroblastic cells. A case of pelvic ganglioneuroma is described
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Affiliation(s)
- K Guzin
- Department of Obstetrics and Gynecology, Goztepe Training and Research Hospital, Istanbul, Turkey
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21
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Zuberi BF, Akhtar N, Afsar S. Comparison of mean platelet volume in patients with diabetes mellitus, impaired fasting glucose and non-diabetic subjects. Singapore Med J 2008; 49:114-116. [PMID: 18301837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Large platelets are more thrombogenic and thus put the patient at a higher risk status. Mean platelet volume (MPV) is a determinant of platelet functionality and increased MPV is associated with increased risk for myocardial infarction, stroke and transient ischaemic attacks. The objective of this study is to compare the MPV in patients with diabetes mellitus (DM), impaired fasting glucose (IFG), and non-diabetic controls. METHODS This cross-sectional study was conducted at Dow University of Health Sciences, Karachi, Pakistan between the period of September 2006 and May 2007. Sample size of 204 in each group was calculated using power (1-beta) of 90 percent and level of significance (alpha) at five percent. Confirmed patients with DM, IFG and non-diabetic controls were selected and allocated to respective groups. A total of 612 patients were selected and allocated to three groups of 204 patients each, referred to as DM group, IFG group and non-DM group. Fasting blood glucose, platelet counts and MPV were done. RESULTS Mean MPV in the DM group was 9.34 fl, in the IFG Group 8.98 fl, and in the non-DM group 8.63 fl. Comparison of MPV values for the three groups showed statistically significant intergroup and intragroup differences, with a p-value of 0.00. CONCLUSION MPV was significantly increased in the IFG group, as compared to the non-DM group, and it increased further when compared to the DM and IFG groups.
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Affiliation(s)
- B F Zuberi
- Dow University of Health Sciences, Baba-e-Urdu Road, Karachi, Pakistan.
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22
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Husain N, Chaudhry I, Afsar S, Creed F. Psychological distress among patients attending a general medical outpatient clinic in Pakistan. Gen Hosp Psychiatry 2004; 26:277-81. [PMID: 15234822 DOI: 10.1016/j.genhosppsych.2004.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2003] [Accepted: 03/09/2004] [Indexed: 01/10/2023]
Abstract
It is not known whether the pattern of psychiatric disorders in medical outpatients in Pakistan is similar to that observed in the West. Consecutive medical outpatients completed the Self-Report Questionnaire (SRQ) to detect probable psychiatric disorder. The usual cut-off score of 8/9 was used. One-thousand and sixty-nine patients completed the SRQ (84% response rate) at four half-day clinics. Sixteen percent of men and 58% of women presented with medically unexplained symptoms. In men, 80% of patients with medically unexplained symptoms had an SRQ score of 9 or above (probable depressive disorder) compared to 40% of those with symptoms caused by recognized physical illness (P<.0005). In women, the respective proportions were 55.4% and 49.6% (P=.34). Depressive disorder is probably very common in medical outpatients in Pakistan, especially in men with medically unexplained symptoms. Systematic attempts to initiate antidepressant treatment in this setting should be attempted.
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Affiliation(s)
- Nusrat Husain
- Department of Psychiatry, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK.
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23
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Gündüz K, Afsar S, Ayhan S, Kandiloglu AR, Türel A, Filiz EE, Ok UZ. Recidivans cutaneous leishmaniasis unresponsive to liposomal amphotericin B (AmBisome). J Eur Acad Dermatol Venereol 2000; 14:11-3. [PMID: 10877246 DOI: 10.1046/j.1468-3083.2000.00004.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A 60-year-old woman with thick crusted erythematous plaques on her glabella, apex nasi and left infraorbital region was diagnosed as recidivans cutaneous leishmaniasis. The lesions were resistant to antimonial drugs. Although some response was observed on the infraorbital region, lesions on the glabella and nose continued to infiltrate despite therapy with liposomal amphotericin B.
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Affiliation(s)
- K Gündüz
- Department of Dermatology, Medical Faculty of Celal Bayar University, Manisa, Turkey
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24
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Ahmed MS, Afsar S, Hentati A, Ahmad A, Pasha J, Juneja T, Hung WY, Ahmad A, Choudhri A, Saya S, Siddique T. A novel mutation in the sterol 27-hydroxylase gene of a Pakistani family with autosomal recessive cerebrotendinous xanthomatosis. Neurology 1997; 48:258-60. [PMID: 9008528 DOI: 10.1212/wnl.48.1.258] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive disorder of lipid storage with prominent neurologic features. The disease is associated with mutations in CYP27, which encodes mitochondrial sterol 27-hydroxylase, an enzyme that catalyzes the oxidation of sterol intermediates during bile acid synthesis. The loss of this enzyme results in accumulation of cholestanol in the nervous system and other tissues. Six different mutations have been previously described in CTX. We analyzed a Pakistani family, which included four affected individuals with clinical characteristics of CTX, for mutations in CYP27. The exons of CYP27 in the family DNA were amplified by polymerase chain reaction (PCR) and analyzed for mutations by band shifts (single stranded conformational polymorphism [SSCP]) and DNA sequencing. The PCR product for exon 4 showed an SSCP change in this family. The DNA of affected individuals showed an abnormal mobility pattern interpreted as homozygous for the mutation. One non-affected sibling was homozygous for the normal migrating pattern, whereas the parents and another non-affected sibling were heterozygous. The sequence of exon 4 of affected individuals showed a substitution of C to T in codon 237, thus substituting arginine to a stop codon. This mutation would terminate the translation, which may result in a protein half the size of the wild type rendering it practically inactive.
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Affiliation(s)
- M S Ahmed
- Department of Neurology, Northwestern University Medical School, Chicago, IL 60611, USA
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25
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Afsar S, Pasha MJ, Salekeen S, Talib A, Iqbal N. Reactive arthritis associated with an amebic liver abscess. J PAK MED ASSOC 1995; 45:105-6. [PMID: 7623397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- S Afsar
- Department of Medicine, Dow Medical College and Civil Hospital, Karachi
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26
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Ahmed A, Salahuddin N, Ahsan T, Afsar S, Nasir N, Farooqui S, Chaoudri AN, Akhtar MA, Agha I, Nagi N. Enoxacin in the treatment of typhoid fever. Clin Ther 1992; 14:825-8. [PMID: 1286490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Enoxacin 400 mg twice daily was given orally to 40 patients who had Salmonella typhi- or Salmonella paratyphi-positive blood or bone marrow cultures. One patient was switched to parenteral therapy within 48 hours of study enrollment, but the remaining 39 patients were given enoxacin for 10 to 14 days. All 39 patients were cured by enoxacin, even though 23 (58.9%) strains were resistant to cotrimoxazole and 16 (41%) strains were multiply resistant to ampicillin, chloramphenicol, and cotrimoxazole. No adverse events necessitated the interruption of therapy. In this study, enoxacin was well tolerated and efficacious in the treatment of typhoid fever.
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Affiliation(s)
- A Ahmed
- Aga Khan University Hospital, Karachi, Pakistan
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27
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Afsar S, Choudhri AN, Talib A, Farooqi T, Pasha MJ. Oxygen desaturation during fiberoptic bronchoscopy. J PAK MED ASSOC 1992; 42:263-5. [PMID: 1479636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A prospective study was performed to detect oxygen saturation (SaO2) during and following fiberoptic bronchoscopy (FOB) in 50 patients. Twenty-five patients (group 1) underwent the procedure without and 25 (group 2) with supplemental oxygen. The SaO2 declined from the baseline value of 96.4% to 92.08% in group 1 and to 94.88% in group 2 after bronchoscopy alone. The decline was also noted when biopsy and broncho-alveolar lavage (BAL) were performed, the lowest values being recorded during BAL. The result showed that the fall in SaO2 in group 2 was significantly less than that in group 1 (P < 0.05). SaO2 returned to baseline values after a mean time of 4.9 minutes in group 1 and 2.4 minutes in group 2, demonstrating the benefit of supplemental oxygen.
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Affiliation(s)
- S Afsar
- Department of Medicine, Dow Medical College and Civil Hospital, Karachi
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28
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Afsar S, Choudhri AN, Ali J, Muneer A. Primary pulmonary amoebiasis--an unusual cause of pulmonary consolidation. J PAK MED ASSOC 1992; 42:245-6. [PMID: 1469769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- S Afsar
- Department of Medicine, Dow Medical College, Karachi
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