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Uterine smooth muscle tumors are common neoplasms of smooth muscle in the uterus. They range from benign leiomyomas and their variants to malignant leiomyosarcomas. Although there are many subtypes of leiomyoma, mitotically active leiomyoma and leiomyoma with bizarre nuclei are sometimes difficult to differentiate from leiomyosarcoma. Our aim in this study was to investigate whether EBP50 and Merlin expression can be used in the differential diagnosis of uterine smooth muscle tumors and to determine their prognostic significance. Our study analyzed 80 cases diagnosed with uterine smooth muscle tumors from the Pathology Department archive of Dicle University Faculty of Medicine between 2012 and 2023. Primary antibodies EBP50 and Merlin were used in the immunohistochemical study. Information regarding patient age, treatment, and clinical follow-up was obtained from Dicle University Department of Obstetrics and Gynecology and Dicle University Department of Medical Oncology. Our study revealed that EBP50 expression was significantly higher in the leiomyosarcoma and STUMP groups, while Merlin expression was significantly higher in only the leiomyosarcoma group. Prognostic parameters were not found to be associated with EBP50 and Merlin expression levels. EBP50 and Merlin expression levels have not been previously studied in uterine smooth muscle tumors. Our study suggests that high expression of EBP50 in STUMP and leiomyosarcoma, as well as Merlin in leiomyosarcoma, may be helpful in the differential diagnosis of uterine smooth muscle tumors.

This study aimed to investigate the relationship between serum vitamin D levels and the severity of symptoms in individuals with hyperemesis gravidarum (HG). A cohort of eighty patients exhibiting vomiting three or more times daily, positive ketones on complete urinalysis, and oral feeding difficulties were recruited. Symptom severity was assessed using the 8-question Rhodes index, categorizing patients into non-symptomatic, mild, moderate, and severe groups. Serum vitamin D levels were measured using venous blood samples; a deficiency was defined as less than 10 ng/mL, an insufficiency as 10-20 ng/mL, and a normal level as more than 20 ng/mL. The distribution of symptom severity revealed 14 (17.5%) with mild, 38 (47.5%) with moderate, and 28 (35%) with severe symptoms. Groups showed no significant differences in demographic or obstetric characteristics except for ketone positivity rates (p<0.05). There was a significant difference in vitamin D levels between the severity groups: mild symptoms (32.12±4.02 ng/mL), moderate symptoms (19.98±6.37 ng/mL), and severe symptoms (8.11±3.06 ng/mL) (p<0.001). Vitamin D and the Rhodes index mean score showed a significant negative relationship (r=-0.844, p=0.001). With 96.4% sensitivity and 89.5% specificity, receiver operating characteristic analysis showed that symptom intensity rose when blood vitamin D levels were less than 11.54 ng/mL. These results highlight a negative relationship between the severity of HG symptoms and serum vitamin D levels. Screening pregnant women with nausea, vomiting, and severe symptoms for serum vitamin D deficiency is recommended. Appropriate pre-pregnancy treatment should be initiated for those deficient or insufficient in serum vitamin D to potentially alleviate HG symptom severity and frequency.

Objective: This study aimed to investigate the relationship between serum vitamin D levels and the severity of symptoms in individuals with hyperemesis gravidarum (HG). Materials and Methods: A cohort of eighty patients exhibiting vomiting three or more times daily, positive ketones on complete urinalysis, and oral feeding difficulties were recruited. Symptom severity was assessed using the 8-question Rhodes index, categorizing patients into non-symptomatic, mild, moderate, and severe groups. Serum vitamin D levels were measured using venous blood samples; a deficiency was defined as less than 10 ng/mL, an insufficiency as 10-20 ng/mL, and a normal level as more than 20 ng/mL. Results: The distribution of symptom severity revealed 14 (17.5%) with mild, 38 (47.5%) with moderate, and 28 (35%) with severe symptoms. Groups showed no significant differences in demographic or obstetric characteristics except for ketone positivity rates (p<0.05). There was a significant difference in vitamin D levels between the severity groups: mild symptoms (32.12[+ or -]4.02 ng/mL), moderate symptoms (19.98[+ or -]6.37 ng/mL), and severe symptoms (8.11[+ or -]3.06 ng/mL) (p<0.001). Vitamin D and the Rhodes index mean score showed a significant negative relationship (r=-0.844, p=0.001). With 96.4% sensitivity and 89.5% specificity, receiver operating characteristic analysis showed that symptom intensity rose when blood vitamin D levels were less than 11.54 ng/mL. Conclusion: These results highlight a negative relationship between the severity of HG symptoms and serum vitamin D levels. Screening pregnant women with nausea, vomiting, and severe symptoms for serum vitamin D deficiency is recommended. Appropriate pre-pregnancy treatment should be initiated for those deficient or insufficient in serum vitamin D to potentially alleviate HG symptom severity and frequency. Keywords: Pregnancy, vitamin D, Rhodes index, vomiting Amac: Bu calismanin amaci hiperemezis gravidarum (HG) hastalarinin semptomlarinin siddeti ile serum D vitamini duzeyleri arasindaki iliskiyi ortaya koymaktir. Gerec ve Yontemler: Gunde 3 veya daha fazla sayida kusma sikeyeti olan, yapilan tam idrar tetkikinde keton pozitifligi tespit edilen ve oral beslenme zorlugu bulunan 80 hasta calismaya dahil edildi. Hastalara, semptomlarinin siddetini belirlemek icin 8 soruluk Rhode'nin indeks skorlama anketi uygulandi. Anket sonucunda 8 puanin altinda olan hastalar semptomatik olmayan grup olarak gorulurken, 9-18 puan arasinda olanlar hafif, 19-32 puan arasinda olanlar orta, 33-40 puan arasinda olanlar siddetli semptomatik grup olarak belirlendi. Tum hastalardan serum D vitamini seviyesini belirlemek icin 5 mL venoz kan ornegi alindi. Serum D vitamin duzeyi <10 ng/mL olan hastalar eksiklik, 10-20 ng/mL arasinda olanlar yetersizlik ve >20 ng/mL olanlar normal seviyede D vitaminine sahip grup olarak siniflandirildi. Bulgular: Rhode'nin indeks skorlamasina gore, calismaya dahil edilen 80 hastanin 14'u (%17,5) hafif, 38'i orta (%47,5), 28'i (%35) agir semptomatik gruba dahil oldu. Gruplar arasinda yas, gebelik, dogum, abortus, yasayan cocuk sayilari, gebelik haftalari ve vucut kitle indeksleri bakimindan anlamli farklilik yoktu. Hafif, orta ve agir derecede semptomatik gruplarda keton pozitiflik oranlari bakimindan anlamli farklilik saptandi (p<0,05). Gruplar arasinda D vitamini duzeyleri bakimindan anlamli farklilik mevcuttu. Hafif semptomatik grupta D vitamini seviyesi 32,12[+ or -]4,02 ng/mL, orta duzeyde semptomatik grupta 19,98[+ or -]6,37 ng/mL ve agir semptomatik grupta 8,11[+ or -]3,06 ng/mL idi (p<0,001). Rhode'nin indeks skoru ile D vitamini arasinda negatif yonde cok guclu bir korelasyon saptandi (r=-0,844, p=0,001). Alici calisma karakteristigi analizinde, serum D vitamini seviyesi <11,54 ng/mL oldugunda %96,4 duyarlilik ve %89,5 ozgulluk ile, bulanti-kusma siddet ve sikliginin arttigi izlendi. Sonuc: Serum D vitamin seviyeleri ile HG semptomlarinin siddeti arasinda negatif yonde guclu bir iliski vardir. Bu sonuclarla,bulanti-kusmasi olup, ciddi semptom yasayan gebelerde serum D vitamin duzeyinin arastirilmasinin ve/veya gebelik oncesinden baslayarak, serum D vitamin duzeyleri bakimindan eksiklik ve/veya yetersizlik seviyesinde degeri olan gebelerde uygun ilaclarla tedavinin, HG semptomlarinin siddetini ve sikligini azaltmada uygun bir yontem olacagini dusunmekteyiz. Anahtar Kelimeler: Gebelik, D vitamini, Rhodes indeks, kusma

This study aims to determine an important parameter in progression from pre-invasive lesions of endometrium to endometrial cancer and also evaluate the effect of this parameter on the progression of endometrial cancer. In our study,30 patients with normal endometrial tissue (group 1), 56 patients who had endometrial hyperplasia without atypia (group 2), 36 patients who had endometrial hyperplasia with atypia (group 3), and 63 patients with endometrial cancer (group 4) were included. Age, parity, body-mass index, systemic diseases, and tumor markers of patients were evaluated. Expression levels of Ezrin, Radixin, and Moesin proteins were immunohistochemically evaluated in terms of frequency, intensity, and score value. When we compared hyperplasia cases with or without atypia; frequency, and score value of ezrin expression and frequency, intensity, and score value of moesin expression was significantly higher in patients who had hyperplasia with atypia (p:0.000 p:0.001 p:0.003, p:0.032 p: 0.035 p:0.015 p:0.005, respectively). It was observed that the frequency and score value of moesin expression were significantly higher in patients with endometrial cancer when compared with patients who had hyperplasia with atypia (p:0.003 p:0.045). The frequency of moesin expression was significantly higher in patients who had postoperative mortality (p:0.030 p:0.039). Increased frequency of moesin expression in the preoperative period in patients with atypical hyperplasia should alert the surgeon in terms of malignancy. If the frequency of moesin expression increases in cases with endometrial cancer, the patient should be followed closely in terms of progression in the postoperative period.

Aim: Preeclampsia and severe preeclampsia are among the most significant causes of maternal mortality. Preeclampsia’s pathogenesis is not fully understood, and it is a disease with early diagnosis and treatment possibilities. In this study, we aimed to investigate the levels of IMA, YKL-40, EN-RAGE, and AIM in maternal and cord blood. The results will ideally shed light on preeclampsia’s pathogenesis and early diagnosis. Methods: The study was conducted with the following three groups: a severe preeclampsia group (group 1), a preeclampsia group (group 2), and a control group (group 3). IMA, YKL-40, EN-RAGE, and AIM levels were measured in all patients across the groups using blood taken from the mothers before delivery and from the cords during delivery. Statistically descriptive analyses were performed. Specifically, a one-way analysis of variance was performed on group variables, and a Tukey test was used to determine the differences between the groups. Results: The mean age was similar across all groups. The gestational week at delivery was low for the severe preeclampsia group (p=0.001). The IMA and YKL-40 levels in the maternal and cord blood were the same between the groups. The EN-RAGE levels in the maternal blood were found to be significantly higher in the control group (p=0.000). While the AIM levels in the maternal blood were high in the control group (p=0.001), they were significantly lower in the cord blood in the control group (p=0.029). Conclusion: EN-RAGE and AIM levels are parameters that can be used in the early diagnosis of preeclampsia and severe preeclampsia.

Methods: Our study included 47 patients who underwent relaparotomy in our clinic between the study dates. Demographic characteristics of the patients, indications for the first operation and the surgical procedure performed during the first operation, the center where the first operation was performed, the indications for relaparotomy and the surgical procedure performed during relaparotomy, the time between two operations, the number of blood transfusion products given, and the mortality after relaparotomy were noted. In our clinic, the incidence of obstetric and gynecological relaparotomy and the mortality rate after relaparotomy were calculated. Patients with risk factors should be informed in advance and we should recommend that their first surgery be performed in tertiary hospitals as much as possible.

The occurrence of uterine perforation due to IUDs can result in contraceptive failure; and adhesion, fistulas, infection, abscess, and the perforation of the surrounding blood vessels, intestine, and bladder due to the migration of the IUD to the peritoneal cavity after uterine perforation (11). Material and Methods This retrospective case control study included 22 patients with uterine perforation after IUD placement (patient group) who were diagnosed and surgically treated in the Gynecology and Obstetrics Clinic of a university hospital between January 2012-March 2020 and 30 control patients with IUDs without any complications. The patient group included patients in whom an IUD was not seen in the endometrial cavity and an IUD string was not seen in the cervical ostium on vaginal examination, patients with an IUD found outside the endometrial cavity in the uterine myometrium, serosa or the abdomen, and patients who were operated; the control group included patients whose IUDs were in place in the endometrial cavity with an IUD string visible in the cervical ostium on vaginal examination. Factors determined to be significant regarding the risk of IUD translocation were subjected to multiple linear regression analysis to determine whether they were influenced by parity.

Objective: This study was aimed to evaluate 8-hydroxy-2-deoxyguanosine (8-OHdG) and malondialdehyde (MDA) levels in patients with first trimester miscarriage.Methods: This prospective cohort study included 35 women, who were diagnosed with miscarriage (patient group) and 35 healthy pregnant women below 14 weeks of gestation (control group), who did not report any complaints. 8-OHdG levels were measured with a competitive ELISA (Enzyme-Linked ImmunoSorbent Assay) high sensitivity kit and MDA levels were also measured in both groups.Results: There wasn't difference in terms of complete blood count, thyroid-stimulating hormone (TSH), homocysteine values, parity, age, body mass index (BMI) and gestational age between the groups. Serum 8-OHdG and MDA levels were significantly higher in the patient group (p=0.001). A moderate positive significant correlation between the gestational week and MDA values and a weak but significant positive correlation between 8-OHdG values and gestational week were detected in the patient group.Conclusion: 8-OHdG and MDA could play a role in the etiopathogenesis of first-trimester miscarriage. However, this role must be further delineated in large-scaled studies for early diagnosis and management of this condition.

Amaç: Kliniğimizde relaparotomi yapılan hastaların verilerini retrospektif olarak incelemek, relaparotomi insidansını, endikasyonlarını ve mortalite oranını belirtmektir. Yöntemler: Çalışmamıza çalışma tarihleri arasında kliniğimizde relaparotomi yapılan 47 hasta dahil edildi. Hastaların demografik özellikleri, ilk operasyon endikasyonları ve ilk operasyon sırasında yapılan cerrahi işlem, ilk operasyonun hangi merkezde yapıldığı, relaparotomi endikasyonları ve relaparotomi sırasında yapılan cerrahi işlem, iki operasyon arasındaki süre, verilen kan transfüzyon ürünlerinin sayısı ve relaparotomi sonrası mortalite olup olmadığı not edildi. Kliniğimizin obstetrik ve jinekolojik relaparotomi insidansı ve relaparotomi sonrası mortalite oranı hesaplandı. Bulgular: Çalışmamıza dahil edilen hastaların %89,4’ü obstetrik relaparotomi, %10,6’sı jinekolojik relaparotomi yapılan hastalardan oluşmaktadır. Kliniğimizin obstetrik relaparotomi insidansı %0,1, jinekolojik relaparotomi insidansı %0,06 olarak tespit edildi. Kliniğimizin relaparotomi sonrası mortalite oranını %2,1 (1/47) olarak tespit ettik. Obstetrik relapatomi yapılan hastaların ilk operasyonlarının en sık %81 (34) oranında sezaryen olduğu, endikasyon olarak en sık %23,8 (10) geçirilmiş sezaryen olduğunu tespit ettik. Jinekolojik relaparotomi yapılan hastaların ilk operasyonlarının en sık %80 (4) oranında total abdominal histerektomi olduğu, endikasyon olarak en sık %60 (3) anormal uterin kanama olduğu tespit edildi. Relaparotomi yapılan hastaların hem obstetrik hem de jinekolojik relaparotomilerde en sık endikasyonunun hematom-hemoraji olduğunu belirledik (sırasıyla %64,3 ve %40 oranında). Relaparotomi operasyonunda yapılan işlem olarak hem obstetrik hem de jinekolojik relaparotomilerde en sık olarak hematom boşaltımı- kanama kontrolü yapıldığını tespit ettik (sırasıyla %52.4 ve %40 oranında). Sonuç: Relaparotomi kararı gerekli hazırlıklar yapıldıktan sonra gecikmeden verilmelidir. Risk faktörü olan hastalar önceden bilgilendirilip ilk operasyonlarının mümkün olduğunca üçüncü basamak hastanelerde olmasını önermeliyiz. İlk operasyon sırasında gerekli kanama kontrolünü yaparak relaparotomi ihtiyacını azaltabileceğimizi düşünmekteyiz.