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Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by hormonal and metabolic abnormalities. Mitsugumin-53 (MG53), a multifunctional E3 ubiquitin ligase, is implicated in insulin signaling and oxidative stress regulation, yet its role in PCOS remains unclear. This study aimed to investigate serum MG53 levels in women with PCOS and explore their associations with hormonal, metabolic, and ovarian parameters. In this case–control study, 64 women with PCOS and 64 healthy controls with comparable age were enrolled. Serum MG53 concentrations were measured by ELISA. Associations between MG53 and continuous variables were assessed using Spearman’s rank correlation. Independent determinants of MG53 were evaluated using multivariable linear regression (including age and BMI as covariates), and diagnostic performance for PCOS was assessed using receiver operating characteristic (ROC) analysis. Serum MG53 concentrations were lower in women with PCOS than in controls (median [IQR]: 124.4 [104.25–202.15] vs. 206.4 [131.63–316.58] pg/mL; p  = 0.001). MG53 correlated positively with sex hormone–binding globulin (SHBG) (ρ = 0.274, p  = 0.002) and inversely with ovarian follicle count (ρ =  − 0.223, p  = 0.011). In multivariable analysis, SHBG remained an independent positive determinant of MG53, whereas hirsutism and follicle count were independent negative predictors. MG53 demonstrated modest discrimination for PCOS (AUC = 0.667, 95% CI 0.569–0.762), with 57.8% sensitivity and 75.0% specificity at an exploratory cut-off of 131.1 pg/mL. Serum MG53 is reduced in PCOS and is associated with SHBG and features related to androgen excess and ovarian morphology. These cross-sectional findings support MG53 as a candidate biomarker reflecting metabolic–reproductive associations in PCOS; however, its diagnostic performance is modest and requires external validation. Trial registration Prospectively registered on ClinicalTrials.gov (NCT07094776) as an observational study.

Background/Objectives Ureteral obstruction is an uncommon but clinically significant complication following benign hysterectomy and may remain asymptomatic until renal impairment develops. Current guidelines do not recommend routine postoperative ultrasonography; however, earlier detection of obstruction may facilitate timely intervention and preservation of renal function. This study aimed to evaluate the diagnostic performance of a structured, two-step postoperative renal ultrasonography protocol. Methods This single-center diagnostic accuracy study retrospectively analyzed 725 patients who underwent benign hysterectomy between January 2023 and June 2025. Renal ultrasonography was performed by the same radiology team using a standardized protocol. Hydronephrosis graded ≥ 2 according to the Society for Fetal Urology classification was considered positive. Computed tomography or urologic evaluation served as the reference standard. Sensitivity, specificity, predictive values, accuracy, and Youden indices were calculated. Results Seven patients (0.9%) were diagnosed with ureteral obstruction. On postoperative day 3, ultrasonography demonstrated a sensitivity of 85.7%, specificity of 99.3%, and a negative predictive value of 99.9%. Of 11 positive findings, six were confirmed as true obstructions, while five represented transient pelvic dilatation. On postoperative day 10, specificity increased to 99.5% and sensitivity reached 100%, reflecting resolution of early false-positive findings. Six obstructions were detected on day 3, and one newly developed obstruction was identified on day 10. All affected patients underwent appropriate intervention, and no short-term loss of renal function was observed in the confirmed cases. Conclusions A two-step renal ultrasonography protocol performed on postoperative days 3 and 10 demonstrated very high specificity and negative predictive value in a very low-prevalence setting for ruling out early postoperative ureteral obstruction after benign hysterectomy. These findings are preliminary and hypothesis-generating due to the low number of outcome events and should be validated in prospective, multicenter studies, including evaluation of feasibility, cost-effectiveness, and patient-reported outcomes, as well as the performance of gynecologist-performed point-of-care ultrasonography (POCUS). Trial registration Not applicable. This study did not involve prospective assignment of a healthcare intervention.

Background/Objectives: This study aimed to investigate the prognostic value of preoperative systemic inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune–inflammation index (SII), and prognostic nutritional index (PNI), in conjunction with tumor markers and histopathological parameters, on overall survival (OS) and disease-free survival (DFS) in patients with endometrioid adenocarcinoma. Systemic inflammation has been increasingly implicated in tumor progression, and inflammation-based indices derived from routine blood tests offer a practical approach for preoperative risk assessment. Methods: A total of 155 patients diagnosed with endometrioid adenocarcinoma between 2016 and 2025 were retrospectively analyzed. The NLR, PLR, SII, and PNI were calculated from preoperative complete blood count and biochemical data. Associations with histopathological parameters, including FIGO grade, myometrial invasion, cervical stromal involvement, lymphovascular invasion, and lymph node metastasis, were evaluated. Survival analyses were performed using the Kaplan–Meier method and Cox proportional hazards regression models. Results: Patients with cervical stromal involvement had significantly higher NLR values (p = 0.028) and lower lymphocyte counts (p = 0.032). Additionally, lower albumin and PNI levels were observed in patients with cervical stromal involvement (p = 0.034 and p = 0.031, respectively). Multivariate Cox regression analysis identified advanced age (HR: 1.09, p < 0.001), subtotal hysterectomy (HR: 3.76, p = 0.006), lymph node metastasis (HR: 4.78, p = 0.020), elevated CRP levels (HR: 1.05, p = 0.004), high SII (HR: 1.002, p = 0.037), and increased CA 15-3 levels (HR: 1.04, p < 0.001) as independent predictors of poor OS. CA-125 level was an independent risk factor for DFS (p = 0.031). Conclusions: Systemic inflammatory markers, particularly SII and NLR, may serve as useful prognostic indicators for endometrioid adenocarcinoma. Their association with survival outcomes and local tumor extension highlights their potential clinical value in preoperative risk stratification and individualized treatment planning. Future prospective studies integrating these markers with molecular classification data are required.

Objective: Preeclampsia is a multisystemic disorder characterized by inflammation, platelet dysfunction, and target-organ involvement. Early identification of disease severity is crucial for improving maternal and fetal outcomes. This study aimed to evaluate the association between preeclampsia severity and hematological, biochemical, and derived inflammatory parameters. Methods: This retrospective study included 135 pregnant women diagnosed with preeclampsia between 2020 and 2025 at a single tertiary center. Patients were classified as having mild or severe preeclampsia based on American College of Obstetricians and Gynecologists criteria. Hematological markers [hemoglobin, white blood cell (WBC), platelet, mean platelet volume (MPV)], biochemical parameters [aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine], and derived indices [neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), platelet-to-neutrophil ratio (PNR)] were recorded. Group comparisons were performed using Student's t-test, Mann-Whitney U test, or Fisher's exact test as appropriate. Statistical significance was set at p<0.05. Results: Severe preeclampsia was associated with significantly higher hemoglobin (p=0.019), WBC (p=0.005), neutrophil counts (p=0.004), and AST, ALT, and creatinine levels (p=0.003, p<0.001, p=0.002, respectively). Platelet counts were lower in severe cases (p=0.0411). No significant differences were found in MPV (p=0.833), NLR (p=0.614), or PLR (p=0.109). PNR was significantly higher in the mild group (p=0.001), whereas NLR and PLR did not differ significantly. Conclusion: Severe preeclampsia is characterized by intensified inflammation, increased platelet consumption, and more pronounced organ involvement. Among the inflammatory indices, PNR differed significantly between severe and mild disease groups, whereas NLR and PLR did not differ significantly. Combined assessment of hematological and biochemical markers may provide a more comprehensive and reliable approach for evaluating preeclampsia severity. PNR may represent a potential supportive parameter associated with disease severity; however, further studies, including diagnostic performance analyses, are required. Keywords: Preeclampsia, disease severity, platelet-to-neutrophil ratio, inflammatory markers

Background. Vitamin B12, an indispensable micronutrient, is pivotal in numerous physiological processes, with particular significance during pregnancy and fetal development. The increasing adoption of vegetarian diets and the economic challenges associated with accessing animal-based food sources contribute to the prevalence of vitamin B12 deficiency. This study aims to examine the levels of vitamin B12 and homocysteine in pregnant women upon admission for delivery and to analyze corresponding cord blood samples from their newborn infants in a substantial sample within the Istanbul metropolitan area. Materials and Methods. This cross-sectional multicenter study included women aged ≥16 years admitted for delivery and their newborns ≥34 weeks. The demographic data and the results of complete blood counts within the previous 24 hours before birth were recorded. Vitamin B12 and homocysteine levels were measured in maternal and cord blood samples. The study parameters were compared between the groups based on the mothers’ and babies’ homocysteine and vitamin B12 levels. Results. The study included 832 pregnant women and 832 neonates. Anemia affected 36% of pregnant women, with a higher frequency in mothers with vitamin B12 deficiency. Seventy-eight mothers and 48.9% of neonates showed Vitamin B12 levels below 200 pg/mL, while elevated homocysteine levels were observed in 30% of mothers and 26% of neonates. Maternal vitamin B12 deficiency was significantly correlated with cord blood B12 deficiency and elevated homocysteine. The median cord blood vitamin B12 level was inversely correlated with the number of previous pregnancies. Conclusion. Vitamin B12 deficiency is extremely common in pregnant women before delivery, significantly correlating to cord blood homocysteine and vitamin B12 levels. However, homocysteine alone is not a reliable marker for maternal vitamin B12 status. Implementing strategies to detect vitamin B12 deficiency and supplying adequate vitamin B12 supplementation during pregnancy holds the potential to enhance maternal and neonatal health in Türkiye. 

Introduction and Hypothesis This video demonstrates the laparoscopic meshless pectopexy with uterine preservation (Salman's modification). Methods This study in a single group semi-experimental design was carried out in a secondary center. From May 2022 to April 2024, a total of 40 consecutive symptomatic women with stage 3–4 apical prolapse requesting uterine protection were included in the study. Without using mesh, patients received a laparoscopic pectopexy using monofilament non-absorbable sutures and preserving the uterus. Pelvic organ prolapses quantitative stage 2 or higher, especially in the central compartment (C ≥—1), and anatomical recurrences of genital prolapse were recorded. Results In the 1st postoperative year, patients showed a significant improvement in the Pelvic Organ Prolapse Quantification central compartment (C score: mean difference −8.21 ± 3.03, 99% confidence interval −9.20 to −7.21) and in all other landmarks ( p  < 0.001). Apical prolapse recurrence occurred in 7.9% of cases and stage 3Bp prolapse developed in one patient during the follow-up period. Sexual function and urinary symptom scores (PISQ-12) were significantly improved after surgery. Conclusions Laparoscopic meshless pectopexy represents an effective and feasible option for the surgical treatment of uterovaginal prolapse, preserving the uterus and preventing postoperative complications associated with mesh use.

In addition to the pain caused byuterine contractions during labour, continuous and severe back pain is observed in 33% of women. Several pharmacological and nonpharmacological methods are available for managing this pain. Sterile water injection is considered as alternative method for nonpharmacological pain management. To assess the satisfaction level and effectiveness of sterile water injection for back pain among women in labour. Randomized controlled trial. A total of 168 term, healthy women with labour pain and severe back pain were randomized into the sterile water injection (study) and dry injection (placebo) groups. Injections were applied to the rhombus of Michaelis in the sacral area. Pain scores were assessed at 10, 30, 60, 120, and 180 min using a visual analogue scale. Additionally, the need for epidural analgesia, Apgar score, mode of delivery, time of delivery, maternal satisfaction, and breastfeeding score were assessed. The mean back pain scores at 30 min after injections were significantly lower in the study group (study group: 31.66±11.38; placebo: 75±18.26, p<0.01). The mean decrease in pain scores after 30 min according to baseline was significantly higher in the study group (study group: 54.82±7.81; placebo: 13.33±12.05, p<0.01). The need for epidural analgesia, time of delivery, mode of delivery, and Apgar and breastfeeding scores were similar in both groups. Maternal satisfaction from the analgesic effect was significantly higher in the study group (study group: 84.5%; placebo: 35.7%, p<0.01). The application of sterile water injection is effective for relieving back pain in the first stage of labour and has a sufficient satisfaction level among women.

ObjectiveThis study aimed to evaluate the effectiveness of oral and vaginal misoprostol in reducing pain levels in patients undergoing office hysteroscopy.MethodsThe study included 225 patients scheduled for office hysteroscopy. The demographic data of the participants were collected. Using the sealed envelope method, patients were allocated into three groups of 75 each: one group received no misoprostol, the second group received oral misoprostol, and the third group received vaginal misoprostol. Oral and vaginal misoprostol (200 mcg) were administered 1 hour before the procedure. Pain levels were evaluated using visual analogue scale (VAS) scores among the groups.ResultsThe pre-procedural VAS scores were significantly higher in patients who received either form of misoprostol than in those who did not receive it (p<0.01). The procedure duration was notably shorter for the groups receiving misoprostol (p<0.05). Post-procedural VAS scores were elevated in the non-misoprostol group in contrast to the misoprostol groups, with the vaginal misoprostol group showing higher scores than the oral group (p<0.05).ConclusionOur findings indicate that both vaginal and oral misoprostol administered before diagnostic hysteroscopy reduce pain and shorten the procedure duration. Further studies are necessary to determine the optimal dosage and timing for minimizing side effects while maximizing efficacy.

Objective: We aimed to analyze the sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) and the accuracy of frozen section (FS) method and compare the concordance of FS responses and paraffin section (PS) (final histopathological diagnoses) results of the ovarian mass operations in our hospital. Methods: We retrospectively reviewed the cases of ovarian lesions operated between March 2008 and June 2018 in which FS was requested. In total 205 cases were found and the results were compared. The FS responses and PS results were classified as benign, borderline and malignant. Seventeen cases weren’t responded in FS (and left to be diagnosed in PS) and they were left out of the study. Results: According to the analyses; the sensitivity of benign, borderline and malignant tumors were 100%, 83%, 95%, and the specificity were 98%, 99%, 98%, respectively. The PPV of borderline and malignant tumors were 91%, 92% and the NPV were 98%, 99% respectively. Furthermore; both of their accuracy was 97%. The concordance between the methods was assessed with Kappa test and found as 94% (p<0.001). Conclusion: In our study we showed that even if all of the FS responses didn’t match with its PS, FS has a very high rate of consistency. FS is a way to help the surgeon during the operation. However, it must not be forgotten that this method has its own pitfalls and limitations.