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Vural F.,Haydarpasa Numune Teaching Hospital | Vural B.,Kocaeli University | Cakirolu Y.,Kocaeli University
BioMed Research International | Year: 2015

Objective. Obesity is a worldwide concern with detrimental health effects including decreased fecundity. However, obesity's impact on in vitro fertilization (IVF) is inconclusive and there is little data concerning poor ovarian responders (POR). This study explored the effects of overweight and obesity on IVF outcomes of POR. Design. We retrospectively evaluated 188 POR undergoing IVF cycles. Methods. Patients were categorized into three groups. Group 1 was normal weight POR (18.5-24.9 kg/m2, n=96); Group 2 was overweight POR (25.0-29.9 kg/m2, n=52); and Group 3 was obese POR (≥30.0 kg/m2, n=40). Main measured outcomes included IVF outcomes. Results. The oocyte maturity, total gonadotropin dose-duration, and cycle cancellation rates were similar. Obese women had significantly decreased LH levels. LH < 4 mIU/mL had a sensitivity (62%) and a specificity (86%) for IVF failure (AUC: 0.71). Fertilization rates of obese subjects were significantly lower than normal and overweight subjects (p=0.04). Obese women's clinical pregnancy rates were significantly lower (15%) than normal weight women (33.3%, p=0.01). Conclusions. Despite similar counts of recruited mature oocytes, obese POR women had decreased fertilization and clinical pregnancy rates. Obesity rather than overweight significantly decreased IVF outcomes in POR. © 2015 Fisun Vural et al.


Korachi M.,Yeditepe University | Ceran N.,Haydarpasa Numune Teaching Hospital | Adaleti R.,Haydarpasa Numune Teaching Hospital | Nigdelioglu A.,Umraniye Teaching Hospital | Sokmen M.,Umraniye Teaching Hospital
International Journal of Infectious Diseases | Year: 2013

Background: Investigational approaches based on genome-wide association studies have proven useful in identifying genetic predictors for many diseases, including susceptibility to chronic hepatitis B and C. In these studies, the majority of genetic variants that have shown a positive association have been identified in genes involved in the immune response. In this study IFN-γ, IFNGR-1, and IRF-1 genes were analyzed for their role in susceptibility to the development of chronic hepatitis B and chronic hepatitis C in a Turkish population. Methods: Polymorphic genes IRF-1 (-410, -388), IFNGR-1 (-56, -611), and IFN-γ (+874) were analyzed in a total of 400 individuals: 100 chronic hepatitis B patients, 100 hepatitis B carriers, 100 chronic hepatitis C patients, and 100 healthy controls. A single base primer extension assay was used. Correlations between genes and gender, viral load, and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were also investigated. Results: The IRF-1 gene at positions -388 and -410 were observed to be candidate gene markers for susceptibility to the development of chronic hepatitis B and C (p< 0.05). IFN-γ +874 and IFNGR-1 (-56 and -611) correlated with chronic hepatitis B but not chronic hepatitis C. Correlation of functional genotype with viral load and AST and ALT levels revealed an association of IFN-γ +874 and IFNGR-1 -611 with chronic hepatitis C and IFN-γ +874 with viral load and chronic hepatitis B (p< 0.05). Conclusions: Findings suggest that IFN-γ (+874), IRF-1 (-410, -388), and IFNGR-1 (-56, -611) are candidate gene markers for determining patient susceptibility to the development of chronic hepatitis B and C. © 2012 International Society for Infectious Diseases.


Vural F.,Haydarpasa Numune Teaching Hospital | Vural B.,Kocaeli University | Cakroglu Y.,Kocaeli University
Journal of Clinical and Diagnostic Research | Year: 2016

Introduction: The integration of family planning education into obstetric care has been suggested to increase postpartum contraception use. However, ideal time and type of counseling is controversial. There is no prospective study about combining prenatal and postnatal education on the postpartum modern contraceptive use (PPMC). Aim: This study was aimed to explore the effects of the addition of postpartum contraceptive counselling to antenatal education on PPMC. Materials and Methods: Family planning counselling was given to all participating patients throughout antenatal care (ANC) via brief communications. After delivery, the women were categorised into two age-matched groups with a 1:1 allocation ratio in the order of the birth date. No further intervention was performed for Group I (n: 98). Women in Group II (n: 102) received further contraceptive education at six weeks after hospital discharge. Six months after delivery, PPMC was compared between the two groups. Results: PPMC was similar between Group I and II (p>0.05). Previous contraceptive experiences, obstetric care service intensity and partner's support were the factors related to postnatal contraceptive use. Logistic regression analysis showed that PPMC was independent of confounding factors in each group. Conclusion: The addition of postnatal counseling to antenatal one did not further increase PPMC. The results of this study suggested that family planning counseling should be provided antenatally. © 2016, Journal of Clinical and Diagnostic Research. All Rights Reserved.


Cilac-Tombus A.,Maltepe University | Tombus O.,Maltepe University | Titiz I.,Haydarpasa Numune Teaching Hospital | Ozkan L.,Kocaeli University
Transplantation Proceedings | Year: 2012

The lack of available deceased donors and the immunological incompatibility between the patients and their voluntary donor candidates make kidney exchange among donor-patient pairs a preferable solution performed locally by many organ transplantation centers in Turkey. However, maximum benefit from kidney exchange can only be achieved when the donor patient pool is maximized using a nationwide kidney exchange program. This work discusses kidney exchange practices worldwide to develop a nationwide exchange program in Turkey and related challenges. © 2012 Elsevier Inc. All rights reserved.


PubMed | Kocaeli University and Haydarpasa Numune Teaching Hospital
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2015

Abdominal wall desmoid tumours (DT) are rare, slow-growing benign muscular-aponeurotic fibrous tumours with the tendency to locally invade and recur. They constitute 0.03% of all neoplasms and high infiltration and recurrence rate, but there is no metastatic potential. Although surgery is the primary treatment modality, the optimal treatment remains unclear. Abdominal wall endometriosis is also an unusual disease, and preoperative clinical diagnosis is not always easy. The preoperative radiologic imaging modalities may not aid all the time. Herein, we report an abdominal mass presenting as cyclic pain. Forty-two years old woman who gave birth by cesarean section admitted the complaints of painful abdominal mass (78x45 mm in size) under her cesarean incision scar. She had severe pain, particularly during menstruation. The clinical and radiological imaging findings mimicking endometrioma. We performed wide surgical excision of mass with a 1 cm tumor-free margin with the diagnosis of a benign mesenchymal tumor in the frozen section. The postoperative course was uneventful and recovered without any complication and recurrence three years after surgery. This report presents a case of abdominal wall desmoid tumor mimicking endometrioma. In this paper, shortcomings in diagnosis, abdominal wall endometriomas, and DTs were discussed in the view of literature.


PubMed | Haydarpasa Numune Teaching Hospital
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2015

Nabothian cysts are common and silent retention cysts of the uterine cervix with no particular intervention required. It is quite rare to reach a size of more than 4 cm and it is a diagnostic dilemma to differ it from adenoma malignum. We report a case of a woman with 38 weeks of gestation presented to the maternity unit with labour pain and protruding cystic mass (60x70 mm) out of the vagina. Simple drainage was performed to allow the vaginal delivery. She delivered 4130 grams, 9-10 Apgar, male baby by spontaneous vaginal delivery. The patients and the newborn postpartum course was uneventful. Gynaecologic examination revealed a persisting cystic mass in the cervix (40x50 mm) two months after the delivery. We performed a total excision of the cyst to confirm the pathologic diagnosis. This paper is the first report of nabothian cysts obstructing labour passage. In the view of this case, we aimed to discuss cervical cystic masses and a review of the literature.


PubMed | Haydarpasa Numune Teaching Hospital
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2016

Benign Metastasizing Leiomyoma (BML) is a rare disease which represents with multiple leiomyomatous lesions in many tissues and organs especially in lungs. These patients have been operated for leiomyoma of the uterus. Here we report a case of a 41-year-old woman who was evaluated in a thoracic surgery hospital for dyspnea and bilateral nodules in chest roentgenogram. She had no history of neoplasm, only myomectomy history of uterine leiomyoma 10 years ago. Biopsy and histopathological examination were consistent with pulmonary leiomyoma. The patient was reffered to our clinic and we performed a total abdominal hysterectomy for her multiple uterine leiomyomas. The final diagnosis was benign pulmonary metastasizing leiomyoma. After this diagnosis, surgical castration was performed but two years later, repeat imaging showed progression in pulmonary lesions and progesterone therapy was administered to the patient. Patient has continued on this hormonal therapy to date and during the 5-years follow-up, the persisting lesions in both lungs regressed.


PubMed | Kocaeli University and Haydarpasa Numune Teaching Hospital
Type: | Journal: BioMed research international | Year: 2015

Obesity is a worldwide concern with detrimental health effects including decreased fecundity. However, obesitys impact on in vitro fertilization (IVF) is inconclusive and there is little data concerning poor ovarian responders (POR). This study explored the effects of overweight and obesity on IVF outcomes of POR. Design. We retrospectively evaluated 188 POR undergoing IVF cycles.Patients were categorized into three groups. Group 1 was normal weight POR (18.5-24.9kg/m(2), n = 96); Group 2 was overweight POR (25.0-29.9kg/m(2), n = 52); and Group 3 was obese POR (30.0kg/m(2), n = 40). Main measured outcomes included IVF outcomes.The oocyte maturity, total gonadotropin dose-duration, and cycle cancellation rates were similar. Obese women had significantly decreased LH levels. LH < 4mIU/mL had a sensitivity (62%) and a specificity (86%) for IVF failure (AUC: 0.71). Fertilization rates of obese subjects were significantly lower than normal and overweight subjects (p = 0.04). Obese womens clinical pregnancy rates were significantly lower (15%) than normal weight women (33.3%, p = 0.01).Despite similar counts of recruited mature oocytes, obese POR women had decreased fertilization and clinical pregnancy rates. Obesity rather than overweight significantly decreased IVF outcomes in POR.


PubMed | Council of Forensic Medicine and Haydarpasa Numune Teaching Hospital
Type: Case Reports | Journal: Journal of forensic sciences | Year: 2016

Nicolau syndrome (NS) is a dermatological adverse reaction of intramuscular injections and is caused by several mechanisms. The etiopathogenesis remains unclear, and several hypotheses have suggested a vascular origin. Rhabdomyolysis (RM) is the destruction of striated muscle, with the subsequent release of muscle cell contents into circulation. NS and RM diagnoses may overlap. Herein, we present the autopsy findings of a 40-year-old female with NS complicated with RM. On clinical follow-up, creatine kinase (CK) was 7146 IU/L, and urea and creatinine levels were elevated on the third day after intramuscular diclofenac injection. Possible ischemic process triggered the RM and subsequent acute renal failure. The opportunity for an early diagnosis was missed because the patient delayed seeking medical aid. The prognosis worsened, and the patient died due to secondary sepsis. Early diagnosis of NS before the occurrence of complications is the most important issue in patient education and can be life-saving.


PubMed | Kocaeli University and Haydarpasa Numune Teaching Hospital
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2016

The integration of family planning education into obstetric care has been suggested to increase postpartum contraception use. However, ideal time and type of counseling is controversial. There is no prospective study about combining prenatal and postnatal education on the postpartum modern contraceptive use (PPMC).This study was aimed to explore the effects of the addition of postpartum contraceptive counselling to antenatal education on PPMC.Family planning counselling was given to all participating patients throughout antenatal care (ANC) via brief communications. After delivery, the women were categorised into two age-matched groups with a 1:1 allocation ratio in the order of the birth date. No further intervention was performed for Group I (n: 98). Women in Group II (n: 102) received further contraceptive education at six weeks after hospital discharge. Six months after delivery, PPMC was compared between the two groups.PPMC was similar between Group I and II (p>0.05). Previous contraceptive experiences, obstetric care service intensity and partners support were the factors related to postnatal contraceptive use. Logistic regression analysis showed that PPMC was independent of confounding factors in each group.The addition of postnatal counseling to antenatal one did not further increase PPMC. The results of this study suggested that family planning counseling should be provided antenatally.

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