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Purpose This prospective cross-sectional study aimed to compare uterine and ovarian arterial Doppler signals in regularly menstruating patients who had been using copper intrauterine devices (IUD) for different durations. Methods Four groups of participants were formed (n = 30 for each) depending on the duration of copper IUD use: less than 1 year (group 1), 1 to 3 years (group 2), and over 3 years (group 3). Women without IUDs formed the control group. All participants were called in on the fifth-eighth days of their menstrual cycle for Doppler blood flow assessment. The pulsatility index (PI) and resistance index (RI) values were recorded in uterine and ovarian arteries. Results The groups 2 and 3 had significantly higher uterine artery PI and RI values than groups 1 and 4. Furthermore, group 2 had uterine and ovarian artery PI and RI values similar to those of group 3. There was a positive relationship between uterine and ovarian arteries' PI and RI values with the duration of IUD use. Conclusions The presence of an IUD for over a year seems to cause changes in the uterine artery PI and RI values assessed by Doppler ultrasonography.

Polyphenols which are produced by plants are very important functional foods in our nutrition. Because of their diverse chemical structures, they are subject to main classification among them. The main groups of polyphenols are; flavanoids, lignans, stilbenes and phenolic acids. At the present time, the health effects of them have been investigated in several in vivo and in vitro studies. In addition to their antioxidant effects, they are known to have a pro-oxidant character. Polyphenols have important effects in protecting the body against external factors and the cleansing of reactive oxygen species which occur as a consequence of some diseases. Furthermore, polyphenols have effects on protection from specific diseases and stop their progression with certain mechanisms. In this review, various effects of polyphenols including antioxidant, pro-oxidant, cytotoxic, anti-inflammatory, antihypertensive, anti-diabetic are discussed which obtained from in vitro, in vivo experimental animal and clinical investigations.

Aim Longitudinally extensive transvers myelitis (LETM) is a rare and disabling condition in childhood. The aim of the present study was to share experiences from our center regarding the treatment features and clinical and radiologic course in our LETM patients in light of the literature data. Material and method The study was designed as cross-sectional and included children who followed for LETM at our pediatric neurology clinic between 2010 and 2019. ATM was diagnosed according to the diagnostic criteria report from the Transverse Myelitis Consortium Working Group. LETM was defined as the presence of spinal cord lesions spanning a length of 3 or more consecutive vertebral segments. The patients’ medical records were examined in terms of demographic characteristics, presenting symptoms, history of infection prior to and during LETM, prodromal history, neurological examination, laboratory and radiological findings, clinical course, and treatment. The Barthel Index was used to assess the physical independence in activities of daily living of patients with LETM who were followed for at least one year. Results A total of 15 (8 girl) patients were included in the study. The patients were between 1 and 17 years of age. Presenting symptoms included inability to walk in 12 patients, incontinence in 9 patients, low back pain in 4 patients, abdominal pain in 2 patients, and inability to use the arms in 2 patients. In Barthel Index assessment of physical independence in activities of daily living, 8 patients were evaluated as completely independent, 3 patients as moderately dependent, and 2 patients as slightly dependent. When the 4 patients with motor area impairment and moderate dependency according to the Barthel Index were examined, it was noted that all of them had been admitted 4 days after the onset of symptoms and that 2 (13.3%) had cervicothoracic involvement and 2 (13.3%) had involvement of the entire cord. Conclusion Shorter delay from symptom onset to initiation of immunomodulatory therapy as well as effective rehabilitation resulted in favorable outcomes, with the most noticeable improvement in the areas of motor function and incontinence.

This study aimed to compare the effects of high doses of ondansetron and granisetron before spinal anesthesia on hemodynamic parameters in patients undergoing elective cesarean section.A double-blinded randomized placebo-controlled trial.Operating room.A total of 120 parturients with term pregnancy undergoing elective cesarean section with combined spinal-epidural anesthesia were included.Three groups (n = 40 for each group) were formed by randomization. Five minutes before the anesthesia procedure, Group I received 8 mg intravenous (IV) ondansetron diluted in 10 ml normal saline, Group II received IV 3 mg granisetron diluted in 10 ml normal saline, and Group III received IV 10 ml normal saline.Following intrathecal drug administration, intraoperative hemodynamic changes were recorded every 2 min for 20 min and then every 5 min until the end of the operation.Twenty patients (50%) in Group I, 12 patients (30%) in Group II, and 29 patients (72.5%) in Group III had hypotension requiring treatment with IV ephedrine (P = 0.001). The ephedrine requirement in Group III was significantly higher than in Groups I (P = 0.033) and II (P 0.001). Also, the ephedrine requirement in Group II was lower than in Group I, but the difference was not statistically significant (P = 0.055). The mean arterial pressure for the three groups differed in the 10th, 18th, and 60th minutes. The number of patients with nausea or vomiting was lower in Groups I and II than in Group III (P 0.001). At 5 min, the Apgar scores were higher than 8 for all neonates. Postoperative scores for the visual analogue scale were similar for all groups.It was concluded that prophylactic IV administration of 3 mg of granisetron or 8 mg of ondansetron before spinal anesthesia results in a significantly lower ephedrine requirement compared to placebo.

Primary dysmenorrhea effects the life-quality of women negatively. The aim of this study was to evaluate heme oxygenase-1 (HO1) activity together with malondialdehyde (MDA) and nitric oxide (NO) levels in patients with primary dysmenorrhea. A total of 28 nulliparous women with the diagnosis of primary dysmenorrhea and 26 healthy controls were included in this study. On the first day of menstruation, all patients underwent ultrasound examination to exclude pelvic pathology and the visual analogue scale was applied to patients. Patient’s visual analogue scale (VAS) scores, age, body mass index (BMI), menstrual cycle length (day), length of bleeding (day) were recorded. In the same day, fasting blood samples were taken from each patient for biochemical analysis. Serum MDA, NO and HO1 levels were found to be higher in women with primary dysmenorrhea compared to healthy controls (p = 0.012, p = 0.009, p

Introduction: Postpartum hemorrhage (PPH) is one of the leading causes of maternal death in the world and it is reported to occur in 5% - 8% of pregnancies. Objective: This study aimed to present a single centre’s experience in treating PPH by balloon tamponade. Methods: During the time period between January 2013 and March 2016, 50 patients who had undergone balloon tamponade for postpartum hemorrhage in our clinic were evaluated retrospectively. The patients’ age, parity, type of delivery, birth weight, hemoglobin and platelet values, total blood loss from catheter, balloon’s staying time, blood and platelet transfusion status, the presence of placenta anomalies and the Bakri balloon hemostasis success rate were evaluated. Results: During the study period, there were 27,249 deliveries. The frequency of massive postpartum hemorrhage was 0.61% (n = 168). Among the 168 patients with massive postpartum hemorrhage, there were 50 patients in whom the Bakri balloon catheter was used. Bakri balloons were placed via cesarean section incision in 19 patients and via vagina in 31 patients. The mean staying time of Bakri balloon was 18 hours. In 8 patients, balloon tamponade failed. Two patients underwent hysterectomy; other two patients had surgical ligation of the hypogastric artery. Four cases were referred to a tertiary center. Placental invasion abnormalities were observed in five patients. The overall Bakri balloon hemostasis successful rate was found to be as 84% in all cases. Conclusion: Bakri balloon tamponade is an effective, safe and practical approach in the treatment of postpartum hemorrhage.

Objective: We hypothesized that maternal and fetal circulations may be affected by moderately high altitudes. Therefore, we compared the differences in maternal and fetal Doppler flow parameters in women with term pregnancy living at a moderately high altitude (1890 m in Erzurum) with those of women living at the sea level (31 m in İstanbul).Material and Methods: Eighty women (n=40, for each group) with full-term and singleton pregnancies underwent Doppler waveform analysis, and the pulsatility and resistance index values for the uterine, umbilical, and mid-cerebral arteries were recorded. Also, sex, birth, and placental weights during delivery were obtained from the medical records.Results: Similar mean placental weight values were found at the sea level compared with the moderately high altitude (p>0.05). The mean birth weight values were found to be lower at the moderately high altitude than those at the sea level (p0.05). However, the pulsatility and resistance index values for both the right and left uterine arteries were higher at the sea level than those at moderately high altitude (p

Background/Aims: To investigate the importance of antioxidant activity in infertility caused by cisplatin in rats. Methods: Rats in cisplatin control (CG), Vitamin E + cisplatin (ECG), Vitamin C + cisplatin (CCG), Hippophae rhamnoides extract (HRE) + cisplatin (HRECG), and thiamine pyrophosphate (TPP) + cisplatin (TPPCG) groups were injected intraperitoneally (ip) with (100 mg/kg) Vitamin E, Vitamin C, HRE, and TPP, respectively. One hour later, ip cisplatin was administered (5 mg/kg), and then antioxidant medications were continued for 10 days. Cisplatin + Vitamin E (CEG-1), cisplatin + Vitamin C (CCG-1), cisplatin + HRE (CHREG-1), and cisplatin + TPP (TPPCG-1) rats received cisplatin (5 mg/kg, ip) and were kept for 10 days. At the end of that period, rats received antioxidant medications for 10 days. (n = 12, for each group). Six rats from each group were sacrificed. Ovaries were removed to measure malondialdehyde, total glutathione, glutathione S-transferase, and glutathione reductase levels. The remaining rats were kept in a suitable laboratory environment. Results: Cisplatin-induced oxidative stress was best prevented by HRE, Vitamin E, Vitamin C, and TPP, in that order. However, infertility caused by cisplatin was only prevented and treated by TPP. Conclusion: Oxidative stress is not a major component in the pathogenesis of cisplatin-associated infertility.

Background/Aims: To evaluate the effects of sildenafil on antioxidant enzyme activities, lipid peroxidation and histopathological changes in ovarian tissue after ischemia-reperfusion (I/R) injury in a rat model. Methods: A total of 18 adult female Wistar albino rats weighing 200-250 g were studied as follows: (1) control group: sham operation, (2) I/R group: 3 h of reperfusion after 3 h of ischemia and (3) I/R + sildenafil group: 3 h of reperfusion after 3 h of ischemia; half an hour before reperfusion, sildenafil (1.4 mg·kg-1) was given by oral gavage. At the end of the reperfusion periods, the ovarian tissues were removed for histopathological examination and to determine malondialdehyde (MDA) levels and glutathione peroxidase, myeloperoxidase (MPO) and superoxide dismutase (SOD) activities. Results: The I/R group had higher ovarian tissue MDA levels than the control group and the IR + sildenafil group (p = 0.016 and p = 0.044, respectively). MPO activity was lower in the IR + sildenafil group compared with the I/R group (p = 0.022). SOD activity was lower in the I/R group compared with the control group and the I/R + sildenafil group (p = 0.030 and p = 0.015, respectively). The I/R + sildenafil group had improved histological appearance which was not different to the control group (p > 0.05). Conclusion: The biochemical and histopathological results of this experimental study demonstrated that I/R injury in the ovary is ameliorated by sildenafil treatment.

Objectives: To explore the protective effect of progesterone on inflammation and oxidative stress in a rat model of sepsis created by cecal ligation and puncture (CLP). Materials and Methods: Rats were randomly divided into 4 groups: Overiectomy group (OVX), sham operated (control), sepsis (CLP) group and progesterone-treated CLP group (CLP+ progesterone). The rats in CLP+ progesterone group received intraperitoneal progesterone (2 mg/kg). Cardiac blood samples were obtained for the measurement levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). Tissue samples, including liver, kidney and uterus of rats were prepared to determine activities of myeloperoxidase (MPO), glutathione peroxidase (GPx) and levels of malondialdehyde (MDA). Results: Increased serum IL-6 and TNF-α levels were found in the CLP group in comparison with the control group ( P = 0.01, P = 0.02; respectively). In CLP+ progesterone group, mean MDA concentration of kidney tissue was significantly lower than in CLP group ( P = 0.003). Liver MDA concentration of the CLP+ progesterone group was not significantly different from that of the control group. While there were no significant differences among groups regarding liver MPO; in the CLP group, MPO activity in kidney ( P = 0.02) and uterine tissues ( P = 0.03) were found to be significantly higher compared to the control group. In CLP+ progesterone group, mean MPO activities of all tissues were not different than those of control group. The uterine tissue GPx activity in the CLP+ progesterone group was not statistically significantly different from control group. Conclusions: We suggest that progesterone ameliorates sepsis syndrome by reduction of the inflammatory cytokines IL-6 and TNF-α, and by restoration of antioxidant enzyme activities in some tissues.

Aim The aim of this case–control study was to compare the efficacy of ethinyl estradiol/drospirenone and Fructus agni casti in women with severe primary dysmenorrhea measuring uterine artery blood flow via Doppler ultrasonography. Methods A total of 60 women with severe primary dysmenorrhea and 30 healthy women (control) were included in this study. Thirty patients were treated with ethinyl estradiol 0.03 mg/drospirenone (group 1) and another 30 were treated with Fructus agni casti (group 2) during three menstrual cycles. Before and at the end of third month of therapy visual analog scale (VAS) scores, pulsatility index (PI), resistance index (RI) of uterine artery were recorded before and after receiving therapy on the first day of the menstrual cycle. Results Mean PI and RI values in patients with severe primary dysmenorrhea were significantly higher than in the control groups on the first day of the menstrual cycle (P

Amaç: Farklı Polikistik over sendromu (PKOS) fenotiplerinde klinik, biyokimyasal ve hormonal değerlerin karşılaştırılması.Gereç ve Yöntem: Çalışmaya Dumlupınar Üniversitesi Evliya Çelebi Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum polikliniğimize Temmuz 2015- Ocak 2016 tarihleri arasında başvurarak PKOS tanısı almış 87 hasta ve yaş – vücut kitle endeksi uyumlu, 34 sağlıklı gönüllü olmak üzere toplam 121 olgu dahil edildi. PKOS tanısı için revize Rotterdam Kriterleri kullanıldı. Hastaların tanımlayıcı verileri, biyokimyasal ve hormonal değerleri karşılaştırıldı. İstatistiksel analizler için SPPS 21.0 programı kullanıldı. P değerinin 0.05’den küçük olması istatistiksel olarak anlamlı kabul edildi.Bulgular: Çalışma grubunun 38’i fenotip 1 (%43.67), 6’sı fenotip 2 (%6.89), 22’si fenotip 3 (%25.28) ve 21’i fenotip 4 (%24.13) idi. PKOS ve kontrol grubunun ortalama yaşları sırasıyla 23,09 ± 4.90 ve 23.15 ± 6.40 idi (p>0.05). Vücut kitle endeksi fenotip 1 ve 2’de daha yüksek olmasına rağmen gruplar arasındaki fark istatistiksel olarak anlamlı değildi. Bel kalça oranında fenotipler arasında fark izlenmedi (p>0.05). Hastaların % 63.2’sinde insülin direnci bulundu. İnsülin direnci en sık fenotip 2’de izlendi. Serum C reaktif protein (CRP) düzeyi incelendiğinde gruplar arasında istatistiksel açıdan anlamlı bir fark görülmedi (p>0.05). Grupların Ferriman Gallwey skorlarına (FGS) bakıldığında fenotip 2 ve 1’in en yüksek skorlara sahip olduğu görüldü. Fenotip 1, 2 ve 3’ün FGS’leri kontrol grubu ve fenotip 4’e göre ileri derecede anlamlı yüksekti (p0.05).Sonuç: Çalışmamızda farklı PKOS fenotiplerinde FGS ve serum LH seviyesi dışında gruplar arasında bir farklılığın olmadığı görüldü. Bununla birlikte, fenotip 2’de insülin direnci ve CRP düzeylerinin istatistiksel olarak anlamlı olmasa da belirgin şekilde yüksek olduğu gözlendi. Bu grubun uzun dönem kardiyovasküler morbidite açısından nisbeten riskli grup olduğu düşünülerek yakın takip yapılması uygun olacaktır. Anahtar kelimeler: Anovulasyon, Fenotip, Hiperandrojenizm, Polikistik over sendromu

Objective Brain-derived neurotrophic factor (BDNF), a member of neurotrophins, plays a critical role in neuronal tissue. In this study, the effects of spinal or general anaesthesia on cord and maternal peripheral blood BDNF and malondialdehyde (MDA) levels were investigated in patients undergoing elective caesarean section. Methods Eighty patients with term pregnancy were included. General anaesthesia was induced with intravenous (IV) propofol 2 mg kg-1 in the general anaesthesia group (n=36). In the spinal anaesthesia group (n=35), hyperbaric bupivacaine 0.5%, 9 mg (1.8 mL) was injected intrathecally. Maternal blood samples were taken immediately after positioning the patient on the operating table (T1), before clamping the umbilical cord (T2) and 24 hours after the first sample was obtained (T3). Cord blood samples were drawn from the umbilical artery (T4). Results Maternal BDNF levels (pg mL-1) measured at T2 time point were higher in the general anaesthesia group compared to the spinal anaesthesia group (p

Aim: To evaluate a possible relationship between body mass index and fetomaternal blood flow parameters in women with term pregnancy.Material and Methods: This study was performed on pregnant women undergoing routine third trimester ultrasound scans. Women were divided into four groups [underweight ( 18.5 kg/m2), normal weight (18.5–24.9 kg/m2), overweight (25-29.9 kg/m2) and obese (≥30 kg/m2)]. The uterine artery (UtA), umbilical artery (UA) and middle cerebral artery (MCA) were examined using color Doppler according to the standard protocols. The systole/diastole (S/D) ratio, pulsatility index (PI), and resistance index (RI) values of UtA, UA and MCA were recorded.Results: All Doppler findings were found to be similar among normal weight, overweight and obese women. There was a positive correlation between UtA-RI and maternal BMI (r=0.350; p0.01). There was a positive association between both UA-PI and UA-RI values with maternal BMI (r=0.372; p0.01; r=0.289; p=0.001, respectively). Also, we observed a positive association between both MCA-RI and MCA-S/D values with maternal BMI (r=0.180; p=0.04; r=0.181; p=0.04, respectively). Conclusion: Normal weight, overweight and obese women with term pregnancy have similar maternal and fetal blood flow parameters. Obese women should be informed about the risks of obesity during pregnancy, and they should be supported to lose weight before conception.

Purpose: To investigate whether there is any therapeutic effect of colchicine on a rat model of polycystic ovary syndrome (PCOS). Methods: Twenty-two Wistar-Albino rats were randomly assigned into four with 8 rats in each group: control group; PCOS only group; PCOS-metformin group and PCOS-colchicine group. PCOS was induced by gavage with letrozole once daily at the concentration of 1 mg/kg orally with 21 consecutive days. After PCOS model assessment, PCOS-metformin group was received metformin orally with 500 mg/kg and PCOS-colchicine group was received colchicine orally with 1 mg/kg for the 35 day. Histopathology of ovaries, circulating estrone (E1), estradiol (E2), total testosterone, androstenedione and c-reactive protein (CRP) levels were evaluated. Results: cystic and atretic follicle number was significantly decreased, but CRP and hormone parameters were not significantly changed with colchicine treatment. Conclusion: Colchicine has provided histopathological improvement compared with metformin in PCOS rat model. © 2015, Springer-Verlag Berlin Heidelberg.

Background/Aims: To investigate the effectiveness of controlled reperfusion (CR) on ovarian tissue malondialdehyde, total glutathione and 8-hydroxyguanine levels and infertility rates in a rat model of induced ischemia-reperfusion (I/R) injury with unilateral oophorectomy. Methods: A total of 135 adult female albino Wistar rats were divided into 9 groups (n = 15 for each group): unilateral ovariectomy + ovarian I/R (OIR), unilateral ovariectomy alone (OEG), a sham operation group (SG), and unilateral ovariectomy + CR performed at different intervals (the clips were released 10 times for 10, 8, 6, 4, 2 or 1 s and closed again 10 times for 10, 8, 6, 4, 2 or 1 s; OCR-1-6, respectively). Five rats from each group were sacrificed, and their ovaries were removed. Results: Higher ovarian tissue malondialdehyde and 8-hydroxyguanine levels and lower ovarian tissue total glutathione levels were found in the OIR group compared with the SG, OEG and OCR-4-6 groups. The number of rats giving birth during the study period was found to be similar among the SG (n = 8), OEG (n = 8) and OCR-6 (n = 7) groups. Conclusion: These results suggest that sterility and ovarian oxidative stress caused by I/R injury decreases in parallel to the shortening of CR duration.

Amaç: Spontan vajinal doğum eylemindeki kadınlarda maternal serum beyin kaynaklı nörotrofik faktör (BDNF) ve malondialdehit (MDA) seviyelerinde oluşan değişiklikleri ortaya koymak.Gereç ve Yöntem: Bu prospektif çalışma, spontan vaginal doğum eylemindeki term gebeliği olan 62 hastada yapıldı. Doğumun latent fazında (T1), göbek kordonu klemplenmeden hemen önce (T2) ve doğumdan 24 saat sonra (T3) maternal kan örnekleri; doğumda göbek kordonu klemplendikten hemen sonra umblikal arterden kord kanı örneği alındı. Alınan kan örneklerindeki MDA ve BDNF seviyeleri ölçüldü ve uygun istatistik testler kullanılarak sonuçlar karşılaştırıldı. Kord kanı BDNF ile kord kanı MDA seviyeleri ve maternal serum BDNF ile maternal serum MDA seviyeleri arasındaki ilişki araştırıldı.Bulgular: T3 zamanındaki maternal serum BDNF seviyeleri (pg/ml) (3729,92 ± 621,68) T1 (956,75 ± 291,47) ve T2 (985,50 ± 291,91)’ den yüksek bulundu (P, Objective: To reveal the changes in maternal serum brain-derived neurotrophic factor (BDNF) and malondialdehyde (MDA) levels in women undergoing spontaneous vaginal delivery.Material and Method: This prospective study was done in sixty-two patients with term pregnancy undergoing spontaneous vaginal delivery. Maternal blood samples in the latent phase of labor (T1), immediately before clamping the umbilical cord (T2) and 24 hours after birth (T3); and umbilical artery cord blood sample immediately after umbilical cord clamping at delivery were obtained. MDA and BDNF levels in collected blood samples were measured and results were compared using appropriate statistical tests. The relationship between cord blood levels of BDNF with cord blood MDA and maternal serum levels of BDNF with maternal serum MDA was investigated.Results: Maternal serum BDNF levels (pg/ml) were significantly higher in the blood sample collected at the T3 time point (3729.92 ± 621.68) compared to blood samples collected at T1 (956.75 ± 291.47) and T2 (985.50 ±291.91)time points (P

Since myomectomy throughout cesarean deliv- ery may lead to hemorrhage and uterinal atony, it is not recommended. But, myomectomy has been reported during cesarean section in recent studies. We presented a patient with large in- tramural myoma who was diagnosed at 34 weeks of pregnancy and operated with an unavoidable cesarean-combined myomectomy. A 33-year-old unpursued primigravida was referred to emer- gency department with abdominal pain and amenorrhea of 34 weeks duration. A sonographic diagnosis of myoma in pregnancy was made. Cesarean section was required for fetal distress and alive 2300 g weighted male infant with Ap- gar score of 6 at one minute, was born. As uterine incision could not be closed because of the myoma, myomectomy was performed dur- ing cesarean section unavoidably. A single 970 g and 15 × 18 cm sized myoma was removed. The physical examinations were unremarkable in the postoperative period. Although there are case series that have demonstrated the safety of myomectomy during cesarean section, we con-cluded that myomectomy during cesarean section is not a safe procedure accept inevitable situa-tions.

This study investigated the association between fear of childbirth (FOC) and women’s knowledge about painless childbirth methods. The study was performed on 900 multiparous women within the last month of pregnancy. Data was obtained through a questionnaire including the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) Turkish form A. FOC was defined as W-DEQ sum score ≥85. Women were questioned about their knowledge about painless childbirth and the most important source of this knowledge. Group 1 consists of participants with knowledge about painless childbirth. Group 2 consists of participants without knowledge about painless childbirth. Five hundred and twenty-four women (58.2%) had knowledge while 376 women (41.7%) had no knowledge about painless childbirth. Mean W-DEQ scores in group 1 (68.46±12.53) were found to be lower than group 2 (71.35±12.28) (P=0.001). FOC was associated with increased maternal request for elective caesarean section (OR 4.22, 95% CI 2.91–6.11). Better informed pregnant women about painless childbirth methods may reduce the number of women with FOC and the rate of preferred elective caesarean section.

In this study, xanthine oxidase (XO), malondialdehyde (MDA), myeloperoxidase (MPO) and glutathione (GSH) levels in the ovarian tissues of rats during the development of ischemia and postischemia-induced reperfusion were investigated, and the effect of ATP on ischemia-reperfusion (I/R) damage was biochemically and histopathologically examined. The results of the biochemical analyses demonstrated that ATP significantly reduced the level of XO and MDA and increased the amount of GSH in both ischemia and I/R-applied ovarian tissue at the doses administered. Furthermore, ATP significantly suppressed the increase in MPO activity that occurred following the application of post ischemia reperfusion in the ovarian tissue. The biochemical results obtained in the present study coincide with the histological findings. The severity of the pathological findings, such as dilatation, congestion, haemorrhage, oedema and polymorphonuclear nuclear leukocytes (PMNLs), increased in parallel with the increase observed in the products of XO metabolism. In conclusion, exogenously applied ATP prevented I/R damage by reducing the formation of XO in ischemic ovarian tissue. Neste estudo, a xantina oxidase (XO), o malondialdeído (MDA), mieloperoxidase ( MPO ) e glutationa ( GSH) nos tecidos do ovário de ratos, durante o desenvolvimento de isquemia e reperfusão induzida por pós-isquemia foi investigada, e o efeito de ATP em isquemia e reperfusão (I/R). O dano foi verificado por provas bioquímicas e por histopatologia. Os resultados das análises bioquímicas mostraram que o ATP reduziu significativamente o nível de XO e MDA e aumentou a quantidade de GSH em ambas as isquemia e no tecido do ovário de I / R - aplicado nas doses administradas. Além disso, o ATP suprimiu significativamente o aumento na atividade de MPO que ocorreu na sequência da aplicação de pós-isquemia reperfusão no tecido ovariano. Os resultados bioquímicos obtidos no presente estudo coincidem com os achados histológicos. A gravidade dos achados patológicos, como a dilatação, congestão, hemorragia, edema e polimorfonucleares leucócitos nucleares (PMNLs), aumentou em paralelo com o aumento observado nos produtos do metabolismo XO. Em conclusão, aplicando exogenamente ATP impedido de I/R, houve danos pela redução da formação de tecido de ovário de XO na isquemia.

Introduction: Depression is the most frequently seen mental disease in the pregnancy period. The first trimester of pregnancy is important in terms of its effects on both the fetus and on the mother. This study has researched the prevalence of depression in women in the first trimester of their pregnancies in Erzurum, which is a large province in the Eastern region of Turkey. Method: The study participants were 463 pregnant women who were in the first trimester of their pregnancy. Screening was primarily carried out using the Edinburgh Postnatal Depression Scale (EPDS), and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders–Fourth Edition ( DSM-IV)–Clinical Version (SCID-I) was applied to those participants with a score of 12 points and higher. To assess the risk factors, a sociodemographic data form was completed by the authors. Results: The total depressive disorder rate was 16.8% in women in the first trimester of their pregnancies (12.3% major depressive disorder, 1.5% double depression, 2.6% minor depressive disorder and 0.4% dysthymia). A history of mental disease, mental disease suffered during a previous pregnancy, exposure to violence in the present pregnancy, an unplanned pregnancy and spouse’s unemployment were predictors for depressive disorders. Conclusion: It is important to identify the risk groups for the early recognition of depression in pregnancy. Developing depression screening programs can be useful for early diagnosis and therapy.

Objective: The technique of anaesthesia in caesarean sections is selected according to the patient’s clinical presentation, experience of the anaesthesist and the patient’s wishes. The purpose of this study was to evaluate the anaesthesia methods employed in our clinic in the last decade (2003-2012). Methods: Records of caesarean operations performed between 2003-2012 in the Anaesthesia department of Ataturk University Medical Faculty and stored in the hospital computer system were examined. The annual distribution of methods of anaesthesia in operations was analysed. Results: During 2003-2012, 9049 caesarean operations were performed in our clinic. General anaesthesia was used in 45% of operations and regional anaesthesia in 54%. Whereas the rate of regional anaesthesia in 2003 was 34%, this increased to 69% in 2012. The most commonly used method of regional anaesthesia was spinal anaesthesia (34%) in 2003, and spinal anaesthesia (41%) and combined spinal-epidural anaesthesia (27%) in 2012. Conclusion: The most commonly used anaesthesia technique for caesarean operations in our clinic between 2003-2012 was spinal anaesthesia. The most widely used regional anaesthetic method in our clinic was spinal anaesthesia. A significant increase in the use of the combined spinal-epidural anaesthetic technique occurred in the last two years of the study period.

This study compared intrathecal hyperbaric bupivacaine with low-dose intrathecal plain bupivacaine plus different doses of meperidine (pethidine), administered sequentially, with regard to blood pressure stability, post-operative analgesia and incidence of side-effects in 80 parturients undergoing caesarean section. Patients were randomly assigned to one of four groups ( n = 20 each group): the HB group received 10 mg hyperbaric bupivacaine intrathecally; the BM35, BM30 and BM25 groups received 5 mg plain bupivacaine plus 35, 30 or 25 mg of meperidine intrathecally, respectively. The incidence of hypotension in the BM25 group was significantly lower than in the HB group. Nausea and vomiting were less prevalent in the BM25 group than in the HB and BM35 groups. In conclusion, sequential administration of 5 mg plain bupivacaine and 25 mg meperidine intrathecally provided better blood pressure stability and a lower incidence of side-effects than bupivacaine alone, without affecting quality of anaesthesia or surgical and patient satisfaction.

The aim of this study was to investigate lipid profile, paraoxonase 1 (PON1) activity, and oxidative stress status in the serum of hyperemesis gravidarum (HG) patients. Thirty‐six HG cases and 36 normal pregnants were included in the study. Serum total cholesterol (TC), triglyceride (TG), high‐density lipoprotein cholesterol (HDL‐C), low‐density lipoprotein cholesterol (LDL‐C), apoproteins A1 (apo A1) and B (apo B), malondialdehyde (MDA), and total antioxidant activity (TAO) values and PON1 and arylesterase activities were determined. Although serum TC, TG, LDL‐C, and apo B levels were not different among; the groups (P>0.05), HDL‐C (P=0.01) and apo A1 (P=0.007) levels were lower in HG patients than in normal pregnants. HG group had significantly lower serum PON1 (P=0.03) and arylesterase activities (P=0.03) compared with the control group. Additionally, mean TAO values were lower (P=0.01) and MDA levels were higher (P=0.02) in HG group than in the healthy pregnants. A significant negative correlation between PON1 and MDA was found in HG group (r=−0.33, P

We evaluated the incidence of hyperemesis between planned and unplanned pregnancy.A prospective study was conducted among 100 women with planned pregnancies and 100 women with unplanned pregnancies. Participants completed a questionnaire to determine the presence of vomiting. If pregnant women had severe vomiting (3 times per day), urinary investigation was performed; at least one positive ketonuria was considered as hyperemesis.There was a significant difference between planned and unplanned pregnancy in terms of the incidence of hyperemesis (p=0.0001). Women with unplanned pregnancies had a more than 18-fold increased risk of hyperemesis (OR=18.88; %95 CI, 8.84-40.31) compared to women with planned pregnancies.Healthy women may be able to improve their management of hyperemesis during pregnancy if they plan their pregnancies.Planlı ve plansız gebelikler arasındaki hiperemezis insidansının farkını araştırmayı amaçladık.Bu çalışma planlayarak gebe kalmış 100 ve plan-lamadan gebe kalmış 100 hastada prospektif olarak yapıldı. Gebeler kusmanın olup olmadığı yönünden sorgulandı. Günde üç defadan fazla kusma tarif eden hastalara tam idrar tetkiki yapıldı. İdrar tetkikinde en az 1 pozitif keton cisim tespit edilen hastalar ” hiperemezis” olarak adlandırıldı.Planlı ve plansız gebelikler arasında hiperemezis insidansı açısından önemli fark bulundu (p=0,0001). Planlanmamış gebeliği olan hastalar 18 kat daha fazla hiperemezis riskine sahipti (OR=18,88; %95 CI, 8,84–40,31).Sağlıklı kadınlar planlayarak gebe kalırlarsa; gebelikte hiperemezis oluşma riskini azaltabilirler.

The authors aimed to research the prevalence of fear of childbirth (FOC) in women with a positive birth experience and some factors associated with FOC.The study sample consisted of 817 women with positive birth experience within the last month of their pregnancy from February 2012 to May 2013. The data were collected with a questionnaire form including women's demographic-obstetric information and the Turkish form of Wijma Delivery Expectancy Questionnaire. Whether it was a planned pregnancy and their preferable delivery method for the current pregnancy were recorded.The total number of women with FOC was found to be 128 (15.6%). None of the patients had severe FOC. Fear of labour pain was found as the major cause for preferring cesarean section (73.5%). FOC was associated with preferring delivery methods (OR 5.91, 95% CI 3.96-8.84). FOC was associated with pregnancy planning status (OR 2.4, 95% CI 1.66-3.58).Fear of childbirth may be seen to some extent in women with a positive birth experience. However even with woman's positive birth experience, it is important to avoid severe FOC. The pregnancy planning status should be evaluated in the early stages of pregnancy and maternal education programs may be offered to reduce FOC level.