Seroprevalence rates of Toxoplasma gondii, Rubella, Cytomegalovirus among first trimester pregnant women in Istanbul

Background: Toxoplasma Gondii, Rubella, and Cytomegalovirus (CMV) are the most common causes of congenital infections worldwide. There is not a consensus on these infectious agents should be screened during pregnancy. The aim of this study is to determine the prevalence of toxoplasma, rubella, and CMV infections in order to know the need for antenatal screening.Methods: This retrospective cross-sectional study was performed on 1309 ambulatory pregnant patients who applied to the obstetric clinic of a university hospital between October 2016 and April 2018. Documents of patients in the first trimester were reviewed and serologic data of Toxoplasma gondii, CMV, Rubella infections were retrieved from the computer database.Results: Of 1309 pregnant women, positivity for anti-Toxoplasma IgG antibody was 352(26.9%), while 17(1.3%) of the subjects tested were positive for the anti-Toxoplasma IgM antibody. These positivities of the pregnant women for anti-Rubella IgG and IgM were 1147(87.6%) and (0.1%), respectively. These positivities of the pregnant women for anti-CMV IgG and IgM were 1163(88.8%) and 17(1.3%), respectively.Conclusions: We detected high rates of immunity against Rubella and CMV but low rates of immunity against Toxoplasma in this retrospective cohort of pregnant women. Due to high rates of seropositivity against Rubella and CMV, routine nationwide screening may not be necessary

Intra-operative diagnosis of an adult ureterocele complicated by hydronephrosis: a case report

Ureterocele is a cystic dilatation of the terminal ureter. Hydronephrosis is less commonly reported in individuals with ureterocele. We report a unique case of an incidental ureterocele with hydronephrosis in a 47-year-old woman; diagnosed with intraoperative control cystoscopy while performing total laparoscopic hysterectomy and bilateral salpingo- oophorectomy

THE RELATIONSHIP BETWEEN BAD OBSTETRIC HISTORY AND THROMBOPHILI

The aim was to evaluate the relationship of recurring miscarriages and in utero mort fetus cases over 20 weeks of pregnancy (except for those caused by a systemic disease or a known pathology) with thrombophilic conditions. Our study was conducted on the patients who were admitted to our clinic with for follow ups or investigation of recurring pregnancy losses. The included patients had had at least 2 fetal losses over 8 weeks into their pregnancy or at least one loss over the 20th gestational week and gave histories of hypertensive pathologies of pregnancy such as preeclampsia or eclampsia. The control group comprised 81 patients who had at least one pregnancy without any complication or fetal loss histories. In our study, the ratios of Factor V Leiden mutation in the study group (106 cases) and the control group (81 cases) were %12 and %1.3 (p=0.01) respectively. In the patient group, the MTHFR homozygous mutation was seen 3.3 times as much and Factor V Leiden heterozygous gene mutation was determined to be seen 8.3 as much as the control group. There was a significant difference between the study and control groups in terms of Protein C and S activity (p<0.0001 ve p<0.001). In the study group, the detection rate of Protein C levels <%65 was 5.2 times more(OR 5.2 2.7-12.49), and the Protein S activity was 12.17 times higher than the control group. Thrombophilic cases may play many roles in the pathologies which arise during pregnancies

The relationship between the helicobacter pylori seropositivity with systemic and local oxidative status and hyperemesis gravidarum: a pilot study

Akpak, Yasam Kemal/0000-0002-1699-8667WOS: 000427919300017PubMed: 28347201Objectives: The aim of study was to determine the helicobacter pylori (HP) seropositivity and oxidative parameters in serum and saliva of pregnant women with poor oral hygiene and hyperemesis gravidarum (HG).Methods: A case-control study was conducted involving 50 pregnant women in their first trimester of pregnancy. Twenty-five subjects had a diagnosis of HG, and remaining 25 were healthy pregnant women who served as control subjects were included. The groups were adjusted for age, parity and gestational week. All patients were subjected to the measurement of total oxidant status (TOS) and total antioxidant status in serum and saliva. Also HP seropositivity was investigated.Results: Serum TAS and TOS values were similar, although oxidative burden in saliva of women with HG were significantly higher than controls. HP seropositivity was found to be 24% in women with HG and 4% of controls.Conclusions: Our results suggest that significantly increased oxidative burden and slightly decreased antioxidative capacity of saliva may be involved in the pathogenesis of HG and this condition may be the result of HP infection which was found to be significantly more common in women with poor oral hygiene and HG

Impacts of Childbirth on the Subsequent Risk of Stress Urinary Incontinence

Akpak, Yasam Kemal/0000-0002-1699-8667WOS: 000441304600004Objective: The purpose of the this study was to indicate the role of childbirth parameters on the development of stress urinary incontinence (SUI). Methods: One hundred-one healthy women (control group) and 98 patients with SUI (study group) were included in this study between March 2008 and April 2009. Obstetric history of participants was taken and labor parameters were compared between control group and study group. Results: The prevalence of SUI reported in the study was 43.9%. The result of prevalence was 43.9% during the study. Parity and gravidity was significantly more in study group (p<0.001). Vaginal delivery, Kristeller manauver, operative delivery by vacuum or forceps extraction and delivery of macrosomic fetus was found to be significant risk factors for SUI (p<0.05). Conclusions: Mode of delivery and obstetric history have significant impact on subsequent SUI. Timely cesarean section in women with obstructed labor may prevent the later occurrence of SUI

Prediction of gestational diabetes mellitus and perinatal outcomes by plasma zonulin levels

Purpose Zonulin has been shown to be associated with many metabolic disorders, including type 2 diabetes mellitus, metabolic syndrome, and obesity. In this study, we aimed to evaluate the association between maternal plasma zonulin levels and gestational diabetes mellitus (GDM) and its perinatal outcomes. Materials A total of 100 pregnant women, 56 with GDM and 44 controls, were included in this prospective case-control study. Maternal plasma zonulin levels were evaluated in each trimester. The association between zonulin levels and GDM, body mass index (BMI) and adverse perinatal outcomes was evaluated. The GDM predictability of zonulin levels for each trimester was analyzed with the receiver operator curve (ROC). Results Plasma zonulin levels were significantly higher in pregnant with GDM in all trimesters (p = 25-30 (kg/m(2))] in all trimesters (p < 0.05; for all). Zonulin levels were significantly higher in pregnant women with composite adverse outcomes that included at least one of neonatal intensive care unit (NICU) admission, meconium-stained amniotic fluid, and 1st minute APGAR score < 7. Conclusion Increased maternal plasma zonulin levels were associated with increased risk of GDM and adverse perinatal outcomes. Zonulin may be a potential marker to predict GDM risk and perinatal outcomes

Effect of Subclinical Hypothyroidism on the Mean Platelet Volume of Pregnant Women

Subclinical hypothyroidism (SH) is a frequently seen clinical disorder, which needs to be managed strictly in the pregnant population. SH is closely related with newborn complications and also suggested to be risk factor for cardiovascular events. Mean platelet volume (MPV), a determinant of platelet function, is a newly emerging risk marker for cardiovascular events. The aim of this study was to evaluate how MPV values and other hematological parameters are influenced in pregnants with subclinical hypothyroidism. A total of 70 subclinical hypothyroidic pregnants and 40 euthyroid pregnant controls were enrolled in our study. Age, body mass index (BMI), erythrocyte and platelet parameters were all evaluated. Erytocyte parameters and thrombocyte parameters, including MPV, were not statistically significantly different between pregnants with SH and healthy pregnants (p&gt;0.05). Mean free T3 and TSH levels of subclinical hypothyroidic pregnants were statistically significantly different from healthy pregnant (p=0.04 and p [Med-Science 2016; 5(1.000): 86-93

Can balneotherapy improve the bowel motility in chronically constipated middle-aged and elderly patients?

Balneotherapy or spa therapy is usually known for different application forms of medicinal waters and its effects on the human body. Our purpose is to demonstrate the effect of balneotherapy on gastrointestinal motility. A total of 35 patients who were treated for osteoarthritis with balneotherapy from November 2013 through March 2015 at our hospital had a consultation at the general surgery for constipation and defecation disorders. Patients followed by constipation scores, short-form health survey (SF-12), and a colonic transit time (CTT) study before and after balneotherapy were included in this study, and the data of the patients were analyzed retrospectively. The constipation score, SF-12 score, and CTT were found statistically significant after balneotherapy (p < 0.05). The results of our study confirm the clinical finding that a 15-day course of balneotherapy with mineral water from a thermal spring (Bursa, Turkey) improves gastrointestinal motility and reduces laxative consumption in the management of constipation in middle-aged and elderly patients, and it is our belief that treatment with thermal mineral water could considerably improve the quality of life of these patients

Effect of Gum Chewing and Coffee Consumption on Intestinal Motility in Caesarean Sections

Akpak, Yasam Kemal/0000-0002-1699-8667WOS: 000423935700012Aim: The time to first postoperative flatulence and defaecation are two of the main factors that determine caesarean patient comfort and morbidity. In this study, the effect of postoperative gum chewing and decaffeinated coffee consumption on intestinal motility was tested in full-term caesarean sections without complication with a prospective, randomised controlled trial. Material and Method: 100 women who underwent caesarean section without a complication were divided into 4 groups using the simple randomisation method: Group 1 (women given sugar-free gum at 4-hour intervals after postoperative hour 2 until defaecation) n:25; Group 2 (women given 100 mL coffee at 4-hour intervals beginning from postoperative hour 2 until defaecation for three times a day) n:25; Group 3 (Sham group-women given 100 ml hot water at 4-hour intervals beginning from postoperative hour 2 until defaecation for three times a day) n:25; and Group 4 (control group) n:25. Time to sensation of first bowel movement and time to passage of first flatus and defaecation were compared between the groups. Results: Times to sensation of first bowel movement and passage of first flatus were significantly shorter in Group 1 compared to the sham and control groups. Time to first defaecation was also detected to be significantly shorter in Groups 1, 2, and 3 compared to the control group. No significant difference could be detected between the groups. Discussion: Sugar-free gum chewing and decaffeinated coffee consumption during postoperative period after caesarean section may decrease the time to first flatulence and defaecation and thus, the hospitalisation time

Effect of vaginal cleansing on postoperative factors in elective caesarean sections: a prospective, randomised controlled trial

Akpak, Yasam Kemal/0000-0002-1699-8667; Ozdamar, Ozkan/0000-0001-9730-0285WOS: 000389666700014PubMed: 27049354Objective: To assess the effect of povidone iodine versus benzalkonium chloride, which were applied preoperatively for vaginal disinfection in caesarean sections, on postoperative factors. Methods: One hundred and twenty patients underwent elective caesarean section were divided into three groups using the simple randomisation method: Group 1 (povidone iodine, n: 41); Group 2 (benzalkonium chloride, n: 39); Group 3 (control group, n: 40). Demographic data, duration of operation, amount of bleeding, postoperative pain, time to first flatulence and defaecation, haematological parameters on postoperative day 1 were compared between three groups. Pain evaluation was performed at 6th and 24th postoperative hour using Visual Analogue Scale. Results: No statistically significant differences were detected between the groups in demographic characteristics. There were no significant differences between the groups with respect to the duration of operation and hospital stay. The patients in the group who underwent povidone iodine vaginal cleansing had statistically significantly less postoperative pain as compared to control group. No difference was observed between the groups in haematological parameters other than C-reactive protein (CRP); however, CRP levels at 24th post-operative hour were significantly lower in Group 1 compared to the other groups. Conclusions: The preoperative vaginal cleansing with povidone iodine could reduce the postoperative pain, analgesic need and infection parameter