Effects of menopause on corneal topography and dry eye

Background: The aim of this study was to investigate the effect of estrogen and progesterone on central corneal thickness, corneal curvature, and the development of dry eye in postmenopausal women.Methods: This is a case-control study including 54 premenopausal and 54 postmenopausal women. The two groups were compared in terms of follicle stimulating hormone, estradiol, progesterone, and horizontal and vertical curvatures, astigmatism, central corneal thickness, Schirmer I test scores, and dry eye scores of both eyes.Results: In the postmenopausal women, central corneal thickness was significantly thinner in both eyes (p=0.017) and the Schirmer test scores were significantly lower both for the right (p=0.001) and the left eye (p=0.003). Estradiol levels were positively correlated with central corneal thickness (p=0.003-0.006) and Schirmer test scores (p=0.004-0.002) whereas progesterone levels showed a positive correlation only with Schirmer test scores (p=0.036-0.044). Although a significant positive correlation was found between estradiol levels and dry eye scores (p=0,009), no significant correlation was found between progesterone levels and dry eye scores (p=0,118).Conclusions: Age-related hormonal abnormalities lead to central corneal thinning, increased dry eye symptoms, and decreased tear flow, particularly in the postmenopausal term. Decreased estrogen levels are associated with central corneal thickness and dry-eye symptoms, decreased estrogen and progesterone levels correlates well with diminished tear production but progesterone levels does not effect dry-eye symptoms

Diagnosis of endometrial pathologies: transvaginal sonography versus hysteroscopy

Background: Abnormal uterine bleeding (AUB) constitutes 69% of all gynecological complaints in the peri- and postmenopausal age groups. The aim of present study was to compare the accuracy of transvaginal sonography and hysteroscopy in diagnosing intracavitary pathologies in women with abnormal uterine bleeding.Methods: A total of 303 premenopausal women with abnormal uterine bleeding who admitted to the gynecology outpatient clinic of the Istanbul Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey, between April 2010 and July 2015, and received hysteroscopy, were evaluated retrospectively. The collected data were assembled from the computerised database. All patients underwent pelvic examination, transvaginal ultrasonography, office hysteroscopy and hystopathologic evaluation. Patients with normal appearing uterine cavities on hysteroscopy additionally underwent full curettage. The pathology reports were considered to be the definitive diagnoses of patients. Transvaginal ultrasonography and office hysteroscopy findings were compared with the pathological reports and the sensitivity, specificity, positive and negative predictive values, accuracy values and likelihood ratios of office hysteroscopy and transvaginal ultrasonography were calculated for the detection of endometrial abnormalities.Results: Endometrial polyps were the most commonly identified pathology with a rate of 77.56%. The sensitivity, specificity, positive and negative predictive values of transvaginal sonography for diagnosing endometrial pathologies were 77%, 32%, 75% and 32%, respectively. The same values for hysteroscopy were 93%, 44%, 88% and 48% respectively. Transvaginal sonography had a sensitivity of 20% with a specificity of 4% for submucous myomas. The sensitivity, specificity, positive and negative predictive values of hysteroscopy for submucous myomas when compared to histopathology were 100% for all.Conclusions: The diagnostic accuracy of office hysteroscopy for focal lesions such as polyps or submucous myomas is higher than the accuracy of transvaginal ultrasonography. Due to its high diagnostic accuracy, lower complication rate and the ability to obtain direct biopsy specimens while providing simultaneous treatment, we believe that hysteroscopy will retain its place as the gold standard procedure for the investigation of endometrial pathologies

The effect of anesthetic agents used in oocyte collection on intracytoplasmic sperm injection results in patients treated for infertility due to male factor

Aim: Different anesthetic methods and agents are used for transvaginal oocyte retrieval procedures (TORP) in assisted reproductive techniques (ART). In our study, we evaluated prospectively the effect of propofol and thiopental sodium during TORP on intracytoplasmic sperm injection (ICSI) results in the spouses of patients with male factor indication.Material and Methods: The study was approved by the ethics committee with Protocol No. 2019-21-07 on dated October 28, 2019. Sixty female patients who underwent TORP for intracytoplasmic sperm injection were included in the study. Anesthesia was randomized into two groups according to propofol (GP) or thiopental sodium (GT) used for induction and maintenance anesthesia. Patients' demographic data, effects of the anesthetic drug used on hemodynamics and nausea and vomiting, laboratory parameters including fertilization rate, cleavage rate, optimal embryo rate and implantation rate, and pregnancy outcomes were recorded.Results: Sixty patients, including the propofol group (n:30) and the thiopental sodium group (n:30), were evaluated. Mean age, body mass index and motile sperm count were similar in both groups. Mean arterial pressures and nausea and vomiting rates were lower in GP (p<0.05). Although intracytoplasmic sperm injection, pronucleus, MII oocyte values were statistically significantly higher in GP, B-HCG and clinical pregnancy outcomes were similar in both groups.Discussion: Our findings revealed that propofol and thiopental sodium, the anesthetic agents used in transvaginal oocyte collection procedure before ICSI treatment, had similar effects on clinical pregnancy. The results of our study are similar to many studies in the literature

Expression of PLIN2 and PLIN3 during the different phases of estrous cycle in mouse

Giriş: Puberteye kadar birinci mayozun profaz evresinde bekleyen primordiyal foliküllerden birkaçı puberte ile birlikte, hormonal uyarı altında her ay tekrarlayan bir serüvene başlar. Bu süreçte ovaryumun stromal hücreleri de farklılaşarak, lipid droplet (LD) açısından zengin teka hücrelerine farklılaşırlar. Farede bu süreç çok kısadır ve ortalama 4 günde tamamlanır. Hücre içi sitoplazmik yapılar olan LD’ler, hücre içi birçok olayda enerji kaynağı olarak karşımıza çıkmaktadır. Perilipin yağ damlacıklarının yüzeyine lokalize olan fosforilasyon bağımlı bir proteindir ve LD’leri hormona duyarlı lipazın etkisinden korur. Materyal-Metot: Seksüel olarak matür, düzenli östrus siklusuna sahip 24 adet dişi fare vajinal smear sonuçlarına göre 4 gruba ayrıldı; proöstrus, östrus, metöstrus, ve diöstrus. Sakrifiye edilen farelerin overleri alındı. Bir over Hematoksilen Eozin boyama ve PLIN2- PLIN3 çift floresan boyama için, diğer over ise Western Blot analiz için kullanıldı. Bulgular: Western Blot analiz sonuçlarına göre PLIN2 ekspresyonu en fazla diöstrus, PLIN3 ekspresyonu ise en fazla diöstrus ve proöstrus fazında ölçüldü. Proöstrus antral folikül oositinde PLIN3 ekspresyonunun aynı gruptaki faklı hücre gruplarına göre anlamlı olarak daha fazla olduğu saptandı (p<0,05). Östrus antral folikül oositinde eksprese olan PLIN3 atretik folikül PLIN3 ekspresyonuna göre anlamlı olarak daha yüksek ölçüldü (p=0,031). Sekonder folikül granüloza hücrelerinde diöstrus fazında PLIN3 ekspresyonu proöstrus (p=0,000), östrus (p=0,001) ve metöstrus (p=0,023) fazlarından anlamlı olarak daha yüksek saptandı. Sekonder folikül oositinde PLIN3 ekspresyonu diöstrus fazında metöstrus fazından anlamlı olarak daha yüksek saptandı. Preantral folikül granüloza hücrelerinde eksprese olan PLIN3’ün östrus fazında proöstrus (p=0,005), metöstrus (p=0.045) ve diöstrus (p=0,025) fazlarına göre anlamlı derecede daha yüksek olduğu saptandı. Atretik folikül granüloza hücrelerinden eksprese olan PLIN3 miktarının östrus fazında proöstrus fazına göre anlamlı olarak daha yüksek olduğu görüldü (p=0.023). Tartışma: Komleks bir süreç olan oosit matürasyonu, ovulasyon ve fertilizasyon aşamalarında gelişen olaylar enerji gerektirir. Bu süreçte hücre içi lipid mobilizasyonunu düzenleyen yollar ile oositi aktive eden yolların yakından ilişkili olduğu çeşitli çalışmalarla ortaya konmuştur. Biz de çalışmamızda östrus siklusunu oluşturan dört fazda PLIN2 ve PLIN3 ekspresyonlarının fazlar arasında ve aynı faz içinde farklı hücre gruplarında ekspresyon farklılıkları gösterdiklerini gösterdik. Bu da bize bu düzenleme ile oosit ve granüloza hücrelerinin enerji ihtiyacına göre perilipin ekspresyonunu ayarladığını ve enerji rezervini koruduğunu göstermiştir.Introduction: Some primordial follicles which waits at the first meiotic prophase stage till puberty begins a recurring adventure with puberty every month under hormonal stimulation. During this process stromal cells differentiate into theca cells which are rich in terms of lipid droplets (LD). This process is very short, and completed an average of 4 days in mice. LDs, which are intracellular cytoplasmic structures, emerges as an energy source in many intracellular processes. Perilipin, a phosphorylation dependent protein, is localized to the surface of the oil droplets and protects LDs from the effect of the hormone-sensitive lipase.Materials and Methods: 24 female mice that are sexually mature and having regular estrous cycle, were divided into 4 groups according to the vaginal smear results; proestrus, estrus, metestrus, and diestrus. Ovaries of the sacrificed mice were isolated. A single ovary was used for hematoxylin eosin sand PLIN2-PLIN3 double fluorescent staining. The other ovary was used for Western Blot analysis.Results: According to the western blot results, PLIN2 expression was detected at most in diestrus stage, and these phases for PLIN3 are diestrus and proestrus. PLIN3 expression was found to be significantly high in comparison to the different cells in. the same group in proestrus antral follicle oocytes (p &lt;0.05). PLIN3 expression in estrus antral follicles is significantly higher than expressed PLIN3 amount in atretic follicles (p = 0.031). PLIN3 expression in diestrous phase for secondary follicular granulosa cells is significantly higher than proestrus (p = 0.000), estrus (p = 0.001) and metestrus (p = 0.023). PLIN3 expression in secondary follicles oocytes were significantly higher in diestrus phase than the the metestrus phase. PLIN3 expression in estrus phase for pre-antral follicle granulosa cells is significantly higher than proestrus (p=0,005), metestrus (p=0.045) and diestrus (p=0,025). PLIN3 expression level in atretic follicular granulosa cells was significantly higher in estrus phase than the proestrus phase (p = 0.023). Discussion: Ongoing events during the complex process of oocyte maturation, ovulation and fertilization stages require energy. By many studies, cross talking of pathways related to activation of oocytes and regulation of lipid mobilization has been demonstrated. Here, in this study, we exhibit the expression alterations of PLIN2 and PLIN3 in different phases or in diverse cells of the same phase during the estrous cycle. According to this data, we can conclude that, energy requirements of the oocyte and granulosa cells regulates the perilipin expression and maintenance of energy reserves

What is new in peripartum hysterectomy? A seventeen year experience in a tertiary hospital

Objective: To identify changing trends in peripartum hysterectomy (PH), both elective. cesarean hysterectomy and emergency cesarean hysterectomy, at a single training and research hospital over the last 17 years in Istanbul, Turkey. Materials and methods: A retrospective cohort study was performed between January 2001 and September 2017. The records of all patients who had PH at Kanuni Sultan S & uuml;leyman Training and Research Hospital were analyzed. Results: There were 243 cases of PH during the study period. A total of 266,386 births occurred, of which 60.1% were vaginal deliveries and 39.8% were cesarean sections. The incidence of PH increased from 0.67 per 1000 deliveries to 1.14 per 1000 deliveries during 2001-2008 and 2009-2017, respectively, with an overall incidence of 0.91 per 1000 deliveries during the 17 years. The main indication for PH changed significantly during this time from uterine atony (57.1%) to placenta accreta spectrum (85%). About 37% of women who underwent PH had at least one previous cesarean delivery during 2001-2008, whereas that percentage increased to 95.4% during 2009-2017. Conclusion: Placenta accreta spectrum was the leading cause of PH and was associated with significant maternal morbidity and mortality

Can CA-125 Predict Lymph Node Metastasis in Epithelial Ovarian Cancers in Turkish Population?

Objective. The role of single preoperative serum CA-125 levels in predicting pelvic or paraaortic lymph node metastasis in patients operated for epithelial ovarian cancer has been investigated. Methods. 176 patients diagnosed with epithelial ovarian carcinoma after staging laparotomy between January 2002 and May 2010 were evaluated retrospectively. Results. The mean, geometric mean, and median of preoperative serum CA-125 levels were 632,6, 200,29, and 191,5 U/mL, respectively. The cut-off value predicting lymph node metastases in the ROC curve was 71,92 U/mL, which is significant in logistic regression analysis (P=0.005). The preoperative log CA-125 levels were also statistically significant in predicting lymph node metastasis in logistic regression analysis (P=0.008). Conclusions. The tumor marker CA-125, which increases with grade independent of the effect of stage in EOC, is predictive of lymph node metastasis with a high rate of false positivity in Turkish population. The high false positive rate may obscure the predictive value of CA-125

Skin closure at cesarean section, polypropylene versus polyglactin 910: A randomized controlled study

Aim: To compare the rates of surgical wound infection in women who have undergone cesarean delivery with subcuticular skin closure with polyglactin 910 or polypropylene. Methods: Between April 2018 and October 2018, patients who had undergone a cesarean delivery for any reason were randomized with polyglactin 910 or polypropylene for subcuticular skin closure. Participants were evaluated for wound complications on day 7 and 30 postoperatively. The primary outcome was surgical site infection within the first 30 days following delivery. In addition, factors affecting surgical site infections were analyzed by binary regression. Results: A total of 220 women who had undergone cesarean delivery were randomized and 213 were included in the final analysis. The groups were similar in terms of demographic characteristics and perioperative features. No statistically significant difference was observed between the groups in terms of wound complications or superficial site infections (8.3% in the polypropylene group versus 10.6% in the polyglactin 910 group, p = .642). Similarly, no difference was observed between the groups in terms of other wound complications. A binary logistic regression analysis indicated that superficial wound site infection was not affected by gravidity, BMI, duration of operation, repeated or unplanned cesarean delivery. Conclusion: It was observed that surgical site infections and other wound complications in skin closures with polyglactin 910 were similar to those with polypropylene

Assessment of fetal right ventricular myocardial performance index changes following intrauterine transfusion

Introduction: Severe fetal anemia may cause cardiac ischemia, reduced contractility, and dysfunction. The purpose of our study is to evaluate right ventricular myocardial performance index (MPI) before and after intrauterine transfusion (IUT) in patients who underwent this procedure because of fetal anemia due to Rh-D alloimmunization. Materials and methods: This prospective cohort study was conducted between January 2018 and June 2019 at Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey. The pregnant women who were applied IUT because of fetal anemia due to Rh-D alloimmunization in our perinatology clinic were included in the study. Fetal right ventricular MPI before and 24 h after IUT were evaluated. Results: A total of 28 IUTs were performed in 17 pregnant women during the study period. The isovolumetric contraction time (ICT) and isovolumetric relaxation time (IRT) values measured before IUT, were found to be significantly longer compared to the ICT and IRT values measured after IUT. The MPI values measured after transfusion was found to be higher than before transfusion. Conclusions: The fetal right ventricular MPI increases 24 h after IUT. This increase in the right ventricular MPI might be used as a marker for predicting adverse fetal outcomes following IUT