Central Sagittal Angle of the Sacrum as a New Risk Factor for Patients with Persistent Low Back Pain after Caesarean Section

Study DesignRetrospective.PurposeThis study investigated the possible association of persistent low back pain (LBP) with caesarean section (CS) under spinal anesthesia.Overview of LiteratureMany women suffer from LBP after CS, which is commonly performed under spinal anesthesia. However, this type of LBP is poorly understood, and there is poor consensus regarding increased risk after spinal anesthesia.MethodsWe examined two groups of patients who underwent cesarean delivery under spinal anesthesia. Group I included patients who presented to a neurosurgical clinic complaining of LBP for at least 6 months. Group II was a control group with patients without LBP. We analyzed clinical and sagittal angle parameters, including age, body mass index, parity, central sagittal angle of the sacrum (CSAS), and sacral slope (SS).ResultsFifty-three patients participated in this study: 23 (43.1%) in Group I and 30 (56.9%) in Group II. Non-parametric Mann–Whitney U-tests showed that age, parity, and CSAS significantly differed between the two groups at 6 months.ConclusionsAge, parity, and CSAS appear to be associated with increased risk for LBP after CS under spinal anesthesia. Future prospective studies on this subject may help validate our results

Relation between uterine morphology and severity of primary dysmenorrhea

WOS: 000556541500002PubMed: 32850181Objective: This study aimed to evaluate whether uterine dimensions including uterine volume, uterine shape, uterine length, cervix length, and cervix thickness measurements have a role in the severity of primary dysmenorrhea in virgin girls. Materials and Methods: Enrollment included 90 virgin girls suffering from primary dysmenorrhea. the girls were divided into three groups according to the severity of dysmenorrhea, which was determined by the visual analog scale (VAS). Patients with VAS scores of 8-10 comprised the severe primary dysmenorrhea group (n=30), 4-7 the moderate primary dysmenorrhea group (n=30), and 1-3 the mild primary dysmenorrhea group (n=30). Uterine characteristics including uterine volume, uterine shape, uterine length, cervix length, and cervix thickness were measured by a high-resolution four-dimensional ultrasound device with real-time capacity. They were recorded to determine if they can be predictors of dysmenorrhea severity. Results: Girls with severe primary dysmenorrhea were more likely to complain of midline pain as opposed to mild and moderate cases with lateral or diffuse pain. None of the uterine characteristics on ultrasonography examination were significant for predicting the severity of primary dysmenorrhea. There were no significant positive correlations between the dysmenorrhea severity and uterine corpus length, cervix length, and uterine volume degree. Any combination of the measured uterine features was not predictive for determining the severity of dysmenorrhea. Conclusion: Ultrasonographic measurements of uterine dimensions in virgins have low accuracy for predicting the severity of pain in primary dysmenorrhea

Serum Preptin and Amylin Levels with Respect to Body Mass Index in Polycystic Ovary Syndrome Patients

Hatirnaz, Safak/0000-0001-8859-0639WOS: 000447725300003PubMed: 30343311Background: Preptin and amylin are pancreatic hormones which participate in glucose homeostasis. This study aimed to evaluate how serum preptin and amylin levels are altered in polycystic ovary syndrome (PCOS) patients and healthy women based on BMI groups (= 25 kg/m(2)). Material/Methods: This was a prospective randomized control study of 40 PCOS patients and 40 healthy women who were matched with respect to BMI (= 25 kg/m(2)). Results: When compared to the healthy women, PCOS patients had significantly higher ovarian volumes, Ferriman-Gallwey scores, and free and total testosterone levels, but significantly lower amylin concentrations (p=0.001, p=0.001, p=0.049, p=0.021, and p<0.001, respectively). Both the normal-weight and overweight PCOS patients had significantly lower amylin levels than the normal-weight and overweight controls (p<0.001, p=0.009, p=0.001, and p=0.001, respectively). Amylin levels were negatively and significantly correlated with the Ferriman-Gallwey scores (r=-0.272, p=0.001) and ovarian volume (r=-0.206, p=0.007). Serum preptin levels were not elevated in either group. Conclusions: Serum preptin levels are statistically similar in PCOS patients and BMI-matched healthy controls. Serum amylin levels are significantly higher in healthy controls than PCOS patients whether they are slim or overweight. These findings suggest the presence of mechanisms that can prevent the elevation in serum amylin concentrations that can occur in response to the impaired glucose metabolism in PCOS patients

Thrombocyte Alterations in Pregnant Women with Gestational Diabetes Mellitus

Objective: Inflammation and its complications might develop in patients diagnosed with diabetes mellitus. It is shown that number, shape and functions of thrombocytes are important for development and prediction of inflammatory process. We aimed to show the changes of number, morphology and functions of platelets in the patients with gestational diabetes mellitus. study design: In a retrospective study, 928 cases in 24-28th weeks of gestation followed regularly in the same clinic were included. We performed 75g oral glucose tolerance test to all cases. Mean platelet volume, platelet distribution width and plateletcrit values of the cases with and without gestational diabetes mellitus according to American Diabetes Association criteria were compared to evaluate the platelet count, morphology, functions and activity. Results: Platelet count and plateletcrit values of cases were significantly higher in the patients with gestational diabetes mellitus. No significant differences were found between the cases with and without gestational diabetes mellitus in mean platelet volume and platelet distribution width values. Conclusion: There is tendency to inflammation in GDM and platelets are part of inflamatuary process in human metabolism. Our findings show that, platelets are affected in GDM. We believe that further studies in this subject will help understanding of pathophysiology of GDM

Comparison of the Effect of Laparoscopic and Abdominal Hysterectomy on Lower Urinary Tract Function, Vaginal Length, and Dyspareunia: A Randomized Clinical Trial

Objectives: The effect of hysterectomy on vesicourethral and sexual functions remains controversial. The primary objective of this study was to compare the effects of a laparoscopic hysterectomy and a total abdominal hysterectomy on lower urinary tract function. The secondary aims were to compare the two surgeries in terms of postoperative vaginal length and dyspareunia. Materials and Methods: This was a prospective randomized clinical study in which 292 women were assigned to either the laparoscopic hysterectomy (n=146) or total abdominal hysterectomy (n=146) groups. The vaginal length and urodynamic measurements were taken, and the patients were asked to grade the presence and severity of dyspareunia using a visual analog scale 3 weeks before and 12 weeks after the surgery. The relationship between the postoperative vaginal length and the incidence of dyspareunia was evaluated. The urodynamic procedures used included uroflowmetry and voiding cystometry to record the maximum flow rate (Q-max) and to assess the bladder capacity. Results: The preoperative vaginal length was similar between the groups, whereas the postoperative vaginal length was significantly longer in the laparoscopic hysterectomy group. When the 15 patients who developed postoperative dyspareunia were evaluated, no differences in the postoperative vaginal length were seen, but a significant difference in the change in the length of the vagina was found when compared with the other patients. No significant difference was found with regard to pre- and postoperative Q-max, bladder capacity, and change in bladder capacity between the study groups. Conclusions: The change in the length of the vagina was much more remarkable after total abdominal hysterectomy, compared with laparoscopic hysterectomy. It seems that the Q-max and the bladder capacity increase after hysterectomies, regardless of the surgical type. Further prospective randomized comparative studies are warranted to ascertain whether laparoscopic hysterectomies cause less damage to the pelvic floor, compared with abdominal hysterectomies

Comparison of the Effect of Laparoscopic and Abdominal Hysterectomy on Lower Urinary Tract Function, Vaginal Length, and Dyspareunia: A Randomized Clinical Trial

Objectives: The effect of hysterectomy on vesicourethral and sexual functions remains controversial. The primary objective of this study was to compare the effects of a laparoscopic hysterectomy and a total abdominal hysterectomy on lower urinary tract function. The secondary aims were to compare the two surgeries in terms of postoperative vaginal length and dyspareunia. Materials and Methods: This was a prospective randomized clinical study in which 292 women were assigned to either the laparoscopic hysterectomy (n=146) or total abdominal hysterectomy (n=146) groups. The vaginal length and urodynamic measurements were taken, and the patients were asked to grade the presence and severity of dyspareunia using a visual analog scale 3 weeks before and 12 weeks after the surgery. The relationship between the postoperative vaginal length and the incidence of dyspareunia was evaluated. The urodynamic procedures used included uroflowmetry and voiding cystometry to record the maximum flow rate (Q-max) and to assess the bladder capacity. Results: The preoperative vaginal length was similar between the groups, whereas the postoperative vaginal length was significantly longer in the laparoscopic hysterectomy group. When the 15 patients who developed postoperative dyspareunia were evaluated, no differences in the postoperative vaginal length were seen, but a significant difference in the change in the length of the vagina was found when compared with the other patients. No significant difference was found with regard to pre- and postoperative Q-max, bladder capacity, and change in bladder capacity between the study groups. Conclusions: The change in the length of the vagina was much more remarkable after total abdominal hysterectomy, compared with laparoscopic hysterectomy. It seems that the Q-max and the bladder capacity increase after hysterectomies, regardless of the surgical type. Further prospective randomized comparative studies are warranted to ascertain whether laparoscopic hysterectomies cause less damage to the pelvic floor, compared with abdominal hysterectomies

Urinary Incontinence in Premenopausal Women: Prevalence, Risk Factors and Impact on Quality of Life

WOS: 000342624600005PubMed: 26663597ObjectivesTo determine the prevalence and risk factors of urinary incontinence (UI), and assess its impact on the quality of life (QOL) in premenopausal women. MethodsIn this cross-sectional study, 690 women aged from 18 to 53 were interviewed using a demographic questionnaire and the International Consultation on Incontinence Questionnaire Short Form. ResultsThe overall prevalence of any UI was 27.2%. of the 188 women reporting UI the types were: stress 36.7%, urgency 32.4% and mixed 30.9%. the mean value of the age and body mass index (BMI) of the cases with UI was statistically significantly higher than the group without UI (P35years had an odds ratio of 1.896 (95% confidence interval [CI]:1.29-2.80); the effect of the status of not attending a school or only attending primary school had an odds ratio 1.839 (95% CI: 1.23-2.75) and the number of pregnancies>2 had an odds ratio 1.495 (95% CI:1.00-2.26). ConclusionBeing older than 35, having a low educational level and a gravida greater than two are the independent risk factors in terms of the occurrence of UI in premenopausal women

Intra-ovarian stem cell transplantation in management of premature ovarian insufficiency: towards the induced Oogonial Stem Cell (iOSC)

SAHIN, Erdem/0000-0001-9492-6223; Ak, Mehmet/0000-0003-3384-0586WOS: 000529791700019PubMed: 32359395The specialized resident-stem cells in gonads are tasked with restorating damaged ovarian cells following injury to maintain sequential reproductive events. When we talk about premature ovarian insufficiency (POI) we accept the existence of decreased stem cell and their regenerative abilities. the present study was to explain how restorating damaged ovarian cells following injury to maintain sequential reproductive events in evidence-based medicine indexed in PubMed and Web of Science. the exact mechanism is unclear stem cells transfer may improve compromised ovarian function and fertility outcome in women with POI. Soluble factors secreted by stem cell may rescue impaired mitochondrial function in oogonial stem cells, enhance metabolic capacity of resident stem cells, induce local neovascularization in the ovary, and activate gene shifting between transferred stem cells and germ cell precursors. This review may provide insight into how stem cells show some of their beneficial effects on compromised ovarian microenvironment and germ cell niche and paves the way for clinical trials for improving ovarian function of women with POI. We also had the opportunity to share our hypothesis about the design and development of induced oogonial stem cell (iOSC) and its use in POI

Laparoscopic Ovarian Drilling Improves Endometrial Homeobox Gene Expression in PCOS

WOS: 000525433100026PubMed: 32046414The study was designed to investigate whether laparoscopic ovarian drilling (LOD) of ovaries alters the expression levels of HOXA-10 and HOXA-11 mRNA in the endometrium of infertile women with clomiphene-resistant PCOS. Expression of HOXA-10 and HOXA-11 mRNA in the endometrium obtained before and after LOD during the midsecretory phase was measured. Expression of each gene was evaluated using real-time reverse transcriptase polymerase chain reaction (RT-PCR). Expression levels of HOXA-10 and HOXA-11 mRNA were lower in endometrium of patients with PCOS before LOD compared with fertile controls. But the differences failed to show statistical significance. Compared with fertile subjects, LOD of PCOS ovaries up-regulated endometrial HOXA-10 and HOXA-11 mRNA expression. Fold changes of HOXA-10 and HOXA-11 mRNA after LOD were found to be 4.46 and 4.19, respectively. Fold change increase in HOXA-10 and HOXA-11 mRNA was found to be statistically significant (P < .01, P < .02). There is a receptivity defect in the endometrium of women with PCOS that affects fertility regardless of other causes of infertility. LOD increases endometrial HOXA-10 and HOXA-11 mRNA expressions and improves receptivity in patients with clomiphene-resistant PCOS