Efficiency of p16 and Ki-67 immunostaining for detecting premalignant cervical lesions in high risk population

Background: This study aimed to evaluate the efficiency of immunostaining with p16 and Ki-67 in cervical cytology specimens for the detection of cervical intraepithelial neoplasia (CIN) in a high risk population.Methods: This was a prospective review of 287 women who underwent pap smear, human papilloma virus (HPV) testing and colposcopy examination, respectively. There were cervical smear abnormalities in 108 women (37.6%) and 141 patients (49.1%) tested positive for HPV. Cervical biopsy revealed normal cervix in 28 patients (9.75%), cervicitis in 48 patients (16.72%), CIN1 in 178 patients (62.02%), CIN2 in 26 patients (9.05%) and CIN3 in 7 patients (2.43%).Results: Positive staining for p16 had a sensitivity of 78.2% and a specificity of 97.4% while positive staining for Ki67 had a sensitivity of 80.6% and a specificity of 57.9% for distinguishing CIN lesions in cervical cytology specimens (p=0.001 for both). Concurrent positive staining for p16 and Ki67 in cervical cytology specimens had a sensitivity of 80.6% and a specificity of 97.4% for CIN lesions (p=0.001). Positive staining for p16 had a sensitivity of 94% and a specificity of 90.6% whereas positive staining for Ki67 had a sensitivity of 97% and a specificity of 33% for differentiating CIN lesions in colposcopic biopsy specimens (p=0.001 for both). Concurrent positive staining for p16 and Ki67 in colposcopic biopsy specimens had a sensitivity of 91% and a specificity of 94% for CIN lesions (p=0.001).Conclusions: p16/Ki-67 immunostaining applied on cervical cytology specimens can screen CIN lesions with high sensitivity and specificity in a low risk population

Investigation of single strand DNA breaks in spontaneous abortion cases with known pesticide exposure

Pesticide exposure is an essential public health problem and endocrine-disrupting factor. Encounters during pregnancy may cause spontaneous abortions or congenital anomalies with embryotoxic or fetotoxic effects. DNA double-strand breaks occur upon exposure of DNA to radiation and chemicals or are caused by faulty DNA metabolic processes. This research examines the relationship of DNA single-strand amount with pesticides and their types. Single-stranded DNA (ssDNA) density was quantitatively determined by fluorometric method in the blood of Spontaneous Abortion with organochlorine and or organophosphate pesticide exposure and in the blood of two patient groups who had normal delivery without pesticide contact. The mutation was screened by next-generation sequencing in 4 women who experienced spontaneous abortion with a high pesticide amount and variety. 91 female patients aged 18-35 years were included in the study. The spontaneous abortion group was 56 (61.5%), and the normal delivery group was 35 (38%) women. The mean age was 28.18(±4.5). There was a significant correlation between Pentachlorophenol -52 (PCB52) and ssDNA level (p0.05). It was determined that ssDNA levels were higher among those with multiple abortions. The ssDNA level was higher in those who had an abortion before (pA (p.Trp2502Ter) variation and the DYNC2H1 gene NM_001377.3 c.8458C>A (p.Pro2820Thr) variation associated with recurrent miscarriages were found to be heterozygous. Studies in this area need to be increased to determine the relationship of ssDNA elevation with pesticide exposure, its predictive value in abortion, and the value of environmental factors in repeated abortions whose etiology has not been clarified. [Med-Science 2023; 12(4.000): 1250-6

Pap Smear Abnormalities in Women Admitted to a Tertiary Health Center in Southeast Turkey

Ozer, Alev/0000-0002-0934-0226WOS: 000376566600016Aim: To analyze the cervical cytological abnormalities which are detected in women undergoing Pap screening in a tertiary health care center within Siirt, a southeastern province of Turkey. Material and Method: A total of 3000 women who underwent Pap screening at the study center between January 1, 2009 and December 31, 2009 were recruited for the study. The women who were diagnosed with benign epithelial changes, infectious alterations, as well as atypical squamous cells with undetermined significance (ASC-US), atypical squamous cells of high significance (ASC-H), and low-grade squamous intraepithelial lesion (LSIL) were included. Results: Benign epithelial alterations, infectious changes, ASCUS, ASC-H, and LSIL were detected in 83.7%, 15.3%, 0.8%, 0.1% and 0.1% of the Pap smears respectively. A significant correlation was found between the patient age and the histopathological alterations in the Pap smears (r= 0.072, p= 0.001). Although no correlation could be detected between gravidity and Pap smear results (r= 0.033, p= 0.067), a significant correlation existed between parity and the histopathological findings within the Pap smears (r= 0.051, p= 0.005). Interestingly, the Pap smear results were found to be unrelated to socioeconomic status (r= 0.088, p= 0.168), education level (r= 0.048, p= 0.257), and smoking habit (r= 0.086, p= 0.077). Discussion: The present study has reported a value of 1.0% for the overall prevalence of cervical cytological abnormalities, which is much lower than in western countries. Thus, rather than being dependent on the data reported by clinical studies that have been conducted in western countries, Turkish health care policy should be based on the data obtained from national studies

Case Report: Pregnancy Associated Uterine Prolapse

Ozer, Alev/0000-0002-0934-0226WOS: 000376567100031Uterine prolapse that appears for the first time during pregnancy is a rarely encountered clinical entity, complicating 1 in 10000 to 1 in 15000 deliveries. A 30-year-old, gravida 3, para 2 woman with a 35-week-old pregnancy who was admitted to the study center was diagnosed with stage III C uterine prolapse according to the Pelvic Organ Prolapse Quantification System. Bed rest in the Trendelenburg position and administration of saline soaks for the reduction of cervical edema were recommended for the palliative treatment of the patient. Five weeks later, a healthy male baby with a birthweight of 3500 grams was delivered by cesarean section. Appropriate management of pregnancy-associated uterine prolapse consists of conservative treatment modalities throughout pregnancy

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

An Autopsy Case Report: Prune Belly Syndrome with Overlapping Presentation of Partial Urorectal Septum Malformation Sequence

Prune belly syndrome (PBS) is characterized by a classical triad of congenitally absent abdominal muscles, bilateral cryptorchidism, and a malformed urinary tract. Urorectal septum malformation sequence (URSM) is identified with the absence of urogenital and anal openings. This case report describes a 15-week-old female fetus with megacystis, ascites and oligohydramnios in a 19-year-old nulliparous woman. The patient underwent preterm labor at the 33rd gestational week and delivered a female newborn weighing 2250 grams who died three days later due to progressive respiratory insufficiency. To the best of our knowledge, this is the third case of an overlap between PBS and URSM in literature. Such an overlap refers to the existence of left renal agenesis, right renal cystic dysplasia, bilateral club foot and lumbar scoliosis as well as the absence of abdominal wall muscles, internal genital organs, urethral, vaginal and anal openings. This case report aims to remind the obstetricians about the concurrent occurrence of PBS with URSM and its poor prognosis

Can sonographic endometrial pattern be an early indicator for tubal ectopic pregnancy and related tubal rupture?

The present study aims to determine whether sonographic endometrial pattern can be addressed as an early indicator for tubal ectopic pregnancy and related tubal rupture in case ultrasonography reveals no adnexal mass and maternal serum beta human chorionic gonadotropin (HCG) level is below the discriminatory zone (a parts per thousand currency sign1,000 mIU/mL)

Predictive power of serum CA-125 and LDH in the outcome of first trimester pregnancies with human chorionic gonadotropin levels below discriminatory zone

The present study aims to investigate the predictive power of serum CA-125 and lactate dehydrogenase (LDH) for evaluating the outcome of first trimester pregnancies with beta human chorionic gonadotropin levels below discriminatory zone (a parts per thousand currency sign1,000 mIU/mL)

The effects of different therapeutic modalities on cardiovascular risk factors in women with polycystıc ovary syndrome: A randomızed controlled study

Objective: This study was designed to evaluate the effects of 3 mg drospirenone/30 μg ethinyl estradiol (OC) alone or combined with 1700 mg metformin on metabolic risk factors. Materials and methods: In this randomized, prospective, controlled study, 87 non-obese (18–30 BMI) women of reproductive age (18–39) with polycystic ovary syndrome (PCOS) were assigned to control (n = 17), OC (n = 21), combination (n = 20) and metformin (n = 29) therapy groups. Results: Adiponectin levels changed −28.27%, −20.37% and 35.78% after OC, combination and metformin therapies, respectively. High sensitive C-reactive protein levels (hsCRP) changed with OC, combination and metformin therapies by 102.32%, 3.2% and −7.14%, respectively. Plasminogen activator inhibitor-1 levels decreased 41.34% in the metformin group. Apolipoprotein-B levels changed in a manner similar to changes in hsCRP levels. The homeostatic model insulin resistance index changed significantly between the groups following treatment (p = 0.001). Conclusion: Six cycles of treatments with OC alone may cause metabolic variables to deteriorate in non-obese women with PCOS. The addition of metformin to OC may ameliorate some aspects of this effect