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Anormal uterin kanamalı kadınlarda uterus içi lezyonların tespitinde dilatasyon ve küretajın tanısal değeri
(2008) Hakverdi, Sibel; Güngören, Arif; Hakverdi, Ali Ulvi; Dolapçıoğlu, Kenan; Çiftçi, Şinasi; Kaya, Zozan; Yalınkaya, Ahmet
AMAÇ: Histerektomi sonrası elde edilen histolojik bulgularla, Dilatasyon ve küretajdan ( D&C) elde edilen histolojik bulguları karşılaştırarak, D&C’nin teşhis açısından yetersizliğini değerlendirmek. Bu retrospektif çalışmada, D&C’nin teşhis açısından kesinliğini tespit etmeyi araştırdık. MATERYAL-METOD: Anormal uterin kanamalı 259 hasta değerlendirildi. Kadınların hepsine jinekolojik ve ultrasonografik muayene uygulandıktan sonra anestezi altında D&C işlemi uygulandı.Semptomların devam etmesinden ya da histolojik bulgulardan dolayı histerektomi gerçekleştirildi. Her hastanın histerektomi ve D&C sonrası histolojik bulgularını karşılaştırmaya çalıştık. SONUÇLAR: Semptomların devam etmesinden ya da histolojik bulgulardan dolayı D&C’den sonraki 2 ay içinde histerektomi gerçekleştirilen 259 hastayı değerlendirdik. Kadınların % 54.5’inde D&C’de patoloji saptanmadı. Diğer hastaların % 59,5’inde patolojik düzensizlikler histerektomide de mevcuttu. 259 hastanın 105’inde histerektomide sıklıkla bulunan intrauterin patolojileri tespit etmede, D&C yetersiz kaldı. Histerektomiden sonra, 259 hastanın 227’sinde D&C deki histolojik teşhise ilave patolojik düzensizlikler bulundu. TARTIŞMA: D&C, serviks laserasyonu ve enfeksiyonu ile uterus perforasyonunu içeren komplikasyonların riskine ve ilave hastane maliyetine yol açar. Uterusta lezyonlar mevcutsa D&C teşhis aracı olarak yetersiz kalır. D&C, alınan uterusta mevcut olan endometrial lezyonların ve majör intrauterin düzensizliklerin % 40.5’ini tanımaz. D&C iyileştirici bir araç olmayabilir. İntrauterin patolojilerin teşhisi için, alternatif ve daha doğru metodların D&C ın yerine kullanılması önerilmektedir.
Deep vein thrombosis in pregnant women with heterozygous factor-V Leiden mutation : A case report
(2009) Fansa, İyad; Güngören, Arif; Hakverdi, Ali Ulvi; Zeteroğlu, Şahin; Yetim, Çağcıl
Deep vein thrombosis during pregnancy is an important risk factor increasing maternal morbidity and mortality. Factor V Leiden mutation is the most frequent one among many hereditary and acquired thrombophilic risk factors during pregnancy. In a 23-year-old woman who had been pregnant for 11 weeks and applied to hospital with sudden onset pain, swelling, and erythema in her left lower extremity, a thrombus from left main iliac to superficial femoral veins was detected via Doppler ultrasonography. She was hospitalized and low molecular-weight heparin (enoxaprine sodium) was initiated with a dosage of 12000 IU/day. She showed a rapid healing clinically and was followed up with enoxaprine and varsity sock until delivery. After labor, the dosage of enoxaprine was halved and withdrawn after six weeks, and oral warfarin sodium was started. The patient is still continued to be followed up without any problems.
Deep vein thrombosis in pregnant women with heterozygous factor-V Leiden mutation: a case report
(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2009) Fansa, Iyad; Gungoren, Arif; Hakverdi, Ali Ulvi; Zeteroglu, Sahin; Yetim, Cagcil
Deep vein thrombosis during pregnancy is an important risk factor increasing maternal morbidity and mortality. Factor V Leiden mutation is the most frequent one among many hereditary and acquired thrombophilic risk factors during pregnancy. In a 23-year-old woman who had been pregnant for 11 weeks and applied to hospital with sudden onset pain, swelling, and erythema in her left lower extremity, a thrombus from left main iliac to superficial femoral veins was detected via Doppler ultrasonography. She was hospitalized and low molecular-weight heparin (enoxaprine sodium) was initiated with a dosage of 12000 IU/day. She showed a rapid healing clinically and was followed up with enoxaprine and varsity sock until delivery. After labor, the dosage of enoxaprine was halved and withdrawn after six weeks, and oral warfarin sodium was started. The patient is still continued to be followed up without any problems.
Detection of trichomonas vaginalis in vaginal speciemens from women by wet mount, culture and PCR
(2015) Çulha, Gülnaz; Güngören, Arif; Demir, Cemil; Hakverdi, Ali Ulvi; Duran, Nizami
Amaç: Trikomonosiosis, seksüel geçişli enfeksiyona sebep olan Trichomonas vaginalis nedenlidir. T.vaginalis, dünyada 180 milyon insanı etkilemektedir ve anlamlı morbidite sebebidir. T.vajinalis enfeksiyonu kadınlarda vajinit, ekzoservisit ve üretrit nedenidir. Bu çalışmanın amacı, üç değişik yöntem sonuçlarını karşılaştırarak T. vajinalis varlığını tespit etmektir. Gereç ve Yöntem: Mustafa Kemal Üniversitesi Tıp Fakültesi Jinekoloji polikliniğine ve Doğumevi hastanesine başvuran toplam 200 hastadan alınan swap örnekleri toplandı. : Mustafa Kemal Üniversitesi Tıp Fakültesi Parazitoloji bölümünde T. vajinalis genotip ve fenotipileri değerlendirildi. T. vaginalis tespiti açısından ve hasta tedavisine etkisi açısından bu çalışma bölgemizde yapılmış ilk moleküler çalışmadır. Bulgular: 200 hastanın 56 sı pozitif olarak bulundu ve bunların 24'ü (%42.8) mikroskopik olarak, 18'i (%32,1) kültür ile, 24'ü (%42,8) PCR ile tespit edildi. Tüm metodlarla tespit edilen hasta sayısı 14 idi. Bu çalışmada, Cochran's Q testi ile elde edilen üç metod karşılaştırılması anlamlı idi.(p=0.022). McNemar yöntemi ile tüm yöntemler ikili olarak karşılaştırıldığında mikroskopi ile kültür arasında (p=0.5),mikroskopi ile PCR arasında (p=0.063), kültür ve PCR arsında (p=0.25) fark bulunamadı. Tartışma: Kültür metodu rutinde kulanılan bir metod değildir ve kontaminasyon riski vardır. PCR metodu direkt olarak parazit DNA'sını göstermektedir ve diğer yöntemlere göre daha güvenilir bir yöntemdir.
DIAGNOSTIC VALUE OF DILATATION AND CURETTAGE TO DETECT INTRAUTERINE LESIONS IN WOMEN WITH ABNORMAL UTERINE BLEEDING
(Galenos Yayincilik, 2008) Hakverdi, Sibel; Gungoren, Arif; Hakverdi, Ali Ulvi; Dolapcioglu, Kenan; Ciftci, Sinasi; Kaya, Zozan; Yalinkaya, Ahmet
Objective: To evaluate the diagnostic inadequacy of dilatation and curettage (D&C) by comparing histologic findings derived from D&C with histologic findings obtained after hysterectomy procedure retrospectively. Material and methods: Files of 259 patients with abnormal uterine bleeding who underwent hysterectomy within two months of a diagnostic D&C were analyzed. All patients had gynecologic and ultrasonographic examination, then they underwent D&C procedure under anesthesia. Hysterectomy was performed accordingly due to the histologic findings or persistence of the symptoms. Histologic diagnosis in D&C and after hysterectomy for each patient were compared. Results: 54.5% of the women had no pathology in D&C techniques. 59.5% of remaining patients had the same the pathologic findings in the hysterectomy specimens. In 105 of 259 patients, D&C failed to detect intrauterine disorders subsequently found at hysterectomy. After hysterectomy, in 227 of 259 patients were found additional pathologic abnormalities besides the histologic diagnosis in D&C specimens. Conclusions: D&C involves additional hospital costs and risk of complications; uterine perforation, infection and laceration of the cervix. If there are lesions in the uterus, dilatation and curettage is an inadequate diagnostic tool. D&C missed 40.5% of major intrauterine disorders and endometrial lesions were still present in the removed uterus. Therefore D&C can not be assessed as a therapeutic tool. Therefore D&C is suggested to be replaced by alternative and more accurate methods of diagnosis of endometrial abnormalities.
Does the presence of anhydramnios affect the duration of medical abortion?
(Via Medica, 2016) Karapinar, Oya Soylu; Gungoren, Arif; Dolapcioglu, Kenan; Silfeler, Dilek Benk; Kurt, Raziye Keskin; Sahin, Hanifi; Hakverdi, Ali Ulvi
Objectives: The aim of the study was to determine whether anhydramnios affected the duration of medical abortion in cases with various indications as compared to cases with normal amniotic fluid volume. Material and methods: Patients who were admitted to our clinic because of medical abortion between January 2010-December 2013 were included in this retrospective study. A total of 32 pregnant women with anhydramnios (study group) and 67 pregnant women with normal amniotic fluid volume but with fetal abnormality (control group) were included in the study. Patient age, gravidity, parity, gestational age, previous delivery route, and duration of the abortion were recorded. Results: Mean duration of the abortion in the study group was 71.93 +/- 47.51 h as compared to 79.08 +/- 52.62 h in the control group. There were no statistically significant differences between the two groups in terms of duration of the abortion (p = 0.516). Also, we found no statistically significant differences in duration of the abortion with regard to previous delivery route (p = 0.220). Conclusions: There were no statistically significant differences between the study group and controls in terms of duration of the abortion. In addition, neither parity nor previous delivery route affected the duration of the abortion.
The effect of obesity on inflammatory markers in patients with PCOS: a BMI-matched case-control study
(Springer Heidelberg, 2014) Kurt, Raziye Keskin; Okyay, Ayse Guler; Hakverdi, Ali Ulvi; Gungoren, Arif; Dolapcioglu, Kenan Serdar; Karateke, Atilla; Dogan, Mustafa Ozcil
Previous studies have shown increased inflammatory activity in patients with polycystic ovary syndrome (PCOS); however, it remains uncertain whether this increased inflammatory activity is a consequence of the disorder itself or of the accompanying obesity. We therefore aimed to test the inflammatory marker levels in obese and lean patients with PCOS by using two separate control groups with matching body mass index (BMI). A total of 120 women in reproductive age with (n = 62) and without (n = 60) PCOS were recruited for the study. Patients with PCOS were divided into two groups as obese (n = 32) and lean (n = 30) PCOS groups according to BMI. Two BMI-matched control groups were created. Furthermore, high sensitive CRP protein (hsCRP), neutrophils, lymphocytes, white blood cell count (WBC) and neutrophil to lymphocyte ratio (NLR) were evaluated with complete blood count. The hsCRP (5.5 +/- A 0.8 vs. 3.1 +/- A 0.7, p < 0.001), neutrophil count (3.8 +/- A 0.4 vs. 2.9 +/- A 0.7, p < 0.001), leukocyte count (7.2 +/- A 1.8 vs. 5.6 +/- A 1.6, p < 0.001), and NLR (2.6 +/- A 1.4 vs. 1.5 +/- A 0.4, p < 0.001) were higher in patients with PCOS compared to the control group while lymphocyte count was lower (1.71 +/- A 0.65 vs. 1.98 +/- A 0.39, p = 0.008). Similarly, both obese and lean patients with PCOS had higher levels of hsCRP, neutrophils, leukocytes and NLR ratios compared to BMI-matched controls. The correlation analysis revealed a moderate correlation between NLR and hsCRP (r 0.459, p < 0.001), and between HOMA-IR (r 0.476 p < 0.001) and BMI (r 0.310, p 0.001). Our study results demonstrated that both lean and obese patients with PCOS have increased inflammatory markers compared to BMI-matched control groups indicating that the inflammation seen in PCOS might be related with the presence of the disorder rather than with obesity.
The Effect of Pregnancy on Urinary Symptoms
(Springernature, 2023) Beyazit, Ahmet; Hakverdi, Ali Ulvi; Goezuekara, Kerem Han
BackgroundUrinary incontinence is a condition that causes social, medical, or hygienic problems. The increase in the incidence of stress incontinence, particularly with increasing parity, emphasizes the role of pregnancy on the etiology of incontinence and other urinary symptoms. This study aimed to estimate the effect of pregnancy on urinary incontinence and other urinary symptoms with history and urodynamic data.MethodologyThis study was conducted at Mustafa Kemal University, Medical Faculty, Obstetrics and Gynecology Department. A total of 72 pregnant primigravid women without any urinary problems were included in the study. Patients with severe chronic disease, neurological disorders, antepartum hemorrhage, multiple pregnancies, younger than 18, and those with physical and mental disabilities were excluded. All patients were initially evaluated in the first trimester and finally in the sixth week of the postpartum period. Demographic and obstetric data, including urological complaints and urodynamic findings, were recorded.ResultsThere were significant increases in nocturia, frequency, dysuria, urgency, and stress urinary incontinence complaints in pregnant women. Urge incontinence was not significantly different after pregnancy. In the postpartum urodynamic studies, nine (12.5%) patients with stress urinary incontinence and six (8.3%) patients with detrusor instability were detected. There was no significant difference between cesarean section and vaginal delivery regarding incontinence.ConclusionsAccording to the study findings, pregnant women who were continent before pregnancy could become incontinent after birth according to urodynamic data. However, long-term studies are needed to determine whether this incontinence is temporary. Additionally, according to our results, cesarean section should not be recommended over vaginal delivery only to prevent incontinence.
Effectiveness of Periurethral Injection on Stress Urinary Incontinence
(Ortadogu Ad Pres & Publ Co, 2011) Gungoren, Arif; Dolapcioglu, Kenan; Hakverdi, Ali Ulvi; Yetim, Cagcil
Objective: To determine one-year subjective and objective evaluation results of penurethral injection (PUT) applied to women suffering from stress urinary incontinence (SUI). Material and Methods: Twenty five patients with complaints of SUI have participated in our study. Preoperative and postoperative results of urinalysis, stress and Q-tip tests, post voiding residual volumes (RV) and survey of incontinence quality of life (I-QOL) criteria were recorded. Later on, Urodex (R) (Cross- linked hyaluronic acid, detxranomere) was injected to them. The cases were monitored at regular intervals for a mean of 14 +/- 5.84 months. Results: Eighteen (72%) out of all cases were encountered during menopausal period. Eight of the patients had previous gynecologic operations. Mean age was 53.97 +/- 13.01 years. Mean application period of PUT was 6.95 +/- 1.46 minutes. Differences between the preoperative and postoperative results of RV and I-QOL were not statistically significant. From subjective success point of view; 17 (68%) of the patients claimed no change on their incontinence problem, two (8%) of the patients claimed that their conditions were slightly improved, and six (24%) of the patients claimed that their conditions significantly improved. When objective success is considered, there was success in seven (28%) patients, and failure in 18 (72%) patients. Conclusion: PUT is a minimally invasive treatment method used in all types of SUI. PUI treatment might be preferred for the old, obese patients with additional health problems, having incontinence dependent on hypermobility at which the open surgery incurs a great risk. However, as the new techniques are not readily available, a periurethral injection technique may still be a valid choice in patients who have poor surgical risks, and to whom the low success rate has been adequately explained.
Evaluation of Fetal Autopsy Findings in the Hatay Region: 274 Cases
(De Gruyter Open Ltd, 2012) Hakverdi, Sibel; Guzelmansur, Ismail; Gungoren, Arif; Toprak, Serhat; Yaldiz, Mehmet; Hakverdi, Ali Ulvi
Objective: The aim of this study was to present the incidence of fetal anomalies in our region of Hatay, Turkey in order to determine the efficiency of prenatal diagnosis through fetal autopsy, and to compare our statistical data with other national and international studies. Material and Method: This study was conducted on 274 fetuses from terminated pregnancies due to abnormal prenatal findings and intrauterine deaths from 2005 to September 2010. Fetuses were evaluated through postmortem examination, external measurements, X-rays, Magnetic Resonance Images, Multislice Computerized Tomography and photographs. The autopsy was completed by the histological examination of each organ. Results: Autopsy was conducted on 274 fetuses. A fetal anomaly was detected in 160 (58.39%) cases. The central nervous system contained the most frequent structural defects (79 cases, 49.38%), followed by malformations in the musculoskeletal system in 36 cases (22.5%). The most frequent multiple system anomalies were central nervous system defect and bilateral adrenal agenesis, musculoskeletal system malformations and urinary system defects. Fetal autopsy provided additional findings in 43 cases (26.88%). Conclusion: Fetal autopsy is a very important procedure and an integral part of the general prenatal management. New findings through this method may suggest invaluable data for parents about potential risks in future pregnancies.
Genital enfeksiyon şüphesi olan adölesan ve yetişkin kadınlarda enfeksiyon etkenleri
(2005) Duran, Nizami; Çulha, Gülnaz; Çetin, Meryem; Zeteroğlu, Şahin; Güngören, Arif; Hakverdi, Ali Ulvi
Amaç: Bu çalışmanın amacı bölgemizde genital enfeksiyon şüpheli adölesan ve yetişkin kadınlarda genital enfeksiyona sebep olan mikrobiyal etkenleri değerlendirmek ve genital enfeksiyon sıklığını araştırmaktır. Gereç ve Yöntem: Çalışmaya Mayıs 2004-Aralık 2004 tarihleri arasında Mustafa Kemal Ünversitesi Tıp Fakültesi Sağlık Araştırma ve Uygulama Hastanesi Kadın Hastalıkları ve Doğum Polikliniğine başvuran yaşlan 16-63 arasında değişen toplam 534 kişi dahil edildi. Adölesan grupta 112 olgu, yetişkin grubunda ise 422 olgu vardı. Sürüntü örnekleri vajinal ve endoservikal akıntıdan alındı. Çalışmada 534 vajinal akıntı örneğinin incelenmesinde; taze preparat, Gram boyama ve kültür yöntemleri kullanıldı. İzole edilen suşlar biyokimyasal testler ve API 20C AUX (bioMerieux) kiti ile tanımlandı. Bulgular: Örneklerin 128 (%23.9)'inde patojen mikroorganizma üremesi saf kültür halinde ya da vajinanın normal flora mikroorganizmalarına baskın olarak tespit edildi. Bunların %48 (62/128)'i Candida albicans, %11 (14/128)'i Candida spp., %13 (17/128)'ü Gardnerella vaginalis, %7 (9/128)'si B grubu streptokok, %7 (9/128)'si Trichomonas vaginalis, %5 (7/128)'ü Escherichia coli, %4 (5/128)'ü Staphylococcus aureus ve %4 (5/128)'ü Enterokok olarak tanımlandı. Vajinal sürüntü örneklerinin %59 (315/534)'unda normal vajinal flora üyesi mikroorganizma üremesi görülürken, örneklerin %17 (91/534)'lik bir kısmında da bakteri üremesi tespit edilemedi. Patojen mikroorganiz¬maların dağılımı incelendiğinde adölesan grupta Candida cinsi mayalar %26 (29/112), bakteriyel orjinli mikroorganizmalar ise %5 (6/112) oranında izole edilirken olguların hiçbirinde Trichomonas vaginalis'e rastlanmamıştır. Yetişkin grupta ise maya izolasyonu %11 (47/422) oranında bulunurken bakteriyel orijinli enfeksiyonların %9 (38/422) olduğu tespit edilmiştir. Adölesan gruptan farklı olarak yetişkinlerde %2 oranında da Trichomonas vaginalis varlığı saptandı. Sonuç: Adölesan grupta Candida cinsi mayaların, yetişkinlerde ise bakteriyel ajanların daha sık enfek¬siyon nedeni olduğu tespit edilmiştir.
Gestasyonel trofoblastik hastalık : üçüncü basamak deneyimi
(2014) Keskin Kurt, Raziye; Hakverdi, Ali Ulvi; Soylu Karapınar, Oya; Karatepe, Atilla; Özçil, Mustafa Doğan
Kliniğimizde gestasyonel trofoblastik hastalık nedeniyle tedavi edilen hastaların risk faktörleri, tanısı, yönetimini araştırmayı amaçladık. Gereç ve Yöntem: Kliniğinize Ocak 2010- Ağustos 2013 yılları arasında molar gebelik tanısı almış hastalar taranarak hastaların yaşı, gravide, parite ve abortus bilgileri kaydedildi. Hastaların şikayeti, muayene, ultrason bulguları, [3 HCG ve tam kan sayımı değerleri, hastalığın tedavisi, patoloji sonuçları, hastalarda gelişen komplikasyonlar, takipte [3 HCG değerleri kayıt edildi. Bulgular: Kliniğimizde molar gebelik hızı 1000 doğumda olarak bulundu. Hastaların ortalama yaşı 28:l:4,5 olup ortalama gestasyonel yaş 8:|:3,2 haftaydı. Hastaların en sık geliş şikâyeti vajinal kanama (n=23, %57,5), amenore (n=10,%25) karın ağrısı (n=6, %15) idi. [3 HCG değerleri 191 ile 125200 arasında değişmekteydi. Hastaların 26 (65%) sında ultrason bulgusu molar gebelik lehine yorumlanmıştı. Patoloji sonuçları 26 (%65) hastada parsiyel mol, 13 (%32.5) hastada komplet mol ve (%2.5) hastada koryokarsinom gelmiştir. Hastalık ve komplikasyonlarına ait ölüm olgusuna rastlanmamıştır. Sonuç: Kliniğimizde molar gebelik hızı 1000 doğumda olup en sık geliş şikâyeti vajinal kanamadır.
Hipergonadotropik hipogonadizmin nadir bir nedeni olarak ullrich turner sendromu : olgu sunumu
(2014) Şilfeler Benk, Dilek; Karateke, Atilla; Tertemiz, Selin; Dolapçıoğlu, Kenan Serdar; Güngören, Arif; Hakverdi, Ali Ulvi; Baloğlu, Ali
Turner sendromlu 45XO/46XY mozaikliği, nadir görülen kromozomal bir anomalidir. Yaklaşık 1/10.000‘de bir görülen bu mozaismin fenotip yansımaları normal bir erkekten, klasik Ullrich-Turner Sendromuna (UTS) kadar değişen çeşitliliktedir. Primer amenore şikayeti ile kliniğimize başvuran hastanın yapılan kromozom analiz sonucu 45XO/46XY olarak geldi.
Histeroskopik septum rezeksiyonu sonrası gebelik sonuçları : retrospektif bir çalışma
(2017) Karapınar Soylu, Oya; Gözükara, İlay; Hakverdi, Ali Ulvi; Benk Şilfeler, Dilek; Şahin, Hanifi; Dolapçıoğlu, Kenan
Amaç: Primer infertilite ve düşük veya prematür doğum öyküsü olan sekonder infertilite tanısı ile başvuran ve uterin septum saptanan olgularda histeroskopik septum rezeksiyonu sonrası gebelik sonuçlarının ve hızlarının retrospektif olarak saptanması. Gereçler ve Yöntem: Eylül 2009- Mart 2014 tarihleri arasında Mustafa Kemal Üniversitesi Kadın Hastalıkları ve Doğum kliniğine başvuran, histerosalpingografi ile uterin septum tanısı koyduğumuz primer veya sekonder infertil hastalara histereskopik septum rezeksiyonu uygulandı. 16 hasta primer infertilite; 20 hasta ise düşük ve/veya prematür doğum öyküsü olan sekonder infertilite grubunda idi. Hastaların retrospektif olarak verileri tarandıktan sonra hastalar aranarak operasyon sonrası gebelik bilgilerine ulaşıldı. Bulgular: 20 vakada komplet septus, 16 vakada parsiyel septus izlendi. Ortalama operasyon süresi 27,5 ± 7,0 dk. İdi. 4 (%11,1) vakada işlem sonrasında asherman sendromu gelişti. 3 (%8,3) vakada işlem sonrası servikal yetmezlik tespit edildiğinden dolayı servikal serklaj uygulandı. Histeroskopik rezeksiyon sonrası 25 olguda (%69,4) konsepsiyon sağlandı. Bu 25 olgunun 19'unda (%52,8) gebelik terme kadar ulaştı. 2 olguda ise düşük meydana geldi. Primer ve sekonder infertil kabul edilen grupta term gebelik hızı sırasıyla %53,3 ve %52,4 olarak bulundu. Histereskopik septum rezeksiyonu sonrası sekonder infertil gruptaki habituel abortuslu hastaların spontan düşük hızı %61,9 'dan %4,8 'e düştü ve canlı doğum oranları %19 'dan % 61,9 'a yükseldi.Sonuç: Histeroskopik septum rezeksiyonu gerek primer, gerekse sekonder infertil olgularda fertiliteyi olumlu bir ölçüde artırmaktadır. Bu yüzden infertilite veya tekrarlayan gebelik kayıpları saptanan olgularda septum varlığı araştırılmalıdır. Bu tür olgularda operasyon süresinin ve hastanede kalış süresinin kısalığı, ayrıca daha sonraki gebeliklere vajinal doğum şansı tanıması açısından histeroskopik yaklaşım tercih edilmelidir.
How effective TV-USG, SIS and hysteroscopy are in evaluating uterine cavity?
(2011) Güngören, Arif; Dolapçio?lu, Kenan; Hakverdi, Ali Ulvi; Çiftçi, Şinasi C.; Yetim, Ça?cil
Objective: To identify how effective transvaginal ultrasonography (TV-USG), saline infusion sonohysterography (SIS) and hysteroscopy are in evaluating the uterin cavity, that were carried out in our clinic between November 2004 and January 2008. Material and Methods: 186 patients, visiting our clinic with the complaints of infertility, repeating pregnancy loss, abnormal uterine bleeding, postmenopausal bleeding, have been included in our prospective study. TV-USG and hysteroscopy were applied to all patients, but saline infusion SIS was applied, before hysteroscopy, to those on who lesion was considered in uterine cavity. In the cases where pathology was identified in the cavity, a biopsy was taken out of the related lesion during hysteroscopy or all structure was resected and sent to pathology. All data dealing with the patients were recorded in SPSS 13.0 program and then sensitivity, specifity, positive and negative predictive data were calculated accordingly. Results: Age interval of the patients studied was between 16 and 73, with the average of 36.19 ± 9.67. 172 patients out of all (92.5%) were in premenopausal, 14 (7.5%) were in postmenopausal period. As a result of hysteroscopy applied on the patients, while uterine cavity was evaluated as normal on 73 patient (39.2%), a uterine pathology was observed or suspected in 113 (59.8%) patients. For TV-USG and SIS, where hysteroscopy was evaluated as gold standard, sensitivity was 69% and 87.8%, specitity 87.7% and 42.8% respectively for all uterine patologies. Hysteroscopy sensitivity was recorded 91.2% and its specifity 30.7% as well when histopathology of the material obtained during the operation was based on as reference. Conclusion: TV-USG, SIS and hysteroscopy are the methods used currently in evaluating the uterine cavity, but hysteroscopy is the most efficient method in terms of diagnostic valuableness. On the other hand, an efficient application of TV-USG and SIS seems more appropriate when evaluated in terms of cost and time consumed. Copyright © 2011 by Türkiye Klinikleri.
Increased Density of Demodex folliculorum Mites in Pregnancies with Gestational Diabetes
(Karger, 2014) Kurt, Raziye Keskin; Kaya, Ozlem Aycan; Karateke, Atilla; Silfeler, Dilek Benk; Karapinar, Oya Soylu; Akkoca, Ayse Neslin; Hakverdi, Ali Ulvi
Objective: To investigate the presence of Demodex in patients with gestational diabetes and the impact of glucose regulation on Demodex density in gestational diabetes. Subjects and Methods: The study population consisted of 33 patients with gestational diabetes and 30 pregnant women without gestational diabetes (control group). The age, parity, gestational age, and BMI of the study group were recorded and the patients were divided into 2 groups, i. e. those with regulated and unregulated glucose levels, according to their postprandial 1st-and 2nd-hour glucose values. A standardized skin surface biopsy method was used to determine if patients had Demodex folliculorum infestation (> 5 mites/cm 2 of skin). Results: Patients with gestational diabetes had a statistically significantly higher Demodex density compared to the control group (24.2 vs. 3.3%; p < 0.001). Furthermore, a significantly higher proportion of gestational diabetes patients with unregulated glucose levels had a higher Demodex density compared to those in the regulated subgroup (6/19 vs. 2/14; p = 0.001). Conclusion: Our study revealed that the Demodex density was increased in gestational diabetes patients. Further, poor glucose regulation could be the mechanism responsible for the increased Demodex density in gestational diabetes patients with unregulated glucose levels compared to those with regulated glucose levels. (C) 2014 S. Karger AG, Basel
The Investigation of the Association Between the Frequency of Trichomonas Vaginalis and Using Intrauterine Contraceptive Device
(Aves Yayincilik, Ibrahim Kara, 2009) Duran, Nizami; Culha, Guelnaz; Hakverdi, Ali Ulvi; Gungoren, Arif
Objectives: We investigated the association between the frequency of Trichomonas vaginalis and using intrauterine contraceptive device (IUD). Patients and Methods: A total of 1058 vaginal swab samples were collected. The study population included 402 symptomatic and 656 asymptomatic women, between 18-45 years of age. Specimens were taken with a speculum and sterile cotton swabs from the posterior fornix of the vagina. Wet mount preparations were examined first, and then inoculated into Trypticase-yeast extract-maltose medium. Results: T vaginalis was determined in 35 (3.31%) samples out of 1058 specimens using both diagnostic methods (direct examination and/or culture). While a total of 402 women were symptomatic, 656 women were asymptomatic. Among 190 IUD users, the frequency of T vaginalis was determined as 6.84%, and among 868 non-users, this ratio was determined as 2.53%. Moreover, while among 100 symptomatic women with IUD, 11 women were positive for T vaginalis (11%), of the 302 symptomatic women without IUD, 17 were positive (5.63%) for T vaginalis. Significant correlation was determined between the use of IUD and the presence of T vaginalis (p<0.05). Conclusion: These results showed that IUD use may increase the growth of T vaginalis in the vaginal mucosa. To reduce the incidence of this pathogen in IUD users, they should be followed up closely.
The investigation of the association between the frequency of Trichomonas vaginalis and using intrauterine contraceptive device
(2009) Duran, Nizami; Çulha, Gülnaz; Hakverdi, Ali Ulvi; Güngören, Arif
Objectives: We investigated the association between the frequency of Trichomonas vaginalis and using intrauterine contraceptive device (IUD). Patients and Methods: A total of 1058 vaginal swab samples were collected. The study population included 402 symptomatic and 656 asymptomatic women, between 18-45 years of age. Specimens were taken with a speculum and sterile cotton swabs from the posterior fornix of the vagina. Wet mount preparations were examined first, and then inoculated into Trypticase-yeast extract-maltose medium. Results: T. vaginalis was determined in 35 (3.31%) samples out of 1058 specimens using both diagnostic methods (direct examination and/or culture). While a total of 402 women were symptomatic, 656 women were asymptomatic. Among 190 IUD users, the frequency of T. vaginalis was determined as 6.84%, and among 868 non-users, this ratio was determined as 2.53%. Moreover, while among 100 symptomatic women with IUD, 11 women were positive for T. vaginalis (11%), of the 302 symptomatic women without IUD, 17 were positive (5.63%) for T. vaginalis. Significant correlation was determined between the use of IUD and the presence of T. vaginalis (p<0.05). Conclusion: These results showed that IUD use may increase the growth of T. vaginalis in the vaginal mucosa. To reduce the incidence of this pathogen in IUD users, they should be followed up closely.
Investigation of the prevalence of Trichomonas vaginalis in women with complaints of vaginal discharge and itching
(2006) Culha, Gülnaz; Hakverdi, Ali Ulvi; Zetero?lu, Sahin; Duran, Nizam
Trichomonas vaginalis (T. vaginalis) is the most common pathogen that is sexually spread in women. In this study, the presence of Trichomonas vaginalis was investigated in patients with vaginal discharge and itching who presented at the polyclinic of the Mustafa Kemal University Medical Faculty Department of Gynecology. These women were between 20-40 years of age. During gynecologic examination of patients, vaginal fluid samples were collected with swaps from the speculum and fornics to two tubes that contained sterile saline. One of the vaginal discharges collected with swaps was used for direct microscopic examination and Giemsa staining. The other one was used for culturing for T. vaginalis in Trichomonas medium that contained horse serum and antibiotics. While the fre-quency of T. vaginalis was found to be 1.81% (5 of the 275 samples) by the direct microscopic examination and Giemsa stain, this ratio was 2.18% (6 of the 275 samples) by the culture method. In conclusion, it was decided to use the culture method in diagnosis of T. vaginalis in addition to direct microscopic examination. This was the first study of T. vaginalis infection in our region and it was compared with other studies carried out in other regions of Turkey. Our results were somewhat lower than those in other regions.
Malignant sarcomatous mural nodule associated with ovarian serous cystadenoma: Case report and review of literature
(2011) Hakverdi, Sibel; Güngören, Arif; Hakverdi, Ali Ulvi; Dolapçio?lu, Kenan; Yaldiz, Mehmet; Bayramo?lu, Neslihan
We present a rare case of ovarian serous cystadenoma with malignant mural nodules. The patient, a 76-year-old woman, was admitted to our hospital with right lower abdominal pain and swelling which was going on for 4 months. A gross tumor, measuring 20 x 15 x 7 cm in size and containing solid and cystic areas, was found and removed. Inner surface revealed a poor-circumscribed nodule measuring 7 x 5 cm. Areas of hemorrhage and necrosis in the nodule were noted. Histopathologic examination of the mass showed cystadenoma with malignant mural nodule. Cases of ovarian serous tumors associated with mural nodules are very rare, and this is the ninth reported case so far. Copyright © 2011 by Türkiye Klinikleri.

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