We investigated the question of how serum zonulin levels change in intrahepatic cholestasis of pregnancy (ICP) and gestational diabetes mellitus (GDM) and, in the case of the coexistence of ICP and GDM, evaluated the eventual increase in zonulin plasmatic levels. Participants were enrolled for the study between 25 February 2021 and 20 August 2021. The prospective case-control study included: group 1 of 95 pregnant women diagnosed with ICP; group 2 of 110 pregnant women diagnosed with GDM; group 3 of 16 women diagnosed with both GDM and ICP; group 4 of 136 healthy pregnant women as the control group. The groups were compared in terms of age, body mass index (BMI), gravidity, parity, gestational week of delivery, plasma zonulin levels, delivery type, birth weight, first- and fifth-minute APGAR scores, newborn intensive care unit (NICU) admission, and meconium staining of amniotic fluid parameters. The results suggested that the plasma zonulin levels of ICP (group 1), GDM (group 2), and GDM with ICP (group 3) patients were higher than those of the healthy pregnant women of group 4 (p < 0.001). Among the patient groups, the highest median plasma zonulin levels were found in group 3 (110.33 ng/mL). Zonulin levels were also associated with the severity of ICP and adverse pregnancy outcomes. High serum zonulin levels were related to GDM, ICP, and adverse perinatal outcomes. The coexistence of GDM and ICP led to higher serum zonulin concentrations.

The objective of this study was to assess the value of serum leptin, adiponectin, apelin, and ghrelin as biomarkers for the prediction and diagnosis of intra-hepatic cholestasis (ICP). This prospective study included pregnant women in the third trimester of pregnancy: 63 with ICP, 48 and 15 of whom had mild and severe disease, respectively, and 32 as controls. ICP women had increased median levels of serum leptin, adiponectin, apelin, and ghrelin compared to the controls (p < 0.05). These biomarkers meaningfully changed regarding the severity of ICP: While leptin was reduced, apelin and ghrelin were increased, and adiponectin was increased somewhat. To predict and diagnose ICP, the predictive values of serum leptin, adiponectin, and apelin need to be accepted as comparable, with moderate to high sensitivity and specificity; however, the predictive value of serum ghrelin was somewhat lower. More research is needed to clarify the potential properties of adipokines to gain acceptance as a predictive or diagnostic biomarker for ICP.

Objective: Preeclampsia is a highly morbid disease of placental origin, life-threatening condition for both a pregnant woman and her fetus. Cadherin 6 and 11 are adhesion molecules that play an important role in trophoblastic development and placentation. In our study, we investigated the change in serum cadherin 6 and 11 levels in pregnant women with preeclampsia. Materials and Methods: Pregnant women with preeclampsia were selected and compared with healthy women (as a control group) for a one-year study. The serum alanine aminotransferase, aspartate aminotransferase, and cadherin levels 6 and 11 of participants were analyzed and compared. Results: A total of 189 pregnant women were subdivided into 2 groups as preeclamptic (n=94) and women with healthy pregnancy (n=95). The cadherin 6 and cadherin 11 levels of the preeclamptic patients were significantly higher than those in the control group (p=0.001), and they were found to be significantly higher mainly in patients with early-onset and severe preeclampsia group (p=0.001). The cut-off cadherin 6 and 11 values for severe preeclampsia were found as 98.174 ng/mL and 1.92 ng/mL; with sensitivity of 88.3% and 84% respectively (p=0.001). Conclusion: The data analysis showed elevated serum cadherin 6 and 11 levels associated with the severity and early onset of pre-eclampsia. Serum cadherin 6 and 11 levels can be a candidate marker for the prediction of preeclampsia.

Objective: To evaluate the complaints of premenopausal and postmenopausal geriatric patient who admitted to gynecology outpatient clinic. Methods: 25 Premenopausal and 25postmenopuasal geriatric patients who admitted to outpatient clinic of gynecology in Sakarya Private Konak Hospital were evaluated retrospectively regarding diagnosis, gravida and parity situations, surgical operations, systemic disorders and ultrasonographic mesaurement of endometrial thickness and copmpared to each other. Results: Frequency of common complatints of admitted patients was 20% vaginitis, 16% irregular menstrual bleeding, 14% postmenopausal bleeding. 76% of patients had no systemic disorder. 6% of patients had diabetes mellitus and 18% had hypertention. Rate of having comorbidity in postmenopausal geriatric group was 44% and that of premenopausal group was 4%. According to our findings the frequecy of diseases in postmenopausal geriatric group was 12% uterine prolapse, 24% cytocel, 20% urinary incontinance 4% vasomotor symptoms 12% vaginitis and 28% posmenopausal bleeding and in premenopausal group 28% vaginitis, 16% uterine myoma, 32% irregular menstrual bleeding, 8% dysmenorrhea, 12% and 4% subcutaneus endometriosis. We stated endometrioid adenocarcinoma as the results of endometrial samplings of 2 patients who had postmenopusal bleeding and these patients were referred to gynecologic oncology clinic. Conclusion: Despite all gynecologic problems could be seen in geriatric age group, diseases such as atrofic symptoms due to hypoostrogenemy, vasomotor symptoms, pelvic organ prolapse and urinary incontinance is frequently seen in these women. Both for women heatlh and geriatric women care performing gynocologic evaluation regarding these, would be benefical in terms of early disgnosis and treatment of the diseaeses.

Kronik pelvik ağrı (KPA) en az 6 ay süren, alt karın bölgesinde veya umbilikusun altında yerleşen fonksiyonel veya psikolojik hastalığa neden olabilen, değerlendirme ve tedavi gerektiren bir ağrıdır. Tedaviye yönelik girişimler, bir tanı olarak KPA tedavisi ve KPA ile ilişkili belli başlı hastalıkların tedavisi etrafında yoğunlaşır. Semptomatik rahatlama için tanı ve tedavide multidisipliner bir yaklaşımın en etkilisi olduğu görülmektedir. Bu çalışmada KPA tedavisinde, tamamlayıcı ve alternatif tıp tekniklerinin de kullanıldığı psikolojik tedavi gibi girişimlerin kanıtları gözden geçirilmiştir. Maalesef bu konuda yapılmış çok az randomize kontrollü çalışma olduğundan en iyi kanıtı bulmak çok zordur. Refrakter KPA tedavisi için zaman geçtikçe bir tedavi kombinasyonuna ihtiyaç duyulmaktadır. KPA’nın multifaktöriyel doğası hastayla tartışmayı, onunla iyi bir uyum içinde bir partner kadar yakın olmayı ve düzenli takip edilecek bir yönetim planı geliştirmeyi gerektirir. Kadınlarda KPA yönetiminde tamamlayıcı ve alternatif tıp tekniklerinin de dahil olduğu multidisipliner bir yaklaşımı teşvik etmek en iyi sonuçları doğuracak gibi görünmektedir.

Aim: The aim of this study was to determine the effect of paternal age on miscarriage rates in couples undergoing in vitro fertilization/intracytoplasmic sperm injection treatment cycles. Material and Methods: Patients were classified into two groups. The study group consisted of the patients whose pregnancy resulted in a miscarriage (n=73) and a control group in which the patients had a live singleton birth (n=256). Demographic characteristics, treatment indications, duration of infertility, menstruation day 3 follicle stimulating hormone, estradiol, luteinizing hormone, total antral follicle count, anti-Mullerian hormone levels and controlled ovarian stimulation parameters, day of trigger, estradiol and progesterone levels on the day of trigger, the total number of oocytes retrieved, the number of mature oocytes, the number and quality of the embryo, endometrial thickness on the day of trigger, oocyte pick up and embryo transfer, the distance of embryo-fundus and the day of embryo transfer were recorded. Results: Totally 329 women were included in the present study. The number of patients with the diagnosis of unexplained infertility was statistically significantly higher in the study group than in the control group (p=0.020). Maternal age was found statistically significantly higher in the study group than in the control group (p=0.025). When maternal age increased by 1 unit, the risk of miscarriage increased by 8.7% and those with unexplained infertility had a 75.6% higher risk of miscarriage than those without unexplained infertility. Conclusion: Paternal age was not associated with miscarriage whereas maternal age and unexplained infertility had a positive correlation with miscarriage rate.