Background and Objectives: Osteoporosis is a common disease of the skeletal system that increases the risk of fracture. The prevalence of osteoporosis has been increasing as the aging population increases, affecting more than 200 million people worldwide. This study aimed to shed light on the clinical impact of osteoporosis on women’s health and quality of life by evaluating the prevalence and risk factors for this disease among postmenopausal women, using a 10-year dataset from a tertiary center. Materials and Methods: This retrospective cohort study was conducted at Dokuz Eylül University, Department of Obstetrics and Gynecology, between 2010 and 2022. A total of 3289 postmenopausal women aged 50–60 years who were undergoing routine gynecological checkups were included in the study. Patients with a prior diagnosis, a history of medical conditions, or who were taking medications affecting bone mineral density (BMD) were excluded. Data on demographics, smoking status, diabetes status, body mass index (BMI), parity, and fracture history were collected. BMD scores were classified as normal, osteopenia, or osteoporosis. Results: The prevalence of osteoporosis was 10.4%. The median age of the patients was 56.0 years. Smoking, diabetes, and a history of bone fractures were found to significantly increase the risk of osteoporosis. BMI was found to have a protective effect against osteoporosis. According to multivariate analysis, the risk of osteoporosis increased by 2.46 times in patients who smoke, 3.78 times in patients with diabetes, and 6.23 times in patients with a history of fractures. Conclusions: Awareness of modifiable risk factors such as smoking is crucial for preventing osteoporosis-related complications. Diabetes, even when it is not complicated, increases the risk of osteoporosis. Physical exercise, calcium, and vitamin D intake are important, especially during young adulthood, as they are the primary contributors to peak bone mass. Because neck fractures are more common in patients with osteopenia, early diagnosis and routine screening can mitigate future complications.

Endometriosis is a gynecologic condition characterized by the growth of endometrium-like stroma and glandular elements outside of the uterine cavity. The involvement of hormonal dysregulation, specifically estrogen, is well established in the initiation, progression, and maintenance of the condition. Evidence also highlights the association between endometriosis and altered immune states. The human endometrium is a highly dynamic tissue that undergoes frequent remodeling in response to hormonal regulation during the menstrual cycle. Similarly, endometriosis shares this propensity, compounded by unclear pathogenic mechanisms, presenting unique challenges in defining its etiology and pathology. Here, we provide a lens to understand the interplay between estrogen and innate and adaptive immune systems throughout the menstrual cycle in the pathogenesis of endometriosis. Estrogen is closely linked to many altered inflammatory and immunomodulatory states, affecting both tissue-resident and circulatory immune cells. This review summarizes estrogenic interactions with specific myeloid and lymphoid cells, highlighting their implications in the progression of endometriosis.

Background: The pathogenesis of endometriosis is still debatable, and many studies reported a predisposition to infectious and immunological factors. In this study, we aimed to evaluate the human papillomavirus (HPV) positivity in endometriosis pain-related symptoms and infertility. Methods: In this cross-sectional study, 410 endometriosis patients were enrolled in this study. HPV-positive (n = 202) and HPV-negative (n = 208) patients compared with pain-related symptoms, infertility, and endometrioma presence. The term “Other HPV” was utilized to encompass all HPV types with the exception of HPV 16 and 18, which were specifically identified as HPV 16/18. Results: Dyspareunia in the “Other HPV”-positive group (12.8 %) was statistically higher than in the HPV-negative group (4.8%; p = 0.007). The infertility rate was significantly higher in the HPV 16/18 positive group (high-risk HPV) 35.8% than in the HPV-negative (7.6%), and “Other HPV” positive group (8%; p < 0.001). Endometriosis-related pain symptoms were significantly higher in high-risk HPV (49%) than in the HPV-negative (37%), and “Other HPV” positive group (46.3%; p = 0.046). The ovarian endometrioma rate was slightly higher in group HPV 16/18 positive population (16.9%) than in “Other HPV” types positive (11.4%), and HPV-negative groups (7.2%; p = 0.08). Conclusions: Our results could provide a potential predisposing role of HPV infection in pain in endometriosis clinics and infertility. Moreover, HPV subtypes may have a different impact on clinical conditions.

Ischemia/reperfusion (I/R) damage following detorsion treatment, tissue fibrosis, and adhesions cause secondary tissue damage in the ovaries. Many studies have been evaluated to minimize antioxidant damage in ovarian reserve loss while minimizing I/R damage. However, no study observed long-term effects on the ovarian torsion model in rats. In this study, we evaluated the profibrotic effects of A. cepa on an ovarian torsion model on rats. Group I (n=7) rats were the sham group. Group II (n=7) rats were the torsion group and Group III (n=7) rats were the torsion + A. cepa group. To observe the long-term effects of allium cepa, rats were fed for 21 days. Cellular damage I/R is evaluated by histopathological damage score, and transforming growth factor-beta 1 (TGF-β1) and alpha-smooth muscle actin (α-SMA) is measured to analyze the profibrotic effect. A. cepa altered cellular damage due to improvement in the histopathological damage score with A. cepa intake. However, the profibrotic mediators TGF-β1 and α-SMA are non- significantly changed by the A. cepa (p=0.477 and p=0.185 respectively). A. cepa is a potent protective on cellular tissue, minimizing I/R damage on ovarian tissue histologically. Our study implies that A. cepa does not affect fibrosis-related mediators in the rat ovary.

Objective: Endometriosis is a common gynecological disease among reproductive-age women. Numerous hypotheses exist regarding the pathogenesis of endometriosis. In Turkey, the consumption of Allium cepa (commonly known as the “onion cure”) is a popular treatment employed to alleviate a variety of gynecological disorders. Methods: In this study, our objective was to assess the therapeutic mechanisms of the onion bulb A. cepa using an autologous endometriosis model in Sprague-Dawley rats. Previous research has shown that A. cepa possesses anti-inflammatory, antioxidant, and antiapoptotic properties. We evaluated the pathological condition of endometriotic implants by employing hematoxylin-eosin staining and Ki67 immunohistochemistry analysis. Transforming growth factor-beta 1 (TGF-β1) and alpha-smooth muscle actin (α-SMA) have been identified as profibrotic markers that are highly overexpressed in endometriotic tissues relative to eutopic endometrial tissue. Furthermore, TGF-β1 influences the differentiation and progression of endometriosis. To quantify profibrotic activity, we measured TGF-β1 and α-SMA using the immunosorbent assay method.Results: Lower histologic evaluation scores for endometriotic implants were observed in the group receiving high-dose A. cepa relative to the other groups. Ki67 expression was reduced following the high-dose A. cepa regimen, which consisted of 30% A. cepa and 70% normal feed. However, no statistically significant differences in TGF-β1 or α-SMA levels were observed among the groups (p=0.7 and p=0.778, respectively). Conclusion: The findings suggest that A. cepa could serve as a therapeutic agent in endometriosis treatment, as evidenced by the reduction in proliferative potential. Nevertheless, A. cepa was not associated with significantly lower levels of endometriosis-associated TGF-β1 or α-SMA.

This paper reports the measures taken to manage the impact of the COVID-19 pandemic on O&G services in a tertiary referal centre and their outcomes. All the patients included in this study received inpatient treatment and underwent surgery between March 10 2020 and end of June 2020, including obstetric or gynaecologic cases combined. Data including age, diagnosis, operation, duration of preoperative and postoperative hospital stay, COVID-19 status were recorded. COVID-19 status of the patients was diagnosed with a nasopharyngeal swab test. Thirty-seven (20%) of 177 operations were performed because of gynaecologic reasons. The rest of them were caesarean sections (C/S). In gynaecologic cases, 22 (59%) of 37 were emergent operations, nine (24%) cases were oncologic and six (16%) cases were elective gynaecological surgeries. On the other hand, 43 (30%) of 140 patients, who underwent caesarean sections, were urgent surgeries. The rest were elective and planned caesarean sections. Only five patients (2.8%) who had undergone caesarean sections were tested positive for COVID-19. No COVID-19 transmission to staff was recorded in this period. Measures against the COVID-19 pandemic must be multidisciplinary and is crucial to prevent the spread of the disease to staff in close contact.