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    Effect of combined oral contraceptive use on serum 25-hydroxy vitamin D levels and ultrasound parameters in patients with polycystic ovary syndrome
    (Taylor & Francis Ltd, 2016) Kalem, Mueberra Namli; Hizli, Deniz; Kamalak, Zeynep; Kosus, Aydin; Kosus, Nermin; Turhan, Nilgun; Kafali, Hasan
    Purpose: To investigate if there is an effect of combined oral contraceptive (COC) use on serum 25-hydroxy vitamin D [25(OH)D] levels in patients with polycystic ovary syndrome (PCOS). Methods: PCOS was defined by the 2003 Rotterdam criteria. All patients with PCOS were treated with a COC containing 0.035 mg ethinylestradiol and 2 mg cyproterone acetate for 6 months. Serum 25(OH)D levels, HOMA-IR, ovarian volume and antral follicule count were measured before and after the treatment. Results: The median 25(OH)D levels were 9.40 (range 4.40-24.50) mu g/l and 7.00 (5.00-13.50) mu g/l before and after COC use, respectively. Serum 25(OH)D levels decreased after the treatment; however, the difference was not statistically significant (p = 0.055). Conclusion: This study seems to be the first prospective trial revealing the effect of COC use on serum 25(OH)D levels in women with PCOS. Although the decrease in serum 25(OH)D levels in patients with PCOS with the use of COC alone, did not reach to statistically significance level after 6 months treatment with COC.
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    Factors affecting the rates of caesarean sections in cases with premature rupture of membranes (PROM) at term
    (Taylor & Francis Inc, 2017) Kalem, Muberra Namli; Kosus, Aydin; Kamalak, Zeynep; Kosus, Nermin; Kalem, Ziya
    The aim of this retrospective study was to investigate the factors affecting the rates of caesarean section in cases with premature rupture of membranes (PROM) in term pregnancies. Eighty-two term PROM patients who presented to Turgut Ozal University and Erzurum Nene Hatun Hospitals between 2012 and 2014 were included. The effects of demographics, nulliparity, active-latent phase durations, presence of meconium and chorioamnionitis, requirement of oxytocin and cervical dilation at the initial examination on C/S rates were assessed. The C/S rates were changed with the duration of active period and the duration of latent period. It was found that the presence of cervical dilation at the initial examination significantly reduced the risk for progress to C/S at a rate of 87.5%. C/S rates did not change with other variables. We conclude that the factors increasing the risk for C/S in PROM at term group are not different from the non-term PROM.Impact statementThe aim of this retrospective study was to investigate the factors affecting the rates of caesarean section (C/S) in cases with premature rupture of membranes (PROM) in term pregnancies. The C/S rates were changed with the duration of active period and the duration of latent period. It was found that the presence of cervical dilation at the initial examination significantly reduced the risk for progress to C/S at a rate of 87.5%.We conclude that the factors increasing the risk for C/S in PROM at term group, are not different from the non-term PROM groups.Currently, the PROM is considered the start of a pathological process in both term and preterm pregnancies and also considered to increase the rates of caesarean sections. Studies on the management of PROM at term have concentrated rather on whether to intervene for accelerating the labour or spontaneous monitorisation. As found by the studies like this one in the literature, the factors having an impact on C/S rates in the cases of PROM at term are similar to those of non-PROM patients at term, may prevent clinicians from taking an invasive or aggressive approach towards the cases of PROM at term.
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    Is There a Relationship Between Pelvic Organ Prolapse and Tissue Fibrillin-1 Levels?
    (Korean Continence Soc, 2015) Eser, Ayla; Unlubilgin, Eylem; Hizli, Fatih; Acar, Muradiye; Kamalak, Zeynep; Kosus, Aydin; Kosus, Nermin
    Purpose: Pelvic organ prolapse is a multifactorial disorder in which extracellular matrix defects are implicated. Fibrillin-1 level is reduced in stress urinary incontinence. In Marfan syndrome, which is associated with mutations in Fibrillin-1, pelvic floor disorders are commonly observed. We hypothesize that Fibrillin-1 gene expression is altered in pelvic organ prolapse. Methods: Thirty women undergoing colporrhaphy or hysterectomy because of cystocele, rectocele, cystorectocele, or uterine prolapse were assigned to a pelvic prolapse study group, and thirty women undergone hysterectomy for nonpelvic prolapse conditions were assigned to a control group. Real-time polymerase chain reaction was conducted on vaginal tissue samples to measure the expression of Fibrillin-1. Expression levels were compared between study and control groups by Mann-Whitney U test with Bonferroni revision. Results: Fibrillin-1 gene expression was not significantly lower in the study group than in the control group. Similarly, no significant correlation between Fibrillin-1 levels and grade of pelvic prolapse was found. Age over 40 years (P = 0.018) and menopause (P = 0.027) were both associated with reduced Fibrillin-1 levels in the pelvic prolapse group, whereas the delivery of babies weighing over 3,500 g at birth was associated with increased Fibrillin-1 expression (P = 0.006). Conclusions: The results did not indicate a significant reduction in Fibrillin-1 gene expression in pelvic prolapse disorders; however, reduced Fibrillin-1 may contribute to increased pelvic organ prolapse risk with age and menopause. Increased Fibrillin-1 gene expression may be a compensatory mechanism in cases of delivery of babies with high birth weight. Further studies are needed for a better understanding of these observations.
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    Is there any effect of demographic features on development of hyperemesis gravidarum in the Turkish population?
    (Tubitak Scientific & Technological Research Council Turkey, 2013) Kamalak, Zeynep; Kosus, Nermin; Kosus, Aydm; Hizli, Deniz; Ayrim, Aylin; Kurt, Gonca
    Aim: To assess the effect of maternal demographic variables on development of hyperemesis gravidarum (HG) in pregnant Turkish women. Materials and methods: Two hundred consecutive women with HG were defined as the study group, and 200 consecutive pregnant women without any signs or symptoms of HG matched for age, parity, and gestational age were defined as the control group. Personal information, including lifestyle, educational level, occupation, and economic status were obtained via questionnaire. Results: The number of abortions was higher but parity was lower in the HG group. The time interval between 2 pregnancies was significantly shorter in the HG group than in the control group. HG developed in all women who had HG in a previous pregnancy. HG was significantly higher in women who graduated from high school or university. Level of monthly income and communication within the family have an effect on development of HG. Logistic regression analysis showed that the most important parameters for prediction of HG were education level, age at marriage, and previous history of abortus. Conclusion: Living conditions, life standards, communication, and experiences in previous pregnancies might affect development of HG.
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    The Effect of Body Mass Index on Acne, Hirsutism and Menstrual Irregularity Symptoms in Turkish Adolescent Girls
    (Gazi Univ, Fac Med, 2013) Hizli, Deniz; Kosger, Hatice; Hacivelioglu, Servet; Kosus, Nermin; Kosus, Aydin; Kamalak, Zeynep; Akcal, Banu
    Purpose: The aim of the present study was to determine whether body mass index (BMI) influences polycystic ovary syndrome (PCOS) related symptoms such as acne, hirsutism and menstrual irregularity in a large healthy adolescent population. Methods: Self-administered questionnaires were distributed to all volunteer female students at 15 different secondary schools. The subjects' BMI, birthweight, age at menarche, pattern of menstrual cycle and presence of acne or hirsutism complaints were recorded. Subjects with BMI of = 18.4 kg/m 2, 18.5-24.9 kg/m(2), 25-29.9 kg/m(2) and > 30 kg/m(2) were defined as group 1, group 2, group 3 and group 4, respectively. The relation between BMI and the symptoms of acne, hirsutism and menstrual irregularity was analyzed. Results: A total of 1309 students filled the questionnaires properly and included in the study. Of these students, 314 were in group 1, 899 in group 2, 81 in group 3 and 15 in group 4. The median ages of participants were 16 years (range 13-20 years) and median age at menarche was 13 years (range of 11-16 years). A total of 106 (8.1%) participants reported various menstrual irregularity. Underweighed girls had significantly less acne (p= 0.001) and hirsutism problems (p<0.001) compared to normo weighed girls. Hirsutism incidence was significantly higher in overweighed girls than in normo weighed subjects (p<0.001). Conclusion: The present study provided the prevalence of PCOS related symptoms in population, including menstrual irregularity, acne and hirsutism according to BMI in a large adolescent population. Our results showed that menstrual irregularity was not significantly increased as BMI increased, however acne and hirsutism problems were significantly increased as BMI increased.