Vitamin D evaluation in adenomyosis: A retrospective cross-sectional study.

Objective: Adenomyosis is a chronic inflammatory illness that depends on estrogen. In addition to its immune regulatory effects in chronic diseases, vitamin D also plays roles in regulating normal cell growth. In the present study, the purpose was to evaluate the possible relationships between serum 25-OH vitamin D levels and clinical and laboratory parameters in patients who were histopathologically diagnosed with adenomyosis. Materials and Methods: A total of 168 females with a history of hysterectomy between January 2019 and November 2022 who were histopathologically diagnosed with adenomyosis and 168 women who were not diagnosed with adenomyosis were retrospectively evaluated in the present study. Demographic, clinical, and laboratory data were recorded at the time of admission. Visual analogue scale (VAS) scores were calculated for each patient to evaluate the severity of dysmenorrhea. Results: There was a significant difference between the groups in terms of VAS: the adenomyosis group scored an average of 6, whereas the control group scored an average of 3 (p<0.001). The average platelet volume value of the patients was 8.6 fL in the adenomyosis group, and that of the control group was 7.2 fL, and it was detected to be significantly elevated in the adenomyosis group (p<0.001). The CA-125 value of the patients was 63.5 U/mL in the adenomyosis group, and that of the control group was 15.6 U/mL and it was detected to be significantly rised in the adenomyosis group (p<0.001). The 25-OH vitamin D level of the patients was 12.6 ng/mL in the adenomyosis group and that of the control group was 19.1 ng/mL and it was detected to be significantly elevated in the control group. Conclusion: The current investigation provides compelling evidence for the association between low vitamin D levels and adenomyosis, which agrees with other research in the field. The current study's findings agree with other research that suggests vitamin D regulates cellular and signaling networks, including those that control cytokines and gene expression during adenomyosis. However, further studies are needed because data assassing the therapeutic efficacy of vitamin D in adenomyosis are questionable.

The role of personality traits on mode of delivery.

PURPOSE: The aim of this study is to understand the motives behind CS requests in nulliparous women in their late pregnancy better and to investigate if specific personality traits affect the maternal decision on mode of delivery. MATERIAL AND METHOD: This prospective study was conducted with 70 healthy, nulliparous parturient with singleton pregnancies. Women at their 28-32. weeks of gestation were asked to fill a socio-demographic data form and the questionnaires; Personality Belief Questionnaire - Short Form (PBQ-SF) and The Childbirth Attitudes Questionnaire (CAQ). After delivery, all the results of pre-filled questionnaires and women's mode of delivery were analyzed and compared. RESULTS: There were significant differences in personality types; dependent (p = 0.033), passive-aggressive (p = 0.031), obsessive-compulsive (p = 0.001), antisocial (p = 0.014), narcissistic (p = 0.014) and borderline (p = 0.014) between vaginal delivery and CS groups. The CAQ scores of the mothers who requested CS were significantly higher (p:0.007). Weak but significant positive relation was found between total CAQ scores and avoidant (p = 0.022), dependent (p = 0.034), passive-aggressive (p = 0.040), narcissistic (p = 0,006), schizoid (p = 0.007), paranoid (p = 0.007) and borderline (p = 0.007) personality types. CONCLUSION: This is the first study that investigates the relationship between mode of delivery and personality traits according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) and cognitive behavioral perspective in the literature. These personality traits can be carried at a level that is not clinically significant to create an obvious pathology, yet they might play a role as the motives behind the apparent reasons for women who request CS. Understanding women's motives and attitudes for childbirth during their pregnancy may help healthcare providers to tailor women's approach to childbirth to avoid unnecessary CS.

Diagnostic value of shear wave velocity in polycystic ovarian syndrome.

Aim: In polycystic ovarian syndrome, the ovaries become stiffer due to chronic anovulation. We aimed to compare tissue elasticity in terms of shear wave velocities measured using acoustic radiation force impulse imaging technique between the ovaries of polycystic ovarian syndrome women and non-polycystic ovarian syndrome women. Material and methods: The study was designed as a retrospective data analysis of women who underwent transvaginal ultrasound and acoustic radiation force impulse imaging in a university hospital between July 2014 and March 2015, for various reasons. There were 32 polycystic ovarian syndrome patients and 32 patients without a diagnosis of polycystic ovarian syndrome. Age, body mass index, fasting glucose levels, cycle day 3 follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, prolactin, antimullerian hormone levels, and menstrual patterns with clinical hyperandrogenism were evaluated. On the menstrual cycle days 2-4, by performing a transvaginal ultrasound scan, the ovarian volumes and antral follicle counts in both ovaries were recorded for each woman. The ultrasound system was converted into the elastography mode, and acoustic radiation force impulse imaging was performed. Shear wave velocity (m/sec) was measured at least 5 times for each ovary, and the mean value was calculated for each polycystic ovarian syndrome and non-polycystic ovarian syndrome woman. Results: Age, body mass index, fasting glucose levels, cycle day 3 follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, and prolactin levels were similar between the groups (p >0,05). Antimullerian hormone levels, antral follicle counts, and mean ovarian volumes were statistically different between the groups (p <0,05). Mean shear wave velocity values for both ovaries were 2.12 ± 0.82 (0.78-4.9) m/sec in the polycystic ovarian syndrome group, and 1.18 ± 0.41 (0.77-2.0) m/sec in the non-polycystic ovarian syndrome group, which was statistically significantly different (p = 0.016). Conclusion: In our study, we found significantly higher shear wave velocity levels in polycystic ovarian syndrome women than non-polycystic ovarian syndrome women, which indicates an impact of the condition on shear wave velocity. The increased acoustic frequencies cause a decreased response in time to transition, and motion becomes out of phase; in other words, scattered waves are faster in stiffer ovaries. Our results are thus compatible with the pathophysiology of the disease. Shear wave velocity is a beneficial tool for evaluating ovarian elasticity in polycystic ovarian syndrome patients in whom the levels are found to be significantly higher than non-polycystic ovarian syndrome women. In light of these findings, shear wave velocity is expected to be slower than polycystic ovarian syndrome levels in ovulatory women.

Measuring visfatin levels in saliva: an alternative approach to gestational diabetes screening

ABSTRACT Objective: Oral glucose tolerance testing (OGTT) is the current recommended approach for the diagnosis of gestational diabetes mellitus (GDM). Visfatin is a type of novel adipokine of interest that mostly participates in glucose metabolism and inflammatory processes. We aim to identify a screening technique for GDM using salivary visfatin levels and to establish this technique's value as a screening method compared to OGTT. Materials and methods: This is a cross-sectional case-control study. The cohort was formed from the saliva samples of pregnant patients in their 24th through 28th weeks of gestation. Patients were divided into two groups depending on their GDM status. OGTT and visfatin test results were compared and subjected to further analysis to establish a cutoff value for visfatin testing. Results: ELISA results indicated a significant difference between patients with GDM compared to patients without GDM; the values were 18.89 ± 9.59 and 12.44 ± 8.75, respectively (p: 0.007). A cutoff value of 10.5 ng/mL can be used to detect GDM with 78% sensitivity and 51% specificity. Conclusion: Salivary visfatin levels were significantly higher in patients with GDM. The existence of a differential in the concentration of visfatin in saliva can be utilized to develop a new screening method for GDM.

Measuring visfatin levels in saliva: an alternative approach to gestational diabetes screening.

OBJECTIVE: Oral glucose tolerance testing (OGTT) is the current recommended approach for the diagnosis of gestational diabetes mellitus (GDM). Visfatin is a type of novel adipokine of interest that mostly participates in glucose metabolism and inflammatory processes. We aim to identify a screening technique for GDM using salivary visfatin levels and to establish this technique's value as a screening method compared to OGTT. METHODS: This is a cross-sectional case-control study. The cohort was formed from the saliva samples of pregnant patients in their 24th through 28th weeks of gestation. Patients were divided into two groups depending on their GDM status. OGTT and visfatin test results were compared and subjected to further analysis to establish a cutoff value for visfatin testing. RESULTS: ELISA results indicated a significant difference between patients with GDM compared to patients without GDM; the values were 18.89 ± 9.59 and 12.44 ± 8.75, respectively (p: 0.007). A cutoff value of 10.5 ng/mL can be used to detect GDM with 78% sensitivity and 51% specificity. CONCLUSION: Salivary visfatin levels were significantly higher in patients with GDM. The existence of a differential in the concentration of visfatin in saliva can be utilized to develop a new screening method for GDM.

Salivary Leptin and Chemerin; a novel way of gestational diabetes screening.

INTRODUCTION: Oral glucose tolerance testing (OGTT) is the recommended approach for the diagnosis of gestational diabetes mellitus (GDM). Leptin and chemerin are two examples of hormones from adipokine family, which mostly takes part in glucose metabolism and inflammatory processes. We aim to find a possible new and tolerable screening technique for GDM using salivary levels of leptin and chemerin. MATERIAL AND METHOD: Saliva samples of pregnant patients, on their 24-28th weeks of gestation, are collected via saliva collection kit. Leptin and chemerin ELISA tests were run from serum samples being hold at -80 °C following their thawing session. Patients are divided into two groups depending on their GDM status. OGTT results of patients are compared with their ELISA results. RESULTS: ELISA study for leptin showed an insignificant difference between patients with GDM and patients without where the values were 0.44 ± 0.33 and 0.34 ± 0.24 respectively (p: 0.155). Chemerin study revealed a significant difference between patients with GDM and without 631.06 ± 344.42, 334.81 ± 244.91 respectively (p < .001). CONCLUSION: Leptin and chemerin can be detected in saliva. Chemerin levels are significantly higher in patients with GDM, thus this knowledge can be used to develop a new screening method for OGTT.

Value of in vitro acoustic radiation force impulse application on uterine adenomyosis.

PURPOSE: Adenomyosis is the presence of endometrial glandular and stromal tissue in the myometrium. This phenomenon can be the cause of excessive bleeding and menstrual pain in premenopausal women. Diagnosis of adenomyosis may present difficulty with conventional methods such as ultrasound and magnetic resonance imaging. Frequently, diagnosis is accomplished retrospectively based on the hysterectomy specimen. MATERIALS AND METHODS: This is a prospective case control study done in vitro on 90 patients' hysterectomy specimens. Acoustic radiation force impulse (ARFI) and color elastography were used to determine the elasticity of hysterectomy specimens of patients undergoing indicated surgeries. Based on histopathological examinations, two groups were formed: a study group (n = 28-with adenomyosis) and a control group (n = 62-without adenomyosis). RESULTS: Elasticity measurements of tissue with adenomyosis were observed to be significantly higher than measurements of normal myometrial tissue (p < 0.01). Uterine fibroids were found to have higher values on ARFI study compared to normal myometrial tissues (p < 0.01). CONCLUSION: The findings lead to the conclusion that adenomyosis tissue is significantly softer than the normal myometrium. ARFI was found to be beneficial in differentiating myometrial tissue with adenomyosis from normal myometrial tissue. It was found to be feasible and beneficial to implement ARFI in daily gynecology practice for diagnosis of adenomyosis.

Placental elasticity on patients with gestational diabetes: Single institution experience.

BACKGROUND: Gestational diabetes is defined as glucose intolerance which is first recognized in pregnancy. Oral glucose tolerance test (OGTT) is the cornerstone in diagnosing gestational diabetes. Placental elasticity evaluation is relatively new concept and is principally used for research purposes. We aimed to find any relation between placental elasticity evaluation and patients of gestational diabetes diagnosed by 75 g OGTT. METHODS: There were 91 patients took part in study, forming two groups as gestational diabetic patients (21 patients) and control group (70 patients). Elasticity of placenta was determined by acoustic radiation force impulse technology utilized by two blinded radiology specialists. RESULTS: We were not able to find any correlation between 75 g OGTT values and placental elasticity measurements (p > .05). Also placental elasticity was not found to be significantly different in two groups (p > .05). CONCLUSION: Placental elasticity measurement on the 24th-28th weeks does not seem to be a marker for identification of gestational diabetes.

Trocar site hernia on an 8-mm port following robotic-assisted hysterectomy.

The increasing use of laparoscopy has resulted in added complications specific to the laparoscopic approach, such as trocar site hernia (TSH), which is an uncommon but well-recognized problem for both regular laparoscopic and robotic-assisted laparoscopic procedures. We describe an extremely rare case of TSH at an 8-mm port site occurring a relatively short time after surgery in a 53-year-old patient undergoing robotic-assisted laparoscopic hysterectomy for benign reasons. Additionally, this report attempts to explain the possible etiological factors relating to TSH following robotic-assisted surgery. According to our case report, a defect in the 8-mm port that may lead to hernia is one possible explanation, and closure of the 8-mm trocar sites' fascia may be a safer approach during robotic-assisted surgery. Additional reports are needed to accurately determine the frequency of occurrence and importance of this complication.

Transobturator tape operation is more effective in premenopausal women than in postmenopausal women with stress incontinence.

PURPOSE: Midurethral synthetic slings for female stress urinary incontinence are minimally invasive polypropylene mesh tapes that are inserted under the midurethra with trocars. In the past decade, this new technology has become the most commonly performed procedure for female stress urinary incontinence, replacing the traditional open procedures. However, its effectiveness in pre- and postmenopausal women has not previously been compared. MATERIALS AND METHODS: We assessed the clinical outcome of the transobturator tape (TOT) procedure in premenopausal (n=45) and postmenopausal (n=49) women by means of self-report and the Urinary Distress Inventory 6 (UDI-6) questionnaire. RESULTS: The mean age of the pre- and postmenopausal women was 44 and 60 years, respectively. Mean parity was 2.4 and 3, respectively. There were no significant differences with respect to mean operation time, duration of hospitalization, or intraoperative and postoperative complications. However, premenopausal women were more satisfied with the operation than were postmenopausal women (p=0.014). Also, UDI-6 scores were significantly better in premenopausal women (p=0.027). CONCLUSIONS: The TOT operation appeared to be more effective in premenopausal women with stress urinary incontinence. However, further studies with larger sample sizes are needed to confirm our results.