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    C677T polymorphism of the methylenetetrahydrofolate reductase gene does not affect folic acid, vitamin B12, and homocysteine serum levels in Turkish children with neural tube defects
    (Funpec-Editora, 2010) Erdogan, M. O.; Yildiz, S. H.; Solak, M.; Eser, O.; Cosar, E.; Eser, B.; Koken, R.
    Association between neural tube defects (NTDs) and C677T polymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene was suspected, because the MTHFR gene codes for a key enzyme in folate metabolism. Its deficiency usually leads to significant reductions in plasma concentrations of folate, vitamin B-12 and methionine, whereas homocysteine levels are increased. We examined folate, vitamin B-12 and homocysteine serum concentrations and polymorphism of the C677T MTHFR gene in Turkish children with neural tube defects. Thirty-three children with NTDs, 26 mothers and 48 healthy individuals were studied. C677T MTHFR polymorphism was determined by melting curve analyses (LightCycler (R)). The levels of folate, vitamin B-12 and homocysteine serum concentrations in NTDs were evaluated and compared, along with information concerning alleles of the MTHFR gene. C677T allele frequencies in NTD children and their mothers were similar to those found in controls. Serum folate and vitamin B-12 concentrations were significantly higher in NTD children than that of controls. Serum homocysteine concentrations were not significantly higher in NTD children and mothers. We concluded that C677T MTHFR gene polymorphism does not affect folic acid, vitamin B-12 and homocysteine metabolism in Turkish children with NTDs. C677T polymorphism of the MTHFR gene cannot be regarded as a major risk factor for NTDs in Turkish children.
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    Can the addition of a paracervical block to systemic or local analgesics improve the pain perceived by the patient during hysterosalpingography?
    (Taylor & Francis Inc, 2014) Hacivelioglu, S.; Gencer, M.; Gungor, A. Cakir; Kosar, S.; Koc, E.; Cosar, E.
    The aim of the present study was to investigate whether the addition of a paracervical block to local intrauterine anaesthesia or the use of an intramuscular non-steroidal anti-inflammatory drug was effective for pain control during and at 30 min after hysterosalpingography (HSG). A total of 120 patients undergoing hysterosalpingography were randomised into four groups. Patients received intramuscular dexketoprofen trometamol with or without a paracervical block or intracavitary lidocaine instillation with or without paracervical block. The primary outcome was the overall pain score from the four stages of the procedure. The lowest pain scores were observed in the patients receiving dexketoprofen trometamol with a paracervical block, whereas the highest pain scores were observed in patients with intracavitary lidocaine instillation without a paracervical block (p = 0.021). No beneficial effect was found when a paracervical block (PCB) was added to either systemic or local analgesics. The combination of intramuscular dexketoprofen and a paracervical block with plain lidocaine produced the best pain relief during the three specified steps and at up to 30 min after the HSG procedure.
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    Cesarean section: requested mode of delivery?
    (7847050 Canada Inc, 2017) Celik, F.; Cosar, E.; Akbas, P.; Kumru, S.; Kose, M.; Yilmazer, M.; Koken, G.
    Aim: To constitute accurate policies for reducing the cesarean section (C/S) the authors evaluated the attitudes and knowledge of health workers and public population towards the mode of delivery, C/S on demand, and delivery complications in a large population. Materials and Methods: 1,892 female volunteers in reproductive age were enrolled in the study and 589 of them were health workers. Patients were evaluated with questionnaire about their delivery mode and their answers were analyzed. Results: The overall cesarean rate of the study population was 45.4%. This rate were 51.4% and 28.2%, respectively, for the health workers and public group (p < 0.001). Medical indication ratio were 57.7% and 40.1% for the healthcare group and the public population respectively and 20.2% of health workers and 13.9% of the public group had C/S by their preference without any medical indications (p < 0.001). Conclusion: C/S rate is high in Turkey and an action plan is needed to decrease the rate. When a patient's preference towards the mode of the delivery is C/S on demand, obstetricians, in their capacity as patient advocate, should help guide their patient through the sophisticated detailed medical information toward a decision that respects both the patient's attitude and the physician's obligation to optimize the health of both the mother and the newborn.
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    CIRCULATING MIRNAS IN ENDOMETRIOSIS
    (Elsevier Science Inc, 2015) Cosar, E.; Cho, S.; Seifer, B.; Krikun, G.; Taylor, H. S.
    [Anstract Not Available]
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    INCREASED EXPRESSION AND CHEMOATRACTANT ACTIVITY OF CXCR4 AND CXCL12 IN ENDOMETRIOTIC LESIONS.
    (Elsevier Science Inc, 2016) Moridi, I.; Mamillapalli, R.; Cosar, E.; Ersoy, G. Sahin; Taylor, H. S.
    [Anstract Not Available]
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    The effect of maternal polycystic ovary morphology on first-trimester maternal serum biochemical markers of aneuploidy and fetal nuchal translucency thickness
    (Imr Press, 2015) Hacivelioglu, S.; Uysal, A.; Gungor, A. N. Cakir; Gencer, M.; Cakir, D. U.; Cosar, E.
    Objective: To evaluate the effect of maternal polycystic ovary (PCO) morphology on maternal serum free beta-human chorionic gonadotropin (beta-hCG), pregnancy associated plasma protein A (PAPP-A), and nuchal translucency (NT) thickness in the first-trimester. Material and Methods: A total of 92 pregnant women in the first-trimester were included in the study. Of them, 57 had PCO morphology, and 35 women constituted the control group, with apparently normal ovaries. Maternal serum free beta-hCG, PAPP-A, and NT thickness were measured and compared in all patients. Results: The multiples of median (MoM) levels of serum free beta-hCG were significantly higher in the PCO morphology group compared to the normal ovary group (p = 0.024). However, the MoM levels of PAPP-A were similar in both groups (p = 0.947). No difference was found between the groups in terms of fasting glucose levels and NT measurements (p = 0.976 and 0.565, respectively). Conclusion: In pregnancies with maternal PCO morphology, the presence of higher maternal serum free beta-hCG levels may require correction in the calculation of risks related to first-trimester screening for chromosomal abnormalities. Larger studies are needed to confirm our preliminary data.