ISSN 1301 - 0883 | E-ISSN: 1309-3886
Eastern Journal Of Medicine - Eastern J Med: 23 (2)
Volume: 23  Issue: 2 - 2018
1.Myoinositol Causes Myometrial Contractions in Isolated Non-Pregnant Rat Myometrium
Ebru Çelik Kavak, Emine Kacar, Salih Burcin Kavak, Ozgur Bulmus, Ihsan Serhatlioglu, Ahmet Tektemur
doi: 10.5505/ejm.2018.05925  Pages 65 - 70
INTRODUCTION: We aimed to investigate the effect of myoinositol, on myometrial contractility of non pregnant rat uterus in vitro and its mechanism of action.
METHODS: In a standard organ bath spontaneous contractions were recorded. After the
cessation of spontaneous contractions, 5μM, 50 μM and 500 μM of myoinositol and 20
μM folic acid were applied to each 7 strips and contractions were again enrolled. Same
procedures were also repeated in calcium free solution. Real Time Polymerase Chain
Reaction (RT-PCR) analysis of ion channels were done only for 50 μM dose of
myoinositol which corresponds to the treatment dose.
RESULTS: It is demonstrated that in all doses increase in frequency and amplitude of contractions were statistically significant. Any contraction was not observed in calcium free solution which demonstrated us that myoinositol uses extracellular calcium for contraction. It is also demonstrated that folic acid does not cause contraction in non pregnant rat uterine smooth muscle cells. Expression of Transient receptor potential cation channel, subfamily M, member 2 (TRPM2) and Transient receptor potential cation channel, subfamily V, member 1 (TRPV1) channels significantly decreased after application of myoinositol (p=0.00 and p=0.00, respectively) whereas expression of Transient receptor potential cation channel, subfamily M, member 7 (TRPM7) and Calcium channel, voltage-dependent, N type, alpha 1B subunit (CACNA1B) channels did not change significantly when compared to the control group (P>0.05 and p>0.05, respectively).
DISCUSSION AND CONCLUSION: We demonstrated for the first time that myoinositol causes contraction in
myometrium of non pregnant rat uterus and it uses the extracellular calcium for

2.1800 MHz radio-frequency electromagnetic radiation induces oxidative stress in rat liver, kidney and brain tissues
Mehmet Berköz, Badel Arslan, Metin Yıldırım, Nurcan Aras, Serap Yalın, Ülkü Çömelekoğlu
doi: 10.5505/ejm.2018.20982  Pages 71 - 78
INTRODUCTION: Radio-frequency electromagnetic radiation (RF-EMR) represents one of the environment factor that influence animal organism that that conduct the organism to stress. In this study we determined the oxidative stress parameters from rat liver, kidney and brain tissues that were exposed to chronic 1800 MHz RF-EMR.
METHODS: Our study was designed in 3 groups as 9 animals in each group. These are; control, sham and RF-EMR exposed group. The control group was not exposed to any procedure; sham group was housed in the same room under the same conditions with equal time period, except that the generator was turned off. RF-EMR exposed group was subjected to 1800 MHz RF-EMR emitted from the signal generator for 2 h per day for eight weeks. All animals that completed the experimental period were sacrificed and liver, kidney and brain tissues of all rats were isolated for analyzing malondialdehyde (MDA), nitric oxide (NO) and reduced glutathione (GSH) levels and superoxide dismutase (SOD) and catalase activities.
RESULTS: Liver, kidney and brain MDA and NO levels were higher and GSH level and SOD and catalase activities were significantly lower in RF-exposed group than control and sham groups (p<0.001). No significant difference was observed in terms of tissue MDA, GSH and NO levels and SOD and catalase activities between control and sham groups in each tissue.
DISCUSSION AND CONCLUSION: The results of our study shows that RF-EMR may act as an environmental stressor and cause oxidative and nitrosative damage in liver, kidney and brain tissues.

3.Compatibility of Na and K Values Measured by Biochemistry Analyser And Blood Gas Analyser In Different Clinical Situations
Ali Haydar Akça, Muhammed İkbal Şaşmaz
doi: 10.5505/ejm.2018.85856  Pages 79 - 83
INTRODUCTION: Severe disturbances in sodium and potassium are frequently encountered in emergency departments and these are among the most important treatable medical emergencies. We aimed to evaluate the correlation of serum sodium and potassium levels measured with blood gas analyzer and biochemistry laboratory autoanalyser.
METHODS: We conducted a retrospective study between April 1st and 30th, in an emergency department of an university hospital. We screened patients whom had both venous blood gas analysis and serum electrolytes in biochemistry panel. Then we grouped electrolyte levels of patients to subgroups to compare separately. Pearson correlation coefficients were calculated for determination linear relationships between the variables.
RESULTS: Study group consisted of 156 patients. The mean level of sodium in serum samples was 138,7 mmol/l compared to 143,2 mmol/l in venous blood gas. Mean variation between two samples was -4,46 mmol/l (95% CI -5,25, -3,67), ranged from -19 mmol/l to 4 mmol/l. The mean level of potassium in serum samples was 4,34 mmol/l compared to 3,74 mmol/l in venous blood gas. Mean variation between two samples was 0,6 mmol/l (95% CI 0,50, 0,69) ranged from -0,50 mmol/l to 2,6 mmol/l. The correlation coefficient was found r=0,852 for Na, r=0,774 for K and p was <0.001 for both values.
DISCUSSION AND CONCLUSION: We found positive correlation in sodium and potassium levels in various strength in different clinical situations. As our opinion, blood gas analyses should help and guide physicians especially in emergent conditions.

4.Examination of the Knowledge, Attitude and Behaviours of Pregnant Women on Screening Tests made during Pregnancy
Dilek Kusaslan Avci, Ercan Oner
doi: 10.5505/ejm.2018.63935  Pages 84 - 89
INTRODUCTION: The importance of screening tests gradually increases in prenatal evaluation today and they find a larger usage area.The purpose of our study was to examine the knowledge, attitudes and behaviors of pregnant women about pregnancy screening tests.

METHODS: This study included a total of 313 pregnant women followed up and treated in obstetrics polyclinic and service. The questionnaire form consisting of 57 questions was completed through face to face interviewing method in our study. Information on the sociodemographical characteristics, additional diseases, pregnancy characteristics, Rh incompatibility, gestational diabetes mellitus, double screening test, triple screening test and TORCH infections were recorded for the patients.
RESULTS: It was detected that 39.3% (n=123) didn't know about her own blood group and 65.8% didn't know (n=206) about her husband's blood group.It was detected that 79.9% (n=250) of the participants in our study heard about Rh incompatibility and 12.64% of these participants (n=30) didn't have any information on whether they had Rh incompatibility in their own pregnancies or not.In our study, it was detected that 52.8% of the pregnant women thought that OGTT should be done.
DISCUSSION AND CONCLUSION: In our study, it was observed that the knowledge levels of the pregnant women on screening tests and their ratio of taking screening tests were not satisfactory. It was detected that some of the pregnant women had wrong information on screening tests. A standard training should be programmed to inform pregnant women on the screening tests made during pregnancy and this training should be managed in Family Health Centers and hospitals.

5.Comparative Evaluation of MDA Levels During Aerobic Exercise in Young Trained and Sedentary Male Subjects
Sermin Algül, Seda Ugras, Mehmet Kara
doi: 10.5505/ejm.2018.40469  Pages 98 - 101
INTRODUCTION: The impacts of acute aerobic exercise on oxidative stress as determined altered MDA levels have been examined in young trained and sedentary male subjects.
METHODS: Total of 20 (10 trained and 10 sedentary) male subjects performed an aerobic cycling exercise at the anaerobic threshold for about 30 min. Pre and post exercise venous blood samples were taken and analysed for MDA using HPLC methods. Wilcoxon and Mann Whitney U test were used to analyse the significance of the data.
RESULTS: Acute exercise caused a systematic increases in MDA levels in trained (36.2%) and sedentary (55.4%) subjects during exercise (p<0.001). The increase in MDA levels were higher in sedentary subjects (0.79±0.08 µmol/L vs. 1.02±0.5 µmol/L) compared to trained subjects (0.73±0.05 µmol/L vs. 0.97±0.07 µmol/L) (p<0.001).
DISCUSSION AND CONCLUSION: Acute exercise may cause higher levels of increase in oxidative stress as determined MDA levels in sedentary subjects. Thus the sedentary subjects should pay more attention to the performed physical activities.

6.Actions of resveratrol and serotonin added to stored bloods on lipid peroxidation and oxidative DNA damage
Zübeyir Huyut, Mehmet Ramazan Şekeroğlu, Hamit Hakan Alp, Ragıp Balahoroğlu, Erdem Çokluk
doi: 10.5505/ejm.2018.94834  Pages 102 - 109
INTRODUCTION: Stored blood for use in diseases such as acute blood loss, injury and anemia can be maintained for about a month. It was reported that some negative changes called "storage lesions" occur in stored bloods time dependently. In order to delay these changes, preservatives are added to stored bloods. In this study, we aimed to determine the effects of resveratrol and serotonin on oxidative DNA and mitochondrial damage and lipid peroxidation in stored blood.
METHODS: Blood was taken from 10 volunteers to different blood bags and each blood separated into 3 groups (control, resveratrol and serotonin groups). Malondialdehyde (MDA), ubiquinone-10 (CoQ10) and 8-hydroxy-2-deoxyguanosine/106deoxyguanosine (8-OHdG/106dG) levels were determined at baseline and on the 7th, 14th, 21st and 28th day after addition of resveratrol and serotonin.
RESULTS: MDA, CoQ10 and 8-OHdG/106dG levels increased over time in the control and serotonin groups (p<0.05). However, resveratrol protected against the time-dependent increase in MDA and CoQ10 values (p>0.05). MDA and CoQ10 levels were significantly lower in the resveratrol-treated group on the 21st and 28th days compared with the other groups (p<0.05).
DISCUSSION AND CONCLUSION: These results show that oxidation sensitivity increased time dependently in stored blood. However, the addition of resveratrol allowed for the extension of the blood’s shelf life by protecting against increased lipid peroxidation and oxidized CoQ10.

7.Uterıne Sarcoma Dılemma: Unexpected or Expected? Does It Matter?
Cetin Kılıççı
doi: 10.5505/ejm.2018.41713  Pages 110 - 114
INTRODUCTION: We aim to identify clinical characteristics, outcome and prognosis of uterine sarcoma cases and compare clinical outcome of preoperatively or postoperatively (unexpected) diagnosed patients.
METHODS: In this retrospective study, medical records of patients with uterine sarcoma at the Zeynep Kamil Women and Children Education and Research Hospital, Department of Obstetrics and Gynecology, from January 2009 to December 2016. The age at diagnosis, gravidity, parity, menopausal status, complaints, comorbidity, tumor grade, tumor histology, stage of disease, postoperative adjuvant therapy, recurrence rate, location of recurrence, follow-up interval, and survival rate. Additionally, patients were divided into two groups: patients with diagnosed preoperatively and diagnosed postoperatively (unexpected). Two groups were compared regarding clinical characteristics.
RESULTS: Sixty-three patients were found to have uterine sarcoma. Mean age of patients was 51.8±11.7. Twenty-nine (46%) patients had leiomyosarcoma, 11 (17.5%) patients had endometrial stromal sarcoma and 13 (20.6%) had malign mixt mullerian tumor. Of 63 patients, 49 had pre-operative uterine sarcoma diagnosis and 14 patients had unexpected uterine sarcoma. The incidence of unexpected sarcoma was detected as 0.3%. The recurrence rate was significantly higher in patients with unexpected uterine sarcoma compared with patients had pre-operative uterine sarcoma diagnosis (42.8% vs 14.2%, respectively, p=0.002). All patients with recurrent disease in unexpected sarcoma group had local recurrence (100%). Regarding survival rates, there was no statistically difference between two groups (65.3% vs 57.1%).
DISCUSSION AND CONCLUSION: Uterine sarcoma is a rare tumor entity. Unexpected sarcoma cases found to have high recurrence rate and had totally local metastases. This finding may result from “myomectomy procedure” itself.

8.Association Between Gestational Weight Gain and Maternal and Neonatal Outcomes
Cigdem Yayla Abide, Evrim Bostanci Ergen, Cetin Kilicci
doi: 10.5505/ejm.2018.49389  Pages 115 - 120
INTRODUCTION: The aim of this study is to assess the effect of gestational weight gain according to initial pregnancy body mass index (BMI) on maternal and neonatal outcomes.
METHODS: This is a retrospective cohort study of 937 pregnant women who were followed up and delivered at Zeynep Kamil Maternity and Childrens’ Diseases Education and Research Hospital.Subjects were divided into three groups according to their weight gain during pregnancy: insufficient (n: 249),adequate (n: 302) and excess (n: 386).We analyzed maternal characteristics such as maternal age, gravida, parity, body mass indeks (BMI: kg/m2 ) initial pregnancy weight, gestational weight gain, and we examine the effect of maternal weight gain on the pregnancy outcome as preclampsia,preterm premature rupture of membranes (PPROM),preterm delivery,gestational age at delivery,delivery type,indications for cesarean delivery,sex of the infant, 1. ve 5. minute Apgar score, admission to the neonatal intensive care unit (NICU).
RESULTS: The mean age of the subjects was 30.04±5.47 years.İnsufficient weight gain was associated with increased risk of PPROM (p<0.05), gestational cholestasis (p<0.05),having infant with low birth weight (LBW) (p<0.01),preterm delivery (<0.01),having infant with smaller than 48 cm lenght (p<0.01), 5. minute apgar score <7 (p<0.01) intrauterine growth retardation (SGA) (<0.01),and admission to the neonatal intensive care unit (NICU) (p=0.047).In women, excess weight gain was associated with increased rates of macrosomia (p<0.01) and ceserean delivery for the cephalopelvic disproportion compared to women with insufficient and adequate weight gain. (p<0.05).
DISCUSSION AND CONCLUSION: Getting under control of gaining excess weight during pregnancy play an important role in reducing the poor maternal and neonatal outcome.

9.Sinus Node Dysfunction in a Child After Developed by the Use of Topical Minoxidil
Serhat Koca, Feyza Ayşenur Pac, Denizhan Bagrul, Ibrahim Ece, Serkan Cay
doi: 10.5505/ejm.2018.47955  Pages 121 - 123
Minoxidil is a drug being widely used in alopecia topically and systemically. Various cardiovascular side-effects corresponding to this drug has been reported in the adults, and leastwise in the pediatric patients. A 9 year old girl, having been using topical minoxidil for 2 years due to alopecia; was directed to our clinic for cardiac assessment prior to commencing systemic minoxidil treatment. No meaningful finding was attained neither in the received history of the patient, and in her physical examination. In the holter examination of the patient with normal echocardiography and electrocardiography, 6 seconds long asystolia attack accompanied by syncope was observed. Upon being hospitalization, minoxidil treatment of the patient was quitted. During monitoring, syncope was not recurred in the patient, sinus node functions of whom were assessed transesophageally as normal. Taking the morbidity of permanent pacemaker implantation in the 9 years old pediatric patient, and the temporariness of the reason of sinus node dysfunction in the patient, the patient was not implanted with permanent pacemaker. The patient, who was monitored for ten days in the service she was hospitalized, and examinations of whom were completed meanwhile, is now monitored trouble-free as an outpatient in our clinic. Since such cardiac side-effects as tachycardia, pericardial effusion, myocardial infarction corresponding to minoxidil usage have been reported in the literature, and due to the presence of sinus arrest having developed in the introduced case likely in correspondence with minoxidil, cardiac attention has to be paid to the patients using minoxidil.

10.Elevated Blood Lithium Concentration following Concomitant Lithium and Propranolol Therapy: A Case Report
Emine Füsun Akyüz Çim, Hulya Cecen
doi: 10.5505/ejm.2018.43434  Pages 124 - 127
Lithium is used in the treatment for many psychiatric disorders, like bipolar disorder, schizoaffective disorder and depression. Lithium has a very narrow therapeutic range and there are many reasons that increase the blood levels of lithium. Combining lithium with other medications with the aim of reducing side effects or supporting the therapy may result in substantial elevations in lithium concentrations and may lead to signs of intoxication.
In this study, was presented with increased blood lithium concentration after the initiation of the concomitant therapy of lithium and propranolol, which is a beta-blocker drug, due to the complaint of tremor causing functional impairment.

11.Colloıd Cyst Presentıng Wıth Acute Hydrocephalus In An Adult Patıent: Case Report and Review Of Lıterature.
Abdurrahman Aycan, İsmail Gulsen, Mehmet Arslan, Fetullah Kuyumcu, Mehmet Edip Akyol, Harun Arslan
doi: 10.5505/ejm.2018.84803  Pages 128 - 131
Colloid cysts (CC) are rare cystic lesions with a wide clinical spectrum including the asymptomatic cysts that are coincidentally diagnosed and the cysts leading to sudden death. The symptoms in CC are usually caused by obstructive hydrocephalus. The most common symptom for CC is headache. CC rarely cause intracranial herniation and death. In this study, we aimed to present our experience in the diagnostic and treatment process of a 57-year-old male patient with CC who presented to the emergency service with sudden severe headache, vomiting, and confusion.

12.Anesthesia management in a patient with Situs Inversus Totalis: Case Report
Abdullah Kahraman
doi: 10.5505/ejm.2018.41636  Pages 132 - 134
Situs inversus totalis is an autosomal recessive congenital anomaly, seen at 1/7000-8000 ratio. It is quite a rare condition characterized by asymmetric placement of abdominal and thoracic organs. In our case, due to acute abdomen, an emergency operation was planned for a twenty-one years old patient diagnosed with situs inversus. Based on a detailed examination and patient history, it was established that there were no additional diseases. The patient was taken to the operation room and was routinely monitored. After anesthesia induction, surgical laparoscopic surgery was applied and during the exploration situs inversus totalis was observed in the patient. Appendectomy was applied to the patient. The patient whose vitals were stable during the operation was extubated postoperatively and sent to the service. Situs inversus totalis is an isolated case, and doesn't carry additional pathology with it, however we would like to remind that it may collocate with heart, spine, and airway borne structural and functional malformations.

13.Genetics of Premature Ovarian Failure
Harun Egemen Tolunay, Barış Boza, Bulut Varlı
doi: 10.5505/ejm.2018.14622  Pages 135 - 140
Premature ovarian failure was defined as the cut-off of menstrual period for at least 4-6 months before 40 years of age, and FSH values measured over a month were over 40 IU / L. Although etiology is not fully understood, it is thought that genetic, immunological and environmental factors can play a role. Nowadays, translational and deletion in the critical regions (Xq13-26) on the X chromosome are defined in the developmental light in the genetic area. New approaches have been developed in clinical follow-up and treatment in recent years. It has been reported that caution should be taken in the follow-up, especially in terms of osteoporosis. In this article, recent literature on premature ovarian failure attempted to reveal current genetic etiology of premature ovarian failure.

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