Betül Keyif

Aim: Menopause involves the cessation of ovarian activity, follicular production, menstruation, and reproductive capacity, and may significantly affect women’s cognitive and emotional health. Estrogen receptors are highly expressed in brain regions such as the hippocampus, which are essential for learning and memory. The sharp decline in estrogen around age 50 may contribute to gray matter volume loss in dementia-vulnerable regions, potentially reflecting early neurodegenerative processes. This study investigated changes in cellular oxygenation capacity during menopause, their relationship with cognitive symptoms, and possible links to neurodegeneration.Material and Methods: The study included 93 women: 53 postmenopausal and 40 premenopausal participants. Demographic data and cognitive assessments were collected using neurological tests, and blood samples were analyzed for HIF1A levels. Statistical analyses were performed using IBM SPSS Statistics 23.Results: Compared with the premenopausal group, postmenopausal women showed significantly lower cognitive performance, particularly in MoCA scores (p=0.002; Holm p=0.006), and lower HIF1A levels (p=0.002; Holm p=0.006). QALY scores were lower before correction but became borderline after Holm adjustment, while EQ-VAS scores did not differ. Sensitivity analyses adjusted for age and EQ-VAS showed persistent MoCA differences, whereas HIF1A and QALY differences weakened.Conclusion: Further studies should explore associations between HIF1A, neural atrophy, and estrogen-related molecular pathways.

Abdominal wall endometriosis (AWE) is a rare form of extrapelvic endometriosis, often developing after cesarean section. While typically presenting as a pa

Aim: This study aimed to evaluate the clinical characteristics and outcomes pregnant women in the third trimester presenting to the emergency department with vaginal bleeding. Material and Methods: This retrospective, observational study included pregnant women at ≥28 weeks of gestation who presented to the ED with vaginal bleeding between January 2013 and December 2023. Demographic characteristics, parity, gestational age, timing of admission, bleeding severity, initial vital signs, laboratory results, and clinical outcomes (delivery, admission, discharge, miscarriage risk) were analyzed. Results: A total of 1263 pregnant women were included. The most frequent complaints were spotting (49.9%) and active vaginal bleeding (46.8%), accounting for over 96% of all visits. Of all patients, 33.7% were hospitalized, 12.9% delivered, and 15.1% were categorized as miscarriage risk. Heavier bleeding was significantly associated with both delivery and miscarriage risk (p

Objective: This study aimed to evaluate the usefulness of intrapartum transperineal ultrasonographic (ITU) parameters in predicting delivery mode. Methods: This prospective study included 104 pregnant women in active labor with ruptured membranes at Düzce University Health Application and Research Center from April 2023 to April 2024. ITU measured the angle of progression (AoP), head-perineum distance (HPD), and midline angle (MLA). These parameters were compared with digital vaginal examinations and delivery outcomes. Results: Of the participants, 93 (89.4%) had spontaneous vaginal deliveries (SVD), 6 (5.7%) had operative vaginal deliveries (OVD), and 5 (4.8%) had cesarean sections (C/S). AoP1 and AoP2 were significantly higher in the SVD group compared to OVD and C/S groups (p

Background: Pelvic organ prolapse (POP) significantly impacts the quality of life, particularly in older women with a history of vaginal deliveries. Although conservative treatments provide some symptom relief, surgical interventions are more effective for managing POP. This study compares the outcomes and effectiveness of sacrospinous ligament fixation (SSLF) and laparoscopic lateral suspension (LLS) surgeries in the treatment of POP. Methods: This retrospective comparative cohort study included patients with symptomatic stage 2 or higher apical POP, treated at a tertiary hospital in Turkey between April 2021 and June 2022. Patients were treated with either SSLF or LLS surgeries and underwent preoperative and postoperative evaluations using the Prolapse Quality of Life (P-QoL) questionnaire and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Patients were divided into two groups: SSLF (n = 47) and LLS (n = 44). The primary outcome was the rate of anatomical failure, while secondary outcomes included improvements in functional capability and quality of life. Results: The study found that the rate of postoperative anterior compartment failure was significantly lower in the LLS group compared to the SSLF group (p = 0.005). The success rate of LLS for apical prolapse was 100%, compared to 93.6% for SSLF. In the posterior compartment, SSLF demonstrated a higher success rate (86.2%) than LLS (68.5%). Both procedures improved P-QoL scores and the PISQ-12 subscales; however, a significant improvement in total PISQ-12 scores was observed only in the LLS group (p = 0.009). Conclusions: Both SSLF and LLS are effective in treating POP and enhancing quality of life. However, LLS demonstrated higher success rates for anterior and apical prolapse, while SSLF was more effective in addressing in posterior compartment defects.

Background: To determine the quality of YouTube videos about premature ovarian failure (POF), and variations in quality of professional YouTube videos about POF. Methods: The selected terms including ‘POF’, ‘premature ovarian insufficiency’, ‘POF, infertility’, ‘POF, symptoms’, ‘POF, diagnosis’, and ‘POF treatment’ were searched on YouTube. Totally, 100 videos each uploaded by professional and non-professional sources were included. Characteristics of videos were noted and quality of YouTube videos were analyzed according to Global Quality Score (GQS) and modified DISCERN scale. The two groups were compared in terms of video characteristics, GQS, and modified DISCERN score. Videos uploaded by professional sources were categorized into two different groups from the first 5 years and the last 5 years, and compared. Results: The mean number of views was 2961 for professional videos and 2003 for non-professional videos (p= 0.006), and the mean duration of videos was 10 minutes for professional videos and 6 minutes for non-professional videos (p= 0.001). When professional videos in the last 10 years were evaluated, number of views and ‘likes’ were significantly higher in favor of professional videos between 2014-2018 (p= 0.033 vs. p= 0.037). Video duration was significantly shortened for videos between 2019-2023 (p= 0.002). Patients as the target audience dominated videos prepared in the last 5 years (p= 0.001). Professional videos had significantly higher GQS and modified DISCERN score (p= 0.001 for each parameter). Moreover, GQS and modified DISCERN scores of professional videos increased significantly in the last 5 years (p= 0.001 vs. p= 0.023). Conclusions: Professional YouTube videos about POF had significantly higher quality and ‘like’ numbers, and the quality of professional YouTube videos about POF significantly increased in the last five years. The proportion of professional videos about POF being prepared for patients increased significantly in the last 5 years, but video length of professional videos significantly decreased.

Aim: This study aimed to investigate whether there is a difference between the results of intracytoplasmic sperm injection (ICSI) pregnancies and subsequent spontaneous pregnancies with a diagnosis of unexplained infertility. Material and Methods: In this retrospective study, a total of 48 women who first conceived with ICSI and then achieved spontaneous pregnancy were included. Duration and causes of infertility, time to spontaneous conception, pregnancy outcomes, and maternal and neonatal complications were evaluated. Results: Maternal age was older in the spontaneous pregnancy group compared to the ICSI group (p=0.029). The gestational age at delivery was found similar in both groups. Although birth weight was higher in the spontaneous pregnancy group, the difference between the groups was not statistically significant (p=0.382). The time to achieve pregnancy was shorter in the spontaneous pregnancy group (p=0.001). Gestational diabetes was significantly higher in the spontaneous pregnancy group (p=0.001), while amniotic fluid abnormality, gestational hypertension (p=0.001), and preterm delivery (p=0.001) were significantly higher in the ICSI group. While the number of babies with the 1st-minute low Apgar score was higher in the ICSI group (%4.16 vs 2.08%, p=0.001), the 5th-minute Apgar score was similar. Conclusion: Even if couples are evaluated as infertile, it should be taken into consideration that they can achieve spontaneous pregnancy. It may be rational to wait for spontaneous pregnancy in eligible couples with unexplained infertility and not to refer the patient for early assisted reproductive techniques.

Introduction: The complete blood count parameters and its combinations, such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and mean platelet volume (MPV), are inflammatory markers. In this study, we aimed to demonstrate the possible role of complete blood count parameters (NLR, PLR, and MPV) in predicting preterm birth. Material and Methods: The complete blood count parameters in the first and third trimesters were recorded, as well as the corresponding NLR, PLR, and MPV. The study population was categorized as preterm (n = 94) and term births (n = 953). The preterm birth group was further divided into early preterm (n = 11) and late preterm birth (n = 83) groups. The inflammatory markers were compared between the study groups for the first and third trimesters separately. The alterations between the first and third trimester values were also compared. Results: The first trimester values were similar across the study groups. Moreover, the MPV difference between the first and third trimesters was significantly lower in the preterm group than in the term group (0.0  1.1 vs. 0.2  1.1, p = 0.038). Furthermore, NLR values were higher in the early preterm subgroup than in the late preterm and term groups for the first and third trimesters (first trimester; 4.0  1.2 vs. 3.1  2.0 and 3.1  1.3, p = 0.005; third trimester; 5.3  1.2 vs. 4.0  1.5 and 4.4  2.9, p = 0.013). Conclusion: NLR and MPV predict preterm births in the first trimester and before birth. This enables physicians to take some precautions in preventing preterm delivery.