Browsing by Author "Balsak, Deniz"

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Evaluation of Visceral Adipokines: Omentin, Vaspin, and Visfatin in Patients With Gestational Diabetes Mellitus
(Imr Press, 2024) Yilmaz, Mehmet; Aksin, Serif; Bozbay, Nizamettin; Balsak, Deniz; Aboalhasan, Yasmin; Kurnuc, Fatma Zehra; Batmaz, Ibrahim
Background: Gestational diabetes mellitus (GDM) is a common metabolic disorder characterized by glucose intolerance that develops during pregnancy. The underlying pathophysiological mechanisms of GDM involve complex interactions between genetic, environmental, and hormonal factors, including adipokines secreted by visceral adipose tissue. Omentin, vaspin, and visfatin are adipokines believed to influence insulin sensitivity and inflammation, though their precise relationship with GDM remains unclear. This study aimed to examine the association between these adipokines and GDM. Methods: This single-center, prospective controlled cohort study included 87 pregnant patients diagnosed with GDM via an oral glucose tolerance test (OGTT) between the 24th and 28th weeks of gestation, along with 87 control subjects without GDM. Serum levels of omentin, vaspin, and visfatin were measured using enzyme-linked immunosorbent assay (ELISA), and their association with GDM was analyzed. Results: Our results demonstrated that omentin levels were significantly higher in the GDM group compared to the control group (p = 0.012), while no significant differences were observed in vaspin and visfatin levels (p > 0.05). An omentin cut-off value of 29.0 ng/mL predicted GDM with 59.1% sensitivity and 59.1% specificity, suggesting its potential as a biomarker for GDM. Conclusions: This study underscores the unique role of omentin in GDM, in contrast to the non-significant changes observed in vaspin and visfatin levels. The elevated omentin levels in GDM patients suggest its potential as a biomarker for diagnosing and managing GDM. Further research is needed to elucidate the mechanisms through which omentin contributes to the pathophysiology of GDM.
Thyroid Function Tests and Thyroid Antibody Tests in Ectopic Pregnancies: a Prospective Cohort Study
(Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Yoldas, Adem; Batmaz, İbrahim; Balsak, Deniz; Aksin, Şerif; Yılmaz, Mehmet; Aboalhasan, Yasmin
Thyroid hormone levels have been observed to induce structural changes in different regions of the fallopian tube. This study aimed to investigate the impact of thyroid hormones on ectopic pregnancy. In pursuit of this objective, 31 patients with ectopic pregnancy were monitored at Siirt University Training and Research Hospital between July 2022 and December 2022. Additionally, a total of 31 patients with normal first -trimester pregnancies, matched for age, parity, and gestational week, were included i n the control group. Various parameters, including patient age, pregnancy history, medical history, treatment methods, clinical and demographic data, TSH, fT3, fT4, TT3, TT4, Thyroglobulin, Anti-thyroglobulin Antibody, TSH receptor antibody (TrAB), Anti -Peroxidase Antibody, Anti-Tyroglobulin Antibody, hemogram, biochemistry, CRP, and sedimentation values, were compared.Clinical Trials no: NCT05446012 Statistically significant differences were noted in Free T3 (p = 0.011) and thyroglobulin (p = 0.018) values between the ectopic pregnancy and control groups. Subsequent ROC analysis was conducted for the significant parameters, determining the AUC (Lower and Upper Bound), sensitivity, specificity, and cut -off values for each parameter. Multivariate logistic regression analysis followed, wherein the \"backward stepwise model\" was applied to the Free T3 parameter. The apparent parameter indicating an increased risk in the disease was Free T3, with a 4.2 -fold increase and a 95% CI of [1.3-13.5]. Lower Free T3 levels were associated with an elevated risk of ectopic pregnancy. The assessment of Free T3 levels during pre-pregnancy counseling may aid in identifying pregnant women at risk of ectopic pregnancy.
A Very Rare Presentation Of Tubal-Ovarian Torsion in a Patient with Endometrioma: A Case Report
(2024) Kurnuc, Fatma; Balsak, Deniz
Endometriozis üreme çağındaki kadınlarda giderek daha fazla teşhis edilmekte ve kadınların %10’unu etkilediği tahmin edilmektedir. Nadir vakalarda endometrioma akut karın tablosuyla birlikte görülür. Ancak bu hastalarda endometrioma ile adneksal torsiyon çok nadirdir. 38 yaşında bir kadın hasta, 4 saattir başlayan aralıklı sol kasık ağrısıyla acilen kadın doğum polikliniğine başvurdu. Hastada aralıklı ağrı ve eşlik eden kusma vardı. Biyokimyasal inceleme normal aralıklarda değerlendirildi. Yaşamsal bulgularında anormallik yoktu. Ultrason görüntülemede endometrioma ve sol adneksal boşlukta heterojen görüntüler ortaya çıktı. Endometrioma torsiyonu düşünülerek acil cerrahiye karar verildi. Laparoskopi planlandı. Operasyon sırasında sol overde endometrioma ve tuba-ovarian torsiyon görüldü. Operasyon sırasında detorsiyone edildi. Endometrioma kist eksizyonu yapıldı. Hasta iyileşmek üzere hastaneden taburcu edildi. Endometrioma vakalarında torsiyon çok nadirdir. Endometriomalar genellikle komşu yapılara sıkıca yapışıktır ve bu nedenle, bu kistlerdeki torsiyon oranı hakkında yeterli veri olmamasına rağmen, adneksal torsiyona neden olma olasılıkları daha düşük görünmektedir. Bu olgu sunumuyla, endometriomadaki torsiyon hakkındaki literatüre katkıda bulunmayı düşündük. Endometrioma hastalarının akut karınla acil servise başvurduklarında çok nadir görülebilen tuba-ovaryan torsiyona sahip oldukları akılda tutulmalıdır.
Relationship Between First Trimester Placental Thickness and Perinatal Prognosis: a Prospective Cohort Study
(Bayrakol Medical Publisher, 2025) Yilmaz, Mehmet; Aksin, Serif; Balsak, Deniz; Aboalhasan, Yasmin; Kurnuc, Fatma Zehra; Batmaz, Ibrahim
Aim: This study aims to investigate the correlation between first-trimester placental thickness and perinatal prognosis. Material and Methods: A prospective cohort study was conducted at Siirt University Faculty of Medicine from March 2022 to March 2023 of 365 pregnant women in their first trimester (11-14 weeks of gestation). Placental volume was measured using two-dimensional (2D) ultrasound, and estimated placental volume (EPV) was calculated using Merwin's EPV Calculator app. The patients were followed until delivery, and outcomes such as gestational age at delivery, mode of delivery, fetal weight, APGAR score, fetal gender, perinatal outcomes, preeclampsia (PE), premature rupture of membranes (PROM), gestational hypertension (GHT), gestational diabetes mellitus (GDM), intrauterine growth restriction (IUGR), preterm birth, oligohydramnios, polyhydramnios, surmaturation, presentation anomaly, intrauterine death, fetal distress, and placental abruption were evaluated. Results: Data from 365 pregnant women were analyzed. The mean maternal age was 27.2 +/- 5.5 years. The distribution of placental location was 38.4% posterior, 43.0% anterior, 7.4% left sidewall and 11.2% right sidewall. No significant differences were found in placental volume measurements based on delivery mode, fetal gender, or conditions such as PE, GDM, IUGR, PROM, preterm birth, or other perinatal pathologies. Statistical analyses showed no significant association between first-trimester placental volume and adverse perinatal outcomes (p>0.05). Discussion: No relationship was found between first-trimester placental thickness and perinatal outcomes.
Ovarian Teratoma Torsion With Ca 19-9 Elevation: Case Report
(2025) Kurnuc, Fatma; Balsak, Deniz
Ovarian torsion is a rare gynecologic emergency and causes serious medical problems. The diagnosis of ovarian torsion is not always easy. Ovarian torsion is the most common complication with a confusing ultrasonographic diagnosis. Although the demonstration of blood flow by Doppler ultrasonography does not rule out the diagnosis of ovarian torsion, a serum marker with high reliability and sensitivity in the preoperative diagnosis of ovarian torsion has not yet been defined. A 19-year-old G0P0 patient was admitted to our clinic with pelvic pain lasting 1 week. Abdominopelvic ultrasound revealed a 9 cm diameter lobulated cystic lesion in the right adnexa. Abdominopelvic magnetic resonance imaging (MRI) showed a 90 × 88 mm cystic lesion consisting of heterogeneous solid structures. The left ovary and other intra-abdominal structures were normal. Tumor markers were as follows: CEA: 24.90 U/mL, AFP: 40 U/mL, CA 15-3: 23.4 U/mL, CA 19-9: 383 U/mL. The patient's MRI report was suspicious for malignancy, and the diagnosis of torsion could not be clarified. As the patient’s condition progressed, laparotomy was decided upon, and a frozen examination was requested. Cystectomy was performed after the findings were compatible with a dermoid cyst. CA 19-9 is a tumor marker that is increased, especially after ovarian teratoma torsion, and may be useful in diagnosing clinical teratoma torsion. However, larger studies are needed to confirm this hypothesis.
Comparison of Orexigenic and Anorexigenic Neuropeptide Levels in Hyperemesis Gravidarum Patients With Normal Pregnant Women: a Prospective Cohort Study
(Lippincott Williams & Wilkins, 2024) Yilmaz, Mehmet; Aksin, Serif; Balsak, Deniz; Aboalhasan, Yasmin; Batmaz, Ibrahim
Background: The aim of this study was to determine whether orexigenic neuropeptides, orexin and galanin, and anorexigenic neuropeptides, alpha-melanocyte-stimulating hormone (alpha-MSH) and cocaine- and amphetamine-regulated transcript (CART), are implicated in hyperemesis gravidarum (HG). Methods: Fifty pregnant women who had been diagnosed with HG between April 2022 and February 2023 at the Siirt University Faculty of Medicine Training and Research Hospital (tertiary center) were recruited for this study. An equal number of pregnant women without an HG diagnosis were included in the study as the control group. Participants' age, pregnancy history, medical history, thyroid function test results, complete blood count results, and electrolyte levels were recorded, and their orexin, galanin, alpha-MSH, and CART serum levels were analyzed using an enzyme-linked immunosorbent assay. Results: No statistically significant differences in orexigenic neuropeptides (orexin and galanin) were observed between the HG and control groups. A statistical difference was found between an anorexigenic neuropeptide (alpha-MSH) and the control group (P = .012). Based on a receiver operating characteristic analysis, the alpha-MSH parameter was statistically significant for distinguishing between participants with an HG diagnosis and those without, with a sensitivity of 63.6%, specificity of 65.9%, and cutoff value of 11769.3 pg/mL (P = .012, area under curve: 0.655). Based on the severity classification of ketonuria (ketonuria levels of +1 or +2 were classified as mild, whereas levels of +3 or +4 were classified as moderate to severe), the anorexigenic CART neuropeptide was found to be a statistically significant diagnostic indicator of severe ketonuria (P = .020). Conclusion: alpha-MSH and CART levels were found to be related in HG patients and in HG patients with severe ketonuria.