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Biomedical subjects

Hasan Kafali

Publications and source records attributed to Hasan Kafali.

At least 19 recordsLinked to original sources
PubMed2006

Evaluation of factors that may be responsible for cyclic change of CA125 levels during menstrual cycle.

OBJECTIVE: To evaluate the factors responsible for fluctuation of CA125 levels during menstrual cycle METHODS: The study was performed with patients who had undergone hysterectomy for benign gynecological disease (group I, n = 30) and patients who had undergone laparoscopy for tubal ligation (group II, n = 30) or for investigation of pelvic cause of infertility (group III, n = 24) and showed normal laparoscopic findings. In groups II and III, blood samplings for serum CA125 determination were performed in menstrual and no-menstrual period. In group I, sampling times were determined by using estrogen and progesterone levels. Mean serum CA125 concentrations were compared using one-way analysis of variance (ANOVA) for multiple group comparisons and paired t test for within-group comparisons. RESULTS: Intra-individual serum CA125 concentrations of group I was not significantly different (P > 0.05). In group II, mean menstrual CA125 concentration was on average 18.2% higher than that of non-menstrual concentration (P < 0.001). Group III showed a similar pattern to that of group II, with a difference of 22% (P < 0.001). Mean CA125 concentration of group I in both menstrual and non-menstrual period was lower than those of groups II and III (P < 0.001). However, there was no significant difference between groups II and III when compared with the corresponding menstrual and non-menstrual CA125 concentrations (P > 0.05). CONCLUSION: Endometrium is responsible for the cyclic changes in serum CA125 concentration during menstrual cycle.

Adult↗
PubMed2006

Vaginal fluid urea and creatinine in diagnosis of premature rupture of membranes.

OBJECTIVE: To evaluate the reliability of vaginal fluid urea and creatinine for the diagnosis of premature rupture of membranes (PROMs). MATERIALS AND METHODS: A total of 139 pregnant women were recruited. Group I consisted of 47 patients with diagnosis of PROM confirmed by amniotic fluid pooling and nitrazine paper test. Group II consisted of 36 patients in whom diagnosis of PROM was suspected but unconfirmed by amniotic fluid pooling (+/-) and/or nitrazine paper test (+/-). Group III consisted of 56 pregnant women without any complaint or complication. All patients underwent speculum examination for amniotic fluid pooling, nitrazine paper test, vaginal washing fluid urea and creatinine sampling. One-way ANOVA test, Scheffe multiple comparison test and receiver operating characteristic curve analysis were used. RESULTS: The mean vaginal fluid urea levels in group I, II, and III were 34.6 +/- 5.3, 2.4 +/- 5.3 and 1.3 +/- 6.2 mg/dl, respectively, where the difference was statistically significant (P < 0.001). The mean vaginal fluid creatinine concentrations of group I were, 1.5 +/- 0.3 mg/dl, found higher against the group II, 0.34 +/- 0.22 mg/dl, and group III, 0.28 +/- 0.23 mg/dl (P < 0.01). The sensitivity, specificity, positive predictivity, and negative predictivity were all 100% in detecting PROM by evaluation of vaginal fluid urea and creatinine concentration with a cut-off value of 12 and 0.6 mg/dl, respectively. CONCLUSION: Vaginal washing fluid urea and creatinine determination for the diagnosis of PROM is a reliable, simple and rapid test.

Adult↗
PubMed2006

Opioid analgesia for hysterosalpingography: controlled double-blind prospective trial with remifentanil and placebo.

BACKGROUND/AIMS: A hysterosalpingogram is an integral part of the evaluation of infertility, however, it is often painful. METHODS: We conducted a randomized double-blinded, placebo-controlled trial of intravenous infusion of remifentanil in women undergoing hysterosalpingography (HSG). We randomly allocated 62 patients scheduled for HSG to receive either a continuous infusion of 0.25 microg.kg(-1) of remifentanil or placebo. The degree of pain was documented via 10-cm visual analog scales (VAS). Patients' discomfort, side effects and recovery times were also recorded. RESULTS: The VAS scores during HSG were 1.25 +/- 1.31 in the remifentanil group and 4.78 +/- 1.7 in the placebo group (p < 0.001). There were more patients in the remifentanil group that rated their condition as excellent (p < 0.001). The groups did not differ with regard to the incidence of side effects. The recovery times were found statistically longer in the remifentanil group (14 +/- 5 vs. 10 +/- 3 min). All the patients were discharged 30 min after the procedures without any side effects. CONCLUSION: Remifentanil infusion during HSG is superior to placebo for relief of pain with minimal opioid side effects.

Adult↗
PubMed2006

Progress in female sexual dysfunction.

INTRODUCTION: Female sexual dysfunction (FSD) is a significant age-related, progressive and highly prevalent problem that affects a substantial number of women that causes personal distress and has negative effects on quality of life and interpersonal relationships. DEFINITIONS: The female sexual response cycle consists of three phases: desire, arousal, and orgasm, and is initiated by non-adrenergic/non-cholinergic, e.g. vasoactive intestinal polypeptide and nitric oxide, neurotransmitters that maintain vascular and non-vascular smooth muscle relaxation resulting in increased pelvic blood flow, vaginal lubrication, and clitoral and labial engorgement. Furthermore, hormonal status may influence female sexual function. For the diagnosis of FSD, a detailed history should be taken initially, followed by a physical examination and laboratory studies. CONCLUSION: Due to the fact that there has been little research and attention on FSD, our knowledge in this field is quite limited and there is still no approved therapy. Future advances in evaluation and treatment of female sexual problems are forthcoming.

Female↗
PubMed2005

Colored illustrations of pediatric otorhinolaryngologic surgical techniques of a Turkish surgeon, Serefeddin Sabuncuoglu, in the 15th century.

OBJECTIVES: Serefeddin Sabuncuoglu is known to be the author of the first illustrated surgery book, Cerrahiyyetu'l Haniyye (Imperial Surgery), which was written in Turkish in 1465 a.d. at the age of 80. The purpose of this paper is to describe his contributions to pediatric otorhinolaryngology. RESULTS: Cerrahiyyetu'l Haniyye consists of three chapters totaling 412 pages, in which there are 191 sections dealing with a wide range of surgical specialties, including pediatric otorhinolaryngologic surgery. Sabuncuoglu explains some of child diseases and their treatment in a whole section, and gives information on the same subject in relevant part of sections. The illustrations he provides are not at a state of the art level with those of his contemporaries, but they bear a great importance considering the attitudes of Islam to the art of painting. For each section, a single, poetic sentence describes in detail the diagnosis, classification and surgical technique. Some authors have claimed that he only translated Ebu Kasim-al Zahravi (Albucasis)'s Al-Tasrif (Textbook of Surgery) and added the illustrations of the surgical techniques. Even if this is accepted, the illustrations are enough to entitle this work as a milestone. Serefeddin Sabuncuoglu describes medical and surgical management pediatric otorhinolaryngologic diseases such as harelip, hypertrophy of adenoids, atresia of external auditory canal, a foreign body in external auditory canal, short frenulum, abscess of head, mass and abscess of neck in children and unpleasant odor in nose in his textbook. CONCLUSIONS: Although not recognized and rewarded in his time, Serefeddin Sabuncuoglu was a great surgeon in Turkish medical history. The sections on children in his book are of great importance in pediatric otorhinolaryngology which became a different speciality in the last century. Writing his book at his 80's, he deserves to be considered as a distinguished scientist, medical doctor and illustrator of his era, considering the insulting and discriminating ideas toward women and children, especially girls, at that period.

Books, Illustrated↗
PubMed2004

Use of CA125 fluctuation during the menstrual cycle as a tool in the clinical diagnosis of endometriosis; a preliminary report.

OBJECTIVE: To elucidate whether endometriosis can be diagnosed clinically by assessing the differences between serum CA125 levels during menstruation and during the rest of the menstrual cycle. METHODS: The study was performed in 28 patients who underwent laparoscopy to check for pelvic causes of infertility. Patients with endometriosis were selected as the study group, and patients with normal laparoscopic findings functioned as the control group. Blood specimens were taken for CA125 determination during menstruation and during the rest of the menstrual cycle. Mean serum CA125 concentrations were compared by the two-sample t-test for between-group comparisons and the paired t-test for within-group comparisons. The receiver operating characteristic curve was applied to assess the usefulness of CA125 level changes during the menstrual cycle in the clinical diagnosis of endometriosis. RESULTS: The mean CA125 concentrations of healthy women during menstruation and during the rest of the menstrual cycle were 12.2 and 10 U ml(-1), respectively. In this group, the mean CA125 concentration was an average of 22% higher during menstruation than during the rest of the menstrual cycle (P < 0.001). The patients with endometriosis showed a similar pattern to that of normal women, but the levels differed by 198.3% in these patients (P < 0.001). Mean CA125 concentrations of these patients during menstruation and in the rest of the cycle were 35.8 and 12 U ml(-1), respectively. The mean CA125 concentration during menstruation was significantly higher in patients with endometriosis than in normal women (P < 0.001), but CA125 concentrations at other points in the menstrual cycle were found to be similar in both groups (P > 0.05). ROC curve analyses set a cutoff of 83% (percentage increment of CA125 level during menstruation compared with that on days without menstrual bleeding), which gives a sensitivity of 93% and specificity of 92%, with a corresponding likelihood ratio of 11.3. CONCLUSIONS: It may be possible to diagnose endometriosis clinically by assessment of the differences in CA125 level during menstruation as against the remainder of the menstrual cycle.

Adolescent↗
PubMed2004

Aspiration and alcohol sclerotherapy: a novel method for management of Bartholin's cyst or abscess.

OBJECTIVE: To investigate the efficiency and safety of alcohol sclerotherapy of Bartholin's cyst or abscess by comparing it with silver nitrate insertion. STUDY DESIGN: Twenty-two patients with unilateral Bartholin's cyst or abscess were randomized into one of the treatment groups according to diameter of cyst or abscess. Group I consisted of 12 patients who were treated with alcohol sclerotherapy and Group II included 10 patients who were treated with silver nitrate insertion. In both groups, treatments were conducted under local anesthesia and in an outpatient setting. The patients were checked for morbidity of operations every 3 days until complete healing was observed and then followed up monthly for over 24 months. RESULTS: The mean duration of procedure was 7+/-2 min in group I and 15+/-3 min in group II. Healing time was 4.8+/-1.3 days in group I and 9.2+/-2.5 days in group II. In group I although 10 patients showed complete healing without any early or late morbidity; two patients suffered from severe vulval pain, edema and echymosis, and then developed a total cyst necrosis. Healing in these patients completed with mild scar formation. Only one recurrence was documented during 24 months follow-up period. All patients in group II complained labial pain, four of them suffered from severe labial pain, edema, and echymosis. Healing in these patients was completed with moderate scar formation. Follow-up of 24 months revealed no recurrence in this group. CONCLUSION: Alcohol sclerotherapy of Bartholin's cyst or abscess is as effective as silver nitrate application and is associated with less complication. It may be ideal, safe and attractive treatment modality for this gynecological disease.

Abscess↗
PubMed2004

A new tension-adjustment technique for sling operation: an animal model.

OBJECTIVE: To investigate the effectiveness of a new tension-adjustment technique for postoperative voiding difficulties encountered after sling operations. METHOD: To test our new method, urethral obstruction was developed in 5 female dogs by modifying the sling operation by exerting more tension on a specially prepared polypropylene strip in which a gap had been developed. After filling the bladder with isotonic solution, detrusor contractions were induced by pelvic nerve stimulations, and urodynamic studies were performed to document the urethral obstruction. In each case Foley catheters were inserted into the bladder and left in place until the time of tension adjustment. Tension adjustment was performed in the 1st, 2nd, 3rd, 4th and 5th weeks postoperatively for dogs 1, 2, 3, 4, and 5, respectively. RESULTS: On the day of tension adjustment, after filling the bladder with isotonic solution and removing the Foley catheter, none of the dogs, except dog 3, was able to produce a free flow of urine either spontaneously or provoked by detrusor contractions. The release of the prolene sutures was readily achieved in all cases except dog 5. In this case, sling takedown was achieved after surgical exploration in which the sling location was confirmed by following the prolene sutures and Hegar's dilator. After identifying the sling, the gap was opened by cutting the prolene sutures, instead of a sling incision. Release of the prolene sutures resulted in a distinct drop in the urethra with decreased resistance of Hegar's dilator. The improvement in voiding was confirmed by postoperative urodynamic studies and was immediate in all cases. CONCLUSION: Our new technique for postoperative voiding difficulties encountered after sling operation is simple, effective and avoids re-operation in the early postoperative period.

Animals↗
PubMed2003

The effect of tension-free vaginal tape (TVT) procedure on sexual function in women with stress urinary incontinence.

The aim of this study was to evaluate the effects of tension-free vaginal tape (TVT) on sexual function in women with stress urinary incontinence (SUI) by questionnaire. Thirty-two sexually active and married women who were planned for TVT to treat SUI constituted the patient group, and 25 women who were healthy, sexually active and married, were selected as the control group; the ages of both groups matched. Sexual functions (desire, arousal, orgasm, pain and satisfaction) were evaluated with the Index of Female Sexual Function (IFSF), and continence status during sexual intercourse was asked about both preoperatively and postoperatively in the 6th month. The mean domain scores of sexual functions such as desire, arousal, orgasm, pain and overall satisfaction preoperatively and postoperatively were 3.37+/-0.69, 3.82+/-0.62, 3.40+/-0.95, 3.41+/-0.98, 3.16+/-1.09 and 3.32+/-0.79, 3.71+/-0.53, 3.06+/-1.04, 2.75+/-1.29, 2.88+/-0.63, respectively, and postoperative scores insignificantly decreased. Also, these scores in the control group were 3.64+/-0.66, 3.96+/-0.73, 4.12+/-0.78, 3.96+/-1.14 and 3.68+/-0.92. In comparison with the control group, whereas all of the preoperative domain scores were found to be decreased but were statistically insignificant except orgasmic function, postoperative scores significantly worsened, except for desire and arousal. However, preoperatively nine patients explained that they had incontinence during sexual intercourse, and this problem persisted in two postoperatively ( p = 0.043). This study shows that both SUI and the TVT procedure negatively affect sexual function in women.

Adult↗
PubMed2003

Hemostatic cervical suturing technique for management of uncontrollable postpartum haemorrhage originating from the cervical canal.

OBJECTIVE: To evaluate the efficacy and safety of a novel cervical suturing technique for management of uncontrollable postpartum haemorrhage originating from the cervical canal. STUDY DESIGN: Cervical suturing was performed on three women to control intractable postpartum haemorrhage originating from the cervical canal and not responding to classic management. Haemostatic cervical suturing by using no. 1 chromic catgut is a new surgical technique which approximates anterior and posterior cervical lips. It controls cervical haemorrhage by attachment and compression of the haemorrhage site of the cervical lips and lower uterine segment. RESULTS: The procedure was effective in all cases and hysterectomy was not needed in any case. No complication occurred and the survival rate was 100%. The procedure required no special expertise or extraordinary equipment. CONCLUSION: Cervical suturing technique for management of postpartum haemorrhage originating from the cervical canal is an easy, safe and highly effective conservative surgical technique that may be alternative to hysterectomy.

Adult↗
PubMed2003

Idiopathic retroperitoneal fibrosis mimicking a pelvic tumor: a case of pericystitis plastica.

Retroperitoneal fibrosis was first described in 1905 by Albarran, a French urologist, who performed ureterolysis for ureteral compression produced by the disease. However, this disease became an established clinical entity by Ormond's account in the English literature in 1948. Pericystitis plastica has been used the define an extremely rare type of Idiopathic retroperitoneal fibrosis (IRF) constricting the bladder. In this study, we discussed the recovery of 29-year-old woman with pericystitis plastica who was misdiagnosed as pelvic malignancy or a chronic/subacut pelvic inflammation at the first evaluation.

Adult↗
PubMed2003

Expeditious method of urethrovesical junction determination in retropubic colposuspension with intraballoon illumination of Foley catheter.

OBJECTIVE: To investigate the efficiency and safety of Foley catheter intraballoon illumination in determining the urethrovesical junction (UVJ) in retropubic colposuspension. METHOD: Our accessory set for UVJ determination is composed of a 24-french Foley catheter and a 5-mm 0 degrees telescope. The telescope is inserted into the catheter from the urinary luminal side until the tip has reached the level of the catheter balloon. After dissection of the bladder, urethra, and paraurethral tissues to reveal the submucosal endopelvic fascia, the accessory set is inserted into the bladder and the balloon is inflated with 5 ml air and illuminated by a switch on the cold light source. To determine the right side of UVJ, the catheter is pulled slightly downward and to the right of the patient. The contralateral side of the UVJ is determined by pulling the catheter slightly downward and to the left of the patient. RESULT: Intraballoon illumination of the Foley catheter helps to ensure accurate placement of paraurethral sutures at UVJ. CONCLUSION: Intraballoon illumination for determination of UVJ is simple, safe, effective and precludes an invasive approach such as cystoscopy and cystotomy.

Catheterization↗