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    Analgesic effects of LI4 acupuncture during intrauterine device insertion: a randomized controlled clinical trial
    (Springer Heidelberg, 2023) Erdogan, Pinar; Yardimci, Harun
    PurposeIntrauterine device (IUD) is one the most effective contraceptive methods with reversible long-term effects. However, the major drawback of IUD use is pain perception during the insertion of the device. The aim of this study is to investigate the effects of bilateral LI4 acupuncture, administered before IUD insertion, on pain perception.MethodsThis is a prospective randomized controlled study. It was held in Community Health Center in Nigde, Turkiye. Individuals enrolled in the study were randomized into the acupuncture group and non-intervention group. Acupuncture group received bilateral LI4 acupuncture prior to IUD insertion while others received no interventions. After IUD insertion, 10 cm visual analog scale (VAS) score was evaluated at 3rd minute and at 10th minute. Health care provider performing the IUD insertion and VAS evaluation was blind to randomization.ResultsIn total 72 participants were included in the study. The VAS scores were significantly lower in the acupuncture group both at 3rd minute and at 10th minute (1.93 & PLUSMN; 1.68; 3.81 & PLUSMN; 1.95; p < 0.001 and 0.53 & PLUSMN; 0.84; 1.64 & PLUSMN; 1.10; p < 0.001 respectively). Linear regression analysis showed that acupuncture was a significant predictor for lowering VAS both at 3rd minutes and 10th minutes following IUD insertion (p < 0.001).ConclusionThis is the first randomized controlled clinical study investigating the effects of acupuncture on pain control during IUD insertion. The results demonstrated that bilateral LI4 acupuncture provides significant pain relief at both cervical and fundal components. Acupuncture prior to IUD insertion is a significant predictor of lowering overall VAS scores of individuals.
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    Case controlled study for determination of risk factors in abdominal wall endometriosis following a cesarean section
    (Sage Publications Ltd, 2022) Erdogan, Pinar; Erdogan, Aliriza; Bolat, Haci; Ozbey, Caner
    Introduction: Abdominal wall endometriosis (AWE) is the presence of ectopic endometrial tissue in abdominal wall and is most frequently encountered in women with previous cesarean section (CS). The aim of this study is to evaluate the possible risk factors of AWE development. Methods: Women with previous CS and pathologically confirmed AWE were included into the study (n=33). Controls (n= 127) were randomly selected among women who had previous CS and absence of AWE were confirmed by physical examination. Clinical characteristics of the patient and the CS operation preceding AWE were recorded. Results: CS was performed before onset of labor in 87.9% in AWE and in 59.1 % of control group (p= 0.002). The antenatal BMI and weight gain during pregnancy were significantly higher in AWE patients (p < 0.0001; p = 0.002, respectively). In logistic regression model procedure duration (p= 0.039; OR= 1083), antenatal BMI (p =0.003; OR= 1254), weight gain (p=0.002; OR= 1171), and CS before spontaneous labor (p= 0.021; OR = 5169) were significant parameters for predicting AWE. Discussion: High antenatal BMI, weight gain during pregnancy, and longer duration of operation are all factors effecting subsequent AWE development. However, CS before spontaneous labor is by far the most powerful risk factor for AWE development.
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    Case controlled study on diagnostic predictive value of inflammatory markers of complete blood count in pregnant women with acute appendicitis
    (Taylor & Francis Inc, 2022) Erdogan, Pinar; Erdogan, Aliriza
    The aim of this study is to evaluate and compare the diagnostic ability of platelet-related parameters and white cell-based parameters in pregnant women with appendicitis. This is a retrospective case-controlled study. Women aged between 18 and 50-years-old who had undergone appendectomy between January 2010 and January 2021 were enrolled in the study. Age, pathological diagnosis and relevant laboratory parameters were recorded for each patient. Gestational characteristics were recorded for pregnant patients. There were 58 pregnant and 1171 non-pregnant women enrolled. Pregnant women with acute appendicitis were significantly younger (p < .0001, d= -0.532), had significantly lower PLT (p = .002, d= -0.428) and ALC (p = .033, d= -.304) levels but had significantly higher MPV (p = .004, d = .415) levels than non-pregnant counterparts. In pregnant women, only MPV was the independent predictor of acute appendicitis (OR: 1,952). MPV cut-off value of 9,6 fL provided 63,5% sensitivity, 67,7% specificity, 94,2% PPV and 17,3% NPV whereas 10 fL provided 55,8% sensitivity, 100% specificity, 100% PPV and 21,4% NPV for acute appendicitis in pregnant women. Therefore, MPV might be useful for diagnosing acute appendicitis in pregnant women.Impact statement What is already known on this subject? In pregnant women, counts and percentages of white blood cells and neutrophils are known to be independent predictors of acute appendicitis. Meanwhile, physiologic leukocytosis of gestation is a challenge for interpretation of these parameters. Platelets and related markers are, as well, predictive for inflammatory processes in the human body. What do the results of this study add? The role of platelet-related markers in the diagnosis of acute appendicitis in pregnant women has not been studied previously. The results of the present study indicate that in pregnant women, changes in mean platelet volume might be an independent predictor of acute appendicitis. What are the implications of these findings for clinical practice and/or further research? Further similar large-scale case-controlled or cohort studies are required to validate the present results. In pregnant women with abdominal pain, the use of mean platelet volume as a biomarker could reduce negative laparotomy rates. A mean platelet volume is a useful tool for diagnosing acute appendicitis in pregnant women and provides helpful guidance for clinicians dealing with these patients in the emergency room.
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    Prevalence of Cesarean Section Scar Endometriosis: Ten-Year Experience of a Tertiary Center and Retrospective Evaluation of 40 Cases
    (Erciyes Univ Sch Medicine, 2021) Erdogan, Alinza; Erdogan, Pinar
    Objective: Cesarean scar endometriosis (CSE) is the presence of ectopic endometrial tissue at the site of the previous cesarean section (CS) scar. The prevalence varies between 0.04 and 0.53. We aimed to evaluate the women with CSE in the past 10 years in Nigde. Materials and Methods: The medical records of Omer Halisdemir University Training and Research Hospital and the single private hospital were retrospectively analyzed through electronic databases between January 2010 and January 2020. Pathological reports with the diagnosis of abdominal wall endometriosis were distinguished. The ones excised from a CS scar were included into the study. For each patient clinical, obstetric and surgical characteristics were recorded. Results: Forty women were included into the study with an average age of 31.6 +/- 5.9 years. The diameter of the CSE lesion was positively correlated in medium strength with body mass index (BMI) at the time of CS (r=0.448, p=0.019). Similarly, the diameter of the lesion and weight gain during pregnancy was correlated in medium strength (r=0.423, p=0.014). The onset of symptoms was correlated in medium strength with lactation period (r=0.539, p=0.001). The rate of correct initial diagnosis was significantly higher in years 2015-2019 than in years 2010-2014 (p=0.004). The CSE prevalence was 0.15 in the present study. Conclusion: High BMI values at the time of CS and weight gain during pregnancy might be contributors of CSE development. Furthermore, lactation might have protective effects against CSE.