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    Cesarean delivery is associated with suppressed activities of the stress axes
    (Taylor & Francis Ltd, 2022) Ucar, Cihat; Bulbul, Mehmet; Yildiz, Sedat
    Maternal pre- and post-delivery stress levels might be different for vaginal or cesarean deliveries. This study aimed to investigate the effects of type of delivery (vaginal or cesarean) and time of delivery (pre- and post-delivery) on the stress axes of the body, namely the hypothalamic-pituitary adrenal axis (HPA) and autonomic nervous system (ANS). Ninety-one pregnant women were volunteered to participate this prospective study. In these women, pre- and post-delivery HPA and ANS activities were measured noninvasively by salivary cortisol and heart rate variability (HRV), respectively. HRV was measured by 5-min electrocardiogram recording and time- and frequency-domain parameters were computed. Salivary cortisol concentration and HRV parameters were higher in women having vaginal delivery than those having cesarean delivery (p < 0.05). Cortisol levels did not differ between pre- and post-delivery (p > 0.05) but the time-domain parameters of HRV decreased post-delivery (p < 0.05). No interactions were observed between the types and times of delivery (p > 0.05). HPA and ANS axes had different activity patterns throughout the delivery process and they were higher during vaginal delivery, suggesting that they are integral parts of normal birth process and that cesarean delivery perturbs the activity of both axes.
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    Effects of Er:YAG Laser on Mineral Content of Sound Dentin in Primary Teeth
    (Hindawi Ltd, 2014) Guler, Cigdem; Malkoc, Meral Arslan; Gorgen, Veli Alper; Dilber, Erhan; Bulbul, Mehmet
    The aim of the present study was to evaluate the mineral content of sound dentin in primary teeth prepared using an Er:YAG laser at two different power settings. Thirty-six primary second molars were used in this study. Three dentin slabs were obtained from each tooth, and the slabs were randomly divided into three groups: Group A, control; Group B, Er: YAG laser at 3.5 W, 175 mJ, and 20 Hz, short pulse mode; and Group C, Er: YAG laser at 4 W, 200 mJ, and 20 Hz, medium-short pulse mode. One dentin slab per group was used to evaluate the dentinal morphology and surface roughness values using SEM and profilometer, respectively. Mineral content in the dentin slabs were calculated by inductively coupled plasma-atomic emission spectrometry (ICP-AES). The data were analyzed by one-way analysis of variance and Tukey's HSD tests. No significant differences in Ca, K, Mg, Na, and P levels or Ca/P ratio were found among the groups (P > 0.05). SEM micrographs showed that surface irregularities increased with a higher power setting. The surface roughness after laser treatment in Group B and Group C was found to be similar, unlike Group A.
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    Evaluation of specific heavy metal levels of pregnant women complicated by neural tube defects
    (2020) Karacor, Talip; Kirici, Pinar; Nacar, Mehmet Can; Bulbul, Mehmet; Onderci, Muhittin; Peker, Nurullah
    Aim: The etiology of neural tube defect (NTD) is still not clear enough. In our study, we aimed to evaluate plasma heavy metal levels of pregnant women with NTD and to determine whether there is a relationship between heavy metal levels and NTD severity.Material and Methods: TThis study was conducted in Adıyaman University, Department of Gynaecology and Obstetrics. The study included 38 pregnant women with NTD and 42 pregnant women with healthy infants. Pregnant women who have NTD were divided into two groups as NTD Type 1 and NTD Type 2 according to the anomaly type. Levels of heavy metals such as Mercury (Hg), Cadmium (Cd), Cobalt (Co), Lead (Pb), Manganese (Mn) and Arsenic (As) were compared between groups.Results: Plasma Hg, Co, Cd and Pb levels were higher in NTD group than control group. (p values, respectively; p 0.001, p = 0.001, p 0.001, p 0.001). As and Mn levels were not statistically different between the two groups (p values; p = .519, p = .819, respectively). In the NTD group, Hg was found to be higher in NTD Type 1 than NTD Type 2 (p 0.001).Conclusion: It is obvious that some histomorphological changes are formed in the cardinal ligaments of patients with uterine prolapse due to pressure on the uterus. We believe that the increase in the number of extravasated erythrocytes and the thickness of the vascular wall and peripheral nerve should be supported by further studies.
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    Extraction of endometrial polyps and type 0 submucosal fibroids under ultrasonographic guidance when hysteroscopy is not available
    (2020) Bulbul, Mehmet; Dilbaz, Berna
    Aim: Endometrial polyp (EP) and type 0-uterine leiomyoma (T0SLM) in the uterus are common pathologies encountered in daily practice. Hysteroscopic resection is the gold standard for removal of these lesions. However, hysteroscopy might not be available in low-source settings. Management of intracavitary lesions by using an ultrasonography-guided approach is presented in this study.Material and Methods: Between March 2016 and June 2018, 14 out of 67 patients diagnosed with EP and T0SML applied to a gynecology department of a tertiary center when hysteroscopic approach was not available and refused to be referred to another city for hysteroscopic approach. All the patients had a thorough ultrasonographic evaluation and saline infusion sonography prior to the surgery. Surgical intervention of the patients was performed under sedation anesthesia. Using a ring forceps, EPs or T0SML were held under ultrasonographic guidance and then removed completely using rotation and traction.Results: The age range and the diameter of the lesions ranged between 35-71 years and 21-61 mm respectively. The mean duration of the surgery was 8.5 ± 1.9 minutes. Eight patients had EP while six had T0SML. In the postoperative 4th month follow-up examination via ultrasonographic investigation, no residual lesion was observed in any of the patients.Conclusion: Although hysteroscopy is the gold standard in the treatment of EP/T0SML, its availability is sometimes limited. Moreover, the cost of hysteroscopy is high in comparison to the conventional methods. Requirement of surgical experience and the necessity of morcellation for the removal of large lesions make hysteroscopy more complicated. Removal of precisely selected large T0SML and EP is effective and cost-effective.
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    MgSO4 prophylaxis for obstetric reasons: Traditional solutions vs ready-made solutions
    (2019) Bulbul, Mehmet; Bucak, Ibrahim Hakan
    Aim: Magnesium (Mg) is frequently used in obstetrics as an anticonvulsant and neuroprotection in daily practice. Although ready-made solutions are produced today, health care workers still prepare and use MgSO4 via traditional methods. We planned this study to investigate the possible benefits of using ready-made solutions. Material and Methods: The solution prepared by traditional methods was compared to a ready-made solution in terms of Mg amount, preparation duration and cost over time. Results: Ready-made solutions resulted in a more homogeneous infusion (386.98±25.30 vs 402.65±21.68), lower cost (6.86 vs 5.56) and less labor loss (1258 (min: 900 – max: 1500) vs 0 sec). Conclusions: This study, it does show that the use of a ready-made solution allows the patient to receive a more homogenous infusion of magnesium over time, and it is more financially profitable. The use of ready-made MgSO4 solution also prevents the loss of time in the labor force that would have been spent preparing the solution.Keywords: Magnesium; prophylaxis; traditional solutions; ready-made solutions.
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    A rare cause of hypovolemic shock after cesarean delivery; Rectus sheath hematoma
    (2019) Bulbul, Mehmet; Karacor, Talip; Nacar, Mehmet Can; Simsek, Memet
    Rectus sheath hematoma (RSH) is usually a self-limiting uncommon condition seen under belly. It is very rare that the hematoma reaches the size of a surgical requirement and that it develops as a result of superior epigastric vessel injury. In this case, we presented treatment of RSH which caused hypovolemic shock due to superior epigastric vascular injury and treated with ligation of vessels with intraperitoneal sutures via Phannensteil incision. In conclusion, surgery should be considered in patients with a hematoma that is large enough to cause hemodynamic instability or hypovolemic shock. In these patients, treatment with good cosmetic results can be performed with the same incision with appropriate sutures without forming comorbidity in the patient.