Ayse Yasemin Karageyim Karsidag

Publications (6)5.04 Total impact

• Article: Comparing the effects of intrauterine progestin system and oral progestin on health‐related quality of life and Kupperman index in hormone replacement therapy

  Zehra Meltem Pirimoglu, Ayse Gul Ozyapi, Bulent Kars, Esra Esim Buyukbayrak, Yakup Solak, Ayse Yasemin Karageyim Karsidag, Orhan Unal, Mehmet Cem Turan
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  ABSTRACT: Aim: The aim of this study was to compare the effects of intrauterine-system-releasing 20 µg daily of levonorgestrel (LNG IUS) plus 1 mg 17 beta-estradiol daily, orally with combined oral pill containing 1 mg 17 beta-estradiol/2 mg drospirenone daily as hormone replacement therapy, on health-related quality of life (HRQoL) and climacteric symptoms in postmenopausal women.Materials and Methods: A 6-month prospective clinical trial was conducted at the Department of Obstetrics and Gynecology, Dr Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey. Ninety postmenopausal women were accepted to be part of the study. The Euro Quality of Life-5 Dimensions (EQ-5D) and Euro Quality of Life Visual Analogue Scale (EQ VAS) indexes for HRQoL and Kupperman indexes were compared between two groups of patients.Results: Kupperman indexes of both treatment groups decreased gradually over 6 months, but indexes decreased significantly more in the group with intrauterine-system-releasing 20 µg daily of levonorgestrel. Elevations were observed in EQ-5D indexes and VAS values of both groups. EQ VAS values significantly increased in the group on intrauterine progestogen system. Similar changes were observed in the EQ-5D indexes of both groups.Conclusion: A hormone replacement therapy regimen that includes an intrauterine progestin system decreased climacteric symptoms and increased HRQoL in postmenopausal women during a follow-up period of 6 months. The extent of the relief of symptoms was greater in this group than in women receiving oral combined hormone replacement therapy. It seems therefore that the intrauterine progestin system could represent a method of choice for endometrial suppression in women using estrogen replacement therapy with distinct advantages over systemically administered progestogens, which have been the subject of considerable debate as reported in the recent literature.
  Journal of Obstetrics and Gynaecology Research 05/2011; 37(10):1376 - 1381. · 0.94 Impact Factor
• Article: Effectiveness of short-term maintenance treatment with cabergoline in microadenoma-related and idiopathic hyperprolactinemia.

  Esra Esim Buyukbayrak, Ayse Yasemin Karageyim Karsidag, Bulent Kars, Orhan Balcik, Meltem Pirimoglu, Orhan Unal, Cem Turan
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  ABSTRACT: This study aimed to determine the effectiveness of short-term maintenance treatment with cabergoline and to find out minimum effective dosage of cabergoline during maintenance treatment for patients with microadenoma-related and idiopathic hyperprolactinemia. Cabergoline was administered orally at a dose of 0.5 mg twice per week to 164 de novo hyperprolactinemic patients until serum prolactin level normalized. After this initial treatment phase, patients started on maintenance phase for which they were previously randomized. No maintenance treatment (Group I, n = 36) or cabergoline 0.5 mg (Group II, n = 46), 0.25 mg (Group III, n = 39), 0.125 mg (Group IV, n = 43) was administered twice per week for 8 weeks as maintenance treatment. Then, maintenance phase was finalized and patients were followed up for 6 months. Mean serum prolactin levels through maintenance treatment phase and follow-up period were assessed between groups and within groups. Except for group I, all the groups showed a similar pattern with fast decrease of serum prolactine level during maintenance phase and slower increase during the follow-up period. Notably, the average prolactin level was significantly lower at the last follow-up visit than at the diagnosis time in all of the groups. Stable normoprolactinemia of the groups at the end of follow-up period were 47.2, 37, 48.7, and 34.9%, respectively. The results indicate that short maintenance treatment in idiopathic and microadenoma-related hyperprolactinemia seems as effective as long maintenance treatment in the present study. But, further studies with larger study population and longer follow-up period are needed to make a decision about early treatment withdrawal. Also, during the maintenance treatment administration of medicine to patients should be tapered down to the lowest dose that will maintain prolactin levels normal.
  Archives of Gynecology 11/2010; 282(5):561-6. · 0.91 Impact Factor
• Article: Diagnosis of vulvovaginitis: comparison of clinical and microbiological diagnosis.

  Esra Esim Buyukbayrak, Bulent Kars, Ayse Yasemin Karageyim Karsidag, Bernan Ilkay Karadeniz, Ozge Kaymaz, Serap Gencer, Zehra Meltem Pirimoglu, Orhan Unal, Mehmet Cem Turan
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  ABSTRACT: The purpose of the present study was to compare the current diagnostic clinical and laboratory approaches to women with vulvovaginal discharge complaint. The secondary outcomes were to determine the prevalence of infections in our setting and to look for the relation between vulvovaginal infections and predisposing factors if present. Premenopausal women applying to our gynecology outpatient clinic with vaginal discharge complaint were enrolled prospectively into the study. Each patient evaluated clinically with direct observation of vaginal secretions, wet mount examination, whiff test, vaginal pH testing and chlamydia rapid antigen test. Each patient also evaluated microbiologically with vaginal discharge culture and gram staining. Clinical diagnosis was compared with the microbiological diagnosis (the gold standard). Diagnostic accuracy was measured with sensitivity, specificity, positive (ppv) and negative predictive values (npv). 460 patients were included in the study. 89.8% of patients received a clinical diagnosis whereas only 36% of them had microbiological diagnosis. The sensitivity, specificity, ppv, npv of clinical diagnosis over microbiological culture results were 95, 13, 38, 82%, respectively. The most commonly encountered microorganisms by culture were Candida species (17.4%) and Gardnerella vaginalis (10.2%). Clinically, the most commonly made diagnoses were mixed infection (34.1%), bacterial vaginosis (32.4%) and fungal infection (14.1%). Symptoms did not predict laboratory results. Predisposing factors (DM, vaginal douching practice, presence of IUD and usage of oral contraceptive pills) were not found to be statistically important influencing factors for vaginal infections. Clinical diagnosis based on combining symptoms with office-based testing improves diagnostic accuracy but is insufficient. The most effective approach also incorporates laboratory testing as an adjunct when a diagnosis is in question or treatment is failing.
  Archives of Gynecology 05/2010; 282(5):515-9. · 0.91 Impact Factor
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  Available from: Esra Esim Buyukbayrak

  Article: The relationship between unexplained elevated serum markers in triple test, uterine artery Doppler measurements and adverse pregnancy outcome.

  Ayse Yasemin Karageyim Karsidag, Esra Esim Buyukbayrak, Bulent Kars, Ugur Suyugul, Orhan Unal, Mehmet Cem Turan
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  ABSTRACT: To investigate the relationship between adverse pregnancy outcomes and unexplained elevations of second trimester maternal serum human chorionic gonadotropin (hCG), alpha fetoprotein (AFP) levels and uterine artery Doppler measurements. A total of 144 women between 16-20 weeks of gestation that applied to our clinic for triple test were enrolled into the study. Study group consisted of 84 pregnant women with hCG and/or AFP levels > or =2 MoM. Control group comprised of 60 pregnant women with hCG and AFP levels <2 MoM. Study group was further subdivided into 3 subgroups: Subgroup I; only AFP> or =2 MoM (n=30), subgroup II; only hCG > or =2 MoM (n=64) and subgroup III; both AFP and hCG > or =2 MoM (n=10). Operative delivery rate (p = 0.0017), overall complication rate (p=0.0002), bilateral early diastolic notch presence rate (p = 0.015) were high and mean birth weight was low (p=0.045) in the study group. In subgroup I patients, low birth weight [LBW] (p = 0.0008), preterm delivery (p = 0.0001), preeclampsia (p = 0.003) and preterm premature rupture of membranes [PPROM] (p = 0.012) rates were high. In subgroup II patients, only small for gestational age baby [SGA] (p = 0.016) rate was high. In subgroup III patients LBW (p = 0.009), preterm delivery (p = 0.0001) and PPROM (p = 0.01) rates were high. According to Doppler velocimetry studies, bilateral early diastolic notch presence rate was high (p = 0.015) in the study group. Patients with high AFP levels and bilateral uterine artery diastolic notch presence, are candidates for pregnancy complications and these groups of patients should be followed up more intensively.
  Journal of the Pakistan Medical Association 03/2010; 60(3):181-6.
• Article: Cervical polyps: evaluation of routine removal and need for accompanying D&C.

  Esra Esim Buyukbayrak, Ayse Yasemin Karageyim Karsidag, Bulent Kars, Onder Sakin, Ayse Gul Ozyapi Alper, Meltem Pirimoglu, Orhan Unal, Cem Turan
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  ABSTRACT: To estimate prevalence of malignancy and dysplasia in cervical polyps and to judge whether cervical polyps need to be removed routinely. Also to investigate if a cervical polyp is an indicator of endometrial pathology and to assess the necessity of performing dilatation and curettage (D&C). We retrospectively reviewed hospital records of 4,063 cervical polyp cases. Patients' age, menopausal status and pathological findings were recorded. Descriptive statistics, Pearson's χ(2), Fisher's exact test were used for statistical analysis. P value of ≤ 0.05 was accepted significant. Among 4,063 cervical polyps, only 3 (0.1%) cases of malignancy were encountered which were metastasis from endometrium. There were also dysplastic (0.4%), metaplastic (2.1%), inflammatory (1%) changes. Accompanying endometrial pathologies were: endometrial cancer (0.3%), hyperplasia without atypia (1.3%), endometrial polyp (6.6%). There was statistically significant relation between menopausal status and malignancy of cervical polyps (P = 0.055) malignancy of endometrial cavity (P = 0.0001). Routine removal of cervical polyps, although not mandatory, seems clinically prudent because pathological evaluation is needed to confirm the diagnosis and to rule out other possibilities. 10.9% of postmenopausal patients and 7.8% of premenopausal patients were diagnosed with any endometrial pathology accompanying cervical polyp. Therefore, cervical polyps can be a sign of endometrial disease, especially in postmenopausal women with cervical polyp endometrium should be evaluated more carefully.
  Archives of Gynecology 03/2010; 283(3):581-4. · 0.91 Impact Factor
• Article: Successful pregnancy in a patient with portal hypertension secondary to portal vein thrombosis due to essential thrombocythaemia: a rare case.

  Esra Esim Buyukbayrak, Bahar Ergen, Ayse Yasemin Karageyim Karsidag, Bulent Kars, Cem Turan, Elif Birtas Atesoglu
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  ABSTRACT: Essential thrombocythaemia (ET) is a disease characterized by an increased platelet count, megakaryocytic hyperplasia and a hemorrhagic or thrombotic tendency. Pregnancy in patients with ET can have a favorable outcome. However, ET has also been reported to complicate pregnancy by recurrent abortions, intrauterine death, and fetal growth retardation due to placental infarctions. ET has an unusual prevalence of intraabdominal (hepatic, portal and mesenteric) vein thrombosis, especially in young patients, which can lead to portal hypertension. There are ample cases in the literature of both essential thrombocytosis complicating pregnancy and portal hypertension complicating pregnancy, but the coincidence of both conditions appears to be unique. In this case report, we report a successful pregnancy in a patient with a prior diagnosis of essential thrombocytosis with remote secondary portal vein thrombosis and portal hypertension (PH).
  The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 02/2010; 23(2):187-9. · 1.36 Impact Factor