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Öğe Adding Ketoprofen to Intravenous Patient-Controlled Analgesia With Tramadol After Major Gynecological Cancer Surgery: A Double-Blinded, Randomized, Placebo-Controlled Clinical Trial(I R O G Canada, Inc, 2003) Tuncer, Sema; Pirbudak, Lütfiye; Balat, Özcan; Capar, M.Ketoprofen is a NSAIDs of the 2-aryl propionic acid class commonly used in the treatment of inflammatory rheumatic disease, acute pain and fever. Clinically, ketoprofen seems to reduce morphine requirements by 33 to 40% with ketoprofen's supposed central mechanism of analgesia. We evaluated the efficacy and safety of intravenous (IV) ketoprofen as an adjuvant to IV PCA (patient con- trolled analgesia) with tramadol after major gynecological cancer surgery for postoperative analgesia. Fifty patients were enrolled in this double-blinded, randomized, placebo-controlled study. Patients were allocated randomly to two groups: group I (25 patients) served as a control group, with patients receiving saline; group II (25 patients) received ketopro- fen. Patients received an intravenous bolus of saline or 100 mg ketoprofen at the end of surgery. Then, PCA was given as a 20 mg tramadol bolus and 10 min lockout time. Pain relief was regularly assessed using a visual analog scale. Tramadol consumption, side effects, and patient satisfaction were noted during the 24 hours after the surgery. No significant difference was observed in pain score, side-effects and patient satisfaction between the groups (p > 0.05). The cumulative PCA-tramadol consumption was lower in the ketoprofen-treated patients than placebo-treated patients (p < 0.05). Our results demonstrate that a single dose of 100 mg ketoprofen reduced tramadol consumption for treatment of postoperative pain after major gynecological cancer surgery.Öğe Are cytokine levels in serum, endometrial tissue, and peritoneal fluid a promising predictor to diagnosis of endometriosis-adenomyosis?(I R O G CANADA, INC, 2016) Ozcelik, K.; Capar, M.; Ucar, M. Gazi; Cakur, T.; Ozcelik, F.; Ilhan, T. TuyanAim: The basic aim was to find a non-invasive procedure to diagnose and monitor endometriosis-adenomyosis. Materials and Methods: A prospective study was carried out. The authors conducted a series of 60 consecutive patients who underwent diagnostic laparoscopy for benign gynecologic conditions. Endometrial, peripheral blood and peritoneal lavage samples were analyzed. IL-6, IL-16, TNF-alpha, and LIF levels were measured and compared. Results: The authors analyzed clinical data of 52 patients (26 endometriosis, 13 adenomyosis, and 13 control group). Peritoneal fluid IL-6 is significantly higher in stage IV endometriosis group than the control group (p = 0.001). In the endometriosis group, the levels of TNF-alpha in the peritoneal fluid was higher than the control group (p = 0.008). In the endometriosis and adenomyosis groups, the levels of IL-16 in the peritoneal fluid were significantly higher than the control group (p - 0.000 and p - 0.002). Conclusions: Significant immune-inflammatory changes were observed. When the underlying molecular mechanisms will be investigated, this will elicit studies on the immunotherapeutic treatment of endometriosis. Further studies are needed to assess various potential therapeutic interests for biomarkers in a large, well-defined patient population.Öğe Removal of intra-abdominal mislocated intrauterine devices by laparoscopy(TAYLOR & FRANCIS INC, 2011) Balci, O.; Capar, M.; Mahmoud, A. S.; Colakoglu, M. C.This retrospective study was carried out on 15 patients who underwent laparoscopy for the removal of a mislocated IUD from 2003 to 2009. The mean duration of usage of an IUD was 16.1 months. The IUD was found in the Pouch of Douglas in six patients; in the posterior wall of the uterus in three patients; in the adnexa in three patients; in the omentum in two patients and it was embedded in the rectal serosa in one patient. The types of the IUDs were TCu-380A (n == 13) and MirenaÖğe Transvaginal Burch operation for stress urinary incontinence: 5-year results(WILEY-BLACKWELL, 2008) Capar, M.; Balci, O.; Acar, A.; Karatayli, R.Several techniques have been developed for the management of stress urinary incontinence (SUI). To establish 5-year outcomes for women who underwent our previously described new retropubic suspension operation (transvaginal Burch operation) for SUI at the Meram Medicine Faculty, a prospective study was performed on 231 women who had been operated on for stress incontinence and who had completed 5 years of follow up. We observed complete remission during the follow-up period in 215 women (93%). No major complication related to the procedure was reported, and results were found to be satisfactory and encouraging.Öğe The treatment of 65 women with imperforate hymen by a central incision and application of Foley catheter(BLACKWELL PUBLISHING, 2007) Acar, A.; Balci, O.; Karatayli, R.; Capar, M.; Colakoglu, M. C.Objective To determine the surgical outcome of 65 women with imperforate hymen treated with a central surgical incision and insertion of a Foley catheter. Design A prospective study. Setting The study was carried out at Department of Obstetrics and Gynecology, Faculty of Meram Medicine, Selcuk University, between 1 January 1996 and 30 June 2006. Population A total of 65 women diagnosed as imperforate hymen. Methods A central oval incision was performed to imperforate hymenal membrane, then 16F Foley catheter was protruded and the balloon was insufflated. Catheter was removed after 2 weeks duration. Estrogen cream was prescribed to all women for application onto hymenal structure for 2 weeks. Main outcome measures Efficacy of procedure in treatment of imperforate hymen, preserving hymenal structural integrity that is accepted as important for virginity in some societies. Results After the procedure, hymenal orifice created remained open and intact in all women except two women. Closure of artificially created hymenal orifice in these two women was believed to be related to inappropriate administration of estrogen cream. Subsequent treatment with local estrogen treatment results in the hymenal orifice remaining opened in these two women. Conclusions We have previously reported the technique in 2002, but now we are able to demonstrate results of our technique in an expanded number of women. This technique is less invasive than other methods and prevents many social problems related to virginity by preventing destruction of the integrity of the hymenal structure and providing an annular-intact hymenal ring.
