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Öğe Can triglyceride related indices be reliable markers in the assessment of polycystic ovarian syndrome?(Walter De Gruyter Gmbh, 2024) Yavuzcan, Ali; Keyif, Betul; Yavuzcan, Gizem; Goynumer, GokhanObjectives: This study aimed to evaluate the diagnostic utility of the Triglyceride Glucose (TyG), Triglyceride Glucose-Body Mass (TyG-BMI), and Lipid Accumulation Product (LAP) indices for both screening Polycystic Ovary Syndrome (PCOS) and diagnosing insulin resistance (IR) in women diagnosed with PCOS. Methods: Retrospective data from medical records of 124 women were analyzed, with 71 in the PCOS group and 53 in the non-PCOS group. The PCOS diagnosis followed the 2003 Rotterdam criteria. Basic clinical and biochemical parameters were compared. The TyG index was computed using the formula ln [Triglyceride (TG) (mmol/L) x fasting plasma glukose (FPG) (mg/dL)/2]. TyG-BMI value was derived as TyG x BMI. LAP was calculated as (waist circumference (WC-58) x TG (mmol/L). IR was identified if Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was >2.7. Results: TyG-BMI (AUC=0.62) and LAP indices (AUC=0.61) did not demonstrate statistically significant diagnostic performance for PCOS. Regarding IR in PCOS patients, the highest AUC was for TyG-BMI (0.84, 95 % CI: 0.73-0.93, p<0.001) with a cutoff at 116.15, showing 80 % sensitivity and 86 % specificity. LAP had an AUC of 0.86 with a cutoff of 30.21 (sensitivity 80 %, specificity 81 %), while TyG showed an AUC of 0.78 (95 % CI: 0.67-0.89, p<0.001) with a cutoff of 4.47, demonstrating a sensitivity of 70 % and specificity of 72 %. Conclusions: Numerous biochemical markers have been explored for PCOS detection, however, many are expensive, not universally available, and necessitate specific test kits. TyG, TyG-BMI, and LAP indices might not serve as reliable markers for PCOS screening but could offer utility in identifying IR in Turkish women diagnosed with PCOS.Öğe McDonald versus modified Shirodkar rescue cerclage in women with prolapsed fetal membranes(Taylor & Francis Ltd, 2020) Basbug, Alper; Bayrak, Mehmet; Dogan, Ozan; Kaya, Aski Ellibes; Goynumer, GokhanPurpose: We compared the efficacy of modified Shirodkar and McDonald rescue cerclage techniques in women with singleton pregnancies. Methods: The study sample included 47 women who presented at two tertiary hospitals in Turkey from 2008 to 2017 and underwent rescue cerclage due to cervical incompetence and cervical dilatation with fetal membranes prolapsed into the vagina. The outcomes were compared by cerclage technique used, Shirodkar or McDonald. Results: The McDonald cerclage was applied in 27 cases, and modified Shirodkar cerclage in 20 cases. A longer cerclage-to-birth interval (83.8 +/- 37.6 vs. 63.7 +/- 38.9 days) and later gestational age at delivery (33 vs. 31 weeks) were observed with the Shirodkar cerclage, although these differences were not statistically significant (p = .08 and .63, respectively). Both groups had similar delivery rates after 28, 32, and 37 weeks (p = .20, .15, and .25, respectively), whereas the modified Shirodkar technique resulted in a higher rate of live births although these differences were not statistically significant (85% vs. 63%, p = .09). Conclusion: The effects of the McDonald and modified Shirodkar cerclage procedures on prolonging pregnancy and improving the live birth rate were similar. Therefore, either technique can be applied to prevent neonatal loss due to advanced prematurity.