Selma Oransay, MD

Dr. ORANSAY is 35 years experienced clinician in OB/ GYN. She worked in the main national maternity educational hospital of Turkey for 20 years than she moved to İstanbul and worked in private hospitals. Her published articles are mostly on topics of menopause and infertility. She is also experienced as a voluntary OB/GYN doctor in African healthcare program.

Racial and ethnic disparities and women health

The well documented racial and ethnic disparities in Obstetrics and Gynecology in the US make available to use them as an indicator of implicit bias in giving unequal health and care service to minorities. Dr. Bryant from Massachusetts General Hospital, Boston, Massachusetts, USA, discussed the concerning inequalities of health care practices related to race/ethnicity globally and their effect on women's reproductive health in the US, in his recently updated study published in "Uptodate". The author gave examples from the literature…

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Diagnosis and treatment algorithm for endometriosis

Endometriosis is a chronic and progressive disease that affects 25-30% of women between 25-35years, clinicians commonly experience during their gynecologic practice. However, the diagnosis is still late or sometimes incorrect, and this creates severe health problems and worse outcomes. A precise strategy for early diagnosis is very important for the correct therapeutic approach to the disease. Findeklee et al., from the Department of Gynecology Obstetrics and Reproductive Medicine, Saarland University Hospital, Hamburg-Germany, noticed the failure of standardization in the current…

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Endometriosis surgery and future pregnancy complications

Endometriosis is one of the known diseases for infertility in the reproductive period of women. Several studies revealed that endometriosis itself maybe the reason for some unfavorable obstetric outcomes. Localization, the type of endometriotic lesions, and the stage of endometriosis may affect pregnancy outcomes. Maternal complications can be notified as preeclampsia, antepartum and postpartum hemorrhage, increased number of cesarian sections, spontaneous hemoperitoneum, and bowel perforation. On the other hand, fetal unfavorable outcomes are preterm birth, prematurity, small for gestational age,…

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Resveratrol for infertility: A frenemy?

Ovarian aging is defined by an age-specific decline of the functional ovarian reserve. Female ovarian reserve declines progressively with increasing chronological age. Chronic damage by reactive oxygen species results in deterioration and aging through mitochondrial dysfunction, telomere shortening, cohesion dysfunction, and spindle instability known as "genetic and environmental factors". To slow down this procedure, a natural compound, "Resveratrol" can be used based on its anti-aging, anti-inflammatory, antioxidant, anti-neoplastic, cardioprotective, vasodilatation, and insulin-sensitizing effects. Despite the beneficial effects of Resveratrol on…

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Appendiceal endometriosis

Jeong et al. from the Departement of Surgery, Trinity School of Medicine, Saint Vincent, recently published their interesting appendectomy case in "Hong Kong Medical Journal". In their case, endometriosis inside the cavity of the appendix mimicked appendicitis, the patient submitted with right lower abdominal crampy pain. At the same time, she had nausea, vomiting, headache, constipation, dizziness, and menorrhagia. In her anamnesis, she told that generally, these symptoms occur when she menstruates, but this time it is particularly severe. The…

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Surgical approach to rectovaginal endometriosis.

Recto-vaginal endometriosis incidence is estimated at 3.8%-37% among women with endometriosis and when it exists it's a part of deeply infiltrated endometriosis, thus advance stage endometriosis. Raimondo et al. from the Department of Obstetrics and Gynecology of the University of Bologna, Italy, aimed to compare the feasibility and safety of total laparoscopy to vaginal assisted surgery in recto-vaginal endometriosis patients and their article is recently published in Acta Obstetricia et Gynecologica Scandinavica. 84 women with recto-vaginal endometriosis were included in…

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Fertility conservation in women with endometriosis

Endometriosis affects 10-15% of women in their reproductive period and almost half of them may need Assisted Reproductive techniques to conceive. Moreover, increased malignancy risk is threatening the women with severe endometriosis in addition to their decreased ovarian reserve. Due to all these reasons, fertility preservation with ovarian tissue cryopreservation need is rising and becoming a common interest. Lantsberg et al., from the Department of Obstetrics Gynecology of Monash University, Australia, recently published a literature review to reveal the methods…

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The Relationship Between Dyspareunia and Infertility in Endometriosis

Wahl et al. from the Center of Pelvic Pain and Endometriosis British Columbia Women's Hospital, Vancouver, Canada studied with endometriotic patients suffering from dyspareunia who were referred to their center and built a cross-sectional study to investigate the relations between dyspareunia symptoms with infertility. Their results were published recently in "Sexual Medicine". The authors hypothesized that both deep dyspareunia and superficial dyspareunia would be independently associated with infertility concerns among women with endometriosis. However, only superficial dyspareunia found to be…

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Diaphragmatic endometriosis

Diaphragmatic endometriosis is a rare clinical condition that may show signs and symptoms like chest pain, right upper quadrant abdominal pain, shoulder pain, pleuritic pain, hemothorax, pneumothorax, hemoptysis, and thoracic endometriosis syndrome while the major part of the patients is asymptomatic (70%). The clinical diagnosis of this form of endometriosis is difficult due to the low sensitivity of imaging techniques and the lack of symptoms in most of the patients.  To reveal the feasibility, safety, and effectiveness of the minimally…

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Adiposity, endometriosis type and severity

Dr. Jiyoung from the division of Public Health, Department of Family and Preventive Medicine of the University of Utah, planned a prospective cross-sectional study to assess whether there is an inverse relationship between the adiposity and endometriosis. The results of the study are published in the "Journal of Minimal İnvasive Gynecology". To reveal that if adiposity is a risk factor for initiating endometriosis, 495 women from 14 clinical centers in Salt Lake City, Utah and San Francisco California, were enrolled…

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Treatment choices for abdominal wall endometriosis

Welch et.al, from the Department of  Radiology, Mayo Clinic, Rochester, worked with his gynecologist colleagues to underline the current treatment algorithm of abdominal wall endometriosis in Mayo Clinic. Their experience results recently published in the journal "Abdominal Radiology". Abdominal wall endometriosis diagnosis is frequently delayed due to other causes of abdominal pain, like hernias that occurred after abdominal operations, and tend to be increased by the increasing rate of cesarean section deliveries. When the diagnosis of abdominal wall endometriosis has…

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Rare lesions in the pathologic examinations of endometriosis.

Dr. Glenn McCluggage from the Department of Pathology, Belfast Health, and Social Care Trust, penned a review about selected uncommon variants of endometriosis or benign alterations that may cause difficulties of pathologic diagnosis and provided all related histopathological illustrations in a recent periodical of Histopathology. The potency of some endometriosis undergoing a malignant transformation like ovarian clear cell carcinoma and endometrioid is well known. Besides them, uncommon tumor types that may arise in endometriosis also be under debate. The author…

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Endometriosis and atherosclerotic cardiovascular disease

Endometriosis and atherosclerotic cardiovascular disease show the same pathologic mechanism in terms of endothelial dysfunction. Tan et al. from the Department of Obstetrics and Gynecology, the University of British Columbia, Vancouver, Canada reviewed the literature aiming to determine whether women with endometriosis are candidates of the high-risk population for lifelong atherosclerotic cardiovascular diseases. Their paper is recently published in the journal named "Reproductive Biomed Online". The diagnosis of endometriosis in women is made in their premenopausal years that makes the…

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How to design patient-centered interventions to meet the needs of endometriosis patients

The treatment of endometriosis is not perfect and necessitates the development of patient-oriented care initiatives. On this basis, patient-related transparent information should be the priority for researchers to find out a way for targeted interventions. Steele et al. from Australia and New Zeland, wrote an opinion paper to explain what is necessary to find an answer to the needs of patients with endometriosis. The paper is recently published in the journal "Australian and New Zeland Obstetrics and Gynecology". When the progression…

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Surgery and the endometriosis associated-pain: A systematic review

The surgical approach for pelvic pain-related to endometriosis depends on the stage and the type of the endometriotic lesion and ranging from ablation and the excision of the lesions to radical surgery as hysterectomy with removal of ovaries and presacral neurectomy. Although in clinical research, no improvement in pain-relief after surgery reported in 20-38% of the patients, preferred conservative surgery for endometriosis remains as protection of the uterus and at least one ovary. Singh et al. from the Department of…

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Risk of placenta previa is elevated in endometriotic women who underwent surgery.

In the last decade concerns raised for surgical operations performed before pregnancies of endometriotic patients due to significantly increased risk of pregnancy complications such as placenta previa, preterm birth, hypertensive disorders of pregnancy, placental abruption, postpartum hemorrhage and small baby for gestational age. The comparison of the efficiency of medical treatment versus surgery before pregnancy remains uncertain. To evaluate the difference between these two regimes affecting perinatal outcomes, Miura et al. from the Department of Obstetrics and Gynecology of Nagoya…

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Cloverleaf Sign: A new MRI sign for diagnosing DIE

Magnetic resonance imaging provides accurate information for the staging of deeply infiltrating endometriosis, especially when the patient is virgin, obese or has limited transvaginal examinations due to pelvic pain. In this recently published study in Investive Radiology, Harma et al. from the University of Bern, Switzerland aimed to evaluate the role of an MRI "cloverleaf" sign as a tool to improve the diagnosis of deep infiltrating endometriosis and to compare related operative findings. Their retrospective study group consists of 103 patients. Two…

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Increased obstetrical complications after ART therapy in endometriosis patients.

To examine the impact of endometriosis and adenomyosis on ART therapy, Harada et al. from the Department of Obstetrics and Gynecology of Tottori University, Japan, planned a prospective cohort study and published their results recently in PLoS One.  The study pool consists of 103.099 pregnancies that resulted in live-birth, stillbirth or abortion between February 2011 and July 2014 on 15 different regions of Japan. The presence of adenomyosis or endometriosis in these patients was based on the responses to a…

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Consquences of endometriosis in menopausal period.

Marie-Scemama et al. from Foch Hospital, Suresnes, France, referred to endometriosis and menopause which is an actual cruising topic and recently published it in the journal named "Hormone Molecular Biology and Clinical Investigation". Endometriosis a well-known estrogen-dependent disease has three distinct phenotypes: Superficial peritoneal endometriosis, ovarian endometrioma, and deeply infiltrated endometriosis. Moreover, this disorder frequently associated with adenomyosis. The mystery about the development of endometriosis is why different forms of the disease are presented in different patients or why all types…

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A new technique for laparoscopic management of ovarian endometriosis.

To cause a minimal hazardous effect on ovarian reserve during laparoscopic surgery of endometriomas is always a great concern for clinicians. Shaltout et al. from Cairo University, Egypt, examined the effect of "Surgicel" on preventing the recurrence of endometriomas and recently published their results in the "Journal of Ovarian Research". Surgicel, an oxidized regenerated cellulose compound, acts as a physical barrier that stimulates platelet aggregation and clotting, while it's acidic nature helps to create vasoconstriction at the application area to…

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