Preemptive analgesia application in acute appendicitis

BACKGROUND: Preemptive analgesia with infiltration of anesthetics into surgical wounds before the incision has been shown to be effective in various elective surgeries. Although this application can decrease the postoperative pain, it is not known whether it is effective in surgery with acute pain or not. AIMS: In this study, we evaluated whether the preincisional local anesthetic application will decrease the postoperative pain in patients undergoing appendectomy for acute appendicitis. MATERIALS AND METHODS: Forty consecutive patients admitted to the Emergency Department with a tentative diagnosis of acute appendicitis were randomly divided into two groups. In Group 1, 1% prilocaine and 0.25% bupivacaine was injected to the planned incision site cutaneously, subcutaneously, and under the fascia of the external oblique muscle. The patients in Group 2 received the same volume of saline to the same anatomical sites. Initially, 1 mg/kg meperidine was administered intramuscularly to both groups for postoperative analgesia. If needed further, meperidine 0.5 mg/kg was administered intramuscularly. Postoperative pain was assed by visual analog scale during the first 24 hours. The analgesic needed and the doses required were recorded. STATISTICAL ANALYSES: All data were stored using SPSS 11.0 for Windows. Wilcoxon test and two independent samples T-test was used as the non-parametric test. RESULTS AND CONCLUSIONS: No statistically significant difference was found between the two groups' pain score, the number of patients who needed analgesic, and the amount and the number of doses administered. In conclusion, we think that preincisional local anesthetic infiltration does not help to decrease the need for postoperative analgesic use in patients with acute pain, and this may be related with previous central sensitization

Tekrarlayan düşükte endokrin ve endometrial faktörler: Üçüncü basamak bir hastane deneyimi

Aim: To investigate endocrinologic and endometrial factors in cases of recurrent abortions. Material and Method: In cases of recurrent abortions, clinical and ultrasonographic features, genetic, anatomic and immunologic factors, hormonal profiles and endometrial samplings were assessed. Chromosomal abnormalities and uterine anomalies were excluded. Results: In 8 (14%) of 57 cases with recurrent abortions, there were low progesterone levels. In 1 (1.75%) case there was a high androgen level. In 2 (3.5%) cases there was hyperprolactinemia and in another 2 (3.5%) cases there were high insulin levels. In 4 (7%) cases two scores of OGTT were high. In 51 cases where endometrial sampling was performed, only one (1.75%) case had delayed endometrial development. Discussion: We conclude that recurrent abortions have a complex etiology related to endocrinologic and endometrial factors

It isn't over ‘till it’s over: A continuing concern of the SARS-CoV-2 variants, and miRNAs targeting the S protein as a probable absolute cure

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak which still continues to affect the general population, has mutated day by day and new variants have emerged. More than 40 variants, usually caused by mutations in the spike (S) protein, have been recorded. Observation of S protein mutations in the development of t herapeutic agents will increase success rates. As we identify the three-dimensional (3D) conformation of viruses, it is more and more possible to work on models for understanding molecular interactions. Development of agents for arrays and 3D sequencing of proteins paves the way for potential therapeutic studies against variants. MicroRNAs (miRNAs) seemingly act as a potentially important group of biomolecules in combating uncontrolled cytokine release. Besides antiviral response, miRNAs promise to be  powerful therapeutic agents against infections. Studies have shown that miRNAs are able to inhibit the genome directly by miRNA-based treatments as they are sprecific to the SARS-CoV-2 genome. In order to expose this potential, in silico studies before continuing with lab studies are helpful. In our bioinformatics analysis, we proposed to compare the S protein similarities of Delta and Omicron, two of the most common variants, and to detect miRNAs targeting the S protein. The S proteins and coding sequences were compared between the two variants, and differences were determined. Within our analysis, 105 and 109 miRNAs for the Delta and Omicron variants, respectively, were detected. We believe that our study will be a potential guide for deciding on the miRNAs that may most likely have an effect on the management of the infection caused by both variants

Dog bite causing ischemia and neurological deficit at the upper extremity

We present a case with median and radial nerve injuries together with brachial artery occlusion after a dog bite that is seen rarely in the literature. A 26 year-old man was admitted to our emergency department with a complaint of dog bite and weakness of fingers at the left upper extremity. There were bite impressions at the left arm. The physical examination of the patient revealed no brachial and radial artery pulse. The neurological examination revealed radial and median nerve deficits. The patient underwent a thromboembolectomy operation following laboratory and radiological evaluations. The nerve injuries were evaluated as partial and medical treatment was administered

Basilar artery angulation and vertigo due to the hemodynamic effect of dominant vertebral artery

Vertebral arteries form the basilar artery at the pontobulbar junction. The vertebral artery may have dominancy in one of them. The branches of basilar arteries supply blood for the vestibular nuclei and its connections. Vertigo is seen generally in the upper middle aged patients. Vertigo can be observed in dolichoectasia of basilar artery such as angulation and elongation, because of the diminished blood supply and changed hemodynamic factors of vestibular nuclei and its connections. We hypothesized that angulation or elongation of basilar artery can be estimated according to the unilateral vertebral artery dominant hypertensive patients. The basilar artery can angulate from the dominant side of vertebral artery to the recessive side. These angulation and elongation can effect the hemodynamic factors in absence of growing collateral arteries. So, the vertigo attacks may occur in these patients. (C) 2007 Elsevier Ltd. All rights reserved

Trombosit fonksiyonları ve RDW ile tekrarlayan gebelik kayıpları arasında bir ilişki var mıdır?

Aim: Recurrent pregnancy loss (RPL) affects 1% pregnancies and its etiology is multi-factorial. Hypercoagulability might result in recurrent abortions; anticoagulant therapy could potentially increase the live-birth rate in subsequent pregnancies in women with unexplained recurrent abortions. Mean platelet volume (MPV) and platelet distribution width (PDW), are a parameter of platelet functions and may be a marker for increased platelet aggregability. In this study we aimed to determine whether MPV, PDW and red cell distribution width (RDW) values differ between patients with RPL and in healthy participants. Material and Method: A total of 50 RPL patients and 49 age matched healthy women were enrolled into the study. For all subjects following tests were performed: Hemoglobin, hematocrit, white blood cells counts (WBC), MPV, PDW, platelet count, RDW and thyroid stimulating hormone (TSH). Results: Compared with healthy controls there were no statistically differences in MPV and PDW between (p > 0.05, respectively) in women with RPL. However, RDW was significantly lower in patients with RPL than in group with control (p = 0.023,). Discussion: It was first shown in the literature that patients with RPL have no significance MPV and PDW than control subjects. However RDW levels were found that it was significantly related to recurrent pregnancy loss

A predictive tool by fuzzy logic for outcome of patients with intracranial aneurysm

We aimed to investigate if the outcome of the patients with intracranial aneurysm could be predicted by fuzzy logic approach. Two hundred and forty two patients with the diagnosis of intracranial aneurysm were assessed retrospectively between January, 2001 and December 2005 We recorded World Federation of Neurological Surgeons Scale (WFNSS), Fisher Scale and age at admission and Glasgow Outcome Score (GOS) at discharge from hospitalization for all the patients We developed fuzzy sets by dividing WFNSS into four groups as good, fair, bad and very bad; age into three groups as young, middle and old, Fisher scale into three groups as few. moderate and large; outcome score Into four groups as bad, fair, good and very good. We calculated the Outcome of the patient with these sets by fuzzy model. Predicted Outcome by fuzzy logic approach correlated with observed outcome scores of the patients (p > 0.05), including 95% confidence interval. We showed that outcome of the patients with aneurysm can be predicted by fuzzy logic approach, accurately (C) 2009 Elsevier Ltd. All rights reserve

Fetal Vegf Genotype is More Important for Abortion Risk than Mother Genotype

VEGF gene has been reported to be related with many diseases and recurrent pregnancy loss in various studies. Concerning the role of VEGF polymorphisms in pregnancy losses, generally mothers genotypes have been analyzed. To evaluate the association between VEGF A +405G/C (rs2010963), -460T/C (rs833061), +936C/T (rs3025039) and - 2578A/C (rs699947) polymorphisms and spontaneous abortion, we studied the genotypes of spontaneously aborted fetuses, their mothers and healthy controls. 23 spontaneously aborted fetal materials, 22 mothers who had these abortions and 86 healthy controls were included in this study. rs2010963, rs833061, rs3025039 and rs699947 polymorphisms were analyzed by Real Time PCR technique after genomic DNA isolation from all subjects. The frequencies of VEGF A rs2010963 GG genotype and rs2010963 G allele were higher in fetuses compared both with mothers and healthy controls. VEGF A rs3025039 TT genotype and rs3025039 T allele frequencies were higher in fetuses comparing with mothers. VEGF A rs833061 CT and TT genotypes frequencies were higher in fetuses comparing with mothers. We ascertained that VEGF A rs2010963, rs833061 and rs3025039 are the risk factors for spontaneous abortion in fetal genotypes comparing with their mothers and healthy controls.Scientific Research Projects [2012-029]; Scientific Research Projects Unit of Canakkale On Sekiz Mart UniversityThis study was supported by a funding from Scientific Research Projects (2012-029) and a permission from Human Researchs Ethics Committee was taken from Canakkale Onsekiz Mart University.This research was supported by a funding from Scientific Research Projects Unit of Canakkale On Sekiz Mart University. Authors thank Sengul TURUNZ for her technical support