A comparison of the effects of different types of laryngoscope on the cervical motions: randomized clinical trial

Background: The rate of cervical injury among all trauma patients is 3.1%. The most important point dur- ing intubation of those patients is not to increase the cervical injury. Aims: In this study, we hypothesize that there will be a minimal cervical extension during a laryngoscopy with the use of optical view laryngoscopes. Study Design: Prospective, randomized clinical trial. Methods: One hundred and fifty adult patients with ASA physical status I to III were enrolled in our study. After routine anesthesia induction, we randomly as- signed the patients into three groups according to the type of laryngoscope. Macintosh type, Truview EVO2® type and Airtraq® type laryngoscopes were used in Group DL (n=50), Group TW (n=50) and Group ATQ (n=50), respectively. After applying gen- eral anesthesia induction and mask ventilation, all of the patients were positioned in the neutral position. An inclinometer was placed on the forehead of the patients. Then, the extension angle during intubation and the Cormack-Lehane Score were measured and the time to intubation was recorded. Results: One of the 50 patients in the DL Group, 2 of the 50 patients in the TW Group, and 4 of the 50 patients in the ATQ Group were excluded from the study because of the failure of intubation at defined times. The angle of cervical extension during laryngoscopy was found to be 27.24±6.71, 18.08±7.53, and 14.54±4.09 degrees in the Groups DL, TV and ATQ, respectively; these differences also had statistical significance (p=0.000). The duration of intubation was found to be 13.59±5.49, 23.60±15.23, and 29.80±13.82 seconds in Groups DL, TV and ATQ, respectively (p=0.000). Conclusion: A minimal cervical motion was obtained during tracheal intubation with the use of Truview EVO2® and Airtraq® types of laryngoscope compared with the Macintosh laryngoscope. (ClinicalTrials.gov Identifier: NCT02191904). Keywords: Airtraq®, airway management, intratracheal equipment, intubation, Macintosh, Truview EVO2&reg

Fat embolism associated with anesthesia induction with propofol-lidocaine combination: A case report

Yağ embolisi sendromu travmatik, cerrahi ve travma dışı olayları takiben tanımlanmıştır. Uzun kemik kırıkları bu sendromun en olası nedenidir. Yağ embolisine bağlı klinik tablo sıklıkla belirgin olmayabilir. Belirtiler değişiklik gösterdiğinden ve rutin laboratuvar ve radyografik tanı yöntemi olmadığından tanı konması zordur. Propofol, anestezi indüksiyonu ve idamesinde yaygın olarak kullanılmaktadır. Propofole lidokain eklenmesiyle, yağ damlacıkları birleşerek ayrı tabaka meydana getirebilmektedir. Propofol-lidokain karışımının yağ embolisi oluşturma riski, kombinasyonun hazırlanması ve verilmesi arasındaki süreye ve lidokain dozuna bağlıdır. Bu yazıda, trafik kazası sonrası alt ekstremite kırığı nedeniyle uygulanan genel anestezi indüksiyonunda yağ embolisi gelişen bir olgu sunuldu. Yağ embolisinin propofol-lidokain karışımına bağlı olduğu düşünüldü. Yağ embolisi tanısı, klinik değişiklikler, radyolojik ve laboratuvar bulgularının yanı sıra gelişen arteryel hipoksemiye neden olabilecek başka bozuklukların olmaması ile kondu.Fat embolism syndrome has been described following traumatic, surgical, and atraumatic conditions. Long-bone fractures are probably the most common cause of this syndrome. Fat embolic events are often clinically insignificant and difficult to recognize since clinical manifestations vary and there is no routine laboratory or radiographic means of diagnosis. Propofol is widely used for the induction and maintenance of anesthesia. Addition of lidocaine to propofol may result in a coalescence of oil droplets, forming a separate layer. The risk of propofol and lidocaine combination to cause fat embolism depends on the dose of lidocaine and the duration between its preparation and administration. We presented a patient who developed fat embolism following anesthesia induction during surgery for a lower extremity fracture due to a traffic accident. The occurrence of fat embolism was attributed to propofol-lidocaine use. The diagnosis of fat embolism was based on clinical manifestations, radiographic and laboratory findings, and elimination of other causes associated with arterial hypoxemia

[BW12O40]^3- ve 2,2'-Bipiridil içeren yeni bir nikel(II) kompleksinin sentezi ve karakterizasyonu

A Keggin-type polyoxometalate {Ni(2,2'-bipy)2(H2O)[BW12O40]}3- (NiBWO) has been hydrothermally synthesized in the high temperature resistant glass bottle for the first time. The structure has been characterized.by elemental analyses, X-ray diffraction, Fourier Transform Infrared Spectroscopy, Thermogravimetric Analysis, Scanning Electron Microscope and X-ray single crystal diffraction analyses. The X-ray single crystal study shows that the asymmetric unit of NiBWO is composed of one [BW12O40] 5- anion, one [Ni(2,2'-bipy)2(H2O)]2+ and one and a half of [Ni(2,2'-bipy)3] 2+ cations.Keggin tipi bir polioksometalat olan {Ni(2,2'-bipy)2(H2O)[BW12O40]}3- (NiBWO) bileşiği yüksek ısıya dayanıklı cam şişede hidrotermal olarak ilk kez sentezlenmiştir. Bileşiğin yapısı elementel analiz, X-ışını kırınımı, Fourier Dönüşümlü Kızılötesi Spektroskopisi, Termogravimetrik Analiz, Taramalı Elektron Mikroskobu ve X-ışını tek kristal kırınım analizleri ile karakterize edilmiştir. X-ışını tek kristal analiz sonucu, NiBWO bileşiğinin asimetrik biriminin bir [BW12O40] 5- anyonu, bir [Ni(2,2'-bipy)2(H2O)]2+ ve bir buçuk [Ni(2,2'-bipy)3] 2+ katyonlarından oluştuğunu göstermiştir

Evaluation of attitudes of university students for handicapped individuals

Education has an important role in humans’ behaviours. Undergraduate education has headed among factors that influence maturation period before vocational lifes of individuals. The purpose of this study is to determine whether attitudes of university students for handicapped individuals differ according to some variables. This study which was carried out in screening model was done with 1167 people including 646 females 521 males who maintain their education at faculties taking initial teacher training in 2016 spring term at Yuzuncu Yil University. As data collection tool, Attitude Scale for Being Educated of Handicapped Individuals and Personal Information Form, which was developed by Kosterilioglu [12], was used. As statistical method, Duncan’s multiple range test was used in determining different groups following one-wat analysis of variance. Among these variables, pearson coefficients of correlation were calculated separately in groups in determining relation. In determining relationship between groups and categorical variables , chi square test was used. In calculations, value of p was taken as 0,05 and SPSS statistic program was used for calculations. While point average of attitudes of male students , who maintain their educations at Yuzuncu Yil University, for handicapped people was ascertained as 54.27±23.54, point average of attitudes of female students was determined as 55.86±26.34. A significant difference between male and female students according to gender variable was not seen in attitudes for being educated of handicapped individuals (P>0,05). It was observed that attitudes for being educated of handicapped individuals in starting and end of undergraduate term were higher than intermediate classes (P<0,01). Although a significant difference in kind of high schools from which students graduated was not seen, attitudes of graduates from science and sport high schools were found higher than graduates from other high schools. Those of students who has low and intermediate academic success were found more significant and different than those of students who has high success. (P<0,01). Whereas a significant difference between students, who took lessons related to education of handicappeds and the students who did not take those lessons during education period was not seen, attitudes of those who took the lesson were found higher. A significant difference was found in attitudes of those who took Handicapped and Sport lecture among lessons learned in comparison to those who took other lectures (P<0,01). Attitudes of those who do not use social media were found more significant and higher (P<0,05). It is thought that addition of practice along with theoretical lectures for individuals with special needs during university education and including public service ads related to handicappeds in social media will make a significant contribution to vocational experiences of teacher candidates

Malatya Yöresinde Organik Kayısı Yetiştiriciliği

Bu çalışma, Malatya yöresinde organik tarım tekniğinde yer alan bitki besleme uygulamalarını konvansiyonel uygulamasıyla karşılaştırarak, kayısı yetiştiriciliği için en uygun organik tarım programını oluşturmak amacıyla planlanmıştır. Çalışma 2002-2006 yıllarında Malatya ili Akçadağ ilçesi Karapınar Köyü’nde, 5 yıldır sertifikalı olarak organik tarım yetiştiriciliği yapılan, 15 yaşında, 10x10 m aralık ve mesafede dikilmiş Hacıhaliloğlu kayısı çeşidinden kurulu kayısı bahçesinde yürütülmüştür. Bu bahçenin yakınında, konvansiyonel tarım sisteminin uygulandığı, 15 yaşında ve 10x10 m aralık ve mesafe ile dikilmiş Hacıhaliloğlu kayısı çeşidinden kurulmuş bir üretici bahçesi de kontrol bahçesi olarak kullanılmıştır. Deneme tesadüf blokları deneme desenine göre 3 tekerrürlü ve her tekerrürde 3 ağaç olacak şekilde kurulmuştur. Çalışmada, organik tarım sistemine uygun 5 farklı bitki besleme uygulaması A (Toprağa Ticari Organik Gübre + Toprağa Çiftlik Gübresi + Yeşil Gübre Uygulaması), B (Toprağa Ticari Organik Gübre + Toprağa Humik Asit Uygulaması), C (Toprağa Ticari Organik Gübre + Toprağa Çiftlik Gübresi Uygulaması), D (Toprağa Organik Gübre + Yeşil Gübre Uygulaması) ve E (Toprağa Ticari Organik Gübre + Yaprağa Ticari Organik Gübre Uygulaması) yapılmıştır. Uygulamaların meyve verim ve kalitesi üzerine etkileri ile ekonomik analizleri yapılmıştır. Uygulamaların ortalama ağaç başına ve gövde kesit alanına verim değerleri üzerine etkisi %1 düzeyinde önemli bulunmuştur. En yüksek ağaç başına ve gövde kesit alanına verim değerleri sırası ile 111.30 kg/ağaç ve 0.18 kg/cm2 ile kontrol uygulamasından, organik uygulamalardan ise en yüksek verim 83.09 kg/ağaç ve 0.16 kg/cm2 ile A uygulamasından elde edilmiştir. En düşük verim ise 55.25 kg/ağaç ve 0.10 kg/cm2 ile D uygulamasından elde edilmiştir. Çalışmanın sonucunda, Malatya koşullarında verim, kalite ve net karlılık kriterleri göz önüne alınarak, organik kayısı yetiştiriciliği için A kombinasyonunun (Toprağa Ticari Organik Gübre Uygulaması + Toprağa Çiftlik Gübresi Uygulama + Yeşil Gübre Uygulaması), tavsiye edilebilir ve uygulanabilir en uygun organik kombinasyon olduğu saptanmıştır

Cochlear implantation in inner ear malformations: Considerations related to surgical complications and communication skills

Introduction: There are particular challenges in the implantation of malformed cochleae, such as in cases of facial nerve anomalies, cerebrospinal fluid (CSF) leaks, erroneous electrode insertion, or facial stimulation, and the outcomes may differ depending on the severity of the malformation. The aim of this study was to assess the impact of inner ear malformations (IEMs) on surgical complications and outcomes of cochlear implantation. Methods: In order to assess the impact of IEMs on cochlear implant (CI) outcomes, 2 groups of patients with similar epidemiological parameters were selected from among 863 patients. Both the study group (patients with an IEM) and control group (patients with a normal inner ear) included 25 patients who received a CI and completed at least 1 year of follow-up. Auditory performance, receptive and expressive language skills, and production and use of speech were evaluated preoperatively and at least 1 year after implantation. Types of surgical complications and rates of revision surgeries were determined in each group. Results: In the study group, the most common malformation was an isolated enlarged vestibular aqueduct (EVA) (44.8%). Overall, the patients with IEMs showed significant improvement in auditory-verbal skills. In general, the patients who had normal cochleae scored significantly better compared to patients with IEMs (p < 0.05). The complication rate was significantly lower in the control group compared to the study group (p = 0.001), but the rate of revision surgeries did not differ significantly (p = 0.637). Conclusion: It is possible to improve communication skills with CIs in patients with IEMs despite the variations in postoperative performances. Patients with EVA, incomplete partition type 2, and cochlear hypoplasia type 2 were the best performers in terms of auditory-verbal skills. Patients with IEMs scored poorly compared to patients with normal cochleae. CSF leak (gusher or oozing) was the most common complication during surgery, which is highly likely in cases of incomplete partition type 3

Effectiveness of balance exercises on postural control and quality of life in patients with lumbar discopathy

Objective: Lumbar discopathy is a common problem that affects musculoskeletal system. Many treatment modalities are in use for patients with lumbar discopathy. Balance exercises could be important for the lumbar discopathy due to the affected musculoskeletal system. This study was planned to investigate the effect of balance exercises on postural control and quality of life for lumbar discopathy. Method: A total of 81 patients were divided into two as the intervention and the control groups. Therapeutic ultrasound, transcutaneous electrical nerve stimulation (TENS), hotpack and therapeutic exercises were applied to all patients 5 times a week during thirty sessions. Additionally, the intervention group received balance exercises. Pain (Visual Analog Scale), disability (Oswestry Disability Index), quality of life (Short Form-36) and postural control (Libra (R)) have been evaluated by same physiotherapist before and after the treatment. Results: Statistically significant differences were found between the groups comparing pain, disability and postural control parameters (p0.05), except the 'physical role' parameter in favor of the control group (p=0.04). Conclusion: This study demonstrated that physiotherapy modalities improve pain, disabiliy, quality of life and postural control parameters in patients with lumbar discopathy but adding classic balance exercises in physiotherapy treatment, do not have a remarkable effect in patients with lumbar discopathy

Yabancı Otlar ile Mücadelede Güncel Yöntem: Robotikler

Dünya üzerinde tarımsal üretim, insanlığın var oluşundan itibaren, üretim metodları değişebilse de temelde insanların yaşamlarını sürdürme mücadelesidir. Tarımsal üretimde yetiştirilen üründen optimal verimi elde etmek asıl hedef olmaktadır. Yetiştirilen ürünlerde bir takım sorunlarla karşılaşılmakta ve sorunun boyutuna göre de elde edilen verim değişebilmektedir. Bitkisel üretimde olduğu gibi hayvansal üretimde de yabancı otlar verimin önündeki büyük bir engeli teşkil etmektedir. Yabancı otlar üstün rekabet güçleri ile verim kayıplarına sebebiyet verirler. Kültür bitkisinin yetişme aşamasında arazideki mevcut yabancı otlar var olan büyüme kaynaklarından daha etkin yararlanabilme özelliğine sahip olduğuklarından dolayı kültür bitkilerinden daha önce gelişimini tamamlayıp kültür bitkilerinin gelişimi için gerekli kaynaklara ulaşabilme imkanını kısıtlamaktadır. Tarımsal üreticiler tarafından çok eski tarihlerden bu yana herhangi bir verim kaybı olmaması için veya kayıpların minimize edilebilmesi için yabancı otlarla mücadele süregelmektedir. Yabancı otlarla elle mücadele şeklinde başlayan mücadele yöntemleri, sonraları teknolojide oluşan çeşitli gelişmelerle birlikte mekanik mücadele, fiziksel mücadele, kimyasal mücadele, biyolojik mücadele gibi çeşitli mücadele yöntemleri şeklinde uygulanmıştır. Bu yöntemler içerisinde en yaygını olanı işçilik ve ekonomik açıdan üreticiyi yormayan yöntem olan kimyasal mücadeledir. Ancak son yıllarda kimyasalların kullanımı sonucu yabancı otlarda direnç oluşması ve tüketicilerde halk sağlığı ve çevre konularında farkındalık oluşumu sebebiyle kimyasal kullanımından gelecekte uzaklaşılacağı düşünülmektedir. Bilim insanları günümüzde teknolojinin gelişimi ve kimyasallara alternatif yöntem arayışıyla robotik mücadeleye yönelmiştir. Robotikler ya hiç kimyasal kullanmayıp mekanik donanımlarıyla yabancı otların zararını önleyebilen ya da hedefe yönelik kimyasal püskürtme mekanizmasına sahip yabancı otlarla mücadele araçlarıdır. Robotikler kimyasallara alternatif olarak yabancı otlarla mücadelede kullanılmasının yanı sıra tarımsal üretimin bütün aşamalarında da kullanılabilmektedir. Bu derlemede yabancı otlarla mücadelede robotiklerin kullanılması ve robotik mücadele hakkında dünya üzerindeki gelişmeler incelenmiştir.Agricultural production on the world is basically the management of people to survive, although production methods may change since the existence of humanity. Obtaining optimal yield from the crop production in agricultural production is the main goal. A number of problems are encountered in the grown products and the yield obtained may vary depending on the size of the problem. As in crop production, weeds create a major obstacle to yield in animal production. Weeds cause yield losses with their high competitive power. During the growing stage of the cultivated plant, the existing weeds in the field have the ability to benefit more effectively from the existing growth resources, thus restricting the possibility of reaching the necessary resources for the development of the cultivated plants by completing their development earlier. The management of weeds has been ongoing since ancient times by agricultural producers in order to avoid any loss of yield or to minimize losses. Weed control methods, which started as manual control, were applied in the form of various control methods such as mechanical control, physical control, chemical control, biological control with various developments in technology. The most common of these methods is chemical control, which does not weak the producer in terms of labor and economy. However, it is thought that the use of chemicals will be avoided in the future due to resistance in weeds as a result of the use of chemicals and awareness of public health and environmental issues in consumers in recent years. Today, scientists have turned to robotic control with the development of technology and the search for alternative methods to chemicals. Robotics are weed control tools that either use no chemicals and can prevent weeds with their mechanical equipment or have a targeted chemical spraying mechanism. Robotics can be used as in the fight against weeds an alternative to chemicals as well as being used in all of process of agricultural production. In this review, the use of robotics in management of weeds and developments in the world about robotic control are examined.</p