Subcutaneous rifampicin versus povidone-iodine for the prevention of incisional surgical site infections following gynecologic oncology surgery — a prospective, randomized, controlled trial

Objectives: Surgical site infection (SSI) following gynecologic oncology surgery is a severe problem for both patientand surgeon in terms of increasing morbidity, length of hospital stay, anxiety, and costs. In this prospective, randomized,controlled study we investigated the effect of subcutaneous rifampicin and povidone-iodine on incisional SSI followinggynecologic oncology surgery.Material and methods: Three hundred patients scheduled for abdominal surgery due to any malign gynecological pathologywere randomly assigned into one of three groups of 100 members each, as follows: the subcutaneous tissue wasirrigated with saline in Group 1; saline + 10% povidone iodine in Group 2; saline + rifampicin in Group 3. Patients wereinvited to follow-up once every 10 days in a 30-day period for evaluation. Patients who developed a superficial incisionalSSI were recorded.Results: No significant relationship was observed between the SSI and the subcutaneous agents used (p = 0.332). It wasobserved that there was a statistically significant increase in the rate of incisional surgical site infections as the periodof hospitalization (p = 0.044), patient’s age (p = 0.003), existence of comorbidities (p = 0.001), and perioperative bloodtransfusion (p = 0.021) increased.Conclusions: Subcutaneous agents are not effective in preventing surgical site infections after gynecologic oncologysurgeries. Further large-scale prospective randomized controlled studies may provide other options to prevent SSIs

Assessment of 8-hydroxydeoxyguanosine levels in patients with preeclampsia: A prospective study

WOS: 000396801700013PubMed ID: 29746027Purpose of investigation: To determine the levels of 8-hydroxydeoxyguanosine (8-OHdG) in preeclampsia (PE) using (enzyme linked immunosorbent assay (ELISA) method. Materials and Methods: Twenty-two pregnant women with severe PE, 18 pregnant women with mild PE, and 40 healthy pregnant women, all between 25 and 41 weeks of gestation, were enrolled in this prospective controlled study. 8-OHdG levels in maternal serum were measured using ELISA method. Results: The authors observed no statistically significant difference in 8-OHdG levels between the mild-severe PE and control groups (p = 0.208). Conclusion: The present results do not support the concept that 8-OHdG has a role in the etiopathogenesis of PE.Gaziantep University [TF. 13. 25]This study was granted by the project research unit of Gaziantep University (project number TF. 13. 25)

Doğum analjezisinde sürekli infüzyon ve hasta kontrollü analjezi yönteminin kombine spinal epidural ile epiduralanaljezi tekniklerinde klinik etkinliklerinin karşılastırılması

Çalısmamızda dogum analjezisinde sürekli infüzyon ile hasta kontrollü analjezi yönteminin kombine spinal epidural (KSE) ile epidural (EP) analjezi tekniklerinde klinik etkinliklerini karsılastırmayı amaçladık. Etik kurul onayı ile, vajinal dogum yapması planlanan gebelik haftası 36. ile 42. haftalar arasında, tek fetus, verteks presentasyonu olan 60 primigravid gebe çalısmaya alındı. Olgular rastgele iki gruba ayrıldı (Grup 1: KSE grubu, Grup 2: EP grubu). KSE grubundaki gebelere 2.5 mg hiperbarik bupivakin ile 25 µg fentanil, toplam volüm 1ml olacak sekilde verildi. Her iki grupta da kullanılmak üzere bupivakain (0.5 mg/ml) ile fentanil (1.5 µg/ml) içeren EP infüzyon solüsyonları hazırlandı. Agrının derecesi vizüel analog skala (VAS) kullanılarak degerlendirildi. EP grubundaki gebelere hemen, KSE grubundaki gebelere ise intratekal dozun analjezik etkisinin geçip VAS 4 oldugunda %0.125 bupivakain + 50 µg fentanil 10 ml yükleme dozu ve hemen ardından 10 ml/saat bazal hız olacak sekilde EP infüzyon baslandı. Iki gruptaki gebelerin ihtiyaç duyduklarında 10 ml bolus doz uygulayabilmeleri saglandı. Maternal ve fetal hemodinamik monitorizasyon yapıldı. Gebelere analjezi baslangıç dozu verildikten sonra agrının tamamen kaybolma süresi kaydedildi. Dogumun 1., 2. dönem süreleri, EPinfüzyon süresi, total EPinfüzyon miktarı, tüketilen bupivakain miktarları, ek bolus doz gereksinimi, travayda ve postpartum dönemde gelisen yan etkiler kaydedildi. KSE grubunda analjezinin baslama süresi EP gruba göre çok kısaydı. KSE grubunda özellikle dogumun 1. evresinde servikal dilatasyonda hızlı artma ve dogumun süresinde kısalma gözlendi. KSE grubunda annenin hemodinamisi daha iyi korundugu hipotansiyonun olmadıgı, infüze edilen lokal anestezi (LA) miktarlarının çok düsük oldugu ve anne memnuniyetinin EPgruba oranla daha fazla oldugu gözlendi. Dogum analjezisinde sürekli infüzyon ile birlikte hasta kontrollü analjezi yönteminde KSE analjezinin EPanaljeziye oranla daha güvenilir bir yöntem oldugunu söyleyebiliriz.Our aim was to compare the clinical efficacies of combined spinal-epidural analgesia and epidural analgesia techniques performed with the continuous patient controlled infusion method in labor analgesia. Following approval of the local ethics committee, 60 primigravid singleton pregnant women between 36 and 42 weeks of pregnancy, with vertex presentation and planned to give vaginal birth were included in the study. Patients were randomly divided into two groups. (Group 1: Combined spinal epidural analgesia (CSE) group and Group 2: Epidural analgesia (EP) group). Participants in CSE group were given a total volume of 1 ml, which is composed of 2.5 mg hyperbaric bupivacain and 25 µg fentanyl. EP infusion solutions were prepared with bupivacaine (0.5 mg/ml) and fentanyl (1.5µg/ml) for use in both groups. The degree of pain was assessed by using visual analogue scale (VAS).A10 ml loading dose consisting of 0.125% bupivacaine and 50 µg fentanyl was applied in the EP group. The CSE group received this dose when the VAS score reached 4 after the disapearance of the effect of intrathecal dose. EP infusions with a basal flow rate of 10ml/hr were given immediately after bolus doses. The pregnant women in both groups were able to apply themselves a bolus dose of 10 ml when needed. Maternal and fetal hemodynamic parameters were monitored. The period of time from the first application of analgesia until total dissappearance of the pain was recorded in all subjects. The durations of the first and second stages of labor, durations of EP infusions, total amounts of EP infusions, consumed bupivacaine amounts, any need for further bolus doses, adverse effects in the intrapartum and postpartum periods were recorded. Initiation time of analgesia in subjects of CSE group was much shorter than the EP group. Especially, more rapid dilatation of cervix in the first stage of labor and a shorter labor time were observed in CSE group. Better preserved maternal hemodynamics without hypotension, lower amounts of infused local anesthetics and better patient satisfaction were also observed in theCSEgroup compared with the EPgroup. We can comment that CSE analgesia technique performed with continuous patient controlled infusion method is a more reliable method than EPanalgesia technique in labor analgesia

Large-vscale hydrogen production and storage technologies: Current status and future directions

This is an accepted manuscript of an article published by Elsevier in International Journal of Hydrogen Energy on 13/11/2020, available online: https://doi.org/10.1016/j.ijhydene.2020.10.110 The accepted version of the publication may differ from the final published version.Over the past years, hydrogen has been identified as the most promising carrier of clean energy. In a world that aims to replace fossil fuels to mitigate greenhouse emissions and address other environmental concerns, hydrogen generation technologies have become a main player in the energy mix. Since hydrogen is the main working medium in fuel cells and hydrogen-based energy storage systems, integrating these systems with other renewable energy systems is becoming very feasible. For example, the coupling of wind or solar systems hydrogen fuel cells as secondary energy sources is proven to enhance grid stability and secure the reliable energy supply for all times. The current demand for clean energy is unprecedented, and it seems that hydrogen can meet such demand only when produced and stored in large quantities. This paper presents an overview of the main hydrogen production and storage technologies, along with their challenges. They are presented to help identify technologies that have sufficient potential for large-scale energy applications that rely on hydrogen. Producing hydrogen from water and fossil fuels and storing it in underground formations are the best large-scale production and storage technologies. However, the local conditions of a specific region play a key role in determining the most suited production and storage methods, and there might be a need to combine multiple strategies together to allow a significant large-scale production and storage of hydrogen.Published versio

Evaluation of sialic acid levels in patients with hydatidiform mole: a preliminary study

WOS: 000376471700022PubMed ID: 27328503Purpose of investigation: This study aims to investigate whether hydatidiform mole (HM) disease with malignant potential is significantly associated with increased sialic acid (SA) levels. Materials and Methods: A total of 114 women were enrolled in this study. Patients were divided into three groups including HM (Group 1, n=34), control group including non-pregnant healthy patients (Group 2, n=42), and another control group including healthy pregnant patients within 12 weeks of gestation (Group 3, n=38). Serum-free SA levels were measured. Results: There was a statistically significant difference in serum-free SA levels among the groups (p < 0.001). Patients with HM had significantly higher levels compared to the control groups. Conclusion: The present study results showed that there was a significant correlation between HM and serum SA level.project research unit of Gaziantep University [TF. 09. 21]This study was granted by the project research unit of Gaziantep University (project number TF. 09. 21)Project research unit of Gaziantep Universit

Outcome of Obstetric Patients Admitted to a Medical Intensive Care Unit in Southeastern Turkey

OBJECTIVE:Obstetric patients represent <2 % of intensive care unit (ICU) admissions with a corresponding ICU utilization rate of 0.17-0.4% of deliveries. There is no data about the rate of ICU utilization by obstetrical patients or the outcome of these patients admitted to ICU in Turkey. The purpose of this study was to look at the outcomes of obstetric patients admitted to a medical ICU at a major referral center in southeastern Turkey. MATERIAL AND METHOD:Prospectively entered ICU database and patient charts were reviewed for obstetric admissions between February 2007 and May 2008. RESULTS:Forty-two obstetric patients were admitted to the ICU representing 4.4% of ICU admissions and 5.1 % of deliveries. Seventy-six percent was admitted in the postpartum period. Main reasons for ICU admission were hemodynamic instability (43%) and mental status change (36%). Fifty-five percent of the admission were due to obstetrical reasons. Hypertensive states of pregnancy (38%) and postpartum bleeding (14%) were the most common obstetrical reasons. CONCLUSION:Maternal mortality was 4.8% in our all patients.Two observed mortalities were due to neurological complications: hemorrhagic CVA in the setting of eclampsia and uncal herniation secondary to cavernous sinus thrombosis

Association Between Maternal Serum Total Oxidant Status Total Antioxidant Status and Preterm Labor: A Prospective - Controlled Clinical Study

OBJECTIVE: To measure the levels of individual antioxidant components of pregnants with preterm labor to evaluate their total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI). STUDY DESIGN: Prospectively-controlled 31 pregnants with a diagnosis of preterm labor (group Ι) and 32 controls (group ΙΙ) were evaluated for demographic data, general and obstetrical physical examination, obstetrical sonography, and routine laboratory tests. TAS, TOS and OSI levels were also measured. RESULTS: There was no difference in terms of demographic data, ultrasound and routine laboratory parameters, total oxidant levels, total antioxidant capacity and oxidative stress index between the two groups (p=0.621, p=0.706 and p=0.450, respectively). CONCLUSIONS: Improper balance between TAS and TOS may not be a major issue in the pathogenesis of preterm labor in which infection does not precede. ‘Screening or prediction of preterm labor‘ needs new trials with large populations, particularly concerning enviromental and dietary features of the population