Clinical Study Gastric Decompression Decreases Postoperative Nausea and Vomiting in ENT Surgery

There is a passive blood flow to the stomach during oral and nasal surgery. It may cause postoperative nausea and vomiting (PONV). We researched the relationship between gastric decompression (GD) and severity of PONV in ear, nose, and throat (ENT) surgery. 137 patients who have been into ENT surgery were included in the study. In Group I ( = 70), patients received GD after surgery before extubation; patients in Group II ( = 67) did not receive GD. In postoperative 2nd, 4th, 8th, and 12th hours, the number and ratio of patients demonstrating PONV were detected to be significantly more in Group II as compared to Group I. PONV was also significantly more severe in Group II as compared to Group I. In Group I, the PONV ratio in the 2nd hour was significantly more for those whose amounts of stomach content aspired were more than 10 mL as compared to those whose stomach content aspired was less than 10 mL. In the 4th, 8th, and 24th hours, there is no statistically significant difference between the stomach content aspired and PONV ratio. GD reduces the incidence and severity of PONV in ENT surgery

The impact of clothing style on bone mineral density among post menopausal women in Morocco: a case-control study

BACKGROUND: The clothing style is an important factor that influences vitamin D production and thus bone mineral density. We performed a case-control study in order to evaluate the effect of veil wearing (concealing clothing) on bone mineral density in Moroccan post menopausal women. METHODS: The cases were osteoporotic women whose disease was assessed by bone mineral density measurement. Each patient was matched with a non osteoporotic woman for age, and body mass index. All our patients were without secondary causes or medications that might affect bone density. The veil was defined as a concealing clothing which covered most of the body including the arms, the legs and the head. This definition is this of the usual Moroccan traditional clothing style. RESULTS: 178 post menopausal osteoporotic patients and 178 controls were studied. The mean age of the cases and the controls was 63.2 years (SD 7) and the mean body mass index was 32.1 (SD 8). The results of crude Odds Ratios analyses indicated that wearing a veil was associated with a high risk of osteoporosis: OR 2.29 (95% CI, 1.38–3.82). Multiparity or a history of familial peripheral osteoporotic fractures had also a significant effect on increasing the osteoporosis risk (ORs: 1.87 (95% CI, 1.05–3.49) and 2.01 (95% CI, 1.20–3.38)). After a multiple regression analysis, wearing the veil and a history of familial osteoporotic fractures remained the both independent factors that increased the osteoporosis risk (ORs: 2.20 (95% CI, 1.22–3.9) and 2.19 (95% CI, 1.12–4.29) respectively). CONCLUSION: our study suggested that in Moroccan post menopausal women, wearing a traditional concealing clothing covering arms, legs and head increased the risk of osteoporosis. Further studies are required to evaluate the clinical impact of the above findings and to clarify the status of vitamin D among veiled women in Morocco

Prevalence of vitamin D deficiency among Turkish, Moroccan, Indian and sub-Sahara African populations in Europe and their countries of origin: an overview

Public Health and primary carePrevention and community carePrevention, Population and Disease management (PrePoD

The prevalence, molecular analysis and HLA typing of late-onset 21-hydroxylase deficiency in Turkish woman with hirsutism and polycystic ovary

We studied the incidence of late-onset congenital adrenal hyperplasia (LOCAH) due to 21-hydroxylase (21-OH) deficiency, its molecular genotype expression, and its association with the major histocompatibility complex in 61 women with hirsutism and polycystic ovary. Ultrasound, clinical and hormonal parameters were used to define polycystic ovary syndrome (PCOS). Baseline and ACTH stimulated 17(x-hydroxyprogesterone (I 7-OHP) levels were measured for screening of LOCAH during follicular phase. Forty-one women were diagnosed as having PCOS (67%) and 20 women were diagnosed as having had LOCAH due to 21-OH deficiency (33%). In LOCAH patients, the most common mutation (Va1281-Leu, V281L) was found in 10 patients (7 heterozygous/3 homozygous). The frequency of V281L mutation was found as 32.5% in 20 patients. All patients with the V281L mutation presented HLA-B14 (100%) and six of them presented DR1 (60%), confirming that LOCAH is linked to the histocompatibility complex. Although molecular analysis is a better and more accurate means for an exact and precise definition of LOCAH, it is not routinely available in our country. So, ACTH stimulation test combined with HLA-B14 typing should be more widely utilized in these patients. As a result, LOCAH due to 21-OH deficiency is unexpectedly high in Turkish patients with hirsutism and PCO

SEZARYEN AMELIYATLARINDA OMEPRAZOL VE H2 RESEPTOR BLOKERLERININ ASPIRASYON PNOMONISI PROFILAKSISINDEKI DEGERI

The effect of omeprazole famotidine, ranitidine and placebo in decreasing the risk of aspiration were investigated in 80 pregnant women undergoing elective cesarean operation and their 80 newborns. Group A consisted of pregnant women and divided into four subgroups. Subgroup AI were given omeprazole 40 mg, PO, two hours prior to anaesthetic induction and groups AII, AIII and AIV were given famotidine 40 mg PO, ranitidine 150 mg PO and isotonic saline respectively. Gastric fluids were aspirated through the nasogastric tube before and after induction and at the 30th minute of anaesthesia and volumes and pH values were recorded. Urine samples were taken with the same intervals and pH values were recorded. The volume of gastric fluid and pH were measured in all the newborns (group B) following birth and the values were evaluated according to the subgroups their mother included. Omeprazole, famotidine and ranitidine decreased gastric fluid volume and increased pH significantly when compared to placebo in all the women. Urine pH of the women and gastric fluid volume and pH of the newborns did not show significant differences. All drugs used were concluded to be equally effective in the prophylaxis of aspiration pneumonia

Intraarticular analgesia after arthroscopic knee surgery: comparison of neostigmine, clonidine, tenoxicam, morphine and bupivacaine

4th Congress of the European-Federation-of-the-International-Association-for-the-Study-of-Pain-Chapters -- SEP 02-06, 2003 -- Prague, CZECH REPUBLICWe conducted a randomized, placebo-controlled, double blinded study to compare the analgesic effects of intraarticular neostigmine, morphine, tenoxicam, clonidine and bupivacaine in 150 patients undergoing arthroscopic knee surgery. General anaesthesia protocol was same in all patients. At the end of the surgical procedure, patients were randomized into six intraarticular groups equally. Group N received 500 mu g neostigmine, Group M received 2 mg morphine, Group T received 20 mg tenoxicam, Group C received 1 mu g kg(-1) clonidine, Group B received 100 mg bupivacaine and Group S received saline 20 ml. Visual analog scale scores 0, 30 and 60 min and 2, 4, 6, 12, 24, 48 and 72 h, time to first analgesic need, analgesic consumption at 48 h and 72 h and side effects were noted. Demographic and operational parameters were similar in six groups. All study groups provided analgesia when compared with saline group (P<0.05). Duration of analgesia in Group N and C was longer than other groups (P<0.001). Analgesic consumptions of Group N, C and T were lower than other groups (P<0.01). Pain scores during 2 h postoperatively were lower in all study groups than the control group (P<0.001). In Group B, median pain scores were higher than Groups N and C at 0 min and 30 min postoperatively (P<0.001). Side effects were not significantly different among the six groups. We conclude that the most effective drugs that are administered intraarticularly are neostigmine and clonidine among the five drugs we studied. Tenoxicam provided longer analgesia when compared with morphine and bupivacaine, postoperatively.European Federat Int Assoc Study Pain Chapter

Vertebra cerrahisinde intraoperatif uygulanan epidural kateter ile bupivakain+morfin ve bupivakain+klonidin uygulamasinin karsilastirilmasi

In this study, for postoperative pain management of 40 patients who were operated for lumbal scoliosis, spondylolystesis and spondylolysis, a catheter was placed into the epidural space, during intraoperative period. By this way bupivacaine+morphine or bupivacaine+clonidine were administered and compared for analgesic, haemodynamic and side effects. In all patients premedication, induction and maintenence of anesthesia were similar. After awakening and neurologic examination, in group I, patients received bupivacaine % 0.125+morphine 2 mg; in group II; bupivacaine % 0.125+1 mcg/kg clonidine; in 10 ml volume of % 0.9 NaCl, via the catheter. Pain (NRS), haemodynamic, respiratory and side effects were noted at: the begining of the postoperative period (0. min.), 30. min. and 1., 2., 6., 12. and 24. hours respectively. 2 mg of morphine was applied from the catheter when needed and total morphine requirements were noted. Data were evaluated statistically; while NRS and haemodynamic results were lower in group II, respiratory values were equal. Analgesia time and side effects were higher in group I. In conclusion, as both combinations were effective and safe in postoperative pain management via an epidural catheter, bupivacaine+clonidine may be an alternative to morphine+bupivacaine