Antibacterial effect of a new haemostatic agent on oral microorganisms

Objective: The purpose of this study was to determine the antibacterial effect of a newly developed haemostatic agent Ankaferd Blood Stopper® (ABS) and Ferric Sulphate (FS) on various oral microorganisms. Study design: Bacterial strains were freshly incubated in their specific broth media. For each of the strains, 3 wells per each agent, with a 5 mm diameter were made under aseptic conditions in the specific agar media. Then they were filled with a test agents or 0.2% chlorhexidine digluconate (CHX) (control group). After 24h and 48h incubation periods, inhibition zones were measured. Results: ABS showed antibacterial effect on all test microorganisms except Lactobacillus acidophilus and Lactobacillus salivarius. Ferric sulphate and CHX have antibacterial effect on all microorganisms. When the test agents compared, the inhibition zones of the ABS were found smaller than the ferric sulphate and CHX. Conclusions: Although ferric sulphate and ABS have antibacterial effect, ferric sulphate had better antibacterial activity than ABS on oral microorganisms under in vitro condition. FS and ABS not only exhibit the haemostatic activity but also antimicrobial activity

Wernicke's Encephalopathy in Colon Cancer

Wernicke's syndrome, caused by thiamine deficiency, is most commonly associated with alcoholism but can also occur in patients who are malnourished or have malabsorption of nutrients for other reasons. Since the classic triad of encephalopathy, nystagmus and ataxia occurs simultaneously in only 10–33% of cases, a high index of suspicion is needed in any patient with confusion and memory loss. In this case report, we present a 56-year-old female patient with metastatic colon cancer complicated with enterocutaneous fistula. She developed Wernicke's encephalopathy precipitated by 5-fluorouracil infusion. Replacement with thiamine rapidly reversed her neurologic symptoms and signs

Emotion regulation and premedication success relationship in children who underwent general anesthesia

Background/aim: This study aims to investigate the relationship between emotion regulation characteristics and the efficacy of midazolam premedication. Materials and methods: Sixty-three children, aged 3 to 8 years old, with tonsillectomy and/or adenoidectomy and taking premedication with midazolam (Group 2) or without premedication (Group 1), were included in this study. The behavioral and emotional status of the children was evaluated with the Conners Parent Rating Scale-48 (CPRS-48) and Emotion Regulation Checklist (ERC). Age, sex, body weight, response to intravenous (IV) cannulation and mask, hemodynamic data, preoperative sedation scores {[}Wilton Sedation Scale (WSS)], postoperative pain intensity {[}Objective Pain Scale (OPS)], and emergence agitation (EA) level {[}Pediatric Anesthesia Emergence Delirium (PAED)] were recorded. Results: A total of 90.6\% patients were quiet and sleepy in Group 2, and 25.8\% in Group 1. The mean scores of OPS and PAED were higher in Group 1, and the percentage of patients with PAED score of > 10 was 51.6\% in Group 1 and 18.8\% in Group 2 (P < 0.05). In Group 1, a significant correlation was found between PAED scores and WSS and the subfactors of the CPRS-48 (P < 0.05). A correlation was found between WSS and subfactors of ERS in Group 1 (P < 0.05). Conclusion: The incidence of anxiety and postoperative EA is increased in children with emotion regulation disorder, and midazolam premedication reduced the frequency of EA

Pediatric tooth extractions under sedoanalgesia

Objective: The present study aims to evaluate intravenous ketamine and inhalation sedation in children, their unwanted side-effects and surgeon satisfaction. Methods: In this study, data of 922 children aged between 1-18 who underwent tooth extraction under sedoanalgesia in our department between September 2015-January 2016 were gathered and anesthesia approaches, unwanted side effects and surgical satisfaction was investigated. Postoperative recovery emergence agitation or delirium was evaluated with Watcha Behavior Scale (WBS). Results: Patients were grouped and compared according to acceptance of intravenous line placement (Group-1) or not (Group-2). Group 1 received intravenous ketamine anesthesia (n=822), Group 2 received inhalation anesthesia with sevoflurane (n=100). Number of patients, age, weight and gender was significantly different in two groups. When side effects were investigated nausea was observed in 30 patients (3.6\%), skin rashes were observed in 26 patients (3.2\%) in Group-1 while skin rashes were observed in one patient (1\%) in Group 2. 95\% of surgeons reported intravenous anesthesia, 18\% of surgeons reported inhalation anesthesia to be the anesthesia of choice. Emergence of postoperative recovery agitation (WBS >= 3) was observed more frequent in Group 2 (p<0.05) than Group 1. Conclusion: Ketamine, which has analgesic, hypnotic and amnestic effects and which does not alter pharyngeal and laryngeal reflexes thus minimizes aspiration possibility, is a safe and effective anesthetic agent for tooth extractions of the pediatric population under sedoanalgesia

Protein structural class determination using support vector machines

Abstract. Proteins can be classified into four structural classes (all-α, all-β, α/β, α+β) according to their secondary structure composition. In this paper, we predict the structural class of a protein from its Amino Acid Composition (AAC) using Support Vector Machines (SVM). A protein can be represented by a 20 dimensional vector according to its AAC. In addition to the AAC, we have used another feature set, called the Trio Amino Acid Composition (Trio AAC) which takes into account the amino acid neighborhood information. We have tried both of these features, the AAC and the Trio AAC, in each case using a SVM as the classification tool, in predicting the structural class of a protein. According to the Jackknife test results, Trio AAC feature set shows better classification performance than the AAC feature.

A study to investigate the relationship between difficult intubation and prediction criterion of difficult intubation in patients with obstructive sleep apnea syndrome

Background and Aim: Obstructive sleep apnea (OSA) syndrome is predisposed to the development of upper airway obstruction during sleep, and it poses considerable problem for anesthetic management. Difficult intubation (DI) is an important problem for management of anesthesia. In this clinical research, we aim to investigate the relationship between DI and prediction criteria of DI in cases with OSA. Materials and Methods: We studied 40 [OSA (Group O, n = 20) and non-OSA, (Group C, n = 20)] ASA I-II, adult patients scheduled tonsillectomy under general anesthesia. Same anesthetic protocol was used in two groups. Intubation difficulties were assessed by Mallampati grading, Wilson sum score, Laryngoscopic grading (Cormack and Lehane), a line joining the angle of the mouth and tragus of the ear with the horizontal, sternomental distance, and tyromental distance. Demographic properties, time-dependent hemodynamic variables, doses of reversal agent, anesthesia and operation times, and recovery parameters were recorded. Results: Significant difference was detected between groups in terms of BMI, Mallampati grading, Wilson weight scores, Laryngoscopic grading, sternomental distance, tyromental distance, doses of reversal agent, and recovery parameters. Conclusion: OSA patient′s DI ratio is higher than that of non-OSA patients. BMI Mallampati grading, Wilson weight scores, Laryngoscopic grading, sternomental distance, and tyromental distance evaluation might be predictors for DI in patients with OSA

Effects of the general anaesthetic agent, propofol, on erythrocyte deformability

Arslan, Mustafa/0000-0003-4882-5063WOS: 000276730200003PubMed: 20437820Objectives: Propofol is an anesthetic agent frequently used for sedation and general anesthesia. The purpose of our study was to investigate the effect of propofol, a general anesthetic, on erythrocyte deformability in rats. Methodology: The study was performed on 20 male and 20 female rats, with 10 rats in each study group and 10 rats in each control group. The rats in the study group were administered propofol (150 mg.kg(-1)) intraperitoneally, and the rats in the control group were administered SF. Erythrocyte packs were prepared using heparinized total blood samples. Deformability measurements were done by erythrocyte suspensions in PBS buffer. A constant flow filtrometer system was used to measure erythrocyte deformability, and the relative resistance was calculated. Results: The use of propofol resulted in the increase in the relative resistance, which is an indicator for the erythrocyte deformability in both male and female rats (p=0.002, p=0.042, respectively). Conclusion: A negative change in the erythrocyte deformability may cause a functional deterioration in blood flow and tissue perfusion (Fig. 1, Ref. 23). Full Text (Free, PDF) www.bmj.sk

Clinically suspected anaphylaxis induced by sugammadex in a patient with Weaver syndrome undergoing restrictive mammoplasty surgery A case report with the literature review

Rationale: Sugammadex is a cylodextrin derivate that encapsulates steroidal neuromuscular blocker agents and is reported as a safe and well-tolerated drug. In this case report, we present a patient who developed grade 3 anaphylaxis just after sugammadex administration. Patient concerns: A 22-year-old woman with diagnosis of Weaver syndrome was scheduled for bilateral mammoplasty and resection of unilateral accessory breast tissue resection. Anesthesia was induced and maintained by propofol, rocuronium, and remifentanil. At the end of the operation, sugammadex was administered and resulted in initially hypotension and bradycardia then the situation worsened by premature ventricular contraction and bigeminy with tachycardia, bronchospasm, and hypoxia. Diagnosis: The Ring and Messmer clinical severity scale grade 3 anaphylactic reaction occurred just after sugammadex injection and the patient developed prolonged hypotension with recurrent cardiac arrhythmias in postoperative 12 hours. Interventions: Treatment was initiated bolus injections of ephedrine, epinephrine, lidocaine, steroids and antihistaminic and continued with lidocaine bolus dosages and norepinephrine infusion for the postoperative period. Outcomes: The general condition of the patient improved to normal 3 hours after the sugammadex injection, and she was moved to the intensive care unit. At 2nd and 8th hours of intensive care unit follow-up, she developed premature ventricular contraction and bigeminy with the heart rate of 130 to 135 beats/min, which returned to sinus rhythm with 50 mg lidocaine. After that, no symptoms were observed and the patient was discharged to plastic surgery clinic at the following day. Lessons: Sugammadex may result in life-treating anaphylactic reaction even in a patient who did not previously expose to drug. Moreover, prolonged cardiovascular collapse and cardiac arrhythmias may occur

Effects of Sevoflurane and Desflurane on Oxidant/Antioxidant Status of Young Versus Old Rat Liver Tissues

Nurlu Ayan, Nilhan/0000-0002-0844-5050WOS: 000260428600002Anesthetic agents modulate on oxidant/antioxidant activity. This study aimed to evaluate the effects of desflurane and sevoflurane anesthesia on the oxidant/antioxidant activity in the liver of young and aged rats. The study involved 60 male Wistar Albino Rats. Rats, which 5-6 months of age deemed as young (Group Y, n = 30) and 10-11 months of age deemed as old (Group O, n = 30). The weight range of the rats was 270-350 g. The groups of rats were randomly divided into 3 groups as the control group [Group Y, (Young Control 100% O-2; n = 10) and Group O-c (Old Control 100% 0,; n = 10)], desflurane group [Group Y-D, (Young Desflurane; 6% Desflurane in 100% O-2; n = 10)] and Group O-2, (Old Desfluranee; 6% Desflurane in 100% O-2; n = 10)] and sevoflurane group [Group Y-S (Young Sevoflurane; 2% Sevoflurane in 100% O-2; n = 10) and Group O-S (Old Sevoflurane; 2% Sevoflurane in 100% 02; n = 10)]. The rats placed into a transparent plastic cage. The rats were exposed to different anesthetic agents or oxygen for 2 h by the use of half open Anesthesia System (AMS, Senior 425), while rats' simultaneous normal breathing was maintained. At the end of the exposure, they were administered a high dose of ketamine and the livers of the animals were sugically removed. SOD, GST and NOS activities were determined and levels of oxidative stress was monitored by measuring TBARS via levels of MDA in the liver. Desflurane induce oxidative stress in both young and old rats, with higher levels in old rats. However, sevoflurane did not cause oxidative stress in young rats. Sevoflurane increased the oxidative stress in the old rats based on SOD and TBARS levels, while it maintained GST activity and decreased NOS activity. However, further studies are needed

Effect of dexmedetomidine on ischemia-reperfusion injury of liver and kidney tissues in experimental diabetes and hepatic ischemia-reperfusion injury induced rats

Arslan, Mustafa/0000-0003-4882-5063WOS: 000403851700006Background: Reperfusion following ischemia can lead to more injuries than ischemia itself especially in diabetic patients. The aim of this study was to evaluate the effect of dexmedetomidine on ischemia-reperfusion injury (IRI) in rats with have hepatic IRI and diabetes mellitus. Methodology: Twenty-eight Wistar Albino rats were randomised into four groups as control (C), diabetic (DC), diabetic with hepatic ischemia-reperfusion injury (DIR), and diabetic but administered dexmedetomidine followed by hepatic IRI (DIRD) groups. Hepatic tissue samples were evaluated histopathologically by semiquantitative methods. Malondialdehyde (MDA), superoxide dismutase (SOD), glutathion s-transpherase (GST), and catalase (CAT) enzyme levels were investigated in liver and kidney tissues as oxidative state parameters. Results: In Group DIR; hepatocyte degeneration, sinusoidal dilatation, pycnotic nucleus, and necrotic cells were found to be more in rat hepatic tissue; while mononuclear cell infiltration was higher in the parenchyme. MDA levels were significantly lower; but SOD levels were significantly higher in Group DIRD with regard to Group DIR. In the IRI induced diabetic rats' hepatic and nephrotic tissues MDA levels, showing oxidative injury, were found to be lower. SOD levels, showing early antioxidant activity, were higher. Conclusion: The enzymatic findings of our study together with the hepatic histopathology indicate that dexmedetomidine has a potential role to decrease IRI