Demonstration of the histopathological and immunohistochemical effects of a novel hemostatic agent, ankaferd blood stopper, on vascular tissue in a rat aortic bleeding model

Background: Ankaferd Blood Stopper®(ABS) is a folkloric medicinal plant extract used as a hemostatic agent in traditional Turkish medicine. This experimental study investigated the histopathological and immunohistochemical effects of ABS on vascular tissue in a rat model of aortic bleeding.Methods: Four groups of 11 Wistar albino rats were used. The abdominal aortas of the rats were wounded; an ABS-soaked tampon was applied to rats in Groups 1 and 3, and a plain gauze tampon was applied to rats in Groups 2 and 4 until the bleeding stopped. The bleeding time was recorded. Immediately following sacrificing, the arteriotomy sites from Groups 1 and 2 were removed. The abdominal incisions in Groups 3 and 4 were closed following hemostasis. On Day 7 of the study, Group 3 and 4 rats were sacrificed and the abdominal aorta arteriotomy sites were removed for histopathological and immunohistochemical evaluation.Results: The mean bleeding time in 15 animals in Groups 2 and 4 was 4.9 ± 0.6 s, and in 22 animals in Groups 1 and 3 was 3.1 ± 0.6 s. Distal aortic occlusion was not observed on either Day 1 or 7 in any group. Significantly more widespread and dense endothelial nitric oxide synthase (eNOS) staining was observed in Group 1 animals than Group 2. On Days 1 and 7 after application of ABS, histopathological changes, consisting of necrosis, inflammation, and endothelial cell loss, in the rat abdominal aortas did not differ between Groups 1 and 2. The basophilic discoloration in the ABS group on the operation day was a result of a foreign body reaction and hemosiderin-loaded histiocyte accumulation, which occurred on Day 7.Conclusions: In this study, hemostasis was successfully achieved with ABS in rat abdominal aortas. No histopathological change was found in the rat abdominal aortas between the ABS and control groups on Days 1 and 7. Further studies on the long-term effects of foreign body reactions and hemosiderin-loaded histiocyte accumulation are required. © 2010 Kandemir et al; licensee BioMed Central Ltd

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Evaluation of the cervical vertebral anomalies in patients with cleft lip and palate in Aegean region of Turkey

Objective: To identify the cervical vertebral anomalies in patients with cleft lip and palate, and to compare unilateral and bilateral cleft lip and palate. Methods: The retrospective cohort study was conducted in 2018 at Department of Orthodontics, Ege University, Izmir, Turkey, and comprised non-deteriorated lateral cephalometric radiographs of non-syndromic patients which showed the entire cervical spine. The radiographs were divided into two groups, with group A having those of patients with cleft lip and palate exposure, and control group B having those with non-exposure. Within group A, unilateral and bilateral cleft lip and palate cases were compared. Data was analysed using SPSS 22. Results: Of the 220 subjects, 110(50%) were in group A with a mean age of 15 +/- 6.3 years, and 110(50%) were in group B with a mean age of 15 +/- 2.1 years. Within group A, 56(50.9%) subjects had unilateral and 54(49.1%) had bilateral cleft lip and palate. Cervical vertebral anomalies were found in 71(64.5%) patients and 45(40.9%) controls (p<0.001). Among those with bilateral condition, it was found in 41(75.9%) and in unilateral 56(56.6%) (p<0.05). Occipitalisation was 21(38.9%) in bilateral and 4(7.1%) in unilateral cases (p<0.001). Fusion was higher in bilateral patients 16(63%) compared to 23(41.1%) unilateral (p<0.05). Posterior arch deficiencies were found in 30(27.3%) patients in group A and 18(16.4%) controls in group B (p<0.05). Fusion was seen in 57(51.8%) group A patients and 33(30%) group B controls (p<0.001). Conclusion: Cervical vertebral anomalies were mostly found in patients with cleft lip and palate. In patients with bilateral condition, more than one anomaly was seen

Visual perception of faces with unilateral and bilateral cleft lip and palate: An Eye-Tracking Study

WOS: 000397052400006PubMed ID: 28102012Objectives: To test the hypotheses that there are differences between orthodontists, individuals with cleft lip and palate (CLP) and laypersons in the visual perception of faces with unilateral (UCLP) and bilateral cleft lip and palate (BCLP), the faces with UCLP and BCLP are visually perceived differently and the hierarchy of visual attention changes when viewing individuals with CLP. Setting and Sample Population: Department of Orthodontics and Experimental Psychology at Ege University, Izmir. Sixty images ( faces with a social smile and at rest) of 30 volunteers (unaffected controls, UCLP, BCLP) were viewed by 80 participants: orthodontists, individuals with CLP and laypersons. Materials and Methods: Eye fixations on four areas of interest were quantified: eyes, nose, upper lip and lower lip-chin. Time to first fixation, fixation before, fixation count and fixation duration parameters were analysed. Results: Orthodontists fixated on the upper-lip area more often than laypersons or individuals with CLP (F-2.144= 8.47, P=. 00,. eta(2) =. 19 in faces at rest). The upper-lip area received more fixations (F2.144=21.93, P=. 00,. eta(2) =. 23) and longer fixation durations ( F2.144= 28.86, P=. 00,. eta(2) =. 27) from all participants who gazed on faces with UCLP and a social smile. Conclusion: The hypotheses of the study were supported. Orthodontists and laypersons focused more attention on the upper lip and eyes in the resting position, respectively. The upper-lip area of the BCLP images captured more attention at rest

A corpus-based analysis of discourse strategy use by English-Medium Instruction university lecturers in Turkey

This article reports a descriptive study that analyzed the discourse strategies used by Turkish university lecturers when delivering academic content in English. Through non-participant observation of English-Medium Instruction (EMI) lessons delivered by seven lecturers from five universities, a corpus of 13 h of recorded data was constructed. The lecturers' strategic language behaviors were identified and categorized based on the taxonomy developed by Dörnyei and Scott (1995), later elaborated by Sánchez-García, (2019). Corpus-based analysis revealed that the lecturers employed a wide range of discourse strategies, the majority of which were fillers, self-rephrasing, and code-switching. Thematic analysis showed that these discourse strategies offered two chief functions: (i) to cope with linguistic issues and (ii) to further students' comprehension. The results also revealed that most strategies only have medium communicative potential. This study highlights the necessity and significance of lecturer professional development to enhance the quality of EMI provision through the employment of discourse strategies that warrant greater communicative potential