The addition of droperidol or clonidine to epidural tramadol shortens onset time and increases duration of postoperative analgesia

Purpose: To compare tramadol alone and the combinations of either tramadol-clonidine or tramadol-droperidol with regard to analgesic and adverse effects. Methods: After Ethic's Committee approval and patient informed consent were obtained, epidural catheters were inserted preoperatively at the L3-4 interspace in 90 ASA physical status I-II adult patients undergoing lower abdominal surgery. Anesthesia was standardized. Patients were randomly assigned to one of three groups. Group I (T) patients received tramadol 75 mg, Group II (TD) patients received tramadol 75 mg plus droperidol 2.5 mg, and Group III (TC) patients received tramadol 75 mg plus clonidine 150 μg in a total volume of 10 mL administered as a single epidural injection in the postanesthesia care unit. The onset time of analgesia and duration of analgesia, visual analogue pain scores, sedation, nausea scores, vital signs and side effects were recorded. Results: Duration of analgesia was similar in both the TD and TC groups, and significantly longer than in the T group (P < 0.001). Group TC patients displayed a significant increase in sedation scores and decrease in blood pressure and heart rate when compared with other groups (P < 0.001). No adverse effects were observed in Group TD, while nausea scores were high in both the T and TC groups (P < 0.001). Pain score, respiration rate, and SpO2 values were similar in all study groups. Conclusion: We conclude that epidural tramadol in combination with droperidol or clonidine prolongs the duration of analgesia; however, droperidol appears to be a better alternative when adverse effects and antiemetic properties are taken into consideration

The Yo-Yo IR2 test in professional basketball players

The aim of this study was to investigate the relationship between direct method and indirect method (Yo-Yo Intermittent Recovery Test Level II) that are used to determine aerobic capacity and endurance. Fourteen basketball players (22.49 ±04.82 year-old with the height 192.36±5.90 cm, weight 89.21±7.6 kg, Body fat percentage 11.07 ± 1.82 %) voluntarily participated in this study. Yo-Yo Intermittent Recovery Test Level II protocol (YIRT 2) was implemented to participants. Distance covered by the athletes, estimated VO2max, direct VO2max, Anaerobic threshold VO2 and Anaerobic threshold heart rate (HRAT) values were recorded. Direct VO2max and other respiratory parameters were measured with telemetric gas analyzer. After 5 minute rest in supine position heart rates (HRrest), rest lactate levels (LArest) and maximal heart rate (HRmax) during the test and post test lactate levels (LApost) were measured. Pearson Correlation Test was used to determine the relationship between the variables. P value was set at 0,05. According to the findings, positively significant large correlation was found between estimated VO2max and direct VO2max(r = 0.504, p < 0.05), HRmax (r = 0.501, p < 0.05), positively significant large correlation was found between distance and Direct VO2max(r = 0.521, p < 0.05), HRmax (r = 0.516, p < 0.05). There is no significant relationship except above-mentioned variables (p<0.05). YIRT2 can guess VO2max of professional male basketball players and can be used to evaluate endurance

Colliding Wave Solutions in a Symmetric Non-metric Theory

A method is given to generate the non-linear interaction (collision) of linearly polarized gravity coupled torsion waves in a non-metric theory. Explicit examples are given in which strong mutual focussing of gravitational waves containing impulsive and shock components coupled with torsion waves does not result in a curvature singularity. However, the collision of purely torsion waves displays a curvature singularity in the region of interaction.Comment: 16 pages, 1 ps figure, It will appear in Int. Jour. of Theor. Physic

Nonlocal Reductions of The Multicomponent Nonlinear Schrödinger Equation on Symmetric Spaces

Our aim is to develop the inverse scattering transform for multicomponent generalizations of nonlocal reductions of the nonlinear Schrödinger (NLS) equation with PT symmetry related to symmetric spaces. This includes the spectral properties of the associated Lax operator, the Jost function, the scattering matrix, the minimum set of scattering data, and the fundamental analytic solutions. As main examples, we use theManakov vector Schrödinger equation (related to A.III-symmetric spaces) and the multicomponent NLS (MNLS) equations of Kulish–Sklyanin type (related to BD.I-symmetric spaces). Furthermore, we obtain one- and two-soliton solutions using an appropriate modification of the Zakharov–Shabat dressing method. We show that the MNLS equations of these types admit both regular and singular soliton configurations. Finally, we present different examples of one- and two-soliton solutions for both types of models, subject to different reductions

Down Sendromlu Çocukların Klinik ve Ekokardiyografik Değerlendirmesi

Amaç: Down sendromu sık rastlanan kromozomal hastalıklardan biridir. Bu hastalarda doğumsal kalp hastalıkları sık görülmekte ve sendromdaki en önemli mortalite ve morbidite nedenini oluşturmaktadır. Çalışmada, Çocuk Kardiyoloji Ünitemize Down sendromu tanısı ile başvuran hastaların demografik özellikleri, eşlik eden doğumsal kalp hastalıkları ve ek anomalileri değerlendirildi.Gereç ve Yöntemler: Ocak 2010-Aralık 2015 tarihleri arasında Çocuk Kardiyoloji Bölümüne başvuran Down Sendromlu toplam 107 olgunun verileri değerlendirildi.Bulgular: Down sendromlu hastaların %77.5'in de doğumsal kalp hastalığı mevcuttu. Bu hastaların %49.3'ün de sekundum tip atriyal septal defekt, %33.7'sinde ventriküler septal defekt, %18.1'inde komplet tip atriyoventriküler septal defekt, %10.8'inde patent duktus arteriyosuz, %3.7'sinde biküspit aortik kapak saptandı. Birer olguda ise pulmoner stenoz, aort koarktasyonu ve fallot tetralojisi vardı. Eşlik eden ek anomalilere bakıldığında; hastaların %38.3'ün dehipotiroidi, %6.5'inde görme bozukluğu, %5.6'sında işitme problemleri, %3.7'sinde inmemiş testis vardı. Hipotiroidisi olan hastalarda kardiyak defektlerin daha fazla olduğu gözlendi (p0.05).Sonuç: Down sendromlu hastalarda doğumsal kalp hastalıkları sık görülmektedir. Klinik belirti ve bulgu olmasa da bu çocukların kardiyak açıdan değerlendirmesi, erken tanıyı sağlayacak ve ileride ortaya çıkabilecek geri dönüşümsüz komplikasyonların gelişmesini engelleyecekti

Mean Platelet Volume and the Ratio of Mean Platelet Volume/Platelet Count in Acute Rheumatic Fever

Aim: Acute rheumatic fever (ARF) is an endemic disease especially in developing countries. Due to an autoimmune response to group B streptococcus throat infection, ARF develops in susceptible children. Mean platelet volume (MPV) reflects the platelet size and the rate of platelet production. It is important in cardiovascular events and rheumatic diseases. The MPV/platelet count ratio was determined to be more sensitive than MPV alone in patients with hepatocellular carcinoma, deep vein thrombosis and myocardial infarction. The aim of this study was to investigate changes in MPV and the MPV/platelet count ratio during the active and remission periods of ARF compared with healthy subjects. Materials and Methods: This study population consisted with 70 ARF patients and 70 age and gender matched healthy controls. In all subjects, complete blood count; including haemoglobin, white blood cell count (WBC), platelet count, MPV and C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were measured during the active stage and during the remission period and compared with healthy individuals. Results: There was no statistically significant difference between the ARF and control groups in terms of the sex and age (p>0.05). Forty-one patients in the ARF group had carditis. The ARF patients in the active stage had significantly higher WBC, CRP and ESR values (p0.05). Although no significant difference was observed in MPV between the groups (p>0.05); the MPV/platelet count ratio was low during the active stage but increased during the remission period and reached the same values as the healthy controls (p0.001). Conclusion: We did not find any relationship between MPV and ARF. However, a decreased MPV/platelet count ratio was detected during the active stage of ARF. The present findings emphasize the association between the MPV/platelet count ratio and ARF. The MPV/platelet count ratio may be used to determine the activity of ARF

Postoperatif ağrı kontrolünde epidural tramadol, tramadol-droperidol ve tramadol-klonidin kombinasyonlarının karşılaştırılması

Bu çalışmada, postoperatif ağrı kontrolünde, epidural yolla uygulanan tramadol, tramadol-droperidol ve tramadol-klonidin kombinasyonlarının, etkinlik ve yan etki açısından karşılaştırılmaları amaçlandı. Etik komite ve hastaların onayı alındıktan sonra, alt batın cerrahisi geçiren ASA I-II grubu, 90 erişkin hastaya preoperatif LlJf aralığından, direnç kaybı yöntemi ile epidural kateter yerleştirildi. Postoperatif dö-nemde, rasgele üç eşit gruba ayrılan hastalardan; 1. gruba 75 mg tramadol (T), 2. gruba 75 mg tramadol-2.5 mg droperidol (TD) ve 3. gruba 75 mg tramadol-150 /ıg klonidin (TK), toplam 10 mi volümde epidural yolla uygulandı. Analjezi başlama zamanı, analjezi süresi, görsel ağrı (VAS), sedasyon, bulantı skorları, kan basın-cı, kalp hm, solunum sayısı ve Sp02 değerleri ile yan etkiler kaydedildi. Analjezi süreleri, TD ve TK gruplarında T grubuna göre ileri derecede anlamlı bir uzama gösterirken (p0.001), iki grup arasında benzer bulundu. TK grubunda diğer gruplara göre anlamlı sedasyon artışı (p0.001), kan basıncı ve kalp hızında azalma saptandı (p0.01). T ve TK gruplarında ileri derecede anlamlı bulantı-kusma ile karşılaşılırken (p0.001), TD grubunda hiç bir yan etki görülmedi. VAS, solunum sayısı ve Sp02 değerlerinde gruplar arasında farklılık bulunmadı. Sonuç olarak epidural tramadole, droperidol ya da klonidin eklenmesiyle daha uzun süreli bir analjezi sağlandığı, ancak yan etki profili ve antiemetik özelliği bakımından droperidolün daha uygun bir adjuvan olduğu kanısına varıldı