Comparison of the harmonic scalpel with scissors in women who experience obturator nerve injury during lymph node dissection for gynaecological malignancies

Objectives: Lymphadenectomy is crucial for accurate staging in most gynecological malignancies. Serious complications can occur during the surgery. The present study aimed to present the early and late findings associated with obturator nerve injury, which is rarely observed during lymphadenectomy but can result in serious sequela if not noticed. Material and methods: The files of the patients who underwent lymphadenectomy at our clinic between 2012 and 2018 were examined. Patients with obturator nerve incisions were identified retrospectively. Results: In total, 287 women patients underwent lymphadenectomy at our clinic between 2012 and 2018. Examination of surgical notes revealed that nine patients underwent obturator nerve incisions using a scissor or a harmonic scalpel (energy- activated ultrasonic scissors). With respect to management of obturator nerve damage, no significant difference was found between the use of a harmonic scalpel and scissors (p < 1.000) and the trendelenburg and lithotomy positions (p < 0.167). In addition, no significant difference was found between laparoscopy and laparotomy in terms of surgical type (p < 0.167). At 6 months post-operatively, sensory-motor examinations and EMG findings of the patients were completely normal. Conclusions: Surgeries performed for gynaecological malignancies have high mortality and morbidity rates. Moreover, in the event of a complication such as nerve damage during laparoscopy, successful management of the complication before the patient undergoes laparotomy allows the patient to continue benefitting from the advantages of the laparoscopy. The results of our study show that these high-risk surgeries should be performed in advanced and well-equipped medical centres by teams experienced in gynaecological oncology

Does intravenous lidocaine added to nonsteroidal anti-inflammatory drugs reduce pain during colposcopy? A prospective randomized double-blind study

Objectives: In recent years, lidocaine infusion for pain management during long operations is becoming more widespread in anesthesiology practice. However, only a limited number of studies have reported the intravenous use of lidocaine for short-term interventions. The aim of this study was to investigate the effectiveness of intravenous lidocaine use in pain management during colposcopic cervical biopsy and endocervical curettage (ECC). Material and methods: Patients between the ages of 18 and 65 years with abnormal cytological findings or who were determined to be human papillomavirus (HPV)-positive were included in this randomized double-blind study. The lidocaine group (Group L, n = 30) was intravenously administered 50 mg dexketoprofen + 1.5 mg/kg lidocaine in 10 mL saline for 3 min 30 min before the procedure. The control group (Group C, n = 30) was intravenously administered 50 mg dexketoprofen in 10 mL saline for 3 min, 30 min before the procedure. During the procedure, pain scores were assessed using the visual analogue scale (VAS). In addition, patients, operator satisfaction and duration of procedure were assessed Results: There were no differences in the demographic data of the groups. Pain scores during biopsy and ECC were significantly lower in Group L than in Group C (p < 0.001). The duration of the procedure was significantly shorter in Group L than in Group C (5.00 ± 0.78 vs 6.12 ± 1.16, respectively; p < 0.001). Patient and operator satisfaction were significantly higher in Group L than in Group C (p < 0.001). Conclusions: Intravenous lidocaine administration can be used as an alternative approach to reduce pain and increase operator and patient satisfaction during colposcopy-directed biopsy and ECC procedures in office settings

The biochemical contents and antioxidant activities of four tanacetum L. taxa

The goal of the present study is to determine some of the biochemical compositions and antioxidant capacities of plant extracts in two endemic taxa for Turkey including T. cadmeum (Boiss.) Heywood subsp. orientale Grierson and T. nitens (Boiss. & Noë) Grierson together with T. polycephalum (L.) Sch.Bip subsp. argyrophyllum (K. Koch) Podlech, and T. parthenium (L.) Sch.Bip. The fatty acids were determined by using gas chromatography, while phenolics, lipid soluble vitamins and sterols were determined by using HPLC and radical scavenging activities, total phenolics, and FRAP were determined spectrophotometrically. It was found that Tanacetum taxa have palmitic acid (C16:0), and stearic acid (C18:0) as major saturated fatty acids and linoleic acid (C18:2 n6), α-linolenic acid (C18:3 n3) and oleic acid (C18:1 n9) as principal unsaturated fatty acids. It was found that Tanacetum taxa had more total unsaturated fatty acid contents (60.24±0.3%- 70.54±0.29%) than saturated fatty acids and it was found that T. parthenium had the highest total essential fatty acid composition (58.65%±0.59%). It was also reported that the omega6/omega3 ratio of T. cadmium subsp. orientale (8.22) differed from other taxa in this study. Also, the present study showed that Tanacetum had the lowest amount of lipid soluble vitamins. On the other hand, catechin was found to be the main polyphenolic compound in this study and it was determined that T. parthenium had the highest catechin (4479.1±5.71 µg/mg) and total phenolic contents (324.91±2.01 µgGAE/mg) in this study. Rutin was only determined in two endemic taxa T. cadmeum subsp. orientale (23±0.91 µg/mg), and T. nitens (5.7±0.27 µg/mg). Also, the naringenin, vanillic acid and caffeic acid amounts of the endemic T. cadmeum subsp. orientale and T. nitens were higher than other taxa in the study. In addition, it was determined that Tanacetum taxa had a high stigmasterol content. However, T. parthenium had a higher ergosterol content (271±2.36 µg/mg). It was also found that T. parthenium has highest D2, α-tocopherol, retinol acetate, ergosterol, and stigmasterol contents among the studied taxa. In addition, the study showed that Tanacetum taxa have strong DPPH and ABTS radical scavenging activities. It was concluded that Tanacetum taxa have potent antioxidant capacity

Coexistence of PFAPA syndrome with separation anxiety

PFAPA syndrome is an auto inflammatory disease. Researchers have stated that auto inflammatory mechanisms can play a role in etiology of several psychiatric diseases and for this reason auto inflammatory diseases are frequently associated with psychiatric disorders. The purpose of this paper, it is aimed to report two cases diagnosed with PFAPA syndrome and having psychiatric symptoms and to discuss them accompanied by literature data. As authors, in the light of cases we report and literature knowledge, we think that children with PFAPA syndrome could be under risk in terms of psychiatric problems due to common inflammatory etiology. [Med-Science 2019; 8(1.000): 247-9

Dynamic characterisation of novel three-dimensional axisymmetric chiral auxetic structure

The study presents an extensive mechanical and computational characterisation of novel cellular metamaterial with axisymmetric chiral structure (ACS) at different strain rates. The Direct Impact Hopkinson Bar (DIHB) testing device was used for impact testing up to 21 m/s striker speed, which was insufficient to reach the shock deformation regime. Thus, using computational simulations to estimate the structure behaviour at high strain rates was necessary. Experimental and computational results showed that all ACS structures exhibit a nominal stress–strain relationship typical for cellular materials. As the loading conditions shifted to a dynamic regime, the micro–inertia effect became increasingly pronounced, leading to a corresponding rise in structure stiffness. The Poisson\u27s ratio in all ACS increases gradually, making them superior to traditional cellular materials, which experience a sudden increase in Poisson\u27s ratio during loading. Additionally, the study found that the structures exhibited a rise in the auxetic effect with an increase in strain rate, highlighting the benefits of axisymmetric structures in high-loading regimes. Overall, the obtained results provide valuable insights into the mechanical properties of ACS under different loading regimes and will contribute to further design improvements and the fabrication of novel ACS metamaterials

TRACE ELEMENT CONTENTS OF RAISINS, GRAPES AND SOIL SAMPLES FROM INCESU-KAYSERI, TURKEY

The concentrations of Pb, Cu, Ni, Zn, Fe, Mn, Cd, Co and Cr in raisins, grapes and soil samples from Incesu-Kayseri were determined by flame atomic absorption spectrometry (FAAS) after digestion. The accuracy of the methods was confirmed by certified reference materials (SRM 2710 Montana Soil and NIST SRM 1515 Apple Leaves). The maximum trace element levels were found to be 732 mu g/g (Fe), 2600 mu g/g (Mn), 48 mu g/g (Zn), 34 mu g/g (Pb), 41 mu g/g (Ni), 38 mu g/g (Cr), 24 mu g/g (Cu), 34 mu g/g (Co), and 4.0 mu g/g (Cd) for soil samples; 62 mu g/g (Fe), 61 mu g/g (Mn), 28 mu g/g (Zn), and 9.8 mu g/g (Cu) for raisin samples; 14.8 mu g/g (Fe), 41.8 mu g/g (Mn), 20.4 mu g/g (Zn), 1.6 mu g/g (Ni), 0.6 mu g/g (Cr), and 2.4 mu g/g (Cu) mu g/g for grape samples from Incesu. The concentrations of trace metals were dependent on grape and soil species. Some of the analyzed samples were accumulated with trace heavy metals