The importance of perfusion index monitoring in evaluating the efficacy of stellate ganglion blockage treatment in Raynaud’s disease

Stellate ganglion blockage (SGB) is a method used for treating Raynaud’s phenomenon (RP). This study primarily aimed to determine whether the perfusion index (PI) can be used an alternative to Horner’s signs in evaluating the efficacy of SGB in patients diagnosed with RP. In a total of 40 patients, aged 18–65 years and diagnosed with primary RP, SGB was applied for 5 days on the same side with the 2-finger method, using 6 mL of 5% levobupivacaine at the 7th cervical vertebra level. The PI values were recorded from the distal end of the 2nd finger of the upper extremity on the side applied with the block at baseline and at 5, 15, 30, 60 and 120 min. The onset time of Horner findings was recorded. The PI values and visual analogue scale (VAS) pain scores were recorded pre-treatment and after 2 weeks.When the PI values of the 40 patients were examined, a 62.7% increase was observed from baseline to the first session at 5 min (p < 0.05). When all sessions were evaluated, a statistically significant increase was determined in the PI values measured at 5, 15, 30, 60 and 120 min compared with the baseline PI values. There was a statistically significant decrease in the post-treatment VAS pain scores and a statistically significant increase in the post-treatment PI values (p < 0.05). By eliminating peripheral vasospasm with the application of SGB in patients with RP, the distal artery blood flow and PI are increased. PI measurement is a more objective method and therefore could be used as an alternative to Horner findings in evaluating the success of SGB. PI is a non-invasive and simple measurement and also an earlier indicator in evaluating the success of SGB than Horner’s signs.Keywords: Raynaud’s phenomenon; perfusion index; stellate ganglion blockage; pain; Horner's sig

Paleoseismology of the North Anatolian Fault at Güzelköy (Ganos segment, Turkey): Size and recurrence time of earthquake ruptures west of the Sea of Marmara

International audienceThe Ganos fault is the westernmost segment of the North Anatolian Fault that experienced the Mw = 7.4 earthquake of 9 August 1912. The earthquake revealed 45-km-long of surface ruptures inland, trending N70 E, and 5.5 m of maximum right lateral offset near Güzelköy. The long-term deformation of the fault is clearly expressed by several pull-apart basins and sag ponds, pressure and shutter ridges and offset streams. In parallel with detailed geomorphologic investigations, we measured co-seismic and cumulative displacements along the fault, and selected the Güzelköy site for paleoseismology. A microtopographic survey at the site yields 10.5 AE 0.5 m and 35.4 AE 1.5 m cumulative lateral offsets of stream channels and geomorphologic features. Seven paleoseismic parallel and cross-fault trenches document successive faulting events and provide the timing of past earthquakes on the Ganos fault segment. Radiocarbon dating of successive colluvial wedges in trench T1, and the fresh scarplet above (probably 1912 surface rupture) indicate the occurrence of three faulting events since the 14th century. Parallel trenches (3, 5, 6 and 7) expose paleo-channels and show a cumulative right-lateral offset of 16.5 AE 1.5 m next to the fault, and 21.3 AE 1.5 m total channel deflection. Radiocarbon dating of past channel units and fault scarp-related colluvial deposits imply an average 17 +/À 5 mm/year slip rate and 323 AE 142 years recurrence interval of large earthquakes during the last 1000 years on the Ganos fault. The succession of past faulting events and inferred slip rate west of the Marmara Sea provide more constraint on the long-term faulting behavior in the seismic gap of the North Anatolian Fault and may contribute to a better seismic hazard assessment in the Istanbul region

Use of Complementary and Alternative Medicine Practices in Patients Admitted to The Pediatric Neurology Outpatient Clinic

Introduction: Despite the developments in pharmacologic treatments, traditional and complementary therapies have recently gained popularity in our country, as well as around the world. Aim: To question complementary and alternative medicine practices CAMP during clinical visits of pediatric neurology patients, to raise awareness of families and patients about the use of complementary and alternative medicine, and to prevent possible negative interactions. Methods: This prospective survey study was conducted with the parents of 300 pediatric patients aged between 6 months and 18 years, who were being treated at the Child Neurology Clinic between March 1st and May 30th, 2020. For the study, 360 patients’ parents who came to the Pediatric Neurology clinic for treatment were randomly selected, and a face-to-face survey lasting 2 minutes was conducted with 300 patients’ parents who agreed to participate in the study. This study was approved with the decision number E-20-12-62 at the meeting dated 21.12.2020 of the Clinical Research Ethics Committee of SBU Ankara Dr Sami Ulus Gynecology and Childhood Health and Diseases Training and Research Hospital. Results: Three hundred parents (56% women) participated in the study. Just over half (55.3%) of the patients were followed up with a diagnosis of epilepsy, 56.6% of the parents stated that they had used traditional and complementary therapy methods before, 43.4% stated that they did not use it, 46.54% stated that they used prayer and 23,9% used vitamin methods, respectively. Conclusion: In neurologic diseases, parents use traditional and complementary therapies as treatment methods, creating an alternative to modern medicine. Families and patients should be informed by investigating the reasons and frequency of using traditional and complementary therapies, raising the awareness of parents, and determining the possible harm caused by traditional and complementary therapies

Effects of modified atmosphere packaging on the storage and shelf life of Hicaznar pomegranate fruits

This study compared the postharvest quality of Hicaznar pomegranate fruit unpackaged and packaged with 5-kg or 12-kg bags of two different modified atmosphere packaging (MAP) materials (X5, X12, L5, and L12) during 6 months of storage at 6 °C. The fruits were also evaluated during a simulated shelf life period at 20 °C for 7 days after each cold storage period. The MAP bags significantly reduced the loss of titratable acidity and ascorbic acid content and retarded husk discoloration of the fruit during cold storage and the shelf life period. The incidence of fungal decay was lower in fruit packaged with MAP bags than unpackaged fruit. X5 and X12 MAP bags were more effective in reducing weight loss and husk scald than L5 and L12 MAP bags. X5 and X12 MAP bags maintained initial red aril color intensity and antioxidant properties of Hicaznar pomegranates throughout cold storage and the shelf life period. Unpackaged control fruit remained marketable for only 4 months at 6 °C plus shelf life period, while packaged fruit maintained visual quality for up to 6 months at 6 °C plus shelf life period

Panic Disorder Induced by a "Herbal" Product Containing Sibutramine: Case Series with Review of Literature

Sibutramine is a serotonin and noradrenaline reuptake inhibitor which has been used for weight loss in obese patients. There are slimming products on the market claiming to be 'natural' which nevertheless contain sibutramine. In this report, we present three cases where panic attacks were associated with the use of a product and persisted even long after its discontinuation

Sellar-Parasellar Brown Tumor: Case Report and Review of Literature

Brown tumors are the end stage of primary or secondary hyperparathyroidism. Such lesions are rare because hyperparathyroidism is now usually diagnosed and treated before they develop. Skeletal bone is most frequently involved, whereas sellar-parasellar involvement is extremely rare. We report a patient with a brown tumor involving the sellar-parasellar region associated with primary hyperparathyroidism. The patient's clinical history and biochemical and radiological tests were used for the diagnosis. Excision of the sellar-parasellar mass enabled histopathological confirmation and surgical decompression of neural structures. After the transsphenoidal surgery, excision of a parathyroid adenoma normalized the patient's metabolic status. Brown tumors are rarely associated with complications but occasionally may compress neural structures such as the optic nerve as they enlarge