Comparison of Clinical and Hemodynamic Effects of Isoflurane and Sevoflurane Anesthesia in Calves

Background: Inhalation anesthesia is the preferred method for use on many animal species, including ruminants, due to its superiority over the injectable anesthetics. The most commonly used inhalation anesthetics are isoflurane and sevoflurane The aim of the study was to investigate the effects of isoflurane and sevoflurane anesthesia on the cardiovascular system of calves.Materials, Methods & Results: A total of 20 calves (11 male, 9 female) between 1 and 6 months in age and 50 to 85 kg in body weight were used. The calves were divided randomly into two groups of 10 each, with one group being administered isoflurane and the other sevoflurane. An intramuscular dosage of 0.1 mg/kg of xylazine was administered to the calves as premedication. Induction was performed 10 min after calves were given an intramuscular dosage of 4 mg/kg of ketamine. Inhalation anesthesia was maintained with isoflurane or sevoflurane in 100% oxygen saturation. Before anesthesia, after induction and at intervals of 5, 10, 15, 20, 25, 30, 45, and 60 min of anesthesia, the body temperature, heart rate, and respiratory rate of the calves were recorded. Additionally, before anesthesia, after induction and at intervals of 15, 30, 45, and 60 min of anesthesia, serum electrolyte (Na+, Ca++, K+, Mg++) and blood gases (pH, pCO2, pO2, HCO3-, TCO2, O2Sat, HCT) were evaluated from blood samples taken from both groups. The second derivation, durations and amplitudes of the P and T waves, the durations and amplitudes of the QRS complex, and the durations of PQ and QT intervals were evaluated on the ECGs recorded before anesthesia, after induction and during anesthesia. Following anesthesia termination, the extubation time and the time it took for straightening of the head and standing up were recorded. Decrease in heart rate and body temperature were found significant in two of the groups. Decrease in respiratory rate compared to initial values after premedication was statistically significant for both groups. However, during anesthesia, an increase occurred. This incresae in respiration rate was not statistically significant compared to initial values. The incease in the values of pCO2, pO2, HCO3 and the decrease in the values of pH and Hct comparing the initial values was found statistically significant in both groups.Discussion: In ruminants, isoflurane has an induction concentration of 3-5% and an anesthetic concentration of 1.5-3%, while sevoflurane has an induction concentration of 4-6% and an anesthetic concentration of 2.5-4%. In this study, the concentration of isoflurane was 2.3% (2-5) and the of sevoflurane was 4.07% (3-5) for surgery. In the isoflurane group, extubation, straightening of the head and standing up times were 12.40 ± 3.77 min, 20.4 ± 1.57 min, and 30.80 ± 1.89 min, respectively. In the sevoflurane group, extubation, straightening of the head and standing up times were 13.40 ± 4.99, 19.2 ± 1.49, and 28.0 ± 1.83 min, respectively. Although the calves in the isoflurane group were extubated earlier than those of the sevoflurane group, the time elapsed for straightening of the head and standing up were longer than that of the sevoflurane group. The anesthesia protocol provided a smooth anesthetic administration, general anesthesia and awakening. In conclusion, the effects of isoflurane and sevoflurane anesthesia on the cardiovascular and respiratory system were similar, and although the changes that emerged during anesthesia were statistically significant, it was nonetheless found that the changes were within the physiological limits

Challenges and lessons learned in mental health research among refugees: a community-based study in Turkey

Background Turkey hosts nearly four million refugees and 99% live in urban areas. Research in urban settings pose different challenges and opportunities than research in refugee camps. In this article, we aimed to share the challenges and experiences we encountered in a mixed-methods study to assess mental health problems and barriers to accessing mental health care among refugees in urban areas of Turkey. Discussion In our case, the main challenges in conducting research with refugees were collecting data from a highly traumatized population, difficulties with contacting undocumented asylum seekers including trust issues and the fear of deportation, the risk of secondary traumatization among data collectors, and the bureaucracy during study approval processes. Targeting a representative sample was not feasible, because of the lack of publicly available demographic data on a district level, presence of undocumented asylum seekers and high mobility among the refugees. Although respondents with significant psychological symptoms were routinely referred to available mental health services, we were able to do less for unregistered refugees with problems in accessing health care. Language/alphabet differences and differing dialects of Arabic posed another challenge in both translation and administration of the scales. Based on cultural characteristics, a gender-balanced team was used and the interviewers were gender-matched whenever needed. Also, the research team had to work after work hours and during weekends to be able to interview male refugees, since most refugee men were at work during working hours and most days of the week. Conclusions The research team’s experience showed that refugee population characteristics including level of trauma, language, culture, gender, legal status, and urban setting characteristics including places of living, mobility, availability of publicly available demographic data, and outreach-related barriers lead to different challenges and ethical responsibilities of researchers and affect the research costs in terms of time, human resources and finance. Even in a host country with geographical, religious and cultural proximity to the refugees, profound challenges exist in conducting mental health research in urban settings. Learning from previous experience and collaborating with local researchers and institutions are vital for better public health research and practice outcomes

Clinical presentation of abdominal tuberculosis in HIV seronegative adults

BACKGROUND: The accurate diagnosis of abdominal tuberculosis usually takes a long time and requires a high index of suspicion in clinic practice. Eighty-eight immune-competent patients with abdominal tuberculosis were grouped according to symptoms at presentation and followed prospectively in order to investigate the effect of symptomatic presentation on clinical diagnosis and prognosis. METHODS: Based upon the clinical presentation, the patients were divided into groups such as non-specific abdominal pain & less prominent in bowel habit, ascites, alteration in bowel habit, acute abdomen and others. Demographic, clinical and laboratory features, coexistence of pulmonary tuberculosis, diagnostic procedures, definitive diagnostic tests, need for surgical therapy, and response to treatment were assessed in each group. RESULTS: According to clinical presentation, five groups were constituted as non-specific abdominal pain (n = 24), ascites (n = 24), bowel habit alteration (n = 22), acute abdomen (n = 9) and others (n = 9). Patients presenting with acute abdomen had significantly higher white blood cell counts (p = 0.002) and abnormalities in abdominal plain radiographs (p = 0.014). Patients presenting with alteration in bowel habit were younger (p = 0.048). The frequency of colonoscopic abnormalities (7.5%), and need for therapeutic surgery (12.5%) were lower in patients with ascites, (p = 0.04) and (p = 0.001), respectively. There was no difference in gender, disease duration, diagnostic modalities, response to treatment, period to initial response, and mortality between groups (p > 0.05). Gastrointestinal tract alone was the most frequently involved part (38.5%), and this was associated with acid-fast bacteria in the sputum (p = 0.003). CONCLUSION: Gastrointestinal tract involvement is frequent in patients with active pulmonary tuberculosis. Although different clinical presentations of patients with abdominal tuberculosis determine diagnostic work up and need for therapeutic surgery, evidence based diagnosis and consequences of the disease does not change

A Fragment of the Us?isavijaya Dhara?i from Turfan Housed in the Museum fur Asiatische Kunst in Berlin

This paper deals with an edition of a newly identifi ed fragment of the Us?isavijaya Dhara?i in Old Uyghur from Turfan, which is preserved in the collection of Museum fur Asiatische Kunst (Museum of Asian Art) in Berlin. The fragment basically represents the dhara?i part of the Us?isavijaya Dhara?i in Old Uyghur script. The fragment is compared with the parallel Old Uyghur fragments that also include the dhara?i section and are preserved in the Berlin Turfan collection. The transcription and transliteration of the work is given. Its versions in other languages are compared to explore diff erences between the texts. Finally, a reconstructed text is presented

SELECTING STATISTICAL METHODS IN MEDICAL RESEARCHES

- [TAF Prev Med Bull 2004; 3(7.000): 162-163

Does Gender Affect The Relationship Between Anxiety Sensitivity And Social Anxiety?

Objective: Although there are studies on the effects of gender and time on social anxiety and anxiety sensitivity, there is no consensus on how these variables moderate the relationship between the two. The aim of this study was to examine the effect of the last year of medical school on social anxiety and to determine the predictors of social anxiety, focusing mainly on gender and anxiety sensitivity. Methods: The study was conducted at two time points. Demographic Information Questionnaire, Liebowitz Social Anxiety Scale and Anxiety Sensitivity Index (ASI) were given to medical school students at Time 1 (n=153): beginning of 6th year of medical school; and at Time 2 (n=130): end of the 6th year. Results: Male gender predicted social anxiety at Time 1 but not at Time 2. Maternal education negatively predicted social anxiety in males; no prediction was observed for females. Psychiatric illness in the family and ASI scores predicted social anxiety. The total scores of social anxiety and anxiety sensitivity did not change over a course of 10 months. ASI subscale scores were not uniform in predicting social anxiety. Conclusions: Our results have confirmed the strong relationship between anxiety sensitivity and social anxiety. Higher maternal education appeared to be a protective factor against social anxiety among males but not among females. It is apparent that a whole educational year of internship does not lead to a significant reduction in social anxiety. We also showed that the physical sensations scale of ASI is sufficient to explain the relationship between anxiety sensitivity and social anxiety.WoSScopusTr-Dizi

Traumatic Stress in Emergency Medical Technicians: Protective Role of Age and Education

WOS: 000366243000003PubMed ID: 26731020Objective: Some professions carry higher risk of being traumatised; health care workers, especially those working at emergency services, are at higher risk in this respect. This study aims to examine the psychological effects of different types of work-related traumatic events on emergency health care staff and possible protective effects of factors such as age, education and experience. Method: The targeted population was all emergency health care workers working at emergency wards and first-aid stations within the province of Nigde. Consenting subjects were given self-report questionnaires on traumatic stress and work-related traumatic events. 135 emergency workers (90 female, 45 male), with complete data sets were included in the study. Results: The subjects reported experiencing 6.8 types of different work-related traumas. Those who are older and with higher education reported higher numbers of event types. Traumatic stress levels were predicted by higher number of reported work-related trauma types. When analyzed separately within age and education groups, number of work-related traumatic events predicted traumatic stress among younger subjects and those with lower education; no such prediction was observed among older or more educated subjects. Conclusion: Findings suggest that lower education and younger age independently predict negative psychological effects of work-related traumatic events. These findings may lead to changes in how emergency health care is organized in Turkey

Cognitive Dysfunctions In Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) is a condition that occurs after a traumatic event, and its diagnostic criteria include attention and memory deficits as well as symptoms of anxiety. We aimed to review the literature related to attention, memory, and executive functions in PTSD. Although studies on the subject are limited (in that there is no uniformity in terms of trauma type, selection of the control groups or types of neuropsychological tests used), most reported similar deficits in PTSD subjects in terms of memory and executive functions including attention. Since the presence of psychiatric comorbidities may disrupt neuropsychological functions, results of studies that have not controlled comorbidity may be questionable. However, studies that excluded the comorbid conditions reported similar deficits in cognitive functions in PTSD patients. The relationship between recovery from PTSD symptoms and change in cognitive functions has been examined in only a few studies, and most have reported an improvement for both memory and executive functions in remitted patients. The improvement in executive functions, however, has been limited by the difficulty of task. Cognitive deficits have been among the major causes of disabilities in PTSD patients. Therefore, the amount of improvement in cognitive dysfunctions by current treatments of PTSD deserves more attention.WoSScopu