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Öğe Anesthetic management for super-super morbidly obese patient(Anaesthesia Pain & Intensive Care, 2014) Erbas, Mesut; Toman, Huseyin; Kiraz, Hasan Ali; Simsek, Tuncer; Arik, M. Kasim; Uyan, Berna; Sahin, HasanObesity leads to several changes in both airway and drug metabolism. The problems are compounded in cases of super super morbid obesity. Gastric banding surgery for weight loss was planned for a 47 year old, super-super morbidly obese female patient (164 kg and 151 cm, BMI: 72 kg/m(2)). On pre-operative examination, patient had a short thick neck and grade 4 Mallampatti class. Induction of anesthesia was done in the sitting / semi-sitting position Maintenance was provided with 6% desflurane and O-2/air mixture. Remifentanil infusion of 0.05 mu g/kg was administered during surgery. Patient had an uneventful recovery. The use of short acting drugs and appropriate monitoring provided hemodynamic stability and a fast and smooth recoveryÖğe Comparing the effect of two different induction regimens with thiopental on hemodynamics during laryngoscopy and tracheal intubation in hypertensive patients(Anaesthesia Pain & Intensive Care, 2018) Ural, Sedef Gulcin; Yazicioglu, Dilek; Simsek, Tuncer; Erbas, Mesut; Sahin, Hasan; Altinisik, Hatice BetulObjective: Inj thiopental is known to result in hypotension during induction, and the effect is more pronounced in hypertensive patients. This study aimed to compare the effect of two different anesthesia induction regimens with pentothal in managing the hemodynamic response to laryngoscopy and endotracheal intubation in known hypertensive patients. Methodology: The study was conducted in Van Educational Research Hospital in 2014 after approval from the ethics committee and informed consent from patients were obtained. The prospective, double-blind, randomized study included the American Society of Anesthesiologists (ASA) grade II-III 90 patients, aged 40-65 y, scheduled for elective abdominal surgery with general anesthesia. Thiopental (3-7 mg/kg) was given to the patients in Group 1 (n = 45) with single dose injection in 20 s. In Group 2 (n = 45), first 75% of the thiopental dose was given, and after the bispectral index- based scale (BIS) value was < 60 and after injecting neuromuscular blocking agent, the rest of the thiopental dose was added and injection duration was recorded. In both groups, midazolam 0.05-0.1 mg/kg was administered for premedication. Fentanyl and rocuronium were used in both groups to complete induction. During the first 25 min, systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, and heart rate of the patients were recorded. Also, BIS values after induction and total additional fentanyl requirement were recorded. Results: Heart rate, mean arterial pressure, and additional fentanyl requirement was significantly lower in Group 2. BIS values were also lower in Group 2. Induction duration was higher in Group 2, but hemodynamic control was more satisfying. Conclusion: The study indicated that injection of thiopental in divided doses is more comfortable and safe when considering hemodynamic instability during anesthesia induction in hypertensive patients.Öğe Comparison of effects of sugammadex and neostigmine on QTc prolongation in rabbits under general anesthesia(Acta Cirurgica Brasileira, 2014) Erbas, Mesut; Toman, Huseyin; Sahin, Hasan; Kiraz, Hasan Ali; Barutcu, Ahmet; Simsek, Tuncer; Yener, Ali UmitPURPOSE: To compare the effects of sugammadex and neostigmine, used to antagonize the effects of rocuronium, on the QT(c) interval. METHODS: This study used 10 adult New Zealand white rabbits of 2.5-3.5 kg randomly divided into two groups: sugammadex group (Group S, n: 5) and neostigmine group (Group N, n: 5). For general anesthesia administering 2 mg/kg iv propofol and 1 mcg/kg iv fentanyl, 0.6 mg/kg iv rocuronium was given. Later to provide reliable airway for all experimental animals V-Gel Rabbit was inserted. The rabbits were manually ventilated by the same anesthetist. After the V-Gel Rabbit was inserted at 2, 5, 10, 20, 25, 27, 30 and 40 minutes measurements were repeated and recorded. At 25 minutes after induction Group N rabbits were given 0.05 mg/kg iv neostigmine + 0.01 mg/kg iv atropine. Group S were administered 2 mg/kg iv sugammadex. RESULTS: Comparing the QT(c) interval in the rabbits in Group S and Group N, in the 25th, 27th and 30th minute after muscle relaxant antagonist was administered the QT(c) interval in the neostigmine group rabbits was significantly increased (p < 0.05). CONCLUSION: While sugammadex, administered to antagonize the effect of rocuronium, did not significantly affect the QTc interval, neostigmine+atropine proloned the QT(c) interval.Öğe Comparison of the effectivity of oral and intra-articular administration of tenoxicam in patients with knee osteoarthritis(Elsevier Science Inc, 2015) Erbas, Mesut; Simsek, Tuncer; Kiraz, Hasan Ali; Sahin, Hasan; Toman, HuseyinBackground and objectives: Tenoxicam is widely used in osteoarthritis treatment and we aimed to compare the effectivity of oral and intra-articular administration of tenoxicam in osteoarthritis treatment. Methods: This study was performed between 2011 and 2012 by retrospectively analyzing and comparing the findings of 60 patients who were clinically and radiologically diagnosed with knee degenerative osteoarthritis in Bunyan state hospital pain policlinic. 60 patients included in the study were divided into two groups. The first group (tenoxicam IA, n=30) included patient findings of those subjected to intra-articular injection of 20 mg tenoxicam to the knee once a week for three weeks and the second group (oral tenoxicam, n=30) included patients who were administered 20 mg oral tenoxicam once a day for three weeks. All patients were clinically evaluated pre-treatment and in the 1st week, 1st month and 3rd month post-treatment according to specified criteria. Results and conclusions: Twenty two of 60 patients included in the study were male and 38 were female. In both groups significant improvements were detected in all of the observed parameters: visual analog scale, Western Ontario McMaster Osteoarthritis Index (pain, physical activity, knee stiffness) and Lequesne index scores and in the evaluations performed in 1st week, 1st month and 3rd month with respect to pre-treatment values. Besides, a better compliance to treatment and gastrointestinal system tolerability in tenoxicam IA group was also observed. Intra-articular tenoxicam administration could be thought as an alternative treatment method in patients with knee osteoarthritis who cannot use oral tenoxicam especially due to systemic gastrointestinal system side effects and those who have difficulties in adapting to treatment. (c) 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.Öğe Comparison of the effects of various airway devices on hemodynamic response and QTc interval in rabbits under general anesthesia(Springer Heidelberg, 2015) Toman, Huseyin; Erbas, Mesut; Sahin, Hasan; Kiraz, Hasan Ali; Uzun, Metehan; Ovali, Mehmet AkifIn this study, we aimed to compare the effects of various airway devices on QTc interval in rabbits under general anesthesia. The subjects were randomly separated into four groups: Group ETT, Group LMA, Group PLA, Group V-gel. Baseline values and hearth rate, mean arterial pressure and ECG was obtained at the 1st, 5th and 30th minutes after administration of anesthesia and placement of airway device and, QTc interval was evaluated. Difference was observed between ET group and V-gel group in the 5th minute mean arterial pressure values (p < 0.05). It was observed that QTc intervals at the 1st and 5th minute in the ET group significantly increased when compared with the other groups (p < 0.05). Again, it was observed that QTc interval of ET group at the 15th and 30th minute was longer when compared with PLA and V-gel groups (p < 0.05). It was also observed that QTc interval of LMA Group at the 5th minute after intubation significantly increased when compared with V-gel group (p < 0.05). It was observed that HR values of ETT group at the 1st, 5th and 15th minutes after intubation increased with regards to PLA and V-gel groups (p < 0.05). It was determined that the 30th minute hearth rate of ETT group was higher when compared to V-gel group (p < 0.05). Conclusion: In our study we observed that V-gel Rabbit affected both hemodynamic response and QT interval less than other airway devices.Öğe Effects of preoperative smoking cessation on HAM-A sedation scores and intraoperative consumption of anesthetics and fentanyl(Anaesthesia Pain & Intensive Care, 2017) Ural, Sedef Gulcin; Yazicioglu, Dilek; Sahin, Hasan; Altinisik, Ugur; Dogu, Tugba; Altinisik, Hatice Betul; Ozmen, MustafaObjective: Patients undergoing surgery, experience acute physiological distress in the preoperative period. Smoking addiction is a complex behavior in which environment and genetic effects play a part. In this study our aim was to compare the impact of cigarette smoking cessation verses continued smoking on preoperative HAM-A scores and anesthetic requirement Methodology: After approval by the Ethic Committee, informed consent was obtained from patients, 1865 years old, American Society of Anesthesiologists (ASA) physical status I-II, 120 patients scheduled for elective laparoscopic cholecystectomy were included in this prospective randomized, double-blind study. Groups were defined as Group N (n:60, patients who continued smoking in the preoperative period) and Group NS (n:60, who stopped smoking 48 hours before the operation). Only the first patient on the list were included... All patients received intravenous midazolam 0.05-0.1 mg/kg as premedication. In the preoperative period HAM-A scores were recorded while the preoperative examination was performed in the outpatient clinic and after premedication. In addition, we monitored patients with Bispectral Index Monitor (BIS) and anesthetic requirements were recorded during surgical procedure. Results: HAM-A scores in the outpatient clinic and after receiving premedication were statistically significantly higher in Group N. Additional fentanyl requirement was also significantly higher in Group N. Conclusion: We conclude that to stop smoking 48 hours before surgery reduced anxiety as measured by HAM-A scores and anesthetic requirement and increased patient comfort.Öğe Effects of Prophylactic Ozone Therapy on General Anesthesia and Surgical Stress Response: Neutrophil/Lymphocyte Ratio and Ischemia-Modified Albumin(Int College Of Surgeons, 2019) Toman, Huseyin; Sahin, Hasan; Erbas, Mesut; Turkon, Hakan; Simsek, Tuncer; Kiraz, Hasan Ali; Ozkan, Muhammed Turgut AlperGeneral anesthesia and surgical stress cause an acute endocrine, metabolic, and immunologic inflammatory response in organisms and an increase in neutrophil lymphocyte ratio (NLR) and ischemia-modified albumin (IMA) levels. Ozone, other than inhalation administration, reduces the release of antioxidants and some proinflammatory cytokines and has been shown to have an anti-inflammatory effect. Our aim is to research how the NLR and IMA response is affected in rabbits undergoing surgical intervention with general anesthesia given prophylactic with ozone therapy. We divided 12 New Zealand rabbits into 2 groups: group O was given 70 lg/mL 10 mL ozone by the rectal route in 6 sessions on alternate days, and group C was given air by the rectal route. The rabbits underwent surgical intervention under general anesthesia. Blood samples were taken at basal, preoperation, 30 minutes postanesthesia, and 24 hours postoperation and were examined for hemogram and IMA. At 24 hours postoperation, an increase in NLR was observed in both groups, more clearly in group C (P < 0.05). In both groups, comparisons within the groups showed a significant increase in NLR only at 24 hours postoperation compared to other times (P < 0.05).When IMA values were compared, differences between the groups were observed between preoperative values and those at the 30 minutes postanesthesia and 24 hours postoperation (P < 0.05). When general anesthesia and surgical stress response were evaluated using inflammatory parameters of both NLR and IMA, there was significantly less of an increase in levels in rabbits given ozone compared to the control group.Öğe Effects of sugammadex on the prevention of postoperative peritoneal adhesions(Wiley, 2015) Sahin, Hasan; Toman, Huseyin; Kiraz, Hasan Ali; Simsek, Tuncer; Erbas, Mesut; Ozkul, Faruk; Arik, Muhammet KasimMany materials and techniques have been used to prevent and repair intra-abdominal adhesions, but an effective solution has not been found. The aim of this study is to research the effect of sugammadex on intra-abdominal adhesions in an experimentally induced intraabdominal adhesion model. Twenty-four female Wistar albino rats were included in the study. The experimental animals were randomly divided into three groups: the sugammadex group (Group SX, n=8), the control group (Group C, n=8), and the shamgroup (Group S, n=8). After starvation for 1 night, the rats were injected with a 50 mg/kg intramuscular dose of ketamine and a 5 mg/kg intramuscular dose of xylazine for anesthesia. The rats in the SX group were given 3 mL sugammadex into the peritoneal cavity, while rats in the control group were given 3 mL 0.9% sodium chloride. In the sham group, the peritoneal cavity was opened, but no chemicals were administered. All rats were sacrificed on the 10th postoperative day. The adhesions were staged as 0, 1, 2, and 3 according to Evans et al.'s model. Our evaluation of macroscopic adhesion intensity found statistically significant differences between the groups. The sugammadex group was observed to have fewer adhesions in a statistically significant manner compared with the control group (p < 0.05). In our experimental intra-abdominal adhesion model in rats, we observed that sugammadex prevented postoperative intra-abdominal adhesions. Copyright (C) 2015, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rights reserved.Öğe Evaluation of Sleep Quality in Patients With Nasal Septal Deviation via the Pittsburgh Sleep Quality Index(Lippincott Williams & Wilkins, 2016) Kara, Medine; Erdogan, Halil; Guclu, Oguz; Sahin, Hasan; Derekoy, Fevzi SefaObjective:To investigate the effect of nasal septum deviation, without obstructive sleep apnea, on sleep quality.Methods:The present case-controlled study enrolled patients older than 16 years with nasal septum deviation who attended the Otorhinolaryngology Clinic between December 2013 and July 2014. The control group was selected from patients attending the clinic for another complaint. Sleep quality was evaluated via the Pittsburgh Sleep Quality Index, and differences between the groups were compared using the Mann-Whitney U test.Results:During the study period, 55 patients with nasal septum deviation were included in the study group, and the control group consisted of 51 patients with no complaints of nasal obstruction. Compared with the control group, patients with nasal septum deviation were found to be significantly higher (P<0.05) in all parameters of Pittsburgh Sleep Quality Index.Conclusion:The presence of nasal septum deviation with nasal obstruction should be investigated in patients with sleep disorders. If any pathology is present, opening the nasal passages should be ensured and sleep disorders reevaluated.Öğe Evaluation of the Approaches of the Anaesthesiologists on Maintenance of Anaesthesia Machines(Aves, 2016) Altinisik, Ugur; Altinisik, Hatice Betul; Simsek, Tuncer; Kiraz, Hasan Ali; Dogu, Tugba; Toman, Huseyin; Sahin, HasanObjective: In this study, we aimed to discuss the level of knowledge and approach on 'maintenance, calibration and cleaning of anaesthesia devices' among anaesthesiologists in Turkey. Methods: A questionnaire was prepared with 21 questions based on the Google document system, and these questionnaires were sent to the anaesthesiologists via e-mail. Results: Overall, 226 anaesthesiologists answered our survey. With respect to the maintenance and calibration, anaesthesiologists had sufficient information about the vaporizer and the carbon dioxide canister devices; however, information about the vital components, such as disassembly of the anaesthesia machine, flow sensor, oxygen sensor, battery and exhaust system, was insufficient. The cleaning and sterilization procedures were performed when the devices became dirty, and the bacteria filter was used only for the protection of the anaesthesia system. There was a lack of knowledge about how and which part of the anaesthesia device should be disinfected. In total, 85% of the survey participants were thinking of the need of additional education on anaesthesia machine maintenance. Conclusion: It is observed that education about anaesthesia device maintenance, calibration and cleaning issues is obviously necessary for the anaesthesiology specialists in our country. We believe that it would be useful to highlight this issue to anaesthesia educational institutions and anaesthesia associations.Öğe Experimental Esophagitis Model Preventing Tracheal Aspiration(Wroclaw Medical Univ, 2015) Kiraz, Hasan A.; Erbas, Mesut; Kucuk, Adem; Topaloglu, Naci; Erdem, Havva; Sahin, Hasan; Toman, HuseyinBackground. Corrosive esophagitis injuries are a serious clinical problem with many agents used for diagnosis and treatment. Experimental esophagus burn models use a method described mainly in studies by Gehanno and Guedon, and modified by Liu and Richardson. Objectives. The aim of this study was to describe a new esophagitis model that prevents tracheal aspiration. Material and Methods. In this study we used 16 Wistar albino rats weighing between 220-240 g. The experimental animals were randomly divided into two groups: the model group (group M, n: 8) and control group (group C, n: 8). The necessary anesthesia was administered. Passing through a median laparotomy incision, the abdomen was entered and in group M and C the esophagus was freed and held by a suture at the gastroesophageal junction. After this procedure, about 1 cm proximal to the gastroesophageal junction, the esophagus was suspended by a suture. The esophagus segment between the two sutures was exposed to 0.1 mL 10% NaOH in group M and 0.1 mL saline in group C for 20 s. Ten days later all experimental animals were sacrificed and their esophagus removed. After dying with hematoxylin and eosine trichrome, the histopathological evaluation results for the rats in all groups were investigated with a light microscope. Results. Histopathological examination indicated submucosal collagen increase, damage to muscularis mucosa and tunica muscularis and collagen deposition. In the model group, the rats had high neutrophils and tissue damage accompanied by necrosis. In the control group, the rats had minimal or no tissue damage and fibrosis was not observed. Conclusions. Our procedure is relatively less invasive and easy to apply with corrosive esophagitis only in the required region, and at the same time treatment medications can be easily administered.Öğe Laparoscopic Repair of Combined Right Diaphragm and Liver Injuries with a Sharp Object: A Case Report(Hindawi Ltd, 2013) Arik, M. Kasim; Tas, Sukru; Ozkul, Faruk; Sahin, Hasan; Karatag, Ozan; Karaayvaz, MuammerIntroduction. Diaphragm injuries develop following penetrating or blunt traumas. The purpose of the case report is to present a 28 year old male patient with stable hemodynamic findings treated with laparoscopic approach following a liver injury combined with a right diaphragm injury caused by a sharp penetrating object. Case. 4 cm long transverse laceration was observed near the middle axillary line in the 6th right intercostal space in the examination performed on a 28 year old male patient who applied to the emergency service due to sharp penetrating object injury. Respiratory sounds were decreased in the right side and the examination revealed sensitivity in the abdomen. Elevation in the right diaphragmand hemopneumothorax was monitored in chest X-ray and computerized tomography. Closed subaqueous thorax drain was placed and the patient was taken to the surgery with a right diaphragm injury prediagnosis. Laparoscopic exploration was performed to the patient with stable hemodynamic findings by entering through 10 mm port above the abdomen. 6 cm long injury at the right side of diaphragm and approximately 2 cm deep at the deepest point and 5 cm long linear laceration was observed in the 7th segment of the liver. The diaphragm was repaired laparoscopically with sutures that do not melt on their own. Tampon was applied to the laceration in the liver and bleeding control was performed with suture. Patient was discharged on the 3rd day because he had no problems during postoperative follow-ups. Result. No noticed right side diaphragm rupture and possible concomitant visceral organ injuries following a penetrant injury that can cause significant mortality and morbidity should be definitely kept in mind. The detection of right side diaphragm and liver injury is vital with high mortality in case of delayed diagnosis, and direct radiography and computerized tomography are helpful in the diagnosis. Surgical treatment with laparoscopic approach is a method that leads to less hospitalization duration and less pain in cases that are hemodynamically stable.Öğe Percutaneous treatment of lumbar synovial cyst: A case report(Acta Medica Mediterranea, 2014) Erbas, Mesut; Ozdemir, Ugur; Toman, Huseyin; Sahin, Hasan; Savluk, Omer Faruk; Luleci, NurettinIntroduction and aims: Synovial cysts are benign cystic lesions that form when the joint capsule is worn during joint movement and synovial fluid leaks out. Intraspinal synovial cysts in the lumbar region are generally diagnosed when investigating patients who complaints of back pain or other symptoms which could be attributed to radiculopathy. The aim of this paper is to present the use of the percutaneous needle aspiration method with tomography guidance to treat an L4-L5 synovial cyst causing radicular symptoms. Case report: A 40-year old female, with a 5-year complaint of back pain, applied to our clinic with recent increase in existing complaints and the addition of left leg pain. Lumbar computed tomography and magnetic resonance imaging examinations showed at L4 vertebra corpus level in the spinal canal right posterolateral recess, neighboring the right L5 nerve root, a 9x7x4 mm T2 hyperintense, T1 hypointense nodular appearance. A percutaneous cyst aspiration was planned and after aseptic conditions were ensured, a 22 G spinal needle was used to aspire the fluid in the synovial cyst between L4-L5 guided by tomography images and 80 mg methyl prednisone with 6 ml 0.25% bupivacaine were injected into cyst and the procedure was completed. Discussion and conclusion: In symptomatic lumbar synovial cyst cases percutaneous cyst aspiration, steroid injection or surgical resection may be chosen. However as percutaneous cyst aspiration has a lower rate of complications such as infection, bleeding, nerve damage and dural puncture compared to surgical treatment, it should be first choice.Öğe PERCUTANEOUS TREATMENT OF LUMBAR SYNOVIAL CYST: A CASE REPORT(Carbone Editore, 2014) Erbas, Mesut; Ozdemir, Ugur; Toman, Huseyin; Sahin, Hasan; Savluk, Omer Faruk; Luleci, NurettinIntroduction and aims: Synovial cysts are benign cystic lesions that form when the joint capsule is worn during joint movement and synovial fluid leaks out. Intraspinal synovial cysts in the lumbar region are generally diagnosed when investigating patients who complaints of back pain or other symptoms which could be attributed to radiculopathy. The aim of this paper is to present the use of the percutaneous needle aspiration method with tomography guidance to treat an L4-L5 synovial cyst causing radicular symptoms. Case report: A 40-year old female, with a 5-year complaint of back pain, applied to our clinic with recent increase in existing complaints and the addition of left leg pain. Lumbar computed tomography and magnetic resonance imaging examinations showed at L4 vertebra corpus level in the spinal canal right posterolateral recess, neighboring the right L5 nerve root, a 9x7x4 mm T2 hyperintense, T1 hypointense nodular appearance. A percutaneous cyst aspiration was planned and after aseptic conditions were ensured, a 22 G spinal needle was used to aspire the fluid in the synovial cyst between L4-L5 guided by tomography images and 80 mg methyl prednisone with 6 ml 0.25% bupivacaine were injected into cyst and the procedure was completed. Discussion and conclusion: In symptomatic lumbar synovial cyst cases percutaneous cyst aspiration, steroid injection or surgical resection may be chosen. However as percutaneous cyst aspiration has a lower rate of complications such as infection, bleeding, nerve damage and dural puncture compared to surgical treatment, it should be first choice.Öğe Prevention of intraocular pressure elevation with oleuropein rich diet in rabbits, during the general anaesthesia(Springer International Publishing Ag, 2016) Simsek, Tuncer; Altinisik, Ugur; Ersan, Ismail; Sahin, Hasan; Altinisik, Betul; Erbas, Mesut; Pala, CigdemBackground: Oleuropein is known to have anti-oxidant and anti-inflammatory effects. An important aim of anesthetic management in ocular surgery is to keep the intraocular pressure under control. Studies have researched a variety of prophylactic materials used to prevent increases in intraocular pressure. We aimed to research the effects of oleuropein on intraocular pressure (IOP) during general anaesthesia. Methods: Fourteen New Zealand rabbits were randomly divided into two groups of seven. The rabbits in Group O were given olive leaf extract (OLE) equivalent to a daily dose of 20 mg/kg oleuropein for 15 days. HPLC method used for oleuropein standardization. For anaesthesia induction 1 mg/kg rocuronium was given and after muscle relaxation all animals had a V-gel Rabbit inserted. Anesthetic maintenance was provided by 1 MAC isoflurane. Twenty minutes after rabbits were given 10 mg/kg ketamine, basal IOP values were measured. After the V-gel rabbit was inserted, in the 5th, 10th, 20th, 25th and 30th minutes measurements were repeated. Results: IOP data variation of OLE group was compared with control group and the measured levels were lower in Group O during the anaesthesia. IOP was 33.8 +/- 4 mmHg in Group C and 24.1 +/- 8 mmHg in Group O in 25th minute and the difference between the two groups was statistically significant at this time. Conclusion: We observed that consumption of prophylactic OLE had a reducing effect on IOP in the period before waking in anaesthesia. We believe it is necessary to investigate the effects of OLE on IOP in broad participation patient groups.Öğe Prevention of rocuronium induced mast cell activation with prophylactic oleuropein rich diet in anesthetized rabbits(Acta Cirurgica Brasileira, 2018) Simsek, Tuncer; Erbas, Mesut; Buyuk, Basak; Pala, Cigdem; Sahin, Hasan; Altinisik, BetulPurpose: The effect of a prophylactic oleuropein-rich diet before anesthesia accompanied by the widely-used steroid-based neuromuscular drug rocuronium on mast cell activation was investigated in the study. Methods: 14 rabbits used in the study. The rabbits in the oleuropein group were given oleuropein-rich extract added to the animals' water at doses of 20 mg/kg oleuropein for 15 days orally. After 15 days, all rabbits in the two groups were given general anesthesia with rocuronium of 1 mg/kg. After 1 day, animals were sacrificed and the liver tissue sections stained with H&E, toluidine blue and tryptase for immunohistochemical study. Results: There was no statistically significant difference between ALT, AST and albumin averages of the oleuropein and control groups (p>0.05). The tryptase average of the control group was higher than the tryptase average of the oleuropein group and this difference was statistically significant (p=0.003). The T. blue average in the oleuropein group was higher than the control group. However, there was no statistically significant difference between groups (p=0.482). Conclusions: Rocuronium adverse effects, like hypersensitivity and anaphylaxis, may limit routine use of this substance. The use of oleuropein reduced the number of inflammatory cells and prevented degranulation.Öğe Profile differences of medical doctors from three different hospitals in Turkey concerning burnout, job satisfaction, and depression(Klinik Psikiyatri Dergisi, 2019) Sahin, Basak; Musaoglu, Esra; Dogan, Bilge; Yildirim, Armagan; Arslan, Tayyibe; Sahin, HasanObjective: This study aimed to compare job satisfaction, burnout, and depression scores of medical doctors from different regions in Turkey. Method: A cross-sectional study was performed during October 2013 in three cities from Turkey. Participants were asked to self-administer a demographic information questionnaire, the Minnesota Satisfaction Questionnaire (Internal work satisfaction-IWS and External work satisfaction-EWS), the Beck Depression Inventory (BDI), the Maslach Burnout Inventory (MBI), Maslach Emotional Exhaustion Score (MEES), and Maslach Personal Accomplishment Score (MPAS). Results: Mean (+/- SD) Total work satisfaction score was 66.2 +/- 12.6.118 participants had BDI scores of 10 or less while 40 participants had 11 or higher scores. Proportions for poor depersonalization, emotional exhaustion, and personal accomplishment were 18.6% (n=29), 5.8% (n=9), and 81.9% (n=127) respectively. There were significant differences concerning some variables between the three cities. Most of the doctors in Sirnak and Hakkari were younger, single, and less experienced compared to the more developed Canakkale (p<0.05). Discussion: In a hierarchical regression analysis, independent of the other factors, MPAS and MEES were predictors of the total job satisfaction score. MPAS and MEES are the most significant independent variables affecting job satisfaction. Decreasing stressors and assuring a motivating and supportive environment may prove to be helpful in the enhancement of job satisfaction.Öğe Protective effect of gel form of gastric gavage applicated aloe vera on ischemia reperfusion injury in renal and lung tissue(C M B Assoc, 2017) Sahin, Hasan; Yener, Ali Umit; Karaboga, Ihsan; Sehitoglu, Muserref Hilal; Dogu, Tugba; Altinisik, Hatice Betul; Altinisik, UgurThe aloe vera plant has become increasingly popular in recent years. This study aimed to research the effect of aloe vera to prevent renal and lung tissue damage in an experimental ischemia-reperfusion (I/R) injury model. The study included 21 male Wistar Albino rats, which were categorized into control group, n = 7 (no procedures), Sham group n = 7 (I/R); and aloe vera therapy group, n = 7 (aloe vera and I/R). Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and malondialdehyde (MDA) were evaluated from lung and kidney tissues for biochemical investigations. As histopathological, hematoxylin and eosin and anti-iNOS were also examined. In biochemical investigations, SOD, CAT, and GPx levels of the Sham group were found to be lower compared with the other groups (P < 0.05). The aloe vera therapy group was not statistically different from control groups but significantly different compared with the Sham group. In the same way, the MDA levels of kidney and lung tissues were statistically significant in the aloe vera therapy group, compared to the Sham group. In the Sham group, the peribronchial and perialveolar edema were observed in lung parenchyma. Also, excess interstitial hemorrhage, leukocyte infiltration, and alveolar wall thickening were identified in ischemic groups. The histopathological changes were much lighter than in the aloe vera therapy group. In renal tissues, excess epithelial cell deterioration, tubular desqumination, and glomerular atrophy were observed in the Sham group. The histopathological changes were markedly reduced in the aloe vera therapy group. In the kidney and lung tissue, the level of iNOS activity in the Sham group was significantly higher than in the control and aloe vera therapy group. This study indicated that aloe vera is protective against oxidative damage formed by I/R in distant organs like the lungs and kidneys.Öğe The comparison of analgesic effects of various administration methods of diclofenac sodium, transdermal, oral and intramuscular, in early postoperative period in laparoscopic cholecystectomy operations(Professional Medical Publications, 2014) Ural, Sedef Gulcin; Yener, Ozlem; Sahin, Hasan; Simsek, Tuncer; Aydinli, Bahar; Ozgok, AysegulObjective: The aim of this study was to compare the efficacy of oral, intra muscular and transdermal diclofenac sodium for pain treatment in patients undergoing laparoscopic cholecystectomy, and their effect on postoperative opioid consumption. Methods: Following informed consent, 90 ASA I-II patients scheduled for laparoscopic cholecystectomy were randomized into three groups. Group PO got oral diclofenac sodium 1 hour before the operation, Group IM 75 mg diclofenac sodium intra muscular and Group TD diclofenac sodium patch 6 hours before the operation. Patients were not premedicated. Routine anaesthesia induction was used. After the operation in post anaesthesia care unit tramadol HCl infusion was delivered by intravenous patient controlled analgesia (iv PCA). Ramsey Sedation Score (RSS), Modified Aldrete's Score System(MASS) and Visual Analog Scale Pain Score (VAS) was used for postoperative evaluation. Postoperative opioid consumption was recorded. Results: Demographic characteristics, intraoperative and postoperative hemodynamics of the patients were similar between groups. Postoperative VAS were lower at all time points in Group IM and Group TD than in Group PO. Lowest Postoperative RSS were in Group IM and the highest were in Group PO, and the difference between groups was significant. There was no significant difference in Postoperative MASS between groups. Postoperative tramadol consumption was statistically different between groups. Tramadol consumption in Group IM and Group TD was lower than Group PO. Postoperative nausea and vomiting was not observed. Local complications related to transdermal and intra muscular applications was not reported. Conclusion: In patients undergoing ambulatory laparoscopic cholecystectomy, a noninvasive application transdermal diclofenac sodium is as effective as intramuscular diclofenac sodium and can be preferred in postoperative pain treatment.Öğe The effect of general and spinal anesthesia on neutrophil to lymphocyte ratio in patients undergoing cesarian section(Anaesthesia Pain & Intensive Care, 2015) Erbas, Mesut; Toman, Huseyin; Gencer, Meryem; Sahin, Hasan; Kiraz, Hasan Ali; Simsek, Tuncer; Saylan, HaticeObjective: Neutrophil to lymphocyte ratio (NLR) has become popular recently so that many studies have been done to find out the predictive value of NLR in many different aspects of clinical practice. The aim of this retrospective study was to evaluate the relationship between blood NLR and anesthetic techniques in patients undergoing cesarian section. Methodology: In this study, eighty patients (American Society of Anesthesiologists physical status I similar to II) undergoing elective cesarian section using spinal (Group S: 40) or general anesthesia (Group G: 40) were retrospectively analyzed for neutrophil to lymphocyte ratio. Results: The demographic characteristics of the groups, amount of bleeding, before the operation hemoglobin values, platelet counts, and NLR values were similar in both the spinal and general anesthesia groups. However, significant differences were observed with regard to NLR values in the postoperative period. Conclusion: Postoperative neutrophil to lymphocyte ratio in patients undergoing cesarian section under spinal anesthesia was found to be significantly lower as compared to general anesthesia.
