International Journal of Current Medical and Biological Sciences

Combined acupuncture for the treatment of pregnancy nausea and vomiting

Kıymet İclal Ayaydın Yılmaz — 2023-04-24

We read with great interest Şahin's case report on nausea and vomiting in pregnancy (morning sickness), titled "Nausea, vomiting in pregnancy and acupuncture", published in your journal (1). The case report of a 31-year-old pregnant woman who presented at 14 weeks of gestation with refractory to medical treatment: severe nausea, sometimes vomiting, and aversion to odors, especially food, provides interesting information. It has been reported that nausea and vomiting decreased 2 days after the session in the patient in whom body and ear acupuncture was applied. It has been stated that the ongoing feeling of nausea can be relieved by putting pressure on the bands attached to the ears.

There are examples of the case presentation presented by the authors with different designs in the literature. However, some points where this case report made a difference caught our attention. It is observed that most of the acupuncture studies for pregnancy nausea and vomiting focus on the P6 point (2). In this presentation, ST36 and REN12 points are used in addition to P6 in order to balance the energy circulating in the stomach canal in body acupuncture. Similarly, sterile permanent seeds were placed at 3 different points in ear acupuncture, and an effective treatment response was obtained by applying pressure in the presence of recurrent symptoms.

Nausea and vomiting (morning sickness) during pregnancy is one of the most common symptoms during pregnancy and may rarely continue throughout the pregnancy. These ongoing complaints may turn into a severe form called “hyperemesis gravidarum” (3). In this patient group, an early-onset treatment may prevent the development of serious complications and increase the quality of life of the pregnant woman. According to the results of the network meta-analysis of randomized controlled trials evaluating the treatment modalities of pregnancy nausea and vomiting by Sridharan K et al.: It was reported that acupuncture was effective against placebo in the primary outcome expressed as the nausea score, but the power of evidence was low (4). However, it is noteworthy that only the P6 point is preferred in the acupuncture studies evaluated in the meta-analysis. On the other hand, according to network meta-analysis results of randomized controlled trials evaluating the treatment modalities of hyperemesis gravidarum by Sridharan K et al.: Acupuncture, acupressure, and methylprednisolone were observed with better therapeutic benefits than other interventions for treating hyperemesis gravidaum (5). Combined body and ear acupuncture applied by the authors and the use of additional focal points may provide more successful results in the prevention of pregnancy nausea and vomiting in the early period. In this regard, the power of evidence for this treatment modality with a low side-effect profile will increase with randomized controlled studies of appropriate design.

The Mediterranean Diet Effects on in-Stent Restenosis.

Aliye Kuyumcu — 2023-04-30

Aim: There is evidence that Mediterranean diet nutrition can help prevent cardiovascular events and atherosclerosis, but research is limited. Despite advances in interventional techniques and medical treatments, as well as lower CVD mortality, increasing percutaneous coronary interventions have made in-stent restenosis (ISR) an important problem in interventional cardiology. The objective of this study is to assess the relationship between in-stent restenosis and the Mediterranean diet score.

Material and Methods: The diet quality of 100 patients with ISR and 100 patients without ISR was determined and compared using a scoring method (5, 6, 9, and 10 points) using the 'Mediterranean Diet Compliance Scale'.

Results: Patients with ISR had lower Mediterranean diet scores (odds ratio [OR]: 0.572, 95% confidence interval [CI]: (0.480-0.681), p<0.001). The ISR and Mediterranean diet score had a significant negative correlation (p<0.001, r = -0.679).

Conclusion: In our study, we found that patients who scored high on the Mediterranean diet had a lower risk of ISR, and there was also a negative correlation between the Mediterranean diet and ISR. It is the first study to look at the effects of the Mediterranean diet on patients with a previous percutaneous coronary intervention. This study, one of a few examining the relationship between the Mediterranean diet and ISR, may aid in understanding the pathophysiology of ISR.

The Relationship of Inclination and Anteversion Angles in The Femur with Other Osteometric Parameters

GAMZE TAŞKIN ŞENOL — 2023-05-10

Aim: The aim of this study is to demonstrate the morphometry of the femur, the component of the bony framework of the hip and knee joint, as a basis for clinically successful and accurate analysis.

Materials and Methods: The study included 65 dry femur bones and parameters determined; the femur length (FL), length of the bicondylar femur (LBF), diameter of the caput femoris (DCF), anterioposterior diameter of the corpus femoris (APDCF), transverse diameter of the corpus femoris (TDCF), circumference of the corpus femoris (CCF), inclination angle (IA), anteversion angle (AA), circumference of the caput femoris (CACF), femoral neck width (FNW), anterior femoral neck length (AFNL), femoral neck axis length (FNAL), intertrochanteric distance (ID), femoral body length (FBL), femoral body width (FBW), bicondylar distance (BD), width of the condylus lateralis (WCL), width of the condylus medialis (WCM), height of the fossa intercondylaris (HFI), width of the fossa intercondylaris (WFI) and fossa intercondylaris shape index (FISI) were measured.

Results: Mean±SD values of the determined parameters; FL; 42,2±2,7, LBF; 72,7±6,3, DCF; 74,5±6,1, APDCF; 44±4,1, TDCF; 27±2,3, CCF; 30,8±3, IA; 8,6±0,6, AA; 43,6±4,8, CACF; 16,5±4,4, FNW; 13,2±1,8, AFNL; 27,4±8,5, FNAL; 32,8±4,2, ID; 94,7±8,4, FBL; 73,4±8,8, FBW; 32,5±2,4, BD; 8,9±0,8, WCL; 32,6±4,4, WCM; 35,2±4,3, HFI; 16,7±4,1, WFI; 10,1±3.and FISI was calculated 0.6±0.2.

Conclusion: The analysis of the parameters will add clinical depth to many surgical approaches such as more accurate analysis of femoral anomalies and fractures, strain and tendinopathies occurring in soft tissues.

Evaluation of morphological changes on the proximal ulna from the 13th century to the contemporary

Nilgün Tuncel Çini — 2023-06-19

Background: The aim of the study is to evaluate the proximal part of the ulna bone of the present and 13th-century Byzantine period using the attachment points of the muscles and to evaluate the morphological changes. Methods: A total of 82 ulnae, 29 of which belong to the contemporary and unknown gender, and 52 from the thirteenth-century late Byzantine period are included in the study. The parameters were measured in millimetres on the photos with the ImageJ software. For the statistical analysis, SPSS 22.0 (IBM) software was used (p<0.005). Results: The descriptive values of the variables were given as mean±standard deviation and minimum-maximum values. According to the results of the statistical analysis, there is no difference in the right and left sides. Except for the angle between the MAPO-MPPO-MAA parameter, the rest of the parameters were higher in the Byzantine period ulnae. Conclusions: In this study, we showed the period differences on the proximal part of the ulna especially the olecranon because of the using the extensor muscle of the forearm and the stabilizer muscle of the elbow. We believe that the data obtained will functional perspective help different disciplines, especially anthropologists and anatomists.

Histopathological Evaluation of The Protective Effects of Resveratrol Against Gastrointestinal Tissue Damage Induced by Cisplatin in Rats

Hatice Hancı — 2023-06-20

Background: The purpose of this study was to investigate the effects of differing doses of resveratrol (RES) against cisplatin (CP)-induced gastrointestinal injury in small intestinal tissue using histopathological and immunohistochemical methods.

Materials and Methods: Forty-eight healthy male Wistar albino rats aged 12-16 weeks were divided into eight groups, control RES-30, RES-60, RES-90, CP, CP+RES30, CP+RES60, and CP+RES90. Small intestine tissues were collected at the end of the experimental period and subjected to routine hematoxylin & eosin and Periodic Acid Schiff staining. Tumor necrosis factor alpha (TNF-α) and interleukin 1 beta (IL-1β) were evaluated from immunohistochemically stained tissues. DNA fragmentation was evaluated using the TUNEL technique.

Results: Based on the histopathological findings, vacuolization and shedding were observed in the small intestine surface epithelium with notable fusion and shortening in the villus structure in the CP group. Significant decreases were observed in the CP+RES30, CP+RES60, and particularly CP+RES90 groups compared to the CP group in terms of apical surface epithelial degeneration, villous fusion, and inflammatory cell infiltration. The apoptotic index (AI) and TNF-α immunoreactivities were significantly higher in the CP group compared to the control group (p<0.05). AI and TNF-α immune intensity were significantly lower in the CP+RES30, CP+RES60, and CP+RES90 groups compared to the CP group (p<0.05). It has been determined that among the treatment groups, particularly the CP+RES30 group showed the lowest damage score values and immunoreactivity of TNF-α with AI compared to the CP group.

Conclusions: In conclusion, CP caused severe histological tissue injury, intestinal apoptosis, and proinflammatory cytokine release, while RES administered before CP treatment exhibited a dose-dependent protective effect (particularly at RES30 mg/kg) against CP-induced intestinal injury.

Comparison the efficacy of intravenous and topical tramadol on postoperative pain control after septoplasty

Ahmet Kaya — 2023-06-23

Purpose

Tramadol hydrochloride is an analgesic drug used in the treatment of moderate or severe postoperative pain. The local anaesthtetic effects of tramadol were demonstrated in previous studies. The aim of this study was to compare the postoperative analgesic efficacy of intravenous tramadol with the local application of tramadol by injection into merocel in patients undergoing septoplasty.

Materials and Methods

A prospective, randomized, controlled study included ASA I-II, 18-65 aged, 60 patients who underwent elective septoplasty. The patients were divided into two groups. Group İ (i.v) received 1mg.kg^-1 tramadol i.v. and Group M (merocel®) 100 mg tramadol injected to the Merocel® nasal packs. Postoperative pain scores, nausea, vomiting and rescue analgesic drug were recorded at the first, second, fourth, sixth, twelfth and twenty fourth postoperative hours.

Findings

No significant differences were found between two groups for demografic datas. There were no statistically significant differences between two groups on VAS scores, nausea-vomiting and needing rescue drug.

Conclusion

With its local effects, topical tramadol application to nasal packs seems to be comfortable approach for pain control in patients undergoing septoplasty.

Effect of Intermittent Online Training on Adult Cardiopulmonary Resuscitation Management in A Tertiary Care Setting

Süeda Zaman — 2023-07-03

Background: Cardiac arrest is a clinical event that occurs often in emergency rooms and has a high mortality rate. The purpose of this study was to assess the impact of education on the quality of cardiopulmonary resuscitation(CPR) performed on patients with out-of-hospital and in-hospital cardiac arrest, as well as to analyze other factors influencing Return of Spontaneous Circulation(ROSC).

Materials and Methods: This study was conducted in the Gulhane Training and Research Hospital's Emergency Department. Cardiopulmonary arrest patients' data were collected using the "Resuscitation Follow-up Form". Descriptive data, including adult arrest case characteristics and CPR protocols, were acquired. ROSC and CPR quality parameters were compared in cases that received CPR before and after training.

Results: A total of 95 patients were included in the study. The mean age of the patients was 69,16±14,606. The 64,2%(n=61) of patients were cardiac arrest patients who were intervened before education and 35,7%(n=34) were after education. The ROSC rate in arrest patients before training was 36,1%, and 38,2% after training. When comparing the pre-training and post-training groups in terms of ROSC, it was seen that the ROSC rates increased after the training. While the rate of EtCO2 use was 3,3%(n=2) in pre-training cases, this rate was 97,1%(n=33) in post-training cases. EtCO2 usage rate increased significantly with education(p=0.001).

Conclusions: We found that repeated trainings improved the quality of arrest case management, and clinically significant benefits were attained. Giving comparable training to teams that respond to pre-hospital arrests would boost clinical success even further.

Comparison of The Effects of Erector Spina Plane Block and Transversus Abdominis Plane Block Methods on Postoperative Analgesia in Elective Caesarian Section with Ultrasonography Account

Melike ABAN YILMAZ — 2023-07-31

Aim: The study aimed to compare the efficacy of erector spina plane (ESP) block and transversus abdominis plane (TAP) block in postoperative analgesia in cesarean section operations.

Materials and Methods: The study included a total of 90 pregnant women scheduled for elective cesarean section under spinal anesthesia between February 2021 and February 2022. Following the completion of the operation, the patients were randomly assigned to three groups: TAP, ESP, and a control group using a closed envelope technique. Demographic data, postoperative Visual Analog Scale (VAS) scores at 0, 2, 4, 8, 12, and 24 hours, time of first analgesic administration in the PCA, the total amount of tramadol consumed, complications, surgeon, and patient satisfaction were recorded.

Results: The time of first analgesic administration was statistically significantly lower in the TAP group than in the ESP group (p<0.01). Postoperative tramadol consumption at 0,2,4 and 8 hours was statistically significantly lower in the ESP group than in other groups (p<0.01). At 24 hours, the total amount of tramadol consumed was statistically significantly lower in the ESP group than in other groups (p<0.01). Patient satisfaction was higher in the ESP group compared to the TAP and control groups (p<0.01).

Conclusion: The study found that ESP and TAP block groups consumed less tramadol postoperatively and had lower VAS scores than the control group in cesarean section operations. We found that the ESP block was more effective regarding VAS scores, tramadol consumption, and patient satisfaction.

Keywords:Cesarean section operation, postoperative analgesia, patient-controlled analgesia, transversus abdominis plane block, erector spina plane block

The Role Of Amıno Acıds In Knee Osteoarthrıtıs

SERAP SATIS — 2023-08-02

Backgrounds

Osteoarthritis is an important public health problem and the most common musculoskeletal disease in the World. The pathogenesis and etiology of osteoarthritis is still unclear. We aimed to make an Amino acids analysis that will contribute to the pathogenesis, diagnosis and treatment of knee osteoarthritis.

Methods

The study included according to the radiological grading scale of Kellgren-Lawrence, 30 patients at Grade 1-2; Group 1 (Grade 1-2), 30 patients at Grade 3-4; Group 2 (Grade 3-4), 30 healthy controls; Group 3. We compared between groups age, sex, body mass index, Western Ontario and McMaster Universities, Short form-36 findings, and plasma-free amino acid levels.

Results

A comparison of the serum norvaline, leucine, isoleucine, allo-isoleucine, cystathionine, phenylalanine, 1-methyl hystidine, arginine, alanine, cystine, valine, threonine, and tryptophane levels of the knee osteoarthritis and control groups compared a statistically significant difference (p=0.000, p=0.000, p=0.000, p=0.000, p=0.044, p=0.003, p=0.000, p=0.035, p=0.010, p=0.011, p=0.000, p=0.000, p=0.003).

Conclusions

We consider that, norvaline leucine; isoleucine, allo-isoleucine, cystathionine, phenylalanine, 1-methyl hystidine, arginine, alanine, cystine, valine, threonine, and tryptophane amino acids could be, as potential systemic serum biomarkers for diagnosis of knee osteoarthritis.