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6. Rejyonel İntravenöz Anestezide Lidokain ve Lidokain-Midazolamın Etkinliklerinin Karşılaştırılması

Author

Yaşar, Nurbanu, Bilir, Ayten, Ceyhan, Dilek, and Sabuncu, Cemil

Subjects
Health Care Sciences and Services, rejyonel intravenöz anestezi,lidokain, regional intravenous anesthesia,lidocaine, Sağlık Bilimleri ve Hizmetleri
Abstract

There is no clearapproach to the ideal agent to be used in regional intravenous anesthesia(RIVA). Various adjuvants are added to local anesthetic agents to increase thequality of RIVA and to avoid local anesthetic side effects. The purpose of thisstudy is to research the effect on block quality in RIVA by adding midazolam tolidocaine. Patients aged 18-60 years old who underwent upper extremity surgerywere randomly assigned 2 groups. A double-headed tourniquet was placed aftervenous drainage by lifting the upper arm. Following inflating the tourniquet,the control group (Group K) received 3 mg/kg 2%lidocaine and the midazolamgroup (Group M) received 3mg/kg lidocaine and 50 µgr/kg midazolam in 40 ccvolume on the arm that will be operated. Tourniquet time, onset and recoverytimes of sensory and motor block, intraoperative pain level, and firstpostoperative analgesic requirement time were recorded. There was no differencebetween the groups in terms of tourniquet time and intraoperative pain levels.Sensory and motor block onset times were significantly shorter in Group M(p:0.000). The first postoperative analgesic requirement time was observedearlier in Group K (Group K:74.678, Group M: 86.123 minute). A quicker onsetanesthesia and analgesia were obtained without any side effects in the RIVA appliedby adding midazolam to the lidocaine., Rejyonel intravenözanestezide (RİVA) kullanılacak ideal ajan ile ilgili net bir yaklaşım yoktur.Lokal anestezik ajanlara çeşitli adjuvanlar eklenerek RİVA kalitesi artırılmayave lokal anestezik yan etkilerinden kaçınılmaya çalışılmaktadır. Bu çalışmadaRİVA sırasında lidokaine eklenen midazolamın blok kalitesi üzerine etkilerininaraştırılması amaçlanmıştır.Üst ekstremite cerrahisi geçirecek yaşları 18-60yaş arasındaki hastalar rastgele 2 gruba ayrıldı. Opere olacak kol yukarıyakaldırılarak venöz boşalma yapıldıktan sonra çift kaflı turnike yerleştirildi,turnikenin şişirilmesini takiben el sırtındaki venöz kanülden kontrol grubuna(Grup K) 40 ml volümde 3 mg/kg %2’lik lidokain, midazolam grubuna (Grup M) isetoplamda 40 ml volümde 3 mg/kg %2’lik lidokain içinde 50 μg/kg midazolamenjekte edildi. Turnike süresi, oluşan duyusal ve motor blok, duysal ve motorblok dönme zamanı, intraoperatif ağrı seviyesi ve postoperatif ilk analjezikihtiyaç zamanı kayıt edildi.Turnike süresi ve intraoperatif ağrı seviyeleri açısındangruplar arasında fark saptanmadı. Duysal ve motor blok başlama zamanı Grup M’dedaha kısa bulundu (p:0.000). Motor blokdönme zamanı Grup M’de daha kısa idi (p:0.003). Postoperatif ilk analjezikihtiyaç zamanının Grup K’da daha önce olduğu gözlendi (Grup K:74.678, Grup M:86.123 dakika). Lidokaine midazolam eklenerek uygulanan RİVA da herhangi biryan etki ile karşılaşılmadan daha hızlı başlangıçlı bir anestezi ve analjezielde edilmiştir.

Published
2018

7. Rejyonel intravenöz anestezide lidokain ve lidokain-midazolamın etkinliklerinin karşılaştırılması

Author

Yaşar, Nurbanu, Bilir, Ayten, and Anesteziyoloji ve Reanimasyon Anabilim Dalı

Subjects
Anestezi ve Reanimasyon, Midazolam, Lidocaine, Anesthesia-conduction, Anesthesiology and Reanimation
Abstract

Yaşar, N. Rejyonel intravenöz anestezide lidokain ve lidokain-midazolamın etkinliklerinin karşılaştırılması. Eskişehir Osmangazi Üniversitesi Tıp Fakültesi Anestezi ve Reanimasyon Anabilim Dalı Tıpta Uzmanlık Tezi, Eskişehir, 2013. Bu çalışmanın amacı üst ekstremite cerrahisi planlanan hastalarda rejyonel intravenöz anestezi uygulayarak lidokaine midazolam eklenmesi ile perioperatif anestezi ve analjezi kalitesinin üzerine etkilerinin araştırılmasıdır. Çalışma, Eskişehir Osmangazi Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı ameliyathanesinde ASA I-II grubundan yaşları 18-60 arasından değişen 40 hasta ile yapıldı. Hastalar rastgele 2 guruba ayrıldı. Kontrol grubuna (Grup K) opere olacak koldan %2lik lidokain 3mg/kg, midazolam grubuna (Grup M) ise %2lik lidokain 3 mg/kg ve 50 µg/kg midazolam eklenip 40 cc volümde uygulandı. Hastaların operasyon öncesi demografik özellikleri ve hemodinamik parametreleri kaydedildi. Çalışma boyunca hemodinamik parametreler ile Visual Analog Skala (VAS) ve Ramsey Sedasyon Skorları (RSS) kaydedildi. Duysal ve motor blok başlama ve dönme zamanı ve ilk analjezik ihtiyaç zamanları kaydedildi. Grupların operasyon öncesinde ve operasyon süresince hemodinamik parametrelerinde periferik oksijen saturasyonu hariç anlamlı bir fark yoktu. Duysal ve motor blok başlama zamanları Grup M?de anlamlı olarak daha kısa bulundu. Motor blok dönme zamanı Grup K?da anlamlı olarak uzun bulundu. İlk analjezik gereksinim süresi, VAS ve RSS değerleri açısından her iki grup arasında fark bulunmadı. Sonuç olarak RİVA?da lidokaine midazolam eklenmesi ile daha hızlı başlangıçlı bir anestezi ve analjezi elde edilirken ilk analjezik gereksinimi az da olsa daha uzun bulunmuştur. Yaşar, N. Comparing effects of lidocaine and lidocaine-midazolam in regional intravenous anesthesia. Eskişehir Osmangazi University Faculty of Medicine Department of Anesthesiology and Reanimation, Medical Specialization Thesis, Eskişehir, 2013. The purpose of this study is to research the quality of perioperative anesthesia and analgesia in application of regional intravenous anesthesia by adding midazolam to lidocaine on patients planned for upper extremity surgery. The study was performed at Eskişehir Osmangazi University Faculty of Medicine Department of Anesthesiology and Reanimation surgery on 40 patients with class of ASA I-II who were in ages between 18-60. The patients were randomly divided in to two groups. The control group (Group K) received 3mg/kg 2% lidocaine and the midazolam group (group M) received 3mg/kg 2% lidocaine and 50ug/kg midazolam in 40 cc volume on the arm that will be operated. The preoperative demographic characteristics and hemodynamic parameters were recorded. During the study hemodynamic parameters , Visual Analog Scale (VAS) and Ramsay Sedation Scale (RSS) were recorded. Onset and recovery times of sensory and motor block and first analgesic requirement time were recorded. Excluding the peripheral oxygen saturation, there were no significant changes in hemodinamic parameters of patients in both groups before and during the operation. Sensory and motor block onset times were significantly shorter in Group M. Recovery time of motor block was significantly longer in Group K. There were no differences found between both groups according to the time of first analgesic requirment, VAS and RSS scores. First analgesic requirement time for Group M was found to be longer that the other group. In conclusion, adding midazolam to lidocaine for IVRA was faster onset anesthesia and analgesia while causing a small increase in time for first analgesic requirement. 47

Published
2013

9. Patterns of Nationhood and Saving the State in Turkey: Ottomanism, Nationalism and Multiculturalism.

Author

Yaşar, Nurbanu

Subjects
*NATIONALISM, *MULTICULTURALISM, *GOVERNMENT policy, *POLITICAL elites
Abstract

Nationalism studies literature typically attributes changes in national identities to either domestic or international factors. Each case study explains a shift in policy changes in national identity; from Ottomanism to Turkish nationalism, from Turkish nationalism to multiculturalism. [Extracted from the article]

Published
2020
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10. [The Mutations on embA, embB and embC Gene Region in Ethambutol-Resistant and Susceptible Clinical Mycobacterium tuberculosis Complex Isolates].

Author

Yaşar N, Tezcan Ülger S, Ülger M, Arslantürk A, Aslan G, and Köksal F

Subjects
Humans, Antitubercular Agents pharmacology, Drug Resistance, Bacterial genetics, Mutation, Codon, Microbial Sensitivity Tests, Ethambutol pharmacology, Mycobacterium tuberculosis
Abstract

Ethambutol (EMB) is one of the first-line drugs used in the standard combination therapy for tuberculosis (TB) caused by Mycobacterium tuberculosis complex (MTC), and resistance to drugs that play a key role in treatment is increasing worldwide. Mutations in the embCAB operon that have been confirmed to be associated with resistance are responsible for EMB resistance. In this study, it was aimed to determine the frequency and patterns of mutations in embA, embB and embC gene regions in clinical MTC isolates found to be phenotypically resistant and susceptible to EMB. A total of 64 MTC isolates, 44 of resistant to EMB and 20 of susceptible to EMB, isoniazid, rifampicin, and streptomycin by conventional phenotypic drug susceptibility test, were included in the study. Following the DNA isolation, embA, embB and embC gene regions associated with EMB resistance were amplified with specific primer sequences. The PCR products were cycle sequenced using the Bigdye Terminator v3.1 Cycle Sequencing kit (Applied Biosystems, USA) and electrophoretically separated on the ABI PRISM 3130XL Genetic Analyzer (Applied Biosystems, USA). Mutated gene regions were identified by aligning sequence analysis data in multiple sequence analysis programs. In the study, genomic mutations in the embCAB operon were detected in 68.2% (30/44) of the EMB resistant isolates. Mutations in the embB gene region were detected in 66% (29/44) of the resistant isolates, 76% (22/29) of these mutations were at codon 306 and the most common mutation patterns in this codon were determined as ATG→GTG (M306V; 58.6%; 17/29), ATG→ATA, ATC or ATT (M306I; 17.2%; 5/29). Other mutations in the embB gene region were determined as Y334H (3.4%; 1/29), D354A (6.9%; 2/29), E378A (3.4%; 1/29), G406C (3.4%; 1/29), M423I (3.4%; 1/29) and E521A (3.4%; 1/29). Of the 44 EMB-resistant isolates, mutations were detected in one (2.3%) of the isolate in the embA gene region (L330L) and in two (4.5%) of the isolates in the embC gene region (T270I in one isolate and T270I and E305E in the other isolate). Of the phenotypically EMB susceptible isolates, mutation was detected in only one (5%) of the isolates in the embA gene region (E180G). In our study, it was determined that mutations frequently occur in codon 306 of the embB gene in EMB-resistant MTC isolates and this mutation has a potential role in the development of EMB resistance. However, it was concluded that the absence of mutations does not exclude phenotypic EMB resistance. Our results will shed light on the molecular epidemiology of embCAB operon mutations that cause EMB resistance in our country.

Published
2023
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11. [Longitudinal Monitoring of Seroconversion Status in SARS-CoV-2 RT-PCR Positive Healthcare Workers].

Author

Ersoy L, Tezcan Ülger S, Gülbudak H, Yaşar N, Yapıcı G, and Aslan G

Subjects
Adult, COVID-19 Vaccines, Female, Health Personnel, Humans, Male, Middle Aged, Real-Time Polymerase Chain Reaction, Reverse Transcriptase Polymerase Chain Reaction, Seroconversion, COVID-19, SARS-CoV-2
Abstract

The impact of the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome 2 (SARS-CoV-2) still continues. The duration of the immune response in individuals recovering from COVID-19 and its protection against future SARS-CoV-2 infection are not fully understood. This study aimed to longitudinally evaluate anti-SARS-CoV-2 seroconversion status in healthcare workers with positive SARS-CoV-2 Real-time reverse transcription polymerase chain reaction (rRT-PCR), test in Mersin University Hospital. A total of 68 healthcare workers with positive SARS-CoV-2 rRT-PCR test between 19 April and 27 November 2020 were included in the study. Blood samples were collected from healthcare workers for SARS-CoV-2 antibody testing in the 1st, 3rd and 5th months following PCR positivity. Healthcare workers were classified as symptomatic, asymptomatic and reinfected according to their clinical findings, and rRT-PCR cycle thresholds (Ct) were recorded. Elecsys Anti-SARS-CoV-2 (Roche Diagnostics, Germany) kit was used for antibody testing. Of the 68 healthcare workers; 46 were classified as symptomatic, 15 as asymptomatic, and seven as reinfected. Twenty-seven (39.7%) of the healthcare workers were male and 41 (60.3%) were female, and the mean age was 36.4 ± 9.04. Seroconversion was detected in 45 (66.2%) of 68 healthcare workers in the study, and only one person had sero-negative result at the end of the 5th month. While seroconversion was detected in 78.3% (n= 36/46) of symptomatic healthcare workers, it was observed in 26.7% (n= 4/15) of the asymptomatic healthcare workers. Seroconversion was detected in only one of the seven reinfected healthcare workers after primary infection. After reinfection, seroconversion was observed in five of seven reinfected healthcare workers. Antibody response was not detected in two of them after both infections. According to the rRT-PCR Ct values; the median of Ct value was found significantly lower in healthcare workers with seroconversion (23.26, IQR= 18.45-27.30), than the ones without seroconversion (36.20, IQR= 33.09-37.56) (p< 0.001). In those who had reinfection, the mean Ct value (31.77 ± 6.62) detected during the primary infection period was statistically higher than the Ct value (22.44 ± 5.54) detected during reinfection (p= 0.008). The most frequently recorded symptoms in healthcare workers were myalgia (57.3%), fatigue (51.5%), headache (51.5%) followed by sore throat (36.7%), fever (33.8%), cough (27.9%), diarrhea (23.5%) and dyspnea (16.2%). In addition, fever (52%) and fatigue (80.6%) were found to be significantly higher in seroconversion-positive healthcare workers than in those without seroconversion (p= 0.028; p= 0.005, respectively). As a result, a higher rate of antibody response was detected in healthcare workers who had symptomatic infection than those who were asymptomatic. It has been observed that patients with asymptomatic primary infection and without antibody response were more susceptible to reinfection. In addition, it was observed that the probability of immune response increased when the viral load increased (Ct value decreased) in symptomatic infections. Although these findings provide important information about the short-term seroconversion status of healthcare personnel; longer-term and larger-scale studies are needed to evaluate the long-term effectiveness of seroconversion and to better understand the effectiveness of the immune response developed after SARS-CoV-2 vaccine administrations.

Published
2022
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