Dexamethasone Addition Impairs the Therapeutic Effects of Nimodipine for Subarachnoid Hemorrhage: An Experimental Animal Study.

AIM: To evaluate the effects of the combination of nimodipine and dexamethasone in subarachnoid hemorrhage (SAH). MATERIAL AND METHODS: In this study, 35 female adult Wistar Albino rats were randomly assigned to four groups: Sham (n=8), SAH with no treatment (n=9), SAH with nimodipine (n=9, oral gavage, 12 mg/kg, BID) treatment, and SAH with combined therapy with nimodipine and dexamethasone (n=9, intraperitoneally, 1mg/kg, BID). The "cisterna magna double injection of autologous blood" model was used. The animals were euthanized 5 days after the first injection. RESULTS: Of the total, five rats died before euthanasia. The SAH+Nontreatment group showed the worst score in neurological examinations, and the most severe histopathological findings were noted in terms of vasospasm. The SAH+Nimodipine group showed the best neurological score and the closest histopathological results to those of the Sham group, whereas adding dexamethasone to nimodipine treatment (the SAH+Nimodipine+Dexamethasone group) worsened the neurological and histopathological outcomes. CONCLUSION: We thus concluded that the therapeutic effects of nimodipine were impaired when combined with dexamethasone. We thus hypothesized that dexamethasone possibly induces the CYP3A4-enzyme that metabolizes nimodipine. However, it should be noted that our results are based on laboratory findings obtained on a small sample, therefore further studies with drug-drug interaction on a larger sample size through CYP3A4-enzyme and clinical confirmation are warranted.

Women in Neurosurgery: Turkey's Yildiz Yalçinlar.

BACKGROUND: Severalreports have been published on the history of pioneering women pursuing neurosurgery. Women in Turkey started receiving neurosurgery specialty training later than men, as was the case in other parts of the world. However, compared to other countries, Turkey saw the admission of women in neurosurgery sooner, with Aysima Altinok who obtained her specialization in 1959. Nevertheless, Yildiz Yalçinlar, one of the pioneers, remains relatively unknown. METHODS & RESULTS: In this paper, we witness Yildiz Yalçinlar's journey, from her graduation from Ankara Medical Faculty in 1954 and her subsequent specialization in general surgery to her arrival in Igdir as a young surgeon in the early 1960s, where she faced cultural challenges. We explored her transition into neurosurgery, becoming the second neurosurgeon in Turkey in 1965. We examine her complex career progression from receiving her specialization in neurosurgery to her academic journey toward becoming a department chief and her role as one of the founding members of the Turkish Neurosurgery Association. CONCLUSIONS: In Turkey, the number of women practicing as neurosurgeons has increased consistently. Despite this upward trend, the representation of women in the field of neurosurgery remains disproportionately low. We hope that Yildiz Yalçinlar's achievements, which began in the early 60s, will encourage women today and contribute to the continuing growth of neurosurgery.