Effect of preoperative anxiety level on postoperative pain, analgesic consumption in patients undergoing laparoscopic sleeve gastrectomy: an observational cohort study

Abstract Backgraund: This prospective observational cohort study aimed to investigate the relationship between preoperative anxiety levels and postoperative pain and analgesic requirement in patients undergoing laparoscopic sleeve gastrectomy. Methods: Forty two female patients with body mass index ≥ 35, who underwent laparoscopic sleeve gastrectomy for treatment of obesity were included in the study. Spielberger's state and trait anxiety scales were used in this study. Demographic data of the patients, anesthetic and analgesic drugs during the surgery, pain levels measured with verbal analog scale at the postoperative 1st, 4th, 12th, and 24th hour, sedation levels measured with the Ramsay sedation scale, and the amount of analgesic consumed were recorded. Anesthesiologist, surgeon, and patient were not informed of the anxiety level results. The relationship between preoperative anxiety and postoperative pain and analgesic consumption was evaluated by Spearman's correlation analysis. Stepwise multiple linear regression analysis was applied. Normal Distribution control was performed by applying the Shapiro-Wilk test to residual values obtained from the final model. Results: There was no relationship between trait anxiety level and postoperative pain and analgesic consumption. A correlation was found between state anxiety level and pain level up to 24 hours and analgesic consumption (p < 0.05). According to the obtained model it had been observed that the university graduates consumed more analgesic compared to other education level groups. Conclusion: In this study, a relationship was found between preoperative state anxiety level and 24-hour pain scores and analgesic consumption in patients who underwent laparoscopic sleeve gastrectomy under general anesthesia.

The Effects of 2100 MHz Radio Frequency Radiation on Thyroid Tissues

ABSTRACT Objective: To reveal the effect of 2100 MHz radio frequency (RF) radiation on thyroid tissues of rats in the 10 days (group E1) and 40 days (group G1) exposure groups. Methods: In this study, 30 healthy female Wistar albino rats, weighing 200−256 g each, were used. The animals were randomly divided into four groups (E1, E2, G1 and G2). Groups E2 and G2 served as the control groups. The exposure groups were exposed to 2100 MHz RF radiation emitted by a generator, simulating a 3G-mobile phone for 6 hours/day, 5 consecutive days/week, at the same time of the day (between 9 am and 3 pm), for 10 days (group E1) and 40 days (group G1). Results: Catalase and xanthine oxidase enzyme activities were compared between the groups E1 and E2; it was found that the difference was statistically significant (p < 0.05). Between the groups G1 and G2, the difference was found to be significant with respect to catalase activities. Tissue samples of the early and late groups showed no serious pathological findings in the histopathological examination. Conclusion: We believe that comprehensive, clinical and experimental studies are needed to assess the effect of the RF exposure duration and dosage of exposure on thyroid tissues.

Effect of silymarin on oxidative stress and liver histopathology in experimental obstructive jaundice model

ABSTRACT PURPOSE: To investigate the effect of silymarin on oxidative stress and hepatic injury induced by obstructive jaundice in an experimental model. METHODS: Thirty Wistar-Albino type female rats were divided into 3 groups each including 10 rats. Only laparotomy was performed in group 1. Bile duct ligation was performed in group 2. In group 3, bile duct ligation was performed and orogastic silymarin 300 mg/kg/day dose was given for seven days. At the end of seven days, rats were sacrificed. The blood and liver tissue samples were taken to be examined biochemically and histopathologically. RESULTS: The plasma and liver levels of malondialdehyde were significantly lower in silymarin group than in the bile duct ligated group. Although liver levels of GSH were significantly higher in silymarin group than in the bile duct ligated group, there was no significant difference between the plasma GSH levels of these groups. In silymarin group; the enlargement of hepatocytes, dilatation of canaliculi and the edema were regressed. CONCLUSION: Silymarin diminished the harmful effects of obstructive jaundice on liver.

Evaluation of incidental thyroid cancer in patients with thyroidectomy / Evaluación incidental del cáncer de tiroides en pacientes con tiroidectomía

OBJECTIVE: The present study aimed to emphasize the necessity and significance of thyroidectomy by determining the prevalence of incidental thyroid cancer in the cases that underwent surgical intervention for the treatment of benign thyroid disease. SUBJECTS AND METHOD: Thyroidectomy was performed in 443 cases including those with benign multinodular goitre (BMNG) or toxic adenoma or toxic multinodular goitre. Diagnosis was made based on routine physical examination, laboratory analyses, imaging methods and postoperative histopathological findings of the cases. RESULTS: The mean age of the cases was 45.5 (19-68) years and 72.5% (n = 321) were female. The most common clinical diagnosis prior to the surgery was BMNG (n = 428, 96.6%). While BMNG was determined to be the most common histopathological diagnosis after thyroidectomy at a rate of 81.7% (n = 362), the rate of thyroid cancer was found to be 14% (n = 81). The prevalence ofpapillary cancer was 84% (n = 56), whereas it was 4% (n = 4), 1% (n = 1) and 0.0% (n = 0) for medullary, follicular and anaplastic cancers, respectively. Papillary cancer was also the most common type of thyroid cancer between genders. As compared to gender, there was no statistically significant difference in terms of distribution of age among general, benign and malignant types of thyroid cancer (p > 0.05). CONCLUSION: It is appropriate to prefer thyroidectomy for the treatment of benign thyroid diseases due to the high prevalence ofincidental thyroid cancer after thyroidectomy in such cases.

OBJETIVO: El presente estudio tiene por objeto destacar la necesidad e importancia de la tiroidectomía mediante la determinación de la prevalencia del cáncer de tiroides incidental en los casos sometidos a intervención quirúrgica para el tratamiento de enfermedades tiroideas benignas. SUJETOS Y MÉTODO: Se practicó la tiroidectomía en 443 casos incluyendo aquellos con bocio multinodular benigno (BMNG) o adenoma tóxico o bocio multinodular tóxico. El diagnóstico se realizó a partir de un examen físico de rutina, análisis de laboratorio, métodos de imaginología, y resultados histopatológicos postoperatorios de los casos. RESULTADOS: La edad promedio de los casos fue 45.5 años (19-68) y 73% (n = 321) eran mujeres. El diagnóstico clínico más común antes de la cirugía fue BMNG (n = 428, 96,6%). Si bien se determinó que BMNG era el diagnóstico histopatológico más frecuente después de la tiroidectomía con una tasa de 81.7% (n = 362), se halló que la tasa de cáncer de tiroides era 14% (n = 81). La prevalencia de cáncer papilar fue de 84% (n = 56), mientras que para el cáncer medular, folicular y anaplásico, fue de 4% (n = 4), 1% (n = 1) y 0.0% (n = 0) respectivamente. El cáncer papilar también fue el tipo más común de cáncer de tiroides entre los géneros. En comparación con el género, no hubo ninguna diferencia estadísticamente significativa en cuanto a la distribución por edad entre los tipos generales, benignos y malignos de cáncer de tiroides (p > 0.05). CONCLUSIÓN: Es apropiado preferir la tiroidectomía para el tratamiento de las enfermedades tiroideas benignas debido a la alta prevalencia de cáncer tiroideo incidental después de la tiroidectomía en tales casos.