Management of foreign body ingestion and food impaction in adults: A cross-sectional study.

BACKGROUND: The management of food impaction and foreign body ingestion in the upper gastrointestinal tract requires careful evaluation and timely intervention. This study was a retrospective evaluation of the management of adult patients with such a history. METHODS: This study included adult patients admitted to a tertiary medical center with foreign body ingestion or food impaction between January 2012 and January 2018. The demographic and clinical data were recorded pro forma for statistical analysis. RESULTS: Of the 122 patients included in this study, 53.2% were male, and the mean age was 46.68+-18.64 years. In 84 of the patients (68.8%), the ingested object was food. Thirty patients were managed solely through laryngoscopy, while 61 patients (50%) underwent a flexible endoscopy. The patients with a foreign body ingestion were older than those with a food impaction (mean age: 51.3+-17.4 vs. 36.5+-17.4 years; p<0.001) and a plain radiograph showed the ingested material more often in those patients (36.8% vs 10.7%; p<0.001). Two patients underwent surgery due to perforations caused by the impacted material. No mortality was observed. CONCLUSION: The management of a foreign body ingestion or food impaction in an emergency setting requires a stepwise, algorithmic approach.

The effect of duloxetine on penicillin-induced epileptiform activity in rats.

AIM: Previous studies showed the existence of a relationship between epilepsy and depression. Duloxetine is a potent and selective inhibitor of serotonin and norepinephrine reuptake (SNRI) used in the treatment of the major depressive disorder. The aim of the present study was to investigate the effect of duloxetine on penicillin-induced epileptiform activity in an experimental rat model of acute partial epilepsy. METHOD: In this study, 35 male rats weighing 200-240 g were used. Under urethane anesthesia, tripolar electrodes were placed for electrocorticography (ECoG) recording. Duloxetine, at 1, 5, 10 or 30 mg/kg rates, was administered intraperitoneally 30 minutes after intracortical penicillin (500 IU) injection. RESULTS: Duloxetine administrations of 1, 5, 10 and 30 mg/kg increased the mean frequency of epileptiform activity 10 minutes after Duloxetine injection compared to the control group (p < 0.05) without changing amplitude in all groups (p > 0.05). CONCLUSION: The results showed proconvulsant effect of duloxetine in penicillin-induced epileptiform activity and indicated that it could pose complications risk for people with partial epilepsy.

Peripapillary retinal nerve fiber layer and ganglion cell-inner plexiform layer thickness in adult-onset familial Mediterranean fever.

OBJECTIVE: The purpose of the present study was to evaluate the thickness of the peripapillary retinal nerve fiber layer (RNFL) and retinal ganglion cell-inner plexiform layer (GCIPL) in adult-onset familial Mediterranean fever (FMF). METHODS: Forty two adult-onset FMF patients and forty two healthy controls were included in the present study. Detailed ocular examination was performed, and then the thickness of the peripapillary RNFL and GCIPL was measured by Spectral domain optical coherence tomography. The patients were divided into two groups according to their disease severity score, M694V gene mutation, colchicine dosage used per day, colchicine usage time period and number of FMF attacks per year. RESULTS: There were no statistically significant differences in peripapillary RNFL and retinal GCIPL thickness in patients with adult-onset FMF and controls. CONCLUSION: According to our study, it looks like that neither adult-onset FMF nor colchicine has any effect on the RNFL and GCIPL thicknesses. Further studies with a large sample size are needed.

Investigating the effect of rose essential oil in patients with primary dysmenorrhea.

OBJECTIVE: This study aimed to evaluate the effects of rose essential oil on primary dysmenorrhea. METHODS: One hundred patients were randomly divided into two groups; Group D received diclofenac sodium (75 mg/im) and Group A administered diclofenac sodium with aromatherapy (2% rose essential oil). The visual analog scale (VAS) scores in all subjects at baseline, 10th min, and 30th min were recorded. RESULTS: When the two groups were compared before and after the treatment, there were significant decreases in VAS values at the 10 min and 30 min compared to baseline values in both groups (p < 0.001). However, the 30th min mean VAS value in Group D was higher than in Group A (p = 0.019). CONCLUSION: The present study suggests that aromatherapy with rose essential oil, which is a nonpharmacologic treatment method, as an adjuvant to conventional treatment methods may be beneficial for pain relief in individuals with primary dysmenorrhea.

The Effect of Lavender Oil in Patients with Renal Colic: A Prospective Controlled Study Using Objective and Subjective Outcome Measurements.

OBJECTIVE: To assess the usability of lavender oil as an adjuvant in the medical treatment of pain due to renal stones. METHODS: One hundred patients age 19-64 years diagnosed with renal colic were included in the study. Group 1 (n=50) received standard medical therapy (diclofenac sodium, 75 mg intramuscularly); group 2 (n=50) received aromatherapy (lavender oil) in addition to the standard medical treatment. In both groups, the severity of the pain was graded between 0 (no pain) and 10 (severe pain) by using the visual analogue scale (VAS). RESULTS: The VAS values at the beginning and at 10 and 30 minutes in group 1 were 7.70±1.61, 5.02±2.20, and 2.89±1.96, respectively; in group 2, the values were 7.83±2.02, 4.42±2.46, and 2.20±1.74, respectively. The VAS values for the male patients in group 1 at the beginning and at 10 and 30 minutes were 7.61±1.47, 4.80±2.00, and 2.67±1.74; in the female patients, the values were 7.81±1.80, 5.40±2.41, and 3.72±1.94. For the male patients in group 2, the VAS values at the beginning and at 10 and 30 minutes were 8.25±2.01, 4.93±2.72, and 2.96±1.90, respectively; for the female patients, the values were 7.52±1.94, 4.15±1.95, and 1.21±0.91, respectively. Results are presented as mean±SD. Although there was no significant difference between the VAS values at the beginning and at 10 minutes in both groups, the VAS values at 30 minutes in the group receiving aromatherapy plus conventional treatment were statistically significantly low. CONCLUSION: These findings suggest that the use of aromatherapy, which is a nonpharmacologic treatment method, as an adjuvant to conventional treatment methods will help decrease pain, particularly in female patients.

Initial experience with delivery of palliative care toterminal cancer patients.

BACKGROUND/AIM: We investigated the symptoms and needs of terminal cancer patients in a region where formal palliative care is limited. Here we present the demographic features and symptoms of end-stage cancer patients living in a city in northern Turkey. MATERIALS AND METHODS: The study was conducted at Gaziosmanpasa University (Tokat, Turkey), in 2011 and 2012. End-stage cancer patients admitted or referred by various departments to our outpatient pain unit were included. Demographic data, treatment histories, primary tumor sites, patient complaints, and symptom intensities measured using the Edmonton Symptom Assessment System Scale were prospectively entered into a database. RESULTS: A total of 107 patients (36 female and 71 male) were included. Gastrointestinal cancer was the most common form of cancer (43%), followed by genitourinary (25.3%) and lung cancer (15%). The most common symptom was fatigue (98.1%). The other symptoms (in decreasing order) were pain (92.5%), insomnia (92.5%), loss of appetite (76.6%), constipation (71%), dyspnea (63.6%), nausea (60.7%), cough (57.9%), and vomiting (48.6%). Eighty-six percent of the patients (n = 92) had metastases. Most lived in the city (59.8%) and 84 (78.5%) lived with their spouses. CONCLUSION: Patients were referred at the late stages of disease with pain as the principal presenting symptom. Family members were the principal caregivers.

[Comparing efficiencies of diclofenac sodium and paracetamol in patients with primary dysmenorrhea pain by using Visual Analog Scale]. / Primer dismenore agrili hastalarda diklofenak sodyum ve parasetamol tedavi etkinliklerinin Vizüel Analog Skala kullanilarak karsilastirilmasi

OBJECTIVES: The aim of this study was to compare the efficiency of diclofenac sodium to paracetamol using a visual analog scale in the patients presenting to the emergency room with primary dysmenorrhea. METHODS: Group I (n=40) patients were diagnosed with primary dysmenorrhea and treated with paracetamol (1 gr intravenous) and Group II (n=40) patients were diagnosed with primary dysmenorrhea and treated with diclofenac sodium (75 mg intramuscular). In both groups, patients were 19-30 years old. In all groups, the intensity of the pain was ranked from 0 (no pain) to 10 (intolerable) using VAS. The VAS scores were compared between treatment groups. RESULTS: Between two groups, there was no statistically significant difference in age, mean arterial pressure and pulse values. The initial VAS values of the first group were higher than that of 2nd group. Following treatment, in the 10th and 30th minutes, the VAS values were lower in Group I than Group II (p=0.00). The VAS values of each group were significantly different from each other on the 10th and 30th minutes. VAS values at the 10th and 30th minutes were lower compared to the initial values and the values in the 30th minute were lower relative to the 10th minute (p=0.00) in both treatment groups. CONCLUSION: We can suggest that paracetamol is more efficient than diclofenac sodium in the treatment of primary dysmenorrhea.

Should the New Injury Severity Score replace the Injury Severity Score in the Trauma and Injury Severity Score?

BACKGROUND: This study was performed to compare the efficacies of Injury Severity Score (ISS) and New Injury Severity Score (NISS), and to investigate whether replacing ISS with NISS in Trauma and Injury Severity Score (TRISS) changes the predictive power for mortality. METHODS: We retrospectively analyzed 550 patients aged over 16 years seen in our center over a period of four years who had injuries in at least two organ systems. The ISS, NISS and TRISS were calculated for each patient. TRISS was calculated in two ways: TRISS 1 with age, Revised Trauma Score (RTS) and ISS, and TRISS 2 with age, RTS and NISS. The cut-off values for TRISS 1, TRISS 2, ISS and NISS were determined by ROC analysis. RESULTS: The ideal cut-off values for the prediction of mortality were 21.0 (AUC: 0.907) for ISS and 25.0 (AUC: 0.914) for NISS. There was no statistically significant difference between the ROC curves of ISS and NISS. The ideal cut-off values for predicting mortality were 90 (AUC: 0.934) for TRISS 1 and 86 (AUC: 0.935) for TRISS 2. There was no statistically significant difference between the ROC curves of TRISS 1 and TRISS 2. CONCLUSION: Use of NISS instead of ISS in the TRISS model demonstrated no significant difference, and it can thus be recommended for use.