Comparison of the patients with diabetes mellitus using either insulin or oral antidiabetic drug in terms of difficult laryngoscopy: A randomized controlled study.

Aim: We aimed to evaluate the differences in the difficult laryngoscopy as a general anesthetic component in patients with Diabetes Mellitus (DM) using either insulin or oral antidiabetic drug (OADD). Materials and Methods: This study was planned for a total of 230 patients including DM patients and non-DM patients as a control group who would undergo elective surgery between 30.01.2020-30.04.2020. Age, gender, body mass index (BMI), Mallampati scores, thyromental distance (TMD), inter-incisor distance (IID), and neck extension measurements were noted. Preoperative HbA1C levels, DM type, diagnosis time, and duration of insulin or OADD use were recorded. Patients without DM (Group C), patients using insulin (Group I), and patients using OADD (Group D) were separated respectively. Cormack-Lehane (CL) classification of the airway, number of laryngoscopic attempts, intubation success at the first attempt, intubation duration, performance of backward-upward-rightward pressure (BURP) maneuver, and requirement of use of different airway equipment were compared between the groups. Results: The data of 192 patients were compared. The mean IID (mm) was lower in Groups I and D than C. It was the lowest in Group I. Presence of neck extension of more than 30° in Groups I and D was lower than C. Classification of CL in Groups I and D was higher than C. Number of laryngoscopic attempts was higher in Groups I and D than C. Intubation success at the first attempt was lower in Groups I and D than C. The intubation duration was longer in Groups I and D than C. It was the longest in Group I. The more BURP maneuvering was required in Groups I and D than C. In Groups I and D, the number of uses of different airway equipment was higher than in Group C. The rate of using a videolaryngoscope (VL) in Group I was higher than in Groups D and C. Conclusion: Difficult laryngoscopy was more common in DM patients. Moreover, in patients with DM using insulin, VL use was more often and intubation duration was longer than in patients with DM using OADD.

Convalescent plasma therapy in critically Ill COVID-19 patients: A retrospective cohort study.

Background: Convalescent plasma (CP) therapy can be defined as a passive immunity transfer approach involving the administration of plasma for therapeutic purposes to inpatients hospitalized due to an active virus infection. Passive immunity antibodies can reduce target organ damage and directly neutralize the responsible pathogens. A limited number of studies on the use of CP have reported that critically ill patients can benefit from CP therapy. Aim: We aimed in this study as the outcomes of CP therapy in critically ill coronavirus disease 2019 (COVID-19) patients in intensive care unit (ICU) and determine the differences between the recovery and mortality groups. Patients and Methods: This retrospective design study involved critically ill patients who were diagnosed with COVID-19 pneumonia or who were suspected of having COVID-19 in the ICU between April 1, 2020, and June 1, 2020. Comorbidity of patients, respiratory findings, hemodynamic data, laboratory data, and poor prognostic measures were compared between mortality and recovery group. Results: Convalescent plasma (CP) therapy was supplied for 41 (13.58%) patients in total of 302 COVID-19 patients. Twenty-nine patients were died in total of 41 COVID-19 patients who supplied CP therapy. The mortality rate is 70.73% in CP therapy. There was a significantly higher incidence (P < 0.021) of invasive mechanical ventilation (IMV) and significantly lower mean arterial pressure (MAP) values in mortality group (P < 0.05). There were significantly higher NLR values (P < 0.05), lower platelet count (P < 0.05), lower of glomerular filtration rate (GFR) level (P < 0.05), higher creatinine values (P < 0.05), higher lactate dehydrogenase (LDH) levels (P < 0.05), higher D-dimer levels (P < 0.05), higher level of pro-brain natriuretic peptide (BNP) (P = 0.000), rate of fever (P = 0.031), arrythmia (P = 0.024), and transfusion-associated circulatory overload (TACO) (P = 0.008) were more often in mortality group. Conclusion: Convalescent plasma therapy seems not useful in critically ill COVID-19 patients.

Comparison of patients with and without intellectual disability under general anesthesia: A retrospective study.

BACKGROUND AND PURPOSE: We analyzed and retrospectively compared patients with and without intellectual disability (ID) who underwent oral surgery under general anesthesia at Istanbul University, Faculty of Dentistry, Department of General Anesthesia, between October 2012 and June 2013 with regard to the following categories: Demographic features, American Society of Anesthesiologists (ASA) classification, Mallampati score, type of anesthetic drug used during the operation, type of intubation used, any difficulties with tracheal intubation, presence of systemic diseases, and recovery times after ending general anesthesia. MATERIALS AND METHODS: A total of 348 patients were selected from the Department of Maxillofacial Surgery and the Department of Pedodontics who underwent surgery with general anesthesia. Medical histories of all patients were taken, and their electrocardiography, chest X-rays, complete blood count, and blood clotting tests were checked during a preoperative assessment. Mallampati evaluations were also performed. Patients were grouped into ASA I, II, or III according to the ASA classification and were treated under general anesthesia. RESULTS: There was no significant difference between normal and intellectually disabled patients in terms of gender, Mallampati scores, intubation difficulties, mean anesthetic period, time to discharge, or postoperative nausea and vomiting. Epilepsy and genetic diseases in intellectually disabled patients were significantly more common than in non-ID (NID) patients. However, the frequency of diabetes and chronic obstructive pulmonary disease in NID patients was significantly higher than in the intellectually disabled patients. CONCLUSION: Dental treatment of intellectually disabled patients under general anesthesia can be performed just as safely as that with NID patients.