Challenge Journal Publications (TULPAR Academic Publishing)
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Instagram: A platform for caudal epidural injection?
Full text linkAim: Caudal epidural injection (CEI) is a widely used procedure in pediatric anesthesia for perioperative pain and in adults for chronic radicular pain. Social media platforms, including Instagram, are being increasingly utilized for the dissemination of information in various fields, including medicine. The aim of this study was to evaluate the information content and sources of CEI on Instagram.Method: This study presents an analysis of Instagram contents containing the keywords #caudalepiduralinjection, #caudalepidural, #caudalepiduralblock, #caudalinjection, and #caudalblock on May 1, 2023. The results were classified into four groups based on the source: posts generated by physicians, organizations, patients, or unspecified sources. The posts were further classified into two categories: educational or experience. User influence was also assessed based on the number of followers and posts.Results: A total of 204 posts were assessed. 72 different accounts were identified and the distribution of these accounts is as follows: physicians accounted for 29.16% (n=21), patients accounted for 51.38% (n=37), medical organizations accounted for 11.11% (n=8), and the remaining 8.33% (n=6) were not otherwise specified. Among the posts, 92 (45.09%) were posted by the patients, 71 (34.80%) were posted by physicians, 25 (12.25%) by medical organizations, and 16 (7.84%) were not specified. There was a significant difference in the number of posts created by patients versus physicians (p=0.036). Furthermore, there was a significant difference in the number of followers between physicians and all other groups analyzed. There were no posts regarding the use of CEI in pediatric anesthesia when searching for posts on CEIs.Conclusions: When searching for posts related to CEIs, it is more likely to encounter posts authored by patients, thus resulting in the educational content created by physicians being overshadowed and buried among numerous other posts. We suggest posting educational medical content with the hashtag #MedEd in an attempt to make educational content more easily accessible. These findings highlight the importance of raising awareness about CEIs on Instagram. Pain medicine societies and specialists should actively contribute by sharing credible posts on CEIs
Assessment of gender equality among graduates of anesthesiology residency in the last decade: A national data analysis
Full text linkAim: Despite the global upward trend in the representation of female doctors, certain medical specialties continue to exhibit a notable gender disparity. The presence of an equitable gender distribution within the healthcare sector has been shown to enhance the overall quality of service provision and has the potential to enhance performance outcomes. The objective of our research is to examine the gender composition of anesthesiology and reanimation professionals in Turkey.Methods: Data was collected regarding physicians who successfully completed their anesthesiology and reanimation specialization training and subsequently participated in the state service obligation lottery since the year 2013. Data provided by the General Directorate of Management Services of the Republic of Turkey Ministry of Health. The gender of the specialist physicians in the specified time period and the type of hospital they trained in were collected.Results: There were 1249 males and 1400 females among the 2649 specialists with no difference in the gender distribution. Upon conducting separate annual evaluations, there were significant increases in the proportions of men in the years 2017 and 2021, as well as women in the years 2019 and 2023. Additionally, 852 of them had received specialization from training hospitals and 1797 from university hospitals. Over the course of a decade, there was an absence of variation in the hospital preferences of anesthesiologists with regards to gender distribution. However, in the subsequent years of 2018, 2021, and 2023, female anesthesiologists exhibited a significantly higher preference for these hospitals. In 2019, a notable trend was observed wherein female anesthesiologists from university hospitals, while in 2021, male anesthesiologists demonstrated a similar inclination.Conclusions: In Turkey, the field of anesthesiology and reanimation demonstrates a balanced gender distribution in terms of expertise. There is no discernible disparity in the gender distribution among anesthesiologist' hospital preferences
The effects of pentoxyphiline on neurocognitive functions and neurobiochemical markers in coronary artery bypass graft surgery
Full text linkAim: Neurocognitive dysfunction is a complication of cardiopulmonary bypass (CPB). Neuron-specific enolase (NSE) and S100ß protein are markers of cerebral injury. With its beneficial rheological and anti-inflammatory properties, pentoxyphiline (PTX) is an interesting agent in cardiac surgery patients. The study was designed to evaluate the influence of prophylactic use of PTX on cognitive function and S100ß and NSE in on-pump coronary artery bypass grafting (CABG) patients.Method: In this prospective study, 40 patients undergoing on-pump CABG and received either PTX (bolus of 5 mg kg-1) after induction of anesthesia or saline are included. Neurological examination and neuropsychologic tests, including the mini-mental state examination test (MMSET) and Benton visual retention test (BVRT), were obtained preoperatively and on the seventh postoperative day. Blood samples for analysis of S100ß and NSE were collected before anesthesia, at the end of CPB, at the 3rd hour and 24th hour postoperatively.Results: Demographic and perioperative data were similar for the two groups. Mean cross-clamping times were 67.86±22.22 and 66.32±27.84 min, respectively. In both groups, S100ß and NSE increased significantly (p0.05). MMSET and BVRT performances of the two groups were similar and did not change compared to preoperative scores.Conclusions: Coronary artery bypass surgery caused a significant increase in NSE and S100ß serum levels but with no deterioration in neuropsychological outcome assessed in the first postoperative week. Although it was reported that PTX could be a promising agent to prevent post-CPB organ dysfunction in elderly cardiac surgery patients, prophylactic use of PTX appeared to offer no advantage for cerebral protection in the age group involved in this study
Optimization of reinforced concrete frame structures and matrix displacement method
Full text linkIn this study, reinforced concrete frame system is generated, and all structural elements which are beam and columns are optimized according to the applied distributed loads and different concrete classes by using Matlab program. Jaya algorithm which is a Metaheuristic Algorithm that enables to optimization process and finds the best cross sections, reinforcement area as well as cost of the system, is proposed. It is observed that cross-section, reinforced area as well as cost of the system are changed when concrete classes are used differently. After finding the optimum design values for frame system, the matrix displacement method is utilized to specify the system displacements and all nodes forces. Furthermore, columns and beam displacement results are not similar, and also internal forces are different for nodes. TS500 (2000) (Reinforced concrete structures design and construction rules) and TBDY (2018) (Turkey Building Earthquake Regulation) are used together to specify variables, constraints and also necessity values. The proposed method is feasible for frame structures consisting of different members
Comparison of the postoperative analgesic efficacy of ultrasound-guided suprainguinal fascia iliaca block applied with two different concentrations of bupivacaine in patients undergoing hip surgery under spinal anesthesia
Full text linkAim: Management of postoperative pain in hip surgeries is important for the quality of recovery. When regional anesthesia techniques are added to the multimodal analgesia plan, they increase the effectiveness of the analgesia plan. Supra-inguinal fascia iliaca block (SIFIB) is a technique that has been reported to be effective in hip surgery but requires the use of high-volume local anesthetics. Our aim in this retrospective study is to investigate the efficacy of local anesthetic in SIFIB when administered at a concentration lower than the conventional concentration.Material and Methods: The files of the patients who underwent hip hemiarthroplasty were planned to be evaluated retrospectively. Patients were grouped according to the bupivacaine concentration used in SIFIB (0.25% vs. 0.20%) and statistically evaluated in terms of morphine requirement, pain scores, and time to first analgesic.Results: There was no significant difference between the groups in terms of NRS score and cumulative morphine consumption at the 3rd, 6th, 12th, 18th, and 24th hours (p>0.05). When compared the first analgesia requirement times, there was no significant difference between Groups (p>0.05).Conclusion: A single shot SIFIB administered at a concentration of 0.20% also has analgesic properties, as do the conventional concentration of SIFIB containing 0.25% bupivacaine
Viscoelastic rod using the generalized finite difference method
Full text linkThe finite difference method is quite extensively used to obtain the approximate solutions of many equations of mathematical physics. In this study, the precise algorithm in the time domain is combined with the generalized finite difference method to solve dynamic viscoelasticity problems. The numerical results obtained are satisfactory, and they are presented together with finite difference and finite element solutions.
Effect of dosage on the mechanical properties of epscrete
Full text linkEpscrete, which is made by employing aggregate made of expanded polystyrene beads, is often used to make wall panels, block components, and insulating plates. For these products to have greater mechanical qualities, 400, 600, and 800 dose epscrete specimens were made in this research, which also considered the influence of cement quantity. The water-cement ratio was considered to be 0.5. In addition to the reference specimens, the same manufacture was carried out utilizing a 1% plasticizer admixture. Specimens were subjected to unit weight, ultrasonic pulse, water absorption, bending, and comprehension tests 7 and 28 days after production. The effects of the dose and plasticizer rate on the physical and mechanical properties of early and ultimate epscrete specimens were determined according to the unit weight, ultrasonic pulse velocity, water absorption rates, bending and compressive strength values. Increasing the dosage increased the ultrasonic pulse velocity, reduced water absorption by reducing the amount of gap and reduced water absorption, and increased compressive strength by approximately 65 % and bending strength by about 60 %. It has been determined that the mechanical and physical properties of epscrete are affected by dose and mixture ratios. By increasing the dosage, it has been seen that carrier light carrier blocks can be obtained