Introduction and Objective TAP block has gained popularity to provide postoperative analgesia after abdominal surgery but its advantage over epidural analgesia is disputed. For lower abdominal surgeries, epidural analgesia has been the gold standard and time-tested technique for providing postoperative analgesia, but contraindications for the same would warrant need for other equally good analgesic techniques. The objective of this study is to compare the analgesic efficacy of both the techniques. Materials and Methods Eighty patients in the ASA I-II risk group, undergone an elective C-section, were randomly assigned to the study. In the TAP group, before the C-section, a single-dose spinal anaesthesia was performed by administering 3 ml of 0.5% hyperbaric bupivacaine to the patients when they were in the sitting position. After the C-section, an ultrasound-guided bilateral TAP block was performed in these patients in the recovery room for postoperative analgesia. In the single-dose EPI group, the patients received 16 cc of isobaric bupivacaine, 3 mg of morphine, and 50 mcg of fentanyl, making a total volume of 20 cc and being administered to the epidural space. Results A higher level of patient satisfaction was observed in the EPI group (p=0.003). The amount (mg) of total analgesics received by the patients in the first 24 hours of the postoperative period was statistically significantly higher (p=0.021) in the TAP group compared to the EPI group. The visual analogue scale (VAS) scores of the EPI group were significantly lower compared to that of the TAP group (p < 0.001). Conclusion The epidural anaesthesia is still the golden standard to achieve a postcaesarean analgesia. Epidural anaesthesia is a considerably effective method in controlling the postoperative pain. We are of the opinion that epidural anaesthesia should be preferred in the first place to achieve a successful postcaesarean analgesia as it provides more effective pain control.
Background and objectives Hypertension is one of the most important risk factors for cardiovascular and cerebrovascular events. Inflammatory processes occupy an important place in the pathogenesis of hypertension. Many studies have studied inflammatory markers responsible for the onset of hypertension and organ damage. In this study, we investigated whether the systemic immune-inflammation index (SII) (platelet × neutrophil/lymphocyte), -one of the new inflammatory markers -can be used to predict cerebrovascular events in hypertensive patients.Methods Ambulatory blood pressure monitoring results between January 2019 and June 2020 of approximately 379 patients followed up with hypertension were retrospectively analyzed. These patients were divided into two groups as with or without a previous cerebrovascular event in the analyzed database. In all patients, complete blood count and biochemistry test results just before the cerebrovascular event were found from the database. SII, atherogenic index, neutrophil-lymphocyte ratio were calculated from the complete blood count. Fortynine patients with stroke (group 1: 12.9%; mean age: 64.3 ± 14.6) and 330 patients without stroke (group 2: 87.1%; mean age: 50.8 ± 14.4).Results Ambulatory blood pressure measurements were lower in group 1. Lipid parameters were also lower in this group. Receiver operating characteristic curve analysis showed that SII had a sensitivity of 85.7% and specificity of 84.8 % for stroke in individuals who participated in the study when the cutoff value of SII was 633.26 × 10 3 (P = 0.0001) area under curve (95%); 0.898 (0.856-0.941). In multivariate logistic regression analysis, age and SII were significantly associated with a higher risk of stroke. Age, (hazard ratio:1.067; 95% CI, 1.021-1.115), SII (hazard ratio:1.009; 95% CI, 1.000-1.009), respectively. ConclusionsIn conclusion, SII is a simple, useful new inflammatory parameter for predicting stroke from hypertension. We found that the high SII levels increase the risk of stroke in hypertensive patients.
Öz 1980 sonrasında küreselleşme ve dinamikleri; ekonomik bütünleşme politikaları ile birlikte sosyal, kültürel ve siyasal uyum süreçleri ve özellikle sermayeyi kentsel gelişmeye yönlendirmesiyle kentsel mekânı da biçimlendirmektedir. Türkiye' de de küreselleşme dalgasıyla; neo liberal politikalar çerçevesinde yaşanan ekonomik değişim sürecinde, kent mekânı rant sektörü için en karlı yatırım alanına dönüştürülmektedir. Konut sektörü, etkin ve yaygın pazarlama stratejileriyle bu sürece hızla ve kolaylıkla dâhil edilmiştir. Bu gelişmede kentsel ölçekte son onlu yıllarda Ankara/Çayyolu, orta-üst ve üst gelir grubundaki kullanıcılarıyla, ekonomik ve sosyal olarak ayrışmaktadır. Bu ayrışma, fiziksel ve mekânsal kalite düzeyi yüksek olan konut alanlarında belirgindir. Ancak, konut kalitesinin ölçülebilir fiziksel ve mekânsal standartlarıyla birlikte, kullanıcının sosyal ve kültürel isteklerinin karşılanması, yaşam kalitesinde önem kazanmaktadır. Bu noktadan hareketle, bu çalışmada, konut alanlarında kullanıcıların fiziksel ve toplumsal çevre algısı ile kalite kapsamındaki talepleri ve farkındalığı, örneklem alan olarak seçilen Ankara-Çayyolu-Prof. Dr. Ahmet Taner Kışlalı mahallesinde incelenmektedir. Bu mahallenin 1980'lerle başlayan var oluş öyküsünde, neo liberal politikalar ve kentsel mekânı biçimlendirme yeteneği baş aktör iken, kullanıcıların bu öyküdeki varlığı, yaşam kalitesi ve farkındalıkla tanımlanmaktadır. Böylece elde edilen çıkarsamalar, yaşanabilir konut alanlarının oluşturulmasında yönlendirici olacaktır. AbstractSince 1980, the dynamics of globalization have directed the processes of social, cultural, and political adjustment as well as those of economic integration and especially capital towards urban development, forming urban space. The wave of globalization in Turkey, within a process of economic change in the context of neo liberal policies, urban space has been turned into the most profitable area of investment in the unearned income (economic rent) sector. The residential sector has been included in this process quickly and easily through effective and widespread marketing strategies. Over the last two decades of this development, the Ankara-Çayyolu District has become segregated economically and socially between its upper and upper-middle class residents in the urban context. This segregation is evident in residential areas with high-level physical and spatial quality. On the other hand, in addition to the measurable physical and spatial standards of
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