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Introduction Amiodarone, a pharmaceutical extensively used to suppress atrial and ventricular tachyarrhythmias, is also known to cause many side effects on many tissues. N-acetyl-cysteine (NAC), vitamin E and vitamin C are known as antioxidants for their ability to minimize oxidative stress. In the peer-reviewed literature, there is no study reporting on the protective effects of these antioxidant agents against its hepatotoxicity. Aim We investigated the oxidative effects of NAC, vitamins E and C on liver tissue after amiodarone treatment. Material and methods Rats were randomly assigned to: control; amiodarone group; amiodarone + NAC treated group; amiodarone + Vit. E group and amiodarone + Vit. C group. Liver tissues were isolated from animals and total glutathione levels were measured. Results In all time intervals, the level of glutathione increased. When all time intervals were compared, the amiodarone group revealed the lowest levels. The antioxidant co-administered group was studied; the glutathione levels were statistically significantly higher than the sole amiodarone group. When vitamins E, C or N-acetyl cysteine were examined, there was no statistically significant difference among them. Conclusions In this study we found that hepatotoxicity capacity of amiodarone may be reduced by taking up antioxidants. In addition, the effect documented here may be reproducible and may be applied to clinical settings.

Introduction: Carotid artery stenosis of 50% or more in the extracranial internal carotid artery is responsible for 10-15% of all strokes. Interventional treatment options include carotid endarterectomy and carotid artery stenting, where endarterectomy is proven to be superior. Aim: In this study, we report the carotid endarterectomy results of patients we operated on using the strategy we termed the "one fits all strategy". Material and methods: Seventy-six patients undergoing carotid endarterectomy between July 2016 and April 2020 were retrospectively studied. Conventional endarterectomy under general anesthesia with primary closure of the arteriotomy was performed in all patients. We used a near infrared spectroscopy oximeter to measure regional cerebral oxygenation continuously throughout the surgery. Results: The mean age of the patients was 70.96 8.15 years. There were 52 male and 24 female patients. The mean followup time was 20.6 ±13.6 months. Coronary artery disease was detected in 52 (73.6%) patients. Coronary artery bypass operation was indicated in 19 patients in whom a staged approach was performed in 13 and a reverse staged approach in 1. There were two perioperative strokes one of which recovered fully spontaneously and the other partially with physiotherapy. Eight cases were revised due to hematoma formation. Conclusions: Carotid endarterectomy continues to prove its safety in carotid artery stenosis patients. Continuous cerebral oxygenation monitoring is indispensable for carotid surgery. Despite discrepancies in surgical techniques, we believe that "one fits all strategy: general anesthesia, conventional endarterectomy without patch plasty, never shunter and always NIRS monitorization" may be used safely in patients undergoing carotid endarterectomy.

SUMMARYAloe vera, a succulent plant species, has a long history in folk medicine. Its clear, viscous liquid has been used to treat skin problems and other disorders since ancient times. In the last century, oral consumption and the injection of aloe have also come to popular attention. Its topical use is effective in the treatment of burns and abrasions, and oral use is effective in the treatment of constipation. However, it has not been found to be superior to standard treatments. Most recently, claims of anti-cancer properties are prevalent. It has been found to inhibit proliferation and angiogenesis, and to induce apoptosis in cancer cells. Yet other clinical studies indicate that Aloe vera did not prevent or reduce the number of radiotherapy-related lesions; it merely delayed onset. Furthermore, many instances of toxicity and mortality have been reported in the literature. Today, it is better to avoid it, especially forms taken orally or by injection.