Objective: In the current study, our primary aim is to compare complication rates between using ProSeal laryngeal mask airway (P-LMA) and endotracheal tube (ETT) in bronchoscopy-guided percutaneous dilatational tracheostomy (PDT) procedure. Our secondary aim is to compare the processing time of these two techniques. Methods: Sixty-one adult patients who were intubated in the intensive care unit and scheduled for PDT due to the need for long-term mechanical ventilation were included in the study. The patients were randomly divided into ETT group or P-LMA group under bronchoscopy guidance. Complications related to the procedures and the duration of each procedure were recorded. Hemodynamic measurements, oxygen saturation, arterial blood gas analysis, preferred mechanical ventilation mode, positive end expiratory pressure and mean airway pressure values were recorded before PDT, and 30 minutes after the procedure. Results: A total of 61 cases, 23 (38%) female and 38 (62%) male, participated in the study. Regarding the complication rates between the groups, we encountered more complications in the ETT group and the most common complication was puncture of the cuff of the intubation tube. The procedure time was also significantly shorter in the P-LMA group (P-LMA; 2.5 min, ETT; 3.6 min). Conclusion: Using P-LMA for PDT under bronchoscopy caused lower complication rate than using ETT. In a addition the duration of PDT procedure was shorter in P-LMA group than ETT group. Keywords: Percutaneous dilatational tracheostomy, bronchoscopy, laryngeal mask

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ÖzIsolated gallbladder injury after trauma occurs rarely and when unrecognized mortality is too high. In some hemodynamically suitable cases, conservative treatment may be the best choise for the patient. We presented a case with conservatively treated abdominal trauma after stucking in the elevator and had isolated gallbladder injury.Travma sonrası izole safra kesesi yaralanması nadir görülmekle birlikte tanı konulmadığında mortalitesi oldukça yüksektir. Hemodinamik olarak uygun vakalarda konservatif tedavi yaklaşımı hasta için en iyi seçenek olabilir. Bu yazımızda asansörde sıkışma sonucunda künt batın travmasına sekonder izole safra kesesi hematomu gelişen hastanın cerrahiye gerek kalmadan konservatif tedavi ile iyileşebileceğini vurguladık.

Introduction:The use of snake skin, both transdermal and orally comes from ancient Chinese medicine. People eat snake skin for skin disorders, convulsions, gallbladder disorders and hypertension. People also apply snake skin by transdermal way for skin disorders such as sores,boils, itching, psoriasis, scabies, hemorrhoids, eye infections, cloudy spots in the eye..etc. There isn't enough reliable information available about snake skin to know if it is safe or what the side effects might be. Case:The patient described in the case report has given his informed consent for publication. We present a case of anaphylaxis developed after 10 days of snake skin eating and dicharged after 4 days treatment with full recovery. Conclusion:It must be kept in mind that natural products are not always necessarily safe and also dosages can be important. Availability of exotic foods for different uses is steadily increasing. No matter how developed we are, those who try traditional medicine methods instead of chemical drugs will always be. So we must be careful and always be awake for different food consumptions.