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Öğe Complete response to acupuncture therapy in female patients with refractory interstitial cystitis/bladder pain syndrome(Via Medica, 2017) Sonmez, Mehmet Giray; Kozanhan, BetulObjectives: Interstitial Cystitis/Bladder Pain syndrome (IC/BPS) is a considerable issue in urology and gynecology and unfortunately, the treatment options recommended are not fully efficient. Therefore, in this study we aimed to determine the effectiveness of acupuncture treatment in patients with refractory IC/BPS. Material and methods: 12 refractory IC/BPS female patients received ten sessions of acupuncture twice a week. The visual analog score (VAS), interstitial cystitis symptom index (ICSI), interstitial cystitis problem index (ICPI), O'Leary-Saint symptom score (OSS), Patient Health Questionnaire (PHQ9), Pelvic pain and urgency & frequency patient symptom scale tests (PUF) and maximum voided volume (MVV) was completed in 1st, 3rd, 6th and 12th months following the treatment. Results: There was a statistically significant decrease in all of the scores evaluated at first month compared with the baseline. While the change in VAS score in 1, 3, 6 and 12th months were found statistically significant, measurements of ICSI, OSS and PUF scores and MVV values in the 6th and 12th months and ICPI and PHQ scores in the 12th month were not found statistically significant compared to the pre-treatment period. Response to treatment for the first three months after acupuncture application was (100%), but this ratio was measured as 33.3% (4/12) in the sixth month and 16.6% in the 12th month (2/12). Conclusions: The results of this study suggest that acupuncture appears to be an effective, useful, non-invasive method in IC/BPS patients. It can be used as an appropriate treatment method not only in refractory but also in IC patients since it is rather advantageous compared to other treating agents.Öğe Development and Validation of a Turkish Version of Obstetric Quality of Recovery-10(Aves, 2022) Kozanhan, Betul; Yildiz, Munise; Polat, Aysenur; Gunenc, Oguzhan; Tutar, Sami Mahmut; Iyisoy, Mehmet Sinan; Kulhan, Nur GozdeObjective: The 10-item Obstetric Quality-of-Recovery 10 scale is a validated patient-reported outcome questionnaire that measures the quality of recovery following delivery. This study aims to develop a Turkish version of the Obstetric Quality of Recovery 10 to evaluate its validity, reliability, and clinical feasibility. Methods: Term parturients who underwent vaginal delivery or elective caesarean delivery were asked to complete a Turkish version of Obstetric Quality-of-Recovery 10 scoring tool and EuroQol 5-dimension 3L scores (including a global health visual analogue scale) 24 hours after delivery. To validate the Obstetric Quality of Recovery 10-Turkish, we assessed validity, reliability, and clinical feasibility and compared it with the EQ-5D-3L questionnaires. Results: One hundred parturients completed the questionnaire in 24 hours (100% response rate). Obstetric Quality of Recovery 10-Turkish correlated highly with EQ-5D-3L score (r = -0.611) and global health visual analogue scale score (r = 0.652) at 24 hours and discriminated well between good versus poor recovery (global health visual analogue scale score >= 70 vs <70; median interquartile range were 86 [80-90] and 68 [59-75] (P <.001), respectively). Scores were similar for caesarean and vaginal deliveries, 83 (76-89) and 82.5 (69-90), respectively (P =.5). Twenty-four-hour Obstetric Quality of Recovery 10-Turkish scores did not correlate with any baseline demographic and clinical data parameters. Internal consistency was good (Cronbach's alpha = 0.87 and inter-item correlation = 0.41), and split-half reliability was very good (Spearman-Brown prophesy reliability estimate = 0.86). Test-retest reliability was excellent (intra-class correlation coefficient = 0.99). No floor or ceiling effects were demonstrated. Conclusion: The Obstetric Quality of Recovery 10-Turkish is a valid, reliable, and clinically feasible measure of inpatient postpartum recovery following caesarean and vaginal delivery modes.Öğe Dynamic thiol disulphide homeostasis in operating theater personnel exposed to anesthetic gases(Wiley, 2017) Kozanhan, Betul; Inanli, Ikbal; Deniz, Cigdem Damla; Iyisoy, Mehmet Sinan; Neselioglu, Salim; Sahin, Osman; Akin, FatmaBackground: The purpose of this study was to investigate the association between dynamic thiol/disulphide homeostasis and occupational exposure to volatile anesthetic gases in operating theater personnel. Decreased blood thiol levels and raised blood disulphide levels serve as biomarkers of oxidative stress. Methods: Weincluded 65 subjects occupationally exposed and 55 unexposed healthy medical professionals into the study. A novel method enabled separate measurements of components involved in dynamic thiol/disulphide homeostasis (native thiol, disulphide, and total thiol). To control for the potential confounding effect on oxidative stress of psychological symptoms potentially caused by occupational stress, we used scores obtained from four different anxiety and depression inventories. Results: Mean +/- standard deviation native thiol was found to be 433.35 +/- 30.68 in the exposed group, lower than among controls, 446.61 +/- 27.8 (P = 0.02). Disulphide in the exposed group was 15.78 +/- 5.12, higher than among controls, 12.14 +/- 5.33 (P < 0.001). After adjusting for anxiety and depression scores, age and gender, native thiol remained lower and disulphide higher in the exposed group (P = 0.008 and P < 0.001). Conclusion: Dynamic thiol/disulphide homeostasis in workers exposed to anesthetic gases was found to be disturbed after adjusting for the possible contribution of anxiety. We infer that this is due to the oxidative effect of exposure to anesthetic gases.Öğe Dynamic thiol/disulfide homeostasis as a novel indicator of oxidative stress in patients with urolithiasis(Korean Urological Assoc, 2019) Sonmez, Mehmet Giray; Kozanhan, Betul; Deniz, Cigdem Damla; Iyisoy, Mehmet Sinan; Kilinc, Muzaffer Tansel; Ecer, Gokhan; Ozturk, AhmetPurpose: A dynamic thiol/disulfide balance is pivotal in organizing anti-oxidant defense, detoxification, apoptosis, and enzyme activities, as well as transcription and cellular signal-transfer mechanisms. The connection between urolithiasis and oxidant/antioxidant status, which can be assessed through thiol-disulfide homeostasis (TDH), has not yet been examined. In this study, we evaluated the effects of TDH on the formation, size, and location of stones by examining the associations between TDH parameters and urolithiasis. Materials and Methods: Patients with urolithiasis and healthy controls were recruited. The patients were divided into subgroups in terms of stone size (>15 mm or <= 15 mm) and stone location (nephrolithiasis or ureterolithiasis). TDH parameters were measured using a novel automatic and spectrophotometric method and compared statistically. Results: TDH parameters were different between the urolithiasis and control groups. TDH tended towards the disulfide side in the urolithiasis group. Stone size increased an average 0.14 mm with a 1 mu mol/L increase in disulfide level and decreased an average 0.058 mm with a 1 mu mol/L increase in native thiol level. Disulfide and native thiol levels were found to be different across patients with stone size >15 mm, <= 15 mm, and controls (p<0.001 and p<0.001, respectively). However, the nephrolithiasis and ureterolithiasis groups were similar in respect of TDH parameters. Conclusions: In this study, it was found that patients with urolithiasis displayed oxidative stress characterized by a TDH tendency towards the disulfide side, and an inadequate antioxidant response identified by a lower level of native thiol as compared with healthy controls.Öğe The effect of erector spinae plane block on postoperative analgesia and respiratory function in patients undergoing laparoscopic cholecystectomy: A double-blind randomized controlled trial(Elsevier Science Inc, 2021) Yildiz, Munise; Kozanhan, Betul; Iyisoy, Mehmet S.; Canitez, Ahmet; Aksoy, Nergis; Eryigit, AysenurStudy objective: Laparoscopic cholecystectomy (LC) causes moderate-to-severe postoperative pain. Postoperative pain is one of the leading contributors to respiratory dysfunction following surgery. This study investigated the effect of erector spinae plane (ESP) block on postoperative analgesia and respiratory function in patients undergoing LC. Design: Prospective, randomized, controlled trial. Setting: University of Health Science. Patients: Sixty-eight adult patients undergoing LC. Interventions: Both groups received a standardized analgesia protocol. Patients assigned to the ESP block group received an additional bilateral ESP block. Measurements: The primary outcome was assessed as postoperative pain intensity associated with a lower opioid requirement and significant respiratory function improvement. Main results: Numerical rating scale (NRS) scores both at rest and during coughing were significantly lower in the ESP block group than in the control group at all time intervals (p < 0.001 in each) except for hour 2 postoperatively (p = 0.06 and p = 0.13, respectively). Tramadol consumption at 2 h and 24 h postoperatively was significantly lower in the ESP block group than in the controls (p < 0.001 for each). There was significant preservation in forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) in the ESP group in comparison to the control group at 2 and 24 h after surgery (p < 0.05 in each). FEV1/FVC and peak expiratory flow rate (PEFR) values were similar in each time interval. Conclusions: Bilateral ESP blocks provides adequate analgesia, allowing for a lower opioid requirement and significant respiratory function improvement after LC; therefore, we concluded that ESP block could be added to the multimodal analgesia protocol in LC.Öğe The Effect of Oxidative Stress Which Can Be Demonstrated with Thiol/Disulfide Homeostasis in Varicocele Patients on Sperm Parameters(Clin Lab Publ, 2018) Sonmez, Mehmet G.; Kozanhan, Betul; Deniz, Cigdem D.; Iyisoy, Mehmet S.; Kilinc, Muzaffer T.; Ecer, Gokhan; Sonmez, Leyla OzturkBackground: We planned to evaluate the effects of thiol/disulfide homeostasis (TDH) on sperm parameters in varicocele patients in this study. Methods: According to sperm concentration (< 15 x 10(6)/mL) sperm morphology (<4%) and progressive motility values (<32%) in the semen analysis, patients were divided into four groups as oligozoospermia (OS, n = 27), oligoasthenozoospermia (OAS, n = 20), oligoteratozoospermia (OTS, n = 26), and oligoasthenoteratozoospermia (OATS, n = 19). Patients with varicocele diagnosis but no pathology in semen analysis were accepted as the control group (n = 25). Groups with impaired semen analysis results were compared to the control group. Results: No difference was detected between OS, OAS, OTS, and OATS groups and the control group in demographical (age, BMI) and varicocele parameters (vein diameter, grade). A significant difference was observed in disulfide level, disulfide/native thiol, disulfide/total thiol rates among OS, OAS, OTS, OATS groups and the control group in the evaluation of TDH parameters. They were significantly higher in OATS group. In OS, OAS, OTS, and OATS groups, it was found that native thiol and total thiol levels were lower and disulfide level was higher than control group, and thiol/disulfide homeostasis shifted to the disulfide side. It was detected that when disulfide value increases 1 mu mol/L, the morphology deteriorated 0.3% and sperm concentration (10(6)/mL) decreased 0.74 and progressive motility decreased 0.68%. Conclusions: The results of the present study suggest that patients with varicocele who have impaired sperm parameters have oxidative stress characterized by TDH slide towards disulfide side and inadequate antioxidant response identified by a lower level of native thiol compared to controls.Öğe The Effects of Positive End-Expiratory Pressure on Cross-Sectional Area of Internal Jugular Vein in Obese Patients(Mary Ann Liebert, Inc, 2016) Kozanhan, Betul; Apiliogullari, Seza; Basaran, Betul; Iyisoy, Mehmet Sinan; Ozmen, SadikIntroduction: Obesity is one of the most important risk factors for complications of internal jugular vein (IJV) cannulation. The efficacy and safety of positive end-expiratory pressure (PEEP) are still under debate in obese patients. The aim of this prospective randomized ultrasound study was to investigate effects of different PEEP levels on the cross-sectional area (CSA) of right IJV and overlap with carotid artery (CA) in anesthetized obese patients. Materials and Methods: Seventy-two obese patients undergoing various elective surgeries under general endotracheal anesthesia were enrolled. We measured CSA of right IJV, margin of safety (MOS), and degree of overlap between CA and IJV at PEEP 0 (P0), 5 (P5), and 12 (P12) cm H2O levels. We defined a 20% increase in CSA as clinically relevant. Results: Data were collected for all the 72 patients enrolled in the study. Application of 12, but not 5cm H2O PEEP, resulted in a clinically significant increase in CSA of right IJV. When compared to P0, application of P5 and P12 increased both degree of overlap (p<0.001 each) and MOS (p<0.001 each). None of the patients experienced severe hypotension or bradycardia. Conclusions: Application of 12cm H2O PEEP provides a clinically significant increase in CSA of right IJV without relevant reduction of MOS in anesthetized obese patients.Öğe Evaluation of rhomboid intercostal and subserratus plane block under direct vision for postoperative analgesia in thoracic surgeries: a prospective, randomized controlled trial(Oxford Univ Press Inc, 2022) Kozanhan, Betul; Semerkant, Tolga; Esme, Hidir; Canitez, Ahmet; Iyisoy, Mehmet SinanOBJECTIVES: This study is designed to evaluate the efficacy of rhomboid intercostal and subserratus plane (RISS) block under the surgeon's direct vision for providing postoperative pain relief after thoracic surgeries. METHODS: Forty patients who underwent thoracotomy were prospectively recruited and randomly assigned to group R (intravenous patient-controlled analgesia + continued RISS block; n = 20) and group C (intravenous patient-controlled analgesia; n = 20). Numeric rating scale at rest and cough, at post-anaesthetic care unit, 1, 2, 6, 9, 12, 24 and 48 h, was used as the primary outcome measure. Secondary outcome measures were the amount of tramadol consumption, the number of patients required rescue analgesia, the occurrence of postoperative adverse effects, pulmonary functions and the overall satisfaction with pain management. RESULTS: Numeric rating scale scores both at rest and during coughing were significantly lower in group R than in group C at all time intervals (P < 0.001 in each). Tramadol consumption at 24 and 48 h was significantly lower in the group R block than in group C (P < 0.001 for each). None of the patients in group R requires rescue analgesia. The incidence of nausea and vomiting was similar among the groups. Compared with group C, change in lung function from baseline levels was significantly less in group R (P = 0.047 and P = 0.04 for FEV1 and FVC, respectively). The satisfaction scores in group R were significantly higher than that in group C (P < 0.001). CONCLUSIONS: Continuous RISS block improved postoperative outcomes of thoracic surgery in terms of reduced postoperative pain scores, sparing opioid consumption, pulmonary function and patient satisfaction.Öğe Is oxidative stress measured by thiol/disulphide homeostasis status associated with prostate adenocarcinoma?(Termedia Publishing House Ltd, 2018) Sonmez, Mehmet G.; Kozanhan, Betul; Deniz, Cigdem D.; Goger, Yunus E.; Kilinc, Muzaffer T.; Neselioglu, Salim; Ere, OzcanAim of the study: We aim to examine the relation between thiol/disulphide homeostasis and transrectal ultrasound guided prostate biopsy (TRUS-Bx) results and evaluate whether it was effective on the distinction of benign and malign prostate disease. Material and methods: The study included 29 men histopathologically diagnosed as prostate adenocancer (Pca) (group 1), 30 men having benign prostate hyperplasia (BPH) (group 2) and age match 30 healthy individuals in the control group (group 3). Thiol/disulphide homeostasis was measured using a novel automatic and spectrophotometric method. Results: Among the three groups, a statistically significant difference was detected among native thiol, total thiol levels and disulphide/total thiol, disulphide/native thiol and native thiol/total thiol ratios which are thiol/disulphide homeostasis parameters apart from disulphide (p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001 respectively). Additionally, no significant difference was detected in albumin and total protein levels among the groups (p = 0.223, p = 0.316 respectively). Serum native and total thiol levels were high and disulphide level was low in group 1 when compared to the group 2 (p = 0.003, p = 0.007, p = 0.265 respectively). In addition, serum native thiol, total thiol and disulphide levels were low in group 1 when compared to the group 3, but while low native and total thiol levels were significant, low disulphide levels were not found significant (p < 0.001, p < 0.001, p = 0.331, respectively). Conclusions: Thiol/disulphide homeostasis was found to be disturbed in Pca patients detected with TRUS-Bx. This is suggesting serum native thiol, total thiol level and ratios provides a novel biomarker for the role for oxidative stress in disease etiopathogenesis.Öğe Is There a Difference Between the Readabilities of Informed Consent Forms Used for Elective and Emergency Procedures in Turkey?(Springer Heidelberg, 2020) Sonmez, Mehmet Giray; Sonmez, Leyla Ozturk; Kozanhan, Betul; Dundar, Zerrin DefneBackground: Informed consent is an important aspect of ethical medical practice. In legal terms, making an intervention without informed consent may mean negligence or malpractice and may lead to legal action, maltreatment, and even attack against the doctor. This study aims to evaluate the readability of informed consent forms (ICFs) used for elective (urology and general surgery) and emergency procedures (emergency medicine and intensive care) by comparing through readability formulas. Methods: Elective and emergency ICFs were accessed through the web sites of national health care associations. A total of 387 consent forms were evaluated and the same forms were included only once. A total of 35 consent forms were evaluated for emergency procedures, while a total of 55 consent forms were evaluated for elective procedures. Atesman and Bezirci-Yilmaz formulas defined for determining the readability level of Turkish texts and Gunning fog and Flesch Kincaid formulas measuring the general readability level were used for calculating the readability level of consent forms. Results: Even though elective ICFs are more readable compared to those of emergency procedures according to Bezirci-Yilmaz formulas, this was statistically insignificant (P = .54). The readability of elective consent forms was found to be at a significantly more difficult level to read compared to Atesman, Gunning fog, and Flesch Kincaid formulas (P = .002, P < .001, P < .001, respectively). Conclusion: Even though the procedure is emergency or elective, a difficult readability level may cause problems for the doctor in legal phases. Readable and understandable consent forms should be available to be able to explain morbidity and mortality and improve prognosis. Education level of our country should also be considered while preparing these consent forms.Öğe Red cell distribution width as a novel predictor of postoperative respiratory adverse events after adenotonsillectomy(Wiley, 2017) Kozanhan, Betul; Iyisoy, Mehmet S.Background: Respiratory adverse events are commonly observed after adenotonsillectomy in children with sleep-disordered breathing. Preoperative prediction of these events enhances quality of care and resource management in facilities while encouraging precautions against them. Red cell distribution width, a measure of erythrocyte size variability, has recently been linked to adverse outcomes in a variety of disorders. Red cell distribution width has also been found to be associated with severity of obstructive sleep apnea in adults due to hypoxia-mediated inflammation. Aim: The objective of this study was to evaluate whether elevated red cell distribution width is associated with postoperative respiratory adverse events in children with symptoms of sleep-disordered breathing. Methods: A prospective, observational, assessor-blinded study was conducted with consecutive children undergoing elective adenotonsillectomy for treatment of sleep-disordered breathing. Under general anesthesia, adenoidectomy was performed by curettage, and tonsillectomy was carried out by dissection. The primary outcome was the occurrence of an adverse event during emergence or in the postanesthesia care unit (PACU). Results: Among 287 patients, with mean +/- SD age 7.49 +/- 3.21, the frequency of respiratory complications during emergence was 62 (22.30%) and in PACU was 56 (20.14%). Mean +/- SD red cell distribution width was 14.36 +/- 1.06 in patients with complications and higher than that in those without complications 13.53 +/- 0.59. Red cell distribution width had an adjusted odds ratio 7.28 (95% CI: 4.30-13.28) and area under the curve value 0.74 (95% CI: 0.67-0.81) to predict postoperative complications. A cutoff value for red cell distribution width was found to be 14.7. Conclusion: Our study showed that preoperative elevated red cell distribution width is associated with an increased risk of respiratory adverse events in children undergoing adenotonsillectomy for sleep-disordered breathing.Öğe Visceral adiposity index in kidney stone patients who have undergone surgery(Polish Urological Assoc, 2022) Sonmez, Mehmet Giray; Kilinc, Muzaffer Tansel; Goksoy, Ibrahim; Kozanhan, Betul; Aydin, Arif; Balasar, Mehmet; Guven, SelcukIntroduction The visceral adiposity index (VAI) is a gender-specific metabolic index that indirectly measures visceral adipose function and distribution using waist circumference, body mass index (BMI), and triglyceride and high-density lipoprotein (HDL) cholesterol values. To assess visceral fat in the diagnostic pathway of urinary stone patients, we investigated the relationship between the VAI and nephrolithiasis as well as the relationship between the VAI and stone and surgery-related parameters. Material and methods Patients who underwent percutaneous nephrolithotomy and retrograde intrarenal surgery for kidney stones were included in the study. The control group comprised of healthy individuals who volunteered to take part in study and did not have urolithiasis as confirmed by abdominal computed tomography imaging. A total of 148 patients were divided into the nephrolithiasis (n = 103) and the control (n = 45) groups. Weight, height, BMI, waist circumference measurements, and VAI were among the metabolic parameters measured. Stone and surgical parameters were evaluated. Results VAI (4.57 vs 2.76), waist circumference (92.1 vs 87.1), and BMI (28.31 vs 26.51) values were higher in the nephrolithiasis group(p = 0.02,p = 0.04, p <0.001,respectively). The VAI was statistically significant in the multivariate analysis for the presence of nephrolithiasis (p <0.001). The VAI negatively correlated with the stone Hounsfield unit (HU) and positively correlated with very-low-density lipoprotein (VLDL), blood creatinine, and calcium levels. The relationship between VAI and surgical parameters was not significant. Conclusions A significant relationship was detected between nephrolithiasis and VAI, a new genderspecific metabolic index that distinguishes between subcutaneous and visceral adipose mass and demonstrates metabolic syndrome. No significant effect of this relationship on surgical parameters was demonstrated in the present study.Öğe What should be done to minimize pain without any sexual function deterioration in transrectal prostate biopsy?(Polish Urological Assoc, 2017) Sonmez, Mehmet Giray; Kozanhan, Betul; Demirelli, Erhan; Sonmez, Leyla Ozturk; Kara, CengizIntroduction The aim of this study was to find an ideal method for the application of a transrectal ultrasound-guided prostate biopsy (TRUS-Bx) without deteriorating patient comfort. Material and methods TRUS-Bx was applied in a total of 93 patients. Taking the application method into consideration, these patients were divided into three groups, each consisting of 31 patients. Methods applied for pain control in the different groups were compared (groups 1, 2 and 3). Age, prostate specific antigen (PSA), prostate volume, cancer detection rate, re-biopsy consent ratio, complication rates, visual analog scale (VAS), and International Index of Erectile Function (IIEF-5) scores were compared among the groups. Results Age, PSA, prostate volume, cancer detection rate, and fever complication rate were not statistically different between the three groups. However, a statistically significant difference was detected among the groups for the VAS measured during and after TRUS-Bx, re-biopsy consent ratio, and hematuria (p < 0.001, p < 0.001, p < 0.001, and p = 0.027, respectively). There was no detected difference in pre-operation IIEF-5 scores, but the difference in IIEF-5 scores in the first month after the operation was significant (p = 0.116, p = 0.024, respectively). Conclusions Anal dilatation after the application of intrarectal topical anesthetic to provide anesthesia during TRUS-Bx and giving lidocaine hydrochloride with epinephrine for periprostatic nerve blockage (PNB) is a successful and effective method to maintain patient comfort, especially as it relates to pain control and sexual function. Anal dilatation seems to minimize any pain that may occur due to probe transition, and adding epinephrine as a vasopressor to the anesthetic agent chosen during the operation will be rather helpful for hemostasis control and pain that results from the needle.
