Nihal Demirkoprulu

Effects of diazeniumdiolates (NONOates) and methylene blue on the reduction of postoperative adhesion in rats

We investigated the effects of spermine NONOate (SPER/NO), diethylenetriamine NONOate (DETA/NO) and methylene blue for preventing postoperative adhesion in a rat uterine horn model. Before operations, rats were randomly assigned into 6 groups, each composed of 12 rats. These were the sham, control, normal saline, SPER/NO, DETA/NO and methylene blue groups. Each rat was anesthetized with ketamine hydrochloride (40 mg/kg i.v.). The abdominal wall was shaved; the surgical site was scrubbed with povidone iodine and rinsed with sterile saline 3 times before surgery. Under sterile conditions, a 3-cm vertical midline incision was made in all groups. In the sham group, we closed the abdominal wall without any procedure. In the other groups, a 2-cm segment of each uterine horn was injured in 10 spots on the antimesenteric surface using unipolar cautery. Before the final abdominal closure, no adjuvant therapy was administered intraperitoneally to the rats in the control group; 2 ml of normal saline solution, 1% methylene blue solution, SPER/NO (0.5 mg/ml) and DETA/NO (0.1 mg/ml) were instilled into the uterine horns of the rats in the respective groups. The incision was closed with a running 4-0 monofilament delayed absorbable suture in a single layer of muscle and fascia in a running pattern, excluding the peritoneum, and in the covering layer of skin in an interrupted pattern, in all groups. Two weeks after the surgery, all animals were killed, second laparotomies were performed, and the extent and severity of adhesions were determined by a blinded examiner. The adhesion scores of the sham group were significantly lower than those of the other groups (p < 0.05). In the methylene blue, SPER/NO and DETA/NO groups, adhesion scores were significantly lower than in the normal saline and control groups (p < 0.05). However, there were no significant differences related to the extent and severity scores of adhesions between the methylene blue, SPER/NO and DETA/NO groups (p > 0.05). This study showed that SPER/NO, DETA/NO and methylene blue administered at the end of surgery reduced the adhesion formation in a rat uterine horn model.

The Oral Toxicity of Resorcinol During Pregnancy: A Case Report

Resorcinol (1,3 benzenediol; m‐dihydroxybenzene: resorcin) is a pharmaceutical agent used topically in dermatological treatments such as acne and related skin conditions. It could also be used in combination with the other acne treatment agents such as sulphur. It could be very hazardous if taken orally and there are limited reports on its toxic effects in human. The present work aimed to report a resorcinol poisoning case in which resorcinol was taken accidentally by a woman at 30 weeks of pregnancy. The major clinical findings were unconsciousness, drowsiness, and respiratory failure that required mechanical ventilation along with tonic‐clonic seizures and hypothermia. In addition, the laboratory findings were leucocytosis, high bilirubin levels, severe metabolic acidosis, and green‐colored urine. The fetus was considered dead 24 h after delivery; however, mothers prognosis was well with supportive management. It could be concluded that the basic approach to the patient with resorcinol poisoning should include the initial stabilization of immediate life‐threatening problems and elimination of the toxin. This is the first report on resorcinol poisoning in pregnant women, indicating its major clinical and laboratory findings.

Maternal mortality in the last decade at a university hospital in Turkey.

Maternal and infant mortality are basic indicators that reflect a nation’s health status. Maternal mortality ratios are reported to be less than 10 per 100 000 live births in developed countries but they may be as high as 1700 per 100 000 live births in developing areas of the world. In developing countries well-known causes of maternal deaths are hemorrhage infection and toxemia. This study reports 35 maternal deaths that occurred at Cumhuriyet University Hospital between 1992 and 2002.The total number of deliveries during the same period was 7748 and 7424 of those were live births. Maternal deaths were defined as deaths that occurred during pregnancy or within 42 days of the end of a pregnancy and for which the cause was listed as a complication of pregnancy childbirth or the puerperium. (excerpt)

Histopathological changes in ovary and endometrium after tubal ligation: a rat model.

Background. To evaluate the histopathological effects of tubal ligation on ovary and endometrium in a rat model.

Prevention of superficial wound disruption in Pfannenstiel incisions by using a subcutaneous drain.

Abdominal wound disruption is a major cause of morbidity following gynecologic surgical procedures. Despite advances in suture materials, antibiotics, and perioperative care, the rate of dehiscence varied little in the 20th century. There may remain a space when an abdominal incision is closed, and that space is conducive to seroma formation and wound infection. Only a few trials have studied the use of a subcutaneous suction drain in the prevention of wound dehiscence 1,2 ; and because in these trials midline incisions were performed on all patients, the effect of subcutaneous drainage has not yet been established for Pfannenstiel incisions. We aimed to determine the effect of subcutaneous drains in the prevention of superficial wound disruption following Pfannenstiel incisions in gynecologic surgery.