Clavicle fractures occur in 35% of shoulder girdle fractures. Surgical fixation is preferred, especially in young patients for optimal functional outcomes, while nondisplaced fractures are usually treated conservatively. A 38-year-old male patient was admitted to the emergency services with a fracture of the left clavicle following a fall. During the preoperative evaluation, the patient requested to be awake during the surgery. Combined supraclavicular and superficial cervical plexus block was performed under ultrasound guidance without complications and the patient experienced no pain. This technique may avoid possible complications related to interscalene brachial plexus block. Future studies are required to confirm the safety and efficacy of this approach.

Objective: The World Health Organization emphasizes that it is essential that infants be fed only breast milk for the first six months. This study is designed to investigate the frequency of exclusive breastfeeding and the related factors during the first six months in infants born in 2016 in Erzincan province. Materials and Methods: Our study is a cross-sectional study, and the study population consisted of 2166 babies born in 2016, and registered with the family physicians. The sample size was calculated as 635 with a 95% confidence interval and 3% error margin, assuming that the frequency of exclusive breastfeeding in first six months is 30%. The family physicians were randomly selected. Mothers included in the study were determined by random sampling method. The data were collected by interviewing the mothers individually, and then analyzed in the SPSS (IBM, SPSS Corp.; Armonk, NY, USA) 21.0 package program. Results: In this study, the rate of infants who received only breast milk for the first six months was calculated as 45.7%. The average period of exclusive breastfeeding was 4.4±2.03 months. It was observed that the children of mothers with prenatal and postnatal education received only breast milk for longer time. Also, mothers who do not work, those who do not use tobacco after birth, and those without depression also fed their children with only breast milk for longer time. In pacifiers or bottle users, infants receiving other nutrients after birth had a lower rate of exclusive breastfeeding for the first six months. Conclusion: In our study, it has been observed that to increase the rate of exclusive breastfeeding, it is necessary to increase the education before and after the birth; to not use any other nutrients, pacifier, or bottle after delivery; and to spend adequate time with the baby. Cite this article as: Salcan S, Topal I, Ates I. The Frequency and Effective Factors of Exclusive Breastfeeding for the First Six Months in Babies Born in Erzincan Province in 2016. Eurasian J Med 2019; 51(2): 144-8.

In the literature, it has been suggested that ketamine-related oxidative organ damage results from increased blood adrenaline level, and thiopental-related oxidative damage is caused by decreased adrenaline level, suggesting that ketamine-thiopental combination (KT) may be beneficial in reducing the hepatotoxic effect of ketamine. To biochemically investigate the effects of ketamine, thiopental and KT on the liver in rats. Male albino Wistar type rats received intraperitoneally (ip.) 30 mg/kg ketamine in the ketamine alone (KG) group (n = 6), 15 mg/kg thiopental in the thiopental alone (TG) group (n = 6), and 30 mg/kg ketamine + 15 mg/kg thiopental in the ketamine+thiopental (KTG) group (n = 6). The same volume of distilled water as solvent was given to the healthy (HG) animal group. This procedure was repeated once daily for 30 days. At the end of this period, the animals were killed by decapitation and their livers were removed. In liver tissue, malondialdehyde (MDA), total glutathione (tGSH), total oxidant status (TOS), total antioxidant status (TAS), tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β), and interleukin-6 (IL-6) levels were measured. The IL-1β, IL-6, TNF-α, adrenalin (ADR), noradrenalin (NDR), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels were determined in blood samples taken from the tail veins. In the group treated with ketamine and thiopental alone, MDA, TOS, IL-1β, IL-6, TNF-α, ADR, NDR, ALT, and AST levels were found to be high, and those of tGSH and TAS to be low. However, there was no significant change in the levels of these parameters in the KTG. These results indicate that oxidative stress and inflammation developed in the liver tissue of the group that used ketamine and thiopental alone, suggesting that the KT form may be safer in terms of toxicity in the clinical usage.

Linezolid, an antimicrobial agent, has been linked to lactic acidosis, oxidative stress, and liver damage. Oxidative stress is considered to play a key role in this damage. Thiamine pyrophosphate (TPP), the active form of thiamine, may prevent lactate accumulation and enhance aerobic capacity. Therefore, this study aimed to evaluate the protective effect of TPP against possible linezolid-induced liver damage and lactic acidosis in rats. Twenty-four male Wistar albino rats were randomly assigned to four groups (n = 6): healthy control (HG), linezolid (LZD), thiamine plus linezolid (TLZD), and TPP plus linezolid (TPLZD). Thiamine and TPP (20 mg/kg, intraperitoneal (i.p.)) were administered once daily, while linezolid (125 mg/kg, per os (p.o.)) was given twice daily (250 mg/kg/day) for 28 days. Animals were euthanized under high-dose anesthesia (with 50 mg/kg, i.p. thiopental sodium). Liver tissues were analyzed for MDA, tGSH, SOD, and CAT, and examined histopathologically. Blood samples were collected prior to euthanasia to assess lactate, LDH, ALT, AST, and TPP levels. In the LZD group, MDA, lactate, ALT, AST, and LDH levels significantly increased, while tGSH, SOD, CAT, and TPP decreased (p < 0.001). Histopathology showed hydropic degeneration, necrosis, and mononuclear cell infiltration (p < 0.05). Thiamine did not prevent these alterations (p > 0.05), whereas TPP significantly prevented both biochemical and histopathological changes (p < 0.05), indicating its protective efficacy. TPP may offer significant protection against linezolid-induced hepatotoxicity and lactic acidosis.

This retrospective study was conducted in order to demonstrate the clinical benefit of infraorbital regional anesthesia performed with intraoperative bupivacaine injection in postoperative pain scores during open septorhinoplasty operations. Postoperative 12-hour pain scores (Visual Analogue Scales) and data obtained from patient files of analgesic consumption of 60 (33 female; 27 male) participants aged 18-45 years who underwent open septorhinoplasty, ASA group I-II, were analyzed.d. The patients were divided into two groups; the control group (group C) included the participant who underwent open septorhinoplasty surgery and did not undergo intraoperative regional anesthesia. Patients who underwent open septorhinoplasty surgery and underwent regional anesthesia with 3 mL (15 mg) of bupivacaine hydrochloride in both infraorbital foramen intraoperatively were included in the bupivacaine group (group B). Patients in group B had lower pain scores at 1 hour postoperatively compared to group C. It was observed that the effective postoperative analgesia continued consistently at the 6th and 12th hours in the patients in group B. At the same time, the need for IV analgesics at the postoperative 12 hours was significantly lower in group B compared to group C. Intraoperative infraorbital regional bupivacaine anesthesia is an effective procedure that reduces postoperative pain levels in septorhinoplasty operations and increases the postoperative comfort of patients.

Background: Tramadol binds to opioid receptors and inhibits norepinephrine and serotonin reuptake, causing serotonin syndrome. Tianeptine stimulates serotonin reuptake and reduces serotonin levels. The aim of this study was to investigate whether tianeptine is effective against serotonin syndrome that may occur with serotoninergic drugs such as tramadol and citalopram. Methods: Rats were divided into eight groups (n = 6) that received tramadol (50 mg/kg), citalopram (10 mg/kg), or tianeptine (5 mg/kg) alone or a combination of tramadol + citalopram, tramadol + tianeptine, citalopram + tianeptine or tramadol + citalopram + tianeptine at the same doses administered to the stomach by oral gavage for 3 weeks. The healthy control group was given saline. Malondialdehyde, total glutathione, superoxide dismutase, and catalase levels were measured in removed brain tissues. The tissues were also examined histopathologically. Results: In the tramadol, tramadol + citalopram, and tramadol + citalopram + tianeptine groups, malondialdehyde levels were found to be higher compared to the control group, while glutathione, superoxide dismutase, and catalase levels were found to be lower. In other groups, values close to the control group were measured. Morphological degeneration was observed in neurons in the tramadol + citalopram group. The swelling of astrocytes and pericellular edema in oligodendrocytes were also observed. A significant population increase was noted in microglial cells. Blood vessels belonging to the tissue were observed to be severely dilated and congested. Histopathological damage was partially resolved in the group given tramadol + citalopram + tianeptine. Conclusions: The tramadol + citalopram combination caused severe oxidative stress in brain tissue. Tramadol alone caused mild damage in brain tissue, whereas tianeptine prevented the brain damage caused by tramadol.