Background/aim: We aimed to evaluate the effectiveness of distal versus proximal greater occipital nerve (GON) pulsed radiofrequency (PRF) treatments in patients with episodic or chronic migraine. Materials and methods: In this prospective, randomized controlled study, sixty participants were randomized to either distal GON PRF (n= 30) or proximal GON PRF (n = 30). Migraine related assessments were conducted at the baseline and at the first, second, and third month. Results: Baseline characteristics indicated a higher migraine burden in the proximal group, including increased monthly headache frequency (15.0 vs. 9.5 attacks, p = 0.007). Both groups experienced significant reductions in headache duration, severity and frequency over three months (Friedman test, p < 0.001). Notably, the proximal group experienced greater reductions in severe headache frequency at all time points (1st month: p = 0.004; 3rd month: p = 0.022) and total headache days by the third month (14.0 vs. 9.5 days, p = 0.039). The distal group exhibited some advantages in reducing headache severity (VAS), showing a trend toward improvement in the second month (p = 0.055) and achieving statistical significance by the third month (p = 0.011). No unexpected adverse effects were observed in either group. Conclusion: Both treatments were well-tolerated, with minimal adverse effects. Our findings indicate that both proximal and distal approaches are safe and effective for migraine management. The proximal approach might offer slightly superior outcomes for patientsexperiencing severe and frequent migraine attacks.

Aims: To evaluate clinical outcomes, patient-reported global improvement, and documented adverse events associated with thoracic interlaminar epidural steroid injections in a real-world cohort with chronic thoracic pain, predominantly postherpetic neuralgia (PHN).Methods: This retrospective single-center study included consecutive adults who underwent thoracic interlaminar epidural steroid injection between January 2022 and December 2025. Pain intensity was assessed using the Numeric Rating Scale (NRS) at baseline and at 1 and 6 months. Global Perceived Effect (GPE), ≥30% and ≥50% NRS responder rates, repeat injections, and documented adverse events were evaluated. Limited missing follow-up information was completed by telephone in five patients under the ethics-approved protocol. Changes in NRS were analyzed using the Friedman test with Bonferroni-adjusted Wilcoxon signed-rank comparisons.Results: Forty-one patients were included; PHN was the predominant etiology (24/41, 58.5%). Median NRS decreased from 7.0 (IQR, 1.0; range, 6-9) at baseline to 3.0 (IQR, 4.0; range, 0-8) at 1 month and 1.0 (IQR, 3.5; range, 0-7) at 6 months (overall p

Background and Objectives: Greater occipital nerve pulsed radiofrequency (GON-PRF) is an effective neuromodulatory treatment for migraine; however, evidence directly comparing unilateral and bilateral approaches remains limited. This prospective randomized controlled trial compared the clinical efficacy of ultrasound-guided proximal GON-PRF performed unilaterally versus bilaterally at the C2 level in patients with migraine. Materials and Methods: A total of 187 patients were randomized to receive unilateral (n = 91) or bilateral (n = 96) ultrasound-guided proximal GON-PRF without concomitant local anesthetic or corticosteroids. Per-protocol analyses included 78 and 88 participants in the unilateral and bilateral groups, respectively. The primary outcome was the change in monthly headache days (MHD) from baseline to 6 months. Secondary outcomes included Visual Analog Scale (VAS) scores, acute medication days (AMD), Headache Impact Test-6 (HIT-6) scores, Migraine Disability Assessment (MIDAS) grades, and Global Perceived Effect (GPE) scores. Longitudinal outcomes were analyzed using multivariable Generalized Estimating Equations (GEE). Results: Of the 187 randomized participants, 166 completed the 6-month follow-up and were included in the per-protocol analysis. Both groups demonstrated significant improvements in all outcomes throughout follow-up (all p < 0.001). At month 6, the Bilateral Group showed lower MHD values (median [IQR]: 7.0 [6.0] vs. 10.0 [6.0], p = 0.030), a higher ≥50% MHD responder rate (77.3% vs. 55.1%, p = 0.003), and lower AMD values (p = 0.024). Adjusted GEE analyses demonstrated significant treatment effects favoring the Bilateral Group for average VAS (p = 0.047) and HIT-6 (p = 0.004). GPE scores also favored the Bilateral Group at month 6 (p = 0.044). No procedure-related complications occurred. Conclusions: Both unilateral and bilateral ultrasound-guided proximal GON-PRF provided significant clinical improvement in patients with migraine. However, bilateral treatment demonstrated superior longitudinal outcomes, including lower headache frequency, reduced acute medication use, higher ≥50% MHD responder rates, and greater patient-reported improvement. These findings remained consistent after adjustment for baseline covariates.

Objectives: To experimentally evaluate the effects of preoperative fasting duration on distant organ liver in renal ischaemia-reperfusion (IR) injury. Methods: This is an experimental study. In the study, 3 groups were formed. In Group A, abdominal laparotomy was carried out after 12 hours of preoperative fasting without any IR damage. In Group B, IR injury was carried out after 12 hours of preoperative fasting, and abdominal laparotomy was carried out, in Group C after 2 hours of fasting after IR injury. Apoptosis, congestion, balloon degeneration, nuclear pleomorphism, and leukocyte infiltration were examined histopathologically and tumor necrosis factor-alpha (TNF-α), interleukin (IL) -1 beta, IL-6, and IL-10 were evaluated biochemically. Results: A statistically significant difference was determined between the groups in respect of postoperative IL-10 levels (p=0.020) with significantly lower levels determined in Group C than in Groups A and B (p=0.021). Similar rates of mild nuclear polymorphism were seen with no statistically significant difference determined between the groups (p>0.167). A statistically significant difference was determined between the groups in respect of the congestion scores (p<0.001), with a lower score in Group C than in Groups A and B, where the scores were similar (p<0.001, p=0.017). Conclusion: With this result, it would be correct to say that the short preoperative fasting period has protective effects on the liver tissue.

Background/aim: Plantar fasciitis (PF) is a common cause of heel pain and may lead to functional impairment and reduced quality of life. This study aimed to compare the short- and medium-term clinical outcomes of corticosteroid injection (CSI) alone versus combined radiofrequency ablation (RFA) and CSI in patients with PF refractory to conservative treatment. Materials and methods: This single-center retrospective comparative study included patients diagnosed with PF between 1 January 2021 and 1 January 2025. Patients who underwent either CSI alone or combined RFA and CSI after failure of conservative management were included. Pain intensity was assessed using a visual analog scale (VAS) at baseline, 1 week, 3 months, and 6 months. Global perceived effect (GPE) scores were evaluated at 1 week, 3 months, and 6 months. Results: Both treatment groups demonstrated significant improvements in VAS scores at 1 week, 3 months, and 6 months compared to baseline (p < 0.001 for all). Baseline and 1-week VAS scores were comparable between the groups (p > 0.05). However, median VAS scores at 3 and 6 months were significantly lower in the group receiving combined RFA and CSI compared to CSI alone (p < 0.001). GPE scores at 1 week did not differ significantly (p = 0.100), but at 3 and 6 months, they were significantly higher in the combined group (p < 0.001). In adjusted longitudinal analysis, the group receiving combined RFA and CSI had lower overall VAS scores over time, with significant group × time interactions at 3 and 6 months. Conclusion: Both CSI alone and combined RFA and CSI provide significant short- and medium-term pain relief. However, the addition of RFA to CSI is associated with superior midterm pain control and greater patient-reported clinical improvement.

Kulak Burun Boğaz cerrahisinde cerrah ile anestezi doktorunun oldukça özel olan ilişkisi bazen çok karmaşık hale gelebilir. Havayolunun içinde bulunduğu bu küçük bölge için iki taraf arasında güçlü bir rekabet bulunmaktadır. Gelişen teknoloji ile bu rekabet daha da karmaşıklaşmaktadır. Gerçekte hem anestezi hem de kulak burun boğaz uzmanları hasta için en iyi sonucu elde etmeye çabalamaktadır ve bu sonuç ekip çalışmasına ve iletişime çok bağlıdır. Bu nedenle iletişim, tüm vakalarda, ancak özellikle zor hava yolu durumlarında anestezi indüksiyonundan çok önce başlamalıdır. Patolojik durumun ameliyat öncesi fotoğrafları ve hava yolunun durumu, hasta ameliyathaneye gelmeden önce ekiple paylaşılmalı hastanın sahip olduğu reaktif hava yolu koşulları ve uyku apnesi gibi önemli komorbiditeler ameliyat öncesi tartışılmalıdır.