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    Blind ending ureter: A rarely diagnosed ureteral duplication anomaly in childhood
    (2010) Balasar M.; Pişkin M.M.; Çiçekçi F.; Gürbüz R.
    Blind ending ureter is a rare congenital malformation of the urinary system and is classified as a ureteral duplication anomaly. Most cases are not diagnosed until they become symptomatic. Although it is a congenital malformation, patients are usually diagnosed in the 3rd and 4th decades and presentation in childhood is very rare. Mostly they manifest with loin pain, urinary tract infection, or stone disease. Intravenous pyelogram, retrograde pyelogram, and computerized tomography can be used for diagnosis. Voiding cystourethrography must be performed to exclude associated vesicoureteral reflux. Herein, we report an 11-year-old child who had a blind ending duplicated ureter associated with vesicoureteral reflux causing renal atrophy.
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    Is unilateral spinal anesthesia superior to bilateral spinal anesthesia in unilateral inguinal regional surgery?
    (American University of Beirut, 2014) Cicekci F.; Yilmaz H.; Balasar M.; Sahin M.; Kara F.
    Background: Unilateral spinal anesthesia is performed to provide restriction of sensory and motor block.Objective: The aim of this study was to compare unilateral and bilateral spinal anesthesia, with regard to limiting the nerve block exclusively to the area of surgery. Methods: This was a prospective, randomised, double-blind study, conducted in 40 consecutive outpatients scheduled for unilateral inguinal regional surgery. Patients in both groups received 0.5 % hyperbaric bupivacaine 15 mg + morphine 0.1 mg. Patients in the unilateral group (Group U) were placed in the lateral decubitus position for 10 minutes (min) on their side to be operated, while patients in the bilateral group (Group B) were placed in the supine position. The pin-prick test was used to assess the times to reach L1, T12 and T10 sensory blocks and the times to reach motor block. In addition, the sensory and motor block recovery times were recorded using a modified Bromage scale. Furthermore, the duration of the operation and the times to first analgesic requirement were noted. Results: There were significant differences between Group U and Group B in the times to reach L1, T12 and T10 dermatome levels of sensory block, and the times to reach motor block using the modified Bromage scale on three levels. However, there was no difference in the time to ambulation, the time to complete sensory regression and the time to first analgesic requirement. Conclusion: The time to reach sensory and motor blocks for unilateral spinal anesthesia could provide an advantage over bilateral spinal anesthesia in inguinal region operations. © 2014, American University of Beirut. All rights reserved.
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    The preventive effect of diphenhydramine on bacterial growth in propofol: A laboratory study
    (2008) Güzelant A.; Apiliogullari S.; Kara I.; Turhan V.; Apiliogullari B.; Yilmaz H.; Balasar M.
    Background and objective: Diphenhydramine has local anaesthetic and antimicrobial activity and may be used to prevent intravenous propofol injection pain. We studied the effect of adding diphenhydramine to propofol emulsions for preventing bacterial growth. Methods: Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli and Candida albicans cultures were inoculated into the following solutions: 1% propofol, 0.05% diphenhydramine + 1% propofol, 0.1% diphenhydramine + 1% propofol, 0.2% diphenhydramine + 1% propofol, 0.3% diphenhydramine + 1% propofol, 1% diphenhydramine and 0.1% lidocaine + 1% propofol. A 100-?L of inoculum suspension adjusted for each of the micro-organisms was added separately to each tube and left at 20°C. A 10-?L aliquot of each mixture was inoculated onto blood agar medium at 5 and 24 h. These plates were incubated at 35°C for 24 h. Each plated medium was read, and the number of colony-forming units were counted and recorded (n = 2). Analysis of variance (ANOVA) with a post hoc Tukey HSD test and paired t-tests were used for data analysis. P < 0.05 was considered as significant. Results: Diphenhydramine inhibited bacterial growth in propofol solutions in a dose-dependent manner. It was more effective than 0.1% lidocaine at similar concentrations in preventing bacterial growth for all organisms. Conclusion: Diphenhydramine had a significant inhibitory effect on bacterial growth in propofol. © 2008 Copyright European Society of Anaesthesiology.