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    Comparison of the effects of magnesium and ketamine on postoperative pain and morphine consumption. A double-blind randomized controlled clinical study
    (Acta Cirurgica Brasileira, 2016) Arikan, Muge; Aslan, Bilge; Arikan, Osman; Horasanli, Eyup; But, Abdulkadir
    PURPOSE: To compare the effects of magnesium sulfate and ketamine on postoperative pain and total morphine consumption in a placebo-controlled design. METHODS: One hundred and twenty women scheduled for total abdominal hysterectomy were included in this prospective, randomized, double-blind study. Postoperatively, when the Numeric Pain Rating Scale (NPRS) was four or more, IV-PCA morphine was applied to all patients. The patients were randomized into three groups: Group K ketamine, Group M magnesium, and Group C saline received as infusion. Total morphine consumption for 48h, pain scores, adverse effects, and patients' satisfaction were evaluated. RESULTS: Total morphine consumption was significantly lower in Group K (32.6 +/- 9.2 mg) than in Group M (58.9 +/- 6.5 mg) and in Group C (65.7 +/- 8.2 mg). The satisfaction level of patients in Group K was higher than the other two groups (p<0.05). Pruritus and nausea were observed more frequently in Group C. CONCLUSION: The addition of ketamine to IV-PCA morphine reduces the total consumption of morphine without psychotic effects; however, magnesium did not influence morphine consumption.
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    Intrathoracic migration of a Kirschner wire
    (Oxford Univ Press, 2014) Ozarslan, Fatma; Arikan, Osman; Acat, Murat; Arikan, Muge; Temel, Volkan
    Kirschner (K) wires can easily migrate, resulting in serious complications. We report a 49-year-old woman who had a rare and late complication related to the migration of K wire. It had been used for left hip replacement 8 years ago. The patient admitted to our hospital with breathing-dependent chest pain and increasing dyspnea for similar to 2 h. Chest X-ray and chest computed tomographic scans revealed the presence of a metallic image of similar to 5-6 cm in the right hemithorax. There was a large hemothorax but no pneumothorax. A right thoracotomy was performed and the wire was removed without complications. Surprisingly, no injury was noted to any intervening abdominal structure intra-operatively. Patients, who are treated with K wire, should be informed of the risk of wire migration and should undergo regular postoperative follow-ups including radiography.
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    VARIABLES AFFECTING MORTALITY IN PATIENTS IN PALLIATIVE CARE UNITS: OR IS IT STILL JUST ALBUMIN?
    (Turkish Geriatrics Soc, 2024) Yesilkaya, Abdullah; Arikan, Muge; Tasdelen, Busra Nur; Meric, Emre; Akhan, Ayse; Dindar, Murat; Ulutas, Arda
    Introduction: This study aimed to evaluate the relationship between biomarkers, clinical prognostic indexes, and mortality in patients without malignancy. Materials and Method: This retrospective study included patients who were followed up in palliative care units between January 2020 and January 2024. Data were collected from patients' digital database records. Demographic characteristics, clinical features, comorbidities, main reasons, and length of hospital stay were recorded. Laboratory parameters were measured at admission. Patient outcomes were also documented. Result: The study included 416 patients. The mortality rate was 28.36% (n=118). When survivors and nonsurvivors were compared, variables including albumin, protein, white blood cells, neutrophils, C -reactive protein, procalcitonin, CRP/albumin, CRP/protein, neutrophil/lymphocyte, and platelet/lymphocyte ratios significantly affected mortality. Logistic regression analysis revealed that only the albumin level was statistically significant (0.010). It was found significant that the albumin value was below 2.76 g/dL (odds ratio 3.688; the area under the curve (AUC)=0.670, and P<.000). The sensitivity and specificity of an albumin cutoff value of 2.05 g/dL were 85% and 97%, respectively. Conclusion: Our study highlights the pivotal role of hypoalbuminaemia as the most significant predictor of mortality in patients on the palliative care unit (PCU) without malignancy. To optimise patient care in palliative settings and better tailor therapeutic interventions, we must recognise the vital role of hypoalbuminaemia as a critical risk factor.