ABSTRACT
Hepatitis B virus (HBV) infection is a significant health problem around the world and may cause serious morbidity and mortality. The most common transmission routes are parenteral, sexual, perinatal and horizontal way. Identification of the risk factors for viral hepatitis transmission is the main rule to reduce the spread of this infection. The aim of this study was to review the possible occupational risk factors for nanparenteral transmission of Hepatitis B virus for health care workers, especially for otorhinolaryngologists. The Medline / PubMed, Google Scholar, and Cochrane databases were searched by using different combinations of MeSH terms for HBV, transmission routes, and risk factors. The results were collected from articles published between January 2000 and July 2015. There were no language restriction during searching the data, whether the abstracts of the studies contain sufficient data were analysed. All searchable relevant data was evaluated and reviewed. The presence of viral particles, including HBsAg and / or HBV DNA in body secretions such as saliva, tears and cerumen may suggest the possibility of horizontal transmission of HBV infection. Therefore, the healthcare workers, particularly otorhinolaryngologists, ophthalmologists or other surgeons, audiologists, dentists, pulmonologists, intensive care specialists and nurses should pay special attention while applying the standard infection control precautions in order to prevent HBV infection in themselves and their patients.
ABSTRACT
Postoperative seizures [expected after neurosurgery] are rare events. When they do occur, they are usually attributable to an identifiable drug reaction, a metabolic or neurological event. We report a case of postoperative seizure in postanesthesia care unit. A 19-yr-old female, 48 kg, was admitted to a hospital for left middle-ear surgery. Her medical history, physical examination and laboratory evaluation were normal. Anesthesia was induced with fentanyl 1 micro g/kg, thiopental 5 mg/kg and rocuronium 0.5 mg/kg to produce neuromuscular blockade. Anesthesia was initially maintained with oxygen, nitrous oxide and sevoflurane. Mastoid surgery was completed in 195 minutes after induction. The patient was extubated, but approximately 10 minutes after arrival in recovery she started to generalized tonic clonic convulsion. Oxygen was administered by face mask and thiopental 100 mg was administered intravenously. Blood sugar, electrolytes and body temperature were normal. After ten minutes convulsion episode was repeated. Because of the continuing seizure activity in a patient at risk of pulmonary aspiration and security of air way, her trachea was intubated by using thiopental and succinylcholine and ventilation controlled artificially. The seizures were controlled with midazolam and phenytoin. Computerized tomography [CT] showed left temporal cortical suspected hipodensity [Fig. 1] and the patient was transferred to ICU