Effectiveness of paracervical block in endometrial sampling procedures for pain control: a randomized controlled clinical trial.

OBJECTIVES: We aimed to evaluate the effect of paracervical block (PCB) on endometrial sampling procedures, to assess the effect on pain of waiting between PCB and intervention, and to compare the effectiveness of PCB with oral non-steroidal anti-inflammatory drugs (NSAID) for decreasing the pain levels associated with endometrial biopsy. MATERIAL AND METHODS: A total of 123 participants were divided into four groups as Group 1: Waiting 1 minute after PCB, Group 2: Waiting 3 minute after PCB, Group 3: Control group, and Group 4: Waiting 60 minute after taking oral NSAIDs. The success of analgesic measures used for endometrial biopsy during and 30 minutes after the procedure was compared with the Numeric Pain Rating Scale (NPRS) system. RESULTS: The Numeric Pain Rating Scale (NPRS) 0 score was 2.60 (± 2.42) in Group 1; 1.60 (± 1.73) in Group 2; 5.30 (± 2.10) in Groups 3; 5.63 (± 1.99) in Groups 4. NPRS 30 score was 0.80 (± 0.88) in Group 1; 0.43 (± 0.81) in Group 2; 1.90 (± 1.32) in Groups 3; 2.70 (± 1.41) in Groups 4. The pain was significantly less in the paracervical block groups compared to control and oral NSAIDs groups. However, there was no significant difference in NPRS 0 (p = 0.196) and NPRS 30 (p = 0.191) scores between Group 1 and Group 2. There was no significant difference in NPRS 0 and NPRS 30 scores between control group and oral NSAID group. CONCLUSIONS: Paracervical block (PCB) is an effective method and superior to oral NSAIDs. Waiting 1 minute or 3 minutes after PCB were equally effective.

COVID-19 Patient Care Leading to Occupational Burnout in Resident Doctors: A Follow-up Study.

Objective: Burnout during residency may require reorganization of health services during the COVID-19 pandemic. This study mainly aimed to compare the burnout levels between resident doctors who cared and those who did not care for COVID-19 patients at the …. University Hospital, which has been serving as a pandemic hospital during the COVID-19 outbreak. Methods: The study was designed as a cross-sectional study. One hundred resident doctors were recruited to the first phase of the current study between April 1, 2020 and June 30, 2020 (T1).These participants were then followed-up and re-called to participate in the second phase of the study between October 30, 2020 and November 30, 2020 (T2). Eighty-four resident doctors were available and agreed to participate in the second phase of the study. Once the participants accepted to participate in the study, they were asked to complete "the Evaluation Form," "the Patient Health Questionnaire-9 (PHQ-9)," "the Beck Anxiety Inventory (BAI)," and "the Maslach Burnout Inventory (MBI)." Results: In both T1 and T2 periods, the resident doctors who provided care to COVID-19 patients had significantly higher BAI and PHQ-9 scores compared to the scores of those who did not care for COVID-19 patients (P < .05). Moreover, in the T2 period, the Maslach Burnout Inventory-Emotional Exhaustion (MBI-EE) and Maslach Burnout Inventory-Depersonalization (MBI-DP) scores of the resident doctors who cared for COVID-19 patients were detected as significantly higher than the scores of those who did not care for COVID-19 patients. Conclusions: This study demonstrated that resident doctors who cared for COVID-19 patients face increased problems of burnout, anxiety, and depression levels.

Retrospective evaluation of anesthetic techniques in pregnant women with renal transplantation

Background/aim: The aim of this study was to evaluate anesthesia management in cesarean operation of pregnant women who underwent renal transplantation and the effects on postoperative renal function, retrospectively. Materials and methods: After obtaining the approval of the ethics committee of our hospital, the records of pregnant women who underwent kidney transplantation and cesarean section between 2007 and 2017 were retrospectively analyzed. The patients' demographic data, concomitant disease history, the treatment received, and type of anesthesia were retrospectively evaluated and recorded in the follow-up form. Results: It was found that a total of 47 women who underwent renal transplantation had 47 live births by cesarean section. The mean age of the pregnant women was 30 ± 5.34 years. The mean time between renal transplantation and conception was 95.34 ± 55.02 months. It was found that 14 (29%) of a total of 47 patients had their first pregnancy. The number of patients with a gravidity of 4 and above was 9 (19%). A total of 21 (44.7%) pregnant women had spontaneous miscarriage. Five (10.6%) patients were treated with curettage for therapeutic purposes. Twenty-two (46%) of the patients whose immunosuppressive therapy was continuing were treated with azathioprine, tacrolimus, and prednisolone. The mean gestational age of delivery was 36.5 ± 1.59 weeks. The rate of prepregnancy hypertension diagnosis was 25.5% (n = 12), while the rate of developing gestational hypertension was 21.3% (n = 10). Spinal anesthesia was administered to 42 (91%) of 47 patients who underwent cesarean section. In the preoperative period, the mean value of serum blood urea nitrogen was 62.88 ± 41.97 mg/dL and the mean serum creatinine level was 3.21 ± 6.17 mg/dL. In the postoperative period, these values were 44.4 ± 29.9 mg/dL and 1.91 ± 1.63 mg/dL, respectively. When the pre- and postoperative serum urea and creatinine levels were compared, they were found to be lower in the postoperative period. However, there was no statistically significant difference (P > 0.05). The mean weight of the newborns was determined as 2707.3 ± 501.5 g. While the number of newborns with a low birth weight (<2500 g) was 18 (38%), among them 3 (0.6%) were below 2000 g. It was found that 36.2% (n = 17) of the newborns required intensive care. None of the patients developed graft rejection. Conclusion: If there is no contraindication, regional anesthesia may be preferred in the first place for pregnant women with renal transplantation. We suggest that this method of anesthesia has some advantages in terms of maintaining postoperative renal function and higher Apgar scores in newborns with low birth weight.