Nosocomial infections are commonly encountered problems for all hospitalized patients. Patients admitted to the neuro intensive care unit (NICU) are at higher risk of developing life-threatening nosocomial infections. These patients are particularly vulnerable because of the serious nature of their illness, the frequency of associated trauma and the presence of invasive devices. In this study, the definition of neuro-intensive care unit nosocomial infections, affecting factors, pathogens, type of the nosocomial infections, and prevention of infection were reviewed.

Objectives:Purpose of our study is to compare the effects of lactulose and magnesium hydroxide on prospectively in patients complaining of constipation in two different departments. Method: A questionnaire was prepared. The questions were asked to the patients and a trourough physical examination was performed in both outpatient clinics. The preferred drug was magnesium hydroxide in pediatric surgery clinic, and lactulose in gastroenterology clinic. Behaviorial information was given to all patients. Patients were called for control on 2 and 10 th weeks after the initiation of the treatment. Results: A total of 43 patients were included in the study. Of these 27 patients referred to pediatric surgery, and 16 patients gastroenterology outpatient clinics. Ten (%39) patients who were treated by pediatric surgery outpatient clinic and 9 (%53) patients who were treated by gastroenterology outpatient clinic had responded to treatment at the second week controls. All the patients who had treatment in the both outpatient clinics had improvement in their symptoms at the tenth week controls. Conclusions: In our study, no significant difference was observed in the treatment of patients with both drugs. However, treatment of constipation be treated with medication alone is probably not enough, we should be in good communication with patients and their families, such as behavior and diet therapy are as important as medication for obtaining good results.

Objectives: The whole surgical team carries out the important tasks of neuromonitoring during craniotomy to prevent neurological damage. We examined the role of the anesthesiologist in intraoperative neuromonitoring in light of experience between 2005-2008. Methods: We gathered the files of patients who underwent craniotomy with neuromonitoring from November 2005 to 2008. The neuromonitoring data were analyzed, details of demographic characteristics, neuromonitoring methods, and anesthesia were recorded. Results: During 3-year period, 204 patients who underwent craniotomy were monitored with the following techniques: SSEP with phase transformation (n:16), motor cortex localization (n:31), corticospinal tract localization (n:51), direct cortical and subcortical stimulation (n:27), motor speech center (Broca) localization (n:3), cranial nerve (n:60), MEP (n:84), SEP (n:92), EEG (n:24), BAEP (n:35), and cranial nerve monitoring (303 cranial nerves). Total intravenous anesthesia with propofol and remifentanil was used in all patients. Patients having EMG and MEP were not given muscle relaxants after anesthesia was induced. The dosages of intravenous anesthetic agents were reduced during subcortical stimulation and EEG monitoring. Conclusion: If anesthesiologists guide the use of anesthetic agents (depending on the neuromonitoring method used) and inform the team of changes in the patient’s hemodynamic status, the information gained through neuromonitoring can be obtained and interpreted more accurately.

Objective: The perinatal outcome of pregnancies with preeclampsia varies in comparison to pregnancies without preeclampsia. In addition, the perinatal outcomes are also altered in preterm birth. This study evaluates the neonatal outcomes of pregnancies with preterm preeclampsia compared to preterm birth related with other etiologies. Methods: This study included the evaluation of 160 premature neonates delivered before 37 weeks gestation. Neonatal outcomes of 35 infants delivered prematurely due to preeclampsia were compared with 125 premature infants delivered due to other etiologies. Neonatal outcomes included: APGAR scores, length of stay in the neonatal intensive care unit (NICU), intubation rates, respiratory distress syndrome (RDS) and neonatal death (NND). Results: There was no difference in the APGAR scores between the two groups (p>0.05). The rate of intubation, RDS, NND and stay in NICU were found similar among the groups (p>0.05). Early preterm delivery (<34 week) rate was found to be higher in preeclampsia (80% vs. 60.8%, p=0.045). The rate of infants with very low birth weight (<1500gr) was found to be higher in preeclampsia compared to the other group (37.1% vs. 18.4%, p=0.034). Conclusion: The neonatal outcomes of infants delivered prematurely due to preeclampsia appeared to be worse than the premature infants delivered due to other etiologies. These results can be explained with the pathophysiology of preeclampsia and its effect on the fetus during the intrauterine period.

Objective: Dicephalic parapagus is a rare anomaly of conjoined twins with severe morbidity and mortality. Early prenatal diagnosis is crucial for the follow-up of the pregnancy. In this article, prenatal diagnosis of parapagus twins with ultrasonography in the first trimester is presented. Case report: Twenty-four-year-old pregnant woman with gravidity 2 whose personal and familial background was uneventful was diagnosed with parapagus dicephalus conjoined twins in the 12th week of gestation by ultrasonographic examination. Fetus with 2 heads with seperate necks, 2 arms, 3 legs, and fused vertebral column was observed by ultrasonographic examination. Conclusion: Early diagnosis of parapagus dicephalus conjoined twins seems to be very important for the management and termination of pregnancy when required.

Tuberous sclerosis is a neurocutaneous syndrome involves skin, brain, kidneys, heart and eyes primarly. Cardiac rhabdomyomas accompany to tuberous sclerosis frequently. Congenital adrenal hyperplasia is group of autosomal disorders of adrenal cortex characterized with enzyme deficiency at cortisol biosynthesis. There is only one case with tuberous sclerosis and congenital adrenal hyperplasia reported in literature. We report a case with intracardiac masses which were detected in the left ventricle with prenatal and postnatal echocardiography. Tuberous sclerosis with subependymal nodules and cortical tubers was detected at postnatal magnetic resonance imaging. Also congenital adrenal hyperplasia was determined at the infant which had areolar and scrotal hyperpigmentation.

Behcet’s disease is a chronic multisystemic vasculitis that is characterized by recurrent oral apthous ulcers, genital ulcers and uveitis and its etiology remains still unknown. Although, It may affect any organ system, also vascular involvement can be seen. Venous involvement is more common than the arterial one but pathologies like as thrombosis and aneurysm formation can be seen in arterial system. Vena cava superior thrombosis can be seen in course of Behcet’s disease as the years pass. We aimed to present a 29 years old male patient with thrombosis of vena cava superior that is diagnosed as Behcet’s Disease in this study.