Epilepsy surgery is a therapeutic intervention for patients with medically refractory seizures. Anesthetic considerations epilepsy surgery for refractory epilepsy include ensuring a safe and comfortable perioperative experience for the patient, providing suitable operating conditions for the neurosurgeon, avoiding interference with intraoperative neuromonitoring recordings. Providing the conditions that simultaneously meet these requirements, using general anesthesia remains a significant challenge for the neuroanesthesiologist. The role of anesthesiologist acquires significant dimensions in management of epilepsy ranging from operative procedure, to the intensive care management of patients with status epilepticus. The knowledge regarding various antiepileptic agents and their potential side effects and interactions with anesthetic agents are of prime concern during surgical procedures for epilepsy. It requires a skilful and clinically precise handling of such patients during perioperative period by the all team, which is structured by anesthesiologist, neurosurgeon and neurologist. In this study, we aimed to discuss our standardized anesthesia protocol and review of the literaturefor epilepsy surgery.

Introduction: We aimed to categorize retrospectively trauma patients by using an anatomical (Injury Severity Score - ISS) and a physiological (Revised Trauma Score - RTS) scoring system in our center, which is established near the east border of Turkey where the specialists are working temporarily during their compulsory medical service. Material and methods: Twenty-five trauma patients who admitted in Igdir Government Hospital with Abbreviated Injury Scale (AIS) scores >3 who has undergone life saving surgery due to a hemodynamically unstable solid organ injury between September 2010 to September 2011 were evaluated retrospectively. The ?2 test was used for categorical variables, the Student t test was used for comparisons of continuous variables. The Mann-Whitney U test was used for other nonparametric quantitative data. A P value less than 0.05 was considered statistically significant. Results: Mean age of the patients was 32.4 years (19-64) and male/female ratio was 19/6. The most frequently detected trauma mechanism was traffic accident (n=12). The most frequently injured solid organ was liver (n=14). The mean initial ISS was 23.6±19.9 and RTS was 6.7±1.8. ISS was higher than 60 pts in four patients, in parallel with their lower mean RTS scores (3.1±1.8) (p<0.05). The mortality rate of this subgroup was 100% (p<0.001). Overall, 7 (28%) of patients had multiple traumas with a mortality rate of 57.1%, while in 4 of them all three body cavities were traumatized. Conclusion: In our level II trauma center which does not have full availability specialties, personnel and equipment; health care, transfer and management of the severe trauma patients who couldn’t be referred to major trauma centers were accomplished properly in accordance with surgical treatment algorithms and trauma scores of the patients. Treatment results of our patients appear to be similar to those reported in the current literature.

Objectives: Our aim was to assess normative data regarding the thyroid gland volume of Turkish newborns with normal thyroid stimulating hormone levels and to detect whether regional differences existed. Method: A total of 201 full-term newborns (term, 37–42 weeks; within 0– 30 days of birth; 104 girls; 97 boys) from four different zones in Turkey (Marmara, Eastern Black Sea, Eastern Anatolian, and Aegean) were included in this study. Thyroid volumes were measured by ultrasonography by using a similar method, and the results were compared. Results: In our study, the newborns’ mean thyroid volume was 0.58 ± 0.19 mL. Thyroid volumes from the Marmara, Eastern Black Sea, Eastern Anatolian, and Aegean regions were 0.50 ± 0.12, 0.79 ± 0.23, 0.56 ± 0.16, and 0.43 ± 0.17 mL, respectively. The ultrasonographically assessed thyroid volume was significantly greater for newborns from the Eastern Black Sea (p < 0.001), followed by the Eastern Anatolia, Marmara, and Aegean regions. No statistically significant difference existed among the latter three zones. Conclusions: The neonates’ normal thyroid volumes varied among the different regions. Newborns from the Eastern Black Sea region possibly have a greater thyroid volume because of a residual effect secondary to a history of iodine deficiency in that region, as well as a correlation between a mother and a neonate in terms of thyroid functions. Thus, in newborns from the East Black Sea region, additional screening tests may be added to routine screening in selected groups.

The etiology of parotitis is unclear, but some possible causes such as obstruction of glandular excretory ducts caused by patient’ or endotracheal tube position and increase in the viscosity of the saliva because of acute dehydratation and/or medications like morphine, atropin have been proposed. In this study, we present a case of acute parotitis in a 21-year-old girl in neuor-intensive care unit 5 hours later the extubation following supratentorial craniotomy under general anesthesia.

In 1937, Hulusi Behçet, a Turkish dermatologist, reported a disease associated with iritis and ulcerations of the mucous membranes of the oral cavity and genitalia. The main symptoms of Behçet’s disease occur not only in the skin, mucosa and eyes, but also in the joints, digestive tract, vascular system, and nervous system. For many years, vascular complications in Behçet’s disease have been attributed to thrombophlebitis, aneurysm and arterial occlusion. Aneurysmal changes develop at relatively earlier ages in this condition. In this case, we report a giant ruptured abdominal aortic aneurysm in a patient with Behcet’s disease.

Secondary products derived from plants may contain harmful substances such as honey. The honey contaminated with grayanotoxin, a diterpene, which is a polyhydroxylated cyclic hydrocarbon that doesn?t contain nitrogen named “deli bali” in Turkish, which is called “[sic] mad honey may cause grayanotoxin toxidrome. It affects multiple systems of the body especially cardiovasculare system in a dose dependent fashion. Herein we present a rewiev of this toxidrome.