Search

In today?s world, all the higher education institutions across the world are trying to keep and improve their educational standards in order to respond to the ever-changing needs and expectations of all their stakeholders and to survive under great environmental pressure resulting from the stiff global and local competition. To this end, they need to plan, control and improve their own educational quality on a regular and continuous basis. However, if there is a considerable gap between the internationally agreed-upon quality standards and the quality offered within the institutional framework, it will be very difficult to claim objectively that the educational services provided are of the highest achievable quality. Thus, obtaining international quality accreditation is of crucial importance both in proving the educational quality offered institutionally and persuading all the stakeholders that the education provided is planned, monitored, evaluated and improved in line with the predefined and preset international quality standards. On the other hand, having an international quality accreditation as a higher education institution might not always guarantee a positive quality perception on the students? part, who are the actual consumers of the quality. The main purpose of this study is to analyze the relationship between the internationally accredited educational quality and the quality perception of the students studying at an English preparatory school of a foundation university in Turkey.

This paper discusses how Turkish Cypriot orthopedically impaired learners who are living in North Cyprus use social networking as a tool for leisure and education, and to what extent they satisfy their personal development needs by means of these digital platforms. The case study described, conducted in North Cyprus in 2015 followed a qualitative research methodology: semi-structured interviews and document analysis were used for data collection. The study sample of 20 orthopedically impaired participants was selected from among members of the Cyprus Turkish Association for the Orthopedically Disabled which asked for volunteers. The study concluded that impaired learners typically satisfy their social and learning needs, or their need for excitement and relaxation, through social media. It is clear that the use of social networking only satisfies individual needs and does not contribute to group interdependence: if orthopedically impaired learners actively directed themselves to communicating more effectively among themselves and creating groups, they could solve personal problems through group solidarity. Social networks contribute to orthopedically impaired learners’ lifelong education process: in addition to providing them with positive gratification, they also “informally” contribute to their personal education. Although the individuals who participated in this study do use social networks, more effort needs to be made within the context of North Cyprus to make use of social networks for formal education purposes. The file in this item is the publisher version (published version) of the article.

In this case report, we aimed to discuss a patient presenting with convulsion and respiratory depression after interscalene brachial plexus blockade (ISB) was performed with ropivacaine 0.5%. A 35 years old man, 70 kg in weight and 174 cm in height was taken to operation for right radial nerve repair. ISB was done with 40mL of ropivacaine 0.5% using peripheral nerve stimulator. Clonic convulsions at the face muscles and respiratory depression occurred 3 min later than ISB. Convulsions and hypotension improved without any intervention, bradycardia was not seen. As a result, slow injection should be performed having continuous dialogue with the patient during the ISB procedure. We hold the opinion that even if the aspiration and test dose are negative, physician should be aware to the cardiovascular and central nervous system complications after the local anesthetic injection. Key words: Regional anesthesia, Brachial plexus block, Ropivacaine, Convulsion, Respiratory depression, Bu olgu sunumunda %0.5 ropivakain ile yapılan interskalen brakiyal pleksus bloğu (ISB) sonrası konvülsiyon ve solunum depresyonu meydana gelen bir olguyu tartışmayı amaçladık. 35 yaşında, 70 kg ağırlığında, 174 cm boyundaki erkek olgu sağ radiyal sinir onarımı için operasyona alındı. Periferik sinir sitümülatörü kullanılarak 40 mL %0.5 ropivakain ile interskalen blokaj yapıldı. ISB yapıldıktan 3 dk sonra yüz kaslarında klonik kasılmalar ve solunum depresyonu meydana geldi. Konvülsiyon ve hipotansiyon herhangi bir müdahaleye gerek kalmadan kendiliğinden düzeldi, bradikardi görülmedi. Sonuç olarak; ISB işlemi sırasında hasta ile sürekli diyalog halinde olunarak yavaş enjeksiyon yapılmalıdır. Ayrıca, aspirasyon ve test dozu negatif olsa bile lokal anestezik enjeksiyonu sonrası kardiyovasküler ve santral sinir sistemi komplikasyonlarına karşı hazırlıklı olunması gerektiğini düşünüyoruz. Anahtar kelimeler: Rejyonel anestezi, Brakiyal pleksus bloğu, Ropivakain, Konvülsiyon, Solunum depresyonu

Acutely developing atelectasis causes disrupted gas exchange, increases risk of infection and resultantly increases the rate of mortality and morbidity if it's not treated urgently. Today flexible fiberoptic broncoscopy (FFB) is a common method in diagnosis and treatment of atelectasis. It has a major role, especially in treatment of mucous related atelectasis.A case report with acutely developed intraoperative atelectasis and rapid recovery. After FFP is presented Key words: Atelectasis, General Anaesthesia, Flexible Fiberoptic Broncoscopy., Akut gelişen atelektazi acil tedavi edilmediğinde gaz değişimini bozup, enfeksiyon riskini arttırarak mortalite ve morbiditede artışa sebep olur. Fleksibl fiberoptik bronkoskopi (FFB) son zamanlarda atelektazinin tanı ve tedavisinde yaygın kullanılan bir metod olup, özellikle hava yolundaki mukusa sekonder atelektazilerin tedavisinde önemli bir role sahiptir. Bu nedenle intraoperatif akut gelişen ve FFB sonrası hızla düzelen bir atelektazi olgusunu sunmayı uygun bulduk. Anahtar kelimeler: Atelektazi, Genel Anestezi, Fleksibl Fiberoptik Bronkoskopi.

Aim: ProSeal LMA (LMA) was developed on the basis of the classic LMA is a supraglottic airway device. In this study, anesthesia records of 428 pediatric patients who PLMA were inserted after induction of general anesthesia in pediatric surgery between May 2009 and June 2011 were reviewed retrospectively. Material-Methods: Demographic characteristics, ASA score, type of surgery and anesthesia time, the premeditation, induction agents, positions of patients, PLMA placement technique, the number of attempts, the practitioners' experience of anesthesia and complications encountered were recorded retrospectively. Results: Anesthesia was induced intravenously or inhalationally in 355 and 73 patients, respectively. PLMA was placed at the first trial to 411 patients and at the second trial to 14 patients. 342 patients who PLMA were inserted underwent to the operation in the supine position, 86 patients had the operation in lithotomy position. PLMA was placed with digital technique to 355 patients, introducer was used in 73 patients. After PLMA was placed, in 4 patients laryngospasm, in 3 patients bronchospasm, in one patient gastric distension, in two patients hiccup developed. After placement of PLMA two patients vomited. After removal of PLMA laryngospasm developed in three patients, blood transmission at PLMA has been found in 2 patients. Conclusion: In children, PLMA with allowing high leak pressures than the classic LMA and separating glottis to esophagus, high placement success and low complication rate is an effective airway device. Key words: Proseal LMA; Children; Complication., Amaç: ProSeal Laringeal Maske (PLMA) klasik LMA temelinde geliştirilen supraglottik bir hava yolu aracıdır. Bu çalışmada Mayıs 2009 ile Haziran 2011 tarihleri arasında çocuk cerrahisi ameliyatlarında genel anestezi indüksiyonu sonrası PLMA uygulanan 428 pediyatrik hasta, anestezi kayıtları gözden geçirilerek geriye dönük olarak değerlendirildi. Gereç ve Yöntem: Çalışmaya alınan hastaların demografik özellikleri, ASA skorları, cerrahi girişim türü ve anestezi süresi, uygulanan premedikasyon, indüksiyon ajanları, hastaların pozisyonları, yerleştirilen PLMA numarası ve hangi yöntemle yerleştirildiği, girişim sayısı, uygulayıcıların anestezi tecrübeleri ve karşılaşılan komplikasyonlar kaydedildi. Bulgular: Anestezi indüksiyonu 355 hastada intravenöz, 73 hastada inhalasyon ajanlarıyla sağlanmıştır. Hastaların 411'ine birinci denemede, 14'üne ikinci denemede PLMA yerleştirilmiştir. PLMA uygulanan hastaların 342'si supin pozisyonda, 86'sı litotomi pozisyonunda operasyon geçirmiştir. 355 hastada dijital teknik ile PLMA takılırken, 73 hastada introduser kullanılmıştır. PLMA yerleştirildikten sonra 4 hastada laringospazm, üç hastada bronkospazm, bir hastada mide distansiyonu, iki hastada hıçkırık gelişmiştir. İki hasta PLMA yerleştirildikten sonra kusmuştur. PLMA çıkarıldıktan sonra üç hastada laringospazm gelişmiş, iki hastada PLMA'da kan bulaşı tesbit edilmiştir. Sonuç: Çocuklarda, PLMA başarılı yerleştirme oranı yüksek, komplikasyon oranı düşük, klasik LMA'ya göre daha yüksek kaçak basınçlarına izin veren, özefagusu glottisden ayıran etkili bir havayolu aracıdır. Anahtar kelimeler: Proseal Laringeal Maske; Çocuklar; Komplikasyon.

Heparin resistance with an unknown mechanism is observed in a wide range of clinical severity. In this report, we aimed to present a case with heparin resistance who had to receive high dose heparin (15 mg/kg) before CPB despite intraoperatively normal levels of antitrombin III and platelet count. Keywords: Anticoagulant, Heparin, Antitrombin III, Surgery, Cardiac., Mekanizması tam olarak bilinmeyen heparin direnci, klinikte değişkenlik gösteren şiddetlerde karşımıza çıkmaktadır. Bu sunuda, intraoperatif dönemde normal antitrombin III düzeyi ve trombosit sayısına rağmen kardiyopulmoner bypass öncesinde yüksek doz heparin (15 mg/kg) verilen heparin direncine sahip bir olguyu sunmayı amaçladık Anahtar kelimeler: Antikoagülan, Heparin, Antitrombin III, Cerrahi, Kardiyak

Ankylosing spondilitis is a chronic, painful, autoimmune seronegative spondyloarthropaty. Both airway management and neuroaxial block of patients with ankylosing spondilitis may have difficulties for anaesthetist. We aimed to present a patient with ankylosing spondilitis that was applied to spinal anaesthesia with lateral approach for total hip replacement surgery. Key words: Ankylosing Spondylitis; Spinal; Anaesthesia., Ankilozan spondilit, kronik, ağrılı, inflamatuar bir seronegatif otoimmün spondiloartropatidir. Anestezistler için ankilozan spondilitte hem hava yolunun yönetimi hem de nöroaksiyel blok uygulamalarında zorluklar olabilir. Total kalça protezi operasyonu geçirecek ankilozan spondilitli hastaya lateral yaklaşımla başarılı spinal anestezi uygulamasını sunmayı amaçladık. Anahtar kelimeler: Ankilozan Spondilit; Spinal; Anestezi.

After adrenalectomy and thyroidectomy which performed as a therapy of multiple endocrine neoplasia II (MEN II), adrenal insufficiency and hypothyroidism may occur. However in response to surgery, both cortisol and thyroid hormones are essential and should be replaced. For any reason if an anaesthesia method will be applied to these cases, regional block is more suitable which causes decreased metabolic and endocrine response. Therefore we aimed to discuss anaesthetic management of a case who underwent vaginal hysterectomy with adrenal insufficiency and hypothyroidism and receives hormonal replacement therapy, first planned to perform epidural anaesthesia but because of the technical difficulties general anaesthesia was attempted. Key words: Anaesthetic Management: Multiple Endocrine Neoplasia II (MEN II), Adrenal İnsufficiency, Hypothyroidism, Hormone Replacement., Multipl Endokrin Neoplazi II (MEN II) nedeniyle yapılan sürrenalektomi ve tiroidektomiyi takiben adrenal yetmezlik ve hipotiroidi gelişebilir. Oysa cerrahiye stres yanıtta gerek kortizol gerekse tiroid hormonları ana unsurlar olup; replasmanları gerekmektedir. Herhangi bir nedenle bu tür vakalara anestezi uygulaması gerektiğinde cerrahiye metabolik ve endokrin yanıtı azalttığı bilinen rejyonal bloklar daha uygun olacaktır. Bu nedenle vajinal histerektomi geçirecek olan, öncelikle epidural anestezi planladığımız ancak uygulama zorluğu nedeniyle genel anestezi vermek zorunda kaldığımız, adrenal yetmezlik ve hipotiroidi replasman tedavisi alan bir olguyu sunmayı amaçladık. Anahtar kelimeler: Anestezi Uygulaması: Multipl Endokrin Neoplazi II (MEN II), Adrenal Yetmezlik, Hipotiroidizm, Hormon Replasmanı.