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    Application of ice and vapocoolant spray to reduce tetanus vaccine pain: A prospective, randomized, controlled, clinical study
    (2019) Akcimen, Mehmet; Bedel, Cihan; Selvi, Fatih
    Aim: Tetanus is one of the vaccine-preventable diseases, that threatens human health in our country and the world, and one of the most common symptoms after vaccination is localized pain. In this study, we aimed to compare the effectiveness of vapocoolant spray with ice application and control group in reducing the pain during vaccination. Material and Method: This prospective randomized controlled trial included 292 patients who received tetanus vaccination between January 1st, 2017 and April 1st, 2017 and who agreed to participate in the study. Patients were assigned to 3 groups. Before vaccination, vapocoolant spray was applied to Group 1 and ice was applied to Group 2, and application was directly performed to Group 3 (control). The pain at the time of vaccination and at injection was noted between 0-100 using Visual Analogue Scale (VAS). Results: Of the 315 patients included in the study, 292 fulfilled the inclusion criteria. Patients who were applied ice (5.3 ± 7.1) or vapocoolant spray (4.1 ± 5.4) at the time of intervention had statistically significantly lower VAS values than control group (8 ± 10.6) (p = 0.002; p <0.001, respectively). The mean VAS values during injection, in control patients and ice and vapocoolant spray applied patients were found to be as 9.5 ± 8.11; 6.3 ± 7.4; 11.5 ± 10.2, respectively. VAS values at injection were statistically significantly lower in ice-applied patients than in the control group (p = 0.039). Conclusions: Both ice and vapocoolant spray reduce pain occurred during tetanus vaccination compared to the control group. With easy and fast applicability, ice and vapocoolant spray can be used to reduce the pain during the tetanus vaccine.
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    The value of the capillary blood ketone measurement in rating of dehydration: An experimental study
    (2019) Akcimen, Mehmet; Bektas, Ahmet Firat; Yigit, Ozlem; Bedel, Cihan
    Aim: In this study, we aimed to determine the value of blood ketone levels in diagnosing and classifying dehydration. Material and Methods: A total of 40 rats were included into the study. Rats were categorized into four groups according to their weight loss: control group (no weight loss), mild dehydration group (3 – 5% weight loss), moderate dehydration group (5 – 10% weight loss) and severe dehydration group (>10% weight loss). The blood samples taken from the rats were analyzed for capillary blood ketone levels, venous blood ketone levels and the other biochemical parameters. Results: There was no significant difference between four study groups according to the venous blood ketone levels and capillary ketone levels. Only Na levels were significantly different between study groups among all the metabolic parameters. (p=0.044). After categorizing the study groups as control and dehydration groups according to the weight loss, a borderline significance was established for Na (146±6 vs 151±2.5; difference: 4.2 mmol/L, %95 CI: -0.2 to 8.6, respectively; p=0.06) and capillary blood ketone (0.4 (IQR:0.3-0.5) vs 0.6 (IQR:0.4-0.7), respectively; p=0.097), while other parameters did not differ significantly. The capillary blood ketone had a sensitivity of 96.7% (95% CI: 82.8 -99.9), specificity of 10% (95% CI: 0.3-44.5) for detecting dehydration. Conclusions: This study showed that there was no significant difference for the development of ketosis in dehydration. However, the borderline significance for the capillary ketone levels indicates the necessity of human studies.