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Öğe Bromelain: a candidate to enhance wound healing after endonasal surgeries(Verduci Publisher, 2023) Esen, E.; Muluk, Nuray Bayar; Sezer, C. Vejselova; Kutlu, H. M.; Cingi, C.OBJECTIVE: In the present study, we investigated the topical bromelain's cytotoxic effects on mouse fibroblast NIH/3T3 cells via cell culture study. MATERIALS AND METHODS: In this cell culture study, Dulbecco's Modified Eagle Medium ( DMEM) with fetal bovine serum (FBS, 10%) and penicillin/streptomycin (1%) was used as a cell growth medium for NIH/3T3 mouse fibroblast cells. MTT test was performed in 96-well plates seeded with NIH/3T3 cells 5x103/ well and under standard cell culture conditions. Bromelain doses of 3.13 to 100 mu M were administered to the wells and incubated for 24, 48, and 72 hours in the same cell culture conditions. For Confocal microscopic evaluation, NIH/3T3 cells were plated on cover slips in 6-well plates (105 cells/ well) and treated with 100 mu M concentration of bromelain for 24 h. Untreated cells were used as controls. RESULTS: M TT r esults s howed t hat b romelain is not cytotoxic on mouse fibroblast NIH/3T3 cells. All three incubation times of 24, 48, and 72 hours bromelain initiated cell growth. A statistically significant rise in cell growth was detected in the only applied highest dose of 100 mu M bromelain for all incubation times except for 24 hours. The nontoxic effect was further investigated by using confocal microscopy by applying the highest bromelain dose of 100 mu M to NIH/3T3 mouse fibroblast cells. Confocal micrographs showed that bromelain did not change the morphology of mouse fibroblast cells at the incubation time of 24h. In untreated cells and bromelain-treated cells, the nucleus of NIH/ 3T3 cells was undamaged and compact, and the cytoskeleton was fusiform and non-fragmented. CONCLUSIONS: Bromelain is not cytotoxic on mouse fibroblast NIH/ 3T3 cells and enhances cell growth. If clinical trials will confirm this, it is possible that bromelain will be used topically in humans to enhance wound healing, in rhinosinusitis and chronic rhinosinusitis with nasal polyps and endonasal surgeries due to its anti-inflammatory effects.Öğe Biologics in allergic rhinitis(Verduci Publisher, 2023) Muluk, Nuray Bayar; Cingi, C.This paper aims to review biologics in allergic rhinitis (AR). Biologic agents of Omalizumab, Dupilumab, Mepolizumab, Reslizumab, and Benralizumab are reviewed in detail. The search is performed in Pubmed, Google, Google Scholar and EBSCO Academic Search Ultimate (EKUAL) database of Kirikkale University Library from 2021 to 2000, and randomized and/or placebo-controlled studies, review papers, meta-analysis, and reports are taken into consideration. The search was performed with the keywords of allergic rhinitis, biologics, biologic agents, Omalizumab, Dupilumab, Mepolizumab, Reslizumab, Benralizumab, Anti IgE, Anti-IL-4/IL-13, Anti IL-5. Search is also performed in the U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA) web systems. Biological agents such as monoclonal antibodies (MAb) in treatment are called biological therapy or biotherapy. Omalizumab is a humanized Anti-Ig Emonoclonal antibody. Omalizumab treatment improved the Daily Nasal Rescue Medication Score (DNSSS) and decreased the use of antiallergic drugs in seasonal and perennial AR and rhino-conjunctivitis. Omalizumab is also used in specific immunotherapy patients with allergic rhinitis and reduced allergic reactions associated with allergen immunotherapy, such as anaphylaxis. Dupilumab is an Anti-IL-4/IL-13 biologic agent. Dupilumab treatment significantly improved sino-nasal Outcome Test (SNOT-22) total scores in perennial allergic rhinitis. Anti-IL-5 monoclonal antibodies of Mepolizumab, Reslizumab Benralizumab reduce the number of eosinophils in the blood and tissue, corticosteroid addiction and asthma attacks are reduced, and their use in the treatment of severe eosinophilic asthma has been approved. Biologics, especially Omalizumab, and Dupilumab, may be used more in allergic rhinitis.Öğe Association between superoxide dismutase 2, glutathione peroxidase 1, xeroderma pigmentosum group d gene variations, and head and neck squamous cell cancer susceptibility(Inst Bioloska Istrazivanja Sinisa Stankovic, 2022) Köse, Gülçin; Oz, Merve Demirbugen; Cömert, Ela; Suzen, Halit SinanAs oxidative stress is implicated in the pathogenesis of head and neck squamous cell cancer (HNSCC), the functions of antioxidant enzyme systems and DNA repair proteins are critical in the development of cancer. To investigate the role of genetic polymorphisms of the antioxidant superoxide dismutase 2 (SOD2) Val16Ala, glutathione peroxidase 1 (GPX1) Pro198Leu, and the DNA repair Xeroderma Pigmentosum Group D (XPD) Lys751Gln genes under exogenous risk factors, including smoking and alcohol consumption, in HNSCC carcinogenesis, we conducted a case-control study on 139 unrelated cases and 265 non-cancer controls. Polymorphisms were analyzed in additive, dominant and recessive genetic models, individually and in an interaction model. Carriers of the T allele of SOD2 were associated with an increased risk for HNSCC in males and smokers; similarly, the T allele of GPX1 was associated with elevated risk in the overall and smoker subgroup. A 12.47-fold increased risk was observed for the carriers of GPX1 TT, SOD2 CT and XPD CC genotypes for HNSCC. This is the first study presenting the potential roles of SOD2, GPX1 and XPD polymorphisms in interaction and under three genetic models in the development of HNSCC. The results suggest that these polymorphisms slightly modify the risk in HNSCC development individually but are significantly higher when they functioned and were evaluated together.Öğe Assessment of olfactory function by Sniffin' sticks in bakery workers exposed to flour dust(Verduci Publisher, 2022) Altintas, M.; Kar, M.; Muluk, Nuray Bayar; Cingi, C.OBJECTIVE: This study used the Sniffin' Sticks test battery to evaluate olfactory function in employees of a bakery exposed to flour dust. SUBJECTS AND METHODS: The study enrolled 43 individuals with exposure ( i.e., to flour) plus 41 healthy volunteers as controls. Olfactory function was assessed in these subjects through the use of the Sniffin' Sticks test battery. The overall score was calculated by adding up the scores for each of the 12 separate odors. A score of 6 or less was deemed anosmia, from 7 to 10 hyposmia, and a score of 11 or 12 was taken to indicate no impairment of olfaction. RESULTS: There was a statistically significant difference between the scores obtained in the exposure group (10.09 +/- 2.29) and the control group (10.73 +/- 2.07), the exposure group having a lower score (p<0.05). Within the exposure group, men and women did not score differently (p>0.05). Furthermore, in this group, the overall score did not correlate significantly with age, sex, length of employment, or use of tobacco or alcohol use (p>0.05). Using the scheme employed in this study, 9.3% of the exposed workers were anosmic, compared to 9.8% in the controls, whereas 34.9% of baker workers were hyposmic, compared to just 14.6% of the controls. Thus, our study shows that impairment of the ability to smell was present in 44.2% of individuals exposed occupationally to flour dust. CONCLUSIONS: This study reveals that being exposed to flour dust reduces the ability to smell normally. In order to minimize the impact of being exposed, workplaces should ensure adequate ventilation and provide workers with protective facemasks.Öğe Are preservation rhinoplasty techniques safer than structural ones?(Verduci Publisher, 2023) Bafaqeeh, Sameer Ali; Muluk, Nuray Bayar; Cingi, CemalThis narrative review paper evaluates the preservation rhinoplasty (PR) technique in all aspects. The literature survey was performed in PubMed, EBSCO, UpToDate, and Proquest Central databases of Kirikkale University, Google and Google Scholar databases. The advent of the preservation rhinoplasty (PR) approach has led to a radical shift in the mind-set surrounding rhinoplasty procedures. K-area ( keystone region) loss, lateral cartilage collapse, and nasal stenosis are all avoidable with preservation measures. The nasal bones, the superior lateral cartilage, the quadrilateral cartilage, and the perpendicular blade of the ethmoid meet at the point known as Zone K. The variety of problems that might develop due to carelessness in this area demonstrates the significance of maintaining the nose's stability and structure. The three components of a preservation rhinoplasty (PR) procedure are (1) preserving the scroll ligament complex by elevating the soft tissue envelope (STE) in a subperichondrial-subperiosteal plane, (2) preserving the nasal dorsum without creating an open roof deformity, and (3) preserving the alar cartilages and achieving the desired shape using sutures rather than excision. Dorsal preservation is one of the three components that make up PR. However, the two concepts are not synonymous. PR involves elevating a skin sleeve from the subperichondrial-subperiosteal plane, preserving the osteocartilaginous dorsum, maintaining the alar cartilages with minor excision and using sutures to achieve the desired form.Öğe Applied surgical methods and outcomes in crooked nose rhinoplasty(Verduci Publisher, 2023) Azizli, Elad; Oğuz, Oğuzhan; Muluk, Nuray Bayar; Sarı, Hüseyin; Dilber, Muhammet; Uyar, Yavuz; Cingi, CemalOBJECTIVE: In this retrospective and multicentric study, we investigated applied surgical methods in rhinoplasty for crooked nose deformity. PATIENTS AND METHODS: The retrospective data for 300 crooked nose deformity cases (191 males and 109 females) were used in our study. Classification of the initial deformities was performed as (1) I-shaped crooked nose deformity, (2) C-shaped crooked nose deformity, (3) Reverse C-shaped crooked nose deformity, and (4) S-shaped crooked nose deformity. As an operation technique, L-strut septoplasty was performed. The applied surgical methods in rhinoplasty to correct the crooked nose are evaluated and classified. RESULTS: Our results showed that initial deformities in crooked nose patients were I-shaped crooked nose deformity (34%), C-shaped crooked nose deformity (28%), Reverse C-shaped crooked nose deformity (21.3%), and S-shaped crooked nose deformity (16.7%). L-strut septoplasty was performed, and the results of the applied methods to correct the crooked nose were evaluated and classified. It was noticed that more than one procedure was applied to each case: (1) double-side lateral osteotomy (86.6%), (2) wedge bone resection on one side of the osteotomy (7.3%), (3) single-side lateral osteotomy (6%), (4) symmetric spreader grafts (56%), (5) asymmetric spreader grafts (10.6%), (6) shaving of the transverse wing of dorsal septum (8%), (7) correction of deviated dorsal septum (16.3%), (8) displaced anterior nasal spine (12.6%), (9) clocking suture (dorsal septal rotation suture) (9%), (10) dorsal septal scoring and splinting graft (8.3%), and equalizing lateral cruses (12.6%). CONCLUSIONS: I-shaped and C-shaped crooked nose deformities were mainly detected in crooked nose deformity patients. Correcting the crooked nose, double- side lateral oste- otomy, and symmetric spreader grafts were the most applied techniques to correct the crooked nose. Other rhinoplasty techniques were also applied to these patients; more than one technique was needed.Öğe An evaluation of the efficacy of indomethacin in experimentally induced acute sinusitis in rats(Verduci Publisher, 2022) Kurt, Y.; Muluk, Nuray Bayar; Yildirim, C.; Dönmez, D. Burukoğlu; Erol, K.; Cingi, C.OBJECTIVE: We evaluated how efficacious indomethacin, at two different doses, is in the treatment of an experimental model of sinusitis in rats. MATERIALS AND METHODS: Twenty-one Wistar albino rats (all male) were sorted at random into one of three groups: 1(st) group (n=7) was placebo. 2(nd) group (n=7). These rats had sinusitis induced experimentally, following indomethacin 3 mg/kg, 5 days was administered to them. 3(rd) group (n=7). These rats had sinusitis induced experimentally, following indomethacin 6 mg/kg, 5 days was administered to them. The animals' sinonasal mucosae were examined histopathologically by standard light microscopy. RESULTS: Experimental sinusitis was observed in the 2(nd) and 3(rd) groups, but not in the rats administered a placebo. Although the in-flammatory features of sinusitis were found to be significantly decreased in the animals administered indomethacin 3 mg/kg (the 2(nd) group), this anti-inflammatory effect was even greater in the 3(rd) group, where indomethacin 6 mg/kg had been administered. Indomethacin at either dose was superior to placebo in reducing inflammatory features of sinusitis. CONCLUSIONS: Topical use of indomethacin nasal drops decreased the inflammatory features in experimentally induced acute sinusitis. Moreover, a higher dose of indomethacin (6 mg/kg) was more efficacious than a lower dose (3 mg/kg). The present study is valuable as an initial step in showing the need to undertake human trials to see the effect of indomethacin nasal drops on sinusitis in humans. In acute rhinosinusitis, the use of topical anti-inflammatory drops may help to decrease the symptoms and may be used adjunctively with antibiotic treatment.Öğe An evaluation of ketoprofen as an intranasal anti-inflammatory agent(Verduci Publisher, 2022) Altıntaş, M.; Muluk, Nuray Bayar; Sezer, C. Vejselova; Kutlu, H. M.; Cingi, C.OBJECTIVE: The objective of the study was to evaluate the effect of ketoprofen when locally applied to tissue-cultured nasal epithelium. MATERIALS AND METHODS: Healthy primary nasal epithelial cells were grown in a tissue culture medium. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide) assay was used to evaluate cytotoxicity. Markers of cellular injury revealed by the MTT assay include fragmentation of DNA, condensed nuclei, and changes affecting the cellular outer membrane and cytoskeleton. Epithelial cells at body temperature in cell culture were exposed over a 24- hour period to ketoprofen. Following the MTT assay, the confocal microscopic examination was performed. The extent to which epithelial cells remained capable of proliferating was evaluated by inducing a scratch injury, waiting for the repair to occur, and then examining the result with the ordinary light microscope. RESULTS: Topically applied ketoprofen does not affect the viability of tissue-cultured nasal epithelial cells within a 24-hour period. Furthermore, there were no cellular morphological alterations observed which would indicate toxicity from ketoprofen. In the scratch assay, the cells regained a normal confluent appearance within 24 hours. Thus, ketoprofen neither increases nor alters the rate at which nasal epithelial cells proliferate. CONCLUSIONS: Ketoprofen, when applied topically for 24 hours to nasal epithelial cells in cell culture, does not cause any alterations in cellular appearance which would suggest impairment of the ability to proliferate or indicate a cytotoxic effect. Extrapolating from these results, it appears acceptable to use ketoprofen topically within the nose in cases of rhinosinusitis (acute or chronic) or nasal pain since there is minimal risk of local toxic injury.Öğe Agility Skills, Speed, Balance and CMJ Performance in Soccer: A Comparison of Players with and without a Hearing Impairment(Mdpi, 2023) Yapıcı, Hakan; Soylu, Yusuf; Gülü, Mehmet; Kutlu, Mehmet; Ayan, Sinan; Muluk, Nuray Bayar; Aldhahi, Monira, I.This study investigates the differences in agility, speed, jump and balance performance and shooting skills between elite hearing-impaired national team soccer players (HISP) and withouthearing-impairment elite soccer players (woHISP). Players were divided into two groups, the HISP group (n = 13; 23.5 +/- 3.1 years) and the woHISP group (n = 16; 20.6 +/- 1.4 years), and were tested in three sessions, seven apart, for metrics including anthropometrics, speed (10 m, 20 m and 30 m), countermovement jump (CMJ), agility (Illinois, 505, zigzag), T test (agility and shooting skills), and balance. The results showed that 30 m, 20mand 10msprint scores, agility/ skills (sec), shooting skills (goals), zigzag, Illinois, and 505 agility skills, and countermovement jump scores were significantly lower among players with hearing impairments (p < 0.05). There were no significant T test differences between HISP and woHISP (p > 0.05). The HISP showed right posterolateral and posteromedial, and left posterolateral and posteromedial scores that were lower than the woHISP group (p < 0.05). Anterior scores were not significantly different between each leg (p > 0.05). In conclusion, the HISP group showed higher performance scores for speed (10 m, 20 m and 30 m), CMJ, agility (Illinois, 505, zigzag) and T test (sec and goals), but not balance. Hearing-impaired soccer players are determined by their skill, training, and strategy, not their hearing ability.Öğe A safety investigation into topical effects of naproxen sodium on nasal epithelial cells and potential toxicity in local application(W B Saunders Co-Elsevier Inc, 2023) Dündar, Rıza; Muluk, Nuray Bayar; Sezer, Canan Vejselova; Kaya, Furkan; Kutlu, Hatice Mehtap; Cingi, CemalObjectives: We examined how topically-applied naproxen sodium affects human nasal epitheliocytes in culture. Methods: Samples of healthy human primary nasal epithelium (NE) harvested during septoplasty from volunteers without rhinosinusitis were incubated in cell culture. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assays may be utilised when assessing cellular damage (toxicity), as evidenced by DNA fragmentation, nuclear condensation, alteration in the outer plasma membrane and cytoskeletal alteration. This was the method used in the study. Cultured epitheliocytes were incubated with naproxen sodium for 24 h at 37 ???C. The MTT assay was then performed and the cells' morphology was examined by confocal microscopy. Additionally, cellular proliferation was assessed by the artificial scratch method followed by light microscopy. Results: The results indicated that naproxen sodium does not cause any cytotoxic effects upon nasal epithelial cells when applied topically. There was no evidence indicating cytotoxicity on the nasal epitheliocytes in culture for the 24 h period over which the drug was applied. In particular, there was no alteration in cellular morphology, damage to the intracellular organelles structure or the cytoskeleton secondary to naproxen sodium. Furthermore, cellular proliferation occurred normally in these conditions, as on scratch test. Conclusion: Topical naproxen sodium may be used on nasal epithelial cells without inducing toxicity. This agent is therefore suitable, given its known anti-inflammatory effects, for use in patients suffering from diseases involving nasal and paranasal sinusal inflammation, including rhinosinusitis (both chronic and acute) and nasal polyposis which should be investigated. In the future, topical medication forms for nasal usage should be developed.Öğe A new preservation technique for dehumping the dorsum(Verduci Publisher, 2023) Azizli, E.; Muluk, Nuray Bayar; Dündar, R.; Cingi, C.OBJECTIVE: We aimed to offer a new preservation strategy for dehumping the dorsum by using a variation of the cartilage push- down ( Ishida) technique. PATIENTS AND METHODS: Three hundred patients (42 males and 258 females) had surgical procedures. All procedures were closed- surgery-type, primary-case procedures performed through a closed incision. Low cartilaginous septal strip resection was performed on 269 individuals, whereas high septal strip resection was performed on the remaining 31 patients. The bony cap is shielded as a separate unit and preserved, so protected from any potential damage. The cartilage roof is separated from the bone roof and lowered while wearing the bony cap component. As a result, less concealment is required. However, it is ineffective on dorsal profiles that are sharp or S-shaped, as opposed to flat. Thus, the modified cartilage push-down with bony cap rasping procedure can be carried out. The sharp hump on the bony crown of the skull is smoothed out and filled. Therefore, the bony cap above the central cartilage roof is much thinner. Because the hump is less likely to appear again, concealment is unnecessary. A median of 8.5 months was spent following-up (6-14 months). RESULTS: According to our method, among men (n=42), the hump size ranged from minor (n=5) to medium (n=25) to big (n=12). There were 258 women, 88 of whom had a little hump, 160 had a medium hump, and 10 had a huge hump. Indicative of surgeon satisfaction with low cartilaginous septal strip excision vs. high septal strip resection include the following: with a total of 269 patients, 35 males, and 234 females had low cartilaginous septal strip resections, with 98 and 96% success rates, respectively, for the surgeons. There were 31 patients, seven men and 24 women, who all underwent high septal strip resections, with a 98% and 96% success rate for the surgeons. It was found that there was a correlation between the size of the hump and the level of satisfaction felt by its bearers. Rates of male satisfaction with humps ranged from 100% for little humps to 100% for medium humps to 99% for huge humps. Satisfaction percentages among women ranged from 98% in the case of little humps to 96% among medium humps and 95% among large humps. CONCLUSIONS: O ur t echnique o f m odification of the cartilage push-down (Ishida)1 method is applied for dehumping the dorsum. High satisfaction percentages were obtained from the patients and surgeons. This technique may be a good option for patients who need dehumping.Öğe A narrative-style review of non-surgical rhinoplasty: Indications, outcomes, and limitations(Churchill Livingstone, 2024) Dilber, Muhammet; Muluk, Nuray Bayar; Cingi, CemalThe aim of this narrative-style review was to evaluate non-surgical rhinoplasty in terms of indications, outcomes, and limitations. Both 'PubMed' and 'Science Direct' were reviewed by all authors, in order to reach consensus with regard to the chosen studies. Studies published from 1980 to 2023 were searched using the key terms non-surgical rhinoplasty, dermal filler, thread lifting, and botulinum toxin, and relevant papers were selected. Non-surgical rhinoplasty refers to the use of injectable temporary fillers to augment selected areas of the nose, in order to achieve improved appearance or function in select patients. It includes the use of dermal fillers, thread lifting, and botulinum toxin injections. The perfect dermal filler would be inexpensive, safe, painless to inject, hypoallergenic, and long lasting. In addition, it should produce consistent and predictable results, feel natural under the skin, take little time to inject, be ready to use, exert no downtime on the patient, and have a low risk of complications. Regions of the nose treated with filler injections include the frontonasal angle, dorsum, nasolabial angle, and columella. Thread lifting and botulinum toxin injection are the other methods of non-surgical rhinoplasty. Dermal fillers, thread lifting, and botulinum toxin injections can be used as non-surgical rhinoplasty. Dermal fillers and botulinum neurotoxin can be used alongside each other to allow minimally invasive resculpting of the nasal region and midface, compensating for a reduction in tissue volume and the formation of rhytides.Öğe A Comparison of Diagnostic Accuracy of Superior Semicircular Canal Dehiscence in MDCT and MRI, and Coexistence with Tegmen Tympani Dehiscence(Thieme Medical Publ Inc, 2021) İnal, Mikail; Muluk, Nuray Bayar; Şahan, Mehmet H.; Asal, Neşe; Şimşek, Gökçe; Arıkan, Osman K.Objective Tegmen tympani dehiscence in temporal multidetector computed tomography (MDCT) and superior semicircular canal dehiscence may be seen together. We investigated superior semicircular canal dehiscence in temporal MDCT and temporal magnetic resonance imaging (MRI). Methods In this retrospective study, 127 temporal MRI and MDCT scans of the same patients were reviewed. In all, 48.8% (n = 62) of cases were male, and 51.2% (n = 65) of cases were female. Superior semicircular canal dehiscence and superior semicircular canal-temporal lobe distance were evaluated by both MDCT and MRI. Tegmen tympani dehiscence was evaluated by MDCT. Results Superior semicircular canal dehiscence was detected in 14 cases (5.5%) by temporal MDCT and 15 cases (5.9%) by temporal MRI. In 13 cases (5.1%), it was detected by both MDCT and MRI. In one case (0.4%), it was detected by only temporal MDCT, and in two cases (0.8%), it was detected by only temporal MRI. Median superior semicircular canal-to-temporal distance was 0.66 mm in both males and females in temporal MDCT and temporal MRI. In both temporal MDCT and temporal MRI, as superior semicircular canal-to-temporal lobe distance increased, the presence of superior semicircular canal dehiscence in temporal MDCT and temporal MRI decreased. Tegmen tympani dehiscence was detected in eight cases (6.3%) on the right side and six cases (4.7%) on the left side. The presence of tegmen tympani dehiscence in temporal MDCT and the presence of superior semicircular dehiscence in MDCT and MRI increased. Conclusion Superior semicircular canal dehiscence was detected by both MDCT and MRI. Due to the accuracy of the MRI method to detect superior semicircular dehiscence, we recommend using MRI instead of MDCT to diagnose superior semicircular canal dehiscence. Moreover, there is no radiation exposure from MRI.Öğe A Case of Miliary Tuberculosis Detected with Laryngeal Oedema: Complication with Septic Shock and Thrombocytopaenia(Aves, 2013) Bulcun, Emel; Ekici, Aydanur; Ekici, Mehmet; Gülhan, Pınar Yıldız; Güngör, Ömür; Kazkayası, MustafaTuberculosis, a disease with a wide clinical spectrum, can involve all tissues and organs. A 57-year-old case appeared in the form miliary tuberculosis after laryngeal oedema. Septic shock developed in the course of tuberculosis. Thrombocytopaenia then developed, while septic shock improved following antituberculosis treatment. Thrombocytopaenia improved after rifampicin was removed from the treatment regimen. We decided to present our case here as an interesting form of tuberculosis with complications.Öğe The Score for Allergic Rhinitis study in Turkey, 2020(Dergipark Akad, 2021) Cingi, Cemal; Muluk, Nuray Bayar; Susaman, Nihat; Kucukcan, Nagehan; Kar, Murat; Altintas, Mustafa; Altin, FaziletObjective: This study aimed to determine how prevalent allergic rhinitis (AR) is in Turkey and to compare the current prevalence with the figures obtained 10 years earlier. Methods: This study included 9,017 participants. The minimum number of participants required from each center was determined via a stratified sampling technique according to regional demographic characteristics as ascertained from the last census. For each region, both men and women were administered the score for allergic rhinitis (SFAR) questionnaire and a score for each participant was calculated based on the responses supplied. Results: A total of 9,017 individuals (55.3% men and 44.7% women) took part in this study. Of these, 94.4% were urban residents and 5.6% lived in a rural setting. Of the men, 38.5% self-reported as suffering from AR. The corresponding figure in women was 40.5%. The overall prevalence of AR, as deduced on the basis of the SFAR, was found to be 36.7%. Comparing the prevalence in different regions, we found that AR was the least prevalent in the Black Sea region with a frequency of 35.8%. The highest prevalence was in the Mediterranean region, where the prevalence was 37.7%. There was no statistical significance in the apparent differences in prevalence between different geographical regions. Despite this, however, there was a clear increase in the frequency of AR over the preceding decade. This increase was most pronounced in the South-Eastern Anatolian region, where the frequency rose from 21.0% to 36.9%. Conclusion: Our results indicate that there has been a marked increase in the prevalence of AR in every region in Turkey over the last 10 years. This could be related to living conditions in urban environments. Alterations in lifestyle, urban living, air pollution causing impairments in immune defense mechanisms, and other aspects of modern lifestyles may account for the increase in AR in Turkey.Öğe Effect of peritonsillar prilocaine infiltration on post-tonsillectomy pain in pediatric population(Cukurova Univ, Fac Medicine, 2021) Taş, Burak Mustafa; Erden, Burak; Şimşek, GökçePurpose: This study aims to evaluate the efficacy of peritonsillar prilocaine in post-tonsillectomy pain by using the Visual Analog Scale (VAS). Materials and Methods: A total of 40 pediatric patients were included in this study. There were 20 patients in the prilocaine group (Group 1) and 20 patients in the control group (Group 2). In Group 1, peritonsillar prilocaine infiltration was performed. In Group 2, peritonsillar saline infiltration was performed. VAS scores of at the postoperative 1st, 4th, 12th and 24th hours and on the 2nd, 3rd, 4th, 5th, 6th and 7th days were evaluated. In addition, the presence of nausea and vomiting and the number of additional doses of intravenous paracetamol administered in the first 24 hours were evaluated. Results: When the groups were compared, a significant reduction in post-tonsillectomy pain was observed in the prilocaine group at the 1st, 4th and 12th hours compared to the control group. There was no significant difference between the two groups in other scores. There was no significant difference between the groups for nausea and vomiting and consumption of paracetamol values. Conclusion: Peritonsillar prilocaine infiltration was effective in post-tonsillectomy pain at the 1st, 4th and 12th hours postoperatively. Thus, peritonsillar prilocaine infiltration can be used in post-tonsillectomy pain because it is fast and effective.Öğe Left vocal cord paralysis due to lymphadenopathy of mediastinal tuberculosis(Deomed Publ, Istanbul, 2013) Dikici, Oğuzhan; Muluk, Nuray BayarThough there are a lot of causes of vocal cord paralysis, such as trauma, cancer and surgery; idiopathic cases are also found. Vocal cord paralysis can be also seen in cases of mediastinal mass or tuberculosis which cause mediastinal lymphadenopathy. In this paper, a patient complaining of hoarseness with the diagnosis of left vocal cord paralysis was presented. Thoracic computed spiral tomography showed conglomerated mediastinal lymphadenopathy and biopsy was reported as granulomatous inflammation. Antituberculostatic therapy was administered to the patient and his follow-up procedures are continuing currently.Öğe Otolaryngological findings in mucopolysaccharidosis(Deomed Publ, Istanbul, 2014) Cingi, Cemal; Muluk, Nuray Bayar; Hanci, Deniz; Şahin, Ethem; Acar, MustafaIn this review paper, we reported otolaryngological problems in patients with mucopolysaccharidoses (MPSs). Mucopolysaccharidoses are a group of lysosomal storage diseases, each of which is produced by an inherited deficiency of an enzyme involved in the degradation of acid mucopolysaccharides, now called glycosaminoglycans (GAGs). The mucopolysaccharidoses consist of a group of 7 metabolic disorders, known as mucopolysaccharidoses types I-VII. In all groups, there are clinical and otolaryngological manifestations. In MPS patients, upper airway obstruction, obstructive sleep apnea, restriction of mouth opening, middle ear effusion, hearing and breathing problems, etc. are reported as common otolaryngological findings. Increasing awareness of MPS's among ENT doctors will be a life saving attempt for MPS suspected patients who admit an ENT doctor rather than a pediatrician. In MPS patients, tracheotomy may be difficult due to short neck. Due to mouth opening restriction, patients should be evaluated carefully before tonsillectomy and adenoidectomy operations. Airway problems must be evaluated before anesthesia. All ENT doctors should be noticed to be aware of these problems.Öğe Sisplatin Ototoksisitesi(2017) Taş, Burak Mustafa; Şimşek, GökçeOtotoksisite çeşitli ilaçlar ve kimyasal maddelerin koklea ve vestibüler organda oluşturduğu hücresel dejenerasyon ve fonksiyon bozukluğudur. Sisplatin (Cis-diamindiklorplatinum II), özellikle baş-boyun tümörlerinde, ürogenital sistem, santral sinir sistemi, solunum sistemi ve özefagus kanserleri olmak üzere birçok malign hastalığın tedavisinde, erişkinlerde ve çocuklarda kullanılmakta olan antineoplastik bir ajandır. Sisplatinin nefrotoksisite ve geri dönüşümsüz ototoksisite dışında diğer önemli doz sınırlayıcı yan etkileri nörotoksisite, gastrointestinal sistem ve kemik iliği toksisitesidir. Sisplatin ototoksik etkisini reaktif oksijen ürünleri ve DNA hasarı ile göstermektedir. Sisplatin ototoksisitesinde klinik olarak başlangışta yüksek frekanslarda, sonrasında konuşma sesini de içeren düşük frekanslarda, bilateral, sensorinöral işitme kaybı görülür. Günümüzde sisplatin bağımlı ototoksisiteyi önlemede standart bir tedavi bulunmamaktadır. Bu derlemede sisplatin ototoksisitesinin tanımı, etki mekanizması, güncel tedavi seçenekleri güncel literatür bilgileri eşliğinde tartışılmıştırÖğe Anatomical Considerations: The Relationship Between The Vertebral Artery And Transverse Foramina At Cervical Vertebrae 1 To 6 In Patients With Vertigo(2018) Kültür, Turgut; Muluk, Nuray Bayar; Iyem, Cihan; Inal, Mikail; Burulday, Veysel; Alpua, Murat; Çelebi, Umut OrkunObjective: In this study, we aimed to investigate the relationship between the size of the vertebral artery and that of the transverse foramina at the C1 to C6 vertebral level in patients suffering from vertigo thought to be related to vertebrobasilar insufficiency (VBI). Materials and Methods: In this retrospective study, two groups were compared in terms of cervical computed tomography (CT): 22 adult patients with vertigo; and a control group consisting of 23 healthy adult indivıduals. Measurement of the vertebral artery and transverse foramina (i.e. sagittal and transverse dimensions, plus area) were performed bilaterally at levels C (cervical vertebra) 1 to C6. Results: For the cases group, at C6 level the right vertebral artery area, sagittal and transverse diameter were larger than in the control group at the level of statistical significance. At C1 level, the area of the right transverse foramina in the cases group was significantly higher than in the control group. At levels C1 to C5, the values obtained for vertebral artery area were positively correlated with the values for the ipsilateral transverse foramina (transverse foramen sagittal and transverse dimensions plus areas). Where the sagittal or transverse dimensions of the transverse foramina, or the area of the transverse foramina were found to be decreased, vertebral artery areas were also observed to have decreased at C1 to C5 levels. Conclusion: We concluded that a decrease in diameter of the bony structures or transverse foramina may cause a decrease in the cross-sectional area of the vertebral artery on the ipsilateral side. Since it is only the left vertebral artery which is dominant for cerebral blood flow, any compensatory increase in right vertebral artery area cannot offset decreased cerebral blood flow. Decreased blood flow (i.e. VBI) on the left side may play a role in the development of vertigo.
