Ferit Akil

A case of oculoglandular tularemia resistant to medical treatment.

Abstract Tularemia is a zoonotic disease of the northern hemisphere. Oculoglandular tularemia is the rarest form, comprising 1.4–4.2% of all cases. We present a patient with oculoglandular tularemia that did not respond to gentamicin to demonstrate the need for prolonged antimicrobial treatment and surgical intervention.

Depression, self-esteem and sexual function in laryngeal cancer patients.

The purpose of this study was to assess sexual function, affective disorders and self‐esteem in patients who were surgically treated for laryngeal cancer.

Detection of incidental pulmonary embolism with multi-slice computed tomography in cancer patients

The aim of this study is to show the frequency of incidentally found (pulmonary thromboembolism) PTE in oncological patients and evaluate dispersion of incidents in terms of underlying primary tumor and seek risk factors associated with incidental PTE. Among one thousand oncology patients, 46 (4.6%) individuals found to have incidental PTE. Of positive patients, the highest proportion (24%) was belong to breast cancer group (n=11). The most common location for pulmonary emboli was the lower lobe branch of right pulmonary artery (n=33, 71.7%). Evident PTE had not been reported in final radiology reports of 21 cases.

Submandibular Gland Excision: 10-Year Outcome

Background: Submandibular gland is the second largest salivary gland in human body. There are neoplastic and non-neoplastic diseases affecting the gland, while sialolithiasis is the most common non-neoplastic disease, pleomorphic adenoma is the most common neoplastic disease of the gland. The most common malignant tumor is adenoid cystic carcinoma. Material and method: Patients who underwent submandibular gland operation at Cerrahpasa Medical School between 2002 and 2012 were retrospectively analyzed. Results: Of the patients, 40 were male and 50 were female. Neoplastic diseases were seen in 42 patients and non-neoplastic diseases were seen in 48. The most common neoplastic benign tumor was pleomorphic adenoma, and the most common malignant tumor was mucoepidermoid carcinoma. The most common non-neoplastic disease was sialolithiasis followed by sialadenitis. Conclusion: While data were consistent with the literature in general, mucoepidermoid carcinoma was found to be the most common malignant tumor of submandibular gland, which was different from the literature.

Spindle cell carcinoma of the larynx following spindle cell pulmonary carcinoma: second primary or metastasis?

lipoblastomatosis, liposarcoma, hemangioma, arteriovenous malformation, nodular fasciitis, and herniation of the buccal fat pad, all of which are rare. A preoperative ultrasound and MRI must be always performed to determine the potential origin of the buccal fat pad, to visualize its extent in the various directions, and to exclude liposarcoma. The gold standard treatment for lipoma of the buccal fat pad is surgical removal. Pediatric lipoma of the buccal fat pad is very rare and little is known about its biologic behavior. This study would be helpful in reaching a conclusion about the correct diagnosis and adequate treatment for lipoma of the buccal fat pad.

Rapidly progressive thyroid mass: amyloid goiter.

Amyloidosis is a disease of unknown etiology characterized by the accumulation of an amorphous proteinaceous material in various organs and tissues of the body. Amyloid goiter is an exceedingly rare pathologic condition due to massive amyloid infiltration of the thyroid tissue. Amyloid goiter occurs in association with both primary and secondary systemic amyloidosis, more commonly in the latter. Preoperatively, it simulates a multinodular goiter, and surgical intervention is often necessary to establish a diagnosis and to relieve compressive symptoms of a neck mass. We present the case of an 85-year-old female patient who presented with a rapidly enlarging goiter. Histologic examination confirmed amyloid goiter.

How does chronic tonsillitis affects anxiety and depression

Chronic/recurrent tonsillitis is a persistent inflammation of the tonsils due to recurrent acute or subclinical infections. During acute tonsillitis, infection may persist in the fibrous tissue and cause another tonsillitis attack after days or weeks if proper antibiotic treatment is not provided for a sufficient time. Furthermore, inflammatory scrapings inside the crypts may cause subclinical infection and subsequent tonsillitis attacks (1). Generally, a diagnosis of chronic/recurrent tonsillitis is based on tonsillitis or throat pain that recurs three to four times a year and does not respond to sufficient antibiotic treatment (2). A recurrent throat pain is generally accompanied by fever, weakness, and arthralgia. Secondary foul breath (halitosis) that fills tonsil crypts may also be present (3, 4). Chronic tonsillitis is in fact an adult disease; however, it can be observed at all ages. Like any other chronic disease, tonsillitis can also trigger psychological disorders. Numerous studies on the relationship between chronic/recurrent tonsillitis in adults and psychological disorders and quality of life are available, whichcompare the quality of life of patients before and after surgery (5) or investigate the quality of life and mental health in pediatric patients (6). This study sought to understand the complex relationship between depression and anxiety and chronic/ recurrent tonsillitis in adult patients, which was probably related to various psychiatric disorders owing to its symptoms (pain, weakness, fever, and halitosis). SUMMARY Chronic/recurrent tonsillitis is a condition that affects the quality of life with symptoms such as pain, fever, halitosis, and so forth. However, the effect of this condition on depression and anxiety has not been studied. Therefore, this study aimed to investigate the complex relationship between chronic/recurrent tonsillitis and depression and anxiety in adult patients. The study included 60 female and 60 male patients and 25 healthy male and 25 healthy female controls, aged 18–40 years. The participants were made to fill out the Beck depression and anxiety inventories (BDI and BAI). Those who met the inclusion criteria were included. The averages and cutoff values of the total scores were investigated separately for males and females. For both males and females, the averages of total BDI scores (P < 0.043 and <0.035, respectively) and total BAI scores (P = 0.019 and 0.027, respectively) were significantly higher in group 2 than in group 1. This study was novel in exploring the relationship between chronic/recurrent tonsillitis and depression and anxiety in adults. The findings of this study might enhance the understanding on this subject and serve as a valuable guidance for the interested researchers.

Acute Intoxications Admitted to Intensive Care Unit: Retrospective Evaluation

1Selahaddin Eyyubi Devlet Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Diyarbakır 2Selahaddin Eyyubi Devlet Hastanesi, Kulak Burun Boğaz Kliniği, Diyarbakır 3Diyarbakır Eğitim ve Araştırma Hastanesi, İç Hastalıkları Kliniği, Diyarbakır 4Trabzon Of Devlet Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Trabzon 5Diyarbakır Bismil Devlet Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Diyarbakır 6Diyarbakır Egitim Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Diyarbakır

Simultaneous idiopathic bilateral sudden hearing loss – characteristics and response to treatment ☆

INTRODUCTION The aetiology of sudden hearing loss is poorly defined; however, infectious, vascular and neoplastic aetiologies are presumed to be responsible. In addition, the aetiology of bilateral sudden hearing loss is also unknown. OBJECTIVE The objective of this study is identify the characteristics and treatment response of simultaneous bilateral sudden hearing loss. METHODS This is a case-control study that practised in tertiary care academic centre. 132 patients with sudden hearing loss who were treated with systemic steroid and hyperbaric oxygen together were included. 26 patients had bilateral sudden hearing loss and 106 patients had unilateral sudden hearing loss. Patients were evaluated with clinical, audiological and radiological examinations and laboratory tests were done. Findings and response to treatment of the patients were compared. RESULTS The mean ages of patients with unilateral and bilateral sudden hearing loss were 42.0 years and 24.5 years respectively with a statistically significant difference (p<0.001). Immune response markers were more prevalent in bilateral sudden hearing loss. Pre-treatment audiologic thresholds were 69.1dB for unilateral sudden hearing loss and 63.3dB for the left ears and 67.6dB for the right ears for bilateral sudden hearing loss without significant difference. Post-treatment average hearing threshold in unilateral sudden hearing loss was 47.0dB and 55.4dB for the left ears and 59.0 for the right ears in bilateral sudden hearing loss. Average hearing improvement in unilateral sudden hearing loss group was significant (p<0.001) in spite of it was not significant in bilateral sudden hearing loss group for both ears. Between the groups; there was a significant difference for hearing improvement favouring unilateral sudden hearing loss (p<0.001). Tinnitus scores decreased significantly in both groups of patients (p<0.001) in spite of there was no significant difference between the groups of patients. CONCLUSION Patients with bilateral sudden hearing loss showed lower age, worse prognosis and higher rate of positive immune response markers. Cardiovascular risk factors seem to have an important role in the aetiology of unilateral cases whereas this importance was not present in bilateral ones.

Differences of the Voice Parameters Between the Population of Different Hearing Tresholds: Findings by Using the Multi-Dimensional Voice Program.

Objectives To compare voice parameters in subjects with different hearing level. Methods The evaluation consisted of Multi-Dimensional Voice Program (MDVP) and electroglottography. Group 1 consisted of normal hearing subjects which is bilateral average hearing better than 25 decibels (dB) whereas group 2 consisted of patients who have bilateral average hearing between the 25 and 60 dB and group 3 consisted of patients who have bilateral average hearing between the 60 and 90 dB. The evaluations were performed on males and females separately. Results In female subjects, fundamental frequency (F0), absolute jitter, %jitter and soft phonation index (SPI) were significantly different between the group 1 and group 2. Also, we detected significant difference on maximum phonation time (MPT), fundamental frequency, absolute jitter and %jitter, and variable F0 (vF0) values between group 1 and group 3. Male subjects demonstrated significant difference between the group 1 and group 2 in MPT, absolute jitter, %jitter, vF0, and SPI parameters. Between the group 3 and group 1; differences in absolute jitter, %jitter, shimmer, %shimmer, vF0, and SPI were also significant. Conclusion This study concluded that even mild to moderate hearing losses may affect voice patterns in adults and also females and males react differently to hearing loss in some parameters.