Mustafa Alparslan Babayigit

Lidocaine 10% spray to the cervix reduces pain during intrauterine device insertion: a double-blind randomised controlled trial.

Objective Fear of pain during intrauterine device (IUD) insertion can be a barrier to widespread use of this safe and highly effective contraceptive method. Our objective was to determine the effectiveness of topical 10% lidocaine spray for pain control during IUD insertion. Methods A total of 200 subjects with the request for IUD insertion were included in the study. The patients were randomly divided into two groups: lidocaine spray (n=100) and placebo (n=100). The pain experienced during the procedure was measured immediately after insertion by a standard Visual Analogue Scale (VAS) administered by a separate researcher with maintenance of allocation concealment. Results The mean pain score during the procedure was 1.01±1.20 in the lidocaine spray group and 3.23±1.60 in the placebo spray group (p<0.001). Lidocaine spray treatment significantly lowered the overall procedural pain score compared with placebo. Conclusions Significant pain reduction during IUD insertion can be achieved by using 10% lidocaine spray alone. Lidocaine spray can be accepted as a non-invasive, easy to apply and more comfortable local anaesthetic method for IUD insertion. Trial registration number NCT02020551.

Coexistence of Epstein-Barr virus and Parvovirus B19 in tonsillar tissue samples: quantitative measurement by real-time PCR.

OBJECTIVE In this study, we aimed to investigate the presence and copy number of six different viruses in tonsillar tissue samples removed surgically because of chronic recurrent tonsillitis or chronic obstructive tonsillar hypertrophy. METHODS In total, 56 tissue samples (tonsillar core) collected from 44 children and 12 adults were included in this study. The presence of viruses was investigated using a new TaqMan-based quantitative real-time PCR assay. RESULTS Of the 56 tissue samples, 67.9% (38/56) were positive for at least one of the six viruses. Epstein-Barr virus was the most frequently detected virus, being found in 53.6% (30/56), followed by human Parvovirus B19 21.4% (12/56), human adenovirus 12.5% (7/56), human Cytomegalovirus 5.4% (3/56), BK polyomavirus 1.8% (1/56), and Herpes simplex virus 1.8% (1/56). Precancerous or cancerous changes were not detected in the tonsillar tissue samples by pathologic examination, whereas lymphoid hyperplasia was observed in 24 patients. In contrast to other viruses, B19 virus was present in high copy number in tonsillar tissues. The rates of EBV and B19 virus with high copy number (>500.000 copies/ml) were higher in children than in adults, and a positive relationship was also found between the presence of EBV and the presence of B19 virus with high copy number (P=0.037). CONCLUSIONS It is previously reported that some viral agents are associated with different chronic tonsillar pathologies. In the present study, the presence of B19 virus in tonsillar core samples was investigated quantitatively for the first time, and our data suggests that EBV infections could be associated with B19 virus infections or could facilitate B19 virus replication. However, further detailed studies are needed to clarify this observation.

Changes in tear film, corneal topography, and refractive status in premenopausal women during menstrual cycle

PURPOSE To investigate the changes in a questionnaire based subjective symptomatology, tear film break-up time, tear volume, corneal topography, and refractive status in premenopausal women during menstrual cycle. METHODS Seventeen premenopausal females and 15 healthy males were enrolled in this prospective study. After routine ophthalmologic examination, an ocular surface disease index questionnaire was administered, tear film break-up time (TBUT), and Schirmer I tests were performed. Keratometry readings and refractive status were also obtained. All examinations were repeated at day 21, day 12 and day 2. RESULTS OSDI score in day 21 was significantly lower than that in day 12 (p=0.004) and day 2 (p=0.01) in the female patients; however, no significant change was found in the male subjects (p>0.05). No statistically significant difference was found in TBUT and Schirmer I tests, keratometry, and refraction results in both of the female and male subjects at all of the test points (p>0.05). There was a significant correlation between OSDI score and TBUT (p=0.02, p=0.03, respectively), and Schirmer I test at day 12 (p=0.004, p=0.008, respectively). A significant negative correlation was found between oestrogen level and horizontal keratometry values at day 21 (r=-0.5, p=0.03; r=-0.4, p=0.04, respectively) for the right and left eyes in the female subjects. CONCLUSION Our study confirms that fluctuations in the blood levels of oestrogen produce alterations in ocular surface equilibrium during the menstrual cycle and consequently affect the subjective dry eye symptoms in female patients. However, no ocular surface parameter changes were observed.

Comparison of local anesthesia with articaine and lidocaine in septoplasty procedure.

Background Only a few studies have so far compared the use of different local anesthetic agents in septoplasty procedure with regard to reduction in pain, effectiveness, and related complications. The aim of this study was to compare articaine and lidocaine as local anesthetics for septoplasty surgery, in terms of their efficacy and safety. Methods Seventy patients randomized into two groups were included in this study. For local anesthesia, 35 patients received articaine and 35 received lidocaine. All patients were asked to rate their pain levels on a visual analog scale (VAS) at the 1st, 2nd, 4th, 6th, 8th, 12th, 18th, and 24th postoperative hours. In addition, analgesic consumption of each patient as well as postoperative complications was recorded in both groups. Results VAS scores for pain were significantly lower in the articaine group than in the lidocaine group at the 2nd, 6th, 8th, 12th, and 24th postoperative hours (p < 0.05). Comparison of the patients’ usage of analgesics during the first 24 hours postoperatively showed that in the articaine group, the percentage of patients that had not used analgesics was 58.5%, and in the lidocaine group the corresponding figure was 41.5%. Conclusion Articaine is a safe local anesthetic agent with rapid onset of action. When compared with lidocaine, it is associated with improved tissue diffusion, rare postoperative complications, and less postoperative pain, thus, representing a safe and effective local anesthetic agent for septoplasty procedure.

Effect of lidocaine spray in pain management during office-based endometrial sampling: A randomised placebo-controlled trial.

Office-based endometrial sampling is the most frequently performed gynaecological procedure. The procedure is usually associated with pain and discomfort. Several anaesthetic and analgesic techniques (e.g., non-steroidal anti-inflammatory drugs, paracervical block, misoprostol and topical anaesthetics) are used for pain management during endometrial sampling. There is no comprehensive study using lidocaine in spray form; we sought to investigate the analgesic efficacy of 10% lidocaine spray in patients undergoing office-based endometrial biopsy. We conducted a prospective, randomised (lidocaine spray (n = 60) and placebo (n = 60), respectively), double-blind study. The mean pain score during procedure was 3.51 ± 1.51 in the lidocaine spray group and 5.11 ± 1.66 in the placebo group. Lidocaine spray treatment significantly lowered the pain scores compared with placebo (p < 0.001). Lidocaine spray can be accepted as a non-invasive, easy to apply and more comfortable anaesthetic method for office-based endometrial sampling.

Trail and trail receptors in patients with laryngeal cancer.

Tumor necrosis factor–related associated‐inducing ligand (TRAIL) is a death ligand currently under clinical trials for laryngeal carcinoma.

MicroRNA-21 in laryngeal squamous cell carcinoma: Diagnostic and prognostic features.

We aimed to determine the microRNA‐21 expression in laryngeal squamous cell carcinoma and assess the association between the disease and clinical characteristics of patients.

Outcomes of trimodality approach in the management of T2N0M0 bladder cancer.

Aims and Background The main objective of this study is to evaluate outcomes of bladder preservation treatment for patients with muscle-invasive bladder cancer. Methods and Study Design 38 patients with histologically proven muscle-invasive bladder cancer treated at our department between January 2008 and December 2013 were analyzed retrospectively. Age, gender, pathology, stage, 3-year overall survival, 3-year disease-free survival, radiotherapy (RT) dose, genitourinary and gastrointestinal toxicity scores and response evaluation of the patients were recorded. 3-year overall survival and 3-year disease-free survivals were calculated by Kaplan-Meier method along with the analysis of gender, pathology, stage and therapy response of the study group. Results 33 patients (86.8%) were managed with concomitant chemoradiotherapy whereas 5 patients (13.2%) received only radiation therapy due to renal insufficency and comorbid diseases. 6 (15.8%) out of 38 patients had partial response (PR) and remaining 32 (84.2%) patients experienced complete response (CR). The PR group underwent salvage cystectomy and CR group had been followed-up after radical radiotherapy. Mean age of the group was 70.9 (range 45–90) years. 26 of all patients were male (68.4%) and 12 were female (31.6%). Mean follow-up time after completion of radiotherapy was 24.7 months (range 12–40). Mean RT dose was 64 Gy (range 60–66). 3-year overall survival was 64% and 3-year disease free survival was 73%. Conclusions Bladder preserving approach is an alternative definitive therapy solution to radical cystectomy in the treatment of muscle-invasive bladder cancer with less morbidity, preserved natural bladder, and high quality of life.