Veysel Yurttas

Effect of pregabalin and dexamethasone on postoperative analgesia after septoplasty.

Objectives. The aim of this study was to explore effect of a combination of pregabalin and dexamethasone on pain control after septoplasty operations. Methods. In this study, 90 patients who were scheduled for septoplasty under general anesthesia were randomly assigned into groups that received either placebo (Group C), pregabalin (Group P), or pregabalin and dexamethasone (Group PD). Preoperatively, patients received either pregabalin 300 mg one hour before surgery, dexamethasone 8 mg intravenously during induction, or placebo according to their allocation. Postoperative pain treatment included tramadol and diclofenac sodium 30 minutes before the end of the operation. Numeric rating scale (NRS) for pain assessment, side effects, and consumption of tramadol, pethidine, and ondansetron were recorded. Results. The median NRS score at the postoperative 0 and the 2nd h was significantly higher in Group C than in Group P and Group PD (P ≤ 0.004 for both). The 24 h tramadol and pethidine, consumptions were significantly reduced in Groups P and PD compared to Group C (P < 0.001 and P < 0.001). The incidence of blurred vision was significantly higher in Group PD compared to Group C within both 0–2 h and 0–24 h periods (P = 0.002 and P < 0.001, resp.). Conclusions. We conclude that administration of 300 mg pregabalin preoperatively may be an adequate choice for pain control after septoplasty. Addition of dexamethasone does not significantly reduce pain in these patients.

Comparison of Histopathological Effects of Thymoquinone and Local Nasal Corticosteroids in Allergic Rhinitis in a Rabbit Model.

Background/Aims: In this study, we aimed to evaluate the histopathological effects of thymoquinone treatment of the nasal mucosa in a rabbit model of allergic rhinitis, and we compared its effects with those of nasal mometasone furoate. Methods: A total of 24 male New Zealand rabbits were used. The animals were randomly assigned to one of four groups. Group 1 received no treatment, while group 2 underwent ovalbumin (OVA) sensitization only. Group 3 was the study group; after OVA sensitization, the rabbits were treated with intranasal thymoquinone. The group 4 rabbits received mometasone furoate for 7 days after OVA sensitization. Mucosal structures were stained with hematoxylin and eosin, while toluidine blue was used to stain mast cells. Apoptosis was evaluated using a TUNEL assay. Results: In the positive control groups, including the thymoquinone and intranasal mometasone furoate groups, intraepithelial and submucosal inflammation and goblet cell hypertrophy were significantly decreased compared to group 2 (p < 0.001). The cilial structure was normal, as was the chondrocyte structure in both treatment groups. Conclusion: This is the first study to evaluate the histopathological effects of thymoquinone in an allergic rhinitis model. Thymoquinone reduced allergic inflammation and may be valuable for treating allergic rhinitis. However, additional studies are needed.

Preparation and placement of cartilage island graft in tympanoplasty

INTRODUCTION Cartilage graft tympanoplasty has a better success rate in the treatment of chronic otitis media if regularly prepared and placed. OBJECTIVE To prepare cartilage island material and evaluate its effect on the success rate of tympanoplasty. METHODS The medical records of 87 patients (48 males and 39 females; mean age, 27.3±11.2 years; range, 14-43 years) with chronic otitis media without cholesteatoma who underwent intact canal-wall-up tympanoplasty and revision surgery between December of 2007 and October of 2011 were retrospectively evaluated. Surgery was performed under general anesthesia via a retroauricular approach. RESULTS The overall success rate of this technique was 93% in terms of perforation closure. No graft lateralization or displacement into the middle ear occurred. The overall average preoperative air bone gap was 37.27±12.35 dB, and the postoperative air bone gap was 27.58±9.84 dB. The mean postoperative follow-up period was 15.3 months (range: 7-21 months). CONCLUSION If cartilage graft is properly prepared and placed, cartilage graft tympanoplasty appears to provide better success rates and hearing results.

The histopathological and electrophysiological effects of thymoquinone and methylprednisolone in a rabbit traumatic facial nerve paralysis model

OBJECTIVE We aimed to determine the effects of methylprednisolone and thymoquinone on nerve healing in a traumatic facial nerve paralysis animal model. SUBJECTS AND METHODS Twenty-four rabbits were randomly divided into 4 groups: group I: control group received no medication and no trauma; group II: sham group received no medication after facial nerve trauma group III: 5mg/kg/day thymoquinone administered; group IV: 1mg/kg/day methylprednisolone administered. An initial electrophysiological assessment was performed in all the animals. The buccal branch of the facial nerve was then clipped to form a traumatic facial paralysis model. The drugs were administered for two weeks once a day. At the end of the second month, the electrophysiological assessments were performed and the distal part of the traumatic facial nerve were dissected and examined under light microscopy. RESULTS Best nerve regeneration was observed in the control and the thymoquinone groups, respectively, whereas the weakest regeneration was determined in the sham group. Thymoquinone and methylprednisolone significantly increased nerve recovery, as measured by histopathological scores and electrophysiological assessment. In the thymoquinone group, due to postoperative amplitude, axon diameter and thickness of myelin sheath values were significantly further increased nerve regeneration compared to that of the methylprednisolone group and these values were close to those of the values of the control group. CONCLUSION Thymoquinone was slightly better than methylprednisolone for functional nerve recovery. The neuroprotective effect of thymoquinone was attributed to its antioxidant and anti-inflammatory effects. Thymoquinone can have a new treatment option to ameliorate the nerve injury.

Evaluation of olfactory memory after coronary artery bypass grafting.

Introduction This study determined whether coronary artery bypass grafting (CABG) surgery has any effect on olfactory function, employing the Brief Smell Identification Test (B-SIT). Material and methods All the participants were informed preoperatively about the B-SIT test and the mode of its application. The test was performed by each patient preoperatively (d0) as well as 1 (d1) and 3 (d3) days following the surgery. C-reactive protein (CRP) levels were recorded at the same time as the smell test. Results This prospective study included 45 patients. The mean age was 67 ± 7.55, and the group was 29% male. The mean durations of cross clamping and cardiopulmonary bypass were 54 ± 32 min and 62.5 ± 37.0 min, respectively. Eleven different odors were tested. Significant differences were observed for several odors: leather between d0 and d3, pine between d0 and d3, onion between d0 and d1, onion between d0 and d3, and soap between d0 and d1. The postoperative CRP levels were significantly higher than the preoperative levels. The correlation analysis determined that the postoperative CRP levels were negatively correlated with the B-SIT score (r = –0.48, p = 0.001). Conclusions Our findings suggest that patients after CABG are prone to develop olfactory dysfunction in the early postoperative period and that olfactory dysfunction is associated with postoperative CRP levels.

Histopathological effects of intranasal phototherapy and nasal corticosteroids in allergic rhinitis in a rabbit model

Allergic rhinitis is one of the most common health problems and has a major effect on quality of life. Although new-generation antihistamines and nasal steroids are the main treatment options, complete resolution cannot be obtained in some patients. Besides common side effects such as nasal irritation and epistaxis, the use of these drugs is controversial in some patients, such as pregnant or breastfeeding women. These findings highlight the need for new treatment options. Although phototherapy has been successfully used in the treatment of atopic dermatitis, which is an IgE-mediated disease and shares several common pathogenic features with allergic rhinitis, there are limited studies about its role in the treatment of allergic rhinitis. In this study, we aimed to evaluate and compare the histopathological effects of intranasal phototherapy (Rhinolight) and nasal corticosteroid treatment on the nasal mucosa in allergic rhinitis in a rabbit model and we found that both treatment options significantly reduced inflammation in the nasal mucosa without increasing apoptosis of mucosal cells.

An evaluation on the role of MPV on idiopathic sudden hearing loss etiology.

With the great interest, we have read the study in your journal entitled ‘‘Increased levels of mean platelet volume: a possible relationship with idiopathic sudden hearing loss’’ by Ulu et al. [1]. We would like to make some comments about this study. In recent years, the number of the studies, which state the increase of mean platelet volume (MPV), plays a role on the etiopathogenesis of many illnesses, gradually increases [2, 3]. In the near future, some studies, which investigate the relations between MPV and idiopathic sudden hearing loss (ISHL) about which there are too few publications, have been reported [1, 4]. Although a good number of assertive results have been announced in these studies, sufficient usage area of MPV value measurement has not occurred in the follow-up and treatment of patients clinically as there is no fully standardized method of this parameter. Some of the factors that affect the standardization of MPV measurement are the environment of blood-taking, type and amount of anticoagulant in the blood collection tube, the duration between blood-taking and examination, being 7–10 days of thrombocytes lifetime, the device of examination and the calibration time of the device. It has been reported that there are measurement differences up to 40 % even among the devices in the studies, in which different devices were used [5, 6]. In your study, the fact that MPV value has been found higher in the patients with ISHL in proportion as control group is agreeable to literature information. In contrast with your study, Karli et al. [4] found no difference between patient group with SHL and control group. Besides this, it has not been stated how much healing rate was and whether MPV value was measured or not after treatment according to audiometric examinatorial results applied on the patients in the first month after the medical treatment in which prednisone (1 mg/kg/day) was given during 15 days. As a result of this, we do not think that the etiology of ISHL can be explained with thrombotic/ischemic events. Moreover, if we consider that MPV measurement may be affected from many factors stated above, we think it is an assertive statement that this value can be used as an instructive marker for ISHL. While hemoglobin and thrombocyte count values between control and working groups were stated in the study, the values of preoperative and postoperative patient groups and the changes in these values were not stated. As a consequence, even if MPV has been associated with many illnesses recently, it does not seem possible for now to associate these results with disease etiopathogenesis in the limited studies that state MPV value as high in the patients with ISHL. To make better comments about this issue, we think that the results should be presented by evaluating pre and post of treatment, on more test subjects and in longer term. This comment refers to the article available at doi:10.1007/s00405-013-2348-9.

Nazofarenks ve larenks amiloidozisi: Bir olgu sunumu

Amyloidosis is a clinical disorder caused by extracellular proteinaceous deposits of insoluble abnormal group of fibrils with characteristic microscopic, histochemical, and ultrastructural features. Amyloid is an extracellular amorphous eosinophilic protein, which displays apple-green birefringence with polarized light when stained with Congo red or shows metachromasia with crystal violet or methyl violet dyes. Systemic and localized forms are the main clinical categories of the amyloidosis. Systemic amyloidosis can manifest as immunoglobulin light chain derivative (AL) amyloidosis, which is associated with primary systemic amyloidosis, multiple myeloma, or plasma cell dyscrasias. Amyloid associated (AA) amyloid occurs in patients with chronic inflammatory conditions or neoplastic disease. Familial amyloidosis is a rare manifestation of systemic amyloidosis which accounts for less than 2% of the cases. In humans, more than 20 different, unrelated proteins are known to form amyloid fibrils. Özet