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Yildirim G.,Okmeydani Education and Research Hospital | Cingi C.,Eskiehir Osmangazi University | Kaya E.,Eskiehir Osmangazi University
European Archives of Oto-Rhino-Laryngology | Year: 2013

Although discussions regarding nasal packing are still ongoing, to eliminate any possible complications, surgeons have used nasal packing for many years. Septoplasty is one of the most frequently performed operations by head and neck surgeons. Any methods to diminish the surgical time or bring comfort to the surgeon will be well appreciated. In this study, we attempted to demonstrate the usefulness of the stapler method by comparing preoperative and postoperative results from the visual analog scale (VAS), nasal obstruction symptom evaluation (NOSE), rhinosinusitis quality of life questionnaire (RQLQ), and acoustic rhinomanometry values. In addition, we evaluated pain scores, postoperative complications, and breathing after nasal packing, stapling, and trans-septal suturing techniques. Patients were divided into three groups. In the first group, deviated cartilage was removed or repositioned and mucoperichondrial flaps were closed with a bioresorbable stapler after septoplasty. Four or five staples were placed on the septum. In the second group, the septum was sutured continuously with 4/0 Pegelak (Doǧsan TR). In the third group, Merocel packs were used without any sutures and were kept for 48 h. Nasal packing leads to patient discomfort after septal surgery; however, there is no difference in patient comfort between closing the mucoperichondrial flaps by suturing the septum or using a stapler. After surgery, there were no differences between the groups in terms of successful breathing. This situation was assessed by endoscopic examination and acoustic rhinomanometry. Thus, there was no objective or subjective difference. Stapling increases the doctor's comfort level and surgical time is optimized. Although experienced surgeons can easily suture the septum, less experienced ones have some difficulty; therefore, stapling may provide more benefit to the latter. Further, four staples are sufficient to close the septum. © 2012 Springer-Verlag. Source

Dilli D.,Dr Sami Ulus Maternity and Children Research and Training Hospital | Aydin B.,Dr Sami Ulus Maternity and Children Research and Training Hospital | Fettah N.D.,Dr Sami Ulus Maternity and Children Research and Training Hospital | Ozyazici E.,Dr Sami Ulus Maternity and Children Research and Training Hospital | And 8 more authors.
Journal of Pediatrics | Year: 2015

Objective To test the efficacy of probiotic and prebiotic, alone or combined (synbiotic), on the prevention of necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants. Study design A prospective, randomized, controlled trial was conducted at 5 neonatal intensive care units in Turkey. VLBW infants (n = 400) were assigned to a control group and 3 study groups that were given probiotic (Bifidobacterium lactis), prebiotic (inulin), or synbiotic (Bifidobacterium lactis plus inulin) added to breastmilk or formula for a maximum of 8 weeks before discharge or death. The primary outcome was NEC (Bell stage 2). Results The rate of NEC was lower in probiotic (2.0%) and synbiotic (4.0%) groups compared with prebiotic (12.0%) and placebo (18.0%) groups (P <.001). The times to reach full enteral feeding were faster (P <.001), the rates of clinical nosocomial sepsis were lower (P =.004), stays in the neonatal intensive care unit were shorter, (P =.002), and mortality rates were lower (P =.003) for infants receiving probiotics, prebiotics, or synbiotic than controls. The use of antenatal steroid (OR 0.5, 95% CI 0.3-0.9) and postnatal probiotic (alone or in synbiotic) (OR 0.5, 95% CI 0.2-0.8) decreased the risk of NEC, and maternal antibiotic exposure increased this risk (OR 1.9, 95% CI 1.1-3.6). Conclusions In VLBW infants, probiotic (Bifidobacterium lactis) and synbiotic (Bifidobacterium lactis plus inulin) but not prebiotic (inulin) alone decrease NEC. © 2015 Elsevier Inc. Source

Erbil N.,Ordu University | Alisarli A.,Ondokuz Mayis University | Terzi H.C.,Medical Park Hospital | Ozdemir K.,Sakarya University | Kus Y.,Okmeydani Education and Research Hospital
Gynecologic and Obstetric Investigation | Year: 2012

Aim: This study was conducted to investigate the prevalence of the practice of vaginal douching among Turkish married women and associations between their douching status, predisposing factors, and effects on their health. Methods: This cross-sectional survey of women between 17 and 61 years of age was conducted between February 1, 2007, and May 18, 2007, in the Maternity-Gynecology and Children's Hospital in Ordu, Turkey. The sample of this study included 427 women. A confidential and anonymous self-reported questionnaire was collected in a convenient sample of the women. Results: Of the 427 women in the study, 165 women (38.6%) had douched at some time. Housewives [odds ratio (OR) 2.660, 95% confidence interval (CI) 1.162-6.090], women who had experienced a spontaneous abortion (OR 4.676, 95% CI 1.606-13.618), or had beliefs about positive health effects of vaginal douching (OR 29.603, 95% CI 14.090-62.192) also had risk factors associated with vaginal douching practices. Conclusion: In conclusion, this study found that vaginal douching is a common practice among women. Many of the women who practiced vaginal douching believed in its health benefits. The results may enhance healthcare practitioners' knowledge and efforts to educate their patients. Copyright © 2011 S. Karger AG, Basel. Source

Atalay N.S.,Pamukkale University | Ercidogan O.,Okmeydani Education and Research Hospital | Akkaya N.,Pamukkale University | Sahin F.,Pamukkale University
Pain Physician | Year: 2014

Background: Although there are several studies of systemic corticosteroid therapies in various doses and various durations in complex regional pain syndrome (CRPS), the outcome measurement parameters are limited to the range of motion measurements, edema, and symptoms of CRPS. Objective: To investigate the effects of prednisolone on clinical symptoms, pain, hand grip strength, range of motion, as well as on functional ability and quality of life in patients who developed CRPS after traumatic upper extremity injury. Study Design: Retrospective evaluation. Methods: Forty-five patients who used prednisolone for CRPS of the upper extremity were retrospectively studied. Prednisolone was started with a dose of 30 mg and tapered by 5 mg every 3 days until discontinuation after 3 weeks. Clinical symptoms (morning stiffness, cold intolerance, shoulder pain, numbness of fingers, hyperesthesia, abnormal sweating, and cyanosis that is exacerbated by exposure to cold temperature), pain (Visual Analogue Scale-Rest [VAS-R] and VASActivity [VAS-A]) were reviewed. The muscle strength with grip strength (GS) (kg), lateral pinch (LP) (pound), tip-to-tip pinch (TP) (pound), and chuck pinch (CP) (pound) measurements; the joint range of motion with using third finger tip-distal crease distance (FT-DC) (cm); functional ability with Quick-Disabilities of the Arm, Shoulder and Hand (Q-DASH) score; and quality of life with Short Form-36 (SF-36) score were evaluated. Results: Mean age was 43.53 ± 11.43 years. After 3 weeks of therapy, patients showed significant improvements in clinical symptoms compared to the basal assessments (P < 0.05). The comparison of pre- and post-treatment results revealed that VAS-R, VAS-A, GS, LP, TP, CP, FT-DC, Q-DASH scores, and all SF-36 subscores were significantly improved (P < 0.05). Limitations: The retrospective design and data collection procedure was limited to the medical records of patients. Conclusion: A short-term oral prednisolone therapy significantly reduced the symptoms and signs of CRPS, and improved the functional abilities and quality of life. Source

Varol A.,Marmara University | Basa S.,Marmara University | Ozturk S.,Okmeydani Education and Research Hospital
Journal of Cranio-Maxillofacial Surgery | Year: 2010

Introduction: To evaluate the role of induced hypotension during maxillary downfracture osteotomy on the requirement for blood transfusion, duration of operation and induced anaemia in bimaxillary surgery. Material and methods: 45 young orthognathic patients were operated under hypotensive anaesthesia between 2004 and 2006. Operations were LeFort I osteotomies (n = 45), bilateral sagittal split osteotomies (BSSO) (n = 42), segmental osteotomies (n = 3), tongue reduction (n = 1), genioplasties (n = 15), digastric myotomies (n = 2), and bone grafts were the supplementary procedures. Pre-postoperative haemograms, intraoperative blood loss, and duration of operations were the studied parameters. Statistical analysis was performed using SPSS 11.5 for Windows. Results: None of the patients received a blood transfusion. Mean blood loss was 377 ± 111.2 mL with the range of 180 mL to the maximum of 625 mL. Mean duration was 267.1 ± 61.2 min with minimum of 180 min and maximum of 400 min. Mean preop Hb level was 14 ± 1.9 g/dL with the range from 10.3 g/dL to a maximum of 17.2 g/dL. Mean postop Hb level was 11.8 ± 2 g/dL with a range of 8.2-16.2 g/dL levels. Preop erythrocyte counts were 435.3 ± 18.2 and 416.4 ± 16.1 (×104/mcL) on the first postop day. Conclusion: Transfusion in bimaxillary orthognathic surgery could be prevented by induction of hypotension during maxillary downfracture. © 2009 European Association for Cranio-Maxillo-Facial Surgery. Source

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