The Effects of Nasal Septum Deviation on Ocular Examination Findings: Does Deviated Nasal Septum Cause Impaired Vision?

Aim: Nasal obstruction due to nasal septum deviation is associated with systemic diseases such as cardiopulmonary disease, neurological and vascular problems. But the effect of pure nasal deviation on the ocular system has not been precisely investigated. The aim of this study was to analyze the association of nasal septal deviation with ocular examination findings. Material and Methods: Twenty-seven adult patients underwent septoplasty and 31 controls were included in the study. The study group was conducted on patients with pure nasal septum deviation which is significantly obstructing the nasal airway (>50%). In ophthalmological examination; peripapillary retinal nerve fiber layer, macular and choroidal thickness measurements were obtained. The examination findings were compared between the study and control groups. Results: The mean macular thicknesses at nasal-500μm were 305.89±32.79 and 287.87±25.00 in the study and control groups, respectively (p=0.021). The mean macular thicknesses at nasal-1000μm were 353.04±21.28 and 341.16±17.97 in the study and control groups, respectively (p=0.025). The mean thickness of choroid was statistically significantly different at central (p=0.036) and peripheral measurements; nasal-500μm (p=0.020); nasal-1000μm (p=0.001); nasal-1500μm (p<0.001); temporal-500μm (p=0.023) and temporal-1000μm (p=0.045). No statistically significant difference was found between the two groups according to ocular tension, thickness of cornea, keratometry, anterior chamber depth, axial length of cornea, and retinal nerve fiber layer thickness. Conclusion: This is one of the pioneer studies evaluating the ocular examination findings in patients with nasal septum deviation. Our results indicate the increased thickness of both macula and choroid in patients with nasal septum deviation

Inborn errors of OAS-RNase L in SARS-CoV-2-related multisystem inflammatory syndrome in children

Multisystem inflammatory syndrome in children (MIS-C) is a rare and severe condition that follows benign COVID-19. We report autosomal recessive deficiencies of OAS1, OAS2, or RNASEL in five unrelated children with MIS-C. The cytosolic double-stranded RNA (dsRNA)-sensing OAS1 and OAS2 generate 2'-5'-linked oligoadenylates (2-5A) that activate the single-stranded RNA-degrading ribonuclease L (RNase L). Monocytic cell lines and primary myeloid cells with OAS1, OAS2, or RNase L deficiencies produce excessive amounts of inflammatory cytokines upon dsRNA or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) stimulation. Exogenous 2-5A suppresses cytokine production in OAS1-deficient but not RNase L-deficient cells. Cytokine production in RNase L-deficient cells is impaired by MDA5 or RIG-I deficiency and abolished by mitochondrial antiviral-signaling protein (MAVS) deficiency. Recessive OAS-RNase L deficiencies in these patients unleash the production of SARS-CoV-2-triggered, MAVS-mediated inflammatory cytokines by mononuclear phagocytes, thereby underlying MIS-C

Vertigo in Children; Differential Diagnosis

Çocuklarda baş dönmesi nadir görülen bir şikayet olmasına rağmen gerek hastada gerekse ailede ortaya çıkardığı anksiyete nedeniyle önemli bir sorundur. Çocuklarda ifade zorluğuna bağlı tanı ve tedavide ciddi sorunlar yaşanmaktadır. Baş dönmesi şikayeti ile gelen çocuk hastada ayrıntılı bir anamnez ve fizik muayene hâlâ tanı koymada en etkili yöntemler olarak durmaktadır. Baş dönmesi şikayetinin en sık nedenleri arasında benign paroksismal vertigo, migren ve kafa travması izlenmektedir. Diğer nedenler ise; vestibüler nörinit, meniere hastalığı, benign pozisyonel paroksismal vertigo, psikojenik, otitis media, santral sinir sistem patolojileri ve ortostatik hipotansiyondur. Baş dönmesi sorunu yaşayan çocuklardaki en önemli problemlerden bir tanesi de kognitif ve motor gelişimin etkilenmesidir ve bu çocuklar mutlaka pediatrist, nörolog, oftalmolog ve gerek halinde ortopedist ve fizyoterapist ile birlikte değerlendirilmelidir.Although vertigo is a rare complaint in children, it is an important problem for both the patient and the family because of the anxiety that it creates. Difficulty of expression in children leads to serious problems in the diagnosis and treatment of vertigo. A detailed anamnesis and physical examination is still the most effective method of diagnosis in children with vertigo. Benign paroxysmal vertigo, migraine and head trauma are the most common causes of a vertigo complaint. Other common reasons are vestibular neuronitis, meningitis, benign positional paroxysmal vertigo, psychogenic, otitis media, central nervous system pathologies and orthostatic hypotension. One of the most important problems in children with vertigo is the effect on cognitive and motor development, and these children should be evaluated together with the pediatrician, neurologist, ophthalmologist and, if necessary, orthopedist and physiotherapist

Investigation of Risk Factors for Otitis Media With Effusion in Patients with Adenotonsillar Hypertrophy (Risk Assessment in Otitis Media with Effusion)

Objective: Sleep Disordered Breathing (USB) is one of the most common childhood disorders ranging from simple snoring to obstructive sleep apnea (OSA), and most common cause of it is the adenotonsillar hypertrophy (ATH). Otitis Media with Effusion (OME) is another important problem in children with USB due to ATH. The aim of this study was to evaluate the possible risk factors for the development of EOM in children with USB due to ATH. Methods: 171 pediatric patients with ATH-related snoring and sleep apnea complaints were included in the study. The patients were divided into two groups. Group 1: patients with ATH + OME and Group 2: patients with ATH alone. A pre-operative standard questionnaire was used to assess USB severity. Twenty-one different parameters were evaluated for both groups. Results: Age, sex, exposure to tobacco smoke, cow milk exposure before 12 months, breast milk only for at least 6 months, duration of symptoms, USB symptom scores, history of recurrent tonsillitis, adenoid / nasopharynx (AN) ratio, tonsil size, body mass index (BMI), hemoglobin (Hb) level, hematocrit (Hct) ratio, mean platelet volume (MPV), eosinophil ratio, neutrophil-lymphocyte ratio (NLR), thyroid function tests (TSH, fT4), folate and vitamin B12 levels were evaluated. There was no statistically significant difference between these parameters except BMI. BMI values were 16.08 +/- 1.96 in Group 1 and 17.11 +/- 2.81 in Group 2, respectively (p: 0.006). Conclusions: Many different parameters were evaluated for EOM, a multifactorial disease. Among the groups, only BMI was different. Further study is required to identify risk factors for the development of EOM in patients with ATH.WOS:00068972950000

Posterior pillar mucosal suspension technique for posttonsillectomy pain and wound healing: a prospective, randomized, controlled trial

WOS: 000447934800034PubMed: 30255204Objectives/hypothesisTo investigate the efficacy of a simple and feasible suturing technique on posttonsillectomy pain control and wound healing.MethodsA prospective, randomized, controlled trial was conducted on a sample of 121 children between 3 and 10years of age. Group A comprised children undergoing surgery with bipolar cautery and the posterior pillar mucosal suspension technique. Bipolar alone (Group B) and cold dissection tonsillectomy (Group C) were used as control groups. Pain was assessed at 1, 3, 5, 7, and 10days postoperatively via visual analog scale scores. Peritonsillar edema, erythema, and granulation tissue in the tonsillar fossa were evaluated by direct visual examination for wound healing on days 1, 3, 5, 7, and 10.ResultsThere were consecutive 121 patients which were included, with mean ages being 6.22.5, 6.1 +/- 2.4, and 6.1 +/- 2.6 in groups A, B, and C, respectively. Postoperative pain scores on days 1 and 3 were significantly lower in Group A than Group B and C (P<.001) and scores were 0.87 +/- 1.1, 3.83 +/- 2.29, and 4.29 +/- 2.48 on day 1 and 0.38 +/- 0.88, 2.25 +/- 2.13, and 2.76 +/- 2.12 on day 3 respectively. The wound-healing scores on postoperative 1st, 3rd, 5th, and 7th days were significantly lower in Group A than control groups (P<.001). The wound-healing score on postoperative day 10 was only different than Group C (P=.020).Conclusions p id=Par4 The posterior pillar mucosal suspension technique is an effective and comparable method in terms of wound healing, maintains the preoperative anatomical structures, and enables a better pain control with reduced analgesic/opioid usage

Large pedinculated antral hyperplastic gastric polyp traversed the bulbus causing outlet obstruction and iron deficiency anemia: endoscopic removal

alper, murat/0000-0001-7069-0623WOS: 000181745400055PubMed: 12632536We present here a large (3 cm) hyperplastic gastric polyp prolapsed into duodenum and caused outlet obstruction and iron deficiency anemia in 60 years old male patient. Endoscopic removal was performed successfully

The Histopathological Findings of Adenoid Tissue After Topical Mometasone Furoate Implementation

WOS: 000441304600013Objective: Pediatric sleep disordered breathing (SDB) is a common childhood disease with a potential risk of several comorbidities. The most common cause of SDB in childhood is upper airway obstruction due to adenotonsillar hypertrophy and the classical treatment is adenotonsillectomy. However, it carries a risk of many complications and persistent apnea. Topical nasal steroid treatment may be an alternative to surgery in the treatment of pediatric SDB. However, histopathological effects of topical nasal steroids are mostly understudied. Methods: A retrospective controlled clinical study in an academic tertiary referral center. A total of 110 children were involved in the study who underwent adenoidectomy for the treatment of SDB. The study group (51-children) was treated with topical nasal mometasone furoate monohydrate 100 mcg/day. The control group (59-children) was selected randomly and all had no history of topical nasal steroid pre-operatively. Post-operative adenoidectomy specimens were reviewed according to acute/chronic inflammation findings, follicular hyperplasia, goblet cell hyperplasia, squamous metaplasia, fibrosis, atrophy, ulcer and hemorrhage. The findings were scored semiquantitatively for statistical analysis. Results: Chronic inflammation findings, follicular hyperplasia and goblet cell hyperplasia were significantly decreased in the study group in addition fibrosis, atrophy and ulcer findings were significantly increased in the study group. However, there was no statistical difference between the groups according to acute inflammation and hemorrhage. Conclusions: Topical nasal corticosteroids significantly suppress the nasopharyngeal inflammatory process in SDB. This treatment may be an alternative to surgery at least in patients with mild and moderate disease