Born in the Ear Canal: Tick Larva on the Eardrum

We report the case of a 54-year-old woman who presented to the ear, nose, and throat (ENT) outpatient clinic with hearing loss, tinnitus, and fullness in her right ear. In the first clinical examination, a pouch hanging in the anterior upper quadrant was detected in the tympanic membrane of the right ear. A tick larva was found in the cyctic lesion located on the tympanic membrane. Our case was unique due to this unexpected diagnosis

Yanıcı, Patlayıcı Kimyasalların Oluşturacağı Tehlikeli Bölgelerin Hesaplanarak Risklerin Değerlendirilmesi, Amonyak Tankı Örneği

Patlayıcı ve yanıcı özellikteki maddelerin ortama sızması sonucunda oluşabilecek tehlikeli bölgelerin bilimsel yöntemle ve nicel değerlerle belirlenmesi, çalışma ortamının güvenliği için son derece önemlidir. Bu çalışmada bir işletmede bulunan amonyak tankının alt çıkışında ve bağlantılarında oluşabilecek sızıntı ihtimalleri değerlendirilerek, muhtemel patlayıcı bölgelerin sınırları ALOAH programında, patlayıcı bölgelerin sınıflandırılması standardına (TS 60079-10-1) göre yapılmıştır. Amonyak tankının pompa ve alt bağlantı flanşlarından meydana gelebilecek tali boşalmanın karakteristiği sırasıyla 24,64 ve 10,36 m3/s, bölge yarıçapları 14 ve 7 m olarak hesaplanmıştır. Yapılan hesaplama ve değerlendirmeler sonucunda oluşacak patlayıcı ortamın Bölge 1 tanımına uyduğu bulunmuştur. L-tipi matris sistemi kullanılarak, haftada bir patlama ihtimalinin oluşabileceği (3P) ve ciddi yaralanmalara (4P) sebep olabileceği düşünülerek risk derecesi 12 olarak hesaplanmıştır. ATEX hesaplamalarının ortam risklerinin nicel olarak tanımlanmasında ve gereken önlemlerin zamanında alınmasında faydalı olduğu anlaşılmaktadır. Ancak bu hesaplamaların farklı iş yerinde her bir patlayıcı kimyasala özgü yapılması halinde riskleri belirlemede etkili olacağı sonucuna varılmıştır

Comparison of the Efficacy of Latanoprost, Bimatoprost, and Travoprost in Patients with Primary Open-Angle Glaucoma and Ocular Hypertension

Objectives: The aim of this prospective study was to compare the efficacy of latanoprost, bimatoprost, and travoprost in lowering intraocular pressure (IOP) and in preventing or delaying visual field loss in patients with primary open-angle glaucoma (POAG) and ocular hypertension (OH). Materials and Methods: The study included 124 eyes of 73 patients who were diagnosed in our clinic as having POAG or OH. All of the patients had IOP values of 22-34 mmHg, an early diagnosis of POAG or OH, without any previous treatment. The patients were randomly divided into 3 Groups: Group 1; 42 eyes treated with latanoprost (0.005%), Group 2; 40 eyes treated with bimatoprost (0.03%), and Group 3; 42 eyes treated with travoprost (0.004%). The visual field has been evaluated via the Humprey visual field evaluation of statistical program Statpac mean deviation (MD) and pattern standard deviation (PSD). The IOP, MD, and PSD values have been measured initially and at the end of the first year of treatment. Results: In comparison to the baseline, the mean changes of IOP values after one year of treatment were 6.99, 6.79 and 5.87 mmHg for the 3 Groups, respectively. The decrease in the IOP was statistically significant for each of the treatment groups (p<0.001), with insignificant differences between the groups (p>0.05). Comparison of the MD and PSD values revealed no significant differences among the treatment groups both initially and at the end of the first year (p>0.05). The mean changes in MD and PSD values at the end of the first year were similar among the treatment groups (p>0.05). Conclusion: In patients with POAG and OH, treatment with latanoprost, bimatoprost, and travoprost decrease the IOP effectively. After a one-year treatment, no significant difference has been found between the efficacy of the 3 drugs in lowering IOP and in preventing or delaying visual field loss. (Turk J Ophthalmol 2014; 44: 170-4

Causes, Treatment, and Outcome in Private School Children Admitted to Emergency Department with Eye Trauma

Objectives: To analyze the causes, treatment, and outcome in the private school children admitted to emergency department (ED) for eye injury. Material and Methods: The recordings of 57 children with eye traumas were examined retrospectively. Examination, treatment, and follow-up files of the children were recorded. Results: The age of the 57 children varied between 8 and 16 years. The trauma causes were impact during playing in 35.1% (20) of cases, hit by ball in 31.5% (18) of cases, injury by paper objects in 7.1% (4) of cases, injury by pencil in 5.3% (3) of cases, and injuries by other foreign objects (glass, rubber, branch of tree, and racket) in 21.0% (12) of cases. Cornea erosion in 54.3% (31) of cases, conjunctival erosion and irritation in 19.2% (11) of cases, eyelid laceration in 8.8% (5) of cases, subconjunctival hemorrhage in 8.8% (5) of cases, eyelid edema in 5.3% (3) of cases, hyphema in 1.8% (1) of cases, and iridocyclitis in 1.8% (1) of cases were found. Repair of eyelid was performed in 3 cases. Conclusion: Eye traumas are very commonly seen in private school children. While most of the cases are simple injuries, significant problems such as lid lacerations that necessitate repair can also encountered in a few cases. A fast and efficient treatment usually minimizes the risk of sequel development. (Turk J Ophthalmol 2014; 44: 216-8

Adjuvant kemoterapi uygulanmış meme kanserli hastalarda prognostik faktörler

Breast cancer is an important health problem. Many prognostic and predictive factors are being intensively investigated to determine most appropriate treatment option for patients with breast cancer. The most important prognostic and predictive factors are axillary lymph node involvement, tumor size, hormone receptor status, c-erbB-2 and p53 expression. In this study, we have investigated impact of these prognostic factors on patient survival in patients with breast cancer who have received adjuvant AC (adriamycin, cyclophosphamide) chemotherapy. Median follow up time was 48 months. In this period, 5 patients had metastases. By Kaplan-Meier method, we have found that disease-free survival at two years was %97, at four years was %73.1. Median disease-free survival was 42.2 months. By log-rank method, we have found that p53 has negative impact on prognosis. This finding is compatible with current literature. Other factors were not found to be statistically important on prognosis.Meme kanseri önemli bir sağlık sorunu haline gelmiştir. Tedavi seçeneklerini en uygun şekilde kullanmak için bir çok prognostik ve prediktif faktör üzerinde yoğun olarak çalışılmaktadır. Bunlardan en önemlileri aksiller lenf nodu tutulumu, tümör çapı, hormon reseptör pozitifliği, p53 ve C-erbB2 onkoprotein varlığıdır. Biz çalışmamızda bu prognostik faktörlerin, opere meme kanseri tanısı ile adjuvant AC (Adriamisin-siklofosfamid) kemoterapisi almış hastalarımızda etkilerini araştırdık. Hastalar ortalama dört yıl süreyle takip edildi. İzlem süresinde 40 hastadan 5'inde metastaz tespit edildi. Kaplan-Meier yöntemi ile hastalıksız sağ kalım 2 yıl için %97.5, 4 yıl içinse %73.1 olarak hesaplandı. Hastalıksız sağ kalım ortalama 42.2 aydı. Log-rank ile yapılan subgrup sağ kalım anazlizinde ise p53 varlığının prognozu kötü yönde etkilediği tespit edildi. Diğer faktörlerin ise prognoz üzerine istatistiksel olarak anlamlı etkide bulunmadığı saptandı