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Umbilical discharge in neonates: A case-based management protocol performed from a different perspective

Aim: This study aimed to retrospectively investigate causes of umbilical discharge (UD), its clinical course, treatment modalities and follow-up in infants with
UD complaints in a major teaching hospital in Turkey. Material and Method: Infants with an UD complaint who were referred to our clinic by a pediatrician or
a family physician from January 2013 to June 2014 were investigated. Results: The study included 291 infants between the ages of 3 and 114 days. Of these
infants, 194 (67%) had an umbilical granuloma, 83 (28.3%) had an umbilical polyp, and 14 (4.8%) had omphalitis. Among 14 infants with omphalitis who were
treated with topical antibiotics, six infants had refractory or recurrent discharge and ultrasonography (US) was performed which revealed a 1-3 mm sized cystic
appearance with no connection to the peritoneum or other tissues. These infants received systemic antibiotics in addition to topical antibiotics. During the
follow-up period, cystic appearance was not present in US in three of these six patients and in the remaining three patients who did not present for follow-up
we learned via phone calls that their complaints had not recurred. Discussion: Cauterization using a silver nitrate pencil was sufficient in the umbilical granuloma.
Ligating, excising and cauterizing the base of the lesions was sufficient in an umbilical polyp. In cases with persistent or recurrent UD, high-resolution
US should be primarily performed, which may direct the subsequent management.

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Efficacy of low-concentration hypochlorous acid spray in acute sore throat relief

Aim: Sore throat is one of the most predominant symptoms of the human population. The aim of the study was to define the efficacy of low-concentration
hypochlorous acid (HOCl) in patients with sore throat. Low-concentration hypochlorous acid (HOCl) is an antiviral and antibacterial agent which is produced
endogenously. Material and Method: 50 patients over the age of 18 were included in this study. The patients were randomly chosen to receive oropharyngeal
mouthwash with either low-concentration HOCl (n= 24) or placebo saline solution (n= 26) for 4 days. We evaluated the sore throat relief using the 7-point
Sore Throat Relief Scale (STRS). Results: The STRS scores were significantly lower in the HOCl group than in the placebo group after 4 days of treatment
(p<0.05). Discussion: This study showed that low-concentration HOCl spray provided better improvement in sore throat symptoms when compared to placebo
saline spray.

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Rhomboid excision and limberg flap reconstruction for pilonidal disease

May 2018 AEMED 53 Views

Aim: Pilonidal sinus is a common disease that affects generally younger patients and occurs mostly in the sacro-coccygeal region. The main treatment of
pilonidal sinus is still controversial. This study aimed to evaluate the usefulness and surgical results of Limberg flap reconstruction in pilonidal sinus disease.
Material and Method: Between January 2012 and January 2017, 78 patients were operated on electively and rhomboid excision with Limberg flap reconstruction
was performed for pilonidal sinus disease in our clinic. Demographic features, clinical data, operative findings, postoperative complications, and patient
follow-up were retrospectively analyzed. Results: The mean age of the patients was 27.91± 6.49 years. Out of the 78 patients, 59 (75.6%) were male and 19
(24.4%) were female. The mean duration of symptoms was 5.38 months (2-13 months) and the mean operative time was 68.4 ± 18.7 min. The median amount
of blood loss during surgery was 75 ml (range from 30 to 200 ml). The mean hospital stay was 7.79 ± 1.85 days. In the postoperative period, recurrences were
noted in only 2 (2.56%) patients in the follow-up period, which ranged from 1 to 6 years. Discussion: Limberg flap is an efficient and easy technique with less
complication. It is especially useful in patients with large diseased pilonidal sinus tissue and multiple sinuses with lateral openings. This technique results in a
reduced hospital stay and recurrence rate which means that the patients can go back to their daily lives sooner.

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