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    Comparison of the effect of two different intravenous methylprednisolone doses on the occurrence time of biphasic reaction
    (2021) Sert, Ekrem Taha; Kokulu, Kamil; Mutlu, Huseyin; Parlak, Ismet
    Aim: The aim of this study is to determine the effect of two different doses of methylprednisolone administered in our emergency department (ED) on the elapsed time in biphasic or recurrent anaphylaxis cases.Materials and Methods: The patients with anaphylaxis admitted to the ED were retrospectively analyzed. A total of 82 patients who received methylprednisolone in combination with epinephrine in the ED due to anaphylaxis and who developed biphasic reaction within 48 h after discharge were included in the study. The patients were classified into two groups according to the dose of methylprednisolone administered: 80 mg (Group 1, low-dose) and 120 mg (Group 2, high-dose). The effect of different doses of methylprednisolone on the development time of biphasic reaction was evaluated.Results: Two different doses of IV methylprednisolone administered in the ED did not affect the development time of biphasic reaction (p = 0.24). The biphasic reaction development times were 335 (IQR, 212–950) min in the low-dose group and 520 (IQR, 265–1150) min in the high-dose group. The earliest development time of biphasic reaction was 125 min (low-dose group) and the latest development time was 2270 min (high-dose group). The relationship between dose and biphasic reaction development times was evaluated using Kaplan–Meier curve. No significant difference was observed between the two groups (p = 0.28). Upon comparing the symptoms in patients’ second admission to the ED due to biphasic reaction, no statistically significant difference was observed in patient symptoms with respect to the dose administered (p > 0.05).Conclusions: Corticosteroids are often used in ED, although there is no definitive evidence that they prevent biphasic reactions. The administration of two different doses of methylprednisolone has no effect on biphasic reaction development time.
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    Etiological characteristics and management of patients with epistaxis in Aksaray
    (2020) Cayir, Serkan; Mutlu, Huseyin; Sert, Ekrem Taha
    Aim: Epistaxis is a common condition in humans, particularly in patients with hypertension, and is one of the most common presenting symptoms in ear, nose, and throat emergency consultation. The present study aimed to examine the treatment and hospitalization characteristics of the patients who presented with epistaxis in Aksaray city and to propose an optimized and updated protocol.Material and Methods: The present study retrospectively evaluated 758 patients who presented with epistaxis to the Training and Research Hospital in Aksaray between January 2016 and February 2020. The patients were analyzed in terms of age, sex, seasonal characteristics, hospitalization rates, pathogenesis of epistaxis, sites of bleeding, and treatments.Results: The study included 349 females (46.1%) and 409 males (53.9%); mean patient age was 60.9 ± 9.3 years (range: 3–89 years). The most common comorbidity was hypertension (47.3%), and the most common site of bleeding was the anterior region including the Kiesselbach’s plexus (88.2%). Nasal packing (58.5%) and electrocauterization (29.9%) were performed in most cases. The treatment success was defined as no instance of re-visit by the patients to the hospital due to nasal bleeding within 24 h after the procedure; the treatment was successful in 698 patients (92.1%).Conclusion: Most cases of epistaxis are successfully treated using endoscopic electrocauterization on an outpatient basis. Hospitalization is indicated if surgical intervention, posterior packing, or embolization is required and if deterioration of general condition is observed. The present study proposes an updated protocol optimized for the management of epistaxis.
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    A retrospective clinical trial on nasal bone fractures admitted to a level three emergency room
    (2020) Mutlu, Huseyin; Cayir, Serkan; Sert, Ekrem Taha
    Aim: The anatomical location and protruding structure of the nasal bone can easily lead to fracture as a result of trauma. The high incidence rates have emphasized that the causes, treatments, and complications of these fractures should be investigated. The purpose of this study is to investigate our treatment modalities and complications by reviewing the current information about such fractures.Material and Methods: A total of 582 patients presented with nasal bone fractures between January 2014 and December 2019 were retrospectively analyzed. Examination findings, patient records, and radiological examinations of fractures were analyzed in detail.Results: The age of the patients was between 2 and 83 years (mean age: 33.9 ± 6.11 years). The study included 451 (77.5%) males and 131 (22.5%) females. The most common etiologic factor was assault (35.7%). The most common postoperative complications included deformity (53 patients; 9.1%), nasal congestion (41 patients; 7.1%), and smell disorders (5 patients; 0.9%), with the complications increased with the severity of fracture.Conclusion: Reduction procedures are successfully performed within the first 2 weeks following nasal fractures, and if there is a suspicion of causing deformity in patients under observation, necessary surgical interventions should be performed.