A retrospective analysis thyroid function and ultrasonography in a group of subjects with lepramatous leprosy in Turkey.

BACKGROUND: There are several studies on thyroid functions and thyroid gland features in patients with leprosy in the literature. The relationship between them have not been clarified yet. These studies are time-expired and don't contain ultrasonography examination. The purpose of the study is to investigate thyroid functions and gland characteristics in leprosy patients by ultrasonography (US) and current laboratory techniques. PATIENTS AND METHODS: This retrospective study was conducted by collecting the data of patients with lepramatous leprosy. Serum thyroid-stimulating hormone, free triiodothyronine, free thyroxine, anti-thyroid peroxidase, antithyroglobulin, and thyroglobulin values and thyroid ultrasonography reports were collected from previous records. RESULTS: The mean age is 75.12±9.89 years of total 17 subjects and 10 patients (58.8%) were male. Thyroid US was performed on 14 of the patients, nodules were detected in a total of 7 (50%) patients. The mean FT3, FT4, TSH, Anti-Tpo, Anti-TG, and TG values of the patients were found to be within normal limits. CONCLUSION: In the present study, no changes were detected in the thyroid functions and structures of the patients with Lepromatous Leprosy. We consider that prospective randomized studies that will include larger sample sizes are needed to determine whether there is a relationship between leprosy and thyroid disease.

Effect of platelet-rich plasma on healing in laser pilonidoplasty for pilonidal sinus disease.

The aim of this study was to evaluate the effects of application of platelet-rich plasma in addition to laser pilonidoplasty for the treatment of pilonidal sinus. Twenty-five patients who were treated by laser pilonidoplasty for pilonidal sinus (group 1) and 25 patients who were treated by platelet-rich plasma in addition to laser pilonidoplasty (group 2) at this clinic were included in the study. Patients were classified according to the Irkorucu and Adana Numune's classification and treatment concept. Duration of stay of the patients in the hospital, time to start daily activities, duration of wound healing, recurrence, and complications were evaluated. Among the 50 patients included in the study, 41 (%82) were males and 9 (%18) were females. The mean age was 25.6 ± 2.4 years and 24.8 ± 3.8 years in groups 1 and 2, respectively. The locations of the pilonidal sinus were similar in the two groups. No statistically significant differences were found in the duration of hospital stay, duration of the procedure, time to return to work, and complication rates between the two groups. Nevertheless, duration of wound healing was 6.1 ± 2.3 and 4.1 ± 0.9 weeks in groups 1 and 2, respectively, and was shorter in group 2. Duration of wound healing was statistically significantly different in the two groups. We concluded in this study that application of platelet-rich plasma in addition to laser pilonidoplasty significantly shortens the time of wound healing.

Serum ghrelin and obestatin levels in patients with acne vulgaris: are they important for the severity?

INTRODUCTION: Acne vulgaris (AV) is a chronic, inflammatory disease of the pilosebaceous unit. Recently, three peptide-structured hormones, products of a single gene, have been discovered. These hormones are acylated ghrelin, des-acyl ghrelin and obestatin. AIM: To demonstrate the association of serum acylated ghrelin, des-acyl ghrelin, and obestatin levels with acne severity. MATERIAL AND METHODS: A total of 63 patients grouped as mild (n = 22), moderate (n = 21) and severe (n = 20) acne according to the Global Acne Grading System and 20 medically healthy volunteers were included in the study. Serum ghrelin and obestatin levels obtained from the participants were examined. RESULTS: When mean ghrelin, des-acyl-ghrelin and obestatin values of the acne-group (AG) were compared with the control group (CG), they were found be lower in the AG, but were not statistically significant. Among the patient groups, while acylated ghrelin values were highest in the severe AG, des-acyl ghrelin values were highest in mild severe AG and mean obestatin values were highest in moderate severe AG (p > 0.05). When the groups were compared for obestatin values; the highest average value was detected in the CG. However, it was not significant when the groups were compared. CONCLUSIONS: It has been suggested that there may be a link between acne and the levels of acylated ghrelin, des-acyl ghrelin and obestatin which are decreased in the serum of acne patients. Because of the decrease observed in the levels of these hormones which have antimicrobial features, we suggest that inflammation in acne cannot be suppressed and the reproduction of the microorganisms that play a role in the aetiology of the disease cannot be prevented. The replacement of these hormones at physiologic concentrations may contribute to the acne treatment.

Effective conservative treatment of umbilical pilonidal sinus disease: Silver nitrate? Salt?

OBJECTIVE: The aim of this study was to compare the three different treatment methods and investigate The effectiveness of the therapeutic effect of common salt. METHODS: This retrospective study involved patients who were treated in our clinic for umbilical pilonidal sinus disease between January 2010 and December 2011. The patients were divided to three subgroups according to treatment methods. Group I: Cases treated with only local debridement and systemic antibiotic, group II: cases treated with local debridement, systemic antibiotic and silver nitrate, group 3: cases treated with debridement, systemic antibiotic and salt. RESULTS: In this study, 63 patients with the diagnosis of UPS were treated in our clinic. The patients were classified into three groups; group I included 20 patients, group II included 18 patients and group III included 18 patients. During 16-24 months of follow-up, 4 (20%) recurrences in group1 and 2 (11.1%) recurrences in group 2 were detected. Recurrence rate of group 3 was significantly different (5.55%) when compared to group 2. The mean period for returning to daily activities and work was 1 day for the patients. CONCLUSION: In conclusion, we suggest that pilonidal sinus cases which are not complicated by abcess and cellulitis can be treated by local removal of umbilical hairs, debridement and dressing without surgery. We conclude that application of common salt (table/ cooking salt) to umbilical pilonidal sinus with granuloma is a simple and highly effective way of treatment without any relapse and complications. KEY WORDS: Conservative treatment, Local debridement, Umblical pilonidal sinus.

A Rare Clinical Entity in the Differential Diagnosis of Mastalgia: Thoracic Zona.

OBJECTIVE: Mastalgia is the most common complaint of patients who are admitted for breast examination. Breast pain may originate breast tissue pathologies or non-breast pathologies adjacent organs. One of the causes of mastalgia is the varicella-zoster infection of the thoracic nerve ganglions. The zona zoster infection is painful, and vesicular lesions in the infected dermatomal regions can be observed because of the reactivation of the latent varicella (Herpes)-zoster virus (VZV) in the dorsal radix of medulla spinalis. There are no reviews of the zona cases of mastalgia patients in the literature. We aimed to investigate and represent the characteristics of these patients. MATERIALS AND METHODS: Patients complaining of mastalgia and who were diagnosed with zona zoster infection after physical examination and clinical evaluation in the outpatients department of General Surgery were investigated retrospectively between January 2010 and January 2015. RESULTS: The study included 12 patients. All of them were female, and the mean age of patients was 51.66 (36-72) years. Eight of the zona cases were seen in the right breast (66.6%), and four of them were seen in the left breast (33.4%). Complaints of patients were pain (100%), eruption (70%), and burning sensation (60%). Underlying pathology was seen in one of the cases. Physical examination at admission revealed that four of the patients did not have any physical abnormality (33.3%). On the contrary of vesicular lesions, typical physical findings of zona, were seen in eight patients (66.7%). CONCLUSION: Detailed history analysis and physical examination of the breast should be performed, particularly in older patients with unilateral severe mastalgia, and zona should be considered.

Minimally invasive treatment of pilonidal disease: crystallized phenol and laser depilation.

Pilonidal disease has been treated surgically and by various other methods for many years. The most important problem associated with such treatment is recurrence, but cosmetic outcome is another important issue that cannot be ignored. Today, crystallized phenol is recognized as a treatment option associated with good medical and cosmetic outcomes. We hypothesized that the addition of laser depilation to crystallized phenol treatment of pilonidal disease might increase the rate of success, and this study aimed to determine if the hypothesis was true. Patients who were treated with crystallized phenol and 755-nm alexandrite laser depilation were retrospectively analyzed. In total, 42 (31 male and 11 female) patients were treated with crystallized phenol and alexandrite laser depilation and were followed up between January 2009 and January 2012. In all, 38 patients (90.5%) had chronic disease and 4 (9.5%) had recurrent disease. Among the patients, 26 (61.9%) recovered following 1 crystallized phenol treatment, and the remaining patients had complete remission following repeated treatment. Some patients needed multiple treatments, even up to 8 times. None of the patients had a recurrence during a mean 24 months (range, 6-30 months) of follow-up. Whatever method of treatment is used for pilonidal disease, hair cleaning positively affects treatment outcome. The present results support the hypothesis that the addition of laser depilation (which provides more permanent and effective depilation than other methods) to crystallized phenol treatment (a non-radical, minimally invasive method associated with very good cosmetic results) can increase the effectiveness of the treatment and also reduce the recurrence rate of the disease.