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Öğe The importance of the structure of pylorus in the success of the gastric botulinum toxin injections(Ali Cangül, 2020) Kanlıöz, Murat; Ekici, Uğur; Tatlı, Faik; Karataş, TurgayIntroduction: In clinical practices, our success rate proved lower in patients with hypotonic pylorus who underwent gastric botulinum toxin A (GBTA) injection. To analyze this methodologically, we researched how considering the pyloric structure contributes to the treatment success in GBTA injection. Materials and Methods: This study included 196 patients who underwent GBTA injection between 2017 and 2018. We measured their body mass indexes (BMI) before treatment (BT) and six months after treatment (AT). Upon no contraindications in the endoscopy, we applied GBTA 200 U to the patients. During the endoscopy, we named the pylori able to strain & relax spontaneously or by a stimulus and close firmly as normotonic pylorus (NP) and patients unable to close firmly and respond to the stimulus as hypotonic pylorus (HP). The patients were analyzed under three groups: G1, G2 and G3, which included patients with NP, HP and NP (+) HP, respectively. In independent group comparisons, we used the Mann-Whitney U test. Further, we made the dependent group comparisons using the Wilcoxon paired sample test. In all tests, a level of 0.05 was considered significant. Results: Of the patients, 63.8% (125) were female and 36.2% (71) were male. Their mean age was 32.27±9.2 years. 148 and 48 of the patients had NP and HP, respectively. The median BMIs of groups were as follows: 35.5 (27.4–48) kg/m2 BT and 32.55 (24–44.1) kg/m2 AT in G3 with -2.95 kg/m2 variation (p=0.048*), 35.7 (27.4–48) kg/m2 BT and 32.35 (24–42.8) kg/m2 AT in G1 with -3.35 kg/m2 variation (p=0.036*), 35.1 (29– 46.2) kg/m2 BT and 34.15 (27.9–44.1) kg/m2 AT in G2 with -0.95 kg/m2 variation (p=0.098). Conclusion: We recommend administering GBTA injection therapy especially to the patients with NP.Öğe Pilonidal Sinus Disease: An Analysis of the Factors Affecting Recurrence(LIPPINCOTT WILLIAMS & WILKINS, TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103, 2021) Kanlıöz, Murat; Ekici, Uğur; Tatlı, Faik; Karataş, TurgayOBJECTIVE: To assess the success of treatment methods at reducing recurrence, the most important problem in pilonidal sinus disease (PSD), along with factors affecting the occurrence of PSD and posttreatment recurrence. METHODS: The researchers retrospectively analyzed files of patients treated for PSD between 2003 and 2018. Three study groups were created: G1, G2, and G3. G1 included all PSDs with recurrence, and a comparable number of cases without recurrence were selected randomly for the G2 group. The control group, G3, included healthy individuals without PSD. In all groups, the following were recorded: body mass index, skin color and oiliness, family history of PSD, hair overgrowth, smoking habit, time spent sitting per day, and number of baths per week. The following were additionally recorded for G1 and G2: treatment methods, follow-up periods, pretreatment abscess(es), and time of onset of complaints before treatment. The number of recurrences and the period between last treatment and recurrence were also recorded for G1. RESULTS: G1 comprised 234 patients; G2, 247 patients; and G3, 128 healthy individuals. The significant factors causing recurrence included body mass index, family history, bathing habits, hair overgrowth, skin color and oiliness, time spent sitting per day, smoking habit, abscess(es), and duration of symptom(s) (P < .05). Limberg flap repair was the most successful treatment method. Sixty-three (27%), 135 (58%), and 185 (79%) recurrences occurred in the first 6 months, in the first year, and in the first 2 years, respectively. CONCLUSIONS: The researchers recommend Limberg flap repair for treatment. It is possible to reduce recurrence by taking preventable factors into consideration.Öğe The place of total testosterone in the etiology of pilonidal sinus disease(İnönü Üniversitesi Tıp Fakültesi, 2020) Kanlıöz, Murat; Karataş, Turgay; Ekici, Uğur; Tatlı, FaikAim: There are lots of factors accused in the etiology of SPSD. One of those factors is hypertrichosis. Hypertrichosis is increased by high levels of testosterone. In our clinical practices, we observe the secondary effects of high testosterone levels in those with SPSD. Hence, we intended to analyze the correlation between testosterone and SPSD. Material and Methods: The first 200 patients who applied to General Surgery Clinic at Malatya State Hospital and were diagnosed with SPDS, were included in the study after being informed of our research and signing the informed consent form. The total testosterone (TT) levels of the patients were measured and recorded along with their demographic data. Also, a control group was formed of male and female patients without SPSD having the same demographic characteristics, whose TT levels were also subsequently recorded. The data from control and study groups were then compared and analyzed. Results: Of the 200 patients included in the study, 43 (21.5%) were female and 157 (78.5%) were male. Their overall mean age was 24.13±7.04 years and the median age was 22 years (min:14- max:50). The male-to-female ratio was 3.65. The rate of females and males who had high levels of TT was significantly higher than that of the control group (p<0.001). Conclusion: We recommend measuring serum TT levels of patients who apply to hospital for SPSD. SPSD might be the first visible ring of the chain of diseases characterized by high levels of TT.Öğe Symptomatic Efficacy of Aloe Vera 2% Cream in the Treatment of Chronic Anal Fissure(Erkan Mor, 2020) Kanlıöz, Murat; Ekici, Uğur; Tatlı, Faik; Karataş, TurgayAim: Chronic anal fissure (CAF) is a common disease for which various alternative treatment options exist. One of these alternatives is topical treatment with Aloe vera 2% cream (AVC), reports of which have increased in the literature over the past decade. This study aimed to analyse the efficacy of AVC in the symptomatic treatment of patients with CAF. Method: Once informed of the treatment method, patients diagnosed with CAF who consented to receive AVC treatment and participate in the study were included in the study. We evaluated four parameters, including duration of stay in the toilet for each defecation, number of defecations per week, haemorrhage during defecation and pain during defecation according to the visual analogue scale, to measure the effectiveness of the treatment in patients with CAF. We posed the same questions to patients before and four weeks after treatment to explore the efficacy of AVC in the treatment of CAF. In all tests, a level of p<0.05 was considered significant. Results: Of the patients, 79.5% (66) were female and 20.5% (17) were male. The mean age was 32.6±9 years. The median, minimum and maximum number of positively changing parameters were 1, 4 and 4, respectively. Of the 83 patients, 81.9% (68) said that the treatment was successful and 18.1% (15) stated that it was not. In all four parameters, the changes were significant (p<0.001). Conclusion: We recommend AVC as a complementary or alternative treatment for CAF.
