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September 2018

Original Article

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

Taylan Gun

ENT Department, Faculty of Medicine, Bahçeşehir University, Ankara Medical Park Hospital, Ankara, Turkey

DOI: 10.4328/ECAM.134


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.


Sore Throat; Hypochlorous Acid; Pain

Corresponding Author: Taylan Gun, Ankara Medical Park Hospital, Kentkoop Mah. 1868 Sok. No:15 Batıkent, Ankara, Turkey. T.: +90 3126668000 GSM: +905323435019 F.: +90 3126668666 E-Mail: taylangun@gmail.com

How to cite this article: Taylan Gun. Efficacy of low-concentration hypochlorous acid spray in acute sore throat relief. Eu Clin Anal Med 2018;6(3): 32-4.

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

Nazile Ertürk1 , Nihan Karaman Ayyıldız2 , Deniz Çavuşoğlu3

1 Department of Pediatric Surgery, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, 2 Department of Pediatric Surgery, Ankara Training and Research Hospital, Ankara, 3 Department of Pathology, Etlik Zübeyde Hanım Women’s Health Training and Research Hospital, Ankara, Turkey

DOI: 10.4328/ECAM.131


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.


Umbilical Discharge; Umbilical Granuloma; Umbilical Polyp; Omphalitis

Corresponding Author: Nazile Ertürk, Muğla Sıtkı Koçman Üniversitesi Tıp Fakültesi, 48000, Muğla, Turkey. GSM: +905057976577 E-Mail: erturknazile@gmail.com

ORCID ID: 0000-0001-9541-9741

How to cite this article: Nazile Ertürk, Nihan Karaman Ayyıldız, Deniz Çavuşoğlu. Umbilical discharge in neonates: A case-based management protocol performed from a different perspective. Eu Clin Anal Med 2018;6(3): 28-31.

Case Report

Metastatic lung carcinoma with unknown primary site

Kübra Aşık Cansız1, Suat Konuk1, Hacı Ali Kılıçgün2, Çetin Boran3, Tuncer Tuğ1

1 Department of Chest Diseases, 2 Department of Thoracic Surgery, 3 Department of Pathology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey

DOI: 10.4328/ECAM.132


Carcinoma of unknown primary origin is defined as metastatic disease in which the primary tumor site is not detected despite all detailed examinations performed. CUP accounts for 3-5% of all cancer cases. The annual incidence is 7-12 in 100,000. It is the 7-8th most prevalent cancer and has the 4th highest mortality. The average age of diagnosis is 60-65 years. In children, it accounts for less than 1% of all cancers. A 71-year-old male applied to our clinic with the complaint of cough and shortness of breath during exercise for the last 4 months. In thoracic CT, an irregularly margined, 17×27 mm diameter, mass lesion was seen in the superior part of the left lower lobe of the lung, adjacent to a fissure. Transthoracic fine needle aspiration biopsy performed on the lesion showed an adenocarcinoma. PET-CT showed no metastatic lesion and the patient was operated on. The pathology report showed a metastatic character of the tumor, yet the primary origin could not be detected.


Malignancy; Adenocarcinoma; Metastasis

Corresponding Author: Suat Konuk, Kültür Mah. Akçam Sok. No: 1/2 Düzce, Turkey. GSM: +905073410126 E-Mail: suatkonukk@windowslive.com

How to cite this article: Kübra Aşık Cansız, Suat Konuk, Hacı Ali Kılıçgün, Çetin Boran, Tuncer Tuğ. Metastatic lung carcinoma with unknown primary site. Eu Clin Anal Med 2018;6(3): 35-8.

Original Image

Leg gangrene in a newborn

Soner Sertan Kara1 , Hasan Kahveci2 , Ali Fettah3

1 Department of Pediatric Infectious Diseases, 2 Department of Neonatology, 3 Department of Pediatric Hematology, Regional Training and Research Hospital, Erzurum, Turkey


A full-term, vaginally delivered, 7-day-old boy presented with poor feeding, tachypnea, and color change on his leg. His prenatal and family histories were unremarkable. Lethargy, decreased neonatal reflexes, respiratory distress, and a necrotic appearance on the distal left foot were observed (figure 1A). Left femoral pulse was absent. Laboratory examination revealed metabolic acidosis, hypernatremia, increased serum creatinine and acute phase reactants, and prolonged coagulation parameters. Doppler ultrasound and computerized tomographic angiography revealed decreased calibration in the left external iliac artery, monophasic weak blood flow in the superficial femoral and popliteal arteries, and absence of blood flow in the dorsalis pedis artery (figures 1B and 1C). Thrombophilia and congenital metabolic disorders were excluded. Low molecular weight heparin and antibiotic therapy led to resolution of the clinical picture except for his leg. Amputation below the knee was performed after demarcation of the gangrene became clear (figure 1D). He was discharged after an uneventful postoperative period. Vascular insufficiency of the extremities, leading to ischemic necrosis of a limb, is a serious complication in newborns. Predisposing factors such as prematurity, polycythemia, maternal diabetes, and umbilical catheterization precipitate arterial thrombosis [1]. Sepsis and hypovolemia in addition to arterial malformation contributed to thrombosis and eventual gangrene in this patient. Amputation should be delayed until definite demarcation of the gangrenous portion is determined and growth plates should be preserved during amputation to ensure an adequate stump for subsequent prosthetic fitting [2].


1. Demirel N, Aydin M, Zenciroglu A, Bas AY, Yarali N, Okumus N, et al. Neonatal thrombo-embolism: risk factors, clinical features and outcome. Ann Trop Paediatr 2009;29:271-9. 2. Letts M, Blastorah B, al-Azzam S. Neonatal gangrene of the extremities. J Pediatr Orthop 1997;17:397-401.

Corresponding Author: Soner Sertan Kara, Department of Pediatric Infectious Diseases, Erzurum Regional Training and Research Hospital, Palandoken, Erzurum, 25280, Turkey. T.: +904422325449 F.: +904422325025 GSM: +905352577885 E-Mail: drsoner@yahoo.com