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Study objective: While some research has been done on Valsalva maneuvers in treating supraventricular tachycardia, there is no standardized algorithm on which technique has been the most effective for the termination of supraventricular tachycardias. In this study, we compare different Valsalva maneuver techniques in order to determine the exact technique needed for maximal vagal response. Methods: This was a repeated measures clinical study, which enlisted a sample of healthy adult volunteers. Participants performed four different Valsalva maneuver techniques (40 mm Hg-10 s, 40 mm Hg-15 s, 50 mm Hg-10 s, and 50 mm Hg-15 s) while lying in a supine position. The maneuvers were repeated three times. An electrocardiography printout was obtained during each trial, and heart rate differences between pre-maneuver and post-maneuver were measured. Results: Among the 97 volunteers who participated in the study, 7 were excluded because the target Valsalva maneuver pressures were not reached, and 1 volunteer was excluded due to T-wave inversion that developed after Valsalva maneuver. We enrolled 89 participants. There was no significant difference in the heart rate decrease among the four techniques. In addition, there was no difference between the vagal responses in terms of age, gender, and body mass index. Conclusion: This study shows that the four different Valsalva maneuver techniques were not superior to one another in terms of decreased heart rate.

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Introduction:Injury to deep neck structures should be considered during emergency room (ER) admissions in patients with a chief complaint of swelling in the neck, particularly when there is a history of trauma to the neck. Life-threatening conditions should be assessed, diagnosis should be made using appropriate imaging modalities, and treatment should be planned accordingly. Case Report: A 30-year-old male presented to the ER with the chief complaint of a swollen neck 2 h after he fell off a bicycle. Based on the ultrasound and computed tomography analysis, he was diagnosed with isolated submandibular injury. Conclusion: Isolated submandibular injury following a blunt trauma is a rare condition. Obtaining appropriate imaging modalities is helpful in confirming the diagnosis. Patients with blunt trauma should also be carefully assessed for other, nonapparent injuries. Giriş Parotis, submandibular ve sublingual bezler majör tükürük bezleridir. Bu bezlerin izole yaralanmaları oldukça seyrektir. Submandibular ve sublingual bez yaralanmaları anatomik pozisyonları nedeniyle parotis bezi ve tükürük kanal yaralanmalarından daha nadir görülür. Etiyolojiden çoğunlukla penetran travmalar sorumludur (1). Bu yazıda, bisikletten düşme sonucu izole künt submandibular bez yaralanması meydana gelen bir olgu sunulmuştur. Olgu SunumuOtuz yaşında erkek hasta, acil servise gelmeden yaklaşık 2 saat önce bisikletten düşme ve sonrasında sağ boyun bölgesinde şişlik oluşması şikayetleriyle başvurdu. Düştüğünde çene ve boyun bölgesini, sivri olmayan sert bir zemine çarptığını belirtti. Boynundaki şişliği, çarptıktan yaklaşık 1 saat sonra fark ettiğini ve bu bölgede boyun hareketleriyle hafif derecede ağrı olduğunu ifade etti. Yutkunma güçlüğü veya nefes darlığı gibi solunum yolunu tehdit eden bir semptom bulunmamaktaydı. Hastanın 56