Isolated nasopharyngeal tuberculosis is a rare condition, even in endemic tuberculosis areas. The most common presentation of nasopharyngeal tuberculosis is with a cervical lymphadenopathy followed by nasal discharge or obstruction. Here we present a 58-year-old patient with nasopharyngeal tuberculosis whose only complaint was snoring. Her oropharyngeal and anterior rhinoscopic examination was normal. On endoscopic examination, mucosal oedema and hyperaemia of the nasopharynx was observed. There was no cervical lymphadenopathy. The tuberculin skin test was positive and histopathological examination of the biopsy taken from posterior nasopharyngeal wall supported the diagnosis of tuberculosis. After anti-tuberculosis therapy, the snoring stopped and the nasopharyngeal examination was normal.
A 67-year-old man with an enlarged left tonsil underwent a tonsillectomy for the suspicion of malignancy. He had had a dental extraction six months earlier. Clinical and histopathological investigations established the diagnosis of primary tonsillar tuberculosis.
Primary hyperparathyroidism is a fairly frequent pathologic diagnosis characterized by hypersecretion of parathyroid hormone, which results from adenomas in 80% to 85% of all cases. At clinical onset, the most common symptoms are hypercalcemia-related and some of them are pain due to kidney stones, polyuria, gastrointestinal, and neurologic disorders, whereas rarer symptoms are due to brown tumors and expansive lesions often found in fibrocystic osteitis. Brown tumors represent the terminal stage of the remodeling processes caused by an increased osteoclastic activity and fibroblastic proliferation during primary or secondary, albeit more seldom, hyperparathyroidism. The manifestation of primary hyperparathyroidism as skeletal disease has nearly disappeared in the last 2 decades. Cases are now most often diagnosed by the coincidental finding of asymptomatic hypercalcemia. Advanced screening techniques have made clinical evidence of bone disease rare. This article contains a case of brown tumor on the maxilla, palate, and mandible in addition to nephrectomy and proximal femur fracture, which are probably associated with primary hyperparathyroidism although less common nowadays. The diagnosis was suggested by the clinical history and confirmed by biochemical, radiologic, and histopathologic evidence. Excision of a parathyroid adenoma normalization of the metabolic status was then realized.
Objectives: This study aims to evaluate the psychiatric symptoms, quality of sleep, quality of life and the predictive factors affecting quality of sleep in patients diagnosed with nasal septal deviation (NSD).
Patients and Methods:Forty male patients (mean age 22.3±1.4 years; range 21 to 26 years) who admitted to the otorhinolaryngology (ORL) clinic of the Ağrı Military Hospital and diagnosed with NSD as a result of a through ORL examination between February 2009 and April 2009 and 36 healthy volunteer (mean age 21.7±1.0 years; range 21 to 25 years) controls, were included in this study. Preand postoperative evaluations were performed using the Quality of Life Scale (Short Form-36/SF-36), the Pittsburgh Sleep Quality Index (PSQI) and the Symptom Check List Revised (SCL-90-R).Results: All patients and controls completed pre-and postoperative evaluations. No complications occurred. There was a statistically significant difference between the groups in the quality of sleep measures, in the SCL-90-R subscales of somatization, obsession, interpersonal sensitivity, depression, anxiety, phobic anxiety, hostility, paranoid thought, and psychoticism, additional scales and in physical health dimension of SF-36 Quality of Life Scale.
Conclusion:Psychiatric symptoms are more common in patients with nasal septal deviation when compared to healthy controls. The impairments in nasal breathing in patients with NSD may cause a decline in the physical dimension of quality of life and a marked impairment in sleep quality.Key Words: Nasal septal deviation; psychiatric symptoms; quality of life; quality of sleep. Sonuç: Sağlıklı kontrollerle karşılaştırıldığında, psikiyatrik semptomlar nazal septal deviyasyonlu hastalarda daha fazladır. Nazal septal deviyasyonlu hastalarda nasal solunumla ilgili bozukluklar, yaşam kalitesinin fiziksel boyutunda azalmaya ve uyku kalitesinde belirgin kötüleşmeye neden olabilmektedir.Anahtar Sözcükler: Nazal septal deviyasyon; psikiyatrik semptomlar; yaşam kalitesi; uyku kalitesi.
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