Friday, July 10, 2020

Abortion prices in istanbul

Abortion prices in 2020 is one of the most frequently asked questions of those who want to have this procedure.
Often, when women need to have an abortion, it is a topic explored.
The abortion procedure to end unwanted pregnancies is a surgical operation based on the procedure of evacuating the baby from the mother's womb.
Abortion prices can range from 1000 - 2500 US Dollars on average.
Although it can be done with many different techniques, the most preferred abortion method worldwide is the vacuum aspiration technique.

This method is the most comfortable option for both the patient and the doctor.
Compared to other abortion techniques, the risk of abortion-related complications is lower, so that the vacuum abortion method is preferred more.
Therefore, the numbers you will encounter during abortion prices in 2020 research are mostly the price of the vacuum aspiration method.
However, in rare cases, it may not be possible to apply the vacuum aspiration technique in some patients.

Sometimes, a different technique can be applied, such as the scraping technique, as the choice of the doctor completely.
It should be noted that the price may change in this case.
Because one of the factors affecting prices in all surgical operations, especially abortion, is with which technique the operation will be performed.
After examining what abortion is, how it is done, why it is done, you can examine the real question.
But first of all, who can have an abortion, what are the general conditions and what should be considered, should be examined.

abortion prices istanbul
abortion prices in istanbul

How Does Abortion Prices Change?

First of all, it should be noted that abortion prices are effective on many factors.
The first is the weeks of pregnancy. At this point, it is also necessary to talk about the legal period. Under the law,
abortion cannot be performed after the 10th week of pregnancy, except in rare cases.
We can give these rare cases such as the occurrence of a life-threatening bleeding problem for the expectant mother,
the death of the baby in the womb or the presence of a health problem that may cause serious problems in maintaining the life of the baby after birth.

In such cases, it may not be possible to evacuate the baby with vacuum aspiration technique and different abortion methods should be applied. Naturally,
unwanted pregnancy to and, prices may also correspond to higher figures.
The abortion method applied in pregnancies lasting less than 10 weeks can be completed in only 10 to 15 minutes. However,
abortion period is longer in large pregnancies and this operation can be performed with a more complex procedure.

This is because the abortion fees are slightly higher.
The doctor's experience is another factor that affects unwanted pregnancy prices and is also important and has a role to affect the unwanted pregnancy price.
Abortion prices The preference of the doctor should not be based on the price information, an experienced doctor should be preferred.

When talking about prices, it is also necessary to touch the exchange rates.
Various medications such as anesthesia drugs used after the procedure may be coming abroad. In this case, exchange rates also come into play because the amount paid for medicines is reflected in the prices offered to the patients.
The tools used are also on the list of determinants of abortion fees.

how much are abortion prices
how much are abortion prices

Does Price Increase in Advanced Pregnancies?

Is abortion prohibited? Is there an abortion in big pregnancies? In the later stages of pregnancy, when an abortion is required for any reason,
different equipment, medicine and medical supplies are used. This situation results in different numbers determined as abortion prices in big pregnancies.
In response to the question of how many months of abortion is performed,
various legal documents such as the court report or the signature of at least 3 physicians from the physician committee are required for abortion in large pregnancies.
So the physician determines.

How is an abortion? If the law permits, the cervix is ​​opened with the help of drugs put into the cervix. At the same time,
these drugs provide a softening in the cervix. The uterus is reached and the baby is evacuated. Of course,
the anesthesia applied in this case is different from the anesthesia applied before vacuum aspiration.
All this affects unwanted pregnancy prices in advanced pregnancies. Of course, depending on the health condition of the expectant mother,
the application of different abortion techniques may also be necessary.

https://www.healthzoneturkey.xyz/2019/08/where-can-i-have-abortion-in-istanbul.html

 Abortion Prices in single and married woman

The abortion procedure is performed with the same procedure in the case of pregnancy developing outside the marriage in married women.
Therefore, abortion prices do not change. In the absence of health problems requiring a different technique,
abortion is completed with the vacuum aspiration method, whether married or not. Therefore, it is not possible to have a difference in prices.
In the clinic of the gynecologist and obstetrician you apply for, the reason why the staff is asked if you are married is not the prices.

The wife's permission is required for married women to have an abortion. The spouse is asked to sign the consent document.
Abortion is prohibited if the spouses do not approve. Because the reason for asking whether you are married is only legal procedures and a permission to be obtained.
Meanwhile, women under 18 must have their parents approved for abortion, whether they are married or not.

How much is abortion prices in 2020?

How much is abortion prices in 2020

How much is abortion prices in 2020


First of all, you should know that it will be misleading to tell you about abortion prices by 2020. Because many different factors,
from which doctor you choose to how long the gestational week is, will have an effect on the budget you need to allocate for this procedure.
So it would not be right for us to tell you about a price or a range of prices and it will mislead you. If you want to get price information,
you must first know what week of pregnancy you are.
Because pregnancy termination prices to be informed to you will be determined by taking this information into consideration.

You may be examined for this and your doctor may also check if your condition is suitable for vacuum abortion during this examination.
Afterwards, it is determined how many weeks you are in pregnancy and you can make the necessary date planning for the abortion procedure.
In this way, a clear figure will be sent to you as abortion fees. However, we can state that the prices are quite reasonable in general.
Abortion in our country does not require a budget of very high numbers.

We can list the Abortion Prices as follows

  • Abortion prices between 6-7 weeks are 1000 US Dollars.
  • Abortion prices between 7-8 weeks are 1000 US Dollars.
  • Abortion prices between 8-9 weeks are 1500 US Dollars.
  • Abortion prices between 9-10 weeks are 1500 US Dollars.

Istanbul European Region Abortion Prices


Some of the women who researched on the European side of Istanbul abortion may think that prices may vary according to the cities.
Just because you live in Istanbul doesn't mean you will face higher or lower abortion prices by 2020. As we mentioned before,
these prices vary depending on different factors, not the city.

In addition, which health institution you prefer is one of the issues that affect prices. Although abortion risk is low, abortion is a surgical operation.
Therefore, choosing an experienced doctor is more important than the price.
In order to carry out the procedure with a comfortable process and to complete the healing process smoothly,
you must first turn your route to experienced doctors.

Meanwhile, abortion is an operation that should be done only by obstetricians and obstetricians.
Do not respect the places called as under the stairs ( Turkish Term) among the people and those who have not received education in medicine.
Because, various situations such as lower abortion prices are offered or women who have exceeded the legal period are also exposed to the press.

Never forget that these places are not a practice or clinic, they are completely illegal, and it is a crime to have an abortion after the 10th week of pregnancy.
On the topic below, you can examine the points to be considered before and after abortion.

https://www.healthzoneturkey.xyz/2019/07/how-to-perform-abortion-in-istanbul.html

Points to Consider

Any intervention done by non-obstetricians and obstetricians can cause serious health problems. Even abortion risks can be a vital condition.
Of course, you can research about abortion prices 2020.

However, never turn your route in a different direction than the doctors who have received medical education and experienced in their field.
It is also wondering whether there is an abortion in public hospitals. Of course, abortion can be done in public hospitals, although not all.
However, due to the intensity, you can make an appointment at a very advanced date and in this case, you can miss the 10th week of pregnancy,
which is the legal period for abortion. If you miss this time, you will not be able to take the baby.

However, in some public hospitals, abortion can only be done in emergency situations,
when the expectant mother's life is at risk or when it is compulsory due to lack of equipment or personnel.
Applications that are made on justified grounds other than these cases may not be accepted.
You should also consider this risk. Because we observe that many women may miss the legal period for reasons such as doing research or undecided in choosing a doctor.

You should not forget that the abortion process also has psychological dimensions.
For what purpose it is necessary, having an abortion is a psychologically challenging process for every woman.
For this reason, at least ensuring that the operation is performed in a comfortable environment by a reassuring doctor helps you feel much better psychologically.

In environments where there is a serious patient density, you may feel more under pressure or experience the feeling of guilt that occurs in many women due to abortion. It would be useful to consider these possibilities as well. Every woman deserves an abortion in a comfortable environment. Do not risk your health in illegal places and value yourself.

How Much Price Will Be Changed By Using Anesthesia ?

The abortion procedure is performed under anesthesia so that the patient does not feel any pain or pain during the operation.
The anesthesia type abortion prices to be applied have an impact on 2020. Of course, the price will be slightly lower if local anesthesia is applied.

The price of an abortion procedure under general anesthesia is slightly higher than the legal price of an abortion with local anesthesia.
The anesthesia applied in this operation is not the same as the anesthesia applied in difficult and long-lasting operations, i.e. narcosis support.
A much lighter anesthetic is applied. However, an increase in price may occur due to the drugs used and similar reasons.

Are pregnancy termination prices the same everywhere?

One of the most curious elements on the subject is the question of whether abortion prices are the same everywhere in 2020.
Of course, the price of this procedure, which is carried out to evacuate the baby from the womb, will not be the same everywhere.

Prices are determined by the institution in every practice or hospital and many factors affect the price,
from the experience of the doctor to the drugs used or the anesthesia applied. However, let's convey the information that there is a minimum price.
Institutions cannot charge less than this minimum price.

The Abortion Price are determined every year in January and June, that is,
twice a year by taking into consideration the coefficient of the Chamber of Medicine. A fee can be charged above this price. However,
it is definitely not right to choose according to the price. Just as the high price does not mean that the operation will be more accurate,
more reasonable prices do not mean that the abortion procedure will not be done correctly. When choosing,
it will be useful to consider the experience of the doctor and the approach to the patient rather than the price.

https://www.healthzoneturkey.xyz/2017/12/abortion-in-istanbul-turkey.html

Does the State Hospital Cover Abortion Prices?

Is abortion legal and does the state meet abortion prices? we can say that the state is very confused about whether the abortion fees are covered by the state.
The price of an abortion in a private practice or hospital is not covered by the government. In order for abortion to be covered by the state,
the operation must be carried out in public hospitals. However, abortion in public hospitals in our country can be done only when there are medical obligations.

Abortion can be done in the state hospital in cases such as mole pregnancy, death of the baby in the mother's womb,
gestational sac not develop, anembryonic pregnancy, excessive bleeding in the patient. Apart from such situations, the operation cannot be performed due to intensity, and the procedure must be performed in a private practice or hospital, and unwanted pregnancy prices are covered by the patient.

In Which Conditions Does Abortion Fees Increase?

Many different factors are taken into account in determining the abortion prices. These factors can also cause the price to increase.
For example, the prices of local anesthesia, sedation anesthesia and general anesthesia are different and are reflected in abortion prices as well.
The highest prices are offered in private luxury hospitals, including hotel service. Within the scope of these services,
which can also be launched as VIPs, prices can reach much higher figures. However, more reasonable fees are offered in practices and clinics.


external sources
https://www.plannedparenthood.org/learn/teens/ask-experts/how-much-does-an-abortion-cost


Dr.Ismet YILDIRIM MD. Gynecologist and Obstetrician, Infertility
Private Office:
İncirli Cad. No:41, Kat:4 Bakırköy - ISTANBUL (Dilek Pastanesi Üstü)
Phone: +902125428785
Mobile: +905323253008
E-Mail: dr.ismetyildirim@hotmail.com

Friday, May 1, 2020

A Rare Cause Of Dry Nose: Sjögren's Syndrome

What is The Sjögren's Syndrome?


Sjögren's Syndrome

Sjögren's Syndrome is an autoimmune (self-made) disease that causes dry eye, dry mouth and dry nose. In autoimmune diseases, the body's defense system functions against it. It is the body's natural defense against immune system antigens (foreign bodies such as bacteria and viruses). Sometimes the immune system does not work properly, and it loses the ability to distinguish between its own body cells and antigens. Instead of fighting antigens, the immune system mistakenly fights against its own body cells. This event is considered an autoimmune event.



Sjögren can occur in two forms: primary and secondary. 

Primary Sjögren Syndrome occurs on its own and is not related to other diseases.

Secondary Sjögren Syndrome occurs with some types of inflammatory rheumatic diseases such as rheumatoid arthritis, lupus, and polymyositis.Sjogren's Syndrome; Although it is relatively rare in people under the age of 20, it can affect people of all ages and races. 90% of the patients are women. The tendency to develop Sjögren Syndrome increases in the event of a disease in one family.

What Happens in Sjögren's Syndrome?


In Sjögren's Syndrome, a white blood cell called lymphocyte occupies glands, such as tear and salivary glands, and glands in the vagina. Lymphocytes can damage these glands and prevent them from producing secretions. As a result, there is dryness in the mouth, eyes, and vagina. Sjögren's Syndrome can also cause problems in other parts of the body. It can cause inflammation in the lungs, kidneys, liver, nerves, thyroid gland, joint, and brain.

Symptoms of Sjögren's Syndrome?

Sjögren's Syndrome affects everyone differently, and its findings are of different severity. Frequent findings are listed below.



Dry mouth


The mouth normally contains saliva and helps to chew and swallow. Patients with Sjogren's Syndrome produce less saliva than usual. This makes it difficult to chew, swallow and speak. This can also reduce the sense of taste.

Dry eyes


The eyes feel dry, sandy. There may be burning and redness in the eyes. Excess mucus (burr) may accumulate around the eyes while sleeping. Your eyes may be more sensitive to sunlight. If not treated well, Sjögren's Syndrome can lead to blind spots in the eyes and corneal ulcer (wound on the outer part of the eyeball). Rarely, this can lead to vision loss.

Swollen salivary glands


Three pairs of large glands produce saliva. These are located under the tongue, under the cheek in front of the ears and behind the mouth. These glands may appear swollen or felt. It can be mixed with mumps. Sometimes it can become sensitive and accompany fever. In Sjögren's Syndrome, swollen glands are observed in approximately half of the patients.

Dental caries


This is a general problem caused by dry mouth. Saliva contains bactericidal substances (enzymes) and these substances fight bacteria. Thus, it acts as a protective against tooth decay. When saliva is reduced, less enzymes are produced. Because of this, teeth are more easily bruised.

Fungal infection in the mouth


Most people with dry mouth have burning and redness in the mouth. This complaint is created by a small fungus called Candida in the mouth.

Dry nose, throat and lungs




Dryness; causes the throat to have a dry and annoying feeling. Dry cough can cause hoarseness, decreased sense of smell and nosebleeds. Dryness can also lead to pneumonia, bronchitis and ear problems.

Dryness of the vagina


Sjögren Syndrome can cause pain and irritation in the vagina due to dryness. It causes sexual intercourse to become painful for the woman.

Tiredness


It is a frequent finding of Sjögren's Syndrome. It can occur due to the disease itself or it can develop as a result of physical and emotional stress caused by having chronic disease.

Other issues


Other problems with Sjogren's Syndrome; inflamed and painful joints, muscle weakness, dry skin, rashes, constipation, feeling of numbness due to inflammation in the nerves, tingling and swollen lymph nodes. These show the importance of the continuation of doctor's follow-ups.

Complaints of Patients With Sjogren's Syndrome


The following symptoms and complaints may occur in patients:

• Dryness, burning, itching, and excessive sensitivity to light develop in the eyes. The patient describes it as, "As if sand is in my eye."
• There may be weakness and joint pain
• Sensitivity of cold and color changes such as whitening in the limbs may occur.
• Swelling of the salivary glands, deterioration in taste and smell can be observed.
• Dryness may occur in the nose, skin and female genital organs. Sometimes, a type of lymph node cancer called "lymphoma" can develop in patients.

Causes of Sjögren's Syndrome?




The reason is unknown. There is evidence that genetics, viral infections and hormones are effective. The causes of Sjögren's syndrome are not fully known. However, there are environmental factors added to genetic susceptibility, namely viruses, hormones, or research showing that all of them are effective. Nine out of ten patients with Sjogren's syndrome are women. Although the average age of occurrence is 40-50 years old, it can also be seen in children, adolescence and young adults. It is not known what caused Sjögren's Syndrome. However, as with all autoimmune diseases, the immune system responds abnormally to the interaction of environmental factors such as infection and medication, as well as the genetic predisposition of the person. The common feature of "autoimmune" diseases is that the immune system, which is originally tasked with defending the body, begins to hurt itself. Although the diseases occurring in these conditions give symptoms depending on the type of body structures involved; however, before considering Sjögren Syndrome, it is necessary to make sure that there are no more common causes such as diabetes, otolaryngology and medications used.

Drying in the eyes and mouth can be a warning for your health!




Sjögren's syndrome (pronounced “Sgrengren's syndrome) (dryness syndrome) is a disease that causes dry mouth and dry eye findings. It is one of the diseases caused by the immune system, which is responsible for protecting the body against damages such as infection from outside, when it does not work properly and damages its organs. Firstly, germ-free inflammation (inflammation) develops in the glands producing salivary glands, tear glands, and pancreas. As a result, saliva and tear production decreases and symptoms of internal organs appear.

What are the findings?


In Sjögren's Ssndrome, suddenly dry mouth and eyes, burning in the eyes, stinging, itching, sand stinging sensation, feeling of something missing, difficulty in swallowing food, needing to drink water while talking, noise in the voice, throat, tooth decay and / or sudden loss of teeth. there may be an increase. Also; dry skin, nose may also develop. There may be occasional short-term swelling on the cheeks, in front of and below the ears, under the chin.
In addition to lung infections such as bronchitis, pneumonia, sinus and ear infections may also develop. In addition, as a result of the damage caused by the fire in the lung, shrinkage of the lung tissue (fibrosis) may occur, it may decrease the effort capacity and shortness of breath.

Some patients with Sjögren's syndrome may develop a small red rash primarily on the legs as a result of a fire developing on the walls of small vessels.Some patients with Sjögren's syndrome may experience bleeding and / or protein excretion, and some may have kidney inflammation, which can lead to kidney failure.

In patients with Sjögren's syndrome, abnormal lymphocytes may proliferate poorly and develop lymph node cancer (lymphoma).In this disease, other organs of the body such as the liver, pancreas, stomach and brain can be involved, as well as in the lungs, kidneys, blood vessels. Often there may be exhaustion, weakness, joint pain, morning stiffness that may impair quality of life.

After all, the symptoms of Sjögren's syndrome are variable and numerous. Dry eye is an important finding. However, the symptoms and histories of two patients with the same diagnosis can be very different from each other. Sjögren Syndrome is a disease that conforms to the classical definition of “there is no disease, there is a patient”.Diagnosis is not easy; Because the symptoms and symptoms of Sjögren's syndrome may resemble many other diseases such as other rheumatological diseases, chronic fatigue syndrome, fibromyalgia, multiple sclerosis. Different symptoms of the disease may be noticed by different specialists whom the person applies, but it may take time to reach the whole. In addition, Sjögren's syndrome is not the only disease that causes dry eyes, mouth or other organs. Medicines used to treat diabetes, hypertension, allergies, depression or colds or gastrointestinal tract can also cause dry mouth and eyes.

Sjogren's Syndrome Treatment




There is no cure for Sjögren Syndrome. However, the approaches applied to early diagnosis and daily life to reduce the effect of the disease are important. Sjögren's syndrome may not be life threatening, but it may impair quality of life. Regular use of moisturizers such as artificial tears, saliva and medical treatment and following the recommendations will prevent the emergence of new problems and will ensure the enjoyment of life. A comfortable treatment can lead a comfortable life.

Source links >> Sjogren's syndrome - Symptoms and causesSjogren's Syndrome | Dry Mouth | Dry Eyes | MedlinePlus



Bosphorus - Istanbul - Turkey - ENT Doctor Istanbul - ENT Specialist Istanbul - Nose Job Istanbul - Rhinoplasty Istanbul - ENT Office Istanbul - Dr.Murat Enoz - ENT Clinic Istanbul - ENT Doctor in Istanbul - Nose Job in Turkey
Bosphorus - Istanbul - Turkey - ENT Doctor Istanbul - ENT Specialist Istanbul - Nose Job Istanbul - Rhinoplasty Istanbul - ENT Office Istanbul - Dr.Murat Enoz - ENT Clinic Istanbul - ENT Doctor in Istanbul - Nose Job in Turkey
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
E-Mail: muratenoz@gmail.com
Mobile phone: +90 533 6550199
Fax: +90 212 542 74 47




Sunday, April 19, 2020

Tonsillectomy and Postoperative Patient Care Points

Tonsil Removal Surgery


Tonsil surgery is performed under general anesthesia and the procedure takes approximately 15-20 minutes according to different techniques. With the Thermal Welding method, bleeding and postoperative pain are less during surgery.

Post-Surgery Recovery Period


Since it is performed under general anesthesia, oral nutrition is not performed for the first 4 hours after surgery. Patients generally experience a painful period after tonsil surgery. The recovery period is in two separate periods. The first period is when the pain is more and the second period is when the pain is less. A few practical applications that reduce pain after surgery are cold serum injections, pain relief injection, intravenous dexamethasone and pain medication injection, and cauterization. Generally, I prefer to sew the front and rear plica as seen in the photo on the side for acceleration of healing or stopping bleeding areas. This practice is almost never painful for the first 4 hours after a few applications, and when the anesthetic effect passes and the first meal time begins, eating ice cream first and then continuing with a soft warm diet reduces pain. The less damaged the tissues other than the tonsil during the procedure; the pain that will be felt after the procedure will be less. 

In the photo above, the throat examination photos of a patient who underwent tonsil surgery are seen before and one week after surgery. In the photo taken at week 1, white fibrotic healing tissues seen in the areas of tonsils can be mistakenly perceived as inflammation by families. 


The post-operative photograph also shows two fusible stitch threads in purple.The first painful period is up to 5-7 days after surgery in children, and 7-10 after surgery for those over 12 years old. time periods up to the day. In this first period, healing tissues of white-gray color will occur in the areas with tonsils and pain that can be seen in the ears by swallowing.



Above, in the first month after tonsil surgery on the left, the intraoral view is seen. On the right, the throat photos taken immediately after the operation are seen. Bloodless and knife-free tonsil surgery was performed in both patients by the thermal welding method.

Tonsil removal videos


Video 1


Video 2



Video 3



Video 4



Important Points Regarding Post-Surgery Patient Care


The patient's dehydration after tonsil surgery is the worst factor for recovery. It causes increased pain, bleeding and infection risks and delayed recovery. Therefore, the key factor in recovery is increasing the patient's oral food intake. Regular intake of foods, especially hard and not hot (soft and warm), is the most important factor for recovery. It may be beneficial to use painkillers to facilitate oral fluid intake and to reduce the pain by taking foods such as ice cream, cold pudding, cold yogurt from time to time. It may be correct to take painkillers before bed, as night swallowing and fluid intake will decrease. It should be kept in mind that the pain can not be passed only with painkiller tablets, syrups or sprays and the necessity of oral liquid food intake.The throat appearance of the patients, who underwent tonsil surgery with thermal welding method and sutured with stitches that can melt the pelicans in front of and behind the tonsil after surgery, is seen above.5-7% bleeding can be seen after tonsil surgery. There is a risk of bleeding until 10th day, especially since collagen, which has healing tissue on the 10th day, has a time to change. After the 10th day, the risk of bleeding will gradually decrease with the intake of soft warm food.The first 10 days should be taken only soft, juicy foods. Any food that is hard and hot can contact the surgery site and cause bleeding. Nevertheless, acidic foods can be irritating and uncomfortable for the first 10 days.Heavy exercise and movements that increase blood pressure should be avoided in the first 10 days.

Bosphorus - Istanbul - Turkey - ENT Doctor Istanbul - ENT Specialist Istanbul - Nose Job Istanbul - Rhinoplasty Istanbul - ENT Office Istanbul - Dr.Murat Enoz - ENT Clinic Istanbul - ENT Doctor in Istanbul - Nose Job in Turkey
Bosphorus - Istanbul - Turkey - ENT Doctor Istanbul - ENT Specialist Istanbul - Nose Job Istanbul - Rhinoplasty Istanbul - ENT Office Istanbul - Dr.Murat Enoz - ENT Clinic Istanbul - ENT Doctor in Istanbul - Nose Job in Turkey
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
E-Mail: muratenoz@gmail.com
Mobile phone: +90 533 6550199
Fax: +90 212 542 74 47




Wednesday, April 15, 2020

A Rare Cause of Unilateral Nasal Congestion: Antrochoanal Polyp

Painless Mass Lesions that Grow in the Nose: Nasal Polyps

What is a nasal polyp?

Nasal polyps or nasal polyps are benign (benign) mucosal and often multiple tissue growths that extend to the lumen in the nasal cavity, characterized by multifactorial-induced mucosal inflammation. They have a structure with feet, smooth surface, and consistency of pellets. The most common cause of mass in the nose are polyps. The incidence of nasal polylpine in the community is about 1-4% and it is more common in men than in women.Nasal polyps can usually be seen at any age between the ages of 20 and 40. But if the nasal polyp is seen before the age of 10, it is mostly associated with cystic fibrosis. 


Nasal polyps are rarely seen in children aged 2 and after 60 years old. Although many theories for the causes of nasal polyp have been proposed, the cause is not fully known. It is reported that allergic, infectious, mechanical, immunological and biochemical factors play a role in the formation of nasal polyp. Nasal polyps are usually located in the lateral wall of the nose and often in the middle meatus or along the upper and middle turbinate and mostly originate from the ethmoid sinuses.

Nomenclature


"What is a nasal polyp?" In order to answer the question, it is necessary to explain the meaning of the word polyp first. As is known, there are many organs or tissues in the human body filled with air. Lungs, stomach, mouth, nose, sinuses around the nose, external ear canal are examples. Sinus is generally the name given to the cavities that resemble an open pouch. Sinuses, whose inflammatory condition is known as “sinusitis” among the people, are air-filled cavities in the head bones associated with the nasal cavity and are called “paranasal sinuses”. There is a thin, superficial layer of tissue in the human body that covers all these cavities and consists of cells. The structures such as meat, which grow out of this tissue layer and grow differently from normal structures, are called "polyp". Polyps can develop in any hollow organ or tissue and are named according to their location. Names such as ear, vocal cord, stomach, intestinal polyp are good examples. Polyps can develop from damage to the tissues lining the inner surface of the sinuses around the nose with the inside of the nose or mouth opening into the nose. The structure formed in this case is named as "Nazal Polip" by defining the place of residence with the word "Nazal" in Latin. The disease state in which these polyps are present is called “Nasal Polyposis”. This term refers to the common polyps in the nose and associated sinuses. Nasal polyps are soft, pale colored, sagging inside the nose, painless to the touch, and can be replaced by gravity.


Antrochoanal Polyp

Anthrocoanal polyp

Anthrocoanal polyp is a type of nasal polyp that originates from the maxillary sinus located at both sides of the nasal entrance and can extend back to the nasal cavity and into the nasal airway passage. Sometimes they can reach large sizes, and when viewed through the mouth, they can be bubble-like, with a liquid-filled bubble that extends from top to bottom. It can move with head movements, repeating sinusitis attacks, nasal discharge, decreased smell (anosmia) can be added to the symptoms by disrupting sinus ventilation. Antrochoanal polyps are usually seen in children and are unilateral.

Anthrochoanal polyps are usually seen unilaterally during careful endoscopic examination. In patients with nasal enlargement and deviation of the septum, they may be accidentally overlooked on the side of the passaged obstruction.

Antrochoanal Polyp


What are the symptoms of nasal polyp?

Many patients with nasal polyp complain of severe nasal congestion that does not pass despite typical medications. The following signs and symptoms may occur in patients with nasal polyps
  • Transparent or colored runny nose
  • Decreased sense of smell and tasting and even disappearing completely
  • Headache
  • Sinus pressure
  • Facial pain is more common in people with chronic sinusitis than those with nasal polyps. 
In those with a serious nasal polyp problem, it may be possible to see the polyp in the nostrils. These structures have a jelly-like appearance. At the same time, allergy, asthma, genetic predisposition, chronic rhinosinusitis and genetic predisposition play a role in the formation of nasal polyps. These factors cause chronic inflammation in the nose, causing edema of the nasal mucosa and formation of polypoid structures with intense fluid accumulation.


Nasal polyps mechanically block the flow of air passing through the nose, causing nasal congestion. In addition, depending on whether there is any other accompanying disease, they can cause a runny nose that changes in consistency and color. A large part of this discharge is downward from the adolescent and can cause severe “Asthma” disease or asthma attacks. Since the air taken from the nose is blocked, the sense of smell may be lost or decreased. They can cause headaches due to the fullness of the sinuses or behind inflammatory conditions. Due to the resulting mouth-to-mouth action, there may be complaints such as snoring or sleep apnea, frequent throat tenderness and inflammation, and long lasting flu and flu. Considering that the discomforts in this emerging picture may cause other things, it is possible that the patient will face more pessimistic situations in the long term.


Causes of nasal polyp


The causes of nasal polyp are multifactorial. Commonly reported causes of nasal polyp include infections, allergic causes, immunological factors, metabolic causes, and hereditary transition. Young syndrome, Churg-Straus syndrome, and Kartagener syndrome, which are accompanied by ciliary anomaly, are among the causes that can be seen especially in the nasal polyposis associated with asthma.

Mucosal edema is a major pathological condition that causes polyps to form. Infection, allergy, asthma, aspirin and pain reliever sensitivity, cystic fibrosis, any inflammatory agent may cause mucous edema causing polyps. Some genetic syndromes also cause nasal polyps. In addition, some drugs are held responsible for nasal polyp formation.

How nasal polyps are formed?

It is not known exactly how polyps are formed and which mechanisms are effective in their formation, and it is still being explored by scientists. Damage due to various causes in the superficial tissue lining the nose and sinuses, and its persistence is the most likely reason. The most important factors causing damage are inflammatory conditions and allergies. Continuous contact or inhalation of some harmful substances or some familial-hereditary causes may also play a role in the formation of polyps. These conditions that cause polyp formation can be alone or all together. As a result, the superficial tissue lining the sinuses swells and grows from the mouth of the sinuses into the nose. Nasal polyp usually occurs on both sides. Nasal polyp may also occur in some known diseases such as "Asthma" and "Cystic Fibrosis".

What is sinonasal polyposis?

If polyps develop both in the air spaces near the nose called sinus and through the nose, they are called sinonasal polyp or sinonasal polyposis. Nasal polyp or sinonasal polyposis develops in 1 in 3 of patients with chronic rhinosinusitis.Nasal polyp and sinonasal polyposis are actually the same disease. The only difference between them is where they form in the body. These names are given to describe the prevalence of the disease in the body.

Diagnosis of nasal polyp

In cases with nasal polyps, the diagnosis is made by the patient's history, physical examination (a complete otolaryngology examination) and nasal endoscopic examination, laboratory tests and radiological imaging (computed tomography and magnetic resonance imaging), allergy tests and histopathological evaluation.

The nasal polyp is seen in an anterior rhinoscopic examination as a smooth, pale, transparent and round mass. They are soft, painless and moving masses during manual examination and do not bleed easily. Nasal polyps are mostly masses with two faces.The nasal polyps can be in appearance ranging from extensive mucosal edema to a single polypoid mass or diffuse polyposis that fills all the paranasal sinuses, and polyps can even fill out the nasal cavity and come out of the nares. Diagnostic nasal endoscopy is the most valuable method used in diagnosis.

Paranasal sinus computed tomography (PNS-CT) is taken in coronal and axial plans to see the prevalence of sinonasal disease that does not respond to treatment after 4-6 weeks of medical treatment and to evaluate patient-specific anatomical features.

Magnetic resonance imaging (MRI), on the other hand, is a valuable method to allow the evaluation of soft tissues with lower radiation risk and to make a differential diagnosis of mucus and polyp. However, it is difficult to distinguish retention in the sinuses and mucosal thickening from the nasal polyp In the differential diagnosis, pathological examination is important to distinguish nasal polyps (intranasal polyps) from inverted papillomas, lymphomas, carcinoma and sarcomas, encephalocele and angiofibromas.

Nasal Polyp Treatment and Drugs

Two types of treatment of nasal polyps are possible:

1.Medical treatment


The majority of nasal polyps are shrunk with intranasal and systemic corticosteroid treatment and improvement in nasal congestion, increase in smell and decrease in nasal discharge can be achieved.

Nasal streoid sprays and drops


Topical nasal steroid sprays are used to reduce the size of the nasal polyp and prevent the growth of polyps after nasal polyp surgery. Drops are preferred instead of spray since it reaches the nasal passage and polybe better.

Corticosteroids


Oral corticosteroids quickly reduce the size of the nasal polyp. However, in cases where the cause of nasal polyps is fungal sinusitis, it may be necessary to use low doses of oral corticosteroids for months to prevent the polyps from growing again after nasal polyps surgery.

Antileukotriene drugs


Antileukotriene drugs are especially useful in the treatment of nasal polyps in those with allergies to aspirin.

Nasal lavage


Saline nasal lavage is especially useful in people with nasal polyp and chronic sinus infections. With this method, it also washes the sinuses along with the nasal passages. 

Allergy shots (immunotherapy)


Nasal polyps that grow again after nasal polyp surgery use allergy shots by some doctors for the purpose of treatment or prevention.

2. Surgical Treatment


If nasal polyps block the sinus passages, if there is chronic infection and inflammation due to drainage disorder in the sinuses, if there are polyps that fill the nasal cavity completely and do not respond to medical treatment, the treatment is surgery. Surgical intervention is performed with an intranasal approach in the form of endoscopic sinus surgery. Depending on the extent of the disease and whether there is an accompanying additional pathology, only polypectomy or enlarged sinus interventions can be performed, in which nasal polyps are removed.

Treatment consists of endoscopic sinus surgery and removal of this polyp. The sinus mouth from which the polyp originates is already extended by the polyp. Endoscopically, aspiration of the sinus content from which the polyp originates at the same time is performed to reduce the risk of re-polyp development.

Nasal polyp surgery has shown important changes in parallel with the technological developments in recent years. By planning on the images given by the computerized tomography in millimetrically, surgical procedures that were performed inside the mouth or in some cases outside the face can be performed endoscopically through the nose today. In the endoscopic method, the light source is entered through the nose using the camera and monitor, and the polyps and damaged tissues in the nasal and sinuses are cleaned. After the polyps are cleaned, the areas of the sinuses opening into the nose are checked and if necessary, the sinuses are returned to normal by opening. The surgery can be performed both through regional anesthesia and asleep under general anesthesia. These surgeries are commonly called “Endoscopic Sinus Surgery”. Thanks to the very thin tools used in the endoscopic method, some undesired results that may occur in close organs such as the eyes and brain can be prevented. These new methods not only ensure that the existing structures are not degraded, but also reduce the recurrence rate of the disease by removing even the smallest polyps. Since no incision is made from the outside of the nose, there is no stitch, stitch scar and a visible scar.

Nasal polyps treatment is drug therapy and surgical treatment. In cases where the nasal passage is completely clogged with polyps, at least 3 weeks of antibiotherapy (antibiotic therapy), 1-2 weeks of corticosteroids (cortisone, prendnisone, dexamethasone and similar group drugs), decongestants and cromolin sodium treatment are given. Antihistamine group drug treatments are also added to patients with allergy problems. With the coronal computed tomography taken 4-6 weeks after the start of drug treatment, the response of the polyp to drug treatment evaluates the extent of the disease and the patient's nasal anatomy. Surgical treatment is performed with the aim of removing surgical polyps completely, improving nasal ventilation and providing drainage in sick sinuses in cases where drug treatment is insufficient.Endoscopic treatment approaches are generally used in the surgical treatment of nasal polyps (nasal polyps). By continuing to use drops, sprays and similar drugs in the postoperative period, recurrence of polyps can be delayed or prevented.

What are the risks of the polyp surgery?


The most common problem in endoscopic surgery is bleeding that may occur during and after surgery. However, since intervention to bleeding tissues and vessels is facilitated by developing methods, bleeding can be successfully managed during surgery. Therefore, most of the time, no tampons are placed even after surgery. Apart from that, unnecessary damage (complications) may occur in the body, although it is rarely seen because there are important organs around the nose and sinuses. The most serious of these are the penetration of the eyeball and nerve by entering the eye cavity, the penetration of the brain fluid through the puncture of the brain membrane, injury of the large vessels, damage to the brain tissue and inflammatory events that may occur after these. Some injuries may require serious treatments, while others can be treated with minor interventions. It should be remembered that some undesirable consequences of anesthesia may also occur.

About success rate of nasal polyp surgery


The success rate of patients who have nasal polyp with simple symptoms without any apparent disease and therefore operated on is above ninety percent. However, the success rate decreases with or in common cases with other diseases such as allergy, asthma, cystic fibrosis and aspirin allergy. In these people, nasal polyps may occur again despite everything. In such patients, the post-operative aim is to delay the formation of polyps as much as possible with drug therapy. If necessary, surgery can be repeated.


Postoperative care after nasal polyp surgery


The most important issue after polyp surgery with the endoscopic method is the regular dressing in the form of cleaning the nose properly. Patients are discharged in a very short time, except for special cases, since tampons are not usually used. It is necessary to go to your doctor every few days after the operation, then less frequently. The timing of dressing varies depending on the conditions encountered in the surgery and the doctor's preference. Your doctor will determine the next meeting time after each dressing. Meanwhile, medical treatment should be used regularly. Usually, the doctor will ask the patient to wash his own nose with saline in the first days to try to prevent adhesion and deposits.


Bosphorus - Istanbul - Turkey - ENT Doctor Istanbul - ENT Specialist Istanbul - Nose Job Istanbul - Rhinoplasty Istanbul - ENT Office Istanbul - Dr.Murat Enoz - ENT Clinic Istanbul - ENT Doctor in Istanbul - Nose Job in Turkey
Bosphorus - Istanbul - Turkey - ENT Doctor Istanbul - ENT Specialist Istanbul - Nose Job Istanbul - Rhinoplasty Istanbul - ENT Office Istanbul - Dr.Murat Enoz - ENT Clinic Istanbul - ENT Doctor in Istanbul - Nose Job in Turkey

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
E-Mail: muratenoz@gmail.com
Mobile phone: +90 533 6550199
Fax: +90 212 542 74 47




Sunday, April 12, 2020

Lung Sounds of Coronavirus (COVID-19)

Coronavirus (COVID-19) Infection





SARS-CoV, a virus that emerged as a previously unknown virus in 2003 as the first international health emergency of the 21st century and caused hundreds of people to die, was isolated as a disease factor in the 1960s and was a disease agent in humans and animals.

Covid-19 Revealed itself in the Recent Years

The virus named MERS-CoV (Middle East Respiratory Syndrome Coronavirus), which has not been previously present in humans or animals from the coronavirus family, has manifested itself in Saudi Arabia for the first time in 10 years as a source of severe infection. Coronaviruses can be classified into four main types. They can be found in human, bat, pig, cat, dog, rodent and poultry domestic and wild animals as alpha-, beta-, gamma- and delta.The spectrum of disease caused by coronavirus in humans can range from simple colds to severe acute respiratory syndrome (Severe Acute Respiratory Syndrome, SARS). He underlined that this virus can cause clinical manifestations in humans and animals, with varying degrees of respiratory infection, intestinal infection, liver diseases and neurological disorders. Disease in adults and children with symptoms of upper respiratory tract infection such as fever, sore throat, cough, weakness, illness or drug use, mostly underlying immune system, diabetes, heart-lung disease, advanced age and others. can be severe, rarely lung infection, kidney failure.

Virus Can Be Transmitted By Droplet!

Like other respiratory infection viruses of the coronavirus, virus spreads to the environment such as coughing and sneezing; He said that if cough, sneezing, mouth and nose should be covered with handkerchief, it can also be transmitted through close contact with sick people, hands should be washed frequently, mouth with nose and eyes should not be touched with dirty hands. It is known to sell wild seafood illegally in the wholesale market and spread through droplets in health centers from person to person. Common symptoms of infection are respiratory symptoms, fever, cough, and weakness. In more serious cases, pneumonia, severe acute respiratory infection, kidney failure, and even death may develop. However, it cannot be commented on the severity of the disease based on the available data.

Travel Restriction Made To Countries With Virus Infection!

It is necessary to consume vegetables and fruits by washing them thoroughly. Those with underlying disease should definitely be consulted by consulting their doctors who are following their journey to the risky area. Contact with wild and domestic animals (live or dead) should be avoided and hand hygiene should be considered. Hands should be washed with soap and water for at least 20 seconds, and alcohol-based hand disinfectant should be used in the absence of soap and water. There is no special treatment or vaccine to provide permanent immunity.

Lung Diseases Cause Coronavirus To Be More Serious!

It is stated that COPD causing chronic respiratory failure is also a risk factor. In addition, asthma and other chronic lung diseases can cause the infection to progress more seriously.
By stating that the effects of Kovid-19 on the lung are variable, even in many people who have no symptoms and who survive the disease, some diseases related to the disease may occur even if there is a lung film or computer tomography. Sometimes this situation can be encountered without any serious symptoms.
It is emphasized that the symptoms and severity of the disease increase depending on the prevalence of pneumonia. Initially, the general symptom of the disease is high fever and then lung involvement, and cough complaints are seen, as the disease progresses, the severity of the cough increases and it may be possible to add shortness of breath to the patient, as the prevalence increases, the patient may experience difficulty in breathing during rest or even later.

Stating that the virus-induced damage to the liver causes inadequate blood supply of oxygen to the blood, which causes a low oxygen level in the blood of the patient, and when this drop reaches a critical point, the need for intensive care may occur. If the patient is taken into care, the oxygen level in the blood is increased to the levels that will sustain life.In some patients, unfortunately, the oxygen levels that will lead to life cannot be easily regained and the patient is lost. What is the factor here? Why are some patients not getting better? We do not know exactly this, there are some risk factors that we know today. Advanced age comes first among these risk factors. By advanced age, I mean 60 or even over the age of 65. The risk increases more with age. This is the conclusion we draw from the experiences obtained. In addition, other diseases of the heart and lungs, vascular diseases, which are present in patients, cause the disease to progress more severely and lung symptoms become more serious. We also know that hypertension, other heart diseases and diabetes are among these. When I look at lung diseases, I can say that COPD causing chronic respiratory failure is also a risk factor. In addition, severe asthma and other chronic lung diseases can cause a more severe course of coronavirus infection. For this reason, the most important point is that those with such chronic lung diseases take regular treatment of these underlying diseases while there is no coronavirus infection yet and ensure that their lungs are prepared for this infection at least as much as possible.

Chronic Diseases Increasing Coronavirus Risks and Recommendations for Protection from Coronavirus

Diabetes

Diabetes is generally in the form of type-2 (90%) and it is mostly seen over the age of 50. Especially uncontrolled diabetes negatively affects the immune system and prevents the body from fighting microbes. Therefore, diabetics are at risk in this outbreak due to both disease and ages. It is imperative that the Ministry of Health's Scientific Committee approach their proposals much more seriously.

Hypertension

The blood pressure is higher than normal and the drugs used for this reason do not suppress the body immune system, but as with diabetes, these patients are generally 50 years of age and over and are at higher risk than the general population.

High cholesterol level

The drugs used in high cholesterol level and treatment do not increase the risk. There is no additional risk apart from age.

Asthma and COPD patients

As it is known, this virus can be more lethal especially when it has a lung infection and affects people with chronic diseases in their lungs much more. Cortisone-style drugs used more frequently in asthma suppress the immune system and increase the risk of infection. If those with chronic lung disease such as asthma and COPD and therefore use cortisone, the risk increases exponentially.

Chronic Kidney and Liver Failure 

Patients with chronic kidney and liver failure, dialysis and cirrhosis are again the most risky group for this infection. These two conditions weaken the body's immune system and cause the virus to spread rapidly in the patient.

Cancer patients

As it is known, wherever the cancer is known, it is treated with treatments such as surgery, chemotherapy or radiotherapy, and these 3 treatments leave the body weak and make the patient open for all types of microbes. These patients are at the top of the most risky groups because their immune systems are weak. The risk is much higher in bone marrow-related cancers.Rheumatic patientsPerhaps one of the most risky groups is these patients. Because almost all drugs used in the treatment of rheumatism weaken the immune system and make patients vulnerable to virus infections such as corona.

What precautions should we take against coronavirus?

  • Let's not leave the house unless it is very compulsory.
  • Let's stay away from crowded environments.
  • Let's suspend visits between houses.
  • Let's wash our hands with soap when it comes to home and after contact with external environments.
  • Let's expand the use of cologne.
  • Let us take a break until the outbreak ends in our culture, such as shaking hands, kissing and embracing. If we are in the risky group, when we absolutely have to go out, let's wear a mask and change the masks frequently.
  • If we get sick, let's take ourselves to rest at home whether there is a corona or not, and make an effort not to spread the disease individually.If we have a flu infection and shortness of breath, burning in the chest, and bloody sputum, let's go to the nearest healthcare provider.Let's ventilate and clean our house and all the environments I live in frequently.
  • Let's pay utmost attention to hygiene conditions regarding the bathroom, toilet and kitchen utensils we use in common.In the presence of the disease, let's use a separate towel, plate, separate toilet and bathroom if possible.It will be more convenient for the individuals who are taken into custody at home with suspicion of the disease, to not take visitors for 14 days and to meet with the people at home to a minimum.
  • Let's not forget that if antiseptic solution is not available, bleach and many other cleaning materials, as well as cologs containing 70% alcohol or more, kill enough germs.People with complaints such as coughs and sneezes should then close their mouths and noses and wash their hands after nasal cleansing.It is especially important that we thoroughly wash and cook all our food. Because foods that are not fully washed and cooked are sources of disease.

How is the treatment of coronavirus infection?


Supportive therapy is applied only to patients whose diagnosis of coronavirus has been confirmed. A drug therapy specific to coronavirus is not yet available. Most people who are already infected have a mild illness and are completely cured.

Who is the risk group for new coronovirus infection?

Cough and / or shortness of breath and / or fever, and have been in close contact with someone with confirmed or suspected coronavirus infection in the past two weeks or in countries where the outbreak has been intense in the past two weeks (such as China, Iran, Italy, South Korea, Japan ) individuals are in a high risk group for coronavirus infection and should be evaluated as soon as possible.Meanwhile, every person suffering from high fever and cough may not have coronavirus infection. Upper respiratory tract infections such as seasonal influenza (influenza), pneumonia (pneumonia), sinusitis can also cause the same complaints. In order to make a differential diagnosis and to make a definitive diagnosis of coronavirus, the closest emergency department should be contacted in the presence of complaints related to the disease and the examinations deemed necessary under the physician's control should be performed.Those who are in countries such as China, South Korea where coronavirus is common or who are in the same environment with people who have been diagnosed with coronovirus are particularly at risk for transmission. A person infected with coronavirus may take time to show symptoms of the disease, and may have no complaints for 2 weeks. Similarly, the person who carries the coronavirus can infect the virus to others without getting sick, causing the disease to spread rapidly to many people.

Is there a vaccine to protect against coronavirus?

No. Also, having a flu vaccine does not protect against coronavirus.

How is coronavirus transmitted?Although the new coronavirus first appeared in wild animals and was transmitted to humans, the main spreading path is then transmitted from person to person via droplet.As far as is known, it is not transmitted from pets to humans.

Does wearing a mask protect from coronavirus?

The use of masks by non-coronavirus does not protect them from coronavirus; however, it can protect it from many other respiratory diseases.

General preventive measures against infection

* Hand hygiene: Washing your hands frequently and properly (at least half a minute, preferably for 1 minute) is the most important hygiene rule. Hands should be washed with soap and plenty of water, including the back of the hands and the inner part of the nails.Towels should be personal. Disposable paper towels are ideal or should be changed frequently if classic towels are used.In the event that there is no water or soap, cologne or hand disinfectants containing at least 60% alcohol can be carried in the form of sprays with 80 c spray.The coronavirus and many other infectious agents are transmitted by the droplets that are scattered from sick people through our mouth, nose and eyes (ie through the droplet) into our body. These droplets in the sick person can spread around a distance of up to one meter. In fact, these people can stick to the surfaces in their environment (door handle, elevator button, table, faucet, money, computer etc.) and the virus can maintain its vitality on these surfaces for a few days.The virus can be transmitted to you when you come into contact with the hand on the surfaces where the sick person is and contaminate the virus and then place your hand on your face (mouth, nose, or eye). Therefore, the most important way to protect yourself is to stay away from sick people, wash hands with soap and water (especially when you come home, before meals, after toilet) and to clean the environment with water and soap (or detergent).* Do not touch your face or the hands and face of others as much as possible, and if necessary, wash your hands before and after.* If you see someone coughing, sneezing, runny nose or fever, try to stay at least one meter away. If you live in the same house with this person, sit in a separate room as much as possible until you recover. Also take care of the hygiene of items such as towels, food, forks, spoons and glasses and not using them in common.* There is no evidence that coronavirus can be transmitted from pets (such as cats and dogs). Therefore, general hygiene principles apply for pets. Hands should be thoroughly washed with soap after touching the animals.* If you are sick, rest at home, wear a mask so that it does not infect other people. While coughing and sneezing, throw away a paper napkin and then wash your hands with soap.* Try to get adequate and hygienic nutrition. It is necessary to take plenty of fluids, to consume fresh-vegetable fruits, uncooked foods should be soaked in vinegar water for half an hour and then peeled and eaten.* Avoid crowd and people who cough or have a fever.* Masks should be used, especially in closed and crowded places.* Adequate and quality sleep should be paid attention.* Care should be taken to clean the environment, indoor environments should be ventilated to occur every day.* Sick people should avoid close contact.* If it is not necessary to travel to risky countries.* Information pollution in the internet and media or social environment should be avoided and the recommendations of your physician and competent people should be taken into consideration.* In case of cough, shortness of breath or fever, immediately contact the nearest emergency department and inform your doctor. Note that these complaints can have many causes other than coronavirus, and try to follow the physician's recommendations as best you can. Do not use antibiotics and do not insist on writing them unless the doctor recommends.

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