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    Comparison between the use of saline and seawater for nasal obstruction in children under 2 years of age with acute upper respiratory infection
    (Tubitak Scientific & Technological Research Council Turkey, 2016) Koksal, Tulin; Cizmeci, Mehmet Nevzat; Bozkaya, Davut; Kanburoglu, Mehmet Kenan; Sahin, Sanliay; Tas, Tugba; Yuksel, Cigdem Nukhet
    Background/aim: The effectiveness of isotonic and hypertonic saline solutions used to open the nasal passage and improve clinical symptoms was compared in children under 2 years of age admitted with the common cold. Materials and methods: The study was performed as a randomized, prospective, and double-blind study. The study included 109 children. The children using saline (0.9%) and seawater (2.3%) as nasal drops (the patient group) and the control group (in which nasal drops were not administered) were compared. Seventy-four patients received nasal drops from package A (seawater) in single days and from package B (physiological saline) in double days. Results: The mean age of the patients was 9.0 +/- 3.9 months and the numbers of boys and girls were 65 (59.6%) and 44 (40.4%), respectively. There was no significant difference between Groups A and B in terms of nasal congestion (P > 0.05). However, a significant difference was found between the control group and Groups A and B (P < 0.05). Conclusion: Relief was seen in nasal congestion, weakness, sleep quality, and nutrition with the use of both saline and seawater in children with the common cold. Seawater or saline drops may be added to standard treatment protocols.
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    Cost-effectiveness of rotavirus vaccination in Turkey
    (Elsevier Taiwan, 2017) Koksal, Tulin; Akelma, Ahmet Zulfikar; Koksal, Ali Osman; Kutukoglu, Irem; Ozdemir, Osman; Yuksel, Cigdem Nuket; Bozkaya, Davut
    Background/Purpose: Cost-effectiveness studies about rotavirus (RV) vaccination programs were performed in many countries due to the severe economic burden of RV infections. This study is an economic evaluation performed to assess the potential for introducing the RV vaccine to the Turkish National Immunization Program. Methods: In this retrospective clinical study, the records and laboratory findings of a total of 4126 patients admitted to Turgut Ozal University Hospital, Ankara, Turkey with acute gastroenteritis were analyzed. A model described by Parashar et al. was used to obtain the annual episodes of diarrhea, hospitalization and outpatients visits in Turkey. Monovalent and pentavalent vaccination was assumed to protect in average 85% of RV acute gastroenteritis. All costs are expressed in 2012 United States (US) $, where US$1 equals 1.8 Turkish Liras (TL). Losses of labor costs were not taken into consideration. Results: The vaccination program with 85% coverage was cost effective and cost saving compared to no vaccination. A projected birth cohort of 1.25 million children was followed until 5 years of age; a routine vaccination could potentially avert 210,994 cases of diarrhea treated in outpatient hospital facilities and 42,715 hospitalizations. The RV associated economic burden was obtained as US$17,909 million per year (US$14.33 per birth annually) in medical direct costs by using the national level of RV diarrhea disease burden estimates. For monovalent and pentavalent vaccination, assuming a cost of US$31.5 and US$38 per vaccine course, the cost of the vaccination program was estimated to be approximately US$37,878 million and US$45,475 million, respectively. Conclusion: At a cost per vaccine course of US$31.5 for monovalent and US$38 for pentavalent vaccine, routine RV vaccination could be potentially cost effective and also cost saving in Turkey. National RV vaccinations will play a significant role in preventing RV infections. Copyright (C) 2016, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC.