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Background Nasal nitric oxide (nNO), a noninvasive indicator for eosinophilic airway inflammation, has not been adequately studied in different types of rhinitis. The aim of this study was to compare nNO levels between allergic (AR) and non-allergic rhinitis (NAR). Patients were included based on their chronic nasal symptoms. Total nasal symptoms score (TNSS) were evaluated. nNO was measured transnasally with a flow of 5 ml/s from the nostril with an NO analyzer (NIOX MINO; Aerocrine, Sweden). Results were evaluated as parts per billion (ppb). Results Four hundred forty-three patients (277 F/166 M)—337 with AR (76%) and 106 with NAR (24%)—were assessed. Patients with AR had significantly higher TNSS, more severe disease, and longer duration of disease compared to NAR group. Allergic rhinitis had significantly higher nNO levels than NAR (370 ppb vs 290 ppb) (p = 0.001). Likewise, significant differences were observed in female gender, in patients with BMI ≥ 25 kg/m2 and those without sinusitis between the two groups. When nNO were further evaluated in comorbid asthma, patients with AR w/o asthma had the highest TNSS and had significantly higher nNO level (p < 0.001). NAR+A group, with the longest duration of rhinitis, was significantly older and had the lowest nNO level (p < 0.001). Conclusions This study showed that nNO levels were significantly higher in AR patients than NAR. Although there is no recommended standard threshold for nNO, this study confirmed the utility of nNO in differentiating AR and NAR in addition to its known fast and non-invasive advantages.

β-Lactams, particularly penicillins, may cause several allergic reactions. We described symmetric drugrelated intertriginous and flexural exanthema (SDRIFE) illness in this case, a rare instance of systemic contact dermatitis caused by amoxicillin/clavulanic acid that needs to be considered in the differential diagnosis. A 65-year-old male patient was admitted to our Allergy Outpatient Clinic because of increased blue-purple pigmentation on the flexural surfaces of the hip, forearm, axilla, and posterior face of the neck. The patient was receiving a combination of angiotensin receptor blocker (ARB) and hydrochlorothiazide diuretic medication for hypertension. The patient used an antibiotic containing amoxicillin three months ago; As a result, there was localized redness, itching, and black spotting without any systemic symptoms. Similarly, the patient reported that when he used amoxicillin for an upper respiratory tract infection eight months ago, he experienced similar side effects within 20 days and recovered when he applied corticosteroid ointment.Due to the symmetrical site involvement following the consumption of penicillin group antibiotics with a five-month gap and subsequent comparable reactions in our patient, SDRIFE was taken into consideration. The results of the skin punch biopsy identified Baboon Syndrome (SDRIFE). Treatment with topical corticosteroids and antihistamines began. Clinically speaking, SDRIFE is distinguished by significant erythema of the gluteal/perianal area and/or V-shaped erythema of the inguinal/perigenital area, symmetric involvement of at least one other intertriginous or flexural area, and the absence of systemic signs or symptoms. The possibility that the medication may have contributed to the patient's erythematous eruption in the flexural regions should be taken into account, and the patient should be advised to stop taking the medication and not use it again.

It has been observed in many different populations that circadian blood pressure (BP) patterns have a significant impact on cardiovascular (CV) results. Important predictors of CV morbidity and mortality are known as non-dipper (ND) and reverse-dipper (RD) BP pattern. RD and ND patterns are frequently encountered in many normotensive patients in daily practice. Methods: The purpose of this study is to evaluate the frequency and quality of sleep, especially in normotensive young individuals, by using sleep questionnaires and to evaluate their relationship with poor BP patterns. A total of 195 normotensive patients (68 dippers, 63 ND, and 65 RD) were enrolled into this cross-sectional study. The insomnia severity index (ISI), Epworth sleepiness scale (ESS), and Pittsburgh sleep quality index (PSQI) approved questionnaires were applied to evaluate the presence and severity of sleep disorders and to determine the patient's sleep quality. Results: When dipper and ND groups were compared, significant differences were observed in ISI, ESS, and PSQI (p<0.001). Then, the study patients were re-evaluated as dipper, ND, and RD groups and seen this significant difference continued (p<0.001). Also, the sleep time was significantly different between all groups of dipper (7.23±0.11 hours), ND (6.72±0.15 hours), and RD (5.79±0.11 hours) (p<0.001). In the correlation analysis, a significant inverse relationship was observed between sleep time and all survey results (p<0.05). Conclusions: RD and ND patterns are associated with sleep quality in healthy individuals. It is necessary to evaluate patients with RD and ND BP patterns in normotensive individuals in terms of sleep disorders in detail.

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