Browsing by Author "Abuhandan, M."
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Article Childhood Brucellosis: a Retrospective Study of 103 Cases(1999) Arslan, S.; Oner, A.F.; Caksen, H.; Cesur, Y.; Ceylan, A.; Atas, B.; Abuhandan, M.In this study, the clinical and laboratory findings of 103 patients who were followed in our hospital with the diagnosis of brucellosis in our hospital were reviewed retrospectively. Our purpose was to determine the initial drug combination used in its treatment, and to stress the importance of this disease as a public health problem in Turkey, particularly in the Van region. Of the 103 patients, 52 were female and 51 were male. The patients' ages ranged from 20 months to 16 years (mean 8.31 ± 3.58 years). The most observed symptoms were fever (55.3%), arthralgia (53.3%), malaise (41.7%) and loss of appetite (30%). The most observed signs were hepatosplenomegaly (22.5%), hepatomegaly (20.5%), arthritis (17.4%) and splenomegaly (15.5%). Anemia was present in 18 (17.4%) patients, leukopenia in eight (7.7%), and leukocytosis in 15 (14.5%). Erythrocyte sedimentation rate was studied in 84 (81.5%) patients; it was higher than 20 mm/hour in 52 (61.9%) patients. Liver function tests were studied in 55 (53.3%) patients; AST (aspartate aminotransferase) and ALT (alanine amino transferase) were abnormal in 31 (56.3%) and in 55 (53.3%) patients respectively. Brucella agglutination test was 1/160 or higher in all patients; it was ≥1/320 in most patients (83.5%). In the treatment, 12 types of drug combination used, primarily rifampin + co- trimoxazole, rifampin + tetracycline and streptomycin + co-trimoxazole. All except seven patients were successfully treated with the initial drug combination used. For the these seven patients, the initial drugs were changed for different drug regimens. There was no difference between the drug combination and recovery ratio (p>0.05). No relaps were noted.Article Clinical and Neurological Findings of Severe Vitamin B12 Deficiency in Infancy and Importance of Early Diagnosis and Treatment(2013) Demir, N.; Koc, A.; Üstyol, L.; Peker, E.; Abuhandan, M.Aim Nutritional vitamin B12 deficiency among children in developing countries may lead to a severe clinical status. In this article, the clinical manifestations of vitamin B12 deficiency and the consequences of delay in its diagnosis have been evaluated. Methods A total of 41 patients who were hospitalised and treated with the diagnosis of severe vitamin B12 deficiency in the paediatric haematology department of the hospital were enrolled in the trial. The diagnosis of severe vitamin B 12 deficiency was based on haematological values, a serum vitamin B12 level of <100 pg/mL and a normal level of folic acid. Mental, neuro-motor and social developments of the enrolled patients were assessed by the same physician using the Ankara Developmental Screening Inventory. Results The mean age of 25 male and 16 female patients was determined as 12 (6-18 months) months. Almost all of the children had been fed with breast milk and a poor nutritional state was found in all of the mothers. Non-specific findings such as growth retardation (78%), hyperpigmentation of the skin (78%), diarrhoea (63.4%), convulsion (14.6%), weakness, reluctance to eat, vomiting, irritability and tremor were found in all the patients, in addition to hypotonia, motor retardation and pallor. Treatment with vitamin B12 provided recovery in all the patients. The mean age of the patients with full recovery was 11.7 months, while the mean age of patients with partial recovery was 12.9 months. Conclusion As a delay in the diagnosis causes irreversible neurological damage, early diagnosis and treatment is highly important. © 2013 The Authors. Journal of Paediatrics and Child Health.Article Hyponatremic Dehydration: an Analysis of 78 Cases(2001) Çaksen, H.; Odabaş, D.; Şar, A.; Çelebi, V.; Arslan, S.; Kuru, M.; Abuhandan, M.Our purpose was to determine the frequency of convulsion in children with hyponatremic dehydration (HD). We also investigated whether or not there was a relationship between the severity of hyponatremia and the degrees of malnutrition in our region (Eastern Anatolia of Turkey) in where malnutrition is frequently observed. In this study, the clinical and laboratory findings of 78 patients with diarrhoea (acute, persistent or chronic diarrhoae) and HD were studied. When diarrhoea lasts longer than 2 and 4 weeks they were accepted as persistent and chronic diarrhoea, respectively. Patients were said to have HD if they had the clinical findings of dehydration associated with hyponatremia [Serum sodium (SNa) <130 mmol/L)]. Nutritional status of the children was assessed by the Gomez classification using weight for age; it was accepted as normal those were between 90%-110%, mild malnutrition 75%-89%, moderate malnutrition 60%-74% and severe malnutrition <60%. Of 78 patients, 40 were boys, 38 were girls. The age and weight of the patients ranged from 40 days to 36 months (8.94 ± 5.49 months) and from 2000 to 10300 g (5535.25 ± 1702.10 g) respectively. All patients except four had malnutrition; 15 (20.3%) had mild malnutrition, 30 (40.5%) had moderate malnutrition and 29 (39.2%) had severe malnutrition. Forty-seven patients had acute, 16 patients had persistent, and 15 patients had chronic diarrhoea. SNa levels were between 104 and 129 mmol/L (121.21 ± 6.12 mmol/L). There was not statistically a significant difference between SNa level and the degree of malnutrition, and SNa level and the types (acute, persistent or chronic) of diarrhoea (p > 0.05). Of 78 patients, 12 (15.3%) patients had convulsion, of whom eight had convulsion associated with fever. Convulsion was noted in nine (19.1%) and three (18.7%) patients with acute and persistent diarrhoea, respectively (p > 0.05). Also, we observed that when hyponatremia was severer, convulsions tended to be more occurring (p < 0.05). Five (6.4%) children died and all of them had severe malnutrition and septicemia. We determined that the frequency of convulsion in HD was 15.3% (12/78), and there was not a difference between the cases of acute, persistent and chronic diarrhoea for the frequency of convulsion. We also found a significant difference was not present between SNa level and the degree of malnutrition, and between SNa level and the types (acute, persistent or chronic) diarrhoea. However, we observed that when hyponatremia was severer, convulsions tended to be more occurring.Article The Preoperative and Postoperative Oxidative Status of Children With Chronic Adenotonsillar Hypertrophy(Soc Editrice Univ, 2013) Abuhandan, M.; Bozkus, F.; Demir, N.; Eren, E.; Koca, B.; Guler, O. Kadir; Selek, S.Aim. This study aimed to evaluate the preoperative and postoperative oxidative status of children with chronic adenotonsillar hypertrophy. Materials and Methods. The study comprised 25 patients with indications for tonsillectomy and/or adenoidectomy following a diagnosis of chronic adenotonsillar hypertrophy and 25 age-gender matched control patients were included to the study. Blood samples were taken from the patients preoperatively and at four weeks postoperatively. Preoperative and postoperative serum total oxidant (TOS) and total antioxidant (TAS) levels were measured and the oxidative stress index (OSI) was calculated. Results. The serum total oxidant level and oxidant stress index values in the preoperative and postoperative periods of the patients were found to be significantly high compared to those of the control group. While the preoperative serum total oxidant level values were found to be significantly high compared to the postoperative values, no statistical significance was found between the total antioxidant and oxidative stress index values. Conclusion. The development of chronic adenotonsillar hypertrophy plays a role in oxidative status and therefore, to neutralize high levels of oxidants in patients, the use of antioxidants for a period preoperatively and postoperatively is thought to be necessary.Article Splenic Abscess, Pleural Effusion and Severe Anemia Caused by Salmonella Typhi(2000) Çaksen, H.; Öner, A.F.; Arslan, Ş.; Köseoǧlu, B.; Harman, M.; Ataš, B.; Abuhandan, M.Various complications related to gastrointestinal system, central nervous system, and skeletal system may be observed during typhoid fever, but splenic abscess and pleural effusion are rarely encountered. A 12-year-old boy was admitted with fever, fatigue and pallor. On examination he had hepatosplenomegaly and severe anemia. He was diagnosed as having Salmonella typhi infection complicating with splenic abscess, pleural effusion and severe anemia, and successfully treated with percutaneous drainage with ultrasonography and antibiotics. In conclusion we would like to emphasize that typhoid fever should also be considered in patients with hepatosplenomegaly and severe anemia, and percutaneous drainage with ultrasonography may successfully be used in management of splenic abscess in typhoid fever.