Browsing by Author "Arslan, S"

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Bilateral Brachial Plexopathy Complicating Henoch-Schonlein Purpura
(Elsevier Science Bv, 2006) Yilmaz, C; Çaksen, H; Arslan, S; Anlar, Ö; Atas, B; Güven, AS; Odabas, D
An 11-year-old boy presented with convulsion, fever, rash, abdominal pain, swelling on the eyelids, elbow and wrists, oliguria and hematuria. Based on the abnormal findings the patient was diagnosed with Henoch-Schonlein purpura. On the 3rd day of admission, neurological examination showed ataxic gait, loss of deep tendon reflexes, and decreased (4/5) of muscle strength on all extremities. Additionally, bilateral loss of touch, pain and temperature sensation in a glove, from the elbows to distal region (on C5-T1 level) was diagnosed. Cerebrospinal fluid examination and cranial magnetic resonance imaging (MRI) were normal. The patient was discharged with oral prednisolone on the 7th day of admission. One week after discharging from the hospital, he was re-admitted with vertigo and seizures. He was in coma. MRI of cranial, cervical and cervical plexus were normal. Electromyography showed severe bilateral brachial plexopathy. Prednisolone and intravenous immunglobulin (IVIG) therapy were given without significant improvement. He was discharged from the hospital on the 17th day of admission. On the second month of follow-up, a second cure of IVIG was given because of no clinical improvement. Now, he is on the 4th month of follow-up, unfortunately, no improvement was noted on his muscle strength and sensorial abnormalities on the upper extremities. (c) 2006 Elsevier B.V. All rights reserved.
A Case of Allgrove (Triple A) Syndrome Associated With Renal Ectopia
(Medecine Et Hygiene, 2002) Çaksen, H; Cesur, Y; Kirimi, E; Üner, A; Arslan, S; Çelebi, V; Odabas, D
Allgrove syndrome (triple A syndrome) is an autosomal recessive disorder characterized by adrenocorticotropin hormone-resistant adrenal insufficiency, achalasia and alacrima. Aside from the classic features of the syndrome, several abnormalities including mainly neurological abnormalities have been reported in the syndrome. Herein, we presented a case of Allgrove syndrome associated with left renal ectopia. To the best of our knowledge renal abnormality in Allgrove syndrome has not been reported in the literature until now. We think that ectopic kidney diagnosed in our patient is coincidental because the incidence of renal ectopia is high, approximately I in 900 in population.
A Case of Chronic Renal Failure Misdiagnosed as Status Asthmaticus
(Elsevier Science inc, 2002) Çaksen, H; Odabas, D; Arslan, S
Central Nervous System Involvement in Childhood Brucellosis
(Elsevier Science inc, 2001) Çaksen, H; Odabas, D; Arslan, S
Childhood Brucellosis Is Still a Severe Problem in the Eastern Region of Turkey
(Sage Publications inc, 2002) Çaksen, H; Arslan, S; Öner, AF; Cesur, Y; Ceylan, A; Atas, B; Abuhandan, M
Cranial Computed Tomography in Purulent Meningitis of Childhood
(informa Healthcare, 2004) Tuncer, U; Çaksen, H; Arslan, S; Atas, B; Üner, A; Öner, AF; Odabas, D
The cranial computed tomography (CT),findings of 48 children with purulent meningitis were examined, prospectively, to determine the importance of cranial CT findings on the prognosis of childhood meningitis, in a developing country. The age of children ranged from 2 months to 13 years. Of 48 patients, 29 (60.5%) survived without sequelae, 13 (27%) survived with sequelae, and six (12.5%) died. Cranial CT was normal in 21 (43%) patients of 48 children with meningitis at admission. Abnormal CT findings were detected in 10, H, and 6 children in the groups of survived without sequelae, survived with sequelae, and deaths, respectively, at admission (p < .05) We found that CT scan results were correlated with neurological signs (p < .05). At least one or more cranial CTs were was re-taken in children in whom the first CT revealed abnormal findings; we did not find a statistically significant difference for the follow-up CT findings between the groups (p > .05). Hydrocephalus and subdural effusion were the commonest abnormal CT findings. In conclusion, our findings showed that cranial CT may safely be used to detect intracranial complications of meningitis in childhood and the ratio of sequelae and death were more common in children with abnormal cranial CT than those of normal cranial CT findings. Additionally, there was a positive correlation between CT scan results and neurological signs.
Deadly Nightshade (Atropa Belladonna) Intoxication
(Arnold, Hodder Headline Plc, 2003) Çaksen, H; Odabas, D; Akbayram, S; Cesur, Y; Arslan, S; Üner, A; Öner, AF
Deadly nightshade (Atropa belladonna) intoxication has been infrequently reported in both children and adults in the literature. In this article, the clinical and laboratory findings of 49 children with acute deadly nightshade intoxication are reviewed. Our purpose was to enlighten the findings of deadly nightshade intoxication in childhood. The most common observed symptoms and signs were meaningless speech, tachycardia, mydriasis, and flushing. None of the children required mechanical ventilation or died in our series. The patients were categorized into two groups, mild/moderate and severe intoxication. Children with and without encephalopathy were accepted as severe and mild/moderate intoxication, respectively. While 43 children were placed in the group of mild/moderate intoxication, six were in severe intoxication group. We found that meaningless speech, lethargy, and coma were more common, but tachycardia was less common in the severe intoxication group (children with encephalopathy) (P < 0.05). In the treatment, neostigmine was used in all children because of no available physostigmine in our country. In conclusion, our findings showed that the initial signs and symptoms of acute deadly nightshade intoxication might be severe in some children, but no permanent sequel and death were seen in children. We also showed that meaningless speech, lethargy, coma, and absence of tachycardia were ominous signs in deadly nightshade intoxication in childhood. Lastly, we suggest that neostigmine may be used in cases of deadly nightshade intoxication if physostigmine cannot be available.
Effects of High-Dose Methylprednisolone Therapy on Coagulation Factors in Patients With Acute Immune Thrombocytopenic Purpura
(Sage Publications inc, 2005) Oner, AF; Bay, A; Kuru, M; Uner, A; Arslan, S; Caksen, H
Autoimmune thrombocytopenic purpura (ITP) is a disease that presents with skin and mucous membrane bleeding due to thrombocytopenia. In the literature, there are a few studies about the effect of high-dose steroid therapy on coagulation tests in different diseases, but their results are still controversial. In this study, coagulation parameters were investigated that might have a role in hemostatic compensation in childhood acute ITP before and after highdose methylprednisolone (HDMP) treatment. The study includes 21 children age 1.5 to 14 years with acute ITP and 21 healthy age-matched control subjects. All patients with acute ITP received HDMP for 7 days. Before and after HDMP treatment (0 and 8 days) prothrombin time, partial thromboplastin time, fibrinogen, Protein C, Protein S, antithrombin 111, and the levels of factor II (FII), FV, FVII, FVIII, FIX, FX, FXI, and FXII were studied in all subjects. The results were compared with those of the control group. Pre-treatment Protein C and Protein S levels in the patient group were significantly lower than those in the control groups (p < 0.05). Protein S and Protein C levels were significantly improved after HDMP treatment in patient group. There were lower FV, FVII, FX values in the patient group compared to the control groups on admission. There was no difference in AT III and fibrinogen levels before and after treatment. As a result, some changes in the coagulation system associated with thrombocytopenia were observed in patients with acute ITP. These changes may be accepted as compensatory mechanisms to maintain hemostasis.
Genetic Parameter Estimations for Persistence of Milk Yield With Different Function Definition in Dairy Cattle
(Scientific Technical Research Council Turkey, 2004) Arslan, S; Mirtaghizadeh, H; Kesici, T
A data set containing 2-year test day milk yield records was used. Random regression model solutions established with a covariance function (CF) approach was used. Persistence and lactation curve explanation performances of polynomial, Wilmink and Ali-Schaeffer curve definitions were compared for CF. When comparisons were made for R-2 values, polynomial (0.9835) definition headed the list, followed by the Ali-Schaeffer curve (0.9534), and Wilmink curve (0.6023) definitions. Among the persistence predictions in respect of lactation orders, the Ali-Schaeffer curve provided predictions with the minimum variance, followed by the Wilmink and polynomial curve approaches. All of the curve definitions were in accord with the literature.
A Girl With a Giant Bladder Stone
(Elsevier Science inc, 2004) Atas, B; Caksen, H; Arslan, S; Akbayram, S; Kirimi, E; Tuncer, O; Kayan, M
Hyperkalemia Most Likely Associated With Massive Cephalhematoma in a Newborn Infant Who Was Treated With Urgent Peritoneal Dialysis: Case Report
(Elsevier Science inc, 2003) Kirimi, E; Tuncer, O; Atlas, B; Arslan, S
Cephalhematomas rarely lead to serious complications such as infection, osteomyelitis and skull fractures. However, we present a newborn infant with hyperkalemia in the context of a serious complication believed to be caused by hemolysis of a large cephalhematoma. The patient was treated with urgent peritoneal dialysis and discharged with a successful outcome. In conclusion, neonates with massive cephalhematoma should be closely examined in terms of bilirubin counts as well as electrolyte counts. (C) 2003 Elsevier Science Inc.
Immunoglobulin Subgroups in Children With Febrile Seizures
(Blackwell Science Asia, 2001) Çaksen, H; Öner, AF; Arslan, S; Kan, MC; Cesur, Y; Üner, A
Background: The aim of the present study was to determine whether or not there was a role for immunoglobulin (Ig) or IgG subgroups in the pathogenesis of febrile seizures (FS). Methods: Serum levels of IgA, total IgG, IgM, IgE, IgG1, IgG2, IgG3 and IgG4 were measured in 34 children with FS and in 37 healthy children used as a control group. Both patients and controls were divided into two groups according to age (group I, 6-24 months; group II, 25-72 months). Results: Compared with controls, mean IgG4 levels in patients were found to be decreased in both groups I and II (group I: 95+/-14 vs 57+/-5, respectively, P=0.01; group II: 178.5+/-38.5 vs 65.1+/-24.5, respectively, P <0.01), while mean IgG2 levels were found to be decreased only in group II patients (170+/-16 vs 103+/-22; P <0.05). Conclusions: The results of the present study suggest that Ig subclass deficiencies may be responsible for the infections connected with FS or that they may be related to the pathogenesis of FS in some children.
Myoglobinuric Renal Failure - Response
(Elsevier Science inc, 2004) Kirimi, E; Tuncer, O; Atas, B; Arslan, S; Ataş, B.; Arslan, S.
Palmoplantar Keratoderma Is Associated With Esophagus Squamous Cell Cancer in Van Region of Turkey: a Case Control Study
(Bmc, 2005) Ilhan, M; Erbaydar, T; Akdeniz, N; Arslan, S
Background: Esophagus squamous cell cancer (ESCC) is the most common cancer in women with 20.2% and second in men with 10.7% relative frequency among all cancer cases diagnosed in Van Region in the east of Turkey. Ninety percent of all esophageal cancer cases are ESCC and 20 - 30% of them have family history of esophageal cancer. The most clear defined hereditary predisposition associated with ESCC is palmoplantar keratoderma (PPK). To examine the relationship between ESCC and PPK, we have carried out this case control study. Methods: The case group consisted of 48 subjects who had new diagnosis of ESCC and did not receive any chemo or radiotherapy. The control group consisted of 96 healthy individuals who were visitors of their relatives in the hospital. Two control persons who matched for age, gender, living place (urban/rural) and region were selected for each case. All subjects were evaluated for PPK by dermatologist. Evaluation was graded as none, mild, evident and severe. None and mild subjects were classified as negative for PPK; and others as positive. Relationship between ESCC and PPK was evaluated with odds ratios and confidence intervals for cases with or without family history of ESCC. Results: The PPK frequencies were 92.3% in ESCC cases with family history, 62.5% in ESCC cases without family history, 70.8% in all ESCC cases, and 28.1% in the control group. Odds ratios for cases with or without family history of esophageal cancer, and for the whole case group were found as 30.7 (95% CI = 3.8 - 247.4), 4.3 ( 95% CI = 1.9 - 9.8) and 6.2 ( 95% CI = 2.9 - 13.3) respectively. Conclusion: Presence of PPK lesions represents genetic susceptibility for ESCC. This susceptibility for ESCC is the highest among those who have PPK lesions and a positive family history of esophageal cancer. Furthermore, a PPK sufferer has an increased risk of developing ESCC even if there is no family history of esophageal cancer.
Pfapa Syndrome Mimicking Familial Mediterranean Fever
(Elsevier Science inc, 2003) Atas, B; Çaksen, H; Arslan, S; Tuncer, O; Kirimi, E; Odabas, D
The PFAPA (Periodic Fever, Aphthous stomatitis, Pharyngitis, Adenitidis) syndrome is characterized by periodic fever, adenitis, pharyngitis, and aphthous stomatitis. Herein, we present a Turkish child with PFAPA syndrome mimicking familial Mediterranean fever because of a rare presentation. A 9-year-old boy was admitted with recurrent fever, aphthous stomatitis, sore throat, headache, and general body pains, lasting 2 to 3 days since 3.5 years of age. He was completely symptom-free between the attacks. He was diagnosed as having familial Mediterranean fever according to the clinical findings when he was 6 years of age and Colchicum tablet was administrated. Despite colchicines therapy for 8 months, his attacks did not subside; therefore, the drug was discontinued. He had high fever, a painful cervical lymphadenopathy, aphthous stomatitis, and tonsillo-pharyngitis. The patient was then diagnosed as having PFAPA syndrome: He was given a single dose of prednisolone (0.35 mg/kg/dose). His complaints dramatically and completely disappeared 3 h after administration of the drug. During the 8(th) month of follow-up, a similar febrile attack lasting only 1 day was noted and it was controlled with a single dose of prednisolone (0.5 mg/kg/day). At this writing the patient is in the 12(th) month of follow-up, and there have,been no symptoms after the second attack. In conclusion, our patient shows that PFAPA syndrome can be confused with familial Mediterranean fever. We also would like to emphasize that the typical PFAPA syndrome can be easily diagnosed by detailed history-taking and physical findings. 2003 Elsevier Inc.
Prognostic Factors in Children With Purulent Meningitis in Turkey
(Okayama Univ Med School, 2003) Kirimi, E; Tuncer, O; Arslan, S; Atas, B; Çaksen, H; Üner, A; Odabas, D
In this study the clinical and laboratory findings of 48 children with purulent meningitis were examined, prospectively, to determine the prognostic factors in childhood meningitis in a developing country. Patients were examined for the following variables: history of antibiotic use; period between onset of symptoms and hospital admission; age at presentation; sex; fever; convulsion; level of consciousness; malnutrition; anemia; leukocyte and thrombocyte counts; erythrocyte sedimentation rate; serum C-reactive protein (CRP) level; and cerebrospinal fluid (CSF) including white blood cell count; glucose, protein, and CRP concentrations; antibiotic treatment; neurological sequelae; and fatality rate during the hospital stay. Most of these parameters were re-evaluated in all patients 36-48 h after admission. Patients were divided into 3 groups: surviving without sequelae, surviving with sequelae, and not surviving (deceased). A total of 48 children, 19 girls (39.5%) and 29 boys (60.5%), aged 2 months to 13 years, were included in the study. Of the 48 patients, 29 (60.5%) survived without sequelae, 13 (27%) survived with sequelae and 6 (12.5%) died. In a comparison among groups, we found that absence of anemia, low (< 1,000) CSF white blood cell (WBC) count, and high CRP level at admission were the indicative of poor prognosis. Thirty-six to 48 h after admission, the presence of fever, depressed level of consciousness, high (> 1,000) CSF WBC count, and low CRP level were also poor prognostic factors. In addition, we observed that mortality rate was lower in the penicillin G+ chloramphenicol group than in the ampicillin-sulbactam + cefotaxime group (P < 0.05). The mean period between onset of symptoms and hospital admission was longer in the surviving with sequelae and in the not surviving groups than in the surviving without sequelae group (P < 0.05).
Report of Eight Children With Amitraz Intoxication
(Arnold, Hodder Headline Plc, 2003) Çaksen, H; Odabas, D; Arslan, S; Akgün, C; Atas, B; Akbayram, S; Tuncer, O
Many pesticides are formulated in organic solvents. An example is amitraz, one of the formamidine groups of pesticidal chemicals. It is commonly used for the treatment of generalized demodicosis in dogs and for the control of ticks and mites in cattle and sheep. In this article, the clinical and laboratory findings of eight children with amitraz intoxication are reviewed. The purpose was to enlighten the findings of amitraz intoxication in children. Of the eight patients, five (62.5%) were boys, three (37.5%) were girls, and the ages ranged from 1 to 4 years. All children accidentally ingested amitraz orally, with no dermal exposure. The most common observed signs were decreased consciousness and bradycardia. Leukocytosis, hyperglycemia, hypernatremia, increased serum aspartate transaminase level, and prolonged partial prothrombin time were diagnosed in children. None of the children had hypothermia, hypotension, or convulsion and none of the patients died. The findings show that the initial signs and symptoms of acute amitraz intoxication appeared severe but they disappeared, with only supportive care needed in most cases within a few days.
Report of Eight Infants With Acute Infantile Hemorrhagic Edema and Review of the Literature
(Japanese dermatolgical Assoc, 2002) Çaksen, H; Odabas, D; Kösem, M; Arslan, S; Öner, AF; Atas, B; Ceylan, N
Acute infantile hemorrhagic edema (AIHE) is a cutaneous leukocytoclastic vasculitis, clinically characterized by the symptom triad of fever, large purpuric skin lesions, and edema. The clinical picture has a violent onset, a short benign course, and spontaneous complete recovery. In this article, we present eight patients who were admitted with rashes on the skin and edema on the eyelids and extremities, and were diagnosed with AIHE according to their clinical and histopathological features (immunohistological study was also performed in three of them). Our purpose was to emphasize that, aside from Henoch-Schonlein purpura, meningococcemia, septicemia, and purpura fulminans, AIHE benign disorder should also he considered in the differential diagnosis to determine the clinical course and treatment protocol in patients with purpuric rashes.
Report of Five Children With Guillain-Barre Syndrome Following a Nationwide Oral Polio Vaccine Campaign in Turkey
(Neurol Soc india, 2003) Anlar, O; Tombul, T; Arslan, S; Akdeniz, H; Caksen, H; Gundem, A; Akbayram, S
Five children with Guillain-Barre syndrome (GBS), following a national oral polio vaccination campaign to eradicate disease, are reported. Clinical examination, cerebrospinal fluid and electromyographic findings conformed to the classical description of GBS. Four of them received therapeutic dose of intravenous immunoglobulin G. Two children succumbed to the disease. It was observed that the number of cases of,GBS in children increased during the period of the oral polio vaccination campaign in Turkey, suggesting a causal relationship.
Septicaemia and Meningitis in an Infant
(Blackwell Publishing Asia, 2001) Arslan, S; Bozkurt, H; Güdücüoglu, H; Berktas, M; Çaksen, H; Akçay, G