Browsing by Author "Demir, N."

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Acute Peritoneal Dialysis in Critically Ill Newborns
(Springer, 2016) Ustyol, L.; Peker, E.; Demir, N.; Agengin, K.; Tuncer, O.
Assessing of Term Newborns Hospitalized in Our Neonatal Unit With the Diagnosis of Indirect Hyperbilirubinemia
(Anatolian Journal of Clinical Investigation, 2015) Demir, N.; Peker, E.; Aslan, O.; Ceylan, N.; Tuncer, O.
The one of most common problems of the newborn baby is indirect hyperbilirubinemia. In this retrospective study; the etiology, clinical and demographic features, treatment methods, and the complications in pathological indirect hyperbilirubinemia and prolonged jaundice were evaluated. 237 cases of pathological indirect hyperbilirubinemia and prolonged jaundice that were viewed in Yüzüncü Yıl University Hospital Neonatology Unit between January 2013 - December 2014 were included in this study. All neonates in the study with following characteristics: 57.8% of patients were male, the mean gestational age of 38.4 ± 1 weeks, mean birth weight of 2870 ± 505 g , mean bilirubin level on admission of 21.6 ± 5.6 mg/dL (13–49), vaginal delivery ratio of 55.7%, first time mother ratio of 34.2%, breastfeeding ratio of 98%. While in 95 (40.1 %) neonates the etiology of hyperbilirubinemia could not be found, urinary tract infection in 34 (14.3%), ABO incompatability in 72 (30.4%) and Rh incompatability in 24 (% 10.1) patients were found. The average length of stay in the hospital and duration of phototherapy were 4 ± 2.9 days and 37.2 ± 14.2 hours, respectively. All of the cases were given phototherapy, but 44 infants were done exchange transfusions. We found that bilurubin induced neurological disorder in 23 newborn had undergone exchange transfusion, and its the most important risk factorwas ABO incompatability (43.2 %). Urinary tract infection (30.8%), and idiopathic causes (42.3 %) were found as the most important risk factors for prolonged jaundice.Pathological indirect hyperbilirubinemia is a major cause of morbidity and mortality in the newborn period. We think that newborns with jaundice should be diagnosis, treatment, and close follow-up in order to prevent development of bilirubin-induced neurologic dysfunction. © 2015, Anatolian Journal of Clinical Investigation. All rights reserved.
Assessment of Cardiac Functions in Infants With Cow's Milk Allergy
(International Scientific Literature Inc., 2014) Ece, I.; Demirören, K.; Demir, N.; Uner, A.; Balli, S.
Background: Cow's milk allergy is the most common food allergy in children, with rates estimated at 1.9% to 4.9%. Clinical phenotypes of cow's milk allergy are varied and involve 1 or more target organs, with the main targets being the skin, respiratory system, and gastrointestinal tract. To date, no studies have investigated detailed cardiac function in children with cow's milk allergy. The current study aimed to investigate cardiac function in infants with cow's milk allergy. Material/Methods: We studied 42 infants with cow's milk allergy and 30 age- and sex-matched healthy subjects. Cardiac functions were evaluated by M-mode, pulsed-wave, and tissue Doppler echocardiography. Results: There were no significant differences in ejection fraction or mitral and tricuspid annular plane systolic excursion between the 2 groups. Pulsed-wave Doppler-derived E/A ratios in mitral and tricuspid valves were similar in both groups. Ea/Aa ratios in the left ventricle posterior wall and right ventricle free wall were lower in patients with cow's milk allergy than in the control group. The E/Ea ratio in the left ventricle, isovolumic relaxation time, deceleration time, and right and left ventricular myocardial performance indices were higher in patients in the study group. Conclusions: Our study identified reduced early diastolic tissue Doppler velocities in infants with cow's milk allergy. © Med Sci Monit, 2014.
Association of Down Syndrome and Morgagni Hernia
(Medecine Et Hygiene, 2014) Taskin, G. Alpaslan; Tuncer, O.; Demir, N.; Bilici, S.; Aktar, F.; Peker, E.; Uner, A.
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.
Efficacy and Safety of Rectal Ibuprofen for Ductus Arteriosus Closure in Very Low Birth Weight Infants
(Springer, 2016) Demir, N.; Peker, E.; Ece, I.; Balahoroglu, R.; Tuncer, O.
Evaluation of the Causes of Early and Late Thrombocytopenia in the Newborn
(OrtadogÂ u Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2018) Karaman, K.; Demir, N.; Çetin, M.; Geylan, H.; Değer, İ.; Başaranoğlu, M.; Öner, A.F.
Objective: Thrombocytopenia is the most common hematological disorder that is encountered in the neonatal intensive care unit (NICU). The incidence of thrombocytopenia in neonates may varies greatly depending upon admitted patients population of unit. This study was performed on neonates admitted to Yuzuncu Yil University of Dursun Odabaş Medical Center of NICU, the incidence and causes of thrombocytopenia. Material and Methods: This retrospective study was conducted on the medical records of all neonates hospitalized at our hospital between May 2012 and March 2015 and those with thrombocytopenia were included in the study. The laboratory results of these newborns were retrospectively screened from the computer program and files, and included in the study were those with a thrombocytopenia level of less than 150.000/μL. Results: About 2780 patients were admitted to our neonatal intensive care unit during the study period. Of the 2780 neonates, 117 (4.2%) had thrombocytopenia (60.7% early onset and 39.3% late onset). Seventy-two of them (61.5%) were preterm. Intrauterine growth restriction, maternal hypertension, respiratory distress syndrome and sepsis were more common causes. Severe thrombocytopenia (<50.000/µL rate was found in 27% of neonates. In addition, although the rate of thrombocytopenia in asfixia was reported in the literature as 12-14%, this rate was 6.8% in our cases. There was no relation between occurrence of thrombocytopenia and gender. Conclusion: This study reveals that the causes of neonatal thrombocytopenia may show variations. In our study, intrauterine growth restriction, maternal hypertension, respiratory distress syndrome, and sepsis seem to be important risk factors for thrombocytopenia in neonates. Copyright © 2018 by Türkiye Klinikleri.
Hyperlipidemia in Infant Case of Acute Monoblastic Leukemia
(Yuzuncu Yil Universitesi Tip Fakultesi, 2016) Ece, İ.; Dogan, M.; Akbayram, S.; Ceylan, N.; Demir, N.; Demirören, K.
Severe hyperlipidemia is a rare presentation usually associated with acute myeloid leukemia. 2-month-old girl complaining of discomfort. Her skin and conjunctivae were pale, abdominal distention and 5 cm hepatosplenomegaly were determined. Blood count revealed anemia (10 g/dL) and thrombocytopenia (41x109/L). Total leukocyte count was 24x109/L, and on blood smear, 58% blast and 42% lymphocytes were seen. Bone marrow aspirate revealed diffuse infiltration with blast cells consistent with acute monoblastic leukemia. Her plasma had a milky appearance. In the laboratory examination, triglyceride level was 1428 mg/dl, cholesterol level was 1291 mg/dl. This case report illustrate that the hematological malignancies may present with severe hypertriglyceridemia. © 2016, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Impact of Patent Ductus Arteriosus and Subsequent Therapy With Ibuprofen on the Release of S-100b and Oxidative Stress Index in Preterm Infants
(International Scientific Literature Inc., 2014) Demir, N.; Ece, İ.; Peker, E.; Kaba, S.; Ustyol, L.; Balahoroğlu, R.; Tuncer, O.
Background: Hemodynamically significant patent ductus arteriosus (hsPDA) leads to injury in tissues/organs by reducing perfusion of organs and causing oxidative stress. The purpose of this study was to evaluate the oxidant/antioxidant status in preterm infants with hsPDA by measuring the total antioxidant capacity and total oxidant status and to assess neuronal damage due to oxidant stress related to hsPDA.; Material/Methods: This prospective study included 37 low-birth-weight infants with echocardiographically diagnosed hsPDA treated with oral ibuprofen and a control group of 40 infants without PDA. Blood samples were taken from all infants, and than the total antioxidant capacity (TAC), total oxidant status (TOS), and S-100B protein levels were assessed and oxidative stress index was calculated before and after therapy.; Results: The mean pre-therapy TOS level and oxidative stress index (OSI) value of the patients with hsPDA were significantly higher, but TAC level was lower than in the control group. There were no statistically significant differences in the mean post-therapy values of TOS, TAC, OSI, and S-100B protein between the two groups.; Conclusions: hsPDA may cause cellular injury by increasing oxidative stress and damaging tissue perfusion; however the brain can compensate for oxidative stress and impaired tissue perfusion through well-developed autoregulation systems to decrease tissue injury. © Med Sci Monit 2014.
An Interesting Coexistence of Patau Syndrome; Spigelian Hernia and Undescended Testes
(Medecine Et Hygiene, 2014) Demir, N.; Tuncer, O.; Peker, E.; Bilici, S.; Yavuz, A.
A Late Diagnosis of Vein of Galen Aneurysm in Newborn
(Yuzuncu Yil Universitesi Tip Fakultesi, 2015) Demir, N.; Ece, İ.; Batur, A.; Peker, E.; Tuncer, O.
The Levels of Vitamin B12, Folate, and Homocysteine in a Population With High Prevalence of Neural Tube Defects
(Springer, 2016) Peker, E.; Demir, N.; Tuncer, O.; Ustyol, L.; Balaharoglu, R.; Kaba, S.; Karaman, K.
A Male Newborn With Simpson-Golabi Syndrome, Presenting With Metopic Synostosis, Anal Atresia, and Total Anomalous Pulmonary Venous Return
(Medecine Et Hygiene, 2014) Demir, N.; Peker, E.; Ece, I.; Kaba, S.; Dogan, M.; Tuncer, O.
A male newborn with Simpson-Golabi-Behmel syndrome, presenting with metopic synostosis, anal atresia, and total anomalous pulmonary venous return: Simpson-Golabi-Behmel syndrome is a clinical condition described by Simpson, characterized with multiple congenital anomalies and caused by Glypican 3 (GPC3) mutations of the X-linked gene. Typical findings such as overgrowth, hypoplastic changes of hands and feet, visceromegaly, cleft palate and macrocephalic distinctive facial features and multiple organ anomalies might be observed. GPC3 mutation is claimed to generally cause metopic synostosis. This case was reported because even though a lot of anomalies accompanying Simpson-Golabi-Behmel syndrome had been noticed, combination of metopic synostosis, has not been reported before.
Massive Gastrointestinal Bleeding Due To Vitamin K Deficiency in a Newborn
(Yuzuncu Yil Universitesi Tip Fakultesi, 2015) Demir, N.; Peker, E.; Demirören, K.; Kaba, S.; Tuncer, O.
Early hemorrhagic disease of the newborn is a disease resulting from vitamin K deficiency, developing within the first 24 hours after birth. The disease may develop in babies born to mothers treated with anticonvulsants and antituberculous drugs, and sometimes as an idiopathic state despite prophylaxis with vitamin K. In this article, a case of early hemorrhagic disease in a newborn, presenting with a course of abundant gastrointestinal bleeding, has been discussed, who was born to mother with no risk factors and no history of drug use during pregnancy, with the disease onset in the first 24 hrs after birth despite administration of 1 mg vitamin K. With this article, we intended to point out that idiopathic early hemorrhagic disease may develop in newborns. © 2015, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Megalencephaly, Polymicrogyria, Polydactyly and Hydrocephalus (Mpph) Syndrome: a New Case With Occipital Encephalocele and Cleft Palate
(Medecine Et Hygiene, 2015) Demir, N.; Peker, E.; Gulsen, I.; Kaba, S.; Tuncer, O.
Megalencephaly, polymicrogyria, polydactyly and hydrocephalus (MPPH) syndrome: a new case with occipital encephalocele and cleft palate: The megalencephaly, polymicrogyria, polydactyly, and hydrocephalus (MPPH) syndrome is quite rarely seen. The four main findings in this syndrome may be accompanied by severe psychomotor retardation, blindness, hypotonia, convulsions, and facial dysmorphism. In this paper, we present a female newborn at 39 weeks gestational age born to parents who are first degree cousins. Beside the facial dysmorphism and four main features of the MPPH syndrome, the findings on the physical examination of the patient were, hypertonicity, occipital encephalocele, cleft palate, and multiple polyps in the tongue. The presence of occipital encephalocele, cleft palate, and polyps in the tongue in this patient was not reported previously in the literature.
Pierre Robin Sequence With H-Type Tracheoesophageal Fistula and Congenital Heart Disease
(2013) Demir, N.; Peker, E.; Tuncer, O.; Üstyol, L.; Bulan, K.
Pierre Robin sequence (PRs) is a congenital disease characterized by micrognathia, cleft palate, glossoptosis and a wide range of other anomalies. The treatment of patients with PRs may be problematic due to the varying anomalies and high mortality rate. In this case report, a 1-day-old newborn with micrognathia, cleft lip and palate, glossoptosis, a membranous ventricular septal defect and an H-type tracheoesophageal fistula has been evaluated and discussed considering the current literature. To the best of our knowledge, the coexistence of PRs with a membranous ventricular septal defect and H-type tracheoesophageal fistula has not been previously described. © 2013 Elsevier Ireland Ltd.
Powder Topical Rifampicin on Reducing Infections After Neural Tube Defect (Ntd) Surgery in Infants
(Springer, 2016) Demir, N.; Peker, E.; Gulsen, I.; Kocaman, S.; Tuncer, O.; Kirimi, E.
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.
A Rare Cause of Metabolic Acidosis; Hypoplastic Left Heart Syndrome
(Yuzuncu Yil Universitesi Tip Fakultesi, 2015) Demir, N.; Ece, İ.; Demirören, K.; Ceylan, N.; Peker, E.; Tuncer, O.
Metabolic acidosis is a common problem especially in newborns. Metabolic acidosis develops due to acid deposition rather than HCO3 loss in body fluids. It separates into two groups as anion gap normal and anion gap increased depending on anion gap level. Metabolic diseases, neonatal sepsis, congenital adrenal hyperplasia and congenital heart diseases should be thought with the observation of metabolic acidosis in a previously healthy infants. NaHCO3 infusion, renal replacement treatment and tamps like karbicarb, dichlora acetate, tromethamine are used for treatment of congenital heart diseases or lactic acidosis secondary to hypoxia. In this article we want to emphasize there are not only congenital metabolic illnesses under this non-response acidosis table but also there are congenital heart diseases which are in substantial rate. © 2015, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Role of Circulating Nesfatin-1 in the Underweight Children With Poor Appetite
(verduci Publisher, 2015) Kaba, S.; Karaman, K.; Komuroglu, U.; Bala, K. A.; Demir, N.; Kocaman, S.; Ceylan, N.
OBJECTIVE: To investigate serum concentration of nesfatin-1 in underweight children who have poor appetite, and its association with anthropometric markers of malnutrition. PATIENTS AND METHODS: We recruited 50 underweight children and adolescents (aged 2-18 years) who presented with loss of appetite. Thirty age-and sex-matched controls were also included in the study. Fasting serum nesfatin-1 concentrations were measured by using Enzyme-Linked Immunosorbent Assay (ELISA) technique. RESULTS: Mean nesfatin-1 level was significantly higher in underweight children when compared to controls (p < 0.001). There was no correlation between serum nesfatin-1 levels and anthropometrics markers. CONCLUSIONS: Our results suggest that nesfatin-1 might have an important role in regulation of food intake and pathogenesis of loss of appetite in children.