Browsing by Author "Doǧan, M."

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A Case of Benzydamine Hcl Intoxication
(2006) Doǧan, M.; Yilmaz, C.; Çaksen, H.; Güven, A.S.
Benzydamine HCl is a nonsteroidal anti-inflammatory drug (NSAID) and is available in mouthwash, dermal cream, aerosol and vaginal douche preparations, besides other compounds administered orally or by otic drops. Acute poisoning with benzydamine HCL is associated with agitation, hallucinations, seizures and rarely somnolence. In this study, we reported a rare case of benzydamine poisoning in a girl who presented with somnolence and visual hallucinations one hour after taking five benzydamine HCL dragees orally equal with 14.7 mg/kg for suicide. An 11 years old girl was brought to our hospital because of visual hallucinations. About 1,5 hours before the admission, she received five benzydamine HCL dragees orally for suicide. Visual hallucinations appeared one hour after ingestion of the drug. She especially mentioned to see snakes and her relatives such as her father who was not in the hospital. On laboratory examination complete blood count, serum electrolytes, renal and liver function tests were normal. The patient was hospitalized with the diagnosis of acute benzydamine HCl intoxication. Gastric lavage was performed and activated charcoal (1 g/kg/dose four doses daily) was given. The hallucinations were resolved and she became symptom and sign free two hours after hospitalization. We suggest that if a patient is presented with somnolence and visual hallucinations, drug intoxication should be considered in the differential diagnosis.
A Case of Isolated Cns Relaps With Atipik Clinical Presentation in an Acute Myeloblastic Leukemia Patient
(2005) Bay, A.; Öner, A.F.; Etlik, Ö.; Doǧan, M.; Izmirli, M.
After the recent advances in chemotherapy and supportive care, survival and the number of extrameduller relaps have increased in childhood acute myeloblastic leukemia (AML). However isolated central nervous system (CNS) relaps is a rare event in AML. We reported a 7 years old child, who presented with dyspnea, diagnosed isole CNS relaps at the 30th week of maintance chemotherapy protocol of AML. He admitted to our emergency service with the complain of dispne. Respiratory track infection or other pathology was not found on phsycal examination and labaratuary tests. On follow up, lumbar puncture was performed to the patient having no any improvement in dispne to evaluate the CNS disorders. Cerebro spinal fluid examination showed a lot of blastic cell and thus isolated CNS relaps was diagnosed. Cranial MRI showed an enlargement at pons and bulbus corresponding leukemic infiltration. Dispne were resolved just after the beginning of administration intratechal and systemic reinduction chemotherapy.
Congenital Primary Hypothyroidism Associated With the Rare Form of Nonimmune Hydrops Fetalis
(2010) Yuca, S.A.; Cesur, Y.; Kirimi, E.; Sari, S.; Kaya, A.; Doǧan, M.
We present a male newborn born with diffuse edema and ascites. A diagnosis of congenital primary hypothyroidism was made based on thyroid hormone levels of total T4 1.74 μg/dL, free T4 0.30 ng/dL and TSH >75 μIU/mL and thyroid hormone replacement therapy was initiated. At day 15 of therapy, the thyroid function tests of the patient reached normal limits, and his edema and ascites regressed. In this report we present a newborn case of hypothyroidism that was accompanied by nonhydrops fetalis. We want to emphasize that congenital hypothyroidism may present with severe symptoms such as hydrops.
The Effect of Childhood Obesity on Cardiac Functions
(Freund Publishing House Ltd, 2014) Üner, A.; Doǧan, M.; Epcacan, Z.; Epçaçan, S.
Obesity is a metabolic disorder defined as excessive accumulation of body fat, which is made up of genetic, environmental, and hormonal factors and has various social, psychological, and medical complications. Childhood obesity is a major indicator of adult obesity. The aim of this study is to evaluate the cardiac functions via electrocardiography (ECG), echocardiography (ECHO), and treadmill test in childhood obesity. A patient group consisting of 30 obese children and a control group consisting of 30 non-obese children were included in the study. The age range was between 8 and 17 years. Anthropometric measurements, physical examination, ECG, ECHO, and treadmill test were done in all patients. P-wave dispersion (PD) was found to be statistically significantly high in obese patients. In ECHO analysis, we found that end-diastolic diameter, end-systolic diameter, left ventricle posterior wall thickness, and interventricular septum were significantly greater in obese children. In treadmill test, exercise capacity was found to be significantly lower and the hemodynamic response to exercise was found to be defective in obese children. Various cardiac structural and functional changes occur in childhood obesity and this condition includes important cardiovascular risks. PD, left ventricle end-systolic and end-diastolic diameter, left ventricle posterior wall thickness, interventricular septum thickness, exercise capacity, and hemodynamic and ECG measurements during exercise testing are useful tests to determine cardiac dysfunctions and potential arrhythmias even in early stages of childhood obesity. Early recognition and taking precautions for obesity during childhood is very important to intercept complications that will occur in adulthood. © 2014 by Walter de Gruyter Berlin Boston 2014.
Efficacy of Intravenous Anti-D Therapy in Childhood Chronic Idiopathic Thrombocytopenic Purpura
(2006) Bay, A.; Öner, A.F.; Doǧan, M.; Açikgöz, M.; Dilek, I.
In this study we examined eleven patients with chronic immune thrombocytopenic purpura (ITP) who received anti D retrospectively. All of the cases have Rh+ blood group and non-splenectomized. Anti D was given 30μg/kg/dose on 0, 1, 7, 14, 21, 28 days by intravenous infusion in one hour. Three of them (27%) had complete response, three of them (27%) had partial response, three of them (27%) had minor response, and two of them (18%) didn't response. On following, only one patient who responded initially, had high trombocyte count over 1 year. The other patient's trombocyte counts were decreased to the initial level within 1-3 months after the treatment. We did not observe any important side effect. In conclusion, anti D should be considered as a therapeutic option for childhood chronic ITP.
High-Dose Steroid-Related Osteonecrosis in a Four-Year Child With Acute Lymphoblastic Leukemia
(2005) Bay, A.; Öner, A.F.; Etlik, Ö.; Doǧan, M.
Osteonecrosis is an uncommon complication of acute lymphoblastic leukemia. One of the risk factor is high-dose corticosteroid therapy. The highest incidence of osteonecrosis is observed in children 9 to 18 years old at diagnosis and it is a rare condition below 5 years of age. We describe a 4 year-old child with acute lymphoblastic leukemia and complaints of progressive bone pain and walking difficulty who developed osteonecrosis and bone fracture after two remission induction chemotherapy.
Massively Enlarged Kidneys Due To Leukemic Infiltration in a Child
(2010) Doǧan, M.; Bay, A.; Bora, A.; Açikgöz, M.; Öner, A.F.
A few cases with bilateral renal enlargement in acute lymphoblastic leukemia were reported in literature. In this article, we reported an unusual case of a child with precursor B-ALL presenting with massively enlarged bilateral unobstructed kidneys and acute renal failure. Renal involvement of ALL should be taken into consideration in case with massively enlarged bilateral kidneys in radiological examination. Based on radiological, clinical and laboratory findings including bone marrow aspirate examination, the patient could be diagnosed as ALL without renal biopsy.
Oxidant/Antioxidant System Markers and Trace Element Levels in Children With Nutritional Rickets
(2012) Doǧan, M.; Cesur, Y.; Doǧan, S.Z.; Kaba, S.; Bulan, K.; Cemek, M.
Objective: To determine the oxidative stress and trace element levels in vivo in patients with nutritional rachitism associated with vitamin D deficiency. Materials and method: A total of 30 patients, 18 males and 12 females, were included in the study. Age, sex, medical history, vital, and physical examination findings of each patient documented at presentation were recorded. Serum calcium, phosphorus, alkaline phosphatase, parathormone, and 25-OH vitamin D levels, as well as oxidant and antioxidant system parameters and trace element levels were studied. After being diagnosed with rachitism, the patients were administered a single dose of 300,000 IU vitamin D by intramuscular injection. The same analyses were repeated post-treatment. Thirty children with normal anthropometric measurements were included as the control group. The analyses described above were performed only once for the control group. Results: Serum calcium, phosphorus, alkaline phosphatase, parathormone, and 25-OH vitamin D levels were different between the controls and children in the patient group (p <0.001). Analysis of trace element levels demonstrated markedly lower pretreatment zinc levels for the patient group compared to the controls, with a statistically significant difference (p =0.001). Comparison of pretreatment oxidant and antioxidant system markers between the patient and control groups demonstrated higher values for vitamin C, β-carotene, reduced glutathione, and superoxide dismutase in the control group, whereas MDA was higher in the patient group. Conclusion: The present study demonstrated increased oxidative stress, reduced antioxidant defence system in patients with nutritional rachitism, with reduced oxidative stress and a pronounced improvement in the antioxidant system with vitamin D treatment.
Prevalence of Overweight and Obesity in Children and Adolescents in Eastern Turkey
(2010) Yuca, S.A.; Yilmaz, C.; Cesur, Y.; Doǧan, M.; Kaya, A.; Başaranoǧlu, M.
Objective: The aim of this study was to estimate the prevalence of overweight and obesity in school children in Eastern Turkey. Methods: This study included 9048 school children aged 6-18 years. The subjects were classified as overweight and obese, according to the International Obesity Task Force. Results: We found prevalence of overweight of 11.1% in the studied population. It was detected that 2.2% of the population in the study was obese; 2.1% of males and 2.3% of females. While the prevalence of obesity was extremely low before 9 ages and after 15, it reached to high values at puberty and just before pubertal period in boys. The prevalence of overweight was higher in girls and reached to peak point at pubertal ages. Generally, the prevalence of obesity and overweight was slightly higher in girls than in boys, although the boys were more obese in prepubertal ages. Conclusion: Overweight and obesity are concerns for children and adolescents in low socio-economic status regions as well. © Journal of Clinical Research in Pediatric Endocrinology.
Rickets in Healthy Adolescents in Van, the Eastern of Turkey
(TIP ARASTIRMALARI DERNEGI, 2010) Üner, A.; Acar, M.N.; Cesur, Y.; Doǧan, M.; Çaksen, H.; Temel, H.; Özbek, H.
Aim: To investigate the ratio of rickets and vitamin D deficiency in healthy adolescents at Van region. Method: Totally 126 cases were included in this study. All cases were evaluated for the presence of rickets symptoms, daily sun exposure, and vitamin usage, covering and eating habit. Diagnosis of rickets was made based on biochemical findings. The children whose vitamin D levels were lower than 10 ng/dl were accepted as vitamin 25(OH)D3 deficiency, but whose levels between 10-20 ng/dl were accepted as vitamin D insufficiency. Result: Sixty girls (47.6%) and 66 boys (52.4%) were included in this study. They were between 9 and 17 years old (11.94 ± 1.9 years). Vitamin D levels in 60 (47.6%) cases were normal, but 48 (38.1%) cases had rickets, 13 (10.3%) cases had vitamin D insufficiency and 5 (4.0%) cases had vitamin D deficiency. There was no statistically significant difference in the incidence of rickets between the cases with or without covered-dress. However, there was a significant difference in the incidence of vitamin D insufficiency (p<0.05). All of the cases had less daily calcium, phosphorus, protein and vitamin D intake than recommended daily amount. In the rickets group, alkaline phosphatase levels were significantly higher comparing with the others (p<0.05), but there was no difference in plasma intact parathyroid hormone levels. Conclusion: Our findings revealed that most adolescents who appeared to be healthy (52.4%) could have vitamin D insufficiency. Therefore, we believe that dietary education and/or vitamin D prophylaxis might be given to all adolescents. However, more extensive researches should be done to elucidate of our suggestion's correction.
Serum Insulin-Like Growth Factor-I and Insulin-Like Growth Factor Binding Protein-3 Levels in Children With Zinc Deficiency and the Effect of Zinc Supplementation on These Parameters
(Walter de Gruyter GmbH, 2009) Cesur, Y.; Yordam, N.; Doǧan, M.
Aim: To determine the effect of zinc (Zn) therapy on serum insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) levels in children with Zn deficiency and growth retardation, but without systemic disease, and to investigate the effect of Zn supplementation on these parameters. Methods: Twenty-nine children (11 girls and 18 boys) were included. Blood samples were obtained for serum IGF-I and IGFBP-3 determination before and after 50 mg/day Zn supplementation for two months. Results: The mean age of the children was 11.0 ± 3.1 years (range 3.7-16.2 years). Serum IGF-I and IGFBP-3 levels were below the mean values in 28 (96.6%) and all children, respectively. After Zn therapy, serum IGF-I levels were increased in 62% of the children; this increase was statistically significant in 48.3% of the children. Serum IGFBP-3 levels were significantly increased in 10 children. There was a positive correlation between serum Zn level and bone age, and serum IGF-I and IGFBP-3 levels. A positive correlation was present between BMI (r = 0.485, p <0.001) and serum IGF-I levels before therapy. Conclusion: Serum IGF-I and IGFBP-3 levels were decreased in children with Zn deficiency, and were increased after Zn supplementation. In addition, after Zn supplementation, increment of serum IGF-I levels was found to be higher in children with low BMI than those with normal BMI; therefore, the nutritional status of children may also be important, as well as Zn supplementation. Additionally, the determination of higher variation percentile of serum IGF-I level in prepubertal children compared to pubertal children was an interesting finding and necessitates further investigation. © Freund Publishing House Ltd.
The Use of Recombinant Factor Viia in a Child With Glanzmann Thrombasthenia
(2006) Bay, A.; Öner, A.F.; Çankaya, H.; Doǧan, M.
Glanzmann thrombasthenia is an autosomal recessive disorder of platelet aggregation that is characterized by a life-long bleeding tendency due to quantitative and qualitative abnormalities of the platelet membrane complex glycoprotein IIb/IIIa (Gp IIb/IIIa). Platelet transfusion is the standard treatment for severe bleeding and surgical support is necessary in these patients. However, repeated platelet transfusions can result in alloimmunization, which makes subsequent transfusions ineffective. Recombinant activated factor VIIa (rFVIIa) has recently been introduced as an alternative to platelet transfusion for treatment of bleeding episodes and to cover surgery in patients with hereditary platelet function defects. We report a 8-year-old child with Glanzmann thrombasthenia. The patient had been treated by nasal tampon placement because of epistaxis three years ago in another hospital. We detected perforation of nasal septum and deformation of nasal bone due to granulation tissue induced by forgotten nasal tampon. Forgotten tampon was removed and granulation tissue was resected. Bolus injections of rFVIIa (90 _g/kg) was given immediately before operation and three times with 2 hours intervals after the surgery. The patient was discharged from hospital without any bleeding complication or thrombocyte replacement.