Browsing by Author "Kaba, S."

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An Analysis of Children With Brucellosis Associated With Haemophagocytic Lymphohistiocytosis
(2016) Karaman, K.; Akbayram, S.; Kaba, S.; Karaman, S.; Garipardiç, M.; Aydin, I.; Öner, A.F.
This retrospective study included seven paediatric cases aged from 4 to 14 (10.2±3.4) years with pathologically proved haemophagocytic lymphohistiocytosis from a single institution during 2009 and 2013. Over this time period, 496 patients with brucellosis were diagnosed. None of the patients (3 boys and 4 girls) had a history of any haematologic disorder. All patients had an anamnesis for recently consumed unpasteurised homemade dairy products or had a contact history with sheep and/or cows. The diagnosis of brucellosis was confirmed by standard tube agglutination test in all patients; titres were 1: 1280 in seven patients. Blood culture was positive for Brucella melitensis in three patients (42%). Bone marrow cultures were positive for B. melitensis in four patients (57%). Fever was present in all patients (100%) with haemophagocytic lymphohistiocytosis. The other most common symptoms were malaise, myalgia, anorexia, sweating and weight loss. In addition, sweating was observed in five patients, and lymphadenopathy, petechiae, and weight loss were observed in one patient. Hepatomegaly, splenomegaly, and hepatosplenomegaly were found in four (57%), six (85%) and four (57%), patients, respectively. Haemophagocytosis was documented in bone marrow examinations of all children except in two cases. All patients recovered completely, and their peripheral blood counts returned to normal by 2 to 4 weeks after antibiotic treatment of brucellosis.
How Appropriate Are the Lengths of Syringe Needles Used for Subcutaneous Injections To the Children at School Age
(Univ West indies Faculty Medical Sciences, 2021) Kaba, S.; Dogan, M.; Bulan, K.; Yavuz, A.; Bora, A.; Didin, M.; Kocaman, S.
Objectives: To define the normal ranges of the thicknesses of the skin and subcutaneous tissues via ultrasonography, and determine whether the current syringe needle-lengths used for the subcutaneous injections were appropriate. Methods: The thicknesses of the skin and subcutaneous tissues of 2244 students were measured at the left arm using ultrasonography. The patients were divided into three groups based on their age: 6-8, 9-12 and 13-17 years. Results: The thicknesses of the skin, subcutaneous tissue and skin-subcutaneous tissue were found to be positively correlated with their age, body mass index (BMI) and body surface area. All these were observed to be gender related. There was the possibility to make intramuscular injections for 50%, 25% and 25% of boys within the age groups of 6-8, 9-12 and 13-17 years, respectively. For girls, the risk of intramuscular injection was 25% for all the age groups. Conclusion: The study showed that the skin and skin-subcutaneous tissue thicknesses varied as a function of the patients' age, gender, BMIs and body surface areas.
Immediate Adverse Reactions To Intravenous Immunoglobulin in Children: a Single Center Experience
(Mattioli 1885, 2017) Kaba, S.; Keskindemirci, G.; Aydogmus, C.; Siraneci, R.; Cipe, F. Erol
Intravenous immunoglobulin (IVIG) is commonly used in primary and secondary immunodeficiency diseases as well as autoimmune conditions as immunomodulatator treatment. Immediate adverse events which are generally mild and occur during infusion are seen in 6 hours. Reported immediate adverse events are in a wide range from 1%-40% in pediatric patients. 115 patients who received IVIG (except newborns) were included into this crosssectional study. IVIG was given to patients for primary immunodeficiencies (n=8), ITP (n=65), Kawasaki disease (n=11), secondary immunosupression (n=28), and passive immunization (n=3). 5%, 10% IVIG preparations and pentaglobin were used. Headache, fever, chills, nausea, rash, arthralgia, myalgia and back pain were accepted as mild immediate events. There were 62 (54%) boys and 53 (46%) girls aged 1 month-18 years. Mean age of the group was 7.4 +/- 4.6 years. Immediate adverse events due to IVIG infusions were seen in 29 (25.2%) of all patients. Gender and types of the disease were not different in significance regarding the presence of adverse events. The rate of adverse events did not change with receiving pre-medication. The most common reaction was fever/chills. Immediate reactions were seen in first 6 hours in 7 patients and during infusion in the remaining. They were treated with slowing of the infusion rate and infusion was stopped in 3 patients because of moderate events. Because of the increasingly use of IVIG therapy, it is important to know the side effects. High doses, high infusion rates, accompanying infection may worsen the adverse effects especially in primary immunodeficiency diseases.
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.
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.
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.
Plasma Amino Acid Profile in Autism Spectrum Disorder (Asd)
(verduci Publisher, 2016) Bala, K. A.; Dogan, M.; Mutluer, T.; Kaba, S.; Aslan, O.; Balahoroglu, R.; Kocaman, S.
OBJECTIVE: In our study, we aimed to reveal pathophysiologic mechanisms in ASD by comparing plasma amino acid levels between patients and healthy controls while considering vitamin B12 and D levels. PATIENTS AND METHODS: The study included 21 patients aged 2-18 years-old who were followed with a diagnosis autism spectrum disorder (ASD) and 21 age and sex-matched healthy children from our outpatient clinic as control group. RESULTS: The study included 42 children and adolescents aged 2-18 years-old (19 girls and 23 boys). There were no significant differences in terms of body weight and height between the groups. We found significant differences in levels of ammonium, phosphoethanolamine, histidine, homocysteine, carnosine, methionine, cystathionine, cyste0ine, threonine, 3-methyl histidine and phenylalanine/tyrosine ratio between patient and control groups. Both vitamin B12 and D were significantly lower in the ASD group compared to controls. In the variance analysis with vitamin B12 and D as covariates, significant differences persisted for only phosphoethanolamine (p=0.04), cystathionine (p<0.001), cystine (p=0.006) and threonine (p=0.02). CONCLUSIONS: Further studies are needed on the amino acids that show variations in children with ASD in order to reveal their role in the etiology and therapeutic use in ASD.
Pseudohypoparathyroisidm Type 1a: a Case Report
(Galenos Yayincilik,, 2016) Doğan, M.; Kocaman, S.; Bala, K.A.; Kaba, S.; Yel, S.; Şen, A.
Objective: Pseudohypoparathyroidism (PHP) is a group of disorders characterized by end-organ resistance to the parathyroid hormone (PTH). PHP type 1a includes multi-hormone resistance syndrome, Albright’s hereditary osteodystrophy, and obesity and is caused by mutations in GNAS exon 1 through 13. Characteristic features of disease are hypocalcemia, hyperphosphatemia, elevated PTH, obesity, round facies, and subcutaneous calcification. The disease is inherited from affected mother. On the other hand, pseudopseudohypoparathyroidism (PPHP) occurs if the mutation is paternally inherited. In PPHP, calcium and phosphorus levels are generally normal. In this report, we want to present a boy with PHP type 1a who has normal calcium and elevated thyroid stimulating hormone (TSH) levels, which is a rare event. Case: The 12-10/12-year-old boy was admitted with the complaint of short stature. On physical examination, brachydactyly, round facies, and short neck were observed as well, indicating PHP 1a. However, serum calcium, phosphorus, alkaline phosphatase, vitamin D, and PTH levels were normal. These results were compatible with PPHP. On the other hand, TSH levels were found to be high (8 µIU/mL, normal range 0.5-4.8 µIU/mL), free thyroxine levels slightly low (0.7 ng/dL, normal range 0.8-2.3 ng/ dL), urine iodine level normal, and thyroid antibodies to be negative. These features were compatible with PHP type 1a. Therefore, genetic analyses were performed and p.D826H (C2476G>C) heterozygous mutation was found in GNAS. The genetic analyses of parents revealed maternal inheritance. As far as we know, this mutation was not reported before and was found to be high risky for being a cause of the disease according to mutation taster and human splicing finder. Conclusion: In this report, we want to emphasize that normocalcemia can be a finding of PHP type 1a. © 2016, Galenos Yayincilik. 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.
A Single Center Experience of Cns Anomalies or Neural Tube Defects in Patients With Jarcho Levin Syndrome
(Springer, 2016) Demir, N.; Peker, E.; Gulsen, I.; Agengin, K.; Kaba, S.; Tuncer, O.
A Study on the Effects of Pica and Iron-Deficiency Anemia on Oxidative Stress, Antioxidant Capacity and Trace Elements
(Sage Publications Ltd, 2013) Bay, A.; Dogan, M.; Bulan, K.; Kaba, S.; Demir, N.; Oner, A. F.
Pica is defined as developmentally inappropriate consumption of nonnutritive substances for at least 1 month. There are a few studies on serum trace element levels of patients with pica. The literature contains contracting data on the levels of oxidative stress and antioxidant levels in patients with iron-deficiency anemia (IDA). The effect of pica on oxidative stress and antioxidant capacity has not been investigated yet. The present study evaluated the effects of pica and IDA on oxidative stress and antioxidant capacity as well as on the levels of trace elements including serum zinc and selenium in 47 children with IDA plus pica, 22 children with IDA only and 21 nonanemic children as controls. The results demonstrated significantly lower levels of serum selenium and zinc in pica and IDA groups compared to the control group. Total oxidant levels were highest in the pica group and consistently, the lowest total antioxidant capacity was observed again in the pica group. Comparison of pica and IDA groups yielded significantly lower levels of total antioxidant levels and significantly higher oxidative stress index in the pica group. Consequently, it is thought that the detrimental effects of pica within the organism were mediated by adverse impacts on antioxidant capacity and oxidative stress. These effects should be kept in mind while managing patients with pica.
Supernumerary Nipples, Congenital Scoliosis, Spina Bifida Occulta, Tethered Cord and Diastematomyelia
(Yuzuncu Yil Universitesi Tip Fakultesi, 2015) Dogan, M.; Kaba, S.; Bora, A.; Bulan, K.; Kocaman, S.
A 3-months old girl who presented to our clinic with accessory breast and had signs of supernumerary nipples, congenital scoliosis and diastematomyelia was presented as she didn’t correspond to any known syndrome. © 2015 Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Two Novel Associations in a Case With Walker Warburg Syndrome; Enophthalmia, Interhemispheric Cyst and Cerebral Hematoma
(Yuzuncu Yil Universitesi Tip Fakultesi, 2017) Kaba, S.; Doğan, M.; Bulut, M.D.; Bulan, K.; Demir, N.; Üstyol, L.; Ceylan, N.
There were severe brain malformations, hydrocephaly, myopathy and congenital cataract in a 5-month old girl presented with seizure. Walker Warburg syndrome is the most severe form of congenital muscular dystrophy accompanied by brain and eye anomalies. The findings in this case fulfilling diagnostic criteria of Walker Warburg syndrome other than type 2 lissencephaly suggest an intermediate form between Walker Warburg syndrome and muscle-eye-brain disease. In this manuscript, we intended to present this case presenting features (enophthalmia, interhemispheric cyst and cerebral hematoma) not reported previously in the spectrum of congenital muscular dystrophy-dystroglycanopathy with brain and eye anomalies. © 2017, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.