Browsing by Author "Karaman, Kamuran"

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0-3 Yaş Çocuklarda İdrar Kültür Yöntemlerinin Karşılaştırılması
(2018) Çetin, Mecnun; Kırımi, Ercan; Karaman, Kamuran; Geylan, Hadi; Tuncer, Oğuz
Amaç: Bu çalışmada şikayetleri ve klinik bulguları ileidrar yolu enfeksiyonu şüphesi uyandıran 229 çocuktaidrar yolu enfeksiyonu tanısını koymada kateter ve torbaile alınan kültür güvenilirliğini karşılaştırıldı.Gereç ve Yöntem: Çalışma Yüzüncü Yıl Üniversitesi TıpFakültesi Hastanesi Çocuk kliniğinde yapıldı.Vakalarımızda tam idrar incelenmesi, idrar sedimentininmikroskopik incelenmesi yapıldı. Tüm vakalarda hemtorba hem de kateter ile alınan idrar örnekleri kültüreekildi. Sonuçlar karşılaştırıldı.Bulgular: Torba ile idrar kültürü alınan 229 vakanın 181tanesinde üreme oldu, 48’inde kontaminasyon görüldü.Torba idrarı kültüründe üreme olan 181 vakanın 58’indekateter idrarı kültüründe de üreme oldu, 123’ünde üremeolmadı. Torba kültüründe kontaminasyon saptanan 48vakanın 5’inde kateter kültüründe üreme oldu. Torbakültüründe yalancı pozitiflik %68 olarak saptandı. Kateterkültürüne göre torba kültürünün İYE tanısındakisensitivitesi %32 olarak saptandı. Torba kültüründe kızve erkeklerde yalancı pozitiflik bakımındankarşılaştırıldığında aralarında anlamlı ilişki bulunmadı.Çalışmada torba kültüründe kontaminasyon, erkekleregöre kızlarda anlamlı yüksek bulundu. Tam idrarincelemesinde; nitrit, hematüri, piyüri ve bakteriüripozitifliği ile idrar kültüründe üreme olması arasındaanlamlı bir ilişki tespit ettik.Sonuç: Bu çalışma ile perineal torba idrar kültürününyalancı pozitiflik oranının yüksek olduğu, perineal torbaile idrar kültürü almanın İYE tanısında yeterince güvenilirolmadığı ve bu nedenle idrar yolu enfeksiy onu düşünülendurumlarda tanı için çok daha güvenilir bir yöntem olanmesane kateterizasyonu veya suprapubik aspirasyon ileidrar alınması gerektiği sonucuna varıldı.
Acute Immune Thrombocytopenic Purpura Following Oral Polio Vaccination
(Taylor & Francis inc, 2015) Akbayram, Sinan; Karaman, Kamuran; Ece, Ibrahim; Akbayram, Tuba Hatice
Acute Intoxications Among Turkish Children
(Edizioni Minerva Medica, 2018) Kizilyildiz, Baran S.; Karaman, Kamuran; Ozen, Selvi; Uner, Abdurrahman
BACKGROUND: The aim of this study was to investigate characteristics, outcomes and clinical features of acute intoxications among children in Van region of Turkey. METHODS: All cases with a diagnosis of acute intoxication admitted to the Pediatric Emergency Department of the Yuzuncu Yil University of Van from June 1, 2010 to November 30, 2011 were evaluated. We retrospectively examined the medical records for demographical and etiological characteristics of patients below 17 years of age. RESULTS: A total of 239 intoxications were recorded. The majority of patients were under 5 years of age. Pharmaceutical agents were identified in 137 (57.3%) patients. Antidepressants with a majority of tricyclic antidepressants were the most common drugs (29.9%). Non-pharmaceutical agents were identified in 102 (42.6%) patients, 38.2% of which were insecticides-pesticides following by plants (25.4%) and carbon monoxide (17.6%). The majority (93.8%) of cases were accidental poisonings. Fourteen cases of intoxications occurred as suicide attempts and 85.7% (N.=12) of those patients were girls. Of all cases, gastric lavage was performed in 36.4% and activated charcoal administration in 53%. After hospitalization, only 23 (9.6%) of all patients received specific treatment besides symptomatic treatment. Specific treatments involved hemodialysis and antidotes such as biperiden, ethanol, atropine, neostigmine and pralidoxime. During the study period, one patient died due to acute intoxication of pesticide. The mortality rate was 0.4%. CONCLUSIONS: Our study revealed that pharmaceuticals were the most common cause of acute intoxications. While, insecticides-pesticides and plants were the leading non-pharmaceutic agents. Our data is important because it is one of few original reports on children with intoxication in Eastern Turkey.
Akut İnfantil Hemorajik Ödem: İki Olgunun Sunumu
(2016) Karaman, Kamuran; Akbayram, Sinan; Öner, Ahmet Faik; Garipardıç, Mesut
Akut infantil hemorajik ödem, üç yaşından küçük çocuklarda, seyrek görülen, derinin lökositoklastik vaskülitidir. Hastalık kendini sınırlar ve iyi klinik seyre sahiptir. Çalışmada; deride purpurik döküntü ve ekstremitelerde ödem yakınmaları ile başvuran, klinik ve laboratuvar incelemeleri sonucunda akut infantil hemorajik ödem tanısı almış iki olgu sunulmuştur. Klinik izlem ve tedavi açısından farklı yaklaşımlar gerektiren özellikle Henoch-Schönlen purpurası, meningokoksemi, purpura fulminans gibi hastalıklarla ayırıcı tanıda akut infantil hemorajik ödemin de düşünülmesi gerektiğini vurgulamak istedik.
Carbamazepine-Induced Dress Syndrome Leading To Reversible Myocarditis in a Child
(Termedia Publishing House Ltd, 2019) Cetin, Mecnun; Mis, Mevsim Demir; Karaman, Kamuran; Yavuz, Ibrahim H.; Geylan, Hadi; Tuncdemir, Perihan; Demir, Feyza
DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome is a rare type of delayed drug hypersensitivity reaction characterised by fever, skin rash, lymphadenopathy, and visceral involvement, which can be life threatening and is a childhood event. An eight-year-old boy was admitted with complaints of extensive rash and fever three weeks after the onset of treatment with carbamazepine for a diagnosis of epilepsy. Fever, as well as patches and plaques with indeterminate limits that tended to merge and were non-blanchable on a widespread erythematous layer, were revealed in physical examination. Extensive cervical, submandibular, and inguinal lymphadenopathy was observed. We present ours as the second case of myocarditis secondary to DRESS syndrome after carbamazepine use in the literature.
Cardiovascular Evaluation and Serum Paraoxonase-1 Levels in Adolescents With Polycystic Ovary Syndrome
(Taylor & Francis inc, 2020) Cetin, Mecnun; Tuncdemir, Perihan; Karaman, Kamuran; Yel, Servet; Karaman, Erbil; Ozgokce, Mesut; Komuroglu, Ahmet Ufuk
The aim of our study was to evaluate whether cardiovascular disease risks seen in adults with polycystic ovary syndrome (PCOS) develop in adolescents with PCOS using conventional Doppler echocardiography (CDE) and tissue Doppler echocardiography (TDE) or not. The other aim was to investigate the association of paraoxonase-1 (PON-1) level with cardiovascular parameters. 30 PCOS patients and 30 control patients were included in the study. All patients were evaluated with TDE and CDE. Paraoxonase-1 levels of both groups were studied. In CDE study, myocardial performance index (MPI) was higher in the PCOS group than in the control group (0.54 +/- 0.11, 0.50 +/- 0.12, p = .049, respectively). In the TDE study, early diastolic myocardial velocity (E)'/late diastolic myocardial velocity (A ') was lower in PCOS group than in the control group (2.07 +/- 0.08, 2.44 +/- 0.10, p = .008, respectively). PON-1 was higher in PCOS group than in the control group (26.81 +/- 3.05, 18.68 +/- 1.18, p = .011, respectively). Cardiovascular disease risks, which are among the long-term complications of PCOS, seem to begin from the early stage of PCOS. The high PON-1 level was thought to increase in response to increased oxidative stress in PCOS.Impact statement What is already known on this subject? Polycystic ovary syndrome (PCOS) is one of the most commonly seen endocrinopathy in the adolescent age group. PCOS has detrimental effects on the cardiovascular system in the adult population which is reported in many studies. What the results of this study add? The result of this study showed that cardiovascular effects, which are among the long-term complications of PCOS, seem to begin from the early stage of PCOS. And also, serum paraoxonase-1 level increases in response to the oxidative stress in the adolescent with PCOS.
A Case of Atypical Brucellosis Presented With Isolated Lymphadenopathy
(Aves Yayincilik, Ibrahim Kara, 2017) Karaman, Kamuran; Akbayram, Hatice Tuba; Akbayram, Sinan; Garipardic, Mesut; Oner, Ahmet Fayik
Brucellosis is transmitted via animal or animal products. The transmission of infection from animal to human occurs by the ways of; generally the direct contact of secretions of infected animals through the human skin which of broken integrity, consumption of unpasteurized milk and milk products, inhalation and contact with conjunctiva with infected aerosols. The infection can be presented with variable manifestations and involment of cardiovascular, central nervous system, skeletal system, skin and gastrointestinal system. It is generally a disease with good prognosis; but the complicated involvement like of bone, cardiovascular and menegial site leads to significant morbidity and mortality. Here, we presents a case of brucella lymphadenitis of 9 years old patiens in whom admitted with isolated lmphadenopathy and recovered clinically and laboratory upon starting the treatment for brucellosis.
Chediak-Higashi Syndrome Presented With Hemophagocytic Lymphohistiocytosis
(Thieme Medical Publ inc, 2018) Karaman, Kamuran; Akbayram, Sinan; Geylan, Hadi; Cetin, Mecnun
Circumcision in Patients With Congenital Factor X Deficiency
(Springer india, 2014) Akbayram, Sinan; Garipardic, Mesut; Karaman, Kamuran; Bilici, Salim; Oner, Ahmet Faik
Clinical and Laboratory Findings of Paediatric Patients With Brucellosis
(Galenos Yayincilik, 2021) Karaman, Serap; Bitkin, Eda Celebi; Sonmez, Bulent; Basaranoglu, Murat; Karaman, Kamuran; Tuncer, Oguz
Objective: Brucellosis is the most common bacterial zoonotic disease transmitted via unpasteurised milk and dairy products from infected animals. This study aimed to evaluate paediatric patients treated for brucellosis and followed for 2 years. Materials and Methods: The records of 73 patients with childhood brucellosis who had undergone treatment and follow-up for 2 years were retrospectively evaluated. Results: The patient age ranged from 1 to 14 years, with 39 boys (53%) and 34 girls (47%). Fever (94%) was the first common symptom. Other symptoms, in the order of frequency, were myalgia (80%), arthralgia (75%), fatigue (38%) and anorexia (33%). Complications included sacroiliitis (12%), hemophagocytic lymphohistiocytosis (4%), epididymo-orchitis (1.3%), focal abscess (1.3 %) and meningitis (1.3%). Splenomegaly, hepatomegaly and lymphadenopathy (24%, 33% and 5%, respectively) were also reported. Moreover, 18% of the patients had hepatosplenomegaly at initial admission. Dermatological involvement revealed maculopapular rash in 4.1% and petechial rash in 9.6% of patients. Body weight loss was observed in 14% of the cases. In addition, 76.3% and 23.7% of the patients had acute and sub-acute forms, respectively. Conclusion: Brucellosis can display several different clinical presentations. This diversity can lead to diagnostic delay. In settlements where the disease is common, patients with fever and joint pain should be treated early and the disease should be ruled out.
Clinical Spectrum of Primary Hemophagocytic Lymphohistiocytosis: Experience of Reference Centers in Central and Southeast Anatolia
(Springer, 2024) Akyol, Sefika; Yilmaz, Ebru; Tokgoz, Huseyin; Karaman, Kamuran; Pekpak, Esra; Ozcan, Alper; Unal, Ekrem
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease, with a high mortality if left untreated. In addition, the disease has unique diagnostic challenges. Therefore, despite the existing guidelines on management, current clinical practice data is informative on the course and outcome. Herein, a retrospective chart review study was conducted through the collaboration of six centers, located in central and southeastern Turkiye. The demographical data, laboratory results, and treatment outcomes were evaluated. Eighty-three patients were enrolled in the study. The mean age was 2 years, whereas the median age was 8 months with a range of a minimum of 1 week and a maximum of 12.6 years. Consanguineous marriage, history of sibling death, and familial history of similar disease were determined in 72.2% (n:60), 34.9% (n:29), and 39.8% (n:33) of the patients, respectively. The most common presentation was fever, followed by hepatosplenomegaly on admission. Disease-causing familial HLH variants were identified in 60.2% (n:50) of the patients. Hematopoietic stem cell transplantation (HSCT) was performed in 39.7% (n:33) of the cohort. The 2-year overall survival (OS) rate was 62.4% for the whole group. Comparing the patients who received HSCT and those who did not; the HSCT group had a 2-year OS of 84.7%, which was significantly better than patients who did not receive HSCT had a 2-year OS of 47.1% (p:0.001). Despite the improvement in HLH diagnostics and treatment options over the last decade, early death remains a leading problem for the survival of these patients. Therefore, appropriate assessment of the patients in experienced centers and HSCT are pivotal for better outcomes.
Çocukluk Çağında Nadir Bir Barsak Obstrüksiyonu Nedeni: Poliüretan Köpük Yutma
(2016) Kızılyıldız, Baran Serdar; Beger, Burhan; Karaman, Kamuran; Melek, Mehmet
Yabancı cisim yutulması çocukluk çağında morbidite ve mortaliteye neden olan önemli bir sorundur. Yutulan yabancı cisimlerin %60'ının midede, %20'sinin özefagusta, %11'inin barsaklarda, %9'unun orofarinkste olduğu bildirilmiştir. Yutulan bu cisimlerin çoğu gastrointestinal sistemi kesintisiz olarak geçmektedir. Olguların %10-20'si endoskopik olarak, %1-14'ü ise cerrahi olarak çıkarılmaktadır. Bu çalışmada poliüretan köpük yutma sonucu gelişen ve ileal obstrüksiyon nedeniyle laparotomi uygulanan 8 yaşındaki bir olgu sunuldu.
Comparison of Serum Ferritin Levels and Cardiac and Liver Mri T2* Results of Transfusion Dependent Β-Thalassemia Major Patients Comparison of Serum Ferritin Levels and Cardiac and Liver Mri T2* Results of Transfusion Dependent Β-Thalassemia Major Patients
(2023) Acar, Bilal; Karaman, Kamuran
Pediyatrik β talasemi majör hastalarında, artmış demir yüküne bağlı olarak organlarda demir birikimi gözlenir ve bu birikim, biriktiği organda disfonksiyona yol açabilir. Çalışmamızda, kalp ve karaciğerdeki demir birikimini değerlendirmek için manyetik rezonans görüntüleme tekniği olan T2* sekansını kullanmayı planladık. Ayrıca, karaciğer ve kalpteki T2* relaksasyon süreleri ile ferritin değerleri arasındaki ilişkiyi ortaya koymayı hedefledik. Gereç ve Yöntem: Bu çalışma 2023 yılında Yüzüncü Yılı Üniversitesi Tıp Fakültesi Çocuk Sağlığın ve Hastalıkların Anal Bilimi Dalından Çocuk Hematoloji ve Onkoloji Polikliniğinde takipli Beta Talasemik Majorü hastaları ile gerçekleştirildi. Çalışmaya dahili edileni hastaları transfüzyonu bağımlı 8 yaş üstü Beta Talasemi Major hastaları idi. Hastalara hastane kayıt sistemi üzerinden ulaşılarak, dosyaları kontrol edildi. Hastaların Radyoloji departmanı tarafından verilen Manyetik Rezonans Görüntüleme (MRG) randevuları takip edilerek, sonuçlanan T2* MRG relaksasyon süreleri kaydedildi. Eş zamanlı serum ferritin düzeyleri, yaş, cinsiyet, kullandıkları ilaçlar, boy ve tartı persentil değerleri, transfüzyon sıklığı, muayene bulguları (hepatosplenomegali ve kardiyak üfürüm) ve hemoglobin değerleri karşılaştırıldı. Bulgular: Çalışmamızı 22 hastam ile yapılmıştır. Hastalarımızın yaşların 8-18 yaşı arasından olup; yaşı ortalaması 13,2±3,3 yılı idi. Hastalarımızın 7'si (%32) kız, 15'i (%68) erkek idi. Çalışmaya dahili edileni hastalarını tümü şelatörü tedavisi almış olan hastalar idi, ancak en az son bir yıldır şelatör tedavisi almamış ve halen kullanmayan 5 hasta mevcuttu. Kullanılan şelatör tedavisi deferasiroks idi. Diğer şelatör tedavileri veya kombinasyon tedavisi alan hastamız yoktu. Hastalarımızdan bir tanesi splenektomi olmuştu. Üç hastamız kemik iliği transplantasyonu olmuştu. Transfüzyon sıklığı olarak medyan ortalamamız 30 günde bir, en düşük 15 günde bir, en yüksek 180 günde bir idi. Ferritin ortama düzeyi 1350,1±1049,5 ng/ml idi. Kardiyak T2* MRG relaksasyon süresi ortalama 33,7 (min.18 – max.47) ms idi. Karaciğer T2* MRG relaksasyon süresi medyan olarak 5,2 (min.1,3 – max.24,9) ms idi. Transfüzyon öncesi baktığımız hemoglobin ortalama değeri 9,6±2,5 g/dl idi. Fizik muayene ile tespit ettiğimiz kardiyak üfürüm gözlenen hasta sayısı 9 (%41) idi. Hastalarımızın boy persentilleri ortalama 9,05 (min.0,03 – max.87) persentil olarak kaydedildi. Tartı persentilleri ortalama 7,25 (min.0,04 – max.66) persentil olarak hesaplandı. Çalışmaya alınan hastaların 16'sında (%73) muayene sırasında hepatosplenomegali saptandı. İstatistik çalışmamızda karaciğer T2* MRG relaksasyon süreleri ile hepatosplenomegali olan ve olmayan gruplarda karşılaştırma sonucu anlamlı veriler elde ettik (p=0.027). Transfüzyon sıklığı ile ferritin düzeyi karşılaştırması yaptığımızda da anlamlı sonuçlar aldık (p<0,001). Transfüzyon sıklığı ile karaciğer T2* MRG relaksasyon süreleri arasında da anlamlı karşılaştırma sonuçları elde ettik (p=0,002). Hemoglobin değeri ile karaciğer T2* MRG relaksasyon sürelerini karşılaştırdık. Bu korelasyon çalışmasında da istatistiksel olarak anlamlı sonuç aldık (p<0,001). Ferritin düzeyleri ile kardiyak T2* MRG karşılaştırmasında; p<0,01 olarak tespit ettiğimiz anlamlı sonuçlara ulaştık. Sonuç: Beta talasemi majör hastalarında ferritin düzeyleri ile kardiyak ve karaciğer demir birikiminin değerlendirildiği çalışmamızda; ferritin düzeylerinin kardiyak demir birikimini göstermede anlamlı olduğunu tespit ettik. Ancak daha çok sayıda hasta ile yapılacak çalışmaları önermekteyiz.
Diagnostic Evaluation of Our Patients With Hemophilia A: 17-Year Experience
(Turkish Pediatrics Assoc, 2015) Karaman, Kamuran; Akbayram, Sinan; Garipardic, Mesut; Oner, Ahmet Fayik
Aim: Hemophilia A is a rare inherited bleeding disorder resulting from factor VIII deficiency and is a group of diseases characterized by intra-articular and intramuscular bleeding. In this study, we aimed to retrospectively evaluate the treatment outcomes, demographic and clinical characteristics of our patients who were treated and followed up for last 17 years in our pediatric hematology unit with a diagnosis of Hemophilia A. Material and Methods: The medical records of 83 patients who were diagnosed with Hemophilia A and followed up between 1997 and 2014 in our hospital's pediatric hematology clinic were reviewed retrospectively. The demographic data, prophylaxis state, development of inhibitors and clinical characteristics of the patients were evaluated. Results: When the complaints at presentation were examined, it was found that 27 (32%) patients had hemarthrosis, 24 (29%) patients had ecchymosis and hematoma, 13 (16%) patients had prolonged bleeding after trauma or cut, 10 (12%) patients had gingival, mouth or nose bleeding, 4 (5%) patients had prolonged bleeding after circumcision, 4 (5%) patients had gastrointestinal bleeding, 1 (1%) patient had hematuria. Fifty (60%) patients were considered severe hemophilia A, 20 (24%) patients were considered moderate hemophilia A and 13 (16%) patients were considered mild hemophilia A according to factor activity. Among severe hemophilia A patients, primary prophylaxis was being administered in 2 (2%) patients and secondary prophylaxis was being administered in 40 (48%) patients. Inhibitor positivity was found in 8 (10%) of these patients. It is found that hemophilic artropathy developed in 17 patients and 8 of these 17 patients had undergone radioisotope synovectomy. Conclusions: Treatment of severe bleeding in hemophilia A patients should be performed in hospital and the presence of inhibitor must be investigated in cases of uncontrolled bleeding where adequate doses of factor concentrates have been administered for treatment. In order to decrease the development of inhibitor, prophlaxis should be suggested to patients rather than repetetive treatment when bleeding occurs. The radioactive synovectomy should not be overlooked in countries like ours in which factors can not be used adequately.
Dyspnea Associated With Vocal Cord Paralysis and Type-2 Chiari Malformation
(Modestum Ltd, 2013) Ceylan, Abdullah; Aktar, Fesih; Karaman, Kamuran; Bektas, M. Selcuk; Kaya, Avni; Caken, Hueyin
The etiology of vocal cord paralysis is highly variable. Neurological, birth trauma, surgical procedure and idiopathic are notable causes. Clinical findings are different according to type of paralysis. Vocal cord paralysis can be seen unilateral or bilateral. Bilateral vocal cord paralysis are more severe clinical findings than according to unilateral paralysis. We report a 9-month child. He was admitted to hospital with stridor and cyanosis He was diagnosed Chiari malformation type 2 and bilateral vocal cord paralysis. Chiari malformation type 2 related vocal cord paralysis can severely respiratory failure.
Effectivity of Pancreatic Enzyme Replacement Therapy in Malnourished Children
(Wiley, 2020) Guven, Burcu; Mis, Mevsim Demir; Karaman, Kamuran; Yasar, Akkiz Sahin
Objective: Malnutrition is commonly seen in children with exocrine pancreatic insufficiency (EPI). Pancreatic enzyme replacement therapy (PERT) is the mainstay treatment of acute malnutrition in children detected with a disease closely associated with EPI (eg, cystic fibrosis). The effectiveness of PERT in children with malnutrition without any chronic disease, however, remains unclear. The aim of this study was to investigate the effectiveness of PERT on weight gain and EPI in children classified as moderately and severely malnourished according to the World Health Organization (WHO) classification. Materials and Methods: The study included a total of 40 children aged 2-16 years who were classified as moderately and severely malnourished according to the WHO classification. The patients were randomly divided into 2 groups: PERT group (n = 20) received 2000 U lipase/kg/day (in 4 doses) in addition to hypercaloric enteral supplements and control group received hypercaloric enteral supplements only. In both groups, anthropometric measurements and the assessment of fecal elastase-1 (FE-1) levels were performed both at first admission and at the end of the 8-week treatment period. Results: On the basis of WHO classification, 10 (25%) children were classified as severely malnourished and 30 (75%) children as moderately malnourished. EPI was detected in all the patients, among whom 24 (60%) patients had severe EPI. At the end of the treatment, body weight, height, and body mass index (BMI) increased significantly in both groups compared to their pre-treatment values, whereas no significant difference was found with regard to waist circumference (WC) and FE-1 levels. Similarly, no significant difference was found between pre- and posttreatment measurements of PERT and control groups (P > 0.05) and between pre- and posttreatment measurements of patients with moderate and severe malnutrition (P > 0.05). Conclusions: Malnutrition remains a serious public health problem, and thus, the development of novel treatment methods is highly essential. PERT is one of the most commonly considered alternatives, although there is little documentation of PERT in the literature. In the present study, although PERT resulted in higher weight gain, it established no significant difference between the 2 groups.
Effects of X-Ray Application on Infertility in New-Born Rats
(Taylor & Francis Ltd, 2023) Cibuk, Salih; Mert, Handan; Mert, Nihat; Tuncer, Oguz; Altindag, Fikret; Karaman, Kamuran; Meydan, Ismet
In this study, the effect of early X-ray exposure on infertility was investigated by creating a newborn model with rats. Fifteen Pregnant rats were divided into five groups. After birth, the study was continued with 12 babies (6 males, 6 females) rat in each group. Different amounts of X-rays were applied to the experimental groups. At the end of the experiment, there was found that testosterone levels decreased in all experimental groups compared to the control group (P < 0.05). When the experimental groups were compared to the control group, there was a decrease in the number of spermatogoniums from all the experimental groups. The decrease in group II, group III and group IV was found to be statistically significant (P < 0.05). As a result, exposure to X-rays in new-borns and premature babies; It was observed that it caused disruption of caspase signaling in gonad organs, a serious decrease in hormonal activity, a significant decrease in spermatogonia number and a decrease in the number of primordial follicles. Considering these results, it can be predicted that exposure to X-rays in the neonatal period, especially in the premature period, may lead to infertility in later life.
Efficiency of Pancreatic Enzyme Replacement in Treatment of Patients With Moderate-To Malnutrition
(2019) Mis, Mevsim Demir; Karaman, Kamuran
Mis D.M, Orta-Ağır Malnütrisyonlu Hastalarda Pankreas Enzim Replasmanının Tedavideki Etkinliği, Van Yüzüncü Yıl Üniversitesi, Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları, Uzmanlık Tezi, Van, 2019. Amaç: Bu çalışmada, Dünya Sağlık örgütü (DSÖ) sınıflamasına göre orta-ağır malnütrisyon tanısı almış hastalara uygun beslenme rejimi ile birlikte pankreas enzim replasman tedavisinin (PERT) kilo alımı üzerinde etkili olup olmadığını araştırmayı amaçladık. Gereç ve Yöntem: 1 Kasım 2018 – 1 Şubat 2019 tarihleri arasında Yüzüncü Yıl Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı Çocuk Gastroenteroloji ve Genel Çocuk polikliniklerine ayaktan başvuran, orta-ağır malnütrisyon tanısı alan 3 ay-17 yaş arası 45 çocuk (22 kız, 23 erkek) çalışmaya alındı. Hastaların demografik özellikleri, antropometrik ölçümleri ve laboratuvar verileri incelendi. Yaşlarına ve kilolarına uygun beslenme rejiminin yanında birinci gruba sadece hiperkalorik mama, ikinci gruba ise hiperkalorik mamanın yanında 2000 U lipaz /kg/gün dozunda PERT verildi. Hastaların ilk ve ikinci ay muayenelerinde antropomerik ölçümler yapıldı, fekal elastaz, desnutrin ve ghrelin seviyeleri çalışılarak PERT'in kilo alımı ve laboratuar değerleri üzerinde etkili olup olmadığı değerlendirildi. Bulgular: 45 hastanın 22si kız (%48,8), 23'ü erkek (%51,2) idi. Hiçbir hastamızda ek hastalık yoktu. Hastaların tamamında pankreas yetmezliği görüldü. Hastaların ilk ve iki aylık tedavi sonrası değerleri karşılaştırıldığında PERT grubundaki hastaların daha iyi kilo aldığı ancak istatiksel anlamlı fark yaratmadığı görüldü. Fekal elastaz, desnutrin ve ghrelin düzeyleri arasında da iki grup arasında anlamlı değişiklik olmadı. Sonuç: Malnutrüsyonun önemli halk sağlığı sorunlarından biri olmayı sürdüğü günümüzde yeni tedavi yöntemlerinin geliştirilmesi hala önemini korumaktadır. PERT üzerinde düşünülen bir seçenek olmakla birlikte bu konuda literatür sınırlıdır. Bildiğimiz kadarıyla çalışmamız bu konuda yapılan hasta grubunun en fazla olduğu ve PERT süresinin en uzun tutulduğu çalışmadır. Malnütre hastalarda PERT verilmesinin klinik ve biyokimyasal etkilerini incelediğimiz çalışmamızda PERT verilen grubun daha iyi kilo almakla birlikte anlamlı fark yaratmadığı, biyokimyasal belirteçler üzerinde beslenme desteğinden farklı bir sonuç çıkarmadığı görülmüştür.
Eosinophilic Leukemoid Reaction in a Male Adolescent With Loeffler Syndrome
(Wolters Kluwer Medknow Publications, 2015) Iclal, Bayhan Gulsum; Garipardic, Mesut; Karaman, Kamuran; Akbayram, Sinan
The Loeffler syndrome is characterized by pulmonary infiltrates on a chest x-ray accompanied with peripheral eosinophilia. In this article, we have highlighted the Loeffler syndrome complicated with a eosinophilic leukemoid reaction in a previously healthy boy. The patient was treated with albendazole for five days, with a successful result. In countries where parasitic diseases are endemic, the Loeffler syndrome must always be considered in patients who present with a eosinophilic leukemoid reaction.
Evaluation of Pentraxin 3 Level and Cardiac Functions in Psoriatic Children
(Turkish J Pediatrics, 2020) Cetin, Mecnun; Yavuz, Ibrahim Halil; Yavuz, Goknur Ozaydin; Karaman, Kamuran
Psoriasis is a chronic inflammatory disorder affecting the skin, nails, and joints. Its lifetime prevelance has been estimated to be at 1% to 3%. This study was designed to examine the association between serum pentraxin 3 (PTX3) and cardiovascular function in psoriatic children. Thirty-three children who were diagnosed with psoriasis, and 29 healthy children, between 4 and 18 years of age, were included in the study. Both patient and control group was evaluated by the pulsed wave tissue doppler imaging (TDI) echocardiography as well as with conventional Doppler echocardiography (CDE). PTX3 values of the groups were evaluated. There was no difference between cases and controls for age (9.67 +/- 3.72, 9.60 +/- 2.84 years, p=0.916, respectively). In evaluation of the left ventricle (LV) CDE; A wave, isovolumic relaxation time (IVRT) and myocardial performance index (MPI) were significantly higher in the study group (p<0.05). Ejection time (ET) was significantly lower in the study group compared to the control group (p<0.05). In evaluation of LV TDI; Deceleration time (DT'), IVRT', E/E' and MPI' were found to be significantly higher in the study group (p<0.05). In addition to, E', E'/A' and ET' were siginificantly lower in study group. PTX3 level was significantly higher in the study group compared to the control group (p=0.009) (Table III). However, no correlation was found between PTX3 level and cardiovascular parameters. In conclusion; both doppler echocardiography and PTX3 may be useful tools for the screening of cardiovascular (CV) risk in these patients. Psoriasis itself may be an independent risk factor for cardiac dysfunction in the pediatric population.