Browsing by Author "Peker, E."

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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.
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.
Baller-Gerold Syndrome Associated With Dextrocardia
(Medecine Et Hygiene, 2011) Ceylan, A.; Peker, E.; Dogan, M.; Tuncer, O.; Kirimi, E.
Baller-Gerold syndrome associated with dextrocardia: Baller-Gerold Syndrome (BGS) is a rare autosomal recessive disorder that is apparent at birth. The disorder is characterized by distinctive malformations of the skull and facial area and bones of the forearms and hands. We report a 4 year old boy in whom the clinical features of craniosynostosis and bilateral absent thumbs and radii led to a diagnosis of Baller-Gerold syndrome. Physical examination revealed that the heart was localized to the right side. Echocardiography confirmed dextrocardia. Dextrocardia has not previously been reported with Baller-Gerold syndrome. To the best of our knowledge, this is the first reported case of Baller-Gerold syndrome associated with dextrocardia.
Buried and Trapped Penis: a Case Report
(Wiley-blackwell, 2010) Isik, D.; Isik, Y.; Peker, E.; Atik, B.
P>While buried penis cases are characterised by congenital normal attachments to penis, trapped penis cases are characterised by insufficiency of penile skin occurring as a complication after surgical operations such as circumcision. Unless diagnosed, circumcision procedures should be avoided in congenital concealed penis cases. Here we present a case of congenital buried penis with deteriorated clinical findings after two circumcision procedures at 1.5 years of age. The surgical treatment applied in this case is discussed.
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.
Comparison of Cerebral Oximeter and Pulse Oximeter Values in the First 72 Hours in Premature, Asphyctic and Healthy Newborns
(Univ West indies Faculty Medical Sciences, 2014) Kaya, A.; Okur, M.; Sal, E.; Peker, E.; Kostu, M.; Tuncer, O.; Kirimi, E.
Aim: The monitoring of oxygenation is essential for providing patient safety and optimal results. We aimed to determine brain oxygen saturation values in healthy, asphyctic and premature newborns and to compare cerebral oximeter and pulse oximeter values in the first 72 hours of life in neonatal intensive care units. Methods: This study was conducted at the neonatal intensive care unit (NICU) of Van Yuzuncu Yil University Research and Administration Hospital. Seventy-five neonatal infants were included in the study (28 asphyxia, 24 premature and 23 mature healthy infants for control group). All infants were studied within the first 72 hours of life. We used a Somanetics 5100C cerebral oximeter (INVOS cerebral/somatic oximeter, Troy, MI, USA). The oxygen saturation information was collected by a Nellcor N-560 pulse oximeter (Nellcor-Puriton Bennet Inc, Pleasanton, CA, USA). Results: In the asphyxia group, the cerebral oximeter average was 76.85 +/- 14.1, the pulse oximeter average was 91.86 +/- 5.9 and the heart rate average was 139.91 +/- 22.3. Among the premature group, the cerebral oximeter average was 79.08 +/- 9.04, the pulse oximeter average was 92.01 +/- 5.3 and the heart rate average was 135.35 +/- 17.03. In the control group, the cerebral oximeter average was 77.56 +/- 7.6, the pulse oximeter average was 92.82 +/- 3.8 and the heart rate average was 127.04 +/- 19.7. Conclusion: Cerebral oximeter is a promising modality in bedside monitoring in neonatal intensive care units. It is complementary to pulse oximeter. It may be used routinely in neonatal intensive care units.
Comparıson of Pulse Oxymeter and Cerebral Oxymeter Values in Healthy Newborns in the First Five Mınutes of Life
(Nobelmedicus, 2014) Taskin, G.A.; Kaya, A.; Sal, E.; Üstyol, L.; Peker, E.; Tuncer, O.; Kırımi, E.
Objective: Practical approaches in delivery rooms have been discussed about oxygen usage in recent years. In this study, it was aimed to correlate preductal arterial oxygen saturation (SpO2), heart rate per minute and serebral oxygen saturation (SbO2) values of first five minutes of life and to try the pulse oxymeter (PO) and cerebral oxymeter (SO) usage practice in delivery room. Material and Method: A hundred healthy term uncomplicated newborn babies, who were born via normally spontan vaginal route, were included in the study. SpO2, SbO2, heart rate measurements and blood gase analysis of first five minutes of postnatal life were completed. Babies, who needed oxygen during measurements, were not taken in to the study.. Results: While postnatal 1st minute SpO2 value was 83.0±4.4 (74-94)%; at 5th minute these measurements reached to 92.9±3.5 (85-98)% with gradually increment. Except values of 4th and 5th minutes; SpO2 values were found statistically significant high with each other (p<0.05). At SbO2 measurements, suitable data was taken from 100% of the babies in first minute of life. While postnatal mean SbO2 value of the first minute was 48.9±9.9 (32-74)%; these measurements were reached to 69.9±9.5 (46-89)% at 5th minute gradually increment as like as SpO2 values. Conclusion: SO is complementary to PO in delivery room and can be used routinely. It was seen also in our study; oxygen need of newborns can be determined faster and more accurately with SO use in delivery room so unnecessary oxygen usage and its potential risks can be avoided.. © 2015, Nobelmedicus. All Rights Reserved.
Congenital Myasthenic Syndrome: a Case Report
(Medecine Et Hygiene, 2011) Ceylan, A.; Tuncer, O.; Sayin, R.; Peker, E.; Caksen, H.; Sari, S.
Congenital myasthenic syndrome: a case report: Congenital myasthenic syndromes (CMS) are diseases of the neuromuscular junction. They usually belong to the disease groups that begin in the infantile or childhood period and carry genetic characteristics. The following is important in establishing the diagnosis of this disease: clinical findings, electromyography, genetic tests, determination of serum acetylcholine receptor antibodies. Acetylcholine esterase inhibitor drugs are used in treatment of CMS. A seven-month old male patient was brought to our department with the complaints of difficult breathing, falling of the eyelids and swallowing difficulty. With clinical and laboratory findings, he was diagnosed with congenital myasthenia and treatment was started. CMS should be suspected in patients with no pathological findings on the physical examination, and normal chest X-rays.
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.
Esophageal Atresia Concomitant With Congenital Hypothyroidism and Phenylketonuria in a Newborn
(Walter de Gruyter GmbH, 2010) Peker, E.; Tuncer, O.; Cagan, E.; Dogan, M.; Kaya, A.; Aveu, S.; Kirimi, E.
Evaluation of Children With Neurobrucellosis
(Comenius Univ, 2012) Akbayram, S.; Dogan, M.; Peker, E.; Bektas, M. S.; Caksen, H.; Karahocagil, M.
Background: Brucellosis is an endemic disease in many areas throughout the world. Central nervous system involvement is a serious complication of brucellosis with a ratio of 4-11% of all patients. Aim: to describe our experience in diagnosis, treatment, and outcome of 25 pediatric patients with neurobrucellosis. Patients and methods: This study included a review of medical records of patients who were diagnosed with neurobrucellosis between March 2001 and March 2009. Patients who had both clinical findings consistent with neurobrucellosis and positive microbiologic/serologic examinations of CSF with abnormal CSF findings were enrolled in the study. Results: The study included 25 patients between 1 and 15 years of age (mean 8.8 years), while 15 were males and 10 were females. Most of the patients (52 %) were in the age group of 5-9 years with male predominance. The distribution of cases showed density in June and February. The most commonly presented complaints were headache, fever and sweating while the most commonly observed findings were fever and meningeal irritation signs. All patients had positive cerebrospinal fluid agglutination test for brucellosis. Four different regimens were used based on ceftriaxone, doxycycline, cotrimoxasole, streptomycin, and rifampicin. One patient died, three patients were discharged with sequel, and the remaining patients (84 %) were discharged with full recovery. Conclusion: Clinicians, especially those providing health services in endemic areas like Turkey, should keep in mind that neurobrucellosis can be involved in patients with unexplained symptoms like memory impairment or in patients diagnosed with meningitis (Tab. 5, Fig, 2, Ref. 39). Full Text in PDF www.elis.sk.
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 Incidence of Asymptomatic Hypertension in School Children
(2010) Akgun, C.; Dogan, M.; Akbayram, S.; Tuncer, O.; Peker, E.; Taşkin, G.; Arslan, D.
Background: Although hypertension is a well-documented risk factor for cardiovascular diseases, including myocardial infarction and stroke, in adults, only recently has knowledge about childhood hypertension increased significantly. Aim: To determine the incidence of asymptomatic hypertension in school-age children. Subjects and Methods: Children in primary school were chosen with a randomized sampling method. During measurement of blood pressure, a calm, comfortable setting was provided. Blood pressure measurements were performed by only 1 researcher. For accurate measurement of blood pressure, recommended standards were followed. Results: A total of 1,963 children were included in the study. The incidence of systolic hypertension and diastolic hypertension were 7% and 2%, respectively. Obesity was present in 10.5% girls with hypertension and 13.9% of boys with hypertension. Conclusion: Our findings indicate that hypertension is an important health problem in children, and its prevalence is quite high. Blood pressure measurements must be a part of routine clinical examinations. Further studies should be performed in high-risk populations to prevent hypertension and to establish methods of early diagnosis and treatment in children.
Increased Serum Malondialdehyde Level in Neonates With Hypoxic-Ischaemic Encephalopathy: Prediction of Disease Severity
(Sage Publications Ltd, 2010) Kirimi, E.; Peker, E.; Tuncer, O.; Yapicioglu, H.; Narli, N.; Satar, M.
Increased serum level of malondialdehyde (sMDA) in neonates with hypoxic-ischaemic encephalopathy (HIE) was evaluated as a possible criterion for determining HIE severity. Mean body weight and gestational age in a healthy control group of neonates (n = 63) and in neonates with HIE (n = 69) were statistically similar. Apgar scores at 1 and 5 min for the HIE group were significantly lower than for the control group. The mean sMDA level for the HIE group was significantly higher than the control group. Within the HIE group, the sMDA level for neonates with Sarnat's grade II and III was significantly higher than for those with Sarnat's grade I. There was a significant correlation between Sarnat's grading and the sMDA level. The sMDA level was significantly higher for neonates who died (n = 20) compared with those who survived (n = 49). In conclusion, the sMDA level was highest in neonates with HIE and correlated with HIE severity. The sMDA concentration could, therefore, be used as a criterion for predicting disease severity.
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.
Joubert Syndrome Associated With Patent Ductus Arteriosus in a Newborn Infant
(Medecine Et Hygiene, 2009) Peker, E.; Kirimi, E.; Sal, E.; Ceylan, A.; Ustyol, L.; Caksen, H.
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.