Browsing by Author "Sal, Ertan"

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Akut Batın Nedeniyle Opere Edilen Akut Romatizmal Ateş Olgusu
(2011) Kaya, Avni; Üner, Abdurrahman; Temel, Hayrettin; Üstyol, Lokman; Sal, Ertan; Bektaş, Mehmet Selçuk
Akut romatizmal ateş bir çok sistemi tutan otoimmun bir bağ dokusu hastalığıdır. Streptokoksik bir üst solunum yolu enfeksiyonunu takiben 10-14 günlük sessiz bir devreden sonra ateş, halsizlik ve solukluk semptomları ile hastalık başlar. Akut romatizmal ateşte küçük eklem tutulumu nadirdir. Ondört yaşındaki erkek hasta her iki el ve ayak bileklerinde ağrı ve şişlik nedeniyle getirildi. Olgu dış merkezde ateş, karın ağrısı ve kusma şikayetleri ile akut apandisit ön tanısı ile opere edilmiş. Hastaya artrit, kardit, sedimantasyon ve C-reaktif protein yüksekliği, elektrokardiyogramda PR uzaması ve antistreptolisin O yüksekliği bulgularıyla modifiye Jones kriterlerine göre Akut romatizmal ateş tanısı kondu. Akut romatizmal ateşin akut batın tablosunda gelip majör bulgularının yanı sıra nadirde olsa küçük eklem tutulumuna olabileceğine dikkat edilmelidir.
Arı Sokmasını Takiben Konvulziyon Geliştiren İki Olgu Sunumu
(2010) Bektaş, Selçuk; Sal, Ertan; Çağan, Eren; Kaya, Avni; Peker, Erdal; Çaksen, Hüseyın; Doğan, Murat
Arı sokmasına bağlı genelde aşırı duyarlılıkbelirtileri ortaya çıkar. Konvülziyon nadir olarakgörülebilen bir bulgudur. Burada arı sokmasınıtakiben nöbet geçiren ve etiyolojide başka nedensaptanamayan 2 olgu sunulmaktadır.
Ateş, Baş Ağrısı, Yürüme, Dik Durma ve Konuşmada Bozuklukla Başvuran Beş Yaşında Erkek Hasta
(2010) Sal, Ertan; Üstyol, Lokman; Kaya, Avni; Çaksen, Hüseyın; Okur, Mesut
Biotidinase Deficiency Accompanied by Diffuse Demyelination and Cerebral Atrophy
(Modestum Ltd, 2012) Okur, Mesut; Bektas, Mehmet Selcuk; Temel, Hayrettin; Caksen, Huseyin; Acikgoz, Mehmet; Sal, Ertan
Biotinidase deficiency is an inherited disorder which has autosomal recessive pattern; it occurs in approximately 1 in 60,000 live births. Usually it manifests seborrheic dermatitis, alopecia, ataxia, convulsions, hypotonia, developmental delay, hearing loss, chronic lactic acidosis and immune deficiency. Its diagnosis is made by the measurement of serum biotinidase enzyme activity and determination of the enzyme. Herein presented that a two and half-month-old boy with biotinidase enzyme deficiency which had cerebral atrophy without any skin signs. In the patients presented with refractory convulsions with unexplainable etiology without any skin lesions, as in our patient, biotinidase enzyme deficiency should be considered and the treatment should be established in early period to prevent many complications that may develop.
A Case of Acute Disseminated Encephalomyelitis Presented With Transvers Myelitis
(Turkish Pediatrics Assoc, 2010) Kaya, Avni; Ozkan, Mustafa; Bektas, M. Selcuk; Acikgoz, Mehmet; Temel, Hayrettin; Sal, Ertan; Caksen, Huseyin
Acute disseminated encephalomyelitis is an inflammatory and demyelinating disorder of central nervous system. A 9-year-old male was admitted with unable to walk, non-sensation of legs, urinary incontinence and encopresis for 2 days. On physical examination, muscle strength was 5/5 on upper extremities and 1/5 on lower extremities. Loss of pain, temperature and touch sensation was present on both lower extremities, reaches to T8 level. On spinal magnetic resonance imaging, diffuse hyperintensity from C3 to conus medullaris was detected. While electromyography was consistent with polyradiculoneuritis, magnetic resonance imaging findings were concordant with acute disseminated encephalomyelitis. On account of this case, we would like to emphasize that acute disseminated encephalomyelitis should be considered in patients presented with transverse myelitis; therefore, in addition to spinal magnetic resonance imaging, cranial magnetic resonance imaging should be examined in these patients. (Turk Arch Ped 2010; 45: 299-302)
A Case of Congenital Hypothyroidism Presented With Dysmyelinization Findings
(Elsevier Science Bv, 2014) Yuca, Sevil An; Yilmaz, Cahide; Kaya, Avni; Ustyol, Lokman; Sal, Ertan; Cesur, Yasar; Caksen, Huseyin
The central nervous system is one of the most crucial targeted systems of hyphotiroidism where tissues undergo various broad developmental processes such as neuronal and glial cellular differentiation, migration and myelinization. However brain images are mainly normal. In this articlel. we present findings related to a 1-year-old girl who has been referred to our outpatient he clinic with complaints of slowing of movement and lack of interest. She was diagnosed with hypothyroidism. Her brain magnetic resonance image obtained during diagnosis displayed dysmyelinization. It showed improvement after Na-L thyroxin therapy during follow up.
A Case With Theophylline Intoxication
(Aves, 2013) Sal, Ertan; Kaya, Avni; Temel, Hayrettin; Basaranoglu, Murat; Caksen, Huseyin
Theophylline is an agent used in the treatment of obstructive airway diseases. It has a risk of intoxication with serum concentrations higher than 15 mu g/mL. A seven-year-old female patient presented with complaints of vomiting and headache. She had tachycardia and other physical examination findings were found to be normal. We were informed that she ingested 10 tablets named Bronkolin (R) each containing 300 mg theophylline. Her serum theophylline levels were found to be > 40 mu g/ml (normal range: 10-20 mu g/ml). She was monitorized and received charcoal, potassium supplementation and intravenous fluid. Her serum theophylline declined to 3.1 mu g/ml and she was discharged. With this case presentation we wanted to emphasize that the possibility of drug intoxication should be considered in presence of hyperglycemia, hypopotassemia and tachycardia with accompanying symptoms including acute and unexplained vomiting and headache.
Clinical Outcome and Magnetic Resonance Imaging Findings in Infants With Hypoglycemia
(Sage Publications inc, 2011) Caksen, Huseyin; Guven, Ahmet Sami; Yilmaz, Cahide; Unal, Ozkan; Basaranoglu, Murat; Sal, Ertan; Kaya, Avni
The authors examined clinical outcome and cranial magnetic resonance imaging (MRI) findings in infants with hypoglycemia to determine the effects of hypoglycemia on the developing brain. A total of 110 infants with hypoglycemia were included in the study. Of the patients, 36 were females and 74 were males. The age of the infants was between 1 day and 22 months. Of the 110 infants, 47 were preterm neonates, 40 were term neonates, and 23 were older than 28 days. No difference in serum glucose level was noted between symptomatic and asymptomatic infants. The most common observed abnormal findings were hyperintense lesions, encephalomalacia, and cerebral atrophy. Abnormal MRI findings were found in 4% of preterm infants, in 32.5% of term infants, and in 43.5% of older infants. Abnormal MRI findings were statistically significantly more common in symptomatic infants than in asymptomatic infants. Of the infants, 45.5% of hypoglycemic infants had cerebral palsy and/or cerebral palsy plus epilepsy.
Çocuklarda Obezite İlişkili Kardiyovasküler Risk Faktörlerini Öngörmede Antropometrik Ölçümlerin Önemi
(2016) Başaranoglu, Murat; Arı, Sevil Yuca; Kaba, Sultan; Sal, Ertan; Bala, Keziban Aslı; Kocaman, Selami; Cesur, Yaşar
Amaç: Çocuklarda obezite ilişkili kardiyovasküler risk faktörlerini öngörmede antropometrik ölçümlerin prognostik önemini saptamak. Gereç ve Yöntem: Obezitesi olan 6-17 yaşlarındaki 100 çocuk vaka grubuna dahil edildi. Yaş ve cinsiyet bakımından benzer 100 sağlıklı çocuk kontrol grubuna dahil edildi. Vaka ve kontrol grubundaki çocukların antropometrik ölçümleri yapıldı ve kan basınçları ölçüldü. Kan lipidleri, HbA1c, açlık glukozu ve insülin düzeyleri hem vaka hem kontrol grubunda ölçülürken, oral glukoz tolerans testi sadece vaka grubunda yapıldı. Vücut yağ oranı bioimpedans vücut analizörü kullanılarak ölçüldü. Antropometrik ölçümlerin prognostik önemi ROC eğrisi kullanılarak değerlendirildi. Bulgular: Vaka grubundaki çocukların ortalama yaşları 11.44 ± 2.38 (48 kız 52 erkek), kontrol grubundaki çocuların yaş ortalamaları ise 11.46 ± 2.33 (48 kız 52 erkek) idi. Vaka grubundaki antropometrik ölçümlerin hepsi, kontrol grubundan daha yüksek bulundu. Obezite grubunda hipertansiyon, dislipidemi ve bozulmuş OGTT sırasıyla 26, 33, 37 çocukta bulundu. Herhangi bir kardiyovasküler risk faktörünü gösteren kesim noktası değeri vücut ağırlığı standart deviasyon skoru (SDS) için +2.6, vücut kitle indeksi (VKİ) SDS için +1.98, vücut yağ oranı için %27.1, subskapular deri kalınlığı için 29 mm, bel/boy oranı için 0.59 ve kalça/ boy oranı için 0.93 olarak bulundu. Sonuç: Antropometrik ölçümlerden subskapular deri kalınlığı ve bel/boy oranı obezite ilişkili kardiyovasküler risk faktörlerini öngörmede kullanılabilecek en iyi parametrelerdir.
Comparison of Pulse Oxymeter and Cerebral Oxymeter Values in Healthy Newborns in the First Five Minutes of Life
(Nobel Ilac, 2015) Taskin, Gokmen A.; Kaya, Avni; Sal, Ertan; Ustyol, Lokman; Peker, Erdal; Tuncer, Oguz; Kirimi, Ercan
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 (SpO(2)), 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. SpO(2), 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 SpO(2) 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 4(th) and 5(th) minutes; SpO(2) 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..
Concurrent Celiac Disease, Idiopathic Thrombocytopenic Purpura and Autoimmune Thyroiditis: a Case Report
(Sage Publications inc, 2011) Dogan, Murat; Sal, Ertan; Akbayram, Sinan; Peker, Erdal; Cesur, Yasar; Oner, Ahmet F.
Celiac disease (CD) is a disease of the small intestine caused by an immune response to ingested gluten. Idiopathic thrombocytopenic purpura (ITP) is a common acquired bleeding disorder of childhood. It may follow a viral infection or immunization and is caused by an inappropriate response of the immune system. Autoimmune thyroiditis (AT) is a disease that occurs due to autoimmune mechanisms. Celiac disease associated with autoimmune thyroid disease is well known, but the association of CD, autoimmune thyroid disease, and ITP has been reported very rarely in the literature. In the current report, we have presented a case with CD, AT, and acute ITP, because this association is rarely seen, and to emphasize that CD and AT should be kept in mind in patients with ITP.
Evaluation of Oxidant and Antioxidant Status in Infants With Hyperbilirubinemia and Kernicterus
(Sage Publications Ltd, 2011) Dogan, Murat; Peker, Erdal; Kirimi, Ercan; Sal, Ertan; Akbayram, Sinan; Erel, Ozcan; Tuncer, Oguz
Objective: The objective of the present study was to determine oxidant and antioxidant status in infants with hyperbilirubinemia and/or kernicterus and to find whether there is a relationship between bilirubin level and oxidant/antioxidant status. Patients: The study includes 69 full-term newborns (neonates with hyperbilirubinemia needing phototherapy [Group 1, n = 36] and neonates with kernicterus [Group 2, n = 33]) and 25 age-matched healthy newborn. Results: Plasma total antioxidant capacity (TAC) and serum total oxidant status (TOS) were significantly higher in Groups 1 and 2 than the control group. There was a significant difference between Group 1 and control cases for malondialdehyde (MDA; p < 0.001). Total free sulfhydryl group (TTHI) values were significantly elevated in Group 1 compared to Group 2 and control cases. Correlation analysis showed that the correlation between total bilirubin (TB) and TAC, TOS, MDA and oxidative stress index may be expressed by a quadratic curve. After phototherapy, a statistically significant increase in nitrite level was observed. Conclusion: We demonstrated that the relationship between serum TB and antioxidants and oxidative stress could be expressed by a quadratic correlation curve.
A Five-Year Boy With Fever, Headache, Disturbances in Walking, Erect Posture and Speech
(Galenos Yayincilik, 2010) Okur, Mesut; Kaya, Avni; Ustyol, Lokman; Sal, Ertan; Caksen, HuSeyin
Iatrogenic Cushing's Syndrome Due To Topical Steroid
(Nobel Ilac, 2009) Kaya, Avni; Yuca, Sevil Ari; Dogan, Murat; Sal, Ertan; Temel, Hayrettin; Cesur, Yasar
Diaper dermatitis (napkin rash) is a skin disease which can be seen in diaper areas of babies as rubor and in more serious cases as bulla and open wounds For treatment in necessary conditions, it is suggested to use antifungals and/or 0.5% hydrocortisone pomads in addition to symptomatic therapy such as moistening of the skin and removal of irritant agents from area Seven-month-girl and six-month-boy case was brought with excess weight intake complaints They were excessively obese and had an increase adipose tissue under their skins Both cases had used pomads involving clobetasol 17-propionate for the last 3 months Their family history was normal. Serum ACTH levels was <5 00 pg/mL (25-100 pg/mL) and plasma cortisol levels was <1 00 mu g/dL (5-23 mu g/dL) in both cases Cushing's syndrome associated with pomade with topical steroid was diagnosed in the cases and pomades that they used were abandoned. The cushinglike appearance has declined over time and disappeared after some time Cases are being followed as asymptomatically. It would not be surprising to sec more new cases of iatrogenic Cushing's syndrome, until usage of topical pomades, which has high steroid effect, without indication and especially without prescription is stopped.
Investigation of Oxidant and Antioxidant Pathway Changes in Acute Rheumatic Fever
(Taylor & Francis Ltd, 2010) Uner, Abdurrahman; Sal, Ertan; Dogan, Murat; Sanli, Fatih M.; Acikgoz, Mehmet; Cemek, Mustafa; Cagan, Eren
Aim - The purpose of this study was to investigate the role of oxidant stress in the clinical process and pathogenesis of acute rheumatic fever (ARF). Material and methods - The study included 33 children with ARF and 20 healthy control subjects. The diagnosis of ARF was established according to the Jones Criteria. Malondialdehyde (MDA), reduced glutathione (GSH), alpha-tocopherol, ascorbic acid, retinol and beta-carotene levels were measured as markers of oxidative stress together with some antioxidant markers. Results - Our study includes 33 (19 male, 14 female) children with ARF and 20 (11 male, 9 female) healthy control subjects. The mean age ranged between 5-16 years and 5-15 years in the study and control groups, respectively. MDA was measured as 2.1 +/- 0.9 nmol/mL in the control group, 3.3 +/- 2.7 nmol/mL in the study group before treatment, and 2.1 +/- 1.2 nmol/mL after treatment. Blood GSH levels were 48.2 +/- 12.7 mg/dL in the control group, 24.7 +/- 16 mg/dL in the study group before treatment, and 40.6 +/- 21.3 mg/dL in the study group after treatment. MDA and GSH levels prior to the treatment were found to be significantly high and low as compared with the levels of the control group, respectively (P < 0.05, P < 0.001). After treatment, statistically important decrements and increments were determined in the levels of MDA (P < 0.05) and GSH (P < 0.01), respectively. Furthermore, alpha-tocopherol, retinol and beta-carotene levels prior to treatment in the study group, were significantly lower in comparison with control group levels (P = 0.05, P < 0.05, P < 0.01, respectively). Conclusion - We suggested that tissue damage in ARF may not only occur in the presence of increased oxidative stress, but also as a consequence of decreased antioxidant markers.
Mycoplasma Pneumoniae Meningoencephalitis: a Case Report
(Wolters Kluwer Medknow Publications, 2013) Bektas, Mehmet Selcuk; Aktar, Fesih; Acikgoz, Mehmet; Sal, Ertan; Caksen, Huseyin
Nervous system is the most affected area in mycoplasma pneumoniae infections with exception of respiratory system. It is an important agent of childhood acute encephalitis and respiratory system infections in school-age children and young adults. Routine clinical and laboratory findings to identify spesific diagnosis is limited. Twelve-year-old female patient was admitted with fever, fatigue, sore throat, slipping the right eye, withdrawal of the mouth from the right and right hemiclonic seizures. Test of anti-Mycoplasma pneumoniae (M. pneumoniae) IgM was positive and IgG antibodies were found to be 4-fold increase in the sera of follow-up. This article was presented with the aim of remembering M. pneumoniae to be an differential diagnosis in children with acute encephalitis.
New Coagulant Agent (Ankaferd Blood Stopper) for Open Hemorrhages in Hemophilia With Inhibitor
(Sage Publications inc, 2010) Oner, Ahmet Faik; Dogan, Murat; Kaya, Avni; Sal, Ertan; Bektas, Mehmet Selcuk; Yesilmen, Osman; Acikgoz, Mehmet
The treatment of hemophilia A patients with inhibitor could be very expensive. Ankaferd blood stopper (ABS) is a unique folkloric medicinal plant extract, which has historically been used in Turkish traditional medicine as a hemostatic agent. In this article, a 16-year-old boy was presented with uncontrolled bleeding, despite the treatment of factor VIII, rVIIa, factor VIII inhibitor bypass activity (FEIBA), cyclophosphamide, and prednisolone at circumcision site that resolved with ABS in minutes. Our patient with hemophilia A and inhibitor is the first clinical pediatric case.
P-Wave and Qt Interval Dispersion Analysis in Children With Eisenmenger Syndrome
(Turkish Soc Cardiology, 2014) Ece, Ibrahim; Uner, Abdurrahman; Balli, Sevket; Oflaz, Mehmet Burhan; Kibar, Ayse Esin; Sal, Ertan
Objectives: P-wave and QT dispersion are increased and associated with atrial and ventricular arrhythmia and an increase in sudden death in a variety of diseases. This study aimed to investigate P-wave and QT dispersion in children with Eisenmenger syndrome (ES). Study design: The study group included 27 children (15 females, 12 males) with both congenital heart disease (CHD) and ES. The control group consisted of 30 children with CHD without pulmonary arterial hypertension. Electrocardiographic records were used to determine P-wave, QT, and corrected QT (QTc) dispersions. 24-hour (h) rhythm Holter was fitted in all patients. Atrial volumes, ventricular dimensions and tricuspid annular plane systolic excursion (TAPSE) were measured by echocardiography Results: There was no difference between groups with regard to age, sex, weight, and body surface area (p>0.05). Right atrial volume was significantly larger in the ES group than in the control group. P-wave, QT and QTc dispersions were higher in the patients with ES (50.10 +/- 11.12 vs. 26.32 +/- 8.90, p<0.001; 57.40 +/- 24.21 vs. 38.20 +/- 8.92 ms, p<0.001; and 78.20 +/- 16.02 vs. 56.52 +/- 13.92 ms, p<0.001, respectively). Ventricular and supraventricular ectopy were significantly more frequent in the ES group. Four patients (14.8%) in the study group had tachyarrhythmias during 24-h Holter monitoring. Conclusion: In our study, P-wave and QT dispersion were found to be greater in children with ES than in the healthy control subjects.
The Ratio of Congenital Heart Disease and Innocent Murmur in Children in Van City, the Eastern Turkey
(Turkish Soc Cardiology, 2009) Uener, Abdurrahman; Dogan, Murat; Bay, Ali; Cakin, Caner; Kaya, Avni; Sal, Ertan
Objective: We tried to determine the prevalence of and expose the significance of clinical evaluation of innocent and pathological murmurs due to underlying disorders and to determine the indication of echocardiographic examination in innocent murmurs' evaluation and the frequency of congenital heart diseases (CHD) in childhood. Methods: This study was performed on 6035 children between 6-15 ages (3306 boys and 2729 girls) who attended six different elementary schools reflecting various economic groups in Van city in the Eastern of Turkey, which is a developing country. Results: We detected murmurs of different intensities in 243 patients (4%). The results showed that 209 children's (3.5%) murmurs were accepted as innocent. The regurgitation was detected in single or two valves in 27% (56 cases) of cases with innocent murmurs. Additionally no valve insufficiency or regurgitation was determined in children who had innocent murmurs except these 56 cases. Of patients who had murmurs, 27 children (0.4%) had congenital heart disease and 7 (0.1%) had rheumatic heart disease. In patients who had CHD, mitral valve prolapsus and tricuspid valve prolapsus were found in 48% and 37% of the cases, respectively. Conclusion: Congenital heart disease was found in similar frequency with the literature. Innocent murmurs were found lower than in the literature, but higher than in other studies done in our country. Our study showed that, especially valve prolapsus, other CHD and less frequently rheumatic carditis can be seen in children who look like otherwise healthy. We emphasize that all children especially attending primary education, should be examined by a cardiologist even they have no complaints. (Anadolu Kardiyol Derg 2009; 9: 29-34)
The Retrospective Evaluation of The Urinary Tract Infection Cases in Van Region
(Nobel Ilac, 2009) Akgun, Cihangir; Kaya, Avni; Atas, Buelent; Sal, Ertan; Tuncer, Oguz; Arslan, Suekrue
Objective: The aim of this study was to obtain the agent pathogens and the etiologic factors of the 1,490 cases that are followed with the diagnosis of urinary tract infection by Van Yuzuncu Yil University, School of Medicine, Department of Pediatric Nephrology. Material and Method: A patient group of the last 8 years who were followed due to the urinary tract infection in out, hospital was examined. This patient group was chosen by file research. 1,490 children were included to the study, age between I day and 204 months. Results: With the evaluation of the factors and distribution of the urinary tract infection, 2897 urinary culture positive cases were obtained. The urinary tract infection etiologic factors in order of frequency were as follows: Escherichia coli, Klebsiella spp, Proteus spp, koagulase negative Stafilococcus spp, Enterobacter spp, Staphilococcusaureus, Pseu-domonas aeruginosa, Enterococcus spp and others. Together with the urinary tract infection gastroenteritis, malnutrition, phimosis, bladder dysfunction, mental-motor deficiency, urinary system stone disease, enuresis nocturna, hyper-calciuria, constipation, neurogenic bladder, febrile convulsion, prolonged jaundice were remarkable. It was seen that 14.3% of the patients had recurrent infection. In our study, it was seen that the females were more than the males, except the newborn period. The females were not 3-5 times more and the ratio was only 1.34 times. The gram negative bacterias which are parallel to the literature were detected at the all age groups. When this study is compared by the similar studies according to vesicouretheral reflux, 11 and III degree vesicouretheral reflux detecting ratios were similar but the first degree vesicouretheral reflux ratio was less. The scar ratio detected at the kidney was nearly similar to the literature but the ratio was more at our cases. Chronic renal failure ratio is 0.07-0.2% at the patients who had the urinary tract infection. In out, cases, chronic renal failure was detected 1.7% (26 patients). This high ratio shows that the chronic renal failure due to the urinary tract infection is a serious morbidity and mortality cause. Conclusion: This study shows that it is needed to make new studies about the urinary tract infection at the low social and low economic regions of Turkey.