Browsing by Author "Ustyol, Lokman"

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Acute Cyanide Intoxication Due To Apricot Seed Ingestion
(Elsevier Science inc, 2013) Akil, Muhammed; Kaya, Avni; Ustyol, Lokman; Aktar, Fesih; Akbayram, Sinan
Acute Cyanide Poisoning After Eating Apricot Pits: a Case Report
(Galenos Yayincilik, 2012) Kaya, Avni; Okur, Mesut; Ustyol, Lokman; Temel, Hayrettin; Caksen, Huseyin
The stones and seeds of some plants such as apples, apricots, and peaches contain significant amounts of cyanide glycosides. Apricot pits are more toxic as they contain higher amounts of cyanogens and release hydrogen cyanide more easily. A previously healthy 27-month old male patient was admitted to our emergency department as intubated. His history revealed that he was intubated in the hospital where he was taken to with the complaint of fainting after having eaten numerous apricot pits with other family members. His general status was poor and he was unconscious. Both of his pupils were reactive. His deep tendon reflexes were increased and his plantar reflex was extensor bilaterally. The case was diagnosed as cyanide intoxication and the patient was admitted to the intensive care unit. Oxygen was constinuosly given under observation. After administration of hydroxocobalamine and sodium bicarbonate and correction of sodium deficit the patient regained consciousness and his general health improved. On the second day of admittance, he was discharged with a stable condition. This case was presented to emphasize that parents should not feed small children with apricot pits. (Turk Arch Ped 2012; 47: 141-2)
Arachnoid Cyst Causing Subfalcine Herniation in a Child Failure To Thrive
(Nobel Ilac, 2011) Dogan, Murat; Yilmaz, Cahide; Ustyol, Lokman; Caksen, Huseyin
Arachnoid cysts represent only 1% in all intracranial masses. The signal and density of arachnoid cysts are mostly the same as cerebrospinal fluid unless be complicated. They do not have calcification and do not retain contrast material but they are benign lesions. Although they can be seen in all ages, they are mostly detected in children. Male-female ratio is In this case report., 18 months-old-boy with subfalcine herniation because of an arachnoid cyst who was brought to our hospital only with complaint of failure to thrive was presented due to its atypical and rare presentation.
Association of Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorders With Mean Platelet Volume and Vitamin D
(int Scientific information, inc, 2017) Garipardic, Mesut; Dogan, Murat; Bala, Keziban Asli; Mutluer, Tuba; Kaba, Sultan; Aslan, Oktay; Ustyol, Lokman
Background: The purpose of this study was to assess the values of the mean platelet volume (MPV) in children with attention deficit hyperactivity disorder (ADHD) and with autism spectrum disorders (ASDs) to determine the risk of cardiovascular disease in these 2 disorder groups. Material/Methods: The study included a total of 79 patients with ADHD or ASDs and controls in the Van region of Turkey. The control group included subjects of matching age and sex with no ADHD, ASDs, or chronic disease and taking no vitamins. The hematological parameters of the patients, including MPV, vitamin B12, and vitamin D, were assessed. Results: The study included a total of 79 children and adolescents aged 2-18 years (32 females and 47 males). Of the patients, 36 were in the ADHD group, 18 in the ASDs group, and 25 in the control group. There was no statistically significant difference in hematological parameters between the groups, but there were significant differences in terms of vitamin D and vitamin B12. The patient groups showed lower levels of vitamin B12 and vitamin D. In the ADHD group, there was a negative correlation between both vitamins and MPV (p<0.05). Partial correlation analysis of the ADHD group showed that MPV in particular was negatively correlated to vitamin D, and not to vitamin B12 (p: 0.03). Conclusions: Both ADHD and ASDs may accompany increased risk for cardiovascular disease due to the presence of vitamin B12 and D deficiency and their own characteristics. Therefore, these disorders should be closely followed up.
A Case of Chediak-Higashi Syndrome Presented With Hemophagocytic Lymphohistiocytosis
(Akad Doktorlar Yayinevi, 2011) Akbayram, Sinan; Akgun, Cihangir; Basaranoglu, Murat; Kaya, Avni; Balta, Gunay; Ustyol, Lokman; Oner, Ahmet F.
Chediak Higashi syndrome, is a rare autosomal recessive disorder characterised by oculocutaneus albinism, recurrent respiratory system infections and other pyogenic infections. Hemophagocytic lymphohistiocytosis can develop in any time of the life in patients with Chediak Higashi syndrome. A 14-month-old girl patient was diagnosed as hemophagocytic lymphohistiocytosis with the laboratory findings of pancytopenia, high levels of triglyceride and ferritin, hypofibrinogenemia, low ratio of natural killers in lymphocyte subtypes, and with determined macrophages that made hemophagocytosis in recurrent bone marrow aspirates. The treatment protocol of hemophagocytic lymphohistiocytosis 2004 was administered. During the maintenance treatment, recurrence was developed. In the second bone marrow examination, the diagnosis of Chediak Higashi syndrome was made with determined intracytoplasmic giant granules. Hair analysis result was meaningful for Chediak Higashi syndrome. In this report, we would like to emphasize the condition that especially in early infants, Chediak Higashi syndrome presenting with hemophagocytic lymphohistiocytosis may be misdiagnosed because of the uncertain clinical findings and this can be the result of resistance to treatment.
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.
The Clinical Outcome of 260 Pediatric Itp Patients in One Center
(Sage Publications inc, 2011) Akbayram, Sinan; Dogan, Murat; Ustyol, Lokman; Akgun, Cihangir; Peker, Erdal; Bilici, Salim; Oner, Ahmet Faik
In the current study, clinical and laboratory findings and treatment modalities of children with acute and chronic immune thrombocytopenic purpura (ITP) were evaluated retrospectively. Our purpose was to determine clinical outcome of children with ITP and their responses to different treatment regimes. Total of 260 children with ITP were enrolled in the study. The mean age of patients was 76.8 +/- 48.1 months. The therapy responses of high-dose methylprednisolone (HDMP; n = 134), standard dose methylprednisolone (n = 32), and intravenous immunoglobulin (IVIG; n = 15) treatments were similar. Two (0.8%) of the 260 ITP patients had intracranial bleeding. None of the patients died due to hemorrhage. Of all the patients with ITP, 191 (73.5%) completely resolved within 6 months after initiation of the disease and therefore they were diagnosed as acute ITP; 69 patients (26.5%) had progressed into chronic ITP. The therapy responses of HDMP, standard dose methylprednisolone, and IVIG treatments are similar.
Comparative Nephroprotective Effects of Silymarin, N-Acetylcysteine, and Thymoquinone Against Carbon Tetrachloride-Induced Nephrotoxicity in Rats
(Kowsar Publ, 2017) Ustyol, Lokman; Demiroren, Kaan; Kandemir, Ibrahim; Erten, Remzi; Bulan, Kezban; Kaba, Sultan; Basunlu, Mehmet Turan
Background: Many pharmacological agents may lead to kidney damage. Preventing nephrotoxicity reduces the risk of morbidity and mortality, as well as decreasing hospitalization costs. Objectives: In this study, we investigated the comparative nephroprotective effects of silymarin, N-acetylcysteine (NAC), and thymoquinone (TQ) in animal models (rats) in which we induced nephrotoxicity using carbon tetrachloride (CCl4). Methods: This animal experimental study was conducted at the experimental animals center of Yuzuncu Yil University, Turkey, in 2015. Thirty-eight adult male Wistar rats were used in this study. We defined five experimental groups and treated them for four weeks. The first group (n = 8) was given no medicine. The second group (n = 8) was given only CCl4 (1.5 ml/kg, intraperitoneally (IP), in olive oil, twice a week). The third group (n = 6) was given TQ (10 mg/kg, IP, in dimethyl sulfoxide (DMSO), daily) and CCl4 (1.5 mL/kg). The fourth group (n = 8) was given silymarin (100 mg/kg, IP, in DMSO, daily) and CCl4 (1.5 mL/kg), while the fifth group (n = 8) was given NAC (10 mg/kg, IP, daily) and CCl4 (1.5 mL/kg). The kidneys of all the rats in every group were evaluated histologically using light microscopic methods at the end of the fourth week. A grading scheme was used to score the histological alterations related to tubular injury: absent (-), mild (+), moderate (++), severe (+++), and quite severe (++++). Results: In terms of the mean values of tubular damage, the first group had a mean of 0.0, the second group had 3.88 +/- 0.35, the third group had 1.00 +/- 0.89, the fourth group had 2.13 +/- 1.13, and the fifth group had 2.75 +/- 1.04. The results showed that, histopathologically, CCl4 had quite a severe toxic effect on the tubules when compared to the control group, although the glomeruli were intact. Silymarin, TQ, and NAC all showed statistically significant nephroprotective effects (P < 0.01). However, of the three, TQ was the most powerful nephroprotective agent (P < 0.01). Conclusions: In conclusion, we suggest that TQ may be used as a prophylactic agent against nephrotoxicity, especially in instances of tubular injury. However, human-based studies are still needed.
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..
Cystinosis in Eastern Turkey
(Walter de Gruyter Gmbh, 2016) Dogan, Murat; Bulan, Keziban; Kaba, Sultan; Cesur, Yasar; Ceylaner, Serdar; Ustyol, Lokman
Background: This study was conducted to investigate CTNS (cystinosin, lysosomal cystine transporter) gene mutations and the clinical spectrum of nephropathic cystinosis among patients diagnosed with the disease in a single center in Turkey. Methods: Patients' clinical and laboratory data were extracted from an electronic health registry. Molecular CTNS gene analysis was performed using either next-generation sequencing or Sanger sequencing. Results: Eleven patients (age range: 1.5-12 years) from nine families were identified. The presenting complaint was growth retardation in seven patients; polydipsia and polyuria in three patients; and vomiting in two patients. At presentation, electrolyte loss was noted in all patients, of which eight patients presented with metabolic acidosis, and three patients presented with metabolic alkalosis. All patients also presented with proteinuria and -glucosuria, and four patients developed varying degrees of renal insufficiency, for which peritoneal dialysis was initiated in one patient. Cystine crystals were detected via ocular examination in one patient at presentation. No cystine crystals were detected among patients who underwent bone marrow aspiration. In the CTNS gene, a p.T7FX7 (c.18-21del4bp) mutation was detected in three patients, whereas a p.E227E (c.681 G > A) (homozygous) mutation was detected in eight patients. Conclusions: We detected two distinct mutations, p.T7FX7 (c.18-21del4bp) and p.E227E (c.681 G > A) (homozygous), in the CTNS gene in 11 patients with cystinosis from the East Anatolian region of Turkey. Patients with a homozygous c.681 G > A (p.E227E) mutation are more likely to develop chronic renal failure and should be monitored closely, whereas patients with a p.T7FX7 (c.18-21del4bp) mutation have a milder phenotype. Additionally, metabolic alkalosis does not exclude cystinosis, although cystinosis is a cause of proximal renal tubular acidosis.
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
Initial Lymphocyte Count as Prognostic Indicator for Childhood Immune Thrombocytopenia
(Springer india, 2017) Akbayram, Sinan; Karaman, Kamuran; Dogan, Murat; Ustyol, Lokman; Garipardic, Mesut; Oner, Ahmet Faik
Acute ITP is a benign, self-limiting disease. Chronic ITP is diagnosed when thrombocytopenia persists beyond 12 months. The main objective of the present study was to examine whether absolute lymphocyte counts at diagnosis has predictive value with chronic ITP. A total of 601 patients diagnosed as ITP between 1995 and 2014 were retrospectively evaluated. CBCs with differential counts were performed at presentation for 601 patients. Absolute lymphocyte counts at presentation were independently predictive of disease duration. The male to female ratio was almost 1:1 and 25.9 % (156/601) of the patients had chronic ITP. We determined that age >6.75 year, platelet counts >6.950/mm(3) and absolute lymphocyte counts <= 2.050/mm(3) was associated with a significant risk for developing chronic ITP. Absolute lymphocyte counts at the time of diagnosis were predictive variables for the development of chronic ITP. Further researches are needed to confirm the current finding and to assess the underlying pathophysiology with the course of the ITP in observational studies.
The Levels of Vitamin B12, Folate and Homocysteine in Mothers and Their Babies With Neural Tube Defects
(Taylor & Francis Ltd, 2016) Peker, Erdal; Demir, Nihat; Tuncer, Oguz; Ustyol, Lokman; Balahoroglu, Ragip; Kaba, Sultan; Karaman, Kamuran
The aim of the present study was to determine the serum levels of vitamin B-12, folate, and homocysteine (Hcy) in mothers and their babies, and to assess the association between these levels and neural tube defect (NTD). The study group included 92 baby-mother pairs, where the babies had NTD, and the control group included 102 pairs, where the babies had no NTD, from May 2012 to May 2015. Plasma vitamin B-12, folate, and Hcy levels of the babies and mothers were measured, and compared with each other. NTD was diagnosed in 2.6% of our babies. The vitamin B-12 levels in the mothers and the babies in the study group were determined as 166.2 +/- 63.7 pg/mL and 240.3 +/- 120.3 pg/mL, and in the control group as 1 9 0 +/- 80.2 pg/mL and 299.5 +/- 151.4 pg/mL, respectively. There was a significant difference between the two groups in terms of both the mothers' and the babies' vitamin B-12 levels (p = 0.024 and p = 0.003, respectively). The plasma folate levels of the mothers in the study group (5.2 +/- 3 ng/mL) were significantly lower than control group (6.4 +/- 4.3 ng/mL, p = 0.032). The plasma Hcy level of the mothers in the study group (9.3 +/- 3.8 mu mol/L) was significantly higher than the control group (7 +/- 3.8 mu mol/L, p<0.001). High plasma Hcy levels and low plasma folate and vitamin B-12 levels are risk factors for NTD. Our results show that the risk for NTD can be decreased by fortification of mothers-to-be, particularly in rural areas with folate and vitamin B-12 deficiency, which would lower the plasma Hcy level.
The Spectrum of Mefv Gene Mutations and Genotypes in Van Province, the Eastern Region of Turkey, and Report of a Novel Mutation (R361t)
(Elsevier, 2015) Coskun, Salih; Ustyol, Lokman; Bayram, Yasemin; Bektas, M. Selcuk; Gulsen, Suleyman; Cim, Abdullah; Savas, Didem
Familial Mediterranean fever (FMF) is the most common hereditary inflammatory periodic disease, characterized by recurrent episodes of fever and abdominal pain, synovitis, and pleuritis. The aim of this study was to determine the frequency and distribution of Mediterranean fever (MEFV) gene mutations in Van province of Eastern Anatolia and to compare them with the other studies from various regions of Turkey. Therefore, we retrospectively evaluated MEFV gene mutations in 1058 pediatric patients with suspected FMF. The MEW gene mutations were investigated using Sanger sequencing and the multiplex minisequencing technique. We identified 37 different genotypes and 16 different mutations. The four most common mutations and allelic frequencies were M694V (36.50%), E148Q (32.77%), V726A (14.09%), and M694I (4.41%). M694V was the most common mutation, and the M694I frequency was found to be higher compared to studies from other regions of Turkey. In addition, we identified a novel missense mutation (R361T, c.1082G>C) in exon 3 of the MEW gene in a 12-year-old boy, who had a typical FMF phenotype. In conclusion, this study evaluated the distribution of MEFV gene mutations in children with FMF as the first study conducted in Van province, Eastern Anatolia. (C) 2015 Elsevier B.V. All rights reserved.
The Use of Acute Peritoneal Dialysis in Critically Ill Newborns
(int Scientific information, inc, 2016) Ustyol, Lokman; Peker, Erdal; Demir, Nihat; Agengin, Kemal; Tuncer, Oguz
Background: To evaluate the efficacy, complications, and mortality rate of acute peritoneal dialysis (APD) in critically ill newborns. Material/Methods: The study included 31 newborns treated in our center between May 2012 and December 2014. Results: The mean birth weight, duration of peritoneal dialysis, and gestational age of the patients were determined as 2155.2 +/- 032.2 g (580-3900 g), 4 days (1-20 days), and 34 weeks (24-40 weeks), respectively. The main reasons for APD were sepsis (35.5%), postoperative cardiac surgery (16%), hypoxic ischemic encephalopathy (13%), salting of the newborn (9.7%), congenital metabolic disorders (6.1%), congenital renal diseases (6.5%), nonimmune hydrops fetalis (6.5%), and acute kidney injury (AKI) due to severe dehydration (3.2%). APD-related complications were observed in 48.4% of the patients. The complications encountered were catheter leakages in nine patients, catheter obstruction in three patients, peritonitis in two patients, and intestinal perforation in one patient. The general mortality rate was 54.8%, however, the mortality rate in premature newborns was 81.3%. Conclusions: APD can be an effective, simple, safe, and important therapy for renal replacement in many neonatal diseases and it can be an appropriate treatment, where necessary, for newborns. Although it may cause some complications, they are not common. However, it should be used carefully, especially in premature newborns who are vulnerable and have a high mortality risk. The recommendation of APD therapy in such cases needs to be verified by further studies in larger patient populations.