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    Assessment of the Optic Disc and Retinal Microvasculature by Optical Coherence Tomography Angiography in Patients With Pediatric Migraine
    (Lippincott Williams & Wilkins, 2023) Kurtul, Bengi Ece; Sipal, Cansu; Akbas, Yilmaz
    Background:Migraine, as a chronic neurovascular disease, is known to be a risk factor for retinal and optic nerve head damage. Herein, we aimed to evaluate the optic disc and retinal microvasculature in pediatric migraine (PM) patients using optical coherence tomography angiography (OCTA).Methods:Forty-six eyes of 23 patients with PM without aura (PM group) and 46 eyes of 23 age- and sex-matched healthy subjects (control group) were included in this cross-sectional prospective study. Demographic features and ophthalmological examination including OCTA measurements were evaluated. OCTA was performed with 6- x 6-mm sections for macula and 4.5- x 4.5-mm sections for optic nerve head in all eyes. Foveal retinal thickness (FRT), peripapillary retinal nerve fiber layer (RNFL) thickness, vessel density in different sections of the retina, and optic disc were analyzed and compared between the groups. All measurements of the PM patients were taken in the attack-free period.Results:The mean ages of the PM group and control group were 11.17 +/- 3.3 and 11.83 +/- 2.8 years, respectively (P = 0.479). Gender and mean intraocular pressures were similar between the groups. The mean central corneal thickness levels in the PM group were significantly lower than control group, 548.28 +/- 26.3 mu m and 562.04 +/- 24.5 mu m, respectively (P = 0.011). There was no significant difference regarding average and all quadrant RNFL thicknesses, foveal avascular zone and flow areas, deep vessel densities, and optic disc capillary densities between the groups. However, compared with the control group, the PM group showed significant higher values of FRT, and lower values of superficial whole and parafoveal vessel densities (247.28 +/- 15.8 mu m vs 285.93 +/- 11.1, P < 0.001, 51.85 +/- 2.4% vs 50.31 +/- 4.0%, P = 0.02, 55.09 +/- 2.3% vs 53.5 +/- 3.5%, P = 0.01, respectively). Disease duration and attacks/year did not show any significant correlations with OCTA values.Conclusions:PM seems to be associated with lower superficial whole and parafoveal vessel densities because of hypoperfusion and ischemia. OCTA may be suggested for use in follow-up and management of PM patients.
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    Combined immunoglobulin and plasmapheresis treatment for Febrile Infection-Related Epilepsy Syndrome (FIRES)*
    (Pergamon-Elsevier Science Ltd, 2022) Coban, Yasemin; Akbas, Yilmaz; Tuncer, Gokcen Oz; Koker, Alper; Koker, Sultan Aydin
    Febrile infection-related epilepsy syndrome (FIRES) is a rarely observed and destructive syndrome progressing with resistant seizures or refractory status epilepticus. In this report we present in a treatment procedure with plasmapheresis of a pediatric patient with FIRES and currently unknown etiology in order to contribute to the literature.
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    An evaluation of the knowledge, attitudes, and behaviors of parents regarding epilepsy
    (Academic Press Inc Elsevier Science, 2022) Akbas, Yilmaz; Kartal, Servet
    Background and aims: Knowledge about epilepsy and attitudes toward people with epilepsy can influence measures taken to manage epilepsy and seizures. The support and understanding of parents of children with epilepsy are invaluable in helping develop ordinary living skills. To determine the educational needs of parents of children with epilepsy, their knowledge, attitudes, and behaviors should be evaluated. Therefore, we interviewed parents who had a child with epilepsy who was treated at the pediatric neu-rology clinic of a university hospital. We aimed to evaluate parents' knowledge, attitudes, and behaviors toward children with epilepsy to determine their educational needs. Methods: This descriptive study included 221 parents of children with epilepsy who applied to Hatay Mustafa Kemal University Medical Faculty Hospital. A questionnaire was used to collect data. Pearson and exact chi-square tests were used for analysis. Results: In the present study, 221 parents were interviewed. A total of 66.5% of the participants were at the primary education level. The rate of participants who preferred healthcare professionals as a source of information about epilepsy was 78.9%. Forty-eight percent of the parents did not see consanguineous marriage as a reason. While some parents stated that epilepsy was supernatural, others had no idea whether it was contagious or not, and 46.2% of the participants stated that epilepsy is not a hereditary disease. The rate of those who tried nonphysician treatment was 16.3%. The rate of participants who thought that drinking alcohol would not trigger seizures was 86.9%. It was determined that 30.8% of the participants pulled the patient's tongue out during seizures. 16.7% of participants thought that pa-tients with epilepsy were disabled. 50.7% of the participants stated that their children with epilepsy could do any profession. Conclusions: Our study documented parents' lack of knowledge about epilepsy. Many parents have sig-nificant misunderstandings, negative attitudes, and parenting practices, and their knowledge and under-standing of epilepsy needs to be improved. Published by Elsevier Inc.
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    An investigation of computer-game addiction, physical activity level, quality of life and sleep of children with a sibling with a chronic condition
    (Wiley, 2024) Bezgin, Sabiha; Ozkaya, Yunus; Akbas, Yilmaz; Elbasan, Bulent
    Background It is known that chronic condition also affects siblings without chronic illness. Healthy siblings of children with a chronic condition and aged 9-14 years and healthy children with a sibling without chronic illness and their parents were included in the study.Aim The aim of our study was to examine the internet-game addiction, physical activity, quality of life and sleep in children with a sibling with chronic condition and compare them with their peers with a healthy sibling.Methods Computer game addiction, physical activity, sleep quality and quality of life were evaluated respectively by Computer Game Addiction Scale for Children, Child Physical Activity Questionnaire, Children's Sleep Disorder Scale and Children's Quality of Life Scale.Results While the mean age of 75 children with chronically ill siblings was 10.65 +/- 1.59 years, the mean age of 75 healthy children with healthy siblings was 10.46 +/- 2.09 years. It was observed that children with a sibling with a chronic condition were more tend to computer-game addiction, had lower sleep quality, lower quality of life in terms of school functionality and psychosocial health compared to children with a healthy sibling (p < 0.05).Conclusions It was revealed that in families with children with a chronic condition, siblings with no health problems should also be evaluated in psychosocial terms and supported by appropriate approaches, such as to increase the level of physical activity.
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    Mean platelet volume and other hematological parameters in pediatric migraine
    (Via Medica, 2022) Akbas, Yilmaz
    Introduction: According to our hypothesis, the mean platelet volume (MPV) value in migraine patients should be lower than in healthy individuals due to recurrent neuroinflammation during headache attacks. Therefore, this study aimed to identify differences between MPV and other hemogram parameters between pediatric patients with migraine and a healthy control group. Material and methods: This study included a total of 80 people, 40 patients and 40 control subjects. Those with hematological diseases, using alcohol or smoking, with malignancy, pregnancy, or with any chronic disease were excluded from the study. Results: Individuals in the control group were chosen to have the same age and same sex as the patient group (p = 0.98). The patient group had statistically significantly higher platelet counts than the control group (p = 0.043). MPV was lower in the patient group compared to the control group (p = 0.001), but platelet distribution width was higher in the patient group compared to the control group (p = 0.034) Conclusions: Migraine patients in the pediatric period were shown in our study to have low MPV values and elevated platelet counts due to recurrent neuroinflammation. This result shows that inflammation especially plays a vital role in migraine pathophysiology. Copyright © 2022.
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    Neuroimaging Findings in Pediatric Patients with Thalassemia Major
    (Mdpi, 2022) Akbas, Yilmaz; Aydin, Sultan; Tuncer, Gokcen Oz; Koker, Alper; Coban, Yasemin; Oktay, Gonul; Yeral, Hakan
    Background: Cranial magnetic resonance imaging (MRI) studies about iron accumulation in children with thalassemia major are quite limited. Aim: This study aimed to detect neurological findings with cranial MRIs in the pediatric patients with thalassemia major who did not develop any neurological complications. Materials and Methods: Pediatric patients with thalassemia major who followed in the Pediatric Hematology Unit between 1 July 2017 and 1 January 2019 were included in the study. The patients underwent cranial MRI scans. Results: A total of 30 patients were included. The median age was 15 (range from 4-18) years old. We found that 7 patients had a splenectomy and 19 of the remaining 23 patients had splenomegaly. In addition, 13 of the patients had hepatomegaly, 10 had skeletal deformities, and 17 had growth retardation. The mean ferritin level was 3772.3 +/- 2524.8. We detected various pathologies on cranial MRI images of 10 (33.3%) patients. In 3 of these patients, millimeter-sized ischemia-compatible lesions were found in the cerebral white matter, which did not fit any arterial area, and 5 patients had hyperintense lesions in the basal ganglia. Conclusion: Our study is valuable since 1/3 of our pediatric patients with thalassemia major were detected with intracranial pathology.
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    Retrospective evaluation of candida infections in pediatric intensive care units
    (Galenos Publ House, 2023) Coban, Yasemin; Koker, Alper; Tuncer, Goekcen Oz; Akbas, Yilmaz; Aydin, Sultan; Kara, Tugce Tural
    Objective: Candida species are the most common infectious agents among the pathogens responsible for nosocomial fungal infections. Transmissions in intensive care units account for a significant proportion of the mortality and morbidity associated with candida infections. The present study evaluates the prevalence, type, treatment approach, underlying risk factors, and outcomes of candida infections in patients treated in a pediatric intensive care unit in T & uuml;rkiye with a dense population of children who have fled the war in Syria. Methods: The study was conducted in the 14 -bed tertiary pediatric intensive care unit of a city hospital between March 2018 and March 2019. Results: Candida species were reproduced in the studied samples of 28 (15.7%) of the 176 patients treated in the intensive care unit during the study period. Mortality occurred in six (21.4%) patients with invasive candidiasis of varying species, namely: C. lusitaniae (n=2); C. parapsilosis (n=2); C. krusei (n=1), and C. albicans (n=1), and candida was considered the cause of mortality in five of the six non -survivors. Resistance to liposomal amphotericin-B was observed in the Candida species isolated from the non -survivors. Conclusion: In the present study, a prolonged stay in the intensive care unit, a higher number of indwelling medical devices, the use of broad-spectrum antibiotics, the presence of an underlying condition, and renal failure were observed to increase incidence of candida infection.