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Öğe Accidental ingestion of concentrated white vinegar in Hatay children in Turkey(Sciendo, 2023) Atici, Ahmet; Micoogullari, Lina; Ugur, Bahar; Celikkaya, Mehmet Emin; Akcora, BulentWhite vinegar which contains high concentrations (similar to 85 %) of acetic acid is a staple ingredient used in food preparation in many Mediterranean cuisines but in small amounts. Being corrosive, it can cause ulcerative injury to the oropharynx and oesophagus and upset the stomach with resulting nausea and vomiting. This study presents 11 cases of paediatric patients (five boys and six girls, aged between 11 and 89 months) with oesophageal strictures who drank white vinegar by accident. They all received endoscopic oesophageal dilation (with a bougie) ranging from one to 28 per patient, depending on the severity of the injury. Follow-up showed uneventful healing in eight patients, who at the time of the telephone call were able to swallow solids and liquids normally. Two patients who could not be reached by telephone were found healthy by consulting the national database (e-Nabiz). Unfortunately, one patient, who was discharged without any symptoms after the first dilation, suffered massive gastrointestinal bleeding 24 hours after the dilation and died. The loss of this patient shows that ingesting white vinegar can be very dangerous in children, especially if parents delay seeking medical help. We believe that controlling the production and sales of highly concentrated white vinegar and selling it in child-proof containers can help to prevent accidental ingestions by children and tragic outcomes such as the one reported here.Öğe ACUTE CYANIDE POISONING AND CHALLENGES IN THE DIAGNOSIS(Bmj Publishing Group, 2019) El, Cigdem; Celikkaya, Mehmet Emin[Abstract Not Available]Öğe Blast Lung Injury in Children(Lippincott Williams & Wilkins, 2023) Korkmaz, Inan; Celikkaya, Mehmet EminBackgroundBombings are the most common cause of civilian deaths in wars, and unfortunately, a large proportion of civilian victims are children.ObjectiveThis study aimed to evaluate the frequency of blast lung injury (BLI), to evaluate lung injury patterns on tomographic images, and to document the relationship between blast lung and mortality in children exposed to the blast effect.MethodsThirty-six children (25.3% of pediatric patients brought to our hospital with blast injury) with BLI were included in the study. The pediatric trauma score evaluations made in the emergency department in the first admission were recorded. Lung injury findings in the computed tomography images of the patients were examined, and injuries detected in other systems were recorded.ResultsThe most common lung injury pattern was contusion (right: 69.4%, left: 80.6%). The incidence of brain damage (52.4%) and intra-abdominal injury (76.2%) in children with low pediatric trauma score value was statistically significantly higher (P = 0.049, P = 0.017, respectively). There was no statistically significant correlation between the presence of lung injury, injury patterns, and mortality. The incidence of brain damage in deceased patients (61.5%) was statistically significantly higher than the incidence of brain damage in surviving patients (26.1%) (P = 0.036). Low pediatric trauma score was observed in 11 (84.6%) of the deceased children and in 10 (43.5%) of the survivors (P = 0.016). The mean age of children with hemothorax in the right lung was statistically significantly lower than those without (P = 0.014).ConclusionOur findings revealed that pediatric BLI is common after a blast, that it is associated with other system injuries, and that a multimodal radiological approach is required in child victims.Öğe Bronchoscopy for foreign body aspiration and effects of nebulized albuterol and budesonide combination(Professional Medical Publications, 2017) Akcora, Bulent; Celikkaya, Mehmet Emin; Ozer, CahitObjective: A foreign body aspiration in the tracheobronchial tree is a dangerous medical condition in the childhood period. Although rigid bronchoscopy is a safe procedure, it may cause complications. The aim of this study was to present our bronchoscopy experience and to evaluate the efficacy of pre-operative administration of nebulized albuterol and budesonide combination for reducing intra-operative complications in foreign body aspirated cases. Methods: In this retrospective study our pediatric cases in which a foreign body was removed from tracheobronchial tree in last 8 years were analyzed. After excluding the patients who needed emergent and negative bronchoscopies, the remaining clinically stable 84 patients were compared for the effects of preoperative administration of nebulized albuterol and budesonide combination on bronchoscopy complications. Results: There were 51 boys (60.3%) and 33 girls (39.7%). There were 38 children in the non-nebulized group and 46 children in the nebulized group. We found that the combined albuterol and budesonide nebulization decrease complications such as arterial oxygen desaturation (p<0.05), and bronchospasm (p<0.05) during the bronchoscopic intervention. Conclusion: Preoperative nebulization of albuterol and budesonide combination may decrease perioperative complications of bronchoscopy.Öğe Can olive oil prevent distal colon mucosal atrophy caused by disuse in rats with colostomy? An experimental animal study(Index Copernicus Int, 2021) Atia, Ahmet; Demir, Emel; Gursoy, Didar; Celikkaya, Mehmet Emin; Akcora, BulentAim: This study aims to investigate the effects of pure olive oil on mucosal atrophy of the distal colon in rats. Material and methods: The study included 28 male albino Wistar rats weighing 300-350 g. A total of 28 animals were randomly allocated to four groups: group 1: control group (n = 6); group 2: ostomy group (n = 6); group 3: ostomy + saline group (n = 8); group 4: ostomy + olive oil group (n = 8). By definition, group 1 did not undergo any procedure. The same surgical procedure was performed for groups 2, 3, and 4 as described below. In all animals from these groups, a two-centimeter-long mid-line incision was made and the colon was divided into 5 cm sections, measured from the distal colon to the caecum. Proximal and distal stomas were created 2 cm apart in the midline with the use of single-layer interrupted sutures. All rats were kept under close daily observation until they were terminated postoperatively after the 1st month. Animals from group 2 did not undergo any additional procedures, while those fromgroups 3 and 4 were given 2 mL of saline and olive oil twice a day, respectively. At the end of the 1st month, the rats were re-operated through the same approach. Biopsies were taken from the proximal and distal stomas of all rats in the same manner for further histopathological analysis. Results: Group 1 showed no significant differences in terms of mucosal thickness, muscular thickness, wall thickness or colonic lumen diameter between the proximal and distal segments of the colon. Although there were significant differences between the proximal and distal colostomies for each parameter in groups 2, 3, and 4, the mucosal thickness, muscular thickness, wall thickness, and colonic lumen diameter differences for proximal and distal ostomies were very small in group 4 when compared to groups 2 and 3. Conclusion: The administration of pure olive oil through the distal colon before colostomy closure may reduce the difference in diameter between the proximal and distal intestinal segments. As a result, a more straightforward surgical procedure may be achieved.Öğe Cardiovascular Screening before Sports Participation: Results of 11487 Children(Georg Thieme Verlag Kg, 2024) Duman, Derya; Demetguel, Hasan; Sel, Kutay; Donmez, Yasemin Nuran; Celikkaya, Mehmet Emin; Huzmeli, Esra Dogru; Akin, AlperAim In this study, it is aimed to analyze the data of children who were referred to our clinic for pre-participation sports screening. Methods Data, between September 2017 and December 2021, had been analyzed. All these subjects had been questioned for their personal and family medical stories and examined for cardiovascular system findings. Electrocardiography (ECG) and echocardiography were applied to all of them. Results 11487 children were consulted to the cardiology clinic for pre-sports participation screening. The mean age was 12.7 +/- 4,57 (7-18 years). 34/11487(0,29 %) subjects weren't allowed to participate in sports activities at first. In 23 of 34 subjects, cardiac arrhythmias were established. 15 had Wolff-Parkinson-White (WPW) syndrome, 3 subjects had ventricular extrasystole, and also ventricular tachycardia in one of them. Four subjects had long QT syndrome and one had ST elevation with the pre-diagnosis of coronary artery disease. ECG screening alone aided in identifying asymptomatic (0.05 %) that could have been potentially at risk for sudden cardiac death. Conclusion Positive ECG and echocardiography findings involve a very little ratio.But ECG involves an important tool for screening lethal cardiac arrhythmias in asymptomatic patients. If ECG or echocardiography couldn't be taken, further evaluation should be necessary with symptoms and/or family history.Öğe THE CAUSE OF FEVER THAT SHOULD BE KEPT IN MIND IN FAMILY MEDICINE IN SETTLEMENTS WHERE LIVESTOCK FARMING IS WIDESPREAD: BRUCELLOSIS(Bmj Publishing Group, 2019) El, Cigdem; Celikkaya, Mehmet Emin[Abstract Not Available]Öğe A common public health problem: corrosive ingestion in children(Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2018) Celikkaya, Mehmet Emin; Atici, Ahmet; El, Cigdem; Akcora, BulentObjective: Corrosive substances are both histologically and functionally damaging agents when contacted with the mucosa. Corrosive substance ingestion is still one of the most important and frequent home accidents because of the reasons such as the storage of corrosives in food containers, colored packages, and places where children can reach easily. Methods: The medical records of 125 patients who were followed up because of intake of corrosive substances between 2014 and 2017 were retrospectively reviewed. Patients were evaluated according to age, gender, type of corrosive substance ingested and type of treatment. Results: Of 125 cases 63 were girls (50.4%), 62 were males (49.6%). The median age of the cases was 4.1 years. Among the corrosive substances, most frequently laundry bleach (48%; n=61), vinegar (17%; n=21), drain opener (12.8%; n=16), washing liquid (9%; n=11), olive sweetener (caustic) (n=3; 2.4%), lime dissolver (n=4; 3.2%), salicylic acid (n=3; 2.4%), oil solvent (n=2; 1.6%), wart drug (n=2; 1.6%), and acetonide (n=2; 1.6%) were ingested in respective number of patients. Esophagoscopy was performed only in patients with symptoms. Conclusion: Prevention of the intake of corrosives is much simpler and more economical when compared with long and expensive treatment processes. It is necessary that everyone who cares about children must be carefull. Corrosive substances must kept in sealed packages even in locked cabinets. Also, packages containing corrosive substances should not contain interesting colors and designs for children.Öğe The comparison of ultrasonography-guided transversus abdominis plane block and wound infiltration for pediatric inguinal hernia repair: Randomized clinical study(Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2017) Ahiskalioglu, Ali; Yayik, Ahmet Murat; Ekinci, Mursel; Golboyu, Birzat Emre; Erguney, Ozlem Dilara; Celikkaya, Mehmet Emin; Ahiskalioglu, Elif OralObjective: Postoperative analgesic effect of transversus abdominis plane (TAP) block in patients undergoing abdominal surgery has been debatable. The aim of this study was to compare the analgesic effect of ultrasound guided TAP block and wound infiltration in pediatric patients undergoing inguinal herniorrhaphy. Methods: After ethical board approval, 60 children between 3 and 8 years of age undergoing unilateral inguinal hernia repair were randomized to TAP block (Group TAP, n=30) or to wound infiltration (Group infiltration, n=30). Group TAPB received ultrasound-guided TAP block with 0.25% bupivacaine 0.5 ml/kg and Group C received wound infiltration with 0.25% bupivacaine 0.5 ml/kg before surgery. Pain scores (Wong-Baker Faces), parental satisfication, block complications and additional analgesia requirements were recorded. Results: Compared with the infiltration group, the pain scores were statistically lower in the TAPB group during the first 12 hours (p<0.05). The additional analgesia requirement was statistically lower in the TAPB group than Group infiltration group (10/30 vs 18/30 respectively, p=0.038). Parental satisfaction was statistically higher in the Group TAPB than Group infiltration (p<0.001). Conclusion: Despite the postoperative effect of TAP block is debatable; ultrasound-guided TAP block reduces postoperative pain after pediatric inguinal hernia repair compared to wound infiltration.Öğe DOES EARLY STABILIZATION APPLICATIONS AFFECT CLINICAL PROGRESSION IN POISONING LINKED TO SNAKE BITES?(Bmj Publishing Group, 2019) El, Cigdem; Celikkaya, Mehmet Emin[Abstract Not Available]Öğe Dual energy CT in necrotizing enterocolitis; a novel diagnostic approach(Tubitak Scientific & Technological Research Council Turkey, 2021) Caglar, Ozgur; Cesur, Emrullah; Sade, Recep; Firinci, Binali; Kara, Mustafa; Celikkaya, Mehmet Emin; Oral, AkgunBackground/aim: Necrotizing enterocolitis (NEC) is one of the most important causes of morbidity and mortality in premature infants. Although there are no specific diagnostic tools, the main factors affecting prognosis are clinical and laboratory findings, and early diagnosis and treatment. In this study, we demonstrate the importance of dual-energy computed tomography (DECT) in confirming intestinal ischemia in neonates with NEC. Materials and methods: Patients diagnosed with NEC in a neonatal intensive care unit were staged according to modified Bell's classification, and DECT was performed on patients with NEC stages 2-A, 2-B and 3-A. According to their DECT reports, these patients were then separated into two groups: those with intestinal ischemia and those without intestinal ischemia. The patients with intestinal ischemia were evaluated using surgical reports, and the other patients were evaluated using clinical findings. Results: DECT was performed in 21 patients with NEC stages 2-A, 2-B and 3-A. Twelve patients (57.1%) without ischemia were followed up without surgery. Nine patients (42.9%) with ischemia on DECT were operated on, and resection and anastomosis or ileostomy and colostomy were performed. Conclusion: In patients with NEC, DECT significantly increases overall diagnostic confidence in assessing intestinal necrosis when compared with traditional diagnostic methods.Öğe Duodenal perforation: an unusual complication of sickle cell anemia(African Field Epidemiology Network-Afenet, 2014) Acipayam, Can; Aldic, Guliz; Akcora, Bulent; Celikkaya, Mehmet Emin; Askar, Hasan; Dorum, Bayram AliDuodenal perforation in childhood is a rare condition with a high mortality rate if not treated surgically. Primary gastroduodenal perforation is frequently associated with peptic ulcer and exhibits a positive family history. Helicobacter pylorus is the most significant agent. Secondary gastroduodenal perforation may be a finding of specific diseases, such as Crohn disease, or more rarely may be associated with diseases such as cystic fibrosis or sickle cell anemia. A 14-year-old boy presented with abdominal and back pain. The patient was operated on for acute abdomen and diagnosed with duodenal perforation. Helicobacter pylorus was negative. There was no risk factor to account for duodenal perforation other than sickle cell anemia. Surgical intervention was successful and without significant sequelae. Duodenal perforation is a rare entity described in patients with sickle cell anemia. To our knowledge, this is the first report of duodenal perforation in a patient sickle cell anemia.Öğe The efficacy of shear-wave elastography - performed simultaneously with Doppler sonography - for differentiating between testicular torsion and epididymo-orchitis(W B Saunders Co-Elsevier Inc, 2019) Atici, Ahmet; Kayali, Alperen; Celikkaya, Mehmet Emin; Akcora, Bulent[Abstract Not Available]Öğe The histopathological effect of tissue adhesive on urethra wound healing process: An experimental animal study(Elsevier Sci Ltd, 2020) Atici, Ahmet; Secinti, Ilke Evrim; Celikkaya, Mehmet Emin; Akcora, BulentIntroduction and Objective: The present study aimed to determine the histopathological effect of Tisseel tissue adhesive on the urethral wound healing process after urethroplasty in a rat model. Study design A total of 24 animals were randomly allocated into three groups: Group 1; control group (n = 6); Group 2; suture-closure group (n = 9); and Group 3; suture + adhesive group (n = 9). In group 2, an incision 4 mm long was made on the ventral skin of the penis along the midline from the glans penis, to open the dartos muscle, corpus spongiosum, and urethra. Next, initially, the urethra alone, and then the layers up to the skin were covered in layers with 8/0 vicryl interrupted sutures. Group 3 underwent the same procedures as group 2, but after the urethra was repaired 0.1 cc of Tisseel tissue adhesive was applied over the urethra. Penile tissue samples were obtained 21 days later, and tissue samples were sent for histopathological analysis. Results Urethral epithelial thickness and connective tissue thickness in group 3 were higher than in group 1 and group 2. Fibrosis in group 3 was higher than in group 2. The difference in inflammation between group 3 and group 2 was not significant. There was no significant difference in microvessel density between group 2 and group 3. Discussion Both increased fibrosis and connective tissue thickness were noted in group 3 compared to group 2 and group 1. These increases may have been caused by the hemostatic effect of the Tisseel adhesive and its triggering of fibroblast growth factors. The epithelial thickness increased significantly in group 3 and group 2 compared to group 1. This increase in tissue thickness without an increased number of epithelial cells can be explained by the development of oedema. Conclusion The present study suggests that while Tisseel tissue adhesive increases connective tissue thickness and fibrosis, it does not demonstrate a prolonged inflammation or increased neovascularization in the urethral wound at 3 weeks after surgery. The data obtained in our study does not support the use of Tisseel in urethroplasty surgery. The results obtained in this study demonstrate a significantly higher formation of fibrosis (scar tissue), which underlines the importance of new studies to identify new treatments for urethral wound healing after urethra trauma or surgery. [GRAPHICS] .Öğe Innocent Children in the Syrian Civil War(Georg Thieme Verlag Kg, 2020) Celikkaya, Mehmet Emin; Atici, Ahmet; Cigdem, E. L.; Akcora, BulentIntroduction Our aim is to present the clinical and surgical characteristics of the children affected by the Syrian civil war. Materials and Methods Medical records were reviewed retrospectively for Syrian war victims between the ages of 0 and 18 who were brought to the emergency department of the Education and Research Hospital between March 2011 and March 2019. Each patient was evaluated with respect to demographic data (gender, age), type of injury, history of operations in Syria, injured organ(s), accompanying traumas and the mortality and trauma score. Results The majority of our study population of 147 patients were male (108/147, 73.46%), and 39 of the total were girls (26.53%). The mean age of the patients was 9 (7.5 +/- 4). The mean age of the girls was 8.5 (range: 7 months to 16 years), and the mean age of the boys was 9.2 (4 months to 17 years). Seventeen patients who had abdominal surgery in Syria were operated on again after clinical and radiological observations. A total of 83 patients were operated on in Turkey. For 66 of those patients, the operation in Turkey was their first surgery on their war injuries. Seventeen patients were operated on in Syria but needed surgery again in Turkey. Conclusion War affects not only the battlefield, but also the neighboring countries in many aspects such as medical, social, and economic. Hollow organ injuries are the most common intraabdominal pathologies. Delayed intervention is associated with increase mortality and morbidity.Öğe IS IT THE NEGATIVE EFFECTS OF SERUM VITAMIN DEFICIENCY OF PREGNANT AND LACTATING WOMEN ON DEVELOPMENT OF NEWBORN NEUROLOGICAL SYSTEM CAN BE AVOIDED(Bmj Publishing Group, 2019) El, Cigdem; Celikkaya, Mehmet Emin[Abstract Not Available]Öğe IS THE SECOND DOSE ANTIVENOM IN SCORPION STINGS: IS IT EFFECTIVE?(Bmj Publishing Group, 2019) El, Cigdem; Celikkaya, Mehmet Emin[Abstract Not Available]Öğe Pediatric esophageal perforation due to firearm injuries during the Syrian war and a new suture technique(Elsevier, 2018) Atici, Ahmet; Celikkaya, Mehmet Emin; El, Cigdem; Akcora, BulentThe incidence of esophageal perforation (EP) due to firearm injury (FAI) is markedly low compared with that occurring in other organs. The most frequently reported cause of EP is iatrogenic injuries. The incidence of EP due to penetrating injuries, such as FAI, is very rare and highly destructive. Here we report cases of EP due to FAI in childhood during the Syrian war and elucidate a new suture technique.Öğe Probiotic use in acute viral gastroenteritis: Is it really effective? Probiotic use in acute viral gastroenteritis(Bayrakol Medical Publisher, 2019) Cigdem, El; Celikkaya, Mehmet EminAim: Acute diarrhea in childhood is the second most common cause of high morbidity and mortality and occurs mostly due to viral agents. The aim of this study is to determine the effect of probiotics on the severity and duration of the complaints of children aged between 2 and 5 years who were treated in our clinic with the diagnosis of acute viral gastroenteritis in early childhood morbidity and mortality. Material and Method: Children aged between 2 and 5 years who were hospitalized in the Pediatric Clinic with acute viral gastroenteritis between October 2017 and October 2018 were included in the study. The patients were divided into groups of those taking probiotic treatment (Group 1) and not taking probiotic treatment (Group 2). Results: Total of 316 stool samples were examined and viral agents were determined in 125 patients (39.55%). Discussion: Especially in the treatment of diarrhea related to viral gastroenteritis, it was found that probiotics could reduce the mean duration of diarrhea until one day independently of the strain and also significantly decrease the number of watery diarrhea.Öğe Pyloric perforation due to stress disorders in an adolescent girl(Elsevier Science Bv, 2018) Atici, Ahmet; Celikkaya, Mehmet Emin; El, Cigdem; Akcora, BulentGastroduodenal perforation is a serious emergency condition. The predominance of duodenal perforation in pediatric age group shifts towards gastric perforation at later ages. However, due to thick muscle tissue pyloric perforation is seen very rarely in all age groups [3]. A 14-year-old female patient with abdominal pain lasting for one day admitted to our pediatric emergency room. During the physical examination, generalized abdominal tenderness and muscular defense were observed in all quadrants of the abdomen. Laparotomy was performed with an upper abdominal median incision. A large amount of serous, non-biliary fluid was observed in the abdomen. A perforation area of nearly 3 mm was identified on the anterior of the pylorus. Primary repair with omentopexy of the pyloric perforation was performed. On postoperative day 7, the patient was discharged without any complication. Pyloric perforation should be considered in the differential diagnosis of patients presented with epigastric pain.
