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Öğe Administration of a second dose antivenom in the early period: Is it effective in scorpion stings?(Galenos Yayınevi, 2020) El, Çiğdem; Çelikkaya, Mehmet EminAim: It has been known for years that the toxic effects of scorpion envenomation can be fatal. Scorpion antivenom administration reduces the severity of systemic toxicity and fatal complications resulting from envenomation. In cases where clinical progression is poor, a second dose of antivenom can be applied. We aimed to investigate the effectiveness of a second dose of antivenom in this study. Materials and Methods: One hundred patients between 0-17 years who were followed up due to scorpion stings or poisonings in Hatay Mustafa Kemal University, Faculty of Medicine, Department of Pediatrics between October 2016 and March 2018 were analyzed for age, gender, season, site of scorpion stings, clinical findings, treatment, follow-up steps and the effects of a second dose of antivenom on clinical progression retrospectively. Results: Of the total 100 patients, 45 were female (45%) and 55 were male (55%). The average age of the patients was 3.5 years. Sting locations in order of frequency were as follows; feet, hands, legs, arms, head-neck, genital area. Single dose antivenom was given to 26 patients and a second dose was given to the remaining 74 patients. All patients recovered except two patients who were referred with cardiopulmonary insufficiency and passed away. Conclusion: We observed that early antivenom therapy reduces the risk of developing systemic toxicity and also an administered second dose of antivenom corrects systemic findings. We think that the second dose of antivenom should be applied at the 8th hour especially in pediatric patients with ongoing serious systemic findings and all patients should be observed for at least 24 hours.Öğe A cause of fever that should be kept in mind in family medicine in settlements where livestock farming is widespread: Brucellosis(Galenos Yayınevi, 2019) El, Çiğdem; Çelikkaya, Mehmet EminAim: In our country, where animal husbandry is widespread, we aimed to examine retrospectively data concerning childhood Brucellosis cases, which are not very high in the literature, which may occur with many variable clinical findings and may cause misdiagnosis and serious complications. Materials and Methods: The data of these patients with the diagnosis of Brucellosis who were treated between October 2016 and October 2018 in a Pediatric Clinic were retrospectively analyzed. For the diagnosis of Brucellosis in patients, the Wright agglutination test with complaints and clinical findings set at the titer being 1/160 or above was used. Results: In our study, the mean age of the patients was 7.4 years (3-15). 52.12% (n=37) were male and 47.88% (n=34) were female. All patients had a risk factor for Brucellosis infection. In 88.7% (n=63) of these patients, consumption of milk and dairy products (precipitates, fresh cheese was not cooked), and 11.3% (n=8) of raw meat (raw meatball) consumption and animal contact history were determined. Conclusion: Although early diagnosis and response to treatment with Brucellosis are very good, late diagnosis and inadequate treatment may cause mortality and morbidity with serious complications. Complaints of fatigue, weight loss and especially joint pain with long term fever should be evaluated by family physicians and pediatricians. The diagnosis of these patients should be kept in mind in the diagnosis of Brucellosis, an endemic disease common in our country.Öğe Clinic entity that should not be forgotten in children with high fever; PFAPA syndrome(İnönü Üniversitesi, 2019) El, Çiğdem; Çelikkaya, Mehmet EminAim: PFAPA syndrome which we thought was not well recognized. The high fever clinic of PFAPA syndrome usually mimics infectious conditions therefore it can lead to unnecessary and costly diagnostic tests and treatments. We evaluated the medical history, clinical findings and outcomes of pediatric patients diagnosed with PFAPA syndrome Material and Methods: In Mustafa Kemal University, Faculty of Medicine, Department of Pediatrics between September of 2016 and 2017, demographics, clinical, laboratory, diagnosis and treatment data of our patients diagnosed with PFAPA syndrome were retrospectively reviewed. Results: 68 patients were studied in our study, of which 27 (39.7%) were females and 41 (6.2%) were males. The mean age at onset of symptoms was 21.7 months. The mean age of diagnosis was 34.9 months. The mean duration between episodes of the disease was 27.05 days and the mean duration of episodes was 4.91 days. Conclusion: PFAPA syndrome which causes unnecessary costly examinations and treatments should be kept in mind in high fever clinic and also medical treatment was found to be effective in patients with PFAPA syndrome.Öğe Effects of wrist fixation board in children on the complication rates of peripheral venous catheters(Ankara Eğitim ve Araştırma Hastanesi, 2019) Atıcı, Ahmet; Çelikkaya, Mehmet Emin; El, Çiğdem; Akçora, BülentPURPOSE: Peripheral intravenous catheter (PIVC) insertion is the most frequently used invasive intervention that is performed in more than 80% of hospitalized children. It is a known that seemingly innocent PIVC may result in various morbidities such as phlebitis, infection, extravasations, and may even lead to mortality. In this study, we aimed to investigate the effect of a new fixation board (wrist-ankle fixation board) on PIVC lifespan and complications rates in pediatric patients undergoing PIVC insertion in the joint area. Material and methods: A total of 49 patients who were treated in the pediatric surgery ward between June and July 2018 and who underwent PIVC insertion were prospectively followed. The patients were divided into the following two groups: ‘Group 1’ in which a wrist-ankle fixation board was used and ‘Group 2’, which was allocated as the control group using Hypoallergenic Elastic Fixation Tape. PVC life and complications (infiltration, purification, displacement) were recorded. Results: Forty-nine patients were included in the present study and they were divided into the following two groups: 25 patients in Group 1 and 24 patients in Group 2. There were no statistically significant differences between the groups in terms of age and gender (p>0.05). There was no statistically significant difference in PIVC lifespan between Groups 1 (31.8 hours) and 2 (29.5 hours) (p = 0.151). The complication rate was noted to be 4% in Group 1 and 29% in Group 2. The difference in complication rates between the two groups was statistically significant (p = 0.02). Conclusions: The rate of complications was lower in pediatric patients with PIVC compared to the other method with the use of a new fixation board (ankle-ankle fixation fixation method). However, no significant results were obtained regarding PIVC life.Öğe Evaluation of cardiorespiratory state in patients with cerebral palsy(İnönü Üniversitesi, 2019) El, Çiğdem; Hüzmeli, İrem; Doğru Hüzmeli, Esra; Duman, FatmaAim: The objective of this study is to compare the cardiorespiratory state of individuals with hemiparetic cerebral palsy and healthy individuals. Material and Methods: The demographic information of 40 individuals were evaluated. Then their body mass index and frequency and duration of physiotherapy were questioned. Gross motor skill levels with the Gross Motor Classification System (GMCS), flexibility with the sit and reach test, cardiorespiratory endurance with the 6-minute walking test and independence in daily life activities with the WeeFIM survey were evaluated. Oxygen saturation, respiration frequency and heart rate were recorded before and after evaluation. Results: 20 individuals with hemiparetic cerebral palsy (%55 female, %45 male) (with an age average of 9.7± 1.94) and 20 individuals as the control group (%65 female, %35 male) (with an age average of 9.1± 1.83) were included in the study. According to the sixminute test analysis, no important variety was observed between the two groups in terms with regard oxygen saturation, respiration frequency and heart rate parameters prior to and after the test (p>0.05). A statistically significant difference was observed between the patient and control groups in terms of walking distance (p=0.001) and the WeeFIM total score (p= 0.001) and flexibility test (p=0.001). Conclusion: Remarkably, walking distance, WeeFIM total score and flexibility test in patients with cerebral palsy can give an idea about prognosis and the adverse effects of disease in early period on patients’ physical, psychological and social development.Öğe Evaluation of long-term lung capacity using spirometry in patients who underwent bronchoscopy due to foreign body aspiration(Çukurova Üniversitesi, 2019) Atıcı, Ahmet; Dikmen, Nursel; Çelikkaya, Mehmet Emin; El, Çiğdem; Akçora, BülentPurpose: The purpose of the present study was to evaluate the long-term lung status using spirometry in patients who underwent rigid bronchoscopy in acute period due to foreign body aspiration. Materials and Methods: Records of 142 children who underwent bronchoscopy due to foreign body aspiration between March 2013 and April 2018 were retrospectively reviewed. The data of 20 patients who cooperated with the spirometry process were included in this study (Group 1). Twenty patients who were admitted to the routine pediatric surgeon polyclinic without any lung problem and pain complaints were included in the study as a control group (Group 2). Forced expiratory flow rate (FEV1), forced vital capacity (FVC), FEV1/FVC, and forced expiratory flow at 25-75% of forced vital capacity (FEF 25–75) parameters were recorded in the first second. Results: Based on the statistical analysis results, there was no significant effect of age, sex, and BMI on FEV1, FVC, and FEF 25–75 values. The effect of bronchoscopy procedure on the same values, the difference between FEV1 and FVC values was statistically significant, whereas the difference between FEV1/FVC and FEF 25–75 values was not statistically significant for Groups 1 and 2. Conclusion: There was no long-term negative effect on lung capacities assessed using spirometry in our patients who received early-diagnosis and intervention within 24 h.Öğe Evaluation of the effects of zinc supplementation on the symptoms and duration of the disease in acute viral gastroenteritis(SERNEV, 2019) El, Çiğdem; Çelikkaya, Mehmet EminIntroduction: Acute viral gastroenteritis is the second most common cause of high morbidity and mortality in childhood. Viral gastroenteritis is the most common cause of severe diarrhea and associated hospitalizations especially in toddlers. It has been shown that the administration of 20 mg of zinc daily during acute diarrhea reduces the duration of watery diarrhea by 25% and it has been reported to have protective and therapeutic effects in the acute period. The aim of this study is to retrospectively determine the beneficial effects of oral zinc supplementation on the severity and duration of complaints of toddlers who were treated in our clinic with the diagnosis of acute viral gastroenteritis. Methods: Toddlers who were hospitalized in the Department of Pediatrics for acute viral gastroenteritis between October 2016 and March 2018 were included in the study. The study was retrospective and the data of the patients were obtained from the patient files. The diagnosis of acute viral gastroenteritis was made by detecting the adenovirus-rotavirus antigen in the fresh stool specimens. The patients were divided into two groups. Group 1: patients who received zinc supplementation in addition to support treatment. Group 2: patients who received only supportive therapy. Results: The mean number of vomiting was 3.60 / day and watery diarrhea was 5.20 / day in group-1 while number of vomiting was 6.1 / day and watery diarrhea was 8.9 / day in group-2 in the 36th hour during treatment. The tolerability of oral feeding at 36 th hour was 49.39% ( 41) in group-1 and 45.07% (32) in group-2. The mean number of vomiting and watery diarrhea in group-1 cases at 72th hours was 1.2 / day and 4.30 / day, while in group-2 cases, 3.90 / day and 7.20 / day. Conclusions: Although the physiopathology of the effects of zinc on gastroenteritis is not yet fully understood, diarrhea is seen both as a cause and as a result of zinc deficiency. The fact that patients with gastroenteritis benefit from zinc support suggests that zinc enhances this effect by increasing intestinal immunity.Öğe Hirschsprung hastalığında transabdominal Duhamel ve Boley prosedürlerinin karşılaştırmalı sonuçları(Türkiye Çocuk Cerrahisi Derneği ve Pediatrik Üroloji Derneği, 2019) Çelikkaya, Mehmet Emin; Atıcı, Ahmet; El, Çiğdem; Urfalı, Senem; Akçora, BülentAmaç: Hirschsprung Hastalığı (HD), intestinal gelişim sırasında nöral krest hücrelerinin göç başarısızlığından kaynaklanan bir nörokrestopatidir. Aganglionik kolon ile sonuçlanır ve çocuklarda fonksiyonel kabızlığa neden olur. Bu çalışmada, Boley ve Duhamel yöntemlerinin ardından HD’li hastalarda istemli barsak hareketleri, dışkı kaçırma ve kabızlık gibi fonksiyonel sonuçları karşılaştırmayı amaçladık. Yöntem: Boley veya Duhamel yöntemleri ile abdominal pull through yapılan hastalar çalışmaya dahil edildi. Tüm hastalara üç aşamalı operasyon uygulandı (ostomi açılması, definitif operasyon ve ostomi kapanması). İstemli bağırsak hareketi, dışkı kaçırma ve kabızlık dahil olmak üzere postoperatif fonksiyonel sonuçları değerlendirmek için Krickenbeck kriterleri kullanıldı. Bulgular: Hastaların 27’si erkek, 12’si kadındı. On iki hastaya Boley, 27 hastaya Duhamel yöntemi ile pull-through uygulandı. Hastaların çoğunda patoloji rektosigmoid bölgede idi (n: %28 71.79). Boley grubunda istemli bağırsak hareket oranı %83,33, Duhamel grubunda %85,18 idi. İki grup arasında istatistiksel olarak anlamlı fark yoktu (p>0,05). İki grup arasında dışkı kaçırma sıklığı ve derecesi açısından anlamlı fark bulunmadı (Duhamel %22,21, Boley %16,66, p>0,05). Duhamel grubunda kabızlık Boley grubundan daha fazlaydı (p<0,05). Tartışma: Her tekniğin birbirilerine göre avantaj ve dezavantajları vardır. Definitif cerrahide hangi tekniğin seçildiğinden bağımsız olarak vakaların çoğunda ciddi bir komplikasyona rastlanmaz. Cerrahın alıştığı ve iyi yaptığı tekniği kullanmaya devam etmesi önerilir.Öğe Infants with vitamin B12 deficiency-related neurological dysfunction and the effect of maternal nutrition(İnönü Üniversitesi, 2019) El, Çiğdem; Çelikkaya, Mehmet EminAim: Studies linked vitamin B12 deficiency in infancy are most commonly in patients with hematological and dermatological complaints rather than infant with neurodevelopmental retardation. In our study we aimed to evaluate the data of infants who presented with various neurological complaints and determined neurodevelopmental retardation due to vitamin B12 deficiency and also effects of maternal diet on the infants. Material and Methods: Infants who were admitted with various neurological complaints due to vitamin B12 deficiency between the dates of September 2016 and March 2018 were included in this study. Patients were retrospectively analyzed according to age, growth and development, clinical and laboratory findings (neurological, hematologic), continuation of breastfeeding, age at onset of complemantary food. During the pregnancy and lactation, the amount of feeding with animal foods, intake of vitamin supplements, duration of breastfeeding and vitamin B12 levels were examined. Results: The most common complaints were fatigue, pallor, no eye contact, apathy, vomiting, constipation, diarrhea, refusal to feed, retardation to growth and development, undeveloped or lost of ability (ability to tonic neck reflex, ability to sit supported and unsupported ability to sit). In the neurological examination of infants; iIn 13 infants, there was hypotonia, undeveloped ability to tonic neck reflex and ability to sit (supported and unsupported). Fifteen, in 15 infants just undeveloped ability to sit (supported and unsupported) and also in 6 infants had swallowing disorders. Conclusion: Vitamin B12 routinely to all pregnant women like folic acid and iron supplementation. In addition, developmental stages of infants should be evaluated and vitamin supplements should be given to infants when necessary.Öğe Investigation of the relationship between physical activity and body mass index in children with down syndrome(Galenos Yayınevi, 2020) El, Çiğdem; Doğru Hüzmeli, Esra; Gökçek, ÖzdenAim: This study aimed was to investigate the relationship between physical activity levels and the Body Mass index (BMI) of children with Down syndrome (DS). Materials and Methods: This study included 26 children (15 male, 11 female) with DS. In this study, demographic information was recorded, the physical activity was measured with the Eurofit battery; body fat content, muscle weight, protein content, body fluid ratio and basal metabolic rate were measured by Bioelectric Impedance Analysis. Results: The mean age of the participants was 10.96±2.94 years and the mean BMI of the participants was 21.51±6.719. There was moderate correlation between general fat weight and arm motion speed (r=0,40); moderate correlation between sit and reach test and general fat weight (r=-0.45), trunk fat weight (r=-0.52), liquid ratio (r=0.54); moderate correlation between basal metabolic rate and right hand grip strength (r=0.73), right arm weight without fat (r=0.70), right arm muscle weight (r=0.69), basal metabolic rate (r=0.73); left hand grip muscle with left arm muscle weight (r=0.74), left arm weight without fat (r=0.75), basal metabolism rate (r=0.72), mineral amount (r=0.83), amount of protein (r=0.83); moderate correlation between thirty-second shuttle and body fat percentage (r=-0.44), liquid ratio (r=0.45), body density (r=0.46); moderate correlation between twisted arm hanging strength and fat rate in arm (r=-0.47) with trunk fat rate (r=-0.40), fat weight (r=-0.39); moderate correlation between twenty-meter resistance and trunk fat rate (r=-0.40). Conclusion: It was seen that the physical activity level decreased as the fat ratio increased in individuals with DS. Basal metabolic rate, fluid ratio, and physical activity were found to be correlated.Öğe Investigation of wind instrument performance level in an asthmatic child case receiving inspiratory muscle training(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2021) Gökçek, Özden; Yurdalan, Ufuk; Doğru Hüzmeli, Esra; El, ÇiğdemAsthma is the most common chronic disease in childhood. There are airway obstruction and expiratory airflow limitation in asthma. In our study, the effectiveness of medical treatment support and inspiratory muscle training (IMT) in the wind instrument of the asthmatic patient was examined. For this purpose, the respiratory values of a twelve-year-old male patient, who was diagnosed with asthma and underwent IMT for six weeks, and quality of life was evaluated. Music education has a positive effect on socialization and development of intelligence (concentration level and memory development, etc.) in children. Exemption of asthmatic children from some lessons causes socialization problems and decreases in school success. Perception of dyspnea during activity, fear of attacks, and absence from school due to hospitalizations negatively affect academic achievement and concentration levels of children. In this study, a case with an increase in the duration of the flute playing of musical piece besides improvement in respiratory values is described. Copyright © 2021 by Türkiye Klinikleri. This is an openÖğe Is there a predictive association between vitamin D concentrations and lower respiratory tract infections in infants?(İnönü Üniversitesi, 2019) El, Çiğdem; Çelikkaya, Mehmet EminAim: Vitamin D deficiency have been estimated to be endemic in the worldwide and in each age group and also it is reported that vitamin D has important effects on both natural and acquired immunity and there may be a relationship between deficiency and predisposition to infections The aim of this study is to investigate whether serum vitamin D level are effective in infant lower respiratory tract infection which is one of the most mortal infectious diseases in worldwide. Material and Methods: In our study, between October 2016 and January 2018 in Department of Pediatrics, the data of 418 infants with LRTI and their ages ranging from 5 to 24 months and were examined retrospectively. Vitamin D levels were studied in 106 of this patients. Results: In group-1, the mean duration of vitamin D supplementation was 4.9 months, while the mean in group-2 was 8.6 months. Breastfeeding time was 3.27 months in group 1 while it was 5.71 months in group 2. Both the duration of breastfeeding and the duration of vitamin D supplementation were shorter in group 1 than in group 2.Those difference between the groups was in terms of statistically significant (p< 0.05) Conclusion: Vitamin D deficiency in infants may be associated with LRTI, and even vitamin D deficiency may be a predisposing factor for severe LRTIs and also the frequency and severity of LRTIs can be reduced with optimal serum levels of vitamin D.Öğe Liver trauma in children with Syrian Civil War: How should treatment management?(Ondokuz Mayis Universitesi, 2022) ÇelıKkaya, Mehmet Emin; Atici, Ahmet; Korkmaz, İnan; El, Çiğdem; Akçora, BülentPatients with liver injuries should be considered multidisciplinary cases, and the decision to operate should be made according to each patient’s clinical and hemodynamic stability. In this study, we aimed to describe treatment management approaches and appropriate operation times for children with liver injuries resulting from the Syrian Civil War. A total 32 patients who were admitted to a pediatric surgery clinic between 2010 and 2020 with liver injuries resulting from Syrian Civil War were examined retrospectively. Patients were evaluated according to age, gender, type of injury, accompanying trauma, treatment modality, and mortality. A total of 21 patients were injured with shrapnel, while 11 patients suffered from blast effect injury. The mean pediatric trauma score of the patients was 5.2, while the mean pediatric trauma score of the six patients who died was 3.11. Liver suturing was performed in four patients due to bleeding. A segmentectomy was performed in one patient with active bleeding in segment 7. This bleeding was stopped by ligating the branches of the hepatic artery. Two patients who were operated on in Syria and to whom packing was applied due to uncontrolled bleeding were referred to Turkey. One patient with inferior vena cava injury died due to excessive blood loss and instability at the time of admission, and six patients died due to accompanying head trauma and/or multiple body trauma. The main purpose in emergency operations is to stop bleeding. Rarely, however, suturing or even segment resection in the bleeding area may be required. © 2022 Ondokuz Mayis Universitesi. All rights reserved.Öğe A significant danger to children : foreign body ingestion(İnönü Üniversitesi, 2018) Çelikkaya, Mehmet Emin; Atıcı, Ahmet; El, ÇiğdemAim: The most important way for children to communicate with their surroundings is to take every substance that they keep in hand to their mouths. Foreign bodies that are ingested can be found anywhere in the gastrointestinal tract. Especially foreign bodies in esophagus may be the cause of morbidity and mortality. For this reason, the ingestion of foreign bodies in children is one of the most important health problems. Material and Methods: Between January 2014 and June 2017, 119 patients, admitted to Mustafa Kemal University [MKÜ] Faculty of Medicine, Department of Pediatric Surgery with foreign body ingestion diagnosis, were retrospectively studied. Patients were evaluated in terms of age, gender, complaints of arrival, ingested foreign body quality, location in the gastrointestinal tract and treatment approaches. Results: Of the patients, 74 were males [62%] and 45 were females [38%]. The mean age of the patients was 4.3 years [6 months-15 years]. Foreign bodies most commonly seen in the esophagus first stenosis in 73 patients [61%].Most commonly complaint at presentation was parental recognition of the ingested object and hypersalivation. The most commonly ingested foreign bodies included coins. Conclusion: Esophagoscopy must be performed foreign bodies in the esophagus should be treated conservatively, in case of clinical suspicion, the possibility of foreign body ingestion must be kept in mind. Education of the parents and taking some precautions where the children play are the most important protective factors.