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Öğe Analysis of Assumed Violence Exposed Pediatric Cases(Derman Medical Publ, 2012) Arica, Vefik; Tutanc, Murat; Arm, Mustafa; Arica, Secil; Turhan, Ebru; Zeren, Cem; Arslan, MustafaAim: Violence against children is among one of the major problems encountered in family health practice. In this study, we aimed to analyze the demographic features of children who what exposed to violence and the types of violence exposed. Material and Method: Records of children who have administered to Hatay Child Police Department among 2005-2008 withcomplaint of violence exposure have been retrospectively analyzed. Results: Pediatric cases were analyzed according to their age, gender and the type of violence that they have benne exposed. The number of children that present with violence exposure was 156 while it raised to 597 with an increase of approximately 382%. 1577 cases presented during study period and 732 cases were male and 845 of them were female. We detected that male children between 0-12 years old age were more prone to violence exerted by family members as physical violence and wounding. Female children were exposed to more sexual violence and suicide while male children were exposed to physical violence.Discussion: We detected in this study that violence exerted to children show differences according to age and gender. It has been suggested that the number of children exposed to violence is much more higher than the reported number if we include economic and emotional abuse. Violence against children is an important issue that should be carefully addressed.Öğe Ceftriaxone ameliorates cyclosporine A-induced oxidative nephrotoxicity in rat(Wiley, 2011) Yilmaz, Nigar; Ilhan, Selcuk; Naziroglu, Mustafa; Oktar, Suleyman; Nacar, Ahmet; Arica, Vefik; Tutanc, MuratA growing body of evidence now suggested that cyclosporine A (CycA)-induced nephrotoxicity is a crucial clinical problem and oxidative stress is importantly responsible for its toxicity. Ceftriaxone induced antioxidant effect in brain and neuronal tissues against oxidative damage although its antioxidant potential effect on kidney has not been clarified. The aim of this study was to evaluate whether ceftriaxone protects CycA-induced oxidative stress kidney injury in rats. Twenty-four rats were equally divided into four groups. First group was used as control. Ceftriaxone (200 mg/kg) and CycA (15 mg/kg) were administrated to second and third groups for 10 days, respectively. The ceftriaxone and CycA combination was given to rats constituting the fourth group for 10 days. Lipid peroxidation (LP), urea nitrogen and lactate dehydrogenase (LDH) levels were higher in CycA group than in control and ceftriaxone groups although LP, urea nitrogen and LDH levels were lower in ceftriaxone + CycA group than in control and ceftriaxone groups. Glutathione peroxidase and catalase activities were lower in CycA group than in control whereas their activities were increased in control and ceftriaxone groups. Superoxide dismutase activity did not change by the treatments. Ceftriaxone administration recovered also CycA-induced atrophy, vacuolization and exfoliations of tubular epithelium and glomerular collapse in histopathological evaluation of kidney. In conclusion, we observed that ceftriaxone is beneficial on CycA-induced oxidative stress in kidney of rats by modulating oxidative and antioxidant system. Copyright (C) 2011 John Wiley & Sons, Ltd.Öğe Cephalometric evaluation of children with familial Mediterranean fever(E H Angle Education Research Foundation, Inc, 2012) Gungor, Ahmet Yalcin; Arica, Vefik; Gungor, Ozge; Tutanc, MuratObjective: To test the null hypothesis that no differences exist in craniofacial morphology between patients with familial Mediterranean fever (FMF) and the healthy population. Materials and Methods: Standardized lateral cephalograms of 32 FMF patients (mean age, 11.50 +/- 2.72 years) and 32 healthy controls (mean age, 11.86 +/- 2.19 years) were obtained. Cranial and dentofacial parameters were measured using a cephalometric analysis program (Nemoceph Imaging Cephalometric and Tracing Software S.L., Spain). All statistical analyses were conducted using SPSS version 17.0.0 (SPSS Inc., Chicago, Ill). Descriptive statistics were calculated for all measurements, and the independent t-test was used to evaluate intergroup differences. Results: The ANB angle was significantly greater in the FMF group (P < .05). Differences in SNA and SNB angles were insignificant. Anterior (P < .001) and posterior (P < .05) face heights were significantly shorter in the FMF group. Mandibular body length (P < .001) and condylion to gnathion (P <.05) measurements were significantly shorter in the FMF group. The upper lip was more protrusive in the FMF group (P <.05). U1 NA (mm; P < .001) and L1-NB (mm; P <.05) measurements were significantly shorter in the FMF group. Conclusion: The hypothesis is rejected. Significant differences exist between the craniofacial morphology of patients with FMF and the healthy population. (Angle Orthod. 2012;82:552-555.)Öğe Childhood Brucellosis in Southeastern Region of Turkey: A retrospective analysis(Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2013) Konca, Capan; Tutanc, Murat; Gunes, Ali; Tas, Mehmet AliObjective: To evaluate the clinical and laboratory findings, treatment modalities and outcomes of children with brucellosis in a four-year period Methods: This retrospective study included 34 children who were admitted to Dicle University Pediatric Infectious Diseases Service with brucellosis between 2003-2007. Demographic features, clinical symptoms, physical examination and laboratory findings of patients were evaluated. The standard tube agglutination test, Rose Bengal test and clinical findings were used as diagnostic criteria for brucellosis. Results: In the study, twelve patients (35%) were female and 22 (65%) were male. The mean age was 9.2+/-3.4 years. Twenty-one patients (61.7%) were from rural areas of Turkey. All of the children except two patients have reported to consume unprocessed milk and dairy products. The most frequent complaints and clinical findings were fever (88.2%) and musculo-skeletal system symptoms (76.4%). Hematological involvement was significantly apparent in laboratory results. Trimethoprimsulfamethoxazole+ rifampicin were administered to children smaller than 8 years and doxycycline+ rifampicin to children older than 8 years during 6 weeks for treatment. Four patients were relapsed. Conclusion: Musculoskeletal system complaints and fever are the most common symptoms in brucellosis. Brucellosis should be considered in the differential diagnosis of patients with hematological signs. Combined treatments should be administered within a sufficient period to provide successful treatment and prevent relapse.Öğe Closed lip schizencephaly: A case report(Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2012) Arica, Vefik; Karakus, Ali; Silfeler, Ibrahim; Arica, Secil Gunher; Altas, Murat; Tutanc, Murat; Basarslan, FatmagulSchizencephaly, has been defined as an almost symmetrical bilateral cleft along the cerebral hemisphere. Clinical findings in patients with schizencephaly depends on the type of clefts (on of off type) and the amount of malformed parenchyma. Incidence of schizencephaly is unclear, while a population-based study performed in the United States reported its incidence as 1.54: 100000. These types of cortical developmental malformations had variable clinical signs depending on the function of the affected area which range widely from mental-motor retardation and epilepsy to focal neurological disorders. We also presented a very rare case with bilateral cleft palate aged 4 years who was referred with recurrent afebrile convulsive episodes and diagnosed as schizencephaly, subependimal heterotopia and temporal lobe epilepsy by cranial MRIÖğe Convulsion in infants as a result of oral use of garden sage(Galenos Yayincilik, 2012) Arica, Vefik; Arica, Secil; Tutanc, Murat; Motor, Sedat; Motor, Vicdan Koksaldi; Dogan, MuratSalvia officinalis is a plant known as Garden Sage and it is used by the community in case of various clinical conditions. Herbalists are the right destinations to provide this special plant. Salvia officinalis is known to be used for its diuretic, anti-inflammatory, antimicrobial, antiseptic, expectorant, spasmolytic and diaphoretic effects. In this case study, a case of intoxication in which a 2-month old infant who presented with convulsion due to accidental oral use of garden sage oil which was actually prepared for topical use by a herbalist is reported. (Turk Arch Ped 2012; 47:67-8)Öğe Daily and every other day use of iron prophylaxis in the first year of life(Galenos Yayincilik, 2010) Arica, Vefik; Arica, Secil; Tutanc, Murat; Motor, Sedat; Onur, Hatice; Dogan, MuratAim: In countries like Turkey where iron deficiency anemia (IDA) is common, it was that iron prophylaxis can be used every other day as intermittent because it would show the same effect and easier for compliance. Material and Method: Two groups of infants born healthy, breastfed exclusively for the first six months and given 400 IU vitamin D were included in the study. In the fourth month of their life, infants started to take iron (Fe +2) 1 mg/kg/day and the second group 2 mg/kg/48 h In use of daily 1 mg/kg/day dose as of the fourth month till the first year 75 patients (the first group), in use of 2 mg/kg/48 h 80 patients (the second group) were involved in our study group. 34 infants (the third group) who did not start to take iron prophylaxis or use any was taken in our study as a control group. Results: It was found out that in the first group 14 infants (18.6%) developed iron deficiency (ID), 3 infants (4%) iron deficiency anemia (IDA), in the second group 16 infants (20%) developed ID and 4 infants (5%) IDA, in the third group, namely in the control group 12 infants (35,3%) developed ID and 10 infants (29.4%) IDA. In comparison of the control group with the first and second groups, IDA portion was less in iron prophylaxis groups, this value was found statistically reliable (p=0.001). When the first and second groups were compared with one another, a statistical difference could not be found between ID/IDA proportions. Because ID and IDA were encountered in both prophylaxis groups it was assumed that iron prophylaxis given just during the first year of life should also be given afterwards. Conclusions: There is no statistical difference between the first and second prophylaxis groups, thus, it was considered that instead of daily use, taking iron every other day would be more effective when it was given in a proper dose. (Turk Arch Ped 2010; 45: 343-7)Öğe Dual effects of erdosteine on hemostasis via its different metabolites in young rats(Sage Publications Ltd, 2011) Arica, Vefik; Tutanc, Murat; Ozturk, Oktay Hasan; Arica, Secil; Basarslan, Fatmagul; Erden, Ersin Sukru; Oktar, SuleymanAim: In the study, we examined erdosteine's effects on platelet functions and coagulation. Materials and methods: A total 29 young albino Wistar rats were divided into four groups. Control rats (n = 6) were given saline; Group I rats (n = 7) were given 3 mg/kg erdosteine by oral gavage for 3 days; Group 2 rats (n = 7) were given 10 mg/kg erdosteine by oral gavage for 3 days; and Group 3 rats (n = 9) were given 30 mg/kg erdosteine for 3 days. Twenty-four hours after the final dose, blood samples were drawn from a portal vein. Prothrombin time (PT), activated partial thromboplastin time (aPTT) and international normalized ratio (INR) were measured, and platelet counts were examined in a peripheral blood smear by light microscopy. Results: PT and INR values of Group I increased compared to the controls but did not change in Group 3. Hemostatic parameters were not measured in Group 2 because the blood samples in Group 2's tubes clotted rapidly. Platelet counts of the peripheral blood from Group 2 were low but were normal in other groups. Conclusion: We have concluded erdosteine may disrupt hemostasis parameters by its different metabolites in patients. Erdosteine has dual effects on hemostasis via its different metabolites, which occur in different doses.Öğe Erdosteine has dual effects on haemostasis via its different metabolites in young rats(Taylor & Francis Inc, 2010) Oktar, Sueleyman; Arica, Vefik; Tutanc, Murat; Ozturk, Oktay Hasan[Abstract Not Available]Öğe Evaluation of cases with diabetic ketoacidosis monitorized in intensive care units(Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2011) Tutanc, Murat; Celik, Tanju; Basarslan, Fatmagul; Gunes, Ali; Konca, Capan; Yel, Servet; Bosnak, MehmetObjective: In this study, we have investigated the demographic and clinical characteristics of pediatric cases with diabetic - ketoacidosis (DKA) followed-up in intensive care units. Methods: This is a retrospective analysis of all patients' files with respect to their demographic factors as gender, complaints, age and clinical features. Mann Whitney U and chi-square statistical tests were performed. Results: The study group consists 16 female and 9 male children with a mean age of 9.9 +/- 3.7 years. The most frequent complaints of the cases were dyspnea, polydipsia, weight loss and polyuria in decreasing order of frequency. They admitted to the hospital because of respiratory distress, tachypnea tachycardia and acidosis. They treated by DKA protocol in the intensive care unit. We normalized Glasgow Coma Scores (GKS) in 12 +/- 5, blood sugar levels in 14 +/- 7, and blood gas levels in 14 +/- 7 hours. Any complication had not developed and the patients under glycemic control were discharged from the hospital with recommendations for outpatient follow-up. Conclusion: DKA cases could be treated rapidly and successfully thanks to accurate and rapid diagnosis followed by strict monitorization protocol. In conclusion we wanted to emphasize that monitorization of patients with DKA should be performed in pediatric intensive care units.Öğe Evaluation of Intoxication Cases Applying to the Emergency Department of Medical School Hospital(Aves, 2012) Zeren, Cem; Karakus, Ali; Celik, M. Murat; Arica, Vefik; Tutanc, Murat; Arslan, M. MustafaObjective: Poisoning has been an important human problem since ancient times. The definition of a poison as a substance drug whch was potentially fatal was first introduced by the British in 1230. In our study, we aimed to retrospectively evaluate the cases of poisoning admitted to the Mustafa Kemal University Hospital between January 1, 2006 and December 31, 2010. Material and Methods: Poisoning cases admitted to the emergency room were reviewed retrospectively. Age, gender, places of transportation, clinical status, types of poisoning, intoxication periods, locations and methods of treatment, length of stay and outcomes were evaluated. Results: A total of 134 cases of poisoning were studied, of whom 30.6% were male and 69.4% were female. The mean age was 27.87 +/- 12.97. The cases were referred to hospital, 53.7% were fully conscious, 35.1% were confused and 11.2% were unconscious Drugs that cause poisoning were classified as, multiple drug (47patients-35.1%), antidepressants (29 patients-21.6%) and pesticides (26 patients-19.4%), respectively. Poisoning is most commonly seen in December. One hundred and twenty-three (91.8%) patients were treated by gastric lavage, activated charcoal and antidote. Seventy-five patients (56%), in the emergency bed service, 21 out (15.6%) in intensive care and 38 patients (28.4%) under emergency observation were discharged following observation. Most of the cases (53 cases 39.6%) were (determined 3 days lies) kept under observation as inpatients for 3 days. The patients were evaluated according to the results of follow-up and treatment; 131 patients (97.8%) were discharged after treatment, 3 patients (2.2%) were transferred No death occurred in the cases of poisoning which were treated. Conclusion: Poisoning was most commonly seen following multiple drug intake, in suicide attempts in adults, and in children by accidental ingesting. Most of the patients can be kept under observation in emergency beds and discharged from the service, by experienced emergency physicians. In order to reduce the incidence of poisoning, the family and society should be educated cleaning agents kept in inaccessible places and advice given regarding not prescribing unnecessary drugs or selling drugs without prescription.Öğe Fukuyama congenital muscular dystrophy(Professional Medical Publications, 2012) Silfeler, Ibrahim; Arica, Vefik; Davran, Ramazan; Tutanc, Murat; Basarslan, FatmagulMuscular dystrophy is an inherited group of disorders that affects skeletal and many other systems. It is transferred to the next generations with autosomal recessive trait. Congenital muscular dystrophy is a rare disorder characterized by findings emerging from birth. There are 12 different forms of mutation according to defects. Fukuyama syndrome is a rare form of congenital muscular dystrophies in our country. There is FKTN gene mutation. Because it is a rare disease in Turkey, we find this case to be worthy of presentation. After the delivery, patients with recurrent convulsion and hypotonia were admitted to pediatric emergency department. Patients were diagnosed as Fukuyama congenital muscular dystrophy after evaluation based on clinical findings, imaging techniques and gene analysis. Congenital muscular dystrophy should be considered, whereas it is a group of disease in which hypotonia and recurrent convulsions are seen in early infancy period.Öğe Intrathoracic Rib Associated with Pulmonary Collapse in a Pediatric Patient(Kowsar Publ, 2012) Basarslan, Fatmagul; Bayarogullari, Hanifi; Tutanc, Murat; Arica, Vefik; Yilmaz, Cahide; Davran, RamazanThe ribs are essential structures of the osseous thorax that provide certain significant information and aid interpretation of radiologic images in daily routine practice. Intrathoracic rib is a rare congenital anomaly that is usually discovered incidentally, but may cause in vain interventions in case of being unaware. We herein report an intrathoracic rib in a girl whose chest X-ray was strange enough to obtain a spiral computed tomography (CT) scanning for a definitive diagnosis afterwards.Öğe Metabolic deterioration just after infancy(Medi+World Int, 2013) Helvaci, Mehmet Rami; Tutanc, Murat; Arica, VefikBackground: We tried to understand whether or not there are some relationships between body weight alone and systolic and diastolic blood pressures (BP) and other metabolic parameters even in childhood. Methods: Consecutive children and adolescents between the ages of 2 and 15 years were studied. Patients with devastating illnesses were excluded to avoid their possible effects on weight. Cases were divided into the four groups according to their percentile for weight alone, including cases below the 3rd percentile in the first, below the 50th percentile in the second, at and above the 50th percentile in the third, and above the 97th percentile in the fourth group. Results: The study included 299 cases. Although mean values of the systolic and diastolic BPs, plasma glucose, total cholesterol, low density lipoprotein cholesterol, triglyceride, and alanine aminotransferase increased, mean value of the high density lipoprotein cholesterol decreased significantly from the first towards the fourth groups in a gradual manner nearly in all steps. Conclusion: Metabolic syndrome is a reversible progression step between complete physical health and irreversible terminal diseases with a very high prevalence in adults. But these findings suggest that pathophysiological mechanisms of the syndrome are already going on even in childhood, and bases of the syndrome are starting to be built up just after the period of infancy, probably due to the eating habits of the families. Therefore, because of the irreversible natures of the terminal diseases of the syndrome, the care to prevent should be started even in childhood.Öğe Methemoglobinemia due to prilocaine administration(Galenos Yayincilik, 2012) Arslan, Mehmet Tayip; Arica, Vefik; Tutanc, Murat; Arica, Secil GunherPrilocaine is the one of the most utilized agents during dorsal penile block in order to prevent pain during circumcision. It is known that prilocaine may lead to methemoglobinemia in neonates and infants. Here we present a 56 days old male patient with prilocaine induced methemoglobinemia who had been referred to intensive care unit for his frank and instant cyanosis after circumcision. Detailed history taking revealed that he needed 1 mg/kg prilocaine administration twice for adequate anesthesia. Patient had frank cyanosis at administration with no other sign. During admission rate of methemoglobin was 16,2% in the blood of the patient and conservative measures lead to complete resolution of all symptoms. Since infants below six months of age are particularly prone to methemoglobinemia due to their low cytochrome b5 levels and fetal hemoglobine is closer to ferric state than adult hemoglobine, it is emphasized in this paper that other alternative anesthetic agents should be utilized instead of prilocaine for regional anesthesia in infants under six months age. (Turk Arch Ped 2012; 47: 305-6)Öğe Neurobrucellosis as a rare complication of brucellosis: three pediatric case reports(Aves, 2012) Arica, Vefik; Silfeler, Ibrahim; Altas, Murat; Tutanc, Murat; Arica, Secil Gunher; Evirgen, Omer; Davran, RamazanBrucellosis is a major worldwide zoonosis. The disease is endemic in developing countries, particularly in the Mediterranean basin. Brucellosis is frequently seen in Eastern and South-Eastern Anatolia regions in Turkey. Around 18 000 new cases are reported annually in Turkey. Any organ or system of the body can be involved. Brucellosis is an infection due to Brucella species and is characterized by acute febrile illness, sweating, weakness, and headache. Involvement of the central nervous system is rare in brucellosis. Brucella is continuing to be an important health problem especially who live in the countryside. The clinicians usually rule out neurobrucellosis in the differential diagnosis of brucellosis. The three neurobrucellosis cases presented in this paper referred with various non-specific symptoms. Only the first patient was found to have hydrocephalus on CT imaging, while the CT images of the other patients were normal. The second case had a history of consumption of fresh herby cheese, however the other cases had no such history. These three patients were found to have recovered without sequela during their long term follow up. The aim of this presentation is to draw attention to the importance of neurobrucellosis especially in endemic regions including our country. (Turk Arch Ped 2012; 47: 218-21)Öğe Oxidative Status in Epileptic Children Using Carbamazepine(Briefland, 2015) Tutanc, Murat; Aras, Mustafa; Dokuyucu, Recep; Altas, Murat; Zeren, Cem; Arica, Vefik; Ozturk, Oktay HasanBackground: There is an increasing attention towards the relationship between oxidative stress and epilepsy. The effect of antiepileptic drugs on oxidant status is of major interest. Antiepileptic drugs can increase levels of free radicals, which consequently might lead to seizures. Carbamazepine (CBZ) is an antiepileptic drug commonly used in childhood and adolescence. Objectives: Therefore we aimed to investigate the effects of CBZ on total antioxidant status, total oxidant stress, and oxidative stress index. Patients and Methods: The study included 40 epileptic patients and 31 healthy children between 4 and 12 years of age. Serum CBZ level, total antioxidant capacity and total oxidant status were measured. Oxidative stress index was also calculated both in controls and patients. Results: In the epileptic group, decreased levels of total antioxidant capacity, increased total oxidative stress and oxidative stress index levels were found. Positive correlation between plasma CBZ levels and total oxidant status was observed. Conclusions: Antioxidant action could not be playing any role in antiepileptic effect of CBZ. Furthermore, increased oxidative stress induced by CBZ could be the cause of CBZ-induced seizures. Therefore combining CBZ with antioxidants could be beneficial.Öğe Pediatric neurobrucellosis associated with hydrocephalus(Medknow Publications & Media Pvt Ltd, 2010) Altas, Murat; Evirgen, Omer; Arica, Vefi K.; Tutanc, MuratBrucellosis is an infectious disease, frequently encountered in developing countries. It may involve multiple organ systems of the human body. However, neurobrucellosis is a rare complication of brucellosis. The most frequent events of cranial involvement are meningitis and meningoencephalitis. In the present case, a 10-year-old girl was referred to our clinic with fever, headache, nausea, and vomiting. The patient's blood and cerebrospinal fluid cultures were found positive for brucellosis. Communicating hydrocephalus was also present in the cranial computed tomography as a complication of neurobrucellosis. The patient was successfully treated by external ventricular drainage and triple antibiotic therapy. There was no need to insert a ventriculo-peritoneal shunt.Öğe Peroral poisoning leading to lung complications(Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2012) Tutanc, Murat; Karcioglu, Murat; Kocamaz, Halil; Gunes, Ali; Ozel, Abdlkadir; Bosnak, Mehmet; Haspolat, KenanObjective: Hydrocarbon compounds swallowed orally show their effects with tissue hypoxia, pulmonary irritation, and systemic toxicities. Pulmonary damage leads to various complications leading to death. In this study, cases of poisoning with paint thinner, turpentine, and kenaz were reported to call attention to the subject. Methods: Information related to the patients were gathered, retrospectively. Effects of inhaled corticosteroids for pulmonary complications were evaluated. Results were discussed in the light of the literature. Results: Twelve of them presented with pulmonary rales, six patients manifested severe respiratory distress, five patients had leukocytosis, and five patients fever. Besides three patients were unconscious, and two patients had impaired liver function tests. Interestingly, respiratory symptoms became prominent after a period of 24 hours in five patients. All patients were discharged within a period of 3 to 8 days after medical treatment. Conclusion: We used inhaled corticosteroids for the treatment of pulmonary complications, but further studies are required to certainly assert their beneficial effects in this field. Most of such type of poisoning can be avoided. On the other hand, parents should be aware of such dangers.Öğe Pituitary apoplexy due to thyroxine therapy in a patient with congenital hypothyroidism(2013) Tutanc, Murat; Altas, Murat; Yengil, Erhan; Ustun, Ihsan; Dolapcioglu, Kenan S.; Balci, Ali; Sefil, FatihA 24-year-old woman was admitted with general weakness, umbilical swelling, developmental delay, speech disorder, constipation, gait problem. Her findings were umbilical hernia, xerosis, dry hair, and short stature. After thyroxine treatment, she also had headache, vomiting, and palpitation, lack of appetite, and sleep disturbance. Pituitary magnetic resonance imaging revealed a heterogeneous mass at the central part of the gland on coronal section and it was interpreted as pituitary apoplexy. In the current case, the patient with congenital hypothyroidism (CH) developed pituitary apoplexy (PA) after thyroxine therapy. Therefore, it is suggested that the complaints were related to PA rather than adrenal insufficiency. Here we describe a case report evaluating PA in a patient with thyrotrophic pituitary adenoma due to CH. To the best of our knowledge, this is the first case in terms of PA associated with CH after thyroxine therapy in the literature.
