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Öğe Assesment of Paediatric Varicella Pneumonia(Univ West Indies Faculty Medical Sciences, 2016) Aktar, F.; Tekin, R.; Bektas, M. S.; Kostu, M.; Aktar, S.; Gunes, A.; Uluca, U.Background: The objective of the study was to determine the clinical presentation, diagnosis, treatment, and respiratory complications of varicella zoster pneumonia (VZP) in children. Material and methods: Relevant data, age, gender, month of admission, demographic data, past medical and family histories, physical findings during admission, laboratory findings, treatments given, and outcome of these treatments with diagnosis of varicella pneumonia were collected retrospectively. Results: In a two-year period, 15 cases were identified and their data were analysed. Eight patients were male (53%) and seven were female (43%). The mean age was 4.7 +/- 3.7 months. Twelve cases (80%) were under six months of age and nine patients (60%) had household contact with persons with chicken pox infection. After onset of the chicken pox rash, the mean time for development of respiratory symptoms was 3.5 +/- 1.0 days. The mean hospital stay was 13 +/- 1.8 days and ranged from 9-17 days. The persisting fever, fatigue, and cough episodes were major presenting symptoms upon admission in almost all the patients. All patients received acyclovir and non-specific pneumonia treatment and all recovered. None of the children were previously immunized against varicella. Conclusions: Varicella zoster pneumonia should be considered in patients with prolonged fever and accompanying cough in patients with chicken pox. Probably the best approach would be a trial of high dose acyclovir treatment in children who develop VZP.Öğe Atropa belladonna (Deadly nightshade) poisoning in childhood(Univ West Indies Faculty Medical Sciences, 2021) Bektaş, M. S.; Aktar, F.; Güneş, A.; Uluca, Ü.; Gülşen, S.; Karaman, K.Objective: A very small amount of Atropa belladonna (AB) can lead to serious symptoms of poisoning and can cause death in children. In this study, demographic, clinic and laboratory results of AB poisoning were evaluated. Methods: A total of 108 cases with belladonna poisoning were retrospectively evaluated. At time of admission, age, age groups, gender; signs and symptoms caused by poisoning, duration of stay in hospital, laboratory data, intensive care needs, and applied treatments were recorded. Results: Approximately 44.4% were females and 55.6% were males. While the most common symptoms were xeroderma and flushing, the most frequent findings were tachycardia and mydriasis. Eight patients complained about astasis and five of them were taken into the intensive care unit. Astasis complaint was relatively higher (p < 0.01) in the patients who needed intensive care than those who did not. Creatine kinase levels were relatively higher (p = 0.06) in the intensive care patients as compared to non-intensive care patients. Neostigmine was given to all patients. Five patients, who failed to respond to therapy, were taken into the intensive care and respond to treatment successfully with physostigmine. Conclusion: Atropa belladonna poisoning may seriously progress in the act of late diagnosis and treatment in childhood. Thus, it is crucial to realize that AB poisoning should be taken into consideration in the patients with flushing, xeroderma with mydriasis, tachycardia, tremor; abdominal pain, and fever symptoms. Patients with astasis complaints should be evaluated carefully in terms of intensive care need. Patients with a Glasgow Coma Scale lower than 12 should be observed in the intensive care.Öğe Comparison of snakebite cases in children and adults(Verduci Publisher, 2015) Tekin, R.; Sula, B.; Cakir, G.; Aktar, F.; Deveci, O.; Yolbas, I.; Celen, M. K.OBJECTIVE: There are very few studies that compare the snakebite cases in children and adults. The present study aimed to compare the demographic characteristics, clinical presentations, laboratory findings, and developed complications in pediatric and adult patients due to snakebites. PATIENTS AND METHODS: This study included the patients admitted to the hospital and monitored due to snakebite between July 1999 and December 2012. The condition of each patient who had been bitten was admitted to the hospital was monitored from the time of admission to the end of their hospital stay. The fact that a snakebite occurred was recorded if the subjects saw the snake or if the appearance of the puncture sites was convincingly a snakebite. RESULTS: The present work included 290 patients, of whom 123 were children and 167 were adults. The most common location of the bites was the lower extremity with 78.9% (n=97) and 63.5% (n=106) in pediatric and adult patients, respectively. All of the pediatric patients received prophylactic treatment with antibiotics, whereas 62 (37.1%) adult patients received antimicrobial treatments due to the soft tissue infection. The most common complication developed was pulmonary edema in children at a rate of 33.3% (n=41) and compartment syndrome in adult patients at a rate of 3% (n=5). CONCLUSIONS: Patients admitted to the hospital due to snakebite should be monitored for at least 12 hours, even if there is no sign of clinical envenomation. Antivenom treatment should be administered to the patients requiring clinical staging. Patients should be kept under close monitoring to prevent the development of serious complications such as cellulitis, pulmonary edema, compartment syndrome, and disseminated intravascular coagulation.Öğe Evaluation of Device-associated Nosocomial Infections in a Paediatric Intensive Care Unit(Univ West Indies Faculty Medical Sciences, 2016) Cevik, S.; Tekin, R.; Gundeslioglu, O. O.; Aktar, F.; Yilmaz, S. M.; Ay, M.Objectives: The aim of this study was to evaluate the rate of device-associated healthcare-associated infections (DA-HAI) in a paediatric intensive care unit (PICU). In addition, the identities of the responsible micro-organisms and of their antibiotic sensitivities were determined. Subjects and Methods: Patients who had been treated and followed-up in a PICU for more than 48 hours between January 2008 and December 2013 were included in the study. Device-associated nosocomial infections were defined by the Centers for Disease Control (CDC) criteria. Results: Nosocomial infections were detected in 244 of the 7376 patients over the six-year period. A diagnosis of DA-HAI was made in 75 (30.7%) of these infections. The rates of device utilization were 26% for mechanical ventilators, 6% for central venous catheters and 0.9% for urethral catheters. The rate of device-associated infections was 30.7%, and their frequency was 1.9/1000 patient-days. The device-associated nosocomial infection rates for mechanic ventilators, central and urethral catheters were 5.6, 1.62 and 3.77 per 1000 patient-days, respectively. Of these infections, Pseudomonas aeruginosa was the most frequent pathogen. Patients who developed hospital infections had longer durations of ICU hospitalizations and more often had to use mechanical ventilators and central and urinary catheters. Conclusions: The duration of hospitalization and the use of mechanical ventilators and central and urinary catheters were related to the increases in nosocomial infections. Therefore, target-oriented active surveillance should be regularly performed, and the superfluous employment of invasive devices should be avoided.Öğe Hemophilia Requiring Surgical Attention: A Report of two Cases(Wiley-Blackwell, 2017) Soker, M.; Uzel, H. V.; Soker, S.; Aktar, F.[Abstract Not Available]
