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Öğe Bacillus Calmette-Guerin is a preventive factor in mortality of childhood tuberculous meningitis(Elsevier Sci Ltd, 2014) Kelekci, Selvi; Karabel, Musemma; Karabel, Duran; Hamidi, Cihat; Hosoglu, Salih; Gurkan, M. Fuat; Tas, M. AliObjectives: Studies have been done that have focused on the efficacy of bacillus Calmette-Guerin (BCG) vaccination in the prevention of cases of childhood tuberculous meningitis (TBM). However the efficacy of the vaccination in the prevention of mortality has not been sufficiently evaluated. This study aimed to determine the main features of TBM cases in childhood and to evaluate the factors related to mortality, proving the protective effect of BCG vaccination in childhood TBM. Methods: In a retrospective approach, all consecutive cases of TBM in children that occurred between 1997 and 2005, at Dicle University Hospital, were studied. The following data were evaluated: demographic aspects, admission symptoms, radiology and laboratory findings, BCG vaccination status, tuberculin skin test (TST) positivity, and mortality rates. Results: In total, 172 cases of childhood TBM were evaluated (mean age 53.3 +/- 55.7 months; 109 boys (63.4%)). The majority of these cases (70.4%) had typical TBM symptoms on admission. BCG vaccination data were available for 152 (88.4%) cases and 29 of them (19.1%) were positive. The TST was performed for 143 patients (83.1%) and 28 (19.6%) were found positive. Hydrocephalus was identified in 118 patients (68.6%) on computed tomography examination. A shunt was placed in 79 cases (45.9%). In total, 24 patients (14.0%) died in the hospital. TST negativity was a significant factor for mortality (p = 0.012). BCG positivity was found to be a preventive factor from mortality (p = 0.05). Conclusions: BCG vaccination is effective in the prevention of TBM-associated mortality in childhood. TST negativity may be a sign of a poor prognosis in TBM cases. (C) 2013 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. All rights reserved.Öğe Complementary and alternative medicine in children with asthma and/or allergic rhinitis(Bilimsel Tip Yayinevi, 2014) Tuncel, Tuba; Cetemen, Aysen; Karabel, Musemma; Kelekci, Selvi; Sen, Velat; Gurkan, M. FuatObjective: The aim of this study is to evaluate the complementary and alternative medicine methods, the prevalance of their use, and to assess the factors that influence using these methods in children with asthma and/or allergic rhinitis. Materials and Methods: The study was conducted between November 2012-May 2013. The data collection form consisting 34 questions was prepared. These questions were posed to mothers of children with asthma and/or allergic rhinitis who were followed at least three months in pediatric allergy outpatient clinic. The data were recorded in SPSS for Windows v.16. Descriptive statistics, chi square, and logistic regression analysis were used. p< 0.05 was considered as significant. Results: The study included 177 patients. The complementary and alternative medicine methods were suggested to 136 (77%) patients and 68 (38.4%) patients used these methods anytime. 34 (43%) patients with asthma, 25 (39.7%) patients with asthma and allergic rhinitis, 9 (25.7%) patients with allergic rhinitis used complementary and alternative medicine. The differences between the groups were not statistically significant (p> 0.05). The honey use was most common method for both asthma and allergic rhinitis (37% and 22.9%, respectively). Herbal medicines were the %67 of complementary and alternative medicine methods. The diagnosis, education levels of parents, the family income, positivity of skin prick test, severity of the asthma and allergic rhinitis, control of the disease, using multiple drugs, using inhaled steroids were not different between the groups (p> 0.05). Logistic regression analysis revealed that these factors were not related to increased risk of complementary and alternative medicine use. Conclusion: The complementary and alternative medicine use is frequent in children with asthma and/or allergic rhinitis. The physicians should have knowledge about these methods and inform parents about the possible effects and side effects.Öğe An evaluation of cases of pneumonia that occurred secondary to hydrocarbon exposure in children(Verduci Publisher, 2013) Sen, V.; Kelekci, S.; Sen, H. Selimoglu; Yolbas, I.; Gunes, A.; Abakay, O.; Gurkan, M. FuatOBJECTIVE: Hydrocarbon pneumonia is distinct among the types of childhood pneumonia in that it has a different pathogenesis and treatment and is preventable. In this study, the cases of 54 children with hydrocarbon pneumonia admitted to the Dicle University Medical Faculty Pediatric Chest Diseases Unit between the years 2006 and 2010 were analyzed retrospectively. PATIENTS AND METHODS: The medical records of 54 patients diagnosed with pneumonia after ingesting/inhaling hydrocarbons were analyzed retrospectively. Age, sex, presenting symptoms, clinical status, radiological and laboratory findings and response to treatment and prognosis were noted. RESULTS: 35 (64.8%) of the patients were male, 19 (35.2%) were female and the ages of the patients ranged from 1 to 5 with an average of 2.49 +/- 0.80. The etiologies of the pneumonia were thinner (33%), naphta (3.7%) and kerosene. In 49 of the patients (90.7%), the symptoms started to occur the day the patient was exposed to hydrocarbons. The average length of hospital stay was 4.0 +/- 2.3 days. Six patients were treated in the intensive care unit (ICU), and one patient with hydrocarbon pneumonia due to kerosene ingestion died. Inhaled corticosteroids were administered to 18 patients who were progressively deteriorating and inhaled salbutamol was given to 16 patients with bronchospasm. Patients with radiological findings on their chest X-rays and auscultatory findings were found to have longer hospital stays (p < 0.05). CONCLUSIONS: To prevent chemical pneumonia, precautions must be taken to stop children under 5 years of age from using/abusing chemical substances. Although some cases of chemical pneumonia lead to death, with diligent care and treatment, the outcomes are promising. The patients in this study group responded well to treatment with inhaled corticosteroids and salbutamol.Öğe Flexible bronchoscopy findings in lung amoebiasis: a case report(Drunpp-Sarajevo, 2012) Kelekci, Selvi; Sen, Velat; Tuncel, Tuba; Sen, Hadice Selimoglu; Cicek, Muttalip; Erge, Duygu; Gurkan, M. FuatThe protozoon Entamoeba histolytica is an agent of human amoebiasis. Amoebiasis is common around the world, especially in tropical and subtropical regions. About 90% of infections are asymptomatic, while the remaining 10% are characterized by dysentery and abscesses observable in the liver or other organs. The liver is the organ most commonly affected by extraintestinal amoebiasis. Pulmonary and invasive amoebiasis is seen in 2-3% of patients, but isolated pulmonary amoebiasis is rarely seen in the pediatric age group. In this study, a 14 year old male patient diagnosed with isolated pulmonary amoebiasis is presented. Diagnosis was based on the detection of trophozoites through direct examination of bronchoalveolar lavage fluid obtained by flexible bronchoscopy, and the presence of amoebic IgG in the blood. Three weeks of metronidazole combined with antimicrobial treatment significantly improved the patient's clinical and radiologic findings. The aim of this report was to present a rare case of childhood pulmonary amoebiasis without liver or other organ involvement and to demonstrate the efficacy of flexible bronchoscopy for diagnosis.Öğe Quality of Life, Alexithymia, Anxiety and Depression Symptoms among Mothers of Children with Atopic Dermatitis(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2016) Simsek, Seref; Tuncel, Tuba; Yuksel, Tugba; Cetemen, Aysen; Gurkan, M. FuatObjective: The mothers of children diagnosed with atopic dermatitis (AD) may be impacted in many different ways. Aim of the present study was to compare quality of life, anxiety, depression, and alexithymia symptoms between mothers of children diagnosed with AD and mothers of healthy children. Method: The study included 34 mothers of children who were diagnosed with AD between June 2012 and July 2013 and 35 mothers of healthy children. In the study, Short Form 36 (SF-36) Health Survey was used to evaluate quality of life, while the Toronto Alexithymia Scale (TAS) was used to evaluate alexithymia level, the State-Trait Anxiety Inventory (STAI) was used to evaluate anxiety symptoms, and the Beck Depression Scale (BDS) was used to evaluate depression symptoms. Results: There was no statistically significant difference between the mothers of AD patients and control subjects in terms of quality of life, anxiety, depression, and alexithymia. In addition, there was no significant difference in disease severity or symptoms scale scores between the two groups. Conclusion: These results may suggest that mothers' mental health is not affected in the early stage of the disease. In later stages of the disease, mothers of children with AD may become psychologically affected. Longterm follow up studies are required to clarify this distinction.Öğe Seropositivity for Chlamydia Pneumoniae and Mycoplasma Pneumoniae in Asthmatic Children(Derman Medical Publ, 2015) Tutanc, Murat; Gurkan, M. Fuat; Yel, Servet; Gunes, Ali; Konca, Capan; Bilen, GulserenAcute respiratory tract infections may trigger acute asthma attacks and may be held responsible for etiopathogenesis in children with asthma. Although bacterial infections attract a limited amount of attention, recently Chlamydia pneumoniae (CP) and Mycoplasma pneumoniae (MP), in particular, are reported to be the possible factors. IgM and IgG seroprevalence was investigated in 66 children patients with bronchial asthma (between the ages of 3 and 14) for CP and Mycoplasma pneumoniae. In a total of 66 cases, 18 (27.2%) patients were detected with IgG positivity for CP whereas 27 of them (40.9%) were detected with IgG positivity for MP. IgG positivity was determined in 6 patients (13.0%) in the control group for CP, and in 6 patients (10.8%) in the control group for MP. The rate of the asthma patients with IgG seropositivity for MP was 4 times higher than that of the control group. It was seen that IgG antibody seropositivity for CP was higher in those with more frequent attacks. No such difference was observed in terms of IgG antibody seropositivity for M. pneumoniae. There are many studies indicating that CP and MP infections take an importance place in the etiology of bronchial asthma and asthma attacks in children. The results obtained reveal the effect of both microorganisms on the etiopathogenesis of the bronchial asthma and the increased number of asthma attacks.Öğe The use of complementary and alternative medicine in children with atopic dermatitis(Bilimsel Tip Yayinevi, 2013) Tuncel, Tuba; Karabel, Musemma; Cetemen, Aysen; Kelekci, Selvi; Sen, Velat; Gurkan, M. FuatObjective: The aim of this study is to evaluate the complementary and alternative medicine methods, the prevalence of their use and to assess the factors that influence using unconventional therapies in children with atopic dermatitis. Materials and Methods: The study was conducted between November 2012-May 2013. The data collection form was prepared which consisted 34 questions. These questions were posed to mothers of children with atopic dermatitis who were followed at least three months in pediatric allergy outpatient clinic. The data were recorded in SPSS for Windows v.16. Descriptive statistics, Mann Whitney-U, Fisher's exact test and logistic regression analysis were used. p< 0.05 was considered as significant. Results: The study included fifty children. 46% of patients have used complementary and alternative medicine. The most common methods were prayer, herbal medicines and application of saliva. The most common reason to apply these interventions was defined as inability to benefit from medical treatment (47%). 13% of users thought complete response and 30% partial response. Complementary and alternative medicine interventions were suggested to 68% of the patients. The family elders and friends were the most common proposers. The level of family income, educational levels of mothers and fathers and the type of the family were not related to frequency of complementary and alternative medicine use (p> 0.05). The severity of the atopic dermatitis was different between two groups and complementary and alternative treatment use increased in the patients with severe atopic dermatitis (p< 0.05). Conclusion: The use of complementary and alternative medicine in the children with atopic dermatitis is very common. The physicians should have knowledge about these methods.
