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Öğe Absolute white blood cell count and neutrophil-lymphocyte ratio may predict the need for double- J stent Insertion in ureteral stones in children: A comparative study(2023) Önen, Abdurrahman; Aydoğdu, Bahattin; Okur, Mehmet Hanifi; Karabel, Musemma; Arslan, Serkan; Azizoğlu, Mustafa; Kamcı, Tahsin OnatObjective: Our goal was to determine whether or not a double-J (DJ) stent insertion is required in cases of ureteral stones based on the absolute white blood cell (WBC) counts, neutrophil-lymphocyte ratio (NLR), absolute monocyte counts, and other laboratory markers. Materials and Methods: The patients were divided into two groups as those who did (Group 1), and did not (Group 2) need DJ stent insertion. The age, symptoms, diagnosis, hemogram parameters, and treatment results of the patients were evaluated. Results: Forty-nine percent (n=44) of the patients were female and 51% (n=46) were male. The groups did not differ in terms of age and gender (p>0.05). A higher incidence of hematuria was observed in Group 1 (p<0.05). WBC (p<0.05), NLR (p<0.05), and monocyte counts (p<0.05) were found to be higher in Group 1. In the ROC analysis; WBC and NLR were found to be two predictive markers for the need for DJ stent insertion. At a cut-off value of 12.6 x 109/L, WBC had 37% sensitivity, and 81% specificity (AUC: 0.67; 95% CI: 0.54-0.80), and at a cut-off value of 3.8, NLR had 65% sensitivity, and 76% specificity (AUC: 0.70; 95%CI: 0.57-0.82) in predicting the need for a DJ stent insertion. Reoperation was not required in any case. Conclusion: In cases of ureteral stones, the absolute WBC count and NLR may help determine the requirement (if any) for a DJ stent insertion.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 Cardiac Tamponade may be the First Symptom of Leukemia(Informa Healthcare, 2014) Karabel, Musemma; Soker, Murat; Kelekci, Selvi; Karabel, Duran; Yel, Servet; Bilici, Meki[Abstract Not Available]Öğe The Clinical Findings and Prophylactic Treatment in Children with Factor X Deficiency(Informa Healthcare, 2013) Karabel, Musemma; Soker, Murat; Yildirim, Aysen Turedi; Oymak, Yesim; Kelekci, Selvi; Karabel, DuranFactor X (FX) is the component of both extrinsic and intrinsic coagulation cascade and is the first enzyme of the common pathway which results in thrombus. Congenital FX deficiency (FXD) is an extremely rare coagulation defect. In this study, we aimed to investigate the clinical and laboratory data of the patients diagnosed with FXD. The files of the 15 patients (7 female, 8 male) diagnosed and followed up for FXD within the last 4 years were evaluated retrospectively. The mean age of the patients was 29 months (min-max: 1-144 months). The most presenting complaints were easy bruisability (n=8; 53%) and epistaxis (n=8; 53%). FX levels were <1% in six patients, 1-5% in four patients, and >5% in five patients. Heparin added-Protrombin Complex was used for prophlaxy (n=11; 73%). Any treatment-related complication was not observed. Heparin-added PCC can be used safely for effective prophlaxy. We suggest that family history is important when considering prophlaxy and in patients with life-threatening bleeding or with FXD sibling the prophlaxy should be introduced in the early course.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 Congenital tuberculosis: presentation of a rare case(Soc Argentina Pediatria, 2015) Sen, Velat; Sen, Hadice Selimoglu; Aktar, Fesih; Uluca, Unal; Karabel, Musemma; Gurkan, Mehmet FuatCongenital tuberculosis is a rare disease with a high mortality rate. Congenital tuberculosis is considered the result of mother-to-child transmission from the placenta to the fetus, through the ingestion of the amniotic fluid, or via transplacental transmission through the umbilical vein. Given the non-specific clinical signs of tuberculosis, it is usually difficult to diagnose it. The case of a 48-day-old male infant hospitalized due to weight loss, fever, cough, hemoptysis, and respiratory distress for the past 20 days, is presented. In this period, he had received broad spectrum antibiotics but with no improvement. A chest x-ray showed the presence of consolidation and a cavitary lesion in the upper and middle left lung fields. Mycobacterium tuberculosis was detected by polymerase chain reaction in a bronchoalveolar lavage specimen. Congenital tuberculosis was diagnosed based on this finding; hence, a tuberculostatic regimen was started accordingly. The patient died 13 days after treatment initiation. Congenital tuberculosis should be considered in infants with weight loss, fever, cough, hemoptysis and respiratory distress.Öğe Evaluation of children and adolescent with cystic fibrosis by pancreatic elastography(Wiley, 2022) Yilmaz, Kamil; Hattapoglu, Salih; Sen, Velat; Karabel, Musemma; Kan, Ahmet; Yilmaz, Engin Deniz; Sen, Hadice SelimogluBackground Cystic fibrosis (CF) is an autosomal recessively inherited disease. Clinical findings vary by age of the patient, the organ systems involved, and the severity of the CFTR gene mutation. Pancreatic and liver involvement is prominent and exocrine pancreatic insufficiency is observed in the majority of patients. Point shear wave elastography (pSWE) is a non-invasive method that can quantitatively determine tissue elasticity and stiffness. In this study, the morphological evaluation of the pancreas was performed using the pSWE technique in pediatric patients diagnosed with CF. The effectiveness of this method for the early detection of pancreatic insufficiency was investigated. Methods Fifty-five patients with CF (24 girls, 31 boys) and 60 healthy children (29 girls, 31 boys) without any chronic diseases and who were suitable for the pSWE examination were included in the study. Results The mean value of pSWE was 1.12 +/- 0.16 in the healthy group and 0.97 +/- 0.16 in the patients with cystic fibrosis. There was a statistically significant difference between the two groups (P < 0.001). Significant negative correlations were found between pSWE and age (r = -0.319; P = 0.018), height (r = -0.293; P = 0.03), serum glucose (r = -0.346; P = 0.01), HbA1C (r = -0.592; P = 0.02), and duration of the disease (r = -0.806; P < 0.001). Conclusions Investigating pancreatic elasticity and detecting pancreatic insufficiency using pSWE (a simple, inexpensive, and non-invasive method) in the early period before overt laboratory and clinical symptoms of EPI appear can contribute positively to long-term results in young patients with CF.Öğe The evaluation of children with prolonged cough accompanied by American College of Chest Physicians guidelines(Wiley, 2014) Karabel, Musemma; Kelekci, Selvi; Karabel, Duran; Gurkan, Mehmet FuatIntroduction In children, coughs lasting longer than 4 weeks are considered to be chronic, with etiological factors varying widely. Objective This study included children with chronic cough who were followed for 1 year. All cases were evaluated with the guidance of the American College of Chest Physicians (ACCP), and etiological factors were analyzed. Methods The study included 270 children between the ages of 2 months and 14 years. Their presenting symptoms, physical examination findings and laboratory data were recorded. All patients underwent laboratory tests including direct chest X-ray and spirometric measurements. Several patients required additional advanced examinations such as a sweat test, determination of immunoglobulin levels and bronchoscopy. Patients were reevaluated according to ACCP recommendations, and etiological factors were investigated. Results The total of 270 patients were included in the study included 43.3% (n = 153) females with a mean age of 6.5 +/- 2.3 years (7 months to 17 years). After a 1-year follow-up of patients, we determined that the most common etiologic factors were asthma (27%), asthma-like syndrome (15.5%) and gastroesophageal reflux (10%). Other etiological factors included upper airway cough syndrome and protracted bronchitis, respectively. Conclusion The use of a standardized clinical approach such as the ACCP increases the possibility for fast and accurate diagnosis during the treatment of children with chronic cough, and the use of these guidelines should be required.Öğe Fasciola hepatica infestation in Turkish children(Edizioni Minerva Medica, 2017) Tokgoz, Yavuz; Karabel, Musemma; Baysoy, Gokhan; Goya, Cemil; Cicek, Muttalip; Pirinccioglu, Ayfer G.; Uluca, UnalBACKGROUND: The data on childhood fascioliasis are limited. We aimed to heighten physicians' awareness of Fasciola Hepatica by presenting 14 cases in this paper. METHODS: The medical records of pediatric patients treated for F. Hepatica infection within the last 2 years were reviewed. ELISA method with a cut-off level of 10 was used as the serological test, in which an absorbance level of >11 DU/mL was considered positive. RESULTS: Ten (71.4%) patients were female. Complaints at presentation were abdominal pain (N.=14; 100%) and loss of appetite (N.=12; 85.7%). Twelve (85.7%) patients were from rural areas. All patients had an elevated eosinophil count (mean: 3885.6/mm(3), minimum: 566/mm(3),maximum: 18687/mm(3)). Six patients had a leucocyte count >10.000 cells/mm(3) and 8 (57%) patients had an ESR>20 mm/h. Gamma-glutamyt transferase (GGT) was normal in all but 1 patient presenting with cholangitis. In hepatobiliary ultrasonography (USG) the most common finding was a heterogeneous solid lesion found in 11 patients. Advanced imaging methods revealed multiple cystic lesions in 10 patients and magnetic resonance imaging (MRI) showed hypo-hyperintense hepatic parenchymal changes in 9 patients. The patients were started on Triclabendazole 10 mg/kg/dose. Clinical, laboratory, and radiological findings of the patients were improved after the therapy. CONCLUSIONS: Fascioliasis should be suspected in children from endemic regions presenting with abdominal pain, weight loss, and fever, which are accompanied by eosinophilia, elevation in transaminases, and cystic/solid lesions in liver, particularly in bile ducts or parenchyma. Triclabendazole is very effective for treatment of this disease.Öğe A Rare cause of recurrent oral lesions: Chediak-higashi syndrome(Galenos Yayıncılık, 2014) Karabel, Musemma; Kelekçi, Selvi; Şen, Velat; Söker, Murat; Karabel, Duran; Aliosmanoğlu, Çiğdem[Özet Yok]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.
