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Öğe Clinical and laboratory presentation of typhoid fever(2001) Yaramis A.; Yildirim I.; Katar S.; Özbek M.N.; Yalçin I.; Tas M.A.; Hosoglu S.A total of 314 children with clinical and/or laboratory diagnosis of typhoid fever admitted to the Dicle University Hospital pediatric infectious diseases ward were reviewed for demographic data such as age, sex, clinical features, and results of laboratory tests. There were 187 male and 127 female patients, with a mean age of 9.6 years ranging from 6 months to 16 years. Eleven of all the children were less than one year of age, while 23 were under the age of five years. Predominant symptoms were fever, abdominal pain, vomiting, and headache. Hepatomegaly was almost twice as frequently observed as splenomegaly. Common clinical signs of typhoid fever in adults such as relative bradycardia and spots were seldom documented. A febrile convulsion was the presenting symptom in nine of the patients, all of whom were under the age of five years. Intestinal perforation was present in five of the patients. Antibiotic susceptibility tests in 67 cases revealed resistance rates of 17% for ampicillin, 5% for trimethoprim-sulfamethoxazole, 4% for ceftriaxone, and 6% for sulbactam-ampicillin. No resistance was detected against the quinolones and chloramphenicol. Elevated serum alanine and aspartate aminotransferase (50 > /U/L) levels were observed in 32% of our patients. At presentation, 38% of all patients were anemic (Hb <12 g/dl), 10% were thrombocytopenic (<105/mm3). Except the two bacteriologically confirmed typhoid fever patients died during the period of observation, all patients survived from their severe illness completely.Öğe Diphtheria in patient presenting multiple system damage(2006) Yaramiş A.; Katar S.A 10 year-old girl was admitted to our hospital with five-day history of fever, bilateral neck swelling, and dyspnea. The patients symptoms suggested nasopharyngeal diphtheria and she was administered penicilin and, antitoxin immediately. Nevertheless myocarditis, syncope, neuropathy and hepatitis developed after two-week hospitalization. The patient was therefore administered carnitine, dopamine, dobutamine and immunglobulin. After hospitalization for 52 days, the patient was discharged with minimal hemiparesis. The remaining of symptoms resolved on follow-up. In this article we report a patient with diphtheria and review the literature.Öğe Enteric fever in 19 children cases with positive hemocultures(2006) Katar S.; Onur H.; Yaramiş A.; Özbek M.N.; Ecer S.Clinical and laboratory findings of 19 children with enteric fever and positive hemocultures, hospitalized in the Infection Clinic of Diyarbakir Children's Hospital, were evaluated retrospectively. Ten patients were male and nine were female, and mean age was 9.3 years. The most common symptoms were fever, malaise and lack of appetite. On admission, clinical and laboratory findings were coated tongue in all cases, abdominal tenderness in four, hepatomegaly in three, nuchal rigidity in two, anemia in 12, leukopenia in four, thrombocytopenia in four, and high levels of transaminases in nine of the cases. Widal test titration was above 1/200 in 15 cases (79%). Antibiogram was applied to all patients; no resistance to antibiotics was determined. All cases were discharged with complete recovery. Given clinical and laboratory findings of enteric fever cases whose cultures were positive within this study, it is implied that multi-drug resistance against Salmonella typhi is an important health problem in Turkey, especially in the southeastern anatolia region.Öğe Henna - Induced hemolytic anemia and acute renal failure(2001) Devecioğlu C.; Katar S.; Doğru Ö.; Taş M.A.Henna is a traditional cosmotic agent and is used worldwide, especially in the Middle East. Its active agent is lawsone (2-hydroxy-1,4-naphthoquinone). Henna is not only applied to hands or hair as a cosmotic agent in traditional ceremonies, but is also applied to the body on lesions in the treatment of seborrheic dermatitis or fungal infections. However, its application over the body or in newborns is rare. Here we report a 27-day-old boy who developed hemolytic anemia and acute renal failure following topical application of henna to his abdomen, intertriginous region and legs to treat diaper rash.Öğe An important problem in neonatal period: Hypernatremic dehydration(2010) Akgün A.; Katar S.; Taşkesen M.; Özbek M.N.Objective: Hypernatremic dehydration of the newborn with breastfeeding, which has a high morbidity and mortality rates, has been reported to be increased in the recent years. In this study, it was aimed to evaluate the demographic, clinical features and the results of management in newborns with hyper-natremic dehydration. Material and Methods: A total of 31 term newborns with hypernatremic dehydration (Na > 150 mmol/L) who admitted to the Newborn Intensive Care Unit between January 2006 and June 2008 were included in this study. Results: Mean±SD weight and age of the newborns were 3362±711.3 g and 6.3±3.4 days respectively and all were breastfeeding. 19.4 % of the patients were born at home, 64.5 % and 3.2 % of the patients were born in city and cottage hospitals respectively. Only 12.9 % of the patients were born in our hospital. Jaundice (61.3 %) and poor sucking (19.4%) respectively were the most common presenting signs. Mean±SD serum and mean breast milk sodium concentrations were 161.7±12.8 mmol/L and >100 mmol/L in two, 78 mmol/L in one and 43 mmol/L in one mother, respectively. Subdural hemorrhage (in one newborn) and diffuse petechial bleeding in both two hemispheres and basal ganglions (in three newborns) were observed, with Cranial MRI. Motor retardation and mental-motor retardation were observed in 2/17 and 2/ 17 of the newborns, respectively. Two newborns died. Conclusion: Morbidity and mortality rates due to hypernatre-mic dehydration of the newborn may be lowered with simple preventive measures. Routine newborn examination in the first few days of life is important in the early diagnosis and prevention. These results have suggested that delivery at home, first pregnancy, cesarean delivery, delivery in hot season and early discharge after delivery are important risk factors in development of hypernatremic dehydration.Öğe Intracranial hemorrhage in newborns due to vitamin K deficiency(2006) Katar S.; Özbek M.N.; Güzel A.; Devecioğlu C.; Ecer S.The late hemorrhagic disease of the newborn results from vitamin K deficiency and the bleeding in these patients is usually intracranial. In this study, clinical and laboratory findings of 10 cases with intracranial bleeding are described. Of these 10 patients, nine had not been given prophylactic vitamin K, while one had received prophylaxis. Eighty percent were male and their age was between 8 and 29 days. All patients were term newborns, with one born in hospital and nine at home. There was no history of medication use, diarrhea or trauma, and all newborns were solely breast-feeding. Prothrombin, partial thromboplastin and coagulation times were prolonged in all cases. Four hours after intravenous administration of vitamin K (2 mg), all these values returned to normal levels. Intracranial bleeding was evacuated surgically in one patient. Two patients died. In conclusion, we believe that every newborn should receive prophylactic vitamin K. In addition, it appears that a second dose of vitamin K is required during the first month of life due to the possibility of late hemorrhagic disease of the newborn despite initial prophylaxis.Öğe Neonatal tetanus in Southeast Turkey(2006) Yaramiş A.; Katar S.; Nuri Özbek M.; Ecer S.Neonatal tetanus is unfortunately still seen in southeast Turkey. Twenty-four patients with neonatal tetanus who were admitted to our clinic between January 1999 and December 2002 were reviewed retrospectively according to clinical features, prognostic aspects and risk factors. Sixteen of 24 cases were male and their ages were from 2 to 15 days. Fever and lack of sucking reflex were the main complaints the admission. Lack of sucking (100%), trismus (79%), fever (58%), risus sardonicus (29%), omphalitis (33%), and opisthotonus (17%) were the most common presenting signs. Untrained traditional birth attendants delivered all the patients at home, and umbilical cords were cut using non-hygienic instruments. Seventy-five percent of the patients who were admitted died. The most important risk factors were uneducated parents, birth at home, cutting of cords using non-hygienic instruments, failure to give mothers tetanus toxoid immunizations during pregnancy, and poor health and sanitary conditions of the mothers and their babies.Öğe A rare cause of respiratory distress in a newborn: Mediastinal enteric cyst associated with costovertebral malformation: Case report(2010) Özbek M.N.; Taşkesen M.; Katar S.; Ecer S.; Onat S.Mediastinal enteric cyst is usually associated with segmental costovertebral malformations include Jarcho-Levin syndrome, spondylocostal dysostosis, and spondylothoracic dysostosis. We aimed to report a case of thoracal vertebral anomaly associated with a mediastinal enteric cyst. A 1 day-old girl patient was admitted to our clinic with symptoms of dyspnea, cyanosis, grunting and poor sucking. Low hairline, a short webbed neck, and flexion contracture in the left fourth phalanx were detected in her physical examination. Posteroanterior chest X-ray and thorax computerized tomography demonstrated a large cystic lesion at the right lung. Herein this newborn with respiratuar distress due to mediastinal enteric cyst associated with costovertebral malformation was reported. Copyright © 2009 by Türkiye Klinikleri.
