Avni Kaya

Prevalence of Overweight and Obesity in Children and Adolescents in Eastern Turkey

Objective: The aim of this study was to estimate the prevalence of overweight and obesity in school children in Eastern Turkey. Methods: This study included 9048 school children aged 6−18 years. The subjects were classified as overweight and obese, according to the International Obesity Task Force. Results: We found prevalence of overweight of 11.1% in the studied population. It was detected that 2.2% of the population in the study was obese; 2.1% of males and 2.3% of females. While the prevalence of obesity was extremely low before 9 ages and after 15, it reached to high values at puberty and just before pubertal period in boys. The prevalence of overweight was higher in girls and reached to peak point at pubertal ages. Generally, the prevalence of obesity and overweight was slightly higher in girls than in boys, although the boys were more obese in prepubertal ages. Conclusion: Overweight and obesity are concerns for children andadolescents in low socio−economic status regions as well. Conflict of interest:None declared.

New Coagulant Agent (Ankaferd Blood Stopper) for Open Hemorrhages in Hemophilia With Inhibitor

The treatment of hemophilia A patients with inhibitor could be very expensive. Ankaferd blood stopper (ABS) is a unique folkloric medicinal plant extract, which has historically been used in Turkish traditional medicine as a hemostatic agent. In this article, a 16-year-old boy was presented with uncontrolled bleeding, despite the treatment of factor VIII, rVIIa, factor VIII inhibitor bypass activity (FEIBA), cyclophosphamide, and prednisolone at circumcision site that resolved with ABS in minutes. Our patient with hemophilia A and inhibitor is the first clinical pediatric case.

Clinical Outcome and Magnetic Resonance Imaging Findings in Infants With Hypoglycemia

The authors examined clinical outcome and cranial magnetic resonance imaging (MRI) findings in infants with hypoglycemia to determine the effects of hypoglycemia on the developing brain. A total of 110 infants with hypoglycemia were included in the study. Of the patients, 36 were females and 74 were males. The age of the infants was between 1 day and 22 months. Of the 110 infants, 47 were preterm neonates, 40 were term neonates, and 23 were older than 28 days. No difference in serum glucose level was noted between symptomatic and asymptomatic infants. The most common observed abnormal findings were hyperintense lesions, encephalomalacia, and cerebral atrophy. Abnormal MRI findings were found in 4% of preterm infants, in 32.5% of term infants, and in 43.5% of older infants. Abnormal MRI findings were statistically significantly more common in symptomatic infants than in asymptomatic infants. Of the infants, 45.5% of hypoglycemic infants had cerebral palsy and/or cerebral palsy plus epilepsy.

Clinical findings in children with cutaneous anthrax in eastern Turkey.

Abstract:  Anthrax is a zoonosis produced by Bacillus anthracis. The aim of this study was to evaluate the clinical findings, therapy, and outcome in children with cutaneous anthrax (CA). Data on age, gender, occupation, clinical symptoms and findings, location and type of lesions, clinical history, laboratory findings, treatment, and outcome were recorded from patients’ medical records, retrospectively. The study included 65 patients between 1 month and 18 years old (9.0 ± 4.0 years), 37 patients (56.9%) were male and 28 (43.1%) were female. Most of the patients (89.1%) were admitted in summer and autumn (p < 0.001). Of the 65 patients, 20 patients (30.8%) had received antibiotherapy before admission to our hospital. All patients except one had a contact history with infected animals. A 1‐month‐old patient had a contact history with his mother who had CA. On clinical examination, anthrax edema was noted in 36 (55.3%) patients, anthrax pustule in 27 (41.5%), and anthrax edema and anthrax pustule in two (3%) patients. Gram staining and culture was positive for B. anthracis in 35 (53.8%) patients, and only Gram staining was positive in 10 (15.4%) patients. In the remaining 20 (30.8%) patients, the diagnosis was made by clinical findings. Because the anthrax outbreak in Turkey was associated with slaughtering or milking of ill cows, sheep, or goats, and handling raw meat without taking any protective measures, persons in the community must be educated about using personal protective equipment during slaughtering of animals and handling of meat and skins.

Thyroid functions and trace elements in pediatric patients with exogenous obesity.

Obesity is a multifactorial disease developing following impairment of the energy balance. The endocrine system is known to be affected by the condition. Serum thyroid hormones and trace element levels have been shown to be affected in obese children. Changes in serum thyroid hormones may result from alterations occurring in serum trace element levels. The aim of this study was to evaluate whether or not changes in serum thyroid hormone levels in children with exogenous obesity are associated with changes in trace element levels. Eighty-five children diagnosed with exogenous obesity constituted the study group, and 24 age- and sex-matched healthy children made up the control group. Serum thyroid stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), thyroglobulin (TG), selenium (Se), zinc (Zn), copper (Cu), and manganese (Mn) levels in the study group were measured before and at the third and sixth months of treatment, and once only in the control group. Pretreatment fT4 levels in the study group rose significantly by the sixth month (p = 0.006). Zn levels in the patient group were significantly low compared to the control group (p = 0.009). Mn and Se levels in the obese children before and at the third and sixth months of treatment were significantly higher than those of the control group (p = 0.001, p = 0.001). In conclusion, fT4, Zn, Cu, Mn, and Se levels are significantly affected in children diagnosed with exogenous obesity. The change in serum fT4 levels is not associated with changes in trace element concentrations.

Combined Occurrence of Alström Syndrome and Bronchiectasis

Alström syndrome (Online Mendelian Inheritance in Man ALMS #203800) is a rare hereditary disorder caused by mutations in the gene ALMS1. This rare disorder’s characteristics are cone-rod dystrophy resulting in blindness in childhood, insulin-resistant type 2 diabetes mellitus, truncal obesity, progressive sensorineural hearing loss, dilated cardiomyopathy, craniofacial features, hypothyroidism, elevation in liver transaminases, renal insufficiency, gonadal dysfunction, and menstrual irregularities. A 13.5-year-old girl was admitted to the hospital for complaints of excessive water consumption and urination over the previous 2 years. The patient’s parents were third-degree relatives. At physical examination, hyperpigmentation was present over the areola and acanthosis nigricans under the arms and on the neck. Audiologic examination revealed bilateral sensorineural hearing loss, and bilateral cataract was determined at ocular examination. The patient was monitored by the chest diseases department due to bronchiectasis. HbA1c was 13.1%. In mutation screening study, 2 novel mutations c.5586T>G; p.Tyr1862* and c.2905insT; p.L968fs*4 were detected in the ALMS1 gene. Saccharin test was positive. We emphasize that Alström syndrome may be complicated by bronchiectasis.

A case of congenital hypothyroidism presented with dysmyelinization findings

Abstract The central nervous system is one of the most crucial targeted systems of hyphotiroidism where tissues undergo various broad developmental processes such as neuronal and glial cellular differentiation, migration and myelinization. However brain images are mainly normal. In this article we present findings related to a 1-year-old girl who has been referred to our outpatient clinic with complaints of slowing of movement and lack of interest. She was diagnosed with hypothyroidism. Her brain magnetic resonance image obtained during diagnosis displayed dysmyelinization. It showed improvement after Na-L thyroxin therapy during follow up.

Evaluation of Lymphocyte Subgroups in Children With Down Syndrome

In this study, lymphocyte subgroups including blood CD3, CD4, CD8, CD4/CD8, CD19, and CD16.56 values were analyzed in children with Down syndrome (DS). The study includes 85 children with DS, followed at Department of Pediatrics, Faculty of Medicine, Yüzüncü Yil University and 64 healthy age-matched control participants. Blood CD3, CD4, CD8, CD4/CD8, CD19, and CD16.56 values were examined in both the groups. Significantly decreased blood CD3, CD4, and CD19 values were found in the study group (P < .05) when compared with the control group. In conclusion, we would like to emphasize that blood CD3, CD4, and CD19 levels were found to be decreased in children with DS. Based on these finding, we think that these decreased lymphocyte subgroups might be responsible for increased susceptibility to infections in children with DS.

Serum 25(OH) D vitamin düşüklüğü çocukluk çağı pnömonileri için bir risk faktörü müdür

OZET Amac: 25(OH) D vitamini reseptorleri T ve B lenfositler, makrofajlar ve dendritik hucreler gibi ozellikle antijen sunan hucreler basta olmak uzere tum immun sistem huc#

An unusual cause of liver abscess.

A 16-year-old girl presented with epigastric pain radiating to the right upper quadrant associated with anorexia and right upper quadrant swelling. Tenderness in the right upper quadrant and hepatomegaly were observed. Leukocytosis and elevated liver enzymes were noted. Erythrocyte sedimentation rate and C-reactive protein were 78 mm/h and 279 mg/L respectively. A radio-opaque, thin foreign body that was presumed to be a pin was observed on the abdominal film (Fig. 1A). Abdominal ultrasonography revealed a 3-cm-high echoic linear shadow in the left lobe, and a heterogeneous echo pattern, whose diameter was 5 cm, consistent with an abscess. Abdominal computed tomography scan revealed a low-density mass region with a high-density metallic foreign body in its centre (Fig. 1B). The patient did not remember ever having ingested a foreign body, when asked. People frequently swallow foreign bodies and these usually pass through the gastrointestinal tract without complications. However, intestinal perforations or abscesses can occur (1). Frequently, patients do not remember swallowing the foreign body and signs may appear months or even years later (2). Liver abscess is a rare complication of foreign body ingestion (2). However, different sharp objects, especially chicken/fish bones, as well as wooden/plastic toothpicks, can easily penetrate the gastric wall into the liver, with a consequent formation of a liver abscess (1–4). We emphasize that foreign bodies should be kept in mind in patients with liver abscess or unexplained right upper quadrant pain.