Ertan Sal

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.

Stroke and recurrent peripheral embolism in left atrial myxoma

Primary cardiac tumours are uncommon, with an estimated incidence between 0.0017% and 0.19%. Cardiac myxoma is a rare cause of cerebrovascular disease, especially in children. This case report emphasizes the importance of cardiac evaluation, especially echocardiographic examination in cases with stroke and peripheral embolism.

Psychotic disorder and extrapyramidal symptoms associated with vitamin B12 and folate deficiency.

Vitamin B12 and folate deficiency causing neuropsychiatric and thrombotic manifestations, such as peripheral neuropathy, subacute combined degeneration of cord, dementia, ataxia, optic atrophy, catatonia, psychosis, mood disturbances, myocardial infarction and portal vein thrombosis are well known. This present report highlights an unusual presentation of vitamin B12 deficiency-psychotic disorder, extrapyramidal symptoms in a 12-year-old boy. His symptoms responded to parenteral vitamin B12 therapy. So with this report we emphasized that serum vitamin B12 and folate levels should be measured, especially in those patients who present with other known neuropsychiatric features of vitamin B12 and folate deficiency.

Evaluation of oxidant and antioxidant status in infants with hyperbilirubinemia and kernicterus

Objective: The objective of the present study was to determine oxidant and antioxidant status in infants with hyperbilirubinemia and/or kernicterus and to find whether there is a relationship between bilirubin level and oxidant/antioxidant status. Patients: The study includes 69 full-term newborns (neonates with hyperbilirubinemia needing phototherapy [Group 1, n = 36] and neonates with kernicterus [Group 2, n = 33]) and 25 age-matched healthy newborn. Results: Plasma total antioxidant capacity (TAC) and serum total oxidant status (TOS) were significantly higher in Groups 1 and 2 than the control group. There was a significant difference between Group 1 and control cases for malondialdehyde (MDA; p < 0.001). Total free sulfhydryl group (TTHI) values were significantly elevated in Group 1 compared to Group 2 and control cases. Correlation analysis showed that the correlation between total bilirubin (TB) and TAC, TOS, MDA and oxidative stress index may be expressed by a quadratic curve. After phototherapy, a statistically significant increase in nitrite level was observed. Conclusion: We demonstrated that the relationship between serum TB and antioxidants and oxidative stress could be expressed by a quadratic correlation curve.

Concurrent Celiac Disease, Idiopathic Thrombocytopenic Purpura and Autoimmune Thyroiditis: A Case Report

Celiac disease (CD) is a disease of the small intestine caused by an immune response to ingested gluten. Idiopathic thrombocytopenic purpura (ITP) is a common acquired bleeding disorder of childhood. It may follow a viral infection or immunization and is caused by an inappropriate response of the immune system. Autoimmune thyroiditis (AT) is a disease that occurs due to autoimmune mechanisms. Celiac disease associated with autoimmune thyroid disease is well known, but the association of CD, autoimmune thyroid disease, and ITP has been reported very rarely in the literature. In the current report, we have presented a case with CD, AT, and acute ITP, because this association is rarely seen, and to emphasize that CD and AT should be kept in mind in patients with ITP.

Investigation of oxidant and antioxidant pathway changes in acute rheumatic fever

Aim — The purpose of this study was to investigate the role of oxidant stress in the clinical process and pathogenesis of acute rheumatic fever (ARF). Material and methods — The study included 33 children with ARF and 20 healthy control subjects. The diagnosis of ARF was established according to the Jones Criteria. Malondialdehyde (MDA), reduced glutathione (GSH), a-tocopherol, ascorbic acid, retinol and b-carotene levels were measured as markers of oxidative stress together with some antioxidant markers. Results — Our study includes 33 (19 male, 14 female) children with ARF and 20 (11 male, 9 female) healthy control subjects.The mean age ranged between 5–16 years and 5–15 years in the study and control groups, respectively.MDA was measured as 2.1 ± 0.9 nmol/mL in the control group, 3.3 ± 2.7 nmol/mL in the study group before treatment, and 2.1 ± 1.2 nmol/mL after treatment. Blood GSH levels were 48.2 ± 12.7 mg/dL in the control group, 24.7 ± 16 mg/dL in the study group before treatment, and 40.6 ± 21.3 mg/dL in the study group after treatment. MDA and GSH levels prior to the treatment were found to be significantly high and low as compared with the levels of the control group, respectively (P< 0.05, P< 0.001). After treatment, statistically important decrements and increments were determined in the levels of MDA (P< 0.05) and GSH (P< 0.01), respectively. Furthermore, a-tocopherol, retinol and b-carotene levels prior to treatment in the study group, were significantly lower in comparison with control group levels (P= 0.05, P< 0.05, P< 0.01, respectively). Conclusion — We suggested that tissue damage in ARF may not only occur in the presence of increased oxidative stress, but also as a consequence of decreased antioxidant markers.

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.

TAR syndrome and esophagial atresia: a concomitant or variant condition?

Thrombocytopenia with absent radii (TAR) is rare cause of neonatal thrombocytopenia. TAR syndrome and esophageal atresia with tracheoesophageal fistula has been reported in only two cases in literature. Our case was the first in literature with unilateral TAR syndrome and bilateral absence of thumbs accompanying EA.

Mycoplasma pneumoniae meningoencephalitis: a case report

Abstract Nervous system is the most affected area in mycoplasma pneumoniae infections with exception of respiratory system. It is an important agent of childhood acute encephalitis and respiratory system infections in school-age children and young adults. Routine clinical and laboratory findings to identify spesific diagnosis is limited. Twelve-year-old female patient was admitted with fever, fatigue, sore throat, slipping the right eye, withdrawal of the mouth from the right and right hemiclonic seizures. Test of anti-Mycoplasma pneumoniae (M. pneumoniae) IgM was positive and IgG antibodies were found to be 4-fold increase in the sera of follow-up. This article was presented with the aim of remembering M. pneumoniae to be an differential diagnosis in children with acute encephalitis.