Mervan Bekdas

Vitamin D status in children with attention‐deficit–hyperactivity disorder

Attention‐deficit–hyperactivity disorder (ADHD), one of the most common psychiatric disorders of childhood, has an early onset, affecting 2–18% of children worldwide. The etiopathogenesis of ADHD is obscure. In recent studies, a low level of vitamin D has been found in association with many disorders as well as in neuropsychiatric diseases. The aim of this study was therefore to investigate serum vitamin D level in pediatric ADHD patients.

Retinal and Choroidal Thickness in Children with Familial Mediterranean Fever

Abstract Purpose: The aim of the present study was to evaluate retinal and choroidal thicknesses in children with familial Mediterranean fever (FMF). Methods: Thirty patients with FMF and 28 healthy controls were included in the study. The thicknesses of the retina and choroid of each subjects right eye were measured at the fovea and horizontal nasal and temporal quadrants at 500-µm intervals to 1500 µm from the foveal center using spectral-domain optic coherence tomography. Results: Retinal and choroidal thicknesses at the fovea did not differ between groups (p = 0.32 and p = 0.39, respectively). Horizontal nasal and temporal retinal and choroidal thickness measurements at 500-µm intervals to a distance of 1500 µm from the foveal center were also similar between the groups (all p > 0.05). Conclusions: The retinal and choroidal thicknesses of children with FMF do not differ from those of age- and sex-matched healthy controls.

Tear and serum vitamin D levels in children with allergic rhinoconjunctivitis

BACKGROUND Although solid cohort studies confirmed a preventative role for the anti-oxidant vitamin D in allergic asthma, a limited number of studies focused on allergic rhinoconjunctivitis (ARC). Here, we aimed to determine 25-hydroxycholecalciferol levels in tear and serum in young allergic rhinoconjunctivitis patients as compared to their apparently healthy matched controls. METHODS In total, 22 children with allergic rhinoconjunctivitis and 31 healthy control subjects underwent serum total IgE and 25-hydroxycholecalciferol measurements. Tear levels of 25-hydroxycholecalciferol were also determined in both groups. RESULTS The mean serum total IgE level in the ARC group (143.6±132.8IU/ml) was significantly higher than that in the control group (54.8±44.1IU/ml; p=0.03). Serum 25(OH)D levels were significantly higher in the ARC group (34.1±12.7ng/ml) than in the healthy controls (21.8±11.3ng/ml; p=0.001). CONCLUSIONS To our knowledge, this is the first reported study to show an association between serum 25-hydroxycholecalciferol and ARC in a childhood group. Higher levels of serum 25-hydroxycholecalciferol in children with allergic rhinoconjunctivitis may indicate a possible aetiopathogenic mechanism in the development of allergic rhinoconjunctivitis. This is also the first report to examine tear fluid vitamin D levels in paediatric ARC patients.

The association of obesity and obesity-related conditions with carotid extra-medial thickness in children and adolescents.

Carotid extra‐medial thickness (EMT) and carotid intima‐media thickness (cIMT) provide information concerning vascular changes.

H1N1 Infection-Related Hemophagocytic Lymphohistiocytosis in a Child

Hemophagocytic lymphohistiocytosis (HLH) is a clinical condition characterized by macrophage and activated histiocyte proliferation, leading to uncontrolled phagocytosis of hematopoietic precursor cells. The clinical presentation is characterized by fever, pancytopenia, hepatosplenomegaly, and hemophagocytosis in the reticuloendothelial system. In addition to the primary form of the disorder, secondary HLH has been associated with a variety of infections, malignancy, and autoimmune disease [1]. Virus-associated HLH is a well-recognized clinical condition. Most cases are related to Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpes virus 6, and human herpes virus 8 infections [2]. H1N1 influenza-associated HLH has been reported in children extremely rarely [3,4]. We present here a successfully treated case of severe H1N1 influenza-related HLH.

Metabolic Acidosis in an Infant Associated with Permethrin Toxicity

Pyrethroids are broad‐spectrum insecticides. Permethrin intoxication due to topical application has not been documented in humans. We report a 20‐month‐old infant who had used 5% permethrin lotion topically for scabies treatment. Approximately 60 mL (20 mL/day) was used and after the third application he developed agitation, nausea, vomiting, respiratory distress, tachycardia, and metabolic acidosis. His clinical symptoms and metabolic acidosis normalized within 20 hours. His follow‐up was unremarkable. Toxicity of permethrin is rare, and although permethrin is a widely and safely used topical agent in the treatment of scabies and lice, inappropriate use may rarely cause toxicity. Moreover, in cases of unexplained metabolic acidosis, topically applied medications should be carefully investigated.

Dissolution of gastric bezoars using cola.

With great interest, we read the recent article by Islek et al. (1) “A rare outcome of iron deficiency and pica: Rapunzel syndrome in a 5-year-old child”. The authors discussed a girl who was referred with an abdominal mass and anemia, diagnosed with Rapunzel syndrome. She had no medical history that supported the presence of trichophagy or any psychiatric or neurological disorders. They mentioned that there was the possibility of the existence of a bezoar in children who have anemia and abdominal mass but no neuropsychiatric disorder. We want to mention that gastric bezoars can be treated occasionally with some adjuvant solutions that have the advantage of being noninvasive and inexpensive.

Pregnancy Outcome in Women of Advanced Maternal Age: A Cross-Sectional Study in a Turkish Maternity Hospital

Abstract Background: There is a current trend towards delayed childbearing around the world. This is considered to increase the risk for poor maternal and neonatal outcomes. In this study, we evaluated pregnancy outcomes in women of advanced maternal age in a single maternity hospital in Turkey. Methods: Medical records of 517 women aged 35 years and older that gave birth between 2009 and 2010 were examined retrospectively. The chi-squared, Mann-Whitney U, and Student t tests were used for statistical analyses. Results: In total, 462 (89.3%) women aged 39 years or less and 55 (10.6%) women aged 40 years and older were included in the analysis. Cesarean sections, and neonatal mortality were more common in women of advanced maternal age (p = 0.004 and p=0.002, respectively). Neonatal mortality (OR: 0.1; 95% CI 0.02-1; p = 0.032), premature birth (OR: 0.4; 95% CI 0.2-0.8; p = 0.008), and low birth weight (LBW) (OR: 0.2; 95% CI 0.1-0.5; p < 0.001) were significantly higher in women 40 years and older. Respiratory distress syndrome (RDS) developed in 26% of babies with LBWs. All patients of neonatal death were diagnosed with asphyxiation or RDS. Conclusions: At the Bolu Izzet Baysal Maternity and Children’s Hospital, advanced maternal age was associated with increased adverse fetal and neonatal outcomes.

Premature Bebekte Pulmoner İnterstisyel Amfizem

Pulmoner interstisyel amfizem genellikle yenidoganlarda aralikli pozitif basincli ventilator izleminin bir komplikasyonu olarak gelisen peribronsial- perialveolar hava kacagi sendromudur. Havanin normal hava yollari disinda, peribronkovaskuler kilifin konnektif dokusu, interlobuler septa ve visseral plevrada birikmesidir. Siklikla yenidogan doneminde, ozellikle de respiratuar distres sendromu nedeniyle ventilator destegine ihtiyac duyan premature bebeklerde gorulur. Birincil tedavi yontemleri lateral dekubit pozisyonu, selektif bronsial entubasyon ve yuksek frekansli ventilasyondur. Ventilator destegi alan, solunum yetersizligi bulunan yenidoganlarda yuksek mortalite ve morbiditesinden dolayi pulmoner interstisyel amfizem akilda tutulmalidir. Burada yenidogan yogun bakim unitesindeki izleminin 9. gununde pulmoner interstisyel amfizem gelisen ileri derecede dusuk dogum agirlikli bebek hasta sunulmustur.

TAM ATRİYOVENTRİKÜLER BLOK VE İZOLE DOĞUŞTAN DÜZELTİLMİŞ BÜYÜK ARTERLERİN TRANSPOZİSYONU OLAN ASEMPTOMATİK BİR OLGU

Corrected transposition of the great arteries (cTGA) is a rare congenital heart disease. c-TGA occurs in 0.5% of patients born with congenital heart disease. Other congenital heart defects commonly accompany this anomaly. Prognosis depends on systemic ventricular function, anomalies accompanying anomalies. The patient was conduction