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Öğe Abelmoschus esculentus (L.) Moench seed extract alleviates acute acetaminophen induced liver damage in rats(National Institute of Science Communication and Information Resources (NISCAIR), 2023) Kocabey, Hüseyin; Bekdaş, Mervan; Çetinkaya, Ayhan; Düzcü, Selma Erdoğan; Alışık, Murat; Türel, İdrisAcetaminophen (N-acetyl-p-aminophenol, APAP), commonly called the 'paracetamol', is one of the most regularly utilized medicines, particularly in children. When administered at the recommended doses, it is a safe medication. However, oxidative stress and inflammation caused by exposure to toxic doses lead to centrilobular hepatic necrosis. N-acetylcysteine (NAC) is utilized in the therapy, however it has potential adverse effects. On the other hand, it is known that the seeds of the common vegetable Okra, Abelmoschus esculentus (AE), a herbal product, possess antioxidant and anti-inflammatory qualities. In the present study, we explored whether AE can be used as an alternative to standard NAC therapy without any adverse effect in the treatment of acute APAP induced liver injury. Forty male Wistar rats were placed into five groups: Control, AE, APAP, APAP+AE and APAP+AE+NAC groups. Antioxidants such as native thiol and total thiol were found rised in the APAP group by adding AE (p =0.043 and p =0.028, respectively). Anti-inflammatory indicator IL-10 was also found increased, while marker ALT, which is a sign of hepatotoxicity, got decreased (P=0.005 and P <0.001, respectively). Histologically, AE has been shown to improve worsened congestion (P =0.003), cytoplasmic vacuolization (P =0.01), sinusoidal dilatation (P =0.001), Kupffer cell proliferation (P <0.001) and inflammation (P <0.001). These results suggest that the okra seeds may be a potential therapeutic agent for paracetamol induced hepatotoxicity and it can be attributed to the antioxidant and anti-inflammatory properties.Öğe The association of obesity and obesity-related conditions with carotid extra-medial thickness in children and adolescents(Wiley, 2016) Bekdaş, Mervan; Kaya, E.; Dağıstan, Emine; Göksügür, Sevil Bilir; Demircioğlu, Fatih; Erkoçoğlu, Mustafa; Dilek, MustafaBackground: Carotid extra-medial thickness (EMT) and carotid intima-media thickness (cIMT) provide information concerning vascular changes. Objectives: In this study, we aimed to evaluate the association between carotid EMT and obesity and its metabolic complications in children. Methods: The study included 38 obese subjects and 30 age-matched and sex-matched healthy controls aged between 7 and 17 years. For all subjects, complete blood count, fasting blood glucose, serum insulin, aspartate aminotransferase, alanine aminotransferase, HDL cholesterol, total cholesterol and triglyceride levels were measured. The carotid EMT and cIMT were measured by an expert radiologist in all patients. Results: Body mass index (BMI) (28.8 +/- 3 vs. 18.1 +/- 2.2, p<0.001), total cholesterol (167.9 +/- 34.8 mg dL(-1) vs. 150.5 +/- 28.1 mg dL(-1), p = 0.029), homeostatic model assessment of insulin resistance (HOMA-IR) (4.3 vs. 1.7, p<0.001), cIMT (0.51 +/- 0.08 mm vs. 0.45 +/- 0.06 mm, p<0.001) and carotid EMT (0.74 +/- 0.11 mm vs. 0.64 +/- 0.1 mm, p<0.001) were significantly higher in obese subjects than in controls, while HDL cholesterol (41.6 +/- 6.5 mg dL(-1) vs. 49.5 +/- 7.5 mg dL(-1), p<0.001) was lower in obesity group. Among the obese subjects, the HOMA-IR values (4.7 vs. 3.6, p = 0.027), cIMT (0.54 +/- 0.07 mm vs. 0.49 +/- 0.07 mm, p = 0.039) and carotid EMT (0.79 +/- 0.1 mm vs. 0.7 +/- 0.1 mm, p=0.013) were significantly higher in postpubertal children compared with prepubertal children. BMI, cut-off values of HOMA-IR and cIMT were significantly associated with increased carotid EMT (p<0.001, p = 0.023 and p<0.001, respectively). The only independent risk factor affecting carotid EMT was BMI (p<0.001). Conclusion: We have found that carotid EMT is associated with cIMT, obesity and insulin resistance and the assessment of carotid EMT may provide additional information concerning early vascular disease.Öğe Bart sendromu: Aplazia cutis ve distrofik epidermolizis büllosa(2016) Dilek, Mustafa; Bilir, Sevil Göksügür; İldeş, Elif Nur; Göksügür, Nadir; Bekdaş, Mervan; Erkoçoğlu, Mustafa; Demircioğlu, FatihOtuz dokuz haftalık 3080 g olarak doğan erkek bebekte yapılan fizik muayenede her iki bacakta dizden başlayan ve ayakların da dâhil olduğu alanda cilt epitelinin olmadığı, solda daha fazla olmakla birlikte, ellerde büllöz lezyonlar görüldü. Takibinde küçük travmalarla yeni büllöz lezyonların oluştuğu izlendi. El tırnaklarında distrofik görünüm olması, Aplazia cutis ve distrofik epidermolizis büllosa birlikteliği ile Bart Sendromu tanısı konuldu. Antibiyotik ve antifungal tedavi sistemik ve lokal olarak uygulandı. Yüzeyel epitelizasyonun yeterli görüldüğü 5. haftasında aileye bakım eğitimleri verilerek taburcu edildi. Bart sendromu; cildin konjenital lokalize yokluğu (aplasia cutis), epidermolizis bülloza ve distrofik tırnak değişiklikleri ile karakterize genetik bir hastalıktır. Aplasia cutis'in epidermolizis büllosa ile birlikte bulunmasını açıklayacak birçok hipotez ortaya atılmıştır. En çok kabul gören ise prenatal dönemde ekstremitelerin sürtünmesi sonucu ortaya çıkan intrauterin bül formasyonlarına bağlı cilt kaybı durumudurÖğe Can excessive oxygen cause hyperactive behavior disorder in preterm children? Cognitive effects of hyperoxia in the preterm brain of rats(Springer, 2019) Dilek, Mustafa; Orallar, Hayriye; Çetinkaya, Ayhan; Bozat, Gökçe; Pehlivan, Fatma; Bekdaş, Mervan; Kabakuş, NimetThere is a paucity of data on the effects of hyperoxia-induced brain damage on learning and such psychosocial phenomenon as anxiety. Preterm infants encounter hyperoxia within a relatively early stage of life (leaving the intrauterine environment earlier than was expected) and are exposed to high-level hyperoxic stress due to the insufficiency of their antioxidant defense mechanisms. In an experimental rat model, we investigated the effects of early postnatal hyperoxia on learning, anxiety, and depression in the early adulthood period. Rat nestlings (n = 7) were exposed to about 80% oxygen for the first 5 days after birth to create a rat model of hyperoxia, and these nestlings and those of the control group (n = 7) were subjected to behavioral tests (Morris water tank, open-field test, elevated plus maze, and Porsolt test) at 30 days old. Video recordings of the tests were captured, and indices of the tests in the experimental groups were compared with the Mann-Whitney U-test. In the Morris water navigation task, the latency and distance required to locate the platform were greater (P = 0.018 and 0.025, respectively) in the hyperoxia group than in the control group, suggesting that exposure to hyperoxia during the development of the brain can exert a negative effect on the learning function. There was no difference in the time spent in the open center area of the open-field test (anxiety), while the rats in the hyperoxia group spent more time in the enclosed area in the elevated plus maze test, suggesting a higher level of anxiety (P = 0.048). In the Porsolt test, rats in the hyperoxia group moved faster (P = 0.013) and travelled a longer distance (P = 0.048). Although this finding suggests less depressive behavior in the mentioned group, which was contrary to the expectations, this may also explain the tendency of preterm infants to hyperactivity at later ages. Thus, it has been demonstrated experimentally that exposure of neonates to oxygen exceeding physiological needs may cause behavioral problems, such as impaired learning, anxiety, and hyperactivity.Öğe Can we prevent childhood asthma?(Wiley-Blackwell, 2016) Erkoçoğlu, Mustafa; Serpen, Ali Fuat; Doğru, Mahmut; Topal, Erdem; Bekdaş, Mervan; Dilek, Mustafa; Demircioğlu, Fatih[No Abstract Available]Öğe A case report of septic arthritis following varicella(2015) Göksügür, Sevil Bilir; Bekdaş, Mervan; Işık, Cengiz; Saraç, Esma Gökçen; Demircioğlu, FatihSuçiçeği, genel olarak iyi huylu bir enfeksiyon hastalığı olmakla beraber cilt ve yumuşak dokuların sekonder bakteriyel enfeksiyonlarına, pnömoniye, hematolojik ve nörolojik komplikasyonlara neden olabilmektedir. Ayrıca, nadir olarak septik artrite de yol açabilmektedir. Bu makalede suçiçeğinden beş gün sonra sağ el bileği ve sağ dizde şişlik kızarıklık ve ağrı gelişen, eklem sıvısı incelemesi ve radyolojik görüntüleme ile septik artrit tanısı konulan üçbuçuk yaşındaki erkek hasta sunulmuştur.Öğe Çocuk hastada kolşisin zehirlenmesine bağlı rabdomiyoliz(2013) Demircioğlu, Fatih; Kazancı, Elif; Erdoğan, Hakan; Bekdaş, Mervan; Göksügür, SevilKolşisin, Colchicum Autumnale bitkisinden ele edilmiş enflamasyon karşıtı etkisi olan doğal bir alkaloiddir. Behçet hastalığı, gut artriti, skleroderma ve özellikle Ailevi Akdeniz Ateşi’nin (AAA) akut ataklarını ve amiloidoz gelişimini önlemede kullanılan bir ilaçtır (1). Ailevi Akdeniz Ateşi hastalığının yaygınlığına bağlı olarak kolşisinin sık kullanımı, zehirlenme olgularının sayısının artışını da beraberinde getirmiştir. Özellikle yüksek dozlarda alındığında ölüme neden olmaktadır. Özdemir ve ark. (2) 1985-2011 yılları arasında kolşisin zehirlenmesi saptanan 23 çocuk hasta üzerinde yaptıkları çalışmada, kolşisini 0,5 mg/kg’dan düşük dozda alan 16 hastadan hiçbirinde ölüm görülmezken, 0,5-0,8 mg/kg dozunda ilaç alan üç hastadan birinde ve 0,8 mg/kg’dan fazla dozda ilaç alan dört hastadan ikisinde ölüm gelişmiştir. Kolşisine bağlı ortaya çıkan rabdomiyoliz nadir olarak bildirilmiş olup hastalık riski nedeniyle önemlidir (3). Biz yanlışlıkla yüksek doz kolşisin alımı sonrası rabdomiyoliz ve kemik iliği baskılanması gelişen bir çocuk olguyu sunuyoruz.Öğe Çocuklarda topikal kortikosteroid kullanımı hakkında ailelerin bilgi ve endişe düzeyleri(2014) Göksügür, Sevil Bilir; Göksügür, Nadir; Bekdaş, Mervan; Demircioğlu, FatihAmaç: Steroid fobisi günlük pratikte tedaviye uyumu olumsuz yönde etkileyebilen önemli bir faktördür. Ülkemizde yapılmış, genel popülasyon ve sağlık çalışanlarının bu konudaki tutumlarını inceleyen bir çalışma bulunmamaktadır. Bizim amacımız ebeveynlerin kortikosteroid içeren topikal ilaçlar hakkındaki bilgi ve endişe düzeylerini ve bunun tedaviye etkilerini incelemektir. Gereç ve Yöntemler: Çocuk sağlığı ve hastalıkları polikliniğine çeşitli sebeplerle başvuran hasta yakınları ve hastanemiz sağlık çalışanlarından oluşan toplam 300 kişiye konuyla ilgili anket uygulanmıştır. Ankette ebeveynlerin çocuklarına daha önceden kortizon içeren bir krem kullanıp kullanmadıkları, bu konu ile ilgili endişelerinin olup olmadığı ve bu ilacın ciltten uygulanması durumunda hangi yan etkileri yapabileceğine dair bilgi düzeyleri ile ilgili sorular yer almıştır. Bulgular: Hasta yakını grubunda steroid kullanımı ile ilgili endişe % 20.5 (n=41), sağlık çalışanı grubunda % 54 (n=54) bulunmuştur. Hasta yakını grubunun % 40’ı tedaviyi endişesi nedeniyle hiç uygulamamış, % 24’ü tedaviyi erken bırak- mıştır. Steroidler hakkındaki endişesi olanlara bunun sebebinin sorulduğu açık uçlu soruya yanıt olarak hasta grubunun % 79’u yan etkileri olabileceğini, % 8.32’si hormon bozukluğuna, % 4.16’sı diyabete, % 4.16’sı kilo artışına, % 4.16’sı da ciltte lekelenmeye yol açabileceğini düşündüklerini belirtmişlerdir. Sonuç: Eğitim seviyesi arttıkça, sağlık çalışanı bile olsa ebeveynlerde yersiz bir steroid fobisinin bulunduğu ve bunun tedavi sürecini olumsuz etkilediğini saptadık. Hekimlerin bu durumu göz önünde bulundurarak tedaviye başlamadan önce ebeveynlere tedavi hakkında yeterli bilgilendirmeyi yapmalarının tedavi sonuçlarını olumlu etkileyeceğini düşünmekteyiz.Öğe Combination of novel c.3484g > t/p.glu162ter variant in abcb11 and c.208g > a/p.asp70asn variant in atp8b1 are associated with severe symptoms in progressive family ıntrahepatic cholestasis(Georg Thieme Verlag Kg, 2020) Bekdaş, Mervan; Can, Güray; Eröz, Recep; Düzcü, Selma ErdoğanProgressive family intrahepatic cholestasis (PFIC) is an autosomal recessive disease that causes chronic cholestasis. It is associated with pathogenic variants in genes that encode proteins involved in bile secretion to canaliculus from hepatocytes. In this study, we present a 16-year-old boy who presented with severe pruritus and cholestatic jaundice. All possible infectious etiologies were negative. A liver biopsy was consistent with intrahepatic cholestasis and portal fibrosis. DNA was isolated from a peripheral blood sample, and whole exome sequencing was performed. A novel c.3484G > T/p.Glu162Ter variant in theABCB11gene and a c.208G> A/p.Asp70Asn variant in theATP8B1gene were detected. Despite traditional treatment, the patient's recurrent severe symptoms did not improve. The patient was referred for a liver transplantation. This novel c.3484G > T/p.Glu162Ter variant is associated with a severe and recurrent presentation, and the two compound variants could explain the severity of PFIC.Öğe Congenital nephrotic syndrome secondary to pertussis(Soc Espanola Nefrologia Dr Rafael Matesanz, 2020) Bekdaş, Mervan; Eroz, Recep; Cihan, BüşraDear Editor, Nephrotic syndrome shows itself as massive proteinuria, hypoalbuminemia, edema and hypercholesterolemia. In the first year of life, nephrotic syndrome is a rare but serious disease. The physio-pathology of congenital nephrotic syndrome (CNS), especially in the first 3 months of life, is different from other nephrotic syndromes of childhood.Öğe Could Serum Copeptin Be Used for Diagnosing Urinary Tract Infections in Children?(2022) Bekdaş, Mervan; Erkocoglu, Mustafa; Karabörk, Şeyda; Dilek, MustafaObjective: Early diagnosis of urinary tract infection (UTI) is important to reduce short- and long-term complications. To this end, effective biomarkers\rare needed. Our aim was to evaluate the role of copeptin in the diagnosis of UTI and in distinguishing upper from lower UTI compared to other\rinflammatory markers.\rMethods: The diagnosis of UTI was based on the presence of typical clinical symptoms and a positive urine culture. The control group was formed by\rhealthy children without signs or symptoms of infection. Complete blood count, CRP, ESR, serum IL -6, NGAL and copeptin were evaluated.\rResults: The study group included 41 patients with UTI and 41 healthy controls. The patients were 5 (0.8-15) years old and 65.9% of them were female.\rIn the patients with UTI, in addition to total WBC (p<0.001) and NGAL (p=0.031), copeptin was also increased (147.9(60.8-361.9) vs. 69.7(24.2-303) ng/\rml, p<0.001). Copeptin could diagnose UTI at a cut-off value of 81.8 ng/ml (p<0.001, sensitivity 80.4%, specificity 60.5%). Within the UTI group, 10 had\rupper UTI and 31 had lower UTI. In the upper UTI group WBC (p=0.019), CRP (p<0.001), ESR (p<0.001) and NGAL (p=0.046) were higher. Copeptin did\rnot differ between upper and lower UTI groups (p=0.82). Copeptin correlated with IL -6 and NGAL (r²=0.23, p=0.002; r²=0.89, p<0.001, respectively).\rConclusion: Copeptin is a useful biomarker to use in the diagnosis of childhood UTI, but more comprehensive studies are needed to evaluate its role\rin distinguishing upper from lower UTI.Öğe A cross-sectional study of non-diabetic macrosomic infants(Sri Lanka College of Paediatricians, 2013) Bekdaş, Mervan; Demircioğlu, Fatih; Göksügür, Sevil Bilir; Ekici, Mustafa Ayhan; Kısmet, ErolObjective: To determine risk factors and short term outcomes in infants with fetal macrosomia independent of gestational diabetes. Method: Patient records of babies born in Bolu IzzetBaysal Obstetrics-Gynaecology and Paediatrics Hospital between 1st January 2007 and 31st December 2010 with weights of 4000g or more were assessed retrospectively. Data were analysed usingSPSS version 17.0. Babies born outside hospital and infants of diabetic mothers were excluded.Control group comprised 500 healthy infants weighing 2500-3999g, born during the same period. Chi-square test, student-t test, Mann-Whitney test and multiple regression analysis were the statistical tests used. Results: Of 10,898 babies delivered in our hospital during the 4 year study period, 509 (4.7%) weighed 4000g or more. Significantly more non-diabetic macrosomic babies were male compared to controls (p<0.001). Significantly more non-diabetic pregnant women older than 35 years delivered macrosomic infants compared to non-diabetic pregnant women 35 years or less (p<0.001). Significantly more non-diabetic pregnant women who delivered macrosomic infants were multipara compared to controls (p<0.001). No significant statistical differences were detected in mode of delivery between cases and controls (p>0.05). The 5th minute Apgar scores in the non-diabetic macrosomic group was significantly lower than in controls (p<0.001). Non-diabetic macrosomic babies had significantly more birth injuries than controls (p=0.009). Risk of developing hypoglycaemia and hypocalcaemia were significantly higher in non-diabetic macrosomic babies compared to controls (p<0.05). Conclusion: In our study the risk factors for nondiabetic fetal macrosomia were advanced age pregnancy, multiparity and male sex.Öğe Dissolution of gastric bezoars using cola(Aves, 2014) Göksügür, Sevil Bilir; Karataş, Zehra; Bekdaş, Mervan; Dilek, MustafaÖğe Do low vitamin D levels facilitae renal parenchymal injury?(Indonesian Pediatric Soc Publishing House, 2020) Bekdaş, Mervan; Çalışkan, Billur; Karabörk, Şeyda; Acar, Seher; Kabakuş, NimetBackground Decreased vitamin D levels lead to an increase in infectious diseases, including urinary tract infections (UTIs). Objective To assess serum vitamin D levels in children with renal parenchymal injury secondary to UTIs. Methods Forty-three upper UTI patients and 24 controls, aged 1-15 years, were included. Vitamin D levels and other laboratory tests were obtained when they first admitted to hospital. 99mTc-labeled dimercaptosuccinic acid (DMSA) scans were performed to evaluate renal parenchymal injury. Results Mean serum 25-hydroxyvitamin D (25 (OH)D) was lower in the upper UTI group compared to the control group [18 (SD 9) vs. 23 (SD 10.6) ng/mL, respectively; P=0.045]. The upper UTI group was sub-divided into two groups, those with 22 (51.1%) and without 21 (48.8%) renal parenchymal injury. Mean 25(OH)D was significantly lower in patients with renal parenchymal injury [15.1 (SD 7.1) vs. 21 (SD 9.9) ng/mL, respectively; P=0.0.3]. The renal parenchymal injury cases were further sub-divided into two groups: 8 patients (36.3%) with acute renal parenchymal injury and 14 (63.6%) with renal scarring (RS), but there was no significant difference in 25(OH)D between these two groups [12.5 (SD 8.9) vs. 16.6 (SD 5.7) ng/mL, respectively; P=0.14). Conclusion Decreased vitamin D is associated with renal parenchymal injury in children with upper UTIs. However, vitamin D is not significantly decreased in renal scarring patients compared to acute renal parenchymal injury patients.Öğe Down sendromlu bir yenidoğanda geçici myeloproliferatif hastalık(2013) Demircioğlu, Fatih; Altunhan, Hüseyin; Bekdaş, Mervan; Göksügür, Sevil Bilir; Yeşiller, Erkan; Saraç, Esma Gökçen; Kısmet, ErolGeçici myeloproliferatif hastalık (GMPH), Trizomi 21 (Down Sendromu) tanısı ile izlenen infantların yaklaşık %10’unda ortaya çıkabilen, periferik kanda myeloid blastların artımı ile karakterize bir durumdur. GMPH, Down Sendromun’nun işaretlerini taşımayan mozaik trizomi 21 hastalarında da görülebilir. GMPH’lı infantlarda ilk 3 yılda akut m ega¬karyoblastik lösemi (AML -M7) gelişme riski yaklaşık % 30’dur. Biz burada GMPH gelişen Down Sendromlu bir vaka sunduk. Down sendromlu yenidoğanlarda hepasopslenom egali, lökositoz veya trombositopeni ve periferik kan yayma incelemeside myeloblast saptanması durumunda GMPH düşünülmesinin önemine vurgu yapmak istedik .Öğe Düşük doğum ağırlıklı bebeklerde morbidite ve mortaliteyi etkileyen faktörler(2013) Bekdaş, Mervan; Göksügür, Sevil Bilir; Küçükbayrak, Beyhan; Ekici, Mustafa AyhanAmaç: Hastanemizde doğan düşük doğum ağırlıklı bebeklerdeki kısa dönem morbidite ve mortalite sıklığını ve bunları etkileyen faktörleri incelemek. Yöntemler: 18 aylık dönem içinde hastanemizde doğan düşük doğum ağırlıklı 195 bebek ve aynı dönem içinde normal doğum ağırlıklı doğan 150 bebek kontrol grubu olarak seçildi. Bulgular: Söz konusu süre içinde hastanemizde doğan bebeklerin %4,4’ü (n=168) düşük doğum ağırlıklı, %0,7’si (n=27) çok düşük doğum ağırlıklı idi. Bu bebeklerde kontrol grubuna kıyasla çoğul gebelik ve asfiktik doğum anlamlı oranda yüksekti (sırasıyla p=0,029, p=0,011). Çok düşük doğum ağırlıklı bebeklerde asfiktik doğum (OR=14,2, 95% CI (6,6-30,7, p<0,001), yenidoğan yoğun bakım ünitesine yatırılma (OR=34,8, 95% CI (4,7-256,3, p<0,001) ve solunum güçlüğü sendromu tanısı alma (OR=11,5, 95% CI (4-33,5, p<0,001) oranları anlamlı oranda yüksekti. Bebeklerin tümünde geçici metabolik bozukluklar anlamlı oranda yüksek saptandı (p=0,045). Bebeklerin doğum kilosu ve gestasyonel yaşı düştüğü oranda fetal ve neonatal mortaliteleri artmaktadır (tümü için p<0,001). Sonuç: Bu çalışma düşük doğum ağırlıklı bebekleri etkileyen en önemli faktörün çoğul gebelik olduğunu gösterdi. Bebeklerin doğum kilosu ve gestasyonel yaşı, perinatal morbidite ve mortalite ile ters orantılı olarak ilişkili idiÖğe The effect of Anatolian syrup on experimentally induced acetaminophen and lipopolysaccharide associated acute kidney injury(2022) Düzcü, Selma Erdoğan; Çetinkaya, Ayhan; Efe, Muhammet; Kayiş, Seyit Ali; Bekdaş, Mervan; Yoldaş, Meyri Arzu; Tirink, Omer FarukBackground: Acute kidney injury develops as a result of various etiologies and pathological mechanisms, with a high mortality rate. This study aimed to investigate the efficacy of Anatolian syrup on histopathological variables in experimentally induced acetaminophen and lipopolysaccharide associated acute kidney injury. Methods: In this study, 5 groups were formed using 40 male Wistar albino rats (200- 220g, 2-4 months old), as follows: Sham, acetaminophen (1 g/kg intraperitoneal (ip)), 3) lipopolysaccharide (5 mg/kg ip), acetaminophen (1 g/kg ip) + Anatolian syrup (15 days orally), and lipopolysaccharide (5 mg/kg ip) + Anatolian syrup (15 days orally).Tubular atrophy, tubular dilatation, cytoplasmic vacuolization in tubular epithelial cells, tubular epithelial cell necrosis, interstitial inflammation, congestion, hemorrhage, glomerular damage and loss of brushy border were evaluated histopathologically semiquantitatively using scoring from 0 to 5. Results: In histopathological variables, tubular atrophy, tubular dilatation, cytoplasmic vacuolization, necrosis, congestion, hemorrhage, glomerular damage, and loss of brushy border were significantly reduced in the acetaminophen + Anatolian syrup group compared to the acetaminophen group and in the lipopolysaccharide + Anatolian syrup group compared to the lipopolysaccharide group (p<0.001). Conclusions: The Anatolian syrup was shown to protect histopathological variables in kidney damage caused by acetaminophen and lipopolysaccharide.Öğe Effect of COVID-19 pandemic on children undergone percutaneous endoscopic gastrostomy due to neurologic diseases(2022) Bekdaş, Mervan; Daniş, Ayşegül; Kilinç, Yasemin Baranoğlu; Yoldaş, Meyri Arzu; Öztürk, HülyaAim: To investigate the effects of SAR-CoV-2 infection on nutritional status in patients who underwent \rpercutaneous endoscopic gastrostomy (PEG) for neurological disorders.\rMethods: The clinical and laboratory follow-up data of the patients who underwent PEG in our clinic between \r2002 and 2018 were evaluated before and during the pandemic. The results were analyzed statistically.\rResults: Twenty patients were included. They were 70.9±64.4 months old at the time of PEG, 97.9±67.8 \rmonths before the pandemic, and 105.5±60.8 months during the pandemic (p=0.048). Weight for age at the \rtime of PEG increased from 10.7±4.6 kg to 15.6±7.2 kg before the pandemic. Hemoglobin was 12.3±1.4 g/dl \rat the time of PEG, 13.5±1.6 g/dl before the pandemic (p=0.045). Vitamin D was 24.1±8.9 ng/ml at the time \rof PEG and increased to 45.7±9.7 ng/ml during the pandemic (p=0.018). The annual number of visits before \rthe pandemic was 9.8±5.7 and decreased to 2±1.7 during the pandemic (p=0.003). Twelve (%60) of the patients \rdeveloped PEG complications, 6(30%) had their PEG replaced. Those who had developed PEG complications \rhad low levels of albumin (3.3±0.4 vs 4±0.4 g/dl, p=0.022) and vitamin B12 (578±199 vs 1299±533 pg/ml, \rp=0.007). \rConclusions: Even if PEG is applied late, it provides a partial improvement in patients, but the COVID-19 \rpandemic reversed these benefits and caused an increase in PEG complications. In order for the patient to get \rthe maximum benefit from PEG, close follow-up is essential.Öğe The effects of intravenous paracetamol use on blood parameters in the treatment of patent ductus arteriosus(2023) Dinçel, Gökçe Kaya; Dilek, Mustafa; Bekdaş, Mervan; Sancak, Selim; Kabakuş, NimetBackground: Patent ductus arteriosus (PDA), a cause of significant hemodynamic imbalance in newborn babies, can be treated using pharmacological or surgical methods. The purpose of this study was to compare intravenous (IV) paracetamol in newborns with hemodynamically significant PDA, with indomethacin and ibuprofen in terms of changes caused in blood parameters. Methods: Intravenous paracetamol was used for 3-6 days at 4x15 mg/kg/dose in cases diagnosed with PDA and admitted for follow-up between November 2014 and December 2015, and unable to receive oral medication or with contraindications for indomethacinibuprofen use. These cases were investigated retrospectively in terms of changes in pre and post-treatment AST (aspartate aminotransferase), ALT (alanine aminotransferase), urea, creatinine, platelet, and neutrophil values. Results: Intravenous paracetamol was administered to 10 cases of PDA, diagnosed between November 2014 and December 2015. Prior to paracetamol therapy, an increase in urea values was present in one case, increased AST in two, and decreased platelet values in two. Post-treatment values returned to normal ranges in all cases, and hemodynamic improvement was observed after the closure of the ductus arteriosus. Conclusion: Our analysis of its effect on PDA closure and its potential side-effect profile in patient blood parameters compared to other known therapeutic agents indicates that intravenous paracetamol, which is easily available and accessible in Turkey, may be an important option for the treatment of PDA.Öğe Effects of serum vitamin D level on ventricular repolarization in children and adolescents(AEPress SRO, 2021) Bekdaş, Mervan; İnanır, Mehmet; İlhan, Z.; İldeş, Elif NurOBJECTIVES: Low levels of vitamin D are known to increase cardiovascular mortality due to different risks. We aimed to examine whether low vitamin D levels in children and adolescents cause ventricular repolarization changes. METHODS: Sixtyseven healthy cases aged between 3.5 and 17 years were included. According to levels of vitamin D, cases were grouped as suffi cient (n=44), insuffi cient (n=13) and defi ciency (n=10). Ventricular repolarization parameters were measured manually. RESULTS: Levels of vitamin D were different for cases with insuffi ciency and defi ciency compared to suffi ciency ones (102 +/- 54.9 vs 24.4 +/- 7 ng/ml, p<0.001 and 102 +/- 54.9 vs 16.6 +/- 8.3 ng/ml, respectively, p<0.001). In the insuffi cient group the following parameters were different from suffi cient group: QTmean (357.8 +/- 25.3 vs 332 +/- 29.9 ms, p=0.012), JTc (310.8 +/- 20.2 vs 331.6 +/- 21 ms, p=0.005) and Tpe/QT (0.2 +/- 0.02 vs 0.22 +/- 0.02, p=0.02). It was found that the level of serum vitamin D correlated with JTc (r=-0.37, p=0.002), Tp-e (r=-0.29, p=0.015) and Tp-e/QT (r=-0.24, p=0.047). In the linear regression analysis, it was found that dropping level of vitamin D below normal was an independent risk factor for prolonged duration of JTc (p=0.015). CONCLUSIONS: Decline in vitamin D levels causes ventricular repolarization anomaly. As the decrease in vitamin D levels deepens, repolarization times become longer. These results could indicate that decrease in vitamin D levels can increase sensitivity to ventricular arrhythmias (Tab. 3, Ref. 45). Text in PDF www.elis.sk
