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    Adolescent suicide: an overview
    (2021) Bülbül, Selda; Kocagözoğlu, Sevim Gonca; Dogan, Sevgi
    Suicide is the second leading cause of death among 15-19 years old group globally. Recent years suicidal thoughts and attempts have increased in adolescents. While Turkey is among the countries with a low suicide rate, the last ten-year statistics show that suicide attempts have steadily increased especially among young people. The aim of this review is to determine the factors that cause suicide and to identify the necessary measures to prevent adolescent suicides.
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    Knowledge of Primary Care Physicians on Lysosomal Storage Disorders
    (2019) Köse, Engin; Bülbül, Selda; Arslan, Nur
    Aim: Since patients with lysosomal storage disorders (LSDs) often apply to primary care physicians initially, these doctors play a crucial role in the early diagnosis of LSDs. In this study, we aimed to determine the knowledge and awareness of primary care physicians regarding LSDs. Materials and Methods: We conducted a survey between January 2016 and April 2016 among primary care physicians from various regions of Turkey. Invitation e-mail was randomly sent to the individual e-mail address of each physician for a web-based survey. The questionnaire globally consisted of three sections with a total of 30 questions. In the first part of the survey, demographic characteristics of physicians (age, gender, career information) were recorded. The second section consisted of questions on LSDs for the evaluation of knowledge among physicians. In the third section of survey, questions were about the reasons of insufficient knowledge on LSDs and possible solutions to raise awareness. Results: A total of 261 primary care physicians [109 females (41.8%), mean age 40.1±8.8 years] were enrolled in the study. The mean working time was 14.9±8.6 years. Among the participants, 75.8% and 88.8% stated that they had never encountered an LSD patient before and never considered LSDs as a differential diagnosis for any patient, respectively. Fifteen percent of physicians stated that they had no idea about the clinical findings and symptoms of LSD. Another 26.2% of the participants stated that LSD is screened during the neonatal screening program in Turkey. Mean “total knowledge score” of the physicians was 13.47±5.85 points [median=15.0 (10.5-18.0)] out of 25. Six (2.3%) primary care physicians had a total score of “0”. Only 1 of them scored “25” points. Conclusion: Knowledge of primary care physicians on LSDs is not satisfactory in Turkey. Undergraduate medical education and postgraduate educations play a key role to raise awareness.
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    Limitations in the approach health caregivers can take in end-of-life care decisions
    (Wiley, 2015) Bülbül, Selda; Surucu, M.; Karavaizoğlu, Çağla; Eke, Murat
    Background In the terminal stages of neuro-metabolic diseases, parents can begin to experience a sense of loss even before the child dies, and might accept death prematurely. Cases A 2.5-year-old female patient with Sandoff Disease (diagnosed at 9 months of age), and a 17-month-old male Krabbe patient (diagnosed at 5 months of age) were admitted to the hospital with hypernatraemic dehydration and bronchopneumonia, respectively, within 10 days of each other. Both patients developed respiratory arrest short after admission and were supported with mechanical ventilation. Both families gave written consent to end life support, but their wishes could not be accepted according to Turkish law. Conclusions Specialists are expected to communicate well with families and give continuous care while respecting the opinions of patients' families on the timing of the withdrawal of life support. However, ethical and legal regulations on the conduct of health care professionals in these circumstances are unclear in Turkey and should be developed rapidly.
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    LYSOSOMAL STORAGE DISEASES: KIRIKKALE UNIVERSITY EXPERIENCE
    (2020) Bülbül, Selda; Çelik, Cansu; Alpcan, Ayşegül
    Objective: Lysosomal storage diseases which were firstdescribed in 1880; are important group of metabolic disorderscharacterized by the deposition of the substrates in lysosomesdue to defects of the activity or transport of lysosomal enzymesor a defect in the receptor proteins. LSDs usually show aprogressive clinical course and may not be represented with anyclinical signs during the neonatal period. The overall prevalenceof LSDs is 1 / 7000-8000. The aim of this study was to share theclinical characteristics of our LSDs patients and the experiencesof our pediatric metabolic diseases department.Material and Methods: This retrospective cohort study wasconducted at Kırıkkale University Hospital with 56 patientsdiagnosed as lysosomal storage disease among 315 patientsdiagnosed with metabolic diseases. Data were collected fromoutpatient clinic patient files who were diagnosed between 2011-2018.Results: A total of 315 patients diagnosed with inheritedmetabolic disease were followed in our clinic and 56 (17.7 %) ofthem were diagnosed as LSDs. The 56 patients were sufferingfrom the following diseases: 10 patients withMucopolysaccharidosis, 1 patient with mucolipidosis type 2 (Icelldisease), 41 patients with sphingolipidoses, two patients withcystinosis, one patient with Infantile Pompe Disease and onepatient with beta-mannosidosis.The mean age of the patients with Fabry Disease and the otherpatients diagnosed with other LSDs were 34.7±14.2 years(minimum 8, maximum 64) and 2.67±3.4 years (minimum 0,maximum 10.5) respectively. All diagnoses were verified byspecific enzyme analysis and/or by conducting genetic mutationanalysis.Conclusion: The most common lysosomal storage diseaseamong our patients were Mucopolysaccharidosis andsphingolipidosis. Treatment options, such as enzymereplacement therapy and bone marrow transplantation exist, and24 of these patients are receiving enzyme replacement therapy.
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    Sleep problems in adolescence and the effective factors
    (2010) Bülbül, Selda; Kurt, Güzide; Ünlü, Erdal; Kırlı, Erhan
    Sleep problems in adolescents are not rare and can cause aggression, inattention and behavioral disorders. This study investigated the sleep habits and sleep problems of adolescents in Kirikkale province. Of 1807 students from two high schools and five elementary schools, with a mean age of 15.1±1.61 years, 60.8% had no sleep problems, 17.2% had difficulty falling asleep, 12.7% had difficulty waking up in the morning, and 9.3% woke up frequently for no reason. Among all, 30.8% stated that they went to bed at 10:00-11:00 p.m., and mean duration of sleep was determined as 8.77±1.37 hours. Those who were exposed to domestic violence, who had a family member with an alcohol problem and who were smokers reported more sleep problems. In contrast, those with regular rituals before sleep, academic success, and who regularly played sports/exercised experienced fewer problems. To decrease sleep problems, teenagers should be recommended to undertake physical exercise, to get sufficient sleep at night, and to adopt habits before going to bed that facilitate falling asleep.
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    Social media and breastfeeding: an Instagram study
    (2021) Bülbül, Selda; Çelik, Cansu; Kocagözoğlu, Sevim Gonca; Gülbahçe, Aliye
    Background: Human milk has many proven benefits but breastfeeding rates are far below the desired optimal level. Social media plays an important role in accessing information and advice on health-related issues. There are several studies investigating how the social media has an impact on the community about health-related issues and decisions. We aimed to reveal how much Instagram has touched on breastfeeding and related contents about infant feeding. Material and Method: This is a descriptive cross-sectional study. We surveyed on Turkish Instagram accounts which only share about children health and diseases between June 2018 and January 2019. We searched the hashtags about child health and infant feeding and we enrolled the accounts that have more than 1000 followers. The obtained data were analyzed by SPSS 16.0 for Windows. The significancy level was accepted as p<0.05. Results: We enrolled 75 Turkish Instagram accounts. The mean number of posts was 743.77 (22-11349) and the mean number of posts of human milk and formula/bottle feeding were 9.80 and 2.07 (p=0.006). Human milk-related posts received a mean of 1368.3 likes, while those associated with formula/bottle feeding received 437.3 (p=0.007). Conclusion: As a result, it is seen that posts on human milk and breastfeeding were significantly more than those on formula and bottle feeding in social media. The expanding world of the internet today, led us to think that social media can be used as an important tool to increase breastfeeding rates. This should be obviously taken into consideration in future plans of policy makers.
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    Use of complementary and alternative medicine in a pediatric population in southern Turkey
    (Canadian Soc Clinical Investigation, 2011) Araz, Nilgün; Bülbül, Selda
    Purpose: The use of complementary and alternative medicine (CAM) in children is becoming increasingly acceptable and popular. The aim of this questionnaire-based study was to determine the prevalence, patterns of use, types, perceived effectiveness and associated factors of CAM in children. Methods: Parents of children (n=268) who attended the Pediatric Outpatient Department of the Faculty of Medicine at Gaziantep University in June and July 2008 were asked to complete a questionnaire. Results: The prevalence of CAM use, at least once in the previous year, was 58.6%. The most commonly used CAM modality was herbal preparations (82.7%), which were used to treat cough (42.0%), diarrhea (30.0%) and gas (colic) pains (34.4%). These products were recommended by the respondents' mother/mother-in-law (52.5%), neighbors (20.0%), friends (14.7%) and doctors (12.8%). Only 31.6% (61) of these parents informed their doctor about their use of CAM to treat their children. Thirty-eight percent (n=102) of the participants stated that they preferred to use CAM modalities rather than referring to a doctor when their child was sick. While most of the families (57.7 %) stated that the method they used was "slightly" useful, 18.6% of them stated the method to be "fairly" useful. The parental use of CAM and the educational level of the parents were among the factors of affecting the use of CAM in children. No correlation was found between the use of CAM and the sex, social security status, income level and other sociodemographic properties of the respondents. Conclusion: This study showed that a great majority of parents of children in this population used CAM modalities and that herbal products were preferred. Most parents did not inform their physicians of their use of CAM. In the light of these findings, pediatricians should be prepared to discuss alternative therapies with parents, since talking about CAM may be helpful in minimizing associated risks.