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    A comparative study between adolescent and adult patients with pilonidal sinus disease
    (2021) Katı, Ömer; Kandur, Yaşar; Kaya, Murat; Güler, Ahmet Gökhan; Dalkıran, Tahir
    Objectives: The main targets of the treatment modalities for pilonidal sinus are to prevent recurrences, and to increase the quality of life. It is unknown whether there is a different treatment trend in pediatric patients as compared with adults. In this study, we aimed to evaluate the surgical methods in pediatric and adult patients with pilonidal sinus. Material and Method: This retrospective study was conducted at the Departments of Pediatric Surgery and General Surgery Department of Necip Fazıl City Hospital, Kahramanmaraş from 2013 to 2017. A total of 66 pediatric patients and 68 adult patients were enrolled in this study. Results: The number of pediatric patients was significantly higher than adults in mean of flap closure (21 (31.8%) vs 2 (2.9%), p?0.01). However, primary closure was the most preferred method both in pediatric and adult patients, 45 (68.2%) pediatric patients and 63 (92.6%) adults. During a postoperative follow-up period of 1 month, 10 (15.2 %) pediatric patients and 12 (17.6%) adult patients developed wound infections (p=0.21). There was no significant difference between pediatric and adult patients with respect to mean recurrence rate (pediatric= 8 (%12.1) vs adult =9 (%13.2) (p=0.527)). Conclusion: We believe that pediatric surgeons should increase their interest in treatment options of PS disease since its prevalence increases in pediatric age group especially in adolescents in recent years. Besides, there was a female prepondarance in pediatric patiens.
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    Aseptic meningitis caused by Coronavirus OC43 in a child: A case report
    (Bayrakol Medical Publisher, 2022) Demirbaş, Yasemin; Alpcan, Ayşegül; İnal, Mikail; Güney, Şeyma; Tursun, Serkan; Kandur, Yaşar
    Human coronavirus OC43 (HCoV-OC43) is one of the coronaviruses that cause the mild cold. On the other hand, extra-respiratory manifestations such as cen-tral nervous system infections with HCoV-OC43 are very rarely reported. We present a case of a previously healthy immunocompetent child with acute aseptic meningitis, as a result of HCoV-OC43 who admitted to the emergency department with a complaint of unconsciousness.. Respiratory tract and cerebrospinal fluid culture showed HCoV-OC43 in viral screening. During the follow-up period, the patient was completely asymptomatic, with normalized consciousness. The clinicians should keep in mind that HCoV-OC43 can be the etiological agent in the differential diagnosis of aseptic meningitis in immunocompetent individuals with reversible neurological symptoms.
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    Association between serum ferritin level and thyroid hormones in hypothyroid pediatric patients
    (2021) Alpcan, Ayşegül; Kandur, Yaşar; Tursun, Serkan; Albayrak, Meryem; Ergür, Ayça Törel
    Aim: The present study aimed to investigate the iron store status in patients with hypothyroidism due Hashimoto thyroiditis and subclinical hypothyroidism. Material and Method: We retrospectively reviewed the medical records of patients who were followed up at our university hospital with the diagnosis of hypothyroidism due to Hashimoto thyroiditis and subclinical hypothyroidism between 2010-2021. Results: Nineteen patients with Hashimoto thyroiditis, 17 with subclinical hypothyroidism, and 20 controls were enrolled in this study. There was no significant difference in mean age among three groups (138.3±46.8 months, 116.0±68.1 months, 151.8±50.3 months in groups of Hashimoto thyroiditis, subclinical hypothyroidism and controls respectively p=0.169) . There was a significant female preponderance in HT group (68.5%, p=0.001). There was no significant difference for mean ferritin levels among groups (p=0.440). There was no correlation between TSH and ferritin level (r=-0.132, p=0.410) but we found a positive correlation between ferritin and free T4 level (r=0.340, p=0.030). Conclusion: We found a positive relationship between ferritin and thyroxine hormone that made us think that iron supplementation may be effective in the treatment of hypothyroidism. But this hypothesis warrants further prospective and experimental studies.
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    Comparison of the Effectiveness of Topical and Oral Beta Blockers in the Treatment of Childhood Hemangiomas
    (2023) Yüksel, Kerim Faruk; Kandur, Yaşar; Alpcan, Ayşegül; Tursun, Serkan; Vural, Sevde Nur; Albayrak, Meryem
    Purpose: Hemangiomas are the most common vascular tumors in childhood, and the treatment options have undergone profound changes in recent years. In this study, we aimed to compare the efficacy and safety of beta-blockers on hemangiomas, both topi-cal and oral, with non-pharmacological treatment in the pediatric age group. Material and Methods: We retrospectively reviewed the medical records of pediatric patients with hemangiomas. Results: Fifty-three patients (F/M=40/13) were enrolled in this study. Superficial hemangiomas were detected in 14 (26.4%) patients, and deep hemangiomas were detected in 39 (73.6%) patients. Seventeen patients were followed without medication, 19 were treated with a topical beta blocker, and 17 were treated with an oral beta blocker. Twelve patients with superficial hemangi-omas were followed without medication, while two received topical timolol treatment. A comparison of lesion progression in patients with superficial hemangiomas in the non-pharmacological treatment and topical treatment groups showed that the mean scores of success, in terms of mean fading and reduction in lesion depth, were significantly higher at the first month (7.0 vs. 1.66; p=0.049; 6.0 vs. 1.5; p=0.045). Among patients with deep hemangiomas, a comparison of mean fading scores showed no difference between the oral and topical treatment groups in the first and fourth months (p=0.551, p=0.551). Conclusion: We believe that oral beta-blockers can be used instead of topical treatment in the future, and they will be preferred more by clinicians and families due to less side effects.
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    OUR RESULTS FOR RIGID URETEROSCOPY AND LASER LITHOTRIPSY IN PEDIATRIC AGE GROUP
    (2021) Güler, Ahmet Gökhan; Karakaya, Ali Erdal; Doğan, Ahmet Burak; Kandur, Yaşar
    Objective: Urolithiasis is an important disease that can lead topermanent kidney dysfunction and severe clinical symptoms inpediatric patients. We aimed to present our findings of rigidureteroscopy combined with Holmium YAG laser lithotripsy.Material and Methods: We retrospectively reviewed theultrasonography, and medical records of pediatric patients withurolithiasis who were operated in Sutcu Imam UniversityDepartment of Pediatric Surgery, Kahramanmaraş betweenApril 2018 and December 2019.Results: Sixty-one pediatric patients (M/F=38/23) withurolithiasis were enrolled in this study. The mean age was6.7±4.9 years (range 3 month-17 years). Thirteen (34.2%) malepatients need an urgent operation (rigid ureteroscopy combinedwith Holmium YAG laser lithotripsy) while the correspondingnumber was 4 (17.4%) in female patients. The differencebetween two sexes was statistically non-significant (p=0.156).Thirty-two male patients (84.2%) and 12 (52.2%) femalespatients had a successful operation (rigid ureteroscopy combinedwith Holmium YAG laser lithotripsy). The difference betweenthe two sexes was statistically significant (p=0.019). The ratio offemale patients with right-sided stone was significantly greaterthan the corresponding rates of male patients (p=<0.001). Therewas no difference between infants (<3 years of age) and toddlers(>3 years of age) with respect to gender, side of stone, proceduralsuccess, and need for urgent surgery (p>0.05). Regressionanalysis showed that female gender was a risk factor for a failedattempt (OR=-0.313, 95% CI: 0.052 – 0.528; p=0.0018).Conclusion: Safe and effective stone treatment can beperformed considering that more than one operation can beperformed in infants and children with mini ureteroscopy andholmium laser. However, while evaluating this treatment optionin female patients, alternative treatment methods such as flexibleor percutaneous nephrolithotomy may be preferred.
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    Polycythemia in a Pediatric Patient with Chronic Kidney Disease: Overuse of Erythropoetin During COVID-19 Isolation
    (2021) Kandur, Yaşar; Alpcan, Ayşegül; Yozgat, Mehmet; Tursun, Serkan
    We describe a case of a patient with Chronic Kidney Disease who developed polycythemia due to Erythropoiesis Stimulating Agents overuse during COVID-19 isolation. A 12-year-old male had not been able to attend routine controls since had been in isolation for 4 months after the COVID-19 outbreak. He had continued to take Erythropoiesis- Stimulating Agents during that period at the starting dose of 150 U/kg/week. He had been on peritoneal dialysis in the last year because of end-stage renal failure. Laboratory investigation revealed a hemoglobin (Hb) level of 20.8 g/dl, hematocrit level of 66%, creatinine level of 6.5 mgr/dl. He underwent daily phlebotomy sessions (10cc/kg/session). During this period aspirin was also started (5mg/kg). After 5 sessions his Hb level decreased to 14 gr/dl and hematocrit to 40%. Pediatric nephrologist should be aware that there is a potential risk of polycythemia with Erythropoiesis Stimulating Agents when Hb level is not appropriately followed on a routine basis.
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    PULMONARY THROMBOEMBOLISM IN A CHILD AFTER BURN INJURY
    (2020) Dalkıran, Tahir; Güngör, Olcay; Kandur, Yaşar; Dağoğlu, Besra; Acıpayam, Can; Alpcan, Ayşegül; Tursun, Serkan
    Pulmonary embolism is rarely diagnosed in pediatric burnpatients and is often only discovered at autopsy. Herein we wouldlike to present the case of a pediatric patient with pulmonarythromboembolism who was burnt by hot water at home. A 4-yearoldgirl who was treated at an external center for 9 days due tosecond degree burn injuries in both legs. After the discharge shehad suddenly become restless and than gone unconscious. Sincepulmonary thromboembolism was suspected as the cause ofcardiopulmonary arrest, a pulmonary computed tomographyangiogram was taken, which showed a thrombus in the lobar andsegmental branches of the right pulmonary artery supplying theright lower lobe. Enoxaparin sodium treatment (2×1mg/kg) wasinitiated. At day 16, a control computed tomography angiogramshowed that the thrombus in the lobar and segmental branches ofthe pulmonary artery had disappeared. This case report illustratesthe importance of chemoprophylaxis against pulmonaryembolism in both pediatric and adult burn patients. In such cases,especially the severe ones, a sudden deterioration of patient’sclinical status in the form of respiratory distress or failure shouldraise suspicion about the possibility of pulmonary embolism.
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    The Course of Congenital Hydronephrosis in Infancy
    (2021) Tursun, Serkan; Alpcan, Ayşegül; Kandur, Yaşar; Acar, Banu Celıkel
    Objective: The aim of our study is to examine the spontaneous resolution rates of congenital hydronephrosis from a recent perspective. Material and Methods: Sixty-nine pediatric patients (M/F=46/23) with congenital hydronephrosis were enrolled in this study. Results: The mean age at the first postnatal examination was 10.8±7.6 days, and the mean age at the time of the final examination was 9.5±3.2 months. Forty-eight patients’ renal anteroposterior diameters (APD) (69.5%) improved while 8 (11.6%) patients’ APDs worsened during the follow-up period. However, MAG3 of these 8 patients was normal. The remaining thirteen (18.9%) patients had congenital anomalies of the kidney and the urinary tract (8 vesicoureteral reflux, 5 cases of ureteropelvic junction obstruction). The mean baseline APD was 9.1±2.8 mm in the group with reduced APD, and 9.7±2.8 mm in the one with increased APD (p=0.461). The mean APD at the final visit was significantly lower in the group with reduced APD than that in the group with increased APD (5.1±1.8 mm vs 17.9±12.6 mm; p=0.001). The anteroposterior diameter of 26 (81.25%) patients with left-sided hydronephrosis and 10 (71.4%) patients with right- sided hydronephrosis regressed spontaneously. The rate of spontaneous resolution was relatively low in patients with bilateral hydronephrosis (n=13; 56.5%) compared to unilateral ones. Conclusion: Our study indicates that an initially mild hydronephrosis does not exclude a pathological course in cases of congenital hyronephrosis. Therefore, in such patients, routine ultrasonography should be done regularly.
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    The predictive value of bleeding score on the diagnosis of Von Willebrand disease in children applied to the hematologic clinic with epistaxis
    (2022) Alpcan, Ayşegül; Tursun, Serkan; Kandur, Yaşar; Yörgüç, Mustafa Çağlar; Albayrak, Meryem
    Aim: Epistaxis may be a symptom of an inherited bleeding disease.. We aimed to analyze an approved pediatric bleeding score (PBS) as a screening test for von Willebrand Disease (VWD) in children with epistaxis Material and Method: We retrospectively reviewed the medical records of pediatric patients, who applied to the Pediatric Hematology Department with the complaint of epistaxis between January 2018 and December 2019. Results: One hundred and sixty eight patients enrolled in this study There were 65(38.7%) girls and 103(61.3%) boys, with a mean age of 114±49 months (range 8 months to 18 years).The PBS of 34 patients was greater than/ or equal to 2. Factor 8, von Willebrand factor antigen, and von Willebrand Ristocetin cofactor levels were significantly lower in patients with PBS?2 compared to those in patients with PBS<2 (%73±43 vs % 91±29, p=0.03; 87±44 vs 106±29 IU/dl, p=0.03; 72±39 vs 98±30 IU/ dl, p=0.001, respectively). While 15 (44%) of 34 patients with PBS ? 2 diagnosed VWD, but in the group with PBS<2, VWD was diagnosed for only 4 children (0.02%) (4/134). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PBS for diagnosis of VWD was 79.0%, 87.2%, 44%, and 97% respectively. Conclusion: PBS could be integrated into the evaluation of children suspected of having a bleeding disorder such as VWD in pediatrician’s offices. Our cut off value 2 appears to be significant in exclusion of VWD, since its high negative predictive value.