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Tanju I.A.,Gulhane Military Medical Academy | Levent F.,University of North Texas Health Science Center | Sezer R.G.,Zeynep Kamil Maternity and Childrens Diseases Training and Research Hospital | Cekmez F.,Gulhane Military Medical Academy
Hepatitis Monthly | Year: 2014

Background: Hepatitis B virus (HBV), hepatitis C Virus (HCV), and human immunodeficiency virus (HIV) infections are significant causes of morbidity and mortality all over the world, especially in underdeveloped countries like Afghanistan. Limited data are available concerning the seroprevalence of HBV, HCV and HIV in the pediatric age group in Afghanistan. Objectives: The aim of the study was to assess HBV, HCV and HIV serology among children at an outpatient clinic in Kabul. Patients and Methods: A total number of 330 children were included to the study from outpatient clinics of Ataturk Kabul ISAF Role II Military Hospital from May to November 2012. Hepatitis B surface antigen (HBsAg), hepatitis C antibody (anti-HCV), and human immunodeficiency virus antibody (anti-HIV) were measured. Results: The mean age of children was 6.5 ± 4.2 years. The frequency of positive results for HBsAg, anti-HBs and anti-HCV in all age groups were 12 (3.6%), 47 (14.2%) and 2 (0.6%), respectively. Anti-HIV was not detected in any of the children's serum samples. The frequency of positive results for HBsAg was significantly higher in children older than six years than in other age groups. Conclusions: Vaccination program including HBV has begun during the last five years in Afghanistan. The continuation of the vaccination program is of great importance. Vaccination program and implementation steps should be revised and the deficiencies, if any, should be overcome without delay. © 2014, Kowsar Corp.; Published by Kowsar Corp.


PubMed | Zeynep Kamil Maternity and Childrens Diseases Training and Research Hospital
Type: Journal Article | Journal: Northern clinics of Istanbul | Year: 2017

In this study, we aimed to compare vitamin D levels of children with recurrent tonsillopharingitis and healthy controls, and investigate the relationship between sociodemographic characteristics and serum vitamin D levels.Children with recurrent tonsillopharingitis and healthy controls aged between 2, and 12 years who consulted to the outpatient clinics of Zeynep Kamil Maternity and Childrens Diseases Training and Research Hospital from January to October 2012 were included in this study. Serum 25 (OH) vitamin D levels were studied by tandem mass spectroscopy (tandem ms) method. Risk factors which might be associated with vitamin D levels were questioned. Ethical aproval was obtained from the Ethics Committee of Zeynep Kamil Maternity and Childrens Diseases Training and Research Hospital and informed consent from the parents of the children.A total of 147 children; 74 (50.3%) patients and 73 (49.7%) controls were included in our study. Age, gender and demographic characteristics did not differ significantly between the two groups. Vitamin D levels in patients with recurrent tonsillopharingitis and controls were 19.78.7 ng/ml and 23.69.2 ng/ml, respectively (p<0.01). Although duration of vitamin D usage was shorter in children with recurrent tonsillopharingitis, this difference was not statistically significant (p>0.05).Vitamin D levels in children with 7 recurrent episodes of tonsillophargitis within the preceeding year were significantly lower compared to the control group. We believe that serum vitamin D levels should be checked in children with recurrent tonsillopharingitis and deficiencies should be treated.


PubMed | Zeynep Kamil Maternity and Childrens Diseases Training and Research Hospital
Type: Journal Article | Journal: Journal of clinical research in pediatric endocrinology | Year: 2016

It is important to identify the possible risk factors for the occurrence of large for gestational age (LGA) in newborns and to determine the effect of birth weight and metabolic parameters on subsequent growth. We aimed to determine the effects of maternal weight, weight gain during pregnancy, maternal hemoglobin A1c (HbA1c), C-peptide and insulin as well as cord C-peptide and insulin levels on birth weight and postnatal growth during the first two years of life.Healthy, non-diabetic mothers and term singleton newborns were included in this prospective case-control cohort study. Fasting maternal glucose, HbA1c, C-peptide and insulin levels were studied. Cord blood was analyzed for C-peptide and insulin. At birth, newborns were divided into two groups according to birth size: LGA and appropriate for GA (AGA). Infants were followed at six-month intervals for two years and their length and weight were recorded.Forty LGA and 43 AGA infants were included in the study. Birth weight standard deviation score (SDS) was positively correlated with maternal body mass index (BMI) before delivery (r=0.2, p=0.04) and with weight gain during pregnancy (r=0.2, p=0.04). In multivariate analyses, the strongest association with macrosomia was a maternal C-peptide level >3.85 ng/mL (OR=20). Although the LGA group showed decreased growth by the 6-month of follow-up, the differences between the LGA and AGA groups in weight and length SDS persisted over the 2 years of follow-up.The control of maternal BMI and prevention of overt weight gain during pregnancy may prevent excessive birth weight. The effect of the in utero metabolic environment on the weight and length SDS of infants born LGA persists until at least two years of age.


PubMed | Zeynep Kamil Maternity and Childrens Diseases Training and Research Hospital and Haydarpasa Numune Training and Research Hospital
Type: | Journal: European journal of ophthalmology | Year: 2016

To evaluate the changes in retinal nerve fiber layer thickness (RNFLT), ganglion cell layer thickness (GCLT), retinal thickness (RT), and subfoveal choroidal thickness (SFCT) in eyes that received pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for idiopathic macular hole (IMH) and to compare these data with data from fellow eyes and healthy controls.This cross-sectional study included 49 subjects. Eighteen eyes that underwent surgery for IMH, 18 fellow eyes, and 31 eyes of the healthy controls were designated as group 1, group 2, and group 3, respectively. The RNFLT, GCLT, RT, and SFCT were measured by using the swept-source optical coherence tomography (SS-OCT) device at last postoperative visit.The RNFLT was significantly lower in group 1 than group 2 and group 3 (p<0.05). The GCLT was significantly reduced in all sectors in group 1 as compared to group 2 and group 3 (p<0.05). The RT was found to be significantly lower (except in central field) in group 1 than group 2 and group 3 (p<0.05). The SFCT was significantly decreased in group 1 as compared to group 2 and group 3 (p<0.05).A reduction in the RNFLT, GCLT, RT, and SFCT was observed following PPV with ILM peeling for IMH detected by SS-OCT.


PubMed | Zeynep Kamil Maternity and Childrens Diseases Training and Research Hospital
Type: Journal Article | Journal: Ophthalmic research | Year: 2016

To evaluate the effect of a single intravitreal bevacizumab (IVB) injection on blood flow parameters in the ophthalmic artery (OA) and middle cerebral artery (MCA) in infants with retinopathy of prematurity (ROP).This prospective and interventional study included 15 infants with ROP who were treated with IVB. Peak systolic velocity (PSV), end-diastolic velocity, mean velocity (MV) and resistivity index were measured using pulse wave Doppler ultrasonography (Philips En Visor C, Amsterdam, The Netherlands) in the OA and MCA, before IVB injection and 1 day, 1 week and 1 month after IVB injection.Measurements of PSV-OA, MV-OA and PSV-MCA showed significant changes after IVB treatment (p = 0.01, p = 0.02, p = 0.02, respectively). The PSV-OA measurements at 1 week and 1 month were significantly lower than the baseline PSV-OA measurement (p = 0.03 and p = 0.01, respectively). The MV-OA measurement was significantly lower at 1 month following IVB as compared to the baseline MV-OA measurement (p = 0.03). The PSV-MCA showed a significant decline 1 day after IVB injection (p = 0.03).The study demonstrated that IVB causes significant alterations in blood flow parameters in the OA and MCA predicted by Doppler ultrasonography in infants with ROP.


PubMed | Zeynep Kamil Maternity and Childrens Diseases Training and Research Hospital, Haydarapasa Numune Training and Research Hospital, Suleyman Demirel University of Turkey, Prof Dr N Resat Belger Beyoglu Eye Training And Research Hospital and GATA Haydarapasa Training and Research Hospital
Type: Journal Article | Journal: Genetics and molecular research : GMR | Year: 2016

Stargardt disease (STGD) is an inherited genetic eye condition involving bilateral macular dystrophy leading to progressive central vision loss. It is the most common form of autosomal recessive juvenile macular dystrophy. In this study, ELOVL4 and PRPH2 genes were analyzed in 30 STGD probands for genetic variations using next-generation sequencing. In the patient group, two genetic variants in exon 6 of ELOVL4, and three in exon 3 of PRPH2 were detected. All sequence modifications in both ELOVL4 and PRPH2 were recorded, including those of a non-pathogenic nature. In the control group, four different genetic variations were detected in ELOVL4, and five in PRPH2. STGD patients of different ethnicities may carry distinct ELOVL4 and PRPH2 sequence variants. We believe that the genetic variations identified in this study may be related to STGD etiopathogenesis.


PubMed | Suleyman Demirel University of Turkey, Zeynep Kamil Maternity and Childrens Diseases Training and Research Hospital, Umraniye Training and Research Hospital and Haydarpasa Numune Training and Research Hospital
Type: Journal Article | Journal: Genetics and molecular research : GMR | Year: 2016

The aim of this study was to screen the visual system homeobox 1 (VSX1) gene in Turkish patients with keratoconus (KC). The patient group consisted of 44 patients who had undergone corneal transplant surgery before the age of 30, for advanced and rapidly progressive KC. The control group comprised 250 healthy individuals. We detected two missense mutations, D144N and D295Y, in exon 2 and exon 5 of the VSX1 gene, respectively, using next-generation sequencing analysis. The pathologic effects of the D144N and D295Y missense mutations on protein function were determined with bioinformatic analysis tools, SIFT, PolyPhen, and MutationTaster. Aspartic acid at the 144th position was more preserved among species than aspartic acid at the 295th position of the VSX1 protein. In the control group, five different genetic variations were detected, two of which (rs8123716 and rs12480307) were synonymous with variations in the patient group. Our results suggested that the D144N and D295Y mutations might have a role in the pathogenesis of KC disease.


PubMed | Zeynep Kamil Maternity and Childrens Diseases Training and Research Hospital and Umraniye Training and Research Hospital
Type: Journal Article | Journal: International ophthalmology | Year: 2016

To evaluate the approach to management of iatrogenic crystalline lens injury occurred during intravitreal injection (IVI). The patients who were managed operatively or followed-up without intervention after the iatrogenic lens injury due to IVI were included in the study. Capsular breaks remained either quiescent or resulted in cataract formation in the patients with inadvertent crystalline lens capsule damage. Phacoemulsification surgery was performed in patients with cataract formation with lower fluidic settings. A total of 9 cases included in the study. Seven cases underwent phacoemulsification with intraocular lens implantation. Two cases remained as quiescent lens injury during the follow-up. In 2 cases, dislocation of lens fragments occurred during phacoemulsification where pars plana vitrectomy was performed at the same session. After iatrogenic crystalline lens injury, capsular damage could remain quiescent or progress to cataract formation. Although phacoemulsification surgery can be performed with appropriate parameters, lens fragment dislocation can be observed in cases with traumatic lens damage secondary to IVI.


PubMed | Adana Numune Training and Research Hospital and Zeynep Kamil Maternity and Childrens Diseases Training and Research Hospital
Type: | Journal: Current eye research | Year: 2016

To evaluate the efficacies and treatment outcomes following intravitreal bevacizumab (IVB), intravitreal ranibizumab (IVR), and laser photocoagulation (LPC) in retinopathy of prematurity (ROP).This was a retrospective interventional case series study including the data of 134 infants (264 eyes) who were treated with IVB, IVR, or LPC for ROP. The data were collected from two major ROP treatment centers in Turkey without any randomization or masking. Regression of ROP, recurrence profile, complications after each treatment modality, and indications for retreatment were evaluated. The main outcome measures included the total inactivation of ROP with anatomic and refractive outcomes at 1.5 years of adjusted age.There were 55 infants (41.1%) in the IVB group, 22 infants (16.4%) in the IVR group, and 57 infants (42.5%) in the LPC group. All but 3 infants (5.5%) in the IVB group and 11 infants (50%) in the IVR group showed recurrence to stage 1 and 2 ROP following IVB and IVR (p < 0.001). Retreatment was performed in three infants in both IVB and IVR groups (p = 0.098). At 1.5 years of adjusted age, all infants showed favorable anatomic outcome except one infant in the LPC group. No significant difference of the mean spherical equivalent (SE) was observed between the groups (p = 0.131). In Zone I ROP, laser treated infants had significantly higher rates of myopia and high myopia than IVB and IVR treated infants (p = 0.040 and p = 0.019, respectively).Both IVB and IVR treated infants had significantly better refractive outcomes in Zone I ROP as compared to LPC treated infants at 1.5 years of adjusted age. The higher rate of disease recurrence was associated with IVR. Gestational age (GA) and the zone of ROP were also predictive factors for recurrence of ROP in the study.


PubMed | Zeynep Kamil Maternity and Childrens Diseases Training and Research Hospital
Type: Journal Article | Journal: Balkan medical journal | Year: 2016

Late preterm infants have increased rates of morbidity and mortality compared to term infants. Determining the risk factors in these infants leads to more comprehensive preventive and treatment strategies.Our aim was to analyse the morbidity rates such as respiratory system diseases, infections, congenital anomalies, hypoglycemia and hematologic abnormalities and mortality rates in a large group of patients at a referral center.Retrospective cross-sectional study.Medical records of late preterm and term infants who were managed at the referral center were analysed.41752 births were analysed in 3 years. 71.9% of all births were between 37-42 gestational weeks (i.e. term) and 16.1% were between 34-37 weeks (i.e. late preterm). Compared to term infants, late preterm infants had increased rates of short-term problems. The rate of mortality increased with decreased gestational age. The duration of hospitalization was significantly higher in the smallest late preterm infants.This study demonstrated the need that late preterm infants who have higher risk for morbidity and mortality, compared to term infants require close monitoring. The rate of mortality and hospitalization increased with decreased gestational age.

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