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  • Küçük Resim
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    Evaluation of Vitamin D Levels According to Age, Gender and Seasonal Characteristics in Children and Adolescents
    (Selçuk Üniversitesi, 2022) Alp, Esma Keleş; Mirza, Sema
    Objective: Vitamin D is an essential hormone for the health of the musculoskeletal system and acts in immune system, cardiovascular system and metabolic homeostasis. The aim of this study was to determine the vitamin D status of children in the central Anatolia region. Also, the study evaluated the age, gender and seasonal variations in the study population. Materials and Methods: Children aged 1-17 years who were admitted to a Secondary Maternity and Children Hospital in Konya were included in this study. The medical records of the participants were retrospectively evaluated from the hospital information system between July 2016 and December 2021. All patients were categorized according to age, gender, and season in which their blood samples were obtained. Results: A total of 3547 children were included in the study. The mean serum level of 25-hydroxyvitamin D in the study population was 16.45±9.39 ng/ml. The number of samples obtained in winter was 1063 (30%) and in summer 756 (21.3%), respectively. Only 7.4% (n=262) of the participants had sufficient vitamin D levels (>30 ng/ml) in the study population. Additionally, severely deficiency of serum 25-hydroxyvitamin D level was mostly measured in winter season (378 patients, 45%). Severely deficiency (352 patients, 41.9%) was most common in children aged 12-17 years. Among all patients, only 7.4% had sufficient serum 25-hydroxyvitamin D levels. Also, 5.2% (103 patients) of the girls and 3.7% (59 patients) of the boys had sufficient 25-hydroxyvitamin D levels. On the other hand, severely deficiency of serum 25-hydroxyvitamin D levels was most common in boys (521 patients, 33.1%) than in girls (137 patients, 6.9%). Conclusion: Vitamin D deficiency/insufficiency is wide spread among children in the world and in Turkiye. Our study revealed that seasonal variations, age and gender affect the serum levels of 25-hydroxyvitamin D in children. In this context, the importance of vitamin D rich foods or vitamin D supplementation is increasing.
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    Primer vezikoüreteral reflüde renal kortikal anormallik ve idrar yolu enfeksiyonu ilişkisinin değerlendirilmesi
    (Selçuk Üniversitesi, 2021) Alp, Esma Keleş; Elmacı,Ahmet Midhat; Dönmez, Muhammet İrfan
    Öz Amaç: Renal skar, primer veziko-üreteral reflü (VUR) hastalarında konjenital veya kazanılmış şekilde gözlenebilir. Renal displazi ise embriyolojik gelişimdeki kusurlar sonucunda ortaya çıkar ve VUR ile birliktelik gösterebilir. Bu çalışmamızda amaç VUR tanısı ile takip edilen hastalarda skar ve displastik böbrek sıklığını ve bunun İYE ile olan ilişkisini araştırmaktır. Gereç ve Yöntem: Kliniğimizde 2012-2018 tarihleri arasında primer VUR tanısı ile takip edilen hastaların dosyaları retrospektif olarak incelendi. Sekonder VUR tanılı hastalar (Nörojenik mesane, posterior uretral valv vb.) çalışma dışı bırakıldı. Hastaların yaş, cinsiyet, idrar analizi, dimerkaptosüksinik asit (DMSA) sintigrafi ve işeme sistoüretrografi (İSUG) bulguları kaydedildi. Dilate VUR, İSUG’da ?grade 3 VUR olarak kabul edildi. Renal skar ve displazinin İYE, VUR derecesi, lateralite ve cinsiyet ile ilişkisi olup olmadığı araştırıldı. Bulgular: Çalışmaya, kriterlere uyan toplam 121 hasta dahil edildi. Hastaların 66’ı kız (%55) iken 55’i erkek (%45) idi. Ortanca yaş 6 ay (2-42 ay) olarak bulundu. Çalışmamızda 58 hastada (%48) bilateral VUR saptanırken, 78 hastada (%65) dilate VUR tespit edildi. İYE, toplamda 76 hastada (%62,8) saptandı. Tüm hastaların 33’ünde (%27,3) displastik böbrek gözlenirken, 20’sinde (%16,5) renal skar tespit edildi. Displazik böbrekli olgularda İYE sıklığı istatistiksel anlamlı oranda daha az (p<0,001) saptanırken, kız çocukların erkeklere oranla anlamlı derecede fazla (p<0,001) İYE geçirdiği görüldü. Ancak, İYE ve renal skar arasında anlamlı ilişki bulunmadı (p=0,217). Ayrıca, dilate VUR hastalarında hem renal displazi hem de renal skar oranı dilate olmayan VUR’lu hastalara göre anlamlı derecede yüksek bulundu. Sonuç: Renal skar ile İYE arasındaki ilişki multifaktöriyeldir. VUR ve renal displazi varlığında İYE sıklığı daha düşüktür. İYE ile displazi/skar ilişkisi açısından prospektif ve genetik analiz içeren çalışmalara ihtiyaç vardır.
  • Küçük Resim
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    Retrospective evaluation of newborn cases who were followed up with the diagnosis of hypernatremic dehydration
    (Selçuk Üniversitesi, 2022) Alp, Esma Keleş
    Aim: The aim of our study is to evaluate the demographic characteristics and epidemiological risk factors of neonatal hypernatremic dehydration and to discuss the precautions applied in our clinic in order to reduce the number of dehydration cases in the light of the literature. Materials and Methods: Newborns who were hospitalized in our neonatal intensive care unit with the diagnosis of HD, whose serum sodium level was >147 mmol/L and born at >37 weeks were evaluated retrospectively. Babies with illnesses that would adversely affect nutritional status were excluded from the study. Results: Mean gestational week of 54 cases included in the study was 39.19±1.07.22. The mean birth weight was 3244.06±458.46 gr. while the mean weight of hospitalization was 2880.28±514.54 gr. The percent of weight loss was found to be 8.51±3.14%. The mean age of hospitalization was 3.7±2.05 days and the mean duration of hospitalization day was 2.26±1.42 days. On admission, 11 (20.4%) patients had fever, 6 (11.1%) patients had jaundice, 3 (5.6%) patients had discomfort, 30 (55.5%) patients had more than one complaint and dehydration was detected in 4 (7.4%) patients during control admission of pediatric outpatient clinic. On physical examination, 46 (85.2%) patients had mild dehydration, 7 (13%) had moderate dehydration, and 1 (1.9%) patient had severe dehydration. The mean serum sodium value of the patients was 150.44±3.62 mmol/L, mean serum urea value was 45.5±18.13 mg/dl, and mean serum creatinine value was 0.79±0.34 mg/dl at the time of admission. The etiologies of dehydration were breast milk insufficiency in 37 (68.5%) cases, inability to breastfeed effectively due to nipple problems in 2 (3.7%) cases, and errors in breastfeeding technique in 15 (27.7%) cases. A positive correlation was found between the degree of dehydration and percent of weight loss and the serum sodium value (p<0.001). Conclusion: In our study, it was found that the most common cause of hypernatremic dehydration was breast milk insufficiency. Considering other reasons, giving breastfeeding education to mothers before discharge from the hospital seems to be important in preventing hypernatremic dehydration.