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Öğe Assessment of the Utility of Plusoptix A09 Handheld Photo-refractometer in Screening Refractory Errors and Amblyopia in Children(Georg Thieme Verlag Kg, 2021) Sinanoglu, Muhammed Selcuk; Yakinci, Cengiz; Demirel, SonerThe aim of this study is to find out the frequency of anisometropic amblyopia in children and to increase awareness about this disease. All children between the ages of 4 and 10 years who were attending 11 kindergarten and primary schools determined by provincial directorate for national education in the center of Malatya were included. A screening team including interns and a resident from the Department of Pediatrics have used Plusoptix A09 handheld photo-refractometer device for detecting amblyopia and its reasons. A total of 7,000 students were screened. The mean age of the students was 7.4 +/- 2 years. Amblyopia was suspected in 357 cases with the Plusoptix S09 screening. After eye examinations performed by an ophthalmologist, 303 cases were found to have pathologic eye examination. Amblyopia was found in 67 (18.8%) of the 303 cases, and anisometropic amblyopia was found in 59 of 67 cases. As a result of the screening, sensitivity of Plusoptix A09 was found to be 88.1%, while its specificity was found to be 88.6%. Its positive predictive value was found to be 64.0% and its negative predictive value was found to be 97.0%. We believe that with screenings performed by health professionals who are given short-term training by using a device that can conduct remote measurements, detection of anisometropic amblyopia, which is the most frequent reason for amblyopia, can be done in a fast and relatively less expensive way and with the minimum number of specialist physician required. This way, children with amblyopia can reach the ophthalmologist earlier for treatment.Öğe Demographic and systemic manifestations of patients diagnosed with ataxia-telangiectasia(Bilimsel Tip Yayinevi, 2014) Catal, Ferhat; Topal, Erdem; Celiksoy, Mehmet Halil; Ermistekin, Halime; Kutluturk, Kazim; Yildirim, Nurdan; Sinanoglu, Muhammed SelcukObjective: Ataxia-telangiectasia is rare, an autosomal recessive, neurodegenerative disorder characterized by progressive cerebellar ataxia, cutaneous and conjunctival telangiectasia, immunodeficiency, and increased risk of malignancy. In this study, we aim to determinate demographics, neurological, dermatological and immunological manifestation of children diagnosed with ataxia-telangiectasia in our clinics. Materials and Methods: We did a retrospective medical chart review of pediatric allergy and immunology database for children diagnosed with ataxiatelangiectasia in Inonu and Ondokuz Mayis University Faculty of Medicine between 2006 and 2013. Results: Ataxia-telangiectasia was diagnosed in 25 patients. The mean age was 10.08 +/- 4.14 (died children were included) and 16 (64%) of the patients were male. The mean follow up period was 5.32 +/- 3.84 years. Ataxia was the first sign of disease which was noticed by the parents and median diagnosis age was 4 years old (min: 1.5, max: 12). Neurological and dermatological manifestations were seen in all patients. Also immunological manifestations were seen in 85% of all patients. The most frequent neurologic sign was ataxia and present in all patients, followed by dysmetria (96%), dysarthria (92%), bradykinesia (80%) and ocular apraxy (60%), respectively. Telangiectasia was present in all patients and the most frequent localization was conjunctiva. Pigmentary anomalies were present in 17 (68%) patients, molluscum contagiosum in 2 (8%) patients and verruca in 1 (4%) patient. The most frequent form of immunologic deficiency was IgA deficiency (80%) which was followed by Ig G deficiency (60%) and lymphopenia (12%). Growth failure was present in 96% of patients and head circumference was under -1 SD in 56% of patients. In follow up, 5 (20%) patients had experienced recurrent otitis media, 18 (% 72) patients had experienced recurrent pulmonary infection. Bronchiectasis was developed in 7 (28%) patients and hemophagocytic sendrome was developed in one patient. Seven patients died (three due to non-Hodgkin lymphoma, two due to pulmonary infection, one due to hemophagocytic sendrome and one due to acute lymphoblastic leukemia). Conclusion: Ataxia and telenjiectasia were the most frequent signs of the disease and followed by immunological and pigmentary anomalies. Therefore, ataxia telenjiectasia should be consider in diagnosis if the patients who have dermatological signs such as telangiectasia and pigmentary anomalies and growth failure with ataxia.Öğe The hematologic manifestations of pediatric celiac disease at the time of diagnosis and efficiency of gluten-free diet(Tubitak Scientific & Technological Research Council Turkey, 2015) Catal, Ferat; Topal, Erdem; Ermistekin, Halime; Yildirim Acar, Nurdan; Sinanoglu, Muhammed Selcuk; Karabiber, Hamza; Selimoglu, Mukadder AyseBackground/aim: To determine the hematologic manifestations at the time of diagnosis of celiac disease in children and the effects of a gluten-free diet on hematologic signs upon follow-up. Materials and methods: The records of patients with celiac disease who received a follow up examination at the Pediatric Gastroenterology Clinic between June 2006 and June 2013 were retrospectively examined. Results: Ninety-one patients were included in the study. The mean age at diagnosis was 8.1 +/- 4.21 years and 59 patients (64.8%) were female. Thirty-two patients (35.2%) had hematologic signs at the time of diagnosis. Anemia (24.2%) was the most common hematologic sign, followed by thrombocytosis (16.5%) and leukopenia (4.4%). The tTG IgA titers were screened in 80 of the 91 patients during diagnosis. Follow-up examinations found that remission for anemia (P = 0.017), thrombocytosis (P = 0.039), and decreases in tTG IgA titers (P = 0.034) were more prominent in patients who had followed a strict gluten-free diet. Conclusion: Approximately one-third of the celiac disease patients had hematologic manifestations at the time of diagnosis. Remission in hematologic signs and decrease in tTG IgA titers were more prominent in patients who had adhered to a gluten-free diet.Öğe The prevalence and severity of reaction during the oral food challenge(Bilimsel Tip Yayinevi, 2014) Topal, Erdem; Catal, Ferhat; Senbaba, Elif; Varol, Fatma Ilknur; Sinanoglu, Muhammed Selcuk; Yildirim, Nurdan; Ermistekin, HalimeObjective: The diagnostic gold standard of food allergy is the oral food challenge. Oral food challenge may induce allergic reactions, ranging from mild cutaneous symptoms to severe, potentially life-threatening reaction. Our aim was to investigate the prevalence and severity of reactions during oral food challenge. Materials and Methods: A retrospective charts review of children undergoing oral food challenge at the our Allergy Clinic between September 2012 and September 2013 was performed. Results: A total of 63 oral food challenges were included the study. Most frequently involved foods were cow's milk, pistachio nut and egg. Oral food challenge were carried out to confirm the diagnosis in 50 (79.4%) patients and were carried out to demonstrate the development of food tolerance in 13 (20.6%). 13/63 (20.6%) were positive. Twelve patients were defined mild reactions and one patient was anaphylaxis. There were no significant differences between the oral food challenge negative group and oral food challenge positive group in terms of sex, age at the time of oral food challenge, concomitant atopic disease, history of IgE mediated food allergy, peripheral eosinophils per cent, serum specific gE and total IgE (p>0.05). But there was a positive correlation between the size of skin prick test and oral food challenge positivity (rho: 0.307, p=0.019). Conclusion: The majority of reactions during oral food challenge were mild. The size of skin prick test was the risk factor for the development of reaction during oral food challenge. Therefore, oral food challenge should be done by the experts and size of skin prick test should be taken into consideration before oral food challenge.
