Browsing by Author "Ozkale, Yasemin"

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Association Between Hypocapnia and Febrile Seizures
(2014) Kilicaslan, Buket; Erol, Ilknur; Ozkale, Yasemin; Saygi, Semra; Sariturk, Cagla; https://orcid.org/0000-0002-3530-0463; https://orcid.org/0000-0003-3009-336X; https://orcid.org/0000-0002-8522-5078; https://orcid.org/0000-0002-4130-1059; 24396127; AAW-9958-2021; AAK-4825-2021; AAL-6136-2021; AAB-1203-2021; AAS-7129-2021
The purpose of this study is to determine whether hyperthermia-induced hyperventilation with subsequent hypocapnia is relevant to febrile seizures in children. This is only the second study to measure pCO2 and pH values in children with febrile seizures. This prospective case-control study enrolled 18 children who presented with febrile seizures and 18 children who presented with a febrile illness without seizures. Venous blood gas analyses were measured both from the febrile seizure and control group. There was no significant difference in mean blood pH between the febrile seizure and control groups but blood pCO2 was significantly lower in the febrile seizure group. Patients with complex febrile seizures exhibited significantly lower pCO2 levels within 1 hour of seizure onset than patients with simplex febrile seizures. These data indicate that febrile seizures may be associated with hyperventilation and that the ensuing hypocapnia may contribute to the development of febrile seizures.
Association between platelet indices and febrile seizures in children
(2016) Ozkale, Murat; Erol, Ilknur; Ozkale, Yasemin; Sariturk, Cagla; 0000-0002-3530-0463; 0000-0003-0625-1057; 0000-0003-3009-336X; AAK-4825-2021; AAS-7129-2021; A-7806-2016; AAL-6136-2021
Purpose: Febrile seizures (FS) are the most common type of seizures in children. The aim of this study was to evaluate the relationship between platelet indices and FS in children. Materials and Methods: This prospective study included 40 children who presented with FS and 30 controls who presented with febrile illnesses without seizures. Complete blood counts, including platelet count (PC), mean platelet volume (MPV), and platelet distribution width (PDW) from both groups within 1 hour of FS and 1 month later were obtained. Results: We found that the MPV and PDW within 1 hour of seizure in children with complex FS group was higher than simple FS group while there was no significant difference in MPV and PDW between patients in the simple and complex FS groups at 1 month. The mean PC was not significantly different between simple and complex FS groups; but, we found that the mean PC in the complex FS group was slightly lower than simple FS group. There was a moderate significant positive correlation between MPV and PDW in children with FS while there was a moderate significant negative correlation between PC and MPV, PDW for FS. Conclusion: Our findings suggest that the increasing platelet turnover in complex FS group causes a slightly decrease in the PC, an significantly increase of MPV and PDW values indicating that these parameters may play an important role in predicting the severity of FS in children at diagnosis.
Cerebellar Mutism Caused by Primary Varicella Infection in an Immunocompetent Child
(2014) Erol, Ilknur; Ozkale, Yasemin; Saygi, Semra; Alehan, Fusun; https://orcid.org/0000-0002-3530-0463; https://orcid.org/0000-0002-8522-5078; 23446802; AAK-4825-2021; AAB-1203-2021
Varicella (chickenpox) is a common childhood infection caused by the varicella-zoster virus, which is often self-limiting and usually benign. Although uncommon, neurologic complications of varicella have been documented that include postinfectious cerebellar ataxia, meningoencephalitis, Reye syndrome, myelitis, optic neuritis, stroke, Guillain-Barre syndrome, seventh cranial nerve palsy, and Ramsay-Hunt syndrome. In this case study, the authors describe a 7-year-old girl who presented with varicella skin rash with unsteady gait and anarthria on day 2, and her condition was attributed to cerebellar mutism. To date, this complication has never been reported in a child with primary varicella infection. Therefore, this case study documents a rare but serious complication of childhood chickenpox.
Chanarin Dorfman Syndrome: A Case Report
(2015) Ozkale, Yasemin; Erol, Ilknur; Canan, Oguz; Durdu, Murat
Chanarin Dorfman Syndrome is a multisystem inherited metabolic disorder associated with congenital ichthyosis and accumulation of lipid droplets in varios types of cells. Observation of lipid vacuoles in neutrophils (Jordan's anomaly) in peirpheral blood smears in patients with ichthyosis is diagnostic for Chanarin Dorfman Syndrome. Since the initial case was reported by Dorfman in 1974, nearly 50 cases have been reported in the literature, and the majority were from Middle East countries. In this report we presented a 5 year old patient who admitted to our hospital for creatine kinase elevation and diagnosed as Chanarin Dorfman Syndrome with clinical and laboratory findings.
Congenital Segmental Spinal Muscular Atrophy: A Case Report
(2015) Savas, Tulin; Erol, Ilknur; Ozkale, Yasemin; Saygi, Semra; 0000-0002-3530-0463; 0000-0002-8522-5078; 0000-0003-3009-336X; 25300987; AAK-4825-2021; AAB-1203-2021; AAL-6136-2021
Spinal muscular atrophies are genetic disorders in which anterior horn cells in the spinal cord and motor nuclei of the brainstem are progressively lost. We present a patient with arthrogryposis due to congenital spinal muscular atrophy predominantly affecting the upper limbs. Spinal muscular atrophies with onset at birth may be a cause of arthrogryposis. Localized forms of neurogenic arthrogryposis have been divided into cervical and caudal forms. Our case is similar to the cases described by Hageman et al (J Neurol Neurosurg Psychiatry 1993;56:365-368): severe symmetric lower motor neuron deficit in the upper extremities at the time of birth, no history of injury to the cervical spinal cord or the brachial plexus during delivery, and severe muscle wasting suggesting chronic denervation in utero. Because there was improvement of our patient's situation, her disease was also possibly nonprogressive and sporadic. To our knowledge, this is the first reported case of a Turkish patient with congenital cervical spinal muscular atrophy. Congenital cervical spinal muscular atrophy affecting predominantly the upper limbs is a relatively rare form of motor neuron disease and should be considered in the differential diagnosis of infants with congenital contractures and severe muscle weakness by wasting mainly confined to the upper limbs.
Demographic, epidemiologic and clinical characteristics of poisoning cases followed in pediatric intensive care unit
(2020) Ozkale, Murat; Ozkale, Yasemin; 0000-0003-3009-336X; 0000-0003-0625-1057; AAL-6136-2021; A-7806-2016
Purpose: This study was planned with the aim of retrospectively reviewing the demographic, epidemiologic and clinical characteristics of poisoning cases who treated in the pediatric intensive care unit and compare them with literature. Materials and Methods: The records of 581 patients admitted to the pediatric intensive care unit due to acute poisoning between 2015 and 2019 were retrospectively evaluated. Results: Five hundred and eightyone cases were enrolled in this study. The poisoned patients were aged between 3 months-18years and the female to male ratio was 1.6. Most poisonings occurred via the oral route (97.8%). It was noted that 57.1% of poisoning cases were accidental, whereas 39.1% were suicidal and 3.8% were a result of a therapeutic error. Eighty point nine percent of the cases were drug related while 19.1% were non-drug-related. Central nervous system drugs (%40.6) were the most common agent in drug-related poisoning, however rat poisons were the most common in non drug-related poisoning. The overall mortality rate in this study was 0.1%. Conclusion: Drug poisoning is the most common cause of poisoning in our region, which requires hospitalization, indicates that the society primarily should be raised more in this regard. In addition, we believe that our study will guide the physicians working in childhood poisoning patients who require hospitalization in our province and it ssurroundings, reflecting the epidemiological and clinical features and our results will contribute to updating the regional poisoning data.
Efficacy of Topical 0.05% Cyclosporine Treatment in Children with Severe Vernal Keratoconjunctivitis
(2014) Coban-Karatas, Muge; Ozkale, Yasemin; Altan-Yaycioglu, Rana; Sizmaz, Selcuk; Pelit, Aysel; Metindogan, Sevda; Canturk-Ugurbas, Silay; Aydin-Akova, Yonca; https://orcid.org/0000-0003-3009-336X; https://orcid.org/0000-0002-9139-8848; https://orcid.org/0000-0002-0662-2033; 25818961; AAL-6136-2021; AAL-4440-2020; F-2809-2015
We aimed to determine the efficacy of topical cyclosporine in children with vernal keratoconjunctivitis refractory to topical mast cell stabilizer and antihistamine therapy. Thirty-one patients, 24 boys and 7 girls younger than 16 years of age, were included in the study. All patients were scored on a four-point scale from 0 to 3 for symptoms and signs. Each patient received topical cyclosporine 0.05% emulsion (Restasis, Allergan Inc., Irvine, CA, USA) four times daily in addition to preservative-free artificial tears and was followed for 6 months. The data was recorded before the initiation of treatment (day 0) and at the 1st, 3rd, and 6th months following treatment. After six months of treatment, severity of all symptoms and signs showed a statistically significant decrease (p<0.05). Patients did not report any serious adverse effects. Topical cyclosporine 0.05% emulsion treatment is a safe and effective treatment option for controlling the symptoms and signs of vernal keratoconjunctivitis in children.
Long-Term Accidental Overdose of Levetiracetam in an Infant
(2014) Ozkale, Yasemin; Ozkale, Murat; Saygi, Semra; Erol, Ilknur; https://orcid.org/0000-0003-3009-336X; https://orcid.org/0000-0003-0625-1057; https://orcid.org/0000-0002-8522-5078; https://orcid.org/0000-0002-3530-0463; 23520362; AAL-6136-2021; A-7806-2016; AAB-1203-2021; AAK-4825-2021
Levetiracetam is one of the new anticonvulsant drugs that has a high therapeutic index and potential antiepileptogenic effects. Herein, we report a patient with multidrug refractory epilepsy and Ohtahara syndrome who was accidentally administered 300 mg/kg/d for 35 days by her mother. To our knowledge, there are only a few cases of accidental overdose of levetiracetam in pediatric patients reported in the literature, and this case study is the first to report such a high and long-term dose in an infant who showed no adverse effects.
Optic Neuritis as A Presenting Symptom of Mycoplasma Pneumoniae Infection
(2015) Ozkale, Yasemin; Erol, Ilknur; Coban Karatas, Muge; Alkan, Ozlem; 0000-0003-3009-336X; 0000-0001-7526-3460; 0000-0002-3530-0463; 27186706; AAL-6136-2021; AAM-4169-2021; AAK-4825-2021
A broad range of neurologic disorders has been described in children infected with Mycoplasma pneumoniae, of which encephalitis is among the most common. In contrast, the association between optic neuritis and Mycoplasma pneumoniae infection has been rarely described in children. We report a case of a 12-year-old girl who was seropositive for antibodies against Mycoplasma pneumoniae and presented with optic neuritis without respiratory symptoms or other neurologic findings.
Overview of Pediatric Peripheral Facial Nerve Paralysis: Analysis of 40 Patients
(2015) Ozkale, Yasemin; Erol, Ilknur; Saygi, Semra; Yilmaz, Ismail; 0000-0002-8522-5078; 0000-0003-3009-336X; 0000-0002-3530-0463; 0000-0002-1694-7608; 24810082; AAB-1203-2021; AAL-6136-2021; AAK-4825-2021; AAJ-2992-2021
Peripheral facial nerve paralysis in children might be an alarming sign of serious disease such as malignancy, systemic disease, congenital anomalies, trauma, infection, middle ear surgery, and hypertension. The cases of 40 consecutive children and adolescents who were diagnosed with peripheral facial nerve paralysis at Baskent University Adana Hospital Pediatrics and Pediatric Neurology Unit between January 2010 and January 2013 were retrospectively evaluated. We determined that the most common cause was Bell palsy, followed by infection, tumor lesion, and suspected chemotherapy toxicity. We noted that younger patients had generally poorer outcome than older patients regardless of disease etiology. Peripheral facial nerve paralysis has been reported in many countries in America and Europe; however, knowledge about its clinical features, microbiology, neuroimaging, and treatment in Turkey is incomplete. The present study demonstrated that Bell palsy and infection were the most common etiologies of peripheral facial nerve paralysis.
Overview of Therapeutic Plasma Exchange in Pediatric Neurology: A Single-Center Experience
(2018) Ozkale, Murat; Erol, Ilknur; Ozkale, Yasemin; Kozanoglu, Ilknur; https://orcid.org/0000-0003-0625-1057; https://orcid.org/0000-0002-3530-0463; https://orcid.org/0000-0003-3009-336X; https://orcid.org/0000-0002-5268-1210; 29882008; A-7806-2016; AAK-4825-2021; AAL-6136-2021; AAE-1241-2021
Therapeutic plasma exchange (TPE) is used in the treatment of neurological, hematological, renal and autoimmune diseases with known or suspected immune pathogenesis. In comparison with neurological diseases of adults, knowledge about the use of TPE in children is incomplete. We report our experience on TPE in children with neurological diseases in a single institution and describe the underlying etiology, clinical course, treatment and outcome. We retrospectively evaluated 22 consecutive children (12 girls, 10 boys, aged 2-16 years) who underwent TPE in the pediatric intensive care unit between January 2010 and January 2017. There were 135 TPE procedures with median 6 TPE sessions per patient. Fresh frozen plasma was used as a replacement fluid in all cases. Most common indications were inflammatory polyneuropathy followed by acquired demyelinating diseases of the central nervous system. Other indications were autoimmune encephalitis and paraneoplastic limbic encephalitis. No mortality was recorded during TPE. The complication rate was 2.2% and consisted of transient events like hypotension and allergic reactions. Therapetic plasma exchange is one of the safe methods of treatment for neuroimmunological disorders in children, with Guillain-Barr, syndrome as the most common indication.
Peripheral Lymphadenopathy in Childhood: Single Center Study
(2015) Ozkale, Yasemin; Ozkale, Murat; Sipahi, Tansu
Purpose: Lymphadenopathy is defined as an abnormality in the size and/or character of lymph node. In this study we aimed to describe the clinical and laboratory findings of benign and malignant causes of peripheral lymphadenopathy in childhood. Material and Methods: Two hundred and twenty four patients who were admitted to the clinic with peripheral LAP were evaluated. Age, gender, laboratory and radiologic findings, final diagnoses, and duration, localization, size, consistency, spread, and accompanying local and systemic symptoms of LAP were determined. Benign and malignant causes of peripheral lymphadenopathy were compared. Results: One hundred twenty-six patients (56.0%) were male and 98 patients (44.0%) were female. After the first evaluation the patients were divided into two groups. The first group included 186 patients with benign causes and the second group included 38 patients with malignant causes. One hundred and sixty four of 224 patients (73.2 %) had localized peripheral lymphadenopathy. The most frequent cause of localized lymphadenopathy in the benign group was acute lymphadenitis (34.8%). The most common cause of localized lymphadenopathy in the malignant group was Hodgkin's lymphoma (4.3%). Sixty of 224 (26.8%) patients had generalized peripheral lymphadenopathy. The most significant cause of generalized lymphadenopathy in the benign lymphadenopathy group was Epstein-Barr virus (10.0%), whereas Hodgkin's lymphoma (23.3%) was the most common cause in malign lymphadenopathy group. Localized and generalized lymph node enlargement was most frequently found in cervical region. The most frequent site of involvement among benign and malignant cases was the cervical area. The results revealed that findings such as chronic course, generalized LAP, supraclavicular, cervical and inguinal location, organomegaly, hilier LAP, abdominal LAP, and abnormal laboratory findings (thrombocytopenia and blasts on the peripheral blood smear) were associated with malignant diseases. Conclusion: Infections are the most common cause of peripheral LAP. The risk of malignany increases with the age of child and the duration of LAP. Older children with chronic LAP, generalized LAP associated with organomegaly, abnormal laboratory findings should be considered as malignant LAP.
Plasma Exchange in the Treatment of A Child with West Nile Virus Encephalitis: A Case Report
(2022) Ozkale, Yasemin; Ozkale, Murat; Ceylan, Ozgur; Erol, Ilknur
Background: West Nile virus (WNV) is a member of the Japanese encephalitis antigenic complex of the family Flaviviridae that can cause a wide range of clinical symptoms, from asymptomatic disease to severe meningitis, encephalitis flaccid paralysis, and death. In immunocompetent children, WNV infection is usually benign and self-limiting. However, this virus is also associated with severe neurological disease in some patients, especially those who are older, have a chronic disease, have undergone organ transplantation, or are immunocompromised. Case Report: A 12-year-old boy with selective immunoglobulin A-deficiency (SIgAD) and refractory seizures due to WNV encephalitis (WNE) was successfully treated with therapeutic plasma exchange (TPE) in conjunction with other immunomodulatory therapies. Conclusion: WNV can progress like autoimmune encephalitis. TPE appears to be safe and effective for treating children with WNE. To our knowledge, this report is the first of a child with WNV infection and SIgAD.
Role Of Automated Red Blood Cell Exchange In The Treatment Of Aluminum Phosphide Poisoning: A Case Report And Review Of The Literature
(2022) Ozkale, Murat; Ozkale, Yasemin; Kozanoglu, Ilknur; https://orcid.org/0000-0002-5268-1210; 35104018; AAE-1241-2021
Aluminum phosphide (AIP) is a fumigant commonly used in agricultural areas. AIP is frequently misused for suicidal purposes because it is easily accessible. AIP poisoning causes severe metabolic acidosis, resistant hypotension, acute respiratory distress syndrome, and multiorgan failure with cardiogenic shock. Despite supportive management and intensive care, most patients die following AIP ingestion because there is no specific antidote. In this case report we present a 15-year-old female who presented with vomiting, coma and epigastric pain. She developed resistant metabolic acidosis and hypotension due to AIP poisoning. Although supportive treatment did not result in clinical improvement, she was successfully treated with automated red blood cell exchange. Automated red blood cell exchange is a procedure which is used to exchange the patient erythrocyte mass with donor red blood cell. Although automated red blood cell exchange is a preferred treatment method in the complications of sickle cell anemia, some blood diseases and infectious diseases such as malaria and babesiosis, there is little information about its use in poisoning. To the best of our knowledge, this is the first child with AIP poisoning who was treated with automated red blood cell exchange.
The Role of Therapeutic Plasma Exchange in the Treatment of Childhood Intoxication: A Single-Center Experience (vol 21, pg e988, 2020)
(2021) Ozkale, Murat; Ozkale, Yasemin
Sadfly fever: two case reports
(2016) Ozkale, Yasemin; Ozkale, Murat; Kiper, Pinar; Cetinkaya, Bilin; Erol, Ilknur; 0000-0002-3530-0463; 0000-0003-0866-7339; 0000-0003-3009-336X; 0000-0003-0625-1057; 27489469; AAK-4825-2021; AAF-1346-2021; AAL-6136-2021; A-7806-2016
Sandfly fever, also known as 'three-day fever' or 'pappataci fever' or 'Phlebotomus fever' is a viral infection that causes self-limited influenza-like symptoms and characterized by a rapid onset. The disease occurs commonly in endemic areas in summer months and especially in August during which sandflies are active. In this article, two siblings who presented with high fever, redness in the eyes, headache, weakness, malaise and inability to walk, who were found to have increased liver function tests and creatine kinase levels and who were diagnosed with sadfly fever with positive sadfly IgM and IgG antibodies are reported because of the rarity of this disease.
Serum Magnesium and Calcium Levels in Children With Breath-holding Spells
(2018) Ozkale, Yasemin; Erol, Ilknur; Ozkale, Murat
Objective: Although breath-holding spells (BHS) are the most common form of non epileptic paroxysmal events in infancy, the pathophysiology of these events remain unknown. Several studies have indicated that multiple factors can be involved in the pathogenesis of BHS. The aim of this study was to assess the associations between BHS and serum magnesium and calcium levels. Materials and Methods: This prospective, case-control study enrolled 79 consecutive children with BHS and 114 healthy children, who were included as controls, without any illness between October 2012 and January 2014. Mean hemoglobin (Hb), mean corpuscular volume, serum iron, serum iron binding protein, magnesium(Mg), calcium(Ca), phosphorus (P), and alkaline phosphatase levels and Ca/Mg ratiowere compared between the two groups. Results: Overall, the Hb, Ca, and P levels were in the normal range in both groups; however, the mean Hb, Ca, and P levels were significantly lower in the BHS group than in the control group. Furthermore, there was no significant difference in the mean serum Mg level or Ca/Mg ratio between the groups. Conclusion: Therefore, low Hb, Ca, and P levels may decrease the threshold of BHS and thus constitute a risk factor for the development of BHS.
Serum Vitamin B12, Folic Acid, and Homocysteine Levels in Children with Febrile Seizure
(2015) Ozkale, Yasemin; Erol, Ilknur; Kilicarslan, Buket; Ozkale, Murat; Saygi, Semra; Sariturk, Cagla; Sezgin, Nurzen; 0000-0002-3530-0463; 0000-0002-8522-5078; 0000-0003-0625-1057; 0000-0003-3009-336X; 0000-0002-4130-1059; 27186696; AAK-4825-2021; AAB-1203-2021; A-7806-2016; AAL-6136-2021; AAS-7129-2021
The aim of this study is to investigate the associations between febrile seizure and serum levels of vitamin B-12, folic acid, and homocysteine. One hundred and four children who presented with febrile seizure and 75 controls who presented with febrile illness unaccompanied by seizure were enrolled into the study. Mean levels of vitamin B-12, folic acid and homocysteine were compared between two groups. Mean vitamin B-12 level in the febrile seizure group was significantly lower than the control group. The febrile seizure patients with 3 or more had significantly lower serum folic acid than the subgroups with two or one episode only. Serum concentrations of folic acid were significantly lower in the febrile seizure subgroup with body temperature 37.5-39.0 degrees C at time of convulsion. Low serum vitamin B-12 may reduce a child's threshold for seizure and may be a risk factor for febrile seizure. Low serum folic acid level may be predisposed to recurrent febrile seizure.
Tic Disorder Probably Associated with Steroid Responsive Encephalopathy with Autoimmune Thyroiditis (SREAT)
(2014) Saygi, Semra; Ozkale, Yasemin; Erol, Ilknur; https://orcid.org/0000-0002-8522-5078; https://orcid.org/0000-0003-3009-336X; 24633901; AAB-1203-2021; AAL-6136-2021
Steroid responsive encephalopathy with autoimmune thyroiditis (SREAT), a rare disorder in individuals of all age groups, including children, is characterized by high titers of anti-thyroid peroxidase antibodies. The present report concerns a previously healthy 12-y-old boy who presented with motor tics. The patient underwent an extensive work-up to identify the underlying etiologies and risk factors predisposing him to tic disorder. Based on the clinical and laboratory results, a diagnosis of SREAT was made. Although some studies have reported associated behavioral and cognitive changes, myoclonus, seizures, pyramidal tract dysfunction, psychosis, and coma. The authors describe a case of tic disorder, probably due to SREAT, as well as its course of treatment.
Toxic Reaction due to Multiple Wasp Stings in a Child: A Case Report
(2022) Ozkale, Yasemin; Ozkale, Murat
Background: Poisoning caused by wasp and bee stings is the most common type of poisoning caused by insects in Turkiye. The wasp belongs to the family Vespidae, a subgroup of the class Hymenoptera (membrane-winged insects). While mild symptoms are frequently observed in response to a single wasp sting, multiple wasp stings can cause severe poisoning and toxic reactions. Case Report: We present a case of a 7-year-old male patient who died after developing rhabdomyolysis, acute kidney injury (AKI), and multiple organ failure as a result of multiple wasp stings. Conclusion: The case report of our patient revealed that poisoning from multiple wasp stings can show a fatal course in children. When the number of wasp stings is 20-200 and when stings occur in the head-and-neck regions, AKI and mortality are high. Therefore, these patients should be hospitalized in the pediatric intensive care unit and monitored closely for toxic reactions.