Lumbar Puncture of the Newborn

Heinrich Irenäus Quincke was the first person in medical history to perform lumbar puncture (LP). Indications of lumbar puncture include suspected meningitis, suspected subarachnoid hemorrhage, administration of chemotherapeutic agents, instillation of contrast media for imaging of the spinal cord, and the evaluation of various neurologic conditions including normal pressure hydrocephalus and Guillain-Barré syndrome, and the treatment of idiopathic intracranial hypertension. Contraindications of lumbar puncture include findings of increased intracranial pressure, bleeding diathesis, cardiopulmonary instability, soft tissue infection at the puncture site, shock, respiratory insufficiency, and suspected meningococcal septicemia with extensive or spreading purpura. Altered mental status, focal neurologic signs, papilledema, focal seizure, and risk for brain abscess are indications for cranial imaging before performing LP. Lack of local anesthetic use and advancement of the spinal needle with the stylet in place were most prominent risk factors for a traumatic LP. Ultrasound may minimize the number of LP attempts and decrease patient and parent anxiety by easily identifying an insertion site. Infection, spinal hematoma, epidermoid tumor, and cerebral herniation are the main complications of LP. When LP is traumatic, the wisest approach is to assume the patient is having meningitis and start empirical therapy

Neonatal Meningitis

Neonatal meningitis continues to be a problematic issue of neonatology and pediatric infectious diseases with its incidence of 0.8–6.1 in 1000 live births, high case fatality rate, and neurological sequelae. Major risk factors for contracting meningitis in the newborn period include maternal peripartum infection, premature rupture of membranes, premature birth, fetal hypoxia, septic or traumatic birth, low birth weight, and galactosemia. The leading causative agent is group B streptococci (in almost half of the cases), and a quarter of cases are due to Escherichia coli. Vertical transmission from the mother is often the route of infection. Neonatal meningitis may not be distinguishable clinically from neonatal sepsis without meningitis. Meticulous care should be taken to perform lumbar puncture whenever the patient’s status permits since it is an indispensable tool for diagnosis. Initial empirical therapy may consist of ampicillin and cefotaxime, ampicillin and gentamicin, or ampicillin + gentamicin + cefotaxime during the first week of life. Ampicillin + gentamicin + cefotaxime for nonhospitalized infants and the same combination with the replacement of ampicillin with vancomycin for infants still in hospital are suitable options after the first week

Sepsis in Children

Sepsis is systemic inflammatory response syndrome due to a documented or suspected infection. Causative agents of sepsis include group B streptococcus, Escherichia coli, and Listeria monocytogenes in infants younger than 2 months, and community‐acquired organisms. Bacteremia may ensue in patients whose defense mechanisms have become vulnerable due to many factors. Sepsis and septic shock can be viewed as clinical pictures, which develop as consequences of proinflammatory processes/cytokines leading to a state that cannot be restrained by anti‐inflammatory processes/cytokines. As yet, a cytokine, which is uniquely associated with severe sepsis and septic shock and can be used as a biomarker, has not been discovered. Sepsis is a cytokine storm, which may adversely affect almost any organ system. Whether there is an association between the severity of sepsis or septic shock and cytokine gene polymorphisms is an important field of study. Mottled skin and prolongation of capillary refill time may help the physician recognize septic shock before hypotension emerges. The management of severe sepsis and septic shock involves (1) the hemodynamic support, (2) inotropes, vasopressors, and vasodilators, (3) antimicrobial therapy, (4) transfusions, and (5) corticosteroids as indicated. Hospital mortality of pediatric sepsis is 2–10%

Prof. Dr. Bedđ N Sehsuvaroglu (1914-1977) , A famous turkish historian of medicine and pharmacy and eczacilik tarđhđ derslerđ (lectures on the history of pharmacy), his book

Reason for this study is to study an important book of Sehsuvaroğlu , a famous Turkish historian of medicine and pharmacy from the point of history of medicine and pharmacy.As method , Sehsuvaroğlu’s biography is given as chronological and his book’s parts are commented .Here, the main aim is to comment on this book. Prof.Dr.Bedi.N.Sehsuvaroglu who was born in Đstanbul in I914 completed his primary and high school education in Kabatas and Kadiköy in Đstanbul and graduated from Đstanbul Faculty of Medicine in 1939. He served as a physician in various places of Turkey . Afterwards , he also became professor of history of medicine in 1962. Sehsuvaroğlu who died in 1977 was the director of the department of deontology , Đstanbul Faculty of Medicine. Eczacılık Tarihi Dersleri (Lectures on History of Pharmacy) is one of the most important books of Sehsuvaroğlu.It is in Turkish and with the date of 1970.This book which is 423 pages gives the development of the pharmacy from the ancient ages to today .In this book ,both Western pharmacy and Turkish pharmacy are present .Moreover, many knowledge on Turkish medical manuscripts are present .In this book , this famous author specifies uses and effects of drugs in these manuscripts. As a result, Prof.Dr.Bedi. N Sehsuvaroğlu is an important Turkish author and his books mention many important topics on history of medicine and pharmacy . One of these books is Eczacılık Tarihi Dersleri( Lectures on History of Pharmacy)

The Impact of COVID-19 Pandemic on Distress Intolerance: Among Panic Buyers in Turkey

In this study, the factors affecting levels of distress intolerance during the Covid-19 pandemic are statistically analyzed among panic buyers in Turkey. Distress intolerance also increased as health status deteriorates. Construct consistency was achieved in measuring distress intolerance during the Covid-19 period. Confirmatory factor analysis (CFA) was performed for participants who engage in panic buying behavior. CFA showed that the reliability and consisteny of this scale was ensured. It was seen that enduring uncomfortable emotions was the condition that affected distress intolerance the most. Doing everything to avoid feeling distressed or sad was found to be the least affecting distress intolerance in the Covid-19 period. When all of the fit criteria were considered, it was evident that the proposed model was valid for sample. Consequently, it is recommended that public health services develop health strategies with respect to the stated risk factors and to provide interventions that increase psychological flexibility to reduce Covid-19 related intolerance to distress

Boron content of Lake Ulubat sediment: A key to interpret the morphological history of NW Anatolia, Turkey

Freshwater Lake Ulubat (c. 1.5 m deep and c. 138 km2) receives sediment from a 10.414 km2 area in the seismically active Susurluk Drainage Basin (SDB) of NW Turkey. The B and trace element contents of the lake infill seem to be a link between the fresh landforms of the SDB and the lacustrine sediment. Deposition in Lake Ulubat has been 1.60 cm.a-1 for the last 50 a according to radionucleides; however the sedimentation rate over the last millennium was 0.37 cm.a-1 based on 14C dating. The B content of the lacustrine infill displays a slight increase at 0.50 m and a drastic increase at 4 m depth occurring c. 31 a and c. 1070 a ago respectively. Probably the topmost change corresponds to the start of open mining in the SDB and the second one to the natural trenching of borate ore-deposits. These dates also show indirectly a 1.4 cm.a-1 erosion rate during the last millennium as the borate beds were trenched up to 15 m. By extrapolation, it is possible to establish that the formation of some of the present morphological features of the southern Marmara region, especially river incision, began in the late Pleistocene, and developed especially over the last 75 ka

The Effect of Corporate Social Responsibility On the Relationship Between Corporate Reputation and Brand Equity – A Study of GSM Users

Corporate reputation refers to stakeholder perception of a company. All companies desire a strong and favorable reputation as it is an effective means to brand loyalty and a competitive edge. Building a strong reputation requires reputation management, which is often based on sustainability and consistency as well as creating an emotional bond with consumers. This has led many companies to be more involved in the social responsibility initiatives since such initiatives are known to change consumer’s beliefs and attitudes toward brands. From this perspective, the present study aims to investigate the mediating role of corporate social responsibility in the relationship between corporate reputation and brand equity perceptions. The study sample consisted of 324 GSM users in Turkey. The data was collected using survey method and analyzed using SPSS 23.0 statistical package. The results of the study showed that corporate reputation has a positive effect on brand equity and corporate social responsibility plays a mediating role in this relationship