Investigation of the effect of Covid 19 outbreak in children and adolescents with type 1 diabetes mellitus using insulin infusion pump on the quality of life in patients and caregivers

YÖK Tez No: 685550İNSÜLİN İNFÜZYON POMPASI KULLANAN TİP 1 DİYABETES MELLİTUSLU ÇOCUK VE ADÖLESANLARDA COVİD 19 SALGINININ HASTA VE BAKIM VERENDE YAŞAM KALİTESİNE ETKİSİNİN ARAŞTIRILMASI Amaç: Bu çalışma insülin infüzyon pompası kullanan Tip 1 Diyabetes Mellitus (DM) tanılı çocuk ve adölesanlarda Covid-19 salgınının hasta ve bakım verende yaşam kalitesine etkisini incelemek amacıyla yapılmıştır. Gereç ve Yöntem: Çalışma, Ocak 2020-Temmuz 2020 tarihleri arasında, Düzce Üniversitesi Tıp Fakültesi Hastanesi Endokrin Bilim Dalı tarafından takip edilen, 6-18 yaş arası, insülin infüzyon pompası kullanan 61 Tip 1 DM tanılı çocuk ve adölesanların katılımı ile yapılmıştır. Çocuk ve adölesanlar için Kindl Yaşam Kalitesi Ölçeği, erişkinler için Dünya Sağlık Örgütü Yaşam Kalite Ölçeği kullanılmıştır. Çocukların uyku kalitesi, Kindl Yaşam Kalitesi anketinin sonuna uyku kalitesini ölçmeye yönelik bir soru eklenerek değerlendirilmiştir. Hastalara ait sosyo-demografik bilgiler ise hastane bilgi kayıt sisteminden alınmıştır. Bulgular: Çalışmaya alınan hastalardan 38'i (%62,3) kız, 35'i (%57,4) adölesan olup 29'u (%47,5) ortaokulda öğrenim görmektedir. Hastaların yaş ortalamaları 12,7 ±2,9 yıl, diyabet sürelerinin ortalaması 6,3±2,5 yıl, pompa kullanım sürelerinin ortalaması 3,2±1,8 yıldır. Hastalardan 56'sı (%91,8) ailesi ile birlikte yaşamakta, 61 (%100) hastanın tamamının annesi ve babası sağ, gelir düzeyi orta düzeyde, 38'inin (%62,3) ailesinin gelir kaynağı baba, 45'inin (%73,8) ailesinde kronik hastalık bulunmamaktadır. Hastaların ve bakım verenlerin pandemi öncesi ve pandemi süreci uyku durumlarında istatistiksel olarak anlamlı farklılık bulunmamıştır (p>0,05). Hastaların HbA1C düzeylerinde pandemi öncesi (8,8±1,2) ve pandemi süreci (7,9±1,1) arasında istatistiksel olarak anlamlı farklılık bulunmuştur (p0.05). A statistically significant difference was found in the HbA1C levels of the patients before and during the pandemic process (p<0.05). In the correlation analysis conducted to determine the relationship between the patients' KINDL quality of life and the caregivers', it was noticed that Children's quality of life subscales were positively correlated with their parents' quality of life both before and during the pandemic process. Conclusion: Diabetes Mellitus reduces the quality of life of children and families. Furthermore, the addition of acute epidemics like Covid-19 on diabetes affected the quality of life more adversely. Providing psychological support to individuals during pandemic and in the process of chronic diseases, delivering adequate and high-quality preventive health services, offering the necessary training for diabetes and increasing their sociocultural level improves their quality of life

A Rare Cause of Acute Renal Failure and Thrombocytopenia in Child: A Case Due to Hantavirus Infection

On yedi yaşında erkek hasta 3 gündür devam eden ateş, halsizlik ve baş ağrısı şikayeti ile aile hekimliğine başvurmuş ve yapılan tetkiklerinde trombositopeni tespit edilmesi üzerine tarafımıza yönlendirilmiş. Hastanemize başvurduğunda orofarinkste hiperemi, 39C ateş, belirgin halsizlik, trombositopeni ve böbrek yetmezliği olduğu görüldü. Hastanın periferik kan yaymasında atipik hücre görülmedi. Hastadan parvovirüs, sitomegalovirüs (CMV), Epstein-Barr virüs (EBV), hepatit belirteçleri, brusella aglütinasyon ve Gruber Widal testleri istenildi ve sonuçlar negatif saptandı. Hastadan alınan ayrıntılı anamnezde ölmüş fareleri yaktığı öğrenildi. Hantavirüsün serolojik tetkikinde hem indirekt immünfluoresan assay (IFA) hem de Biot Analysis’de IgG ve IgM antikorları pozitif saptandı. Hastada kanamalı ateş ile seyreden akut renal sendroma yol açan hantavirüs enfeksiyonu düşünüldü ve sadece semptomatik tedavi uygulandı.Seventeen years old yo male patient had applied to the primary care center for his complaints; fever, malaise and headache, and was he was investigated for causes thrombocytopenia of after thrombocytopenia had been detected in the workup. He had hyperaemia in oropharynx, 39C fever, noticaable malaise, thrombocytopenia and renal failure at admittance to our clinic. No atypic cell was seen in peripheral blood smear of the patient. Laboratory tests for parvovirus, cytomegalovirus (CMV), Epstein-Barr virus (EBV), brucella agglutination and gruber widal test and markers for hepatitis were examined and the results were neg-ative. A detailed patient history showed that we had informed that the patient had burned dead mice bodies. Serolohical investigation showed that IgG and IgM antibodies were positive in both Biot Analysis and in-direct immunofluorescence assay (IFA). We observed a hantavirus infec-tion causing haemorrhagic fever with renal syndrome (HFRS) and corre-spondingly applied symptomatic treatment

ALL’s rare form of admission; Diabetes Mellitus

Akut lenfoblastik lösemi kemik iliği öncü hücrelerinin kontrolsüz biçimde çoğalmaları sonucu kemik iliği hücrelerinin vücuda yayılmasıyla oluşan malign seyirli bir hastalıktır, çocukluk çağında en sık görülen malignitedir. Bulgu ve semptomları çok farklı olabilmektedir. Bu makalede diyabet ön tanısıyla tarafımıza yönlendirilen tetkik ve takiplerinde ALL tanısı konulan olgu sunularak nadir olsa da ALL’nin diyabet semptomlarıyla bulgu verebileceği vurgulanmak istenmiştir.Acute lymphoblastic leukemia is a most common type of cancer and leukemia in children characterized by proliferation of bone marrow precursor cells in the uncontrolled form.Clinical presentation can be with various signs and symptoms. In this article, we wanted to report a child had consulted our hospital with preliminary diagnosis of diabetes mellitus who diagnosed with ALL by advanced medical research in our hospital to emphasize that ALL infrequently can be presented with symptoms of diabetes mellitus

Çocuklarda nadir akut böbrek yetmezliği ve trombositopeni nedeni: Hantavirüs enfeksiyonu olgusu

17 years old male patient had applied to the primary care center for his complaints; fever, malaise and headache, and was he was investigated for causes thrombocytopenia of after thrombocytopenia had been detected in the workup. He had hyperaemia in oropharynx, 39°C fever, noti-caable malaise, thrombocytopenia and renal failure at admittance to our clinic. No atypic cell was seen in peripheral blood smear of the patient. Laboratory tests for parvovirus, cytomegalovirus (CMV), Epstein-Barr virus (EBV), brucella agglutination and gruber widal test and markers for hepatitis were examined and the results were negative. A detailed patient history showed that we had informed that the patient had burned dead mice bodies. Serolohical investigation showed that IgG and IgM antibodies were positive in both Biot Analysis and indirect immunofluo-rescence assay (IFA).We observed a hantavirus infection causing haem-orrhagic fever with renal syndrome (HFRS) and correspondingly applied symptomatic treatment. © 2018 by Pediatric

A Case of Choroid Plexus Papilloma with Rare Location Presenting with Impaired Consciousness

Naldemir, Ibrahim Feyyaz/0000-0002-0804-7378; kilicaslan, onder/0000-0002-9311-006XWOS: 000499969200016Intraventricular papillary neoplasms originating from the choroid plexus epithelium are called choroid plexus tumors (CPT). In pediatric patients. The most common findings in CPT are seizures, subarachnoid hemorrhage, focal neurological deficits, hydrocephalus and symptoms of increased intracranial pressure. A 4.5-month-old, previously healthy girl was admitted to our Pediatric Emergency Department with complaints of inadequate nutrition, vomiting and drowsiness in the last 2 days. The patient was admitted to the pediatric intensive care unit and saline loading treatment was initiated due to presumed dehydration caused by inadequate nutrition. As dehydration-related pathology was not detected, brain tomography scan was performed for possible cranial pathology and it revealed increased bilateral lateral ventricular diameters. As a result of magnetic resonance imaging results, the patient was diagnosed as having choroid plexus papilloma. After the shunt was inserted, the patient regained consciousness and an elective surgery was planned. Inadequate nutrition and drowsiness are the most common causes of admissions to pediatric emergency department, and these symptoms are usually due to dehydration. Cranial pathologies should be considered in patients who do not respond to fluid loading treatments and whose laboratory findings and vital signs are stable. As in our patient, the patients with choroid plexus papilloma should be evaluated clinically and shunt surgery should be performed firstly. Timing of surgery should be decided according to the effect and clinical status

Transmission dynamics and timing of key events for SARS-CoV-2 infection in healthcare workers

Backgroun