Assessment of Voiding Dysfunction and Nocturnal Enuresis Rates in Primary School Children in an Anatolian City with a Validated Dysfunctional Voiding Scoring System Questionnaire

Objective:To investigate the prevalence of voiding dysfunction (VD) and nocturnal enuresis (NE) in Turkish primary school children using a previously validated Dysfunctional Voiding Scoring System (DVSS) questionnaire and a self-administered questionnaire.Materials and Methods:The previously validated DVSS questionnaire was completed by the parents of 3015 randomly selected children. Another questionnaire was also administered for studying VD and NE rates, demographic characteristics, and learning or behavioral problems of children.Results:Of all children, 6.6% (n=199) had a score suggesting VD and 6.1% (n=185) had NE. No significant differences were found between children with and without VD in terms of age, gender, and fluid intake. Children with VD had significantly high rates of constipation (19.7% vs 5.2%; p<0.001) and fecal soiling (32.1% vs 5.1%; p<0.01) compared with children without VD. Children with a higher DVSS score had more frequent behavioral or psychological problems (20.7% vs 4.7%; p<0.01) and learning disabilities (14.7% vs 5.5%; p<0.01). VD had no correlation with overall maternal education level and the type of school (government or private).Conclusion:VD and NE are highly frequent in early childhood and positively correlated with children’s learning disabilities and psychological problems

Single-center experience with routine clinical use of 3D technologies in surgical planning for pediatric patients with complex congenital heart disease

PURPOSEThis study was planned to assess the application of three-dimensional (3D) cardiac modeling in preoperative evaluation for complex congenital heart surgeries.METHODSFrom July 2015 to September 2019, 18 children diagnosed with complex congenital heart diseases (CHDs) were enrolled in this study (double outlet right ventricle in nine patients, complex types of transposition of the great arteries in six patients, congenitally corrected transposition of the great arteries in two patients, and univentricular heart in one patient). The patients’ age ranged from 7 months to 19 years (median age, 14 months). Before the operation, 3D patient-specific cardiac models were created based on computed tomography (CT) data. Using each patient’s data, a virtual computer model (3D mesh) and stereolithographic (SLA) file that would be printed as a 3D model were generated. These 3D cardiac models were used to gather additional data about cardiac anatomy for presurgical decision-making.RESULTSAll 18 patients successfully underwent surgeries, and there were no mortalities. The 3D patient-specific cardiac models led to a change from the initial surgical plans in 6 of 18 cases (33%), and biventricular repair was considered feasible. Moreover, the models helped to modify the planned biventricular repair in five cases, for left ventricular outflow tract obstruction removal and ventricular septal defect enlargement. 3D cardiac models enable pediatric cardiologists to better understand the spatial relationships between the ventricular septal defect and great vessels, and they help surgeons identify risk structures more clearly for detailed planning of surgery. There was a strong correlation between the models of the patients and the anatomy encountered during the operation.CONCLUSION3D cardiac models accurately reveal the patient’s anatomy in detail and are therefore beneficial for planning surgery in patients with complex intracardiac anatomy

A Survey Study on Evaluation and Management of Nocturnal Enuresis in Pediatricians and Family Physicians

Objective:Nocturnal enuresis (NE) is one of the most common disorders in pediatric urology, and patients often turn to family physicians (FP) and pediatricians (P) initially. The aim of this study was to understand the awareness, self-confidence and suggestions of physicians regarding the management of NE.Materials and Methods:In this study, 360 FP and family medicine residents (FMR), as well as 280 P and pediatrics residents (PR), were contacted through a cellular phone texting system. A simple multiple-choice questionnaire (Surveymonkey®) consisting of 10 questions was used to gather data. The survey included questions about their experience, training, evaluation, and management of NE.Results:A total of 119 FPs and Ps (18.5%) filled the questionnaire. Thirty (25.21%) of the participants were P, 27 (22.69%) PR, 3 (2.52%) FP and 59 (49.58%) FMR. The rate of physicians who encounter at least 5 children with NE per month is 31.33%. The mean self-confidence in the management of NE was 4.5 out of 10. The self-confidence of pediatricians was significantly higher than that of PR and FMR (p<0.001, p<0.001). Most (n=78, 65.55%) of the participants stated that they received training on EN during medical faculty and 62 (52.10%) during residency. Psychological problems (89.92%), sleep disorders (78.15%), and excessive fluid intake (75.63%) were the most frequently considered factors in etiology. While most responders (75.63%) considered dietary regulation and behavioral interventions as the first-line treatment, 25.21% consult a pediatric urologist and only 1.6% recommend medical treatment.Conclusion:Although FP and P admit they had training on NE, they mostly felt incompetent to manage NE and exclusively avoided pharmacological treatment

Treatment of depression in an adolescent with cardiomyopathy and arrhythmia

WOS: 000361384800036PubMed ID: 25400066Patients with cardiomyopathy have a higher incidence of mood and anxiety disorders, resulting in greater probability for hospitalisation and increased risk for arrhythmia and death. We report a case of a 16-year-old boy with Danon disease, Wolff-Parkinson-White syndrome, and hypertrophic cardiomyopathy, who later developed depression and significant weight loss. The patient was successfully treated for his anxiety and depression with mirtazapine without any adverse cardiac effects

Türkiye ve Gürcistan arasındaki HVDC back to back enterkonneksiyonuna ilişkin koruma sisteminin tasarımı ve bağlantı fonksiyonlarının geliştirilmesi.

HVDC Back-to-Back interconnection between Turkey and Georgia is operational since November 2013. Previous feasibility analysis regarding to this project has shown that depending on the amount of power transfer between parties and loading conditions, there might be transmission bottlenecks and problems observed in Turkish Power System. In this respect, special protection coordination is required to maintain reliable and sustainable operation. In this thesis, design of a special protection scheme that coordinates outages in the region along with some countermeasures is introduced. The design study starts with analyzing critical scenarios and instabilities endangering the normal operation of Turkish Power System in order to define requirements of the special protection scheme. In this regard, static and dynamic analyses are carried out to identify instability patterns and solution spaces for critical instability conditions. The results have shown that regional system is highly vulnerable to the contingencies and may face regional collapse even without interconnection. Hence, several scenarios and several loading conditions have been analyzed in detail in order to give insight to special protection logic design and calculate countermeasures required for critical instability conditions. As a result of these studies, requirements for stable and sustainable operation of the region are specifically determined and a wide area measurement based special protection scheme is designed. In addition, modelling of the designed scheme in a power system simulation environment and simulation results of the proposed scheme are presented. Finally, coordination and compliance between existing protection measures with the proposed protection scheme are also investigated.M.S. - Master of Scienc