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Öğe Chitotriosidase Levels in the Colostrum from Mothers of Term and Preterm Infants(MARY ANN LIEBERT, INC, not defined) Korgali, Elif Unver; Dogan, Halef OkanBackground: Breast milk Chitotriosidase (Chit 1) shows antifungal effect and has an active role in the natural immune response against certain pathogens. The aim of this study was to compare colostrum Chit 1 levels from mothers of term and preterm infants. Materials and Methods: The study included 72 mothers of 32 preterm and 40 term infants (gestational age; 33.7 +/- 1.8 vs. 39.1 +/- 1.1 weeks, birth weight; 1931.7 +/- 539.8 vs. 3350.9 +/- 419.7 g). Breast milk samples were taken at postnatal 24-48 hours. Chit 1 level was evaluated with the quantitative calorimetric method. Results: No significant difference was determined between the term and preterm groups in terms of maternal age, education level, weight gain in pregnancy, and body mass index (BMI). The median colostrum Chit 1 level was higher in the preterm group, but the difference was not statistically significant between two groups (p = 0.43). There is no association between colostrum Chit 1 level, maternal age, gravida, BMI, infant gender, income level, and pre-eclampsia. The colostrum Chit 1 level of mothers who had weight gain exceeding the recommended limits was significantly lower than mothers with weight gain within the recommended limits in the term group (4346.2 vs. 4914.2, p = 0.021). A negative correlation was determined between the birthweight of term infants and the colostrum Chit 1 levels (p = 0.045, r = -0.319). Conclusion: Although the data need to be validated by further investigation, the observations made in this study seem to indicate that colostrum Chit-1 may have role in the protection of preterm infants.Öğe Hypernatremic Dehydration in Breastfed Term Infants: Retrospective Evaluation of 159 Cases(MARY ANN LIEBERT, INC, 2017) Korgali, Elif Unver; Cihan, Meric Kaymak; Oguzalp, Tahir; Sahinbas, Ali; Ekici, MahmutObjectives: The aim of this study was to reveal the frequency, presenting complaints, risk factors, complications, and ways for prevention of hypernatremic dehydration (HD) among term breastfed infants. Methods: The files of 159 breastfed term infants hospitalized because of HD between the years 2009 and 2014 were examined retrospectively in the Neonatal Intensive Care Unit of Sivas State Hospital, Turkey. The patients were classified according to serum sodium (Na) levels, group 1 (Na: 146-149 mEq/L, n = 68) and group 2 (Na >= 150 mEq/L, n = 91). Results: The most common complaint was fever (67.9%), and the most common physical finding was oral mucosal dryness (76%). There were positive correlations between serum Na levels and weight loss, hospital stay, admission age, admission to neonatal unit after discharge, serum urea levels, and body temperature (p < 0.05). The normalization period of Na levels was significantly longer (21.7 +/- 8.8 versus 29.3 +/- 17.8 hours, p = 0.03), and Na reduction rate was faster in group 2 (0.41 +/- 0.3 versus 0.50 +/- 0.3 mEq/L/hour, p = 0.02). Bradycardia was seen more commonly in group 2 (1.5% versus 16.5%, p = 0.002). Conclusions: HD is a significant condition that should be treated appropriately to avoid serious complications.Öğe The Impact of Transfusion and Chelation on Oxidative Stress in Immigrant Syrian Children with beta-Thalassemia(SPRINGER INDIA, 2017) Cihan, Meric Kaymak; Belen, Burcu; Bolat, Fatih; Bulbul, Ozlem Gumustekin; Korgali, Elif Unver; Kocak, UlkerIron overload in beta-thalassemia major and intermedia patients leads to oxidative stress and causes to formation of lipid hydroperoxides. Thiobarbituric acid reactive substances (TBARS) are a well established method for screening and monitoring of lipid peroxidation. We aimed to investigate serum TBARS and its relationship with biochemical and hematologic parameters of Turkish and immigrant Syrian beta-thalassemia children reflecting the effects of this socioeconomic condition on follow up of these patients. Lipid peroxidation products (TBARS) of Turkish (TR) (n = 62, from the cities of Gaziantep and Sivas, Turkey) and Syrian (SYR) (n = 34, from Gaziantep, Turkey) beta-thalassemia patients aged 2-17 years and 58 healthy subjects aged 2-16 years were studied. Liver and renal function tests, serum ferritin levels, white blood cell, absolute neutrophil and platelet counts, hemoglobin (Hb) levels of the patients were analyzed. Serum TBARS concentrations were found to be elevated in beta-thalassemia patients compared to healthy subjects (mean: 12.47 +/- 8.53 vs. 9.78 +/- 7.09, p = 0.045). In SYR patients mean pretransfusional Hb level (7.26.2.04 vs. 8.49 +/- 1.01, p = 0.002) was lower and ferritin levels (5983.56 +/- 5065.56 vs. 3234.60 +/- 2237.82, p = 0.001), liver enzymes (ALT: 77.82 +/- 76.48 vs. 42.13 +/- 51.50, p = 0.005) were higher when compared to TR group. Positive correlation between TBARS and ferritin levels (p = 0.029, r = 0.231) and liver enzymes (for ALT p < 0.001, r = 0.373) was observed. beta-thalassemia patients are under more oxidative stress than healthy subjects. Liver is one of the major organs which are mainly affected by oxidative stress. War and migration might have caused inappropriate transfusion conditions and insufficient chelation therapy in the SYR group.Öğe Is there an association between vitamin D level and iron deficiency in children?(SOC ARGENTINA PEDIATRIA, 2018) Cihan, Meric Kaymak; Korgali, Elif UnverIntroduction. Vitamin D (VitD) affects the erythropoiesis. The aim of this study was to evaluate the association between maternal/child 25-OH VitD (25-OHD) levels and iron deficiency (ID) and anemia (IDA) in children aged 6 months-5 years. Population and methods. Between September 2014 and January 2016 children who were admitted to outpatient clinic were included to study. We excluded the children with acute or chronic infection, malnutrition, chronic disease and preterm birth history. Complete blood count, serum iron, total iron binding capacity, ferritin, 25-OHD levels were examined from children and their mothers. Iron and VitD supplementation during infancy and pregnancy and breastfeeding history were questioned. Results. The study included totally 117 children. There were 67 children with ID/IDA [Group 1, mean age (years): 2.05 +/- 1.24 (0.5-5)] and 50 normal children [Group 2, mean age (years): 1.87 +/- 1.12 (0.58-5)]. There were more VitD deficient children and mothers in Group 1 than in Group 2 (respectively, children 49.3 % vs. 20 % p=0.002; mothers 94 % vs. 64 %, p=<0.001). There was a positive correlation between hemoglobin levels of children and maternal/child 25-OHD. The independent risk factors for IDA in children were longer exclusively breastfeeding time (odds ratio [OR], 0.35; 95 % confidence interval [CI], 0.155-0.789; p=0.011), shorter duration of regular iron supplementation during infancy and pregnancy (infancy: OR, 1.69; 95 % CI 1.148-2.508; p=0.008. pregnancy: OR, 1.39; 95 % CI, 1.070-1.820; p=0.014) and lower maternal 25-OHD level (OR, 1.16; 95 % CI, 1.034-1.292; p=0.011). Conclusions. Maternal/child VitD deficiency is associated with ID/IDA in children aged 6 months-5 years.Öğe Megacystis Microcolon Intestinal Hypoperistalsis Syndrome in Which a Different De Novo Actg2 Mutation was Detected: A Case Report(TAYLOR & FRANCIS INC, 2018) Korgali, Elif Unver; Yavuz, Amine; Simsek, Cemile Ece Caglar; Guney, Cengiz; Kurtulgan, Hande Kucuk; Baser, Burak; Atalar, Mehmet Haydar; Ozer, Hatice; Egilmez, Hatice ReyhanIntroduction: Megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS) is characterized by bladder distension without urinary tract obstruction, decreased or absent intestinal peristalsis and microcolon. Although the definitive cause remains unknown, changes in the ACTG2 gene are thought to be responsible for the intestinal and bladder hypoperistalsis. Case report. This female newborn with MMIHS had a c.532C > A /p.Arg178Ser heterozygous de novo mutation detected in the ACTG2 gene. Normal immature ganglion cells, normal calretinin punctate positivity, maintence of smooth muscle actin immunoreactivity, and decreased numbers of interstitial cells of Cajal(ICCs) were detected. Conclusion: This previously unreported c.532C >A /p.Arg178Ser heterozygous de novo mutation in the ACTG2 gene may lead to a severe form of MMIHS.Öğe Mortality in patients with hypoxic ischemic encephalopathy treated with therapeutic hypothermia(Cukurova Univ, Fac Medicine, 2025) Tunc, Gaffari; Korgali, Elif Unver; Mutlu, Muhammet Ali; Unsal, Gulsah; Gulturk, Esra AkaydinPurpose: Hypoxic-ischemic encephalopathy is a heterogeneous clinical syndrome that occurs in the perinatal period and is characterized by altered consciousness or seizures, respiratory depression, and hypotension. The aim of this study was to evaluate mortality in hypoxic-ischemic encephalopathy patients receiving therapeutic hypothermia. Materials and Methods: The study included 97 hypoxicUnit. The cases were evaluated for mortality and were divided into two groups: group 1 (n: 9, non-survivors) and complications of hypoxic-ischemic encephalopathy, APGAR scores, blood support, and laboratory parameters were evaluated for mortality. the risk of death. Conclusion: Mortality rates were significantly higher cases that developed Meconium aspiration syndrome associated hypoxic-ischemic encephalopathy than hypoxic-ischemic encephalopathy cases without meconium aspiration syndrome. A low APGAR score, increased number of intubation days, acute kidney injury, thrombocytopenia, and need for fresh frozen plasma were associated with a high risk of mortality in infants receiving therapeutic hypothermia for hypoxic-ischemic encephalopathy, and the presence of meconium aspiration syndrome significantly increased this risk.Öğe Serum Bcl-2, caspase-9 and soluble FasL levels as perinatal markers in late preterm pregnancies with intrauterine growth restriction(Turkish J Pediatrics, 2019) Genc, Serife Ozlem; Karakus, Savas; Cetin, Ali; Cetin, Meral; Dogan, Halef Okan; Korgali, Elif UnverIntrauterine growth restriction (IUGR) is the inability of the fetus to grow and develop in the expected pattern. It occurs in about 5% of pregnancies and is associated with severe fetal mortality and morbidity. Affected infants are also highly vulnerable to diseases such as perinatal asphyxia, cerebral palsy, meconium aspiration syndrome, coagulation disorders, and immune system disorders that require long-term treatment. Apoptosis is thought to play a key role in the etiopathogenesis of IUGR. In conclusion, fetal complications are thought to be related to the severity of apoptosis in pregnancies complicated with IUGR. The aim of the study was to test the measurability of the severity of apoptosis using Bcl-2, caspase-9, soluble Fas ligand (sFasL) markers and the maternal blood sample in addition to the diagnostic methods commonly used to diagnose IUGR; and to decrease the rates of adverse perinatal outcomes due to IUGR and to evaluate the fetal well-being status without feeling a need for invasive procedures. One hundred and fifty-nine late preterm pregnancies were included in the study. Eighty were diagnosed with IUGR and the others were the control group. During delivery, maternal and umbilical cord blood samples were taken. Bcl-2, caspase-9, sFasL marker levels in maternal and umbilical cord sera were determined using ELISA method. Bcl-2 levels were found to be significantly high in the maternal and umbilical cord sera in the IUGR group. There was also no significant difference between umbilical cord sera of the two groups in terms of sFasL and caspase-9 levels. The results suggest that maternal serum Bcl-2 levels may also be helpful in the diagnosis of IUGR when used besides the ultrasonographic findings. Multicenter studies with large patient groups will increase knowledge in this area.Öğe A Severe Congenital Neutropenia Type 4 Case (G6PC3 Mutation) Presented With Large Platelets in the Peripheral Smear(LIPPINCOTT WILLIAMS & WILKINS, 2016) Cihan, Meric Kaymak; Bolat, Fatih; Onay, Huseyin; Sari, Ahmet; Korgali, Elif Unver; Aslan, Sukran; Cura, Ceylan; Icagasioglu, DilaraSevere congenital neutropenia type 4 is a disorder of the hematopoietic system associated with mutations in the glucose-6-phosphatase catabolic 3 (G6PC3) gene. This disorder is characterized by neutropenia, congenital heart defects, urogenital malformations, and prominent superficial veins. To our knowledge, although intermittent thrombocytopenia is observed in this mutation, the coexistence of large thrombocytes is rarely seen. Here we present a case of severe congenital neutropenia type 4 with G6PC3 mutation and large platelets in the peripheral smear.Öğe The levels of postpartum depression, anxiety, and hopelessness of the mothers of infants receiving therapeutic hypothermia in NICU(Routledge Journals, Taylor & Francis Ltd, 2023) Korgali, Elif Unver; Tunc, GaffariThe aim of this study was to evaluate anxiety, postpartum depression (PPD), and hopelessness in the mothers of newborns receiving therapeutic hypothermia for hypoxic ischemic encephalopathy (HIE) in NICU. A total of 104 mothers and infants were analyzed as a study group with HIE (n = 52) and a control groups of non-HIE (n = 52). All the mothers completed The State-Trait Anxiety, Beck Hopelessness and Edinburgh Postpartum Depression Scales (EPDS). The EPDS scores, the rate of PPD, state-trait anxiety and hopelessness levels were similar in the two groups. In the HIE group, chest compression and persistent pulmonary hypertension in infants were associated with maternal anxiety, hopelessness, and PPD. The absence of a statistical difference between the two groups in the current study does not mean that these differences do not exist. These results demonstrate the need for further detailed studies on this subject.Öğe The relationship between the perception of breast milk of parents with term infants and exclusive breastfeeding in the postnatal first six months(Aves, 2021) Donmez, Amine Yavuz; Korgali, Elif UnverObjective: Breast milk is the ideal food that meets all kinds of nutritional contents of babies. The World Health Organization recommends that all babies be fed exclusively breastfeeding for the first 6 months. This study aimed to evaluate the relationship between the perception of breast milk of mothers and fathers with term babies and exclusively breastfeeding status in the first 6 months and to investigate the factors affecting exclusively breastfeeding status. Material and Methods: Our longitudinal type study includes healthy/term infants and their parents born between 1 July-30 September 2018. In the postpartum period adult's perception level of breast milk scale was completed by the parents. The nutritional properties of the babies were recorded by reaching the families by phone when they were 2, 4, and 6 months old. Of the 341 families that participated in the study, 332 were evaluated and the study was completed with 304, 297, and 292 families at the 2nd, 4th, and 6th months, respectively. Results: Exclusively breastfeeding ratio was 85.5%, 68%, and 50% in the 2nd, 4th, and 6th months, respectively. The mean score of the mothers on perception level of milk scale was significantly higher than the fathers (133.97 +/- 10.01 vs 123.91 +/- 13.41, p<0.001, respectively). The scale score of the mothers receiving breastfeeding training was significantly higher than the mothers without training (135.19 +/- 8.55 vs 130.91 +/- 12.25, respectively, p=0.008). The mode of delivery is related to the level of perception of breast milk of mothers and fathers. Mothers who had the last cesarean section had lower scale scores than those who delivered normally (131.71 +/- 12.11 vs 134.94 +/- 8.80, respectively, p=0.007). In the fathers whose spouse had a cesarean section, the scale scores were significantly higher than those whose spouses had normal delivery (126.42 +/- 12.73 vs 122.83 +/- 13.57, p=0.026, respectively). There was no correlation between exclusively breastfeeding status and breastmilk perception levels of the parents in the first 6 months. The mother's breastfeeding her previous child for >= 6 months and the use of pacifier/baby bottle were associated with exclusively breastfeeding status in the first 6 months. Conclusion: Fathers should be included in breastmilk and breastfeeding training.
