INTRODUCTION: To evaluate reliability and effectiveness of paracetamol therapy in medical closure of patent ductus arteriosus (PDA).
METHODS: A total of 11 preterm infants with hemodynamically significant PDA detected who received oral or intravenous paracetamol therapy as the first line treatment were retrospectively evaluated in this study. One cure of paracetamol therapy was administered as 60 mg/kg/day (4 doses, 3 days). Post-treatment echocardiographic and laboratory findings of the subjects were assessed.
RESULTS: The study included 11 preterm infants with a gestational age of 24-29 weeks. The closure of ductus was achieved following the first cure of treatment in 2 of 3 infants administered oral paracetamol therapy and in 5 of 8 infants given intravenous paracetamol therapy. After two cures of paracetamol therapy, ductus was closed in all infants who received oral or intravenous paracetamol therapy. Re-opening was not detected in either group. No side effect was noted due to paracetamol therapy during the treatment.
DISCUSSION AND CONCLUSION: Oral or intravenous paracetamol therapy which is an inexpensive, easily accessible and effective treatment method with less side effects can be used for medical closure of PDA as the drug of first choise.In order to generalize the conclusions further randomized,controlled trials are warranted.

INTRODUCTION: Epidemiological studies have shown that perimenopausal contraception is an important medical problem because perimenopausal women still need an effective contraception. The aim of the study is to evaluate the contraceptive preferences of Turkish women over 40 years of age.
METHODS: This descriptive and cross-sectional study was conducted between February 2013 and May 2013 at 4 Family Health Centers affiliated with Çanakkale Public Health Directorate. The sample of the study consisted of 386 women who admitted to the Family Health Centers for examination, were married, were aged between 40-49 years, did not go through menopause, and agreed to participate in the study. A questionnaire with questions including socio-demographic characteristics, obstetric and gynecological history, and contraceptive methods of the women was used to collect the data. The data were collected by using the face-to-face interview technique. The Chi-square test, Fisher's exact test and logistic regression analysis were used to perform statistical analyses.
RESULTS: In the study, 58.3% of the women used a modern contraceptive method, 28.7% used a traditional contraceptive method, and 13% did not use any contraceptive method. The most commonly used modern contraceptive methods were IUD (68.8%), tube ligation (5.4%), condom (21.9%) and hormonal method (4%). Women's preferences for the use of modern contraceptive method were positively affected by having a secondary school degree, residing in the city center, and being employed. In addition, having a single child increased the use of modern contraceptive methods by three times.
DISCUSSION AND CONCLUSION: This study revealed that about half of the women over 40 years of age did not use a modern family planning method. By considering the health risks of pregnancy in advanced age, health specialists need to pay more attention to counseling of perimenopausal contraception.

Infantile hemangioma is common benign vascular tumor in early childhood. It typically appears as a small lesion, grows rapidly during the first nine months of life, and resolves over years. Approximately 20% of cases with infantile hemangioma require treatment due to bleeding, ulceration, and obstruction. Propranolol, a beta-blocker, is the first-choice treatment for infantile hemangioma. It must be started as soon as possible to prevent growth and must be used for at least one year to reduce the risk of recurrence of the lesion. Propranolol is an effective and safe treatment, however, it may cause severe side effects such as hypoglycemia and associated convulsion, bradycardia, hypotension, atrioventricular block, and bronchospasm. In this report, we present the clinical features of an 18-month-old female infant with severe hypoglycemia under propranolol therapy for hemangioma.

INTRODUCTION: Tracheostomy is applied for many different indications in children. The most comman indications are prolonged intubation, central hypoventilation, neuromuscular disorders, severe laryngomalacia or tracheomalacia.
METHODS: Our aim was to evaluate the demographic features and follow-up processes of patients with tracheostomy at our clinic. The data of 48 patients were retrospectively reviewed.
RESULTS: Forty eight patients were enrolled, 19 of them were girls, 29 of them were boys. The mean age of the patients was 2.5 ± 1.8 years. The median age of tracheostomy operations was 6 months (25P: 3 months, 75P: 15 months). Tracheostomy indications were prolonged intubation, neuromuscular disorders, upper airway anomalies and trauma, respectively. The most common underlying causes in patients with prolonged intubation were bronchopulmonary dysplasia and congenital heart disease. All patients received mechanical ventilation (MV) support before prosecure, and for 32 patients (66.7%) there were no need for respiratory support at follow up. Twenty-one patients (43.8%) were still tracheostomized and 19 patients (39.6%) were decannulated. Fourteen of twentyone patients who were tracheostomized and 2 of 19 patients who were decannulated were still receiving respiratory support at home during the study period. Two patients (4.2%) were lost during follow up and 6 patients (12.4%) died.
DISCUSSION AND CONCLUSION: Tracheostomy is a voluable prosecure for patients who need prolonged intubation by shortening intensive care stay, allowing the follow up at home in normal life, and low cost. However, successful decanulation as soon as possible, is the final goal of management.

INTRODUCTION: Sleep is a protective function of the human organism. It is known that sleep has an important role especially in the growth and development of children for the repair and protection of tissues. Studies reveal that approximately one quarter of children has sleep problems. This study was conducted to identify sleep problems in children in the 0-3 year age group.
METHODS: The descriptive study was carried out between February–1 and June–30,2015 in Family Health Centers, where families from various socioeconomic levels admitted. The study population consisted mothers having babies at 0-36 months of age and living in regions of the respective FHCs in the study period. The study was carried out with 225 mothers who agreed to participate in the research without any sample group selection. Data were collected by "Information Form" and "Infant Sleep Problems Diagnosis Questionnaire" through face-to-face interview method. The data were assessed using number and percentage distributions, means and standard deviation in a computer environment.
RESULTS: The average age of mothers was 27.99±5.47, and the average age of children was 2.82±1.39 years. It was determined that 39.6%of the mothers was literate and primary school graduate, and 42.2% has one child. The sleeping hours of children aged 0-3 years at night were found as at 22: 00 for 38.7%, at 21: 00 for 27.1% at 23: 00 for 16.4%, at 20: 00 for 9.3% and at 24: 00 for 8.4% respectively. Of the children, 24.9%was found to wake up two times at night, and 24.4% was found to wake up three times; and the mean total sleep time was found as 10.83±3.04 hours.
DISCUSSION AND CONCLUSION: Study showed that sleep problems are very common in 0-3 year old children. Nurses are recommended to try to identify the sleep problems and find out the factors affecting these problems in children; and to provide training and consulting services to mothers regarding the issue is recommended as well.

INTRODUCTION: We aimed to evaluate the prevalence of Helicobacter pylori (H. pylori) infection in asthmatic and healthy children without gastrointestinal complaints and its effect on respiratory function test, asthma severity and control level.
METHODS: From March 2008 to April 2009, 70 asthmatic patients aged 6-14 years without dispeptic complaints were included in the study group; 70 children matching in terms of age, gender and sociodemographic characteristics and without chronic disease, asthma-allergy and dyspepsia symptoms were included in the control group. The asthma grading of patients with asthma were determined according to the Global Initiative for Asthma (GINA) criteria. Respiratory function tests were performed and H. pylori antigen was examined in the stool in all the cases.
RESULTS: The mean age was 115.7 ± 24.7 months. There was no significant difference in H. pylori infection rate between asthmatic and healthy groups (p=0,398). The rates of low socioecononomic level (p = 0,001), living in a crowded family (p = 0.001), living with many children (p = 0.001), community water use (p = 0,001), ulcer in family membres (p=0,043) were higher in children with H. pylori infection. In asthmatic group, 23 patients were mildly intermittent whereas 47 children were mildly persistent; it was also observed that 40 of them were partially controlled and that 30 of them were well-controlled. There was no significant difference in asthma grade, control level, and respiratory function test parameters (PEF and FEV1) in the asthmatic group with and without H. pylori infection. There was no significant difference of H. pylori infection in patients with and without allergic rhinitis.
DISCUSSION AND CONCLUSION: Our study showed that H. pylori infection was not more frequent in patients with asthma and allergic rhinitis, and that it didn’t have any effect on respiratory function test results, asthma severity and control level.

INTRODUCTION: Several factors affecting neurodevelopment in the prenatal period and early stage of life may be related to cognitive, social and behavioral problems that may emerge later. This research was intended to compare a clinical sample diagnosed with attention-deficit hyperactivity disorder (ADHD) with a healthy control group by examining pre- and postnatal characteristics, and to investigate potential differentiating risk factors for ADHD.
METHODS: Sixty-four children and adolescents assessed at the Namık Kemal University Medical Faculty Child and Adolescent Mental Health and Diseases clinic and diagnosed with ADHD based on DSM-V diagnostic criteria were compared with 40 healthy controls in terms of sociodemographic, pre- and postnatal characteristics. A sociodemographic data form, the semi-structured Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) and the Child Behavior Checklist (4-18 years) (CBCL) were used.
RESULTS: No statistically significant differences were determined between the ADHD and healthy control groups in terms of mother’s gestational age, smoking during pregnancy, perinatal complications, hypoxia and incubator care, birth weight, birth length or duration of receipt of mother’s milk. However, significant differences were determined in terms of parental separation, multivitamin use during pregnancy and development of expressive language skills.
DISCUSSION AND CONCLUSION: ADHD is a common disorder with a high socioeconomic burden and is frequently accompanied by comorbid psychiatric diseases. Revelation of environmental etiologial factors will help prevent the emergence of clinical manifestations of ADHD in genetically predisposed individuals.

INTRODUCTION: Our primary aim is to investigate the efficacy of cytology to detect preinvasive and/or invasive cervical pathologies in patients with postcoital bleeding and our secondary aim is to determine the management of postcoital bleeding with severe bleeding, abnormal cytology and normal cytology.
METHODS: Between January 2013 and September 2016, at Zeynep Kamil Women's and Children's Diseases Training and Research Hospital, 317 patients who underwent colposcopy for postcoital bleeding were retrospectively evaluated and divided into 3 groups: without smear due to excessive hemorrhage (Group 1), with normal smear (Group 2) and with abnormal smear (Group 3). Biopsy results were compared between both groups and menopausal status. SPSS 15 was used for statistics. Sensitivity and specificity of pap smear were calculated for preinvasive and invasive pathology.
RESULTS: Menopause rate and age were not different between the groups. In the total patient group, it was observed that the highest rate of invasive cancer were in group without smear due to severe bleeding (group 1), and lowest rate were in group with normal cytology (group 2). The difference was statistically significant between the 3 groups (12.5%, 1.9% and 4%, respectively, p< 0.0001). Similar rates were also found in the premenopausal group (12.8%, 1.8% and 4.5%, respectively, p <0.0001). There was a statistically significant difference for invasive cancer incidence only between group 1-2 (p=0.0034), for pre-invasive/invasive cancer between both group 1-3 (p=0.004) and group 2-3 (p<0.0001). Sensitivity of smear was found to be 0.52 and specificity of smear was found to be 0.94 in detecting preinvasive/invasive cervical pathologies.
DISCUSSION AND CONCLUSION: Colposcopy is unnecessary in patients with postcoital staining-like mild bleeding, without visible lesion and with negative smear. However, colposcopic examination and biopsy are necessary for patients with bleeding during the examination or with abnormal smear results.

INTRODUCTION: The aim of this study was to determine the risk factors associated with the number of parities of grand multiparities
METHODS: Between 2013 and 2018, 139 grandmultipar women with ≥ 7 parities and 160 grandmultipar women with between 5 and 7 parities were included in this study. Two groups were compared in terms of age, gestational week, maternal and fetal outcomes.
RESULTS: Almost all of the grandmultipar women with between 5 and 7 parities (99.4%) were over 35 years old. There were no differences in terms of preeclampsia, EDT, EMR, neonatal intensive care need, fetal weight, low birth weight and macrosomia. However, IUGR and postterm ratios were more frequent in grandmultipar women with between 5 and 7 parities.
DISCUSSION AND CONCLUSION: We believe that grandmultipar women with ≥ 7 parities are associated with similar risks in terms of antepartum and intrapartum complications compared to grandmultipar women with between 5 and 7 parities.

INTRODUCTION: We aimed to compare short tau inversion recovery (STIR) sequences and dynamic magnetic resonance imaging (MRI) in early diagnosis of sacroiliitis and to evaluate the correlation between them and laboratory findings.
METHODS: One hundred thirty-seven patients who admitted to clinic of the Physical Therapy Rehabilitation and Rheumatology in Ankara University Faculty of Medicine between 2011-2015 were included. All of the patients were diagnosed with early sakroiliit. MRI images of all patients were included in the study. Subchondral sclerosis, erosion, periarticular fat accumulation, narrowing of the joint space / ankylosis, bone marrow edema (BME) / osteitis, synovitis, enthesitis, capsulitis symptoms were evaluated about sacroiliitis by MRI of the sacroiliac joint. Sacroiliac joint (SİJ) was separated superior and inferior by the imaginary line which passed through S2 vertebral body. Joint surfaces of SİJ were classified as sacral and iliac. Each SİJ were divided in 4 quadrants; namely total into eight segments bilaterally. CNR values which was calculated in dynamic MRI and STIR sequences were compared. The analysis of data was done in SPSS for Windows 20 programme, p<0.05 was accepted statistically significant.
RESULTS: Total of 137 patients whom 38.7%(n=53) were male and 61.3%(n=84) were female, mean age of 38.47, median age 38 (19-61) were included in our study. Statistically significant differences were detected in comparing signal noise ratio (CNR) values of dynamic MRI and STIR sequences. BME visibility was detected highly in dynamic MRI than STIR sequences (p = 0.003). There was no statistically significant relationship between the sedimentation value and BME (p = 0.288). However, there was a statistically significant association between CRP and BME (p = 0.001).
DISCUSSION AND CONCLUSION: We detected that STIR sequences has almost same success as dynamic MRI in detecting BME but the visibility of BME was found to be the most in dynamic MRI. There was no correlation between sedimentation and BME but there was correlation between CRP and BME.

INTRODUCTION: Colpocleisis is a vaginal obliterative procedure that is performed for the treatment of pelvic organ prolapse (POP), especially in elderly women. To evaluate the anatomical success rate, improvements in POP symptoms and urinary and defaecatory symptoms, and surgical satisfaction and regret of patient 12 months after colpocleisis.
METHODS: Twenty-two females who underwent colpocleisis during 2013–2016 were evaluated retrospectively. Assessment of the pelvic organ prolapse quantification (POP-Q) system and the Pelvic Floor Distress Inventory (PFDI-20) preoperatively and at 1 year after surgery; the Surgical Satisfaction Questionnaire (SSQ-8) that include question related with the regret of surgery was also completed 1 year after surgery.
RESULTS: Significant improvements in the total PFDI-20 score and subscale scores (all p < 0.001) were evident 1 year after colpocleisis; the POP-Q stage of all patients was ≤1, the SSQ-8 total score was 86. There is no regret because of the loss of sexual intercourse.
DISCUSSION AND CONCLUSION: The anatomical and functional outcomes of colpocleisis were satisfactory 12 months after surgery.

GİRİŞ ve AMAÇ: Türkiye’de 1996 yılında kamuda, otobüslerde ve bazı iç mekânlarda sigara içimyasağı başlamış, 2008 yılında yasak kapsamı genişletilmiştir. Kanunun uygulanması sırasında evde sigara içme yüzdesi azalmıştır, ancak evlerde pasif sigara içilmesi hala ülkedeki çocuklar için bir halk sağlığı sorunudur. Bu çalışmada, çocukların evlerde sigara dumanından pasif etkilenimlerini belirlemek amaçlanmıştır.
YÖNTEM ve GEREÇLER: Bu tanımlayıcı çalışma, 11-21.01.2016 tarihleri arasında Antalya Atatürk Devlet Hastanesi Hüseyin Savaş Semt Polikliniğine başvuru yapan 0-11 yaş arası çocuğu olan (n=524) 113 anne-baba üzerinde yapılmıştır. Araştırma verilerinin toplanmasında araştırmacılar tarafından oluşturulan bir form kullanılmıştır.
BULGULAR: Misafirin evde sigara içmek için katılımcıların %17.7’sinin izin istemediği, %23’ünün bazen izin istediği saptanmıştır. Katılımcıların %66.4’ünün izinsiz sigara içen misafiri uyardığı ve %69.9’unun çocuklarının herhangi bir şekilde (bazen, genellikle ve her
zaman) sigara dumanına maruz kaldığı bulunmuştur. Katılımcılar, sigara içilmesi ile ilgili aile kurallarının olduğunu (%66.4) ve evde yaşayan aile bireylerinin evin hemen her mekânında sigara içtiğini bildirmişlerdir. Onların bildirimine göre, evde sigara içen annelerin oranı % 80.0, babaların oranı % 76.5'tir (p <0.001).
TARTIŞMA ve SONUÇ: Ailelerin sigara içme kurallarının olmasına rağmen, evlerde tütüne maruz kalma yüzdesi halen çok yüksektir. Aileler, evlerinde tütün kurallarını gözden geçirmeli ve sağlıklı bakış açıları ile kendi kurallarını geliştirmelidir. Özellikle, sigara içen ailelerinin farkındalığı arttırılmalıdır.

INTRODUCTION: Turkey, the prohibition of smoking was started in governmental places, buses and some indoors in 1996, the coverage of prohibition was extended in 2008. During the implementation of the law, the percentage of smoking at homes have decreased, but passive smoking at homes are still a public health problem for the children in the country. This study is aimed to find out the Passive Influence of Children on Smoking at Home.
METHODS: This descriptive study was carried out on 113 parents between 0-11 years old who applied to Antalya Atatürk State Hospital Hüseyin Savaş Polyclinic (n=524) between 11-21.01.2016. A form created by researchers was used to collect research data.
RESULTS: It has been determined that 17.7% of the participants do not want permission to smoke at home and 23% of them want permission sometimes. It was found that 66,4% of the participants were warning guests without permission and 69,9% of the children were exposed to cigarette smoke in some way (sometimes, usually and always). Participants reported that smoking cessation had family rules (66.4%), and family members living in the home smoked in almost every room of the house. According to their declaration, the percentage of smoker mothers who smoked at homes 80.0% and the percentage for fathers was 76.5% (p<0.001).
DISCUSSION AND CONCLUSION: Even though the families had some smoking rules, the percentage of exposure to tobacco at homes was still so high. The families should review their tobacco rules at homes and they should develop their rules with healthy perspectives. The awareness of the families, especially smoker families should be increased.