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Drug-induced gingival enlargement is proportional to the inflammation caused by poor oral hygiene. In this case report, gingival enlargement due to the use of the antihypertensive drug amlodipine, which is a Ca channel blocker derivative, is presented. In the anamnesis taken from a 56-year-old female patient who applied to Ankara University Faculty of Dentistry Periodontology Department with complaints of swollen and bleeding gingival enlargements, pain and discomfort when chewing, it was learned that she had been using 10 mg amlodipine (Norvasc®, Pfizer, USA) daily for 6 years due to hypertension. During clinical examination, it was determined that the patient had poor oral hygiene and the presence of gingival growths. In the patient's treatment, the hypertension medication was first changed to an alternative with cardiology consultation. The patient underwent scaling, root planing and oral hygiene training. Growth regression was observed at the patient's 1st, 3rd and 6th month follow-up visits. Following medication change and non-surgical periodontal treatment, at the 1-year followup, the gingival growths had completely regressed, no bleeding was detected on probing, and plaque control was achieved. The patient gained oral hygiene habits and left satisfied. In cases of gingival enlargement due to amlodipine use, drug replacement, scaling, root planing, plaque control, oral hygiene motivation and regular patient follow-up play a key role in the treatment of these diseases. [ABSTRACT FROM AUTHOR]

Objective: Patients with benign prostatic hypertrophy (BPH) are treated with transurethral resection of the prostate (TURP). The passage of irrigation fluid into the systemic circulation can cause hypervolemia, hyponatremia and due to them TURP syndrome with restlessness, confusion, dyspnea, arrhythmia and seizures. The most important point is early diagnosis. Our aim was to reveal the statistical relationship between serum sodium (Na) values and the pleth variability index (PVI) in patients who underwent TURP. Methods: Thirty-three ASA I-III and 40-80 years old patients who underwent TURP under spinal anesthesia were included in the study. The patients were taken to the operating room and standard monitoring was applied. Venous blood samples were taken from the peripheral vascular access before and after the procedure, and Na values were determined; PVI values were recorded at 5-minute intervals from the preoperative period to the postoperative period by performing PVI monitoring. Results: The PVI data correlated with postoperative osmolarity, postoperative Na concentration, resection time and irrigation amount as an early predictor of hypervolemia and seconder hyponatremia. Conclusion: We think that more comprehensive case studies are needed in terms of the usability of PVI, which is a noninvasive method compared to blood gas sampling, an invasive method for the diagnosis of hypervolemia and hyponatremia, and that continuous monitoring and follow-up provide an advantage in early diagnosis. [ABSTRACT FROM AUTHOR]

Objective: Breath-holding spells (BHS) are common paroxysmal events in earlychildhood with unknown pathophysiology. Hypoxia can be the cause or result of BHS and the damage caused by hypoxia is of paramount importance. Therefore, exposure to hypoxia should be minimized in children with BHS. The present study, for the first time in the literature, investigated the staging of palatinetonsil and soft palate hypertrophy in children with BHS and their relationship with BHS. Material and Methods: The retrospective study included 45 children with BHS with no iron deficiency and no complaints of frequent infections and had been followed up for a minimum of one year over between 2012 and 2016. A control group of 45 age-matched subjects. BHS was diagnosed based on patient history, clinical observations, and video records. Duration of spell, spell type, and the staging of palatinetonsil and soft palate hypertrophy were compared among the patients and with the control subjects in terms of age groups and genders. Results: Mean age was 28.9±12.9 (range, 8-56) months in the BHS group. In the same group, the patients had stage 1-2 palatinetonsil hypertrophy (total 81.8%) and stage 2-3 soft palate hypertrophy (78.9%) and a significant difference was found between the BHS and control groups (p=0.000). In patients with cyanotic BHS, tonsillar hypertrophy was grade 2-3 and a positive correlation was found between cyanotic BHS and tonsillar hypertrophy (r: 0.315, p=0.032). Mean duration of spell was 3.5±1.3 minand tonsillar hypertrophy established a stronger correlation with spell duration and soft palatinetonsil hypertrophy (r: 0.459, p=0.000;r: 0.734, p=0.000, respectively). Conclusion: The results indicated that the BHS patients with no iron deficiency and no complaints of frequent infections had greater palatinetonsil hypertrophy and a higher stage of soft palate hypertrophy compared to control subjects. We suggest that the presence of a high-stage soft palate hypertrophy increases the risk of developing BHS and the duration of spell by 1.5 times and thus requires early intervention and clinical follow-up. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the clinical, and laboratory factors that may effect the left ventricular mass index in children with stage predialysis chronic renal disease. Method: Children with predialysis chronic renal disease consisted the study group. The weight, height, renal diagnosis and follow-up duration were retrieved from medical records. Instantaneous and ambulatory blood pressure measurements were performed. Laboratory tests were performed. The left ventricular mass index was calculated based on the echocardiographic measurements. Frequency of hypertension was calculated, and the correlation between the clinical and laboratory parameters and the left ventricular mass index was investigated. Results: Mean left ventricular mass index was 48.8±12.74 g/m2.7, and left ventricular hypertrophy was detected in 16 (76.1%) patients. Hypertension was detected in 5 (23.8%) patients by instantaneous measurements. However, ambulatory measurements showed systolic and diastolic hypertension in 6 (28.6%) and only diastolic hypertension in 2 (9.5%) patients. A positive and significant correlation was detected between left ventricular mass index and relative body mass index, mean night diastolic blood pressure, night diastolic load and cholesterol level (p<0.05). Also a negative significant correlation between albumin and hemoglobin was detected (p<0.05). Conclusion: The results of our study indicate that in predialysis children; ambulatory blood pressure measurement is superior to instantaneous measurements in prediction of left ventricular hypertrophy, and the left ventricular mass index significantly correlates with hemoglobin, cholesterol and albumin levels in addition to blood pressure parameters. [ABSTRACT FROM AUTHOR]

Background: In this study, it was aimed to evaluate the correlation of ultrasonography (USG) parameters (pyloric muscle sizes) with age in term infants diagnosed with infantile hypertrophic pyloric stenosis (IHPS). Materials and Methods: Data of 49 patients diagnosed with IHPS between November 2015 and December 2019 and underwent pyloromyotomy surgery were retrospectively analyzed for this study. The demographic and laboratory data were obtained from the electronic records of the patients. USG parameters such as pyloric muscle thickness (PMT), pyloric diameter (PD), and pyloric muscle length (PML) were measured separately. Term infants were divided into two groups as neonatal (0-28 days) and postneonatal (29-364 days) in order to compare the distribution of USG parameters by age. Infants whose clinical data and USG images were not available together with preterm infants (gestational age <37 weeks) were excluded from the study. Results: Of the 32 patients included in the study, 24 (75%) were male and 8 (25%) were female, and the mean age of the infants was 57.8 days and the median (minimum-maximum) value was 57.5 (9-180) days at the time of admission. In USG examinations, the hypertrophic pyloric muscle was detected in elongated and thick appearance, narrowing the lumen in all patients. There were 15 (46.9%) infants in the neonatal period and 17 (53.1%) in the postneonatal period. In the preoperative measurements, PMT, PD, and PML were high (median value; 4.8, 11.2 and 19.5 mm, respectively). The pyloric measurements of infants in the neonatal and postneonatal period were similar between the two groups, and there was no statistically significant difference (p> 0.05). The correlation between PMT and PML (r = 0.490, p = 0.033) and the correlation between PMT and PD (r = 0.741, p < 0.001) were significant. However, no significant correlation was found between age and pyloric measurements (p> 0.05). When comparing laboratory data, hemoglobin values were significantly lower in infants in the postneonatal period compared to the neonatal group (11±1.5 and 13.7±2.7 g/dL; p < 0.001, respectively). Conclusion: Due to the advantages of USG ionizing radiation used in the diagnosis of IHPS, high sensitivity, and dynamic examination, it is an effective and reliable imaging method that should be preferred first. Although pyloric measurements are valuable for diagnosis, it has been concluded that there is no significant correlation between age and pyloric sizes. [ABSTRACT FROM AUTHOR]

Aim: Upper respiratory tract obstruction can cause cardiac and pulmonary dysfunction in children, which are largely reversible. We assessed the impact of upper respiratory tract obstruction on cardiac function in children scheduled for surgery for adenoidal and/or tonsillar hypertrophy. Methods: In total, 30 patients who were admitted to the ear nose and throat outpatient clinic and were scheduled for surgery for adenoidal and/or tonsillar hypertrophy and 30 control subjects were included into study. Peak nasal inspiratory flow (PNIF) was measured in all subjects, and echocardiographic and electrocardiographic examinations were performed. Results: The mean age of the patients was 9.43±2.51 years. The mean PNIF was significantly lower in patients (110.0 ± 43.9 L/min) than in the control group (140.7±39.4 L/min; p=0.006), and the mean P wave amplitude was significantly higher in patients than in controls (p<0.001). The mean pulmonary ejection time (ET) was significantly shorter in patients than in controls. Conclusion: Lower mean PNIF values in the patient group indicated increased airway resistance, suggesting that PNIF values below 110 L/min may affect right heart function. PNIF can be used by the pediatrician for screening to guide surgeons in children with adenoidal and/or tonsillar hypertrophy. [ABSTRACT FROM AUTHOR]

Objective: The nasal cavity is anatomically and functionally communicates with eyes, paranasal sinuses, nasopharynx, middle ear and lower airways. Therefore, comorbid diseases such as asthma, chronic sinusitis, adenoid hypertrophy allergic conjunctivitis are common in patients with allergic rhinitis. In our study, we aimed to evaluate the frequency of comorbid diseases, clinical features of patients who referred to our outpatient clinic with allergic rhinitis. Method: The study included children aged between 3-17 years who were diagnosed with moderate to severe allergic rhinitis between September 2015 and March 2016 in our pediatric allergy outpatient clinic. Patient files were retrospectively reviewed; comorbid diseases, family history, eosinophil percentage, total IgE level and allergy test results and the number of drugs used were recorded. In the first month of the treatment, visual analog scale was used to score the symptoms. P<0.05 was considered significant in the statistical analysis. Results: A total of 106 patients (33 female, 73 male) with respective median ages of 7.25 and 5.13 years [range: 3.0-17.0, years] were included in the study. In 84.9% of our patients, skin test was positive, and in 69.8% of the patients the symptoms persisted for more than 2 years. The most common comorbid diseases were asthma (52.8%) and adenoid hypertrophy (30.2%). In our study, the incidence of adenoid hypertrophy was higher and total IgE levels were lower in the skin test-negative group (p=0.019, p=0.027). Conclusion: In our study, the most common comorbid diseases in patients with allergic rhinitis were asthma and adenoid hypertrophy, and in the skin test-negative group adenoid hypertrophy was more frequent. [ABSTRACT FROM AUTHOR]

Background: The aim of the study is to analyze the clinical symptoms and histopathologic diagnoses of patients with unilateral sinonasal symptoms who have been operated on in our clinic. Methods: We performed a retrospective review of the medical records of 54 patients with unilateral sinus disease who underwent surgical intervention and had pathological specimens between June 2013 and May 2017. Presenting symptoms, medical histories, and previous treatments were analyzed. Results: Fifty-four patients were diagnosed pathologically by endoscopic sinonasal surgery. In 40 of the patients non-tumoral pathologies were stabbed and in 14 patients tumoral pathology was detected. Of the nontumoral lesions, 29 patients had chronic sinusitis-nasal polyps, 5 patients had isolated inferior turbinate mulberry hypertrophy, 3 patients had rhinolitis, 2 patients had mucocele, and 1 patient had accessory middle turbinate. In tumoral pathologies, 6 patients had hemangiomas, 5 patients had inverted papillomas, 2 patients had osteomas and 1 patient had malignant melanomas. Epistaxis was more frequently detected in tumoral pathologies, while the most frequent cause was nasal obstruction. Conclusion: Although the majority of unilateral sinonasal pathologies are benign lesions, tumoral pathologies are more common than bilateral diseases. An important finding in our study is that inferior turbinate mulberry hypertrophy and nasal hemangiomas are not uncommon and constitute a significant part of unilateral nasal lesions. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this was to compare direct radiography and magnetic resonance imaging in analysis of hemophilic arthropathy. Materials and Methods: The direct radiography and magnetic resonance imaging findings of hemophilic arthropathy were compared in 109 joints of 23 male hemophilia patients. Kappa statistic was used to analyze the agreement between the methods. Results: Magnetic resonance imaging revealed effusion in 17 joints, hemosiderin-hemarthrosis in 48, cartilage loss in 29, osteonecrosis in 30, and detached fragment in 3, while direct radiography was negative. Direct radiography revealed osteoporosis in 16 joints, epiphysial growth in 16, subchondral surface irregularity in 30, narrowing in joint spaces in 28, joint related failure in 2, and joint deformity in 7, while magnetic resonance imaging was negative. Magnetic resonance imaging was negative in 3 joints where direct radiography found erosion. Between direct radiography and magnetic resonance imaging, there was aweak agreement in analysis of erosion, moderate agreement in subchondral cyst analysis, and weak agreement in synovial hypertrophy analysis. Conclusion: Magnetic resonance imaging is obviously superior than direct radiography in evaluating in-joint effusion, hemosiderin-hemarthrosis, synovial hypertrophy, erosion, subchondral cysts, cartilage loss, osteonecrosis and detached fragment of hemophilia patients. The sensitivity of MRI in evaluating synovial hyperthrophy and hemarthrosis makes it preffered imaging modality for the selection of patients who are candidate for prophylactic theraphy and for the decision of synoviectomy. [ABSTRACT FROM AUTHOR]

Objective: Drug therapy recommended for people with Type 1 diabetes is insulin. One of the complications of insulins medication is lipohypertrophy. The aim of this study was to analyze the frequency and risk factors of lipohypertrophy in the children with Type 1 diabetes. Material and Methods: A descriptive cross sectional study design was used. The study was conducted between June-October 2017 in a Diabetes Education and Monitoring Center in a Children's Hospital in Turkey. A descriptive information form was used to collect the data. Ethical approval and permission were obtained from the ethics committee and the institution, respectively. As a result of the study, number, percentage and chi-square analysis were used to evaluate the data. Results: In this study, 61.1% of the patients were found to have lipohipthrophy, and it was determined that lipohipertrophy was mostly found in arms (73.61%), arms were followed by abdominal region, its incidence was 18.5% in the abdominal region. However, it was determined that the duration of diabetes diagnosis, duration of diabetes treatment and field rotation were significant factors which affect the development of lipohipertrophy. Conclusion: In this study, it was determined that the incidence of lipohypertrophy in the children with Type 1 diabetes is substantial, lipohipertrophy was mostly observed in eyes. In addition, in children with Type 1 diabetes, diabet nurses should be careful about the duration of diabetes diagnosis, duration of insulin treatment and field rotation. It is recommended to perform randomized controlled interventional studies on how to prevent the development of lipohypertrophy. [ABSTRACT FROM AUTHOR]

Donohue syndrome (Leprechaunism) is characterized by severe insulin resistance, hyperinsulinemia, postprandial hyperglycemia, preprandial hypoglycemia, intrauterine and postnatal growth retardation, dysmorphic findings, and clinical and laboratory findings of hyperandrogenemia due to homozygous or compound heterozygous inactivating mutations in the insulin receptor gene. A female newborn presented with lack of subcutaneous fat tissue, bilateral simian creases, hypertrichosis, especially on her face, gingival hypertrophy, cliteromegaly, and prominent nipples. Her laboratory tests revealed hyperandrogenism, postprandial hyperglycemia and preprandial hypoglycemia, and very high concurrent insulin levels. She was diagnosed as having Donohue syndrome. Metformin and continuous nasogastric feeding were administrated. During follow-up, relatively good glycemic control was obtained. However, severe hypertrophic obstructive cardiomyopathy and severe malnutrition developed. She died aged 75 days of severe heart failure and pneumonia. Her INSR gene analysis revealed a compound heterozygous mutation. One of these mutations was a p.R813 (c.2437C>T) mutation, which was defined previously and shown also in her father, the other mutation was a novel p.777-790delVAAFPN^SSTSVPT mutation, also shown in her mother. The parents were heterozygous for these mutations. [ABSTRACT FROM AUTHOR]

Hypertrophic cardiomyopathy, is unexplained reasons and characterized with left ventricular hypertrophy, is an inherited chronic disease of the heart muscle. Hypertrophic cardiomyopathy is seen rarely but it is very important because of genetic transmission and high risk of sudden cardiac death. Echocardiography is basic application for diagnosis left ventricular hypertrophy. We defined a rare case in literature which has massive left ventricular hypertrophy. [ABSTRACT FROM AUTHOR]