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Öğe Can prevention of erection with sulpride be a way to increase success in hypospadias surgery? A case report(Duzce University Medical School, 2021) Kara, Halil; Öztürk, Ayşe Betül; Çetinkaya, MirayHypospadias is treated surgically and different methods can useable for this way. Due to involuntary erections during adolescence and later, neourethra seems at risk until wound healing is complete. Erections following penile surgery are painful and can affect the healing process negatively, because the stitches may not withstand a strong erection. Therefore, prevention of erection and management of pain are extremely important after the hypospadias surgery; especially in adolescents. Preventing erection may increase the chance of success from surgery. Short-term use of antipsychotics may be beneficial to prevent erection. In this case report, the use of sulpride in an eighteen-year-old patient after hypospadias repair and the effect of this treatment on the results of the surgery was presented.Öğe Changes in symptoms and severity of obsessive compulsive disorder in children and adolescent patients following the covid-19 pandemic(University of São Paulo, 2021) Kara, Halil; Özkan, Selçuk; Almbaidheen, MahmoudThe need to stay at home and follow the rules of personal hygiene for protection are generally stimuli that can increase the anxiety of obsessive compulsive disorder (OCD) patients during covid-19 pandemic. The aim of this study was to examine how this situation has changed the disorder severity and symptoms in OCD patients. This multi-centre study included 73 OCD patients aged 7-17 years, who had been followed up for at least 8 weeks before the pandemic. The range and severity of symptoms were evaluated with the Children's Yale-Brown Obsessive Compulsive Scale (CYB-OCS). The disorder severity scores evaluated in the 8th week of treatment were compared with disorder severity scores after the pandemic, and a statistically significant difference was determined (p=0.04). There was seen to be an increase in contamination, ilness and sexual obsessions after the pandemic compared to the 8th week of treatment. The study results showed that pandemic-origin stress had a negative effect on young OCD patients. There should be advance planning of how treatment processes will not be interrupted and how children with mental health problems can be helped in times of stress, such as natural disaster and pandemics, which affect the whole population and therefore, children.Öğe Duygudurum bozukluğu ve psikotik bozukluğu olan çocuk ve ergenlerde metabolik sendrom ve özellikleri(Anadolu Psikiyatri, 2019) Kavurma,Canem; Kara, Halil; Yalın Sapmaz, Şermin; Öztürk Kara, Deniz; Önder, ArifAmaç: Metabolik sendrom (METs) santral yağlanma, yüksek tansiyon, düşük seviyede yüksek yoğunluklu lipopro- tein (HDL) kolesterol, yükselmiş trigliserit(TG) ve hiperglisemi gibi bir dizi risk etkeninin birlikteliği şeklinde tanım- lanır. Metabolik sendrom yaygınlığı yetişkin popülasyonda birçok psikopatoloji ile hem artan belirti şiddeti düzeyin- de, hem de antidepresan kullanımı ile ilişkilendirilmiştir. Çalışmamızda duygudurum ve psikotik bozukluğu olan çocuk ve ergenlerde METs özellikleri ve METs oluşumunda var olan psikiyatrik bozuklukların ve psikotrop kullanı- mının etkilerini araştırmayı amaçladık. Yöntem: Çalışmaya Ruhsal bozuklukların Tanısal ve Sayımsal El kitabı, yeniden gözden geçirilmiş dördüncü baskısı (DSM-IV-TR) tanı ölçütlerine göre bipolar bozukluk, şizofreni, şizoaffek- tif bozukluk ve şizofreniform bozukluğu olan 13-20 yaşları arasındaki 30 hasta ve psikiyatrik bozukluğu olmayan 30 sağlıklı kontrol grubu çocuk ve ergen alınmıştır. Katılımcıların antropometrik ölçümleri (vücut ağırlığı, boy, bel çevresi, beden kitle indeksi-BKİ) yanında kan basıncı ölçümleri yapılmıştır. Katılımcıların total kolesterol, trigliserit, HDL, düşük yoğunluklu lipoprotein (LDL) değerleri ve açlık kan şekeri (AKŞ) düzeyleri ölçülerek, tüm verilerin değer- lendirilmesi sonucunda METs tanısı International Diabetes Foundation (IDF) ölçütleri temel alınarak konulmuştur. Bulgular: Çalışmamızda tüm örneklem grubumuzda METs oranı %20 (n=12) olarak belirlendi. Bunlardan dokuzu (%27) olgu grubunda, üçü (%10) kontrol grubunda idi. METs grubunun BKİ değeri, ortalama ağırlık, bel çevresi uzunluğu, serum trigliserit ve AKŞ değerleri kontrol grubundan istatistiksel olarak yüksek bulunmuştur. Ayrıca duygudurum düzenleyici ilaçların kullanımının METs gelişmesine istatistiksel olarak anlamlı bir etkisi olduğu saptan- mıştır. Sonuç: Çalışmamızda çocuk ve ergenlerde psikiyatrik bozuklukların ve antipsikotik kullanımının metabolik düzenlemeyi bozduğu ve METs için risk oluşturduğu belirlenmiştir. Bulgularımızın özellikle METs açısından risk taşıyan çocuk ve ergenlerde antipsikotik kullanımına yeni yaklaşımlar sağlayacağı kanısındayız.Öğe Effect of methylphenidate as a dopaminergic agent on myopia: Pilot study(Wiley, 2021) Gürlevik, Uğur; Kara, Halil; Yaşar, ErdoğanBackground Methylphenidate (MPH) hydrochloride is used as a first-line treatment for attention deficit hyperactivity disorder (ADHD). However, there is concern that this treatment may be associated with increased risk of refractive disorder. The aim of this study was to investigate the effect of MPH therapy on myopic shifts in refraction in children diagnosed with ADHD. Methods This study, children with ADHD and meeting inclusion criteria were examined before the initiation of MPH treatment and 3, 6 and 12 months after the initiation of treatment. Twenty age-gender-matched participants who applied to the outpatient ophthalmology clinic with various complaints were included in the study as a control group. Cycloplegic refraction examination and detailed eye measurements were performed at each visit. Results Nineteen patients were included in this study and the group consisted of 11 (57.9%) females and 8 (42.1%) males. The mean age of patients was 11.3 +/- 2. (range: 8-18) years. During 12 months of use of MPH, the spherical equivalent changed from -0.36 +/- 1.08 to -0.39 +/- 1.05, and this difference was not statistically significant (P = .187). Axial length ranged from 22.92 +/- 0.66. There was a change to 22.93 +/- 0.62, and this difference was not statistically significant (P = .076). In the control group, the spherical equivalent changed from -0.43 +/- 0.62 to -0.56 +/- 0.84, and this difference was statistically significant. (P = .012) There was a change in the axial length from 22.97 +/- 0.78 to 22.99 +/- 0.62, and this difference was statistically significant (P = .015). Conclusions No significant changes spherical equivalent and axial length were detected during 12-month MPH use, but the increased spherical equivalent and axial length in the control group in the similar age group may indicate that MPH may reduce myopic shifts in refraction progression through dopamine, similar to in vivo studies. What's newWhat's known Myopia is spreading rapidly in technologically advanced societies. There is strong evidence that myopia develops as the axial length of the eye increases as a result of spending more time indoors and working in close distances in parallel with the increase in education level. Animal studies have shown that decreased dopamine release plays an important role in the development of myopia. The effect of dopamine in slowing or stopping myopia in experimental studies has also been demonstrated in human studies. No significant change in spherical equivalent and axial length was observed in methylphenidate users compared with control patients of similar age group. A significant increase in spherical equivalent and axial length was detected in the control group. This pilot study will shed light on future studies on the safe use of dopamine in the treatment of myopic shifts.Öğe Evaluation of the ganglion cell layer thickness in children with attention deficit hyperactivity disorder and comorbid oppositional defiant disorder(Klinik Psikiyatri Dergisi, 2018) Bodur, Şahin; Kara, Halil; Açıkel, Burak; Yaşar, ErdoğanObject: We aimed to compare the Retinal Nerve Fiber Layer (RNFL), ganglion cell layer (GCL), and the optic nerve thicknesses (ONT) of children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) to a healthy control group; and the possible worse effect of the Oppositional Defiant Disorder (ODD). Methods: 31 patients, (n=16 ADHD and n=15 ADHD+ODD) and a control group of 31 participants included. The Conners' Teachers Rating Scale and the Conners' Parent Rating Scale were used for the severity of the symptoms in children. Ophthalmologic measurements performed with optic coherence tomography device. Results: In this study, different ophthalmologic measurements (RNFL, GCL and optic nerve thicknesses) are compared between ADHD children and controls. Results show primarily bilateral thinner GCL in ADHD children compared to controls, which is the first demonstration. Optic nerve thicknesses of right eye inferior quadrant and left eye superior quadrant, as well as mean optic nerve thickness of left eye, and furthermore both eyes total GCL thickness measurement averages with also their thicknesses in superior, inferior area of patient group were found as statistically lower (p<0,05) than control group. The measured thinning of RNFL wasn't statistically significant for both eyes in patient group. Discussion: In patients diagnosed with ADHD, thinning of the GCL and optical nerve thicknesses were found statistically significant compared to the control group, whereas the thinning of RNFL was only numerical. ODD comorbidity was thought to have no additional effect on thinning. This may lead to the idea that the negative effect of the ODD on the neurodegenerative process may be assessed with larger sample studies.Öğe Galectin-3 levels in school aged children with autism spectrum disorder(Taylor and Francis Ltd., 2023) Artık, Abdülbaki; Kocaman, Orhan; Kara, Halil; Tuncer, Sibel ÇiğdemAutism spectrum disorder (ASD) is a group of neurodevelopmental disorders with underlying pathogenesis and etiological factors not fully understood. We assumed that galectin-3, which is also linked with inflammatory responses, may be central to the ethiopathogenesis of ASD. Method: The current study consisted of 33 psychotropic medication-naive children with ASD and 32 control subjects. The Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Present and Lifetime Version-DSM-5 (K-SADS-PL-DSM-5) was used to screen healthy controls for psychiatric disorders by a psychiatrist after a physical examination by a pediatrician. The clinical severity of the ASD symptoms has been assessed by the Childhood Autism Rating Scale (CARS). Venous blood samples were collected and serum galectin-3 levels were measured. Results: When the ASD and control groups are compared, the mean galectin-3 level is 417.77 (SD = 200.20) in the ASD group and 243.08 (SD = 64.65) in the control group, and there is a statistically significant difference between the groups (p < 0.001). When examining whether there is a correlation between galectin-3 levels and CARS total scores, no statistically significant correlation was found between them (r = 0.015, p = 0.933). Discussion: In this study, we examined whether serum galectin-3 levels have a relation with ASD in childhood or not. Our findings have indicated that the children with ASD have higher serum galectin-3 levels compared to the controls. However, no significant relationship has been found between serum galectin-3 levels and ASD symptom severity.Öğe Impact of parental impulsivity on attention deficit hyperactivity disorder and oppositional defiant disorder: Do mothers' attitudes predict symptom severity in children?(NLM (Medline), 2021) Demircan Tulacı, Özge; Çetinkaya, Miray; Tulacı, Rıza Gökçer; Kara, Halil; Erarslan, Ayşe Nihal; Durukan, İbrahimAttention deficit hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder that occurs early in school-aged children, and it is highly comorbid with oppositional defiant disorder (ODD). Parents of children with ADHD frequently show mental problems related to impulsivity. The aim of this study was to examine the relationship between impulsivity of the mothers and the symptom patterns and severity of children. A total of 85 children between the ages of 6 and 12 and their mothers participated. Conners' Parent and Teacher Scales, Structured Clinical Interview for DSM-IV Personality Disorders, and ıowa gambling task were applied. We found a positive correlation between the impulsivity of the mothers and the total symptom severity of ADHD and ODD in children. During the treatment process of ADHD, the evaluation of impulsivity in mothers of children with ODD comorbidity and treatment of impulsivity in the mother would be beneficial. In future studies, examining the effects after treatment of impulsivity may contribute to the literature.Öğe Increasing the awareness of autism spectrum disorder with training of Pre-School teachers and school counselors in Turkey(Georg Thieme Verlag, 2020) Kara, Halil; Demirtaş, Mehmet SemihTraining programs for the awareness of autism for professions are supported under the leadership of the United Nations. Misinformation can cause socially destructive results as that which is incorrect is assumed to be known correctly. This study included a total of 308 participants comprising 226 (73.4%) preschool teachers and 82 (26.6%) school counselors. The basic questions related to the awareness and knowledge of autism spectrum disorder (ASD) were selected based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). It was attempted to categorize the questions into four fields: (1) social interaction, (2) social communication and speech, (3) limited interest pattern with stereotypical and ritualistic behaviors, and (4) comorbidities, etiological characteristics, and the relationship between vaccinations and autism. The results of the study indicate that the awareness of ASD, including core symptoms, was extremely lacking in preschool teachers and school counselors. Moreover, they had extreme prejudice to information known to be incorrect.Öğe Is pseudomyopia associated with anxiety and related disorders(Professional Medical Publications, 2021) Kara, Halil; Yaşar, Erdoğan; Gürlevik, UğurObjective: To investigate in detail the exact relationship between Pseudomyopia, also termed accommodative spasm, and psychiatric disorders. Methods: Twenty-one young people between the ages of 12-18 who were diagnosed with pseudomyopia between March 2019 and July 2020 in the ophthalmology eye clinic of a university hospital, Turkey were included in the study. A difference of at least 2.20 D between refractive error measurements before and after cycloplegic drop was accepted as pseudomyopia. Scl-90-r symptom screening scale was applied to each case. Afterwards, each case was evaluated by k-sads-pl-dsm-5-t semi-structured technique according to age. The relationship between psychiatric disorders in cases of pseudomyopia was examined. Results: The average age of patients in the study was 15,4 +/- 1,9 (12-18), 13 (61,9%) girl and 8 (38,1%) boy. The mean initial refraction was -4,19D +/- 2,48D (-1,75D /-8,50D), and the result refraction was +0,38D +/- 0,22D (0,25D / -1,00D). The average amount of accommodation was 4,56D +/- 2,59D (2,25D / 9,50D). Following the SCL-90-R screening scale and psychiatric evaluation, five generalized anxiety disorders, three obsessive compulsive disorders, three panic disorders, one social anxiety disorder, one posttraumatic stress disorder, one conversion disorder, one major depressive disorder were diagnosed. As a result, 15 (71,4%) of 21 patients were treated with a psychiatric diagnosis. In addition, a positive correlation (p: 0,010-r: 0,621, p: 0,029-r: 0,546) was detected between anxiety- somatization scores and accommodation amount. Conclusions: It is necessary to request psychiatric consultation in each case of pseudomyopia. Comorbidity of anxiety and depressive disorders is more common in pseudomyopia cases. In addition, as the severity of psychiatric symptoms increases, the amount of accommodation also appears to increase.Öğe Prevalence and risk factors of attention deficit hyperactivity disorder in children admitted to the emergency department due to traumas(Turkish Association of Trauma and Emergency Surgery, 2024) Yazıcı, Ramiz; Mutlu, Hüseyin; Kılıçaslan, Cengizhan; Sert, Ekrem Taha; Kokulu, Kamil; Kara, Halil; Kılıçaslan, Murat; Ekici, Mustafa; Bulut, BensuThis study aims to determine the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) symptoms and the associated risk factors in children admitted to the Emergency Department (ED) due to traumas. METHODS: EChildren aged 3-16 years admitted to the ED for traumas were included in the study. The control group consisted of children aged between 3-16, who visited the pediatric ED for non-traumatic reasons. The Revised Conners Parent Rating Scale (CPRS-R) was administered to parents who agreed to participate following initial intervention and stabilization. Trauma patients were divided into two groups: those diagnosed with ADHD and those without ADHD. Risk factors likely to increase the identification of ADHD were assessed. RESULTS: The study included 917 children, with both groups showing similar characteristics regarding age, sex, demographic, and cultural factors. The most common reason for ED visits was extremity traumas, accounting for 296 (35.2%) cases. The majority of trauma patients (95.9%) were discharged from the ED after outpatient interventions. All subscale scores of the CPRS-R, except for the social problems subscale, were significantly higher in the study group compared to the control group. Factors that increased the risk of ADHD included admission with extremity traumas (p<0.001), previous ED admissions due to traumas (p<0.001), and having a family member previously diagnosed with ADHD (p<0.001). CONCLUSION: The prevalence of ADHD symptoms may be higher in children admitted to the ED due to traumas. Furthermore, extremity traumas, previous trauma-related ED-admissions, and a family history of ADHD increase the risk of ADHDÖğe Serum zonulin levels are correlated with symptom severity independent from body mass index and gender in children with attention deficit hyperactivity disorder(ANP Publishing, 2022) Çetinkaya, Miray; Kara, Halil; Açıkel, Burak; Tuncer, Sibel ÇigdemIt has been recently emphasized that neurodevelopmental disorders such as schizophrenia, autism spectrum disorder and attention deficit hyperactivity disorder (ADHD) may be related to the gut-brain axis. Zonulin is a protein that changes the integrity of tight junctions between gastrointestinal mucosa cells. We aimed to investigate serum zonulin levels and its relationship with symptom severity in children with ADHD. Method: 21 ADHD patients and 19 controls were included. Zonulin levels were obtained from blood specimens. Clinical severity of the ADHD symptoms was evaluated by Conner’s Parents Rating Scale-Revised/Long Form (CPRS-R/L) and Conner’s Teacher Rating Scale-Revised/Long Form (CTRS-R/L) in ADHD group. Results: There was no significant difference between the groups in terms of age, gender and body mass index. Mean serum zonulin level of the ADHD group was 13.45±9.08 and 21.32± 19.96 in the control group. There was no significant difference between groups (t=1.99, p=0.51). Significant correlation was found (R=0.82, p<0.01) between serum zonulin levels and CTRS-R/L scores in the ADHD group. This correlation persisted when BMI and sex variables were controlled (R=0.85, p<0.01). Discussion: We have found significant correlation between ADHD symptom severity and serum zonulin levels, whereas there was no significant difference between children with ADHD and controls.Öğe Serum zonulin levels are higher among children with autism spectrum disorders and correlated with social impairment(Cukurova University, 2021) Kara, Halil; Açıkel, Sadettin Burak; Çetinkaya, Miray; Tuncer, Sibel ÇiğdemZonulin is a protein that affects the integrity of intercellular connections in the intestines. It has been emphasized that autoimmune diseases as well as neurodevelopmental disorders, for example autism spectrum disorder (ASD), may occur through alterations in intestinal permeability and blood-brain barrier. We aimed to investigate the gastrointestinal permeability of individuals with ASD by determining serum zonulin levels and their relationship to symptom severity. Methods: Twenty-five ASD patients and 19 controls were included. Serum zonulin levels were measured by enzyme-linked immunosorbent assay kits. Clinical severity was assessed by the Childhood Autism Rating Scale (CARS), and social skills of the control group were evaluated by the Conners’ Parents and Teacher’s Rating Scales-Revised/Long Forms (CPRS-CTRS). Results: Mean zonulin levels were significantly higher in the ASD group and positively correlated with CARS scores. After regression analysis, serum zonulin levels predicted CARS total scores. We could not find any significant correlation between zonulin levels and CPRS-CTRS sociability subscale scores in the control group. Conclusion: The positive correlation between serum zonulin levels and ASD severity may require precaution for impaired intestinal permeability in clinical practice, especially for the cases in which sociability is severely impaired. However, it is too early to state that intestinal permeability has a role in the etiology of ASD. Further studies involving specific autism subgroups, and samples with certain dietary differences are needed.Öğe The association between parents' problematic smartphone use and children's speech delay(Yerküre Tanıtım ve Yayıncılık A.Ş., 2020) Kara, Halil; Açıkel, Sadettin BurakObjective: Children's use of television is an important environmental risk factor associated with speech delay. Although the relationship between television use and speech delay has been examined, there is no study in the literature investigating the relationship between parent's smartphone use and speech delay. In this study, we aimed to investigate the relationship between speech delay and problematic smartphone use and to test the hypothesis that the rate of problematic smartphone use is higher in the parents of children with delayed speech compared to those parents of children with healthy development. Methods: 20 children with delayed speech and their parents (patient group) and 20 children with normal speech development and their parents (control group) were included the study. The development of children evaluated with Ankara Developmental Screening Inventory. The problematic smartphone use measured by Problematic Mobile Phone Usage Scale. Results: Problematic Mobile Phone Usage Scale score was significantly higher in parents of children with speech delay. This difference continues after controlling confounding effect of parent's age, education, and income level. Conclusion: In this study, problematic smartphone usage was found to be more frequent in families of children with speech delay. According to our knowledge this is the first study which investigates the association with speech delay and parent's use of smartphone. While evaluating children with speech delay in clinical practice, it is essential that the smartphone usage of the parents is taken into consideration further prospective, follow-up studies can be conducted on this topic.
