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Öğe A deficiency or developmental defect in paneth cells may contribute to the pathogenesis of appendicitis in children(2023) Harma, Birsen; Tecellioglu, FahriyeAim: The aim of this study was to investigate whether there were differences in the Paneth cells between children with acute appendicitis (AA) and those with normal appendix (NA), and to reveal the distribution and morphological changes in Paneth cells in appendix inflammation. Materials and Methods: The data of 63 patients who underwent appendectomy diag- nosed with acute appendicitis between January 2021 and December 2022, including age, gender, operative diagnosis, and postoperative histopathological examination results, were analyzed retrospectively. To evaluate the distribution and changes of Paneth cells through- out AA and NA groups, samples with hematoxylin and eosin (H&E)-stained sections were obtained from the Department of Histopathology’s archives. Selected blocks were stained with Masson-Trichrome. The number of Paneth cells and the degree of granular density in the appendicitis tissues were statistically evaluated and compared with the results of the control group. Results: A total of 63 appendectomies were performed, including 31 incidental appen- dectomies and 32 performed for acute appendicitis. There were no statistically significant differences between the groups that underwent surgery for AA and the NA in terms of gender and age (p>0.05). It was observed that the number of Paneth cells and granule density decreased significantly in acute appendicitis (AA) group (p<0.05). Conclusion: Reduction or developmental deficiency in Paneth cells, may results in the loss of protective secretion, and may increase the appendix’s susceptibility to bacterial infection by allowing organisms to adhere and penetrate the mucosa. The resultant en- hancement of infection may contribute to the pathogenesis of appendicitis.Öğe Conservative management of anal fissure accompanying constipation in school-age children(2023) Harma, BirsenAn anal fissure is a common problem in children and it refers to a longitudinal tear or an ulcer in the anoderm. The conventional therapy for anal fissures has been warm sitz baths and lthe ocal application of analgesic ointments, stool softeners ,and behavioral therapy as necessary. Simple wound care may often be sufficient for the treatment of anal fissure, but a comprehensive approach is required for accompanying constipation. Between 2015-2022, a total of 263 children suffering from constipation and perianal pain were diagnosed with anal fissure (AF) based on physical examination. Anal fissure and constipation (AFC) questionnaire forms were retrospectively reviewed and results of routine management protocol were assessed which was focused on local wound care and dietary regulation. The ratio of children consuming more than 2-3 cups of packed beverages containing artificial sweeteners, colorants or corn syrup was found 63,89 % (n=167). Daily water consumtion of less than five glasses was 71.1% (n=187). Daily milk consuming was 71,86% (n=189). Stool withholding and soiling was found 57,41% (n=151) and 48,67% (n=128) respectively. In only four cases (1.52%), constipation persisted for more than eight weeks despite meticulous management and improvement was achieved with anal dilatation on the tenth week. It is possible to treat anal fissures successfully and in a reasonable duration with simple local care with prednisolone pomade and a strict diet arrangement that restricts the consumption of packed foods, beverages, snacks, and milk while promoting drinking water and raw fiber intake.Öğe Iron Deficiency may be a Risk Factor for Inguinal Hernia Development in Children(2023) Harma, Birsen; KIRAN, TUGBA RAIKA; İnceoğlu, FeyzaObjectives: This case control study aimed to investigate whether the routine hemogram and biochemical parameters of pediatric patients who have undergone surgery for inguinal hernia are associated with the etiopathogenesis of the disease. Methods: Eighty cases of inguinal hernia surgery performed between January 2019 and November 2022 were included in the study. A control group was also established using hospital records, consisting of eighty pediatric patients without any known his- tory of hematological or metabolic disease or use of regular medication. Statistical analysis was conducted to compare the total hemoglobin (Hgb), hematocrit (Htc), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), erythrocyte distribution width (RDW) and thrombocyte (PLT) values in both groups. Results: The age range of the pediatric patients was 1-14 years. Of the eighty children, 47 (58.8%) were male and 33 (41.3%) were female, with a mean age of 5.79±3.26. The values of Hgb, Htc, MCH, MCHC, and MCV in the inguinal hernia patients were found to be statistically significantly lower than those in the control group (p<0.05). Additionally, the patient RDW values were found to be statistically significantly higher than those in the control group (p<0.05). Conclusion: Compared to the control group, the observed decrease in MCH, MCHC, MCV, Hgb, HTC values, as well as the increase in RDW in patient group, suggests a predisposing effect of iron deficiency. These specific changes suggested that iron deficiency may lead structural changes in the collagen construction and may contribute the etiopathogenesis of childhood inguinal hernia.Öğe Some biochemical tips in the etiopathogenesis of Pectus Excavatum(2023) Harma, Birsen; KIRAN, TUGBA RAIKA; İnceoğlu, FeyzaPectus excavatum (PE) is the most common deformity among anterior chest wall abnormalities. Although many theories on the pathogenesis of PE have been described, the uncertainty is still going on whether it is a result of developmental, biochemical, or biomechanical reasons or their combination. The aim of this study was to evaluate the biochemical parameters that may cause or be associated with the development of PE between children with PE and their healthy peers. A total of 33 patients' medical records were retrospectively analyzed who followed up because of pectus excavatum between 2019 and 2021. A control group was formed from 32 healthy children from the hospital records with similar age and gender profiles as the patient group. The data from both groups were collected and statistically analyzed in terms of gender, age, and laboratory tests, including hemogram, Vit B12, Parathormone (PTH), Vit.D, Alkaline phosphatase (ALP), and serum Calcium (Ca) and Phosphor (P) levels. Compared to the control group, statistically, significantly higher serum ALP, P, and PTH levels with low Vit.B12 levels were detected. The significant difference in the levels of ALP, PTH, P, and Vit B12, which have an important place in the construction and development of osteochondral structures, may impair the remodeling capacity of the costosternal structure with the contribution of thoracic biomechanics. When PE deformity is noticed, if appropriate medical treatment such as vitamin and mineral supplements and diet regulation is applied to children in the follow-up process, the process can be slowed down, and the deformity can be alleviated.
