INTRODUCTION: Asthma is a chronic inflammatory disease of respiratory tract. many different invasive and noninvasive tests are performed to diagnose asthma. Yet no definite criteria for diagnosing asthma are determined.
METHODS: In our study we aimed to show the relation between blood parameters and pulmonary function tests (PFT) with the asthma severity in patients with a diagnosis of asthma, and post-treatment changes in these parameters.
RESULTS: Children aged 0-14 years with asthma seen in our outpatient policlinic were prospectively evaluated. Complete blood count, ECP, specific IgE,Total IgE levels of the patients are recorded at the beginning of the study. Children > 6 years performed spirometry. All patients filled a study registration form that includes major and minor risk factors. We classified the severity of the disease according to GINA (Global Initiative for Asthma) and we followed the treatment protocol. The severity of the disease did not show any significant
correlations with the gender, atopic history and family history. A statistically significant difference was found between the ECP, Total IgE levels and severity of asthma. We observed a decrease in the asthma severity during 2nd visit.
DISCUSSION AND CONCLUSION: Our results showed that serum ECP levels are significantly correlated with the severity of asthma and may be useful in the assessment of asthma control. Hence the PFT is quite difficult to perform in children, noninvasive parameters are becoming more important for the follow up of the treatment.

INTRODUCTION: We compared the postoperatif pain relief and PONV of caudal blockade with bupivacaine or morphine plus bupivacaine.
METHODS: 100 ASA I 2-12 yr old children schedulled for circumcision surgery were randomized to receive caudal blockade with bupivaine or bupivacaine with morphine. Grup 1 received 0,25% bupivacaine, grup 2 received bupivacaine with 10μgr/kg morphine. Number of patients requiring rescue analgesic in 24 h following caudal blokade, time to first rescue analgesic, 4.hour pain scores, postoperatif pain and side effects during the first 24 hour were recorded.
RESULTS: Within 24 hours pain have been identified at 24 patient in group 1 and 2 patients in group 2. Patients in Group 1 had a statistically significantly higher incidence of pain than group 2 patients for 24 hours, (p<0.001). There is no statistically significant difference incidence of nausea and vomiting between groups. Side effects were not observed in Group 1 like as late respiratory depression, nausea, vomiting, urinary retention and pruritus.
DISCUSSION AND CONCLUSION: As a result, it was concluded that as an adjuvant agent caudal morphine provided safe and effective analgesia with lower than recommended doses.

INTRODUCTION: In intensive care units, respiratory tract infections take first place in the hospital infection. In this study, bacteria which were isolated from sample deep tracheal aspirate (DTA) materials sent from intensive care unit and their antibiotic resistance were investigated.
METHODS: Between January 1, 2010 and December 31, 2011, for all deep tracheal aspirates (DTA) cultures, identification of bacteria and their
antibiotic susceptibilities were avaluated according to CLSI criteria defined by VITEK 2 (bioMeriux, France) automated identification system.
RESULTS: During this two-year period, 280 different bacteria, including the most common Pseudomonas aeruginosa and Acinetobacter baumannii were isolated as causative pathogens from DTA cultures. Extendedspectrum beta-lactam resistance ratio were 52% for Escherichia coli strains and 84% for Klebsiella spp. strains. For Staphylococcus aureus, methicilin resistance was 60%.
DISCUSSION AND CONCLUSION: For our intensive care unit, rate of antibiotic resistance in pathogens isolated from DTA culures were very common. Because treatment
of infections secondary to this pathogens is quite difficult, appropriate approaches are preventing cross-contamination, maintaining
effective infection control program and surveillance.

INTRODUCTION: Although, the effective of corticosteroids and bronchodilators with inhaler devices is featured in asthma and COPD, disease control is inadequate. Treatment failure is usually related of improper use of devices. Education of patient is a critical component of treatment
and requirs cooperative effort of doctor, nurse and pharmacist. We aimed to evaluate inhaler device usage skills of doctors,nurses, pharmacist and assistant pharmacist who trains patients.
METHODS: A total number of 120 doctors,nurses, pharmacist and assistant pharmacist included the study. We asked to demostrate the use of each device which are widely used, metered dose inhaler(MDI), diskus, turbuhaler, aerolizer and easyhaler. Correct use of each devices was assessed in ten steps over 10 points.
RESULTS: The mean age of medical personell included the study was 31.8 ± 7.0. %92.5 of participants knew how to use meter dose inhalers, %85 of aerolizer. %70 of participants was trained before about the inhaler device tehcniques. Mean demostration score for meter dose inhaler 6.5±2.4, discus 6.8±2.9, turbuhaler 5.8±3.7, aerolizer 7.4±2.8 and easyhaler 2.9±0.3. Mean demostration score for meter dose
inhaler, discus, turbuhaler,aerolizer, easyhaler 6.3±2.0, 7.3±1.8, 6.6±2.8, 7.7±1.6, 3.5±3.3 in assistant pharmacist, 6.3±2.0, 6.8±2.3, 5.5±3.5, 6.7±2.9, 3.5±3.1 in pharmacist, 6.3±3.1, 6.0±3.7, 4.8±4.2, 7.8±3.5, 3.1±1.3 in nurses, 6.4±2.0, 6.4±3.1, 4.3±4.1,6.2±3.5, 1.4±0.3 in family physician, 9.0±1.1, 9.5±1.0, 9.2±1.3, 9.6±0.8 ve 9.7±0.9 in pulmonologist (p<0.05) respectively. The percentage of true usage techniques were % 58.3 for MDI, %66.7 for discus, %55.8 for turbuhaler, %76.7 for aerolizer, %25.0 for easyhaler.

DISCUSSION AND CONCLUSION: In conclusion we determined high incidence of incorrect usage of inhaler devices among the all groups. We suggest that medical personnel and pharmacist should have adequate and periodically education to increase patient compliance and treatment success.

INTRODUCTION: Upper respiratory tract obstruction (URTO) caused by tonsiller hypertrophy, adenoid hypertrophy or both of them have been reported as one of the etiologic reasons of monosymptomatic enuresis nocturna( MNE).
METHODS: We aimed to compare rates of MNE recovery in children with URTO and control group.
RESULTS: The MNE rates were %31 and %37 (P=0.41) in study group and control group respectively before operation.The cure rates are %45
and %44 in study group and control group respectively after 4 months postoperatively. (p: 0.55).
DISCUSSION AND CONCLUSION: We could not find any association between surgical treatment of URTO and MNE resolution.

INTRODUCTION: Tinea capitis profunda is a disease associated with purulent discharge and regional lymphadenopathy which characterized with suppurative and painful nodules. It is seen more common in families living crowded and low socioeconomic status. We aimed to evaluate the clinical, demographic and environmental features of cases in the our region that analysed patients with tinea capitis profunda hospitalized in the our clinic.
METHODS: Twenty-seven patients (13 female, 14 male) were analysed retrospectively who varied between ages 2-11 and treated with diagnosis tinea capitis profunda in the our clinic. Demographic, clinical and environmental features were enrolled. The results were analysed with
SPSS 16.0 statistical software.
RESULTS: Thirteen patients were female, 14 were male. The mean of ages were 6.04 years. The duration of disease varied between 15 days to 4 years. The mean of lesions number were 3.62. Nineteen of patients (70%) had history of contact with animals. The mean of lesions number in individuals being history of contact with animals were 4.62, in those without it were 1.62 The onset of lesions 14 of patients (51.8%) were in spring season (p: 0.015). Five of patients (18.5%) had id reaction and this finding was described in contact with animals only. The relationship with id reaction and the mean of lesions number was statistically significant (p: 0.002). One of patients was observed myiasis.
DISCUSSION AND CONCLUSION: Tinea capitis profunda is usually seen which had with direct contact to animals. Also in these patients are described increased the number of lesions and probability of id reaction. In this study, less frequently of male patients according to other studies might be because of treated earlier and the benefit of priority from healthy before who progression to tinea capitis profunda in the our region.

INTRODUCTION: Sarcoidosis is a multisystem disease with unknown etiology and progresses with non caseating granuloma.
METHODS: We evaluated the demographic features, first application complaints, tuberculin skin test, laboratory parameters, radiologic stage, pulmonary function test and DLCO, diagnosis, treatment and following up results for sarcoidosis patients in our clinic.
RESULTS: In this study, 131 (F: 85 - 64,8% M: 46 - 35,2% ) cases, average age 43,2 (Min: 20 Max: 75) years were included. At first application 16,7 % (n: 22) cases had no complaint, the most common complaint was cough (39,6%). According to laboratory tests serum angiotensin converting enzyme
(sACE) levels were elevated (>40 mg/dl) in 82 (62,5 %) of cases. Stage 1: 80 (61 %) Stage 2: 42 (32%) Stage 3: 9 (7%) were detected for Siltzbach Classification. Mediastinoscopy (29,7%) was the most frequent diagnosis method. 100 (76,3 %) cases were followed
without treatment, 26 (19,8 %) cases were began corticosteroid, 4 (3,1 %) cases were treated with inhaled corticosteroid and 1 (0,8%) case was treated with pentoxifylline.
DISCUSSION AND CONCLUSION: As a result, sarcodosis is a good prognosed disease and mostly progress with spontan remission. The frequency and the progress of sarcoidosis in our country is not known clearly. Regularly following up and pulmonary/extrapulmonary organ involvement interrogation may prevent the treatment delay and also may determine the progress and prognosis of the disease.

INTRODUCTION: Normal hearing in early infancy is essential for speech, language, and social and emotional development of human beings. Congenital hearing loss has an impact on normal speech and language, on cognitive and behavioural development in babies. Newborn hearing screenings has been proposed for the early diagnosis and treatment of infants with hearing loss, and thereby improve language outcomes in these babies.
METHODS: Our aim was to evaluate the relationships between risk factors for hearing impairment and otoacoustic emission (OAE) and auditory brainstem responses (ABR) results in patients followed at Neonatal Clinic of Umraniye Training and Research Hospital.
RESULTS: Seventeen out of 100 neonates in the group with risk factors failed OAE tests, of which 5 were also failed ABR test. Tree out of 100 neonates in the group without risk factors failed OAE tests, of which 1was also failed ABR test. When the test fails compared with the number of risk factors; 1% of neonates without risk factors, 3.2% of neonates with 1 risk factor, 25% in the group with two risk factors, 100% of neonates with 3 risk factors did not pass the screening.
DISCUSSION AND CONCLUSION: As a conclusion, the increase in the number of risk factors significantly increases the failure rate of the ABR test.

Pilonidal sinüs disease is a chronic disease, usually presented with a drained sinus and abscess in sacrococcygeal region.The incidence is highest in ages between 15-25 and approximately 80% of patients are male. The disease is diagnosed when a drained sinus is detected about 4-5 cm above anus.The main surgical approach is excision of sinus and closure of this defect with different techniques. The most
commonly used techniques are; Primary repair, marsupialization, Karydakis operation and Limberg flep.In this review, The current diagnosis and treatment of pilonidal sinus disease is discussed.

Although bleeding is the most serious complication of oral anticoagulant treatment, epidural hemotoma and hemothorax are extremely rare. In this case, we want to report rare sequential complications (spinal epidural hematoma, hemothorax and intraalveolar hemoragia) in a patient with a mechanical aortic valve taking warfarin.

Intraosseous epidermal cyst within phalanks is an unusual benign condition. Differential diagnosis includes aneurysmal bone cyst, unicameral (simple) bone cyst, enchondroma etc. The case is an 84 year old man has a painless nodule in the left hand for 20 years.
He was made local excision and diagnosed “intraosseous epidermoid cyst”

Neuroretinitis is a form of optic neuropathy characterised by acute unilateral or bilaterale visual loss and macular star added one or two weeks. Our case was a woman aged 25 years old, visual loss and disk edema beginning at left eye, continueing with right eye in 3 days. Macular star was seen at the second week and because of bad clinical findings, pulse steroid was begun. The patient was better at one month. The purpose of this report was to remember Leber’s idiopathic stellate neuroretinitis one more, a case with good prognosis.