Person: KÖKSAL, FATMA NİRGÜL
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KÖKSAL
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FATMA NİRGÜL
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Publication A comparison of chlorhexidine and povidone-iodine solutions in neonatal intensive care units(Wiley, 2023-01) Küçüker, Hakan; Çakır, Salih Çağrı; Köksal, Nirgül; Özkan, Hilal; Kocael, Fatma; Dorum, Bayram Ali; Yıldırım, Cansu Sivrikaya; Çelebi, Solmaz; Hacımustafaoğlu, Mustafa; KÜÇÜKER, HAKAN; ÇAKIR, SALİH ÇAĞRI; KÖKSAL, FATMA NİRGÜL; ÖZKAN, HİLAL; KOCAEL, FATMA; SİVRİKAYA YILDIRIM, CANSU; ÇELEBİ, SOLMAZ; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Dorum, Bayram Ali; Bursa Uludağ Üniversitesi/Tıp Fakültesi; 0000-0002-1636-5819; 0000-0001-5761-4757; 0000-0002-1787-6872; 0000-0003-4646-660X; 0000-0002-2823-8454; CZJ-5958-2022; HJZ-4508-2023; CZV-1969-2022; IGT-7005-2023; DXK-0792-2022; A-5375-2017; KGF-7434-2024; ENK-4130-2022; CTG-5805-2022Background: Povidone-iodine (10%; PI) and 2% chlorhexidine in 70% isopropyl alcohol (CHG-IA) solutions are among the most widely used disinfectants in the neonatal intensive care units. This study compares the use of these disinfectants and helps decide which is superior to the other for neonatal use.Methods: All term and preterm infants born and hospitalized in Bursa Uludag University Hospital between July 2018-March 2020 were included. The infants were randomized into two disinfectant groups before birth. The application site was cleaned with the assigned disinfectant before intervention. The infants were screened for rates of neonatal sepsis, thyroid-stimulating hormone (TSH) levels, free thyroxine (fT4) levels, skin reactions to the assigned solution, and acute neurological side effects.Results: We enrolled 208 term and preterm infants (PI:104 vs. CHG-IA: 104) in the study. The prematurity rates were identical (PI: 74.0%; CHG-IA: 72.1%; p = 0.755). Neonatal sepsis rates among these groups were not statistically different (PI: 8.7%; CHG-IA: 4.8%; p = 0.406). The median TSH value of the PI group was high (4.05 mIU/L) in comparison with that of the CHG-IA group (3.09 mIU/L; p = 0.016). No cutaneous or neurological side effects were recorded in patients treated with CHG-IA solution.Conclusions: Although these two solutions were equally protective against infections, the CHG-IA solution was a better alternative to PI for neonatal use. Considering that the PI solution may be responsible for impaired thyroid function, the CHG-IA solution is a good alternative because it provides sufficient protection with a safer adverse effect profile.Publication Aluminum exposure in premature babies related to total parenteral nutrition and treatments(Türk Pediatri Dergisi, 2018-07-01) Asut, Emre; Köksal, Nilgün; Dorum, Bayram Ali; Özkan, Hilal; Asut, Emre; KÖKSAL, FATMA NİRGÜL; Dorum, Bayram Ali; ÖZKAN, HİLAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Yenidoğan Bilim Dalı; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı; 0000-0002-2823-8454; A-5375-2017; AAG-8393-2021; HJH-3690-2023; JGS-7600-2023; JJY-3921-2023This study aimed to measure aluminum contamination of parenteral nutrition (PN) solutions and aluminum contents of parenteral products given to newborn infants for nutrition or treatment. In this study, the aluminum content of the first products used to prepare PN solutions for premature neonates, of the final parenteral products prepared therefrom, and of the parenteral drugs frequently used in newborn units was measured using the inductively coupled plasma mass spectrometry. The aluminum contamination of all parenteral nutritional products evaluated, except for one, was detected to be over the recommended doses. Of all the first products analyzed within the scope of the study, trace-element preparation, preparation containing fat-soluble vitamins, 20% dextrose solution, calcium gluconate ampoule and sodium phosphate ampoule indicated high aluminum contamination. The total aluminum content of the prepared final products was identified to be at least 40% higher than the total aluminum content of the ingredients added to the compound. Accordingly, the minimum amount of aluminum content was measured as 233 mu g/kg/day in nutrition solutions prepared for a baby weighing 1,000 g. Contamination was detected in 9 of the 18 drugs evaluated. This study indicated that the rate of aluminum exposure of the premature babies receiving parental nutrition is still much higher than the safe doses recommended as 5 mu g/kg/day by the FDA. Products with lower aluminum content should be preferred in the care of premature infants.Publication Risk factors for respiratory syncytial virus infections in moderate/late premature infants in Turkey: A prospective multicenter epidemiological study(Thieme Medical Publ Inc, 2020-07-13) Özkan, Hilal; Çelebi, Solmaz; Köksal, Nilgün; Hacımustafaoğlu, Mustafa; Koç, Esin; Tezer, Hasan; Çetinkaya, Merih; Cebeci, Burcu; Erdeve, Ömer; Özdemir, Halil; Turkish Neonatal Soc RSV Study Grp; Turkish Pediat Infect Dis Soc RSV; ÖZKAN, HİLAL; ÇELEBİ, SOLMAZ; KÖKSAL, FATMA NİRGÜL; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri bölümü; 0000-0003-1886-8126; GRN-8407-2022; IGT-7005-2023; CZV-1969-2022; CTG-5805-2022Objective Respiratory syncytial virus (RSV) is one of the most prevalent causes of lower respiratory tract infection (LRTI). The primary objective of this study is to provide the risk modelling of confirmed RSV infection in children who were born preterm at 29 to 35 weeks of gestational age and presented with LRTI. Study Design This prospective, multicenter study was performed between October 2015 and March 2017. Premature infants born with gestational age between 29 and 35 weeks that were <= 2 years of age at the beginning of the RSV season and admitted to the hospital with clinical findings of LRTI during the season were included. RSV-positive and -negative infants were compared in terms of demographic features, risk factors, and requirement of hospitalization. Results RSV positive group was lower than RSV negative group and ratio of <= 3 months age at admission was significant higher in RSV (+) group. RSV-positive infants were found to be significantly born during or 3 months prior to RSV season. The rate and duration of hospitalization and need for mechanical ventilation were significantly higher in RSV positive infants. The rate and duration of hospitalization in RSV positive patients was related to the chronological age. Conclusion This study showed that preterm infants with RSV-associated LRTI significantly needed more hospitalization, intensive care admission, and mechanical ventilation. In addition need of hospitalization and duration of hospitalization were significant higher in <= 3 months of age. Therefore, we suggest the importance of palivizumab prophylaxis in infants <= 3 months chronological age, especially during the RSV season.Publication The distribution of etiology in newborns with prolonged jaundice(Galenos Yayıncılık, 2008-12-01) Çetinkaya, Merih; Özkan, Hilal; Köksal, Nirgün; Akacı, Okan; Çetinkaya, Merih; ÖZKAN, HİLAL; KÖKSAL, FATMA NİRGÜL; Akacı, Okan; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Neonatol Bilim Dalı; 0000-0002-2148-1160; AFO-2965-2022; AFP-9671-2022; JLK-4920-2023; JGS-7600-2023Aim: The aim of this study is to determine the etiology in neonates admitted with prolonged jaundice.Materials and Method: Neonates with prolonged jaundice were included to this prospective study designed between January 2007 and December 2007. Prolonged jaundice was defined as total bilirubin level >5 mg/dL in newborns older than 14 days of age. After detailed history and physical examination, blood tests including blood groups of baby and mother, total, direct and indirect bilirubin, complete blood count (CBC), blood smear, reticulocyte count, Coombs test, serum aspartattransaminase (AST) level, serum alanin transaminase (ALT) level, viral markers, thyroid function tests, and glucose-6 phosphate dehydrogenase (G-6 PD) level and routine urine analysis with urine culture were performed in all newborns.Results: A total of 154 neonates were enrolled to the study. The most frequent cause of prolonged jaundice was breast milk jaundice (53%). It was followed by urinary tract infections and clinical sepsis (29%), hemolytic causes due to blood group incompetency (10%) and congenital hypothyroidism (8%). However, there were no significant differences between etiology and mean bilirubin levels.Conclusion: It is important to determine the etiology and to plan therapy according to etiology is important in newborns with prolonged jaundice. Breast milk jaundice, urinary tract infection and sepsis, hypothyroidism and hemolytic causes must be considered as the main etiology in newborns with prolonged jaundice.