Anticorrosion effect of a green sustainable inhibitor on mild steel in hydrochloric acid.

Green inhibitors are an important way to decrease the corrosion rate of different industrial metals. The present work shows the corrosion behavior of the mild steel medium (MS) in hydrochloric acid 1 M by the aqueous extract of Artemisia Herba Alba (AHA), which is an green sustainable inhibitor to reduce its corrosive action by exploiting a variety of techniques and methods namely: Weight loss, electrochemical techniques [electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization (PDP], SEM-EDX, XPS and theoretical calculations for the majority molecule. Hydrodistillation is the extraction method that has been used to prepare the aqueous extracts. Otherwise, phytochemical screening characterization of different parts of the plant was applied to show the proportions of chemical compounds that exist in the plants. The highest inhibition efficiency obtained is 92% for 0.4 g/L of AHA aqueous extract in 1 M HCl at 303 K. PDP study confirmed that the AHA extract is of mixed-kind inhibitor. A CPE, Q determined by fit and graphical methods plotted by synthetic data, was utilized. To characterize the mild steel surface, scanning electron microscopy was also used; SEM/EDX allowed the investigation of the AHA effect on the surface of mild steel specimens. To comprehend the adsorption mechanism of AHA extract for MS in the 1 M HCl, XPS technique was accomplished. Theoretical approaches based on chemical quantum calculations and molecular dynamics simulation clearly explains the mode of adsorption of the majority molecule on the iron surface.

Differences in hepatitis A seroprevalence among geographical regions in Turkey: a need for regional vaccination recommendations.

Hepatitis A is a worldwide vaccine-preventable infection. Recommendation of vaccination depends on the endemicity of the disease. The World Health Organization recommends universal hepatitis A vaccination in intermediate areas; however, there is no need of mass vaccination in high and low endemicity regions. Therefore, most of the countries are using a vaccination policy according to the endemicity characteristic representing the whole of the country. The endemicity of this infection varies due to sanitary and hygiene conditions and socioeconomic differences among the countries and in various regions of the same country. A sample of 1173 persons between the age of 0 and 91 years from nine randomly selected medical centres from five different geographical centres of Turkey were tested for the level of anti-hepatitis A virus (anti-HAV) immunoglobulin-G antibodies using an enzyme-linked immunosorbent assay. The overall prevalence of anti-HAV antibodies was 64.4% (1142/1173). While the rate of sero-positivity was over 80% in the 5-9 age group and more than 90% after 14 years of age in south-eastern and eastern regions, it was lower than 50% at the age of 5-9 years in central and western regions and remains under 80% in those areas. We conclude that the differences observed in HAV sero-positivity among various geographical regions in Turkey support a universal HAV immunization policy for children currently living in regions of intermediate endemicity.

A case of Gianotti Crosti syndrome with HBV infection.

Gianotti-Crosti syndrome (papular acrodermatitis of childhood), which was first described in 1955, is a nonspecific rash that usually consists of the abrupt onset of pink flesh coloring, smooth or lichenoid, flat-topped papules. It was first related to hepatitis B virus (HBV) infection; however, cases not associated with HBV infection were reported as well. Although a type of delayed hypersensitivity reaction is speculated as a cause, exact pathogenesis still remains unclear. The prognosis is favorable and successful management relies upon general supportive and symptomatic care. We report a seven-year-old boy diagnosed with Gianotti-Crosti syndrome with monomorphous papules on his cheeks, buttocks and extremities associated with hepatitis B virus infection.

Pamidronate treatment in acute vitamin D intoxication.

Management with glucocorticoid, high iv fluid saline intake, furosemide and calcitonin may not result in a favorable reduction of hypercalcemia and may cause several side effects in infants with acute vitamin D intoxication. The bisphosphonate pamidronate, a specific inhibitor of bone resorption through osteoclast mediation was successfully used in a 6-month old infant with acute vitamin D intoxication managed in the Pediatric Emergency and Intensive Care Unit, after an ineffective trial of hydration, furosemide, calcitonin and prednisolone. After a double infusion of pamidronate on two consecutive days (1 mg/kg/day), an early and safe correction of hypercalcemia/hypercalciuria was supplied. Pamidronate therapy may be considered in patients with hypercalcemia secondary to acute vitamin D poisoning.

Interferon-alpha therapy in idiopathic thrombocytopenic purpura.

BACKGROUND: Acute idiopathic thrombocytopenic purpura (ITP) represents the most frequent hemorrhagic diathesis in childhood. Up to 30% of patients with ITP are regarded as refractory to standard therapy. The rare mortality from acute ITP in childhood is almost exclusively due to intracranial hemorrhage. This complication occurs in less than 1% of ITP patients. This study was designed to evaluate the effect of alpha-interferon (IFN-alpha) in eight patients whom did not respond to conventional therapy. METHOD: In spite of conventional therapies, the patient whose platelet count could not be increased to 50;10(9)/L were accepted as refractory ITP. Eight of these patients whose platelet count lower than 20;10(9)/L were included in the prospective cohort study. Interferon alpha 2b 5 MU/m(2) was administered subcutaneously three times a week, totalling 12 times in a month. According to the platelet count on the 28th day of therapy, we grouped the patients into three categories. After 60 days, the survey was re-evaluated according to the platelet count. RESULTS: The mean age of children was 3.5+/-2.5 (ranged between 3.5 and 9) years. Six of them were boys and two were girls. There was no response in one patient, partial response in one, and good response in six patients on the 28th day of therapy. The maximum rise in platelet count was observed from 7 to 14 days after the initiation of interferon. The median platelet count which was 15+/-5;10(9)/L before therapy, raised to 60+/-12;10(9)/L after therapy. However, on the 60th day of therapy, there were only two patients who had a platelet count over 100;10(9)/L. CONCLUSION: In our study, we did not observe the long-term benefit of IFN-alpha therapy in refractor ITP in childhood. However, in good responding patients, platelet levels were increased in a short time. Alpha-interferon may be alternative therapy for patients whom had a platelet count below 20;10(9)/L and not responding to standard therapy, or for patients whom immunosuppressive therapy is contraindicated.

Lamivudine and interferon-alpha combination treatment of childhood patients with chronic hepatitis B infection.

BACKGROUND: The aim of our study was to compare the efficacy of combined interferon-alpha and lamivudine in children with chronic hepatitis B infection and two durations of treatment (6 and 12 months). METHODS: Combination of interferon-alpha 2b (10 MU/m2 of body surface) and lamivudine 4 mg/kg (maximum, 100 mg) were given synchronously to 30 patients for 6 months (Group 1) and to 27 patients for 12 months (Group 2). Biochemical, virologic and serologic features were compared between two groups at the end of therapy and 6 months after therapy. RESULTS: Hepatitis B e antigen clearances were 33 and 59% at the end of treatment and 37 and 56% 6 months after therapy in Groups 1 and 2, respectively (P > 0.05). Hepatitis B virus DNA clearances were 97 and 100% at the end of treatment and 97 and 96% 6 months after therapy in Groups 1 and 2, respectively (P > 0.05). In both groups normalization of alanine aminotransferase was maintained at the end of therapy and 6 months after therapy (P < 0.05). Sustained complete responses were obtained in 20 and 37% of patients at the end of therapy and 6 months after therapy, respectively (P = 0.07). CONCLUSIONS: When the combination of large dosage interferon-alpha 2b and lamivudine therapy in children was compared at the end of therapy and 6 months after therapy, normalization of alanine aminotransferase and the clearances of hepatitis B e antigen and hepatitis B surface antigen in both groups were directly proportional to the duration of treatment. However, the higher complete response rate at 12 months of combination therapy was not statistically different from that at 6 months.

Parental history of migraine and bronchial asthma in children.

BACKGROUND: a possible association between migraine and various allergic disorders have been reported. It was aimed in this study to inquire the association between bronchial asthma in children and parental history of migraine. METHODS AND RESULTS: parental history of allergic diseases and migraine were inquired among 140 asthmatic children (91 males, 49 females) and 110 age and sex matched control subjects who had not any allergic or hypersensitivity disorders, followed-up at Pediatric outpatient clinics of Dicle University Hospital. While 13 of 140 asthmatic children (9.3%) had parental history of migraine, 2 of 110 control subjects (1.8%) had parental migraine history. Difference between asthmatic and control subjects was significant (OR: 5.5, 95% Cl: 1.3-25.0). Children who had parental history of migraine also had significantly more frequent parental history of asthma, eczema and particularly allergic rhinitis (p=0.007). CONCLUSIONS: our results suggest that children are at increased risk of asthma if their parents have a history of migraine. Migraine in one generation and asthma in the next lead to the conclusion that the two disorders may have a relationship to a common denominator.

Parental history of migraine and bronchial asthma in children

Background: a possible association between migraine and various allergic disorders have been reported. It was aimed in this study to inquire the association between bronchial asthma in children and parental history of migraine. Methods and results: parental history of allergic diseases and migraine were inquired among 140 asthmatic children (91 males, 49 females) and 110 age and sex matched control subjects who had not any allergic or hypersensitivity disorders, followed-up at Pediatric outpatient clinics of Dicle University Hospital. While 13 of 140 asthmatic children (9.3%) had parental history of migraine, 2 of 110 control subjects (1.8%) had parental migraine history. Difference between asthmatic and control subjects was significant (OR: 5.5, 95% CI: 1.3-25.0). Children who had parental history of migraine also had significantly more frequent parental history of asthma, eczema and particularly allergic rhinitis (p = 0.007). Conclusions: our results suggest that children are at increased risk of asthma if their parents have a history of migraine. Migraine in one generation and asthma in the next lead to the conclusion that the two disorders may have a relationship to a common denominator (AU)

Antecedentes: se ha comunicado una posible asociación entre la migraña y diversas alteraciones alérgicas. Se emprendió este estudio para investigar la asociación entre el asma bronquial infantil y los antecedentes paternos de cefalea vascular.Métodos y resultados: se estudiaron los antecedentes paternos de enfermedad alérgica y migraña de 140 niños asmáticos (91 niños y 49 niñas) y un grupo control de 110 niños de edades y distribución sexual similar, sin alteraciones alérgicas o de hipersensibilidad. El seguimiento de ambos grupos fue llevado a cabo en el ambulatorio del Hospital Universitario de Dicle. Trece de los 140 niños asmáticos (9,3 por ciento) tuvieron antecedentes paternos de migraña frente a 2 de los 110 controles (1,8 por ciento). La diferencia entre los asmáticos y controles fue significativa (OR: 5,5; 95 por ciento CI: 1,3-25,0). Los niños con antecedentes paternos de migraña también tuvieron una mayor frecuencia de antecedentes paternos de asma, eccema y, sobre todo, rinitis alérgica (p = 0,007).Conclusión: nuestros resultados sugieren que los hijos de padres que tienen una historia de migraña tienen mayor riesgo de padecer asma. La presentación de migraña en una generación y asma en la siguiente que ambos trastornos pueden relacionarse con un factor común. (AU)

Tuberculous peritonitis in 11 children: clinical features and diagnostic approach.

BACKGROUND: Tuberculous peritonitis (TBP) is a rare manifestation of childhood tuberculosis characterized by long-lasting abdominal symptoms and exudate and lymphocytes in the ascitic fluid. The diagnosis of TBP is rarely established unless a high index of suspicion is maintained. METHODS: The diagnostic features of 11 cases who were hospitalized with TBP in the Pediatric Infectious Diseases Ward of Dicle University Hospital, Turkey, were evaluated retrospectively. RESULTS: Seven cases were male and the ages of all cases ranged between 1 and 11 years. The onset of symptoms was 1-12 months (mean +/- SD 3.1 +/- 2.7 months) prior to the admission time. Nine patients gave a history of familial tuberculosis. Three cases had Bacillus Calmette-Guérin (BCG) scars and the results of five tuberculin unit (TU) tests in cases without and with BCG were over 10 and 15 mm, respectively. The most common presenting clinical symptoms and signs at admission were abdominal distention and ascites (100%), fever (27%) and loss of weight (18%). One case had accompanying tuberculous meningitis and two cases had concomitant pulmonary tuberculosis. Only one of 11 samples of ascitic fluid yielded Mycobacterium tuberculosis by the polymerase chain reaction method and no other microbiologic evidence was obtained in culture specimens. Ultrasonographic and computed tomographic imagings revealed high-density ascites that contributed well to the diagnosis. The diagnosis in two patients was proven histopathologically via peritoneoscopy and laparoscopy. All cases were treated with isoniazide, rifampisin for 9 months and pyrazinamide for the first 2 months. CONCLUSIONS: Radiologic diagnostic techniques, positive skin tests and a history of exposure to tuberculosis may contribute to the diagnosis of TBP, helped by clinical symptoms and findings, particularly when invasive diagnostic methods via peritoneoscopy and laparoscopy are not available in developing countries.

Neonatal tetanus: a continuing challenge in the southeast of Turkey: risk factors, clinical features and prognostic factors.

Neonatal tetanus (NT) still causes significant mortality in developing countries, although in 1989 WHO adopted the goal of eliminating the disease by 1995-2000. To characterize the regional characteristics, clinical charts of 55 neonates (42 males and 13 females) admitted to the Pediatric Infectious Diseases Ward of Dicle University Hospital, Diyarbakir, Turkey with the diagnosis of NT from 1991 to 1997 were reviewed. Mean age at admittance was 8.9+/-4.3 days with a range of 3-25 days. Mean period for the appearance of first symptoms was 5.8 days ranging between 1 and 21 days. Mean birth weight of the patients was 3369+/-560g. All patients were from rural areas and were delivered at home by untrained traditional birth attendants with no prior antenatal healthcare services. Razor blade (55%), scissors (27%), and knife (18%) were the instruments used to cut the cord in non-hygienic conditions. No mothers had prior vaccination with tetanus toxoid during their pregnancy. Spasticity (76%), lack of sucking (71%), trismus (60%), fever (49%), omphalitis (44%), irritability (24%), risus sardonicus (22%), and opithotonus (15%) were the most common presenting signs and symptoms. Age at admission < 7.5 days and symptoms of onset <4.9 days, risus sardonicus and opisthotonus were associated with fatal outcome. All patients were treated with human tetanus immunglobulin or equine tetanus antitoxin where available, antibiotic therapy by penicillin G (100.000 U/kg/day) and intravenous high dose diazepam (40 mg/kg/day). Overall mortality rate was 40% (22 cases), without any equipment for mechanical ventilation. Health education of mothers and birth attendants, promotion of hospital delivery and prenatal tetanus immunization of all pregnant women particularly in rural areas are recommended, if NT is to be prevented.

Intravenous magnesium sulphate in the management of moderate to severe acute asthmatic children nonresponding to conventional therapy.

Management of severe acute asthma attacks in children sometimes bring difficulties to the physician. Some current treatment strategies have focused on intravenous magnesium sulphate administration in patients nonresponding to therapy with beta-2 agonists and corticosteroids. The use and efficacy of this drug has been discussed in this randomized, double-blind, placebo-controlled clinical trial consisting of 20 children with moderate to severe acute asthma exacerbation admitted to the emergency department in Dicle University Hospital, Turkey. Magnesium sulphate infusion therapy of 40 mg/kg doses (maximum 2 g) or an equivalent volume of normal saline solution were administered to randomly assigned 10 patients in each group to the selected patients who were being treated for an acute asthma exacerbation with a peak expiratory flow rate (PEFR) less than 60% of the predicted value after receiving three beta-2 adrenergic nebulizer treatments (salbutamol) given at an interval of 20 minutes each. Vital signs, PEFR and physical examinations were serially recorded at 15 minutes intervals for a total of 90 minutes after the initiation of magnesium sulphate therapy. At 30 minutes, compared with the placebo group, the magnesium sulphate receiving group had lower clinical asthma scores (4.0+/-0.5 vs. 5.5+/-0.5, p = 0.0002) and a significantly greater percentage of improvement from baseline in PEFR (43.0+/-6.3% vs. 14.6+/-3.7%, p = 0.0002). These significant changes persisted at 45, 60, 75 and 90 minutes. No significant side effects were observed. In conclusion, severe asthmatic cases may benefit from magnesium sulphate therapy when beta-2 agonists are inadequate in preventing deterioration.

Miliary tuberculosis in children: a clinical review.

Miliary tuberculosis infection in childhood remains a significant health problem in developing countries. To characterize the clinical features of the disease, symptoms, signs and laboratory findings, associated infections and outcomes of the 23 children (14M, 9F) with miliary tuberculosis admitted to the Dicle University Hospital, Diyarbakir, Turkey from 1990 to 1997 were analysed. Mean age of the patients was 3.7 y ranging between 6 months and 11 y. All but 3 patients were below 6 y of age, and 5 of the patients were under 1 y of age. All of the children had not received BCG vaccination except for 1 who was immunized after the age of 5 y. Only 6 children had a positive reaction to 5 TU tuberculin test at admission to hospital. Eight of the 23 subjects were infected in the family, and all were nonHIV infected cases. All of the children were diagnosed clinically and by a miliary infiltrate visible on chest roentgenogram. Five cases had positive culture results for Mycobacterium tuberculosis. Duration of onset of symptoms prior to admission ranged between 15 d and 8 months with a mean of 58 d. The most frequently seen symptoms and clinical findings were fever in 17 cases, rales in 14, loss of appetite and weight in 10 and hepatosplenomegaly in 9 cases. Two cases had prior measles infection and 1 of the patients presented facial paralysis. Seven cases had also tuberculous meningitis. The outcome in general was good, with mortality in 2 cases.