{"id":900,"date":"2011-06-03T11:26:43","date_gmt":"2011-06-03T08:26:43","guid":{"rendered":"http:\/\/www.islamidavet.com\/kutuphane\/\/?p=900"},"modified":"2011-06-03T11:26:43","modified_gmt":"2011-06-03T08:26:43","slug":"cocuk-hastaliklari","status":"publish","type":"post","link":"https:\/\/www.islamidavet.com\/kutuphane\/cocuk-hastaliklari\/","title":{"rendered":"\u00c7ocuk Hastaliklari"},"content":{"rendered":"

1. A\u011eIZ \u0130\u00c7\u0130 \u0130LT\u0130HABI
\nDi\u015fetinin ve a\u011f\u0131z i\u00e7i mukozas\u0131n\u0131n bir hastal\u0131\u011f\u0131d\u0131r. Yeti\u015fkinlere k\u0131yasla \u00e7ocuklarda daha s\u0131k g\u00f6r\u00fcl\u00fcr. Bu durumun en ba\u015fta gelen nedenleri, yetersiz temizlik, k\u00f6t\u00fc beslenme ve sa\u011fl\u0131ks\u0131z bar\u0131nma bi\u00e7imleridir. Ama a\u011f\u0131z i\u00e7i iltihab\u0131, k\u0131z\u0131l hastal\u0131\u011f\u0131, k\u0131zam\u0131k, tifo, ra\u015fitizm(kemik hastal\u0131\u011f\u0131) ve frengi hastal\u0131\u011f\u0131ndan da kaynaklanabilir. Bu hastal\u0131k bula\u015f\u0131c\u0131d\u0131r, ki\u015fiden ki\u015fiye ge\u00e7er. Hastan\u0131n a\u011fz\u0131ndan etrafa k\u00f6t\u00fc bir koku yay\u0131l\u0131r. Di\u015feti k\u0131zar\u0131r ve \u015fi\u015fer. Ayr\u0131ca a\u011f\u0131z i\u00e7inde \u00fclserler olu\u015fur. Di\u015fler sallanmaya ba\u015flar ve hatta d\u00fc\u015febilirler. Di\u015feti s\u0131n\u0131rlar\u0131nda, dilde ve a\u011f\u0131z mukozas\u0131nda, sar\u0131mtrak \u015fi\u015fkin b\u00f6lgeler a\u00e7\u0131kl\u0131kla g\u00f6r\u00fclebilir. K\u00f6t\u00fc kokulu salyan\u0131n rengi de k\u00f6t\u00fcle\u015fir. A\u011f\u0131z i\u00e7i ve yutak a\u011fr\u0131l\u0131d\u0131r.
\nBu hastal\u0131\u011f\u0131n tedavisi i\u00e7in g\u00fcnde 4-5 kere \u0131l\u0131k gargaralar yap\u0131l\u0131p a\u011f\u0131z bo\u015falt\u0131l\u0131r. Bu gargaralar i\u00e7in ada\u00e7ay\u0131 kullan\u0131l\u0131r. Ayr\u0131ca, a\u011f\u0131z i\u00e7ine g\u00fcnde bir kere ada\u00e7ay\u0131 bu\u011fu tedavisi uygulan\u0131r. \u0130\u00e7ecek olarak en uygun olan\u0131 madensuyu ve meyve suyudur. Gargara yapamayan k\u00fc\u00e7\u00fck \u00e7ocuklar\u0131n a\u011f\u0131zlar\u0131n\u0131n i\u00e7i, ada\u00e7ay\u0131 ile \u0131slat\u0131lm\u0131\u015f yumu\u015fak bir bezle silinir. \u00c7i\u011fnemek \u015fiddetli a\u011fr\u0131lara yol a\u00e7abilece\u011fi i\u00e7in, bu hastal\u0131k s\u0131ras\u0131nda lapa t\u00fcr\u00fc besinlerle beslenmek do\u011fru olur.
\nAda\u00e7ay\u0131: Bir tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f ada\u00e7ay\u0131, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr.
\n2. ALERJ\u0130
\nAyn\u0131 miktar\u0131 ba\u015fka ki\u015filerde herhangi bir tepki olu\u015fturmayan bir maddeyle kar\u015f\u0131la\u015f\u0131ld\u0131\u011f\u0131nda organizman\u0131n tepkisiyle olu\u015fan de\u011fi\u015fiklikler alerji olarak tan\u0131mlan\u0131r. Bunun anlam\u0131: Mukozalar, deriler veya i\u00e7 organlar\u0131, baz\u0131 besinlere, kimyasallara, \u0131s\u0131lara veya bitkisel \u00fcr\u00fcnlere kar\u015f\u0131 a\u015f\u0131r\u0131 tepki verirler. Alerjiler kal\u0131tsal olabildi\u011fi gibi, sonradan da kazan\u0131labilirler. Suyun d\u0131\u015f\u0131nda, hemen hemen t\u00fcm maddelere alerjiler saptanm\u0131\u015ft\u0131r. En \u00fcnl\u00fc t\u00fcr\u00fc saman nezlesidir. \u00d6teki alerji t\u00fcrleri ise, serum hastal\u0131\u011f\u0131(serum sickness), bron\u015fiyal ast\u0131m, deri tepkileri ve deri hastal\u0131klar\u0131, \u00e7e\u015fitli mide-ba\u011f\u0131rsak hastal\u0131klar\u0131, kan ve damar hastal\u0131klar\u0131d\u0131r. T\u00fcm alerjilerin temeli, bir antijen-antikor tepkimesine dayan\u0131r: Antijenler, insan organizmas\u0131nda bir savunma mekanizmas\u0131 olu\u015fturan antikorlar\u0131n olu\u015fumuna yol a\u00e7an, kayna\u011f\u0131 ve t\u00fcr\u00fc \u00e7ok \u00e7e\u015fitli olabilen yabanc\u0131 maddelerdir. \u0130kinci bir antijen temas\u0131 ise alerjileri ba\u015flat\u0131r.
\nAlerjik tepkilere yol a\u00e7an antijenler, alerjen olarak tan\u0131mlan\u0131r. Bir alerji kendini genellikle bir deri tepkisi bi\u00e7iminde(k\u0131zar\u0131kl\u0131k, ka\u015f\u0131nt\u0131l\u0131 kabar\u0131kl\u0131klar veya \u00f6dem), bazen de ast\u0131m krizleri, \u015fok veya baz\u0131 belirli enfeksiyonlar\u0131n sonucunda romatizma olu\u015fumu bi\u00e7iminde belli eder.
\nIs\u0131rganotu: Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f \u0131s\u0131rganotu, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcnde 3-4 bardak taze demlenmi\u015f \u0131s\u0131rganotu \u00e7ay\u0131 so\u011futulmadan yudumlan\u0131r.
\nEbeg\u00fcmeci y\u0131kamalar\u0131: Deri alerjileri ebeg\u00fcmeci y\u0131kamalar\u0131 ile tedavi edilebilir. Ka\u015f\u0131nan ve yanan y\u00fcz alerjilerinin \u0131l\u0131k ebeg\u00fcmeci \u00e7ay\u0131 ile y\u0131kanmas\u0131 b\u00fcy\u00fck rahatl\u0131klar sa\u011flar.
\nBir tatl\u0131 ka\u015f\u0131\u011f\u0131 dolusu ince k\u0131y\u0131lm\u0131\u015f ebeg\u00fcmeci, yar\u0131m litre so\u011fuk suda 12 saat demlendikten sonra \u0131s\u0131t\u0131l\u0131r ve s\u00fcz\u00fcl\u00fcr. S\u00f6z konusu b\u00f6lgeler bu ebeg\u00fcmeci \u00e7ay\u0131 ile g\u00fcnde pek \u00e7ok kere y\u0131kan\u0131r.
\n3. ANEM\u0130 (KANSIZLIK)
\nGenel dola\u015f\u0131mdaki kanda alyuvarlar miktar\u0131n\u0131n d\u00fc\u015fmesiyle birlikte g\u00f6r\u00fclen hastal\u0131klar, kans\u0131zl\u0131k hastal\u0131klar\u0131 olarak adland\u0131r\u0131l\u0131r (kans\u0131zl\u0131k, anemi).Bazen demir veya vitamin eksikli\u011finden, bazen de hormon dengesizli\u011finden veya yanl\u0131\u015f bir ya\u015fam bi\u00e7iminden kaynaklanan (yetersiz g\u00fcne\u015f \u0131\u015f\u0131\u011f\u0131 ve hareketsizlik), gen\u00e7 k\u0131zlar\u0131n solgunlu\u011fu (chlorosis) bir \u00e7e\u015fit anemi, daha do\u011frusu demir yetersizli\u011fi anemisidir. Anemiye yol a\u00e7abilecek nedenler \u015f\u00f6yle s\u0131ralanabilir:S\u00fcrekli kan kayb\u0131 (h\u00f6moroit, \u00fclserler), demir eksikli\u011fi, B12 vitamini eksikli\u011fi, kemik ili\u011fi hastal\u0131klar\u0131 veya do\u011fumsal \u00f6zellikler. Kandaki alyuvarlar say\u0131s\u0131n\u0131n azalmas\u0131yla birlikte bedendeki oksijen dola\u015f\u0131m\u0131 da azal\u0131r; pek \u00e7ok organ, oksijen yetersizli\u011fi nedeniyle zarara u\u011frayabilir.
\nAnemi, hastan\u0131n belirgin derecede solgunlu\u011fu, uykusuzlu\u011fu, sinirlili\u011fi, kalp at\u0131m\u0131n\u0131n ve solunumun h\u0131zlanmas\u0131 veya sinir sisteminde olu\u015fan baz\u0131 bozukluklarla kendini belli eder. Anemide giderek artan kan y\u0131k\u0131m\u0131n\u0131n bir sonucu olarak, ba\u015flang\u0131\u00e7 a\u015famas\u0131nda sar\u0131l\u0131k ve dalakta \u015fi\u015flik de olu\u015fabilir. Bu durumlara kar\u015f\u0131 anemi tedavisi uygulan\u0131r. \u015eiddetli akut kanamalarda en g\u00fcvenilir \u00e7\u00f6z\u00fcm kan naklidir. Kronik kanamalarda ise, kanama nedeninin tedavisi gerekir. Demir ve C vitamini a\u00e7\u0131s\u0131ndan zengin besinlerin t\u00fcketilmesi yararl\u0131 olacakt\u0131r(sakatat, bira mayas\u0131, dar\u0131, \u0131spanak, \u0131s\u0131rganotu, baklagiller, \u015feftali ve kuru kay\u0131s\u0131). Bedensel yorgunluklardan uzak durmak ve bol uyku da \u00e7ok yararl\u0131d\u0131r.
\nIs\u0131rganotu: Kan yapt\u0131r\u0131c\u0131 etken maddeleri sayesinde \u0131s\u0131rganotu anemide bile yard\u0131mc\u0131 olabilir.
\nYar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f \u0131s\u0131rganotu, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcnde 3-4 bardak taze demlenmi\u015f \u0131s\u0131rganotu \u00e7ay\u0131 so\u011futulmadan yudumlan\u0131r.
\n4. ANJ\u0130N
\nYutak ve \u00e7evre dokularda akut bir iltihaplanmad\u0131r. Anjin (angina) Latincede dar anlam\u0131n\u0131 ta\u015f\u0131r ve yutaktaki bu belirgin daralma, iltihapl\u0131 bademciklerin \u015fi\u015fmesi nedeniyle olu\u015fur. Yutma zorluklar\u0131yla birlikte, birden ate\u015f y\u00fckselir ve halsizlik ba\u015flar. Bademcikler k\u0131zarm\u0131\u015ft\u0131r ve en ge\u00e7 hastal\u0131\u011f\u0131n ikinci g\u00fcn\u00fcnde iltihap damlac\u0131klar\u0131yla kaplan\u0131r ve bunlar k\u0131sa s\u00fcrede birle\u015ferek tam bir iltihap tabakas\u0131 olu\u015ftururlar. Basit bademcik iltihab\u0131nda, k\u0131zar\u0131kl\u0131k, \u015fi\u015flik ve iltihaplanma, \u00f6zel bir tedavi uygulanmadan da, bir iki hafta i\u00e7inde iyile\u015fir. Yatakta istirahat edilmelidir. Boyuna uygulanan kuru sarg\u0131lar rahatlatabilir.
\nKoyunotu: Koyunotu t\u00fcm bo\u011faz, a\u011f\u0131z i\u00e7i ve yutak iltihaplanmalar\u0131nda \u00f6nemli bir iyile\u015ftirici g\u00fcce sahiptir. Mesleklerinde \u00e7ok konu\u015fmak veya \u015fark\u0131 s\u00f6ylemek zorunda olan ki\u015filer, hastal\u0131klara kar\u015f\u0131 \u00f6nlem olarak her g\u00fcn koyunotu \u00e7ay\u0131 ile gargara yapmal\u0131d\u0131rlar.
\nYar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f koyunotu, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcnde 2 bardak taze demlenmi\u015f bitki \u00e7ay\u0131 so\u011futulmadan yudumlan\u0131r.
\n(\u00c7evirenin notu: Ayn\u0131 ama\u00e7la, ada\u00e7ay\u0131 ve may\u0131s papatyas\u0131 e\u015fit kar\u0131\u015f\u0131m\u0131n\u0131n \u00e7ay\u0131ndan da yararlan\u0131labilir.)
\n4.1. Bademcik \u0130ltihab\u0131 (Anjin)
\nEbeg\u00fcmeci: Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f ebeg\u00fcmeci, bir bardak so\u011fuk suda 12 saat demlendirildikten sonra \u0131s\u0131t\u0131l\u0131r ve s\u00fcz\u00fcl\u00fcr. G\u00fcn boyuna yay\u0131larak 2-3 bardak s\u0131cak \u00e7ay yudumlanarak i\u00e7ilir. Bir kerede demlenen g\u00fcnl\u00fck \u00e7ay miktar\u0131 bir termosta s\u0131cak olarak muhafaza edilebilir.
\nAda\u00e7ay\u0131: Bademcik iltihab\u0131nda ada\u00e7ay\u0131, d\u0131\u015ftan kompres, gargara ve \u00e7ay i\u00e7imi bi\u00e7iminde kullan\u0131labilir.
\nYar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f ada\u00e7ay\u0131, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcn boyunca \u0131l\u0131k \u00e7ayla pek \u00e7ok kere gargara yap\u0131l\u0131r. Arada bir de birka\u00e7 yudum ada\u00e7ay\u0131 tabi ki i\u00e7ilmelidir.
\nAda\u00e7ay\u0131 kompresi: Bademcik iltihab\u0131nda ve bo\u011faz hastal\u0131klar\u0131nda d\u0131\u015ftan yap\u0131lan ada\u00e7ay\u0131 kompresleri \u00e7ok \u00f6nemli yararlar sa\u011flar. Ada\u00e7ay\u0131 ile bo\u011faza s\u0131cak kompresler uygulan\u0131r.
\nBir tatl\u0131 ka\u015f\u0131\u011f\u0131 dolusu ince k\u0131y\u0131lm\u0131\u015f ada\u00e7ay\u0131, yar\u0131m litre kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve 1-2 dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. \u00c7aya bat\u0131r\u0131lan temiz bir bez biraz s\u0131k\u0131larak bo\u011faza sar\u0131l\u0131r ve s\u0131k s\u0131k \u00e7aya bat\u0131r\u0131larak tazelenir. Ama kompresin ve bo\u011faz\u0131n mutlaka s\u0131cak tutulmas\u0131 gerekir. Bunun i\u00e7in, kompresin \u00fcst\u00fc kuru bir bezle veya atk\u0131yla \u00f6rt\u00fclmelidir.
\nAtkuyru\u011fu: Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f atkuyru\u011fu, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. Il\u0131k atkuyru\u011fu \u00e7ay\u0131 ile g\u00fcn boyunca s\u0131k s\u0131k derin gargaralar yap\u0131l\u0131r.
\n5. BA\u011eIRSAK ASALAKLARI
\n\u0130nsan ba\u011f\u0131rsa\u011f\u0131nda \u00e7o\u011funlukla, solucan(askaris), \u015ferit(cestodes), ve i\u011fne solucan\u0131(oxyuris) t\u00fcr\u00fc asalaklar ya\u015far.
\n\u015eeritler: \u0130nsan ba\u011f\u0131rsa\u011f\u0131nda ya\u015fayan \u015feritler metrelerce uzunlu\u011fa ula\u015fabilirler. Bu asalaklar insan bedenine yaln\u0131zca \u00e7i\u011f s\u0131\u011f\u0131r eti yenildi\u011finde ula\u015fabilirler. Bu ger\u00e7e\u011fi anlayabilmek i\u00e7in, \u015feritlerin olu\u015fum evresini bilmek gerekir. Ba\u011f\u0131rsaklar\u0131nda \u015ferit olan bir insan\u0131n d\u0131\u015fk\u0131s\u0131nda di\u015fi ve erkek \u015ferit yumurtalar\u0131 bulunur. Bu d\u0131\u015fk\u0131lar g\u00fcbre olarak ye\u015fil alanlara ula\u015ft\u0131\u011f\u0131nda, bu yumurtalar oralarda otlayan s\u0131\u011f\u0131rlar\u0131n bedenine ula\u015f\u0131r ve b\u00f6ylece hayvanlar\u0131n kas yap\u0131s\u0131nda \u015ferit embriyonlar\u0131 olu\u015fur. Daha sonra bu embriyonlar, yeterince pi\u015firilmemi\u015f s\u0131\u011f\u0131r etinin i\u00e7inde yeniden insan ba\u011f\u0131rsa\u011f\u0131na ula\u015f\u0131rlar. Embriyon, toplui\u011fne ba\u015f\u0131 b\u00fcy\u00fckl\u00fc\u011f\u00fcndeki kafas\u0131yla ba\u011f\u0131rsak duvar\u0131na kenetlenir ve konu\u011fu oldu\u011fu ev sahibinin besinlerini emmeye ba\u015flar. Bu durumdaki ki\u015fide pek \u00e7ok rahats\u0131zl\u0131klar olu\u015fur: D\u00fczensiz d\u0131\u015fk\u0131lama, i\u015ftahs\u0131zl\u0131k, halsizlik ve kans\u0131zl\u0131k. \u0130\u00e7inde yumurtalar\u0131n bulundu\u011fu \u015feridin bedeninden zaman zaman kopan b\u00f6l\u00fcmler d\u0131\u015fk\u0131yla birlikte yeniden d\u0131\u015f d\u00fcnyaya ula\u015f\u0131rlar. Olu\u015fum evresi b\u00f6ylece yeniden ba\u015flar.
\nSolucan: Yer solucan\u0131n\u0131 and\u0131ran, 15-40cm uzunlu\u011fundaki ba\u011f\u0131rsak solucanlar\u0131, \u00fczerinde solucan yumurtalar\u0131 bulunan sebze ve meyvelerin iyice y\u0131kanmadan yenmesiyle ba\u011f\u0131rsaklara ula\u015f\u0131rlar. Kar\u0131n a\u011fr\u0131s\u0131, kusma, baz\u0131 \u00f6zel durumlarda ba\u011f\u0131rsak t\u0131kanmas\u0131 veya sar\u0131l\u0131k gibi rahats\u0131zl\u0131klara yol a\u00e7abilirler. Ba\u011f\u0131rsak solucanlar\u0131ndan kurtulmak i\u00e7in, bir ba\u011f\u0131rsak k\u00fcr\u00fc ka\u00e7\u0131n\u0131lmazd\u0131r.
\n\u0130\u011fne solucan\u0131: \u0130\u011fne solucanlar\u0131 insan\u0131n ince ba\u011f\u0131rsa\u011f\u0131nda ya\u015farlar. An\u00fcs \u00e7evresinde biriken i\u011fne solucan\u0131 yumurtalar\u0131 herhangi bir yolla a\u011fza ula\u015f\u0131rlarsa, yeni bir enfeksiyon olu\u015fabilir. \u00d6zellikle bu nedenle, her d\u0131\u015fk\u0131laman\u0131n ard\u0131ndan an\u00fcs\u00fcn iyice y\u0131kanarak temizlenmesine ve yemeklerden \u00f6nce ellerin sabunla iyice y\u0131kanmas\u0131na \u00f6zen g\u00f6stermek gerekir.
\n5.1. Ba\u011f\u0131rsak Asalaklar\u0131n\u0131n Tedavisi
\nAy\u0131sar\u0131msa\u011f\u0131: Midemizi ve ba\u011f\u0131rsak sistemimizi tedavi edici \u00f6zellikleri sayesinde, ay\u0131sar\u0131msa\u011f\u0131 ba\u011f\u0131rsaklar\u0131m\u0131z\u0131 asalaklardan da kurtarabilir. \u0130lkbaharda toplanan taze yapraklar iyice y\u0131kan\u0131p ince k\u0131y\u0131ld\u0131ktan sonra \u00e7i\u011f olarak t\u00fcketilebilir. Ayn\u0131 maydanoz gibi, t\u00fcm yemeklerin \u00fcst\u00fcne serpi\u015ftirilebilir, ayr\u0131ca tereya\u011fl\u0131 ekmek \u00fcst\u00fcnde de yenebilir. Ay\u0131sar\u0131msa\u011f\u0131 yapraklar\u0131 salatalarda kullan\u0131labilir veya \u0131spanakla kar\u0131\u015ft\u0131r\u0131larak yeme\u011fi pi\u015firilebilir.
\nAy\u0131sar\u0131msa\u011f\u0131 tent\u00fcr\u00fc: Ay\u0131sar\u0131msa\u011f\u0131n\u0131n tedavi edici g\u00fcc\u00fcne b\u00fct\u00fcn y\u0131l boyunca sahip olabilmek i\u00e7in, bitkinin tent\u00fcr\u00fc haz\u0131rlanabilir. Bir \u015fi\u015fe, ince k\u0131y\u0131lm\u0131\u015f yapraklarla veya bitkinin ince k\u0131y\u0131lm\u0131\u015f so\u011fan\u0131yla \u00be oran\u0131nda doldurulur ve \u00fczerine 38-40 derecelik kanyak veya votka eklenir. \u015ei\u015fenin \u00e7alkalanabilmesi i\u00e7in biraz bo\u015fluk b\u0131rak\u0131lmal\u0131d\u0131r. \u015ei\u015fe en az iki hafta s\u0131cak bir ortamda bekletilirken arada bir \u00e7alkalan\u0131r. S\u00fcre sonunda t\u00fclbentten ge\u00e7irilerek s\u00fcz\u00fcl\u00fcr ve koyu renkli \u015fi\u015felerde muhafaza edilir.
\nB\u00f6yle haz\u0131rlanan tent\u00fcrden, g\u00fcnde 4 kere, 10-15 damla, yar\u0131m kahve fincan\u0131 \u0131l\u0131k suya eklenerek al\u0131n\u0131r.
\nKabak \u00e7ekirde\u011fi: Kabak \u00e7ekirde\u011fi, i\u011fne solucanlar\u0131na kar\u015f\u0131 \u00e7ok eski zamanlardan beri kullan\u0131lan bir ila\u00e7t\u0131r. \u00c7ocuklar g\u00fcnde 10-15 tane, yeti\u015fkinler ise 20-30 tane ay\u0131klanm\u0131\u015f kabak \u00e7ekirde\u011fi yerler. Kabuk ay\u0131klan\u0131rken, i\u00e7 \u00e7ekirde\u011fin \u00fcst\u00fcndeki zar\u0131n yitirilmemesine dikkat edilmelidir. \u00c7ekirdekler \u00e7ok iyi \u00e7i\u011fnendikten sonra yutulur. Bir saat sonra da yar\u0131m \u00e7ay ka\u015f\u0131\u011f\u0131 hintya\u011f\u0131 i\u00e7ilir.
\n\u015eerit tedavisinde \u00e7ekirdek miktar\u0131n\u0131n artt\u0131r\u0131lmas\u0131 gerekir. Ba\u015fka hi\u00e7bir \u015fey yenmeden, 80-100 tane kabak \u00e7ekirde\u011fi, d\u00f6rt e\u015fit porsiyona ayr\u0131larak, belirli aral\u0131klarla g\u00fcn boyuna yay\u0131larak, \u00e7ok iyi \u00e7i\u011fnendikten sonra yutulur. Her porsiyonun yutulmas\u0131ndan bir saat sonra bir \u00e7ay ka\u015f\u0131\u011f\u0131 veya bir tatl\u0131 ka\u015f\u0131\u011f\u0131 hintya\u011f\u0131 i\u00e7ilir. Bu k\u00fcr, ba\u015far\u0131ya ula\u015f\u0131lana kadar yinelenebilir, hi\u00e7bir yan etkisi yoktur.
\nBa\u011f\u0131rsak solucanlar\u0131na kar\u015f\u0131 \u00e7i\u011f havu\u00e7 ve \u00e7i\u011f pancar etkilidir. Bu sebzeler yenirken \u00e7i\u011f lahana \u00f6zsuyunun da i\u00e7ilmesiyle etki artar. Ba\u011f\u0131rsak solucanlar\u0131ndan k\u0131sa s\u00fcrede kurtulabilmek i\u00e7in ayr\u0131ca, i\u00e7inde sar\u0131msak, karaturp veya so\u011fan pi\u015firilmi\u015f s\u00fct, elden geldi\u011fince s\u0131cakken, yudumlanarak i\u00e7ilir.
\nAyn\u0131safa: Bir yemek ka\u015f\u0131\u011f\u0131 dolusu ayn\u0131safa \u00e7i\u00e7ek yapra\u011f\u0131, bir bardak dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. Bu bir bardak \u00e7ay g\u00fcn boyuna yay\u0131larak yudumlan\u0131r.
\nEk\u015fiyonca: Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f taze yaprak, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcnde 2 bardak taze demlenmi\u015f \u00e7ay so\u011futulmadan yudumlan\u0131r.
\n\u0130sve\u00e7 \u015eurubu: Yukar\u0131da \u00f6nerilen bitki \u00e7aylar\u0131ndan birine eklenerek, g\u00fcnde 2-3 tatl\u0131 ka\u015f\u0131\u011f\u0131 dolusu \u0130sve\u00e7 \u015eurubu, yemeklerden \u00f6nce ve sonra olmak \u00fczere i\u00e7ilir.
\nG\u00f6bek b\u00f6lgesine ayn\u0131safa merhemi s\u00fcr\u00fcld\u00fckten sonra, \u0130sve\u00e7 \u015eurubuyla nemlendirilmi\u015f bir bezle veya pamuk par\u00e7as\u0131yla o b\u00f6lgeye 1-2 saat s\u00fcreli kompresler uygulan\u0131r.
\n6. BO\u011eAZ A\u011eRISI
\nKoyunotu: Bitki, t\u00fcm yutak, bo\u011faz ve a\u011f\u0131z i\u00e7i iltihaplanmalar\u0131na kar\u015f\u0131 \u00e7ok etkilidir. \u00d6teki kullan\u0131m alanlar\u0131 ise, anjin, g\u0131rtlak hastal\u0131klar\u0131 ve a\u011f\u0131z i\u00e7i iltihaplanmalar\u0131d\u0131r.
\nYar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f koyunotu, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. Sabah ve ak\u015fam olmak \u00fczere, g\u00fcnde iki kere, taze demlenmi\u015f \u0131l\u0131k \u00e7ayla uzun s\u00fcreli derin gargaralar yap\u0131l\u0131r.
\nAda\u00e7ay\u0131: Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f ada\u00e7ay\u0131, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. Sabahlar\u0131 ve ak\u015famlar\u0131 olmak \u00fczere, g\u00fcnde iki kere, taze demlenmi\u015f \u0131l\u0131k \u00e7ayla uzun s\u00fcreli derin gargaralar yap\u0131l\u0131r. Gargaran\u0131n yan\u0131 s\u0131ra, uygun b\u00fcy\u00fckl\u00fckte bir pamuk \u00e7ayla \u0131slat\u0131l\u0131r, hafif\u00e7e s\u0131k\u0131l\u0131r ve a\u011fr\u0131yan b\u00f6lgeye d\u0131\u015ftan kompres olarak uygulan\u0131r.
\nCeviz yapra\u011f\u0131: Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f ceviz yapra\u011f\u0131, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. Sabah ve ak\u015fam olmak \u00fczere, g\u00fcnde iki kere, taze demlenmi\u015f \u0131l\u0131k \u00e7ayla uzun s\u00fcreli derin gargaralar yap\u0131l\u0131r.
\n6.1. Bo\u011faz A\u011fr\u0131s\u0131 (Bo\u011faz \u0130ltihab\u0131)
\nBo\u011faz a\u011fr\u0131lar\u0131 genelde bir so\u011fuk alg\u0131nl\u0131\u011f\u0131 hastal\u0131\u011f\u0131n\u0131n belirtisidir. Ama ba\u015fka herhangi bir belirti e\u015fli\u011finde olmad\u0131\u011f\u0131nda, yutak b\u00f6lgesine \u00e7ok so\u011fuk havan\u0131n girmesinin bir sonucu olabilir.
\nYap\u0131\u015fkanotu \/ Yo\u011furtotu: Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f yap\u0131\u015fkanotu veya yo\u011furtotu, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. Taze demlenmi\u015f \u0131l\u0131k \u00e7ayla g\u00fcn boyunca pek \u00e7ok kere derin gargaralar yap\u0131l\u0131r.
\nKoyunotu: Koyunotu, t\u00fcm bo\u011faz, yutak ve a\u011f\u0131z i\u00e7i iltihaplar\u0131na kar\u015f\u0131 ba\u015far\u0131yla kullan\u0131labilir. \u00d6teki kullan\u0131m alanlar\u0131 ise, anjin ve g\u0131rtlak hastal\u0131klar\u0131d\u0131r.
\nYar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f koyunotu, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. Sabah ve ak\u015fam olmak \u00fczere, g\u00fcnde iki kere, uzun s\u00fcreli derin gargaralar yap\u0131l\u0131r.
\n\u0130sve\u00e7 \u015eurubu: Yar\u0131m veya bir tatl\u0131 ka\u015f\u0131\u011f\u0131 \u0130sve\u00e7 \u015eurubu yar\u0131m bardak bitki \u00e7ay\u0131na eklenir ve bu yar\u0131m bardak \u00e7ay\u0131n yar\u0131s\u0131 yemekten yar\u0131m saat \u00f6nce, \u00f6teki yar\u0131s\u0131 ise yar\u0131m saat sonra i\u00e7ilir. Yani, \u00fc\u00e7 \u00f6\u011f\u00fcnde toplam olarak 3 ka\u015f\u0131k \u0130sve\u00e7 \u015eurubu i\u00e7ilmi\u015f olur.
\n6.2. Bo\u011fmaca
\nSolunum yolunun herhangi bir yerindeki t\u00fcm aksakl\u0131klara beden \u00f6ks\u00fcr\u00fckle yan\u0131t verir. K\u00fc\u00e7\u00fck \u00e7ocuklarda g\u00f6r\u00fclen akut \u00f6ks\u00fcr\u00fck krizleri, bo\u011fmacan\u0131n bir belirtisi olabilir. Bula\u015f\u0131c\u0131 bir solunum yollar\u0131 enfeksiyonu olan bo\u011fmaca hastal\u0131\u011f\u0131 genelde 1-3 ya\u015f aras\u0131ndaki k\u00fc\u00e7\u00fck \u00e7ocuklarda g\u00f6r\u00fcl\u00fcr. Hastal\u0131\u011f\u0131n g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131nda ve \u015fiddetinde s\u00fcre\u011fen bir azalma vard\u0131r. Bunun nedeni, hastal\u0131\u011f\u0131n kaynakland\u0131\u011f\u0131 vir\u00fcs\u00fcn etkinli\u011findeki de\u011fi\u015fimler olabilir. Bu vir\u00fcsler yaln\u0131zca, havadaki \u00f6ks\u00fcr\u00fck damlac\u0131klar\u0131 ile birlikte solundu\u011funda bir enfeksiyon ba\u015flatabilirler. Hastal\u0131\u011f\u0131n kulu\u00e7ka d\u00f6nemi 7-14 g\u00fcn civar\u0131ndad\u0131r. Doruk noktas\u0131na ula\u015fan \u00f6ks\u00fcr\u00fc\u011f\u00fcn \u00fc\u00e7 evresi vard\u0131r: \u00d6nce nezleyi and\u0131ran, \u00f6ks\u00fcr\u00fck ve y\u00fcksek ate\u015fli d\u00f6nem(1-2 hafta). Daha sonra, 3-6 hafta kadar s\u00fcrebilen, sonunda yo\u011fun balgam kusulan krampl\u0131 \u00f6ks\u00fcr\u00fck n\u00f6betleri d\u00f6nemi ba\u015flar. Bu d\u00f6nemde hastan\u0131n y\u00fcz\u00fc \u015fi\u015ftir ve konjunktiva kanamalar\u0131 g\u00f6r\u00fclebilir (konjunktiva= g\u00f6z k\u00fcresinin \u00f6n y\u00fcz\u00fcn\u00fc ve g\u00f6zkapaklar\u0131n\u0131n arka y\u00fcz\u00fcn\u00fc \u00f6rten ince, d\u00fcz, parlak, saydam zar). \u00d6ks\u00fcr\u00fck n\u00f6betlerinin aras\u0131ndaki s\u00fcre\u00e7te hasta genellikle rahatt\u0131r. \u0130yile\u015fme d\u00f6neminin ba\u015fl\u0131ca \u00f6zellikleri, n\u00f6betlerin seyrekle\u015fmesi, \u00f6ks\u00fcr\u00fc\u011f\u00fcn azalmas\u0131 ve kusman\u0131n g\u00f6r\u00fclmemesidir. \u0130yile\u015fme 6-12 haftal\u0131k bir s\u00fcrede ger\u00e7ekle\u015fir.
\nSinirliot: Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f taze sinirliot yapra\u011f\u0131, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcnde 2-3 bardak taze demlenmi\u015f sinirliot \u00e7ay\u0131 so\u011futulmadan yudumlan\u0131r.
\nKekik: \u00c7ok ince k\u0131y\u0131lm\u0131\u015f sinirliot ve kekik e\u015fit oranda kar\u0131\u015ft\u0131r\u0131l\u0131r. \u0130\u00e7inde bir dilim limon ve bir \u00e7ay ka\u015f\u0131\u011f\u0131 dolusu n\u00f6bet \u015fekeri bulunan bir bardak so\u011fuk su kaynama derecesine kadar \u0131s\u0131t\u0131l\u0131r, ocaktan indirilir ve i\u00e7ine yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 bitki kar\u0131\u015f\u0131m\u0131 eklenir. \u00c7ay yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr ve elden geldi\u011fince s\u0131cak durumda yudumlanarak i\u00e7ilir. G\u00fcn boyunca 4-5 bardak taze demlenmi\u015f \u00e7ay i\u00e7ilmelidir.
\n\u00d6ks\u00fcr\u00fckotu(veya ebeg\u00fcmeci): \u015eiddetli \u00f6ks\u00fcr\u00fcklerde, balgam s\u00f6kt\u00fcr\u00fcc\u00fc ve iltihap giderici \u00f6zellikleri nedeniyle \u00f6ks\u00fcr\u00fckotu (veya ebeg\u00fcmeci) tavsiye edilir. \u0130lkbahar ba\u015flang\u0131c\u0131nda a\u00e7an sar\u0131 \u00f6ks\u00fcr\u00fckotu \u00e7i\u00e7ekleri ve ancak yaz ba\u015flang\u0131c\u0131nda geli\u015fimini tamamlayan \u00f6ks\u00fcr\u00fckotu yapraklar\u0131 toplanarak kurutulur ve ince k\u0131y\u0131larak kar\u0131\u015ft\u0131r\u0131l\u0131r.
\nE\u015fit oranda kar\u0131\u015ft\u0131r\u0131lm\u0131\u015f yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 \u00f6ks\u00fcr\u00fckotu (veya ince k\u0131y\u0131lm\u0131\u015f ebeg\u00fcmeci), orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. Balla tatland\u0131r\u0131lan taze demlenmi\u015f \u00e7aydan g\u00fcnde 2-4 bardak, elden geldi\u011fince s\u0131cak bi\u00e7imde yudumlanarak i\u00e7ilir.
\n\u00d6zellikle uzun s\u00fcreli \u00f6ks\u00fcr\u00fcklerde, yukar\u0131da tarif edilen \u00e7aydan g\u00fcn boyunca s\u0131k\u00e7a i\u00e7ilmesi \u00f6nerilir.
\n7. GAZ \u015e\u0130\u015eK\u0130NL\u0130\u011e\u0130
\nSindirim s\u0131ras\u0131nda genellikle sindirim sisteminde gazlar olu\u015fur. Her sa\u011fl\u0131kl\u0131 midede biraz hava vard\u0131r. Gaz olu\u015fumunda ba\u015fl\u0131ca etken ise, al\u0131nan besinin t\u00fcr\u00fc ve miktar\u0131d\u0131r. Gaz olu\u015fumu belirgin d\u00fczeye ula\u015f\u0131p rahats\u0131zl\u0131k vermeye ba\u015flad\u0131\u011f\u0131nda, \u015fi\u015fkinlikten \u015fikayet edilmeye ba\u015flan\u0131r. Gaz olu\u015fumunun nedenleri genelde s\u0131radan nedenler olarak tan\u0131mlanabilir. Yaln\u0131zca belirli bir miktar so\u011fan, lahana, baklagiller veya \u015f\u0131ra gaz yapt\u0131rabilir. Tedavide, \u00f6zellikle gaz yapt\u0131r\u0131c\u0131(yukar\u0131da belirtilenler) besinlerden uzak durmak gerekir. \u00d6zel bir beslenme diyeti uygulanmal\u0131 ve d\u00fczenli d\u0131\u015fk\u0131lamaya \u00f6zen g\u00f6sterilmelidir.
\nMay\u0131s papatyas\u0131: Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 papatya, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcn boyunca 2-4 bardak taze demlenmi\u015f papatya \u00e7ay\u0131 so\u011futulmadan yudumlan\u0131r.
\nAda\u00e7ay\u0131: Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f ada\u00e7ay\u0131, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcnde 2 bardak taze demlenmi\u015f ada\u00e7ay\u0131 so\u011futulmadan yudumlan\u0131r.
\nCivanper\u00e7emi: Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f civanper\u00e7emi, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcnde 1-2 bardak taze demlenmi\u015f civanper\u00e7emi \u00e7ay\u0131 so\u011futulmadan yudumlan\u0131r.<\/p>\n

8. KANSIZLIK
\nIs\u0131rganotu: Genelde hor g\u00f6r\u00fclen \u0131s\u0131rganotu, kan yapt\u0131r\u0131c\u0131 \u00f6zelli\u011fi nedeniyle, kans\u0131zl\u0131\u011fa kar\u015f\u0131 mutlaka kullan\u0131lmas\u0131 gereken bir bitkidir.
\nYar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f \u0131s\u0131rganotu, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcnde 3-4 bardak taze demlenmi\u015f \u0131sr\u0131rganotu \u00e7ay\u0131 so\u011futulmadan yudumlan\u0131r.
\nArslanpen\u00e7esi: Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f arslanpen\u00e7esi, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcn boyunca 3 bardak taze demlenmi\u015f \u00e7ay so\u011futulmadan yudumlan\u0131r.
\nCivanper\u00e7emi: Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f civanper\u00e7emi, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcnde 2-3 bardak taze demlenmi\u015f civanper\u00e7emi \u00e7ay\u0131 so\u011futulmadan yudumlan\u0131r.
\n9. KONU\u015eMA BOZUKLUKLARI
\nPeltek konu\u015fma veya kekemelik her zaman konu\u015fma organ\u0131 bozuklu\u011fu anlam\u0131na gelmez. Genellikle bu aksakl\u0131klar\u0131n temelinde bir duygusal yetersizlik aranmas\u0131 gerekir. Peltek konu\u015fma ger\u00e7ekten de alt\u00e7enenin bir konum yanl\u0131\u015fl\u0131\u011f\u0131ndan kaynaklan\u0131rken, kekemelik kesinlikle altbilin\u00e7sel bir \u00e7ekingenlikten kaynaklan\u0131r. Sinirlenmeye yatk\u0131nl\u0131k ve iz b\u0131rakan bir olay (\u00f6rne\u011fin \u015fok, kaza, hastal\u0131k) genelde birle\u015firler ve t\u00fcm\u00fcyle sa\u011fl\u0131kl\u0131 \u00e7ocuk birden kekelemeye ba\u015flar.
\nSar\u0131 Kantaron: Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f kantaron, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcn boyunca 2-3 bardak taze demlenmi\u015f sar\u0131 kantaron \u00e7ay\u0131 so\u011futulmadan yudumlan\u0131r.
\n\u0130sve\u00e7 \u015eurubu: Konu\u015fma bozukluklar\u0131 ve hatta kekemelik bile, beyincik \u00fcst\u00fcne uygulanan \u0130sve\u00e7 \u015eurubu kompresleriyle ba\u015far\u0131yla tedavi edilebiliyor. Uygun b\u00fcy\u00fckl\u00fckte bir pamuk \u0130sve\u00e7 \u015eurubuyla \u0131slat\u0131l\u0131r ve her g\u00fcn beyinci\u011fin \u00fcst\u00fcne kompres olarak yat\u0131r\u0131l\u0131r.
\n10. KUSMA
\nAyn\u0131safa merhemi: Bir \u0130sve\u00e7 \u015eurubu kompresinden \u00f6nce b\u00f6lgeye s\u00fcr\u00fclmesi gereken ayn\u0131safa merheminin haz\u0131rlan\u0131\u015f\u0131:
\nBir tavada veya tencerede 250g saf domuz ya\u011f\u0131(kaz ya\u011f\u0131 veya tereya\u011f\u0131) iyice k\u0131zd\u0131r\u0131l\u0131r. K\u0131zg\u0131n ya\u011fa iki avu\u00e7 dolusu ince k\u0131y\u0131lm\u0131\u015f taze ayn\u0131safa bitkisi(yaprak, \u00e7i\u00e7ek, sap) eklenir, k\u00f6p\u00fcklenme ba\u015flay\u0131nca k\u0131saca kar\u0131\u015ft\u0131r\u0131l\u0131r ve serin bir yerde ertesi g\u00fcne kadar bekletilir. Ertesi g\u00fcn, ya\u011f iyice ak\u0131\u015fkan hale gelene kadar \u0131s\u0131t\u0131l\u0131r, bir t\u00fclbentten veya s\u0131k bir s\u00fczge\u00e7ten ge\u00e7irilerek s\u00fcz\u00fcl\u00fcr ve kapakl\u0131 merhem kaplar\u0131na aktar\u0131l\u0131r.
\n(\u00c7evirenin notu: S\u00fczme s\u0131ras\u0131nda posalar s\u0131k\u0131lacak olursa, bitkinin \u00f6zsuyu ya\u011f\u0131n dibine \u00e7\u00f6ker ve k\u00fcf olu\u015fturur. Bu t\u00fcr merhemlerin buzdolab\u0131nda saklanmas\u0131 gerekir.)
\n\u0130sve\u00e7 \u015eurubu kompresi: \u00d6nceden ayn\u0131safa merhemi s\u00fcr\u00fclen kar\u0131n b\u00f6lgesine, \u0130sve\u00e7 \u015eurubuyla nemlendirilen uygun b\u00fcy\u00fckl\u00fckte bir pamuk kompres olarak uygulan\u0131r. Kompresin etkileme s\u00fcresi 1-2 saattir.
\n11. MENENJ\u0130T (BEY\u0130N VE OMUR\u0130L\u0130K ZARI \u0130LT\u0130HABI)
\nAkut beyin hastal\u0131klar\u0131, \u00e7ocuklar\u0131n sinir sistemi hastal\u0131klar\u0131 alan\u0131nda geni\u015f kapsaml\u0131 bir yer tutar. Menenjit, burun-yutak b\u00f6lgesinde bulunan vir\u00fcslerin sinir lifleri yoluyla beyine ula\u015fmalar\u0131 sonucunda olu\u015fur. Ayr\u0131ca, baz\u0131 enfeksiyon etkenleri zarlara do\u011frudan bir yara arac\u0131l\u0131\u011f\u0131 ile d\u0131\u015fardan, kan yoluyla \u00f6teki b\u00f6lgelerdeki enfeksiyon odaklar\u0131ndan yada do\u011frudan yay\u0131lmayla, yak\u0131ndaki kafatas\u0131 ve beyin b\u00f6lgelerinden ula\u015fabilir. Menenjitte \u00f6ncelikle y\u00fcksek ate\u015f ve kusma, ayr\u0131ca ba\u015f a\u011fr\u0131s\u0131 ve kramplar da g\u00f6r\u00fcl\u00fcr. A\u011f\u0131r durumlarda olu\u015fan bilin\u00e7 kayb\u0131 komaya kadar varabilir.
\n\u0130sve\u00e7 \u015eurubu kompresleri: Uygun b\u00fcy\u00fckl\u00fckte bir pamuk par\u00e7as\u0131 \u0130sve\u00e7 \u015eurubuyla nemlendirilir ve beyincik \u00fcst\u00fcne 3-4 saat s\u00fcreli bir kompres uygulan\u0131r.
\n12. ORTAKULAK \u0130LT\u0130HABI
\nOrtakulak iltihab\u0131 bakteriler taraf\u0131ndan olu\u015fturulur. \u00c7ocuklarda bu hastal\u0131k s\u0131k\u00e7a g\u00f6r\u00fcl\u00fcr, \u00e7\u00fcnk\u00fc k\u0131z\u0131l hastal\u0131\u011f\u0131 ve k\u0131zam\u0131k gibi enfeksiyon hastal\u0131klar\u0131nda bakteriler kan yoluyla ortakula\u011fa ula\u015f\u0131rlar. Bu b\u00f6lgede olu\u015fan irin, d\u0131\u015far\u0131 akamad\u0131\u011f\u0131 i\u00e7in kendine ba\u015fka bir \u00e7\u0131k\u0131\u015f yolu a\u00e7maya \u00e7al\u0131\u015f\u0131r. Kulak zar\u0131 \u00f6ne do\u011fru bombe yapar ve irinli ak\u0131nt\u0131 mastoit \u00e7\u0131k\u0131nt\u0131s\u0131n\u0131n i\u00e7indeki bo\u015flu\u011fa ula\u015f\u0131r. Ortakulak iltihab\u0131na e\u015flik eden belirtiler, kulak a\u011fr\u0131s\u0131 ve y\u00fcksek ate\u015ftir. Kulak zar\u0131 k\u0131zar\u0131r ve \u015fi\u015fer, hatta baz\u0131 durumlarda hastal\u0131k a\u011f\u0131r i\u015fitmeye bile yol a\u00e7abilir. Hastal\u0131k s\u00fcrecinde kulak zar\u0131 delinecek olursa, irinli ak\u0131nt\u0131 d\u0131\u015far\u0131 akar. A\u011f\u0131r bir grip sonras\u0131nda olu\u015fan bir ortakulak iltihab\u0131nda ise, genellikle kanla kar\u0131\u015f\u0131k bir ak\u0131nt\u0131 g\u00f6r\u00fcl\u00fcr. Hafif iltihaplanmalarda ise ak\u0131nt\u0131 yeniden emilir. Hasta mutlaka yatakta dinlenmelidir. En do\u011frusu, kula\u011f\u0131n bir termofor kompresiyle s\u0131cak tutulmas\u0131d\u0131r. \u0130rinli ak\u0131nt\u0131n\u0131n ard\u0131ndan kulak yolu papatya \u00e7ay\u0131yla y\u0131kanmal\u0131 ve bir pamukla kurulan\u0131lmal\u0131d\u0131r. Kulak yolu derisi ayn\u0131safa veya yo\u011furtotu merhemiyle korunabilir. Ama dikkat: Pamuk dikkatli kullan\u0131lmal\u0131d\u0131r! Pamuk hi\u00e7bir \u015fekilde derine sokulmamal\u0131d\u0131r! Aksi halde, bir apse sertle\u015fmesine yol a\u00e7\u0131labilir.
\nYap\u0131\u015fkanotu\/Yo\u011furtotu merhemi: Bir tavada veya tencerede 500g saf domuz ya\u011f\u0131(kaz ya\u011f\u0131 veya tereya\u011f\u0131) iyice k\u0131zd\u0131r\u0131l\u0131r. Bu k\u0131zg\u0131n ya\u011fa, d\u00f6rt avu\u00e7 dolusu ince k\u0131y\u0131lm\u0131\u015f taze yap\u0131\u015fkanotu veya yo\u011furtotu eklenir. K\u00f6p\u00fcklenme ba\u015flay\u0131nca k\u0131saca kar\u0131\u015ft\u0131r\u0131l\u0131r ve serin bir yerde ertesi g\u00fcne kadar bekletilir. Ertesi g\u00fcn, ya\u011f iyice ak\u0131\u015fkan hale gelene kadar \u0131s\u0131t\u0131l\u0131r, t\u00fclbentten veya s\u0131k bir s\u00fczge\u00e7ten ge\u00e7irilerek s\u00fcz\u00fcl\u00fcr ve kapakl\u0131 merhem kaplar\u0131na aktar\u0131l\u0131r. Merhem buzdolab\u0131nda muhafaza edilir.
\nAyn\u0131safa merhemi: Bir tavada veya tencerede 250g saf domuz ya\u011f\u0131(kaz ya\u011f\u0131 veya tereya\u011f\u0131) iyice k\u0131zd\u0131r\u0131l\u0131r. K\u0131zg\u0131n ya\u011f\u0131n i\u00e7ine iki avu\u00e7 ince k\u0131y\u0131lm\u0131\u015f taze ayn\u0131safa bitkisi(yaprak,\u00e7i\u00e7ek, sap) eklenir, k\u00f6p\u00fcklenme ba\u015flay\u0131nca k\u0131saca kar\u0131\u015ft\u0131r\u0131l\u0131r ve serin bir yerde ertesi g\u00fcne kadar bekletilir. Ertesi g\u00fcn, ya\u011f iyice ak\u0131\u015fkan hale gelene kadar \u0131s\u0131t\u0131l\u0131r, t\u00fclbentten ve s\u0131k bir s\u00fczge\u00e7ten ge\u00e7irilerek s\u00fcz\u00fcl\u00fcr ve kapakl\u0131 merhem kaplar\u0131na aktar\u0131l\u0131r.
\n(\u00c7evirenin notu: S\u00fczme s\u0131ras\u0131nda posa s\u0131k\u0131lacak olursa, bitki \u00f6zsuyu ya\u011f\u0131n dibine \u00e7\u00f6ker ve k\u00fcf olu\u015fturur. Bu t\u00fcr merhemlerin buzdolab\u0131nda muhafaza edilmeleri gerekir.)
\n13. \u00d6KS\u00dcR\u00dcK
\n\u00d6ks\u00fcr\u00fckotu: \u015eiddetli \u00f6ks\u00fcr\u00fckte, balgam s\u00f6kt\u00fcr\u00fcc\u00fc ve iltihap \u00f6nleyici etkileri nedeniyle \u00f6ks\u00fcr\u00fckotu \u00f6nerilir. \u0130lkbahar ba\u015flang\u0131c\u0131nda yapraklardan \u00f6nce ortaya \u00e7\u0131kan sar\u0131 \u00e7i\u00e7ekler ve daha sonra may\u0131sta geli\u015fen yapraklar toplanarak kurutulur, ince k\u0131y\u0131l\u0131r ve harmanlan\u0131r.
\nYar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f \u00f6ks\u00fcr\u00fckotu, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcnde bir bardak \u00e7ay, balla tatland\u0131r\u0131larak, elden geldi\u011fince s\u0131cak yudumlan\u0131r. \u00d6zellikle uzun s\u00fcreli \u00f6ks\u00fcr\u00fcklere ve ses k\u0131s\u0131kl\u0131klar\u0131na kar\u015f\u0131 g\u00fcn boyunca s\u0131k s\u0131k, balla tatland\u0131r\u0131lm\u0131\u015f \u00f6ks\u00fcr\u00fckotu \u00e7ay\u0131n\u0131n \u00e7ok s\u0131cakken i\u00e7ilmesi \u00f6nemle tavsiye edilir.
\nEbeg\u00fcmeci: Bitkinin yaprak, sap ve \u00e7i\u00e7ekleri ince kar\u0131\u015ft\u0131r\u0131larak harmanlan\u0131r.
\nYar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 bitki, bir bardak so\u011fuk suda 12 saat demlendirildikten sonra \u0131s\u0131t\u0131l\u0131r ve s\u00fcz\u00fcl\u00fcr. G\u00fcn boyunca 2 bardak \u00e7ay so\u011futulmadan yudumlan\u0131r. \u015eiddetli so\u011fuk alg\u0131nl\u0131\u011f\u0131nda, s\u00fcz\u00fclen bitki lapalar\u0131 \u0131s\u0131t\u0131larak bron\u015flara, bo\u011faza ve akci\u011ferlere kompres olarak uygulan\u0131r.
\nSinirliot: Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f sinirliot yapra\u011f\u0131, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcn boyunca s\u0131k s\u0131k bir bardak taze demlenmi\u015f sinirliot \u00e7ay\u0131 so\u011futulmadan yudumlan\u0131r.
\nKu\u015fekme\u011fi(Polygonum aviculare): Bir yemek ka\u015f\u0131\u011f\u0131 dolusu ince k\u0131y\u0131lm\u0131\u015f ku\u015fekme\u011fi bitkisi, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcn boyunca 2 bardak taze demlenmi\u015f \u00e7ay so\u011futulmadan yudumlan\u0131r.
\nBitki kar\u0131\u015f\u0131m\u0131 \u00e7ay\u0131: \u00d6ks\u00fcr\u00fckotu(\u00e7i\u00e7ek ve yaprak), s\u0131\u011f\u0131rkuyru\u011fu \u00e7i\u00e7e\u011fi, and\u0131zotu k\u00f6k\u00fc ve sinirliot yapra\u011f\u0131 ince k\u0131y\u0131larak e\u015fit oranda harmanlan\u0131r.
\nBir tatl\u0131 ka\u015f\u0131\u011f\u0131 dolusu bitki kar\u0131\u015f\u0131m\u0131, orta boy bir su barda\u011f\u0131 kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve 3-4 dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcnde 3 bardak taze demlenmi\u015f \u00e7ay, balla tatland\u0131r\u0131larak so\u011futulmadan yudumlan\u0131r.
\nEv re\u00e7etesi: Yayvan ve k\u00fc\u00e7\u00fck bir tencereye, dibi \u00f6rt\u00fclecek kadar s\u00fct koyulur, \u00fcst\u00fcne 125g \u00e7\u00f6kelek(ek\u015fimik) eklenir ve s\u00fcrekli kar\u0131\u015ft\u0131r\u0131larak s\u0131cak(\u00e7ok s\u0131cak de\u011fil) bir lapa olu\u015fturulur. Bu beden \u0131s\u0131s\u0131ndaki lapa temiz bir bezin \u00fcst\u00fcne yay\u0131l\u0131r ve yatmadan \u00f6nce kompres olarak g\u00f6\u011f\u00fcs b\u00f6lgesine yat\u0131r\u0131larak tespit edilir.
\n14. SAMAN NEZLES\u0130
\nSaman nezlesi bir alerjidir. Nedeni ise, mukozalar\u0131n \u00e7i\u00e7ek ve \u00e7imen polenleriyle ili\u015fkisidir. \u0130lkbahar ve yaz aylar\u0131nda polenler r\u00fczgarlara kap\u0131larak geni\u015f alanlara yay\u0131l\u0131rlar. Saman nezlesine yatk\u0131n ki\u015finin polenlerle temas\u0131n\u0131n hemen ard\u0131ndan, burun, g\u00f6z, damak ve yutak mukozalar\u0131 \u015fi\u015fmeye ba\u015flar. \u015eiddetli hap\u015f\u0131r\u0131klar e\u015fli\u011finde burun suya benzer bir ak\u0131nt\u0131 salg\u0131lamaya ba\u015flar. Bazen ast\u0131m krizleri, deri tepkileri ve y\u00fcksek ate\u015f de g\u00f6r\u00fclebilir.
\nIs\u0131rganotu: Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f \u0131s\u0131rganotu yapra\u011f\u0131, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcn boyunca 3-4 bardak taze demlenmi\u015f \u0131s\u0131rganotu \u00e7ay\u0131 so\u011futulmadan yudumlan\u0131r.
\n\u0130sve\u00e7 \u015eurubu: Is\u0131rganotu \u00e7ay\u0131na g\u00fcnde 3 \u00e7ay ka\u015f\u0131\u011f\u0131 \u0130sve\u00e7 \u015eurubu eklenerek, \u00f6\u011f\u00fcnlerden \u00f6nce ve sonra i\u00e7ilir.
\n15. SO\u011eUK ALGINLI\u011eI
\nGrip gibi, genelde t\u00fcm so\u011fuk alg\u0131nl\u0131\u011f\u0131 hastal\u0131klar\u0131 vir\u00fcs enfeksiyonlar\u0131d\u0131r. So\u011fuk alg\u0131nl\u0131\u011f\u0131 hastal\u0131\u011f\u0131 olu\u015fana kadar pek \u00e7ok etkenin bir araya gelmesi gerekiyor. So\u011fuk alg\u0131nl\u0131\u011f\u0131ndan s\u00f6z edildi\u011finde, genelde bir grip enfeksiyonu veya nezle dile getirilmek istenir. Halbuki hastal\u0131k belirtileri olduk\u00e7a de\u011fi\u015fiktir. Hafif ate\u015f, ba\u015f a\u011fr\u0131s\u0131 ve k\u0131rg\u0131nl\u0131k g\u00f6r\u00fclebilir. Bedenin \u00fc\u015f\u00fcmemesi sa\u011fland\u0131\u011f\u0131nda, so\u011fuk alg\u0131nl\u0131\u011f\u0131 belirtileri genelde k\u0131sa bir s\u00fcrede yok olurlar. Bedeni s\u0131cak tutabilmek i\u00e7in ise s\u0131cak ayak banyolar\u0131 yap\u0131labilir veya yatakta dinlenilebilir. Ama yine de dikkatli olmak gerekir, \u00e7\u00fcnk\u00fc so\u011fuk alg\u0131nl\u0131\u011f\u0131 belirtilerinin ard\u0131nda, \u00f6rne\u011fin bir akci\u011fer iltihab\u0131 gizlenmi\u015f olabilir. Bedenin savunma sistemlerinin g\u00fc\u00e7lendirilmesiyle, so\u011fuk alg\u0131nl\u0131\u011f\u0131na kar\u015f\u0131 etkili bir tedavi uygulanabilir. Bir \u00e7ocu\u011fun ate\u015fi y\u00fckseldi\u011finde veya bo\u011faz\u0131 a\u011fr\u0131d\u0131\u011f\u0131nda, a\u015fa\u011f\u0131daki \u00f6neriler en iyi bi\u00e7imde yard\u0131mc\u0131 olacakt\u0131r:
\nSo\u011fuk bald\u0131r sarg\u0131lar\u0131: Bald\u0131r sarg\u0131s\u0131, ayak bile\u011finden diz alt\u0131na kadarki b\u00f6lgeyi kapsar. Islak tabaka ve orta tabaka olarak kaba bir keten bezi ve \u00fcst tabaka olarak bir y\u00fcnl\u00fc kuma\u015f kullan\u0131l\u0131r. Islak i\u00e7 tabaka 80x100cm boyutunda olmal\u0131d\u0131r. Kesinlikle uyulmas\u0131 gereken \u00f6zellik,d\u0131\u015f tabakan\u0131n orta tabakaya, orta tabakan\u0131n i\u00e7 tabakaya g\u00f6re daha geni\u015f olmas\u0131d\u0131r, ki sarg\u0131 bald\u0131r\u0131 iyice kavrayabilsin. B\u00fcy\u00fck keten bezinden i\u00e7 tabaka so\u011fuk suya bat\u0131r\u0131l\u0131r ve s\u0131k\u0131l\u0131r. Sonra bald\u0131ra sar\u0131l\u0131r ve d\u00fczg\u00fcnle\u015ftirilir. Onun \u00fcst\u00fcne ayn\u0131 bi\u00e7imde ama kuru bir keten bezi ve en \u00fcste de y\u00fcnl\u00fc bez sar\u0131l\u0131r. Sarg\u0131 \u00e7ok s\u0131k\u0131 olmamal\u0131 ama bald\u0131r\u0131 kavramal\u0131d\u0131r. So\u011fuk bald\u0131r sarg\u0131s\u0131 yap\u0131l\u0131rken, omuzlar ve kollar yorganla \u00f6rt\u00fcl\u00fcr. So\u011fuk sarg\u0131dan beklenen tepki (bir saat kadar sonra terleme) olu\u015fmazsa, bir s\u0131cak termofor uygulanabilir.
\nBitki \u00e7ay\u0131: So\u011fuk bald\u0131r sarg\u0131s\u0131n\u0131n yan\u0131 s\u0131ra \u00e7ocu\u011fa terletici bir bitki \u00e7ay\u0131(\u00f6rne\u011fin \u0131hlamur) veya bron\u015fit \u00e7ay\u0131 i\u00e7irilir. E\u011fer \u00f6ks\u00fcr\u00fcyorsa rezene \u00e7ay\u0131 i\u00e7irilir.
\nBitki katk\u0131l\u0131 banyolar: Kekik veya lavanta banyolar\u0131 solunum yollar\u0131 i\u00e7in \u00e7ok iyidir. \u00c7ocuklar i\u00e7in banyo suyu 35 dereceyi a\u015fmamal\u0131 ve banyo s\u00fcresi 5 dakikay\u0131 ge\u00e7memelidir. Banyodan sonra \u00e7ocuk yatakta dinlenmelidir.
\nBo\u011faz kompresi: Bo\u011faz a\u011fr\u0131s\u0131na ve \u015fi\u015fen lenf bezlerine kar\u015f\u0131 bir bo\u011faz kompresi uygulanabilir. Islak bir bez bo\u011faza yat\u0131r\u0131l\u0131r ve \u00fcst\u00fcne s\u0131cak bir kuru havlu \u00f6rt\u00fcl\u00fcr. K\u00fc\u00e7\u00fck hasta bu arada 1-2 saat yatakta dinlenir.
\nIs\u0131rganotu: \u00c7ok y\u00f6nl\u00fc \u0131s\u0131rganotu bedenin savunma sistemlerini g\u00fc\u00e7lendirir ve so\u011fuk alg\u0131nl\u0131\u011f\u0131n\u0131n bula\u015fmas\u0131na kar\u015f\u0131 \u00f6nlem olarak kendini yeterince kan\u0131tlam\u0131\u015ft\u0131r.
\nYar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f \u0131s\u0131rganotu yapra\u011f\u0131, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcnde iki litreye yak\u0131n miktarda \u0131s\u0131rganotu \u00e7ay\u0131 rahatl\u0131kla i\u00e7ilebilir. Bu ama\u00e7la demlenen \u00e7ay bir termosta s\u0131cak durumda muhafaza edilebilir.
\nCivanper\u00e7emi: Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f civanper\u00e7emi, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcn boyunca 3-4 bardak taze demlenmi\u015f civanper\u00e7emi \u00e7ay\u0131 so\u011futulmadan yudumlan\u0131r.
\nIhlamur: Yar\u0131m tatl\u0131k ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f \u0131hlamur, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcnde 3-4 bardak taze demlenmi\u015f \u0131hlamur \u00e7ay\u0131, balla tatland\u0131r\u0131larak elden geldi\u011fince s\u0131cak i\u00e7ilir.
\nEv re\u00e7etesi: 10-15 dakikal\u0131k s\u0131cak ayak banyolar\u0131 yap\u0131l\u0131r. Su dayan\u0131labilecek kadar s\u0131cak olmal\u0131 ve s\u00fcrekli s\u0131cak su eklenerek so\u011fumas\u0131 \u00f6nlenmelidir.
\n\u0130sve\u00e7 \u015eurubu: So\u011fuk alg\u0131nl\u0131\u011f\u0131nda, bir ka\u015f\u0131\u011fa \u0130sve\u00e7 \u015eurubu damlat\u0131l\u0131r ve a\u00e7\u0131k a\u011f\u0131zla \u015furubun kokusu i\u00e7e \u00e7ekilir.
\nCivanper\u00e7emi \u00e7ay\u0131na eklenerek g\u00fcnde 3 \u00e7ay ka\u015f\u0131\u011f\u0131 \u015furup al\u0131n\u0131r. \u00d6\u011f\u00fcnlerden yar\u0131m saat \u00f6nce yar\u0131s\u0131 ve yar\u0131m saat sonra \u00f6teki yar\u0131s\u0131 i\u00e7ilen yar\u0131m bardak bitki \u00e7ay\u0131na bir \u00e7ay ka\u015f\u0131\u011f\u0131 \u015furup eklenir. B\u00f6ylece, \u00fc\u00e7 \u00f6\u011f\u00fcnde toplam 3 \u00e7ay ka\u015f\u0131\u011f\u0131 \u0130sve\u00e7 \u015eurubu i\u00e7ilmi\u015f olur.
\n16. TOMBULLUK
\nG\u00fcn\u00fcm\u00fczde \u00e7ocuklar\u0131n bile kilo problemi var. E\u011fer \u00e7ocuk fazla kilolar\u0131 y\u00fcz\u00fcnden s\u0131k\u0131nt\u0131larla m\u00fccadele etmek zorunda kal\u0131yorsa tombulluk ruhsal bir probleme de d\u00f6n\u00fc\u015febiliyor. \u00c7ocuklarda tombulluk \u00e7e\u015fitli nedenlerden kaynaklanabilir. Genellikle bilinen, tipik hareket yetersizli\u011fi veya bir ya\u011f ve karbonhidrat yo\u011funluklu beslenme ba\u015fl\u0131ca neden olabiliyor. Ama daha \u00e7ok, ya\u011flanmada kal\u0131t\u0131msal bir yatk\u0131nl\u0131k \u00f6n plana \u00e7\u0131k\u0131yor: bazen metabolizma aksakl\u0131klar\u0131 veya salg\u0131 sistemindeki yetersizlikler. Tedavi i\u00e7in temel olarak bir beslenme diyetinin uygulanmas\u0131 gerekiyor. \u00d6rne\u011fin, g\u00fcnl\u00fck beslenmenin 1000 (kcal) kaloriye e\u015fde\u011fer d\u00fczeye indirgenmesi ve bedensel hareketlili\u011fe y\u00f6nelik bir ya\u015fam bi\u00e7iminin uygulanmas\u0131 s\u00f6z konusu oluyor. Bu y\u00f6ntemin desteklenmesi i\u00e7in de bol miktarda bitki \u00e7ay\u0131 i\u00e7ilmesi gerekiyor.
\nArslanpen\u00e7esi: 1000 metrenin \u00fczerindeki y\u00fcksekliklerde yeti\u015fen g\u00fcm\u00fc\u015f renkli bir arslanpen\u00e7esi t\u00fcr\u00fc vard\u0131r. Bu bitkinin yapraklar\u0131yla demlenen \u00e7ay, ya\u011flanma e\u011filimine ve ya\u011flanmaya kar\u015f\u0131 yard\u0131mc\u0131 olabilir. Bitki, genel metabolizman\u0131n i\u015flevini h\u0131zland\u0131r\u0131r. Hareketleriyle enerji \u00fcreten kas yap\u0131s\u0131, titreyerek \u00e7al\u0131\u015fmaya ba\u015flar (n\u00f6bet titremesi gibi). Hissedilen \u00fc\u015f\u00fcme duygusu, \u0131s\u0131n\u0131n d\u0131\u015favurumunu \u00f6nlemek i\u00e7in, y\u00fczeysel kan damarlar\u0131n\u0131n b\u00fcz\u00fclmesinden kaynaklan\u0131r. Olu\u015fabilen y\u00fcksek ate\u015f genellikle, bedenin ya\u011flanma e\u011filimine kar\u015f\u0131 koyu\u015funun bir g\u00f6stergesidir.
\nYar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f g\u00fcm\u00fc\u015f renkli arslanpen\u00e7esi(yaprak, \u00e7i\u00e7ek, sap), orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcn boyunca 2-3 bardak taze demlenmi\u015f \u00e7ay so\u011futulmadan yudumlan\u0131r.
\nArslanpen\u00e7esi tam banyosu: 200g ince k\u0131y\u0131lm\u0131\u015f arslanpen\u00e7esi, 6-8 litre so\u011fuk suda 12 saat demlendirildikten sonra \u0131s\u0131t\u0131l\u0131r ve s\u0131cak banyo suyuna eklenir. Banyo s\u00fcresi 20 dakikad\u0131r. Kalp b\u00f6lgesi suyun d\u0131\u015f\u0131nda kal\u0131r. S\u00fcre sonunda kurulan\u0131lmadan bir bornoz giyilir ve s\u0131cak yatakta bir saat s\u00fcreyle ter at\u0131larak dinlenilir.
\n17. YATA\u011eI ISLATMA
\n\u00c7ocuk ikinci ya\u015f\u0131n\u0131 s\u00fcrd\u00fc\u011f\u00fc s\u0131ralarda, mesanenin doldu\u011funu anlayarak, bilin\u00e7li olarak mesane kaslar\u0131n\u0131 d\u00fczenleyebilme yetene\u011fine kavu\u015fmas\u0131n\u0131 sa\u011flayacak sinir ileticileri geli\u015fir. Bu s\u00fcrecin ard\u0131ndan normalde \u00e7ocu\u011fun uykuda bilin\u00e7siz olarak mesanesini bo\u015faltma d\u00f6nemi sona erer. E\u011fer \u00e7ocu\u011funu be\u015f ya\u015f\u0131ndan sonra da uykuda idrar\u0131n\u0131 tutam\u0131yorsa, yata\u011f\u0131 \u0131slatmaktan (yata\u011fa i\u015femekten) s\u00f6z edilebilir. Bu duruma ancak baz\u0131 s\u0131n\u0131rl\u0131 organik nedenler, \u00f6rne\u011fin \u00fcriner sistemdeki veya omurilikteki yap\u0131sal bozukluklar, idrar yolu iltihab\u0131, \u015feker hastal\u0131\u011f\u0131 veya baz\u0131 ba\u011f\u0131rsak asalaklar\u0131 neden olabilir. Yata\u011f\u0131 \u0131slatmak, genellikle ruhsal(duygusal) nedenlerden kaynaklanan bir durumdur. A\u015f\u0131r\u0131 otoriter e\u011fitim, \u015f\u0131mart\u0131lma, \u00f6nemsenmeme, k\u0131skan\u00e7l\u0131k, korku, ba\u015fkald\u0131r\u0131c\u0131l\u0131k, ruhsal bozukluklar ve ruhsal hastal\u0131klar.
\nSar\u0131 Kantaron: Sar\u0131 kantaron, i\u00e7ten \u00e7ay i\u00e7imi ve d\u0131\u015ftan oturma banyolar\u0131 bi\u00e7iminde, yata\u011f\u0131 \u0131slatmaya kar\u015f\u0131 ba\u015far\u0131yla kullan\u0131labilir.
\nYar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f kantaron, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcn boyunca 2-3 bardak taze demlenmi\u015f kantaron \u00e7ay\u0131 so\u011futulmadan yudumlan\u0131r.
\nSar\u0131 kantaron oturma banyosu: Bir kova dolusu taze veya 100g kuru ve ince k\u0131y\u0131lm\u0131\u015f bitki, 5 litre so\u011fuk suda 12 saat demlendirildikten sonra \u0131s\u0131t\u0131l\u0131r ve s\u0131cak banyo suyuna eklenir. Banyo suyu ancak b\u00f6brek b\u00f6lgesinin \u00fcst\u00fcne \u00e7\u0131kmal\u0131d\u0131r. Banyo s\u00fcresi 20 dakikad\u0131r. S\u00fcre sonunda kurulan\u0131lmadan bir bornoz giyilir ve s\u0131cak yatakta bir saat s\u00fcreyle ter at\u0131larak dinlenilir.
\nCivanper\u00e7emi oturma banyosu: 100g ince k\u0131y\u0131lm\u0131\u015f kuru bitki, 5 litre so\u011fuk suda 12 saat demlendirildikten sonra \u0131s\u0131t\u0131l\u0131r ve s\u0131cak banyo suyuna eklenir. Banyo suyu ancak b\u00f6brek b\u00f6lgesinin \u00fcst\u00fcne \u00e7\u0131kmal\u0131d\u0131r. Banyo s\u00fcresi 20 dakikad\u0131r. S\u00fcre sonunda kurulan\u0131lmadan bir bornoz giyilir ve s\u0131cak yatakta bir saat s\u00fcreyle ter at\u0131larak dinlenilir.
\nKu\u015fekme\u011fi(Polygonum aviculare): Yar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 ince k\u0131y\u0131lm\u0131\u015f ku\u015fekme\u011fi k\u00f6k\u00fc, bir bardak so\u011fuk suda 12 saat demlendirildikten sonra \u0131s\u0131t\u0131l\u0131r ve s\u00fcz\u00fcl\u00fcr. G\u00fcn boyuna yay\u0131larak taze demlenmi\u015f 3 bardak ku\u015fekme\u011fi \u00e7ay\u0131 so\u011futulmadan yudumlan\u0131r. Bir kerede demlenen g\u00fcnl\u00fck \u00e7ay miktar\u0131, bir termosta s\u0131cak durumda muhafaza edilebilir.
\nBitki kar\u0131\u015f\u0131m\u0131 \u00e7ay\u0131: \u0130nce k\u0131y\u0131lm\u0131\u015f sar\u0131 kantaron ve atkuyru\u011fu e\u015fit oranda iyice harmanlan\u0131r.
\nYar\u0131m tatl\u0131 ka\u015f\u0131\u011f\u0131 bitki kar\u0131\u015f\u0131m\u0131, orta boy bir su barda\u011f\u0131 dolusu kaynar derecede s\u0131cak suyla ha\u015flan\u0131r ve yar\u0131m dakika demlendikten sonra s\u00fcz\u00fcl\u00fcr. G\u00fcnde 1-2 bardak taze demlenmi\u015f \u00e7ay so\u011futulmadan yudumlan\u0131r.
\nAk\u015famlar\u0131 elden geldi\u011fince kuru yiyecekler t\u00fcketilmesi do\u011fru olur.<\/p>\n

18. KIZAMIK <\/p>\n

Y\u00fczy\u0131llardan beri en s\u0131k rastlanan \u00e7ocukluk \u00e7a\u011f\u0131 d\u00f6k\u00fcnt\u00fcl\u00fc hastal\u0131klar\u0131ndan birisidir. Sa\u011fl\u0131k ko\u015fullar\u0131 iyi olan toplumlarda k\u0131zam\u0131k ve k\u0131zam\u0131\u011f\u0131n ortaya \u00e7\u0131kard\u0131\u011f\u0131 di\u011fer olaylardan dolay\u0131 \u00f6l\u00fcm oran\u0131 azalm\u0131\u015f durumdad\u0131r. Viral bir enfeksiyondur. A\u015f\u0131laman\u0131n yeterince iyi yap\u0131lmad\u0131\u011f\u0131 b\u00f6lgelerde genellikle 5-10 ya\u015f grubu \u00e7ocuklarda g\u00f6r\u00fclmesine ra\u011fmen, a\u015f\u0131laman\u0131n yayg\u0131n oldu\u011fu b\u00f6lgelerde ise a\u015f\u0131lanmam\u0131\u015f gen\u00e7lerde, eri\u015fkinlerde yada a\u015f\u0131lanma ya\u015f\u0131n\u0131n alt\u0131ndaki bebeklerde daha \u00e7ok g\u00f6r\u00fcl\u00fcr.
\nYeni do\u011fan \u00e7ocuklar ve k\u00fc\u00e7\u00fck bebeklerin ( 6 aydan daha k\u00fc\u00e7\u00fck) \u00e7o\u011fu k\u0131zam\u0131ktan, annelerinden kendilerine ge\u00e7en antikorlar sayesinde korunurlar. Ama alt\u0131nc\u0131 aydan sonra k\u0131zam\u0131\u011fa daha duyarl\u0131 hale gelirler.
\n18.1. Hastal\u0131kla Bula\u015fma
\nSon derece bula\u015f\u0131c\u0131 bir hastal\u0131kt\u0131r. Bu vir\u00fcs ile infekte ki\u015filerden:
\n\uf0c8 Kan
\n\uf0c8 \u0130drar
\n\uf0c8 Damlac\u0131k yolu ile (vir\u00fcs hastan\u0131n nazofariksine yerle\u015fti\u011finden \u00f6t\u00fcr\u00fc, soluk al\u0131p verimi s\u0131ras\u0131nda t\u00fckr\u00fck damlac\u0131klar\u0131 sayesinde) bula\u015f ger\u00e7ekle\u015fmektedir.
\nHastal\u0131\u011f\u0131n bula\u015ft\u0131r\u0131c\u0131 oldu\u011fu d\u00f6nem;
\n\uf0c8 Vir\u00fcsle infekte olan \u00e7ocuk d\u00f6k\u00fcnt\u00fclerin \u00e7\u0131kt\u0131\u011f\u0131 d\u00f6nemden 1-2 g\u00fcn \u00f6ncesinden, d\u00f6k\u00fcnt\u00fcler \u00e7\u0131kt\u0131ktan 5 g\u00fcn sonras\u0131na kadar bula\u015ft\u0131r\u0131c\u0131d\u0131r.
\n\uf0c8 \u0130nk\u00fcbasyon s\u00fcresi (Hastal\u0131kta vir\u00fcs v\u00fccuda girdikten sonra arazlar\u0131n olu\u015ftu\u011fu d\u00f6neme kadar ge\u00e7en s\u00fcre):
\nVir\u00fcs \u00e7ocu\u011fa bula\u015ft\u0131ktan sonra belirtilerin ortaya \u00e7\u0131k\u0131\u015f\u0131na kadar olan s\u00fcre 7- 12 g\u00fcn, d\u00f6k\u00fcnt\u00fclerin olu\u015ftu\u011fu d\u00f6nem ise bula\u015ft\u0131klar 2 hafta sonrad\u0131r.
\nY\u00fczy\u0131llardan beri en s\u0131k rastlanan \u00e7ocukluk \u00e7a\u011f\u0131 d\u00f6k\u00fcnt\u00fcl\u00fc hastal\u0131klar\u0131ndan birisidir. Sa\u011fl\u0131k ko\u015fullar\u0131 iyi olan toplumlarda k\u0131zam\u0131k ve k\u0131zam\u0131\u011f\u0131n ortaya \u00e7\u0131kard\u0131\u011f\u0131 di\u011fer olaylardan dolay\u0131 \u00f6l\u00fcm oran\u0131 azalm\u0131\u015f durumdad\u0131r. Viral bir enfeksiyondur. A\u015f\u0131laman\u0131n yeterince iyi yap\u0131lmad\u0131\u011f\u0131 b\u00f6lgelerde genellikle 5-10 ya\u015f grubu \u00e7ocuklarda g\u00f6r\u00fclmesine ra\u011fmen, a\u015f\u0131laman\u0131n yayg\u0131n oldu\u011fu b\u00f6lgelerde ise a\u015f\u0131lanmam\u0131\u015f gen\u00e7lerde, eri\u015fkinlerde yada a\u015f\u0131lanma ya\u015f\u0131n\u0131n alt\u0131ndaki bebeklerde daha \u00e7ok g\u00f6r\u00fcl\u00fcr.
\nYeni do\u011fan \u00e7ocuklar ve k\u00fc\u00e7\u00fck bebeklerin (6 aydan daha k\u00fc\u00e7\u00fck) \u00e7o\u011fu k\u0131zam\u0131ktan, annelerinden kendilerine ge\u00e7en antikorlar sayesinde korunurlar. Ama alt\u0131nc\u0131 aydan sonra k\u0131zam\u0131\u011fa daha duyarl\u0131 hale gelirler.
\n18.2. Belirti Ve Bulgular <\/p>\n

Hastal\u0131\u011f\u0131n ilk belirtilerinin ortaya \u00e7\u0131kt\u0131\u011f\u0131 d\u00f6nemlerde \u015fu bulgular g\u00f6r\u00fclmektedir:
\n\uf0c8 \u00d6ks\u00fcr\u00fck
\n\uf0c8 Burun ak\u0131nt\u0131s\u0131
\n\uf0c8 G\u00f6zde: Konjiktivit (g\u00f6z konjiktivas\u0131n\u0131n iltihaplanmas\u0131), konjonktivada g\u00f6z kapa\u011f\u0131 s\u0131n\u0131r\u0131 boyunca izlenen tipik yatay bir \u00e7izgi (Stimson \u00e7izgisi) ve fotofobi (\u0131\u015f\u0131\u011fa bakamakda zorlanma) g\u00f6r\u00fclebilir.
\n\uf0c8 Yanak mukozas\u0131nda: \u201cKoplik lekeleri\u201d (alt molar di\u015f hizas\u0131nda yanak mukozas\u0131nda gri-beyaz, toplu i\u011fne ba\u015f\u0131 b\u00fcy\u00fckl\u00fc\u011f\u00fcnde lekeler) 12-24 saat s\u00fcreyle kal\u0131r, sonra kaybolur. G\u00f6r\u00fcld\u00fc\u011f\u00fcnde hastal\u0131\u011f\u0131n tan\u0131s\u0131nda \u00f6nemli bir bulgudur.
\n\uf0c8 D\u00f6k\u00fcnt\u00fc evresinde ate\u015f s\u0131kl\u0131kla 40.0-40.5\u00b0C ye kadar y\u00fckselebilir.
\n\uf0c8 V\u00fccutta d\u00f6k\u00fcnt\u00fc: Mak\u00fcler d\u00f6k\u00fcnt\u00fc sa\u00e7l\u0131 deri hizas\u0131ndan, ense ve al\u0131ndan ba\u015flayarak 24 saat i\u00e7erisinde y\u00fcze, boyuna, \u00fcst kol ve g\u00f6vdeye yay\u0131l\u0131r. Y\u00fcz ve boyundaki d\u00f6k\u00fcnt\u00fcler birle\u015fme e\u011filimindedirler. Hastal\u0131\u011f\u0131n a\u011f\u0131rl\u0131\u011f\u0131 d\u00f6k\u00fcnt\u00fcn\u00fcn yayg\u0131nl\u0131\u011f\u0131 ile uyumludur. Solmas\u0131 da ayn\u0131 \u015fekilde olur. D\u00f6k\u00fcnt\u00fc olu\u015ftuktan sonra 3. g\u00fcnden itibaren solmaya ba\u015flamaktad\u0131r, solma esnas\u0131nda geride esmerimsi bir renk b\u0131rakmas\u0131 ve deride un s\u00fcr\u00fclm\u00fc\u015f\u00e7esine bir pullanma yapmas\u0131 \u00f6nemlidir.
\n\uf0c8 Lenfadenit (boyun lenf bezlerinde iltihaplanma), splenomegali (dalakta b\u00fcy\u00fcme) ve mezenterik lemfadenopati (kar\u0131n a\u011fns\u0131yla birlikte) olabilir. Karaci\u011fer tutulumu eri\u015fkinlerde s\u0131kt\u0131r.
\n18.3. Komplikasyonlar
\n\uf0c8 K\u0131zam\u0131kta s\u0131kl\u0131kla orta kulak iltihaplanmas\u0131 g\u00f6r\u00fcl\u00fcr.
\n\uf0c8 K\u0131zam\u0131kta, daha \u00f6ncesinden t\u00fcberk\u00fcloz (Verem) ge\u00e7irmi\u015f hastalarda verem yeniden aktive olabilir.
\n\uf0c8 S\u00fct \u00e7ocuklar\u0131nda, \u00f6zellikle bak\u0131ms\u0131z ve zay\u0131f \u00e7ocuklarda bron\u015fiyolit ve bronkopn\u00f6moni s\u0131k rastlan\u0131lan bir komplikasyondur.
\n\uf0c8 Pn\u00f6moni (Zat\u00fcrre) ve bronkopn\u00f6moni az geli\u015fmi\u015f ve geli\u015fmekte olan \u00fclkelerde \u00f6l\u00fcme yol a\u00e7an en \u00f6nemli k\u0131zam\u0131k komplikasyonudur.
\n\uf0c8 Servikal lenfadenit (Boyun b\u00f6lgesindeki lenf bezi iltihaplanmalar\u0131), antibiotik kullan\u0131m\u0131na ba\u011fl\u0131 olarak olduk\u00e7a d\u00fc\u015fm\u00fc\u015ft\u00fcr.
\n\uf0c8 Ensefalit (Beyin iltihab\u0131) g\u00f6r\u00fclebilir. (Subakut sklerozan panensefalit; K\u0131zam\u0131\u011f\u0131n ge\u00e7 d\u00f6nem bir komplikasyonudur.)
\n18.4. Tan\u0131
\n\uf0c8 Klinik g\u00f6r\u00fcn\u00fcm tipiktir.
\n\uf0c8 Nazal mukoza s\u00fcr\u00fcnt\u00fcs\u00fcnde \u00e7ok \u00e7ekirdekli dev h\u00fccrelerin g\u00f6r\u00fclmesi
\n\uf0c8 K\u00fclt\u00fcrde vir\u00fcs izolasyonu
\n\uf0c8 \u0130yile\u015fme d\u00f6neminde serumda tan\u0131sal antikor y\u00fckselmesinin belirlenmesi yeterlidir.
\n18.5. Tedavi
\nKomplikasyon geli\u015fmemi\u015f bir \u00e7ocukta tedavi semptoma y\u00f6neliktir. Fotofobi g\u00fc\u00e7l\u00fc \u0131\u015f\u0131kta artar, bundan ka\u00e7\u0131nmak gerekir. Yatak istirahat\u0131, sulu ve yumu\u015fak g\u0131dalar yemesi \u00f6nerilir. G\u00f6z kapaklar\u0131 \u0131l\u0131k su ile temizlenir. Y\u00fcksek ate\u015f durumunda ise, ate\u015f d\u00fc\u015f\u00fcr\u00fcc\u00fc ajanlar verilmelidir. A vitamininin 200 000 Ul a\u011f\u0131z yolu ile al\u0131nmas\u0131,beslenme bozuklu\u011fu olan infekte \u00e7ocuklarda yararl\u0131 olur. A\u011f\u0131r infeksiyonlarda intraven\u00f6z olarak verilen ribavirin de yararl\u0131 olabilir
\n18.6. Koruyucu \u00d6nlemler
\n\uf0c8 En etkili koruyucu \u00f6nlem, her sa\u011fl\u0131kl\u0131 \u00e7ocu\u011fa k\u0131zam\u0131k a\u015f\u0131s\u0131 uygulanmas\u0131 yolu ile olur.
\nNot: A\u015f\u0131lar\u0131n hangi tarihte yap\u0131lmas\u0131 gerekti\u011fini, hesaplay\u0131c\u0131lar b\u00f6l\u00fcm\u00fcm\u00fczden a\u015f\u0131 testini se\u00e7erek \u00f6\u011frenebilirsiniz. (Bu b\u00f6l\u00fcmde \u00e7ocu\u011funuzun do\u011fum tarihini girerek, hangi ay ve ya\u015fta hangi a\u015f\u0131lar\u0131 olaca\u011f\u0131n\u0131 bulabilirsiniz.)
\n\uf0c8 K\u0131zam\u0131k ile temas eden bir \u00e7ocuk temastan sonra 1-2 g\u00fcn i\u00e7erisinde k\u0131zam\u0131k a\u015f\u0131s\u0131 yapt\u0131rarak k\u0131zam\u0131ktan korunabilir. Bu \u00f6nlemin al\u0131namad\u0131\u011f\u0131 durumlarda ise bula\u015fman\u0131n ilk 6 g\u00fcn\u00fc i\u00e7erisinde 0,4 ml\/kg gamaglob\u00fclin uygulanabilir.
\n19. KABAKULAK
\nS\u0131kl\u0131kla parotis (t\u00fckr\u00fck bezi) bezinin, daha nadir olarak di\u011fer d\u0131\u015f salg\u0131 bezlerinin, bazen de merkezi sinir sisteminin iltihab\u0131 ile olu\u015fan ani geli\u015fim g\u00f6steren, ate\u015fli ve bula\u015f\u0131c\u0131 bir viral enfeksiyondur.
\n\uf0c8 Her iki cinste de g\u00f6r\u00fcl\u00fcr.
\n\uf0c8 Kabakula\u011fa yakalanan her 20 \u00e7ocuktan 17\u2019si on be\u015f ya\u015f\u0131ndan k\u00fc\u00e7\u00fck \u00e7ocuklard\u0131r.
\n\uf0c8 Daha \u00e7ok k\u0131\u015f sonu ve ilkbahar aylar\u0131nda g\u00f6r\u00fcl\u00fcr.
\n\uf0c8 Geli\u015fmi\u015f \u00fclkelerde kabakula\u011f\u0131n g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131 a\u015f\u0131lama ile azalm\u0131\u015ft\u0131r.<\/p>\n

19.1. Bula\u015fma Yollar\u0131
\n\uf0c8 Vir\u00fcs ile direkt temas.
\n\uf0c8 Damlac\u0131k yolu ile solunan havadan veya hastan\u0131n t\u00fckr\u00fc\u011f\u00fc ile kirlenmi\u015f e\u015fyadan olur.
\nHastal\u0131\u011f\u0131n bula\u015f\u0131c\u0131 oldu\u011fu d\u00f6nem;
\n\uf0c8 Vir\u00fcs parotis bezinin (kulak memesinin a\u015fa\u011f\u0131s\u0131nda \u00e7ene kemi\u011fi alt\u0131nda yerle\u015fim g\u00f6sterir) \u015fi\u015fmesinden 6 g\u00fcn \u00f6ncesinden 9 g\u00fcn sonras\u0131na kadar t\u00fck\u00fcr\u00fckte saptanmakla beraber, bula\u015ft\u0131r\u0131c\u0131l\u0131k \u015fi\u015fmenin 1 g\u00fcn \u00f6ncesinden 3 g\u00fcn sonras\u0131na dek s\u00fcrer .
\n\uf0c8 Ya\u015fam\u0131n ilk 6 ay\u0131nda anneden ge\u00e7en antikorlar bebe\u011fi bu hastal\u0131ktan korur.
\n\uf0c8 Kabakulak sonras\u0131nda ya\u015fam boyu ba\u011f\u0131\u015f\u0131kl\u0131k s\u00f6z konusudur
\n\u0130nk\u00fcbasyon s\u00fcresi: (Hastal\u0131kta vir\u00fcs v\u00fccuda girdikten sonra arazlar\u0131n olu\u015ftu\u011fu d\u00f6neme kadar ge\u00e7en s\u00fcre)
\n\uf0c8 Genelde 16-21 g\u00fcnd\u00fcr.
\n19.2. Klinik Belirti Ve Bulgular
\n\u0130nfeksiyon %30-40 herhangi bir bulgu vermeden seyreder, semptomlar ortaya \u00e7\u0131karsa;
\n\uf0c8 Ate\u015f: 39-40 dereceye kadar \u00e7\u0131kabilir.
\n\uf0c8 Kas a\u011fr\u0131lar\u0131 g\u00f6r\u00fclebilir.
\n\uf0c8 Ba\u015f a\u011fr\u0131s\u0131.
\n\uf0c8 Halsizlik ve t\u00fckr\u00fck bezlerinde 4-10 g\u00fcn s\u00fcren a\u011fr\u0131 ve \u015fi\u015fme olur. \u015ei\u015fme mandibula (\u00e7ene kemi\u011fi) a\u00e7\u0131s\u0131n\u0131 \u00f6rter, kulak memesini yukar\u0131 ve d\u0131\u015fa iter. Genellikle t\u00fckr\u00fck bezlerinden ilk \u00f6nce birisi, birka\u00e7 g\u00fcn sonra ikincisi infekte olur ve \u015fi\u015fer. Bazen ise \u015fi\u015fme tek tarafl\u0131 olabilir.
\n\uf0c8 Beze dokunulmas\u0131 ve a\u011fz\u0131n a\u00e7\u0131lmas\u0131 a\u011fr\u0131ya neden olur. portakal ve limon suyu gibi t\u00fck\u00fcr\u00fck salg\u0131s\u0131n\u0131 art\u0131ran maddeler de ayn\u0131 etkiyi yarat\u0131r. \u015ei\u015fme ve eritem Stensen kanal\u0131n\u0131n \u00e7evresini de sarar. \u00c7ene alt\u0131ndaki di\u011fer bezler de parotisin \u015fi\u015fmesine e\u015flik edebilir. Sublingual (dil alt\u0131) bezler ise daha az tutulur.
\n19.3. Komplikasyonlar
\nOr\u015fit (Erkek Yumurtalar\u0131n\u0131n \u0130ltihaplanmas\u0131):
\nBu komplikasyonlar ergenlik \u00e7a\u011f\u0131ndaki erkek \u00e7ocuklar\u0131n ve eri\u015fkinlerin %15-35’inde ortaya \u00e7\u0131kar, ender olarak ergenlik \u00e7a\u011f\u0131ndan \u00f6nce g\u00f6r\u00fcl\u00fcr. Hastal\u0131\u011f\u0131n ilk haftas\u0131n\u0131n sonunda belirir. Hastalar\u0131n %3’\u00fcnde \u00e7ift tarafl\u0131 tutulum g\u00f6r\u00fcl\u00fcr. Yumurtalar k\u0131rm\u0131z\u0131, \u015fi\u015f ve duyarl\u0131d\u0131r. Sekel olarak yumurtalarda atrofi (eriyip ufalma) s\u0131kt\u0131r, k\u0131s\u0131rl\u0131k ise seyrek olarak g\u00f6r\u00fcl\u00fcr.
\n\uf0c8 Menenjit ve ensefalit (beyin iltihaplanmas\u0131):
\n\uf0c8 Vakalar\u0131n yakla\u015f\u0131k %l0’dan fazlas\u0131nda klinik olarak meningoensefalit g\u00f6r\u00fclebilir. \u00c7ocukluk ya\u015flar\u0131nda daha s\u0131k g\u00f6r\u00fcl\u00fcr. Kabakulaktan 5-7 g\u00fcn sonra ortaya \u00e7\u0131kar. Erken g\u00f6r\u00fclen menenjit b\u00fcy\u00fck olas\u0131l\u0131kla beyinde do\u011frudan vir\u00fcs infeksiyonuna ba\u011fl\u0131d\u0131r.
\n\uf0c8 Pankreatit: Hafif dereceli pankreatit s\u0131kt\u0131r; Kar\u0131n a\u011fr\u0131s\u0131, duyarl\u0131l\u0131k, titreme, ve kusma ile kendini g\u00f6sterir. Kabakulakta klinik pankreatit olsa da olmasa da genellikle serum amilaz d\u00fczeyi y\u00fckselir. Pankreas yada t\u00fck\u00fcr\u00fck bezi tutulumunun g\u00f6stergesidir.
\n\uf0c8 Seyrek G\u00f6r\u00fclen Komplikasyonlar: Bunlar aras\u0131nda b\u00f6brek tutulumu, kalp kas\u0131 tutulumu, sa\u011f\u0131rl\u0131k, kemik tutulumu, g\u00f6zle ilgili komplikasyonlar say\u0131labilir.
\n\uf0c8 Anne karn\u0131ndaki bebekte enfeksiyon:
\nGebelik d\u00f6neminde annenin ge\u00e7irdi\u011fi kabakulak enfeksiyonu sonucu bunun fet\u00fcse ge\u00e7i\u015fi %5 kadard\u0131r. Bu olaya ba\u011fl\u0131 olarak \u00e7ocukta zeka gerili\u011fi, kalp ve g\u00f6z tutulumu gibi anormallikler bildirilmi\u015ftir.
\n19.4. Tan\u0131
\n\uf0c8 Klinik belirti ve bulgular tan\u0131 konulmas\u0131nda \u00e7ok \u00f6nemlidir.
\n\uf0c8 Serum amilaz\u0131nda y\u00fckselme tipiktir, ortaya \u00e7\u0131k\u0131\u015f\u0131 parotis bezinin \u015fi\u015fmesiyle paralellik g\u00f6sterir.
\n\uf0c8 Ayn\u0131 zamanda tan\u0131 vir\u00fcs\u00fcn t\u00fckr\u00fck, idrar, beyin omurilik s\u0131v\u0131s\u0131 yada kandan rutin viral k\u00fclt\u00fcrde izole edilmesiyle konabilir.
\n\uf0c8 Serumda kabakulak antikorlar\u0131nda y\u00fckselme de tan\u0131sald\u0131r.
\n19.5. Tedavi
\nDestekleyici bak\u0131m d\u0131\u015f\u0131nda bir tedavisi yoktur.
\n19.6. Korunma Yollar\u0131
\nCanl\u0131 aten\u00fce kabakulak a\u015f\u0131s\u0131 kabakulak vakalar\u0131n\u0131n g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131n\u0131 belirgin olarak d\u00fc\u015f\u00fcrm\u00fc\u015ft\u00fcr, 15 ayl\u0131k \u00e7ocuklara k\u0131zam\u0131k-kabakulak-k\u0131zam\u0131k\u00e7\u0131k (MMR) a\u015f\u0131s\u0131n\u0131n bir par\u00e7as\u0131 olarak uygulanmas\u0131 gerekir.
\nParotit ve meningo ensefalit koruyuculu\u011fu y\u00fcksek olan kabakulak a\u015f\u0131s\u0131n\u0131n seyrek g\u00f6r\u00fclen komplikasyonudur.
\n20. VAR\u0130CELLA (SU \u00c7\u0130\u00c7E\u011e\u0130) <\/p>\n

\uf0c8 Bu hastal\u0131\u011f\u0131 yapan vir\u00fcs Varicella-zoster vir\u00fcs\u00fc\u2019d\u00fcr.
\n\uf0c8 Varicella \u00e7ocukluk \u00e7a\u011f\u0131n\u0131n son derece bula\u015f\u0131c\u0131 bir hastal\u0131\u011f\u0131d\u0131r.
\n\uf0c8 Giri\u015f g\u00f6z konjuktivas\u0131 yada \u00fcst solunum yolu iledir.
\n\uf0c8 S\u0131kl\u0131kla 5-10 ya\u015f civar\u0131nda g\u00f6r\u00fclmektedir.
\n\uf0c8 Il\u0131man iklimlerde 10 \u00e7ocuktan 1 \u00e7ocuk 10 ya\u015f\u0131na kadar bu infeksiyonu ge\u00e7irir.
\n\uf0c8 Mevsimsel olarak k\u0131\u015f sonu ve ilkbahar aylar\u0131nda g\u00f6r\u00fclme oran\u0131 daha y\u00fcksektir.
\n\uf0c8 Gebeli\u011finin ilk 3 ay\u0131nda su\u00e7i\u00e7e\u011fi ge\u00e7iren annelerin \u00e7ocuklar\u0131nda ilk ya\u015flarda zoster enfeksiyonu g\u00f6r\u00fclebilir.Gebeli\u011finin son d\u00f6nemlerinde bu enfeksiyonu ge\u00e7iren annelerde ise \u00e7ocuk su\u00e7i\u00e7e\u011fi belirtileri ile do\u011fabilir.
\n20.1. Bula\u015fma Yollar\u0131
\n\uf0c8 Do\u011frudan direkt temas
\n\uf0c8 Damlac\u0131k ve hava yolu ile olur.
\nVir\u00fcs v\u00fccuda girdikten sonra hastal\u0131k olu\u015funcaya kadar ge\u00e7mesi gereken kulu\u00e7ka s\u00fcresi 13 ile 23 g\u00fcn aras\u0131d\u0131r.
\nBula\u015ft\u0131rma s\u00fcresi d\u00f6k\u00fcnt\u00fc ba\u015flang\u0131c\u0131ndan 2 g\u00fcn \u00f6ncesinden t\u00fcm lezyonlar\u0131n kabukland\u0131\u011f\u0131 7 g\u00fcn sonras\u0131na kadar olabilir.
\n20.2. Klinik Bulgular
\nD\u00f6k\u00fcnt\u00fcler ortaya \u00e7\u0131kmadan bir g\u00fcn \u00f6nce
\n\uf0c8 Ate\u015f
\n\uf0c8 Halsizlik
\n\uf0c8 \u0130\u015ftahs\u0131zl\u0131k \u00e7\u0131kabilir.
\n\uf0c8 D\u00f6k\u00fcnt\u00fcler: Tipik d\u00f6k\u00fcnt\u00fc k\u00fc\u00e7\u00fck k\u0131rm\u0131z\u0131 nokta \u015feklinde lekelerdir, h\u0131zla k\u0131rm\u0131z\u0131 g\u00f6bekli olmayan, oval ”g\u00f6z- ya\u015f\u0131” \u015feklindeki su toplam\u0131\u015f d\u00f6k\u00fcnt\u00fclere d\u00f6n\u00fc\u015f\u00fcr. S\u0131v\u0131 \u00f6nce berrakken sonra bulan\u0131kla\u015f\u0131r sonra \u00fclserle\u015fir, kabuklan\u0131r ve iyile\u015fir. D\u00f6k\u00fcnt\u00fcler yay\u0131l\u0131ma \u00f6nce y\u00fcz ve sa\u00e7lar\u0131n aras\u0131ndan ba\u015flayarak sonra tercihen s\u0131rt, g\u00f6\u011f\u00fcs, kar\u0131n, kol ve bacaklara yay\u0131l\u0131r.Toplam 100 civar\u0131nda lezyon bulunur ve ayn\u0131 anda t\u00fcm lezyon \u015feki1leri bir arada g\u00f6r\u00fclebilir. Ka\u015f\u0131nt\u0131 \u00e7o\u011funlukla vard\u0131r. Lezyonlar t\u00fcm m\u00fck\u00f6z membranlarda (\u00d6r: a\u011f\u0131z mukozas\u0131, yanak, dudak, di\u015f eti, genital organlar vs..) g\u00f6r\u00fclebilir. D\u00f6k\u00fcnt\u00fclerin g\u00f6r\u00fclme s\u00fcresi ortalama 6 g\u00fcn kadard\u0131r, kabuklanmalar ise 2 haftada d\u00fc\u015fer. D\u00f6k\u00fcnt\u00fcn\u00fcn derecesi ile ate\u015f ve sistemik bulgular de\u011fi\u015fkendir
\n\uf0c8 Yayg\u0131n lemfadenopati (lenf bezi iltihaplanmas\u0131) bulunabilir.
\n20.3. Do\u011fumsal Su \u00c7i\u00e7e\u011fi
\nGebe kad\u0131nlarda fetal varicella infeksiyonu sonucu d\u00fc\u015f\u00fck do\u011fum a\u011f\u0131rl\u0131\u011f\u0131, beyinde kortikal atrofi, n\u00f6betler, zeka gerili\u011fi, g\u00f6zde katarakt, mikrosefali, k\u00fc\u00e7\u00fck intrakraniyal kalsifikasyonlar ve g\u00f6vde yada ekstremitelerde tan\u0131sal skarlar, geli\u015fme gerili\u011fi \u015feklinde g\u00f6r\u00fcn\u00fcm ortaya \u00e7\u0131kabilir.
\nDo\u011fumdan 5 g\u00fcn \u00f6ncesinden 2 g\u00fcn sonras\u0131na kadar su\u00e7i\u00e7e\u011fi ge\u00e7iren annelerin bebeklerinde, transplasental antikor yoklu\u011funa ba\u011fl\u0131 oldu\u011fu d\u00fc\u015f\u00fcn\u00fclen a\u011f\u0131r bir varicella sendromu geli\u015fir. Bu bebekler olabildi\u011fince \u00e7abuk zoster imm\u00fcn globulini (ZIG) ile tedavi edilerek infeksiyonlar \u00f6nlenmeli yada hafifletilmelidir.
\n20.4. Komplikasyonlar
\n\uf0c8 Varicella yenido\u011fan1ar, eri\u015fkin1er ve ba\u011f\u0131\u015f\u0131kl\u0131k sistemi bask\u0131lanm\u0131\u015f ki\u015filer i\u00e7in daha ciddi bir hastal\u0131kt\u0131r .
\n\uf0c8 Deri lezyon1ar\u0131n\u0131n stafilokok yada streptokoklarla ikincil infeksiyonu en s\u0131k g\u00f6r\u00fclen komplikasyondur.
\n\uf0c8 Zat\u00fcrre sa\u011fl\u0131kl\u0131 \u00e7ocuklarda ender g\u00f6r\u00fcl\u00fcr, ancak sa\u011fl\u0131kl\u0131 eri\u015fkin ve ba\u011f\u0131\u015f\u0131kl\u0131k sistemi bask\u0131lanm\u0131\u015f ki\u015filerin %15-20’sinde olu\u015fabilir.
\n\uf0c8 \u25baKalp tutulumu, or\u015fit (erkek yumurtas\u0131 iltihaplanmas\u0131) hepatit, \u00fclseratif gastrit, b\u00f6brek tutulumu ve eklem tutulumu bu enfeksiyonu yapan vir\u00fcs\u00fcn di\u011fer komplikasyon1ar\u0131d\u0131r.
\n\uf0c8 Varicella infeksiyounda Reye sendromu g\u00f6r\u00fclebilir , bu y\u00fczden aspirin kullan\u0131lmamal\u0131d\u0131r.
\n\uf0c8 N\u00f6rolojik sistem ile ilgili bir \u00e7ok komplikasyona da sebep olabilir.
\n\uf0c8 Ba\u011f\u0131\u015f\u0131kl\u0131k yetersizli\u011fi yada bask\u0131lanmas\u0131 olan \u00e7ocuklarda \u00f6l\u00fcmc\u00fcl olabilir. Varicella i\u00e7in profilaksi veya tedavi yap\u0131lmam\u0131\u015f l\u00f6semili \u00e7ocuklarda \u00f6l\u00fcm oran\u0131 %l0’a yakla\u015f\u0131kt\u0131r.
\n20.5. Tan\u0131
\n\uf0c8 Klinik belirti ve bulgular
\n\uf0c8 \u0130\u00e7i s\u0131v\u0131 dolu d\u00f6k\u00fcnt\u00fclerden al\u0131nan s\u0131v\u0131 veya kaz\u0131nt\u0131n\u0131n sitoloji ve elektron mikroskopik incelenmesi tan\u0131da yard\u0131mc\u0131d\u0131r.
\n\uf0c8 D\u00f6k\u00fcnt\u00fcden al\u0131nan s\u0131v\u0131da monoklonal antikorlar\u0131n imm\u00fcn floresans\u0131 ile varicella \u00f6zg\u00fcl antijeninin belirlenmesi yada akut ve konvalesan antikorda varisella zoster vir\u00fcs antikoru aranmas\u0131 ile do\u011frulanabilir.
\n20.6. Tedavi Yollar\u0131
\nVaricella’n\u0131n semptomatik tedavisinde aspirin d\u0131\u015f\u0131 a\u011fr\u0131 kesici ate\u015f d\u00fc\u015f\u00fcr\u00fcc\u00fcler, so\u011fuk banyolar ve hijyene dikkat edilmesi vard\u0131r. Ba\u011f\u0131\u015f\u0131kl\u0131k sistemi bask\u0131lanm\u0131\u015f ki\u015filerde varicella tedavisinde intraven\u00f6z acyclovir etkilidir.
\n20.7. Korunma Yollar\u0131
\n\uf0c8 Bir\u00e7ok \u00fclkede canl\u0131, aten\u00fce bir a\u015f\u0131 kullan\u0131lmaktad\u0131r. Bu a\u015f\u0131, baz\u0131 ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131 k\u0131r\u0131lm\u0131\u015f olan \u00e7ocuklar da dahil, herkes i\u00e7in g\u00fcvenli g\u00f6r\u00fcnmektedir .
\n\uf0c8 Pasif ba\u011f\u0131\u015f\u0131kl\u0131k a\u011f\u0131r hastal\u0131k riski ta\u015f\u0131yan ki\u015filerde temastan 4 g\u00fcn sonras\u0131na kadar kullan\u0131labilen ZIG (zoster immun glob\u00fclin) sa\u011flanabilir. ZIG adaylar\u0131 aras\u0131nda ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131 k\u0131r\u0131lm\u0131\u015f yada imm\u00fcn sistemi bask\u0131lanm\u0131\u015f ki\u015filer, do\u011fumdan 5 g\u00fcn \u00f6nce yada 2 g\u00fcn sonra su \u00e7i\u00e7e\u011fi ba\u015flayan infekte annelerin yeni do\u011fan bebekleri, 7 aydan k\u00fc\u00e7\u00fck premat\u00fcreler veya \u00f6nceden su \u00e7i\u00e7e\u011fi ge\u00e7irmemi\u015f annelerin premat\u00fcre bebekleri ve varicella ile yak\u0131n temastaki 15 ya\u015f\u0131ndan b\u00fcy\u00fck \u00e7ocuklar veya eri\u015fkinler bulunur.
\n\uf0c8 T\u00fcm vezik\u00fcller kabuklanana dek \u00e7ocuklar okula g\u00f6nderilmemelidir.
\n\uf0c8 Varicella nedeniyle hastaneye yat\u0131r\u0131lan \u00e7ocuklar havaland\u0131rma sisteminin vir\u00fcs\u00fc sa\u00e7mas\u0131n\u0131 \u00f6nleyecek odalarda izole edilmelidir.
\n21. \u0130SHAL
\n\u00c7ocu\u011fun d\u0131\u015fk\u0131s\u0131n\u0131n normalden daha sulu ve g\u00fcnde 3 defadan daha s\u0131k yap\u0131lmas\u0131 haline ishal denir. S\u0131k ama normal k\u0131vamda d\u0131\u015fk\u0131lama ishal olarak kabul edilmemektedir. Ayr\u0131ca, anne s\u00fct\u00fc ile beslenen bebeklerin normalden daha s\u0131k d\u0131\u015fk\u0131 yapabilece\u011fi ak\u0131ldan \u00e7\u0131kar\u0131lmamal\u0131d\u0131r. Bunlar\u0131 ishal olarak de\u011ferlendirmemek gerekir.
\n\u00d6zellikle 6 ay-2 ya\u015f aras\u0131ndaki \u00e7ocuklarda s\u0131k g\u00f6r\u00fclmektedir. \u0130nek s\u00fct\u00fc yada mama ile beslenen 6 ayl\u0131ktan k\u00fc\u00e7\u00fck \u00e7ocuklar ishale normalden daha s\u0131k yakalan\u0131rlar. Bazen ani bir ba\u015flang\u0131\u00e7 g\u00f6sterip birka\u00e7 g\u00fcn i\u00e7erisinde ge\u00e7er iken bazen ise 15 g\u00fcnden daha fazla s\u00fcrebilir.
\n\u0130shal k\u00f6t\u00fc beslenen \u00e7ocuklarda daha s\u0131k g\u00f6r\u00fcl\u00fcr ve daha a\u011f\u0131r seyreder. Ayr\u0131ca ishalin kendisi de beslenme bozuklu\u011funa neden olur. Daha \u00f6nceden beslenme yetersizli\u011fi var ise, ishal bu olay\u0131 daha da k\u00f6t\u00fcle\u015ftirir. Sonu\u00e7 olarak beslenme yetersizli\u011fi hatta \u00f6l\u00fcme bile neden olabilmektedir.
\n21.1. Belirti Ve Bulgular
\n\uf0c8 Yumu\u015fak, s\u0131v\u0131 d\u0131\u015fk\u0131lama (bu olaya bazen kan ve mukus da eklenebilir) vard\u0131r.
\n\uf0c8 Ate\u015f
\n\uf0c8 Kar\u0131n a\u011fr\u0131s\u0131 ve \u015fi\u015fkinlik
\n\uf0c8 Ba\u015f a\u011fr\u0131s\u0131
\n\uf0c8 \u0130\u015ftahs\u0131zl\u0131k ve zay\u0131flama
\n\uf0c8 Halsizlik
\n\uf0c8 Kusma
\n\uf0c8 Kas a\u011fr\u0131s\u0131
\nV\u00fccut normalde gereksinimi olan su ve tuzlar\u0131, yiyecek ve i\u00e7ecekler yoluyla al\u0131r ve d\u0131\u015fk\u0131, idrar, terleme ve solunum yoluyla d\u0131\u015far\u0131 atar. Hasta ne kadar \u00e7ok sulu d\u0131\u015fk\u0131 yaparsa o kadar fazla su ve tuz kaybeder. \u0130shalle birlikte g\u00f6r\u00fclen kusma da bunu artt\u0131r\u0131r. S\u0131cak havalarda ve ate\u015fin y\u00fcksek oldu\u011fu durumlarda s\u0131v\u0131 ve tuz kayb\u0131 daha fazla olmaktad\u0131r.
\n21.2. Hangi Durumlarda Evde \u0130shal Tedavisi Uygulanabilir?
\n\uf0c8 Kusma yok yada \u00e7ok az ise
\n\uf0c8 Su i\u00e7ebiliyor ve susuzlu\u011fu yok ise
\n\uf0c8 Genel durumu iyi ise
\n\uf0c8 Sulu d\u0131\u015fk\u0131lama say\u0131s\u0131 g\u00fcnde 4′ den az ise
\n21.3. Tedavi Yollar\u0131
\n1.) Yap\u0131lacak en acil \u015fey, \u00e7ocu\u011funuza bol s\u0131v\u0131 vermektir. Bu durum; ishali durdurmak i\u00e7in de\u011fil, kaybolan suyu yerine koymak i\u00e7indir.
\nHer ishalli d\u0131\u015fk\u0131lamadan sonra ne kadar s\u0131v\u0131 verilmelidir?
\n\uf0c8 2 ya\u015f\u0131n\u0131n alt\u0131ndaki \u00e7ocuklara yar\u0131m ile bir \u00e7ay barda\u011f\u0131
\n\uf0c8 2 ya\u015f\u0131ndan b\u00fcy\u00fcklere yar\u0131m ile bir su barda\u011f\u0131
\n\uf0c8 Daha b\u00fcy\u00fck \u00e7ocuklara i\u00e7ebildi\u011fi kadar s\u0131v\u0131 verilmelidir.
\n2.) \u00c7ocu\u011fun beslenmesine devam edilmelidir. \u0130shali olan \u00e7ocu\u011fa yemek vermemek veya az vermek beslenme yetersizli\u011fine neden olur, yada beslenme yetersizli\u011fi varsa daha da k\u00f6t\u00fcle\u015fir.
\n\uf0c8 E\u011fer bebek meme emiyor ise, yap\u0131labilecek en iyi \u015fey, daha s\u0131k emzirmektir.
\n\uf0c8 Anne s\u00fct\u00fc almayan bebeklerde her zamanki mamas\u0131na daha s\u0131k olarak devam edilir.
\n\uf0c8 \u015eiddetli ishallerde, kaybedilen s\u0131v\u0131 ve minerallerin yerine konmas\u0131 amac\u0131yla, tuz-\u015feker \u00e7\u00f6zeltisi (ORS) i\u00e7irin. Bu \u00e7\u00f6zeltiyi \u201cSa\u011fl\u0131k ocaklar\u0131 veya ana \u00e7ocuk sa\u011fl\u0131\u011f\u0131 merkezinden\u201d \u00fccretsiz alabilirsiniz.
\n\uf0c8 6 aydan b\u00fcy\u00fck ve kat\u0131 g\u0131da alan \u00e7ocuklara s\u00fcte ek olarak sebze, hububat ve di\u011fer g\u0131dalar verilir. Yo\u011furt, patates p\u00fcresi, iyi pi\u015fmi\u015f ya\u011fs\u0131z et, pirin\u00e7 lapas\u0131, bal\u0131k gibi y\u00fcksek enerji ve protein i\u00e7eren yiyecekler, \u015feftali, elma p\u00fcresi ,taze meyve sular\u0131 ve muz gibi potasyumdan zengin besinler tercih edilmelidir.
\n\u00c7ocuk her 3-4 saatte bir beslenmelidir. Bir anda a\u015f\u0131r\u0131 g\u0131da al\u0131m\u0131 zararl\u0131 olabilir.
\n21.4. Hangi Durumlarda Hekime Ba\u015fvurulmal\u0131d\u0131r?
\n\uf0c8 A\u015f\u0131r\u0131 susama
\n\uf0c8 Kusma ile a\u015f\u0131r\u0131 s\u0131v\u0131 kayb\u0131
\n\uf0c8 \u00c7\u00f6km\u00fc\u015f g\u00f6zler, b\u0131ng\u0131ldakta \u00e7\u00f6k\u00fckl\u00fck
\n\uf0c8 Cildi iki parmak aras\u0131nda s\u0131k\u0131p b\u0131rak\u0131nca eski haline d\u00f6nmemesi
\n\uf0c8 \u0130\u015ftah azl\u0131\u011f\u0131 ve az su i\u00e7me
\n\uf0c8 Y\u00fcksek ate\u015f
\n\uf0c8 D\u0131\u015fkada kan g\u00f6r\u00fclmesi
\n\uf0c8 3-4 g\u00fcn i\u00e7inde iyile\u015fme olmamas\u0131 halinde.
\n\uf0c8 D\u0131\u015fk\u0131lama say\u0131s\u0131nda artma
\n21.5. \u0130shalden Korunmak \u0130\u00e7in Nelere Dikkat Edilmelidir?
\n\uf0c8 Bebeklere ilk 6 ay sadece anne s\u00fct\u00fc verilmelidir.
\n\uf0c8 Anne s\u00fct\u00fc almayan bebeklere mama biberonla de\u011fil, ka\u015f\u0131kla verilmelidir.
\n\uf0c8 \u0130\u00e7me suyu temiz olmal\u0131d\u0131r, klorlu de\u011filse kaynatarak i\u00e7ilmelidir.
\n\uf0c8 Bayat-bekletilmi\u015f yemek verilmemelidir.
\n\uf0c8 Sebze ve meyveler yenmeden \u00f6nce temiz su ile iyice y\u0131kanmal\u0131d\u0131r.
\n\uf0c8 Tuvaletler temiz ve sa\u011fl\u0131kl\u0131 olmal\u0131, eller tuvaletten sonra ve yemekten \u00f6nce mutlaka sabunla y\u0131kanmal\u0131d\u0131r.
\n\uf0c8 \u00c7\u00f6pler a\u011fz\u0131 kapal\u0131 kaplarda toplanmal\u0131d\u0131r.
\n\uf0c8 Sineklerle m\u00fccadele edilmelidir.
\n22. KIZIL
\nK\u0131z\u0131l hastal\u0131\u011f\u0131 A grubu beta hemolitik streptokoklar\u0131n neden oldu\u011fu d\u00f6k\u00fcnt\u00fcl\u00fc bir hastal\u0131kt\u0131r. 3 ya\u015f\u0131ndan k\u00fc\u00e7\u00fcklerde genellikle nadir olarak g\u00f6r\u00fcl\u00fcr. Mikrop v\u00fccuda girdikten sonra hastal\u0131k ortaya \u00e7\u0131kmas\u0131 i\u00e7in gereken s\u00fcre 1g\u00fcn ile 1 hafta aras\u0131 de\u011fi\u015fmektedir.
\nBula\u015f \u00e7o\u011funlukla solunum yolu iledir, ancak bazen streptokoklar\u0131n giri\u015f yeri yara, yan\u0131k veya ba\u015fka bir deri enfeksiyonu olabilir.
\n22.1. Klinik Bulgu Ve Belirtiler
\n\uf0c8 Ani ba\u015flayan ate\u015f
\n\uf0c8 Bo\u011faz a\u011fr\u0131s\u0131
\n\uf0c8 Ba\u015f a\u011fr\u0131s\u0131
\n\uf0c8 Yutma g\u00fc\u00e7l\u00fc\u011f\u00fc
\n\uf0c8 D\u00f6k\u00fcnt\u00fc
\n\uf0c8 Ani ba\u015flayan ate\u015f: \u0130kinci g\u00fcn en y\u00fcksek de\u011ferine y\u00fckselir ve kontrol alt\u0131na al\u0131nmaz ise tehlikelidir (febril konv\u00fclziyon vs a\u00e7\u0131s\u0131ndan) 5-7 g\u00fcn sonra normale iner. Hafif olarak bu hastal\u0131\u011f\u0131 ge\u00e7iren vakalarda ate\u015f d\u00fc\u015f\u00fck olabilir. Nab\u0131z ate\u015f y\u00fcksekli\u011fi ile beraber h\u0131zl\u0131 iken ate\u015f normale inince oda normale iner.
\n\uf0c8 Bo\u011faz a\u011fr\u0131s\u0131
\n\uf0c8 Ba\u015f a\u011fr\u0131s\u0131
\n\uf0c8 Yutma g\u00fc\u00e7l\u00fc\u011f\u00fc
\n\uf0c8 D\u00f6k\u00fcnt\u00fc: Bu belirtilerden 1-2 g\u00fcn sonra ortaya \u00e7\u0131kar.
\nD\u00f6k\u00fcnt\u00fcn\u00fcn \u00f6zellikleri \u015f\u00f6yledir:
\nEnantem: D\u00f6k\u00fcnt\u00fcler ilk olarak bademcik, farinks dil ve damaktan ba\u015flar. A\u011f\u0131z i\u00e7i ve yanaklar a\u015f\u0131r\u0131 derecede k\u0131rm\u0131z\u0131d\u0131r. A\u011f\u0131r vakalarda bademcik dokusunun \u00fczeri \u00fclsere lezyonlar ile kaplan\u0131r.
\nDilin \u00fczeri ilk iki g\u00fcn beyaz pas ile kapl\u0131 olup, dil ucu ve kenarlar\u0131 k\u0131rm\u0131z\u0131d\u0131r. Ancak ilerleyen d\u00f6nemde dil \u00fczerindeki papillalar k\u0131rm\u0131z\u0131 ve belirgin duruma gelir. Bu duruma \u201c beyaz \u00e7ilek dili\u201d denir. 4 ve 5. g\u00fcnlerde beyaz pas rengi ge\u00e7erek k\u0131rm\u0131z\u0131 zeminde belirgin papillalar g\u00f6r\u00fcl\u00fcr bu duruma ise \u201ck\u0131rm\u0131z\u0131 \u00e7ilek dili\u201d ismi verilir. Dama\u011f\u0131n ise \u00fczeri k\u00fc\u00e7\u00fck nokta \u015feklinde serpilmi\u015f kanama odac\u0131klar\u0131 ile kapl\u0131d\u0131r.
\nEgzantem: V\u00fccut d\u00f6k\u00fcnt\u00fcleri ba\u015flang\u0131\u00e7 belirtilerinden 12-48 saat sonra belirir. D\u00f6k\u00fcnt\u00fc ilk olarak koltuk alt\u0131, kas\u0131k ve boyundan ba\u015flamaktad\u0131r. Deride k\u0131rm\u0131z\u0131 z\u0131mparaka\u011f\u0131d\u0131 g\u00f6r\u00fcn\u00fcm\u00fc s\u00f6z konusudur. K\u0131sa s\u00fcrede genelle\u015fir. D\u00f6k\u00fcnt\u00fc genellikle y\u00fczde yoktur. Al\u0131n ve yanaklar parlak k\u0131rm\u0131z\u0131 renktedir ve a\u011f\u0131z etraf\u0131 soluktur. Koltuk alt\u0131, kas\u0131k, parmak k\u0131vr\u0131mlar\u0131, dizin arka k\u0131sm\u0131ndaki eklem \u00e7ukurunda, deri b\u00fckl\u00fcmlerinin oldu\u011fu yerlerde ve bas\u0131n\u00e7 g\u00f6ren v\u00fccut b\u00f6lgelerinde d\u00f6k\u00fcnt\u00fc daha fazlad\u0131r. Bunlar baz\u0131 b\u00f6lgelerde yo\u011funla\u015farak enine \u00e7izgilenmeler g\u00f6sterir. \u201cpastia \u00e7izgileri\u201d
\n\u0130lk 5 g\u00fcn i\u00e7erisinde deri d\u00fcz bir cisim ile \u00e7izilirse 1-2 dk kadar s\u00fcren beyaz bir \u00e7izgi ortaya \u00e7\u0131kar. \u201cdermographismus albus\u201d
\nD\u00f6k\u00fcnt\u00fcn\u00fcn en karakteristik bulgular\u0131ndan birisi ise soyulmad\u0131r. D\u00f6k\u00fcnt\u00fc ba\u015flang\u0131c\u0131ndan 3-4 g\u00fcn sonra solmaya ba\u015flar, \u00fc\u00e7\u00fcnc\u00fc haftada ise soyulma \u00e7ok belirginle\u015fir ve deri lameller \u015feklinde kalkar. Pullanma \u015feklinde soyulma ilk \u00f6nce y\u00fczden ba\u015flar, sonra g\u00f6vde, kol ve bacaklarda olu\u015fur. Kal\u0131n b\u00fcy\u00fck lameller \u015feklinde deri kalkar. El ve ayaklar en son soyulan b\u00f6lgelerdir.
\n22.2. Tan\u0131
\n\uf0c8 Tan\u0131 \u00f6ncelikle klinik bulgulara dayan\u0131r.
\n\uf0c8 Ancak kesin tan\u0131 mikroorganizman\u0131n izolasyonu (bo\u011faz k\u00fclt\u00fcr\u00fc) ve immunolojik yan\u0131t\u0131n pozitifli\u011fi ile kesinle\u015fir. ASO, Anti-DNAaz vs\u2026)
\n22.3. Tedavi Yollar\u0131
\nStreptokok enfeksiyonlar\u0131n\u0131n tedavisi i\u00e7in se\u00e7ilecek antibiotik penisilindir. Ancak penisiline alerjisi olan \u00e7ocuklarda Eritromisin, Linkomisin veye klindamisin kullan\u0131labilir.
\nNot:Tedavi ancak ve ancak bir hekim muayenesi sonucu onun verece\u011fi re\u00e7eteye uygun olarak uygulanmal\u0131d\u0131r.
\n22.4. Korunma Yollar\u0131
\nHastal\u0131ktan korunma \u00f6zellikle Romatizmal Ate\u015fi \u00f6nlemek amac\u0131 i\u00e7in gereklidir. Hasta \u00e7ocuk 7 g\u00fcn izole edilmelidir. Daha \u00f6nce bir romatizmal ate\u015f devresini ge\u00e7irmi\u015f kimselerde g\u00fcnl\u00fck a\u011f\u0131zdan yada ayl\u0131k olarak IM (iyne ile kas i\u00e7erisine) uzun etkili penisilin verilmesi ile streptokok enfeksiyonlar\u0131n\u0131n bir\u00e7o\u011funun olu\u015fumu ve de tekrar\u0131 engellenmi\u015f olur.
\n23. A\u015eILAMA TABLOSU VE YEN\u0130 A\u015eILAR
\nAktif imm\u00fcnizasyon, mikroorganizman\u0131n tamam\u0131n\u0131n veya belirli i\u015flemlerden ge\u00e7mi\u015f par\u00e7alar\u0131n\u0131n canl\u0131lara verilmesi ile onlarda \u00f6nemli bir sorun olu\u015fturmadan, do\u011fal imm\u00fcn cevaba benzer cevap al\u0131nmas\u0131d\u0131r. Bu cevap ile koruyucu h\u00fcmoral ve sell\u00fcler imm\u00fcnite olu\u015fturulur. B\u00f6ylece ya hayat boyu yada k\u0131smen koruyucu olacak veya belirli aral\u0131klarla tekrarlanma ile koruyucu imm\u00fcnite devam ettirilir.
\n\u00dclkemizde halen rutin uygulanan a\u015f\u0131 program\u0131 Tablo 1\u2019de g\u00f6sterilmi\u015ftir.
\nSa\u011fl\u0131k Bakanl\u0131\u011f\u0131n\u0131n finansman eksikli\u011finden dolay\u0131 \u015fu anda bu tablodaki HepB ve Trimovax a\u015f\u0131lar\u0131 \u00fccretsiz a\u015f\u0131 program\u0131nda de\u011fildir.
\nHalen rutin programda olan bu a\u015f\u0131lar d\u0131\u015f\u0131nda Varisella, Kuduz ve Hib a\u015f\u0131lar\u0131 istek ve duruma g\u00f6re \u00e7ocuklara uygulanmaktad\u0131r. Amerikada ki rutin programda Varisella ve Hib a\u015f\u0131lar\u0131 da uygulanmakta olup varisella i\u00e7in 12-18 ay aras\u0131nda bir kez, \u015f\u00fcpheli gurupta 11-12 ya\u015fda rapel, Hib a\u015f\u0131s\u0131 i\u00e7in ise 12-15 ayda bir kez yap\u0131lmas\u0131 \u00f6nerilmektedir. Yine Amerika\u2019da se\u00e7ilmi\u015f b\u00f6lgelerde Hep A a\u015f\u0131s\u0131 24 ay ile 11-12 ya\u015f aras\u0131nda yap\u0131lmaktad\u0131r.
\nYukar\u0131daki rutin a\u015f\u0131 program\u0131n\u0131n d\u0131\u015f\u0131nda kalan baz\u0131 yeni a\u015f\u0131lar i\u00e7in burada bilgi verilecektir.
\n23.1. Pn\u00f6mokok A\u015f\u0131lar\u0131
\nS. pn\u00f6monia veya pn\u00f6mokokus\u2019a kar\u015f\u0131 haz\u0131rlanm\u0131\u015ft\u0131r. Bu organizma \u00e7ocukluk \u00e7a\u011f\u0131nda, ad\u00f6lasan ve adult d\u00f6nemde \u00dcSYE ve hayat\u0131 tehdit eden invazif enfeksiyonlar\u0131n en \u00f6nemli nedenlerinden biridir. Menenjit, bakteriyemi, pn\u00f6moni, septik artirit, osteomiyelit, akut otitis media, sin\u00fczite neden olur. A\u015f\u0131lar tip I, II, V, VII kaps\u00fcler polisakkaride kar\u015f\u0131 p\u00fcrifiye edilerek haz\u0131rlanm\u0131\u015ft\u0131r. \u0130nfantlarda hastal\u0131k yapan 6A, 14, 23 F\u2019e kar\u015f\u0131 imm\u00fcnetenin zay\u0131f olu\u015fmas\u0131 nedeni ile 24 ay\u0131n alt\u0131nda yap\u0131lmas\u0131 \u00f6nerilmemektedir. Bu gurupta kullan\u0131labilecek konjuge a\u015f\u0131lar halen faz 1 ve faz 2 d\u00fczeyinde \u00e7al\u0131\u015fma a\u015famas\u0131ndad\u0131r. Pn\u00f6mokok a\u015f\u0131s\u0131n\u0131n endikasyonlar\u0131 Tablo 2\u2019de g\u00f6r\u00fclmektedir. Pn\u00f6mokok a\u015f\u0131s\u0131 ta\u015f\u0131y\u0131c\u0131l\u0131k durumunda veya otitis mediaya kar\u015f\u0131 olu\u015facak etki azl\u0131\u011f\u0131 nedeni ile Hib a\u015f\u0131s\u0131 ile konj\u00fcge edilebilir yada ayn\u0131 anda uygulanabilir. A\u015f\u0131n\u0131n uygulanmas\u0131 intramuskuler yada subkutan olarak 0. 5 ml ve tek doz olarak uygulan\u0131r. A\u015f\u0131 uygulananlarda yakla\u015f\u0131k 48 saat i\u00e7inde lokal bulgular ve hafif sistemik ate\u015f, miyalji olabilir. A\u011f\u0131r sistemik reaksiyonlar (anaflaktik reaksiyonlar, Guillain-Barre sendromu) nadiren bildirilmi\u015ftir. Koruyuculu\u011fu yakla\u015f\u0131k % 80 civar\u0131ndad\u0131r.
\n23.2. \u0130naktif Polio A\u015f\u0131lar\u0131 (IPA)
\nKlasik IPA 1950\u2019li y\u0131llardan beri kullan\u0131lmaktad\u0131r. 1960\u2019 l\u0131 y\u0131llarda yerini OPA ya b\u0131rakmakla birlikte 1995 y\u0131l\u0131ndan itibaren Amerika\u2019da \u00f6zellikle geli\u015ftirilen yeni tipi kullan\u0131lmaya ba\u015flanm\u0131\u015ft\u0131r. Bu tipe kar\u015f\u0131, 2. dozdan sonra % 99-100 oran\u0131nda imm\u00fcnite sa\u011fland\u0131\u011f\u0131 g\u00f6sterilmi\u015ftir. Polio a\u015f\u0131s\u0131 i\u00e7in \u00fc\u00e7 tip program \u00f6nerilmektedir. Bu programlar Tablo 3\u2019de g\u00f6sterilmi\u015ftir. Sadece IPA\u2019 n\u0131n \u00f6nerildi\u011fi ki\u015filer; imm\u00fcnkompromize veya evlerinde imm\u00fcnkompromize ki\u015filerin oldu\u011fu bilinen vakalard\u0131r. Ad\u00f6lasan veya endikasyonu oldu\u011fu bilinen yeti\u015fkinlerde IPA uygulanmal\u0131d\u0131r. Sistemik imm\u00fcnizasyonu OPA ile ayn\u0131d\u0131r. Ancak maddi olarak y\u00fck getirmektedir. A\u015f\u0131 yap\u0131ld\u0131\u011f\u0131nda barsak yolu ile sekonder ge\u00e7i\u015fi olmad\u0131\u011f\u0131 i\u00e7in OPA\u2019 ya \u00fcst\u00fcnl\u00fc\u011f\u00fc mevcuttur. Halen sokak virusu yayg\u0131n olarak bulunan \u00dclkemizin de i\u00e7inde bulundu\u011fu birinci gurupta Afrika ve Asya\u2019n\u0131n bir k\u0131sm\u0131ndaki \u00fclkelerle birlikte polio eradikasyonu i\u00e7in OPA uygulanmas\u0131 \u00f6nerilmektedir.
\n23.3. Asell\u00fcler Bo\u011fmaca A\u015f\u0131s\u0131
\nBu a\u015f\u0131da Pertusis toksini inaktive edilmi\u015ftir. Bunun yan\u0131nda \u00fc\u00e7 tane proteini de i\u00e7erir. Bunlar; FHA (filamantous hemaglutinin), PRN (pertactin), FIM (fimbrial agglutinojenler) dir. Sell\u00fcler bo\u011fmaca a\u015f\u0131s\u0131n\u0131n koruyuculu\u011funun % 96-98 olmas\u0131na ra\u011fmen baz\u0131 dezavantajlar\u0131 nedeni ile asell\u00fcler a\u015f\u0131 geli\u015ftirilmi\u015ftir. Bu dezavantajlar Tablo 4\u2019de g\u00f6sterilmi\u015ftir. Bu yan etkiler oldu\u011funda asell\u00fcler bo\u011fmaca a\u015f\u0131s\u0131 kullan\u0131lmaktad\u0131r. A\u015f\u0131 pahal\u0131 oldu\u011fu i\u00e7in ABD dahil bir \u00e7ok \u00fclkede rutin uygulamada kullan\u0131lmamaktad\u0131r. 2, 4, 6 aylar ve 15-18 aylarda uygulanan a\u015f\u0131 4-6 ya\u015f aras\u0131nda tekrarlanmaktad\u0131r. T\u00fcrkiyede yap\u0131lan bir \u00e7al\u0131\u015fmada 3, 4 ve 5. aylarda uygulanmas\u0131ndan sonra % 97-100 aras\u0131nda koruyuculu\u011fu g\u00f6sterilmi\u015ftir. Bu a\u015f\u0131n\u0131n uygulanamamas\u0131 i\u00e7in a\u015f\u0131 sonras\u0131 ensefalopati olmas\u0131 ve anaflaksi \u00f6nemli kontendikasyonlard\u0131r. Anaflaksi oldu\u011funda DtaB\u2019n\u0131n hangi kompenentine kar\u015f\u0131 oldu\u011fu bilinemiyece\u011fi i\u00e7in a\u015f\u0131 bir daha yap\u0131lamaz. Bu a\u015f\u0131lar\u0131n yap\u0131lmas\u0131 \u00f6nemli ve gerekli oldu\u011fu i\u00e7in allerji merkezinden yard\u0131m al\u0131nabilir. Ensefalopati ve 24 saatte d\u00fczelmiyen konv\u00fclsiyonlar i\u00e7in a\u015f\u0131n\u0131n yap\u0131lmamas\u0131 \u00f6nerilmemektedir. 24 saatte d\u00fczelen konv\u00fclsiyonlarda a\u015f\u0131n\u0131n yap\u0131lmas\u0131nda sak\u0131nca yoktur.
\n23.4. Hemofilus \u0130nfluenza Tip B (Hib B) A\u015f\u0131s\u0131
\nHib B 6 ya\u015f\u0131ndan k\u00fc\u00e7\u00fck \u00e7ocuklarda \u00e7ok say\u0131da hastal\u0131\u011f\u0131n nedenidir. Sistemik a\u015f\u0131 uygulama program\u0131ndan \u00f6nce ilk s\u0131rada bakteriyel menejit nedeni olarak an\u0131l\u0131rken rutin programlar\u0131n yap\u0131ld\u0131\u011f\u0131 \u00fclkelerde arka s\u0131ralara gerilemi\u015ftir. Korunmada esas \u00f6nemli antijenik yap\u0131n\u0131n PRP oldu\u011funun anla\u015f\u0131lmas\u0131ndan sonra bu antijene kar\u015f\u0131 olu\u015fan antikorlar\u0131n; kompleman\u0131 aktive etti\u011fi, bakterisidal oldu\u011fu, opsonofagositik oldu\u011fu ve klinik olarak koruyucu oldu\u011fu g\u00f6sterilmi\u015ftir. Bu a\u015f\u0131 di\u011fer polisakkarid a\u015f\u0131larda oldu\u011fu gibi 2 ya\u015f\u0131ndan k\u00fc\u00e7\u00fck \u00e7ocuklarda imm\u00fcnojenik ve koruyucu de\u011fildir. 2 ya\u015f\u0131n \u00fczerinde ise olduk\u00e7a imm\u00fcnojenik ve korucudur. Ancak yakla\u015f\u0131k 1. 5 y\u0131l sonra koruyuculuk azalmakta ve maalesef yap\u0131lan rapel doz koruyuculu\u011fu art\u0131rmamaktad\u0131r. Hastalanan gurubunun ya\u015f s\u0131n\u0131rlar\u0131n\u0131n 2 ya\u015ftan \u00f6nce olmas\u0131 ve koruyuculuk s\u00fcresinin k\u0131sa olmas\u0131 nedeni ile konj\u00fcge a\u015f\u0131lar geli\u015ftirilmi\u015ftir. Konj\u00fcge-PRP a\u015f\u0131lar\u0131n rutin a\u015f\u0131 program\u0131nda DBT, polio ve Hep-B ile uygulanmas\u0131 hem maliyeti azaltm\u0131\u015f hemde a\u015f\u0131ya uyumu artt\u0131rm\u0131\u015ft\u0131r. \u00d6nerilen a\u015f\u0131 uygulama d\u00f6nemi konj\u00fcge a\u015f\u0131 i\u00e7in 2, 4, 6 aylard\u0131r. Bir y\u0131l sonra 1 doz rapel \u00f6nerilmektedir. 1- 5 ya\u015f aras\u0131nda tek doz a\u015f\u0131 \u00f6nerilir. A\u011f\u0131r Hib B enfeksiyonu ge\u00e7iren hastalarda, asplenik ve orak h\u00fccreli anemisi olan hastalarda \u00f6nerilir.
\n23.5. Varisella A\u015f\u0131s\u0131
\nVarisella Zoster virusu su\u00e7i\u00e7e\u011fi ve Herpes Zostere yol a\u00e7an virustur. Bu hastal\u0131klar\u0131n kalp, b\u00f6brek ve di\u011fer organlarda yol a\u00e7t\u0131\u011f\u0131 yan etkiler bilinmektedir. Bu nedenle Japonlar taraf\u0131ndan geli\u015ftirilen varisella a\u015f\u0131s\u0131 hastal\u0131\u011fa kar\u015f\u0131 ilk bir y\u0131l i\u00e7inde % 100 korumaktad\u0131r. \u00c7ocuk daha sonra varisella ge\u00e7irse bile hastal\u0131k hafif klinik bulgularla gitmektedir. Varisella a\u015f\u0131s\u0131 MMR a\u015f\u0131s\u0131 ile ayn\u0131 zamanda, farkl\u0131 b\u00f6lgelerden uygulanabilir. E\u011fer ayn\u0131 zamanda yap\u0131lmayacaksa iki a\u015f\u0131 aras\u0131nda 1 ay olmal\u0131d\u0131r. Di\u011fer a\u015f\u0131larla uygulanmas\u0131 imm\u00fcn cevab\u0131 etkilememektedir. Tek doz olarak ve intramuskuler olarak \u00f6nerilir. 12-13 ya\u015flarda hastal\u0131\u011f\u0131 ge\u00e7irmemi\u015f veya a\u015f\u0131lanmam\u0131\u015f \u00e7ocuklarda bir doz olarak a\u015f\u0131 yap\u0131lmas\u0131 \u00f6nerilmektedir. Yan etkileri \u00e7ok azd\u0131r. A\u015f\u0131dan bir ay sonraki s\u00fcre i\u00e7inde vakalar\u0131n %7 sinde mak\u00fclopap\u00fcler yada vezik\u00fcll\u00fc-b\u00fcll\u00fc d\u00f6k\u00fcnt\u00fc g\u00f6r\u00fclebilir. Konjenital imm\u00fcn yetmezli\u011fi olan, a\u011f\u0131r hasta olan ve steroit kullanan ki\u015filerle l\u00f6semili vakalarda \u00f6nerilmemektedir.
\n23.6. \u0130nfluenza A\u015f\u0131s\u0131
\n\u0130nfluenza ani geli\u015fen titreme ile birlikte ate\u015f, ba\u015fa\u011fr\u0131s\u0131, halsizlik, miyalji ve kuru \u00f6ks\u00fcr\u00fck ile karekterize bir hastal\u0131kt\u0131r. Bu bulgular\u0131 takiben bo\u011faz a\u011fr\u0131s\u0131 ve nazal konjesyon da olabilir. Virusun A, B, C, D olarak adland\u0131r\u0131lan d\u00f6rt farkl\u0131 \u00f6zellik ta\u015f\u0131yan tipi vard\u0131r. Bu nedenle a\u015f\u0131 hangi antijenik \u00f6zellikte haz\u0131rlanaca\u011f\u0131 her y\u0131l WHO taraf\u0131ndan belirlenmektedir. A\u015f\u0131 inaktif ve aktif olarak haz\u0131rlanm\u0131\u015ft\u0131r. \u00dclkemizde inaktif formu bulunmaktad\u0131r. Her y\u0131l, o y\u0131l dola\u015f\u0131mda olmas\u0131 muhtemel a\u015f\u0131 k\u0131\u015f ba\u015f\u0131nda uygulanmaktad\u0131r. A\u015f\u0131 y\u00fcksek derecede safla\u015ft\u0131r\u0131lm\u0131\u015f, noniffeksiy\u00f6z hale getirilmi\u015f ve yumurtadan \u00fcretilmi\u015ftir. 13 ya\u015f alt\u0131 \u00e7ocuklara febril yan etkileri en aza indirmek amac\u0131 ile split a\u015f\u0131lar uygulan\u0131r. 9 ya\u015fa kadar, daha \u00f6nce a\u015f\u0131lanmam\u0131\u015f \u00e7ocuklarda etkin ba\u011f\u0131\u015f\u0131kl\u0131k sa\u011flamak i\u00e7in bir ay ara il 2 kez, 9 ya\u015f\u0131n \u00fczerindeki \u00e7ocuklarda tek doz \u00f6nerilir. A\u015f\u0131n\u0131n yap\u0131lmas\u0131 \u00f6nerilen risk gurubu Tablo 5\u2019de g\u00f6sterilmi\u015ftir.
\n23.7. Hepatit A (HAV) A\u015f\u0131s\u0131
\nHepatit A hastal\u0131\u011f\u0131n\u0131n etkeni olan virus pikornaviruslardan heparna virus ailesinin tek \u00fcyesi olan hepatit A virusudur. Hastal\u0131\u011f\u0131n ya\u015f k\u00fc\u00e7\u00fcld\u00fck\u00e7e semptom g\u00f6sterme oran\u0131 azalmaktad\u0131r. Hepatit B\u2019 de g\u00f6r\u00fclen kronikle\u015fme Hepatit A\u2019 da azd\u0131r. Hatta kolestatik hepatit d\u0131\u015f\u0131nda yoktur. Ancak nadir g\u00f6r\u00fclmesine ra\u011fmen fulminan tipleri nedeni ile a\u015f\u0131 geli\u015ftirilmi\u015ftir. Haz\u0131rlanan a\u015f\u0131 intramuskuler olarak 0, 1, 6 aylarda yeti\u015fkinlerde 720, \u00e7ocuklarda 360 Eu olarak uygulanmakta ve koruyuculu\u011fu % 88-100 olarak bildirilmektedir. 0, 1 ve 12 ay olarak uygulanan \u015femalar\u0131n koruyuculu\u011funun daha y\u00fcksek oldu\u011fu bildirilmektedir. Son y\u0131llarda yap\u0131lan \u00e7al\u0131\u015fmalarda ise a\u015f\u0131n\u0131n 0, 6 yada 0, 12 ay gibi iki kez uygulanmas\u0131n\u0131n yeterli imm\u00fcniteyi olu\u015fturdu\u011fu bildirilmi\u015ftir. Etkin imm\u00fcnitenin yakla\u015f\u0131k 20 y\u0131l devam etti\u011fi yap\u0131lan \u00e7al\u0131\u015fmalarla ortaya konmu\u015ftur. Halen Amerika\u2019 da endemik b\u00f6lgelere seyahat edenlere imm\u00fcnitesine bak\u0131lmaks\u0131z\u0131n a\u015f\u0131 uygulamas\u0131 yap\u0131lmaktad\u0131r. Bilinen a\u015f\u0131 yan etkisi olarak: bir g\u00fcn kadar s\u00fcrebilen a\u015f\u0131 yeri lokal bulgular\u0131 ve hafif sistemik yan etkilerdir. Yap\u0131lmas\u0131 \u00f6nerilen risk gruplar\u0131 Tablo 6\u2019da g\u00f6sterilmi\u015ftir.
\n23.8. Meningokok A\u015f\u0131lar\u0131
\nNeisseria Menengitidis hem endemik hemde epidemik b\u00f6lgelerde invazif hastal\u0131klar\u0131n nedeni olarak kar\u015f\u0131m\u0131za \u00e7\u0131kmaktad\u0131r. Hib-B nin rutin olarak yap\u0131ld\u0131\u011f\u0131 \u00fclkelerde menejitin etyolojik ajanlar\u0131n i\u00e7inde ilk s\u0131rada an\u0131lmaktad\u0131r. \u0130nvazif hastal\u0131\u011fa neden olan bir \u00e7ok serogrubu olan gram negatif bir diplokoktur. A\u015f\u0131 A, C, Y, WW-135 serotiplere kar\u015f\u0131 olarak geli\u015ftirilmi\u015ftir. Ancak \u00fclkemizde hangi su\u015flar\u0131n hastal\u0131\u011fa neden oldu\u011funa dair yap\u0131lm\u0131\u015f hen\u00fcz bir \u00e7al\u0131\u015fma yoktur. A\u015f\u0131n\u0131n \u00f6nerilen \u015fekli 0. 5 ml, tek doz ve subkutan olarak verilmesidir. \u0130lk y\u0131l i\u00e7inde % 85-100 imm\u00fcnizasyon sa\u011flar. Bir y\u0131ldan sonra etkinli\u011fi % 10 lara kadar d\u00fc\u015fmektedir. Genel kullan\u0131mda 2 ya\u015f \u00fczerine uygulanmaktad\u0131r. Zorunlu durumlarda 3 ayl\u0131k \u00e7ocuklarada yap\u0131labilir. Ancak bu k\u0131sa s\u00fcreli koruma sa\u011fl\u0131yabilir. Uygulanmas\u0131 \u00f6nerilen grup Tablo 7\u2019de verilmi\u015ftir.
\nSon y\u0131llarda kombine a\u015f\u0131 geli\u015ftirme \u00e7abalar\u0131 artm\u0131\u015ft\u0131r. A\u015f\u0131n\u0131n uygulanabilirli\u011fi, tek enjeksiyonla verilebilen a\u015f\u0131 say\u0131s\u0131n\u0131n daha fazla olmas\u0131, hasta vizit say\u0131s\u0131n\u0131n azalt\u0131lm\u0131\u015f olmas\u0131, maliyetinin d\u00fc\u015f\u00fcr\u00fclm\u00fc\u015f olmas\u0131, a\u015f\u0131n\u0131n korunmas\u0131ndaki kolayl\u0131k bu yolun se\u00e7ilmesindeki ba\u015fl\u0131ca nedenlerdir. Bu a\u015f\u0131lar Tablo 8\u2019de g\u00f6r\u00fclmektedir.
\nA\u015f\u0131 program\u0131 devaml\u0131 de\u011fi\u015febilmektedir. Bu d\u00fczen \u00f6n\u00fcm\u00fczdeki dekatlarda s\u00fcratle de\u011fi\u015fecektir. \u00d6rne\u011fin yeni haz\u0131rlanmakta olan Lyme Hastal\u0131\u011f\u0131\u2019na kar\u015f\u0131 a\u015f\u0131 programda \u00f6n\u00fcm\u00fczdeki g\u00fcnlerde yer alacakt\u0131r. Ya da yenilebilir bitki a\u015f\u0131lar\u0131 \u00f6nem kazanacakt\u0131r. FDA 1999\u2019da Lyme\u2019\u0131 kabul etmi\u015f ve 15 ya\u015f\u0131n alt\u0131ndaki \u00e7ocuklara \u00f6nermektedir.<\/p>\n","protected":false},"excerpt":{"rendered":"

1. A\u011eIZ \u0130\u00c7\u0130 \u0130LT\u0130HABI Di\u015fetinin ve a\u011f\u0131z i\u00e7i mukozas\u0131n\u0131n bir hastal\u0131\u011f\u0131d\u0131r. Yeti\u015fkinlere k\u0131yasla \u00e7ocuklarda daha s\u0131k g\u00f6r\u00fcl\u00fcr. Bu durumun en ba\u015fta gelen nedenleri, yetersiz temizlik, k\u00f6t\u00fc beslenme ve sa\u011fl\u0131ks\u0131z bar\u0131nma bi\u00e7imleridir. Ama a\u011f\u0131z i\u00e7i iltihab\u0131, k\u0131z\u0131l hastal\u0131\u011f\u0131, k\u0131zam\u0131k, tifo, ra\u015fitizm(kemik hastal\u0131\u011f\u0131) ve frengi hastal\u0131\u011f\u0131ndan da kaynaklanabilir. Bu hastal\u0131k bula\u015f\u0131c\u0131d\u0131r, ki\u015fiden ki\u015fiye ge\u00e7er. Hastan\u0131n a\u011fz\u0131ndan etrafa …<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1407,1403],"tags":[2706,2696,2699,2701,2705,2702,2694,2698,2703,2700,2695,2513,2697,2355,2485,2704],"class_list":["post-900","post","type-post","status-publish","format-standard","hentry","category-fen-ve-teknoloji-odevleri","category-odevler","tag-adacayi","tag-agiz-ici-iltihabi","tag-alerji","tag-anemi","tag-atkuyrugu","tag-b12-vitamin","tag-cocuk-hastaliklari","tag-frengi","tag-homoroit","tag-kansizlik","tag-kemik-hastaligi","tag-kizamik","tag-kizil-hastaligi","tag-rasitizm","tag-tifo","tag-ulserler"],"_links":{"self":[{"href":"https:\/\/www.islamidavet.com\/kutuphane\/wp-json\/wp\/v2\/posts\/900","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.islamidavet.com\/kutuphane\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.islamidavet.com\/kutuphane\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.islamidavet.com\/kutuphane\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.islamidavet.com\/kutuphane\/wp-json\/wp\/v2\/comments?post=900"}],"version-history":[{"count":0,"href":"https:\/\/www.islamidavet.com\/kutuphane\/wp-json\/wp\/v2\/posts\/900\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.islamidavet.com\/kutuphane\/wp-json\/wp\/v2\/media?parent=900"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.islamidavet.com\/kutuphane\/wp-json\/wp\/v2\/categories?post=900"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.islamidavet.com\/kutuphane\/wp-json\/wp\/v2\/tags?post=900"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}