Spec. MD. Selami Ay

A 3-year-old refugee child from Syria, recently resettled in Bursa with his single mother, presented with failure to thrive and developmental delay. Beyond nutritional deficiencies, Dr. Ay identified a profound sensory processing disorder exacerbated by trauma. His intervention involved a novel, play-based sensory integration therapy program conducted through an interpreter, coupled with intensive social work support for housing and benefits. The child showed marked improvement in engagement and weight gain after 6 months.

A 14-year-old boy from an affluent family, an aspiring programmer, was brought in for chronic headaches. Standard neurology workups were negative. Dr. Ay, noting the patient's excessive consumption of energy drinks and 'nootropic' supplements purchased online, diagnosed caffeine-induced anxiety disorder and medication overuse headache. Treatment involved a strict detoxification schedule, cognitive behavioral therapy for anxiety, and the introduction of structured breaks and outdoor activity, resolving the headaches within 8 weeks.

A 7-year-old girl from a remote village presented with cyclical episodes of severe abdominal pain and confusion. Local clinics had suspected behavioral issues. Dr. Ay diagnosed Acute Intermittent Porphyria, a rare metabolic disorder, after ordering specific urinary porphobilinogen tests. He initiated treatment with hemin infusions during attacks and educated the family on trigger avoidance (certain medications, fasting). He established a long-term management plan with the national rare diseases center, stabilizing her condition.

An 11-year-old professional child actor presented with sudden-onset vocal tics and repetitive blinking. Previous consultants suggested stress. Dr. Ay, observing a subtle, preceding streptococcal pharyngitis history, diagnosed Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS). Treatment involved a course of antibiotics, a short burst of corticosteroids, and a referral to a specialized immunology-neuropsychiatry team, leading to a 90% reduction in symptoms over 3 months.

A 9-year-old competitive gymnast from a middle-class family presented with persistent wrist pain, dismissed by coaches as 'growing pains.' Dr. Ay discovered a rare, stress-induced osteochondral lesion of the lunate bone (Kienböck's disease variant in a child). He coordinated with a pediatric hand surgeon to develop a non-surgical protocol involving custom orthotics and modified training, allowing her to continue her sport at a modified level while the bone healed over 18 months.