Makale Arama

Aim: In the study where antibiotic resistance of Pseudomonas aeruginosa (P. aeruginosa) strains were aimed to be investigated. Material and method: In the study 130 P.aeruginosa strains isolated from various samples as materials were utilized. Result: Isolated strains were mainly provided from the intensive care unit (60%), the pediatry department (16.2%), and the otorhinolaryngology department (10%). As a result of the sensitivity tests performed for P. aeruginosa strains, the most resistance was provided with gentamicin (75.4%), tobramycin (64.6%), and imipenem(50%). Conclusion: Consequently, it was determined in our study that antimicrobial resistance of P. Aeruginosa strains be decreased, except gentamicin compared to previous years.

VSD is the most common cardiac malformation among congenital cardiac diseases and ocur in 3-6 in 1000 live births. The pattern of this defect may vary from a minor hole in the muscular septum, with a tendency to spontaneous closure, to complicated lesions requiring heart surgery. The aim of this study was to evaluate retrospectively long-term follow-up results and prognosis of pediatric patients with isolated VSD. The study was conducted in Selçuk University Medicine Faculty Pediatric Cardiology Department between July 2010 and February 2013. The echocardiography results of the patients with isolated VSD have been examined retrospectively. Among the included patients, % 71.52 of cases were perimembranous (n=103), % 40.6 of cases were muscular (n=80) and % 9.72 of cases were multipl VSD (n=14). Spontaneous closure rate was % 52.4 (n=54). % 22.3 of the cases required surgical closure because of heart failure. % 43.4 of the cases that requıred surgical closure were perimembranous VSD defects. VSD is the most common malformation of congenital cardiac diseases and can lead to heart failure by left to right shunt. And also the incidence of endocarditis in these patients has increased so the follow-up of the patients is significant.

in this study, we rewieved 95 patients with uri-nary tract stone that had been treated in Dicle Univer-sity Medical Faculty Urology Clinic between the years of 1984-1988 and 136 patients with urinary tract stone that had been treated in Selçuk University Medical Faculty Urology Clinic between the years of 1983-1992. %73 of the patients were males and %44.5 of them were 0 to 5 years old. The stones were found mostly in kidneys (%53 .9) and bladder (%21 ). Urinary tract infection was found in %78 of the patients with stone. Causative microorganism were E.coli (%59), pseudomonas (%17) and streptococcus faecalis (%13.3). in order to show the relation between stone and infection, the patients were divided into two groups according to the existance of infection. The two groups were studied with respect to the age, sex, lo-calization, hiochemical analysis, pre and post opera-tion urine cultures. It is concluded that the above parameters were ef-fective in the development of infection in patients with urinary tract stone. It is also concluded that the infection site was not effective in the localization of the stne.

In this study, it was aimed to evaluate the effects of functional abdominal pain and psychiatric signs on life quality in childrens and adolescents. 30 patients diagnosed with functional abdominal pain according to Roma III criterias and 30 healthy children as control group matched of age and gender were included in the study. Child Depression Inventory (CDI), State-Trait Anxiety Inventories for Children (STAI-C) and Pediatric Quality of Life Inventory Parent and Child Versions (PedQL-P and C) were applied to both patient and control groups. All scale scores of life quality of childrens and adolescents with functional abdominal pain were statisticaly significance lower than control group (p<0.001). All the score of life quality in terms of parents of childrens and adolescents with functional abdominal pain were statisticaly significance lower than control group (p<0.001). Depression scale, trait anxiety inventory and state anxiety scores for children and adolescents with functional abdominal pain were statisticaly significance higher than control group (p<0.001, p=0.003, p=0.001, respectively). When compared to control group, lower life quality scale scores , increased anxiety levels tendency to depression and generally decreased life quality status were determined in functional abdominal pain group.

Patients with acute rheumatic fever, who were admitted to Pediatric Cardiology Unit of Selçuk University Meram Faculty of Medicine, were studied ret- rospectively to verify the clinical and laboratory profile of the disease. 395 cases were identified among patients admitted to the present institution. Age on admission was 5-18 years (mean 11.3±2.8), they were 213 (53.9%) boys, and 182 (46.1%) giriş. Manifestations included carditis 70.3°%, arthritis 66.5°%, Sydenham’s chorea 22.2%, eritema marginatum 1 °%,subcutaneous nodules 0.7%. Pericardial effusion was occurred in 3.5°%. Mitral insuffi- ciency and aortic insufficiency and aortic insufficiency were occurred in 95.3°% and 46.4°%, respectively. The regur- gitation disappeared in 23.6°% and 33°% of patients with mitral and aortic regurgitation, during follow-up. The caus- ing recurrence was the non-compliance with penicillin prophylaxis.

Nowadays, interventional treatment is one of the indispensable methods of treatment for pediatric cardiology centers. The results of interventional treatment of our center were presented within two years. The results of 40 patients who underwent interventional procedure in our center between February 2011-November 2012 were retrospectively reviewed. Interventional therapy was applied to 40 patients. Fifty-five percent (n:22) of these patients were female, 45% (n:18) were male. Their age is from 10 days to 15 years, their weight is between 3.7 and 60 kg. Pulmonary balloon valvuloplasty was performed to nine patients with valvular pulmonary stenosis. Angioplasty was performed to 10 patients with the coarctation of aorta. Transcatheter ASD closure was performed to 12 patients with atrial septal defect. The five patients’ ductus with a wide range closed by transcatheter. Mitral balloon valvuloplasty was performed to 14-year-old patient with mitral stenosis. In our hospital,angiography was performed since June 2010 until November 2012, with total of 155 patients with angio process and interventional procedure was applied to 40 of these patients (25.8%). At first,diagnostic angiography is performed in our angiography unit. Subsequently, interventional procedures were performed such as balloon angioplasty to the coarctation of the aorta and pulmonary balloon valvuloplasty, respectively. Recently, processes that are complicated and requires experience such as transcatheter closure of ASD and PDA, and aortic stent implantation transactions began to be performed in our clinic. Considering the last 6 months, the rate of invasive procedures increased to 50% compared with diagnostic procedures.

The newborn infants with IUGG are an important problem for pediatritions today, Because of the fact that this kind of births are releated to the socioeconomic status of population, it has been shown that these births are especially seen in the underdeveloped countries. In this investigation, we have searched the IUGG incidence and the re/ationship between IUGG and rnother's age, the number and the fri-quency of delivery.

Respiratory Syncytial Virus(RSV) is a fi-equent cause of respiratory tract infections in children. In this study. the serological response ta respiratory Syncytial Virus in 126 pediatric patients with lower respiratory infection was investigated hy 1ndirect immunolltıorescence Antibody(IFA) technique for spesific Ig M and 1g G. RSV- Ig M and RSV- 1g G antihodies vere detected in 44.44% and 56.34% of the hlood samples, respectively.

Aim: In this retrospective study, our patients with nephrotic syndrome (NS) were evaluated according to age, sex, etiology, response to steroid, prognosis, and compared with national data and the literature. Material and method: 141 children with nephrotic syndrome (NS) who admitted to the Department of Pediatric Nephrology of Selcuk University between January 2000 and December 2006 were assessed. Patients were classified into two groups according to etiology as primary and secondary NS. Results: 59% of the patients were male and 41% of them were female. Male/female ratio was 1.44, and median age was 9 (0.3-18.5) years. It is observed that 81.5% of the cases had primary and 18.5% had secondary NS. 67 of the patients with primary NS were male and 48 of them were female. Median age was 8 (0.3-18) years. 16 of the patients with secondary NS were male and 10 of them were female. Median age was 14 (7.5-18.5) years. Of patients with primary NS, 76.5% had steroid-responsive, and 22.6% steroide resistant. %64.8 of the patients with steroid responsive NS developed one and more relapses. Percentage of rare and frequent relapses were 3.4% and 61.3%, respectively. Our results showed that mesangioproliferative glomerulonephritis (MesPGN) was the most common histopathologic diagnosis, 15 (45%) of the 31 biopsied patients with primary NS were found to have MesPGN. Henoch Schonlein purpura nephritis was diagnosed in 14 (53.8%) patients and it was the most common cause of secondary NS. As a result, NS frequency and response to rate of steroid therapy are similar to present literature finding. However, frequent relaps ratio was lower than the others studies. Conclusion: We think that further research including more patients population and multiple center and control studies to investigate NS events to reveal causes of concerning with regional, national or race differences at the childhood period is warranted.

The aim of the study was to evaluate the problems and progresses of esophageal atresia (EA) treated in our department for 20 years at a single tertiary center for pediatric surgery. The study used a retrospective chart review of infants diagnosed with EA between 1991 and 2010. Patients were divided into 2 groups as Group I (1991-1998) and Group II (1999-2010) according to the years of diagnosis. All patients were also assessed regarding the prenatal history, delivery method and time, time of admission, diagnostic procedures, time of surgery, surgical techniques, associated anomaly, complications, and mortality rates. Mean weight of the cases was 1960±5.35 gr when they were admitted, 75% of deliveries was performed in hospital and 25% was at home. 85% of the babies was in term and 15% was preterm. Prenatal polyhydramnios story was detected in 55% of babies. Mean admittion time of the cases was 5.9±1.42 days. Almost all the patients admitted to our department had prediagnosis. The associated anomaly rate was 39%. Patients in Group I were operated immediately, and the ones in Group II were operated in elective conditions after being stabilized. As surgical technique, primary repair and end-to-end anastomosis were carried out in most of the cases. Most common intraoperative complication was iatrogenic pleural opening. The most common early period postoperative complications were pneumonia and atelectesia; late complication was gastroesophageal reflux. Overall mortality was 56% and this rate was 76% for Group 1 and 45% for Group 2. Respiratory insufficiency, pneumonia, and anastomotic leakage were the most common causes of mortality. This retrospective study performed in our department showed that corrected intensive care conditions and the developments in surgical techniques decreased preoperative and postoperative complications and mortality rates in esophageal atresia, which was one of the most anomalies seen in newborns.

The study compares the recovery charecteristics of desflurane and isoflurane in children undergoing tonsillectomy and/or adenoidectomy. Forty children 4-12 year of age were studied and thirty minutes prior to the induction of anesthesia, ali patients received 0.5 mg/kg midazolam orally. They were randomly assigned to receive 1-1.5 % isoflurane (group I) and 6-7 % desflurane (group II) for maintenance of anesthesia afterpatients given 2-2.5 mg/kg propofol and 10 pg/kg alfentanyl for anesthesia induction. Before surgery, patients received 20 mg/kg paracetamol rectally for postoperative analgesia. Dexamethasone 150 pg/kg was given to reduce the incidence of postoperative nausea and vomiting. Administration of anesthetic agents was terminated at the end surgery. At the end of operation extubation and recovery time determined. Extubation time was defined as the time from discontinuation of anesthetics to extubation. Recovery time was measured from the time the anesthetics were discontinued until the patients achieved a score of 8 on the Aldrete score. Agitation was evaluated by using the three-point score. Extubation and recovery time were significantly faster in the desflurane group than isoflurane group (p<0.05). İncidence of agitation was similar for both groups. As a result, desflurane provides a faster recovery than isoflurane in short-term surgery on children.

Gastrointestinal procedures are the most frequent ones in outpatient anesthesia applications which increase day by day. However pediatric cases are rare. Out patient anesthesia applications, especially in pediatrik patients, are more difficult and so it is important to use guidelines in this manner. In this article our anesthetic experience in a endoscopic retrograde cholangiopancreatography applied on a pediatric patient is reported with literature review.

Intake of high doses of calcium channel blocker can cause serious clinical consequences and death. A child patient at 13 years old was admitted to the intensive care unit because of significant hypotension due to high-dose amlodipine and valsartan+hydrochlorothiazide intake aiming commit suicide. The patient successfully treated with fluid, calcium gluconate, dopamine, dobutamine in addition to insulin and glucose was discharged from intensive care unit after eight days healthy by preventing development of further complications.

Although it remains relatively stable childhood cancer rates in the last two years, thanks to advances in early diagnosis and treatment there has been a serious decline in the mortality rate. Despite all these developments, it still experienced today that children diagnosed with cancer 75% more than they can not survive more than five years. Before cancer treatment, oral and dental health problems may impair during and after the child’s health and quality of life. Therefore, pediatric dentists, the provision of oral hygiene and dental treatment needs of these patients have a very important place.

Background: We aimed to investigate the neurodevelopmental outcomes and school success of 11- to 12-year-old children born as moderate/late preterm infants and identify risk factors affecting prognosis.

Methods: Moderate/late preterm infants followed in the neonatal intensive care unit between January 2004 and December 2004 were included, and the children were examined again in our pediatrics outpatient clinic in 2016. Perinatal and neonatal histories were obtained from the hospital database. Physical growth characteristics were interpreted. Neurodevelopment was evaluated using the revised Wechsler Intelligence Scale for Children (WISC-R). The Pediatric Symptom Checklist (PSC) was also applied. The effect of socioeconomic level on neurodevelopmental outcome was examined. School performance was evaluated using report card grades.

Results: Forty-one children with a mean age of 11.6 years were evaluated. Risk factors associated with physical growth outcomes were maternal age of >35 years, fetal distress, and patent ductus arteriosus. Sepsis was associated with a decrease in verbal intelligence while periventricular leukomalacia had negative effects on both verbal and performance intelligence. Socioeconomic level showed a medium correlation with performance and full-scale intelligence. The intelligence quotients of the children with positive PSC scores were significantly lower.

Conclusions: Moderate/late preterm infants lag both neurologically and developmentally due to incomplete maturation of the brain and natal problems. Similarly, to early preterm infants, these children should be monitored for extended periods, and family support, rehabilitation, and special education needs should be met.

Cerebrospinal fluid lactate dehydrogenase (LDH) enzyme levet was investigated in this research for the differential diagnosis of bacterial and aseptic meningitis. LDH enzyme levels in CSF were determined in a group of 58 pediatric cases which were constituted of 30 normal imdividuals, 14 patients with bacterial meningitis and 14 patients with aseptic meningitis. The values of CSF LDII levels in normal group, bacterial meningitis group and aseptic meningitis group were obtained as 25,02 ±9 ,47 IUIL, 119,26 ±41,34 IUIL, ± 0 ÷ ,61 IUIL, respectively. In the levels of LDH enzyme ,in CSF of bacterial meningitis cases, a significant difference was found in comparison to the other groups which were normal individuals and aseptic meningitis cases (p<0,001).Based on these findings, it is concluded that the determinations of LD11 levels of CSF are helpful in differentiating bacterial from aseptic meningitis.

The Wellcogen latex agglutination test was applied to 44 patients who were hospitalized in the Department of Pediatric Health and Diseases for meningitis, and the results were compared with the cerebrospinal fluid culture results. When latex agglutination and culture were used together, it gave a higher rate than culture alone. However, when the culture results were compared with latex agglutination, no statistical difference was found between the results, as in the literature. It was thought that the absence of group B N. meningitidis kit among the kits we used was responsible for this result and latex agglutination test would yield more significant results than culture in places where antibiotics were used indiscriminately, such as in our country.

Aim: In this study, examination of the index of cardiac-electrophysiological balance (iCEB) and of other
risk markers for cardiac arrhythmia in electrocardiography of children with acute rheumatic carditis was
aimed.
Patients and Methods: Forty pediatric patients with acute rheumatic carditis and 40 healthy children
matched in terms of gender and age were retrospectively enrolled in the study between January 2016
and August 2018. Demographic data of all cases were obtained from records. By electrocardiography, P
dispersion (Pd), dispersion durations of QT (QTd) and corrected QT (QTcd), Tpeak-to-end interval (Tpe),
ratios of Tp-e/QT and Tp-e/QTc, and measurements of iCEB and corrected iCEB (iCEBc) were all
compared between the groups. Statistically significant dif ference was accepted as p< 0.05.
Results: In the patient and control groups, mean ages were 11.40±3.48 years and 11.41±3.31 years,
respectively. Both groups had 16 female (40%) and 24 male (60%) children. In the patient group, heart
rate, PR interval, Pd, QTd, QTcd, Tp-e, Tp-e/QT ratio and iCEBc were found to be significantly increased.
Though iCEB level was higher in the patient group, there was no statistically significant difference with
healthy controls.
Conclusion: In children with acute rheumatic carditis, repolarization-depolarization balance may be
impaired. Therefore, in addition to other electrocardiographic risk parameters for arrhythmia, use of
iCEB(c) may also be beneficial. However , further studies on this issue are needed.

It is well known that malignancies especially of lymphoreticular and gastrointestinal origin are more common in patients with common variable immune deficiency (CVID). Incidence of malignancy among relatives of patiens with CVID was reported in a limited number of studies. In this study incidence of malignancy among patients with CVID, IgA deficiency and their relatives were investigated. We evaluated 25 CVID and 68 IgA deficiency patients, and their 727 and 1802 respective relatives for the presence of malignancy. In addition, all the first degree relatives of patients with CVID were screened for the presence of IgA deficiency and autoantibodies in terms of positive anti nuclear antibody (ANA) and anti double stranded DNA antibody (dsDNA). Incidence of malignancy in patients with CVID and their relatives were 12% and 1.9%, respectively. A history of malignancy was positive in none of the patients with IgA deficiency but in 2.3% of their relatives. None of the patients with CVID had positive ANA or anti dsDNA. Our results confirm the notion that incidence of malignancy is increased in patients with CVID. However, relatives of neither CVID nor IgA deficiency patients , displayed any increase in the incidence of malignancy. Screening of patients with CVID for malignancy and their relatives for IgA deficiency might provide early diagnosis of these conditions.

In 0-72 months aging children with early childhood caries, general anesthesia is often preferred due to the following reasons; the non-cooperation based on age, anxiety development during the dental procedures and long treatment sessions. It is known that early childhood caries have a significant impact on the quality of life of child patients’ and their families’. In the assessment of quality of life scores, different questionnaires were developed for children and their parents. Today, Parental Perception Questionnaire and Family Impact Scale, which are composed of two parts including Early Childhood Oral Health Impact Scale, is used for children under 6 years old age. This study included 158 patients who received comprehensive oral rehabilitation under general anesthesia in Necmettin Erbakan University, Department of Pediatric Dentistry and their parents. Demographic information and dmft values of the patients were recorded before the procedure. Parents were asked to complete the relevant questionnaire at the beginning of the procedure and at the 2nd and 4th weeks following the procedure. The data were statistically analyzed by the SPSS program. It was considered that if the effect size was greater than 0.7, a major change occurring in the data exchange. A statistically significant decrease in all values was observed after the treatments performed under the general anesthesia. The greatest reduction was found in the oral symptoms and functional status of the child. In conclusion, dental procedures performed under general anesthesia in children with early childhood caries appear to have a positive impact on the quality of life of patients and their families.

Facial asymmetry in new-born babies is not always due to facial paralysis. Congenital facial asymmetry, might as well as be due to depressor anguli oris muscle aplasia (DAOA), so called “congenital asymmetric crying facies”. Additional congenital anomalies like skeletal, cardiovascular, urogenital, respiratory or central nerve system anomalies can also accompany this disorder. Here, we present a case with DAOA whose cousin had aplasia of 8 fingers in two hands, hip dislocation, partial cutaneous syndactyly in bilateral feet fingers, and ASD. DAOA is a rare congenital anomaly with unknown etiology; therefore, screening tests should be done when encountered by otolaryngologists and pediatricians.

It is not possible to determine dysrhythmias at any time, because those may occur briefly and unpredictably throughout the day. Transtelephonic electrocardiography (TTE) allows arrival to the hospital by the phone line dysrhythmia at the time. The aim of this study was to evaluate the value of TTE in the diagnosis and treatment of dysrhythmias, especially seen intermittently, in pediatric patients. We retrospectively evaluated records of 121 children, followed-up in Pediatric Cardiology Unit between May 2003 and May 2006. The patients were age of between 4 months to 18 years (median age 12 ± 4.4 years). The most common presenting symptoms were palpitation (42.1%), chest pain (15.7%), palpitation together with chest pain (6.6%), syncope (5%), easy fatigability (5%) and also the research of drug efficiency (3.3%). The dysrhythmia findings were determined on TTE in 21 of 110 cases whose standard electrocardiographies were normal. On TTE, supraventricular tachycardia was observed in three of 25 patients with normal HM. The dysrhythmia was detected in 24% of TTE records (supraventricular extrasystoles, ventricular extrasystoles, sinusal tachycardia, supraventricular tachycardia, sinus bradycardia, sinus tachycardia, sinus pause, Mobitz type I atrioventricular block were detected in 11, 7, 4, 3, 2, 1 and 1 cases, respectively). Four patients were using drugs (verapamil in 3 and propranolol in 1) before TTE recordings. According to the TTE records, medical treatments were started in 10 patients with previously untreated (verapamil in 5, propranolol in 3, digoxin in 1 and also amiodarone in 1). Eventually, we suggest that HM is a usefull, reliable and non-invasive diagnostic method for the detection of dysrhythmias in patients with dysrhythmia suggestive symptoms and normal ECG. Additionally, TTE should be used in follow-up and treatment of the patients with some dysrhythmias, even undetectable with HM.

Abstract

Aim: Respiratory infections caused by PIV are related to major morbidity and hospitalization rates in infants and young children. The aim of the present retrospective study is to investigate the rate and seasonal distribution of PIV infections in pediatric patients with lower respiratory tract infections.

Patients and Methods: Nasopharyngeal swab specimens of pediatric in- and outpatients with the diagnosis of lower respiratory infection were collected from various pediatric clinics between January 2014 and December 2016. PIV types 1, 2, 3 and 4 were identified by multiplex real time PCR method.

Results: One of the four PIV types was identified in 224 of 1983 nasopharyngeal swab specimens of patients aged less than 18 years (11.3%). PIV-3 was the most common agent among the subtypes (75%) followed by PIV- 4 (15.2%). The rate of PIV-1 and PIV-2 were 5.8% and 4%, respectively. Of all pediatric patients, 75.9% were under 5 years of age. When the seasonal distribution was examined, it was determined that PIV-3 was frequently observed in summer (53.6%), whereas PIV-1 and PIV-2 were observed in autumn and winter months.

Conclusion: PIV-3 was the most common subtype. Prompt identification of PIV by multiplex real time PCR method would be very helpful for clinicians in the treatment and prevention of the respiratory infections caused by viral pathogens.

In this investigation, it has been introduced Orle kundred and thirty five cases wich vere retrospective//y diagvosed as Sydenham Chorea iri cleparment of pediatric cardiology of Hacettepe medical faculty between 1975 and 1980. It has been reviewed its relation with the heart disease and it has been discussed t.he results.

Aim: Many different methods have been used for detection of antiepielptic drug concentrations for many years in clinical chemistry laboratories. In our study we aimed to evaluate the performance of turbidimetry as a method for detection of serum antiepileptic drug concentrations by comparing it with HPLC technique. Material and Method: Measurements were performed in both methods teknion the blood samples of the epileptic patients who were in follow up in neurology and pediatrics clinics of Ministry of Health Ankara Education and Research Hospital. This study was carried on laboratory of biochemistry of the same hospital. 35 samples for carbamazepine, 31 for phenytoin and 30 for phenobarbital were taken into this study. Results: Within run CV values for HPLC technique in measurement of sera were as follows for each drug: Carbamazepine 1.57% and 3.62%; phenytoin 2.15% and 4.14%; and phenobarbital 1.53% and 4.34%. They were found in turbidimetric method as follows: Carbamazepine 2.66% and 7.03%; phenytoin 1.98% and 2.04% and phenobarbital 3.3%1 and 5.24%. There was a significant correlation between turbidimetric method and HPLC technique (for carbamazepine r= 0.95, phenytoin r= 0.97 and phenobarbital r= 0.86 ). The recovery rates for each drug in turbidimetry were satisfactory (carbamazepine R%= 80.4%, phenytoine 88% and phenobarbital 86.8%).They were as follows in HPLC technique: R%= 105%, 107%, 110%. Conclusion: HPLC technique is accepted as a reference method for detection of serum antiepileptic drug concentrations. The performance of turbidimetric method is weak when compared with HPLC technique. But because of the cost effectiveness and the short turn around time, turbidimetry was preferred in our country.

This study included 102 leukemic and lympho,rıa patients tit ho were ıreated in Internal Medicine pediatric Clinic of Selçuk University Medical Faculty and Ilematology Clinic of İbn-İ Sina Hospital of Ankara University. CMV-IgM and 1gG antibodies were investigated with the enzyrne-linked immunosorbent assay (ELİSA) rnethod on the blood saınples, The serologic examinations were made in Alicrobiology ELİSA taboratory of Selçuk University Medical Faculty. The finding.s- in 69 leukernic and 33 iyınphoma patients compared tere control group. CA1V-IgM seropositivity was found in 7 lebtkernic palienis (10.15%) and 1 lyınphoırıa patienı (3,03%). CMV-1gG seropositivity waz found in 35 leukeınic patients (50,72%) and 13 lymphoına patients (39,39%). CMV-IgM sero-positivily of control group was found in 1 patient (2';;> and CMV-1gC sepropositivity was found in 25 patients (50%, seropositivity wa? Pyr,nd in 2 paıienis (6.25[70) and CMV-IgG in 13 pa-tients (40.63%) 'vere not (reale(' with cyto(atic ::-1ceıno0;crapy. scropositivily was

Aim: Pediatric age period has a dynamic structure for nevogenesis. In this paper, it was aimed to contribute to recognition of banal and atypical nevi through examining dermoscopic pattern and pigment network structures of acquired melanocytic nevi in pediatric age group. 
Patients and Methods: One hundred and fifty pediatric volunteers who were not predisposed to nevogenesis were included in the study. Children were divided into two groups as 7 and under, and 8 and over. 
Results: It was observed that the mean number of nevus was higher in the older age group (9.72) than in the younger age group (3.44). It was observed that the predominant pattern structure was globular pattern in both groups, and nevi with reticular patter in the age group of 8 and above were more than the age group 7 and below (p = 0.03). In both groups, nevi with globular pattern were found to be denser in the trunk and nevi with reticular patter in the extremities (p = 0.001). When the pigment network structures of nevi were examined, it was observed that the most frequently observed pigment network was uniform, but nevi with central pigmentation changes were observed more frequently in the age group of 8 years and older (p = 0.001).
Conclusion: Although acquired melanocytic nevi in the pediatric age group often have a globular pattern and uniform pigment network, the number of nevi with reticular pattern and central pigmentation changes increases with increasing age. 

Serum zinc and copper levels were investigated in 14 pituitary dwarfism cases and 14 control groups who applied to the Selcuk University Medical Faculty Pediatric Outpatient Clinic between July 1986 and June 1987. The relationship between the calendar age and bone age was examined. Zinc levels in patients with hypoglycemic dwarfism averaged 69.286-T 3.086 ugr / 100 ml., In the control group 79.429: F-3.291 ugr / 100 ml. found as. The difference between the two groups was statistically significant. (P <0.05). Serum bacterial levels averaged 133.286-T8.754 ugr / 100 ml in the patient group and 100.813 = 7-4.845 ugr / 100 ml in the control group. found as. The difference between the two groups was found to be statistically significant. (P <0.01).

Paroxysmal supra ventricular tachycardia is a cardiae aritmia which can alsa be occurred in pediatric popullation. in this article a patient with supra ventricular tachycardia has been presented and this subject has been shortly reviewed.

This study included 102 leukemic and lymphoma patients who were treated in internal Medicine Clinic, pediatric Clinic of Selçuk University and Ileınatolog,y Clinic of İbn-i sina Hospital of Ankara University. toxoplasma IgM and IgG antibodies were investigated with the enzyme-linked immuno-sorbent assay (ELISI%) ınethod on the blood saınples. The serologic examination was made in Micro-biology ELISA laboratory of Selçuk University. The findings in 69 leukemic and 33 lymphorna pa-tients cornpared with the control group. toxoplasma IgM seropositivity was found in 3 leukemic patients (4.35%) and 2 lyrrıphorna patients (6.06%). Toxoplasma IgG seropositivity was found in 34 leukeınic patients (49.28%) and 14 lyrrıphorna patients (42.42%). Toxoplasma IgG seropositivity of control group was found in 24 patients (46%). Alt control pers-ons were seronegative for toxoplasma IgM antibody. Toxoplasına 1gM seropositiVity was found in 1 patients (3.13%) and IgG in 14 pa-tients (43.75%) who were not treated with cylostatie chemodıerapy, toxoplasma IgM seropositivity was found in 4 patients (5.71%) and IgG in 34 patients (48.57%) in the patients who were treated

Introduction: Our aim is to evaluate the cardiac involvement of Neurofibromatosis type 1  patients in our region and to compare them with other clinical findings. In this study, we wanted to show the frequency and variety of cardiac involvement.

Material and Methods: Patients diagnosed with Neurofibromatosis type 1  in Hatay Mustafa Kemal University Medical Faculty Pediatric Neurology Clinic between 01/09/2019 and 01/09/2020 were included in the study. The patients included in the study were examined by a Pediatric Cardiology Specialist, and echocardiography and electrocardiography were taken. Demographic information, examination findings, brain magnetic resonance images were collected from the files of the patients. Electrocardiography and echocardiography were examined and recorded by the Pediatric Cardiology Specialist.

Results: We accepted 17 patients from our center to the study. Six patients (35.3%) were diagnosed with sporadic Neurofibromatosis type 1, while 11 patients (64.7%) had familial Neurofibromatosis type 1. All of our patients had cafe au late spots on the skin. In addition, 10 (58.8%) patients also had axillary and / or inguinal freckles. We detected optic glioma in 3 of our patients with ocular involvement, and lish nodules in 3 of them with papillary edema. When we looked at central nervous system involvement, we encountered various involvements in brain MRIs of 8 (47%) patients. In our cardiac examination, we found QT length in 1 patient’s electrocardiography. In the echocardiography we performed for the detection of cardiac structural pathologies, we detected nodular appearance compatible with subendocardial neurofibroma in 3 patients, mitral insufficiency in 3 patients, patent foramen ovale in 1 patient, atrial septal defect in 1 patient, and bicuspid aorta in 1 patient.

Discussion: In our study, unlike the literature, subendocardial nodular hyperechogenic appearance was present in 3 patients. Although these findings are quite rare, subendocardial nodular hyperechogenic images in 3 of our 17 patients suggest that this pathology may be more common. In addition, one of our patients had a long QT. As far as we know, this is the first case of Neurofibromatosis type 1 and Long QT syndrome. In conclussion; Cardiac involvement in patients with Neurofibromatosis type 1 could more common than mentioned in the literature.

Cerebrospinal fluid alkaline phosphatase enzyme level was investigated in this research for the differential diagnosis of meningitis. Cerebrospinal fluid alkaline phosphatase enzyme levels were de-terrnined en a group of 58 pediairic cases which were constituted of 30 normal individuals, 14 pa-'lents with bacterial meningitis and 14 patients with aseplic meningitis. In the normal group, the levels of alkaline phosphatase in cerebrospinal fluid ıvere estimated as 0,13 ± 0,8 Kuld.I.The values of alkaline phosphatase levels in bacterial and aseptic meningitis were obtained as 1,33 ± 0,78 KU/ dl, 0,29 ± 0,12 KUM], respectively. In cases of bacterial meningitis, a significant difference was founcl in comparison to the other groups which normal group and aseplic meningilis group (p<0,001). Based on these findings its is concluded that the determinations of alkaline phosphatase levels in the cerebrospinal fluid are helpful in differentiating bacierial from aseptic meningitis, especially in the cases which were negative cultures.

Aim: The aim of the study was to evaluate the clinical features and consultation process of the patients who
were consulted from the pediatric emergency department to the surgical departments during the pandemic
period, and to compare the findings with the data before the pa ndemic.
Patients and Methods: The research was conducted between 11.03.2020-11.03.2021 in the pediatric
emergency department of our hospital. The enrolled patients at 0-18 years of age were retrospectively
evaluated in terms of gender, age, diagnosis, consultation result, consultation response time. Our study was
compared with the prepandemic data between 01.01.2019 and 31.12 .2019.
Results: Of the patients; 42,4% were female and 57,6% were male. The mean age was 6,9±4,9 years. It
was determined that 27,3% of our patients were consulted to one of the surgical clinics with the diagnosis of
foreign body, 22,2% acute abdomen, 10.6% foreign body aspiration. It was found that 38,5% of the patients
were consulted to the pediatric surgery department, 33,9% to the otolaryngology department and 11,4% to the
thoracic surgery department. The mean consultation response time was 72,2±48,8 minutes. The distribution
of diagnoses, consultation response time, consulted surgical departments, consultation results by age groups,
and distribution of the consultation response times by surgical departments during the pandemic were found
to be statistically significant compared to the pre-pandemic pe riod (p<0,05).
Conclusion: In our study, it was found that the number of patients admitted to the pediatric emergency
department decreased during the pandemic period, the number of hospitalizations increased, the diagnoses
associated with trauma and close physical contact decreased, and the diagnosis of epididymorchitis increased.
In addition consultation response times were observed to be con siderably longer.

Objective: Epistaxis is a common condition in the childhood age group. However, it is important to diagnose the underlying bleeding disorders in children presenting with this complaint. Simple methods to be used in primary health care are needed to determine whether patients have bleeding disorders.

This study aims to evaluate patients presenting with epistaxis with the bleeding questionnaire and determine the diagnostic value of patients with symptomatic but normal hemostatic tests.

Methods: Seventy-seven children with epistaxis were included in the study group and 20 healthy children in the control group. Pediatric Bleeding Questionnaire (PBQ) was used for evaluation.

Results: In our study, 19.4% (n = 15) of the patients were diagnosed with bleeding diathesis (vWh: 10, rare factor deficiency: 5). The mean age at presentation was 8.99 ± 3.42 (3-17) years. Thirty-seven (48%) were girls and 40 were boys. In terms of PBQ epistaxis score, there was no statistically significant difference between those with and without bleeding diathesis. However, the overall score was not statistically different; it was higher in the group with bleeding diathesis. The cutaneous bleeding score was higher in the group with bleeding diathesis and there was a statistically significant difference.

 Conclusions: This study showed that bleeding scores can be used in patients with epistaxis who apply to primary health care institutions and patients with high overall scores and cutaneous bleeding scores should be directed to the hematologist for further research.Keywords: Epistaxis, bleeding diathesis, bleeding score

Aim: Kluyvera sp., a Gram-negative bacterium in Enterobacteriaceae family, may give rise to such infections as urinary system infections, enteritis, soft tissue infections and sepsis in children. It is known that Kluyvera species is an opportunistic pathogen detected in immunosuppressed hosts as well as in immunocompetent ones. Considering that it may enlight future studies related to Kluyvera infections, studies in the literature have been scanned. Material and Method: The data about Kluyvera spp. isolates were obtained retrospectively from clinical microbiology records. Result: It was seen that, of the 3 Kluyvera isolates, 1 was a urine specimen, and the other 2 were from umbli cal area. In this study, antimicrobial susceptibility studies of the clinically significant Kluyvera isolates showed susceptibility patterns similar to those reported in the medical literature, namely trends of resistance to ampicillin and first- and second-generation cephalosporins. Moreover none of the clinically significant isolates were resistant to amikacin, ciprofloxacin, gentamycin, and trimethoprim+sulfametoxazole. Conclusion: It was concluded in the light of both the studies in the literatüre and this study that rare and opportunistic organisms, such as Kluyvera may be an infection cause in children.

Aim: In this study, we aimed to evaluate the ratio of hepatitis A seropositivity in patients who applied to the outpatient clinics of of Pediatrics in Meram Medical Faculty of Selcuk University. Material and Method: 345 patients who applied to our outpatient clinics between December 2005 and June 2006 were included in the study. These children were divided into three groups as 2-6, 7-11 and 12-16 years, respectively. AntiHAV Ig M and Ig G were studied in all patients using ELISA method. The statistical analysis of the results was evaluated according to SPSS 10.0 program. Results: Positivity of anti-HAV Ig M and Ig G were found as 1.4 % and 28.7 %, respectively. When compared, hepatitis A seropositivity was significantly higher in children of school age than children under school age. Conclusion: Because hepatitis A seropositivity in children increases significantly with school age, vaccination should be recommended before school age.

Croup syndrome is a term that defines barking cough , hoarseness, inspiratory stridor, and presenting with changeable severity of respiratory distress according to the l (severity) of obstruction, Foreign body aspirations, retropharyngeal abscess, bacterial tracheits and epiglottitis are also reasons for croup like acute airway obstructions. We a 4 years old child with biphasic stridorwho admitted to the Pediatric Emergencydepartment In consequence of unresponsive medical treatment pati endoscophic examination has performed and a Szygium aromaticum at the level of vocal cordswas found The foreign body had removed with general anesthesia by endoscophy.

Foreign body aspirations (FBA), which have high mortality and morbidity rate, are common pediatric emergency issues occured in childhood. FBA is seen more frequently among children under 3 years old. If there is no history of sudden-onset choking and cough, it can be ignored and the patient may come with recurrent pulmonary infections and its related complications. In this report, 10-monthold boy patient who was brought with complaints of sudden-onset of cough, vomiting and wheezing after eating a kind of broad bean ( termiye) was presented. Diagnosis was established on the history, physical examination, the chest X-ray and bronchoscopy. The foreign body (termiye) was located in the right inferior bronchus and removed. This case emphasizes that the presence of a foreign body aspiration must be kept in mind in childhood. Because foreign body aspiration is a serious problem that may lead to complications or even to death.

Aim: It is aimed to evaluate the necessity of echocardiographic asssesment for the patients in whom the innocent heart murmurs are heard after the cardiovascular system examination. Material and Methods: The files of 466 patients, ages varied between 1 day and 17 years-old, who were performed echocardiographic assessment and referred to our Pediatric Cardiology Outpatient Clinic because of innocent heart murmur due to physical examination, electrocardiography and telecardiograpy between June 2007- December 2007 were evaluated respectively. Result: Patients who have innocent heart murmurs were not detected any important cardiac patology for hemodynamic physiology. Also, when the innocent heart murmurs is evaluated according to types, it is determinated that the most heart murmur is the innocent pulmoner murmur (47,4%). Results: In 69% of the patients who were performed ecocardiographic assesment, minor congenital heart anomalies were establised with any hemodynamic abnormalities and also 12% of them were given infective endocarditis preventive treatment. For this reason; it is determined to be suitable that echocardiographic assesment for the children who are reffered to our outpatient clinic because of heart murmur in physical examination despite the result of innocent heart murmur.

Evaluation of body temperature in a day period in Down syndrome children with congenital heart disease and comparison of results with control group. Fifty-one Down syndrome children with congenital heart diseases who were hospitalized and followed up in pediatric cardiology clinic because of various non-infectious etiologies between September 2010 and August 2011 were included in the study. The two control groups were selected from 26 non-Down children who had and had not congenital heart disease respectively. Sedimentation rate, C-reactive protein and procalsitonine levels, white blood cell and platelet counts were determined in all groups during hospitalization. Humoral and cellular immune systems were evaluated in Down syndrome patients with recurrent and/or nonexplained upper and lower airway infectious. Body temperature was determined in all patients twice a day in morning, noon, evening and night. No statistical differences was detected between the groups according to sedimentation rate, C-reactive protein and procalsitonine levels, white blood cell and platelet counts. Isolated ventricular septal defect is the most common detected congenital heart disease in Down syndrome patients. Body temperature measurements were statistically different in Down syndrome group than two control groups and it was detected that basal body temperature was higher during the day. Body temperature is higher in Down syndrome children with congenital heart disease during the day. This is because of the defect in hypothalamic temperature regulator center rather than the hemodynamic defect. For this reason the limit temperature of fever in Down syndrome patients should be different than healthy children.

Aim: It was aimed to compare with healthy volunteers the changes in heat shock protein (HSP) 90 alpha and vitamin levels during exacerbation and remission periods in our patients with familial Mediterranean fever (FMF), to research whether these molecules will benefit in control of FMF exacerbation and prevention of amyloid accumulation, and also to investigate the relationship of these molecules with FMF gene mutations.

Patients and Methods: HSP 90 alpha, vitamin A, vitamin B 12, vitamin D, vitamin E and folic acid levels were studied in 30 patients with AAA diagnosed in our hospital's pediatric nephrology department during the exacerbation and remission periods and 30 healthy volunteers. The results were compared statistically.

Results: In our series, 19 (63.3%) of the patients were male, 11 (36.7%) were female, with a mean age of 11 years. The most common presenting complaint was abdominal pain (n=19; 63.3%) after fever and only high fever was found to be present in five (16.7%) patients. The most common genetic mutation was M694V (n=14; 46.7%), whereas no mutation was detected in five (16.7%) patients. Although HSP 90 alpha was the highest in the exacerbation group and the lowest in the remission group, there was no significant difference between the groups. Vitamin B12 was significantly different between the groups and the highest value was in the control group. Vitamin D was significantly different between the exacerbation and the remission groups and the highest value was in the exacerbation group. In addition, vitamin D levels were significantly higher in boys. There was no significant difference between vitamin A, vitamin E and folic acid levels. FMF gene mutations did not affect HSP 90 alpha and vitamin levels.

Conclusion: Our findings showed that serum HSP 90 alpha, vitamin D, vitamin E and folic acid levels were normal in AAA, but vitamin B12 and vitamin A levels were low during exacerbation and remission. However, we think that prospective studies including larger series should be performed about the subject.

Aim: In this study, we discuss the efficacy and safety of autologous hematopoietic stem cell transplantation
(AHSCT) for high-risk pediatric solid-tumor patients based on 1 2 years of experience.
Patients and Methods: The data of patients aged < 18 years with pediatric malignancies who underwent
AHSCT between January 2009 and July 2021 at the Pediatric Bone Marrow Transplant Unit were evaluated
retrospectively.
Results: Fifty-one patients (24 girls and 27 boys; median age, 7.8 years; range: 0.5–18 years) were
enrolled in the study; 20, 15, 8, 4, 2, and 2 patients had diagnoses of neuroblastoma, Ewing’s sarcoma,
Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, germ cell tumor, and soft tissue sarcoma, respectively.
The median neutrophil and platelet engraftment times were 11 (8–45) and 16 (4–62) days, respectively,
and the median hospital stay was 38 (17–67) days. The median follow-up time was 2.83 (0.12–10.81)
years and the overall survival (OS) rate was 51.3 ± 10.3% for all patients; the median follow-up times
and survival rates for the Ewing’s sarcoma and neuroblastoma cases were 2.63 (0.12–10.55) years and
64.2 ± 14.9%, and 2.81 (0.31–7.91) years and 42.8 ± 12%, respectively. All four patients who received
the conditioning regimen of carboplatin, etoposide, and melphalan (CEM) died; 6 of 16 neuroblastoma
patients who received the busulfan and melphalan (Bu/Mel) regimen as a conditioning regimen died: the
median follow-up period of the Bu/Mel neuroblastoma patients was 3.08 (0.32–7.91) years and the OS
rate was 55.1 ± 13.8%.
Conclusion: Although the number of patients in this study was limited, AHSCT resulted in better survival
for Ewing’s sarcoma and neuroblastoma cases than reported for those who did not undergo AHSCT in
our clinic.

Mechanical ventilation (MV) is the most important part of contemporary critical care concept and one of the most frequent reasons for intensive care admissions. Currently, there is a tendency to use the mechanical ventilators in the intensive care units by pediatric intensivists. The aim of this review is to summarize the basic principles of mechanical ventilation in order to be applied when required by all physicians. There is an indication for MV when the spontaneous respiration is threatened to sustain life. Currently, the principal criteria to determine the need for MV is the clinical judgement of the physician rather than laboratory results of the patients. Some of terminology should be well- known to initiate the MV. The main difference between the basic ventilator modes ventilator’s ability to detect and and respond to patient’s own spontaneous respiration.

Between 1983 and 1996 splenic surgerv was peıfonned irr a tatar` of 47 .children in the Research Hospital of Medical Faculty of Selçuk Unive•sity. The age• of the patients were betıveen one and 16 vc'ars. Of the patients 38 under•ent splenectomy. of. which 17 were pelforıned general sur.,!:;eons be-Pre 1991_ Pediatric surgeons have been performin these procedures since rhen. When these two periods are coınpared It is frJldlrfl that. the most U)/i dication.v for ,splenectomy are trannut and he-motological diseases before 1991 aml cıfıer tlıen. respectivelv. Wc' suppusod that. the ı-eason of the (lif-frrence between tvı,o periods is the impo•tance of- the jımetions of the spleen is not elem- in adults as iır (.-hildren and therefrre. .fi)r the menagemenı of the trattmatic children, the methocl used hrgenaral sur-geons i.s different from ılıaı (ıf pedian-k:surgeons_

Nearly all of the reports about pneumomediastinum associated with pneumonia have been conducted in adults as pneumomediastinum was uncommon in pediatric age group. This case report is described an infant with pneumonia complicated with pneumomediastinum and epidural emphysema. Her original disease is a severe combine immunedeficiency (SCID). Another reason to provide this case report is that epidural emphysema or pneumorachis associated with pneumonia and pneumomediastinum is a rare condition.

Because of the hot climate of Diyarbakır we have investigated the incidence of urinary tract infection among the students of elementary-school in Diyarbakır and the predisposing factors which can cause urinary tract infection. We have also investigated the distrubition of urinary tract infection according to age and sex, the complaints, c/inica/ and /aboratuary findings among the students who vere diagnosed to have urinary tract infection. The high incidence of urinary tract infection is attributed to the hot climate and the abundant predisposing factors. The attention of the pediatrists is attracted upon the importance of this subject.

Chest pain is a common complaint in children. It doesn’t usually indicate a cardiac problem but it is considered as heartache by the patients and their families. In this article, the patients with chest pain in pediatric cardiology clinic for the last 18 months have been evaluated and the etiology of chest pain has been discussed. The study includes 441 patients with chest pain, who were admitted to the Department of pediatrics, Division of pediatric cardiology, Faculty of Medicine, Selçuk University between May 2011 and November 2012. The data of the patients has been reviewed retrospectively. Medical history and family history of the patients, cardiac physical examination, electrocardiography, echocardiography, 24-hour rhythm holter monitoring, exercise testing and laboratory tests have been evaluated. In our study the mean age of the patients was 11 (5-18 year-old). 217 (49.2%) of the patients were male and 224 (50.8%) of the patients were female. Medical history, physical examination, electrocardiography and echocardiography of all the patients have been evaluated. Cardiac pathology has been recognized in 10 (2.3%) of the patients. The reasons that cause chest pain are idiopathic in 378 (85.7%) patients, psychological in 22 (5%) patients, lung diseases in 20 (4.5%) patients, gastrointestinal disorders in 6 (1.4%) patients, musculoskeletal system diseases in 3 (0.7%) patients, Familial Mediterranean Fever in 1 (0.2%) patient and pectus excavatum in 1 (0.2%) patient. According to this study, the etiology of chest pain in children is extra cardiac factors in majority. Differential diagnosis should be made carefully due to possibility of life threatening consequences of cardiac disorders. If there is no cardiac pathology as a result of medical history, physical examination and laboratory tests the patient and the family should be informed about this.

Ocular findings in children with neurofibromatosis type 1 (NF 1) and tuberous sclerosis (TS) are presented. The study was conducted prospectively and comprised 31children who were referred from pediatric neurology clinic to the ophthalmology clinic. Sixteen of 22 patients with NF1 (72.7%) were male and 6 (27.3%) were female and the mean age was 9.9 ± 4.2 (3-16 years). Two of 9 patients with TS (22.2%) were male and 7 (77.8%) were female, the mean age was 5.5 ± 3.6 (1.5-12 years). Twenty of children with NF1 had cooperation to the snellen chart, the mean visual acuity of the right and left eye were 0.93 ± 0.14 (0.4-1.0) and 0.94 ± 0.14 (0.4-1.0), whereas the mean visual acuity of 7 patients with TS was 0.84 ± 0.22 (0.4-1.0) at the right and 0.85 ± 0.19 (0.5-1.0) at the left eyes. Percentages of myopia, hyperopia and astigmatism in children with NF 1 were 40.9%, 4.5% and 18.1%, respectively. Percentages of myopia, hyperopia, astigmatism in children with TS were 11.1%, 22.2% and 11.1%, respectively. In a NF 1 patient with keratoconus, his visual acuity was 0.4. Also another patient with TS had diminished visual acuity of 0.4 at the right eye and 0.5 at the left eye because of hyperopic astigmatism. Iris Lisch nodules were detected in 14 (63.6%) of children with NF 1. Five cases (22.7%) had bilateral optic glioma, the mean age was 7.6 (3-15 years). All tumors were located at intraorbital and the patients were asymptomatic. Except optic glioma, it was found out that one patient (4.5%) had bilateral myelinated nerve fibers and the other one (4.5%) had bilateral optic atrophy due to previous neurosurgery. Sectorial iris hypopigmentation was determined in one (11.1%) of nine children with TS. Detailed ophthalmic examination has a great importance in patients with TS and NF 1 because of ocular findings which are commonly seen. Patients should be evaluated by ophthalmologists in terms of refractive error and optic glioma.

Aim: Hepatitis B virus infection is a very important health problem in our country. In this regard, we evaluated the children who were inspected in our outpatient clinics for Hepatitis B virus seropositivity. We aimed to join the children who were seronegative in the immunization program. Material and method: A total of 297 children between the ages of 3 months and 18 years who were inspected in the General Pediatric Outpatient Clinics of Meram Medical Faculty except for jaundice between July 2005 and December 2005 were evaluated. The children were divided into two groups as 3 months-7years and 8-18 years. After getting permission from parents, 3 cc venous blood samples were collected from all of the children. The serological markers of Hepatitis B virus were studied by Enzyme-Linked Immunosorbent Assay Method in the microbiology laboratories of Meram Medical Faculty. The statistical analysis was performed by SPSS 10.0 program. Results: Anti-HBs positivity were found in 143 ( 48,1 %) of 297 children. One hundred seventeen (81,8 %) of those children were vaccinated while 26 (17,5 %) of them had experienced the infection. Five children (%1,6) had HBsAg positivity. The ratios of children who were vaccinated were 66,4 % in 3 months-7years group and 11,0 % in 8-18 years group, respectively. The ratio of children who were vaccinated was 39,3 % in all children. Conclusion: Although Hepatitis B vaccination is a part of our National Immunization Program, the seropositivity of our region is not as much as it is expected. In this study, we found that the people in our region are not well-informed about the necessity of vaccination against Hepatitis B virus infection, and attention is called to the importance of our job in this point.

In our study; we tried to evaluate the int-raosseous route for water-electrolyte replacement and anesthetic induction with ketamine in children. 48 patients whose ages are between I and 6 years, were divided into three groups. 2 mg/kg ke-tamine intraosseous (10) in group 1; 2 mglkg ke-tamine intravenous (IV) in group II, and 6 mgike ke-tamine intramuscular (IM) in group II was used for induction. The maintenance of anesthesia in all three groups were administered with 1.5 % tsof lurane and N20. Nystagmus was considered as the begining time of induction for ketamine. During the operation the heard rate (HR), systolic arterial blood pressure (SABP) and diastolic arterial blood pressure (DABP) was recorded and the comp-lications of the intraosseous route were evaluated. When we have compaired the SABP, DABP and HR values of each group recorded during operation, it was found that there were no significant sta-tistically difference among them. As a conclusion; if the intravenous approach is impossible, the intraosseous route is a safe al-ternative for water-electrolyte replacement and in-duction with ketamine.

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Three hundred seventy patients with congenital heart defects (CHD) who were admitted to Pediatric Cardiyology Unit of Selçuk University, Meram Medical School Hospital, between September 1999 and September2001, were evaluated. Ventricular septal defect was the most common type of CHD and it was follovved by atrial septal defect as in literatüre. Consanguinity marriage was detected as 30.0 % among the parents of the patients with CHD. This ratio was significantly higher than the ratio detected from the healthy control group. As we Investigated the degree of relativity among the parents of the patients with CHD, we found that the first cousin marriage was higher than the far consanguinity marriage. These findings indicated that first cousin marriage could increase the occurence of CHD among the offsprings.

\r\n Prognostic importance of thrombocyte indices in children with carbon monoxide poisoning

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\r\n Abstract

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\r\n Objective: Carbon monoxide (CO) poisoning is still being a major cause of morbidity and mortality all over the world. Although the role of platelet functions in CO poisoning is not clear, increased platelet activation and aggregation had been reported previously. Increased thrombotic tendency due to endothelial damage, increased platelet stickiness, and alterations in the fibrinolytic pathway occurs in CO poisoning. The aim of our study was to determine whether platelet indices provide clinical benefit or not in children with CO poisoning.

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\r\n Materials and Methods: We retrospectively reviwed the records of children with the diagnosis of CO poisoning who admitted to the pediatric emergency departments of Konya Beyhekim State Hospital and Necmettin Erbakan University Meram Medical Faculty. A total of 92 children with CO poisoning and 62 age- and gender-matched healthy controls were included in the study.

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\r\n Results: While mean platelet volume (MPV) and platelet distribution width (PDW) levels were significantly higher (9,34±0,55 vs 9,78±0,97fL, p=0.001 ; 11,46±2,64 vs 10,57±1,41, retrospectively, p=0.007), platelet count and plateletcrit (PCT) (324,05±82,07 vs 357,27±89,70 x10⁹ p=0.015 ; 0,31±0,06 vs 0,33±0,07, retrospectively, p=0.039) were significantly lower in patients with CO poisoning. MPV levels were also significantly higher in patients with a carboxy hemoglobin (COHb) level higher than 20, when compared with COHb levels between 10-20 (9,40±0,84 vs 10,08±1,22 fL, p=0.003).

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\r\n Conclusion: Our results showed that platelet indices MPV and PDW are markedly elevated in patients with CO poisoning while platelet count and PCT were decreased. MPV and PDW levels, which reflect the changes in platelet activation and function, may predict the development of especially thromboembolic complications in the course of CO poisoning.  MPV and PDW levels may be useful in prognostic estimation of CO poisoning.

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\r\n Keywords: carbon monoxide; children; platelet indices; poisoning

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Absent pulmonary valve syndrome (APVS) is a rare congenital heart disease. It can be seen isolated or with other congenital heart diseases. Here, we presented a neonate with cyanosis and dyspnea because of APVS. A-female-newborn was referred to pediatric cardiology due to cyanosis, respiratory distress and prenatally diagnosed right ventricular dilatation. Rudimentary pulmonary valves and severe pulmonary and tricuspid regurgitations were determined postnatally with echocardiography and magnetic resonance imaging. Additionally, main pulmonary artery and its branches were seen dilated. Unfortunately she died on third day of her life, although supportive and medical treatments were administered intensively. Most of APVS cases are a variant of Tetralogy of Fallot. But clinical findings, prognosis and hemodynamic conditions can be different. Infants requiring mechanical ventilation shold be undergone operation as soon as possible. Our case could not be operated because of unstable vital functions. Absent pulmonary valve syndrome should be considered as a differential diagnosis in neonates with cyanosis and respiratory distress. If prenatal diagnosis is present, we suggest that parturition should happen in a medical center includes pediatric cardiology and cardiovascular surgery and also neonatal intensive care unit.

Aim: Coughing is a common symptom in childhood. The cough last for over 4 to 6 weeks and also which makes patients the family and the doctor feel discomfort is called chronic cough. If this cough last long and repeats, it has to be investigated. After a detailed history and physical examination, distinctive studies have to be made. The purpose of this study is to evaluate the patients, which have been made flexible bronchoscopy because of chronic cough, by their clinical, laboratory and bronchoscopic findings. Material and Method: In this study we evaluated 23 patients with chronic cough; which were examined between January 2002 and December 2006 in Pediatric Chest Unit of Hacettepe University. Patients have cough for over 4 to 6 weeks, without specific chest X Ray findings, gastroesophageal reflux and problem with their immunologic system were and because of all these reasons they have been made bronchoscopy. The patients files are analyzed retrospectively by their demographic, clinic and bronchoscopic findings. Results: The study consisted of 23 patients: (12 males/11 females). The age of the patients vary between 1 and 13,8 years (mean age: 5 years). All patient’s radiological findings were normal without one patient. This patient’s have bronchial abnormalities in sanal bronchoscopy. When it is observed with flexible bronchoscopy ten patients have abnormal findings. Two patients have foreing body aspiration in their left main bronchus, two patients have tracheomalasia, three patients have hyperemia and secretions infection and two have bronchial abnormalites.In six patients’ bronchoalveolar lavage microorganism grew. Three patients have lipid laden macrophage and two patients whose previous gastroesophageal reflux scintigraphie were negative then found in and started treatment Conclusion: Although flexible bronchoscopy is an invasive technique, it evaluates respiratory system’s functional, anatomic characteristics well and it is a valuable technique in finding the etiology of chronic cough.

Risk factors and encountered problems during follow-up in babies with low birth weight (SGA) were investigated. 108 babies with SGA and who were follovved by our pediatrics department vvere evaluated. 52cases vvere male (48.2%) and 56 cases vvere female (51.8%) .40.7% of ali cases vvere prematüre and others (59.3%) vvere term babies. 53.7% of ali cases vvere applied from the city çenter. Low socioeconomic level, mother’s age lovver than 18 years, and preeclampsia vvere the most freguent risk factors. Infections (32.4%) , asphyxia (25.9%), hypoglysemia (21.3%) and polycythemia (19.4%) vvere the freguent problems. Important causes for mortality vvere infections, congenital abnormalities, and asphxy.

Amaç: Çocukluk döneminde Epstein-Barr virüsüne (EBV) nedenli enfeksiyöz mononükleoz olguları yüksek sıklıkta görülmektedir. Akut EBV enfeksiyonu belirti ve bulguları farklı klinik tablolarla kendini gösterebilmektedir. Çalışmamızda çocuklar arasında yaş ve yüksek riskli yaş gruplarına göre akut EBV enfeksiyonlarının klinik sunumunun incelenmesi amaçlandı.

Aim: In childhood, infectious mononucleosis cases caused by Epstein-Barr virus (EBV) are seen with high frequency. The signs and symptoms of acute EBV infection can manifest with different clinical pictures. Care should be taken in differential diagnosis for correct treatment. In our study, it was aimed to examine the clinical presentation of acute EBV infections by age and high-risk age groups among children.

Patients and Methods: A total of 337 pediatric patients with infectious mononucleosis who applied to our tertiary hospital in 2013-2020 were included in the study. EBV VCA IgM and IgG antibodies were studied by ELISA method (quantitative microplate ELISA, Euroimmun®, Germany) in accordance with company recommendations. Patient information and results were evaluated retrospectively.

Results: The mean age of the patients was 5.1 ± 3.4 years. 22.8% of the patients were in the group of 0-2, 43.0% of them were 3-5, 29.7% of them were 6-12, and 4.5% of them were 12 years old and above. The most common signs or symptoms in children diagnosed with acute EBV infection were lymphadenopathy (59.6%), lymphocytosis (45.1%), fever (40.9%), swelling in the throat (39.2%) and pharyngitis (30.0%). Fever complaints were significantly higher between the ages of 3-5 compared to other age groups. The seasonal distribution of the cases was similar. It was determined that the cases increased over the years and the most cases were seen in 2019 (23.4%). It was observed that the time between the start of complaints and the application to the hospital increased directly proportional to age groups.

Conclusion: In our study, it was concluded that there was no difference in acute EBV infection in childhood age groups in terms of signs and symptoms, and the number of cases increased slightly over the years, especially in children with lymphadenopathy, splenomegaly and hepatomegaly.

İn this study; lumbar and thoracic epidural applications under sedation in school age children were presented. Thoracic epidural catheters were inserted before elective thoracotomies and were combined with general anes­ thesia. Lumbar epidural catheters were inserted in the emergency orthopedic cases that had contraindication for general anesthesia and were combined with sedation.

Aim: Studies of paediatric acute pancreatitis have remained in the shadow of adult literature for many
years, and have only increased following the recent acceptance of the severity classification. There is now
a need to determine inflammatory biomarkers which will be able to rapidly predict in the early stage which
patients will develop severe disease. This study's purpose was to research the efficacy as early predictors
and determine cutoff values for inflammatory biomarkers including the systemic immune-inflammation
index (SII), and the neutrophil-lymphocyte ratio (NLR).
Patients and Methods: A retrospective evaluation was made of the clinical characteristics, laboratory
test results, and imaging findings of 53 children diagnosed with acute pancreatitis between 2019-2022.
The study population were separated into groups as ‘mild’ and ‘moderately severe-severe’ according
to severity. The groups were compared in respect of inflammatory markers. Factors predicting disease
severity were evaluated with ROC curve analysis. For the significant cutoff values, positive predictive
value (PPV), negative predictive value (NPV), sensitivity and s pecificity were calculated.
Results: The NLR, and SII values were found to be statistically significantly higher in the “moderately
severe-severe” group than in th “mild” group (p<0.001 for all). The cutoff values of NLR≥3.33 (AUC:0.894,
95% CI:0.81-0.979, PPV 89.7%, NPV 83.3%), and SII≥1225.57 (AUC:0.912, 95% CI:0.831-0.992, PPV
90.0%, NPV 87.0%) were determined to be able to predict disease severity with high sensitivity and
specificity.
Conclusion: The NLR, and SII are inflammatory biomarkers that can make an early prediction of a poor
outcome in paediatric acute pancreatitis. To the best of our knowledge, this is the first study to have
evaluated the prognostic importance of these biomarkers, in pae diatric acute pancreatitis.

Cyclic vomiting syndrome (CVS) is characterized by recurrent episodes of nausea and vomiting. Age at onset of symptoms ranges between 4–6 years and there is a female predominance. CVS attacks are generally associated with psychosocial or physical triggers. In last years a shared pathophysiology between migraine and CVS has suggested. Children with CVS and their mothers have elevated rates of anxiety disorders. In this report, we presented a 5-year-old girl who referred to our out-patient clinic because of recurrent vomiting episodes. Because of her anxiety symptoms and vomiting attacks, escitalopram, a selective serotonin reuptake inhibitor, was initiated and she had significant improvement during treatment.

In the echocardiography laboratory of the pediatric cardiology unit of our faculty, 371 patients who underwent echocardiographic examination in the first six months of their activation were examined from different aspects. It was found remarkable that acute rheumatic carditis is an important health problem for our region. The results obtained were compared with the literature data.

Aim: It is important to identify allergens in reducing disease-related symptoms and improving quality of life in the allergic diseases. Therefore, we aimed to evaluate the frequency of aeroallergens in allergic patients in our region.

Method: 1078 patients (2-18 years) who applied to the pediatric allergy immunology outpatient clinic between September 2017- March 2018 were included to the study. The demographic and clinical characteristics of 642 patients with at least one allergic sensitization in the skin prick test were evaluated retrospectively. Total IgE levels, peripheral eosinophil counts in the blood, aeroallergen sensitivities in skin prick test were evaulated from the patient’s files. The study was approved by the Ethics Committee of the Alanya Alaaddin Keykubat Medical Faculty.

Results: In 642 of the patients (59.5%), a positive response was observed against at least one aeroallergen. Among patients, 34.8% had asthma, 73.7% had allergic rhinitis, 12.6% had atopic dermatitis, and 3% had chronic urticaria. 24.8% of the patients (159) had more than one allergic disease. When the evaulation of the patients with positive skin prick test, 57.3% were male and 42.7% were female. The mean age was 8.49 +/- 4.15 years. The sensitivity of house dust mites was the most common (76.1%). In the second and third frequency, molds (51.8% Alternaria alternata, 41.7% Claudosporum herbarum) and grass and cereal pollen (39.8%) sensitivity were observed. Other determined aeroallergen sensitivity frequencies were; weed pollen mixture (24.6%), trees pollen mixture (21.7%), cockroach (17.8%), cat hair (31.2%), olive tree (20%). The mean serum total IgE level was 215.6 IU/ml and the mean eosinophil count was 410.63/mm³.

Conclusion: Detection of responsible allergens is important to control symptoms and to give the chance the course of the disease with immunotherapy in the selected cases.

 

This study was iınplemented on patients' parents or relatives who brought their children to the Polyc-clinic of Departmant of Pediatrics in Faculty of Me-dicine, Selçuk University between 18 and 22nd of November 1991. 1n this study it was observed that only 17 percent of patients had applied for tertiarv care wlüle 71 percent of diem had came for primarv care. Patients applying for tertiary care were usually brought to the hospital by their fathers and male pa-tients more in number and relatively higher in 0-6 age group (p<0.05). It was also observed that number of patients, e.specially of those referred, decreased to-wards weekend (p>0.05) and parents were utilizing less health service in each level of care for their third and more childs (p>0.05). We believe that it will be more usefid for both community and health organi-zations ta make primary health care services more effective and such regulations, in which university hospitals, vvithoıtt taking care of patients social insu-rance guarantees, just can be used for tertiary health care services a step-by-step referral system.

Foreign body aspiration (FBA) is a serious problem especially in pediatric age group. Delay in diagnosis and intervention can lead to a life-threatening condition. Young children are more concerned with the environment and neuromuscular mechanisms do not develop sufficiently. Factors such as lack of molar teeth and failure to perform chewing are the main causes of high FBA in children under 3 years of age. It is of vital importance that the patient is referred to a hospital where a rigid bronchoscopy can be performed quickly after the diagnosis. We retrospectively evaluated 47 patients who were treated in our clinic such as clinical symptoms, age, gender, foreign body (FB), location, positive radiological findings, and duration of stay.

47 patients; 29 male (63%), 18 female (37%), age ranging from 3 months to 8 years. The age of the 37 patients (80%) was below the age of 3 years. The main complaint at the time of admission was cough (80%) in 37 patients, wheezing in 23 patients (50%), shortness of breath in 15 patients (32.6%), infection in 5 patients (10.8%), high in 2 patients. there was fever (4.3%). In 37 patients (78%), the foreign body was of organic origin (such as inside or outside the shell, peanuts, hazelnut pieces) while in 10 patients (22%), an inorganic foreign object was found (such as a pen tip, a toy part, plastic parts, etc.). FB was located in the right main bronchus in 18 patients (39%), in the left main bronchus in 25 patients (51%) and in the trachea in 4 patients (8.7). There were no radiological findings in 18 patients (39%). Although 11 patients (23.9%) were anamnesis, their findings were normal. Twenty-three patients applied to our clinic within the first 24 hours after the event, and 24 patients were admitted to our clinic 24 hours after the event.

Although the results were generally consistent with the literature, the left main bronchus was 51% in terms of the localization of FB.

Intussusception is the most common cause of intestinal obstruction in childhood. 11 children with intussusception were retrospectively reviewed in the departmant of pediatric surgery in Selçuk Üniversity medical faculty. Age configuration, symptoms and signs were similar with the other reports, but most of the patients were girls (girl I boy:9/2) and (his made the difference. Besides intestine resection ratio was high and the patients presentations in hospital were lale. There is a relationship between resection ratio and the patients lale presentations. And this was related to the loss of time with the wrong diagnosis and treatment.

Bleedin in newborn infants is an important problem, among these, caused by disseminated intravascular coagulopathy has the most serious prognosis. In this report we discussed disseminated intravascular coagulopathy which is one of the most serious problem in newborn period in pediatrics.

This study was done on 32 -premature and 32 term infants with hyperbilirubinemia hospitalized in Newborn Unit of Pediatric Clinics of Medical Facul-ty of Selçuk University, Serum vitamin E leveis of premature infants' were found as 053 ± 0.08 mgldl, term infants levels were found as 054 ± 0.07 mgldl. Serum vitamin E levels were cotnpared according w sex, birth week and birth weight.

Between January 1994 and December 1995.29 pa-tients were treated with laparoscopic surgery in our department. The aim of this study is to present our ex-perience with the indications and efficacy of la-paroscopic surgery in pediatric surgery. The age of the patients was heteen one and 16 years. The most common procedure that we per-formed was appendectomy (13 patients). The other-common procedures were ovarian cyst drainage (four patients), hemostasis in traumatic int-raabdominal hemorrhage (three patients). sple-nectomy (four patients). Swenson's procedure (three patients), and cholecystectomy (three patients). We had to converse to open surgery for technical reasons in a total of four patients (10%). We observed extra peritoneal insujilation in ma patients, transient tachycardia and arrhythmia in five patients. and tran-sient hyperthermia in another two patients as int-raoperative complications. One patient developed postoperative ileus after appendectomy. The duration of the laparoscopic procedures was longer than that of the open surgery in spknectomy and Swenson's procedure. similar in apendectomy, but shorter in cholecystectomy, ovarian cyst dra-inage, and hemostasis for intraandominal he-morrhage. Hospital stays were shorter in all la-paroscopic procedures comparing with open surgery. Laparoscopic surgerey is a useful method with low incidence of complications which are well to-lerated for the treatment of the surgical pediatric pa-tients.

Aim: Burns are common, especially in children. Here, we aimed to determine incidence of attention deficit
hyperactivity disorder (ADHD) symptoms in children with burns a nd compare them with healthy children.
Patients and Methods: This prospective study was conducted between August 2019 and April 2021. The
study group consisted of pediatric patients aged between 3-16 years admitted to the pediatric emergency
with burns. Children aged between 3-16 years admitted for non-traumatic reasons also constituted the
controls. Cultural and demographic characteristics of both groups were similar. After initial intervention
and stabilization, the revised Conners’ Parental Rating Scale (CPRS-R) was applied to both groups.
Results: The study group consisted of 143 individuals with a mean age of 6.93±2.96 years, and 69
(48.3%) were girls. The control group consisted of 140 children (mean age: 6.72±2.48 ranging between
3-16 years), and 49.3% were girls. There was no statistically significant difference between both groups
regarding age and gender (p=0.36, 0.84, respectively). The most common cause of burns (69.2%)
was exposure to hot water or oil spill. Most of the victims due to burns (89.5%) were discharged from
emergency after outpatient intervention. All subscale scores calculated through CPRS-R, except for
cognitive problems/inattention subscale scores, were significantly higher in the study group than the
controls. The educational status of the parents in the study group was hi gher than those of the controls.
Conclusion: Our findings indicated that the incidence of ADHD symptoms may be higher in children
admitted to the emergency department due to burn injuries.

Mortality rate of 92 premature babies accepted to pediatrics department of Medical Faculty of Selçuk Oniversity between January and Decernber 1990 was investigated. Mortality rate was cletermined as 30.4 percent. The mortality rate was decreased with the duration of gestation and the weight of babies at term. Also, the mortality rate of babies born at ob-stetrics clinics of the faculty was less than those born at home or brought from other hospitals in or out of Konya. According to the clinical evaluation, the primary causes of death vere found to be respira-tory distress syndronw, anoxic birth and sepsis. Our finclings are discussed with those of literature.

Aim: This study aimed to evaluate vitamin D levels, which were determined over a year in the pediatric
clinic of a training and research hospital in Central Anatolia, according to age groups, gender, and
seasonal characteristics.
Patients and Methods: This retrospective study was conducted using the data of children aged 0–18
years who applied to the children’s clinic of a hospital between January 2019 and December 2019 and
whose vitamin D levels were determined. Children were divided into five different age groups, 28 days–12
months, 13 months–2 years, 2–5 years, 6–11 years, and 12–18 years, in accordance with Standard 6
recommendations. Vitamin D levels were evaluated in terms of age group, gender, and admission season.
Results: A total of 9496 children, 5360 (56.4%) females and 4136 (43.6%) males, were included in the
study. A 25(OH)D level below 20 ng/mL (representing a deficiency) was found in 6472 (68.2%) of the
participants, while 2085 (21.9%) participants had a 25(OH)D level between 21–29 ng/mL (representing an
insufficiency) and 939 (9.9%) participants had a 25(OH)D level over 30 ng/mL (representing sufficiency).
It was determined that vitamin D levels are lower in girls than in boys, vitamin D levels are inversely
proportional to age, and vitamin D levels reach their lowest values in winter and highest values in summer.
The effects of age group, gender, and season of admission on vitamin D levels were statistically significant
(P < 0.001).
Conclusion: The mean vitamin D levels for all age groups were either insufficient or deficient. Vitamin D
levels in children aged 0–18 is related to age, gender, and season. Necessary measures should be taken,
especially for at-risk groups, to prevent vitamin D deficiency or insuf ficiency.

Acute pancreatitis is an important cause of acute abdominal pain in children and requires prompt treatment because it may become life-threatening. The incidence of acute pediatric pancreatitis is increasing. Although epidemiology of acute pancreatitis, clinical manifestations and acute pancreatitis course in children are generally different than in adults, information about etiology, management and results are obtained on the basis of adult studies. In most cases, inflammation may limit itself, but in some cases acute pancreatitis, acute recurrent pancreatitis or chronic pancreatitis may progress. It is necessary to provide optimal management in the acute period of pancreatitis in children, as this may prevent secondary conplications. In this review we summarise the epidemiology of acute pancreatitis, role of imaging and imaging findings in the diagnosis of acute pancreatitis, treatment methods and management and complications of acute pancreatitis.

Anorectal malformations occur in an average of 4000-5000 newborns and are more common in males (1). Congenital malformations of the anus, rectum, and urogenital system were often found together. imperforate antisla, enteric urinary fistulas, renal agenesis, irritable-theropelvic obstruction. iireterovesical darhk. The association of structural genitourinary anomalies such as and-zicoureteral reflux, cryptorchidism, ectopic mourning deferens and hypospadias is well known (2, 3). These pathologies are usually detected by pediatric surgeons. However, urologists play the main role in the diagnosis and treatment of these complex and difficult-to-solve clinical problems. Appropriate treatment: depends on the knowledge of normal and abnormal embryology, the presentation of clinical problems associated with these disorders, and the implementation of diagnostic studies that will determine the exact pathology (4).

Ketamine has been applied in children in dif-ferent doses and ways for patients. Ketamine was given to the first group in dose 4 mglkg and to the second group in dose 6 mglkg mixed in 0.2 mlik-g cola 20 minutes before induction of anesthesia.,Ke-tamine was tolerated well in both groups. Sedation was evaluated according to Wilton's sedation scales. Five minutes after premedication there was no sta-tistical difference in sedation scores (p>0.05). But in the period 10., 15. and 20. minutes after pre-medication significant statistical difference was oh-served in the scores of awake, calm and asleep si-tuation (p<0_05). The second group tolerated the mask better than the first. As a complication nis-tagmus, tongue fasciculation, increase in oral sec-reafion were noticed during the procedure_ As a result oral ketamine in dose 6 mglkg was found preferable due to sedation, reaction to mask, I.V. catheter application and causing the similar complication as comparated with oral ketamine in doses, 4 mg/ k g

Hirschsprung's Disease (111-1) is functional intestinal obstruction with still blurred etiology. Although cases of this disease were published before, the Danish pediatrician Hirschspring said in 1886, with clinical and autopsy findings of the two cases he followed, that the disease may be a congenital malformation. For this reason, the disease was named after him in the following years.