Makale Arama

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.

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.

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. 

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

 Moyamoya disease is an entity, which is caused by obstruction or stenosis in the area between the internal carotid artery, and anterior and middle cerebral arteries, identified angiographically, and does not have an exactly known etiology. The most frequent symptoms of onset are hemorrhage in adults and ischemia in children. In this paper, we present a case of Moyamoya disease which was diagnosed with a 21 year old male patient who was admitted to our emergency department with headache, nausea vomiting and left hemiparasi complaints and whose radiological findings showed right basal ganglia hemorrhage.

\r\n Colloid cysts are rare benign tumors of the third ventricle and have a wide range of clinical representations from incidentomas to acute death.  The growth of these cysts is an uncommon event and may cause obstructive hydrocephalus that lead to sudden deterioration in the patient's condition and may cause life-threatening complications. The large colloid cyst of third ventricle caused sudden death of children due to clogging, diagnosed in vivo is a very rare case in literature. We are representing here a case which patient admitted to emergency room for sudden loss of consciousness. Even he had urgent ventriculostomy due to acute hydrocephalus development, brain death has occured because of 3rd ventricle colloid cyst.

Iron is a medication that is used more in iron deficiency anemia. The use of iron in high doses can cause a multisystemic effect. The toxicity of iron depends upon the amount of elemental iron ingested. The minimum toxic dose and the lethal doses of iron are not firmly established. However, side effects that may be life-threatening are seen on the heart and liver. This paper presents a 16-year-old patient who used 720 mg; 12mg / kg / dose preparation of iron for suicide purposes. The control blood tests performed while planning the discharge of the patient, who had no complaints but were followed up clinically, continued to be followed up because of the increase in the value of troponin. The patient who has no record of physical examination, electrocardiogram (ECG), echocardiography (ECO) and indication for iron chelation and in whose troponin level a decrease was diagnosed in the monitoring was discharged with recommendations. Due to the rare occurrence of cardiac involvement and being the first case reported in our country, the effects of the drug on toxicity were discussed in the light of the literature.

\r\n PURPOSE
\r\n             The aim of this study is to analyze if there were any factors that would indicate the diagnosis of dilating vesicoureteric reflux (VUR) (≥ grade 3) in the second voiding cystourethrogam (VCUG) of children with a normal first VCUG.

\r\n MATERIAL AND METHODS
\r\n             Patients who underwent VCUG between 2012 and 2017 were retrospectively reviewed. Within the cohort, patients who required more than one VCUG were abstracted and those with an abnormal first VCUG (VUR, posterior urethral valve, etc.) were excluded. Factors such as; age, gender, lower urinary tract dysfunction (LUTD), renal scarring, recurrent urinary tract infection, abnormal ultrasonography findings (bladder abnormalities/variable degrees of hydronephrosis), and technical problems (absence of voiding phase) were noted. Mann-Whitney U test was used for continuous variables whereas Chi Square test was used for categorical values.

\r\n RESULTS
\r\n             A total of 25 patients were found to have undergone more than 1 VCUG (19 girls, 6 boys; mean age 6 ± 3 years). Median time period between the two VCUGs were 12 months (range 1 – 72 months). VUR was detected in 11 patients, while dilating VUR was discovered in 7 patients. Among those, 6 patients were diagnosed with bilateral VUR. Recurrent UTI was found to be the only factor that would indicate dilating VUR in the second VCUG (p=0,049). Interestingly, no VUR was detected in cases that were performed after a first VCUG with inadequate technique. 

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\r\n CONCLUSION

\r\n             Recurrent UTI was shown to be the sole factor that would indicate the diagnosis of dilating VUR in the second VCUG. In our study, 28% patients with a normal first VCUG were shown to have dilating VUR in the second study. Therefore, in recurrent febrile UTI, second VCUG should be considered in patients with a normal previous imaging.
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Aim: Many scales have developed to assess daily living activities, clinical functions of patients with brachial plexus palsy. "Brachial Plexus Outcome Measure " was developed by Emily Ho in 2012, activity and self-rating substance scale consisting of components total 14 items. Aim of this study, make an inter-observer reliability of scale, to make clinical trial in patients.

Materials and Methods:Demographic and clinic datas recorded,"Brachial Plexus Outcome Measure " was applied by two different observers. Inter-observer reliability in items examined by using kappa statistic.

Results:Eighteen female (37.5%) totally 48 patients included. Mean inter-observer agreement in the items was almost perfect (kappa 0.93) in raters. Fitted statistics showed much variation in observers had moderate (kappa 0.57) agreement in items.

Conclusion: Between observes, “Brachial Plexus Outcome Measure” is reliable measurement for assessing functions in children with brachial plexus palsy in Turkey. Clinical usage is appropriate.

Aim: Executive function deficits are very common in attention deficit hyperactivity disorders (ADHD).
Recent studies suggest that common mechanisms in the pathophysiology of obesity and ADHD may be
related to impulse control and executive functions. This study aimed to compare the executive functions
and self-esteem levels of children and adolescents with ADHD with and without overweight/obesity. The
study also aimed to examine the relationships between overweight/obesity, executive functions, ADHD
and self-esteem in children and adolescents.
Patients and Method: Participants included 71 children/adolescents (mean age = 16.12±1.71; age range=
12-18 years; 71.83% males) with ADHD who applied to Gazi University Child and Adolescent Psychiatry
outpatient clinics between March 2021 and April 2022 and did not use any medication. Participants
completed the Executive Functions Behavior Evaluation Inventory Scale (parent form), Conners Parent
Rating Scale-Revised Short Form and Rosenberg Self-Esteem Scale .
Results: Results showed that hyperactivity symptoms and working memory function were significant
predictors of self-esteem in adolescents with ADHD. In addition, when adolescents with ADHD were
compared according to their overweight/obesity level, significant differences were found between the
groups in working memory and planning/organization functions. However, no difference was found
between the groups in terms of self-esteem and ADHD severity.
Conclusion: The findings suggest that working memory and hyperactivity symptom severity may play an
important role in understanding the self-esteem of adolescents with ADHD. While no difference was found
in terms of self-esteem and ADHD clinic in adolescents diagnosed with ADHD according to overweight/
obesity status, differences in working memory and planning/organization skills suggest that executive
functions play a critical role in overweight/obesity in ADHD.

Aim: Index of cardiac electrophysiological balance (iCEB), calculated as QT interval / QRS duration, has been described as a novel indicator for predicting malignant ventricular arrhythmias. Herein, we aimed to explore the relation of coronary collateral circulation (CCC) degree with iCEB and Tp-e / QT ratio.

Patients and Methods: Forty-four patients diagnosed with chronic total occlusion (CTO) and 55 healthy subjects in comparable age and sex distribution were included. We classified the CTO patients as good (n= 24) and poor (n= 20) collateral groups. Standard 12-lead standard electrocardiogram (ECG) of all patients was recorded and Tp-Te interval, QT interval, QRS duration, Tp-Te/QT ratio and QT/QRS ratio were measured.

Results: Mean Tp-e interval and Tp-e/QT ratio were similar between groups. Also, the groups were comparable regarding iCEB or iCEBc values. In subgroup analysis, there was no relationship between the degree of CCC and ECG parameters including Tp-e/QT ratio, Tp-e and QT/QRS ratio.

Conclusion: There was no significant relationship between the iCEB and Tp-e/QT ratio, and the degree of CCC development in patients having CTO.

\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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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.

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.

Aim: The aim of this study was to primarily investigate the effects of selected anesthesia method on anxiety, patient satisfaction and pain level in elective caesarean section, and secondarily obtain information about quality of service.

Materials and Methods: The study was carried out as a prospective questionnaire in the Department of Anaesthesiology and Reanimation the Meram Medical Faculty Hospital of Necmettin Erbakan University between June 2017 and August 2017, on 160 volunteers aged between 18 and 45 years for whom elective cesarean section under General Anesthesia (GA) or Spinal Anesthesia (SA) was planned. Demographic data of the patients such as age, place of residence, education level, number of children, and cesarean experiences were recorded. In the preoperative and postoperative period, anxiety levels were measured by State-Trait Anxiety Inventory (STAI-D), pain levels were measured by Visual Analog Scale (VAS) scores and satisfaction levels were evaluated at postoperative 6th and 24th hours by (Quality of Recovery: QoR 40 T) questionnaire.

Results: There was no statistically significant difference between the patients' preoperative and postoperative anxiety scores and demographic data (p> 0.05). Patients with previous cesarean experience had lower preoperative anxiety levels (p <0.05). The STAI-D scores and the numbers of patients with anxiety in the GA and SA groups were similar (p> 0.05).Postoperative anxiety levels were significantly lower in both groups than in the preoperative period (p <0.05). VAS values of the SA group at the 6th and 24th hours were significantly higher than the group treated with GA.(p<0.05). The 24th hour VAS values of the SA group were higher than the VAS values at the 6th hour (p <0.05). In the GA group, VAS values at 24th hour were lower than the VAS values at 6th hour (p <0.05). The satisfaction levels of general anesthesia and spinal anesthesia were similar in the postoperative period (p> 0.05). Complaint of headache was high in SA group while complaint of sore throat was high in GA group(p<0.05). While there was no correlation between anxiety level, VAS values and satisfaction level (p> 0.05), there was a negative correlation between VAS values and pain parameters, which are the subgroup of satisfaction questionnaire, in both groups (p <0.05).

Conclusion: It is concluded that the preferred anesthesia method in elective cesarean section has no effect on anxiety and satisfaction, and the patient satisfaction level and service quality will be improved by providing effective analgesia by reviewing our postoperative pain algorithm.

Aim: Forearm supination deformity is a serious sequela of brachial plexus birth palsy(BPBP) that affects
both functionality and apperance. In the early phase, soft tissue procedures are preferred whereas bone
procedures are preferred in the late phase. In this study, the techniques of forearm supination deformity
restoration and their results were evaluated.
Patients and Methods: Forty three children (mean age of 8.2 years) were included in the study. Eighteen
patients had soft tissue procedures and 25 patients had bone procedures. For soft tissue procedures, 14
patients had bracioradialis re-routing pronatorplasty and 4 patients had biceps re-routing procedures. For
bone procedures, 10 patients had radius rotation osteotomies, 11 patients had radial head excisions and
9 patients had distal radio-ulnar synostosis. Preoperative and postoperative active and passive forearm
supination and pronation degrees were measured goniometrically .
Results: The mean preoperative and postoperative active pronation degrees for brachioradialis re-routing
pronatorplasty and biceps re-routing changed from -32.8° to 30.7° and from -40° to 42.5° respectively.
The mean preoperative and postoperative active pronation degrees for radius rotation osteotomy, radial
head excision and distal radio-ulnar synostosis changed from -70° to -4° and from -53° to 43° and -80°
to -19° respectively .
Conclusion: Satisfactory functional and postural improvements may be obtained with palliative surgeries
that involve either the soft tissue or the bone in the setting of forearm supination deformities that are late
sequelae of BPBP.

Bezoars are concretions in the gastrointestinal tract that increase in size by continuous accumulation of non-absorbable food or fibers. Most bezoars in children are trichobezoars from swallowed hair from the dolls or brushers. Trichobezoars typically cause abdominal pain and nausia, but can also present as an asymptomatic abdominal mass, progressing to intestinal obstruction and perforation. It is predominantly found in emotionally disturbed or mentally retarded youngers. We report a case of an unusual giant trichobezoar in 8-year-old girl. It was not extracted endoscopically, because it was huge and passed into the duodenum. Attempts at dissolving the bezoar with enzymes (papain) or meat tenderizers have not been efficacious. The abdomen was explored through a supraumblical median incision, an approximately 15X3 cm trichobezoar in diameter was identified in 50 cm distance from ileocecal segment, and was removed. In addition, ischemic and rupture 10 cm jejunal segment was repaired. These two rupture segments were repaired using Heineke Mikulicz procedure.

Introduction: Circulating stem cells (CSCs) are released from bone marrow in to the circulation after myocardial injury to improve tissue repair. Radiofrequency ablation (RFA) of cardiac arrhythmias, particularly for atrial fibrillation, has been shown to trigger the release of CSCs through inflammatory mediators. We aimed to investigate whether CSCs are increased in the circulation following non-extensive ablation procedures such as slow pathway or accessory pathway ablations.

Methods: Twenty-six patients [13 females, 54 (18-74) years old] who underwent slow pathway ablation for atrioventricular nodal reentrant tachycardia (n=18) and accessory pathway ablation for atrioventricular reentrant tachycardia (n=8) were included. Peripheral blood CD34+ cell count and multiple serologic markers [troponin I (Tn-I), C-reactive protein (CRP), interleukin-6 (IL-6), stromal cell derived factor (SDF) 1 alpha] were evaluated before the ablation procedure and 7 and 30 days after the procedure.

Results: The CD34+ cell count was significantly increased on the 7^th day after the procedure when compared to baseline [33 (15-133) vs. 22,5 (5-79) cells per microliter respectively, P<0.001]. The CD34+ cell count was similar to baseline on the 30^th day following the procedure. Levels of Tn-I, CRP, IL-6 and SDF1-α did not change significantly following ablation. The amount of energy applied during RFA (watts) was significantly correlated with the 30^th day CD34+ cell count (r: 0.460; p= 0.018).

Conclusions: Peripheral blood CSCs are increased after slow pathway or accessory pathway ablations which are less extensive ablations compared to atrial fibrillation ablation. The levels return to baseline by the 30^th day following the procedure. The increase in CSCs was positively correlated with the amount of energy delivered during the procedure.

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.

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.

Context: Alcohol dependence syndrome is a major problem affecting both individuals and their family. Children of alcohol dependent parents are vulnerable to a host of behavioural problems. Studies in the west have shown both internalizing and externalizing symptoms in these children.

Aims: To assess the psychological functioning in offspring of alcohol dependent parents and its association with severity of alcohol dependence.

Settings and Design: This study was conducted at the Department of Psychiatry of a Tertiary hospital in Bangalore spanning a period of one year. Eighty children aged 11 years - 18 years, along with their alcohol dependent fathers were included.

Methods and Material: Socio demographic details of the parent and the child were collected by a semi structured Performa along with informed consent. Alcohol dependence was diagnosed based on ICD 10 criteria. Severity of Alcohol dependence was assessed using Severity of Alcohol Dependence Questionnaire (SADQ). Psychological functioning of the children was assessed using Youth Self Report Scale (YSR).

Statistical analysis used: descriptive statistics, and Chi-square test

Results: Among 80 children assessed 41 were males and 39 were females. 47.5% of them showed significant internalizing symptoms and 48.7% significant externalizing symptoms. Internalizing scores had higher correlation with girls (P – 0.004) and externalizing symptoms in boys (P – 0.008). However no correlation was found with severity of dependence in the father.

Conclusions: It was found that there was high prevalence of psychiatric morbidity in terms of externalizing and internalizing behaviours in children of alcohol dependent fathers. Thus early detection of these problems and intervention would ensure improved functioning in this group.

\r\n Autism spectrum disorder is a neuro-developmental disorder characterized by social interaction and communication, and restricted and repetitive behaviors. Autism is seen in nearly one of 68 children. The incidence is reported to increase, and the increase is suggested to arise from increased information, awareness and alterations in diagnostic criteria. However, environmental factors and their relationships to several unknown genetic factors are also considered to contribute to the increase. The assessment of whether environmental factors lead to risks for autism spectrum disorder in perinatal period, especially when children are exposed to these factors in a neurodevelopmentally important and fragile stage, is so important. It is reported that in pregnancy, there is an association between autism spectrum disorder, and exposure to such drugs as valporic acid, terbutaline and Selective Seratonin Reuptake Inhibitors.Exposure to heavy metals and pesticides increases the risk of autism spectrum disorder.Intense smoking, and alcohol consumption and drugsdisrupt neurodevelopmental process, Also, gestational diabetes may elavate the risk of autism spectrum disorder due to autoimmunal disorders, infections and inflammatory pocesse of prolonged fever. Migration, seasons and air pollution exposed in pregnancy are also reported to affect autism spectrum disorder risk. The awareness level between environmental factors and autism spectrum disorder should be increased among prospective mothers, and these mothers should be trained as to the risk factors. Because prospective mothers avoid these factors, or the elimination of these factors should be beneficial for reducing autism spectrum disorder risk, analyzing related studies and enlightening risk factors are especially important. Here, we aimed at revising recent studies related to prenatal factors from a holistic perspective.

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.

Objective: ıt was aimed to retrospectively evaluate the sociodemographic characteristics, anxiety and depression levels of adolescent mothers who were referred for marriage leave. Material and methods: 65 adolescent cases who became mother when they applied to the outpatient clinic for marriage permission between 2018-2020. Hospital records, sociodemographic data and edited forensic reports including psychiatric evaluations of the cases were reviewed retrospectively. In order to determine their depression and anxiety levels during the evaluation period, they were asked to fill in the anxiety and depression scale-revised self-report scale and kent e-g-y and porteus labyrinths intelligence tests applied by the psychologist were applied to evaluate the cognitive development.

Results: The mean age of the subjects included in the study was 16.33±0.307 years. It was determined that the mean age at which they were married unofficially was 15.44±0.499 years. It was observed that the average education period was 5.08±1.461 years. Before the unofficial marriage, 70.8% of the cases lived in the village and 29.2% in the city, after the marriage, 53.8% of the cases lived in the village and 46.2% in the city. It has been determined that 27.7% of unofficial marriages are consanguineous marriages. It was determined that the mean age of the children of the patients when they applied to the clinic was 4.05±3,701 months.

Conclusion: Girls who married early and gave birth before the age of 18, ıt reveals that their education period is short, their socioeconomic level is low, the age gap with their spouses is high, and their spouses' job opportunities are limited. The development of intervention programs and legal regulations aimed at preventing early marriages may contribute to the prevention of both adolescent marriages and the negative consequences of being an adolescent mother.

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.