Vitamin D levels in children with sleep terror: Analytical cross-sectional study

Objective: This study aimed to investigate 25(OH) vitamin D levels in children with sleep terror compared to those in normal controls.Materials and Methods: In this study, we enrolled 81 children diagnosed with sleep terrors and 81 normal control children of similar ages. We analyzed plasma 25(OH) vitamin D, calcium, phosphorus, alkaline phosphatase, and parathyroid hormone levels. Levels of 25(OH) vitamin D less than 20 ng/ml were interpreted as representing vitamin D deficiency, while levels of 20-30 ng/ml indicated vitamin D insufficiency.Results: The mean serum 25(OH) vitamin D level of children with sleep terror was 23.29 +/- 10.39 ng/ml, which was significantly lower than in the control group at 29.07 +/- 8.32 ng/ml (p<0.001). Children with sleep terror with frequent attacks had lower 25(OH) vitamin D levels than those without frequent attacks (p<0.001).Conclusion: This study demonstrated a greater prevalence of vitamin D deficiency or insufficiency among children with sleep terror. We now need further studies with larger series investigating the effect of vitamin D replacement on sleep terror

A Case of Carbon Monoxide Poisoning in which the Diagnosis was Rejected by the Family

Karbonmonoksit (CO) renksiz, kokusuz, tatsız ve irritan olmayan bir gaz olması nedeniyle zehirlenildiğinin fark edilmesi oldukça zordur. İstatistikler, ülkemizde CO zehirlenmesi ve buna bağlı ölümlerin en çok ısınma amaçlı kullanılan sobalardan kaynaklandığını göstermektedir. Bulantı, baş ağrısı ve sersemlik hissinden, komaya kadar değişen klinik görünümü olabilir. Bu çalışmada, iki kez aynı tabloda acil servisimize başvuran, CO zehirlenmesi düşünülen, temas öyküsü olmayan, tüm aile fertlerinin de farkında olmadan etkilendiği bir olgu sunulmuştur.It is very difficult to recognize carbon monoxide (CO) poisoning since CO is a colorless, odorless, tasteless, and non-irritating gas. Statistical data indicates that CO poisoning and related deaths in Turkey are mostly caused by coal burning stoves used for heating. There are a wide variety of clinical features, ranging from nausea, headache and dizziness to coma. In this study, we present a case of poisoning in a patient who attended the emergency department twice with the same clinical signs. The patient was considered to have CO poisoning, had no anamnesis of exposure, and all family members were affected without being aware of it

Uncontrolled Agitation and Flushed Face Due to Tropicamide: A Missed Diagnosis

Introduction: Topical ophthalmic drugs that are not used in appropriate doses may lead to overdose symptoms. Case Report: A 2-month-old boy presented to the emergency department with extreme agitation, flushed face, mydriasis, cataract in the left eye, dry oral mucosa, spasticity in all extremities, and wheezing. It was learned that the patient had been receiving eye drops containing tropicamide at repeated doses before ophthalmologic evaluation. Pheniramine maleate and methylprednisolone were given to counter the drug-related side-effects or allergic reactions to the eye drop. At the follow-up, his symptoms and findings had become exacerbated, and he was admitted to the pediatric intensive care unit due to shock and drug-related anticholinergic toxicity. Conclusion: This case illustrates the importance of recognizing toxidromes at differential diagnosis and is the first reported pediatric case with tropicamide-induced anticholinergic syndrome

Knowledge and Attitudes of Parents Regarding Fever in Children

Amaç: Ateş çoğu kez ciddi bir hastalık belirtisi olmamasına rağmen, aileleri kaygılandıran ve çocuk acil birimlerine sıklıkla başvuruya neden olan bir yakınmadır. Doğal bir savunma düzeneği olduğu sağlık çalışanlarınca bilindiği halde, ailelerin ateş düşürücü ilaç kullanımına erken ve sık başvurduğu görülmektedir. Bu çalışma üçüncü basamak çocuk acil birimimize ateş yakınmasıyla getirilen hastaların ebeveynlerinin konu ile ilgili bilgi düzeyi, tutum ve davranışlarını belirleyen tanımlayıcı bir çalışmadır.Yöntemler: Ateş yakınmasıyla getirilen çocukların ebeveynlerine araştırmanın amacı ile ilgili bilgi aktarılıp, yüzyüze görüşme yapılarak 22 soruluk anket formu uygulanmıştır. Bulgular: Çalışmamıza %91'i anne olmak üzere 200 ebeveyn katıldı. Hastalarımızın %73'ü sadece ateş yakınması ile başvurdu. %36'sının başvuru sırasında >38 °C vücut sıcaklığı olduğu görüldü. Ebeveynlerin %58 ateşi >38 °C olarak tanımladığı, %47,5'inin ise ateşi ölçerek belirlediği, %84,5'inin evinde ateş ölçer bulundurduğu, %62,5'inin ateş hakkında bilgiyi sağlık personelinden aldığı görüldü. Ebeveynlerin eğitim düzeyinden bağımsız olarak %83,5 oranında hekim önerisiyle doğru dozlarda ilaç uyguladıkları belirlendi. Sonuç: Önceki çalışmalara göre ateş ile ilgili ebeveynlerin bilgi ve hekim ile iletişim aşamasında ılımlı düzeyde iyileşme olduğu düşüncesine varılmıştır. Ailelerde ateş varlığında panik hali, kaygı duygusu ve yanlış uygulamaların devam ettiği görülmüştür. Bu nedenle de kapsamlı aile eğitimlerinin olması gerektiği ve süreğen eğitim ile ateşli çocuğun yönetiminin geliştirilebileceği, acil birimlerine başvuruların azaltılabileceği kanaatine varılmıştır.Introduction: Although fever is mostly not a sign of a serious disease, it causes concern in parents as well as frequent admissions to pediatric emergency units. Healthcare professionals are aware that fever is a natural defense system of the body, however, most families administer antipyretics early and frequently. The present study was performed as a descriptive study to demonstrate the level of knowledge, attitudes and behavior patterns regarding fever among the parents of patients brought to our tertiary care pediatric emergency unit with the complaint of fever. Methods: The researchers approached parents in the emergency department and informed them about the study. A 22-item questionnaire was given to the parents. Results: A total of 200 parents participated in the study and 91% of them were mothers. 73% of patients presented to the emergency department with the only complaint of fever. At admission, 36% of patients were found to have a body temperature of >38 °C. 58% of parents reported a temperature of >38 °C to define fever. 47.5% of parents determined fever by measurement and 84.5% of them reported having temperature measurement device in their house. 62.5% of participants stated that they have acquired knowledge about fever from health professionals. The majority of parents (83.5%), independent from their educational level, were using antipyretics with a right dose and interval based on healthcare professionals' recommendations. Conclusion: Compared to the previous studies, a moderate improvement was noted in the parents' knowledge of fever and their communications with the physicians. However, parents still continued to experience a state of panic and anxiety, and to perform incorrect interventions. There is still a need for comprehensive family educations, and continuous education may improve the management of children suffering from fever and reduce the number of emergency department admissions

Epidemiological, Clinical, and Laboratory Features of Children With COVID-19 in Turkey

Objectives: The aim of this study is to identify the epidemiological, clinical, and laboratory features of coronavirus disease 2019 (COVID-19) in children