Vitamin D Deficiency in Children and Adolescents

Objective Vitamin D deficiency is an important health problem in both developed and developing countries. Recent reports on the extraskeletal effects of vitamin D have led to increased interest in prevalence studies on states of deficiency/insufficiency of vitamin D. The aim of this study was to determine the frequency of vitamin D deficiency and insufficiency in children and adolescents residing in Ankara, Turkey and to investigate the factors associated with low vitamin D status

Congenital asymmetric crying face: a case report

Congenital asymmetric crying face is an anomalia caused by unilateral absence or weakness of depressor anguli oris muscle The major finding of the disease is the absence or weakness in the outer and lower movement of the commissure during crying. The other expression muscles are normal and the face is symmetric at rest. The asymmetry in congenital asymmetric crying face is most evident during infancy but decreases by age. Congenital asymmetric crying face can be associated with cervicofacial, musclebone, respiratory, genitourinary and central nervous system anomalia. It is diagnosed by physical examination. This paper presents a six days old infant with Congenital asymmetric crying face and discusses the case in terms of diagnosis and disease features

The Significance of Lung Ultrasonography in Children with COVID-19

Introduction:The infection of new Coronavirus disease-2019 (COVID-19) continues to affect both adults and children worldwide. Although there are studies of adult patients with COVID-19 that defined ultrasound findings, there is limited data available on the diagnostic use of ultrasonography in children. This study is aimed to evaluate the results of bedside lung ultrasonography (LUS) performed in pediatric patients with COVID-19.Methods:The study included pediatric patients who were diagnosed with COVID-19. All lung areas were visualized on LUS and evaluated together with demographic, clinical, and laboratory data, and chest X-ray (CXR) findings.Results:An evaluation was made of 102 pediatric patients, comprising 54 girls and 48 boys with a mean age of 9.65±4.78 (min 35 days-max 17) years. Forty-six percent of the patients had respiratory system symptoms, 36% were asymptomatic, and 18% had symptoms other than in the respiratory system. Pathologic findings were determined on CXR in 36% of patients, and on LUS in 57%. The difference in the detection rate of pathologic findings between LUS and CXR was statistically significant (p=0.001). Pathology was observed on LUS in 29 of 65 patients with normal CXR. The sensitivity rate for detecting pathology in patients with respiratory symptoms was 49% on CXR and 77% on LUS (p=0.001).Conclusion:We determined that the sensitivity of LUS is higher than CXR in demonstrating lung involvement in patients with COVID-19 with respiratory symptoms. LUS may be helpful in the evaluation of pediatric patients with COVID-19 but more studies are needed to prove its feasibility in children

Atypical Papular Purpuric Eruption Induced by Parvovirus B19 Infection

Parvovirus B19 infection’s most common dermatological manifestation is erythema infectiosum as also known the fifth disease. Rare clinical presentations of parvovirus B 19 like papulopurpuric gloves and socks syndrome and acropetechial syndrome has also been described re­cently. This study presents report of a case with atypical feature and distribution of rash due to parvovirus B19 in­fection. We want to emphasize that pediatricians should consider parvovirus B19 infection of any patient who has leukopenia presenting with petechial/purpuric eruption of an unclear origin

The Effect of Carbon Monoxide Poisoning on Platelet Volume in Children

Introduction: Carbon monoxide poisoning is one of the most important causes of morbidity and mortality. There is increasing evidence supporting the important role of mean platelet volume (MPV) as a marker of hypoxia and inflammation. In this study, we aimed to determine changes in MPV values in pediatric patients with carbon monoxide poisoning. Methods: We retrospectively evaluated children who were diagnosed with carbon monoxide poisoning in our hospital between January 2005 and 2014.\ud Results: We included 228 children with carbon monoxide poisoning (49% male) in this retrospective, controlled study. The mean age of the patients was 88±56 months. Control group consisted of 200 age-matched healthy children. There was no statistically significant difference in MPV levels between the study and control groups (8.43±1.1 fL and 8.26±0.7 fL, respectively). No correlation of MPV and platelet count with carboxyhemoglobin (COHb) was found. Conclusion: In our study, it was determined that MPV value was not a helpful parameter for predicting the diagnosis of acute carbon monoxide poisoning in childhood. The difference between the MPV values and the lack of significance and the absence of correlation between MPV value and COHb level led to the fact that MPV was not a guide indicating the clinical severity of the condition

Resistance of group A beta Haemolytic streptococcus isolated from children with tonsillopharyngitis against commonly used antibiotics

Objectives: We aimed to assess the antimicrobial susceptibility (penicillin, amoxicillin-clavulanate, amoxicillin and azithromycin), of A group beta haemolytic streptococci (AGBHS) isolated from children with tonsillopharyngitis.Materials and methods: AGBHS were isolated from throat swaps cultures according to CLSI criteria from children aged 5 to 15 years who applied to the Pediatric outpatient policlinics with complaints of high fever, sore throat and difficulty in swallowing. Antimicrobial susceptibilities were assessed. Susceptibilities of isolates to penicillin, amoxicillin-clavulanate, amoxicillin and azithromycin were determined by disk diffusion method.Results: AGBHS were isolated from 216 (26,3%) of 821 of throat swaps cultures samples. Amoxicillin-clavulanate was found to be the most sensitive antibiotic with a sensitivity of 99,5%, which was followed by amoxicillin (95,8%), penicillin (95,3%), and azithromycin (78,7%) (p<0.05). However, 21.3% percent of the bacteria were found to be resistant to azithromycin.Conclusion: Amoxicillin-clavulanate was found to be the most sensitive antibiotic, and AGBHS isolates were found to be highly resistant to azithromycin. The resistance to azithromycin can be decreased by preventing unnecessary use of this antibiotic in children with tonsillopharyngitis

The skills of defibrillation practice and certified life-support training in the healthcare providers in Turkey.

Aim of the study Successful cardiopulmonary resuscitation and early defibrillation are critical in survival after in- or out-of-hospital cardiopulmonary arrest. The scope of this multi-centre study is to (a) assess skills of paediatric healthcare providers (HCPs) concerning two domains: (1) recognising rhythm abnormalities and (2) the use of defibrillator devices, and (b) to evaluate the impact of certified basic-life-support (BLS) and advanced-life-support (ALS) training to offer solutions for quality of improvement in several paediatric emergency cares and intensive care settings of Turkey. Methods This cross-sectional and multi-centre survey study included several paediatric emergency care and intensive care settings from different regions of Turkey. Results A total of 716 HCPs participated in the study (physicians: 69.4%, healthcare staff: 30.6%). The median age was 29 (27-33) years. Certified BLS-ALS training was received in 61% (n = 303/497) of the physicians and 45.2% (n = 99/219) of the non-physician healthcare staff (P < .001). The length of professional experience had favourable outcome towards an increased self-confidence in the physicians (P < .01, P < .001). Both physicians and non-physician healthcare staff improved their theoretical knowledge in the practice of synchronised cardioversion defibrillation (P < .001, P < .001). Non-certified healthcare providers were less likely to manage the initial doses of synchronised cardioversion and defibrillation: the correct responses remained at 32.5% and 9.2% for synchronised cardioversion and 44.8% and 16.7% for defibrillation in the physicians and healthcare staff, respectively. The indications for defibrillation were correctly answered in the physicians who had acquired a certificate of BLS-ALS training (P = .047, P = .003). Conclusions The professional experience is significant in the correct use of a defibrillator and related procedures. Given the importance of early defibrillation in survival, the importance and proper use of defibrillators should be emphasised in Certified BLS-ALS programmes. Certified BLS-ALS programmes increase the level of knowledge and self-confidence towards synchronised cardioversion-defibrillation procedures