Assesment of Upper Gastrointestinal Bleeding in the Pediatric Emergency Department

Introduction:Upper gastrointestinal bleeding is an important emergency problem that can occur at any age in childhood and requires urgent treatment for the underlying cause. Etiological causes of gastrointestinal bleeding vary by age and geographic region. In this study; we aimed to investigate the demographic characteristics, etiological causes, endoscopic intervention results, and the relationship between analgesic/antipyretic drug use and bleeding in patients admitted to the pediatric emergency department with upper gastrointestinal bleeding.Methods:The records of patients aged 1 month to 18 years who presented to our pediatric emergency department with upper gastrointestinal bleeding between January 2017 and 2019 were retrospectively reviewed. Demographic features, complaints at admission, etiological reasons, endoscopy findings, diagnoses, and antipyretic/analgesic drug use were recorded.Results:There were 108 patients presenting with upper gastrointestinal bleeding, and 53.7% of the patients were male. The mean age was 76.7±58.3 months. Hematemesis was present in 100 patients. Symptoms of the patients; vomiting was present in 82.4%, upper respiratory tract infection in 36.1%, fever in 29.6%, and abdominal pain in 25.9%. There were 52 patients with a history of antipyretic and/or analgesic drug use. An endoscopic examination was performed in 74 patients. In patients who underwent endoscopic examination; pathological changes were detected in 26 of 32 patients who used drugs and 30 of 42 patients who did not use drugs.Conclusion:In patients presenting to the pediatric emergency department with upper gastrointestinal bleeding, the bleeding is usually acute and self-limiting, but requires prompt diagnosis and treatment. Approximately half of the patients in our study had a history of antipyretic/analgesic drug use in etiology. When the endoscopic findings of drug users and non-users were compared, no statistically significant difference was observed in terms of pathological findings

The Effect of Intramuscular Onusetron Treatment on Prognosis in Patients Diagnosed with Acute Gastroenteritis

Introduction:Vomiting is an important symptom that limits oral intake and may result in hospitalizations and prolonged hospital stays for intravenous fluid therapy. In our study, we aimed to compare the rates of hospital revisit and hospitalization due to vomiting within seven days of admission in children with acute gastroenteritis in two groups who received and did not receive intramuscular ondansetron.Methods:Files of patients aged 6 months-15 years (without dehydration) diagnosed with acute gastroenteritis (ICD A09) in our pediatric emergency clinic between December 2015-February 2016 (non-ondansetron period) and December 2019-February 2020 (intramuscular ondansetron period) were analyzed retrospectively. The patients included in the study were evaluated in two groups, the first group receiving a single dose of intramuscular ondansetron and the second group not receiving ondansetron treatment. Our primary aim was to determine the rates of readmission and hospitalization in the first 7 days of both groupsResults:It was determined that 21% of the patients who received ondansetron and 28% of the group who did not receive ondansetron were admitted to the emergency department due to vomiting in the first 7 days. In comparison of both groups, 5% of group I patients and 13% of group II patients needed intravenous fluids (odds ratio =0.3; 95% confidence interval =0.19-0.59) at repeated admission and required hospitalization in the emergency department.Conclusion:Intramuscular ondansetron treatment reduces the rate of hospital readmission, hospitalization and intravenous fluid requirement during re-admission in children with acute gastroenteritis with vomiting

Covid-19 Vaccine Acceptance Among Parents: Are They Willing to Vaccinate Their Children?

Purpose: The aim of this study was to evaluate the willingness of parents to allow their children to receive a COVID-19 vaccine and the factors affecting the decision. Materials and Methods: This study was conducted as a prospective, cross-sectional and descriptive survey study. A survey consisting of questions about the COVID-19 vaccination was conducted with parents. Results: The study included 592 parents, 180 (30.4%) male, and the mean age was 34.14±7.42 years. There were 257 (43.4%) parents would vaccinate their children. A high level of education of parents (p=0.022), a high monthly income of the family (p=0.006), and male gender (p=0.002) were associated with high willingness to vaccinate their children. Two hundred twenty two parents stated that their decision may change depending on whether the vaccine is of domestic or foreign origin, and 215 (96.85%) of them stated that they would prefer domestic vaccines. The most frequent reasons for vaccine hesitancy or refusal to their children were: fear of possible side effects and it being a foreign vaccine. Conclusion: The hesitancy or refusal of parents to vaccinate their children with the COVID-19 vaccine is high. Public health authorities should inform the public about the importance of vaccination and domestic vaccine production should be encouraged

In a real-life setting, direct-acting antivirals to people who inject drugs with chronic hepatitis c in Turkey

Background: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. Methods: We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis

Determination of environmental stressors perceived by patients hospitalized in the coronary intensive care unit

Hastaneye yatma süreci çoğu birey için stres yaratan bir durumdur. Bu tanımlayıcı çalışma, koroner yoğun bakım ünitesinde yatan hastaların algıladıkları çevresel stresörlerin belirlenmesi amacıyla 01.08.2019-01.12.2019 tarihleri arasında Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi koroner yoğun bakım ünitesinde yatan 315 hasta üzerinde yapıldı. Örnekleme, 18-75 yaş arası, yoğun bakım ünitesinde 24-72 saat yatan, iletişim sorunu olmayan ve araştırmaya katılmayı gönüllü olarak kabul eden hastalar da?hil edildi. Veri toplamak için, araştırmacı tarafından literatür taraması ile hazırlanan "Hasta Tanıtım Formu" ve Türkiye'de geçerlik ve güvenirlik çalışması ASLAN (2010) tarafından yapılmış olan "Yoğun Bakım Ünitesinde Çevresel Stresörler Ölçeği" (YBÜÇSÖ) kullanıldı. Verilerin analizi, tanımlayıcı istatistikler, Mann Whitney U testi, Kruskall Wallis testi, Pearson Ki Kare ve Fisher Kesin Ki Kare Testi kullanılarak yapıldı. Analiz sonuçları p<0.05 anlamlılık düzeyinde yorumlandı. Araştırmanın sonucunda, Yoğun Bakım Ünitesinde Çevresel Stresörler Ölçeği'nden alınan puan ortalaması 56,33±12,09 olarak bulunmuştur. Çalışmamızda hastaların en çok etkilendiği 5 stresör sırasıyla; "Eşini Özlemek", "Sürekli Tavana Bakmak", "Sıkılmak", "Aile ve Arkadaşlarını Günde Sadece Birkaç Dakika Görmek" ve "Uyuyamamak"tır. Hastaların en az etkilendikleri 5 stresör ise sırasıyla; "Hemşirelerin Yatağınızın Etrafında Sürekli Bir Şeyler Yapmaları", "Sık Sık Tansiyon Ölçülmesi", "Doktor ve Hemşireler Tarafından Sık Aralıklarla Fiziksel Muayene Yapılması", "Telefon Sesini Duymak", "Hemşirelerin Makineleri, Sizi İzlediklerinden Daha Yakından İzlemesi"dir. Hastalara ait "Cinsiyet", "Eğitim Durumu", "Medeni Durum", "Şu Anki Hastalık" ve "Daha Önce Yoğun Bakımda Yatma" değişkenlerinin, Yoğun Bakım Ünitesinde Çevresel Stresörler Ölçeği puanını, anlamlı düzeyde etkilediği tespit edildi.Hospitalization process is a stressful situation for most individuals. This descriptive study was performed on 315 patients hospitalized in the coronary intensive care unit of Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital between 01.08.2019 and 01.12.2019 in order to determine the environmental stressors perceived by patients hospitalized in the coronary intensive care unit. Patients who were between the ages of 18 and 75, stayed in the intensive care unit for 24 to 72 hours, had no communication problems and voluntarily agreed to participate in the research were included in research sample. In order to collect data, "Patient Identification Form" prepared by the researcher through literature review and the "Intensive Care Unit Environmental Stressor Scale" (ICUESS), the validity and reliability study of which was carried out in Turkey by ASLAN (2010), were used. Data analysis was made by means of descriptive statistics, Mann Whitney U test, Kruskall Wallis test, Pearson Chi-squared test and Fisher Exact Chi-Square Test. Analysis results were interpreted at p<0.05 significance level. As a result of the research, the mean score obtained from the Intensive Care Unit Environmental Stressor Scale was found to be 56,33±12,09. In our study, the 5 stressors that the patients were affected at most were "Missing your husband or wife", "Staring at the Ceiling", "Being bored", "Only seeing family and friends for a few minutes each day" and "Not being able to sleep", respectively. The 5 stressors that the patients were affected at the least were "Having nurses constantly doing things around your bed", "Having your BP taken often", "Frequent physical exams by doctors and nurses", "Hearing the telephone ring" and "Feeling nurses are watching the machines closer than watching you", respectively. It was determined that the variables of "Sex", "Educational Status", "Marital Status", "The Present Illness" and "Previously Stay in the Intensive Care Unit" for the patients had a significant effect on the score of the Intensive Care Unit Environmental Stressor Scale

Koroner Yoğun Bakım Ünitesinde Yatan Hastaların Algıladıkları Çevresel Stresörlerin Belirlenmesi

Amaç: Bu araştırma, koroner yoğun bakım ünitesinde yatan hastaların algıladıkları çevresel stresörlerin belirlenmesi amacıyla yapılmıştır. Yöntem: Tanımlayıcı tipteki bu çalışma, bir hastanenin koroner yoğun bakım ünitesinde yatan 315 hasta üzerinde 01.08.2019- 01.12.2019 tarihleri arasında yapıldı. Veri toplamak için, Hasta Tanıtım Formu ve Yoğun Bakım Ünitesinde Çevresel Stresörler Ölçeği (YBÜÇSÖ) kullanıldı. Veriler; SPSS 22.0 programı kullanılarak analiz edildi. Analiz sonuçları p<0.05 anlamlılık düzeyinde yorumlandı. Bulgular: Hastaların YBÜÇSÖ’den aldıkları puan ortalaması 56.33±12.09 idi. Kadın hastalar, ortaokul mezunu olanlar, evli hastalar ve daha önce yoğun bakımda tedavi görmüş olanlar, yoğun bakımdaki stresörlerden, istatistiksel olarak anlamlı düzeyde daha çok etkilenmişti (p<0.05). Periferik arter hastalığı olan hastalar, miyokard infarktüsü ve aritmi tanılı hastalardan, koroner arter hastalığı olanlar aritmi tanılı hastalardan, istatistiksel olarak anlamlı düzeyde daha düşük puanlar almıştı (p<0.05). Sonuç: Koroner yoğun bakım ünitesinde yatan hastalar, yoğun bakımdaki çevresel stresörlerden belirli düzeylerde etkilenmişti. Hastaların bazı sosyodemografik ve klinik özellikleri; çevresel stresörleri algılama durumları üzerinde etkiliydi. Çevresel stresörlerin, hastalara ilişkin sosyodemografik ve klinik özellikler ışığında alınacak tedbirlerle kontrol altına alınması, bu süreçte standart bakım planlarının uygulanması yerine, bireye özgü bakım yaklaşımının uygulanması önerilmektedir

Effect of Cup Feeding and Bottle Feeding on Breastfeeding in Late Preterm Infants

Background: Cup feeding has been used as an alternative feeding method for preterm infants

Effect of Cup Feeding and Bottle Feeding on Breastfeeding in Late Preterm Infants: A Randomized Controlled Study

Background: Cup feeding has been used as an alternative feeding method for preterm infants