Decreased Vitamin B12 Levels in Children with Nocturnal Enuresis

Objectives. Nocturnal enuresis is a common pediatric problem, the etiology of which is unclear. In the present study, vitamin B12 and folate levels were measured in children with nocturnal enuresis and compared with those in healthy control group children to investigate whether there was any relation with enuresis and neurogenic maturation as a first time in the literature. Methods. In this cross-sectional study, we included thirty children (16 girls, 14 boys) who had presented with primary nocturnal enuresis (PNE) complaints in the study group and 31 children (13 girls, 18 boys) in the control group. Body weight and height measurements were obtained and complete blood counts and vitamin B12 and folate levels were measured in all children. Results. No difference was found in age, height, and weight between study and control groups. Also the mean levels of the hemoglobin, hematocrit, and mean corpuscular volume (MCV) were not different between the two groups. Significantly lower mean vitamin B12 and folate levels were found in the enuresis group compared with the control group. Conclusions. Further studies are needed to clarify B12 and folate deficiency in larger series so that these tests can be included in routine investigations of enuretic children

An overlooked association of brachial plexus palsy: Diaphragmatic paralysis

Diaphragmatic paralysis in newborns is related to brachial plexus palsy. It can be overlooked if thorough examination isn't done. We present a two-weeks-old baby with a birth weight of 3800 grams who had a left-sided brachial plexus palsy and torticollis with an undiagnosed left diaphragmatic paralysis even though he was examined by different physicians several times. The role of physical examination, the chest x-rays of patients with brachial paralysis and the treatment modalities of diaphragmatic paralysis due to obstetrical factors are discussed

Eosinophilic leukemoid reaction in a male adolescent with Löeffler syndrome

The Löeffler syndrome is characterized by pulmonary infiltrates on a chest x-ray accompanied with peripheral eosinophilia. In this article, we have highlighted the Löeffler syndrome complicated with a eosinophilic leukemoid reaction in a previously healthy boy. The patient was treated with albendazole for five days, with a successful result. In countries where parasitic diseases are endemic, the Löeffler syndrome must always be considered in patients who present with a eosinophilic leukemoid reaction

Anesthesia for a patient with Fanconi anemia for developmental dislocation of the hip: a case report

Fanconi anemia is a rare autosomal recessive inherited bone marrow failure syndrome with congenital and hematological abnormalities. Literature regarding the anesthetic management in these patients is limited. A management of a developmental dislocation of the hip was described in a patient with fanconi anemia. Because of the heterogeneous nature, a patient with fanconi anemia should be established thorough preoperative evaluation in order to diagnose on clinical features. In conclusion, we preferred caudal anesthesia in this patient with fanconi anemia without thrombocytopenia, because of avoiding from N2O, reducing amount of anesthetic, existing microcephaly, hypothyroidism and elevated liver enzymes, providing postoperative analgesia, and reducing amount of analgesic used postoperatively

Prevalence and associated factors of day wetting and combined day and night wetting

Background: This study was conducted to determine the prevalence of diurnal enuresis ( DE) and its association with background variables among children aged 5-15 years living in Sivas and Kahramanmaras, Turkey. Methods: The parents of 1,760 children voluntarily completed a questionnaire consisting of 42 items under supervision of a researcher. Results: Overall, the reported prevalence of DE was 4.2%, with a tendency to decrease with increasing age and with no difference between genders. Smoking during pregnancy, delayed initiation and dealing with the child by punishment in toilet training, urination frequency, urgency, soiling, arousal difficulty, urinary infection history, lower school performance, poor social adaptation, wetting history in the family, were all significantly prevalent among diurnal enuretics (p 0.05). 63.9% of all parents reported some level of concern about the wetting problem and 51.7% of the diurnal enuretics had previously visited a physician. Conclusions: The prevalence of DE in our sample is not too different from the prevalence rates reported previously from Turkey and other countries. This type of enuresis seems to be more associated with an organic neurological or urological disorder than is nocturnal enuresis. Copyright (c) 2008 S. Karger AG, Basel

Craniosynostosis Associated With La�Cunar Skull: Three-Dimensional Com�Puted Tomography Features

Craniosynostosis is the premature closure of the cranial sutures. We present the radiological findings of a six-month old case who presented with small head and frontal triangular shape and who was found to have generalized pitting and softness on palpation of the head. The three-dimensional images computed tomography (CT) showed a sagittal, coronal and metopic suture synostosis with exaggerated convolutional markings in the form of lacunar skull. This case report showed that patients with craniosynostosis should be evaluated by three-dimensional images C

Successful Treatment With Enoxaparin of Glans Ischemia Due to Local Anesthesia After Circumcision

The severe ischemia or necrosis of the glans penis is a rarely seen complication after circumcision. We report the case of a 7-year-old boy with severe glans penis ischemia occurring 24 hours after circumcision with local anesthesia (0.1% xylocaine containing ephedrine). His hemogram and levels of proteins C and S and fibrinogen were normal, but the D-dimer level was higher than normal (2.57 mg/L; normal level 0-0.5 mg/L). Normal blood flow was indicated on color Doppler ultrasonography. The severe ischemia in the glans penis was successfully treated with subcutaneous injection of enoxaparin (low-molecular-weight heparin) for 5 days, and the appearance of the glans was close to normal on the fifth day. The patient did not require any surgical intervention and was discharged without sequelae. As a result, we consider that ischemia of the glans penis may initially be managed with enoxaparin, especially in cases in which the D-dimer level is higher than normal. Pediatrics 2013; 131: e608-e61

Oxidative stress and antioxidant status in neonatal hyperbilirubinemia

Conclusions: In this sample, infants with significant hyperbilirubinemia had elevated oxidative stress and disturbed antioxidant enzyme activity. Since these states have been shown to cause cellular injury in neonatal patients with indirect hyperbilirubinemia, such patients should be followed-up and undergo therapy to prevent the harmful effects of hyperbilirubinemia. Further Studies are needed to investigate possible benefits of antioxidants in hyperbilirubinemia

Respiratory Syncytial Virus Infection Outbreak Among Pediatric Patients With Oncologic Diseases and/or BMT

Background: Respiratory syncytial virus (RSV) has been reported to cause severe morbidity and mortality among cancer patients receiving chemotherapy with or without autologous/allogeneic hematopoetic stem cell transplantation (HSCT). There have been few reports describing the outcome of RSV infection specifically among pediatric oncology patients. Methods: Two RSV infection outbreaks developed between February-April 2006 and January-March 2009 in hospitalized pediatric patients for various hemato-oncological diseases HSCT A survey of respiratory viruses was done using direct immunofluorescent antibody assay from nasopharyngeal washing aspirate. Results: In two RSV infection outbreaks (2006 and 2009), RSV antigen was detected in 6/30 patients. Five of six patients with RSV antigen were all treated with 0.2-0.4 g/kg intravenous immune globulin (IVIG) and specific antiviral therapy, oral ribavirin (20-25 mg/kg/day in three doses). Five patients recovered fully, although two were retreated due to recurrent (+) RSV antigen and respiratory symptoms within 2 weeks. We did not give oral ribavirin to one patient with (+) RSV antigen due to mild symptoms. All patients are alive and well. Conclusions: In contrast with the outcome of RSV infection in adult oncology patients, the mortality associated with RSV infection in pediatric oncology patients even in post bone marrow transplantation (BMT) period, is low when diagnosed and treated early enough. Oral ribavirin might be an option together with IVIG in the treatment of RSV especially when other forms of antivirals could not be obtained. This approach will make it possible to give the scheduled anti-neoplastic therapy on time. Pediatr ulmonol. 2010;45:307-311. (C) 2010 Wiley-Liss, Inc