Vitamin D Levels in Children With Recurrent Aphthous Stomatitis

Background: Recurrent aphthous stomatitis is one of the most prevalent oral mucosa diseases and the etiology is unclear. As a potent anti-inflammatory and immunomodulating agent, vitamin D can significantly affect oral cavity homeostasis. However, to the best of our knowledge, no study has been conducted in pediatric population on the potential role of vitamin D in recurrent aphthous stomatitis to date. The aim of the present study is to determine the vitamin D status in recurrent aphthous stomatitis in children. Methods: This study is conducted retrospectively. Seventy-two patients with minor recurrent aphthous stomatitis and 70 age-matched healthy controls included in the study. 25-Hydroxyvitamin D levels were measured in all patients using enzyme immunoassay. Results: Serum vitamin D levels were 16.4 (8.6) ng/mL in patient group and 23.1 (11.5) ng/mL in healthy controls. There was a statistically significant difference between the groups in terms of serum vitamin D levels (P= .002). There was no significant correlation between serum vitamin D levels and the severity of the recurrent aphthous stomatitis (r= 0.54,P= .76). Conclusions: Our study showed a significant difference in vitamin D levels between patients with recurrent aphthous stomatitis and the healthy control group. We also found no correlation between vitamin D status and the severity of the disease

Assessment of sleep in children with periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome

Background. Periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) syndrome is the most common cause of periodic fever in childhood. This study aimed to investigate sleep patterns and possible factors that are associated with sleep disturbances among children with PFAPA syndrome. Methods. Sixty-two patients with PFAPA and 68 age and sex matched healthy controls were enrolled in the study. Patients who had an attack during the former 2 weeks were not included. Demographic and anthropometric data, duration of fever episodes, laboratory results, and clinical manifestations of patients were recorded. The Children's Sleep Habits Questionnaire was administered. Results. The total sleep scores of patients with PFAPA were significantly higher than the control group (49.6 +/- 10.7 vs. 38.3 +/- 7.5, p = 0.002 ). Children with PFAPA had significantly higher scores regarding sleep-onset delay, sleep anxiety and night wakening (p=0.003, p=0.007, and p=0.014, respectively). Total sleep durations were similar between children with PFAPA and the control group. There was a significant positive correlation between the total sleep score and disease duration (r=0.425, p=0.002). Also there was a significant positive correlation between disease duration and sleep onset delay (r=0.561, p<0.001) and night wakening (r=0.327, p=0.003). Conclusion. This study showed for the first time that patients with PFAPA have significantly disturbed sleep when compared to otherwise normal children. This study emphasized the need to assess sleep problems in children with PFAP

Knowledge and Attitudes of Mothers About Breastfeeding During COVID-19 Infection

Amaç: Bu çalışmanın amacı; Tekirdağ bölgesinde yaşayan COVID-19 aile içi yüksek riskli teması olan veya kesin laboratuvar tanısı konmuş emziren annelerin, pandemi döneminde anne sütü ve emzirme ile ilgili bilgi ve tutumları hakkında bilgi edinmektir.Materyal ve Metot: Çalışmada, Tekirdağ il sınırları içinde ikamet etmekte olan ve COVID-19 enfeksiyonu tanısı alan kişi ile ev içi yakın temas öyküsü olan ya da kendisi laboratuvar ile kanıtlanmış, minimal semptom gösteren ve evde tedavi edilen COVID-19 (+) hasta olan 30 gün-6 ay arası bebeği olan annelerin iletişim bilgilerine Namık Kemal Üniversitesi Tıp Fakültesi Hastanesi ve Çocuk Sağlığı İzlemPolikliniği kayıtlarından ulaşılarak, araştırmaya dahil olmayı kabul eden gönüllülere telefon yoluyla demografik verileri içeren ve bu süreçteki emzirme deneyim ve tutumlarını inceleyen bir anket uygulanmıştır. Çalışma kriterlerine uygun 31 anneye ulaşılmış ve bunlardan 28 anne çalışmaya katılmayı kabul etmiştir. Tüm çalışma grubuna ulaşıldıktan sonra anket verileri toplanarak demografik özellikleri ve COVID-19 sürecinde emzirme deneyimleri, bilgi kaynakları ve bu süreçteki tutumları IBM SPSS 20.0 paket programı kullanılarak işlenmiş ve p <0.05 istatistiksel anlamlılık düzeyi olarak kabul edilmiştir.Bulgular: Araştırmaya katılan annelerin 11'i (%39.3) ev içi yakın temaslı olup, 17 (%60.7) anne laboratuvar testleri ile kesin COVID-19 tanısı konmuş, hafif klinik bulguları olan ve evde tedavi edilen kişilerdir. Temaslı ve hasta grupta annelerin emzirme deneyimleri sorgulandığında, temaslı olan annelerin %54.5'inin bebeklerini sadece anne sütü ile beslediği, %36.4'ünün ise anne sütü yanında formül mama da kullandığı görülmüştür. Ancak hasta olup evde tedavi almakta olan grupta, annelerin %35.3'nün bebeklerini sadece formül mama ile beslemeyi tercih ettikleri, sadece %17.6'sının bebeklerini tek başına anne sütü ile beslediği görülmüştür. Bulgularımıza göre hasta olan annelerin bebeklerini daha yüksek oranda formül mama ile besledikleri ve bebekleri ile farklı odayı paylaşma eğiliminde oldukları görülmüştür.Sonuç: COVID-19 tedavisi sırasında emzirmenin sürdürülmesi konusunda gereken özen gösterilmelidir. Araştırmamızın sonuçlarına göre bu açıdan ailelerin bilgilendirilmesi önem taşımaktadır.Aim: The aim of this study is; to obtain information about the knowledge and attitudes of mothers who live in Tekirdağ region with high risk contact of COVID-19 in family or who have been diagnosed with a definite laboratory finding of COVID-19 about breastfeeding during the COVID-19 pandemic period. Materials and Methods: Mothers with COVID-19 high risk contact in the family and have been diagnosed with definite laboratory findings of COVID-19 who are living in Tekirdağ and having a baby between 30 days and 6 months were included in the study. The records of the patients were obtained from Namık Kemal University Medical School, Pediatric Outpatient Clinic Well Child Unit and a questionnaire was applied to the volunteers who accepted to be included in the study. 31 mothers who met the study criteria were reached and 28 of them agreed to participate in the study. After reaching the whole study group, the survey data were collected and their demographic characteristics and breastfeeding experiences, information sources and attitudes during the COVID-19 process were processed using IBM SPSS 20.0 package program and p <0.05 was accepted as the statistical significance level. Results: Of the mothers participating in the study, 11 (39.3%) were in high risk contact at home, 17 (60.7%) mothers were definitively diagnosed with COVID-19 by laboratory tests, had mild clinical findings and were treated at home. When the breastfeeding experiences of the mothers were questioned, it was observed that 54.5% of the mothers who were in high risk contact only fed their babies with breast milk, and 36.4% used formula in addition to breast milk. However, 35.3% of the mothers preferred to feed their babies only with formula, in the group that was sick and receiving treatment at home, only 17.6% of them fed their babies with breast milk alone. According to our findings, it was observed that mothers who were sick fed their babies with formula at a higher rate and tended to share a different room with their babies. Conclusion: Care should be taken to maintain breastfeeding during treatment for COVID-19. According to the results of our research, it is important to inform families in this regard

Akut Bronşiolit Tanılı İnfantlarda Ortalama Platelet Hacmi, İkisi Arasında Bir Korelasyon Var Mı?

Aim: Acute bronchiolitis is the most common lowerrespiratory tract infection of children younger than 2 years ofage. There aren't any standardized diagnostic criteria andseverity assessment classifications for acute bronchiolitisavailable in literature. Mean platelet volume (MPV) has shownto be effected in inflammatory conditions and to ourknowledge there's only one recent study in children with acutebronchiolitis that demonstrated an association between MPVchange and acute brınchiolitis.Materials and Methods: In this retrospective study weenrolled 555 children diagnosed with Acute bronchiolitis and516 healthy infants with a matching age and sex.Results: MPV levels were found significantly higher in patientgroup (8,2 ± 0,8 fL) than the control group (7,9 ± 0,8 fL). Interms of hospitalization need, no significant difference wasdetected between the MPV values of the hospitalized groupand the outpatients (8,3±0,8 fL; 8,2±0.7 fL, respectively).Conclusions: In conclusion, our data show that MPV valuesare significantly elevated in acute bronchiolitis compared tohealthy infants. However, MPV can't be used as a guidance inattack severity nor can it predict hospitalization and systemicsteroid need.Amaç: Akut bronşiolit, 2 yaşından küçük çocuklarda en sık görülen alt solunum yolu enfeksiyonudur. Literatürde akut bronşiolit için standart tanı kriterleri ve şiddet değerlendirme sınıflamaları mevcut değildir. Ortalama platelet hacminin (MPV) lokal inflamasyondan etkilendiği gösterilmiştir ve akut bronşiolit ile MPV ilişkisini gösteren tek bir çalışma bulunmaktadır. Materyal ve Metot: Bu çalışmada MPV ile akut bronşiyolit arasındaki ilişkiyi belirlemeyi amaçladık, ayrıca hastalığın şiddetini değerlendirmede yararlı bir belirteç olup olmadığını araştırdık. Bu retrospektif çalışmada akut bronşiolitis tanısı alan 555 çocuğa ve eşleştirilmiş yaş ve cinsiyete sahip 516 sağlıklı bebek çalışma grubuna dahil edilmiştir. Bulgular: MPV düzeyleri hasta grubunda (8,2 ± 0,8 fL) kontrol grubuna (7,9 ± 0,8 fL) göre anlamlı olarak yüksek bulundu. Hastaneye yatış açısından hastaneye yatırılan grup ve poliklinik hastalarının MPV değerleri arasında anlamlı bir fark saptanmamıştır (sırası ile, 8,3 ± 0,8 fL; 8,2 ± 0,7 fL) Sonuç: Sonuç olarak, verilerimiz, akut bronşiolit varlığında MPV değerlerinin sağlıklı bebeklere göre anlamlı derecede yükseldiğini göstermektedir. Bununla birlikte, MPV atak şiddetinde bir rehber olarak kullanılamaz ve hastaneye yatışı ve sistemik steroid ihtiyacını tahmin edemez

EVALUATİON OF SKİN PRİCK TEST RESULTS OF PATİENTS WİTH ALLERGİC RHİNİTİS LİVİNG İN TEKİRDAĞ

Allerjik rinit, görülme sıklığı giderek artan çocukluk çağının en sık allerjik solunum yolu hastalığıdır. Allerjen dağılımı coğrafi bölge ve hastalığın başlama yaşı ile değişiklik göstermektedir. Bu çalışmada Tekirdağ bölgesinde yaşayan allerjik rinit tanılı hastalarda allerjen dağılımının belirlenmesi hedeflenmiştir.Allergic rhinitis is the most prevalent chronic disease of childhood with an increasing prevalence. Allergen distribution changes with geographic region and starting age of the disease. In this study we aim to determine the allergen distribution in patients with allergic rhinitis living in Tekirdağ

Evaluation Of Skin Prick Test Results of Patients With Allergic Rhinitis Living in Tekirdağ

Aim:Allergic rhinitis is the most prevalent chronic disease of childhood with an increasing prevalence. Allergen distribution changes with geographic region and starting age of the disease. In this study we aim to determine the allergen distribution in patients with allergic rhinitis living in Tekirdağ.Material and Methods:We performed skin prick test to 78 (32 girls, 46 boys) patients with allergic rhinitis aged between 4-14 years old admitted to Namık Kemal University. Patients with asthma and atopic dermatitis were excluded.Results:We found sensitivity to at least one allergen in 31 (39,7%) patients. 16 (51,6%) patients had sensitivity to only one allergen. However, 15 (48,4%) patients had sensitivity to more than one allergen. The most sensitive group found was house dust mites with 18(58%) patients. 10 (32,25%) patients had sensitivity to weeds, 8 (25,8%) patients to tree pollens, 7 (22,5%) patients to molds, 2 (6,4%) patients to cats and 1 (3,2%) patient to foods.Conclusion:We found that the most sensitive allergens were house dust mites and tree pollens in our clinic. These findings were consistent with literature. Allergen sensitivity may change with geographic region and socio-economic status. To our knowledge this is the first study conducted in Tekirdağ, so our research may be used as a source in future studies

Evaluation of Allergen Sensitization in Patients with Allergic Rhinitis and/or Asthma in Tekirdag

Aim: Allergic rhinitis (AR) and asthma are the most prevalent allergic diseases, and environmental allergens are important factors in the pathogenesis and the exacerbation of these diseases. Although there are many studies investigating aeroallergen sensitivities in different regions of our country, this study aimed to identify the aeroallergen sensitization in the Tekirdag province in the part of Turkey in Europe, namely Thrace, where it is important to know aeroallergen sensitivities. Materials and Methods: Four hundred and sixty children with asthma and AR who were followed up and had at least one aeroallergen sensitivity in a skin prick test (SPT) were retrospectively evaluated. All patients had undergone a SPT using the standard extracts, including house dust mites, molds, animal dander, pollens, and latex. Results: The mean age of the patients was 10.2 +/- 3.4 (5-18) years, 57.6% of them were male. The diagnoses of the patients were AR in 57.8%, asthma in 22.6% and both in 19.6%. 42.6% (n=196) of the patients were sensitized to more than one allergen. The most common aeroallergens in SPT were house dust mites (63%), grass-rye mix (26.5%), grass mix (26.1%), molds (19.8%), cat epithelium (11.3%), cockroach (8.5%), weed mix (7%), olive tree (7%), dog (5.7%), cupressus (4.3%), tree pollen mix (3.5%), poplar (1.5%), mugwort (1.3%), and latex (0.4%). Although the cockroach, pet, olive tree and multiple allergen sensitivities were more frequent among male children (p0.05). House dust mites were the most common allergens throughout all seasons. Conclusion: The results of this study will be important in guiding elimination measures against the triggering allergens which are important for the treatment and the course of the disease of the those patients with asthma and/or AR in this region

Indirect Benefits of Vaccines

Aşı programları, aşı ile önlenebilir hedef bulaşıcı hastalığı önlemek ve bu hastalığa bağlı oluşabilecek komplikasyon ve ölümleriengellemeyi amaçlar. Bununla beraber, aşı uygulamalarının yaygınlaşması ile toplumda hedef patojeni bulaştırma potansiyeli olanbireylerin sayısı azalır, böylece aşılanmamış bireylerin hastalık etkeni ile teması azalır ve bu bireylerde dolaylı yoldan korunmuş olur.Ayrıca aşıların, toplumdaki genel morbidite ve ölüm oranları üzerine hedef hastalığın önlenmesi ile açıklanamayacak olan ikincil olumluetkileride bulunmaktadır. Aşı uygulamalarına bağlı oluşan ikincil etkiler son yıllarda araştırmacıların daha fazla ilgisini çekmeyebaşlamıştır. Aşı uygulamalarına dair ikincil etkileri belirleyebilmek için doğru, açık ve standart gözlem metotları uygulanmalıdır.Epidemiyolojik sürveyans, hastalığın yükünün belirlenmesi, hedef grupların ortaya çıkarılması ve bağışıklama programlarının etkisininbelirlenmesi için dikkatle yürütülmelidir. Bu sayede bir ülkenin ulusal bağışıklama programı belirlenirken basit ve kanıta dayalı bilgilerlehareket edilebilir.Vaccination programs aim to prevent the target infectious disease and also prevent complications and mortality related to this disease. However, with the widespread use of vaccines, the number of individuals with the potential to infect the pathogen in the community decreases, so that the contact of the non-vaccinated individuals with the pathogen decreases, and these individuals are protected indirectly. In addition, vaccines have secondary positive effects on overall morbidity and mortality rates in the community, which cannot be explained by the prevention of target disease. Secondary effects due to vaccine applications have attracted more attention from researchers in recent years. Accurate, clear, and standard observation methods should be applied to identify secondary effects on vaccine applications. Epidemiological surveillance should be carried out carefully to determine the burden of the disease, to reveal target groups and to determine the effect of immunization programs. In this way, it is possible to act with simple and evidence-based information when determining a national immunization program

Effect of Fluid Supplementation on Serum Bilirubin Level During Phototherapy of Exclusively Breastfed Term Infants with Hyperbilirubinemia

Aim:This study compared the rates of decrease in serum bilirubin levels in severely jaundiced healthy term infants given oral or intravenous fluid supplementation during phototherapy.Materials and Methods:A randomized controlled study was carried out in the neonatal intensive care unit of Zeynep Kamil Maternity and Children Training and Research Hospital (Istanbul, Turkey) over a 4-month period. Fifty healthy term infants with hyperbilirubinemia were randomized to receive either solely breastmilk (n=25) or both breastmilk and intravenous fluid (n=25) during phototherapy.Results:There were no significant differences (p>0.05) in the mean birth weight, mean gestastional age, modes of delivery, mean time of admission age, mean serum osmolality, and hematocrit and reticulocyte count between the two groups. Similarly, there was no significant difference (p>0.05) in the mean indirect serum bilirubin level at the time of admission to the neonatal intensive care unit and at 4, 8, 12, 24, and 48 hours after commencement of phototherapy between the two groups. There was no significant difference (p>0.05) in the mean duration of phototherapy or in the median duration of hospitalization between the two groups.Conclusion:Based on our results, intravenous fluid support has no effect on the rate of decrease in serum bilirubin and decrease in duration of phototherapy in healthy term newborns with no dehydration. However, using the oral route avoided the need for intravenous cannula and their attendant complications. Insensible fluid loss is increased during phototherapy, so protection of hydration status with oral feeding is important for newborns

Acute Facial Paralysis Due to EBV Infection

Ebstein Barr virüs (EBV) Herpes-viridae ailesinin bir üyesidir. EBV enfeksiyonu seyrinde üst solunum yolu enfeksiyonu bulguları ile birlikte asemptomatik karaciğer enzimlerinde yükselme sıklıkla izlenmekle birlikte akut fasiyal paralizi oldukça nadir görülmektedir. Burada sekiz yaşında EBV enfeksiyonuna bağlı akut fasiyal paralizi olgusu sunulmuştur. Semptomatik tedavi ile birlikte hasta kortikosteroid ve antiviral tedavi ile sekelsiz iyileşmiş ve herhangi bir komplikasyon gelişmemiştir. Hekimler EBV’ye bağlı gelişen enfeksiyöz mononükleoz seyri sırasında üst solunum yolu enfeksiyonları dışında fasiyal paralizi gibi nörolojik komplikasyonların da gelişebileceğini ve hastaların yakından takip edilmesi gerektiğini akılda bulundurmalıdır.Ebstein Barr virus (EBV) is a member of Herpes-viridae. Altough elevations of liver enzymes and upper respiratory tract infection findings is commonly seen during the EBV infection, acute facial paralysis is rare complication. Here, we report acute facial paralysis associated with EBV infection in an eight years old girl. With symptomatic treatment, the patient recovered without cure with corticosteroids and antiviral therapy and no complications developed. Physicians should keep in mind that neurological complications, such as facial paralysis, other than upper respiratory tract infections, may develop during infectious mononucleosis due to EBV and that patients should be followed closely