Scorpion Sting in Pregnancy

Akrep sokması sonrasında hafif yerel bulgulardan yaşamı tehdit edebilecek ağır sistemik bulgulara kadar değişebilenklinik seyir gözlenebilir. Bu olgu sunumumuzda, literatürde kısıtlı bilgiye sahip olduğumuz ve çocuk acillerde nadirkarşılaştığımız akrep sokması sonrası çocuk acile başvuran bir gebede ve fetüste akrep toksininin etkilerini tartışmayıamaçladık. Olgumuz 17 yaşında 35 gestasyonel hafta+1 günlük gebe akrep sokması sonrasında acile başvurdu. Yerelbulgu dışında belirti ve bulgusu olmayan hasta, herhangi bir tedavi verilmeden yakın izlendi. Hastada ve fetusta yirmidört saatte herhangi bir bulgu gelişmemesi üzerine önerilerle taburcu edildi.Sonuç olarak, akrep sokması farklı klinik bulgularla acile başvurabilir. Tedaviyi düzenlerken akrep antiserumunun yanetkileri de düşünülerek hareket edilmeli, hastanın kliniğine göre karar verilmelidir. Gebelikte akrep sokmasıyla ilgili sınırlı bilgiye sahip olduğumuz için gebe hasta grubunda hem anne, hem fetus göz önüne alınarak tedavi seçenekleri değerlendirilmelidir CAYD 2015;2(1):41-44.Scorpion stings are rarely encountered in the pediatric emergency department. Post-sting clinical manifestations range from mild localized skin erythema to life-threatening systemic reaction. We present a case ofscorpion sting in a 17 years old, 35 weeks +1 day pregnant female evaluated in our emergency department. The patient presented to our emergency department with localized skin irritation at the site of the sting. No symptoms of systemic involvement were noted in the ED and the patient was admitted to the hospital for further evaluation. No anti-venom was administered during hospitalization and the patient was discharged home in good condition and no adverse e?ects were noted on the unborn fetus. Conclusion: In pregnant patients with scorpion sting and localized skin irritation following scorpion sting anti-venom may be safely withheld. Decisions regarding the use of anti-venom in pregnant women should be carefully considered given the limited information on the safety pr

KLİNİĞİMİZE BAŞVURAN MOL GEBELİK OLGULARININ RETROSPEKTİF İNCELENMESİ: 5 YILLIK KLİNİK DENEYİM

Aim: In this study, we aimed to determine the incidence of gestational trophoblastic disease by using data of patients who were treated for molar pregnancies. Material and methods: . The patients diagnosed as gestational trophoblastic disease between January 2009- January 2014 was evaluated retrospectively. Patients’ age, gravidity, parity and aborts were noted. Patients’ history, ultrasonographic findings, β HCG and laboratory results, hystopathology findings, treatment modalities and β HCG for following-up were recorded. Results: The incidence of molar pregnancy was found as 8 per 1000 deliveries. The mean age of patients was 28.72 ±7,5 and mean gestastional week was 10±2,4. β HCG values was found between 240 and 145100. Out of all patients, 20 (33.3%) had ultrasonographic signs of molar pregnancy. Pathology results revealed partial mole in 45 (75%), complete mole in 12 (20%) patients and choriocarcinoma in 3 (5%) patients. No mortality related to disease and complications was observe

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

Neuropsychiatric involvement in juvenile-onset systemic lupus erythematosus: A multicenter study

Introduction: Neuropsychiatric (NP) involvement is a restricted area in juvenile-onset systemic lupus erythematosus (jSLE). Aim: To investigate the prevalence, demographic and clinical features, and outcomes of the neurological involvement in the Turkish jSLE population. Methods: This study was based upon 24 referral centers’ SLE cohorts, multicenter and multidisciplinary network in Turkey. Patient data were collected by a case report form which was standardized for NP definitions according to American Collage of Rheumatology (ACR). Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) neuropsychiatric part was used to determine NP damage. Variables were evaluated Ward's hierarchical clustering analyses, univariate, and multivariate logistic regression analyses. Results: A hundred forty-nine of 1107 jSLE patients had NP involvement (13.5%). The most common NPSLE findings were headache (50.3%), seizure (38.3%), and acute confusional state (33.6%). Five clusters were identified with all clinical and laboratory findings. The first two clusters involved neuropathies, demyelinating diseases, aseptic meningitis, and movement disorder. Cluster 3 involved headache, activity markers and other SLE involvements. Idiopathic intracranial hypertension, cerebrovascular disease, cognitive dysfunction, psychiatric disorders and SLE antibodies were in the fourth, and acute confusional state was in the fifth cluster. In multivariate analysis, APA positivity; OR: 2.820, (%95CI: 1.002–7.939), P: 0,050, plasmapheresis; OR: 13.804 (%95CI: 2.785–68.432), P: 0,001, SLEDAI scores; OR: 1.115 (%95CI: (1.049–1.186), P: 0,001 were associated with increased risk for neurologic sequelae. Conclusion: We detected the prevalence of juvenile NPSLE manifestations in Turkey. We have identified five clusters that may shed light pathogenesis, treatment and prognosis of NP involvements. We also determined risk factors of neurological sequelae. Our study showed that new definitions NP involvements and sequelae for childhood period are needed