An overview of the health status of Syrian refugee children in a tertiary hospital in Turkey

Objective: Migration is a problem affecting all family members, but particularly children. Child refugees are the highest risk group for the health systems of receiving countries. We investigated the health of 104 Syrian child refugees presenting to a tertiary hospital in Turkey. Settings and Design: A retrospective study was conducted in the pediatric clinic. Materials and Methods: The medical files of Syrian refugee children (0–18 years) presenting to Adiyaman University Hospital, Pediatric Clinic between 01 and 30 November 2015, were investigated. Demographic data, body measurements, and laboratory results obtained from patients' medical records were evaluated. Results: Mean age of patients was 53.5 ± 49.6 (2–198) months; 63 were male and 41 were female. Seventy-two patients (69.2%) were under 5 years of age. Weight in 20 patients (19.2%), height in 33 (31.7%), head circumference in 2 (1.9%), and body mass index in 7 (6.7%) were below the third percentile. All patients with body weight below the third percentile had chronic malnutrition. Anemia was present in 35 (50%) of the 70 patients for whom complete blood count data were available. Conclusion: Health workers involved with Syrian refugee children must consider the two preventable conditions; malnutrition and anemia

An Evaluation of Factors Influencing the Use of Child Car Safety Seats and Safety Belts By Families Presenting to the Pediatric Emergency Department

Introduction: In-car safety precautions are the most important means of protecting children against traffic accident-related death and injury. The purpose of this study was to perform an evaluation of the use of child car seats and safety belts by families presenting to the pediatric emergency department in the province of Adıyaman. Methods: A questionnaire concerning child car seat and safety belt use was administered to the parents of 200 patients presenting to the pediatric emergency department. Those with child safety seats were classified as group 1 and those without as group 2. Results: One hundred-two (51%) of the 200 patients given the questionnaire were included in the study, 38 (37.3%) in group 1 and 64 (62.7) in group 2. The mean age of the parents (mother or father) completing the questionnaire in groups 1 and 2 was 30.2±6 and 35.6±7.8, respectively (p<0.001). The rate of having a child car seat increased in line with the number of children in the family (r=0.381 and p<0.001), use of safety belts when traveling in the vehicle (r=0.286 and p<0.001), awareness of the legal obligation concerning the use of child seats (r=0.342 and p<0.001) and the age of the parents completing the questionnaire (r=0.364 and p<0.001). Conclusion: The levels of child seat and safety belt use in subjects presenting to our hospital emergency department were quite low. This is due to the fact that families do not have enough knowledge of the safety of their children. In this regard, we believe that family trainings to be made by health workers will be the most effective factor in increasing these rates. In addition, reduction of tax on safety equipment can contribute to the increase in the frequency of their use

Hemochromatosis Presenting with Ascites in a Newborn Infant

Background: Although the incidence of neonatal hemochromatosis (NH) is not known exactly, it is one of the causes of acute liver failure in the newborns. NH is a rare iron metabolism disease characterized by excessive iron accumulation in the tissues that onsets in-utero. Here, a patient diagnosed with NH who developed ascites while investigating the etiology of cholestasis has been presented. Case report: A 35-week-old premature female baby was referred us to investigate the etiology of cholestasis. She had a sibling who died at 34 days of age due to liver failure. Abdominal examination revealed a palpable liver 4 cm from the costal margin. On laboratory, aspartate transaminase was 111 U/L (range 9-80), alanine transaminase 62 U/L (range 8-32), total bilirubin 12.6 mg/dL, and direct bilirubin 5 mg/dL. Prothrombin time was 18.4 sec (range 10-14) and INR 1.86 (range 0.8-1.2). Magnetic resonance imaging revealed a diffuse reduction in liver density due to iron accumulation. Focal iron accumulation consistent with NH was observed in hepatocytes in liver biopsy. In the clinical follow-up, the patient developed abdominal distension. Abdominal ultrasonography showed excessive fluid accumulation in the abdominal cavity. Following intravenous immunoglobulin (1g/kg, single dose) and antioxidant cocktail, her abdominal distension subsided and liver function tests regressed. The patient has been discharged on the postnatal 67th day with planned liver transplantation. Conclusion: Neonatal hemochromatosis should definitely be kept in mind in newborns with hepatic failure. As seen in this case, NH should also be considered in the differential diagnosis of ascites in newborn infants