Congenital asymmetric crying face: a case report

Congenital asymmetric crying face is an anomalia caused by unilateral absence or weakness of depressor anguli oris muscle The major finding of the disease is the absence or weakness in the outer and lower movement of the commissure during crying. The other expression muscles are normal and the face is symmetric at rest. The asymmetry in congenital asymmetric crying face is most evident during infancy but decreases by age. Congenital asymmetric crying face can be associated with cervicofacial, musclebone, respiratory, genitourinary and central nervous system anomalia. It is diagnosed by physical examination. This paper presents a six days old infant with Congenital asymmetric crying face and discusses the case in terms of diagnosis and disease features

Tiroid fonksiyonunun prematüre bebeklerde patent duktus arteriozus üzerine etkisi

Amaç: Patent duktus arteriyozus PDA ile konjenital hipotiroidi arasındaki ilişkinin araştırılmasıdır. Gereç ve Yöntem: Çalışmaya Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi Yenidoğan Ünitesinde Ocak 2015- Aralık 2017 tarihleri arasında yatan, doğumda gestasyon haftas

Comparison of Mortality and Morbidities in Small and Appropriate For Gestational Age Preterm Infants

Aim:To compare morbidity and mortality in very low birth weight premature infants (VLBW) with small (SGA) and appropriate (AGA) for gestational age.Materials and Methods:The records of infants with VLBW who were followed up in our unit between 2013 and 2017 were retrospectively analyzed. SGA was defined as the birth weight being below the 10th percentile compared to the gestational week and the AGA birth weight being between the 10th and 90th percentile. A total of 96 SGA infants were identified as the study group and 204 AGA infants randomly selected and matched with the gestational week of the study group. Infants with major congenital anomalies and lack of data were excluded from the study.Results:The mean gestational age (28.3 ± 1.1–28.3 ± 1.2, p = 0.94) and birth weight (769 ± 144–1132 ± 190 g, <0.001, respectively) were in the SGA and AGA group respectively. Preeclampsia and cesarean delivery were significantly more frequent in the SGA group, whereas APGAR score was lower and CRIB score was significantly higher. The frequency of surfactant requirement, moderate-severe bronchopulmonary dysplasia, spontaneous intestinal perforation, periventricular leukomalacia, premature osteopenia, postnatal growth retardation, mortality and feeding intolerance were found to be significantly higher in SGA infants. Similarly, the duration of invasive ventilation and additional oxygen requirement and hospital stay were longer in SGA infants.Conclusion:The birth of premature babies with low birth weight according to gestational age causes premature morbidity and mortality

A national survey and assesment for clinical ultrasound use of neonatal physicians in Turkey

Giriş: Türkiye’deki yenidoğan hekimlerinin klinik ultrasonografi (US) kullanımı, görüş ve deneyimleri hakkında bilgi bulunmamaktadır. Çalışmamızın amacı ülkemizdeki yenidoğan hekimlerinin klinik US kullanımı konusundaki, tutum, tercih, kullanım sıklığı ve bakış açılarının değerlendirilmesidir. Gereç ve Yöntem: Çalışma Türkiye’deki yenidoğan hekimlerinin anket yoluyla elektronik ortamda 01 Şubat-1 Mart 2020 tarihleri arasında katılımı ile gerçekleştirildi. Katılımcıların yaş, cinsiyet, görev yapılan sağlık kurumu, yenidoğan yoğun bakımdaki deneyim süresi ve akademik unvan bilgileri kaydedildi. Ankete katılan katılımcılara, klinikte US kullanıp kullanmadığı, kullanıyorsa hangi vücut bölgesi ve hangi girişim için kullandığı, bunun için eğitim alıp almadığı gibi sorular yöneltildi. Klinik US ile ilgili tutumları 5 noktalı Likert skalası ile değerlendirildi. Bulgular: Çalışmaya 120 yenidoğan hekimi katıldı. Katılımcıların yaş ortalaması 40,38±5,24 yıl olarak bulundu. Katılımcıların kliniklerinde %90 (n=108) oranında US cihazı bulunurken katılımcılar arasında US yapma sıklığı %69,1 (n=83) olarak tespit edildi. Klinikte US cihazı mevcudiyeti, kullanımı, klinik US eğitimine katılım, pediatrik radyoloji rotasyonunun yenidoğan yan dal eğitim programında yer alması, kranial US, abdominal US ve santral ven kateterizasyonu için US kullanımı konusunda akademik ünvana göre cevaplarda gruplar arası fark bulunmadı (p>0,05). Akciğer US kullanımı yan dal araştırma görevlisi grubunda (%86,7) diğer akademik ünvanlara oranla anlamlı olarak daha yüksek oranda bulundu (p0,05). Lung US use was found at a significantly higher rate in the neonatology fellows group (86.7%) compared to other academic titles (p<0.05). Conclusions: The study is the first national study in its field. It has been determined that US, which has an important role in the diagnosis, monitoring and treatment of the critically ill group in Turkey, is not used effectively by neonatal physicians

Resistance of group A beta Haemolytic streptococcus isolated from children with tonsillopharyngitis against commonly used antibiotics

Objectives: We aimed to assess the antimicrobial susceptibility (penicillin, amoxicillin-clavulanate, amoxicillin and azithromycin), of A group beta haemolytic streptococci (AGBHS) isolated from children with tonsillopharyngitis.Materials and methods: AGBHS were isolated from throat swaps cultures according to CLSI criteria from children aged 5 to 15 years who applied to the Pediatric outpatient policlinics with complaints of high fever, sore throat and difficulty in swallowing. Antimicrobial susceptibilities were assessed. Susceptibilities of isolates to penicillin, amoxicillin-clavulanate, amoxicillin and azithromycin were determined by disk diffusion method.Results: AGBHS were isolated from 216 (26,3%) of 821 of throat swaps cultures samples. Amoxicillin-clavulanate was found to be the most sensitive antibiotic with a sensitivity of 99,5%, which was followed by amoxicillin (95,8%), penicillin (95,3%), and azithromycin (78,7%) (p<0.05). However, 21.3% percent of the bacteria were found to be resistant to azithromycin.Conclusion: Amoxicillin-clavulanate was found to be the most sensitive antibiotic, and AGBHS isolates were found to be highly resistant to azithromycin. The resistance to azithromycin can be decreased by preventing unnecessary use of this antibiotic in children with tonsillopharyngitis

Clinical findings and treatment recommendations of hypernatremic dehydration due to breast milk

Objectives: In this study, we aimed to assess the inci-dence, presenting complaints, risk factors of hyperna-tremic dehydration (DH), and to stage the degree of hy-pernatremic DH among term, exclusively breast feedinginfants, and to suggest a therapy for hypernatremic DH.Methods: Term, exclusively breast feeding neonates ad-mitted to our neonatology policlinics, with a more than 7%weight loss, serum sodium concentrations of ≥147 mEq/Lwere allocated for the study. ‘Maternals and infants’ medi-cal history, examination, including presenting complaints,risk factors, stool- urine frequency, weight loss, the du-ration of the treatment, the rate of sodium decrease byhourly was calculated and recorded. Percentage of weightloss by taking into account, degree of DH (mild, moder-ate, severe) was created.Results: Dehydration were determined in 126 of 3642 pa-tients (3.5%). Patients were allocated as Group 1, mild DH(n=59, 47%), group 2, moderate DH (n=43, 34%), group3, severe DH (n=24, 19%). Relevant clinical fi ndings onadmission were jaundice (46.8%), fever (42%), poor oralfeeding (36.5%), reduction in the amount of stool- urina-tion (32.5%). Clinical fi ndings of dehydration were morefrequent than other groups in group 3. On the admissionday, postnatal age, blood urea, creatinine levels, dura-tion of the therapy, sodium levels were higher than othergroups in group 3. Intravenous (IV) fl uid requirement wasover than other groups in group 3. Only two patients hadseizures in the severe DH group. Positive correlation wasdetermined between percentage of weight loss and se-rum sodium, urea and creatinine levelsConclusion: Diagnosis of hypernatremic DH is delayed,because of no obvious signs of dehydration is present inthe early period. There is no specifi c sign to determine thedegree of DH. Weight loss is the most prominent fi nding,accompanied by jaundice, fever, a decrease in urine andstool frequencies. Creation of a common treatment proto-col is the solution of questions in minds

Evaluation of risk factors for necrotizing enterocolitis in preterm infants

Giriş: Bu çalışmada nekrotizan enterokolit (NEK) gelişiminde anne, bebek ve bebek bakımı ile ilişkili faktörlerin etkilerinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Doğum haftası ≤32 ve doğum ağırlığı ≤1500 gram olan hastalar çalışmaya dâhil edildi. Maternal demografik özellikler ve gebelik öyküsü, antenatal ve natal takipteki problemler, antenatal steroid tedavisi, doğum şekli (NVY, C/S), ve bebeğin doğum öyküsü kayıt edildi. NEK tanısından önce prematüre bebeğe uygulanan ventilasyon tedavisinin süresi ve transfüzyon sayıları kayıt edildi. Çalışmaya evre 2 ve evre 3 NEK olguları alındı. Bulgular: Beş yüz otuz iki hastadan 61’ine (%11,4) NEK tanısı konuldu ve çalışma grubu olarak belirlendi. 60 hasta kontrol grubu olarak seçildi. Çalışma ve kontrol grubu arasında demografik özellikler, APGAR skoru, resüsitasyon gereksinimi ve antenatal steroid kullanımı açısından farklılık bulunmadı. NEK’li hastalarda ventilatörde kalım süresinin (p=0,037) ve eritrosit süspansiyonu transfüzyon sıklığının daha fazla olduğu görüldü (p=0,032). Antenatal steroid kullanımının evre 2 NEK’li hastalarda daha fazla olduğu (p=0,011), evre 3 olanlarda ventilatörde kalım süresinin daha fazla olduğu bulundu (p=0,020). NEK’li hastalarda mortalite oranı %31,1 olarak saptandı. Ölen hastaların %84’ünde evre 3 NEK olduğu, doğum ağırlığı ve haftalarının daha düşük olduğu görüldü. NEK grubunda respiratuvar distress sendromu (RDS) (p=0,02); RDS ve patent duktus arteriosus (PDA) birlikteliği daha fazla olduğu (p=0,03), intrakranial kanamanın (‹KK) evre 3 NEK’te fazla olduğu (p=0,034) saptandı. Evre 3 NEK’li olgularda RDS, PDA ve ‹KK birlikteliği daha fazla bulundu (p=0,006). Evre 3 NEK’li hastaların annelerinde kronik hipertansiyon (p=0,003), eklampsi (p=0,034) ve infeksiyon (p=0,011) sıklığının fazla olduğu görüldü. Sonuç: Bu çalışmada antenatal, natal ve postnatal faktörlerin NEK gelişiminde önemli rol oynadığı gösterilmiş olup, bu faktörlere yönelik alınacak önlemlerle hastalığın sıklığının azaltılabileceği önerilmiştir.Introduction: In the present study, it was aimed to evaluate the effects of the maternal and infantile factors and factors associated with the care of the infants in the development of necrotizing enterocolitis (NEC). Materials and Method: Infants with ≤32 weeks of gestational age and ≤1500 grams of birth weight were included in the study. Maternal demographic characteristics and pregnancy history, antenatal and postnatal follow-up problems, antenatal steroid treatment, modes of delivery (NVY, C/S), and the babies’ birth history were recorded. The duration of ventilation treatment and the number of transfusions applied before the diagnosis of NEC in premature infants were recorded. Patients with stage II and stage III NEC were included in the study. Results: Sixty one of 532 patients (11,4%) were diagnosed as NEC and allocated in the study group. Sixty patients were enrolled as the control group. There were no differences between both groups with respect to demographic characteristics, APGAR score, need for resuscitation and antenatal steroid treatment. The duration of ventilation treatment (p=0.037) and the frequency of red blood cell transfusion (p=0.032) were considered to be higher in the NEC group. Antenatal steroid administration was higher in patients with stage 2 NEC (p=0.011), but the duration of ventilation treatment was higher in those with stage 3 (p=0.020). The mortality rate was 31.1% in the patients with NEC. It was observed that 83% of patients who died had stage 3 NEC and a lower birth weight and gestational age. Respiratory distress syndrome (RDS) (p=0.02), togetherness of RDS and patent ductus arteriosus (PDA) were higher in the NEC group (p=0.03), and more intracranial hemorrhage (ICH) was detected at stage 3 NEC (p=0.034). RDS, PDA and ‹CH were frequently determined together in patients with stage 3 NEC (p=0.006). Chronic hypertension (p=0.003), eclampsia (p=0.034), and infection (p=0.011) were found to be more frequent in the mother of the patients with stage 3 NEC. Conclusion: In the present study, antenatal, natal and postnatal factors were shown to play an important role in the development of NEC, and if proposed measures to be taken, these factors may reduce the incidence of the disease

The Effect of Dexpanthenol Treatment on Renal Parenchymal Injury in Rats with Induced Renovascular Occlusion

&lt;p&gt;&lt;strong&gt;Abstract&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;Kidney damage due to ischemia-reperfusion injury (IRI) is a serious cause of morbidity and mortality. We induced an experimental kidney ischemia-reperfusion model in rats where intraperitoneal dexpanthenol were given and compared to controls in terms of oxidative stress, tubular damage, apoptosis, and its effect on renal inflammation.&nbsp;Twelve-week-old male albino Wistar rats were used for creating the experimental model and the study sample were divided into three groups (n=16); control group (intraperitoneal 2cc/kg saline was injected), IRI group and IRI+dexpanthenol group via intraperitoneal injection. Blood samples were obtained from rats 24 hours after perfusion and their left kidneys were removed. In order to determine the percentage of apoptotic cells, a total of 100 cells were counted in each region and the number of cells with caspase-3 positivity was recorded for each region. Mortality was lower, although not statistically significant in the IRI+dexpanthenol group (n=3; 18.8%) compared to the IRI group (n=6; 37.5%) (p=0.216). In addition, kidney parenchyma and tubular damages were significantly lower in the dexpanthenol group compared to the IRI group (p&lt;0.05). Dexpanthenol significantly decreased oxidative stress and inflammation. Caspase-3 positive stained cell numbers were lower in the dexpanthenol group and also apoptosis rates were significantly lower (p&lt;0.05). Dexpanthenol treatment in kidney ischemia-reperfusion models showed significant recovery in kidney tubular cell and parenchyma damages, apoptosis, oxidative stress, and inflammation. These results show us that dexpanthenol treatment can be a promising alternative in improving the prognosis of adults with kidney IRI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Özet&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;İskemi-reperfüzyon injürisine (IRI) bağlı böbrek hasarı ciddi bir morbidite ve mortalite nedenidir. İntraperitoneal dekspantenol verilen ratlarda deneysel bir böbrek iskemi-reperfüzyon modeli oluşturduk ve oksidatif stres, tübüler hasar, apoptoz ve renal inflamasyon üzerindeki etkisi açısından kontrollerle karşılaştırdık. Deneysel modelin oluşturulmasında 12 haftalık erkek albino Wistar ratlar kullanıldı ve çalışma örneklemi 3 gruba ayrıldı (n=16); kontrol grubu (intraperitoneal 2cc/kg salin enjekte edildi), IRI grubu ve intraperitoneal enjeksiyon uygulaması ile oluşturulan IRI+dekspantenol grubu. Perfüzyondan 24 saat sonra ratlardan kan örnekleri toplandı ve sol böbrekleri alındı. Apoptotik hücre yüzdesini belirlemek için her bölgede toplam 100 hücre sayıldı ve her bölge için kaspaz-3 pozitifliği olan hücre sayısı kaydedildi. Mortalite IRI+dekspantenol grubunda (n=3; 18.8), IRI grubuna (n=6; %37.5) göre istatistiksel olarak anlamlı düzeyde olmamakla beraber daha düşüktü&nbsp;(p=0.216). Ayrıca böbrek parankimi ve tübüler hasarlar dekspantenol grubunda IRI grubuna göre anlamlı olarak daha düşüktü (p&lt;0.05). Dekspantenol, oksidatif stresi ve enflamasyonu önemli ölçüde azaltmıştı. Dekspantenol grubunda kaspaz-3 pozitif boyanan hücre sayıları ve apoptoz oranları anlamlı olarak düşüktü (p&lt;0.05).&nbsp;Böbrek iskemi-reperfüzyon modellerinde dekspantenol tedavisi, böbrek tübüler hücre ve parankim hasarlarında, apoptozda, oksidatif streste ve inflamasyonda önemli iyileşme gösterdi. Bu sonuçlar bize dekspantenol tedavisinin böbrek IRI'si olan yetişkinlerin prognozunu iyileştirmede umut verici bir alternatif olabileceğini göstermektedir.&lt;/p&gt;Dekspantenol Tedavisinin Renovasküler Oklüzyon Oluşturulan Ratlarda Renal Parankim Hasarına Etkis

Glucocorticoids in a neonatal hyperoxic lung injury model: Pulmonary and neurotoxic effects

Background We aimed to compare the effect of dexamethasone (Dex), hydrocortisone (Hc), and methylprednisolone (Mpz) at equivalent doses on somatic growth, lung healing, and neurotoxicity in a hyperoxic rat model. We hypothesized that Mpz and Hc would be superior to Dex with less neurotoxicity by exerting similar therapeutic efficacy on the injured lung. Methods Neonatal rats were randomized to control, bronchopulmonary dysplasia (BPD), Dex, Hc, and Mpz groups. All drugs were administered daily following day 15 over 7 days. Histopathological and immunohistochemical analyses of the lung and brain were performed on day 22. Results All types had much the same impact on lung repair. Oxidative markers in the lung were similar in the steroid groups. While nuclear factor erythroid 2-related factor and heat-shock protein 70 dropped following steroid treatment, no difference was noted in other biochemical markers in the brain between the study groups. Apoptotic activity and neuron loss in the parietal cortex and hippocampus were noted utmost in Dex, but alike in other BPD groups. Conclusions Mpz does not appear to be superior to Dex or Hc in terms of pulmonary outcomes and oxidative damage in the brain, but safer than Dex regarding apoptotic neuron loss. Impact This is the first study that compared the pulmonary efficacy and neurotoxic effects of Dex, Hc, and Mpz simultaneously in an established BPD model. This study adds to the literature on the importance of possible antioxidant and protective effects of glucocorticoid therapy in an oxidative stress-exposed brain. Mpz ended up with no more additional neuron loss or apoptosis risk by having interchangeable effects with others for the treatment of established BPD. Mpz and Hc seem safe as a rescue therapy in terms of adverse outcomes for established BPD in which lung and brain tissue is already impaired