Evaluation of The Relationship of Necrotizing Enterocolitis and Mortality in Premature Babies

INTRODUCTION: Necrotizing enterocolitis is one of the most common serious gastrointestinal problems in neonatal intensive care units. In this study, the relationship between necrotizing enterocolitis cases and mortality was evaluated. METHODS: This study included 157 cases of necrotizing enterocolitis of stage II and above, who were followed up and treated in Department of Pediatrics, Neonatal Intensive Care Unit between June 2019 and June 2021. RESULTS: 51% (80) of the cases were female and 49% (77) were male, birth weight was 1147+-436 g, gestational age was 27.9+-3.1 weeks, maternal age was 29.2+-7.4, and maternal pregnancy number was 3.59+-2.2. Distribution by birth weight, ≤1000 gr 41.4%(65), 1001-1500 g 40.8%(64), 1501-2000 g 13.4%(21), 2001-2500 g 3.2%(5) and 2501 g and above 1.3% (2) found. The distribution of the cases according to the gestation age was found to be ≤27 weeks 42.7% (67), 28-32 weeks 49% (77), 33-36 weeks 7.6% (12), and 37 weeks and above 0.6% (1). There was no statistically significant relationship between gender and maternal age and mortality. As the birth weight and gestational age decreased and the number of maternal pregnancies increased, mortality and frequency of necrotizing enterocolitis were found to increase statistically significantly (p<0.05). DISCUSSION AND CONCLUSION: Decreased birth weight and gestational age in premature infants in the neonatal period cause a serious increase in both the frequency of necrotizing enterocolitis and the mortality rate due to necrotizing enterocolitis

Non-epileptic paroxysmal disorders

Epileptik konvülsiyonlarla sıklıkla karışır. Pediatrik acil servislerine yaklaşık olarak %1 oranında gelir. Senkop 10-12 yaşından önce sık değildir, ergen dönemde kızlarda oldukça sık görülür. Senkopta geçici serebral hipoperfüzyon, bilinç ve postural tonusun kaybı ve bunu takip eden spontan iyileşme vardır. Serebral kan akımında 8-10 saniye süren kesinti bilinç kaybına neden olur. Aynı zamanda yüksek merkezlerde iskeminin artması beyin sapında retiküler formasyonda inhibitör etkileri açığa çıkarır. Retiküler formasyonda nöronal deşarjlar olduğunda senkoplu hastaların yaklaşık %50’sinde yüz, gövde ve ekstremitelerde kısa tonik kasılmalar oluşur

Widespread intravascular coagulation

Yaygın damariçi pıhtılaşması veya diğer adıyla dissemine intravasküler koagülasyon DİK ; farklı nedenlerle meydana gelen ve sınırlanamayan intravasküler koagülasyonun aktivasyonu, mikrovasküler fibrin oluşumu, koagülasyon faktörlerinin tüketimi, trombin ve plazminin endojen üretimi ile tanımlanan yaygın edinsel bir klinikopatolojik bozukluktur

Mediastinal gastroenteric cyst in a neonate

Yenidoğan bebeklerde mediyastinal kist nadiren bildirilmiştir. Posterior mediyastendeki enterik kistler çoğunlukla asemptomatiktir. Vertebral malformasyonlar eşlik edebilir. Solunum sıkıntısı şeklinde klinik bulgu verebilir. Burada doğumdan itibaren solunum sıkıntısı bulguları gösteren bir mediyastinal gastoenterik kist ve meningomiyelosel olgusu sunuldu. Mediyastinal kistin çıkarılması ve meningomiyelosel duramaterinin kapatılması ile hasta tedavi edildi. Detaylı antenatal taramanın yapılması, erken tanı ve daha iyi bir sonuç alımında faydalı olabilir. Ayrıca, solunum sıkıntısı olan bebeklerin akciğer grafisindeki vertebral anomali, olası bir mediyastinal enterik kist varlığını akla getirmelidir.Mediastinal cysts in neonates are infrequently reported. Enteric cysts in the posterior mediastinum are mostly asymptomatic. Vertebral malformations may contribute. Clinical presentation may include respiratory distress. Herein, we report a case of mediastinal gastroenteric cyst and meningomyelocele in a neonate presented respiratory distress signs after delivery. The patient was well managed by excision of mediastinal cyst and closure of dura mater of meningomyelocele. A detailed antenatal scan may help in early diagnosis and better outcome. Moreover, vertebral anomaly in chest radiograph of infants with respiratory distress should suggest the possible presence of a mediastinal enteric cyst

A rare cause of neonatal meningitis: Group A streptecocci

Grup A streptokoklar neonatal menenjitin oldukça nadir etkenlerindendir. Biz literatür ışığında A grubu beta hemolitik streptokokun neden olduğu bir yenidoğan menenjit olgusunu tartıştık. Daha önce sağlıklı olan 24 günlük erkek bebek; bir gündür devam eden ateş, emmeme ve sola lokalize konvülziyonla başvurdu. Yapılan lomber ponksiyonu pürülan menenjit ile uyumluydu. Hem kan hem de beyin omurilik sıvısı kültüründe A grubu beta hemolitik streptokok üredi. Hasta Penisilin G ile tedavi edildi. Klinik seyrinde tetra ventriküler hidrosefali geliştiği gözlendi. Ancak şant takılmasına ihtiyaç duyulmadı. Takiplerinde de işitme kaybı geliştiği tespit edildi. Grup A streptokok menenjiti yenidoğan döneminde oldukça nadir görülmesine rağmen yenidoğan sepsis ve menenjit olgularında akılda bulundurulması gereken etkenlerdendir. Grup A streptokok menenjiti diğer yenidoğan menenjit etkenleri gibi ciddi nörolojik sekellere yol açabilir.Group A Streptococci are rare cause of neonatal menin- gitis. In this case report, we discussed a case of newborn meningitis caused by Group A beta hemolytic streptococ- cus under the light of related literature. Twenty four days old male baby who was reported to be completely healthy before was referred to our clinic with symptoms of fever, not sucking and left localized convulsion which were pres- ent for one day. Lumbar puncture was consistent with pu- rulent meningitis. Group A beta hemolytic streptococcus growth both in blood and Cerebrospinal liquid. Patient was treated with Penicillin G. In clinical follow-up, tetra ventricular hydrocephaly was detected but there was no need for shunt. Later follow-up revealed hearing loss. Meningitis caused by Group A beta hemolytic streptococ- cus although is quite rare must be kept in mind in cases of newborn meningitis. Group A Streptococcus can also cause serious neurological sequel as in other newborn meningitis causes

Hepatitis A seroprevalence in patients who admitted to a training and research hospital in Southeast Anatolia

Objective: In this study; patients admitted to Diyarbakır Gazi Yaşargil Training and Research Hospital were evaluated retrospectively according to age groups for hepatitis A virus seroprevalence. Methods: Anti HAV IgG and Anti HAV IgM test results of patients who admitted to our hospital for various reasons between January 2010 and December 2014 were evaluated. HAV IgG and HAV IgM antibodies were studied via chemiluminescence immune method in Advia Centaur XP (Siemens, Germany) system following the manufacturer's instructions. Results: 97.30% of the samples was positive for Anti HAV IgG and 0.87 of the samples was positive for Anti HAV IgM. Anti HAV IgM positivity was 10% in the 0-10 years age group and 3.09% in the 11-20 age group. We detected advancing age has been found to reduce the incidence of disease and most of the patients encountered disease in childhood and gained immunity. Conclusion: As a result, in this study we found the HAV seroprevalence in the largest hospital of our province. We thought we could contribute; preventive measures, immunization program studies and determination of vaccine efficacy studies with the light of this data

An evaluation of patients with culture-proven sepsis in a neonatal intensive care unit

Objective: Despite in diagnosis, treatment and the development of the neonatal intensive care, neonatal sepsis continues to be an important cause of morbidity and mortality. In this study, we aimed to evaluate that having followed and treated in neonates with culture-proven sepsis. Methods: Between September 2012 -2014, the retrospective analysis was performed in the diagnosis of neonatal patients with culture-proven sepsis. For this purpose, 52 patients who had been diagnosed with culture-proven sepsis were admitted in the study. Results: The mean gestational age of patients was 32,75±1,45 weeks, and the average weight was 1895±516,49 grams. The patients were 35 (67.3%) premature and 17 (32.7%) term newborn. From sum of 1641 patients in our study had been diagnosed with sepsis 137 patients (8%), and 52 of them (3.2%) had a diagnosis of proven sepsis in patients with culture. Growth rate in culture for clinical sepsis patients were 38% (52/137). They were diagnosed 3 patients (5.8%) early neonatal sepsis and 49 (94,2%) patients late neonatal sepsis. Retraction was the most common finding 50% (26/52), bradycardia second 42.3% (22/52) and feeding intolerance the third 38.5% (20/52) were other common findings. The first three agents in positive blood cultures were Coagulase-negative staphylococci 46.1% (24/52), Klebsiella pneumoniae 21.2% (11/52) and Escherichia coli 9.6% (5/52). Conclusion: Blood culture results obtained may vary between units and also vary in sensitivity to antimicrobial therapy. Therefore, each unit should establish treatment strategies for sepsis in units according to the culture results are obtained