INTRODUCTION: This study aims to evaluate the sleep quality and the quality of life of adolescents with chronic gastritis, and determine the related factors.
METHODS: This study included patients who were diagnosed with chronic gastritis both clinically and histopathologically. The Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale were used to assess the sleep quality, and the Pediatric Quality of Life Inventory was used to assess the quality of life. The control group included healthy volunteers with no chronic diseases and no gastrointestinal system complaints.
RESULTS: Fifty-six patients with gastritis and 55 healthy volunteers were included. The patients with gastritis were found to have significantly lower overall quality of life subscale, and total scale scores, except the social functioning total score. Except for the subjective sleep quality, significant differences were seen between the groups in the sleep quality subscale, total scale, and sleepiness scale averages. The total score of sleep quality scale was significantly higher in patients who had lower incomes than expenses. There were no significant differences in between the obese or overweight patients with gastritis and rest of the gastritis patients in the study sample. There were no significant differences found between the Helicobacter pylori positive and negative gastritis patients in terms of the total quality of life and sleepiness scale scores.
DISCUSSION AND CONCLUSION: This study is important because it is the first study in adolescents in this respect. The sleep and quality of life scores of the adolescents with chronic gastritis were lower than the control group.

INTRODUCTION: The aim of this study is to determine the correlation between the perceived social support and burnout levels of the mothers having intellectually disabled children and the effective factors.
METHODS: This descriptive and cross-sectional study was conducted in the fourteen Special Training and Rehabilitation Centers in the city center of Trabzon between 01 June 2014 and 30 November 2014. The sample of the study consisted of 128 mothers who had 6-14 year old children with intellectual disability. The data of the study were collected using Personal Information Form, Maslach Burnout Inventory, and Multidimensional Scale of Perceived Social Support.
RESULTS: In the study, more than half of the mothers were determined to have difficulty in care of their intellectually disabled children. The mothers were found to have difficulty mostly because of financial problems and their children’s aggressive behaviors. It was determined that relationships of one third of the mothers with their husbands and one fourth with their healthy children and relatives were affected. Burnout levels of the mothers who had difficulty in care of their intellectually disabled children, were secondary school graduate, had an extended family, were unemployed, had social security, and an intellectually disabled boy, were found to be higher. In the study, social support levels of the mothers were good and their burnout levels were above the mean.
DISCUSSION AND CONCLUSION: It was recommended to determine multiple factors causing burnout in mothers of intellectually disabled children, accordingly to support mothers with multi-factorial team approach through different studies to be conducted about this matter, and for mothers to take short vacations and participate in activities they like.

INTRODUCTION: The aim of the study is to determine the relationship between the extracardiac abnormalities with congenital heart diseases in the fetuses that were referred for fetal echocardiography because of various reasons.
METHODS: A total of 1158 pregnant woman whose fetal echocardiograms and detailed fetal anomaly scanning were performed between June 2017 and July 2018 were included in the study. The documents of the pregnant were reviewed retrospectively. The fetuses who were determined various organ anomalies and congenital heart defects were recorded.
RESULTS: While 664 pregnant were in low risk group, 494 pregnant were in high risk group in the study. Congenital heart defect were detected in a total of 38 pregnant (3.28%). The prevalence of all gastrointestinal system, urinary system and central nervous system anomalies are 5.35%, 3.79% and 6.73%, respectively. Interventricular septum, aorta, pulmonary and tricuspid valves’ associated congenital heart diseases were found to be mostly related with these organ anomalies.
DISCUSSION AND CONCLUSION: Gastrointestinal system and central nervous system anomalies were found to be mostly associated with congenital heart diseases. Also, the interventricular septum, aortic, pulmonary and tricuspid valves’ anomalies were the most frequently detected congenital heart diseases in these situations.

INTRODUCTION: The purpose of this study was to compare the efficacy and safety of aerosolized intranasal midazolam to oral chloral hydrate as procedural sedatives in pediatric patients undergoing CT imaging.
METHODS: A prospective, randomized, double-blind clinical trial was utilized in children aged 1 to 8 years who presented to the ED with minor head trauma and scheduled to undergo the brain CT scan.
One hundred sixty children were randomized to receive intranasal midazolam (INM) 0.3 mg/kg with oral placebo or 75 mg/kg oral chloral hydrate (OCH) with intranasal placebo. If the patient was not adequately sedated 20 minutes after the initial dose, a second dose of the same medication at one-third of the initial dosage was given. The sedation level of patients after drug administration was assessed using Ramsay sedation scale (RSS)

RESULTS: Both groups were comparable with respect to age, male to female ratio, weight, and baseline vital signs. 62 children (77.50%) in INM group and 59 children (73.42%) in OCH groups reached Ramsay score of four, respectively (p=0.55). There was no significant difference in regards to the time to become adequately sedated (21.32±6.54 vs 23.62±7.40, p= 0.173) and time for completing CT scan (30.37±7.18 vs 32.96±7.85, p=0.185). However, the time to recovery was shorter for the INM group (72.52±10.17 vs 88.10±10.27, p= 0.001). No serious side effects were seen in study groups (p=0.836). The majority of parents were somewhat to very satisfied, 83.54% and 81.25% in OCH and INM groups, respectively (p=0.928).
DISCUSSION AND CONCLUSION: Intranasal midazolam can be used to sedate the children at age group between 1 to 8 years who undergo computed tomography imaging of brain with the comparable rate of efficacy and safety as oral chloral hydrate.

INTRODUCTION: Since patients with lysosomal storage disorders (LSDs) often apply to primary care physicians initially, these doctors play a crucial role in the early diagnosis of LSDs. In this study, we aimed to determine the knowledge and awareness of primary care physicians regarding LSDs.
METHODS: We conducted a survey between January 2016 and April 2016 among primary care physicians from various regions of Turkey. Invitation e-mail was randomly sent to the individual e-mail address of each physician for a web-based survey.
The questionnaire globally consisted of three sections with a total of 30 questions. In the first part of the survey, demographic characteristics of physicians (age, gender, career information) were recorded. The second section consisted of questions on LSDs for the evaluation of knowledge among physicians. In the third section of survey, questions were about the reasons of insufficient knowledge on LSDs and possible solutions to raise awareness.
RESULTS: A total of 261 primary care physicians (109 females (41.8%), mean age 40.1±8.8 years) were enrolled in the study. The mean working time was 14.9±8.6 years. Among the participants, 75.8% and 88.8% stated that they had never encountered an LSD patient before and never considered LSDs as a differential diagnosis for any patient, respectively. Fifteen percent of physicians stated that they had no idea about the clinical findings and symptoms of LSD. Another 26.2% of the participants stated that LSD is screened during the neonatal screening program in Turkey.
Mean “total knowledge score” of the physicians was 13.47 ± 5.85 points (median: 15.0 [10.5-18.0]) out of 25. Six (2.3%) primary care physicians had a total score of “0”. Only 1 of them scored “25” points.
DISCUSSION AND CONCLUSION: Knowledge of primary care physicians on LSDs is not satisfactory in Turkey. Undergraduate medical education and postgraduate educations play a key role to raise awareness.

INTRODUCTION: This study was conducted for determining the relationship between psychosocial development and liking of children in nursing working in pediatric clinics.
METHODS: The study was conducted as descriptive and correlational study on 110 nurses working at two hospitals. Data were collected using information form, the Modified Erikson Psychosocial Stage Inventory (MEPSI), and the Barnett Liking of Children Scale. Descriptive statistical tests, Mann–Whitney U test, Kruskal–Wallis, Pearson correlation and regression analysis and Cronbach’s alpha were used in the data analysis stage.
RESULTS: It was found that there was a positive, weak, and significant correlation between liking of children and the subscales of trust, autonomy, industry, identity, and generativity (p<0.05). On the other hand, there was a very weak, positive, and significant correlation between liking of children and the subscales of initiative and ego integrity (p<0.05). No significant correlation was observed between liking of children and the subscale of intimacy (p>0.05). It was observed that there was a weak correlation between the level of liking of children and the determinant variables of trust, autonomy, initiative, industry, identity, intimacy, generativity, and ego integrity (R2=0.133).
DISCUSSION AND CONCLUSION: It was concluded nurses’ levels of trust and autonomy increased the level of liking of children.

INTRODUCTION: Our objective is to evaluate the sleep quality in adolescents in relation to age and sleep-related habitual and environmental factors.


METHODS: A total of 150 adolescents aged 12-20 years (mean(SD) age: 15.5(1.9) years; 65.3% were female) were included on a voluntary basis in this cross-sectional questionnaire survey. The questionnaire form included items on subject demographics (age, gender), before sleep activities (tea/coffee consumption, reading, use of social media), presence and of electronic devices (computer, TV, cell phone) in the bedroom and presence of roommate, as well as items on Pittsburgh Sleep Quality Index (PSQI).
RESULTS: Usual bedtime between 23: 00-24: 00 pm (38.0%), sleep latency of 15 minutes (38.0%), sleep duration of ≥7 hours (79.0%) and usual wake up time between 6.00-7.00 am (41.7%) were the most commonly identified sleeping patterns. PSQI total scores revealed poor sleep quality (scores ≥5) in 82.0% of participants, while 40.0% of participants rated their sleep quality to be poor. Later bedtime (≥24.00) was more likely in late-adolescents (64.7%) than earlier age groups (p=0.009). Sleep latency >30 minutes, difficulty in breathing and bad dreams during sleep, presence of electronic device in the bedroom and use of social media before sleep and difficulty in performing daily activities were associated with higher likelihood of PSQI-based poor sleep quality (p<0.05 for each).
DISCUSSION AND CONCLUSION: In conclusion, our findings revealed poor sleep quality (PSQI scores >5) in 82.0% of adolescents, regardless of adolescence period, and association sleep latency >30 minutes, difficulty in breathing and bad dreams during sleep, presence of electronic device in the bedroom and use of social media near bedtime with higher likelihood PSQI-based poor sleep quality.

INTRODUCTION: Acute viral respiratory tract infection is the leading cause of hospitalization for infants and young children in developed countries and is a major cause of death in developing countries. The aim of this study was to identify the viruses in children hospitalized for lower respiratory tract infections during winter period and to evaluate the relationship between the clinical features of the patients and the severity of the disease.
METHODS: The nasopharyngeal aspirates of 200 patients aged 0–24 months hospitalized with a diagnosis of lower respiratory tract infection were analyzed using the real-time polymerase chain reaction method. We looked for associations between viral agent, duration of hospitalization and respiratory distress scale.
RESULTS: The viral factor was identified in 150 (75%) patients. Rhinovirus was the most frequent viral agent followed by respiratory syncytial virus and adenovirus; (52.67%), (16.0%) and (8.67%) respectively. The average length of hospitalization for respiratory syncytial virus ( p=0.001), adenovirus (p=0.009), influenza A virüs (p=0.007), and bocavirus (p=0.009) infections were significantly longer. Adenovirus (p=0.029), respiratory syncytial virus (p=0.001) and bocavirus (p= 0.009) were significantly associated with length of hospitalization. No significant correlation was identified between the viruses and respiratory distress scores (p>0.05).
DISCUSSION AND CONCLUSION: We conclude that in hospitalized children with lower respiratory tract infection, rhinovirus was the most frequently observed viral etiological agent. Longer length of hospitalization was needed in RSV, adenovirus and bocavirus in infants with lower respiratory tract infections. Infants with respiratory infections should be monitored due to the risk of developing severe complications during disease progression.

INTRODUCTION: Urinary tract infection (UTI) is one of the common infectious diseases of children. Due to the limited use of fluoroquinolones in children, they still have no resistance problems as the same as the adult population. However, recent reports suggested an increase in resistance to fluoroquinolones among bacteria caused UTI in children. Therefore, the aim of this study is to evaluate the prevalence of Escherichia coli and Klebsiella pneumoniae isolates resistant to ciprofloxacin and to detect mutations in their gyrA and parC genes.
METHODS: The present study was conducted on 78 bacterial strains isolated from the children with UTI during 2016-2017 at Imam Reza Hospital in Kermanshah, Iran. The bacteria were identified based on microbiological methods and antibiotic susceptibility test using disc diffusion and broth microdilution methods. Then, PCR and sequencing were performed to investigate mutations in gyrA and parC genes.
RESULTS: In general, 15.3 of isolates of E. coli and K. pneumonia were resistant to ciprofloxacin. Sequence analysis confirmed mutations in gyrA and parC genes in all of the isolates resistant to ciprofloxacin. The results showed changes in amino acids (ser83leu, ser83phe and Asp87Asn) in codons 83 and 87 in the QRDR region of the gyrA gene, three substitutions in both the 80 and 84 positions in the parC, ser80Ile, Glu84val and Glu84lys genes.
DISCUSSION AND CONCLUSION: The results of this study revealed resistance to ciprofloxacin in the pediatric population. Given that the use of ciprofloxacin in children is limited, this resistance cannot be due to the antibiotic selective pressure. On the other hand, the mutations in the gyrA and parC genes in children was similar to adults which indicate that these resistant isolates can be transmitted from adults to children.

INTRODUCTION: Ultrasonography (USG) is an important tool used in the diagnosis of critical patients. The present study was carried out in order to detect intra-peritoneal free liquid in cases with high-energy trauma by using “extended-focused trauma ultrasonography” (E-FAST USG) and to determine the diagnostic power and benefits of this method.
METHODS: The medical records of pediatric cases with high-energy trauma were examined retrospectively. The results of computed tomography (CT) and radiologist-operated abdominal ultrasonography (Rad-USG) and the demographic data of patients were compared with the results obtained from E-FAST USG performed by a pediatric emergency specialist. Chi-square test was used to compare the categorical measurements among the groups.
RESULTS: One hundred sixty patients were observed during the study period. When E-FAST USG was compared to Rad-USG, the accuracy rate of E-FAST USG was found to be 97.5%, sensitivity to be 90.9%, and specificity to be 98%. Forty-one of the patients were examined using CT. The sensitivity of Rad-USG was found to be 64.6% and specificity to be 93.3%, whereas the sensitivity of FAST USG was found to be 81.8% and specificity to be 93.3%.
DISCUSSION AND CONCLUSION: FAST USG can be used in pediatric trauma cases at high sensitivity-specificity levels, and the radiation exposure of CT, which is a major consideration during childhood, can be reduced.

INTRODUCTION: A brief resolved unexplained event (BRUE) is characterised sudden alterations in an infant’s breathing, color, tone, or responsiveness. The aim of this study was to evaluate the necessity of electroencephalography (EEG) in high-risk BRUE cases.
METHODS: Of 51 patients were cases were analysed retrospectively. All of the patients were younger than 1 month so considered as high-risk group. The gestational week, the age of the patient, the duration of the event, the conditions related to the event, whether or not any intervention needed, type of intervention if done, if the event was recurred, the number of recurrences, state of consciousness during the event, respiratory pattern, muscle tone, sleeping position, suspicion of trauma, use of medication for mother and baby, smoking exposure were evaluated in detail.
RESULTS: : The mean age of the patients was 15.74 ± 14.96 days, 31 (60.78%) were male and 20 (39.21%) were female. The mean gestational age was 37.64 ± 2.35 weeks. Neurological examination of the patients were evaluated as normal. EEG was performed in 36 (70.58%) of the 51 patients and only one patient had sharp waves in the left hemisphere central region. In 11 patients hospitalized with a preliminary diagnosis of BRUE, final diagnoses were found as congenital pyloric stenosis, dehydration, fetal myocarditis, patent ductus arteriosus, lower respiratory tract infection and gastroesophageal reflux.
DISCUSSION AND CONCLUSION: It would be more appropriate to plan the tests to be carried out by evaluating many factors such as recurrence of the event in the high-risk BRUE group, family history, and neurological examination findings. As a result, even in the high-risk group BRUE, it would be cost effective to acquire an EEG if only the clinical cues are strongly suggestive for the diagnosis of epilepsy.

INTRODUCTION: The aim of the study was to investigate the possible effects of maternal anemia in pregnant women with respect to placental weight and newborn weight.

METHODS: In this cross-sectional study, 68 healthy pregnant women were included from the 2nd Obstetrics and Gynecology Department, Izmir Atatürk Training and Research Hospital. Maternal anemia was defined with a hemoglobin value less than 10 g / dl. The correlations were studied between the parameters (hemoglobin levels, placental weight and newborn weight ) in primiparous and multiparous women.
RESULTS: The study cohort consisted of 36 (52%) multiparous and 32 (48%) primiparous women (mean age ± SD: 27.40 ± 7.23 years. range: 17-45 years). The mean age of the newborns was 39.8 weeks. The rate of gestational anemia was as 27%. The rate for multıparous pregnant women (31.7%) was four times higher rates anemia compared to the rate of primiparous pregnant woman (8.3%). A positive correlation was found between placental weight and child weight (R = 0.657, t value = 0.00). There was a weak negative correlation between placental weight and Hb values. However, there was no statistically significant correlation between maternal Hb values and neonatal weight.
DISCUSSION AND CONCLUSION: Maternal anemia is an important and frequently encountered antenatal problem for pregnant women and it should be investigated in pregnant women and as well as candidates for pregnancy.

INTRODUCTION: In our country, where animal husbandry is widespread, it is aimed to determine retrospectively the data of our childhood brucellosis cases which are not very high in the literature, which may occur with many variable clinical findings and may cause misdiagnosis and serious complications.


METHODS: The data of the patients who were treated with the diagnosis of brucellosis between October 2016 and October 2018 in the Pediatric Clinic were retrospectively analyzed. The data of the patients who were treated with the diagnosis of brucellosis between October 2016 and October 2018 in the Pediatric Clinic were retrospectively analyzed.Diagnosis of brucellosis in patients; Wright agglutination test with complaints and clinical findings was based on the titer being 1/160 or above.
RESULTS: In our study, the mean age of the patients was 7.4 years (3-15). 52.12% (n: 37) were male and 47.88% (n: 34) were female. All patients had a risk factor for brucellosis infection. In 88.7% (n: 63) of these patients, consumption of milk and dairy products (precipitates, fresh cheese was not cooked), and 11.3% (n: 8) of raw meat (raw meatball) consumption and animal contact history were found to be.
DISCUSSION AND CONCLUSION: Although early diagnosis and response to treatment with brucellosis are very good, late diagnosis and inadequate treatment may cause mortality and morbidity with serious complications. Complaints of fatigue, weight loss and especially joint pain with long term fever should be evaluated by family physicians and pediatricians. The diagnosis of these patients should be kept in mind in the diagnosis of brucellosis, an endemic disease common in our country.

Crohn’s disease is a chronic disease of the digestive system. It is characterized by lesions predominantly located in the small intestine and colon, although they may also occur in any segment of the gut, including oral cavity. Involvement of the oral mucosa in Crohn’s disease may be underreported, as up to 42% of the pediatric patients with Crohn’s disease were found to have oral lesions after undergoing a thorough oral examination. Here, we present a case of Crohn’s disease, in which the patient referred to the dentist due to non-healing aphthous ulcers in the mouth. Our patient, a 16 year-old boy, admitted to the dentistry clinic with swelling of the oral mucosa and the lips, for the last 3 months. The patient was referred to our department due to non-response of the mucosal lesions to repeated cycles of medical treatment. Colonoscopy revealed a cobblestone appearance especially in the left colon, partly normal mucosa, and exudative ulcers. Biopsy samples showed increased inflammatory cell infiltration in the lamina propria, cryptitis in some of the crypts. A close collaboration between gastroenterologists and dentists is useful when addressing the diagnosis and appropriate management of these patients.

Congenital myasthenic syndromes (CMS) are neuromuscular hereditary diseases with the symptoms of fatigue, weakness, ptosis, ophthalmoparesis, respiratory problems. This disease group is classified as congenital myasthenic syndromes originating from the presynaptic region, synaptic gap and postsynaptic region according to the origin of the neuromuscular junction. Most of the patients are affected by receptor defects originating from the postsynaptic gap.
Here we presented a case who was thirteen years old and had CHRNE genotype p.Y124 * (c.372C> G) homozygous mutation, which was associated with weakness, low voice, ophthalmoparesis, frequent respiratory infection since birth.
Our patient has compliance with non-kinetic AChR deficiency and the case is important with the detection of a new mutation.Keywords: acetylcholine receptor deficiency, congenital myasthenic syndrome

Although there is no gold standard therapy in the treatment of atelectasis in newborns, surfactant therapy, inhaled mucolytic agents, recombinant human DNase, positive pressure mechanical ventilation, postural changes and drainage can be used. However, N-acetylcysteine, via endo-bronchoscopy, is rarely used to break the disulfide bonds in the mucus. It is cheap and easily available to apply for treatment. Here we presented a newborn with neonatal pneumonia to whom we instilled N-acetylcysteine thorough endotracheal tube to resolve the right lung total atelectasis. The atelectasis responded to instillation quickly and successfully. We are presenting the case in order to suggest a novel effective treatment modality for already intubated newborns with atelectasis. This case also represents the treatment of first successful case in newborn period.