INTRODUCTION: The Covid-19pandemic has caused a worldwide public health emergency, especially affecting people with chronic illnesses including lysosomal storage disorders (LSDs). The unfavorable conditions due to Covid-19 have mostly affected people with chronic conditions, in terms of disease vulnerability and access to health-care.In the present study, we aimed to assess the problems the patients with LSDs on enzyme replacement therapy (ERT) have encountered during the pandemic, and their level of anxiety. Parental evaluation has also been made for pediatric patients.
METHODS: A total of 19 participants were recruited. A semi-structured interview was structured to evaluate the effects of the Covid-19 pandemic on ERT. The Turkish version of “Hospital Anxiety and Depression Scale” (HADS) for adult patients and parents were used to evaluate anxiety. Patients between ages 8-17 completed the child version of the Revised Child Anxiety and Depression Scale (RCADS).
RESULTS: The study was completed by 19 patients, and 13 parents. Five patients (26%) admitted temporary disruption of treatment, of which the most common reason was the fear of getting infected. Eighty-nine percent of all participants were willing to receive treatment at home. Only one adult patient revealed to feel anxiety (16%). While among parents evaluated with HADS, 7/13 had scores that indicated depression and anxiety, 3/4 pediatric patients had RCADS scores indicative of anxiety and depression.
DISCUSSION AND CONCLUSION: The problems LSD patients have been facing during the pandemic, should be identified along with their attitudes regarding ERT in order to maintain the sustainability of their treatment. The psychological health of these patients should also be identified and supported, to provide optimal care to patients.

INTRODUCTION: Aim of the study is to investigate the complications of percutaneous endoscopic gastrostomy in children.
METHODS: 91 paediatric patients introduced with PEG insertion by pull technique in last five years were enrolled the study. Hospital records had been searched retrospectively for demographic data of the patients, primary diseases causing nutritional insufficiency, major and minor complications after the PEG insertion.
RESULTS: 91 patients had been included the study aging between 1 month - 18 years (median 79 months). 45,1 % (n=41) of the patients were female. Majority of the patients (76,9 %, n=70) had neurological diseases. Nineteen patients (20,9%) had metabolic diseases and two patients had cystic fibrosis (2,2 %). We had observed totally 37 (40,7%) complication. Three (3,3%) of them were major and 34 (37,4%) of them were minor complications.
DISCUSSION AND CONCLUSION: Endoscopic percutaneous gastrostomy placement is an important way to continue enteral feeding in children. Although PEG is a minimally invasive technique, there are some problems waiting children and parents after PEG insertion, majority of the them are minor complications.

INTRODUCTION: Kidney transplantation is the most preferred long-term treatment of children with end stage renal disease since 1954. Graft dysfunction has been divided into three categories based on timing of presentation. In this article, we aim to present the etiologic factors of acute graft dysfunction in the first year of renal transplantation in children.
METHODS: The patients, diagnosed with acute allograft dysfunction in first year of kidney transplantation, in Izmir Tepecik Research Hospital between March 2005 and October 2017 were analyzed prospectively in this study.
RESULTS: Over the 15 year period, 56 pediatric renal allograft patients were followed in Izmir Tepecik Training and Research Hospital. During this period, 25 patients had diagnosed with early allograft dysfunction. Five patients were admitted two times in a year with allograft dysfunction. The mean age of patients was 12.6 (4.0±21.0) years, with a male and female ratio of 17: 8. Delayed graft function was occurred in four patients (16%). Among 25 renal allograft recipients showed early graft dysfunction on average of 4.2 months (1-10 months) after transplantation. The etiology of early graft dysfunction showed 10% immunologic diseases and 90% nonimmunologic factors. Five patients (16,7%) diagnosed with urinary tract infection, one patient (3,3%) diagnosed with CMV nephropathy, five patients (16,7%) diagnosed with BK nephropathy, eight patients (26,7%) diagnosed with acute cyclosporine toxicity, seven patients (23,3%) were diagnosed with dehydration and one patient (3,3%) diagnosed with urologic anomalies. Twelve patients had performed renal allograft biopsy. The histological findings were consistent with T cell mediated rejection in two patients; B cell mediated rejection in one patient and viral nephropathy in five patients. Nonspecific histological findings were determined in five patients.
DISCUSSION AND CONCLUSION: Early recognition of the etiology of graft dysfunction that develops at 1 year and appropriate treatment will contribute to the preservation of long-term graft dysfunction.

INTRODUCTION: The purpose of this study was to examine the effects of antiepileptics on thyroid function tests and to compare these effects among the different antiepileptics.
METHODS: Two hundred twenty patients (102 female and 118 male) aged 1-17 indicated for antiepileptic drug (AED) therapy for epilepsy were enrolled in this study performed in the pediatric neurology unit of a university hospital between January 2014 and January 2018. Patients using a single AED and with complete seizure control were included. During the study period, the local protocol required the systematic control of free thyroxine (fT4) and thyroid-stimulating hormone (TSH) levels at the beginning of treatment and at the 12th month of AED therapy.
RESULTS: The mean age of the patients was 10.2±4.4 years. TSH elevation was observed in only eight patients. These eight patients’ thyroid autoantibodies were negative and their thyroid USGs were normal. Subclinical hypothyroidism (TSH: 5-10, fT4 normal) was present in three of the eight patients, and these were therefore not started on medication. The other five were started on L-thyroxine. Four of these were using valproic acid and one was using carbamazepine. We found no significant difference between TSH and fT4 levels measured before the start and at the 12th month of drug therapy, nor among the AEDs.
DISCUSSION AND CONCLUSION: AEDs have no marked effects on thyroid function, and may therefore be safely used from that perspective.

INTRODUCTION: Public health emergencies are not easy for anyone to comprehend or accept. many young children can feel frightened and confused in this process
METHODS: This study was carried out to determine how Covid-19 experiences of their children were evaluated by parents.
The qualitative research method was used in the research. The data were collected using a sociodemographic data form and a semi-structured questionnaire. The data of the research were made with online methods for coronavirus due to continuing social isolation measures in Turkey. The study was completed with 28 parents. The data obtained were analyzed by thematic coding.

RESULTS: Three main themes have been identified regarding the coronavirus agenda of children: (1) children's questions about coronavirus, (2) children's statements about coronavirus, (3) children's reaction to the process. Each theme are identified two sub theme. It was found that the children had expressions and questions about corona virus, ways of protection, effects of the virus, what it was and who would harm it. In addition, it was determined that children gave emotional and behavioral reactions in this process.
DISCUSSION AND CONCLUSION: In our study results, it was found that the expressions, questions and reactions of children about coronavirus differ according to their age periods. Creating an open environment where children are free to ask questions can help them cope with stressful events and experiences and reduce the risk of permanent emotional problems.

INTRODUCTION: Introduction
Vesicoureteral reflux (VUR) is an important risk factor for urinary tract infection (UTI). We aimed to investigate the relationships between VUR and ultrasound with late dimercaptosuccinic acid (DMSA) scan findings in children older than two years with the first febril UTI (FUTI).



METHODS: The data from the patients with the first FUTI were retrospectively analysed. A late DMSA scan was performed at least 6 months after an acute FUTI. The late DMSA scan were graded as mild (focal defect in uptake), moderate (uptake of renal radionuclide from 20 to 40%), and severe (shrunken kidney with uptake less than 20%). Micturiting cystourethrography was performed at 3 to 6 weeks after FUTI.
RESULTS:
The records of 220 patients (61 mild VUR, 60 severe VUR, 99 without VUR) were reviewed. An abnormal US was more common in patients with VUR than those of without VUR (p=0.009). Abnormal US had a sensitivity of 79.34% for VUR and 81.67% for severe VUR. Negative predictive value of renal US for severe VUR was 91.13%. The frequency of renal scarring was higher in the patients with VUR than those of without VUR (102/44, p=0.001). a logistic regression analysis showed significant associations between abnormal US and VUR or severe VUR (p=0.019, p=0.011, respectively). Renal scarring had a sensitivity of 84.3% for VUR, 91.67% for severe VUR.

DISCUSSION AND CONCLUSION: The late DMSA scan findings could predict the presence and grade of VUR in older children with the first FUTI. Normal renal US could predict the absence of severe VUR.

INTRODUCTION: Our aim was investigate the effect of polychlorobifenyls (PCBs) and other factors on puberty precocious (PP) in girls were diagnosed with idiopatic PP and premature thelarche (PT).
METHODS: The study group included 50 girls aged between 2-8 years old with PP and PT. The control group included 50 healty girls with same age range and no puberty findings. Data was collected in terms of breast and pubic hair stages, weight, height, body mass index (BMI), standard deviation scores (SDSs), location of residence, gestational age and maternal age at menarche (AAM). Twenty-one PCB levels were evaluated in serum and urine. One Way ANOVA test was used for comparison between the groups. For subgroup analysis, Mann-Whitney U test, multiple regression analysis were used.
RESULTS: The mean age of the study and control groups were 6.70 ± 1.20 and 5.23 ± 1.25 years, respectively. The studied PCBs were not detectable found in either the study or the control groups. The BMI SDSs of the patients in study and healthy groups were 0.49 ± 1.09 and -0.12 ± 1.28, respectively (p=0.1). Weight SDSs in the study group were found to be significantly higher than healthy group (0.72 ± 1.35 vs -0.20 ± 1.47, p=0.008 Maternal AAM of the patients in study group was significantly lower (p= 0.006). In study group 98% of the patients were living in down town and district, whereas this ratio was 92% in control group (p= 0.024). In study group 29 patients (58%) were diagnosed with PT. Basal follicle stimulating hormone and estradiol levels, bone age and uterine longest axis dimensions results were significantly different.
DISCUSSION AND CONCLUSION: We found that studied PCBs don't influence on PP in girls aged between 2-8 years old. However, weight SDS, maternal AAM, location of residence of the patients had a significant role on PP in this patient population.

INTRODUCTION: This study aimed to analyze the effect of food addiction in children on obesity.
METHODS: A comprehensive literature review was conducted between January 2013 and July 2019 (Pubmed, PsycINFO, EBSCOHost, ScienceDirect, BioMed Central, Embase/Elsevier, Google Scholar). The keywords “child”, “adolescent”, “obesity”, “food addiction”, “eating behaviors”, and “food addiction scale for children” were used during the search process. The selected articles were examined in detail by two independent reviewers, and the methodological quality of the studies to be included in the study was evaluated using the Joanna Briggs Institute Meta-Analysis Statistical Appraisal and Review Tool (JBI-MAStARI Critical Appraisal Tool). General effect size, tests of heterogeneity, publication bias, and sensitivity analyses were performed with the random-effects model. The Comprehensive Meta-Analysis 3 software package was used for data analysis.
RESULTS: As a result of the test of heterogeneity, studies falling within food addiction in children sub-dimension were determined to show heterogeneous characteristics (Q = 74.109, I2 = 83.80, p <0.01). The result of the publication bias test indicated the presence of publication bias. The overall effect size value of all studies, which was found using the random-effects model, was determined as 0.346 (95% CI), a value between the 0.152-0.539 confidence interval. According to the random-effects model, food addiction was found to have a positive and moderate effect size on obesity when the average effect sizes within a 95% confidence interval were considered. Accordingly, food addiction was determined to significantly affect obesity in children (p <0.05).
DISCUSSION AND CONCLUSION: In this study, food addiction in children was determined to affect the prevalence of obesity in children.

INTRODUCTION: Aim: This study was conducted to determine the knowledge level and opinions of parents about circumcision.
METHODS: The descriptive style study was conducted with 258 individuals that were the parents of male patients being treated in the pediatric surgery department of a university hospital. The data of the study were collected through a questionnaire, that was designed in line with the literature, through a face-to-face interviewing method. The data were analyzed by using descriptive statistics with the SPSS 21.0 package program for Windows.
RESULTS: A total of 84.9% of the parents were the mothers of the children. A total of 70.2% of the parents stated that they had their children circumcised by a physician in a hospital setting. Regarding the purpose of circumcision, a total of 27.5% of the parents stated medical and emergency requirements while 25.6% of them of the cultural factors. A total of 23.3% of the parents stated that their children did not want to be circumcised while 57.4% of them stated that they made the circumcision decision together with their spouse. A total of 54.3% of the parents mentioned that their children experienced pain after circumcision. It was detected that parents had a moderate level of knowledge in regard to the benefits of circumcision however most of them had no idea about the practices of circumcision.
DISCUSSION AND CONCLUSION: Parents emphasized the cultural and medical factors as the most effective factors for the decision of getting their children circumcised. Parents have a lack of knowledge of circumcision practice, benefits of it, and post-circumcision care. Training that is aimed to increase the knowledge of parents about circumcision should be planned. Qualitative and quantitative studies on the subject may be recommended to be conducted in different regions and with large populations

INTRODUCTION: It can be challenging to distinguish between Influenza and coronavirus disease 2019 (COVID-19) during influenza seasons. Therefore, we aimed to compare clinical symptoms, laboratory findings, and outcome of the two diseases in children.
METHODS: Thirty-two children with COVID-19 and 22 children with influenza who were hospitalized in our clinic were included in the study. The demographic, clinical, and laboratory findings of the patients were retrospectively reviewed.
RESULTS: The median age of patients with influenza and COVID-19 was 1.4 and 15.3 years, respectively. Fever (77.3% vs 46.9%, p= 0.02), nasal obstruction (27.3% vs 0, p=0.003), wheezing (54.5% vs 3.1%, p< 0.001), bilateral cracklings sounds (63.6% vs 15.6%, p<0.001), prolonged expirium (63.6% vs 3.1%, p<0.001), tachycardia (36.4% vs 0, p<0.001) and tachypnea (54.5% vs 0, p<0.001) were significantly more frequent in patients with influenza compared to COVID-19. Patients with influenza had significantly increased leucocyte count, lymphocyte count, and AST levels and lower albumin levels compared to patients with COVID-19. In the influenza group, three patients needed intensive care, and one of them died. None of the patients with COVID-19 needed intensive care and there was no death in this group.
DISCUSSION AND CONCLUSION: In hospitalized children, the clinical and laboratory findings were milder in patients with COVID-19 compared to influenza.

INTRODUCTION: This study aimed to examine the status of vitamin D in children, to compare vitamin D levels according to the seasons to estimate vitamin D testing trends during the years of the study.
METHODS: Blood 25(OH)D levels of 51560 children aged between 0-18 years, and having been admitted to nine hospitals between 2015 and 2017 were evaluated. Comparisons between 25(OH)D levels and age groups, gender, and seasons were made. Vitamin D testing was compared year by year in terms of frequency.
RESULTS: Of the patients, 20% (n=10,611) had vitamin D deficiency and 34% (n=17,385) had vitamin D insufficiency. Serum 25(OH)D levels were significantly higher in boys than in girls (p < 0.01). There was a significant difference between serum 25(OH)D levels and the age groups. The highest mean 25(OH)D levels were detected in infants (33.95 ng/mL) and the lowest in adolescents (18.3 ng/mL). Significant seasonal variability of 25(OH)D levels was detected (P < 0.01). Vitamin D deficiency was determined most frequently in winter with a frequency of 30.7%. A three-fold increase in 25(OH)D testing was determined over a 3-year period.
DISCUSSION AND CONCLUSION: Girls, adolescents, winter season were found to be important risk factors for vitamin D deficiency or insufficiency. Further evidence is needed to clarify whom to test to prevent overtesting.

INTRODUCTION: Most of the surgical strategies for pediatric urethral strictures are derived from the adult experiences. Owing to this, we carried out this study to assess the management strategies for pediatric urethral strictures (PUS) in our institute.
METHODS: This prospective study included 28 patients with pediatric urethral strictures. Preoperatively, patients were assessed clinically and were subjected to VCUG and pre-procedure cystoscopy. Intraoperatively, urethroscopy, VCUG and retrograde urethrography were used to evaluate the length of the stricture.
Urethral dilatation (UD), direct visualization and internal urethrotomy (DVIU), excision and primary anastomosis (EPA) with or without pubectomy and dorsal onlay urethroplasty (DOU) were the procedures instituted to treat the strictures. After procedure, a silicone catheter was left in situ for 1-2 weeks in cases of DU and DVIU and 4-6 weeks in cases of EPA and DOU.
Postoperatively patients were assessed for symptoms and VCUG/cystoscopic evidence of reestablishment of urethral continuity. Average follow up 1.9 years. Long term results with regards to erectile dysfunction are yet awaited.

RESULTS: Three patients were successfully treated with single session urethral dilatation and another three with multiple sessions. Two UD patients required excision and primary anastomosis. Direct visualization and internal urethrotomy was performed in four patients which failed in one requiring EPA. EPA was carried out in fourteen patients with two requiring redo-EPA. Graft onlay urethroplasty was performed in five patients with satisfactory results.
DISCUSSION AND CONCLUSION: The procedure to address a stricture should be tailored to the individual urethral anatomy, stricture length and the surgeons’ experience. For smaller and partially obstructing strictures DVIU and DU can be tried but seem to be less effective than EPA, with high rates of secondary procedures. However, if not accompanied by complete excision of fibrosed spongiosum, EPA may be faced with recurrences. For longer bulbar strictures substitution urethroplasties are viable alternatives.

INTRODUCTION: Familial Mediterranean Fever (FMF) is one of the most frequent genetic diseases with a frequency of 1/1000 in our country. We aimed to assess the awareness of FMF among caregivers of patients with and without FMF.
METHODS: Caregivers of the FMF patients (Group1) and the others who were in the hospital for other reasons (Group2) were subjected to a questionnaire about FMF and the results were compared between them.
RESULTS: The mean ages were similar between Group1 (n=142) and Group2 (n=207). Female gender and lower educational status were more frequent in Group1. Group1 was more aware that recurrent fever, joint pain, abdominal pain, appearing in attacks are seen in FMF; the disease is inherited rather than contagious; a specific treatment exists; risk of kidney and heart failure increases when not treated; attacks are triggered by sleeplessness, tiredness and emotional stress; colchicine does not provide complete recovery; diarrhea is the most common side effect of colchicine (p<0.05). However, awareness about chest pain as a feature, infertility as a complication, non-adherence as a trigger for the disease and the statement that patients feel healthy between the attacks were similar (p>0.05). Interestingly, Group 2 was more aware that different treatment options exist (p=0.04). The total score was higher in Group 1 and in participants who graduated from secondary school or less (p<0.01).
DISCUSSION AND CONCLUSION: Being a caregiver of a patient caused a higher level of awareness of FMF regardless of education level, however, they still need to be informed about current developments.

INTRODUCTION: This study was conducted to determine the effect of the use of noise meter giving visual and auditory alarms on reducing noise.
METHODS: The study was conducted as experimental design a hospital in Neonatal Intensive Care Unit (NICU). In the study, a noise meter giving visual and auditory alarms and digital noise meter was placed in a room (Group 1); whereas, in the other room only digital noise meter was placed (Group 2). The noise meter giving visual and auditory alarms was hung on the most visible wall in the room and visual and auditory alarms were provided to the staff members in the room. The digital noise meter was hidden behind a closet in the same area in both rooms. Noise levels of the rooms were measured via the digital noise meter in both rooms in a way that data would come in 24/7 for two weeks.
RESULTS: It was found that the total mean noise level in Group 1 was significantly lower than Group 2 for two weeks (p<0.01). It was determined that the noise levels on weekdays and at the weekend were significantly lower in Group 1 than Group 2 in Week 1 (p<0.01); whereas, in Week 2 there was no difference between the groups in terms of the noise levels on weekdays and at the weekend (p>0.05).
DISCUSSION AND CONCLUSION: The use of noise meter giving visual and auditory alarms might be effective on reducing noise in NICU.

INTRODUCTION: Medical conditions can affect oral health status as well as directly affect dental treatment planning and patient management. The purpose of this study is to evaluate the various medical condition prevalence of the children in a community-based dental hospital.
METHODS: In this study, the anamnesis forms of 30,161 children aged 0-15 who referred to a university dental hospital, from a defined geographical area in southeastern Turkey between 2010 and 2020 were evaluated. Patients who had a medical risk and chronic/systemic/genetic diseases were included in the study. Medical records saved for acute conditions, cooperation problems and isolated tooth anomalies not associated with any syndrome or genetic disease were excluded from the study.
RESULTS: 1619 (5.36%) of the patients included in the study had at least one systemic disease. According to medical conditions which were examined and categorized, the most common disease group was neurological disorders (17.1%) and the most common disease was epilepsy (11.7%). It’s followed by Congenital/Chromosomal malformations (14.8%), while autism was the most common in this group with a rate of 36.7%.
DISCUSSION AND CONCLUSION: Obtaining a detailed medical history from every patient who referred to the dental clinic is very significant in terms of treatment planning, non-routine required protocols and complications. Dentists and pediatricians should evaluate more frequently and rigidly with a multidisciplinary approach in children with systemic diseases whose oral and dental health becomes very fragile as a result of their medical condition.

INTRODUCTION: This study determined the effectiveness of reproductive health education for adolescents.
METHODS: We used a quasi-experimental design with pretest and posttest control groups. A total of 161 adolescents were included in the study, 84 in the intervention group and 77 in the control group. A personal information form and a reproductive health information form were used for data collection. Reproductive health training was given in classes of 2 hours a week (total 14 hours) by the researchers. Before the intervention and 2 months after the intervention, the knowledge level of the students was evaluated using data collection forms.
RESULTS: There was no statistically significant difference (p>0.05) between the mean pretest knowledge scores of the intervention and control groups (17.97±5.22 and 18.18±5.28, respectively). A statistically significant difference was found between the intervention and control groups’ mean posttest scores (27.51±3.83 and 18.36±5.88, respectively) (p<0.05).
DISCUSSION AND CONCLUSION: Students who participated in the reproductive health education program had a higher mean knowledge score for reproductive health after the program, which shows that this reproductive health education program is effective.

INTRODUCTION: The importance of managing fetal arrhythmia has increased with the advance of fetal echocardiography. We aimed to describe incidence, type, clinical characteristics, treatment, and follow-up of fetal arrhythmia diagnosed patients in our center.
METHODS: Fetal echocardiographic examinations performed in our units between January 2016 and September 2019 were retrospectively evaluated. Fetal arrhythmias and their subtypes were identified using M-mode and Doppler echocardiography in all patients. Maternal age, gestational age, history of maternal or gestational pathology, diagnoses, and medications were recorded. Fetal arrhythmias were categorized in three main groups: 1) Irregular heart rhythm (ectopic beats, 2) Bradyarrhythmias: ventricular rate less than 110 bpm; and 3) Tachyarrhythmias: ventricular rate exceeding 180 bpm.
RESULTS: A total of 60 patients were diagnosed with fetal arrhythmia, corresponding to an overall incidence of 0.5%. Mean maternal and gestational age of patients with fetal arrhythmia were 28.35 ± 4.88 years and 31.03 ± 5.94 weeks. One patient had maternal systemic disease, and four had concurrent congenital cardiac disease. Fetal tachycardia, bradycardia, and irregular heart rhythm were detected in 10 (16.6%), 8 (13.3%), and 42 (70%) patients, respectively.
DISCUSSION AND CONCLUSION: Fetal echocardiography represents the main diagnostic tool for prenatal evaluation of fetal arrhythmias, which have a variable prognosis depending on the type of arrhythmia. The most common fetal arrhythmia, the irregular heart rhythm, generally does not necessitate any treatment and resolves spontaneously. The treatment plan in patients should be based on etiology and fetal conditions.

INTRODUCTION: Due to restrictions in COVID-19 pandemic, smartphone, tablet and computer (STC) overuses might occur. There were some concerns that light sources emitted blue light might affect anterior and posterior segment structures. We investigated effects of STC overuses on children’s eyes in pandemic.
METHODS: Sixty-four children’s findings at baseline (early periods of pandemic) (group-1) were compared with those after 1 year (group-2). Correlations between daily STC use time (DSTCUT) and ocular parameters were evaluated in group-2.
RESULTS: Compared to group-1, group-2 had longer DSTCUT (1.49±0.33 vs 5.62±0.57 hours, p<0.001), lower tear break-up time (TBUT) (12.70±1.45 vs 9.50±2.10 seconds, p=0.015), higher ocular surface disease index (OSDI) score (14.52±4.19 vs 25.22±5.75, p=0.007), more myopic spherical equivalent refraction (SER) (-1.00±0.30 vs -1.80±0.40 diopters, p=0.031), and greater axial length (22.69±0.43 vs 23.42±0.37 millimeters, p=0.038). Schirmer tests, central corneal thicknesses (CCT), keratometries, anterior chamber depths (ACD), lens thicknesses (LT), retinal nerve fiber layer thicknesses, choroidal thicknesses and macular thicknesses of groups were similar (p>0.05). In group-2 as DSTCUT increased, TBUT (r=-0.368, p=0.034) decreased, OSDI score (r=0.384, p=0.028) increased and more myopic SER (r=0.340, p=0.045) occurred.
DISCUSSION AND CONCLUSION: To our knowledge, this is the first study in children to comprehensively investigate effects of STC overuses in pandemic on ocular surface, anterior and posterior segment structures together. We found that STC overuses in pandemic might increase tendency to dry eye and myopia, and might cause axial elongation. We also determined that at 1-year follow-up, STC overuses had no effect on CCT, keratometry, ACD, LT, and posterior segment parameters.

It is possible to describe the term fistula as an abnormal connection between different parts of the body. Untreated specific infections or diseases, chronic infections, congenital deformities, traumatic injuries, and postoperative recovery abnormalities may lead to a fistula's formation. The most common oral fistulas can be classified as dentoalveolar, oroantral, oronasal, and orocutaneous fistulas.
Dentists and doctors can frequently misdiagnose odontogenic cutaneous fistulas as cutaneous lesions or non-odontogenic infections. As a consequence of incorrect diagnosis, patients can undergo unneeded and ineffective treatments, such as the surgical excision of the cutaneous lesion, multiple biopsies, and repeated antibiotic cures. It was observed that misevaluation of the lesion and repeated ineffective interventions led to scar formation on the skin, pit defects, hyperpigmentation, and iatrophobia.
This case report aimed to present the follow-up results of a patient with an odontogenic orocutaneous fistula, who was misdiagnosed and treated by medical doctors from different branches.

Cholestatic jaundice is a complex diagnostic problem with a wide spectrum of possible differential diagnosis in early infancy. We present a case of congenital intrahepatic portosystemic venous shunt as a rare cause of neonatal cholestasis with current treatment recommendations.

Although insulin therapy has a critical role in the management of patients with type 1 diabetes, it may cause various side effects at varying rates. Insulin edema is a very rare complication that is mostly associated with the initiation of insulin therapy in patients with newly diagnosed diabetes or intensification of insülin therapy in those with poor glycemic control. Its clinical spectrum ranges from mild peripheral edema to severe serosal effusions (peritoneal, pleural and pericardia) and heart failure. Although it is a known for a long time, a small number of cases have been reported so far and its incidence is not clear, and additionally most cases are thought to be undiagnosed due to mild clinical presentation. Here, we present a 10-year-old male with type 1 diabetes who developed insulin edema following insulin therapy and improved spontaneously with fluid / salt restriction. In conclusion, it should be kept in mind that there is a possibility of development of insulin edema after the initiation of insulin therapy in patients with diabetes.

Total colonic duplications are rare. This case was reported to discuss the treatment of tubular duplication of the entire colon, appendix and terminal ileum. A 2-years-old girl was admitted with the complaints of vomiting, abdomen distension, and defecation difficulty. During laparotomy, a tubular duplication with separate mesentery which has no common intestinal wall was detected at the last 20 cm of ileum. This duplication was continuing with the common wall and mesentery from the cecum to the sigmoid colon ending blindly. Resection anastomosis was performed for the completely separated tubular duplication at the terminal ileal segment. Remaining of tubular duplication continuing along the cecum, appendix and colon could not be resected because of its common mesentery, vascular system, and wide common wall with normal colon. Colotomy performed at the site of sigmoid colon allowed to open the distal of the cyst to normal colon lumen. Gastrointestinal duplication cysts should be kept in mind in patients with chronic abdominal distension. Surgical treatment methods differ because of different features and localizations of this tubular duplication.

Shock in newborn and especially preterm infants carries significant risk of morbidity and mortality if not early recognized and adequately treated. Early signs of shock maybe missed and only identified in the late decompensated phase with lactic acidosis, cellular disruption and irreversible multiorgan damage. In neonates, the etio-pathologic origin of shock is unique particularly in extreme preterm infants with complicated postnatal transition phase, immature myocardium, and high peripheral systemic resistance. Hypovolemic shock shortly after birth is uncommon and may complicates fetomaternal or fetoplacental transfusion, abruptio placenta, intracranial hemorrhage, or capillary leak syndrome. In the absence of obvious history of blood loss, a careful second clinical assessment maybe warranted to recognize the underlying etiology and institute a targeted intervention.