The COVID-19 Pandemic and the Prevalence of Childhood Obesity in Turkiye.

OBJECTIVES: To examine the prevalence of overweight and obesity in school-age children in Isparta Province, Turkiye, during the coronavirus disease 2019 (COVID-19) pandemic, and to compare the results with those of previous studies conducted in Isparta in 2005, 2009, and 2014. METHODS: The study was carried out in schools in the city center of Isparta in March 2022, during which the weight and height of students were measured using a scale and stadiometer, and the body mass indices (BMI), BMI percentiles, and z scores were calculated. RESULTS: Of the 8871 students assessed, 4547 (51.3%) were female and the mean age of the sample was 11.92 ± 3.42 (6-18.93) years. The prevalence of overweight was 12%, the prevalence of obesity was 14.5%, and the prevalence of overweight + obesity was 26.5%. A comparison of the figures since 2005 revealed the prevalence of overweight to be stable, while the prevalence of obesity and the prevalence of overweight + obesity were found to have witnessed a increase (χ 2 : 57.01, P < 0.001). The prevalence of obesity was 13% among girls under 11 years of age and 14.3% among girls over 11 years of age; and 18.2% and 12.8% among boys under and over 11 years of age, respectively (χ 2 : 23.26, P < 0.001). The prevalence of obesity was significantly higher in boys under 11 years of age. CONCLUSIONS: The prevalence of overweight + obesity was nearly stable in the 3 studies conducted over the 17-year period, but we witnessed an increase in our most recent study conducted during the pandemic. The prevalence of obesity is significantly higher in boys under 11 years of age.

Foreign Body Ingestion and Management in Children.

OBJECTIVE: The aim of the study is to evaluate of the children who came to our hospital with the complaint of foreign body (FB) ingestion and were treated. METHODS: A retrospective evaluation was made of the records of children who presented at our institution between January 2014 and August 2021 with the complaint of FB ingestion. RESULTS: Evaluation was made of 297 children, comprising 121 female children (40.7%) with a mean age of 61.1 ± 50.3 months (range, 4-202 months). The ingested FB most frequently was coins (n = 88, 29.6%). The most common complaint on presentation was vomiting in 47 cases (15.8%). Endoscopy was applied to 75 cases (25.3%), and most common FB was removed from the upper esophagus in 31 cases (41.3%). The most frequently removed FB was coins at the rate of 40%. Of the 211 cases left to a spontaneous course, 117 were in the intestines, 22 in the stomach, and in 72 cases localization could not be determined on conventional radiography as the FB was not opaque. In 7 cases with a bolus of food caught in the esophagus, 3 had corrosive esophagus stricture (1 case with colon transposition), 2 had operated esophagus atresia, 1 had eosinophilic esophagitis, and 1 had congenital esophagus stricture. CONCLUSIONS: Although there can be serious outcomes, there is spontaneous expulsion in most cases. However, a significant proportion requires a timely endoscopic procedure. Attention must be paid to underlying diseases when FBs, such as a food bolus, are in the esophagus.

COVID-19-associated multisystem inflammatory syndrome in children: Experiences of three centres in Turkey.

BACKGROUND: The pathogenesis and clinical manifestations of the multisystem inflammatory syndrome in children (MIS-C) has not yet been fully elucidated and there is no clear consensus on its treatment yet. OBJECTIVES: To evaluate our patients diagnosed with MIS-C and present them to the literature in order to contribute to the better understanding of this new disease, which entered paediatric practice with the SARS-CoV-2 peak. METHODS: In this study, 17 MIS-C cases diagnosed according to the Centers for Disease Control and Prevention criteria were included. RESULTS: Of the patients, 7 (41.2%) had a comorbidity. Gastrointestinal system involvement was the most prominent in the patients (70.6%). Laparotomy was performed in 3 patients due to acute abdomen. Two patients had neurological involvement. Of the patients, 15 (88.2%) received intravenous immunoglobulin and 13 (76.5%) received both intravenous immunoglobulin and methylprednisolone. Two patients received invasive mechanical ventilation and 4 patients received high flow rate nasal cannula oxygen therapy. One of our patients who needed invasive mechanical ventilation and high vasoactive-inotrope support died despite all supportive treatments including plasmapheresis and extracorporeal membrane oxygenation. CONCLUSIONS: MIS-C picture can have a fatal course and may present with severe gastrointestinal and neurological signs. Unnecessary laparotomy should be avoided.

Childhood Poisoning During the COVID-19 Pandemic.

OBJECTIVE: To determine changes caused by the effect of the COVID-19 pandemic by examining the children admitted to our hospital because of poisoning during the pandemic and comparing these with data from a study conducted in the pre-pandemic period. MATERIALS AND METHODS: A retrospective examination was made of children who were admitted to our pediatric emergency department with poisoning between March 2020 and March 2022. RESULTS: Of the 82 (0.7%) patients admitted to the emergency department, 42 (51.2%) were girls, the mean age was 6.43 ± 5.62 years, and the majority of children (59.8%) were under 5 years of age. The poisonings were determined to be accidental in 85.4% of cases, 13.4% were suicide attempts, and 1.2% were iatrogenic. Poisonings occurred most frequently (97.6%) at home and most frequently (85.4%) by digestive tract. The most common causative agent (68%) was non-pharmacological agents. Caustic-corrosive substances were determined in 39% of cases, medical drugs in 32%, toxic gases in 11%, alcohol (hand sanitizers) in 8.5%, insecticide-pesticide in 6.1%, food in 1.2%, and animal bites in 1.2%. Compared to the study conducted in our hospital in 2013-2014, the difference in terms of factors causing poisoning was statistically significant (P < .001). Of the current study cases, 14 (17.1%) were followed up in the intensive care unit, and no mortality developed. CONCLUSIONS: The period of the COVID-19 pandemic was seen to cause an increase in poisoning rates with caustic-corrosive substances, alcohol (hand disinfectants), and toxic gases. Families should be made aware of this issue and take special precautions.

Comparison of Body Composition and Body Mass Index in the Determination of Obesity in Schoolchildren.

OBJECTIVE: The determination of obesity that develops with an increase in the percentage of fat in the body may not always be possible in the real sense with body mass index, which is frequently used in practice. This study aimed to compare the results obtained from body mass index and bioelectrical impedance analysis measurements in evaluating obesity in Turkish school-aged children using age-related percentile curves. MATERIALS AND METHODS: The study included 1127 children (604 boys and 523 girls) recruited from a screening of the schools in the city center of Isparta between May 20 and June 20, 2014. Body mass index was calculated, and the variables of fat mass, body fat percentage, fat-free body mass, and total body water were measured with a Tanita BC-418 MA device. RESULTS: According to the body mass index values, 23.8% of the study sample was overweight/ obese, and according to bioelectrical impedance analysis, this rate was 14.7%. When examined by gender, males' overweight/obese ratio was 19.9% (overweight 11.3% and obese 8.6%) according to body mass index and 12.9% (overweight 7.1% and obese 5.8%) using the bioelectrical impedance analysis method. In females, the overweight/obese ratio was 19% (overweight 9.4%, obese 9.6%) according to body mass index and 16.7% (overweight 9.6% and obese 7.1%) using the bioelectrical impedance analysis method. CONCLUSION: The results obtained from the weight-based body mass index method were not consistent with the body fat percentage results obtained with the bioelectrical impedance analysis method. Since the fat ratio is also crucial in evaluating obesity, care should be taken when diagnosing obesity using body mass index only.

Brucellosis with splenic abscess in a child initially suspected to have covid-19.

COVID-19 can manifest with signs and symptoms related to many different systems. Therefore, in the examination of almost every patient, COVID-19 infection is excluded first This may cause other diseases to be missed, as almost occurred in the case of a 15-year old boy with brucellosis and a splenic abscess. Public and health care personnel fear of COVID-19 may cause more harm than the virus itself.

Clinical profile and long-term outcome of the first seizures in children.

BACKGROUND: Seizures are one of the most common causes of pediatric admissions to hospitals in children. This study aims to identify the clinical profile and outcome of first seizures in children. METHODS: Children who presented to the pediatric neurology outpatient clinic and pediatric emergency service with a first-time seizure and aged one month through 18 years old were enrolled to the study. At the time of the study, enrolled children were categorized into three study groups according to seizure characteristics: febrile seizure, nonfebrile-provoked seizure and, unprovoked seizure. RESULTS: The study group consisted of 138 children. Of the 138 patients, 60 (43%) had febrile first seizures, 23 (17%) had nonfebrile-provoked first seizures, and 55 (40%) had unprovoked first seizures. The patients did not experience the recurrence of a seizure by the treatment of underlying cause at the eighteenth month and the eighth year follow-up in the nonfebrile-provoked seizure group. Among the children admitted for unprovoked first seizures, 33 (60%) patients had seizure recurrence during 18 month follow-up and 36 (82%) patients had seizure recurrence during eight year follow-up. Seizure recurrence rate was statistically higher in patients with abnormal EEG and cranial MRI findings in the unprovoked seizure group (p < .05). CONCLUSIONS: The patients with provoked first seizure did not develop epilepsy during eight year follow-up. However, 36 patients with unprovoked seizures were diagnosed with epilepsy during eight year follow-up. It is essential to determine the causes of the seizures and treat the condition.

The effects of probiotics on treatment of Helicobacter pylori eradication in children.

OBJECTIVES: To investigate the eradication rates and side effects of probiotics added in standard triple therapy for the treatment of Helicobacter pylori (H. pylori). METHODS: A prospective open study was performed in the outpatient clinics of the Department of Pediatric Gastroenterology, School of Medicine, Suleyman Demirel University, Isparta, Turkey between March 2012 and May 2013. Sixty-one symptomatic children (range 7-18 years) with H. pylori infection were randomized to 2 groups: group 1 received standard triple therapy (lansoprazole, amoxicillin, and clarithromycin for 14 days), group 2 received the standard triple therapy plus probiotics (Lactobacillus casei, Lactobacillus acidophilus, and Bifidobacterium lactis). Side effects of the drugs were recorded. The 14C-urea breath test was performed for 6 weeks after discontinuation of the therapy. RESULTS: Helicobacter pylori infection was detected in 61 of 95 (64.2%) children. Fifty-six patients (38 girls and 18 boys) completed the study. Their mean age was 13.9 ± 2.7 years. Helicobacter pylori eradication rate was 68.9% in group 1, and 66.6% in group 2 (p=0.78). No statistically significant difference was observed between the 2 groups in terms of side effects. CONCLUSION: We found no evidence in terms of eradication of H. pylori, or impact on adverse effects obtained after the addition of probiotics to standard treatment. Larger randomized controlled investigations are needed to clearly understand the effects of probiotics on H. pylori eradication.