Evaluation of clinical and laboratory findings in severe group COVID-19 pregnants without comorbidity.

BACKGROUND: COVID - 19 disease may be seen with different clinical presentations in pregnant women. Comorbid diseases are important factors affecting the progression of this disease. In this study, we aimed to evaluate the clinical and laboratory findings in pregnant women with COVID - 19 who had no comorbid disease. METHODS: This retrospective designed study included 217 patients with Covid PCR positive in typically COVID - 19 clinic. The patients were classified into asymptomatic, nonsevere, and severe disease groups. The symptoms, laboratory results, hospital followups and intensive care records of the patients and the findings of new borns are presented. RESULTS: Most of the patients (78%) were in the third trimester of pregnancy, and 103 patients in the study group had severe disease. Fever in the non-severe group and respiratory distress in the severe group were the most common symptoms in the patients. The severe clinical manifestations were specifically observed in the third trimester patients. In the severe group, neutrophil, lactat dehydrogenase, ferritin, CK - MB, IL - 6, and hospital stay were statistically higher than those in other groups (p < 0.05). Increase in BUN and creatine were the most predictive parameters in intensive care admission. While the intensive care unit (ICU) requirement was higher in patients in the severe group, premature birth was observed more frequently in the severe group (p < 0.05) .

Determination of ventriculoperitoneal shunt dysfunction using optic nerve sheath diameter measurement on CT scan in pediatric patients with hydrocephalus.

PURPOSE: We aimed to evaluate whether optic nerve sheath diameter (ONSD) measurement by computed tomography (CT) can be a diagnostic criteria for the detection of ventriculoperitoneal shunt dysfunction among children whose fontanels are still open. METHODS: Patients with a ventriculoperitoneal shunt who were currently showing clinical and radiological signs of acute hydrocephalus depending on the shunt dysfunction were included in this study. The study was designed to compare the preoperative and postoperative ONSDs of three groups of patients divided according to their ages: group 1, patients aged < 4 months; group 2, patients aged 4-18 months; and group 3, patients aged > 18 months. RESULTS: We included 138 patients (mean age, 35.18 ± 51.01 months). Among the patients, 46.4% were females and 53.6% were males. ONSD measurements in the preoperative period were < 2.86 ± 0.59 in group 1, 3.93 ± 0.82 in group 2, and 5.40 ± 0.81 in group 3 and those in the postoperative period were 2.02 ± 0.38 in group 1, 2.72 ± 0.62 in group 2, and 3.64 ± 0.81 in group 3. Right, left, and mean ONSDs increased significantly in the three groups and were found to be statistically significant. CONCLUSION: ONSD measurement in CT has been evaluated as an appropriate finding that can be used especially in acute hydrocephalus, when clinical and radiological findings are not diagnostic.

Can Hematological Parameters be a Indicator Risk Factor in the Development of Retinopathy of Prematurity?

BACKGROUND: Hematological parameters have been investigated as being indicative of increased inflammatory response in morbidity of very preterm infants. This study aims to determine whether the hematologic parameters and ratios of preterms can be an indicative risk factor for the development of retinopathy of prematurity (ROP). MATERIALS-METHODS: This retrospective cohort study examined newborns born before 32 weeks. Twenty-three patients treated with the diagnosis of ROP were included in the patient group. The control group included 23 patients who did not have ROP (no-ROP). Medical records of eligible preterm infants were retrospectively reviewed. Hemogram samples obtained from all patients during the first 24 h of life and samples of their mothers obtained before delivery were evaluated. The hemogram parameters of white blood cell (WBC) count, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, lymphocyte/monocyte ratio, and platelet mass index were calculated. RESULTS: No difference was observed between the groups in terms of demographic data. In terms of hematological parameters, maternal WBC counts of ROP patients were significantly higher than those of no-ROP patients and WBC counts of ROP patients were significantly lower than those of no-ROP patients. CONCLUSIONS: This study found that high WBC counts in mothers before delivery and/or low WBC counts in preterms during the first postnatal day were higher in developed ROP. These results could lead to the development of prospective studies to assess the real prognostic value of WBC in ROP.

Pediatric Spinal Traumas.

INTRODUCTION: Although childhood trauma is a major cause of morbidity and mortality, the incidence of spinal trauma is significantly lower in children than in adults. Existing studies on pediatric spinal trauma (PST) largely concern cervical trauma because of its frequency of incidence. We aimed to obtain more information by examining all types of spinal trauma, and evaluating factors such as age, trauma type, injury type, and American Spinal Injury Association score and comparing them with data from the literature. METHODS: We retrospectively reviewed 30 pediatric trauma patients with spinal pathology confirmed by spinal imaging. RESULTS: The mean age was 166.4 months. Mean age for each mechanism of injury was: 142.7 months for a simple fall, 149.0 months for injury involving a foreign object, 163.5 months for a fall from a height, and 181.6 months for traffic accidents. There was no statistically significant difference in mean age for different mechanisms of injury (p = 0.372). The levels of the spinal injuries were: lumbar 53.3% (16), thoracic 26.6% (8), and cervical 20.0% (6). Mean age for each level of spinal injury was 113.3 months for the cervical area, 172.2 months for the thoracic area, and 183.3 months for the lumbar area. Mean age was found to be statistically significant (p = 0.000). DISCUSSION: PST is uncommon and the type of trauma and the spinal level affected varies with age. Cervical trauma predominates at younger ages, but adult-like traumas begin to occur with increasing age. It should be considered that the risk of developing neurological deficits is higher in pediatric patients than in adults, and the risk of multisystem injury is also high.

Sociodemographic and culture results of paediatric burns.

Paediatric burn wounds are challenging conditions to manage for both the doctors and patients and can cause several complications entailing a complicated treatment and recovery process. This study aims to evaluate sociodemographic conditions and antibiogram culture results of paediatric burn wounds. Our study retrospectively evaluated 419 paediatric patients with burns regarding age, gender, burn area and degree, total days spent in hospital, surgical history, final condition, additional disease history, previous attempts, and culture results with their antibiotic resistances, haemogram results, C-reactive protein results, sociocultural conditions, burned region of the body, and structure of the burn. The prominent observations were an increased rate of incidence in male patients and patients with low socioeconomic conditions, the highest incidence of burns from scalding and domestic accidents, and the highest incidence of third-degree burns. Furthermore, even though the most encountered burn types were extremity burns, the burn types with the highest culture growth ratio were the perineum burns. The dominant culture growth bacterial group was coagulase-negative staphylococcus, and the ratio of medication resistance was 67.8%. It is imperative to raise awareness regarding domestic accidents to prevent paediatric burn wounds. The mortality risk can be reduced by carefully monitoring multiple organ involvement and providing timely treatment. Moreover, appropriate wound care is warranted to avoid infection from skin flora.

Meckel-Gruber Syndrome: A Case Who Lived for 5 Months.

The Meckel-Gruber syndrome is a rare, congenital, and lethal malformation characterized by typical manifestations such as encephalocele, polycystic kidneys, and polydactyly. Herein, we present a case of a patient with the typical triad as well as facial, ocular, liver, and genital abnormalities who lived for almost 5 months.

The seasonal and monthly distribution of body limbs affected by burns in paediatric patients in southeast Turkey.

Studies on the frequency of burned limbs according to season and months are limited. The burning of some body limbs, especially in some months, shows that the causes of burns are different, and knowing the reasons is important for providing preventive measures. The aims of this study were to determine the distribution rate of child burns by months and seasons and to contribute to preventive measures by determining the distribution of the burning of body limbs by months. We retrospectively evaluated 419 paediatric patients (0-17 years of age) who were hospitalised in the burn unit between 1 May 2017 and 1 November 2018. The demographic characteristics of the patients were recorded according to age, gender, months, and seasons of the patients admitted; cause of burns; degree of burns; total body surface area; and burning regions. The distribution of burns by months was established as being mainly in May to October. As for the distribution of the patients according to the seasons, it was found that it was most common in summer, 122 (29.1%), and in the autumn season as well, it was 122 (29.1%). While body burns increased in the summer-autumn seasons (P < .023), genital area burns were the lowest in winter and were the highest in summer and autumn seasons. Genital site burns increased statistically in September, October, and November (P < .010). Burn traumas are observed to be more frequent in some seasons and months. The environments where individuals live, forms of life, forms of warming, areas of interest, and sociocultural and economic levels are the causes of this variability.

Validity of Six Month L-Thyroxine Dose for Differentiation of Transient or Permanent Congenital Hypothyroidism

Objective: The tendency to reduce thyroid stimulating hormone (TSH) referral cut-off values in congenital hypothyroidism (CH) neonatal screening programs has resulted in an increase in the incidence of CH, but also the referral of infants with mild transient elevation of TSH. Therefore, there is a need to develop markers for differentiation of transient elevated TSH and permanent CH as early as safely possible to avoid unnecessary treatment. The aim was to evaluate sixth-month L-thyroxine (LT4) dose as a predictive marker for differentiation of transient elevated TSH and permanent CH. Methods: Data of patients who had been followed after referral from the neonatal screening programme between the year 2010 and 2019 in a tertiary pediatric endocrine centre were examined retrospectively. Results: There were 226 cases referred, of whom 186 (82.3%) had eutopic thyroid gland, and 40 (17.7%) had dysgenetic gland. In patients with a dysgentic gland there was a non-significant tendency to have lower diagnostic free thyroxine concentration but significantly higher TSH compared with those with eutopic gland (p=0.44 and p=0.023, respectively). Patients with thyroid dysgenesis required higher initial and six month LT4 doses compared with those with eutopic glands (p=0.001). Receiver operator curve analysis showed the optimum cut-off value for LT4 at six months for transient vs. permanent CH was 2 µg/kg/day (sensitivity 77% and specificity 55%), regardless of etiology. Similarly, in patients with eutopic glands the optimum cut-off value for LT4 dose at six months for permanent vs. transient patients was 2 µg/kg/day (sensitivity 72% and specificity 54%). Conclusion: Results suggest that LT4 requirement at six months of therapy may be a good marker for predicting transient TSH elevation in patients with eutopic thyroid gland, thus facilitating the decision to halt LT4 therapy.