Acute intoxications among Turkish children.

BACKGROUND: The aim of this study was to investigate characteristics, outcomes and clinical features of acute intoxications among children in Van region of Turkey. METHODS: All cases with a diagnosis of acute intoxication admitted to the Pediatric Emergency Department of the Yüzüncü Yil University of Van from June 1, 2010 to November 30, 2011 were evaluated. We retrospectively examined the medical records for demographical and etiological characteristics of patients below 17 years of age. RESULTS: A total of 239 intoxications were recorded. The majority of patients were under 5 years of age. Pharmaceutical agents were identified in 137 (57.3%) patients. Antidepressants with a majority of tricyclic antidepressants were the most common drugs (29.9%). Non-pharmaceutical agents were identified in 102 (42.6%) patients, 38.2% of which were insecticides-pesticides following by plants (25.4%) and carbon monoxide (17.6%). The majority (93.8%) of cases were accidental poisonings. Fourteen cases of intoxications occurred as suicide attempts and 85.7% (N.=12) of those patients were girls. Of all cases, gastric lavage was performed in 36.4% and activated charcoal administration in 53%. After hospitalization, only 23 (9.6%) of all patients received specific treatment besides symptomatic treatment. Specific treatments involved hemodialysis and antidotes such as biperiden, ethanol, atropine, neostigmine and pralidoxime. During the study period, one patient died due to acute intoxication of pesticide. The mortality rate was 0.4%. CONCLUSIONS: Our study revealed that pharmaceuticals were the most common cause of acute intoxications. While, insecticides-pesticides and plants were the leading non-pharmaceutic agents. Our data is important because it is one of few original reports on children with intoxication in Eastern Turkey.

Avian influenza A (H5N1) infection in eastern Turkey in 2006.

BACKGROUND: An outbreak of highly pathogenic avian influenza A (H5N1) that had previously been detected throughout Asia, with major economic and health repercussions, extended to eastern Turkey in late December 2005 and early January 2006. METHODS: We documented the epidemiologic, clinical, and radiologic features of all cases of confirmed H5N1 virus infection in patients who were admitted to Yuzuncu Yil University Hospital in Van, Turkey, between December 31, 2005, and January 10, 2006. RESULTS: H5N1 virus infection was diagnosed in eight patients. The patients were 5 to 15 years of age, and all eight had a history of close contact with diseased or dead chickens. The mean (+/-SD) time between exposure and the onset of illness was 5.0+/-1.3 days. All the patients had fever, and seven had clinical and radiologic evidence of pneumonia at presentation; four patients died. Results of enzyme-linked immunosorbent assay and rapid influenza tests were negative in all patients, and the diagnosis was made by means of a polymerase-chain-reaction assay. CONCLUSIONS: H5N1, which causes a spectrum of illnesses in humans, including severe and fatal respiratory disease, can be difficult to diagnose.

A new enema for treatment of intussusception with hydrostatic reduction: Olive oil.

OBJECTIVES: Intussusception is routinely treated using ultrasound-guided hydrostatic reduction (USGHR) with normal saline in our paediatric surgery department. With this study, olive oil was added to normal saline in ultrasound-guided reduction of intussusception. MATERIALS AND METHODS: Forty patients who were diagnosed and treated for intussusception in Van Yuzuncu Yil University Faculty of Medicine Pediatric Surgery Department from March 2017 to May 2017 were included in the study. During this retrospective study, randomly chosen 20 patients that treated with USGHR using normal saline were marked as Group 1. Moreover, 20 patients that treated with USGHR using a mixture of olive oil and saline (10% olive oil 90% normal saline) were marked as Group 2. Patients' age, gender, symptoms, treatment techniques, complications and hospitalisation periods were retrospectively noted. RESULTS: Forty patients were included in the study. In Group 1, 14 patients were treated in the first session, 4 patients were treated in the second session and 2 patients required laparotomy. Mean reduction time in this group was 15 min mean fluid volume used in each reduction was 80 ml/kg and mean hospitalisation period was 38 h. In Group 2, 19 patients were treated in the first session, and only 1 patient required a second session. Mean reduction time was 12 min, used fluid volume was 58 ml/kg for each reduction and hospitalisation period was 24 h. CONCLUSION: The average volume of fluid used for reduction, average reduction time, numbers of recurrent reductions and hospitalisation were less when a mixture of olive oil and normal saline were used in comparison with when normal saline was used alone to reduction the intussusception under ultrasound guidance. Using olive oil mixed with normal saline as a new enema fluid is likely to increase the success rate of ultrasound-guided reduction of intussusception.

Abdominal Complications of Ventriculoperitoneal Shunt in Pediatric Patients: Experiences of a Pediatric Surgery Clinic.

OBJECTIVE: To relate the experiences of a pediatric surgery clinic in diagnosis and treatment of abdominal complications related to ventriculoperitoneal shunts (VPSs) in pediatric patients who had VPSs implanted to treat hydrocephalus. METHODS: Patients admitted to the Pediatric Surgery Department of Van Yuzunciyil University Faculty of Medicine between April 2013 and December 2017 who had VPSs implanted and subsequently developed abdominal complications were reviewed retrospectively. Demographic information, surgery dates, time intervals between surgery and development of abdominal complication, complication types and applied treatments, and follow-up durations were recorded. RESULTS: There were 16 patients (6 girls, 10 boys) with a mean age of 3 years (range, 1 month to 8 years) reviewed. Complications following VPS implantation included abdominal pseudocyst, anal protrusion, volvulus, peritonitis, abdominal distention, and herniation. Complications were treated successfully with contemporary surgical methods. No issues during long-term postoperative follow-up were identified. CONCLUSIONS: VPS implantation can result in abdominal complications with a wide range of clinical presentations. Predicting which abdominal complications might occur in children with VPSs can be lifesaving with early diagnosis and treatment.

Prevalence, Demographic Characteristics and Associated Risk Factors of Malnutrition Among 0-5 Aged Children: A Cross-Sectional Study From Van, Eastern Turkey.

Malnutrition in childhood is a dramatic indicator of poor socio-economical status worldwide. To recognize and reveal the socio-demographic features is crucial, especially for developing countries. Our aim was to investigate the prevalence and association with sociodemographic variables of malnutrition in 0-5 years old children in Van, Turkey. A total of 702 children are included in this cross-sectional study. Demographic features of subject including age, gender, family characteristics and other data were obtained. Nutritional assessment was done using anthropometric indices including weight-for-age, height-for-age, weight-for-height, head circumference and body mass index-for-age. Multivariate logistic regressions were carried out to assess malnutrition-associated factors. Prevalence of underweight, stunting and wasting were 19.7, 17.7 and 16.2%, respectively. Socio-demographic variables that statistical significantly in association with malnutrition were low monthly family income, educational level and employment status of father, parental consanguinity, number of pregnancies, regular intake of vitamin D and history of prematurity. The prevalence of children with head circumference-z score ≤2SD and body mass index-for-age ≤2SD were 9.8 and 16.3%, respectively. Multivariate analysis detected following risk factors for these indices; low monthly family income, history of prematurity, unemployed father and the period between pregnancies (1-2 years). We found that prevalence of malnutrition in the city of Van, was still higher than more developed regions of Turkey. The associated risk factors of malnutrition should be specifically interpreted by health professionals and also by government authorities that are responsible for making practical politics of public health.

Seroprevalence of hepatitis a and associated factors among 1-15 year old children in Eastern Turkey.

BACKGROUND: Hepatitis A is a common infectious disease during childhood worldwide. Recently, great deal of changes in the epidemiology has been reported. The seroepidemiologic studies of this infection are not sufficient in Eastern region of Turkey. OBJECTIVE: To investigate the seroprevalence and association with socio-demographic variables of hepatitis A in 1-15 year old children in Van. PATIENTS AND METHODS: This study was performed on 510 one to fifteen year old children from outpatient pediatric clinics in Yüzüncü Yil University, Faculty of Medicine during last three months of 2009. Anti-HAV IgG was measured in sera by enzyme-linked immunosorbent assay. The information about subjects was recorded on standardized forms and a chart review survey was performed. RESULTS: The overall ratio for seropositivity was 54.9%. Statistical significance was found between hepatitis A seroprevalence and age, collective use of domestic items, fresh water resources, localization and type of toilet and the number of households. CONCLUSION: This study provided the most recent data of seropositivity and revealed the preliminary indication of epidemiological shift in seroprevalence of Hepatitis A virus in a region with high endemicity.

Cortical dysplasias, and corpus callosum and posterior fossa abnormalities: correlation of clinical findings with magnetic resonance imaging (MRI) characteristics.

This study examined clinical findings and magnetic resonance imaging (MRI) characteristics in 114 patients with cortical dysplasia and corpus callosum and posterior fossa abnormalities to determine the clinical findings with the extent of the lesions on MRI. The age of patients was between 1 day and 15 years. Group 1 included 74 patients with corpus callosum abnormalities and/or cortical dysplasias and group 2 included 40 patients with posterior fossa abnormalities, which were isolated and/or associated with cortical dysplasia and/or corpus callosum abnormalities. Although associated congenital abnormality apart from central nervous system abnormalities, syndrome, or systemic disorder were more common in group 2 than group 1 patients (P < .05), we did not find a difference between the groups for psychomotor retardation and epilepsy (P > .05).