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Breath-holding spells are benign, paroxysmal events with apnea and postural tone changes after a crying episode in infants. The objective of this study was to investigate the pathologies in brain metabolite values in the absence of seizure in children with breath-holding spells by using magnetic resonance spectroscopy (MRS). Brain MRS examination was performed on 18 children with breath-holding spells and 13 neurologically normal children who were included as the control group. There was no significant difference in terms of N-acetyl aspartate (NAA), choline (Cho), creatine (Cr), and myoinositol (mI) levels and also in terms of NAA/Cr, Cho/Cr, and mI/Cr ratios between the patients and the control group (all P>0.05). Our study suggested that there is no permanent neuronal damage in patients with breath-holding spells. This result confirms the previous studies, which reported no permanent neuronal damage in patients with breath-holding spells.

Objective Hemoglobin (Hb) measurement is one of the most commonly used laboratory tests in medical practice. Unnecessary blood sampling, especially in neonatal intensive care units (NICUs), contributes to iatrogenic anemia. Continuous non-invasive monitoring of total Hb (SpHb) was compared with invasive venous blood samples (tHb) in NICU patients. Methods Three hundred and ten patients were identified in NICU. Non-invasive Hb measurement was performed immediately before venous blood sampling and comparison of invasive with non-invasive values was undertaken. Results There was a strongly positive correlation between SpHb and tHb (r = 0.965, p < 0.001). Bland–Altman analysis was performed in 95% limits of agreement for Hb values measured by both methods. The mean bias between tHb and SpHb measurements was 0.05 g/dl (−1.85 to 1.96). In Passing–Bablok regression analysis, the CUSUM test p value was found to be 0.98 for Hb levels measured by SpHb and tHb; and the difference between the methods was not significant. Conclusion In newborns, SpHb method offers reliable Hb values, which are comparable with the more traditional tHb method. Continuous non-invasive monitoring of total Hb may help prevent unnecessary blood sampling and iatrogenic anemia. Further clinical studies are required for the effectiveness of the method in critically ill patients with circulatory disorders.

ObjectivesPoisoning occurring in childhood still continues to be an important public health issue. The aim of the study is to socio-demographically and clinically examine poisoning cases consulted to emergency department.MethodsThe findings of 121 patients between the ages of 1 month and 17 years consulting to the pediatric emergency department with the suspicion of poisoning were examined retrospectively in the study.ResultsThe mean age of the patients was 6.60 ± 5.70 (min-max: 0–17) years and 49.6% of the patients were male and 50.4% were female. The most common causes of poisoning were corrosive chemicals in 35 patients (28.9%), poisonous animals in 24 patient's (19.8%) and prescription medications in 24 patients (19.8%). While 103 (85.1%) of the cases were exposed to the factor accidently, 18 of the cases (14.9%) had attempted suicide. The mean monthly family income levels of accidently poisoned cases were significantly higher than those who attempted suicide (p < 0.001). The father's education level was lower in cases who were poisoned by suicide attempt than in those who were accidently poisoned (p < 0.001).ConclusionPoisoning rates in childhood and varieties of factors differentiate among the regions. The rate of poisoning cases due to poisonous animals was found to be quite high in the region where this study was carried out. In addition, the study showed that poisoning rates due to suicide attempt in children of families with low income level and/or father's education level have increased.

To investigate the complaints and findings of COVID-19 infection in a paediatric age group. Material and Method:The study included 130 patients with COVID-19 infection confirmed with reversetranscription polymerase chain reaction (RT-PCR) test positivity. The cases were evaluated in respect of demographic data, such as age and gender, and clinical findings, such as fever, weight, cough, shortness of breath, and history of infectious contact.Results: Evaluation was made of 130 COVID-19-positive paediatric patients, comprising 69 (53%) males and 61 (47%) females, of which 54% were asymptomatic and 5.4% had severe clinical findings requiring follow up in the Intensive Care Unit (ICU). Of the symptomatic patients, fever was determined in 30%, listlessness in 24%, cough in 10.8%, respiratory problems in 9.2%, diarrhea in 6.2%, abdominal pain in 6.2%, vomiting in 2.3%, joint pain in 2.3%, and convulsions developed in 1.5% who had no previous history of convulsions. Of the 7 patients who required intensive care, 2 had cerebral palsy, 1 had hydrocephaly+shunt, 1 had metabolic disease (propionic acidemia), 2 had a history of trauma (struck by a motor vehicle), and in 1 there was no comorbidity. Mortality developed in 6 of the 7 patients in ICU. Conclusion:In a significant proportion of children, COVID-19 has an asymptomatic course, which contributes greatly to the spread of the disease. While COVID-19 can cause morbidities such as convulsions in the paediatric population, it may also result in mortality in children with underlying serious diseases.

Childhood brucellosis is a common public health problem in developing countries. The diagnosis of brucellosis based on nonspecific symptoms is an ongoing problem for physicians, especially in endemic areas. In this study, it is aimed to discuss the efficacy of frequently used test methods in the differential diagnosis of brucellosis. Methods The records of 332 patients admitted to pediatric clinic on suspicion of brucellosis were retrospectively analyzed. Patients with brucellosis were included in the positive group (n = 262) and those without brucellosis were included in the negative group (n = 70). Results As a result of biochemical analysis of the cases, median alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), erythrocyte sedimentation rate (ESR), and C reactive protein (CRP) values were significantly higher in the positive group than that in the negative group (p<0.05). There was no significant difference between median white blood cell, neutrophil, lymphocyte, neutrophil to lymphocyte ratio, hemoglobin, and platelet values between groups (p>0.05). Receiver operating curves were plotted to compare predictive values of CRP (area under curve (AUC): 0.635, p= 0.001), ESR(AUC:0.701, p<0.001), AST(AUC: 0.595, p=0.015), ALT(AUC:0.604, p=0.007), and GGT(AUC:0.593, p=0.016) in 332 patients with suspected brucellosis. Conclusions Increased levels of AST, ALT, GGT, CRP, and ESR may have a complementary role in the differential diagnosis of childhood brucellosis. However, all of these markers should be evaluated with clinical findings due to their low specificity and sensitivity.

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