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A spectrum of critical abdominal pathological conditions that might occur in neonates and children warrants real-time point-of-care abdominal ultrasound (abdominal POCUS) assessment. Abdominal radiographs have limited value with low sensitivity and specificity in many cases and have no value in assessing abdominal organ perfusion and microcirculation (Rehan et al. in Clin Pediatr (Phila) 38(11):637–643, 1999). The advantages of abdominal POCUS include that it is non-invasive, easily available, can provide information in real-time, and can guide therapeutic intervention (such as paracentesis and urinary bladder catheterization), making it a crucial tool for use in pediatric and neonatal abdominal emergencies (Martínez Biarge et al. in J Perinat Med 32(2):190–194, 2004) and (Alexander et al. in Arch Dis Child Fetal Neonatal Ed 106(1):F96–103, 2021). Conclusion: Abdominal POCUS is a dynamic assessment with many ultrasound markers of gut injury by two dimensions (2-D) and color Doppler (CD) compared to the abdominal X-ray; the current evidence supports the superiority of abdominal POCUS over an abdominal X-ray in emergency situations. However, it should still be considered an adjunct rather than replacing abdominal X-rays due to its limitations and operator constraints (Alexander et al. in Arch Dis Child Fetal Neonatal Ed 106(1):F96–103, 2021). What is Known: • Ultrasound is an important modality for the assessment of abdominal pathologies. What is New: • The evidence supports the superiority of abdominal POCUS over an abdominal X-ray in emergency abdominal situations in the neonatal and pediatric intensive care units. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the effect of lullabies and classical music on preterm neonates' cerebral oxygenation, vital signs, and comfort during orogastric (OG) tube feeding. Methods: This was a parallel-group pretest-posttest randomized controlled study. The research was conducted between December 2020 and May 2022. The sample consisted of 51 preterm neonates hospitalized in the neonatal intensive care unit (NICU) of Selçuk University Faculty of Medicine Hospital in Konya, Türkiye. Participants were randomized into three groups (17 preterm infants in each group). The first group listened to lullabies sung by their mothers and the second group listened to classical music during OG tube feeding. The control group received routine care with no music. Data were collected using a Neonatal Identification Information Form, Physiological Parameters and rSO2 Monitoring Form, and the Newborn Comfort Behavior Scale (Comfort-Neo). The study was registered on the ClinicalTrials database (NCT05333575). Results: The lullaby group had stable peak heart rates and oxygen saturation levels (p =.002). Both lullaby and classical music groups had significantly higher cerebral oxygenation levels than the control group. The classical music group had the highest cerebral oxygenation level (p =.001). Both lullaby and classical music groups had significantly higher mean Comfort-Neo scores than the control group. The classical music group had the highest mean Comfort-Neo score (p =.040). Conclusion: Preterm neonates who listen to lullabies and classical music are likely to have higher cerebral oxygen and comfort levels. Listening to lullabies helps stabilize vital signs. These results suggest that healthcare professionals should encourage parents to get their preterm neonates to listen to lullabies and classical music. [ABSTRACT FROM AUTHOR]

Purpose: The present study was conducted to determine the effect of odor stimulation with breast milk (BM) applied to premature newborns before and during enteral feeding on feeding cues, transition time to oral feeding and abdominal perfusion. Design: This study was a parallel group pretest-post test randomised controlled trial (RCT). Methods: The study was conducted in the neonatal intensive care unit (NICU) in Türkiye. Study data were collected from 32 premature newborns between October 2020 and December 2021. Newborns were randomly assigned to either intervention (n = 16) or control (n = 16) groups. Odor stimulation with BM was applied to newborns in the intervention group (IG) before and during enteral feeding for 3 days. Data were collected with the Newborn Information Form, Abdominal Perfusion Follow-up Form, and Feeding Cues Follow-up Form. Yates corrected and Fisher chi-squared test, Mann-Whitney U test, Cohen Kappa statistics, Permanova analysis, and Wilcoxon test were used in the analysis. The study was registered in ClinicalTrials.gov (NCT04843293). Results: The frequency of feeding cues in newborns who were exposed to the odor of BM, was higher than in the control group (CG) (p <.05). The transition times to oral feeding were similar in newborns in the IG and CG (p >.05). Abdominal perfusion level of newborns in the IG was higher than the CG (p <.05), and the level of abdominal perfusion showed a significant difference in terms of group*time interaction (p <.05). Conclusion: Our findings suggest that odor stimulation with BM will be beneficial in improving the digestive functions of premature newborns. [ABSTRACT FROM AUTHOR]

Presents a case report on a patient with prune-belly syndrome, a condition affecting the abdominal wall and genitourinary system. Background of the patient; Physiological findings on the patient; Gastrointestinal anomalies in the syndrome; Conditions associated with the syndrome.

Infantile-onset megalencephalic leucoencephalopathy (IML) is a recently recognized autosomal recessive white matter disorder. Unlike other megalencephalic leucoencephalopathies, in patients with IML a mild clinical course, a slowly progressive delay in motor development and mild mental deterioration are typical. We report on two affected siblings who have typical clinical and radiological findings of IML. Cranial magnetic resonance imaging showed involvement of the capsula externa, extrema and interna, nucleus dentatus, crus cerebri, periventricular and subcortical white matter. In addition, bilateral cystic changes were determined predominantly in the temporal lobes. There were no clear biochemical or metabolic disturbances. In the present paper, we discuss the clinical and neuroimaging findings of IML. [ABSTRACT FROM AUTHOR]

Describes the case of a child diagnosed with hypothalamic-hypodipsic-hypernatremia (HHH) syndrome. Correction of dehydration and hypernatraemia; Information on HHH; Pathological manifestations of adipsia-hypodipsia.

Necrotizing enterocolitis(NEC) is the most significant gastrointestinal emergency in neonates, particularly affecting those who are premature. Neonatal appendicitis is highly uncommon in term infants and its diagnosis is typically incidental. The clinical presentation of newborn appendicitis is nonspecific and usually mimics that of NEC. Pneumatosis intestinalis is a finding that is extremely specific to NEC; it is very surprising to observe this finding in a patient with acute appendicitis. A 2730-g male infant was born at 39 weeks gestation to a 33-year-old mother. 30 minutes after delivery, the patient exhibited grunting and respiratory distress and was subsequently admitted to the Neonatal Intensive Care Unit. On the 7th day, the patient developed nutrition intolerance. The feeding was discontinued and the nasogastric catheter was switched to free drainage. Abdominal examination and laboratory parameters were not significant, but direct abdominal radiographs showed findings suggesting pneumatosis intestinalis. NEC was considered and the antibiotics were revised accordingly. The department of pediatric surgery was consulted as the patient's abdominal examination and radiographs showed abnormalities suggestive of advanced NEC. The patient was taken into operation, gangrenous appendicitis was detected and an appendectomy was performed. When considering the differential diagnosis of NEC in neonatal patients, especially in term infants, clinicians should be mindful of acute appendicitis. In this study, we present a case of neonatal appendicitis, which is relatively common in pediatric cases but uncommon in the neonatal period, presenting as atypical NEC. [ABSTRACT FROM AUTHOR]

Aim: Congenital heart disease (CHD) is one of the most common congenital anomalies. It is known that early detection of the critical lesions without symtomatic improves the prognosis of patients in the long term. In our study, we aimed to evaluate the efficacy and cost of pulse oximetry screening for detection of CHD in Konya region. Material and Methods: In our study, we analyzed the results of pulse oximetry screening of infants born between 2016 and 2018 in Selcuk University and Saglik Bilimleri University Konya Training and Research Hospital. Positive screening test results and their costs was evaluated. Results: Pulse oximetry was performed on a total of 3440 infants for screening congenital heart disease at two different centers. 2003 (58.2%) of the cases were female and 1437 (41.8%) were male. The mean timing of screening was 24.7±13.1 (4-100) hours (mean ± SD (min-max). 292 (8.48%) infants were tested positive. Echocardiographic examination was performed in the positive cases. The prevalence of CHD was found to be 27.6 ‰. The prevalence of critical CHD was 1.16 per 1000 live births. The false-positive screen rate was found to be 197 (5.7%). Among the cases who were screened, the most common CHD was the secundum ASD. The total cost of probes was 2622 ₺ ($497.91). The cost of echocardiography for 292 babies was approximately 13181 ₺ ($2503). Conclusion: Screening for heart disease can be used effectively in the early diagnosis of serious and life-threatening diseases in newborn and the cost is unneglectable in the early screening of patients. This study, the total cost of each infant screening is approximately 4.5 ₺ ($0.85) which appears to be a quite cheap and effective screening compared to the other countries. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to review accompanied congenital anomalies to gastrointestinal pathologies. Materials and Methods: The medical records of patients who were admitted to neonatal intensive care unit with gastrointestinal system surgical pathologies during 2015-2018 were retrospectively evaluated for associated congenital anomalies. Results: 67 patients were identified during the study period. The most common gastrointestinal system pathology was anal atresia in 15 cases (22.4%), followed by diaphragmatic hernia in 14 cases (20.9%), esophageal atresia (n:10) and ileal atresia (n:10) (14.9%). Thirty two patients (48.8%) have had accompanied congenital anomalies to gastrointestinal system pathologies. Congenital heart disease was the most common anomaly and the most frequent one was atrial septal defect in 18 cases (26.8%). In addition, there was complex congenital heart disease in (n:13) 19.4%. In 12 patients (17.9%), accompanied extracardiac anomalies were detected. Hydronephrosis and sludge in gall bladder were detected in three patients (4.5%). Vesicoureteral reflux or ectopic kidney or polysplenia was detected as a separate anomaly in each case. In our cases, prematurity rate was found in 54%. Conclusion: Gastrointestinal system pathologies are frequently associated with multiple anomalies, especially with congenital heart diseases. In addition, these patients are likely to be preterm baby. [ABSTRACT FROM AUTHOR]

Meckel-Gruber syndrome, which is firstly described by Friedrich Meckel and Georg B. Gruber, is an autosomal recessive disorder that is characterized triad of occipital encephalocele, bilateral renal dysplasia and polydactyly. Because of the genetic heterogeneity, multiple organs can be affected. The worldwide incidence varies from 1 in 13,250 to 1 in 140,000 live births. We have reported a male baby born at 37-week gestation, who has occipital encephalocele, polydactyly and cystic dysplasia of both kidneys. As a result of these clinical findings, Meckel-Gruber Syndrome is suspected for his baby. This study is presented to draw attention to the Meckel Gruber Syndrome which has high risk of recurrence and early diagnosis by ultrasonographic screening can be confident. [ABSTRACT FROM AUTHOR]

Midazolam is a relatively new anticonvulsive agent in the benzodiazepine group. It has a short onset of duration and is practical for use, providing several alternatives such as intravenous, intramuscular, and intranasal routes. The buccal route could be an alternative choice for seizure control in an emergency setting. However, no sufficient reports are available on buccal midazolam administration. The present study was designated to examine the efficacy of buccal midazolam in children at different ages with seizures of more than 5 min duration. Nineteen previously unreported children, aged from 1 month to 15 years, were treated with a 0.3 mg/kg dose of buccal midazolam; 13 had prolonged seizures, and six had status epilepticus, with a duration of 5–45 min (mean 22 min). Sixteen of 19 seizures (84.2%) stopped within 10 min of buccal midazolam being given. The drug efficacy in patients with status epilepticus was 50%. However, all patients with convulsions shorter than 30 min showed a perfect response (100%). Convulsion episodes stopped within 3.89±2.22 min (median time 3 min). Seizure duration was correlated with cessation of seizure (r=0.76, P<0.001). No clinically important side effects were seen in any patient. On the basis of this experience, we concluded that a 0.3 mg/kg dose of buccal administration of midazolam might offer an effective treatment in all ages of children. [Copyright &y& Elsevier]