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Background: Neonatal thrombocytopenia is a common hematological abnormality that occurs in 20–35% of all newborns in the neonatal intensive care unit. Platelet transfusion is the only known treatment; however, it is the critical point to identify neonates who are really at risk of bleeding and benefit from platelet transfusion as it also has various potential harmful effects. Aims: To investigate the prevalence and risk factors of neonatal thrombocytopenia and its relationship to intraventricular hemorrhage in the neonatal intensive care unit and to determine whether the use of platelet mass index-based criteria could reduce the rate of platelet transfusion. Study Design: Retrospective cohort study. Methods: This study was conducted in the neonatal intensive care unit of a tertiary university hospital. The medical records of neonates in the neonatal intensive care unit with platelet counts

Objective: Neonates with hyperbilirubinemia are at risk of brain damage, and at least two-thirds of neonates show clinical signs of jaundice in the first week of life. To predict the correlation between cord carboxyhemoglobin (COHb) with postnatal 24th-hour total serum bilirubin (TSB) level in newborns with ABO incompatibility. Methods: This retrospective cohort study included newborns older than 35 weeks of gestation who were followed up in the Neonatal Intensive Care Unit of Tokat Gaziosmanpaşa University Hospital between January 2019 and December 2023. Patients were divided into three groups; Group 1: ABO incompatibility with direct Coombs (DC) positive newborns, Group 2: ABO incompatibility and DC negative newborns, and Group 3: ABO incompatibility with no known hemolysis risk factors. Results: A total of 292 patients in 3 groups were included in the study. Group 1 consisted of 93 patients, Group 2 consisted of 99, and Group 3 consisted of 100. The mean newborn cord COHb was 1.59±0.56%, the mean cord bilirubin was 3.12±2.05 mg/dL, the mean 24-h TSB was 6.40±1.99 mg/dL, and the mean cord blood gas hemoglobin was 18.06±2.57 g/dL. In the first group, the correlation between cord COHb and 24-h TSB was high and statistically significant. In the second group, the correlation between cord COHb and 24-h PTH was low and statistically significant. Conclusion: The use of COHb as a predictor of 24-h postnatal TSB levels in ABO-incompatible neonates is plausible.

Aim: Immune thrombocytopenia (ITP) is the most common acquired bleeding disorder in childhood. The study aimed to assess the demographic and clinical characteristics, and treatment responses and to evaluate their effects on chronicity in pediatric ITP cases. Material and Methods: Primary ITP patients aged 1 month to 18 years, who were diagnosed and followed up in the Pediatrics Clinic of Tokat Gaziosmanpaşa University Hospital between January 2010 and December 2018, were retrospectively analyzed. Results: Thirty-eight patients with a diagnosis of primary ITP were included in the study. The mean age of the patients was 94.3±53.4 (14-199) months. The female/male ratio was 1. Twenty (57.1%) patients had acute ITP, and 15 (42.9%) patients had chronic ITP. There was no significant difference between the acute ITP group and the chronic ITP group in demographic, clinical features, laboratory findings, and treatment responses. In the first 12 months, the number of admissions with a platelet count of

IntroductionOromotor therapy exercises used for preterm infants in the NICU might promote oral-motor skills and shorten discharge day. This study investigates the impact of an oral-motor therapy program on the successful transition to breastfeeding (BF) and the enhancement of feeding skills in preterm infants below 30 weeks of gestational age who experience feeding intolerance.MethodsThe intervention group received oral-motor therapy programme for one month, while the control group did not. The feeding skills were evaluated by Early Feeding Skills Assessment Tool (EFS) and Preterm Oral Feeding Readiness Scales (POFRAS).ResultsThere was a significant difference in EFS and POFRAS scores, transition to bottle feeding at discharge and transition to BF after discharge between babies given oral-motor therapy programme and controls (p

Objective: To address the gap in evidence related to molluscum contagiosum in children by focusing on demographic and clinical features as well as risk factors. Method: The multicentre, prospective, clinical study was conducted at four hospitals in Ankara and Tokat cities of Turkey from August 1, 2014, to August 5, 2019, and comprised patients aged 18 years diagnosed with molluscum contagiosum. Data about demographics, day nursery and preschool attendance, the seasons when the disease occurred, any use of Turkish baths and swimming pools, history of personal/familial atopy, coexistence of diseases, disease duration, courses, number of lesions and anatomic localisation. Data was analysed using SPSS 19. Results: Of the 286 patients, 130(45.5%) were girls and 156(54.5%) were boys. The overall mean age was 5.94±3.95 years. The median duration of the disease was 5 weeks (interquartile range: 3.00-12.00 weeks). There was a significant number of cases with family history 18(48.6%) in the 0-3 age group (p=0.027). History of personal atopy was significantly high in the winter season (p20 lesions had used swimming pools significantly more frequently than the rest (p=0.042). The trunk was the most commonly involved region 162(56.6%). Conclusion: Providing prospective data about demographics, clinical characteristics and risk factors of molluscum contagiosum in children will lead to appropriate preventive and therapeutic measures. Key Words: Children, Molluscum contagiosum, Epidemiology.

OBJECTIVE: Newborns in neonatal intensive care units (NICUs) are at high risk for developing nosocomial infections (NIs), which may result in morbidity and mortality. In this study, we aimed to ascertain the bacteriological profiles and their antimicrobial susceptibility patterns in NIs. METHODS: We conducted a cross-sectional study in the NICU. Late-onset sepsis (LOS) cases confirmed with blood cultures were evaluated retrospectively. Laboratory parameters, demographics, and clinical data were collected and analyzed from hospital records retrospectively. RESULTS: Of the 1210 infants in the NICU, 76 (6.3%) had LOS. A total of 86 episodes of LOS were documented; in 10 infants, two pathogens were identified. The mean gestational age (GA) of the infants with LOS was 33.2+-4.8 weeks (23 to 42 weeks). Gram-positive cocci (GPC) caused most of the LOS episodes (65.8%, 50/76), with coagulase-negative Staphylococcus (CoNS) as the most common cause of LOS (50%, 38/76). Gram-negative rod species (GNRs) accounted for 32.9% (25/76) of the LOS cases, and fungi accounted for 1.3% (1/76). The mortality rates for GNR and GPC were 17.9% and 6.4%, respectively (p>0.05). The mean CRP and conjugated bilirubin levels for the GPC and GNR groups were 37.5 vs. 29.5 mg/dl and 0.7 vs 1.5 mg/dl, respectively (p>0.05). GNRs had a 20–25% ceftriaxone resistance. Two (4%) GPC species were resistant to linezolid, while all were susceptible to vancomycin. All of the GNRs were susceptible to carbapenems. CONCLUSION: These results underscore the recent emergence of CoNS in NICUs. LOS due to GNRs seems to display higher C-reactive protein and conjugated bilirubin values than those due to GPC. Clinical monitoring of NIs and bacterial resistance profiles are required in all NICUs.

Prune belly syndrome (PBS) is characterized by a classical triad of congenitally absent abdominal muscles, bilateral cryptorchidism, and a malformed urinary tract. Urorectal septum malformation sequence (URSM) is identified with the absence of urogenital and anal openings. This case report describes a 15-week-old female fetus with megacystis, ascites and oligohydramnios in a 19-year-old nulliparous woman. The patient underwent preterm labor at the 33rd gestational week and delivered a female newborn weighing 2250 grams who died three days later due to progressive respiratory insufficiency. To the best of our knowledge, this is the third case of an overlap between PBS and URSM in literature. Such an overlap refers to the existence of left renal agenesis, right renal cystic dysplasia, bilateral club foot and lumbar scoliosis as well as the absence of abdominal wall muscles, internal genital organs, urethral, vaginal and anal openings. This case report aims to remind the obstetricians about the concurrent occurrence of PBS with URSM and its poor prognosis.

Aim: Endotracheal intubation is a common procedure in the delivery room and neonatal intensive care unit. We aimed to determine the accuracy of this method of endotracheal tube (ETT) placement in our neonatal cohort. Materials and Methods: Data on infants requiring oral intubation were reviewed retrospectively. The initial ETT depth of insertion had been calculated using the Tochen 7-8-9 rule. The initial depth was compared to the mid-tracheal region. The differences between the initial and ideal depth was calculated and divided by the mid-tracheal distance. Infants were grouped according to their weights as ≤1000 g, 1001 to 2000 g, 2001 to 3000 g and ≥3001 g. Results: We evaluated ETT placement in 160 neonates. The mean gestational age was 32.2±4.4 weeks (23 to 41 weeks) and the mean weight was 1989±829 g (560 to 3800 g). The mean range of the difference between the initial depth and ideal depth divided by mid-tracheal distance was 0.39±0.04, 0.35±0.04, 0.46±0.05, and 0.23±0.04 in infants weighing ≤1000 g, 1001 to 2000 g, 2001 to 3000 g and ≥3001 g respectively (p=0.025). The differences between the 2001-3000 g group and the 1001-2000, also the 2001-3000 g group and the ≥3001 g group were statistically significant (p

Aim: In kidney diseases, renal damage may be mild and initially asymptomatic. Proteinuria, a marker of kidney injury, directly contributes to chronic tubulointerstitial damage. We investigated the prevalence of proteinuria (POP) in school-aged children in Turkey. Materials and Methods: The cluster sampling method was used to calculate the required size of the study group for this cross-sectional study. Urine samples were randomly obtained to determine urinary protein/creatinine ratio (Upr/Ucr) from 1374 children aged 6 to 18 years. POP was also specifically assessed in hypertensive and obese children. Results: The mean age of the subjects was 11.68±3.43 years. The children were from rural (23.9%) and urban (76.1%) regions of Tokat, Turkey. Upr/Ucr ≥0.20 was detected in 92 children, corresponding to a POP rate of 6.7%, without any statistically significant difference between girls and boys. Among 141 obese children, 16 (11.3%) and 76 of 1233 non-obese children (6.2%) had proteinuria (p0.05). Conclusion: Among school-aged Turkish children POP was 6.7%. POP was higher in obese than in non-obese children. But there was no association between POP and hypertension. While screening programs allow the early detection of renal disease, further cohort studies are required to be able to suggest urinary screening programs.

ObjectiveTo investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants discharged home from neonatal intensive care units (NICUs) in Turkey.Material and methodsA prospective cohort study was performed between April 1, 2016 and April 30, 2017. The study included VLBW infants admitted to level III NICUs. Perinatal and neonatal data of all infants born with a birth weight of ≤1500 g were collected for infants who survived.ResultsData from 69 NICUs were obtained. The mean birth weight and gestational age were 1137±245 g and 29±2.4 weeks, respectively. During the study period, 78% of VLBW infants survived to discharge and 48% of survived infants had no major neonatal morbidity. VLBW infants who survived were evaluated in terms of major morbidities: bronchopulmonary dysplasia was detected in 23.7% of infants, necrotizing enterocolitis in 9.1%, blood culture proven late-onset sepsis (LOS) in 21.1%, blood culture negative LOS in 21.3%, severe intraventricular hemorrhage in 5.4% and severe retinopathy of prematurity in 11.1%. Hemodynamically significant patent ductus arteriosus was diagnosed in 24.8% of infants. Antenatal steroids were administered to 42.9% of mothers.ConclusionThe present investigation is the first multicenter study to include epidemiological information on VLBW infants in Turkey. Morbidity rate in VLBW infants is a serious concern and higher than those in developed countries. Implementation of oxygen therapy with appropriate monitoring, better antenatal and neonatal care and control of sepsis may reduce the prevalence of neonatal morbidities. Therefore, monitoring standards of neonatal care and implementing quality improvement projects across the country are essential for improving neonatal outcomes in Turkish NICUs.

We aimed to define the etiologic and prognostic factors in live-born infants with hydrops fetalis (HF) in our tertiary neonatal intensive care unit over a 10-year period. Methods: Medical records of newborn infants with HF during 2002–2011 were reviewed retrospectively. Demographic data, prenatal interventions, clinical and laboratory findings, outcomes, and the results of postmortem examinations were analyzed. Results: During the study period, 62 newborn infants with HF were identified from 16,200 live-born deliveries and the incidence of HF was 3.8/1000 live births in our hospital. Twenty-eight infants (45.2%) had immune HF, whereas 34 (54.8%) had nonimmune HF. An etiologic factor could be identified in 24 (70.5%) infants with nonimmune HF. Lymphatic dysplasias comprised the majority (23.5%) of the infants with nonimmune HF. Mortality rate was 50%. The presence of two or more serous cavity effusions and gestational age were independently associated with the risk of mortality. Conclusion: Despite the improvements in neonatal care, mortality rate in infants with HF is still high. Gestational age and the extent of serous cavity determine the risk of mortality. Timely and advanced prenatal or postnatal new therapeutic strategies may alter this fatal outcome in appropriate patients.