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Objective: Vitamin D is an essential hormone for the health of the musculoskeletal system and acts in immune system, cardiovascular system and metabolic homeostasis. The aim of this study was to determine the vitamin D status of children in the central Anatolia region. Also, the study evaluated the age, gender and seasonal variations in the study population. Materials and Methods: Children aged 1-17 years who were admitted to a Secondary Maternity and Children Hospital in Konya were included in this study. The medical records of the participants were retrospectively evaluated from the hospital information system between July 2016 and December 2021. All patients were categorized according to age, gender, and season in which their blood samples were obtained. Results: A total of 3547 children were included in the study. The mean serum level of 25-hydroxyvitamin D in the study population was 16.45±9.39 ng/ml. The number of samples obtained in winter was 1063 (30%) and in summer 756 (21.3%), respectively. Only 7.4% (n=262) of the participants had sufficient vitamin D levels (>30 ng/ml) in the study population. Additionally, severely deficiency of serum 25-hydroxyvitamin D level was mostly measured in winter season (378 patients, 45%). Severely deficiency (352 patients, 41.9%) was most common in children aged 12-17 years. Among all patients, only 7.4% had sufficient serum 25-hydroxyvitamin D levels. Also, 5.2% (103 patients) of the girls and 3.7% (59 patients) of the boys had sufficient 25-hydroxyvitamin D levels. On the other hand, severely deficiency of serum 25-hydroxyvitamin D levels was most common in boys (521 patients, 33.1%) than in girls (137 patients, 6.9%). Conclusion: Vitamin D deficiency/insufficiency is wide spread among children in the world and in Turkiye. Our study revealed that seasonal variations, age and gender affect the serum levels of 25-hydroxyvitamin D in children. In this context, the importance of vitamin D rich foods or vitamin D supplementation is increasing. [ABSTRACT FROM AUTHOR]

Aim: The aim of our study is to evaluate the demographic characteristics and epidemiological risk factors of neonatal hypernatremic dehydration and to discuss the precautions applied in our clinic in order to reduce the number of dehydration cases in the light of the literature. Materials and Methods: Newborns who were hospitalized in our neonatal intensive care unit with the diagnosis of HD, whose serum sodium level was >147 mmol/L and born at >37 weeks were evaluated retrospectively. Babies with illnesses that would adversely affect nutritional status were excluded from the study. Results: Mean gestational week of 54 cases included in the study was 39.19±1.07.22. The mean birth weight was 3244.06±458.46 gr. while the mean weight of hospitalization was 2880.28±514.54 gr. The percent of weight loss was found to be 8.51±3.14%. The mean age of hospitalization was 3.7±2.05 days and the mean duration of hospitalization day was 2.26±1.42 days. On admission, 11 (20.4%) patients had fever, 6 (11.1%) patients had jaundice, 3 (5.6%) patients had discomfort, 30 (55.5%) patients had more than one complaint and dehydration was detected in 4 (7.4%) patients during control admission of pediatric outpatient clinic. On physical examination, 46 (85.2%) patients had mild dehydration, 7 (13%) had moderate dehydration, and 1 (1.9%) patient had severe dehydration. The mean serum sodium value of the patients was 150.44±3.62 mmol/L, mean serum urea value was 45.5±18.13 mg/dl, and mean serum creatinine value was 0.79±0.34 mg/dl at the time of admission. The etiologies of dehydration were breast milk insufficiency in 37 (68.5%) cases, inability to breastfeed effectively due to nipple problems in 2 (3.7%) cases, and errors in breastfeeding technique in 15 (27.7%) cases. A positive correlation was found between the degree of dehydration and percent of weight loss and the serum sodium value (p<0.001). Conclusion: In our study, it was found that the most common cause of hypernatremic dehydration was breast milk insufficiency. Considering other reasons, giving breastfeeding education to mothers before discharge from the hospital seems to be important in preventing hypernatremic dehydration. [ABSTRACT FROM AUTHOR]

Several congenital heart diseases (CHD) are present in children with congenital anomalies of the kidney and the urinary tract (CAKUT) in syndromic or nonsyndromic patterns. The purpose of this study was to identify nonsyndromic children with CAKUT who required echocardiographic evaluation and to find the prevalence of CHD in these patients. Retrospective chart review of nonsyndromic patients with CAKUT between 2012 and 2018 was conducted. Types of congenital anomalies of the kidney and urinary tract and echocardiogram reports of the patients, age, gender, prematurity, prenatal diagnosis of CAKUT, and family history were noted. Among 806 children with CAKUT, 135 patients underwent transthoracic echocardiographic evaluation and CHD was detected in 91 (11.2%). The most common type of CHD was secundum type atrial septal defect that was found in 73 (80.2%) patients. On the other hand, the most frequent types of congenital anomalies of the kidney and the urinary tract were isolated hydronephrosis and primary vesicoureteral reflux (61.4% and 12.8%, respectively). Our results showed that 75.8% of the patients with congenital heart diseases had isolated hydronephrosis. Finally, only 18 (2.2%) cases out of 806 patients that were evaluated via transthoracic echocardiography due to the clinical findings and family history had a CHD that required close (<6 months) follow‐up. Congenital heart diseases that required close follow‐up are rarely observed in nonsyndromic patients with CAKUT. Therefore, we suggest echocardiography should be performed in cases of clinical suspicion and family history rather than routinely in this patient group. [ABSTRACT FROM AUTHOR]

Introduction: Identifying and understanding the factors on exclusive breastfeeding duration and continuation at the community level in a clinician's setting is vital for designing interventions to improve. The objective of this study was to evaluate the factors associated with exclusive breastfeeding time and total continued breastfeeding period among mothers in the middle region of Turkey. Materials and Methods: A questionnaire form including; information about women's and children's socio-demographic characteristics and breastfeeding habits was used. Results: A total of 1041 mothers were included in the study. Exclusive breastfeeding time and total continued breastfeeding period were found as 5.45±1.98/month and 17.56±8.17/month, respectively. On the other hand, most of the mothers (74.9%) exclusively breastfed their children more than 6 months while only 35% of mothers continued breastfeeding over 24 months. Current study showed that types of first prelacteal feeds, maternity age (30-40 years of age), socioeconomic status, single child birth and doctor/nurse as the source of knowledge about benefits of breastfeeding were strongly associated with the exclusive breastfeeding time of ≥6 months. In addition, young mothers (20-30 years of age), primiparous, breast milk as the first prelacteal feed, lower educational level, low socioeconomic status, nuclear type of family status and doctor/nurse as the source of knowledge about benefits of breastfeeding were found to be strongly associated with total continued breastfeeding period of ≥24 months. Conclusions: Certain factors can be associated with exclusive breastfeeding duration and breastfeeding continuation. So, community-based proposals should be prepared by working on the determined factors to improve breastfeeding duration. [ABSTRACT FROM AUTHOR]

Objective: Renal scars may be observed either as congenital or acquired in patients with vesicoureteral reflux (VUR). On the other hand, renal dysplasia occurs due to faulty embryogenesis and may accompany VUR. The aim of this study is to observe the rates of renal scarring and dysplasia in patients with primary VUR and to evaluate its association with urinary tract infections (UTI). Material and Methods: Files of the patients that were followed-up in our clinic with the diagnosis of VUR between 2012 and 2018 were retrospectively reviewed. Those with secondary VUR (Neuropathic bladder, posterior urethral valves etc.) were excluded. Age, gender, diagnosis of UTI, DMSA (dimercaptosuccinic acid) scan and VCUG (voiding cystourethrography) results were noted. VUR ≥grade 3 were regarded as dilating. The relationships of renal scarring and renal dysplasia with UTI, VUR degree, laterality and gender were assessed. Results : There were 121 patients in the cohort, 66 girls (55%) and 55 boys (45%) with a median age of 6 months (range 2-42 months). VUR was bilateral in 58 (48%) while it was dilating in 78 (65%). UTI was detected in 76 patients (62.8%). Dysplastic kidney was present in 33 patients (27.3%) and renal scars were present in 20 (16.5%). UTI rate was statistically lower in dysplastic kidneys (p<0.001) and it was higher in girls (p<0.001). However, there was no correlation with UTI and renal scarring (p=0.217). In addition, dilating VUR patients showed higher rates of renal dysplasia and renal scarring. Conclusions: Relationship between renal scarring/dysplasia and UTI is multifactorial. UTI rate is lower when dysplasia is presented along with VUR. Prospective studies including genetic analysis are required to assess dysplasia/renal scarring and UTI relation. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to determine the relationship between extracardiac abnormalities and congenital heart diseases in fetuses that were referred for fetal echocardiography due to a variety of reasons. Materials and Methods: A total of 1,158 pregnant woman whose fetal echocardiograms and detailed fetal anomaly scanning were performed between June 2017 and July 2018 were included in this study. The documents of the pregnant women were reviewed retrospectively. Those fetuses who were determined to have various organ anomalies and congenital heart defects were recorded. Results: While 664 pregnant women were in the low-risk group, 494 pregnant women were in the high-risk group in the study. Congenital heart defects were detected in a total of 38 pregnant women (3.28%). The prevalence of all gastrointestinal system, urinary system and central nervous system anomalies were 5.35%, 3.79% and 6.73%, respectively. Interventricular septum, aorta, pulmonary and tricuspid valves associated with congenital heart diseases were found to be mostly related with these organ anomalies. Conclusion: Gastrointestinal system and central nervous system anomalies were found to be mostly associated with congenital heart diseases. Also, the interventricular septum, aortic, pulmonary and tricuspid valves' anomalies were the most frequently detected congenital heart diseases in these situations. [ABSTRACT FROM AUTHOR]

Chest pain is a frequent complains in children and especially in adolescents which is most likely non-cardiac in origin. Variant angina (VA) is a rare cause of cardiac originated chest pain in children. Although it is well documented in adults, (VA) is a rare cause of chest pain in adolescents. Three adolescents with variant angina were reported in this article and the use of cardiac computed tomography in the diagnosis and treatment strategies were discussed detailed in company with the literature. [ABSTRACT FROM AUTHOR]

The article presents the case history of a 10-month-old girl with giant atrial septal aneurysm prolapsing into the right ventricle.