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Objective Retinopathy of prematurity (ROP) is the most common cause of visual impairment and disability in preterm infants. Human breast milk contains stem cells which have the ability to differentiate into all three germ layers. This study investigated whether breast milk used as an eye drop reduces severe ROP or laser-requiring ROP in VLBWinfants. Methods A single-blinded, multicenter, prospective, randomized controlled trial was conducted from May 2021 to December 2021 in four level 3 neonatal intensive care units in (hidden for reviewer) in preterm infants younger than 32 weeks gestation. Participants were randomly assigned to use either breast milk eye drops or a placebo (0.9% normal saline). The primary outcome was any stage of ROP. Secondary outcomes were laser-requiring ROP and the highest stage of ROP during follow-up. Results For the final analysis, a total of 62 participants (28.6 (2) weeks) were included in the breast milk group (BMG) and 39 participants (29.9 (2) weeks) were included in the placebo group (PG). Although risk factors for the development of ROP and advanced stage ROP were consolidated in BMG, treatment with breast milk reduced ROP progression in patients with ROP in the first examination (stage 2–3 ROP n = 9 (75%) in BMG vs. n = 3 (80%) in PG), RR = 0.93, 95% CI: [0.54–1.61]; p = 0.999). No serious adverse effects were observed in either group. Conclusion The use of freshly expressed breast milk as eye drops reduced the advanced stage of ROP or laser-required ROP in patients with ROP on initial examination.

Objective Health care associated infections (HAIs) in the neonatal intensive care unit (NICU) are a significant cause of neonatal morbidity and mortality. Enterobacter aerogenes, a gram-negative bacterium, rarely causes HAI in the pediatric and NICUs. We report the case of a HAI outbreak of E. aerogenes in an NICU and discuss the clinical spectrum and outcome of the affected preterm newborns and successful prevention measures. Materials and Methods A retrospective study was conducted in a level III NICU of Etlik Zubeyde Hanım Women's Health Teaching and Research Hospital. The infants with blood cultures positive for E. aerogenes during the outbreak were enrolled. Perinatal risk factors, laboratory findings, symptoms, treatment, and prognosis were recorded. Clinical applications and prevention measures were identified. Results A preterm infant of 27 weeks of gestation who was diagnosed on the eighth postnatal day was the initial case of the reported outbreak of health care associated E. aerogenes infection. Subsequently, 12 more infants were diagnosed in the next 3 months. Infants' mean gestational age was 27.1 ± 2.3 weeks, and mean birthweight was 902 ± 161 g. The clinical symptoms at presentation were respiratory distress, sclerema, circulatory failure, and shock, which appeared at a mean age of 7.6 ± 5.8 days. Analysis of E. aerogenes strains revealed that all strains were of the same clonal type. Eight patients died in follow-up due to E. aerogenes septicemia during this outbreak. The mean interval between the onset of symptoms and death was 1.5 ± 1 days. Conclusion Outbreaks of health care associated E. aerogenes infection result in a high mortality rate among very low birthweight infants. Awareness of adjustable risk factors and preventive measures to control the outbreak decreases both morbidity and mortality.

Background: Thiols are organic compounds containing sulfhydryl groups which exert antioxidant effects via dynamic thiol–disulfide homeostasis. The shift towards disulfide indicates the presence of ...

Noroglial heterotopiler nadir gorulen konjenital kitlelerdir. Nazal heterotopiler nazal glial heterotopi veya nazal gliom olarak adlandirilir. Ayirici tanida hemanjiom, dermoid / epidermoid kistler, ensefalosel ve tumorler bulunmaktadir. Cerrahi eksizyon tedavi secenegidir. Burada literaturde ilk kez tanimlanan cok dusuk dogum agirlikli bebekte nazal gliom sunulmustur. ABSTRACT Neuroglial heterotopias are rare congenital masses. Nasal heterotopies are termed as nasal glial heterotopia or nasal glioma. The differential diagnosis includes hemangioma, dermoid/epidermoid cysts, encephalocel and tumors. Surgical excision is the treatment of choice. We report an extremely low birth weight infant with nasal glioma as firts time in the literature.

Objective A temporal relationship has been reported between necrotizing enterocolitis, anemia, and red blood cell transfusion (RBCT) in preterm neonates. However, the mechanism underlying this association is not clearly defined. Intestinal (I-) and liver (L-) fatty acid binding proteins (FABPs) have been proposed as plasma markers for the detection of acute intestinal injury. This study aimed to investigate the effect of anemia and RBCT on intestinal injury in preterm neonates by measuring serum I-FABP and L-FABP levels. Study Design A prospective cohort study including preterm neonates with gestational age Results In total, 39 infants transfused for anemia and 20 controls were enrolled. L-FABP levels were significantly higher in neonates with anemia compared with controls (p Conclusion Anemia is associated with intestinal injury documented by increased L-FABP levels in preterm infants, and this injury is more severe with lower hemoglobin levels.

Beken, Serdar/0000-0002-8609-2684; BAS, AHMET YAGMUR/0000-0002-1329-2167; Bulbul, Ali/0000-0002-3510-3056; Karatekin, Guner/0000-0001-7112-0323, WOS: 000534242500056, PubMed: 31851725, Objective To investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants discharged home from neonatal intensive care units (NICUs) in Turkey. Material and methods A 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. Results Data 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. Conclusion the 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., Turkish Neonatal Society [2-2016]; Turkish Neonatal Society, This study was supported by the Turkish Neonatal Society, http://www.neonatology.org.tr, number 2-2016, received by AYB. Turkish Neonatal Society funded the study's online registry system. the funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Aim: Neonatal abstinence syndrome (NAS) is a clinical condition characterized by findings that develop after intrauterine exposure to addictive substances, especially opioids, and is characterized by signs related to the absence of the addictive substance in the postpartum period. Typically, NAS manifests in the first few days of life in the form of hypertonia, autonomic instability, irritability, poor absorption reflex, weight loss and, rarely, seizures. The present study was performed the clinical features of mothers who used addictive substances during pregnancy.Materials and Methods: Neonates born between September 2016 and December 2019 to opioid-addicted mothers and admitted to the neonatal intensive care unit (NICU) after birth for findings consistent with NAS were included in this study. The patients' files were analyzed retrospectively. Maternal age, drug used/duration of use, smoking/alcohol use, the last time the substance was taken, gestational week of neonates, mode of delivery, birth weight, onset of NAS symptoms, highest Finnegan score, nutritional status, length of hospitalization, treatment duration and NICU follow-up data were recorded.Results: Nine babies were admitted to the NICU of follow-up for NAS symptoms. All mothers had heroin addiction. The median gestational week of the neonates was 37 (31-40) weeks and median birth weight was 2740(1530-3860) g. Median onset of symptoms was 2(1-4) days and the median Finnegan score of the patients was 10(3-17). Six (66.7%) neonates who did not recover with nonpharmacological treatment received phenobarbital therapy. Conclusions: For patients with NAS, phenobarbital therapy can be used as the first option when symptoms cannot be controlled by nonpharmacological methods in settings such as Turkey where oral morphine solution is not available. In our study, the symptoms were successfully controlled by phenobarbital therapy. However, more comprehensive studies are needed as there are insufficient data on long-term results.

Nitric oxide (NO), synthesized from the amino acid L-arginine by the action of NO synthases (NOS), is a pulmonary vasodilator. Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of NOS. Preterm infants have higher plasma ADMA concentrations than term infants which could cause inhibition of NO synthesis and deterioration in pulmonary functions. We aimed to investigate the relationship between serum ADMA and L-arginine levels of preterm infants and respiratory distress syndrome (RDS), requirement of surfactant treatment, duration of mechanical ventilation, oxygen treatment, and development of bronchopulmonary dysplasia (BPD).A prospective cohort study was conducted including 80 preterm infants born with gestational age (GA) ≤ 32 weeks and birth weight (BW) ≤ 1500 g. Blood samples were obtained from all infants immediately after birth, and at postnatal 28th day of age. The relationship of first-day serum ADMA and L-arginine levels and surfactant requirement, duration of mechanical ventilation, oxygen treatment was investigated. Serum ADMA and L-arginine levels at 1st and 28th days were compared at patients with and without BPD. The role of serum ADMA levels at postnatal 28th day of age to predict the requirement of oxygen at postmenstrual 36 weeks of age was also investigated.Eighty preterm infants (42 male, 38 female) were enrolled in the study. Mean BW and GA for the total cohort was 1144.81 ± 220.44 g and 28.3 ± 1.8 weeks, respectively. Sixty-one infants were diagnosed as RDS and 44 infants treated with surfactant. The first-day ADMA levels were significantly higher in infants with surfactant requirement (1.14 ± 0.23 versus 0.86 ± 0.37, p 0.01). First-day L-arginine levels were lower in infants with surfactant requirement compared to infants without surfactant requirement (22.32 ± 2.33 versus 23.75 ± 2.42, p 0.05) but not significantly. Serum ADMA and L-arginine concentrations at first day were not different among infants with and without BPD (p 0.05). ADMA concentrations at 28th day was significantly higher in infants with BPD (1.00 ± 0.25 versus 0.81 ± 0.25, p 0.05). The cutoff level of 0.875 μmol/L for ADMA at 28th day offered the best predictive value for oxygen requirement at postnatal 36 weeks of age with a sensitivity of 88% and a specificity of 54%. Conclusıon: Serum ADMA and L-arginine levels are related to pulmonary morbidities in newborn. The results of this study show that increased ADMA levels are associated with poor pulmonary outcomes in preterm infants.

Hyperglycemia commencing within the first 6 months of life requires exogenous insulin therapy and, if the condition persists for >2 weeks, is termed neonatal diabetes mellitus (NDM). This rare illness is of two types: transient and permanent NDM. Most cases come to medical attention because of nonspecific symptoms, including intrauterine growth retardation, dehydration, difficulties in feeding and inadequate weight gain. In the present article, we describe an infant who smelt of ketones during examination and who was diagnosed with transient NDM caused by a ZFP57 mutation, accompanied by ketoacidosis. This is the first report of such a condition.

Background and Aims Hemoptysis in children is a rare but potentially life-threatening symptom of an underlying respiratory tract abnormality. Hemoptysis, when massive and untreated, has a mortality rate of more than 50%. With interventional radiological procedures and surgery, this rate has dropped to 7%–18%. The experience with bronchial arterial embolization in childhood is very limited; only a few case reports with short-term follow-up have been reported. Methods We report herein two patients with massive hemoptysis due to abnormal systemic arterial bleeding of the lung; neither patient had any lung or systemic disease. In both cases, the bleeding was controlled with endovascular embolization. The first case had bronchopulmonary arterial anastomosis and represents the first reported case with this anomaly. The second case had recurrent massive hemoptysis due to bronchial artery bleeding, and repeat embolization was performed. Results Both of these children had rare vascular anomalies without parenchymal lung disease and were treated successfully with bronchial arterial embolization. Conclusion Massive hemoptysis due to abnormal systemic bleeding of the lung in the absence of parenchymal disease is an uncommon and severe symptom in childhood. Embolization can be a treatment option in children with abnormal vasculature bleeding and can be repeated safely when needed.

Ozcan B, Kavurt AS, Aydemir O, Gencturk Z, Bas AY, Demirel N. SNAPPE-II and risk of neonatal morbidities in very low birth weight preterm infants. Turk J Pediatr 2017; 59: 105-112. Illness severity scores were described to estimate the mortality and morbidity risks based on data obtained shortly after admission to an intensive care unit. The aim of this study is to evaluate Scores for Neonatal Acute Physiology-Perinatal Extension-II (SNAPPE-II) as a predictors of neonatal morbidities such as bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP). A retrospective cohort study was conducted between October 2011- 2012. A total of 278 preterm infants born with gestational age (GA) < 32 weeks and birthweight (BW) < 1,500 g were given SNAPPE-II scores based on data collected within the first 12 h of admission to ICU. The main outcomes were the development of BPD and ROP. The main variable was the SNAPPE-II obtained at admission. Logistic regression and receiver-operating characteristics (ROC) curve were calculated for SNAPPE-II. The mean GA and mean BW of the whole cohort were 29.2 weeks (± 2.15) and 1,323 g (±331,4), respectively. The median SNAPPE-II value was significantly higher among patients with BPD and ROP. After logistic regression the SNAPPE-II was independent risk factor for BPD and ROP. The best discriminative cutoff value for BPD was 14.5 (sensitivity 92%) and for ROP was 23.5 (sensitivity 80%). The present study reviewed an association between SNAPPE-II and neonatal morbidities including ROP and BPD.

Objective: Nonimmune hydrops fetalis (NIHF) is associated with abnormal fluid collections in fetal soft tissues and serous cavities due to nonimmunologic causes. It should be considered as a symptom, rather than a disorder. We aimed to investigate etiology and pathophysiology in cases with NIHF during a four-year time period. Methods: Eleven live-born infants with NIHF were evaluated retrospectively. Demographic data, laboratory values, and results of specified tests were recorded. Etiology and pathophysiological mechanisms were established. Results: The mean gestational age at birth was 32.8±2.6 weeks and the mean birth weight was 2545±809 grams. All cases presented with edema and ascites. Chromosomal disorders (5/11) were the leading etiology. Pathophysiological mechanisms were observed as fetal hypotonia, fetal hypoxia, lymphatic disorders, hypoalbuminemia, early closure of ductus arteriosus, anemia, and right-sided heart failure. Mortality was 72%. Conclusion: In the presented study NIHF occurred as a symptom which was presented in various conditions based on different mechanisms. Evaluations made in infants with NIHF should aim both diagnosis of the condition as well as finding out the underlying pathophysiological mechanisms. Mortality rate in infants with NIHF is high even though the improvements in neonatal care.

Nitric oxide (NO) formed by the enzyme NO synthase (NOS) from L-arginine, is an important mediator for pathogen elimination. Being a potent vasodilator NO is implicated in hypotension and decreased organ perfusion in sepsis. Asymmetric dimethylarginine (ADMA) is an endogenous NOS inhibitor. We investigated ADMA and L-arginine levels in neonatal sepsis and their relation to disease severity.A prospective controlled study was conducted including 31 neonates with sepsis and 20 controls. Serum ADMA and L-arginine levels were measured within 24 h of sepsis diagnosis. Clinical and laboratory data including clinical risk index for babies (CRIB) score, presence of septic shock, organ dysfunction and death were recorded.L-arginine and ADMA levels were higher in neonates with sepsis compared to controls (p = 0.029 and p = 0.001, respectively). Neonates with septic shock had higher ADMA levels compared to septic neonates without shock (p = 0.026) and controls (p 0.001). L-arginine levels were higher in neonates with septic shock compared to septic neonates without shock (p = 0.012) and controls (p 0.001). Survivors and non-survivors had similar L-arginine and ADMA levels. ADMA levels were correlated with CRIB score (rho = 0.320, p = 0.025).L-arginine and ADMA levels are elevated in neonatal sepsis and even higher levels are observed in septic shock.

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.Keywords: Newborn; congenital heart disease; pulse oximetry screening; cardiovascular disease.

Neonatal abstinence syndrome (NAS) due to prenatally exposure to citalopram can develop during the first days of life even with low dose of drug exposure. Supportive management is the first choice but phenobarbital can be used in treatment of this syndrome. Breastfeeding should not be interrupted. These neonates should be followed both for NAS and neurodevelopmental outcome. In this article, we reported a newborn with NAS due to citalopram exposure with a lower dose than previously reported in the literature, during the last six months of pregnancy. Phenobarbital was used because of non-pharmacological treatment failure.El síndrome de abstinencia neonatal (SAN) debido a la exposición prenatal al citalopram se desarrolla durante los primeros días de vida, incluso con una exposición al fármaco en dosis bajas. El tratamiento de apoyo es la primera opción, aunque puede usarse el fenobarbital en el tratamiento de este síndrome. No debe interrumpirse la lactancia. Debe hacerse un seguimiento de estos recién nacidos para establecer el desenlace del SAN y las consecuencias en el desarrollo neurológico. En este artículo presentamos el caso de un recién nacido con SAN debido a exposición al citalopram en una dosis más baja que lo informado previamente en la bibliografía durante los últimos seis meses del embarazo. Se utilizó el fenobarbital debido al fracaso del tratamiento no farmacológico.

Summary Objectives: To evaluate one-year structural outcomes of bedside diode laser photocoagulation with remifentanil analgesia for retinopathy of prematurity (ROP) and discuss clinical and demographic characteristics of infants and other possible risk factors that may affect the outcome. Materials and Methods: The medical records of premature infants who were treated with bedside transpupillary diode laser photocoagulation under remifentanil analgesia for ROP were evaluated for clinical and demographic characteristics, accompanying systemic risk factors, laser parameters, complications of treatment, retreatment rate and one-year structural outcomes. Results: One-hundred and ninety-five eyes of 99 infants (59 males, 40 females) were recruited for the study. The mean gestational age and birth weight were 27.4±2.3 weeks (23-34) and 1003.3±297.8 g (570-2250), respectively. Laser therapy was performed for high-risk prethreshold ROP in 66.2% of eyes, aggressive posterior ROP (APROP) in 15.4% and threshold ROP in 18.4%. The mean number of laser spots was 1510.4±842.1 per laser session. No adverse effects of laser photocoagulation were observed except small lens opacities in two eyes and corneal opacity in one eye. Retreatment was needed in only three eyes, and vitreoretinal surgery was needed in six eyes of six patients despite laser treatment. Anatomic outcome was favorable in 189 eyes (96.9%) at the end of a 1-year follow-up. Presence of dilated and tortuous iris vessels (p=0.002) and tunica vasculosa lentis (p=0.009) along with type of ROP (APROP and stage 4a ROP at initial presentation) (p=0.001) were associated with poor anatomical outcome. Conclusion: Accurate and timely bedside transpupillary diode-laser photocoagulation under remifentanil analgesia is an effective and safe treatment modality for ROP, and may prevent vision-threatening retinal detachment and reduce the need for vitreoretinal surgery.

To evaluate the incidence, risk factors and severity of retinopathy of prematurity in neonatal intensive care unit and to evaluate its relationship with gestational age.Cohort study of neonates with gestational age ≤ 32 weeks or birthweight ≤ 1500 g.Of the 495 neonates screened, 43 (8.7%) infants were small for gestational age; the frequency of severe retinopathy of prematurity was 5.8%. Sepsis and being small for gestational age were independent risk factors for severe retinopathy of prematurity.Clinicians should be aware of the presence of presence of retinopathy of prematurity when caring for protein small for gestational age infants.

To evaluate the central corneal thickness (CCT) and intraocular pressure (IOP) of premature infants and to document correlation of them with gestational age, chronological age, and birth weight of infants. Using a hand-held applanation tonometer and a portable pachymeter, IOP and CCT of 170 premature infants were measured just before initial retinopathy of prematurity screening examination and re-measured 4 weeks after the first visit. The CCT and IOP were positively correlated during the first (r = 0.616, p < 0.001) and second (r = 0.564, p < 0.001) visits. The mean CCT at first and second visits were 568.1 ± 22.1 (527-628) and 561.6 ± 21.4 (520-619) µm, consecutively (p < 0.001). Gestational age, chronological age and birth weight of infants were found to be negatively correlated with CCT at first (r = -0.751, p < 0.001; r = -0.745, p < 0.001; r = -0.581, p < 0.001, consecutively) and second (r = -0.729, p < 0.001; r = -0.729, p < 0.001; r = -0.555, p < 0.001, consecutively) visits. The mean IOP at first and second visits were 14.1 ± 1.9 (11-19) and 13.7 ± 1.7 (11-18) mmHg, consecutively (p < 0.001). Gestational age, chronological age, and birth weight of infants were found to be negatively correlated with IOP at first (r = -0.724, p < 0.001; r = -0.715, p < 0.001; r = -0.558, p < 0.001, consecutively) and second (r = -0.704, p < 0.001; r = -0.703, p < 0.001; r = -0.518, p < 0.001, consecutively) visits. CCT and IOP of the premature infants with a smaller gestational age were found to be higher (p < 0.001 for both). Premature infants with smaller gestational age have higher CCT and IOP values when compared to older infants. These values tend to become lower 4 weeks after the first examination as infants become older. The CCT and IOP were positively correlated with each other and both were negatively correlated with gestational age, chronological age, and birth weight during first and second visits.

Hemoptysis in children is a rare but potentially life-threatening symptom of an underlying respiratory tract abnormality. Hemoptysis, when massive and untreated, has a mortality rate of more than 50%. With interventional radiological procedures and surgery, this rate has dropped to 7%-18%. The experience with bronchial arterial embolization in childhood is very limited; only a few case reports with short-term follow-up have been reported.We report herein two patients with massive hemoptysis due to abnormal systemic arterial bleeding of the lung; neither patient had any lung or systemic disease. In both cases, the bleeding was controlled with endovascular embolization. The first case had bronchopulmonary arterial anastomosis and represents the first reported case with this anomaly. The second case had recurrent massive hemoptysis due to bronchial artery bleeding, and repeat embolization was performed.Both of these children had rare vascular anomalies without parenchymal lung disease and were treated successfully with bronchial arterial embolization.Massive hemoptysis due to abnormal systemic bleeding of the lung in the absence of parenchymal disease is an uncommon and severe symptom in childhood. Embolization can be a treatment option in children with abnormal vasculature bleeding and can be repeated safely when needed.

A variety of diseases can cause vesicular or pustular eruptions in newborns. A thorough clinical history and physical exam provide important clues for differential diagnosis. Goltz syndrome, also known as focal dermal hypoplasia, is a rare genodermatosis and generally diagnosed by the presence of the characteristic skin lesions. We present an infant with aplasia cutis, atrophic skin lesions, syndactyly and eye abnormalities who was diagnosed with Goltz syndrome soon after birth. Goltz syndrome should be considered in differential diagnosis of hypoplastic or aplastic skin lesions in neonates in the presence of skeletal or ophthalmic anomalies.

Congenital megalourethra is a rare urogenital malformation characterized by severe dilatation and elongation of the penile urethra. It causes functional obstruction of the lower urinary system. Herein, we present a newborn with congenital megalourethra with single umbilical artery.

Seroprevalence data indicate that West Nile virus (WNV) activity is present in Turkey; however, no pediatric cases of WNV infection have been reported to date. WNV is an emerging flavivirus in Turkey, and in September2010, the Turkish Ministry of Health reported the first seven cases of laboratory-confirmed WNV infection from five different cities in the western part of the country. This is the first report of a child from central Anatolia, indicating the existence of the virus in other regions of the country.