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BACKGROUND We aimed to compare the clinical and laboratory characteristics and imaging methods of patients diagnosed with preseptal cellulitis and orbital cellulitis in the pediatric age group. METHODS The study was designed retrospectively, and the medical records of all patients who were hospitalized with the diagnosis of preseptal cellulitis and orbital cellulitis were reviewed. The findings of preseptal cellulitis and orbital cellulitis groups were compared. The risk factors for the development of orbital involvement were analyzed. RESULTS A total of 123 patients were included, 90.2% with preseptal cellulitis and 9.8% with cellulitis. The male gender ratio was 60.2%, and the mean age was 72 ± 43 months. While all patients had eyelid swelling and redness, 20.3% had fever. Ocular involvement was 51.2% in the right eye and 4.9% in both eyes. The most common predisposing factor was rhinosinusitis (56.1%). Radiological imaging (computed tomography/magnetic resonance imaging) was performed in 83.7% of the patients. Subperiostal abscess was detected in 7 cases (5.6%) in which three of the cases were managed surgically and four were treated with medically. The levels of C-reactive protein were significantly higher in patients with orbital involvement (P = 0.033), but there was no difference between the presence of fever, leukocyte and platelet values. CONCLUSIONS Rhinosinusitis was the most common predisposing factor in the development of preseptal cellulitis and orbital cellulitis. Orbital involvement was present in 9.8% of the patients. It was determined that high C-reactive protein value could be used to predict orbital involvement.

Aim: We aimed to assess the impact of COVID-19 on asthma exacerbations and to compare the severity of symptoms of SARS-CoV-2 infection of asthmatic children with those of healthy children. Methods: The clinical course of COVID-19 was compared among 89 children with asthma and 84 healthy children with age- and gender-matched. Demographic factors, severity of asthma, duration of asthma, presence of atopy, type of treatment, and compliance to treatment in asthmatic children on clinical course of infection and to determine the risk factors for severe course for asthma exacerbation during COVID-19 were evaluated retrospectively. Demographic characteristics, clinical symptoms, duration of complaints, and hospitalization rates were statistically compared between the two groups. Results: Both groups had similar rates of symptomatic disease, hospitalization, and duration of fever. Among children with asthma mean age was 10.3 years, 59.6% were male, and 84.3% had mild asthma. Dyspnea was more prevalent in asthmatic children (p:0.012), but other clinical findings were not different from those of healthy controls. 12.4% (n:11) of asthmatic children had asthma exacerbation, 2.2% (n:2) of them were hospitalized; one (1.1%) of which was due to asthma exacerbation. Conclusion: The course of COVID-19 in patients with mild to moderate asthma, who were followed up regularly and who were compliant with their treatment, was similar to their healthy peers. Since there was no severe asthma case in our study, the results could not have been generalized to all asthmatic patients. Further comprehensive and multicenter studies are required in pediatric population.

Background: To compare the clinical and laboratory characteristics and imaging methods of patients diagnosed with preseptal cellulitis and orbital cellulitis in the pediatric age group. Methods: The study was designed retrospectively and the medical records of all patients who were hospitalized with the diagnosis of preseptal cellulitis and orbital cellulitis were reviewed. The findings of preseptal cellulitis and orbital cellulitis groups were compared. The risk factors for the development of orbital involvement were analyzed. Results: A total of 123 patients were included, 90.2% with preseptal cellulitis and 9.8% with cellulitis. The male gender ratio was 60.2% and the mean age was 72±43 months. While all patients had eyelid swelling and redness 20.3% had fever. Ocular involvement was 51.2% in the right eye and 4.9% in both eyes. The most common predisposing factor was rhinosinusitis (56.1%). Radiological imaging (Computed tomography/magnetic resonance imaging) was performed in 83.7% of the patients. Subperiostal abscess were detected in 7 cases (5.6%) which three of the cases were managed surgically and four were treated with medically. The levels of c-reactive protein were significantly higher in patients with orbital involvement (p:0.033) but there was no difference between the presence of fever, leukocyte and platelet values. Conclusions: Rhinosinusitis was the most common predisposing factor in the development of preseptal cellulitis and orbital cellulitis. Orbital involvement was present in 9.8% of the patients. It was determined that high c-reactive protein value could be used to predict orbital involvement. Keywords: Childhood, preseptal cellulit, rhinosinusit, orbital cellulit, subperiostal abscess.

Acute hemorrhagic edema of infancy is a leukocytoclastic small vessel vasculitis of young children that is limited to the skin, generally has a benign course without systemic involvement, and does not require treatment. It is characterized by fever, edema of the lower extremities, and wide purpuric rash of the skin. It typically affects infants aged 6-24 months with a history of recent respiratory system illness. An 11-month-old and a 57-month-old cases with acute hemorrhagic edema of infancy who concurrently have a lower respiratory system infection are presented in this case report.

Objectives: The aim of this study was to evaluate factors that affected decisions regarding breastfeeding and complementary feeding practices in children aged 24 to 48 months. Methods: Children aged 24 to 48 months who were presented at the outpatient clinic of a single hospital over a 6-month period were included in the study. Children who were born prematurely, hospitalized in the neonatal intensive care unit, and those with a chronic disease were excluded. A questionnaire was administered to parents who provided consent. Data related to demographic characteristics, socioeconomic status, and infant nutrition practices were collected and analyzed. Results: A total of 100 cases were included. The distribution of the gender of the children was 49% female and 51% male, and the mean age was 36.2±7.8 months. The mean duration of exclusive breastfeeding was 4.83±1.23 months, the mean length of total breastfeeding was 17.65±8.44 months, and the mean initiation of complementary feeding was 5.71±1.23 months of age. The most frequent reason provided for the cessation of breastfeeding was the mother’s decision to wean. The duration of exclusive breastfeeding and the total length of breastfeeding feeding was significantly shorter among children who were born by cesarean section, and those who used a pacifier and or feeding bottle. Non-working mothers used formula for a longer period (p=0.043) and introduced solid foods and the use of utensils later than other mothers (p=0.001, p=0.03, respectively). Complementary food was provided to the infants of families whose monthly income level was less than TL 1000 earlier than in higher income level groups (p=0.04). The results of this study also showed that complementary food choices were most influenced by older members of the family and members of the mother’s immediate circle (42%) and healthcare professionals (36%). Mothers who received information about the addition of complementary food did not demonstrate a significantly different length of time devoted to exclusive breastfeeding; however, the duration of breastfeeding overall, alone and in combination with solid foods, increased (p=0.03). Conclusion: Before the birth, families should be informed and prepared regarding the necessity of exclusive breastfeeding for the first 6 months and the continuation of breastfeeding until 2 years of age, the potential impact of relevant factors related to the type of birth, and the potentially negative effects of the use of a pacifier or bottle. All members of the family, particularly mothers and close relatives, should be advised about proper complementary feeding techniques, including the need to increase the consistency of food gradually, introducing solid foods before the 10th month, and using natural, home-cooked items instead of prepared foods. The appropriate information and guidance should be provided to all families with consideration for their education level, social environment, and life conditions.

Objectives The aim of this study was to evaluate factors that affected decisions regarding breastfeeding and complementary feeding practices in children aged 24 to 48 months. Methods Children aged 24 to 48 months who were presented at the outpatient clinic of a single hospital over a 6-month period were included in the study. Children who were born prematurely, hospitalized in the neonatal intensive care unit, and those with a chronic disease were excluded. A questionnaire was administered to parents who provided consent. Data related to demographic characteristics, socioeconomic status, and infant nutrition practices were collected and analyzed. Results A total of 100 cases were included. The distribution of the gender of the children was 49% female and 51% male, and the mean age was 36.2±7.8 months. The mean duration of exclusive breastfeeding was 4.83±1.23 months, the mean length of total breastfeeding was 17.65±8.44 months, and the mean initiation of complementary feeding was 5.71±1.23 months of age. The most frequent reason provided for the cessation of breastfeeding was the mother's decision to wean. The duration of exclusive breastfeeding and the total length of breastfeeding feeding was significantly shorter among children who were born by cesarean section, and those who used a pacifier and or feeding bottle. Non-working mothers used formula for a longer period (p=0.043) and introduced solid foods and the use of utensils later than other mothers (p=0.001, p=0.03, respectively). Complementary food was provided to the infants of families whose monthly income level was less than TL 1000 earlier than in higher income level groups (p=0.04). The results of this study also showed that complementary food choices were most influenced by older members of the family and members of the mother's immediate circle (42%) and healthcare professionals (36%). Mothers who received information about the addition of complementary food did not demonstrate a significantly different length of time devoted to exclusive breastfeeding; however, the duration of breastfeeding overall, alone and in combination with solid foods, increased (p=0.03). Conclusion Before the birth, families should be informed and prepared regarding the necessity of exclusive breastfeeding for the first 6 months and the continuation of breastfeeding until 2 years of age, the potential impact of relevant factors related to the type of birth, and the potentially negative effects of the use of a pacifier or bottle. All members of the family, particularly mothers and close relatives, should be advised about proper complementary feeding techniques, including the need to increase the consistency of food gradually, introducing solid foods before the 10th month, and using natural, home-cooked items instead of prepared foods. The appropriate information and guidance should be provided to all families with consideration for their education level, social environment, and life conditions.

Summary Hemangiomas those can be detected in all regions of the body are frequent benign tumors seen in 10% of the children. They may be present in the scrotum rarely. The treatment depends on the location, invasion and symptoms. Scrotal hemangiomas are generally asymptomatic and regress after 1 year of age. Due to locating in the diaper region, ulceration, infection and hemorrhage may complicate. Using local zincoxide emolients and frequent changing diapers may prevent ulceration. According to the occurred symptoms medical or surgical treatment may be required so early diagnosis and treatment depending to the invasion is crucial. A male patient was applied to the hospital due to scrotal mass and hyperemia and was diagnosed with scrotal hemangioma without intrascrotal invasion by ultrasound. Local management with zinc-oxide emolients, frequent changing diaper and applying to the hospital in the presence of bleeding or infection were advised. There were no complications and change in the size of the lesion in the 12th months of follow-up due to appropriate management in the primary care health center.

Attention-deficit/hyperactivity disorder (ADHD) is the most common neuropsychiatric disease affecting 5.3% of school-aged children. Methylphenidate is the primary stimulant, which has been used wid...

Background: Vitamin B12 plays a role in hematopoiesis, neuronal functions, the synthesis of myelin and epithelium, and the mucosal functions of the gastrointestinal system, so patients with vitamin B12 deficiency may complain of a variety of symptoms. Objectives: This study aimed to investigate the association between vitamin B12 levels and clinical symptoms in children and adolescents. Methods: Patients visiting the pediatric outpatient clinic for any reason between April 1 and September 30, 2014 were enrolled in the study. Patients with active infectious diseases, with chronic diseases, or who had any disease or were taking any medications causing vitamin B12 deficiency were excluded from the study. The patient’s complaints were recorded. Each patient’s serum vitamin B12, 25-OH vitamin D, folic acid, and complete blood count were measured in addition to routine tests. Results: A total of 524 patients who were 8.3 ± 4.2 years old (2.6 months - 15.3 years), which consisted of 272 females (51.9%) and 252 (48.1%) males, met the inclusion criteria. The vitamin B12 level was less than 200 pg/mL in 166 (31.7%) of these patients and was less than 300 pg/dL in 302 (57.6%) of these patients. Vitamin B12 level was not associated with any complete blood count parameters except MCV. The patients with vitamin B12 deficiency were also 25-OH vitamin D deficient (P < 0.00). Symptoms, especially forgetfulness, depression, and anxiety were more common in the adolescent age group; these symptoms were significantly related to vitamin B12 deficiency (P < 0.05). Forgetfulness, fatigue, anxiety, and headache were the most common symptoms. There was no significant difference between the symptoms of the patients with vitamin B12 < 200 pg/mL and those with vitamin B12 < 300 pg/mL. Conclusions: With vitamin B12 deficiency defined as a vitamin B12 level < 300 pg/mL, we treated patients with vitamin B12 deficiency in order to prevent the progression of their symptoms to more serious complications. The early treatment of vitamin B12 deficiency may prevent the development of depression and anxiety in adolescents.

Vitamin D supplementation in childhood in order to rickets prophylaxis is given from the neonatal period. However, inappropriate vitamin D supplementation may be administered by families for children’s growth and development and early teething or may be given high dose vitamin D for the treatment by physicians due to incorrect assessment of rickets laboratory findings. For these reasons, vitamin D intoxication related hypercalcemia in some cases determined. This article are presented for emphasize the efficacy of pamidronate treatment in vitamin D intoxication developed five month old girl after use of vitamin D once ampoules, developing hypercalcemia and nephrocalcinosis stage 2.