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Objective: The aim of this study was to measure serum lipid levels and epicardial adipose tissue thickness in patients determined with subclinical hypothyroidism. Methods: The study included 61 paediatric patients with a diagnosis of subclinical hypothyroidism and a control group of 61 healthy children. The thyroid hormone levels, lipid parameters and epicardial adipose tissue thickness were examined in all the patients. Results: The mean epicardial adipose tissue thickness of the subclinical hypothyroidism patients was higher than that of the control group but not at a level of statistical significance (4.15±0.91 vs 4.06±0.99, p=0.598). The mean high-density lipoprotein cholesterol level of the subclinical hypothyroidism group was statistically lower than that of the control group (p=0.040). Conclusion: The results of this study showed a significant decrease in the high-density lipoprotein cholesterol levels of children with subclinical hypothyroidism. No significant increase was seen in the epicardial adipose tissue thickness of the children with subclinical hypothyroidism. This is the first study to have examined epicardial adipose tissue thickness in children with subclinical hypothyroidism.

PMID: 35110115 Objective: Although many pediatric studies on children infected with coronavirus disease 2019 (COVID-19) have been published, the diagnosis, clinical symptoms, laboratory findings, and treatment of COVID-19 in children are still unclear. Materials and Methods: This study was conducted with an aim to examine the hematological findings of symptomatic pediatric patients diagnosed with COVID-19 in May 2020 at the Pandemic Hospital in Dicle University. Patient records were evaluated retrospectively. This study involved 59 symptomatic pediatric patients with a definite diagnosis of COVID-19 who had positive SARS-CoV-2 RT-PCR test results on nasopharyngeal swab between March 15, 2020 and May 31, 2020. Results: The records of a total of 10 (16.9%) patients under the age of 1; 21 (35.6%) patients aged 1-10 years, and, 28 (47.5%) patients aged 10-18 years, who had been diagnosed with COVID-19 were evaluated. Based on severity, 35 (59.3%) patients were in the mild group (group 1) and 24 (40.7%) patients were in the moderate-severe group (group 2). The blood parameters of WBC, neutrophil, lymphocyte, monocyte, and thrombocyte counts, the hemoglobin (Hgb) level, and NLR, PLR, MPV, fibrinogen, ferritin, and D-dimer levels were compared between groups, the difference was not statistically significant (P > .05). LDH was higher in group 2 (P = .014). Conclusion: Since children infected with COVID-19 show mild clinical symptoms or are asymptomatic, fewer pediatric patients may be detected than adults. Therefore, it should be known that the laboratory findings typical for adults may not accompany the disease in pediatric cases. More studies are needed to determine the most appropriate COVID-19 treatment approach for children, as hospitalization history and testing rates are less reported among children.

Objective: This study aims to determine the frequency and prognostic significance of lactic acidosis in children with diabetic ketoacidosis (DKA) admitted to the pediatric intensive care unit. Methods: The study was carried out retrospectively by examining the patients admitted to the pediatric intensive care unit for the treatment of DKA. The ages of the patients ranged from 2 to 18 years. The patients with the following parameters were enrolled in the study: serum blood glucose>200 mg/dL, ketonuria presence, venous blood gas pH ≤7.1, bicarbonate

PMID: 26690601 Akın A, Bilici M, Demir F, Gözü-Pirinççioğlu A, Yavuz C. Cardiac thrombus developing after an accidental high-voltage electric shock in a child. Turk J Pediatr 2015; 57: 180-182. Electric shock is a condition that may affect various organ systems and potentially cause death. Cardiac findings vary from asymptomatic mild injury to fatal myocardial involvement. Herein we present a five-year-old boy with a cardiac thrombus developing after an accidental electrical shock. Cardiac arrhythmias and evidence of ischemia have been reported after electric shock; we were, however, unable to identify an earlier case report of intracardiac thrombosis related to electric shock. Findings such as elevated cardiac enzymes and systolic dysfunction, which indicate myocardial damage following electric shock, were present in our patient. We think that the cardiac thrombus might have resulted from the myocardial damage and the slowed intracardiac blood flow related to systolic dysfunction. As the thrombus was thought to have been formed through known mechanisms, it was treated traditionally. However, further data regarding the etiology and management of such thrombi is needed.

Objective: Hypothyroidism usually appears in the second decade of life and is thought to be associated with iron overload in patients with thalassemia major. This study aimed to evaluate thyroid dysfunctions in patients with beta-thalassemia major and to see if they appear in the earlier period of life. Methods: Thyroid function and iron load status were evaluated in 90 children with a mean age of 7.17±3.78 years with beta-thalassemia major by measuring serum free thyroxin (FT4), serum free triiodothyronine (FT3), total thyroxin (T3), serum total triiodothyronine (T4), thyroid-stimulating hormone (TSH) and ferritin levels from serum of patients admitted to the Pediatric Department, Faculty of Medicine University of Dicle between March 2005 and July 2009. A control group formed from an age-sex matched healthy children with a mean age of 6.98±3.66 years was also included. A standard thyrotropin releasing hormone test was applied to 3 patients who had high TSH levels and were classified as subclinical primer hypothyroidism. The study was designed according to the Declaration of Helsinki and informed consent was obtained from the parents of all participants. Findings: All thyroid parameters in patients were in the normal ranges compared with the controls except three of them which had high TSH levels. Serum ferritin level (2703±1649 ng/mL) in patients was significantly higher than in controls (81.5±15.5 ng/mL). Conclusion: The work implies that hypothyroidism could be even seen in the first decade of life in patients with beta-thalassemia major in spite of improved hematological cares.

Background: The objects of the study was to investigate the role and importance of N-Terminal Pro-B-Type natriuretic peptide (NT-Pro-BNP) as a biochemical marker in patients with congenital heart disease and to determine if there is any relationship between anthropometric measurements and natriuretic peptide. Method: Forty-five children with CHD (17 cyanotic and 28 acyanotic) and thirty children with normal echocardiography were enrolled in the study. Patients were divided into two groups as cyanotic or acyanotic. Anthropometric measurements including body weight, height, BMI and Zscore(weight) and Z-score(height) and thorough physical examination were recorded on admission. Serum NT-Pro-BNP was also measured Results: Majority of patients in cyanotic and acyanotic groups had tetralogy of fallot and ventricular septal defect, respectively. The mean age was significantly lower in cyanotic patients compared with acyanotic and controls. N-Terminal-Pro-B-Type natriuretic peptide levels were significantly elevated in cyanotic and acyanotic patients compared with controls. N-Terminal-ProBNP was negatively correlated with left ventricular ejection fraction among the echocardiographic parameters (p=0.014, r=-0.364). In acyanotic patients, NT-Pro-BNP was positively correlated with shunt ratio (p=0.029, r=0,428) and Systolic pulmonary arterial pressure (p=0.005, r= 0.519) while it was negatively correlated with Z-score (weight) (p=0.044, r=-0.390). Conclusion N-Terminal-pro-BNP is one of essential serum markers for cardiac disease and it could be used to predict the severity and prognosis of CHD as a response to ventricular volume expansion and pressure overload

Hydatid cyst (HC) is still frequently encountered in Turkey and especially in its south-eastern part, with different clinical symptoms and locations. The disease show different symptoms according organs where it settled and developed. The location of HC occurs almost in all organs but most frequently in the liver, lung, central nervous system, muscle tissues. In this article, we present one case with multi-organ involvement in liver, lung, spleen, kidney and central nervous system

The symptoms and findings of influenza A (H1N1) resemble the symptoms and findings of seasonal influenza and it generally emerges as an upper respiratory tract disease. Although the majority of patients with the influenza A virus recover spontaneously without complications, there have been occasional reports of myopericarditis. However, the most frequent complications have been reported as viral pneumonia and more rarely dilated cardiomyopathy. In this paper, we report a 4-month-old infant, who admitted with shortness of breath, cough, tachycardia and respiratory problems and was diagnosed as having developed dilated cardiomyopathy associated with H1N1.

Aim: This study aimed to analyze and describe the epidemiology, risk factors, and prognosis of pediatric drowning and near-drowning incidents.Materials and Methods: Forty-four children were included in to the study. Data on social demographics, the location of drowning, clinical and laboratory results, and progress as well as outcome of patients were retrospectively investigated. Results: The median age of patients was 4.2±2.9 years. Most of drownings (65.9%) occurred during the summer, in swimming pools (47.7%), and mostly on weekends (70.4%). Sixteen patients (47%) were not supervised by their caregivers. None of the children had received resuscitation before arriving at the emergency department. Clinical outcomes included 10 (22.7%) deaths, 7 (15.9%) discharges with neurologic sequelae, and 27 (61.3%) successful discharges. Conclusion: Public education, safety regulations, lifeguards at swimming pools, restrictions on access to swimming in ponds, canals, and rivers, supervision of children, and increased awareness of this problem are necessary to reduce the rate of pediatric drowning. Amaç: Bu çalışmanın amacı suda boğulma veya boğulayazma hastalarının demografik özelliklerini, risk faktörlerini ve prognozunu değerlendirmektir. Gereç ve Yöntemler: Suda boğulma veya boğulayazma nedeniyle izlenen 44 hasta çalışmaya alındı. Demografik özellik, olay yeri, klinik, laboratuvar ve izlem bulgularını içeren kayıtlar geriye dönük olarak incelendi. Bulgular: Hastaların ortalama yaşı 4.2±2.9 yıl idi. Suda boğulma veya boğulayazmaların çoğu yaz aylarında (%65.9), yüzme havuzlarında (%47.7) ve çoğunlukla hafta sonlarında (%70.4) olmuştu. Olay 16 hastada (%47) aileleri tarafından izlenmediği dönemde olmuştu ve hiçbir çocuğa acil servise ulaşmadan önce herhangi bir ilkyardım yapılmamıştı. İzlem sonuçlarında 10 hasta (%22.7) kaybedilirken, 7'si (15.9%) nörolojik sekelli olarak, 27 hasta ise (%61.3) şifa ile taburcu edildi. Sonuç: Toplumun bu konuda eğitimi, güvenlik önlemlerinin alnması, havuzlarda kurtarıcıların olması, kanal, nehir ve göletlerde yüzmenin kısıtlanması ve denetlenmesi çocukluk çağında suda boğulma veya boğulayazmaların azaltılması için gereklidir.

Bone mineral status has extensively been investigated in adult thalassemics but less in thalassemic children. This study involves measurements of the bone mineral density (BMD), various demographic and biochemical parameters in 47 thalassemic children and 50 healthy controls with comparable age, sex, socioeconomic and regional distribution. Patients have significantly higher aspartate aminotransferase, alanine aminotransferase, phosphorous, osteocalcin, serum carboxy terminal teleopeptide fragment of type I collagen, intact parathyroid hormone (iPTH) and ferritin levels while they have significantly lower 25-hydroxy vitamin D (25OH-D), alkaline phosphatase and z-scores both at lumbar and femur compared to controls. Patients with high iPTH (30%) had significantly lower z-scores and 25OH-D while larger osteocalcin. We conclude that a significantly lower BMD in beta-thalassemic children compared with their healthy counterparts is a complex process and may partially attributed to their slower physical development, caused by iron overload and chelation therapy which may influence the liver as well as the endocrine tissues.