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Amaç: Bu çalışmanın amacı, annelerde postpartum depresyon, sosyal destek ve emzirme öz yeterliliği arasındaki ilişkiyi belirlemektir. Gereç ve Yöntem: Tanımlayıcı ve kesitsel desende gerçekleştirilen çalışma, doğumundan sonraki 2 hafta- 4 ay içerisindeki 155 anne ile yürütülmüştür. Veriler, Soru Formu, Çok Boyutlu Algılanan Sosyal Destek Ölçeği (ÇBASDÖ), Edinburgh Doğum Sonrası Depresyon Ölçeği (EDSDÖ) ve Emzirme Öz Yeterlilik Ölçeğinin kısa formu (EÖYÖ) kullanılarak toplandı. Bulgular: Katılımcıların yaş ortalaması 27.21±5.48 idi. Araştırmaya katılan annelerin çeşitli tanıtıcı özellikleri ile ölçekler arasında anlamlı ilişki olduğu saptandı. EDSDÖ kesme puanı 13 alındığında, %33.5’inin ölçekten aldıkları puan ortalaması 16.67±2.90 ile kesme puanının altında kaldıkları (depresyon var), %66.5’inin puan ortalaması ise 6.72±2.93 ile kesme puanının üstünde oldukları ve aradaki bu farkın anlamlı olduğu görüldü (Z=-10.171; p

Aim: The study has been conducted in order to determine the impact of training which giving to peadiatric nurses by interactive workshops against to problems during lactation period.Methods: This study, which is an experimental type in which pre-test/ post-test measurements were taken, was carried out in a state hospital in Samsun in October 2014. Before the training, the nurses accepted the presentation invitation. Evaluation of participants’ knowledge on the subject was performed via a Multiple Choice Questionnaire (MCQ) prepared by the researchers in relation with the literature. The study was conducted by 33 volunteer nurses working in the pediatric departments of a state hospital in the conference hall. MCQ, consisting of 24 questions, was answered by the participants before and after the interactive workshop. Analyses were performed using commercial software (IBM SPSS Statistics 20, SPSS Inc. An IBM Corp., Armonk, NY)Findings: Nurses (n= 33) who work in pediatric units participated in the study. The average age of nurses who participated to study is 36.30 ± 6.47 (min=21 max=48). There was a significant improvement in mean test score after the lecture when compared with pre-lecture score (Mean =23.66, SD=0.54 vs. Mean=12.24, SD=4.11, z= -5.021 p = 0.000)Conclusions: Lecture based interactive workshop on the problems faced during lactation period helps to improve nurses’ knowledge. It also helps in overcoming deficiencies in nurses training.

Amaç: Bu çalışma babaların sosyodemografik özelliklerinin eş desteği ve emzirme başarısına etkisini değerlendirmek amacıyla planlanmıştır.Yöntem: Tanımlayıcı ve kesitsel yapılan araştırma, Mayıs - Kasım 2017 tarihleri arasın-da 0-24 ay bebeğe sahip özel bir bakım evinde çalışan veya çocuğu bu bakımevinde bakılan 78 baba çalışma kapsamına alınarak gerçekleştirildi. Gönüllü babalara yirmi sorudan oluşan anket formu dolduruldu. Verilerin değerlendirilmesinde yüzde, aritme-tik ortalama, frekans ve Ki-kare analizi kullanıldı.Bulgular: Yaşı 20-30 yıl, üniversite mezunu, kentsel bölgede yaşayan, tek çocuğa sahip, ekonomik durumu yüksek ve çekirdek aileye sahip olan babaların, gebelik kararını eşi ile birlikte alma, gebelik kontrollerine gitme, baba adayı eğitim programına katılma, eşi ile anne sütü ve yararları hakkında konuşma oranlarının istatistiksel olarak anlam-lı derecede daha yüksekdi (p

Tüm dünyadaolduğu gibi ülkemizde de yenidoğan bebeklerin emzirilmesi konusunda yoğun çabaharcanmaktadır. Ancak bu çabalara rağmen anne sütü ile beslenme konusunda anneve bebeğe ait sorunlar yaşanmakta ve anneler bebeklerini emzirmeye başlasalarbile, bir süre sonra emzirmeyi bırakabilmektedirler. Bu sorunlardan en önemlilerinden birisiannelerin, anne sütü ve emzirme konusundaki bilgi ve motivasyonlarının yetersizolmasıdır. Başarılı emzirmenin başlatılması ve sürdürülebilmesi için sağlıkekibi tarafından annelerin emzirme konusunda gebelik döneminden başlayarakbilgilendirildiğinde, emzirme sürecinde desteklendiğinde emzirme sorunları dahaaz yaşanmakta ve sadece anne sütü verme oranları artmaktadır. Bu derlemede, başarılıemzirmenin başlatılması, sürdürülmesi ve desteklenmesinde emzirme danışmanlığıve emzirmenin desteklenmesinde hemşirenin rolü literatür doğrultusundairdelenecektir.

BackgroundThe 12-lead electrocardiogram shows a broad range of abnormal patterns in trained athletes. The primary end point of this study was to investigate P wave dispersion, and P wave durations and related factors in different genders applying for registration to the School of Physical Education and Sports.Methods and ResultsFrom 2006 to 2009, a total of 2093 students – 1674 boys with a mean age of 19.8 plus or minus 1.9 years and 419 girls with a mean age of 19.1 plus or minus 1.8 years – were included in the study. All 12 leads of the resting electrocardiogram were evaluated for P wave dispersion and electrocardiogram abnormalities. Baseline parameters such as age, body weight, body height, and body mass index, as well as electrocardiogram findings such as P wave maximal duration and P wave dispersion, were significantly higher in boys than in girls. Of all the parameters tested with correlation analysis, only gender (p = 0.03) (r = 0.04), body weight (p < 0.001) (r = 0.07), body height (p = 0.004) (r = 0.06), and body mass index (p = 0.01) (p = 0.05) were correlated with P wave dispersion.ConclusionThe frequencies of all electrocardiogram abnormalities, P wave dispersion, and P wave maximal duration were higher in boys as compared with girls in an unselected student population applying for registration to the School of Physical Education and Sports; in addition, P wave dispersion was correlated with gender, body weight, body height, and body mass index.

Background: P-wave dispersion, an electrocardiographic marker, is an independent predictor of atrial fibrillation. P-wave dispersion is associated with inhomogeneous and discontinuous propagation of sinus impulses. The aim of this study was to investigate P-wave dispersion in students who apply for registration to School of Physical Education and Sports. Methods: Totally 984 students (810 boys [mean age: 19.8 ± 2.0 years] and 174 girls [mean age: 19.0 ± 1.8 years]) who applied for registration to School of Physical Education and Sports with a training history of some years were included in the study. P-wave duration was calculated in all 12 leads of the surface electrocardiography, which were simultaneously recorded. The difference between P maximum and P minimum durations was defined as P-wave dispersion. Results: Age, body mass index (BMI), systolic blood pressure, diastolic blood pressure, P-wave maximal duration, and P-wave dispersion were increased in boys as compared with girls. Of age (P = 0.53), systolic blood pressure (P = 0.42), diastolic blood pressure (P = 0.50), pulse pressure (P = 0.73), gender, heart rate, and BMI tested with univariate linear regression analysis in all subjects; only gender (P < 0.001), BMI (P = 0.01), and heart rate (P = 0.02) were associated with P-wave dispersion (F = 5.16, P < 0.001, R2= 0.03). Conclusions: P-wave dispersion was increased in boys as compared with girls who exercise regularly. P-wave dispersion is affected by gender, BMI, and heart rate in healthy students.

Celiac disease (CD) is a lifelong gluten-sensitive intestinal enteropathy that is multifactorial in its etiology. In the present study, we evaluated basic anthropometric, clinical, laboratory, and histological features of 140 Turkish children with CD. We particularly underscored the association of CD with other autoimmune diseases.During the period from 1999 to 2005, CD was diagnosed in 140 children according to ESPGAN criteria. The age, gender, clinical findings, hematological, and biochemical parameters at diagnosis were noted. Symptoms and signs were recorded. Endoscopic intestinal biopsies were taken from all children.Of the 140 children with CD, 75 (53.6%) were female, and 65 (46.4%) were male. Mean age was 8.56 ± 4.43 years (range 13 months to 18 years). The most frequent symptom was failure to thrive (81.4%), followed by chronic diarrhea (60%). Of the children with CD, nine (6.4%) had type 1 diabetes mellitus (DM), six (4.3%) had familial Mediterranean fever, three (2.1%) had alopecia areata, three (2.1%) had vitiligo, three (2.1%) had Down syndrome, two (1.4%) had lung tuberculosis, two (1.4 %) had autoimmune hepatitis, two (1.4%) had growth hormone deficiency, one (0.7%) had osteogenesis imperfecta, and one (0.7%) had Floating Harbor Syndrome. Elevated serum levels of ALT, CK and AST were detected in 48(34.8%), 50 (38.2%) and 67 (48.6%) children, respectively.The spectrum of clinical findings is very wide. In order to avoid overlooking CD in patients with extra intestinal symptoms and signs, physicians, especially pediatricians, should be informed about new atypical manifestations of CD.Çölyak Hastalığı (ÇH) multifaktöryel etyolojili hayat boyu devam eden glutene duyarlı incebarsak hastalığıdır. Bu çalışmada ÇH lıklı 140 Türk çocuğunun histolojik, laboratuar, klinik, antropometrik bulguları değerlendirildi.2000–2008 yılları arasında ESPGAN tanı kriterlerine göre 140 çocuk ÇH tanısı aldı. Çocukların tanı anındaki yaş, cins, klinik bulguları, hematolojik ve biyokimyasal parametreleri belirlendi. Endoskobik ince barsak biyopsisi tüm olgulardan alındı.ÇH’ lıklı 140 çocuğun 75(% 53,6)’ i kız, 65 (% 46,4)’ ü erkek idi. Olguların ortalama yaşları 8,56 ± 4,43 yıl (13 ay–18 yaş). En sık görülen semptom büyüme gelişme geriliği idi. ÇH’ çocuklardan 9 (% 6,4)’ unda tip 1 diabetes mellitus (DM), 6 (% 4,3)’ sında ailevi akdeniz ateşi, 3 (% 2,1)’ ünde alopesia areata, 3 (% 2,1)’ ündevitiligo, 3 (% 2,1)’ ünde Down sendromu, 2 (% 1,4)’ sinde akciğer tüberkülozu, 2 (% 1,4)’ sindeotoimmun hepatit, 2 (% 1,4)’ sinde büyüme hormonu eksikliği, birinde (% 0,7) osteogenezis imperfekta, birinde (% 0,7) Floathing Harbor sendromu saptandı. ALT, AST ve CK’ nın serum düzeylerinde artış sırası ile şöyle idi: 48 (% 34,8), 50 (% 38,2), and 67 (% 48,6).ÇH’ lıklı çocuklarda klinik bulguların dağılımı çok geniş idi. Ekstra intestinal semptomlu hastalarda ÇH tanısını gözden kaçırmamak için hekimler, özellikle çocuk hekimleri ÇH’ nın yeni atipik bulguları hakkında düzenli olarak bilgilendirilmelidirler.

Objectives: Whether breast-feeding is associated with decreased incidence of the lymphoid malignancies in children is uncertain. We evaluated childhood acute leukemia and lymphoma in relation to duration of breast-feeding. Methods: We investigated this issue in a case-control study comprising 137 patients, aged 1 to 16 years, with acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML), Hodgkin or non-Hodgkin lymphoma, in addition to 146 controls matched for age and sex. Results: The median duration of breast-feeding among patients was shorter than that of controls (10 vs 12 months). Patients with ALL and AML had shorter mean breast-feeding duration compared with healthy children (P = 0.001 and P < 0.001, respectively). The shortest mean breast-feeding duration was noted in the children with AML. Breast-feeding for a duration of 0 to 6 months, when compared with feeding of longer than 6 months, was associated with increased odds ratios (ORs) for ALL [OR = 2.44, 95% confidence interval (CI) = 1.17-5.10], AML (OR = 6.67, 95% CI = 1.32-33.69), Hodgkin lymphoma (OR = 3.33, 95% CI = 0.60-18.54), non-Hodgkin lymphoma (OR = 1.90, 95% CI = 0.68-5.34) and overall (OR = 2.54, 95% CI = 1.51-4.26). Conclusions: Our findings suggest that breast-feeding of more than 6 months is protective against childhood lymphoid malignancies, especially for AML and ALL.

Objective Pediatric vaccinations have decreased the incidence and mortality from infectious diseases in children, but adolescents continue to be adversely affected by vaccine preventable disease. The present study was performed to determine the status of adolescents immunization and to investigate the effect of several socio-demographic factors on immunization. Material and method Using the cluster-sampling method, 817 adolescents were selected in 24 high schools (15,000 students) in central district of Erzurum (Turkey). Adolescents were categorized as completely vaccinated, incompletely vaccinated, unvaccinated or vaccination status unknown. Results Of the 817 adolescents, 6.9% were completely vaccinated, 24.4% were incompletely vaccinated and 64.1% were unvaccinated. The vaccination status of 4.6% of adolescents was unknown. A significantly correlation was seen between the number of siblings, the level of mother and father education, the level of parent's socio-economics status, health insurance and immunization status. Conclusion Our findings indicated a small percentage of adolescents receive all of the recommended vaccine. In immunization programs in Turkey, priority should be given to increase adolescent immunization rate with a middle school and/or adolescents, vaccination.

Ghrelin, a gastrointestinal hormone, has effects on nutrient intake and growth. Because celiac disease (CD) has intestinal histopathologic alterations and subsequent malnutrition and/or growth failure, we hypothesized that there would be alterations in serum ghrelin levels of those patients. In this study, we aimed to determine serum ghrelin levels in childhood CD, to observe probable alterations under gluten-free diet (GFD), and to see whether there is a relationship between ghrelin levels and the presentation of the disease and/or diet compliance.Thirty-six children with CD and 10 healthy children were included. Serum fasting ghrelin level was measured using radioimmunoassay method. After 6 months under GFD, sera of 19 patients were retested for ghrelin level.Mean serum ghrelin levels in children with CD and in controls were 478.2+/-154.6 and 108.3+/-49.1 pg/mL, respectively (P0.001). Serum ghrelin level was not different in different clinical presentations. Ghrelin was negatively correlated with body mass index, both in healthy children and in children with CD on admission (P0.01). Ghrelin level was lower after 6 months under GFDcompared with the level detected on admission (P0.001), but was still higher compared with that of healthy children (P0.001). Strict diet compliance lowered ghrelin level, although not statistically.Ghrelin is increased in childhood CD and is responsive to GFD. Further studies are needed to clarify the mechanism underlying its action in CD.

This study was performed to determine the status of measles immunization and the effect of several sociodemographic factors on immunization in children aged between 10 months and 6 years. Using cluster sampling, 663 healthy children were selected at random from three provinces in Eastern Turkey. The immunization histories of these children were obtained from their immunization cards. With respect to their vaccination status, children were categorized as vaccinated, unvaccinated or unknown. If the child had no immunization card, he or she was classified as unknown. Of these children, 81.6% were vaccinated and 15.1% were unvaccinated. The vaccination status was not known in 3.3% of the children. In children aged 10–12 months, the vaccination rate was 68.6%. For age groups of 1–2, 2–3, 3–4, 4–5 and 5–6 years, the vaccination rates were 84.2, 82.2, 85.3, 82.1 and 76.8%, respectively, but these differences were not significant. The vaccination rates increased in parallel with maternal education level (P=0.009). Also, vaccination rates were significantly correlated with settlement area (P=0.036), and were higher in urban regions than suburban and rural regions. There was no difference in vaccination rates with respect to gender, paternal education level, number of siblings and socio-economic status. The results of this study show that the level of immunization necessary for measles elimination has not yet been reached in Eastern Turkey. Priority should be given to increase the immunization levels to 90–95% among children.

The most important factor affecting the success of measles immunization is the disappearance of maternal anti-measles antibodies. In order to determine the optimum age for measles vaccination and to contribute towards the Expanded Programme on Immunization as currently applied in Turkey, we investigated the rate of disappearance of anti-measles antibodies. The study population consisted of 124 healthy infants aged 1-15 months from Erzurum, Erzincan, and Kars. The overall proportion of seropositivity, which is the result of the presence of maternal anti-measles antibodies, was 67/124 (54 per cent). The proportion of infants with detectable antibodies declined progressively with increasing age. The distribution of maternal antibody levels with respect to age showed a progressive reduction with increasing age from 7 months to 15 months. Thus the proportion of antibody-positive infants declined from 50 per cent at 7-9 months to 10 per cent at 13-15 months. While an evident decrease occurred during these months, no important decline was observed up to 9 months of age. The results of this study show that the minimum proportion of antibody-positive infants (10 per cent at 13-15 months of age) is still higher than the optimum proportion (5 per cent). The Schwarz vaccine, which is used mostly in measles immunization, seems not to be effective to obtain a high seroconversion rate in our infants. Edmonston-Zagreb vaccine strain should be given to children under the age of 15 months in eastern Turkey. In addition, serological studies should be performed periodically, and vaccination programmes appropriate for our country should be determined according to these data.

The hepatitis B virus (HBV) seroprevalence rate is known to be 25–60% in Turkey with the highest prevalence in the east and south-east. There are insufficient data on sero-epidemiology of HBV infection in children living in East Turkey. The objective of this study was to estimate the seroprevalence of HBV infection in 6–17 year olds living in the largest city in East Turkey, and to correlate the serological results with epidemiological data. A total of 1091 serum samples were tested for hepatitis B surface antigen (HBsAg), antibody to HBsAg (anti-HBs) and antibody to hepatitis B core antigen (anti-HBc) using a commercially available enzyme-linked immunosorbent assay. The overall seroprevalence rate was 9.7% and was correlated with age ( P =0.011). No statistical difference was detected between subjects with or without risk factors ( P =0.77). The seroprevalence of HBsAg was 1.8%, and it was higher in children with a low socio-economic status ( P =0.047). The educational status of the parents and sibling size did not affect the rate of total seroprevalence or HBsAg seroprevalence. Although we found that the HBV seroprevalence rate in East Turkey was not as high as reported previously, we emphasize the importance of screening children in order to identify asymptomatic patients in Turkey until HBV infection is entirely eradicated with vaccination programmes.

Background: Cervical cancer which is one of the most preventable cancers is an important public health problem worldwide, and especially in developing countries. The aim of this study was to determine knowledge and attitudes about the HPV vaccination of mothers with 0- to 18-year old children. Materials and Methods: Written approval was taken from the local authorities. The study subjects consisted of 799 mothers who agreed to participate. The data were collected via a " Personal Information Form" which included 30 questions that were prepared by the researchers themselves in line with the literature. The data were collected by face to face interviews with the mothers. Analyses were performed using commercial software. Results: The mean age of the mothers who participated in the study was 32.0 +/- 6.52, and 88.1% reported no information about HPV, and 83.5% no information about HPV vaccination. Only 0.7% of the mothers had daughters who had HPV vaccination, and 44.3% of the mothers who had sons were found out to be indecisive about having HPV vaccination. There was a significant corelation between the educational status of the mothers and their knowledge about HPV vaccination (p< 0.05). However, there was no significant correlation in terms of economic conditions (p>0.05). Conclusions: This study suggested that mothers had very little information on HPV and HPV vaccination. Knowledge of the disease and its vaccination is an essential factor for the success of the vaccination program. It is of great importance that mothers are trained in this subject by health professionals.

Objectives: The purpose of this study was to determine the breastfeeding self-efficacy of mothers in the 0-3 month period and the affecting factors. Material and methods: The study was conducted between January-April 2011. The universe of the study consisted of all the mothers who were living in the center of Sakarya province and had infants ages 0-3 months. The sample used in the study consisted of 152 mothers who agreed to participate. The data were collected through face-to-face interviews with the mothers, using the "Personal Information Form" developed by the researchers and the "Breast-feeding Self-efficacy Scale-Short Form / BSES-SF" developed by Dennis. Turkish validity and reliability of the scale were done by Tokat et al. (2010). The data were evaluated with the SPSS program, using percentages, averages, the t-test, chi-square and ANOVA. Results: The average total score from the "taken BSES-SF" was determined as 58.61 ± 8.93, min = 16, max = 70. No significant differences were found between the scale score and maternal age (F = 0.437, p = 0.781), maternal education (F = 0.625, p = 0.645), economic status (F = 0.253, p = 0.777) and mode of delivery (t = 0.922, p = 0.358). The mean scores were determined as being higher for mothers who indicated having received training for breastfeeding compared to others who indicated having received no such training, and the difference between the scale score was statistically significant (X2 = 50.848, p = 0.010). Conclusions: Requirements for developing breastfeeding adequacy among mothers were determined. Nurses can give the necessary support to low breast-feeding mothers by assessing and identifying those requirements with help of this scale. Objetivos: el objetivo de este estudio fue determinar la autoeficacia de las madres en cuanto a la lactancia durante el período de 0-3 meses y los factores que la afectan. Materiales y métodos: el estudio se realizó entre enero y abril de 2011. El universo del estudio estuvo compuesto por todas las madres que vivían en el centro de la provincia de Sakarya y tenían niños lactantes de 0-3 meses. La muestra utilizada en el estudio estuvo conformada por 152 madres que aceptaron participar. Los datos fueron recolectados a través de entrevistas cara a cara con las madres, utilizando el "Formulario de Información Personal" desarrollado por los investigadores y el "Formulario de Escala de Autoeficacia en Lactancia - versión abreviada/ BSES-SF" desarrollado por Dennis. La validez y confiabilidad de la escala usada en Turquía fueron medidas por Tokat et al. (2010). Los datos fueron evaluados a través del programa SPSS, utilizando los porcentajes, los promedios, la prueba t, el chi-cuadrado y ANOVA. Resultados: el puntaje total promedio de la "BSES-SF tomada" se determinó como 58,61 ± 8,93, min. = 16, máx. = 70. No se hallaron diferencias significativas entre el puntaje de la escala y la edad materna (F = 0,437, p = 0,781), la educación materna (F = 0,625, p = 0,645), la situación económica (F = 0,253, p = 0,777) y el tipo de parto (t = 0,922, p = 0,358). Los puntajes promedio fueron mayores para las madres que indicaron haber recibido capacitación para la lactancia materna en comparación con otras que indicaron no haber recibido dicha formación, y la diferencia entre el puntaje de la escala fue estadísticamente significativa (X2 = 50,848, p = 0,010). Conclusiones: los requisitos para el desarrollo de un nivel adecuado de lactancia materna entre las madres fueron identificados. Las enfermeras pueden dar el apoyo necesario a las madres con bajo nivel de lactancia mediante la evaluación y la identificación de los requisitos con la ayuda de esta escala. Objetivos: o objetivo deste estudo foi determinar a autoeficácia das mães quanto à lactancia durante o período de 0-3 meses e os fatores que a afetam. Materiais e métodos: o estudo foi realizado entre janeiro e abril de 2011. O universo do estudo esteve composto por todas as mães que moravam no centro da província de Sakarya e tinham crianças lactantes de 0-3 meses. A amostra utilizada no estudo esteve conformada por 152 mães que aceitaram participar. Os dados foram coletados por meio de entrevistas cara a cara com as mães, utilizando o "Formulário de Informação Pessoal" desenvolvido pelos pesquisadores e pelo "Formulário de Escala de Autoeficácia em Lactancia - versão abreviada BSES-SF" desenvolvido por Dennis. A validade e confiabilidade da escala usada na Turquia foram medidas por Tokat et al. (2010). Os dados foram avaliados por meio do programa SPSS, utilizando as porcentagens, as médias, a prova t, o qui-quadrado e Anova. Resultados: a pontuação total média da "BSES-SF tomada" foi determinada como 58,61 ± 8,93, min. = 16, máx. = 70. Não se constataram diferenças significativas entre a pontuação da escala e a da idade materna (F = 0,437, p = 0,781), da educação materna (F = 0,625, p = 0,645), da situação econômica (F = 0,253, p = 0,777) e do tipo de parto (t = 0,922, p = 0,358). As pontuações médias foram maiores para as mães que indicaram ter recebido capacitação para a lactancia materna em comparação com outras que indicaram não ter recebido essa formação, e a diferença entre a pontuação da escala foi estatisticamente significativa (X2 = 50,848, p = 0,010). Conclusões: os requisitos para o desenvolvimento de um nível adequado de lactancia materna entre as mães foram identificados. As enfermeiras podem dar o apoio necessário às mães com baixo nível de lactancia mediante a avaliação e a identificação dos requisitos com a ajuda dessa escala.

Summary Background To explore Turkish parents' practices in childhood fever management. Methods A cross-sectional study with 205 randomly selected Turkish parents of febrile children 6-months to 5-years from the paediatric hospital and two family health centres in Sakarya, Turkey in 2009. Data explored general fever management practices on the 8-item Parents' Fever Management Scale – Turkish version (5-point Liket scale; 1=never to 5=always) and socio-demographics. Results Parents wanted to know their child's temperature (61.5%), took temperatures (60%), slept in the same room (58.5%) and sought medical advice (53.7%). Non-evidence-based-practices included over-the-counter medications (42.4%); waking children during the night for fever reducing medication (33.2%). Evidence-based-practice ensured febrile children had plenty to drink (30.2%) and febrile children were checked during the night (59%). Conclusions Parents' reports indicate high levels of concern about fever, overuse of over-the-counter medications and health services. Practices increase parents' burden of care, are disruptive of family life and lead to parental fatigue. The study confirms the appropriateness and applicability of the fever management instrument, a simple tool to incorporate into assessment of febrile children, in identifying Turkish parents' fever management practice.

P-wave dispersion is associated with inhomogeneous and discontinuous propagation of sinus impulses. The aim of this present study was to investigate the impact of P-wave dispersion in children with stable asthma.In this cross-sectional study, the study group consisted of 20 children (12 boys, 8 girls) with stable asthma and mean age of 7.7 +/- 2.0 years. During the study, these patients were treated with low dose inhaled corticosteroids for at least six months. Control group consisted of 20 healthy children matched by same sex and age population. Age, weight, height, echocardiographic values, P-wave maximum duration and P-wave dispersion were compared between asthmatic and healthy children. P-wave duration was calculated in 12-leads of the surface electrocardiography. The difference between P maximum and P minimum durations was defined as P-wave dispersion. The obtained results were compared by independent samples t test and Mann-Whitney U test. Correlations for P-wave dispersion were calculated using Pearson test.P-wave maximum duration is slightly increased in patients with stable asthma (0.092 +/- 0.017 ms) as compared with healthy controls (0.083 +/- 0.011 ms) (p=0.07). We found significant correlation between P-wave dispersion and age (r=0.40, p=0.01), weight (r=0.41, p=0.008) and height (r=0.41, p=0.008).P-wave maximum duration is slightly increased and P-wave dispersion is correlated with age, weight and height in children with stable asthma.

Ghrelin, an appetite-stimulating peptide, increases in cachectic conditions. It probably reflects peripheral nutritional status and influences nutrient intake and growth. The aim of the present study was to determine serum ghrelin levels in children with primary protein-energy malnutrition (PEM) and to find if any correlation exists between serum ghrelin levels and the clinical presentation of those patients.Twenty-eight children with primary PEM and 10 healthy children were included. Serum fasting ghrelin levels were measured using radioimmunoassay.Mean serum ghrelin level of healthy children and those with PEM were 107.7 +/- 40.1 pg/mL and 141.6 +/- 123.8 pg/mL, respectively (P0.001). Ghrelin levels were independent of age and sex (P0.05). Ghrelin was negatively correlated with body mass index in healthy children (P0.01), but not in those with PEM (P0.05). Mean serum ghrelin level of children with moderate malnutrition was higher than that of children with severe malnutrition (199.2 +/- 154.1 pg/mL vs 98.4 +/- 74.3 pg/mL, P0.05). Mean serum ghrelin levels of patients with kwashiorkor, marasmic kwashiorkor, and marasmus were 127.9 +/- 97.8 pg/mL, 138.7 +/- 95.8 pg/mL, and 162.3 +/- 185.0 pg/mL, respectively (P0.05).Serum ghrelin level is higher in patients with PEM, especially in those with marasmus, compared to healthy children. Although this observation suggests that ghrelin helps to fight malnutrition in children, it is obvious that further studies are needed to clarify the exact pathogenetic mechanism regarding this condition.

INTRODUCTION Measles is a highly contagious disease usually seen in childhood. It can prove fatal and is primarily controlled by vaccination (1). In this study, the authors aimed to determine the seroprevalence of measles antibodies in children six years and under in Eastern Turkey and to identify the relationship between measles seroprevalence and several socio-demographic characteristics, and to develop the best vaccination policy for measles. The study sample consisted of 840 children, up to six years of age, from three provinces (Erzurum, Erzincan and Kars). The cluster sampling method was used for selecting subjects of a predetermined number in the rural and urban areas (2, 3). A composite index was used to determine the socio-economic level of the family (4).

Objective: The aim of the study was to determine VZV seroprevalence under age 30 and to identify the relationship of VZV seroprevalence and several sociodemographic characteristics of the study subjects. The results were presented in order to design a strategy for vaccination against varicella-zoster virus (VZV). Material and method: It was planned to include a total of 568 subjects. The sampling method of 30 clusters recommended for field studies was used for selecting subjects of a predetermined number in the rural and urban areas in eastern Turkey. ELISA method was used to examine the blood samples for VZV seropositivity. Age, gender, place of living, educational level, family size and socioeconomic status was investigated in the study subjects. Results: Positive VZV seroprevalence was detected in 78% of 559 subjects. Seroprevalence increased with age. Seroprevalence was 16.67% at the age of 1 year, subsequently increased to 57.58% at the age of 4 years, 70% at the age of 7 years, 92.31% at the age of 10 years and then remained 86.78–96.36% in subjects over the age of 10 years. No association was found between sociodemographic variables studied and prevalence levels of antibodies except for educational level in the 0–14 year group. Conclusion: These results suggest that the majority of VZV infections occur during the early childhood; the best option to reduce the circulation of wild type VZV in the population would be the immunization of young children. VZV vaccine should be introduced into the routine childhood vaccination programme in Turkey.

Objectives: To determine the seroprevalence of diphtheria in 767 children aged 0-6 years and to identify the relationship between diphtheria seroprevalence and several sociodemographic characteristics of the study subjects in the Erzurum, Erzincan and Kars cities situated in Eastern Turkey. Design: A cross sectional study. Setting: The subjects were recruited from three cities (Erzurum, Erzincan, Kars). The sampling method of 30 clusters recommended for field studies was used for a predetermined number of selecting subjects in the rural and urban areas in each city. Subjects: Of the 767 children included in this study, 423 were from Erzurum, 187 from Kars and 157 from Erzincan. Diphtheria serology was used to examine the blood samples by ELISA method. Results: Positive diphtheria seroprevalence was detected in 77.9% of 767 subjects in Eastern Turkey. Seroprevalence was 74.5% in children younger than one year of age, increased to 84% at the age of 3-4 years, and reduced to 80% at the age of 4-5 years and 69.8% at the age of 5-6 years. The seroprevalence rates were similar in sex and number of siblings. Seroprevalence of diphtheria increased with educational level of parents in the rural area. Conclusion: Positive seroprevalence against diphtheria in eastern Turkey is disturbingly low. East African Medical Journal Vol.80(12) 2003: 617-621

In underdeveloped and developing countries where protein energy malnutrition (PEM) is common, it is sometimes difficult to exclude the diagnosis of cystic fibrosis (CF) in malnourished children because both primary PEM and CF share similar symptoms, signs, and laboratory findings, such as elevated sweat chloride value. This study was performed to investigate sweat test results and determine percentile values in children with primary PEM.A total of 90 children with PEM and 30 healthy children were included. PEM was classified according to criteria defined by Gomez, Waterlow, and McLaren. Sweat tests were performed using the Macroduct conductivity system.Patient age and gender did not affect the test results (P0.05). The mean sweat conductivity (equivalent NaCl mMol/L) of patients with PEM was higher than that of controls (P0.001) and increased with the degree of malnutrition (P0.001). Inverse correlations between sweat conductivity and weight for age, height for age, and weight for height were detected (P0.001). The highest value was found in children with wasting and stunting, followed by those with stunting (P0.05) and those with marasmic kwashiorkor (P0.01). Of all children with PEM, 6.7% had elevated sweat test results that normalized after nutritional management; of children with third degree PEM, the figure was 20%. Ninety-fifth percentile values of first, second, and third degree malnutrition were 47 mMol/L, 49 mMol/L, and 69 mMol/L, respectively.Elevated sweat test result is not an important problem, especially in first and second degree PEM, but borderline values can be detected in as many as 20% of cases of third degree malnutrition. Sweat conductivity may increase to 69 mMol/L in children with stunting, those with wasting and stunting, and in those with third degree PEM.

This study was designed to investigate the overall usefulness of rectal thiopental, rectal midazolam and i.m. modified cocktail (meperidine-chlorpromazine hydrochloride-feniramin maleat) in 70 children undergoing computed tomography (CT) and magnetic resonance imaging (MRI).The dosage of thiopental was 50 mg per kg for infants under 6 months of age, 35 mg per kg between six and 12 months, and 25 mg per kg for older children. The maximal dose did not exceed 700 mg in this study. The dosage of midazolam was 1 mg per kg for all children. A modified cocktail was described as a formulation including 11 mg/mL of meperidine, 2.8 mg/mL of chlorpromazine and 2.8 mg/mL of pheniramine maleat. The dosage of modified cocktail was 0.1 mL per kg for all children.The mean induction time for the i.m. cocktail was significantly longer than that for rectal thiopental (P0.001). The mean duration of deep sedation was 60.79 +/- 27.00 min with rectal thiopental and 58.74 +/- 39.70 min with i.m. cocktail (P0.05). Although the mean duration of sleep for rectal thiopental and i.m. cocktail was similar, the mean discharge duration for i.m. cocktail was significantly longer than that for rectal thiopental (P0.05). Children sedated with the cocktail therapy also required a longer period of observation in the department. Significant decreases in heart rate, systolic blood pressure and oxygen saturation occurred in three groups (P0.001). Significant decreases in body temperature occurred after rectal thiopental and i.m. cocktail therapy (P0.01). The effect of rectal midazolam was minimal.Rectal thiopental may be the drug of choice for pediatric sedation because it has a more rapid onset and offset of action. It is also safe and effective at the dosage studied in children undergoing MRI. Rectal midazolam also may be used in children undergoing CT imaging because of minimal side-effects.

The organisms; the genetic structure of which are modified by introducing foreign genes into their bodies, which integrate foreign genes to their genomes and reflect these features are called “genetically modified organisms (GMO)”. Agriculture and food sectors have been the widest usage area of GMOs; which have come into our daily life in many areas since they were developed. However, there are arguments defending that GMOs and their derivatives, which we have been consuming especially as food for a long time, can cause problems on human body such as allergic and toxic reactions, resistance to antibiotics and boosting some diseases such as cancer. In this article, we aimed to give information about genetically modified foods and their potential negative effects on human health., Bünyelerine yabancı genler dahil edilerek genetik yapıları değişikliğe uğratılan, yabancı genleri genomlarına entegreeden ve bu özellikleri gösteren organizmalara “genetiği değiştirilmiş organizma (GDO)” denir. Geliştirilmelerindenbu yana; birçok alanda gündelik hayatımıza giren GDO’ların, en yaygın uygulama alanı bulduğu sektörler, tarım vegıda sektörü olmuştur. Ancak, uzun süredir özellikle gıda olarak tükettiğimiz GDO’ların ve türevlerinin, insansağlığı üzerinde; alerjik ve toksik etkiler oluşturma, antibiyotiklere direnç gelişimine neden olma, kanseroluşumunda rol oynama gibi olumsuzluklara yol açabileceğini savunan tartışmalar yapılmaktadır. Bu makalede;genetik olarak modifiye edilmiş gıdalar ve bunların insan sağlığı üzerinde oluşturabileceği potansiyel olumsuz etkilerhakkında bilgi verilmesi amaçlanmıştır.

Thirty-eight cases of tuberculous meningitis in children were studied. Mortality was 28.9%; most of these presented with stage III disease. Tuberculous meningitis (TBM) still ranks as one of the most important communicable diseases in terms of morbidity and mortality. It is universally fatal if not treated and has high morbidity and mortality, if not recognized early. According to WHO's data, 1.3 million new TB cases under 15 year olds were reported. In Turkey, the TB prevalence is 0.4 %. According to data from the Turkish Ministry of Health, the number of admissions to hospitals dropped from 108 per 100,000 in 1971 to 51 per 10,000 in 1988. Early diagnosis and treatment of TBM are essential in order to prevent late sequelas and death. The diagnosis of TBM may be delayed because many patients initially have vague, seemingly minor, signs and symptoms. In this study, the clinical and laboratory findings of 38 patients with the diagnosis of TBM in our hospital were reviewed, retrospectively, during the past five years. Our purpose was to stress the importance of TBM as a public health problem in Turkey, particularly in the Eastern of Turkey.

Background and Aim Having a new baby, mothers need the support of relatives due to they often live stress or sometime faced with difficult situations. The study was done as descriptive in order to determine mothers’ perceived family support and affecting factors in postpartum period. Methods Sample of the study was consisted with 140 volunteer mothers in Sakarya. The data were collected using a questionnaire developed by researchers and “Perceived Social Support from Family Scale” (PSS-Fa) developed by Procidana and Hellen (1983) and also validity and reliability made by Eskin (1993). Results Most of the mothers were determined as 75.7% (n=106) between the ages of 21–35, 87 and 48.6% (n=68) primary school graduates. The mean total score of the scale was determined as 14.04±4.29 (min=1, max=20). When compared a total score received from the scale with the economic situation of families; Family support were determined as higher (F=16.014 p=0.000) in families with moderate and good economic situation compared to the bad economic situation. Between perceived family support and the number of children showed a significant relationship (F=3.462 p=0.010). It is determined that when the number of chilren was increased family support was reduced. Relationship between mother’s age, employment status and perceived family support were determined as not statistically significant (respectively F=.554 p=0.576, t=0.335 p=0.738). Conclusion Mothers in bad economic situation and having more number of children found low perceived family support is remarkable case.