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Aim: The study was conducted to investigate the effect of an education program about evidencebased interventions for oral feeding supporting practices in preterm infants on the knowledge levels of neonatal nurses and physicians. Materials and Methods: The study is a single group study with a pretest-posttest pre-experimental design. It was conducted on 44 healthcare professionals (nurses and physicians) at a medical faculty hospital in Turkey. Data were collected using the Demographic Characteristics Form and the Preterm Infant Feeding Knowledge Form. The participants were divided into groups of 8 to 10 and each education was completed in a single session lasting for about 45 minutes, in a total of five days. The participants completed the pretest prior to the education program. The posttest was administered two weeks after the completion of the education. The data were analyzed using the McNemar test and the paired t test. Results: The average age of the participants is 26.14±4.81. Of the 44 participants, 86.4% are nurses, 13.6% are physicians, and 88.6% are female. While 63.6% of the healthcare professionals had a Neonatal Resuscitation Program certificate, 70.5% did not have the neonatal intensive care nursing certificate. It was found that 40.9% of the participants did not receive education about preterm infant feeding, while those who received training before were found to have breast milk training in the context of in-service training. The mean pretest rate of correct answers was 58.69%, while the mean posttest rate of correct answers was 78% (p, Amaç: Çalışma, preterm bebeklerde oral beslenmeyi destekleyici uygulamalara yönelik kanıta dayalı beslenme protokolleri konusunda bir eğitim programının yenidoğan yoğun bakım ünitesinde çalışan sağlık profesyonellerinin bilgi düzeylerine etkisini belirlemek amacıyla yapılmıştır. Gereç ve Yöntem: Çalışma, tek grup öntest-sontest deney öncesi tasarımdır. Çalışma, bir tıp fakültesi hastanesinde 44 sağlık profesyoneli (hemşire ve hekim) ile yürütüldü. Veriler “Demografik Özellikler” ve “Preterm Bebek Beslenmesine Yönelik Bilgi Formu” kullanılarak toplandı. Eğitimler 8-10 kişilik gruplar halinde ortalama 45 dakika süren tek oturumda beş günde yapıldı. Eğitim öncesinde öntest ve eğitim tamamlandıktan iki hafta sonra sontest uygulandı. Veriler, McNemar test ve paired t testi ile analiz edildi. Bulgular: Katılımcıların yaş ortalaması 26,14±4,81’dir. Katılımcıların %86,4’ü hemşire, %13,6’sı hekim ve %88,6’sı kadındır. Sağlık profesyonellerinin %63,6’sının yenidoğan resüsitasyon programı (NRP) sertifikası varken, %70,5’i yenidoğan yoğun bakım hemşireliği sertifikasına sahip değildir. Katılımcıların %40,9’unun preterm bebek beslenmesi hakkında eğitim almadığı, eğitim alanların ise hizmet içi eğitim kapsamında emzirme eğitimi aldıkları belirlendi. Doğru yanıtların öntest ortalaması %58,69 iken, sontest ortalaması %78 dir (p

Aim: Congenital heart disease (CHD) is one of the most common congenital anomalies. It is known that early detection of the criticallesions without symtomatic improves the prognosis of patients in the long term. In our study, we aimed to evaluate the efficacy andcost 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 2018in Selcuk University and Saglik Bilimleri University Konya Training and Research Hospital. Positive screening test results and theircosts 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 24.713.1 (4-100) hours (mean SD (min-max). 292 (8.48%) infants were tested positive. Echocardiographic examination was performed in the positive cases. Theprevalence of CHD was found to be 27.6 ‰. The prevalence of critical CHD was 1.16 per 1000 live births. The false-positive screenrate was found to be 197 (5.7%). Among the cases who were screened, the most common CHD was the secundum ASD. The totalcost 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 diseasesin newborn and the cost is unneglectable in the early screening of patients. This study, the total cost of each infant screening isapproximately 4.5 (0.85) which appears to be a quite cheap and effective screening compared to the other countries.

WOS: 000480626400016, Purpose: The aim of this study was to review accompanied congenital anomalies to gastrointestinal pathologies. Materials and Methods: The medical records of patients who were admitted to neonatal intensive care unit with gastrointestinal system surgical pathologies during 2015-2018 were retrospectively evaluated for associated congenital anomalies. Results: 67 patients were identified during the study period. The most common gastrointestinal system pathology was anal atresia in 15 cases (22.4%), followed by diaphragmatic hernia in 14 cases (20.9%), esophageal atresia (n: 10) and ileal atresia (n: 10) (14.9%). Thirty two patients (48.8%) have had accompanied congenital anomalies to gastrointestinal system pathologies. Congenital heart disease was the most common anomaly and the most frequent one was atrial septal defect in 18 cases (26.8%). In addition, there was complex congenital heart disease in (n: 13) 19.4%. In 12 patients (17.9%), accompanied extracardiac anomalies were detected. Hydronephrosis and sludge in gall bladder were detected in three patients (4.5%). Vesicoureteral reflux or ectopic kidney or polysplenia was detected as a separate anomaly in each case. In our cases, prematurity rate was found in 54%. Conclusion: Gastrointestinal system pathologies are frequently associated with multiple anomalies, especially with congenital heart diseases. In addition, these patients are likely to be preterm baby.

Platelet indices such as mean platelet volume (MPV) and platelet numbers (Plt) have been used as predictive indicators in many diseases of preterm infants. However, there is limited data regarding use of plateletcrit (PCT) as an indicator of many detrimental conditions (ie, gestational diabetes, hypertension and infection) and also clinical conditions such as necrotizing enterocolitis (NEC), sepsis and mortality in preterm neonates.Objective: The aim of this retrospective study was to investigate if PCT in the first 24 hour could indicate above mentioned conditions and predict poor prognosis compared to other blood parameters such as Hemoglobin (Hgb), Mean Corpuscular Volume (MCV), Red Blood Cell Distribution Width (RDW), White Blood Cell (WBC), Plt, MPV and Platelet Distribution Width (PDW). Design/Method: All premature babies ≤ 32 weeks and admitted to NICU of Selcuk University between January 2018 to June 2019 were investigated. Their maternal conditions for gestational hypertension (GH), diabetes and infection during pregnancy were analysed to reveal potential relation between antenatal conditions and postnatal markers. Infants were also reviewed according to their clinical prognosis and presence of intrauterine growth restriction (IUGR), sepsis, NEC and mortality. The first blood parameters (Hgb, MCV, RDW, WBC, Plt, MPV, PDW and PCT were recorded and evaluated. Results: Of the 186 infants (GW: 29±1weeks, BW: 1300±100 gr), 92 (49.5%) were girls and 94 (50.5%) were boys. Mean maternal age was 28 ± 1years and 3.8% of these mothers had gestational diabetes, 10.2% hypertension and 9.7% infection. From baby standpoint, 20 infants (10.8%) had IUGR, 50 (26.8%) infants had sepsis, and 18 (9.6%) infants had NEC. Thirty five infants (18.8%) died during hospital course. In term of gender, there was no difference between BW, Mother’s age, although male infants were heavier than females (p0.05). WBC, Plt, RDW parameters were affected from GH. Interestingly MPV was not affected from any antenatal and postnatal conditions, but PCT levels were significantly low in IUGR, sepsis and in mortality group. Although, platelet numbers are closely related with PCT, they were also affected from IUGR. Both sepsis and mortality were found associated with GW and BW. Conclusions: Unlike to many studies showing benefits of MPV as a marker of poor prognosis in preterm babies, our study did not show such a benefit of MPV. On the other hand we found PCT as a good marker for detection of antenatal and postnatal detrimental factors on the newborn babies. We believe that prospective studies are needed to understand value of using PCT in this tiny population.

Spina bifida, is a common term for malformations ofspinal cord and vertebra caused by in completefusion of the embryonic neural tube. Meningomyelocele is amalformation that consists 90% of spina bifida and is caused by opening of thespinal cord and spinal nevre roots together. More than 90% of the malformationshave multifactorial heredity. Because siblings of the se patients have alsosimilar diagnoses and their parents are relative to each others, it supports aheredity origin of the disease. It can be diagnosed prenatally by theultrasound. In this paper, we present a case, who born to non-consanguineo usparents, and it was thought as a case of teratoma, but postnatally diagnosed asanteroposteriormeningomyelocele., Spinabifida,embriyonik nöral tüpün kapanma defektinin neden olduğu, spinal kord vevertebranın malformasyonları için kullanılan ortak bir terimdir.Meningomyelosel ise spinal kord ve spinal sinir köklerinin birlikte açıktakalması ile meydana gelen ve spina bifidanın % 90’ını oluşturan birmalformasyondur. Bu malformasyonların % 90‘ından fazlası multifaktöriyelkalıtımla oluşmaktadır. Hastaların kardeşlerinde benzer tanı vehikâyelerinde ebeveyn akrabalığı olması hastalığın genetik kalıtımı olduğunuortaya koymaktadır. Hastalığın tanısı ultrasonografi ile prenatal dönemdekonulabilmektedir. Buradaanne baba arasında akrabalık bulunmayan ve antenatal dönemde teratom düşünülenancak postnatal olarak anteroposterior yerleşimli meningomyelosel tanısı alanbir yenidoğan olgu sunulmuştur.

World Health Organization recommends that all infants should receive breast milkin the first 6 months, but in our country only 10% of infants have this opportunity. Minimal enteral feeding is defined as feeding with small amounts for 3-5 days of preterminfants or infants with high risk. Feeding should be started in all preterm infants withthe first 6-12 hours if no contraindications exist. For normal newborn infants, the best method of feeding is breast feeding. Colostrum may be considered as the first vaccination of the infant. 100 ml breast milk contains approximately 1,3 grams of protein, 4,2grams of fat and 7 grams of carbohydrates. Skin-to-skin contact with the mother and infant is important because it increases the interaction, is an opportunity for breast feedingand beneficial in thermoregulation, pain control and adaptation to extra-uterine life. However, if weight loss is more than 7% in the 5-6th day, the infants should have close fol-low up. If own mother’s milk is not available, donor milk or a formula may be used., ÖzDünya Sağlık Örgütü’nün (DSÖ) ilk 6 ay boyunca sadece anne sütü alınmasını tavsiye etmesine karşılık ülkemizde 4-5 aylık bebeklerin sadece %10’u bu şansa sahiptir. Prematüre ve riskli bebeklerin gastrointestinal sistemin (GİS) maturasyonunu sağlamakve enfeksiyonlardan korumak amacıyla 3-5 gün süreyle az miktarda beslenmesi minimal enteral beslenme olarak bilinir. Prematüre bebeklerde eğer ciddi bir kontrendikasyon sözkonusu değilse beslenme ilk gün hatta ilk 6-12 saat içinde başlatılmalıdır. Normal yenidoğanlar için en uygun beslenme şekli kendi annesi tarafından emzirilmesidir.Kolostrum bebeğin ilk aşısı özelliğindedir. 100 ml anne sütünde yaklaşık 1,3 gr prote-in, 4,2 gr yağ, yaklaşık 7 gr karbonhidrat bulunmaktadır. Tensel temasın anne ve bebekarasındaki etkileşim artırdığını, emzirme için fırsat olduğu, termoregülasyon, ağrı yönetimi, rahim dışı yaşama daha kolay geçiş gibi yararları olduğunu vurgulamıştır. Tar-tı kaybı 5-6. günde %7’den fazla ise yakın takip edilmelidir. Beslenme desteğinde ilkseçenek annenin kendi sütünün sağılıp verilmesidir. İkinci seçenek, varsa süt annedentemin edilecek ya da banka sütü, yoksa formül mamalardır.

WOS: 000484450300007, PubMed: 31236020, Hemodynamic instability is frequent in high-risk infants admitted to neonatal intensive care units. However, monitoring and treatment strategies of those conditions might show variations among the units. Different factors can compromise hemodynamic status in preterm/term infants. Treatment options mostly include volume replacement, inotropes and/or vasopressors (dopamine, dobutamine, epinephrine and milrinone) and hydrocortisone. In general, these treatments are driven by predetermined protocols, which are not patient-based. According to the current knowledge, a physiology-driven approach that takes the individual characteristics of the newborn into consideration is accepted to be more suitable. In neonatal hemodynamics, important determinants are cardiac output, systemic vascular resistance, blood pressure, regional tissue perfusion and oxygenation. The novel technological methods, "targeted neonatal echocardiography" and "near-infrared spectroscopy" can help to delineate the underlying pathophysiology better, when added to the clinical assessment. In this review, strategies for the assessment of neonatal hemodynamics, as well as etiology, monitoring, and treatment of hemodynamic instability in preterm and term infants are presented.

WOS: 000419686600005, Meckel-Gruber syndrome, which is firstly described by Friedrich Meckel and Georg B. Gruber, is an autosomal recessive disorder that is characterized triad of occipital encephalocele, bilateral renal dysplasia and polydactyly. Because of the genetic heterogeneity, multiple organs can be affected. The worldwide incidence varies from 1 in 13,250 to 1 in 140,000 live births. We have reported a male baby born at 37-week gestation, who has occipital encephalocele, polydactyly and cystic dysplasia of both kidneys. As a result of these clinical findings, Meckel-Gruber Syndrome is suspected for his baby. This study is presented to draw attention to the Meckel Gruber Syndrome which has high risk of recurrence and early diagnosis by ultrasonographic screening can be confident.

Diaphragmatic hernias (DH) aee rare congenitat defects with different types. Morgagni hemia (MH) is the least frequent one. Aithough Morgagni hernia is a surgicai condition, for its asymptomatic course, diagnosis is usuaiy incidentai in a pediatric unit. Morgagni hemia can be associated with other congenitat anomaiies such as heart defects, omphaioceie, mentai retardation, pectus carinatum and trisomia 21. The association of Morgagni hernia and genitourinary anomaiy is very rare. Here we report a case of Morgagni hernia accompanied by uretero-peivic obstruction. Key words: Morgagni hernia, genito-urinary anomaiy, chiidhood., Diyafragma herniieri nadir görülen konjenitai defektierdir. Bir çok tipleri olmakla birlikte, en az görülen tiplerinden birisi Morgagni hem isidir. Her ne kadar cerrahi bir olay olsa da, semptomsuz olması nedeniyle Morgagni hernilerinin çoğu bir pediatri ünitesinde tesadüfen saptanır. Morgagni hernisi ile kalp defektieri, omfalosel, mentai retardasyon, güvercin göğsü anomalisi ve trizomi 21 birlikte bulunabilir. Genitoüriner sistem anomalisi ile birlikteliği de çok nadir olarak rapor edimiştir. Biz de uıetero-pelvik obstrüksiyonia birlikte olan Morgagni hernisini ünitemizde teşhis ederek, çok nadir görülmesi nedeniyle rapor ettik. Anahtar kelimeler: Morgagni hernisi, genito-üriner anomali, çocukluk çağı.

Morgagni hernia is a rare retrosternal congenital defect of the diaphragm These hernias are often asymptomatic and are usually diagnosed incidentally The majority of cases may be assoociated with some congenital anomalies especially cardiac pathologies However the association of hernia with pectus carinatum anomaly is reported rarely Three cases of Morgagni hernia one of these cases had pectus carinatum anomaly the other two had liver herniation into the thorax who all had symptoms and were treated surgically with succes are reported Key words: Morgagni Hernia Childhood Pectus Carinatum Anomaly, Morgagni hernisi restosternal yerleşimli nadir görülen bir diyafragmatik defekttir Bu herniler sıklıkla asemptomatik olarak seyreder ve tanı çoğunlukla tesadüfen konulur Başta kalp patolojileri olmak üzere bazı konjenital anomaliler ile birlikte görülebilirler Ancak güvercin göğsü anomalisi ile birlikte görülmesi çok nadir olarak rapor edilmiştir Burada birinde güvercin göğsü anomalisi olan ikisinde herni kesesi içinde karaciğer bulunan ve her üçü de transabdominal yaklaşımla öpere edilerek başarılı bir şekilde tedavi edilen semptomatik Morgagni hernili üç vaka sunulmuştur Anahtar kelimeler: Morgagni Hernisi Çocukluk Çağı Güvercin Göğsü Anomalisi