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This study aimed to evaluate and compare changes in the posterior segment of pediatric asthma patients, potentially associated with asthma or inhaled corticosteroids. A retrospective analysis was conducted on children aged 7–17 diagnosed with atopic asthma. The participants were categorized into groups: Group 1 (no inhaled corticosteroids) and Group 2 (inhaled corticosteroid treatment). A control group of healthy children was also included. Demographic data, clinical findings, and laboratory results (e.g., eosinophil count, IgE, CRP levels) were collected. Optical coherence tomography (OCT) and OCT angiography (OCTA) were used to measure posterior segment parameters. Asthma patients demonstrated a statistically significant reduction in subfoveal choroidal thickness, the superficial capillary plexus in the superior and nasal quadrants, the choriocapillaris in the foveal quadrant, and the peripapillary vascular density in the inferior and superior quadrants compared to controls. Inflammation markers such as eosinophil count and CRP showed significant correlations with changes in vascular density. Asthma, as a chronic inflammatory and hypoxic condition, can significantly affect posterior segment parameters, leading to potential visual function impairments in children. Regular monitoring with OCT and OCTA can help detect early microvascular changes, allowing for timely interventions to preserve visual health.

This study aimed to identify the biopsychosocial stressors influencing child and adolescent mental health during periods when facetoface education was suspended and to evaluate the psychological sequelae of school closures and related restrictions. We conducted a retrospective observational study at Kartal Dr. Lütfi Kırdar City Hospital, a tertiary care center in İstanbul, reviewing all patients referred to the child and adolescent consultation-liaison psychiatry (CLP) unit between March 2020 and March 2022. We assessed associations between psychiatric diagnoses and health-related stressors, school closure status, age, and sex using both frequentist and Bayesian methods. During the study period, 264,013 pediatric admissions were recorded, of whom 270 (0.10%) required psychiatric consultation. The proportions of suicide attempts and anxiety diagnoses did not differ between periods of open and closed schools (BF10 = 0.21 and 0.138, respectively; moderate evidence for the null). Multivariate analysis showed that the odds of suicide attempts were higher in patients exposed to family or schoolrelated stressors (OR = 6.63, 95% CI 2.72–16.19), in females (OR = 8.10, 95% CI 4.16–15.77), and with increasing age (OR = 1.32 per year, 95% CI 1.16–1.50). Female sex (OR = 4.17, 95% CI 2.03–8.55) and older age (OR = 1.30 per year, 95% CI 1.12–1.50) were also associated with depression. Anxiety was more likely in those facing isolation or healthrelated stressors (OR = 3.91, 95% CI 1.66–9.22). These findings highlight the differential impact of stressor type on internalizing symptoms and may inform resource allocation and crisisresponse planning in child mental health services.

The purpose of the study is to explore the use of Calgary scoring (CS) and Modified Calgary scoring (MCS) in the differentiation of genetic generalized epilepsy and syncope in children. The study involved 117 patients aged < 18 years who presented to our hospital’s pediatric neurology outpatient clinic with TLOC between June 2020 and June 2022. In addition to CS and MCS scoring, all patients were subjected to statistical analysis based on their age, sex, number of episodes and distribution during the day, duration of syncope, and family history. Seventy-one patients with syncope and 46 with epilepsy were included in the study. At a CS value >  − 1, sensitivity was 86.9% and specificity 63.4%, while at an MCS value >  − 1, sensitivity was 76.1% and specificity 71.8%. CS had less specificity and sensitivity in predicting epilepsy when focal epilepsies were excluded. Abnormal behavior noted by bystanders, including witnessed unresponsive, unusual posturing, or limb jerking? (Q5) emerged as the most important question for the detection of epilepsy. Compared with other syncope findings, loss of consciousness during prolonged sitting or standing (Q9) emerged as the most important for the detection of syncope.

IntroductionThis study aimed to investigate the prevalence of lactic acidosis, its effect on the duration of intensive care unit (ICU) stay and hospital stay, and other factors affecting morbidity in patients with diabetic ketoacidosis (DKA).MethodsWe reviewed the records of 56 patients, including 26 (46.4%) girls and 30 (53.6%) boys, under 18 years of age, diagnosed as DKA. The cut-off value for elevated lactate levels was set at ≥2 mmol/L. The length of hospital stay, ICU stay, and mortality rate were recorded.ResultsThere was no statistically significant correlation between length of hospital and ICU stay with lactate levels. In addition, no statistically significant relationship was found between the time of transition to subcutaneous therapy and lactate. There was a statistically significant positive correlation between lactate level, respiration rate, glucose level, and pediatric risk of mortality III score.ConclusionLactic acidosis is common in pediatric patients with DKA. Although lactate levels were reported to be a significant independent predictor of morbidity and mortality in adult ICU patients, no effect was found on the length of hospital stay, ICU stay, and the time to transition to subcutaneous therapy with lactate levels in pediatric DKA patients.

Objective: Nowadays, viruses are the leading cause of acute gastroenteritis, while Rotavirus (RV) is the most common cause of acute viral gastroenteritis. In this study, the RV antigen positive diagnosis of gastroenteritis patients hospitalized in the pediatric service of the sociodemographic, clinical and laboratory features was aimed to be interpreted by comparison with literature data. Method: Socio-demographic data of patients hospitalized with the diagnosis of RV gastroenteritis, clinical and laboratory findings were retrospectively evaluated the hospital’s file was obtained from the records. Results: The study of children hospitalized with acute gastroenteritis caused a mean age of 17.68 months from 740 patients who were enrolled, and 270 patients who were positive for RV and RV ratio was found to be 36%. Although the cases were most frequently seen in the spring, the most common months were February, March and April. The most frequent application causes were diarrhea and vomiting and the most common age group was the age group of 6 months-2 years of age. Five patients developed complications were detected. Laboratory findings in 101 patients with C-reactive protein positive (37.4%), 213 patients (78.8%) serum aspartate aminotransferase levels were high, in 94 patients (34.8%) had elevated alanine aminotransferase levels. Conclusion: Most cases of gastroenteritis were admitted to the service accounted for RV diarrhea and especially important cause of diarrhea is seen in winter and spring seasons. Therefore, the RV detection in cases of gastroenteritis is important to predict patient’s clinic and prevent unnecessary use of antibiotics.

Background. This study aims to compare the posterior ocular structure parameters in children with migraine without aura (MWA), tension-type headache (TTH), and a healthy control group. Methods. The study included 31 patients with MWA, 29 patients with TTH, and 38 healthy controls between 6 and 18 years of age. For all participants, the detailed eye examination and measurements including peripapillary retinal nerve fiber layer (pRNFL) thickness, central macular thickness (CMT), subfoveal choroidal thickness (SCT), macular vessel densities and foveal avascular zone (FAZ) parameters measured by optical coherence tomography (OCT) and OCT-angiography (OCTA), were obtained from the patient files. Results. The mean age was 12.1±3.3 years in MWA patients, 12.4±2.8 years in TTH patients, and 11.9±3.8 years in the healthy controls (p=0.844). Among the groups, the mean pRNFL thickness, CMT, and SCT values were lowest in the MWA group. However, this difference was not statistically significant (p=0.621, p=0.854 and p=0.201, respectively). The mean and four-quadrant (superior, inferior, temporal, nasal) pRNFL thicknesses, the CMT, and the SCT were not statistically significant between the groups (p=0.621, p=0.500, p=0.186, p=0.565, p=0.744, p=0.854 and p=0.201, respectively). The macular vascular densities were lower in MWA patients than in the other two groups, and there was a statistically significant difference between the groups only in the nasal quadrant of the deep retinal capillary plexus (p = 0.014). There were also no statistically significant differences between the groups in the superficial and deep FAZ area parameters (p=0.652 and p=0.985). Conclusion. This study suggested that differential diagnosis between MWA and TTH can be difficult in childhood, as these conditions, which can present with ocular symptoms, may also be characterized by changes in posterior segment parameters. Long-term studies incorporating OCT-A in larger patient populations may provide valuable insights into retinal changes associated with these two distinct headache spectrums.

Atopic dermatitis (AD) is a chronic and recurrent inflammatory skin condition characterized by itching, eczematous plaques, and dry skin. Despite ongoing research, its exact cause remains elusive. In this study, we aimed to explore the factors that influence the severity of AD in children and assess the relationship between serum vitamin D levels and the disease’s severity. We enrolled 96 AD patients in our investigation, evaluated their clinical condition using the Scoring Atopic Dermatitis (SCORAD) index, and compared them to a group of 90 healthy controls. Our analysis revealed that serum vitamin D levels and eosinophil counts significantly impacted the SCORAD index (p < 0.001). According to standardized regression coefficients, for each incremental unit in serum vitamin D levels, the SCORAD index exhibited a decrease of 0.449 units. Similarly, a one-unit increase in eosinophil count resulted in a 0.009 unit increase in the SCORAD index. It is worth noting that the influence of serum vitamin D levels on disease severity surpasses that of eosinophil counts and atopic conditions. In our patient cohort, we uncovered a negative correlation (r = −0.419, p < 0.001) between serum vitamin D levels and the SCORAD index. Our findings suggest that low serum vitamin D levels may have a more substantial impact on AD severity than atopic conditions and eosinophilia. Furthermore, we observed a negative association between the severity of AD and serum 25(OH)D3 levels.

Objective:We aimed to investigate the parameters of complete blood count and the levels of systemic inflammatory biomarkers in children with allergic conjunctivit and to evaluate their role in diagnosis in this study.Method:We included 71 pediatric patients with allergic conjunctivit diagnosis referred from the ophthalmology outpatient clinics who had sensitivity to at least one allergen and 71 age- and sex-matched healthy controls and compared complete blood count results, immunoglobulin E (IgE), neutrophil/lymphocyte, and platelet/lymphocyte ratios and systemic immune-inflammation index results. We built a multivariate model with correlated results.Results:Eosinophil counts and serum total IgE values were significantly higher in the patient group compared to the control group (p<0.001). Other parameters were not statistically different. 70.4% (n=50) of the patients had seasonal allergic conjunctivit, and 29.6% (n=21) had perennial allergic conjunctivit. In the skin prick tests performed in the patient group, 60.6% (n=43) of the patients had pollen, 54.9% (n=39) mite, 12.7% (n=9) dander, 11.3% (n=8) cockroach, and 4.2% (n=3) had alternaria sensitivities. In the multivariate analysis, every 100-cell increase in eosinophil count increased the hazard ratio of allergic conjunctivitis 1.3 times (95% confidence interval: 1.1-1.5), and every 100-units increase in total IgE levels increased 1.2 times (95% confidence interval: 1.1-1.5).Conclusion:We found no significant relationship between neutrophil/lymphocyte and platelet/lymphocyte ratios, and SII with allergic conjunctivit. Increasing eosinophil count and serum total IgE levels increase the hazard ratio for developing allergic conjunctivit. Pollen sensitivity was the most common factor in the skin test in allergic conjunctivit-diagnosed patients.

Objective: Pediatricians’ knowledge, attitudes, and practices regarding the etiology of eye diseases play a critical role in the early diagnosis of these conditions and in referring patients to ophthalmologists when necessary. The aim of this study is to evaluate pediatricians’ knowledge, attitudes, and behaviors related to childhood ocular disorders. Method: In our study, we used a descriptive cross-sectional study design to assess the knowledge, attitudes, and practices of pediatricians in our country regarding childhood ocular disorders. The survey was conducted online via Google forms and distributed to participants through WhatsApp and e-mail. The questionnaire consisted of two sections: One addressing demographic information and the other evaluating pediatricians’ knowledge, attitudes, and practices related to childhood ocular diseases. Results: A total of 110 pediatricians participated in our study. Of the participants, 84.5% reported performing eye examinations in children, but only 16.7% conducted routine eye exams during every child visit. All participants reported assessing the light reflex during eye exams. Nearly all participants were able to identify the risk factors for retinopathy of prematurity. The majority of pediatricians (99.1%) stated they would immediately refer a child with suspected glaucoma to an ophthalmologist. Regarding leukocoria, most participants identified retinoblastoma (89.8%) and cataracts (85.2%) as the primary causes of this condition. Almost all pediatricians (98.2%) indicated they would immediately refer a child with suspected leukocoria to an ophthalmologist. Only 63.2% of participants acknowledged that refractive errors could contribute to strabismus. A large proportion of pediatricians (82.6%), concerned about amblyopia (88.1%) and central causes (77.1%), stated they would promptly refer children with strabismus to an ophthalmologist. Conclusion: Although pediatricians’ overall knowledge and attitudes are satisfactory, there are significant gaps in the understanding of certain eye diseases. It is crucial to enhance pediatricians’ knowledge of eye disorders through comprehensive ophthalmology training and workshops during residency. Furthermore, pediatricians should be encouraged to perform detailed eye exams, and collaboration between ophthalmology and pediatrics should be strengthened.

Introduction: The aim of this study was to evaluate the demographic and clinical characteristics and treatment outcomes of children with Salmonella gastroenteritis. Methodology: We retrospectively reviewed the medical records of pediatric patients aged between 1 month and 18 years with the diagnosis of Salmonella gastroenteritis between May 2015 and December 2021. Results: A total of 172 children diagnosed with Salmonella gastroenteritis, including 113 outpatients and 59 hospitalized children, were included in this study. There were 95 (55.2%) males and 77 (44.8%) females with a median age of 59.5 months (interquartile range [IQR]: 33.5–96 months, min–max: 1–205 months). The most common clinical symptoms were diarrhea (n = 166, 96.5%), fever (n = 113, 65.7%) and abdominal pain (n = 73, 42.4%). Bloody diarrhea was seen in 19.2% of patients. Fifty (29.1%) of the Salmonella species could not be typed. Serogroup D (n = 106, 61.6%) was the predominant serogroup isolated from stool cultures, followed by serogroup B (n = 16, 9.3%). 62.2% of the isolates were susceptible to ampicillin, 97.7% to ciprofloxacin, 98.8% to trimethoprim-sulfamethoxazole, and 98.8% to ceftriaxone. Fever, vomiting, and underlying disease occurred more frequently in hospitalized patients than in outpatients (p: 0.005, p: 0.000, p: 0.000, respectively). C-reactive protein value was found to be higher in hospitalized patients (p: 0.000). Conclusions: Salmonella should be considered as a causative agent in pediatric patients with abdominal pain, fever, and bloody-mucous diarrhea, and patients with severe clinical conditions should be hospitalized and antibiotic therapy initiated if indicated.