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Introduction: In recent years, the use of dietary supplements has increased in all age groups. Parents may also use these supplements for their children for different reasons. This study aims to determine the use of dietary supplements by children, the factors affecting this use, and the attitudes of parents about these products. Methods: A total of 1038 children aged 2–18 years without any chronic disease who presented to the pediatric outpatient clinics of Ege University Children’s Hospital were included in this study. Parents (n = 1000) who agreed to participate in the study were interviewed face-to-face, and a comprehensive questionnaire including questions about children’s use of dietary supplements, sociodemographic characteristics, and parents’ attitudes towards dietary supplements was administered. Analyses were performed with SPSS 25.0. Results: The mean age of the children included in our study was 8.6 ± 4.8 years, and 51% (n = 510) were male. It was found that 32.5% of the children used nutritional supplements, and vitamin–mineral preparations (23.2%) were the most frequently used. Omega-3 (19.3%) and immune support products (9.4%) were the second and third most frequently used supplements, respectively. A significant relationship was found between the use of dietary supplements and the child’s age, body weight, body mass index, parents’ educational level, being health worker, and economic status (p < 0.05). It was found that most of the families thought that vitamin–mineral and omega-3 products were beneficial for growth and development and that they received information from doctors most frequently before taking these products. However, it was found that families followed the media as the second most frequent source of information for these products. Conclusions: Approximately one-third of the children in our study use dietary supplements. It is very important to raise awareness among families about the use of these products when necessary and with the recommendation of a physician. To prevent families from using dietary supplements that are not necessary for their children, especially due to misinformation in the media, pediatricians should provide correct information to parents about these products at every clinic visit. A concerted effort is needed from policy makers, media organizations, and health care providers to guide the safe use of DS. The results obtained from this study will shed light on future randomized controlled prospective studies

Aim: To evaluate using different iron preparations for iron deficiency and/or iron deficiency anemia prophylaxis in infants and their iron status. Methods: In this study, we retrospectively evaluated the electronic patient records of 651 healthy children aged 9 to 13 months who met the inclusion criteria and who were followed up in pediatric follow-up outpatient clinics between January 2023 and June 2023. Results: A total of 651 children with a mean age of 11.2 ± 1.4 months, 54.7% of whom were boys, who met the inclusion criteria were included in the study; 56.5% of the children were using Fe + 3 salt and the others were using Fe + 2 salt, microencapsulated iron, or sucrosomial iron drops. After the fifth month of prophylaxis, when the effects of the iron preparations used on the mean laboratory values were evaluated, it was found that hemoglobin, serum iron, and ferritin levels were lower in sucrosomial iron and microencapsulated iron users compared to other preparations (p = 0.001). When statistically pairwise comparisons were made between the groups, hemoglobin and serum iron values were found to be lower in the group using sucrosomial iron compared to the groups using Fe + 2 and Fe + 3 salts (p < 0.0001). Hemoglobin and ferritin levels were higher in the group using Fe + 2 salt compared to both sucrosomial iron and microencapsulated iron groups (p < 0.0001). When the infants were evaluated according to iron status, it was found that 208 (31.9%) had iron deficiency. Iron deficiency was found to be less in infants of families who defined their economic status as rich and in infants who used iron regularly (p-values 0.044 and 0.001, respectively). Iron deficiency/iron deficiency anemia was observed at a higher rate in the group using sucrosomial iron and microencapsulated iron prophylaxis (p = 0.001). Conclusions: To prevent iron deficiency, it is very important to use appropriate iron preparations for prophylaxis and to feed foods with high iron content. Although we found that families were willing to use different iron preparations other than iron salts for their infants, the results presented herein indicate that the rate of iron deficiency was lower in patients using iron salts. However, randomized controlled studies are needed to determine whether these preparations are effective in iron prophylaxis in infants.

Upper respiratory tract infections (URTIs) are a condition characterized by upper airway inflammation often caused by viruses in humans. The present study aimed to assess the effectiveness of the liquid herbal drug preparation from the root extracts of Pelargonium sidoides in improving symptoms of uncomplicated URTIs. One hundred sixty-four patients with URTI were randomized and given either verum containing the root extracts of Pelargonium sidoides (n = 82) or a matching placebo (n = 82) in a single-blind manner for 7 days. The median total scores of all symptoms (TSS) showed a significant decreasing trend in the group treated with the root extracts derived from Pelargonium sidoides compared to the placebo group from day 0 to day 7 (TSS significantly decreased by 0.85 points in the root extract group compared to a decrease of 0.62 points, p = 0.018). “Cough frequency” showed a significant improvement from day 0 to day 3 (p = 0.023). There was also detected a significant recovery in “sneezing” on day 3 via Brunner-Langer model, and it was detected that the extract administration given in the first 24 h onset of the symptoms had provided a significant improvement in day 0 to day 3 (difference of TSS 0.18 point, p = 0.011).Conclusion: The findings of the study revealed that the Pelargonium sidoides extracts are effective in relieving the symptom burden in the duration of the disease. It may be regarded as an alternative option for the management of URTIs. What is Known:• Upper respiratory tract infections (URTIs), an inflammation on the upper airways, are the most common infectious disease in children.• Pelargonium sidoides, a traditional medicinal plant native to South Africa, is one of the ornamental geraniums that is thought to be effective in treating URTIsWhat is New:• It may be revealed that the dried root extract of Pelargonium sidoides compared with placebo might be an alternative treatment in improving the symptoms such as dry cough, sneezing, and relieving cough frequency.• The administration of the root extract at the onset of URTIs’ signs may be regarded as an adjunctive option for the management of URTIs due to its effectiveness in decreasing the symptom burden of the disease.

Aim Vitamin A deficiency is an important public health problem worldwide, especially in undeveloped and developing countries. Vitamin A deficiency; It can cause visual disorders, growth retardation, as well as cellular and humoral immunological disorders. We aimed to evaluate vitamin A levels in hospitalized patients and to determine the factors that may be related to vitamin A deficiency. Method Children between the ages of 2 months and 18 years admitted to Ege University Faculty of Medicine, General Pediatrics Unit in 2017–2020 were included. Three hundred sixty patients with vitamin A levels were evaluated retrospectively. Results The mean serum vitamin A level of the study group was 413.6 ± 187.7. Serum vitamin A level was found to be below 316 µg/L (low) in 89 (24.7%), and within normal limits in 271 (75.3%) of the 360 patients. In 62 (69.6%) of the patients with low vitamin A levels, vitamin A was found to be in the marginal range, while in 27 (30.4%) patients, it was below 200 µg/L. Malnutrition was found in 98 (27.2%) of 360 patients included in the study. Conclusion Vitamin A deficiency may be observed in hospitalized children. Detailed evaluation of each patient, especially in developing countries, will prevent vitamin A deficiencies and malnutrition.

Background Molar Incisor Hypomineralization (MIH) is a qualitative enamel defect affecting first permanent molars often involving incisors. It presents clinical challenges including hypersensitivity, rapid caries, and restorative difficulties. Though its etiology is unclear, systemic and environmental factors have been implicated. Objective This study aimed to determine the prevalence and associated factors of MIH and to assess the risk factors. Methods A cross-sectional study was conducted on children aged 6–12 years in İzmir, Türkiye. Among 700 children examined, 50 diagnosed with MIH were included in the case group, while 50 healthy children formed the control group. Parental interviews assessed sociodemographic, prenatal, perinatal, postnatal factor. Biochemical parameters were analyzed appropriate statistical tests. Results MIH prevalence was 12% and 76% had severe defects (MIH-2), and 24% had mild opacities (MIH-1). Significant associations were observed with socioeconomic status, maternal employment, birth weight, antibiotic use and respiratory infections ( p  < 0.005). Exclusive breastfeeding duration was longer in controls ( p  = 0.020). Conclusion MIH is a multifactorial condition influenced by systemic and environmental factors. Early diagnosis and prevention are essential. Longer breastfeeding duration may offer a protective effect. Larger longitudinal studies are needed to better understand associated factor of MIH.

In Turkey, a single-dose varicella vaccine was introduced into the National Immunization Program in 2013. Before this implementation, varicella vaccine had been available in the private sector since 2000. However, varicella outbreaks continued to occur in preschools and elementary schools. We investigated a varicella outbreak to estimate the effectiveness of 1-dose varicella vaccine and to evaluate potential risk factors for breakthrough disease. This study was carried out during a varicella outbreak in 3 preschools in İzmir, Turkey, in April 2016. Using questionnaires, data including children`s medical and vaccination histories were collected from their parents. Attack rates in vaccinated and unvaccinated children were calculated and the analyses of vaccine effectiveness and of risk factors for breakthrough disease were conducted. A total of 124 children were enrolled in the study. Of the 124 children, 77 (62%) had received 1-dose varicella vaccine before the outbreak. Varicella developed in 34 of 124 children during the outbreak, and 18 of them (53%) had breakthrough varicella. The attack rate was 23.4% among vaccinated children and 34% among unvaccinated children. The effectiveness of single-dose varicella vaccine was 33.6% against varicella disease of any severity and 82.5% against moderate or severe varicella. Children vaccinated 5 or more years before the outbreak had 3.5 times the risk of disease than those who had been vaccinated more recently (OR 3.5 [95% CI, 1.08-11.5]); p= 0.046). Age at vaccination ( < 15 months vs.≥15 months) and the brands of varicella vaccine were not associated with the increased risk of breakthrough varicella. Our study suggests that one-dose of varicella vaccine is not sufficient to prevent school outbreaks. A 2-dose varicella vaccination program may help to prevent varicella outbreaks and achieve effective control of the disease.

Aim:Natural disaster related injuries result in deaths and disabilities such as from a major earthquake. The object of this case series study was to determine the demographic characteristics, injuries, and clinical outcomes of victims admitted to a General Pediatrics Unit within the first weeks after an earthquake.Materials and Methods:This was a retrospective case series study carried out on Kahramanmaraş earthquake victims in a tertiary medical faculty in İzmir from February 13th to March 29th, 2023.Results:Of the followed up 9 earthquake survivors, their mean age was 3.8 years. All of the victims were transferred from other earthquake affected provinces to İzmir. In all, 9 of the cases were admitted to the emergency services of the disasters area hospital and 5 (55.5%) of the 9 cases were rescued from under rubble. For all age groups who were extracted from under the rubble, the extremities were most injured (44.5%). All survivors trapped under the rubble needed fluid therapy, renal support treatment (hemodialysis), and 2 cases required amputation.Conclusion:The description of the demographic characteristics and clinical outcomes of earthquake victims is important in order to determine medical amelioration and rehabilitation services for future disasters.

Aim: Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis in children. The purpose of this study was to assess the clinical, epidemiological, and laboratory features of 117 children diagnosed with HSP. Materials and Methods: This study was conducted to evaluate the data of 117 children with HSP, retrospectively. The presence of the cardinal clinical findings such as purpura, abdominal pain, and arthralgia; and the presence of increased erythrocyte sedimentation rate, decreased serum C3 levels, leukocytosis, blood in the stool, haematuria, and proteinuria were assessed in children with HSP. Results: Of the 117 patients enrolled in the study, 68 were males (58.1%) and 49 were females (41.9%). The median age was 85 (49) months. Purpuric skin lesions were detected in ninety-eight (97.9%) patients, arthritis/arthralgia in 71 (60.6%), gastrointestinal involvement in 52 (44.4%), and renal involvement in 27 (23%) patients. The median duration of hospitalization day was 6 (10) days. Non-palpable purpuric skin lesions mostly located on ankles were the most common involvement in the patients. Conclusion: Non-palpable purpuric skin lesions were the most common presentations followed by arthritis/arthralgia, and gastrointestinal involvement in our patients. Seasonal distributions, gender, and ages of the patients were concluded to be noncontradictory compared with the literature. Although variable clinical findings in the patients were found, the cardinal features of HSP were determined in almost all subjects in this study.

•Evaluation of the nutritional status of hospitalized children should be routinized.•Each hospitalized child should be evaluated by one of the scoring systems.•Using only one screening tool may give inaccurate results for some patients.•Using of anthropometric measurements may provide additional value. Many screening methods, such as the Screening Tool Risk on Nutritional Status and Growth (STRONGkids) and the Pediatric Yorkhill Malnutrition Score (PYMS), have been developed to detect malnutrition in pediatric patients. We aimed to explore the prevalence of malnutrition risk in hospitalized children via symptoms and identification of contributing factors, and to examine the efficacy of malnutrition screening tools for hospitalized children. STRONGkids and PYMS were applied to 1513 inpatients at 37 hospitals in 26 cities from different regions of Turkey. Physical measurements were collected at hospital admission and at discharge. z-Scores of height-for-age, weight-for-age, weight-for-height, and body mass index–for–age were calculated. Overall, 1513 patients were included in the study. A body mass index standard deviation score of less than −2 was present in 9.5% of the study population at hospital admission, whereas 11.2% of the participants had a weight-for-length/height score of less than −2 at hospital admission. According to STRONGkids results, the proportion of the patients with an underlying chronic disease was higher for the patients at high risk of malnutrition than for the patients at medium or low risk (91% compared with 47% or 45%, respectively). PYMS results indicated that patients at high risk of malnutrition have more chronic diseases (75%) than the patients at medium or low risk of malnutrition (55% and 44%, respectively). Use of anthropometric measurements in addition to screening tools to identify hospital malnutrition (such as PYMS, STRONGkids) will prevent some nutritional risk patients from being overlooked.

Background/Objectives: This study aimed to evaluate the correlation of mid-upper arm circumference (MUAC) z-scores with body mass index (BMI) and weight-for-height (WFH) z-scores to determine its reliability in identifying malnutrition and its potential in clinical practice in healthy children and adolescents. Methods: Our study included 906 healthy children and adolescents aged between 2 months and 18 years who were admitted to University Hospital’s General Pediatrics Clinic and attended 12 primary schools in 6 additional Izmir provinces. Anthropometric measurements (weight, length/standing height, MUAC, BMI, WFH) were performed. The relationship between MUAC z-scores, BMI, and WFH z-scores of cases with malnutrition were evaluated. Results: According to the WHO BMI z-score classification, 6 (0.7%) of the children were defined as having severe undernutrition, 43 (4.7%) as moderate undernutrition, 146 (16.1%) as mild undernutrition, 486 (53.6%) as normal, 142 (15.7%) as overweight, and 83 (9.2%) as obese. At any age over two years, fair agreement was observed between MUAC z-scores and WHO BMI z-scores in defining malnutrition alone compared to other growth measures (weighted kappa = 0.371). Under two years of age, the correlation between MUAC z-scores and BMI z-scores showed moderate agreement in detecting overweight and obesity (weighted kappa = 0.479), and between MUAC and WHO WFH z-scores showed moderate agreement (kappa = 0.252). Conclusions: The study found a moderate and fair connection between MUAC z-scores and other criteria. However, further MUAC z-score screening and diagnostic power testing in larger pediatric populations are needed to validate its use alongside other key anthropometric indicators in malnutrition diagnosis. MUAC measurement should be popularized in routine pediatric outpatient clinics to detect malnutrition quickly.