2021 Cilt 19 Sayı 1

Permanent URI for this collectionhttps://hdl.handle.net/11452/20060

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Antibiotic usage in the pediatric population: The need for effective role of parents and prescribers
(Bursa Uludağ Üniversitesi, 2021-01-04) Karataş, Yusuf; Khan, Zakir
Antibiotics are an important aspect of pediatric medical treatment and infectious diseases are the leading cause of child mortality. Antibiotics are the cornerstone of the treatment for bacterial infections, and children received these drugs more frequently than any other class of medication. Inappropriate use of antibiotics is of international concern and promotion of appropriate and safe antibiotic usage is the need of the hour. The high percentage of inadequate antibiotic prescriptions in hospitals and the community is reported in the pediatric population around the globe. The improper and excessive use of antibiotics in children leads to resistance and adverse drug reactions (ADRs). Parents and prescribers influence the prescription of antibiotics in children. It is reported that only proper educational intervention by the right people with the right tools for both parents and prescribers can sufficiently improve the problem of inappropriate antibiotic practices and gradually eliminate the risk of antibiotic resistance. This narrative review paper provides an overview of the use, ADRs, allergy, errors, and off-label usage of antibiotics in children and also discusses the important role of the parents and prescriber in the use of antibiotics therapy.
The association between obesity, being overweight and socio-economic status among school-age children living in big cities
(Bursa Uludağ Üniversitesi, 2020-12-31) Aka, Sibel; Arapoğlu, Mujde
Introduction: Obesity has become a serious health concern worldwide. Risk factors of obesity are different in urban and rural areas. The aim of this study was to determine the risk factors related to obesity and being overweight among children in low and high socio-economic groups in a big metropolitan city, Istanbul. Materials and Methods: A cross-sectional study was carried out on 490 school age children between 5 and 15 years. Low and high socio-economic groups were determined according to socio-economic status (SES). Socio-demographic characteristics of children were collected from the parents. Results: The effect of having frequent snacks rich in carbonhydrates (p=0,001) and sedentary lifestyles (p=0,001) on BMI was significant in both SES groups. In high SES group, BMI of the <10 years boys was significantly higher than that of the <10 years girls; Boys also had higher BMI at both age groups of either younger or older than 10 years. In low SES group, girls were significantly more overweight than boys. High family income, high paternal BMI and consuming energy rich products increased the obesity risk in children 1,560 times (OR: 1,560, %95 CI: 1,046-2,326), 2,015 times (OR: 2,015, %95 CI: 1,092-3,720), and 4,33 times (OR: 4,330, %95 CI: 2,897-6,472), respectively. Conclusions: As conclusion, high family income, high paternal BMI and consuming energy rich products incre-ased the obesity risk. We suggest that every community has own characteristics but boys tend to have high BMIs in families with high SES.
Clinical features and quality of life in duchenne and becker muscular dystrophy patients from a tertiary center in Turkey
(Bursa Uludağ Üniversitesi, 2021-01-15) Köken, Özlem Yayıcı; Kucur, Özge; Taşkıran, Candan; Sel, Çiğdem Genç; Öztoprak, Ülkühan; Aksoy, Erhan; Aksoy, Ayse; Yoldaş, Tamer; Yüksel, Deniz
Introduction: Duchenne Muscular Dystrophy (DMD) and Becker Muscular dystrophy (BMD), are chronic and progressive and rare genetic disorders that cause systemic involvement such as progressive muscle deterioration, motor disability, cardiomyopathy, and respiratory problems, with an increased risk of cognitive decline and psychological problems They are a group of neuromuscular diseases in which psychological problems affect negatively on quality of life (Qol) not only patients but also caregivers. This study demonstrates the clinical features of patients with DMD/BMD and their caregivers and compares controls with respects to psychological and social aspects. Materials and Methods: A total of 20 patients (3 with BMD and 17 with DMD), aged between 8 and 18 years, and 20 age-matched healthy children were included in this descriptive and cross-sectional study. The patients were evaluated by the pediatric neurology, cardiology, and psychiatry departments at the study time. Their demographic and clinical features were recorded. The Wechsler Intelligence Scale for Children-Revised (WISC-R), Pediatric Quality of Life Inventory (PedsQL) and its parent form, and the Strengths and Difficulties Questionnaire (SDQ) were applied to all of the participants. Results: The QoL scores were lower in patients with moderate and severe DMD/ BMD and their caregivers. In patients with DMD and in both groups, emotional symptoms, peer problems and prosocial behavior scores were higher in the subsets of the SDQ. The PedsQL child-parent scores were lower in all of the subsets with statistical significance. Conclusions: DMD and BMD comprise a group of chronic diseases with multiple complications that are difficult to manage. A QoL equal or close to that of the healthy children should be targeted. Today, proposed or experimental treatments for this disease group are assessed based on their ability to enhance QoL. Inquiring into the QoL and counseling should become routine.
Comparison of corrected QT and Tp-e/QTc interval in intoxication with drugs that cause QT prolongation in children
(Bursa Uludağ Üniversitesi, 2020-12-18) Gökay, Sinem Sarı; Tutun, Buğra
Introduction: Childhood intoxications are among the most common reasons for admission to the emergency department. The aim of this study is to evaluate whether there is a primary marker that can determine the risk of arrhythmia by comparison of QT, QTc, QT/QTc, Tp-e/QT, Tp-e/QTc intervals in drug intoxications with prolonging QTc which can be fatal by causing arrhythmia in children. Materials and Methods: In this study, 55 patients who were admitted to Pediatric Emergency Department of Training and Research Hospital between January 2018 and August 2019 within the first 6 hours due to intoxication with QTc prolongation and followed up in our pediatric emergency department were retrospectively reviewed. In patients hospital records, age, sex, medication, time of application, clinical and physical examination findings, vital signs, treatments and results, laboratory findings, electrocardiogram findings at the time of admission hospital and in the 6. hour control, QT, QTc, Tp-e, Tp-e/QT and Tp-e/QTc times were recorded. Results: The median age of the patients in study was 155±77.2 months. The number of female patients was 33 (60%) and the number of male patients was 22. There was a statistically significant difference between leukocyte count, hemoglobin, platelet,bun, creatinine, SGPT and calcium values at the time of admission and control at the 6th hour. There was no statistically significant difference between CK-MB and troponin levels. Also, there was no statistically significant difference between QT, QTc, QT/QTc, Tp-e/QT and Tp-e/QTc intervals. But there was a statistically significant difference between Tp-e/QTc ratio and gender. Conclusions: Although QTc interval continues to be used to determine the risk of arrhythmia in children with drugs prolonging QTc, it may be significant to compare Tp-e and Tp-e/QTc ratio. However, studies involving a larger number of patients are needed to determine whether Tp-e interval and Tp-e/QTc ratio are a priority marker.
Importance of delta over baseline values in predicting the severity of helicobacter pylori infection in children
(Bursa Uludağ Üniversitesi, 2021-01-01) Güven, Burcu; Gülerman, Hacer Fulya; Kaçmaz, Birgül
Introduction:Although severe forms of the disease are seen in adults, the Helicobacter pylori (H. pylori) infection is usually acquired during childhood. Therefore, prompt diagnosis of H. pylori infection in childhood is of prime importance. In the present study, we aimed to identify the sensitivity and specificity of 13C urea breath test (UBT) in the diagnosis of H. pylori infection and to assess the severity of the disease with delta over baseline (DOB) values. Materials and Methods: UBT was administered to 200 children who presented with epigastric pain and/or nausea. Esophagogastroduodenoscopy (EGD) was performed in patients. UBT results were compared with histopathological findings. In the Area Under the ROC Curve analysis, a cutoff DOB value was found for the severity of H. pylori infection. Results: 193 children with a mean age of 13.50±2.98 years were included in the analysis. Of these, 71 (36.8%) patients had a positive UBT and 122 (63.2%) had a negative UBT. EGD was performed in 60 out of 71 patients with positive UBT and in 30 out of 122 patients with negative UBT. The sensitivity and specificity of UBT were 85.1% and 100%. DOB was found to be a significant predictor of moderate/ marked H. pylori density at a cutoff value of 6%. Conclusions: The positive correlation detected between the level of DOB values and the density of H. pylori and inflammatory activity can be an advantage for detecting the severity of disease.
Perceptions and approaches of mothers towards the weight of their overweight and obese child
(Bursa Uludağ Üniversitesi, 2021-12-10) Çolak, Bahar; Kahriman, İlknur; Meral, Buket
Introduction:This study aimed to determine how mothers with overweight and obese child perceived their child’s weight and how they approached his/her weight problem. Materials and Methods: The study was carried out between April and December 2017 with 212 mothers who agreed to participate voluntarily in the study at a university hospital and a public hospital. The data that were collected using a questionnaire prepared by the researchers were gathered by face-to-face interview method. The questionnaire consists of four parts including demographic information about the mother and the child, mothers’ perceptions of their child’s weight, mothers’ applications for his/her weight and the methods used by mothers and the attitude they had in applying these methods respectively. Results: The mean age of the mothers was 35.75±5.56. 50% of them had secondary school or below education level. 52.4% of overweight or obese children were girls, and the mean age of the children was 7.94±2.91. Besides, 47.6% of mothers were at a normal weight, 39.2% were overweight and 12.3% were obese. 54.7% of mothers perceived their child’s weight inaccurately. Conclusions: The study demonstrated that the majority of the mothers perceived the weight of their overweight and obese child inaccurately and considered him/ her at a normal weight. Mothers who were aware of the fact that their child was overweight or obese performed various applications to solve the child’s weight problem.
The prevention of non-traumatic home accidents among children aged 0-6 year
(Bursa Uludağ Üniversitesi, 2021-01-15) Doğan, Murat; Öztürk, Mehmet Adnan
Introduction:Home accidents are a general problem of societies and most of them are preventable. The aim of this study is to investigate the factors affecting the non-traumatic household and the prevention of accidents in the 0-6 age group. Materials and Methods: We evaluated 335 non-traumatic home accident cases between January 2018-December 2019. The data were collected through a questionnaire developed in the light of the literature. In this form, questions were asked about the characteristics of the children and their families and how the home accident happened. Results: Home accident occurred more frequently in boys. The most common type of home accident was taking medication (45.8%), followed by corrosive substance ingestion (28%), foreign body ingestion and aspiration (26.2%). Most of the cause of home accident was due to family reasons (neglect/inattention). There was a positive correlation between the level of education of parents and home accidents. Neglect/inattention-related home accident increased significantly with the increase in maternal age, the rate of non-working parents and the low level of education of the parents (p<0.001). Conclusions: As a result of our study, we found that the majority of home accidents were not due to the neglect and inattention of the parents. We think that almost all home accidents can be prevented by education. In order to prevent home accidents in children 0-6 years of age, families and child minders should be educated about the developmental characteristics of children, home accidents risk factors, home accidents safety measures and home environments.
Vitamin D levels of COVID-19 positive sypmtomatic pediatric cases
(Bursa Uludağ Üniversitesi, 2021-02-02) Söbü, Elif; Karaaslan, Ayşe; Çetin, Ceren; Akın, Yasemin
Introduction:Vitamin D is known as a vitamin but also it acts as a prohormone and has many functions. The aim of this study is to investigate the vitamin D levels in pediatric patients with COVID-19. Materials and Methods: A retrospective study was performed in a tertiary education and research hospital in Istanbul, Turkey during the period of Marcht o April 2020. Children diagnosed with symptomatic COVID-19 infection were included in the study. Demographic, clinical and laboratory findings were recorded from patient charts retrospectively. All patients investigated for vitamin D levels. Control group consists of healthy children admitted to pediatric outpatient units for routine check-up in the same season.Thirty children with COVID-19 and 82 healthy children included in this study were compared due to 25-OH vitamin D levels. Results: The median age of COVID-19 positive patients was 11.8 (1.8-17.6) years and the median age of control group was 12.7 (1-16.4) years old. There were 15 (50%) females and 15 (50%) males in infected group and there were 39 (47.5%) females and 43 (52.5%) males control group. Age and gender did not differ among the groups. Median vitamin D level in COVID-19 positive group was 8.9 ng/ml (3- 42 ng/ml) and 18.5 ng/ml (9-40.7 ng/ml) in control group. We detected significantly lower vitamin D values in COVID19(+) group when compared with control group (p<0.001). CT was performed 19 patients in COVID-19 positive group and viral pneumonia was detected in 12(63%) of 19. pneumonia (+) group a 17.4-years-old female patient and a 13.1-years-old male patient had low phosphorus levels by age (2.2 and 2.4 mg/dl). Both of them needed high flow oxygen therapy. None of the other cases needed oxygen therapy. Conclusions: This is the first study to date has measured vitamin D levels in children with COVID-19 in Turkey. We detected significantly lower vitamin D values in COVID-19(+) hospitalized children.

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