Mean platelet volume can predict cerebrovascular events in patients with sickle cell Anemia

The purpose of this study was to determine the impact of mean platelet volume [MPV] on the frequency and severity of vaso-occlusive and cerebrovascular events in patients with sickle cell anemia [SCA]. The 238 cases diagnosed with SCA were evaluated retrospectively with respect to the occurrence of painful crisis for the previous year. The incidence, severity and type of the vaso-occlusive crises of the patients with SCA between March 2010 and March 2011 were recorded. The last MPV values in patients who were free of erythrocyte transfusion for the last three months and who had no current vaso-occlusive crises were evaluated. All the patients were grouped according to the frequency of the crises for the previous year preceding the data collection. Group 1: 1 to 3 crises, Group 2: 4 to 5 and Group 3: 6 or more crises annually. In accordance with the results obtained during the evaluation of the cases diagnosed with sickle-cell anemia, MPV value was found to be significantly higher in patients with cerebrovascular events. Also MPV values increased with increasing incidence of the crises [r=0.297] [p=0.001]. One of the contributing factors for this clinical heterogeneity may be related to the MPV values in patients with sickle cell anemia. The higher MPV values may be an early predictor of future cerebrovascular events in patients with sickle cell anemia and may require close follow-up and additional measures

Higher frequency of methicillin resistant bacteria in children with familial mediterranean fever

To investigate resistant microorganisms in nasal mucosa of children with Familial Mediterranean Fever. The study was conducted from March to May 2013 at Mustafa Kemal University, Turkey, and comprised children with Familial Mediterranean Fever and healthy controls. All subjects had no history of antibiotic or local and/or systemic steroid use within the preceding 2 weeks. Nasal swab samples were obtained from all the subjects. Strain identification was done by using standard methods. SPSS 13 was used for statistical analysis. Of the 151 subjects in the study, 73[48.34%] were cases and 78[51.65%] were controls. Among the cases, there were 26[35.6%] girls, while among the controls, there were 40[51.3%] girls [p=0.052]. The mean age of the cases was 7.78 +/- 3.34 years [range: 3-15 years], while it was 8.15 +/- 2.71 years [range: 3-16] among the controls [p=0.208]. Methicillin-resistant coagulase-negative staphylococcus and methicillin-resistant staphylococcus aureus were isolated in both the groups. The growth rate of resistant bacteria was 63% [n=46] in the cases, in the controls [p=0.003; odds ratio [OR]: 2.7; 95% confidence interval [CI]: 1.4-5.2]. Among the controls, history of hospitalisation increased the risk for the presence of resistant bacteria by 7.7 fold [OR: 7.7; 95% CI: 1.4 - 40.4]. Higher rates of resistant bacteria showed that they were at risk of comorbidities related to antibiotic resistance

Risk factors for lower respiratory tract infections in children

Acute respiratory tract infections are divided into two groups as upper and lower respiratory tract infections. These are very common diseases in childhood. In this study, we aimed to determine risk factors for lower respiratory tract in this region. Three hundred and fifty children who presented at pediatric polyclinics of our hospital were included in our study. Their examinations, backgrounds, family histories and information about environmental factors were recorded in questionnaire forms. Lack of vaccination, duration of breastfeeding, onset age of cow's milk, family history for asthma and food allergy, number of hospitalized people in the same room, number of people who live in same house and smoking around the children were evaluated for the presence of LRTI, and LRTI risks of these factors were respectively observed as 1.69, 1.71, 1.61, 1.69, 1.20, 1.47, 1.56 and 2.63 fold increased. Standardization of clinical diagnosis, accurate and realistic use of antibiotics, correction of nutrition, improvement of socio-economic situation and the elimination of environmental factors will significantly reduce morbidity and mortality in children due to Lower Respiratory Infections

Fukuyama congenital muscular dystrophy

Muscular dystrophy is an inherited group of disorders that affects skeletal and many other systems. It is transferred to the next generations with autosomal recessive trait. Congenital muscular dystrophy is a rare disorder characterized by findings emerging from birth. There are 12 different forms of mutation according to defects. Fukuyama syndrome is a rare form of congenital muscular dystrophies in our country. There is FKTN gene mutation. Because it is a rare disease in Turkey, we find this case to be worthy of presentation. After the delivery, patients with recurrent convulsion and hypotonia were admitted to pediatric emergency department. Patients were diagnosed as Fukuyama congenital muscular dystrophy after evaluation based on clinical findings, imaging techniques and gene analysis. Congenital muscular dystrophy should be considered, whereas it is a group of disease in which hypotonia and recurrent convulsions are seen in early infancy period

youngest patient of lupus vulgaris; a cutaneous tuberculosis case report

Tuberculosis, which may involve most organs, is still a major health problem in developing countries. Despite a high and increasing frequency of tuberculosis, cutaneous tuberculosis [CT] is an uncommon form. CT may develop due to Mycobacterium tuberculosis, Mycobacterium bovis, and the Bacille Calmette-Guerin [BCG]. CT may have various clinical forms. The most frequent form of CT is lupus vulgaris [LV]. LV originates from inactive tuberculosis focus in the body and spreads by hematogenous or lymphatic way and by direct or exogenous inoculation. A diagnosis of LV was made based on clinical and histopathological examination. The lesions regressed after treatment with 3 antituberculous drugs. CT must be considered in cases with chronic skin lesions because tuberculosis prevalence is high in our country. Early diagnosis and treatment of patients with CT is extremely important in order to prevent complications. We report, to the best of our knowledge, the youngest CT affecting case

Vaginal perforation caused by distal tip of ventriculoperitoneal shunt: report of a rare complication

Ventriculoperitoneal [VP] shunt is commonly employed in the management of hydrocephalus. Various complications such as dissection or migration may develop besides shunt malfunction. Migration may occur into the lateral ventricle mediastinum, gastrointestinal tract, abdominal wall, bladder, vagina, or scrotum. Although vaginal penetration is rare, we present a case of migration of the peritoneal catheter out of the vagina

Role of proper physical examination in diagnosis of cutaneous manifestation [erythema nodosum] of primary tuberculosis

Erythema nodosum [EN], which is a rare skin manifestation among children, is associated with a wide variety of disease processes. Here a 10 year old female patient with EN is presented. She was initially suspected to have coagulation abnormality by many physicians. She was diagnosed to have primary tuberculosis. This paper stresses the importance of proper physical examination in cutaneous lesions and of ruling out primary tuberculosis in endemic countries in children presenting with EN

Spontaneous pneumomediastinum associated with subcutaneous emphysema causing brachial plexus palsy in a term newborn

Neonatal pneumomediastinum is a rare condition which often occurs during the setting of assisted ventilation of premature or diseased lungs. Brachial palsy occurs in presence of impression on cervical and throcal nerve roots due to birth-related trauma. In this case; we present a progressive spontaneous pneumomediastinum. Although subcutaneous emphysema was involving the whole neck, right cervical region was predominantly involved. Even though there was no diagnosed brachial palsy just after delivery, in time, we realized that the right arm was affected. In the literature, we couldn't find any reported case of spontaneous pneumomediastinum associated with subcutaneous emphysema causing brachial plexus palsy in neonatal period

Malondialdehyde level in the cord blood of newborn infants

In this study, we aim to demonstrate that measurement of the malondialdehyde [MDA] level in the umbilical cord blood of newborn infants born via cesarean section [C/S] and normal vaginal delivery [NVD] is indicative of oxidative stress during the perinatal period. The study was conducted at Bakirkoy Training and Research Hospital between January 2006 and April 2006 on 15 newborns born via elective C/S, 15 newborns born via emergency C/S, and 15 newborns born via normal vaginal delivery. Complete blood count, total bilirubin, glucose, creatinine phosphokinase [CPK], uric acid, iron, blood gas, and malondialdehyde levels were measured in the umbilical cord blood. Malondialdehyde levels in the umbilical cord blood in the emergency C/S and NVD groups were found to be statistically and significantly higher than those in the elective C/S group. In the emergency C/S group, it was determined that the malondialdehyde level increased as the oxygen saturation of the umbilical cord blood increased. In the NVD group, a positive correlation was detected between the total bilirubin and malondialdehyde levels in the umbilical cord blood. In the emergency C/S group, the malondialdehyde level was recorded to be high in the infants with high level of uric acid in the umbilical cord blood. We concluded that the malondialdehyde level in umbilical cord blood could serve as an indication of perinatal oxidative stress and that it could thus help in preventing permanent damage

EBV-induced fulminant hepatic failure treated with liver transplantation

Viral hepatitis is the leading cause of fulminant hepatitis. Infectious mononucleosis caused by primary infection of EBV is a self-limiting lymphoproliferative disease, and shows concomitant clinical features such as pyrexia, cervical lymphadenopathy, liver dysfunction and hepatosplenomegaly. Even though approximately more than 90 percent of all humans are infected with EBV it rarely causes hepatitis and even if it does it is usually benign and it rarely causes hepatic failure in which the outcome has a high mortality rate. We report a case of fulminant hepatic failure in an immunocompetent 3.5 years old girl caused by primary EBV infection that was treated by orthotropic liver transplantation. This observation emphasizes that EBV must be known as a possible cause of fulminant hepatitis and that liver transplantation is probably the unique therapeutic option to avoid a usually fatal course