A comparison of preoperative and postoperative testicular volume and blood flow in patients with inguinal hernia, hydrocele, and cord cyst: A prospective cohort study.

OBJECTIVE: To evaluate the effect of inguinal operations performed with a modified Ferguson technique upon testicular volume and blood flow. METHODS: This study involved 23 children receiving surgery for inguinal hernia, hydrocele, and cord cyst. This was a prospective study performed between April 2016 and June 2016 in a medical faculty pediatric surgery unit. The color Doppler ultrasound (CDUS) was used to assess testicular volume and blood flow before and after a modified Ferguson technique surgery. The pre- and post operative testicular volume and blood flow were compared with the contralateral testes. SPSS software was used to statistically analyze the data arising; the Mann-Whitney U test and Friedman test were used to compare samples, and P<0.05 was accepted as statistically significant. RESULTS: Preoperative and postoperative testicular volumes were not statistically different when compared to contralateral testes. In patients with right sided inguinal pathology, testicular blood flow on the right side was significantly lower than that on the left side (P=0.023). The testicular blood flow was not statistically different compared with the contralateral testes during the first week evaluation and first month evaluation. The blood flow, probably reduced due to the pressure caused by inguinal pathology, was normalized through surgery. CONCLUSIONS: The modified Ferguson technique do not change the testes volume and blood flow.

Systemic Manifestation of Rotavirus Infection in Children: A Report of Three Cases.

INTRODUCTION: Rotavirus is a leading cause of acute gastroenteritis in children. Although the clinical complaints associated with rotavirus are generally gastrointestinal, including vomiting and diarrhea, data suggest that it can also cause symptoms that extend beyond the gastrointestinal tract. CASE PRESENTATIONS: We report three pediatric cases of rotavirus infection: one accompanied by encephalopathy and two with elevated hepatic transaminase activity. The patients were admitted to Dr. Sami Ulus maternity and children's health and diseases training and research hospital, Ankara, Turkey, from 2012 - 2014. The presented patients' aspartate aminotransferase (AST) (1765-2614 IU L-1) and alanine aminotransferase (ALT) (1448-3558 IU L-1) levels are, to date, the highest reported levels associated with rotavirus infections, and suggest that the rotavirus can cause severe hepatic transaminase elevation. CONCLUSIONS: This report aimed to increase awareness of the occurrence of extra-intestinal systemic manifestations of rotavirus infection. Although such cases may be rare, they still suggest that that rotavirus is a systemic viral infection.

Características demográficas de pacientes con enfermedad de pie-mano-boca. Serie de casos atípicos / Demographic characteristics of patients with hand-foot-and-mouth disease. Atypical cases series

La enfermedad de pie-mano-boca es un exantema frecuente en la niñez. Se han descrito varios tipos de lesiones de distribución generalizada en casos atípicos, aunque los datos sobre la predilección respecto de la localización de estas lesiones son insuficientes. Nuestro objetivo fue describir las características demográficas de los pacientes con esta enfermedad y caracterizar las localizaciones de las lesiones en pacientes con erupciones atípicas, tratadas en un centro ambulatorio de dermatología de un hospital pediátrico, entre noviembre de 2011 y agosto de 2013. Se incluyen a 67 pacientes en el estudio. La edad media de los pacientes fue de 34 meses con predominio de varones (60%). Todos los pacientes tuvieron erupciones en la boca, las manos y los pies. Los niños <24 meses se vieron afectados en la zona cubierta por el pañal y las extremidades, con un compromiso significativamente mayor en los que tenían entre 24 y 48 meses y en los >48 meses (p <0,0001 y p= 0,011, respectivamente). Ninguno de los pacientes tuvo complicaciones sistémicas graves.(AU)

Hand-foot-and-mouth disease (HFMD) is a common childhood exanthem. Various types of lesions and widespread distribution in atypical cases have been described, but data on the predilection of lesion localizations in atypical cases are insufficient. We aimed to describe the demographic features of patients with HFMD, and to characterize lesion localizations in patients with atypical eruptions treated at an outpatient dermatology clinic of a pediatric hospital, between November 2011 and August 2013.The study included 67 patients. Mean age of the patients was 34 months and there was a male predominance (60%). All the patients had eruptions on hands, feet, and mouth. Children aged <24 months had involvement of the diaper area and extremities, which was significantly higher than those aged 24-48 months and >48 months (P < 0.0001 and P= 0.011, respectively). None of the patients had serious systemic complications.(AU)

Características demográficas de pacientes con enfermedad de pie-mano-boca. Serie de casos atípicos / Demographic characteristics of patients with hand-foot-and-mouth disease. Atypical cases series

La enfermedad de pie-mano-boca es un exantema frecuente en la niñez. Se han descrito varios tipos de lesiones de distribución generalizada en casos atípicos, aunque los datos sobre la predilección respecto de la localización de estas lesiones son insuficientes. Nuestro objetivo fue describir las características demográficas de los pacientes con esta enfermedad y caracterizar las localizaciones de las lesiones en pacientes con erupciones atípicas, tratadas en un centro ambulatorio de dermatología de un hospital pediátrico, entre noviembre de 2011 y agosto de 2013. Se incluyen a 67 pacientes en el estudio. La edad media de los pacientes fue de 34 meses con predominio de varones (60%). Todos los pacientes tuvieron erupciones en la boca, las manos y los pies. Los niños <24 meses se vieron afectados en la zona cubierta por el pañal y las extremidades, con un compromiso significativamente mayor en los que tenían entre 24 y 48 meses y en los >48 meses (p <0,0001 y p= 0,011, respectivamente). Ninguno de los pacientes tuvo complicaciones sistémicas graves.

Hand-foot-and-mouth disease (HFMD) is a common childhood exanthem. Various types of lesions and widespread distribution in atypical cases have been described, but data on the predilection of lesion localizations in atypical cases are insufficient. We aimed to describe the demographic features of patients with HFMD, and to characterize lesion localizations in patients with atypical eruptions treated at an outpatient dermatology clinic of a pediatric hospital, between November 2011 and August 2013.The study included 67 patients. Mean age of the patients was 34 months and there was a male predominance (60%). All the patients had eruptions on hands, feet, and mouth. Children aged <24 months had involvement of the diaper area and extremities, which was significantly higher than those aged 24-48 months and >48 months (P < 0.0001 and P= 0.011, respectively). None of the patients had serious systemic complications.

[Demographic characteristics of patients with hand-foot-and-mouth disease. Atypical cases series]. / Características demográficas de pacientes con enfermedad de pie-mano-boca. Serie de casos atípicos.

Hand-foot-and-mouth disease (HFMD) is a common childhood exanthem. Various types of lesions and widespread distribution in atypical cases have been described, but data on the predilection of lesion localizations in atypical cases are insufficient. We aimed to describe the demographic features of patients with HFMD, and to characterize lesion localizations in patients with atypical eruptions treated at an outpatient dermatology clinic of a pediatric hospital, between November 2011 and August 2013.The study included 67 patients. Mean age of the patients was 34 months and there was a male predominance (60%). All the patients had eruptions on hands, feet, and mouth. Children aged <24 months had involvement of the diaper area and extremities, which was significantly higher than those aged 24-48 months and >48 months (P < 0.0001 and P= 0.011, respectively). None of the patients had serious systemic complications.

La enfermedad de pie-mano-boca es un exantema frecuente en la niñez. Se han descrito varios tipos de lesiones de distribucion generalizada en casos atípicos, aunque los datos sobre la predilección respecto de la localizacion de estas lesiones son insuficientes. Nuestro objetivo fue describir las caracteristicas demograficas de los pacientes con esta enfermedad y caracterizar las localizaciones de las lesiones en pacientes con erupciones atipicas, tratadas en un centro ambulatorio de dermatologia de un hospital pediatrico, entre noviembre de 2011 y agosto de 2013. Se incluyen a 67 pacientes en el estudio. La edad media de los pacientes fue de 34 meses con predominio de varones (60%). Todos los pacientes tuvieron erupciones en la boca, las manos y los pies. Los ninos <24 meses se vieron afectados en la zona cubierta por el panal y las extremidades, con un compromiso significativamente mayor en los que tenian entre 24 y 48 meses y en los >48 meses (p <0,0001 y p= 0,011, respectivamente). Ninguno de los pacientes tuvo complicaciones sistémicas graves.

Evaluation of children presenting to the emergency room after electrical injury.

BACKGROUND/AIM: To evaluate children who presented to the Pediatric Emergency Department with electrical injury and to discuss the follow-up of these cases and potential precautions that can be taken. MATERIALS AND METHODS: A total of 36 patients presented to the Pediatric Emergency Department with electrical injury between May 2010 and May 2013, and these cases were investigated retrospectively. The patients' age and sex, location and form of exposure to electric current, seasonal distribution, length of hospital stay, musculoskeletal and cardiovascular system complications, renal damage, and treatments were recorded. RESULTS: The majority of the patients were exposed to low-voltage electrical current at home. When the patients were evaluated based on the type of electric current, alanine transaminase, aspartate transaminase, creatine kinase, and creatine kinase-myocardial isoenzyme levels were found to be significantly higher among patients who were exposed to high-voltage electric current. None of the patients died, and the mean length of hospital stay was 2.50 ± 1.06 days. CONCLUSION: Electrical injuries can present with a wide variety of problems, ranging from a simple injury to life-threatening severe multiple organ injury. Even simple precautions can prevent possible morbidity and mortality. We think that the public level of knowledge and awareness should be increased.

Comparison of risk factors in newborn hearing screening in a developing country.

The aim of this study is to evaluate the results of the newborn-hearing screening program (NHSP) in our institute, investigate the risk factors and their correlation to congenital hearing loss (CHL). Newborns who admitted to our clinic for NHSP from June 2014 to December 2014 were included in the study. After the test parents were asked to fill a questionnaire about the risk factors of CHL. Test results and referral rate were compared with risk factors. One thousand consecutive babies were included in the study. The overall referral rate was 3.5%. Mechanic ventilation, history of familial CHL and familial consanguinity were found to be significantly related to CHL.In the light of our results we can conclude that getting access to every newborn for hearing screening is mandatory and targeting the risk factors and informing the family about the follow-up period is important for diagnosing the delayed hearing impairment.

Accuracy of Internet guidance on pediatric otolaryngology procedures.

OBJECTIVES: To evaluate the reliability and accuracy of the most visited Internet websites for the frequently performed surgical pediatric otorhinolaryngology procedures. STUDY: A google.com search was used to determine the top 20 Internet sites for the terms 'adenoidectomy', 'tonsillectomy' and 'ventilation tube surgery'. The DISCERN plus questionnaire was used to score each website. Furthermore, a 'hit list' of reliable and accurate websites was created depending on the most clicked healthcare organizations with corporate identities and the personal websites of the otolaryngologists with academic titles who were members of the Turkish Society of Otolaryngology Head and Neck Surgery. The pages were also investigated as if they were in this list of accurate websites. RESULTS: Of the 60 websites viewed for the terms 'adenoidectomy', 'tonsillectomy' and 'ventilation tube surgery', only 23.3% were matching the list of accurate websites. The mean DISCERN plus score was 35.70 (16-58), 38.02 (16-80) and 39.08 (16-58) for adenoidectomy, tonsillectomy and ventilation tube surgery respectively. There was no significant difference between the three groups (p>0.05). The mean DISCERN plus score for all the websites was 37.37 out of the maximum score of 80. CONCLUSIONS: In the light of our results we can conclude that the quality of data on the Internet is not adequate enough to obtain information about the most frequent surgical procedures in pediatric otorhinolaryngology. Clinicians must be aware about this fact and warn the parents about the disinformation which may lead to wrong decisions.

Method of the diagnosis of adenoid hypertrophy for physicians: adenoid-nasopharynx ratio.

OBJECTIVE: We aimed to describe the feasibility of a prediction of adenoid hypertrophy by pediatricians for diagnostic accuracy of nasopharyngeal x-ray in a pediatric unit. METHODS: Forty-six patients with a history of probable adenoid hypertrophy between January 2013 and August 2013 were included in the study. Participants were excluded from the study if they had previous adenoidectomy; anatomic anomaly in the nose, palate, or nasopharynx; and acute infection. Nasal endoscopy was performed and evaluated adenoid size (choanal obstruction ratio) in all patients by an otorhinolaryngologist who was blinded to the information of other data. Lateral nasopharyngeal x-ray graphs of all patients were evaluated by pediatricians with adenoid-nasopharynx (A-N) ratio, who were blinded to the information of other data. The A-N ratio was calculated by Fujioka method. The A-N ratio of each patient was compared with the choanal obstruction ratio that was determined in the nasal endoscopic examination. Spearman correlation test was used for statistical analysis, and P < 0.05 was described as significant. RESULTS: Forty-six patients were included in this study. The study sample consisted of 25 male (54.3%) and 21 female (45.7%) patients. The mean age of the patients was 6.17 years (range, 2-14 y). In the nasal endoscopic examination, the mean (SD) choanal obstruction ratio was 64.6% (19.5%) (range, 12.5%-90%). Mean (SD) A-N ratio was found to be 16.7 (14.4). The A-N ratio correlated with nasal endoscopic examination findings (r = 0.334, P = 0.023) CONCLUSIONS: The A-N ratio was found to be a useful, tolerable, and confident diagnostic method in pediatric patients for adenoid hypertrophy. Pediatricians can confidently use this method for decision after follow-up or operation.

Laryngeal fibrous hamartoma presenting with airway obstruction at birth.

Hamartoma is an extremely rare congenital malformation of the larynx. Hamartomas of the nasal cavity or nasopharynx are classified as epithelial, mesenchymal, and mixed epithelial and mesenchymal types. Presenting symptoms result from airway obstruction and may include slowly rising respiratory distress, stridor, changes in voice, eating, and activity levels. We present a 1-day-old newborn with a history of stridor and respiratory distress caused by a polypoid mass on the anterior half of the left ventricular band. We performed an excisional biopsy under direct laryngoscopy. Histopathologic finding after excisional biopsy was consistent with hamartoma. We report and discuss the pathological features and differential diagnosis of this rare laryngeal hamartoma. To our knowledge, laryngeal hamartoma presenting with stridor has not been described in the literature thus far.

Audiologic evaluation in pediatric patients with type 1 diabetes mellitus.

OBJECTIVE: The aim of this study was to perform audiological evaluation of children with type 1 diabetes mellitus (DM). METHODS: One hundred DM patients (200 ears) were included in the study. Pure-tone audiometry at frequencies of 0.25, 0.5, 1, 2, 4, and 8 kHz; immittance measures including tympanometry and acoustic reflex testing; transient evoked otoacoustic emission (TEOAE); and auditory brainstem response (ABR) testing were performed in the patients. The results were statistically compared with metabolic control of DM, positive and negative autoantibodies, duration of DM, and present concomitant Hashimoto and celiac diseases. RESULTS: The proportion with a result of 'fail' for the TEOAE test in the DM patients was not statistically significant among all groups (p > 0.05). The autoantibodies, blood glucose level, and present concomitant Hashimoto and celiac diseases were not associated with prolonged ABR latencies. However, ABR peripheral transmission time (wave I) was significantly delayed with the increasing duration of DM (p < 0.05). CONCLUSION: Pediatric patients with type 1 DM do not frequently present with cochleovestibular symptoms, but show higher audiometric thresholds and the absence of or reduction in TEOAE amplitudes. In ABR testing, the increase in the peripheral transmission time (wave I) is more suggestive of retrocochlear alterations in pediatric cases of type 1 DM compared with conventional audiometric tests (e.g., pure-tone audiometry and OAEs), which may indicate possible initial auditory neuropathy. Further longitudinal investigations on a wide range of control and pediatric subjects with DM will be necessary to confirm the present data and to detect initial auditory neuropathy.