Ayse Esra Yilmaz

Methylphenidate-Induced Acute Orofacial and Extremity Dyskinesia

Methylphenidate is a short-acting stimulant. In this article, the authors report a 7-year-old male patient who presented with orofacial and limb dyskinesia after his first dose of methylphenidate treatment for a diagnosis of attention-deficit/hyperactivity disorder; he was also receiving sodium valproate treatment for epilepsy. Orofacial dyskinesia appeared 5 hours after methylphenidate administration, persisted for 10 hours, and had completely resolved within 2 days. Although limb dyskinesia after methylphenidate is a commonly reported side effect, to the authors’ knowledge this is only the second reported case to develop both orofacial and limb dyskinesia in the acute period after the first dose of methylphenidate. This case is reported to emphasize the potential side effects of methylphenidate, individual differences in drug sensitivities, and drug–receptor interactions via different mechanisms.

Prevalence of oral mucosal lesions from birth to two years

OBJECTIVE The purpose of this study was to determine the prevalence of lesions of the oral mucosa from birth to two years in Turkish pediatric patients . MATERIALS AND METHODS A total of 299 infants from newborn to two years of age were evaluated from the Outpatient Clinics of the Pediatric Department, in the Fatih University Hospital, Ankara, Turkey. The mucosal lesions were documented. The data were presented as percentages and for categorical comparisons Chi-square or Fishers Exact test were used. A P-value less than 0.05 was considered statistically significant. RESULTS Of the 299 infants, mucosal lesions were seen in only 65 (21.27%). In the study, the most common lesions were candidiasis (10.70%), Ebsteins pearls (2.68%), and geographic tongue (2.68%). The frequency of children with mucosal alterations was higher in the group of children from two to twelve months. CONCLUSIONS Although the lesions that were found the most in our study were benign lesions, unrelated to systemic diseases, we still believe that oral mucosal lesions can be a sign of a systemic or dermatological disease in infants, which affects the oral feeding of the infants. Routine examination of the oral mucosa should be a part of the pediatric examination.

Comparison of clinical and microbiological features of vulvovaginitis in prepubertal and pubertal girls

BACKGROUND/PURPOSE Vulvovaginitisis the most common gynecological problem of childhood. The aim of the study was to determine and compare clinical and microbiological features of vulvovaginitis in prepubertal and adolescent girls. METHODS In this retrospective study, the records of patients who were diagnosed with vulvovaginitis between January 2005 and December 2010 in the pediatric outpatient clinic at Fatih University Hospital were retrieved. Information regarding age, symptoms, history of antibiotic use within 1 month prior to presentation, findings on urinalysis, serum antistreptolysin-O levels, and results of urine/vaginal cultures was collected. RESULTS The records of 112 patients were evaluated, 72 of which were prepubertal (64.2%) and 40 were pubertal (35.7%) at the time of diagnosis. Thirty-eight prepubertal patients (52.7%) had a positive result on vaginal culture, the most commonly encountered microorganism being group A beta-hemolytic streptococcus (15.2%). Culture positivity rate in the pubertal group was 47.5% (19 patients), with Candida albicans being the most frequently isolated microorganism (27.5%). CONCLUSION The etiopathogenesis and culture results differ between prepubertal and adolescent girls with vulvovaginitis, which should be taken into consideration in the treatment approach of this disorder.

The relationship between serum magnesium levels with childhood obesity and insulin resistance: a review of the literature.

Abstract Background: Magnesium, the second most abundant intracellular cation, plays a major role in regulating insulin effect and insulin mediated glucose uptake. It has been shown that serum magnesium levels were negatively correlated with HOMA-IR (homeostasis model of insulin resistance) index. Aim: To investigate the relationship between serum magnesium levels with obesity and insulin resistance in childhood. Methods: Two hundred and three children and adolescents (117 obese children and 86 controls) were included. Obese cases were also subgrouped according to the presence or absence of insulin resistance (IR) as “IR (+) obese” and “IR (–) obese”, respectively. Serum glucose, insulin and magnesium levels were measured after a 12-h fasting at 8–8.30 a.m. We assessed insulin sensitivity by using HOMA-IR index as a surrogate marker of insulin resistance. Results: Serum levels of magnesium were significantly lower in the IR (+) obese group than controls (p=0.014). At the same time, there was a positive correlation between serum magnesium levels and body mass index-standard deviation score (BMI-SDS) (r=–0.28, p=0.03) in the IR (–) obese group. Conclusions: Low serum magnesium levels may contribute to the development of insulin resistance in obese children.

Nail alterations in 250 infant patients: a clinical study.

Aims  To investigate the frequency and the nature of nail alterations in infants.

Baby walkers: a perspective from Turkey

Aim:  To determine in an urban population in Turkey, the frequency of baby walker (BW) use, beliefs and attitudes of mothers regarding BWs, frequency of BW‐related injuries and whether families receive counselling from their paediatricians about BWs or not.

Separation anxiety disorder increases among neonatal intensive care unit graduates.

Aim: To evaluate whether separation anxiety disorder (SAD) develops in the later life of the infants, who were separated from their mothers in relation to being in neonatal intensive care unit (NICU). Methods: A group of 57 children, ages over 6 years old who were cared in NICU has been evaluated retrospectively by using the SAD diagnostic scale which is adapted according to DSM-IV. Another age and sex matched 50 children who admitted to the outpatient unit were selected as control group. Results: We found that the scores and incidence of SAD were increased among children who were cared in the NICU and both were correlated with the duration of stay in the NICU. Conclusion: The NICU should be arranged to support the development of the baby. Families should be informed about the necessity of sustaining an early mother-infant interaction. By supporting mother-infant interaction, it will be provided that the baby will establish a more secure relation with his/her mother, develop more healthy and have less behavior problems in the future life.

Preauricular sinus, nephrolithiasis, infantine eczema and natal tooth: a new association

Preauricular sinuses (ear pits) are common congenital abnormalities. The incidence of preauricular sinus is widely varied. Usually asymptomatic, they manifest as small hollows adjacent to the external ear near the anterior margin of the ascending limb of the helix, most frequently on the right side. Preauricular sinuses can be either inherited or sporadic. They may be bilateral, increasing the likelihood of being inherited, in 25-50% of cases. Preauricular sinuses are features of other conditions or syndromes in 3-10% of cases, primarily in association with deafness and branchio-oto-renal (BOR) syndrome. When other congenital anomalies coexist with these sinuses, auditory testing and renal ultrasound should be considered. A girl, who was three months and 20 days old, was presented because of the co-existence of a right infected preauricular sinus, nephrolithiasis, infantile eczema and a natal tooth.

Children with food refusal: An assessment of parental eating attitudes and their styles of coping with stress

Background: In this study, we aimed to assess the eating attitudes and stress coping styles of parents whose children presented to the clinic complaining of food refusal. Methods: The parents of 31 children aged ≥3 years, presented to the clinic with the complaint of food refusal. The control group consisted of 30 healthy children with no prior history of food refusal, and their parents. In both groups, birth features, body mass indexes (BMIs), eating attitudes and stress coping styles of the parents were assessed. The parents of both groups were studied, in part utilizing the eating attitudes test (EAT), and the coping styles of stress scale (CSSS). Results: Our study found that body weights and BMI values of the fathers in the study group were significantly lower than fathers in the control group. There was no significant difference in EAT scores between the two groups; however, where the childrens body weight and height for age percentile was under 25%, the parents had significantly lower EAT scores. When CSSS scores were assessed, the optimistic approach score of the mother and the self‐confident score of the father were found to be significantly high in both groups. Conclusion: The parental perception and definition of eating problemsdoes not necessarily indicate the presence of an eating disorder in a child. In fact, the eating attitudes of the fathers were related to the low percentile weight and height values of the children, and a childs food refusal was not dependent on the stress coping style used by the parent.

Is routine abdominal ultrasonography necessary in macrosomic newborns with difficult delivery

Adrenal hemorrhage is a relatively uncommon clinical problem of the newborn period. Clinical features of adrenal hemorrhage are variable. An abdominal mass, anemia, unexplained/persistent jaundice, bluish discoloration of the scrotum may be the presenting sign. Here, we presented a macrosomic infant (4150 gr) whose left side adrenal hematoma associated with asphixia and early onset of hyperbilirubinemia. We concluded that the pediatricians should be considered abdominal US screening regard as internal hemorrage in macrosomic newborns who delivered with difficult labor and then seen pathologic jaundice.