Pelin Zorlu

Effects of Intranasal Midazolam and Rectal Diazepam on Acute Convulsions in Children: Prospective Randomized Study

In this study, the effects and side effects of rectal diazepam and intranasal midazolam were compared in the treatment of acute convulsions in children to develop a practical and safe treatment protocol. In the diazepam group, the seizures of 13 (60%) patients terminated in 10 minutes; however, 9 (40%) patients did not respond. In the midazolam group, 20 (87%) patients responded in 10 minutes, but 3 (13%) patients did not respond. Regarding the anticonvulsant effect, midazolam was found to be more effective than diazepam, and the difference was statistically significant (P < .05). The necessity of a second drug for the seizures that did not stop with the first drug was higher in the diazepam group than the midazolam group, and the difference was statistically significant (P < .05). We conclude that as an antiepileptic agent, intranasal midazolam is more effective than rectal diazepam. After administration, we did not observe any serious complications. Further investigations are necessary; however, intranasal administration is easy, so if the nasal drop and spray forms used in some European countries and the United States are available worldwide, it will be very useful for physicians in the emergency room. (J Child Neurol 2002;17:123-126).

Nasal Midazolam Effects on Childhood Acute Seizures

Sixteen children, aged from 2 months to 14 years, with a diagnosis of acute seizures and seen at Dr. Sami Ulus Child Health and Disease Center, were included in this study. Midazolam (5 mg/mL) 0.2 mg/kg was administered intranasally in 30 seconds by an injector. The heart rate, respiratory rate, blood pressure, and oxygen saturation were recorded at 0, 5, and 10 minutes after administration. The seizures of three (18.7%) patients terminated within 1 minute, of seven (43.7%) patients in 1 to 2 minutes, and of three (18.7%) patients in 2 to 5 minutes. However, three (18.7%) patients did not respond to treatment. As a result, it was concluded that intranasal midazolam administration is easy and effective. The half-life of midazolam is shorter than diazepam, and midazolam has fewer complications when compared with diazepam. It is easier to use in nasal drop and spray forms. (J Child Neurol 2000;15:833-835).

Echocardiographic evaluation of cardiac functions and left ventricular mass in children with malnutrition.

Objective: This study was undertaken to assess the left ventricular mass (LV Mass) and systolic and diastolic functions of the left ventricle in children with protein energy malnutrition (PEM).

Evaluation of shigellosis in a Turkish children’s hospital

Background: The aim of the present study was to evaluate cases of Shigella and determine the pattern of antimicrobial resistance of shigella species in central Turkey.

Single dose povidone-iodine on thyroid functions and urinary iodine excretion

The effect of single dose povidone-iodine on serum thyrotropin and thyroxine levels and urinary iodine excretion in 30 preterm, 40 full-term newborns and 50 infants at Dr. Sami Ulus Children’s Hospital was studied. There was no significant change of thyroid function in any of the groups (p>0.05). Urinary iodine excretion in preterm and full-term groups elevated significantly (p<0.05). The authors conclude that patients who receive single dose povidone-iodine for skin disinfection are not at risk for thyroid disorders.

Can zinc deficiency be used as a marker for the diagnosis of celiac disease in Turkish children with short stature

Abstract Background : It is generally accepted that celiac disease (CD) must always be considered when dealing with growth failure in children. Therefore, it is important to develop screening tests for detecting patients that need an intestinal biopsy. The aim of the present study was to investigate the value of plasma zinc levels for the diagnosis of monosymptomatic CD in short‐statured children.

TRANSFUSION-RELATED ACUTE LUNG INJURY (TRALI): A Report of Two Pediatric Cases

Transfusion-related acute lung injury (TRALI) is a life-threatening adverse effect of transfusion that should be considered in the differential diagnosis of all patients who develop respiratory distress during or within 6 h of transfusion. Two children with TRALI are presented and the diagnosis, pathophysiology, treatment, and need for understanding and recognition to reduce morbidity and mortality are discussed.

HEMOPHAGOCYTOSIS: The Cause of Anemia and Thrombocytopenia in Congenital Syphilis

Congenital syphilis is a rare, serious disease that continues to be a major health-care problem. The infected neonate may be asymptomatic or multiple-organ system involvement may occur. Anemia and thrombocytopenia are common hematological findings. Hemophagocytic lymphohistiocytosis (HLH) is a clinicopathological condition characterized by activation and uncontrolled nonmalignant proliferation of T lymphocytes and macrophages. The authors report an infant with congenital syphilis as a very rare cause of hemophagocytic syndrome. The reason for anemia and thrombocytopenia in congenital syphilis is not clear. The authors suggest that hemophagocytosis may play role in pathogenesis of cytopenia, particularly thrombocytopenia in patients with congenital syphilis.

Is it a new syndrome or a clinical variability in cerebro‐oculo‐nasal syndrome?

We present a male infant 2.5‐months old with asymmetric skull, anophthalmia, apparent hypertelorism, abnormal nares, unilateral cleft lip and palate, and structural abnormalities of the central nervous system. These findings are similar to cerebro‐oculo‐nasal syndrome except for the appearance of nose. This case is either a clinical variability in cerebro‐oculo‐nasal syndrome or a new entity.

Importance of high sensitivity C-reactive protein in the evaluation of wheezing in children.

It is important to determine the presence of asthma in children under the age of 3 with recurrent wheezing. Inflammatory markers have been investigated in the diagnosis and treatment of asthma. The aim of the present study was to investigate the relationship between recurrent wheezing with or without modified asthma predictive index (mAPI) positivity and high‐sensitivity‐C reactive protein (hs‐CRP) level in children aged 6–36 months.