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    Breath-holding Spells: Etiological Factors, Laboratory Findings, and Rates of Response to Iron Therapy
    (2021) Hanci, Fatma; Türay, Sevim; Tirink, Omer Faruk; Kabakuş, Nimet
    Aim: In this study, we aimed to investigate the etiological factors, electroencephalographic (EEG) findings, rates of response to iron therapy, and factors affecting response to iron therapy in children diagnosed with breath-holding spells (BHS). Methods: The study included 136 children aged 1 to 48 months who received iron therapy after a BHS diagnosis at our pediatric neurology clinic between November 2015 and No¬vember 2019. Patient medical records (physical examination, laboratory and EEG findings, medical history, and effectiveness of iron therapy) were reviewed retrospectively. Results: Of all patents, 81 (59.6%) exhibited partial response (partial remission) to iron therapy (50% decrease in BHS frequency), 52 (39%) responded completely (complete remission), and 2 were unresponsive. Comparison of the patients with complete and partial remission revealed a higher rate of complete remission in girls. In addition, patients with complete remission had higher levels of hemoglobin, MCV, and ferritin than those with partial remission. Complete remission rates were also higher in patients with normal EEG findings. Conclusion: BHS in childhood is a benign, recurring, and non-epileptic disorder and its differentiation from epilepsy is important. Children with BHS respond well to iron therapy, which can be recommended even if the serum iron and ferritin levels are normal.
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    Does Clarithromycin Use in Acute Viral Bronchiolitis Shorten Length of Hospital Stay?
    (2020) Esenülkü, Gülnur; Hanci, Fatma
    Acute bronchiolitis is the most common cause of hospitalization among infants. Although antibiotics are not recommended in the absence of secondary bacterial infection, rates of antibiotic usage is high rate in clinical practicesTo test the hypothesis that clarithromycin use in infants with acute viral bronchiolitis shortens length of hospital stay.One hundred sixty-seven patients aged 1-24 months hospitalized for treatment with a diagnosis of acute viral bronchiolitis at pediatric clinic between April 2017 and May 2018 were investigated retrospectively. The patients were divided into two separate groups, Group A (122 patients), using clarithromycin therapy during hospitalization, and Group B (45 patients), which did not receive clarithromycin (Group B). Demographic and clinical data, treatments received, and duration of hospital stay were obtained from patients’ records.The rate of clarithromycin use in this study was 73%. No statistically significant difference in length of hospital stay was determined between patients receiving clarithromycin and those receiving no antibiotic therapy. However, length of hospital stay decreased with age. Clarithromycin use elicited no statistically significant decrease in hospital stay in patients with acute viral bronchiolitis.The routine use of clarithromycin is not recommended in acute viral bronchiolitis in the light of its cost and side-effects, and the fact is has no impact on clinical status and hospital stay.
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    Migralepsy; clinical and electroencephalography findings in children
    (2019) Kabakuş, Nimet; Hanci, Fatma; Turay, Sevim; Dilek, Mustafa; Bektaş, Mervan
    Aim: Migralepsy is a clinical entity that occasionally represents a diagnostic problem. An apparenthistory and clinical manifestation of migraine may mask the epileptic attack accompanyingmigralepsy. The aim of this study is to present our experience with clinical andelectroencephalography (EEG) findings and treatment of our patients diagnosed with childhoodmigralepsy disease.Methods: We documented six patients who were initially followed-up with a diagnosis of migraine,subsequently observed to have epileptic seizures, and then diagnosed with migralepsy.Result: Our patients became asymptomatic by giving good responses to antiepileptic therapy basedon clinical and electroencephalography (EEG) findings.Conclusions: This case series shows that EEG recording can be useful in all stages of migraine forlong-term, safe monitoring. Identifying patients with possible migralepsy will enable them to receiveantiepileptic treatment.
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    An overview of vitamin B12 and iron deficiencies as a risk factors in children with febrile seizure etiology
    (2021) Türay, Sevim; Hanci, Fatma; Özde, Sukriye
    Aim: To determine serum iron, ferritin, folate, and vitamin B12 deficiency and associated hemoglobin (Hb),hematocrit (Hct), mean corpuscular volume (MCV), and red cell distribution width (RDW) values in childrenundergoing febrile seizure, and thus to reveal their potential etiological role.Method: The serum iron, folate, vitamin B12, and ferritin, and Hb, Hct, MCV, and RDW values of 98 patientsundergoing FS and presenting to the pediatric neurology department and of 64 control patients were retrievedretrospectively and compared. Patient group data were also compared within the group.Results: Serum iron, ferritin, and vitamin B12 values were significantly lower in the patient group than in thecontrol group. Intragroup comparison revealed higher RDW values in patients with more than three FS and inthose with complicated seizures.Conclusion: This is the first study to investigate the relationship between vitamin B12, folate, and irondeficiency and FS. It should be remembered that deficiencies in these micronutrients, which are not routinelyinvestigated in patients presenting with FS, may play a role in the etiology, and that the frequency can decreasewith treatment. It should also not be forgotten that FS patients with high RDW values may be at risk of frequentseizure recurrence.
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    The predictive role of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyteratio in children with simple febrile seizures
    (2021) Yoldaş, Meyri Arzu; Hanci, Fatma; Dinçel, Gökçe Kaya; Bekdaş, Mervan
    Aim: To evaluate the predictive roles of biochemical and complete blood count parameters in the diagnosis of febrile seizures by comparing these between patients with simple febrile seizures and febrile patients without seizures. Methods: One hundred fifty-two children (66 girls and 86 boys), aged 6-60 months presenting with fever symptoms presenting to our hospital’s pediatric emergency department between January 2015 and January 2020 were included in the study. Demographic data, complete blood count parameters and biochemical parameter levels were compared between the two groups. These were divided into a patient group with simple febrile seizures (n = 74) and a febrile control group without seizures (n = 78). Results: Comparison of biochemical parameters revealed significantly higher glucose, CRP, and ALT levels in the febrile seizure group, while Ca and Na were significantly lower. Comparison of complete blood count parameters revealed significantly higher white blood cell (WBC), neutrophil, red cell distribution width, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) values in the febrile seizure group, while hemoglobin, hematocrit, mean corpuscular volume, lymphocytes, and mean platelet volume were significantly lower. Conclusions: We think that in addition to markers such as WBC, leukocytes, and CRP for evaluating inflammation in patients with febrile seizures, simple, easily available, and inexpensive tests such as NLR and PLR can also be useful for assessing inflammation.
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    The Predictors of Pneumonia in Children with COVID-19
    (2023) Yoldaş, Meyri Arzu; Tayfur, Aslı Çelebi; Daniş, Ayşegül; Hanci, Fatma; Atasoy, Halil Ibrahim; Bolu, Semih; Cosgun, Zeliha
    The purpose of this study was to evaluate the relationship between the presence of pneumonia and blood parameters in cases of Coronavirus disease (COVID-19) and to examine their predictive characteristics in terms of pneumonia. We reviewed the file records of 151 pediatric patients with a diagnosis of COVID-19 confirmed by the real time-reverse transcription polymerase chain reaction test in nasopharyngeal swabs. The patients were divided into two groups based on direct chest X-ray and computed tomography results in [Group 1 (n:41), with pneumonia findings, and Group 2 (n:110), with no pneumonia findings]. The groups’ demographic data, clinical and laboratory findings were compared. Pulmonary involvement was determined in 41 (27.1%) of the 151 patients. The [body mass index (BMI) Z-score], red blood cell distribution width (RDW), mean platelet volume (MPV), neutrophil lymphocyte ratio, passive leg raise, and D-dimer levels were significantly higher in patients with pneumonia than those without pneumonia in our study. Based on multivariate logistic regression analysis, BMI Z-score, MPV, and RDW were found to be independent risk factors of pneumonia in patients. The current study showed higher levels of blood parameters in patients with coronavirus disease 2019 (COVID -19) presenting with pneumonia than those without pneumonia. We suggest that BMI-Z score and MPV value may assist in predicting pulmonary involvement in patients with COVID-19.
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    Similarities and differences between familial Mediterranean fever (FMF) and multisystem inflammatory syndrome (MIS-C) in children
    (2023) Yoldaş, Meyri Arzu; Tayfur, Aslı Çelebi; Hanci, Fatma; Daniş, Ayşegül; Bolu, Semih; Atasoy, Halil Ibrahim
    Aim: We aimed to reveal the similarities and differences between the rare and severe multisystem inflammatory syndrome (MIS-C) and active familial Mediterranean fever (FMF) disease in children. Our study may help in the early recognition of MIS-C syndrome in children and distinguish it from other diseases with similar symptoms. Methods: We evaluated the demographic and clinical characteristics, laboratory findings, treatments and outcomes of patients with MIS-C syndrome and active FMF. Results: The clinical and laboratory findings of a total of 66 patients hospitalized in our pediatric clinic with the diagnosis of active FMF (n:42) and MIS-C syndrome (n:24) were reviewed retrospectively. The reason for pediatric emergency admission was determined as resistant fever in all patients. When the clinical findings of the patients were compared, it was determined that joint and abdominal pain in the FMF group and vomiting, rash, cough, Lenfadenopati (LAP) and myalgia findings in the MIS-C group were statistically significantly higher (p<0.05). When the laboratory findings were evaluated between the two groups, the lymphocyte count and vitamin D levels were statistically significantly lower, while the leukocyte count, glucose, C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH), sedimentation, aspartate aminotransferase (AST), alanine aminotransferase (ALT) were found to be significantly higher in the group with MIS-C syndrome (p<0.05 ). Conclusion: We think that the results of our study may guide pediatricians and clinicians in the early differential diagnosis and management of MIS-C, by showing the similarities and differences among MIS-C patients from autoinflammatory diseases such as FMF.