Primer immunodeficiency disorders (PIDs) are a heterogeneous group of rare inherited disorders of the immune system. Children with PIDs show increased sensitivity to frequent and multiple infections, immune dysregulation with autoimmune disease, and malignancy. PIDs have clinical and epidemiological importance since they cause serious morbidity and mortality, although seem rarely. Children and adolescents with PIDs are expected increased prevalance of psychopathologies and lower level of the health quality of life (HR-QOL). In this text, we aimed to review current literature and summarized.

INTRODUCTION: We aimed to determine the frequency of rebound hyperbilirubinemia (RHB) needing treatment and therefrom, to clarify the clinical importance to routinely check serum total bilirubin (STB) levels after the cessation phototherapy and to define an optimal timing to check STB levels for detecting RHB.
METHODS: Term and late preterm babies who received phototherapy were included in the study. The demographic and clinical features, time of onset of jaundice, phototherapy time and results to determine the etiology of jaundice were recorded for all babies. Serum “rebound” bilirubin measurements were performed for a total of two times including at 12 and at 24 hours after terminating phototherapy. The reinitiation of phototherapy according to the 12th and 24th hour STB levels was accepted as “early rebound” and “late rebound”, respectively. IBM SPSS 22 was used for statistical analyses.
RESULTS: Data was available for 110 infants. The rebound rate requiring phototherapy was 9.1% (n: 10) and all had a risk factor. Most of the babies (9/10) rebounded at the 12th hour after the termination of phototherapy. Hemolysis and prematurity were found to be statistically significant for RHB (p: 0.008; p: 0.048).
DISCUSSION AND CONCLUSION: Post-phototherapy bilirubin follow up may be incorporated using a combined approach of individualization, evaluation of risk factors, and application of common sense before discharge. Our study showed that STB levels could be measured after the cessation of phototherapy, especially in patients with a risk factor, at the 12th hour before discharge. Randomized controlled studies with larger sample sizes are still needed for definitive recommendations.

INTRODUCTION: We aimed to evaluate the effect of short term probiotic yogurt consumption on pH, buffering capacity, and streptococcus mutans, Lactobacilli and secretory IgA levels in saliva of 6-8 months old healthy infants.
METHODS: Twenty healthy infants and their mothers were enrolled in the study. They were randomly allocated into two groups as study and control. In the study group, probiotic yogurt (Bifidobacterium Longum BB536, Bifidobacterium Bifidum Bb12,Lactobacillus RhamnosusHN001) was given to infants for 3 weeks whereas in the control group home made yogurt was consumed. A dental saliva pH-Indicator strip (GC, Japan) was used for salivary pH measurements. Buffering capacity was determined using CRT buffer (Ivoclar Vivadent,Liechtenstein). The counts of salivary mutans streptococci and lactobacilli were evaluated using CRT bacteria (Ivoclar Vivadent,Liechtenstein). Enzyme-Linked Immuno-Sorbent Assay (ELISA) was used for secretory IgA. Scores at baseline and three weeks after were statistically evaluated by Wilcoxon test using IBM SPSS 20.0 programme.
RESULTS: Salivary pH, IgA, Streprococcus mutans and and lactobacilli values showed no significant change after 3 weeks of probiotic yogurt consumption however there was a statistically significant increase in the buffering capacity of saliva (p=0.04)
DISCUSSION AND CONCLUSION: Short term probiotic yogurt intervention in infants at early stages of life might have benefits for oral health. Further studies with both short and long term use of probiotics must be implemented in infants to confirm the results and see the effects on other caries risk factors.

INTRODUCTION: The purpose of this study is to determine eating habits of school age children and to evaluate the effect of nutrition education with games on gaining healthy eating habits.
METHODS: The study, which is quasi-experimental with pre test-post test experimental model without a control group, was conducted at a primary school. The population of the study includes the 2nd-grade students at the age of 8. The population consists of 59 primary school students who participated in all nutrition education and completed the pre-test, the other two post-tests. The data were analyzed via descriptive statistics, Wilcoxon, McNemar, Shapiro-Wilk tests.
RESULTS: According to the findings, 59.3% of the students didn’t have any nutrition education and 84.7% of them considered their eating habits as good. It was also found that 50.8% of the students before the training, 30.5% of them right after the training and 40.7% of them 3 months after the training stated they skipped one of the meals and that it was lunch which was the most frequently skipped meal. Although there was no change in consumption of fresh fruit and fruit juice, there was an increase in the consumption of fresh vegetable and vegetable meals, but this wasn’t transformed to behavior. The consumption of dairy products increased and transformed to behavior. The average nutrition knowledge of the students increased both right after the training and 3 months later.
DISCUSSION AND CONCLUSION: It was also suggested that the nutrition education given to the school age children had a positive effect on the nutrition knowledge, attitudes, behaviors.

INTRODUCTION: Coagulation and fibrinolytic systems play an important role in the pathogenesis of complicated pneumonia. This study aims to evaluate and compare coagulation and fibrinolytic system markers and natural anticoagulant proteins with acute phase reactants, such as C - reactive protein, procalcitonin in children with pneumonia.
METHODS: 115 patients and 87 healthy children were included in the study. Patients were separated into two groups based on viral and bacterial pneumonia diagnosis. Coagulation and anticoagulation system markers were compared with acute phase reactants in children with pneumonia.
RESULTS: White blood cell numbers and d - dimer levels were higher in the pneumonia patients compared to the control group (p = 0.001 and 0.001 respectively). Protein C activity and antithrombin activity in the patient group were significantly lower compared to the control group (p = 0.001 and p = 0.011 respectively). Acute phase reactants and d - dimer levels in the bacterial pneumonia patients were higher compared to the viral pneumonia patients (p < 0.05). Protein S activity, fibrin monomers and fibrin degradation products were not significantly different between bacterial and viral pneumonia patients. Protein S activity in the bacterial pneumonia patients was lower compared to the viral pneumonia patients (p = 0.040). There was no difference in terms of antithrombin activity and protein C activity.
DISCUSSION AND CONCLUSION: As a result, the relationships among acute phase proteins, anticoagulation proteins, and fibrinolytic system markers show that the coagulation and fibrinolytic system has an important role in pneumonia pathogenesis and associated inflammation. Evaluation of the coagulation system may help determine the severity of pneumonia in children and monitor its clinical progress.

INTRODUCTION: Gonadotropin-releasing hormone agonists (GnRHa) are widely used in the treatment of central precocious puberty (CPP). There is concern that the GnRHa treatment, whose positive effects on the adult height are known, may cause weight gain and body mass index (BMI) increase. The aim of this study was to assess the effect of the GnRHa treatment on BMI and height in female patients with CPP.
METHODS: 92 patients diagnosed with idiopathic CPP and 22 patients diagnosed with organic CPP, who received the GnRHa treatment were included in the study. The data of the treatment start date, 6th month, 1st and 2nd year height, weight, BMI, bone age were obtained retrospectively from the file records.
RESULTS: BMI SDS increased during the treatment period in all the patients. In the second year of GnRHa treatment, BMI SDS was higher in the organic CPP, compared to the idiopathic CPP (0.66±0.84 and 1.35±0.72, p=0.007). In both groups, at the beginning of GnRHa treatment, the BMI SDS increase was higher in the patients with normal weight than those who were overweight- obese. In both groups, the prevalence of obesity was higher than the reference population at the beginning of treatment. An increase were determined in the height SDS and PAH in both groups according to bone age.
DISCUSSION AND CONCLUSION: In patients with CPP, the prevalence of obesity was higher in the first application compared to the reference population. In CPP, BMI SDS increased with GnRHa treatment. The weight of the patients at the beginning of treatment affected the weight and BMI change with GnRHa treatment. The patients with the organic CPP were more prone to the weight gain and BMI increase.

INTRODUCTION: Acute rheumatic fever (ARF) is an inflammatory disease developing as a response to group A streptococcal infection. Platelet parameters and neutrophil/lymphocyte ratios (NLRs) have been used as markers of inflammation severity in various inflammatory diseases in recent years. The purpose of this study was to evaluate platelet parameters and NLRs of patients with a diagnosis of ARF and under monitoring by our clinic, and to compare these with a healthy control group.
METHODS: Fifty patients diagnosed with ARF (37 carditic and 13 non-carditic) and 50 age- and sex-matched healthy children were included in the study. Cases’ demographic characteristics, complete blood count values, acute phase reactants, and transthoracic echocardiography (ECHO) findings were recorded.
RESULTS: NLR, and leukocyte, neutrophil, and platelet numbers were statistically significantly higher in the ARF group than in the control group(p<0.001), while hemoglobin, lymphocyte, and mean platelet volume (MPV) values were significantly lower (p<0.001). No statistically significant difference in MPV, plateletcrit (PCT) or NLR values was observed between the ARF subgroups with and without carditis. Platelet distribution width (PDW) was significantly higher in the ARF patients with carditis(p=0.003). Correlation analysis revealed that platelet count was positively correlated with leukocyte and neutrophil numbers, MPV was negatively correlated with leukocyte numbers, and PCT was significantly positively correlated with leukocyte and neutrophil numbers. PDW exhibited negative correlation with lymphocyte count and positive correlation with NLR.
DISCUSSION AND CONCLUSION: MPV values were significantly low and NLR values significantly high in patients with ARF. We therefore think that these parameters can be used as markers in patients diagnosed with ARF

INTRODUCTION: Turner syndrome (TS) is a genetic disorder caused by numerical or structural aberration of the X chromosome, which is associated with a female phenotype. Concerning oral status several studies have revealed that girls with TS have dental anomalies and periodontal problem. The aim of the study was to evaluate the effect of oral bacteria on caries prevalence and periodontal status, in pediatric patients with TS.
METHODS: Twenty TS patient and 17 healthy girl were examined for cariological and periodontal status. The levels of mutans streptococci (MS), lactobacilli (LB), yeast and 10 different periodontal bacteria were determined by using culture and microarray techniques in children 's stimulated saliva samples.
RESULTS: There was no difference in salivary flow rate and buffering capacity, DMFT, MS, LB, yeast levels in the groups. PI and GI levels were significantly higher in the Turner group and dft was significantly higher in the control group (p < 0,05). As a result microarray analysis, P. intermedia, F. nucleatum, E. corrodens, A. actinomycetemcomitans, A. viscosus were detected at high levels in Turner group (p < 0,05).
DISCUSSION AND CONCLUSION: Besides dental and craniofacial anomalies, the clinicians should be cautious with in early diagnosis and treatment of periodontal problems in patients with TS.

INTRODUCTION: Respiratory Syncytial virus (RSV) is an important pathogen of childhood that causes lower respiratory system infection. The aim of this study was to evaluate whether the mean platelet volume (MPV) changes are significant in the prediction of bronchiolitis with respiratory syncytial virus (RSV) and other respiratory viruses.
METHODS: A standard protocol was followed, and 184 patients were divided into groups based on being RSV positive and other respiratory viruses positive. Using the ROC, diagnostic accuracy was evaluated according to the AUC for the diagnosis of bronchiolitis. A P value of <0.05 was considered statistically significant.
RESULTS: MPV was significantly lower in patients with single RSV (6.6 ± 1.1 vs. 7 ± 1.2, P < 0.05). The MPVs were similar in patients with positive and negative RSV bronchiolitis (6.8 ± 1.5 vs. 7 ± 1.3, P > 0.05) and other viruses. ROC curve analysis suggested that MPV level cut-off point for making the diagnosis of single RSV bronchiolitis was 6.63 fL with a sensitivity, specificity of 55%, 63% respectively. The median AUC was 0.384 for the MPV (95 % CI 0.270-0.499, P = 0.04).
DISCUSSION AND CONCLUSION: Mean platelet volume may be a useful marker to provide a prediction on single Respiratory syncytial virus bronchiolitis. However, measurement of mean platelet volume might not be correct and sufficient to provide a prediction on type of respiratory viruses in bronchiolitis.

INTRODUCTION: This study was conducted for the purpose of determining the validity and reliability of the Parenting Scale in the Turkish sample.
METHODS: The study was conducted as a methodological-descriptive-cross sectional study. The study sample consisted of 355 parents that had applied to Child and Adolescent Psychiatry Polyclinic of Uludağ University. However; as 85 parents did not precisely fill the scales, they were excluded from the sample and the analyses were conducted on the basis of 270 parents. The study data were collected by using the Demographic Data Collection Form and the Parenting Scale. Validity analyses of the scale were examined via explanatory and confirmatory factor analysis. Internal consistency of the scale was evaluated via cronbach alpha, Spearman-Brown and Guttman split-half coefficients. The relationship between item-total score and item-subscale total score was examined via pearson correlation analysis.
RESULTS: The cronbach alpha values of the Parenting Scale were determined as; 0.935 in the lower dimension of Laxness, 0.916 in the lower dimension of Over-reactivity, 0.770 in the lower dimension of Hostility (use of verbal or physical force) and 0.829 in the total scale. The factor loads varied between; 0.52 and 0.98 in the lower dimension of Laxness, 0.75 and 0.92 in the lower dimension of Over-reactivity and 0.46 and 0.95 in the lower dimension of Hostility. It was determined that the total scale scores and correlations of items in the scale varied between 0.20-0.66. It was also determined that item-subscale total score correlations varied between; 0.61-0.96 in the lower dimension of Laxness, 0.70-0.86 in the lower dimension of Over-reactivity and 0.68-0.91 in the lower dimension of Hostility.
DISCUSSION AND CONCLUSION: Parenting Scale is a valid and reliable tool that could be used in the Turkish culture.

INTRODUCTION: Evaluation of the etiology, clinical and laboratory findings, treatment and complications of preseptal and orbital cellulitis in patients and to show that these complications can be prevented with early diagnosis and effective treatment.

METHODS: Thirty-eight patients with orbital and preseptal cellulitis who were admitted to Ankara Educational and Research Hospital Pediatric Clinic between September 2015 and February 2017 were retrospectively studied.

RESULTS: Thirty-five patients (92.1%) were diagnosed with preseptal cellulitis and 3 patients (7.9%) with orbital cellulitis. The mean age at diagnosis of the patients (24 girls [63.2%] and 14 boys [36.8%]) was 4.01 ± 3.72 years. The most frequent etiologic factor was conjunctivitis (28.9%). 25 patients (65.7%) were treated with intravenous ampicillin-sulbactam alone as the first treatment. No patients underwent surgery. All patients recovered completely without any eye illnesses and no complications were observed.
DISCUSSION AND CONCLUSION: Orbital infections can be healed by early diagnosis and effective antibiotic therapy in childhood and ampicillin-sulbactam therapy alone should be preferred over combination therapy because of it’s high effectiveness and relatively low side effects.

Orbital myositis is an inflammatory disease affecting the extraocular muscles, especially the medial rectus. The cases are usually referred to clinics with complaints such as diplopia, orbital / periorbital pain, limitation in ocular movements, increased pain with eye movements, proptosis, swelling of the eyelid, hyperemia in the conjunctiva. Orbital myositis is usually idiopathic and autoimmunity is often accused in etiology. It is reported that the disease is associated with polymyositis, thyroid diseases, juvenile rheumatoid arthritis, kawasaki disease, scleroderma, systemic lupus erythematosus, crohn's disease, ankylosing spondylitis. In this article we present a 15-year-old girl who presented with diplopia, pain in both eyes, anomalous head posture, periorbital edema and was diagnosed with idiopathic orbital myositis through history, clinical findings and imaging methods. In this article, it is aimed to draw attention to the diagnosis of idiopathic orbital myositis which is rare in childhood.

Juvenile myasthenia gravis (JMG) is an autoimmune disease caused by antibodies to the postsynaptic membrane at the neuromuscular junction. The association of JMG with Type I diabetes mellitus (DM), another autoimmune disease, is very rare and the pathogenesis has not been fully explained. Our case is the youngest patient where this association has been reported in the literature and presented at the age of 4 years when diabetic ketoacidosis developed together with the emergence of ocular myasthenia findings. She is the only case diagnosed with juvenile myastenia gravis among the 510 type 1 DM patients followed-up at our clinic. Although an autoimmune process may have triggered both autoimmune diseases at the same time in this case, we believe the diabetic ketoacidosis was a triggering factor for the juvenile myasthenia gravis and discuss this association.

Abdominal lymphangioma is a rare presentation of abdominal cystic lesions. They generally arise from small bowel mesentery. Migration of abdominal masses is an uncommon entity and usually occurs due to the gossypiboma. There have been many reports of the radiologic appearance and unusual complications of mesenteric lymphangioma. However, to our knowledge, migration of mesenteric lymphangioma has not been reported in the literature. We present imaging findings of migrated-mesenteric lymphangioma from intrauterine to postnatal period with histopathological correlation.

Uluslar Arası Baş Ağrısı Derneği, oftalmoplejik migreni tutulan sinirdeki manyetik rezonans görüntüleme bulguları dışında, herhangi bir gösterilebilir kafa içi lezyonun yokluğunda, bir veya daha fazla oküler kafa sinirinin felcinin eşlik ettiği, tekrarlayan, migrenöz karekterde baş ağrısı atakları olarak tanımlar. Oftalmoplejik migrenlerde en sık tutulum okulomotor sinirlerde görülür. Genel olarak çocukluk çağında başlaması, öncesinde baş ağrısının olması ve tek taraflı üçüncü sinir paralizisi, dilate pupil, oftalmopleji oftalmoplejik migrenlerde görülen klinik özelliklerdir.
Burada, biz steroidle tedavi edilen ve dramatik bir düzelme gösteren, oftalmoplejik migrenli erkek bir adolesanı sunuyoruz. Biz inanıyoruz ki bu vaka raporu oftalmoplejik migrenin anlaşılmasına ve tedavi seçeneklerine katkıda bulunacaktır.

The International Headache Society defines ophthalmoplegic migraine as recurrent attacks of headaches with migrainous characteristics, associated with the paresis of one or more ocular cranial nerves and in the absence of any demonstrable intracranial lesion, other than MRI changes within the affected nerve. In ophthalmoplegic migraines, the most common involvement is seen in the oculomotor nerves. The clinical features of ophthalmoplegic migraine including the onset in childhood period, headaches preceding and ipsilateral to the third nerve paresis, a dilated pupil, ophthalmoplegia.
Here, we report an adolescent boy with ophthalmoplegic migraine, treated with steroid and showing a dramatic improvement. We believe that this report would add to the understanding and treatment options of ophthalmoplegic migraines.

Diamond-Gardner Syndrome (DGS) is an autoimmune disease characterized by painful ecchymoses that develop following emotional stress or trauma. The lesions are observed mostly in the extremities and these lesions are the result of autosensitization to extravasated erythrocytes after trauma. The majority of the patients diagnosed with this disease is composed of young women. In this case report, a teenager who had complaints of recurring painful ecchymoses with no related personal or familial background and later-diagnosed with DGS was presented. Although it is seen less commonly, DGS should be considered in the differential diagnosis of cutaneous lesions and hemorrhages of childhood period, especially in adolescence.