Infectious diseases constitute the major cause of hospital admissions in pediatric age. Microbiological studies usually form the basis of definitive diagnosis for these disorders. Nonspecific biocemistry tests can be obtained quickly, thus they have been used to support the eventual diagnosis. Among biochemical work-up, the role of erythrocyte sedimentation rate, C-reactive protein and complete blood count in the management of infectious diseases have been discussed in this article.

OBJECTIVE: This study was undertaken to assess outcomes in unselected women with maternal serum human chorionic gonadotropin (MShCG) 2.0 MoM or greater.
METHODS: This is an observational cohort study of 559 women with MShCG less then 2.0 MoM and 146 women of the same age with MShCG 2.0 MoM or greater who were evaluated for preterm delivery, preeclampsia, stillbirth, and intra uterine growth restriction.
RESULTS: Women with elevated human chorionic gonadotrpin levels showed an increased risk for preeclampsia and preterm delivery (OR: 13.83 95% CI: 4.91-38.98, OR: 7.13 95% CI: 3.11 – 16.33 ).
CONCLUSION: Adverse pregnancy outcome is associated with MShCG 2.0 MoM or greater, thus increased antenatal surviellance is warranted with greater values.

OBJECTIVE: Our aim was to determine whether leukocytosis occurs in non-febrile convulsions of childhood in the absence of infection, whether there were a relationship between leukocytosis and duration or type of convulsion, and to establish the duration of leukocytosis and leukocyte subgroups, which are responsible for leukocytosis.
METHODS: White blood cell count and peripheral blood smear were ordered in all patients at presentation. Urinalysis, blood culture and urine culture were studied in children with leukocytosis. A second white blood cell count was done in the patients with leukocytosis 24 hours after presentation.
RESULTS: A total of 215 children (96 females, 119 males) were enrolled in the study. The mean age was 6.34±4.2 years (0.5-16). Leukocytosis was detected in 47.6% of the patients with status epilepticus, and in 6.2% of the patients without status epilepticus. The subgroup responsible for the leukocytosis was neutrophils. Leukocytosis has improved in all patients at 24 hours after the presentation.
CONCLUSION: Temporary leukocytosis may occur in children with non-febrile convulsions in the absence of any infection. As the duration of convulsions gets longer, the possibility of
presence of leukocytosis increases.

OBJECTIVE: Rare factor deficiencies are autosomal recessvely inherited disorders. Their frequency are approximately 1: 1500000 to 1: 2000000 in general population. In this study, we aimed to evaluate central nervous system bleedings of 14 patients with rare factor deficiency. One hundred and nine patients were followed with this diagnosis in our clinic between 1990-2009.
METHODS: Patients’ data were investigated retrospectively from our archieves.
RESULTS: Sixty nine patients were male and 40 were female. Their ages were ranging from one week to 19 years. Familial consanguinity was present in %38.9 of these patients. Ten patients were diagnosed as fibrinogen deficiency (9.2%), 5 as factor V (4.5%), 73 as factor VII deficiency (67%), 11 as factor X deficiency (10.1%), 7 as factor XI deficiency(6.5%), 2 as factor XIII deficiency (1.8%), one of them as factor II deficiency (0.9%). The ratio of easy bruising and cutaneous bleeding was 66.8%, whereas the ratios of hemarthroses, oral cavity bleeding, epistaxis, CNS bleeding and gastrointestinal bleeding were 22.7%, 21.2%, 17.4%, 12.8% and 9.6%, respectively. Of these patients with CNS bleeding, 8 had factor VII deficiency (57.2%), 4 (28.6%) had factor X, one (7.1%) had factor V and another one (7.1%) had fibrinogen deficiency. Ten of cases were diagnosed under the age of three months (71.5%). Three cases (21.4%) aged between 3 months and 1 year, and 1 patient older than 1 year (7.1%) had the diagnosis of CNS bleeding.
CONCLUSION: The importance of early diagnosis of rare factor deficiencies and the necessity of prophylactic treatments were emphasized in this study.

OBJECTIVE: We aimed to determine the frequency and antibiotic susceptibility pattern of gram negatif bacteria causing urinary tract infections (UTI).
METHODS: Culture results of urinary specimens received during October 2008-June 2009 from patients suspected of UTI in pediatric clinics were analysed retrospectively. Standart methods were used for identification of bacteria. Gram negative bacteria with pure growth were included. Antibiotic susceptibility was studied with disc diffusion method.
RESULTS: A total of 1015 Gram negative isolates were identified. E. coli was the most common bacrteria (68.7%) followed by Klebsiella, Proteus, Pseudomonas spp, Enterobacter spp and Acinetobacter (12.5, 2.7, 2.1, 0.8 and 0.3 % respectively. Among E. coli isolates, 71% were resistant to ampicillin, 55% resistant to trimethoprim sulfamethoxazole (SXT) and 44.2% resistant to cefuroxime axetil. For Klebsiella spp, ampicillin resistance was 80% while SXT and cefuroxime axetil resistances were 58.8 % and 46.8%. Resistance patterns among Proteus spp were 54.8% for ampicillin, 45.1% for SXT and 22.5% for cefuroxime axetil. Carbapenems, third generation cephalosporins, aminoglycosides and quinolones were the most susceptible antibiotics.
CONCLUSION: UTIs must appropriately treated according to culture results and antibiotic susceptibility pattern in order to prevent grave complications like irreversible renal damage. Continous surveillance studies are necessary for determination of empiric therapy.

OBJECTIVE: The aims of the study were to determine the frequency of adenovirus and rotavirus as causative agents of diarrhea in children of 1-24 months of age and to evaluate risk factors, clinical features and the differences in therapy.
METHODS: Age, gender, birth weight, current weight, height, head circumference, nutritional history, mother's age, smoking history of the mother, symptoms, the beginning and duration of the symptoms, physical examination findings, dehydration score, socioeconomic score, laboratory findings, therapy and duration of hospitalization were recorded.
RESULTS: A total of 207 patients (95 females, 112 males) with diarrhea were enrolled in the study. The mean age was 8,12 ± 5,40 months (1-24). The causative agent was adenovirus and rotavirus in 23.7% and 39.6% of the patients, respectively. Rotavirus and adenovirus was most frequent in children of 7-12 months of age, whereas adenovirus had a relatively uniform frequency throughout the year. Our results show that breastfeeding prevents viral diarrhea. Low birth weight and low socioeconomic score were risk factors for diarrhea. Fever, vomiting were more frequent and diarrhea was more severe in rotavirus diarrhea, though the duration of diarrhea was longer in adenovirus infections. Durations of hospitalization and treatment were longer in cases due to rotavirus.
CONCLUSION: Rotavirus and adenovirus were the most common causes of diarrhea. As the epidemiologic and clinic knowledge increase, unnecessary tests and antibiotic treatment of viral diarrhea will be seldom used.

SUMMARY:
Congenital pyloric atresia is an infrequent anomaly. İt can occur as a result of incomplete evolution and is usually seen isolated. Our case which included polyhydoamniosis and a gastric pouch without any sign of intestinal loop in prenatal history was diagnosed as pyloric atresia and was operated after birth. The patient was hospitalized for 27 days and then had been discharged uneventful.This rare anomaly is here been presented as a case.

Detection of umbilical cord anomalies before delivery is not always possible. The most important method to determine high risk situations is the routine follow up of the fetus during antenatal period. Umbilical cord rupture develops either due to umbilical cord anomalies or secondary to interventions performed to the mother during antenatal period. A term neonate with regular antenatal follow up was delivered by emergent cesarean section because of developing fetal distress. During labor umbilical cord was found to detach at fetal site. Blood loss was prevented by immediate application of compress. The patient was monitorized and given observational care.
Umbilical cord rupture is frequently encountered during everyday practice. Especially in patients with intrapartum umbilical cord rupture, early manipulation would prevent morbidity and mortality. Especially a positive maternal antenatal history should raise the suspicion of placental anomalies.