Childhood influenza is often an acute, self-limiting and complication-free illness in immunocompetent children. Although rarely, it may be severe and fatal.
While influenza C virus is a rare cause of upper respiratory disease, influenza A and B viruses are responsible for epidemics.
Influenza viruses may cause pandemics leading to mass deaths worldwide. Mortality in childhood influenza is lower than that in adults.
In children older than 13 years of age, the most severe clinical course is caused by influenza A (H3N2), followed by influenza B and seasonal influenza A (H1N1). There is no relationship between the symptom severity and the virus serotype in children younger than 13 years of age.
With respect to complications rate, there is no significant difference between 2009 H1N1 influenza virus and those in circulation in the two previous influenza seasons.
The major step in the diagnosis of influenza is the suspicion that the patient may have influenza. Polymerase chain reaction is the preferred method for diagnosis.
Neuraminidase inhibitors (zanamivir and oseltamivir) are used in the pharmacotherapy and chemoprophylaxis of influenza. Antiviral therapy should be started while pending the results of viral tests. The most efficient way of prophylaxis is having yearly influenza vaccine shots. Influenza vaccines are reconstituted every year with antigens of three of the most anticipated epidemic serotypes.

OBJECTIVE: To examine the effects of proteinuria on perinatal and maternal outcomes in severe preeclampsia cases.
METHODS: We examined perinatal and maternal outcomes of the severe preeclamptic womens in our clinic by dividing them two group according to the amount of proteinuria per 24 hours (group1<2g, group2 >=2g).
RESULTS: Six hundred and ninety paitents met the inclusion criteria. Group 1 constituted 42.8% (296) and group 2 is 57.2% (394) of all cases. There weren’t any significant differences between two groups regarding perinatal and maternal outcomes. However, mean gestational age at delivery was lower in the group with proteinuria >=2g (p= 0.0005) and total maternal morbidity rates was significantly higher in the group 2 (p=0.009).
CONCLUSION: Significant proteinuria doesn't have adverse effects on perinatal and maternal outcomes in severe preeclamptic patients. Proteinuria must not be considered as an indication for delivery.

OBJECTIVE: Evaluate and discuss the mesh erosions occurring after TOT operations.
METHODS: Mean age of 130 cases was 50.5 ± 9.5 ( 29 – 72 ). Mean postoperative follow up period was 15.5 ± 7.9 months. Polyprepylene macroporous meshes have been used in all cases. Among intraoperative and postoperative complications only mesh erosions are investigated.
RESULTS: Mesh erosions were observed in six cases among 130 TOT operations ( % 4.6 ). Vaginal erosions were diagnosed during the first six months of the postoperative period. There was vaginal discharge and ache in 4 cases. There was disparauni complaintment in 3 cases. Woman without infections mesh erosions were excised and vaginal mucosa was resutured after debridement.
CONCLUSION: Mesh erosions are important complications observed after TOT operations and they should be treated immediately for infection risk.

OBJECTIVE: Primary nocturnal enuresis is one of the most frequent problem in childhood and is defined as bed-wetting after 5 years old. This condition may cause behavioral and psychiatric disturbances. The aim of this study is to determine the depression levels of children with primary nocturnal enuresis and their mothers.
METHODS: Fourty children diagnosed as primary nocturnal enuresis and responsive to desmopressin treatment lasting 3 months were enrolled in the study. Depression Scale for Children was performed for children and Beck Depression Scale was performed for their mothers to evaluate depression level before and after treatment. The results of depression scales before and after treatment were compared.
RESULTS: The mean age of the children was 10.8±2.2 years (7-15 years) and 21 of them (52.5%) weremale, 19 (47.5%) were female. The mean score of the children in Depression Scale for Children before and after treatment were 10.5 ± 6 and 8±5.5, respectively. The mean score after treatment was found to be significantly decreased in comparison with the mean score before treatment in children (p<0.003). Although mean post-treatment depression score was diminished in evaluation of the mothers, this decrease was not statistically significant.
CONCLUSION: Primary nocturnal enuresis may cause emotional stress and negative affectivity both in children and their mothers. Therefore, children with primary nocturnal enuresis should be treated properly, followed regularly and given psychological support in collaboration with pediatric psychologists. The mothers of these patients should be supported as well.

OBJECTIVE: Our aim was to evaluate the culture results of all hospitalized newborns to assess the rate of culture positive sepsis, risk factors, responsible microorganisms, antibiotic resistance and prognosis.
METHODS: Blood, urine, cerebrospinal fluid culture results of all newborns who were prediagnosed with sepsis, in level I-II-III neonatal intensive care units between the dates of January-December 2007 were evaluated. Risk factors such as sepsis, birth place, birth weight, gestational age, premature rupture of membranes, ventilatory support, exchange transfusion, hospitalization duration and septic birth were questioned. Early and late sepsis ratio, distribution of microorganisms, antibiotic resistance and mortality ratios were determined.
RESULTS: Totally 4250 blood, urine and cerebrospinal fluid cultures were obtained from 3865 infants in a year. Bacterial growth was detected in 8.8% of blood, 7.3% of cerebrospinal fluid, 0.14% of urinary cultures. The isolates yielded from blood cultures comprised coagulase negative Staphylococcus (41%), Staphylococcus aureus (18%), Grup B streptococcus (11%), Escherichia coli (3.3%), Klebsiella pneumoniae (2%), other gram (-) bacterias (7.9%), Candida albicans (1.6%). Sixty % of cases were early and the rest were late sepsis.
Prolonged hospital stay, prematurity, ventilatory support, birth at home and exchange transfusion were defined as important risk factors.


CONCLUSION: The etiologic agents in our center were similar to developed countries. A substantial increse in prevelance of group B streptococci was detected. Resistance against antibiotics used for gram (-) and gram (+) bacterias in our unit wasnt higher than the literatüre.Sepsis mortality was low.

OBJECTIVE: To investigate problems of infants of diabetic mothers who are born in our hospital and then treated in NICU during newborn period because of their clinical problems.
METHODS: The study is based on the 82 infants of Diabetic mothers who were born in İstanbul Bakırköy Maternity and Children Hospital between 1st January 2008 and 1 st January 2009 and also were treated in NICU because of their clinical problems in the newborn period. The documents of the patients were analyzed retrospectively.The study report which includes the mother’s data (type of Diabetes, medications, smoking and presence of chronic disease) and the newborns’ data (birth weight, type of delivery, 1st and 5th second APGAR scores, sex and clinical problems such as RDS, TTN, MAS, septisemia, hypocalcemia, hypomagnesemia, hypoglycemia, polistemia, hyperbilirubinemia, birth injuries, congenital malformations, congenital heart diseases) was formed. The data were analyzed statistically.
RESULTS: The distribution of 82 cases according to their types of mother diabetes were as following; the mothers of 2 (2%) newborns were type 1 DM, the mothers of 4 (5%) newborns were Type 2 DM and the mothers of 76 (93%) newborns were Gestational DM.The 31(38%) of newborns were female, 51(62%) of newborns were male.The birth weights of 6 (7% ) cases were under 2500 gr (SGA), 39 (47% ) of the cases were over 4000 gr (LGA) and the birth weights of other 37 (45%) cases were 2500-4000 gr (AGA). The most frequently seen newborn period clinical problems were; hyperbilirubinemia in 33 cases, hypoglycemia in 29 cases,congenital heart diseases in 28 cases. The most frequently observed echocardiography findings were Hypertrophic CMP, ASD, and PDA.The average hospitalization period of cases were 7,9±5,5 days.
CONCLUSION: Several problems may occur, such as hyperbilirubinemia, hypoglycemia and congenital cardiac disorders in infants diagnosed with infant of diabetic mother. To reduce the possibility of morbidity and mortality, it is recommended that these infants should be followed closely during their prenatal, natal and postnatal periods.

The incidence of Heterotopic Pregnancy (HP) has increased as the use of assisted reproductive technologies (ART) has become more widespread. A 32-year-old pregnant woman self referred to our emergency unit with abdominal pain. The patient had a history of embryo transfer due to primary infertility. During the operation, a left ampullar mass, in size of 3x2 cm, resected. Histology showed a tubal pregnancy.
Key words: heterotopic pregnancy, ectopic pregnancy, assisted reproductive technologies

Aim: In this study we represent a case of Mowat-Wilson Syndrome (MWS) with Hirschsprung disease(HD).
Case: .In MWS, intestinal motility disorder represents a wide spectrum of clinical findings from milder form of constipation to severe HD resistent to medical and surgical therapy.
Conclusion: Mutation or deletion of ZEB 2 (ZFHX1B=SIP-1) gene is indicated as the etiology of MWS. The investigations of this gene or part of chromosome will also show the way of HD in future.

Key words: Mowat-Wilson sydrome, Hirschsprung disease, intestinal motility disorder