The Journal of Pediatric Academy

Advancing Pediatric Epilepsy Care: Efficacy and Mechanisms of Melatonin Intervention

2024-09-11T15:30:31+03:00

Seizures and epilepsies pose significant challenges in pediatric populations, necessitating precise classification and effective management. The International League Against Epilepsy updated its classification system in 2017 to standardize epilepsy care. This study investigated melatonin, a neurohormone known for its role in circadian rhythm regulation, and its potential to enhance the diagnosis, management, and quality of life of pediatric epilepsy patients. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review was conducted to explore the relationship between melatonin and pediatric epilepsies. PubMed searches were performed using specific search terms, with eligibility criteria including studies on melatonin’s pathophysiological, biochemical, and therapeutic effects in pediatric epilepsy. Studies involving patients aged 0-18 years were published between 2003 and 2023. Four-teen studies with 898 pediatric patients were included. Melatonin was administered as an adjunct to antiepileptic therapy with the aim of alleviating disorders associated with epileptic encephalopathies or assisting electroencephalogram procedures. Findings were varied: Some studies indicated a reduction in seizure frequency with melatonin, while others provided inconclusive results. Improvements in sleep disorders related to epilepsy were noted with melatonin supplementation, which indirectly enhanced the overall quality of life. Melatonin has potential as an adjunctive therapy for pediatric epilepsy, with positive effects on seizure frequency and sleep quality. However, methodological limitations in some studies and inconclusive data underscore the need for further research to determine the efficacy of melatonin in pediatric epilepsy management. The diverse potential of melatonin in treating neurological disorders highlights the importance of continued, comprehensive research into its therapeutic application.

Median Arcuate Ligament Syndrome Involving a Celio-Mesenteric Trunk-a Lesson Learnt

2024-06-20T13:08:49+03:00

Celio-mesenteric trunk (CMT) is a rare vascular variation of the ventral branches of the abdominal aorta that supply blood to the mesentery and the gut. This rare variation is seen in 2/100.000 population. The presence of this anomaly is associated with an increased risk of mesenteric ischemia in the case of proximal occlusion. Median arcuate ligament (MAL) syndrome is a controversial entity characterized by compression of the celiac axis by MAL causing post-prandial pain. We report the fourth case of MAL compression syndrome involving a CMT in the world

Vitamin D Levels in Growth-Paining Children

2024-06-05T18:40:12+03:00

The most common cause of non-inflammatory recurrent musculoskeletal pain in children is growing pains. History and physical examination are often sufficient to diagnose these patients. Since the exact etiology is not known, different treatments can be applied. The effect of vitamin D levels on children with growing pains was investigated. Clinical and laboratory findings of 138 pediatric patients with growing pain and 30 healthy control subjects were examined and then the changes in pain scores of children and their families with follow-up and treatment were evaluated. The pain was most commonly seen in the form of lower extremity pain at night and in girls. Although growing pains can be treated with nonpharmacological methods, there were also patients who required pharmacological treatment. Vitamin D deficiency was observed in children with growing pain. Vitamin D treatment was given to 46 patients with vitamin D deficiency. Pain scores made by both themselves and their families decreased in 91.4% of the patients who came for control. After the use of vitamin D in children with growing pains, the mean pain score reported by the children decreased from 7.26±1.757 to 2.46±2.38. The mean pain score reported by families about their children decreased from 7.56±1.97 to 2.51±2.53 after vitamin D supplementation. Although most of the time growing pain is a self-limiting clinical picture, vitamin D supplementation may be necessary after a differential diagnosis was made because of the high level of anxiety in the families of children who do not respond to non-pharmacological approaches.

Effects of Treatment Model on Bone Metabolism in Patients with Severe Hemophilia A

2024-07-01T10:41:37+03:00

Improving bone health and preventing osteoporosis is an essential approach for hemophilia patients. Regarding precautions, the treatment model may affect bone health. To detect the effect of a treatment model (prophylaxis/on-demand treatment) on bone metabolism in patients with severe hemophilia A was the primary aim of this study. The biochemical markers of bone metabolism and bone mineral density were obtained from the patients enrolled in the study. No statistically significant differences were found between the groups due to the limitations of the prophylaxis group, such as adaptation problems, personal differences, and type of prophylaxis.

Evaluation of Patients with Cockayne Syndrome

2024-08-02T11:57:43+03:00

Cockayne syndrome (CS) is a rare, severe, genetic neurodegenerative disorder. To better understand the condition, this article aimed to discuss the clinical manifestations and prognosis of CS. This clinical study was a retrospective review of the medical records of patients diagnosed with CS between January 2010 and January 2020. A total of 9 patients (6 males, 66.7%; 3 females, 33.3%) from 7 families were enrolled in the study. The median age of the patients was 94 (4-186) months. Genetic confirmation of CS was obtained in 5 of the patients and ERCC8 mutations were identified in all patients who underwent genetic confirmation of the disease. On admission, 8 patients were found to have microcephaly 4 patients were admitted for psychomotor retardation, 3 for seizures, and two for walking disabilities. The diagnosis of patients with CS can be challenging due to the wide range of symptoms. In patients who are normal at birth but develop microcephaly during follow-up, physicians should consider CS in addition to metabolic diseases in the differential diagnosis.

Effective Use and Cost-Evaluation of Erythrocyte Suspension in Surgical Branches of Tertiary Hospital

2024-09-03T13:13:27+03:00

Blood has been accepted as the basic symbol of life from the past to the present. Transfusion is the transfer of blood and blood components to a patient due to various health problems. The present study aimed to evaluate the effective use and cost of erythrocyte suspension in surgical branches in a tertiary hospital. In this study, the use and cost-effective evaluation of erythrocyte suspension, a blood component, after surgical intervention in brain and nerve diseases surgery, orthopedics and traumatology, general surgery, gynecology and obstetrics, and organ transplantation clinics between 01/01/2023 and 31/12/2023 were retrospectively evaluated. Because blood products are provided as voluntary donations, their appropriate use will help reduce hospital and patient costs. We believe that strict compliance with national and international standards and guidelines, quality management, and good clinical practices, as well as ensuring continuity of training on these issues, will enable more efficient product acquisition and decrease blood component disposal in all blood services units.