Background Coronavirus disease 2019 (COVID-19) usually leads to a mild infectious disease course in children, while serious complications may occur in conjunction with both acute infection and neurological symptoms, which have been predominantly reported in adults. The neurological complications in these patients vary based on patient age and underlying comorbidities. Data on clinical features, particularly neurological features, and prognostic factors in children and adolescents are limited. The present study provides a concise overview of neurological complications in pediatric COVID-19 cases. Materials and Methods The retrospective study reviewed medical records of all patients who were admitted to our hospital and were diagnosed with COVID-19 by real-time reverse-transcription polymerase-chain-reaction (RT-PCR) assay between March 11, 2020 and January 30, 2021. Patients with a positive PCR result were categorized into two groups: Out Patient Departments (OPD) patients and In Patient Departments (IPD). Results Of the 2,530 children who underwent RT-PCR during the study period, 382 (8.6%) were confirmed as COVID-19 positive, comprising 188 (49.2%) girls and 194 (50.8%) boys with a mean age of 7.14±5.84 (range, 0-17) years. Neurological complications that required hospitalization were present in 34 (8.9%) patients, including seizure (52.9%), headache (38.2%), dizziness (11.1%) and meningoencephalitis (%5.8). Conclusion The results indicated that neurological manifestations are not rare in children suffering from COVID-19. Seizures, headaches, dizziness, anosmia, ageusia, and meningoencephalitis major neurological manifestations during acute COVID-19 disease. Although seizures were the most common cause of hospitalization in IPD patients, the frequency of meningoensalitis was quite high. Seizures were observed as febrile seizures for children under six years of age and afebrile seizures for those over 6 years of age. Febrile seizure accounted for half of all seizure children.

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Congenital leukemia is a rare disease. The majority of cases of this disease are acute myelogenous leukemia (AML). Congenital acute lymphoblastic leukemia (ALL) is rare and most often is of B cell lineage. Rarely, some cases have been designated biphenotypic or mixed phenotype acute leukemia (MPAL). Herein, we report a preterm newborn referred to us as a result of the appearance of blue-violaceous dermal nodules on her body at birth. She was a twin and the product of an in vitro fertilization (IVF) pregnancy. Physical examination showed jaundice, hepatosplenomegaly, and peripheral facial nerve palsy in addition to dermal nodules. Bone marrow aspiration showed 40% blasts of lymphoid lineage; skin biopsy and its immunohistochemistry revealed myeloblastic infiltration of the dermis. Cytogenetic analysis (46,XX), fluorescence in situ hybridization (FISH) analysis, and cranial magnetic resonance were normal. The patient was diagnosed with congenital MPAL, and an association between IVF and congenital leukemia was suggested.

Pseudohypoparathyroidism (PHP) is a heterogenous group of disorders characterized by hypocalcemia with hyperphosphatemia, increased serum concentration of parathyroid hormone (PTH), and insensitivity to the biological activity of PTH. Calcinosis cutis, the cutaneous deposition of calcium salts in the dermis, is a rare clinical symptom in infancy. The deposition of calcium in the skin may be classified as dystrophic, metastatic, idiopathic, and iatrogenic. Although a few infants with PHP and calcinosis cutis have been reported, to the authors' knowledge, the combination of neonatal transient PHP and calcinosis cutis associated with calcium treatment has not been previously reported. The authors report a newborn boy with transient PHP presenting with early hypocalcemia, hyperphosphatemia, increased PTH levels, and calcinosis cutis after intravenous treatment of calcium gluconate.

Sir, Pentavalent antimonial drugs have been used for many decades as standard treatment for Visceral Leishmaniasis Sundar et al. 1 The emergence of Leishmania strains resistant to pentavalent antimonials and the occurrence of side effects have prompted the evaluation of alternative drugs, including liposomal amphotericin B (L-amB) with Mediterranean VL Cascio et al. 2 A 7-year-old boy, who admitted to Pamukkale University in Turkey, had such as prolonged fever, cough, pallor, weight loss, splenomegaly and hepatomegaly. Full blood count was done and cytopenia (leucopenia (3200/µL), neutropenia (320/ µL), moderate anemia (8.8 gr/dl), high total protein (8.8 d/dl), hypoalbuminemia (2.5 g/dl), hypergammaglobulinemia (6.3 g/dl), inversion of A/G ratio, high IgG (1987 mg/dl; N: 670-1500), high aspartate aminotransferase (153 IU/l) and alanine aminotransferase (133 IU/l) levels was observed.The rK39 ELISA test was slightly positive. Leishmania antibodies titre (IFAT) was 1:128. Leishmania amastigotes were not detected on bone marrow aspirate.Diagnosis of VL was established by presence of clinical signs and IFAT at a titre of 1: 128 without finding any parasitological evidence of infection.The patient was treated with L-AmB at a dose of 3 mg/kg of body weight/day for 6 days and over a 10-day period (on days 1, 2, 3, 4, 5 and 10), reaching a total dose of 18 mg/kg. Patient became afebrile after 2-days of treatment. Whereas hematological, such as hemoglobulin, leucocyte, liver function tests, and gammaglobulin restroration occurred on the 17th, 12th, 21th and 19th days, respectively.IFAT was at a titre of 1:256 one month after the time treatment initiated.On the 72nd day, fever, anemia, SGOT and SGPT elevation, splenomegaly and high IgG level (3690 mg/ dl) was observed. IFAT was not different (1: 256) and the patient was accepted as relapse. First relapse was retreated with 3 mg/kg L -AmB for 10 consecutive days (a total dose of 30 mg/kg). After the first relapse therapy, on the 65th day, high fever, increase of SGOT and SGPT levels, splenomegaly and hypergammaglobulinemia (IgG: 4950 mg/dl) was observed again. IFAT was at a titre of 1: 1024 and the patient was accepted as second relapse. Leishmania amastigotes on bone marrow aspirate were not seen on the first and second relapses.On the second relapse, meglumine antimonate was administered i.m. for 28 days at a dosage of 20 mg/kg per day. For this time, clinical and laboratory responses were good. After one month of treatment, IFAT was at a titre of 1: 512. for 7 months, no more relapse was seen.The pentavalent antimony compound meglumine antimonite remains the worldwide standard antileishmanial treatment except in India, where resistance has curbed its use. Resistance to antimonial agents is rare in the MVL Tanir et al 3 carried out a treatment of VL with antimonials in pediatric patients in Turkey, which is a relatively inexpensive, safe and effective with low relapse rates. L-amB may be useful in cases of treatment failure with antimonials or significant adverse effe...