Approximately 5 million children present to emergency departments, seeking care for head injuries, each year, and 80% of these children are classified as cases of mild head injury. Due to the huge number of patients and low frequency of intracranial lesions in this group, obtaining a computed tomography scan for each and every patient is a significant economic problem. This study was conducted to identify the clinical parameters and the radiographic findings that may be associated with intracranial lesions in children with mild head injury. 421 patients, with a Glasgow Coma Scale score of 15 and without any focal neurological deficit, were studied. Intracranial lesion was noted in 37 cases (8.8%). Sensitivity of a plain radiogram was 43.2%, and specificity was 93%. An intracranial pathology was demonstrated in 28.9% of the patients with a linear skull fracture. The only clinical parameters associated with an increase in the frequency of detection of intracranial lesions were posttraumatic seizures and loss of consciousness. Age, sex, headache, vomiting and scalp lacerations were not associated with a higher frequency. Even when patients with a history of loss of consciousness or posttraumatic seizure were subtracted from the study group, intracranial lesions were noted in 4.1% of the cases, and in 1.8% neurosurgical intervention was required. Computed tomography is the gold standard in the evaluation of pediatric patients with mild head trauma, and every child who has experienced a head injury should undergo a cranial computed tomography evaluation, even if he or she appears in perfect health.

Background Refugees face circumstances where their health and well-being are compromised. In this qualitative study, the aim was to understand Syrian refugee women’s needs for care and the predisposing and enabling factors to healthcare access and utilisation. Methods Out of 945 Syrian mothers who gave birth in our university hospital between 2014 and 2018, 195 were reached; out of which, 47 women were included. Semi-structured in-depth interviews were conducted and were later analysed using a qualitative content analysis approach. Depression was assessed by the Patient Health Questionnaire-9 at the end of the interview. Results Social isolation and maternal depression, language barrier and challenges while navigating the healthcare system emerged as the main themes of the study. Low educational and occupational status of the women, poor social resources, limited Turkish proficiency and unfamiliarity with the host healthcare system were identified as the predisposing factors for poor healthcare services utilisation. Conclusion Recommendations include bridging language gaps, improving the navigation of the healthcare system by visual support or in-person interpretation, and psychosocial support. Providing hospital-based language courses to mothers and social integration programs for families will improve the mothers’ well-being and indirectly care of the child.

ÖzAmaç: Türkiye'de 2011 yılında doğum iznini düzenleyen yasada bir iyileştirme yapılmıştır. Ücretsiz izin arttırılmış, gece nöbette çalışmama hakkı verilmiş ve çalışma saatleri iyileştirilmiştir. İşe geri dönmenin, tek başına anne sütü ile besleme ve toplam emzirme süresi açısından bir engel olduğu bilinmektedir. Yasal düzenlemeler, çalışan annelerin bebeklerini emzirebilmeleri açısından çok önemlidir. Bu çalışmanın amacı, iyileştirilen yasanın, kadın hekimler arasında, emzirme oranları üzerindeki etkisini hesaplamaktır. Ayrıca, yeni yasa ile, tek başına anne sütü ile besleme ve toplam emzirme sürelerinde oluşan farklar değerlendirilmiştir. Gereç ve Yöntemler: İstanbul'da bulunan üç büyük hastane çalışmaya alındı. Pilot bir çalışma ile sorularımız sınanmıştı. Asıl çalışmaya her hastaneden 40 kadın hekim alındı. Doğum öncesi ya da doğum sonrası komplikasyon yaşayan anneler çalışma dışında bırakıldı. Doğumdan sonra yoğun bakım gereksinimi olan ya da hiç anne sütü ile beslenmemiş bebekler de benzer şekilde çalışma dışında bırakıldı. Çalışmaya 109 kadın asistan hekimin anketi alındı. Bulgular: Yasadaki iyileştirmenin, doğum sonrası izin süresi ve işe geri dönüş sonrasında çalışma saatlerinde iyileşme üzerindeki etkileri istatistiksel olarak anlamlı bulundu (OR: 2,74 ve OR: 2,52). Tek başına anne sütü ile besleme ve 12 aydan daha uzun süre emzirmeye devam etme oranları, yeni yasadan sonra anlamlı derecede artmıştı (OR: 4,47 ve OR: 2,56). Çıkarımlar: Bu çalışma yasal iyileştirmelerin anne sütü ile beslenme konusunda olumlu sonuçlar doğurduğunu göstermiştir. Özellikle çalışma yerlerinin koşulları ve cerrahi bölümlerde çalışan kadınlara eşit hakların verilmesi ile ilgili olarak daha atılacak çok adım vardır. Hekimler anne olduktan sonra emzirebilirlerse, onların deneyimleri, emzirme savunuculuklarını ve hastalara sağladıkları rehberliği etkileyebilir. AbstractAim: A recent improvement was made on the law regulating maternity leave in 2011 in Turkey. The leave without pay period was increased, the right to stop working on night shifts was granted, and work hours were improved. It is a known fact that returning to work is a barrier against exclusive and total breastfeeding duration. Legal regulations have crucial importance on the ability of working mothers to breastfeed their infants. The aim of this study was to calculate the effect of the improved law on breastfeeding rates among female physicians. Moreover, the difference in the duration of exclusive breastfeeding and total breastfeeding were evaluated in relation to the new law. Material and Methods: Three of the major hospitals in Istanbul were included in the study. A pilot study was planned and our questionnaire was tried. The actual study included 40 female physicians from each hospital. Mothers who went through antenatal or postnatal complications were excluded from the study. Infants who required intensive care after birth or were never breastfed were similarly excluded. A total of 109 female physician resident mothers' questionnaires were included in the study.

Neurotoxicity of methotrexate is a well‐documented issue, but development of an intracerebral hematoma following administration of intrathecal methotrexate is an extremely rare entity. A 6‐year‐old male with the diagnosis of non‐Hodgkin lymphoma was put on a treatment regimen, including intrathecal methotrexate. Six days following the last intrathecal methotrexate administration, the patient developed a deteriorating state of consciousness. There was no history of trauma. Coagulation studies and platelet count were normal. Magnetic resonance imaging of the brain demonstrated a large left frontoparietal hematoma. Intracerebral hematoma may be a very rare, but serious, complication of intrathecal methotrexate administration. Pediatr Blood Cancer 2008;50:152–154. © 2006 Wiley‐Liss, Inc.

Baby Walker Use and Its Consequences in a Group of Turkish ChildrenObjective: Although not recommended, nowadays baby walkers (BWs) are commonly used by many parents in the pre-walk period of children. Therefore studies are needed about the use and effects of BWs on child health and development to provide evidence based recommendations to parents. The aim of this study was to determine the frequency of BW-use, and related injuries among baby walker users, to investigate the effect of BW use on gross motor development of children and the relationship between BW use and gait disorders.Material and Method: 193 children aged 8-84 months, born fullterm without any chronic disease who were followed up in