Rhabdomyolysis is a clinical emergency that can result in life-threatening complications. The etiology for rhabdomyolysis is broad. Infecitons are the most common cause in pediatric patients. Underlying inherited metabolic diseases are also a cause of rhabdomyolysis and can often have a diagnostic challenge, considering their marked heterogeneity and comparative rarity. The purpose of this review is to summarize the essential characteristics and diagnostic clues of inborn errors of metabolism associated with rhabdomyolysis.

Objective: Diet is the main component in the treatment of classical phenylketonuria (PKU). Living in the same house as a PKU patient affects the lifestyle of family members in many ways. The present study examines the dietary habits of the parents of PKU patients.
Methods: The parents of 32 PKU patients were asked about their socio-demographic characteristics, family dietary patterns (mealtimes; frequency of meals with the PKU patient; content of foods at mealtimes, etc.) the parental dietary regimen and any food allergies.
Results: The mean age of the PKU patients was 11.5±4.3 years, and 14 (44%) were female. The mean plasma phenylalanine (Phe) level over the previous year was 732.4±339.0 μmol/L in the patient group. Within the study sample, 2 (6%) families prepared only low-protein meals in the home, and the Phe levels of the two PKU patients in these families never exceeded >600 μmol/L, and 26 (81%) parents prepared separate meals for the PKU patient and for the other family members every day. The 28 (88%) parents had no special dietary regimen, with a mean Phe level of 774.8±345.4 μmol/L (p=0.055). Finally, 26 (81%) of the parents were careful about the foods they consumed while eating with the PKU patient, opting especially for foods that are low in Phe.
Conclusion: Diet is an indispensable part of the treatment of PKU and can affect the dietary patterns also of parents. Phe levels are lower in the children of parents who adopt a protein-restricted diet as a lifestyle, such as vegan and pescetarian. Large-scale studies are needed to investigate the physical, social and psychological effects of parents’ dietary habits on PKU patients.

Objective: With a child’s less developed ability to express oneself when compared to adults, it is a more challenging task to manage pain in children. Nurses, as those who spend the most time with patients, need to have sufficient knowledge about assessing and managing pain in children. The aim of this study is to determine the knowledge and pediatric practices of nurses working in pediatric clinics on pain management in children.
Methods: This descriptive study was completed with 134 nurses. Study data were captured through using a questionnaire drafted, and rearranged in line with specialist advice, by the researchers. Data were electronically evaluated with percentage, Kruskal-Wallis H and Mann-Whitney U tests using analysis system.
Results: It was determined that 81.3% of nurses had not been trained on pain management in children. It was established that nurses preferred pharmacological methods to non-pharmacological, that 54.5% of them used a combination of pharmacological and non-pharmacological methods to relieve pain in children, and that 16.4% mentioned difficulty in pain management due to lack of time. Nurses’ knowledge of pain management was found to be slightly above the average (maximum 22 points; median ± standard deviation=16.50±2.74; minimum-maximum: 9-21).
Conclusion: The study established that nurses’ level of knowledge about pain management was inadequate, that nurses encountered various challenges in pain management arising from the workplace setting, and that rate of use of non-pharmacological pain treatment methods, an independent function of nursing, is significantly low.

Objective: A small number of studies were reported regarding the direct and indirect effects of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) especially on the erythrocyte series. The purpose of this study was to examine the effects of GH treatment (GHT) used in patients with isolated GH deficiency (IGHD) on hematological parameters.
Methods: The records of the patients who were diagnosed as having IGHD in our clinic and received GHT for at least two years between 2013 and 2019 were retrospectively examined. Height, height standard deviation scores (SDS), weight, weight SDS, IGF-1, annual growth rates, and changes in blood count parameters before and after the GHT were recorded. The statistical analyses were made using SPSS v.20 Package Program, and the significance level was accepted as p<0.05.
Results: A total of 37% (n=23) of the 62 patients that were included in the study were female, and 63% (n=39) were male. It was determined that the age of the patients was between 2-16 years at the time of diagnosis, and the median age at diagnosis was 10.8. After the GHT, a significant increase was detected in the distribution and volume of hemoglobin, hematocrit, and red sphere count (p<0.05). A statistically significant but clinically insignificant decrease was detected in the platelet count and there was an increase in the platelet volumes (p<0.001). A clinically significant decrease was detected in the number of white sphere, lymphocyte and neutrophil counts (p<0.05). Conclusion: It was determined that GHT had a stimulating effect on erythropoiesis in IGHD. It was also shown that GHT caused a number of changes on the platelet count, white sphere count, and the lymphocyte and neutrophil parameters, which were not clinically important. We believe that studies at in vitro and molecular level are needed to explain the effects of GHD and GHT on the hematopoietic system.

Cyclopentolate hydrochloride, belonging to a class of drugs known as anticholinergics, is an ophthalmic solution frequently used in ophthalmology clinics because of its cycloplegic and mydriatic effects in both refractions as well as fundus examinations. After application, the maximum cycloplegic effect begins approximately after 30-60 min, which can further continue up to 24 h. Due to a dose-dependent relationship, cyclopentolate hydrochloride’s side effects can be observed both in an ocular and systemic manner which may occur if solutions more than 0.5% concentration are used. Herein, we report central anticholinergic syndrome due to the administration of excessive amounts of cyclopentolate hydrochloride in a child.