Bullying Victimization and Psychiatric Symptoms Among Syrian Adolescent Refugees in Southeast Turkey: A Structural Equation Modeling Study

ObjectiveThe purpose of this study was to compare the peer bullying of refugee and non-refugee adolescents, and to explore the association between bullying victimization and psychiatric symptoms among Syrian adolescent refugees in the Southeast Anatolia region of Turkey. Methods: The sample of the study consists of 217 adolescents in the 13-17 age group who are school-going, 102 refugee adolescents, and 115 non-refugee adolescents. The study data was obtained using the Sociodemographic Characteristics Questionnaire developed by the researchers, Olweus Bully/Victim Questionnaire (OBVQ) and Depression Anxiety Stress Scale 42 (DASS-42). A structural equation model was used to assess the association between bullying victimization and depressive symptoms, while also considering mediation by stress and anxiety. Results: In this study, 44.1% of refugee adolescents reported experiencing at least one bullying victimization, while this rate was 27.8% in the non-refugee group, and this difference was found statistically significant. The logistic regression analysis revealed that poor school performance was a risk factor for bullying victimization in refugee adolescent. Moreover, the structural equation model analysis revealed that bullying victimization significantly increased the stress level in refugee adolescents, and depressive symptoms were significantly affected by stress and anxiety levels. Conclusion: Taking into consideration that bullying victimization is a significant problem among Syrian refugee adolescents; anti-bullying programmes should be implemented as this may improve the mental health of Syrian refugee adolescents.

Predicting Factors of Brucella melitensis Bacteremia in Children Admitted with Brucellosis

Objective Brucellosis is the most common zoonotic disease. Isolation of Brucella melitensis in blood culture is accepted as the gold standard for diagnosis. This study aims to determine the predictive factors of B. melitensis bacteremia in pediatric patients followed up with brucellosis.

Methods Two-hundred twenty pediatric brucellosis patients were included in the study. The epidemiological, clinical, and laboratory data were recorded.

Results The patients comprised 63.2% males and 36.8% females with a mean age of 10.45 ±  4.36 years (range, 1–18 years), and 70.5% were younger than 14 years old. B. melitensis was isolated in the blood culture in 33.6% of patients. In the epidemiological history of pediatric patients with bacteremic brucellosis, there was a history of dealing with, owning, or working with livestock. In patients with brucellosis, fever and weight loss, hepatomegaly, and arthritis were more common in patients with bacteremia than in those without bacteremia. Among laboratory findings, leukopenia, low albumin value, and high C-reactive protein were calculated as predictors of Brucella bacteremia in patients with brucellosis.

Conclusion In regions where brucellosis is endemic, serum agglutination tests may be positive without clinical findings. Brucellosis can mimic many other diseases, so the definitive diagnosis is demonstrated by bacteremia. Blood cultures should be taken in patients with predictive factors suggestive of brucellosis.

A Predictor of Oxidative Stress in the Children with Measles: Thiol–Disulfide Homeostasi

Objective: Measles is an infectious disease, in which oxidative stress increases. Thiols are an antioxidant substance which play a critical role in programmed cell death, detoxification, and regulation of cellular enzymatic activity, and the thiol–disulfide balance is associated with some diseases. The purpose of this study was to evaluate the thiol–disulfide balance in children with measles.

Materials and Methods: This descriptive study included case and control groups. The plasma total oxidant status level was measured using the Erel method, and the groups were compared. Before the study, informed consent was obtained from patients and Ethics Committee approval was provided (No:17/Session:05, Date: May 2019). The Pearson’s and Fisher’s chi-square tests were applied in the comparisons of categorical data, and independent t-test/Mann–Whitney U tests were used to compare the patient and the control groups.

Results: There were no significant differences between the patient-control groups in terms of age and gender (P > .05). The total antioxidant status value was significantly lower, and the total oxidant status and oxidative stress index values were significantly higher (P < .05) in the patient group compared to the control group. Native thiol, total thiol, and native thiol/total thiol percentage values were significantly lower, and the disulfide, disulfide/native thiol, and disulfide/total thiol percentage values were significantly higher (P < .05) in the patients compared to the controls.

Conclusions: The detection of oxidative stress in patients with measles is important, and these results show the possibility of using the thiol/disulfide homeostasis and oxidative stress index values as biomarkers of oxidative stress in patients with measles.

Anxiety in Paediatric Patients Diagnosed with COVID-19 and the Affecting Factors

OBJECTIVE

Children may be greatly affected by events that increase stress in individuals in general and are reported as the vulnerable groups during the coronavirus disease-19 (COVID-19) pandemic. But most of the studies in the literature investigating the mental effects of the pandemic on children were conducted with healthy children and limited study has evaluated the effect on children diagnosed with COVID-19. The aim of this study is to determine the anxiety level in paediatric patients diagnosed with COVID-19 and the affecting factors.

METHODS

This descriptive study was conducted with 292 children aged 8-18 years who were diagnosed with COVID-19. Data were collected using the Descriptive Characteristics Questionnaire and the Screen for Child Anxiety Related Emotional Disorders (SCARED). Interviews were held by phone.

RESULTS

Males were 51.4% of participants, the mean age was 16.04 ± 1.93. 84.1% of them had a chronic disease; the transmission source was family/relatives/friends for 41.1%. By social isolation, 49.3% were affected and 33.2% were affected by disease symptoms the most in this process. The most common symptoms were headache (61.6%), and asthenia (59.9%). Mean anxiety scale score was 25.5 ± 14.37. The effect of gender, number of symptoms and transmission source on anxiety score was significant (p < 0.05).

CONCLUSION

Paediatric patients diagnosed with COVID-19 were found to have high anxiety levels. It is recommended to re-evaluate the duration of children's social participation and support the management of COVID-19 symptoms that affect their anxiety level.

Comparison of Clinical Characteristics and Pregnancy and Neonatal Outcomes Between Turkish Citizens and Syrian Refugees with High-Risk Pregnancies

Refugee women experience more negative pregnancy and neonatal outcomes, such as low birth weight and preterm birth. The aim of the present study was to compare the clinical characteristics and pregnancy and neonatal outcomes between Turkish citizens and Syrian refugees with high-risk pregnancies. This prospective cohort study was conducted between March and December 2020 in Sanliurfa, Turkey. The maternal characteristics and pregnancy and neonatal outcomes were compared between the two groups. In this study, a total of 302 high-risk pregnant women (233 Turkish citizens and 69 Syrian refugees) were included. Parity and pregnancy spacing shorter than 2 years were significantly higher in Syrian refugees. Age, previous abortion or miscarriage and rates of cesarean section (C/S) were significantly higher in Turkish citizens. The live birth (Turkish: 94.8% vs Syrian: 92.8%), preterm birth (Turkish: 10% vs Syrian: 9.4%), low birth weight (Turkish: 7.7% vs Syrian: 3.1%) rates and birth weight (g) (Turkish: 3097.5 ± 501.3 g; Syrian: 2980.2 ± 395.0 g) were not significantly different between Turkish citizens and Syrian refugees with high-risk pregnancy. Similar pregnancy and neonatal outcomes could be attributed to the Syrians receiving adequate and free maternity care, similar to the Turkish citizens.

Depression, loneliness and factors influencing in Syrian refugee children

AIMS

About 3.5 million Syrian refugees are living within the borders of Turkey. This study examined depression, loneliness and factors influencing refugee children who live outside the camps and attend school in Turkey.

METHODS

This was a descriptive study in Sanliurfa, which has the second highest refugee population in Turkey. The sample consisted of 535 students attending 6-8 grades in five schools randomly selected of 18 schools located in the city centre where the Syrian children received their education. Data were collected using the Sociodemographic Characteristics Question Form, the Depression Scale for Children and the UCLA Loneliness Scale. Data were analysed by IBM spss v23. The percentage, average and standard deviation were determined. A linear regression analysis was used to examine the independent variables affecting loneliness and depression scores, and the Backward method was used to include independent variables in the model. Significance level was considered as P < .05.

RESULTS

The average age of the children was 13.22 ± 1.33 years and 57.9% female. The average UCLA Loneliness Scale score was 42.95 ± 7.77. About 42% of the children received ≥19 on the depression scale, and 65% of them received ≥40 on the UCLA Loneliness Scale. Independent variables affecting depression score and UCLA loneliness score were analysed by a linear regression analysis. The linear regression model established for depression and UCLA loneliness score was obtained as statistically significant (P < .001).

CONCLUSION

Depression and loneliness scores were relatively high in children, particularly those exposed to the devastating impacts of war. These results will make significant contributions to the planning of services to be provided for this group of children.

Assessment of thiol/disulfide balance as an oxidative stress marker in children with β-thalassemia major

Objective:

We aimed to investigate the oxidative stress status in children with β-thalassemia major (β-TM) by measuring native thiol (SH), disulfide (SS) and total thiol (SH + SS) plasma levels.

Methods:

This study was carried out from November 2017 to March 2018 at the Pediatric Hematology Clinic of the Harran University Medical Faculty Hospital. Blood specimens were collected from 100 participants, including 50 β-TM patients and 50 controls, and SH, SS and SH+SS levels were detected through a newly developed method.

Results:

SH, SS, SH+SS levels and SS/SH ratio were markedly higher in β-TM patients than in controls. In β-TM group, SH and SH+SS levels were positively correlated with age, albumin and total bilirubin. Serum ferritin level was positively correlated with SH, SH+SS, aspartate transaminase and alanine transaminase.

Conclusions:

We found that the SS/SH ratio was high in patients with β-TM, which shows increased oxidative stress. This ratio may be considered as a tool for the determination of oxidative status in such patients due to easily calculate, suitable for routine use and economical.

Serum paraoxonase/arylesterase activity and oxidative stress status in children with metabolic syndrome

OBJECTIVE

This study aimed to measure paraoxonase/arylesterase activities and to evaluate the total oxidant and antioxidant capacities in obese children and in children with metabolic syndrome (MetS).

METHODS

A total of 151 children of comparable ages (13.23±1.96 years, 13.45±1.85 years and 13.95±1.31 years) were enrolled in the study. Forty of these were children with MetS, 55 were obese and 56 were healthy controls. Diagnosis of the MetS was made according to International Diabetes Federation criteria. Paraoxonase/arylesterase activities were evaluated by using paraoxon and phenylacetate substrates. Total oxidant status (TOS) and total antioxidant status (TAS) were measured and oxidative stress index (OSI) was estimated by calculation.

RESULTS

High levels of paraoxonase were detected in the obese group, whereas high levels of arylesterase were detected in both MetS and obese groups. Higher values for TOS, TAS and OSI were found in the MetS group (p<0.05).

CONCLUSION

Higher values of mean TOS and OSI in the MetS group than those in the control groups indicate that these parameters may be indicators of future risks such as atherosclerosis in patients with MetS.

Evaluation of selenium levels and mean platelet volume in patients with simple febrile convulsion

OBJECTIVE

This study aimed to evaluate serum selenium levels and mean platelet volume in children who experience simple febrile convulsion.

METHODS

The study comprised 42 patients diagnosed with simple febrile convulsions and a control group of 30 healthy children. Blood samples were taken following a febrile convulsion. Selenium levels in the serum of both the patients and control subjects were measured with the hydride formation method on an atomic absorption spectrometry device and mean platelet volume was evaluated.

FINDINGS

When the mean values of the febrile convulsion patients were compared with those of the control group, the mean selenium levels and thrombocyte count were found to be statistically significantly low (P=0.002, P=0.01 respectively) and the mean platelet volume values were statistically significantly high (P=0.002).

CONCLUSION

While low serum selenium levels cause the onset of a febrile seizure in patients with simple febrile convulsion, it is thought that the increased mean platelet volume shows infection activity causing febrile convulsion.