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Extreme Reactive Thrombocytosis Post-Splenectomy in 16 Years Old Boy
Desmiyati Natalia Adoe,
Ketut Ariawati,
Aankp Widnyana
Issue:
Volume 7, Issue 3, September 2021
Pages:
95-99
Received:
20 May 2021
Accepted:
7 June 2021
Published:
16 June 2021
Abstract: Thrombocytosis is a common occurrence in childhood. The most common causes of thrombocytosis are infection, trauma, surgery, and malignancy. Splenectomy may cause reactive thrombocytosis, which affects approximately 75-80% of patients and is associated with an increased risk of thrombotic and hemorrhagic complications. The appearance of thrombocytosis must be diagnosed in order to determine the treatment and prognosis. Antiplatelet agents, cytoreductive therapy, and/or therapeutic apheresis can be used to accomplish this. We reported a 16-year-old male who developed extreme reactive thrombocytosis following splenectomy. He was admitted to the hospital with a grade IV spleen rupture as a result of blunt abdominal trauma and underwent total splenectomy. After splenectomy, his platelet count was 229x109/L and increased to 1154x109/L on the ninth postoperative day. He stated that he was suffering from a fever, headache, fatigue, and abdominal pain. Therefore, he was referred to a consultant pediatric haemato-oncology specialist for thrombocytosis management and was diagnosed with extreme reactive thrombocytosis. Cytoreductive agents such as hydroxyurea were used to treat him. His platelet count decreased to less than 400x109/L after 37 days of treatment. At 1-year follow-up, his complete blood count remains normal. He has been asymptomatic. We concluded that splenectomy may lead to extreme thrombocytosis, resulting in thrombotic and hemorrhagic complications. Thus, physicians should clinically monitor patients to ensure prompt diagnosis and appropriate treatment, as well as to prevent thrombosis and hemorrhage complications.
Abstract: Thrombocytosis is a common occurrence in childhood. The most common causes of thrombocytosis are infection, trauma, surgery, and malignancy. Splenectomy may cause reactive thrombocytosis, which affects approximately 75-80% of patients and is associated with an increased risk of thrombotic and hemorrhagic complications. The appearance of thrombocyto...
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Risk Factor of Elevated Blood Pressure Among Children in Tulikup Village, Bali
Christin Natalia Kalembang,
Gusti Ayu Putu Nilawati,
Bagus Ngurah Mahakrishna
Issue:
Volume 7, Issue 3, September 2021
Pages:
100-104
Received:
31 May 2021
Accepted:
15 June 2021
Published:
23 June 2021
Abstract: Elevated blood pressure in children is a worldwide problem, constitute as major, often overlooked, public health problem in many countries. Normal blood pressure value in children varies based on age, sex and body height which available in standardized table. Measurement of blood pressure is crucial and needed to be done at least once a year in every child with risk factors. Risk factors for elevated blood pressure includes family history of hypertension, salt intake, physical activity, stress level and obesity. Therefore we aimed to determine risk factors for elevated blood pressure among children in Tulikup village Bali. This observational analytic study with cross-sectional design, was conducted in children age 1-18 years old whom visit child health community service program in Tulikup. We collected data from 81 children, age range from 1 to 13 years old, with median age was 4 years old. Data was collected by using questionnaire and physical examination. This study was dominated by female and elevated blood pressure (11.1%). On the other hand, nutritional status were both equal between well-nourished status and mild nutrition (44.4%). Multivariate analysis showed two factors associated with elevated blood pressure such as family history of hypertension with p=0.045 (OR 8.89; 95% CI 1.05-75.29) and excessive salt intake with p=0.046 (OR 5.24; 95% CI 1.02-26.77). Therefore risk factors such as family history of hypertension and excessive salt intake, significantly cause elevated blood pressure in children.
Abstract: Elevated blood pressure in children is a worldwide problem, constitute as major, often overlooked, public health problem in many countries. Normal blood pressure value in children varies based on age, sex and body height which available in standardized table. Measurement of blood pressure is crucial and needed to be done at least once a year in eve...
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Assessment of Awareness Among Parents of Children with Thalassemia Major in Bangladesh: A Hospital Based Study
Mohammad Musa Meah,
Zabeen Choudhury,
Mohammad Bani Yeamin,
Bimal Chandra Das,
Jhulan Das Sharma
Issue:
Volume 7, Issue 3, September 2021
Pages:
105-112
Received:
20 April 2021
Accepted:
3 June 2021
Published:
28 June 2021
Abstract: Introduction: Thalassemia is the world’s most common hereditary disease and is a paradigm of monogenic genetic disease. Many children in Bangladesh are carrier of thalassemia which is a major threat for the upcoming generation. The aim of this study was to determine the awareness among parents of children with thalassemia major. Methodology & Materials: This descriptive cross-sectional study was conducted in the Department of Pediatrics, Chittagong Medical College Hospital, Bangladesh during July 2010 to December 2010. A total of 131 parents of diagnosed cases of thalassemia major children attended for blood transfusion in the Pediatric Ward of Chittagong Medical College Hospital and Thalassemia Centre, Jamal Khan, Chittagong, Bangladesh were enrolled in this study. The collected data were analyzed by the SPSS 23.0 windows version and the association between the categorical variables was assessed through Chi-Squared test where p<0.05 considered as significant. Result: A total of 131 parents of children with thalassemia major were included in this study. The socio-demographic characteristics of the majority parents were low. The educational qualification of the majority father was up to secondary level (29.77%) and the maximum mother’s educational qualification was up to primary level (31.30%). Most of the parents fully immunized their children according to EPI schedule (73.28%) but majority of them not received Hepatitis B vaccine (74.05%). A large number of parents had no knowledge about consanguinity of marriage (68.70%), 92 (70.23%) parents had no knowledge about mode of inheritance of the disease, 100 (76.34%) parents had no knowledge about premarital screening, 74.81% had no other affected children in their family, 42 (32.06%) parents collected blood from professional blood donors, 47 (35.88%) parents screened the blood of their children regularly and had knowledge about screening of blood before transfusion for HBV, HCV, HIV, malaria and syphilis were being 19 (14.50%), 12 (9.16%), 7 (5.34%), 6 (4.58%) and 4 (3.05%). Parents’ knowledge regarding iron overload, iron chelation, oral iron chelation, parenteral iron chelation and use of infusion pump also were being 48 (36.64%), 42 (32.06%), 27 (20.61%), 09 (6.87%), 06 (4.58%) and 29 (22.14%). All the above factors were statistically significant (p<0.05). Conclusion: The awareness and knowledge among parents of children with thalassemia major were insufficient. They have inadequate knowledge regarding the disease, safe blood transfusion and treatments of associated complications. Awareness programs should be taken to improve knowledge among the parents of the children with thalassemia.
Abstract: Introduction: Thalassemia is the world’s most common hereditary disease and is a paradigm of monogenic genetic disease. Many children in Bangladesh are carrier of thalassemia which is a major threat for the upcoming generation. The aim of this study was to determine the awareness among parents of children with thalassemia major. Methodology & Mater...
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Metabolic Syndrome in Obese Children over Five Years Old
Douaa Kharbotly,
Ahmad Chreitah,
Muhammed Imad Khayat
Issue:
Volume 7, Issue 3, September 2021
Pages:
113-116
Received:
9 June 2021
Accepted:
21 June 2021
Published:
9 July 2021
Abstract: Background: Obesity is an important pediatric public health problem associated with increased risk of many complications in childhood and increased morbidity and mortality throughout adult life. Objectives: To assess the prevalence of Metabolic Syndrome in obese children and the relationship between Metabolic Syndrome and Body mass index (BMI), sex, age and family risk factors like obesity, hypertension, diabetes mellitus and cardiovascular disease. Materials and Methods: An analytic cross-sectional study was conducted in 178 overweight and obese children and adolescents aged 5-16 years old seen at the General Pediatric Clinic of the Tishreen University Hospital between March 2020 and February 2021. Weight, high, waist Circumference and blood pressure were measured. Blood samples were taken after 12 hours fasting and fasting blood glucose (FBG), total cholesterol (T Cho), high- density lipoprotein cholesterol (HDL) and low- density lipoprotein cholesterol (LDL) were measured. The Metabolic Syndrome MS was diagnosed based on pediatric and adolescent criteria adapted from the National Cholesterol Education Program Third Adult Treatment Panel (NCEP-ATP III) definition. Results: A total of 178 children, 82 males (46.1%) and 96 females (53.9%) with mean age 9.9±2.5 SD were in our study. Out of the 178 children, 62 (34.8%) were overweight, 101 (56.7%) obese and 15 (8.4%) were severe obese. According to the NCEP ATP III, (32.6%) out of (178) children were diagnosed with MS. Among children with MS, most components of MS were increased waist circumference WC (93.1%), increased TG (86.2%), reduced HDL (51.7%), increased BP (50%) and increased FBS (25.9%). MS prevalence was 12.9%, 36.6%, 86.7% in overweight, obese and severe obese children respectively
Abstract: Background: Obesity is an important pediatric public health problem associated with increased risk of many complications in childhood and increased morbidity and mortality throughout adult life. Objectives: To assess the prevalence of Metabolic Syndrome in obese children and the relationship between Metabolic Syndrome and Body mass index (BMI), sex...
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The Prevalence of Positivity of Anti Tissue Transglutaminase in Patients with Short Stature in Pediatric Endocrinology Clinic of Tishreen Hospital in Lattakia
Mohammad Daaboul,
Ahamad Chreitah,
Ali Mohamed
Issue:
Volume 7, Issue 3, September 2021
Pages:
117-120
Received:
14 June 2021
Accepted:
23 June 2021
Published:
10 July 2021
Abstract: Background: Short stature is a public health problem that, by definition, affects 2.5% of the population around the world, and higher rates in some areas. Celiac disease is one of the causes of short stature, it occurs with multiple mechanisms. And it is one of the causes that can be treated and thus the final length improvement, especially with the early start of treatment. Detection of celiac disease serologically is easy and cost-effective. Aims: To determine the prevalence of antiTTG-IGA antibody positivity in patients who meet the standard definition of short stature. Methods: A cross-sectional study that included 132 short children over two years of age attending the Pediatric endocrinology Clinic at Tishreen University Hospital from the beginning of 2016 until the end of 2019. The data of the patients attending the clinic with complaints of short stature was reviewed and the patients with antiTTG-IGA antibodies were identified and their data related to anemia and clinical symptoms were analyzed. Results: The number of short children included in the study was 132 children (69 males and 63 females), 10 of whom had positive antiTTG-IGA antibodies that were 7.6%. Digestive symptoms or anemia were not statistically significant in predicting the presence of celiac disease. It was found that the near-normal BMI and the absence of severe weight growth failure do not exclude the presence of celiac disease. Conclusion: Celiac disease is an important cause of short stature that is difficult to predict through clinical symptoms, which requires for titration of antiTTG-IGA antibodies in all children with short stature.
Abstract: Background: Short stature is a public health problem that, by definition, affects 2.5% of the population around the world, and higher rates in some areas. Celiac disease is one of the causes of short stature, it occurs with multiple mechanisms. And it is one of the causes that can be treated and thus the final length improvement, especially with th...
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Childhood Pneumonia: Prevalence and Associated Factors as Seen at a Tertiary Health Institution in Southeast Nigeria
Chukwuemeka Ngozi Onyearugha,
Nneka Chioma Okoronkwo
Issue:
Volume 7, Issue 3, September 2021
Pages:
121-125
Received:
25 June 2021
Accepted:
21 July 2021
Published:
24 July 2021
Abstract: Background: Pneumonia has been reported to be a leading cause of mortality in children aged less than 5 years worldwide particularly in low resource nations. To achieve the Sustainable Developmental Goal (SDG) 3.2 which aims at reducing neonatal mortality and under five mortality, effective steps should be taken to stem the prevalence and mortality from childhood pneumonia. Aim: To determine the prevalence, monthly variations and mortality from pneumonia in children aged 1 month to 16 years at the department of Paediatrics of the Abia State University Teaching Hospital, Aba. Patients and methods: This was a retrospective review of the medical records of children aged 1 month to 16 years, diagnosed with pneumonia, at the department of Paediatrics of the Abia State University Teaching Hospital, Aba. Relevant information were extracted from case files of qualified subjects and subsequently analyzed using SPSS version 24. Result: There was a total of 440 admissions out of which 74 had a diagnosis of pneumonia, giving a prevalence of 16.8%. Six of the cases had inadequate data and were discarded. Sixty eight (68) were used for subsequent analysis. Forty five (45) were males, while 23 were females, giving a male: female ratio of 1.8: 1. Approximately 88% of the cases occurred in children aged ≤ 5 years with 61.8% of the patients aged less than one year. The greatest monthly prevalence, 25%; was in January and February. Mortality rate was 4.4%. Conclusion: The prevalence of childhood pneumonia is high. Children below 5 years are very vulnerable. Effective steps to reduce childhood pneumonia will drastically reduce under-5 mortality and achieve SDG 3.2.
Abstract: Background: Pneumonia has been reported to be a leading cause of mortality in children aged less than 5 years worldwide particularly in low resource nations. To achieve the Sustainable Developmental Goal (SDG) 3.2 which aims at reducing neonatal mortality and under five mortality, effective steps should be taken to stem the prevalence and mortality...
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Clinico- Radiologic and Genetic Study of Fraser Syndrome: A Case Report
Sujayendra Kulkarni,
Ashwini H.,
Ashalata Mallapur,
Yasmeen Maniyar
Issue:
Volume 7, Issue 3, September 2021
Pages:
126-129
Received:
14 June 2021
Accepted:
12 July 2021
Published:
27 July 2021
Abstract: Cryptophthalmos syndrome or Fraser syndrome is a rare autosomal recessive disorder, characterized by major features such as cryptophthalmos, cutaneous syndactyly, malformation of the larynx, abnormal genitalia, craniofacial dysmorphism, orofacial clefting, mental retardation and musculoskeletal anomalies. It is inherited in an autosomal recessive pattern where both the parents must be possessing one defective allele for Fraser syndrome. Since both the parents are carriers for the Fraser syndrome, there is a chance for 25% of their children being affected, 50% of their children to be carriers and 25% of their children to be normal. A 22 year old pregnant woman with a family history of third degree consanguineous marriage was diagnosed to have a fetus with many of the above findings in her anomaly scan which was done to manage child birth and as it is crucial to get prenatal diagnosis early in the pregnancy. Parents decided to terminate the pregnancy. Soon after the abortus was expelled, cord blood was collected and subjected to Karyotype test. Karyotype analysis revealed the absence of a short sequence on chromosome number 4 in q arm at 4q21 region, which may be responsible for the above mentioned deformities. Due to the high morbidity and mortality associated with Fraser syndrome, early detection by amniotic fluid karyotyping may be helpful in early intervention.
Abstract: Cryptophthalmos syndrome or Fraser syndrome is a rare autosomal recessive disorder, characterized by major features such as cryptophthalmos, cutaneous syndactyly, malformation of the larynx, abnormal genitalia, craniofacial dysmorphism, orofacial clefting, mental retardation and musculoskeletal anomalies. It is inherited in an autosomal recessive p...
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Attachment-Based Therapy for Addiction and Trauma in Children and Adolescents
Issue:
Volume 7, Issue 3, September 2021
Pages:
130-136
Received:
23 June 2021
Accepted:
21 July 2021
Published:
27 July 2021
Abstract: This article is about why children and adolescents with traumatic experiences are particularly at risk of becoming severely addicted. It addresses the question of why it is so difficult for them to feel safe in therapeutic relationships. It will be examined to what extent the epidemiology of addiction, trauma, and attachment disorder provides evidence as to whether there is a significant relationship among the disorders that contributes to the complicated and lengthy nature of therapy for adolescents who have become severely addicted. It will describe how the reward system, attachment system, and anxiety-stress system (limbic system) interact at the neurobiological level. As a result of the study, it is shown that the role of the reward system in understanding the development of dependence cannot be understood neurophysiologically without the role of attachment and anxiety-stress. One conclusion from this is that this relationship should be taken into account therapeutically in order to be able to expand the spectrum of therapeutic intervention options and to be able to make the therapy of severe dependence disorders in adolescence more successful. Methodologically, two levels of description are compared here: On the first level, the neurobiological research findings are presented as the connection between addiction, trauma and attachment; on the second level, the significance of the research findings for therapeutic practice is concretely described and empirically demonstrated on the basis of a case report. In conclusion, it is shown that understanding the neurobiological function of the implicit memory systems of reward, attachment, and anxiety/stress has a central importance for the further development of addiction therapy for dependent adolescents.
Abstract: This article is about why children and adolescents with traumatic experiences are particularly at risk of becoming severely addicted. It addresses the question of why it is so difficult for them to feel safe in therapeutic relationships. It will be examined to what extent the epidemiology of addiction, trauma, and attachment disorder provides evide...
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Current Prevalence and Determinants of Anaemia in Under-five Children in Rural Bangladesh: A Cross Sectional Study
Mohammad Moniruzzaman Mollah,
Ashik Mosaddik,
Asgor Hossain,
Andrew Asim Roy,
Sultana Naznin,
Mohammad Shukur Ali,
Parvez Hassan
Issue:
Volume 7, Issue 3, September 2021
Pages:
137-144
Received:
3 July 2021
Accepted:
24 July 2021
Published:
2 August 2021
Abstract: Background: Anaemia and its association with low physical and cognitive development in under-five children remain a common public health burden in developing countries including Bangladesh. Childhood anemia is significantly associated with age, rural residence, infant and young child feeding (IYCF) practices, infectious disease, maternal illiteracy etc. We have studied to identify the current prevalence and to explore associated socio-demographic, health, and nutritional factors of anaemia in under-five children of rural Bangladesh. Methods and Materials: A cross-sectional study was conducted at five remote northern districts of Bangladesh involving rural children aged 6 - <60 months. We used an interviewer-administered questionnaire for data collection. Potential study subjects were approached conveniently at selected rural health centres. The chi-squared test was the main statistical model to identify the association between explanatory variables and anaemia. A p-value <0.05 was considered significant. Results: The overall prevalence of anaemia (N=258) was 61.23% with mild, moderate and severe anaemia of 28.29%, 28.68% and 4.26% respectively. The prevalence of anaemia was the highest (72%) in the age group 6-24 months, which were followed by 63% in >24-36 months and 44.3% in >36-<60 months categories. The following explanatory variables showed statistically significant association with high anaemia: younger-age (p=<0.001), low family income, and maternal education (p=<0.001), exclusive versus non-exclusive breastfeeding (p=0.02), and timely versus delayed or early weaning (p=<0.001). Non-consumption of animal proteins, fruits and green leafy vegetables were also significantly linked to high anaemia prevalence (p=0.001). Further, underweight, stunting, and wasting were significantly related to anaemia (p=0.02, 0.006, and 0.001 respectively). Conclusion: The prevalence of anaemia in under-five children of rural Bangladesh remains noticeably high. Age, maternal education, family income, consumption of animal protein, green leafy vegetables, and fruits along with underweight, stunting and wasting are inversely related to anaemia prevalence. Exclusive breastfeeding and timely weaning may reduce the risk of anaemia.
Abstract: Background: Anaemia and its association with low physical and cognitive development in under-five children remain a common public health burden in developing countries including Bangladesh. Childhood anemia is significantly associated with age, rural residence, infant and young child feeding (IYCF) practices, infectious disease, maternal illiteracy...
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A Neonatal Case with a Prenatal Diagnosis of Capillary Malformation-arteriovenous Malformation Syndrome (CM-AVM)
Somia Errazaki,
Martina Marangoni,
Guillaume Smits,
Boris Lubicz,
Dorottya Kelen
Issue:
Volume 7, Issue 3, September 2021
Pages:
145-149
Received:
28 June 2021
Accepted:
23 July 2021
Published:
9 August 2021
Abstract: Capillary malformation arteriovenous malformation syndrome (CV-AVM) is marked by the appearance of vascular lesions on the skin, frequently found on the face and limbs. The main genetic defect in this syndrome is a mutation in the RASA-1 gene transmitted in an autosomal dominant manner. Besides, this syndrome is characterized by a wide intra- and interfamilial variability in clinical manifestations. In fact, little is known about prenatally diagnosed cases of CV-AVM. Here, we report the case of a 25 year-old woman admitted during her third pregnancy for management of unexplained polyhydramnios. Prenatal genetic analysis (Mendeliom sequencing from amniotic fluid), performed due to two previous unexplained fetal losses, showed a mutation in a heterozygous state in RASA-1 gene c.2367 C>T (p.Arg789*). Hence, an antenatal diagnosis of CV AVM was then made. An emergency cesarean section was performed at 31 5/7 weeks due to complications of the second amnioreduction. At birth, the neonate presented five erythematous lesions with diameters of 1-3 cm, similarly to those found on the father. No signs of arteriovenous malformations was detected on MRI of the brain and spine. No other anomaly has been found. Despite its autosomal mode of transmission, CV-AVM is still underrecognized due to its variable clinical presentation. Our report underlines that CM-AVM should be considered at the first clinical examination of a neonate revealing atypical capillary malformations especially in the context of unexplained polyhydramnios, previous fetal losses, or family history of clinical presentation of CM. When genetic diagnose is made a follow-up should be organized during the period of early childhood.
Abstract: Capillary malformation arteriovenous malformation syndrome (CV-AVM) is marked by the appearance of vascular lesions on the skin, frequently found on the face and limbs. The main genetic defect in this syndrome is a mutation in the RASA-1 gene transmitted in an autosomal dominant manner. Besides, this syndrome is characterized by a wide intra- and i...
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Evaluation of Risk Factors and Management of Neonatal Jaundice in Newborns Admitted in a Tertiary Care Hospital of Rural Haryana
Rupan Deep Kaur,
Sonika Lamba,
Manoj Rawal
Issue:
Volume 7, Issue 3, September 2021
Pages:
150-153
Received:
15 July 2021
Accepted:
2 August 2021
Published:
9 August 2021
Abstract: Introduction: Neonatal jaundice is one of the most common medical problems in healthy full-term infants during the immediate postnatal period. Neonatal jaundice is the most common cause of readmissions in hospitals in the neonatal period. In low-resource settings, where the majority of births occur outside facilities and access to monitoring and laboratory testing is limited, many of the proven diagnostic and treatment strategies are not available. Aim and objectives: The harmful effects of hyperbilirubinemia can be prevented by early recognition and prompt management of those at risk. This study was aimed to provide information on the risk factors and management associated with neonatal jaundice in a low-resource setting with the objective of identifying potentially modifiable risk factors to reduce the incidence and consequences of jaundice in neonates. Methodology: Patients of Jaundice admitted in pediatrics ward, Bhagat Phool Singh Government Medical College for a period of 4 months formed the sample population. Data included birth weight, gestational age, mother’s age, the onset time of hyperbilirubinemia, the onset of breast feeding, history of formula feeding and technique of delivery. Lab data including CBC, bilirubin levels, blood group & Rh type of mother and neonates. Microsoft word and SPSS software were used for the analysis of the results. Results: Among 100 neonates with neonatal jaundice 19% of neonates were pre term. 89 neonates were given exclusive breastfeeding. 4 of them were given infant formula powder and the remaining 7 were fed on cow’s milk. Gestational age <37 weeks was present in 19. Birth weight of 22 neonates was <2000g. 77% of them were born by vaginal delivery and 23% by caesarean section. In management of neonates, phototherapy was done in 89 neonates, 10 neonates were given conservative treatment and 1 was referred to higher center for exchange transfusion. Conclusion: Several known risk factors for neonatal jaundice were confirmed in this study. It is very essential for health care professionals to be aware of all potential risk factors so that the disease is detected and treated early. The LED phototherapy has decreased the need of exchange transfusion in neonatal jaundice.
Abstract: Introduction: Neonatal jaundice is one of the most common medical problems in healthy full-term infants during the immediate postnatal period. Neonatal jaundice is the most common cause of readmissions in hospitals in the neonatal period. In low-resource settings, where the majority of births occur outside facilities and access to monitoring and la...
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The Effect of Obesity and Overweight on Pulmonary Function in School-Aged Children
Nurshan Mohamed Hamzah,
Ahmed Chreitah,
Maamoun Hakim
Issue:
Volume 7, Issue 3, September 2021
Pages:
154-158
Received:
27 June 2021
Accepted:
28 July 2021
Published:
11 August 2021
Abstract: Background: Obesity has an increasing prevalence worldwide in both industrial and developing countries. It also leads to serious complications among most body systems including the respiratory system; which has not been well studied and proven in Arab countries. Objective: To evaluate the association between obesity degrees, and pulmonary function parameters. Methods: Non-asthmatic children aged 5 to 14 years old were enrolled in this study. We obtained height and weight for each child then we calculated body mass index. We performed pulmonary function tests using spirometer. Results: This study included a total of 99 children (51 boys, 49 girls), the mean age was 10.5 years. Spirometric parameters such as Forced Vital Capacity (FVC) was higher in children with overweight and obesity. While Forced Expiratory Volume during the first second (FEV1) in addition to FEV1 to FVC Ratio were lower in children with overweight and obesity. There also was a negative linear correlation between Body Mass Index in percentiles and FEV1, FEV1/FVC Ratio, which reflects an airway obstruction inappropriate with lung volumes. Conclusion: we recommend conducting the measurement of pulmonary function via spirometer within the investigations of children with overweight and obesity to detect pathological changes as early as possible.
Abstract: Background: Obesity has an increasing prevalence worldwide in both industrial and developing countries. It also leads to serious complications among most body systems including the respiratory system; which has not been well studied and proven in Arab countries. Objective: To evaluate the association between obesity degrees, and pulmonary function ...
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Kocuria Kristinae Meningitis and Cranial Nerve Palsies Secondary to Sphenoid Sinusitis: About a Case
Werdani Amina,
Yahyaoui Omar,
Jammeli Nesrine,
Rassas Ahmed,
Boussofara Raoudha,
Khedher Mohamed,
Mahjoub Bahri
Issue:
Volume 7, Issue 3, September 2021
Pages:
159-162
Received:
25 July 2021
Accepted:
9 August 2021
Published:
23 August 2021
Abstract: Kocuria spp, previously classified as the members of Micrococcacae family, was rarely reported as a human pathogen. Kocuria Kristinae could cause invasive infections of large variety of tissues in patients of any age. We report the first case of meningitis with sixth and third nerve palsies secondary to sphenoid sinusitis caused by Kocuria Kristinae in a previously healthy 13 year-old boy. In effect, his cerebrospinal fluid (CSF) showed a cloudy appearance of the CSF, white blood cells count was 600 cells/µl (polymorphs 90% and 10% lymphocytes), red blood cells count was 200 cells/µl, protein level was elevated at 5.3 g/l and glucose level was low at 0.1 mmol/l. The direct examination showed positive-gram diplococci. The patient was initially treated with intravenous cefotaxim and vancomycin. The CSF culture was positive for gram-positive diplococci, which was identified as Kocuria kristinae. The meningitis was characterized by insidious evolution and persistent very low CSF glucose level. It was difficult to diagnose the sphenoid sinusitis because it is not accessible to direct clinical examination. It was diagnosed after the occurrence of a complication due to its anatomical location and proximity to the intracranial and orbital content. At day 5, the patient had remarkable resolution of symptoms. Complete recovery of cranial nerve palsy was noted at day 8. The aim of this case report is to present the first isolation of Kocuria Kristinae from cerebrospinal fluid sample and describe the clinical presentation and management outcomes.
Abstract: Kocuria spp, previously classified as the members of Micrococcacae family, was rarely reported as a human pathogen. Kocuria Kristinae could cause invasive infections of large variety of tissues in patients of any age. We report the first case of meningitis with sixth and third nerve palsies secondary to sphenoid sinusitis caused by Kocuria Kristina...
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Risk Factors of Ischemic Stroke in Children with Head and Neck Tumors: A Clinical Case Description with a Literature Review
Anastasia D. Rodina,
Vladimir Sh. Vanesyan,
Tatiana V. Gorbunova,
Natalia V. Ivanova,
Vladimir G. Polyakov
Issue:
Volume 7, Issue 3, September 2021
Pages:
163-169
Received:
10 August 2021
Accepted:
24 August 2021
Published:
31 August 2021
Abstract: Ischemic stroke (AI) is becoming an increasingly important and urgent problem in pediatrics due to the occurrence of neurological disorders that affect the quality of life and limit the social adaptation of a child. The clinical picture of ischemic stroke in pediatric practice differs from the manifestation of this pathology in adult patients. Children have special risk factors for the development of IS. In pediatric oncology, there are such factors like invasive tumor growth, the development of tumor embolism, and blood clotting disorders. Side effects of anticancer treatment occupy a special place in the development of IS. The relationship between post-radiation arteriopathies and ischemic stroke has been more studied among cancer patients who underwent neck irradiation. In children, it was found that after radiation therapy to the head and neck region and, thus, the risk of ischemic stroke in childhood increases. This review is devoted to the possible pathophysiological causes and mechanisms of stroke in children with head and neck tumors. In addition, descriptions of clinical cases of patients with ischemic stroke in the course of anticancer treatment are presented.
Abstract: Ischemic stroke (AI) is becoming an increasingly important and urgent problem in pediatrics due to the occurrence of neurological disorders that affect the quality of life and limit the social adaptation of a child. The clinical picture of ischemic stroke in pediatric practice differs from the manifestation of this pathology in adult patients. Chil...
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Progressive Hyperpigmentation in a Child: An Early Marker of Infantile Tremor Syndrome
Shivi Nijhawan,
Anviti Gupta,
Manisha Nijhawan,
Divya Yadav,
Madhu Mathur
Issue:
Volume 7, Issue 3, September 2021
Pages:
170-173
Received:
13 July 2021
Accepted:
2 August 2021
Published:
4 September 2021
Abstract: Hyperpigmentary disorders are commonly encountered group of dermatoses in the paediatric age group. One of the most common causes of progressive generalised hyperpigmentation in paediatric population is nutritional vitamin B12 deficiency (NVBD). NVBD can present with a bunch of signs and symptoms like skin hyperpigmentation, pallor and regression of neurodevelopment. We report a case of a plump looking 13 months old, girl child from non-consanguineous marriage of low socioeconomic family who presented with generalised hyperpigmentation, failure to thrive and regression of mile stones. Physical examination revealed anaemia and sparse, thin, lustreless hair with dull, apathetic look. A differential diagnosis of Addison’s disease, hypothyroidism, and neurodegenerative disease, was considered based on clinical suspicion. She was further investigated by a paediatrician. Her blood investigations revealed low levels of Vitamin B12 (159 pg/dl) and haemoglobin (2.6 g/dl). On radiological examination, NCCT brain showed cortical atrophy. A final diagnosis of Infantile Tremor Syndrome (ITS) was made. ITS is a rare condition which presents with cutaneous manifestation like hyperpigmentation, scanty scalp hair along with lethargy, apathy along with signs and symptoms of neurodegeneration. Progressive cutaneous hyperpigmentation in a child can present as early marker of a rare neurodegenerative condition like ITS.
Abstract: Hyperpigmentary disorders are commonly encountered group of dermatoses in the paediatric age group. One of the most common causes of progressive generalised hyperpigmentation in paediatric population is nutritional vitamin B12 deficiency (NVBD). NVBD can present with a bunch of signs and symptoms like skin hyperpigmentation, pallor and regression o...
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Application of Bundle Intervention in Infant Chloral Hydrate Enema Sedation
Sha Wang,
Caiqing Wu,
Shaoxin Lin,
Xufen Huang
Issue:
Volume 7, Issue 3, September 2021
Pages:
174-177
Received:
19 August 2021
Accepted:
31 August 2021
Published:
8 September 2021
Abstract: It is annoying for infants to operate examination, because they often cry during examination, which makes it difficult to carry out the examination smoothly. Therefore we aimed to investigate the effect of bundle intervention on chloral hydrate enema sedation in infants. This observational analytic study was a design of a non-randomized controlled trail, we conducted in infants aged from 0 to 3 who were hospitalized in a pediatric hospital. A total of 293 infants from July to December in 2020 were sedated by chloral hydrate enema. According to the admission time, they were divided into a control group (admitted from July to September) and an experimental group (admitted from October to December). The control group received chloral hydrate enema sedation under conventional nursing, while the experimental group was given both the conventional chloral hydrate enema sedation and bundle intervention. The success rate of chloral hydrate enema sedation was compared between the two groups. The success rate of chloral hydrate sedation in the experimental group was 92.50%, significantly higher than that in the control group (74.60%), and there was a significant difference between the two groups (P < 0.05). Therefore, bundle intervention can effectively improve the sedation success rate of chloral hydrate enema in infants and relieve the pain caused by repeated enema, which has great clinical application value.
Abstract: It is annoying for infants to operate examination, because they often cry during examination, which makes it difficult to carry out the examination smoothly. Therefore we aimed to investigate the effect of bundle intervention on chloral hydrate enema sedation in infants. This observational analytic study was a design of a non-randomized controlled ...
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The Value of Calretinin in the Diagnosis of Hirschsprung's Disease in Dakar
Abdou Magib Gaye,
Gabriel Nougnignon Comlan Deguenonvo,
Ibou Thiam,
Sophia Raafa,
Marie Joseph Dieme-Ahouidi,
Cherif Mouhamed Moustapha Dial
Issue:
Volume 7, Issue 3, September 2021
Pages:
178-181
Received:
3 September 2021
Accepted:
17 September 2021
Published:
26 September 2021
Abstract: Introduction: Hirschsprung's disease is a congenital anomaly characterised by a rarefaction or absence of ganglion cells associated with schwannian hyperplasia or hypertrophy involving the colon or a segment of the colon. Its diagnosis is based on clinical, radiological and histological evidence. Haematoxylin-eosin examination is used in cases of suspected Hirschsprung's disease. However, in some situations it is insufficient to confirm or refute the diagnosis. Immunohistochemical and histo-enzymatic techniques can be used to demonstrate aganglionosis. The aim of our study is to evaluate the interest of calretinin in the diagnosis of Hirschsprung's disease in Dakar. Materials and methods: This was a retrospective and descriptive study from 1 January 2018 to 31 August 2019. It was conducted at the pathology laboratory of Idrissa Pouye General Hospital where 51 paraffin blocks from suspected Hirschsprung's Disease cases were included. All blocks were immunohistochemically studied with anti-calretinin antibody. The diagnosis of Hirschsprung's disease on standard histological examination was based on the absence of lymph node cells in the submucosal and myenteric plexuses. Calretinin immunoreactivity was shown by nuclear and cytoplasmic labelling of ganglion cells and nerve nets. In Hirschsprung's disease, there is an absence of labelling of the nerve plexuses. Results: The majority of patients (73.5%) were aged 2 years or older with a mean age of 3.4 years. The sex ratio was 2. Biopsies constituted 56.86% of the specimens and surgical specimens 43.14%. Concordance between haematoxylin-eosin examination and calretinin immunohistochemistry was observed in 47 cases (92.15%) and discordance in 4 cases (7.15%). The sensitivity of calretinin was 93.75% and the specificity 89.47%. The kappa index was 0.92. The recto-sigmoid form was the most frequent topographic form observed in 83.3% of patients. Conclusion: Morphological examination with haematoxylin-eosin remains a good diagnostic method for Hirschsprung's disease. Calretinin immunohistochemistry is necessary in equivocal cases, in neonates and infants and in case of superficial biopsies.
Abstract: Introduction: Hirschsprung's disease is a congenital anomaly characterised by a rarefaction or absence of ganglion cells associated with schwannian hyperplasia or hypertrophy involving the colon or a segment of the colon. Its diagnosis is based on clinical, radiological and histological evidence. Haematoxylin-eosin examination is used in cases of s...
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