-
Newborn BCG Vaccinations: Scar Formation and Tuberculin Conversion Rates: A Retrospective Study
Hanieh Tabatabaei,
Sam Hassan
Issue:
Volume 5, Issue 1, March 2019
Pages:
1-6
Received:
20 December 2018
Accepted:
14 January 2019
Published:
31 January 2019
Abstract: Through this study, we aimed to determine the Bacillus Calmette-Guérin (BCG) vaccination uptake by scar formation rate following newborn BCG vaccinations and tuberculin conversion in a tertiary hospital setting in Dubai, United Arab Emirates. A retrospective cohort analysis was conducted on 945 babies vaccinated with BCG during 1 January and 31 December 2017. All babies were administered with intradermal 0.05 ml of BCG in the left deltoid. The descriptive variables include vaccination coverage. The outcome data includes follow up at 2, 4, and 6 months for scar formation, Mantoux test results, and revaccination data. Out of 945 babies, 911 (96.4%) were vaccinated by trained nurses with BCG after birth and before being discharged. This was following written consent from parents who were well informed by the details of the vaccinations. The non-vaccinated babies 34 (3.6%) were from different resident nationalities and the parents declined the BCG vaccine. Reason for such decline is not documented but it is likely because in their home country such vaccines are not routinely given. The number of babies who did not return for follow up was 483 (53%). These babies were followed by other centers or outside the country hence were not included in the study. The number of babies followed up with no record on BCG scar was 334 out of the total number of 482 (78%). BCG scar formation was recorded in 84 babies (19.6%) followed up. Scar formation failure was recorded in 10 (2.3%). Six babies (60%) of those who had no scar had Mantoux test performed. The association between absence of scar and negative Mantoux results were highly significant (P< 0.05) with 100% of babies having negative Mantoux results, therefore, no immunity. It is concluded that BCG scar is poorly recorded similarly to other high-income countries. There is a good correlation between lack of BCG scar and no immunity to Tuberculosis. Improvement of newborn BCG uptake is importantly needed. It is recommended to introduce mandatory recording of the outcome of BCG scar formation and resultant outcomes in the vaccinations books. Training of personnel administering the BCG vaccination is an important element for successful vaccination in this vulnerable age group.
Abstract: Through this study, we aimed to determine the Bacillus Calmette-Guérin (BCG) vaccination uptake by scar formation rate following newborn BCG vaccinations and tuberculin conversion in a tertiary hospital setting in Dubai, United Arab Emirates. A retrospective cohort analysis was conducted on 945 babies vaccinated with BCG during 1 January and 31 Dec...
Show More
-
Radio-Nuclear Investigations in Children Aged 16 Years and Younger with Confirmed Urinary Tract Infection: A Cross Sectional Retrospective Study
Reem Al Qutami Al Suwaidi,
Sam Hassan
Issue:
Volume 5, Issue 1, March 2019
Pages:
7-13
Received:
23 December 2018
Accepted:
29 January 2019
Published:
19 February 2019
Abstract: A retrospective cross-sectional study conducted at Mediclinic City Hospital; a teaching hospital in collaboration with Mohammad Bin Rashid University for Medicine and health sciences in Dubai, United Arab Emirates (UAE). The aim of this study is to ascertain conduction of renal radio nuclear investigations, explicitly Kidney ureter bladder ultrasound scans (KUB US), Micturating cystourethrogram (MCUG), and Dimercaptosuccinicacid (DMSA) in children following Urinary Tract Infection (UTI), based on; age, type of UTI, and recurrence. Medical records of 421 patients aged 0-16 years with UTI were retrospectively studied. Sociodemographic variables were age, gender, type of UTI, and recurrence. Results showed that the most carried out investigation was KUB US (38.2%) (n=161). In children aged between 7 months and 3 years, 15% (n=8) of them had VUR or renal scarring, while only12% (n=11) of children aged > 3 years showed abnormal MCUG or DMSA regardless of the KUB US results. Interestingly more than half (56%) (n=236) of all patients (n=421) with recurrent UTI showed abnormalities by MCUG and or DMSA, while only 12.3% (n=14) of children with atypical UTI showed abnormalities. It is concluded that VUR and renal scarring predominantly occurred in patients with recurrent UTI and atypical UTI. Thus, children presenting with recurrent UTI are recommended to undergo MCUG and DMSA after the second recurrent episode rather than waiting for the third UTI incident. This study suggests that children aged 7 months to 3 years post UTI should undergo KUB US, MCUG (if it was a recurring UTI) plus DMSA or MAG3 with post-micturition study instead. Children older than 3 years presenting with recurrent UTI are recommended to undergo DMSA (regardless of the US results) and MAG3 with post-micturition study or MCUG especially if DMSA is abnormal. Keeping in mind, evaluating risk factors like family and past medical history are crucial before conducting any investigation, this is to avoid unnecessary scans, and at the same time implement measures to reduce risks resulting from complicated UTIs.
Abstract: A retrospective cross-sectional study conducted at Mediclinic City Hospital; a teaching hospital in collaboration with Mohammad Bin Rashid University for Medicine and health sciences in Dubai, United Arab Emirates (UAE). The aim of this study is to ascertain conduction of renal radio nuclear investigations, explicitly Kidney ureter bladder ultrasou...
Show More
-
Current Approaches to the Treatment of Gastroesophageal Reflux Disease in Children with Neurology
Nurlan Nurkinovich Akhparov,
Riza Zulkarnaevna Boranbayeva,
Saule Bakhtyarovna Suleimanova,
Vasiliy Mikhailovich Lozovoy
Issue:
Volume 5, Issue 1, March 2019
Pages:
14-17
Received:
10 January 2019
Accepted:
14 February 2019
Published:
5 March 2019
Abstract: The incidence of gastroesophageal reflux in children with neurological disorders is more common than in the rest of the pediatric population. The risk of reflux development in these children is due to abnormal motility of the gastrointestinal tract, their long term staying in bed (a horizontal position), a disruption of the swallowing process, a delayed evacuation of food from the esophagus and stomach, and a weakened muscle tone that pose a serious threat to a patient by possible complications (such as reflux esophagitis, peptic stricture, erosion and bleeding), and sometimes being one of the causes of death. From 2008 to 2018, 128 patients with gastroesophageal reflux disease were hospitalized in the Department of Surgery of the Scientific Center for Pediatrics and Pediatric Surgery including 33 (26%) children with neurological disorders, of which 28 (85%) were operated. All of the patients underwent Nissen esophagofundoplications, of which in 21 (75%) children it was combined with Stamm gastrostomy and in 18 (64%) children with Mikulich pyloroplasty. The results of surgical treatment were analysed in all the 28 patients in the early period (7-14 days) after surgery. In 2 (7%) children who did not undergo the pyloroplasty there was a complication in the form of gastric distress syndrome, which required an additional surgery in order to drain the stomach. A relapse of gastroesophageal reflux disease was observed in 1 (4%) patient who was re-operated. In the remaining 25 (89%) children, the postoperative period was favourable. Their gastrostomy tube feeding was carried out according to the age requirements. The long-term results were studied in time interval from 6 months to 3 years after surgery. X-ray control examination, fibroendoscopy and 24-hour pH monitoring were conducted in all children in the distant period. The results of the treatment are favourable, the weight deficit is filled, the reflux esophagitis is stopped and the reflux-associated inflammations of the bronchopulmonary system are reduced. To a large extent, the choice of operational tactics can be adapted to the condition of a particular child, the results of objective and instrumental tests for GERD, the pseudobulbar disorders and associated pyloric functional disorders. Timely correction of reflux disorders in children with pathologies of the central nervous system helps prevent the development of serious complications, which will inevitably improve a child’s quality of life.
Abstract: The incidence of gastroesophageal reflux in children with neurological disorders is more common than in the rest of the pediatric population. The risk of reflux development in these children is due to abnormal motility of the gastrointestinal tract, their long term staying in bed (a horizontal position), a disruption of the swallowing process, a de...
Show More
-
Evaluation of Intussusceptions in Under - Five Children in Aba Nigeria
Samuel Chidi Ekpemo,
Emeka Nkwo
Issue:
Volume 5, Issue 1, March 2019
Pages:
18-21
Received:
15 January 2019
Accepted:
18 February 2019
Published:
11 March 2019
Abstract: Background: Intussusception remains a common cause of intestinal obstruction in infants and children. The operative treatment remains the main stay of treatment due to late presentation, long referral chain, paucity of knowledge about the disease condition by midwife and doctors. This study is intended to ascertain the pattern of presentation, management and outcome. Method: This is a prospective study of 48 children that was managed for intussusceptions at the Abia State University Teaching Hospital from November 2016 t0 November 2018. Structured proforma was opened for demography, clinical presentation, investigation, treatment modalities and outcome. Data was analysed using SPSS version 17 for proportions and percentages. Results: There were 24 boys and 24 girls aged 3 months to 13 months with a mean of 8months. The median duration of symptoms onset and presentation was 4 days {1 day to 14days}. Thirty-six patients {75%} presented after 48hours of onset of symptoms. A classic triad {bilious vomiting, bloody mucoid stool and abdominal mass} was present in over 40 patients {83%}. Ten patients did not pass bloody mucoid stool. Thirty patients {62.5%} had predisposing factors which included gastroenteritis and/or respiratory tract infection. 8 patients had hydrostatic saline reduction under ultrasound with success in six patients. Forty-two patients were operated {40 patients primarily and 2 patients following failed hydrostatic reduction}. Twenty-eight patients had resection and anatomises of ileocolic segment due to gangrenous bowel. Fourteen patients had manual reduction of intussuception with healthy bowel. Mortality was 8.3% {4 patients} from overwhelming sepsis and respiratory distress. Twenty patients had surgical site infection and 4 patients had incisional hernias. Conclusion: Late presentation was high in this series, however, emphasis on health education of mothers during antenatal visit that passage bloody mucoid stool by their child needs evaluation by a paediatrician will reduce late presentation morbidity and mortality in our patients.
Abstract: Background: Intussusception remains a common cause of intestinal obstruction in infants and children. The operative treatment remains the main stay of treatment due to late presentation, long referral chain, paucity of knowledge about the disease condition by midwife and doctors. This study is intended to ascertain the pattern of presentation, mana...
Show More
-
Restrictive Infusion Therapy in Patent Ductus Arteriosus Management in Premature Infants
Aleksii Obolonskyi,
Olha Obolonska,
Kateryna Dereza
Issue:
Volume 5, Issue 1, March 2019
Pages:
22-27
Received:
26 November 2018
Accepted:
26 February 2019
Published:
21 March 2019
Abstract: The persistence of hemodynamically significant patent ductus arteriosus (НPDA) has a great value on a short term and long term outcomes in preterm infant. There is no hesitation that PDA should be closed pharmacologically or surgically if present. The aim of the study was to establish the advisability, efficiency and safety of using different volumes of infusion in combination with COX inhibitors and to determine its effect on the timing of the НPDA closure. Retrospectively has been studied 91 preterm infants with gestational age 26-31 weeks, manifestations of respiratory distress syndrome, НPDA treated at the NICU. The research groups were representative for gestational age, gender and weight (1205.0 ± 435.0 grams). The therapy of PDA closure included using of different volumes of restrictive or liberal infusion therapy (from 50 to 100 ml/kg/day) in combination with COX inhibitors. COX inhibitors prescribed according to standard regimens: in the first 3 days - indomethacin orally in doses 0.2/0.1/0.1 mg/kg/day. If the preterm infant had symptoms of intestinal paresis (this prevented the oral administration of indomethacin). Ibuprofen administered in a three-day course in doses of 10/5/5 mg/kg/day intravenously or 20/10/10 mg/kg/day in a rectal form. In all groups of preterm used a standard therapy of PDA closure. The volume of infusion therapy was restricted in the first group. Preemies received 53.5 ± 6.4 ml/kg/day on DOL1 and 2. From the third day increased urinary excretion, there was an increase in the amount of infusion therapy up to 63.6 ± 5.6 ml/kg/day, and at day 5 it was raised to 89.7 ± 6.8 ml/kg/day. In the second group there was no strict adherence to the restriction of the volume of infusion therapy (especially in the first 5 days), and delayed term for the PDA closure (on average at 14.55 ± 0.56 DOL) associated with that fact. In the first group the limit of the volume of infusion therapy observed more clearly in the first 5 days, and the closure of the arterial duct occurred exceptionally early (at 2.35 ± 0.48 DOL). With regard to the volume of infusion therapy in a more distant terms (14 and 28 days), there was no fundamental difference in the volume of infusion in all groups, which suggests that the principle was the restriction of the infusion therapy in the first 5 days only.
Abstract: The persistence of hemodynamically significant patent ductus arteriosus (НPDA) has a great value on a short term and long term outcomes in preterm infant. There is no hesitation that PDA should be closed pharmacologically or surgically if present. The aim of the study was to establish the advisability, efficiency and safety of using different volum...
Show More
-
Systemic Lupus Erythematosus (SLE) with Lupus Nephritis in a 15 Year-Old Male – A Case Report
Rahmi Utami,
Syarifuddin Rauf
Issue:
Volume 5, Issue 1, March 2019
Pages:
28-33
Received:
14 January 2019
Accepted:
20 February 2019
Published:
21 March 2019
Abstract: Systemic lupus erythematosus is a chronic autoimmune inflammatory disease that can affect any part of the body. Lupus Nephritis is one of the most common, and most important, serious manifestations of SLE particularly for male. We present a case of 15 year old male that is diagnosed with a systemic lupus erythematosus (SLE) based on 6 of the American College of Rheumatology (ACR), diagnostic criteria developed namely: malar rash, arthritis, photosensitive, kidney disorders (hematuria), immunological disorders (positive anti-dsDNA), and blood disorders (anemia, leucopenia). The result of the kidney’s biopsy indicated the patient already developed Lupus Nephritis.. The patient responded very well with corticosteroid. Although male patient with SLE is not commonly seen, the manifestations are life threatening and early detection of disease will lead to better outcome of the patient. Antimalaria drugs Hydrochloroquine is useful in patients with SLE glomerulonephritis. In consequences of their numerous beneficial effects, antimalarials appear to have a protective effect on survival in SLE.
Abstract: Systemic lupus erythematosus is a chronic autoimmune inflammatory disease that can affect any part of the body. Lupus Nephritis is one of the most common, and most important, serious manifestations of SLE particularly for male. We present a case of 15 year old male that is diagnosed with a systemic lupus erythematosus (SLE) based on 6 of the Americ...
Show More
