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Study of Prognostic Factors of Death in Children with Sickle Cell Diseases Followed at the Albert Royer National Children's Hospital Center, Dakar, Senegal
Boubacar Gueye,
Cheikh Tacko Diop,
Ndéye Marième Diagne,
Aminata Paye,
Ibrahima Diagne
Issue:
Volume 6, Issue 1, March 2020
Pages:
1-11
Received:
9 December 2019
Accepted:
2 January 2020
Published:
21 January 2020
Abstract: Objectives. The objectives of our study are: i) estimate the survival time of cases of sickle cell diseases monitored at the Albert Royer National Children's Hospital Center, Dakar, Senegal from 1990 to 2010, ii) identify prognostic factors related to deaths. Methods. Comprehensive and retrospective survival analysis of the prognostic factors of death of the 1650 patients with sickle cell disease followed in the sickle cell management unit of Albert Royer National Children's Hospital Center from January 1st, 1991 to December 31, 2010 (20 years). 17 variables were studied: gender, ethnicity, geographical origin, age of the patient at onset of the disease, age of the patient at onset of follow-up, number of vaso-occlusive crisis in the last year of follow-up duration of which is ≥72h, type of hemoglobinopathy, baseline hemoglobin level, fetal hemoglobin level at time of diagnosis, vaccination with at least one antigen, regular folic acid intake, regular penicillin intake, hydroxyurea therapy, acute complications (severe infections, severe anemia and serious vaso-occlusive accidents) in the last year of follow-up and chronic complications. The Cox model was used. Results. We conducted 1650 observations with 44 deaths, and a lethality of 2.6%. The death incidence rate is 3.51 deaths per 100 person-years. The Cox model highlighted the prognostic factors which significantly explain the model (p < 0.05). Vaccination with at least one antigen and the existence of chronic complications improved patient survival. However, the number of vaso-occlusive crisis in the last year of follow-up (duration is ≥72h), the existence of serious vaso-occlusive accidents in the last year of follow-up, the very low baseline hemoglobin level (≤5mg/100 mn), the early age of late follow-up (≥15 months) reduced patients survival. Conclusions. The prognosis of patients with sickle cell disease followed at the Albert Royer National Children's Hospital Center (ARNCHC) is difficult to establish. In fact, in addition to genetic, clinical and evolutionary factors, there are poorly understood environmental and socio-economic factors that affect survival. A prospective study would shed more light on the prognostic factors of death in children with sickle cell disease.
Abstract: Objectives. The objectives of our study are: i) estimate the survival time of cases of sickle cell diseases monitored at the Albert Royer National Children's Hospital Center, Dakar, Senegal from 1990 to 2010, ii) identify prognostic factors related to deaths. Methods. Comprehensive and retrospective survival analysis of the prognostic factors of de...
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Study of the Efficacy of Stimulation Physiotherapy in the Management of Severe Acute Malnutrition in Children Aged 6-59 Months in Bamako, Mali
Maty Diagne Camara,
Cheikh Tacko Diop,
Oumar Bassoum,
Jean Augustin Diégane Tine,
Mohamed Ibrahim Mahmoud,
Mamadou Makhtar Mbacké Leye,
Mayacine Ndiongue,
Kadim Niang,
Adama Faye
Issue:
Volume 6, Issue 1, March 2020
Pages:
12-21
Received:
7 January 2020
Accepted:
21 January 2020
Published:
31 January 2020
Abstract: The main objective of this study is to analyse the effects of stimulation kinesitherapy on psychomotor and cognitive development in these children followed by Severe Acute Malnutrition, aged 6 months to 59 months in the intensive nutritional educational recovery units. Prospective cohort study with 2 groups: one group subjected to stimulation Kinesitherapy and the other group without stimulation Kinesitherapy in six INERU in the District of Bamako. The population is represented by the children followed for Severe Acute Malnutrition, aged 6 months to 59 months in 6 of the 8 Bamako intensive nutritional educational recovery units of the "Strengthening Project intensive nutritional educational recovery units". The sampling is exhaustive, all children, aged 6 to 59 months, admitted to phase 2 of nutritional recovery between April 1, 2014 and July 15, 2017. The data collected includes socio-demographic, medical, psychomotor and anthropometric characteristics and physiotherapy sessions. Child development was measured using a child development assessment grid. An age-specific child development score was calculated. A bivariate analysis and a logistic regression were performed. The analysis covered 126 subjects in the group with kinesitherapy and 131 subjects in the group without Kinesitherapy. The psychomotor development score, weight/height ratio and developmental delay of the children after treatment were significantly improved in the group with stimulation Kinesitherapy compared to the group without stimulation Kinesitherapy (p<0.001). The children in the group without stimulation Kinesitherapy had 20.59 times more risk (OR=20.59 CI 6.05; 70.09) of having a developmental delay on Day 35 compared to the group with stimulation Kinesitherapy, after adjusting for age, developmental delay on Day 1, and the number of psychosocial stimulation sessions. Children with developmental delay on Day 1 were 4.16 times more likely (OR=4.16 CI 1.34; 12.90) to have a developmental delay on Day 35 compared to children without developmental delay on Day 1, after adjusting for age, physical stimulation therapy, and the number of psychosocial stimulation sessions. The anthropometric and psychomotor characteristics of the children after treatment were better in the Stimulation Kinesitherapy group, hence the need to reinforce stimulation and stimulation activities in the management of malnutrition in children aged 6-59 months.
Abstract: The main objective of this study is to analyse the effects of stimulation kinesitherapy on psychomotor and cognitive development in these children followed by Severe Acute Malnutrition, aged 6 months to 59 months in the intensive nutritional educational recovery units. Prospective cohort study with 2 groups: one group subjected to stimulation Kines...
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Prevalence of Electrocardiogram Abnormalities in Human Immunodeficiency Virus-Infected Children
Ni Luh Sri Apsari,
Eka Gunawijaya,
Ni Putu Veny Kartika Yantie,
Ketut Dewi Kumara Wati,
Komang Ayu Witarini,
Hendra Santoso
Issue:
Volume 6, Issue 1, March 2020
Pages:
22-26
Received:
17 December 2019
Accepted:
10 January 2020
Published:
7 February 2020
Abstract: HIV is an important cause of childhood morbidity and mortality affecting more than 1.3 million children worldwide, one of the morbidity is cardiac abnormalities. Cardiovascular abnormalities are still subclinical during childhood then become symtomatic in adulthood. Electrocardiography is effective to detect cardiac diseases. This study aimed to assess ECG changes in HIV infected children and describe ECG abnormalities in HIV-infected children with or without HAART. From 70 subjects, we found the most common abnormality was sinus tachycardia in 17 patients (24.3%), sinus bradycardia 1 patient (1.4%) and 2 patients with sinus arrhythmia (2.9%). The mean QTc interval was 0.42 seconds (±0.07) and 14 patients (20%) had prolongation. The mean PR interval was 0.12 seconds (±0.02), 11 patients (15.7%) experienced prolongation of PR interval. The mean QRS duration was 0.06 seconds (±0.09). Left ventricular enlargement was present in 6 patients (8.6%), conduction disturbance which is characterized by Bundle branch block was found in 2 patients (2.9%) and ST changes was seen in 2 patients (2.9%). Other ECG abnormalities are characterized by right ventricle hyperthropy in 4 patients and a patient had T tall. The prevalence of cardiac abnormalities based on ECG examination from this study was 51.3%, consist of heart rhythm abnormality, prolonged PR interval, prolonged QTc interval, bundle branch block, ventricle hypertrophy and ST changes.
Abstract: HIV is an important cause of childhood morbidity and mortality affecting more than 1.3 million children worldwide, one of the morbidity is cardiac abnormalities. Cardiovascular abnormalities are still subclinical during childhood then become symtomatic in adulthood. Electrocardiography is effective to detect cardiac diseases. This study aimed to as...
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Correlation Between Interleukin-6 Serum and Hepcidin Serum in Obese Children
Ni Komang Diah Saputri,
I Gusti Lanang Sidiartha,
I Made Gede Dwi Lingga Utama
Issue:
Volume 6, Issue 1, March 2020
Pages:
27-30
Received:
17 January 2020
Accepted:
6 February 2020
Published:
18 February 2020
Abstract: The number of obesity in children and adolescents is increasing. Obese children are believed to experience chronic inflammation as evidenced by high levels of inflammatory markers, especially interleukin-6 (IL-6). Obese children have high incidence of anemia caused by inflammatory process proven by high level of serum hepcidin. This study aimed to investigate correlation between interleukin 6 with serum hepcidin in obese children, aged 6-10 years old whom were recruited consecutively from elementary schools in Denpasar from November 2016 until April 2017. Obesity was established using the Body Mass Index (BMI) measurements based on the CDC 2000 chart. The correlation between serum IL-6 and serum hepcidin was tested by using pearson test. Fifty-eight subjects in this study had mean Body Mass Index (BMI) 27.3 kg/m2. The mean interleukin-6 level was 3.1 gr with standard deviation (SD) 2.9 gr. Mean level of serum hepcidin 20.5 ng/ml, standard deviation (SD) 12.5 ng/ml. Pearson’s analysis test showed strong positive correlation between IL-6 level and hepcidin serum level (r=0.748; p=0.0001). Multivariate analysis by using partial analysis showed hepcidin correlate with IL-6 serum and BMI (r=0.737 and p=<0.001; r=0.385 and p=0.004, respectively). Bivariate analysis with matrix correlation showed weak correlation between IL-6 serum and BMI (p=0.289; r=0.028). This study found that IL-6 serum had strong positive correlation with hepcidin serum in obese children.
Abstract: The number of obesity in children and adolescents is increasing. Obese children are believed to experience chronic inflammation as evidenced by high levels of inflammatory markers, especially interleukin-6 (IL-6). Obese children have high incidence of anemia caused by inflammatory process proven by high level of serum hepcidin. This study aimed to ...
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Lupus Nephritis in Children: 21-Year Experience of a Single Center in Belarus
Ina Kazyra,
Alexander Sukalo
Issue:
Volume 6, Issue 1, March 2020
Pages:
31-36
Received:
15 January 2020
Accepted:
10 February 2020
Published:
18 February 2020
Abstract: The article presents a historical and prospective analysis of the clinical and paraclinical data of a cohort of children suffering from systemic lupus erythematosus (SLE) with kidney damage, observed in a single center for 21 year. The case histories of 62 patients (51 girls and 11 boys) with a diagnosis of SLE and lupus nephritis (LN) who were monitored and treated at the Byelorussian Center for Pediatric Nephrology and Renal Replacement Therapy of the 2nd Children's Clinical Hospital in Minsk in the period from 1998 to 2019 yrs. We evaluated the initial manifestations of the disease, age of the onset, time of diagnosis (from the first symptom to the diagnosis), clinical manifestations at the time of diagnosis, the duration of SLE and treatment at the time of kidneys biopsy, as well as the activity of the disease. During the observation period (from 3 months up to 12 years) the frequency of extrarenal and renal exacerbations was analyzed, and the activity, treatment and outcome were evaluated. Male gender and early debut are factors worsening the prognosis of the disease (55% of boys showed progression of CRF). In children, the disease proceeds with a high degree of activity, rapid multi-organ involvement, requires more aggressive therapy with prescription of several immunosuppressive agents, which increases the risk of infection. Nephritis is an unfavorable prognostic criterion and is crucial in determining the volume of therapy for SLE. Noncompliance in therapy, social status were factors of an unfavorable outcome in children. Timely diagnosis and aggressive intervention to suppress the activity of the disease should be used to prevent chronic irreversible damage. Children with SLE and kidney damage are at high risk for early development of cardiovascular disorders. Steroid-sparing strategies must be actively implemented in clinical practice in order to prevent severe side effects.
Abstract: The article presents a historical and prospective analysis of the clinical and paraclinical data of a cohort of children suffering from systemic lupus erythematosus (SLE) with kidney damage, observed in a single center for 21 year. The case histories of 62 patients (51 girls and 11 boys) with a diagnosis of SLE and lupus nephritis (LN) who were mon...
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New Biomarkers in the Diagnosis of Kidney Injury in Children with Hereditary Nephritis and Tubulopaties
Hanna Bialkevich,
Ina Kazyra,
Alexander Sukalo
Issue:
Volume 6, Issue 1, March 2020
Pages:
37-41
Received:
15 January 2020
Accepted:
7 February 2020
Published:
18 February 2020
Abstract: The search of non-invasive methods of diagnosis of kidney disease, new biomarkers of injury and its level is very important at present time. Such markers are KIM-1 (kidney injury molecule - 1), TGF-β1 (transforming growth factor - β1), RBP (retinol-binding protein) and β2-MG (β2 – microglobulin). β2-MG and RBP are low molecular weight proteins which are rapidly filtered in the glomerulus and catabolized in the renal tubules after resorption by cells of proximal part. These proteins aren't reabsorbed and appear in the urine in the pathology of the tubules. This fact allows using β2-MG and RBP for diagnostics of injury of the proximal tubules. KIM-1 isn't detected in normal kidney tissue. However, the expression level of this biomarker increases significantly on the surface of the epithelial cells of the proximal tubules after ischemic or toxic damage of kidneys. For this reasons KIM-1 is an ideal markers of kidney injury and allows differentiating ischemic damage from prerenal azotemia and chronic kidney disease (CKD). TGF-β1 indicates endothelial dysfunction and fibroangiogenesis which are the basis of remodeling of the microvascular bed of the kidney in various kinds of glomerulopathies. The results of determination of concentration in serum and urine are presented in this article. The introduction of KIM-1, TGF-β1, RBP and β2-MG into clinical practice will expand the possibility of diagnosis of kidney diseases, allow non-invasive monitoring of progression and the effectiveness of nephroprotective therapy.
Abstract: The search of non-invasive methods of diagnosis of kidney disease, new biomarkers of injury and its level is very important at present time. Such markers are KIM-1 (kidney injury molecule - 1), TGF-β1 (transforming growth factor - β1), RBP (retinol-binding protein) and β2-MG (β2 – microglobulin). β2-MG and RBP are low molecular weight proteins whic...
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The Sensitivity and Specificity of Kuesioner Praskrining Perkembangan to Detect Delayed Development in Children
I. Gusti Ayu Trisna Windiani,
I Gusti Agung Ngurah Sugitha Adnyana,
Soetjiningsih
Issue:
Volume 6, Issue 1, March 2020
Pages:
42-45
Received:
2 February 2020
Accepted:
14 February 2020
Published:
21 February 2020
Abstract: Kuesioner Praskrining Perkembangan (KPSP) is Indonesian child development pre-screening questionnaire. One method that is very easy and quick to detect early developmental deviations is the pre-screening method. A pre-screening device must has validity, reliability, sensitivity, specificity, acceptability and suitability to local conditions. The accuracy of KPSP has not been assessed adequately. The aim of this study was to assess the sensitivity and specificity of KPSP as a prescreening tool for children development compare to Capute Scales. We conducted KPSP diagnostic study, using Capute Scales test as gold standard. Subjects were children aged 3 to 24 months old who came for routine vaccination in Public Healthcare Centre South Denpasar from March until May 2018. Inclusion criteria were children aged 3 to 24 months whom agreed to be participate, while the exclusion criteria were children with Down syndrome, congenital hypothyroid, cerebral palsy, autisms spectrum disorder or mayor congenital disorder. One hundred twenty-seven were included after the exclusion of 5 children who fulfilled the inclusion criteria. Kuesioner Praskrining Perkembangan (KPSP) had 75% sensitivity, 99.16% specificity, 85.71% positive predictive value (PPV) and 98.33% negative predictive value (NPV). Kuesioner Praskrining Perkembangan (KPSP) has good sensitivity and specificity to detecting developmental deviations in children with Capute Scales as the gold standard.
Abstract: Kuesioner Praskrining Perkembangan (KPSP) is Indonesian child development pre-screening questionnaire. One method that is very easy and quick to detect early developmental deviations is the pre-screening method. A pre-screening device must has validity, reliability, sensitivity, specificity, acceptability and suitability to local conditions. The ac...
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The Relation Between Maternal / Neonatal Vitamin D Levels and Early Onset Neonatal Sepsis
Dina Kamal Ali,
Iman Abdel Mohsen Shaheen
Issue:
Volume 6, Issue 1, March 2020
Pages:
46-51
Received:
12 January 2020
Accepted:
17 February 2020
Published:
26 February 2020
Abstract: In addition to its classical role in bone metabolism, vitamin D also has an immunomodulatory effects on immune function. Our aim was to determine the relation between serum 25-hydroxy vitamin D(25(OH)D) concentrations in newborns and their mothers with early onset neonatal sepsis (EOS). Also we aim to study the effect of severity of vitamin D deficiency on incidence of EOS. The design comprises a hospital- based case- control study. The study group consisted of 50 newborns with EOS who was admitted to neonatal intensive care unit and their mothers. Controls were 50 healthy newborns of the same age as the study group and their mothers. The study subjects were divided into insufficient, moderate and severe deficiency according to vitamin D level. There is no significant statistical difference between study and control groups in gestational week, birth weight, birth height, head circumference and age. The mean serum 25(OH)D concentrations in the study group newborns were significantly lower than those of the control group (11.58±4.883 ng/ml and 28.78±6.453 ng/ml respectively). The 25(0H)D concentrations of newborns were highly correlated with mothers’ serum in both groups. Severe vitamin D deficiency was significantly more common in the sepsis group. Data shows that 25(OH)D concentrations of the newborns were highly correlated with the level of CRP, duration of hospital stay, and complications caused by sepsis. Our findings suggest that newborns with vitamin D deficiency may have an increased risk of suffering from EOS. Newborns with more vitamin D deficiency were found to have higher CRP levels, a longer hospital stay, and a higher incidence of complications. The strong positive correlation between newborns’ and their mothers’ 25(OH)D concentrations makes that adequate vitamin D supplementation of mothers during pregnancy is of great importance, through a proper ante-natal care, especially in winter months.
Abstract: In addition to its classical role in bone metabolism, vitamin D also has an immunomodulatory effects on immune function. Our aim was to determine the relation between serum 25-hydroxy vitamin D(25(OH)D) concentrations in newborns and their mothers with early onset neonatal sepsis (EOS). Also we aim to study the effect of severity of vitamin D defic...
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Perinatal Outcome in Hypertensive Disorder of Pregnancy - A Retrospective Study from a Tertiary Care Teaching Hospital
Mustafa Captain,
Sanjay Natu,
Sameer Mhatre,
Anjali Parekh,
Manas Kumar Behera
Issue:
Volume 6, Issue 1, March 2020
Pages:
52-57
Received:
22 January 2020
Accepted:
18 February 2020
Published:
26 February 2020
Abstract: Hypertensive disorder of pregnancy (HDP) is a multisystem disorder of pregnancy known to jeopardize safe pregnancy thereby increasing the maternal and neonatal morbidity and mortality. A retrospective observational study of nine months duration was conducted to determine the fetal and early neonatal outcome in pregnancies complicated with HDP in a tertiary care hospital. Result: 163 women with HDP delivered during the study period. Out of total 163 births, perinatal deaths occurred in 18 (11.04%) cases, of which 10 (6.13%) were stillbirth and 8 (5.23%) were early neonatal death thus making a perinatal mortality rate of 110 per 1000 births. Low birth weight and preterm delivery occurred in 71 (43.56%) & 42 (25.77%) respectively. Amongst the 53 (32.52%) neonates who required admission to the NICU, 37 (69.8%) neonates had respiratory distress including 23 (43.4%) neonates’ requiring ventilatory support. Occurrences of adverse perinatal outcomes were significantly higher in eclampsia & preeclampsia as compared to gestational HTN except for metabolic abnormalities. Conclusion: There is a significant burden of perinatal mortality and morbidity more so with pre-eclampsia & eclampsia. The findings of this study can represent an evidence for healthcare providers and policy makers in devising more appropriate interventions for in utero transfer of women with HDP so as to improve perinatal outcomes.
Abstract: Hypertensive disorder of pregnancy (HDP) is a multisystem disorder of pregnancy known to jeopardize safe pregnancy thereby increasing the maternal and neonatal morbidity and mortality. A retrospective observational study of nine months duration was conducted to determine the fetal and early neonatal outcome in pregnancies complicated with HDP in a ...
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Antibiotic Prescription Pattern for Neonatal Sepsis at the University College Hospital, Ibadan; How Judicious
Olukemi Oluwatoyin Tongo,
Adeyemi Adeyinka Labaeka
Issue:
Volume 6, Issue 1, March 2020
Pages:
58-61
Received:
3 February 2020
Accepted:
14 February 2020
Published:
26 February 2020
Abstract: Multidrug-resistant bacterial infection is a global phenomenon and newborn units are not spared. Judicious use of antibiotics is one of the measures employed to curb the emergence of multidrug-resistant bacteria. It entails the use of empiric antibiotics based on knowledge of prevailing pathogens and antibiotic susceptibility patterns while awaiting the results of cultures. This retrospective review of records of 170 outborn neonates treated at the emergency room of the University College Hospital (UCH), Ibadan sought to determine indications for antibiotic therapy, the available supporting investigations and factors militating against the judicious use of antibiotics in newborns. The median age at presentation was three days. The majority (91.2%) were commenced on antibiotics on admission without any prior laboratory investigations. The indications for antibiotics were based on clinical signs only in 48% of cases, risk factors for sepsis with clinical signs in 42% of cases and no apparent reason in 6.8%. Lack of funds and logistic problems with the laboratory were the reasons for not conducting investigations before the commencement of antibiotics in 49.4% and 15.3% of cases respectively. Full blood count was eventually done in 32.9% of which a third were consistent with sepsis. Blood cultures were eventually done in 33.5% and positive in 5.3% of cases. Majority of newborns had empiric antibiotic therapy without the necessary laboratory back up due largely to financial constraints and other logistic issues with the laboratory. Inappropriate use of antibiotics in terms of initiation of empiric treatment, choice of drugs and failure to investigate as necessary was common.
Abstract: Multidrug-resistant bacterial infection is a global phenomenon and newborn units are not spared. Judicious use of antibiotics is one of the measures employed to curb the emergence of multidrug-resistant bacteria. It entails the use of empiric antibiotics based on knowledge of prevailing pathogens and antibiotic susceptibility patterns while awaitin...
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Neurotoxicity of Drugs in Children During Antenatal and Postnatal Development Periods
Sergey Postnikov,
Natalia Teplova,
Aleksey Ermilin,
Marya Kostyleva,
Anna Gratzhianskaya,
Galina Chervyakova,
Yulia Eremina
Issue:
Volume 6, Issue 1, March 2020
Pages:
62-67
Received:
8 November 2019
Accepted:
14 February 2020
Published:
28 February 2020
Abstract: Neurotoxicity is not rare and periodically severe and even life-threatening adverse effect (AE) of drugs belonging to many therapeutic groups. Manifestations of neurotoxicity are variable: disturbances of peripheral nervous system (ototoxicity and ophtalmotoxicity, visceral neuropathy, neuromuscular blockade), involving of central nervous system (CNS) (developmental brain malformations, seizures, impairment of consciousness, nonspecific encephalopathy). In the way of its consequences central nervous system damage is the most severe manifestation of drug neurotoxicity but the main predisposing factor is related to immature but growing intensively child brain of first years of life; the primary factor for neurotoxic effect is the capacity of drugs to transfer through brain-blood barrier and cumulate into CNS. The principal mechanism of neurotoxicity is dysfunction/apoptosis of nervous cells. Aim of this survey is to provide data and attract once again the professionals attention to the neurological complications of those drugs in the first place that are mainly targeted to the CNS effects (anticonvulsants, antidepressants, antipsychotic drugs, anesthetics) among the mostly sensitive groups – pregnant women, newborns, infants. Results. Based on analyzed data it was revealed high incidence of CNS complications both transient (seizures, temporarily impairment of consciousness) and persistent (developmental brain malformations, decrease of cognitive functions) in case of use of the drugs of current interest (anticonvulsants, antidepressants, antipsychotics, anesthetics (general and local), antibiotics) in risk groups – fetus, newborns, infants. Population risk of neurotoxicity includes also ethnic and genetic special features, renal and hepatic failure, background neuropsychic diseases except determined age groups. Conclusion. Neurotoxicity is one of the most severe manifestations of drug intolerance that depends on different aspects. The youngest targeted group is children of 0 – 3 years old due to their developmental immature brain and age-dependent specific characteristics of pharmacodynamics and pharmacokinetics that could result in drug overdose as a particular case of neurotoxicity due underestimation of the mentioned above factors.
Abstract: Neurotoxicity is not rare and periodically severe and even life-threatening adverse effect (AE) of drugs belonging to many therapeutic groups. Manifestations of neurotoxicity are variable: disturbances of peripheral nervous system (ototoxicity and ophtalmotoxicity, visceral neuropathy, neuromuscular blockade), involving of central nervous system (C...
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Experience of Treating Acute Appendicitis in Tashkent
Akilov Khabibullo Ataullayevich,
Urmanov Nozim Tursinaliyevich,
Primov Farhod Sharifjonovich,
Djurayev Jurat Atkhamovich,
Yuldashev Tolib Akromovich,
Khidoyatov Komronbek Zaynitdinovich
Issue:
Volume 6, Issue 1, March 2020
Pages:
68-72
Received:
20 January 2020
Accepted:
17 February 2020
Published:
28 February 2020
Abstract: Modern diagnostics of acute appendicitis in children should include abdominal ultrasound investigation upon admission to a specialized hospital, if necessary, in an ultrasound monitoring mode during clinical dynamic observation of the child. Surgical treatment is indicated only for destructive appendicitis. The method of a surgical treatment choice is laparoscopic surgery including destructive appendicitis complicated by appendicular peritonitis. Surgeries in acute appendicitis make up 75% of all emergency surgical interventions. Annually only in the Republican Research Centre of Emergency Medicine 700 appendectomies in children are made on average. The article summarizes data obtained in the retrospective analysis of case histories of 6 256 patients with acute appendicitis and its complications who were hospitalized in the pediatric department of emergency surgery for 12 years. The following incidence of acute appendicitis in children is reported: from 1 to 3 years old - 0.6 per 1 000; from 4 to 7-1.4 - 2.6 per 1 000; 13 years of age - 8 per 1 000. The authors discuss specific features in the clinical picture of acute appendicitis in children depending on patient’s age and anatomical location of the appendix. The clinical picture in children of older age and of the first three years of life is discussed separately. Among 6 256 pediatric patients with acute appendicitis 72 (1.15%) were children younger than 3 years. The authors have substantiated a complex of diagnostic and therapeutic manipulations as well as tactic options to the treatment of this category of patients. Widespread implementation of the laparoscopic technique into surgical practice has significantly changed the tactics of treatment. The number of surgeries for simple appendicitis in children has decreased up to 3.9-7%.
Abstract: Modern diagnostics of acute appendicitis in children should include abdominal ultrasound investigation upon admission to a specialized hospital, if necessary, in an ultrasound monitoring mode during clinical dynamic observation of the child. Surgical treatment is indicated only for destructive appendicitis. The method of a surgical treatment choice...
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Haptoglobin Polymorphism and Morbidity in Children Born Prematurely
Irena Kessel,
Michal Molad,
Rada Nemirovsky,
Keren Lavie-Nevo,
Andrew Peter Levy,
Shany Blum,
Avi Rotschild
Issue:
Volume 6, Issue 1, March 2020
Pages:
73-77
Received:
26 January 2020
Accepted:
24 February 2020
Published:
28 February 2020
Abstract: Haptoglobin (Hp) is an acute phase protein. There exists three different Hp phenotypes that differ in their pro-inflammatory and anti-inflammatory action. Inflammation and oxidative stress are critically involved in many pathophysiological processes in childhood. We previously reported on the relationship of in-hospital clinical events and the Hp phenotype in a cohort of consecutive premature infants. This study provides follow up of childhood morbidity data and its relationship to the Hp phenotype for the previously reported study premature infant cohort. A phone questionnaire was carried out among the parents and medical history records were evaluated. The age of participants varied from eight to eleven years. The questionnaire included information about diseases with an inflammatory component in pathogenesis, infections and need for hospitalization. Of the original 122 study participants, morbidity data at eight to eleven years was available for 101 participants, and 100 were enrolled in the study. A less anti-inflammatory Hp phenotype (Hp 2-2) was more prevalent in participants who suffered from diseases with an inflammatory component in their pathogenesis (RTI, pneumonia, UTI, OM and tonsillitis) when these entities were analyzed as a group (p=0.043). Subsequent comparison of the cumulative number of episodes of these entities between Hp phenotypes during all follow up period detected a trend in the same direction. Further research involving a larger population is required for better understanding of the Hp phenotype role in infantile and pediatric morbidity.
Abstract: Haptoglobin (Hp) is an acute phase protein. There exists three different Hp phenotypes that differ in their pro-inflammatory and anti-inflammatory action. Inflammation and oxidative stress are critically involved in many pathophysiological processes in childhood. We previously reported on the relationship of in-hospital clinical events and the Hp p...
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