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A Determination of the Serum Ascitic Fluid Albumin Concentration Gradient in Children with Chronic Liver Disease and Nephrotic Syndrome
Md. Zakaria,
ASM Bazlul Karim,
Mohammad Monir Hossain,
Md. Wahiduzzaman Mazumder,
Md. Mostafa Zaman,
Nadira Parvin
Issue:
Volume 6, Issue 4, December 2020
Pages:
386-391
Received:
5 February 2020
Accepted:
23 April 2020
Published:
30 September 2020
Abstract: This prospective cross sectional study was carried out in the Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital and Dhaka Shishu Hospital, Dhaka for a period of one year and six months starting from July 2012 to December 2013. The main objective of the study was to determine the serum ascitic fluid albumin concentration gradient in children with chronic liver disease and nephrotic syndrome. A total of 55 children were studied. Among them, 31 children with chronic liver disease with ascites were designated as Group I and rest 24 nephrotic syndrome children with ascites were designated as group II. The mean age of the children was 8.3±3.6 years ranging from 1.0-15.0 years. The mean age of the male patient was 8.0±3.6 years and that of female patients was 9.3±3.5 years. No statistically significant mean age difference was found between male and female patients (p>0.05), although female patients had a bit higher mean age than male patients. The mean age of the group I patients was 9.2±3.7 years ranging from 1.0-14.0 years and group II patients was 7.2±3.2 ranging from 2.0 to 15.0 years and the mean age difference between two groups patients was statistically significant (p<0.05) indicated that patients with chronic liver disease had higher age than patients with nephrotic syndrome. Chronic liver diseases patients where liver biopsy could not be performed to ascertain the exact nature of the disease were labeled as unclassified chronic liver disease. The aetiology of chronic liver diseases of the group I patients. Out of 31 patients, highest percentage of patients were of unknown etiology 17 (54.9%) followed by hepatitis B virus 7 (22.6%) and Wilson’s disease 5 (16.1%). It was evident that 24 (77.4%) had serum bilirubin >1.2 mg/dl, serum ALT >40 IU/L was 25 (80.6%), prothrombin time more than 3 second than control 23 (74.2%) and serum albumin less than 3.5 mg/dl was 24 (77.4%). The mean serum albumin was 2.8±0.5 mg/dl in group I patients and 1.7±0.4 mg/dl in group II patients. The albumin in ascitic fluid was 1.2±0.4 mg/dl in group I patients and 0.9±0.3 mg/dl in group II patients. Similarly, serum-ascites albumin gradient was 1.6±0.5 in group I and 0.8±0.2 in group II. It was evident that mean serum albumin, ascetic albumin as well as serum-ascites albumin gradient was significantly higher among the group I patients compared to group II patients (p<0.001).
Abstract: This prospective cross sectional study was carried out in the Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital and Dhaka Shishu Hospital, Dhaka for a period of one year and six months starting from July 2012 to December 2013. The main objective of the study was to determine the serum ascitic flu...
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The Prevalence and Risk Factors of Sleep Disorders Among Adolescent in Junior High School
Defranky Theodorus,
I Gusti Ayu Trisna Windiani,
I Gusti Agung Ngurah Sugitha Adnyana,
Soetjiningsih
Issue:
Volume 6, Issue 4, December 2020
Pages:
392-396
Received:
20 September 2020
Accepted:
30 September 2020
Published:
13 October 2020
Abstract: Sleep disorders are collection of symptoms characterized by disruption of amount, quality, or time of sleep. Adolescent are high-risk group for sleep disorders. Sleep disorders among adolescent are affected by various factors such as extracurricular activities, watching television, using computer, using mobile phone and homework could delay sleeping time. This study aimed to find the prevalence and risk factors of sleep disorders among adolescent in Junior High School. It was a cross-sectional study among students in St. Joseph Junior High School, Denpasar aged 12-15 years old in August 2019, by using stratified purposive sampling. Data was collected by using Sleep Disturbance Scale for Children (SDSC) which was filled by parents and children. Chi-square test and logistic regression were used for statistical analysis. This study showed the prevalence of sleep disorders was 47.8%. Disturbance with initiating and maintaining sleep was the most common disorder, 22.8%. Watching television, using computers and playing telephone / gadgets were associated with increased sleep disturbance (p=0.02, PR 3.17, CI 95% 1.17-8.59), (p=0.02, PR 2.64 CI 95% 1.14-6.14), (p=0.02, PR 2.94, CI 95% 1.12-7.7), while extracurricular activities, nap habits, caffeine consumption were not risk factors, (p=0.07, PR 2.3, CI95% 0.94-5.95), (p=0.28, PR 1.57 CI 95% 0.68-3.58), (p=0,78, PR 0.89, CI 95% 0.38-2.03). The prevalence of sleep disorder among adolescent was considerably high. Risk factors of sleep disorder were watching television, using computer, and using mobile phone/gadget.
Abstract: Sleep disorders are collection of symptoms characterized by disruption of amount, quality, or time of sleep. Adolescent are high-risk group for sleep disorders. Sleep disorders among adolescent are affected by various factors such as extracurricular activities, watching television, using computer, using mobile phone and homework could delay sleepin...
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The Impact of Combined Steroid-propranolol Therapy on the Involution of Infantile Hemangioma
Mosaad Abdel Hameed Soliman,
Khalid Abdel Aziz Mowafy,
Mohamed Adel Abdel Maksoud,
Amr Mostafa Elshafey,
Nashaat Abdrabo Elsaadany,
Reem Mosaad Soliman
Issue:
Volume 6, Issue 4, December 2020
Pages:
397-407
Received:
17 September 2020
Accepted:
7 October 2020
Published:
17 October 2020
Abstract: Infantile hemangioma (IH) is the most common benign vascular neoplasm of infancy, occurring in 1.0–2.5% of white infants, especially girls. Steroids and propranolol are the most widely used drugs as a primary treatment for IH. Although their mechanism of action is not well understood, their beneficial effect is documented. Our purpose was to compare the clinical efficacy of propranolol alone and propranolol combined with steroids on the outcome of IH. A total of 450 children (median age: 9 months; range: 7 days to 3 years) were included in this randomized controlled study, being treated with combined steroid and propranolol (Group A: 230 children) compared to those treated with propranolol plus placebo (Group B: 220 children). The steroid was given as a loading dose of 2–3 mg/kg/day and then gradually tapered over 6 months, whereas propranolol was given as an incremental dose starting at 0.16 mg/kg/day and reaching a maximum of 2 mg/kg/day maintained for 18 months (duration of therapy). Frequent monitoring of the blood sugar level was mandatory in the first 2 months: electro- and echocardiograms were recorded initially but not repeated. A more rapid involution rate, recognized by color fading and flattening of the lesions, was noted in Group A compared to Group B, with the peak response reached after 10 months of therapy followed by a slower but steady rate of further improvement. No major adverse effects were observed in Group A with regard to hypoglycemia or hypotension. On the other hand, ten cases of vomiting and diarrhea, one case of fungal infection and twelve cases of somnolence and fatigue were observed in Group B. Steroid induction seems to cover the gap at initiation of therapy where propranolol cannot be given as a full dose, especially in neonates. Steroid combination minimizes the adverse effects of propranolol, namely, hypoglycemia, hypotension and bradycardia. Children treated with a combined regimen showed more effective clearing of lesions, were less likely to require surgery for residual lesions and had minimal adverse effects compared to the single-drug group. In both groups there was a faster clearing rate for the head and neck lesions than elsewhere in the body, which can be explained by the higher blood flow to this region, magnifying the level of medication to these lesions and achieving a better response.
Abstract: Infantile hemangioma (IH) is the most common benign vascular neoplasm of infancy, occurring in 1.0–2.5% of white infants, especially girls. Steroids and propranolol are the most widely used drugs as a primary treatment for IH. Although their mechanism of action is not well understood, their beneficial effect is documented. Our purpose was to compar...
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The Impacts of Home Confinement Due To Coronavirus (COVID-19) on Children: A Cross Sectional Survey Study, Mediclinic City Hospital, Dubai, UAE
Sam Hassan,
Mary Saviour,
Sanjay Perkar,
Tessy Augustine,
Samie Ullah Ahmed,
Bindu Radhadevi,
Shaheena Batool,
Rawan Abunqira,
Erica Delos Santos,
Helen Strike,
Manal Blelepsm
Issue:
Volume 6, Issue 4, December 2020
Pages:
408-420
Received:
20 September 2020
Accepted:
7 October 2020
Published:
17 October 2020
Abstract: Children are developing individuals with countless factors affecting their growth and development, from genetics to parenting, schools, environments, nutrition, good habits of sleep and health. They are very sensitive individuals to sudden changes in routine. Schools represent life for them and a place of not only learning, but also social interaction and sensory neurodevelopment. Disasters and pandemics such as the existing situation of COVID-19 are a major cause of trauma affecting their education, play, mental health, physical health, vaccinations, sleep, and development. The governments’ strategies particularly home confinement and school closure to prevent the COVID-19 pandemic spread added unavoidable stress and psychosocial impacts on both adults and children. Trauma of this kind may endure for a long time with negative consequences that may manifest later on, even up to adult life. We conducted a cross sectional parental survey, to assess the impacts of home confinement on children in the cosmopolitan city of Dubai, UAE. Children included were from 3 years until 16 years old who were in schools or pre-school placements before COVID-19 started. Total number of children included in the survey was 658 of which 327 were boys and 331 girls. We found that the impact of the home confinement on children was significant and directly affected their quality of life (QoL) that may extend beyond the lockdown for longtime. This study will help relevant authorities and organizations to understand the negative impacts brought by the COVID-19 confinement on children and to adopt appropriate strategies to help children and their parents tackle these impacts and get them back to normal life and school again. This study also paved the way for future studies in the identification and management of children’s behavior, attention, education, and other factors that play active roles in QoL and normal development. Moreover, this study may help in embracing early preventative and management plans by schools and authorities in future similar pandemics, infections, disasters or school outbreaks. We also discuss strategies for school reopening and flexibility when an outbreak happens again in a school or community.
Abstract: Children are developing individuals with countless factors affecting their growth and development, from genetics to parenting, schools, environments, nutrition, good habits of sleep and health. They are very sensitive individuals to sudden changes in routine. Schools represent life for them and a place of not only learning, but also social interact...
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Prevalence of Adverse Childhood Events (ACEs) and Its Relationships to Life-Satisfaction Among Patients with Psychiatric Disorders
Issue:
Volume 6, Issue 4, December 2020
Pages:
421-427
Received:
23 September 2020
Accepted:
7 October 2020
Published:
17 October 2020
Abstract: Objective: To demonstrate the prevalence of ACEs and the association of ACEs’ effects on life- satisfaction among patients with psychiatric disorders. Methods: Patients with psychiatric disorders aged ≥ 18 were enrolled. Patients who had dementia and could not read or write in Thai were excluded. Patients were asked to complete demographic, ACEs, and life-satisfaction questions. The study was held in a psychiatric clinic with prompt intervention to help patients who might be sensitive to ACEs questions. Results: 271 patients, with a mean age of 37.6 years (range 18-80 yr.) completed questionnaires. 66.8% were males. 59.4% of patients suffered from substance related disorders. Overall, 45% of patients had ≥ 1 ACE and of these, 5.5% had ≥ 4 ACEs. The top three ACEs were feelings of abandonment by a family, parents divorced or separated, and being a witness of domestic violence. After adjusted confounders, ACEs could significantly increase feeling bored with life; feelings of failure; and feelings of suffering in life; and significantly decrease feelings of life-satisfaction; feelings of ease and happiness; feeling safe; and feeling love in a family; feeling of accepting; and handling of difficult situations. The protective factors of ACEs were living with both parents, living with either of them, and living in a family that could support each other during difficulties. Conclusion: The prevalence of ACEs among patients with psychiatric disorders is quite common. ACEs showed negative relationships with later life-satisfaction and happiness. The graded negative relationships of ACEs to life-satisfaction found at every ACE that increases. Solutions to decrease the impacts of ACEs are to promote parents to live with their children during their childhood periods and to strengthen family relationship to support each other during difficulties.
Abstract: Objective: To demonstrate the prevalence of ACEs and the association of ACEs’ effects on life- satisfaction among patients with psychiatric disorders. Methods: Patients with psychiatric disorders aged ≥ 18 were enrolled. Patients who had dementia and could not read or write in Thai were excluded. Patients were asked to complete demographic, ACEs, a...
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Generalized Tetanus in an 8-Years-Old Boy: A Case Report
Katharina Yosephin Lakonawa,
I Made Gede Dwi Lingga Utama,
I Wayan Gustawan
Issue:
Volume 6, Issue 4, December 2020
Pages:
428-432
Received:
21 September 2020
Accepted:
7 October 2020
Published:
23 October 2020
Abstract: Nowadays tetanus is a rare disease in developed countries due to the success of immunization, but children who were not immunized are still at risk. Awareness of early clinical symptoms of tetanus is crucial since the diagnosis is based on clinical symptoms. Severe tetanus can occur and lead to sequelae if there was no timely diagnosis and proper treatment. This case report aimed to emphasize the importance of recognizing early symptoms of tetanus and immunization. An 8 year old boy complained stiffness all over his body since 4 days before admission to hospital. Stiffness was started with pain on his back and stomach since 7 days before admitted, 3 days later his neck and back became stiff and got worsen until his mouth became stiff too. His left toe was pricked by a plant thorn about 3-4 weeks before admission. Physical examination showed risus sardonicus, trismus, stiff hands and opisthotonus. He didn’t get complete immunizations. He was admitted in Pediatric Iintensive Care Unit (PICU) with Human Immunoglobulin, metronidazole, and diazepam. He was treated for 14 days and given Td vaccine before discharged. He underwent physiotherapy in medical rehabilitation department for 1 month because of persisting stiffness in his legs and arms. The diagnosis of tetanus was made based on clinical findings. There was no laboratory test to confirm it. Without timely diagnosis and proper treatment, severe tetanus can be fatal causing sequelae. Tetanus treatment follows several principles such as initial stabilization, maintainance of airway, prevent absorption of tetanospasmin, eradicating organism and supportive therapy. Management of tetanus takes a long time because the irreversible bound of toxin to tissues. It takes 4-6 weeks for the growth of new nerve terminal which is required in recovery period. So it is very important to recognize the symptoms of tetanus and treat it immediately to prevent more toxin bind to neuron.
Abstract: Nowadays tetanus is a rare disease in developed countries due to the success of immunization, but children who were not immunized are still at risk. Awareness of early clinical symptoms of tetanus is crucial since the diagnosis is based on clinical symptoms. Severe tetanus can occur and lead to sequelae if there was no timely diagnosis and proper t...
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Beckwith-Wiedemann Syndrome: A Case Report at the Gynaeco-Obstetric and Pediatric Hospital in Yaounde, Cameroon
Daniel Armand Kago Tague,
Evelyn Mah,
Félicitee Nguefack,
Georges Pius Kamsu Moyo,
Lionel Loic Kago Tcheyanou,
Faustin Mouafo
Issue:
Volume 6, Issue 4, December 2020
Pages:
433-436
Received:
28 September 2020
Accepted:
15 October 2020
Published:
23 October 2020
Abstract: Beckwith-Wiedemann syndrome is a rare congenital syndrome, but one of the most common among overgrowth syndromes. It was described firstly by Beckwith in 1963. The incidence of BWS is about 1:13 700 births, with an equal sex distribution. It is characterized by macrosomia, macroglossia, omphalocele and anterior abdominal wall defects. It is a complex multigenic disorder caused by dysregulation of the gene printed on chromosome 11p. 15. A relationship has been established between assisted fertilization methods and its occurrence. This syndrome predisposes to childhood cancer. Its incidence is not known in developing countries such as Cameroon due to the rarity of reported cases, variability in the presentation of the syndrome, financial constraints and lack of access to genetic and molecular studies. In our opinion, we are reporting the first case of Beckwith-Wiedemann syndrome in our country. We present here the case of a newborn female baby delivered at the gyneco-obstetric and pediatric hospital in Yaoundé and admitted to our neonatology unit. The diagnosis was made on the basis of clinical signs suggestive of Beckwith-Wiedemann syndrome. She presented an omphalocele diagnosed on antenatal ultrasound, macrosomia, macroglossia and ear abnormalities. The case is presented to raise awareness and highlight the particularity of the management of this rare disease.
Abstract: Beckwith-Wiedemann syndrome is a rare congenital syndrome, but one of the most common among overgrowth syndromes. It was described firstly by Beckwith in 1963. The incidence of BWS is about 1:13 700 births, with an equal sex distribution. It is characterized by macrosomia, macroglossia, omphalocele and anterior abdominal wall defects. It is a compl...
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Characteristics of Pseudomonas Aeruginosa Infection in Pediatric Patients Treated in Sanglah General Hospital Denpasar During Period February 2017 - May 2019
Ida Ayu Putu Purnamawati,
I Wayan Gustawan,
I Made Gede Dwi Lingga Utama,
Ni Made Adi Tarini
Issue:
Volume 6, Issue 4, December 2020
Pages:
437-441
Received:
6 October 2020
Accepted:
17 October 2020
Published:
23 October 2020
Abstract: Health-care-associated infections is one of the causes of high mortality among inpatient children. Globally, prevalence nosocomial infection are 8.7%. In Indonesia, prevalence of nosocomial infection at 2014 are 148.703 cases. One of the Gram negative pathogen that has been known can cause nosocomial infection is Pseudomonas aeruginosa. This study aims to know patient characteristic with P. aeruginosa infection at Sanglah Hospital. This research is descriptive study with a cross-sectional approach conducted in Sanglah Hospital, Denpasar. The study used secondary data from medical records of pediatric patients who were proven to have P. aeruginosa infection through microbiological examination while undergoing treatment at Sanglah hospital in the period of Februari 2017- Mei 2019. Incomplete medical record data were excluded from the study. There were 30 children with positive blood culture P. aeruginosa. Most of them were male (17/30), with underlying disease pneumonia (13/30), length of stay before infection 16,8 days, total length of stay 28,5 day. Most patients died (19/30). 7 patients had history positive blood culture before P. aeruginosa infection. 29 patients using peripheral intravenous line (mean 22.5 day). Most patients were sensitive to Cefepime (80%) and resistant to Ampicilin Sulbactam (80%). Characteristic patients with Pseudomonas aeruginosa infection mostly were male, with underlying disease pneumonia, using medical device peripheral line, and died. Most of them were sensitive to Cefepime and resistant to Ampicilin Sulbactam.
Abstract: Health-care-associated infections is one of the causes of high mortality among inpatient children. Globally, prevalence nosocomial infection are 8.7%. In Indonesia, prevalence of nosocomial infection at 2014 are 148.703 cases. One of the Gram negative pathogen that has been known can cause nosocomial infection is Pseudomonas aeruginosa. This study ...
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Outcome Comparison Between Pulmonary and Extrapulmonary Acute Respiratory Distress Syndrome in Pediatric Intensive Care Unit
Ni Made Reditya Noviyani,
Ida Bagus Gede Suparyatha,
Dyah Kanya Wati,
I Nyoman Budi Hartawan
Issue:
Volume 6, Issue 4, December 2020
Pages:
442-447
Received:
9 October 2020
Accepted:
22 October 2020
Published:
30 October 2020
Abstract: Acute respiratory distress syndrome (ARDS) is a lung disease characterized by severe diffuse inflammation and hypoxemia. The cause of ARDS can be pulmonary or extrapulmonary originated. The outcome of pulmonary and extrapulmonary pediatric ARDS are poorly described. The objective of this study was to determine the outcome differences between pulmonary and extrapulmonary pediatric ARDS. A retrospective study was carried out in 60 patients who admitted to the Pediatric Intensive Care Unit (PICU), Sanglah Hospital, between January 2018 until December 2019. All children aged 0-18 years old diagnosed with ARDS according to Pediatric Acute Lung Injury Consensus Conference (PALICC) criteria were included in this study. Length of ventilation, ventilator-free days, PICU length of stay, and PICU mortality as the outcome of this study were obtained from medical records. Statistical analysis was done using Chi-square and Mann-Whitney test. Most of the patients were supported by invasive ventilation with the severity of ARDS was mild to moderate. The underlying disease of pulmonary ARDS (ARDSp) was pneumonia (100%), whereas in extrapulmonary ARDS (ARDSexp) was sepsis (100%). Analysis of outcome showed significant difference in mortality (33.3% vs 73.3%, p=0.002). The mortality was higher among those in the moderate severity of oxygenation index (64.5%, p=0.001). No significant difference was found in length of ventilation and PICU length of stay. The ventilator-free days in ARDSp was higher (22 days vs 0 days, p=0.000) compared with the ARDSexp. This study concluded that patients with extrapulmonary ARDS had poorer outcomes (higher mortality and less ventilator-free day) compared with pulmonary ARDS. The severity of ARDS based on the oxygenation index measurement can be used to discriminate mortality.
Abstract: Acute respiratory distress syndrome (ARDS) is a lung disease characterized by severe diffuse inflammation and hypoxemia. The cause of ARDS can be pulmonary or extrapulmonary originated. The outcome of pulmonary and extrapulmonary pediatric ARDS are poorly described. The objective of this study was to determine the outcome differences between pulmon...
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A Clinical Profile and Immediate Outcome of Acute Glomerulonephritis (AGN) in Hospitalized Children
A. N. M. Shahidul Islam Bhuiyan,
Zahangir Alam,
Khondaker Zahirul Hasan,
Md Mostafa Zaman,
Md Zakaria
Issue:
Volume 6, Issue 4, December 2020
Pages:
448-454
Received:
26 July 2020
Accepted:
13 October 2020
Published:
4 November 2020
Abstract: Introduction: Acute glomerulonephritis includes renal diseases in which immunologic mechanism triggers inflammation and proliferation of glomerular tissue that can result in damage to the basement membrane, proliferation of mesangium, capillary endothelium. Objectives: The objective of this study is to know the clinical profile and immediate outcome of acute glomerulonephritis in hospitalized children. Material & Methods: The study was done in Chittagong Medical College Hospital Pediatric Unit during the period of June 2007 to February 2008. All patients admitted with AGN, with or without complications were included in this study. Diagnostic criteria were scanty urine (infrequent and less than normal in amount as stated by the parents), swelling, high colored urine with or without albuminuria, no past history of similar attack and microscopic or naked eye haematuria. Criteria of discharge from the hospital were absence of puffiness and oedema, adequate urine formation, absence of heart failure and hypertensive encephalopathy. These were taken as clinical recovery. No long-term follow up was done. Results: Seventy-eight cases of acute glomerulonephritis (AGN) in children under 12 years of age were studied. Male to female ration 3:2. Scanty urine (84.0%), puffy face (88.5%) h, haematuria (80.0%), hypertension (82.5%), heart failure (11.5%) convulsion (14%) anuria (3.8%), RBC (92.3%), RBC cast (41%), albumin one (+) (52.6%) two + (14.1%) three + (14.1%), raised s. creatinine was (25.6%), blood urea (26.9%). Four patients were died. Among them three was due to hypertension and heart failure. One due to the development of acute renal failure. History of skin infection like scabies was present in 61.4% patient. Conclusion: Skin infection is the commonest cause of acute glomerulonephritis. Nephritic presentation (scanty urine oedema, haematuria, hypertension and heart failure) was the commonest mode of presentation. Immediate prognosis was excellent- Long term follow up is recommended.
Abstract: Introduction: Acute glomerulonephritis includes renal diseases in which immunologic mechanism triggers inflammation and proliferation of glomerular tissue that can result in damage to the basement membrane, proliferation of mesangium, capillary endothelium. Objectives: The objective of this study is to know the clinical profile and immediate outcom...
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Pyloric Duplication in Ten Years Old Girl: A Case Report
Ni Made Reditya Noviyani,
Ni Nyoman Metriani Nesa,
I Gusti Ngurah Sanjaya Putra,
I Putu Gede Karyana,
Kadek Deddy Ariyanta,
I Made Darmajaya,
Pande Putu Yuli Anandasari,
Ni Wayan Winarti
Issue:
Volume 6, Issue 4, December 2020
Pages:
455-458
Received:
10 October 2020
Accepted:
26 October 2020
Published:
9 November 2020
Abstract: Gastrointestinal duplication cysts are rare congenital anomalies. Pyloric duplication represents 2.2% of all gastrointestinal tract duplications. The presentations merely depend on the site of occurrence, size and type of the cyst, and presence of ectopic mucosal lining. A ten years old girl vomited for two months, accompanied with stomach ache and difficulty in defecation. The color of stool sometimes was black. The body weight decreased twelve kilograms in two months. On physical examination, no abdominal distention and no palpable mass was found, bowel sound was decreased and there was tenderness in epigastric area. Nutritional status of patient was severe malnutrition. Laboratory test revealed mild hypochromic microcytic anemia, severe hyponatremia, severe hypokalemia, and hypoalbuminemia. Abdominal ultrasound revealed thickening of the gastric wall and upper gastrointestinal contrast study revealed partial stenosis with thickening of pyloric wall. Esophagogastroduodenoscopy revealed multiple gastric ulcers and gastric outlet obstruction. Cyst duplication and stricture in the pylorus were found during surgical procedure. The pediatric surgeon performed an excision of duplication cyst and gastroduodenostomy side to side anastomosis. Histopathologic examination from cyst confirmed the enteric duplication cyst. The patient was discharged in good condition. We concluded that pyloric duplication is considered as one of the differential diagnosis in children with symptoms of gastric outlet obstruction. Appropriate surgical procedures should be undertaken to avoid complications.
Abstract: Gastrointestinal duplication cysts are rare congenital anomalies. Pyloric duplication represents 2.2% of all gastrointestinal tract duplications. The presentations merely depend on the site of occurrence, size and type of the cyst, and presence of ectopic mucosal lining. A ten years old girl vomited for two months, accompanied with stomach ache and...
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The Quality of Life in Children with Hemophilia in Bali
I Gusti Ayu Trisna Windiani,
Putu Antara,
Soetjiningsih,
I Gusti Agung Ngurah Sugitha Adnyana,
Ketut Ariawati
Issue:
Volume 6, Issue 4, December 2020
Pages:
459-462
Received:
4 March 2020
Accepted:
15 September 2020
Published:
11 November 2020
Abstract: Hemophilia in children adversely affects both their psychological as well as their physical health. It is important to understand more about the quality of life (QoL) in this patient population. The aim of this study was to assess health-related QoL of children with hemophilia in Bali. A cross sectional study was carried out on children with hemophilia in Bali. Data on the quality of life was collected through questionnaires using PedsQL Generic Core Scales version 4.0 inventory. Independent t test was used to analysis data. Child reports showed mean score on each domain function (physical, emotional, social and school function) in hemophilia group compared to healthy children group were 71.8 vs 97.9, 81.4 vs 94.5, 85.0 vs 97.5, and 73.1 vs 94.5, respectively. Parent-proxy reports showed mean scores on each domain function (physical, emotional, social, and school function) in hemophilia group compared to healthy children group were 73.3 vs 97.3, 79.5 vs 94.5, 80.2 vs 97.5, and 67.4 vs 89.8, respectively. Total PedsQL score in hemophilic children and healthy group showed a significant difference in both reports (child report; p<0.05, with the mean difference was -18.7 with 95% CI of -25.9 to -13.6 and parent-proxy report; p<0.05 the mean difference was -19.8 with 95% CI of -25.9 to -13.5). Hemophilia has a negative impact on the children’s daily life. Hemophilia group reported poor quality of life as regards the physical, emotional, social, school functioning domains, and total quality of life than healthy children group.
Abstract: Hemophilia in children adversely affects both their psychological as well as their physical health. It is important to understand more about the quality of life (QoL) in this patient population. The aim of this study was to assess health-related QoL of children with hemophilia in Bali. A cross sectional study was carried out on children with hemoph...
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Correlation of Occipito-Frontal Circumference and Occipito-Heel Length with Birth Weight of Singleton Term Babies in Enugu, South East, Nigeria
Ozor Ignatius Ikemefuna,
Nduagubam Obinna Chwukwuebuka,
Okafor Igwebuike Innocent,
Agwagu Zita Njideka,
Abireh Ifeanacho Ezeteonu,
Ozioko Sebastine Uche,
Ugwuanyi Obinna Kingsley
Issue:
Volume 6, Issue 4, December 2020
Pages:
463-467
Received:
4 August 2020
Accepted:
18 August 2020
Published:
19 November 2020
Abstract: Background: Anthropometric measurements of the new-borns are important indicators of their intra-uterine growth and development; and could be reliable predictors of their health status. This study was carried out to determine the relationships between occipito-frontal head circumference and occipito-heel length to the birth weight of singleton term newborns in ESUTH, Enugu. Methods: A total of 1000 (500 males and 500 females) live singleton term babies whose mothers gave consent for participation and satisfied the inclusion criteria were consecutively recruited from the labour ward of ESUTH, Enugu from June 1, 2015 to May 31, 2017. The birth weight (BW), occipito-frontal circumference (OFC) and occipito-heel length (OHL) of the new-borns were measured and documented. The weight and OHL of the new-borns were used to calculate the babies’ body mass index (BMI). Data obtained was entered into SPSS version 20 and then analysed. Results: The mean values of their OFC, OHL and BW were 34.6±2.2 cm; 49.8±3.0 cm and 3.3±1.4 kg respectively. There was a significant difference between the OFC (p=0.012) and OHL (P=0.035) but not in BW (P=0.220) and BMI (p=0.446) in males neonates compared to females. A significant correlation (Pearson’s) of OFC (r=0.149; P=0.000) and OHL (r=0.145; p=0.000) with birth weight was also found. There was also a significant correlation of OFC (r=0.106; P=0.001) and OHL (r=-0.156; p=0.000) with BMI. Conclusion: The birth weight and BMI of new-born babies are good determinants of their OFC and OHL.
Abstract: Background: Anthropometric measurements of the new-borns are important indicators of their intra-uterine growth and development; and could be reliable predictors of their health status. This study was carried out to determine the relationships between occipito-frontal head circumference and occipito-heel length to the birth weight of singleton term...
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A Comparative Study between SAM with Edema and SAM without Edema and Associated Factors Influencing Treatment, Outcome & Recovery
Zabeen Choudhury,
Dhiman Chowdhury,
Tanjina Hoq,
Morjina Begum,
Mohammad Shamsul Alam
Issue:
Volume 6, Issue 4, December 2020
Pages:
468-475
Received:
7 May 2020
Accepted:
10 July 2020
Published:
23 November 2020
Abstract: Severe acute malnutrition (SAM) is an established contributor of under-five mortality and morbidity. Achieving desired treatment outcome has proven to be challenging. There is limited data concluding the success of treatments in the study area. Objective: This study was aimed to compare the recovery from severe acute malnutrition with identified medical complications where presence or absence of edema denotes a major predictor among children aged 0-59 months of age. Methods: This was a retrospective observational study on facility based management which was conducted in SAM block of Chattogram Medical College hospital, Chattogram, Bangladesh. Here a total of 485 patients were admitted during the period of 2013-2017 and among them, 266 patients were successfully discharged from the hospital. Based on WHO & National guidelines for management of severely malnourished children in Bangladesh, treatment protocol, admission and discharge criteria were followed. A structured and prescribed data format was prepared and data were collected from the hospital records. Daily observation, monitoring and follow-up notes of the patients were also recorded. After data collection, they were cleaned, edited and stored into excel, EPI-INFO and analyzed by SPSS. Results: More than half of the admitted patients were cured and routinely discharged. 8.04% patients died during this period. 39.7% (193) children recovered according to the set discharge criteria as per guidelines. Mean age of the observed patients was 22.35±15.8607 months. More than half of the admitted patients showed moderate to good weight gain during hospital stay. Mean weight gain was higher in non-edematous patients. 50% of non – edematous patients started to gain weight in 3-5 days while 76% of edematous patients required 6-10 days to start weight gain. 4.3% patients did not gain weight during hospital stay. Both descriptive and analytic analyses were executed. P value<0.05 was considered as statistically significant Conclusions: The mean duration of hospital stay (in days) of the patients with oedema (15.64±SD 7.133 days) was higher than that of the patients without oedema (9.47±SD 5.881 days). But greater portion of patients with edema were cured. Independent-Sample T Test revealed the difference statistically significant, where t=(438,485)=-9.878, p=0.002.
Abstract: Severe acute malnutrition (SAM) is an established contributor of under-five mortality and morbidity. Achieving desired treatment outcome has proven to be challenging. There is limited data concluding the success of treatments in the study area. Objective: This study was aimed to compare the recovery from severe acute malnutrition with identified me...
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Graves’ Disease in Fourteen Years Old Girl
I Gusti Ayu Prema Yani Sidemen,
I Made Arimbawa
Issue:
Volume 6, Issue 4, December 2020
Pages:
476-480
Received:
5 November 2020
Accepted:
18 November 2020
Published:
4 December 2020
Abstract: Graves’ disease (GD), an autoimmune disorder resulting from thyrotropin (TSH) receptor stimulation by autoantibodies, is an uncommon disease in children. The incidence of GD is thought to be rising and is currently about 0.1 per 100,000 person-years in young children to 3 per 100,000 person-years in adolescents. The estimated prevalence varies between countries, from 1/10,000 in the United States to 1/100,000 person-years (for children aged 0–15 years) in the UK and Ireland. We reported one female patient, 14 years old, complained neck lump accompanied by exophthalmos, palpitation especially at night, followed by easily sweating all over her body. That manifestation also followed by increased of appetite, sleep disturbance, agitated, and behavioural changes those affecting her school report. Physical examination revealed hypertension, tachycardia, proptosis of both eyes, a non-pain palpable soft diffuse symmetrical mass on front neck followed down when swallowing, a systolic murmur, sweating on palms and soles of the feet. Laboratorium investigation was found FT4 >100,000 ng/dL (0.93-1.70); TSHs <0.05 IU/mL (0.27-4.20); T3 Total 28.6 nmol/L; TRAb 36.5 IU/L (≤1.75) and an ECG result found sinus tachycardia. Patient was treated with thyrozol (thiamazole) and propranolol. We need to increase awareness to adverse event of antihyperthyroid drugs, remission rate, predictor factors in successful treatment to get a better long-term outcomes of medical therapy in Grave’s disease.
Abstract: Graves’ disease (GD), an autoimmune disorder resulting from thyrotropin (TSH) receptor stimulation by autoantibodies, is an uncommon disease in children. The incidence of GD is thought to be rising and is currently about 0.1 per 100,000 person-years in young children to 3 per 100,000 person-years in adolescents. The estimated prevalence varies betw...
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Clinical Presentation and Complications of Different Congenital Heart Disease in Children
Kuntal Roy,
Md. Humayun Shahed,
Kaushik Roy,
Quazi Sahely Sarah,
Nandita Sur Chowdhury
Issue:
Volume 6, Issue 4, December 2020
Pages:
481-487
Received:
14 June 2020
Accepted:
10 October 2020
Published:
16 December 2020
Abstract: The clinical presentation of congenital heart disease varies according to the type and severity of the defect. Aim of the study: The aim of this study is to observe the clinical presentation and complications of different congenital heart disease. Material & Methods: It was a hospital based Cross-sectional study carried out prospectively in the department of pediatrics of Rajshahi medical college & hospital in from July 2011 to December 2011. The study population was all the children up to 12 years of age admitted in three pediatric units of this hospital during the study period. History included the presenting complaints of the patient’s e.g. breathlessness, cough, palpitation, undue fatigability, bluish coloration or lips, tongue and extremities, history suggestive of cyanotic spell, feeding problem, poor weight gain, recurrent chest infection etc. Onset of symptoms and duration were noted. Chest X-ray reports were done by radiologists, ECG reports and echocardiography were done by cardiologists of RMCH. Among the 147 clinically suspected cases congenital heart disease was confirmed in 110 cases by echocardiography. Results: Total 110 patients with different types of congenital heart disease were included in this study. Male: female ratio were 2:1. the commonest lesion was VSD present in 39.1 (%) patients and single ventricle with single A-V canal defect in 0.9 (%). Rest patients had multiple lesions. The commonest presentation was recurrent chest infection which present in 69.1 (%) of patients. The commonest physical finding was anemia, present in 72.7 (%) of patients. Among 110 patients, 101 presented with different complications. Heart failure was present in total 15 cases, among them 40 (%) of VSD, 33.3 (%) of PDA and 26.7 (%) of multiple lesions patients presented with heart failure. Growth failure was observed in total 23 cases, among them 13 (%) of VSD, 21.7 (%) of ASD, 43.5 (%) of TOF, 8.7 (%) of PDA and 13.1 (%) of other patients presented with growth failure. Pneumonia was noted in 54.3 (%) of VSD, 22.9 (%) of ASD, 17.1 (%) of PDA and 5.7 (%) of other patients. Recurrent chest infection was noted in 70 (%) of VSD and 30 (%) of PDA patients. Pneumonia with heart failure was noted in 54.3 (%) of VSD, 22.9 (%) of ASD, 17.1 (%) of PDA and 5.7 (%) of other patients. Cerebral abscess occurred only in TOF cases. Conclusion: Fast breathing, chest indrawing, cough, poor weight gain, feeding problems, anemia, cyanosis, clubbing, easy fatigability, recurrent chest infection and murmur detected in routine cardiac examination
Abstract: The clinical presentation of congenital heart disease varies according to the type and severity of the defect. Aim of the study: The aim of this study is to observe the clinical presentation and complications of different congenital heart disease. Material & Methods: It was a hospital based Cross-sectional study carried out prospectively in the dep...
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Influence of Exercise on Body Composition and Patient Outcomes in a Multidisciplinary Pediatric Obesity Clinic
Rebecca Espinosa,
Kelly Hearne,
Ayoola Adigun,
Lisa Farkas,
Ryan Cranshaw,
Cara Boyarin,
Morgan Sawyer,
Debora Duro
Issue:
Volume 6, Issue 4, December 2020
Pages:
488-494
Received:
10 November 2020
Accepted:
21 November 2020
Published:
16 December 2020
Abstract: Background: Childhood obesity has become a global epidemic, with approximately 34% of American children affected. This study describes outcomes seen in patients of a Multidisciplinary Pediatric Obesity Clinic (MPOC) who are compliant with individualized exercise regimens conducted by a Clinical Exercise Physiologist (CEP). The goal of this study is to track body composition, physical fitness measures, laboratory results, dietary and behavioral changes over the course of the program. Methods: Prospective cohort study design was implemented. There were 8-week exercise sessions conducted. Participants were evaluated by the CEP before, after the 8-week session using a standardized physical fitness evaluation, measurement of body composition and circumferences. Results: Statistical significance was observed with the increase in height (p<0.001), weight (p=0.014), Total Lean Mass (p=0.015). Increase in percent lean mass for all ethnicities in the study group i.e. black (male and female), hispanic (male and female) and white (male). An increase in the number of push-ups (p=0.012) was also observed. Conclusion: We can conclude that the use of an MPOC, CEP, and an exercise program early in childhood can potentially prevent the complications of obesity later in life.
Abstract: Background: Childhood obesity has become a global epidemic, with approximately 34% of American children affected. This study describes outcomes seen in patients of a Multidisciplinary Pediatric Obesity Clinic (MPOC) who are compliant with individualized exercise regimens conducted by a Clinical Exercise Physiologist (CEP). The goal of this study is...
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Fever as an Adverse Drug Reaction of Different Therapeutic Groups
Sergey Postnikov,
Natalia Teplova,
Aleksey Ermilin,
Marya Kostyleva,
Anna Gratzyanskaya,
Yulia Eremina,
Galina Chervyakova
Issue:
Volume 6, Issue 4, December 2020
Pages:
495-503
Received:
16 November 2020
Accepted:
4 December 2020
Published:
16 December 2020
Abstract: Fever (t>38°C) developed in association with drug usage is rare but sometimes severe side effect (SE). It could manifest as single symptom or as a part of such life-threatening syndromes like malignant hyperthermia (MH), serotonin syndrome (SS), neuroleptic malignant syndrome (NMS). Fever could be caused by different therapeutic groups of drugs but the leading positions are occupied by antibiotics (mainly beta-lactams), substances acting on central nervous system (CNS) and chemotherapeutic agents. Main mechanisms are allergic and receptive. Curative measures include discontinuation of the suspected drug, introduction of agents blocking the action of the trigger factor - dantrolene (МН), bromocriptine (NMS), cyproheptadine (SS). Purpose of this review: to present the global and Russian data concerning fever as a drug-induced side effect. To distinguish the groups of patients and drugs of the highest risk. To evaluate aid measures. Results: fever as monosymptom of drug allergy is a difficult condition to be diagnosed and there are only few things that could help to recognize it such as temporal association with the suspected drug use and manifestation of fever along with the following resolution after suspected drug discontinuation and recurrence fever after suspected drug re-challenge. Among four syndromes described in this review such as serum sickness-like reaction (SSLR), NMS, SS and MH just fever at MH is not only a sign like in case of three others but it is significant and life-threatening manifestation and therefore requires additional curative methods (in addition to pharmacological support with dantrolene) – rapid cooling measures: ice-water nasogastric and rectal lavage, infusion of crystalloid solutions cooled up to 4°C, ice packs placing on main blood vessels and liver area, ventilatory measurements.
Abstract: Fever (t>38°C) developed in association with drug usage is rare but sometimes severe side effect (SE). It could manifest as single symptom or as a part of such life-threatening syndromes like malignant hyperthermia (MH), serotonin syndrome (SS), neuroleptic malignant syndrome (NMS). Fever could be caused by different therapeutic groups of drugs but...
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Neonatal Complications of Teenage Pregnancies: Prospective Study About 209 Cases in Senegal
Modou Gueye,
Djibril Boiro,
Amadou Sow,
Yaay J Dieng,
Dieynaba F Cisse,
Aliou Abdoulaye Ndongo,
Seynabou Senghor,
Papa Moctar Faye,
Ousmane Ndiaye
Issue:
Volume 6, Issue 4, December 2020
Pages:
504-507
Received:
25 November 2020
Accepted:
4 December 2020
Published:
16 December 2020
Abstract: Summary: Early pregnancy is associated with a high risk of maternal and neonatal complications with significant neonatal morbidity and mortality, especially in developing countries. The objective was to assess morbidity and analyze the causes of neonatal mortality linked to these early pregnancies. Methodology: This was a prospective and descriptive study that took place from August 1, 2016 to January 31, 2017 in a hospital in Dakar. Included were newborns born to mothers aged 19 and under who gave birth in the maternity hospital. Results: 209 parturient were collected out of a total of 2073 parturient (10.08%). The average age was 17.59 years. Thinness was noted in 7.3% and overweight in 19%. Pregnancy was poorly followed in 32.1%. The most common obstetric complications were the threat of premature delivery, premature rupture of membranes (PRM), arterial hypertension and preeclampsia. The indications for Caesarean sections were dominated by pelvic abnormalities (28.4%) and PRM (11.4%). The most common neonatal complications were prematurity 39.1%, respiratory distress 12.72%, maternal-fetal infections 12.27% and perinatal asphyxia 8.18%. Mortality was 8.2%. The number of prenatal consultation less than 4 was significantly associated with neonatal deaths. Conclusion: Teenage pregnancy is the source of many complications, especially in newborns. It is necessary to conduct communications campaigns in order to stem them.
Abstract: Summary: Early pregnancy is associated with a high risk of maternal and neonatal complications with significant neonatal morbidity and mortality, especially in developing countries. The objective was to assess morbidity and analyze the causes of neonatal mortality linked to these early pregnancies. Methodology: This was a prospective and descriptiv...
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