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Monofluoroquinolones (МFQs): Safetyuseinpediatrics (Clinical, Morphological and Follow-up Data)
Sergey Postnikov,
Natalia Teplova,
Galina Chervyakova,
Anatolyi Kamenev,
Vladimir Nazhimov,
Alexey Ermilin,
Marya Kostyleva,
Anna Gratsyanskaya
Issue:
Volume 7, Issue 4, December 2021
Pages:
182-188
Received:
31 August 2021
Accepted:
22 September 2021
Published:
12 October 2021
Abstract: 2 groups of children were included to assess monofluoroquinolones (МFQs) safety in open observational prospective study: 169 cystic fibrosis patients (pulmonary exacerbation phase) and 55 aplastic anemia patients (neutropenia phase) at age 6 months to 16 years treated with ciprofloxacin (CPF), ofloxacin (OF) or pefloxacin (PF) at different time points. Study purpose was to compare МFQS tolerability (arthropathy-focused mainly) in intermittent (treatment doses 15-50 mg/kg in cystic fibrosis patients) or uninterrupted prolonged use (prophylactic doses 10-15 mg/kg in aplastic anemia patients). It was showed (accumulated data in both groups) that quinolone arthropathy (QА) had developed in 8.4% of cases mostly in PF group (74%), more frequently in cystic fibrosis patients (CF) and exclusively in adolescents with full regression and without any height impact. Absence of residual arthrological symptoms and any height impact resulted from the fact that FQs are not cumulated in cartilaginous structures in chondropathogenic concentrations, and the occurrence of QA is caused by the development of synovitis as a result of individual FQs intolerance.
Abstract: 2 groups of children were included to assess monofluoroquinolones (МFQs) safety in open observational prospective study: 169 cystic fibrosis patients (pulmonary exacerbation phase) and 55 aplastic anemia patients (neutropenia phase) at age 6 months to 16 years treated with ciprofloxacin (CPF), ofloxacin (OF) or pefloxacin (PF) at different time poi...
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A Scoping Review of Excessive Prenatal Ultrasonography as a Potential Risk Factor for Autism
Hissa Moammar,
Larry Desch,
Rabi Sulayman
Issue:
Volume 7, Issue 4, December 2021
Pages:
189-197
Received:
1 September 2021
Accepted:
28 September 2021
Published:
28 October 2021
Abstract: For the past several decades, abdominal/pelvic prenatal ultrasonography (P-USG) has been the most significant technology used in obstetrics. There has been a tremendous increase in use throughout the world and there have been many improvements in the technology used. However, there are aspects of the technology such as frequency, exposure time, thermal and cavitation exposure indices, and increased acoustic output of the ultrasonic waves that possibly could be harmful to the embryo/fetus. In particular, prolonged exposure may increase susceptibility to Autism Spectrum Disorder (ASD). Along with the increasing use of P-USG, there has been a similar increase in the incidence of ASD. The diagnosis of ASD has been found to be more common in geographic areas with a more affluent ethnicity, high socioeconomic status, and high parental education. These are also areas where prenatal ultrasonography is readily available and affordable. Given that there are biophysical risks from P-USG, especially in non-medical settings, P-USG may emerge as a possible risk factor for ASD. The past history of radiography provides a historical perspective: the predominant past opinion years ago was that exposure to X-rays during pregnancy caused no significant risk to a fetus. However, the association between X-ray exposure and childhood leukemia was only established 40 years after X-ray use began. This review focuses on the literature which supports the generation of the hypothesis that excessive P-USG usage may be a factor in the etiology of ASD.
Abstract: For the past several decades, abdominal/pelvic prenatal ultrasonography (P-USG) has been the most significant technology used in obstetrics. There has been a tremendous increase in use throughout the world and there have been many improvements in the technology used. However, there are aspects of the technology such as frequency, exposure time, the...
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Anesthetic Management of an Intrathoracic Fetus in Fetus Case in a 5 Months Old Infant at a Low Resources African Sub-saharan Hospital
Joseph Akodjènou,
Abdel-Kémal Bori Bata,
Antoine Séraphin Gbénou,
Médard Guedenon,
Morgiane Houngbadji,
Eulalie Sansuamou,
Maroufou Jules Alao,
Eugène Zoumènou,
Jean Etienne Bazin,
Francis Veyckemans
Issue:
Volume 7, Issue 4, December 2021
Pages:
198-202
Received:
30 September 2021
Accepted:
19 October 2021
Published:
28 October 2021
Abstract: Fetus in fetus (FIF) is an extremely rare congenital condition characterized by the parasitic development of a malformed fetal twin within a normal second twin’s body. The localization is mostly abdominal in the retroperitoneum. Thoracic localization is extremely rare. In this clinical case, a 5 month old female infant weighing 5 kg presented with a chest mass causing respiratory distress. We realized a chest CT-Scan; the latter revealed a heterogeneous mass, completely occupying the left hemithorax. Imaging studies confirmed the presence of the fetus in fetus occupying the entire left hemithorax and mediastinum, pushing the heart to the right. A complete resection of the mass could be performed under general anesthesia and orotracheal intubation (GA + OTI). The monitoring involved ECG, SpO2, NIBP, PR, T°, and Capnometry. The ventilation was first mechanical and secondarily manual. The patient did not receive unipulmonary ventilation nor central IV line. Postoperative period marked by volume overload, anemia, cardiac arrest, with successful resuscitation. Histopathology studies and imaging confirmed the diagnosis. On D9, she was discharged from pediatric critical care and from hospital on day ten postoperative. She presented in good clinical condition after a 3-month follow-up. We report this case in order to show how we took care of this FIF case in the precarious conditions.
Abstract: Fetus in fetus (FIF) is an extremely rare congenital condition characterized by the parasitic development of a malformed fetal twin within a normal second twin’s body. The localization is mostly abdominal in the retroperitoneum. Thoracic localization is extremely rare. In this clinical case, a 5 month old female infant weighing 5 kg presented with ...
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Clinical Manifestation of Biliary Atresia in Bali
Merry Natalia,
I Gusti Ngurah Sanjaya Putra,
Ni Nyoman Metriani Nesa,
I Putu Gede Karyana
Issue:
Volume 7, Issue 4, December 2021
Pages:
203-206
Received:
16 October 2021
Accepted:
3 November 2021
Published:
10 November 2021
Abstract: Biliary atresia is a rare disease of the liver and bile ducts that occurs in infants. Biliary atresia is a condition in which the absence of a lumen in the extrahepatic biliary tract causes obstruction of bile flow. Symptoms of the disease appear or develop about two to eight weeks after birth. This study aims to describe the clinical manifestations of patients with Biliary Atresia at Sanglah General Hospital, Bali. This cross-sectional study was performed at the Sanglah Hospital Denpasar, Bali. Data was taken from medical record from January 2015 - December 2020. Study population were children who diagnosed as Biliary Atresia. Diagnosis was confirmed by cholangiography and liver biopsy. The study included 30 infants with Biliary Atresia, mostly (70%) were girl. Average age at admission was 3 months. Ninety percent subject had hepatomegaly in physical examination. Acholic stool were found in 80% subject. The average serum levels of conjugated bilirubin were 9.8 mg/dL, alanine aminotransferase (ALT) was 182 u/L, aspartate transaminase (AST) was 324 u/L, gamma-glutamyl transpeptidase (GGT) level was 671 u/L and albumin was 3.8 g/dL. Seventy percent patient showed triangular cord sign in abdominal ultrasonography. Kasai procedure was performed to all those infants. The most common clinical manifestation was icteric, dark urine, acholic stool and hepatomegaly. Triangular cord sign was the most common finding in abdomen ultrasonography.
Abstract: Biliary atresia is a rare disease of the liver and bile ducts that occurs in infants. Biliary atresia is a condition in which the absence of a lumen in the extrahepatic biliary tract causes obstruction of bile flow. Symptoms of the disease appear or develop about two to eight weeks after birth. This study aims to describe the clinical manifestation...
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Paediatric Laparoscopic Inguinal Hernia Repair: A Comparison Among Techniques
Shah Md. Ahsan Shahid,
Md. Nowshad Ali,
Khondokar Seheli Nasrin Lina,
Shantona Rani Paul,
Sayed Sirajul Islam,
Tanzilal Lisa
Issue:
Volume 7, Issue 4, December 2021
Pages:
207-210
Received:
14 April 2020
Accepted:
5 October 2021
Published:
17 November 2021
Abstract: Background: Traditionally in herniotomy, indirect hernial sac is dealt by high ligation and removal of the redundant part, to avoid recurrence. However, some authorities are of the opinion that excision of the hernial sac without ligation, is not associated with recurrence of the hernia. Some have even shown adverse events related to hernial sac ligation like increased post-operative pain and discomfort. There is no consensus on how the hernial sac should be managed during laparoscopic herniotomy. Objectives: Present study aimed to determine the feasibility of laparoscopic sac excision without ligation in paediatric age group, by a randomized comparison. Patients and Methods. This interventional study was performed in the department of Paediatric Surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh, over a period of one year. A total of 189 patients were included in the study as per inclusion and exclusion criteria and randomized in the three groups. Comparisons were made among three procedures of laparoscopic herniotomy, namely; Percutaneous extraperitoneal closure, Intraperitoneal purse-string closure and laparoscopic sac excision without ligation. The main outcome measures were recurrence rate, operative time, hospital stay, postoperative hematoma and hydrocele formation. Results: Recurrence rate, operative time and hospital stay were not amplified in laparoscopic sac excision procedure than others. Postoperative hydrocele formation were significantly less. Conclusion: Laparoscopic sac excision in indirect paediatric inguinal hernia is safe. The procedure is not associated with early recurrence when it is performed in cases with deep ring diameter less than 10mm.
Abstract: Background: Traditionally in herniotomy, indirect hernial sac is dealt by high ligation and removal of the redundant part, to avoid recurrence. However, some authorities are of the opinion that excision of the hernial sac without ligation, is not associated with recurrence of the hernia. Some have even shown adverse events related to hernial sac li...
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Method of Correction of Meconium Peritonite and Its Complications During Pregnancy and After Birth (Clinical Case)
Ovsyanikov Philipp Andreevich,
Ryabokon Nikita Romanovich,
Bairov Vladimir Gireyevich,
Sukhotskaya Anna Andreevna,
Zazerskaya Irina Evgenievna,
Korolev Mikhail Vladimirovich
Issue:
Volume 7, Issue 4, December 2021
Pages:
211-218
Received:
11 September 2021
Accepted:
29 September 2021
Published:
27 November 2021
Abstract: This article describes a clinical case of management of a pregnant woman with meconium peritonitis of the fetus and further observation and treatment of the child. Meconium peritonitis, being aseptic intrauterine peritonitis, is a serious disease that requires an integrated approach. The tactics in relation to the fetus, intrauterine risks and prognosis of survival in this pathology, as well as the possibility of choosing a method for correcting meconium peritonitis and its complications during pregnancy and after childbirth are discussed. With meconium peritonitis, timely prenatal diagnosis is extremely important, which significantly improves the prognosis and allows prenatally to take measures aimed at stabilizing the condition of the fetus and the pregnant woman. On the example of this clinical case, an assessment was made of the possibility of reducing the risks of life-threatening complications, depending on the clinical course of peritonitis. Due to the appearance of ultrasound criteria of severity (meconium ascites, compression of the chest cavity of the fetus, dropsy and polyhydramnios), it became possible to predict the course of development of meconium peritonitis. The stages of pregnancy, childbirth and the neonatal period are described in detail, as well as the therapeutic and surgical correction of this severe pathology with further early rehabilitation.
Abstract: This article describes a clinical case of management of a pregnant woman with meconium peritonitis of the fetus and further observation and treatment of the child. Meconium peritonitis, being aseptic intrauterine peritonitis, is a serious disease that requires an integrated approach. The tactics in relation to the fetus, intrauterine risks and prog...
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Practice of Pediatric Anesthesia in Sub-Saharan Africa: Experience of Two Referral Hospitals in Benin
Akodjènou Joseph,
Mewanou Serge,
Ahounou Ernest,
Lalèyè Yasmine,
Zoumenou Eugène,
Gbénou Séraphin Antoine,
Fiogbé Michel Armand
Issue:
Volume 7, Issue 4, December 2021
Pages:
219-224
Received:
10 November 2021
Accepted:
29 November 2021
Published:
11 December 2021
Abstract: Introduction: The practice of pediatric anesthesia present particular risks and requires specifically trained staff. We describe here the practice of pediatric anesthesia in two referral hospitals of Cotonou. Method: This was an observational study conducted over a period of 05 months from August 4 to December 31, 2020. All children who had undergone an anesthetic procedure in these reference hospitals of Cotonou during the study period and who met the inclusion criteria were recruited. Data collection was carried out by filling out an individual physical form for each child on whom a surgery was performed. Children who underwent surgery were followed up until their discharge from hospital and called back 30 days later. Results: A total of 345 patients were registered. Among them, 224 (64.9%) were male, for a sex ratio of 1.85. The average age was 55 months±4 months with extremes of one day and 190 months. Medical history was found in 9.56% of cases, and in 80.90% of cases, most interventions were scheduled. Digestive surgery was the most common (30.1%). The ASA1 class was the most represented (73.04%). The practice of pediatric anesthesia was medicalized in 17.39% of cases. All children were monitored. General anaesthesia was the most commonly used anaesthesia technique (89.85%). Loco-regional anaesthesia techniques were less used (27.53%). Spinal anesthesia (11.90%) and caudal anesthesia (11.30%) were the most commonly used local anesthesia techniques. The prevalence of anesthetic incidents and/or accidents during our study was 23.7% with a rate of 29 cardiac arrests per 10,000 anesthetics and an intraoperative mortality rate of 29 per 10,000 anesthetics. Perioperative complications were dominated by respiratory complications (11.57%), followed by cardiovascular complications (8.68%) and neurological complications (6.95%). A total of 84.35% of our patients were referred to an immediate post-interventional monitoring unit. I recorded 13 deaths in the postoperative period, representing a mortality rate of 3.7%. Conclusion: This work shows that the practice of pediatric anesthesia in Benin compared to previous years is becoming more and more satisfactory, even if the anesthetic safety is not yet optimal. It seems imperative to favor the specialization of practitioners, to promote loco-regional anaesthesia and to create pediatric hospitals with adapted resuscitation rooms and operating theaters.
Abstract: Introduction: The practice of pediatric anesthesia present particular risks and requires specifically trained staff. We describe here the practice of pediatric anesthesia in two referral hospitals of Cotonou. Method: This was an observational study conducted over a period of 05 months from August 4 to December 31, 2020. All children who had undergo...
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Ceftriaxone-Associated Gallbladder Pseudolithiasis in a Pediatric Patient, Case Report and Review of the Literature
Hesham Mubarak Abdalla,
Mustafa Mohammed Kafaji,
Ahmed Essam Khedr,
Abdullah Al-Shamrani
Issue:
Volume 7, Issue 4, December 2021
Pages:
225-228
Received:
26 November 2021
Accepted:
15 December 2021
Published:
24 December 2021
Abstract: Ceftriaxone plays a vital role in modern medicine due to its broad-spectrum coverage of common microbes. A relatively frequent, yet underplayed side effect is pseudolithiasis, especially in the pediatric setting. While most cases resolve spontaneously, there have been reports of patients requiring surgical treatment after developing further complications. We report a case of an abrupt onset (<3 days) pseudolithiasis occurring after just four moderate doses of Ceftriaxone. A previously healthy 2 years and 9-month-old girl was admitted as a case of exudative tonsillitis with secondary gastroenteritis. On day three of Ceftriaxone treatment, sudden onset severe abdominal pain ensued which warranted an abdominal ultrasound showing multiple gallbladder stones. Consequently, Ceftriaxone was changed to Cefotaxime and the pain subsided following a further two inpatient days and outpatient follow-up appointments were scheduled. Ceftriaxone has a high elimination in the bile, which gives predominance for potential biliary complications. It is well documented that high and prolonged doses increase the likelihood of these complications. In our case the accelerated progression of the pseudolithiasis could be due to the dehydration caused by the background gastroenteritis. Reduced oral intake and dehydration causes biliary stasis which accelerates the formation of biliary sludge and gallbladder precipitates due to biliary stasis. In the future, physicians could reconsider the use of ceftriaxone in patients with similar presentations.
Abstract: Ceftriaxone plays a vital role in modern medicine due to its broad-spectrum coverage of common microbes. A relatively frequent, yet underplayed side effect is pseudolithiasis, especially in the pediatric setting. While most cases resolve spontaneously, there have been reports of patients requiring surgical treatment after developing further complic...
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Blood Purification Technology in the Treatment of Type Ia Glycogen Storage Disease Complicated with Severe Lactic Acidosis: A Case Report and Literature Review
Yu Luo,
Fang Yang,
Ding Liu,
Zhiqiang Guo,
Chongfeng Chen
Issue:
Volume 7, Issue 4, December 2021
Pages:
229-233
Received:
28 November 2021
Accepted:
15 December 2021
Published:
29 December 2021
Abstract: Glycogen storage disease type Ia is a genetic disease caused by glucose-6-phosphatase deficiency, which often causes hypoglycemia, hyperuricemia, hypertriglyceridemia, and lactic acidemia. Severe lactic acidosis is a serious complication of glycogen storage disease type Ia. This study aimed to analyze the clinical features and treatment of glycogen storage disease type Ia with severe lactic acidosis. We performed a retrospective analysis of the diagnosis and treatment of a patient with glycogen storage disease type Ia with severe lactic acidosis admitted to our department during the COVID-19 period and reviewed the related literature. The patient was admitted to our hospital for chest pain and vomiting of three days duration, which was accompanied by dyspnea for five hours. The patient has had a type Ia glycogen storage disease for 11 years, and arterial blood gas analysis revealed a pH of 7.192 and lactic acid levels of 26.77 mmol/L. However, the patient was diagnosed with type Ia glycogen storage disease alongside severe lactic acidosis. After 4 hours of hemodialysis and 36 hours of continuous blood purification, the patient had no shortness of breath, dyspnea, nausea, or vomiting. Biochemical retesting indicated a pH of 7.482, lactic acid levels of 7.41 mmol/L, and blood glucose levels of 10.7 mmol/L. Glycogen storage disease type Ia can lead to life-threatening severe lactic acidosis. Continuous renal replacement therapy is an effective treatment for severe lactic acidosis. Therefore, as prevention and control are being carried out during the COVID-19 period, attention should be given to the treatment of special populations, such as those with glycogen storage disease to prevent serious complications.
Abstract: Glycogen storage disease type Ia is a genetic disease caused by glucose-6-phosphatase deficiency, which often causes hypoglycemia, hyperuricemia, hypertriglyceridemia, and lactic acidemia. Severe lactic acidosis is a serious complication of glycogen storage disease type Ia. This study aimed to analyze the clinical features and treatment of glycogen...
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