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Case Report
Scurvy in Children: A Case Report
Siham Satlane*
,
Imane Chahid,
Fatima Harim,
Meriem Atrassi,
Dalal Bensabbahia,
Abdelhak Abkari
Issue:
Volume 10, Issue 2, June 2024
Pages:
48-51
Received:
4 March 2024
Accepted:
20 March 2024
Published:
2 April 2024
Abstract: Scurvy is all the symptoms associated with a diet deficient in ascorbic acid or vitamin C, found in fresh fruit and vegetables. Scurvy is a pathology resulting from a deep and prolonged vitamin C deficiency, which can manifest itself as a bleeding syndrome, wound healing disorders, rheumatic signs, or gum damage. If left untreated (vitamin C supplementation), the disease can be fatal. This water-soluble vitamin is neither synthesized nor stored in the body. In recent years, there has been a resurgence of this pathology due to unbalanced nutrition. Clinical presentations are deceptive and variable, with orthopedic abnormalities and a diffuse hemorrhagic syndrome secondary to a defect in collagen fiber synthesis in children. The diagnosis of scurvy is confirmed by measuring ascorbemia, which is less than 2 mg/L (5-15 mg/L or 17-94 mmol/L), and treatment is based on vitamin C supplementation at 100 to 300 mg/day until complete recovery. We report the case of a 7-year-old patient with an autistic spectrum disorder associated with epilepsy, who presented with scurvy revealed by bone involvement consisting of bone pain, a bleeding syndrome and gingival hypertrophy in context of altered general condition. The diagnosis was confirmed by a collapsed ascorbic acid level (<3 mmol/l) and progressed favorably on vitamin supplementation.
Abstract: Scurvy is all the symptoms associated with a diet deficient in ascorbic acid or vitamin C, found in fresh fruit and vegetables. Scurvy is a pathology resulting from a deep and prolonged vitamin C deficiency, which can manifest itself as a bleeding syndrome, wound healing disorders, rheumatic signs, or gum damage. If left untreated (vitamin C supple...
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Research Article
Epidemiology of and Factors Associated with Helicobacter Pylori Infection and Proportion Requiring Treatment Among Symptomatic Children in Northwestern Tanzania
Mwanaidi Mkwizu*,
Hyasinta Jaka,
Stephen Mshana,
David Majinge,
Igembe Nkandala,
Delfina Msanga,
Tulla Masoza,
Benson Kidenya,
Elig Kimosso,
Neema Kayange
Issue:
Volume 10, Issue 2, June 2024
Pages:
52-62
Received:
23 February 2024
Accepted:
19 March 2024
Published:
11 April 2024
DOI:
10.11648/j.ajp.20241002.12
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Abstract: Background: Helicobacter pylori infection has been reported to affect more than half of the global population. The persistence of H. pylori infection results to chronic gastritis and peptic ulcer disease. Despite this burden there is limited published studies regarding proportion of Helicobacter pylori infected children that require treatment in many settings in low and middle-income countries (LMICs). Therefore this study aimed to determine the epidemiology of and factors associated with Helicobacter pylori infection and proportion requiring treatment among symptomatic children in northwestern Tanzania. Methodology: This was a hospital based cross-sectional study conducted at BMC hospital in Northwestern Tanzania from December 2021 and April 2022 among outpatient children aged 1 to 15 years with gastrointestinal symptoms. The main study outcome (event) was presence of H. pylori infection as evidence by positive stool antigen test. Independent factors associated with H. pylori infection were determined by logistic regression model. The significance level was set at p-value of <0.05. Oesophagogastroduodenoscopy (OGD) was performed to the randomly serially selected representative sample of symptomatic children with positive H. pylori stool antigen test to determine the proportion of children requiring treatment. Results: A total of 422 symptomatic children were included in the study. The median age was 7 [IQR 3 – 10] years. The prevalence of H. pylori infection was 105 (24.9%). More than half of the participants (56.4%) were males. The risk of H. pylori infection was significantly associated with increase in age (OR= 1.09; 95%CI; 1.03 – 1.15; P= 0.002), and abdominal pain (OR=2.2; 95%CI 1.2 – 4.0; P= 0.01). About 55 participants were randomly selected for OGD among 100 children above or equal 2 years of age with positive stool antigen for H. pylori. The majority were found to have lesion warranting treatment. These lesions included gastritis 47 (85.5%), duodenal ulcers 2 (3.6%) and gastric ulcers 1 (1.8%). Conclusion: About a quarter of the enrolled children had H. pylori infection. Increase in age and abdominal pain were independently associated with H. pylori infection. Most H. pylori stool antigen test positive children had endoscopic lesions that warranted treatment. Therefore every H. pylori stool antigen test positive child needs eradication therapy.
Abstract: Background: Helicobacter pylori infection has been reported to affect more than half of the global population. The persistence of H. pylori infection results to chronic gastritis and peptic ulcer disease. Despite this burden there is limited published studies regarding proportion of Helicobacter pylori infected children that require treatment in ma...
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Research Article
Factors Associated with Drug Use Among Secondary and High School Adolescents
Mekone Nkwele Isabelle*,
Menguene Justine Laure,
Abada Siméone Carelle,
Kamo Hélène Selangai,
Elong Jules Thierry,
Meguieze Claude Audrey,
Epee Ngoué Jeannette,
Nsoh Ndeh-Fofang,
Nguefack Séraphin
Issue:
Volume 10, Issue 2, June 2024
Pages:
63-68
Received:
15 March 2024
Accepted:
27 March 2024
Published:
11 April 2024
Abstract: Introduction: Drug abuse is a significant public health concern among adolescents, who are a very susceptible group. This study aimed to identify the various factors associated with drug use among adolescents in secondary school. Methodology: Between October 2022 and April 2023, a cross-sectional and analytical study was carried out among adolescents in fourteen secondary schools in the city of Yaoundé, the administrative capital of Cameroon. The sampling was consecutive and non-exhaustive. The SPSS software version 23.0 was used for data analysis. Multivariate analysis was achieved using the logistic regression model. An Odd Ratio with a 95% confidence interval was used to establish associated factors. The association between categorical variables was measured using Chi-square and Fisher's exact tests (p < 0.05). Results: Of the 1987 adolescents included, the prevalence of drug use was 27.5%, i.e. 546 pupils with an average age of 16.9 ± 1.4 years. The prevalence of drug use in the study was 27.5%. The risk factors identified were students aged 15 to 18, being in the first and final year of secondary school, being raised by either their father or grandparents only and having a bar at home. The protective factor was the absence of drug use by a household member. Conclusion: The high prevalence of drug use among teenagers at school means that preventive measures need to be instilled for school health and the community.
Abstract: Introduction: Drug abuse is a significant public health concern among adolescents, who are a very susceptible group. This study aimed to identify the various factors associated with drug use among adolescents in secondary school. Methodology: Between October 2022 and April 2023, a cross-sectional and analytical study was carried out among adolescen...
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Research Article
Diagnostic Value of Faecal Calprotectin in Children with Chronic Gastrointestinal Disorders at Yaounde General Hospital
Mekone Nkwele Isabelle*,
Ngo Libii Li Ntep Marguerite Audrey,
Nkeck Jériel Pascal,
Epée Ngoué Jeannette,
Ngogang Marie Paul,
Nguefack Félicité,
Ama Moor Vicky Jocelyne
Issue:
Volume 10, Issue 2, June 2024
Pages:
69-74
Received:
18 March 2024
Accepted:
1 April 2024
Published:
11 April 2024
Abstract: Introduction: Chronic gastrointestinal disorders are common in children. Numerous faecal biomarkers, such as faecal calprotectin, are used in the aetiological diagnosis of these digestive disorders. The study aimed to investigate the diagnostic value of faecal calprotectin in paediatric chronic gastrointestinal disease compared with that obtained in healthy children. Methodology: This was a comparative, analytical cross-sectional study from October 2022 through June 2023 at Yaoundé General Hospital. Participants were children aged between four and eighteen with chronic digestive disorders. Using a pre-established questionnaire, we collected the socio-demographic and clinical characteristics of each participant. The participants' faecal calprotectin was tested at the laboratory of the Yaoundé University Hospital Center by Enzyme-Linked Immunosorbent Assay (ELISA). Associations between variables were investigated by linear regression and calculation of the odds ratio (OR). The significance threshold was 5%. Results: Sixty stool samples were analysed for faecal calprotectin from 30 patients and 30 healthy participants. The mean age of the population was 9.47 (± 3.35) years for patients and 10.67 (± 3.70) years for healthy participants, with a sex ratio of 1.14 for patients and 0.87 for healthy participants. The threshold value for faecal calprotectin was 2.75 µg/g, with a sensitivity of 60%, a specificity of 63%, a positive predictive value of 61.20% and a negative predictive value of 62.06%. There were no significant differences in faecal calprotectin concentrations between children with chronic gastrointestinal disorders (peptic ulcer disease: p=0.10; functional gastrointestinal disorder associated with peptic ulcer disease: p= 0.710; functional gastrointestinal disorder: p= 0.143) and healthy children. Conclusion: The diagnostic value of faecal calprotectin as a biomarker in the diagnosis of chronic gastrointestinal disease was not observed in this study. However, the biological parameters assessed were measured only once, and given that their concentrations may vary over time, we recommend a subsequent longitudinal study.
Abstract: Introduction: Chronic gastrointestinal disorders are common in children. Numerous faecal biomarkers, such as faecal calprotectin, are used in the aetiological diagnosis of these digestive disorders. The study aimed to investigate the diagnostic value of faecal calprotectin in paediatric chronic gastrointestinal disease compared with that obtained i...
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Case Report
Endoscopic Repair of Refractory Tracheoesophageal Fistula with a Cardiac Septal Occluder Device in a 12 Years-Old Patient
Issue:
Volume 10, Issue 2, June 2024
Pages:
75-80
Received:
22 February 2024
Accepted:
7 April 2024
Published:
28 April 2024
Abstract: Purpose: Esophageal atresia (EA) and tracheoesophageal fistula (TEF) are rare anomalies in neonates that must be surgically repaired by esophageal reconstruction with or without ligation of the fistula. Recurrent tracheoesophageal fistula (rTEF) occurs in 3-15% of primary surgical repairs in esophageal atresia; it is associated with recurrent hospital admissions and up to 27% short term mortality. Dependable reparation very often proves difficult by standard surgical techniques. Using oesophageal fully covered self-expandable metal stents in adult patients yields a <50% efficacy and other endoscopic techniques such as occlusion by clips or glue show no better results. A minimally invasive alternative is the use of vascular plug septal occluders. We report the efficacy of endoscopic placement of a cardiac septal occluder (CSO) in a paediatric patient. Clinical case: A 12-year-old female with recurrent (rTEF) and refractory tracheoesophageal fistula (refTEF) was subjected to an refTEF closure procedure via endoscopic placement of a cardiac septal occlusion device. Conclusion: Debate regarding the gold standard of rTEF treatment closure a hot debate but flexible endoscopy is an accepted alternative. This report describes the successful fixing of a refTEF using a cardiac septal occluder. After four weeks follow up, no re-incidence of the tracheoesophageal fistula was detected. The results advocate for the endoscopic closure of refractory tracheoesophageal fistula with cardiac occluders in children thus establishing a promising therapeutical alternative in refTEF in paediatric population patients.
Abstract: Purpose: Esophageal atresia (EA) and tracheoesophageal fistula (TEF) are rare anomalies in neonates that must be surgically repaired by esophageal reconstruction with or without ligation of the fistula. Recurrent tracheoesophageal fistula (rTEF) occurs in 3-15% of primary surgical repairs in esophageal atresia; it is associated with recurrent hospi...
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Research Article
Complete Versus Incomplete Antenatal Corticosteroid Therapy and Number of Doses of Surfactant Used Posnatally: A Single-Center Study
Suzi Mansour*,
Rami Harb,
Philippe Michel,
Sarah Cassandra Raymond,
Suzanne Borrhomée
Issue:
Volume 10, Issue 2, June 2024
Pages:
81-95
Received:
19 January 2024
Accepted:
12 February 2024
Published:
28 April 2024
Abstract: Introduction: Antenatal corticosteroid therapy reduces the risk of developing RDS in premature infants. A single complete course of two doses of betamethasone is recommended between 24 weeks and 34 weeks. There are few data on the neonatal effects of an incomplete course of antenatal corticosteroid therapy. The main objective of our study is to evaluate the effectiveness of a complete versus incomplete course of antenatal corticosteroid therapy on the number of doses of surfactant received postnatally. Methods: This is a single-center retrospective study, including 145 newborns with RDS, divided into 2 groups according to the number of doses of antenatal corticosteroid therapy (1 dose; n = 23 and 2 doses; n = 95). Results: The clinical characteristics of the newborns were similar in the 2 groups. The number of doses of surfactants received postnatally and the severity of RDS are not influenced by the number of doses of antenatal corticosteroid therapy. On the other hand, the number of doses of surfactants received is influenced by the term of birth, the presence of an neonatal sepsis and by resuscitation in the delivery room. The severity of RDS is not influenced either by the interval between the last dose of antenatal corticosteroid therapy and delivery, nor by the cause of prematurity. We did not note any statistically significant difference in clinical improvement (duration of intubation, duration of non-invasive ventilation), the need for postnatal corticosteroid therapy and the risk of occurrence of morbidity and mortality (mortality rate, occurrence of BPD, IVH, severe NEC) between the two groups. Conclusion: just like a complete course, an incomplete course of antenatal corticosteroid therapy can also act on the severity of RDS. Prospective randomized studies should be considered for a formal determination of the neonatal effects of a complete versus incomplete course of antenatal corticosteroid therapy, including the trial BETADOSE.
Abstract: Introduction: Antenatal corticosteroid therapy reduces the risk of developing RDS in premature infants. A single complete course of two doses of betamethasone is recommended between 24 weeks and 34 weeks. There are few data on the neonatal effects of an incomplete course of antenatal corticosteroid therapy. The main objective of our study is to eva...
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Research Article
Application of the Rox Index as a Predictor of Respiratory Failure in Pediatric Patients Receiving High-Flow Oxygen Therapy Support at the Roberto Gilbert Elizalde Hospital
Karla Calderón-Salavarría*,
Jimmy Barreiro-Casanova
Issue:
Volume 10, Issue 2, June 2024
Pages:
96-106
Received:
29 April 2024
Accepted:
15 May 2024
Published:
30 May 2024
Abstract: Background: High-flow oxygen therapy is an ideal treatment for managing respiratory failure. It avoids orotracheal intubation; however, some patients are refractory to this treatment. The ROX Index aims to detect early failure in high-flow oxygen therapy; nevertheless, its use has been poorly studied in pediatrics. Objective: To evaluate the applicability of the ROX Index as a tool to determine the failure of high-flow oxygen therapy in pediatric patients admitted to the Roberto Gilbert Hospital. Methodology: Observational, prospective, longitudinal cohort study with a descriptive approach including 209 patients between 1 month and 17 years old who required high-flow oxygen therapy within the first 24 hours. ROX Index measurements were taken at 2, 4, 6, 12, and 24 hours with follow-up to determine the outcome. Result: A total of 209 patients meeting the inclusion criteria were obtained; 27 (12.9%) required endotracheal intubation (ETI), and 182 (87%) received high-flow oxygen therapy (HFNC). A higher frequency of younger infants was observed among patients who required ETI, with a median age of 12 months. A significant difference in the ROX index was found from two hours onwards with cutoff points on the AUROC curve above 0.5. Conclusion: It was determined that the ROX Index can be used as a complementary tool to strengthen decision-making in pediatrics.
Abstract: Background: High-flow oxygen therapy is an ideal treatment for managing respiratory failure. It avoids orotracheal intubation; however, some patients are refractory to this treatment. The ROX Index aims to detect early failure in high-flow oxygen therapy; nevertheless, its use has been poorly studied in pediatrics. Objective: To evaluate the applic...
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Research Article
The Relationship Between Perioperative Blood Product Use and the Incidence of Postoperative Renal Injury in Infants Undergoing Cardiac Surgery
Yuan Yuan*
Issue:
Volume 10, Issue 2, June 2024
Pages:
107-111
Received:
19 May 2024
Accepted:
5 June 2024
Published:
19 June 2024
Abstract: Cardiac Surgery Associated Acute Kidney Injury (CS-AKI) is a serious complication that occurs in patients following cardiac surgery. It is characterized by the rapid decline in kidney function, leading to potential long-term kidney damage or even kidney failure. CS-AKI is a significant health concern, as it not only prolongs hospital stays and recovery time but also increases the risk of mortality. This study, conducted as a prospective observational study, aimed to investigate the relationship between perioperative blood product use and the incidence of postoperative acute kidney injury (AKI) in infants and young children undergoing cardiac surgery. It examined the perioperative use of these blood products and its association with the occurrence of AKI. The findings of this study revealed a significant association between the use of red blood cell suspension and platelets and the development of postoperative AKI. This suggests that the administration of these blood products during cardiac surgery may increase the risk of kidney injury in infants and young children. However, it is important to note that the study did not find a statistically significant association between plasma transfusion volume and the incidence of AKI. This suggests that while the use of certain blood products may contribute to the risk of AKI, the volume of plasma transfused does not seem to have a significant impact. The findings of this study provide valuable insights into the perioperative management of infants and young children undergoing cardiac surgery. It underscores the importance of carefully considering the use of blood products during surgery and taking necessary measures to minimize the risk of AKI.
Abstract: Cardiac Surgery Associated Acute Kidney Injury (CS-AKI) is a serious complication that occurs in patients following cardiac surgery. It is characterized by the rapid decline in kidney function, leading to potential long-term kidney damage or even kidney failure. CS-AKI is a significant health concern, as it not only prolongs hospital stays and reco...
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