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Sensitivity Patterns of Isolated Salmonella Typhi in Children with Typhoid Fever
Sk. Mohammad Ali Rashed,
Murshida Akhter,
Md. Ruhul Amin,
Mahbub Mutanabbi,
Choudhury Ali Kawser
Issue:
Volume 7, Issue 2, June 2021
Pages:
44-48
Received:
13 February 2021
Accepted:
26 February 2021
Published:
1 April 2021
Abstract: Background and objective: Enteric fever is a common febrile illness and one of te major health problem in Bangladesh. So the present study was conducted to determine the demographic characteristics, clinical profile, hematological feature and current sensitivity patterns of isolated S typhi in patients suffering from enteric fever in some of the tertiary care hospitals in Dhaka. Materials & Methods: This was a cross sectional study conducted in the Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College Hospital (DMCH) and SSMCH – Sir Salimullah Medical College & Hospital (SSMCH), Dhaka, Bangladesh for a period of one year from July 2015 to June 2016. A total number of 100 children with enteric fever were studied and diagnose were based on clinical features, Wedel test and blood culture. Results: Out of 100 diagnosed enteric fever children, 60 (60%) were male and 40 (40%) were female. Fever was present in all patients. Other most common manifestation are loss of appetite, vomiting, diarrhea, headache and constipation. Coated tongue was the predominant examination finding followed by hepatomegaly, splenomegaly and abdominal tenderness. Sensitivity to ceftriaxone was 100% in our study while resistance to nalidixic acid was 90%. MDR S.typhi is still a threat but there was re-emergence of sensitivity to Cotrimoxazole and Chloramphenicol. Conclusion: The study concluded that clinical pattern of typhoid fever conforms well to that of known pattern of the disease in children. Blood culture profile shows widespread emergence of nalidixic acid related resistant strains and the sporadic occurrence of cephalosporin resistant strains of S. Typhi. However, the first line antibiotics such as chloramphenicol and cotrimoxazole still have a role to play in the treatment of typhoid due to re-emergence of sensitivity.
Abstract: Background and objective: Enteric fever is a common febrile illness and one of te major health problem in Bangladesh. So the present study was conducted to determine the demographic characteristics, clinical profile, hematological feature and current sensitivity patterns of isolated S typhi in patients suffering from enteric fever in some of the te...
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Prenatal Diagnosis of Type 1c Choledochal Cysts in 1 Month Old Baby
Ida Ayu Agung Wijayanti,
Ni Nyoman Metriani Nesa,
I Gusti Ngurah Sanjaya Putra,
I Putu Gede Karyana,
Kadek Deddy Ariyanta,
I Made Dharmajaya,
Ni Made Mahastuti
Issue:
Volume 7, Issue 2, June 2021
Pages:
49-52
Received:
10 March 2021
Accepted:
30 March 2021
Published:
13 April 2021
Abstract: Choledochal cysts (CCs) are congenital dilatations of extrahepatic and/or intrahepatic bile ducts. It is a rare biliary entity, in the Asian population, the incidence can be as high as 1:1000 live. We reported case of One-month old baby girl with yellowish skin and acholic stool the baby has been suspected with anechoic abdominal mass at 17 weeks of gestational age using fetal ultrasound. From physical examination, jaundice was seen on the sclera and all over the body. The bowel sound was normal, without distention, without palpable liver nor spleen. The mass was not palpable either. Aspartate transaminase serum (AST), alanine aminotransferase serum (ALT), gamma glutamyl tranferase (GGT), bilirubin level was increased. Ultrasound was performed and revealed extrahepatic dilation to form a saccus in the proximal CBD, according to the picture of type 1 choledocal cyst. The surgeon performed cyst excision and hepatoduodenostomy procedure and found choledochal cyst. Histopathologic examination from cyst confirmed the choledochal cyst. The patient was discharged in good condition. We conclude that Type I choledochal cysts can be identified prenatally during a detailed fetal sonogram. The newborn should be investigated to confirm the diagnosis and undergo cyst excision promptly to reduce the potential for complications.
Abstract: Choledochal cysts (CCs) are congenital dilatations of extrahepatic and/or intrahepatic bile ducts. It is a rare biliary entity, in the Asian population, the incidence can be as high as 1:1000 live. We reported case of One-month old baby girl with yellowish skin and acholic stool the baby has been suspected with anechoic abdominal mass at 17 weeks o...
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Blood Transfusion: Prevalence, Indications and Associated Factors in Children Presenting to a Tertiary Health Institution in Southeast Nigeria
Chukwuemeka Ngozi Onyearugha,
Nneka Chioma Okoronkwo,
Prince Ezenwa Onyemachi
Issue:
Volume 7, Issue 2, June 2021
Pages:
53-56
Received:
15 March 2021
Accepted:
6 April 2021
Published:
13 April 2021
Abstract: Blood is an essential component of paediatric care worldwide. Blood and blood products are scarce and expensive and may be associated with health hazards post-transfusion. This study aims at determining the prevalence, indications and associated factors of blood transfusion in children in an academic hospital. Materials and Methods: This was a retrospectively review of all records of blood transfusions conducted at the Children’s Emergency and Paediatrics wards of the State University Teaching Hospital, Southeast Nigeria; from 1st January 2016 to 31st December 2017. Results: The prevalence of blood transfusion was 7%. Total number of transfusions was 56. Male: female ratio was 0.8: 1. Median age of transfused children was 5 years (range 2 months to 12 years). Forty one (73.3%) of the transfused children were aged <3 years with 17 (30.4%) being less than 1 year. The most frequent indications for transfusion were severe malaria 36 (64.3%) and sepsis 12 (21.4%). Sedimented red blood cells, 50 (89.3%), was the most frequently transfused blood product while whole blood constituted 11.7%. Case fatality among the transfused children was 16%. Discussion: Blood transfusion rate of 7% is higher than most previous studies, with the most frequent indication being severe malaria. Sedimented red blood cells was the most frequently transfused blood product. Application of malaria control measures is still needed.
Abstract: Blood is an essential component of paediatric care worldwide. Blood and blood products are scarce and expensive and may be associated with health hazards post-transfusion. This study aims at determining the prevalence, indications and associated factors of blood transfusion in children in an academic hospital. Materials and Methods: This was a retr...
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Often a Sick Child from the Perspective of a Pediatrican/Clinical Immunologist
Issue:
Volume 7, Issue 2, June 2021
Pages:
57-61
Received:
22 March 2021
Accepted:
6 April 2021
Published:
13 April 2021
Abstract: The author considers the term "often a sick child" and discusses this topic in relation to the gradually maturing immune system. He points out the specifics of different age periods and tries to prove that the not always higher frequency of diseases (especially the most common ones - respiratory tract infections) must have a cause in the immune system. Above all, it is necessary to distinguish between primary-congenital immune disorders, which often require lifelong specialized care, from secondary-acquired disorders, for which it is most important to identify the cause of such a disorder and try to eliminate it. An irreplaceable role in the diagnosis and care of often ill children is played by general practitioners caring for children and adolescents, who know the environment in which the child develops and have the possibility of basic immunological examination to identify more serious immune disorders.
Abstract: The author considers the term "often a sick child" and discusses this topic in relation to the gradually maturing immune system. He points out the specifics of different age periods and tries to prove that the not always higher frequency of diseases (especially the most common ones - respiratory tract infections) must have a cause in the immune sys...
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Effect of Inhaled Nitrogen Oxide on the Plasma Concentration of Cytokines and Endogenous Nitrogen Oxide
Vladimir Vladimirovich Estrin,
Marina Gaevna Pukhtinskaya
Issue:
Volume 7, Issue 2, June 2021
Pages:
62-67
Received:
22 March 2021
Accepted:
7 April 2021
Published:
20 April 2021
Abstract: Rationale. The nitrogen oxide molecule (NO) is a fundamental factor of the anti-infectious resistance of an organism. Research objective. To evaluate the effectiveness and safety of the prevention of sepsis by the inhalation of nitrogen oxide (iNO) in newborns with respiratory pathology on artificial pulmonary ventilation. Methods. Controlled, randomized, blind clinical trial included 97 newborns with respiratory pathology for artificial pulmonary ventilation. Patients received standard intensive therapy. The main group (n=44) received inhaled nitrogen oxide. The control group (n=53) did not receive inhaled nitrogen oxide. On Days 1, 3, and 20, the plasma concentrations of IL-1ß, IL-6, IL-8, TNF-α, G-CSF, s-Fas, FGF, and nitrogen oxide were measured by capture ELISA. Results. Inhaled nitrogen oxide as a part of intensive care decreased the rate of sepsis development, the duration of mechanical ventilation, and the period of hospitalization. It provided a tendency towards a decrease in the rate of lethal outcomes and reduced cytokine aggression. Conclusions. Inhaled nitrogen oxide in standard intensive care effectively and safely prevented the development of sepsis in newborns with respiratory pathology on artificial lung ventilation. A decrease in the concentration of pro-inflammatory cytokines, including IL-6, against the background of nitrogen oxide inhalation, confirmed the possibility of using inhaled nitrogen oxide as a therapy for COVID-19.
Abstract: Rationale. The nitrogen oxide molecule (NO) is a fundamental factor of the anti-infectious resistance of an organism. Research objective. To evaluate the effectiveness and safety of the prevention of sepsis by the inhalation of nitrogen oxide (iNO) in newborns with respiratory pathology on artificial pulmonary ventilation. Methods. Controlled, rand...
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The Mixed Bacterial-viral Intestinal Infections in Children of Early Age
Zemfira Mekhtiyevna Kuliyeva,
Lala Islakhovna Rustamova,
Fatma Vagifovna Qilindjova,
Matanat Nabiyevna Mamedova,
Mehriban Musayevna Isayeva,
Rena Mammadovna Akhundova
Issue:
Volume 7, Issue 2, June 2021
Pages:
68-71
Received:
13 March 2021
Accepted:
19 April 2021
Published:
8 May 2021
Abstract: The aim of investigation to study the of some clinico-microbiological characterisrics of mixed intestinal infections in children of early age. Material and methods – the children under the age of 3 (infants and children), hospitalized in the Children’s Clinical Hospitals № 1 and 7 in Baku for the 2019 year have been examined. Bacteriological and serological studies were carried out to diagnose intestinal infections on the day of admission to hospital feces of sick children were take as material for analyses. Totally the 117 children have been observed. To convirm the diagnosis of bacterial intestinal infection feces were cultured with subsequent detection of sensitivity to antibiotics and for viral intestinal infection, immunochromatografic test was used. The bacteriological and serological investigations were arried out in the Scientific-Research Institute of Medical Prophylaxis named after V. Y. Akhundov during 2019 year. Results – As a result of our studies, 33,3% (39) of children had mixed infection: a combination of viruses, particularly rotaviruses with St.aureus, E.Coli and C.albicans. From observing children 25 were under 6 month (21,4%), 15 – 7-12 month (12,8%), 77 – 1-3 years (65,8%). The combination of rotaviruses with other viruses (adenovirus and astrovrus) were the most frequently observed ones (5,1±2,0% and 6,8±2,3% accordingly) (p=0,167; p=0,067). Among opportunistic microbes the S.albicans was a leader. (In 18 (15,4%) patients). C.albicans was with rotavirus (p=0,063), in 5 (4,3±1,9%) with St.aureus and rotavirus (p=0,118) and in 4 (3,4±1,7%) with rotavirus and E.Coli (p=0,056). The viral intestinal infection with 2 associates occured in 5 (4,3±1,9%) of patients – rotavirus + St.aureus + C.albicans and rotavirus + E.Coli + C.albicans (p=0,056).
Abstract: The aim of investigation to study the of some clinico-microbiological characterisrics of mixed intestinal infections in children of early age. Material and methods – the children under the age of 3 (infants and children), hospitalized in the Children’s Clinical Hospitals № 1 and 7 in Baku for the 2019 year have been examined. Bacteriological and se...
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Profile and Outcome of Children with COVID-19 Attending Bangabandhu Sheikh Mujib Medical University
Mujammel Haque,
Kamrul Laila,
Mohammad Hafiz Al-Mamun,
Sutopa Halder Supti,
Shahana Akhter Rahman
Issue:
Volume 7, Issue 2, June 2021
Pages:
72-78
Received:
7 April 2021
Accepted:
23 April 2021
Published:
8 May 2021
Abstract: Background: Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 is a global pandemic. Covid-19 has spread around Bangladesh and children are also being infected with comparatively fewer symptoms and lower case-fatality rates. Objectives: To assess the clinical profile, disease severity, presence of co-morbidities and outcome of pediatric COVID-19 patients. Methods: This prospective observational study was conducted in the fever clinic and the Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU). Data were collected from the confirmed cases by using a structured questionnaire by face to face interview and also over telephone at 1st visit and at 2nd and 8th week of disease course. Collected data were analyzed using appropriate statistical tests. Result: Among 2091 suspected COVID 19 cases attending fever clinic and department of Pediatrics, 462 (22.09%) were real time polymerized chain reaction (RT PCR) COVID 19 positive. Of them 377 (81.60%) responded to the questionnaire and subsequent follow up. Highest numbers of cases were found in June 2020. More than 60% of cases were within the age group of 10 to 18 years and 3.44% were infants. Male: female ratio was 1.04:1. Associated co-morbid conditions were present in 21.48% patients. Fever was the most common (72.67%) clinical feature followed by others. Incidences of severe and critical illness were more in older children. Most of the moderate cases and all of the severe and critical COVID cases were managed in the inpatient department including Pediatric intensive care unit. Among them, 100% required oxygen therapy, 72.41% needed oral or IV steroids, 8.6% and 6.9% needed intravenous immunoglobulin and biological agents (Tocilizumab) respectively. Seventeen patients (4.5%) recovered with some complications. Conclusions: Among suspected cases 22% were RT-PCR positive. Majorities were in the older age group and most of the moderate and all the severe and critical cases also belonged to older age group. Most of the cases (94.42%) recovered without complication and 4.5% recovered with some complications. Mortality was 1.06%.
Abstract: Background: Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 is a global pandemic. Covid-19 has spread around Bangladesh and children are also being infected with comparatively fewer symptoms and lower case-fatality rates. Objectives: To assess the clinical profile, disease severity, presence of co-morbidities and outcome of pediatric COVID...
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Sleep and Breathing Disturbance in Joubert Syndrome: A Case Report
Abdullah Saeed Al-Shamrani
Issue:
Volume 7, Issue 2, June 2021
Pages:
79-84
Received:
6 May 2021
Accepted:
24 May 2021
Published:
31 May 2021
Abstract: Joubert syndrome is a rare autosomal-recessive disease, and the description was coined by Dr. Marie Joubert in 1968 in a family presenting with breathing problems and certain central nervous system malformations in the form of hypotonia, cerebellar vermis hypoplasia, and developmental delay. There is a paucity of literature describing the clinical characteristics and types of sleep abnormalities in patients with Joubert’s syndrome. We report the case of a young child observed to have breathing difficulties since the early neonatal period. He was initially diagnosed with seizure disorder, with little improvement with antiepileptic medications. The child showed significant psychomotor retardation. Our patient continued to have breathing disorders, mainly recurrent apnoea and nocturnal hypoxemia, which further worsened the child’s development and mental status. A genetic study confirmed the diagnosis of Joubert’s syndrome, and polysomnography further confirmed the severity of sleep disorder of breathing, which included predominantly central apnoea. Bilevel positive airway pressure (BiPAP) therapy was initiated and resulted in a marked improvement in the apnoea/hypopnoea index (AHI) and sleep quality, especially in the rapid eye movement (REM) stage. As the clinical manifestations proven to be atypical, it might be very challenging for health care providers to prove the diagnosis. We highlight some difficulties faced when encountering these patients, starting from diagnostic confirmation, therapeutic intervention to the prognosis and outcome of such condition.
Abstract: Joubert syndrome is a rare autosomal-recessive disease, and the description was coined by Dr. Marie Joubert in 1968 in a family presenting with breathing problems and certain central nervous system malformations in the form of hypotonia, cerebellar vermis hypoplasia, and developmental delay. There is a paucity of literature describing the clinical ...
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Efficacy of Prednisolone in Recovery from Acute Bronchiolitis: Study in a Tertiary Care Hospital, Dhaka, Bangladesh
Khondaker Zahirul Hasan,
Md. Abid Hossain Mollah,
Mohammad Monir Hossain,
Muhammad Zahangir Alam,
A. N. M. Shahidul Islam Bhuiyan,
Md. Faruk Ahmed,
Md. Iftekhar-ul-Haque Khan
Issue:
Volume 7, Issue 2, June 2021
Pages:
85-90
Received:
13 February 2021
Accepted:
21 April 2021
Published:
4 June 2021
Abstract: Introduction: Acute bronchiolitis is a condition where patients are presenting with breathing difficulties, cough, poor feeding, and irritability. Treatment of bronchiolitis have many controversies. Most trials of bronchiolitis treatment suffer from 2 constraints: possible inclusion of patients with asthma and inconsistent outcome measures. The aim of the study was to determine the efficacy of prednisolone in recovery from acute bronchiolitis who have a family history of atopy. Material & Methods: This randomized double blind placebo controlled trial (RCT) was conducted in the department of pediatrics Dhaka Medical College Hospital (DMCH) from July 2008 to June 2010. Sixty (60) bronchiolitis patients having family history of atopy were included in his study. Prednisolone and placebo were packaged in identical envelops with separate code number given by the guide and the code number were recorded in a preformed questionnaire. The trial was so planned that neither the parents nor the investigator were aware of group allocation. The collected data were analyzed thoroughly by SPSS program version of 16.0 software. Informed written consent from parents or legal guardians was taken and ethical clearance was obtained from the ethical review committee of Dhaka Medical College to conduct the research works. Results: In our study, mean age of the patients of this series were 3.68 months (±1.29SD) and 3.52 month’s (±1.1SD) in prednisolone and placebo group respectively. Use of accessory muscle score was assessed twice at 8 am and 8 pm each day for three days. On first assessment at day 1 the score was similar in both the treatment groups (P>.05). More people in Prednisolone arm recovered within 3 days then the placebo group. The difference is statistically significant (P<.01). Conclusion: Three-day oral prednisolone treatment was effective in accelerating clinical recovery (Fast breathing, use of accessory muscle, wheezing) in acute bronchiolitis cases who had family history of atopy.
Abstract: Introduction: Acute bronchiolitis is a condition where patients are presenting with breathing difficulties, cough, poor feeding, and irritability. Treatment of bronchiolitis have many controversies. Most trials of bronchiolitis treatment suffer from 2 constraints: possible inclusion of patients with asthma and inconsistent outcome measures. The aim...
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Prevalence and Risk Factors of Low Birth Weight in Neonates Born in Tishreen University Hospital - Latakia
Noura Shoaib,
Ahmad Chreitah,
Oday Jouni
Issue:
Volume 7, Issue 2, June 2021
Pages:
91-94
Received:
10 May 2021
Accepted:
27 May 2021
Published:
4 June 2021
Abstract: Background: Low birth weight is a public health problem of global prevalence with a significant impact on health in childhood and adulthood. Objective: The purpose of the current study is to determine the prevalence and risk factors of low birth weight in neonates born in Tishreen University Hospital- Latakia. Methods: In an Observational analytical cross-sectional study design included 711 neonates born at Tishreen University Hospital in Latakia over 1 year period from January 2020. Questionnaires were administered after the birth of the infant included gender, gestational age, order of pregnancy, maternal age, weight, work, education, Parental relationship, history of low birth weight, chronic disease, pregnancy complications, birth defects. Results: The results showed that the prevalence of low birth weight was 13.4%. There was a significant relationship between low birth weight with the Preterm, complications during pregnancy, Mother’s age (<18, ≥35 years), previous of Low birth weight, and smoking during pregnancy. The preterm (OR=9.6), complications during pregnancy (OR=4.5), mother’s age (<18, ≥35 year) (OR=3.2), previous of LBW (OR=2.9), and smoking during pregnancy (OR=2.5) were the most factors associated with low birth weight. Conclusion: The current study found a high prevalence of low birth weight associated with many factors including (The preterm, complications during pregnancy, Mother’s age, previous of LBW, and smoking during pregnancy). The current study could be used as a preventative strategy to reduce the risk of low birth weight by prediction of risk factors.
Abstract: Background: Low birth weight is a public health problem of global prevalence with a significant impact on health in childhood and adulthood. Objective: The purpose of the current study is to determine the prevalence and risk factors of low birth weight in neonates born in Tishreen University Hospital- Latakia. Methods: In an Observational analytica...
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