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Artificial Intelligence in Paediatric Emergencies: A Narrative Review
Saeed Abdullah Alzahrani,
Abdullah Ahmad Alzahrani,
Abdullah Al-Shamrani
Issue:
Volume 8, Issue 2, June 2022
Pages:
51-55
Received:
12 March 2022
Accepted:
31 March 2022
Published:
9 April 2022
Abstract: Background: The functionality of Artificial intelligence (AI) in paediatric practices has been gaining more attention for last five years. Since then, researchers have started observing that the techniques are helpful in dealing multiple facets of childhood diseases including emergency like situations. This article has been aimed to discuss the current status of usefulness of AI in paediatric emergencies. Methods: Total 22 research articles have been reviewed. Articles were searched from electronic database like Pubmed, Medline, Google scholar. Artificial intelligence, machine learning, paediatric emergencies, childhood diseases were the key words used to ease the search. Results: Out of 22, 15 were chosen as relatable to paediatric emergency situations per se. After reviewing the available literature, the utility of AI in paediatric emergencies had been discussed under four sub headings: i) Diagnosis; ii) Predictive modelling iii) Assistance in Antimicrobial stewardship iv) Management of emergency department resources. Conclusion: AI and different machine learning techniques have been proven as reliable accompaniment of paediatricians. They can provide their support in terms of early diagnosis for example the septic shock in children, prediction of disease severity like in the cases of traumatic brain injury, drug doses and emergency resource management. Lack of research on extensive data on far reaching population, legal and trust issues and unfriendly software’s are the challenges those need to be resolved for utilizing AI at its higher potential in paediatric healthcare.
Abstract: Background: The functionality of Artificial intelligence (AI) in paediatric practices has been gaining more attention for last five years. Since then, researchers have started observing that the techniques are helpful in dealing multiple facets of childhood diseases including emergency like situations. This article has been aimed to discuss the cur...
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Lung Clearance Index to Detect Early Pulmonary Changes in Children with Sickle Cell Disease
Sophia Williams,
Monica Chaung,
Paul Kang
Issue:
Volume 8, Issue 2, June 2022
Pages:
56-62
Received:
24 December 2021
Accepted:
23 March 2022
Published:
14 April 2022
Abstract: Objective: Pulmonary complications including acute chest syndrome, are leading causes of sickle cell disease (SCD) related morbidity and mortality. Prior studies have shown that patients with pulmonary complications have evidence of pulmonary involvement reflected in lung functions trends as early as childhood. Spirometry is the current standard for measuring lung function. Growing evidence suggests that lung clearance index (LCI) which is a commonly reported parameter of multiple breath washout (MBW) tests, is more sensitive than spirometry measurements in the early identification of pulmonary changes in pediatric patients. The aim of our study was to determine if this relationship between LCI and spirometry existed within the pediatric sickle cell population. Study Design: This is a cross-sectional, retrospective study to compare LCI to spirometry measurements in children with SCD. Charts were reviewed of clinic encounters at Phoenix Children’s Hospital from March 1, 2013 – June 30, 2017. Spirometry and MBW measurements were collected from 23 patients between the ages of 5 years – 22 years. The MBW utilized sulfur hexafluoride (SF6) as the tracer gas. Demographics and SCD variant (e.g. HbSS, HbSC, etc.) for each encounter were also collected. Results: Our results show that LCI correlates to FEV1% predicted (Spearman’s coefficient -0.44, p = 0.003) and FEF25-75% (Spearman’s coefficient -0.49, p <0.001) over time. Based on demographics, LCI is affected by weight (p = 0.046) but not age or height. When comparing LCI and FEV1% predicted, abnormal LCI results were noted to occur even in the presence of normal FEV1% predicted measurements. Conclusions: Our data support LCI correlating with spirometry measurements, but more studies are necessary to explore whether LCI can be used as a screening test to detect pulmonary changes in young children with SCD. Earlier monitoring of lung function will allow for preventative therapies and delayed progression of pulmonary dysfunction.
Abstract: Objective: Pulmonary complications including acute chest syndrome, are leading causes of sickle cell disease (SCD) related morbidity and mortality. Prior studies have shown that patients with pulmonary complications have evidence of pulmonary involvement reflected in lung functions trends as early as childhood. Spirometry is the current standard fo...
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Determinants of Low Birth Weight at the University Hospital Center of Brazzaville (Republic of Congo)
Buambo Gauthier Regis Jostin,
Ngakengni Nelie Yvette,
Eckoba Oba Jean Baptiste,
Potokoue Mpia Sekangue Samantha Nuelly,
Mokoko Jules Cesar,
Itoua Clautaire,
Iloki Leon Herve
Issue:
Volume 8, Issue 2, June 2022
Pages:
63-69
Received:
13 March 2022
Accepted:
30 March 2022
Published:
14 April 2022
Abstract: Objective: Analyze the determinants of low birth weight at the Center Hospitalier Universitaire de Brazzaville. Methods: Case-control study, conducted from January 01 to June 30, 2020, in the Gynecology-Obstetrics department of the Brazzaville University Hospital, comparing 200 mother and newborn couples with a birth weight < 2500g (Cases) and 200 other mother and newborn couples -born with birth weight ≥ 2500g (Controls). The variables studied were pre, per and post partal. The p-value of the probability was considered significant for a value less than 0.05. Results: The mothers were different in age (age < 20 years: ORa = 6.0 [2.6-13.7]; p < 0.05 and age > 35 years ORa = 2.6 [1.1-6.0]; p < 0.05) mostly single (OR = 1.6 [1.3-3.9]; p < 0.05) with a history of low birth weight (ORa = 6.1 [1.2- 13.5]; p < 0.05) and lean (ORa = 8.4 [4.7-15.0]; p < 0.05). Pregnancies were associated with malaria (ORa = 3.0 [1.7-5.4]; p < 0.05) and arterial hypertension (ORa = 8.3 [3.1-22.3]; p<0.05). Most of them gave birth vaginally (OR= 1.8 [1.1-3.0]; p < 0.05), before term [(90.0% vs 8.5%); p<0.05)]. Conclusion: Low birth weight is of multifactorial origin. Its prevention requires management of the risk factors associated with it.
Abstract: Objective: Analyze the determinants of low birth weight at the Center Hospitalier Universitaire de Brazzaville. Methods: Case-control study, conducted from January 01 to June 30, 2020, in the Gynecology-Obstetrics department of the Brazzaville University Hospital, comparing 200 mother and newborn couples with a birth weight < 2500g (Cases) and 200 other mother and newborn couples -born with birth weight ≥ 2500g (Controls). The variables studied were pre, per and post partal. The p-value of the probability was considered significant for a value less than 0.05. Results: The mothers wer...
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Quality Improvement Initiative in Pediatric Critical Care
Issue:
Volume 8, Issue 2, June 2022
Pages:
70-76
Received:
14 March 2022
Accepted:
6 April 2022
Published:
14 April 2022
Abstract: In a large academic pediatric medical center the formation of specialty care teams in the pediatric critical care setting led to the improvement in quality delivered to patients who had tracheostomies. Through frontline staff participation and interdisciplinary leadership – the team developed and strengthened processes that led to implementation of improvement strategies aimed at reducing hospital acquired pressure injury and decannulations. During this two-year time 150 nursing surveys and comprehensive literature reviews were completed to identify best practices and essential learning needs of the staff. The outcomes of these reviews helped to create improvement strategies which included developing educational initiatives focused on to support specific pathophysiologic issues impacting morbidity of patients leading to the quality metric goals. Upon completion of the educational and training initiatives led by the specialty care team, the incidence in tracheostomy decannulations and pressure injuries reduced significantly. Conclusions from this work highlight the importance of frontline staff as pivotal leaders in process change management and quality improvement changes. The teamwork among the interdisciplinary members allowed for enhanced collaboration in improving patient care outcomes and remains an active forum for evaluation of improvement in patient care. The efforts of the specialty care team provided sufficient data to support the implementation of specialty care teams that align efforts with that of organizational goals and aimed at reducing patient harm.
Abstract: In a large academic pediatric medical center the formation of specialty care teams in the pediatric critical care setting led to the improvement in quality delivered to patients who had tracheostomies. Through frontline staff participation and interdisciplinary leadership – the team developed and strengthened processes that led to implementation of...
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Child and Adolescent Psychiatric Late Effects of Early Herpes Simplex Virus Type 1 Encephalitis
Patrick Galland,
Frank Maria Fischer,
Oana Funke,
Stephan Förster,
Berenike Steven,
Melissa Spitzer
Issue:
Volume 8, Issue 2, June 2022
Pages:
77-85
Received:
1 March 2022
Accepted:
6 April 2022
Published:
20 April 2022
Abstract: The most common late sequelae of herpes simplex virus type 1 encephalitis (HSVE) include secondary epilepsy, learning, language and memory disorders, and chronic headaches. The typical pattern of HSVE leads to necrosis in the temporal and frontal lobes, thus affecting areas of the brain specifically responsible for the coordination of memory and emotion. This case report describes the course of a patient who, in addition to the typical neurological long-term sequelae, also showed severe psychiatric abnormalities and subsequently addresses the question of why there have been hardly any reports of child and adolescent psychiatric late sequelae after HSVE to date. It can be assumed that the frequency of psychiatric late sequelae is underestimated in pediatrics and in child and adolescent psychiatry and that a targeted anamnestic diagnosis is therefore too often omitted later in child and adolescent psychiatry when psychiatric symptoms appear with a long latency. The second part of the article reviews the state of research to date, revealing that there are too few data on how often and to what extent early-experienced HSVE leads to psychiatric late effects. On the basis of the case report, the specific symptoms to which particular attention should be paid and the brain structures that are typically involved in relation to a psychiatric disorder are presented. From this, it can be deduced, according to the conclusion in the third part of the article, which medications might help. Because of the typical symptomatology of emotional instability some years after HSVE, it is suggested to consider the possibility of mood-stabilizing therapy. The results from the case report presented suggest this.
Abstract: The most common late sequelae of herpes simplex virus type 1 encephalitis (HSVE) include secondary epilepsy, learning, language and memory disorders, and chronic headaches. The typical pattern of HSVE leads to necrosis in the temporal and frontal lobes, thus affecting areas of the brain specifically responsible for the coordination of memory and em...
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The Association Between Nutritional Status on Admission and Hospital-Acquired Malnutrition in Pediatric Patients at Sanglah General Hospital
Jessica Sugiharto,
I Gusti Lanang Sidiartha,
I Gusti Ayu Putu Eka Pratiwi
Issue:
Volume 8, Issue 2, June 2022
Pages:
86-90
Received:
11 March 2022
Accepted:
9 April 2022
Published:
20 April 2022
Abstract: Introduction: Hospital-acquired malnutrition is one aspect of childhood malnutrition that healthcare professionals might not recognize. The prevalence of hospital-acquired malnutrition globally and in developing countries is still high varies between 6.1%-40.9%. Various factors contributed to the frequency of hospital-acquired malnutrition, including the nutritional status at the onset of the disease. Material and Methods: The prospective cohort study was conducted on the patients in Pediatric Ward at Sanglah General Hospital, Denpasar Bali period July 2020 and January 2021. We Include children aged one month to 18 years old. Samples were taken by consecutive sampling. Hospital-acquired malnutrition was marked by more than 2% loss of weight from the measurement during admission. Univariate analysis was performed using the chi-square test. Nutritional status presented as Prevalence Ratio (PR) and 95% Confidence Interval (95% CI). The result is considered as significant if p<0.05. Results: 208 subjects were included and analyzed in this study. Malnutrition incidence was 15.4%. The risk factors significantly associated with hospital-acquired malnutrition were an underlying disease, length of stay, admission nutritional status. Malnutrition, length of stay and underlying condition were the independent risk factors for hospital-acquired malnutrition with PR 7.528 (95% CI, 2.528-21.033; p=0.001), PR 9.061 (95% CI, 2.925-28.066; p=0.001) and PR 2.638 (95% CI, 1.0325-6.724; p=0.042). Conclusion: The incidence of hospital acquired malnutrition in Sanglah Hospital was 15.4%. Children with malnutrition, prolonged hospitalization length, and underlying disease are associated with hospital-acquired malnutrition.
Abstract: Introduction: Hospital-acquired malnutrition is one aspect of childhood malnutrition that healthcare professionals might not recognize. The prevalence of hospital-acquired malnutrition globally and in developing countries is still high varies between 6.1%-40.9%. Various factors contributed to the frequency of hospital-acquired malnutrition, includi...
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Evaluation of Remineralization Effect of Various Toothpastes on White Spot Enamel Lesions: An in Vitro Study
Masoumeh Moslemi,
Mehrnaz Mahmodabadi,
Zahra Bastani,
Zahra Khalili Sadrabad,
Faezeh Sadat Faghihi,
Zahra Shadkar
Issue:
Volume 8, Issue 2, June 2022
Pages:
91-97
Received:
6 March 2022
Accepted:
14 April 2022
Published:
28 April 2022
Abstract: Despite the high prevalence of tooth-caries and various efforts to prevent it, studies on plant compounds and their anti-caries properties have been largely neglected. Brushing with toothpaste is the most effective way for caries prevention. This study was performed on KREND herbal toothpaste (containing Calendula and Salvia Officinalis), Herbex (containing propolis), and Crest herbal toothpaste. The remineralization effect of these toothpaste brands on carious lesions has not been studied yet. Therefore, we compared the remineralizing effect of Iranian toothpaste and foreign types in this study. Method and materials: 60 caries-free human premolar teeth were collected after extraction for orthodontic purposes. The surface microhardness (SMH) was measured using the Vickers microhardness testing machine at baseline and after four days of immersing in demineralization solution and after treatment. The pH cycle was then performed for 28 days. The teeth were allocated randomly into one of the four groups, group 1 (as the control group and immersed in distilled water), group 2 (treated with KREND herbal solution), group 3 (treated with Crest solution), and group 4 (treated with Herbex solution). Finally, data were analyzed with Repeated Measure ANOVA and SPSS version 18. All study groups' surface micro-hardness measures were decreased after demineralization (P=0.001) and were increased after pH cycling (P<0.001). There wasn't a statistically significant difference in mean Surface micro-hardness changes between study groups (P=0.433). This study showed that the remineralization ratio in study group samples increased after treatment with herbal toothpaste, and the Iranian toothpaste (Krend) and foreign ones had a similar remineralizing effect.
Abstract: Despite the high prevalence of tooth-caries and various efforts to prevent it, studies on plant compounds and their anti-caries properties have been largely neglected. Brushing with toothpaste is the most effective way for caries prevention. This study was performed on KREND herbal toothpaste (containing Calendula and Salvia Officinalis), Herbex (c...
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Role of Human Milk Oligosaccharides (HMOs) on Proper Growth, Immunity, and Tolerance in Ensuring Lifelong Health for Infants and Toddlers
Aftab Yusuf Raj,
Rajesh Majumder,
Fuadul Islam,
ATM Rafique Uzzal,
Kuntal Roy,
Kamrul Hasan,
Sabira Rahman
Issue:
Volume 8, Issue 2, June 2022
Pages:
98-103
Received:
19 March 2022
Accepted:
8 April 2022
Published:
29 April 2022
Abstract: Human milk oligosaccharides (HMOs) contain numerous biomolecules. It is the third most abundant solid component of breast milk, after lactose and lipids, that plays an important role in infant growth and the development of human life. Several studies have reported the health benefits of HMOs, which include modulation of the intestinal microbiota, anti-adhesive effect against pathogens, modulation of the intestinal epithelial cell response, development of the immune system, increasing the intestinal barrier and so many health benefits can be achieved through the presence of HMOs in breast milk. Infant growth is indirectly or directly dependent on so many compounds of the biological and chemical composition of mother milk, HMOs are one of them. The genetic background of the mothers and the diversity of HMOs are determined and the non-secretor mothers secrete lower HMOs than secretor mothers. The breastfed infants of secretor mothers gain more health benefits than those of non-secretor mothers. Here the study critically reviewed the role of HMOs in proper growth, immune system, and development in ensuring the health impact of infants and toddlers. The study also focuses on current knowledge of the HMOs study and the beneficial effect of HMOs types and their importance to infant growth and protection against NEC. HMOs are applied now in infant formulas to imitative nutrition composition of breast milk and their study and challenges are vastly discussed in a specific manner in the human study. In conclusion, it is stated that the supplementation of infant formula with 2′-FL and LNnT is a promising innovation for infant nutrition.
Abstract: Human milk oligosaccharides (HMOs) contain numerous biomolecules. It is the third most abundant solid component of breast milk, after lactose and lipids, that plays an important role in infant growth and the development of human life. Several studies have reported the health benefits of HMOs, which include modulation of the intestinal microbiota, a...
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Osteopathic Evaluation and Positional Plagiocephaly: A Descriptive Study on a Population of Children with ASD
Magda Di Renzo,
Alessandro Laurenti,
Federico Bianchi Di Castelbianco,
Elena Vanadia,
Massimiliano Petrillo,
Simona D’Errico,
Rosaria Ferrara,
Lidia Racinaro,
Monica Rea
Issue:
Volume 8, Issue 2, June 2022
Pages:
104-110
Received:
29 March 2022
Accepted:
25 April 2022
Published:
10 May 2022
Abstract: The discipline of osteopathy is a whole person approach that incorporates medical and scientific knowledge using an array of manipulative techniques for diagnosis and treatment of several types of diseases (WHO). The ostheopathic examination allows to locate somatic dysfunctions which are the hallmarks of health imbalance caused by stressful events, external or internal to the body, such as trauma and / or other pathologies. The objective of osteopathic treatment is to improve posture and motor skills, which are the prerequisites for a balanced and harmonious development of the body. The osteopathic evaluation of children with autism spectrum disorder allows the identification of dysfunctional aspects at a somatic level that can enrich the understanding of the child's health and behavior, starting from the structure / function relationship, including craniofacial dimorphisms and plagiocephaly. The present exploratory research has made it possible to detect the presence of signs of plagiocephaly in about half of a sample of 250 preschool and school age children with autism spectrum disorder; the 44% of these, shows signs of craniofacial dysmorphism, which indicates a continuous morphostructural adaptation not yet sufficiently considered as an interferent element in the overall development of the child. The observed incidence is consistent with the incidence of plagiocephaly in the pediatric population and supports the hypothesis that in children with autism spectrum disorder it may be useful to integrate the osteopathic expertise with the other health professionals involved in the diagnostic and therapeutic process. The authors conclude that osteopathic observation can contribute to the definition of the functioning profile of the children with autism spectrum disorder and their needs, in a global perspective of taking charge and individualization of care.
Abstract: The discipline of osteopathy is a whole person approach that incorporates medical and scientific knowledge using an array of manipulative techniques for diagnosis and treatment of several types of diseases (WHO). The ostheopathic examination allows to locate somatic dysfunctions which are the hallmarks of health imbalance caused by stressful events...
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Duplex Collecting System of Right Kidney in 3-Year-Old Child: A Case Report
Ni Made Dwi Angga Riani,
Gusti Ayu Putu Nilawati,
Gede Wirya Kusuma Duarsa,
Pande Putu Yuli Anandasari,
Bagus Ngurah Mahakrishna
Issue:
Volume 8, Issue 2, June 2022
Pages:
111-114
Received:
3 April 2022
Accepted:
5 May 2022
Published:
12 May 2022
Abstract: Background: The duplex collecting system is one of the congenital anomalies of kidney and urinary tract. It occurs in 0.2-2% of the general population. It can remain asymptomatic or become symptomatic. Affected children may present with urinary tract infections. Treatment options include pharmacological and surgical approaches. Case: We reported a 3-year-old male child, who was referred to Sanglah Hospital with recurrent fever. From the physical examination, we found positive costovertebral angle tenderness. Urinalysis showed high leukocyte sediments (1655/field of view), positive urine culture (Enterococcus gallinarum), and decreased glomerular filtration rate (68.75 ml/minute/1.73 m2). Ultrasonography of the right kidney showed two pelvicalyceal systems with severe hydronephrosis of upper moiety. The intravenous pyelography showed the drooping lily sign in the right kidney. We diagnosed the patient with a complicated urinary tract infection caused by Enterococcus gallinarum, duplex collecting system of right kidney, chronic kidney disease stage II. Antibiotics were administered due to complicated UTI. Open heminephrectomy was done. The patient was discharged in stable condition. Conclusion: The duplex collecting system may cause recurrent urinary tract infection. It can be a risk factor for renal scarring and cause chronic kidney disease. Comprehensive diagnostic workup and multidisciplinary management are needed to promote a good clinical outcome.
Abstract: Background: The duplex collecting system is one of the congenital anomalies of kidney and urinary tract. It occurs in 0.2-2% of the general population. It can remain asymptomatic or become symptomatic. Affected children may present with urinary tract infections. Treatment options include pharmacological and surgical approaches. Case: We reported a ...
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Nomadic and Rural Population of Balochistan: Exploring the Pockets of Poor Childhood Immunization in the Most Under-Vaccinated Province of Pakistan
Sumera Akram,
Muhammad Ahmed Khan,
Abdul Rehman,
Noor-ul-Haq
Issue:
Volume 8, Issue 2, June 2022
Pages:
115-120
Received:
25 April 2022
Accepted:
20 May 2022
Published:
31 May 2022
Abstract: Objective: To assess the immunization coverage of children less than 2 years of age in rural and nomadic population of Balochistan. To assess the knowledge of parents about EPI immunization and find reasons of poor vaccination. Material and methods: The cross-sectional survey was conducted in rural population and nomadic tribes located in suburbs of district Zhob, Balochistan. One hundred families of rural areas and 100 families of nomadic tribes were interviewed. Information regarding the vaccination status of children, parents’ knowledge of EPI vaccinationand reasons of not vaccinating children or skipping vaccines were asked and noted. Education status of parents and socioeconomic status was also noted. Results: There were 295 children under 2 year age in the study population with 146 (49.5%) males and 149 (50.5%) females. Among rural population, 25 (16.4%) children were completely vaccinated, 106 (69.7%) children were partially vaccinated and 21 (13.8%) children never received any vaccination. In nomadic population, 10 (7%) children were completely vaccinated, 88 (61.5%) were partially vaccinated and 45 (31.5%) were unvaccinated. There was significant difference between vaccination status of families belonging to rural population versus those of nomadic population (P=0.002). Most common reason of skipping one or more vaccines was lack of knowledge and awareness in 28.8% cases. There was significant association between education status of fathers and mothers with vaccination status of families. Conclusion: Routine immunization of children in rural and nomadic population of Balochistan is dismal. Main culprits are lack of knowledge and awareness, compounded by illiteracy and poor education status of parents.
Abstract: Objective: To assess the immunization coverage of children less than 2 years of age in rural and nomadic population of Balochistan. To assess the knowledge of parents about EPI immunization and find reasons of poor vaccination. Material and methods: The cross-sectional survey was conducted in rural population and nomadic tribes located in suburbs o...
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Prevalence and Biochemical Risk Factors of Severe Acute Malnutrition in Infants Under 6 Months Old in Single Tertiary Referral Hospital
Leni Lukman,
I Gusti Ayu Putu Eka Pratiwi,
I Gusti Lanang Sidiartha
Issue:
Volume 8, Issue 2, June 2022
Pages:
121-125
Received:
6 May 2022
Accepted:
19 May 2022
Published:
31 May 2022
Abstract: Severe acute malnutrition remains to be a burden in developing countries, including Indonesia. Recent studies and researches started to highlight the importance of recognizing severe acute malnutrition in infants under 6 months old. This is a cross-sectional study aims to know the prevalence and biochemical risk factors of severe acute malnutrition in infants under 6 months old in our single tertiary referral hospital, Sanglah General Hospital, Denpasar, Bali, Indonesia. From January 2017 to December 2018, there were 138 children with severe acute malnutrition admitted to Sanglah General Hospital, Denpasar. From 138 subjects, 19 were below 6 months old of age (13,8%) and 119 were older than 6 months old (86,2%). Majority of our study samples were males with ratio of 1,5:1, had length of stay of more than 15 days (60,9%) and were marasmic (96,4%). Death occurred in 44,9% of study samples. Bivariate analysis including gender, length of stay, death, comorbidities, anemia, hypoalbuminemia, hypokalemia, hyponatremia and hypocalcemia. Of all the variables analyzed, only hypocalcemia yielded significant result with prevalence ratio between below and older than 6 months old age group was 0,432 (p value 0,045). The prevalence of hypocalcemia in infants under 6 months old with acute severe malnutrition is lower than children above 6 months old of age.
Abstract: Severe acute malnutrition remains to be a burden in developing countries, including Indonesia. Recent studies and researches started to highlight the importance of recognizing severe acute malnutrition in infants under 6 months old. This is a cross-sectional study aims to know the prevalence and biochemical risk factors of severe acute malnutrition...
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Implementation, Patient Satisfaction and Usability of Telemedicine Services for Pediatric Thalassemia Cases in Balochistan During COVID-19 Pandemic and Beyond
Sumera Akram,
Muhammad Ahmed Khan
Issue:
Volume 8, Issue 2, June 2022
Pages:
126-131
Received:
25 April 2022
Accepted:
23 May 2022
Published:
16 June 2022
Abstract: Background: Telemedicine health service has revolutionized delivery of health care to the doorsteps of needy and deserving cases especially since the onset of the recent pandemic; COVID-19. Beta thalassemia major children require lifelong medical care, despite any untoward circumstances. Aim of this study is to identify role of telemedicine in diagnosing, treating and following-up of thalassemia cases and assess patient satisfaction. Objective: To assess implementation, patient satisfaction and usability of telemedicine health service for pediatric thalassemia cases in Northern Balochistan. Study place and duration: Study was carried out at District Headquarter Hospital Zhob from April 2021 to September 2021. Material & methods: Telemedicine service was established at Pediatric Department DHQ Hospital Zhob during COVID-19 pandemic. The data of all thalassemia cases that were managed/provided health care via telemedicine was collected and recorded. Patient satisfaction and usability of telemedicine service provided was assessed using a questionnaire prepared after thorough study of literature. The parents and care-givers of thalassemia cases treated via telemedicine were interviewed on mobile cell phones/telephone and the questionnaires were filled. Overall satisfaction was also gauged according to a scale from 1 to 5, where 1 depicted extremely dissatisfaction and 5 showed extreme satisfaction. The data was analyzed with Statistical package for social science (SPSS 21). Results: Total 347 patients of thalassemia received telemedicine health service during the study period. There were 182 (52.4%) males and 165 (47.6%) females with age range of 1 – 15 years (mean age 8.09 + 3.47 years). Total 289 (83.3%) telemedicine service seekers were residing in rural areas and rest 58 (16.7%) resided in urban areas. Ninety seven families (28%) belonged to poor class, 192 (55.35) belonged to lower middle class, 55 (15.9%) belonged to upper middle class and 3 (0.9%) belonged to rich class. Majority of participants (97.4%) were significantly satisfied with telemedicine service (p value 0.001). Conclusion: During current COVID-19 pandemic telemedicine has emerged as an exceptional alternate mode of healthcare delivery. It saves cost and time of travelling for thalassemia cases who require life-long hospital visits and follow-up. People have shown high satisfaction and positive attitude towards telemedicine health service provision.
Abstract: Background: Telemedicine health service has revolutionized delivery of health care to the doorsteps of needy and deserving cases especially since the onset of the recent pandemic; COVID-19. Beta thalassemia major children require lifelong medical care, despite any untoward circumstances. Aim of this study is to identify role of telemedicine in diag...
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Pulmonary Endarterectomy for Chronic Thromboembolic Pulmonary Hypertension in a 5-year-old Girl with No Risk Factors - A Case Report
Sudivya Sharma,
Adeel Rahman,
Arun Beeman,
Shahin Moledina,
Alex Robertson,
David Jenkins,
Mirjana Cvetkovic,
Nagarajan Muthialu
Issue:
Volume 8, Issue 2, June 2022
Pages:
132-136
Received:
13 May 2022
Accepted:
31 May 2022
Published:
16 June 2022
Abstract: Chronic thromboembolic pulmonary hypertension (CTEPH) in pediatric population is rare. We present a case of five-year-old female child, diagnosed as CTEPH on warfarin and home oxygen for 6 months. Imaging showed extensive thrombus in distal right pulmonary artery (RPA) than left pulmonary artery (LPA). She clinically deterioration inspite of maximal medical management and was referred for surgical option. Considering lack of literature evidence on surgical outcomes in pediatric CTEPH, decision to perform surgery was made after multi-disciplinary team discussion between adult and paediatric pulmonary hypertension and cardiothoracic surgical teams across two units in UK. We performed pulmonary thromboendarterectomy (PEA) using cardiopulmonary bypass under deep hypothermic circulatory arrest (DHCA). The surgical procedure was uneventful with good clinical recovery. Our report highlights the need for earlier and prompt diagnosis with a need for referral to a specialized surgical center at an earlier stage before intractable vascular resistance ensues. Surgery can be safely performed for CTEPH in pediatric populations.
Abstract: Chronic thromboembolic pulmonary hypertension (CTEPH) in pediatric population is rare. We present a case of five-year-old female child, diagnosed as CTEPH on warfarin and home oxygen for 6 months. Imaging showed extensive thrombus in distal right pulmonary artery (RPA) than left pulmonary artery (LPA). She clinically deterioration inspite of maxima...
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Influence of Birth Season Climate on Adult Total Serum IgE Levels
Issue:
Volume 8, Issue 2, June 2022
Pages:
137-140
Received:
22 May 2022
Accepted:
10 June 2022
Published:
16 June 2022
Abstract: Background: The effect of birth season climate on adult IgE-mediated respiratory disease is an important public health issue. Objective: To determine the effect of birth season climate on adult total serum IgE (TSIgE) levels. Study design: The study is a retrospective chart review with the following inclusion criteria: TSIgE measurement, age ≥ 16, and northeastern Tennessee birthplace. Main outcome measures include TSIgE levels, birth season climatic conditions, and regional pollen-producing plant and pollen counts. Results: The records of 1,274 women (mean age 40.8 ± 17.5, age range 16-96) and 762 men (mean age 38.1 ± 17, age range 16-82) seen in our Allergy Clinic were reviewed. Persons born in the spring and summer, the seasons with the highest pollen counts and the most favorable climatic conditions for plant growth, had nearly twice the odds of having TSIgE levels > 1σ above the mean of the study group when compared to those born in the fall or winter (odds ratio (OR) 1.75, 95% confidence interval (CI) 0.96-3.17 and OR 1.93, 95% CI 1.04-3.57, respectively); odds were highest for those born in March (OR 2.55, 95% CI 1.37-4.74) and July (OR 2.38, 95% CI 1.25-4.51) and lowest for those born in November (OR 0.11, 95% CI 0.0068-1.79). When averaged over the 95-years of study and five 30-year climate cycles TSIgE levels increased linearly as the seasons progressed from fall to summer (r2 = 0.9475, P = 0.0266). Of the climatic factors, TSIgE levels correlated most strongly with levels of precipitation (r2 = 0.9145, P = 0.0437). Conclusion: Climatic conditions that increase birth season exposure to environmental allergens may have a life-long effect on TSIgE production.
Abstract: Background: The effect of birth season climate on adult IgE-mediated respiratory disease is an important public health issue. Objective: To determine the effect of birth season climate on adult total serum IgE (TSIgE) levels. Study design: The study is a retrospective chart review with the following inclusion criteria: TSIgE measurement, age ≥ 16, ...
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Profound Sensorineural Hearing Loss Following Adjuvant Steroid Delay in Pediatric Bacterial Meningitis
Nayri Topalian,
Amani Mansour,
Saraa Wehbe,
Sarah El Yaman
Issue:
Volume 8, Issue 2, June 2022
Pages:
141-145
Received:
23 May 2022
Accepted:
14 June 2022
Published:
27 June 2022
Abstract: Streptococcus pneumonia is a gram positive, polysaccharide-encapsulated diplococcus associated with various pulmonary and extra-pulmonary clinical presentations including invasive diseases such as acute meningitis. It can be associated with high rates of morbidity and mortality in both the pediatric and the adult populations. The introduction of the pneumococcal conjugate vaccine which expanded to cover 13 strains allowed remarkable protection against these invasive infections. In addition, the use of adjuvant corticosteroid therapy in the last few years; in particular dexamethasone, for the management of acute bacterial meningitis reduced the incidence of severe hearing loss in both Hib and other bacterial meningitis. The IDS guidelines recommend administering the first dose of steroids just before or with the start of antibiotics due to its decreased effectiveness with the late presentations of meningitis. We present the case of a 14-year-old female adolescent refugee, with incomplete vaccination status prior to relocating to Lebanon presenting with pneumococcal meningitis. Her hospitalization was complicated by bilateral profound sensorineural hearing loss (SNHL) following a delay in steroid administration. The aim of this article is to highlight the role of vaccines in decreasing morbidity of vaccine-preventable illnesses, and the importance of early administration of steroids as adjuvant to therapy for prevention of neurologic sequeleae.
Abstract: Streptococcus pneumonia is a gram positive, polysaccharide-encapsulated diplococcus associated with various pulmonary and extra-pulmonary clinical presentations including invasive diseases such as acute meningitis. It can be associated with high rates of morbidity and mortality in both the pediatric and the adult populations. The introduction of th...
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Microorganism and Antibiotik Sensitivity Pattern of Children Bacterial Meningitis in Denpasar Tertiary Hospital 2019-2020
Dewi Sutriani Mahalini,
Putu Pradnyanita Mustika,
I Gusti Ngurah Made Suwarba
Issue:
Volume 8, Issue 2, June 2022
Pages:
146-151
Received:
30 May 2022
Accepted:
16 June 2022
Published:
27 June 2022
Abstract: Introduction: Bacterial meningitis is a severe acute infection of the central nervous system that caused by bacteria. The antibiotic should be given immediately. An appropriate antibiotic may reduce the morbidity and mortality caused by bacterial meningitis. This study aims to evaluate the bacterial pattern and antibiotic sensitivity in children bacterial meningitis at tertiary hospital in Denpasar. Material and methods: This retrospective descriptive study was using a cross-sectional design that involved pediatric patients aged 1 month-18 years old with suspected bacterial meningitis who underwent a lumbar puncture at Sanglah Hospital from January 2019 to December 2020. The diagnosis of bacterial meningitis was made based on cerebrospinal fluid culture and antibiotic sensitivity test. Samples were taken by consecutive sampling method and would be excluded if the medical record was incomplete. Results: There were ninety five pediatric patients treated with suspected meningitis. Thirty-three subjects had positive cerebrospinal fluid culture results with eight of them were contaminants. The proportion of bacterial meningitis was 26.3%. Bacterial meningitis was more common in children younger less than two years old (72%) compare with older children. The most gram-positive bacteria were Staphylococcus sp. while for gram-negative was Acinetobacter sp. and Sphingomonas paucimobilis. Vancomycin had a high sensitivity (92.8%) for gram-positive therapy, while for gram-negative it was cephalosporin drug which is ceftriaxone and cefepime (63.6%). Conclusion: Ceftriaxone as the main choice of empiric therapy still has high sensitivity to gram-negative bacteria but low sensitivity to gram-positive bacteria.
Abstract: Introduction: Bacterial meningitis is a severe acute infection of the central nervous system that caused by bacteria. The antibiotic should be given immediately. An appropriate antibiotic may reduce the morbidity and mortality caused by bacterial meningitis. This study aims to evaluate the bacterial pattern and antibiotic sensitivity in children ba...
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