Pub Date : 2024-04-04DOI: 10.18203/2349-3291.ijcp20240924
Rajith M. L., Punyashree R.
Background: Increased duration of neonatal intensive care unit (NICU) stay of preterm neonates have becoming an emotional and financial burden to parents leading to very high chances of parents discontinuing the treatment and thus increased morbidity and mortality of neonates. Oxygen dependency is the major cause of the prolonged NICU stay for the neonates having respiratory illness like respiratory distress syndrome (RDS), meconium aspiration syndrome (MAS), and pneumonia. Inhaled budesonide being a safe immunosuppressor has shown the promising result in the treatment of these immune system activated respiratory disorders of neonate and thus reduction of oxygen dependency and later reducing the hospital stay duration. The intent of this study is to evaluate the usefulness of inhaled budesonide in such respiratory disorders of neonate. Methods: A randomized controlled trial involving 60 oxygen dependent neonates in NICU was conducted from July 2021 to March 2023. Results: Budesonide nebulization decreased the duration of oxygen dependency of neonates and thus reduced NICU stay. Conclusions: Budesonide nebulization is associated with improvements in respiratory parameters in neonates with RDS, MAS, Pneumonia leading to early oxygen weaning and early discharge.
{"title":"Study of usefulness of budesonide nebulization in oxygen dependent preterm newborns in NICU","authors":"Rajith M. L., Punyashree R.","doi":"10.18203/2349-3291.ijcp20240924","DOIUrl":"https://doi.org/10.18203/2349-3291.ijcp20240924","url":null,"abstract":"Background: Increased duration of neonatal intensive care unit (NICU) stay of preterm neonates have becoming an emotional and financial burden to parents leading to very high chances of parents discontinuing the treatment and thus increased morbidity and mortality of neonates. Oxygen dependency is the major cause of the prolonged NICU stay for the neonates having respiratory illness like respiratory distress syndrome (RDS), meconium aspiration syndrome (MAS), and pneumonia. Inhaled budesonide being a safe immunosuppressor has shown the promising result in the treatment of these immune system activated respiratory disorders of neonate and thus reduction of oxygen dependency and later reducing the hospital stay duration. The intent of this study is to evaluate the usefulness of inhaled budesonide in such respiratory disorders of neonate.\u0000Methods: A randomized controlled trial involving 60 oxygen dependent neonates in NICU was conducted from July 2021 to March 2023.\u0000Results: Budesonide nebulization decreased the duration of oxygen dependency of neonates and thus reduced NICU stay.\u0000Conclusions: Budesonide nebulization is associated with improvements in respiratory parameters in neonates with RDS, MAS, Pneumonia leading to early oxygen weaning and early discharge.","PeriodicalId":13870,"journal":{"name":"International Journal of Contemporary Pediatrics","volume":"111 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140742737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-04DOI: 10.18203/2349-3291.ijcp20240925
Kristīne Kalēja, Ilze Apine, Inita Kaže
This report presents the case of a 13-year-old female with a history of ulcerative colitis who underwent ileostomy closure after total colectomy. Postoperatively, she developed right leg paresis and extensive swelling of the lower extremities. Imaging investigations revealed myositis with avascular necrosis in the distal femoral condyles. These findings were consistent with myositis as an extraintestinal complication of ulcerative colitis.
{"title":"Myositis as a de-novo extraintestinal manifestation of ulcerative colitis in a pediatric patient developing post-colectomy: a case report","authors":"Kristīne Kalēja, Ilze Apine, Inita Kaže","doi":"10.18203/2349-3291.ijcp20240925","DOIUrl":"https://doi.org/10.18203/2349-3291.ijcp20240925","url":null,"abstract":"This report presents the case of a 13-year-old female with a history of ulcerative colitis who underwent ileostomy closure after total colectomy. Postoperatively, she developed right leg paresis and extensive swelling of the lower extremities. Imaging investigations revealed myositis with avascular necrosis in the distal femoral condyles. These findings were consistent with myositis as an extraintestinal complication of ulcerative colitis.","PeriodicalId":13870,"journal":{"name":"International Journal of Contemporary Pediatrics","volume":"19 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140742162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-04DOI: 10.18203/2349-3291.ijcp20240923
Rajith M. L., Punyashree R.
Background: Hyaline membrane disease/RDS is an important cause for newborn morbidity and mortality. Many studies have established an association of infants of diabetic mothers (IDMs) with respiratory distress syndrome (RDS) since decades. Modern lifestyle changes have increased the prevalence of obesity in women and thus diabetes in pregnancy. Maintaining strict euglycemia is a double-edged sword in pregnancy which has been affecting the neonatal health and respiratory maturity in particular which has been associated with increased mortality and morbidity. Methods: It was a prospective case control study done over a span of one year. Results: Hyaline membrane disease (RDS) is significantly associated with gestational diabetes mellitus (GDM). Conclusions: Even our study emphasized the ill effects of gestational diabetes on the respiratory development of baby. Most of the babies are manageable and outcome can be drastically improved by early diagnosis and efficient treatment. Education and anticipation of the complications and prompt referral are the need of the hour in peripheries and advancement of neonatal intensive cares in the referral hospitals is needed.
{"title":"A study of incidence of respiratory distress syndrome in newborns born to mothers with gestational diabetes","authors":"Rajith M. L., Punyashree R.","doi":"10.18203/2349-3291.ijcp20240923","DOIUrl":"https://doi.org/10.18203/2349-3291.ijcp20240923","url":null,"abstract":"Background: Hyaline membrane disease/RDS is an important cause for newborn morbidity and mortality. Many studies have established an association of infants of diabetic mothers (IDMs) with respiratory distress syndrome (RDS) since decades. Modern lifestyle changes have increased the prevalence of obesity in women and thus diabetes in pregnancy. Maintaining strict euglycemia is a double-edged sword in pregnancy which has been affecting the neonatal health and respiratory maturity in particular which has been associated with increased mortality and morbidity.\u0000Methods: It was a prospective case control study done over a span of one year.\u0000Results: Hyaline membrane disease (RDS) is significantly associated with gestational diabetes mellitus (GDM).\u0000Conclusions: Even our study emphasized the ill effects of gestational diabetes on the respiratory development of baby. Most of the babies are manageable and outcome can be drastically improved by early diagnosis and efficient treatment. Education and anticipation of the complications and prompt referral are the need of the hour in peripheries and advancement of neonatal intensive cares in the referral hospitals is needed.","PeriodicalId":13870,"journal":{"name":"International Journal of Contemporary Pediatrics","volume":"55 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140742052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-22DOI: 10.18203/2349-3291.ijcp20240351
Aneeta Chaudhary, Arun Kumar Arya
Ethmocephaly is a rare but lethal congenital anomaly. Its incidence rate is 1 in 15,000 live births and 1 in 250 in abortuses. Babies have typical dysmorphic facies in form of orbital hypotelorism, proboscis and low set malformed ears. 32 years old, daily wage labourer delivered a baby with ethmocephaly. Baby had typical facies, and no extracranial abnormality present. Baby was stillborn. She had no antenatal checkup or ultrasonogram done. However, she had history of ingestion of certain plants during early months of pregnancy. Ethmocephaly is a lethal anomaly and mostly eliminated prenatally. Although there is no diagnostic test for ethmocephaly, and confirmation of it is done only by appearance of baby after birth, important clues like recognition of risk factors like maternal diabetes, alcohol intake, ingestion of certain plants, antenatal hydrocephalus, should not be missed. Importance of routine antenatal checkup and ultrasonogram is emphasized. Recognition of risk factors and a possible co-relation with ingestion of certain other plants is also emphasized.
{"title":"Ethmocephaly: a rare but lethal congenital anomaly","authors":"Aneeta Chaudhary, Arun Kumar Arya","doi":"10.18203/2349-3291.ijcp20240351","DOIUrl":"https://doi.org/10.18203/2349-3291.ijcp20240351","url":null,"abstract":"Ethmocephaly is a rare but lethal congenital anomaly. Its incidence rate is 1 in 15,000 live births and 1 in 250 in abortuses. Babies have typical dysmorphic facies in form of orbital hypotelorism, proboscis and low set malformed ears. 32 years old, daily wage labourer delivered a baby with ethmocephaly. Baby had typical facies, and no extracranial abnormality present. Baby was stillborn. She had no antenatal checkup or ultrasonogram done. However, she had history of ingestion of certain plants during early months of pregnancy. Ethmocephaly is a lethal anomaly and mostly eliminated prenatally. Although there is no diagnostic test for ethmocephaly, and confirmation of it is done only by appearance of baby after birth, important clues like recognition of risk factors like maternal diabetes, alcohol intake, ingestion of certain plants, antenatal hydrocephalus, should not be missed. Importance of routine antenatal checkup and ultrasonogram is emphasized. Recognition of risk factors and a possible co-relation with ingestion of certain other plants is also emphasized.","PeriodicalId":13870,"journal":{"name":"International Journal of Contemporary Pediatrics","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139957987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-22DOI: 10.18203/2349-3291.ijcp20240346
Jayesh R. Solanki, Kishan S. Patel
Background: Acute kidney injury (AKI) is characterized by a reversible increase in the blood concentration of creatinine and nitrogenous waste products and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately. There is minimal data on the clinical profile of pediatric AKI patients age less than 15 years who required renal replacement therapy (RRT). Methods: A total of 301 patients (3%) were diagnosed with AKI, amongst them 66 patients who required RRT from January 2021 to December 2022 were enrolled. Their clinical, biochemical, and etiological profile were studied to find out their influence in modifying the outcome of AKI patients requiring RRT. Results: AKI was noted in 301 patients (3%), amongst them 66 patients we had analyzed who underwent RRT. Result were analyzed in three age group (0-2 month, 2 month-8 year, 8 year-15 year). Male preponderance was seen amongst all age groups with male: female ratio being 2:1, 5:1 and 1.8:1 respectively and rural area preponderance seen in all age groups. Birth asphyxia, neonatal sepsis and septicemia were leading etiologies in different groups. Peritoneal dialysis (PD) was only RRT modality in the 0-2 month age group, while hemodialysis and PD modalities were used in rest groups. Multi-organ dysfunction syndrome was commonly seen comorbidity associated with all groups along with pyogenic meningitis, and encephalopathy. Mortality rate was observed at 47% (n=31). Conclusions: From our study, we conclude that to expand the facility of point of care, hemodialysis facility in ICUs with a larger study or multicentric study in the pediatric age group is required.
{"title":"Clinical profile of pediatric acute renal failure patients requiring renal replacement therapy age less than 15 years: an ambivalent COHORT study","authors":"Jayesh R. Solanki, Kishan S. Patel","doi":"10.18203/2349-3291.ijcp20240346","DOIUrl":"https://doi.org/10.18203/2349-3291.ijcp20240346","url":null,"abstract":"Background: Acute kidney injury (AKI) is characterized by a reversible increase in the blood concentration of creatinine and nitrogenous waste products and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately. There is minimal data on the clinical profile of pediatric AKI patients age less than 15 years who required renal replacement therapy (RRT).\u0000Methods: A total of 301 patients (3%) were diagnosed with AKI, amongst them 66 patients who required RRT from January 2021 to December 2022 were enrolled. Their clinical, biochemical, and etiological profile were studied to find out their influence in modifying the outcome of AKI patients requiring RRT.\u0000Results: AKI was noted in 301 patients (3%), amongst them 66 patients we had analyzed who underwent RRT. Result were analyzed in three age group (0-2 month, 2 month-8 year, 8 year-15 year). Male preponderance was seen amongst all age groups with male: female ratio being 2:1, 5:1 and 1.8:1 respectively and rural area preponderance seen in all age groups. Birth asphyxia, neonatal sepsis and septicemia were leading etiologies in different groups. Peritoneal dialysis (PD) was only RRT modality in the 0-2 month age group, while hemodialysis and PD modalities were used in rest groups. Multi-organ dysfunction syndrome was commonly seen comorbidity associated with all groups along with pyogenic meningitis, and encephalopathy. Mortality rate was observed at 47% (n=31).\u0000Conclusions: From our study, we conclude that to expand the facility of point of care, hemodialysis facility in ICUs with a larger study or multicentric study in the pediatric age group is required.\u0000 ","PeriodicalId":13870,"journal":{"name":"International Journal of Contemporary Pediatrics","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139957920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-16DOI: 10.18203/2349-3291.ijcp20240328
Kovvuru Ashrita, Ethuri Lokesh
Mucopolysaccharidosis (MPS) IVA, or Morquio syndrome, is a rare lysosomal storage disorder characterized by skeletal dysplasia. It is caused due to deficiency in the enzyme N-acetylgalactosamine-6-sulfatase (GALNS), which results from an autosomal recessive mutation in the GALNS gene. The frequency of this mutation is equivalent in men and women. Here in, we present the case of Morquio syndrome, in a male child of twin gestation with poor antenatal and natal history. The peculiar presentations are those of skeletal deformities, coarse facial features, recurrent respiratory tract infections, and a history of NICU admission for meconium aspiration syndrome. This case is unique because, despite a negative family and prenatal history, and one of the twins being unaffected which adds to its appeal. Later, on biochemical and radiological investigations, he was diagnosed with mucopolysaccharidoses IVA and ultimately managed him supportively.
{"title":"Typical presentation of mucopolysaccharidosis type IVA: a case report","authors":"Kovvuru Ashrita, Ethuri Lokesh","doi":"10.18203/2349-3291.ijcp20240328","DOIUrl":"https://doi.org/10.18203/2349-3291.ijcp20240328","url":null,"abstract":"Mucopolysaccharidosis (MPS) IVA, or Morquio syndrome, is a rare lysosomal storage disorder characterized by skeletal dysplasia. It is caused due to deficiency in the enzyme N-acetylgalactosamine-6-sulfatase (GALNS), which results from an autosomal recessive mutation in the GALNS gene. The frequency of this mutation is equivalent in men and women. Here in, we present the case of Morquio syndrome, in a male child of twin gestation with poor antenatal and natal history. The peculiar presentations are those of skeletal deformities, coarse facial features, recurrent respiratory tract infections, and a history of NICU admission for meconium aspiration syndrome. This case is unique because, despite a negative family and prenatal history, and one of the twins being unaffected which adds to its appeal. Later, on biochemical and radiological investigations, he was diagnosed with mucopolysaccharidoses IVA and ultimately managed him supportively.","PeriodicalId":13870,"journal":{"name":"International Journal of Contemporary Pediatrics","volume":"58 45","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139961109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The nascent respiratory tract of infants is highly vulnerable to frequent infections, thereby making acute respiratory infections a major risk factor for under five years morbidity and mortality. The clinical presentation of acute respiratory tract infections (ARTI) is however ambiguous and varied depending on a plethora of factors. The aim was to delineate the respiratory disease profiles of children aged 2 months-5 years in Western Maharashtra. Methods: The present cross sectional analytical study was conducted on 249 children aged between 2 months-5 years consulting the Pediatric wards and OPD with complaints of fever with cough, cold, breathlessness, and chest pain. A comprehensive medical history was procured, followed by general and systemic examinations. Infections were assessed and x-ray was taken for all the patients. Data was analyzed using statistical software R version 4.0.3 and Microsoft Excel. Results: The male:female ratio in the study was 137:112. Cold (80.72%) and cough (74.3%) were the most widely experienced symptoms among patients, while chest pain (0.8%) was the least common. Among 249 cases, upper respiratory tract infection (URTI; 60%) was more predominantly noted than lower respiratory tract infections (LRTI; 44.8%). Nasopharyngitis (34.14%) and tonsillopharyngitis (6.83%) were the commonly prevalent types of URTI whereas pneumonia and bronchiolitis were the most recurrent types in the LRTI. Conclusions: Practitioners must consider the possibility of acute URTI more closely and must not be quick to disregard common symptoms such as cold and cough. Misdiagnosis or delayed diagnosis can severely hamper the prognosis of ARTI in young children. Hence, keeping abreast of the current clinical profiles exhibited by ARTI is of paramount importance for practitioners and the general population in the fight against under 5 mortalities.
背景：新生儿的呼吸道极易受到频繁感染，因此急性呼吸道感染成为五岁以下儿童发病和死亡的主要风险因素。然而，急性呼吸道感染（ARTI）的临床表现模糊不清，且因多种因素而各不相同。本研究旨在了解马哈拉施特拉邦西部 2 个月至 5 岁儿童的呼吸道疾病谱：本横断面分析研究的对象是 249 名 2 个月至 5 岁的儿童，他们在儿科病房和门诊就诊，主诉为发烧伴咳嗽、感冒、呼吸困难和胸痛。研究人员全面询问了病史，随后进行了全身和系统检查。所有患者均接受了感染评估和 X 光检查。数据使用 R 4.0.3 版统计软件和 Microsoft Excel 进行分析：研究中的男女比例为 137:112。感冒（80.72%）和咳嗽（74.3%）是患者最常见的症状，而胸痛（0.8%）是最不常见的症状。在 249 个病例中，上呼吸道感染（URTI；60%）比下呼吸道感染（LRTI；44.8%）更常见。鼻咽炎（34.14%）和扁桃体咽炎（6.83%）是上呼吸道感染的常见类型，而肺炎和支气管炎则是下呼吸道感染中最常见的类型：医生必须更仔细地考虑急性尿路感染的可能性，不能轻易忽视感冒和咳嗽等常见症状。误诊或延误诊断会严重影响幼儿急性尿路感染的预后。因此，掌握 ARTI 目前的临床表现对于从业人员和普通民众降低 5 岁以下儿童死亡率至关重要。
{"title":"Current clinical profiles of acute respiratory tract infections in children between 2 months to 5 years","authors":"Junita Desouza, Mohan Patil, Indu Thomas, Juanita Desouza","doi":"10.18203/2349-3291.ijcp20240089","DOIUrl":"https://doi.org/10.18203/2349-3291.ijcp20240089","url":null,"abstract":"Background: The nascent respiratory tract of infants is highly vulnerable to frequent infections, thereby making acute respiratory infections a major risk factor for under five years morbidity and mortality. The clinical presentation of acute respiratory tract infections (ARTI) is however ambiguous and varied depending on a plethora of factors. The aim was to delineate the respiratory disease profiles of children aged 2 months-5 years in Western Maharashtra.\u0000Methods: The present cross sectional analytical study was conducted on 249 children aged between 2 months-5 years consulting the Pediatric wards and OPD with complaints of fever with cough, cold, breathlessness, and chest pain. A comprehensive medical history was procured, followed by general and systemic examinations. Infections were assessed and x-ray was taken for all the patients. Data was analyzed using statistical software R version 4.0.3 and Microsoft Excel.\u0000Results: The male:female ratio in the study was 137:112. Cold (80.72%) and cough (74.3%) were the most widely experienced symptoms among patients, while chest pain (0.8%) was the least common. Among 249 cases, upper respiratory tract infection (URTI; 60%) was more predominantly noted than lower respiratory tract infections (LRTI; 44.8%). Nasopharyngitis (34.14%) and tonsillopharyngitis (6.83%) were the commonly prevalent types of URTI whereas pneumonia and bronchiolitis were the most recurrent types in the LRTI.\u0000Conclusions: Practitioners must consider the possibility of acute URTI more closely and must not be quick to disregard common symptoms such as cold and cough. Misdiagnosis or delayed diagnosis can severely hamper the prognosis of ARTI in young children. Hence, keeping abreast of the current clinical profiles exhibited by ARTI is of paramount importance for practitioners and the general population in the fight against under 5 mortalities.","PeriodicalId":13870,"journal":{"name":"International Journal of Contemporary Pediatrics","volume":"19 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139595565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Poisoning is a common paediatric emergency. Worldwide estimate suggests that the rate of poisoning in under 20 years is 1.8 per one lakh population and for India it ranges between 0.6 to 11.6%. Methods: The study was conducted at B. J. Medical College Ahmedabad and Civil Hospital, Ahmedabad. A prospective analytical study consisting of total 110 patients, admitted in the intensive care unit during the period from June 2018 to November 2018 with inclusion criterion of children <12 years of age, presented with history of consumption of poisonous substances/insect bite irrespective of signs and symptoms excluding cases of food poisoning and idiosyncratic drug reactions. Detailed proforma was filled after taking necessary consent from the parents. Routine investigations and gastric samples for forensic analysis were sent in all irrespective of type or route of poisoning. Specific investigations done wherever required. Analysis of outcomes done using chi square. Results: The most common age group was 3-6 years with male to female ratio of 1.5:1. 99.1% poisoning were accidental with hydrocarbon poisoning being the most common of all (27.2%), followed by household substance poisoning in 20.9%. Snakebite was the most common insect bite (10.9%). The average duration of stay was 3.9 days, 8.1% children died with maximum mortality happened in children presented after 6 hours of intoxication. Conclusions: Management of poisoning requires immediate advice and first aid, followed by a directed treatment. Decontamination, enhanced elimination, antidotes, and supportive care are commonly used to manage poisoning cases.
{"title":"Study of clinical profile and outcome of children presented with poisoning in tertiary care hospital","authors":"Chirag D. Shah, Aditi Kaple, Kankana Pratihar, Kush Patel, Jhalak Patel","doi":"10.18203/2349-3291.ijcp20240094","DOIUrl":"https://doi.org/10.18203/2349-3291.ijcp20240094","url":null,"abstract":"Background: Poisoning is a common paediatric emergency. Worldwide estimate suggests that the rate of poisoning in under 20 years is 1.8 per one lakh population and for India it ranges between 0.6 to 11.6%.\u0000Methods: The study was conducted at B. J. Medical College Ahmedabad and Civil Hospital, Ahmedabad. A prospective analytical study consisting of total 110 patients, admitted in the intensive care unit during the period from June 2018 to November 2018 with inclusion criterion of children <12 years of age, presented with history of consumption of poisonous substances/insect bite irrespective of signs and symptoms excluding cases of food poisoning and idiosyncratic drug reactions. Detailed proforma was filled after taking necessary consent from the parents. Routine investigations and gastric samples for forensic analysis were sent in all irrespective of type or route of poisoning. Specific investigations done wherever required. Analysis of outcomes done using chi square.\u0000Results: The most common age group was 3-6 years with male to female ratio of 1.5:1. 99.1% poisoning were accidental with hydrocarbon poisoning being the most common of all (27.2%), followed by household substance poisoning in 20.9%. Snakebite was the most common insect bite (10.9%). The average duration of stay was 3.9 days, 8.1% children died with maximum mortality happened in children presented after 6 hours of intoxication.\u0000Conclusions: Management of poisoning requires immediate advice and first aid, followed by a directed treatment. Decontamination, enhanced elimination, antidotes, and supportive care are commonly used to manage poisoning cases.","PeriodicalId":13870,"journal":{"name":"International Journal of Contemporary Pediatrics","volume":"73 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139596890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-25DOI: 10.18203/2349-3291.ijcp20240105
Lokesh Naik Mude, O. Shukla, Rinki H. Shah, Rajesh Rambhai Barad
A 10-year-old female was brought to emergency department with complaint fever, cold, and cough for 5 days followed by weakness of upper limb weakness more than Lower limb associated with inability to walk/stand, brought to emergency with altered sensorium. Nervous system: Confused and altered, tone is normal, power: 3/3 in upper limbs 2/2 in lower limbs and reflexes in bilateral knee brisk, bilateral plantar-extensor; On general examination revealed hypomimia, dysarthria and bilateral bradykinesia along with ataxic gait and pyramidal signs. Blood investigation were normal and diagnosis made by neuroimaging s/o: Bilaterally symmetrical abnormal signal in both postero-medial thalami, bilateral insular cortices, pons and bilateral middle cerebellar peduncles. It is extending into pons involving transverse pontocerebellar tracts and median pontine raphe nuclei giving 'Hot cross bun sign' (HCBS). During course of treatment child had autonomic disturbances. Child was treated with supportive medication and methyl-presdnisolone followed by oral steroid. Child had responded to treatment given and child has been discharged with no neurological deficit on oral medications. We concluded autonomic dysfunction in any patient presenting with acute onset of weakness with short duration must evaluate for MSA and institute appropriate treatment.
{"title":"Hot cross bun in pediatric age multi-system atrophy an unusual presentation","authors":"Lokesh Naik Mude, O. Shukla, Rinki H. Shah, Rajesh Rambhai Barad","doi":"10.18203/2349-3291.ijcp20240105","DOIUrl":"https://doi.org/10.18203/2349-3291.ijcp20240105","url":null,"abstract":"A 10-year-old female was brought to emergency department with complaint fever, cold, and cough for 5 days followed by weakness of upper limb weakness more than Lower limb associated with inability to walk/stand, brought to emergency with altered sensorium. Nervous system: Confused and altered, tone is normal, power: 3/3 in upper limbs 2/2 in lower limbs and reflexes in bilateral knee brisk, bilateral plantar-extensor; On general examination revealed hypomimia, dysarthria and bilateral bradykinesia along with ataxic gait and pyramidal signs. Blood investigation were normal and diagnosis made by neuroimaging s/o: Bilaterally symmetrical abnormal signal in both postero-medial thalami, bilateral insular cortices, pons and bilateral middle cerebellar peduncles. It is extending into pons involving transverse pontocerebellar tracts and median pontine raphe nuclei giving 'Hot cross bun sign' (HCBS). During course of treatment child had autonomic disturbances. Child was treated with supportive medication and methyl-presdnisolone followed by oral steroid. Child had responded to treatment given and child has been discharged with no neurological deficit on oral medications. We concluded autonomic dysfunction in any patient presenting with acute onset of weakness with short duration must evaluate for MSA and institute appropriate treatment.","PeriodicalId":13870,"journal":{"name":"International Journal of Contemporary Pediatrics","volume":"40 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139598025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-25DOI: 10.18203/2349-3291.ijcp20240103
Nazish Malik, Mohammad Arif
In this case report, we present two rare cases of acute post-streptococcal glomerulonephritis with unusual manifestations in the form of myocardial dysfunction and thrombocytopenia. APSGN typically follows Streptococcal infections and is characterized by inflammation of glomeruli. These cases, however, exhibited additional complexities. The first case involved a 12-year-old male with fever, shortness of breath, and cough. He presented with pedal edema, pallor, and hypertension. Laboratory findings revealed thrombocytopenia, anemia, and decreased C3 levels, while echocardiography indicated grade-3 diastolic dysfunction. The second case featured a 5-year-old female with icterus, fever, and body swelling. She had a palpable liver, pleural effusion, and thrombocytopenia. Both cases were diagnosed with APSGN, congestive heart failure, and thrombocytopenia. Thrombocytopenia is a rare finding in APSGN, and its etiology remains debated. Treatment included decongestive therapy and antihypertensive medication. Notably, thrombocytopenia in both cases improved without specific intervention, challenging the necessity of steroids or IVIg therapy. This report illuminates on the atypical presentation of APSGN, highlighting the potential coexistence of glomerulonephritis and thrombocytopenia. It underscores the need for further research to better understand this association and determine appropriate treatment protocols. These cases emphasize the importance of considering diverse clinical manifestations in the context of APSGN, calling for a broader understanding of this condition.
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