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Acute neonatal airway management - The role of laryngeal mask airway 急性新生儿气道管理-喉罩气道的作用
Pub Date : 2021-11-11 DOI: 10.32677/ijch.v8i10.3094
P. M. C. Nair, Anagha Padmarajan
Positive pressure ventilation with Ambu bag and face masks or T-piece resuscitation in preterm babies have proved their worth in acute neonatal airway management. However, failure rates are high and endotracheal intubation is the final life-saving procedure. However, intubation is an invasive procedure and requires good expertise, especially for handling acute emergency situations. Expertise of trainees as well as consultants is coming down rapidly due to various reasons. In these situations, supraglottic airways (laryngeal mask airway or LMA) seem to be ideal. Here, we are reviewing the application and utility of LMA in acute neonatal airway management.
早产儿正压通气加Ambu袋面罩或t片复苏在急性新生儿气道管理中的价值已得到证实。然而,失败率很高,气管插管是最后的救生程序。然而,插管是一种侵入性程序,需要良好的专业知识,特别是处理急性紧急情况。由于种种原因,受训人员和咨询人员的专业知识正在迅速下降。在这些情况下,声门上气道(喉罩气道或LMA)似乎是理想的。在此,我们就LMA在急性新生儿气道管理中的应用和应用进行综述。
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引用次数: 0
Prevalence of nutritional anemia in children of high socioeconomic status in a tertiary care center 在三级保健中心的高社会经济地位的儿童营养性贫血的患病率
Pub Date : 2021-11-11 DOI: 10.32677/ijch.v8i10.3060
Pradeep Kalaiselvam, S. Chelliah, Meganathan Pachamuthu
Background: Anemia is a highly prevalent condition developed in children belonging to all socioeconomic status and is mainly caused due to iron deficiency in nutrition. Aim: To identify the Prevalence of nutritional anemia in children of high socioeconomic status. Methods: Children between 6 months and 14 years of age belonging to high socioeconomic status, admitted in pediatric ward of Kauvery Hospital, a tertiary center at Trichy were included in the study. Children with hemolytic anemia, chronic illnesses, and those who received blood transfusion were excluded from the study. The World Health Organization classification was used for grading the severity of anemia as mild, moderate, and severe based on hemoglobin levels for the age. Modified Kuppuswamy scale 2016 was used to assess the socioeconomic status of the children. Children belonging to upper and upper middle socioeconomic status were included in the study. Results: The overall prevalence of anemia among the study population was 44.5%. Out of 400 subjects, 178 participants were anemic. Of the 178 anemic children, 78.1% were in the age group of 6 months–5 years, 20.2% in 5–11 years, and 1.7% in 12–14 years. Among children between 6 and 23 months, 75 were anemic. Almost all patients showed microcytic hypochromic anemia. There were a significantly higher number of overweight and obese children among those anemic in all age groups. Conclusion: This study concludes that every other child is anemic even in families of high socioeconomic status, especially <2 years of age. There is an urgent need to screen and treat all children regardless of their socioeconomic status or body mass index.
背景:贫血是发生在所有社会经济地位的儿童中的一种非常普遍的疾病,主要是由营养缺铁引起的。目的:了解高社会经济地位儿童营养性贫血的患病率。方法:选取特里希三级中心Kauvery医院儿科病房住院的6个月~ 14岁的高社会经济地位儿童为研究对象。患有溶血性贫血、慢性疾病和接受输血的儿童被排除在研究之外。根据年龄的血红蛋白水平,世界卫生组织将贫血的严重程度分为轻度、中度和重度。采用2016年修正Kuppuswamy量表评估儿童社会经济地位。属于中上层社会经济地位的儿童被纳入研究。结果:研究人群中贫血的总体患病率为44.5%。在400名受试者中,178名参与者患有贫血症。178例贫血儿童中,78.1%为6个月- 5岁年龄组,20.2%为5-11岁年龄组,1.7%为12-14岁年龄组。在6至23个月的儿童中,有75人贫血。几乎所有患者均表现为小细胞性低色素贫血。在所有年龄组的贫血儿童中,超重和肥胖儿童的数量明显增加。结论:本研究的结论是,即使在高社会经济地位的家庭中,也有其他儿童贫血,特别是<2岁的儿童。迫切需要对所有儿童进行筛查和治疗,无论其社会经济地位或体重指数如何。
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引用次数: 0
Superiority of mosapride citrate to picosulfate sodium as a laxative for withdrawal from regular enemas in children with severe functional constipation 枸橼酸莫沙必利对picosulfate钠作为一种轻泻剂在严重功能性便秘儿童从常规灌肠中退出的优越性
Pub Date : 2021-10-29 DOI: 10.32677/ijch.v8i9.3020
Yoshimitsu Fujii, Eriko Kouhata, K. Kaneko
Background: Severe functional constipation (FC) with low bowel movement frequency (BMF) of ?1 day/week and hard stools oftenrequires regularly repeated enemas or often leads to enema dependency (ED). Aim: The current study aimed to compare the efficacy of mosapride citrate (Mo) with the traditional stimulant laxative picosulfate sodium (Pi) for withdrawal from ED in children with severe FC. Results: Twenty-four treatment-naïve patients who met the Rome IV diagnostic criteria for FC seen at our center for 8 years from 2012 were enrolled. Glycerin enema was repeated until the BMF was ?3.5 days/week. Simultaneously, Mo at 0.3 mg/kg/day (n=11) or Pi at 0.25 mg/kg/day (n=13) was administered concomitantly with magnesium oxide or lactulose. The proportion of withdrawal from ED was significantly higher in the Mo group than Pi group during the 4 months observational period (90.9% vs. 46.2%, respectively; p=0.034) and shorter in time to withdraw from ED (0 vs. 3.5 months, respectively; p=0.015). Conclusion: Mo is more effective than Pi for withdrawal from ED in children with severe FC.
背景:严重的功能性便秘(FC)伴低肠蠕动频率(BMF)为每周1天,并且大便坚硬,经常需要定期重复灌肠或经常导致灌肠依赖(ED)。目的:本研究旨在比较枸橼酸莫沙匹利(Mo)与传统的兴奋剂泻药picosulfate sodium (Pi)对重度FC患儿退出ED的疗效。结果:从2012年起8年间在我中心就诊的24例treatment-naïve患者符合FC的Rome IV诊断标准。反复进行甘油灌肠,直至BMF达到3.5天/周。同时,Mo 0.3 mg/kg/day (n=11)或Pi 0.25 mg/kg/day (n=13)与氧化镁或乳果糖同时施用。在4个月的观察期内,Mo组退出ED的比例显著高于Pi组(分别为90.9%和46.2%;p=0.034),且退出ED的时间更短(分别为0个月和3.5个月;p = 0.015)。结论:莫替尼对重度FC患儿ED的戒断效果优于皮替尼。
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引用次数: 0
A study of occurrence of non-alcoholic steatohepatitis in children with obesity and overweight 肥胖和超重儿童发生非酒精性脂肪性肝炎的研究
Pub Date : 2021-10-29 DOI: 10.32677/ijch.v8i9.3018
S. Patil, Kumar Angadi, Meghana Somasundara
Background: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children and its increasingprevalence is associated with a concomitant rise in obesity. Anthropometric measurements and non-invasive tests (liver function tests and USG abdomen) help in early recognition of non-alcoholic steatohepatitis (NASH) and reduce consequent morbidity and mortality. Aim: This study aims to study the occurrence of NASH in obese and overweight children and to derive the correlation of NASH with clinical and biochemical parameters in overweight and obese children. Methods: This hospital-based prospective study included children (age?18 years) who met the inclusion criteria. Diagnosis of NASH was based on the USG abdomen. Measurements included anthropometry, ultrasonography, fasting glucose, alanine aminotransferase (ALT), lipid profile and additional parameters of blood pressure, fasting insulin, and homeostatic model assessment of insulin resistance (HOMA-IR). The variables were compared between children with and without NASH. Results: A total of 146 patients (female: 51.4%, male: 48.6%) were enrolled in the study. The most common age group affected was 11–18 years (50.7%) followed by 6–10 years (43.2%) and <5 years (6.2%). The occurrence of NASH in the study group was 63% of obese and overweight children. Mean weight, body mass index (BMI), waist circumference, waist-hip ratio, blood pressure (BP), serum glutamic-pyruvic transaminase (SGPT), fasting insulin level, and HOMA-IR were significantly higher in children with NASH. There was a significant association between SGPT and NASH. Elevated SGPT of 79.3% and 1.9% were observed among the subjects with and without NASH, respectively. Conclusion: Anthropometric indices and biochemical parameters were more elevated in the NASH group showing its direct correlation with hepatic steatosis.
背景:非酒精性脂肪性肝病(NAFLD)是儿童中最常见的慢性肝病,其患病率的增加与肥胖的增加有关。人体测量和非侵入性检查(肝功能检查和腹部USG)有助于早期识别非酒精性脂肪性肝炎(NASH),并降低随之而来的发病率和死亡率。目的:本研究旨在研究肥胖和超重儿童NASH的发生情况,并得出超重和肥胖儿童NASH与临床及生化参数的相关性。方法:这项以医院为基础的前瞻性研究纳入儿童(年龄?18岁),符合纳入标准。NASH的诊断是基于USG腹部。测量包括人体测量、超声检查、空腹血糖、谷丙转氨酶(ALT)、血脂和血压的附加参数、空腹胰岛素和胰岛素抵抗的稳态模型评估(HOMA-IR)。比较了NASH患儿和非NASH患儿之间的变量。结果:共纳入146例患者,其中女性占51.4%,男性占48.6%。最常见的年龄组为11-18岁(50.7%),其次为6-10岁(43.2%)和<5岁(6.2%)。在研究组中,肥胖和超重儿童的NASH发生率为63%。NASH患儿的平均体重、体重指数(BMI)、腰围、腰臀比、血压(BP)、血清谷丙转氨酶(SGPT)、空腹胰岛素水平和HOMA-IR均显著升高。SGPT与NASH之间存在显著关联。在NASH患者和非NASH患者中,SGPT分别升高79.3%和1.9%。结论:NASH组人体测量指标及生化指标升高,与肝脂肪变性有直接关系。
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引用次数: 0
Cardiovascular disease risk factors: Role of legislations that control marketing of breastmilk substitutes 心血管疾病风险因素:控制母乳代用品销售的立法的作用
Pub Date : 2021-10-29 DOI: 10.32677/ijch.v8i9.3052
A. Abul-fadl, M.M.K. Mourad, O. S. Arafa, Hanin Al-Jawaldeh
Background: Cardiovascular diseases (CVDs) are the leading cause of mortality throughout the world. Breastfeeding has been shown to play a role in the prevention of CVD. The International Code for Marketing of Breastmilk Substitutes (BMSs) and its relevant resolutions (the Code) were adopted by the World Health Assembly to protect breastfeeding. Aim: This study aims to study the relationships between breastfeeding rates and laws that cover the code with CVD risk factors (obesity and blood pressure) and death from non-communicable diseases (NCDs). Methods: Data for scores given to national laws and provisions under the Code for protecting breastfeeding were obtained from the World Health Organization (WHO)/International Baby Food Action Network report in 2020. Data for exclusive breastfeeding (EBF) during infancy were obtained from United Nations International Children’s Emergency Fund Global data. The WHO data for CVD risk factors in adults (>18 years) included overweight, obesity raised blood pressure (RBP), raised blood glucose level (RBGL), and death from NCDs. Results: There were significant negative correlations of overweight, obesity, raised BP, and death from NCD with EBF and with scores given to national laws that cover the Code. RBGL correlated negatively with overweight and obesity. Overweight, obesity, RBP, and death from NCDs correlated inversely with provisions in the national laws for monitoring and enforcement at p<0.015. Engagement of health staff and systems and promotion in health facilities correlated with RBP and death from NCDs at p<0.01. Conclusions: Prevention of CVD can benefit from improving breastfeeding rates by the enactment of national laws that cover the Code in its entirety. All countries should enact, monitor, and enforce these laws for promoting and protecting breastfeeding and preventing long-term consequences of feeding BMS.
背景:心血管疾病(cvd)是世界范围内导致死亡的主要原因。母乳喂养已被证明在预防心血管疾病方面发挥作用。世界卫生大会通过了《国际母乳代用品销售守则》及其相关决议(《守则》),以保护母乳喂养。目的:本研究旨在研究母乳喂养率与涵盖CVD风险因素(肥胖和血压)和非传染性疾病(NCDs)死亡的法律之间的关系。方法:国家法律和《母乳喂养保护法》规定的得分数据来自世界卫生组织(世卫组织)/国际婴儿食品行动网络2020年的报告。婴儿时期纯母乳喂养(EBF)的数据来自联合国国际儿童紧急基金全球数据。世卫组织关于成人(>18岁)心血管疾病危险因素的数据包括超重、肥胖、高血压(RBP)、血糖水平升高(RBGL)和非传染性疾病死亡。结果:超重、肥胖、血压升高和非传染性疾病死亡与EBF以及涵盖该法典的国家法律的得分呈显著负相关。RBGL与超重和肥胖呈负相关。超重、肥胖、RBP和非传染性疾病死亡与国家监测和执法法律的规定呈负相关(p<0.015)。卫生人员和卫生系统的参与以及卫生设施的推广与RBP和非传染性疾病死亡相关(p<0.01)。结论:通过制定涵盖《守则》全部内容的国家法律,提高母乳喂养率有助于预防心血管疾病。所有国家都应制定、监测和执行这些法律,以促进和保护母乳喂养,并防止喂养BMS的长期后果。
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引用次数: 0
Severe coronavirus disease 2019 pulmonary disease in very low birth weight preterm babies 极低出生体重早产儿的严重冠状病毒病2019肺部疾病
Pub Date : 2021-10-29 DOI: 10.32677/ijch.v8i9.3021
Kailas Randad, Deepika Bishnoi, S. Sakhare, Rahul Jethaliya
Severe coronavirus disease 2019 (COVID-19) in neonates is considered a rarity due to vertical transmission and most of the affected babies are asymptomatic. Here, we describe two severe cases of very low birth weight (VLBW) preterm babies in sick newborn care unit (SNCU) due to horizontal transmission. Case 1 describes a VLBW preterm baby (29 weeks) weighing 1300 g who was undergoing care in SNCU. He developed classical symptoms of cold in the form of nasal congestion with mild rhinorrhea, fever, and cough followed by severe prolonged hypoxia with full recovery. Case 2 describes another VLBW preterm (27.3 weeks) weighing 1175 g who was suffering from severe progressive hypoxia around same time. He was initially responsive to oxygen therapy but succumbed to refractory hypoxia later on. We conclude that severe COVID-19 pulmonary disease can occur in few unfortunate VLBW preterm neonates
由于垂直传播,新生儿中的严重冠状病毒病2019 (COVID-19)被认为是罕见的,大多数受影响的婴儿是无症状的。在这里,我们描述了两个严重的极低出生体重(VLBW)早产儿在生病的新生儿护理单位(SNCU)由于水平传播。病例1描述了一名体重1300克的VLBW早产儿(29周)在SNCU接受护理。他出现典型的感冒症状,鼻塞伴轻度鼻漏、发热和咳嗽,随后出现严重的长期缺氧,但完全恢复。病例2描述了另一个VLBW早产儿(27.3周),体重1175 g,大约在同一时间患有严重的进行性缺氧。他最初对氧疗有反应,但后来死于难治性缺氧。我们的结论是,少数不幸的VLBW早产儿可能发生严重的COVID-19肺部疾病
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引用次数: 0
Retinopathy of prematurity: Postnatal weight gain and risk factors profile; a hospital-based study from a tertiary care center 早产儿视网膜病变:产后体重增加及危险因素分析一项来自三级保健中心的医院研究
Pub Date : 2021-10-29 DOI: 10.32677/ijch.v8i9.3051
P. Subramanya, G. Pradeep, M. Sharanabasavesh, M. Krithika
Background: Premature infants often develop blindness in one or both eyes due to disparity in retinal growth. This condition is termed as retinopathy of prematurity (ROP). Aim: The aim of the study is to study the postnatal weight gain pattern of preterm infants (Age < 32 weeks) and risk factors of ROP in a tertiary care center and to validate the lower birth weight and gestational age (GA) for ROP. Methods: Hospital-based study on 110 preterm neonates admitted in the neonatal intensive care unit (NICU) who fulfilled the criteria for ROP screening. On screening, 55 neonates were identified to have ROP and 55 neonates identified to have no ROP. The profiles of ROP and risk factors were documented according to the International Classification for ROP recommendations. The data were analyzed for GA, birth weight, and risk factors predisposing to ROP. Results: A total of 110 preterm neonates were screened, out of which, 55 had ROP. The mean GA (P = 0.002), Apnea (P = 0.001), ventilation (P = 0.001), and surfactant (P = 0.001) were observed a significant difference. Further, a significant difference in weight gain pattern in the two groups (P < 0.05) was also observed. The group without ROP had a better weight gain pattern than the group with ROP. Conclusion: Our study revealed prematurity, low birth weight, and birth weight increasing patterns were found to be strong predictors of ROP. GA, apnea, ventilation, and surfactant were found to be statistically significant factors associated with ROP.
背景:早产儿由于视网膜生长发育的差异,经常发展为单眼或双眼失明。这种情况称为早产儿视网膜病变(ROP)。目的:本研究的目的是研究三级保健中心早产儿(年龄< 32周)出生后体重增加模式和ROP的危险因素,并验证低出生体重和胎龄(GA)对ROP的影响。方法:以医院为基础,对110例符合ROP筛查标准的新生儿重症监护病房(NICU)早产儿进行研究。在筛查中,55名新生儿被确定为ROP, 55名新生儿被确定为无ROP。根据ROP建议的国际分类记录了ROP的概况和风险因素。对数据进行GA、出生体重和易患ROP的危险因素分析。结果:共筛查早产儿110例,其中ROP 55例。平均GA (P = 0.002)、呼吸暂停(P = 0.001)、通气(P = 0.001)、表面活性剂(P = 0.001)差异有统计学意义。此外,两组的体重增加模式也有显著差异(P < 0.05)。无ROP组比有ROP组有更好的增重模式。结论:我们的研究显示,早产、低出生体重和出生体重增加模式被发现是ROP的强预测因子。GA、呼吸暂停、通气和表面活性剂是与ROP相关的统计学显著因素。
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引用次数: 1
A demographic study of patients with behavioral and neurodevelopmental disorders among children in East India 东印度儿童行为和神经发育障碍患者的人口统计学研究
Pub Date : 2021-10-29 DOI: 10.32677/ijch.v8i9.3027
Papiya Khawash, A. Chatterjee, Adrita Adrita
Background: The prevalence of behavioral and neurodevelopmental disorders of children in India is changing according to recent data, as more young children with these problems are now being identified. Aim: Our study aims to assess the emerging patterns of these disorders in patients attending an urban child guidance clinic in Kolkata. Method: A retrospective analysis of the demographic data of patients attending the clinic over the period of 1 year (April 2018–March 2019) was performed. Results: A significant 55.6% of the total 651 patients in our study were children with autism spectrum disorder (ASD). Children <5 years of age constituted a significant percentage (55.3%) of patients attending the clinic and boys were in significantly larger numbers (74.8%) compared to girls (25.2%). About 52.3% of the children came from Kolkata, 35.4% from other districts of West Bengal, 5.4% from other East Indian states, and 6.9% from the neighboring country Bangladesh. Conclusion: ASD, a developmental disability of public health importance affecting both child and family, has been identified in a significantly large number of children in our study. This may be attributed to increased community awareness resulting in earlier identification/referral of cases; although an actual rise in incidence is also a possibility. The male bias noted in the study is ascribed to a significantly larger number of boys with ASD, behavioral issues, attention deficit hyperactivity disorder, learning disabilities, and intellectual impairment.
背景:根据最近的数据,印度儿童行为和神经发育障碍的患病率正在发生变化,因为现在发现了更多患有这些问题的幼儿。目的:我们的研究旨在评估在加尔各答城市儿童指导诊所就诊的患者中出现的这些疾病模式。方法:对2018年4月- 2019年3月1年间就诊患者的人口学资料进行回顾性分析。结果:在我们的研究中,651例患者中有55.6%是自闭症谱系障碍(ASD)儿童。5岁以下儿童占就诊患者的很大比例(55.3%),男孩(74.8%)明显多于女孩(25.2%)。约52.3%的儿童来自加尔各答,35.4%来自西孟加拉邦其他地区,5.4%来自其他东印度邦,6.9%来自邻国孟加拉国。结论:ASD是一种影响儿童和家庭公共卫生的重要发育障碍,在我们的研究中已经在大量儿童中发现。这可能是由于社区意识的提高,导致病例的早期发现/转诊;尽管发病率也有可能实际上升。研究中提到的男性偏见归因于大量患有自闭症、行为问题、注意力缺陷多动障碍、学习障碍和智力障碍的男孩。
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引用次数: 0
Multiple urolithiases in pediatric acute lymphoblastic leukemia 小儿急性淋巴细胞白血病多发尿石症
Pub Date : 2021-10-29 DOI: 10.32677/ijch.v8i9.3032
Ayumi Fujishiro, Ryosuke Matsuno, Taichi Omachi, Takashi Yamazoe, M. Okano, K. Kaneko
Current study is a case report of a 5-year-old patient with T-cell acute lymphoblastic leukemia (ALL) and multiple urolithiasis. Complex factors, including glucocorticoid-induced hypercalciuria, fluid restriction for the syndrome of inappropriate secretion of antidiuretic hormone, and long-term bed rest, predispose children with ALL to develop urolithiasis. To prevent urinary urolithiasis formation, urinary calcium excretion should be monitored during chemotherapy and when administering glucocorticoids.
本研究报告一例5岁的t细胞急性淋巴细胞白血病(ALL)合并多发性尿石症患者。糖皮质激素诱导的高钙尿症、因抗利尿激素分泌不当引起的流质限制以及长期卧床休息等复杂因素使ALL患儿易患尿石症。为了防止尿石症的形成,在化疗期间和使用糖皮质激素时应监测尿钙排泄。
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引用次数: 0
Bacterial meningitis in a known case of steroid-resistant nephrotic syndrome 已知一例类固醇抵抗性肾病综合征的细菌性脑膜炎
Pub Date : 2021-10-29 DOI: 10.32677/ijch.v8i9.3039
Saili Bunde, M. Sharif, A. Saxena
Nephrotic syndrome (NS) is a kidney disorder in which, excess protein is being excreted through urine. While most cases of idiopathic nephrotic syndrome respond to steroid therapy and experience a limited number of relapses prior to complete remission, some cases suffer from frequent relapses and become steroid-dependent or are primarily steroid-resistant. Treatment options are limited to immunosuppressive drugs with significant side effect profiles. Infections in nephrotic syndrome are common and can be severe. Meningitis is one of the complications associated with nephrotic syndrome. Here, we report a child with steroid-resistant nephrotic syndrome (SRNS) with meningitis. Early detection and appropriate treatment of these complications can be lifesaving.
肾病综合征(NS)是一种肾脏疾病,其中过量的蛋白质通过尿液排出。虽然大多数特发性肾病综合征病例对类固醇治疗有反应,并且在完全缓解之前经历有限次数的复发,但一些病例经常复发并成为类固醇依赖或主要是类固醇抵抗。治疗选择仅限于具有显著副作用的免疫抑制药物。肾病综合征的感染很常见,而且可能很严重。脑膜炎是与肾病综合征相关的并发症之一。在这里,我们报告了一个患有类固醇抵抗性肾病综合征(SRNS)并脑膜炎的儿童。这些并发症的早期发现和适当治疗可以挽救生命。
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引用次数: 1
期刊
The Indian journal of child health
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