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Argininaemia presenting as acute encephalitis in a child 儿童精氨酸血症表现为急性脑炎
Q4 Medicine Pub Date : 2023-09-05 DOI: 10.4038/sljch.v52i3.10459
K. J. Kumar, H. R. Nandish, Devesh Bhaskar Yerrapagada, V. G. Manjunath
No abstract available
没有摘要
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引用次数: 0
Apert syndrome in a Sri Lankan boy with normal head growth and without clinical features of raised intracranial pressure during infancy 一个斯里兰卡男孩的Apert综合征,头部生长正常,没有婴儿期颅内压升高的临床特征
Q4 Medicine Pub Date : 2023-09-05 DOI: 10.4038/sljch.v52i3.10418
M. Manamperi, Nadunika Amarasinghe, Thilini Harshani, Paba Atapattu, T. Somaratne
No abstract available
没有摘要
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引用次数: 0
A case of bilateral humeral fractures associated with Erb’s palsy in a newborn 新生儿双侧肱骨骨折伴Erb麻痹1例
Q4 Medicine Pub Date : 2023-09-05 DOI: 10.4038/sljch.v52i3.10445
M. Lakra, Sagar A. Karotkar, B. Lakhkar
No abstract available
没有摘要
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引用次数: 0
Comparison of PRISM IV and PIM III prognostic scores as mortality indicators among paediatric intensive care unit patients  PRISM IV和PIM III预后评分作为儿科重症监护病房患者死亡率指标的比较
Q4 Medicine Pub Date : 2023-09-05 DOI: 10.4038/sljch.v52i3.10527
Mukund Vaja, Shashank Jain, Pradhyumn Pamecha, Ashutosh Singh Rathore, Anushka Aggarwal, Kiran Kumar Jain, Manan Arora
Introduction: Identifying prognosis of patients admitted in the paediatric intensive care unit (PICU) is of paramount importance to better allocate medical resources, reduce patient-doctor conflict and for overall better patient care. Many scoring systems have been formulated to accomplish this task including paediatric risk of mortality (PRISM) IV and paediatric index of mortality (PIM) III.Objectives: To compare PRISM IV and PIM III as prognostic scoring tools in the PICU of a tertiary healthcare centreMethod: This prospective observational study was conducted in the PICU, Dhiraj hospital, SBKS MI&RC, Gujarat, India, from March 2021 to September 2022. It included all patients from age 1 month to 18 years who were admitted in the PICU for >24 hours and gave consent for this study. They were thoroughly examined and investigations were done within the first hour of admission as per standard guidelines and their PRISM IV and PIM III scores were calculated and data were analysed.Results: A total of 74 patients was enrolled in this study. Whilst 43 (58.1%) patients were discharged, 18 (24.3%)] were discharged against medical advice(DAMA) moribund, 4 were DAMA (non-moribund) and 9 (12.2%) died. Receiver Operating Characteristic (ROC) curves were made for both PRISM IV and PIM III scores. Discriminatory powers of PIM III (AUC 0.725; 95% CI: 0.609 to 0.823) and PRISM IV (AUC 0.8; 95% CI: 0.691 to 0.884) were acceptable. Whilst PRISM IV was the better predictor of mortality at cut off point of >4 with area under curve of 0.8 for correctly predicting mortality, this difference was not statistically significant (p value=0.354). Multivariate logistic regression analysis showed that the duration of stay(days) and PRISM IV value >4 were significant independent risk factors of mortality after adjusting for confounding factors.Conclusions: Both PRISM IV and PIM III were good prognostic scoring tools in the PICU of the tertiary healthcare centre. Multivariate logistic regression analysis showed that the duration of stay(days) and PRISM IV value >4 were significant independent risk factors of mortality after adjusting for confounding factors.
引言:确定儿科重症监护室(PICU)住院患者的预后对于更好地分配医疗资源、减少医患冲突和全面改善患者护理至关重要。已经制定了许多评分系统来完成这项任务,包括儿科死亡率(PRISM)IV和儿科死亡率指数(PIM)III。目的:比较PRISM IV和PIM III作为三级医疗中心PICU的预后评分工具,2021年3月至2022年9月。它包括所有1个月至18岁的患者,这些患者在PICU住院超过24小时,并同意本研究。他们在入院后的第一个小时内按照标准指南进行了彻底检查和调查,并计算了他们的PRISM IV和PIM III评分并分析了数据。结果:本研究共纳入74例患者。43名(58.1%)患者出院,18名(24.3%)患者在临终时违反医嘱出院,4名患者为非临终患者,9名(12.2%)患者死亡。为PRISM IV和PIM III评分绘制受试者工作特性(ROC)曲线。PIM III(AUC 0.725;95%CI:0.609-0.823)和PRISM IV(AUC 0.8;95%CI:0.691-0.84)的判别力是可接受的。PRISM IV是在临界点>4时死亡率的更好预测因子,曲线下面积为0.8,多因素logistic回归分析显示,在校正混杂因素后,住院时间(天)和PRISM IV值>4是显著的死亡率独立危险因素。结论:PRISM IV和PIM III都是三级医疗中心PICU的良好预后评分工具。多因素logistic回归分析显示,在校正混杂因素后,住院时间(天)和PRISM IV值>4是显著的死亡率独立危险因素。
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引用次数: 0
N-acetylcysteine vs placebo as adjunctive treatment in paediatric leukaemia: A single blind, randomized controlled trial n -乙酰半胱氨酸与安慰剂作为儿科白血病辅助治疗:一项单盲、随机对照试验
Q4 Medicine Pub Date : 2023-09-05 DOI: 10.4038/sljch.v52i3.10541
Teny Tjitra Sari, Indah Dina Maritha, Isyanaditta Agung Putri
Background: Acute lymphoblastic leukaemia (ALL) accounts for about 25% of all cancer types in children. Many chemotherapeutic agents have been shown to be related to increased oxidative stress and hepatotoxicity which affect the survival rate. N-acetylcysteine (NAC) has been used as adjunctive treatment in malignancy. Objectives: To analyse the effect of NAC administration towards blood oxidant, transaminase enzyme, and bilirubin level in ALL children undergoing induction phase of chemotherapy. Method: This is a single-blind placebo-controlled randomized clinical trial carried out from August to December 2020 in Cipto Mangunkusumo National Hospital, Jakarta, Indonesia. Subjects were randomized consecutively into 2 groups treated with NAC or placebo. Inclusion criteria were newly diagnosed ALL-standard risk (SR) children undergoing chemotherapy induction. Exclusion criteria were subjects contraindicated to NAC, already diagnosed with liver dysfunction, and already taken antioxidants. Data were analysed using SPSS 21. Normality test was conducted followed by data analysis with unpaired t-test. Results: A total of 18 subjects were included in study and 2 of them were excluded. Malondialdehyde levels showed an increase of 0.17nmoL in the NAC group and a decrease of 0.19nmoL in the placebo group. Aspartate transaminase (AST) level increased in mean of 11.40 U/L in the NAC group compared to placebo group 5.67 U/L. Alanine transaminase (ALT) level in the NAC group showed an increase in mean of 23.24 U/L compared to placebo group which showed a decrease in mean of 3.5 U/L. Bilirubin level in the NAC group showed an increase of 0.7 mg/dL compared to placebo group 0.17 mg/dL. There was no significant difference in MDA levels, AST, ALT, and bilirubin levels in the 2 groups (p=0. 186; p=0.638; p=0.164; p=0.352, respectively). Conclusions: Higher malondialdehyde level was shown as a trend in subjects in both groups before chemotherapy was done. N-acetyl cysteine administration showed no significant difference in reducing MDA levels, transaminase enzymes, and bilirubin levels in ALL-SR patients compared to placebo.
背景:急性淋巴细胞白血病(ALL)约占儿童所有癌症类型的25%。许多化疗药物已被证明与增加氧化应激和肝毒性有关,从而影响生存率。n -乙酰半胱氨酸(NAC)已被用作恶性肿瘤的辅助治疗。目的:分析NAC对ALL患儿化疗诱导期血液氧化剂、转氨酶及胆红素水平的影响。方法:这是一项单盲安慰剂对照随机临床试验,于2020年8月至12月在印度尼西亚雅加达Cipto Mangunkusumo国立医院进行。受试者随机连续分为两组,分别采用NAC或安慰剂治疗。纳入标准为新诊断的all标准危险(SR)儿童,接受化疗诱导。排除标准为NAC禁忌症、已诊断为肝功能障碍、已服用抗氧化剂的受试者。数据采用SPSS 21进行分析。进行正态性检验,然后进行非配对t检验。结果:共纳入18例受试者,其中2例被排除。丙二醛水平在NAC组增加了0.17nmoL,在安慰剂组减少了0.19nmoL。NAC组谷草转氨酶(AST)水平平均升高11.40 U/L,而安慰剂组平均升高5.67 U/L。NAC组丙氨酸转氨酶(ALT)水平比安慰剂组平均升高23.24 U/L,安慰剂组平均降低3.5 U/L。NAC组的胆红素水平比安慰剂组的0.17 mg/dL增加了0.7 mg/dL。两组患者丙二醛、谷丙转氨酶、谷丙转氨酶及胆红素水平比较,差异均无统计学意义(p= 0.05)。186;p = 0.638;p = 0.164;分别为p = 0.352)。结论:化疗前,两组患者丙二醛水平均有升高的趋势。与安慰剂相比,给予n -乙酰半胱氨酸在降低ALL-SR患者的MDA水平、转氨酶和胆红素水平方面没有显著差异。
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引用次数: 0
Managing excessive screen time in children and adolescents 管理儿童和青少年屏幕时间过长
Q4 Medicine Pub Date : 2023-09-05 DOI: 10.4038/sljch.v52i3.10661
Yasodha Maheshi Rohanachandra
No abstract available
没有摘要
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引用次数: 0
Clinical and demographic characteristics of organic acidaemias in children in a tertiary care hospital in Sri Lanka: A 4-year experience in a single centre 斯里兰卡三级保健医院儿童有机酸血症的临床和人口特征:在单一中心的4年经验
Q4 Medicine Pub Date : 2023-09-05 DOI: 10.4038/sljch.v52i3.10542
D. M. Vidanapathirana, P. M. S. Fernando, K. L. S. P. K. M. Jayasena, N. D. P. D. Chandrasiri, A. V. Gunaratne, D. Samaranayake, P. M. Jones, E. A. Jasinge
Background: Organic acidaemias (OAs) are a biochemically heterogeneous group of inborn errors of metabolism. They are rare and infrequently reported worldwide. Most OAs are clinically apparent in the neonatal period or early infancy while some can present as a chronic progressive form or even an asymptomatic form. Objectives: To describe the clinical presentation, demographic characteristics and the incidence of OAs in Sri Lankan children. Method: A retrospective descriptive cross-sectional study was conducted over a 4-year period by reviewing records of children suspected of having OAs referred to the Department of Chemical Pathology, Lady Ridgeway Hospital. Demographic information, clinical manifestations, biochemical investigations and mutational results were recorded and analysed using descriptive statistics. Definitive diagnosis was established by gas chromatography and mass spectroscopy (GC-MS) of urine for organic acids. Results: Among the 458 patients suspected, 20 (4.3%) were confirmed to have an OA resulting in an incidence of 13/319,000 live births per year. The mean ages at onset of symptoms and diagnosis were 11.8 months (range; day 1 to 5 years) and 27.1 months (range; day 10 to 12 years) respectively. Among the 20 patients were 5 (25%) with propionic acidaemia and 4 (20%) with beta-ketothiolase deficiency. Nineteen (95%) presented acutely. Common manifestations were respiratory distress in 12 (60%) and persistent or recurrent vomiting in 10 (50%). Learning difficulty, dyskinesia and macrocephaly were some chronic manifestations. Biochemically, 15 (75%) had acidosis and 9 (45%) had ketosis. There were 13 (65%) deaths of which 6 were neonates with acute presentation. Conclusions: Propionic acidaemia and beta-ketothiolase deficiency were the common OAs identified. Common clinical presentations were respiratory distress and persistent or recurrent vomiting. Acidosis was a common biochemical finding.
背景:有机酸血症(OAs)是一种生物化学异质性的先天性代谢异常。它们在世界范围内很罕见,很少被报道。大多数OAs在新生儿期或婴儿期早期临床表现明显,而有些可表现为慢性进行性形式,甚至无症状形式。目的:描述斯里兰卡儿童OAs的临床表现、人口学特征和发病率。方法:回顾性描述性横断面研究进行了超过4年的时间,通过回顾记录疑似有OAs的儿童转介到Ridgeway夫人医院的化学病理学。人口统计学信息、临床表现、生化调查和突变结果记录,并采用描述性统计方法进行分析。通过尿液的气相色谱和质谱(GC-MS)对有机酸进行了明确的诊断。结果:在458例疑似患者中,20例(4.3%)被证实患有OA,导致每年319,000例活产中有13例的发病率。出现症状和诊断的平均年龄为11.8个月(范围;第1天至第5年)和27.1个月(范围;第10 ~ 12天)。20例患者中丙酸血症5例(25%),β -酮硫酶缺乏症4例(20%)。19例(95%)急性表现。常见表现为呼吸窘迫12例(60%),持续或反复呕吐10例(50%)。学习困难、运动障碍和大头畸形是一些慢性表现。生化方面,酸中毒15例(75%),酮症9例(45%)。有13例(65%)死亡,其中6例为新生儿急性发病。结论:丙酸血症和β -酮硫酶缺乏症是常见的OAs。常见的临床表现为呼吸窘迫和持续或反复呕吐。酸中毒是一种常见的生化发现。
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引用次数: 0
A case of neonatal I-cell disease with multiple intrauterine fractures  新生儿i细胞病合并多处宫内骨折1例
Q4 Medicine Pub Date : 2023-09-05 DOI: 10.4038/sljch.v52i3.10444
Santoshi Subhadarsini, R. Prashanth, A. Mujeeb, A. Haribalakrishna
No abstract available
没有可用的摘要
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引用次数: 0
Do children need humans or screen? Institutional-based cross-sectional study 孩子需要真人还是屏幕?基于机构的横断面研究
Q4 Medicine Pub Date : 2023-09-05 DOI: 10.4038/sljch.v52i3.10501
M. Rajalakshmi, Reena Mohan, T. Kanimozhi, Karthika Devi
Introduction: Screen exposure is on the rise and has been virtually unavoidable in the post-Covid era. Screen exposure during the critical period of brain development results in delayed language, learning and behaviour problems and subsequent sedentary lifestyle results in non-communicable disease later in life.Objectives: To assess the burden of digital screen exposure and parental perceptions of its effects in children.Method: This institution-based cross-sectional study was conducted among children aged 1-13 years in a tertiary healthcare centre in Puducherry, India, from April 2022 to June 2022. Data were collected using the Digital Screen Exposure Questionnaire (DSEQ), administered by trained Compulsory Rotatory Residential Internship (CRRI) after pilot testing.Results: Our study shows that the prevalence of excessive screen exposure (>1 hour) was 25% during weekdays and 44.9% during weekends. The most common media used was television (TV) in 92.8%, closely followed by smart phones in 90%. Most frequently watched content (>5 times/ week) was random things for enjoyment in 57.8% followed by rhymes in 25.7%; 57.1% had no outside play during weekdays. Mother’s education was the main predictor which influenced the duration of screen exposure in study participants.Conclusions: Our study shows that the prevalence of excessive screen exposure (>1 hour) was 25% during weekdays and 44.9% during weekends. Common media used were TV in 92.8% and smart phones in 90%. Except for mother’s education, no other socio-demographic factor influenced the duration of screen exposure in study participants. There was excessive screen exposure in children despite parental perception of its harmful effects
简介:屏幕曝光率正在上升,在后新冠时代几乎是不可避免的。在大脑发育的关键时期,屏幕暴露会导致语言、学习和行为问题的延迟,随后久坐的生活方式会导致日后的非传染性疾病。目的:评估数字屏幕暴露的负担及其对儿童影响的父母认知。方法:这项基于机构的横断面研究于2022年4月至2022年6月在印度普杜切里的一家三级医疗中心对1-13岁的儿童进行。使用数字屏幕暴露问卷(DSEQ)收集数据,该问卷由经过培训的强制性轮岗实习(CRRI)在试点测试后进行管理。结果:我们的研究表明,工作日过度屏幕暴露(>1小时)的患病率为25%,周末为44.9%。最常用的媒体是电视(92.8%),其次是智能手机(90%)。最常观看的内容(每周5次以上)是随机的娱乐内容(57.8%),其次是押韵内容(25.7%);57.1%的人在工作日没有户外活动。母亲的教育程度是影响研究参与者屏幕暴露时间的主要预测因素。结论:我们的研究表明,过度屏幕暴露(>1小时)的患病率在工作日为25%,在周末为44.9%。92.8%的人使用电视,90%的人使用智能手机。除了母亲的教育程度外,没有其他社会人口因素影响研究参与者的屏幕暴露时间。尽管父母认为其有害影响,但儿童仍过度接触屏幕
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引用次数: 0
Varied presentation of rickettsial meningoencephalitis in children: A case series 儿童立克次体脑膜脑炎的不同表现:一系列病例
Q4 Medicine Pub Date : 2023-09-05 DOI: 10.4038/sljch.v52i3.10415
S. Gaikwad, Punam Uke, Ashwini Kundalwal, Lavanya Ramakrishnan, Sai Samhita Chundi
No abstract available
没有摘要
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引用次数: 0
期刊
Sri Lanka Journal of Child Health
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