Rapunzel syndrome is a very rare form of trichobezoar. It is strongly linked to psychiatric conditions; trichotillomania and trichophagia. These conditions in the pediatric population point to the presence of childhood stressors like child neglect, abuse, etc. This case report highlights that child neglect may be an underlying contributing factor in selected cases of Rapunzel syndrome. Hence, a multidisciplinary approach should be sought in all cases of Rapunzel syndrome, catering to the emotional and psychological needs of the pediatric population. A 7-year-old girl from a low socioeconomic background presented with periorbital and facial swelling, abdominal distension, and pallor. On physical examination, she showed bilateral pitting edema and a distended abdomen with poor overall hygienic condition. Her family history was positive for Wilson’s disease. Lab investigations highlighted iron deficiency anemia (Hb 8.2 g/dL), with normal liver function. Ultrasound demonstrated ascites, liver changes, and pleural effusion. The work-up for Wilson’s disease was unremarkable. During the hospital course, her abdominal distention lessened; a non-tender epigastric mass (4 × 5 cm) was thus discovered. An abdominal X-ray revealed an entangled mass outlining the gastric shadow. Her parents also revealed a history of trichophagia. Suspecting a large trichobezoar, a laparotomy was performed. After the midline incision, the stomach was opened anteriorly between stay sutures along the curvature. It delivered a large trichobezoar, 65 cm in length extending up to the proximal jejunum. Rapunzel syndrome diagnosis was finally established. This unique presentation emphasizes the need to consider this rare etiology, even with unusual clinical histories especially with a history of child neglect, while collaborative surgical interventions facilitate successful outcomes.
{"title":"Rapunzel syndrome’s silent cry: addressing neglect and psychiatric factors in pediatric cases","authors":"Arshia Warsi, Rabeea Mushtaq, Syed Waqas Ali, Farah Anwer","doi":"10.1186/s43054-024-00259-1","DOIUrl":"https://doi.org/10.1186/s43054-024-00259-1","url":null,"abstract":"Rapunzel syndrome is a very rare form of trichobezoar. It is strongly linked to psychiatric conditions; trichotillomania and trichophagia. These conditions in the pediatric population point to the presence of childhood stressors like child neglect, abuse, etc. This case report highlights that child neglect may be an underlying contributing factor in selected cases of Rapunzel syndrome. Hence, a multidisciplinary approach should be sought in all cases of Rapunzel syndrome, catering to the emotional and psychological needs of the pediatric population. A 7-year-old girl from a low socioeconomic background presented with periorbital and facial swelling, abdominal distension, and pallor. On physical examination, she showed bilateral pitting edema and a distended abdomen with poor overall hygienic condition. Her family history was positive for Wilson’s disease. Lab investigations highlighted iron deficiency anemia (Hb 8.2 g/dL), with normal liver function. Ultrasound demonstrated ascites, liver changes, and pleural effusion. The work-up for Wilson’s disease was unremarkable. During the hospital course, her abdominal distention lessened; a non-tender epigastric mass (4 × 5 cm) was thus discovered. An abdominal X-ray revealed an entangled mass outlining the gastric shadow. Her parents also revealed a history of trichophagia. Suspecting a large trichobezoar, a laparotomy was performed. After the midline incision, the stomach was opened anteriorly between stay sutures along the curvature. It delivered a large trichobezoar, 65 cm in length extending up to the proximal jejunum. Rapunzel syndrome diagnosis was finally established. This unique presentation emphasizes the need to consider this rare etiology, even with unusual clinical histories especially with a history of child neglect, while collaborative surgical interventions facilitate successful outcomes.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140594007","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 : 2024-03-29DOI: 10.1186/s43054-024-00269-z
Izchel Valdez García, Alejandro Solano Gutierrez, Sofia Brenes Guzmán, Brenda Aguilar Viveros
Inflammatory myofibroblastic tumor is a rare yet profoundly impactful condition, particularly within the pediatric population. This case report illuminates the intricate challenges of diagnosing and managing inflammatory myofibroblastic tumors in children, underscoring the importance of interdisciplinary collaboration in formulating effective treatment strategies. Notably, the choice of surgical approach holds a paramount influence on the risk of recurrence and metastasis, with wide resection with bronchotomy, lobectomy, and pneumonectomy demonstrating significantly diminished recurrence rates compared to wedge resection in bronchoscopic removal. We present the case of a 3-year-old girl with a progressive, nonproductive cough, occasionally accompanied by episodes of hemoptysis and pneumonia for a year, secondary to an inflammatory myofibroblastic tumor that was removed by bronchotomy with excellent results. Given the extraordinary rarity of this disease in pediatric patients, ongoing research endeavors and the accumulation of collective expertise are paramount.
{"title":"Inflammatory myofibroblastic tumor in pediatric patients: challenges in diagnosis, multidisciplinary management, and surgical strategies","authors":"Izchel Valdez García, Alejandro Solano Gutierrez, Sofia Brenes Guzmán, Brenda Aguilar Viveros","doi":"10.1186/s43054-024-00269-z","DOIUrl":"https://doi.org/10.1186/s43054-024-00269-z","url":null,"abstract":"Inflammatory myofibroblastic tumor is a rare yet profoundly impactful condition, particularly within the pediatric population. This case report illuminates the intricate challenges of diagnosing and managing inflammatory myofibroblastic tumors in children, underscoring the importance of interdisciplinary collaboration in formulating effective treatment strategies. Notably, the choice of surgical approach holds a paramount influence on the risk of recurrence and metastasis, with wide resection with bronchotomy, lobectomy, and pneumonectomy demonstrating significantly diminished recurrence rates compared to wedge resection in bronchoscopic removal. We present the case of a 3-year-old girl with a progressive, nonproductive cough, occasionally accompanied by episodes of hemoptysis and pneumonia for a year, secondary to an inflammatory myofibroblastic tumor that was removed by bronchotomy with excellent results. Given the extraordinary rarity of this disease in pediatric patients, ongoing research endeavors and the accumulation of collective expertise are paramount.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140324406","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 : 2024-03-25DOI: 10.1186/s43054-024-00257-3
Amr I. Risha, Mervat A. Hesham, Usama R. Elsafy, Yosria A. El Taweel, Mohammed M. Omar, Sara F. Saadawy, Diana Hanna
Neurological complications, including peripheral polyneuropathy, have been reported in β-thalassemia patients that negatively impact their quality of life. Chronic hypoxia, iron overload, average age, and iron chelators-induced neurotoxicity might contribute to the development of neuropathy. However, the leading offender of this complication remains not clear. We aimed to study the frequency and potential risk factors of polyneuropathy in β-thalassemia patients. We performed a cross-section study on 150 transfusion-dependent β-thalassemia major patients with a mean age of 16.44 ± 3.32 years. We performed electrophysiological studies for motor and sensory nerves. We found that 31.3% of cases had neurological manifestations with significant relation to age, duration of the disease, and frequent transfusion. Out of 47 patients with neurological manifestations, 12 (25.5%) had abnormal nerve conduction velocity (NCV). Abnormal median, peroneal, and tibial nerve motor amplitudes were detected in 10.6%, 10.6%, and 14.9% of patients respectively. Abnormal median, peroneal, and sural nerve sensory amplitudes were detected in 4.3%, 2.2%, and 10.6% of patients respectively. Apart from a significant relation between abnormal NCV and older ages, no significant relation was detected with other studied clinical and laboratory parameters. We detected a high frequency of motor and sensory polyneuropathy in B-thalassemia patients. Polyneuropathy was predominately detected in older ages highlighting that neuropathy in thalassemia patients is probably age-dependent. Other factors including disease duration, transfusion frequency, and iron overload might have a contributing effect, however, that could not be confirmed in this study. Further studies are needed to verify the frequency and predictors of polyneuropathy in B-thalassemia patients.
据报道，β-地中海贫血患者出现了神经系统并发症，包括外周多发性神经病，这对他们的生活质量造成了负面影响。长期缺氧、铁超载、平均年龄和铁螯合剂引起的神经毒性可能是导致神经病变的原因。然而，导致这一并发症的罪魁祸首仍不明确。我们的目的是研究β地中海贫血患者发生多发性神经病的频率和潜在风险因素。我们对 150 名输血依赖型重型β地中海贫血患者进行了横断面研究，他们的平均年龄为 16.44 ± 3.32 岁。我们对运动神经和感觉神经进行了电生理研究。我们发现，31.3%的病例有神经系统表现，这与年龄、病程和频繁输血有很大关系。在 47 例有神经系统表现的患者中，12 例（25.5%）神经传导速度（NCV）异常。10.6%、10.6%和14.9%的患者发现正中神经、腓神经和胫神经运动幅度异常。分别有 4.3%、2.2% 和 10.6% 的患者发现正中神经、腓总神经和胫神经感觉振幅异常。除了 NCV 异常与年龄较大有明显关系外，与其他临床和实验室参数没有明显关系。我们在 B 型地中海贫血患者中发现了高频率的运动和感觉多发性神经病。多发性神经病主要发生在年龄较大的患者身上，这说明地中海贫血患者的神经病可能与年龄有关。包括病程、输血频率和铁超载在内的其他因素可能也有影响，但本研究无法证实。还需要进一步的研究来验证 B 型地中海贫血患者发生多发性神经病的频率和预测因素。
{"title":"Frequency and potential risk factors of polyneuropathy in transfusion-dependent Β-thalassemia major patients: a cross-sectional study","authors":"Amr I. Risha, Mervat A. Hesham, Usama R. Elsafy, Yosria A. El Taweel, Mohammed M. Omar, Sara F. Saadawy, Diana Hanna","doi":"10.1186/s43054-024-00257-3","DOIUrl":"https://doi.org/10.1186/s43054-024-00257-3","url":null,"abstract":"Neurological complications, including peripheral polyneuropathy, have been reported in β-thalassemia patients that negatively impact their quality of life. Chronic hypoxia, iron overload, average age, and iron chelators-induced neurotoxicity might contribute to the development of neuropathy. However, the leading offender of this complication remains not clear. We aimed to study the frequency and potential risk factors of polyneuropathy in β-thalassemia patients. We performed a cross-section study on 150 transfusion-dependent β-thalassemia major patients with a mean age of 16.44 ± 3.32 years. We performed electrophysiological studies for motor and sensory nerves. We found that 31.3% of cases had neurological manifestations with significant relation to age, duration of the disease, and frequent transfusion. Out of 47 patients with neurological manifestations, 12 (25.5%) had abnormal nerve conduction velocity (NCV). Abnormal median, peroneal, and tibial nerve motor amplitudes were detected in 10.6%, 10.6%, and 14.9% of patients respectively. Abnormal median, peroneal, and sural nerve sensory amplitudes were detected in 4.3%, 2.2%, and 10.6% of patients respectively. Apart from a significant relation between abnormal NCV and older ages, no significant relation was detected with other studied clinical and laboratory parameters. We detected a high frequency of motor and sensory polyneuropathy in B-thalassemia patients. Polyneuropathy was predominately detected in older ages highlighting that neuropathy in thalassemia patients is probably age-dependent. Other factors including disease duration, transfusion frequency, and iron overload might have a contributing effect, however, that could not be confirmed in this study. Further studies are needed to verify the frequency and predictors of polyneuropathy in B-thalassemia patients.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140303227","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 : 2024-03-22DOI: 10.1186/s43054-024-00271-5
Diana K. Damian, Francis F. Furia, Germana Leyna
Tanzania is among the countries in sub-Saharan Africa with the highest under-five mortality rate. The leading causes of mortality among these children include vaccine-preventable infections. Strategies for reducing under-five mortality in hospital settings require a good knowledge of driving factors, which are largely unknown in Tanzania. This study was conducted at Muhimbili National Hospital to determine mortality and its predictors among under-five admitted in the general paediatric wards. We conducted a prospective cohort study among children aged between 1 and 59 months admitted in the paediatric wards at Muhimbili National Hospital from 2nd October 2017 to 13th April 2018. We recruited eligible children consecutively and followed them up until discharge or death. We calculated the mortality rate as the incidence density rate and determined the causes and predictors of mortality. We analyzed data to identify and quantify predictors of deaths and used Kaplan-Meir and Cox regression analyses to determine predictors of survival. A P-value of < 0.05 was considered statistically significant. We recruited 925 children aged 1–59 months with a median age of 13 and (IQR) of (20) months, females constituted 40.8%. The overall mortality rate was 12.2% (95% CI: 10.2%-14.5%). We found septicaemia (27%), malnutrition (12%), congenital heart disease (12%), pneumonia (11%), and Human Immunodeficiency Virus infection (9%) to be leading causes of mortality. More deaths were observed at night, during the first 24 h of admission, and on weekends. Independent factors for mortality were found to be low wealth quintiles (lowest quintile (AOR = 4.0; 95% CI: 1.19–13.51), second quintile (AOR = 5.2; 95% CI: 1.65–16.69) and middle quintile (AOR = 3.6; 95% CI: 1.14–11.33), unconsciousness on admission (AOR = 18; 95% CI: 6.70–56.82), inability to feed (AOR = 5.7; 95% CI: 1.97–16.51), lethargy (AOR = 4.9; 95% CI: 2.32–10.40), severe wasting (AOR = 4.5; 95% CI: 2.49–8.10), and respiratory distress (AOR = 2.6; 95% CI: 1.40–4.97). A high mortality rate was noted in this study and low wealth quantile, low parental education, and lack of health insurance were associated with high mortality. Patients had the highest risk of mortality within 24 h of admission, therefore it is important to raise awareness among clinicians regarding the need for improvement in the monitoring of patients, especially within 24 h of admission.
{"title":"Predictors of mortality among children at a tertiary hospital in Tanzania: a cohort study","authors":"Diana K. Damian, Francis F. Furia, Germana Leyna","doi":"10.1186/s43054-024-00271-5","DOIUrl":"https://doi.org/10.1186/s43054-024-00271-5","url":null,"abstract":"Tanzania is among the countries in sub-Saharan Africa with the highest under-five mortality rate. The leading causes of mortality among these children include vaccine-preventable infections. Strategies for reducing under-five mortality in hospital settings require a good knowledge of driving factors, which are largely unknown in Tanzania. This study was conducted at Muhimbili National Hospital to determine mortality and its predictors among under-five admitted in the general paediatric wards. We conducted a prospective cohort study among children aged between 1 and 59 months admitted in the paediatric wards at Muhimbili National Hospital from 2nd October 2017 to 13th April 2018. We recruited eligible children consecutively and followed them up until discharge or death. We calculated the mortality rate as the incidence density rate and determined the causes and predictors of mortality. We analyzed data to identify and quantify predictors of deaths and used Kaplan-Meir and Cox regression analyses to determine predictors of survival. A P-value of < 0.05 was considered statistically significant. We recruited 925 children aged 1–59 months with a median age of 13 and (IQR) of (20) months, females constituted 40.8%. The overall mortality rate was 12.2% (95% CI: 10.2%-14.5%). We found septicaemia (27%), malnutrition (12%), congenital heart disease (12%), pneumonia (11%), and Human Immunodeficiency Virus infection (9%) to be leading causes of mortality. More deaths were observed at night, during the first 24 h of admission, and on weekends. Independent factors for mortality were found to be low wealth quintiles (lowest quintile (AOR = 4.0; 95% CI: 1.19–13.51), second quintile (AOR = 5.2; 95% CI: 1.65–16.69) and middle quintile (AOR = 3.6; 95% CI: 1.14–11.33), unconsciousness on admission (AOR = 18; 95% CI: 6.70–56.82), inability to feed (AOR = 5.7; 95% CI: 1.97–16.51), lethargy (AOR = 4.9; 95% CI: 2.32–10.40), severe wasting (AOR = 4.5; 95% CI: 2.49–8.10), and respiratory distress (AOR = 2.6; 95% CI: 1.40–4.97). A high mortality rate was noted in this study and low wealth quantile, low parental education, and lack of health insurance were associated with high mortality. Patients had the highest risk of mortality within 24 h of admission, therefore it is important to raise awareness among clinicians regarding the need for improvement in the monitoring of patients, especially within 24 h of admission.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140198734","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 : 2024-03-18DOI: 10.1186/s43054-024-00255-5
İrem Çağla Özel, Gizem Erbaş Ünverdi, Pınar Serdar Eymirli, Nurcan Yabancı Ayhan
The aim of this study is to evaluate the relationship between dental caries, food intake, and body composition in school-age children. The study was conducted on 210 children, 105 boys and 105 girls, aged 6–12 years, without mental and/or physical disorders. Oral examinations of the children were performed by paediatric dentists and DMFT–DMFS and dmft–dmfs values were recorded. A detailed food frequency questionnaire was applied to determine the consumption frequency of dairy products and sugar‐added foods. Children’s height, waist and hip circumference measurements were taken by the researcher; body weight and body composition were evaluated with a Tanita body analyzer. The DMFS value of children who consumed white cheese daily is lower than children who did not (p < 0.05). The DMFT and DMFS values were found to be higher in children who consumed sweets, biscuits, and spreadable chocolate daily compared to children who did not (p < 0.05). Body weight and waist circumference are positively correlated with DMFT and negatively correlated with dmft. BMI is positively correlated with DMFT and negatively correlated with dmft (p < 0.05). In binary logistic regression, it was found that maternal education level, frequency of added sugar intake and body fat ratio were predictors of the presence of caries. In this study, dental caries was associated with food consumption and body mass index. In children, consumption of sugary foods should be reduced and consumption of dairy products should be increased.
{"title":"The relationship between dental caries, dietary intake and body composition in school-age children","authors":"İrem Çağla Özel, Gizem Erbaş Ünverdi, Pınar Serdar Eymirli, Nurcan Yabancı Ayhan","doi":"10.1186/s43054-024-00255-5","DOIUrl":"https://doi.org/10.1186/s43054-024-00255-5","url":null,"abstract":"The aim of this study is to evaluate the relationship between dental caries, food intake, and body composition in school-age children. The study was conducted on 210 children, 105 boys and 105 girls, aged 6–12 years, without mental and/or physical disorders. Oral examinations of the children were performed by paediatric dentists and DMFT–DMFS and dmft–dmfs values were recorded. A detailed food frequency questionnaire was applied to determine the consumption frequency of dairy products and sugar‐added foods. Children’s height, waist and hip circumference measurements were taken by the researcher; body weight and body composition were evaluated with a Tanita body analyzer. The DMFS value of children who consumed white cheese daily is lower than children who did not (p < 0.05). The DMFT and DMFS values were found to be higher in children who consumed sweets, biscuits, and spreadable chocolate daily compared to children who did not (p < 0.05). Body weight and waist circumference are positively correlated with DMFT and negatively correlated with dmft. BMI is positively correlated with DMFT and negatively correlated with dmft (p < 0.05). In binary logistic regression, it was found that maternal education level, frequency of added sugar intake and body fat ratio were predictors of the presence of caries. In this study, dental caries was associated with food consumption and body mass index. In children, consumption of sugary foods should be reduced and consumption of dairy products should be increased.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140152206","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 : 2024-03-12DOI: 10.1186/s43054-024-00254-6
Ahmed M. Abd El Moktader, Remon M. Yousef, Ahmed Safwat, Heba A. Borayek
Using conventional echocardiography, this study aimed to evaluate the epicardial fat thickness (EFT) and its role in discriminating infants of diabetic mothers (IDMs) from those of non-diabetic mothers (INDMs) and to assess its prognostic role in IDMs. This case control study was conducted at the Neonatology and Cardiology Units of Pediatric Department, Fayoum University Hospital, Egypt, between February and September 2023. A total of 54 neonates were enrolled into three groups: 18 IDMs with well-controlled diabetes mellitus (DM), 18 IDMs with poorly controlled DM, and 18 INDMs. The sensitivity, specificity, and cutoff of EFT were 100%, 100%, and 3.950 mm for detecting cases of IDMs and were 66.7%, 72.2%, and 5.100 mm for differentiating controlled from uncontrolled diabetic mothers, respectively. The interventricular septum in diastole (IVSd), interventricular septum in systole (IVSs), estimated pulmonary artery pressure (PAP), left ventricle (LV) Tei index, and isovolumetric relaxation time (IVRT) of LV all showed a positive correlation with EFT (r = 0.35, 0.31, 0.41, 0.34, and 0.39; P = 0.009, 0.025, 0.002, 0.01, and 0.003; respectively). There was a significant negative correlation between EFT and left ventricular internal dimensions in diastole (LVIDd) and left ventricular internal dimensions in systole (LVIDs) (r = − 0.44 and 0.42, P = 0.001 and 0.001). Regarding tissue Doppler, there was a significantly higher Tei index in group I cases compared to control (0.59 ± 0.10 vs. 0.49 ± 0.09, P < 0.001). The EFT is higher in IDMs than in INDMs, with a positive correlation with birth weight, IVSd, IVSs, Tei index of mitral, IVRT, and ESPAP and a negative correlation with LVIDd and LVIDs. Neonatal EFT can be used as one of the helpful parameters to detect IDMs. Also, it may be used as one of the prognostic factors in IDMs as it is positively correlated with the diastolic function of the LV.
{"title":"Epicardial fat thickness among neonates of diabetic mothers attending the neonatal intensive care unit at Fayoum University Hospital: a case control study","authors":"Ahmed M. Abd El Moktader, Remon M. Yousef, Ahmed Safwat, Heba A. Borayek","doi":"10.1186/s43054-024-00254-6","DOIUrl":"https://doi.org/10.1186/s43054-024-00254-6","url":null,"abstract":"Using conventional echocardiography, this study aimed to evaluate the epicardial fat thickness (EFT) and its role in discriminating infants of diabetic mothers (IDMs) from those of non-diabetic mothers (INDMs) and to assess its prognostic role in IDMs. This case control study was conducted at the Neonatology and Cardiology Units of Pediatric Department, Fayoum University Hospital, Egypt, between February and September 2023. A total of 54 neonates were enrolled into three groups: 18 IDMs with well-controlled diabetes mellitus (DM), 18 IDMs with poorly controlled DM, and 18 INDMs. The sensitivity, specificity, and cutoff of EFT were 100%, 100%, and 3.950 mm for detecting cases of IDMs and were 66.7%, 72.2%, and 5.100 mm for differentiating controlled from uncontrolled diabetic mothers, respectively. The interventricular septum in diastole (IVSd), interventricular septum in systole (IVSs), estimated pulmonary artery pressure (PAP), left ventricle (LV) Tei index, and isovolumetric relaxation time (IVRT) of LV all showed a positive correlation with EFT (r = 0.35, 0.31, 0.41, 0.34, and 0.39; P = 0.009, 0.025, 0.002, 0.01, and 0.003; respectively). There was a significant negative correlation between EFT and left ventricular internal dimensions in diastole (LVIDd) and left ventricular internal dimensions in systole (LVIDs) (r = − 0.44 and 0.42, P = 0.001 and 0.001). Regarding tissue Doppler, there was a significantly higher Tei index in group I cases compared to control (0.59 ± 0.10 vs. 0.49 ± 0.09, P < 0.001). The EFT is higher in IDMs than in INDMs, with a positive correlation with birth weight, IVSd, IVSs, Tei index of mitral, IVRT, and ESPAP and a negative correlation with LVIDd and LVIDs. Neonatal EFT can be used as one of the helpful parameters to detect IDMs. Also, it may be used as one of the prognostic factors in IDMs as it is positively correlated with the diastolic function of the LV.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140105980","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 : 2024-03-08DOI: 10.1186/s43054-024-00249-3
Diya Alzu’bi, Hanady Obeidat, Dua’a Ghabashineh, Omayma AbuRass, Ola Musadag, Dua’ N. Samara, Belal Al Droubi, Gamal T. Abdelhady, Suleimman Al-Sweedan
Febrile neutropenia (FN) is a life-threatening complication of cancer therapy. Appropriate antibiotic treatment improves the clinical outcome in these patients; however, the increasing rate of anti-microbial resistance makes its therapy particularly challenging. This study aims to investigate the microbial spectrum and antimicrobial resistance pattern in cancer patients with FN at King Abdullah University Hospital, Jordan. Blood cultures of 261 FN patients pre-diagnosed with malignancy (age 1–18 years) were enrolled in this study. The most common isolated microorganisms were gram-positive bacteria (50.2℅). Gram-infections with coagulase-negative Staphylococcus (CONS) are the most prevalent pathogens, followed by gram-negative infections with Klebseilla pneumonia and fungal infections with nonalbicans strains. All CONS, Methicillin-resistant Staphylococcus aureus (MRSA), and enterococcus species were sensitive to Vancomycin and Teicoplanin. Ten percent of the gram-negative organisms were Extended-spectrum beta-lactamase (ESBL) and all were sensitive to carbapenems. 66.7% of pseudomonas aeruginosa blood cultures were sensitive to Piperacillin-Tazobactam and 83.4% were sensitive to carbapenems. All Enterobacter species were sensitive to Carbapenems. Isolates showed various antibiotic sensitivity and resistance patterns; therefore, a judicious management plan is essential to establish an appropriate and effective institutional policy for the use of empirical antibiotics in patients of FN.
{"title":"The microbial spectrum and antimicrobial resistance pattern in pediatric cancer patients with febrile neutropenia at King Abdullah University Hospital, Jordan","authors":"Diya Alzu’bi, Hanady Obeidat, Dua’a Ghabashineh, Omayma AbuRass, Ola Musadag, Dua’ N. Samara, Belal Al Droubi, Gamal T. Abdelhady, Suleimman Al-Sweedan","doi":"10.1186/s43054-024-00249-3","DOIUrl":"https://doi.org/10.1186/s43054-024-00249-3","url":null,"abstract":"Febrile neutropenia (FN) is a life-threatening complication of cancer therapy. Appropriate antibiotic treatment improves the clinical outcome in these patients; however, the increasing rate of anti-microbial resistance makes its therapy particularly challenging. This study aims to investigate the microbial spectrum and antimicrobial resistance pattern in cancer patients with FN at King Abdullah University Hospital, Jordan. Blood cultures of 261 FN patients pre-diagnosed with malignancy (age 1–18 years) were enrolled in this study. The most common isolated microorganisms were gram-positive bacteria (50.2℅). Gram-infections with coagulase-negative Staphylococcus (CONS) are the most prevalent pathogens, followed by gram-negative infections with Klebseilla pneumonia and fungal infections with nonalbicans strains. All CONS, Methicillin-resistant Staphylococcus aureus (MRSA), and enterococcus species were sensitive to Vancomycin and Teicoplanin. Ten percent of the gram-negative organisms were Extended-spectrum beta-lactamase (ESBL) and all were sensitive to carbapenems. 66.7% of pseudomonas aeruginosa blood cultures were sensitive to Piperacillin-Tazobactam and 83.4% were sensitive to carbapenems. All Enterobacter species were sensitive to Carbapenems. Isolates showed various antibiotic sensitivity and resistance patterns; therefore, a judicious management plan is essential to establish an appropriate and effective institutional policy for the use of empirical antibiotics in patients of FN.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140071849","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 : 2024-03-04DOI: 10.1186/s43054-024-00250-w
Shimaa Reffat, Alaa Fahmy AL-Nemr
Children with cerebral palsy (CP) may have different gross motor impairments which in sequence affecting their life occupations. The purpose of the study is to investigate the correlation between Gross Motor Function Measurement-66 (GMFM-66), the test of Bruininks-Oseretsky Motor Proficiency (BOTMP), and the Peabody Developmental Motor Scale–Second Edition (PDMS-2) in young children with CP. A correlational study was applied on 50 children aged from 4 to 6 years (30 girls, 20 boys) with spastic CP. The Pearson correlation coefficient between the GMFM scale and PDMS-2 motor quotients, and its subscales (stationary, locomotion, and object control) and also between GMFM and BOTMP gross motor quotients and its subscales (strength, agility, and body coordination) were statistically significant. Spearman’s coefficients between the grade of the Gross Motor Classification System (GMFCS) and the PDMS-2 Gross Motor Composite, BOTS-2, and its subscale results were also statistically significant. The three measurement scales, GMFM- 66, BOTS-2, and PDMS-2, are significantly related. Therefore, GMFCS is useful in predicting movement performance in children with CP and correlated with predictive guidance in treatment development. ClinicalTrials.gov Identifier: NCT06124352.
{"title":"Correlation between clinical measurement scales on gross motor function in children with spastic cerebral palsy","authors":"Shimaa Reffat, Alaa Fahmy AL-Nemr","doi":"10.1186/s43054-024-00250-w","DOIUrl":"https://doi.org/10.1186/s43054-024-00250-w","url":null,"abstract":"Children with cerebral palsy (CP) may have different gross motor impairments which in sequence affecting their life occupations. The purpose of the study is to investigate the correlation between Gross Motor Function Measurement-66 (GMFM-66), the test of Bruininks-Oseretsky Motor Proficiency (BOTMP), and the Peabody Developmental Motor Scale–Second Edition (PDMS-2) in young children with CP. A correlational study was applied on 50 children aged from 4 to 6 years (30 girls, 20 boys) with spastic CP. The Pearson correlation coefficient between the GMFM scale and PDMS-2 motor quotients, and its subscales (stationary, locomotion, and object control) and also between GMFM and BOTMP gross motor quotients and its subscales (strength, agility, and body coordination) were statistically significant. Spearman’s coefficients between the grade of the Gross Motor Classification System (GMFCS) and the PDMS-2 Gross Motor Composite, BOTS-2, and its subscale results were also statistically significant. The three measurement scales, GMFM- 66, BOTS-2, and PDMS-2, are significantly related. Therefore, GMFCS is useful in predicting movement performance in children with CP and correlated with predictive guidance in treatment development. ClinicalTrials.gov Identifier: NCT06124352.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140035331","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 : 2024-02-29DOI: 10.1186/s43054-024-00268-0
Rajesh Nare, Vishal Dnyaneshwar Sawant, Rahul Surve
Metabolic bone disease (MBD) is an important cause of morbidity in premature, very low birth weight (VLBW), and sick infants and, if left undiagnosed, may lead to structural deformities and spontaneous fractures. The objective of the present study was to study the profile of MBD and to determine the incidence of MBD in infants ≤ 32 weeks/≤ 1250 g at birth. A total of 57 infants ≤ 32 weeks/≤ 1250 g at birth admitted in our NICU from October 2020 to July 2021 were included in the study. These infants underwent screening for MBD at 4 weeks of age. They were stratified into three groups based on their gestation (≤ 28 weeks, 29–30 weeks, 31–32 weeks). MBD was observed in 100% of extreme preterm babies and 69% of very preterm babies. Overall, the incidence of MBD was 73%. Serum phosphorus level normalized by 42–44 weeks post menstrual age (PMA) across all gestations. Alkaline phosphatase (ALP) levels normalized by 42–44 weeks only in very preterm babies. Seventeen babies ≤ 30 weeks required inorganic phosphorus supplementation in addition to calcium phosphate supplementation in order to correct the MBD. Drugs like caffeine, steroids, and furosemide have significant impact on the development of MBD. The time to reach full feeds with fortification had no statistically significant effect on the incidence of MBD as detected by serum phosphorus level and serum ALP level. The profile outlined in the present study matches the literature reports in many aspects, revealing the importance of characterizing this group for the prognosis and short- and long-term follow-up of newborns with bone metabolic disease.
{"title":"Profile of metabolic bone disease in extremely low birth weight (ELBW) and very low birth weight (VLBW) neonates","authors":"Rajesh Nare, Vishal Dnyaneshwar Sawant, Rahul Surve","doi":"10.1186/s43054-024-00268-0","DOIUrl":"https://doi.org/10.1186/s43054-024-00268-0","url":null,"abstract":"Metabolic bone disease (MBD) is an important cause of morbidity in premature, very low birth weight (VLBW), and sick infants and, if left undiagnosed, may lead to structural deformities and spontaneous fractures. The objective of the present study was to study the profile of MBD and to determine the incidence of MBD in infants ≤ 32 weeks/≤ 1250 g at birth. A total of 57 infants ≤ 32 weeks/≤ 1250 g at birth admitted in our NICU from October 2020 to July 2021 were included in the study. These infants underwent screening for MBD at 4 weeks of age. They were stratified into three groups based on their gestation (≤ 28 weeks, 29–30 weeks, 31–32 weeks). MBD was observed in 100% of extreme preterm babies and 69% of very preterm babies. Overall, the incidence of MBD was 73%. Serum phosphorus level normalized by 42–44 weeks post menstrual age (PMA) across all gestations. Alkaline phosphatase (ALP) levels normalized by 42–44 weeks only in very preterm babies. Seventeen babies ≤ 30 weeks required inorganic phosphorus supplementation in addition to calcium phosphate supplementation in order to correct the MBD. Drugs like caffeine, steroids, and furosemide have significant impact on the development of MBD. The time to reach full feeds with fortification had no statistically significant effect on the incidence of MBD as detected by serum phosphorus level and serum ALP level. The profile outlined in the present study matches the literature reports in many aspects, revealing the importance of characterizing this group for the prognosis and short- and long-term follow-up of newborns with bone metabolic disease.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140006129","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}
The incidence of thyroid cancer has been increasing among the population less than 20 years of age, especially during the second decade of life. Differentiated papillary thyroid cancer is the most common pathology in children. It usually presents with thyroid nodules with or without cervical lymphadenopathy. Thyroid nodules carry a considerable risk of malignancy in children. We herein report a 5-year-old girl with poorly differentiated papillary thyroid cancer which is an extremely rare finding at this age. The patient underwent right thyroid lobectomy followed by left hemi thyroidectomy and right central and lateral neck dissection. Pathologic examination revealed a poorly differentiated papillary thyroid carcinoma with nodal deposits. It is essential to raise awareness of proper evaluation and management of thyroid nodules at such an age.
{"title":"Poorly differentiated papillary thyroid carcinoma in a 5-year-old girl: a case report","authors":"Mohanned Mohsen, Omar Hamdy, Ahmad Ramadan, Shadi Awny, Khaled Zalata, Mohamed Ezat","doi":"10.1186/s43054-024-00251-9","DOIUrl":"https://doi.org/10.1186/s43054-024-00251-9","url":null,"abstract":"The incidence of thyroid cancer has been increasing among the population less than 20 years of age, especially during the second decade of life. Differentiated papillary thyroid cancer is the most common pathology in children. It usually presents with thyroid nodules with or without cervical lymphadenopathy. Thyroid nodules carry a considerable risk of malignancy in children. We herein report a 5-year-old girl with poorly differentiated papillary thyroid cancer which is an extremely rare finding at this age. The patient underwent right thyroid lobectomy followed by left hemi thyroidectomy and right central and lateral neck dissection. Pathologic examination revealed a poorly differentiated papillary thyroid carcinoma with nodal deposits. It is essential to raise awareness of proper evaluation and management of thyroid nodules at such an age.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139968303","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：