Pub Date : 2022-01-01DOI: 10.1177/11795565221139118
Hiroo Kinami, Kiyozo Morita, Gen Shinohara, Yoshimasa Uno
Background: We sought to determine the difference in geometric parameters in the left atrioventricular valve (LAVV) postoperative complete atrioventricular septal defect (CAVSD) compared to the normal heart, and the correlation between geometric and functional parameters for detecting the mechanism of LAVV regurgitation (LAVVR) in CAVSD.
Methods: LAVV geometric parameters based on complete and acceptable quality echocardiograms of 18 patients with repaired CAVSD compared with 17 normal controls. LAVVR severity was also quantified by indexed vena contracta (I-VC) (mm) and % jet area/left atrium area (% Jet/LA), and the correlation with LAVV parameters in the CAVSD group was investigated.
Results: In the CAVSD group, the posterior closing angle (Pc) was nearly the same as the anterior closing angle (Ac), yet in the normal heart, the Pc angle was double the Ac angle. The anterior opening angle (Ao) and posterior-to-anterior leaflet diameter ratio (a/p) in the CAVSD group was also significantly smaller. The CAVSD group also had a shorter indexed coaptation length (I-CL) and indexed tenting height (I-TH). Displacement length (ΔD) differed completely between the CAVSD and Normal groups, and also showed a strong positive correlation to the functional parameters of LAVVR (% Jet/LA: r = .70, P = .02; I-VC: r = .60, P = .02).
Conclusions: The parameters in this study were applicable to CAVSD AV valve coaptation characteristics. We introduced 2 novel measures that may provide important insights into the differences in geometry and performance of the LAVV in repaired CAVSD as compared to normal hearts.
背景:我们试图确定左房室瓣(LAVV)术后完全性房室间隔缺损(CAVSD)与正常心脏的几何参数差异,以及几何参数与功能参数之间的相关性,以检测CAVSD中LAVV反流(LAVVR)的机制。方法:对18例修复后的CAVSD患者的超声心动图进行完整、质量可接受的LAVV几何参数分析,并与17例正常对照。用指数静脉收缩(I-VC) (mm)和% jet /左心房面积(% jet /LA)量化LAVVR严重程度,并探讨CAVSD组与LAVV参数的相关性。结果:在CAVSD组中,后关角(Pc)与前关角(Ac)几乎相同,而在正常心脏中,后关角(Pc)是前关角的两倍。CAVSD组的前开角(Ao)和后前叶直径比(a/p)也明显小于CAVSD组。CAVSD组的索引覆盖长度(I-CL)和索引帐篷高度(I-TH)也较短。位移长度(ΔD)在CAVSD组和Normal组之间完全不同,并且与LAVVR功能参数(% Jet/LA: r =)呈强正相关。70, p = .02;I-VC: r =。60, p = .02)。结论:本研究参数适用于CAVSD房室瓣适配特性。我们介绍了两种新的测量方法,可以为修复后的CAVSD与正常心脏相比,LAVV的几何形状和性能差异提供重要的见解。
{"title":"Echocardiographic Evaluation of Postoperative Coaptation Geometry of Left AV Valve in Complete Atrioventricular Septal Defect.","authors":"Hiroo Kinami, Kiyozo Morita, Gen Shinohara, Yoshimasa Uno","doi":"10.1177/11795565221139118","DOIUrl":"https://doi.org/10.1177/11795565221139118","url":null,"abstract":"<p><strong>Background: </strong>We sought to determine the difference in geometric parameters in the left atrioventricular valve (LAVV) postoperative complete atrioventricular septal defect (CAVSD) compared to the normal heart, and the correlation between geometric and functional parameters for detecting the mechanism of LAVV regurgitation (LAVVR) in CAVSD.</p><p><strong>Methods: </strong>LAVV geometric parameters based on complete and acceptable quality echocardiograms of 18 patients with repaired CAVSD compared with 17 normal controls. LAVVR severity was also quantified by indexed vena contracta (I-VC) (mm) and % jet area/left atrium area (% Jet/LA), and the correlation with LAVV parameters in the CAVSD group was investigated.</p><p><strong>Results: </strong>In the CAVSD group, the posterior closing angle (Pc) was nearly the same as the anterior closing angle (Ac), yet in the normal heart, the Pc angle was double the Ac angle. The anterior opening angle (Ao) and posterior-to-anterior leaflet diameter ratio (a/p) in the CAVSD group was also significantly smaller. The CAVSD group also had a shorter indexed coaptation length (I-CL) and indexed tenting height (I-TH). Displacement length (ΔD) differed completely between the CAVSD and Normal groups, and also showed a strong positive correlation to the functional parameters of LAVVR (% Jet/LA: <i>r</i> = .70, <i>P</i> = .02; I-VC: <i>r</i> = .60, <i>P</i> = .02).</p><p><strong>Conclusions: </strong>The parameters in this study were applicable to CAVSD AV valve coaptation characteristics. We introduced 2 novel measures that may provide important insights into the differences in geometry and performance of the LAVV in repaired CAVSD as compared to normal hearts.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dc/76/10.1177_11795565221139118.PMC9742689.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10731072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/11795565221142810
Jay Lodhia, Hilary Chipongo, Beatrice Mathew, David Msuya, Samwel Chugulu, Rune Philemon
Intestinal obstruction is one of the most common surgical emergencies in the neonatal period. Early diagnosis is vital for proper management and good outcome. Intestinal obstruction can be divided into high, for example, duodenal atresia and jejunal atresia, or low, for example, ileal atresia, colonic atresia, and Meckel's diverticulum. The most common cause of intestinal obstruction in neonates is midgut atresia. Surgical correction is needed and is a challenge in the developing countries where there is lack of pediatric surgeons, anesthesiologists, and intensive care. More research and data is also needed across countries to show the uneven distribution of the available resources.
{"title":"Midgut Atresia: Diagnostic and Management Challenges From Northern Tanzania.","authors":"Jay Lodhia, Hilary Chipongo, Beatrice Mathew, David Msuya, Samwel Chugulu, Rune Philemon","doi":"10.1177/11795565221142810","DOIUrl":"https://doi.org/10.1177/11795565221142810","url":null,"abstract":"<p><p>Intestinal obstruction is one of the most common surgical emergencies in the neonatal period. Early diagnosis is vital for proper management and good outcome. Intestinal obstruction can be divided into high, for example, duodenal atresia and jejunal atresia, or low, for example, ileal atresia, colonic atresia, and Meckel's diverticulum. The most common cause of intestinal obstruction in neonates is midgut atresia. Surgical correction is needed and is a challenge in the developing countries where there is lack of pediatric surgeons, anesthesiologists, and intensive care. More research and data is also needed across countries to show the uneven distribution of the available resources.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/92/c2/10.1177_11795565221142810.PMC9761201.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10418925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Globally, the major cause of neonatal mortality and morbidity is neonatal sepsis, which is defined as a clinical course marked by systemic inflammation in the presence of infection in a newborn. There are limited data concerning neonatal sepsis in eastern Ethiopia. As a result, this study aimed to determine the prevalence of neonatal sepsis and associated factors among neonates admitted to intensive care units at general hospitals in Eastern Ethiopia. Methods: A hospital-based cross-sectional study with retrospective document review was conducted among newborns hospitalized in neonatal intensive care units. Using simple random sampling, the charts of 356 newborns who were hospitalized between January and December 2019 were included, and data were collected using a pretested checklist. Data were entered into Epi data version 3.1 and analyzed with SPSS version 22. Results: The overall prevalence of neonatal sepsis was 45.8% (95% CI 40.7, 51.4). Prolonged rupture of the membrane (AOR = 2.38, 95% CI: [1.27-4.45]), vaginal delivery (AOR = 1.78, 95%, CI: [1.09, 2.96]) APGAR score <7 (AOR = 4.55, 95% CI: [2.49-8.29]), prelacteal feeding (AOR = 3.54, 95% CI: [1.68-8.23]), and mechanical ventilation (AOR = 4.97,95%CI: [2.78-8.89]) were predictors associated with neonatal sepsis. Conclusion: In this study, the prevalence of neonatal sepsis was high, and factors associated with neonatal sepsis included prolonged rupture of membrane, mode of delivery, low APGAR score, prelacteal feeding and mechanical ventilation. As a result, maternal and neonatal care should be enhanced to lower the risk of neonatal sepsis.
{"title":"Neonatal Sepsis and Associated Factors Among Neonates Admitted to Neonatal Intensive Care Unit in General Hospitals, Eastern Ethiopia 2020","authors":"Abdurahman Kedir Roble, Liyew Mekonen Ayehubizu, Hafsa Mohamed Olad","doi":"10.1177/11795565221098346","DOIUrl":"https://doi.org/10.1177/11795565221098346","url":null,"abstract":"Introduction: Globally, the major cause of neonatal mortality and morbidity is neonatal sepsis, which is defined as a clinical course marked by systemic inflammation in the presence of infection in a newborn. There are limited data concerning neonatal sepsis in eastern Ethiopia. As a result, this study aimed to determine the prevalence of neonatal sepsis and associated factors among neonates admitted to intensive care units at general hospitals in Eastern Ethiopia. Methods: A hospital-based cross-sectional study with retrospective document review was conducted among newborns hospitalized in neonatal intensive care units. Using simple random sampling, the charts of 356 newborns who were hospitalized between January and December 2019 were included, and data were collected using a pretested checklist. Data were entered into Epi data version 3.1 and analyzed with SPSS version 22. Results: The overall prevalence of neonatal sepsis was 45.8% (95% CI 40.7, 51.4). Prolonged rupture of the membrane (AOR = 2.38, 95% CI: [1.27-4.45]), vaginal delivery (AOR = 1.78, 95%, CI: [1.09, 2.96]) APGAR score <7 (AOR = 4.55, 95% CI: [2.49-8.29]), prelacteal feeding (AOR = 3.54, 95% CI: [1.68-8.23]), and mechanical ventilation (AOR = 4.97,95%CI: [2.78-8.89]) were predictors associated with neonatal sepsis. Conclusion: In this study, the prevalence of neonatal sepsis was high, and factors associated with neonatal sepsis included prolonged rupture of membrane, mode of delivery, low APGAR score, prelacteal feeding and mechanical ventilation. As a result, maternal and neonatal care should be enhanced to lower the risk of neonatal sepsis.","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85755268","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 : 2022-01-01DOI: 10.1177/11795565221075313
Gregory Goodluck, Marianne Gnanamuttupulle, A. Sadiq, D. Msuya, Samwel Chugulu, J. Lodhia
Jenunoileal atresia is a congenital defect that causes small bowel obstruction in newborns. They are classified into 5 types and simple abdominal x-ray can aid in the diagnosis and with prompt resuscitation and surgery provides positive outcome. We present a 5-day-old newborn male baby was presented with features of intestinal obstruction since birth. Diagnosis of atresia of the small bowel was made through plain abdominal x-ray and was successfully operated. During the recovery, the baby developed surgical site infection which was managed promptly.
{"title":"Jejunoileal Atresia in a Newborn: Our Experience From Northern Tanzania and Literature Review","authors":"Gregory Goodluck, Marianne Gnanamuttupulle, A. Sadiq, D. Msuya, Samwel Chugulu, J. Lodhia","doi":"10.1177/11795565221075313","DOIUrl":"https://doi.org/10.1177/11795565221075313","url":null,"abstract":"Jenunoileal atresia is a congenital defect that causes small bowel obstruction in newborns. They are classified into 5 types and simple abdominal x-ray can aid in the diagnosis and with prompt resuscitation and surgery provides positive outcome. We present a 5-day-old newborn male baby was presented with features of intestinal obstruction since birth. Diagnosis of atresia of the small bowel was made through plain abdominal x-ray and was successfully operated. During the recovery, the baby developed surgical site infection which was managed promptly.","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90409523","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}
Objectives: To address pneumonia, a major killer of under-5 children in India, a multimodal pulse oximeter was implemented in Health and Wellness Centers. Given the evidence of pulse oximetry in effective pneumonia management and taking into account the inadequate skills of front-line healthcare workers in case management, the device was introduced to help them readily diagnose and treat a child and to examine usability of the device.
Design: The implementation was integrated with the routine OPD of primary health centers for 15 months after healthcare workers were provided with an abridged IMNCI training. Monthly facility data was collected to examine case management with the diagnostic device. Feedback on usefulness of the device was obtained.
Setting: Health and Wellness Centers (19) of 7 states were selected in consultation with state National Health Mission based on patient footfall.
Participants: Under-5 children presenting with ARI symptoms at the OPD.
Results: Of 4846 children, 0.1% were diagnosed with severe pneumonia and 23% were diagnosed with pneumonia. As per device readings, correct referrals were made of 77.6% of cases of severe pneumonia, and 81% of pneumonia cases were correctly given antibiotics. The Pulse oximeter was highly acceptable among health workers as it helped in timely classification and treatment of pneumonia. It had no maintenance issue and battery was long-lasting.
Conclusion: Pulse oximeter implementation was doable and acceptable among health workers. Together with IMNCI training, PO in primary care settings is a feasible approach to provide equitable care to under-5 children.
{"title":"Experiences From an Implementation Model of ARI Diagnostic Device in Pneumonia Case Management Among Under-5 Children in Peripheral Healthcare Centers in India.","authors":"Harish Kumar, Enisha Sarin, Prasant Saboth, Avinash Jaiswal, Nidhi Chaudhary, Jaya Swarup Mohanty, Nitin Bisht, Shailendra Singh Tomar, Anil Gupta, Ranjan Panda, Rachana Patel, Arvind Kumar, Sachin Gupta, Varun Alwadhi","doi":"10.1177/11795565211056649","DOIUrl":"10.1177/11795565211056649","url":null,"abstract":"<p><strong>Objectives: </strong>To address pneumonia, a major killer of under-5 children in India, a multimodal pulse oximeter was implemented in Health and Wellness Centers. Given the evidence of pulse oximetry in effective pneumonia management and taking into account the inadequate skills of front-line healthcare workers in case management, the device was introduced to help them readily diagnose and treat a child and to examine usability of the device.</p><p><strong>Design: </strong>The implementation was integrated with the routine OPD of primary health centers for 15 months after healthcare workers were provided with an abridged IMNCI training. Monthly facility data was collected to examine case management with the diagnostic device. Feedback on usefulness of the device was obtained.</p><p><strong>Setting: </strong>Health and Wellness Centers (19) of 7 states were selected in consultation with state National Health Mission based on patient footfall.</p><p><strong>Participants: </strong>Under-5 children presenting with ARI symptoms at the OPD.</p><p><strong>Results: </strong>Of 4846 children, 0.1% were diagnosed with severe pneumonia and 23% were diagnosed with pneumonia. As per device readings, correct referrals were made of 77.6% of cases of severe pneumonia, and 81% of pneumonia cases were correctly given antibiotics. The Pulse oximeter was highly acceptable among health workers as it helped in timely classification and treatment of pneumonia. It had no maintenance issue and battery was long-lasting.</p><p><strong>Conclusion: </strong>Pulse oximeter implementation was doable and acceptable among health workers. Together with IMNCI training, PO in primary care settings is a feasible approach to provide equitable care to under-5 children.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2021-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/83/10.1177_11795565211056649.PMC8600550.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39643065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-21eCollection Date: 2021-01-01DOI: 10.1177/11795565211049897
Tahir Dalkıran, Yaşar Kandur, Emine Manolya Kara, Besra Dağoğlu, Sevgin Taner, Doğan Öncü
In this case report, we report a pediatric patient with COVID-19 and atypical hemolytic uremic syndrome (aHUS). A 3-year-old girl with fever and respiratory distress was admitted to the hospital. The patient tested positive for COVID-19 by a PCR test. As her respiratory distress increased and blood gas indicated deep respiratory acidosis on the third day of the pediatric intensive care unit follow-up, the patient was intubated and ventilated. Thorax computerized tomography (CT) showed bilateral effusion and atelectasis. During her follow-up, the pleural effusion resolved but there were marked consolidation areas and ground glass opacities compatible with COVID-19 on the follow-up CT. On the 10th day, she became anuric and developed progressive thrombocytopenia and persistent microangiopathic hemolytic anemia, which were suggestive of HUS given a high creatinine level (1.9 mg/dl), an undetectable haptoglobin level, reticulocytosis (8%), and an LDH level of 2540 U/l. Direct Coombs test returned negative. Examination of a peripheral blood smear revealed schistocytes. Disseminated intravascular coagulation was ruled out by normal INR and PTT. In the light of the available findings, we considered the patient to have thrombotic microangiopathy (TMA) triggered by COVID-19. It was not a TTP-form of TMA but rather an aHUS type, based on an ADAMTS13 activity level >5%. Hence, plasmapheresis was performed with fresh frozen plasma (FFP). After 4 weeks, she became completely asymptomatic, and her hemodynamic parameters normalized. COVID-19 induced uncontrolled complement activation leading to the development of aHUS. Early diagnosis and treatment may reduce morbidity and mortality since its treatment options.
{"title":"Thrombotic Microangiopathy in a Severe Pediatric Case of COVID-19.","authors":"Tahir Dalkıran, Yaşar Kandur, Emine Manolya Kara, Besra Dağoğlu, Sevgin Taner, Doğan Öncü","doi":"10.1177/11795565211049897","DOIUrl":"10.1177/11795565211049897","url":null,"abstract":"<p><p>In this case report, we report a pediatric patient with COVID-19 and atypical hemolytic uremic syndrome (aHUS). A 3-year-old girl with fever and respiratory distress was admitted to the hospital. The patient tested positive for COVID-19 by a PCR test. As her respiratory distress increased and blood gas indicated deep respiratory acidosis on the third day of the pediatric intensive care unit follow-up, the patient was intubated and ventilated. Thorax computerized tomography (CT) showed bilateral effusion and atelectasis. During her follow-up, the pleural effusion resolved but there were marked consolidation areas and ground glass opacities compatible with COVID-19 on the follow-up CT. On the 10th day, she became anuric and developed progressive thrombocytopenia and persistent microangiopathic hemolytic anemia, which were suggestive of HUS given a high creatinine level (1.9 mg/dl), an undetectable haptoglobin level, reticulocytosis (8%), and an LDH level of 2540 U/l. Direct Coombs test returned negative. Examination of a peripheral blood smear revealed schistocytes. Disseminated intravascular coagulation was ruled out by normal INR and PTT. In the light of the available findings, we considered the patient to have thrombotic microangiopathy (TMA) triggered by COVID-19. It was not a TTP-form of TMA but rather an aHUS type, based on an ADAMTS13 activity level >5%. Hence, plasmapheresis was performed with fresh frozen plasma (FFP). After 4 weeks, she became completely asymptomatic, and her hemodynamic parameters normalized. COVID-19 induced uncontrolled complement activation leading to the development of aHUS. Early diagnosis and treatment may reduce morbidity and mortality since its treatment options.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2021-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/95/40/10.1177_11795565211049897.PMC8543637.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39564331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-21eCollection Date: 2021-01-01DOI: 10.1177/11795565211049904
Christoph Hoehn, Natasha Lelijveld, Martha Mwangome, James A Berkley, Marie McGrath, Marko Kerac
Background: There is increasing global focus on small and nutritionally at-risk infants aged <6 months (<6 m). Current WHO guidelines recommend weight-for-length z-score (WLZ) for enrolment to malnutrition treatment programmes but acknowledge a weak evidence-base. This review aims to inform future guidelines by examining which anthropometric criteria best identify infants <6 m at high risk of mortality/morbidity.
Methods: We searched Medline, EMBASE, CINAHL, Global Health, Cochrane Library and POPLINE for studies conducted in low- and middle-income countries and published between 1990 and October 2020. We included studies reporting anthropometric assessment of nutritional status in infants <6 m and assessed the association with subsequent morbidity or mortality.
Results: A total of 19 studies were included in the final review, covering 20 countries, predominantly in sub-Saharan Africa. WLZ had poor reliability and poor prognostic ability to identify infants at risk of death. Mid-upper arm circumference (MUAC) and weight-for-age z-score (WAZ) were better at identifying infants at risk of mortality/morbidity. MUAC-for-age z-score did not perform better than using a single MUAC cut-off. Suggested MUAC cut-offs for this age group varied by context, ranging from 10.5 to 11.5 cm. The assessment for reliability showed that length was difficult to measure, making WLZ the least reliable indicator overall.
Conclusion: Evidence from our review suggests that a change in current practice is necessary. To better identify small and nutritionally at-risk infants <6 m WAZ and/or MUAC rather than WLZ should be used. Future research should explore possible benefits for programme coverage, impact and cost-effectiveness. Research should also examine if context-specific MUAC thresholds are needed.
{"title":"Anthropometric Criteria for Identifying Infants Under 6 Months of Age at Risk of Morbidity and Mortality: A Systematic Review.","authors":"Christoph Hoehn, Natasha Lelijveld, Martha Mwangome, James A Berkley, Marie McGrath, Marko Kerac","doi":"10.1177/11795565211049904","DOIUrl":"10.1177/11795565211049904","url":null,"abstract":"<p><strong>Background: </strong>There is increasing global focus on small and nutritionally at-risk infants aged <6 months (<6 m). Current WHO guidelines recommend weight-for-length <i>z</i>-score (WLZ) for enrolment to malnutrition treatment programmes but acknowledge a weak evidence-base. This review aims to inform future guidelines by examining which anthropometric criteria best identify infants <6 m at high risk of mortality/morbidity.</p><p><strong>Methods: </strong>We searched Medline, EMBASE, CINAHL, Global Health, Cochrane Library and POPLINE for studies conducted in low- and middle-income countries and published between 1990 and October 2020. We included studies reporting anthropometric assessment of nutritional status in infants <6 m and assessed the association with subsequent morbidity or mortality.</p><p><strong>Results: </strong>A total of 19 studies were included in the final review, covering 20 countries, predominantly in sub-Saharan Africa. WLZ had poor reliability and poor prognostic ability to identify infants at risk of death. Mid-upper arm circumference (MUAC) and weight-for-age <i>z</i>-score (WAZ) were better at identifying infants at risk of mortality/morbidity. MUAC-for-age <i>z</i>-score did not perform better than using a single MUAC cut-off. Suggested MUAC cut-offs for this age group varied by context, ranging from 10.5 to 11.5 cm. The assessment for reliability showed that length was difficult to measure, making WLZ the least reliable indicator overall.</p><p><strong>Conclusion: </strong>Evidence from our review suggests that a change in current practice is necessary. To better identify small and nutritionally at-risk infants <6 m WAZ and/or MUAC rather than WLZ should be used. Future research should explore possible benefits for programme coverage, impact and cost-effectiveness. Research should also examine if context-specific MUAC thresholds are needed.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2021-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8543668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10664948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-18eCollection Date: 2021-01-01DOI: 10.1177/11795565211041348
Addisu Seneshaw Bezabih, Daniel Eshetu, Nigussie Yohanis, Agete Tadewos Hirigo
Background: Exposure to sunlight is vital for the synthesis of vitamin-D and vitamin D plays an important role in growth and bones strength. Therefore, this study aimed to assess the knowledge and practice of infants exposure to sunlight among lactating women.
Methods: A cross-sectional study was conducted from May 01 to 30, 2019 among 327 infant coupled lactating mothers attended at Yirgalem General Hospital. An interviewer-administered questionnaire was used to collect relevant data through a convenient sampling technique.
Results: A total of 84.7% of respondents exposed infants to sunlight. More than 94% knew the benefit of exposing infants to sunlight. About 20.9%, 25.6%, and 19.9% of mothers exposed infants to sunlight within 15, 16 to 30, and 31 to 45 days of birth, respectively. In addition, 59.9% of respondents exposed infants to sunshine daily and 72.2% exposed without clothing the infants' body. Moreover, 63.5% of mothers have applied lubricants and overall 54.5% of mothers exposed infants to sunlight in good practice. Unemployed women were 4.7 times more likely (aOR; 95%CI: 4.7; 2.0-11.4) to expose infants to sunlight when compared to those employed, while women whose husbands have at least secondary education level were 5.1 times more likely (aOR; 95%CI: 5.1; 1.6-16.1) to expose infants to sunlight when compared to those unable to read and write.
Conclusion: More than 45% and more than one-third of lactating mothers had poor practice and exposed infants to sunlight for inadequate time, respectively. Therefore, the finding indicates a need for awareness creation to increase women's knowledge and practice toward the exposure of infants to sunlight.
{"title":"Knowledge and Practice of Infants Exposure to Sunlight Among Lactating Mothers Attending at Yirgalem Hospital, Sidama Regional State.","authors":"Addisu Seneshaw Bezabih, Daniel Eshetu, Nigussie Yohanis, Agete Tadewos Hirigo","doi":"10.1177/11795565211041348","DOIUrl":"https://doi.org/10.1177/11795565211041348","url":null,"abstract":"<p><strong>Background: </strong>Exposure to sunlight is vital for the synthesis of vitamin-D and vitamin D plays an important role in growth and bones strength. Therefore, this study aimed to assess the knowledge and practice of infants exposure to sunlight among lactating women.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from May 01 to 30, 2019 among 327 infant coupled lactating mothers attended at Yirgalem General Hospital. An interviewer-administered questionnaire was used to collect relevant data through a convenient sampling technique.</p><p><strong>Results: </strong>A total of 84.7% of respondents exposed infants to sunlight. More than 94% knew the benefit of exposing infants to sunlight. About 20.9%, 25.6%, and 19.9% of mothers exposed infants to sunlight within 15, 16 to 30, and 31 to 45 days of birth, respectively. In addition, 59.9% of respondents exposed infants to sunshine daily and 72.2% exposed without clothing the infants' body. Moreover, 63.5% of mothers have applied lubricants and overall 54.5% of mothers exposed infants to sunlight in good practice. Unemployed women were 4.7 times more likely (aOR; 95%CI: 4.7; 2.0-11.4) to expose infants to sunlight when compared to those employed, while women whose husbands have at least secondary education level were 5.1 times more likely (aOR; 95%CI: 5.1; 1.6-16.1) to expose infants to sunlight when compared to those unable to read and write.</p><p><strong>Conclusion: </strong>More than 45% and more than one-third of lactating mothers had poor practice and exposed infants to sunlight for inadequate time, respectively. Therefore, the finding indicates a need for awareness creation to increase women's knowledge and practice toward the exposure of infants to sunlight.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2021-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/81/dc/10.1177_11795565211041348.PMC8450552.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39442594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The aim of the study was to determine and compare the clinical and social characteristics of minors using alcohol and drugs for inebriation, and the same for those using them for suicide.
Methods: This study includes an analysis of case histories of adolescents hospitalized in the Pediatric Intensive Care Unit because of acute alcohol or/and drug intoxication in 2015 to 2017. Two groups (group I: inebriation, and group II: suicide) were compared on age, sex, severity of intoxication, used substances, presence of other self-harm evidence, and social status.
Results: A total of 390 cases were registered: 78.21% in Group I and 21.79% in Group II. The Glasgow-Coma-Scale scores showed that patients from Group I were more severely intoxicated, with an average score of 11.47, whereas patients from Group II averaged 13.45 (P < .001). Self-harm was more prominent among minors from Group II, with an incidence of up to 65.09%. The most common substance used to become inebriated was alcohol (72.79%), and for committing suicide was medication (88.24%). Patients who were living in children's care homes composed 13.33% of all cases included into the study, despite the low frequency of these minors in Lithuania (0.8%).
Conclusions: The substance used for deliberate intoxication was mostly alcohol. Minors experiencing inebriation were hospitalized in worse clinical condition in comparison to those who had attempted suicide. Other signs of self-harm were significantly more common among suicidal minors. Living in children's care homes is a possible risk factor for deliberate intoxication among young people in Lithuania.
{"title":"Clinical and Social Characteristics of Deliberately Intoxicated Minors Treated in Pediatric Intensive Care.","authors":"Kinciniene Odeta, Lesinskaite Auge, Sambaras Rokas, Ramune Vankeviciene, Asta Dervinyte-Bongarzoni, Lesinskiene Sigita","doi":"10.1177/11795565211029258","DOIUrl":"10.1177/11795565211029258","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to determine and compare the clinical and social characteristics of minors using alcohol and drugs for inebriation, and the same for those using them for suicide.</p><p><strong>Methods: </strong>This study includes an analysis of case histories of adolescents hospitalized in the Pediatric Intensive Care Unit because of acute alcohol or/and drug intoxication in 2015 to 2017. Two groups (group I: inebriation, and group II: suicide) were compared on age, sex, severity of intoxication, used substances, presence of other self-harm evidence, and social status.</p><p><strong>Results: </strong>A total of 390 cases were registered: 78.21% in Group I and 21.79% in Group II. The Glasgow-Coma-Scale scores showed that patients from Group I were more severely intoxicated, with an average score of 11.47, whereas patients from Group II averaged 13.45 (<i>P</i> < .001). Self-harm was more prominent among minors from Group II, with an incidence of up to 65.09%. The most common substance used to become inebriated was alcohol (72.79%), and for committing suicide was medication (88.24%). Patients who were living in children's care homes composed 13.33% of all cases included into the study, despite the low frequency of these minors in Lithuania (0.8%).</p><p><strong>Conclusions: </strong>The substance used for deliberate intoxication was mostly alcohol. Minors experiencing inebriation were hospitalized in worse clinical condition in comparison to those who had attempted suicide. Other signs of self-harm were significantly more common among suicidal minors. Living in children's care homes is a possible risk factor for deliberate intoxication among young people in Lithuania.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2021-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/68/10.1177_11795565211029258.PMC8287355.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39276470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-06eCollection Date: 2021-01-01DOI: 10.1177/11795565211029250
Canna Ghia, Gautam Rambhad
Respiratory syncytial virus (RSV) is one of the leading causes of lower respiratory tract infections in young children. Globally, there is huge disease burden, high treatment cost, and health impact beyond acute episodes due to RSV which necessitate development and implementation of preventive strategies for the control of RSV infection. The disease burden due to RSV in pediatric population across India is still not clearly understood so this literature review was therefore conducted to gather data on disease burden due to RSV in Indian pediatric population. Systematic literature search was performed using PubMed and Google search with different medical subject headings from 2007 to 2020. Studies performed in Indian pediatric population were selected for review. Literature review revealed that in India, epidemiology of RSV infection is well documented in young children (0-5 years) as compared to children from other age groups. The rates of RSV detection in various studies conducted in younger children (0-5 years) vary from 2.1% to 62.4% in India which is higher as compared to children from other age groups. In India, RSV mainly peaks around rainy to early winter season, that is, during months of June through October while smaller peak was noted during December, January, and February. In 2020, higher RSV-associated disease burden was reported among children (<5 years) in low-income and lower-middle-income countries. Considering significant disease burden due to RSV in young Indian children, availability of RSV vaccine would be crucial to prevent RSV infections in children and its spread in the community.
{"title":"Disease Burden Due to Respiratory Syncytial Virus in Indian Pediatric Population: A Literature Review.","authors":"Canna Ghia, Gautam Rambhad","doi":"10.1177/11795565211029250","DOIUrl":"https://doi.org/10.1177/11795565211029250","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) is one of the leading causes of lower respiratory tract infections in young children. Globally, there is huge disease burden, high treatment cost, and health impact beyond acute episodes due to RSV which necessitate development and implementation of preventive strategies for the control of RSV infection. The disease burden due to RSV in pediatric population across India is still not clearly understood so this literature review was therefore conducted to gather data on disease burden due to RSV in Indian pediatric population. Systematic literature search was performed using PubMed and Google search with different medical subject headings from 2007 to 2020. Studies performed in Indian pediatric population were selected for review. Literature review revealed that in India, epidemiology of RSV infection is well documented in young children (0-5 years) as compared to children from other age groups. The rates of RSV detection in various studies conducted in younger children (0-5 years) vary from 2.1% to 62.4% in India which is higher as compared to children from other age groups. In India, RSV mainly peaks around rainy to early winter season, that is, during months of June through October while smaller peak was noted during December, January, and February. In 2020, higher RSV-associated disease burden was reported among children (<5 years) in low-income and lower-middle-income countries. Considering significant disease burden due to RSV in young Indian children, availability of RSV vaccine would be crucial to prevent RSV infections in children and its spread in the community.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2021-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/11795565211029250","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39203185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}