Juvenile systemic lupus erythematosus is a multisystem disorder of autoimmune aetiology and is diagnosed on the basis of criteria such as the constitutional symptoms, various symptoms, and signs related to multi-system involvement and supporting laboratory investigations. It is sometimes very challenging when we come across some JSLE cases with an atypical presentation or as a catastrophe. We have discussed a few atypical cases of systemic lupus erythematosus here. Definitive diagnostic tests such as the anti-nuclear antibody with a high negative predictive value and other diagnostic tests would take time and it is worth starting treatment rather than waiting for the investigations in some cases. This case report study is to sensitise the treating paediatrician to use clinical acumen to plan meticulously the management of JSLE cases.
{"title":"Childhood lupus emergency presentation: Is early treatment justified: A case series","authors":"Rajendra Raghunath Khadke, Abhijit Venkatesh Joshi, Ganesh Laxmikantrao Kulkarni, Manish Ganesh Kulkarni","doi":"10.25259/kpj_48_2023","DOIUrl":"https://doi.org/10.25259/kpj_48_2023","url":null,"abstract":"Juvenile systemic lupus erythematosus is a multisystem disorder of autoimmune aetiology and is diagnosed on the basis of criteria such as the constitutional symptoms, various symptoms, and signs related to multi-system involvement and supporting laboratory investigations. It is sometimes very challenging when we come across some JSLE cases with an atypical presentation or as a catastrophe. We have discussed a few atypical cases of systemic lupus erythematosus here. Definitive diagnostic tests such as the anti-nuclear antibody with a high negative predictive value and other diagnostic tests would take time and it is worth starting treatment rather than waiting for the investigations in some cases. This case report study is to sensitise the treating paediatrician to use clinical acumen to plan meticulously the management of JSLE cases.","PeriodicalId":499914,"journal":{"name":"Karnataka paediatric journal","volume":"31 13","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135774652","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}
We report a case of a 7-month-old underweight male infant who developed a unilateral parotid abscess due to Staphylococcus aureus infection and was managed with surgical intervention. An acute parotid abscess is uncommon in paediatric patients but can occur in neonates and premature infants with certain risk factors. Parotitis, the most common inflammatory condition of the parotid gland, usually responds well to medical management but can occasionally progress to a parotid abscess. Conservative management with hydration, oral hygiene, and antibiotics is recommended, but if the disease worsens, suppurative parotitis or parotid abscess can develop. S. aureus and anaerobic bacteria are the most common pathogens, with streptococci and candida also reported. Ductal stones are rare in children and parotid abscesses are usually non-obstructive. Differential diagnosis should consider other conditions such as trauma, lymphadenitis, and neoplasia. Computed tomography scans are preferred for complications or suspected neoplastic lesions. Incision and drainage in paediatric patients can have good outcomes, but there is a risk of facial nerve damage.
{"title":"Parotid gland abscess in an underweight infant: A comprehensive analysis","authors":"M. S. Vishak, Tejaswi Mishra, Kalaiarasi Raja","doi":"10.25259/kpj_50_2023","DOIUrl":"https://doi.org/10.25259/kpj_50_2023","url":null,"abstract":"We report a case of a 7-month-old underweight male infant who developed a unilateral parotid abscess due to Staphylococcus aureus infection and was managed with surgical intervention. An acute parotid abscess is uncommon in paediatric patients but can occur in neonates and premature infants with certain risk factors. Parotitis, the most common inflammatory condition of the parotid gland, usually responds well to medical management but can occasionally progress to a parotid abscess. Conservative management with hydration, oral hygiene, and antibiotics is recommended, but if the disease worsens, suppurative parotitis or parotid abscess can develop. S. aureus and anaerobic bacteria are the most common pathogens, with streptococci and candida also reported. Ductal stones are rare in children and parotid abscesses are usually non-obstructive. Differential diagnosis should consider other conditions such as trauma, lymphadenitis, and neoplasia. Computed tomography scans are preferred for complications or suspected neoplastic lesions. Incision and drainage in paediatric patients can have good outcomes, but there is a risk of facial nerve damage.","PeriodicalId":499914,"journal":{"name":"Karnataka paediatric journal","volume":"31 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135774654","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: Diarrhoea is a significant cause of morbidity and mortality among children under 2 years old in low- and middle-income countries, including Yemen. This study investigated the association between feeding practices, water used and the prevalence of diarrhoea in infants under two in Hodeida City, Yemen. Material and Methods: The study employed a cross-sectional design, gathering data on infant feeding methods and the prevalence of diarrhoea. The sample consisted of 360 mothers or caregivers of children under the age of 2 years. Data were collected from a sex medical centre in rural and urban Hodeida City, Yemen. The data were analysed, and logistic regression was applied to obtain the odds ratio (OR) of association. Results: Results showed significant associations between feeding practices, water type and diarrhoea prevalence. Dropper users had twice the odds of diarrhoea versus spoon/cup users (OR 2.0, 95% confidence interval [CI] 1.2–3.4). Boiled water users had half the odds of diarrhoea compared to tap water users (OR 0.5, 95% CI 0.3–0.8) and purified water users (OR 0.3, 95% CI 0.2–0.6). Infants given bottles later had 1.2 times higher odds of diarrhoea (OR 1.2, 95% CI 1.0–1.5). Conclusion: These findings highlight the importance of appropriate feeding practices and water sources in reducing the risk of diarrhoea in infants under two in Yemen. They may have significant implications for public health policies and infant feeding recommendations in Yemen and other similar settings.
目标:腹泻是包括也门在内的中低收入国家2岁以下儿童发病和死亡的一个重要原因。本研究调查了也门荷台达市两岁以下婴儿喂养方式、用水与腹泻患病率之间的关系。材料和方法:本研究采用横断面设计，收集婴儿喂养方法和腹泻流行率的数据。样本由360名母亲或2岁以下儿童的看护人组成。数据是从也门荷台达市农村和城市的一家性医疗中心收集的。对数据进行分析，并应用逻辑回归获得关联的优势比(OR)。结果:结果显示喂养方式、水类型和腹泻患病率之间存在显著关联。滴管使用者腹泻的几率是勺子/杯子使用者的两倍(OR 2.0, 95%可信区间[CI] 1.2-3.4)。与自来水使用者(OR 0.5, 95% CI 0.3 - 0.8)和纯净水使用者(OR 0.3, 95% CI 0.2-0.6)相比，开水使用者腹泻的几率只有一半。后来给婴儿喂奶的婴儿腹泻的几率高出1.2倍(OR 1.2, 95% CI 1.0-1.5)。结论:这些发现强调了适当的喂养方法和水源对于降低也门两岁以下婴儿腹泻风险的重要性。它们可能对也门和其他类似国家的公共卫生政策和婴儿喂养建议产生重大影响。
{"title":"Prevalence of diarrhoea with different feeding methods and water used among infants under two years: A cross-sectional study in Hodeida city, Yemen, 2021","authors":"Khaled Abdo Alselwi","doi":"10.25259/kpj_52_2023","DOIUrl":"https://doi.org/10.25259/kpj_52_2023","url":null,"abstract":"Objectives: Diarrhoea is a significant cause of morbidity and mortality among children under 2 years old in low- and middle-income countries, including Yemen. This study investigated the association between feeding practices, water used and the prevalence of diarrhoea in infants under two in Hodeida City, Yemen. Material and Methods: The study employed a cross-sectional design, gathering data on infant feeding methods and the prevalence of diarrhoea. The sample consisted of 360 mothers or caregivers of children under the age of 2 years. Data were collected from a sex medical centre in rural and urban Hodeida City, Yemen. The data were analysed, and logistic regression was applied to obtain the odds ratio (OR) of association. Results: Results showed significant associations between feeding practices, water type and diarrhoea prevalence. Dropper users had twice the odds of diarrhoea versus spoon/cup users (OR 2.0, 95% confidence interval [CI] 1.2–3.4). Boiled water users had half the odds of diarrhoea compared to tap water users (OR 0.5, 95% CI 0.3–0.8) and purified water users (OR 0.3, 95% CI 0.2–0.6). Infants given bottles later had 1.2 times higher odds of diarrhoea (OR 1.2, 95% CI 1.0–1.5). Conclusion: These findings highlight the importance of appropriate feeding practices and water sources in reducing the risk of diarrhoea in infants under two in Yemen. They may have significant implications for public health policies and infant feeding recommendations in Yemen and other similar settings.","PeriodicalId":499914,"journal":{"name":"Karnataka paediatric journal","volume":"31 14","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135774651","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}
Alok Kumar, Reginald King, Kim Morris, Kandamaran Krishnamurthy
Numerous studies from around the world have documented disruption as well as a decrease in child health services. In this study, we look at the impact of the pandemic from a different perspective. We compare the spectrum of non-COVID-19 illnesses which necessitated hospitalisation among children during this pandemic and the pre-pandemic times. This is a population-based prospective clinical audit of children (Age <16 years) admitted for COVID-19-unrelated illnesses during the ongoing COVID-19 pandemic. Data on admissions are routinely collected for clinical audits. The study period was extended from April 2020 to March 2022. The primary measured outcome was the primary discharge diagnosis. Other outcome measures were frequency of admissions, frequency of intensive care and number of deaths. The measured outcome during the pandemic was compared with the corresponding period in the pre-pandemic period. There were 1282 non-COVID medical admissions from children (<16 years) during the COVID-19 pandemic compared to the 2168 admissions during the corresponding months in the immediate pre-pandemic period. This corresponds to a decline of 40.7% (95% confidence interval = 8.1%, 42.9%). Mean monthly admissions from acute respiratory illnesses (acute exacerbation of asthma phenotypes and respiratory tract infections) and acute gastroenteritis was 5.4 (±1.8) and 2.6 (±0.7) during the pandemic months compared to 35.1 (±7.2) and 5.3 (±0.8) during the corresponding pre-pandemic months, respectively. Both these differences were statically significant (P < 0.0001). There was a significant decline in the admissions from medical illnesses among children and this was almost entirely due to a sharp and significant decline in admissions form acute respiratory illnesses and acute gastroenteritis.
{"title":"Non-COVID-19 reasons for hospitalisation among children during the COVID-19 pandemic compared with the pre-pandemic period – A prospective population-based study from Barbados","authors":"Alok Kumar, Reginald King, Kim Morris, Kandamaran Krishnamurthy","doi":"10.25259/kpj_24_2023","DOIUrl":"https://doi.org/10.25259/kpj_24_2023","url":null,"abstract":"Numerous studies from around the world have documented disruption as well as a decrease in child health services. In this study, we look at the impact of the pandemic from a different perspective. We compare the spectrum of non-COVID-19 illnesses which necessitated hospitalisation among children during this pandemic and the pre-pandemic times. This is a population-based prospective clinical audit of children (Age <16 years) admitted for COVID-19-unrelated illnesses during the ongoing COVID-19 pandemic. Data on admissions are routinely collected for clinical audits. The study period was extended from April 2020 to March 2022. The primary measured outcome was the primary discharge diagnosis. Other outcome measures were frequency of admissions, frequency of intensive care and number of deaths. The measured outcome during the pandemic was compared with the corresponding period in the pre-pandemic period. There were 1282 non-COVID medical admissions from children (<16 years) during the COVID-19 pandemic compared to the 2168 admissions during the corresponding months in the immediate pre-pandemic period. This corresponds to a decline of 40.7% (95% confidence interval = 8.1%, 42.9%). Mean monthly admissions from acute respiratory illnesses (acute exacerbation of asthma phenotypes and respiratory tract infections) and acute gastroenteritis was 5.4 (±1.8) and 2.6 (±0.7) during the pandemic months compared to 35.1 (±7.2) and 5.3 (±0.8) during the corresponding pre-pandemic months, respectively. Both these differences were statically significant (P < 0.0001). There was a significant decline in the admissions from medical illnesses among children and this was almost entirely due to a sharp and significant decline in admissions form acute respiratory illnesses and acute gastroenteritis.","PeriodicalId":499914,"journal":{"name":"Karnataka paediatric journal","volume":"209 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135484713","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}
Asthma is a chronic airway inflammatory disorder, with variable severity. The mainstay of asthma management is to control symptoms. Sometimes, asthma symptoms will not be controlled in spite of optimal treatment. Many associated conditions such as allergic rhinitis, gastroesophageal reflux disease, obesity, obstructive sleep apnoea, and psychological disturbances are among a few conditions seen concomitantly in patients with asthma, which can directly/indirectly have an impact on the disease process. Influences of comorbid conditions are variable and still uncertain, but many a time alters asthma responses to treatment. Evaluation and appropriate treatment of these comorbidities should be part of asthma management.
{"title":"Allergic rhinitis","authors":"Sowmya A N, N. S. Harsha","doi":"10.25259/kpj_20_2023","DOIUrl":"https://doi.org/10.25259/kpj_20_2023","url":null,"abstract":"Asthma is a chronic airway inflammatory disorder, with variable severity. The mainstay of asthma management is to control symptoms. Sometimes, asthma symptoms will not be controlled in spite of optimal treatment. Many associated conditions such as allergic rhinitis, gastroesophageal reflux disease, obesity, obstructive sleep apnoea, and psychological disturbances are among a few conditions seen concomitantly in patients with asthma, which can directly/indirectly have an impact on the disease process. Influences of comorbid conditions are variable and still uncertain, but many a time alters asthma responses to treatment. Evaluation and appropriate treatment of these comorbidities should be part of asthma management.","PeriodicalId":499914,"journal":{"name":"Karnataka paediatric journal","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135734763","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 COVID-19 pandemic has had a significant impact on routine vaccination rates around the world. According to the WHO and UNICEF, more than 23 million children missed their routine vaccination doses in 2020. This is a major setback for global health, as it puts children at risk of preventable diseases such as diphtheria, pertussis, tetanus, polio and measles.
{"title":"Journal watch","authors":"Vikram Sakleshpur Kumar","doi":"10.25259/kpj_33_2023","DOIUrl":"https://doi.org/10.25259/kpj_33_2023","url":null,"abstract":"The COVID-19 pandemic has had a significant impact on routine vaccination rates around the world. According to the WHO and UNICEF, more than 23 million children missed their routine vaccination doses in 2020. This is a major setback for global health, as it puts children at risk of preventable diseases such as diphtheria, pertussis, tetanus, polio and measles.","PeriodicalId":499914,"journal":{"name":"Karnataka paediatric journal","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135348892","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}
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