Sudanese journal of paediatrics最新文献

A descriptive cross-sectional hospital-based study was conducted with the objectives to study clinical presentations, complications and outcomes of breastfeeding-associated hypernatraemia (BFAHN) in full-term neonates admitted to Ibrahim Malik Teaching Hospital, Khartoum, Sudan, during the period September 2017-2019. Eighty-four neonates with BFAHN were enrolled in the study. Collected demographic data of the neonates and their mothers included age at presentation, gender, birth weight, current weight, mode and place of delivery, maternal age, parity, education level, time of starting breastfeeding, presenting symptoms and signs, complications and outcome. The prevalence of the BFAHN was 15.5%. The mean age at presentation was 9.38 ± 5.95 days, range of 2-27 days and 59.5% were males. Most of them delivered vaginally (85.7%) and in hospital (63.1%). The mothers were multigravida in 58% and with a mean age of 28.14 ± 6.68 years and 3/4th of them started breastfeeding within the first hour. The most common symptoms and signs were fever, poor feeding, decreased urine output, jaundice, dehydration and loss of weight more than 10% of birth weight. The mortality rate was 21.4%. Complications included acute kidney injury in 82.1%, two patients needed peritoneal dialysis, one-third developed convulsions and two patients had intracranial bleeding. Factors associated with the development of the BFAHN were excessive loss of weight, multigravida, low maternal education level and vaginal delivery. Associated factors for death included thrombocytopenia, convulsions and severe hypernatraemia. Breast-milk sodium levels in mothers of 10 of the patients were high compared to 10 controls.

Haemoglobin A1c (HbA1c), glycosylated haemoglobin, is a crucial tool in monitoring long-term glycaemic control in diabetic patients. Studies have also demonstrated that it has a role in the prognostication of diabetic microvascular complications. However, certain conditions can interfere with HbA1c interpretation. Haemoglobin variants and disorders are important conditions that can lead to HbA1c misinterpretation. In this report, we describe an uncontrolled diabetic child who was found to have a low value of HbA1c and how this affected the clinical decisions regarding his management.

The objective of this study was to review the outcome of patients who underwent transcatheter closure of ventricular septal defect (VSD) using Nit-Occlud^® Leˆ VSD-Coil.A retrospective study was carried out at King Abdulaziz Cardiac Center on all paediatric patients who underwent interventional VSD closure, during the period from 2011 and 2016. Data were collected, including demographic information, cardiac diagnosis, pre-operative diagnosis, intra-operative findings and postoperative events. Out of 46 patients, who were evaluated for VSD device closure, 17 of them were excluded; 24 patients out of 29 had successful closure of VSD using Nit-Occlud Leˆ VSD-Coil (success rate of 83%), and five cases were referred to surgery. The age group was from 2 years up to 18 years. Almost 90% of VSD was the perimembranous (PM) type (26 patients) and 3 patients (10%) with muscular VSD. Ten of the 26 PM VSDs had TV accessory tissue partially covering the VSD defects. The hemodynamic assessment showed pulmonary blood flow to systemic blood flow ratio (Qp:Qs) > 1.5 in almost all the patients who underwent defect closure. Immediate closure of the defect was achieved in 11/24 patients (45%). In five additional patients, there was a tiny residual and eight with a small residual. With 6 months of follow-up, only six patients remained with tiny residual VSD defects.The Nit-Occlud^® Leˆ VSD-Coil device has minimal effects on the aortic and tricuspid valves, and there was no permanent atrioventricular block, especially in patients with PM VSDs. Patients with a residual shunt should be followed, especially for haemolysis.

Exploring the determinants of timely initiation of breastfeeding is necessary for planning efficient breastfeeding promotion programmes. The present study aimed to investigate the frequency and related factors of timely initiation of breastfeeding among Turkish mothers. This study was a cross-sectional, descriptive, mixed model study, which was carried out on mothers with healthy children up to 3 years old who presented to the paediatric clinic between 01 November 2019 and 30 December 2019 in a university hospital. Of the 307 participant mothers, the mean age was 28.3 ± 3.9 years. The frequency of timely initiation of breastfeeding was 70.7%. Significant associations were found between timely initiation of breastfeeding status and residence, type of delivery, type of anaesthesia, birth weight of babies, counselling on timely initiation of breastfeeding during antenatal care and consultant medical staff. In order to increase the breastfeeding rate in the first hour, spontaneous vaginal delivery should be supported and spinal/epidural anaesthesia method should be preferred in cases where caesarean delivery is indicated. Other important steps to increase the ratio of timely initiation of breastfeeding are strengthening breastfeeding counselling services and the midwifery system.

Heterologous immunity is a well-known concept in immunology wherein prior exposure to an antigen confers cross-protection against an unrelated antigen. With the surge in global COVID-19 cases, there has been significant research into the application of vaccine-induced heterologous immunity associated with measles, mumps and rubella (MMR) vaccine, Bacillus Calmette-Guérin vaccine, oral polio vaccine, and hepatitis A vaccine in curbing the worst outcomes of COVID-19 infection. Despite having specific vaccines against COVID-19, it is worthwhile exploring the application of available vaccines in the prevention of severe disease until the vaccines reach all sections of the population across the globe. In this article, we aim to outline the concept of heterologous immunity and its relevance in context to MMR vaccine and COVID-19.

Extravasation injury is tissue infiltration and injury related to drugs or infusates. Preterm infants are most susceptible due to many factors related to their prematurity. Our aim was to report on the prevalence of extravasation injury in our neonatal unit to attract attention to the existence of this problem in the neonatal units. This is an observational, longitudinal, hospital-based study, conducted in the period from February 2012 to February 2019. All preterm infants admitted to Sea Port Hospital Neonatal Unit, Port Sudan City, Sudan, were included. Infants with any other congenital or transient skin diseases were ruled out. From 434 preterm infants admitted, 249 (57.4%) infants were affected and 28 (11.2%) of them were injured significantly. We concluded that neonatal extravasation injuries (including severe forms) are significantly observed in our neonatal unit, and measures to screen for, avoid, and treat this morbidity, should be implemented.