Sudanese journal of paediatrics最新文献

Spinal dural arteriovenous fistula (AVF) is an abnormal shunting between the segmental artery and radicular vein adjacent to the dural root sleeve in the spine. This is the most common vascular malformation of the spinal cord and is a rare but treatable cause of para or quadriplegia. It most commonly occurs in elderly men and often affects the thoracolumbar region. These patients clinically present with progressive myelopathies, and other autonomic symptoms (e.g., bladder and bowel dysfunction) subsequently in the later course of the disease. Computed tomography angiography and magnetic resonance imaging remain the modality for initial evaluation. Herein, we present a rare case of spinal dural AVF in a child along with a review of imaging modalities. To the best of our knowledge, there are few case reports of this condition in a paediatric age group.

Orofacial cleft (OC) is a group of heterogeneous congenital abnormalities affecting the orofacial region. All over the world, several studies have been conducted on OC. This study aims to analyze OC research outputs in Nigeria. A SCOPUS-based bibliometric analysis of OC research outputs in Nigeria was done. A total of 130 outputs, of which 90% were articles, published within a 5-2-year (1970-2022) interval were identified. These publications had a total of 1,145 citations with a h-index of 19. There was skewedness in the geopolitical distribution and ownership of Nigerian institutions engaged in OC research; the majority of which were owned by the federal government and situated in the southern parts of Nigeria. The University of Lagos was the Nigerian institution with the highest frequency (n = 52) of outputs on OC research. Adeyemo WL was the Nigerian researcher with the highest: number of publications on OC (n = 46), h-index (n = 11) and citations on OC publications (n = 474). Half of the top ten overseas institutions having researchers collaborating with OC researchers in Nigerian institutions were based in the USA. All the institutions funding OC research in Nigeria were foreign and predominantly in the USA. The majority of the 10 most-cited OC outputs from Nigerian institutions were first authored by foreign researchers. There is a need to locally strengthen OC research capacity in Nigeria, especially in the area of funding, and institutional strengthening.

Alagille syndrome (ALGS) is a multisystem autosomal dominant disorder in which patients may have characteristic facial features and involvement of the liver, heart, vessels, bones, eyes, kidneys and central nervous system. As there is little published data on ALGS in Africa, our aim was to describe the presentation and outcomes of ALGS in South Africa. The study constitutes a retrospective analysis of 25 patient medical records diagnosed as ALGS at Chris Hani Baragwanath Academic Hospital Pediatric Gastroenterology clinic between January 1992 and January 2020. Twenty-five patients met the diagnostic criteria for ALGS over the period investigated. Eighteen (72%) patients were less than 1 year old at first presentation. Seven patients (28%) had all five main clinical manifestations of ALGS, and the rest had an equal proportion of four and three main clinical manifestations. Cholestasis, one of the main clinical manifestations, was present in 72%; 80.0% had the typical Alagille facial features; 64% had cardiovascular disease, 36% had ocular abnormalities and 40% had skeletal abnormalities. Of the 16 patients, (64%) who presented with cardiovascular disease, seven patients presented with more than one cardiac lesion. As of January 2020, 8 (32%) patients are still being followed up at the pediatric GIT clinic, 13 (52%) patients were lost to follow-up and four patients (16%) were demised. Low- to middle-income countries, with no readily available access to genetic testing, need to rely on diagnostic criteria to make a diagnosis of Alagille syndrome in infants who present with cholestasis.

Multisystem inflammatory syndrome of childhood (MIS-C) is a recently described entity in pediatrics post-COVID-19 pandemic. Hemophagocytic lymphohistiocytosis (HLH) is a clinical syndrome caused by an unregulated proliferation of macrophages as well as T lymphocytes. Both entities can be considered overlapping, although distinct criteria for each can be found in the literature. Herein, we report a patient with MIS-C post-COVID-19 infection, complicated with HLH secondary to Plasmodium falciparum malaria from a blood transfusion.

Simulation in medical education improves clinical competence. The Diagnostic Clinical Reasoning Program (DxR), a web-based simulated patient cases software, augments students' clinical skills in a virtual hospital setting. In the Arabian Gulf University, Bahrain, it is used to train medical students before they begin the clinical clerkship. This study aims to assess the impact of using the DxR software during pediatric clerkship on the clinical skills of year-5 medical students. 186 fifth-year medical students attending the pediatric clerkship during the academic year 2018-2019 were enrolled in the study. The students were randomised into two equal groups with similar gender ratios. Both groups attend all the regular educational activities of the pediatric clerkship. The study group used the DxR software to study five simulated patients' scenarios and the control group examined five hospitalised patients and wrote their case write-ups. The scores obtained by the two groups in the written and clinical components of the pediatric end-of-clerkship examination were compared. The students in the study group obtained higher scores than the students in the control group in the objective structured clinical examination and the long case. The difference was statistically significant (p < 0.001). There was no significant difference between the two groups in the scores of the written examination. Training using the DxR software has a positive impact on the clinical skills of medical students in their pediatric clerkship. Using the software as an integral part of clerkship training would be useful.

Menstruation is a normal physiological process in females, and a lack of knowledge and understanding about it can lead to unsafe hygienic practices. This study aimed to assess sociodemographic and menstrual factors that affect the knowledge, attitude and practices of menstrual hygiene among adolescent girls. This cross-sectional study was done among adolescent school girls in Eastern Uttar Pradesh for nine months using an interviewer-administered questionnaire. It consisted of five sections on sociodemographic, menstrual, knowledge, attitude and practice-related questions. Knowledge, attitude and practice-related questions scored one mark for each correct response. Those who scored >50% and ≤50% in each of the sections were categorised into acceptable and unacceptable. Data were analysed using SPSS version 20. The mean age at menarche was 13.11 (1.14) years. Acceptable scores in the knowledge, attitude and practice sections were obtained by 63.1%, 47.7% and 44.1% of girls, respectively. Living with parents and higher education of mothers was associated with acceptable menstrual hygiene knowledge, attitude and practices. Older age of girls and urban residences were associated with acceptable menstrual hygiene knowledge and practices. Girls with acceptable knowledge and those living in nuclear families had acceptable menstrual hygiene practices. Lower age, not living with parents, rural residence and mother's lower education were all significant predictors of poor menstrual hygiene practices. There is a need to develop awareness campaigns and programs for adolescent girls to improve their menstrual hygiene practices.