Sudanese journal of paediatrics最新文献

Children with malignancies can present with varied symptoms mimicking rheumatological or orthopedic conditions. Symptoms such as fever, myalgia, arthralgia, and arthritis usually suggest an underlying musculoskeletal condition. However, malignancies in children can also present with such symptoms. The objective of this study was to analyze the clinical and laboratory features of children with malignancies presenting with arthritic manifestations to the paediatric rheumatology clinic and to raise awareness of these presentations among practising physicians. A retrospective case review was carried out in 53 patients who presented to 2 paediatric rheumatology units in 2 tertiary care hospitals in South India. These children presented with musculoskeletal symptoms and had a final diagnosis of malignancy. The median age was 6.1 years with a range from 1 to 15 years and male:female ratio of 1.12:1. The most common presentation was bone pain (75%), followed by fever (53%), polyarthralgia (51%), refusal to bear weight in lower limbs (40%), night pain (40%), and joint swelling (15%). Anemia with Hb < 8 g/dl was observed in 26% of the patients, white cell count (WCC) < 4000 cells/mm³ in 17%, WCC > 12,000 cells/mm³ in 15%, platelets < 150,000/ml in 43%, and erythrocyte sedimentation rate > 20 mm/hr in 77%.The peripheral smear was positive for malignancy in only 40% of the patients. Before referral to tertiary units, 34% were already treated with steroids with a suspected diagnosis of juvenile idiopathic arthritis. Treatment with steroids could mask the symptoms of malignancy and could lead to a delay in diagnosis and a poor outcome.

Rheumatic heart disease (RHD) is a completely preventable, life-threatening complication of group A streptococcal pharyngitis and the commonest cause of acquired heart disease in children and young adults in low- and middle-income countries. Conventional control measures are faced with many obstacles including the difficulty of early diagnosis of bacterial pharyngitis and acute rheumatic fever (ARF) leading to late presentation with established RHD which is not curable. Recent evidence confirmed the role of echocardiography screening of asymptomatic children in the early detection of 'latent' RHD. Benzathine penicillin prophylaxis was shown to be effective in halting the progression of latent RHD. There is enough evidence to warrant the implementation of control strategies that use lower thresholds for the diagnosis of group A streptococcal infection and ARF and we believe that it is high time to introduce an echocardiography screen-to-treat policy in endemic areas.

Autism spectrum disorder is a collection of developmental abnormalities that can lead to significant social, communicative and behavioural challenges. A nurse is critical in establishing a parent's level of autism awareness and coping skills. Our purpose was to evaluate how a parenting program for mothers influenced their ability to manage with autistic children. Quasi-interventional research, before and after the program was done. A total of 70 mothers of autistic children were enrolled in Khartoum State's five autism centres. The Short Form Parenting Stress Index was used to measure the level of stress and burden experienced by mothers caring for children with autism. The study showed that 31.4% of mothers had a good score in physical care skills before the intervention and 50.0% after the intervention. The mean scores of stresses pre-training 134.48 decreased to 64.1 post training program. In the pre-training program 42.90% of the mothers used problem focus coping strategy and the post-training program represented 92.85%. The educational health and counselling program played an important role in improving mothers' ability to cope with their autistic children.

Rosai-Dorfman disease (RDD) is a rare histiocytic disorder, usually presenting with massive lymphadenopathy. The involvement of extra nodal sites, bone and nodal sites like mediastinum are rare. Clinical data of three cases of extra nodal RDD who were admitted in our paediatric haemato-oncology unit were analysed in the last 5 years. The extra nodal RDD (maxillary sinus, nasal pharyngeal focus, and external auditory meatus) were diagnosed based on histopathology and positron emission tomography scan. They were treated with steroids but were refractory hence requiring salvage chemotherapy. Currently all three of them are in complete remission. Extra nodal RDD is difficult to diagnose, histopathology and radiology play an important role. Here, we present three cases, of which two were steroid-refractory which were treated with salvage chemotherapy and are in complete remission.

Khalawi are one of the most ancient non-governmental educational institutions that are commonly found all over Sudan playing a major role in the Sudanese society. The majority of Khalwa students are children. This study was part of a mixed methods project, conducted by Khartoum Medical Students' Association, aiming to investigate the health status of Khalwa students. It is a cross-sectional study carried out in Mustafa Alfadni Khalwa, Sharg Al-Neel suburb in Khartoum State. The participants were clinically assessed by a doctor and data were collected by using a data entry tool made specially to screen for major infectious diseases among students. The results showed a mean age of 13.7 years. Most of the students (47.7%) were originally from Darfur, and 27.5% of them had only Khalwa education. Respiratory clinic results revealed that 10% were complaining of cough, and 3.4% were diagnosed with pneumonia. Additionally, 44.6% of the students had tinea capitis and 21% had scabies. On examination, 2.3% and 1.1% had mild splenomegaly and hepatomegaly, respectively. Infectious conjunctivitis and trachoma were reported among 11.7% and 10.9%, respectively. Blood films for malaria were positive in 51.3%. Macroscopic and microscopic haematuria was evident among 13.4% and 10.8% of the participants, respectively. Stool examination results showed that 1.4% of the students had worms, 1.5% had ova and 18.8% had red blood cells in stools. Infectious diseases are very common among Khalwa students and their living environment is facilitating the transmission of these diseases. Agent control and sanitation improvement are crucial to decrease such infectious diseases.

Anthropometry is the most common technique used to indicate nutritional status and to assess the presence and degree of protein-energy malnutrition. No doubt providing the human body with the proper dietary substances, especially in early life, has a considerable effect on long-term health and development. This study aimed to provide growth references for height and weight for infants from 6 to 12 months of age in Khartoum State, Sudan. A cross-sectional study was conducted in Khartoum state on 419 infants between 6 and 12 months of age. The height and weight of these infants were measured for each month separately. This method was implemented to develop growth charts of the National Centre for Health Statistics/World Health Organisation. The mean weight and height of males included in this study were more than females. The mean height and weight of male and female infants in this study were below the reference height and weight of the same age group in the Centres for Disease Control and Prevention (CDC). This is a pilot study, which revealed a difference in height and weight of infants from 6 to 12 months of age in Khartoum State compared to a similar age group of those in the CDC. However, further larger-sized studies are needed.

This study aimed to assess parents' perceptions of the quality of life (QoL) of their children with type 1 diabetes (T1D) during Ramadan fasting (RF). In this cross-sectional study, an Arabic-translated version of the standard diabetes-specific QoL questionnaire (PedsQL™ version 3.0) was used to compare perceptions of QoL during Ramadan month (Rm) versus non-Rm (NRm) of parents of children/adolescents with T1D from two tertiary hospitals in Riyadh. We used regression analysis to compare proxies (parents' reports) of their perceptions on their children/adolescents' QoL during Rm compared to NRm. A sample of 61 proxies (parents') of two age groups T1D offspring: 8-12 years (41%) and 13-18 years (59%) who reported their perceptions of their children/adolescents QoL during Rm were matched by children/adolescents' age and gender of 61 proxies in NRm. QoL scores of all domains were significantly lower in Rm compared to NRm; p < 0.0001, however, worries domain showed no statistical differences p = 0.052 in a regression analysis. The total aggregate median (IQR) in Rm was 850 (612-1,062) compared to 1,750 (1,475-2,062) in NRm, p < 0.001. The highest differences in NRm and Rm median scores were observed in communications (OR = 3.64; 95% CI 2.7-5.57) and treatment adherence (OR = 3.09; 95% CI 2.48-3.84) domains especially in the age of 13-18 years. Parents of adolescent boys, who are usually risk-takers and more exposed to outdoor activities, perceived lower QoL for them. Parents of adolescents with T1D perceived a lower QoL for their children during RF, especially in the treatment adherence and communication domains.

Background: Epidemiological data regarding paediatric pyogenic musculoskeletal infections from developing countries of Asia and Africa are sparse and further complicated by the presence of factors like malnutrition, delay in initiating treatment and belief in alternative forms of treatment and under vaccination. The aim of this study is to retrospectively analyse the cases of paediatric pyogenic musculoskeletal infections in a tertiary care centre in India.

Methods: It is a retrospective study including patients below 18 years of age who had been diagnosed with any pyogenic musculoskeletal infection. Demographic, clinical, laboratory, and radiological details were collected.

Results: A total of 216 children, with a mean age of 12.8 ± 4.9 years (10 days-18 years), were included in the study. The causative organism could be isolated in 98 cases (45.3%). Escherichia coli and methicillin-sensitive Staphylococcus aureus were the most common pathogens isolated in infants and children, respectively. Imipenem and linezolid were the commonest sensitive antibiotics for children up to 10 years and above 10 years, respectively. Linezolid was the antibiotic of choice in culture-negative cases. The majority (78.3%, n = 169) of children underwent a surgical procedure during the stay at the hospital. A higher relapse rate (61%) was noted in culture-negative patients.

Conclusion: Improved methods of pathogen detection should be explored to improve the rate of positive cultures. Additional prospective studies with longer patient follow-up and the creation of care protocols are necessary to improve therapeutic decision-making and the prognosis for children with suspected musculoskeletal infection.