Pub Date : 2018-09-11DOI: 10.15406/JPNC.2018.08.00341
Kailas Bh, Arkar
A newborn male baby was referred to our institute on day 2 of life with history of persistent projectile non-bilious vomiting since birth. The baby was full term and was born by normal vaginal delivery. There was no history suggestive of pyloric stenosis in the family. Nor was there any maternal exposure to macrolides or smoking. The possibility of mal rotation was considered. We investigated the neonate with contrast study and ultrasound which were consistent with hypertrophic pyloric stenosis. The muscle thickness was 5mm and the pyloric length was 14mm. Upper gastro-intestinal contrast study demonstrated a dilated stomach with string sign and shouldering of the pyloric muscle. The blood gas showed severe alkalosis. We did not perform gastrin levels. He was operated on day 3 of life after correction of electrolytes and alkalosis. Open Ramstad’s pyloromyotomy was performed. Postoperative recovery was uneventful. Feeds were started after 24 hours and the neonate was
{"title":"Congenital hypertrophic pyloric stenosis-a rare presentation of a common entity","authors":"Kailas Bh, Arkar","doi":"10.15406/JPNC.2018.08.00341","DOIUrl":"https://doi.org/10.15406/JPNC.2018.08.00341","url":null,"abstract":"A newborn male baby was referred to our institute on day 2 of life with history of persistent projectile non-bilious vomiting since birth. The baby was full term and was born by normal vaginal delivery. There was no history suggestive of pyloric stenosis in the family. Nor was there any maternal exposure to macrolides or smoking. The possibility of mal rotation was considered. We investigated the neonate with contrast study and ultrasound which were consistent with hypertrophic pyloric stenosis. The muscle thickness was 5mm and the pyloric length was 14mm. Upper gastro-intestinal contrast study demonstrated a dilated stomach with string sign and shouldering of the pyloric muscle. The blood gas showed severe alkalosis. We did not perform gastrin levels. He was operated on day 3 of life after correction of electrolytes and alkalosis. Open Ramstad’s pyloromyotomy was performed. Postoperative recovery was uneventful. Feeds were started after 24 hours and the neonate was","PeriodicalId":92678,"journal":{"name":"Journal of pediatrics & neonatal care","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67081009","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 : 2018-08-31DOI: 10.15406/JPNC.2018.08.00338
S. Rainey
{"title":"ADHD and sleep history taking at a resident staffed, university affiliated, community health clinic","authors":"S. Rainey","doi":"10.15406/JPNC.2018.08.00338","DOIUrl":"https://doi.org/10.15406/JPNC.2018.08.00338","url":null,"abstract":"","PeriodicalId":92678,"journal":{"name":"Journal of pediatrics & neonatal care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48896755","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 : 2018-08-31DOI: 10.15406/jpnc.2018.8.00338
Shane C Rainey Do, Natasha BraunBS, Mohannad Mannaa
Attention deficit hyperactivity disorder (ADHD) is a disorder manifesting predominantly in childhood with symptoms of hyperactivity, inattention, and impulsivity which can have a dramatic effect on the child’s behavioral, social, and emotional functionality.1 As many as 8 to 11% of school aged children are diagnosed with ADHD, and billions of dollars have been dedicated to their care, both pharmacologic and psychological.2 The pathogenesis of ADHD is incompletely understood. A genetically inherited imbalance in catecholamine metabolism is the most commonly accepted hypothesis given the available animal studies, functional brain imaging, and patients’ efficacious response to stimulant medications.3 However, in recent years, a number of researchers have proposed a link between ADHD symptoms and sleep disorders.4–8 In a recent review in Pediatrics, Bonuck et al.,6 found that those with sleep disordered breathing were significantly more likely to have behaviors resembling ADHD than those without sleep disordered breathing.6 Obstructive sleep apnea (OSA) is a sleep disorder commonly affecting children and can have significant neuro developmental implications on the child’s health.7,8 American Academy of Pediatrics clinical practice guidelines recommend that patients or their caregivers be screened for snoring (as well as a focused evaluation for other symptoms if noted to have habitual snoring) at each routine health examination, and if positive, be referred to a sleep specialist.9 Despite these recommendations, screening for snoring is widely variable and many children at risk for OSA are not being screened according to the guidelines.10 Previous studies have reported screening proportions ranging from 8% to 24%; however, few studies have examined practitioners’ screening patterns for OSA when considering the diagnosis of ADHD.11,12 The aims of this study were to describe the snoring screening practices of various clinicians when considering the diagnosis of ADHD and to analyze various patient and provider characteristics to determine their predictiveness for screening about snoring. We hypothesized that patients were not being routinely screened for OSA risk factors prior to being diagnosed with ADHD.
{"title":"ADHD and sleep history taking at a resident staffed, university affiliated, community health clinic","authors":"Shane C Rainey Do, Natasha BraunBS, Mohannad Mannaa","doi":"10.15406/jpnc.2018.8.00338","DOIUrl":"https://doi.org/10.15406/jpnc.2018.8.00338","url":null,"abstract":"Attention deficit hyperactivity disorder (ADHD) is a disorder manifesting predominantly in childhood with symptoms of hyperactivity, inattention, and impulsivity which can have a dramatic effect on the child’s behavioral, social, and emotional functionality.1 As many as 8 to 11% of school aged children are diagnosed with ADHD, and billions of dollars have been dedicated to their care, both pharmacologic and psychological.2 The pathogenesis of ADHD is incompletely understood. A genetically inherited imbalance in catecholamine metabolism is the most commonly accepted hypothesis given the available animal studies, functional brain imaging, and patients’ efficacious response to stimulant medications.3 However, in recent years, a number of researchers have proposed a link between ADHD symptoms and sleep disorders.4–8 In a recent review in Pediatrics, Bonuck et al.,6 found that those with sleep disordered breathing were significantly more likely to have behaviors resembling ADHD than those without sleep disordered breathing.6 Obstructive sleep apnea (OSA) is a sleep disorder commonly affecting children and can have significant neuro developmental implications on the child’s health.7,8 American Academy of Pediatrics clinical practice guidelines recommend that patients or their caregivers be screened for snoring (as well as a focused evaluation for other symptoms if noted to have habitual snoring) at each routine health examination, and if positive, be referred to a sleep specialist.9 Despite these recommendations, screening for snoring is widely variable and many children at risk for OSA are not being screened according to the guidelines.10 Previous studies have reported screening proportions ranging from 8% to 24%; however, few studies have examined practitioners’ screening patterns for OSA when considering the diagnosis of ADHD.11,12 The aims of this study were to describe the snoring screening practices of various clinicians when considering the diagnosis of ADHD and to analyze various patient and provider characteristics to determine their predictiveness for screening about snoring. We hypothesized that patients were not being routinely screened for OSA risk factors prior to being diagnosed with ADHD.","PeriodicalId":92678,"journal":{"name":"Journal of pediatrics & neonatal care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47475292","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 : 2018-08-31DOI: 10.15406/jpnc.2018.08.00339
F. Ahammad, T. Begum, JesminAkter, Evana Nasrin
Neonatal death is high in our country and it comprises 60% of total Under-5 mortality.1 So to achieve MDG-4 we have to reduce neonatal death. The Lancet series on neonatal health reported that preterm birth directly causes 28% of neonatal deaths.2 Prematurity and its complication is the major cause of neonatal death in our country and shares around 45% of neonatal death. Premature babies are prone to develop many complications. One of the common complications is Feeding Intolerance (FI). Feeding intolerance can be attributed to the immaturity of gastrointestinal motility,3, 4 as small intestinal motility and phase-3 activity of the migrating motor complex (MMC) are more immature in preterm infants, especially those with a gestational age of less than 32 weeks.3,5 Gastrointestinal motility is influenced by motilin, a 22 amino-acid peptide produced by the enterochromaffin cells of the duodenal and jejunal mucosa.6 Gastric emptying, in particular, is dependent on co-ordination between the motor activities of the gastric antrum and duodenum. Preterm infants often have difficulty in tolerating oral feeds due to immaturity of mechanical and hormonal control of their gastrointestinal system.3 Feed tolerance requires co-ordinated caudal intestinal transit of food. The clusters of phase 3 migrating motor complexes (MMC) that propagate food are associated with a twoto fourfold increase in plasma motilin levels.7 But the association between motilin, MMCs and feed tolerance, however, is unclear in preterm infants. Even though the numbers of MMCs are reduced in preterm infants of less than 32 wk gestation8 fetuses by week 20 of gestation, demonstrate intestinal distribution of motilin similar to that in adults. Motilin levels of fasting preterm infants are also similar to those of term infants, who rarely exhibit the degrees of feeding intolerance characteristic of premature infants.5 It is also noted that fetal intestine is structurally mature by 25 weeks of gestation and capable of digesting and absorbing milk feeds, motor activity develops more slowly and may limit the tolerance to enteral feeds.9 FI often needs prolong parenteral nutrition which predisposes nosocomial infections, hepatic dysfunction and prolong hospitalization.10,11 Though FI is a common problem, literature contain little information about the influence of prematurity on feeding intolerance. There is also scarcity of information regarding the prevalence of feeding intolerance among preterm babiesand whereas the more preterm babies develop more frequent feeding intolerance yet to be determined.
{"title":"Comparison of feeding intolerance between very preterm and moderate preterm neonates – a prospective cohort study","authors":"F. Ahammad, T. Begum, JesminAkter, Evana Nasrin","doi":"10.15406/jpnc.2018.08.00339","DOIUrl":"https://doi.org/10.15406/jpnc.2018.08.00339","url":null,"abstract":"Neonatal death is high in our country and it comprises 60% of total Under-5 mortality.1 So to achieve MDG-4 we have to reduce neonatal death. The Lancet series on neonatal health reported that preterm birth directly causes 28% of neonatal deaths.2 Prematurity and its complication is the major cause of neonatal death in our country and shares around 45% of neonatal death. Premature babies are prone to develop many complications. One of the common complications is Feeding Intolerance (FI). Feeding intolerance can be attributed to the immaturity of gastrointestinal motility,3, 4 as small intestinal motility and phase-3 activity of the migrating motor complex (MMC) are more immature in preterm infants, especially those with a gestational age of less than 32 weeks.3,5 Gastrointestinal motility is influenced by motilin, a 22 amino-acid peptide produced by the enterochromaffin cells of the duodenal and jejunal mucosa.6 Gastric emptying, in particular, is dependent on co-ordination between the motor activities of the gastric antrum and duodenum. Preterm infants often have difficulty in tolerating oral feeds due to immaturity of mechanical and hormonal control of their gastrointestinal system.3 Feed tolerance requires co-ordinated caudal intestinal transit of food. The clusters of phase 3 migrating motor complexes (MMC) that propagate food are associated with a twoto fourfold increase in plasma motilin levels.7 But the association between motilin, MMCs and feed tolerance, however, is unclear in preterm infants. Even though the numbers of MMCs are reduced in preterm infants of less than 32 wk gestation8 fetuses by week 20 of gestation, demonstrate intestinal distribution of motilin similar to that in adults. Motilin levels of fasting preterm infants are also similar to those of term infants, who rarely exhibit the degrees of feeding intolerance characteristic of premature infants.5 It is also noted that fetal intestine is structurally mature by 25 weeks of gestation and capable of digesting and absorbing milk feeds, motor activity develops more slowly and may limit the tolerance to enteral feeds.9 FI often needs prolong parenteral nutrition which predisposes nosocomial infections, hepatic dysfunction and prolong hospitalization.10,11 Though FI is a common problem, literature contain little information about the influence of prematurity on feeding intolerance. There is also scarcity of information regarding the prevalence of feeding intolerance among preterm babiesand whereas the more preterm babies develop more frequent feeding intolerance yet to be determined.","PeriodicalId":92678,"journal":{"name":"Journal of pediatrics & neonatal care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47892364","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 : 2018-08-22DOI: 10.21767/2471-805x-c3-010
D. Ireland
{"title":"Parent opinion in medical care for congenital diaphragmatic hernia","authors":"D. Ireland","doi":"10.21767/2471-805x-c3-010","DOIUrl":"https://doi.org/10.21767/2471-805x-c3-010","url":null,"abstract":"","PeriodicalId":92678,"journal":{"name":"Journal of pediatrics & neonatal care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46994424","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 : 2018-08-20DOI: 10.15406/JPNC.2018.08.00337
S. Villar, F. T. Piedra, Robert Cilveti Portillo, J. Coromina, R. G. Puig
Despite advances in diagnostic approach, antibiotic therapy and intensive care, bacterial meningitis is still associated with a significant mortality and a high number of complications and neurological sequelae. Although the vast majority are single episodes, approximately 1-4.8% of all cases of acute bacterial meningitis are recurrent, which is defined as the reappearance of signs and symptoms of meningitis by the same microorganism or a new episode by a different microorganism that occurs at least 3 weeks after the sterilization of the cerebrospinal fluid (CSF). Different factors predisposing to recurrent meningitis have been identified, such as deficits in humoral and cellular immunity and congenital or acquired structural defects that establish an anatomical communication between the subarachnoid space and the skin or the middle ear and the paranasal cavities. The clinical history and the findings of the physical examination and the microbiological data can help guide the origin of meningitis. A prompt identification of immunological deficiencies or anatomical defects is important in preventing new episodes and potential sequelae.
{"title":"Recurring E. coli meningitis in an infant","authors":"S. Villar, F. T. Piedra, Robert Cilveti Portillo, J. Coromina, R. G. Puig","doi":"10.15406/JPNC.2018.08.00337","DOIUrl":"https://doi.org/10.15406/JPNC.2018.08.00337","url":null,"abstract":"Despite advances in diagnostic approach, antibiotic therapy and intensive care, bacterial meningitis is still associated with a significant mortality and a high number of complications and neurological sequelae. Although the vast majority are single episodes, approximately 1-4.8% of all cases of acute bacterial meningitis are recurrent, which is defined as the reappearance of signs and symptoms of meningitis by the same microorganism or a new episode by a different microorganism that occurs at least 3 weeks after the sterilization of the cerebrospinal fluid (CSF). Different factors predisposing to recurrent meningitis have been identified, such as deficits in humoral and cellular immunity and congenital or acquired structural defects that establish an anatomical communication between the subarachnoid space and the skin or the middle ear and the paranasal cavities. The clinical history and the findings of the physical examination and the microbiological data can help guide the origin of meningitis. A prompt identification of immunological deficiencies or anatomical defects is important in preventing new episodes and potential sequelae.","PeriodicalId":92678,"journal":{"name":"Journal of pediatrics & neonatal care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43960634","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 : 2018-08-16DOI: 10.15406/JPNC.2018.08.00336
M. Ramzan, Mohammed Lukman, S. Sharma, S. Katewa
Cystic fibrosis (CF) is an autosomal recessive multisystem disorder characterized by the formation of thick, sticky mucus that can hamper our various organs.1 CF is caused by the alteration of a gene located on the long arm of chromosome7 that encodes a protein, the cystic fibrosis trans membrane conductance regulator (CFTR), which functions as a chloride channel on the apical membrane of epithelial cells.2 The disorder’s common symptomatology is due to progressive damage to the respiratory system, digestive system, exocrine pancreatic insufficiency (diarrhea and failure to thrive), though their severity varies among affected individual.3 Those infant who are not having classical clinical manifestations suggestive of CF or uncommon presentation, neonatal screening or early suspicion is helpful in detection of disease which allows prompt treatment of CF related complications, improving survival and conceptualizing the treatment strategies.4 Meconium ileus may be the first manifestation of CF in the neonatal period, occurring in approximately 20% of patients with pancreatic insufficiency.5 Though iron deficiency anemia may be present due to malabsorption in children,6 transfusion dependent severe anemia in early infancy associated with CF is not mentioned in literature. Our objective of the present publication is to report the case of an infant who had uncommon presentation of CF with recurrent anemia and pneumonia without full blown evolution of the disease despite the clinical suspicion of CF.
{"title":"Recurrent anemia in an infant with pneumonia: be vigilant for uncommon presentation of cystic fibrosis","authors":"M. Ramzan, Mohammed Lukman, S. Sharma, S. Katewa","doi":"10.15406/JPNC.2018.08.00336","DOIUrl":"https://doi.org/10.15406/JPNC.2018.08.00336","url":null,"abstract":"Cystic fibrosis (CF) is an autosomal recessive multisystem disorder characterized by the formation of thick, sticky mucus that can hamper our various organs.1 CF is caused by the alteration of a gene located on the long arm of chromosome7 that encodes a protein, the cystic fibrosis trans membrane conductance regulator (CFTR), which functions as a chloride channel on the apical membrane of epithelial cells.2 The disorder’s common symptomatology is due to progressive damage to the respiratory system, digestive system, exocrine pancreatic insufficiency (diarrhea and failure to thrive), though their severity varies among affected individual.3 Those infant who are not having classical clinical manifestations suggestive of CF or uncommon presentation, neonatal screening or early suspicion is helpful in detection of disease which allows prompt treatment of CF related complications, improving survival and conceptualizing the treatment strategies.4 Meconium ileus may be the first manifestation of CF in the neonatal period, occurring in approximately 20% of patients with pancreatic insufficiency.5 Though iron deficiency anemia may be present due to malabsorption in children,6 transfusion dependent severe anemia in early infancy associated with CF is not mentioned in literature. Our objective of the present publication is to report the case of an infant who had uncommon presentation of CF with recurrent anemia and pneumonia without full blown evolution of the disease despite the clinical suspicion of CF.","PeriodicalId":92678,"journal":{"name":"Journal of pediatrics & neonatal care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47428051","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 : 2018-08-13DOI: 10.15406/JPNC.2018.08.00335
Kashish Khanna, Shilpa Sharma, D. Gupta
required ventilator support. A paediatric surgery referral was sent in view of history of repeated admissions for severe recurrent RTI every 3-4 weeks since birth. A flexible endoscopic examination revealed a fistulous opening in the posterior wall of the trachea raising the suspicion of an H type trachea-oesophageal (TEF) fistula. On deeper probing, the mother gave a history of choking during feeds. After proper stabilization rigid bronchoscope under general anaesthesia revealed a fistula in the posterior wall of trachea which was first cannulated, and then ligated and repaired from the right cervical route (Figure 1). The child was discharged after 10 days and was followedup for the next 10 months. He had no other episode of RTI which required admission.
{"title":"Recurrent respiratory tract infections in children; beyond medical causes!","authors":"Kashish Khanna, Shilpa Sharma, D. Gupta","doi":"10.15406/JPNC.2018.08.00335","DOIUrl":"https://doi.org/10.15406/JPNC.2018.08.00335","url":null,"abstract":"required ventilator support. A paediatric surgery referral was sent in view of history of repeated admissions for severe recurrent RTI every 3-4 weeks since birth. A flexible endoscopic examination revealed a fistulous opening in the posterior wall of the trachea raising the suspicion of an H type trachea-oesophageal (TEF) fistula. On deeper probing, the mother gave a history of choking during feeds. After proper stabilization rigid bronchoscope under general anaesthesia revealed a fistula in the posterior wall of trachea which was first cannulated, and then ligated and repaired from the right cervical route (Figure 1). The child was discharged after 10 days and was followedup for the next 10 months. He had no other episode of RTI which required admission.","PeriodicalId":92678,"journal":{"name":"Journal of pediatrics & neonatal care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44657581","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 : 2018-07-25DOI: 10.15406/jpnc.2018.08.00334
F. Cavagnaro, M. J. Yubero, I. Fuentes, F. Palisson
specifically looking at renal dysfunction (urinary nitrogen/plasmatic creatinine, serum amyloid A and electrolytes in plasma), hematuria (urinalysis) and proteinuria (micro albuminuria). When a urological cause is discarded, a renal biopsy is highly advice to obtain a specific diagnosis, and eventually its, treatment and prognosis. The biopsy is afterwards sent for histopathology analysis, which includes light microscopy, immune fluorescence and electron microscopy.
{"title":"Renal involvement in epidermolysis bullosa patients: a case series study","authors":"F. Cavagnaro, M. J. Yubero, I. Fuentes, F. Palisson","doi":"10.15406/jpnc.2018.08.00334","DOIUrl":"https://doi.org/10.15406/jpnc.2018.08.00334","url":null,"abstract":"specifically looking at renal dysfunction (urinary nitrogen/plasmatic creatinine, serum amyloid A and electrolytes in plasma), hematuria (urinalysis) and proteinuria (micro albuminuria). When a urological cause is discarded, a renal biopsy is highly advice to obtain a specific diagnosis, and eventually its, treatment and prognosis. The biopsy is afterwards sent for histopathology analysis, which includes light microscopy, immune fluorescence and electron microscopy.","PeriodicalId":92678,"journal":{"name":"Journal of pediatrics & neonatal care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45276018","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 : 2018-07-19DOI: 10.15406/JPNC.2018.08.00333
S. Nirmala, Degala Saikrishna
These are the most severe of congenital anomalies which affect the mouth and related structures. There are one of the most common congenital defects and occur about once in 1000 births. 1 There is a family history in only about one third of cases. Clefts of the palate only are more common in girls while clefts of the lip, with or without palatal involvement, are more common in boys. It is interesting to know that the left side is more often than the right.2 The exact cause of clefting is unknown in most cases. For most cleft conditions, no single factor can be identified as the cause. However, it is important to distinguish between isolated clefts (in which the patient has no other related health problems) and clefts associated with other birth disorders or syndromes.3,4 In the absence of the family history the occurrence of a congenital abnormality may be due to the action of mutation or some chance occurrence during the pregnancy. The lips and palate develop during the 5 -8 weeks of intrauterine life and any factor disrupting the heir formation must exert its influence during this relatively short period. In this respect it is difficult to offer positive views on factors related to maternal health during the pregnancy. it is accepted that German measles and x-ray examination during early pregnancy may produce congenital abnormalities and are to be avoided. The teratogenic action of certain drugs, particularly thalidomide is well known. Infarct the expectant mother is well advised to avoid all necessary drugs taking during the early stages of pregnancy.5-7 (Table 1-3) A useful classification of clefts is that of Kernahan and stark which is bases on an embryological considerations of the tissues involved there are essentially three main groups.7,8
{"title":"Dental concerns of children with lip cleft and palate - a review","authors":"S. Nirmala, Degala Saikrishna","doi":"10.15406/JPNC.2018.08.00333","DOIUrl":"https://doi.org/10.15406/JPNC.2018.08.00333","url":null,"abstract":"These are the most severe of congenital anomalies which affect the mouth and related structures. There are one of the most common congenital defects and occur about once in 1000 births. 1 There is a family history in only about one third of cases. Clefts of the palate only are more common in girls while clefts of the lip, with or without palatal involvement, are more common in boys. It is interesting to know that the left side is more often than the right.2 The exact cause of clefting is unknown in most cases. For most cleft conditions, no single factor can be identified as the cause. However, it is important to distinguish between isolated clefts (in which the patient has no other related health problems) and clefts associated with other birth disorders or syndromes.3,4 In the absence of the family history the occurrence of a congenital abnormality may be due to the action of mutation or some chance occurrence during the pregnancy. The lips and palate develop during the 5 -8 weeks of intrauterine life and any factor disrupting the heir formation must exert its influence during this relatively short period. In this respect it is difficult to offer positive views on factors related to maternal health during the pregnancy. it is accepted that German measles and x-ray examination during early pregnancy may produce congenital abnormalities and are to be avoided. The teratogenic action of certain drugs, particularly thalidomide is well known. Infarct the expectant mother is well advised to avoid all necessary drugs taking during the early stages of pregnancy.5-7 (Table 1-3) A useful classification of clefts is that of Kernahan and stark which is bases on an embryological considerations of the tissues involved there are essentially three main groups.7,8","PeriodicalId":92678,"journal":{"name":"Journal of pediatrics & neonatal care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43624478","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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