Kam Lun Hon, Alexander K C Leung, James W C H Cheng, David C K Luk, Agnes S Y Leung, Mark J A Koh
{"title":"Allergic Contact Dermatitis in Pediatric Practice.","authors":"Kam Lun Hon, Alexander K C Leung, James W C H Cheng, David C K Luk, Agnes S Y Leung, Mark J A Koh","doi":"10.2174/1573396320666230626122135","DOIUrl":"10.2174/1573396320666230626122135","url":null,"abstract":"<p><strong>Background: </strong>Allergic contact dermatitis (ACD) is prevalent among pediatric population, adolescent and young adults. Patients with ACD experience a lot of sociopsychological and qualityof- life (QoL) difficulties. Children and their caregivers alike are vulnerable to the burden of ACD.</p><p><strong>Objectives: </strong>We have, in this paper, provided an overview of ACD and discussed common and unusual causes of ACD.</p><p><strong>Methods: </strong>We performed an up-to-date literature review in the English language on \"allergic contact dermatitis\" <i>via</i> PubMed Clinical Queries, using the keywords \"allergic contact dermatitis\" in August 2022. The search included meta-analyses, randomized controlled trials, clinical trials, casecontrol studies, cohort studies, observational studies, clinical guidelines, case series, case reports, and reviews. The search was restricted to English literature and children.</p><p><strong>Results: </strong>ACD may be acute or chronic and it affects more than 20% of children and adults with significant quality-of-life impairments. ACD is manifested by varying degrees of cutaneous edema, vesiculation, and erythema. The hypersensitivity reaction is one of the most prevalent forms of immunotoxicity in humans. Localized acute ACD lesions can be managed with high-potency topical steroids; if ACD is severe or extensive, systemic corticosteroid therapy is often required to provide relief within 24 hours. In patients with more severe dermatitis, oral prednisone should be tapered over 2-3 weeks. Rapid discontinuation of corticosteroids can result in rebound dermatitis. Patch testing should be performed if treatment fails and the specific allergen or diagnosis remains unknown.</p><p><strong>Conclusion: </strong>ACD is common and can be a physically, psychologically, and economically burdensome disease. Diagnosis of ACD is primarily based on history (exposure to an allergen) and physical examination (morphology and location of the eruption). Skin patch test can help determine the causative allergen. Allergen avoidance is the cornerstone of management. Topical mid- or highpotency corticosteroids are the mainstay of treatment for lesions on less than 20% of the body area. Severe cases of ACD may require treatment with systemic corticosteroids.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"478-488"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9687127","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}
{"title":"The Evaluation of the Impact of Antibiotic De-escalation among Paediatric Patients Admitted to Tertiary Care Hospital in Ajman, UAE: A Cross-sectional Retrospective Observational Study.","authors":"Nour Elshaeir, Syed Wasif Gillani","doi":"10.2174/0115733963283670240401075342","DOIUrl":"10.2174/0115733963283670240401075342","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic de-escalation therapy plays a vital role in reducing the risk of bacterial resistance across the globe. This study elucidates the significance, determinants, and outcomes pertaining to Antibiotic De-escalation (ADE). The ADE is acknowledged as a crucial component within Antimicrobial Stewardship Programs (ASPs). The proliferation of antimicrobial-resistant bacteria arises as an anticipated outcome of the extensive utilization of antibiotics, heightening researchers' apprehensions regarding this global challenge.</p><p><strong>Objective: </strong>The primary objective of the study was to evaluate the usage of antibiotics in terms of clinical outcomes (re-admission within 30 days and therapy outcomes upon discharge), adverse events, duration of de-escalation, and duration of hospitalizations among pediatric patients admitted to a tertiary care hospital due to various infectious diseases.</p><p><strong>Methods: </strong>A retrospective study was conducted during a four-month period, from January 2022 to April 2023, at a tertiary care facility in Ajman, United Arab Emirates. Participants included in this study were based on specific inclusion and exclusion criteria.</p><p><strong>Results: </strong>A total of 200 pediatric records were screened. The majority of participants, accounting for 66.0%, were female, and 54.0% were classified as Arabs in terms of race. The mean age was 7.5 years (± 2.8). The most prevalent symptoms reported were fever (98%), cough (75%), and sore throat (73%). Male participants were more inclined to present with bacterial infections (88.2%) compared to viral infections (3.8%), bacterial and viral co-illnesses (2.5%), or parasitic infections (1.3%) at the time of admission. Regarding clinical outcomes, 27% of patients were readmitted with the same infection type, while 52% did not experience readmission. The analysis also included information on the number of patients within each antibiotic therapy duration category, alongside the mean duration of antibiotic de-escalation in hours with standard deviation (± SD). The statistical significance of these associations was assessed using P-values, revealing a significant relationship (P < 0.0001) between the duration of antibiotic therapy and the time required for antibiotic de-escalation.</p><p><strong>Conclusion: </strong>The study's analysis revealed that individuals readmitted to the hospital, irrespective of whether they presented with the same or a different infection type, exhibited prolonged durations of antibiotic de-escalation. This observation underscores the potential influence of the patient's clinical trajectory and the necessity for adjunctive therapeutic interventions on the duration of antibiotic de-escalation.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"67-74"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792101","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}
{"title":"Premature Thelarche: An Updated Review.","authors":"Alexander K C Leung, Joseph M Lam, Kam L Hon","doi":"10.2174/1573396320666230726110658","DOIUrl":"10.2174/1573396320666230726110658","url":null,"abstract":"<p><strong>Background: </strong>Premature thelarche is the most common pubertal disorder in girls. The condition should be differentiated from central precocious puberty which may result in early epiphyseal fusion and reduced adult height, necessitating treatment.</p><p><strong>Objectives: </strong>The purpose of this article is to familiarize physicians with the clinical manifestations of premature thelarche and laboratory tests that may help distinguish premature thelarche from central precocious puberty.</p><p><strong>Methods: </strong>A search was conducted in September 2022 in PubMed Clinical Queries using the key term \"Premature thelarche\". The search strategy included all clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used to compile the present article.</p><p><strong>Results: </strong>Premature thelarche denotes isolated breast development before the age of 8 years in girls who do not manifest other signs of pubertal development. The condition is especially prevalent during the first two years of life. The majority of cases of premature thelarche are idiopathic. The condition may result from an unsuppressed hypothalamic-pituitary-gonadal axis in the early years of life, an \"overactivation\" of the hypothalamic-pituitary axis in early childhood secondary to altered sensitivity to steroids of the hypothalamic receptors controlling sexual maturation, increased circulating free estradiol, increased sensitivity of breast tissue to estrogens, and exposure to exogenous estrogens. The cardinal feature of premature thelarche is breast development which occurs without additional signs of pubertal development in girls under 8 years of age. The enlargement may involve only one breast, both breasts asymmetrically, or both breasts symmetrically. The breast size may fluctuate cyclically. The enlarged breast tissue may be transiently tender. There should be no significant changes in the nipples or areolae and no pubic or axillary hair. The vulva, labia majora, labia minora, and vagina remain prepubertal. Affected girls have a childlike body habitus and do not have mature contours. They are of average height and weight. Growth and osseous maturation, the onset of puberty and menarche, and the pattern of adolescent sexual development remain normal. Most cases of premature thelarche can be diagnosed on clinical grounds. Laboratory tests are seldom indicated. No single test can reliably differentiate premature thelarche from precocious puberty.</p><p><strong>Conclusion: </strong>Premature thelarche is benign, and no therapy is necessary apart from parental reassurance. As enlargement of breasts may be the first sign of central precocious puberty, a prolonged follow- up period every 3 to 6 months with close monitoring of other pubertal events and linear growth is indicated in all instances.</","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"500-509"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9879244","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}
{"title":"Mask Wearing and Childhood COVID-19: A Local Perspective.","authors":"Kam Lun Hon, Yok Weng Tan, Karen Ka Yan Leung","doi":"10.2174/1573396319666230227124957","DOIUrl":"10.2174/1573396319666230227124957","url":null,"abstract":"","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"283-285"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10780721","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}
{"title":"Pediatric Trauma - A Silent Epidemic.","authors":"Neha Thakur, Narendra Rai, Samir Misra, Maitreyi Misra","doi":"10.2174/1573396320666230407092601","DOIUrl":"10.2174/1573396320666230407092601","url":null,"abstract":"<p><p>Trauma is the leading cause of preventable deaths in children all over the world. In the majority of cases, children are innocent victims of road traffic accidents. They suffer from both short-term and long-term impacts of trauma. Deaths from road traffic accidents can be prevented by adopting simple road safety measures and the use of protective equipment. Worldwide programs have been initiated to curb this ever-rising menace; however, the success of these programs depends on their outreach and acceptance among the population in general. Golden hours in trauma management is the initial hour post-trauma, the success of resuscitation depends on the appropriate management of pediatric trauma victims in hospitals dedicated to the management of pediatric trauma victims. The current review highlights the epidemiology, pattern of injury, road safety measures, and global health initiatives for the prevention of accident-related injury in children. The shortcomings of this review are as follows- Firstly pediatric trauma is an exhaustive topic, it is impossible to cover all aspects of pediatric trauma. Thus, the review might have missed some important aspects of pediatric trauma. Secondly, the concept of a pediatric trauma registry is nonexistent in almost all developing countries; hence a true picture of pediatric trauma epidemiology and injury patterns is missing. Thirdly not much work has been done on pediatric trauma in developing countries leading to insufficient data from these countries.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"472-477"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9257509","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}
Alexander K C Leung, Joseph M Lam, Benjamin Barankin, Kin Fon Leong, Kam Lun Hon
{"title":"Erythema Infectiosum: A Narrative Review.","authors":"Alexander K C Leung, Joseph M Lam, Benjamin Barankin, Kin Fon Leong, Kam Lun Hon","doi":"10.2174/1573396320666230428104619","DOIUrl":"10.2174/1573396320666230428104619","url":null,"abstract":"<p><strong>Background: </strong>Erythema infectiosum occurs worldwide. School-aged children are most often affected. Since the diagnosis is mainly clinical, physicians should be well-versed in the clinical manifestations of erythema infectiosum to avoid misdiagnosis, unnecessary investigations, and mismanagement of the disease.</p><p><strong>Objectives: </strong>The purpose of this article is to familiarize physicians with the wide spectrum of clinical manifestations and complications of erythema infectiosum associated with parvovirus B19 infection.</p><p><strong>Methods: </strong>A search was conducted in July 2022 in PubMed Clinical Queries using the key terms \"Erythema infectiosum\" OR \"Fifth disease\" OR \"Slapped cheek disease\" OR \"Parvovirus B19\". The search strategy included all clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article.</p><p><strong>Results: </strong>Erythema infectiosum is a common exanthematous illness of childhood caused by parvovirus B19. Parvovirus B19 spreads mainly by respiratory tract secretions and, to a lesser extent, the saliva of infected individuals. Children between 4 and 10 years of age are most often affected. The incubation period is usually 4 to 14 days. Prodromal symptoms are usually mild and consist of lowgrade fever, headache, malaise, and myalgia. The rash typically evolves in 3 stages. The initial stage is an erythematous rash on the cheeks, with a characteristic \"slapped cheek\" appearance. In the second stage, the rash spreads concurrently or quickly to the trunk, extremities, and buttocks as diffuse macular erythema. The rash tends to be more intense on extensor surfaces. The palms and soles are typically spared. Central clearing of the rash results in a characteristic lacy or reticulated appearance. The rash usually resolves spontaneously within three weeks without sequelae. The third stage is characterized by evanescence and recrudescence. In adults, the rash is less pronounced than that in children and is often atypical. Only approximately 20% of affected adults have an erythematous rash on the face. In adults, the rash is more frequently found on the legs, followed by the trunk, and arms. A reticulated or lacy erythema is noted in 80% of cases which helps to distinguish erythema infectiosum from other exanthems. Pruritus is noted in approximately 50% of cases. The diagnosis is mainly clinical. The many manifestations of parvovirus B19 infection can pose a diagnostic challenge even to the best diagnostician. Complications include arthritis, arthralgia, and transient aplastic crisis. In most cases, treatment is symptomatic and supportive. When parvovirus B19 infection occurs in pregnant women, hydrops fetalis becomes a real concern.</p><p><strong>Conclusion: </strong>Erythema infectiosum, the mo","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"462-471"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9399473","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}
{"title":"Distinctive Clinico-electrographic and Radiological Profile of Childhood and Adolescent Seizures.","authors":"Rashmie Prabha, Rahul Bhakat, Kriti Mohan, Nikhil Rajvanshi, Swathi Chacham, Latika Mohan","doi":"10.2174/1573396320666230508150342","DOIUrl":"10.2174/1573396320666230508150342","url":null,"abstract":"<p><strong>Aim: </strong>Electroencephalogram (EEG) is specific, but not sensitive, for the diagnosis of epilepsy. This study aimed to correlate the clinico-electrographic and radiological features of seizure disorders in children attending a tertiary care centre in northern India.</p><p><strong>Methods: </strong>Children aged between one to 18 years with seizure episodes were included. Clinical details, including historical as well as physical findings, were evaluated along with EEG and neuroimaging (Magnetic resonance imaging). Details were noted on pre-designed proforma. Variables were analysed by using appropriate statistical methods.</p><p><strong>Results: </strong>A total of 110 children with seizures were enrolled in the study. Male to female ratio was 1.6: 1, and the mean age of the study children was 8 years. The majority of the children were symptomatic for more than one year. The most common seizure type was Generalised Tonic Clonic Seizure (GTCS), and Hypoxic-ischemic Encephalopathy (HIE) sequelae was the most commonly attributed etiology, followed by neurocysticercosis. EEG and neuroimaging findings were found to correlate well with seizure semiology from history. The incidence of febrile seizures was 10% in this study, with nearly three-fourths of them being simple febrile seizures.</p><p><strong>Conclusion: </strong>Microcephaly and developmental delay were the most distinctive clinical correlates in children with seizures. There was a fair agreement between the types of seizures described in history and depicted on EEG with Cohen's kappa of 0.4. Also, there was a significant association between the type of seizures on EEG and the duration of symptoms.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"357-364"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9425129","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}
Tamara Sljivancanin Jakovljevic, Nadja Nikolic, Jelena Martic
{"title":"A Survey of the Course: 'How to Successfully Write a Scientific Article'.","authors":"Tamara Sljivancanin Jakovljevic, Nadja Nikolic, Jelena Martic","doi":"10.2174/0115733963277385230920054052","DOIUrl":"https://doi.org/10.2174/0115733963277385230920054052","url":null,"abstract":"<p><strong>Background: </strong>The aim of the present survey was to analyze the knowledge and skills in medical paper writing of physicians who attended the course \"how to write successfully a scientific paper.\"</p><p><strong>Methods: </strong>A blind survey was used to analyze participants' knowledge on the topic of the course \"how to write successfully a scientific paper.\" Before starting the workshop, participants anonymously filled out the input questionnaire containing 12 preliminary data questions. The three-hour course included a lecture on the steps of creating and writing a scientific article with examples. At the end, all participants anonymously completed the exit questionnaire consisting of 18 questions. Differences and associations between the collected data were analyzed using appropriate statistical tests.</p><p><strong>Results: </strong>The survey included 22 participants, most of whom were women (16, 72.7%). The participants' educational level was proportional to their age. 12 of the participants had an intermediate level, while the others reported higher English proficiency. Half of the participants had never published an article. A significant difference was observed between English level and being the first author of an article published in a scientific journal (p = 0.044). Before class, only 13.6% of participants knew that guidelines are mandatory for making clinical decisions according to evidence- based medicine. There was a significant positive correlation between sex and current affiliation (p = 0.038). A negative correlation was observed between sex and article publication (p = 0.037). A positive correlation was observed between English level and current affiliation (p = 0.020). There was a negative correlation observed between previous sources of learning scientific article writing and having already published an article (p = 0.025). A positive correlation was found between reading an article and publishing it (p = 0.046). Statistical analysis showed a significant difference between reading frequency, number of published articles, being the first author, and knowing the title of a scientific article (p = 0.036, p = 0.027, and p = 0.030, respectively).</p><p><strong>Conclusion: </strong>The results of the questionnaires revealed discrepancies in prior research engagement and understanding of scientific concepts and rules. This survey highlights the importance of the course \"how to successfully write a scientific article\" in improving participants' knowledge of scientific work and the process of creating an article for submission to medical journals.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50157295","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}