{"title":"Study on Inborn and Outborn Neonatal Admissions in Relation to Gestational Maturity in Neonatal Intensive Care Unit at a Tertiary Care University Hospital in Upper Egypt","authors":"Safwat M. Abdel-Aziz, Enas A. Hamed, A. Shalaby","doi":"10.1055/s-0041-1736478","DOIUrl":"https://doi.org/10.1055/s-0041-1736478","url":null,"abstract":"Neonatal morbidity and mortality rates indicate a country's socioeconomic status and the quality, and effectiveness of its health care system. This research aimed to identify the clinical pattern and causes of neonatal admission for inborn and outborn babies in a tertiary care university hospital and their outcomes. Over a year, this prospective hospital-based research was conducted in the neonatal intensive care unit (NICU) of Assiut Children's Hospital in Upper Egypt (January 1st to December 31st, 2020). Gender, birth weight, gestational age, postnatal age, delivery mode, delivery place, admission cause, hospital stay period, and neonatal outcomes were collected. A total of 1,638 newborns were admitted; 930 (56.8%) were preterm and 708 (43.2%) full-term. Inborn admissions were 1,056 (64.5%) and outborn 582 (35.5%). The majority of inborn admissions were preterm 726 (68.8%), and outborn were full-term 378 (64.9%). The commonest admission causes among inborn and outborn preterm infants were respiratory distress syndrome (84.3%) and congenital intestinal obstruction (22.5%), respectively, while multiple congenital anomalies were the commonest cause for admission among both inborn and outborn full-term babies. The mortality rate was 708 (43.2%), higher among inborn (50%) versus outborn (30.9%). The leading cause of death was respiratory distress syndrome among premature inborn with case fatality rate of (56.9%) and multiple congenital anomalies among premature outborn (60%), as well as inborn (67.4%), and outborn (42.6%) full-term neonates. In conclusion, the neonatal mortality rate was high among studied cases. Morbidity and mortality of respiratory distress syndrome and congenital anomalies were alarmingly high. Therefore, all health care providers must devote a considerable effort to improve health care delivered to these neonates.","PeriodicalId":41283,"journal":{"name":"Journal of Child Science","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42370843","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":"Homozygous Missense Mutation on Exon 22 of PKHD1 Gene Causing Fatal Autosomal Recessive Polycystic Kidney Disease","authors":"Sajina Sathyan, Femitha Pournami, G. Madhavilatha, Amrita Tuteja, Anand Nandakumar, Jyothi Prabhakar, Naveen Jain","doi":"10.1055/s-0041-1725175","DOIUrl":"https://doi.org/10.1055/s-0041-1725175","url":null,"abstract":"Abstract Autosomal recessive polycystic kidney disease, described as a congenital hepatorenal fibrocystic syndrome, is a significant inherited cause of end stage renal failure in children with reported incidence of 1 in 20,000 live births. The clinical spectrum is wide. Antenatal findings of echogenic reniform enlarged kidneys associated with evidence of intrauterine renal failure in the form of severe oligoamnios are pathognomonic. Postnatal illness ranges from fatal respiratory failure due to pulmonary hypoplasia in neonates to chronic kidney disease in children, or later presentation of ductal plate malformation and portal hypertension. Advances in genetic diagnostic techniques have allowed recognition of genotypes. We report a novel homozygous missense variant on exon 22 of PKHD1 gene (chr6:51915067G > A; c.2167C > T) that results in the amino acid substitution of cysteine for arginine at codon 723 (p.Arg723Cys). The affected neonate presented with antenatal anhydramnios, classical radiological features, and severe hypoxic respiratory failure likely due to pulmonary hypoplasia and succumbed. The parents were found to be heterozygous carriers. Detection of the specific variant in the proband facilitated prenatal investigation in the next pregnancy.","PeriodicalId":41283,"journal":{"name":"Journal of Child Science","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1725175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42395210","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}
V. Anand, Femitha Pournami, Anand Nandakumar, Jyothi Prabhakar, Naveen Jain
{"title":"Precision Medicine with Genetic Testing in Neonatal Intensive care","authors":"V. Anand, Femitha Pournami, Anand Nandakumar, Jyothi Prabhakar, Naveen Jain","doi":"10.1055/s-0041-1733875","DOIUrl":"https://doi.org/10.1055/s-0041-1733875","url":null,"abstract":"The highest impact of genetic disorders through a human being ’ s lifespan isduring fetal, perinatal, and neonatal periods. Accurate diagnosis optimizes managementdecisions, and aids parent counseling. Medical professionals in the fi eld must therefore be cognizant of the foundations of genetic diseases and the indications, choices, prerequisites, and bene fi ts of selection of appropriate tests. Inappropriate selection of tests comes with several downsides — in the form of costs, inconclu-sive results, and ethical dilemmas. This article seeks to demystifysuccinctly,fromaclinician ’ sperspective,thevarious genetic tests available and aid selection of the most appropriate one in a given situation. We fi","PeriodicalId":41283,"journal":{"name":"Journal of Child Science","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45670277","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}
Efstathia Danai C. Bikouli, A. Vazeou, M. Xatzipsalti, G. Servos, D. Delis, D. Maritsi
{"title":"Blau Syndrome Complicated by Atypical Type IIa Takayasu Arteritis","authors":"Efstathia Danai C. Bikouli, A. Vazeou, M. Xatzipsalti, G. Servos, D. Delis, D. Maritsi","doi":"10.1055/s-0041-1740463","DOIUrl":"https://doi.org/10.1055/s-0041-1740463","url":null,"abstract":"Abstract Blau syndrome (BS) is a rare, autosomal dominant monogenic autoinflammatory disease, usually presenting as a triad of symptoms (granulomatous dermatitis, uveitis, and nonerosive arthritis) and caused by gain-of-function mutations in the nucleotide oligomerization domain 2 (NOD2) gene. However, very few reports in children of copresence of BS with large vessel vasculitis exist. We hereby describe a case of BS associated with clinical features of Takayasu arteritis. An 8.5-year-old boy presented with hypertension, cardiac insufficiency, arthritis, and ocular disease. Among other investigations, he underwent cervical and chest computed tomography and computed tomography angiography scans that revealed the presence of type IIa Takayasu arteritis lesions. Genetic analysis revealed a heterozygous mutation of NOD2 gene leading to the amino acid exchange Arg-587-Cys in the NACHT domain of the NOD2 protein (R587C) as pathogenic cause of BS. He received treatment with prednisolone, methotrexate, and infliximab (antitumor necrosis factor-α) in addition to antihypertensive medication with a favorable clinical response. Cases of BS should be investigated for the coexistence of Takayasu arteritis. However, further research is required to delineate a possible common pathogenic mechanism between the two clinical entities.","PeriodicalId":41283,"journal":{"name":"Journal of Child Science","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45294877","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}
Meryam Jan, Kathleen Dully, C. Kostecki, R. Alexander
{"title":"Tea or Thrush?: A Case of Nonaccidental Oral Injury in an Infant","authors":"Meryam Jan, Kathleen Dully, C. Kostecki, R. Alexander","doi":"10.1055/s-0041-1733869","DOIUrl":"https://doi.org/10.1055/s-0041-1733869","url":null,"abstract":"Abstract A 5-month-old girl child patient presented to the emergency department for oral thrush and poor feeding but instead demonstrated concern for abuse after physical exam, as findings were consistent with oral injury. Correct identification of the oral findings as traumatic necessitated navigating language and cultural issues before the mechanism of injury and abuse determination could be made. Exploring the involvement of other caregivers was a crucial piece for investigation of the clinical scenario. The incidence of child abuse and pediatric oral injuries concerning for abuse were reviewed in this case report.","PeriodicalId":41283,"journal":{"name":"Journal of Child Science","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41800012","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":"Streptococcal Throat Carriage among Primary School Children Living in Uyo, Southern Nigeria","authors":"K. Edem, E. Ikpeme, M. Akpan","doi":"10.1055/s-0040-1722274","DOIUrl":"https://doi.org/10.1055/s-0040-1722274","url":null,"abstract":"Abstract Surveillance of the carrier state for β-hemolytic streptococcal (BHS) throat infections remains essential for disease control. Recent published works from Sub-Saharan Africa have suggested a changing epidemiology in the burden of BHS throat infections. The objective of the present study was therefore to determine the prevalence and pattern of BHS throat carriage in school-aged children in Uyo, Akwa Ibom State. This was a prospective cross-sectional study of 276 primary school children in Uyo. Subjects were recruited by multistage random sampling. Obtained throat swabs were cultured on 5% sheep blood agar. Lancefield grouping on positive cultures was done by using the Oxoid Streptococcal Grouping Latex Agglutination Kit, United Kingdom. Antimicrobial susceptibility testing was done with the disk diffusion method. Associations were tested with Fischer's exact test. The prevalence of BHS carriage was 3.3%. Group C Streptococcus was identified in 89% of isolates and Group G Streptococcus in 11%. Younger age and larger household size were associated with asymptomatic streptococcal throat infections. Antimicrobial susceptibility was highest with cefuroxime and clindamycin (89% of isolates each), while 78% of isolates were susceptible to penicillin. None of the tested isolates was susceptible to co-trimoxazole. The prevalence of streptococcal throat carriage in the study area was low. There were no Group A Streptococcus isolates suggesting an evolving epidemiology of BHS disease in the study area.","PeriodicalId":41283,"journal":{"name":"Journal of Child Science","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1722274","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43146436","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}
Rokhsareh Jafaryazdi, S. Shams, A. Setoodeh, R. S. Badv, V. Ziaee, F. Abbasi, Mohammad Taghi Haghi Ashtiani, Fatemeh Mozafari, L. Shafeghat
{"title":"Evaluation of Patients Referred to Children's Medical Center Laboratory for Diagnosis of Mucopolysaccharidoses: Eight Years' Experience from Iran","authors":"Rokhsareh Jafaryazdi, S. Shams, A. Setoodeh, R. S. Badv, V. Ziaee, F. Abbasi, Mohammad Taghi Haghi Ashtiani, Fatemeh Mozafari, L. Shafeghat","doi":"10.1055/s-0041-1740059","DOIUrl":"https://doi.org/10.1055/s-0041-1740059","url":null,"abstract":"Mucopolysaccharidoses (MPSs) are rare lysosomal storage diseases, resulting from deficiencies of enzymes responsible for Glycosaminoglycans (GAGs) degradation. This leads to accumulation of GAGs in tissues and their excretion in urine, with a wide variety of manifestations. Early diagnosis of MPSs is strictly recommended due to available therapy that can slow down disease progression during the early ages. This study aimed to evaluate patients with suspected MPS referred to Children's Medical Center laboratory over eight years. We also evaluated the usefulness of urine GAG as a screening test for identification of such patients. A total of 1414 patients (40% female, 60% male, with mean age 3.1 ± 4.1years) have participated in this study. The urinary GAG analysis (uGAG) was performed by 1, 9-dimethyl-methylene blue (DMMB) and Berry spot test (BST). All patients with positive and mild positive results or with disease-related symptoms were evaluated in terms of definitive diagnosis, received treatments, morbidity, and mortality rate. In 407 (36.5%) patients uGAG were positive or mild positive, of which 26.3% suffered from one of the types of MPSs, 28.5% suffered from other diseases, 32.9% were undiagnosed, 12.3% were apparently healthy, and 19 died. The negative predictive value of uGAG test in our study was 100%. About 21% of MPSs patients received enzyme replacement therapy, while four patients underwent stem cell transplants. The rest received supportive care. We concluded that a combination of DMMB and BST methods has acceptable sensitivity for screening suspicious MPS patients.","PeriodicalId":41283,"journal":{"name":"Journal of Child Science","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45129120","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}
Nishu Gupta, Gunjan Jindal, Hanish Singla, D. Garg
{"title":"Primary Disseminated Hydatid Disease Involving Multiple Organs in a Pediatric Patient: A Rare Case Report","authors":"Nishu Gupta, Gunjan Jindal, Hanish Singla, D. Garg","doi":"10.1055/s-0041-1731306","DOIUrl":"https://doi.org/10.1055/s-0041-1731306","url":null,"abstract":"Abstract Hydatid disease is a parasitic infestation by Echinococcus genus of tapeworm, resulting from ingestion of tapeworm eggs and leading to formation of cysts predominantly in the liver and lungs. Multiorgan involvement in children is unusual. We present a case of a 12-year-old female with multiple organ involvement. Patient had history of abdominal pain, breathlessness, irritability and vomiting. Plain radiograph showed a large ovoid calcific lesion projected over the liver. Abdominal sonography demonstrated multiple hydatid cysts in the liver, spleen and left kidney. Ultrasound findings were further confirmed by contrast-enhanced computed tomography that showed additional hydatid cysts in bilateral lungs. All accessible cysts were excised on laparotomy. Cystic hydatid disease should be suspected in all pediatric patients with multiple cystic lesions, especially in endemic areas.","PeriodicalId":41283,"journal":{"name":"Journal of Child Science","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1731306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43012045","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}
S. Sebban, D. Evenou, C. Jung, C. Fausser, S. Durand, M. Bibal, V. Geninasca, M. Saux, J. Jeulin
{"title":"Bronchial Clearance Physiotherapy in Pediatrics. A Controlled, Randomized, Multicenter Study of the Short-Term Effects on Respiration during Outpatient Care for Infants with Acute Bronchiolitis","authors":"S. Sebban, D. Evenou, C. Jung, C. Fausser, S. Durand, M. Bibal, V. Geninasca, M. Saux, J. Jeulin","doi":"10.1055/s-0041-1731304","DOIUrl":"https://doi.org/10.1055/s-0041-1731304","url":null,"abstract":"Abstract Objectives The use of chest physiotherapy (CP) has not, to date, been shown to be effective in the care of infants hospitalized for bronchiolitis. However, it has not yet been studied in outpatient settings. The aim of our study was to examine the short-term benefit of CP with the increased exhalation technique (IET) on the respiratory conditions of nonhospitalized infants. Methods Our research consisted of a multicenter, randomized, controlled, single-blind study of infants under 1 year old. A decrease in the severity score of the infants' respiratory condition was compared between two groups: one receiving CP and one without CP. Eighty-two infants were randomized: 41 in the CP group and 41 in the control group. Blinded assessors determined the Wang Clinical Severity Score at inclusion (T0) and 30 minutes later (T1) for each group. Results Improvement in the severity score was observed for 29 infants (70.7%) in the group receiving CP, compared with 4 infants (9.76%) in the control group (p < 0.001). The mean decrease in the Wang Clinical Severity Score was −2 (±1.32) in the group receiving physiotherapy compared with −0.22 (±0.99) in the control group (p < 0.001). Conclusion For outpatient care of infants with bronchiolitis, the results of this study suggest that CP with IET leads to a short-term improvement of mucus airway obstruction parameters.","PeriodicalId":41283,"journal":{"name":"Journal of Child Science","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1731304","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44352251","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}
Sujitha Mukkiri, P. Kandasamy, M. Subramanian, Venkatesh Chandrasekaran, S. Kattimani
{"title":"Inclusive Education for Children with Special Needs and Autism: Status in the Schools of Puducherry, India","authors":"Sujitha Mukkiri, P. Kandasamy, M. Subramanian, Venkatesh Chandrasekaran, S. Kattimani","doi":"10.1055/s-0041-1735882","DOIUrl":"https://doi.org/10.1055/s-0041-1735882","url":null,"abstract":"Abstract Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting social interaction and communication. Children with autism are at risk of school exclusion because of the inherent problems in behavior and communication. This study was performed in Puducherry to determine whether inclusive education is practiced for children with ASD and to ascertain the difficulties faced by educators in the schools that enroll children with ASD. This study was performed in the mainstream (regular) and special schools of Puducherry between November 2018 and February 2019. The mainstream schools were contacted over the telephone, by e-mail, and by regular post, and the investigator contacted the special schools in person. Data were collected using a semistructured proforma. A total of 66 schools participated in the survey (60 mainstream and 6 special schools). Among 60 mainstream schools comprising 3,967 children, 18 (0.45%) were children with special needs (CWSN) and 2 (0.05%) had ASD. In the six special schools comprising 2,167 children, 1,844 (85%) were CWSN and 323 (15%) were those with ASD. Among the 60 mainstream schools, only 14 (23.3%) schools had provision for special educators, accounting for 42 teachers. Behavioral problems were commonly reported in special schools. Enrollment of children with ASD is negligible in mainstream schools compared with special schools in Puducherry. More studies are needed to explore the reason for the same and to explore the feasibility of providing access to disabled children in mainstream schools.","PeriodicalId":41283,"journal":{"name":"Journal of Child Science","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44512116","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}