Progressing Aspects in Pediatrics and Neonatology

Santosh Kumar K*

DOI : 10.32474/PAPN.2018.02.000134

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Apnoea of prematurity (AOP) is a common problem affecting premature infants. Apnoea is defined as cessation of breathing for more than 20 seconds or for lesser duration when associated with bradycardia and desaturation. The most likely and accepted pathogenesis is the “physiologic” immaturity of respiratory control in the neonates. The physiological immaturities include altered ventilatory responses to hypoxia, hypercapnia, and altered sleep states. Other hypotheses include gastroesophageal reflux and anaemia which are still controversial. Three types have been identified namely obstructive, central and mixed types of apnoea. Management options include the use of supplemental oxygen, position chages and drug therapy with methyxanthines. Other supportive therapies include kangaroo care, packed cell transfusions. The long term neu..... ReadMore

Ghassan Saleh Ahmed Salama* and Yasser Fouad Mahmoud Amer

DOI : 10.32474/PAPN.2018.02.000132

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Objective: To examine effects of early amino acid (AA) infusion on serum glucose and calcium levels of very low birth weight (VLBW) preterm newborns, through the first 72 hours of life. Study Design: hospital designed prospective study of total 110 VLBW newborns with < 32 weeks gestation, and less than 1500 g was performed. 55 newborns received AA within 6 hours of life (early group) while 55 newborns did not receive AA during the first 72 hours of life (late group). Results: Average glucose levels were significantly lower in the early group during the first 72 hours of life. Average serum Ca levels during first 72 hours of life were significantly higher in newborns with early group. Conclusions: Early amino acid infusion improve serum glucose and Ca levels in VLBW newborns, and thus decreasing the risk of hyperglycemia and hypoca..... ReadMore

Ponnambalam Arun*, Kaveri Krishnasamic, Palani Gunasekeranc and Vidya Padmanabhan

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Diarrheal diseases continue to be largest and deadliest ones globally especially affecting children. From earlier days there is renewed interest in the discovery of novel compounds that can be used to fight these kinds of diseases using plants and its materials. Rotavirus has been recognized as the major etiological agent of diarrheal diseases of young children in developed as well as developing countries. The presence of various phytochemicals like flavonoids, tannins, saponins, alkaloids and terpenes present in the active extracts increase the colonic water and electrolyte reabsorption and result in treatment of diarrhea. This study was undertaken to know about traditional herbal plant having medicinal value. Euphorbia hirta was analyzed for the presence of phytochemical and cytotoxic activity using MA104 cell line. Non toxic dose..... ReadMore

Shubhankar Mishra*

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Juvenile myasthenia gravis (JMG) is an autoimmune disorder of neuromuscular transmission caused by production of antibodies against components of the postsynaptic membrane of the neuromuscular junction. The patients present with a wide range of symptoms-from isolated intermittent ocular symptoms to general muscle weakness with or without respiratory insufficiency. Prepubertal children in particular have a higher prevalence of isolated ocular symptoms, lower frequency of acetylcholine receptor antibodies, and a higher probability of achieving remission. It must be differentiated from congenital myasthenia which is a channelopathy rather than autoimmune disease. Treatment commonly includes anticholinesterases, corticosteroids with or without steroid-sparing agents, and newer immune modulating agents. Plasma exchange and intravenous immunogl..... ReadMore

Naveen Ganapan and Charul Mehta*

DOI : 10.32474/PAPN.2018.02.000126

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Aim: To study the disease control via pulmonary function test with usage of bronchodilators in bronchial asthma patients. Setting and design: Prospective cohort study done at Asthma clinic, Dept of pediatrics, BJ medical college, Ahmedabad. Materials and Methods: Patients enrolled in this study were from asthma clinic BJ medical college and Civil hospital. Pulmonary function test was done on total of 91 known asthma patients. Here three parameter of lung function is taken in to account. Percentage OD FEV1 of predicted, FEV1:FVC Ratio and PEFR , its effect on bronchodilators on PEFR. Results: Out of 91 patients, 72 (79.25%) patients had almost normal pulmonary function. Only 1 patient had severe restriction of pulmonary function and 18 patients had moderate restriction of lung function. All patients shows improvement in PEFR more than 2..... ReadMore

Yaëlle Chaudy*, Thomas M Connolly and Brian Magowan

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Clinical Decision Support (CDS) is a growing field and the technology is increasingly used by both clinicians and patients. In maternity care, numerous guidelines exist on risk assessment and proposed care plans during pregnancy and labour. However, as new evidence arise, these guidelines are subject to change. It is time consuming for clinicians to a. Compile all this information and b. Keep it up to date. This paper presents our approach to overcoming these two issues: the SAFER (Safe Assessment Form to Evaluate Risk) maternity system. This CDS system contains rules extracted from current guidelines on maternity care and generates care plans at various stages of gestation based on patient data. The system includes a mobile application and a web interface. The mobile application can be used to visualise care plans and edit patient dat..... ReadMore

Shubhankar Mishra

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Neurodegenerative disorders of childhood are complicated diseases with wide range of systematic involvement. These diseases often pose great challenge to clinicians in terms of diagnosis and management. The purpose of this article is to outline a systematic approach to a child presenting with suspected neurodevelopmental regression. Many inherited metabolic disorders present with neural regression. The clinical approach depends upon the age of presentation, site of involvement in brain. Sound clinical knowledge and better approach leads to early diagnosis, better management and above all genetic counselling. As the medical science is in the track of rapid progression several treatment modalities are in the pipeline for neurodegenerative syndromes, early diagnosis and referral to higher centres can bring a better future to the child...... ReadMore

Khatuna Lomauri*

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Neonatal chylothorax results from the accumulation of chyle in the pleural space and may be either congenital or an acquired condition. Congenital chylothorax is most likely due to abnormal development or obstruction of the lymphatic system and often associated with hydropsfetalis. It can be idiopathic or may be associated with various chromosomal and other genetic abnormalities. It is important to identify infants with chylothorax, as there are specific issues that need to be addressed in the management of these patients...... ReadMore

Wala Ben Kridis*, Ines Werda, Rim Kallel, Nabil Toumi, Tahia Boudawara, Afef Khanfir and Mounir Frikha

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Neuroblastoma is a relatively common pediatric pathology of the sympathetic nervous system. The particularity of neuroblastoma lies in its development from cells whose embryological maturation into adult sympathetic nerve cells or chromaffin cells is incomplete. In the literature, many cases of spontaneous regression of neuroblastoma have been reported, but the mechanisms for which they are responsible remain ambiguous. The specificity of our case is the benign evolution of an osteomedullary stage 4 neuroblastoma and its maturation into a ganglioneuroma 6 years after the end of chemotherapy. This transformation depends on various factors related to the tumor (such as the over expression or not of N-myc, the presence or absence of Treks and their receptors), the host (the intervention of the immune system) and to other external..... ReadMore

George Gregory Buttigieg KM

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Modern medico-legal evaluation of Neonatal Cerebral Palsy (NCP) demands recognition of Neonatal Hypoxic Ischaemic Encephalopathy (NHIE) as an indispensable proof of peri-partum fetal hypoxia. Without proven NHIE, modern jurisprudence should not even consider obstetric/paediatric liability of causative peri-partum hypoxia of negligence on the grounds of medically responsible fetal/newborn hypoxia leading to Cerebral Palsy...... ReadMore

Santosh Kumar K*, Mangalabharathi S and Kamalarathnam CN

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Objective: To study the spectral characteristics of the phototherapy systems and to identify variations in spectral properties with changes in height, voltage, tilt and temperature output. Setting: Research laboratory at a tertiary care hospital. Methods: The spectral characteristics were measured from two compact fluorescent lamp (CFL) and eight light emitting diode (LED) phototherapy devices in a dark room with an irradiance of <0.1µW/cm2 /nm. The variations in the spectral characteristics with changes in height, tilt and voltage were measured. Heat output was documented...... ReadMore

İsmail Aytac

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Loeys-Dietz Syndrome is a otosomal dominant connective tissue disorder which has characteristic triad with a) Arterial tortuosity, aneurysms or dissections; b) Hypertelorism; and c) Bifid uvula or cleft palate. This review summarizes the features of anesthesia management in this syndrome..... ReadMore

Elena Lanvers

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We report on a spontaneously delivered, female neonate, born in week 35+1 of gestation, weighing 2230g. It was presented pale, hypotonic, without respiratory movement and a heart rate below 100 bpm. Therapeutic treatment started with bag-mask- ventilation, followed by the installation of a pharyngeal tube and CPAP-ventilation for a total of six hours applying a PEEP of 6 millibar. The X-ray displayeda pneumomediastinum, showing elevation of both thymus lobes in the sense of an angel-wing sign (also known as spinnaker-sail sign) [1-3] (Figure 1). Ending CPAP- ventilation, treatment continued vianasal cannula without oxygen supply for one more day, resulting in a stable respiratory status. The radiographic follow-up pres..... ReadMore

Volkan Sarper Erikci

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Acute scrotal conditions are common clinical concern in infants and children. The true cause is difficult to determine. There are several etiologic factors for this syndrome. These are torsion of the testis (TT), torsion of the testicular appendix (TTA), epididymo- orchitis (EO) and strangulated inguinoscrotal hernia (SIH). It is generally admitted that EO is rare in children and is associated with structural anomalies of the urinary tract. The aim of this study is to review the various causes of pediatric acute scrotal conditions and to assess management of these patients under the light of relevant literature...... ReadMore

MM Nasirov

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Rehabilitation of patients after anoplastic surgery is the most complex and poorly studied problem in the surgery of anorectal malformations. The process of rehabilitation should begin from the moment of diagnosis. Already in the earliest period, the question should be decided at what age a radical operation will be carried out. The second problem is always to determine the size of the outer opening of the ectopic anal canal. If the available opening is not sufficient for normal bowel evacuation, which is accompanied by signs of intestinal obstruction, this child should be given a colostomy, with which the patient will live until the moment of the radical surgery. In those cases where the external aperture of the ectopic anal canal allows unobstructed evacuation of the intestine before the radical surgery is performed, the colostomy shoul..... ReadMore

Andreas Chiabi , Félicitée D Nguefack , Palma H Abouame , Seraphin Nguefack , Nelson S. Njedock , Edmond N Chiabi , Roland M Chiabi and Marie T Obama

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Knowledge and practices of mothers on the home management of diarrhea is a key element in the management of diarrhea in a child so as to intervene early and thereby avoiding complications. The knowledge and practices of mothers on the early management of diarrhea at home is important in the prevention of diarrhea related complications. Despite all the strategies put in place in communities and health facilities to reduce childhood mortality in Cameroon, the prevalence of diarrheal diseases remains high, especially in the northern regions. This study was aimed at assessing the knowledge and practices of mothers on the home management of childhood diarrhea in Ngaoundere, a town in the northern part of Cameroon where its prevalence still remains high. This was a cross sectional and analytical study in the urban zone of the Ngaoundere from Fe..... ReadMore

Kana Serizawa*, Atsushi Ogihara

DOI : 10.32474/PAPN.2018.02.000111

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Object To review the literatures on the causes of low birth weight. Method: On the Pub Med and Ichushi (Japan Medical Abstracts Society) websites, the literatures on the causes of low birth weight published between 1975 to 2011 were searched for the Results: From among the 469 original articles retrieved, 65 articles containing any description of the cause of low birth weight were identified, of which the 32 articles well-structured in the format of scientific writing were selected and reviewed. Conclusion: The suspected causes of low birth weight from pre-pregnancy risks were classified into two categories: a) Family risk factors, b) Mother herself risk factors. Further large-scale follow-up studies from birth would be needed at the prefectural level. . Keywords: Low birth weight; Risk factors; Pre-pregnancy..... ReadMore

Edwin Dias*

DOI : 10.32474/PAPN.2018.02.000106

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Alcohol and other drug use among adolescents has been a public health problem for decades. Although some substance use is developmentally routine, a number of adolescents meet the criteria for a substance use disorder and could significantly benefit from excellent treatment programs. However, parents and health care providers want confirmation of the efficacy of adolescent-specific alcohol treatment programs . The factors surrounding issues regarding the efficacy of current adolescent treatment programs are as follows, adolescent-specific treatment services specific to adolescents; the variety of therapeutic modalities; post treatment relapse and recovery rates; and the need for evidence-based, quality assessments and research. Current Adolescent alcohol treatment efforts are summarized, with regard to the efficacy of adolescent treatment..... ReadMore

Shubhankar Mishra*

DOI : 10.32474/PAPN.2018.02.000109

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Autoimmune encephalitis (AE) comprises an expanding group of clinical syndromes that can occur at all ages, but preferentially affect younger adults and children. These disorders associate with antibodies against neuronal cell surface proteins and synaptic receptors involved in synaptic transmission, plasticity, or neuronal excitability. The spectrums of symptoms include psychosis, catatonia, alterations of behaviour and memory, seizures, abnormal movements, and autonomic dysregulations. Inflammatory findings in the cerebrospinal fluid may be present. Magnetic resonance imaging (MRI) may also demonstrate abnormalities for better diagnosis, particularly on fluidattenuated inversion recovery or T2-weighted images. Patients may initially be diagnosed with idiopathic encephalitis, likely viral but with negative viral studies. Autoimmune encep..... ReadMore

Rohit Vohra* and Dr. Minakshi

DOI : 10.32474/PAPN.2018.02.000108

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Hemophagocytic lymphohistiocytosis (HLH) is an aggressive and life-threatening syndrome of excessive immune activation. It commonly affects infants from birth to 18 months of age, but the disease can be seen in children and adults of all ages. HLH can occur as a familial or sporadic disorder, and it can be triggered by a variety of events that disrupt immune homeostasis. Prompt recognition of the disease and initiation of treatment is essential for the survival of affected patients [1]..... ReadMore