Pediatrics
Anahita Alizadeh Ghamsari; Nafiseh Pourbadakhshan
Volume 10, Issue 1 , January 2024
Abstract
Objective: Snake bites represent a significant public health issue worldwide, as venomous snake bites can result in dangerous and sometimes lethal consequences. Sometimes, the diagnosis is difficult. Herein, we present the case of a 4-year-old child who posed a challenge to diagnosis.Case Presentation: ...
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Objective: Snake bites represent a significant public health issue worldwide, as venomous snake bites can result in dangerous and sometimes lethal consequences. Sometimes, the diagnosis is difficult. Herein, we present the case of a 4-year-old child who posed a challenge to diagnosis.Case Presentation: A 4-year-old child was brought to the emergency department with sudden, severe general weakness and impaired consciousness. Initially, the cause of these symptoms was unclear and difficult to diagnose. However, after a more thorough examination, it was determined that the likely cause was a neurotoxic snake bite. The child was hospitalized for three days. He received anti-venom, painkillers, and symptomatic treatments and left the hospital in good general condition.Conclusion: Snakebites are very dangerous and sometimes have unusual manifestations, so adequate personnel and physician information is necessary for timely diagnosis and appropriate management.
Pediatrics
Sangeetha Shenoy; Shruti Patil
Volume 9, Issue 2 , July 2023, , Pages 109-113
Abstract
Objective: Organ dysfunction is an important factor determining the severity and outcome of critical illness in children. Organ dysfunction scores are based on the number of organs involved and the severity of dysfunction in each. This study aimed to evaluate organ dysfunction using PELOD-2 in critically ...
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Objective: Organ dysfunction is an important factor determining the severity and outcome of critical illness in children. Organ dysfunction scores are based on the number of organs involved and the severity of dysfunction in each. This study aimed to evaluate organ dysfunction using PELOD-2 in critically ill children.Methods: This prospective observational study included all consecutive critically ill children with organ dysfunction aged one month to 15 years admitted to pediatric intensive care unit of a Ramaiah Medical College Hospital, Bangalore between January 2018 and December 2020. The severity of organ dysfunction was scored using Pediatric logistic organ dysfunction-2 (PELOD-2) and evaluated based on the outcome using SPSS and PASW statistics for Windows version 18.0. The sample size required for the study with 95% confidence level and 10% relative precision was 149 critically ill children. The children were classified based on the presence of single and multiple organ dysfunction. Demographics and laboratory parameters were compared between the two groups using non parametric tests. The factors affecting mortality among children with multiple organ dysfunction were assessed using univariate and multivariate analysis.Results: Of the 550 children admitted with critical illness during the study period, organ dysfunction was present in 84% of the patients. Of these, 43% had multiple-organ dysfunction. The median (interquartile range) of the patients was 5.5 (1, 11) years with a male-to-female ratio of 1.7:1. The mortality rate was 14.4%. The PELOD-2 score and mortality steadily increased with the number of organs involved. The presence of more than two organ dysfunctions had an odd ratio (OR) of 45.7 for mortality (95% CI: 18.9–110.6, P value<0.001). The area under the receiver operating curve(ROC) for predicting mortality using the number of organs affected was 0.96 (95% CI: 0.94–0.97, P value<0.001). Dysfunction in more than two organs had a sensitivity of 92.5% and a specificity of 91% in predicting mortality. The presence of cardiovascular dysfunction and the need for ventilation were found to be independent predictors of mortality.Conclusion: The presence of more than two organ dysfunctions in PELOD-2 increased the risk of mortality; the need for ventilation and the presence of cardiovascular dysfunction were independent predictors of mortality.
Pediatrics
Esra Polat; Nevzat Aykut Bayrak; Günsel Kutluk; Hasret Ayyıldız Civan
Volume 6, Issue 2 , July 2020, , Pages 59-62
Abstract
Objective: Upper gastrointestinal bleeding (UGB) is one of the most important and serious cause of emergency admission in childhood. The aim of the study was to evaluate the etiological factors and the treatment approaches in patients with UGB.Methods: In this retrospective study, children with UGB admitted ...
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Objective: Upper gastrointestinal bleeding (UGB) is one of the most important and serious cause of emergency admission in childhood. The aim of the study was to evaluate the etiological factors and the treatment approaches in patients with UGB.Methods: In this retrospective study, children with UGB admitted to emergency clinics of Istanbul Health Sciences University Kanuni Sultan Suleyman Research and Training Hospital, Istanbul Bakirkoy Sadi Konuk Research and Training Hospital and Diyarbakir Children’s Hospital were evaluated between January 2014 and August 2017.Results: Of the 198 children, 14.6% had non-steroid anti-inflammatory drug (NSAID) history, and 12.6% had chronic liver disease. We detected esophagitis, esophagus varices and peptic ulcer with upper gastrointestinal endoscopic evaluation (47%, 11.1%, 18.1%, respectively). Helicobacter pylori was found in 61.6% of patients. Endoscopic therapeutic procedures (band ligation therapy, sclerotherapy, and adrenaline injection) were appied in 11.1% of patients. Eighty-four (42.4%) patients were hospitalized, and erythrocyte transfusion (ET) was ordered in 29 (14.6%) patients.Conclusion: Approximately in 20% of the pediatric patients, the source of gastrointestinal bleeding is the upper gastrointestinal system. The cause of UGB varies with age. Appropriate diagnostic and therapeutic approaches are very important for management and to reduce mortality.
Pediatrics
Parvin Aَbbaslou; Maryam Ahmadipour
Volume 6, Issue 2 , July 2020, , Pages 118-120
Abstract
Objective: Foreign body swallowing is a common pediatric problem. A foreign body in the pharynx is a medical emergency that requires urgent intervention. Evaluation and treatment of pharyngeal foreign bodies is much more difficult in children than in adults and sometimes requires hospitalization and ...
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Objective: Foreign body swallowing is a common pediatric problem. A foreign body in the pharynx is a medical emergency that requires urgent intervention. Evaluation and treatment of pharyngeal foreign bodies is much more difficult in children than in adults and sometimes requires hospitalization and removal of the foreign bodies under general anesthesia due to children’s lack of cooperation. Fish and chicken bones are the most common swallowed foreign bodies, but an interesting case of a piece of dishwashing steel wool stuck in a child’s pharynx is reported in this article.Case Presentation: A 10-year old boy was presented with a history of dysphagia from five weeks ago. Oral examination did not reveal anything significant. In lateral neck radiographs of the patient, a metal wire was observed in the hypopharyngeal region opposite the 4th and 5th cervical vertebrae. Endoscopic attempts to remove the foreign body were not successful. Therefore, the foreign body was removed from the patient’s pharynx in the operating room under general anesthesia. No complications were observed.Conclusion: Despite the prevalence of swallowing foreign bodies in children, ingestion of a piece of dishwashing steel wool not diagnosed for three weeks was considered interesting to report. Pharyngeal foreign bodies are medical emergencies; therefore, it is particularly important to suspect the presence of a foreign body and perform diagnostic procedures.
Surgery
Haleh Mousavi; Samad Shams Vahdati; Roshan Fahimi
Volume 3, Issue 2 , July 2017, , Pages 66-67
Abstract
Invagination is a kind of intestine disease in children and it is occurred between 2 upto 14 years old. This is a report of 17 months infant with intussusception due to trauma. The patient had admitted to emergency department because of motor vehicle accident and because of abdominal pain, abdominal ...
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Invagination is a kind of intestine disease in children and it is occurred between 2 upto 14 years old. This is a report of 17 months infant with intussusception due to trauma. The patient had admitted to emergency department because of motor vehicle accident and because of abdominal pain, abdominal computed tomography (CT) scan was done.
Pediatrics
Mahesh Chand Meena; Kuldeep Panchal; Mukta Rani
Volume 3, Issue 1 , January 2017, , Pages 34-37
Abstract
Oculocardiac reflex (OCR) sometimes occurs as a result of pressure on the eye or traction of the intraorbital surrounding structures during ophthalmic surgery. This can result in bradycardiac arrhythmia and cardiac arrest. A 45-year-old female was undergoing an elective squint correction surgery of one ...
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Oculocardiac reflex (OCR) sometimes occurs as a result of pressure on the eye or traction of the intraorbital surrounding structures during ophthalmic surgery. This can result in bradycardiac arrhythmia and cardiac arrest. A 45-year-old female was undergoing an elective squint correction surgery of one eye under local anaesthesia in a private hospital in December 2013. The patient was preoperatively examined, investigated and admitted to the hospital one day prior to operation. There was no previous history of any chronic illnesses. The patient collapsed during surgery and declared dead. Doctors attempting strabismus surgery under local anaesthesia should be familiar with this phenomenon.