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Asploro Journal of Pediatrics and Child Health (ASJPCH) is an international, peer-reviewed open access journal in which it addresses not only health related issues (disease, infection, genetic disorder, growth impairment etc.), but also aims to cover topics related to the physical, emotional and social well-being of children. Child psychology, behavioral aspects, societal apathy, exposure to the criminal and violent environment, parental negligence, and cultural background, are some of the factors that influence the development of a child; and any research related to these issues will be accepted for publication….
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Introduction: Cholelithiasis has been reported in 12%-24% of Cystic Fibrosis (CF) patients, and is usually made up of cholesterol gallstones. These abnormalities are frequently asymptomatic and can include intra and extrahepatic ducts, gallbladder thickening and contraction, micro gallbladders, and cholelithiasis. Abdominal sonography is routinely used in order to detect these abnormalities.
Objectives: To obtain the prevalence of gall stones (Cholelithasis) in CF patients and its relation to other clinical, laboratory, radiological, and genetic data.
Methodology: A retrospective chart review as part of the CF registry data from the period 1st January 1984 – 1st June 2018. All confirmed CF the patients of all age groups that have US studies done were included in the study. Patients with positive gallstones or sludge were evaluated and discussed.
Results: A total of 391 confirmed CF patients were involved. Out of them, 252 patients had an abdominal ultrasound, 7 patients (3%) had gallstones on the abdominal US, 8 patients (3%) were revealed to have sludge and 237 patients (94%) had normal gallbladders. Pancreatitis was found in 4 patients (2%). 191 patients (76%) had pancreatic insufficiency.77 patients had follow up abdominal ultrasounds and 5 patients (7%) were found to have persistent gallstones, 4 patients (5%) had persistent sludge and 68 patients (88%) remained negative for gallstones. 2 patients required cholecystectomy.
Conclusion: Cholelithiasis is a common complication of CF disease; its incidence is more than the general population. Thus, we recommend that every CF patient get an ultrasonography study as part of liver disease screening to rule out any Gallbladder pathology.
Heller’s medial canaliform dystrophy (MCD) is a rare entity characterized by the paramedian crest formation of one or both thumbnails.
We report a case of a 13-year-old child who was used to biting thumbnails during several stressful events and diagnosed as medial ductal dystrophy of the thumbnail.
Mesenteric cyst is presented as lump abdomen or detected incidentally in ultrasonography for other reason or when it becomes symptomatic due to complications. Spontaneous infection or rupture of the mesenteric cyst and disseminated infections are very rare complications in children. Expeditious diagnosis and surgical excision of the cyst are imperative for fruitful outcome. We report a case of a perforated mesenteric cyst with sepsis and intracerebral haemorrhage in a 9 month child who was managed successfully in our institute.
Aim: It was a question of determining the epidemiological, diagnostic and therapeutic aspects of the digestive surgical emergencies of the child in our environment.
Patients and Methods: This is a prospective and descriptive study carried out for 12 months in the pediatric surgery department.
Results: During the study period, on 668 patients admitted we retained 87 cases of digestive surgical emergencies; representing a hospital frequency of 13%. The mean age was 7.6 ± 3.5 years (range 30 days and 16 years). We noted a male predominance with 61 boys (70.1%) for 26 girls (29.9%). The taxi was the most used form of transportation in 77 cases (88.5%). The average consultation time was 5.4 days ± 5.3 days (1 hour and 21-day extremes). Abdominal pain was the main reason for consultation with 66.7% of cases. Generalized acute peritonitis was the predominant diagnosis with 32 cases (39.1%), followed by strangulated parietal hernias with 17 cases (19.5%) and acute intestinal intussusception with 11 cases (12.6%). The postoperative course was complicated in 27 cases (33.7%). parietal suppurations were the most common complication with 77.8% of cases. Six patients (6.9%) died.
Conclusion: Digestive surgical emergencies represent a frequent nosological entity in our practice. Abdominal pain is the first reason for consultation. Appendicular peritonitis are the first cause of digestive surgical emergency in children in our practice. They remain a worrying problem for pediatric surgeons.
Objective: To compare medication errors that reached pediatric and adult patients during hospitalization.
Methods: Observational, non-experimental, cross-sectional study from January 2011 to March 2015 at two community-based, teaching hospitals
Results: Over a 4-year period, there were 4.2 and 13.3 million doses dispensed in pediatrics and adults, respectively. Less than 0.25% of doses dispensed contributed to medication errors, with 9.6% of these medication errors reaching patients and 0.04% causing harm. There was no statistical difference in medication error rates based on doses dispensed, patient-days, admission rate, and severity. However, significantly more errors in the documentation and prescribing processes occurred in adults (21.9% vs 6.5% and 37.4% vs 29.8% respectively, p<.001) versus administration in pediatrics (42.5 vs 29.8% in adults, p <0.001). Errors in drug administration that occurred in pediatrics consisted of infusion devices, incorrect dose, the omission of medication, and time of administration. Pediatrics had higher medication errors related to electrolytes and total parenteral nutrition. Independent of age, there were more medication errors that caused harm in patients residing in the intensive care unit (5.5% of 769 vs 3.5% of 2800 patients, respectively, p =0.006).
Conclusion: While the prevalence of medication errors that reached patients and caused harm were similar between adults and pediatrics, the types of errors within the medication use process, class of drugs, and severity of the mediation errors varied between the groups. Given these differences, it is quintessential to develop population-specific medication safety programs aimed at addressing the needs of pediatric patients to enhance safe medication use.
An umbilical cord hernia (UCH) is a form of abdominal wall defect, affecting 6 out of every 10,000 newborns. The persistence of urachus is an embryonic remnant that connects the bladder to the abdominal wall at the level of the umbilicus, being yet more uncommon. We reviewed the literature, searching in PubMed, under the terms “Hernia of umbilical cord”, “Congenital hernia of cord” and “Persistent Urachus”. Only a few similar cases of both pathologies associated described were found. Our main objective is to highlight the distinct clinical features, embryogenesis, prognosis and associated anomalies of two infrequent embryopathies. And to describe a infrequent case of both abnormalities presenting simultaneously.
UCH are often misdiagnosed with other abdominal wall deffects, such as omphalocele, umbilical hernias, gastroschisis and umbilical cord cysts. The normal cord insertion, adequate muscle development of the abdominal wall and a wall defect less than 5cm is what differentiates it from an omphalocele. UCH has a low morbidity overall, as it is not associated with other anomalies. The most frequently observed urachal malformations are the persistence of a urachus and urachal cyst. The prenatal diagnosis of patent urachus is made by ultrasound or magnetic resonance, being easily mistaken with abdominal wall defects, confirming the diagnosis with an ultrasound at birth. The persistence of urachus may resolve spontaneously, if not, surgical resolution is recommended. Similar to a UCH, a patent urachus shows little association with other malformations.
It is important to know the clinical presentation and the diagnostic perinatal methods employed for appropriate management and favorable results for both pathologies. This relies on knowing when to suspect possible associated anomalies and when complementary studies might be needed. It is also important to be aware that there is the possibility of a UCH and a patent urachus existing simultaneously.