• Title/Summary/Keyword: Paediatric

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Clinical Analysis of Foreign Bodies in Gastrointestinal Tract in Children (소아에서 위장관내 이물질의 임상적 고찰)

  • Choi, Eunsoo;Lee, Hyo Gyun;Choi, Soo Jin Na;Chung, Sang Young
    • Advances in pediatric surgery
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    • v.20 no.1
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    • pp.12-16
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    • 2014
  • Foreign body ingestion is a common problem among paediatric populations. Most of the ingested foreign bodies spontaneously pass through the gastrointestinal tract, but approximately less then 10% of them remain without being discharged, and trigger complications. Therefore, proper evaluation and treatment according to the situation is required. In this study, clinical progress and complications were analyzed according to the clinical features and treatment in children who ingested foreign bodies. Among pediatric patients under 18 who were admitted to Chonnam National University Hospital after ingesting foreign bodies between January 2008 to June 2012, only the patients who had their foreign body in the gastrointestinal tract were included in this study. Based on medical records, age, type of foreign body, time spent till admission, and whether the endoscopy was done or not, complication were researched retrospectively. According to symptoms and plain abdomen X-ray findings, treatment was chosen and conducted among endoscopy, observation and emergency operation. Among 273 patients, 9 (3.3%) of them had surgical removal. Seven (2.6%) of them had an emergency operation on the day of admission, and the rest 2 (0.7%) had operation during observation. Removal through initial endoscopic approach was tried in 157 (57.5%) patients. Eleven (70.8%) of them had their foreign body removed at the initial trial, and 5 (4.9%) of them at the second trial. Among 109, who were on observation status, 9 (8.3%) of them needed endoscopic removal, and 2 (1.8%) of them suffered from surgical removal. It is thought to be better to approach slowly considering the type, size and symptoms in foreign body ingestion of pediatric patients, rather than immediate and invasive removal.

Efficacy and Tolerance of a New Anti-Regurgitation Formula

  • Dupont, Christophe;Vandenplas, Yvan;SONAR Study Group
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.2
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    • pp.104-109
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    • 2016
  • Purpose: Regurgitation is a common physiological phenomenon in infants. The aim of the present study was to evaluate the efficacy of a new anti-regurgitation (AR) formula (Novalac), thickened with an innovative complex including fibres, on the daily number of regurgitations and to assess its impact on stool consistency and frequency. Methods: Infants younger than five months, presenting at least 5 regurgitations per day were recruited in this trial. The efficacy of the new formula on regurgitation (daily number and Vandenplas score), stool frequency and consistency were assessed at day 14 and 90. Growth data were recorded at each study visit. Results: Ninety babies (mean age $9.6{\pm}5.8weeks$) were included in the full analysis data set. The mean number of regurgitation episodes at inclusion was $7.3{\pm}3.4$. In all infants, regurgitations improved after 2 weeks. The daily number of regurgitations decreased significantly ($-6.3{\pm}3.3$, p<0.001) including in those previously fed a thickened formula ($-6.2{\pm}3.0$, p<0.001). There was no significant change in stool consistency at day 14. After 3 months, 97.5% of infants had formed or soft stools. Growth was appropriate with a slight increase of weight-for-age z-score (from $-0.5{\pm}1.0$ to $-0.1{\pm}0.9$) and no change of weight-for length z-score ($-0.1{\pm}1.1$ to $-0.1{\pm}-1.1$). Conclusion: The new AR formula thickened with an innovative complex is very effective in reducing the daily number of regurgitations without having a negative impact on stools consistency.

Relation between brucellosis and husbandry practices in goats in Bangladesh

  • Uddin, Muhammad Jasim;Rahman, Md Siddiqur;Hossain, Mohammad Arif;Akter, Sayeda Hasina;Majumder, S.;Park, Jin-Ho;Song, Hee-Jong
    • Korean Journal of Veterinary Service
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    • v.30 no.2
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    • pp.259-267
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    • 2007
  • A study on the relation between some husbandry practices and brucellosis in goats in Bangladesh was conducted at selected areas of Mymensingh and Dhaka district, Bangladesh, from March 2005 to May 2006. Sera from 300 goats were tested by Rose bengal test (RBT), plate agglutination test (PAT), tube agglutination test (TAT) and mercaptoethanol test (MET). Out of the 300 goats, 1.670% (n=5) were positive to RBT and PAT respectively, and 2.0% (n=6) were positive to TAT and 2.33% (n=7) were positive to MET. The prevalence of brucellosis was bigger in goats reared collectively (n=2, 4%) than reared individually (n=5, 2%), and bigger in goats housed with concrete floor (n=2, 4%) than that of bare floor (n=5, 2%). The rate of brucellosis was higher in goats keep separately (n=6, 2.61%) than that of kept with other animals (n=1, 1.43%) especially with cattle. Out of 290 goats from free grazing, 7 were positive but no positive reactor(n=10) was found in non grazing goats. In conclusion, however, seroprevalence of brucellosis had no statistically significant association with rearing type, housing type and grazing or not.

Prevalence of malocclusion and its relationship with caries among school children aged 11 - 15 years in southern India

  • Baskaradoss, Jagan Kumar;Geevarghese, Amrita;Roger, Clement;Thaliath, Anil
    • The korean journal of orthodontics
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    • v.43 no.1
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    • pp.35-41
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    • 2013
  • Objective: To assess the prevalence of malocclusion and its relationship with dental caries among school children in southern India. Methods: This cross-sectional study included 1,800 students aged 11 - 15 years whose Dental Aesthetic Index (DAI) and dentition status were recorded and analyzed. The chi-square test, ANOVA, and Spearman's correlation tests were carried out. Results: The mean DAI score ${\pm}$ the standard deviation was $18.61{\pm}6.1$. Approximately 85% of the students (83.0% males, 86.8% females) had DAI scores of < 26 and were classified as not requiring orthodontic treatment. One tenth of the sample had mean DAI scores between 26 - 30 (indicating definite malocclusion and elective treatment), while about 3% had mean scores between 31 - 35 (indicating severe malocclusion and treatment desirability). Only 29 children (1.6%; 16 boys, 13 girls) had a DAI score of > 35, which suggested very severe or handicapping malocclusion requiring mandatory treatment. The mean decayed, missing, filled teeth (DMFT) was $2.28{\pm}1.47$. A DMFT of > 0 was observed in 91.8% of the study subjects. Children with a DAI score of > 35 were found to have significantly (p < 0.001) higher caries experience as compared to other children. Moreover, the DAI scores showed a significant correlation with the mean DMFT scores (r = 0.368, p < 0.05). Conclusions: A positive correlation was found between the severity of malocclusion and dental caries.

Assessing the Parasitic Burden in a Late Antique Florentine Emergency Burial Site

  • Roche, Kevin;Pacciani, Elsa;Bianucci, Raffaella;Bailly, Matthieu Le
    • Parasites, Hosts and Diseases
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    • v.57 no.6
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    • pp.587-593
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    • 2019
  • Excavation (2008-2014) carried out under the Uffizi Gallery (Florence, Italy) led to the discovery of 75 individuals, mostly buried in multiple graves. Based on Roman minted coins, the graves were preliminarily dated between the second half of the 4th and the beginning of the 5th centuries CE. Taphonomy showed that this was an emergency burial site associated with a catastrophic event, possibly an epidemic of unknown etiology with high mortality rates. In this perspective, paleoparasitological investigations were performed on 18 individuals exhumed from 9 multiple graves to assess the burden of gastrointestinal parasitism. Five out of eighteen individuals (27.7%) tested positive for ascarid-type remains; these are considered as "decorticated" Ascaris eggs, which have lost their outer mammillated coat. Roundworms (genus Ascaris) commonly infest human populations under dire sanitary conditions. Archaeological and historical evidence indicates that Florentia suffered a period of economic crisis between the end of 4th and the beginning of the 5th centuries CE, and that the aqueduct was severely damaged at the beginning of the 4th century CE, possibly during the siege of the Goths (406 CE). It is more than plausible that the epidemic, possibly coupled with the disruption of the aqueduct, deeply affected the living conditions of these individuals. A 27.7% frequency suggests that ascariasis was widespread in this population. This investigation exemplifies how paleoparasitological information can be retrieved from the analysis of sediments sampled in cemeteries, thus allowing a better assessment of the varying frequency of parasitic infections among ancient populations.

Comparison of four nutritional screening tools for Korean hospitalized children

  • Lee, Yeoun Joo;Yang, Hye Ran
    • Nutrition Research and Practice
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    • v.13 no.5
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    • pp.410-414
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    • 2019
  • BACKGROUND/OBJECTIVES: Several nutritional screening tools were recently developed to screen the risk of malnutrition in hospitalized children, but have not been validated in Asia. We compared four nutritional screening tools for pediatric patients in evaluating nutritional risks in newly hospitalized children. SUBJECTS/METHODS: Medical records of newly admitted pediatric patients between June 2016 and May 2017 at two tertiary hospitals were reviewed. Initial information by nurses and hospital records by doctors on baseline demographic, clinical, and anthropometric data at admission were collected in all subjects. Nutritional risks were evaluated using four nutritional screening tools including the pediatric nutritional risk score (PNRS), the screening tool for the assessment of malnutrition in pediatrics (STAMP), the paediatric Yorkhill malnutrition score (PYMS), and the screening tools for risk of nutritional status and growth (STRONGkids). RESULTS: A total of 559 patients (310 boys and 249 girls, mean age $6.3{\pm}5.5years$) were recruited. Patients in medical and surgical departments were 469 (83.9%) and 90 (16.1%), respectively. The prevalence of patients at risk of malnutrition were 31.1% for low risk, 52.2% for medium risk, and 16.6% for high risk by PNRS; 11.4%, 39.7%, and 48.8% by STAMP; 26.5%, 25.4%, and 48.1% by PYMS; and 35.6%, 58.9%, and 5.5% by STRONGkids. PNRS versus STRONGkids and STAMP versus PYMS showed moderate agreement (kappa = 0.566 and kappa = 0.495, respectively). PYMS and STAMP revealed a relatively high sensitivity of 87.8% and 77.6% for wasting. CONCLUSION: Different nutritional screening tools revealed considerably different results in evaluating nutritional risks in newly hospitalized children. Since pediatric patients are at risk of malnutrition at admission and during hospitalization, screening tools should be applied properly according to the situation of each hospital.

Proposed parameters of optimal central incisor positioning in orthodontic treatment planning: A systematic review

  • Sangalli, Linda;Dalessandri, Domenico;Bonetti, Stefano;Mandelli, Gualtiero;Visconti, Luca;Savoldi, Fabio
    • The korean journal of orthodontics
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    • v.52 no.1
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    • pp.53-65
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    • 2022
  • Objective: Planning of incisal position is crucial for optimal orthodontic treatment outcomes due to its consequences on facial esthetics and occlusion. A systematic summary of the proposed parameters is presented. Methods: Studies on Google Scholar©, PubMed©, and Cochrane Library, providing quantitative information on optimal central incisor position were included. Results: Upper incisors supero-inferior position (4-5 mm to upper lip, 67-73 mm to axial plane through pupils), antero-posterior position (3-4 mm to Nasion-A, 3-6 mm to A-Pogonion, 9-12 mm to true vertical line, 5 mm to A-projection, 9-10 mm to coronal plane through pupils), bucco-lingual angulation (4-7° to occlusal plane perpendicular on models, 20-22° to Nasion-A, 57-58° to upper occlusal plane, 16-20° to coronal plane through pupils, 108-110° to anterior-posterior nasal spine), mesio-distal angulation (5° to occlusal plane perpendicular on models). Lower incisors supero-inferior position (41-48 mm to soft-tissue mandibular plane), antero-posterior position (3-4 mm to Nasion-B, 1-3 mm to A-Pogonion, 12-15 mm to true vertical line, 6-8 mm to coronal plane through pupils), bucco-lingual angulation (1-4° to occlusal plane perpendicular on models, 87-94° to mandibular plane, 68° to Frankfurt plane, 22-25° to Nasion-B, 105° to occlusal plane, 64° to lower occlusal plane, 21° to A-Pogonion), mesio-distal angulation (2° to occlusal plane perpendicular on models). Conclusions: Although these findings can provide clinical guideline, they derive from heterogeneous studies in terms of subject characteristics and reference methods. Therefore, the optimal incisal position remains debatable.

Quality of Life and Anorectal Malformations: A Single-Center Experience

  • Scire, Gabriella;Gabaldo, Riccardo;Dando, Ilaria;Camoglio, Francesco S.;Zampieri, Nicola
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.4
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    • pp.340-346
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    • 2022
  • Purpose: The treatment and long term clinical outcomes of anorectal malformations (ARM) in children have always been the focus of pediatric surgeons. This study aimed at reporting our experience as far as long-term follow-up of ARM in children is concern. Methods: We enrolled patients treated between 1999 and 2019, and established selection criteria to choose appropriate subjects. A validated questionnaire was used to determine long-term quality of life outcomes. Results: Out of a total of 48 patients treated within the study period, 28 were enrolled in this study. Among the latter, more than 35% had at least one long-time complication, and more than 90% had a good lifestyle. Urinary and fecal continence was achieved in more than 95% of the patients using medical devices. Conclusion: This study aimed to bring up new concepts; taking into consideration all aspects of life in patients with ARM, from school life to sexuality, while evaluating fecal and urinary continence. This is essential for the improvement of the skills of the different specialists involved in the management of these patients, and for the implementation of strategies that can improve postoperative function. Most especially, it will also help improve communication between doctors to ensure an adequate transition of these children into adult life.

International Cross-Sectional Survey among Healthcare Professionals on the Management of Cow's Milk Protein Allergy and Lactose Intolerance in Infants and Children

  • Madrazo, J Armando;Alrefaee, Fawaz;Chakrabarty, Anjan;de Leon, Julia C.;Geng, Lanlan;Gong, Sitang;Heine, Ralf G.;Jarvi, Anette;Ngamphaiboon, Jarungchit;Ong, Christina;Rogacion, Jossie M.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.3
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    • pp.263-275
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    • 2022
  • Purpose: The present international survey among healthcare providers aimed to collect data on theoretical knowledge and clinical practices in the diagnosis and management of cow's milk protein allergy (CMPA) and lactose intolerance (LI) in infants. Methods: A global survey was conducted in several countries with diverse health care settings. The survey consisted of multiple-choice questions in 3 main domains: (1) understanding and clinical practices around CMPA and LI; (2) case scenarios; and (3) disease-specific knowledge and potential educational needs. Results: Responses were available from 1,663 participants. About 62% of respondents were general practitioners or general pediatricians, and the remainder were pediatric allergists/gastroenterologists (18%) or other health practitioners (20%). The survey identified knowledge gaps regarding the types of CMPA (IgE-mediated vs. non-IgE-mediated) and the clinical overlap with LI. The survey suggested diverse clinical practices regarding the use of hypoallergenic formulas, as well as misconceptions about the prebiotic benefits of lactose in extensively hydrolyzed formulas in non-breastfed infants with CMPA. Responses to the two case scenarios highlighted varying levels of awareness of the relevant clinical practice guidelines. While respondents generally felt confident in managing infants with CMPA and LI, about 80% expressed an interest for further training in this area. Conclusion: The current survey identified some knowledge gaps and regional differences in the management of infants with CMPA or LI. Local educational activities among general and pediatric healthcare providers may increase the awareness of clinical practice guidelines for the diagnosis and treatment of both conditions and help improve clinical outcomes.

A Comparative Study Between Cytomegalovirus Immunoglobulin M-Positive and CMV Immunoglobulin M-Negative Biliary Atresia in Infants Attending a Tertiary Care Hospital in Bangladesh

  • Akter, Sharmin;Karim, ASM Bazlul;Mazumder, Md Wahiduzzaman;Rukunuzzaman, Md;Nahid, Khan Lamia;Dey, Bishnu Pada;Sayeed, Maimuna;Rahman, AZM Raihanur;Fathema, Kaniz;Khadga, Mukesh
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.5
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    • pp.413-421
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    • 2022
  • Purpose: Perinatal cytomegalovirus (CMV) infection can lead to biliary atresia (BA) in different entities. This study aimed to compare the clinical, hematological, biochemical, and histological features of infants with BA based on their CMV immunoglobulin M (IgM) status at presentation. Methods: This cross-sectional descriptive study was carried out between January 2019 and June 2020 at the Department of Pediatric Gastroenterology and Nutrition at the Bangabandhu Sheikh Mujib Medical University (BSMMU) in Dhaka. Forty-three patients with BA were selected purposively and categorized into either the CMV IgM-positive or CMV IgM-negative BA group. Categorical variables were compared using Fisher's exact test and chi-square tests, while the Student's t-test and Mann-Whitney U-test were used to compare continuous variables. For all statistical tests, a p-value <0.05 was considered statistically significant. Results: Thirty-three (76.7%) of the cases were between 2 and 3 months of age on admission. The clinical, hematological, and biochemical parameters did not differ significantly between the CMV IgM-positive and CMV IgM-negative BA groups. Most (50.0%) of the CMV IgM-positive cases had fibrosis stage F2, while 43.5% of the CMV IgM-negative cases had fibrosis stage F3, with no significant difference between the groups (p=0.391). Conclusion: Our data shows no significant distinction between CMV IgM-positive and CMV IgM-negative BA, suggesting that CMV does not contribute to BA pathogenesis.