Paediatrics and international child health
-
Paediatr Int Child Health · Aug 2017
Case ReportsAuto-immune anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis: three case reports.
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a recently identified auto-immune disorder characterised by severe memory deficit, a decreased level of consciousness, seizures, autonomic dysfunction and movement disorders. Three girls with the disorder are reported; they were aged 4 years, 5 years and 10 months. The 10-month-old infant who is one of the youngest patients reported with anti-NMDAR encephalitis worldwide, had MRI features suggestive of herpes simplex encephalitis (known to trigger anti-NMDAR encephalitis), but CSF PCR for herpes simplex was negative. ⋯ Intravenous immunoglobulin, corticosteroids and rituximab were administered at different intervals. Cases 1 and 2 made a full recovery, but case 3 has mild motor and speech delay. Patients who present with encephalopathy, seizures and movement disorders should be tested for anti-NMDAR antibodies in serum and CSF in addition to being screened for herpes simplex encephalitis.
-
Paediatr Int Child Health · May 2017
Prioritising minimum standards of emergency care for children in resource-limited settings.
There is global variation in the ability of hospital-based emergency centres to provide paediatric emergency medicine (PEM) services. Although minimum standards have been proposed, they may not be applicable in resource-limited settings. ⋯ Experts with experience in acute care of children in resource-limited settings have prioritised standards for paediatric emergency care. They identified 26 variables in nine domains from the original IFEM list of standards and two additional free text standards for the care of acutely ill children. This list may serve as a helpful guide for emergency centres to provide medical treatment for acutely ill children in resource-limited settings.
-
Paediatr Int Child Health · Feb 2017
Observational StudyIncidence, risk factors and outcome of acute kidney injury in critically ill children - a developing country perspective.
Acute kidney injury (AKI) is common in critically ill children and is associated with poor outcome. ⋯ A high incidence of AKI was noted in the PICU that was associated with high mortality. The RIFLE criterion is an effective tool which can be used not only for predicting the outcomes, but may help in the early identification of patients at risk for AKI.
-
Paediatr Int Child Health · Nov 2016
Case ReportsHuge epiglottic cyst: a rare cause of airway obstruction in an adolescent.
A 15-year-old boy presented with airway obstruction and a history of sore throat and progressive dyspnoea for 1 month. A lateral neck radiograph showed an enlarged epiglottis, and a neck computed tomography (CT) demonstrated a cyst attached to the lingual surface of the epiglottis. A large epiglottic cyst, 4 cm in length, was removed surgically. Epiglottic cysts have been reported to cause airway obstruction in neonates, infants and adults, but, to the best of our knowledge, it has rarely been reported in adolescents.
-
Paediatr Int Child Health · Nov 2016
Adverse drug reactions in Nigerian children: a retrospective review of reports submitted to the Nigerian Pharmacovigilance Centre from 2005 to 2012.
Adverse drug reactions (ADRs) in children recorded in national pharmacovigilance databases in high-income countries have been analysed. Nigeria has a population of 31 million children and became a member of the WHO Programme for International Drug Monitoring in 2004 since when it has been submitting reports of suspected ADRs to the WHO Global Individual Case Safety Report database, VigiBase. ⋯ Anti-infective agents (antibiotics, anti-malarials and anti-retrovirals) were associated with a majority of the ADRs. Stevens-Johnson syndrome was the most frequent severe ADR. Some of the fatalities were associated with sub-standard and herbal medications.