Journal of tropical pediatrics
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Fulminant hepatic failure is a rare and devastating event during childhood. The etiology of liver failure is reported to change according to age and geographical location. We aimed to investigate, retrospectively, causes and outcome of fulminant hepatic failure in Turkish children. ⋯ Encephalopathy grade, total and indirect bilirubin levels were found to be significantly higher in patients who died (p = 0.004, p = 0.03, p = 0.04). Seven patients could have been transplanted (two cadavaric, five living related) and the mortality of this group was 28.5 per cent (n = 2). It was concluded that fulminant hepatitis A virus (HAV) infection is the most common detectable cause of fulminant hepatic failure in Turkish children.
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Data on the incidence of hypocalcaemia in critically ill children admitted to a Paediatric Intensive Care Unit (PICU) is scarce, especially from developing countries. We have studied serum calcium in a prospective cohort of 100 children (68 boys, 32 girls), admitted consecutively to a PICU of a tertiary-care teaching hospital and correlated it with the outcome. Venous blood was obtained for serum calcium, magnesium, sodium, potassium, and arterial blood for ionized calcium and pH at admission and on every alternate day of hospital stay. ⋯ Correlation between serum total and ionized calcium levels was not significant (r = 0.25, p = 0.089). Mortality was significantly higher in hypocalcaemic (28.3 per cent) compared with normocalcaemic (7.5 per cent) patients (p < 0.05). We conclude that hypocalcaemia is common in critically ill children admitted to a PICU and is associated with higher mortality.
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The aim of this study was to determine the relative frequency of underlying illnesses for recurrent pneumonia in children. Children who had two or more episodes of pneumonia per year, or three or more episodes in a lifetime were investigated retrospectively at Ankara University Medical School, Department of Pediatric Infectious Diseases, between January 1997 and October 2002. Out of 788 children hospitalized for pneumonia, 71 (9 per cent) met the criteria for recurrent pneumonia. ⋯ In conclusion, approximately one-tenth of hospitalized children with pneumonia in our hospital had recurrent pneumonia. Most of these children had an underlying illness, which was demonstrated by intensive investigation. Bronchial asthma in children aged more than 2 years and gastroesophageal reflux in children aged less than 1 year were the most common underlying illnesses for recurrent pneumonia.
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The aim of the present study was to study the epidemiological and clinical profile of patients attending an exclusive pediatric Emergency Department (ED). Data was retrieved from records of the patients seen over a 6-year period from 1995 to 2000. Descriptive analysis was done to define demographic and clinical details, and monthly admission rates and diagnoses. ⋯ Eight illnesses, i.e. acute diarrhea, upper respiratory infection, pneumonia, acute asthma, seizures, meningitis, and neonatal sepsis and jaundice, comprised nearly half of all the emergency visits. Acute diarrhoeal diseases, pneumonia, asthma, and encephalitis showed a distinct seasonal trend. Our data implies that planning of staff training and triage and efficient resource utilization in the pediatric ED in a developing country such as ours should take into consideration the preponderance of infants, seasonal trends, and the most common emergencies (acute diarrhea, pneumonia, acute asthma, seizures and neonatal infection) as priorities.
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The Genetic Blood Disorders Survey is the first community-based survey in the Arabic world and the Middle East to determine the prevalence of the most common genetic blood disorders. The objective of the survey was to determine the prevalence of the most common genetic blood disorders reported among Omani children under 5 years of age in order to provide the planners and policy-makers with reliable information suitable for formulating health policies, planning, and evaluation. The survey was designed, executed, and financed by the Ministry of Health of the Sultanate of Oman. ⋯ Total consanguinity rate including second cousin relationships and beyond was 58 per cent. We recommend that a national prevention programme for genetic blood disorders be formulated by the authorities. The programme could be included in the Ministry of Health 5-year health development programme for prevention of non-communicable diseases which already exists.