Journal of tropical pediatrics
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Review Comparative Study
Kernicterus and G6PD deficiency--a case series from Oman.
The relationship between glucose-6 phosphate dehydrogenase (G6PD) deficiency and jaundice in the newborn period is well recognized. However, there is concern about the increasing incidence of kernicterus being reported worldwide, especially due to unrecognized G6PD deficiency and early discharge from hospital after birth. ⋯ Fourteen cases of kernicterus were seen during a time period of 6 years, 71 per cent of them had G6PD deficiency. Recent literature is reviewed and possible preventive measures in the light of current information and practices are suggested.
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The aim of this prospective study was to evaluate the use of pediatric risk of mortality (PRISM) score to predict the patient outcome in Alexandria Pediatric Intensive Care Unit (PICU). The study included all admissions to a tertiary care teaching hospital for 13 months. All patients were subjected to thorough history taking and clinical examination. ⋯ Multiple logistic regression analysis revealed that PRISM score, LOS, and the primary affected system were relevant predictors of patient outcome in PICU. In conclusion, the PRISM score is proved to be a good predictor of outcome for children admitted to a PICU with a cut-off point of 26. The mortality in the PICU is affected by LOS, primary system affected, and number of organ failure on admission.
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Data on magnesium disturbances in critically ill children admitted to a Paediatric Intensive Care Unit (PICU) are scarce, especially from developing countries. We have studied occurrence and incidence of hypo- and hypermagnesaemia in children admitted to a PICU and the correlation between such disturbances and the outcome of illness. A total of 100 children (68 boys, 32 girls) aged 6 months to 12 years (mean +/- SD 4.9 + 3.5 years) admitted consecutively to a PICU were studied. ⋯ Mortality was nine-fold higher in hypomagnesaemic (30 per cent, 19 of 63) compared with normomagnaesemic (3.3 per cent, one of 30) patients. If Mg and Ca both were low, the mortality rate was 33 per cent (15 of 45 patients) in contrast to nil if both were normal (p < 0.05). We conclude that hypomagnesaemia and low RBC-Mg are a common occurrence in PICU patients and are associated with higher mortality.
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Cryptococcus neoformans is an infrequent cause of meningitis in children. We report two cases of HIV positive children of HIV non-reactive parents who were diagnosed as suffering from cryptococcal meningitis. Treatment with amphotericin B and flucytosine was instituted in both the children who recovered and are doing well.
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Randomized Controlled Trial Clinical Trial
Randomized comparison of oxygen mask treatment vs. nasal continuous positive airway pressure in dengue shock syndrome with acute respiratory failure.
Dengue hemorrhagic fever (DHF) is caused by dengue virus. Patients with DHF grade 3-4, termed Dengue Shock Syndrome (DSS), may develop acute respiratory failure after initial fluid resuscitation. Previously, these patients were treated with oxygen on a nasal cannula, or if necessary with tracheal intubation and mechanical ventilation. ⋯ However, subsequently a significant difference of unresponsiveness to treatment between the oxygen mask group and the NCPAP group (13/19 vs. 4/18,p < 0.01) was noted. Complications of NCPAP or oxygen mask treatment were not documented. We conclude that NCPAP is useful in improving the management of acute respiratory failure in children with DHF/DSS in dengue-endemic areas.