Asian Journal of Pediatric Research

Multisystemic Inflammatory Syndrome in Children: A Retrospective Study

E. Bahous — 2022-11-18

Introduction: Pediatric Multisystem Inflammatory Syndrome linked to temporal with SARS-Cov2 is a new hyper inflammatory disorder that affects children with Covid-19 infection. It usually occurs 2 to 6 weeks following illness or exposure.

Materials and Methods: Descriptive retrospective study of a cohort of 11 patients with MIS-C treated in the pediatric department of the Mohamed V military hospital in Rabat between December 2020 and September 2021. We analyzed the epidemiological, clinical, biological, imaging, therapeutical and evolutionary data of our patients.

Results: The average age is 9 years; the sex ratio is 1,2. The average exposure gap is 3.7 weeks. All patients presented with fever with multivisceral involvement, 81% presented digestive signs, 100% mucocutaneous signs, 63% cardiac signs and 54% neurological signs. Inflammatory markers were consistently high. Anemia (91%), neutrophilic leukocytosis (91%), lymphopenia (73%) are constant. The Covid-19 RT-PCR was negative and the SARSCov2 IgG serology testing was positive in all our patients. 54% of our cases have echocardiographic signs. Treatment was based on polyvalent intravenous immunoglobulins (IVIG) in all cases associated with corticosteroid therapy in 45% of cases and antiplatelet therapy in 91% of cases. The outcome was favorable in all of our patients.

Conclusion: MIS-C should be considered in children with fever, rash, headache, tachypnea, and gastrointestinal symptoms such as vomiting, diarrhea, and abdominal pain. Cardiogenic shock is the main complication. IVIG and systemic corticosteroid therapy are the fundament of treatment.

Evaluation of Heart Rate Variability in Children with Congenital Heart Diseases before and after Surgical Repair

Nashwa Ibrahim Ebied — 2022-11-10

Background: Surgical repair of congenital heart diseases (CHD) affects heart rate variability (HRV) in different ways. It leads to varying degrees of cardiac autonomic derangement, clinically detectable as depression of HRV parameters. The aim of this work was to evaluate HRV in children with CHDs before and after surgical repair to detect the effect of CHDs (acyanotic or cyanotic) and cardiac surgery on cardiac autonomic function.

Methods: This observational case-control study enrolled thirty cases with CHD. Cases were divided in two equal groups: group1 included children with CHDs (not repaired) before surgical intervention and group 2 included children after surgical repair of CHDs. Another fifteen healthy children, matched for age and sex, were enrolled as a control group. All children in this study were subjected to full history taking, clinical evaluation, Holter monitor, twenty-four-hour ambulatory electrocardiographic recordings and the seven time-domain indices of HRV.

Results: There was significant increase of HR in patients before surgical repair as compared to patients after surgical repair as compared to control group. There was significant decrease of PNN50, r MMSD, SDNN index and SDANN of children before surgical repair as compared to children after surgical repair as compared to controls. There was a negative significant correlation between HR and age before surgery, after surgery there was a negative significant correlation between HR and age, pNN50, rMMSD, SDNN index and SDANN, in control there was negative significant correlation with age, SDNN index, SDANN and SDNN.

Conclusion: HRV parameters increased significantly in children with CHDs after surgical repair as compared to these before surgical repair denoting effect of cardiac surgery on cardiac autonomic function.

Pattern of Neonatal Admissions and Care Outcomes in Special Care Newborn Unit of Cox’s Bazar District Hospital, Bangladesh

Olusola Oladeji — 2022-11-23

Background: Neonatal morbidity and mortality contribute significantly to under‑five morbidity and mortality. A substantial reduction in neonatal mortality is therefore necessary to achieve the Sustainable Development Goals targets.

Aims: Assessed the pattern of neonatal admission and care outcomes.

Place and Duration of Study: Special Care Newborn Unit of Cox’s Bazar District hospital, Bangladesh conducted in September 2022.

Methodology: Hospital-based retrospective study. Data extracted from the admission register and the records of 3982 newborns admitted between August 2021 and July 2022. Bivariate analysis using the Chi-square test, was performed to determine factors associated with neonatal mortality and p value was set at significant level of 5%.

Results: 3982 neonates were admitted, 2426 (61%) were male and 1556 (39%) were female with1071 (27%) from the hospital and 2911(73%) from outside the hospital. Birth asphyxia was the commonest morbidity,49% followed by Low Birth Weight/prematurity (18%) and neonatal sepsis 17%. 3,225 (81.4%) of the neonates admitted survived while 538 (13.5%) died and 203(5.1%) were discharged against medical advice. There was significant association between birth weight, morbidity pattern and mortality p<0.05) with most deaths associated with prematurity/LBW. There was significant association between neonatal mortality and the place of delivery, death among outborn was 16% compared with 7% among inborn (p<0.05) but no significant association between neonatal mortality and gender.

Conclusion: There was a high burden of neonatal care at the hospital and majority of causes of neonatal morbidity and mortality were preventable. There is need for holistic approach to pregnancy, delivery and newborn care to reduce neonatal morbidity and mortality in the district.

Guillain-Barré Syndrome and It’s Effect on Child Population

Anand Prakash Datta — 2022-11-18

Background: Guillian Barre Syndrome (GBS) is the most common cause of minor flaccid paralysis in the world and post-polio eradication is the most common cause on the Indian subcontinent as well. It affects 0.6-4 people per 1 lakh people per year. Guillian-Barre syndrome should be distinguished by a variation associated with inflammation of the cortical area of brain of chronic inflammatory polyneuropathy predicting prognosis and clinical course. Children have a better prognosis than adults and usually recover after a different period. However, in the Pressing event of the disease, the damage can be severe and can lead to mechanical failure and even death. There are a few studies in the indian subcontinent that show the effects of GBS in children and the effect of regional variability of the outcome. This study is therefore designed to study prospective clinicians, as well as the overall effect on children with GBS in India.

Objective: Studying the short-term and long-term effect of Guillian Barre Syndrome in children.

Methods: This is a health care infrastructurel-based study to be conducted at Acharya Vinoba Bhave Rural hospital (ABVRH) for a period of one year. All children under the age of 18 between August 2019 to July 2020 are admitted to the PICU and completing the comprehending criteria will be comprised in the study. Patient details regarding the progression of the disease, the results of the investigation, the PICU stay, clinical studies in the hospital, the treatment received and the state of discharge will be recorded in the pre-prescribed proforma. The data obtained will be analyzed simultaneously.

Conclusion: Information on factors associated with positive and negative outcomes in children with GBS will serve as a guide for your treating pediatrician to plan a treatment plan and will also help them explain their predictions to parents.