Open Access Letter to the Editor
The “Type of Article” of this paper is “Letter to the Editor”. This paper discuses about: “Effect of COVID-19 on Routine Pediatric Vaccination”. No formal abstract is available. Readers are requested to read the full article.
Open Access Short Communication
Aims: To firstly determine the incidence of acute renal failure (ARF) related to malaria in a series of 11 cases among admitted patients at the pediatric hospitals in Dakar, Senegal and to lastly measure the performance of rapid diagnostic test (RDT) and microscopy in malaria diagnosis using polymerase chain reaction (PCR) as a gold standard.
Study Design: A bi-centric and descriptive study was carried out.
Place and Duration of Study: From June 2018 to January 2019 in two university hospitals of Dakar, Senegal: Aristide Le Dantec university hospital and Albert Royer university hospital.
Methodology: Pediatric patients aged under 18 years with confirmed malaria by RDT or microscopy and ARF defined by anuria or oligo-anuria and a decrease in glomerular filtration rate were included. Nested PCR was performed to confirm malaria diagnosis and Plasmodium species typing.
Results: In total, 11 ARF cases (8.5%) related to malaria among 130 children infected with malaria parasites were included out of 4,474 hospitalized. Affected children were aged between 2 and 16 years with a mean age of 11 years and a sex ratio of 0.57. For malaria diagnosis, RDTs were positive for all patients while microscopy only revealed 6 cases (54.5%) as well as PCR. However, microscopy and PCR presented two discrepancies. Considering PCR as the gold standard tool, RDT showed a relative high sensitivity (100%) and zero specificity with a positive predictive value (PPV) of 54.6% while microscopy respectively showed a sensitivity and a specificity of 66.7 and 60%.
Conclusion: This study showed the relatedness between ARF and P. falciparum malaria. Even though microscopy remains the gold standard for the diagnosis of malaria but microscopists must be regularly trained. In addition, RDT should always be confirmed by microscopy and preferably by PCR.
Open Access Original Research Article
Background: Children with vesicoureteral reflux (VUR) are posed to the danger of recurrent pyelonephritis, kidney scar and renal failure. Nowadays, the evaluation of VUR is carried out using different imaging methods that are accompanied with different limitations. Pediatricians usually look for other evaluation methods that are feasible, easy to implement and carries the least amount of danger to the patient.
Objectives: The aim of this study was to investigate the level of serum Procalcitonin (PCT) as a predictor of VUR instead of the voiding cystourethrogram (VCUG).
Methods: This case-control study was conducted from 2013 to 2014. One hundred and ten children younger than five years old were divided into two groups: (i) the case group with 76 children diagnosed with urinary tract infection (UTI) using urine culture test, and (ii) the control group with 34 healthy children. Serum levels of PCT were measured by a commercial kit. Demographic data were collected using a questionnaire and analyzed by software SPSS.
Results: Of the samples, 69.1% of them had no VUR, 20% and 10.9% of the samples suffered from severe unilateral VUR and severe bilateral VUR, respectively. With regard to the level of serum PCT, 61.8% of the samples were positive. One-half of those samples (38 people) who was diagnosed to be healthy had a normal level of serum PCT. However, 30 people (88.2%) of the samples diagnosed to be healthy using VCUG had increased level of serum PCT. The positive and negative predictive values of the level of serum PCT were 44% and 90%, respectively. In this respect, 50% of the samples diagnosed by using level of serum PCT were false positive and 11.8% were false negative. The kappa score for the level of serum PCT was 0.3 (P < 0.0001). The positive predictive value of the serum level of PCT for the female and male samples were 43% and 50% respectively.
Conclusions: There was no statistically significant relationship between VUR and the serum level of PCT.
Open Access Original Research Article
Background: Diarrhoea is one of the commonest causes of death in children in developing countries. Proper home management can reduce morbidity and mortality. High rates of dietary restriction, poor knowledge of preparation of ORS solutions and low attention given to clinical indicators are causes for seeking hospital management. This study was done to observe the knowledge of caregivers regarding home management of acute watery diarrhoea and to assess the impact of home management on severity of dehydration.
Methods: This study was a prospective study carried out on children with acute diarrhea who attended outpatient department (OPD) of Rangpur Medical College Hospital and duration of the study was 6 months. A total of 100 cases were included in this study who fulfilled the definition of acute diarrhea by WHO. The investigator questioned each mother with the help of a preformed questionnaire.
Results: In 85% of cases, caregivers perception about diarrhea was an increase in the frequency and fluidity of stool. About 95% of cases were initially treated at home; treatment was given at home with ORS (95%). There was change in feeding pattern and modified food was given (24%). Perception about ORS preparation was appropriate in 64% and inappropriate in 31% of cases. Inadequate amount of ORS was given in 74% cases. There was no interruption of breast feeding; dietary restriction during diarrhoea was observed only in 2% cases. Most of the parents did not know when to return immediately to hospital. Dehydration status of diarrhoeal cases was no dehydration (81%), some dehydration (18%) and severe dehydration (1%). In majority of the cases different drugs were used.
Conclusion: Most of the caregivers’ decided to treat diarrhoea at home. Many of them had wrong perception about preparation of ORS and some of them did not know how to make ORS solution. Inadequate amount of ORS was given in most of the cases. Thus to lessen hospital burden and to prevent dehydration increased emphasis should be given to health education of home management of diarrhea.
Open Access Original Research Article
Aims: To understand the accuracy of non-invasively obtained blood pressure gradients (cuff vs Doppler gradient) with an invasively measured pressure gradient.
Study Design: Retrospective study.
Place and Duration of Study: Department of Pediatrics, Section of Pediatric Cardiology, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia, between Jan, 2010 till Jan, 2020.
Methodology: A retrospective study of patients with CoA who underwent cardiac catheterization between Jan, 2010 till Jan, 2020 was performed. Cuff BP gradients and Doppler echocardiography were measured prior to cardiac catheterization and afterwards, when an intervention was performed. Student t test and Bland-Altman analysis were performed.
Results: 55 patients with aortic coarctation underwent 92 cardiac catheterizations. Among them 75 needed interventions. This resulted in a total of 162 cardiac catheterizations (cath), from them 67 pressure gradients included in the analysis. There was no statistically significant difference between mean Doppler measurements and invasively derived catheter gradients (p=0.12). In contrast peak Doppler measurement (p < 0.00001) and cuff blood pressure gradients (p=0.03) showed significant differences to the cath gradient. We found that cuff blood pressure gradients accurately reflected cath measurement in native COA (p=0.40) and in those who weigh less than 10 kg (p=0.67). Mean Doppler measurements had a small tendency for underestimation. Peak Doppler gradient and cuff pressure gradient usually overestimated cath measurement.
Conclusion: The mean Doppler echocardiography seems to be the most accurate among the other noninvasive methods in use to estimate severity of aortic coarctation. It provided reasonable agreement with the invasively obtained aortic coarctation gradient.