Open Access Case Study

A Case Report of Allergy to Peach’s Lipid Transfer Protein

F. Yatribi, F. Benbrahim, N. Elhafidi, S. Benchekroun, C. Mahraoui

Asian Journal of Pediatric Research, Page 22-25
DOI: 10.9734/ajpr/2021/v6i130186

Peach belongs to the Rosaceae family. One of the particularities of this allergy is the difference in clinical reactivity according to geography. We report a 4-year 8-month-old boy with well-controlled asthma and no symptoms of allergic rhinitis, that at the age of 1 year, 15 minutes after the ingestion of a fruit compote, presented urticaria with respiratory discomfort. At the age of 3 years, following ingestion of fruit salad, the child presented a few minutes later, a similar episode but of greater intensity. At the age of 4, following contact with a fruit basket, the child immediately presented a generalized reaction more severe and intense than the previous ones. Investigation of allergies to aerial allergens was negative. Skin tests for cooked and raw peach were positive for the peel and pulp. Specific-IgE was positive for Pru p 3 (5.7 KIU/l) and negative for Pru p 1. LTPs are particularly stable and resistant to proteolysis and heat. Management consisted of avoidance of peach, education of the child and family, and prescription of an emergency kit including self-injectable adrenaline. Our observation highlights the strong association between Pru p 3: peach’s Lipid Transfer Protein (LTP) positivity and the severity of allergy symptoms. We consider this case as a primary sensitization to peach’s LTP.

Open Access Case Study

Congenital Coagulation Factor XIII Deficiency Revealed by Convulsion: A Case Report

N. Mebrouk, T. Benouachane, L. Chtouki, F. Jabourik, A. Bentahila

Asian Journal of Pediatric Research, Page 26-29
DOI: 10.9734/ajpr/2021/v6i130187

Factor XIII deficiency is a rare inherited disease, with a particularly high risk of intracerebral hemorrhage. We report the case of a newborn who was suspected to have a coagulation disorder at birth, due to an intracerebral hemorrhage. A quantitative dosage of factor XIII was requested but the usual coagulation tests (thromboplastin, thrombokinase, fibrinogen) were normal.  Because of unavailability of specific treatment with factor XIII concentrate, the patient was treated with fresh frozen plasma.  The initial dose was for normalizing factor XIII; subsequent monthly doses were designed for preventing the occurrence of serious bleeding.

Open Access Original Research Article

Microbiological Profile and Sensitivity Data among the Neonatal Population from a Tertiary Care Hospital in South India

Mohamed Reshad, Balachandran Binesh, Moideen Sharief, Muheidheen Shad

Asian Journal of Pediatric Research, Page 1-6
DOI: 10.9734/ajpr/2021/v6i130183

Background: Sepsis is one of the most common causes of mortality and morbidity among neonates. The prevalence of microorganisms varies with regions, and the sensitivity pattern also changes over time.  

Aim: To study the prevalence of various microorganisms and their sensitivity pattern among the neonatal population in a tertiary care hospital in South India.

Methods: This was a retrospective descriptive study. We screened the records of all neonates admitted to the hospital during a period starting from January 1st, 2016, to September 30th, 2018. The details of the patients with any sterile body fluids showing microbial growth were collected. Descriptive analysis was done using IBM SPSS version 20.

Results: There were 77 organisms isolated during the study period, with the majority among outborn babies. Seventy-two isolates were from blood, two from CSF and urine, with one from the central line. The most common organism was Klebsiella (22%), followed by Burkholderia cepacia (12%), Staphylococcus aureus (9%), and Streptococcus agalactiae (7%). 9% of the organisms were fungus, with the most common being Kodamaea Ohmeri. Among the antibiotics tested for sensitivity, Meropenem had the maximum sensitivity ratio (84%), followed by Co-trimoxazole (83%) and Vancomycin (82%). Piperacillin tazobactam sensitivity was only 56%, and Ciprofloxacin was sensitive in 65% of cases. Most (6 out of 7) of the fungal isolates were sensitive to fluconazole.

Conclusions: Klebsiella remains to be the most common organism causing severe infection in young infants. Worrying rise in the incidence of uncommon organisms (like Kodamaea Ohmeri, GBS, Burkholderia) and carbapenem resistance was noted.  It is, therefore, essential to update the antibiotic policy of the neonatal units on a timely basis.

Open Access Original Research Article

Guidewire for Retrograde Passive Dilatation of Ureter in Pediatric Patients with Urolithiasis: A Novel Technique from a Tertiary Center in Nepal

Uspal Bahadur Bajracharya, Anil Kumar Sah, Rajeev Kumar Pandit, Guna Kumar Shrestha

Asian Journal of Pediatric Research, Page 7-12
DOI: 10.9734/ajpr/2021/v6i130184

Objective of the Study: We sought to evaluate the role of guidewire placement as ureteral stent in passive ureteral dilatation for uretero-renoscope negotiation in pediatric patients.

Study Designs: This was a prospective cross-sectional study.

Place and Duration of the Study: Department of Urology, Manmohan Memorial Medical College and Teaching Hospital, Kathmandu, Nepal, (December 2019 to November 2020).

Methodology: All pediatric patients (<18 years) diagnosed with more than 6mm size of distal ureter stone undergoing ureteroscopic lithotripsy under general anesthesia in which ureteroscope (4.5/6.5 Fr) negotiation and double J (DJ) ureteral stent (4 Fr) insertion could not be successful in first sitting were selected for the study. Data collection included demographics, clinical parameters, and perioperative and postoperative complications of those patients undergoing preoperative ureteral stenting with guidewire for 2 weeks for ureteroscopic management of ureteric stone after removal of guidewire. The statistical analysis of data was done using Microsoft Excel.

Results: A total of 12 (41 %) cases underwent passive dilatation of ureter with guidewire. The mean age of the patients and mean stone size were 8.42 ± 1.7 years and 6.1 ±0.65mm respectively. None of the patients developed intraoperative and postoperative complications related to the procedure.

Conclusion: Guidewire placement as ureteral stent for 2 weeks would result sufficient passive ureteral dilatation for the ureteroscope negotiation without any complication. PUD with guidewire is safe and effective. Additional research is necessary to determine whether the findings will be similar or not.

Open Access Original Research Article

Peripheral Neutrophil- Lymphocyte Ratio as a Predictor of Seizure in Preterm Infants with Intra-Ventricular Hemorrhage

Heba Ibrahim Ashraf, Mai Rabie El-Sheikh, Abd El-Rahman Mohamed El-Mashad

Asian Journal of Pediatric Research, Page 13-21
DOI: 10.9734/ajpr/2021/v6i130185

Background: Preterm infants with Intra-Ventricular Hemorrhage (IVH) are at risk for developing significant complications, including post hemorrhagic hydrocephalus and seizures. Neonatal seizures are the most common overt manifestation of neurological dysfunction in the newborn, and is associated with short- and long-term adverse effects.

Objective: The aim of the study is to evaluate the value of Peripheral Neutrophil- lymphocyte ratio (NLR) as a predictor of seizure in preterm infants with intra-ventricular hemorrhage.

Methods: This prospective cohort study that comprised 60 Preterm infants with IVH admitted at NICU pediatric department Tanta university hospital from November 2019 to May 2020, Preterm infants were divided into two groups according to incidence of seizure.

Preterm infants in this study subjected to Careful history taking, clinical examination and investigations (laboratory and Trans-cranial ultrasound) as well as analysis of result and follow up clinical status for development of seizure.

Results: There was a statistically highly significant difference regarding NLR and development of seizure with p value <0.001 (NLR ≥ 2.3 with sensitivity 96%, specificity 93%, Area under the curve 0.849 and accuracy 84.9%).

Conclusion: NLR is a predictor of seizure in preterm infants with intra-ventricular hemorrhage.