Open Access Case Study

Neonatal hypocalcemic Seizures: About a 41-Day-Old Infant

A. Radi, O. Bakkali, M. Kmari, A. Ourrai, A. Hassani, R. Abilkassem, A. Agadr

Asian Journal of Pediatric Research, Page 9-14
DOI: 10.9734/ajpr/2020/v3i430133

Neonatal crises have several etiologies. Hypovitaminosis D and hypocalcemia are the most common cause of childhood seizures, but their frequency has been reduced due to vitamin D supplementation and infant formula. Most hypocalcemic crises have an underlying endocrinological origin rather than a deficit in intake. We describe the case of a 41-day-old infant admitted for neonatal seizures for hypocalcemia. Although symptoms and concentrations of calcium and parathyroid hormone (PTH) levels favored isolated congenital hyperparathyroidism after eliminating other differential diagnoses. The course of the disease was favorable with intravenous (IV) calcium gluconate 10%, then orally alfacalcidol and vitd2. The case is presented with a brief review of the pathophysiology, differential diagnosis and treatment of neonatal hypocalcemia.

Open Access Case Study

Concurrent Sickle Cell Anemia and Diabetes Mellitus with Ketosis in a Libyan Toddler: First National Report and Youngest Case Study

Moftah Alhagamhmad, Alia Alhassony, Abdulhamid ., Aisha Elarwah, Shirin Alougly, Suliman Elbrgathy, Nuri Shembesh, Emhemed Mousa

Asian Journal of Pediatric Research, Page 15-19
DOI: 10.9734/ajpr/2020/v3i430134

Sickle cell Anemia (SCA) is a common inherited haemoglobinopathy resulting from a single-point mutation on the β-globin subunit of hemoglobin. It is a chronic condition with multi-system involvement. Growth delay, osteopenia and hypogonadism are common endocrine dysfunctions with a lower frequency of impaired glucose tolerance. However, there is an association between SCA and diabetes mellitus (DM), though it is very rare. Certainly, there are only a few published reports worldwide outlined this uncommon combination. In this report, we will present the first Libyan case study of co-existence of the two diseases in a-16-month-old male toddler recording the youngest patient diagnosed with such a rare combination. The child, who was diagnosed earlier with SCA, brought with concerns of frequent changing nappies (polyuria) and excessive thirst (polydipsia) for 2 weeks that worsened recently. On admission, the toddler was distressed, lethargic and his lab parameters showed hyperglycemia, ketonuria, glycosuria and acidosis, a diagnosis of diabetic ketoacidosis (DKA) on the background of SCA therefore was made. Further observations are warranted to properly guide about the diagnosis and management of such rare cases.

Open Access Case Study

A Painful Shoulder Revealing Langerhans Cell Histiocytosis

N. A. R. Ranaivo, M. L. Rakotomahefa Narison, M. Bemena, S. H. Raobijaona

Asian Journal of Pediatric Research, Page 24-27
DOI: 10.9734/ajpr/2020/v3i430137

Introduction: Langerhans cell histiocytosis is a systemic proliferative disease. It is a rare disease that can affects all tissues. Evolution can be spontaneously favorable. Multi-organ involvement may be life-threatening. We report the case of an toddler with bone lesion and issues.

Case Report: It was a 33-month-old infant with right shoulder pain. Clinically, she had a swelling in the front side of the right shoulder with a limited abduction. X-ray of the right shoulder showed osteolysis with an irregular boundary of the right humeral head. The blood work was normal. In view of the painful swelling of the right shoulder, a biopsy was performed. Histological examination confirmed the diagnosis of Langerhans histiocytosis. A conservative treatment was decided after a multidisciplinary consultation meeting. After six months, spontaneous improvement was noted.

Conclusion: Langerhans cell histiocytosis is a proliferative pathology that can affect one or more organs. The clinical presentation is polymorphic according to the affected organ. An extension assessment is fundamental in the management in order to determine the treatment.

Open Access Short Research Article

The Rate of Hospitalizations and Intensive Care Admissions in Boston Children Hospital

Rajeev Nagpal, Stanislav Seltser, Nitender Goyal

Asian Journal of Pediatric Research, Page 20-23
DOI: 10.9734/ajpr/2020/v3i430136

Much remains unknown about the overall impact of COVID-19 on the pediatric population because of the relative low incidence of symptomatic pediatric cases compared to other age groups. Recent anecdotal reports of rare and unique illnesses related to COVID-19 in this population calls for a more robust analysis. A time series analysis from open source Center for Disease Control (CDC) data on Boston Children’s Hospital over a three-week period from April 21, 2020 thru May 9, 2020 was completed. An overall downward trend of both COVID-19 hospitalizations and patients requiring Intensive Care Unit (ICU) care was found. Moreover, the ratio of patients hospitalized requiring ICU treatment decreased. These findings suggest that pediatric patients were seen earlier in the course of illness as reports emerged linking COVID-19 to symptomatic and life-threatening illness in children. This data is intended to raise this general issue to the broad readership of The Asian Journal of Pediatric Research.

Open Access Original Research Article

A Retrospective Study of Pediatric Urinary Tract Infections of Tamatave University Hospital Center, Madagascar

Arthur Bien Aimé Ratsimbazafy, Andry Maharo Andrianarivelo, Narison Mbolanirina Lala Rakotomahefa, Heriniaina Rakotoarisoa, Van Cuong Miora Anissa, Jean De La Croix Rasolonjatovo, Norotiana Rabesandratana

Asian Journal of Pediatric Research, Page 1-8
DOI: 10.9734/ajpr/2020/v3i430132

Urinary tract infection (UTI) is very common in children. The future of kidney function depends on its management.

Our objective was to investigate the epidemio-clinical, bacteriological and therapeutic profile of UTIsin the Pediatric Department of Tamatave University Hospital Center, Madagascar for better care of children.

Methods: This is a retrospective and descriptive study that was carried out in the Pediatrics Department of Tamatave University Hospital over a three-year period from January 1, 2017 to December 31, 2019. The parameters retained and studied were age, gender, clinical signs, pathogens identified with the results of the antibiotic susceptibility tests and the treatments received.

Results: The frequency of UTI was 7.46%. The average age was 11.21 months, with extremes of 2 to 120 months. Fever was the main symptom found (80.95%) followed by urinary signs. Escherichia coli was the most frequently isolated bacteria (61.90%). Almost all of the isolates found (98%) were resistant to amoxicillin, tetracycline and cotrimoxazole. Ceftriaxone alone was the most used (44.44%).

Discussion: This study suggests that gentamicin and ceftriaxone (even though ESBLs were found) should be included in the treatment protocol for UTIs in the absence of an antibiogram, which is not always available in our context.