Multisystem Inflammatory Syndrome in Children: Experience from October 2020 to January 2021 at a tertiary hospital in Navi Mumbai, India

2021 ◽  
Author(s):  
Priyanka S. Amonkar ◽  
Suhas N. Kharche ◽  
Amol A. Madave ◽  
Jeetendra B. Gavhane
Keyword(s):  
Renal Failure ◽  
Pulmonary Involvement ◽  
Tertiary Hospital ◽  
World Health ◽  
Febrile Child ◽  
Common System ◽  
Multisystem Involvement ◽  
Health Organization ◽  
Atypical Presentations ◽  
Inflammatory Syndrome

AbstractAlthough presentation of multisystem inflammatory syndrome (MIS-C) in children is typically with fever and symptoms like diarrhea, vomiting, rash, conjunctival injection, or shock, the spectrum of associated multisystem involvement is wide. Here, we present an account of patients with MIS-C that presented at a tertiary hospital in Navi Mumbai, India in the latter half of the pandemic from October 2020 to January 2021. We retrospectively studied the clinical features of 12 patients satisfying World Health Organization criteria for MIS-C. Eleven (91.6%) required PICU admission. Median age was 7 years and two had comorbidity. At the time of presentation, eight (66.6%) had respiratory failure, four (33.3%) had shock, and one (8.3%) had renal failure. The most common system involved was respiratory (75%) followed by mucocutaneous manifestations (66.6%). Seven patients (58.3%) showed involvement of >4 systems. Atypical presentations included a 14-year-old male with COVID-19 like pulmonary involvement on computed tomography, and a 20-month-old male with gross hematuria, nephrotic range proteinuria, and rapidly progressive renal failure. Elevated N-terminal-pro B-type natriuretic peptide was seen in 75% patients and abnormal two-dimensional echo in 50%. All patients were treated with intravenous methylprednisolone at 30 mg/kg/day for 5 days. Death occurred in three (25%), all of whom had hypotensive shock at presentation. In the wake of an ongoing pandemic, any febrile child with nonspecific symptoms suggestive of multisystem involvement warrants suspicion of MIS-C and should be evaluated with the help of markers of systemic inflammation and organ involvement, after ruling out other obvious causes. We report good response to methylprednisolone in patients without hypotensive shock at presentation and its use as firstline drug may be considered in settings with financial constraints.

scholarly journals Multisystem inflammatory syndrome in an adolescent girl presenting as atypical Kawasaki-like illness associated with coronavirus disease-19

2021 ◽  
Vol 8 (8) ◽  
pp. 302-304
Author(s):  
Meghmala Sadhukhan ◽  
Ranjit K. Joshi ◽  
Prabin P. Pahi
Keyword(s):  
Intensive Care ◽  
Coronary Artery ◽  
Adolescent Girl ◽  
Similar Case ◽  
World Health ◽  
Intensive Care Admission ◽  
Multisystem Involvement ◽  
The World ◽  
Health Organization ◽  
Inflammatory Syndrome

During the current pandemic of Coronavirus disease (COVID)-19, multiple cases of a new condition in children have been reported with multisystem involvement associated with severe acute respiratory syndrome coronavirus-2, requiring intensive care admission. The World Health Organization has defined it as multisystem inflammatory syndrome in children and adolescents. Here, we report a similar case of a 15-year-old adolescent who presented with clinical features of Kawasaki-like illness along with multisystem involvement. The echocardiogram suggested the presence of coronary artery dilatation and the patient responded well to Intravenous immunoglobulin. Hence, pediatricians need to be aware of this condition in children with multisystemic involvement and these patients need to be treated as early as possible since they may deteriorate quickly.

scholarly journals Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania

2020 ◽  
Vol 6 (1) ◽  
pp. 1
Author(s):  
Boushab Mohamed Boushab ◽  
Mohamed Salem Ould Ahmedou Salem ◽  
Ali Ould Mohamed Salem Boukhary ◽  
Philippe Parola ◽  
Leonardo Basco
Keyword(s):  
Renal Failure ◽  
Respiratory Distress ◽  
Severe Malaria ◽  
Falciparum Malaria ◽  
Clinical Features ◽  
Signs And Symptoms ◽  
Plasmodium Falciparum Malaria ◽  
Severe Anaemia ◽  
World Health ◽  
Health Organization

Severe malaria in adults is not well-studied in Sahelian Africa. Clinical features and mortality associated with severe Plasmodium falciparum malaria in adult patients hospitalized in Kiffa, southern Mauritania, were analysed. Patients over 15 years old admitted for severe malaria between August 2016 and December 2019 were included in the present retrospective study. The World Health Organization (WHO) criteria were used to define severe malaria. The presenting clinical characteristics and outcome were compared. Of 4266 patients hospitalized during the study period, 573 (13.4%) had a positive rapid diagnostic test for malaria, and 99 (17.3%; mean age, 37.5 years; range 15–79 years; sex-ratio M/F, 2.1) satisfied the criteria for severe malaria. On admission, the following signs and symptoms were observed in more than one-fourth of the patients: fever (98%), impairment of consciousness (81.8%), multiple convulsions (70.7%), cardiovascular collapse (61.6%), respiratory distress (43.4%), severe anaemia ≤ 80 g/L (36.4%), haemoglobinuria (27.3%), and renal failure (25.3%). Patients were treated with parenteral quinine or artemether. Fourteen (14.1%) patients died. Multiple convulsions, respiratory distress, severe anaemia, haemoglobinuria, acute renal failure, jaundice, and abnormal bleeding occurred more frequently (p < 0.05) in deceased patients. Mortality due to severe falciparum malaria is high among adults in southern Mauritania. An adoption of the WHO-recommended first-line treatment for severe malaria, such as parenteral artesunate, is required to lower the mortality rate associated with severe malaria.

Myocarditis Prevalence in Paediatric Dengue Infection: A Prospective Study in Tertiary Hospital in Yogyakarta, Indonesia

2019 ◽  
Vol 65 (6) ◽  
pp. 603-608
Author(s):  
Sarah Buntubatu ◽  
Endy P Prawirohartono ◽  
Eggi Arguni
Keyword(s):  
Creatine Kinase ◽  
Prospective Study ◽  
Troponin I ◽  
Dengue Infection ◽  
Dengue Shock Syndrome ◽  
Tertiary Hospital ◽  
World Health ◽  
Exact Test ◽  
Creatine Kinase Mb ◽  
Health Organization

Abstract Awareness of cardiac involvement in dengue infection has potentially valuable management implications. To determine the prevalence of myocarditis in dengue severity, we conducted prospective study of paediatric dengue illness at Dr. Sardjito General Hospital, a tertiary hospital in Yogyakarta, Indonesia, from period of July 2015 to May 2016. World Health Organization (WHO) Dengue Guideline 2011 classification system was used. Diagnosis of dengue infection was made based on either by dengue serology and/or NS1 test. Myocarditis was assessed based on elevation of cardiac enzymes, as creatine kinase (CK), creatine kinase-MB (CK-MB), Troponin I (TnI) and by electrocardiography (ECG). Proportion between groups was compared using the Fisher’s exact test. We analysed 50 children with diagnosis of dengue fever (DF), 12 of dengue haemorrhagic fever (DHF) and 23 of dengue shock syndrome (DSS). Myocarditis diagnosed in 53%, 75% and 96% of DF, DHF and DSS, respectively. We found that myocarditis was more prevalent significantly in DSS than DF (p = 0.003).

scholarly journals Quality of Life and Migraine Disability among Female Migraine Patients in a Tertiary Hospital in Malaysia

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Munvar Miya Shaik ◽  
Norul Badriah Hassan ◽  
Huay Lin Tan ◽  
Siew Hua Gan
Keyword(s):  
Quality Of Life ◽  
Psychological Health ◽  
Tertiary Hospital ◽  
Poor Quality ◽  
World Health ◽  
Control Group ◽  
Healthy Controls ◽  
Pain Scores ◽  
Health Organization

Background. Disability caused by migraine may be one of the main causes of burden contributing to poor quality of life (QOL) among migraine patients. Thus, this study aimed to measure QOL among migraine sufferers in comparison with healthy controls.Methods. Female diagnosed migraine patients (n= 100) and healthy controls (n=100) completed the Malay version of the World Health Organization QOL Brief (WHOQOL-BREF) questionnaire. Only migraine patients completed the Malay version of the Migraine Disability Assessment questionnaire.Results. Females with migraines had significantly lower total WHOQOL-BREF scores (84.3) than did healthy controls (91.9,P<0.001). Similarly, physical health (23.4 versus 27.7,P<0.001) and psychological health scores (21.7 versus 23.2,P< 0.001) were significantly lower than those for healthy controls. Seventy-three percent of patients experienced severe disability, with significantly higher number of days with headaches (13.8 days/3 months,P< 0.001) and pain scores (7.4,P< 0.013). Furthermore, migraine patients with lower total QOL scores had 1.2 times higher odds of having disability than patients with higher total QOL scores.Conclusions. The present study showed that migraine sufferers experienced significantly lower QOL than the control group from a similar population. Disability was severe and frequent and was associated with lower QOL among the migraine patients.

scholarly journals Refractory Multi-Inflammatory Syndrome in a Two Weeks Old Neonate with COVID-19 Treated Successfully with Intravenous Immunoglobulin, Steroids and Anakinra

2020 ◽  
Vol 5 (4) ◽  
Author(s):  
Magboul S
Keyword(s):  
Intravenous Immunoglobulin ◽  
Clinical Course ◽  
Virus Disease ◽  
Interleukin 1 ◽  
Signs And Symptoms ◽  
World Health ◽  
Case Presentation ◽  
Health Organization ◽  
Inflammatory Syndrome ◽  
Pulse Steroid

Background: World Health Organization (WHO) and other Health officials alert clinicians about a rare but severe inflammatory condition seen in children and linked to Corona Virus Disease 2019(COVID-19). The WHO is describing the condition as a multisystem inflammatory syndrome in children (MIS-C) and is recommending clinicians to report those cases to get a better understanding of the disease and clinicians can learn more. Case Presentation: We are reporting the clinical course of the youngest case of COVID-19 related MIS-c; a two-week-old term neonate with COVID-19 infection and features suggestive of MIS-C, managed with intravenous immunoglobulin (IVIG), pulse steroid, and interleukin-1 inhibitor (Anakinra). By reviewing the literature, our baby is the first neonatal case who has been diagnosed with MIS-C. Conclusion: COVID-19 infections in pediatrics are likely to present with a mild course; however, some may develop a hyperinflammatory syndrome. Pediatricians should be aware of such presentation, the clinical course, the management modalities,and inform parents and caregivers about common signs and symptoms. Anakinra may consider as effective second agent in (IVIG and steroid-refractory pediatric cases).

scholarly journals Multisystem inflammatory syndrome in children - a clinical example in pediatrics

2021 ◽  
Vol 25 (2) ◽  
pp. 258-260
Author(s):  
V. M. Dudnyk ◽  
V. Н. Furman ◽  
I. I. Andrikevych ◽  
N. O. Buglova ◽  
O. V. Кutsak ◽  
...  
Keyword(s):  
Serological Test ◽  
World Health ◽  
Rt Pcr ◽  
The Us ◽  
Control And Prevention ◽  
Coronavirus Infection ◽  
Polymerase Chain ◽  
Health Organization ◽  
Inflammatory Syndrome

Annotation. Peculiarities of clinical course and differential diagnosis of multisystem inflammatory syndrome (MIS-C) in children with coronavirus infection are described. The main features of this disease are long-term fever, multiorgan dysfunction, laboratory signs of inflammation and positive tests for SARS-CoV-2 (polymerase chain reaction using reverse transcription (RT-PCR), antigen test or positive serological test). The criteria of the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC) are used to confirm the MIS-C diagnosis.

scholarly journals Evaluasi Jumlah Kebutuhan Nitrogen Dan Energi Pasien Gagal Ginjal Akut Usia Dewasa Di RSUP Dr. Sardjito Periode 2003-2004

2010 ◽  
Vol 1 (1) ◽  
pp. 33
Author(s):  
Yunika Sary
Keyword(s):  
Amino Acids ◽  
Renal Failure ◽  
Data Analysis ◽  
Parenteral Nutrition ◽  
Diet Therapy ◽  
World Health ◽  
Average Amount ◽  
Acid Base ◽  
Collection Method ◽  
Health Organization

A cute renal failure is one of the disease that have suddenly decrease of renalfunction, renal could not to escrate the metabolic product (nitrogen and water) and couldnot balance the acid base. Malnutrition in every stage always happen in the hospital. Thisfact can make an infection, increase the complication, can make respon to the medicaltherapy, and can make the badly result clinic. Because of that, this research have aim toknow the need of nitrogen and energy in adult patient that have acute renal failure, and tosee if there are different significant between amount of nitrogen that patient need and alsoamount of energy that patient need, account with equation of Food and AgricultureOrganization/World Health Organization/United Nations University (FAO/WHO/UNU)and harris Benedict, even the nutrition come from diet therapy and amino acids fromparenteral nutrition. Data collection method with retrospektif and result data analysistwith analitic deskriptive method statistic; paired sample t test. That comparing amount ofnitrogen with energy that patient need, with patient get from diet therapyand amino acidsfrom parenteral nutrition. Data analysis show that the average amount of nitrogen thatpatient need is 9,626 g everyday, the average amount of energy at 56 patient non aminoacids from parenteral nutrition with FAO/WHO/UNU method is 2306,426 kkal and withsimilary of Harris Benedict is 2085,349 kkal, from 12 patient who get amino acids fromparenteral nutrition, data analysis show there are significant differences from hospital, sopositif equivalent happends and there is no significant differences between amount ofenergy that patient need and anergy that patient get from hospital during the treathment,even account with equation of FAO/AHO/UNU and with Harris Benedict.

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