scholarly journals Clinical features of anaphylaxis in children

2022 ◽  
Vol 43 (1) ◽  
pp. 50-56 ◽  
Author(s):  
Mahir Serbes ◽  
Ayse Senay Sasihuseyinoglu ◽  
Dilek Ozcan ◽  
Derya Ufuk Altıntas

Background: Despite the considerable increase in anaphylaxis frequency, there are limited studies on clinical features of anaphylaxis in children in developing countries. Objective: We aimed to analyze the demographic and clinical features of anaphylaxis in children in Turkey by comparing different age groups and triggers. Methods: Medical records of 147 children, ages 0‐18 years, diagnosed with anaphylaxis between 2010 and 2019 were retrospectively analyzed. Results: The mean ± standard deviation age at first anaphylaxis episode was 5.9 ± 5.2 years, with a male predominance (63.9%); 25.2% were infants and 52.4% were < 6 years of age at their first anaphylaxis episode; 78.2% were atopic, with the highest frequency in children with food-induced anaphylaxis (FIA). The home (51.7%) was the most frequent setting. The overall leading cause of anaphylaxis was food (44.2%), which was more frequent at < 6 years of age, followed by drugs (28.6%) and bee venom (22.4%), both were more frequent among older children (>6 years). The patients with venom allergy had the highest rate of rapid onset of symptoms (p < 0.001). Gastrointestinal symptoms were observed significantly more in infants (48.6%) and in children with FIA (38.5%); cardiovascular symptoms were more frequently observed in children > 6 years of age (48.6%) and in children with drug-induced anaphylaxis (64.3%). Although recurrent anaphylaxis was reported for 23.1% of the patients, it was highest in the patients with FIA (35.9%). Overall, only 47.6% of the patients received epinephrine in the emergency department (ED) and 27.3% were referred to an allergy specialist, with the patients with FIA having the lowest rate for both, 32.3% and 10.8%, respectively. Children with drug-induced anaphylaxis had the highest rate of severe anaphylaxis (57.1%). Conclusion: There is a need to improve anaphylaxis recognition and management in all children regardless of age and trigger. Inadequate treatment was most evident in infants and patients with FIA.

2013 ◽  
Vol 20 (03) ◽  
pp. 348-353
Author(s):  
SOHAIL ASHRAF ◽  
ARSHALOOZ J. RAHMAN

Background: Guillian Barre Syndrome is a polyradiculopathy characterized by symmetric ascending paralysis andareflexia. It affects all age groups and both sexes with an unpredictable outcome. Objectives: The aims of this study were to identify thevarious diseases presenting as Acute Flaccid Paralysis and notice clinical features and outcome of cases of Guillian Barre Syndrome.Materials and Methods: Retrospective analysis of 53 patients presenting as Acute Flaccid Paralysis was done. Clinical features andlaboratory investigations of 39 patients of Guillian Barre syndrome were reviewed. Results: Among all cases of Acute Flaccid Paralysis,Guillian Barre syndrome formed the bulk of the cases (73.6%).It was more common in females and in age group of 10 years or below. Inmajority of the cases, rapid onset of weakness was the initial symptom. Mortality was 100% in patients who had respiratory muscleinvolvement and who required mechanical ventilation. Conclusions: In our study the main factor causing death in a case of Guillian Barresyndrome was bulbar involvement requiring mechanical ventilation. Early recognition of the prognostic factors may lead to decreasedmortality in case of Guillian Barre syndrome.


Author(s):  
Dr. Sheetal Gupta ◽  
Dr. Anita Gupta ◽  
Dr. Sushmita Ahirwal

Visual perception is the process by which individuals assign meaning, understanding, and interpretation to what they have seen. The aim of this study was to determine the visual perceptual skills of typically developing Indian children on MVPT-4. A sample of 180 typically developing Indian students were included in the study using convenience sampling method. They were divided in six age groups with age ranging from 6years to 12 years with 30 children in each age group. It was found that visual perceptual skills of typically developing Indian children in 6-12 years of age group can be assessed using MVPT-4. Analysis was done using One-way Anova to compare the mean raw score of each age group. There was a significant difference between the age groups at statistical value of p< 0.001. The score improved with age, signifying refined and matured visual perceptual skills in older children. Age influences visual-perceptual skills of these children. This study also provides a foundation for further researches and highlights the importance of MVPT-4 as a screening tool to be used by the occupational therapist in order to assess the visual perceptual skills of children.


2021 ◽  
Vol 65 ◽  
pp. 91-96
Author(s):  
MD Sharma ◽  
P Biswal ◽  
N Taneja ◽  
A Agarwal

Introduction: Occurrence of G induced loss of consciousness (G-LOC) during centrifuge training is a known entity. The Indian Air Force is currently undertaking high G training of its fighter pilots in High Performance Human Centrifuge (HPHC) which has significantly higher operational capabilities. The study aimed to analyse the incapacitation periods and myoclonic jerks associated with G-LOC occurring during HPHC training. Material and Methods: Records of episodes of 161 G-LOC during closed loop Rapid Onset Rates (ROR) runs over a period of 7 years from 2011 to 2017 were analyzed. The video recordings of these G-LOC episodes were assessed in terms of the participant demographics, +Gz onset rates, incapacitation periods, and presence or absence of myoclonic jerks during the G-LOC episodes. Descriptive statistics was applied to analyze the incapacitation periods and the duration of the myoclonic flail movements. Single tailed t-test was used to analyze the difference between the incapacitation periods of the aircrew who suffered myoclonic flail movements and those who did not. One-way ANOVA was carried out to assess the differences in incapacitation periods, if any, between aircrew of different age groups. Significance was set at P < 0.05. Results: Of these 161 episodes of G-LOC, 43.5% were seen in trainee aircrew. The mean Absolute Incapacitation Period (AIP), Relative Incapacitation Period (RIP) and Total Incapacitation Period (TIP) was 6.9 ± 2.3 s, 12.2 ± 4.7 s, and 19.1 ± 5.5 respectively. Age and flying experience did not show any significant effect with any of the incapacitation periods (p>0.05). The TIP correlated better with the RIP than with the AIP (Pearson’s correlation values of 0.9 and 0.52 respectively). Myoclonic flail movements were witnessed in 25.5% of G-LOC episodes with an average duration of 5.3 s and more than 50% occurring at ≥8Gz. The mean duration of RIP was significantly higher (P=0.03) when G-LOC was associated with myoclonic flail movements, whereas, the duration of AIP did not show any significant difference. Conclusion: The shorter incapacitation periods observed in the study compared to that reported in most of the previous studies could be attributed to the faster Gz offset rates of the present HPHC. Episodes of G-LOC having myoclonic movements were found to have higher relative incapacitation periods. Even though these movements were associated with G-LOC occurring at higher Gz levels, the durations were independent of the Gz levels.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Martin Salö ◽  
Gustav Friman ◽  
Pernilla Stenström ◽  
Bodil Ohlsson ◽  
Einar Arnbjörnsson

Background. This study aimed to evaluate Pediatric Appendicitis Score (PAS), diagnostic delay, and factors responsible for possible late diagnosis in children <4 years compared with older children who were operated on for suspected appendicitis.Method. 122 children, between 1 and 14 years, operated on with appendectomy for suspected appendicitis, were retrospectively analyzed. The cohort was divided into two age groups: ≥4 years (n=102) and <4 years (n=20).Results. The mean PAS was lower among the younger compared with the older patients (5.3 and 6.6, resp.;P=0.005), despite the fact that younger children had more severe appendicitis (75.0% and 33.3%, resp.;P=0.001). PAS had low sensitivity in both groups, with a significantly lower sensitivity among the younger patients. Parent and doctor delay were confirmed in children <4 years of age with appendicitis. PAS did not aid in patients with doctor delay. Parameters in patient history, symptoms, and abdominal examination were more diffuse in younger children.Conclusion. PAS should be used with caution when examining children younger than 4 years of age. Diffuse symptoms in younger children with acute appendicitis lead to delay and to later diagnosis and more complicated appendicitis.


1996 ◽  
Vol 7 (11) ◽  
pp. 2385-2391
Author(s):  
B A Warady ◽  
S R Alexander ◽  
S Hossli ◽  
E Vonesh ◽  
D Geary ◽  
...  

Accurate characterization of peritoneal solute transport capacity in children has been hampered by a lack of standardized test mechanics and small patient numbers. A standardized peritoneal equilibration test was used to study 95 pediatric patients (mean age, 9.9 +/- 5.6 yr) receiving chronic peritoneal dialysis at 14 centers. Patients were divided into four age groups (< 1, 1 to 3, 4 to 11, 12 to 19 yr) for analysis. Each patient received a 4-h peritoneal equilibration test with an exchange volume of 1100 mL/m2 per body surface area. Dialysate to plasma (D/P) ratios for creatinine (C) and urea (U) and the ratio of dialysate glucose (G) to initial dialysate glucose concentration (D/D0) were determined. Mass transfer area coefficients (MTAC) were calculated for the three solutes and potassium (P). The mean (+/- SD) 4-h D/P ratios for C and U were 0.64 +/- 0.13 and 0.82 +/- 0.09, respectively. The mean 4-h D/D0 for G was 0.33 +/- 0.10. D/P and D/D0 ratio results were similar across age groups. Normalized (for body surface area) mean MTAC (+/- SD) values were as follows: C, 10.66 +/- 3.74; G, 12.93 +/- 5.02; U, 18.43 +/- 4.02; and P, 14.02 +/- 3.94. Whereas a comparison of the normalized MTAC values across age groups with an analysis of variance showed significant age group differences only for glucose (P = 0.001) and potassium (P = 0.036), analysis by quadratic regression demonstrated a nonlinear decrease with age for C (P = 0.016), G (P < 0.001), and P (P = 0.034). In summary, evaluation of D/P and D/D0 ratios obtained from a large group of children in a standardized manner reveals values that are similar across the pediatric age range and not unlike the results obtained in adults. In contrast, normalized MTAC values of young children are greater than the values of older children, possibly as a result of maturational changes in the peritoneal membrane or differences in the effective peritoneal membrane surface area.


2021 ◽  
Vol 5 (3) ◽  
pp. 336
Author(s):  
Sadia Akther Sony ◽  
Fariha Haseen ◽  
Syed Shariful Islam ◽  
Ishrat Jahan

Background: Socio-epidemiological data of dental caries helps to plan effective community interventions.Objective: To estimate the prevalence and assess the experience of dental caries among school going adolescents in a rural area of Bangladesh.Methods: A cross-sectional study was donein Sylhet District in Bangladesh, between January and December of 2014. Students of class VIII, IX and X, aged 12-16 years were taken for the study. A total of 90 studentswere divided into 12-14 years and 15-16 years age groups using simple random sampling technique. A pre-designed, self-administered questionnaire was used for demographic survey. Students were examined for dental caries. Assessment of Experience of dental caries was done by Decayed, Missing and Filled teeth (DMFT) index.Results: The mean age of the respondents was 14.37±0.50 years. Females were 68(75.6%) and males were 22(24.4%). 31(34.4%), 30 (33.3%) and 29(32.2%) were from VIII, IX and X respectively. The older age group (15-16 years) had more decayed teeth than that of 12-14 years group (2.28 vs. 1.46; p=0.04). The mean DMFT score was lower in male compared to female (1.43 vs. 2.30; p>0.05).There was significant difference in the total DMFT score among the classes (p=0.009). Mean DMFT score was 1.88. Caries prevalence was 42.2% in the maxillary arch and 58.9% in the mandibular arch. Among males, the mandibular arch showed a higher caries level (63.64%) than the maxillary arch (40%), while in females, in maxillary and mandibular archeswere 42.64% and 42.65% respectively (p>0.05).Conclusion: 64.4% of the study population had dental caries with male predominance; mandibular arch was more involved.International Journal of Human and Health Sciences Vol. 05 No. 03 July’21 Page: 336-340


1987 ◽  
Vol 99 (3) ◽  
pp. 647-657 ◽  
Author(s):  
M. B. Skirrow

SUMMARYFive laboratories serving a population of 1·5 million participated in a 2-year survey of campylobacter, salmonella and shigella infections in patients suffering from gastrointestinal symptoms. In total, 33857 faecal specimens were examined of which 5·5% yielded campylobacters, 3·4% salmonellas and 0·8% shigellas; incidence of infection (per 100,000 population per year) was 58, 38 and 9 respectively. Peak incidences occurred at different ages for each organism: campylobacter, 1–4 years (183); salmonella, less than 1 year (181); shigella, 1–4 years (17). There was a secondary peak in campylobacter incidence in patients aged 15–24 years (87), which was not seen with salmonella or shigella infections.By recording the age and sex of all patients submitting faecal specimens, it was shown that sampling rates were disproportionately high in infants aged less than 1 year (12:1 relative to other ages). Thus the percentage of faecal samples positive in infants – in sharp contrast to incidence values – was the lowest of any age group for all three organisms. By taking the numbers of faecal specimens tested as denominators in this way, the highest campylobacter isolation rates were in young adults, with a notable male predominance in the 15–24 year (1·7:1) and 45–54 year (1·6:1) age groups. This male predominance was accentuated during the summer (2·1:1) when incidence was generally high. The maximum percentage isolation recorded by any laboratory was 32·5% in males aged 15–24 years in June.The reasons for this pattern of campylobacter infection are unknown, but the similarity of the results between laboratories and the regularity of the seasonal fluctuations recorded over the last G years indicate that the sources and routes of infection are geographically similar and stable, yet different from those of salmonellosis.


2017 ◽  
Vol 1 (6) ◽  
pp. 533-537
Author(s):  
Lorenz von Seidlein ◽  
Borimas Hanboonkunupakarn ◽  
Podjanee Jittmala ◽  
Sasithon Pukrittayakamee

RTS,S/AS01 is the most advanced vaccine to prevent malaria. It is safe and moderately effective. A large pivotal phase III trial in over 15 000 young children in sub-Saharan Africa completed in 2014 showed that the vaccine could protect around one-third of children (aged 5–17 months) and one-fourth of infants (aged 6–12 weeks) from uncomplicated falciparum malaria. The European Medicines Agency approved licensing and programmatic roll-out of the RTSS vaccine in malaria endemic countries in sub-Saharan Africa. WHO is planning further studies in a large Malaria Vaccine Implementation Programme, in more than 400 000 young African children. With the changing malaria epidemiology in Africa resulting in older children at risk, alternative modes of employment are under evaluation, for example the use of RTS,S/AS01 in older children as part of seasonal malaria prophylaxis. Another strategy is combining mass drug administrations with mass vaccine campaigns for all age groups in regional malaria elimination campaigns. A phase II trial is ongoing to evaluate the safety and immunogenicity of the RTSS in combination with antimalarial drugs in Thailand. Such novel approaches aim to extract the maximum benefit from the well-documented, short-lasting protective efficacy of RTS,S/AS01.


1970 ◽  
Vol 4 (2) ◽  
pp. 74-77
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77


2020 ◽  
Vol 16 (3) ◽  
pp. 241-247
Author(s):  
Atifete Ramosaj-Morina ◽  
Alije Keka-Sylaj ◽  
Arbana Baloku Zejnullahu ◽  
Lidvana Spahiu ◽  
Virgjina Hasbahta ◽  
...  

Background: Celiac disease is an immune-mediated disorder characterized by variable clinical manifestations, specific antibodies, HLA-DQ2/DQ8 haplotypes, and enteropathy. Objectives: The aim of this study was to present the clinical spectrum and patterns of celiac disease in Kosovar Albanian children. Methods: A cross-sectional retrospective study was performed with Albanian children aged 0-18 years, treated for celiac disease in the Pediatric Clinic, University Clinical Center of Kosovo from 2005 to 2016. Results: During the study period, 63 children were treated for celiac disease. The mean age at diagnosis was 5.5 years (SD ± 3.31). The mean age at celiac disease onset was 3.3 years (SD ± 2.02), while the mean delay from the first symptoms indicative of celiac disease to diagnosis was 2.2 years (SD ± 2.09). More than 70% of the patients were diagnosed in the first 7 years of life, mainly presented with gastrointestinal symptoms, while primary school children and adolescents mostly showed atypical symptoms (p<0.001). The classical form of celiac disease occurred in 78% of the cases. Sixty (95%) patients carried HLA-DQ2.5, DQ2.2 and/or HLA-DQ8 heterodimers, and only three of them tested negative. Conclusions: Kosovo, as the majority of developing countries, is still facing the classical form of celiac disease as the dominant mode of presentation; as a result, most children with other forms of the celiac disease remain undiagnosed. : Physicians should be aware of the wide range of clinical presentations and utilize low testing thresholds in order to prevent potential long-term problems associated with untreated celiac disease.


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