Non-Hodgkin’s Lymphoma: A Case Report

Introduction: Hodgkin's and non-lymphomas Hodgkin's are malignant tumours of lymphoid tissue. Non-lymphomas Hodgkin's are a type of lymphoid tissue cancers that arise from T or B cells or their progenitors, and can be indolent or aggressive. B-cell lymphomas account for around 80% of all cases in the United States. Chronic lymphocytic leukaemia or small lymphocytic lymphoma, follicular lymphoma, diffuse large B-cell lymphoma, and primary cutaneous B-cell lymphoma are all examples of Non-Hodgkin's Lymphoma. Non-Lymphoma Hodgkin's is the sixth most prevalent malignancy in the United States, with incidence rates nearly doubling in the last 35 years. With each decade of life, the incidence rises; the median age upon diagnosis is 66. In India, the incidence rates in urban regions are many times higher than in rural areas, with the incidence being higher in metropolitan cities and among Indian immigrants, implying that urban lifestyles and economic advancement may boost cancer incidence. In 2010, NHL was projected to have caused roughly 0.36 million new cases and 0.19 million deaths. Case Presentation: A male patient of Two and half years from Shiwangaon MO, was admitted to Paediatric Ward, AVBRH on 31st May, 2021 with a known case of Non-Hodgkin Lymphoma which was diagnosed itself at AVBRH on 31st May,2021. My patient was brought with a chief complain of swelling in the testicular region for 6 days. As narrated by the patient’s father, my patient was apparently alright 6 months back and then patient develop swelling in temporal region suddenly, associated with pain on touch, as the swelling develops more and uncomfortable, patient was brought immediately to AVBRH and was admitted in Paediatric Ward for further investigation.

Music therapy methods, strategies and techniques for engaging children in meaningful music therapy encounters in hospital play therapy settings

<p>This qualitative study examines a music therapy student’s practice on a paediatric ward in a general hospital in New Zealand. The study arose after I experienced challenges engaging and interacting with patients in a hospital play therapy setting, where patients stay was short-term. The research identified the music therapy methods, techniques and strategies I used to initiate and sustain musical interaction with them. Findings were generated from secondary analysis of two months’ worth of clinical documentation and reflection. Both inductive and deductive thematic analysis was used to analyse the clinical data and reflection. The literature on paediatric music therapy, musical play and play therapy were reviewed. Findings are presented in two parts. The first section highlights the predominant music therapy methods I used: range of instruments, singing, use of props, listening, use of discussion and musical games; and the overlaps of strategies and techniques within. The second section identifies four main categories of music therapy goals to illustrate the unique and subtle differences of music therapy methods, strategies and techniques in relation to the goals. Subsequently, in the discussion section, findings are considered in the light of the literature, and limitations of the research are addressed.</p>

Music therapy methods, strategies and techniques for engaging children in meaningful music therapy encounters in hospital play therapy settings

<p>This qualitative study examines a music therapy student’s practice on a paediatric ward in a general hospital in New Zealand. The study arose after I experienced challenges engaging and interacting with patients in a hospital play therapy setting, where patients stay was short-term. The research identified the music therapy methods, techniques and strategies I used to initiate and sustain musical interaction with them. Findings were generated from secondary analysis of two months’ worth of clinical documentation and reflection. Both inductive and deductive thematic analysis was used to analyse the clinical data and reflection. The literature on paediatric music therapy, musical play and play therapy were reviewed. Findings are presented in two parts. The first section highlights the predominant music therapy methods I used: range of instruments, singing, use of props, listening, use of discussion and musical games; and the overlaps of strategies and techniques within. The second section identifies four main categories of music therapy goals to illustrate the unique and subtle differences of music therapy methods, strategies and techniques in relation to the goals. Subsequently, in the discussion section, findings are considered in the light of the literature, and limitations of the research are addressed.</p>

Case Report of Multisystem Inflammatory Syndrome in a Child Related to COVID-19

Background : Multisystem Inflammatory Syndrome in Children (MIS-C) is a serious condition that appears to be linked to Coronavirus Disease 2019 (COVID-19). Most children who become infected with the COVID-19 virus have only a mild illness. Aim of this study to evaluate the children who go on to develop MIS-C, some organs and tissues-such as the heart, lungs, blood vessels, kidneys, digestive system, brain, joints, skin or eyes -become severely inflamed. Case Report : 11 years old girl admitted in Paediatric Ward of in Imperial Hospital Chattogram on 12 July 2020 with the complains of fever, loose motion, rash in hands, body and legs, swelling of the wrist and ankle joints which were associated with anorexia, nausea , vomiting and bodyache. For this reason the child was evaluated. Conclusion : Clinical features in children have varied but predominantly include cardiac dysfunction, abdominal pain, and elevated inflammatory markers, including C-Reactive Protein (CRP) Ferritin, D-dimer and Interleukin-6. MIS-C can lead to shock and multiple organ failure requiring intensive care. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 89-92

A Music Therapy Student's Exploration of Single Session Music Therapy for Children on a Paediatric Ward Using Action Research Methodology

<p>This study aimed to answer the question “How can I, as a music therapy student in a paediatric ward, provide children with beneficial single session music therapy?” In order to answer this question, action research methodology was employed. This methodology allowed the researcher to monitor and question her actions in order to improve her practice. Furthermore, principles from music therapy and other disciplines were applied and adapted. The researcher’s practice would be made more appropriate, therefore, for a paediatric ward where only brief information about the children was provided and limited time was available to work with them. There were four cycles in the study. The challenges and concerns that emerged through the course of this research were 1) how to approach the children or get the music therapy session underway, 2) how to provide suitable sessions for the different needs and developmental stages of the children; 3) how to be more aware of the children’s needs, and 4) how to maintain my inspiration. All the findings from these concerns were formulated into some helpful principles that played an important role during the course of this study. The principles are: 1) being flexible; 2) keeping the patients’ and the therapist’s control in balance; 3) being sensitive to children’s responses and to their needs; 4) being familiar with background knowledge; 5) being able to build a rapport in a short time; 6) being available; 7) being open-minded; and 8) being able to reduce the therapist’s anxiety. It is recommended that these principles be employed in other contexts where the therapist has little time at his/her disposal to assess or establish a rapport with the children, and where it is hard to predict the situation or plan the session ahead.</p>

A Music Therapy Student's Exploration of Single Session Music Therapy for Children on a Paediatric Ward Using Action Research Methodology

<p>This study aimed to answer the question “How can I, as a music therapy student in a paediatric ward, provide children with beneficial single session music therapy?” In order to answer this question, action research methodology was employed. This methodology allowed the researcher to monitor and question her actions in order to improve her practice. Furthermore, principles from music therapy and other disciplines were applied and adapted. The researcher’s practice would be made more appropriate, therefore, for a paediatric ward where only brief information about the children was provided and limited time was available to work with them. There were four cycles in the study. The challenges and concerns that emerged through the course of this research were 1) how to approach the children or get the music therapy session underway, 2) how to provide suitable sessions for the different needs and developmental stages of the children; 3) how to be more aware of the children’s needs, and 4) how to maintain my inspiration. All the findings from these concerns were formulated into some helpful principles that played an important role during the course of this study. The principles are: 1) being flexible; 2) keeping the patients’ and the therapist’s control in balance; 3) being sensitive to children’s responses and to their needs; 4) being familiar with background knowledge; 5) being able to build a rapport in a short time; 6) being available; 7) being open-minded; and 8) being able to reduce the therapist’s anxiety. It is recommended that these principles be employed in other contexts where the therapist has little time at his/her disposal to assess or establish a rapport with the children, and where it is hard to predict the situation or plan the session ahead.</p>

Standardization of rounds on a general paediatric ward: Implementation of a checklist to improve efficiency, quality of rounds, and family satisfaction

Objective The purpose of this study was to develop a standardized rounding tool for use on the general paediatric ward and to determine if its use can improve quality of rounds as well as patient and parent satisfaction. Methodology The study used a pre- and post-intervention prospective observational methodology. The intervention consisted of the implementation of a Checklist Rounding Tool (CRT) entitled the ‘Paediatric Inpatient Rounding Checklist (PIRC)’ which outlined items deemed essential to discuss during rounds for all patients admitted to the paediatric ward. The PIRC was created by the research team after reviewing the literature and it was peer reviewed by a panel of expert paediatricians. Performance on rounds based on discussion of checklist items as well as patient and parent satisfaction were evaluated by an external observer both pre- and post-PIRC implementation. Results Four of the five less frequently addressed checklist items were discussed significantly more post-intervention. The Rounds Quality Score was significantly improved after checklist implementation, the pre- and post-intervention scores being 8.24 and 9.61/10, respectively (P-value &lt;0.001). Patient and parent satisfaction were rated higher with the use of the checklist. There was no difference in the duration of rounds between the pre- and post-implementation phases. Conclusion In summary, utilization of a standardized rounding tool on an inpatient paediatric ward led to improvement in quality of rounds as well as patient and parent satisfaction.

Evaluation of direct costs associated with the management of clinical stage of malaria in children under five years old in Gabon

Background Malaria is one of the leading causes of morbidity and mortality in African countries. It is one of the leading causes of hospital visits and hospitalization in pediatric wards for children under 5 years old. Interestingly however, the economic burden of this disease remains unknown in these endemic countries including Gabon. The purpose of this study is to assess the direct hospital cost for the management of malaria in children under 5 years old at the Libreville University Hospital Centre (CHUL, Centre Hospitalier Universitaire de Libreville) in Gabon. Methods This research work is a retrospective study using a comprehensive review of medical records of patients seen at the CHUL over a two-year period extending from January 2018 through December 2019. The study focused on children under 5 years old, admitted for malaria in the paediatric ward of the CHUL. The analysis targeted specifically direct hospital costs, which excluded salary and wages of health care workers. The monetary currency used in this study was the CFA francs, as that currency is the one used in Central Africa (as reference, 1 Euro = 656 CFA francs). Results For the set timeframe, 778 patient records matched the study criteria. Thus, out of 778 admitted patients, 58.4% were male while 41.5% were female. Overall, the average age was 13.2 months (± 13.8 months). The total cost incurred by the hospital for the management of these 778 malaria patients was 94,922,925 CFA francs (144,699.58 €), for an average expense per patient topping at 122,008 CFA francs (185.99 €). The highest expenditure items were hospitalizations (44,200,000 CFA francs, 67,378.1 €), followed by drugs (26,394,425 CFA francs, 40,235.4 €) and biomedical examinations (14,036,000 CFA francs, 21,396.34 €). Conclusion The financial burden for managing malaria in the paediatric ward seems to be very high, not only for the hospital, but also for families in spite of the government medical insurance coverage in some cases. These findings bring new insights as to the urgency to develop policies that foster preventive initiatives over curative approaches in the management of malaria in children in endemic countries.

Surgical Outcome of Hirschsprung’s Disease in Male Child: A Rare Case Report

Introduction: This disorder characterized by absence of particular nerve cells (ganglions) in a segment of the bowel in an infant. Ganglion cell absence allows the muscles of the intestines to lose their capacity to pass faeces across the peristalsis of the intestine. This condition affects the large intestine and causes problem with passing stool. The condition is congenital. In around 1 out of 5000 live births, Hirschsprung disease occurs and is three times more frequent in boys than girls. About 12% of cases are due to genetic disorders. Patient history: A 2 years old male was admitted in A.V.B.R. Hospital in paediatric ward. His chief complaint was inability to pass stools on his own, fever, vomiting, constipation. Paediatric history: This male child was born by Lower segment caesarean section. At the age of 17 months, the complaint started with inability to pass stool on his own. After that his parents approached A.V.B.R. Hospital and Doctor advised for further medical and surgical management. Main symptoms and importance of clinical findings: The patient had undergone various investigations like blood tests, USG, Physical examination and. rectal biopsy and per abdominal x-ray. Medical Management: Patient was treated with trans-anal endorectal pull through surgery under general anaesthesia Nursing management: Administered fluid replacement i.e. DNS and RL, monitored all vital signs checked 8 hourly. Conclusion: The 2 years old male was admitted in A.V.B.R. Hospital in paediatric ward. His chief complaint was inability to pass stools on his own, fever, vomiting, constipation etc. after undergoing investigation he was diagnosed as Hirschsprung’s disease.

SARS-CoV-2-related Multisystem Inflammatory Syndrome in Children

On 27 April 2020, the National Health Service England issued an emergency alert for a new condition owing to the observation of an increasing number of cases of a COVID-19-related hyperinflammatory syndrome termed multisystem inflammatory syndrome in children (MIS-C). Some of the presenting symptoms appeared similar to the Kawasaki disease and toxic shock syndrome. We report the cases of six children fitting the criteria of MIS-C, admitted to Royal Hospital and Sohar Hospital, Oman, between the months of June and July in 2020. Four of these patients required admission at the paediatric intensive care unit for inotropic support while two were admitted to the paediatric ward on suspicion of appendicitis. MIS-C has been reported in a small number of individuals below the age of 21 years with a median age of 9–10 years. Five of the current patients were aged less than the median age reported in the existing literature. All of the patients showed complete recovery with supportive management, intravenous immunoglobulin and steroids, with one patient requiring interleukin-6 inhibitor (tocilizumab). Keywords: COVID-19; SARS-CoV-2; Kawasaki Disease; Multisystem Inflammatory Syndrome in Children; Toxic Shock Syndrome; Case Report; Oman.