EL ROL DEL PERSONAL DE ENFERMERÍA EN LA PROMOCIÓN DEL BIENESTAR BIOPSICOSOCIAL DURANTE LA EXPERIENCIA DE HOSPITALIZACIÓN PEDIÁTRICA.

La estancia en el hospital de niños y niñas es desafortunadamente común y está asociada a regresión en los comportamientos, agresión, falta de cooperación, retraimiento, dificultad para recuperarse, llanto excesivo, y disminución de la comunicación y/o actividad, por lo que el proceso atención enfermero necesita no solo una perspectiva biológica, sino también incluir a las esferas psicológicas y sociales. El rol del personal de enfermería, al ser los principales referentes de cuidado dentro del contexto sanitario, resulta esencial pues son percibidos como la mayor fuente de apoyo e información de los padres, madres y pacientes. En el documento se proporcionan algunas pautas, dirigidas al personal de salud, para aumentar el bienestar integral a través de acciones concretas y de fácil ejecución. Palabras clave: hospitalización, personal de enfermería, humanización de la atención. ABSTRACT The hospital stay of children is unfortunately common and is associated with regression in behaviors, aggression, lack of cooperation, withdrawal, difficulty in recovering, excessive crying, and decreased communication and / or activity, so The nursing care process needs not only a biological perspective, but also includes the psychological and social spheres. The role of the nursing staff, being the main care references within the healthcare context, is essential since they are perceived as the greatest source of support and information from parents and patients. The document provides some guidelines, aimed at health personnel, to increase comprehensive well-being through concrete and easy-to-implement actions. Keywords: hospitalization, nursing staff, humanization of care.

A Rare Case of Acute Hemorrhagic Leukoencephalitis in a Neonate

Acute hemorrhagic leukoencephalitis (AHLE) is a fulminant demyelinating disease associated with severe inflammation of the white matter. In this article, we reported a case of previously healthy 27 days old baby admitted to the hospital with fever, excessive crying, seizures, and respiratory distress. A diagnosis of AHLE was made based on the clinical and radiological findings. The infant patient was managed in the neonatal intensive care unit; however, he died unfortunately on the 35th day of his life. Although this highly fatal disease is very rare in this age group, early diagnosis can help in reducing morbidity and mortality.

Neonatal Dhatura like poisoning - A premedication error in neonatal anesthesia

Overdosing of drugs sometimes produce fatal consequences. We report such a case of premedication dosing error in neonates with Glycopyrrolate leading to central anticholinergic syndrome (CAS) as in Dhatura poisoning. Accidental overdosing with glycopyrrolate resulted in symptoms like tachycardia, tachypnea, shock, hyperpyrexia, irritability and excessive crying. These symptoms resolved with symptomatic treatment. Errors can occur at any step of the path from drug prescription to administration. Medication errors are common and it should be immediately suspected in neonates with abnormal symptoms after injecting some drug, so that early diagnosis and treatment can be started timely. Identifying such medication errors is a challenge in neonatal care and should be a priority among caregivers in order to prevent future incidents and for patients’ safety.

Nondysraphic Intradural Spinal Lipoma: A Rare Case in a Child

Lipoma is a rare and benign tumor, with lesions associated with spinal dysraphisms. The reported case is about an 8-month-old child who arrived at the hospital with developmental delay, excessive crying, undergoing MRI and reported spinal cord lipoma. Intradural lipomas without association with dysraphism are difficult to diagnose, being the most accurate form of MRI.

THE ROLE OF LAVANGCHATUHSAMACHURNA IN MANAGEMENT OF UDARSHOOL (ABDOMINAL PAIN) DISEASE IN CHILDERN – A CASE STUDY

Udarshool is one of the common prevalent disease is in pediatric age Abdominal group .it is defined as pain in children is dened as, atleast three episodes of pain that at least 3 months and affects the child's ability to perform normal activities.Udarshool can be correlated with Abdominal pain as both the terminology have similar feature like , ( stanamvyudasyate Refusal of feed), Rauti (Excessive crying), Udarsthabdhata (Abdominal distension), Mukhasweda(Sweating over face),Shaityam ( . Cold extrimities).ect We are discussing here a case report of 7 years old male child having history of Udarshool for last 15 days . he came to us with complaint of loss of appetite, Abdominal distention and pain , poor intake ,bowel irritability .since last 4days. Generally he got relief from morden medicine , but this time symptoms reoccur after 7days. He was treated with ayurvedic medicine which gave effective result from the day of treatment. In a search of new potent option, is in the management of udarshool (colicky pain) in children. there drugs Lavangchatuhsama Churna when used in the management of give long lasting effect with minimal or no side effect.

Lethal lullabies

Poppy extract accompanied the human infant for more than three millennia. Motives for its use included excessive crying, suspected pain, and diarrhoea. In antiquity, infantile sleeplessness was regarded as a disease. Dabbing maternal nipples with bitter substances and drugging the infant with opium were used to hasten weaning. Opiates joined the treatment of difficult teething in the 17th century. Foundling hospitals and wet nurses used them extensively. With industrialization, private use was rampant among the working class. In German-speaking countries, poppy extracts were administered in soups and pacifiers. In English-speaking countries, proprietary drugs containing opium were sold at the doorstep or in grocery stores. Opium’s toxicity for infants was common knowledge, but the willingness to use it in infants persisted and physicians continued to prescribe it for babies. Intoxication became a significant factor in infant mortality. As late as 1912, the International Opium Convention signed at The Hague forced governments to implement legislation which effectively curtailed the access to opium and broke the dangerous habit of sedating infants.

Acute acalculous cholecystitis: an unusual presentation of vitamin B12 deficiency

Paediatric cases of acute acalculous cholecystitis (AAC) are due to infectious diseases or immune mediated disorders. Hereby, we present a case of 6 months old infant who presented with excessive crying with irritability and tenderness over right hypochondrium region with a palpable liver. Investigations revealed AAC and anaemia. In the work-up of anaemia, vitamin B12 deficiency was diagnosed and after giving treatment with vitamin B12, anaemia resolved as well as AAC. Through this case report we intent to emphasize the possibility of vitamin B12 deficiency presenting as AAC.

Emphysematous pyelonephritis in an infant from Sokoto, north-western Nigeria

Introduction: Emphysematous pyelonephritis is a life-threatening necrotising bacterial infection of the kidneys. It is rare among children and can be fatal if not promptly identified and treated.Case presentation: A 7-month-old male infant presented to the Emergency Paediatric Unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, on 12 November 2019 with a 5-day history of fever and vomiting, and a 3-day history of a progressively enlarging, left-side abdominal mass. There was associated excessive crying on micturition, refusal to feed and weight loss. He looked ill and was in respiratory distress, irritable, febrile (38.8 °C), moderately dehydrated and pale. His weight and length were 5.5 kg and 64 cm. He had a tender, firm and ballotable abdominal mass on the left flank measuring 8 cm × 10 cm. His pulse rate was 140 beats/min, blood pressure 60/40 millimetres of mercury and respiratory rate was 65 cycles/min. He had widespread coarse crepitations and normal heart sounds on chest auscultation.Management and outcome: An initial diagnosis of sepsis was made. Other considerations were nephroblastoma and neuroblastoma. Ceftriaxone and blood transfusion were commenced with subsequent administration of intravenous fluids. Further radiologic investigations revealed emphysematous pyelonephritis. The patient had percutaneous drainage and extended spectrum β-lactamase-producing Escherichia coli (sensitive to meropenem) which was isolated from the aspirate culture after 48 h of incubation. Meropenem could not be commenced because of non-availability and high cost. The patient subsequently deteriorated and died from septic shock.Conclusion: Emphysematous pyelonephritis has a fulminant course when not diagnosed promptly and treated adequately.

Identifying potential treatment effect modifiers of the effectiveness of chiropractic care to infants with colic through prespecified secondary analyses of a randomised controlled trial

Background A recent trial identified large variation in effect of chiropractic care for infantile colic. Thus, identification of possible effect modifiers could potentially enhance the clinical reasoning to select infants with excessive crying for chiropractic care. Therefore, the aim of this study is to identify potential treatment effect modifiers which might influence the effect of chiropractic care for excessive crying in infancy. Methods Design: Prespecified secondary analyses of data from a randomised controlled trial. The analyses are partly confirmative and partly exploratory. Setting: Four chiropractic clinics in Denmark. Participants: Infants aged 2–14 weeks with unexplained excessive crying. Of the 200 infants randomised (1:1), 103 were assigned to a chiropractic care group and 97 to a control group. Intervention: Infants in the intervention group received chiropractic care for 2 weeks, while the control group was not treated. Main analyses: The outcome was change in daily hours of crying. Fifteen baseline variables and 6 general variables were selected as potential effect modifiers, and indices based on these were constructed. Factor analyses, latent class analyses and prognosis were used to construct other potentially modifying variables. Finally, an attempt at defining a new index aiming at optimal prediction of the treatment effect was made. The predictive value for all resulting variables were examined by considering the difference in mean change in crying time between the two treatment groups, stratified by the values of the candidate variables, i.e. interaction analyses. Results None of the predefined items or indices were shown to be useful in identifying colicky infants with potentially larger gain from manual therapy. However, more baseline hours of crying (p = 0.029), short duration of symptoms (p = 0.061) and young age (p = 0.089) were all associated with an increased effect on the outcome of hours of crying. Conclusion Musculoskeletal indicators were not shown to be predictive of an increased benefit for colicky infants from chiropractic treatment. However, increased benefit was associated with early treatment and a high level of baseline crying, suggesting that the most severely affected infants have the greatest potential of benefiting from manual therapy. This finding requires validation by future studies. Trial registration Clinical Trials NCT02595515, registered 2 November 2015.

The effect of chiropractic care on infantile colic: results from a single-blind randomised controlled trial

Background Chiropractic care is commonly used to treat infantile colic. However large trials with parental blinding are missing. Therefore, the purpose of this study is to evaluate the effect of chiropractic care on infantile colic. Method This is a multicenter, single-blind randomized controlled trial conducted in four Danish chiropractic clinics, 2015–2019. Information was distributed in the maternity wards and by maternal and child health nurses. Children aged 2–14 weeks with unexplained excessive crying were recruited through home visits and randomized (1:1) to either chiropractic care or control group. Both groups attended the chiropractic clinic twice a week for 2 weeks. The intervention group received chiropractic care, while the control group was not treated. The parents were not present in the treatment room and unaware of their child’s allocation. The primary outcome was change in daily hours of crying before and after treatment. Secondary outcomes were changes in hours of sleep, hours being awake and content, gastrointestinal symptoms, colic status and satisfaction. All outcomes were based on parental diaries and a final questionnaire. Results Of 200 recruited children, 185 completed the trial (treatment group n = 96; control group n = 89). Duration of crying in the treatment group was reduced by 1.5 h compared with 1 h in the control group (mean difference − 0.6, 95% CI − 1.1 to − 0.1; P = 0.026), but when adjusted for baseline hours of crying, age and chiropractic clinic, the difference was not significant (P = 0.066). The proportion obtaining a clinically important reduction of 1 h of crying was 63% in the treatment group and 47% in the control group (p = 0.037), and NNT was 6.5. We found no effect on any of the secondary outcomes. Conclusion Excessive crying was reduced by half an hour in favor of the group receiving chiropractic care compared with the control group, but not at a statistically significant level after adjustments. From a clinical perspective, the mean difference between the groups was small, but there were large individual differences, which emphasizes the need to investigate if subgroups of children, e.g. those with musculoskeletal problems, benefit more than others from chiropractic care. Trial registration Clinical Trials NCT02595515, registered 2 November 2015