Low Sodium Levels in Children Affected with Community Acquired Pneumonia

Objective: The objective of this study is to find out whether subjects who are suffering from community acquired pneumonia also had low sodium levels. Methods: One hundred children fulfilling our criteria and admitted in Department of Pediatrics, Services Hospital, Lahore were included in the study. Five cc venous blood was drawn from each children of community acquired pneumonia and sent to hospital laboratory for evaluation of blood sodium levels. Results: one hundred cases of CAP were included in the study. When mean +SD of age was calculated, mean age of the study population was found to be 1.55+0.52 years. In addition, 55 %( n=55) were male while 45 %( n=45) were females. 27 %( n=27) children effected with CAP were found to be having low sodium levels whereas 73 %( n=73) had normal sodium levels. Conclusion: After conducting research, we have come to the conclusion that community acquired pneumonia is very frequent among children in the age group between 1-1.5 years. If it is promptly treated, children can be saved from life threatening pathologies. Key Words: Children, community acquired pneumonia, hyponatremia How to cite: Zaheer M.,Azam M.M., Shabir M., Saeed H.,Touseef A., Azhar Z., Low Sodium Levels in Children Affected with Community Acquired Pneumonia. Esculapio. 2021; 17(01): 75-78

Adhesive intestinal obstruction as a complication of Meckel’s diverticulum in children

Meckel’s diverticulum (DM) is a formation of the ileum caused by incomplete obliteration of the omphalomesenteric duct in the developing embryo. This is one of the most common anomalies of the digestive tract in children. Most DM develops completely asymptomatically. Clinical symptoms develop in only 16% of cases, and 50–60% of them are children under 10 years, an average of 2.5 years of age. The severity of clinical symptoms in DM is associated with the development of complications: intestinal bleeding, intestinal obstruction (intussusception, strangulation intestinal obstruction), diverticulitis with perforation and peritonitis, etc. The article presents a clinical case of adhesive intestinal obstruction in an 8-year-old, which occurred after DM in the anamnesis. As the adhesive intestinal obstruction is an extremely rare complication of DM in children, the presence of patients with acute surgical pathology of the abdominal cavity requires pediatric surgeons to clearly understand the occurrence of such complications in the perspective of the development of intestinal tube defect – DM and the need for the immediate radical treatment tactics in the event of this problem. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: children, Meckel’s diverticulum, complications, adhesive intestinal obstruction.

Clinical manifestations of Williams syndrome in children

Williams syndrome (WS), also known as Williams–Beuren syndrome, is a rare genetic disorder affecting many organs and caused by hemizygous deletions of the long arm of chromosome 7 (7q11. 23). In this article, we describe typical pathological changes in the cardiovascular, endocrine, urinary, digestive, and nervous systems, as well as phenotypic characteristics and psychological aspects of this disease. We also cover a correlation between clinical manifestations of WS and genes in the remote area. The article contains a summary of the main recommendations for the treatment of individual manifestations, i.e. pathological conditions associated with this syndrome. Key words: children, Williams syndrome, cardiovascular disorder, hypercalcemia, hypothyroidism, growth retardation, mental retardation

Stridor in children: etiology, diagnosis, differential diagnosis, and treatment

This article is devoted to the problem of stridor in children. We analyze terminological nuances in detail, specify principal differences between stridor and croup, and discuss almost all possible causes of this pathology. We also cover the ways of diagnostic search and main aspects of differential diagnosis. Particular attention is paid to medications used for stridor, as well as surgical treatment options. Key words: children, diagnosis, treatment, stridor

Iron metabolism in obese children and adolescents

The review presents new data about the causes and molecular mechanisms of iron metabolism in obesity. Obesity is associated with dysregulated iron metabolism. Three hypotheses of the hypoferremia of obesity have been proposed: nutrition hypothesis, large blood volume hypothesis, and the inflammation hypothesis. The latter has been better supported, it is consistent with the data about low-grade inflammation taking place in excessive accumulation of adipose tissue. The key role in the development of functional hypoferremia belongs to the hepcidin-leptin association. Key words: children, iron deficiency anaemia, iron metabolism, obesity, adolescents

Coats' disease

In this article, we report a case of Coats' disease, a rare idiopathic disorder leading to complete or partial blindness in children who did not receive adequate and timely treatment for several years. We cover the hypotheses of pathogenesis, classification, basic principles of diagnosis (including differential diagnosis), and treatment of exudative hemorrhagic retinitis. Our case demonstrates a stable course of the disease that remained undiagnosed for a long time, as well as positive effect of laser coagulation of altered retinal vessels. Timely diagnosis and adequate treatment ensure rapid remission. Patients with Coats' disease should be examined in specialized institutions at least once every six months. Key words: children, laser coagulation, macular edema, Coats' disease, telangiectasias, exudative lesions

Rehabilitation of children infected with Mycobacterium tuberculosis in special kindergartens: current opportunities

The WHO End TB Strategy for 2016–2035 aimed at elimination of tuberculosis makes the search for new criteria for assessing the effectiveness of anti-tuberculosis measures highly relevant. According to the literature, insufficient attention is paid to the rehabilitation of children infected with Mycobacterium tuberculosis (MBT) in special kindergartens. Objective. To assess the effectiveness of rehabilitation in special kindergartens for children infected with MBT. Patients and methods. We analyzed anthropometric data, parameters of adaptive potential (AP), frequency and duration of respiratory infections, dynamics of sensitivity to tuberculin in response to preventive measures in children who attended special kindergartens for rehabilitation (n = 28) and regular kindergartens (n = 29). Results. Children attending special kindergartens for rehabilitation demonstrated greater increase in their height (from 108.93 ± ± 2.05 cm to 113.36 ± 2,04 cm; р = 0.000), significantly lower increase of the AP (0.08 ± 0.01 and 0.16 ± 0.02; р = 0.04), fewer days missed due to acute respiratory infections (ARIs) (11.57 ± 1.44 and 17.00 ± 1.73; р = 0.020), and fewer ARI episodes (1.75 ± 0.18 and 2.66 ± 0.27; р = 0.007). Conclusion. Our findings suggest high effectiveness of special kindergartens for the rehabilitation of children with MBT infection. In addition to generally accepted tuberculin skin tests, we recommend the assessment of AP dynamics in children with MBT infection in order to evaluate the efficiency of preventive measures. Key words: children, infection with Mycobacterium tuberculosis, rehabilitation, adaptive potential, kindergartens

Features of the treatment of secretory evacuation disorders in acute bronchitis in children with impaired respiratory function

Objective: to increase the efficiency and safety of the treatment of the bronchi secretory-evacuation disorders in acute bronchitis with impaired respiratory function in children by using a medication with minimal effect on the cardiovascular system. Materials and methods. Under observation were 60 children aged 6 to 11 years. 2 observation groups were formed (30 children in each group): 1st group — children receiving the Bronchipret® for 10 days with acute bronchitis with impaired respiratory function; 2nd group — children who do not receive the Bronchipret in acute bronchitis with impaired respiratory function. Results. In the group of patients taking Bronchipret®, in addition to faster clinical dynamics, according to spirography, there was an improvement in the parameters of the external respiration function, characterizing the obstructive component of the obstruction of the air flow. After therapy with Bronchipret®, normalization of the functioning of the autonomic nervous system and the predominance of eutonia were observed against the background of a decrease in the number of registration of parasympathicotonia. Conclusion. The good tolerance and safety of Bronchipret® during 7-day use in patients aged 6–11 years allows us to recommend this drug as a highly effective treatment for bronchi secretory-evacuation disorders in acute bronchitis in children. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: children, bronchitis, spirography, treatment, thyme, ivy.

COVID-19 pandemic — analysis of the peculiarities of the life activity of families of children with epilepsy, existing problems and their overcoming

Using an electronic version of an anonymous questionnaire specially developed by employees of the Department of Child Psychoneurology and Paroxysmal Conditions for parents (guardians) of children with epilepsy, we obtained information about 133 families in which there are children with this pathology from the age of 3 months to 18 years. The survey lasted from May 18 to May 23, 2020 and displays data for the period from the beginning of the introduction of strict anti-epidemic measures in Ukraine, that is, for 2.5 months. It has been established that the most significant for families with children suffering from epilepsy during the COVID-19 pandemic are financial problems and issues of ensuring continuous use of antiepileptic drugs. The possibilities of providing a sufficient level of counseling for children with epilepsy during the crisis of COVID-19 using modern means of communication are shown. A relatively low rate of increase in stress, behavioral and emotional disorders in children with epilepsy during the COVID-19 crisis was revealed. Key words: children, epilepsy, families,COVID-19

Efficacy of the drug containing sodium picosulfate and magnesium citrate in bowel preparation for colonoscopy in children

Objective. To evaluate the efficacy, safety, and tolerability of the drug containing sodium picosulfate and magnesium citrate (SPMC) used for bowel preparation in children. Patients and methods. We have assessed the quality of bowel preparation for colonoscopy in 80 children aged between 9 and 18 years (40 of them received SPMC for it and another 40 were prepared by cleansing enemas). The effectiveness of bowel preparation was evaluated using the Boston and Chicago Bowel Preparation Scales (BPS). Tolerability of the SPMC preparation scheme was estimated using a specially designed questionnaire. Results. Effective bowel preparation was achieved in 85% children receiving SPMC (excellent in 27.5% of cases and good in 57.5% of cases), whereas children in the control group have demonstrated significantly lower quality of bowel preparation (p = 0.021). We have observed that the right colon was significantly better prepared in the SPMC group than in the control group (p < 0.001). Ninety percent of children were satisfied with the SPMC preparation scheme and agreed to use it in the future. Conclusion. Preparation of children for colonoscopy with SPMC was effective, safe, and well tolerated by them; therefore, SPMC is preferable over traditional cleansing enemas. Key words: children, inflammatory bowel diseases, colonoscopy, bowel preparation, sodium picosulfate–magnesium citrate