Medical honey and the role in pediatric emergency wound management

The use of complementary medical treatment in wound management has continued to grow throughout the world. There is a large body of evidence to support the use of honey as a wound dressing for a wide range of types of wounds. Clear guidelines for the use of honey in pediatric wound care do not exist. We present an update of present knowledge using honey as a form of complementary medicine in pediatric wound management.

CONGENITAL DILATED CARDIOMYOPATHY – A RARE GENETIC CONDITION IN INFANTS

A male newborn admitted in the Neonatal Intensive Care Unit due to dyspnea and cyanosis. The babywas intubated due to tachypnea. No murmurs were heard on auscultation.The ultrasound of the fetalheart before birth showed cardiac malformations. Chest X-ray showed : Increased pulmonary vascularmarkings and cardiomegaly. The abdominal X-ray showed normal liver, spleen and intestine.Electrocardiogram showed Sinus rhythm and tachycardia.On the first day after birth, two-dimensional echocardiography demonstrated marked hypertrophy ofboth ventricles (the posterior wall of the left ventricle was 33mm thick).The baby was started on treatment with low flow oxygen support, digoxin and captoril to enhancemyocardial contractility, creatine phosphate for myocardial nutrition , furosemide diuretic to reducedload, enhance feeding, monitor bilirubin, prevent neonatal jaundice, and close attention was paid to thedisease changes. The baby was stable and was discharged from the hospital. After 20days of discharge,the baby was admitted again with complains of shortness of breath and cyanosis after 20 days ofdischarge. The heart beat was low on auscultation with alternating tachycardia and bradycardia, with anoccasional gallop rhythm. The baby was kept on ventilator assisted ventilation with the requiredparameters and necessary investigations were performed.On repeating the two-dimensional echocardiography, the left ventricular posterior wall and the ventricularseptum was increased compared to the previous echocardiography. A mutation on Chromosome 18,c.1921G>A was detected on gene mutational analysis. Recently, some genetic studies have shown thatmutations in chromosomes 1, 11, 14 and 15, and mutations in sarcomere proteins genes are autosomaldominant

The outline of naming process, anatomy and histopathology of infraorbital dark circles

Infraorbital dark circle,previously known as allergic shiners.The pathogenesis,the swollen turbinate compressing the sphenopalatine vein plexus,causing venous congestion of eyelid vein and the canthus in eyes,is unattested.This article studies the anatomical structure under the orbital part.It is believed that the mechanism is more closely related to the backflow obstruction of infraorbital vein.Besides,it may also be the causes of infraorbital dark circle of local congestion of infraorbital space and inferior orbital lymph nodes backflow blocked.Finally, the histopathological findings of some aesthetic medicine are reviewed.

Clinical characteristics of children with cerebral palsy in Chengdu, China: A cross-sectional study

Objective: To describe the subtypes, motor function, and comorbidities of cerebral palsy (CP) in children in Chengdu, China.Methods: A cross-sectional survey of children with CP was performed in 2013 and participants were enrolled from the branches of China Disabled Persons’ Federation in Chengdu. Diagnosis, clinical subtypes, gross and fine motor function outcomes, and comorbidities of CP were determined through caregiver interviews, evaluation of medical records, and thorough physical examinations.Results: Four-hundred and twenty-two children were diagnosed with CP (mean age, 7.7 ± 3.8 years). Spastic diplegia was the predominating subtype (35%). Mild impairments in gross and fine motor function were present in 45% and 52% of the patients, respectively. Cognitive impairment (60%) was the most common comorbidity, and was followed by language disorder (41%) and microcephaly (35%). About 79% of children with cerebral palsy had at least one comorbidity, and the number of cumulative comorbidities was positively correlated with Gross Motor Function Classification System and Manual Ability Classification System scores. Preterm birth (52%) was the most common risk factor, and was followed by low birth weight (42%) and birth asphyxia (27%).Conclusion: Distributions of CP subtypes, motor functions, and comorbidities in a Chinese population were similar to those in developed countries, but different from those in other developing countries. The trend for decreased numbers of children with preterm CP since 2009 indicates an improvement in neonatal care. However, perinatal healthcare should still be improved to reduce the occurrence of birth asphyxia.

Massive ribs fractures due to artriohepatic dysplasia (Alagille syndrome): a case report.

Alagille syndrome (ALGS) is a rare multisystem congenital disorder, with a minimum incidence of approximately 1:30,000 live births. It is an autosomal dominant disease that arises from mutations in the Jagged1 (JAG1) gene (approximately 60% of cases are caused by de novo mutations), which encodes a ligand for Notch receptors. The most common symptoms associated with this syndrome are cholestasis with the obstruction or slowing of biliary flow, congenital heart disease (pulmonary artery stenosis), and butterfly-shaped vertebrae, anterior chamber eye defects, and dysmorphic faces. Several of the characteristics of Alagille syndrome may result in patients having an especially high risk of fracture. The majority of patients suffer from chronic cholestasis, which can have a variety of adverse effects on bone metabolism. Case presentation; A 6-months-old girl admitted to pediatric surgery unit with jaundice since one month of age, progressive abdominal distention. She had been diagnosed with biliary atresia at the age of 1 month on the base of clinical diagnosis, she was malnourished with stunted growth. She had most of the features of Alagille syndrome. Chest radiographs showed generalized decreased in bone density with multiple ribs fractures on the left side, with pulmonary consolidation in the left middle and lower zone. Osteodystrophy (haptic cause) was enrolled based on the fact that there was no evidence or history of trauma (child abuse by the family was not considered). Our study is one of a few reports to document ribs fracture in children with AGLS.

Melanoma in an obese diabetic adolescent

Aim: The study was aimed to describe an obese and type 2 diabetic male adolescent with necrobiosis lipoidica (NL) and melanoma. Methods: The patient aged 13 years suffered from skin lesions showing hyperemic and hyperpigmented subcutaneous nodular plaques of different dimensions in the lower limbs. Results: The biopsy of lesions revealed NL and melanoma, this was radically removed with excisional biopsy. No metastasis has occurred after six months of follow up. Conclusion: NL and melanoma should be taken a serious consideration and suspicion in distinguishing from other common or benign skin lesions.

Antiviral and anti-inflammatory effects of medicated thread moxibustion combined with Shujin Jiannao granule in the treatment of HFMD

Objective To investigate antiviral and anti-inflammatory effects of medicated thread moxibustion combined with Shujin Jiannao granule in the treatment of HFMD. Methods A total of 124 children with HFMD were collected to divided into western medicine group (62 cases) and experimental group(62 cases) while 62 healthy children were enrolled to become normal control group. Western medicine group was treated according to conventional therapy while experimental group was treated with combined treatment of traditional Chinese medicine(TCM) and western medicine. To determine serum levels of S100B, NSE, CRP and WBC and observe the clinical effectiveness. Results In the western medicine group the total effectiveness rate is 88.7% while it is 96.8% in the experimental group（P<0.05）; the average disappearance time of symptoms are shorter in the experimental group than that in the western medicine group（P<0.05）. Compared with the control group，the serum levels of S100B, NSE, CRP and WBC all rise in HFMD children（P<0.05 or P<0.01）. After treatment , the serum levels of S100B, NSE, CRP and WBC reduce in both the experimental group and the western medicine group, when compared with that before treatment.The difference is statistically significant（P<0.05 or P<0.01）.

Assessment of the Possibilities of B-Mode Ultrasonography in the Diagnosis of Lumbar Intervertebral Discs Protrusion in Adolescents

Objective: To improve the efficiency of lumbar intervertebral discs protrusion by determining the ultrasound biomarkers. Materials and Methods: The study included 68 patients with the disc protrusion and 65 healthy adolescents with normal lumbar intervertebral discs and neurologic status aged 16-18 years. Ultrasonography (USG) was performed at the level of disks L1-L2, L2-L3, L3-L4, L4-L5, L5-S1 in longitudinal and transverse projections. In longitudinal section was measured height of lumbar vertebrae and intervertebral discs, in axial section – the sagittal sizes of intervertebral discs and spinal canal, width of spinal nerve canals, thickness of the yellow ligament. Results: In 31 (45,6±6,0%) cases the protrusion was paramedian, in 16 (23,5±5,1%) – posterolateral, in 13 (19,1±4,8) – median and in 8 (11,8±3,9%) – circular types. The paramedian protrusion was significantly more frequently recorded than the posterolateral (P<0,05), median and circular (p <0.001) types. In 7 (10,3±3,7% ) cases the protrusion was localized at the level of L2-L3, in 13 (19,1 ±4,8%) – L3-L4, in 27 (39,7±5,9%) - at the level of L4-L5 and in 21 (30,9±5,6%) – at the level of L5-S1 respectively. There were no significant differences in the frequency of occurrence between L2-L3 and L3-L4, as well as L4-L5 and L5-S1. The lower located lumbar discs were significantly more affected than the upper ones (P<0,05; P<0,001).Conclusions: In adolescents in the lumbar spine, paramedian protrusion are most commonly found, which are most often localized at the level of both L4-L5 and L5-S1. The greatest narrowing and deformation of the spinal nerve canal is observed by posterolateral and paramedian protrusion. The greatest thickness of the yellow ligament, radiculopathy is observed at level of L5-S1 protrusion.

A novel PKHD1 mutation identified in a family affected by ARPKD Ling Hou, Yue Du, Chengguang Zhao, Yubin Wu

Objective Autosomal recessive polycystic kidney disease (ARPKD) is a rare inherited renal cystic disease involving multiple organs. It is caused by mutations in the PKHD1 gene. Here, we investigate the gene mutations in a family affected by ARPKD. Methods Genomic DNA was extracted from peripheral blood leukocytes obtained from the subjects, by means of targeted gene capture and next generation sequencing technologies for mutation screening, and were confirmed by Sanger sequencing. Results Two heterozygous mutations of PKHD1, c.6890T>C (p.Ile2297Thr) and c.11215C>T (p.Arg3739Trp), located in exons 43 and 62, respectively, were identified in the patient. Furthermore, the father and mother were revealed to be carriers of heterozygous c.6890T>C (p.Ile2297Thr) and c.11215C>T (p.Arg3739Trp) mutations, respectively. Mutation of c.11215C>T (p.Arg3739Trp) has been found in the ARPKD Mutation Database (http://www.humgen.rwth-aachen.de) but mutation of c.6890T>C (p.Ile2297Thr) has not been reported. Conclusions Compound heterozygous PKHD1 mutations were elucidated to be the molecular basis of ARPKD in this patient. The newly identified c.6890T>C (p.Ile2297Thr) mutation in the patient expands the mutation spectrum of the PKHD1 gene. Targeted gene capture and next generation sequencing are suitable for genetic diagnosis of single-gene inherited diseases like ARPKD, in which the pathogenic gene is large.

Sinus histiocytosis with massive lymphadenopathy: a case report and literature review

Sinus histiocytosis with with massive lymphadenopathy is a benign lymphoproliferative disorder.In 1969, Rosai and Dorfman[1] made detailed research on it, so it was also called Rosai DorfnlRn disease (rosai.dorfmandisease, RDD).The clinical manifestations were fever, neck lymph node enlargement, leukocytosis and high gamma globulin.Histopathological findings showed that lymph node involvement was present in group RDD, and the infiltration of the cells was predominant, especially the phagocytosis of the histiocytic cells.About 43% of RDD patients have lymph node involvement in [2], in which the skin is the most common extranodal organs involved.About 10% of patients with skin damage, skin rash and morphological diversity, is easy to be misdiagnosed.In this paper, through the analysis of a case of RDD and EB virus infection, in clinical in patients with special infection can be early detection and treatment.