Current Issue : October-December Volume : 2022 Issue Number : 4 Articles : 5 Articles
Objective: High-frequency ventilation (HFV) is an effective means to achieve gas exchange in neonates. Adequate carbon dioxide (pCO2) levels are best achieved immediately after starting HFV, avoiding either hypercapnia or hypocapnia. We aimed to determine the initial pCO2 levels after starting HFV, and the time taken to obtain the initial blood gas. Methods: We conducted an observational retrospective study on neonates that required their first episode of HFV. Data included the first blood gas result after starting HFV and when the gas was taken after starting HFV. Results: This study included 112 neonates with a median birth weight of 938 (IQR: 692 - 1549) grams and gestational age of 27.2 (24.6 - 30.7) weeks. The first pCO2 after starting HFV (mean (SD)) was 53.7 (22) mmHg. Of 112, 15 (13.4%) showed initial hypocapnia (pCO2 < 35 mmHg), and 17 (15.2%) showed hypercapnia (pCO2 > 65 mmHg)—a total of 28.6% unacceptable pCO2 levels. Of 112, the first blood gas was obtained within 30 minutes in 47 (42%) and within one hour in 85 (76%), with a significant delay of two or more hours in eight (7.1%). Conclusion: Many neonates had unacceptable pCO2 levels upon starting first-time HFV. There were significant delays in obtaining the initial gas....
Eagle’s syndrome is a collection of symptoms caused by styloid process elongation or calcification of the stylohyoid ligament, measuring more than 2.5 centimeters. It is a radio-clinical entity characterized by a heterogeneous polymorphic symptomatology most often involving headaches, facial pain, dysphagia and a foreign body sensation in the throat. Its management is mainly surgical. It is a rarely diagnosed condition in children. Here we report a typical case of Eagle’s syndrome which was diagnosed in a 14-year-old child with a history of chronic right unilateral pharyngeal discomfort, odynophagia and oropharyngeal foreign body sensation. CT scan showed a long left styloid process. The patient underwent surgical removal of the elongated styloid process externally. The outcome was favorable after surgery....
Introduction: The most frequent glomerular pathology in children, nephrotic syndrome (NS) is a cosmopolitan affection. It is an immunological disease and certain environmental factors, in particular viral infections and allergens, influence its occurrence. The climatic and environmental differences coupled with the frequency of infectious pathologies signing the African particularity and the absence of data in Mali on this affection, motivated us to carry out this work. Objective: To study the epidemiological aspects of nephrotic syndrome in hospitalized children aged 0 - 15 years. Patients and Methods: This was a descriptive prospective study from January 1 to December 31, 2021 in the Pediatrics Department of the University Teaching Hospital (UTH) Gabriel Touré, anational pediatric reference service in Mali. Diagnostic confirmation was provided by biology. Results: In one year, 120 children were hospitalized for nephrotic syndrome with a sex ratio of 2.75. Male exclusivity was observed at the ages of one year, eight years and 14 years and a reversal at 13 years (sex-ratio = 0.33). The median age was 6 years for an average age of 6.4 years ± 2.4 years with extremes ranging from one year to 14 years. The first attack of nephrotic syndrome occurred outside the classic age (<1 year and >10 years) in 16.67%. Nephrotic syndrome is observed throughout the year with two peaks in summer (July to September) and winter (December to February). Many ethnic groups were affected by this condition with a high frequency among ethnic groups where endogamy is common. All patients were melanoderms. No cases of NS were recorded in Caucasian children from Northern Mali. The patients came from Bamako in 47.5% of cases. Two brothers from the same siblings had had their first attack of nephrotic syndrome the same year, ten months apart. Conclusion: Nephrotic syndrome in pediatric hospitals of Bamako occurs at a median age of six years all along the year with a summer and winter peaks. It is more observed in ethnic groups where the practice of endogamy is common and concerns melanoderm children....
Most newborn deaths occur in two regions of the world, South Asia and sub- Saharan Africa. In Senegal, much progress has been made over the past two decades with a reduction in overall infant mortality by 38%. However, the decline in neonatal mortality has been slower during the same period. The objective of this study is to assess neonatal mortality, to determine the different causes and to make recommendations for improving care in rural areas. This is a retrospective study with a descriptive and analytical aim carried out in the pediatrics department of the Diourbel regional hospital, 130 km from Dakar, the Senegalese capital, over a 12-month period from January 1 to January 31, December 2018. All newborns hospitalized in the pediatric ward during the study period were included. Overall mortality was 30.6%, newborns between 0 and 7 days accounted for 90.6% of deaths, INBORNs accounted for 62.3% of deaths. Newborns whose mother’s age was between 20 and 35 years of age accounted for 69.3% of deaths. Newborns of first-time mothers accounted for 40.2% of deaths and those of multiparous mothers 31%. Newborns who did not reach term accounted for 58.9% of deaths. Newborns admitted for respiratory distress represented the majority of deaths 45.5% (n = 93) followed by those with low birth weight 32.5 (n = 65) followed by those with neurological manifestations 30.5 (n = 62). Conclusion: Neonatal mortality is very high in the Diourbel region and the main cause is the lack of human resources and a very insufficient technical platform. The fight against this mortality involves improving the technical platform and recruiting sufficient and well-trained staff....
Two to five percent of infants and children experience febrile seizures (FS). Breastfeeding is beneficial to the health of mothers and children. Nevertheless, the benefits of breastfeeding in reducing FS remain unclear; thus, the present study aimed to evaluate this association. The case group was selected from 2010 to 2019, and the selected population was children younger than 5 years (i.e., children born from 2005–2019). The control group was selected from newborn infants at our hospital born between 2005 and 2019. Finally, 55 children with FS and 110 children in the control group were recruited. The results show longer breastfeeding duration is associated with an increased risk of FS (adjusted odds ratio: 1.06, 95% confidence interval: 1.01–1.11, p = 0.028). When comparing cases of FS with the control group, the percentage of inclusive breastfeeding over 12 months (32.7% vs. 9.1%, p = 0.017) and longer duration of exclusive breastfeeding were higher (10.86 ± 11.82 vs. 5.40 ± 7.17 months, p < 0.001). However, the comparison of the prevalence of FS between the different breastfeeding duration groups did not reach statistical significance. In conclusion, our study showed that a longer breastfeeding duration was associated with a higher risk of FS. Future large-scale studies evaluating the association between breastfeeding duration and febrile seizures are needed....
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