IMPACT FACTOR: 2.1
Short Name: Ann Pediatr
ISSN: 2637-9627
Publisher: MedDocs Publishers LLC
Fetus In Fetu (FIF) is identified by the appearance of a partially formed fetus inside a twin which is an extremely rare congenital pathology. This rare disease has less than 200 reported cases globally. FIF can arise from a deviation in the twinning process.
Metabolic Dysfunction Associated Steatotic Liver disease is the most common cause of chronic hepatitis in children and adults. The patients with MASLD have low thyroid hormone activity in the liver. Recent evidence suggests that patients with MASLD may also have haptic growth hormone deficiency.
Choledochal Cysts (CDC) are rare congenital cystic dilation of the biliary tract. Usually, the CDC presents in the first decade of life, and its prognosis is excellent. There is no debate regarding managing a typical CDC with the usual presentation, while complicated CDC still has challenges.
Globally 1% of the live births are affected by some form of congenital heart anomaly. Genetics and environment both play a role in its causation but very little of these aspects are explored from the Indian subcontinent. One of the first and key transcription factors required for the formation of the heart during development is NKX2-5.
The COVID-19 pandemic led to training programs abruptly stopping in-person learning and redesigning curricula. Trainees had decreased patient contact. Trainee well-being became even more vital with social isolation and fears of infecting loved ones increased.
Steroid induced acute pancreatitis can be challenging to diagnose leading to fatal complications. There are very few reports about it in the literature. Careful review of history and exclusion of other common diagnosis on time is crucial to prevent further complications.
Chemotherapy-Induced Neuropathic Pain (CINP) is one of the underestimated and/or undertreated complications of pediatric cancer practice due to lack of sufficient knowledge and pertinent pharmacological intervention.
We report the case of a newborn male, admitted on his first day of life for a left knee hyperextension of 60 degrees. The diagnosis of isolated reducible left congenital genu recurvatum, classified as Leveuf and Pais stage A, without ipsilateral quadriceptal hypoplasia was made.
In this case report we describe how an asymptomatic stroke was diagnosed from the detection of the presence of heterochromia on the red reflex. The newborn was in full health and showed no evident neurological symptoms.
Perinatal asphyxia is one of the three major causes of neonatal morbidity and mortality, along with prematurity and neonatal sepsis. The aim of the study was to identify the mortality risk factors associated with perinatal asphyxia in a hospital of a developing country, in order to reduce neonatal mortality linked with this major public health problem.
Perinatal asphyxia is one of the three major causes of neonatal morbidity and mortality, along with prematurity and neonatal sepsis. The study was conducted with the aim to describe the means of diagnosis and treatment, as well as, the outcome of management in a developing country in order to contribute to reduce the neonatal morbidity and mortality associated with this major public health problem.
Perinatal asphyxia is one of the three leading causes of neonatal morbidity and mortality, along with prematurity and neonatal sepsis and the burden of these diseases is greatest in nations with limited resources. With this objective, the present study was conducted to describe the epidemiological and clinical aspects of perinatal asphyxia in a developing country to reduce neonatal morbidity and mortality linked to this major public health problem.
Dentoalveolar trauma is one of most commonly encountered oral emergencies in the pediatric population. Therefore, an effective emergency management and treatment plan are crucial to preserve or ofacial functions, aesthetics, and to promote self esteem.
To study the possible role of GFAP in predicting neuro developmental outcome in perinatal asphyxia complicated by hypoxic encephalopathy.
Objectives: To assess:
1. To study the levels of GFAP in neonates affected with perinatal asphyxia.
2. To guide the optimal timing in relation to detection of GFAP after an acute perinatal hypoxic event.
Children are the future of our society. Their overall health has been improved and illnesses have de[1]creased. In any country, mothers and children constitute approximately 60% of the population [1]. Health care delivery system has changed rapidly and role of nurses has also expanded [2].
This paper presents the clinical case of a four-month-old male infant diagnosed with Kawasaki Disease (KD), notable for unusual clinical presentations such as urinary tract infection and brachial artery involvement, and briefly reviews the current medical literature on this subject.
Neuronal Ceroid Lipofuscinoses (NLCs) belong to the group of lysosomal diseases. Their transmission is autosomal recessive. They are characterized by progressive degenerative neurological damage of variable clinical expressions, and by ophthalmic damage.Jansky-Bieloschowsky disease is the classic late infantile form of CLNs or classic CLN2.
Background: Neonatal jaundice is a common condition that affects about 60–80% of newborns and, if severe, can lead to serious neurological squeals. Globally, every year about 1.1 million babies develop it, and the vast majority resides in sub-Saharan Africa and South Asia.
Background: In young infants, presenting signs and symptoms of urinary tract infection (UTI) usually non-specific and can be a manifestation of congenital urinary tract defects. There is no practice guideline for UTI and few studies about extended-spectrum β-lactamase (ESBL) in children aged under 2 months.
In pediatric genetic practice, the follow-up and treatment of some chronic diseases such as Ehlers-Danlos Syndrome (EDS) is of particular importance. EDS is a heterogeneous group of inherited diseases with joint hypermobility, skin hyperextensibility, and tissue fragility. There is no specific treatment for EDS. Follow-up and cure treatment continue to prevent severe compositions and to treat symptoms. Correct management may be vital for these children, as well as for increasing their quality of life.
Introduction: Hydrops fetalis refers to fetal edema and is divided into Immune and Non-immune hydrops fetalis. There is fluid collection in different cavities of the body. IHF, which has decreased with the use of anti-D immune globulin, accounts for 12.7% of cases and is associated with antigen-antibody mediated red cell hemolysis.
Wheezing is one of the most common respiratory causes for seeking medical consultation for children up to one year of age, which has proven negative health, social and economic effects. Moreover, wheezing in patients of the mentioned age group is characterised by clinical heterogeneity, a broad spectrum of etiological causes and complex pathogenesis which make it difficult to choose the right therapeutic approach.
Background: Congenial Heart Defects are amongst the leading causes of childhood mortality with varied presentation. CHDs have complex etiology of with interplay of several genetic and environmental factors. This article discusses various factors in the data compiled in Biobank at Sri Sathya Sai Sanjeevani Research Foundation (SSSSRF), Palwal, Haryana, India which have been reported in literature as the potential contributors to CHD.
Objective: The aim of this research is to find out the long-term effect of Hypoxic Ischemic Encephalopathy (HIE) in term neonates on their feeding and swallowing skills. And to estimate the prevalence and severity of feeding and swallowing problems in children with neurological impairment due to HIE.
Background: Globally, Severe Acute Malnutrition (SAM) remains a major killer of children under 5 years of age. The highest magnitude is seen in sub-Saharan Africa, including Ethiopia. Hypoglycemia is the most common complication of Severe Acute Malnutrition (SAM) and the most life-threatening condition in pediatric society.
Angiopoietin-2 has been used in adult patients for diagnosis of sepsis, prediction of sepsis severity and mortality. However, few studies have assessed its utility in pediatric sepsis.
This study intends to analyse the information needs reported by mothers and fathers of very preterm babies and their perception about the quality, comprehensibility, usefulness and availability of the main sources of information used to fulfil them. Parents (n=211) of very preterm infants hospitalised in all level III NICU in the Northern Health Region of Portugal were consecutively and systematically invited to participate in the study (July 2013-June 2014). Mothers attributed higher importance to information needs than fathers (Median (P25-P75): 3.8(3.6-3.9) vs 3.7(3.5-3.9), p<0.05). Parents focused on information regarding infants' health and treatment during hospitalisation that is provided by nurses and physicians, considering it of good quality, easy to understand and useful. Information provided by nurses was perceived as the easiest to obtain. Improvements in parent-centred communication in NICU depend on assessing gender-specific needs of information, diversifying the sources used during infants' hospitalisation, and assuring the quality of the information.
In prior research maternal upper-body fat is positively associated with infant birthweight, while lower-body fat is utilized for lactation; our goal was to ascertain if the utilization of body fat differs across body types. We hypothesized that only women with large lower-body fat stores accompanied by small upper-body adiposity will uti-lize their lower-body fat in fetal growth.
Mutations in SLC5A7 are associated either with a form of recessive congenital myasthenic syndrome or with autosomal dominant distal hereditary motor axonal neuronopathy type VIIa. The aim of the study is to describe the twelve-year neurological and clinical follow-up of a child with a mutations in SLC5A7.
Pediatric pancreatitis has increased in recent decades. The aim of the present study was to analyze the etiology, clinical manifestations, treatment, complications and outcome of pediatric pancreatitis to help physicians better manage it. Materials and Methods. Data were retrospectively collected from 36 children with pancreatitis admitted to the Gaslini Pediatric Tertiary Center from January 2015 to December 2020.
Anomalous origin of the Left Coronary Artery (ALCAPA) can be revealed in the early infancy through signs of decreased perfusion or sweating and poor feeding. Unfortunately, pain or distress can be misdiagnosed as food intolerance or gaseous colic. Only early diagnosis and surgery to restore two normally arising coronary arteries can be life-saving.
Congenital microgastria is an extremely rare anomaly, which is due to failure of gastric development, and causes a tubular stomach with reduced capacity. It can be isolated or associated with other congenital anomalies.
Loss of response to anti-TNFα treatment occurs frequently in Paediatric Inflammatory Bowel Disease (IBD) patients. Here, we assess the predictive value of serum γ-globulin and IgG concentrations for treatment failure and development of anti-drug antibodies (ADAs).
To evaluate the genetic and clinical characteristics of boys with Dystrophinopathy at the neuromuscular multidisciplinary clinic of a single tertiary pediatric center in Israel. One hundred and sixteen boys with Dystrophinopathy were retrospectively analyzed. The diagnosis of DMD or BMD was based on clinical findings and the dystrophin mutation.
To verify if parents of children aged 0-12 months receive guidance on safe sleep habits and measures to prevent Sudden Infant Death Syndrome (SIDS) in pediatric childcare consultations. This is an exploratory, crosssectional population-web- based survey, with parents of infants who were born in all regions of Brazil.
Neonates graduates usually experience readmissions to hospital. Preterm neonates have 3-4 times more risk for readmissions following discharge compared to the term counterparts. There are several challenges to study readmissions and associated factors with within the neonatal populations, which include high hospital transfer rate during birth hospitalization. Nearby 50% of an infant’s faces readmissions in their first 2 years of life.
Acute bronchiolitis is a clinical entity that may cause morbidity and mortality in infants. The aim of the study was to assess the viral frequency, seasonality, effect of viral pathogens in the course of the disease. A total of 516 pediatric patients under 2 years of age with acute bronchiolitis were evaluated for the study. The most common virus identified was Respiratory syncytial virus in 203 subjects (45%) as in other studies.
A previously healthy, full-term female infant presents to an emergency department with a 3-week history of a persistent diaper rash that has now spread to her abdomen and extremities. The patient is noted to be increasingly agitated at home but without fevers, weight loss, neurological changes or changes to urine or stool output. She has been seen by her PCP who prescribed oral dexamethasone 1 week prior to the emergency department visit, which the patient was taking nightly...
Christian-Weber disease is a rare inflammatory chronic disease of the subcutaneous adipose tissue. It is characterized by idiopathic, relapsing, and febrile episodes of non-suppurative lobular panniculitis. We typically describe the recurrent appearance of painful inflammatory nodules due to systemic inflammation associated with necrosis in the subcutaneous tissue as well as lipophagy leading to lipoatrophy. This skin disorder is associated with recurrent episodes of fever, chills, arthralgia, and myalgia...
Testicular torsion is a rare medical condition among neonates. Main symptoms are swelling, erythema and pain of the scrotum. It can be both perinatal (diagnosed at birth) and postnatal (diagnosed after birth to 28 days of life). If not treated, atrophy of both involving and/or contra lateral testis can be developed. Still being the main treatment option is surgery, new researches suggest delayed surgery in perinatal torsion because of low rates of salvaging involving testis...
NLRP3 gene responsible for an uncontrolled activation of the innate immunity. Objective is to study epidemiological, clinical, genetic, therapeutic and evolutionary characteristics of CAPS.
Material and methods: It is a retrospective analysis over 20 years (2000 to 2020) of 10 cases of CAPS, followed by the P-IV service and the pediatric rheumatology consultation at the Rabat children’s hospital.
This was a new born at 5 days of age, with a non consanguineous marriage, a healthy sibling, born by cesarean section, with a birth weight of 3700g. At birth, he had distension + thoracic swelling with a club foot, which led to a malformative assessment: Transfontanellar ultrasound (normal), transthoracic ultrasound (normal).
A 8-month-old boy from a consanguineous marriage, and having as ATCD two deceased sisters: one who died at the age of 4 years in an unexplored table of poor weight gain and the 2nd died at the age of 4 months in a picture of convulsion. The boy was admitted to the service at birth with a picture of generalized neonatal convulsions. The biological assessment showed a low calcemia, a high phosphoremia and very low parathyroid hormone levels PTH...
A 9-year-old girl, admitted for hemoptysis with chronic cough and weight loss in a febrile context. The pulmonary X-ray showed opacity of the right middle lobe and the thoracic CT showed mediastinal adenopathy necrosé center with focal areas of banded atelectasia. In front of this subacute evolution and the radiological images, tuberculosis was evoked and anti bacillary treatment was started however the phtysiological balance remained negative...
The study is about a 6 years old boy who was hospitalized during the neonatal period for 10 days in the neonatal intensive care unit for a status epileptical with a normal check-up (CT, ETF, EEG and biological check-up).
At the age of 1 year, the parents noticed a delay in psychomotor acquisition, a delay in dental growth and blindness.
Background: With recent advances in medical care, the overall life expectancy of Trisomy 18 has improved significantly. With this, solid tumor reports have increased, with Wilms tumor as the second most common malignancy described. We present a patient with Trisomy 18, Wilms tumor and Eisenmenger syndrome, requiring multidisciplinary management given her complex medical history.
Background: Acute kidney injury is one of the commonest diseases among newborn babies hospitalized in the neonatal intensive care units. It is potentially preventable and treatable with timely intervention which includes conventional therapy and Kidney Replacement Therapy. However access to dialysis consumables is a challenge in developing countries. International Society of Peritoneal Dialysis has set recommendations to use when standard peritoneal dialysis is not accessible.
Axillary fossa masses can be due to a very different kind of medical causes like lymphadenopathy, lymphomas, metastasis. Schwannoma is just one of these. We present a case of a median nerve Schwannoma in a pediatric patient that is a new clinical finding in literature.
A 3-year-old immunized male with a history of prematurity at 34 weeks, asthma, elevated blood lead levels, and speech delay presented with an acute episode of drooling, grunting, and abdominal pain after waking up from a nap. He was taken to the emergency department as his respiratory distress worsened. His mother denied any recent illness, ingestion of caustic substance, trauma, or history of anaphylaxis...
Lateral ventral hernia, which is also called spigelian hernia, is a rare abdominal wall defect seen in children. This hernia is caused by the herniation of preperitoneal fatty tissue and internal organs through the weakness of the aponeurosis which is between semilunar line and lateral edge of rectus muscle...
We report an 8-year-old girl with COVID-19 infection and acute disseminated encephalomyelitis (ADEM). She presented with 2 weeks of fatigue, headache, malaise, and new onset of unsteady gait. She was positive for COVID-19 infection on the respiratory PCR panel with CSF analysis negative for direct infection...
Gastroschisis is one of the most common anterior abdominal wall defects described in literature. Over the last two to three decades, the incidence of gastroschisis has trended upwards and currently stands at 1-3 per 10,000 live births (about 1,871 infants each year)...
Introduction: Primary chronic osteomyelitis is a nonbacterial inflammation of the bones; in the maxillofacial region mainly appears in the jaw. The treatment of this disease may require both surgery and anti-inflammatory drugs for a long time.
We present a reversible case of Obstructive Sleep Apnea (OSA), disseminated histoplasmosis with epiglottis. The patient had resolution of OSA after treatment of the underlying upper airway infection. This case underlies the importance of recognizing reversible causes of OSA. It also reinforces the importance of repeating Polysomnogram (PSG) in certain settings.
Acute Lymphoblastic Leukemia (ALL) is typically diagnosed with an abnormal CBC and blasts on peripheral blood smear and confirmed with peripheral blood or bone marrow flow cytometry. However, this is not always the case, sometimes the diagnosis is guided by other diagnostic tools such as imaging...
The endometrium is the deepest layer of the uterus, and endometriosis happens when endometrium-like tissue structures injuries outside of the uterine depression - ordinarily including the ovaries, the fallopian tubes and the tissue coating the pelvis.
Now and again, endometrial tissue might spread past the pelvic organs.
Background: Intussusception is not an uncommon abdominal surgical emergency in children. However, spontaneous reduction of intussusception is possible, though uncommon.
Materials and methods: This was a retrospective study of the characteristics of infants who had spontaneous reduction of intussusception at a tertiary hospital in Enugu, Nigeria. The study covered a 5-year period. Diagnosis of intussusception was made and confirmed based on clinical features and imaging (ultrasound) findings respectively...
Objective: Neonatal birth asphyxia is a serious health condition. In developing countries, when neonates are referred to Neonatal Intensive Care Units (NICU), sometimes their results for Arterial Blood Gas (ABGs) measurements collected from their umbilical cord blood do not get provided to the NICU. Hence, neonatologists need a proxy parameter to help them detect birth asphyxia...
Inflammatory ocular involvement is a frequent pathology in pediatrics, which is mainly associated with juvenile idiopathic arthritis, Behçet's disease and granulomatosis. Our study was conducted on a series of 55 cases, with ocular involvement associated with different chronic inflammatory diseases, collected in the department of pediatric rheumatology of the Children's Hospital of Rabat over a period of 15 years (2003-2018). The age at diagnosis of ocular involvement was 7.5 years for JIA and 8.8 years for Behcet...
Background: Malaria in pregnancy is a major public health problem that poses significant risks to mothers and their babies. The aim of this work was to study the maternal fetal and neonatal prognosis of malaria in pregnant women at the CNHU-HKM, the CHU-MEL and the SAINT LUC hospital in Cotonou (Benin).
A 07-months-old boy, from a non-consanguineous marriage, born by cesarean section, with a birth weight of 3300g, unique of his family.
He has a familial history: Her mother has a malformation of the fingers with a well tolerated trabecular ventricular communication, acute rheumatoid arthritis treated with extencillin until the age of 18.
Self-medication is defined as "The use by people for themselves or for their relatives, on their own initiative and without the advice of a doctor, of drugs considered as such and having received the Marketing Authorization"[1].
Few studies have been published on self-medication in pediatrics, whether it is to assess the importance or the risks to children. Drug intoxications in pediatrics represent 40% of accidental intoxications due to errors the use of medications [2]. It also exposes to risks of allergy, drug interactions and wrong diagnosis.
We present a case of an adolescent male who presented with altered mental status secondary to hypoglycemia. After evaluation of relevant studies, the patient was revealed to have an insulinoma. Insulinoma in the pediatric population is quite rare yet should be considered when encountering recurring episodes of hypoglycemia in the hospital setting.
In the August 2020 issue of Annals of Pediatrics Capone, et al reported on 4 female pediatric patients who were diagnosed with Celiac Disease (CeD) based on abnormal celiac autoantibodies and duodenal histology [1]. While all patients improved symptomatically on a Gluten Free Diet (GFD), they all had persistently elevated autoantibodies and ongoing villous atrophy on repeat duodenal biopsies despite strict adherence to the GFD...
Background: HIE remains a significant cause of mortality and long-term disability in late preterm and term newborns. At birth, the only available distinction between mild, moderate, and severe HIE is based on the clinical ground. Nevertheless, mild HIE can be presented with subtle or subjective clinical features which may mislead the treating physician and delay his decision to intervene.
Introduction: The mortality of severely ill children presenting with life-threatening emergencies remains high in emerging countries. The objective of this study was to evaluate the management of shock in the pediatric emergency department of the CNHU in accordance with WHO guidelines.
Background: Pyogenic Spondylodiscitis (PSD) is the concurrent bacterial infection of the intervertebral disc and the adjacent vertebral bodies. There is a substantial lack of structured reviews about this topic. Many aspects of the treatment are under debate, mainly because there are no guidelines for paediatric PSD.
Objective: The description of COVID-19 in children has evolved over time. We report here its epidemiological, clinical and evolutionary aspects in a hospital setting in sub-Saharan Africa.
Methods: The study was prospective cross sectional, from January 1 to June 30, 2021. It included all children from 1 month to 18 years of age, admitted to the pediatric emergency ward of the CNHU HKM of Cotonou, tested positive for SARS-CoV-2 by RT-PCR on nasopharyngeal swabs.
Intestinal Lymphangiesctasia (IL) is a rare disease characterized by the dilation of intestinal lymphatics. It can be classified as primary or secondary depending on the underlying etiology. It usually shows in childhood or adolescence, chronic diarrhea and diffuse edema are the main clinical manifestations of the disease. True lymphoedemas can also be present and affect the lower and upper limbs, they are concomitant with the diagnosis or occur during the course.
Calcinosis is a common complication of connectivities, including systemic scleroderma, CREST syndrome, dermatomyositis and systemic lupus erythematosus [1]. Our study consists of the retrospective analysis of five patients followed for calcinosis in the pediatric department of the children’s hospital over a period from 2003 to 2019.
The average age of our patients was 5.9 years with 100% female predominance. Calcinosis was secondary to juvenile dermatomyositis in four cases, and idiopathic in only one case. It affected several anatomical sites in all our patients.
Objective: Gastrointestinal colonization has been proposed as an important risk factor for subsequent Acinetobacter - Blood Stream Infection (ACB-BSI) septicemia, however its association in neonates remains unproven.
Material and methods: In this cohort study, we obtained rectal swabs from all neonates, admitted to Neonatal Intensive Care Unit (NICU) within 48 hours of their stay...
Cornelia de Lange Syndrome (CdLS) is a genetic disorder. It has an autosomal dominant pattern of inheritance and is characterized by multisystem malformations. In this report, we present a case of a newborn having distinctive features such as: Facial dysmorphia (arched eyebrows, synophrys, depressed nasal bridge, long philtrum, down-turned angles of the mouth), upper-extremity deficiency or shortening, hirsutism, cardiac defects, cognitive retardation and gastrointestinal abnormalities...
Background: Paediatric Multisystem Inflammatory Syndrome (PIMS-TS) temporally associated with SARS-CoV-2 was described in April 2020. The incidence of PIMS-TS is rare and the overall risk to children in the UK is considered to be low. We report a cluster of children presenting with PIMS-TS and Kawasaki disease to an Emergency Department (ED) in an NHS trust in London from 17th January 2021 to 28th February 2021.
Eosinophilic Granulomatosis Polyangiitis (EGPA) is a rare ANCA-associated multisystem vasculitides that affects mainly adult population. Occurrence in pediatrics population is extremely rare with only few cases been reported in adolescent patients. Clinical manifestations include respiratory, renal, gastrointestinal, skin, joints and others. Perinuclear antineutrophil cytoplasmic antibodies (C-ANCA) especially directed toward myeloperoxidase antibodies very helpful in diagnosis in addition to biopsy. Systemic corticosteroids and immunosuppressive modulators are the cornerstone in management.
Small for Gestational Age (SGA) is a term used as a proxy for poor intrauterine fetal growth and is associated with higher perinatal mortality and morbidity. A retrospective cohort study was carried out analysing outcomes amongst SGA neonates born over 2 years in a tertiary-care referral teaching hospital. Out of 21086 neonates born during the study period, 3229 (15.3%) were Small for Gestational Age (SGA);...
Nationwide CF newborn screening in Germany was established in 2016. Through the failsafe section of screening algorithm an IRT > 99.9 percentile is rated screening positive and conformation diagnostic (Sweat Test) is initiated without any further (e.g. Genetic) testing.
We present the case of a boy with positive CF newborn screening through the failsafe section, but 2 negative sweat tests carried out at 3 weeks and 5 months of age.
Since 2019, including children from Wuhan, China, there have been few childhood deaths from Covid-19 infections. We documented six deaths worldwide. We show a support for a hypothesis that could explain this phenomenon which includes findings of minimal deaths in countries which have had recent measles outbreaks associated with mass immunizations with Measles, Mumps and Rubella (MMR). It is possible that children are protected from Covid-19 deaths because of recent MMR vaccination.
Objective: Childhood malnutrition is a global problem. Around 20 million children become a victim of Severe Acute Malnutrition across the globe. Malnutrition is believed to contribute to nearly half of deaths among children under five years of age in Asian and African continents. Main aim of this study was to determine the frequency of co-morbidities (Measles, Acute Diarrhea, Pneumonia, Tuberculosis, and Malaria) and their outcomes in children presenting with severe acute malnutrition in Pediatrics emergency department at a tertiary care hospital Karachi.
Vernal Keratoconjunctivitis (VKC) is a severe ocular, chronic, allergic eye disease, characterized by chronic corneoconjunctival inflammation with giant tarsal papillae and/or limbal inflammation. It can result in loss of visual acuity and blindness. For treatment of keratoconjunctivitis topical antihistamines, mast-cell stabilizers, corticosteroids or topical immunosuppressors are prescribed. However, control of ophthalmological symptoms can be challenging and severe adverse events in long-term use especially with systemically applied corticosteroids have to be considered.
The empowerment and participation of patients and families in the health decision-making process are essential elements of patient-centered care. Patients and their families, as well as the associations that represent them, have gradually organized themselves to participate in this process. The advisory councils are one method of engagement for patients. These are seen as well stable bodies of participation in hospitals and health centers.
Objectives: To characterise the features of children diagnosed with new onset type 1 diabetes in the COVID-19 pandemic, exploring the incidence of Diabetic Ketoacidosis (DKA) and investigating any association with SARS-CoV-2.
Methods: We analysed the characteristics of children with new onset type 1 diabetes aged 6 months-17 years presenting from January to July 2020 to 12 Paediatric Diabetes Units (PDUs) in the UK. Data from the same time period in 2019 was compiled for comparison.
Background: Enterocutaneous Fistula (ECF) in children is a rare but a well-recognized complication after abdominal surgical interventions. The conservative management of the ECF is a challenge and a multidisciplinary approach is required. A clinical and chemical monitoring, bowel rest, intravenous antibiotics and parenteral nutrition therapy seems to be the pillar of the medical treatment. Octreotide can hasten the non-operative resolution of the ECF without complications.
A 4-year-old patient presented with abdominal pain and intestinal sub-occlusion. On physical examination, she had an evident state of malnutrition, marked abdominal distention, non-tender abdomen with resistance to palpation, and two cutaneous lipomas. She underwent ultrasound evaluation, x-ray and Computed Tomography (CT) scan with evidence of a large mass occupying most of the abdominal cavity, from the retro-peritoneum to the anterior abdominal wall and displacing cranially the small intestine.
Background: Parapneumonic Pleural Effusions including Pleural Empyema (PPE/PE) are rare complications of respiratory infections in children. Chest tube drainage and intrapleural fibrinolytics are used since more than ten years mainly in order to avoid surgery. Athough guidelines regarding the use of fibrinolytics exist, clinical practice is often different and literature is confusing. Internal standards are intended to support the implementation of guidelines according to local circumstances.
Adolescent athletes merit special medical attention. Recent literature highlights the growing problem of physical inactivity among young people while exploring various dimensions that may explain the lack of physical activity and potentially relevant interventions and strategies. There is growing evidence that physical inactivity predisposes to the development of asthma.
Kawasaki Disease (KD) is an acute, self-limited systemic vasculitis that affects the middle and small arteries, especially the coronary arteries. The incidence is currently on the rise, with about 15 to 25 per cent of children without systemic disease eventually developing coronary artery damage, becoming the most common cause of child-acquired heart disease in the countries where it occurs. At present, stem cell therapy for Kawasaki Disease in mice has made important progress. This article reviews the formation of stem cell therapy for Kawasaki disease.
Objective: To study the sonographic features of lobar pneumonia with parapneumonic effusion in children.
Materials and methods: Retrospective review of 11 children with lobar pneumonia and parapneumonic effusion. The clinical pictures, plain chest X-rays, computed tomographic chest sonographic findings were collected and studied.
Objectives: As potential auto-immune process, Inflammatory Bowel Disease (IBD) was studied following papilloma vaccination. Preliminary, we assessed its incidence and description among girls at age to vaccinate.
Methods: Cohort study including girls aged 9-18 years between 2002-2016 using the Spanish Primary Care Database For Pharmacoepidemiological Research (BIFAP).
Objective: Methotrexate (MTX) is one of the major chemotherapeutic drugs in childhood Acute Lymphoblastic Leukemia (ALL) patients. However the bioavailability of MTX is different in each patient. This study aims to show the bioavailability variances in childhood ALL patients taking MTX as maintenance treatment and thus having a sensitive parameter to determine patients at risk for relapse or toxicity and to determine the optimum plasma MTX dose by measuring the plasma MTX level.
Objective This study aim at assessing the serum iron, ferritin, transferrin, transferrin receptor and Total Iron Binding Capacity (TIBC) in paired mother and newborns in the immediate neonatal period to establish the relationship between the pair, and the role of maternal iron status on that of the newborn.
Atrial Ectopic Tachycardia (AET) may lead to Tachycardia-Induced Cardiomyopathy (TIC) and severe hemodynamic instability. This case report describes a patient presenting with AET and severe myocardial dysfunction. The arrhythmia resulted is cardiorespiratory collapse, requiring mechanical circulatory support. The patient was managed with catheter ablation of the atrial ectopic focus with dramatic fast improvement in function to follow.
The COVID-19 pandemic caused by SARS-COV-2 virus affects fewer children than adults and there are no reports of children with asthma developing severe COVID-19 disease [1]. However, the COVID-19 pandemic has caused a devastating impact on health care delivery and resources [2]. Children with severe asthma suffer from significant morbidity and mortality [3]...
The most common malignancy in childhood is Acute Lymphoblastic Leukemia (ALL). Survivors need a regular follow-up after the cessation of chemotherapy for the long-term complications that are related to the type and intensity of the treatment regimen. Asparaginase is a milestone in the ALL treatment and even though a direct neurotoxicity is uncommon, it is associated with coagulopathy causing both hemorrhagic and thrombotic complications..
Objective: Preoxygenation aims to maximize the pulmonary oxygen reserve to prolong the period of safe apnea during induction. In pediatric anesthesia, adequate preoxygenation is not always possible since young children are often reluctant to accept the face-mask. This study aimed to evaluate the effects of introducing a best-possible preoxygenation routine in a pediatric anesthesia unit.
Objective: Temperature derangement is associated with higher morbidity and mortality in high-risk neonates. The aim of this study was to investigate the prevalence of, and factors associated with temperature derangement in high-risk neonates after birth resuscitation and upon neonatal ward admission.
Background: The implantation of an Medication Reconciliation (MR) process has been shown to significantly reduce ME in the adult population. Although MR is an increasingly consolidated activity in adults, the same cannot be said of the pediatric population, which is a group particularly at risk of suffering ME.
Recently, the use of Clindamycin has increased significantly in pediatric population. Immediate and delayed skin allergic reactions to Clindamycin have been rarely reported in pediatrics. In this case report, we report a delayed maculopapular skin eruptions caused by clindamycin in a 12-year-old girl.
Objectives: This study was conducted to assess the effect of Nocturnal Enuresis (NE) on quality of life of affected children and the associated socio-demographic, family and clinical characteristics of enuretic children.
Methods: A hospital-based cross sectional study with analytic component was conducted on 200 children recruited from NE clinic of Mansoura University Children’s Hospital, Mansoura, Egypt.
Guillain-Barre Syndrome (GBS) is a rare diagnosis in the paediatric population and usually presents with classic post-viral ascending paralysis and Areflexia. Stridor is a common presentation to acute paediatric services and is usually caused by laryngotracheobronchitis (viral croup).
We present two case studies of paediatric patients who presented acutely with respiratory distress and stridor.
Intestinal malrotation is a congenital condition that can have a disastrous and potentially fatal outcome if not diagnosed early. We report a case of malrotation that presented at two weeks of age with severe diarrhea, poor weight gain, and metabolic acidosis. The patient also developed hypoalbuminemia secondary to protein-losing enteropathy. Infective and metabolic causes were ruled out.
Background: The critical analysis of systemic antifungal use in pediatric cancer patients may elucidate targets for antifungal stewardship in the prophylaxis and treatment of Invasive Fungal Infection (IFI). Hitherto, any correlation between pharmacy dispensing data (antifungals) and patient-derived consumption in g/100 inpatient days is unknown.
We report on a term neonate with idiopathic left heart Intracardiac Thrombus formation (ICT), mitral valve insufficiency and as a result heart failure. Thrombolysis with recombinant tissue plasminogen activator (Alteplase) and Heparine was performed successfully. ICT dissolved completely without occurrence of severe complications, such as embolism or hemorrhagic complications. Therefore, we suggest consideration of Alteplase for ICT treatment in neonates.
Background: Bacterial meningitis remains a serious global health problem, with over 1.2 million of cases worldwide each year. It still affects mostly children with significant morbidity and mortality despite the presence of vaccines. The aim of this study was to assess the incidence, clinical presentation, etiologies and outcome of bacterial meningitis in hospitalized children.
Introduction: Acute appendicitis is a common reason to visit the pediatric emergency department, the delayed diagnosis of which is associated with increased morbidity and mortality. The aim of this work is to investigate risk factors associated with delayed diagnosis of Acute Appendicitis (AA).
The study describes the temporal trend of type 1 diabetes (IDDM) in the 0-29 year’s age range in the province of Trento between 1.1.1998 and 31.12.2017, as well as the seasonal and geographical distribution.
The source of the cases is represented by the provincial registry of IDDM which is part of the national RIDI (Italian register of insulin-dependent diabetes) network.
In 2016, the AAP published recommendations for infant safe sleep environment. Since that time, the Virginia Department of Social Services has developed a program to provide an inexpensive but appropriate sleep space for newborns up to 6 months of age. This information had not been introduced to our local hospital that resides in the area of the state with the highest incidence of Sudden Infant Death Syndrome.
The infant population and more specifically infants between 6 to 12 months are the most vulnerable to suffering from diseases that jeopardize the immune conditions of their developing organism. To counteract this, this research aimed to: develop a functional food baby pureed for an infant aged 6 to 12 months, using a probiotic strain, where the probiotic strain studied was Bacillus coagulans.
Mesenteric Lymphatic Malformations (LM) are an unusual and yet important cause of abdominal mass in children and multi-modality imaging can support accurate diagnosis. We report the case of a four-month-old male who presented with symptoms of intermittent bowel obstruction. Radiographic imaging determined the presence of an intra-abdominal mass, displacing adjacent bowel.
This study describes the time course of ketoacidosis (DKA) at the clinical onset of IDDM in childhood and early adulthood in the resident population of the province of Trento, between 1998 and 2017. The source of the cases is represented by the provincial registry of IDDM which is part of the national RIDI Italian registry of insulin-dependent diabetes) network. The registry includes individual’s aged 0-29 years resident in the province of Trento.
The infant mortality rate in Pakistan is still relatively high. One of the factors associated with a high infant mortality rate is the lack of evidence-based health care practices in Pakistan. Non evidence based traditional practices may be associated with poor health outcomes. This study explores a few traditional practices and associated factors regarding infant care among mothers of infants in Karachi, Pakistan.
We describe a case of a 17-month old diagnosed with multiple small left frontal cerebral abscesses with moderate left lateral ventriculomegaly. His initial presentation was high grade fever, vomiting and focal neurological deficits in the setting of a urinary tract infection. A Transthoracic Echocardiography (TTE) with agitated saline contrast study revealed superior sinus venosus defect with Partial Anomalous Pulmonary Venous Return.
Arthritis is an uncommon complication of poorly controlled cystic fibrosis. Our patient is a 13-year-old Caucasian female who presented to the Children’s Hospital of Michigan’s Pediatric Rheumatology clinic with a primary complaint of relapsing and recurring monoarticular arthritis of the ankle over a 2-3-year long period. When reviewing her history, it is noted that she had chronic sinus congestion and a nasal polyp.
Pakistan is experiencing a rapid nutrition transition with a shift from underweight to overweight and obesity. This paper will examine the role of household socioeconomic position (SEP), community SEP and urbanicity on the nutritional status (underweight, overweight and obesity) of Pakistani women. We analysed data on 34,391 women aged ≥20 years enrolled in 2011 National Nutritional Survey of Pakistan (NNS).
The diagnosis of ‘delayed visual maturation’ (DVM) is the terminology preferably used in a normal developing baby with a transient visual deficit and normal ophthalmological findings. With longer follow-up more neurological problems emerge in this group of patients at follow-up.
Respiratory viral infections cause a significant morbidity in children. Significance of isolation of multiple viruses in Acute Lower Respiratory Infections (ALRI) in children is not well characterized. The aim of this study was to compare demographics, resource utilization, and outcomes of patients with single versus multiple viral co-infections.
Coronavirus disease 2019 (COVID-19), which is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is spreading across the world now. Infants and children can be infected by the virus-carrying caretaker, including family members, through respiratory droplets or direct contact. Being exposed in hospital environment or other public spaces could also lead to COVID-19.
Our single hospital report on 8 infants with development delays from 71 neonatal Group B Streptococci (GBS) meningitis/sepsis cases during 2007-2017 in Hong Kong draws attention to the limited information on long-term sequelae after early-life GBS infection in Asia. Two meningitis survivors showed more extreme condition, such as epilepsy. Strategies to reduce such burden in infants remains to be sought.
Most children with Celiac Disease (CD) respond to a Gluten-Free Diet (GFD). Rarely elevation of celiac autoantibodies or Villous Atrophy (VA) persist almost always related to ongoing incidental gluten ingestion; yet some patients remain refractory despite the strictest GFD. Cow’s Milk Protein Allergy (CMPA) can cause enteropathy and recently was associated with elevated Tissue Transglutaminase IgA (TTG).
Goodpasture’s syndrome (GPS) remains a very rare disease entity in the pediatric population characterized by the presence of pulmonary hemorrhage and rapidly evolving glomerulonephritis. Without any appropriate treatment, the disease is generally fulminant, and patient and kidney survival is poor. We hereby describe the case of a 15-year-old boy who presented as an early symptom poorly tolerated anemia, with normal renal function and no oliguria nor respiratory symptoms.
A 2-year-old girl presents to the Emergency Department (ED) with a 36-hour history of redness to the left shoulder and left shoulder pain. Mother reports that a day prior, the daycare staff reported that patient was less playful and acting more irritable. Patient has a history of recurrent ear infections and mother was concerned about another ear infection.
The current coronavirus pandemic has first presented children as healthy, asymptomatic carriers but then cases were reported including severe forms. However, some serious forms have been reported requiring admission to intensive care with an association with Kawasaki disease. Today the desire to broaden serological tests in the population makes it possible to identify IgG antigens specific to Sars-CoV2 by RT-PCR.
Conjugate anti-pneumococcal vaccines are available in routine practice for over two decades now. They have enabled tremendous progress to be achieved in the prevention of severe Streptococcus pneumoniae infections in both children and the elderly. S. pneumoniae is a complex bacterium that has over 90 capsular serotypes each with specific virulence.
Pneumomediastinum is an uncommon entity among pediatric population, being mostly associated in early childhood with pulmonary exacerbations. Association with pneumorrhachis is rare, few cases being reported so far in the literature. We present the case of a 2 years old child who presented in the pediatric pneumology department of “Grigore Alexandrescu” Emergency Children’s Hospital in February 2020 for 24 hour onset of fever, productive cough and dyspnea.
The first two years of life are crucial to the establishment of food preferences. Appropriate feeding practices for infants and young children are among the most effective interventions to improve the health of children. The availability of timely and reliable data can be a way to help early detection of inadequate food consumption and its impact on health and to support decision makers in selecting more effective interventions.
In this cross-sectional, convenience sample study, we screened adolescents for stress using a measure of stressful life events experienced over the last 12 months, a measure of perceived stress, and salivary cortisol in a public-school setting in the Southern United States
Our patient diagnosed as systemic PHA type I which is characterized by salt wasting crises, hyperkalemia, metabolic acidosis, with markedly elevated plasma aldosterone and high plasma renin activity and the diagnosis confirmed by gene study. Treatment of PHA type 1 comprises adequate hydration, replacement of salt loss, and correction of hyperkalemia and acidosis. PHA1 should be kept in mind as a rare cause of electrolyte emergency in infants.
A 13-year-old boy presented to the primary care clinic with asymptomatic, spreader hyperpigmented macules in the anterior and posterior trunk and cervical region that had first appeared 6 months earlier and is spreading...
Background: Infantile brain damage and dysfunction are prime risk factors for developmental delay and cerebral palsy in childhood that may affect school performance and educational success. Prediction of developmental performance would improve current preschool support strategies.
Abbreviations: ANA: Antinuclear Antibodies; CNS: Central Nervous System; CBC: Complete Blood Count; CK: Creatine Kinase; CMP: Complete Metabolic Profile; CT: Computed Tomography; DNA: Deoxyribonucleic Acid; EBV: Epstein-Barr Virus; ESR: Erythrocyte Sedimentation Rate; HIV: Human Immunodeficiency Virus; ICP: Intracranial Pressure; IgM: Immunoglobulin M; MRA: Magnetic Resonance Angiography; MRI: Magnetic Resonance Imaging; MRV: Magnetic Resonance Venography...
The availability of Echocardiography (ECHO) skills is an important aspect of hemodynamic assessment in the management of neonatal patients [1]. It is recommended that a clinician with ECHO skills be on the acute neonatal transfer team, as neonatal transport has become one of the key components of neonatal critical-care services and uplift moves of sick neonates are quite frequent [2]. This case report demonstrates that the availability of neonatal ECHO can significantly contribute to better patient care.
A six-day-old term male presented to our hospital emergency department with a total serum bilirubin (TSB) of 34.8 mg/dL. Double volume exchange transfusion resulted in a fall to 20.6 mg/dL, and intensive phototherapy resulted in a gradual further fall to 5.4 mg/dL by discharge home eight days later. This was the first child of a consanguineous couple from Southern India, with no family history of anemia or jaundice. Extensive evaluation for the etiology of the hyperbilirubinemia revealed homozygous biallelic mutations in GSR, the gene encoding Glutathione Reductase and the heterozygous polymorphism UGT1A1*28....
Over the last three-and-a-half decades, many advances have been made in the care of preterm infants. Some of the most important developments have been in hemodynamic management, including the use of functional echocardiography exams. The Right Ventricle (RV) functional assessment has enabled investigators to track cardiac maturational changes in the first few months of life of Very and Extremely Preterm Infants (VEPIs)...
Introduction: The diagnosis of Juvenile Idiopathic Arthritis (JIA) is difficult in sub-Saharan countries due to the complexity and polymorphism of the disease. JIA can be accompanied by the presence of Anti-Cyclic Citrullinated Peptide Antibodies (ACPA). This work aims to determine the prevalence of ACPA among children suffering from juvenile idiopathic arthritis in Benin....
Introduction: Neuromyelitis Optica Spectrum Disorder (NMOSD) is an inflammatory disease of the central nervous system, generally associated with Anti-Aquaporin-4 (AQP4) antibody. It is characterized by severe attacks of optic Neuritis (ON) and Longitudinally Extensive Transverse Myelitis (LETM). Classically, it tends to spare the conus medullaris...
I present an 11-year-old Caucasian male with a past history of Autism Spectrum Disorder and chronic constipation with overflow incontinence admitted to an inpatient psychiatric unit for worsening agitation. This case describes a correlation between effective constipation management and subsequent reduction in agitation. According to current literature review, no similar pediatric case has described this relationship in clinical practice.
Seizures occur in the neonatal period more than any other time in human life. Status Epilepticus (SE), although poorly defined for neonates, is a seizure lasting more than 30 minutes, or multiple distinct episodes of seizure without a return to neurologic baseline within a 30-minute timeframe. Refractory Status Epilepticus (RSE) is the persistence of seizure activity despite administration of first and second line Antiepileptic Drugs (AED)...
Background: A case of sudden unexpected death of an 11-year-old child with tonsillitis illustrates acute myocarditis and the difficulty in diagnosing it...
Choledochal cysts are a rare phenomenon, with the incidence in western countries estimated to be between 1:100,000 to 1:150,000 births [1]. However, the incidence may be higher in other countries, with some reports suggesting up to 1:1000 [2]. They are more common in females, with a ratio of 3:1 or 4:1 [3,4]. Due to their congenital predominance, most choledochal cysts have been diagnosed in the pediatric population [5]. Their pathogenesis remains unclear, although recent studies suggest that an abnormal pancreaticobiliary junction (ABPJ) may play a role [6]. Choledochal cysts ...
Pneumonia is a common acute disease of the respiratory tract in childhood. In this paper, 700 cases of pneumonia in Changan Hospital of Xi'an city were summarized. All seasons are easy to occur, especially in winter and spring. It is easy to recurrent attacks affect the growth and development of children, if the treatment is not complete. The clinical data of the children are reported as follows...
A 5-month old male presented to the emergency room with fussiness, emesis and fever. An abdominal CT showed a diffusely hypo attenuated spleen concerning for splenic liquefaction, and a Doppler US confirmed no detectable splenic blood flow. At laparotomy, a wandering spleen was identified with 720 degrees of torsion, and he then underwent a splenectomy. This case emphasizes the importance of considering splenic torsion on the differential for pediatric abdominal pain.
Omphaloceles are one of the most common abdominal wall defects, and unfortunately multiple long-term medical problems can occur as a result. Specifically, other structural and chromosomal abnormalities may be present in the setting of an omphalocele. Treatment options vary depending on the size of the defect, with a common option being the "paint and wait" technique, in which a topical agent is applied that allows epithelialization over the amnion sac. Here, we discuss two such cases of omphalocele, and although both received the same treatment, very different outcomes occurred.
A wheeze is a continuous, musical, high-pitched, expiratory sound, heard on chest auscultation as a result of airways narrowing and subsequent airflow limitation [1].
Parents hardly are able to report correctly a child's wheezing, since often they can't distinguish it from a heavy breathing or a whistling and sometimes consider it as the same as cough. This is the reason why both GINA guidelines and in the ERS task force report state that a clinician or a health professional should assess a wheezing diagnosis [1,2].
Influenza is one of the most important vaccine preventable infections and influenza disease and vaccination are one of the most frequent challenges faced by clinicians. According to the Centers for Disease Control and prevention (CDC) and American Academy of Pediatrics (AAP), influenza activity is presently increasing in the United States and there have already been eight pediatric deaths due to influenza this season, hence there is need to heighten awareness to immunize against influenza.
In 2010, the American Academy of Pediatrics (AAP) published guidance that premedication should be used for all new born intubations except emergent events. We aimed to use a multi disciplinary approach to improve Walter Reed National Military Medical Center Neonatal Intensive Care Unit (WRNMMC NICU) compliance for nonemergent intubations to greater than 80% by May 1, 2014.
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Authors
Bridget K Cunningham
Department of Neonatology, Walter Reed National, Military Medical Center, Bethesda, USA
Received: Dec 17, 2017
Accepted: Jan 28, 2018
Published Online: Feb 16, 2018
Authors
Ashlesha Kaushik
Pediatric Infectious Diseases, UnityPoint Health, Iowa, USA
Received: Jan 03, 2018
Accepted: Mar 17, 2018
Published Online: Mar 26, 2018
Authors
Laura Petrarca; Antonella Frassanito; Fabio Midulla; Raffaella Nenna*
Department of Pediatrics, “Sapienza” University of Rome, Italy
Received: Jan 09, 2018
Accepted: Apr 09, 2018
Published Online: Apr 24, 2018
Authors
Christina Kamm, NNP; Courtney D Grassham, NNP; Jennifer Rael, MD; Janell Fuller, MD; Jessie R Maxwell, MD*
Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA
Received: Jan 12, 2018
Accepted: May 07, 2018
Published Online: May 10, 2018
Authors
Winston Wu1*; George Wadie2 ; Jonathan Ho3 ; Olly C Duckett3 ; Samy Saad3
1Pediatric Emergency Medicine, University of North Carolina Chapel Hill, USA
2Wakemed Pediatric Surgery, USA
3Wake Emergency Physicians, USA
Received: Mar 31, 2018
Accepted: May 28, 2018
Published Online: June 01, 2018
Authors
Hui Wen1 ; Fang Qu1 *; Lei Sun1 ; Yajie Lei1 ; Rui Wang2
1Dept of Pediatrics, Changan Hospital, Xi’an, China
2Xi’an Medical University, 1401 class of clinical pediatrics rui wang, China
Received: Mar 11, 2018
Accepted: July 03, 2018
Published Online: July 10, 2018
Authors
Niloy Ghosh BS; Jason Nirgiotis, MD; Janet Meller, MD*
Texas Tech University Health Sciences Center, School of Medicine, Department of Pediatrics, 1400 S Coulter St, Amarillo, TX 79106
Received: Apr 27, 2018
Accepted: Aug 02, 2018
Published Online: Aug 07, 2018
Authors
Évelin Carvalho Carneiro1 ; Nathalie JM Bravo-Valenzuela1,2*; José Valdez de Moura Castro2,3
1Pedicor (Pediatric and Fetal Cardiology Center), Sao Jose dos Campos, SP, Brazil
2Department of Medicine, Taubate University (UNITAU), Taubate, SP, Brazil
3Pediatrics, Department of Medicine, Paris University (Sorbonne), Paris, France
Received: Mar 23, 2018
Accepted: Aug 15, 2018
Published Online: Aug 20, 2018
Authors
B Jason Brotherton, MD, MS1 *; Arthur Partikian, MD2
1AIC Kijabe Hospital, PO Box 20, Kijabe, Kenya
2Keck School of Medicine of USC & LAC+USC Medical Center, USA
Received: Oct 05, 2018
Accepted: Nov 09, 2018
Published Online: Nov 14, 2018
Authors
Amani Saeed; Husam Salama*; Amr Moussa; Mai Al Qubasi; Safaa Al Saige; Shihab kannappillil; Sara Ahmed
Women's Wellness and Research Center (WWRC), Qatar.
Received: Aug 19, 2021
Accepted: Sep 08, 2021
Published Online: Sep 10, 2021
