Common Illness In Children Research Articles

Successful Treatment of Acute Enteric Myocarditis with IVIG Infusion: An Unusual Complication of Enteric Fever.

Myocarditis, the inflammation of myocardium can be caused by a variety of etiological agents with clinical manifestations ranging from asymptomatic to cardiogenic shock. Enteric fever is a very common illness in children and can have a wide range of complications both enteric and non-enteric. The reported incidence of myocarditis in enteric fever ranges from about 1-5%. Paediatricians must be aware of the rare complications that might make the diagnosis challenging. We present one such case of a 6-year-old boy who came to us with a history of fever, diarrhoea and hypotension. On initial evaluation, the child was in cardiogenic shock and was started on IV antibiotics and inotropes. Laboratory evaluation confirmed enteric fever, and Electrocardiogram and echocardiography revealed myocarditis with dilated cardiomyopathy. The child did not improve with initial supportive care. Administration of IVIG resulted in a dramatic improvement in LVEF. The child is now thriving well with normal cardiac function.

AN OVERVIEW OF SIDDHA POLYHERBAL FORMULATION: MILAGU LEGIYAM

Milagu Legiyam is a polyherbal Siddha formulation mentioned in the Siddha literature "Aathmaratchamirtham". It indicates silethumam 96. In the Siddha system of medicine, the clinical presentation of acute pharyngotonsillitis is described under "virana silethumam". Vitiation of kabam is responsible for the virana silethumam. According to modern medicine, this occurs due to the viruses and beta?hemolytic group A streptococci. Nowadays, this is a common illness in children that often leads patients to consult paediatricians. The hot potency of the ingredients of Milagu Legiyam plays the leading role in the management of virana silethumam. Hence, this review highlights the fields of research conducted on the ingredients of Milagu Legiyam. The data was collected from the scientific databases and various textbooks. This review revealed the presence of antimicrobial, antiviral, antioxidant, anti-inflammatory, analgesic, antipyretic, anthelmintic and anticancer activities.

American Medical Society of Sports Medicine Position Statement: Mononucleosis and Athletic Participation.

Infectious mononucleosis (IM) is a common illness in children and young adults caused primarily by the Epstein-Barr Virus (EBV). Transmission occurs primarily through sharing oral secretions, thus IM is known as the "kissing disease." Common clinical manifestations include fever, pharyngitis, posterior cervical lymphadenopathy, and splenomegaly. Atypical lymphocytosis and transaminase elevations are common, and the diagnosis of IM is confirmed with laboratory findings of a positive heterophile antibody ("Monospot"), polymerase chain reaction, or antibodies specific to EBV. Individuals with acute IM may be quite symptomatic and not feel well enough to participate in sports. Splenic enlargement is common, with rupture a relatively rare occurrence, typically occurring within a month of symptom onset, but this risk complicates sports participation, and is often the reason for restricting activity. The management of IM is primarily supportive, with no role for antivirals or corticosteroids. The variability of clinical presentation and the risk of splenic rupture in patients with IM present clinicians with challenging return to play/return to sport (RTS) decisions. This position statement updates the Evidence-Based Subject Review on Mononucleosis by the American Medical Society for Sports Medicine published in 2008 and reviews the epidemiology, clinical manifestations, laboratory assessment, and management including RTS for the athlete with IM. This statement also addresses complications, imaging, special considerations, diversity and equity considerations, and areas for future clinical research. Understanding the evidence regarding IM and sport is essential when communicating with athletes and their families and incorporating shared decision-making in the RTS decision.

Recurrent respiratory infections and vitamin A levels: a link? It is cross-sectional.

Respiratory tract infections are common illnesses in children, causing significant morbidity and negatively affecting their health. Vitamin A protects against infections and maintains epithelial integrity. The goal of this study was to determine the correlation between vitamin A deficiency and recurrent respiratory tract infections (RRTIs). Participants in this cross-sectional study were divided into 3 groups: RRTIs (including patients with history of RRTIs presenting with respiratory tract infection symptoms), RTI (including patients without history of RRTIs presenting with respiratory tract infection symptoms), and control (including children who came for a routine health checkup without a history of RRTIs or respiratory tract infection symptoms). The vitamin A assay was performed using high-performance liquid chromatography. The study included 550 children aged 6.64 ± 2.61 years. The RRTIs group included 150 children (27.3%), the RTI group included 300 children (54.5%), and the control group included 100 children (18.2%). Subclinical vitamin A deficiency and vitamin A deficiency affected 3.1% and 1.3% of subjects, respectively. Subclinical vitamin A deficiency and vitamin A deficiency were higher in children with RRTIs than in those with RTI (8% vs 1.3%, P = .001 and 4% vs 0.3%, P = .006). Additionally, children with RRTIs had significantly higher rates of subclinical vitamin A deficiency and vitamin A deficiency than those in the control group, which had 1% subclinical vitamin A deficiency (P = .017) and no cases of vitamin A deficiency (P = .043). The RRTIs group had higher rates of otitis media (27.3%), sinusitis (20%), and pneumonia (4.7%) than the RTI group (P = .002). Vitamin A insufficiency was associated with RRTIs in children.

A Study on Customized Prediction of Daily Illness Risk Using Medical and Meteorological Data

This study selected the most common illnesses in children and older adults and aimed to provide a customized degree of daily risk for each illness based on patient data for specific regions and illnesses. Sample medical data of one million people provided by the National Health Insurance Corporation and information regarding the meteorological environment and atmosphere from the Korea Meteorological Administration and a public data portal using application programing interface were collected. Learning and predictions were carried out with machine learning. Models with high R2 were selected and tuned to determine the optimal hyperparameter for predicting the degree of daily risk of an illness. Illnesses with an R2 value greater than 0.65 were considered significant. For children, these consisted of acute bronchitis, the common cold, rhinitis and tonsillitis, and middle ear inflammation. For older adults, they consisted of high blood pressure and heart disease, the common cold, esophageal inflammation and gastritis, acute bronchitis, eczema and dermatitis, and chronic bronchitis. This study provides the degree of daily risk for the most common illnesses in each age group. Furthermore, the results of this study are expected to raise awareness of illnesses that occur in certain climates and to help prevent them.

Understanding Internal and External Drivers Influencing the Prescribing Behaviour of Informal Healthcare Providers with Emphasis on Antibiotics in Rural India: A Qualitative Study.

Globally, Antibiotic resistance is a major public health concern, with antibiotic use contributing significantly. Targeting informal healthcare providers (IHCPs) is important to achieve universal health coverage and effective antibiotic stewardship in resource-constrained settings. We, therefore, aimed to analyse the internal and external drivers that influence IHCPs’ prescribing behaviour for common illnesses in children under five, with an emphasis on antibiotic use in rural areas of India. A total of 48 IHCPs participated in focus group discussions. Thematic framework analysis with an inductive approach was used, and findings were collated in the theoretical framework based on knowledge, attitude, and practice model which depicted that the decisions made by IHCPs while prescribing antibiotics are complex and influenced by a variety of external and internal drivers. IHCPs’ internal drivers included the misconception that it is impossible to treat a patient without antibiotics and that antibiotics increase the effectiveness of other drugs and cure patients faster in order to retain them. Formal healthcare providers were the IHCPs’ sources of information, which influences their antibiotic prescribing. We found when it comes to seeking healthcare in rural areas, the factors that influence their choice include ‘rapid cure’, ‘cost of treatment’, ‘distance’ and ‘24 h availability’, instead of qualification, which may create pressure for IHCPs to provide a quick fix. Targeted and coordinated efforts at all levels will be needed to change the antibiotic prescribing practices of IHCPs with a focus on behaviour change and to help resolve misconceptions about antibiotics.

Observed reduction in the diagnosis of acute lymphoblastic leukaemia in children during the COVID-19 pandemic.

To contain the spread of the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), the Norwegian government implemented lock-down restrictions from 13.03.2020: schools, day cares and after-school activities were closed, 2-week quarantine was required following international travel, physical distancing (2 metres) was recommended and groups were restricted to 5 people.

Comparison of effectiveness between polyethylene glycol 4000 and lactulose in the treatment of pediatric functional constipation

Aim: Functional constipation is a common illness in children that requires close follow-up and long-term treatment. This study aims to compare the effectiveness of lactulose and PEG 4000 in the treatment of pediatric functional constipation. Methods: One hundred and twenty-three patients included in this cross-sectional study were all diagnosed with functional constipation according to Rome IV criteria. The ages of the patients, who were all referred to the pediatric gastroenterology outpatient clinic between November 2017 and May 2018, ranged between 8 months and 4 years. Patients with accompanying organic diseases were excluded from the study. Children treated with Lactulose were included in the LAC group and those treated with PEG 4000 were included in the PEG group. The number of bowel movements, Bristol Stool Form Scale (BSFS), pain during bowel movements, formation of anal fissures and fecal impaction at diagnosis and during follow-up were noted from the patient files. A comparison was then made in 1st and 3rd months between the diagnostic findings and follow-up of patients in both groups. Results: There were no age or gender-based differences between the two groups. Sixty-two (50%) patients received lactulose and the remaining 61 patients (50%) received PEG 4000 as treatment. At the end of the third month, patients had improved significantly more in the PEG group in terms of number of daily bowel movements, the presence of pain during bowel movement and median BSFS score (P<0.001). Conclusion: While lactulose and PEG 4000 are both effective in the treatment of functional constipation in children, PEG 4000 is a more effective and successful treatment option compared to lactulose without increased side effects.

A Pre-experimental Study to Assess the Effectiveness of Structured Teaching Program Regarding Knowledge about Home Management of Selected Common Illnesses in Pre-school Children among Mothers Residing in Rural Area of Panipat

Background: Child care is mostly responsibility of mothers. Therefore, the mother’s knowledge about child care influences the nature and quality of care that is given to the child. Several studies have revealed that the mother’s level of education has a positive impact on her knowledge and how she deals with child health care issues.Aims: To assess the knowledge about home management of common illness.Method: A one group pre-test post-test pre-experimental design and evaluative approach adopted. The study was conducted among 60 mothers conveniently selected from rural area of Panipat.Result: The results of the study shows that in pre-test, mothers were having poor knowledge 31.66%, Average knowledge 68.34% and good knowledge 0.00% regarding selected common illness of children and mean score was 11.57 in post-test, poor knowledge is 0.00%, average 41.66% and good knowledge is 58.34% regarding selected common illness of children and means score was 20.77, The post-test mean knowledge score is significantly greater than the pre-test mean knowledge score so structured teaching programme was effective.Conclusion: This study concluded that structure teaching programme was highly effective in improving knowledge of mothers about home management of common illness in children.

Iota-Carrageenan as an Antiviral Treatment for the Common Cold

Introduction: The common cold syndrome of acute upper respiratory tract viral infection is the most common disease among mankind and is an extremely common illness in children. There is a great need for a safe and effective antiviral treatment with minimal side effects. The challenge in developing a treatment is the numerous and varied respiratory viruses that cause this common illness and the need for a treatment with good tolerability and safety. Explanation: All respiratory viruses must reach the cell surface by passing through respiratory fluid and mucus, and this common feature may allow for the development of antivirals that capture viruses during this transit. This article discusses how large polyanionic molecules such as iota-carrageenan may trap positively charged respiratory viruses. Iota-carrageenan is a large polysaccharide molecule which is neither absorbed from the respiratory tract nor metabolised. It, therefore, does not have any pharmacological properties. Iota-carrageenan nasal spray has been shown to reduce the titres of respiratory viruses and to reduce the severity of symptoms in placebo-controlled clinical trials, including children and adults. The results of four clinical trials are presented. Conclusion: Iota-carrageenan is a good candidate as a safe and effective non-specific antiviral treatment for common cold, and more research is justified on polyanionic molecules like carrageenans as antivirals.

Out-of-pocket health expenditure on diarrheal illness among under-five children in a teaching hospital ins Odisha, India.

Diarrhea is the most common illness in children under 5 years of age, accounting for a financial burden for families in developing countries. The aim of this study is to determine the out-of-pocket health expenditure for the management of diarrhoeal illness among the under-five children in in-patient and out-patient cases. A cross-sectional study was conducted during January-April 2018 among 60 under-five children with diarrheal illness reporting to pediatric outpatient department (OPD) and 60 under-five children admitted to pediatric ward of a tertiary care teaching hospital. For determining the out-of-pocket health expenditure, both direct and indirect costs for the management of diarrheal illness were estimated both for out-patient and in-patient cases. The cost of the treatment has been presented as the cost of prehospital visits, during a hospital visit and posthospital visit. Overall, median out-of-pocket health expenditure for the management of diarrheal illness for out-patient and in-patient cases were Rs. 1186 (interquartile range [IQR]: Rs. 510) and Rs. 6385 (IQR: Rs. 5889), respectively. The median direct expenditure for OPD cases was Rs. 778.50 (IQR: Rs. 263) and indirect expenditure for OPD cases were Rs. 407.50 (IQR: Rs. 336) The median direct and indirect expenditure for inpatient cases were Rs. 3823 (IQR: Rs. 1942) and Rs. 2237 (IQR: Rs. 4256) respectively. Only 13% of in-patient cases had some kind of medical insurance. A considerable economic burden is faced by the families for treating diarrhea in under-five children. Improved access to safe drinking water and sanitation, promotion of hand hygiene, exclusive breastfeeding, rotavirus vaccination, and use of oral rehydration therapy will reduce hospitalization and out-of-pocket expenditure. The study findings recommend for appropriate policy for provision of financial protection while seeking health care services.

Infekcyjne zapalenie wsierdzia u dzieci — wzrastający problem

Infective endocarditis (IE) is becoming a more common illness in children, especially in patients with congenital heart disease. There remains no consensus as to the optimal diagnosis, treatment and prophylaxis. One of the most challenging problems in this group of patients is surgery, because of the often extremely small dimensions and the lack of proper valve prosthesis. In light of this growing problem, there is a need for better knowledge regarding IE if this insidious disease is to to be promptly identified and and effectively treated.

Rapid detection of respiratory organisms with the FilmArray respiratory panel in a large children\u2019s hospital in China

BackgroundRespiratory tract infections (RTIs) are the most common illness in children, and rapid diagnosis is required for the optimal management of RTIs, especially severe infections.MethodsNasopharyngeal swab or sputum specimens were collected from children aged 19 days to 15 years who were admitted to a hospital in Shanghai and diagnosed with RTIs. The specimens were tested with the FilmArray Respiratory Panel, a multiplex PCR assay that detects 16 viruses, Mycoplasma pneumoniae (M. pneumoniae), Bordetella pertussis (B. pertussis) and Chlamydophila pneumoniae (C. pneumoniae).ResultsAmong the 775 children studied, 626 (80.8%, 626/775) tested positive for at least one organism, and multiple organisms were detected in 198 (25.5%). Rhinoviruses/enteroviruses (25.5%, 198/775) were detected most often, followed by respiratory syncytial virus (19.5%, 151/775), parainfluenza virus 3 (14.8%, 115/775), influenza A or B (10.9%), adenovirus (10.8%), M. pneumoniae (10.6%) and B. pertussis (6.3%). The prevalence of organisms differed by age, and most of the viruses were more common in winter. Of the 140 children suspected of having pertussis, 35.0% (49/140) tested positive for B. pertussis.ConclusionsFilmArray RP allows the rapid simultaneous detection of a wide number of respiratory organisms, with limited hands-on time, in Chinese pediatric patients with RTIs.

Morbidity due to Infections in Preschool Children from Urban Low Income Households

Respiratory infection, diarrhea and fever are three common infections in underfive children; there are substantial differences in the reported prevalence and ranking of these three morbidities between studies and surveys. Seasonal and year to year variation in prevalence of morbidity and impact of health care on the duration and severity of infection has not been explored. A large scale mixed longitudinal study of under-five children from urban low income households was carried out to document year to year and seasonal variations in the prevalence and type of morbidity and utilization of health care for morbidity and their impact on duration and severity of morbidity. Between January 2012 and Dec 2015 a total of 3888 pre-school children were investigated and 74636 observations were made; prevalence of morbidity was 10.3% (range 7.2%-11.6%). Prevalence of morbidity was higher between July and October. Respiratory infection was the most common and diarrhea was the least common illness in children. Over years there was a rise in the respiratory illness because of increase in construction activity in the study area. There was a fall in diarrhoeal diseases after construction of water supply and drainage system. Majority of the households accessed health care; as a result duration of illness was short and severe morbidity was rare. Improvement in environmental hygiene can result in reduction in morbidity. Access to health care reduces duration and severity of infection.

EVALUATION OF CRYSTALLINE PENICILLIN UTILIZATION IN PEDIATRICS WARD OF TERTIARY CARE HOSPITAL OF EASTERN ETHIOPIA: THE CASE OF HIWOT FANA SPECIALIZED UNIVERSITY HOSPITAL

Background: Crystalline penicillin is one the commonly prescribed antibiotics that has been used for the treatment of certain susceptible bacterial infections over several years in Ethiopia. However, little is known about the appropriateness of clinical indication, dose and frequency of administration, duration and therapeutic outcome of patients in general and pediatrics in particular. Therefore, the study aimed to evaluate the rational use of crystalline penicillin injection in pediatrics ward of Hiwot Fana Specialized University Hospital (HFSUH), Eastern Ethiopia. Methods: Retrospective cross sectional study was employed for evaluating medication records of hospitalized pediatric patients who received crystalline penicillin from Dec 1, 2015- Feb 29, 2016 at pediatrics ward of HFSUH. Based on Joint Commission on Accreditation of Healthcare Organizations (JCAHCO) criteria, 114 medical records (20%) were selected by systematic random sampling from the total of 570 records. The study was conducted from Mar 1-Mar 15, 2016. Besides, the data were evaluated against Standard treatment guideline (STG) of Ethiopia for general hospitals and World Health Organization (WHO) drug use evaluation guideline Results: Among the 114 medical records of pediatric patients included in the study, the dose and frequency of administration, contra-indications and drug interactions of crystalline penicillin were according to the STG of Ethiopia for general hospitals, and WHO Guidelines for the management of common illnesses in children in areas with limited resources. All the 114 (100%) cases were consistent with guidelines for contra-indications and drug interaction of crystalline penicillin use. Moreover, 108(94.74%) and 112 (98.24%) of the cases were in accordance with the guidelines for the dose and frequency of administration, respectively. However, 93 (81.58%), 59 (51.75%) and 59 (51.75%) of the patient cases were not according to the guidelines of crystalline penicillin use for indications, duration and outcome of therapy, respectively. Conclusion: Crystalline penicillin utilization pattern in pediatric ward of HFSUH has fully adhered to the STG of Ethiopia for general hospitals and WHO Guideline for the majority of the parameters with regard to dose and frequency of administration, contraindications, and drug interactions as well as met the thresholds set for most of the DUE criteria. However, indication, duration and outcome of therapy were not in accordance with the guideline. Keywords: Drug use evaluation; Pediatrics; medication records; crystalline penicillin; Standard treatment Guidelines; World Health Organization

Dust Mite–Induced Perennial Allergic Rhinitis in Pediatric Patients and Sublingual Immunotherapy

Allergic rhinitis (AR) is a common illness in children and can impair their quality of life. Furthermore, many children remain symptomatic despite maximizing systemic antihistamine and topical therapies. It is at this clinical juncture that immunotherapy may be considered. The efficacy and safety associated with both subcutaneous (SCIT) and sublingual (SLIT) approaches are reviewed and positioned as treatment options for pediatric patients, with specific focus on current literature as it relates to SLIT in children, including those with perennial allergic rhinitis. Although there is more extensive experience with SLIT treatment in Europe, grass and ragweed tablet forms of SLIT are approved in the US. Approaches to the care of pediatric patients with allergic rhinitis are presented.

Comparison of Clinical Findings and Rapid Streptococcal Antigen Detection Test in the Diagnosis of Group A Streptococcal (GAS) Pharyngitis

Background: Group A -hemolytic Streptococcal (GAS) pharyngitis is a common illness in children. Diagnosis and proper treatment of group A streptococcal sore throat is important particularly to prevent non-superlative sequel. Clinical findings continue to be used in differentiating streptococcal infection from viral sore throat. Objectives: The aim of this study was to evaluate the accuracy of clinical findings and rapid test in comparison with culture in the diagnosis of group A Streptococcal (GAS) pharyngitis. Patients and Methods: Ninety-four children between 3 to 16 years, who were referred to the pediatric clinic of Rasoul-e-Akram hospital with clinical findings of fever or sore throat were evaluated from October 2006 to May 2007. Clinical findings were recorded and swabs were taken for group A streptococcal cultures and streptococcal rapid antigen detection test. Analysis of statistical significance was performed using the chi-square method. The accuracy of clinical findings and rapid test was compared with the culture method as the gold standard, and sensitivity, specificity, positive predictive values, negative predictive value, positive likelihood ratio (LR+) and negative likelihood ratio (LR-) were calculated. Results: The culture was positive in 38 (40.4%) of the 94 evaluated children. The mean age of children was 8 3.7 years. The presence of petechiae, exudate and Lymphadenopathy (LAP) was more likely in children with positive streptococcus culture and rapid test (P value < 0.05). Lymphadenopathy was known to feature the most sensitivity (100%), specificity (76.8%), and positive predictive value (74.5%), negative predictive value (100%) and positive likelihood ratio (LR) (4.3) among clinical findings. The results of rapid test showed sensitivity of 89.4%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 93.3% in comparison with culture as the gold standard. In general, the accuracy of rapid test was found higher than subjective clinical findings (P = 0.001). Conclusions: Although LAP had good performance in early diagnosis of GAS, a combination of clinical findings, including tonsillar exudates, petechiae with results of rapid antigen test or culture is necessary for clinician judgment. Throat culture is the gold standard test for detecting group A Streptococcal infection, but rapid test is a good replacement for culture.

Application of oral food challenge in the diagnosis of gastrointestinal food allergy in the children

Food allergy is a common illness in children, which is divided into IgE-mediated, non-IgE mediated and mixed-mediated food allergy.Gastrointestinal tract is the mainly affected organ, mostly mediated by non-IgE mechanism.Gastrointestinal food allergy are lack of unified diagnostic criteria currently, whose mechanism is also elusive.Moreover, the double-blind placebo-controlled food challenge is the gold standard for the diagnosis of food allergy.This review focuses on the procedure for the oral food challenge and its application in the diagnosis of gastrointestinal food allergy. Key words: Oral food challenge; Food allergy; Gastrointestinal tract; Diagnosis

How general practitioners treat migraine in children--evaluation of a headache guideline.

Migraine is a common illness in children associated with a negative impact on the quality of life. In the Netherlands, treatment of migraine is commonly performed by general practitioners (GPs). The migraine guideline of the Dutch College of General Practitioners recommends inactivity and acetaminophen in patients with migraine who are younger than 18 years of age. The aim of our study was to evaluate the pharmacological treatment of migraine in children by GPs before referral to the hospital. Our objective was to answer the following questions. First, are GPs inclined to prescribe medication not listed in the Dutch College of General Practitioners Guideline? Second, which clinical characteristics are associated with the use of medication not listed in this guideline? In this retrospective cross-sectional study, prescribed medication and migraine characteristics were investigated in Dutch migraine patients (age <18 years), using hospital records and a paper-and-pencil questionnaire. A total of 223 children were included. Medications not listed in the guideline were used in 41.3% of the patients before referral. In children younger than 12 years, the use of medication not listed in the guideline was associated with an older age, when compared with children who were treated according to the guideline. In the group of patients older than 11 years, the use of medication not listed in the guideline was associated with a longer history of migraine and a longer duration of the migraine attacks. Medications not listed in the GPs guideline were used in a large portion of the patients younger than 18 years with migraine who were referred to secondary care.

Effectiveness of information booklet on knowledge regarding home management of selected common illness in children

Background: Child care is mostly the responsibility of mothers. Therefore, the mother's knowledge about child care influences the nature and quality of care that is given to the child. Several studies have revealed that the mothers’ level of education has a positive impact on her knowledge and how she deals with child health care issues. Aims and objectives: The study aimed at assessing knowledge of mothers regarding home management of selected common illness in children ,evaluate the effectiveness of information booklet on knowledge regarding home management of selected common illness in children and find out the association between the post test scores with selected demographic variables. Material and Methods: A one group pre-test post-test pre-experimental design and evaluative approach was adopted. The study was conducted among 60 mothers conveniently selected from amodar village at Vadodara. Results: The results of the study shows that in pre test, mothers were having on average 44.26% knowledge regarding selected common illness of children and mean score was 25.8±3.96 in post test , average 75.88% knowledge regarding selected common illness of children and means score was 25.8±3.96 . The post test mean knowledge score is significantly greater than the pre-test mean knowledge score so information booklet was effective.