Paralysis In Infants Research Articles

Pengaruh Pendidikan Kesehatan terhadap Tingkat Pengetahuan tentang Imunisasi Polio dan Pentabio pada Ibu yang Memiliki Anak (Usia 0-6 Bulan) di Wilayah UPTD Puskesmas Kayon Palangka Raya

Background Polio immunization is used to prevent poliomyelitis disease that can cause paralysis in infants. The disease is caused by a poliomyelitis virus that enters through the food, breeds in the gastrointestinal lymph nodes, then spreads through the blood to the nervous system, resulting in paralysis or lifelong disability. Immunization of combined pentabio DPT-HB and Hib vaccine. Pentabio immunization prevents certain diseases, such as diphtheria, whooping cough, tetanus, hepatitis B, meningitis, and pneumonia caused by Hib bacteria (Haemophilus influenza type b). The phenomenon that occurred at Kayon Health Center when interviewed, there are still many mothers who are less aware of polio and pentabio immunization. Objectives The purpose of this study was to determine the effect of health education on the level of knowledge about polio immunization in mothers who have babies (aged 0-6 months) in the UPTD Work Area of the Kayon Health Center Palangka Raya. The design used in this study uses a pre-experimental research design with a "one group pre-test and post-test design. Sampling using purposive sampling and a sample of 15 respondents mothers who have a baby (age 0-6 months). The data were collected using questionnaires, then analyzed using a non-parametric statistic test of the Wilcoxon sign tank test. The result of statistical test analysis using the Wilcoxon test above got a P-Value of 0,003 <0,05, so health education influences the mother's knowledge level about polio immunization and pentabio at baby 0-6 months. In conclusion, after being given health education, respondents have an increased level of knowledge. It is expected that the research can provide information about the influence of health education on the level of knowledge about immunization of polio and pentabio in mothers who have babies (ages 0-6 months) to increase mothers' knowledge in the importance of polio and pentabio immunization in children.

Recovery Infectious Enterovirus 71 by Bac-to-Bac Expression System in vitro and in vivo.

Enterovirus 71 (EV71) is one of the most important etiological agents for hand–foot–mouth disease. Compared with coxsackievirus A16 infection, EV71 infection is often associated with severe central nervous system complications, such as encephalitis, encephalomyelitis, and acute flaccid paralysis in infants and young children. In this study, we constructed a recombinant baculovirus with T7 ribonucleic acid polymerase under the control of a cytomegalovirus promoter and simultaneously engineered the T7 promoter upstream of a full-length EV71 complementary deoxyribonucleic acid. After transduction into mammalian cells, typical cytopathic effects (CPEs) and VP1 signals were detected in cells transfected with recombinant baculovirus. Additionally, viral particles located in the cytoplasm of human rhabdomyosarcoma cells (Rd) and Vero cells were observed by electron microscope, indicating that EV71 was recovered using a Bac-to-Bac expression system in vitro. After four passages, the rescued virus had a growth curve and plaque morphology similar to those of the parental virus. Furthermore, the Vp1 gene and the protein from the mouse brain were detected by reverse transcription polymerase chain reaction and immunohistochemistry after intracerebral injection of purified recombinant baculovirus. Typical CPEs were observed after inoculation of the supernatant from mouse brain to Rd cells, revealing a reconstruction of EV71 in vivo. Thus, we established a new approach to rescue EV71 based on a baculovirus expression system in vitro and in vivo, which may provide a safe and convenient platform for fundamental research and a strategy to rescue viruses that currently lack suitable cell culture and animal models.

Reasons for Vaccine Rejection in 0 to 2 Years Old Children Registered to Family Health Centers in Konya

AbstractObjective According to the 2017 report of the World Health Organization (WHO), ∼1.5 million people die from vaccine preventable diseases. The WHO is working to generate and popularize effective vaccination programs. However, the concept of “vaccine rejection,” which first started in Europe and United States, has started to make an impact in Turkey during the past 10 years. It is therefore seen as a growing danger in future. This study was conducted to determine, detect, and prevent the reasons of vaccine rejection that have increased in recent years.Methods A cross-sectional study was conducted between June and December at 2015. In all districts of Konya (n = 31), it was aimed to reach all 242 families who rejected vaccination to their 0 to 2 years old babies. Families having more than one child refused to vaccinate all of their children. A questionnaire consisting of 47 questions was prepared by the researchers, using the standard trainings of the Ministry of Health and the literature. A total of 172 families agreed to participate in this study. The questionnaire was applied to the parents using the telephone interview technique. Data were presented as mean ± standard deviation and percentage.Results About 41.3% (n = 71) of the mothers were high school graduates, 50.6% (n = 87) of their fathers were university graduates. About 82.6% (n = 142) of the participants received examination, treatment and follow-up services from family physicians and family health personnel. About 20.9% (n = 36) of the children were the only children of the family. About 55.8% (n = 96) of the families also refused the vaccination for other children. About 83.7% (n = 144) of the unvaccinated children had infants/children follow-up care. While all participants stated that vaccines had side effects, 31.4% (n = 54) of these believed that vaccines cause autism or paralysis in infants. About 62.2% (n = 107) of their mothers did not receive tetanus vaccine during pregnancy. The highest rate of nonvaccination was with the second dose of hepatitis A vaccine, which 96.5% (n = 166) refused. The most accepted vaccine was the first dose of hepatitis B vaccine, which was refused by 18.0% (n = 31). About 79.7% (n = 137) of the participants did not know the reason for the vaccination and 95.9% (n = 165) thought that the vaccines were not required. All participants received information from the health personnel about the vaccines. While 9.9% (n = 17) of the families thought that vaccines cause infertility, 44.8% (n = 77) did not receive vaccination because the vaccines were produced abroad.Conclusion A growing number of families refuse to have their babies vaccinated. The production of vaccines abroad is a major cause of insecurity. There are also beliefs that vaccines cause infertility. Vaccine production in Turkey should be accelerated and public education about vaccines should be reviewed. Training provided to families about vaccines should also be reviewed.

Unilateral Phrenic Nerve Palsy in Infants with Congenital Zika Syndrome

Abstract Since the first identification of neonatal microcephaly cases associated with congenital Zika virus infection in Brazil in 2015, a distinctive constellation of clinical features of congenital Zika syndrome has been described. Fetal brain disruption sequence is hypothesized to underlie the devastating effects of the virus on the central nervous system. However, little is known about the effects of congenital Zika virus infection on the peripheral nervous system. We describe a series of 4 cases of right unilateral diaphragmatic paralysis in infants with congenital Zika syndrome suggesting peripheral nervous system involvement and Zika virus as a unique congenital infectious cause of this finding. All the patients described also had arthrogryposis (including talipes equinovarus) and died from complications related to progressive respiratory failure.

BELL’S PALSY AMONG INFANTS - OUR EXPERIENCES IN A TERTIARY CARE HOSPITAL OF EASTERN INDIA

Objectiv:The most common etiology of unilateral facial palsy is Bell’s palsy, also called as idiopathic facial palsy. Bell’s palsy in infant is rare and an uncommon clinical entity and often taken as pediatric emergency by parents. Paralysis of facial nerve has a tremendous impact on patient as well as parents particularly when a pediatric patient is affected. It is regarded as a diagnosis of exclusion. Bell’s palsy in infants is rare than adults and diagnosis is made on the basis of exclusion.Aim and Objectives:Clinical diagnosis and management of Bell’s palsy among infants from a tertiary care hospital of eastern India.Material and Methods:In this prospective study, we have documented detail clinical manifestation and management of infants of Bell’s palsy from the pediatric age group. When an infant presents with facial nerve paralysis, a full clinical history and detailed examination were recommended for accurate diagnosis. Simultaneously, the parents were reassured and the prognosis was explained to the parents. Oral steroids along with physiotherapy were started in the outdoor basis.Results:We diagnosed six infants of Bell’s palsy in age group of 5 months to 12 months. Among them 4 females and rest 3 were male. These Infants showed improvement with complete recovery in 83% cases within 3 weeks whereas partial recovery was seen in rest.Conclusion:In this study, we find out that, oral steroids along with physiotherapy and eye care are effective for Bell’s palsy in infants.Keywords:Bell’s palsy, infant, facial nerve, oral steroid.

Idiopathic bilateral vocal cord paralysis in infants: Case series and literature review.

Vocal fold paralysis is the second most common congenital laryngeal anomaly in newborns. Bilateral paralysis is a severe condition and often remains of unknown etiology. We report our experience of congenital idiopathic bilateral vocal fold paralysis in newborns and infants, and discuss the therapeutic options. Retrospective review. A retrospective review was carried out at a single tertiary referral center over a 15-year period of children presenting with congenital idiopathic bilateral laryngeal paralysis (CIBP). Twenty-six patients were identified and managed over period of the study (mean follow-up, 6.7 years). A tracheostomy was eventually performed in 14 patients, 12 during the neonatal period. Endoscopic treatment was performed in 16 patients and an external approach in five patients after endoscopic failure. Three patients were managed by watchful waiting. Spontaneous recovery occurred in 16 patients (median age, 14.5 months), including nine with a tracheostomy. Decannulation was achieved in 12 patients (median age, 42 months), and noninvasive positive pressure ventilation (NPPV) was applied in six patients. Only inhomogeneous series of pediatric bilateral laryngeal palsies have been published so far, making it difficult to identify prognostic and predictive markers, as well as therapeutic guidelines. Focusing on CIBP, our data suggest that the management strategy must take into account the possibility of a delayed spontaneous recovery. NPPV is an interesting therapeutic tool in this situation. A systematic somatic assessment is mandatory to look for associated conditions.

Bilateral diaphragm paralysis after simultaneous cardiac surgery and Nuss procedure in the infant

The case of a 15-month-old boy with bilateral diaphragm paralysis after simultaneous cardiac surgery for tetralogy of Fallot, and Nuss procedure for pectus excavatum, is presented. Extubated one day after his first operation, the boy suffered severe respiratory distress soon after, due to bilateral diaphragmatic paralysis. Diaphragm paralysis restricted abdominal respiration, while thoracic respiration was inhibited by metallic bar after the Nuss Procedure, which combined prevented extubation for 47 days. Thoracoplasty, such as the Nuss Procedure, should not be performed simultaneously with cardiac surgery because abdominal and thoracic respiration can be restricted in infants, causing prolonged, severe, post-surgical respiratory failure. • Bilateral Diaphragmatic Paralysis in infants causes severe respiratory failure. • Bilateral Diaphragmatic Paralysis restricts abdominal respiration. • Thoracic respiration is restricted just after thoracoplasty. • Cardiac surgery and thoracoplasty should be performed separately.

Infant botulism in Costa Rica: first report from Central America

Clostridium botulinum is known to cause descending paralysis in infants throughout the world. The subject of this study was a three-month-old Costa Rican boy who was hospitalized because of poor suction and feeding, hypotonia, and constipation. Clinical history and physical examination findings suggested infant botulism. Samples were sent to the Winnipeg Public Health Laboratory, where Clostridium botulinum toxin A was identified by PCR and culture from the stools, making this the first report of infant botulism in Central America. Although infant botulism is a known disease, the limitations in identifying it in Central America contributes to the misdiagnosis and under-reporting of this disease.

Congenital Vocal Cord Paralysis

Congenital stridor is rare. The most common presentation for congenital stridor is chronic loud breathing since birth. It is noticed in patients by the first 4 to 6 weeks of life. There are many causes of congenital stridor. Laryngomalacia is the most common cause of congenital stridor. Congenital vocal cord paralysis is the second most common cause of congenital stridor. Vocal cord paralysis in infants and children can be either congenital or acquired and either unilateral or bilateral. Although most commonly the paralysis is idiopathic, there are many causes of acquired vocal cord paralysis. Arnold-Chiari malformation is the most common congenital central nervous system abnormality resulting in vocal cord paralysis, and central nervous system abnormalities usually may cause bilateral vocal cord paralysis. In this article, we report 2 patients with idiopathic congenital vocal cord paralysis. One of them has the unilateral vocal cord paralysis, and the other, bilateral.

Vocal Fold Paralysis in Infants with Tracheoesophageal Fistula

We describe the clinical characteristics and management of vocal fold paralysis in infants who were born with a tracheoesophageal fistula (TEF). This retrospective case series included all infants born with TEFs who presented to our pediatric otolaryngology unit and intensive care unit because of dyspnea or aphonia in the years 2005 and 2006, and who were found to have vocal fold paralysis. Five boys and 1 girl were studied. One infant had stridor before TEF repair, and 5 after it. All children underwent flexible laryngotracheobronchoscopy and were treated in the pediatric intensive care unit before diagnosis of the vocal fold paralysis (5 bilaterally and 1 unilaterally) was made. The ages at diagnosis of paralysis ranged between 14 days and 14 months. Five infants required tracheostomy. Vocal fold paresis in infants is difficult to diagnose. The risk for recurrent laryngeal nerve injury associated with TEF and TEF repair should be emphasized in these children. We recommend that all newborns with TEF should be examined by an otolaryngologist before operation to confirm the mobility of the vocal folds and to rule out other associated airway malformations, and examined after operation if respiratory difficulties develop.

Laser cordotomy for the treatment of bilateral vocal cord paralysis in infants

Vocal cord paralysis is the second cause of neonatal stridor. Several surgical treatments are proposed in order to avoid tracheotomy or to decanulate patients. Laser posterior partial cordotomy is supposed to be a minimal invasive procedure. The purpose of the study is to share our experience in management of laryngeal paralysis with this technique in infants and appreciate its role in avoiding tracheotomy in infants. Retrospective study. The charts of 0-2-year-old patients treated for vocal cord paralysis from 1996 to 2007 are reviewed. Eleven infants with bilateral laryngeal paralysis in adduction presented severe dyspnoea. Tracheotomy was performed in four out of them, proposed in five others. One infant out of 11 underwent long-term intubation, and one presented with progressive dyspnoea. The laser posterior partial cordotomy allowed the decanulation after one session (n=2) or avoided tracheotomy (n=5), one patient had significant improvement of his respiratory function. Two patients needed a second session of laser cordotomy and were decanulated. The functional results for the voice and swallowing qualities were subjectively satisfactory. One patient had pejorative evolution. Posterior partial cordotomy is an effective, minimal invasive technique which can be proposed to avoid tracheotomy in infants with bilateral adduction vocal cord paralysis. No functional sequelae were observed.

Aspiration in Infants and Children

1. Parvathi Mohan, MD 1. Children’s National Medical Center Washington, DC 1. Gastroesophageal Reflux . Orenstein SR. In: Pediatric Gastrointestinal Disease . Wyllie R, Hyams JS, eds. Philadelphia, Pa: WB Saunders;1993:337–369 2. Disorders of Deglutition . Tuchman DN. In: Pediatric Gastrointestinal Disease . Walker WA, Durie PR et al, eds. Ontario, Toronto, Canada: B C Decker Inc; 2000:277–288 3. Vocal Cord Paralysis in Infants and Children . De Jong AL, Kuppersmith RB, Sulek M, Friedman EM. Otolaryngol Clin North Am . 2000;33:131–149 4. Advances in Pediatric Airway Radiology . Wiet GJ, Long FR, Shiels WE II, Rudman DT. Otolaryngol Clin North Am . 2000;33:15–28 Safe swallowing of solid foods and liquids is the result of a complex interaction of cranial nerves and muscles of the oral cavity, pharynx, and proximal esophagus. During the voluntary oral phase, the food bolus is altered in the mouth and propelled past the pharynx where the respiratory and gastrointestinal tracts meet; precise coordinating mechanisms are crucial to prevent aspiration into the respiratory passage. Normal mechanisms of safe swallow include raising of the palate, epiglottic tilt, cord closure, primary peristalsis of the esophagus, and the tone and sequential relaxation of the upper and lower esophageal sphincters. Disorders affecting the central and peripheral nervous system and muscles of the previously noted structures, therefore, can affect swallowing mechanisms and lead to potentially dangerous sequelae. Aspiration may be defined as the accidental entry of a foreign …

Character and treatment of diaphragmatic paralysis in infant and toddler

Character and treatment of diaphragmatic paralysis in infant and toddler

Idiopathic Facial Paralysis in Infants

Idiopathic Facial Paralysis in Infants

Incidence of vocal fold paralysis in infants undergoing ligation of patent ductus arterious: Zbar R.I.S.; Chen A.H.; Behrendt D.M.; Bell E.F.; Smith R.J.H.Ann. Thorac. Surg. (USA) (1996) 61/3 (814–816)

Incidence of vocal fold paralysis in infants undergoing ligation of patent ductus arterious: Zbar R.I.S.; Chen A.H.; Behrendt D.M.; Bell E.F.; Smith R.J.H.Ann. Thorac. Surg. (USA) (1996) 61/3 (814–816)

Incidence of vocal fold paralysis in infants undergoing ligation of patent ductus arteriosus

Left-sided, iatrogenic vocal fold paralysis (IVFP) secondary to recurrent laryngeal nerve injury is a potential complication of ligation of patent ductus arteriosus (PDA). This study investigates specific risk factors associated with IVFP. A retrospective chart review was performed for all infants 12 months of age or younger who underwent operative PDA closure at the University of Iowa from January 1, 1991, to January 1, 1994. Six cases of IVFP were diagnosed in 68 infants who underwent PDA ligation using clips (52.9%), suture ligatures (41.2%) or both (5.9%). Compared with infants without postoperative IVFP, infants with IVFP were smaller at birth (0.9 versus 2.3 kg; p < 0.001) and more premature (gestational age, 26.3 versus 33.8 weeks; p < 0.001), and were smaller (1.1 versus 3.4 kg; p < 0.001) and younger (31.9 versus 88.4 days; p < 0.001) at operation. Weight gain from birth to operation was significant only in infants without postoperative IVFP (p < 0.05). Although the overall incidence of IVFP in all infants undergoing PDA closure was 8.8%, five of the six cases (83.3%) of IVFP occurred in extremely low birth weight infants, ie, those weighing 1 kg or less at birth. Among the cohort of extremely low birth weight babies undergoing operation, the incidence of IVFP was 22.7%. Iatrogenic vocal fold paralysis was associated only with the use of surgical clips; however, because clips were used in 90.9% of the premature infants requiring PDA ligation, it was not possible to establish whether suture ligature is a safer technique. This study demonstrates that the single major risk factor for IVFP after ligation of PDA is birth weight less than 1 kg.

Vocal fold paralysis in infants twelve months of age and younger.

Seventeen cases of unilateral or bilateral vocal fold paralysis were diagnosed in infants younger than 12 months from 1991 to 1994 at the University of Iowa Hospitals and Clinics. Eight (47%) children with left vocal fold paralysis had a history of prior thoracic surgery--two to repair complex congenital anomalies and six to ligate a patent ductus arteriosus. During the study period, a total of 81 patent ductus arteriosus ligations were performed, yielding a 7.4% postoperative incidence of vocal fold paralysis. Seven (41%) children had idiopathic vocal fold paralysis (3 right, 1 left, 3 bilateral). Two (12%) children had VFP caused by central nervous system pathology (1 right, 1 bilateral). Tracheotomy was not required in any case. Prognosis for vocal fold paralysis varied with cause. With left vocal fold paralysis caused by thoracic surgery, no improvement was noted after an average follow-up of 6 months; with idiopathic vocal fold paralysis infants improved within an average of 6 weeks of diagnosis; with vocal fold paralysis caused by central nervous system pathology, treatment of the underlying condition was followed by return of vocal cord function. Irrespective of cause, the morbidity associated with vocal fold paralysis is minimal. Although tracheotomy is not required, careful airway observation is important. Differences and similarities of these results with other studies are discussed.

Vocal fold paralysis in infants twelve months of age and younger

Seventeen cases of unilateral or bilateral vocal fold paralysis were diagnosed in infants younger than 12 months from 1991 to 1994 at the University of Iowa Hospitals and Clinics. Eight (47%) children with left vocal fold paralysis had a history of prior thoracic surgery–two to repair complex congenital anomalies and six to ligate a patent ductus arteriosus. During the study period, a total of 81 patent ductus arteriosus ligations were performed, yielding a 7.4% postoperative incidence of vocal fold paralysis. Seven (41%) children had idiopathic vocal fold paralysis (3 right, 1 left, 3 bilateral). Two (12%) children had VFP caused by central nervous system pathology (1 right, 1 bilateral). Tracheotomy was not required in any case. Prognosis for vocal fold paralysis varied with cause. With left vocal fold paralysis caused by thoracic surgery, no improvement was noted after an average follow-up of 6 months; with idiopathic vocal fold paralysis infants improved within an average of 6 weeks of diagnosis; with vocal fold paralysis caused by central nervous system pathology, treatment of the underlying condition was followed by return of vocal cord function. Irrespective of cause, the morbidity associated with vocal fold paralysis is minimal. Although tracheotomy is not required, careful airway observation is important. Differences and similarities of these results with other studies are discussed. (Otolaryngol Head Neck Surg 1996;114:18-21.)

Randomised Trial of Routine versus Selective Paralysis during Ventilation for Neonatal Respiratory Distress Syndrome

The strategy of non-selective neuromuscular paralysis was compared with that of synchronised (fast rate) ventilation and selective paralysis in infants receiving mechanical ventilation for respiratory distress syndrome with chronic lung disease as the primary outcome measure. One hundred and ninety three infants weighing under 2000 g were randomly allocated to receive either pancuronium during mechanical ventilation in the acute phase of respiratory distress syndrome (non-selective group) or synchronised ventilation (initial ventilatory rate at or above that of the infant's) (selective group). Infants in the selective group received pancuronium if they were consistently expiring during the inspiratory phase of the ventilator cycle. There was no significant difference between the groups with respect to birth weight, gestation, and sex distribution. There was no significant difference between the group with respect to death (selective 19%, non-selective 16%), pneumothorax (selective 14%, non-selective 14%), chronic lung disease (selective 49%), non-selective 47%), and oxygen dependency at 36 weeks' postmenstrual age (selective 32%, non-selective 39%). Routine paralysis of ventilated infants has potential complications that may be avoided by using synchronised ventilation. As the latter is not associated with an increased incidence of long term respiratory complications, it is concluded that it is the optimum strategy of the two for ventilating infants with respiratory distress syndrome.

Bilateral vocal fold paralysis in infants: tracheostomy or not?

Tracheostomy has, in the past, been performed in the majority of children under one year with bilateral vocal fold paralysis. We present our experience of 11 cases over a ten-year period during which tracheostomy was avoided whenever possible. Ten cases were managed conservatively but in the youngest a tracheostomy was required. Full bilateral vocal fold mobility developed in all cases at a mean age of 11.5 months (range 5-26 months). Our experience suggests that the airway can commonly be managed expectantly without a tracheostomy.