Introduction: Acute otitis media is an acute inflammation of the mucosa of the middle ear cavities. It is often secondary to nasopharyngitis, which favors the passage of infection through the Eustachian tube to the mi...Introduction: Acute otitis media is an acute inflammation of the mucosa of the middle ear cavities. It is often secondary to nasopharyngitis, which favors the passage of infection through the Eustachian tube to the middle ear. The aim of our study was to improve the management of AOM in the Paediatric Department of the Hospital National Ignace Deen (Conakry). Patients and Methods: This was a prospective descriptive study lasting 6 months from 01 July to 31 December 2011;the study covered 525 cases out of a total of 6276 children, i.e. a frequency of 8.36%. Results: The most affected age group was 6 to 11 months. Males predominated (69.71%). 82.29% had a history of recurrent rhinopharyngitis. The most frequent reason for consultation was incessant crying (66.29%). Rhinopharyngitis and malaria were the most commonly associated pathologies (87.62% and 39.62% respectively). 72.19% of our patients were admitted with congestive AOM and received medical treatment. We recorded one case of otomastoiditis which was treated surgically. Conclusion: AOM is more common in children aged between 6 and 24 months. Good collaboration between paediatricians and ENT specialists is essential to reduce the morbidity of AOM.展开更多
Introduction: Sickle cell disease has physical and emotional repercussions on the child and his family. The aim of this study was to describe the psychosocial experiences of mothers of children with sickle cell diseas...Introduction: Sickle cell disease has physical and emotional repercussions on the child and his family. The aim of this study was to describe the psychosocial experiences of mothers of children with sickle cell disease in order to improve the overall care of the child. Methods: This was a descriptive cross-sectional study carried out in the pediatrics department of Bouaké University Teaching Hospital from June to September 2023. It focused on mothers of major sickle-cell-affected children followed up in the pediatrics department of the Bouaké University Teaching Hospital. The variables studied were sociodemographic, psychological, social and economic. Results: Of the 40 mothers surveyed, 15% were not in school and 32.5% were unemployed. For them, sickle cell disease was of natural (genetic) origin in 90% and supernatural in 10%. They stated that the child had an average age of 36 months (extremes 7 and 108 months) when the disease was discovered. And 52% of them were satisfied with the way the disease was clearly and completely announced. Following the announcement, the questioned mothers said they had felt shock (35%), sadness (31.7%), guilt (23.3%) and discouragement (10%). Anxiety and depression were experienced by 77.5% and 22.5% respectively. In 60% of cases, they stated that the disease was incurable, and the outcome was fatal in 2.5% of cases. The child’s illness was a source of problems in the home in 25% of cases, represented by arguments in 92% and divorce in 8%. In 97.5% of cases, the mother told her family and friends about the child’s illness. In 90% of cases, the mother and child benefited from psychological support from family and friends. Conclusion: Sickle cell disease is a serious illness with a psychological and social impact on mothers. We recommend psychological support for mothers from the moment of diagnosis and throughout follow-up.展开更多
Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September...Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the Department of Pediatrics at Gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommendations.展开更多
<strong>Ba</strong><span style="font-family:Verdana;"><strong>ckground:</strong></span><span><span><span style="font-family:""><span st...<strong>Ba</strong><span style="font-family:Verdana;"><strong>ckground:</strong></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Angina is a common </span><span style="font-family:Verdana;">paediatric</span><span style="font-family:Verdana;"> condition. It has certain peculiarities in children, particularly </span><span style="font-family:Verdana;">with regard to</span><span style="font-family:Verdana;"> the frequency of bacterial germs and the use of diagnostic tests. </span><span style="font-family:Verdana;">The aim of this study was</span><span style="font-family:Verdana;"> to determine the place of the rapid diagnostic test in the management of group A beta-hemolytic streptococcal angina in children in the </span><span style="font-family:Verdana;">paediatric</span><span style="font-family:Verdana;"> ward at Donka National Hospital. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a prospective descriptive study lasting 6 months from 1st February to 31st July 2019 concerning childr</span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">en aged between 3 and 15 years old who were diagnosed with angina. Epidemiological, clinical, para-clinical </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> therapeutic variables were studied. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of 1494 registered children, we collected 116 cases of angina (7.76%). Out of 52 patients who benefited from the rapid diagnostic test, we recorded 13 cases of angina due to group A beta-hemolytic </span><span style="font-family:Verdana;">strptococcus</span><span style="font-family:Verdana;">. The male sex was the most dominant with 31 cases (59.69%) and a G/F sex ratio of 1.47. The age group most affected was between 3 and 5 years old (50%). The average age of our patients was 4.8 years with extremes of 3 and 14 years. Clinical manifestations were dominated by fever and dysphagia (100%) followed by odynophagia (11.79%). We recorded 13 cases of streptococcal angina (25%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The factors that influence it are multiple, dominated by community life, passive smoking </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> allergies. The use of RDTs in these young children would help in the diagnosis of acute group A </span><span style="font-family:Verdana;">beta hemolytic</span><span style="font-family:Verdana;"> streptococcal angina and rational antibiotic prescription.</span></span></span></span>展开更多
<strong>I</strong><strong>ntroduction:</strong> Priapism is a rare pathology, known since antiquity. Sickle cell disease is the main aetiology in Africa. The aim of our work was to report our e...<strong>I</strong><strong>ntroduction:</strong> Priapism is a rare pathology, known since antiquity. Sickle cell disease is the main aetiology in Africa. The aim of our work was to report our experience in its treatment. <strong>Material and Methods:</strong> This is a prospective, descriptive study carried out at the urology department of the Libreville University Hospital from January 2018 to December 2020. All sickle cell patients admitted to urology for priapism were included. The parameters studied were socio-demographic, clinical and therapeutic parameters as well as the evolution after treatment. <strong>Result:</strong> We collected 19 priapisms in sickle cell patients. The average age was 20.9 years with extremes of 4 and 53 years. Fifteen patients were homozygous SS. All patients had stasis priapism. The average consultation time was 22.4 hours. All patients had perioperative medical management combining hyperhydration, analgesia and antibiotic prophylaxis. A vasoactive drug was administered to 13 patients. Sixteen patients had a puncture of the corpus cavernosum. A distal cavernosal-spongiosum shunt under penile block was performed in 6 patients. The outcome was favorable from the outset in 12 cases, marked by complete detumescence of the corpus cavernosum. Partial detumescence was noted in 7 patients with the need for a new puncture of the cavernous body. A complication such as edema of the penis was in only one of our patients. A recurrence was noted in 2 patients. After an average follow-up of 6 months, no sequelae erectile dysfunction was observed. <strong>Conclusion:</strong> Priapism is a frequent complication among sickle cell patients in Libreville. Medical management associated with a cavernous puncture with administration of vasoactive drugs allows a favourable evolution without after-effects.展开更多
Introduction: Worldwide, 2.3 million children died in the first 20 days after birth in 2022, according to the WHO. In Mali, according to the sixth Demographic and Health Survey, the neonatal mortality rate was estimat...Introduction: Worldwide, 2.3 million children died in the first 20 days after birth in 2022, according to the WHO. In Mali, according to the sixth Demographic and Health Survey, the neonatal mortality rate was estimated at 33% live births in 2018. The Timbuktu region had the highest neonatal mortality rate in the country with 44%. The objective of this work was to study the causes of neonatal morbidity and mortality and related factors in the paediatrics department of Timbuktu hospital. Materials and method: This was a descriptive, cross-sectional study conducted from 1 January to 31 December 2023 in the neonatology unit of the paediatrics department of Timbuktu hospital, including all newborns admitted to hospital. Results: Our study took place over 12 months, during which 618 admissions were made to the paediatric ward, including 244 newborns, i.e. 39.48%. The majority of newborns (86.5%) were admitted in the first week of life. The mean age was 3 days, with a sex ratio of 1.1 for males. Weight under 2500 g was 54.1% for an average weight of 2372 g. The main mode of admission was transfer from the hospital maternity unit (62%). The main reasons for admission were acute foetal distress (27.9%) and prematurity (26.2%). The average age of the mothers was 24, with extremes of 15 and 49. The mothers were housewives (87.3%), uneducated and primiparous (59% and 36.5% respectively);only 40.2% had made more than 3 antenatal care visits. Newborns born by vaginal delivery accounted for 80.7% and those born by caesarean section for 19.3%. The risk of infection was present in 52.5% of cases. The three leading causes of hospitalisation were birth asphyxia (40.2%), neonatal infection (32.4%) and prematurity (25%). The mortality rate was 21.7%. The main causes of death were prematurity (39.6%), birth asphyxia (32.1%) and neonatal infection (24.5%). Conclusion: Neonatal morbidity and mortality remain a concern in Timbuktu. Despite the unfavourable security situation, morbidity and mortality indicators are close to those in some hospitals in Mali. The correct application of Essential Newborn Care and antenatal care remains a major challenge for the hospital and the Timbuktu region.展开更多
Diagnosis of childhood tuberculosis (TB) is difficult, especially in resource-limited countries where the number of reported cases of TB-HIV co-infection continues to rise. This co-infection poses a diagnostic and the...Diagnosis of childhood tuberculosis (TB) is difficult, especially in resource-limited countries where the number of reported cases of TB-HIV co-infection continues to rise. This co-infection poses a diagnostic and therapeutic problem for caregivers. We report a case of rifampicin-resistant HIV-TB pulmonary coinfection in a 19-month-old infant.展开更多
Introduction: Viral hepatitis B (VHL) is a public health problem, particularly in sub-Sahara Africa. The aim of this study was to assess vaccination coverage against HBV in children in Brazzaville. Patients and Method...Introduction: Viral hepatitis B (VHL) is a public health problem, particularly in sub-Sahara Africa. The aim of this study was to assess vaccination coverage against HBV in children in Brazzaville. Patients and Methods: This was a cross-sectional analytical study conducted in Brazzaville health centres from January to September 2019. It involved children aged between six months and six years who received a vaccination against HBV. Sampling was exhaustive and based on stratified sampling. Results: The overall prevalence of children vaccinated against HBV in Brazzaville was 96.2%. It was insufficient in the Talangai health district (79%). The pentavalent vaccine was administered to 97.7% of children, 85% of whom had received all three doses. The reasons for incomplete vaccination were parents’ ignorance of HVB (85.6%) and of vaccination (14.3%). Conclusion: Although the prevalence of vaccinated children is high in Brazzaville, it is still insufficient in some health districts, particularly Talangai, because parents are unaware of the disease and of vaccination. Pentavalent is the only vaccine available in the national vaccination programme, which is why an effective national vaccination policy needs to be put in place. .展开更多
Background: Testicular atrophy is recurrent after orchidopexy for intra-abdominal cryptorchidism due to damage to vessels. Fowlers-Stephens and Shehata methods proposed staged orchidopexy, but are still associated to ...Background: Testicular atrophy is recurrent after orchidopexy for intra-abdominal cryptorchidism due to damage to vessels. Fowlers-Stephens and Shehata methods proposed staged orchidopexy, but are still associated to a rate of atrophy greater than 10%. Purpose: We set out to present a new technique that preserves testicular vessels. Our study is aimed at investigating testicular vitality after surgery. Patients and Method: We reviewed files of boys who underwent orchidopexy for 2 years in our department. Those who have been operated for intra-abdominal cryptorchidism with the new technique and aged between 6 months and 14 years old were included in our study. We excluded boys who have been operated before 6 months and after 14 years old and those who did not respect their follow-up plane. Ultrasound (US) outcomes were used to measure testicular volumes and blood flow at each postoperative visit. The Sample population was divided into group A and group B representing testes that were followed respectively for 12 and 24 months. Results: 22 boys with 25 testes were included in our study;11 testes in group A and 14 testes in group B. In each group, we noted a significant difference of UDT volumes from the third month after surgery with respective P-values 0.05. There was no statistical difference between UDT and contra lateral testes volumes 12 months after surgery in group A and 24 months in group B with respective P-values of 0.07 and 0.72. All volume differential indexes were Conclusion: This method offers a new perspective in performing safe orchidopexy for intra abdominal undescended testes.展开更多
Introduction: Acute diarrhoea is a real public health problem worldwide and is responsible for considerable mortality in developing countries. The aim of this study was to evaluate the management of acute diarrhoea in...Introduction: Acute diarrhoea is a real public health problem worldwide and is responsible for considerable mortality in developing countries. The aim of this study was to evaluate the management of acute diarrhoea in children aged 0 - 59 months hospitalised in the paediatric ward of the Ratoma CMC. Material and Methods: This was a descriptive cross-sectional study lasting 6 months, from 01 July to 31 December 2023, including all children aged 0-59 months admitted for diarrhoea lasting no more than 14 days and whose parents agreed to take part in the study. Sociodemographic, clinical, therapeutic and evolutionary data were studied. Results: 79 children were seen for acute diarrhoea out of 330 consulted, i.e., a frequency of 23.9%. The age group 0 - 11 months was the most represented, at 54.4%. Males predominated: 62% with a sex ratio of 1.6. The average consultation time was 3 days, with extremes of 0 to 10 days. The number of bowel movements per day varied from 3 to 12. The stools were liquid in 82.27% of cases. All hospitalised children were dehydrated, with 68.4% suffering from moderate dehydration, 21.5% from mild dehydration and 10.1% from severe dehydration. Malaria was the condition most frequently associated with diarrhoea (27.8%). Malnutrition was found in only 2.5%. 82% of the children had received oral rehydration with ORS and 18% intravenous rehydration. Almost all the children (93.67%) had a favourable outcome. We recorded one case of death, a rate of 1.26%. Conclusion: Acute diarrhoea in children is one of the most frequent reasons for consultation in the paediatric department of the Ratoma CMC. Often accompanied by fever and vomiting, it is frequently observed in children aged 0 to 11 months, with a predominance of males. The overall management of acute diarrhoea in children involves improving people’s standard of living, combating faecal peril, drinking water consumption, promoting vaccination, the use of oral rehydration solutions and zinc, and training healthcare staff.展开更多
Introduction: Neonatal mortality remains a major public health concern. According to the World Health Organisation (WHO), the number of newborns dying each year has fallen from 5 million in 1990 to 2.4 million in 2019...Introduction: Neonatal mortality remains a major public health concern. According to the World Health Organisation (WHO), the number of newborns dying each year has fallen from 5 million in 1990 to 2.4 million in 2019. The aim of our study was to describe the main morbid conditions and their lethality in newborns admitted to the paediatric ward of the CSREF in Commune V. Methodology: We conducted a 12-month prospective descriptive and analytical study from August 2020 to July 2021. Results: During the 12 months of the study, out of 2654 neonates admitted to hospital, 216 met our inclusion criteria, i.e. 8%. Newborns admitted in the first few hours of life represented 99.54% of cases. Full-term newborns accounted for 65.74% of the total. Forty-eight percent of newborns had hypothermia on admission. The most common diagnosis was asphyxia in 55.56% of cases, followed by neonatal infection in 27.78% and prematurity in 10.65%. Death was recorded in 22.2% of cases. Asphyxia was the main cause of neonatal death, followed by prematurity in our context. Conclusion: Improving the prognosis of newborn babies will require a thorough understanding of neonatal pathologies and the implementation of a pre- and perinatal prevention policy.展开更多
Background: Exclusive breastfeeding is globally promoted as a preventive health measure. However, an increasing incidence of jaundice among exclusively breastfed neonates has been observed. In Jos, Nigeria, anecdotal ...Background: Exclusive breastfeeding is globally promoted as a preventive health measure. However, an increasing incidence of jaundice among exclusively breastfed neonates has been observed. In Jos, Nigeria, anecdotal evidence suggests a rise in jaundice cases among breastfed infants during their first week of life. This study investigates the relationship between neonatal jaundice and the biochemical composition of maternal breast milk in Jos, Nigeria. Objective: To evaluate the role of maternal milk protein status and other milk constituents in the development of neonatal jaundice among exclusively breastfed full-term infants. Methods: This cross-sectional study involved 152 participants, comprising of 76 neonates (38 jaundiced and 38 healthy controls) and their corresponding 76 mothers at Jos University Teaching Hospital. Biochemical analyses were conducted on maternal breast milk (albumin, proteins, casein, fat, lactose, enzymes) and infant serum (bilirubin, albumin, proteins, enzymes). Statistical analysis was performed using Mann-Whitney tests with significance set at p ≤ 0.05. Results: Maternal breast milk from mothers of jaundiced infants showed significantly lower protein (0.73 ± 0.07 g/100ml), albumin (0.62 ± 0.04 g/100ml), and casein (1.6 ± 0.12 g/100ml) levels compared to controls (p Conclusion: The study highlights a potential link between lower maternal milk protein levels and the occurrence of neonatal jaundice. Interventions aimed at enhancing maternal nutrition and promoting more frequent breastfeeding may mitigate the risk. Further research should explore additional maternal and neonatal factors contributing to this condition.展开更多
Introduction: Osteosarcoma is the most common primary malignant bone tumor in children. It is highly aggressive and has a poor prognosis. A late presentation modifies and makes difficult the management affecting the s...Introduction: Osteosarcoma is the most common primary malignant bone tumor in children. It is highly aggressive and has a poor prognosis. A late presentation modifies and makes difficult the management affecting the survival of children. We report the case of a large conventional osteosarcoma in a 13-year-old girl. Case Presentation: Adolescent girl admitted for painful swelling of the left shoulder with absolute functional impotence of the thoracic limb and severe anemia. The painful swelling was thought to have been caused by a minor trauma that had occurred six months previously. The patient’s general condition was poor, and she presented with a large, shiny, painful mass over the shoulder and upper 2/3 of the left arm, measuring 28 cm long by 28 cm wide and 57 cm in circumference, and a large fistulous axillary adenopathy. CT scan showed a tumour lesion of the left humerus with liver and lung metastases, raising suspicion of osteogenic osteosarcoma. The tumor was classified according to TNM staging: T2N1M1(a + b). Management was modified when uncontrolled bleeding developed. It consisted of an extended amputation of the left thoracic limb. Pathological analysis showed a high-grade conventional osteosarcoma. Quality improvement was obtained for thirty days, followed by the onset of dyspnea. The evolution was towards death at forty days post-operatively. Conclusion: Osteosarcoma is a highly aggressive cancer. Delayed treatment leads to a fatal outcome. Early diagnosis is one of the challenges to be met in order to improve survival.展开更多
Liver cell transplantation presents clinical benefit in patients with inborn errors of metabolism as an alternative,or at least as a bridge,to orthotopic liver transplantation.The success of such a therapeutic approac...Liver cell transplantation presents clinical benefit in patients with inborn errors of metabolism as an alternative,or at least as a bridge,to orthotopic liver transplantation.The success of such a therapeutic approach remains limited by the quality of the transplanted cells.Cryopreservation remains the best option for long-term storage of hepatocytes,providing a permanent and sufficient cell supply.However, isolated adult hepatocytes are poorly resistant to such a process,with a significant alteration both at the morphological and functional levels.Hence,the aim of the current review is to discuss the state of the art regarding widely-used hepatocyte cryopreservation protocols,as well as the assays performed to analyse the post-thawing cell quality both in vitro and in vivo. The majority of studies agree upon the poor quality and efficiency of cryopreserved/thawed hepatocytes as compared to freshly isolated hepatocytes.Intracellular ice formation or exposure to hyperosmotic solutionsremains the main phenomenon of cryopreservation process,and its effects on cell quality and cell death induction will be discussed.The increased knowledge and understanding of the cryopreservation process will lead to research strategies to improve the viability and the quality of the cell suspensions after thawing.Such strategies,such as vitrification,will be discussed with respect to their potential to significantly improve the quality of cell suspensions dedicated to liver cell-based therapies.展开更多
Sleep and epilepsy are two well recognized conditions that interact with each other in a complex bi-directional way. Some types of epilepsies have increased activity during sleep disturbing it; while sleep deprivation...Sleep and epilepsy are two well recognized conditions that interact with each other in a complex bi-directional way. Some types of epilepsies have increased activity during sleep disturbing it; while sleep deprivation aggravates epilepsy due to decreased seizure threshold. Epilepsy can deteriorate the sleep-related disorders and at the same time; the parasomnias can worsen the epilepsy. The secretion of sleep-related hormones can also be affected by the occurrence of seizures and supplementation of epileptic patients with some of these sleep-related hormones may have a beneficial role in controlling epilepsy.展开更多
AIM: To determine if dopamine is effective in treating neonatal hypotension and safe to use comparing to other inotropes. METHODS: This is a review of evidence on inotropic treatment of neonatal hypotension. Databases...AIM: To determine if dopamine is effective in treating neonatal hypotension and safe to use comparing to other inotropes. METHODS: This is a review of evidence on inotropic treatment of neonatal hypotension. Databases searched were MEDLINE and the Cochrane Library, a total of 134 studies were identified. Only studies with high quality evidence(level 1a and b and 2a) were included. After review, only eight studies were included in the final analysis. Pooled risk ratios derived for each outcome [Mantel-Haenzel(M-H) fixed effect] with CI, as reported in the Cochrane reviews were plotted in forest plot form. RESULTS: Eight articles met inclusion criteria, which all included treatment in preterm infants. Dopamine increased mean arterial blood pressure(BP)(n = 163; r = 0.88, 95%CI: 0.76 to 0.94) and systolic BP(n = 142; r = 0.81, 95%CI: 0.42 to 0.94) comparing to placebo. Dopamine has been shown overall to be statistically more effective in increasing BP than dobutamine(n = 251, r = 0.26, 95%CI: 0.20-0.32). However there were no differences in short term outcomes(periventricular leucomalacia, periventricular haemorrhage) and mortality between both drugs. There is no statistical evidence of dopamine being more effective than adrenaline or corticosteroids. There was no difference in morbidity and mortality outcomes when dopamine was compared to hydrocortisone(RR 1.81, 95%CI: 0.18 to 18.39) or adrenaline. CONCLUSION: In preterms, dopamine is the most studied drug, and we suggest it could be used as first line treatment in hypotension.展开更多
Objective: To observe the effect of Astragalus Injection (AD on levels of blood selenium (Se) and cytokines, and T cellular immune function with viral myocarditis (VM) in children. Methods: Eighty children with VM wer...Objective: To observe the effect of Astragalus Injection (AD on levels of blood selenium (Se) and cytokines, and T cellular immune function with viral myocarditis (VM) in children. Methods: Eighty children with VM were randomly divided into 2 groups. The control group consisted of 38 patients, to whom conventional therapy, including energy mixture, vitamin C and coenzyme Q10, etc. were given. The treated group (n = 42), to whom combination therapy of conventional therapy and Al were given. The levels of blood Se and cytokine, including interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and also evaluation of T lymphocyte subsets and cardiac function were observed. Results: The results showed that after treatment, the levels of blood Se were significantly higher (P<0.01), while IL-1,IL-6 and TNF-a were significantly lower (P<0.01) than those before treatment in the control group. The left ventricular end diameter (LVED) were significantly decreased (P<0.01), left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were significantly increased than those before treatment in the treated group(P<0.01, P<0.05). T lymphocyte subsets got normalized (P<0.01), and compared with the control group, the difference was significant (P<0.01). Conclusion: Astragalus membranaceus possesses anti-viral effect, adjusts the balance of cytokine and T cellular immunity, and improves the clinical manifestation and cardiac function. It is an effective approach in treating viral myocarditis.展开更多
BACKGROUND Lisfranc injuries are rare and can be easily missed. This injury is extremely rare in children, with limited published data. Different treatment options have been described; one of the options in adults is ...BACKGROUND Lisfranc injuries are rare and can be easily missed. This injury is extremely rare in children, with limited published data. Different treatment options have been described; one of the options in adults is the "mini" TightRope^(TM) Syndesmosis Device that provides non-rigid fixation with impressive results. However, there is no reference regarding the use of this device in children.CASE SUMMARY We describe the case of an 11-year-old girl who sustained a Lisfranc injury of her right foot that was initially missed in the Accident and Emergency department of her local hospital. This case was a ligamentous/periosteal sleeve avulsion type of Lisfranc injury and a percutaneous technique using the "mini" TightRope^(TM)syndesmosis device was used. Clinical and radiological results were excellent at final follow up.CONCLUSION The "mini" TightRope^(TM) syndesmosis device is a promising method of fixation for children with certain Lisfranc injuries. This method has many advantages,including the non-rigid type of the fixation and no need for subsequent metalwork removal.展开更多
Congenital heart disease is a common problem in children with Down syndrome(DS). Echocardiography plays an important role in the detection of both structural and functional abnormalities in this group of patients. Fet...Congenital heart disease is a common problem in children with Down syndrome(DS). Echocardiography plays an important role in the detection of both structural and functional abnormalities in this group of patients. Fetal echocardiography can help in the early recognition of DS by detecting soft markers of DS, but its main role is to define the exact nature of the suspected cardiac problem in the fetus. Postnatal echocardiography is mandatory in the first month of life for all neonates with DS. It is also indicated before any cardiac surgery and for serial follow-up after cardiac surgery.In this article, we discuss the types and mechanism of cardiac abnormalities in DS children and the role of both fetal and postnatal echocardiography in the detection of these abnormalities.展开更多
文摘Introduction: Acute otitis media is an acute inflammation of the mucosa of the middle ear cavities. It is often secondary to nasopharyngitis, which favors the passage of infection through the Eustachian tube to the middle ear. The aim of our study was to improve the management of AOM in the Paediatric Department of the Hospital National Ignace Deen (Conakry). Patients and Methods: This was a prospective descriptive study lasting 6 months from 01 July to 31 December 2011;the study covered 525 cases out of a total of 6276 children, i.e. a frequency of 8.36%. Results: The most affected age group was 6 to 11 months. Males predominated (69.71%). 82.29% had a history of recurrent rhinopharyngitis. The most frequent reason for consultation was incessant crying (66.29%). Rhinopharyngitis and malaria were the most commonly associated pathologies (87.62% and 39.62% respectively). 72.19% of our patients were admitted with congestive AOM and received medical treatment. We recorded one case of otomastoiditis which was treated surgically. Conclusion: AOM is more common in children aged between 6 and 24 months. Good collaboration between paediatricians and ENT specialists is essential to reduce the morbidity of AOM.
文摘Introduction: Sickle cell disease has physical and emotional repercussions on the child and his family. The aim of this study was to describe the psychosocial experiences of mothers of children with sickle cell disease in order to improve the overall care of the child. Methods: This was a descriptive cross-sectional study carried out in the pediatrics department of Bouaké University Teaching Hospital from June to September 2023. It focused on mothers of major sickle-cell-affected children followed up in the pediatrics department of the Bouaké University Teaching Hospital. The variables studied were sociodemographic, psychological, social and economic. Results: Of the 40 mothers surveyed, 15% were not in school and 32.5% were unemployed. For them, sickle cell disease was of natural (genetic) origin in 90% and supernatural in 10%. They stated that the child had an average age of 36 months (extremes 7 and 108 months) when the disease was discovered. And 52% of them were satisfied with the way the disease was clearly and completely announced. Following the announcement, the questioned mothers said they had felt shock (35%), sadness (31.7%), guilt (23.3%) and discouragement (10%). Anxiety and depression were experienced by 77.5% and 22.5% respectively. In 60% of cases, they stated that the disease was incurable, and the outcome was fatal in 2.5% of cases. The child’s illness was a source of problems in the home in 25% of cases, represented by arguments in 92% and divorce in 8%. In 97.5% of cases, the mother told her family and friends about the child’s illness. In 90% of cases, the mother and child benefited from psychological support from family and friends. Conclusion: Sickle cell disease is a serious illness with a psychological and social impact on mothers. We recommend psychological support for mothers from the moment of diagnosis and throughout follow-up.
文摘Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the Department of Pediatrics at Gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommendations.
文摘<strong>Ba</strong><span style="font-family:Verdana;"><strong>ckground:</strong></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Angina is a common </span><span style="font-family:Verdana;">paediatric</span><span style="font-family:Verdana;"> condition. It has certain peculiarities in children, particularly </span><span style="font-family:Verdana;">with regard to</span><span style="font-family:Verdana;"> the frequency of bacterial germs and the use of diagnostic tests. </span><span style="font-family:Verdana;">The aim of this study was</span><span style="font-family:Verdana;"> to determine the place of the rapid diagnostic test in the management of group A beta-hemolytic streptococcal angina in children in the </span><span style="font-family:Verdana;">paediatric</span><span style="font-family:Verdana;"> ward at Donka National Hospital. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a prospective descriptive study lasting 6 months from 1st February to 31st July 2019 concerning childr</span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">en aged between 3 and 15 years old who were diagnosed with angina. Epidemiological, clinical, para-clinical </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> therapeutic variables were studied. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of 1494 registered children, we collected 116 cases of angina (7.76%). Out of 52 patients who benefited from the rapid diagnostic test, we recorded 13 cases of angina due to group A beta-hemolytic </span><span style="font-family:Verdana;">strptococcus</span><span style="font-family:Verdana;">. The male sex was the most dominant with 31 cases (59.69%) and a G/F sex ratio of 1.47. The age group most affected was between 3 and 5 years old (50%). The average age of our patients was 4.8 years with extremes of 3 and 14 years. Clinical manifestations were dominated by fever and dysphagia (100%) followed by odynophagia (11.79%). We recorded 13 cases of streptococcal angina (25%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The factors that influence it are multiple, dominated by community life, passive smoking </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> allergies. The use of RDTs in these young children would help in the diagnosis of acute group A </span><span style="font-family:Verdana;">beta hemolytic</span><span style="font-family:Verdana;"> streptococcal angina and rational antibiotic prescription.</span></span></span></span>
文摘<strong>I</strong><strong>ntroduction:</strong> Priapism is a rare pathology, known since antiquity. Sickle cell disease is the main aetiology in Africa. The aim of our work was to report our experience in its treatment. <strong>Material and Methods:</strong> This is a prospective, descriptive study carried out at the urology department of the Libreville University Hospital from January 2018 to December 2020. All sickle cell patients admitted to urology for priapism were included. The parameters studied were socio-demographic, clinical and therapeutic parameters as well as the evolution after treatment. <strong>Result:</strong> We collected 19 priapisms in sickle cell patients. The average age was 20.9 years with extremes of 4 and 53 years. Fifteen patients were homozygous SS. All patients had stasis priapism. The average consultation time was 22.4 hours. All patients had perioperative medical management combining hyperhydration, analgesia and antibiotic prophylaxis. A vasoactive drug was administered to 13 patients. Sixteen patients had a puncture of the corpus cavernosum. A distal cavernosal-spongiosum shunt under penile block was performed in 6 patients. The outcome was favorable from the outset in 12 cases, marked by complete detumescence of the corpus cavernosum. Partial detumescence was noted in 7 patients with the need for a new puncture of the cavernous body. A complication such as edema of the penis was in only one of our patients. A recurrence was noted in 2 patients. After an average follow-up of 6 months, no sequelae erectile dysfunction was observed. <strong>Conclusion:</strong> Priapism is a frequent complication among sickle cell patients in Libreville. Medical management associated with a cavernous puncture with administration of vasoactive drugs allows a favourable evolution without after-effects.
文摘Introduction: Worldwide, 2.3 million children died in the first 20 days after birth in 2022, according to the WHO. In Mali, according to the sixth Demographic and Health Survey, the neonatal mortality rate was estimated at 33% live births in 2018. The Timbuktu region had the highest neonatal mortality rate in the country with 44%. The objective of this work was to study the causes of neonatal morbidity and mortality and related factors in the paediatrics department of Timbuktu hospital. Materials and method: This was a descriptive, cross-sectional study conducted from 1 January to 31 December 2023 in the neonatology unit of the paediatrics department of Timbuktu hospital, including all newborns admitted to hospital. Results: Our study took place over 12 months, during which 618 admissions were made to the paediatric ward, including 244 newborns, i.e. 39.48%. The majority of newborns (86.5%) were admitted in the first week of life. The mean age was 3 days, with a sex ratio of 1.1 for males. Weight under 2500 g was 54.1% for an average weight of 2372 g. The main mode of admission was transfer from the hospital maternity unit (62%). The main reasons for admission were acute foetal distress (27.9%) and prematurity (26.2%). The average age of the mothers was 24, with extremes of 15 and 49. The mothers were housewives (87.3%), uneducated and primiparous (59% and 36.5% respectively);only 40.2% had made more than 3 antenatal care visits. Newborns born by vaginal delivery accounted for 80.7% and those born by caesarean section for 19.3%. The risk of infection was present in 52.5% of cases. The three leading causes of hospitalisation were birth asphyxia (40.2%), neonatal infection (32.4%) and prematurity (25%). The mortality rate was 21.7%. The main causes of death were prematurity (39.6%), birth asphyxia (32.1%) and neonatal infection (24.5%). Conclusion: Neonatal morbidity and mortality remain a concern in Timbuktu. Despite the unfavourable security situation, morbidity and mortality indicators are close to those in some hospitals in Mali. The correct application of Essential Newborn Care and antenatal care remains a major challenge for the hospital and the Timbuktu region.
文摘Diagnosis of childhood tuberculosis (TB) is difficult, especially in resource-limited countries where the number of reported cases of TB-HIV co-infection continues to rise. This co-infection poses a diagnostic and therapeutic problem for caregivers. We report a case of rifampicin-resistant HIV-TB pulmonary coinfection in a 19-month-old infant.
文摘Introduction: Viral hepatitis B (VHL) is a public health problem, particularly in sub-Sahara Africa. The aim of this study was to assess vaccination coverage against HBV in children in Brazzaville. Patients and Methods: This was a cross-sectional analytical study conducted in Brazzaville health centres from January to September 2019. It involved children aged between six months and six years who received a vaccination against HBV. Sampling was exhaustive and based on stratified sampling. Results: The overall prevalence of children vaccinated against HBV in Brazzaville was 96.2%. It was insufficient in the Talangai health district (79%). The pentavalent vaccine was administered to 97.7% of children, 85% of whom had received all three doses. The reasons for incomplete vaccination were parents’ ignorance of HVB (85.6%) and of vaccination (14.3%). Conclusion: Although the prevalence of vaccinated children is high in Brazzaville, it is still insufficient in some health districts, particularly Talangai, because parents are unaware of the disease and of vaccination. Pentavalent is the only vaccine available in the national vaccination programme, which is why an effective national vaccination policy needs to be put in place. .
文摘Background: Testicular atrophy is recurrent after orchidopexy for intra-abdominal cryptorchidism due to damage to vessels. Fowlers-Stephens and Shehata methods proposed staged orchidopexy, but are still associated to a rate of atrophy greater than 10%. Purpose: We set out to present a new technique that preserves testicular vessels. Our study is aimed at investigating testicular vitality after surgery. Patients and Method: We reviewed files of boys who underwent orchidopexy for 2 years in our department. Those who have been operated for intra-abdominal cryptorchidism with the new technique and aged between 6 months and 14 years old were included in our study. We excluded boys who have been operated before 6 months and after 14 years old and those who did not respect their follow-up plane. Ultrasound (US) outcomes were used to measure testicular volumes and blood flow at each postoperative visit. The Sample population was divided into group A and group B representing testes that were followed respectively for 12 and 24 months. Results: 22 boys with 25 testes were included in our study;11 testes in group A and 14 testes in group B. In each group, we noted a significant difference of UDT volumes from the third month after surgery with respective P-values 0.05. There was no statistical difference between UDT and contra lateral testes volumes 12 months after surgery in group A and 24 months in group B with respective P-values of 0.07 and 0.72. All volume differential indexes were Conclusion: This method offers a new perspective in performing safe orchidopexy for intra abdominal undescended testes.
文摘Introduction: Acute diarrhoea is a real public health problem worldwide and is responsible for considerable mortality in developing countries. The aim of this study was to evaluate the management of acute diarrhoea in children aged 0 - 59 months hospitalised in the paediatric ward of the Ratoma CMC. Material and Methods: This was a descriptive cross-sectional study lasting 6 months, from 01 July to 31 December 2023, including all children aged 0-59 months admitted for diarrhoea lasting no more than 14 days and whose parents agreed to take part in the study. Sociodemographic, clinical, therapeutic and evolutionary data were studied. Results: 79 children were seen for acute diarrhoea out of 330 consulted, i.e., a frequency of 23.9%. The age group 0 - 11 months was the most represented, at 54.4%. Males predominated: 62% with a sex ratio of 1.6. The average consultation time was 3 days, with extremes of 0 to 10 days. The number of bowel movements per day varied from 3 to 12. The stools were liquid in 82.27% of cases. All hospitalised children were dehydrated, with 68.4% suffering from moderate dehydration, 21.5% from mild dehydration and 10.1% from severe dehydration. Malaria was the condition most frequently associated with diarrhoea (27.8%). Malnutrition was found in only 2.5%. 82% of the children had received oral rehydration with ORS and 18% intravenous rehydration. Almost all the children (93.67%) had a favourable outcome. We recorded one case of death, a rate of 1.26%. Conclusion: Acute diarrhoea in children is one of the most frequent reasons for consultation in the paediatric department of the Ratoma CMC. Often accompanied by fever and vomiting, it is frequently observed in children aged 0 to 11 months, with a predominance of males. The overall management of acute diarrhoea in children involves improving people’s standard of living, combating faecal peril, drinking water consumption, promoting vaccination, the use of oral rehydration solutions and zinc, and training healthcare staff.
文摘Introduction: Neonatal mortality remains a major public health concern. According to the World Health Organisation (WHO), the number of newborns dying each year has fallen from 5 million in 1990 to 2.4 million in 2019. The aim of our study was to describe the main morbid conditions and their lethality in newborns admitted to the paediatric ward of the CSREF in Commune V. Methodology: We conducted a 12-month prospective descriptive and analytical study from August 2020 to July 2021. Results: During the 12 months of the study, out of 2654 neonates admitted to hospital, 216 met our inclusion criteria, i.e. 8%. Newborns admitted in the first few hours of life represented 99.54% of cases. Full-term newborns accounted for 65.74% of the total. Forty-eight percent of newborns had hypothermia on admission. The most common diagnosis was asphyxia in 55.56% of cases, followed by neonatal infection in 27.78% and prematurity in 10.65%. Death was recorded in 22.2% of cases. Asphyxia was the main cause of neonatal death, followed by prematurity in our context. Conclusion: Improving the prognosis of newborn babies will require a thorough understanding of neonatal pathologies and the implementation of a pre- and perinatal prevention policy.
文摘Background: Exclusive breastfeeding is globally promoted as a preventive health measure. However, an increasing incidence of jaundice among exclusively breastfed neonates has been observed. In Jos, Nigeria, anecdotal evidence suggests a rise in jaundice cases among breastfed infants during their first week of life. This study investigates the relationship between neonatal jaundice and the biochemical composition of maternal breast milk in Jos, Nigeria. Objective: To evaluate the role of maternal milk protein status and other milk constituents in the development of neonatal jaundice among exclusively breastfed full-term infants. Methods: This cross-sectional study involved 152 participants, comprising of 76 neonates (38 jaundiced and 38 healthy controls) and their corresponding 76 mothers at Jos University Teaching Hospital. Biochemical analyses were conducted on maternal breast milk (albumin, proteins, casein, fat, lactose, enzymes) and infant serum (bilirubin, albumin, proteins, enzymes). Statistical analysis was performed using Mann-Whitney tests with significance set at p ≤ 0.05. Results: Maternal breast milk from mothers of jaundiced infants showed significantly lower protein (0.73 ± 0.07 g/100ml), albumin (0.62 ± 0.04 g/100ml), and casein (1.6 ± 0.12 g/100ml) levels compared to controls (p Conclusion: The study highlights a potential link between lower maternal milk protein levels and the occurrence of neonatal jaundice. Interventions aimed at enhancing maternal nutrition and promoting more frequent breastfeeding may mitigate the risk. Further research should explore additional maternal and neonatal factors contributing to this condition.
文摘Introduction: Osteosarcoma is the most common primary malignant bone tumor in children. It is highly aggressive and has a poor prognosis. A late presentation modifies and makes difficult the management affecting the survival of children. We report the case of a large conventional osteosarcoma in a 13-year-old girl. Case Presentation: Adolescent girl admitted for painful swelling of the left shoulder with absolute functional impotence of the thoracic limb and severe anemia. The painful swelling was thought to have been caused by a minor trauma that had occurred six months previously. The patient’s general condition was poor, and she presented with a large, shiny, painful mass over the shoulder and upper 2/3 of the left arm, measuring 28 cm long by 28 cm wide and 57 cm in circumference, and a large fistulous axillary adenopathy. CT scan showed a tumour lesion of the left humerus with liver and lung metastases, raising suspicion of osteogenic osteosarcoma. The tumor was classified according to TNM staging: T2N1M1(a + b). Management was modified when uncontrolled bleeding developed. It consisted of an extended amputation of the left thoracic limb. Pathological analysis showed a high-grade conventional osteosarcoma. Quality improvement was obtained for thirty days, followed by the onset of dyspnea. The evolution was towards death at forty days post-operatively. Conclusion: Osteosarcoma is a highly aggressive cancer. Delayed treatment leads to a fatal outcome. Early diagnosis is one of the challenges to be met in order to improve survival.
基金Supported by The Belgian National Fund for Medical Research, the Région Wallonne-DGTRE(Grant WALEO/HEPATERA) and "La Fondation St Luc-ARC Thérapie Cellulaire"Stéphenne Xis recipient of a Grant-FNRS for cell cryopreservation
文摘Liver cell transplantation presents clinical benefit in patients with inborn errors of metabolism as an alternative,or at least as a bridge,to orthotopic liver transplantation.The success of such a therapeutic approach remains limited by the quality of the transplanted cells.Cryopreservation remains the best option for long-term storage of hepatocytes,providing a permanent and sufficient cell supply.However, isolated adult hepatocytes are poorly resistant to such a process,with a significant alteration both at the morphological and functional levels.Hence,the aim of the current review is to discuss the state of the art regarding widely-used hepatocyte cryopreservation protocols,as well as the assays performed to analyse the post-thawing cell quality both in vitro and in vivo. The majority of studies agree upon the poor quality and efficiency of cryopreserved/thawed hepatocytes as compared to freshly isolated hepatocytes.Intracellular ice formation or exposure to hyperosmotic solutionsremains the main phenomenon of cryopreservation process,and its effects on cell quality and cell death induction will be discussed.The increased knowledge and understanding of the cryopreservation process will lead to research strategies to improve the viability and the quality of the cell suspensions after thawing.Such strategies,such as vitrification,will be discussed with respect to their potential to significantly improve the quality of cell suspensions dedicated to liver cell-based therapies.
文摘Sleep and epilepsy are two well recognized conditions that interact with each other in a complex bi-directional way. Some types of epilepsies have increased activity during sleep disturbing it; while sleep deprivation aggravates epilepsy due to decreased seizure threshold. Epilepsy can deteriorate the sleep-related disorders and at the same time; the parasomnias can worsen the epilepsy. The secretion of sleep-related hormones can also be affected by the occurrence of seizures and supplementation of epileptic patients with some of these sleep-related hormones may have a beneficial role in controlling epilepsy.
文摘AIM: To determine if dopamine is effective in treating neonatal hypotension and safe to use comparing to other inotropes. METHODS: This is a review of evidence on inotropic treatment of neonatal hypotension. Databases searched were MEDLINE and the Cochrane Library, a total of 134 studies were identified. Only studies with high quality evidence(level 1a and b and 2a) were included. After review, only eight studies were included in the final analysis. Pooled risk ratios derived for each outcome [Mantel-Haenzel(M-H) fixed effect] with CI, as reported in the Cochrane reviews were plotted in forest plot form. RESULTS: Eight articles met inclusion criteria, which all included treatment in preterm infants. Dopamine increased mean arterial blood pressure(BP)(n = 163; r = 0.88, 95%CI: 0.76 to 0.94) and systolic BP(n = 142; r = 0.81, 95%CI: 0.42 to 0.94) comparing to placebo. Dopamine has been shown overall to be statistically more effective in increasing BP than dobutamine(n = 251, r = 0.26, 95%CI: 0.20-0.32). However there were no differences in short term outcomes(periventricular leucomalacia, periventricular haemorrhage) and mortality between both drugs. There is no statistical evidence of dopamine being more effective than adrenaline or corticosteroids. There was no difference in morbidity and mortality outcomes when dopamine was compared to hydrocortisone(RR 1.81, 95%CI: 0.18 to 18.39) or adrenaline. CONCLUSION: In preterms, dopamine is the most studied drug, and we suggest it could be used as first line treatment in hypotension.
文摘Objective: To observe the effect of Astragalus Injection (AD on levels of blood selenium (Se) and cytokines, and T cellular immune function with viral myocarditis (VM) in children. Methods: Eighty children with VM were randomly divided into 2 groups. The control group consisted of 38 patients, to whom conventional therapy, including energy mixture, vitamin C and coenzyme Q10, etc. were given. The treated group (n = 42), to whom combination therapy of conventional therapy and Al were given. The levels of blood Se and cytokine, including interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and also evaluation of T lymphocyte subsets and cardiac function were observed. Results: The results showed that after treatment, the levels of blood Se were significantly higher (P<0.01), while IL-1,IL-6 and TNF-a were significantly lower (P<0.01) than those before treatment in the control group. The left ventricular end diameter (LVED) were significantly decreased (P<0.01), left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were significantly increased than those before treatment in the treated group(P<0.01, P<0.05). T lymphocyte subsets got normalized (P<0.01), and compared with the control group, the difference was significant (P<0.01). Conclusion: Astragalus membranaceus possesses anti-viral effect, adjusts the balance of cytokine and T cellular immunity, and improves the clinical manifestation and cardiac function. It is an effective approach in treating viral myocarditis.
文摘BACKGROUND Lisfranc injuries are rare and can be easily missed. This injury is extremely rare in children, with limited published data. Different treatment options have been described; one of the options in adults is the "mini" TightRope^(TM) Syndesmosis Device that provides non-rigid fixation with impressive results. However, there is no reference regarding the use of this device in children.CASE SUMMARY We describe the case of an 11-year-old girl who sustained a Lisfranc injury of her right foot that was initially missed in the Accident and Emergency department of her local hospital. This case was a ligamentous/periosteal sleeve avulsion type of Lisfranc injury and a percutaneous technique using the "mini" TightRope^(TM)syndesmosis device was used. Clinical and radiological results were excellent at final follow up.CONCLUSION The "mini" TightRope^(TM) syndesmosis device is a promising method of fixation for children with certain Lisfranc injuries. This method has many advantages,including the non-rigid type of the fixation and no need for subsequent metalwork removal.
文摘Congenital heart disease is a common problem in children with Down syndrome(DS). Echocardiography plays an important role in the detection of both structural and functional abnormalities in this group of patients. Fetal echocardiography can help in the early recognition of DS by detecting soft markers of DS, but its main role is to define the exact nature of the suspected cardiac problem in the fetus. Postnatal echocardiography is mandatory in the first month of life for all neonates with DS. It is also indicated before any cardiac surgery and for serial follow-up after cardiac surgery.In this article, we discuss the types and mechanism of cardiac abnormalities in DS children and the role of both fetal and postnatal echocardiography in the detection of these abnormalities.
