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Toulouse, France

Hussain M.,Children Hospital
Journal of Ayub Medical College, Abbottabad : JAMC | Year: 2010

While there is much data on cardiac problems of adults, there is a limited statistical data available to evaluate the magnitude of the cardiac problems in children in Pakistan. Many of these children present with recurrent chest infections and congestive cardiac failure (CCF), and are managed by general practitioners. A careful search for underlying cardiac problems and awareness about the presentation of CCF and its magnitude will definitely decrease the morbidity and mortality of these children. The objective of this study was to see the frequency and clinical presentation of CCF in children with Ventricular Septal Defect (VSD). Forty-nine patients met the preset criteria during the study period of 6 months. A detailed history and physical examination with special emphasis on symptoms and signs was sought and the findings were noted in a questionnaire. Data was analysed using SPSS-11. Frequencies and percentages were calculated for all categorical variables. CCF in VSD was found more in males, with a male to female ratio of 1.45:1. Majority (63.1%) of the patients presented in infancy. The common symptoms at presentation were dyspnoea (98%), cough (83.7%), and feeding difficulty (9.6%). Other important symptoms were fever, fatigue, failure to thrive, sweating and wheezing. The common physical signs in order of frequency were murmur 98%, tachypnoea 91.8%, tachycardia 89.8%, hepatomegally 89.9% and crackles in chest 85.7%. Other presenting signs were displaced apex beat 57%, oedema 28.6% and chest deformity 20.4%. Regarding the type of VSD, perimembranous was the commonest 61.2% as confirmed by echocardiography. This study was done on a smaller scale in hospitalised children. The exact studies regarding CCF in paediatric patients are scarce. There is a need to design more studies in children with CCF. Early recognition of signs and symptoms of CCF on paediatric patients with VSD and awareness at primary health care level can prevent the delay in the diagnosis and early referrals by GPs to hospital setup will definitely reduce the morbidity and mortality.

Strzelecka J.,Children Hospital
Research in Autism Spectrum Disorders | Year: 2014

An important factor in the diagnosis and treatment of Autism spectrum disorder (ASD) is prescribed Electroencephalography (EEG). EEG changes may show the following: slowing, asymmetry, sharp waves or spikes, sharp and slow waves, generalized sharp and slow waves, or generalized polyspikes in a distributed or general area, multifocal or focal, unilateral or bilateral, and they may be located in many different areas of the brain. There is a need to look for a EEG phenotype typical of patients with ASD. The importance of gamma waves, rhythm mu, mirror neurons, and their role in patients with ASD was discussed. Epilepsy is reported to occur in one third of ASD patients. In ASD, seizures and EEG paroxysmal abnormalities could represent an epiphenomenon of a cerebral dysfunction independent of apparent lesions. This article reviews ASD and EEG abnormalities and discusses the interaction between epileptiform abnormalities and cognitive dysfunction. © 2013 Elsevier Ltd. All rights reserved.

Mallick M.S.,Children Hospital
African Journal of Paediatric Surgery | Year: 2014

Background: Foreign body aspiration (FBA) is a common cause of respiratory compromise in early childhood. The objective of this study was to describe the features and outcomes of children with FBA in early and late presentations and to examine the reasons for the delay in diagnosis. Patients and Methods: This is a retrospective review of all children who were admitted with suspected FBA between July 2001 and June 2010. Patient's characteristics, history, clinical, radiographic, bronchoscopic findings, reason for delay presentation, and complications were noted. Results: A total of 158 children admitted to the hospital with suspected FBA were included in this study. The average age was 3.28 years. Forty-eight (30.3%) children were presented late (more than 14 days after FBA) and 110 (69.7%) children were presented early (0-14 days). The common clinical manifestations of FBA were persistent cough (100%) and choking (72%). The most frequent radiological finding observed was air trapping (40%) followed by atelectasis (14%). Chest radiographs were normal in 32.2% patients. Ten children in early diagnosis group and 29 children in late diagnosis group presented with complications. The diagnosis delay was mainly attributed to physician misdiagnosis (41.6%). Rigid bronchoscopy was performed in all patients. Foreign body was found in all of the cases except six. Watermelon seeds and peanuts accounted for 80% of the aspiration. Conclusion: FBA is difficult to diagnose in children. Delay in diagnosis appears to result from a failure to give serious consideration to the diagnosis. Early diagnosis and removal of foreign bodies must be achieved to avoid complications. © 2014 African Journal of Paediatric Surgery. All rights reserved.

Munshi F.,King Abdulaziz University | Lababidi H.,CRESENT | Alyousef S.,Children Hospital
Journal of Taibah University Medical Sciences | Year: 2015

Simulation has been widely used in the education of healthcare workers. In simulation training, there is an approximation to reality in which trainees are supposed to react to problems or conditions as they would under genuine circumstances. The educational value of simulations has been determined to be valuable. Simulation has a significant impact on health care education across the disciplines and in both undergraduate and postgraduate studies. Recent development in technologies permits the reproduction of real-life scenarios with acceptable fidelity, thus profoundly enhancing the learning environment. However, the educational outcomes of high- versus low-fidelity simulations remain controversial. This article aims to review the effectiveness of low- and high-fidelity simulations in teaching and assessing clinical skills. © 2015 The Authors.

Sales de Gauzy J.,Children Hospital
Orthopaedics and Traumatology: Surgery and Research | Year: 2010

The objectives of pelvic osteotomies are to improve femoral head coverage and coxofemoral joint stability. The most currently used osteotomies can be divided into reorientation osteotomies (Salter and Pol le Cœur triple osteotomy) and acetabuloplasties (Pemberton and Dega). All these osteotomies share an identical installation on the table and bikini-type incision. The Salter osteotomy uses a single osteotomy line located at the inferior gluteal line. The Pol Le Cœur triple pelvic osteotomy combines innominate osteotomies of the iliopubic and ischiopubic rami via a genitofemoral approach (inguinal). In these two reorientation osteotomies, the acetabulum tilts in retroversion, improving the anterior and lateral coverage but reducing the posterior coverage. In the Pemberton acetabuloplasty, the osteotomy line is incomplete. It begins anteriorly between the iliac spines and ends posteriorly immediately above the triradiate cartilage. The posterior part of the ilium remains intact. The Pemberton acetabuloplasty causes retroversion and plicature of the acetabulum responsible for reducing its diameter. Anterior and lateral coverage of the femoral head is improved and posterior coverage remains unchanged. In the Dega acetabuloplasty, the osteotomy line is incomplete. It begins laterally above the acetabulum and terminates just above the triradiate cartilage. The medial part of the ilium remains intact. The Dega acetabuloplasty reduces the diameter of the acetabulum and improves overall femoral head coverage (anterior, lateral, and posterior). © 2010 Elsevier Masson SAS.

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