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  • ISSN: 2373-9312
    Early Online
    Volume 8, Issue 1
    Case Report
    Aldo Jos F da Silva*
    Introduction: Hydrocephalus occurs in 80% of patients with DandyWalker (DW) syndrome. Accord-ing to the literature, when permeability of the cerebral aqueduct is demonstrated, it is possible to use a sin-gle shunt, either ventriculoperitoneal or cystoperitoneal. The case of an asymptomatic child with a large Dandy-Walker cyst despite the presence of a ventriculoperitoneal shunt is reported herein.
    Case report: A 1-year-old female child was brought to an emergency department (General State Hospital) with a clinical picture of macrocephaly and signs of intracranial hypertension (headache, vomit-ing, and papilledema). A CT scan of the head revealed hydrocephalus and other changes, such as a cyst in the fourth ventricle and hypoplasia of the cerebellar vermis, which were compatible with Dandy-Walker malformation (DWM). It was decided to place a ventriculoperitoneal shunt. After six years of follow-up, the child still had the cyst in the fourth ventricle, which caused compression of the brainstem and hypopla-sia of the cerebellar vermis, but there was no hydrocephalus. Nevertheless, the child remains asymptomatic, with normal motor development.
    Discussion/Conclusion: The treatment of hydrocephalus and DWM remains complex and therefore controversial. However, some children may benefit from a ventriculoperitoneal shunt and remain asymp-tomatic despite the persistence of Dandy-Walker cysts.
    Alline Neves Mota, Juliana Bacellar Nunes de Brito, Caroline Cunha da Rocha, Mayara Silva Nascimento, Carlos Victor da Silva Nascimento*, Beatriz Costa Cardoso, Alyne Conduru dos Santos Cunha, Walter Refkalefsky Loureiro, and Francisca Regina Oliveira Carneiro
    Background: Necrotizing fasciitis is a soft tissue infection, mainly related to penetrating trauma, which creates a gateway for pathogens.
    Case presentation: A female patient, 8 months old, is admitted to the Pediatrics Emergency Unit of the with erythema, edema and hemorrhagic blister at the site of application of the Influenza vaccine 4 days post-vaccination.
    Discussion: Necrotizing fasciitis is a dermatological condition with a polymicrobial etiology, due to the synergism of the necrotoxins of such pathogens. Tests show leukocytosis and significant elevation of C-reactive protein. Treatment should be performed with broad-spectrum antimicrobials initially and with subsequent adjustment for those of proven sensitivity, in addition to early surgical debridement.
    Conclusion: Necrotizing fasciitis is a severe infection, with fast evolution which can lead to death. Its presentation after vaccination must be considered and avoided with proper hygiene and prophylactic methods during the administration of the vaccine.
    Research Article
    Hardy JD*
    Background: A comparison of outcomes for CH before and after the start of the NSP in the UAE.
    Methods: Review of the findings of all the babies with CH seen in the period 1996 to 2004.
    Results: Before the UAE NSP babies were usually diagnosed very late often with a bad outcome. The NSP resulted in much earlier diagnosis and better outcome. The incidence of CH was high compared to most other studies and eutopic hypothyroidism was nearly as common as ectopic hypothyroidism. Some of the former could come off treatment later and some of the latter were very mild.
    Conclusion: The most important conclusion is that the NSP is very worthwhile with generally good outcomes.
    Yasin F*, Afridi ZS, Mahmood Q, Khan AA, Condon S, and Khan R
    Bronchiolitis is the most common lower respiratory illness that characteristically affects the children below two years of age accounting about 2-3% of patients, admitted to hospital each year. We compared the effect of Racemic Epinephrine (RE) and 3% Hypertonic saline (HS) nebulization on the length of stay (LOS) in the hospital. We looked at the infants with moderate bronchiolitis, from October 2013 through March 2014. Out of eighty cases, 16 in HS and 18 in RE groups were enrolled.
    At the time of admission, 0.2ml of RE added to 1.8ml of distilled water was nebulized to RE group, as compared to 2ml of 3% HS in nebulized form. RE was re-administered if needed on 6 hourly in comparison to 3% HS at the frequency of 1 to 4 hourly. One infant from RE group and three infants from HS group were excluded due to progression towards severe bronchiolitis. The LOS in RE group ranged between 18-160 hrs (Mean 45 hrs) while in HS group, LOS was 18.50- 206 hrs (Mean 74.3 hrs). The LOS was significantly short in RE group (p-value 0.015) which was statistically significant. Racemic Epinephrine nebulization as first-line medication may significantly reduce the length of hospital stay in infants with moderate bronchiolitis in comparison to nebulized HS.
    Review Article
    Saccomanni Bernardino*
    Fractures of the carpal scaphoid are not common in children. When they occur the fractures are usually located in the distal pole but they have also been sustained through the waist. Resultant scaphoid non-unions have been reported. Their optional treatment remains controversial. Most fractures of the scaphoid in the immature skeleton heal with immobilization. Other options may be included bone grafting with K-wire fixation, without osteosynthesis and Herbert screw fixation with or without bone grafting. I believe that open reduction and internal fixation with Herbert screw using bone grafting is a reliable option that obtained excellent results. Here, I document a review of literature. In this review, there are not figures and outcomes.
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