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  • ISSN: 2373-9312
    Volume 3, Issue 2
    Research Article
    Kenneth I Onyedibe1*, Fidelia Bode-Thomas2, Victor Nwadike3, Tolulope Afolaranmi4, Mark O. Okolo1, Omini Uket5, Udochukwu M. Diala2, Clement K. Da'am1, Daniel Z. Egah1 and Edmund B Banwat1
    Abstract The era of multiple antibiotic resistances in bacteria causing infections have led to increased morbidity and mortality and has posed huge therapeutic challenges to clinicians. Consequently, we determined the presence of these resistance patterns in the common bacterial isolates of neonatal sepsis in a tertiary care hospital.
    A total of 75 non duplicate bacteria isolates from 218 neonates with suspected sepsis were analyzed by standard methods. Antibiotic susceptibility testing was carried out by Kirby Bauer's disc diffusion method and specific multidrug resistance patterns identified.
    The common bacterial isolates were Klebsiella pneumoniae, Staphylococcus aureus and Escherichia coli. Fifteen (62.5%) of the K. pneumoniae and five (62.5%) E. coli isolates produced Extended Spectrum Beta Lactamases (ESBLs). Amp C genes were identified in eight (33.3%) K. pneumoniae and three (37.5%) E. coli isolates. Two (66.7%) Citrobacter isolates and one (50.0%) Enterobacter species produced both ESBLs and Amp C properties. Klebsiella pneumoniae Carbapenemases (KPC) production was seen in four (16.7%) K. pneumoniae isolates. Methicillin resistance was identified in six (26.1%) and three (60.0%) of the S. aureus and Coagulase Negative Staphylococci (CoNS) isolates respectively. This study has shown high rates of multiple antibiotic resistance patterns especially amongst the gram negative isolates which invariably reduce therapeutic options. We recommend culture, sensitivity and resistance testing in all cases of neonatal sepsis. Further studies evaluating institutional surveillance mechanisms for these resistant organisms and the infection control practices in our hospitals are required.
    AbeerAbd Elmoneim1*, Abdulaziz Alhosaini1, Saud Sultan1, Khulood Fallatah1, Ghaid Jabri1, Zakaria Alhawsawy2, Mohammed Zolaly1 and Ehab S Abd El-moneim1
    Abstract
    Background and Aim: Blood transfusion is the main treatment for people who have moderate or severe thalassemias. The main side effect of transfusion therapy is that the patient develops iron overload, which lead to serious damage to the internal organs. Many foods can play an important role in decreasing iron absorption from the intestine and that could improve the prognosis of these patients. The aim of our study is to detect the effect of diet adjustment in thalassemia children, to a more iron-execrating and less iron-absorption diet, on their level of serum ferritin.
    Patients and Methods: In a randomized case control study, 36 thalassemia patients presented to the hematology/oncology center at the Maternity and children Hospital (MCH) in Almadinah Almounourah, KSA in the period from January 2014 to July 2014 were observed prospectively for their serum ferritin level. The cases were asked to follow a diet that limits iron absorption and increases iron excretion.
    Results: Serum ferritin level is significantly decreased in cases after 6 months of diet iron restriction more than in controls (p value =0.03).
    Conclusions: Restriction of foods that contain iron and increase intake of foods that execrate iron from body can significantly decrease serum ferritin level in thalassemia children.
    Recommendations: According to our results, control of diet and following food regimens that can minimize iron absorption and maximize iron execration are of great benefit for thalassemia children and can act as an adjuvant for drug chelation therapy.
    Case Report
    Rao KS*, Kalpana Malla, Abhishek Singh, Shanker poudel, Ganesh BK, Sudhir Adhikari, Tewari PK, Vishal Sharma
    Abstract Boerhaave's syndrome is associated with spontaneous rupture of lower end of esophagus after a bout of vomiting, leading to chest pain and sub cutaneous emphysema, pneumomediastinum and leakage of fluids in to the base of the lungs. Boerhaave's syndrome is rare in paediatric practice. Only 28 cases were reported in children till date. The youngest child reported to have boerhaave's syndrome was a six month old Hispanic male infant who was undergoing chemo therapy for leukaemia and developed respiratory distress after a bout of vomiting. He was found to have precardial and mediastinal emphysema with evidence of lower end esophageal perforation. We now report a case of a four month old infant who was suffering from acute gastroenteritis and after a bout of vomting has developed mediastinal emphysema ( both pre and retro cardiac region) and subcutaneous emphysema over the chest wall extending to the neck and both sides of the face with evidence of a rent in the lower end of oesophagus suggestive of Boerhaave's syndrome . He was treated conservatively without resorting to surgery.
    Fehmida Najmuddin*, Rajesh Rai, Riya George, and Keya Lahiri
    Abstract Neonatal cholestasis is a prolonged elevation of the serum levels of conjugated bilirubin beyond the first 14 days of life. Commonest etiologies include extrahepatic conditions like biliary atresia, intrahepatic like congenital malformations, infections and inborn errors of metabolism. TORCH infections constitute 22%cases of neonatal hepatitis, of which Cytomegalovirus is the commonest agent. Ganciclovir and its prodrug valganciclovir are recommended in the management of Cytomegalovirus infection. We, hereby report a 2 month old child, a case of Cytomegalovirus induced neonatal cholestasis with marked improvement in clinical and biochemical parameters, post treatment with intravenous ganciclovir.
    Review Article
    Kathleen Armstrong1*, Meredeth Rowe2 and William Kohler3
    Abstract Up to 68 % of children with Autism Spectrum Disorders (CwASD) suffer from sleep disturbances that adversely affect their learning, emotional regulation, behavioral functioning, and safety, as well as impact their parents' sleep and stress levels. The most common sleep concernsreported by parents/caregivers include difficulty initiating or maintaining sleep and early rising, resulting in insufficient sleep time. Furthermore, sleep problems in CwASD occur early in development, persist into adolescence, and continue into the adult years, making this a life-long challenge.Inadequate sleep duration has been shown to increase ASD symptoms, disruptive behavior problems, and anxious symptoms;to reduce the effectiveness of therapeutic and educational interventions; and to impair family functioning; making sleep a critical area for intervention. Although more rigorous research is needed to establish the efficacy for behavioral interventions and sleep disturbances in CwASD, parents/caregivers prefer behavioral interventions over pharmaceutical treatment options, and a growing body of evidence suggests that behavioral interventions can be associated with behavior changes and positive outcomes for CwASD. This article describes factors related to sleep disorders, different types of sleep problems including poor sleep hygiene, assessment of sleep disturbances, and interventions to utilize in clinical practice.
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