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  • ISSN: 2373-9312
    Volume 3, Issue 6
    Case Report
    Atiye Nur Aktay*
    Cyclic Vomiting Syndrome (CVS) is characterized by recurrent, discrete episodes of vomiting between periods of completely normal health. Cannabinoid-induced CVS have been documented in adults but the link is often overlooked in children. To our knowledge this one of the youngest reported cases of cannabinoid induced CVS.
    A 14.5-year-old male had been admitted to the hospital 9 times with episodes of CVS over a period of 24 months.Diagnostic tests including several imaging studies and laboratory tests were unremarkable except positive urine toxicology for cannabinoids at each hospitalization. Marijuana abuse is on the rise among adolescents in United States. It should be considered in young adolescents presenting with episodes of CVS prior to costly diagnostic testing which is a significant financial burden to the healthcare system.
    Deepshikha*, Prabhas Prasun Giri, Apurba Ghosh
    Familial Hemophagocytic lymphohistiocytosis (FHL) is a fatal autosomal recessive hyperinflammatory syndrome characterized by fever, hepatosplenomegaly, cytopenia, hyperferritenemia and widespread hemophagocytosis in the reticuloendothelial tissues. Diagnosis of FHL can be confirmed by the presence of typical clinical and laboratory features along with presence of a specific genetic mutation. Mutation in STXBP2 encoding syntaxin binding protein 2 (Munc 18 -2) is the newest described mutation that gives rise to FHL5. Here we present a case of FHL 5 with typical clinical and laboratory features of FHL and came out to be positive for homozygous missense variation in exon 3 of the STXBP2 gene (chr19:7703978; G>T).
    Narayan JP*, Karnawat BS, Joshi A
    Lymphangiomas are rare benign neoplasms believed to be result of abnormal development of lymphatic system. They grow very slowly usually localized to one organ, but occasionally involve several organs in one part of the body. Reports of single organ involvement have been published relating to nearly all organs of the body except CNS with certain predilection tocervicothoracic region. Lymphangiomatosis or multifocal/ diffuse lymphangiomas presented during childhood mainly in the head and neck region; less than 5% are intra-abdominal. In one large series, lymphangioma of head and neck accounted for nearly 50% of cases in children, while 10% of cases had visceral disease including thorax. We report 4-year-old child with lymphangiomatosis having cannon ball opacities on chest radiograph and simultaneous pulmonary and hepatic involvement which has never been reported and is unusual presentation.
    Kayal S*, Dogan V, Keskin M, Yoldas T, Kaya O, Ozgur S, Ertugrul I, Orun UA and Karademir S
    Various rhythm and conduction disturbances have been reported in patients with acute rheumatic fever, that first-degree atrioventricular block is the most common one. The second or third-degree AV block, junctional tachycardia with or without AV dissociation, supraventricular tachycardia, premature ventricular contraction, ventricular tachycardia, right and left bundle branch block have been reported rarely during the course of the acute rheumatic fever. In this report, we present four children with acute rheumatic fever associated cardiac rhythm disturbances.
    Case Series
    Aditi Khokhar*, Vatcharapan Umpaichitra and Sheila Perez-Colon
    Background: Septo-optic dysplasia (SOD) is a rare condition characterized by midline brain abnormalities, optic nerve hypoplasia and hypothalamic-pituitary deficiencies. Both genetic and environmental factors are involved in its pathogenesis. Genetic abnormalities are identified in only one percent of patients.
    Objective: To describe varied clinical spectrum of SOD among five children from different ethnicities living within the same geographical area and to review and identify common maternal and perinatal factors among them.
    Method: Retrospective chart review.
    Conclusion: Five patients were diagnosed with SOD over a period of fifteen months. Patients had varied clinical spectrum but shared common maternal and perinatal factors. SOD is more common in young primigravida mothers and in first-born appropriate for gestational age children. Central Brooklyn is a region with high population density. Not all patients had pituitary insufficiency at presentation. Early diagnosis of this condition should decrease the disease related morbidity and mortality.
    Research Article
    Kwashie Ajibade Ako-Nai, CynthiaChidinma Uzochukwu, Blessing Itohan Ebhodaghe, Peter Bankole Kuti, Samuel AdemolaAdegoke, Winston A Anderson3, Olakunle O Kassim
    Background: Children with sickle cell disease have been shown to be at greater risk of bacterial infections from Streptococcus pneumoniae, Hemophilus influenzae and Salmonella enteritidis and from complications of septicaemia, pneumonia, respiratory difficulty and bone pain. The study compared the nasopharyngeal bacterial carriage of 87 children with sickle cell disease (SCD) and 160 children without SCD, ranging in age from four months to fifteen years. The study, conducted at the Wesley Guild Hospital, Ilesa in south- western Nigeria between January and November 2014, also looked at the antibiotic resistance profiles of the bacterial isolates and the presence of specific resistance and virulence genes.
    Methods: Samples were collected from each study participant with the aid of a cotton-tipped applicator initially dipped into sterile saline and introduced into nasopharynx of subject, applied onto sterile thioglycolate fluid medium and incubated at 37oC for 24 hr. When growth was noticed, a loopful was retrieved and applied onto blood and chocolate agar as well as other selective and differential media. Bacterial colonies that grew on such media were picked and studied initially by Gram reaction, cultural and biochemical methods. Antibiotic susceptibility testing was done for selected bacterial isolatesalong with PCR demonstration of resistance and virulence genes.
    Results: The results showed that the 1-5 and the 5-10 year SCD childrenhad the highest frequency of bone pain episode, hospitalization for malaria, bacterial infections and sepsis and blood transfusions for chronic anemia. Corynebacterium spp predominated among the nasopharyngeal isolates from both SCD and non-SCD children. C. Xerosis accounted for 55.38% among the non- SCD isolates and C. Ulcerans represented 35.84%of the SCD isolates.We recorded low carriage rates for H. influenzae, S. Pneumonia and S.aureus in the nasopharynx of the study participants. Widespread antibiotic resistance was observed among SCD and non-SCD isolates, with demonstration of resistance blaZ and tetK resistance genes and sea, and eta virulence genes by PCR.
    Conclusion: The predominance in this study of Corynebacterium spp over organisms such as H. influenzae,S. Pneumonia and S. aureus that are common invasive pathogens of the nasopharynxwas both interesting and unexpected. The predominance suggested a shift in the community nasopharyngeal flora that may have resulted from long-term prophylactic use of antibiotics and successful administration of bacterial vaccines in the study population.
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