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  • ISSN: 2373-9312
    Volume 3, Issue 8
    Research Article
    Lilly Immergluck*, Shabnam Jain, Susan Ray, Robert Mayberry, Sarah Satola, Trisha Chan Parker, Keming Yuan, Victoria Churchill1 and Robert C. Jerris
    Abstract
    The purpose of this study was to examine community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) carriage and infections and determine risk factors associated with specific S. aureus strains, specifically MRSA USA300. A case control study was conducted in a pediatric emergency department. Nasal and axillary swabs were collected, and participants were interviewed for risk factors for MRSA infections. The primary outcome was the proportion of S. aureus carriers among those presenting with and without a skin and soft tissue infection (SSTI). S. aureus carriers were further categorized into MRSA USA300 carriers or non MRSA USA300 carriers. MRSA USA300 carriage rate was higher in children less than 2 years of age, those with an SSTI, children with recent antibiotic use, and those with a family history of SSTI compared to non MRSA USA300 carriers. MRSA USA300 carriers were also more likely to have lower income compared to non MRSA USA300 carriers and no S. aureus carriers. Rates of presence of Panton-Valentine leukocidin (PVL) genes were higher in MRSA carriage isolates with an SSTI, with all 39 being USA300, compared to MRSA carriage isolates of patients without an SSTI. Our results indicate risk factors associated with MRSA USA300 carriage were age younger than two years, low income, recent antibiotic use, and previous or family history of SSTI. There is also an association between MRSA USA300 carriage and presence of PVL in those diagnosed with an abscess.
    Gopal Bhandari*, Raghunandan Byanju, Ram Prasad Kandel
    Abstract
    Background: Amblyopia is the most common visual disorder in childhood. Its prevalence is often underestimated because of lack of awareness and proper study. This study aims to assess the magnitude and clinical profile of amblyopia in children attending Bharatpur Eye Hospital, Nepal.
    Methods: This study included 113 amblyopic children among a total of 8,017 children below 16 years of age. Relevant demographic and ocular parameters were noted for each child. Visual acuity (VA) was taken with appropriate charts based on the age and cooperation level of the child. Amblyopic children underwent cycloplegic refraction, orthoptic evaluation and ocular examination. Severity of amblyopia was classified as mild moderate and severe based on the acuity line difference in Snellen's chart.
    Results: The prevalence of amblyopia in the study was 1.40%. Amblyopia was more prevalent in males (1.47%) than females (1.11%). The mean age of the children was 9 years and 3.8 months with only 37(32.74%) presenting below the age of 8 years. More than 40 %( n-49) had no history of eye checks and were only detected amblyopic at the time of study. The majority of the children were amblyopic due to uncorrected refractive error, Forty (35.4%) were isoametropic, 34(30.1%) were anisometropic and only 12.4% were strabismic amblyopia respectively. Most children had severe (57.5%) and moderate (25.5%) amblyopia.
    Conclusion: Uncorrected refractive error is a major cause of amblyopia in children. Early detection and correction of refractive error alone can reduce the burden of child's visual impairment due to amblyopia.
    Case Report
    Atiye Nur Aktay*
    Abstract
    Hookworm infestation of small bowel on Wireless Capsule Endoscopy (WCE) was reported in the adult population but not in children. It is an uncommon cause of iron deficiency anemia and abdominal pain in Midwestern United States. The purpose of this case report is to alert other physicians that small bowel hookworm infections could be incidentally found on WCE in non-endemic regions of the US.
    A 15 year-old Caucasian female was seen in the clinic with 3-month history of abdominal pain and fatigue. She had no recent travel history or sick contacts. Laboratory findings revealed iron deficiency anemia. Imaging tests, upper endoscopy and ileo-colonoscopy were normal. The patient underwent WCE for suspected small bowel Crohn's Disease, and several hookworms were visualized in the small bowel. She was treated with mebendazole. The follow up laboratory test revealed normal albumin-CBC and ESR after the treatment.
    Andrew Knox*, Mark Schapiro, Charu Venkatesan
    Abstract
    Duplication of the 2q24.3 region containing the SCN sodium channel genes has recently been described as a cause of neonatal epilepsy. Here we describe a patient with duplication of 2q23.3-2q31.2 who presented with neonatal epilepsy, developmental delay and associated congenital anomalies (dysmorphic features, horseshoe kidney, small VSD and right ventricle hypertrophy, and mild brain anomalies). After multiple daily seizures despite treatment with phenobarbital, levetiracetam, and topiramate, initiation of phenytoin led to cessation of seizures. This case highlights the efficacy of anti-epileptic medications that act on sodium channels in patients with neonatal epilepsy due to 2q24.3 duplication, as well as the importance of screening for associated congenital anomalies in such patients.
    Review Article
    George SL, Tucker ER and Chesler L*
    Abstract
    High-risk neuroblastoma remains a significant treatment challenge. Currently, less than half of patients survive, despite intensive multi-agent, multimodal therapies. We give an overview of the current treatment strategy and summarize the evidence for this approach, before discussing options for treatment of refractory and relapsed disease. Finally, we discuss significant international collaborative efforts to improve treatment by specifically targeting the key genetic drivers of neuroblastoma to positively impact on survival.
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