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  • ISSN: 2373-9312
    Volume 9, Issue 8
    Research Article
    Carina Pereira da Silva*, Hemerson Iury Ferreira Magalhães, and Aníbal de Freitas Santos Júnior
    Introduction: Caffeine has been commonly used for the prevention and treatment of apnea-related symptoms in preterm infants. However, exposure to caffeine can influence weight gain in this population.
    Objectives: To evaluate the weight evolution of preterm newborns (NB), up to 34 weeks using caffeine citrate in a neonatal intensive care unit (NICU) of a philanthropic hospital in Salvador-Bahia-Brazil.
    Materials and Methods: This is a prospective longitudinal research with a descriptive character. The study evaluated the weight evolution of preterm infants up to 34 weeks exposed to caffeine citrate at doses ranging from 5mg/kg to 10mg/kg. Preterm infants with sepsis confirmed by blood culture and premature infants with congenital anomalies of the gastrointestinal tract were excluded from the study.
    Preliminary Results: Premature infants who received a maintenance dose of caffeine >5mg/kg/day had a slight reduction in weight gain. The use of caffeine associated with other factors did not have a negative impact on caloric gain. Premature infants < 32 weeks using caffeine required a higher intake of calories.
    Final Considerations: Caffeine contributes positively to the treatment of apnea in prematurity, but its catabolic effect can result in less weight gain in preterm infants.
    Shyam S. Meena, Monika Matlani, Deepika Meeena, and Vinita Dogra
    Introduction: Concurrent infections among tropical fevers like Dengue, Scrub typhus, Malaria, Chikungunya, Enteric fever and Leptospirosis have recently been recognized as an emerging problem. The objectives of this study were to determine the prevalence of concurrent infections among above mentioned tropical fevers in children hospitalized in an apex medical centre in North India and to correlate the epidemiology and therapeutic outcomes.
    Methods: This hospital based retrospective study was conducted over a period of 6 months, from June 2019 to December 2019. The clinical records of 126 patients who had been admitted in paediatric wards with tropical fevers were retrieved and investigated for the presence of concurrent infections.
    Results: Twenty six out of 126 patients were found to have different coinfections. The most common coinfection was Enteric fever with Malaria in eight patients while coinfection of Malaria and Scrub typhus was reported in six patients. Coinfections of Dengue with Malaria and Dengue along with Enteric fever were recorded in three patients. Whereas Dengue and Scrub typhus and Dengue with Chikungunya were observed in two (2) and one (1) patient respectively. Scrub typhus along with Enteric fever coinfection was observed in two (2) patients. Triple infection of Scrub typhus, Dengue and Plasmodium vivax Malaria was detected in one (1) patient. Thrombocytopenia, hepatitis and shock were the frequently noted complications in this study.
    Conclusions: Dengue, Scrub typhus, Malaria, Chikungunya and Enteric fever were the major aetiologies of tropical fevers which existed as coinfections. This resulted in the increase in severity of these infections along with different complications. Point of care testing for these infections greatly aids in the early diagnosis with significantly improved outcome.
    Márcia Regina Rigon*, Nathalia Nahas Donatello*, Lia Karina Volpato, and Anna Paula Piovezan#
    Problem: It is quite common the appearance of disorders of various natures in children and its adequate management its necessary to prevent worsening and improve quality of life. Complementary therapies are an available and growing resource to assist in a nurse setting, such as aromatherapy which can be an excellent tool within clinical practice and assist in the treatment of many childhood conditions. This review aimed to gather evidence of studies that used essential oils as treatment, in children up to 12 years old, and the outcomes observed by them.
    Eligibility criteria: Clinical trials or observational studies that evaluated the use of essential oils on the treatment of childhood conditions published till April of 2021, in English, Portuguese, Spanish, Italian or French. The data bases NDLTD, Brazilian digital library of theses and dissertations (BDLTD), CAPES Repository, BIREME, The Directory of Open Access Journals (DOAJ), EMBASE, and Pubmed were searched for studies.
    Sample: 22 studies were included in this review.
    Results: Pain and anxiety are the most studied conditions, and Lavender is the most used essential oil on the studies included. It is inferred from the studies that aromatherapy is a low-cost and easy-to-apply method, which can be applied with some safety throughout childhood.
    Conclusion: It is concluded that Aromatherapy can be used within pediatric care by nurses and other health professionals, but it is important to carry out more studies that also check for side effects and standardize effective and safe doses, to allow the professionals to make a safe prescription. When performed, it is important that the studies’ methodology is adequate and the scientific name of essential oils, as well as their concentrations and chemical profile are specified.
    Implications: Aromatherapy as care in childhood has been adopted by the multidisciplinary team and parents/guardians, demonstrating the importance of physical and mental well-being in this age group. Given its wide use in childhood disorders, as well as multiple application routes, ease of use and good cost-effectiveness, new studies are essential for individual or collective implementation for the benefit of children, family members and professionals involved in the care.
    Jéssica K. De Oliveira*, Camila W. Schaan, Camila M. De Campos, Nathalia Vieira, Rayane Da S. Rodrigues, Larissa Dos S. De Moraes, Janice L. Lukrafka, and Renata S. Ferrari
    Background: The evaluation of functional status and disability of the patients after critical disease are significant aspects to be measured. Therefore, we aimed to evaluate the functional status of critical pediatric patients after hospital discharge.
    Methods: Prospective longitudinal observational study, with age between one month and <18 years old, who needed PICU admission. The functional status was evaluated with FSS-Brazil at baseline, PICU discharge, hospital discharge, three and six months after this and new morbidity was defined as a worsening in functional status in the FSS-Brazil of two or more points in the same domain compared with the baseline score. The Generalized Estimating Equation model was used to compare the FSS-Brazil scores. McNemar Chi-square test was used to evaluate the difference between the categories of functional status in each domain. Poisson regression was performed to determine associations between clinical variables and functional status.
    Results: It was included 214 patients and 135 finished the follow-up. The majority of the sample was males (57.5%), with some chronic condition (76.2%), and 45.8% were readmitted to the hospital. We observed a higher incidence of moderate dysfunction at PICU discharge (42.1%), and the new morbidity was observed in 11.5% of the sample after hospital discharge. More days in invasive mechanical ventilation increases 1.02 the risk of new morbidity.
    Conclusions: Patients who needed PICU recovered functional status after hospital discharge and remained stable in three and six months. The incidence of new morbidity was low and invasive mechanical ventilation was a risk factor for new morbidity.
    Review Article
    Tiffany Field*
    Long COVID-19 or the persistence of COVID-19 symptoms beyond four weeks has been recently recognized as a medical condition in children and adolescents. Only twelve studies could be found in the Long COVID literature on youth. This narrative review is a brief summary of some informative research on Long COVID in adults followed by a more detailed review of the studies on Long COVID in children and adolescents. Just as the prevalent COVID-19 acute infection symptoms are similar in adults and youth, so are the Long COVID symptoms including fatigue and dyspnea. Other persistent symptoms shared by the two age groups include headaches, muscle pain, memory loss and “brain fog” as well as similar patterns of brain PET hypometabolism. At this time, the symptoms have been less severe and persistent for youth versus adults. This may relate to their lesser severity of acute infection, in turn, related to less developed ACE-2 receptors and autonomic function or less frequent comorbidities. This research has several methodological limitations including non-representative samples that have typically been surveyed almost exclusively on physical symptoms at only one point in time and have not been compared to non-Long COVID control groups. Nonetheless, this sparse literature may inform potential diagnostic and preventative interventions.
    Case Report
    Shajie Ur Rehman Usmani, Muhammad Daniyal, Hanif Kamal, and Alina Moin
    Shwachman-Diamond syndrome (SDS), is an autosomal recessive multi-organ genetic disorder characterized mainly by exocrine pancreatic insufficiency, skeletal abnormalities and hematological abnormalities due to bone marrow dysfunction. It is a rare condition with only a few hundred cases reported. Herein, we report a case of SDS for the first time in Pakistan. Our patient, a 2-year old male child, presented with a chronic history of severe failure to thrive, diarrhea and vomiting. After undergoing extensive evaluation and testing, he was eventually diagnosed as a case of SDS. Elaborate clinical features and details pertaining to the diagnostic process and management are described.
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