Day 1 :
- Pediatrics | Pediatric Surgery | Pediatric Nutrition | Pediatric Allergy and Asthma | Neonatology | Pediatric Oncology | Pediatric Neurology | Pediatric Infectious Disease
All India Institute of Medical Sciences, Raipur, CG, India
Dr. Charu Tiwari is currently working as Assistant Professor in Dept. of Pediatric Surgery at All India Institute of Medical Sciences, Raipur, CG, and India. She completed her Super specialization (Mch Pediatrics Surgery) in 2015 at TNMC & BYL Nair Hospital, Mumbai and has 7 years of experience post-super specialization. She is interested in Congenial Anomalies, Pediatric Gastrointestinal Surgery, Neonatal and Pediatric Emergencies of aero-digestive tract and Minimal Access Pediatric Surgery. She is interested in Research work and has more than 50 publications in indexed journals and has received Young Women Research Scientist Award in July 2021 awarded by VDGOOD, Mysore, India.
Background: Foreign body aspiration is very common among pediatric population. Removal of these foreign bodies, especially the vegetable organic ones, could be quite challenging. These vegetable foreign bodies account for approximately 60-70 percent of all aspirated foreign bodies in children. These foreign bodies usually get swollen and become difficult to remove through rigid bronchoscopy. With this Background, we describe four cases of old aspirated tamarind seeds who presented to us and all the challenges faced during bronchoscopy and their removal.
Methods Four patients who presented to our Pediatric Surgery Department with history of aspiration of tamarind seed (vegetable foreign body) for more than one week duration in the past 4 years are described along with the challenges faced during bronchoscopy and their removal.
Rescue us: Four pediatric patients with old history of aspirated tamarind seeds are described. All four patients presented with mild tachypnea at room air on admission. However, saturation was maintained in all four of them. The diagnosis was confirmed with HRCT Thorax in all. All four patients underwent rigid bronchoscopy with appropriate size brioche scope under General Anesthesia. The foreign body (tamarind seed was found impacted and swollen during removal- 3 in right main stem bronchus and one in left main stew bronchus. The optical forceps were used for removal. The tamarind seeds were swollen and hence could not be retrieved in toil in two patients. Hence, the seeds were broken and removed in pieces in these two patients. In the other two patients, tracheosloiny was required as the swollen seeds could not be negotiated through the narrow subglottic.
All had uneventful post-operative course and were discharged.
Conclusion: Bronchoscopy removal of vegetable foreign body from the tracheobronchial tree is challenging. Anticipating the difficulty and being prepared well will reduce intraoperative difficulty and allow successful removal with favorable patient outcomes. The operating surgeon should take consent for tracheostomy and have an lracheostoiny instrument set and appropriate sized tracheostomy tubes ready during the procedure to minimize the complications and ensure better outcome.
University Hospital Sharjah, UAE
Dr. Naguib has many years of clinical experience in pediatrics. He has contemporary experience in the management of young children and teenagers with endocrine disorders specially childhood diabetes and obesity, including modern therapeutic interventions like insulin pump and continuous blood glucose monitoring. He also runs a general pediatric clinic that deals with common pediatric problems like fever, asthma and common respiratory problems, vaccinations, common gastrointestinal disorders, follow up of nutrition, growth and development.
Background: This study looks at weight perception among parents and health care providers in Sharjah, UAE.
Methods: This study was done through reviewing 1000 patients’ files who visited the pediatric OPD in university hospital Sharjah (UHS) during 2015. The files were reviewed for the cause of the visit, the diagnosis of weight status and weight counselling.
Results: 18% of study patients were either overweight or obese. In children with abnormal weight status, the cause of the visits was weight related in 3.3% of patients, while it was due to weight unrelated causes in 96.7%. Weights counseling in obese individuals were reported in 35.5% of obese patients. While in overweight group, weight counselling was found in 5% of the patients and in patients with normal BMI, counselling was done in 0.2% of patients.
Conclusions: This study shows clear defects in weight awareness and perception in parents and health care providers. Most parents are either not aware about the weight status of their kids or they don’t consider overweight or obesity as medical issues that require medical advice. The very low percentage of specific weight counselling shows weight counselling is not practiced if these patients are evaluated for other complaints. Weight misperception among parents and health care providers can be genuine barriers for prevention of childhood obesity.
Keywords: Children, Obesity, Parents, Physicians, Weight awareness
Alleppo University, Syria
Muna Mohamed Jawish expertise and passion in clinical practice in general pediatrics as well as pediatric emergency since 1998 when she started my residency in pediatrics in Alleppo University Hospital / Syria , and continued her practice in general pediatrics till 2007 , when she moved to pediatric emergency medicine at King Fahed Medical City(KFMC) , Riyadh Saudi Arabia , and she accomplished my fellowship PEM in 2013 , to work as consultant in pediatric emergency till now in Security Forces Hospital .(SFH)
Medical teaching is my other interest as she was the department education supervisor before in KFMC and now in SFH, with fellowship program director deputy assignment.
Background: working in pediatric emergency department is challenging. Starting from ED entrance where unpredictable cases may come through to the urgency for early detection and stabilization of sick children, in a very noisy crowded environment; in addition to; dealing with many parties in ED
(staff, families , children , other specialties) add extra challenge.
Objective: to emphasize the importance of physician skills to conduct a proper history and physical examination as they form the corner stone in the chain of patients approach, by demonstrating few real cases from our ED.
I will present 4-5 cases (real patients) to highlight some ticks and tips in history and physical examination in these cases and how we manage them .These cases represent a range of diseases that daily present to ED and can easily be missed unless proper history and exam been carried out, even when no time or even place with urgency to move on to see the next patient.
Conclusion: despite the huge advance in technology which is utilized in medical diagnosis either LAB or imaging, still physician, s skills in history and physical exam are the key point in medical care.
1.Department of Emergency Paediatrics, CHI @ Tallaght University Hospital 2.Trinity College Dublin
Dr. John Drought MB BaO BCh is currently working as an Intern in General Medicine in St. James Hospital, Dublin & Dr. John Coleman MB BaO BCh is currently working as a Registrar in Clinical Genetics in Crumlin Hospital, Dublin. For queries contact [email protected]
Presentations of allergies are becoming an increasing burden in Ireland with up 4% of Irish children now suffering from a food allergy
(1). Despite this, few studies have evaluated the outcome of allergy presentations to the emergency department
(2) and most existing literature focuses on anaphylaxis outcomes
(3). Outcomes can be dictated by management in the emergency department.
- To identify the common allergens presenting to the unit.
- To evaluate treatment, outcomes and follow-up of patients presenting with allergy to the emergency care unit.
- A retrospective chart audit focusing on clinically confirmed allergy diagnosis to the department over a 6 month period from 1st March 2021 to 30th September 2021. Patient records were accessed electronically through local software.
Results - Demographics
- There was 76 eligible patients included.
- The median age of presentation was 3.
- 50% male and 50% female patients
- 44% a documented history of ad eczema.
- 28% of patients had other known allergens. 3
- 5% of patients had a family history of allergy.
Results – Presentations
- The common allergens included food (70%), environmental (18%) and other (12%).
- The most common food allergens were tree nuts representing 15 of the 53 (28%) food allergens, peanuts 12 (22%) and eggs 8 (15%).
- There were 2 suspected shellfish allergies and 1 suspected fish. 2 patients reacted to mango.
- 6 presentations were caused by anaphylaxis (8%). These did not require inpatient admission.
- 1 patient presented with serum sickness and this was the only admission.
Results – Outcomes
- 87% required acute treatment with antihistamines, 12% with steroids and 7% with adrenaline.
- 26% were prescribed or already had discharge adrenaline auto-injectors.
- 74% were prescribed a discharge antihistamine and 7% were discharged on oral steroids.
Results – Follow Up
- Advice resources were documented in 23%. The most common sources were other health care professionals (allergy nurse, GP, pharmacy).
- 39% of patients were newly referred to an allergist. 11% were known allergy patients. 11% were referred for GP follow up and 39% had no follow up arranged.
- In 22% of cases exclusion or reintroduction advice was formally documented.
The majority of allergy presentations to our department were related to food allergens.
Nuts including peanuts and tree-nuts appear to account for a large portion of food allergens (50%) and indicative of the more severe symptoms experienced in these cases.
- A large proportion of treatments involved antihistamines or no treatment at all and were managed in the ED, with a very low admission rate.
Irish Food Allergy Network (IFAN), Online publication, Accessed from http://ifan.ie/childcare-schools, Sept 2021
2.) Melville N, Beattie T, Paediatric allergic reactions in the emergency department: a review, Emergency Medicine Journal 2008;25:655-658.
3.) Braganza SC, Acworth JP, Mckinnon DR, Peake JE, Brown AF. Paediatric emergency department anaphylaxis: different patterns from adults. Archives of Disease in Childhood. 2006 Feb;91(2):159-163. DOI: 10.1136/adc.2004.069914.