Pediatrics Commons^™

Frequency And Mortality Associated With Hyperglycemia In Critically Ill Children, Sabeen Abid Khan, Mohsina Noor Ibrahim, Anwarul Haque

Department of Paediatrics and Child Health

Objective: To determine the frequency of hyperglycemia in critically ill children admitted in PICU of a tertiary care hospital of Karachi and to compare the mortality of critically ill children with and without hyperglycemia.

Study Design: Cross-sectional study.

Place and Duration of Study: Paediatrics Intensive Care Unit (PICU) of National Institute of Child Health (NICH), Karachi, from November 2011 to April 2012.

Methodology: One hundred fifty critically ill children admitted to PICU were included. Patients who had fasting blood sugar levels more than 126 mg/dl within 48 hours of admission were included in the hyperglycemic group. The normoglycemic and hyperglycemic …

Can Routine Screening And Iron Supplementation For Iron Deficiency Anemia In Nonsymptomatic Pregnant Women Improve Maternal And Infant Health Outcomes?, Anoosh Moin, Zohra S. Lassi

Department of Paediatrics and Child Health

Pregnant women have an increased need for iron that might not be met with diet alone. Due to physiologic anemia and population differences, no set criteria for defining iron deficiency anemia (IDA) are available globally. Serum ferritin and transferrin levels are often used to guide therapy by clinicians. Studies have reported an association between poor iron status and negative health outcomes such as low birth weight, premature birth, and perinatal death for women and their infants, although the evidence is weak.

Short-Term Effects On The Fetus And Long-Term Outcome On Children Exposed To Maternal Chemotherapy, Yocheved Kramer

The Science Journal of the Lander College of Arts and Sciences

Ethical questions with regard to treatment arise when pregnant women are diagnosed with cancer. Does the health of the mother or the health of the fetus take priority? However, research suggests that concern over transplacental transfer should not deter those seeking treatments since avoidance of favorable transfer drugs can allow chemotherapy to be a viable option if properly administered. Doctors highly contraindicate the use of chemotherapeutic drugs in the first trimester due to high risks such as teratogenesis and fetal death. However, they reassure that treatment can be given in the final two trimesters. It presents minimal consequences as long …

Factors Facilitating Constructive Coping With Stress, Kamilla Bargiel-Matusiewicz, Hatim A. Omar

Pediatrics Faculty Publications

This review focuses on coping with stress, with particular emphasis on mechanisms facilitating constructive coping with stress. An important area of contemporary research is the attempt to identify factors that make it possible to stay mentally healthy or preventing the weakening of the cognitive and social functioning. The currently prevailing approach to stress is the relational approach. According to this approach, the criterion for the occurrence of stress is the cognitive assessment of the situation made by an individual. This review presents the most recent proposals concerning the analysis of specific methods of coping with stress, in particular from the …

Revisiting Menstrual Bleeding Patterns In Adolescents Using Etonogestrel (Eng) Implant, Anna Iddings, Hatim A. Omar

Pediatrics Faculty Publications

Etonogestrel (ENG) implant is an effective method of contraception. The implant is designed to provide contraceptive efficacy for three years with a relatively quick return of fertility upon its removal. Dysfunctional uterine bleeding (DUB) is a common side effect of long acting progestins and is often the reason patients state for removal or discontinuation. A retrospective chart analysis was completed on 292 patients who chose to be on the ENG implant. Age of patients ranged from 10-29 years of age with the average age at implant being 17 years +/- 3 years. Patients retained implant for 1-68 months with the …

Cyberbullying In Adolescents: The Prevalence Of Mental Disorders And Suicidal Behavior, Elizabeth L. Mirsky, Hatim A. Omar

Pediatrics Faculty Publications

This paper defines the phenomena of cyberbullying in relation to traditional bullying, along with its negative consequences on adolescents in modern society. The reasons for the highly destructive effects of cyberbullying are given along with information about psychological instability resulting from the occurrence of cyberbullying. The correlation of cyberbullying with suicidal thoughts and behaviors is also discussed. Finally, some prevention techniques are listed in an attempt to lower the prevalence of cyberbullying.

Syphilis: The Forgotten Sexually Transmitted Disease. A Brief Case Report, Amy Burnett, Hatim A. Omar

Pediatrics Faculty Publications

Syphilis has declined significantly over the last 30 years. Due to that success, many physicians no longer have the skills to recognize its symptoms. We present a case of syphilis as a demonstration of this fact.

Hiv And Minority Youth, Mandakini Sadhir, Hatim A. Omar

Pediatrics Faculty Publications

Human Immunodeficiency virus (HIV) infection is a major public health problem with the burden of disease increasing in adolescents and young adults particularly among black males and males who have sex with males (MSM).

Paper I: Stress In Adolescents, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

It is well known that adolescents experience stress. In this article, sources of adolescent stress will be discussed as well as the physiological effects of stress on the body. Stress disorders will also be briefly reviewed. Mainly, research on stress management strategies that have been evaluated in adolescents will be presented. Many studies have a small number of participants and lack control groups. Therefore, there is a need for ongoing research in this important area.

Part Ii - Stress And Stress Management Strategies In Adolescents, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

It is well known that adolescents experience stress. In this article, sources of adolescent stress will be discussed as well as the physiological effects of stress on the body. Stress disorders will also be briefly reviewed. Mainly, research on stress management strategies that have been evaluated in adolescents will be presented. Many studies have a small number of participants and lack control groups. Therefore, there is a need for ongoing research in this important area.

The Importance Of Comprehensive Sexuality Education In Adolescents, Sarah Lebrun, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Female Athlete Triad Review, Hannah Harrison, Hatim A. Omar

Pediatrics Faculty Publications

This article defines the female athlete triad and discusses long-term consequences for adolescents and women symptoms related to the triad. The pillars of the female athlete triad consist of menstruation disruption, decreased bone mineral density, and disordered eating (energy availability). We will discuss the problems that can arise from each of the three pillars of the female athlete triad and the relationships among them. There are different treatments for the triad based on the needs of the individual and new treatments are being researched. Finally, the need for more informed coaches, parents, and medical professionals is discussed.

Effective Youth Suicide Prevention: Evidence From Kentucky, Dessi Slavova, Hatim A. Omar

Pediatrics Faculty Publications

In 2013, Suicide was the second leading cause of death among U.S. young adolescents (15-19 years of age), accounting for 18.4% of all deaths in this age group. According to a nationally representative study on the lifetime prevalence of adolescent suicidal behaviors, 12.1% of U.S. adolescents experience suicidal ideation, 4.0% develop a plan, and 4.1% attempt suicide. The same study estimated that approximately 60% of young people with a suicide plan will attempt suicide, and most of the adolescents who subsequently make an attempt do so within the first year after the onset of ideation.

These findings support the importance …

Children With Asthma: What About The Quality Of Life Of Their Parents?, Anna Trzcieniecka-Green, Kamilla Bargiel-Matusiewicz, Agnieszka Wilczyńska, Hatim A. Omar

Pediatrics Faculty Publications

An increased frequency of asthma in children has been lately observed. The course of asthma depends not only on treatment. but also on the actions taken by the parents of a sick child. Design: A non-experimental cross-sectional design. Methods: In this study the Pediatric Asthma Quality of Life Questionnaire (PACQLQ) and Satisfaction with Life Scale (SWLS) were administered to 60 parents of children with :asthma. Two groups of parents were compared. The first group consisted of parents of children who had been diagnosed with asthma less than three months before the beginning of the study. The second group consisted of …

Starting Off, Hatim A. Omar

Pediatrics Faculty Publications

This book is really a reflection of the past 15 years of work with teens and suicide prevention in the state of Kentucky. The work to establish the "Stop Youth Suicide Campaign (SYS)" has resulted in contact with many young adults and we have found that the most important thing for all of them, was finding a caring person they trust and can talk to. Because of the constant need, the SYS went from a goal of one year awareness campaign to a major community resource, to work with the state and local governments and state legislators to add as …

Disability And Suicide, Divya Nagraj, Hatim A. Omar

Pediatrics Faculty Publications

We provide a systematic review of suicide among adolescents with physical disabilities, intellectual disability and learning disability. A search was performed of English articles published prior to December 2014 in the PubMed database for studies examining suicide, suicidal behavior and suicidal ideation among adolescents with and without varied disabilities. Nine studies were retrieved, of which two studies examined adolescent populations with physical disabilities, three looked at suicide in adolescents with intellectual disability and four studies examined adolescents with learning disabilities. There were consistent results to prove that these adolescents with special needs had an increased tendency to commit suicide and …

Self-Cutting And Suicide In Adolescents, Donald E. Greydanus, Hatim A. Omar

Pediatrics Faculty Publications

Deliberate self-harm (DSH) is a common and typically secret phenomenon in adolescents, especially females that involves two main features—self-derogation and negative emotionality. Causes of non-suicidal self-injury include attempts to get help from professionals, express disgust or self-anger, resist suicidal thoughts, and correct episodes of dissociation. DSH is associated with eating disorders and alcohol abuse, as well as other illict drug abuse. Fortunately, most self-cutters are not at high risk for eventual suicide; however, all those with DSH histories should be carefully assessed for suicide as well as offered comprehensive management. Programs for prevention of suicide should be implemented for adolescents …

Patient- And Family-Centered Care Of Children In The Emergency Department., Nanette Dudley, Alice Ackerman, Kathleen M. Brown, Sally K. Snow, American Academy Of Pediatrics Committee On Pediatric Emergency Medicine, American College Of Emergency Physicians Pediatric Emergency Medicine Committee, Emergency Nurses Association Pediatric Committee., Gregory P. Conners

Manuscripts, Articles, Book Chapters and Other Papers

Patient- and family-centered care is an approach to the planning, delivery, and evaluation of health care that is grounded in a mutually beneficial partnership among patients, families, and health care professionals. Providing patient- and family-centered care to children in the emergency department setting presents many opportunities and challenges. This revised technical report draws on previously published policy statements and reports, reviews the current literature, and describes the present state of practice and research regarding patient- and family-centered care for children in the emergency department setting as well as some of the complexities of providing such care.

Child Rights And Social Justice Framework For Analyzing Public Policy Related To Hpv Vaccine, David Wood, Rita Nathaward, Jeffrey L. Goldhagen

ETSU Faculty Works

Human papilloma virus (HPV) is the most common viral infection of the reproductive tract and a well-established cause of cervical, anal, and oropharyngeal cancers in both women and men worldwide. Despite data that supports HPV vaccine as an effective measure to prevent such cancers, vaccine uptake has not been optimal in many countries. In the United States (US) for example, rates have stagnated over the past few years and only one-third of adolescents are fully immunized, in contrast to other adolescent vaccines such as Tdap and meningococcal that have double the rates of uptake. Current approaches to HPV vaccine education …

Manufacturing Doubt About Endocrine Disrupter Science - A Rebuttal Of Industry-Sponsored Critical Comments On The Unep/Who Report "State Of The Science Of Endocrine Disrupting Chemicals 2012", Åke Bergman, Georg Becher, Bruce Blumberg, Poul Bjerregaard, Riana Bornman, Ingvar Brandt, Stephanie Casey, Heloise Frouin, Linda Giudice, Jerrold J. Heindel, Taisen Iguchi, Susan Jobling, Karen A. Kidd, Andreas Kortenkamp, P. Monica Lind, Derek Muir, Roseline Ochieng, Erik Ropstad, Peter S. Ross, Niels Erik Skakkebaek, Jorma Toppari, Laura N. Vandenberg, Tracey J. Woodruff, R. Thomas Zoeller

Paediatrics and Child Health, East Africa

We present a detailed response to the critique of “State of the Science of Endocrine Disrupting Chemicals 2012” UNEP/WHO, 2013) by financial stakeholders, authored by Lamb et al. (2014). Lamb et al.'s claim that UNEP/WHO (2013) does not provide a balanced perspective on endocrine disruption is based on incomplete and misleading quoting of the report through omission of qualifying statements and inaccurate description of study objectives, results and conclusions. Lamb et al. define extremely narrow standards for synthesizing evidence which are then used to dismiss the UNEP/WHO 2013 report as flawed. We show that Lamb et al. misuse conceptual frameworks …

Best Practices For Improving Flow And Care Of Pediatric Patients In The Emergency Department., Isabel Barata, Kathleen M. Brown, Laura Fitzmaurice, Elizabeth Stone Griffin, Sally K. Snow, American College Of Emergency Physicians Pediatric Emergency Medicine Committee, Emergency Nurses Association Pediatric Committee, Gregory P. Conners, American Academy Of Pediatrics Committee On Pediatric Emergency Medicine

Manuscripts, Articles, Book Chapters and Other Papers

This report provides a summary of best practices for improving flow, reducing waiting times, and improving the quality of care of pediatric patients in the emergency department.

Project Spraoi: A Strategy To Improve Nutrition And Increase Physical Activity In Primary School Children, Lisa Delaney

Masters

Introduction: Paediatric obesity has become a global epidemic with many countries developing strategies to help tackle its prevalence. School based physical activity (PA) and nutrition interventions have proven to play a promising role in tackling childhood obesity.

Background: Project Spraoi is an Irish primary school based intervention. The intervention was delivered to an intervention school to help enhance PA and nutritional behaviour amongst pupils. The intervention school was assigned an ‘Energizer’; a trained PA and nutrition change agent who worked with the school to achieve the objectives. For evaluation purposes a control school was recruited.

Methodology: Pupils from the intervention …

Primary Care Providers’ Knowledge And Experience With Pediatric Acute Watery Diarrhea And Hemolytic Uremic Syndrome, Krista Marie Cassel

DNP Projects

The purpose of this capstone is to investigate the potential for hemolytic uremic syndrome (HUS) risk reduction in children through the evaluation of current evidence as well as pediatric primary care providers' knowledge and experience with children at risk for HUS. The goals of this capstone are to 1) evaluate the current literature to determine best practice for prevention of HUS, 2) assess primary care provider knowledge of HUS and experience with children with acute watery, and 3) develop a guideline for the initial management and referral of these children at risk for HUS.

Foster Parents' Perceptions And Beliefs About Social Emotional Development In Infants And Toddlers, Susan R. Noel

DNP Projects

Infants and toddlers placed in foster care are at increased risk for social-emotional (SE) development dysregulation. Foster parents, as surrogate parents, play a critical role in a young child having the potential for healthy SE development. The transactional model supports the complex and intricate interplays and transactions of the child, the foster parent, and the environment that influences a healthy SE development. This qualitative descriptive study explored foster parent knowledge, behavioral cue recognitions, and role perception regarding a young child's SE development. Although the sample size was small, the study provides relevant information, from the on-going experiences of foster parents, …

Psychobiobehavioral Model For Preterm Birth In Pregnant Women In Low- And Middle-Income Countries, Shahirose S. Premji, Ilona S. Yim, Aliyah Dosani (Mawji), Zeenatkhanu Kanji, Salima Sulaiman, Wangira Musana, Pauline Samia, Kiran Shaikh, Nicole Letourneau

School of Nursing & Midwifery, East Africa

Preterm birth (PTB) is a final common outcome resulting from many interrelated etiological pathways; of particular interest is antenatal psychosocial distress (i.e., stress, anxiety, and depression). In LMI countries, both exposure to severe life stressors and rate of PTB are on average greater when compared with high-income countries. In LMI countries women are exposed to some of the most extreme psychosocial stress worldwide (e.g., absolute poverty, limited social resources). High prevalence of antenatal stress and depression have been observed in some studies from LMI countries. We propose a psychosocial, biological, and behavioral model for investigating the complex multisystem interactions in …

Children With Sli Exhibit Delays Resolving Ambiguous Reference, Julie M. Estis, Brenda L. Beverly

University Faculty and Staff Publications

Fast mapping weaknesses in children with specific language impairment (SLI) may be explained by differences in disambiguation, mapping an unknown word to an unnamed object. The impact of language ability and linguistic stimulus on disambiguation was investigated. Sixteen children with SLI (8 preschool, 8 school-age) and sixteen typically developing age-matched children selected referents given familiar and unfamiliar object pairs in three ambiguous conditions: phonologically distinct word (PD), phonologically similar word (PS), no word (NW). Preschoolers with SLI did not disambiguate, unlike typically developing age-matched participants, who consistently selected unfamiliar objects given PD. School-age children with SLI disambiguated given PD. Delays …

Diagnostic Accuracy Of Who Verbal Autopsy Tool For Ascertaining Causes Of Neonatal Deaths In The Urban Setting Of Pakistan: A Hospital-Based Prospective Study, Sajid Bashir Soofi, Shabina Ariff, Ubaidullah Khan, Ali Turab, Gul Nawaz Khan, Atif Habib, Kamran Sadiq, Zamir Suhag, Zaid Bhatti, Imran Ahmed, Rajiv Bhal, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Globally, clinical certification of the cause of neonatal death is not commonly available in developing countries. Under such circumstances it is imperative to use available WHO verbal autopsy tool to ascertain causes of death for strategic health planning in countries where resources are limited and the burden of neonatal death is high. The study explores the diagnostic accuracy of WHO revised verbal autopsy tool for ascertaining the causes of neonatal deaths against reference standard diagnosis obtained from standardized clinical and supportive hospital data.
Methods: All neonatal deaths were recruited between August 2006 –February 2008 from two tertiary teaching …

Abdominal Lymphonodular Cryptococcosis In An Immunocompetent Child, Mehjabeen Zaidi, Sonia Qureshi, Sadia Shakoor, Saira Fatima, Fatima Mir

Department of Paediatrics and Child Health

We describe our experience with an apparently immunocompetent child presenting with pyrexia of unknown origin without focal signs. Investigations revealed lymphadenopathy at lung hila, mesentery, and porta hepatis. The child had received at least two months of empiric antituberculous therapy (ATT) before she came to us. A CT-guided biopsy revealed granulomatous inflammation. PAS stain showed yeasts which stained blue with Alcian blue, suggesting C. neoformans.

Diagnosis And Management Of Preeclampsia In Community Settings In Low And Middle-Income Countries, Rehana A. Salam, Jai K. Das, Anum Ali, Soumyadeep Bhaumik, Zohra S. Lassi

Department of Paediatrics and Child Health

Hypertensive disorders of pregnancy contribute significantly to maternal mortality and morbidity. Preeclampsia belongs to the spectrum of hypertensive disorders of pregnancy and if undiagnosed and/or untreated leads to fatal consequences for both the mother and the baby. Early detection and prevention of preeclampsia is limited by uncertainty in the knowledge about its etiopathogenesis. While much work has been done in establishing clinical guidelines for management of preeclampsia in the hospital or tertiary care settings, there is considerable lack of work in the domain of evidence-based guidelines for screening, identification and management of preeclampsia at the community-level. The article reviews these …

Impact Of Withholding Breastfeeding At The Time Of Vaccination On The Immunogenicity Of Oral Rotavirus Vaccine--A Randomized Trial, Asad Ali, Abdul Momin Kazi, Margaret M. Cortese, Jessica A. Fleming, Sungsil Moon, Umesh D. Parashar, Baoming Jiang, Monica M. Mcneal, Duncan Steele, Zulfiqar Bhutta

Department of Paediatrics and Child Health

Background: Breast milk contains anti-rotavirus IgA antibodies and other innate immune factors that inhibit rotavirus replication in vitro. These factors could diminish the immunogenicity of oral rotavirus vaccines, particularly if breastfeeding occurs close to the time of vaccine administration.
Methods: Between April 2011 and November 2012, we conducted an open label, randomized trial to compare the immunogenicity of Rotarix (RV1) in infants whose breastfeeding was withheld one hour before through one hour after vaccination with that in infants breastfed at the time of vaccination. The trial was conducted in the peri-urban area of Ibrahim Hyderi in Karachi, Pakistan. Both groups …