Metoclopramide-Induced Dystonic Reaction in an Infant

Metoclopramide-induced dystonic reaction (MIDR) is a clinical condition that can be seen even in all age groups even in treatment doses. A nine-month-old girl was brought to our emergency department with acute dystonic reaction that occurred after her 2.5-years-old sister gave her a 10 mg/kg metoclopramide tablet two hours before admission to the hospital. Diphenhydramine was given to the patient. One hour later, the patient's clinical findings regressed and patient was hospitalized, and was discharged from the hospital after 66 hours without sequelae. Although metoclopramide-induced dystonic reaction is frequently reported, the number of cases under one year of age is very limited. The case presented in this report is a patient who received a higher drug dose compared to other cases reported in the literature and recovered without sequelae after follow-up. The most important factor resulting in poisoning in children is not arranging the living spaces of the children by the parents. The easiest way to prevent such cases is to educate families on this issue

A Current Analysis Of Caregivers' Approaches To Fever And Antipyretic Usage

Introduction: The aim of this survey was to investigate the current knowledge, attitudes, and practices of febrile children's caregivers about fever, antipyretic usage, and temperature measurement methods in a tertiary care hospital. Methodology: A 41-item questionnaire was administered to a convenience sample of febrile children's caregivers in face-to-face interviews by two research assistants from January 2012 through June 2012 in an urban region of Turkey. Results: A total of 1,032 caregivers completed the interview. Approximately one-third of caregivers considered a temperature of less than 37.8 degrees C (100 degrees F) to be a fever, and 13% of all respondents would give antipyretics for a body temperature <= 37.8 degrees C. Furthermore, 76% of parents would wake their children from sleep to administer antipyretics. Although a high proportion (89.5%) of respondents believed that fever had harmful effects, 10.5% considered fever to be beneficial. Alternating use of acetaminophen and ibuprofen (44%) and giving antipyretics routinely (71%) before and after immunizations were common parental practices and generally advised by pediatricians. Parents with higher levels of education were more likely to consider fever to be beneficial and to treat fever with antipyretics, and less likely to seek medical attention for mild fever. Most caregivers stated that they were unsure about the right site (90%) and thermometer type (95%) for temperature measurement. Conclusions: Persistent fever anxiety and excessive antipyretic usage may be heightened by the lack of knowledge regarding accurate temperature measurement methods with digital thermometers in our population. Parental education may positively affect the approach to fever and antipyretic usage.WoSScopu

Adulthood behavioral and neurodevelopmental effects of being raised by an ambivalent mother in rats: what does not kill you makes you stronger

Background/aim: This study aimed to investigate the effects of early adverse life events and being raised by an ambivalent mother on rats. Materials and methods: The rats were separated into four groups: 1) the control group (n = 12), which was raised under standard care; 2) the early handling (EH) group, which was raised using an EH model (n = 16); 3) the early deprivation (ED) group, which was raised using an ED model (n = 13), and 4) the ambivalent mother (AM) group, which spent 3 h/day with a ``fake mother{''} (n = 17). When they became adults, their anxiety levels, depressive-like behaviors, and memory functions were measured using the elevated plus maze test, the forced swim test, and the novel object recognition test, respectively. Their neurodevelopment was evaluated by measuring the brain-derived neurotrophic factor (BDNF) levels in the prefrontal cortex, the dentate gyrus, and the cerebellum via ELISA. Results: The rats in the ED and AM groups exhibited less anxiety and depressive-like behavior than those in the control and EH groups, particularly in females. There was no significant difference between the groups in memory function or brain BDNF levels. Conclusion: Severe and ambivalent early adverse life events may decrease anxiety and depressive-like behavior in adult rats

How should one intervene when a foreign body is blocking a child’s oral cavity?

Foreign bodies lodged in the oral cavity can be life-threatening. Their removal should be determined on the basis of the patient’s condition, the type of object, the removal techniques available, the appropriate medication available and the potential complications. A 9-month-old girl was brought to the emergency room by ambulance after a part of a toy became stuck in her oral cavity. Her father had unsuccessfully attempted to remove it at home. A blue cylindrical, rigid plastic toy part was seen during examination of her oral cavity and her tongue was trapped inside it. On initial assessment, her vital signs were within the normal range. She was agitated, a small amount of saliva mixed with blood was coming out of her mouth and she could not swallow her spittle. She was treated in the resuscitation room by an otorhinolaryngologist and a paediatric emergency team, and the foreign body was removed using bayonet forceps inside the mouth. The child was monitored in the paediatric emergency observation unit for 6 hours for signs of asphyxia and aspiration, and she was discharged without complications. Foreign bodies in the oral cavity can cause serious complications, including injury, bleeding and sudden airway obstruction. Experienced healthcare professionals, especially those skilled in airway management, should handle these cases using a multidisciplinary approach to ensure respiratory safety. Abbreviations: LMA: laryngeal mask airway; PED: paediatric emergency department.</p

The skills of defibrillation practice and certified life-support training in the healthcare providers in Turkey

Aim of the study Successful cardiopulmonary resuscitation and early defibrillation are critical in survival after in- or out-of-hospital cardiopulmonary arrest. The scope of this multi-centre study is to (a) assess skills of paediatric healthcare providers (HCPs) concerning two domains: (1) recognising rhythm abnormalities and (2) the use of defibrillator devices, and (b) to evaluate the impact of certified basic-life-support (BLS) and advanced-life-support (ALS) training to offer solutions for quality of improvement in several paediatric emergency cares and intensive care settings of Turkey. Methods This cross-sectional and multi-centre survey study included several paediatric emergency care and intensive care settings from different regions of Turkey. Results A total of 716 HCPs participated in the study (physicians: 69.4%, healthcare staff: 30.6%). The median age was 29 (27-33) years. Certified BLS-ALS training was received in 61% (n = 303/497) of the physicians and 45.2% (n = 99/219) of the non-physician healthcare staff (P < .001). The length of professional experience had favourable outcome towards an increased self-confidence in the physicians (P < .01, P < .001). Both physicians and non-physician healthcare staff improved their theoretical knowledge in the practice of synchronised cardioversion defibrillation (P < .001, P < .001). Non-certified healthcare providers were less likely to manage the initial doses of synchronised cardioversion and defibrillation: the correct responses remained at 32.5% and 9.2% for synchronised cardioversion and 44.8% and 16.7% for defibrillation in the physicians and healthcare staff, respectively. The indications for defibrillation were correctly answered in the physicians who had acquired a certificate of BLS-ALS training (P = .047, P = .003). Conclusions The professional experience is significant in the correct use of a defibrillator and related procedures. Given the importance of early defibrillation in survival, the importance and proper use of defibrillators should be emphasised in Certified BLS-ALS programmes. Certified BLS-ALS programmes increase the level of knowledge and self-confidence towards synchronised cardioversion-defibrillation procedures

Age-Specific Frequencies and Characteristics of Ovarian Cysts in Children and Adolescents

Objective: The aim of the present study was to document ovarian cyst frequency and characteristics as well as distribution of these parameters with respect to age in children and adolescents. Methods: We retrospectively analyzed the medical records of 1009 girls between the ages of 5-18 years who presented to our pediatric emergency department (PED) with pelvic pain and therefore underwent pelvic ultrasound examination between June 2011 and May 2014. Results: In total, 132 of 1009 girls (13.1\%) were identified as having ovarian cysts >= 1 cm in diameter. The frequency of ovarian cysts was found to be 1.8\% (6/ 337) in children aged 5-9 years and 18.8\% (126/ 672) in those aged 10-18 years. All the cysts detected in children aged 5-9 years were small (< 3 cm) and simple with age-specific frequencies ranging between 1.5-2.7\%. With the onset of adolescence, ovarian cyst frequency started to increase with age and ranged between 3.8-31.3\% throughout adolescence. Age of peak ovarian cyst frequency was 15 years with a rate of 31.3\%. Large ovarian cysts(> 5 cm) were identified in 19 adolescents (15.1\%) with most occurring during middle adolescence. Of the 19 adolescents, five were found to have cyst-related significant ovarian pathologies including cystadenoma (n=3) and ovarian torsion (n= 2). Conclusion: In children aged 5-9 years, ovarian cysts were infrequent and small (< 3 cm). Peak ovarian cyst frequency was detected at the age of 15 years. All patients diagnosed with cyst- related significant ovarian pathologies were adolescents having a cyst > 5 cm in diameter with a complex appearance in most

Successful treatment of refractory listeria meningitis and bacteremia with trimethoprim-sulfamethoxazole in an immunocompetent child

Listeria monocytogenes is an important cause of life-threatening bacteremia and meningoencephalitis in neonates, pregnant women, the elderly, and immunocompromised individuals. However, it is an uncommon cause of illness in immunocompetent children beyond the neonatal period. Ampicillin with or without an aminoglycoside remains the best treatment for listeriosis. Here, we report a rare case of Listeria meningitis and bacteremia in a 7-month-old immunocompetent girl, which was refractory to ampicillin plus gentamicin treatment and successfully treated by the addition of TMP/SMX