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ABSTRACT: Asthma is a common chronic disease of children. A good control of symptoms will improve quality of patient life. Inhalation technique is an important aspect in the management of asthma. The better the inhalation technique the better the lung deposition of asthma therapy especially inhaled corticosteroids. This will lead to better control of symptoms and improve adherence to treatment. In the following study the inhalation technique of asthma devices were compared using inhalation technique score system. The asthma devices studied were metered dose inhalers (pressurized MDI) without spacers and dry powder inhalers (DPI). The hypothesis studied was that the inhalation technique score of dry powder inhalers will be adversely affected with concurrent use of metered dose inhalers without spacers.
Internet Journal of Pediatrics and Neonatology 06/2011; 13(1).
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ABSTRACT: Patients with severe idiopathic scoliosis are reported to have significant pulmonary complications, including recurrent chest infections, alveolar hypoventilation and respiratory failure.
We report a case of a 13-year-old boy with moderate-to-severe scoliosis resulting in torsion or twisting of the bronchus intermedius, which contributed to airflow obstruction defects, as revealed by both spirometry and bronchoscopy.
We recommend that inspection of the shape of the maximal expiratory flow-volume loop obtained from spirometry, as well as other parameters suggestive of obstructive lung disease, may be important in children with scoliosis. To the best of the authors' knowledge, this is the first report of a child in which pulmonary function testing and direct visualization via a flexible bronchoscope have been used to characterize intrathoracic large airway obstruction.
Journal of Medical Case Reports 02/2008; 2:171.
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ABSTRACT: OBJECTIVES: To examine the pattern of urinary tract infection (UTI) in boys < 5 years admitted to general pediatric wards and to identify the approach to imaging investigations. DESIGN: During the period from January 2002 through December 2002, 34 boys < 5 years of age were admitted to Farwania Hospital with UTI. Age at diagnosis, presenting features, urinalysis, pathogens, acute phase reactants and imaging procedures were reviewed for these patients. RESULTS: All 34 patients in this study were less than one year. Fever was the most common presenting feature and was seen in 70.6% of patients. Pyuria was found in 77% , positive leukocyte esterase (LE) test in 85.7% and positive nitrite test in 45.7% of patients. Significant leukocytosis was found in 39.3%, high C-reactive protein (CRP) in 46.8% and high erythrocyte sedimentation rate (ESR) in 50% of children. Escherichia coli (E.coli) were the most common pathogen affecting 77.1% patients. Radiological investigations were recommended as follows: ultrasound scan (US) for all patients (94.2% did the test, 46.8% had normal scans and 43.7% had dilatation of pelvicalyceal system); Early-scheduled (99m)Tc dimercaptosuccinic scan (DMSA) was done in seven patients. Five or 71% had evidence of acute pyelonephritis; Late-scheduled DMSA was recommended for 25 patients. Only 52% did the test and out of those 46% had evidence of chronic involvement of the kidney(s); Micturating cystourethrogram (MCUG) was advised for 32 patients. 43.8% failed to carry out the procedure. Vesicoureteric reflux (VUR) was found in 38.8% of those who performed the test. CONCLUSION: Unexplained fever in young boys should suggest UTI. Absence of fever does not exclude UTI, if other suggestive features exist particularly in the very young. UTI is commonly suggested by findings on urinalysis, on the other hand, negative urinalysis should not exclude the infection. Empiric antibiotics should cover gram-negative bacilli. Innovative strategies to ensure compliance to radiological investigations are needed.
The Kuwait medical journal: KMJ: the official journal of the Kuwait Medical Association 09/2006; 38(3):220-225.
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ABSTRACT: BACKGROUND: Inhaled corticosteroids (ICS) have an important role in the treatment of chronic asthma in children. The prevalence of asthma symptoms in children varies from 0 to 30 percent in different populations with the highest prevalence occurring in Australia, New Zealand and England. METHODS: A review of the literature and studies about inhaled corticosteroids safety, action and adverse events in children and adults where applicable was done. CONCLUSION: Inhaled corticosteroids are the main stay therapy for persistent asthma in children. Their safety and efficacy is proven from the literature. Proper education of the parents about asthma and inhaled corticosteroids is very important and improve asthma control. Keeping in mind to taper the inhaled corticosteroids to the lowest dose needed to control asthma and using correct inhalation technique by the use of spacers with metered dose inhalers or dry powder inhalers (Turbuhaler and Diskus) will prevent the occurrence of adverse events.
Internet Journal of Pediatrics and Neonatology 01/2006; 6(1).
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ABSTRACT: There is considerable evidence from the literature that children with chronic lung disease of infancy (CLD) have abnormal pulmonary function in childhood and this could have an impact on their life quality and overall health. There are similarities between CLD and asthma, and corticosteroids are the mainstay treatment for asthma. Many physicians use inhaled corticosteroids in children with CLD with no evidence. Therefore we wish to conduct a randomized double-blinded placebo controlled trial to test for the role of inhaled corticosteroids in children aged from 3 to 9 years with a history of CLD. Our primary hypothesis will be that inhaled corticosteroids are beneficial in children with CLD.
Our primary hypothesis is that using inhaled steroids; Beclomethasone Dipropionate (QVAR) 100 mcg 2 puffs 2 times a day for 6 weeks will improve the respiratory system resistance and the quality of life in children with CLD.
We propose that Beclomethasone Dipropionate (QVAR) will affect the pulmonary function after 6 weeks of treatment. In summary we think that our study will highlight knowledge on whether the use of inhaled steroids is clinically effective for CLD.
BMC Pulmonary Medicine 02/2005; 5:6. · 1.33 Impact Factor
