Pediatric Case Presentation

TUBEROUS SCLEROSIS IN CHILDREN : A CASE REPORT

Tuberous sclerosis (TS) is inherited abnormality with variable penetrance. It has a wide clinical spectrum varying from severe mental retardation and seizures to normal intelligence without seizures. Diagnosis is established based on the history, physical examination, and imaging procedures to explore multiple organs abnormalities such as the skin, brain, heart, eye, and kidney.

Major Features of TS : Facial angiofibroma, Ungual/periungual fibroma,  Cortical tuber, Shagreen patch,  Subependymal nodule, Subependymal giant cell astrocytoma , Cardiac rhabdomyoma, Lymphangioleiomyomatosis Hypomelanotic macules (>3)

Minor Features of TS:  Multiple pits in dental enamel, Hamartomaous rectal polyps, Bone cysts, Gingival fibromas,  Non-renal hamartoma, Retinal achromic patch, Multiple renal cysts, Skin tags

This is a case ofA 9 years old boy, with body weight 25 kg, came to the hospital with chief complaints of loss consciousness for 5 minutes, 1 hour before admission.

(Presented in “Pertemuan Ilmiah Tahunan ke-5 Ikatan Dokter Anak Indonesia, Bandung,13-17 Oktober 2012)

Authors : Martinus M. Leman,  Rinaldi, Priscilla Sharon, Fransisca Mayer, from Sentra Medika Hospital, Cibinong, Bogor, Jawa Bara, Indonesia

Background: Misuse of antibiotics in the treatment of URTI among children is becoming a major contributor to the emergence of antibiotic resistance that is becoming a major public health problem worldwide. Mothers must be equipped with essential knowledge and skills about proper antibiotics use for their children with URTIS to avoid antibiotic resistance. Aim: The aim of this study was to assess maternal knowledge and treatment practices regarding the use of antibiotics among their children with URTIS. Method: A cross-sectional descriptive design was conducted on a convenience sample of 100 mothers throughout 3 months who attending the General Outpatient Clinics number 4 and 5 and inpatient Cardiology and Medical departments at Mansoura University Children Hospital (MUCH). Data was collected by using a structured interview questionnaire sheet that consisted of three parts; characteristics of the studied mothers and their children, mothers' knowledge about antibiotics and mothers' practices regarding the use of antibiotics for their children with URTI. Results: More than half of the studied mothers (64.0%) had poor knowledge about antibiotics and the majority of them (84.0%) had satisfactory practices regarding use of antibiotics for their children with URTI. A relationship was founded between mothers' knowledge and their residence, educational level and occupation with statistical significance (p≤0.05). Also; a relationship was founded between the studied mothers' practices regarding giving antibiotic suspension for their children with URTI and their educational level with statistical significance (p≤0.019). Conclusion: it is concluded that more than half of the studied mothers had poor knowledge about antibiotics and the majority of them had satisfactory practices. Also, the studied mothers' knowledge is affected by their residence, educational level and occupation. As well as, the studied mothers' practices are affected only by their educational level. Recommendation: it is recommended to implement health educational program for mothers about antibiotic use to improve their knowledge and practices towards the safe use of antibiotics for their children with URTI.

Abstract: Despite efforts to decrease unnecessary use of antibiotics, misconceptions about antibiotics use persist
and continue to be more prevalent among mothers of children with URTIs. Aim: This study aimed to study the
effectiveness of learning package application on the use of antibiotics for mothers of children with URTIs. Method:
A quasi-experimental design was conducted on 214 mothers with their children regardless their gender, age, free
from chronic diseases, diagnosed with URTIs and managed by antibiotics, who attended the General Outpatient
Clinics at Mansoura University Children's Hospital (MUCH). Tools: A structured interview questionnaire sheet
for mothers' knowledge and practical knowledge, observational checklist for mothers' practices about
administration of antibiotic suspension and learning package evaluation checklist. Results indicated that, the
majority of the studied mothers had good knowledge (85.5%) and most of them (98.6%) had competent practices
immediately post the learning package application with highly statistical significant differences (p=0.00).
Conclusion: There was an improvement in mothers' knowledge, practical knowledge and practices after
application of learning package. Recommendations: Provide in-services, up to date and regular training programs
to improve mothers' knowledge and practices regarding the use of antibiotics for their children with URTIs.
Further studies are recommended to repeat this study on a larger sample size and on a wide scale in various
governorates of Egypt.
Keywords: Antibiotics, Bacterial resistance, Children, Knowledge, Learning package, Mothers, Practices and
Upper respiratory infections.

Pediatrics is the specialty of medical science concerned with the physical, mental, and social health of children from birth to young adulthood. Pediatric care encompasses a broad spectrum of health services ranging from preventive health care to the diagnosis and treatment of acute and chronic diseases.
https://clinicalcasereports.conferenceseries.com/call-for-abstracts.php Pediatrics is a discipline that deals with biological, social, and environmental influences on the developing child and with the impact of disease and dysfunction on development. Children differ from adults anatomically, physiologically, immunologically, psychologically, developmentally, and metabolically.

Acute anisocoria and unilateral mydriasis is physically alarming to patients and diagnostically worrisome to clinicians. We report the case of a 14-year-old girl who presented to the pediatric emergency department with acute anisocoria and unilateral mydriasis after contacting an Angel's trumpet plant and who had complete resolution of symptoms four days following eye contamination. The Angel's trumpet plant contains three active components which can result in mydriasis: hycosamine, atropine, and scopolamine. The three active components occur in different parts of the plant, including on the small glandular hairs that cover the entire plant. This likely explains why even brief contact with the plant can result in unintentional contamination of the eye and in mydriasis. It is critical when obtaining a history from a patient with such a presentation to ask explicitly about any contact with plants prior to onset of symptoms. Although eye contamination with the Angel's trumpet plant is self-limited and resolves within a week, the appearance of a persistently unilateral mydriatic eye can be alarming to patients and clinicians, which too often results in an unnecessary, costly workup.