ABSTRACT
@#<p>Covid-19 which was first documented in the Philippines in January 2020 had spread alarmingly. Severe acute respiratory symptoms were the most common presentation of this novel coronavirus infection. Reports have described neurologic manifestations of this disease involving the central nervous system as well as the peripheral nervous system. However, studies among the pediatric population are limited. In this paper, we present three pediatric patients who were diagnosed with COVID-19, via RT-PCR, presenting with seizures and behavioral changes. Two of these patients have no concomitant respiratory symptoms while the other one had Pediatric Community Acquired Pneumonia. These patients were managed as cases of acute viral meningoencephalitis and were given supportive care.</p>
Subject(s)
Humans , Male , FemaleABSTRACT
BACKGROUND@#Anti-N-Methyl-D-Aspartate receptor (anti-NMDAR) Encephalitis is the most common type of autoimmune encephalitis that affects children, adolescents and young adults. Since its discovery in 2007, there is still a paucity of data on the disease and factors affecting its outcome.@*OBJECTIVES@#To describe the clinical characteristics of children and adolescents with anti-NMDAR encephalitis and to analyze factors that may affect its outcome.@*METHODS@#Forty-three patient records of diagnosed anti-NMDAR Encephalitis were included. The outcome was evaluated using the modified Rankin Scale (mRS), and Clinical Assessment Scale for autoimmune Encephalitis (CASE). @*RESULTS@#Ages ranged from 2 years to 18 years old, majority in the 12-18 years age range. Sixty percent were female. First line treatment using immunotherapy was given to all patients: 37% as monotherapy and 84% combination therapy (MPT only 23%, IVIg only 4%, MPT + IVIg or TPE 21-26%, and MPT + IVIg + TPE 16%). Clinical outcomes on discharge and on follow-up were assessed using the mRS and CASE. On discharge the proportion of the patients who had mild impairment (mRS<2, CASE<9) was more than 50%. On median duration follow-up of 31 weeks (range 24-40 weeks), 96.8% had significant improvement (mRS<2, CASE<9). Among the possible factors that were assessed to affect outcome, only severity of the illness at the start of the treatment influenced clinical outcome.@*CONCLUSION@#Early diagnosis and initiation of treatment before the progression of the disease will promote faster recovery and more optimal clinical outcome. CASE may be used as an additional tool in assessing response to treatment.
ABSTRACT
@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To compare the effect on Total Aerobic Count (TAC) of application of Isopropyl alcohol, Chlorhexidine, and povidone iodine plus alcohol prior to venipuncture and development of phlebitis in children admitted at a tertiary hospital.</p><p style="text-align: justify;"><strong>METHODS</strong>: A prospective randomized clinical trial in a tertiary hospital in Quezon City. A total of 129 patients one-year old and above with physician orders for IV insertion and extractions. Pre and post swabbing of the venipuncture site was done and placed on a blood agar plate. The three antiseptic solutions were applied over the venipuncture site and swabbed and placed on the agar plate. The primary outcome measure was the TAC in each blood agar of the tested antiseptic solution and correlation to developing phlebitis.</p><p style="text-align: justify;"><strong>RESULTS</strong>: The CFU/mL after disinfection was significantly different between groups, with the lowest CFU/mL observed among patients disinfected with Chlorohexidine. Phlebitis was only noted in the alcohol group. No reactions were observed from patients who were disinfected with povidone iodine and chlorohexidine.</p><p style="text-align: justify;"><strong>CONCLUSIONS</strong>: Single application of Chlorhexidine is the optimal method to be used as antisepsis prior to procedures like venipuncture. However, the use of povidone iodine plus 70% isopropyl alcohol also has comparable effect to Chlorhexidine.</p>