Pediatric Fulminant Cerebellitis Is Still a Fatal Disease that We Know Little About! Two Case Reports and a Literature Review.

BACKGROUND Acute cerebellitis is a rare inflammatory disease with a variable clinical course that ranges from self-limiting illness with a benign outcome to a fulminant process (known as fulminant cerebellitis) associated with high risk of morbidity and mortality. It poses a unique challenge to the pediatric community due to its infrequent occurrence and variable presentation, which ultimately contribute to variation in treatment and variation in clinical outcome. This condition has received little attention, with scattered case reports and reviews in the literature and no clear consensus or guidelines for pediatricians to standardize the approach and management. CASE REPORT We report the cases of 2 previously healthy children diagnosed with fulminant cerebellitis. The clinical picture started with severe headache, irritability, and acute deterioration of consciousness level with the absence of cerebellar signs. There was radiological evidence of obstructive hydrocephalus and cerebellar tonsillar herniation in the context of the inflamed cerebellum. The 2 patients received timely standard medical and surgical management for acute cerebellitis in the form of neuroprotective measures, osmotherapy, broad-spectrum antibiotics, and CSF diversion. One patient received aggressive immunomodulatory therapy and had a better outcome compared with the other patient who received no immunomodulatory therapy and had a poor outcome. CONCLUSIONS A high index suspicion and early aggressive intervention are the best tools for achieving optimal outcomes in fulminant cerebellitis in children, given the lack of classic cerebellar signs. In addition to CSF diversion and broad-spectrum antibiotics and antivirals, some patients may benefit from early immunomodulator therapy and posterior fossa decompressive craniotomy.

Student's Knowledge, Attitudes, and Practices Related to Cardiopulmonary Resuscitation at Qassim University, Saudi Arabia.

Background Cardiopulmonary resuscitation (CPR) is a lifesaving technique that is vital to deal with in many emergencies. Early interference with the cardiopulmonary resuscitation technique is really important for the survival of the patient. This study assesses the level of knowledge, attitudes, and practices regarding CPR among Qassim University students. Materials and methods A cross-sectional study was conducted at Qassim University. The sample was university students. The colleges were chosen by a simple random technique. Data were collected using a pretested, semi-structured questionnaire for knowledge, attitudes, and practices related to CPR. The data were analyzed using Statistical Package for the Social Sciences (SPSS; IBM Corporation, Armonk, NY). Results The total sample size of the participating students was 1148, of which 589 (51.3%) were female and the remaining were male (559, 48.7%). The common age was between 20 and 23 years old and most were from non-medical colleges (54.1%); the remaining (45.9%) were from medical colleges. The majority of female students (45.7%) in medical colleges knew the right location for chest compression better than the males, with a significant difference (p<0.05). No significant difference existed between males and females (p>0.05) regarding most CPR practices. On the other hand, there was a significant increase among medical students as compared to non-medical students (p<0.05) regarding most knowledge, attitudes, and practice items of CPR. Conclusion Based on our study, the knowledge, attitudes, and practices of Qassim University students toward CPR are insufficient and need to be improved. Also, medical students are better than non-medical students at CPR, so we recommend that the incorporation of a Basic Life Support (BLS) course, including CPR learning procedures in the university curriculum, with regular reassessments, would increase the knowledge and application of CPR skills among students for saving people's life.