ABSTRACT
Rett syndrome consists of a highly complex but consistent set of clinical signs and symptoms. Clinical characteristics consist of microcephaly, delayed psychomotor development, autistic behavior, stereotyped hand-washing, and seizures. Over a period of 14 years (1987-2000), 7 patients with Rett syndrome were evaluated at the Out Patient Unit, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. All seven patients were females aging 1 1/2 to 5 years old when diagnosis was established. All were appearently normal at birth and had developmental regression after a period of time. All of them developed microcephaly, autistic features, seizures, and stereotyped hand-washing-movement. Five of seven patients (71.42%) developed episodic hyperventilation. All cases had abnormal electroencephalogram. Computer tomography scan were examined in 3 cases which were normal while magnetic resonance imaging were studied in 2 cases and was abnormal in one.
Subject(s)
Rett Syndrome/diagnosis , Child, Preschool , Disease Progression , Electroencephalography , Female , Humans , Incidence , Magnetic Resonance Imaging , Prognosis , Rett Syndrome/epidemiology , Rett Syndrome/therapy , Thailand/epidemiologyABSTRACT
We report a child with typhoid glomerulonephritis who presented with fever, gastrointestinal symptoms, edema, hypertension and abnormal urine findings including microscopic hematuria and proteinuria. Salmonella typhi resistant to ampicillin and cotrimoxazole was isolated from a blood culture. Renal biopsy was not performed. The child successfully treated with ceftriaxone.
Subject(s)
Glomerulonephritis/etiology , Typhoid Fever/complications , Adolescent , Ceftriaxone/therapeutic use , Cephalosporins/therapeutic use , Child , Child, Preschool , Female , Glomerulonephritis/diagnosis , Glomerulonephritis/drug therapy , Glomerulonephritis/physiopathology , Humans , Male , Thailand , Typhoid Fever/diagnosis , Typhoid Fever/drug therapy , Typhoid Fever/physiopathologyABSTRACT
Among 47 children admitted to the Chulalongkorn Medical School Hospital for neurotoxic snake bite, the attackers were identified in 15; the cobra (Naja naja) was the snake involved in all cases. Clinical manifestations in all 47 children appeared to follow a similar pattern. Drowsiness heralded the systemic effects in most of the patients. The characteristic systemic signs were those resulting from the neuromuscular effects of the venom and included ptosis, frothy saliva, slurred speech, respiratory failure, and paralysis of the skeletal muscles. These episodes occurred within 8 hours in 94% of the cases, and at the latest 19 hours following the bite. In some cases unconsciousness accompanied respiratory failure. Necrosis in the region of the bite, the prominent local sign, developed in 40% of the cases at the end of the 1st week after the bite. Infusion of specific antivenom was an effective therapeutic measure for the neuromuscular changes. Respiratory assistance was mandatory in cases of respiratory failure. Edrophonium chloride demonstrated a supportive role as a countermeasure against the neuromuscular effects.
Subject(s)
Antivenins/therapeutic use , Snake Bites/therapy , Child , Child, Preschool , Elapid Venoms/antagonists & inhibitors , Hemoglobins/analysis , Humans , Infant , Leukocyte Count , Male , Neuromuscular Diseases/etiology , Respiration Disorders/etiology , Seasons , Snake Bites/blood , Snake Bites/pathology , Snake Venoms/antagonists & inhibitors , ThailandABSTRACT
A case of lead encephalopathy in a 2-month-old child is reported. Modes of poisoning are discussed and the unusual clinical manifestations of metallic brownish discoloration of nails and subdural effusion are presented. The possibility of lead poisoning as a cause of convulsions in neonates should be considered by doctors caring for these patients. Detailed history of lead exposure in prenatal and postnatal periods aids in early diagnosis and treatment which, thus, prevent severe neurological sequelae.
