BackgroundDeferoxamine (DFO) is one of the most commonly used chelation treatments for transfusional hemosiderosis. Pattern dystrophies constitute a distinct entity of retinal disorders that has been occasionally identified in association with deferoxamine.Case presentationWe report two cases of bilateral macular pattern dystrophy in transfusion dependent patients undergoing chronic chelation therapy with deferoxamine due to thalassemias. Our patients were evaluated with multimodal imaging and the results are presented. Both patients had normal cone and rod responses in the full-field electroretinogram and continued the prescribed chelation therapy, after hematology consult. The patients were followed up every 3 months for 2 and 4 years respectively for possible deterioration. Their best corrected visual acuity remained stable with no anatomic change on Optical Coherence Tomography findings.ConclusionMultimodal imaging of our patients allowed a better evaluation and possibly earlier detection of the DFO-related changes. Screening and close follow up of patients under chronic chelating therapy is important in order to promptly diagnose and manage possible toxicity either with discontinuation of the offending agent or dose modification.
Introduction: Cyclone Nargis struck on 2 nd May 2008 and was the worst natural disaster in the recorded history of Myanmar. More than 2 million people were affected by the cyclone which left 146, 000 people dead. Children made up a significant proportion of those affected by the cyclone and they formed a significant patient load during Team Singapore's medical relief mission. It was our aim to study the paediatric morbidity to help in planning for future disaster relief missions.Methods: Demographic and medical data from the medical records of the 4489 patients seen by our doctors was collected and analysed.Results: 1402 paediatric patients aged 16 years and below were seen in 9 operational days from our visits to a hospital, 8 camps/villages and an orphanage. They formed more than 30% of our total clinical workload. Most of them suffered from respiratory (36%) and gastrointestinal infections (29%). Injuries and wounds made up 12% of the attendances and 2.8% of the children presented with psychological manifestations/ post traumatic stress disorder.
Conclusions:Children are more susceptible to infection and vulnerable to the effects of vomiting and diarrhea and often form a large population of victims in a disaster. Their psychological needs have to be addressed. The needs of children are unique and medical aid should be rendered by paediatric specialists trained to render medical assistance to children in extreme situations. The special requirements of children must be taken into account in the planning of any disaster relief mission.
HEAD INJURIES IN CHILDHOOD
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