Flexible fiberoptic bronchoscopy a vital diagnostic and therapeutic procedure for assessing the airway. Its logistics, clinical indications and utility need to be elucidated in pediatric context. Pediatric flexible fibreoptic bronchoscopy is useful for diagnosis of airway anomalies, bronchoalveolar lavage for diagnostic and therapeutic purposes, and interventions like foreign body removal. Newer ultrathin bronchoscopes can be used to perform this procedure in children of all ages. Pediatric flexible bronchoscopy is a valuable diagnostic and therapeutic tool in the hands of skilled personnel when used judiciously.
Purpose of review The rising global burden of allergic diseases, particularly in the pediatric population, is of serious concern. Ocular allergy is one of the most common ocular pathologies met in clinical practice. A large proportion of children and adolescents suffer from allergic eye diseases (AEDs), which affect their quality of life. The available treatments and surgical modalities have their limitations and side effects. Therefore, the development of novel and alternate strategies is the need of the hour and requires a timely review of currently available knowledge. Recent findings The current review covers the incidence and prevalence of AEDs, factors influencing occurrence and severity of AED (age, sex, socioeconomic status etc.), underlying mechanisms, role of allergy testing and immunotherapy in children, development of diagnostic markers and novel therapies including cells and molecules. Summary Understanding the demographics, clinical patterns and risk factors of AED can help formulate appropriate preventive and therapeutic strategies for the effective management of this common cause of ocular morbidity. The future therapeutics for AED seems to rely primarily on cells (mesenchymal stem cells, Tregs, mast cells), cell products, molecules with immunosuppressive potential and immunotherapy.
Objective: To describe the utility of flexible fiberoptic bronchoscopy for the diagnosis and management in the neonatal ICU. Methods: A retrospective, medical chart review was conducted in neonates who underwent flexible fiberoptic bronchoscopy over a period of 7 years. Besides demographic data and diagnostic findings, the results of medical and/or surgical interventions done by treating neonatologist were recorded. Results: 88 bronchoscopies were performed in 83 neonates, of which 37 were done through endotracheal tube. Indications included persistent need for mechanical ventilation (32), persistent atelectasis (21), and stridor (27). Most common airway anomalies diagnosed included tracheobronchomalacia (20), laryngomalacia (18), subglottic stenosis (7), choanal atresia (4), laryngeal cleft (4), and tracheoesophageal fistula (4). Surgical interventions were undertaken in 17 cases (9 tracheostomies and 2 cases of slide tracheoplasty). Conclusion: Flexible fiberoptic bronchoscopy can be beneficial for the diagnosis and management of neonates with persistent or undiagnosed respiratory problems.
Malaria caused by Plasmodium species is a disease with high morbidity and mortality, especially in children. The changing clinical and blood manifestations of P.falciparum, emerging trends of complications with P.vivax are some of the important issues that merit attention at present in India. The prospective crosssectional study conducted on 170 patients of malaria in Mumbai aimed at studying the clinico-haematological alterations in the disease. Fever and splenomegaly were critical findings in majority of patients so that they may be used for clinical diagnosis of malaria and early institution of therapy. P.vivax was the predominant species with severe thrombocytopenia however anemia was common in P.falciparum infection.Older children were affected more severely than infants with hematological complications, namely anemia and thrombocytopenia. Anemia and thrombocytopenia were common observations while leucocyte count was normal in most patients. After 48 hours of antimalarial treatment, platelet count improved with restoration to normal in majority of patients while anemia worsened in most cases. There was a negative correlation between platelet count and hyperparasitemia. Despite availability of extensive literature on various manifestations of malaria, the evolving nature of the disease mandates continuous revision of existing data.
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