Sitanshu Barik;Vikash Raj;Sant Guru Prasad;Richa;Varun Garg;Vivek Singh
Hip & pelvis
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v.35
no.2
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pp.73-87
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2023
The aim of this review is to conduct an analysis of existing literature on outcomes of application of various methods of joint decompression in management of septic arthritis of the hip in children. A search of literature in PubMed, Embase, and Google Scholar was conducted for identification of studies reporting on the outcomes of intervention for septic arthritis of the hip in children. Of the 17 articles selected, four were comparative studies; two of these were randomized controlled trials while the rest were single arm studies. Statistical difference was observed between the proportion of excellent clinical and radiological outcomes in arthrotomy (90%, 95% confidence interval [CI] 81-98%; 89%, 95% CI 80-98%), arthroscopy (95%, 95% CI 91-100%; 95%, 95% CI 90-99%), and arthrocentesis (98%, 95% CI 97-100%; 99%, 95% CI 97-100%), respectively. The highest overall rate of additional unplanned procedures was observed in the arthrocentesis group (24/207, 11.6%). Patients who underwent arthrocentesis had a statistically greater chance of excellent clinical and radiological outcomes, although the highest level of need for additional unplanned surgical intervention was observed in the arthrocentesis group, followed by the arthroscopy group and the arthrotomy group. Future conduct of a prospective multi-centric study focusing on the developed and developing world, along with acquisition of data. such as delay of treatment and severity of disease will enable assessment of the efficacy of one technique over the other by surgeons worldwide.
The main purpose of the study is to identify critical risk factors for development of a family assessment tool to screen high risk family. This study used a conceptual framework of family diagnosis developed by Eui-sook Kim's (1993) and analyzed risk factors to identify the high risk family. As employing a explorative and methodological study design, this study has four stages. 1. In the first stage, 34 family risk factors were identified by doing intensive literature review on conceptual framework of family diagnoses. 2. In the second stage, above risk factors were tested for content validity by consultation with 29 persons in community health nursing, nursing education, family theory, and social work. 3. In the third stage, existing survey data was used for actual application of the identified risk factors. The survey data used for this purpose was previously collected for the community diagnosis in a region of Seoul. At the final stage, through the comparison between high risk and low risk families, initially identified 34 risk factors decreased to 25 risk factors. Among 34 risk factors, six factors did not agree with content of questionnaries sand two factors were not significant in differentiating the high risk family Also, two risk factors showed high correlation between themselves, so only one of those two factors was chosen. As a result, twenty-five risk factors chosen to identify the high risk family are following ; 1. A single parent family due to divorce or death of a partner, or unweded single mother 2. A family with an unrelated household members 3. A family with a working mother with a young child 4. A family with no regular income 5. A family with no rule in family or too strict rules 6. A family with little or no support from other lam-ily members 7. A family with little or no support from friends or relatives 8. A family with little or no time to share with each other 9. A family with family history of hypertension, diabetus, cancer 10. A family with a sick person 11. A family with a mentally ill person 12. A family with a disabled person 13. A family with an alcoholic person 14. A family with a excessive smoker who smokes more than 1 pack / day 15. A family with too much salt intake in their diet. 16. A family with inappropriate management skills for family health 17. A family with high utilization of drug store than hospital to solve the health problems of the family 18. A family with disharmony between husband and wife 19. A family with conflicts among the family members 20. A family with unequal division of labor among family members 21. An authoritative family structure 22. A socially isolated family 23. The location of house is not residential area 24. A family with high risk of accidents 25. The drinking water and sewage systems are not hygienic. The main implication of the results of this study is clinical use. The high risk factors can be used to identify the high risk family effectively and efficiently. The use of high risk factors woule contribute to develop a conceptual framework of family diagnosis in Korea and the list of risk factors need to be revised continuously. Further researches are needed to develop an index of weight of each risk factor and to validate the risk factors.
Jin, Bo Kyung;Bang, Ji Seok;Choi, Eun Young;Kim, Gi Beom;Kwon, Bo Sang;Bae, Eun Jung;Noh, Chung Il;Choi, Jung Yun;Kim, Woong Han
Clinical and Experimental Pediatrics
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v.56
no.3
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pp.125-129
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2013
Purpose: The use of implantable cardioverter defibrillators (ICDs) to prevent sudden cardiac death is increasing in children and adolescents. This study investigated the use of ICDs in children with congenital heart disease. Methods: This retrospective study was conducted on the clinical characteristics and effectiveness of ICD implantation at the department of pediatrics of a single tertiary center between 2007 and 2011. Results: Fifteen patients underwent ICD implantation. Their mean age at the time of implantation was $14.5{\pm}5.4$ years (range, 2 to 22 years). The follow-up duration was $28.9{\pm}20.4$ months. The cause of ICD implantation was cardiac arrest in 7, sustained ventricular tachycardia in 6, and syncope in 2 patients. The underlying disorders were as follows: ionic channelopathy in 6 patients (long QT type 3 in 4, catecholaminergic polymorphic ventricular tachycardia [CPVT] in 1, and J wave syndrome in 1), cardiomyopathy in 5 patients, and postoperative congenital heart disease in 4 patients. ICD coils were implanted in the pericardial space in 2 children (ages 2 and 6 years). Five patients received appropriate ICD shock therapy, and 2 patients received inappropriate shocks due to supraventricular tachycardia. During follow-up, 2 patients required lead dysfunction-related revision. One patient with CPVT suffered from an ICD storm that was resolved using sympathetic denervation surgery. Conclusion: The overall ICD outcome was acceptable in most pediatric patients. Early diagnosis and timely ICD implantation are recommended for preventing sudden death in high-risk children and patients with congenital heart disease.
The Journal of Korean Academy of Sensory Integration
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v.14
no.1
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pp.19-30
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2016
Objective : The purpose of this study was to identify the effects of Interactive Metronome (IM) training on short-term memory and attention for children with mental retardation. Methods : For this study, single-subject experimental research was conducted using an ABA design. We observed two children, twice a week for 9 weeks, which was 18 sessions in total. We evaluated the children's brain waves without intervention and the child's pseudo randomly selected sample of one short-term memory task as assessed in the baseline A phase for three sessions. In the intervention phase the children received 40-50 minutes of Interactive Metronome training twice a week, a total of 12 sessions. The short-term memory test and long form test as assessed after treatment, without brain wave in short form test measuring. During the baseline A phase, data were collected using the same procedure as the baseline A phase. Results : After the interactive metronome training, positive changes was observed in brain waves, attentions and short-term memory. Conclusion : The results of this study expect that IM training has a potential for improving cognitive functions of children with mental retardation. In addition, the results of this study can be used as basic data in attention and short-term memory of occupational therapy intervention for children with mental retardation.
The Journal of Korean Academy of Sensory Integration
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v.10
no.1
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pp.21-31
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2012
Objective : This study aims to examine the Effect of the Brotherhood Group Sensory Integration intervention to Social Interaction of the Children with Pervasive Developmental Disorders. Methods : The Group Sensory Integration intervention was implemented for 8 weeks period from July to September 2011 targeting 2 children of 7~8 ages diagnosed Pervasive Developmental Disorders. For the study A-B-A' design among Single subject research design was used, while baseline A 3 phases, intervention B 16 phases, baseline A' 3 phases in total 22 phases were applied. The Quality of Social Interaction was measured through ESI(Evaluation Social interaction) during the baseline between A and A' period, and the Frequency of Social Interaction was measured under the condition that non-availability of intervention during baseline period, while during intervention period, it was measured by utilizing Interval recording method upon filming by video of 10 minutes free-play after every intervention. Results : The Quality of Social interaction indicated a statistical significance by all targeted children after intervention. Also a statistical significance was indicated in the Frequency of Social interaction as there appeared consecutively more than two of the values of baseline A average and Standard deviation band from all targeted children at the free-play implemented after each intervention of every phase. Conclusion : It could be verified that Brotherhood Group Sensory integration intervention has a positive effect to Social interaction of the Children with Pervasive Developmental Disorders. Therefore, the Brotherhood Group Sensory integration intervention can be effectively applicable as being a therapy to improve Social interaction toward Children with Pervasive Developmental Disorders at the clinic.
Purpose: The survival rate for childhood acute lymphoblastic leukemia (ALL) has improved significantly. However, overall prognosis for the 20 to 25% of patients who relapse is poor, and allogeneic hematopoietic stem cell transplantation (HSCT) offers the best chance for cure. In this study, we identified significant prognostic variables by analyzing the outcomes of allogeneic HSCT in ALL patients in second complete remission (CR). Methods: Fifty-three ALL patients (42 men, 79%) who received HSCT in second CR from August 1991 to February 2009 were included (26 sibling donor HSCTs, 49%; 42 bone marrow transplantations, 79%). Study endpoints included cumulative incidence of acute and chronic graft-versus-host disease (GVHD), relapse, 1-year transplant-related mortality (TRM), disease-free survival (DFS), and overall survival (OS). Results: Cumulative incidences of acute GVHD (grade 2 or above) and chronic GVHD were 45.3% and 28.5%, respectively. The estimated 5-year DFS and OS for the cohort was $45.2{\pm}6.8%$ and $48.3{\pm}7%$, respectively. Only donor type, i.e., sibling versus unrelated, showed significant correlation with DFS in multivariate analysis ($p$=0.010). The rates of relapse and 1 year TRM were $28.9{\pm}6.4%$ and $26.4{\pm}6.1%$, respectively, and unrelated donor HSCT ($p$=0.002) and HLA mismatch ($p$=0.022) were significantly correlated with increased TRM in univariate analysis. Conclusion: In this single institution study spanning more than 17 years, sibling donor HSCT was the only factor predicting a favorable result in multivariate analysis, possibly due to increased TRM resulting from unrelated donor HSCT.
Purpose: This study aimed to evaluate and compare the characteristics of infective endocarditis (IE) between children and adults with congenital heart disease (CHD) at a single tertiary care center. Methods: In this retrospective medical record review, we extracted the demographic characteristics, diagnostic variables, and outcomes of patients diagnosed with IE and CHD between 2000 and 2016. Results: We identified a total of 14 pediatric patients (nine male; median age at diagnosis, 3 years). Of the 14 patients, six had a history of previous open heart surgery, while four had undergone tetralogy of Fallot repair, with transannular patch or Rastelli procedure. Among the 10 children with positive blood cultures, the most common isolated organism was Staphylococcus spp. (8/10, 80%). Eleven adult patients had IE and CHD. Among the adult patients, only four were diagnosed with CHD before IE, and ventricular septal defect was the most common CHD. The most common isolated organism was Streptococcus spp. (6/11, 55%). Compared with adult patients, pediatric patients had a higher incidence of previously diagnosed CHD (P=0.001), with Staphylococcus spp. as the causative organism (P=0.027). The median duration between the onset of symptoms and diagnosis of IE was 9 days in children and 42 days in adults (P=0.012). Conclusions: Significant differences with regard to the diagnosis and progress of IE were observed between children and adults. Age-adjusted and systematic reassessment may be necessary for the diagnosis and management of IE.
Objective : The purpose of this study was to investigate the effects of an Interactive Metronome on increasing attention and impulsivity control for children with attention deficit hyperactivity disorder(ADHD). Methods : This study was conducted through the ABA'design among single-case research methods with one child with ADHD. From May to July, 2014, 3 sessions of baseline phase(A), 15 sessions of intervention phase(B), and 3 sessions of post baseline(A') were conducted. The intervention was IM training, and each session carried out short form assessment(SFA) of IM and concentration tasks. In addition, long form assessment(LFA) of IM and Self-Control Rating Scale (SCRS) were conducted at baseline, intervention and post baseline. Results : After IM training as the intervention, the participation showed an increase in attention and controled in impulsivity. After the intervention, it was demonstrated that the effects were maintained or improved in the post baseline. Conclusions : IM training can be useful for increasing attention and impulsivity control of children with ADHD. The results demonstrated the efficacy of IM training as a new approach for children with ADHD.
Journal of the korean academy of Pediatric Dentistry
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v.31
no.2
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pp.136-143
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2004
The purpose of this study was to investigate the relationship between morphology and position of deciduous double teeth, and the occurrence of other dental anomalies in the same subject. Four morphological types were indentified according to Ailing's classification: type I, bifid crown-single root; type II, large crown-large root; type III, two fused crowns-single root; type IV, two fused crowns-two fused roots. Fifty-four double teeth were found in a total of 1,803 children, who had visited Wonkwang university hospital for dental treatment from January 1, 2003 to September 30, 2003. All of these children were examined clinically and intra-oral radiographs were taken. The results were as follows; 1. 49 children(2.7%) had more than one double teeth, 5 of these children had two double teeth on the bilateral side. And one child showed triple teeth which has three crowns and three roots. 2. Double teeth were predominantly situated in the anterior region, with a preference for the mandible. The ratio of cases involving central incisor and lateral incisor was higher than other cases. 3. There were 25 cases(46.2%) of missing successors among 54 cases of the double teeth. And, prevalence of the missing teeth was highest in the cases involving maxillary central incisor and lateral incisor. 4. In the case of type II(large crown-large root) had more missing successors.
Objective: To determine the utility of computed tomography (CT) ventricular volumes and morphometric parameters for deciding the treatment strategy in children with a hypoplastic left ventricle (LV). Materials and Methods: Ninety-four consecutive children were included in this study and divided into small LV single ventricle repair (SVR) (n = 28), small LV biventricular repair (BVR) (n = 6), disease-matched control (n = 19), and control (n = 41) groups. The CT-based indexed LV volumes, LV-to-right-ventricular (LV/RV) volume ratio, left-to-right atrioventricular valve (AVV) area ratio, left-to-right AVV diameter ratio, and LV/RV long dimension ratio were compared between groups. Proportions of preferred SVR in the small LV SVR group suggested by the parameters were evaluated. Results: Indexed LV end-systolic (ES) and end-diastolic (ED) volumes in the small LV SVR group ($6.3{\pm}4.0mL/m^2$ and $14.4{\pm}10.2mL/m^2$, respectively) were significantly smaller than those in the disease-matched control group ($16.0{\pm}4.7mL/m^2$ and $37.7{\pm}12.0mL/m^2$, respectively; p < 0.001) and the control group ($16.0{\pm}5.5mL/m^2$ and $46.3{\pm}10.8mL/m^2$, respectively; p < 0.001). These volumes were $8.3{\pm}2.4mL/m^2$ and $21.4{\pm}5.3mL/m^2$, respectively, in the small LV BVR group. ES and ED indexed LV volumes of < $7mL/m^2$ and < $17mL/m^2$, LV/RV volume ratios of < 0.22 and < 0.25, AVV area ratios of < 0.33 and < 0.24, and AVV diameter ratios of < 0.52 and < 0.46, respectively, enabled the differentiation of a subset of patients in the small LV SVR group from those in the two control groups. One patient in the small LV biventricular group died after BVR, indicating that this patient might not have been a good candidate based on the suggested cut-off values. Conclusion: CT-based ventricular volumes and morphometric parameters can suggest cut-off values for SVR in children with a hypoplastic LV.
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