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It is imperative to manage children with empathy and concern for their well-being in order to carry out any dental procedure smoothly. Owing to the inherent fear of dental operatory, behaviour management of children is an important aspect of pediatric dental care. Many techniques are available to help manage the behaviour of children. It is, however important to educate parents about these techniques and to get their cooperation for these techniques to be used on their children.This study aimed to familiarize the parents with non-pharmacological behavior management techniques and to determine the parental acceptance of such techniques in children seeking dental treatment in specialty care dental units. A total of 303 parents were evaluated through online questionnaires in this research. They were shown videos of randomly selected non-pharmacologic behaviour management techniques including tell-show-do, positive reinforcement, modelling and voice control. Parents were asked to watch the videos and give their response on seven-items inquiring about their acceptance levels regarding the respective techniques. The responses were recorded on a Likert scales ranging from strongly disagree to strongly agree. According to parental acceptance score (PAS), positive reinforcement was the most accepted technique whereas voice control was the least acceptable technique. Majority of the parents were more receptive towards those techniques that involved a healthy and friendly communication between a dentist and the pediatric patient such as, positive reinforcement, tell show do and modelling. Most significantly the people having low socio-economic status (SES) in Pakistan were more acceptable of voice control than people with high SES.
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Conducta Infantil , Restricción Física , Niño , Humanos , Estudios Transversales , Padres , Atención OdontológicaRESUMEN
BACKGROUND: Basal metabolic index (BMI) is a unique anthropometric indicator used to define the relative amount of body fat on an individual's frame. There are many diseases and conditions associated with obesity and underweight. Recent research trials suggest that there is a significant association between oral health indicators and BMI as both are attributed to common risk factors such as dietary, genetic, socioeconomic, and lifestyle issues. OBJECTIVES: The main objective of this review paper is to emphasize the association between BMI and oral health with available literature evidence. METHODOLOGY: A literature search was conducted using multiple databases comprising of MEDLINE (via PubMed), EMBASE, and Web of Science. The terms used for the search were "body mass index", "periodontitis", "dental caries", and "tooth loss". RESULTS: In total, 2839 articles were obtained from the analysis of the databases. Unrelated articles from the available full text of 1135 articles were excluded. The main reasons for excluding the articles were: they were dietary guidelines and policy statements. A total of 66 studies were finally included in the review. CONCLUSION: The presence of dental caries, periodontitis and tooth loss may be associated with a higher BMI or obesity, whereas, improved oral health might be associated with lower BMI. Promoting general and oral health should be a hand in hand feature, as common risk factors can be embattled.
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The aim of the study was to translate and validate the Urdu version of the Chronic Oral Mucosal Disease Questionnaire (COMDQ) and measure the oral health-related quality of life (OHRQoL) in Pakistani patients with chronic oral mucosal disease. One hundred and twenty patients with chronic oral mucosal diseases were recruited for this study. Two types of reliability of the COMDQ were tested. First, the internal consistency was calculated using Cronbach's alpha, and second, test-retest reliability was calculated using intraclass correlation coefficients (ICC). Convergent validity was assessed for testing the validity of the COMDQ by examining the correlations with the Visual Analogue Scale (VAS) and OHIP-14 using Pearson's correlations coefficient, and a t-test was used to compare the COMDQ domains and the socio-demographic characteristics. The most prevalent chronic oral mucosal disease (COMD) among the participants was recurrent aphthous stomatitis (47.5%), and the least prevalent was oral granulomatosis (6.6%). The total mean score for COMDQ was 43.5 (SD = 18.4). It showed a high level of internal consistency (Cronbach's a = 0.81), and test-retest reliability was also good (r = 0.85). The total score of COMDQ was strongly correlated with the total score of OHIP-14 and VAS (r = 0.86 and r = 0.83), which indicated good convergent validity. The score of pain and the functional limitation domain reported a significant difference with age (p < 0.021) and employment status (p < 0.034). The Urdu version of COMDQ is an accurate, valid, and reliable instrument that can be used to assess the OHRQoL in patients with chronic oral mucosal diseases in Pakistani and other Urdu-speaking populations of different age groups.
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A 10-year-old boy presented with a right flank mass. Computed tomography, ultrasound scan, and magnetic resonance imaging confirmed the presence of a multiloculated cystic mass. After right kidney nephrectomy, the biopsy proved the diagnosis of cystic renal cell carcinoma, which is a rare subtype of renal cell carcinoma in the pediatrics age group. The knowledge about this incidence can optimize the investigations, management, and outcomes.
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INTRODUCTION: Bahrain has high prevalence rates of sickle cell and thalassemia in the population. This study reports the frequencies and phenotypic characteristics of α- and/or ß-thalassemia associated with sickle-cell disease (SCD) in a tertiary care hospital. METHODS: Adult SCD patients (n = 200) were screened for the common α- and ß-thalassemia alleles prevalent in the region using molecular techniques. Results of CBC, hemoglobin analysis, and average annual frequencies of severe pain episodes and numbers of transfused red cell units were documented. RESULTS: Patients were grouped on the basis of molecular studies as sickle-cell anemia (SS, n = 131), SS/α-thalassemia with three normal genes (n = 27), SS/α-thalassemia with two normal genes (n = 11), sickle-ß-thalassemia (Sß, n = 23), and Sß with co-inherited α-thalassemia (n = 8). Identified α-thalassemia determinants were -α3.7 (n = 52), -α4.2 (n = 4), αT-Saudi α (n = 1), and αHph α (n = 1). All ß-thalassemia alleles were ß0 defects. Sickle-thalassemia association resulted in higher hemoglobin, hematocrit, and erythrocyte counts with reduced MCV and reticulocytes. Significant clinical associations were as follows: increased severe pain frequency with α-thalassemia (three-gene group); red cell transfusion with ß-thalassemia alleles and female gender. CONCLUSION: One-third of patients with SCD co-inherited α- and/or ß-thalassemia alleles and these associations explained some of the observed phenotypic variability. A low prevalence of nondeletion α-thalassemia alleles was observed in these patients. The most significant disease amelioration occurred in SCD associated with two α-thalassemia alleles.
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Alelos , Anemia de Células Falciformes , Frecuencia de los Genes , Talasemia alfa , Talasemia beta , Adulto , Anemia de Células Falciformes/sangre , Anemia de Células Falciformes/epidemiología , Anemia de Células Falciformes/genética , Bahrein/epidemiología , Femenino , Humanos , Masculino , Prevalencia , Talasemia alfa/sangre , Talasemia alfa/epidemiología , Talasemia alfa/genética , Talasemia beta/sangre , Talasemia beta/epidemiología , Talasemia beta/genéticaRESUMEN
Everyone who works with children, including teachers, GPs, other medical professionals and the police, has a responsibility to keep children safe and protect them from harm. Simply put, safeguarding children is everyone's responsibility. Children should be protected from maltreatment and any impairment that may affect their health and development. In addition, we all have to ensure that children grow up with safe and effective care. At particular risk, and therefore in particular need of safeguarding, are children who are disabled; who have educational or other specific additional needs; and who bear signs of child abuse, substance abuse, or domestic violence. Under the Children Act 1989, local authorities are required to provide services for children in need for the purposes of safeguarding and promoting their welfare. Nurses are well-placed to identify children and young people who may be at risk, and to act to safeguard them. Nurses and other health professionals should be familiar with local referral arrangements, usually to children's social care.
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Maltrato a los Niños/prevención & control , Protección a la Infancia , Rol de la Enfermera , Niño , Maltrato a los Niños/diagnóstico , Protección a la Infancia/legislación & jurisprudencia , Humanos , Derivación y Consulta , Reino UnidoRESUMEN
Behavioural problems are usually influenced by both biological and environmental factors. Disruptive behavioural problems such temper tantrums or attention deficit hyperactivity disorder are displayed during the first years of childhood. Breath-holding attacks are relatively common and are an important problem. Although the attacks are not serious and the prognosis is usually good, parents often fear that their child may die during an attack. Parents therefore require explanation and reassurance from health professionals. Conduct disorders (often referred to as antisocial behaviours), such as aggression to others or theft, are more serious as they tend to be repetitive and persistent behaviours where the basic rights of others are violated. Emotional problems, such as anxiety, depression and post-traumatic stress disorder tend to occur in later childhood, and are often unrecognised because young children often find it difficult to express their emotions, or it may go unnoticed by the child's parents. This article briefly discusses the most common behavioural problems, including autism, that affect children of all ages.
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Trastornos de la Conducta Infantil/enfermería , Trastornos Mentales/enfermería , Niño , Humanos , Guías de Práctica Clínica como AsuntoRESUMEN
Eating disorders are essentially psychological diseases that are characterised by abnormal eating habits. Anorexia nervosa and bulimia are the most common forms of eating disorders. There is an increased recognition of eating disorders among both men and women, and growing numbers of children and teenagers seeking help for eating disorders. Fear of body-weight gain is central to both anorexia nervosa and bulimia. Before the diagnosis of an eating disorder is made, it is essential to exclude organic diseases that may present with similar symptoms to eating disorders. Management initially should focus on correcting the nutritional deficiencies and dehydration at a paediatric or paediatric gastroenterology department, followed by a multidisciplinary approach. At the other extreme, the prevalence of obesity in children is increasing at an alarming rate, and presents a serious public health challenge.
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Trastornos de Alimentación y de la Ingestión de Alimentos/terapia , Obesidad/terapia , Adolescente , Niño , Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Femenino , Humanos , Masculino , Obesidad/diagnóstico , Obesidad/tratamiento farmacológico , Obesidad/cirugíaRESUMEN
The important causes of neonatal mortality are congenital malformations, birth trauma, neonatal infections, and respiratory, metabolic and heart diseases. Although many of the neonatal problems are benign, self-limited and treatable, some are life-threatening and a direct cause of disability and death. Professionals who provide care for children must be aware of these problems, their natural history, their impact on children's heath and their treatment. Birth marks are common and often harmless, but parents need explanation and reassurance. Follow-up appointments are often necessary to ensure the general wellbeing of the affected children. Birth trauma, such as intracranial haemorrhage or arm paralysis, may occur during delivery, and treatment at a specialised unit is usually required. The prognosis of neonatal infections is generally poor, with high mortality unless treatment is started promptly and adequately. Respiratory diseases occur mainly in low birth-weight infants who may require mechanical ventilation. Metabolic and heart diseases are rare, but early detection is essential to ensure a high survival rate.
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Peso al Nacer , Mortalidad Infantil , Enfermedades del Recién Nacido/enfermería , Femenino , Humanos , Lactante , Recién Nacido , Cuidado Intensivo Neonatal , EmbarazoRESUMEN
Seizures are common events in children and up to 10% of all children experience at least one seizure during their childhood. They can be triggered by many conditions such as fever, medications or injury. Febrile seizures are the most common types of seizures, affecting 3-4% of children. While epilepsy is typically recurrent and unprovoked, a single, isolated seizure is not epilepsy. Taking a detailed history of the seizure description helps establish the diagnosis. A video recording of the event can also support the diagnosis and rule out non-epileptic seizures that resemble seizures, such as pseudo-seizure. Seeing a child having a seizure, particularly if it is the first one, is usually frightening and distressing for the parents. First seizure should always be evaluated by health professionals because of a possible serious underlying cause. If the seizure occurs at home, the child should be placed in the recovery side position to prevent the swallowing of any vomit. The care of a child who does have epilepsy is best achieved by a community or hospital epilepsy specialist nurse. These nurses play a pivotal role in providing a close link between the epileptic children and their families. Such a nurse is also in an ideal position to establish a link between the doctor and affected families, offering valuable advice and support, and visiting the epileptic child at home.
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Convulsiones/terapia , Anticonvulsivantes/uso terapéutico , Niño , Epilepsia/diagnóstico , Epilepsia/tratamiento farmacológico , Epilepsia/mortalidad , Humanos , Convulsiones/diagnóstico , Convulsiones Febriles/terapiaRESUMEN
Abdominal pain (AP) is a very common complaint caused by a variety of conditions. Mild or moderate AP affects practically all children of all ages. The pain usually settles spontaneously without medical intervention. AP severe enough to require medical intervention has both surgical and non-surgical causes. It is responsible for considerable morbidity, missed school days, and significant use of health resources. Children usually present either with an acute or recurrent AP. In comparison, chronic AP with persistent symptoms, lasting days or weeks, is rare in children. Surgical conditions may be the underlying causes in acute AP, but non-surgical conditions are diagnosed more commonly in children with recurrent AP. Management can be difficult, time-consuming and often clinically challenging to diagnose and treat. In most instances, the cause of AP can be diagnosed through the history and physical examination. The main objective in managing an affected child is to differentiate between benign, self-limited conditions such as constipation or gastroenteritis, and more life-threatening surgical conditions such as intussusception or appendicitis. Irritable bowel syndrome (IBS) and Crohn's disease should be considered in any child presenting with recurrent AP.
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Dolor Abdominal/tratamiento farmacológico , Dolor Abdominal/etiología , Analgésicos/uso terapéutico , Enfermedades Gastrointestinales/diagnóstico , Enfermedades Gastrointestinales/terapia , Manejo del Dolor/métodos , Adolescente , Apendicitis/complicaciones , Apendicitis/diagnóstico , Apendicitis/cirugía , Niño , Preescolar , Estreñimiento/complicaciones , Estreñimiento/diagnóstico , Estreñimiento/tratamiento farmacológico , Enfermedad de Crohn/complicaciones , Enfermedad de Crohn/diagnóstico , Enfermedad de Crohn/tratamiento farmacológico , Diagnóstico Diferencial , Inglaterra , Femenino , Gastroenteritis/complicaciones , Gastroenteritis/diagnóstico , Gastroenteritis/tratamiento farmacológico , Enfermedades Gastrointestinales/complicaciones , Humanos , Lactante , Recién Nacido , Intususcepción/complicaciones , Intususcepción/diagnóstico , Intususcepción/tratamiento farmacológico , Síndrome del Colon Irritable/complicaciones , Síndrome del Colon Irritable/diagnóstico , Síndrome del Colon Irritable/tratamiento farmacológico , Masculino , Recurrencia , Resultado del TratamientoRESUMEN
Body temperature measurement is most commonly taken to confirm the presence or absence of fever. Many decisions concerning the investigation and treatment of children are based on the results of temperature measurement alone. Determining the presence of fever in young children is particularly important. A missed fever is serious, but a false-positive fever reading can result in unnecessary septic workups. The axillary, rectal, oral and tympanic membrane sites are most commonly used to record body temperature, and electronic and infrared thermometers are the devices most commonly used. Each site and device has numerous advantages and disadvantages, which are described in this article. The search for the means of measuring body temperature that best combines accuracy, speed, convenience, safety and cost-effectiveness goes on. The infrared thermometer and the tympanic site appear to offer such a combination. Electronic thermometers are also suitable when used orally or at the axilla in newborn babies.
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Fiebre/diagnóstico , Fiebre/enfermería , Enfermería Pediátrica/instrumentación , Enfermería Pediátrica/métodos , Termómetros , Niño , Preescolar , Humanos , Lactante , Recién NacidoAsunto(s)
Temperatura Corporal , Termómetros , Enfermería Basada en la Evidencia , Humanos , Reino UnidoRESUMEN
Fever is a very common complaint in children and is the single most common non-trauma-related reason for a visit to the emergency department. Parents are concerned about fever and it's potential complications. The biological value of fever (i.e., whether it is beneficial or harmful) is disputed and it is being vigorously treated with the belief of preventing complications such as brain injury and febrile seizures. The practice of alternating antipyretics has become widespread at home and on paediatric wards without supporting scientific evidence. There is still a significant contrast between the current concept and practice, and the scientific evidence. Why is that the case in such a common complaint like fever The article will discuss the significant contrast between the current concepts and practice of fever management on one hand, and the scientific evidence against such concepts and practice.
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Uncontrolled bleeding due to pelvic fractures contributes to trauma-related morbidity and mortality. Three main strategies that have been outlined to combat this condition which include reduction of pelvic volume that lead to tamponade-like effect, arresting haemorrhage through angioembolization of the major vessels, and stabilization of the pelvic bone with external fixation need to be initiated early. A prehospital device that allow these strategies will aid significantly in the management of the patient. At present most devices used to treat pelvic fractures in the pre-hospital setting do have its’ own advantages but also have some limitations. A characteristic ‘wish-list’ of a good pelvic and lower limb immobilization device was created and the research team from UKM takes the challenge to design and produce a device that concurs to it. A two phase development project that incorporate anthropometric, biomechanical, cadaveric and radiological study was carried out over a period of seven years. Finally, BRIMTM immobilizer, a new pelvic and lower limb immobilization device that is user friendly, tough, cost effective, radiolucent, light and reusable that answers most of the requirement of a good device was invented.
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Little attention has been given to the relationship between fever and the severity of asthma. The authors studied 202 successive admissions of children with asthma over a period of 16 months to investigate the relationship between fever and the clinical course of asthma. There were 38 febrile children (18.8%), who were mostly younger than 5 years. Febrile children had a shorter mean hospital stay than afebrile children (1.7 vs 2.0 days). There were 25 episodes of acute severe asthma (13%): 2 among the 38 febrile children (5.2%), compared with 23 episodes among the remaining 164 afebrile children (14%). Three children, who had very severe asthma requiring transfer to an intensive care unit, were afebrile. Radiological abnormalities (collapse/consolidation) occurred in 13 cases: 3 from the febrile and 10 from the afebrile group. Monitoring body temperature is important in cases of asthma. Febrile children tend to be younger and are more likely to have a less severe clinical course of asthma.
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Asma/complicaciones , Asma/diagnóstico , Fiebre/virología , Adolescente , Factores de Edad , Asma/tratamiento farmacológico , Asma/epidemiología , Niño , Preescolar , Femenino , Fiebre/tratamiento farmacológico , Fiebre/epidemiología , Humanos , Lactante , Tiempo de Internación/estadística & datos numéricos , Masculino , Monitoreo Fisiológico/métodos , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Reino Unido/epidemiologíaAsunto(s)
Analgésicos no Narcóticos/uso terapéutico , Fiebre/tratamiento farmacológico , Analgésicos no Narcóticos/efectos adversos , Actitud Frente a la Salud , Niño , Medicina Basada en la Evidencia , Fiebre/inmunología , Fiebre/psicología , Humanos , Práctica Profesional , Procedimientos InnecesariosRESUMEN
There is little agreement as to the most appropriate thermometer, the anatomical site to carry out temperature measurement in children with cancer, or the type of thermometer preferred by the patients. The authors carried out this study to assess temperature measurement in children with cancer who were admitted for febrile episodes. The body temperatures of children with cancer who were admitted consecutively between January and October 2005 to the paediatric department because of febrile episodes were measured on admission and over the next 24-36 hours using an electronic thermometer sublingually as the standard reference site. These measurements were compared with those obtained with two ear-based thermometers, a forehead thermometer, and from the axilla (representing current practice). The parents were asked about the type of thermometer they used at home and the children were asked about the type of thermometer they preferred. There were 34 admissions during this period, of which 19 (56%) were confirmed as febrile. Altogether, 108 sets of temperature measurements were obtained, producing a total of 540 measurements from these admissions. Measurements with the two ear-based thermometers in febrile children achieved higher sensitivity than that with axillary and the forehead measurements. The ear-based thermometer was the most common type used at home while the forehead thermometer was the one preferred by the children. In conclusion, ear-based temperature measurements in febrile children were more accurate than axillary and forehead temperature measurements. The current practice of axillary temperature measurement needs to be re-considered.
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Fiebre/diagnóstico , Neoplasias/complicaciones , Evaluación en Enfermería/métodos , Termografía/métodos , Termómetros/normas , Adolescente , Análisis de Varianza , Axila , Temperatura Corporal , Niño , Preescolar , Conducta de Elección , Investigación en Enfermería Clínica , Fiebre/etiología , Fiebre/psicología , Frente , Humanos , Suelo de la Boca , Mucosa Bucal , Evaluación en Enfermería/normas , Enfermería Oncológica , Aceptación de la Atención de Salud/psicología , Psicología Infantil , Sensibilidad y Especificidad , Termografía/instrumentación , Termografía/enfermería , Membrana TimpánicaRESUMEN
AIMS: Desmopressin is a useful treatment for primary nocturnal enuresis (PNE), a common childhood condition that can persist into adolescence. This open-label, randomised, cross-over study evaluated the preference of children and adolescents with PNE for sublingual desmopressin oral lyophilisate (MELT) vs. tablet treatment, and the efficacy, safety, compliance and ease of use associated with each formulation. In total, 221 patients aged 5-15 years who were already receiving desmopressin tablets were randomised 1 : 1 to receive desmopressin treatment in the order MELT/tablet (n = 110) or tablet/MELT (n = 111) for 3 weeks each. Each formulation was administered in bioequivalent doses (0.2/0.4 mg tablets identical with 120/240 microg MELT). Following treatment, patients were questioned regarding treatment preference. Diary card data and 100 mm Visual Analogue Scale scores were also recorded. RESULTS: Overall, patients preferred the MELT formulation to the tablet (56% vs. 44%; p = 0.112). This preference was age dependent (p = 0.006); patients aged < 12 years had a statistically significant preference for desmopressin MELT (p = 0.0089). Efficacy was similar for both formulations (MELT: 1.88 +/- 1.94 bedwetting episodes/week; tablet: 1.90 +/- 1.85 episodes/week). Ease of use of both formulations was high. Compliance (> or = 80%) was 94.5% for MELT patients vs. 88.9% for the tablet (p = 0.059). No serious/severe adverse events were reported. CONCLUSIONS: There was an overall preference for the MELT, and a statistically significant preference for desmopressin MELT in children aged 5-11 years. Desmopressin MELT had similar levels of efficacy and safety at lower dosing levels than the tablet, and therefore facilitates early initiation of PNE treatment in children aged 5-6 years.