Pediatr. Rep., Volume 9, Issue 1 (March 2017) – 4 articles

The early postnatal weight loss (EPWL) is highly variable in the extremely low birth weight infants (birth weight <1000 g, ELBW). It is reported to be unassociated with adverse outcomes within a range of 3- 21% of birth weight. Its wide range might have contributed to this lack of association. The aim of our paper is to study the effects of maximum EPWL, graded as low, medium and large on clinical outcomes in ELBW infants. In a retrospective cohort observational study EPWL was measured as maximum weight loss from birth weight (MWL) in ELBW infants and grouped as low (5-12%) moderate (18.1-12%) and high (18-25%). The clinical course and complications of infants were compared between the groups. Gestational age (GA) was highest and surfactant administration, peak inspiratory pressure requirement, fluid intake, urinary output, oxygen dependent days and the number of oxygen dependent infants at age 28 days were lower in the low MWL compared to the high MWL group. However, all these significant P-values declined after controlling for GA. Diabetes mellitus and pregnancy associated hypertension were not noted in mothers in high MWL group, whereas 38% of mothers in low MWL group suffered from the latter (P=0.05). Maximum postnatal transitional weight loss, assessed in the range of low, moderate and high, is not associated with adverse outcomes independent of gestational age in ELBW infants. Maternal hypertension decreases EPWL in them. Full article

Children with hemoglobin SC (HbSC) disease suffer a significant incidence of silent cerebral infarcts but stroke is rare. A 2-year-old African American boy with HbSC disease presented with focal neurologic deficits associated with magnetic resonance imaging evidence of cerebral infarction with vascular abnormalities. After the acute episode he was treated with monthly transfusions and subsequently transitioned to hydroxyurea therapy. The benefits of hydroxyurea as a fetal hemoglobin inducer in HbSC disease, to ameliorate clinical symptoms are supported by retrospective studies. This case highlights the rare occurrence of stroke in a child with HbSC disease and the use of hydroxyurea therapy. Full article

Meckel’s diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract. Painless intestinal hemorrhage is a frequently occurring complication that relates to MD in children. Bowel obstruction is a rare complication of MD in children. We report on the case of a fouryear old male child who presented with abdominal pain and hematemesis. Finally, bowel obstruction due to MD was confirmed at surgery. Full article

Patients with Autism Spectrum Disorder present with a heterogeneous mix of features beyond the core symptoms of the disorder. These features can be emotional, cognitive or behavioral. Behavioral symptoms often include self-injury, and this may take the form of repetitive skin-picking. The prevalence of skin-picking disorder in Autism is unknown. Skin-picking may lead to significant medical and psychosocial complications. Recent data suggest that behavioral interventions may be more effective than medications at reducing skin-picking in neurotypical patients. In this case, an 11-year-old male with intellectual disability and autistic spectrum disorder, with self-injurious skin-picking, was treated with risperidone with complete resolution of skin-picking symptoms. risperidone has been approved for irritability and aggression in Autistic spectrum disorder, and may be a valuable treatment option for skinpicking in pediatric patients with developmental disabilities. Full article