Cough ; diagnosis ; therapy ; Female ; Humans ; Male

INTRODUCTIONThe addition of glutamine to parenteral nutrition (PN) in neonates has not shown significant benefits as compared to adults thus far. This study aimed to determine the potential benefits of the addition of glutamine to neonatal PN in a tertiary hospital in a middle-income country.

METHODSThis was a double-blinded randomised controlled trial. Babies who were admitted to the neonatal intensive care unit (NICU) and who required PN were eligible for inclusion in the study. The subjects were randomised to receive either glutamine-added PN (intervention) or standard PN (control). The most important outcomes included time to full enteral nutrition, incidence of sepsis and necrotising enterocolitis (NEC), clinical or culture-proven sepsis.

RESULTSOut of 270 subjects, 132 were randomised to the intervention group and 138, to the control group. Baseline data were comparable in both groups. The median time taken to reach full enteral nutrition was similar for both intervention and control groups (six days in each group, p-value is 0.52). The incidences of NEC, clinical sepsis and culture-proven sepsis did not differ significantly in the intervention and control groups (5.8 vs. 7.1 percent, p-value is 0.68; 15.7 percent vs. 10.2 percent, p-value is 0.21 and 16.5 percent vs. 15.7 percent, p-value is 0.38, respectively). Other outcomes such as duration of ventilation, duration of NICU stay and a subgroup analysis for preterm and term babies also showed no statistically significant differences.

CONCLUSIONAddition of glutamine to neonatal PN was not shown to improve outcome.

Double-Blind Method ; Enteral Nutrition ; Female ; Glutamine ; therapeutic use ; Humans ; Infant Nutritional Physiological Phenomena ; Infant, Newborn ; Intensive Care, Neonatal ; Malaysia ; Male ; Parenteral Nutrition ; Respiratory Tract Infections ; diagnosis ; Sepsis ; microbiology ; prevention & control ; Treatment Outcome

Paroxysmal non-kinesigenic dyskinesia is a very rare movement disorder. Few cases have been reported in the literature so far. We present a 40-year-old man with non-kinesigenic paroxysmal dyskinesia, which was initially diagnosed as a psychogenic disorder. This case highlights the varied presentation of this condition and an excellent response to clonazepam.
Adult ; Chorea ; diagnosis ; Humans ; Male

INTRODUCTIONThere are various aetiologies for recurrent pericardial effusions. Malignancy is the commonest cause in the West, but in Asia and sub-Saharan Africa, tuberculosis is common and contributes towards a high prevalence of tuberculous recurrent pericardial effusions.

METHODSIn our hospital-based descriptive study of 32 patients, we looked into various characteristics of recurrent pericardial effusions using the hospital data.

RESULTSWe found tuberculosis to be the commonest cause of recurrent effusions, occurring in 50 percent (n = 16) of our patients, followed by malignancy (n = 9). The clinical features at presentation in patients who eventually developed recurrent pericardial effusions were more severe, compared to uncomplicated pericardial effusions.

CONCLUSIONKnowledge of the presenting features of patients with recurrent pericardial effusions is crucial, so that they can be placed under increased surveillance and considered for early institution of pericardial fluid drainage procedures.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Neoplasms ; complications ; Pericardial Effusion ; diagnosis ; etiology ; Recurrence ; Tuberculosis, Pulmonary ; complications

Argentina ; Developing Countries ; Education, Medical, Undergraduate ; methods ; Educational Measurement ; methods ; Humans ; Problem-Based Learning

Anti-Bacterial Agents ; therapeutic use ; Cephalosporins ; therapeutic use ; Drug Resistance, Multiple, Bacterial ; Escherichia coli ; drug effects ; Escherichia coli Infections ; drug therapy ; Hospitals, Urban ; Humans ; India ; Intensive Care Units ; Klebsiella Infections ; drug therapy ; Klebsiella pneumoniae ; drug effects ; Microbial Sensitivity Tests ; Penicillanic Acid ; analogs & derivatives ; therapeutic use ; Piperacillin ; therapeutic use ; Sepsis ; drug therapy ; Thienamycins ; therapeutic use ; beta-Lactamases ; analysis ; drug effects

Adolescent ; Adult ; Antigens, Human Platelet ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Malaysia ; epidemiology ; Male ; Middle Aged ; Oceanic Ancestry Group ; genetics ; Polymorphism, Genetic

Biomedical Research ; trends ; Computers ; Humans ; Implants, Experimental ; Myelin Proteins ; antagonists & inhibitors ; immunology ; Nerve Regeneration ; immunology ; physiology ; Nogo Proteins ; Patient Education as Topic ; Spinal Cord Injuries ; therapy

Autobiography as Topic ; History, 20th Century ; Hospitals, General ; Singapore ; Warfare

Retinoblastoma, the most common primary intraocular malignancy of childhood, usually presents in the first three years of life. Atypical presentation of retinoblastoma can masquerade as virtually any ocular or orbital pathology, which may lead to diagnostic dilemmas especially in the presence of other systemic diseases. We report a 20-month-old boy who was diagnosed with coronary aneurysm as a complication of Kawasaki disease, and presented with sudden left eye redness. His mother noticed the presence of white pupillary reflex three months earlier. Atypical acute ocular presentation secondary to Kawasaki disease was initially suspected, but the presence of multiple calcification and mild proptosis on imaging suggested characteristics of advanced retinoblastoma. Histopathological examination of the enucleated eye, which revealed a classical rosette pattern appearance, confirmed the diagnosis. Atypical presentations of retinoblastoma are usually associated with advanced disease. The presence of other systemic conditions further complicates the diagnosis. Early diagnosis is important to reduce the mortality and morbidity.
Coronary Aneurysm ; complications ; diagnosis ; Diagnosis, Differential ; Eye ; diagnostic imaging ; physiopathology ; Eye Diseases ; diagnosis ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnosis ; Retinal Neoplasms ; complications ; diagnosis ; diagnostic imaging ; Retinoblastoma ; complications ; diagnosis ; diagnostic imaging ; Treatment Outcome ; Ultrasonography