Normal Value of Skull Base Angle Using the Modified Magnetic Resonance Imaging Technique in Thai Population
Published on: 20th March, 2017
OCLC Number/Unique Identifier: 7286350678
Purpose: To determine the normal value of basal angle measured using the modified MR imaging technique in Thai population compared with the standard value obtained from the Western population.
Material and Methods: We retrospectively evaluated midline sagittal SE T1 weighted MR images in 200 adults and 50 children. The basal angle of the skull base was measured using the modified MR imaging technique described by Koenigsberg et al. The angle was formed by a line extending across the anterior cranial fossa to the tip of the dorsum sellae and another line drawn along the posterior margin of the clivus. The mean values of the basal angles among different age groups and sex were calculated and analyzed.
Results: The mean skull base angle of our adult population was 115° (range 100.5°-130°, SD=5.7) with an inter-observer agreement of 0.85, slightly smaller than the previous study from the USA which was 117°. There was no significant difference between the male and female groups. The mean skull base angle in our children population was 114.7° (range 102- 130.5°, SD=6.3) with an inter-observer agreement of 0.89, quite similar to the previous USA study which was 114°. There was no significant difference between adult and children.
Conclusion: The mean adult skull base angle measured using the modified MR imaging technique in Thai population was slightly smaller than the Western population, while the mean skull base angle of children was quite similar. The basal angle range of 103.6°-126.4° may be used as a guide for the potential range of normal skull base angles in Thai population and possibly also the Southeast Asian population.
Visualization and Evaluation of Changes after Rapid Maxillary Expansion
Published on: 30th March, 2017
OCLC Number/Unique Identifier: 7286430438
Objectives: The aim of the study was to develop a mathematical model for the visualization and evaluation of transversal palatal soft tissue changes; and to carry out a statistical evaluation of the changes in vertical and sagittal dimensions after rapid maxillary expansion treatment.
Material and Methods: 33 Caucasian children with posterior crossbite, 10 boys and 23 girls, aged 7 to 10 years (median 8 years 8 months) were treated with tooth-borne Haas type expander. Dental casts were digitalized by scanner and on the basis of quantitative mesh shape CPD-DCA analysis, coloured morphometrical maps were created. The statistical significance of individual vertex displacements was calculated by performing Hotelling’s T2 paired test. To determine the significance of the vertical and sagittal profile changes, the paired t-test and Wilcoxon signed rank test were carried out in 20 patients
Results: Visualization of the palatal soft tissue widening showed it to be greatest in the areas of the second deciduous and first permanent molars with maximum of 0.75 mm for each palatal side. Hotelling’s T2 paired test showed significant differences of p<0.01 in transversal width dimension. Cephalometric measurements of the changes to vertical and sagittal dimensions were statistically evaluated using the Wilcoxon and paired t-tests, and were shown to have insignificant values of p>0.05.
Conclusion: The expansion appliance in children resolved the crossbite and led to palatal widening, which was clearly visualized by creating mathematical morphometric models. The cephalometric measurements carried out did not reveal statistically significant relevance in changes to facial vertical or sagittal dimensions.
Premaxillary osteotomy in children with bilateral cleft lip and palate: Skeletal and dental changes
Published on: 16th July, 2020
OCLC Number/Unique Identifier: 8639114756
Purpose: To evaluate changes in children with bilateral cleft lip and palate (BCLP) who premaxillary osteotomy and secondary alveolar bone grafting as compared to children with BCLP who are not indicated for surgery, and to determine variables that differentiate patients who do or do not require osteotomy.
Material and methods: Twenty-four children with BCLP were included in the study: 12 who underwent osteotomy (intervention group) and 12 who had no surgery (control group). Radiographic and model values of the intervention group were compared before (T1) and after (T2) premaxillary osteotomy, and measurements were compared with those from the control group at T1.
Results: Convexity, ANB (point A-nasion-point B), and maxillary depth was more diminished at T2 in children in the intervention group. Point A, anterior nasal spine, and pogonion were retroposed after surgery, and the anterior spine was higher. At T2, the upper incisors were proinclinated and intruded, and overbite was improved.
Models revealed increased intermolar intercanine width as well as intrusion of upper incisor after surgery. Premaxilla and upper molars were more extruded, had a higher total maxillary height and increased extrusion of upper incisor in children who underwent osteotomy.
Conclusion: After surgery, children who undergo surgery have a premaxilla that is more normalized and more level with the occlusal plane, as well as improved dental inclination. Variables that differentiate children who require osteotomy from those who do not include more extrusion and protrusion of the premaxilla, and a greater extrusion of the upper incisors.
Intracerebral Hemorrhage of Brainstem in triple pregnancy after in vitro fertilization by receiving Ovum Donation: A case report and review
Published on: 16th December, 2019
Deliveries prior to 28 weeks’ gestation (extreme preterm birth) pose a global health concern, according to the World Health Organization (WHO). Extreme preterm birth is associated with several complications in the newborn and management in neonatal intensive care unit would incur high expenses. In parallel, advancements in in vitro fertilization will give an opportunity for women to conceive in cases of ovarian failure. At the same time, health providers also encourage patients to receive more than one embryo simultaneously during an embryo transfer. Here we report a case of a patient in coma condition of triplet pregnancy, post ovum donation with three-embryo transfer. Following stabilization, cranial computed tomography (CCT) was performed. The result showed bleeding in the brainstem and into intraventricular spaces at 25+4 gestation weeks. Furthermore, ICH during pregnancy is considered as a rare case in obstetrical field, especially involving the brainstem. This could lead to life-threatening conditions and serious disability in the future. On the fifth day of hospitalization, she suffered from pneumonia and pulmonary edema. On the eight day (26+5 gestations weeks), an emergency caesarean section was performed due to fully dilated of the cervix with breech presentation of all fetuses. Mother and the children survived with some non-life-threatening disabilities.
This is the very first case reported of intracerebral hemorrhage in the brainstem in triplet pregnancy after receiving ovum donation. Heterologous conception could be an iceberg phenomenon of gestational complications among the population. Reproductive tourism could still become greater in the future.
Maternal, neonatal and children´s health in Sub-Saharan East Africa
Published on: 29th May, 2020
OCLC Number/Unique Identifier: 8611934005
The Czech model for reducing maternal and neonatal mortality for countries in sub-Saharan East Africa was created on the basis of the Archdiocesan Charity Prague project for a specific region-subcounty Buikwe, Diocese of Lugazi, Mukono Region in Uganda, a region with about 30,000 inhabitants. The aim of the first phase of the project was to build a new hospital, equip it completely for obstetric and surgical operations from the Czech Republic, ensure its activities with Czech and Slovak doctors experts, junior Ugandan doctors and Ugandan medical staff, provide obstetric training for villagers, ensure connections with villages and possibility of fast transport and urgent solution of all acute pathologies in the hospital, capable of 24-hour surgical readiness. In the second phase of the project, a school for midwifery was to be established. This second part of the project has not yet been implemented. The project could serve as an example and guide for similar humanitarian activities in other regions of Uganda and other countries in equatorial Africa.
The choice of optimal modern muscle relaxants (rocuronium bromide, atracurium besilate and cisatracurius besilate) in one-day surgery in children
Published on: 15th June, 2020
OCLC Number/Unique Identifier: 8633140096
The choice of the optimal muscle relaxant in one-day surgery in children with “small” surgical interventions remains relevant to this day. In modern pediatric surgery, the requirements for the quality of muscle relaxation are highest. However, along with the effectiveness of the drug, its duration and controllability of the action, as well as the safety of use, are important [1-7].
The aim of the study: To determine the pharmacoeconomic rationale for the rational use of muscle relaxants, depending on the duration of operations in one-day surgery in children.
Material and research methods: The study was conducted in surgical clinics of the Azerbaijan Medical University. The study included 156 children who were operated on routinely from 0 to 16 years old (risk of anesthesia I-II ASA), who used combined endotracheal anesthesia during surgery. Based on the requirements of the GCP international program (Good Clinical Practice), the inclusion of children in the study was carried out only after the written consent of the parents. The studied patients were divided into 3 groups depending on the muscle relaxant used: IA (n = 52) - rocuronium bromide (esmeron), IB (n = 52) - atracurium besilate (tracrium), IC (n = 52) - cisatracurius besilate (nimbex). Depending on the type of general anesthesia, these groups were also divided into 2 subgroups: anesthesia based on isoflurane + fentanyl ″ + iso ″ and anesthesia based on sevoflurane + fentanyl ″ + sev ″. The main groups were also divided into 2 age subgroups: children under 2 years of age – IA1, IB1, IC1 and children from 2 to 16 years old – IA2, IB2, IC2.
The influence of HBV or HCV infections on the pregnancy course
Published on: 14th August, 2020
OCLC Number/Unique Identifier: 8667859611
The incidence of HBV infections among the pregnant in Europe falls within the range of 1% - 7%, whereas it is 1.7% - 4.3% for HCV.
The aim was to assess the course of pregnancy among women infected with HBV or HCV, and the condition of neonates in the fifth minute after the birth.
The study included 157 pregnant individuals infected with HBV, 53 infected with HCV, and 330 healthy pregnant women. None of the women infected with HBV and HCV as well as from the control group were infected with HIV, and none of them took intoxicants.
Weight of neonates delivered by healthy women was higher as compared with children born by women infected with HBV or HCV (3,517 vs. 3,347 and 3,366). The Apgar score of neonates delivered by women with HBV and HCV infections was lower as compared with the children born by healthy women (9.4 vs. 9.3 vs. 9.7; p < 0.05). Premature births occurred more often in HBV and HCV-infected women than in the control group (14.6% and 24.5% vs. 6.96%; p < 0.05). Miscarriages were significantly more common among the pregnant with HCV infections as compared with the pregnant who were healthy (9.4% vs. 1.8%; p < 0.05). In comparison with the healthy individuals, this group of patients experienced pruritus (10.5% vs. 4.2%; p < 0.05), oedemas (9.4% vs. 2.4%; p < 0.05), and hypertension (9.4% vs. 1.5%; p < 0.05) more often.
An increase in HBV loads was observed between the 6th and 28th – 32nd week of pregnancy among the infected with HBV, and then, a decrease was observed in the 6th months after the delivery.
The pregnant infected with HBV without HBsAg (-) and the infected with HCV are subject to common incidence of premature births. Women infected with HCV often experience oedemas, hypertension, and pruritus.
Molecular analysis of immunoglobulins related to Salmonella typhi in pediatric patients
Published on: 24th April, 2020
OCLC Number/Unique Identifier: 8591037429
Typhoid fever is a systemic infection caused by Salmonella enterica serotype typhi. It is of major concern in tropical regions of the world. Highest episodes of typhoid fever occur in Asia i.e.93%. Early diagnosis of the disease is mandatory to lower the mortality rate associated with it as well as to prevent the emergence of antimicrobial drug resistance by Salmonella typhi. Research work was conducted in Immunology Department of the Children’s Hospital, Lahore for the period of one year including a total of 60 patients suspected of having typhoid fever. Serum samples of these patients were tested for typhidot IgG and IgM antibodies as well as for the antibodies against TO and TH antigens using Widal test. Of the total 60 patients, 10 (16.7%) were positive for both typhidot IgG and IgM, 16 (26.7%) were positive for typhidot IgM, 3 (5%) were Positive for typhidot IgG and 31 (51.66%) were negative for both typhidot IgG and IgM. Reading the results of Widal test, 8 (13.33%) were positive for Widal TO and TH antigens, 3 (5%) were positive for Widal TO antigen, 19 (31.7%) were positive for Widal TH antigen and 30 (50%) were negative for Widal TO and TH antigens. IgM is positive at the early stage of acute typhoid fever, IgM along with IgG positive means the middle stage of acute illness. The detection of only IgG cannot discriminate between acute and convalescent phases as it can stay in the serum for at least 2 years or more. The typhidot test is much helpful for the rapid diagnosis of typhoid fever as compared to Widal test which is still being used in some set ups in poor countries, although has become mostly obsolete. By testing the rise of IgM and IgG antibodies against Salmonella typhi, we can detect the infection at early and late stages, respectively
Determination of antibiotics susceptibility profile of Shigella species isolated from children with acute diarrhea
Published on: 15th December, 2020
OCLC Number/Unique Identifier: 8870458574
Diarrheal diseases continue to be the major cause of morbidity and mortality among children under 5 years. This study aimed to isolate, identify and determining the prevalence, antimicrobial susceptibility profile of Shigella sp associated with acute diarrhea among children in Kano, Northern Nigeria. A cross sectional study was conducted among children less than 5 years diagnosed with acute diarrhea and admitted to paediatric ward of Murtala Muhammad Specialist Hospital Kano. Stool samples from a total of 37 (20 male and 17 female) subjects were used to isolate and identified the pathogen. Antimicrobial susceptibility test was conducted using disc diffusion method. The result showed 12 out of 37 samples were positive for Shigella sp which accounted for 32.4%. Higher incidence of Shigella sp was found among subjects of age between 2 – 3 years. The isolates were 100% resistant to Ampicillin. High resistance was also observed in Amoxicillin (83.33%), Chloramphenicol (58.33%) and Tetracycline (25%). The isolates are 100% sensitive to ciprofloxacin, 66.7% to Levofloxacin and Gentamicin each and 58.33% to Erythromycin. Three (3) isolates were resistance to Ampicillin and Amoxicillin, 5 isolates were resistance to Ampicillin, Chloramphenicol and Amoxicillin while 2 isolates were resistance to Ampicillin, Chloramphenicol, Tetracycline and Amoxicillin. It is concluded that Shigella sp is one of the etiological agent of diarrhea in children. Ciprofloxacin, levofloxacin and Gentamicin are drugs of choice for treating diarrhea caused by Shigella sp.
A rare cause of obstructive jaundice - case report
Published on: 10th July, 2017
Obstructive jaundice in children is not uncommon and has diverse etiologies. We report a rare cause of obstructive jaundice, cholangitis and pancreatic mass in a young boy due to eosinophilic cholangiopathy who responded to oral steroids. Presence of peripheral eosinophilia, elevated serum IgE level, radiological imaging and tissue eosinophilia helped in diagnosis. Eosinophilic cholangiopathy with pancreatitis is a benign treatable cause of obstructive jaundice though it can masquerade as malignancy.
Anemia due to a rare anomaly - Case Report
Published on: 14th July, 2017
OCLC Number/Unique Identifier: 7317600166
Anemia due to gastrointestinal blood loss can occur due to many conditions and rarely to bowel structural anomalies. We report a 12 years old girl with anemia due to small bowel duplication cyst, posing diagnostic challenge intra operatively. Surgery offered cure without recurrence of bleeding. Common symptoms can be due to a rare surgical condition in practice.
Assessment of Complementary Feeding Practice of infants and young children aged 6-23 months in Gode Town, Somali Regional State of Ethiopia
Published on: 9th November, 2017
OCLC Number/Unique Identifier: 7286424898
Malnutrition is the largest risk factor caused by inadequate nutrition that leads to childhood morbidity and mortality, as well as inadequate growth and development. Infants are at increased risk of malnutrition by six months, when breast milk alone is no longer sufficient to meet their nutritional requirements. However the factors associated with nutritional status of infants after 6 months of age have received little attention in pastoralist communities of Ethiopia. The aim of this study was to assess the complementary foods of infants and young children (6-23 months) in Gode town of Kebele 01. The prevalences of wasting, stunting and underweight among infants and young children were 6.1%, 56.1%, 10.0% reespectively. Undernutrition is a public health problem among infants and young children in Gode town of Kebele 01. Breastfeeding was slightly positive associated with lower chances of wasting at r=0.61, p= 0.01 and underweight at r=0.331, p=0.01. While diarrheal disease was associated with higher chances of wasting and underweight. Initiation of complementary food was slightly positive association with wasting at r=0.179, p=0.05.
Chemical composition and organoleptic properties of Cocoyam starch-wheat flour blend noodles
Published on: 13th November, 2017
OCLC Number/Unique Identifier: 7286352858
Noodles are strips or strands cut from a sheet of dough made from flour, water and either common salt or a mixture of alkaline salt. Noodles consumption represents about 40% of the total wheat flour which are mainly consumed by school children. The use of composite flour has been encouraged since it reduces the importation of wheat. Utilization of locally available, inexpensive materials like cocoyam that can substitute a part of wheat flour without adversely affecting the acceptability of the product will be a product development. This study therefore studied the chemical composition and organoleptic properties of instant noodles from the blend of wheat and cocoyam starch. Cocoyam starch was substituted into wheat flour at 20, 40, 60 & 80%. Analysis revealed higher carbohydrate (63.50-70.05)%, moisture (4.54-5.07)% and vitamin A (10.01-30.47) mg/100g, B1 (11.43-32.15) mg/100g but lower protein (4.56-8.79)%, phosphorus (0.34-0.52)%, calcium (1.83-0.98)%, iron (0.15-0.32) % and ash (1.19-3.20)%. The composite noodles revealed higher carbohydrate and mineral but lower protein than the commercial noodles. The sensory analysis revealed that 20% cocoyam compared favourably with the commercial noodles in terms of all the sensory attributes evaluated. This shows the possibility of producing noodles from cocoyam tubers which serves as novel food. This will further help to promote and improve utilization of cocoyam tuber.
Mild to moderate iodine deficiency in pregnancy: A matter of debate
Published on: 12th March, 2021
OCLC Number/Unique Identifier: 8980359493
During the last few decades painstaking efforts have been made to eliminate iodine deficiency through the world. Nowadays in regions where dietary iodine intake is adequate or borderline, the main focus is increasing dietary iodine supply in the target population during pregnancy and the first years of life. Severe iodine deficiency during pregnancy increases the risk of irreversible brain damage, intellectual disability, neurologic abnormalities, stunted growth, increased pregnancy loss, infant mortality, impairments in child development and cretinism. The potential effects of mild-to-moderate iodine deficiency are debated. Results from animal studies and observational human studies indicate that maternal mild-to-moderate iodine deficiency disturbs thyroid function in pregnancy and it also may affects fetal neurodevelopment. The effect of supplementation of iodine on thyroid function of pregnant women and their newborn, neurodevelopment of infants and cognitive performance of children have been investigated using iodine nutrition in pregnancy, based on median urinary iodine concentration. However they have found conflicting results regarding the benefits or harms of iodine supplementation in pregnancy. Although many epidemiological, interventional and clinical studies have supported the association between thyroid function in pregnant women and later psychomotor and mental development of their children, the effect of iodine supplementation in pregnant women on neurodevelopment of children is inconclusive. Even in areas with well-established universal salt iodization program, pregnancy could be at risk of having iodine deficiency and despite WHO/ICCIDD/UNICEF recommendation which believe that dietary iodine fortification during pregnancy depends primarily on the extent of pre-existing iodine deprivation, systematic dietary fortification needs to be implemented in this vulnerable group. However, iodine supplementation of mildly iodine deficient pregnant women may not have beneficial effects in their thyroid function or neurodevelopment of their children.
Cytomegalovirus pneumonia and Cryptogenic organizing pneumonia following pediatric stem cell transplantation for leukemia
Published on: 12th September, 2017
OCLC Number/Unique Identifier: 7355939062
Background: Knowledge of pulmonary complications (PCs) in children after hematopoetic stem cell transplantation (allo-HSCT) is limited; most data are from adult studies.
Case: We describe a 8 year old girl with high risk acute myeloid leukemia who developed graft versus host disease (GVHD) on Day 20, Cytomegalovirus (CMV) pneumonia on Day 50 and Cryptogenic organizing pneumonia (COP) on Day 170 after allo-HSCT.
Discussion: Cryptogenic organizing pneumonia is a rare noninfectious PCs that can be idiopathic or have several risk factors as a secondary causes, such as viral respiratory infections, drugs, GVHD and allo-HSCT. Viral respiratory infections and alloimmune lung syndromes have been reported in a few patients who have undergone transplantation.
Conclusion: Transplant physicians should be kept in mind for the development of alloimmune lung syndrome in the form of COP following CMV pneumonia in patients after allo- HSCT
Atopic Conjunctivitis in Children: Influence of Treatment with Topical Cyclosporin 0.05% in the Quality of Life
Published on: 31st January, 2017
OCLC Number/Unique Identifier: 7317598595
Introduction: Forty-six per cent children have allergic rhinoconjunctivitis (Allergologica 2005).
Working hypothesis: Ocular topical cyclosporine improves the quality of life for these patients.
Material, methods, design: 2-year prospective study (2015-16), 40 patients with topical corticosteroids without improvement, followed 20 and 20 switched to corticosteroids cyclosporine 0.05%. Interview with Quality of Life Questionnaire in Children with rhinoconjunctivitis (PRQLQ) before and at the end of treatment. Mean age of 10.3 years with 60% male-40% female. Treatments were applied from January to March. There were 15 questions divided into two blocks. Children responded using a card with responses rated from zero (not bothered at all) to 6 (quite upset).
Results: Before the 100% reported that, the itching was very bothersome. In the group of 40 children, 80% showed symptoms of epiphora and 60% showed symptoms of ocular inflammation. 100% complained of significant discomfort in rubbing their eyes, 30% did not like to take medications. Headaches affected 20%. 100% stated that they cannot play normally. 80% showed decreased concentration in class.
Continuing with corticosteroids did not show statistically significant changes.
Patients with cyclosporine improved the results by 3 points, with decreased itching, tearing, swelling, pain, eye rubbing, medication and headaches. In the 2nd questionnaire there was limited variation in the results related to fatigue, malaise, and irritability but with substantially improved balance of sleep, insomnia and concentration at school.
Conclusion: Cyclosporine A is a cyclic polypeptide calcineurin inhibitor developed from the fungus Tolypocladium inflatum. The first dilution was 2% but it is currently used at a dilution of 0.05% and recent publications suggest nanosuspensions. Our study showed improvement in parameters related to symptoms, especially itching and lower improvement of psychological aspects, this achieves a better quality of life for children and more willingness to adhere to the treatment.
Stem cell therapy in children with acute liver failure: The dream could come true
Published on: 11th January, 2021
OCLC Number/Unique Identifier: 8899340842
Acute liver failure (ALF) in children is a severe disease with a high mortality rate. The current treatment strategies are still defective, with many cases die when liver transplantation is unavailable. The current protocol of steroids therapy improved the survival rate of hepatitis A virus (HAV)-related ALF. However, there is still a high mortality for non-HAV cases. Stem cell therapy (SCT) has been tried in experimental animals with ALF and in few adult studies with acute-on-chronic liver failure. No previous trials of SCT have been tested in children with ALF. The absence of SCT application in ALF in children could be due to some issues. These could be related to safety, sources, administration route, optimum dosage, efficacy, and survival. It is proposed that could be the future therapy if these obstacles have been well studied and solved.
Chemo-cytokines network is main target for control of Allergic asthma
Published on: 25th January, 2018
OCLC Number/Unique Identifier: 7347023872
Asthma is a chronic respiratory disease which characterized by recurrent airflow obstruction, wheezing, chest tightness and coughing. Management of allergic asthma especially in children, is main problem for industrial world. Immunological factors have critical role in pathogenesis of allergic asthma. Cytokines as major controller of immune system, are important in this reaction. Allergic asthma is a disease with symptoms: eosinophilic inflammation, mucus hyper secretion, airway obstruction, airways hyperresponsivness, IgE high level production, smooth muscle spasm. Cytokines have main and complicated role in pathophysiology of allergic asthma.
Role of Serum Magnesium levels in Asthmatic with children
Published on: 23rd February, 2018
OCLC Number/Unique Identifier: 7347025914
Objective: To determine the association between serum magnesium level and asthma, by establishing the difference in serum magnesium level between children with asthma and controls.
Method: Serum magnesium levels of 44 children with acute asthma and 44 controls of the age group of 6-16 years was determined and statistically compared. Lung function tests (FEV1%) were done and correlated with serum magnesium levels using Pearson’s comparison coefficient.
Results: The mean serum magnesium value of cases (1.9136±0.44) is lower than the controls (2.0042±0.26), with 32 cases showing a deficiency of serum magnesium. Pearson’s correlation coefficient, reveals positive correlation between FEV1% with serum magnesium levels, r=0.819, P<0.001.
Conclusions: This study reveals that the serum magnesium levels, even if in normal range, are statistically lower amongst asthmatics. It also brings out the relationship between magnesium levels and lung function tests, showing an improvement in the latter with increase in the former.
Diagnosis of Asthma in Childhood Age
Published on: 13th September, 2018
OCLC Number/Unique Identifier: 7878010008
Background: Asthma is the most common chronic respiratory disorder in childhood. Asthmatic attacks are described and classified according to the type of wheezing to Non –atopic and Atopic asthma (IgE mediated wheezing). The aim of this review is to determine the onset of clinical diagnosis in relation to clinical presentation of asthma in children and obstacles related to delay of Asthma diagnosis.
Methods: This review highlights the results of studies done regarding clinical diagnosis in relation to clinical presentation and of asthma in children. An extensive search has been conducted for researches about asthma in children. This search based on the publications posted on the National Center for Biotechnology Information PubMed or by Google Scholar. Key words used for the research: Asthma, clinical diagnosis, children.
Results and Conclusion: Diagnosing asthma in young children is difficult because children often cough and wheeze with colds and chest infections, but this is not necessarily asthma. Miss diagnosis of asthma in children occurs when physicians diagnose patients with asthma from the clinical diagnosis in the first attack without excluding other asthma mimickers which can be any other respiratory problem. There is over-diagnosis of asthma due to the symptoms which mimic other respiratory infections. First episodes of cough, runny nose and fever that happen in cold/flu season- fall/winter/early spring is likely not asthma. If the child has several more episodes of wheeze and cough, it is likely to be asthma. Since there is no diagnostic test available for children younger than 6 years of age, making a diagnosis in this age group is more difficult than in older children. Over the age of about 6 years it is possible for a child to have a spirometer test
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