International Journal of Integrative Pediatrics and Environmental Medicine

A Case Report on Gastroparesis Secondary to a Posterior Fossa Tumor.

2024-04-04T04:40:05+00:00

Introduction. Gastroparesis is an uncommon condition with scarce available literature. The presented child had a three-month history of persistent unexplained vomiting and inability to maintain adequate nutrition with severe gastroparesis on gastric emptying study. He was refractory to medical and surgical management.

Case Report. A 20-month-old male was brought into the ED and diagnosed with gastroenteritis. Abdominal X-ray was normal, and the vomiting persisted despite antiemetic (ondansetron) administration. He was started on bethanechol for gastroparesis, which was changed to intravenous metoclopramide as he did not tolerate the oral route. His presentation further progressed with intracranial hypertension, hydrocephalus, seizure, and acute respiratory failure necessitating intubation. He was subsequently diagnosed with an atypical teratoid rhabdoid tumor of the cerebellum, for which pediatric neurosurgery performed surgical resection.

Discussion. The patient was initially diagnosed with post-viral gastroparesis; however, he had shown poor response to medical and surgical therapy and later presented with developmental regression and signs of increased intracranial pressure leading to the diagnosis. In this case, we speculate that the development of gut dysmotility results from disruption of the dorsal motor nucleus of the vagus and autonomic nuclei in the brain stem, which may also have been the reason for medication resistance.

Conclusion. Pediatric gastroparesis is largely diagnosed as idiopathic; however, clinicians should be vigilant to look for secondary causes, especially in treatment-resistant cases.

Strengthening Capacity for a Hardly Reached Pediatric Population to Achieve Equity in Access to Clinical Trials.

2024-01-16T06:05:38+00:00

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Adenovirus-induced Acute Necrotizing Encephalopathy in a Previously Healthy Infant- A case report

2023-08-24T22:53:26+00:00

Acute necrotizing encephalopathy of childhood has been described as a rare entity that usually affects immunocompetent infants and children, mainly in East Asia, and typically after a viral infection. We describe the case of an 8-month-old, previously healthy Lebanese boy, who presented with fever and seizures and was found to have acute necrotizing encephalopathy with Adenovirus detected in the CSF. The clinical presentation and laboratory and radiological findings are described, and the outcomes are discussed.

Parental Obesity: The Pandemic of Intergenerational Physical and Mental Health Carnage

2023-08-22T22:48:30+00:00

A review of the maternal and paternal impact of obesity at conception on the subsequent health of the offspring paints a nightmarish future in terms of suffering and out-of-control healthcare spending. Consequences of parental obesity on the offspring include obesity, type 2 diabetes, cardiovascular disease, chronic kidney disease, stroke, and premature death. Children of obese women tend to have high blood pressure, left ventricular thickening, increased abdominal fat mass, hyperlipidemia with reduced high-density lipoprotein levels, increased aortic root diameter, insulin resistance, and elevated inflammatory markers, which culminate in a threefold greater risk of cardiometabolic complications than in children of normal-weight mothers. Babies are at greater risk of developing asthma, autism spectrum disorder, attention deficit hyperactivity disorder, cognitive delays, inflammation, cerebral palsy, epilepsy, and the chronic diseases of obesity (such as insulin resistance, high blood pressure, atherosclerosis, cardiovascular disease, stroke, some cancers, including breast, endometrial, and colon cancer, gall bladder disease, polycystic ovarian syndrome, musculoskeletal problems such as osteoarthritis and back pain, gout, cataracts, stress incontinence, and sleep apnea), as well as psychiatric disorders including substance abuse. All parents desire healthy babies, as does society, to avoid the health costs and consequences of our obesity pandemic, but significant personal, societal, public policy, economic, and marketplace interventions will be necessary to avert further devastating impacts. We need to publicize the intergenerational harm caused by obesity, offer support to individuals to help change eating habits and produce a healthier food chain for the nation. Interventions fashioned after the twelve-step program of Alcoholics Anonymous and the adoption of a low carbohydrate abstinence model have proven effective. The time has come to spread the obesity and intergenerational obesity research findings, long accepted by the scientific community but scarcely recognized by the public. We must act before another generation is impacted by lifestyles that have continuously worsened since the 1970s.