Intestinal parasites in Malaysian children with cancer.

In this prospective study, we examined stool specimens from children with cancer receiving chemotherapy who were admitted for fever to the Universiti Sains Malaysia Hospital in Kota Baru, Kelantan. Stool specimens were examined for ova and cysts of parasites. Over a period of 15 months, there were 129 febrile episodes in 50 children with cancer and, in all, 237 stool specimens were examined. Sixty-six per cent of febrile episodes were associated with neutropenia and 9 per cent were associated with diarrhoea. Stool parasites were found in 42 per cent of children. The most common were helminths, followed by protozoa. Trichuris trichiura was the most common parasite (24 per cent), followed by Ascaris lumbricoides (22 per cent). Hookworm was found in 2 per cent. Giardia lamblia was found in 6 per cent of children, Blastocystis hominis in 4 per cent, and Cryptosporidium parvum in 2 per cent.     

Intestinal parasites and bacteria in Aboriginal children in South West Australia

In a study of intestinal parasites in 697 Aboriginal children under the age of 6 years in South-west Australia, Giardia lamblia was recorded in 26% and Hymenolepis nana in 13.9%. G. lamblia infections occurred above 4 months of age, and H. nana infections above 18 months of age. There was a close correlation between infection with these two species (X², P <0.001). Campylobacter jejuni , the predominant bacterial species recorded, was isolated in 2.3%, and was related to bowel symptoms in one child. G. lamblia was more prevalent in the country areas than in the Perth metropolitan area (X², P <0.05. H. nana was more prevalent in children whose weight was below the third percentile (X², P <0.02), and in those with diarrhoea (X², P <0.01). There were strong correlations between low weight (below third percentile), a history of recent diarrhoea, and discharging ears.     

Intestinal parasites and bacteria in Aboriginal children in South West Australia

In a study of intestinal parasites in 697 Aboriginal children under the age of 6 years in South-west Australia, Giardia lamblia was recorded in 26% and Hymenolepis nana in 13.9%. G. lamblia infections occurred above 4 months of age, and H. nana infections above 18 months of age. There was a close correlation between infection with these two species (chi 2, P less than 0.001). Campylobacter jejuni, the predominant bacterial species recorded, was isolated in 2.3%, and was related to bowel symptoms in one child. G. lamblia was more prevalent in the country areas than in the Perth metropolitan area (chi 2, P less than 0.05. H. nana was more prevalent in children whose weight was below the third percentile (chi 2, P less than 0.02), and in those with diarrhoea (chi 2, P less than 0.01). There were strong correlations between low weight (below third percentile), a history of recent diarrhoea, and discharging ears.     

Intestinal parasites and lactose malabsorption

Breath-test was performed for diagnosis of lactose malabsorption in 50 Gabonese children of normal nutritional status, aged 5 to 15 years, with parasites in stools, but without diarrhoea or digestive symptoms. Control group was unparasitized and consisted of 17 children and 18 young adults living in the same area. Parasites discovered by stool examination were Ascaris lumbricoides in 76% of parasitized children, Trichuris trichiura in 58%, Giardia in 24%, Entamoeba histolytica in 20%, Schistosoma intercalatum in 16% and Necator Americanus in 14%. Children were given a 10 g lactose load and adults 20 g. Lactose malabsorption was discovered in 64% of parasitized patients and in 63% of unparasitized. Ten of 12 (83.3%) of Giardia infected children had a lactose malabsorption (no significant difference). These data show that decrease of lactase activity in African children is not related to the presence or to the importance of intestinal parasitism, except for Giardia infestation, if nutritional status is normal.     

Detection of parasites in children with chronic diarrhea

The aim of this study was to investigate the frequency of intestinal parasites in patients with chronic diarrhea and clarify the importance of these parasitic pathogens in such cases. A total of 60 pediatric patients with chronic diarrhea between June 2012 and October 2014 were enrolled in the study. Out of 60 stool samples, five were positive for Giardia lamblia, two, Dientamoeba fragilis, and one, Blastocystis hominis. One stool sample was positive for Entamoeba hartmanni and B. hominis, another one was positive for G. lamblia and B. hominis, another, G. lamblia and E. hartmanni and one sample was positive for Enterobius vermicularis, D. fragilis and B. hominis together. Parasitic infection, which decreases quality of life and increases susceptibility to other infections, should not be neglected, particularly in patients with chronic diarrhea. Accurate diagnosis decreases morbidity and mortality in patients with parasite infection.     

Intestinal motility in symptomatic children with fundoplication

Fundoplication alters the anatomy of the lower esophageal sphincter but should have no direct effects on motility distal to the sphincter. Of 55 children referred for evaluation of symptoms consistent with upper gastrointestinal motor dysfunction, 28 had undergone fundoplication 6 months to 4 years earlier to treat severe gastroesophageal reflux that had failed medical management. All 28 children had symptoms that were unchanged or worsened after fundoplication. In all children, we studied fasting and fed antroduodenal motility, and compared results from groups with and without fundoplication. Abnormalities in antroduodenal motility were found in 25 of 28 of the fundoplication group and in 25 of 27 of unoperated children. We found a wide range of abnormalities, but there were no differences in the types of severity of abnormalities between groups. In summary, in children with severe functional gastrointestinal symptoms, antroduodenal manometry uncovered physiological abnormalities, and fundoplication failed to relieve symptoms. These data suggest that preoperative intestinal manometry could identify children unlikely to benefit from fundoplication.     

Intestinal perforation in children

There were 102 cases of intestinal perforation seen in children at the Department of Paediatric Surgery at S.S. Hospital, Varanasi during a 3 year period. Enteric (typhoid) perforation (29%), intussusception (15%) Ascaris lumbricoides infestation (9%) and appendicitis (9%), which are rarities in the reported literature, were the major causes of intestinal perforation. Radiological evidence of pneumoperitoneum was seen in 88% of patients. The majority of cases in this study were older than 5 years of age (48%). Peritoneal fluid culture revealed Escherichia coli and Klebsiella to be the most common aerobic micro-organisms, while Bacteroides fragilis, Clostridia and Peptostreptococcus were the most frequent anaerobes. The overall mortality rate was high (19%).     

Intestinal transplantation in children

Intestinal transplant is now considered a viable option for children with irreversible intestinal failure suffering life limiting complications of parenteral nutrition. Identifying the possible candidates and referring them early to the transplant centre allows consideration of transplantation before the clinical situation deteriorates, and ensures the establishment of communication pathways between the family, transplant centre and the patient's local team. This encourages optimal care both before and after transplantation, and has been shown to improve long-term outcome.There are different types of intestinal transplants that may be performed according to the indication. With improvements in surgical techniques, immunosuppression, early identification of rejection and good communication between professionals and families, outcomes for patients undergoing these procedures continue to improve.     

Intestinal perforation in children

Abstract There were 102 cases of intestinal perforation seen in children at the Department of Paediatric Surgery at S.S. Hospital, Varanasi during a 3 year period. Enteric (typhoid) perforation (29%), intussusception (15%) Ascaris Iumbricoides infestation (9%) and appendicitis (9%), which are rarities in the reported literature, were the major causes of intestinal perforation. Radiological evidence of pneumoperitoneum was seen in 88% of patients. The majority of cases in this study were older than 5 years of age (48%). Peritoneal fluid culture revealed Escherichia coli and Klebsiella to be the most common aerobic micro-organisms, while Bacteroides fragilis, Clostridia and Peptostreptococcus were the most frequent anaerobes. The overall mortality rate was high (19%).     

Intestinal parasitism in children

Summary Two hundred cases have been studied from April, 1936 to November, 1937, to detect the infestation with intestinal parasites. The age of the cases studied varies from 5 days to II years. The incidence of parasite was more common in the second half of the year. The youngest child harbouring the parasite was 7 months old. The commonest parasite was giardia lamblia and next the ascaris lumbricoides; trichomonas infestation is abnormally high in comparison to the incidence in other countries. From the Chittaranjan Sishu Sadan (Children's Hospital), Calcutta.     

Pattern of neoplasms in children

Pattern of neoplasms in children under 15 years is reviewed. Of 1424 lesions, 57 per cent were benign. The common malignant tumours in order of frequency were; lymphoma, central nervous system (CNS) tumors, soft tissue sarcomas, bona sarcomas, retinoblastoma, Wilms' tumour and carcinomas. Males were affected more often than females (ratio of 2·6∶1). Malignant tumours were commonest in the first five year of life.