Pharmacists’ Approach to Optimise Safe Medication Use in Paediatric Patients

Paediatric patients are unique, yet challenging patients to care for by pharmacists. Paediatric medicine use requires special consideration. Pharmacists play an important role in educating and counselling patients, carers, and healthcare workers. Further, pharmacists have the necessary knowledge and skills to optimise safe medicine use in paediatric patients. This article provides basic principles for safe practices in paediatric medicine by following the nine rights of medication administration.

Doctors, families and the industry in the clinic: the management of ‘intersex’ children in Swiss paediatric medicine (1945–1970)

This manuscript investigates clinical decisions and the management of ‘intersex’ children at the University Children’s Hospital Zurich between 1945 and 1970. This was an era of rapid change in paediatric medicine, something that was mirrored in Zurich. Andrea Prader, the principal figure in this paper, started his career during the late 1940s and was instrumental in moving the hospital towards focusing more on expertise in chronic diseases. Starting in 1950, he helped the Zurich hospital to become the premier centre for the treatment of so-called ‘intersex’ children. It is this treatment, and, in particular, the clinical decision-making that is the centre of our article. This field of medicine was itself not stable. Rapid development of diagnostic tools led to the emergence of new diagnostic categories, the availability of new drugs changed the management of the children’s bodies and an increased number of medical experts became involved in decision-making, a particular focus lay with the role of the children themselves and of course with their families. How involved were children or their families in an era widely known as the golden age of medicine?

The current state of general paediatric fellowships in Canada

Introduction The field of Paediatric Medicine has grown tremendously over the last two decades. Several niche areas of practice have emerged, and opportunities for focused training in these areas have grown in parallel. The landscape of ‘General Paediatric Fellowship’ (GPF) Programs in Canada is not well described; this knowledge is needed to promote standardization and high-quality training across Canada. This study explores the structure and components of existing GPFs in Canada and identifies the interest and barriers to providing such programs. Methods A questionnaire was created to explore the landscape of GPF Programs in Canada. Invitations to participate were sent to leaders of General Paediatric Divisions across Canada, with a request to forward the survey to the most appropriate individual to respond within their local context. Results A total of 19 responses (95%) representing 17 different Canadian universities were obtained. Eight universities offered a total of 13 GPF Programs in 2019, with one additional university planning to start a program in the coming year. Existing programs were variable in size, structure and curriculum. Most programs identified as Academic Paediatric Programs, with an overlap in content and structure between Academic Paediatrics and Paediatric Hospital Medicine programs. The majority of respondents felt there was a need for GPF Programs in Canada but cited funding as the most common perceived barrier. Conclusion A growing number of GPF Programs exist in Canada. Current fellowship programs are variable in structure and content. Collaboration between programs is required to advance GPF training in Canada.

STUDY OF HAEMATOLOGICALABNORMALITIES AMONG PAEDIATRIC LUPUS CASES ATTENDING A TERTIARY CARE HOSPITAL IN INDIA

Systemic lupus erythematosus or SLE is a chronic autoimmune disorder of multiple systems that affects blood vessels and connective tissues. Children with SLE generally have a more severe and aggressive disease course than patients with adult-onset disease. Assess the hematological manifestations of systemic lupus erythematosus (SLE), amely leucopenia, thrombocytopenia, anaemia-with special reference to autoimmune haemolytic naemia (AIHA). Co-relation among different antibodies and clinical and hematological findings In-patients and Out-patients Department (OPD) of Paediatric Medicine, and out-patient Department (OPD) of Dept. of Rheumatology IPGME&R and SSKM Hospital, Kolkata 700020, a tertiary care center in West Bengal. Period of study-1.5 years (February 2018-July 2019). Inpatient Department and Out patient Department(OPD) of Department of Paediatric Medicine, IPGMER& SSKM Hospital. Depending upon the previous records, available patients eligible for the study , 30 patients were taken as study population. Definition of population- Children upto 12 years of age, attending the Department of Paediatric Medicine of IPGME&R and SSKM Hospital, who were diagnosed cases of Systemic Lupus Erythematosus satisfying inclusion and exclusion criteria for this study. Lupus nephritis was seen in more than half of the pediatric SLE cases. Larger number of study population needed to find statistically significant association between different parameters in this study

Clino-pathological features of urinary tract infection: a study at Nishtar University Hospital Multan, Punjab, Pakistan

Background: Urinary tract infection (UTI) is a common clinical issue among pediatric population and might progress into renal scaring, hypertension as well as end stage kidney disease. This study was aimed at finding clino-pathological features of UTI and antibiotic sensitivity against most common causative agents involved at a tertiary care hospital of South Punjab, Pakistan.Methods: This descriptive case series study was conducted at department of Paediatric Medicine, Nishtar University Hospital Multan from July to December 2019. A total of 100 children fulfilling the inclusion criteria, presenting in outpatient department or emergency section of paediatric medicine department, having positive urine culture and sensitivity were selected. Their detailed history, clinical examination and relevant investigations were done.Results: Out of the 100 children, 73 (73.0%) were female and 27 (27.0%) were male. There were 57 (57.0%) children from 1 year to 4 years age group and 43 (43.0%) were of more than 4 years. Most common clinical presentations were fever 83 (83.0%), urinary symptoms, vomiting 52 (52.0%) and pain abdomen 48 (48.0%). Most common aetiological agents were Escherichia coli 74 (74.0%) and Klebsiella pneumoniae 9 (9.0%).Conclusions: UTI is more common in female children. Most common presentation observed was fever and/or urinary symptoms while most common aetiological agent was E. coli.

Systematic and concise guide to equine paediatric medicine

Reviewed by Michael Hewetson, an equine internal medicine specialist at the Royal Veterinary College

The Relationship between Job Satisfaction and Absenteeism at the Georgetown Public Hospital Corporation

Objective: Job satisfaction is a major determinant of performance in the workplace. Studies have shown that job dissatisfaction can intensify emotional exhaustion, and this can influence nurses to perceive their work as tiresome and repetitive, leading to frustration and discouragement. The purpose of this study was to investigate the relationship between job satisfaction and absenteeism at Georgetown Public Hospital Corporation (GPHC), and to explore the parameters that may impact on job satisfaction among nurses in 3 different units (Paediatric High Dependency Unit (PHDU), ICU, Paediatric Medicine ward), at GPHC. Methods: The study was a retrospective audit of the nurses’ timesheets of 3 departments at GPHC to determine the level of absenteeism among the various levels of nursing staff (RNS, NAs). The nurses of each unit were then given an anonymous Lickert job satisfaction survey to complete to ascertain the potential impact of various parameters on their level of satisfaction. The data was analysed to determine if there was any correlation between the level of job satisfaction and the level of absenteeism. Results: The absent days of the PHDU was 48 (31 official sick leave) for 11 staff members (360 shifts). The absent days on the ICU was 193 (51 official sick leave) for 27 staff members (540 shifts). The absent days on the Paediatric Medicine ward was 323 (136) for 22 staff members (540 shifts). The level of job satisfaction across most parameters related to supervision, support and teamwork was significantly better in the PHDU than the other two units. General parameters related to promotion and administrative support remained low among all 3 units. Conclusions: The level of absenteeism was markedly lower in the PHDU when compared to the other two units. The majority of respondents were unsatisfied with conditions related to their jobs. The respondents from the PHDU displayed higher satisfaction than their counterparts in the ICU and Paeds med units.

Paediatric Medicine in India and Bottlenecks of Development in Nurturing Demographic Assets

This article argues that the poor state of paediatric medicine in India still restrains and often prevents the healthy development of far too many young Indians. Infants as junior-most citizens deserve diligent care, as they have legal entitlements to specialised medical services, ensuring their survival and healthy growth, ultimately for the benefit of the entire nation. The article first traces the somewhat stunted colonial institutional development of paediatric medicine in India. It then proceeds to perform a critical analysis of the continuing harm of negligence concerning the health and upbringing of India’s vulnerable infants, challenging the state to become more committed to integrated child development.