Probiotics for the treatment of Helicobacter pylori infection in children

The combination of a proton pump inhibitor and two antibiotics(clarithromycin plus amoxicillin or metronidazole)has been the recommended first-line therapy since the first guidelines for Helicobacter pylori(H.pylori)infection in children were published.In recent years,the success of eradication therapies has declined,in part due to the development of H.pylori resistant strains.Alternative anti-H.pylori treatments are currently becoming more popular than the traditional eradication methods.Components that may be used either as a monotherapy or,in combination with antimicrobials,resulting in a more effective anti-H.pylori therapy have been investigated in depth by several researchers.One of the potential therapies is probiotic cultures;promising results have been observed in initial studies with numerous probiotic strains.Nevertheless,many questions remain unanswered.In this article,we comprehensively review the possible mechanisms of action of probiotics on H.pylori infection,and present the results of published studies using probiotics as possible agents to control H.pylori infection in children.The effect of the addition of probiotics to the standard H.pylori eradication therapy for the prevention of antibiotic associated side-effects is also discussed.

Changing Grains for the Prevention and Treatment of Kashin-Beck Disease in Children: a Meta-analysis

To evaluate the efficacy of changing grains on the prevention and treatment of Kashin-Beck Disease （KBD） in children, community-based trials were acquired from seven electronic databases （up to July 2014）. As a result, the methodological quality of the six trials that have been included into our analysis was low. The pooled ORs favoring the prevention and treatment effects of changing grains were 0.15 （95% CI： 0.03-0.70） and 2.13 （95% CI： 1.44-3.16） respectively by meta-analysis. Subgroup analysis demonstrated the pooled OR favoring treatment effect of exchanging grains rather than drying grains both compared with endemic grains. The results showed that changing grains had obvious effects on the prevention and treatment of KBD in children. However, the evidences were limited by the potential biases and confounders. Large and well-designed trials are still needed.

The Treatment of Children's Diarrhea with Massage and Acupunture in 58 cases

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Effect of Socio-Demographic Factors on Zinc Status of Infants and Preschool Children in East Gojjam, Amhara Region of Ethiopia

Zinc deficiency is a public health concern and is the most prevalent micronutrient deficiencies in developing countries. The main objective of this study was to assess the prevalence and risk factors of zinc deficiency among infants and preschool children. Based on a community, the cross-sectional study was conducted in East Gojjam between October 2011 and April 2012. Two hundred and forty infants and preschool children were randomly selected in the study. Data on potential determinants of zinc deficiency were collected using a structured questionnaire. Serum zinc concentration was measured using atomic absorption spectrometer. Statistical analysis was done using ANOVA, independent sample student＇s t-test and linear regression model. The mean serum zinc concentration of infants and preschool children was 62.98 （±13.03） μg/dL in 95% confidence interval （CI） between 61.32 and 64.63 （i.e., 95% CI： 61.32, 64.63）. About 57,1% of the subjects were zinc deficient. The main determinants of low serum zinc status of infants and preschool children were age and number of family members living on the same land. Zinc status of older children was 3.67 μg/dL （95% CI： -5.58, -1.77） lower than children who were aged 6-10 months. Serum zinc status of infants and preschool children is decreased by 0.83 p.g/dL （95% CI： -1.36, -0.30） with each additional family member. Food insecurity, dietary diversity, sex, child health, anthropometric indices, maternal education and wealth index were not associated with serum zinc status. Zinc deficiency among infants and preschool children is highly prevalent. Such potential deficiencies require urgent attention, including complementary food preparation education, traditional phytate reduction method and family planning implementation recommended in the study area.

The Microscopic Surgical Treatment for Tumor of Posterior Cranial Fossa in Children

OBJECTIVE To analyze and discuss about the clinicalcharacteristics, pathological types, surgical modalities andtechniques, and postoperative complications in children withtumor of posterior cranial fossa .METHODS Retrospective study was conducted on 102 cases ofpediatric tumor of posterior cranial fossa, admitted and treated inour hospital during the period of January 1996 to January 2007.All patients underwent microscopic surgical treatment. Fifty-eight were male and 44 cases were female. The age ranged from 9months to 14 years old, with an average of 6.1 ± 0.5 of age. CranialCT or MRI examination was conducted before and after thesurgery on all patients.RESULTS The primary manifestations for this group of patientswere increased intracranial pressure and/or ataxia. Postoperativepathological diagnoses showed: 46 cases of medulloblastoma, 43cases of astrocytoma, 11 cases of ependymoma (including 1 caseof degenerative ependymoma), 1 case of dermoid cyst, and 1 caseof teratoma. In this group of the patients, radical surgery wasused in 68 cases and subtotal surgical removal used in 31 cases,while surgical removal of large section was performed on 3 cases.There were no deaths from surgery reported. Ninety-one casesshowed significant symptomatic improvement when comparedwith preoperative conditions, while 11 cases showed either noimprovement or more severely affected afterward. For 6 cases,postoperative ventriculoperitoneal shunt was performed within7 days to 2 months after the surgery. Sixty-three patients gainedfollow-up for 3 to 60 months in duration. Thirty-nine patientsregained normal life and were able to learn well, while there were7 patients who could not live normally on their own. During thefollow-up period, there were 17 cases of recurrence and 7 casesof death. In 23 cases of medulloblastoma in children with age of3 years old or above, 2 cases who underwent surgical removal ofintracranial ependymoma received small dosage of postoperativeX-ray radiotherapy on the the brain and spinal cord. Nine casesof medulloblastoma in children under age of 3 and 17 cases ofastrocytoma diagnosed after the surgery received chemotherapyof Carmustine.CONCLUSION Medulloblastomas and astrocytomas werethe most common types of pediatric tumor of posterior cranialfossa, right followed by ependymoma, and dermoid cysts andteratomas were rare. Early correct diagnosis, proper selection ofappropriate surgical modality and the surgical margin, propertreatment of postoperative complications, and the selecting rightradiotherapy or chemotherapy were the key factors in influencingthe prognostic outcome of children with tumor of posterior cranialfossa.

Acute Malnutrition and Infection with the Human Immuno-Deficiency Virus (HIV) in Children Followed up at the Pediatrics University Hospital Charles de Gaulle: Evolution of Anthropometric Parameters on Antiretroviral Treatment

Burkina Faso, a country with very scarce resources, undertook to fight against HIV infection. In 2013, according to UNAIDS, 110,000 persons were living in this country with HIV infection. 18,000 children among these persons were under 15. We conducted a retrospective study from January 2003 to December 2012 at the Pediatrics University Hospital Charles De Gaulle, Ouagadougou (CHUP CDG), Burkina Faso. The study aimed at assessing the children’s ponderal growth when under antiretroviral treatment. The children who were under 15 and who had been on antiretroviral treatment for at least 5 years were included in the study. Acute malnutrition concerned children whose height/weight ratio (H/W) was lower at -2 width type (or Z score) of the median of reference regarding age according to WHO. Two categories of malnutrition were outstanding in our study: moderate acute malnutrition, (-3 Z-score ≤ H/W -2 Z-score) and severe acute malnutrition (W/H -3 Z-score). The clinical and paraclinical data recorded during previous consultations were extracted from the ESOPE (Monitoring and follow-up of patients) data basis and exported to the ENA software and SPSS for their analysis. In total, 210 out of 529 children’s cases were considered. These children’s average age was 6.9 years. There were 55.7% of male and 44.3% of female children. HIV1 was found in 97.6% of the children against 2.4% for HIV2. In a 5 year follow-up, 46 among the children, namely 20.4% were on a second line protocol of antiretroviral treatment and 164 among them were still on a first line protocol of antiretroviral treatment. When they were admitted at hospital, 38% of the children showed characteristics of acute malnutrition. 17.8% of these children presented characteristics of severe form of acute malnutrition. During this 5-year follow-up, the average of the W/H index of the children gradually rised from -1.62 Z-score when being admitted to -0.18 Z-score at after a 60-month antiretroviral treatment. Our study showed an effective ponderal catch-up with an average of the W/H index at -1.02 Z-score after a 12-month antiretroviral treatment. This study completed by the search for nutritious factors is likely to influence the infected children’s ponderal growth.

TCM Treatment of Asthma in Children with Yin Hua Wu Mei Tang——Professor Liu Bichen's Experience in Treating Asthma

Asthma is characterized by paroxysmaldyspnea,rales in the throat,difficulty in breathing,and inability to lie horizontally.It is commonly seenin children with a weak body constitution,and tendsto be intractable,thus being harmful to the

Effect of intervention treatment from different stages on prognosis in children with central coordination disturbance

BACKGROUND： Central coordination disturbance is regarded as the early-stage symptom of brain injury-induced cerebral palsy. This disease manifests itself as motor disorder, abnormal attitudinal reflex and muscular tension. Early intervention may improve its prognosis. OBJECTIVE： To observe the effects of intervention treatment from different stages on the prognosis of central coordination disturbance following brain injury in children patients. DESIGN： A contrast observation experiment SETTING： Department of Neurology and Rehabilitation, Urumqi Children＇s Hospital PARTICIPANTS ： Totally 151 children who were diagnosed as central coordination disturbance from January 2002 to December 2003 in the Department of Neurology and Rehabilitation of Urumqi Children＇s Hospital were recruited. All the children patients, including 101 male and 50 female, aged from 3 months to 1 year old, met the diagnosis criteria of central coordination disturbance from Vojta. They were divided into slight, moderate and severe abnormity according to Vojta attitudinal reflex. All 151 patients were divided into 2 groups according to their age at diagnosis： 3-6 months old group （n=74）, 62 severe, 10 moderate and 2 slight; 7-12 months old group （n=77）, 66 severe, 7 moderate and 4 slight. All the relatives of children patients were informed of the experiment. METHODS： ① Both groups received physical training （PT） as the main treatment; Hand training was given if necessary. All of the patients received additional hyperbaric oxygen therapy, bioelectric therapy, scalp acupuncture, drug treatment and family training. The importance of integration of hospital and family based rehabilitation was stressed. Those who did not catch up with the normal development or had abnormal reflexes continued to receive treatment. ② Around the age of 2 years old, all children did a final evaluation using Bayley Scales of Infant Development （BSID）. Mental development index （MDI） and physical development index （PDI） were taken as evaluative criteria. Children with scores 80 and above on MDI and PDI were considered to have normal motor and mental development; 79 and below were considered delayers. The Diagnostic Criteria of Cerebral Palsy and Infantecondary School Social Adaptation Scale were used in the final evaluation[scores ≤5 was extremely severe （extremely severe cerebral palsy）, 6 was severe（severe cerebral palsy）, 7 was moderate（moderate cerebral palsy）, 8 was slight（slight cerebral palsy）, 9 was borderline（slight cerebral palsy）, 10 was normal, 11 was above average, 12 was excellent and ≥13 was extremely excellent]. ③ Final evaluative results of 2 groups were compared. And u test was used for the comparison of Bayley development index and Chi-square test for the comparison of normalization rate. MAIN OUTCOME MEASURES： BSID MDI and PDI as well as the normalization rate of motor function and mental behavior of children patients at 2 years old. RESULTS： Totally 151 children patients entered the stage of result analysis. ①Two groups of children patients were given integrated rehabilitation therapy , and evaluated at 2 years old . The 3-6 months old group had higher MDI and PDI than the 7-12 months old group （91.81＋19.99 vs 71.93＋18.98;91.55＋23.61 vs 68.95＋23.51, u=6.265,5.894,P 〈 0.01 ）.②After being given integrated rehabilitation therapy, children patients of 3-6 months old group had significantly higher normalization rate of motor function and mental behavior than 7-12 months old group （73% ,27%,X2=29.723 9,P 〈 0.01 ）. ③Six slight and 17 moderate central coordination disturbance children of 2 groups all completely recovered; After intervention treatment, among 128 severe central coordination disturbance children, 52 recovered and 76 were still abnormal, in which, 43 slight cerebral palsy, 18 moderate cerebral palsy, 5 severe cerebral palsy and 10 extremely severe cerebral palsy. CONCLUSION： To perform integrated intervention treatment before 6 months old can better improve and promote mental and physical development levels of children patients with central coordination disturbance after brain injury than 6 months later.

Diagnosis and treatment of children sinus pericranii

Objective To discuss the diagnosis and treatment of children sinus pericranii ( sp) Methods From Jan. 2000 to Dec. 2008,12 cases of SP were treated. The clinical data and CT results were studied. If SP had no com-

Current treatment options and response rates in children with chronic hepatitis C

Vertical transmission has become the most common mode of transmission of hepatitis C virus (HCV) in children.The rate of perinatal transmission from an HCVinfected mother to her child ranges from 2% to 5% and the prevalence of HCV in children in developed countries ranges between 0.1% and 0.4%.Spontaneous viral clearance seems to be dependent on the genotype and has been reported between 2.4%-25%.For chronically infected patients,treatment with recombinant polyethylene glycol (PEG)-interferon α-2b and daily ribavirin has now been approved as standard treatment for children 2-17 years of age.In five large prospective studies,a total of 318 children and adolescents aged 3-17 years were treated either with subcutaneous PEG-interferon α-2b at a dose of 1-1.5 μg/kg or 60 μg/m2 once a week in combination with oral ribavirin (15 mg/kg per day) or PEG-interferon α-2a with ribavirin.Subjects with genotype 1 and 4 received the medication for 48 wk and individuals with genotype 2 and 3 mainly for 24 wk.Overall sustained viral response (SVR) was achieved in 193/318 (60.7%) of treated patients.Stratified for genotype;120/234 (51%) with genotype 1,68/73 (93%) with genotype 2/3,and 6/11 (55%) with genotype 4 showed SVR.Relapse rate was between 7.7% and 17%.Overall,treatment was well tolerated;how-ever,notable side effects were present in approximately 20%.According to recent experiences in the treatment of chronic hepatitis C in children and adolescents,a combination of PEG-interferon α with ribavirin has been found to be well tolerated and highly efficacious,particularly in individuals with genotype 2/3.Thus,this treatment can be recommended as standard of care until more effective treatment options will become available for genotype 1 patients.

Life cycle assessment for waste acid treatment in zinc smelting

Lift cycle assessment(LCA)methodology was applied to evaluating and comparing two waste acid disposal processes in zinc smelting.The results indicate that environmental impacts of gas−liquid vulcanization technologies are human toxicity,abiotic depletion potential,and global warming risk,which are mainly caused in neutralizing−evaporating−crystallization unit and electrodialysis unit.As for traditional lime neutralization method,vulcanization unit is the main factor.In this regard,the total environmental impact of traditional lime neutralization method is much higher than that of gas−liquid vulcanization technologies.Furthermore,the sensitive analysis shows that electricity and sodium sulfide(60%)are sensitive factors in two waste acid disposal technologies.In addition,the total cost of disposing a functional unit waste acid in traditional lime neutralization process is nearly 27 times that of the gas−liquid vulcanization waste acid disposal technologies.

Biological treatment of wastewater with high concentrations of zinc and sulfate ions from zinc pyrithione synthesis

An enriched and domesticated bacteria consortium of sulfate-reducing bacteria(SRB)was used to treat wastewater from zinc pyrithione(ZPT)production,and the effects of different reaction parameters on sulfate reduction and zinc precipitation were evaluated.The single-factor experimental results showed that the removal rates of Zn2+and24SO?decreased with an increased ZPT concentration ranging from3.0to5.0mg/L.Zn2+and24SO?in wastewater were effectively removed under the conditions of30?35°C,pH7?8and an inoculum concentration of10%?25%.The presence of Fe0in the SRB system enhanced Zn2+and24SO?removal and may increase the resistance of SRB to the toxicity of Zn2+and ZPT in wastewater.A Box?Behnken design was used to evaluate the influence of the main operating parameters on the removal rate of24SO?.The optimum parameter values were found to be pH7.45,33.61°C and ZPT concentration of0.62mg/L,and the removal rate of24SO?reached a maximum of91.62%under these optimum conditions.

Acceptability and Compliance to a 10-Day Regimen of Zinc Treatment in Diarrhea in Rural Bangladesh

We hypothesised that the promotion of blister packs of zinc may be carried out by health personnel in health care facilities to the mothers of children suffering from diarrhea. We predicted that good acceptability and good compliance to zinc treatment in rural Bangladesh would be over 75% and at least 60%, respectively. Between January and December 2011, six hundred and thirty five children aged 6 - 59 months who presented with acute diarrhea received a 10-day zinc regimen. Determination of acceptability and compliance of a dispersible zinc tablet in children 6 - 59 months old was main point of the study. In-home follow-ups started within 2 - 3 weeks after the regimen began. Seventy seven percent of the mothers/caretakers perceived that the taste of the zinc tablets was the same or better than that of other medicines given to their children and expressed willingness to use zinc in the future (good acceptability). Sixty-two percent of the children completed full 10-day course of zinc treatment by taking one tablet a day that had been completely dissolved in a small amount of water (good compliance). There was 63% excess risk for poor compliance to zinc if father stays at home with the family [OR = 1.63 (95%CI;1.09, 2.46) p = 0.019]. Despite vomiting, 33% children continued to receive zinc tablet [OR = 0.67 (95%CI;(0.47, 0.97, 0.032)] after adjusting for co-variates. Both acceptability and compliance to dispersible zinc tablets in childhood diarrheal illnesses are still not at the expected level in rural Bangladesh.

THE EFFECT OF STATUS OF ZINC, CALCIUM ON GROWTH OF CHILDREN AGED 3～6 YEARS IN XI'AN AND ANALYSIS OF EFFECTIVENESS OF ZINC SUPPLEMEINT

In this study the correlation of heights and weights of 456 healthy children in xi'an aged 3 to 6 years with concentrations of serum zinc, calcium was investigated. The results showed that the concentrations of serum zinc and calcium in the three groups with heights (weights) <x, <x - sand < x - 2s were significantly lower than those in the group with heights (weights) ≥x (P <0. 01). Heights- weights and level of serum calcium of 156 zinc deficient children were lower than those of the children with normal zinc. After zinc supplement, heights and weights of children rapidly increased (P < 0. 01) and calcium level significantly rose (P < 0. 01), with the increase in serum zinc- It is suggested that the deficiency of Zn in children in Xi'an is considerably common and the preschool children with poor growth should be supplemented by zinc

The effect of zinc supplementation on diarrheal diseases in children in the Niger Delta Sub-Region of Nigeria

This study evaluated the trend of diarrheal diseases managed with zinc supplementation by comparing it with diarrheal diseases managed without zinc supplementation at the University of Port Harcourt Teaching hospital (UPTH), Nigeria. The study was a descriptive retrospective study done at the Diarrhea Training Unit (DTU) of UPTH to determine the effect of zinc supplementation in the management of diarrhea in children under 5 years. Out of the 134 case records studied, of children aged 0 to 59 months who presented with diarrhea at the DTU, 57 children did not receive zinc supplementation between October and December, 2007 and 77 children received zinc supplementation between October and December 2009. The results showed that (74) 96.1% of patients who received zinc supplementation, and (48) 84.2% of those who did not, had no repeat diarrheal episodes when seen at the follow up clinic. On the other hand, 1.3% of those who received zinc supplementation and 1.8% of those who did not, had increased episodes of diarrhea when seen at the follow up clinic. Of those who received, and those who did not receive zinc supplementation, 2.6% and 14% respectively, had reduced episodes of diarrhea. These findings clearly demonstrate the effectiveness of zinc supplementation in halting the course of diarrheal diseases in children aged 0 to 59 months. We therefore advocate for the use of zinc supplementation in the management of diarrhea in

Iron, Zinc, and Copper Malnutrition among Primary School Children in Lagos, Niagara

This study assessed the iron, zinc and copper status of primary school-attending children in Lagos. A sample of 200 primary School-attending children was randomly selected using a stratified 2 – stage sampling technique. Data was collected in the 2 major seasons in Nigeria;Dry and Rainy seasons using dietary intake (24 hr dietary recall protocol) venipuncture blood samples, and a self-administered questionnaire. The data were analyzed using descriptive and inferential statistics. Among ages 5 - 8 years, the main dietary intake for iron was 10.66 ± 12.44 mg/d (106% of DRI), for zinc, 7.30 ± 7.39 mg/d (92% of DRI) and for copper, 1.55 ± 1.31 mg/d (390% of DRI). For ages 9 - 13 yrs, the mean intake of micronutrients showed that iron was 11.03 ± 12.72 mg/d (138% of DRI), 3inc was 8.44 ± 7.7 mg/d (105% of DRI) and copper was 3.75 ± 15.17 mg/d (536% of DRI). Biochemical results indicated that 19.8% of the subjects had inadequate serum iron, 21% and 32.1% were zinc and copper deficient respectively prevalence of anemia was 38.1% while iron deficiency anemia was 13.06% and iron deficiency was 34.6%. Dietary intakes did not provide right amounts of micronutrients to meet body requirements. There is the need to formulate and implement nutrition education programs to correct micronutrient deficiency among primary school-attending children in Lagos, Nigeria.

Determinants of Delay in Malaria Prompt Diagnosis and Timely Treatment among Under-Five Children in Shashogo Woreda, Hadiya Zone, Southern Ethiopia: A Case Control Study

Background: Ensuring prompt diagnosis and timely malaria treatment will prevent most cases of uncomplicated malaria from progressing to severe and fatal illness. To avoid this progression, treatment must begin as soon as possible, generally within 24 hours after symptoms onset. The reason why mothers/caretakers delay in malaria prompt diagnosis and timely treatment for under-five is not well studied in the study area as well as in Ethiopia. Objective: To assess determinants of delay in malaria prompt diagnosis and timely treatment among under-five children in Shashogo Woreda, Hadiya Zone, Southern Ethiopia, 2013. Methods: An unmatched case control study was conducted from March 25-April 25, 2013. A total sample size of 302 with 151 cases and 151 controls were selected by systematic random sampling techniques. Cases were under-five children who had clinical malaria and sought treatment after 24 hours of symptoms onset, and controls were under-five children who had clinical malaria and sought treatment within 24 hours of symptoms onset. Both bivariate and multivariate logistic regressions were done to identify determinant of delay in malaria prompt diagnosis and timely treatment. Results: A total of 151 mothers/caretakers of cases and 151 mothers/caretakers of controls were interviewed. Illiterate mothers (AOR = 7.14;95%CI: 1.10, 46.39), monthly income ≤500 ETB (AOR = 5.49;95%CI: 2.09, 14.45), females sex (AOR = 3.45;95%CI: 1.62, 7.34), distance from health facility >5 km (AOR = 4.31;95%CI: 1.22, 15.23), absence of history of child death (AOR = 4.21;95%CI: 1.514, 11.68), side effects of antimalarial drugs (AOR = 2.91;95%CI: 1.15, 7.33) and khat chewing (AOR = 2.38;95%CI: 1.28, 5.79) were determinants of delay in malaria prompt diagnosis and timely treatment of under-five children. Conclusion: Mother’s education, monthly income, distance from health facility, absence of history of child death, complained about side effects of drugs and khat chewing were predictors of delay of prompt diagnosis and timely malaria treatment. Effective malaria control programs revision would be required to avoid delay of prompt diagnosis and timely treatment for under-five children.

Awareness and Behaviour Related to Orthodontic Treatment among School Children in Aseer Region, Kingdom of Saudi Arabia

Background: Awareness of malocclusion and the need to make corrections have increasingly become prevalent among the young population. In the period of adolescence, physical appearance is crucial in the construction of personal identity, including one’s relationship with one’s own body. Orthodontic treatment includes improved oral health and enhanced psychological wellbeing. Early orthodontic treatment for children will be crucial to improving oral health. The present study aims to assess the awareness towards orthodontic treatment among school children’s of Aseer region, Saudi Arabia. Materials and Methods: A total of 835 (450 boys and 385 girls) school children’s, of age group between 10 - 15 years were included in the study. A total of 16 schools in the all Aseer region were surveyed during January to May 2018. A pre-structured self-administered questionnaire consisting of 12 questions with multiple answers were given to the children after the clinical examination to assess their knowledge and attitude towards Orthodontic treatment. Statistical Analysis: The survey data was collected and organized into Microsoft Excel spreadsheets (Microsoft Inc., USA), and was statistically analyzed utilizing the Statistical Package for the Social Sciences version 20.0 software (IBM Inc., USA). The statistical test used here was the chi-square test and P values less than 0.05 were considered to be statistically significant (P Result: A total of 292 (65%) of males and 285 (74%) of females have heard of an orthodontist. 234 (52%) of males said that orthodontist would align their teeth. 203 (45%) and 250 (65%) of males and females respectively are aware that few teeth needed to be removed for aligning irregular teeth. Majority of the children are aware of taking braces treatment at an earlier age would improve facial appearance. 320 (83%) and 227 (59%) of female children aware of that irregular teeth can affect chewing ability and speech respectively. 261 (58%) of males knew that orthodontic treatment is longer than other dental procedures. Conclusion: Findings confirmed that there is a positive awareness towards orthodontic treatment among school children’s, but specific misconceptions and barrier exist. There is no statistical difference between males and females in knowledge and behaviour related to orthodontic treatment and malocclusion in school going, children.

Pyogenic liver abscess in children: Diagnosis and treatment at the teaching hospital Gabriel Touré, Bamako, Mali

Purpose: To determine diagnostic and therapeutic problems of pyogenic liver abscess in our hospital. Method and material: We conducted a retrospective study from January 2006 to December 2010 of all children aged from 0 - 15 years admitted and treated for pyogenic liver abscesses. Amoebic liver abscesses and other hepatobiliary disorders were not considered. Results: Pyogenic abscesses accounted for 50 cases. The mean age of patients at presentation was 2.4 ± 0.78 years (range from 6 months to 15 years). Sex ratio was 2.8 for boys. Abdominal pain was the primary reason for consultation in 27 cases (54%). Fever has been noted in 42 patients (84%) and the patient general state was altered in 13 patients (26%). Escherishia coli was the most frequent bacteria found at pus. The pus was sterile in 25 cases (50%). The ultrasonographic percutaneous drainage was performed in 33 patients (66%), open surgery in 6 (12%) and antibiotics alone in 11 others (22%). The short outcomes were simple in 36 patients (72%) while pain and fever persisted in 12 others (24%). Two patients (4%) died from sepsis soon after the operating room. Improving the frequency of early diagnosis will depend on education of clinicians about the need for clinical suspicion aided by ultrasound.