Datura stramonium is a widespread annual, leafy herbaceous plant that is a powerful hallucinogen. It can cause severe anticholinergic poisoning after inappropriate and unconsciously usage. We would like to present an approach, accompanied by literature, to the poisoning case for a 6-year-old child who initially presented with altered mental status, abnormal/incoherent speech and agitation, and had an only response to physostigmine. It is essential to consider anticholinergic plant-based ingestions in the differential diagnosis of children presenting with altered mental state, hallucination, and agitation. Health care workers and parents should be aware of toxicities and potential risks of these plants.
Background:
The Rome IV includes a redefinition of functional gastrointestinal disorders and diagnostic criteria. The present study aimed to compare the Rome III and Rome IV classification results and to reveal their differences in children with chronic abdominal pain.
Methods:
The present study is a prospective observational cohort study. Three hundred forty-four children, who were admitted to the pediatric gastroenterology clinic, had abdominal pain for more than 2 months, and were not diagnosed with an organic disease, were included in our study.
Results:
In children with chronic abdominal pain, Rome IV criteria did not cause a change in the number of patients diagnosed with functional abdominal pain disorders according to Rome III (89.8% vs 89.2%,
P
>.05). Functional abdominal pain and functional abdominal pain syndrome were the most common diagnoses in Rome III and functional abdominal pain, not otherwise specified in Rome IV. When compared to Rome III, while the diagnosis of functional dyspepsia increased in Rome IV, irritable bowel syndrome decreased.
Conclusion:
In children with chronic abdominal pain, Rome IV criteria did not cause a change in the number of patients diagnosed with functional abdominal pain disorders according to Rome III, but it caused a diagnostic shift. It was seen that some of the children diagnosed with irritable bowel syndrome in Rome III shifted to functional dyspepsia diagnosis in Rome IV.
Background
Acute gastroenteritis (AGE) in children is still one of the most important causes of mortality and morbidity in developing countries. Therefore, it is very important for clinicians to detect the presence and severity of acute gastroenteritis. Red cell distribution width (RDW) is thought to have the potential for AGE evaluation in children. We sought to investigate the value of RDW for severity assessment in children with AGE.
Methods
A total of 97 AGE patients were included in a prospective observational study. Complete blood count, serum C‐reactive protein, and stool examinations were carried out. Modified Vesikari score (MVS) was evaluated to determine severity.
Results
Median age was 19 months (min–max, 1–198 months). The male/female ratio was 1.55 (59/38). Rotavirus was detected in 31 of 97 children (32%). median MVS was 9 points (min–max, 5–24 points). A total of 32 (33%), 43 (44%) and 22 patients (23%) were classified in the mild‐, moderate‐, and high‐severity groups, respectively. There were no significant differences between rotavirus‐positive and rotavirus‐negative children. Hemoglobin, mean corpuscular volume, and RDW differed significantly according to severity. RDW had the highest area under the curve when the high‐severity group was compared with the combination of low‐ and moderate‐severity groups on receiver operating characteristic analysis.
Conclusions
Red cell distribution width increased with the increase in severity of AGE. RDW may offer additional severity stratification in children with AGE.
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