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  1. Article ; Online: Chryseobacterium indologenes Bacteraemia: A Potential Cause of Early-onset Neonatal Sepsis in a Full-term Baby

    Paul, Siba Prosad / Heaton, Paul Anthony

    Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

    2022  Volume 32, Issue 4, Page(s) 535–537

    Abstract: Chryseobacterium indologenes is considered as an emerging pathogen known to cause pneumonia, bacteremia, and meningitis in children. It has been reported previously, mainly from the Indian subcontinent, as a rare cause of early-onset neonatal infection, ... ...

    Abstract Chryseobacterium indologenes is considered as an emerging pathogen known to cause pneumonia, bacteremia, and meningitis in children. It has been reported previously, mainly from the Indian subcontinent, as a rare cause of early-onset neonatal infection, mostly affecting preterm infants. We report the first case in the United Kingdom in which C. indologenes was isolated from the blood culture of a term infant who was clinically suspected of having early-onset neonatal sepsis. Our case had a good outcome, but mortality has been reported in published literature. A positive neonatal blood culture of C. indologenes should not automatically be considered as a contaminant; and a joint discussion between neonatologists and microbiologists should determine the appropriate management and antibiotic regimen. Key Words: Early-onset neonatal sepsis, Bacteremia, Chryseobacterium indologenes, Contaminant, Antibiotics.
    MeSH term(s) Bacteremia/diagnosis ; Bacteremia/drug therapy ; Bacteremia/microbiology ; Child ; Chryseobacterium ; Flavobacteriaceae Infections/diagnosis ; Flavobacteriaceae Infections/drug therapy ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Neonatal Sepsis/diagnosis ; Neonatal Sepsis/drug therapy
    Language English
    Publishing date 2022-03-21
    Publishing country Pakistan
    Document type Case Reports
    ZDB-ID 2276646-7
    ISSN 1681-7168 ; 1022-386X
    ISSN (online) 1681-7168
    ISSN 1022-386X
    DOI 10.29271/jcpsp.2022.04.535
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    Zs.A 6532: Show issues Location:
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  2. Article ; Online: Letter to the Editor about the article published in Clinical Oral Investigations titled "Effect of frenotomy on breastfeeding and reflux: results from the BRIEF prospective longitudinal cohort study" (Slagter KW, Raghoebar GM, Hamming I, Meijer J, Vissink A. Clin Oral Investig. doi: 10.1007/s00784-020-03665-y).

    Paul, Siba Prosad / Heaton, Paul Anthony

    Clinical oral investigations

    2021  Volume 25, Issue 8, Page(s) 5117–5118

    MeSH term(s) Breast Feeding ; Cohort Studies ; Female ; Humans ; Longitudinal Studies ; Prospective Studies
    Language English
    Publishing date 2021-05-05
    Publishing country Germany
    Document type Letter ; Comment
    ZDB-ID 1364490-7
    ISSN 1436-3771 ; 1432-6981
    ISSN (online) 1436-3771
    ISSN 1432-6981
    DOI 10.1007/s00784-021-03973-x
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  3. Article ; Online: Multiple Magnet Aspiration into the Lungs in an Adolescent.

    Paul, Siba Prosad / Ahmad, Amna / Heaton, Paul Anthony

    Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

    2021  Volume 31, Issue 6, Page(s) 754–755

    MeSH term(s) Adolescent ; Humans ; Lung/diagnostic imaging ; Magnets ; Respiration Disorders
    Language English
    Publishing date 2021-06-10
    Publishing country Pakistan
    Document type Journal Article
    ZDB-ID 2276646-7
    ISSN 1681-7168 ; 1022-386X
    ISSN (online) 1681-7168
    ISSN 1022-386X
    DOI 10.29271/jcpsp.2021.06.754
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  4. Article ; Online: IMPROVED ADHERENCE TO THE ESPGHAN GUIDELINES IS NECESSARY FOR DIAGNOSING CELIAC DISEASE IN CHILDREN: A SINGLE-CENTER EXPERIENCE.

    Lau, Wing-Yu Siobhan / Heaton, Paul Anthony / Paul, Siba Prosad

    Arquivos de gastroenterologia

    2021  Volume 58, Issue 2, Page(s) 164–167

    Abstract: Background: Celiac disease (CD) is an immune-mediated systemic disorder elicited by the ingestion of gluten. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines published in 2012 suggested a no-biopsy ... ...

    Abstract Background: Celiac disease (CD) is an immune-mediated systemic disorder elicited by the ingestion of gluten. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines published in 2012 suggested a no-biopsy pathway (NBP) for symptomatic children with IgA tissue transglutaminase (TGA-IgA) ≥10x upper limit of normal (ULN). Biopsy confirmation remained mandatory for other cases.
    Objective: This retrospective case note study was aimed at evaluating the adherence to the ESPGHAN 2012 guidelines for diagnosing CD in our unit.
    Methods: Forty-three cases with positive TGA-IgA were identified by a laboratory database search from January 2013 to December 2019. 6 of 43 patients were not referred for a confirmation of CD diagnosis. Data was collected on the diagnostic pathways followed, and appropriateness of adherence was compared with the existing ESPGHAN guidelines.
    Results: A total of 37 cases were included with 35 children diagnosed with CD. 29/35 (83%) were diagnosed via the NBP;15/29 (52%) children did not meet all the criteria required for NBP, but were diagnosed and managed as having CD. 20/35 (57%) children were diagnosed with CD in adherence to the 2012 guidelines.
    Conclusion: The recommended diagnostic guidelines were frequently not implemented; adherence to the guidelines may improve following regular educational sessions. The revised 2020 ESPGHAN guidelines which exclude HLA-DQ2/DQ8 testing would address the issue of diagnosis for the 10/15 NBP cases (with TGA-IgA >10xULN) in our study who did not have HLA testing and were therefore non-adherent to the 2012 diagnostic guidelines. NBP, with the reduced need for endoscopy may be beneficial in resource limited settings.
    MeSH term(s) Autoantibodies ; Biopsy ; Celiac Disease/diagnosis ; Child ; Gastroenterology ; Glutens ; Humans ; Retrospective Studies ; Transglutaminases
    Chemical Substances Autoantibodies ; Glutens (8002-80-0) ; Transglutaminases (EC 2.3.2.13)
    Language English
    Publishing date 2021-06-30
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 137743-7
    ISSN 1678-4219 ; 0004-2803
    ISSN (online) 1678-4219
    ISSN 0004-2803
    DOI 10.1590/S0004-2803.202100000-28
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  5. Article: Acute abdominal surgical presentations in children.

    Syrett-Page, Joanne / Heaton, Paul Anthony / Jenner, Lucy / Paul, Siba Prosad

    British journal of nursing (Mark Allen Publishing)

    2021  Volume 30, Issue 13, Page(s) 780–786

    Abstract: Surgical conditions affecting the abdomen in children can be associated with significant morbidity and mortality if they are not recognised and managed appropriately. It is therefore important that the correct diagnosis is made quickly, and the ... ...

    Abstract Surgical conditions affecting the abdomen in children can be associated with significant morbidity and mortality if they are not recognised and managed appropriately. It is therefore important that the correct diagnosis is made quickly, and the appropriate intervention is initiated in a timely manner and, if necessary, rapid transfer is made to a specialist paediatric surgical facility. This article provides an overview of the different surgical presentations encountered in children, and outlines the most important points in the history, examination and management of such cases, whether encountered in the emergency setting or in the community. Two illustrative case studies have been included to demonstrate how these emergencies may present in clinical practice.
    MeSH term(s) Abdomen/surgery ; Child ; Emergencies ; Humans
    Language English
    Publishing date 2021-07-12
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1119191-0
    ISSN 0966-0461
    ISSN 0966-0461
    DOI 10.12968/bjon.2021.30.13.780
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  6. Article ; Online: NICE guideline review: fever in under 5s: assessment and initial management (NG143).

    Paul, Siba Prosad / Kini, Prashant Karkala / Tibrewal, Shiv Ratan / Heaton, Paul Anthony

    Archives of disease in childhood. Education and practice edition

    2021  Volume 107, Issue 3, Page(s) 212–216

    MeSH term(s) Emergency Service, Hospital ; Fever/diagnosis ; Fever/etiology ; Guideline Adherence ; Humans
    Language English
    Publishing date 2021-07-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 2148818-6
    ISSN 1743-0593 ; 1743-0585
    ISSN (online) 1743-0593
    ISSN 1743-0585
    DOI 10.1136/archdischild-2021-321718
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  7. Article: Hypothermia induced by therapeutic doses of antipyretics: misdiagnosis of cold sepsis.

    Dey, Indranil / Singhal, Natasha / Walsh, Hannah Ruth / Heaton, Paul Anthony / Paul, Siba Prosad

    Sudanese journal of paediatrics

    2022  Volume 21, Issue 2, Page(s) 205–208

    Abstract: Fever is a natural and almost universal mammalian response to infection. There exists a fear amongst general public and healthcare providers regarding fever being harmful leading to its overzealous management with antipyretics. Although the National ... ...

    Abstract Fever is a natural and almost universal mammalian response to infection. There exists a fear amongst general public and healthcare providers regarding fever being harmful leading to its overzealous management with antipyretics. Although the National Institute for Health and Care Excellence (NICE) guidelines suggest the use of single antipyretic agent for management of fever, combination therapy with paracetamol, and ibuprofen is common in paediatric practice in the United Kingdom. These antipyretics at times can cause significant adverse events even when administered at regular therapeutic doses. We describe a young boy who presented with significant hypothermia (34.1°C) and was initially treated as cold sepsis. Once the boy got warmed up and as blood results became subsequently available, it became clearer that the hypothermia was secondary to therapeutic doses of antipyretics. In conclusion, we hope to improve awareness regarding this condition in clinical practice and educate health care professionals and caregivers with recommended NICE guidelines.
    Language English
    Publishing date 2022-01-03
    Publishing country Sudan
    Document type Case Reports
    ZDB-ID 3035197-2
    ISSN 1858-8360 ; 0256-4408
    ISSN (online) 1858-8360
    ISSN 0256-4408
    DOI 10.24911/SJP.106-1601033976
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  8. Article: Turnaround times for molecular testing of pediatric viral cerebrospinal fluid samples in United Kingdom laboratories.

    Paul, Siba Prosad / Balakumar, Varathagini / Kirubakaran, Arangan / Niharika, Jothilingam / Heaton, Paul Anthony / Turner, Paul Christopher

    World journal of clinical pediatrics

    2022  Volume 11, Issue 3, Page(s) 289–294

    Abstract: Background: Rapid molecular testing has revolutionized the management of suspected viral meningitis and encephalitis by providing an etiological diagnosis in < 90 min with potential to improve outcomes and shorten inpatient stays. However, use of ... ...

    Abstract Background: Rapid molecular testing has revolutionized the management of suspected viral meningitis and encephalitis by providing an etiological diagnosis in < 90 min with potential to improve outcomes and shorten inpatient stays. However, use of molecular assays can vary widely.
    Aim: To evaluate current practice for molecular testing of pediatric cerebrospinal fluid (CSF) samples across the United Kingdom using a structured questionnaire.
    Methods: A structured telephone questionnaire survey was conducted between July and August 2020. Data was collected on the availability of viral CSF nucleic acid amplification testing (NAAT), criteria used for testing and turnaround times including the impact of the coronavirus disease 2019 pandemic.
    Results: Of 196/212 (92%) microbiology laboratories responded; 63/196 (32%) were excluded from final analysis as they had no on-site microbiology laboratory and outsourced their samples. Of 133 Laboratories included in the study, 47/133 (35%) had onsite facilities for viral CSF NAAT. Hospitals currently undertaking onsite NAAT (
    Conclusion: Onsite/near-patient rapid NAAT (including polymerase chain reaction) is recommended wherever possible to optimize patient management in the acute setting.
    Language English
    Publishing date 2022-03-18
    Publishing country United States
    Document type Journal Article
    ISSN 2219-2808
    ISSN 2219-2808
    DOI 10.5409/wjcp.v11.i3.289
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  9. Article: The recognition and nursing management of common oncological emergencies in children.

    Sherwen, Olivia / Baron, Madeleine Kate / Murray, Natalie Strachan / Heaton, Paul Anthony / Gamble, Jane / Paul, Siba Prosad

    British journal of nursing (Mark Allen Publishing)

    2022  Volume 31, Issue 1, Page(s) 20–27

    Abstract: An oncological emergency may be the initial presentation of a cancer, a sign of cancer progression, or a complication of cancer treatment. The most frequently encountered paediatric oncological emergencies include neutropenic sepsis, hyperleukocytosis, ... ...

    Abstract An oncological emergency may be the initial presentation of a cancer, a sign of cancer progression, or a complication of cancer treatment. The most frequently encountered paediatric oncological emergencies include neutropenic sepsis, hyperleukocytosis, brain tumours presenting with raised intracranial pressure, tumour lysis syndrome and superior mediastinal syndrome. These are all life-threatening conditions that require urgent recognition and management. Health professionals working in an emergency department (ED) are likely to be involved in managing these children. This article brings together the current guidance and recommendations for these specific emergencies. It also includes two case studies that demonstrate the challenges health professionals can face while managing these situations. It is important that health professionals have an acute awareness of oncological emergencies. Confidence in recognising the presentations, diagnoses and initial management are essential because these conditions may be life-threatening and time critical.
    MeSH term(s) Child ; Emergencies ; Humans ; Medical Oncology ; Neoplasms/complications ; Neoplasms/therapy ; Nursing Care ; Sepsis
    Language English
    Publishing date 2022-01-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 1119191-0
    ISSN 0966-0461
    ISSN 0966-0461
    DOI 10.12968/bjon.2022.31.1.20
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    Zs.A 3449: Show issues Location:
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  10. Article: COVID-19 complications in children.

    Baron, Madeleine / Sherwen, Olivia / Heaton, Paul Anthony / Paul, Siba Prosad

    British journal of nursing (Mark Allen Publishing)

    2020  Volume 29, Issue 20, Page(s) 1146

    MeSH term(s) Age Factors ; Betacoronavirus ; COVID-19 ; Child ; Coronavirus Infections/complications ; Coronavirus Infections/genetics ; Coronavirus Infections/therapy ; Humans ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/genetics ; Pneumonia, Viral/therapy ; Risk Factors ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-11-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 1119191-0
    ISSN 0966-0461
    ISSN 0966-0461
    DOI 10.12968/bjon.2020.29.20.1146
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