Aim: To investigate and compare parent, dentist and Dental Surgery Assistant (DSA)’s ability in assessing child’s dental anxiety and to identify the factors that can influence their assessments.

Design: All 3-5 years old children who first visited the Paediatric Dentistry Clinic of the Prince Philip Dental Hospital were recruited. The accompanying parents were given a questionnaire which consisted of 2 parts, including (i) parent’s and child’s demographic backgrounds and their own dental histories, and (ii) parent’s self-report Modified Dental Anxiety Scale (MDAS) and parental proxy of the Modified Child Dental Anxiety Scale (MCDAS)
Oral examination was carried out in a clinic setting and the subjects were given the Facial Image Scale (FIS) which comprises of five faces from very happy to very unhappy. The child was asked to select the one that represents him self or her self at that moment before the dental examination. The score was given by the value 1 to the happiest and 5 to the unhappiest. The parent, dentist and DSA were also asked to select the value that they thought which represented the child best at that moment.

Results: The mean FIS score reported by children was 2.16. The mean FIS score reported by the parents, dentist and DSA were 2.61, 2.69 and 2.59, respectively. The agreement of parents, dentist and DSA with the children regarding the FIS score was analysed using the Linear Weighted Kappa and the figure was 0.225, 0.311 and 0.328. Parent’s agreement with the children regarding the FIS scores appears to be affected by whom the child’s main caregiver is. Both DSA and dentist’s agreement with the children regarding the FIS scores appears to be affected by the child’s age.

Conclusion: The study showed that the agreement of the parents, dentist and DSA with the children regarding the FIS is weak. Assessment by observation is operator-biased and may be inaccurate. They tended to overrate the anxiety level. DSA and dentists showed better agreement compared to the parents. Children’s self-reported level of dental anxiety should be first considered even in young children whenever it is possible.

Objectives: Exit-site care is important in prevention of Peritoneal Dialysis (PD) associated infections. But there was no clear recommendation for standard exit-site care. The aim of the study was compare local mupirocin and neomycin in exit-site care of chronic PD.

Methods: 32 children in chronic PD was included the study. The mean age was 11.3±4.8 years and mean follow-up period for dialysis before study was 15.9±10 months. The patients were randomized to mupirocin (n=16) or neomycin (n=16) groups and followed for 12 months. Mupirocin or neomycin was added to standard exit-site care with local dressing every alternate day.

Results: Total 313 patient follow-up months was recorded. Mean exit-site score at beginning and end of the study was not different in both groups. The increasing of the exit-site score between beginning and end of the study was significant in mupirocin group (p<0.01). Total 6 exit-site infection (3 culture negative, 1 MRSA, 1 pseudomonas and with 1 corynebacterium) was found in 4 patients. The incidence of exit-site infections was 24 treatment months in mupirocin group and no exit-site infection was found in neomycin group (p=0.036). Total 15 peritonitis (5 culture negative, 4 MRSA, 2 streptococcus, 2 staphylococcus, 1 E.coli, 1 enterococus) was recorded in 13 patients during study. The peritonitis incidence was not different between mupirocin and neomycin groups respectively (20.9 vs. 20.9 treatment months.

Conclusion: Neomycin is more effective then mupirocin for prevention of exit-site infection in children with chronic PD with relatively higher local adverse events.

Background: In developing countries, most of esophageal burns are seen at the step of caustic stenosis which is frequent, and their treatment is grafted with difficulties associated with lack of therapeutic means. We aim to take stock of accidental circumstances, therapeutic and evolutionary aspects of cases we treated during six years’ experience.

Materials and Methods: It was a retrospective study over 6 years in the Pediatric Surgery Department of Lomé, involved children treated for esophageal caustic stenosis. Savary-Gilliard dilators were used for dilations by laryngoscopy. Endoscopy was not available on-site. Therapeutic results were assessed on the quality of the oral feeding recovery and were considered successful in case of normal oral total swallowing; average in case of semi-solid food swallowing and bad in case of important dysphagia sequelae or death.

Results: During 6 years, 18 cases of caustic stenosis of esophagus were treated in 10 boys and 08 girls with average age of 5.03 years. Ingestion was accidental in 17 cases and intentional in 1 case. Caustic agents were a base in 17 cases and a hydrochloric acid in 1 case. UGI was implemented in 17 children. Stenosis were in the middle third in 10 children, the upper third in 5 children, the lower third in 1 child, the esophageal mouth in one child and a triple stenosis layered in 1 child. Fifteen children were treated by esophageal dilations, one had esophagocoloplasty, one is waiting for esophagocoloplasty and one was transferred to Switzerland for a pharyngo-oesophagoplasty. Results were good in 16 cases and bad in 1 case. In the latest case, the result will be appreciated after the oesophagoplasty.

Introduction: Primary coenzyme Q10 (CoQ10) deficiencies are a group of mitochondrial disorders that has proven responsiveness to replacement therapy. Mutations in enzymes involved in the biosynthesis of CoQ10 genes are associated with these deficits. The clinical presentation of this rare autosomal recessive disorder is heterogeneous and depends on the gene involved. Mutations in the COQ2, COQ6, PDSS2, and ADCK4 genes are responsible for Steroid-Resistant Nephrotic Syndrome (SRNS), which is associated with extra-renal symptoms. Previous studies have reported COQ6 mutations in 11 patients from five different families presenting with SRNS and sensorineural deafness.

Case reports: Our study reports the cases of two brothers of Turkish origin with renal failure and sensorineural deafness associated with COQ6 mutations responsible of CoQ10 deficiency. Ocular symptoms were present in the eldest that improved with coenzyme Q10 therapy.

Conclusion/Discussion: For the first time, COQ6 mutation with ocular involvement is associated with renal and hearing impairment. Although the response to replacement CoQ10 therapy was difficult to evaluate, we think that this treatment was able to stop the disease progression in both patients, and even to prevent the occurrence/development of ocular and neurological impairment in the younger brother. Mitochondrial dysfunction secondary to CoQ10 deficiency should always be suspected in patients with SRNS and extra-renal symptoms. Early recognition of this genetic SRNS is mandatory since SRNS can be avoided by adequate treatment based on CoQ10 supplement. All cases of primary CoQ10 deficiency should be treated at an early stage to limit the progression of lesions and prevent the emergence of new symptoms.

The head injury is one of the most common traumatic pathology that may be the cause of serious sequelae; particularly since it mainly affects the young active population

Aim: The aim of this study is to evaluate the epidemiologic profile of victims of head trauma and the lesion characteristics.

Patients and methods: This is a retrospective descriptive study including all children (age 0 to 15 years) who have been hospitalized in the year 2010 for head injury in our department.

A total of 191 children (131 boys and 60 girls) with a mean age of 5, 94 years were managed. The causes of head injury were: domestic accidents in 65, 9% of cases, accident of public roads in 32, 5% of cases and aggression in 3 cases. Head injuries were benign in 83, 4% of cases, moderate in 8, 9% of cases and severe in 3, 7% of cases. 188 patients were explored by CT scan that objectified an elementary lesion in 63, 3% of cases. In major cases, treatment consisted in saline infusion, oxygenation and neurological monitoring. Intubation and mechanical ventilation was necessary in only 11 cases (5, 76%). Evolution was satisfactory in 96% of cases. Five patients died in our series and tow had major neurological sequelae.

Conclusion: Head trauma is common in children especially in males. Although most of them are benign, it may in some cases be responsible for major neurological sequelae.