Publications by authors named "Rashmi d'Souza"
Objective: To evaluate medium-term self-reported respiratory and gastrointestinal (GI) outcomes in children with congenital diaphragmatic hernia (CDH).
Design: Self-reported respiratory and GI outcomes correlated with prenatal severity indicators.
Setting: Prospective study at three fetal medicine units.
Aims: Controversy persists regarding operative strategy for necrotising enterocolitis (NEC). Some surgeons advocate resecting all necrotic bowel, whilst others defunction with a stoma, leaving diseased bowel in situ to preserve bowel length. We reviewed our institutional experience of both approaches.
View Article and Find Full Text PDFObjectives: To evaluate the usefulness and effectiveness of a new structured education module for children with type 1 diabetes: S E R E N (SEREN) 'Diabetes at Diagnosis'.
Design: Retrospective questionnaire-based service evaluation.
Setting: 12/14 paediatric diabetes centres across Wales took part.
Purpose: Recurrence of congenital diaphragmatic hernia (CDH) was retrospectively evaluated after correction with or without a patch in an institution where tension-free repair is advocated.
Methods: Demographics and outcomes of patients with a postero-lateral CDH repaired (2000-2016) were analyzed (univariate tests and binary logistic regression adjusting for time since start of study, gender, defect side, liver herniation, patch, surgical approach, absence of postero-lateral rim and length of follow-up).
Results: Of 203 patients, 107 received a patch (P), and 96 were not patched (NP).
Article Synopsis
- Acute-on-chronic liver failure (ACLF) in children with biliary atresia (BA) significantly increases the risk of mortality and complications while awaiting liver transplantation (LT).
- In a study of 99 children, 20 developed ACLF, which was linked to a higher death rate (20% vs. 4%) and common issues like sepsis and gastrointestinal bleeding.
- The findings suggest that early identification of patients at risk for ACLF, particularly those with high bilirubin levels post-surgery, is crucial for optimizing wait-list management and prioritizing transplantation.
Long-term graft fibrosis occurs in the majority of pediatric liver transplant recipients. Serial biopsies to monitor graft health are impractical and invasive. The APRI has been evaluated in pediatric liver disease, but not in the context of post-transplantation fibrosis.
View Article and Find Full Text PDF