Publications by authors named "Siba Paul"

In January 2020, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) updated its guidelines for the diagnosis of paediatric coeliac disease. The revised ESPGHAN guidelines offer a more streamlined approach to diagnostic pathways for the detection of this disease in children. This article provides an update for clinicians on how to diagnose and manage coeliac disease in children based on the revised guidelines and other available literature.

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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.

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Bicycle handlebar injuries are the commonest cause of pancreatic trauma in children and adolescents, especially in males. Recognition of such injuries and initiation of correct treatment may be delayed when there is no abdominal wall bruising. We present a case of a 6-year boy with severe pancreatic trauma, who was referred from a local hospital following bicycle handlebar injury five days earlier.

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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.

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Objective: European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines on coeliac disease (CD) recommend that children who have IgA-based antitissue transglutaminase (TGA-IgA) titre ≥10× upper limit of normal (ULN) and positive antiendomysial antibody, can be reliably diagnosed with CD via the no-biopsy pathway. The aim of this study was to examine the relationship between TGA-IgA ≥5×ULN and histologically confirmed diagnosis of CD.

Methods: Data including TGA-IgA levels at upper gastrointestinal endoscopy and histological findings from children diagnosed with CD following endoscopy from 2006 to 2021 were analysed.

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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.

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Abdominal X-rays (AXRs) are often used as an imaging modality in children who present with abdominal pain with a suspected serious underlying pathology. Nausea, vomiting and constipation that are unresponsive to treatment may also prompt a request for an AXR in a child. Nurses play an important role in ensuring that requests for AXRs in children are appropriate and that the procedure is performed safely.

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Coeliac disease (CD) is an autoimmune gluten-dependent condition with a prevalence of 1% in the population, if screened. However, approximately only a third of children with CD are diagnosed. When CD is suspected, serological screening with anti-tissue transglutaminase titres should be performed.

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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.

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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.

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Abdominal X-rays (AXRs) are one of the most common imaging modalities used to investigate suspected abdominal conditions in neonates. They are frequently requested for a variety of suspected conditions including necrotising enterocolitis, congenital diaphragmatic hernia, duodenal atresia and Hirschsprung's disease. Nurses play an important role in preparing and supporting neonates who are undergoing an AXR, and in some centres advanced neonatal nurse practitioners may be involved in requesting and interpreting AXRs as part of their enhanced role in patient management.

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Objectives: The 2012 European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines on celiac disease (CD) recommended a no-biopsy pathway (NBP) for symptomatic children with high immunoglobin A (IgA)-based anti-tissue transglutaminase (TGA-IgA) titers, positive anti-endomysial antibody and human leukocyte antigen (HLA)-DQ2/DQ8 status. We aimed to understand variations in practice amongst specialist pediatric gastroenterology centers (SPGIC) in the United Kingdom (UK).

Methods: A survey questionnaire was sent to all UK SPGIC (n = 29) providing endoscopy services for CD diagnosis.

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