The unprecedented scale of the coronavirus disease 2019 (COVID-19) pandemic has indeed brought about tremendous ramifications on the state of mental health for children. One notable aspect deserving emphasis however, is the psychological impact in children as a result of the purported surge of domestic violence (DV) in many of the countries that imposed stay-at-home requirement. The imposition of movement restriction policy led to isolation and overcrowding, made worse by loss of income in some instances, causing high levels of stress and anxiety, thereby increasing the risk of DV and child abuse particularly those already living within violent or dysfunctional families. Children exposed to DV have higher risk of developmental delay and behavioural problems, more likely to suffer from post-traumatic symptoms, depression and anxiety, reduced cognitive functioning and social competence. Additionally, these children tend to have poorer academic performance and are more likely to engage in violent or abusive relationship later in life. Health care providers need to be vigilant and actively screen and identify children or families that are affected by DV to protect their physical and mental health well-being.
The discovery of a solitary pulmonary nodule (SPN) on chest imaging can be alarming for both the clinician and the patient. In the absence of a uniform guideline, managing SPN is nothing short of challenging for primary care physicians (PCPs). We present a case here of a patient presenting with prolonged cough who also displayed unilateral SPN on her chest radiograph. Through further examination, this presence was later shown to be a nipple shadow simulating SPN, and the patient was spared unnecessary testing and psychological distress.
Children with musculoskeletal symptoms are commonly seen by general practitioners (GPs). Those that present with atraumatic limp pose a particular diagnostic challenge. Although uncommon, Perthes disease (PD) is an important cause of atraumatic limp in children and may result in debilitating consequences if missed. We put forward a case of delayed diagnosis of PD in a child, thus highlighting the need for a greater index of suspicion among GPs in approaching any child with a limp.
Juvenile recurrent respiratory papillomatosis (JRRP) is a rare condition. The varied presentation of this condition predisposes to misdiagnosis and potential life-threatening airway obstruction. In this paper, we have reported a case of JRRP presenting as severe respiratory distress and consequently mistreated as asthmatic attack culminating in a near fatal acute airway obstruction.