Global Pediatric Health最新文献

Background. Child abuse in Suriname has a prevalence between 58.2% and 68.8%. This prospective observational study evaluates the implementation of screening for child abuse at the Emergency Department (ED) of the Academic Hospital Paramaribo (AZP). Methods. Children (0-16 years) presenting with injury from 01-02-2018 until 31-08-2018 were eligible. Case-record-forms were completed. Multidisciplinary meetings were used to evaluate positive screened and admitted patients. Diagnostic accuracy was calculated and results were compared to retrospective data from 2016. Results. 3253 Children attended the ED. In 1190 (36.6%) children, the screening was completed. The screening was positive in 148 (12%); in 71 (6%) cases child abuse was confirmed. The sensitivity and specificity were 0.88 and 0.92 respectively, PPV 0.43, NPV 0.99. There was a significant increase of detected child abuse cases; 4.4% in 2016 versus 6% in 2018 (P = .04). Conclusion. Implementation of screening at the ED in the AZP increased detection of child abuse. To improve screening's accuracy, more education for healthcare professionals is pivotal.

Objective. To describe heated humidified high-flow nasal cannulas (HHHFNC) utilization in level III neonatal intensive care units (NICUs) in Saudi Arabia. Methods. A prospective cross-sectional study using an electronic web-based questionnaire. The survey targeted level III NICUs hospitals using HHHFNCs, covering HHHFNC availability, protocols, patient characteristics, and indications. It also collected opinions on the benefits of HHHFNCs compared to nasal continuous positive airway pressure (nCPAP). Results. Out of 47 government-level III neonatal intensive care units, 35 (74%) responded to the survey. Among the included units, 46% had guidelines for HHHFNC use. Additionally, 51% reported using HHHFNC in infants of all gestational ages. The primary indication for HHHFNC use was weaning off nCPAP (34%), with 60% of the respondents noting its advantages for kangaroo care and breastfeeding. Conclusion. HHHFNC are increasingly prevalent in NICUs in Saudi Arabia. However, there remain no clear policies or guidelines regarding their use in preterm infants.

Objectives. The Brief Reason for Living Inventory for Adolescents (BRFL-A) is used to assess protective factors against suicide in non-clinical settings. This study aimed to validate the psychometric properties of BRFL-A in Bahasa Indonesia. Methods. A total of 728 high-school and university students filled BRFL-A questionnaire and the results were analyzed. The reliability, content, convergent, discriminant, and factorial or construct validity, were investigated using content validity index Cronbach's Alpha, while content validity index (CVI), confirmatory factor analysis, and Pearson product-moment correlation were assesed with MSPSS, SIS, INQ-15, and DASS-18. Results. The results showed that the Indonesian version of BRFL-A had good internal consistency, test-retest reliability, as well as content and concurrent validity, supporting both the 1-factor and the 5-factor model of factorial validity. Conclusions. The Indonesian version of the BRFL-A was valid and reliable to measure protective factors against suicide risk among adolescents and young adults in non-clinical settings.

Fibrous dysplasia is a rare non-hereditary congenital condition characterized by 2 main forms: monostotic and polyostotic. Monostotic is the more common form, while polyostotic, often associated with a syndrome, is rarer. The case presented involves a 10-year-old patient who was diagnosed with polyostotic fibrous dysplasia accompanied by an endocrinopathy. This report explores the clinical and radiological aspects of this condition based on the patient's case.

Objective. This study aimed to evaluate allergic diseases in pediatric patients with SLE and their association with SLE disease activity. Method. Patients with SLE aged ≤18 years were enrolled. Allergic diseases were screened using the International Study of Asthma and Allergies in Childhood questionnaire. Patients with a positive allergic disease screen were evaluated by a pediatric allergist for diagnostic confirmation and severity assessment. Results. Out of 118 patients, 16 patients (13.56%) were confirmed to have 1 or more allergic diseases; fourteen with allergic rhinitis, 4 with asthma, and 2 with atopic dermatitis. Two patients had severe-persistent allergic rhinitis and one patient had undiagnosed, uncontrolled severe asthma. No statistically significant correlations between the severity of allergic diseases and SLE disease activity were identified. Conclusions. The overall prevalence of allergic disease among pediatric patients with SLE is within the range of the general population. Severe and undiagnosed allergic diseases and SLE can coexist.

Background. Autoimmune hepatitis (AIH) is increasingly seen in children worldwide and it is more severe in children compared to adults. This study highlights the biochemical and clinical aspect, treatment given and outcome of the disease including pediatric liver transplantation. Study. Retrospective review (2012-2022) was done in Shifa International Hospital, Islamabad. Patients under 18 years diagnosed with AIH were included. Data related to age, gender, clinical features, laboratory investigations including liver function test, liver biopsy findings and imaging modalities were included. Results. Fifteen patients were included 7 (47%) were males and 8 (53%) females. AIH type 1 was the most common type seen in 7 (46%), AIH type 2 in 5 (33%) and seronegative in 3 (20%). Jaundice was the most common symptom. Liver biopsy showed findings characteristic of AIH. Liver transplant performed in 3 patients. Conclusion. The study highlights the varied clinical presentation of AIH in Pakistani children.

Objectives. Preterm infants are at risk of hypothermia. This study described the available infant warming devices (IWDs) and explored the barriers and facilitators to their implementation in neonates in Malawi. Methods. A qualitative descriptive study was conducted among 19 health care workers in Malawi from January to March 2020. All interviews were digitally recorded, transcribed, and managed using NVivo and analyzed using a thematic approach. Results. The warming devices included radiant warmers, Blantyre hot-cots, wall-mounted heaters, portable warmers, and incubators. Inadequate equipment and infrastructure and gaps in staff knowledge and capacity were reported as the main challenges to optimal IWD implementation. Caregiver acceptance was described as the main facilitator. Strategies to optimize implementation of IWD included continuous practical training and adequate availability of equipment and spare parts. Conclusion. Implementation of warming devices for the management of neonatal hypothermia is effective when there are adequate human and material resources.

Objective. Commonly recommended drugs for adults and children include proton pump inhibitors (PPIs), proven effective for treating peptic diseases like stomach ulcers, GERD, and Helicobacter pylori infections in children over 1-year-old. Yet, prolonged PPI use carries higher risks of adverse reactions, prompting this study's analysis. Methods. We have performed a systematic review of 30 articles, which include a total of 762 505 pediatric patients. Results. Adverse effects were encountered in 6.98% of the population. The 5 most common adverse effects were respiratory tract complications, gastrointestinal complications, urinary tract infections, asthma, and ENT infections. Conclusion. Hence, PPIs should be prescribed only when necessary, and physicians should prioritize patient education when considering their use.

Introduction. School environments may impact elementary school students' attachment levels to school as well as their mental and emotional well-being. Yet investments in recess/play infrastructure lag commitments to academic resources, particularly in developing countries. The main objective was to examine the impact of installing playground equipment, in the school yard, on students' attitudes toward school, peers, and the capacity to play of elementary-school children in an underserved, inner-city school in Chennai, India. Methods. A previously validated school attachment questionnaire was modified and administered to 140 and 148 students in pre- and post-playground installation, respectively. Results. For 7 out of 13 survey questions, student attitudes about their own recreational time and their attitudes toward peers significantly improved after playground installation. Conclusion. These results highlight the need for investments in play spaces, and recreational equipment may be just as important as addressing academic needs, especially among underserved children.