Pub Date : 2025-11-28DOI: 10.1016/j.gpeds.2025.100306
Hanan Fadhil Alautry , Hadi Ghasemi , Mohammad Hossein Khoshnevisan , Mahshid Namdari
Objective
This study aimed to evaluate the cost-effectiveness of fluoride varnish application on the occurrence of dental caries in permanent teeth among 8-10-year-old children in Iraq.
Methods
: The effectiveness and cost were determined from a cluster randomized controlled trial in 372 schoolchildren, 186 in each group. At the beginning of the study, subjects in the intervention group received oral health education (OHE) and a single dose of 5 % sodium fluoride varnish for all teeth surfaces, while the control group only received oral health education. In this study, the economic analysis was considered from the public payer perspective, only the direct costs were considered which included human resources and supplies of varnish application. Incremental cost-effectiveness ratios (ICERs) were calculated to provide an estimate of the mean cost per additional unit of outcome. An independent t-test was used to compare the mean scores of caries increment between the two groups.
Results
The study participants consisted of 372 children with no significant difference in baseline characteristics between the intervention and control groups. The DMFS and DMFT increments at the six-month follow-up for the intervention group were 0.2 and 0.1, respectively, while for the control group were 0.8 and 0.5, respectively. The average cost per child in the intervention group was $4.00 and $1.70 for the control group. The ICER was 0.28 for preventing each tooth from being filled in the intervention group.
Conclusion
School-based oral health programs that include fluoride varnish application with OHE were slightly more costly but cost-effective in dental caries prevention compared with OHE alone.
{"title":"Cost-effectiveness analysis of fluoride varnish for preventing dental caries in Iraqi schoolchildren: A cluster-randomized controlled trial","authors":"Hanan Fadhil Alautry , Hadi Ghasemi , Mohammad Hossein Khoshnevisan , Mahshid Namdari","doi":"10.1016/j.gpeds.2025.100306","DOIUrl":"10.1016/j.gpeds.2025.100306","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the cost-effectiveness of fluoride varnish application on the occurrence of dental caries in permanent teeth among 8-10-year-old children in Iraq.</div></div><div><h3>Methods</h3><div><strong>:</strong> The effectiveness and cost were determined from a cluster randomized controlled trial in 372 schoolchildren, 186 in each group. At the beginning of the study, subjects in the intervention group received oral health education (OHE) and a single dose of 5 % sodium fluoride varnish for all teeth surfaces, while the control group only received oral health education. In this study, the economic analysis was considered from the public payer perspective, only the direct costs were considered which included human resources and supplies of varnish application. Incremental cost-effectiveness ratios (ICERs) were calculated to provide an estimate of the mean cost per additional unit of outcome. An independent t-test was used to compare the mean scores of caries increment between the two groups.</div></div><div><h3>Results</h3><div>The study participants consisted of 372 children with no significant difference in baseline characteristics between the intervention and control groups. The DMFS and DMFT increments at the six-month follow-up for the intervention group were 0.2 and 0.1, respectively, while for the control group were 0.8 and 0.5, respectively. The average cost per child in the intervention group was $4.00 and $1.70 for the control group. The ICER was 0.28 for preventing each tooth from being filled in the intervention group.</div></div><div><h3>Conclusion</h3><div>School-based oral health programs that include fluoride varnish application with OHE were slightly more costly but cost-effective in dental caries prevention compared with OHE alone.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"15 ","pages":"Article 100306"},"PeriodicalIF":0.0,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-25DOI: 10.1016/j.gpeds.2025.100304
Amna Minhas , Georgi Mladenov , Joyce McRae , Arsalan Javid , Rosemary Vannix , Andrew Hopper , Nicole Kraus , Andrei Radulescu
Purpose
Necrotizing enterocolitis (NEC) is a severe gastrointestinal emergency in preterm infants, often associated with respiratory compromise. We evaluated the association between respiratory support requirements at NEC diagnosis and time to surgery in very low birth weight (VLBW) infants with surgical NEC.
Methods
A retrospective review of VLBW, preterm neonates (< 1500 grams and <34 weeks gestational age) with surgical NEC from January 2010 till December 2019 was conducted at an academic tertiary care center. Respiratory parameters were recorded after NEC onset. Time to the operating room (OR) was defined as median duration (hours) from diagnosis to surgery. High respiratory support group was defined as patients on invasive respiratory support.
Results
Sixteen neonates were included. Mean gestational age and age at diagnosis were 26.9 ± 2.9 weeks and 18.9 ± 12.3 days, respectively. Average birth weight was 951 ± 338 grams. Infants in the high respiratory support group (n = 10) had a shorter median time to OR (28 vs 229 h, p = 0.2), with respiratory acidosis significantly more prevalent in this group (90 % vs. 33 %, p = 0.03). These infants had longer hospital stays (159 vs. 73 days, p = 0.2) and a higher likelihood of multiple surgeries (80 % vs. 50 %, p = 0.3). Mortality was higher in neonates with low respiratory requirements, though this difference did not reach statistical significance (50 % vs. 20 %, p = 0.3).
Conclusion
Higher respiratory support requirements at NEC diagnosis were linked to earlier surgical intervention, greater disease severity, and prolonged hospitalization. While limited by small sample size, our findings suggest that worsening respiratory status may serve as an early, objective marker of clinical deterioration, warranting closer monitoring and potentially expediting surgical decision-making in very low birth weight infants.
{"title":"Timing of surgery in NEC: Do respiratory requirements influence time to operating room?","authors":"Amna Minhas , Georgi Mladenov , Joyce McRae , Arsalan Javid , Rosemary Vannix , Andrew Hopper , Nicole Kraus , Andrei Radulescu","doi":"10.1016/j.gpeds.2025.100304","DOIUrl":"10.1016/j.gpeds.2025.100304","url":null,"abstract":"<div><h3>Purpose</h3><div>Necrotizing enterocolitis (NEC) is a severe gastrointestinal emergency in preterm infants, often associated with respiratory compromise. We evaluated the association between respiratory support requirements at NEC diagnosis and time to surgery in very low birth weight (VLBW) infants with surgical NEC.</div></div><div><h3>Methods</h3><div>A retrospective review of VLBW, preterm neonates (< 1500 grams and <34 weeks gestational age) with surgical NEC from January 2010 till December 2019 was conducted at an academic tertiary care center. Respiratory parameters were recorded after NEC onset. Time to the operating room (OR) was defined as median duration (hours) from diagnosis to surgery. High respiratory support group was defined as patients on invasive respiratory support.</div></div><div><h3>Results</h3><div>Sixteen neonates were included. Mean gestational age and age at diagnosis were 26.9 ± 2.9 weeks and 18.9 ± 12.3 days, respectively. Average birth weight was 951 ± 338 grams. Infants in the high respiratory support group (<em>n</em> = 10) had a shorter median time to OR (28 vs 229 h, <em>p</em> = 0.2), with respiratory acidosis significantly more prevalent in this group (90 % vs. 33 %, <em>p</em> = 0.03). These infants had longer hospital stays (159 vs. 73 days, <em>p</em> = 0.2) and a higher likelihood of multiple surgeries (80 % vs. 50 %, <em>p</em> = 0.3). Mortality was higher in neonates with low respiratory requirements, though this difference did not reach statistical significance (50 % vs. 20 %, <em>p</em> = 0.3).</div></div><div><h3>Conclusion</h3><div>Higher respiratory support requirements at NEC diagnosis were linked to earlier surgical intervention, greater disease severity, and prolonged hospitalization. While limited by small sample size, our findings suggest that worsening respiratory status may serve as an early, objective marker of clinical deterioration, warranting closer monitoring and potentially expediting surgical decision-making in very low birth weight infants.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"15 ","pages":"Article 100304"},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
An unusual disorder seen in newborns with natal or neonatal teeth is traumatic ulceration of the ventral surface of the tongue (Riga-Fede disease). During physiological actions like sucking and swallowing, the tongue and natal or neonatal teeth come into constant contact, causing these lesions and worsening them. This can interfere with appropriate eating, placing the newborn at risk for nutritional deficiencies.
Case presentation
We present a case of a 25-day-old infant presented with pain and ulceration on ventral surface of tongue caused due to trauma by natal tooth. Clinical examination revealed a solitary ulcerative lesion on the ventral surface of the tongue measuring 5 × 8 mm. Due to increased mobility of natal tooth, extraction of tooth was performed followed by regular monitoring of the patient.
Conclusion
Infants with prematurely erupted teeth should undergo thorough examination to enable early diagnosis and appropriate treatment. When the baby is unable to breastfeed or devoid of any nutrition because of Riga-Fede disease, or when the teeth are poorly implanted which poses a risk of aspiration, extraction is the only way out to avoid further complication.
{"title":"Riga-Fede disease in an infant: Clinical challenges and management strategies in resource limited setting- a case report","authors":"Bikal Ghimire , Nabina Miya , Samir Bhandari , Prabin Pokhrel","doi":"10.1016/j.gpeds.2025.100303","DOIUrl":"10.1016/j.gpeds.2025.100303","url":null,"abstract":"<div><h3>Introduction</h3><div>An unusual disorder seen in newborns with natal or neonatal teeth is traumatic ulceration of the ventral surface of the tongue (Riga-Fede disease). During physiological actions like sucking and swallowing, the tongue and natal or neonatal teeth come into constant contact, causing these lesions and worsening them. This can interfere with appropriate eating, placing the newborn at risk for nutritional deficiencies.</div></div><div><h3>Case presentation</h3><div>We present a case of a 25-day-old infant presented with pain and ulceration on ventral surface of tongue caused due to trauma by natal tooth. Clinical examination revealed a solitary ulcerative lesion on the ventral surface of the tongue measuring 5 × 8 mm. Due to increased mobility of natal tooth, extraction of tooth was performed followed by regular monitoring of the patient.</div></div><div><h3>Conclusion</h3><div>Infants with prematurely erupted teeth should undergo thorough examination to enable early diagnosis and appropriate treatment. When the baby is unable to breastfeed or devoid of any nutrition because of Riga-Fede disease, or when the teeth are poorly implanted which poses a risk of aspiration, extraction is the only way out to avoid further complication.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"15 ","pages":"Article 100303"},"PeriodicalIF":0.0,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neonatal hypoxic-ischaemic encephalopathy (HIE), characterized by significant brain and multi-organ dysfunction, accounts for a substantial portion of neonatal mortality and morbidity among survivors. Therapeutic hypothermia (TH) has demonstrated promising efficacy in reducing both disability and mortality in affected neonates, but studies from low- and middle-income countries have reported variable outcomes. This case series presents the real-world experience of implementing therapeutic hypothermia in resource-limited settings.
Methods
Ten neonates with moderate to severe hypoxic-ischemic encephalopathy (HIE) who met the criteria for therapeutic hypothermia underwent whole-body cooling using gel packs with servo-controlled heating at a level 4 private tertiary care hospital in Dar es Salaam, Tanzania. Core body temperature was continuously monitored via a rectal probe and maintained between 33.5 °C and 34.5 °C.
Results
Temperatures were effectively maintained within the target range, with a mean of 33.5 ± 0.7 °C, and no adverse events were observed.
The overall mortality rate was 50 % (5/10). All neonates with severe HIE (5/5) died, whereas all those with moderate HIE (5/5) survived; two survivors exhibited no residual neurological deficits at one year of age. All neonates with a base excess (BE) greater than –20, a Thompson score ≥ 15 within the first six hours, and an abnormal middle cerebral artery resistive index did not survive.
Conclusion
TH implementation using gel packs and servo-control is feasible. Neonates with severe HIE require careful selection for TH, as cooling these neonates in a resource-constrained setting may increase the overall resource burden.
{"title":"Who to cool? A case series on therapeutic hypothermia following perinatal asphyxia from a private hospital in Tanzania","authors":"Rukhsar Osman , Elisamia Ngowi , Amri Kyaruzi Ishengoma , Aleya Remtulla , Yaser Abdallah","doi":"10.1016/j.gpeds.2025.100302","DOIUrl":"10.1016/j.gpeds.2025.100302","url":null,"abstract":"<div><h3>Background</h3><div>Neonatal hypoxic-ischaemic encephalopathy (HIE), characterized by significant brain and multi-organ dysfunction, accounts for a substantial portion of neonatal mortality and morbidity among survivors. Therapeutic hypothermia (TH) has demonstrated promising efficacy in reducing both disability and mortality in affected neonates, but studies from low- and middle-income countries have reported variable outcomes. This case series presents the real-world experience of implementing therapeutic hypothermia in resource-limited settings.</div></div><div><h3>Methods</h3><div>Ten neonates with moderate to severe hypoxic-ischemic encephalopathy (HIE) who met the criteria for therapeutic hypothermia underwent whole-body cooling using gel packs with servo-controlled heating at a level 4 private tertiary care hospital in Dar es Salaam, Tanzania. Core body temperature was continuously monitored via a rectal probe and maintained between 33.5 °C and 34.5 °C.</div></div><div><h3>Results</h3><div>Temperatures were effectively maintained within the target range, with a mean of 33.5 ± 0.7 °C, and no adverse events were observed.</div><div>The overall mortality rate was 50 % (5/10). All neonates with severe HIE (5/5) died, whereas all those with moderate HIE (5/5) survived; two survivors exhibited no residual neurological deficits at one year of age. All neonates with a base excess (BE) greater than –20, a Thompson score ≥ 15 within the first six hours, and an abnormal middle cerebral artery resistive index did not survive.</div></div><div><h3>Conclusion</h3><div>TH implementation using gel packs and servo-control is feasible. Neonates with severe HIE require careful selection for TH, as cooling these neonates in a resource-constrained setting may increase the overall resource burden.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"15 ","pages":"Article 100302"},"PeriodicalIF":0.0,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145600533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Scorpion envenomation represents a significant public health challenge in Morocco and North Africa due to the severe complications it can cause. Among these, cardiogenic shock is particularly feared. This study focuses on the use of the non-invasive cardiac output monitor ICON to understand the hemodynamic profile of children admitted to pediatric intensive care for scorpion envenomation complicated by cardiogenic shock.
Methods
We conducted a prospective study in the pediatric intensive care unit at Mohammed VI University Hospital in Marrakech. Children aged 0 to 16 years admitted for scorpion envenomation were included. Using the ICON device, we measured several hemodynamic parameters upon admission and two hours after treatment. The children were divided into two groups: those who had received dobutamine prior to admission and those who received it upon admission.
Results
Out of 30 initially considered patients, only 8 were analyzed. The average age was 9.5 years. The results showed a significant improvement in hemodynamic parameters after the administration of dobutamine, including an increase in cardiac output and a reduction in vascular resistance.
Conclusion
The conclusions of this study highlight the potential of the ICON monitor to improve the management of children in cardiogenic shock due to scorpion envenomation. The adoption of non-invasive techniques could transform the treatment and prognosis of these patients. However, further research with a larger sample size is needed to strengthen these findings.
{"title":"Hemodynamic assessment of pediatric scorpion envenomation using the non-invasive cardiac output monitor (ICON)","authors":"Manal Merbouh , Houssam Eddine Sarhaoui , Ennour idrissi iliass , Youssef Mouaffak , Said Younous","doi":"10.1016/j.gpeds.2025.100300","DOIUrl":"10.1016/j.gpeds.2025.100300","url":null,"abstract":"<div><h3>Introduction</h3><div>Scorpion envenomation represents a significant public health challenge in Morocco and North Africa due to the severe complications it can cause. Among these, cardiogenic shock is particularly feared. This study focuses on the use of the non-invasive cardiac output monitor ICON to understand the hemodynamic profile of children admitted to pediatric intensive care for scorpion envenomation complicated by cardiogenic shock.</div></div><div><h3>Methods</h3><div>We conducted a prospective study in the pediatric intensive care unit at Mohammed VI University Hospital in Marrakech. Children aged 0 to 16 years admitted for scorpion envenomation were included. Using the ICON device, we measured several hemodynamic parameters upon admission and two hours after treatment. The children were divided into two groups: those who had received dobutamine prior to admission and those who received it upon admission.</div></div><div><h3>Results</h3><div>Out of 30 initially considered patients, only 8 were analyzed. The average age was 9.5 years. The results showed a significant improvement in hemodynamic parameters after the administration of dobutamine, including an increase in cardiac output and a reduction in vascular resistance.</div></div><div><h3>Conclusion</h3><div>The conclusions of this study highlight the potential of the ICON monitor to improve the management of children in cardiogenic shock due to scorpion envenomation. The adoption of non-invasive techniques could transform the treatment and prognosis of these patients. However, further research with a larger sample size is needed to strengthen these findings.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"14 ","pages":"Article 100300"},"PeriodicalIF":0.0,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-04DOI: 10.1016/j.gpeds.2025.100298
Shaina P. Brady , Peter C. Rockers , Denise Evans , Lezanie Coetzee , Diana C. Lopera-Perez , Günther Fink , Davidson H. Hamer , Aisha K. Yousafzai , Amanda R. Tarullo
Early neural development underlies fundamental behavioral outcomes. In low- and middle-income countries (LMICs), healthy development is often perturbed by compounded adversities, yet little is known about the neural mechanisms driving these trajectories. The current study explores the relationship between infant EEG power and early childhood developmental outcomes at two timepoints in the Greater Tzaneen subdistrict, Mopani district, Limpopo Province, South Africa. In a sample of 242 children, we assessed how EEG relative power at seven months related to development at 17 and 36 months. Increased left hemisphere theta band activity (4–6 Hz) predicted lower caregiver-reported language and motor skills, and increased left hemisphere beta activity (13–30 Hz) predicted reported motor skills at 17 months. Increased infant gamma power (30–48 Hz) in the left hemisphere was associated with higher observed language and gross motor skills at 36 months. Results suggest that early neural oscillations have small but consistent associations with later language and motor skills in a LMIC context.
{"title":"Infant EEG power predicts early childhood language and motor skills in a rural South African cohort","authors":"Shaina P. Brady , Peter C. Rockers , Denise Evans , Lezanie Coetzee , Diana C. Lopera-Perez , Günther Fink , Davidson H. Hamer , Aisha K. Yousafzai , Amanda R. Tarullo","doi":"10.1016/j.gpeds.2025.100298","DOIUrl":"10.1016/j.gpeds.2025.100298","url":null,"abstract":"<div><div>Early neural development underlies fundamental behavioral outcomes. In low- and middle-income countries (LMICs), healthy development is often perturbed by compounded adversities, yet little is known about the neural mechanisms driving these trajectories. The current study explores the relationship between infant EEG power and early childhood developmental outcomes at two timepoints in the Greater Tzaneen subdistrict, Mopani district, Limpopo Province, South Africa. In a sample of 242 children, we assessed how EEG relative power at seven months related to development at 17 and 36 months. Increased left hemisphere theta band activity (4–6 Hz) predicted lower caregiver-reported language and motor skills, and increased left hemisphere beta activity (13–30 Hz) predicted reported motor skills at 17 months. Increased infant gamma power (30–48 Hz) in the left hemisphere was associated with higher observed language and gross motor skills at 36 months. Results suggest that early neural oscillations have small but consistent associations with later language and motor skills in a LMIC context.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"14 ","pages":"Article 100298"},"PeriodicalIF":0.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain in children is a commonly unaddressed, neglected, and undertreated issue. This study aims to assess pain, the clinical profile associated with pain, and pain management practices in children.
Methodology
A hospital-based cross-sectional study was conducted in the Pediatric ward from March 20 to June 30, 2020. A total of 238 children were selected using a stratified sampling method. Pain was assessed through history (guardian/patient report), the FLACC scale (for infants and young children), and a numerical pain scale for older children. Data were analyzed using SPSS, with statistical significance considered at p-value < 0.05.
Results
All 238 patients were enrolled in the study. The mean age of the study subjects was 6.6 ± 5.5 years. The severity of pain was assessed at the time of admission, during the hospital stay, and at discharge. The overall pain prevalence, as reported by caregivers and patients, was 67.6 %. Based on different pain assessment tools for various age groups, the magnitude of pain was 64.3 % at admission, 55.9 % during the hospital stay, and 26.5 % at discharge. Multivariable regression showed that age, area of residency, and diagnosis were significantly associated with pain. Eighty-four children (39.3 %, 84/214) who were in pain did not receive any pain relief. Paracetamol was used as an analgesic in 31.8 % of patients, and >50 % of paracetamol doses were administered as needed.
Conclusion
Pain remains a prevalent problem at admission and during the hospital stay. A significant number of patients were not properly assessed or treated for pain.
{"title":"Assessment of pain and pain management practices in hospitalized children in Ayder, Tigray, Ethiopia","authors":"Hansa Haftu Lemma, Afewerk Salih, Amanuel Hadgu, Dawit Seyum, Goitom Gebrekidan","doi":"10.1016/j.gpeds.2025.100296","DOIUrl":"10.1016/j.gpeds.2025.100296","url":null,"abstract":"<div><h3>Background</h3><div>Pain in children is a commonly unaddressed, neglected, and undertreated issue. This study aims to assess pain, the clinical profile associated with pain, and pain management practices in children.</div></div><div><h3>Methodology</h3><div>A hospital-based cross-sectional study was conducted in the Pediatric ward from March 20 to June 30, 2020. A total of 238 children were selected using a stratified sampling method. Pain was assessed through history (guardian/patient report), the FLACC scale (for infants and young children), and a numerical pain scale for older children. Data were analyzed using SPSS, with statistical significance considered at p-value < 0.05.</div></div><div><h3>Results</h3><div>All 238 patients were enrolled in the study. The mean age of the study subjects was 6.6 ± 5.5 years. The severity of pain was assessed at the time of admission, during the hospital stay, and at discharge. The overall pain prevalence, as reported by caregivers and patients, was 67.6 %. Based on different pain assessment tools for various age groups, the magnitude of pain was 64.3 % at admission, 55.9 % during the hospital stay, and 26.5 % at discharge. Multivariable regression showed that age, area of residency, and diagnosis were significantly associated with pain. Eighty-four children (39.3 %, 84/214) who were in pain did not receive any pain relief. Paracetamol was used as an analgesic in 31.8 % of patients, and >50 % of paracetamol doses were administered as needed.</div></div><div><h3>Conclusion</h3><div>Pain remains a prevalent problem at admission and during the hospital stay. A significant number of patients were not properly assessed or treated for pain.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"14 ","pages":"Article 100296"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-13DOI: 10.1016/j.gpeds.2025.100295
Mariagiovanna Di Chiano , Emanuela Calò
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and social interaction across multiple contexts, as well as restricted, repetitive, and stereotyped patterns of behaviour, interests, or activities. In this context, individuals often exhibit behavioural alterations and frequent gastrointestinal disturbances, which are often associated with gut dysbiosis.
In recent years, interest in prebiotics as modulators of the gut microbiota has grown significantly, as these compounds promote the growth of beneficial bacteria and the production of metabolites with potential neuroprotective effects.
This review summarizes the main preclinical and clinical evidence on the use of prebiotics in the context of ASD, describing the biological mechanisms underlying their potential therapeutic effects.
Several studies suggest that supplementation with prebiotics, such as galacto-oligosaccharides and fructo-oligosaccharides, may improve both gastrointestinal symptoms and certain behavioral aspects in individuals with ASD. These effects are thought to be mediated through modulation of the microbiota, reduction of inflammation, and regulation of the gut–brain–microbiota axis.
However, the literature highlights significant methodological heterogeneity and inconsistent findings, underscoring the need for more rigorous and standardized studies.
In conclusion, prebiotics represent a promising complementary therapeutic strategy in ASD, but further research is needed to precisely determine their efficacy, safety, and optimal use.
{"title":"Infuence of prebiotics on childhood autism: Evidences and implications","authors":"Mariagiovanna Di Chiano , Emanuela Calò","doi":"10.1016/j.gpeds.2025.100295","DOIUrl":"10.1016/j.gpeds.2025.100295","url":null,"abstract":"<div><div>Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and social interaction across multiple contexts, as well as restricted, repetitive, and stereotyped patterns of behaviour, interests, or activities. In this context, individuals often exhibit behavioural alterations and frequent gastrointestinal disturbances, which are often associated with gut dysbiosis.</div><div>In recent years, interest in prebiotics as modulators of the gut microbiota has grown significantly, as these compounds promote the growth of beneficial bacteria and the production of metabolites with potential neuroprotective effects.</div><div>This review summarizes the main preclinical and clinical evidence on the use of prebiotics in the context of ASD, describing the biological mechanisms underlying their potential therapeutic effects.</div><div>Several studies suggest that supplementation with prebiotics, such as galacto-oligosaccharides and fructo-oligosaccharides, may improve both gastrointestinal symptoms and certain behavioral aspects in individuals with ASD. These effects are thought to be mediated through modulation of the microbiota, reduction of inflammation, and regulation of the gut–brain–microbiota axis.</div><div>However, the literature highlights significant methodological heterogeneity and inconsistent findings, underscoring the need for more rigorous and standardized studies.</div><div>In conclusion, prebiotics represent a promising complementary therapeutic strategy in ASD, but further research is needed to precisely determine their efficacy, safety, and optimal use.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"14 ","pages":"Article 100295"},"PeriodicalIF":0.0,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-10DOI: 10.1016/j.gpeds.2025.100294
Serafina Perrone , Silvia Carloni , Virginia Beretta , Serena Benedetti , Elena Scarpa , Laura Cannavò , Chiara Petrolini , Federica Grassi , Vincenzo Raitano , Maria Cristina Albertini , Domenico Corica , Tommaso Aversa , Elvira Di Pasquo , Maria Elisabeth Street , Malgorzata Wasniewska , Andrea Dall’Asta , Tullio Ghi
Background
Oxidative stress has been implicated in impairing tissue development, but its impact on early postnatal skeletal growth in humans remains poorly understood. This study investigates the relationship between perinatal redox status and bone development during infancy, using Radiofrequency Echographic Multi Spectrometry (REMS), a non-invasive, radiation-free technology for bone quality assessment.
Methods
A longitudinal observational study on a cohort of healthy, full-term neonates (n = 65, 29 females and 36 males) was conducted. Total antioxidant capacity (TAC) and markers of protein and DNA oxidation (advanced oxidation protein products (AOPP); 8-hydroxy-2′-deoxyguanosine (8OH-dG)) were measured in arterial cord blood at birth. Auxological parameters were collected at birth and during follow-up visits at 1, 3, 6, and 12 months. Bone quality was assessed using REMS at 3, 6, and 12 months, and results were expressed as age-adjusted Z-scores.
Results
Cord blood TAC levels showed a significant positive correlation with birth weight (r = 0.51, p < 0001), length (r = 0.40, p = 0.0013), and birth head circumference (r = 0,42, p = 0,0017). Statistical positive correlations were also found between cord blood TAC and length and weight a 1 month of age (r = 0.51, p < 0.001; r = 0.36, p = 0.0067). In contrast, higher levels of oxidative damage were inversely associated with REMS-derived Z-scores at both 6 and 12 months of life (8OH-dG vs REMS-derived Z-scores at 6 months (r=-0.23, p = 0.02), and AOPP vs REMS-derived Z-scores at 12 months (r=-0.33 p = 0.022; r=-0.64, p < 0.001, respectively). REMS Z-scores also showed strong internal consistency across timepoints (3 vs 6 months, r = 0.53, p < 0.001,; 6 vs 12 months, r = 0.29, p = 0.046). A significant correlation was observed between REMS Z-score and head circumference at 3 months (r = 0.48, p < 0.001).
Conclusions
Our findings suggest that perinatal oxidative balance plays a critical role in early longitudinal growth. REMS appears to be a reliable tool for tracking bone quality in infancy, with potential for future applications in pediatric bone health monitoring. Although limited to healthy infants born from physiological pregnancies, this study provides foundational data in a largely unexplored area and supports the hypothesis that fetal redox status may influence lifelong skeletal outcomes.
氧化应激与组织发育受损有关，但其对人类出生后早期骨骼生长的影响尚不清楚。本研究利用射频超声多光谱法（REMS）研究围产期氧化还原状态与婴儿期骨骼发育之间的关系，REMS是一种无创、无辐射的骨质量评估技术。方法对健康足月新生儿65例（女性29例，男性36例）进行纵向观察研究。总抗氧化能力（TAC）和蛋白质和DNA氧化标记（高级氧化蛋白产物（AOPP））；8-羟基-2′-脱氧鸟苷（8OH-dG）)测定。出生时以及1、3、6和12个月的随访期间收集生长学参数。在3、6和12个月时使用REMS评估骨质量，结果用年龄调整后的z分数表示。结果新生儿血TAC水平与出生体重（r = 0.51, p < 0001）、体长（r = 0.40, p = 0.0013）、出生头围（r = 0,42, p = 0.0017）呈正相关。脐带血TAC与1月龄婴儿的长度和体重也存在统计学上的正相关（r = 0.51, p < 0.001; r = 0.36, p = 0.0067）。相比之下，较高水平的氧化损伤与6个月和12个月时的rem衍生z -评分呈负相关(6个月时的8o - dg与rem衍生z -评分（r=-0.23, p = 0.02），以及12个月时的AOPP与rem衍生z -评分（r=-0.33 p = 0.022; r=-0.64, p < 0.001）。REMS z -得分也显示出跨时间点的强内部一致性（3个月vs 6个月，r = 0.53, p < 0.001, 6个月vs 12个月，r = 0.29, p = 0.046）。3个月时REMS Z-score与头围有显著相关性（r = 0.48, p < 0.001）。结论围产期氧化平衡在早期纵向生长中起关键作用。REMS似乎是跟踪婴儿骨质量的可靠工具，在未来的儿童骨健康监测中具有潜在的应用前景。尽管该研究仅限于生理妊娠出生的健康婴儿，但该研究在很大程度上未被探索的领域提供了基础数据，并支持胎儿氧化还原状态可能影响终身骨骼结果的假设。
{"title":"Perinatal oxidative stress and bone development in the first year of life: A preliminary study using REMS","authors":"Serafina Perrone , Silvia Carloni , Virginia Beretta , Serena Benedetti , Elena Scarpa , Laura Cannavò , Chiara Petrolini , Federica Grassi , Vincenzo Raitano , Maria Cristina Albertini , Domenico Corica , Tommaso Aversa , Elvira Di Pasquo , Maria Elisabeth Street , Malgorzata Wasniewska , Andrea Dall’Asta , Tullio Ghi","doi":"10.1016/j.gpeds.2025.100294","DOIUrl":"10.1016/j.gpeds.2025.100294","url":null,"abstract":"<div><h3>Background</h3><div>Oxidative stress has been implicated in impairing tissue development, but its impact on early postnatal skeletal growth in humans remains poorly understood. This study investigates the relationship between perinatal redox status and bone development during infancy, using Radiofrequency Echographic Multi Spectrometry (REMS), a non-invasive, radiation-free technology for bone quality assessment.</div></div><div><h3>Methods</h3><div>A longitudinal observational study on a cohort of healthy, full-term neonates (<em>n</em> = 65, 29 females and 36 males) was conducted. Total antioxidant capacity (TAC) and markers of protein and DNA oxidation (advanced oxidation protein products (AOPP); 8-hydroxy-2′-deoxyguanosine (8OH-dG)) were measured in arterial cord blood at birth. Auxological parameters were collected at birth and during follow-up visits at 1, 3, 6, and 12 months. Bone quality was assessed using REMS at 3, 6, and 12 months, and results were expressed as age-adjusted Z-scores.</div></div><div><h3>Results</h3><div>Cord blood TAC levels showed a significant positive correlation with birth weight (<em>r</em> = 0.51, <em>p</em> < 0001), length (<em>r</em> = 0.40, <em>p</em> = 0.0013), and birth head circumference (<em>r</em> = 0,42, <em>p</em> = 0,0017). Statistical positive correlations were also found between cord blood TAC and length and weight a 1 month of age (<em>r</em> = 0.51, <em>p</em> < 0.001; <em>r</em> = 0.36, <em>p</em> = 0.0067). In contrast, higher levels of oxidative damage were inversely associated with REMS-derived Z-scores at both 6 and 12 months of life (8OH-dG vs REMS-derived Z-scores at 6 months (<em>r</em>=-0.23, <em>p</em> = 0.02), and AOPP vs REMS-derived Z-scores at 12 months (<em>r</em>=-0.33 <em>p</em> = 0.022; <em>r</em>=-0.64, <em>p</em> < 0.001, respectively). REMS Z-scores also showed strong internal consistency across timepoints (3 vs 6 months, <em>r</em> = 0.53, <em>p</em> < 0.001,; 6 vs 12 months, <em>r</em> = 0.29, <em>p</em> = 0.046). A significant correlation was observed between REMS Z-score and head circumference at 3 months (<em>r</em> = 0.48, <em>p</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>Our findings suggest that perinatal oxidative balance plays a critical role in early longitudinal growth. REMS appears to be a reliable tool for tracking bone quality in infancy, with potential for future applications in pediatric bone health monitoring. Although limited to healthy infants born from physiological pregnancies, this study provides foundational data in a largely unexplored area and supports the hypothesis that fetal redox status may influence lifelong skeletal outcomes.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"14 ","pages":"Article 100294"},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-09DOI: 10.1016/j.gpeds.2025.100293
Gebretekle Gebremichael Hailesilase, Haylay Araya Gebrezgabiher, Abrahaley Mulu Kidane
Background
Drug-related problems (DRPs) are associated with increased risks of morbidities and mortalities. However, there are limited studies on DRPs among hospitalized pediatric patients in Ethiopia. This study aimed to evaluate DRPs and associated factors among hospitalized pediatric patients in Adigrat general hospital, Tigrai, northern Ethiopia.
Methods
A retrospective cross-sectional study was conducted among hospitalized pediatric patients in Adigrat general hospital. Data was collected from the patients’ medical charts between 01 July 2024 and 31 August 2024. Potential drug-drug interactions were screened using Micromedex 2.0 software. Logistic regression was used to analyze association of variables with DRPs. Data was analyzed using statistical package for social science version 21 and statistical significance was set at P value < 0.05 in the multivariate analysis.
Results
A total of 114 (77.6 %) patients had at least one DRP. A total of 325 DRPs were identified in those 114 patients, averaging 2.85 (113) DRPs per patient. Moreover, 15.0 % of the patients experienced 5 DRPs. Regarding the proportion of DRPs, unnecessary drug therapy, ADRs and dosage too low accounted for 22.8, 18.5 and 18.1 % of the DRPs, respectively. Substantial proportions (n = 47; 14.5 %) of the ADRs were due to potential drug-drug interactions. Anti-infectives for systemic use (68.8 %) and drugs of the alimentary tract and metabolism (10.2 %) were the most commonly implicated drug classes in DRPs. The number of diseases per patient was significantly associated with the occurrence of DRPs (Adjusted Odds ratio = 5.875, 95 % CI: 1.735–19.895).
Conclusions
The DRPs were prevalent among hospitalized pediatric patients. Unnecessary drug therapy, ADRs and dosage too low were the most widespread categories of DRPs. Clinicians should follow pediatrics guidelines and use drug interaction screening databases when prescribing drugs to pediatric patients.
{"title":"Drug‑related problems and associated factors among hospitalized pediatric patients in a general hospital, Tigrai, northern Ethiopia: a cross-sectional study","authors":"Gebretekle Gebremichael Hailesilase, Haylay Araya Gebrezgabiher, Abrahaley Mulu Kidane","doi":"10.1016/j.gpeds.2025.100293","DOIUrl":"10.1016/j.gpeds.2025.100293","url":null,"abstract":"<div><h3>Background</h3><div>Drug-related problems (DRPs) are associated with increased risks of morbidities and mortalities. However, there are limited studies on DRPs among hospitalized pediatric patients in Ethiopia. This study aimed to evaluate DRPs and associated factors among hospitalized pediatric patients in Adigrat general hospital, Tigrai, northern Ethiopia.</div></div><div><h3>Methods</h3><div>A retrospective cross-sectional study was conducted among hospitalized pediatric patients in Adigrat general hospital. Data was collected from the patients’ medical charts between 01 July 2024 and 31 August 2024. Potential drug-drug interactions were screened using Micromedex 2.0 software. Logistic regression was used to analyze association of variables with DRPs. Data was analyzed using statistical package for social science version 21 and statistical significance was set at P value < 0.05 in the multivariate analysis.</div></div><div><h3>Results</h3><div>A total of 114 (77.6 %) patients had at least one DRP. A total of 325 DRPs were identified in those 114 patients, averaging 2.85 (1<span><math><mo>−</mo></math></span>13) DRPs per patient. Moreover, 15.0 % of the patients experienced <span><math><mo>≥</mo></math></span>5 DRPs. Regarding the proportion of DRPs, unnecessary drug therapy, ADRs and dosage too low accounted for 22.8, 18.5 and 18.1 % of the DRPs, respectively. Substantial proportions (<em>n</em> = 47; 14.5 %) of the ADRs were due to potential drug-drug interactions. Anti-infectives for systemic use (68.8 %) and drugs of the alimentary tract and metabolism (10.2 %) were the most commonly implicated drug classes in DRPs. The number of diseases per patient was significantly associated with the occurrence of DRPs (Adjusted Odds ratio = 5.875, 95 % CI: 1.735–19.895).</div></div><div><h3>Conclusions</h3><div>The DRPs were prevalent among hospitalized pediatric patients. Unnecessary drug therapy, ADRs and dosage too low were the most widespread categories of DRPs. Clinicians should follow pediatrics guidelines and use drug interaction screening databases when prescribing drugs to pediatric patients.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"14 ","pages":"Article 100293"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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