Egyptian Pediatric Association Gazette最新文献

{"title":"An atypical presentation of ulcerative colitis: case report","authors":"Avanti Saoji, Madhura Kavishwar, Praveen Unki, Surbhi Rathi","doi":"10.1186/s43054-024-00252-8","DOIUrl":"https://doi.org/10.1186/s43054-024-00252-8","url":null,"abstract":"Bloody diarrhea in children often indicates a severe gastrointestinal illness. Although infections are the most likely cause, inflammatory bowel disease (IBD) is a close mimic. IBD generally presents with chronic and persistent symptoms requiring long-term treatment. Hence, acute or atypical presentations may mislead the physician leading to delays in diagnosis. We report the case of an atypical presentation of ulcerative colitis. We present the case of a 6-year-old girl with acute symptoms of bloody diarrhea, fever, abdominal pain, and tenesmus for 5 days. The child came to us after the non-resolution of symptoms after treatment from a local practitioner. The child was found to have signs of chronic malnutrition and clubbing on general examination. After ruling out infective causes, the child was evaluated further by colonoscopy, which revealed lesions suggestive of ulcerative colitis, and hence started on topical and oral treatment for the same. Awareness about the disease and its atypical presentations like poor growth, anemia, or extraintestinal manifestations is necessary, especially in primary healthcare and resource-poor settings as it can lead to early diagnosis, referral, and treatment initiation.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":"18 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139752234","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}

{"title":"Survey of current maintenance intravenous fluids prescribing practices among Egyptian pediatricians","authors":"Alyaa Ahdy Abdelaziz, Hafez Mahmoud Bazaraa, Sherif Reda Omar, Rasha Ashmawy, Yousra A. El-Maradny, Ramy Mohammed Ghazy","doi":"10.1186/s43054-024-00245-7","DOIUrl":"https://doi.org/10.1186/s43054-024-00245-7","url":null,"abstract":"Recent research has firmly linked the administration of hypotonic fluids with the incidence of hospital-acquired hyponatremia in pediatric patients. This study examined the prevailing practices in prescribing maintenance intravenous fluids (mIVFs) among Egyptian pediatricians, assessed the compliance of current prescribing practices with the American Academy of Pediatrics Clinical Practice Guidelines (AAP-CPG), and emphasized the urgency for revised educational initiatives. To recruit pediatricians for this study, a convenience and snowballing sampling methods were used. The questionnaire was created in Google Forms and then distributed in English to Egyptian Facebook groups devoted to pediatric education. The data collection phase started on January 1, and ended on February 28, 2022. Different case scenarios with increased antidiuretic hormone were introduced, and respondents were asked to choose the optimum mIVFs in each case scenario. Finally, respondents were directly asked how often they use isotonic fluids as their primary mIVFs and what caused them to not use isotonic fluids. For this study, a total of 513 participatants were included. The survey revealed that Egyptian pediatricians did not not fully comply with AAP-CPG regarding the mIVFs in pediatrics. Hypotonic fluids are still preferred, but there is a shift towards 0.45% sodium chloride (NaCl) from the previously favored 0.2% NaCl. Isotonic fluids are more common in older age groups and conditions that involve potential excessive antidiuretic hormone secretion, while 0.2% NaCl remains popular in neonatal care. Balanced solutions are underused, indicating practice variation. The utilization of isotonic fluids in the treatment of neurologic conditions has experienced a notable increase, propelled by heightened awareness and a growing demand for continuous medical education. To comprehensively address concerns related to fluid management beyond the scope of AAP-CPG, it is imperative to conduct multicenter studies across governmental, private, and educational pediatric healthcare settings to assess and improve pediatracians' clinical practice.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":"50 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139752393","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}

{"title":"Eligibility for hematopoietic stem cell transplantation in a cohort of children with sickle cell disease: a single-center report","authors":"Khaled Salama, Asmaa F. Allam, Yasmeen M. M. Selim","doi":"10.1186/s43054-024-00247-5","DOIUrl":"https://doi.org/10.1186/s43054-024-00247-5","url":null,"abstract":"Hematopoietic stem cell transplantation (HSCT), is the only currently available curative option for SCD. Yet, the eligibility of SCD patients for HSCT is always limited by the significant associated toxicity and lack of suitable donors. At Cairo University’s pediatric hematology outpatient clinic, we aimed to determine hematopoietic stem cell transplantation (HSCT) candidates among a sickle cell disease (SCD) cohort, estimate the number of possible donors, and analyze the differences between patients with and without an HSCT indication. This study was a cross-sectional analytic study including 128 SCD children. Their demographic, clinical, and laboratory profiles, total number, and number of siblings with SCD were obtained from their medical records. Sixty-nine (53.9%) had at least one HSCT indication. Recurrent severe pain episodes despite hydroxyurea were the most common indication. Hemoglobin was lower, while reticulocyte count, serum ferritin, and aspartate aminotransferase were higher in HSCT candidates (p value < 0.001). Additionally, the prevalence of splenomegaly, the dose of hydroxyurea, and the number of transfusions were noticeably higher in HSCT candidates (p value = 0.013, 0.005, and < 0.0001 respectively). Among those indicated for HSCT; 75.3% had at least one healthy sibling who might be a potential donor. More than half were eligible for HSCT which should always be considered to provide a possible cure for the disease. Of the transplantation-eligible cases, about two-thirds had at least one healthy sibling who might potentially serve as a donor. Those meeting the requirements for HSCT eligibility should routinely undergo human leukocyte antigen (HLA) testing of their unaffected siblings.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139657155","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}

{"title":"Pediatric anterior thoracic wall reconstruction: a successful case of extensive resection and repair","authors":"Izchel Valdez García, Alfa Guadalupe Barraza Tinajero, Nayely Carrillo Ibarra, Sofia Brenes Guzmán","doi":"10.1186/s43054-024-00248-4","DOIUrl":"https://doi.org/10.1186/s43054-024-00248-4","url":null,"abstract":"Thoracic tumors are a challenge for pediatric surgeons. They comprise a heterogeneous group of neoplasms classified based on histological variety, location, presentation, biological behavior, treatment response, and prognosis. Primary tumors of the thoracic wall in children and adolescents are sporadic, accounting for only 1–2% of all pediatric thoracic neoplasms, with two-thirds of them being malignant. We present the case of a 16-year-old male patient with osteoblastic osteosarcoma localized in the right anterior rib cage. The patient underwent extensive tumor resection using titanium bars. Thoracic reconstruction following extensive resection in pediatric cancer patients has been underexplored and poorly described. Nevertheless, it has been demonstrated to be feasible, particularly considering the 5-year survival rate of 60% following tumor resection. This approach helps prevent anatomical and physiological complications that may arise without reconstruction. We report a successful single-stage resection and thoracic reconstruction case in a pediatric patient. This case underscores the importance of considering reconstruction in patients with thoracic tumors, as it can contribute to improving prognosis and preventing associated complications.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":"36 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139588937","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}

{"title":"Insights from a retrospective study: an understanding of pediatric colorectal carcinoma","authors":"Sofia Brenes Guzmán, Edgar Fernando Oliver García, Edgar Guillermo Lazcano Rojas, Alfa Guadalupe Barraza Tinajero, Daniela Hernández Meza, Jose Luis González Chávez, Edgar Melo Camacho, Juan Carlos Nuñez Enríquez","doi":"10.1186/s43054-024-00246-6","DOIUrl":"https://doi.org/10.1186/s43054-024-00246-6","url":null,"abstract":"Pediatric colorectal cancer, comprising just 1% of childhood cancers, has surged among young individuals, underscoring its significant health impact. Diagnostic challenges arise from atypical presentation and nonspecific symptoms in 90% of cases, leading to delayed detection in 19%. Methods A 2-year retrospective study of pediatric colorectal carcinoma cases was conducted across a specialized surgical pediatric center. Data were gathered, including age, symptoms, diagnostics, treatments, and outcomes. Results Six colorectal carcinoma cases (median age, 16) were documented, mainly in males (66%). Predominant histological types included mucinous adenocarcinoma and signet ring cell carcinoma. Metastasis was present in all cases, with symptoms including hematochezia (83%), abdominal pain (100%), weight loss (66%), and anemia (100%). Diagnosis often faced misidentification, fostering disease progression and metastasis. Various diagnostic and treatment modalities were employed, including surgery and neo-adjuvant or adjuvant chemotherapy. Conclusion Swift detection and intervention for pediatric colorectal carcinoma are pivotal. Efficient diagnostics and heightened awareness among medical professionals and the public are imperative. Early surgical intervention remains a cornerstone, especially for patients with pertinent family histories and characteristic symptoms. Tailored guidelines for pediatric patients are needed to enhance outcomes and survival. • CC is rare but increasing among young individuals. • CC is often diagnosed late or misdiagnosed due to atypical presentation and nonspecific symptoms. • Early detection and treatment of CC are crucial for patient survival. • CC treatment involves surgery, chemotherapy, and targeted therapies. • Awareness of CC symptoms and risk factors is vital for early detection and management.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":"56 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139517648","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}

{"title":"Promoting child health through a comprehensive One Health perspective: a narrative review","authors":"Ramy Mohamed Ghazy, Asma Saidouni, Sarah Hamed N. Taha","doi":"10.1186/s43054-023-00243-1","DOIUrl":"https://doi.org/10.1186/s43054-023-00243-1","url":null,"abstract":"Children are increasingly exposed to health risks as a result of adverse effects of climate change, including more frequent and intense extreme weather events, disruption of food systems, an increase in food-, water- and vector-borne diseases, mental health issues, clean water scarcity and zoonoses, and habitat destruction causing “zoonotic spillovers”. To address these emerging and new health risks, a holistic approach is required. Understanding how these risk drivers impact the physiological and mental development of children is a highly complex challenge. Addressing this complexity requires the collaborative development of multi-disciplinary and comprehensive approaches. In addition, factors such as inadequate nutrition that leads to stunting, maternal characteristics (including age, height, pregnancy, and postnatal care), hygiene habits at home, gender disparity, and the financial situation of the household also play crucial roles. This review is prompted by the pressing need to tackle the substantial and diverse health impacts that will affect children throughout the current century. Emphasizing the importance of adopting the One Health approach, this review aims to mitigate these effects and pave the way for a healthier future for the younger generation.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":"22 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139470184","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}

{"title":"Relationship between effectiveness of asthma management and genetic variants in asthmatic Egyptian children","authors":"Hoda H. Ahmed, Tarek M. Farid, Maha M. A. Abo Hashish, Areef R. Ibrahim, Amr M. Mustafa, Aliaa Ahmed Wahby, Mirhane Hassan, Eman Hany Elsebaie, Abeer Ramadan, Sameh Abdelaziz Mansour","doi":"10.1186/s43054-023-00242-2","DOIUrl":"https://doi.org/10.1186/s43054-023-00242-2","url":null,"abstract":"Personalized asthma medicine research identifies critical genes like ADRB2 and ADH5 that affect disease and treatment outcomes, necessitating a deeper exploration of these genetic influences on asthma prevalence and management in Egyptian children. This study aimed to examine the relationship between asthma control and specific genetic variants in Egyptian children, focusing on four significant SNPs within four key genes. A cross-sectional genetic study was conducted between December 2020 and May 2021 at two hospitals affiliated with Al-Azhar University to assess gene polymorphisms in adolescent asthmatic patients. Blood samples were taken from participants, with portions dedicated to DNA extraction and serum level measurements. The extracted DNA was then genotyped using the real-time PCR technique, and specific genotypes were identified based on their fluorescence characteristics. A total of 93 subjects were enrolled in the study. Cases (asthmatic children) had a significantly higher BMI than controls—healthy children—(33.65 ± 3.88 vs. 21.10 ± 3.48, p < 0.001). A notable distinction was observed in residence, with 30.6% of cases from urban areas versus 85.7% in controls (p < 0.001). Cases had a markedly higher incidence of familial asthma history (86.1% vs. 0.0%, p < 0.001), atopy (95.8% vs. 0.0%, p < 0.001), food allergies (80.6% vs. 9.5%, p < 0.001), and animal contact (79.2% vs. 14.3%, p < 0.001) compared to controls. The genetic marker rs4795399's CC allele was found in 10.0% of controls but not in any cases (p = 0.024), and the AA allele of rs7927044 was significantly more common in controlled asthmatics than in uncontrolled ones (p = 0.030). The studied genetic variants were not significantly associated with asthma severity; however, patients with uncontrolled asthma were associated with significantly higher polymorphism of GG and AG alleles of rs7927044. Additionally, there was a significant difference between the asthmatic patients and healthy individuals in terms of the polymorphism of the rs4795399 TT allele.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139397869","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}

{"title":"Prevalence and types of anemia in infancy, Egypt: cross-sectional study","authors":"Mahmoud Abdelgawad Elattar, Samah Ahmed Gad, Amany Mohamed Abd ela-zziz, Taghreed Salah Elsheikh, Esraa Morshedy Beltagy, Asmaa Nabil Elgamal, Hassan Yousef Elmsri, Vian Abd el halim El refae","doi":"10.1186/s43054-023-00239-x","DOIUrl":"https://doi.org/10.1186/s43054-023-00239-x","url":null,"abstract":"Infant anemia has a significant impact on physical and cognitive development, not only in infancy but also throughout their life. The study aimed to estimate the prevalence, types, and risk factors of anemia in infancy. A cross-sectional study was conducted on 498 infants aged 6-23 months who attended five primary healthcare centers in Kafr-el Sheikh governorate, Egypt, for vaccination and follow-up. The prevalence of anemia among the study infants was 44%, with the highest in those aged 6-12 months. Maternal anemia in pregnancy, low birth weight infant, and lack of adherence to iron supplementation were the significant risk factors for anemia. Infant anemia in Egypt resembles a complicated multifactorial severe health issue with a long-run burden. Health policy interventions such as early screening at 6 months old, more adherence to iron supplements for infants, maternal nutrition education, family planning, and birth spacing between siblings should be accessed to overcome and manage this health problem.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":"14 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139082801","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}

{"title":"Co-existence of Morgagni’s cyst with a twisted vas aberrans and “bell clapper” deformity in a 15-year-old boy: a case report","authors":"Athanasios G. Pegios, Apostolos P. Andronikou, Ioannis Ch. Georgakis, George S. Papouis","doi":"10.1186/s43054-023-00241-3","DOIUrl":"https://doi.org/10.1186/s43054-023-00241-3","url":null,"abstract":"The testicular appendix is a residual of the paramesonephric and mesonephric duct, most commonly found close to the superior pole of the epididymis as Morgagni’s cyst. Torsion of such cysts is a common event in children, and the patient usually presents with a palpable testis with a tender mass in its upper pole. The co-existence of two or more appendices is very rare. In addition to the fact that Morgagni’s cyst was the non-twisted one and vas aberrans was, made clinical and radiological diagnosis difficult. Our patient, a 15-year-old boy, presented with persistent pain in the right scrotum, a significant palpable mass accompanied by vomiting. Upon surgical exploration, a large dark cyst was found located on the right side of the right testicle with a 720-degree torsion. The cyst was straightened and excised along with a Morgagni’s cyst. The testis was fixed in the right hemiscrotum due to a “bell clapper” deformity that was also a finding. Pathological findings were consistent with a twisted cyst of a testicular appendix (vas aberrans). Co-existence of two or more appendices is very rare in addition to the fact that Morgagni’s cyst was the non-twisted one. Usually and in very few cases, a second appendix is found randomly, during surgical exploration for acute scrotum due to torsion of Morgagni’s cyst.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":"40 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138821556","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}

{"title":"ADAMTS13 in pediatric sepsis: a prognostic biomarker with potential therapeutic implications","authors":"Muhammad Said El-Mekkawy, Sara Mahmoud El-Deeb, Maha Fawzy El-Hanafy","doi":"10.1186/s43054-023-00219-1","DOIUrl":"https://doi.org/10.1186/s43054-023-00219-1","url":null,"abstract":"Growing evidence implicates a pro-thrombotic state, caused by ADAMTS13 deficiency, in sepsis-associated organ dysfunction, but pediatric data is limited. Our purpose was to evaluate association of ADAMTS13 with prognosis of pediatric sepsis. This was prospective observational study, conducted on 70 children with sepsis and 18 healthy controls. Patients were classified upon Pediatric Intensive Care Unit (PICU) admission into sepsis, severe sepsis, and septic shock groups. Serum ADAMTS13 was measured within 24 h of admission. The primary outcome was all-cause PICU mortality. ADAMTS13 was lower among patients than controls [median and interquartile range (IQR): 1.30 (0.88–3.13ng/mL) vs. 6.00 (5.55–6.50 ng/mL); p < 0.001]. ADAMTS13 was lower in both severe sepsis and septic shock than sepsis [median (IQR): 0.90 (0.80–1.75 ng/mL); 1.0 ng/ml (0.90–1.20); and 2.80 (1.00–3.85ng/mL), p = 0.026 and 0.006 respectively]. ADAMTS13 was lower among non-survivors compared with survivors [median (IQR): 0.9 (0.80–1.18 ng/mL) vs. 2.45 (0.98–3.50 ng/mL); p < 0.001]. ADAMTS13 had area under Receiver Operating Characteristic Curve (AUC) of 0.77 for mortality prediction. Lower ADAMTS13 level was associated with mechanical ventilation; vasoactive medications; acute respiratory distress syndrome; and multiple organ dysfunction syndrome. ADAMTS13 correlated with pediatric Sequential Organ Failure Assessment (pSOFA) score (rs = -0.46, p < 0.001); vasoactive infusion days ((rs = -0.48, p < 0.001); and vasoactive-inotropic score on day1 (rs = -0.43, p < 0.001) and day2 ((rs = -0.41; p < 0.001). In pediatric sepsis, lower ADAMTS13 level is a risk factor for organ dysfunction and mortality, lending theoretical foundations to therapeutic interventions aiming at reversing the pro-thrombotic state in sepsis.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":"1 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138821788","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}