Clinical Medicine Insights-Pediatrics最新文献

{"title":"Epidemiological Patterns of Neurological and Neuromuscular Disorders in the Potohar Region of Pakistan.","authors":"Sheikh Ahmed Gull, Shamsa Batool, Naghmana Iqbal, Faiza Batool, Mahnoor Mughal, Sajid Malik","doi":"10.1177/11795565261456621","DOIUrl":"10.1177/11795565261456621","url":null,"abstract":"<p><strong>Background: </strong>Neurodevelopmental disorders (NDDs) are major contributors to cognitive, behavioral, communication, and motor impairments arising from abnormal brain development. Pakistan lacks comprehensive epidemiological data on NDDs, limiting evidence-based health planning and targeted interventions.</p><p><strong>Objectives: </strong>To determine the prevalence patterns and bio-demographic correlates of neurological disorders (ND) and neuromuscular disorders (NMD) in the population of the Potohar plateau, Pakistan.</p><p><strong>Design and methods: </strong>A cross-sectional study (2019-2023) was conducted using a mixed recruitment approach involving district hospitals, community settings, and door-to-door surveys. Standardized classification was performed using OMIM and ICD-10 databases. Descriptive statistics and multivariable logistic regression analyses were applied.</p><p><strong>Results: </strong>A total of 1169 independent patients were enrolled; 62% were males. Most participants belonged to rural, low-income, and nuclear-family backgrounds. ND accounted for 63% of cases and NMD for 37%, further classified into 70 minor entities. The most prevalent ND was intellectual disability (ID, 36%), followed by Down syndrome (8%) and microcephaly (7%). Among NMD, cerebral palsy (CP, 35%) and muscular dystrophies (8%) predominated. Parental consanguinity was 76% overall, highest in ID (81%) and lowest in epilepsy (59%). Sixty-five percent of anomalies were sporadic, while 35% were familial. More than 30 rare disorders were also identified. Age showed strong associations, with older participants more likely to present with ND, and younger children with NMD, particularly CP. Socioeconomic status demonstrated a protective effect against CP but not against ID.</p><p><strong>Conclusions: </strong>This study documents a substantial burden of neurological and neuromuscular disorders in the Potohar region, dominated by ID and CP and characterized by high consanguinity and a significant number of rare disorders. The findings highlight the urgent need for improved antenatal care, early diagnosis, health education, and strengthened molecular diagnostic services to reduce the burden and improve outcomes for affected populations.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"20 ","pages":"11795565261456621"},"PeriodicalIF":1.7,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing Medication Errors in Paediatrics: A Narrative Review.","authors":"Namita Singh, Alan Silburn","doi":"10.1177/11795565261457813","DOIUrl":"10.1177/11795565261457813","url":null,"abstract":"<p><p>Paediatric medication errors remain a major and preventable cause of patient harm worldwide. Children are particularly vulnerable to medication-related adverse events because of weight-based dosing requirements, age-dependent pharmacokinetics, off-label medication use, communication limitations, and the need for complex drug preparation and administration processes. High-risk settings such as neonatal intensive care units, emergency departments, oncology services, and transitions of care are associated with particularly high rates of prescribing and administration errors. This narrative review examines the epidemiology, causes, and prevention of paediatric medication errors, with a focus on system-level contributors and evidence-based safety strategies. Common sources of error include dosing miscalculations, interruptions during medication administration, inadequate communication, insufficient paediatric-specific decision support, and caregiver-related challenges such as low health literacy and language barriers. The review highlights the role of technological interventions, including computerised physician order entry, clinical decision support systems, barcode medication administration, and smart infusion pumps in reducing prescribing and administration errors. Additional effective strategies include standardised dosing protocols, structured communication tools, pharmacist integration into multidisciplinary teams, independent double-checking processes, and family-centred education using teach-back methods and pictorial instructions. Although significant progress has been made in high-resource settings, important gaps remain in low- and middle-income countries where access to paediatric formulations, trained personnel, and electronic safety systems may be limited. Emerging technologies such as artificial intelligence-based dosing support may offer future benefits but also introduce ethical and governance challenges. Improving paediatric medication safety requires coordinated system-level approaches that combine technology, standardisation, workforce training, human-factors design, and active caregiver engagement to achieve sustained reductions in preventable harm.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"20 ","pages":"11795565261457813"},"PeriodicalIF":1.7,"publicationDate":"2026-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148272682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating Uncertainty: The Role of Poetry in Reflecting Pediatric Clinical Complexities.","authors":"Zhaohui Su","doi":"10.1177/11795565261454798","DOIUrl":"https://doi.org/10.1177/11795565261454798","url":null,"abstract":"<p><p>Utilizing poetry as an investigative venue, this commentary explores how poetic verses can serve as a reflective narrative on the uncertainties and ambiguities inherent in pediatric medicine, particularly during times of emerging infectious diseases like the coronavirus disease 2019 (COVID-19). Using free verse, the poem captures the shifting, often conflicting definitions of illness, the fluidity of diagnosis, and the complexities of disease transmission and immunity. Rather than providing clear-cut answers, the poem highlights the diagnostic and emotional challenges faced by both patients, healthcare providers, and informal caregivers, illustrating the multifaceted and multidimensional nature of clinical practice. The commentary further positions poetry as a valuable research method in clinical medicine, offering qualitative insights into the lived experiences of patients, clinicians, and families.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"20 ","pages":"11795565261454798"},"PeriodicalIF":1.2,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Schistosomal Colitis as an Uncommon Cause of Hematochezia in a School-Aged Boy: A Case Report.","authors":"Mujaheed Suleman, Alex Mremi, Misso Kennedy, David Msuya, Jay Lodhia","doi":"10.1177/11795565261456425","DOIUrl":"10.1177/11795565261456425","url":null,"abstract":"<p><p>Schistosomiasis is a neglected tropical disease with clinical presentations that vary depending on the species involved. Schistosomal colitis is a rare manifestation, with few cases documented in the literature. We report a case of a 9-year-old boy presenting with painless hematochezia and a history of residence in a schistosomiasis-endemic region. Colonoscopy revealed evidence of colitis, and histopathological examination of colon biopsy confirmed schistosomal ova with eosinophilic infiltration in the colonic mucosa. The patient responded well to treatment with oral Praziquantel (40 mg/kg). This case underscores the need for a high index of suspicion and the inclusion of tropical diseases in the differential diagnosis when evaluating patients with lower gastrointestinal bleeding, particularly in endemic areas. Pediatric schistosomal colitis in Africa represents a clinically significant yet often underdiagnosed manifestation of Schistosomiasis, highlighting the need for heightened awareness of its distinctive gastrointestinal presentations, diagnostic challenges, and implications for early intervention in children living in endemic regions.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"20 ","pages":"11795565261456425"},"PeriodicalIF":1.7,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional Status Changes During Pediatric Acute Lymphoblastic Leukemia Treatment: A Study from a Tertiary Care Hospital in Pakistan.","authors":"Sadia Imran, Namrita Rai, Malick Muhammed Sabih Masood, Wasfa Farooq, Kishwer Nadeem","doi":"10.1177/11795565261454801","DOIUrl":"10.1177/11795565261454801","url":null,"abstract":"<p><strong>Background: </strong>Acute Lymphoblastic Leukemia (ALL) is the most common pediatric cancer with a 5-year survival rate of 90% in High Income Countries (HICs), but in lower-to-middle-income countries (LMICs) survival rates fall below 60%. This is influenced by many factors; one of the major ones being malnutrition.</p><p><strong>Objectives: </strong>To ascertain the changes in and association of nutritional status in the treatment of pediatric ALL patients.</p><p><strong>Design: </strong>This article investigated the association between nutritional status in patients receiving ALL treatment, and morbidity and mortality. This is a retrospective study for the period of May 2022 to April 2023 including a total of 332 patients.</p><p><strong>Methods: </strong>The study used WHO defined weight-for-age and height-for-age for patients from 1 year of age up till the age of 5 years old, and BMI for age for patients over the age of 5 to assess nutritional status. Various disease and treatment variables were analyzed with patients' nutritional statuses.</p><p><strong>Results: </strong>From the sample, more than one-third of patients (38.5%) were malnourished with the majority of them being underweight or severely underweight. Wilcoxon signed-rank test for paired values showed a <i>P</i>-value of .0177 (<i>z</i> = 2.373) when used to compare patient weight at initial assessment and weight after intensive phase of treatment, indicating a significant change in weight between both timepoints. Nutritional status was significantly associated with the number of patients with positive bacterial cultures (<i>P</i> = .01) and multiple hospital admissions (<i>P</i> = .004), but was not significantly associated with mortality (<i>P</i> > .05).</p><p><strong>Conclusion: </strong>Nutritional status changed significantly after intensive phase of treatment. Malnutrition in ALL patients was significantly associated with bacterial infections, however, it was not significantly correlated to patient mortality. Future prospective studies with a longer study period should be planned to follow patients compromised nutrition to assess long term survival.</p><p><strong>Registration: </strong>Not applicable.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"20 ","pages":"11795565261454801"},"PeriodicalIF":1.7,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Poisoning With Ibuprofen in Youth: A What, When and Why Clinical Framework.","authors":"Babak Dehestani, Louisa Kelly, Fiona McNicholas","doi":"10.1177/11795565261454795","DOIUrl":"10.1177/11795565261454795","url":null,"abstract":"<p><p>Deliberate self-poisoning (DSP) among children and adolescents has been steadily increasing over the past decade worldwide with paracetamol and ibuprofen the most common medications used. Assessment and management often fall to Emergency Department (ED) staff with varied psychiatric experience. We outline an easy-to-use psychiatry framework for ED clinicians to guide them in assessing and managing young people who present with DSP with Ibuprofen. A \"what, when and why\" framework derived from the authors' clinical experience in child and adolescent liaison psychiatry and emergency care, is outlined. This may guide ED clinicians in the assessment of what medication is ingested, when DSP occurred on as well as when to initiate treatment and how to explore why the DSP episode took place. DSP with Ibuprofen has the potential to cause severe physical sequelae ranging from renal and liver impairment to severe gastro-intestinal bleeds and thrombocytopaenia. Establishing what was used in the DSP episode and when it occurred is therefore crucial to allow for timely treatment and management. Establishing reasons why the young person took the overdose, along with thorough risk assessment is crucial in aiding safe discharge planning. Given the importance of timely intervention, the suggested framework provides an easy-to-remember method for assessment, informing management and discharge planning.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"20 ","pages":"11795565261454795"},"PeriodicalIF":1.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13254133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Status of Pediatric Hearing Loss Cases in Oita University Hospital From 2016 to 2019.","authors":"Tetsuo Watanabe, Takashi Hirano","doi":"10.1177/11795565261443150","DOIUrl":"10.1177/11795565261443150","url":null,"abstract":"<p><strong>Objective: </strong>The importance and effectiveness of Newborn hearing screening (NHS) have been widely recognized. However, there are a few cases of false-negative NHS results. Hearing loss in children causes various disorders. Therefore, attention should be paid to pediatric hearing loss in clinical otolaryngology. We examined the multiple causes of children referred for detailed hearing loss examination.</p><p><strong>Methods: </strong>This retrospective study included 154 patients, 68 males and 86 females, 3 to 12 years old, referred to our outpatient department between January 2016 and December 2019. We reviewed data on reasons for consultation, newborn hearing screening results, and diagnosis.</p><p><strong>Results: </strong>Seventy-one patients (46.1%) were identified during the health examinations. Seventy-five patients (48.7%) were referred for hearing loss, and 8 (5.2%) were referred for language delay or dysarthria. Most cases are not diagnosed by newborn hearing screening. There were 33 (21.4%) patients who had no hearing loss, 54 (35.1%) had functional hearing loss, 24 (15.6%) had severe-to-profound unilateral hearing loss, 24 (15.6%) had mild to moderate unilateral hearing loss, and 18 (11.7%) had mild to moderate bilateral hearing loss. Of the 66 patients with substantial hearing loss, 40 (61%) had unknown causes and 26 (39%) had middle or inner ear malformations.</p><p><strong>Conclusions: </strong>Appropriate diagnostic imaging is essential in pediatric cases of hearing loss to assess for middle or inner ear malformations. Strategies to address false-negative results in neonatal hearing screening, functional hearing loss, and severe to profound unilateral hearing loss remain important challenges for future clinical practice.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"20 ","pages":"11795565261443150"},"PeriodicalIF":1.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13254136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selective Serotonin Reuptake Inhibitors for Children with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis.","authors":"Elisabetta Trinari, Noella Juliana Noronha, Davide Papola, Tahira Devji, Tamara Navarro, Olaf Kraus de Camargo, Alfonso Iorio","doi":"10.1177/11795565261442820","DOIUrl":"10.1177/11795565261442820","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Effects of SSRI for symptoms of ASD and comorbid conditions are uncertain. We conducted a systematic review and meta-analyses to determine the efficacy and safety of SSRIs in children with ASD on 8 clinically relevant outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We searched 7 databases to retrieve RCT of SSRIs versus placebo in children with ASD. Two authors independently extracted data, assessed risk of bias and rated the certainty of evidence using the GRADE method.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seven RCTs with a total of 606 participants were included. The evidence is very uncertain on the effect of SSRIs on restricted repetitive behaviors and anxiety symptoms in children with ASD. There is low certainty of the evidence suggesting that SSRIs result in little to no effect on obsessive-compulsive symptoms and disruptive behaviors, and there is moderate certainty of the evidence that SSRIs likely result in little to no difference in global functioning and a slight increase in adverse events. No studies evaluated depressive symptoms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The number of studies on this population remains limited. The current body of evidence shows no benefit of the use of SSRIs in children with ASD. Risk/benefit assessment should be carefully considered on an individual basis until further evidence is made available.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Protocol registration number: &lt;/strong&gt;PROSPERO-CRD42020169836.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Lay abstract: &lt;/strong&gt;&lt;b&gt;Efficacy of SSRIs in children with ASD&lt;/b&gt; &lt;b&gt;Do SSRIs Help Children with Autism?&lt;/b&gt; The scope of this systematic review of the literature was to identify if medications called SSRIs (Selective Serotonin Reuptake Inhibitors) are helpful and safe for children with Autism Spectrum Disorder (ASD). These medicines are sometimes used to treat anxiety, obsessive-compulsive behaviors, or other symptoms. &lt;b&gt;What Did the Study Look At?&lt;/b&gt; The researchers carefully examined seven studies that included 606 children with ASD. They compared the effects of SSRIs to a placebo (a pill with no active medicine). &lt;b&gt;What Did They Find?&lt;/b&gt; The researchers found that there is not enough data to confidently judge the effect of SSRI on restricted-repetitive behaviors and anxiety symptoms in children with ASD.Data available shows that SSRIs likely don't improve obsessive-compulsive symptoms or disruptive behaviors in children with ASD.SSRIs probably don't make a noticeable difference in overall daily functioning in children with ASD.Children taking SSRIs might experience a small increase in side effects like upset stomach or sleep problems.No studies looked at how SSRIs affect depression in children with ASD. &lt;b&gt;What Does This Mean for Families?&lt;/b&gt; Right now, there isn't strong evidence to support using SSRIs for children with ASD. Every child is unique, so if you're considering this medication, it's essential to weigh the possible risks and benefits with your doctor.More research is needed to p","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"20 ","pages":"11795565261442820"},"PeriodicalIF":1.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13254149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developmental Dysplasia of the Hip: Management from a Pediatrician Perspective.","authors":"Anthony El Alam, Joseph Mouawad, Andrew Takchi, Joeffroy Otayek, Joe Ghanimeh, Elie Saliba","doi":"10.1177/11795565261431184","DOIUrl":"10.1177/11795565261431184","url":null,"abstract":"<p><strong>Objectives: </strong>Developmental Dysplasia of the Hip (DDH) is a common congenital anomaly requiring early diagnosis to minimize invasive treatments. This study evaluates Lebanese pediatricians' knowledge of DDH risk factors, screening methods, and treatment strategies, comparing their practices to American and European guidelines to propose screening recommendations.</p><p><strong>Methods: </strong>A cross-sectional descriptive study was conducted using a confidential questionnaire to assess Lebanese pediatricians' knowledge and practices regarding DDH. Contact information for pediatricians was obtained from the Lebanese Order of Physicians. Out of 600 emailed and 100 distributed questionnaires, 263 responses were received, and data were analyzed using proportion tests.</p><p><strong>Results: </strong>Of the 263 respondents (19.9% response rate), 84% routinely ordered radiographs at 4 months, while only 0.4% followed recommended guidelines. About 50% performed hip stability tests (Barlow and Ortolani) at 6 months, and 78.32% recommended the Pavlik harness for post-6-month treatment. Additionally, 97% valued periodic reminders about DDH. Significant gaps were identified in training on risk factor identification, physical examination procedures, imaging indications, management of abnormal findings, and treatment choices.</p><p><strong>Conclusions: </strong>The study highlights a critical training gap in DDH screening among Lebanese pediatricians. Implementing routine neonatal screening aligned with international recommendations is essential to reduce delayed diagnosis and its associated economic burden. Improved education and training on DDH screening and treatment are crucial for early detection and better patient outcomes.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":" ","pages":"11795565261431184"},"PeriodicalIF":1.7,"publicationDate":"2026-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a Predictive Nomogram for Mortality Among Neonates With Necrotizing Enterocolitis in Tertiary Care Hospitals at Bahir Dar City, Bahir Dar, Northwest Ethiopia.","authors":"Belaynew Alebachew Zemed, Zelalem Alamrew Anteneh","doi":"10.1177/11795565261443888","DOIUrl":"10.1177/11795565261443888","url":null,"abstract":"<p><strong>Background: </strong>Necrotizing Enterocolitis (NEC) is a serious gastrointestinal disease primarily affecting preterm neonates. Despite improvements in neonatal care, NEC continues to contribute significantly to neonatal mortality, particularly in low-resource settings. In Ethiopia, NEC-related mortality rates vary from 45% to 89%, reflecting both the severity of the disease and inconsistencies in existing evidence. Moreover, little is known about the predictors of NEC-related mortality in the local context. This underscores the need for a locally derived predictive model to support early risk stratification and guide clinical decision-making.</p><p><strong>Methods: </strong>A prospective cohort study was conducted among 251 neonates hospitalized with Necrotizing Enterocolitis. Data were analyzed using R, a multivariable analysis was performed to identify predictors of mortality, and a nomogram was developed. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC) and calibration plot. Bootstrapping was used to validate all accuracy measures. A decision curve analysis was used to evaluate the clinical and public health utility of our model.</p><p><strong>Results: </strong>NEC mortality rate was 51% (95%CI: 45.00-57.34). Out born delivery, lower gestational age, disease onset ⩽3 days, delayed first feeding beyond 48 hours of postnatal age, abdominal wall erythema, stage III NEC, severe thrombocytopenia, clinical deterioration within 48 hours of diagnosis, and hospital-acquired infection were Key predictors remained in the reduced model. The AUC of the original model was 0.965 (95%CI: 0.943, 0.982), whereas the nomogram model has an AUC of 0.959 (95%CI: 0.942, 0.982). Our decision curve analysis for the model provides a higher net benefit across ranges of threshold probabilities.</p><p><strong>Conclusions: </strong>Our model has excellent discrimination and calibration performance. Similarly, the nomogram model has excellent model ability with an insignificant loss of accuracy from the original. The models can have the potential to improve care and treatment outcomes in the clinical settings.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":" ","pages":"11795565261443888"},"PeriodicalIF":1.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}