Pediatric health, medicine and therapeutics最新文献

{"title":"Short-Term Impact of Cardiac Intervention on the Nutritional Status of Malnourished Children with Congenital Heart Disease – A Report from a Developing African Country, Ethiopia","authors":"Kidist Tesfaye, Temesgen Tsega","doi":"10.2147/PHMT.S431164","DOIUrl":"https://doi.org/10.2147/PHMT.S431164","url":null,"abstract":"Background and Objective Malnutrition is a common problem in infants and children with congenital heart defect and has an impact on the disease outcome. This study aimed to assess the short-term impact of corrective cardiac intervention on growth recovery of malnourished children with congenital heart defects. Methods A retrospective cohort study was conducted over a year period (April 2021 to April 2022) by retrieving data from pediatric corrective cardiac interventions performed over a period of 5 years (2017–2021). We enrolled pediatric patients with congenital heart disease whose age is less than 18 years and have undergone corrective cardiac intervention. Those children identified to have malnutrition pre-operatively have been followed for 6 months postoperatively. Anthropometry measurements were used to measure the outcome, before intervention and every 3 months for a total of 6 months after correction. Results A total of 148 children from age 2 months to 18 years with a mean age of 5 years were included in the study. Most of the subjects had acyanotic CHD accounting for 93.2%. Magnitudes of underweight, wasting and stunting at pre intervention were 54%, 54.1% and 59.5% respectively, decreased to 40.7%, 39.2%, 49.2% and 29.3%, 25.9%, 34.8% at the 3rd and 6th month of the post intervention period respectively. Predictors of undernutrition at post intervention were type of CHD, age at correction, PAH, type of intervention and were summarized. Comparison of Z-scores for WFH and HFA on the 3rd and 6th month post intervention has shown significant improvement from baseline. Those subjects with PAH and older age at correction have a greater chance of being underweight and wasted. Conclusion Malnutrition is very common in children with CHD and is predicted by the presence of pulmonary hypertension and older age at correction. Corrective cardiac intervention significantly improved nutritional status during the follow-up over 6 months.","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"195 3","pages":"465 - 475"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138621469","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":"School Feeding and Nutritional Status of Students in Dubti District, Afar, Northeast Ethiopia: Comparative Cross-Sectional Study [Letter].","authors":"Vernando Yanry Lameky","doi":"10.2147/PHMT.S447517","DOIUrl":"10.2147/PHMT.S447517","url":null,"abstract":"","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"453-454"},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10695016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138489302","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":"Prevalence of Bradycardia After Induction of General Anesthesia and Associated Factors Among Surgical Pediatric Patients. A Prospective Observational Study.","authors":"Tajera Tageza Ilala, Gudeta Teku Ayano, Minda Abebe Seife, Mengistu Yinges Kebede, Belete Alemu Geleta, Kidanemariam Tamrat Yilma","doi":"10.2147/PHMT.S429321","DOIUrl":"10.2147/PHMT.S429321","url":null,"abstract":"<p><strong>Background: </strong>Heart rate is the main determinant factor of the child's cardiac output in the first year of life. Thus, bradycardia decreases cardiac output leading to fatal cardiac arrhythmias, cardiac arrest, and even death. The objective of this study is to determine the prevalence of bradycardia and its associated factors after induction of general anesthesia among pediatric patients operated at Hawassa University Comprehensive Specialized Hospital (HUCSH).</p><p><strong>Methods: </strong>Prospective observational study was employed at HUCSH by using a systematic random sampling technique. Pediatric surgical patients less than 6 years old were included in the study. Data were entered into Epi data statistical software (version 4.6.0.) and exported to SPSS (version 25.0). Categorical data were analyzed using chi-square statistics, and continuous data were analyzed using Student's <i>t</i>-test. Bivariable logistic regression was used to select candidate variables for multivariable logistic regression.</p><p><strong>Results: </strong>The prevalence of bradycardia among 205 pediatric patients included in this study was 19.5%. Preoperative risk of hypoxia, opioids premedication, inhalational induction (halothane), difficult intubation, intraoperative complications, and significant surgical blood loss were independently associated with bradycardia.</p><p><strong>Conclusion: </strong>The prevalence of bradycardia after induction of general anesthesia was 19.5%. Preoperative risk of hypoxia, opioids premedication, inhalational induction (particularly with halothane), difficult intubation, intraoperative complications such as hypoxia, and significant blood loss were significantly associated with bradycardia.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"419-434"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10637223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89721009","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":"Detection and Severity Identification of Neonatal Seizure Using Deep Convolutional Neural Networks from Multichannel EEG Signal.","authors":"Biniam Seifu Debelo, Bheema Lingaiah Thamineni, Hanumesh Kumar Dasari, Ahmed Ali Dawud","doi":"10.2147/PHMT.S427773","DOIUrl":"https://doi.org/10.2147/PHMT.S427773","url":null,"abstract":"<p><strong>Introduction: </strong>One of the most frequent neurological conditions in newborns is neonatal seizures, which may indicate severe neurological dysfunction. These seizures may have very subtle or very modest clinical indications because patterns like oscillatory (spike) trains begin with relatively low amplitude and gradually increase over time. This becomes very challenging and erroneous if clinical observation is the primary basis for identifying newborn seizures. In this study, a diagnosis system using deep convolutional neural networks is proposed to determine and classify the severity level of neonatal seizures using multichannel neonatal EEG data.</p><p><strong>Methods: </strong>Datasets from publicly accessible online sources were used to compile clinical multichannel EEG datasets. Various preprocessing steps were taken, including the conversion of 2D time series data to equivalent waveform pictures. The proposed models have undergone training, and evaluations of their performance were conducted.</p><p><strong>Results: </strong>The proposed CNN was used to perform binary classification with an accuracy of 92.6%, F1-score of 92.7%, specificity of 92.8%, and precision of 92.6%. To detect newborn seizures, this model is utilized. Using the proposed CNN model, multiclassification was performed with accuracy rates of 88.6%, specificity rates of 92.18%, F1-score rates of 85.61%, and precision rates of 88.9%. The results demonstrated that the suggested strategy can assist medical professionals in making accurate diagnoses close to healthcare institutions.</p><p><strong>Conclusion: </strong>The developed system was capable of detecting neonatal seizures and has the potential to be used as a decision-making tool in resource-limited areas with a scarcity of expert neurologists.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"405-417"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489750","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":"Management Strategies for Pediatric Moderate-to-Severe Plaque Psoriasis: Spotlight on Biologics","authors":"Angelo Ruggiero, Antonio Portarapillo, Matteo Megna, Cataldo Patruno, Maddalena Napolitano","doi":"10.2147/phmt.s389108","DOIUrl":"https://doi.org/10.2147/phmt.s389108","url":null,"abstract":"Abstract: Although psoriasis onset has been reported at any ages, in up to one-third of cases, it begins during childhood, with an estimated prevalence of about 2% in pediatric population. The management of moderate-to-severe forms of childhood psoriasis may represent a challenge for dermatologists, especially for parents’ concerns about the need of systemic treatments. However, a prompt safe and effective treatment is mandatory in these patients, due to the significative impact that psoriasis may have on their quality of life, with well-known consequences on psychological health of both patients and caregivers. Due to the relatively frequent parents’ refusal of systemic treatments, probably due to the fear of eventual adverse events, difficulties of oral or injective route, the management of moderate-to-severe forms still represents a challenge. Herein, we report a narrative review, aiming to resume the systemic treatments for pediatric psoriasis, focusing on the use of biologics and small molecules in the pediatric ages. The most widely used therapeutic strategies today for the pediatric population with moderate-severe psoriasis are traditional systemic therapies, while more innovative drugs such as biologics and small molecules now represent a somewhat unexplored but certainly promising field for unresponsive patients. Keywords: psoriasis, biologics, childhood, pediatric, small molecules, treatment","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"15 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135764342","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":"Clinical Characteristics, Treatment Outcome and Associated Factors of Epilepsy Among Children at Hospitals of North-West Ethiopia.","authors":"Mohammed Nasir,&nbsp;Ermias Abebaw,&nbsp;Muluken Ahmed,&nbsp;Daniel Bekele Ketema","doi":"10.2147/PHMT.S436022","DOIUrl":"https://doi.org/10.2147/PHMT.S436022","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy is an important cause of neurological morbidity in children and adolescents. Clinical parameters are the main diagnostic tools, especially in developing countries. Although cost-effective treatments for epilepsy are available, studies have shown that uncontrolled seizures can occur in many patients.</p><p><strong>Objective: </strong>To assess clinical characteristics, treatment outcomes, and associated factors for controlled epilepsy among children with epilepsy who underwent follow-up at the Debre Markos Comprehensive Specialized Hospital, North-west Ethiopia from October 28, 2020, to April 28, 2021.</p><p><strong>Methods: </strong>An institutional-based retrospective cohort study was conducted from October 28, 2020, to April 28, 2021. A total of 385 participants who fulfilled the inclusion criteria were included in the study. A pretested, structured, interviewer-administered questionnaire with a chart review was used to collect data. The data were entered into the Epi-data software version 4.4.2.1 and then exported to the Stata version 14 statistical package for analysis. Descriptive statistics were used to describe the sociodemographic and clinical characteristics, treatment profiles, and treatment outcomes of patients with epilepsy. Bivariate and multivariate analyses were used to identify factors associated with treatment outcomes.</p><p><strong>Results: </strong>The most frequent type of seizure among the 385 respondents was Generalized-tonic-clonic seizures (88.1%). The proximate cause of seizures was identified in 15% of patients, of whom 45 had a perinatal history (8.8%), head injury (3.6%), and CNS infection (2.3%). One-third of patients had poor seizure control. Caregiver relationship (father AOR=0.58; 95th CI:0.35,0.97) and poor adherence (AOR=2.97; 95th CI:1.82, 4.86) were significantly associated with treatment outcome.</p><p><strong>Conclusion: </strong>One-third of children with epilepsy have poor seizure control. Poor adherence to treatment is implicated in poor control. Counseling caregivers on proper treatment and adherence to anti-epileptic medication is recommended to improve treatment outcome in children.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"385-404"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489749","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":"Forty days old infant with Pig Bronchus, presenting with recurrent pneumonia: A Case Report.","authors":"Abdul Jamil Rasooly,&nbsp;Sahar Noor,&nbsp;Saif Ullah,&nbsp;Abdul Tawab Baryali,&nbsp;Ahmed Maseh Haidary","doi":"10.2147/PHMT.S429852","DOIUrl":"https://doi.org/10.2147/PHMT.S429852","url":null,"abstract":"<p><strong>Background: </strong>Pig bronchus is rare and usually asymptomatic, but it may also cause significant respiratory symptoms such as recurrent pneumonia, chronic bronchitis, atelectasis, and difficult airway management in surgical and critical care patients. This study is aimed to examine a case of pig bronchus in which the patient presented with recurrent pneumonia in her early days of life.</p><p><strong>Case report: </strong>A case report is the study design utilized in this assessment of a 40-days-old girl from a consanguineous marriage, who presented with cough and difficulty breathing for approximately a month. She was referred from a provincial hospital with no improvement in respiratory symptoms after three times hospitalization since birth. Radiological investigation revealed pig bronchus as the cause of recurrent pneumonia.</p><p><strong>Conclusion: </strong>Pig bronchi, if not diagnosed on time, may result in severe lung infection that can even result in fatal disease. A high level of clinical suspicion is required to initiate an appropriate diagnostic workup. The gold standard modality for the diagnosis of pig bronchus is computed tomography (CT), ideally with multi-detector three-dimensional (3D) image reconstruction.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"379-383"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10624115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489751","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":"Incidence, Outcome and Determinants of Unplanned Extubation Among Pediatric Intensive Care Unit Addis Ababa, Ethiopia, 2023: Nested, Unmatched Case-Control Study Design.","authors":"Aster Shawel Mekonnen,&nbsp;Zegeye Kebede,&nbsp;Dereje Bayissa Demissie","doi":"10.2147/PHMT.S429457","DOIUrl":"https://doi.org/10.2147/PHMT.S429457","url":null,"abstract":"<p><strong>Background: </strong>Unplanned extubating is the most common adverse event occurring in intensive care units (ICUs) and significantly increases morbidity and mortality in children, but there is limited current evidence on unplanned extubating in Ethiopia. Therefore, this study aimed to determine the incidence, outcome, and determinants of unplanned extubating among children in the pediatric intensive care unit in Addis Ababa, Ethiopia, in 2023.</p><p><strong>Methods: </strong>A nested unmatched case-control design study was conducted at selected government hospitals in Addis Ababa from September 1, 2022, to April 30, 2023. A total of 198 intubated child patients (66 cases of unplanned extubating were nested with 132 controls of planned extubating) were followed up until they completed the full weaning process or based on hospital protocols. Data was collected through standardized data extraction, and the data was cleaned, entered into Epidata version 4.6, and exported to SPSS version 25.0 for further analysis. Binary and multiple logistic regression analyses were used to identify determinants of unplanned extubating, with an adjusted odds ratio (AOR) of 99% confidence interval (CI) at p value <0.01.</p><p><strong>Results: </strong>The study revealed a high mortality rate of 15.65% among intubated children in pediatric intensive care units, and the incidence of unplanned extubating was 7.2 per 100 days. This study identified determinants of unplanned extubating among patients admitted to the pediatric intensive care unit: agitated patients (AOR = 3.708; 99% CI: 1.401-9.81), working in night shift hours (AOR: 8.789; 99% CI: 2.37-32.58), use of plaster or roll bandages separately (AOR = 4.12; 99% CI: 1.215-13.96), A nurse-to-patient ration 1:2 (AOR: 6.65, 99% CI: 1.87-23.69), intermittent sedation (AOR, 3.717; 99% CI, 1.017-10.816), physically restrained (AOR = 3.717; 99% CI: 1.02-13.54), and death outcome (AOR = 14.86, 99% CI: 3. 24-68.097), respectively.</p><p><strong>Conclusion and recommendations: </strong>This study found that the incidence and mortality rate of unplanned extubating were high, with identified determinants increasing the risk of unplanned extubating among patients admitted to pediatric intensive care unit. Therefore, policymakers and health planners should design further protocols and algorithms for the management of pediatric endotracheal intubation (ETT) quality of patient outcomes and to prevent unplanned extubating in a resource limited set up.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"347-359"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10614650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71429882","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":"Exocrine Pancreatic Insufficiency in Children - Challenges in Management.","authors":"Senthilkumar Sankararaman,&nbsp;Teresa Schindler","doi":"10.2147/PHMT.S402589","DOIUrl":"https://doi.org/10.2147/PHMT.S402589","url":null,"abstract":"Abstract Cystic fibrosis (CF) is the leading etiology for exocrine pancreatic insufficiency (EPI) in children, followed by chronic pancreatitis, Shwachman-Diamond syndrome, and other genetic disorders. Management of EPI in children poses several unique challenges such as difficulties in early recognition, lack of widespread availability of diagnostic tests and limited number of pediatric-specific pancreatic centers. Pancreatic enzyme replacement therapy is the cornerstone of EPI management and in young children difficulties in administering pancreatic enzymes are frequently encountered. Patients with EPI also should be screened for fat-soluble vitamin deficiencies and receive appropriate supplementation. Among disorders with EPI in children, CF is the relatively well-studied condition, and most management recommendations for EPI in children come from expert consensus and conventional practice guidelines. The impact of EPI can be greater in children given their high metabolic demands and rapid growth. Early diagnosis and aggressive management of EPI prevent consequences of complications such as malnutrition, fat-soluble vitamin deficiencies, and poor bone health and improve outcomes. Management by multi-disciplinary team is the key to success.","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"361-378"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10615098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71429881","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":"Diagnostic and Management Strategies of Food Protein-Induced Enterocolitis Syndrome: Current Perspectives.","authors":"Angela Mulé,&nbsp;Catherine Prattico,&nbsp;Adnan Al Ali,&nbsp;Pasquale Mulé,&nbsp;Moshe Ben-Shoshan","doi":"10.2147/PHMT.S404779","DOIUrl":"https://doi.org/10.2147/PHMT.S404779","url":null,"abstract":"<p><p>Food protein-induced enterocolitis syndrome (FPIES) is a form of non-IgE mediated food allergy that presents with delayed gastrointestinal symptoms after ingestion of the trigger food. The data regarding FPIES are sparse, despite being recognized as a distinct clinical entity. This narrative review presents the characteristics of this disorder in the pediatric population, as well-standard diagnostic and management protocols. FPIES can be classified into acute and chronic subtypes, and some cases may develop into an IgE-mediated allergy. Given that skin prick tests and specific IgE levels are negative in the majority of cases, diagnosis relies on clinical history and oral food challenges. Management involves elimination diets, assessment of tolerance through oral food challenges, and rehydration in the event of a reaction. Future research should focus on improving diagnostic methods, illustrating underlying pathogenesis and biomarkers, and assessing long-term natural history. Increased knowledge and awareness for FPIES are required.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"337-345"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10612481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415833","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}