World journal of clinical pediatrics最新文献

{"title":"Childhood gastroesophageal reflux disease: A comprehensive review of disease, diagnosis, and therapeutic management.","authors":"Daniyal Raza, Farhan Mohiuddin, Muhammad Haris Khan, Maheen Fawad, Syed Musa Raza","doi":"10.5409/wjcp.v14.i2.101175","DOIUrl":"10.5409/wjcp.v14.i2.101175","url":null,"abstract":"<p><p>Gastroesophageal reflux disease (GERD) affects both adults and children, although the symptoms differ significantly between these groups. While adults typically experience heartburn and regurgitation, children may present with more subtle signs, such as failure to thrive, chronic cough, wheezing, and Sandifer syndrome. Diagnosing GERD in children necessitates a multifaceted approach due to the diverse symptomatology and challenges in communication. Clinical assessment serves as the cornerstone of diagnosis, supported by tools like pH monitoring, esophageal impedance testing, and upper gastrointestinal endoscopy. Imaging studies, such as barium swallow, can also provide valuable insights into anatomical abnormalities and the extent of reflux. Treatment strategies for pediatric GERD include lifestyle adjustments, pharmacotherapy, and, in severe cases, surgical interventions. Lifestyle adjustments may involve changes in feeding patterns, positional therapy, and weight management. Pharmacological options range from acid suppression with proton pump inhibitors or histamine-2 receptor antagonists to surgical procedures like fundoplication for refractory cases. Personalized management is essential, considering the child's age, symptom severity, and the presence of complications. This article aims to offer a comprehensive understanding of pediatric GERD by utilizing current research to enhance clinical approaches and improve patient outcomes.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"101175"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259582","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":"Escalation of soya cross-allergy in infants with cow's milk allergy.","authors":"Bhaswati C Acharyya, Meghdeep Mukhopadhyay","doi":"10.5409/wjcp.v14.i2.101663","DOIUrl":"10.5409/wjcp.v14.i2.101663","url":null,"abstract":"<p><strong>Background: </strong>Cow's milk allergy (CMA) is a common condition in infants, requiring alternative protein sources in their diets. Soya milk has become a popular substitute, especially in developing countries where it is a more affordable option compared to expensive hypoallergenic feeds for infants with insufficient breast milk supply. However, recent observations have shown an increase in soya cross-allergic reactions among infants with CMA.</p><p><strong>Aim: </strong>To determine how often infants diagnosed with CMA also had soya cross-allergy and to examine the symptoms and outcomes of these infants at 2 years of age.</p><p><strong>Methods: </strong>Data from two pediatric centers were analyzed, looking at clinical records of children under 2 years old diagnosed with CMA from August 2015 to July 2023, divided into two four-year periods.</p><p><strong>Results: </strong>The records of 432 infants with CMA were analyzed. In the first four-year period from August 2015 to July 2019, 142 infants were studied, with 27 (19%) found to have soya-protein allergy as well. In the second four-year period, a total of 290 infants were studied, and soya allergy was found in 136 babies (47%). This represents a significant increase (<i>P</i> < 0.0001) in cases of soya protein cross-allergy among infants with CMA. The most common symptoms observed were gastroesophageal reflux disorder (39%), followed by failure to thrive, bloody diarrhea, watery diarrhea, and constipation. At 2 years of age, these infants showed significant growth failure compared to infants with CMA only.</p><p><strong>Conclusion: </strong>In conclusion, this study emphasizes the importance of being cautious when using soy protein in infants with cow's milk protein allergy, especially in areas where cost is a major concern.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"101663"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259588","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":"Importance of celiac disease oral manifestations in pediatric patients: A systematic review.","authors":"Viviana Macho, Rita Rodrigues, Diana Pinto, Rita Castro, Cátia Carvalho Silva, Cristina Cardoso Silva, Sandra Clara Soares","doi":"10.5409/wjcp.v14.i2.102002","DOIUrl":"10.5409/wjcp.v14.i2.102002","url":null,"abstract":"<p><strong>Background: </strong>Celiac disease (CD) is an autoimmune disease triggered by the ingestion of gluten in genetically predisposed individuals. It is more commonly diagnosed in children presenting typical clinical signs and symptoms but most of the CD patients diagnosed in the developed world are silent cases with no prominent gastrointestinal features. Thus, there are silent forms of the disease in which oral manifestations are the first sign. In the pediatric population oral health can affect growth and self-esteem and have a negative impact in their life quality.</p><p><strong>Aim: </strong>To assess the prevalence and types of oral manifestations in pediatric patients with CD.</p><p><strong>Methods: </strong>We performed a comprehensive literature search in PubMed, Scielo, Cochrane Library and Lilacs databases from 2014-2024. Three independent researchers screened and extracted the information, applying the eligibility criteria and bias was assessed using Joanna Briggs Institute tools.</p><p><strong>Results: </strong>Of the initial 241 articles, 14 studies fulfilled the proposed objectives and were included in the review. The main oral manifestations found were recurrent aphthous stomatitis and enamel defects. Additionally, delayed tooth eruption, angular cheilitis, glossodynia and xerostomia were also reported.</p><p><strong>Conclusion: </strong>Assessing oral manifestations is crucial, especially in underdiagnosed cases of children with CD. Recognizing these signs helps pediatricians or general practitioners identify them during routine exams, enabling early diagnosis and treatment to prevent negative impacts on the child's and family's quality of life.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"102002"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259594","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":"Visceral adiposity index and cardiorespiratory fitness: Unmasking risk of impaired fasting glucose among adolescents.","authors":"Ravi Shah, Rimesh Pal, Juniali Hatwal, Akash Batta, Bishav Mohan","doi":"10.5409/wjcp.v14.i2.103442","DOIUrl":"10.5409/wjcp.v14.i2.103442","url":null,"abstract":"<p><p>Type 2 diabetes mellitus (T2DM) is increasing among adolescents, but paediatric risk predictors are relatively underdeveloped. This study aimed to establish the associations of visceral adiposity index (VAI) and cardiorespiratory fitness (CRF) with fasting plasma glucose in 418 Nigerian adolescents aged 11 years to 19 years. Using a cross-sectional design, participants were stratified by VAI and CRF tertiles to examine variations in impaired fasting glucose (IFG) risk. The findings of this study revealed significant gender differences: In the case of boys, high VAI and low CRF is associated with IFG, while no association was present in girls. CRF, measured by the 20-meter shuttle run, was a stronger predictor of IFG than VAI, suggesting that physical fitness is a protective factor against glucose dysregulation. These findings point to VAI and CRF as useful, non-invasive predictors of risk for T2DM in youth, supporting school-based fitness programs that promote CRF and attenuate visceral adiposity, particularly in males. Future work must validate these predictors across various ethnic populations and identify other risk factors that can augment plans for early interventions aimed at the prevention of adolescent T2DM.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"103442"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259535","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":"Breaking the cycle: Psychological and social dimensions of pediatric functional gastrointestinal disorders.","authors":"Mohammed Al-Beltagi, Nermin K Saeed, Adel S Bediwy, Reem Elbeltagi","doi":"10.5409/wjcp.v14.i2.103323","DOIUrl":"10.5409/wjcp.v14.i2.103323","url":null,"abstract":"<p><strong>Background: </strong>Functional gastrointestinal disorders (FGIDs) in children present with chronic symptoms like abdominal pain, diarrhea, and constipation without identifiable structural abnormalities. These disorders are closely linked to gut-brain axis dysfunction, altered gut microbiota, and psychosocial stress, leading to psychiatric comorbidities such as anxiety, depression, and behavioral issues. Understanding this bidirectional relationship is crucial for developing effective, holistic management strategies that address physical and mental health.</p><p><strong>Aim: </strong>To examine the psychiatric impacts of FGIDs in children, focusing on anxiety and depression and their association with other neurodevelopmental disorders of childhood, such as attention-deficit/hyperactivity disorder, emphasizing the role of the gut-brain axis, emotional dysregulation, and psychosocial stress. Key mechanisms explored include neurotransmitter dysregulation, microbiota imbalance, central sensitization, heightening stress reactivity, emotional dysregulation, and symptom perception. The review also evaluates the role of family dynamics and coping strategies in exacerbating FGID symptoms and contributing to psychiatric conditions.</p><p><strong>Methods: </strong>A narrative review was conducted using 328 studies sourced from PubMed, Scopus, and Google Scholar, covering research published over the past 20 years. Inclusion criteria focused on studies examining FGID diagnosis, gut-brain mechanisms, psychiatric comorbidities, and psychosocial factors in pediatric populations. FGIDs commonly affecting children, including functional constipation, abdominal pain, irritable bowel syndrome, gastroesophageal reflux, and cyclic vomiting syndrome, were analyzed concerning their psychological impacts.</p><p><strong>Results: </strong>The review highlights a strong connection between FGIDs and psychiatric symptoms, mediated by gut-brain axis dysfunction, dysregulated microbiota, and central sensitization. These physiological disruptions increase children's vulnerability to anxiety and depression, while psychosocial factors - such as chronic stress, early-life trauma, maladaptive family dynamics, and ineffective coping strategies - intensify the cycle of gastrointestinal and emotional distress.</p><p><strong>Conclusion: </strong>Effective management of FGIDs requires a biopsychosocial approach integrating medical, psychological, and dietary interventions. Parental education, early intervention, and multidisciplinary care coordination are critical in mitigating long-term psychological impacts and improving both gastrointestinal and mental health outcomes in children with FGIDs.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"103323"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259581","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":"Disorders of gut-brain interaction are a new challenge of our increasingly complex society, with worldwide repercussions.","authors":"Earl B Ettienne, Klaus Rose","doi":"10.5409/wjcp.v14.i2.103608","DOIUrl":"10.5409/wjcp.v14.i2.103608","url":null,"abstract":"<p><p>The term disorders of gut-brain interaction (DGBIs) encompasses gastrointestinal disorders that globally affect more than one third of all people. The Rome IV criteria replaced the former term \"functional gastrointestinal disorders.\" DGBIs can seriously challenge health and quality of life (QoL). A traditional but outdated approach differentiated \"organic\" <i>vs</i> \"functional\" disorders, seen by some as real <i>vs</i> psychiatric or undefined ones. This traditional distinction did not help patients whose health and QoL are seriously affected. DGBIs include motility disturbance; visceral hypersensitivity; altered mucosal and immune function; altered central nervous system processing, and more. Several DGBIs affect both children and adolescents. DGBIs are characterized by clusters of symptoms. Their pathophysiology relates to combinations of altered motility, visceral sensitivity, mucosal immune function, and more. Routine investigations find no structural abnormality that would easily explain the symptoms. Symptom-based criteria were developed to better understand patients where no mechanistic explanation was available for clinical practice and inclusion into clinical trials. To understand DGBIs and to find ways to treat them, these rigid mechanistic views fall short.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"103608"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259586","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":"Clinical and genetic diagnosis and management of Silver-Russell syndrome: Report of four cases.","authors":"Ilektra Toulia, Parthena Savvidou, Athina Ververi, Maria G Grammatikopoulou, Konstantina Kosta, Vaya Tziaferi, Charalampos Antachopoulos, Dimitrios G Goulis, Alexandros Sotiriadis, Kyriaki Tsiroukidou","doi":"10.5409/wjcp.v14.i2.100330","DOIUrl":"10.5409/wjcp.v14.i2.100330","url":null,"abstract":"<p><strong>Background: </strong>Silver-Russell syndrome (SRS) is a clinically heterogeneous entity characterized by intrauterine and postnatal growth restriction, relative macrocephaly at birth, distinct facial features, and body asymmetry combined with other malformations.</p><p><strong>Case summary: </strong>Herein, we describe four individuals with SRS, focusing on their prenatal phenotype, postnatal presentation, diagnosis, and management. All cases had a typical phenotype, including postnatal growth failure, short stature (chronic malnutrition), and protruding forehead. Individually, they presented with feeding difficulties, leg length discrepancy, triangular face, or relative macrocephaly at birth, and each one exhibited distinct SRS features, including motor and/or speech delay, experiencing frequent hypoglycemic episodes. The fact that each patient exhibited a different combination of clinical findings underlines the heterogeneity of the syndrome.</p><p><strong>Conclusion: </strong>SRS is diagnosed clinically. However, only 60% of cases are genetically confirmed, while most are sporadic. Although SRS is a well-described syndrome, a delayed diagnosis can have grave consequences on a child's growth. Recombinant human growth hormone treatment is often initiated shortly after the diagnosis. The follow-up requires a multidisciplinary approach.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"100330"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259583","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":"Clinical course and management of hypertriglyceridemia thalassemia syndrome: A case-based systematic review.","authors":"Chane Choed-Amphai, Pattranan Kusontammarat, Supapitch Chanthong, Nattawan Arkarattanakul, Poonyapon Rodchaprom, Lalita Sathitsamitphong, Rungrote Natesirinilkul, Pimlak Charoenkwan","doi":"10.5409/wjcp.v14.i2.101543","DOIUrl":"10.5409/wjcp.v14.i2.101543","url":null,"abstract":"<p><strong>Background: </strong>Hypertriglyceridemia thalassemia syndrome is a rare condition that occurs in patients with thalassemia. It typically presents with a combination of profound anemia and milky serum. Although previous case series have demonstrated the benefit of blood transfusions in reducing serum triglycerides, information regarding clinical outcomes and standard management in this setting remains limited.</p><p><strong>Aim: </strong>To identify the clinical course, treatment strategies, and outcomes of patients with hypertriglyceridemia thalassemia syndrome.</p><p><strong>Methods: </strong>We performed a comprehensive search of the Scopus, PubMed, and Embase databases. We included only English-language articles and did not apply any publication date limits. The databases were last accessed on September 1, 2024. This study was registered under number CRD420250587918 and included studies involving children and adults with thalassemia, hypertriglyceridemia, and available data on clinical course.</p><p><strong>Results: </strong>A total of 14 publications were included in the analysis, all of which were case reports or case series. No higher-quality evidence was available. Among 28 children with hypertriglyceridemia thalassemia syndrome, there were 22 cases of β-thalassemia major and 6 cases of hemoglobin E/β-thalassemia, including our illustrative case. The median age of onset was 11 months, and 92.3% of cases presented prior to the first blood transfusion. The common clinical manifestations included pallor (100%) and hepatosplenomegaly (67.9%). For hypertriglyceridemia-related symptoms, lipemia retinalis and xanthomas were observed in 25.0% and 10.7% of cases, respectively. The median hemoglobin level was 5.5 g/dL, while the median triglyceride level was 935 mg/dL. For management, 92.9% of cases received blood transfusions with or without other interventions. At a median of 12 months' follow-up, all patients responded to the treatment without lipid-lowering agents, and 85.7% of cases were alive.</p><p><strong>Conclusion: </strong>Hypertriglyceridemia thalassemia syndrome occurs exclusively in young children and usually presents with anemia and severe hypertriglyceridemia prior to the first transfusion. Management with blood transfusions provides a favorable response. However, long-term regular monitoring is warranted.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"101543"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259584","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":"Impact of nutritional status on the outcome of critically ill pediatric patients.","authors":"Samriddhi Jain, Amit Agrawal, Shweta Sharma, Ramkumar Chinnadurai","doi":"10.5409/wjcp.v14.i2.103377","DOIUrl":"10.5409/wjcp.v14.i2.103377","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition among patients admitted to a pediatric intensive care unit (PICU) is common. However, there is a lack of data on its impact on the critically ill.</p><p><strong>Aim: </strong>To assess the impact of nutritional status on the outcome of critically ill children admitted to PICU.</p><p><strong>Methods: </strong>This observational study was conducted in a tertiary care teaching institute for one year, including 210 children aged 1 month to 14 years admitted to a 15-bed PICU for a minimum of 24 hours. Patients with less than 24 hours of PICU stay, who received palliative care, or with syndromic short stature were excluded. Relevant data were collected including anthropometric details, demographic data, duration of mechanical ventilation (MV), PICU, and hospital stay and outcome. Malnourished and well-nourished groups were compared using an independent <i>t</i>-test, one-way analysis of variance, and <i>χ</i> ² test.</p><p><strong>Results: </strong>Among 210 patients, there were 129 males and 81 females. There were 57 (27.1%) children less than 6 months of age, 95 (45.2%) between 6 months and 5 years, and 58 (27.6%) more than 5 years of age. The prevalence of malnutrition in the study sample was 51.9% (<i>n</i> = 109). The overall mortality was 22.9% (48/210), 26.6% (29/109) among malnourished, and 18.8% (19/101) among well-nourished children (<i>P</i> = 0.241). A significant association was found between the severity of malnutrition and duration of MV (<i>P</i> = 0.001), PICU stay (<i>P</i> = 0.001), and hospital stay (<i>P</i> = 0.021).</p><p><strong>Conclusion: </strong>Malnutrition is common in critically ill children and contributes to poor clinical outcomes such as duration of MV, PICU, and hospital stay. However, mortality was comparable in both groups.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"103377"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259593","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":"Parental presence in the pediatric intensive care unit reduces postoperative sedative requirements: A retrospective study.","authors":"Vitaliy Sazonov, Alpamys Issanov, Sayazhan Turar, Zaure Tobylbayeva, Olga Mironova, Askhat Saparov, Dmitriy Viderman","doi":"10.5409/wjcp.v14.i2.102049","DOIUrl":"10.5409/wjcp.v14.i2.102049","url":null,"abstract":"<p><strong>Background: </strong>Although critically ill pediatric patients can benefit from the use of sedation, it can cause side effects and even iatrogenic complications. Since pediatric patients cannot adequately express the intensity or location of the pain, discriminating the cause of their irritability and agitation can be more complicated than in adults. Thus, sedation therapy for children requires more careful attention.</p><p><strong>Aim: </strong>To evaluate the association of the internal parental care protocol and the reduction in pediatric intensive care unit (PICU) postoperatively.</p><p><strong>Methods: </strong>This retrospective cohort study was carried out in the PICU of the tertiary medical center in Kazakhstan. The internal parental care protocol was developed and implemented by critical care team. During the pandemic, restrictions were also placed on parental presence in the PICU. We compare two groups: During restriction and after return to normal. The level of agitation was evaluated using the Richmond Agitation-Sedation Scale. Univariate and multivariate logistic regression analyses were performed to examine associations of parental care with sedation therapy.</p><p><strong>Results: </strong>A total of 289 patients were included in the study. Of them, 167 patients were hospitalized during and 122 after the restrictions of parental care. In multivariate analysis, parental care was associated with lower odds of prescribing diazepam (odds ratio = 0.11, 95% confidence interval: 0.05-0.25), controlling for age, sex, cerebral palsy, and type of surgery.</p><p><strong>Conclusion: </strong>The results of this study show that parental care was associated only with decreased odds of prescribing sedative drugs, while no differences were observed for analgesics.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"102049"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259595","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}