This study aimed to assess clinical outcomes and associated factors among children with meningitis at Ras Desta Damtew Memorial Hospital. A retrospective cohort study was conducted from April 2022 to May 2024. Multivariable logistic regression analyses were performed after adjusting for potential confounders and P < .05 considered significant. The magnitude of good clinical outcome was 90.9% (95% CI: 87.3, 94.4). Factors significantly associated were: age >2 months (AOR: 12.1; 95% CI: 3.39, 42.89; P < .001), duration of illness <72 hours prior to hospital admission (AOR: 4.75; 95% CI: 1.36, 16.56; P = .014), completed immunization status (AOR: 3.72; 95% CI: 1.19, 11.63; P = .024), and absence of severe acute malnutrition (AOR: 5.18; 95% CI: 1.18, 22.71; P = .029). Public health strategies should prioritize addressing severe acute malnutrition, ensuring complete immunization, and promoting early healthcare-seeking within 72 hours of symptom onset.
Dengue is endemic in India, placing all pregnant women at risk, with the highest likelihood of vertical transmission in the third trimester. Perinatal dengue remains poorly understood, particularly its hepatic manifestations and management in preterm neonates. We report a preterm male neonate (30 + 6 weeks, 1.94 kg) born to a dengue-infected mother, presenting with fever on day 4. Vertically transmitted dengue was confirmed by positive IgM and NS1 antigen. The infant developed severe hepatitis (SGOT 2160 U/l, SGPT 358 U/l), refractory thrombocytopenia (nadir 21 000/cumm) and hyperferritinaemia (>100 000 ng/ml). The baby was successfully managed with intravenous N-acetylcysteine for dengue-associated hepatitis and methylprednisolone for refractory thrombocytopenia, resulting in dramatic clinical improvement. Subsequently, he developed prolonged cholestasis, and by day 36, ultrasound showed hepatic dystrophic calcifications as post-infective sequelae, highlighting the need for vigilance and prolonged follow-up.
The GM2 gangliosidoses (GM2) are ultra-rare neurodegenerative disorders caused by deficient hexosaminidase A and/or B activity, leading to lysosomal GM2 ganglioside accumulation. Disease onset ranges from infancy to adulthood, with earlier onset associated with more rapid progression. Neurofilament light chain (NfL), a sensitive marker of axonal injury, has been extensively investigated as a biomarker for neurodegenerative disorders, including GM2. To evaluate its clinical utility as a biomarker for GM2, NfL was measured in patients with GM2 enrolled in a Phase 2b, multinational, rater-blinded study of levacetylleucine [NCT03759665], and in its open-label Extension Phase (EP). Nineteen participants had viable samples for NfL analysis at baseline, after six weeks of treatment, and after a six-week washout; 10 had samples in the long-term EP. After the initial 6-week treatment phase, NfL concentration declined a mean - 8.9% (SD 13%; p < 0.008), followed by a rebound of + 9.2% (SD 16.1%; p = 0.022) during the post-treatment 6-week washout. Changes in NfL correlated with the statistically significant and clinically meaningful changes captured on the primary Clinical Impression of Change in Severity (CI-CS), and secondary Scale for the Assessment and Rating of Ataxia (SARA) and Modified Disability Rating Scale (mDRS). In the EP, patients showed a mean NfL reduction of - 16.9% after 1 year (SD 15.0; p = 0.010) and - 33.5% after 2 years (SD 12.8; p < 0.001) of levacetylleucine treatment. These findings support NfL as a promising surrogate outcome candidate for GM2 and link biochemical improvement with functional benefit, which is reasonably likely to predict both disease activity and treatment response/clinical benefit.
Hemolytic uremic syndrome is an acute condition where microvascular thrombi occur in the vasculature of the renal system, resulting in thrombocytopenia, microangiopathic hemolytic anemia, and acute kidney injury. Hemolytic uremic syndrome may originate from either congenital or acquired causes. Hemolytic uremic syndrome is initially treated with supportive care measures; however, if fulminant renal failure ensues, dialysis may be necessary.
To investigate the association of serum 25(OH)D levels with dengue severity in Vietnamese children and the association of common VDR gene polymorphisms with disease outcomes. This cross-sectional study included 178 children with confirmed dengue at a tertiary hospital in 2024. Serum 25(OH)D levels were measured, and 4 VDR polymorphisms (FokI, ApaI, TaqI, BsmI) were genotyped. Associations with WHO-defined severity were assessed using logistic regression. Severe dengue was more common in older children and was characterized by greater plasma leakage and thrombocytopenia (P < .001). Serum 25(OH)D concentrations were independently and inversely associated with dengue severity, with an adjusted odds ratio of 0.89 (95% CI: 0.85-0.93; P < .001). In contrast, allele and genotype distributions of the 4 VDR polymorphisms did not differ significantly across severity groups (P > .05). Our findings suggest vitamin D status may be more relevant to dengue severity than inherited VDR variation.
Pediatric nursing is rapidly evolving with the integration of innovative technologies aimed at improving healthcare delivery and outcomes for children. To map the extent and characteristics of pediatric nursing literature on (1) virtual reality (VR) for procedural care, (2) telehealth models, (3) artificial intelligence (AI)-supported diagnostics, (4) technology-enabled obesity interventions, and (5) digital mental-health tools; and to identify outcomes studied, populations/settings, study designs, and research gaps. A scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines was conducted. Peer-reviewed articles published from 2010 to 2024 were retrieved from PubMed, CINAHL, Scopus, Cochrane Library, and Google Scholar. Inclusion criteria were studies involving pediatric populations and addressing one of the specified technologies or interventions. Twenty-five studies were included. VR was effective in reducing procedural pain and anxiety. Telehealth improved care access, especially in underserved areas. AI-supported early diagnosis of diseases such as congenital heart defects. Nursing interventions for childhood obesity were most effective when multidisciplinary and personalized. Digital tools helped pediatric patients manage mental health conditions associated with chronic illness. However, gaps exist in long-term effectiveness, scalability, and integration. Emerging technologies in pediatric nursing offer substantial benefits but require further validation and structured implementation. Future research should focus on standardizing protocols, assessing cost-effectiveness, and addressing equity in access.
Henoch-Schoenlein purpura (HSP) is an immunoglobulin A mediated vasculitis and mainly affects skin, joints, gastrointestinal tract, and kidneys. Typically, skin lesions present as erythematous maculopapular, petechiae, and purpuric rash and atypically as a bullous lesion. A 6-year-old female presented with bullous lesions over her hands and legs, oligoarthritis, abdominal pain complicated with hypotensive shock. The patient was managed with fluid resuscitation, corticosteroids, and antibiotics which offered significant improvement. Bullous IgA vasculitis complicated by non-hemorrhagic hypovolemic shock is rare and may pose diagnostic challenges. Early recognition and timely management are essential to prevent morbidity.
Spina bifida (SB) is a congenital disorder often leading to disability and limited social participation. Children with SB face challenges engaging at home, school, and in the community. This review examined the types and degrees of social functioning in children with SB. Researchers searched 5 databases (CINAHL, MEDLINE, PubMed, EMBASE, and PsycINFO) for studies of various designs, both qualitative and quantitative, published between 2000 and 2025 that involved children with spina bifida (SB) aged 18 years or younger. Findings revealed restricted participation with peers and family due to continence issues, motor impairments, stigma, and cognitive difficulties. Four domains of social functioning emerged: school and community participation, peer relationships and freindships, family interactions and parental role, and independence and autonomy. Children with SB demonstrate reduced social functioning. More research is needed to clarify the impact of parental expectations on social outcomes.
Bowel obstruction is a major surgical emergency associated with considerable postoperative morbidity and mortality, particularly in low-resource settings. Evidence on surgical outcomes in Ethiopia remains inconsistent. This systematic review and meta-analysis aimed to estimate the pooled magnitude of poor surgical treatment outcomes of bowel obstruction and identify associated factors. A comprehensive search of PubMed, Cochrane Library, HINARI, AJOL, and google scholar was conducted. Observational studies reporting surgical outcomes among Ethiopian patients with bowel obstruction were included. Poor surgical outcomes were identified as postoperative complications and/or death in the hospital. A random effect meta-analysis model was used to calculate pooled prevalence and pooled odds ratios with 95% confidence intervals. Heterogeneity and publication bias were assessed using standard statistical methods. Twenty-one studies comprising 5,429 patients were included. The pooled prevalence of poor surgical treatment outcomes in Ethiopia was 24% (95% CI: 19%-28%), with substantial heterogeneity (I2=93.6%). Delayed hospital presentation (>=24hours) (OR=2.2; 95% CI: 1.52-3.24), hospital stay >7 days (OR=2.37; 95%CI 1.72-3.25), and undergoing resection and anastomosis (OR=3.35; 95% CI: 2.07-5.4) were significantly associated with poor outcomes. The prevalence of poor surgical treatment outcomes of bowel obstruction in Ethiopia was relatively high. Early presentation, timely intervention, and strengthening perioperative care are critical to improving surgical outcomes.
Anemia is a global public health concern. This study aimed to analyze the non-fatal health outcomes of dietary iron deficiency anemia in ESSA from 1990 to 2023. Data from the Global Burden of Diseases 2023 study was used to estimate the non-fatal health outcomes of dietary iron deficiency anemia. In 2023, the age-standardized prevalence and YLD rate of dietary iron deficiency anemia were 26899 (95% UI: 23092, 31657), and 807 (95% UI: 488, 1357) in ESSA. The Prevalence and YLD rates were highest among children under five years, with females showing higher rates across nearly all age groups. From 1990 to 2023, the age-standardized rates remained unchanged throughout the region. Dietary iron deficiency anemia remains a public health problem in the ESSA region since 1990.
In 2023, Kakuma refugee camp experienced measles outbreaks leading to delayed provision of pediatric surgical care. Our objective was to assess postoperative outcomes following the implementation of a new protocol to minimize pediatric surgical patient exposure to measles. We retrospectively reviewed ambulatory pediatric surgical care in Kakuma refugee camp to determine demographic information, diagnoses and procedures done, and postoperative outcomes following implementation of the new protocol. We conducted a total of 28 ambulatory pediatric procedures. All 25 patients had received their measles vaccine preoperatively (100%); 35.7% of the procedures were inguinal hernia repairs, 50 % were hydrocele repairs, and 10.71% were umbilical hernia repairs. There were no postoperative deaths, cases of measles, and no surgical site infections (0%). Ambulatory pediatric surgical care provision is feasible in the refugee context during a measles outbreak, and the outcomes were comparable to other settings.
Early childhood development is shaped by interactions between biological, prenatal, nutritional, and social factors. Evidence regarding their domain-specific associations across ASQ-3 domains remains limited in Eastern Europe. To examine biological, prenatal, nutritional, and social predictors of developmental outcomes measured with the ASQ-3. This cross-sectional study included 167 full-term Bulgarian children aged 14-42 months. Parents completed age-appropriate ASQ-3 questionnaires and a structured survey on prenatal and family characteristics. Raw ASQ-3 scores were converted into age-standardized Z-scores. Stepwise multiple linear regression analyses were conducted for each domain. Longer breastfeeding duration was positively associated with communication, fine motor, and problem-solving outcomes. Prenatal tobacco exposure was associated with lower communication, fine motor, and problem-solving scores. Communication outcomes were additionally associated with residential setting and bilingual home environment. No significant predictors were identified for gross motor development. Early developmental domains demonstrate distinct associations with prenatal, nutritional, and social factors.
Lipoma of the corpus callosum is a rare congenital malformation of the central nervous system and is seldom encountered in clinical practice. These lesions are most often discovered incidentally during neuroimaging performed for unrelated clinical indications. We report the case of a male neonate presenting with transient hypotonia, in whom a congenital lipoma of the corpus callosum was identified on imaging. The diagnosis was established using cranial ultrasonography followed by magnetic resonance imaging. The clinical course was favorable, with spontaneous resolution of hypotonia under conservative management. This case highlights the role of ultrasound and MRI in the diagnosis of congenital intracranial lipomas and the typically benign course of isolated corpus callosum lipomas.
Despite improved survival after pediatric hematopoietic stem cell transplantation (HSCT) in Thailand, many children experience physical and psychological distress. This pilot study evaluated the feasibility of a child life program and its preliminary effects on outcomes. This pilot pre-post study included 10 children aged 2-8 years undergoing HSCT. The program comprised an HSCT educational video, therapeutic play, art therapy, online group activities, and homebound instruction after discharge. Outcomes were assessed at baseline and 6 months using the Pediatric Quality of Life Inventory (PedsQL), Child Behavior Checklist (CBCL), and Parenting Stress Index (PSI). Changes were analyzed using paired t-tests. PedsQL total, nausea, and nutrition scores improved significantly. PSI difficult child scores decreased slightly, whereas CBCL scores showed no significant changes. Six children returned to school within one year. Child life services were feasible and showed potential to improve short-term quality of life in HSCT patients.
Low birth weight (LBW) is a major contributor to neonatal mortality globally. In Uganda, a surge in LBW deliveries has been noted. This retrospective study assessed LBW prevalence, associated factors, and outcomes at Kayunga Regional Referral Hospital from February 2023 to February 2024. Of 1,177 neonatal admissions, 37.4% were LBW, with detailed analysis of 204 LBW weighing <2.0 kg requiring inpatient care. Data analyzed using STATA v15, logistic regression done for multivariate analysis. Ethical approval was obtained. Lower gestational age (AOR = 333.04; 95% CI: 57.84-1917.53; P < .001), respiratory distress syndrome (AOR = 0.02; 95% CI: 0.01-0.29; P < .001) and apnea of prematurity (AOR = 0.08; 95% CI: 0.02-0.35; P < .001) were associated with LBW. Mortality was highest among very LBW (44.4%). The study highlights a high burden of LBW with poorer outcomes among very and extreme LBW neonates, underscoring the need to strengthen antenatal care and neonatal care services.
In rural Ghana, families caring for children with cerebral palsy face physical, emotional, and financial challenges, yet little context-specific evidence exists. This study explored the lived experiences of caregivers at Upper East Regional Hospital. Using a qualitative, descriptive, exploratory design under the ABC-X model, 15 purposively sampled caregivers of children ≤ 18 years with CP were interviewed. Data were analyzed via Braun and Clarke's reflexive thematic approach. Two main themes, perceptions and role challenges, with 8 sub-themes emerged. Caregivers' understanding ranged from accurate knowledge (eg, prematurity, birth complications) to misconceptions. Caregiving imposed physical, financial, and social burdens. Cultural beliefs and stigma influenced care, prompting navigation between traditional and biomedical treatments. Caregivers face multidimensional burdens compounded by limited knowledge and stigma. Interventions should include CP education, psychosocial support, stigma reduction, and strengthened biomedical and community-based services to improve caregiver and child well-being.
To assess resting-state functional connectivity and exploratory cognitive vulnerability in pediatric survivors of severe COVID-19 compared with healthy pre-pandemic controls. Pediatric neurocognitive sequelae after SARS-CoV-2 infection remain poorly characterized. We conducted an observational case-control study including 14 children hospitalized for severe COVID-19 and 31 healthy pre-pandemic controls scanned on the same 3T MRI system using identical rs-fMRI protocols and a standardized CONN/SPM pipeline. ROI-to-ROI connectivity was analyzed with cluster-level FDR correction (P < .05). Post-COVID participants showed 3 altered connectivity clusters: increased Default Mode-visual medial coupling, stronger dorsal attention-sensorimotor anticorrelations, and enhanced temporo-occipital-vermis connectivity. In an exploratory subset (8 post-COVID, 12 controls), 50% of post-COVID children had abnormally low Timeliness and 25% low Impulsivity MOXO-d-CPT z-scores, whereas no controls were abnormal. These preliminary findings suggest subtle post-infectious cognitive vulnerability and warrant confirmation in larger longitudinal cohorts.
Crohn's disease is a chronic inflammatory bowel disease in which extraintestinal manifestations may occur before the onset of intestinal symptoms. Ocular manifestations, such as orbital myositis, are extremely rare as initial presentations. We present an interesting case of a 10-year-old female who presented with fever, abdominal pain, weight loss, diarrhea, and purulent rectal drainage and was subsequently diagnosed with Crohn's disease. Notably, she had been diagnosed with orbital myositis the previous year after presenting with right-greater-than-left eyelid drooping, swelling, pain, and redness. This case underscores the importance of recognizing the rare yet clinically significant association between orbital myositis and Crohn's disease. Awareness of this relationship may facilitate prompt diagnosis and earlier therapeutic intervention, potentially preventing disease progression or complications. Clinicians should consider inflammatory bowel disease in their differential diagnosis workup of patients presenting with initial symptoms concerning for orbital myositis.
Childhood granulomatous periorificial dermatitis is an uncommon variant of periorificial dermatitis seen in patients under 18 years of age with several proposed triggers, including topical or inhaled corticosteroid exposure. We report and discuss a case of refractory childhood granulomatous periorificial dermatitis in a 14-year-old female with past inhaled corticosteroid use. After 7 months of isotretinoin therapy followed by 3 months of oral methotrexate, we observed complete resolution of her facial eruption.
Pediatric delirium remains understudied among oncology patients. This study aimed to evaluate the prevalence of delirium and associated factors among children admitted to the pediatric intensive care unit (PICU) in Jordan. A cross-sectional study was conducted over 6 months, including 165 pediatric oncology patients aged 1 month to 18 years. Delirium was assessed twice daily using the Cornell Assessment of Pediatric Delirium (CAPD). Demographic and clinical variables were analyzed for associations with delirium. Delirium occurred in 29% of patients. Younger age (<5 years), prolonged PICU stay (>7 days), and higher night-shift acuity scores were significantly associated with delirium (P < .05). Delirium was also more frequent among patients receiving low-flow oxygen therapy, likely reflecting greater illness severity. Delirium was common among critically ill pediatric oncology patients admitted to the PICU. These findings highlight the importance of routine delirium screening using validated tools in this population.