Bartter syndrome (BS) is a rare inherited renal tubular disorder characterized by hypokalemia, metabolic alkalosis, renal salt wasting, and secondary hyperreninemic hyperaldosteronism with normal or low blood pressure. The classical form (type III) is commonly present in infancy or early childhood but may demonstrate variable clinical features, leading to delayed diagnosis. A 9-month-old male infant was admitted with severe pneumonia and septic shock requiring mechanical ventilation. The child developed persistent hypokalemia, hyponatremia, and metabolic alkalosis despite appropriate correction, resulting in four episodes of extubation failure. Persistent dyselectrolytemia in the presence of normotension and inappropriate renal electrolyte losses raised suspicion of an underlying renal tubular disorder. Elevated plasma renin and aldosterone levels supported the diagnosis of classical BS. Stabilization of serum electrolytes resulted in successful extubation and clinical improvement. This case highlights the importance of considering BS in infants with refractory electrolyte imbalance and unexplained ventilator dependence, particularly when renal salt wasting is evident.

Background: Harlequin Ichthyosis (HI) is a rare, severe autosomal recessive keratinization disorder caused by mutations in the lipid-transporter gene ABCA12. The mutation leads to defective lipid transport, impaired ceramide formation, and failure of epidermal barrier development, predisposing neonates to infection, dehydration, and respiratory compromise. Case Presentation: A 38–39-week gestational age male neonate, born via lower-segment cesarean section to second-degree consanguineous parents, presented at birth with generalized rigid hyperkeratotic yellow skin plates separated by deep erythematous fissures, bilateral ectropion, eclabium, malformed ears, and limb contractures. Supportive care, including emollients, sterile non-adherent dressings with topical antibiotic over fissures, and graded enteral feeding, was provided. On day 3, the neonate developed progressive respiratory insufficiency with oxygen desaturation, requiring endotracheal intubation; however, he succumbed to death within hours due to respiratory failure. Postmortem genetic sequencing could not be performed. Conclusion: This case highlights the fulminant clinical course of severe HI phenotype, persistent mortality risk in resource-limited settings, and the importance of early clinical suspicion, multidisciplinary supportive care, informed consent-based photo documentation, and parental genetic counseling.

Background: Children with spinal muscular atrophy (SMA) have significantly reduced bone mineral density (BMD) compared to other neuromuscular disorders, predisposing them to frequent fractures. Despite this, bone health is frequently under-researched and under-managed in SMA care. Intravenous (IV) bisphosphonates, particularly zoledronate, reportedly improve BMD and reduce fracture risk in other disorders, with a favorable safety profile. This study aimed to evaluate the safety and tolerability of IV zoledronate in SMA type 2 pediatric patients in a tertiary care hospital. Materials and Methods: An observational retrospective study was conducted between June 2022 and July 2024. Twenty-two patients with SMA type 2 had their case notes from the SMA clinic retrospectively reviewed; of these, 8 patients (aged 5-17 years) with SMA type 2 had low BMD (Z <-2.5 on DEXA scan) who met the fitted inclusion criteria and received 0.05 mg/kg body weight of IV zoledronate every 6 months. Patients were monitored for adverse events (AEs), fractures, and clinical outcomes. Results: Fifteen infusions were administered in total; no serious Adverse Events (AEs) or adverse drug reactions (ADR) were observed. Grade I fever in 50% (3/6) of the females and infusion-related grade II pain in 87.5% (7/8) of the patients were observed, which resolved within 24 h with paracetamol. No patient required re-admission. Laboratory parameters and motor scales remained stable and no fractures occurred during the study period. Conclusion: IV zoledronate is safe and well-tolerated in children with SMA type 2 in their multidisciplinary management.

Background: Childhood obesity is a growing public health concern worldwide, with implications for both physical health and cognitive development. Limited data exist in Mosul, Iraq, regarding the prevalence of obesity among primary school children and its potential impact on academic performance. Materials and Methods: An analytical cross-sectional study was conducted from January to June 2025 among 2,310 primary-school children aged 6–12 years in Mosul. Anthropometric measurements (height, weight, BMI) were obtained and classified using CDC growth charts. A structured questionnaire assessed sociodemographic and lifestyle factors. Academic performance was evaluated using standardized Stage 6 mathematics examination scores. Logistic regression identified predictors of overweight/obesity, while multiple linear regression examined associations between obesity and mathematics scores, adjusting for confounders. Results: The prevalence of overweight and obesity was 6.1%, with boys (7.8%) more affected than girls (4.3%). Significant predictors included age (11–12 years), male gender, higher household income, urban residence, parental obesity, prolonged screen time, reduced physical activity, and frequent fast-food consumption. Mathematics scores were negatively associated with obesity, male gender, screen time ≥3 hours/day, and fast-food intake, while positively associated with parental education, higher parental income, urban residence, and daily physical activity ≥30 minutes. Conclusion: Childhood overweight and obesity in Mosul are relatively common and significantly associated with lower mathematics performance. Early interventions involving schools, families, and healthcare providers are essential to promote healthier lifestyles and academic achievement.

Background: Cerebral palsy (CP) is a common childhood disability worldwide that places significant demands on caregivers. Empirical evidence on caregiver strain is scarce in India. This cross-sectional study assessed the quality of life (QOL) of 140 purposively chosen caregivers of children aged 4-12 with CP in Assam, India, using the WHOQOL-BREF questionnaire. Methods: Subscale scores were computed with reliability confirmed using Cronbach's α. Spearman's rank correlation and chi-square tests were performed to investigate the associations of caregiver and child characteristics with the QOL of caregivers. Results: The overall QOL score was 48.46 ±11.49, with 82% of caregivers reporting poor QOL. Significant variations in QOL were associated with parental education, father’s occupation, perceived parental physical and mental health, social isolation, awareness of social services, child’s GMFCS levels, special school enrolment, associated conditions, and social support. Spearman’s rank correlation revealed that the father’s age, mother’s years of schooling, GMFCS levels, and associated conditions of the child were correlated with the QOL of caregivers. Conclusions: Community-level awareness generation programs, establishment of an affordable special school, and increased enrolment, along with a disability-friendly health system, will enhance the QOL of the caregivers.

Neuro-Behçet’s disease (NBD) refers to a constellation of neurological signs and symptoms occurring in patients with Behçet's disease (BD). Pediatric NBD (PNBD) is extremely rare and can present with headache, meningitis, stroke, cerebral venous sinus thrombosis (CVST), psychiatric symptoms, and recurrent fever. Optic nerve involvement in BD has been reported. However, it almost always occurs alongside other features of BD or NBD, which either precede or follow ocular symptoms. Isolated ocular manifestations of PNBD are extremely rare. NBD can be associated with characteristic abnormalities in neuroimaging.We present an unusual PNBD case with recurrent unilateral (left) optic neuritis (ON) without any systemic features or neurological manifestations. The diagnosis was made based on the Cascade sign visualized on Brain Magnetic Resonance Imaging (MRI), highlighting the importance of recognizing neuroimaging patterns. A differential diagnosis of PNBD should be considered in such unusual cases in which other causes of ON have been ruled out, and there are supporting diagnostic markers, such as human leukocyte antigen B51 (HLA-B51) positivity, with or without neuroimaging features of NBD. Early diagnosis ensures disease remission and prevents PNBD-associated morbidity.

Child maltreatment remains a major public health concern in India. Child abuse includes physical, emotional, sexual, and neglect-related harm. Risk factors operate across individual, family, community, and societal levels. Legal protections are extensive but unevenly implemented, despite comprehensive legislation, including the Protection of Children from Sexual Offences Act and the Juvenile Justice Act; the burden of abuse remains high with persistent underreporting.National health programs support early identification. Persistent clinical challenges include limited training, unclear pathways, and rising digital threats. Strengthened training, structured screening tools, multidisciplinary collaboration, and enhanced community awareness are essential to improve child protection. This review summarises the epidemiology, types of abuse, risk factors, legal frameworks, national health programs, and current management approaches. Gaps in paediatric awareness, challenges in reporting, inconsistent enforcement, and emerging threats such as cyber abuse are also highlighted.

Satoyoshi Syndrome, also known as Komuragaeri disease, is a rare multisystemic autoimmune disorder characterised by alopecia, intermittent painful muscle spasms, diarrhoea, endocrinopathies, skeletal deformities, and positivity for antinuclear antibodies (ANA). The etiology of this condition remains unclear. This case report discusses Satoyoshi Syndrome in a 10-year-old girl, emphasising the diagnostic challenge, clinical course, treatments, and outcomes.

Paediatric arterial ischemic stroke (AIS) is a significant cause of acquired brain injury in children, leading to considerable morbidity and mortality. The incidence of AIS in children ranges from 1.2 to 8 cases per 100,000, with diverse etiologies that differ from adults, including congenital abnormalities and lifestyle factors. Recent studies highlight the exacerbating role of infections, such as influenza, and the importance of vaccination in prevention. Diagnosis remains challenging due to nonspecific symptoms and the need for rapid imaging techniques, with vascular imaging being crucial for accurate etiological diagnosis. The management of pediatric AIS requires tailored strategies, including the use of thrombolysis and mechanical thrombectomy, although evidence for these treatments in children is limited. Recovery outcomes are influenced by early intervention, access to rehabilitation services, and parental involvement. The establishment of dedicated pediatric stroke centres and standardized protocols are essential for improving diagnosis and treatment outcomes. Additionally, ongoing research is necessary to develop evidence-based guidelines specifically for pediatric stroke management, addressing the unique needs of this vulnerable population to enhance recovery prospects and quality of life for affected children.

Human milk banking, also known as breast milk banking or lactarium, is a vital service that collects, screens, processes, pasteurizes, and dispenses donated human milk to infants who cannot receive their mother's milk. When a mother’s milk is unavailable, donor human milk is the best alternative for babies who are born premature and low birth weight. Donor human milk acts as a lifeline for infants who can’t receive their mother’s milk. This practice plays a crucial role in providing optimal nutrition and crucial health benefits, particularly for premature, sick, and vulnerable newborns. Growing recognition of the benefits of donor human milk has led to increasing global interest in creating and sustaining human milk banks to fulfill the need for donor human milk. This article will focus on the basics of Human Milk Banking and it’s continuously evolving areas of interest.