Childhood Illness Research Articles

Prediction of Operability by Pulmonary Artery Acceleration Time and Right Ventricular Ejection Time in Large Ventricular Septal Defects with Severe Pulmonary Arterial Hypertension

Background: Diagnosing and treating cardiopulmonary illnesses in children depend heavily on evaluating pulmonary hemodynamics. Severe pulmonary artery hypertension (PAH) and Eisenmenger’s syndrome are most frequently seen in post-tricuspid shunts. Right heart catheterization is the gold standard test for calculating pulmonary vascular resistance and pulmonary artery pressures, but it has many flaws, especially regarding shunt abnormalities. Right ventricular ejection and pulmonary artery acceleration times can be useful alternatives for determining pulmonary vascular resistance. Aims and Objectives: This study aimed to correlate pulmonary artery acceleration time (PAAT) and right ventricular ejection time (RVET) with PAH. Materials and Methods: We included 52 patients with large ventricular septal defects (VSD) and severe pulmonary artery hypertension. All children with large VSD and severe PAH admitted for diagnostic catheterization after satisfying the inclusion criteria were included in the study following approval from the institutional ethics committee. All pre-catheterization echocardiographic data were collected with a Philips iE33 ultrasound machine. All of them underwent diagnostic catheterizations. Results: We observed that the chance of operability was high earlier in the age of presentation. PAAT: RVET had a positive correlation with Qp:Qs (pulmonary flow: systemic flow) and were negatively correlated with pulmonary vascular resistance index (PVRI), pulmonary vascular resistance: systemic vascular resistance (PVR:SVR), and mean pulmonary artery pressure (mPAP). In our study, we found that both PAAT and PAAT: RVET were moderately negatively correlated with PVRI and PVR: SVR (r: -0.72, P < 0.001, r: -0.71, P < 0.001 and r: -0.67, P < 0.001, r: -0.71, P < 0.001 respectively). PAAT and PAAT: RVET were moderately negatively correlated with mPAP (r: -0.7. P < 0.001; r: -0.71, P < 0.001 respectively) and positively with Qp:Qs (r: +0.63, P < 0.001; r: 0.67, P < 0.001 respectively). Conclusion: PAAT and PAAT: RVET index are important parameters in assessing pulmonary arterial pressure in large VSD with severe PAH.

AN OVERVIEW OF SIDDHA POLYHERBAL FORMULATION: MILAGU LEGIYAM

Milagu Legiyam is a polyherbal Siddha formulation mentioned in the Siddha literature "Aathmaratchamirtham". It indicates silethumam 96. In the Siddha system of medicine, the clinical presentation of acute pharyngotonsillitis is described under "virana silethumam". Vitiation of kabam is responsible for the virana silethumam. According to modern medicine, this occurs due to the viruses and beta?hemolytic group A streptococci. Nowadays, this is a common illness in children that often leads patients to consult paediatricians. The hot potency of the ingredients of Milagu Legiyam plays the leading role in the management of virana silethumam. Hence, this review highlights the fields of research conducted on the ingredients of Milagu Legiyam. The data was collected from the scientific databases and various textbooks. This review revealed the presence of antimicrobial, antiviral, antioxidant, anti-inflammatory, analgesic, antipyretic, anthelmintic and anticancer activities.

Identifying serious bacterial illness in children: is it time to show the red card to NICE's red flags?

Identifying serious bacterial illness in children: is it time to show the red card to NICE's red flags?

To assess the knowledge and attitudes about depression in the general population in the Wardha District, India.

Background: Physical symptoms of depression, especially tiredness, pain, or disturbed sleep, are common. Some people may experience depression as a chronic condition, with more episodes increasing the risk of recurrence. Others may experience a single episode of depression in their lifetime. Given its great incidence and crippling consequences on development, early-onset depression is regarded as one of the most common mental illnesses in children and adolescents which can last into adulthood. The following categories can be used to classify the factors that affect depression susceptibility: genetics, familial environment, individual characteristics, and extreme stress. Gender, history of depression in the family, subclinical symptoms, poor cognitive style, and negative life events are also main risk factors. Methods: This protocol is for an observational study, which will take place over a four month period in the Wardha district. Participants will be recruited via the Acharya Vinoba Bhave Rural Hospital (AVBRH) as a medical center from the general population. A piloted questionnaire with a Likert scale will be completed by the participants enrolled in the study with assistance from interviewers. Frequency percentage, mean, and SD will be calculated to understand the relationship between various demographic variables and knowledge. Chi-square tests will also be used. Distribution: The data collection of this study is supposed to be completed August 2023 and the results will be communicated to the external funding body through formal report. In addition, the trial results will be communicated to the public through publishing as dataset and original research published in the relevant scientific journals.

Mechanisms of Lung and Intestinal Microbiota and Innate Immune Changes Caused by Pathogenic Enterococcus Faecalis Promoting the Development of Pediatric Pneumonia.

Bacterial pneumonia is the main cause of illness and death in children under 5 years old. We isolated and cultured pathogenic bacteria LE from the intestines of children with pneumonia and replicated the pediatric pneumonia model using an oral gavage bacterial animal model. Interestingly, based on 16srRNA sequencing, we found that the gut and lung microbiota showed the same imbalance trend, which weakened the natural resistance of this area. Further exploration of its mechanism revealed that the disruption of the intestinal mechanical barrier led to the activation of inflammatory factors IL-6 and IL-17, which promoted the recruitment of ILC-3 and the release of IL-17 and IL-22, leading to lung inflammation. The focus of this study is on the premise that the gut and lung microbiota exhibit similar destructive changes, mediating the innate immune response to promote the occurrence of pneumonia and providing a basis for the development and treatment of new drugs for pediatric pneumonia.

Approach to resistant IVIG Kawasaki disease in children

Kawasaki disease (KD) is an acute febrile illness of early childhood characterized by vasculitis of the medium-sized arteries. There is no diagnostic test for KD because the cause is unknown, so diagnosis relies on the recognition of the diagnostic clinical criteria. The most feared sequela of KD is development of coronary artery abnormalities, which occur in 20-25% of untreated children. IVIG reduces this risk in 2-5% when administrated within 10 days from the onset of fever. Here is reported the case of an infant which resulted resistant to 2 consecutive doses of IVIG. Glucocorticoids are recommended as an appropriate therapy in IVIG resistant Kawasaki disease.

Investigation and analysis of children's behavior and outpatient number of respiratory diseases in Shanghai before and after the COVID-19 pandemic

ObjectiveAlterations in behavioral habits of children were analyzed in Shanghai in the winters prior to and following the COVID-19 pandemic, with the aim of assisting in the prevention of children's respiratory diseases in the post-pandemic era. MethodThis cross-sectional survey was conducted via an offline questionnaire from January 1 to February 28, 2021. The behavioral habits of Shanghainese children in different age groups during the winter of 2019 and 2020 were statistically analyzed using the SPSS 25.0 software. The parameters surveyed and analyzed included the frequency of outdoor activities, self-protection measures (frequency of wearing masks and washing hands after going out), travel history, time to visit since symptom onset, and influenza vaccination status. Lastly, the number of cases of respiratory diseases in the pediatric outpatient department of our hospital was analyzed during the same period. ResultA total of 1816 questionnaires were investigated and analyzed, and the results revealed that self-protection measures were significantly enhanced in children of all age groups after the COVID-19 pandemic breakout compared with those before the pandemic, whereas the frequency of outdoor activities and traveling were reduced. In the age group over 3 years old, the time to visit since symptom onset was shorter, and the influenza vaccination rate increased following the pandemic. During the same period, the number of cases of children with respiratory diseases in our outpatient department was significantly decreased compared with that prior to the COVID-19 pandemic. ConclusionThe COVID-19 pandemic has had a significant impact on self-protection measures, outdoor activities, and other children's behaviors in all age groups in Shanghai. These changes in habits were correlated with a lower incidence and transmission of respiratory diseases in children. Overall, this study lays a theoretical basis for the prevention of childhood illnesses in the post-pandemic era.

Contribution of female community health volunteers on the utilization of ANC and PNC by mothers in two districts of Nepal: a Qualitative study

Background and Objectives: A group that has been credited behind the reduction in child and maternal mortality through programs like immunization, integrated management of childhood illnesses, family planning, and preparing pregnant women for delivery are known as Female Community Health Volunteers (FCHV). FCHVs’ roles have gradually expanded beyond family planning programs and especially are focused on maternal and child health services at a large scale. FCHV is often spoken about or spoken for, but there is little evidence of FCHV's own characterization of their practice. so, this study is designed to explores the roles, practices and experiences of FCHVs in the utilisation of Antenatal care (ANC) and Postnatal Care (PNC) services in two contexts; rural and urban Nepal. Materials and Methods: This is a qualitative study carried out in two districts (one urban and the next rural) viz. Kathmandu and Terathum. Questionnaires leading to in-depth interviews were carried out with 28 FCHVs and 15 service users and Key- Informant Interview with the 8 health facility staff and 15 service users who were purposely selected Data were analyzed using thematic analysis. Results: The study found out that the FCHVs have been involved rigorously on screening and counseling pregnant women on nutritious foods, counseling family about the birth preparedness, institutional delivery, ANC and PNC services provided at the health facility in rural Nepal. While in urban Nepal, the referrals on ANC existed only in those places which were outside the ringroad. The PNC services were not that used by the mothers in rural Nepal while the PNC referrals were not made by urban FCHVs as the maternity hospital itself called for a follow-up. The motivating factors for FCHVs were self-identity, social responsibility and social recognition and status that kept them in doing voluntary workers over the years. Conclusion: FCHVs have been contributing a lot of their time and effort to every possible way to make the women of their community survive while being pregnant or after delivery. This study also underlines some of the differences in the real picture of their roles in urban and rural Nepal.

Direct costs of blood drawings with pre-analytical errors in tertiary paediatric hospital care.

Blood drawings is a common hospital procedure involving laboratory and clinical disciplines that is important for the diagnosis and management of illnesses in children. Blood drawings with pre-analytical error (PAE) can lead to increased costs for hospitals and healthcare organisations. The direct cost of blood drawings after a PAE is not fully understood in paediatric hospital care. The aim of this study was to estimate the average direct cost of PAE per year and per 10,000 blood drawings in tertiary paediatric care. A cost analysis using a bottom-up approach was conducted on the basis of combined information from the hospital's laboratory register for the period 2013-2014 and clinical in-ward observations at a tertiary children's referral hospital in Sweden, the Astrid Lindgren Children's Hospital. For the analysis, we hypothesised the re-collection of all blood drawings with PAE and included the average costs of the sampling materials, the time of the healthcare personnel, the laboratory analyses, and in-ward premises based on the time spent on the blood sampling procedure. The annual cost of PAE was estimated to be 74,267 euros per 54,040 blood drawings, which corresponds to 13,756 euros per 10,000 blood drawings or 1.5 euros per draw. The personnel cost represented 60.1% (45,261 euros per year) of the cost due to PAE, followed by costs for hospitalisation (25.2%), laboratory analyses (8.1%), and materials (5.7%). PAEs lead to substantial increases in the costs in tertiary paediatric hospital care. If these PAEs can be avoided, costs related to the re-collection of blood drawings with PAE may be re-allocated to other health-promoting activities for children visiting hospital institutions.

Once Forgotten Now Re-emerging: Scrub Typhus Infection in Pediatric Patients From North West India.

Background Scrub typhus is an important cause of acute febrile illness in children. It is one of the re-emerging infections in the Asia Pacific region. It is caused by the gram-negative bacteriaOrientia tsutsugamushiand is spread by the bite of trombiculid mites. The initial symptomatology is nonspecific with fever, headache, vomiting, etc. The presence of eschar is said to be pathognomic. It is a systemic illness, and vasculitis is the basic pathogenic mechanism. Materials and methods A retrospective observational study was conducted in two medical colleges and associated hospitals of western Uttar Pradesh (UP) and Rajasthan, India. Case files of 21 confirmed cases of scrub typhus admitted from April 2021 to October 2022 were reviewed. Scrub typhus was suspected in children with acute undifferentiated fever, and suggestive signs and symptoms were confirmed serologically with IgM enzyme-linked immunoassay (ELISA). Demographic and clinical details were noted. Results During the study period, a total of 335 cases of acute undifferentiated fever were seen, and 6.2% of them were diagnosed as having scrub typhus infection on detailed investigation. The most common symptom was fever in 100% of them, vomiting in 57.1%, abdomen pain in 42.8%, and diarrhea in 19%. Maculopapular, erythematous rash was present in 19% of cases. None of the patients had eschar. Microvascular leakage was the main complication in 28.5%.Unusual complications seen were empyema and valvulitis in 4.7% of patients. Conclusion Scrub typhus is also seen in urban setups and in dry arid areas like Rajasthan and North West UP. So, relevant investigations should be a part of the evaluation in pediatric patients with acute undifferentiated fever.Eschar can be absent, and empyema and valvulitis are some uncommon complications. A high degree of suspicion and early diagnosis are essential as an undiagnosed infection is rapidly fatal.

Prevalence of Selective Immunoglobulin A Deficiency in Egyptian Asthmatic Patients

Abstract Background Asthma is the most common chronic illness in childhood and a major cause of morbidity in adults, affecting 9.6-13% of children, 7.7-10.1% of adults in the US, and 300 million people globally. Aim of the Work to assess prevalence of selective immunoglobulin A (sIgA) deficiency in Egyptian Asthmatic patients. Patients and Methods This case control study conducted on patients 60 with bronchial asthma according to GINA2011 attending allergy and clinical immunology outpatient clinic at Ain Shams University hospital. They were divided into three groups: the first group includes 20 Asthmatic patients with recurrent chest infections. The second group includes 20 Asthmatic patients without recurrent chest infections and the third group includes 20 healthy controls. All participants were subjected to the following: full history, full clinical examination in addition to the following investigations, complete blood count (CBC) with differential, spirometery, chest X-ray, serum IgG, serum Ig A, serum Ig E, serum IgM and CRP. Conclusions Asthma is one of the most common diseases in the world that can be triggered with SIgAD. Asthmatic patient is more prone to the risk of infections. It may be due to impaired innate and adaptive immune system that predisposes individuals to microbial infections or may be related to the presence of one type of primary immune deficiency such as; SIgAD.

Acceptability and Feasibility of Text Message Interface to Assess Parents' Real-time PICU Experiences.

Parents of children in the pediatric intensive care unit (PICU) experience substantial stress; a parent's perception of their child's illness severity, more than objective measures, predicts psychological outcomes. No tools exist to assess parents' real-time experiences. This pilot study evaluated the feasibility and acceptability of a text-based tool to measure parental experience. Inclusion criteria included PICU stay >48 h, physician approval, smartphone access, and English-speaking caregiver. Eligible parents received a text-based baseline survey and surveys every other day while hospitalized regarding their mood/experiences and optional open-ended questions regarding stressors. They received post-discharge follow-up surveys at 1 week and 1, 3, and 6 months. Follow-up surveys assessed mood and symptoms of depression, anxiety, and post-traumatic stress. Interviews and surveys about the interface were conducted 1 week and 3 months following discharge. Feasibility was assessed by descriptive statistics (eg, response rates), and acceptability was assessed by descriptive statistics (survey results) and thematic analyses of interviews. Of 20 enrolled participants, the first 5 were excluded due to technical issues. Of the 15 included, results demonstrated feasibility and acceptability. Most participants (86%) completed all surveys during the PICU stay and continued to complete surveys at a high rate: 79%-94% 3 months post-discharge. All participants agreed that the system was easy to use and were satisfied with the system at discharge, and 91% remained satisfied 3 months post-discharge. Additionally, 76% reported comfort, and 69% reported benefit. From the interviews, participants lauded the system's convenience and applicability of content. Some proposed changes to improve ergonomics. Many suggested this interface could help teams better support families. A text-based interface for measuring experience in the PICU is feasible and acceptable to parents. Further research can explore how this could identify parents most at risk of adverse psychological sequelae and lead to earlier supportive interventions.

Young Child Undernutrition: Crucial to Prioritize Nutrition Interventions in the First 1000 Days of Life.

The implications of young childhood undernutrition on health, development and productivity are grave. In the last two decades, global and Indian studies on undernutrition in under five years have concluded that stunting and underweight rate increases steadily between 0-24 mo, and then stabilises. The available evidence highlights the significance of concentrating interventions to tackle child undernutrition in the first 1000 d of life, which should aim at universal coverage of essential nutrition interventions (ENIs) and maternal-child health care package comprising maternal nutrition care, adoption of appropriate infant and young child feeding practices (IYCF), iron-folic acid supplementation, immunization, deworming, appropriate management of childhood illness etc. Additionally, it is critical to address context specific nutrition sensitive measures such as socio-economic empowerment of women, preventing domestic violence, adolescent conception, appropriate water -sanitation-hygiene and family planning services etc. Mapping of the 'at risk' households having a member falling in the 1000 d window needs special attention and is central to the ongoing efforts in India through the National Nutrition Mission/ POSHAN Abhiyaan. However, for effective implementation, there is an urgent need to consider to shift the lead responsibility of ENIs in the first 1000 d of life to the health care system in India and strategize to integrate maternal nutrition care interventions and establishing of IYCF practices by ensuring optimum use of contacts with antenatal care and routine child immunization services.

Evaluation of Characterized Depressive Disorder in Children and Adolescents: A Study of 79 Cases

Depression in children and adolescents is a major mental health concern, being the leading cause of illness and disability in children over ten years old. It increases the risk of suicide, affects education, social interactions, and contributes to obesity, tobacco, and substance use. The aim of this study was to highlight the sociodemographic and clinical profile of depression in young individuals, identify risk factors, and discuss appropriate therapeutic options. We conducted a retrospective descriptive and analytical study, using a questionnaire completed jointly by children with characterized depressive disorder and their parents. The study included 79 participants. Statistical analysis was performed using Jamovi version 2.3.21.0 and Microsoft Excel 2021. We found a predominance of females, with an average age of 13.5 years. Antecedents of self-harm and family history of psychiatric disorders were risk factors for suicidal ideation. Common symptoms included sleep disturbances (89.9%), irritability (83.5%), and mood sadness (70.9%). Depression had a significant impact, with 88.6% experiencing social withdrawal and 81% showing decreased school engagement, reflecting the multidimensional effects of depression. Pharmacotherapy was used in 82.3% of cases. However, therapeutic adherence was only good in 60.4% of cases. In summary, this study provides crucial insights into the characteristics, risk factors, and treatments of depression in young individuals within a specific hospital setting. It reinforces knowledge while emphasizing the importance of early and personalized intervention to counteract negative consequences during this critical age.

Prevalence and risk factors of anemia in the mother–child population from a region of the Colombian Caribbean

BackgroundDespite Colombia's robust well-child visits program, Colombian children and mothers still suffer from anemia, especially in populations of lower socioeconomic status. In this study, we aimed to quantify the prevalence and risk factors among mothers and their children attending their well-child visits in Apartadó, a municipality in the Urabá region of the Colombian Caribbean.MethodsThere were 100 mother–child pairs enrolled in this secondary data-analysis study from a health facility in the municipality of Apartadó, Urabá, Colombia, during well-child visits. Self-reported data included child illnesses in the past two weeks (diarrheal, fever, or respiratory symptoms), child feeding practices (breastfeeding, complementary feeding), child vaccinations, and demographic characteristics (mother’s and child’s age, mother’s education, marital status, race, and child sex) and socioeconomic status. Mother and child anthropometry data were collected via standardized weight and height measurements. Mother or child anemia status was collected via a blood test. Chi-squared tests and multivariable logistic regression were used to assess associations between risk factors and anemia.ResultThe anemia prevalence in children (74%) and mothers (47%) was higher than the Colombian national prevalence. Reported child comorbidities in the preceding two weeks were not significantly associated with child anemia and included respiratory illnesses (60%), fever (46%), and diarrhea (30%). Stunting (8%) was not significantly associated with anemia. Wasting (0%) was not observed in this study. Reported child breastfeeding and complementary feeding were also not significantly associated with child anemia. In adjusted models, the child's significant risk factors for anemia included the mother's "Mestiza" race (OR: 4.681; 95% CI: 1.258, 17.421) versus the Afro-Colombian race. Older children (25–60 months) were less likely to develop anemia than younger (6–24 months) children (OR: 0.073; 95% CI: 0.015, 0.360).ConclusionsThe finding of high anemia prevalence in this study advances our understanding of child and maternal anemia in populations of low socioeconomic status where health care is regularly accessed through well-child programs.

Non-Participatory Observation Of Integrated Management Of Childhood Illness Practices At Selected Basic Health Units Of District Abbottabad, Kp, Pakistan: A Qualitative Hermeneutic Study.

It was in 1995 when a strategy was devised to reduce under-five mortality in countries with a prevalence of child mortality above 40/1000 live births. This strategy is called "Integrated Management of Childhood Illness" (IMCI). Improvement in the skills of healthcare workers (HCWs) depends on the IMCI training received by them. To make IMCI training more effective and scale up, a global technical consultation committee in Geneva recommended implementing an innovative training approach in 2014: the distance learning IMCI (dIMCI). This study was conducted to observe qualitatively the practices of IMCI-trained HCWs at their respective workplaces. This qualitative hermeneutic study was conducted through non-probability criterion sampling in the district Abbottabad of Pakistan on all 26 basic health units trained in IMCI (either standard or distance learning) from December 9, 2019, to March 9, 2020. Data collection was done by qualitatively observing consultations and interactions of caretakers of under-five children at basic health units. Inductive thematic analysis was used. This qualitative exploration was underpinned by Hans Georg Gadamer's philosophy of hermeneutics. Four themes emerged from the observation notes. These themes are gratification after consultation, altercation for medication, non-observance of protocol, and methodical consultation. Improvement in the skills of HCWs in the form of IMCI training, either through distance learning or the common eleven-day standard method, can improve caretakers' satisfaction. However, awareness at the community level is needed for better compliance.

Factors Contributing to the Delayed Vaccination Among Children in Riyadh City, Saudi Arabia: A Cross-Sectional Study.

Background Immunizations protect children from deadly infectious diseases. The timeliness of vaccinating children is crucial to ensure effective immunization and to decrease the burden of many infectious diseases. Therefore, this study assessed the prevalence and determinants of vaccination delay among children in Riyadh City, Saudi Arabia. Methods This cross-sectional study was conducted at the primary healthcare centers in Riyadh City, Saudi Arabia, on 593 parents with children of two years of age or below. It used a self-administered questionnaire inquiring about socio-demographic characteristics and assessing the vaccination statuses of their children and the causes of delayed vaccinations. Results The results showed that 7.1% of children had a delay in the previous vaccination. Of those delays, collectively, 77.5% were delays in inactivated poliovirus vaccine (IPV), oral poliovirus vaccine (OPV), and meningococcal vaccine (MCV) vaccines. The delay was mostly caused by an illness of the child on vaccination day, carelessness of parents, or long postponement. After adjusting for confounders, the father's high school or bachelor's education level (OR = 1.18, 95% CI: 1.03, 1.36) (p<0.05), child's mix-type nutrition (OR = 1.06, 95% CI: 1.02, 1.10) (p=0.001), and the belief that multiple vaccines are harmful to the child (POR = 1.03, 95% CI: 1.01, 1.06) (p=0.005) were positively associated with vaccination delay, while prematurity was negatively associated with vaccination delay (OR = 0.96, 95% CI: 0.93, 0.99) (p=0.031). Conclusion The study found the prevalence of vaccination delay was lower than in previous COVID-19-era studies. The child's illness was the main reason for the delay. Factors like parental education, nutrition type, and vaccine beliefs contributed to delays, while prematurity reduced delays. Measures should be strengthened to increase vaccination coverage for children.

Parents' Knowledge, Attitude, and Practice Regarding Traditional Medicine on Their Children: A Community-Based Cross-Sectional Study in Bisha City, Saudi Arabia.

Background The use of traditional medicine (TM) in children is widespread, particularly in developing countries. Parents often rely on TM to treat their children's illnesses or maintain their health. However, the safety and efficacy of TM are often unclear, and there is a need to assess parents' knowledge, attitudes, and practices toward its use. Methods This is a community-based cross-sectional study conducted in Bisha,Saudi Arabia, with a sample size of 555. The study used amodified questionnaireto collect data.The data were collected from March to June 2023. This study involved both descriptive and inferential statistics. Results The study included 555 participants, most of whom were female, Saudi nationals, and married and had a bachelor's degree. More than half of the participants reported using TM, and most believed that it had fewer side effects and could be taken with allopathic medicines. However, many participants did not believe that TM could prevent or cure all diseases or that it was always safe. The median knowledge score was 4.0, with higher scores associated with older age and higher educational level. Most participants had a positive attitude toward TM, with higher attitude scores associated with younger age, male gender, lower educational level, and healthcare-related occupation. The median practice score was 31.0, with higher scores associated with younger age, male gender, illiteracy, and healthcare-related occupation. Overall, the study highlights the importance of understanding the patterns of use, knowledge, attitudes, and practices of TM in the population, particularly among different demographic groups. Conclusions This study highlights the need for better regulation and supervision of TM outlets to ensure the safety and efficacy of the products. It also emphasizes the importance of consulting healthcare professionals before using TM on children. The findings suggest that healthcare providers should be knowledgeable about TM and provide guidance to parents on its appropriate use.

Role of the School Nurse in Addressing Climate-Associated Illnesses of School-Age Children.

Climate change is associated with global health emergencies. School-age children are particularly susceptible to the health effects associated with climate change. School nurses are uniquely positioned to address children's climate-associated illnesses. This article is the first in a series of articles that aims to inform existing knowledge gaps, raise awareness among school nurses, and equip school nurses with the skills they need to protect the health of school-age children. This series of articles will briefly discuss different aspects of the Impact of Climate Change on Human Health diagram, which was created by the Centers for Disease Control and Prevention.

Generation of a recombinant Saffold Virus expressing UnaG as a marker for the visualization of viral infection

BackgroundSaffold virus (SAFV), which belongs to the genus Cardiovirus of the family Picornaviridae, is associated with acute respiratory or gastrointestinal illnesses in children; it is also suspected to cause severe diseases, such as acute flaccid paralysis and aseptic meningitis. However, the understanding of the mechanism of its pathogenicity is still limited due to the many unknowns about its lifecycle; for example, the cellular receptor for its infection remains to be determined. A system to monitor SAFV infection in vitro and in vivo is required in order to accelerate research on SAFV.ResultsWe generated a recombinant SAFV expressing green fluorescent protein (GFP) or UnaG, a novel fluorescent protein derived from Japanese eel. HeLa cells infected by either GFP or UnaG-expressing SAFV showed a bright green fluorescent signal, enabling convenient monitoring of SAFV infection. However, the expression of GFP but not UnaG was quickly lost during virus passaging due to the difference in genetic stability in the SAFV virus genome; the UnaG gene was stably maintained in the virus genome after at least five passages.ConclusionsSAFV infection of cultured cells can easily be monitored using UnaG-expressing SAFV, which is superior to GFP in terms of genetic stability in the virus genome. This virus could be a useful tool for SAFV research, such as comparing the susceptibility of various cells to SAFV infection and evaluating the effects of antivirals on SAFV infection in high-throughput screening.