Children Mean Age Research Articles

Prevalence and attributes of traumatic dental injuries to anterior teeth among school going children of Kolkata, India

BackgroundTraumatic Dental Injuries (TDI) have emerged as a very significant public health and social problem, especially among children and adolescents. The aim of this study was to investigate the prevalence and associated risk factors of traumatic dental injuries to permanent anterior teeth in school going children of Kolkata aged 7-14 years. MethodA cross-sectional study was conducted among 3762 school going children attending various private and public schools of Kolkata aged 7–14 years. A multistage random clustering sampling technique was adopted to select the children.Type of trauma using Ellis and Davey classification of fractures along with Andresen’s Epidemiological Classification of Traumatic Injuries to Anterior Teeth, including WHO codes, was used. All values were considered statistically significant at P < 0.05. ResultsPrevalence of TDI to anterior teeth was found to be 9.89%. The mean age of children who presented with TDI was 11.06 ± 1.99.years. The most common place of occurrence of TDI was home. Falls were the most common causes of trauma. Children belonging to higher socioeconomic status were observed to have an increased prevalence of TDIs.The highest potential risk factor for the occurrence of trauma was a past history of trauma. ConclusionPresent study found a prevalence of 9.89%, and a very low percentage of children had received treatment.

Comparison of Clinical and Diagnostic Features of Pediatric Oncology Patients With or Without COVID-19 Infection: A Retrospective Chart Review.

There is a scarcity of data summarizing the clinical picture, laboratory, and imaging findings and outcome in children with malignancy and coronavirus disease 2019 (COVID-19) infection. This study characterizes a detailed comparison of pediatric oncology patients with and without COVID infection. A retrospective study was conducted at The Indus Hospital, Karachi, from March 2020 to June 2020. Clinical presentation, laboratory and imaging findings, disease severity, and outcome were compared between cohorts. The mean age of children with and without COVID was 8.0±4.9 and 7.4±4.1 years, respectively. Hematologic malignancy comprised the largest number of patients, followed by solid tumors. Lymphocytosis and low neutrophil-lymphocyte ratio was observed in the COVID positive group. Cardiac dysfunction (1.4% vs. 0%), acute respiratory distress syndrome (8% vs. 0%) and lower peripheral capillary oxygen saturation/fraction of inspired oxygen ratio (473 vs. 486) found to be associated with severe disease in COVID positive group (P<0.05). Overall mortality in children with COVID was 6.8% versus 2.7% in children without COVID. Pediatric patients with malignancy have different clinical features and laboratory parameters as compared with children without malignancy. Acute respiratory distress syndrome, absolute lymphocytosis and low neutrophil-lymphocyte ratio is associated with severe disease in children with malignancy and COVID infection. In contrast to adults, biochemical markers and complete blood count parameters do not help recognize COVID infection in pediatric patients with malignancy.

Computer Vision Syndrome among Children Using Online E-Learning during the COVID-19 Pandemic

Background: Since the declaration of the lockdown due to COVID-19, the usage of digital devices has gone up across the globe, resulting in a challenge for the visual systems of all ages. The aim of this study was to determine frequency, symptoms frequency and associated risk factors of Computer Vision Syndrome (CVS) among children attending online classes during COVID-19 pandemic.&#x0D; Materials and methods: The online electronic survey form was prepared on the Google app. Children/parents were asked to indicate the total duration of digital device use before and during COVID era. The symptoms of CVS, its severity and frequency were recorded and measured with the Computer Vision Syndrome Questionnaire.&#x0D; Results: One hundred and sixty four parents responded to the questionnaire, of these 124 were complete. Mean age of children was 14±3.01 years. Mean duration of digital device used during COVID era was 34.11±2.08 hours which was more than pre COVID era (0.98±0.24 hours). 36.29% used digital devices &gt;5 hours in COVID era as compared to 0% before COVID era. The most common digital device used was smartphones (62.1%). Sixty seven children (54.03%) were attending online classes for &gt;2 hours per day. 50% of the children had CVS. Of these 25% were mild, 12.9% moderate and 12.1% of severe grade. Most common symptoms were itching and headache. Multivariate analysis revealed age &gt;14 years, male gender, smartphone use, use of device &gt;5 hours and mobile games &gt;1 h/day as independent risk factors for CVS in children.&#x0D; Conclusion: There is an increased prevalence of CVS among children in COVID era. Awareness about prevention of CVS should be stressed and going forward, measures to bring these adverse effects to a minimum should be explored.&#x0D; JCMCTA 2021 ; 32 (1) : 48-52

Behavioral Strategies to Minimize Procedural Distress During In-Office Pediatric Tympanostomy Tube Placement Without Sedation or Restraint

The purpose of this study was to evaluate behavioral strategies to minimize procedural distress associated with in-office tympanostomy tube placement for children without general anesthesia, sedation, or papoose-board restraints. 120 6-month- to 4-year-olds and 102 5- to 12-year-olds were treated at 16 otolaryngology practices. Mean age of children was 4.7 years old (SD = 3.18 years), with more boys (58.1%) than girls (41.9%). The cohort included 14% Hispanic or Latinx, 84.2% White, 12.6% Black, 1.8% Asian and 4.1% ‘Other’ race and ethnicity classifications. The in-office tube placement procedure included local anesthesia via lidocaine/epinephrine iontophoresis and tube placement using an integrated and automated myringotomy and tube delivery system. Behavioral strategies were used to minimize procedural distress. Anxiolytics, sedation, or papoose board were not used. Pain was measured via the faces pain scale-revised (FPS-R) self-reported by the children ages 5 through 12 years. Independent coders supervised by a psychologist completed the face, legs, activity, cry, consolability (FLACC) behavior observational rating scale to quantify children’s distress. Mean FPS-R score for tube placement was 3.30, in the “mild’ pain range, and decreased to 1.69 at 5-min post-procedure. Mean tube placement FLACC score was 4.0 (out of a maximum score of 10) for children ages 6 months to 4 years and was 0.4 for children age 5–12 years. Mean FLACC score 3-min post-tube placement was 1.3 for children ages 6 months to 4 years and was 0.2 for children age 5–12 years. FLACC scores were inversely correlated with age, with older children displaying lower distress. The iontophoresis, tube delivery system and behavioral program were associated with generally low behavioral distress. These data suggest that pediatric tympanostomy and tube placement can be achieved in the outpatient setting without anxiolytics, sedatives, or mechanical restraints.

Clinical characteristics of acute liver failure associated with hepatitis A infection in children in Mogadishu, Somalia: a hospital-based retrospective study

BackgroundHepatitis A is one of the most common infectious causes of acute hepatitis, and currently, a neglected global public health problem necessitating an urgent response in Somalia. Hepatitis A infection and its rare complication of acute liver failure in children are largely based on very limited data. The aim of the study was therefore to investigate the Hepatitis A infection and its rare complication of acute liver failure in children in Somalia.MethodsThis retrospective study was conducted on children aged 0–18 years who were admitted to the pediatric departments of the Somalia Mogadishu-Turkey Training and Research Hospital, Somali, from June 2019 and December 2019. Patients who were tested for hepatitis A infection during the study period and had complete data were included. Children with chronic disease, primary or secondary immunodeficiency, blood transfusion history, and missing data were excluded. ed data including patients' demographics, clinical presentation, laboratory results, ultrasonographic findings, length of hospital stay, clinical course and outcome were retrieved from the hospital database system.ResultsOf the 13,047 children, 219 were analyzed. Of the 219 Hepatitis A cases, 25 (11%) were diagnosed with pediatric acute liver failure (PALF). The mean age of children with Hepatitis A was 6.7 years. The majority of cases were reported in the 5–9 (39.7%) year age range. Hepatic encephalopathy, length of hospital stay, levels of albumin, and values of PT, aPPT, and INR were significantly higher in children with acute live failure. The presence of cholecystitis and cholecystitis with ascites in the sonographic evaluation were poor prognostic markers for acute liver failure.ConclusionsThis study revealed hepatitis A virus infection and its related acute liver failure among hospitalized children in Somalia of which 11% had PALF. Hence, the introduction of Hepatitis A vaccination, which is the main public health tool, into the national immunization program, the improvement of hygiene conditions, raising awareness of the disease, and increasing health literacy are necessary to prevent the consequence of the Hepatitis A virus in children.

Correlation between concentrations of four heavy metals in cord blood and childhood blood of Jamaican children

This study investigated whether the concentrations of four metals [lead (Pb), mercury (Hg), manganese (Mn), and aluminum (Al)] are correlated in cord blood and childhood blood samples from Jamaican children. Cord blood samples were obtained from 21 pregnant women enrolled in the second Jamaican Birth Cohort Study from July 1, 2011 to September 30, 2011, and blood samples were drawn from their children who participated in a follow up study when the children were 4–8 years old. Correlations were assessed by the Pearson or the Spearman’s rank correlation coefficient. The mean ages of children at the childhood visit and their mother at the child’s birth were 5.5 years and 29.8 years, respectively. About 47.6% of children were male. Statistically significant correlations between cord blood and childhood blood concentrations of Pb (r Spearman =0.45; P = 0.04) and Mn (r Pearson=0.48; P = 0.03) were found, and these remained significant when adjusted for the child’s sex, age, or both. For Al and Hg, r Spearman=0.29 and 0.08, respectively, but the correlations were not statistically significant (both P ≥ 0.20). A significant correlation between cord blood and childhood blood Pb concentrations for children 4–8 years old has not been previously reported.

Trajectories of perinatal depressive symptoms in the context of the COVID-19 pandemic.

This study sought to advance understanding of the potential long‐term consequences of the COVID‐19 pandemic for child development by characterizing trajectories of maternal perinatal depression, a common and significant risk factor for adverse child outcomes. Data came from 393 women (86% White, 8% Latina; mean age = 33.51 years) recruited during pregnancy (n = 247; mean gestational age = 22.94 weeks) or during the first year postpartum (n = 146; mean child age = 4.50 months; 55% female). Rates of depression appear elevated, relative to published reports and to a pre‐pandemic comparison group (N = 155). This study also provides evidence for subgroups of individuals who differ in their depressive symptom trajectories over the perinatal period. Subgroup membership was related to differences in maternal social support, but not to child birth outcomes.

Multisystem inflammatory syndrome in infant temporally associated with SARS-CoV-2 infection

Since the end of December 2019, corona virus disease (COVID-19) has spread globally. Though the majority of COVID-19 cases in pediatric age group have not been critical, a novel disease named as multisystem inflammatory syndrome in children (MIS-C) have been emerging as the pandemic progresses. A systemic review of the literature was performed in the principle medical databases including Pubmed, Embase and Google Scholar between December 2019 and March 2021. A total of 40 articles were identified in the described database. Altogether 12 articles met the inclusion criteria and were eligible. The critical and severe case were more in infant age group, also the number of hospitalization was more in infant age group than other pediatric age groups. A number of case reports reflected that infants with COVID-19 positive may present with shock and sepsis. The mean age of MIS-C COVID-19 positive children was 1.1 year emphasizing the vulnerability of infant age group to this novel disease MIS-C. MIS-C is a new type of presentation of COVID-19 infection. Special emphasis should be given in infant age group with COVID-19 who are vulnerable to develop MIS-C.

The effect of COVID-19 lockdowns on paediatric lower limb orthopaedic presentations.

IntroductionAs the COVID-19 pandemic was spreading in 2020, the government imposed national lockdowns. We considered the effects these lockdowns had on the paediatric population, with a specific focus on lower limb orthopaedic trauma. We hypothesise that these restrictions will have altered the mechanisms of injury and reduced the number of referrals.Materials and methodsWe retrospectively analysed data from 28/08/19 to 01/04/21, considering the variations in referrals and operations during these times, and analysed these data using an online statistical calculator. We examined the rate of referrals, types of fractures referred to the centre, mechanism of injury, volume of operations performed, and average wait times to undergo an operation. The data were compared in pre-lockdown and lockdown times.Results67 paediatric patients with lower limb fractures were included in this study. Throughout the lockdown periods, the mean age of children referred was younger (6.9 from 11.1) and they were less likely to be injured as a result of sport (p = 0.0493). They were more likely to fracture their lower leg (p = 0.0016) when compared with other anatomical regions. The average weekly rate of referrals dropped (0.84–0.68), but the rate of operations almost quartered (0.39–0.16). The average wait times for operations dropped significantly, with patients waiting 80% less time from the date of their injury.ConclusionThis study highlights the impact of the coronavirus pandemic on the prevalence and management of lower limb paediatric trauma. The demographics and mechanisms of injury which presented to the trust over the pandemic and associated national lockdowns were significantly different. There was a drop in the number of referrals and a preference to non-operative management when patients did present.

Endoscope-Assisted Microsurgery in Pediatric Cases With Pineal Region Tumors: A Study of 18 Cases Series.

Background: An endoscope-assisted technique was recently introduced to microsurgery (MS) and may compensate for the disadvantages of MS for deep-seated lesions. This study was performed to identify the effectiveness and safety of endoscopic-assisted microsurgery (EAM) and share our experience of EAM for pediatric cases with pineal region tumors.Method: We retrospectively analyzed the clinical data of consecutive pediatric cases with pineal region tumors treated by EAM or MS from January 2016 to June 2020. These data included the patient population, clinical manifestations, preoperative examination findings, surgical approach, pathological results, and clinical outcomes. The clinical outcomes were analyzed in the EAM group and MS group with a focus on the gross total resection (GTR) rate, postoperative hydrocephalus remission rate, and Karnofsky performance score (KPS). Studies on the surgical management of children with pineal region tumors in the last decade were reviewed.Result: Eighteen children successfully underwent tumor resection via MS (n = 8) or EAM (n = 10). The children's mean age was 11.4 ± 4.7 years, and the male to female ratio was 7:2. Seventeen patients (94.4%) complicated preoperative hydrocephalus, and 16 (88.9%) presented headache with nausea and/or vomiting. The pathological examination revealed germ cell tumors in 11 (61.1%) patients, neuroepithelial tumors in 4 (22.2%) patients, and a pineoblastoma, arachnoid cyst, and atypical teratoid rhabdoid tumor in 1 (5.6%) patient each. GTR was more commonly achieved in the EAM than MS group (80.0 vs. 50.0%, respectively), and the postoperative hydrocephalus remission rate was higher in the EAM than MS group (87.5 vs. 50.0%, respectively). At a mean follow-up time of 23.6 ± 11.5 weeks, the mean improvement of the KPS 6 months postoperatively was greater in the EAM than MS group (24.0 ± 9.7 vs. 17.5 ± 7.1 points, respectively).Conclusion: EAM combines endoscopic and microsurgical techniques and can be safely and effectively performed to achieve GTR of pineal region tumors in pediatric patients. In children with pineal region tumors who have obstructive hydrocephalus, EAM could improves hydrocephalus remission rates by checking and clearing the midbrain aqueduct under visualization.

Comparison of Clinical and Laboratory Features and Treatment Options of 237 Symptomatic and Asymptomatic Children Infected with SARS-CoV-2 in the Early Phase of the COVID-19 Pandemic in Turkey.

Little is known about the therapeutic use of hydroxychloroquine in pediatric patients with coronavirus disease 2019 (COVID-19). Here, we retrospectively retrieved data of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR-positive pediatric patients from 20 hospitals in 8 Turkish cities. We obtained epidemiological, clinical, and laboratory features of the patients, as well as the drugs used for treating COVID-19. A total of 237 nasopharyngeal swab SARS-CoV-2 PCR-positive children were included in the study from March 26, 2020 to June 20, 2020. The mean age of asymptomatic children (118 ± 62 months) was higher than that of symptomatic children (89 ± 69 months). Symptomatic children had significantly lower mean lymphocyte counts and higher mean CRP, D-dimer, procalcitonin, and LDH levels than asymptomatic children in the univariate analysis. Among 156 children, 78 (50%), 15, 44, and 21 were treated with a hydroxychloroquine-containing regimen, hydroxychloroquine + azithromycin + oseltamivir, hydroxychloroquine + azithromycin, and hydroxychloroquine alone, respectively. Among 156 patients who received medical treatment, 90 (58%) underwent pre- and/or post-treatment electrocardiogram (ECG). However, none of them had ECG abnormalities or required hydroxychloroquine discontinuation due to adverse drug reactions.

Is Body Mass Index Related to Skin Reactivity to Histamine but not to Specific Allergens? A 2-Year Follow-up Study on Korean Children.

Skin prick tests are widely used to diagnose allergic sensitization. The influence of obesity on the skin prick test result has not been clearly established, even though the association between allergic disease and obesity is relatively well known. To determine whether a change in body mass index (BMI) contributes to skin reactivity to histamine and allergens in a skin prick test, we performed a 2-year follow-up study on Korean children. Skin prick tests for common aeroallergens were performed on elementary school students from Jeju Island, Korea. BMI was calculated using weight and height after measuring both, and demographic characteristics were surveyed. The same tests were repeated after 2 years. The sensitization rate increased during the 2 years between tests and the children's mean BMI also increased, along with their age. The wheal sizes induced by Dermatophagoides pteronyssinus, Dermatophagoides farinae, Japanese cedar, and histamine were significantly increased during 2 years; however, only the histamine reaction associated with increased BMI had statistical significance. Furthermore, other variables-including the number of sensitized allergens-were not related to histamine skin reactivity. Histamine skin reactivity increased in children over time and some allergens showed increased specific reactions; however, BMI gain is a specific predictor of histamine reactivity. Further studies are needed to elucidate the clinical significance of these changes.

Assessment of Knowledge, Attitude, Handwashing Practices and its associated factors Among Mothers of Children Presenting in Paediatric Department of a Tertiary Care Hospital of a Developing Country.

Objective: Despite remarkable progress in scientific methods and measures against infectious disease transmission, the prevalence of infectious diseases is still on the rise in resource-poor countries. Hand hygiene is considered an effective way of fighting against deadly infectious diseases. Our study aimed to assess knowledge, attitude, and hand hygiene practices among mothers of children presenting for routine paediatric check-up in the department of paediatrics in a tertiary care hospital of Rawalpindi.Materials and Methods: It’s a descriptive cross-sectional study involving 400 mothers from the paediatric department of the Holy family hospital (HFH), Rawalpindi. A convenient sampling technique was used to select the study participants. A semi-structured, pre-tested questionnaire that included demographic details, knowledge, attitude, and practice levels were assessed through validated questionnaires used in previously published studies. Descriptive statistics were used for demographic details and chi-square analysis was used to find an association between handwashing practice with knowledge and attitude. A P&lt;0.05 was taken as significant. Data analysis was done through SPSS.v.23.Results and Discussion: In total, 400 females participated in the study and the mean age (±SD) was 32.4±10.2 years. The mean age of children was 31.2±12.2 months. The level of good handwashing knowledge and attitude was 93% and 60% respectively. However, the level of good handwashing practice was just 40%. The age of mothers, residential area, occupation, socioeconomic status, and the level of knowledge regarding handwashing, showed significant association with handwashing practices.Conclusion: In our study handwashing practice among mothers was relatively low. Age of mothers, residential area, occupation, socioeconomic status, and the level of knowledge regarding handwashing, were significantly associated with handwashing practices.International Journal of Human and Health Sciences Vol. 05 No. 04 October’21 Page: 418-423

First report of Kingella kingae diagnosed in pediatric bone and joint infections in Morocco

BackgroundThe progress of diagnostic strategies and molecular methods improved the detection of Kingella kingae in bone and joint infections, and now, Kingella kingae is being increasingly recognized as the most frequent cause of bone and joint infection BJI in early childhood. The main objective of this prospective study is to report the frequency of Kingella Kingae in negative culture bone and joint pediatric infections, and to describe the clinical and biologic features of these children.MethodsFrom December 2016 to June 2019, we selected all hospitalized patients with suspected BJI. When culture was negative on the fifth day, children under 10 years were subsequently included in the study, and PCR assay was performed systematically for researching K. kingae specific gene cpn60. Microbial culture and identification were made using standard bacteriological methods. The demographics, clinical, laboratory, radiographic and clinical features were reviewed from medical records.ResultsWe enrolled 65 children with culture negative BJI, 46 of them having under 10 years old have been screened for the cpn60 gene. Thus, the gene encoding Kingella kingae was positive for 27 BJI cases (58.7%). The mean age of children was 3.02 years, 55.6% were aged 6 months-4 years and 29.6% of them were aged 5–10 years. The male to female ratio was 1.7 and 16 cases (59.26%) occurred during the fall-winter period. The most frequent BJI type was septic arthritis (77.8%) and the most affected sites were knee (51.9%) and hip (37.0%). We recorded a mild clinical picture with normal to mildly raised inflammatory markers. All patients had good clinical and functional outcomes, with no serious orthopedic sequelae..ConclusionK kingae is an important pathogen of culture-negative BJI in Moroccan children. PCR testing should be performed in culture-negative cases of children not only in the typical age range of 6 months to 4 years. When implemented in the routine clinical microbiology laboratory, a specific K. kingae PCR assay can provide a better diagnostic performance of BJI.

Determinants of appropriate complementary feeding practices among women with children aged 6-23 months in Iseyin, Nigeria

Malnutrition and poor complementary feeding are more predominant in rural than urban areas. Yet, little attention has been given to these discrepancies and the use of validated composite index to explore determinants of complementary feeding practices. Hence, this study was aimed at identifying the determinants of appropriate complementary feeding practices among mothers with children aged 6-23 months in Iseyin, Nigeria.A community based cross sectional survey involving 390 mother-child dyads was conducted using a three-stage simple random sampling. Information on household sociodemographic characteristics, complementary feeding practices, 24-hour dietary intake and anthropometric characteristics of youngest child in the household were obtained using a semi-structured questionnaire. Complementary feeding indicators and anthropometric indices were estimated using the 2008 World Health Organization recommendations and WHO Anthro, respectively. Data were analysed using descriptive statistics and logistic regression at p<0.05.Mothers’ mean age was 28.7± 5.6 years, 99.4% were married, and 92.1% attended antenatal care sessions. Mean age of children was 14.5±5.1 months, 56.2% were male and 31.0% were firstborn. Of all the children, 72.3% had timely introduction of complementary food, 17.7% had minimum dietary diversity, 46.9% had minimum meal frequency and 14.9% had minimum acceptable diet. Grains, root and tubers (91.3%) constituted the mostly consumed complementary foods. Overall, only 10.0% of children had appropriate complementary feeding; child's age, birth order and mother's income were determinants of appropriate complementary feeding.Appropriate complementary feeding practices remain very low and this is influenced by the child's age, birth order and mother's income.

Identifying HbA1c trajectories and modifiable risk factors of trajectories in 5- to 9-year-olds with recent-onset type 1 diabetes from the United States.

To explore glycated haemoglobin (HbA1c) patterns in 5- to 9-year-olds in the recent-onset period of type 1 diabetes and identify parent psychosocial factors that may predict children's HbA1c trajectory using a prospective, longitudinal design. We measured family demographics and parent psychosocial factors at baseline. We collected HbA1c levels from children every 3months for up to 30months. Deriving several features around HbA1c trends, we used k-means clustering to group trajectories and linear and logistic regressions to identify parent psychosocial predictors of children's HbA1c trajectories. The final cohort included 106 families (48 boys, mean child age 7.50±1.35years and mean diabetes duration 4.71±3.19months). We identified four unique HbA1c trajectories in children: high increasing, high stable, intermediate increasing and low stable. Compared to a low stable trajectory, increasing parent-reported hypoglycaemia fear total score was associated with decreased odds of having a high stable or intermediate increasing trajectory. Increasing parent-reported diabetes-specific family conflict total score was associated with increased odds of having a high stable or intermediate increasing trajectory. We are the first to identify distinct HbA1c trajectories in 5- to 9-year-olds with recent-onset type 1 diabetes as well as parent psychosocial factors that may predict high stable or increasing trajectories and could represent future treatment targets.

Blood's Concentration of Lead and Arsenic Associated with Anemia in Peruvian Children.

This exploratory, descriptive cohort study (N = 60) determined lead (Pb) and arsenic (As) blood concentrations in Peruvian children and their association with hematological parameters of iron-deficient anemia (IDA) and anthropometric measurement. The mean age of children was 10.8 months (SD = 4.7) and ranged from 3 to 24 months old. Anemia (Hb levels below 10.5 g/dL) was found in 20% of this cohort. Additionally, microcytosis (MCV < 70 fL) was present in 54%, and hypochromia (MCH < 23 pg) in 42% of the group of children. Chi-square analysis showed that 88% of the children with anemia also had microcytosis and hypochromia (p < 0.001). Pb and As were detected in 100% of the infants' blood samples, and the concentrations were significantly higher in older infants than in younger ones. Pb and As were not associated with the sex, anthropomorphic parameters, or infant hemogram changes. Infants who received iron supplementation were 87% less likely to have low Hb compared with those who did not (OR = 0.13, 95% CI = 0.02–0.88, p=0.04). Herbal tea intake was significantly associated with microcytosis and hypochromia. Our finding uncovered that hematological parameters for anemia are modified in Peruvian children with high levels of microcytosis and hypochromia. Concentrations of Pb and As were above method detection limits in all Peruvian children, but these were not associated with IDA or anthropometric measurements. A large study, including other variables, would benefit from allowing a more complex model predicting anemia in Peruvian children.

Knowledge, Attitude, and Practices of Tobacco Vendors toward Selling Tobacco Products to Young Children and Adolescents in Central Delhi.

BackgroundTobacco consumption by youth is a serious public health problem. Regulation on tobacco sales has been given enough attention in our country, but very less information exists about the knowledge and attitude regarding tobacco laws by tobacco vendors.Aim and objectiveTo study the knowledge, attitude, and practices of tobacco vendors regarding the selling of tobacco to children and adolescents up to 18 years of age in the Central Delhi area.Materials and methodsA total sample size of 60 tobacco vendors was selected by random sampling method. The procedure and objectives of the study were explained to them and written informed consent was obtained. A casual interview of the tobacco vendor was taken and answers given by them were recorded using a questionnaire. After completing the data, statistical analysis was performed.ResultsThe mean age of children and adolescents visiting tobacco shops was 11.83 years and the minimum age was 8 years. It was reported that 19 (31.7%) vendors always asked the age of the child while none of them asked for proof of age. Forty-two (70%) of them reported these children and adolescents visit their shop alone while 18 (30%) reported that they visit with friends. Khaini was the commonest form of tobacco bought/consumed by children and adolescents. Twenty-seven (45%) vendors reported that these children consume tobacco publically.ConclusionDespite knowing various anti-tobacco laws, tobacco vendors are selling harmful tobacco products to children and adolescents.How to cite this articleVerma AR, Goswami M. Knowledge, Attitude, and Practices of Tobacco Vendors toward Selling Tobacco Products to Young Children and Adolescents in Central Delhi. Int J Clin Pediatr Dent 2021;14(1):97–99.

P-EP024. Prevalence and clinical characteristics of pediatric haemorrhagic stroke complicated with seizure in Sardjito Hospital, Yogyakarta, Indonesia

Introduction. Intracerebral haemorrhage (ICH) is a condition of brain parenchymal haemorrhage with or without intraventricular bleeding. Although rare, ICH remains the most common cause of stroke in pediatric population. Previous study showed that prognosis of ICH in pediatric population is better than elderly, however neurologic sequelae should be considered, including seizure that may progress to epilepsy. Objective of this study is to determine the incidence of seizure in pediatric patients with intracranial haemorrhage. Methods. Retrospective cross-sectional study of children with ICH in Sardjito Hospital during 5 years period (January 2014 – December 2019). Results. There was 94 total ICH patient complicated with seizure, 36 (38.29%) of them are children (aged <18 years old). Approximately half of them suffered from status epilepticus, accounted for 15 children. Mean age of children with ICH complicated by stroke was 60.58 months, while those complicated with status epilepticus were older than non-status epilepticus, 84 months and 47.8 months respectively. Mortality rate of children population (66.67%) in this study was higher than adults (48%), which mainly as a consequence of status epilepticus which has mortality rate of 50%. Children with status epilepticus also had prolonged length of stay, around 19.92 days. Eleven children had hematologic disorder with thrombocytopenia, such as ALL (6), AML (1), hemophilia (1), thalassemia (1), anemia apalastic (1), and ITP (1), while congenital malformation was only in two children. Almost half of sample had multiple ICH, and can be a combination of parenchymal, SAH, EDH, and SDH. Only two children complicated with hypertension. Conclusion. Mortality rate among pediatric ICH with seizure was high, especially when complicated with status epilepticus. Multifocal hemorrhagic lesion was prominent in this studied population, therefore further study is needed to evaluate this associations with seizure symptoms.

Real-world data on MTX tolerance with regimens used in children versus adults.

Methotrexate (MTX) is one of the most commonly used disease-modifying anti-rheumatic drugs which can cause gastrointestinal side effects. MTX intolerance is defined as gastrointestinal and behavioral symptoms occurring before and after MTX administration. This study aims to evaluate and compare the frequency of methotrexate intolerance in adult and pediatric patients. Patients with a rheumatic disease who used oral or parenteral methotrexate for at least 3months were included in the study. Methotrexate intolerance was assessed using the Methotrexate Intolerance Severity Score (MISS) questionnaire and visual analog scale (VAS). In the pediatric patient group, the MISS questionnaire and VAS assessment were applied to both patients and families. A total of 200 patients, 100 of whom were children, were enrolled in the study. The mean age for children and adults were 11.9 (± 3.7) and 52.0 (± 10.9). The prevalence of MTX intolerance was higher in the pediatric group, 64.0 and 10.0% (p < 0.001), respectively. Compared with oral administration, the patients receiving parenteral MTX had a higher proportion of MTX intolerance (p < 0.001). Younger age was the independent risk factor for MTX intolerance. There was a strong correlation between MISS and VAS scores between the evaluations of the patient and the family (p < 0.01, r = 0.95/p < 0.01, r = 0.94). Methotrexate intolerance was higher in childhood. All patients using MTX should be monitored and questioned for signs of intolerance.