Demographic Characteristics Of Children Research Articles

The Association Between Lumbar Lordosis and Functional Performance in Children with Duchenne Muscular Dystrophy

Purpose: The aims of this study were to compare the lumbar lordosis measured with flexible ruler between healthy peers and children with Duchenne Muscular Dystrophy (DMD) and to investigate the relationship between lumbar lordosis and functional performance in children with DMD. Material and Methods: This study included 20 children with DMD (median age: 8.29 years) and 10 healthy peers (median age: 7.96 years). Lumbar lordosis and postural alignment were assessed with flexible ruler and New York Posture Rating (NYPR), succesively. Functional performance was evaluated with Motor Function Measure and timed performance tests. Results: Demographic characteristics of children with DMD and healthy peers were similar (p>0.05). Children with DMD (median angle: 46.58 degrees) had a higher degree of lumbar lordosis than their healthy peers (median angle: 36.10 degrees) (p

Risk predictors of glycaemic control in children and adolescents with type 1 diabetes: A systematic review and meta-analysis.

To conduct systematic evaluation of the risk predictors of glycaemic control in children and adolescents with type 1 diabetes mellitus. Cohort studies on risk predictors of glycaemic control in children and adolescents with type 1 diabetes were retrieved from CNKI, PubMed, Web of Science, Embase databases, etc. from the construction of the repository to 3 February 2023. Literature screening was conducted according to inclusion and exclusion criteria, then data extraction of region, sample size, age, follow-up time, risk predictors, outcome indicators, etc., and quality evaluation of The Newcastle-Ottawa Scale were conducted by two researchers while the third researcher makes decisions if there are disagreements. Finally, Revman5.4 and StataMP17 were used for meta-analysis. A total of 29 studies were included, and the results showed that insulin pump [Weighed mean difference (WMD) = -.48, 95% CI (-.73, -.24), p < .01], high-frequency sensor monitoring, early use of insulin pumps, prospective follow-up male, white race, large body mass index-standardised scoring, conscientiousness, agreeableness of mothers, eicosapentaenoic acid, leucine and protein (p < .05) were beneficial for reducing HbA1c levels in children and adolescents with diabetes. Ketoacidosis [WMD = .39, 95% CI (.28, .50), p < .01], selective admission, higher HbA1c level at one time (p < .01), higher glutamate decarboxylase antibody at 1 month after diagnosis, lower socio-economic status, non-living with biological parents, non-two-parent family, family disorder, family history of diabetes and high carbohydrate intake (p < .05) increased HbA1c levels in children and adolescents with diabetes. For children and adolescents with type 1 diabetes mellitus, the use of insulin pump, high-frequency sensor monitoring, prospective follow-up, good family support and reasonable diet are conducive to blood glucose control, while selective admission and DKA are not. Disease characteristics and demographic characteristics of children are closely related to subsequent blood glucose control, and the relationship between diagnosis age and blood glucose control needs to be further explored.

Impact of Childhood Cancer on Family Functioning and Family Quality of Life in the Western Region of Saudi Arabia.

Childhood cancer affects families and friends and causes lifestyle changes that become overwhelming for them. Childhood cancer may cause decreased physical, emotional, and social health-related quality of life (QOL). Childhood cancer may cause strain on the financial status of the family and shape their coping strategy to the disease. The extent of the impact of childhood cancer on families is associated with several demographic characteristics of the family such as diagnosis, phase of treatment, and parent's educational level, employment, and marital status of the parents. The objective of this study was to explore the impact of childhood cancer on family functioning and family quality of life (QOL) in the Western Region of Saudi Arabia. This study was a quantitative, randomized, cross-sectional study. 187 participants were randomly selected from the population of parents whose children have cancer and treated at Princess Noorah Oncology Center in King Abdulaziz Medical City, Jeddah. A survey was used to collect data for this study. Healthcare and social systems may have to consider the impact of childhood cancer in the care plans of the patients. Leukemia represents the highest disease prevalence followed by brain tumor. The highest score of the impact on the family survey was familial social concerns domains followed by financial burden with mean scores of 3.59 (98.8%) and 3.56 (98.0%), respectively. Then, mastery domain mean score is 3.43 (85.8%) and finally personal strain with mean score of 3.21 (980.3%). The QOL of the family results indicated that the highest was physical/material well-being with mean score of 3.84 (76.8%) and family interaction with mean score of 3.82 (76.4%), followed by emotional well-being with mean score of 3.54 (70.8%) and parenting with mean score of 3.53 (70.6.%). Significant differences were found between the overall scales of QOL and the scale of impact on the family and some demographic characteristics of children and their parents. Childhood cancer has a substantial effect on family functioning and the family's QOL. In addition, both were significantly associated with some demographic characteristics of the child and his parents.

Comparison of Clinic and Demographic Characteristics of Children with Laboratory-Confirmed and Suspected COVID-19 who Admitted to Pediatric Emergency Clinic

Aim: To determine the frequency of COVID-19 infection in children and to compare the parameters of laboratory-confirmed and suspected cases.&#x0D; &#x0D; Material and Methods: Medical records collected with a prospective design of 1300 pediatric patients who applied to COVID-19 triage of pediatric emergency service. Clinic and demographic characteristics of children with laboratory-confirmed and suspected COVID-19 were compared. Nasopharyngeal swab sample was taken from all pediatric patients in accordance with the possible case definition determined by the national Ministry of Health.&#x0D; &#x0D; Results: The COVID-19 test was found positive in 94 (7.2%) children. Of those, 34.5% children had a history of contact, and 31.9% of all cases were asymptomatic. The mean age of children who were positive for COVID-19 was higher than those who were negative (p

Findings on Sleep of Children with Cerebral Palsy and Their Mothers' Sleep and Emotional Intelligence

Objective: This study was aimed to (i) sleep characteristics of children with cerebral palsy (CP), and sleep and emotional intelligence results of their mothers, and (ii) explore the relationship these parameters both with each other and with demographic characteristics of children and their mothers. Methods: Thirty-three children with CP and their mothers were included this study. Functional level of children was evaluated with Gross Motor Function Classification Scale (GMFCS) while sleep parameters with Child Sleep Habits Questionnaire-Abbreviated Form (CSHQ-AF). Sleep quality and emotional intelligence of mothers was evaluated by The Pittsburg Sleep Quality Index (PSQI) and Revised Schutte Emotional Intelligence Scale (RSEI), successively. Results: The highest percentage of children with CP participating in the study was at level 3 (GMFCS) with 24.24%. Mean sleep score of children with CP according to CSHQ-AF was 50.33 (SD: 9.38) points. Twenty-nine (87.9%) of children with CP had pediatric sleep problem while 51.5% of mothers had poor sleep quality. RSEI total score of mothers was 149.54 (SD: 16.94). No relationship was found between sleep and emotional intelligence of mothers with sleep of children with CP (p&gt;0.05). Conclusion: The rate of sleep problems was found to be higher in children with CP compared to their mothers as expected. The lack of relationship between sleep and emotional intelligence can be explained by the reality that both parameters can be affected by many factors.

Maternal Age, Nutrition and Literacy; Targeting the Root Cause for Undernutrition in Children under the Age of Two Years.

Objective: To analyze the risk factors for child undernutrition in mothers of malnourished children under the age of 2 years.&#x0D; Methods: This cross-sectional study was conducted at the Pediatric Medicine Department of The Children’s Hospital Lahore from January to December, 2019. A total of 210 malnourished children in the age bracket of 2 months to 24 months and accompanying mothers admitted in the Stabilization Center for nutritional rehabilitation were included. Demographic characteristics of children and their mothers were taken.&#x0D; Results:&#x0D; Out of a total of 210 children there was slight male preponderance 116 (55%). Mean age of children was 8.89 + 6.74 months. During first six months of life, only 31 (15%) were exclusively breast fed and in six months or older children weaning food was not started at appropriate age in 91 (43%). Illiteracy was more in mothers as compared to fathers 140 (66.7%) vs 82 (39%). Half 104 (49.5%) of the mothers had satisfactory BMI of 18.5-23 kg/m2 and remaining were either severely under nourished or overweight/obese. With advancing age significantly more mothers were obese 17% as compared to 2.4% in younger age (18-25 years) (p= 0.007). Improper weaning practice was significantly more in mother of younger age group (p=0.023). A significant number of children who were older than six months of age and in whom weaning was not started at appropriate age had WHZ score &lt;-3SD (p=0.019). There was no association of maternal nutrition, maternal/paternal education with the nutritional status of children (p=&gt;0.05).&#x0D; Conclusion: Maternal illiteracy and both undernutrition and overweight/obesity were prevalent among the mother of undernourished children under the age of two years. Improper weaning was the major contributing factor in child’s malnutrition and improper weaning practice was significantly more in mother of younger age group.

Clinical and epidemiological characteristics of SARS-CoV-2 virus in ambulatory children under 2 years old.

SARS-CoV-2 is an emerging virus that has mainly affected adults; hence, most clinical information has been derived from that population. Most pediatric cases are mild and with nonspecific symptoms requiring outpatient management. Children are a major source of spread for most traditional respiratory viruses. Their role in SARS-CoV-2 transmission was thought to be relevant. Children under the age of two comprise a group that is more susceptible to infection since vaccines have not been approved for them until recently. The knowledge of clinical manifestation of COVID-19 in young children is scarce. To describe the clinical, epidemiological, and demographic characteristics of children under 2 years old with confirmed COVID-19, who did not require hospitalization. This descriptive study was performed from May, 2020 to June, 2021. Children ages 0-2 years with COVID-19, confirmed by transcriptase-polymerase chain reaction assay that were performed in laboratories of the Red de Salud UC CHRISTUS Health Network, were selected to be contacted. If the parents accepted participating and their children were not hospitalized, a survey was sent to the patients' caregivers. Of the 242 cases, 159 caregivers answered the survey (65.7%). The median age of the subjects was 14 months, and 53.5% were males. Fifty percent had comorbidities, of which one third corresponded to atopy. Ninety eight percent were secondary cases. Most of them were infected within their households (81%). The most frequent sources were their parents, followed by their grandparents. The most common symptom was fever (78%) followed by irritability (67.3%), rhinorrhea (66%), and fatigue (64.8%). Infants less than 6 months old more often presented with conjunctival congestion and less loss of appetite compared to older children (p < 0.05). This study provides valuable insights regarding COVID-19 in ambulatory young children. Most cases of SARS-CoV-2 infection in children under 2 years old do not require hospitalization. There was a slight male predominance, and the majority had been infected within their households. SARS-CoV-2 infection should be suspected in children under 2 years old presenting with fever, irritability, fatigue, and rhinorrhea. Children with positive household contacts and fever should also be tested for COVID-19.

Nosocomial RSV-related In-hospital Mortality in Children

According to the World Health Organization, the global burden of nosocomial infections is poorly characterized as surveillance systems are lacking. Nosocomial infections occur at higher rates in low- and lower-middle-income countries (LMICs) than in high-income countries (HICs). Current global RSV burden estimates are largely based on community-acquired infection. We aimed to characterize children with nosocomial RSV-related mortality and to understand the potential impact of RSV immunization strategies. RSV GOLD is a global registry of children younger than 5 years who died with laboratory-confirmed RSV infection. We compared clinical and demographic characteristics of children with nosocomial and community-acquired RSV in-hospital mortality. We included 231 nosocomial and 931 community-acquired RSV-related in-hospital from deaths from 65 countries. Age at death was similar for both groups (5.4 vs. 6 months). A higher proportion of nosocomial deaths had comorbidities (87% vs. 57%; P < 0.001) or was born preterm (46% vs. 24%; P < 0.001) than community-acquired deaths. The proportion of nosocomial deaths among all RSV deaths was lower in LMICs than in upper-middle-income countries (UMICs) and HICs (12% vs. 18% and 26%, respectively). This is the first global case series of children dying with nosocomial RSV infection. Future infant-targeted immunization strategies could prevent the majority of nosocomial RSV-related deaths. Although nosocomial RSV deaths are expected to occur at highest rates in LMICs, the number of reported nosocomial RSV deaths was low in these countries. Hospital-based surveillance is needed to capture the full burden of nosocomial RSV mortality in LMICs.

Clinical and laboratory predictors of long-COVID in children: a single center retrospective study.

The majority of children experience a mild course of acute Coronavirus Disease 2019 (COVID-19). Only few studies have looked at long-term recovery from COVID-19 infection in children. The purpose of this study was to identify the predictors of long-COVID by performing a thorough analysis of the clinical, laboratory, and demographic characteristics of children with COVID-19. Between August and October 2021, data were obtained retrospectively from the medical records of 251 children diagnosed with COVID-19 at a tertiary single-center hospital. The prognostic effects of admission-related factors were compared between patients who experienced long-lasting symptoms and those who did not. Long-COVID symptoms were noted in 12.4% of patients. Joint pain (7.6%), lumbago (4.8%), and headache (3.2%) were the most common symptoms. The mean onset of long-COVID symptoms was 1.35±0.49 months. The onset of long-COVID symptoms was 4 weeks after initial diagnosis in 64.5% of patients and 4-8 weeks later in 35.5% of the patients. The mean duration of long-COVID symptoms was 5.32±2.51 months. Children with long-COVID had higher leukocytes, neutrophils, monocytes, basophils, platelets, and D-dimer when compared with patients without long-COVID (p < 0.001). Leukocytes, neutrophils, monocytes, platelets, and D-dimer had the highest AUC in the ROC analysis (0.694, 0.658, 0.681, 0.667, and 0.612, respectively) and were statistically significant. Despite the majority of children with COVID-19 having mild or asymptomatic acute disease, the majority of long-COVID symptoms were associated with functional impairment between 1 and 9 months after the start of the infection. Increased leukocytes, monocytes, neutrophils, platelets, and D-dimer appear to be the most powerful laboratory predictors for long-COVID and monitoring these predictors may assist clinicians to identify and follow-up patients with higher risk for long-COVID.

Demographic Characteristics of Children with Biliary Atresia in dr. Kariadi General Hospital, Semarang

Background: Biliary atresia (BA) is a progressive fibrosing obstructive cholangiopathy involving both the intrahepatic and extrahepatic biliary system; resulting in obstruction of bile flow and neonatal jaundice. Early diagnosis of biliary atresia and Kasai procedure improves patients outcome. Data form several studies revealed that BA is the most common cause of neonatal cholestasis (25%) and the leading cause of end-stage liver disease in pediatric population. The aim of this study is to determine the outcome and characteristics of children with biliary atresia in dr. Kariadi General Hospital, Semarang.&#x0D; Methods: In this study, a retrospective database analysis of 80 infants diagnosed with biliary atresia was conducted. Patient’s demographic data including age, sex, age at disease onset, were collected from year 2018 to 2022; including all comorbidities and complications. Data regarding procedure performed for each patient and their outcome were included in this study. &#x0D; Results: Eighty children were included in this study. The mean age of children referred with biliary atresia was 1.89 month, while the mean age at diagnosis was 2.5 month. Most of the patients were girls. The incidence of cytomegalovirus infection comorbidity in patients with biliary atresia is quite high, which were reported at 82%. Children diagnosed with biliary atresia and cytomegalovirus infection resulted in worse prognosis than those without.&#x0D; Conclusion: Our study support the theories that biliary atresia may be caused by the exposure of external environment during perinatal period such as viral infection. The prognosis of patients with cytomegalovirus comorbidity is worse than that without.

Interactions between genetic variants and near-work activities in incident myopia in schoolchildren: a 4-year prospective longitudinal study

ABSTRACTClinical relevanceKnowledge of interactions between genetic variants and near-work activities at the onset of myopia can facilitate health education regarding myopia.BackgroundTo investigate the interactions between genetic variants (PDE10A, AREG and GABRR1) and near-work activities in the onset of myopia in southeastern Chinese school children.MethodsA total of 458 non-myopic, grade 1 children aged 6–7 years were included in a 4-year follow-up examination; 409 children were assessed further. Manifest (non-cycloplegic) refraction and axial length (AL) were measured every year, and questionnaires were administered annually to assess information regarding the demographic characteristics of children, near-work activities, outdoor exposure and parental myopia. Oral mucosa was collected in the last year of follow-up, and Sanger sequencing was used to genotype single nucleotide polymorphisms (SNPs) in DNA.ResultsThe cumulative change in the spherical equivalent refraction (SER) over 4 years was −1.20 ± 1.00 D, and the proportion of children with incident myopia was 42.9%. Multivariate logistic regression analysis showed that an increased amount of time spent doing homework (>2 h/d) was an independent risk factor for incident myopia. The PDE10A rs12206610CT genotype and spending > 5 h/d on near-work activities showed an interaction for incident myopia (OR = 4.29, 95% CI: 1.27-14.53; Pinteraction = 0.02); moreover, the rs12206610CT genotype carriers who used electronic devices for > 1 h/d displayed an increased risk of incident myopia (OR = 3.43, 95% CI: 1.07-11.01; Pinteraction = 0.043).ConclusionsThe rs2206610CT genotype carriers with near-work activities of >5 h/d were more likely to show incident myopia, especially those who used electronic devices >1 h/d. However, interactions between the rs12206610 SNP and near-work activities require further verification in animal models and larger sample cohorts.

Vaccine Administration in Children's Hospitals.

To examine inpatient vaccine delivery across a national sample of children's hospitals. We conducted a retrospective cohort study examining vaccine administration at 49 children's hospitals in the Pediatric Health Information System database. Children <18 years old admitted between July 1, 2017, and June 30, 2019, and age eligible for vaccinations were included. We determined the proportion of hospitalizations with ≥1 dose of any vaccine type administered overall and by hospital, the type of vaccines administered, and the demographic characteristics of children who received vaccines. We calculated adjusted hospital-level rates for each vaccine type by hospital. We used logistic and linear regression models to examine characteristics associated with vaccine administration. There were 1 185 667 children and 1 536 340 hospitalizations included. The mean age was 5.5 years; 18% were non-Hispanic Black, and 55% had public insurance. There were ≥1 vaccine doses administered in 12.9% (95% confidence interval: 12.8-12.9) of hospitalizations, ranging from 1% to 45% across hospitals. The most common vaccines administered were hepatitis B and influenza. Vaccine doses other than the hepatitis B birth dose and influenza were administered in 1.9% of hospitalizations. Children had higher odds of receiving a vaccine dose other than the hepatitis B birth dose or influenza if they were <2 months old, had public insurance, were non-Hispanic Black race, were medically complex, or had a length of stay ≥3 days. In this national study, few hospitalizations involved vaccine administration with substantial variability across US children's hospitals. Efforts to standardize inpatient vaccine administration may represent an opportunity to increase childhood vaccine coverage.

Demographic characteristics of children with growth hormone deficiency from 1996 to 2015 in Japan: 20 years of data from the foundation for growth science in Japan.

Growth hormone (GH) deficiency (GHD) in children is a heterogeneous condition that includes several entities of various severities. GH treatment has been affected by various factors. Because comprehensive analyses for Japanese children with GHD over time are scarce, we investigated the baseline characteristics of patients with GHD at the start of GH treatment between 1996 and 2015 using data from the Foundation for Growth Science in Japan. During the registration period, 19,717 subjects were determined to be eligible for GH treatment as GHD. Overall analyses revealed that there were twice the number of male patients as female patients, and the etiology was idiopathic in 91.1%, central nervous system (CNS) tumor at the hypothalamus-pituitary area in 1.7%, CNS tumor distant from the hypothalamus-pituitary area in 0.68%, other tumors in 0.91%, congenital CNS malformations in 0.83%, and other diseases in 1.1% with their specific characteristics. The latest average age, height standard deviation score (SDS), insulin-like growth factor-1 SDS, and proportion of severe GHD at GH treatment initiation were 8.8 years, -2.76, -1.42, and 19.5%, respectively. The proportions of breech delivery and asphyxia gradually decreased, whereas that of caesarean section gradually increased during the registration period with the latest values of 2.2%, 4.9%, and 14.0%, respectively (all analyses: p < 0.0001). In contrast, the proportion of idiopathic GHD with breech delivery seemed to reach the lowest level among those with a birth year before 2000. This study identified the characteristics and changes of patients with GHD over 20 years.

Socioeconomic and Demographic Characteristics of Children Under Five Years of Age Suffering from Stunting in Magelang Regency, Indonesia

This study is set out to examine the socioeconomic and demographic characteristics of stunted children under five years of age in Magelang Regency, Central Java Province. Indonesia. It used questionnaire surveys (structured interviews) to collect data on 266 heads of households with stunted children under-five that had been selected using a tiered sampling method, then analyzed the data in the SPPS program. Also, in-depth interviews were conducted with informants from these households and staff of community health center, Health Office, Social Office, and Regional Development Planning Agency (BAPPEDA), and the resulting data were processed and analyzed through the stages of data reduction, data presentation, conclusion withdrawal, and verification. The quantitative data were tested for validity using the statistical procedures provided in the SPSS program, while the qualitative data were examined for their reliability by the triangulation method. The results showed that the majority of stunted children under-five in the regency had normal birth weight and length, received a complete series of immunization, and were breastfed. Furthermore, about one-third of the mothers were employed, showing that many of the families observed are less stable economically. This study also found that parents still lacked the knowledge to recognize stunting in their children, about 80 percent of which did not realize that their children experienced impaired growth and development. Another finding is that government programs have reached 50 percent of families with stunted children under-five.

An evaluation of the factors affecting the clinical and laboratory findings, prognosis, and treatment response in children with chronic urticaria.

Chronic urticaria (CU) is a rare disease in childhood, and studies in children are limited. In this study, the aim was to investigate the clinical and laboratory findings and demographic characteristics of children with CU and to determine the factors affecting prognosis. The study included 141 patients aged 0-18 years who were diagnosed with CU in the pediatric allergy outpatient clinic between January 1, 2013, and December 31, 2018. Risk factors related to prognosis were investigated by comparing the duration of CU and treatment response with clinical and etiological features. IBM SPSS version 24 was used for statistical analyses. In the study group, the female/male ratio was 69/55, and the median age at first visit was 9.5 years (min:1, max:17). Among patients, 63 (44.5%) had an accompanying atopic disease, and 23 (16.3%) had chronic disease. Of the patients, 124 (88%) had chronic spontaneous urticaria, and 17 patients (12%) had chronic inducible urticaria (CIU). Of those with CIU, 72.2% had symptomatic dermographism, 16.7% had cholinergic urticaria, and 11.1% had cold urticaria. After the evaluations, the most common pathological findings in our patients were intestinal parasitosis (n=14), anemia (n=10), and urinary tract infection (n=8). The median total duration of urticaria was 47 weeks (min:8, max:284). The duration of urticaria was longer in patients with atopy (p < 0.05), and the group that went into remission with standard-dose antihistamine was the group with highest eosinophil count (p=0.022). In most children with CU, the underlying cause/disease cannot be determined. In our study, treatable triggers were found in some of the patients. Therefore, it is appropriate for each patient to be evaluated with selected laboratory tests after detailed history and physical examination.

A retrospective study on the long-term outcomes of pulpectomy and influencing factors in primary teeth

Background/purposePulpectomy is the last means to preserve primary teeth with pulpitis or pulp necrosis. The aim of the study was to investigate the survival rate of primary teeth after pulpectomies and to explore the factors influencing the prognosis of pulpectomy. Materials and methodsThis retrospective study was performed on patients who received primary tooth pulpectomy in the Department of Pediatric Dentistry at Peking University Hospital of Stomatology between January 2014 and February 2019. The demographic characteristics of children and the information of teeth treated were collected, and the clinical and radiographic examination after treatment were evaluated. Survival analysis was performed to determine the influencing factor of pulpectomy failure. ResultsA total of 592 primary anterior teeth and 583 primary molars were included. The 30-month survival rate of primary anterior teeth was 58.5% and that of primary molars was 37.0%. The survival rate of postoperative primary molars was lower than that of primary anterior teeth (P < 0.05). Primary anterior tooth interventions with preoperative periapical lesions, Vitapex® filling, or nongeneral anesthesia treatment had a higher failure risk (P < 0.05). Treatment at an older age and glass ionomer cement filling indicated a higher failure risk for primary molar pulpectomies. ConclusionPrimary anterior teeth after pulpectomies had a higher survival rate than primary molars. Periapical lesions, treatment methods, and root filling materials had significant impacts on the prognosis of primary anterior pulpectomies, and children's age significantly affected the prognosis of primary molar pulpectomies, which has not been reported before.

Convulsions in children hospitalized for acute gastroenteritis

The study aim was to examine possible correlates of convulsions in children hospitalized for acute gastroenteritis (AGE). Data collected in a prospective study of AGE hospitalizations in children aged 0–59 months in 3 hospitals in Israel during 2008–2015 were analyzed. Stool samples were tested for rotavirus using immunochromatography and stool culture was performed for the detection of Salmonella, Shigella and Campylobacter We compared clinical and demographic characteristics of children hospitalized for AGE who had convulsions (n = 68, cases) with children hospitalized for AGE without convulsions (n = 3505, controls). Age differed between children with and without convulsions (p = 0.005); the former were mostly toddlers aged 12–23 months (51%) compared to 30% of the control group. A higher percentage of cases tested positive for Shigella (11% vs. 4%, p = 0.002), the opposite was found for rotavirus (2% vs. 30% p < 0.001). A multivariable model showed that body temperature (OR 2.91 [95% CI 1.78–4.76], p < 0.001) and high blood glucose level (> 120 mg/dL) (OR 5.71 [95% CI 1.27–25.58] p = 0.023) were positively related to convulsions in children with AGE, while severe AGE (Vesikari score ≥ 11) was inversely related with convulsions (OR 0.09 [95% CI 0.03–0.24], p < 0.001). Conclusion: Elevated body temperature is associated with convulsions in children with AGE, but not severity of AGE, while hyperglycemia might reflect a neuroendocrine stress reaction to convulsions, AGE or both.

Oxidant and antioxidant balance in patients with COVID-19.

BackgroundA crucial balance exists between oxidant and antioxidant mechanisms in the functional immune system. We aimed to evaluate the contributions of balance between these systems to coronavirus disease 2019 (COVID‐19), a devastating pandemic caused by viral infection.MethodWe analyzed serum oxidant and antioxidant stress parameters according to the clinical and demographic characteristics of children and adults with COVID‐19 and compared them against the values of healthy controls. Serum native thiol (NT), total thiol (TT), disulfide, total antioxidant status, total oxidant status, and ischemia‐modified albumin levels were evaluated and compared between groups.ResultsA total of 79 children and 74 adults were evaluated in the present study, including 46 children and 40 adults with COVID‐19, 33 healthy children, and 34 healthy adults. TT, NT, and disulfide levels were significantly lower in the adult COVID‐19 group than in all other groups (p = .001, p = .001, and p = .005, respectively). Additionally, TT and NT levels were significantly lower in both pediatric and adult COVID‐19 cases with severe disease course than mild/moderate course. TT and NT levels were identified as predictors for the diagnosis of the adult COVID‐19 cases and as independent predictors for disease severity in both children and adults with COVID‐19.ConclusionParameters that reveal the oxidant and antioxidant capacity, including TT and NT, appear to be good candidates for the accurate prediction of the clinical course among patients with COVID‐19.

Children With Down Syndrome and Obstructive Sleep Apnea: Outcomes After Tonsillectomy.

To evaluate outcomes of tonsillectomy and predictors for persistent obstructive sleep apnea (OSA) in children with Down syndrome in an ethnically diverse population. Case series with chart review. UT Southwestern/Children's Medical Center Dallas. Polysomnographic, clinical, and demographic characteristics of children with Down syndrome ages 1 to 18 years were collected, including pre- and postoperative polysomnography. Simple and multivariable regression models were used for predictors for persistent OSA. P≤ .05 was considered significant. Eighty-one children were included with a mean age of 6.6 years, 44 of 81 (54%) males, and 53 of 81 (65%) Hispanic. Preoperatively, 60 of 81 (74%) patients had severe OSA. Posttonsillectomy improvements occurred for apnea-hypopnea index (27.9 to 14.0, P < .001), arousal index (25.2 to 18.8, P = .004), percent time with oxygen saturations <90% (8.8% to 3.4%, P = .003), and oxygen nadir (81.4% to 85%, P < .001). Forty-seven children (58%) had persistent OSA. Fifteen children (18.5%) had increased apnea-hypopnea index postoperatively: 2 from mild to moderate, 2 from mild to severe, and 2 from moderate to severe obstructive sleep apnea. Persistent OSA predictors were asthma (odds ratio, 4.77; 95% CI, 1.61-14.09; P = .005) and increasing age (odds ratio, 1.25; 95% CI, 1.09-1.43; P = .001). Children with Down syndrome are at high risk for persistent OSA after tonsillectomy with about 20% worsening after tonsillectomy. Asthma and increasing age are predictors for persistent OSA in children with Down syndrome.

Effect of Mothers’ Nutritional Knowledge, Attitude, and Practices in Childcare on the Growth of Children

Well education about nutrition can improve maternal nutritional knowledge and practices significantly, that improve the growth of children. Aim: Assess the effect of mothers’ nutritional knowledge, attitude, and practices in childcare on the growth of children. Subjects and method: Design: An analytical cross-sectional study research design was conducted for 100 mothers and their children aged 6-23 months in Medical Pediatric Out-Patient Clinic in Sohag University Hospital. Tools for data collection: Four tools were used to collect the data in the current study, tool (I): A structured questionnaire that consisted of two parts: part (1): Sociodemographic characteristics of mothers of children, part (2): Demographic characteristics of children, tool (II): Anthropometric measurement tool, and tool (III): Nutrition-related KAP model questionnaires (Module 2: Feeding young children (6–23 months), and tool (IV): Modified Fahmy and ElSherbini scale. Results: it observed that a significant positive relationship was detected between knowledge, attitude, and practices and WFA (r = 0.26, P = 0.0001) and between WFH (r = 0.11, P = 0.02). In the studied young children, it was observed that 54% of young children between 6-8 months consume the recommended and 59% of young children between 9 and 23 months consume more than recommended. Conclusion: Mothers’ nutritional knowledge, attitude, and practices regarding childcare have positively affected the growth of children. Recommendations: Educational programs about balanced nutrition for children aged 6-23 should be taught to all mothers.