Male Children Research Articles

Plasma metabolites in childhood Burkitt lymphoma cases and cancer-free controls in Uganda

IntroductionBurkitt lymphoma (BL) is an aggressive non-Hodgkin lymphoma associated with Plasmodium falciparum and Epstein-Barr virus, both of which affect metabolic pathways. The metabolomic patterns of BL is unknown.Materials and methodsWe measured 627 metabolites in pre-chemotherapy treatment plasma samples from 25 male children (6–11 years) with BL and 25 cancer-free area- and age-frequency-matched male controls from the Epidemiology of Burkitt Lymphoma in East African Children and Minors study in Uganda using liquid chromatography-tandem mass spectrometry. Unconditional, age-adjusted logistic regression analysis was used to estimate odds ratios (ORs) and their 95% confidence intervals (CIs) for the BL association with 1-standard deviation increase in the log-metabolite concentration, adjusting for multiple comparisons using false discovery rate (FDR) thresholds and Bonferroni correction.ResultsCompared to controls, levels for 42 metabolite concentrations differed in BL cases (FDR < 0.001), including triacylglyceride (18:0_38:6), alpha-aminobutyric acid (AABA), ceramide (d18:1/20:0), phosphatidylcholine ae C40:6 and phosphatidylcholine C38:6 as the top signals associated with BL (ORs = 6.9 to 14.7, P < 2.4✕10− 4). Two metabolites (triacylglyceride (18:0_38:6) and AABA) selected using stepwise logistic regression discriminated BL cases from controls with an area under the curve of 0.97 (95% CI: 0.94, 1.00).ConclusionOur findings warrant further examination of plasma metabolites as potential biomarkers for BL risk/diagnosis.

The mutual influence of parent-child maladaptive emotion regulation on posttraumatic stress following flood exposure.

Decades of disaster research support the influence parents have on their children's adaptation. Recently, research has shifted to focus on disasters as a whole family experience. Using the actor-partner interdependence model, this study examines maladaptive cognitive emotion regulation strategies in parents and children and how these strategies influence their own and one another's posttraumatic stress symptoms (PTSS). The present study includes 485 parent-child dyads who experienced the 2015-2016 Texas floods. The majority of parents identified as mothers (66.3%), with a male child (52.8%) whose average age was 13.75 years. Mplus was used to identify the models and evaluate differences between each cognitive emotion regulation strategy across parent-child dyads in the high disaster exposure group compared to all other levels of exposure (other-exposure). Odds ratios examined differences not captured by the actor-partner interdependence model. Support for interdependence was found for the other-exposure group, suggesting parents and children mutually influence each other's PTSS by their own cognitive emotion regulation. No interdependence was found in the high-exposure group. However, high-exposure child actor effects were found for self-blame and other-blame, and child partner effects were only found for self-blame. Parent actor effects were only significant for catastrophizing and parent partner effects for catastrophizing and rumination. Odds ratios for the high-exposure group found that only child self-blame influenced parent PTSS, and only parent rumination and catastrophizing influenced child PTSS. Implications for supporting families after disasters are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Macrolide-resistant mycoplasma pneumoniae infection in children observed during a period of high incidence in Henan, China

ObjectiveMycoplasma pneumoniae (Mp) is one of the major pathogens that causes respiratory tract infections, and macrolide resistance has increased rapidly in recent years due to the inappropriate use of macrolides in northeastern Asia. In the present study, we aimed to investigate Mp infection and macrolide resistance during a period of high incidence of Mp infection in Henan, China. MethodsA total of 29473 suspected children with Mp infection were enrolled in the study from July to December 2023. Throat swab specimens were collected from all the study subjects, and real-time PCR was performed to detect the Mp-DNA and macrolide resistance-associated A2063G or A2064G mutations. ResultsThe overall percentage of Mp-DNA-positive patients was 51.1 %, and the percentage of macrolide-resistant strains was 91 %. The rate of macrolide resistance remained stable from July to December. The Mp-DNA positivity rates among the different age groups from low to high were 0–1, 1–3, 3–6, 10–18 and 6–10 years. The macrolide resistance rate was the lowest in the 0–1 age group and highest in the 6–10 age group. No difference in the rate of macrolide resistance was observed between male and female children. ConclusionsThe macrolide resistance rate of Mp did not change during the investigated period of high incidence of infection, and no sex difference existed. The macrolide resistance rate of Mp was the lowest in children under 1 year old.

Poland syndrome: a case report

Poland syndrome is characterized by the absence or hypoplasia of other chest muscles: small pectoral muscle, anterior tightened muscle, grandorsal muscle, and deltoid muscle. Anomalies of the thoracic cage: agenesis or hypoplasia of one or more costal segments, pectus carinatum, excavatum, clavicular hypoplasia, pulmonary herniation. Abnormalities of the mammary region: agenesis or hypoplasia of the breast, areola and nipple. The reported incidence of Poland’s syndrome ranges from 1 in 7,000 to 1 in 100,000. Males are affected more frequently by a 2:1 to 3:1 ratio Poland’s syndrome has also been diagnosed in 1 of 19,000 mammograms. The right side of the body was found to be involved in 60% to 75% of patients - associated malformations: genitourinary malformations, cardiac malformation, hepatic and biliary tract malformations. Case report Our case involves a 7-month-old boy with no medical history of cardiac or respiratory complaints. This is a male child with around 65cm height, and 7kg weight. There is no family history of consanguineous marriage and no family history of congenital anomalies. All siblings are alive and healthy. The child’s milestones are within normal limits. There is aplasia of the right sternocostal head and clavicular heads and abdominal head of the pectoralis major muscle, there is a hypoplasia of the right nipple and breast and absence of subcutaneous fat on the same side. Ribs are visible on the right chest wall. Physical examination shows no history of hand and digit anomaly and no rib anomalies. Chest wall asymmetry with right chest wall showing depression on axillary floor. The anterior axillary fold is absent. On attempting abduction of the shoulder, it shows the absence of the sternocostal head of the pectoralis major.

Ultrasound imaging for sternoclavicular joint involvement in enthesitis-related arthritis: A closer look at capsular enthesitis

Introduction: Enthesitis-related arthritis is a specific subtype of juvenile idiopathic arthritis characterised by the co-presence of arthritis and enthesitis or the evidence of one of them coupled with at least two among sacroiliac joint tenderness, inflammatory back pain, presence of human leukocyte antigen-B27, acute symptomatic anterior uveitis, onset in a male child aged 6 years or older or history of spondyloarthropathy in a first-degree relative. Small joints like the sternoclavicular joint are rarely affected, and the prevalence of their involvement in enthesitis-related arthritis has been poorly assessed in the pertinent literature. Case report: The authors report an atypical case of left sternoclavicular joint arthritis/enthesitis in a 12-year-old male child with juvenile idiopathic arthritis. The B-mode sonographic findings of articular effusion, synovial hypertrophy and capsular bulging, coupled with the microvascular mapping with colour Doppler of the sternoclavicular joint, have been crucial to optimising the pharmacological approach in clinical practice. In this sense, the sonographic examination presented as a natural extension of the physical examination to accurately define the poor control of disease activity using first-line pharmacological agents. Discussion: The present case report can be considered the first to accurately report the B-mode and the colour Doppler findings of a pathological sternoclavicular joint in a patient enthesitis-related arthritis. Ultrasound imaging demonstrated intra-articular effusion, capsular bulging and synovial hypertrophy clearly defining sternoclavicular joint arthritis. Interestingly, the hypervascularisation involved both the synovial tissue and the capsule–bone interface – that is, the enthesis of the joint capsule – suggesting a potential co-existence of arthritis and enthesitis of the sternoclavicular joint in enthesitis-related arthritis patients. Conclusion: The high-resolution point-of-care ultrasound seems to be a potential ‘game changer’ in paediatrics to promptly optimise the pharmacological management in enthesitis-related arthritis patients. Indeed, unlike other imaging modalities such as magnetic resonance imaging, modern high-frequency ultrasound transducers guarantee a superior spatial resolution of superficial joints and allow an accurate mapping of small-size and low-flow vascular elements of synovial and capsular tissues optimising the grading of disease activity and avoiding the use of contrast agent.

A Case of Autism Spectrum Disorder Treated with Theridion currasavicum Prescribed on the Basis of Group Approach

Abstract Background Autism spectrum disorder (ASD) is a pervasive developmental disorder of unknown aetiology. There is a growing prevalence of ASD globally. Currently, there are no specific treatment that can address the core impairments of ASD. Case Summary A 5-year male child was brought to outpatient department with complaints of irritability, restlessness, howling, repeating words spoken to him, repeating phrases, hand flapping, self-hurting and hurting others, climbing stairs repeatedly, repeated drawing of squares everywhere, poor social interaction, poor peer-play and inappropriate playing with toys. The case was diagnosed as ASD and was assessed with the autism treatment evaluation checklist (ATEC) at baseline and follow-up visits. The case was treated with Theridion currasavicum in centesimal scale. ATEC score at baseline of 118 turned to 69 at the 12th month and 42 after 24 months of treatment. The remedy was repeated during monthly visits in ascending potencies. The child improved in the domains of social interaction, communication, repetitive stereotype movements, restricted interests and general health. The likelihood of causal relationship between intervention and outcome has been discussed as per modified Naranjo criteria for homoeopathy. This case report highlights the usefulness of the group approach and aetiological prescription as one way of arriving at the similimum in children with autism.

Time to treatment-seeking by caretakers of children under-five with diarrhea and associated factors in Uganda: a multilevel proportional hazards analysis

BackgroundDiarrhea is considered to be one of the major public health concerns in developing countries. It has a detrimental impact, reflecting one of the highest child mortality rates globally, especially in Sub-Saharan Africa, where 2 out of every 10 children in Uganda under the age of five die. The objective of this study was to investigate the factors associated with time to treatment seeking by caretakers of children under-five with Diarrhea in Uganda.MethodDOVE dataset of 745 caretakers in a prospective and retrospective incidence-based study using multi-stage sampling design was used in the assessment. The analysis was done using a time-to-event approach using life tables, Kaplan Meier survival analysis and multilevel proportional hazards model.ResultsKaplan-Meier survival analysis indicated the median time to seeking treatment among 745 caretakers of children under-Five after onset of diarrhea was 2 days. The multi-level proportional hazards model of a Weibull distribution showed that the estimated frailty variance was 0.13, indicating heterogeneity of treatment seeking time by caretakers of under-five children with diarrhea across regions in Uganda. Significant factors found to influence time to treatment-seeking by caretakers of children under-five with diarrhea were, male children (HR = 0.82; 95% CI = 0.71–0.95, p = 0.010), belonging to richest wealth quintile (HR = 1.37; 95% CI = 1.05–1.78, p = 0.022), and residing more than 5 km away from a health facility (HR = 0.68; 95% CI = 0.56–0.84, p = 0.000).ConclusionsThere are delays in seeking diarrhea treatment in Uganda because two days are enough to claim a life after dehydration.The policymakers should pay attention to formulate effective intervention to sensitize caregivers on the importance of early treatment-seeking behavior to avoid severe malnutrition caused by diarrhea. Community awareness program should also be encouraged particularly in areas of more than 5 km from the health facility to make people aware of the necessity to take prompt action to seek care in the early stage.

Megaloblastic anemia due to combined deficiency of Vitamin B12 and folic acid in an 8-month-old male child: A case report

Megaloblastic anemia due to combined deficiency of Vitamin B12 and folic acid in an 8-month-old male child: A case report

Overlap between Obsessive–compulsive Disorder, Psychosis, and Autism Spectrum Disorders

ASD is a neurodevelopmental disorder characterized by impairments in social communication and social interaction, repetitive and stereotyped behaviours, and/or sensory aberrations. OCD is characterized by the presence of obsessions and/or compulsions. Schizophrenia consists of delusions, hallucinations, negative and cognitive symptoms. Children often present with overlapping symptoms and complex psychopathologies and adolescence is often the period where these symptoms get heightened or get noticed. Furthermore, some psychiatric disorders like OCD, ASD and psychosis often have overlaps with confusing presentations. We present a case of a 15year old male child who presented with overlapping symptoms.

Old Age Security: Impacts of Social Security Systems on Households Fertility Decisions

The social security system is one of the biggest government public expenditures across countries with diverse influences on peoples daily lives. In this study, longitudinal household survey data from the China Health and Retirement Longitudinal Study are used to examine the influence of social security systems on households fertility decisions. Using the method of regression analysis, the impact of three types of social security systems are investigated: pensions, medical insurance, and reimbursements. It is found that social security systems significantly decrease the number of children per household. However, it does not affect households gender preferences and fails to achieve gender balance as reflected in the more-than-average number of male children across time. These findings afford valuable insights for the government in formulating social security policies while concurrently addressing the decreasing fertility rate in recent years.

Voice Disorder Prevalence and Vocal Health Characteristics in Children

Voice disorders impede communication and limit quality of life for many children. However, research demonstrating the prevalence of pediatric voice problems and associated voice use patterns is scarce. This investigation examined the prevalence of voice problems and vocal health characteristics of school-aged children. To examine the prevalence of voice problems in school-aged children throughout the US with reference to lifestyle, demographic characteristics, and voice use patterns. This study used a cross-sectional design to survey a probability sample of caregivers of children aged 4 to 12 years living throughout the US in 2023. Caregivers were surveyed regarding their children's voice use, voice symptoms, voice problems, extracurricular activities, and demographic information. Caregivers also competed the Pediatric Voice-Related Quality of Life questionnaire. The Fisher exact test, χ2 tests, and logistic regression were used to compare children with and without voice problems. Overall, 6293 panelists were invited to complete screening questions for the survey, and 1789 individuals were screened for eligibility between March and April 2023. Of these, 1175 parents (65.7%) completed the survey. Twenty-one (1.8%) were excluded for a combination of either high refusal rates (n = 16), speeding (n = 2), or straight lining (n = 12). The final number of participants included in analysis was 1154 caregivers of children aged 4 to 12 years (559 female children [48.4%]; 595 male children [51.6%]; mean [SD] age, 8.02 [2.49] years). The prevalence of voice problems in children was 6.7% (n = 78), and the lifetime prevalence was 12% (n = 138). Benign vocal fold lesions was the most common diagnosis underlying voice complaints, and other causes included respiratory illness, allergies, autism-related voice issues, and other neurological conditions. Risk factors for pediatric voice problems included being male (odds ratio [OR], 1.47; 95% CI, 1.0-2.1), having more than 4 individuals living in the household (OR, 2.30; 95% CI, 1.2-4.4), poor speech intelligibility (OR, 2.26; 95% CI, 1.2-4.3), maternal history of voice problems (OR, 4.54; 95% CI, 1.2-16.4), participating in online gaming (OR, 1.56; 95% CI, 1.0-2.3), and secondhand smoke exposure (OR, 1.7; 95% CI, 1.1-2.6). Voice use-related risk factors included frequent talking, coughing, throat clearing, tantrums/crying, and vocal strain. Voice problems were associated with substantially detracted quality of life as measured by the Pediatric Voice-Related Quality of Life questionnaire, limited social/extracurricular interactions, increased school absences, and negative attention from adults. The results of this survey study suggest that pediatric voice problems are relatively common and detract from quality of life. Specific environmental and behaviorial factors are associated with increased risk for voice disorders.

Machine learning algorithms to predict healthcare-seeking behaviors of mothers for acute respiratory infections and their determinants among children under five in sub-Saharan Africa.

Acute respiratory infections (ARIs) are the leading cause of death in children under the age of 5 globally. Maternal healthcare-seeking behavior may help minimize mortality associated with ARIs since they make decisions about the kind and frequency of healthcare services for their children. Therefore, this study aimed to predict the absence of maternal healthcare-seeking behavior and identify its associated factors among children under the age 5 in sub-Saharan Africa (SSA) using machine learning models. The sub-Saharan African countries' demographic health survey was the source of the dataset. We used a weighted sample of 16,832 under-five children in this study. The data were processed using Python (version 3.9), and machine learning models such as extreme gradient boosting (XGB), random forest, decision tree, logistic regression, and Naïve Bayes were applied. In this study, we used evaluation metrics, including the AUC ROC curve, accuracy, precision, recall, and F-measure, to assess the performance of the predictive models. In this study, a weighted sample of 16,832 under-five children was used in the final analysis. Among the proposed machine learning models, the random forest (RF) was the best-predicted model with an accuracy of 88.89%, a precision of 89.5%, an F-measure of 83%, an AUC ROC curve of 95.8%, and a recall of 77.6% in predicting the absence of mothers' healthcare-seeking behavior for ARIs. The accuracy for Naïve Bayes was the lowest (66.41%) when compared to other proposed models. No media exposure, living in rural areas, not breastfeeding, poor wealth status, home delivery, no ANC visit, no maternal education, mothers' age group of 35-49 years, and distance to health facilities were significant predictors for the absence of mothers' healthcare-seeking behaviors for ARIs. On the other hand, undernourished children with stunting, underweight, and wasting status, diarrhea, birth size, married women, being a male or female sex child, and having a maternal occupation were significantly associated with good maternal healthcare-seeking behaviors for ARIs among under-five children. The RF model provides greater predictive power for estimating mothers' healthcare-seeking behaviors based on ARI risk factors. Machine learning could help achieve early prediction and intervention in children with high-risk ARIs. This leads to a recommendation for policy direction to reduce child mortality due to ARIs in sub-Saharan countries.

Mapping the geographical distribution of the mucosa-associated gut microbiome in GI-symptomatic children with autism spectrum disorder.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by cognitive, behavioral, and communication impairments. In the past few years, it has been proposed that alterations in the gut microbiota may contribute to an aberrant communication between the gut and brain in children with ASD. Consistent with this notion, several studies have demonstrated that children with ASD have an altered fecal microbiota compared with typically developing (TD) children. However, it is unclear where along the length of the gastrointestinal (GI) tract these alterations in microbial communities occur. In addition, the variation between specific mucosa-associated communities remains unknown. To address this gap in knowledge of the microbiome associated with ASD, biopsies from the antrum, duodenum, ileum, right colon, and rectum of children with ASD and age- and sex-matched TD children were examined by 16S rRNA sequencing. We observed an overall elevated abundance of Bacillota and Bacteroidota and a decreased abundance of Pseudomonadota in all GI tract regions of both male and female children with ASD compared with TD children. Further analysis at the genera level revealed unique differences in the microbiome in the different regions of the GI tract in children with ASD compared with TD children. We also observed sex-specific differences in the gut microbiota composition in children with ASD. These data indicate that the microbiota of children with ASD is altered in multiple regions of the GI tract and that different anatomic locations have unique alterations in mucosa-associated bacterial genera.NEW & NOTEWORTHY Analysis in stool samples has shown gut microbiota alterations in children with autism spectrum disorder (ASD) compared with typically developing (TD) children. However, it is unclear which segment(s) of the gut exhibit alterations in microbiome composition. In this study, we examined microbiota composition along the gastrointestinal (GI) tract in the stomach, duodenum, ileum, right colon, and rectum. We found site-specific and sex-specific differences in the gut microbiota of children with ASD, compared with controls.

Effect of ethnic diversity on child labor: Empirical evidence from Ghana

AbstractOne of the persistent global problems today is child labor with the current estimates indicating that 160 million children were in child labor as at the beginning of 2020. To reduce child labor, it is important to unearth the factors that influence it for policy implementation. We contribute to the literature and policy by examining the impact of ethnic diversity on child labor, while considering the mediating effects of informal work and household poverty. Using ethnic fractionalization and polarization indexes, we find that a unit increase in ethnic diversity is associated with an increase in child labor. Gender‐wise, we find the effect to be bigger for male child workers. Based on location, we find that the effect is pronounced for working children living in rural areas. Also, our mediation analysis shows that informal work, and household poverty are the pathways through which ethnic diversity increases child labor.

Land ownership and nutrition in Nepal

AbstractThis paper provides empirical evidence on the relationship between women's land ownership and nutritional outcomes in Nepal. Using three waves of the Nepal Demographic and Health Survey and employing a bounding technique by Oster, I estimate bounded treatment effects of land ownership. The results show that women's land ownership is associated with a reduction in the incidence of childhood underweight and stunting and an increase in women's body mass index. Additionally, I find the selection on unobservable characteristics has to be larger than the selection on observable characteristics to drive these estimates to zero, suggesting that land ownership credibly improves nutritional outcomes. Furthermore, heterogeneous results show that the negative association between land ownership and childhood nutritional status is more prominent in male children and children from the Brahmin caste. Similarly, the negative relationship between land ownership and underweight in women is more pronounced in women employed in agriculture and rural areas. While I argue that landownership improves nutrition, these estimates are sensitive to the assumptions made.

Incision and drainage as mainstay therapy in antibioma: A case report

Antibioma is a chronic sterile, tough fibrous abscess formed commonly due to prolonged and inappropriate use of antibiotics for infections, without facilitating proper drainage of the pus. It is a localized swelling which is painless, smooth, non-tender and firm on palpation. It is only after the abscess has been incised, the body defence mechanism and antibiotic can eradicate the infection by releasing pressure, increasing blood circulation and oxygen to the anaerobic environment. Here, a rare case of antibioma in the neck of an 8 year old male child who had undergone extraction of an offending tooth to eradicate the infection. However, inadequate drainage of the abscess and lack of proper postoperative follow-up led to persistence of residual infection.

Intestinal perforation due to a ventriculoperitoneal shunting catheter

Introduction: The ventriculoperitoneal (VP) shunt allows the drainage of excess cerebrospinal fluid; among its gastrointestinal complications are intestinal volvulus, pseudocyst, and perforation, the last of which is rare but potentially serious, with a frequency between 0.1% and 0.7% and a mortality rate around 15%. We present the case of a male child who required VP shunt colocation and suffered GI tract perforation with transanal protrusion. Case report: A three-year-old male with a long clinical history of pilocytic astrocytoma in the posterior fossa that was partially resected in February 2022 and with VP shunt placement since March 2022. He was diagnosed with an intestinal perforation and anal externalization due to a VP shunt. He required surgery and management with combined antimicrobials. Discussion: Although the aetiology of GI tract perforation due to a VP shunt is not fully established, some risk factors have been described, including the use of abdominal trocars, rigid distal catheters, silicone allergies, and children's thin intestine walls. Treatment must be individualized, with some principles including external drainage of the proximal part until the CSF fluid reaches a biochemically near-normal state and becomes sterile on culture; secondly, the administration of intravenous antibiotics; and finally, the removal of the perforating section of the catheter. Conclusions: Bowel perforation due to a VP shunt is an extremely rare entity whose aetiology is not fully established, primarily affects children and may be mostly related to chronic-irritative gastrointestinal distress. Individualizing treatment is the cornerstone of the therapeutic approach that includes VP shunt replacement, antimicrobial therapy, and management of life-threatening complications.

Sustained aviremia despite anti-retroviral therapy non-adherence in male children after in utero HIV transmission.

After sporadic reports of post-treatment control of HIV in children who initiated combination anti-retroviral therapy (cART) early, we prospectively studied 284 very-early-cART-treated children from KwaZulu-Natal, South Africa, after vertical HIV transmission to assess control of viremia. Eighty-four percent of the children achieved aviremia on cART, but aviremia persisting to 36 or more months was observed in only 32%. We observed that male infants have lower baseline plasma viral loads (P = 0.01). Unexpectedly, a subset (n = 5) of males maintained aviremia despite unscheduled complete discontinuation of cART lasting 3-10 months (n = 4) or intermittent cART adherence during 17-month loss to follow-up (n = 1). We further observed, in vertically transmitted viruses, a negative correlation between type I interferon (IFN-I) resistance and viral replication capacity (VRC) (P < 0.0001) that was markedly stronger for males than for females (r = -0.51 versus r = -0.07 for IFN-α). Although viruses transmitted to male fetuses were more IFN-I sensitive and of higher VRC than those transmitted to females in the full cohort (P < 0.0001 and P = 0.0003, respectively), the viruses transmitted to the five males maintaining cART-free aviremia had significantly lower replication capacity (P < 0.0001). These data suggest that viremic control can occur in some infants with in utero-acquired HIV infection after early cART initiation and may be associated with innate immune sex differences.

Dilatative fetal cardiomyopathy followed by amirror syndrome.

Mirror syndrome (Ballantyne syndrome) is arare condition characterized by maternal edema, which often affects the lungs. It mirrors the image of fetal and placental edema; therefore, it is also called triple edema. We present the case of a37-year-old secundigravida, referred to our clinic at 26weeks of apregnancy complicated by fetal dilatative restrictive cardiomyopathy and hydrops, placentomegaly, new-onset dyspnea, and maternal calf edema. Due to worsening mirror syndrome, preterm labor was induced. Labor was complicated, with soft tissue dystocia, stillbirth, and postpartum hemorrhage. The first pregnancy was also complicated by fetal right ventricular noncompaction dilatative cardiomyopathy. Aeutrophic male child was born vaginally at term and died due to deterioration of the cardiac disease in the third year of life. Next-generation sequencing panel for pediatric cardiology was performed in the deceased child and parents. Two gene variants were recorded: MYOM1: c.770_771delCA (p.Thr257fs) and TPM1: c.814G>A (p.Glu272Lys). Both variants were classified as variants of uncertain significance. This case emphasizes the importance of antenatal counseling, the timing of labor induction, appropriate management of possible complications such as postpartum hemorrhage and soft tissue dystocia, and the interpretation of placental biomarkers in the context of mirror syndrome. Finally, it contributes to understanding the clinical significance of the MYOM1 and TPM1 gene variants.

Determinants of aggregate anthropometric failure among children under-five years in Ethiopia: Application of multilevel mixed-effects negative binomial regression modeling.

Undernutrition significantly contributes to failure to thrive in children under five, with those experiencing multiple forms of malnutrition facing the highest risks of morbidity and mortality. Conventional markers such as stunting, wasting, and underweight have received much attention but are insufficient to identify multiple types of malnutrition, prompting the development of the Composite Index of Anthropometric Failure (CIAF) and the Composite Index of Severe Anthropometric Failure (CISAF) as an aggregate indicators. This study aimed to identify factors associated with CIAF and CISAF among Ethiopian children aged 0-59 months using data from the 2019 Ethiopia Mini Demographic and Health Survey. The study included a weighted sample of 5,259 children and used multilevel mixed-effects negative binomial regression modeling to identify determinants of CIAF and CISAF. The result showed higher incidence-rate ratio (IRR) of CIAF in male children (adjusted IRR = 1.27; 95% CI = 1.13-1.42), children aged 12-24 months (aIRR = 2.01, 95%CI: 1.63-2.48), and 24-59 months (aIRR = 2.36, 95%CI: 1.91-2.92), those from households with multiple under-five children (aIRR = 1.16, 95%CI: 1.01-1.33), poorer households (aIRR = 1.48; 95%CI: 1.02-2.15), and those who lived in houses with an earthen floor (aIRR = 1.37, 95%CI: 1.03-1.82). Similarly, the factors positively associated with CISAF among children aged 0-59 months were male children (aIRR = 1.47, 95% CI = 1.21-1.79), age group 6-11 months (aIRR = 2.30, 95%CI: 1.40-3.78), age group 12-24 months (aIRR = 3.76, 95%CI: 2.40-5.88), age group 25-59 months (aIRR = 4.23, 95%CI: 2.79-6.39), children from households living with two and more under-five children (aIRR = 1.27, 95%CI:1.01-1.59), and children from poorer households (aIRR = 1.93, 95% CI = 1.02-3.67). Children were more likely to suffer from multiple anthropometric failures if they were: aged 6-23 months, aged 24-59 months, male sex, living in households with multiple under-five children, and living in households with poor environments. These findings underscore the need to employ a wide range of strategies to effectively intervene in multiple anthropometric failures in under-five children.