Children Mean Age Research Articles

Health-related quality of life of intellectually disabled children attending a special school in Puducherry-A cross-sectional study.

Health-related quality of life (HRQOL) is a measure of an individual's psychosocial, emotional, and physical well-being. Around 1 in 20 children are less than 15 years of age and are living with a moderate-to-severe form of disability. Thus, our study aims to determine the HRQOL of intellectual disabled (ID) children attending a special school in Puducherry and to determine the socio-demographic factors influencing the level of HRQOL. A cross-sectional analytical study was conducted among 350 ID children attending a selected special school in Puducherry over 1 year. By the universal sampling method, all the caregivers of ID children were recruited and the parent proxy form of Pediatric Quality of life Inventory scale version 4.0 (PedsQL ver 4.0) was used to assess the level of HRQOL of ID children. The data were analyzed using the Statistical Package for Social Science version 16.0 (SPSS ver. 16.0) and the statistical significance was set at P value <0.05. Among the 350 respondents, a majority of the caregivers were mothers (78.9%) and 65.7% were homemakers by occupation. Most of the respondents were from the nuclear family (77.7%) and 55.1% were from urban areas. The mean age of ID children was 12 (±3.8) years; 61.2% were males and 40.8% of the children had a moderate form of ID. The HRQOL of ID children is found to be lower. The factors influencing the lower HRQOL were age, the intelligent quotient (IQ) of ID children, and type of marriage of the caregivers.

Contribution of bread and biscuits to vitamin A daily requirement of preschool children in Lagos State, Nigeria

Introduction and aim. Vitamin-A-deficiency is a public health problem among preschool children of Nigeria. Study determined the contribution of bread and biscuits to vitamin A-daily-requirement of preschool children in Lagos-State, Nigeria. Material and methods. A community-based-study using a cross-sectional-design with analytical component was carried out from 2013-2015. Multi-stage-sampling-technique was used to select mothers of preschool-children (n=1599) in 5 Local-Government- Areas of Lagos. Respondents’ socio-demographic information and samples consumption-pattern were collected using validated, food-frequency-questionnaire/dietary recall. Retinyl palmitate content of randomly selected commonly-consumed brands of oven-fresh-bread stored for 5-days and biscuits (30- to 60-days) at prevailing outdoor-market-temperatures were analysed using High-Performance-Liquid-Chromatography. Contribution to preschool children’s vitamin A-daily-requirements were determined. Data were analysed using Student’s t-test and ANOVA at p&lt;0.05. Results. Mean age of preschool children was 31.44±5.28 months. Mean intakes of samples were bread (117.6 ±15.9 g/d) and biscuits (59.8±27.9 g/d). Range of contribution to vitamin-A-daily-requirement of preschool-children was 0-178.4 %. Samples contribution to vitamin A-daily-requirement of pre-school-children were oven-fresh bread (68.3 %); 5 days bread (20.7%); 30-days biscuits (25.0%) and 60-days biscuits (6.8%). Overall contribution to vitamin A-daily-requirement were bread (51.4%) and biscuits (22.4%). Statistically significant difference existed between samples contribution and vitamin-A-daily-requirement of preschool children. Conclusion. Bread and biscuits samples contributed significantly to the vitamin-A-daily-requirement of preschool children.

DEVELOPING DIGITAL CAPACITY FOR GRADE 9 STUDENTS BEING A MINORITY CITIZENS IN THE NORTH MOUNTAIN AREA OF VIETNAM IN TEACHING LITERATURE

In modern society, digital competence is of great importance for both adults and children. In a world where half of the population lives and works online, where 70% of the population is aged 15-24, the ability of citizens to make the most of digital and Internet opportunities has become very important. This is even more important for children, as children tend to spend more time online than adults and so they will benefit more from and take more risks online. Furthermore, investing in children's digital literacy means creating a future generation of more responsible, workable, and tolerant citizens. However, developing this capacity for ethnic minority students in Vietnam still faces many difficulties. The article presents research results on the concept of digital competence, factors affecting the ability to develop digital competence of 9th grade students who are ethnic minorities, the current situation, and some solutions to develop digital competence. There are digital resources for 9th grade students who are ethnic minorities in the northern mountainous areas of Vietnam.

Вакцинальный статус и причины нарушения сроков вакцинации у детей раннего возраста

Objective. To evaluate the vaccination coverage in children aged 10 months to 3 years, identify the causes of non-adherence to vaccination schedule, and suggest strategies to ensure timely vaccination of children residing in two districts of Saint Petersburg. Materials and methods. We analyzed vaccination coverage (according to the National calendar) in 90 children aged 10 months to 3 years using the data from medical registration forms: child development cards (f.112/y) and vaccination cards (f.063/y). Parents of these children were asked to fill in online questionnaires to analyze their reasons for non-adhering to vaccination schedule. Fifty-two parents agreed to answer. Data analysis was performed using the Microsoft Excel 2010/DataAnalysis software. Results. The vaccination coverage varied between 71% (rubella) to 99% (tuberculosis). Many parents delayed vaccination. Completed vaccination with other vaccines was detected in 57% (pneumococcal vaccine) and up to 80% (hepatitis B) of patients. Revaccination was also delayed in many children. For example, 30% to 41% of children were revaccinated against diphtheria, pertussis, tetanus, polio, and pneumococcus later than it was planned in the schedule. We identified the mean age of children with completed age-appropriate vaccination. The time of delay was usually 1–3 months for different vaccines. Conclusion. The most common causes of non-adhering to vaccination schedule were as follows: untimely visit to a polyclinic (n = 61; 67.8%), temporary medical contraindications (n = 25; 27.8%), and parents' refusal to vaccinate their children 4.4% (n = 4; 4.4%). None of the participants had absolute medical contraindications to vaccination. The analysis of parents' questionnaires demonstrated the following results: 2 out of 52 parents refused to vaccinate their children (3.9%); 37 parents (71.2%) answered that they did not visit polyclinic in time because the child had mild respiratory infection; 3 parents (5.7%) reported that they had come in time; and 10 parents (19.2%) said that they had delayed vaccination for family reasons. We suggested special sanitary, educational, and organizational measures to increase the vaccination coverage among young children. Key words: vaccination, children, vaccine-preventable diseases, vaccination status

Ocular morbidity among school children of Pokhara valley

Background: Ocular morbidity is common among school going children. The uncorrected refractive error is an important cause of childhood blindness and visual impairment. School based eye screening programs help to identify the ocular abnormalities so that early intervention can be done and prevent children from permanent visual disability. Objectives: This research was done to find the prevalence of ocular morbidity and their pattern among primary school children of Pokhara Valley, Nepal. Methods: A descriptive cross-sectional study was conducted among children of three primary schools of Pokhara Valley from January to March 2021. Children who needed further evaluation were referred to ophthalmology department, Gandaki Medical College. After the ethical clearance from the institutional review committee, 1034 children were taken by convenient sampling method. Visual acuity, objective and subjective refraction, extraocular motility, cover test, anterior and posterior segment findings were documented in predesigned proforma. Point estimate at 95% confidence interval along with frequency and proportion were calculated. SPSS 20.0 was used for data analysis. Results: A total 1034 children between 5-16 years were examined. Ocular morbidity was observed in 181 (17.5%) at 95% confidence interval (15.4-18.6). The mean age of children with ocular morbidity was 12.33 ± 2.39 years with male to female ratio of 1.18:1. The common type of ocular morbidity was refractive error 107 (10.35%), conjunctivital diseases 35 (3.38%) and eyelid diseases 26 (2.5%). Myopia 83 (8.02%) was the most common type of refractive error. Conclusion: Refractive error was the commonest form of ocular morbidity among school children.

Modern features of the evolution of IgA-vasculitis in children according to catamestic study

Abstract. There is a tendency to an increase in the frequency of hospitalization of children with mixed forms of IgA-vasculitis with pronounced abdominal syndrome and involvement in the pathological process of the kidneys, which is possibly associated with an increase in the level of comorbid pathology of the gastrointestinal tract, and with a premorbid state of the mucosa membranes of the digestive system. There is a need to study the course and evolution of IgA vasculitis in children with gastrointestinal manifestations in order to improve the diagnostic search, accurate prognosis and create a standardized treatment protocol for IgA vasculitis in children. Objective. To investigate the clinical and diagnostic manifestations and evolution of IgA vasculitis in children with lesions of the gastrointestinal tract. Materials and method. The surveys of patients and their parents and retrospective analysis of 58 maps of inpatients with IgA vasculitis and digestive lesions aged 0 to 18 years, who were hospitalized in the somatic departments of the National Children's Specialized Hospital " OKHMATDYT" Kyiv, Ukraine in the period from 2008 to 2018. Results. The mean age of children with IgA vasculitis was 8,03 years, and the ratio of boys to girls was 1,32: 1. Skin syndrome occurred in 58/58 patients (100%), and joint symptoms were observed in 34/58 (58,62%) patients. There were 29/58 patients (50,0%) with kidney disease. The incidence of renal pathology was higher in children with severe symptoms of the digestive system and in persons older than 7 years. 23/29 (79,31%) patients had manifestations of kidney damage in the first month after the onset of IgA vasculitis with gastrointestinal symptoms. Conclusions. In the study among hospitalized children, clinical and laboratory features and the evolution of IgA vasculitis in children with gastrointestinal lesions were similar to the literature. In 79,31% of patients, the onset of renal syndrome occurred in the first month after the onset of IgA vasculitis. In 20,69% of patients there was an evolution of kidney damage into chronic kidney disease. Therefore, careful monitoring of renal impairment should be performed to assess the progression of chronic kidney disease in patients who develop IgA vasculitis over 7 years of age and in those children who have severe symptoms of gastrointestinal damage.

The effect of play therapy as a therapeutic communication on social interactions of Children with Special Needs

Therapeutic communication is one of the communications applied to Children with Special Needs (CSN), designed for therapy. This research is triggered by the number of Children with Special Needs who have not been accommodated to receive a complete education; this means Children with Special Needs have not been able to get an education because of various problems such as school places, parents inability, and the unwillingness of parents to let their children study which is influenced by social difficulties. Children with Special Needs typically feel scared, reluctant, hesitant, or unable to express themselves; these children are often excluded because they cannot communicate and socialize well, so that the impact is not good for the psychic, mental, social, and sensory of the children. This study aims to analyze the effect of empathy and warmth on associative and dissociative social processes. The research uses a study type with a quantitative approach with 50 people as samples. Data collection is carried out through primary data collection by using a questionnaire spread to several respondents and field observation to see the therapy used. The results showed that the empathy correlation coefficient value of the associative social process was 0.443 (strong enough), and the dissociative social process was 0.554 (strong enough). Meanwhile, the value of the warmth coefficient correlation to the associative social process was 0.850 (strong), and the dissociative social process was 0.880 (strong). Thus, the effect of play therapy as a therapeutic communication on social interaction is 0.428 (strong enough), while the achievement coefficient of determination is 0.283. The independent variables have an influence and contribute with a rate of 28.3% to the independent variable.

Growth Failure in Pediatric Inflammatory Bowel Disease: A Preliminary Analysis

Background: Inflammatory bowel disease (IBD) is a chronic relapsing disease, characterized by chronic inflammation of the gastrointestinal tract (GIT). The incidence of IBD has been increasing over the last two decades, for example, from 1999- 2008 incidence increased from 21.3 to 26.2 per 100,000. Inflammatory bowel disease is mainly classified into two types: Crohn’s disease (CD), and ulcerative colitis (UC). Both types can be identified and distinguished through laboratory tests such as ESR, CRP, and fecal calprotectin, radiographic imaging, and direct visualization via colonoscopy. The etiology of growth failure in IBD, BMI z-score of less than -2.5, is poorly understood; however, chronic inflammation, low-calorie intake, and consequential steroid treatment are the most important factors. This study aims to determine the incidence of growth failure and associated factors in pediatric patients with IBD.&#x0D; Methods: This was a retrospective cohort study of children aged 15 years and below, with the diagnosis of IBD. Data were obtained from the pediatric gastroenterology department pediatric inflammatory bowel disease database from 2007 to 2017. Our study identifies the prevalence of growth failure via a calculated BMI z-score of less than -2.5 among the pediatric inflammatory bowel disease (PIBD) population. The Chi-square test is used for categorical data and Wilcoxon rank-sum test for continuous data. A p-value &lt;0.05 was considered statistically significant. All analyses were carried out with Stata IC/15.1 (StataCorp LP, College Station, TX, USA).&#x0D; Results: A total of 36 patients were included. The mean age of children with growth failure at the time of IBD diagnosis was 8 (±4), and more than half of them (58.3%) were boys. The incidence of growth failure at the time of diagnosis was 22.2% and declined to 11.1% over 26 months. Furthermore, the mean BMI z-score gradually improved from -0.741 to -0.1 over the same period of follow-up after proper management and multidisciplinary involvement.&#x0D; Conclusion: Growth failure in IBD patients according to our data is uncommon, however, it was reduced by 50% over 26 months. This could be attributed to nutritional status improvement over the management period. We recommend following the stepwise approach according to the severity of the disease and managing IBD patients by a multidisciplinary team. However, due to the relatively small sample size and low growth failure incidence, a large-scale study is recommended to determine any causal relations.

Group engagement in parent-focused telehealth interventions for families of children with type 1 diabetes

Introduction Group engagement is an important component of video-based telehealth interventions, yet this construct remains understudied. In the present study, we applied a multidimensional conceptualization of group engagement in two video-based telehealth interventions that either aimed to reduce fear of hypoglycemia or diabetes distress in parents of children with type 1 diabetes. We examined variability in group engagement across parents and assessed the relationship between parents’ level of group engagement and their treatment outcomes. Methods Twenty-nine parents participated in one of two manualized, closed-group, telehealth interventions and completed outcome measures pre- and post-treatment. We behaviorally coded telehealth sessions based on six dimensions of group engagement using the Group Engagement Measure (inter-rater reliability = 0.94). We examined correlations between group engagement dimensions, parent psychosocial well-being, and child hemoglobin A1c. Further, we examined independent sample t-tests to assess differences between treatment groups. Results Mean parent age was 37.69 ± 6.83 years, mean child age was 7.69 ± 3.76 years, and mean child hemoglobin A1c was 8.06 ± 1.27% (41.4% had a hemoglobin A1c <7.5%). Parents who spent more time attending to other group member's issues, reported lower hypoglycemia fear at post-treatment, and parents who showed more active support of the group leader's purpose/goals during the session also reported fewer depressive symptoms at post-treatment. Discussion We identify several dimensions of group engagement that are associate with improved parent psychosocial and child hemoglobin A1c outcomes. Intervention designs that use group engagement to guide treatment planning or inform treatment-related decisions in video-based telehealth interventions could help families achieve more optimal treatment outcomes.

Prenatal lead exposure, telomere length in cord blood, and DNA methylation age in the PROGRESS prenatal cohort

BackgroundLead is a ubiquitous pollutant with deleterious effects on human health and remains a major current public health concern in developing countries. This heavy metal may interfere with nucleic acids via oxidative stress or epigenetic changes that affect biological markers of aging, e.g., telomere length and DNA methylation (DNAm). Telomere shortening associates with biological age in newborns, and DNA methylation at specific CpG sites can be used to calculate “epigenetic clocks". ObjectiveThe aim of this study was to examine the associations of prenatal lead exposures with telomere length and DNA-methylation-based predictors of age in cord blood. DesignThe study included 507 mother–child pairs from the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) study, a birth cohort in Mexico City. Maternal blood (second trimester, third trimester and at delivery) and bone lead levels (one month postpartum) were measured using inductively coupled plasma-mass spectrometry and X-ray fluorescence, respectively. Cord blood leukocyte telomere length was measured using quantitative PCR and apparent age by DNA methylation biomarkers, i.e., Horvath's DNA methylation age and the Knight's predictor of gestational age. ResultsAverage maternal age was 28.5 ± 5.5 years, and 51.5% reported low socioeconomic status. Children's mean telomere length was 1.2 ± 1.3 relative units, and mean DNA methylation ages using the Horvath's and Knight's clocks were −2.6 ± 0.1 years and 37.9 ± 1.4 weeks (mean ± SD), respectively. No significant associations were found between maternal blood and bone lead concentrations with telomere length and DNAm age in newborns. ConclusionWe found no associations of prenatal lead exposure with telomere length and DNA methylation age biomarkers.

ETIOLOGICAL PROFILE OF CHILDREN ADMITTED WITH FEVER WITHOUT FOCUS FOR LESS THAN 7 DAYS DURATION AT TERTIARY CARE CENTER

Objective: The objective of the study was to know about the etiology of acute undifferentiated febrile illness (AUFI) or fever without focus in children admitted at tertiary care hospital. Methods: A study was conducted at medical college, Jhalawar, for a period of 3 months. Pediatric patients presenting with fever for less than or equal to 7 days duration without focus, who required hospitalization were included in this study. Results: A total of 200 children enrolled in study. Male-to-female ratio was 1.9:1. Mean age of children was 7.21±4.2 years. About 142 (71%) patients presented after 3 days of fever. Average duration of fever before admission was 4.62±1.78 days. The most common cause of fever of short duration (less than 7 days) was dengue fever 74 (37%) followed by malaria 58 (29%) and typhoid fever 36 (18%). About 26 (13%) patients had mixed infection. Out of 200 patients, 70 (35%) patients had splenomegaly, 66 (33%) had hepatomegaly, and 26 (13%) patients had both hepatosplenomegaly. Conclusion: The common etiology of AUFI with short duration in children was dengue, malaria, and typhoid. Vector control measures, drinking water supply, and sanitation should be improved to prevent vector-borne and water-borne diseases.

Sedative and Analgesic Effects of Intravenous Midazolam and Ketamine Combination in Bone Marrow Aspiration and Biopsy of Childhood Cancer

Background: Various drugs, including ketamine and midazolam, are used for sedation in children. Objectives: This study aimed to evaluate the effectiveness of intravenous midazolam and ketamine combination in bone marrow aspiration and biopsy in children with cancer. Methods: This descriptive cross-sectional study was conducted on 100 children aged six months to 17 years candidates for bone marrow aspiration or biopsy. Sampling was easy, accessible, and sequential. Children were injected with 0.05 mg/kg midazolam and 1 mg/kg ketamine for sedation and analgesia. Then, sedation rate, restlessness, nausea, vomiting, laryngospasm, and decreased oxygen saturation were assessed. Data were analyzed using SPSS version 18 software. Results: The mean age of children was 6.8 ± 4.3 years. The mean degree of sedation based on the modified Ramsey score was 5.2 ± 0.74. Nausea and vomiting were observed in nine (9%) children. Six (6%) children had arterial saturation of less than 90%. Twelve (12%) children showed restlessness when waking up. There were no cases of laryngeal spasms. Conclusions: The present study showed that the intravenous midazolam and ketamine combination provides suitable sedation and analgesia to children, with low and negligible side effects.

Nutritional Status of Children with Pediatric Acute Lymphoblastic Leukemia

Aim: To analyze the nutritional status of children with pediatric Acute Lymphoblastic Leukemia (ALL) at presentation. Study design: Descriptive prospective study Place and duration of study: Department of Paediatric Haematology Oncology, Children Hospital, Lahore from March 2018 to April 2019. Methodology: A total of 195 children diagnosed as acute lymphoblastic leukemia on bone marrow biopsy were included. Anthropometric measurements were taken for each patient. Results: Out of 195 diagnosed patients with ALL, majority were having B-cell ALL 165(84.6%) and 30(15.4%) T-cell ALL. There was almost equal number of both standard and high risk patients (49% vs 51%) respectively. Mean age of children was 6.79±3.78 years and there was male predominance 120(61.5%). The percentage of children having weight for age &lt;5th centile was 91(47), only 8(4%) were overweight or obese. Children under the age of five years had a slightly higher propensity of weight &lt;5th centile i.e. 47(51.6%) as compared to older age group 5-10 years 26(28.7%) and &gt;10 years 18(19.7%) (p=0.295).Similarly height for age was &lt;5th centile in 50(26%) children in total, and in under 5 year age group 26(13.3%) but there was no statistically significant difference related to age above 5 years (p=0.547). Conclusion: Pediatric ALL has overall high prevalence of under nutrition and both weight for age and height for age is lower in under-five children as compared to older age group. Keywords: Children, cancer, nutrition, malnutrition, Acute Lymphoblastic leukemia

Upper-limb function in Brachial Plexus birth palsy: Does the Pediatric Outcomes Data Collection Instrument correlate with the Brachial Plexus Outcome Measure?

Functional outcome assessment for children with brachial plexus birth palsy (BPBP) is essential. We aimed to investigate the association between the Brachial Plexus Outcome Measure (BPOM) and the Pediatric Outcomes Data Collection Instrument (PODCI) in children with BPBP and healthy matched controls, and to explore upper-limb function and the discriminative properties of the two tests. Thirty children, aged 6–14 years, diagnosed with BPBP and undergoing shoulder tendon transfer and 20 age-matched healthy controls were included. In both groups, the Turkish version of the PODCI, used to evaluate daily living activities, was implemented. The Turkish version of the BPOM, specifically developed for BPBP, was applied in children with BPBP. Test results, demographic and clinical characteristics were recorded. The mean age of children with BPBP was 8.53 ± 2.53 years and their BPOM Activity scale score was 42.93 ± 8.28. The PODCI Upper Extremity Function score (74.97 ± 23.49 vs. 100) and the PODCI Global Functioning score (89.20 ± 7.73 vs. 99.36 ± 7.73) were significantly lower in the BPBP group (p < 0.01). While there was a significant and very strong relationship between the BPOM Activity and PODCI Global Functioning scores (r = 0.845; p = 0.037), no correlation was found between the BPOM Self-Evaluation scale and PODCI Global Functioning score (r = 0.456; p = −0.141). The PODCI correlated with the BPOM Activity scale, providing an appropriate alternative measurement for upper-limb function in children with BPBP after shoulder tendon transfer.

Association Of Children’s Dental Health Status with Their Parents’ Oral Health Literacy and Family Characteristics

Background and Objective: Oral health literacy (OHL) is a type of health literacy that specifically focuses on people`s literacy and knowledge about oral health. It has been shown that oral health literacy can be a powerful predictor of people's health, health-related behaviors, and medical outcomes. As parents play a crucial role in their child`s health, in this study we aimed to assess the oral health literacy of the adults and its relation with their children`s dental status.Materials and Methods: Four hundred parents with their children participated in this cross-sectional study. Two hundred OHL questionnaires were distributed to parents of 3–6-year-old patients referred to pediatric hospitals for any reason. The OHL was assessed in three domains: reading comprehension, numeracy and appropriate decision-making. The score were categorized as inadequate, 0-7; marginal, 8-9, and adequate, 10-15. Then a dentist did the dental examination of their children, and the DMFT (decay-missing-filled teeth) index was calculated. Chi-square, independent sample t-test, Mann-Whitney, and Kruskal-Wallis tests were used for comparative analysis.Results: 69.2%, 21.2% and 9.6% of the parents had inadequate, marginal and adequate OHL, respectively. The mean DMFT was 4.5±4.47 (median:3) with minimum of 0 and maximum of 17. The mean age of parents and children did not differ between 3 groups of OHL, but DMFT was significantly higher in participant with inadequate OHL (p=0.03). The mean DMFT was also higher in families with greater than four family members(p=0.002). It is shown that the frequency of inadequate OHL was higher among parents with lower education(p=0.002), while the DMFT did not differ in 3 groups of education(p=0.84).Conclusion: Parents with inadequate OHL was associated with high children’s dental caries. So, conducting oral health education for parents is essential. Holding training classes in health centers can improve the parent’s oral health literacy, and hopefully motivate them to look after their child’s dental health.

Oral dyspraxia in self-limited epilepsy with centrotemporal spikes: a comparative study with a control group.

self-limited epilepsy with centrotemporal spikes, previously considered benign focal childhood epilepsy with centrotemporal spikes show clinical signs of involvement of Rolandic areas, mainly lower area, which may affect the planning and execution of motor sequences. This study aimed to evaluated oral praxis in children with self-limited epilepsy with centrotemporal spikes and compare to the age-matched control group. This was a descriptive study with 74 children with self-limited epilepsy with centrotemporal spikes, with the classical forms according to International League Against Epilepsy, and between 4 and 15 years of age, selected from the child neurology outpatient clinic of the Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, and 239 age-matched and educational level-matched (convenience sampling) control children. All children were submitted to the battery of oral volitional movements, which consisted of 44 tests for oral movement (tongue, lip, cheek, jaw, and palate) and 34 phonemes and consonant cluster tasks, with simple and sequenced oral movements. The mean age and standard deviation (SD) of children with epilepsy was 9.08 years (SD 2.55) and of controls 9.61 years (SD 3.12). The results showed significant differences between the groups with a poorer performance of children with epilepsy compared to children without epilepsy in simple and particularly in sequenced movements. These findings can be attributed to the genetically determined immaturity of cortical structures related to motor planning in children with self-limited epilepsy with centrotemporal spikes.

Childhood Obesity in Public and Private Middle School Students

Background: Obesity is defined as the syndrome in which excessive fat deposits in the adipose tissues, which affects the normal functioning of the body. Childhood obesity is the great challenge these days. In Pakistan recent study on children 10-15 years of age shows high prevalence of childhood obesity. The present study will help to inform the community regarding the frequency and percentage of overweight and obese children in middle standard schools. Objective: Objective so this study were to identify the recent estimate of frequency of obesity in middle school students in year 2017 and then to compare the frequency of obesity in public and private sector schools. Material and methods: This Descriptive cross sectional study was conducted in 2 private schools of Sahiwal and 2 government schools of Lahore, Punjab, Pakistan. About 324 children (81 from each school) were recruited randomly and interviewed about their physical activities. Height and weight were measured and BMI was calculated. Children were distributed in different BMI group and obesity as assessed. Results: The mean age of children in government school was 13.01 ± 1.09 years while in private school was 12.75 ± 1.08. 50% were females from government school and 50% from private school. 50% were male students from government school and 50% from private schools. The mean BMI of participants was 18.48 ± 3.36 kg/m2 in government school while 20.14 ± 3.66 kg/m2 in private school. When frequency of government and private school was compared results shows that out of 162 students from each school, 13 (8%) in government schools and 24 (14.8%) in private schools are overweight, while 8 (4.9%) in government schools and 17 (10.5%) in private schools are obese. Conclusion: High frequency of obesity and over weight in children of middle schools was noted. This frequency is greater in students of private schools both males and females as compared to students of government schools both males and females. Keywords: Obesity, school going Children, private school, government school, body mass index, height, weight

Conjunctival Lesions: A 5-Year Basic Demographic Data and Clinicopathological Review in a Tertiary Eye Care Hospital

BackgroundConjunctival lesions are common with a wide spectrum of benign, premalignant, and malignant lesions. Few histopathological studies have been conducted on conjunctival lesions with variable designs and results. Our aim in this study is to provide information on common conjunctival lesions seen in an ophthalmology tertiary care center in Saudi Arabia.MethodsA retrospective, observational study of all consecutive conjunctival tissue specimens sent for histopathological assessment to the pathology department from 2015 to 2019 were analyzed. Clinical data were collected from medical records, and the histopathological slides were reviewed by a single pathologist.ResultsA total of 110 conjunctival specimens from 108 patients were included (mean age: 53 years, 67 males and 43 females). Bilateral involvement was mostly found in inflammatory lesions (40%). Most lesions were benign (91%), with a significantly longer duration of symptoms in malignant lesions (p = 0.036*). The clinical diagnosis matched the final histopathological diagnosis in 75.5% of the total specimens. The most frequent category of benign lesions was fibrodegenerative and proliferative lesions (53.6%), with a significantly higher prevalence among adult males (p < 0.001). Melanocytic lesions were more common in children (33.3%) than adults (9.8%), and the mean age of children was significantly lower (p = 0.013). The most frequent malignant lesion was ocular surface squamous neoplasia (50%), with equal prevalence among males and females. The overall outcome was favorable in 89.4% and unfavorable in 10.6%, mostly due to surgical complications, further progression of the lesion, or recurrence.ConclusionThis study shows variability in the frequency of conjunctival lesions based on gender, age, geographical, racial, and environmental factors. There has been a shift in the gender-based prevalence of ocular squamous neoplasia over the last three decades, probably due to a change in lifestyle.

Comparison of Clinical Outcomes of Flexible Intramedullary Nailing (FIN) with External Fixation in Pediatric Open Tibial Fractures

Objective: To compare the clinical outcome of flexible intramedullary nailing (FIN) with external fixator in pediatric open tibial fractures. Subjects and Methods: In this randomized comparative study, 80 children having age 5 year to 14 years who presented with open tibial fractures were included. The study was conducted from June-2020 to June-2021 in Islam Hospital Sialkot and Allama Iqbal Memorial Hospital Sialkot. Patients were divided into two equal groups. Group A: underwent external fixation and group B: underwent flexible intramedullary nailing for the surgical management of tibial fractures. Frequency of infections surrounding pins, painful bursitis and re fracture rate within 3 months after surgery was recorded. Results: The mean age of children was 8.42±3.82 years in external fixator group versus 8.40±4.0 years in FIN group (p-value 0.97). Infection-surrounding pins occurred in 9 (22.5%) children were belonging to external fixator group and 01 (2.5%) children was belonging to FIN group (p-value 0.007). Refracture occurred in 6 (15.0%) patients in external fixator group and in no (0.0%) children in FIN group (p-value 0.01). Painful bursitis occurred 2 (5.0%) patient was in external fixator group and in 13 (32.5%) in FIN group (p-value 0.002). Conclusion: Clinical outcome is better in patients treated with FIN as compared to the external fixator for the treatment of pediatric open tibial shaft fractures. Keywords: Flexible intramedullary nails, External fixator, Tibial fractures.

Evaluation of Acute Kidney Injury and its Risk Factors in Children Admitted with Diagnosis of Nephrotic Syndrome

Abstract Background and Aim: Acute Kidney Injury (AKI) is an important complication of Nephrotic Syndrome (NS) associated with adverse outcome. The frequency of AKI has increased to almost double in the last decade. To determine the incidence of AKI, risk factors and its association with outcome in hospitalized children with NS. Methods – All children aged 1-18 years with diagnosis of NS from 01 November 2018 to 31 May 2020 were enrolled for the study. AKI was diagnosed using the KIDIGO 2012 guidelines and classified according to pediatric RIFLE definition. Results –The mean age of children in this cohort was 4.7± 2.8 years. Complications were observed in 67% cases only. Among all complications the most frequent complication was anemia (25%). The incidence of AKI in hospitalized children with NS was 18.6%. According to pRIFLE criteria of AKI; 11.6% of children met Stage 1 (risk) criteria, 4.6% met Stage 2 (injury) criteria and 2.3% met Stage 3 (failure) respectively. Among all NS children, 53% received nephrotoxic drugs during the hospital stay. On applying multivariate logistic regression analysis, only male gender, associated anemia and Vancomycin use in NS patients came out to be significant independent risk factor for acute kidney injury. Conclusions: AKI is more frequent in first episode of NS rather than in any type of relapses. Although, nephrotoxic drug and male gender are known independent risk factors for development of AKI, associated anemia is till yet not considered as independent risk factor for AKI in children with NS.