Medical Problem In Children Research Articles

Investigation of Factors Affecting the Prevalence of Sinusitis in Children Referred to Abu Ali Sina Balkhi Educational Hospital

Sinusitis is one of the most common medical problems in children, caused by inflammation and infection in the nasal sinuses. This disease can have a significant impact on the growth and health of children. Investigating the factors affecting the prevalence of sinusitis in children is necessary in order to take appropriate preventive and therapeutic measures. In this regard, the present study aimed to investigate the factors affecting the prevalence of sinusitis among children referred to Abu Ali Sina Educational Hospital in Balkhi. Materials and Methods: This study includes the design of a prospective descriptive study, data were collected using patients' files, then by analyzing the data, the causes of the prevalence of sinusitis in children referred to Abu Ali Sina Balkhi Educational Hospital will be identified and the results will be presented in the form of a scientific article. The findings showed that the prevalence of sinusitis was higher among children admitted to Abu Ali Sina Educational Hospital in Balkhi and viral infections (influenza 20%, adenovirus 24% and Ronovirus 40%) were reported. The majority of patients had symptoms such as nasal congestion and discharge, a feeling of congestion in the ears, headache, and fever. In the majority of patients, their growth and development disorders have also been observed.

Pediatrics, Pediatricians and Child Care : Based on 16th Dr. K. C. Chaudhuri and Dr. Amala Chaudhuri Oration, on 15th October 2023.

Medical problems of children and their differences from adults have been mentioned in the ancient texts. Important contributions to medicine, including treatment of diseases of children were made by Greek and many scholars from middle East countries in 10th century. Pediatrics became widely recognized in Europe and USA during early 19th century and a number of children's hospitals were established in major cities. With technological advances, pediatric subspecialties also developed. In India, pediatrics was recognized around 1950s and thereafter, gradually progressed. Pediatric specialties came up in 1970s and became well established during 2020s.Pediatricians are regarded as doctors treating sick children. Pediatric specialists have the responsibility of providing tertiary care to patients with complex systemic diseases and critical care. In our country having a huge underprivileged population, pediatricians need to play a wider role and aim to provide comprehensive care that would lead to optimum development for every child. They should be aware of child rights, widely prevalent child abuse and exploitation and legal protective mechanisms, and attempt to tackle these issues in association with other agencies and organizations working for child welfare.

The experience of fathers of children hospitalised with advanced heart disease.

There are little reported data on the perspectives of fathers caring for children with chronic conditions. Although survival of children with advanced heart disease has improved, long-term morbidity remains high. This study describes the experience and prognostic awareness of fathers of hospitalised children with advanced heart disease. Cross-sectional survey study of parents caring for children hospitalised with advanced heart disease admitted for ≥ 7 days over a one-year period. One parent per patient completed surveys, resulting in 27 father surveys. Data were analysed using descriptive methods. Nearly all (96%) of the fathers reported understanding their child's prognosis "extremely well" or "well," and 59% felt they were "very prepared" for their child's medical problems. However, 58% of fathers wanted to know more about prognosis, and 22% thought their child's team knew something about prognosis that they did not. Forty-one per cent of fathers did not think that their child would have lifelong limitations, and 32% anticipated normal life expectancies. All 13 fathers who had a clinical discussion of what would happen if their child got sicker found this conversation helpful. Nearly half (43%) of the fathers receiving new prognostic information or changes to treatment course found it "somewhat" or "a little" confusing. Fathers report excellent understanding of their child's illness and a positive experience around expressing their hopes and fears. Despite this, there remain many opportunities to improve communication, prognostic awareness, and participation in informed decision-making of fathers of children hospitalised with advanced heart disease.

Acquired methaemoglobinaemia in infancy associated with acute diarrhoea: A case series.

Acute diarrhoeal illness remains a common medical problem in children with nearly 1.7 billion cases globally every year. We report five infants who, following severe diarrhoea, developed methaemoglobinemia. This is an altered state of haemoglobin presenting with cyanosis and can pose a diagnostic dilemma. It should be suspected in young infants without cyanotic heart disease presenting with severe diarrhoea, sepsis and cyanosis disproportionate to their clinical status. Its outcome depends on prompt treatment, the severity of underlying sepsis and co-morbidity.

The role of telehealth in pediatric emergency care.

In 2006, the Institute of Medicine published a report titled "Emergency Care for Children: Growing Pains," in which it described pediatric emergency care as uneven at best. Since then, telehealth has emerged as one of the great equalizers in care of children, particularly for those in rural and underresourced communities. Clinicians in these settings may lack pediatric-specific specialization or experience in caring for critically ill or injured children. Telehealth consultation can provide timely and safe management for many medical problems in children and can prevent many unnecessary and often long transport to a pediatric center while avoiding delays in care, especially for time-sensitive and acute interventions. Telehealth is an important component of pediatric readiness of hospitals and is a valuable tool in facilitating health care access in low resourced and critical access areas. This paper provides an overview of meaningful applications of telehealth programs in pediatric emergency medicine, discusses the impact of the COVID-19 pandemic on these services, and highlights challenges in setting up, adopting, and maintaining telehealth services.

The Lived Experience of Parents' Receiving the Diagnosis of CDKL5 Deficiency Disorder for Their Child.

CDKL5 deficiency disorder (CDD), a severe developmental and epileptic encephalopathy, is being diagnosed earlier with improved access to genetic testing, but this may also have unanticipated impacts on parents' experience receiving the diagnosis. This study explores the lived experience of parents receiving a diagnosis of CDD for their child using mixed methods. Thirty-seven semistructured interviews were conducted with parents of children with a diagnosis of CDD, which were coded and analyzed to identify themes. Grief was a nearly universal theme expressed among participants. Parents of younger children discussed grief in the context of receiving the diagnosis, whereas parents of older children indicated they were at different stages along the grieving journey when they received the diagnosis. Parents with less understanding of their child's prognosis (poorer prognostic awareness) connected their grief to receiving the diagnosis as this brought a clear understanding of the prognosis. Several themes suggested what providers did well to improve the diagnostic experience for parents, much of which aligns with existing literature around how to provide serious news. Additionally, parents identified long-term benefits of having a diagnosis for their child's medical problems. Although interview data were concordant with a survey of parents' diagnostic experience from a large international cohort, most participants in this study were relatively affluent, white mothers and further research is needed to better understand if other groups of parents have a different diagnostic experience. This study gives context of parental experience that providers should be aware of when conveying new genetic diagnoses to families.

English

BACKGROUND Urinary tract infections (UTI) constitute a common cause of morbidity in infants and children. When associated with abnormalities of urinary tract, they may lead to long-term complications including renal scarring, loss of function and hypertension. Most urinary tract infections remain undiagnosed if investigations are not routinely performed to detect them. Prompt detection and treatment of urinary tract infections and any complicating factors are important. The objective of the study is to know the clinical, epidemiological and bacteriological profile (i.e. clinical signs and symptoms, age, sex, family history, associated urinary tract abnormalities, & causative organisms) of urinary tract infections in febrile children with culture positive urinary tract infection. METHODS This descriptive, cross sectional observational study was conducted at outpatient clinics of our “child health clinics” between May 2016 and April 2017 (one year). All children aged 0 to 12 years with culture positive urinary tract infections were included in this study to evaluate the clinical, epidemiological and bacteriological profile. RESULTS A total of 69 children with culture positive urinary tract infections were included in this study. Out of 69 children included in this study, 36 (52.2 %) were females and 33 (47.8 %) were males. Overall female preponderance was seen and the M: F ratio was 0.9:1. But during first year of life in our study group we had more boys (10, 14.49 %) affected with urinary tract infection than girls. 49.3 % of urinary tract infections in the present study belonged to lower socio-economic status. Most common organism causing urinary tract infection in our group was E. coli (56.5 %). Fever (100 %), anorexia or refusal of feeds (52.2 %), dysuria (46.4 %), vomiting (46.4 %) and abdominal pain (39.1 %) were the predominant clinical manifestations observed in our study. CONCLUSIONS Urinary tract infection is a common medical problem in children and it should be considered as a potential cause of fever in children. As febrile children with urinary tract infection usually present with non-specific signs and symptoms, urine culture should be considered as a part of diagnostic evaluation. KEYWORDS Urinary Tract Infections (UTI), Febrile Children, Bacteriological Profile, Urine Culture

Parent and Physician Understanding of Prognosis in Hospitalized Children With Advanced Heart Disease.

BackgroundThe unpredictable trajectory of pediatric advanced heart disease makes prognostication difficult for physicians and informed decision‐making challenging for families. This study evaluated parent and physician understanding of disease burden and prognosis in hospitalized children with advanced heart disease.Methods and ResultsA longitudinal survey study of parents and physicians caring for patients with advanced heart disease age 30 days to 19 years admitted for ≥7 days was performed over a 1‐year period (n=160 pairs). Percentage agreement and weighted kappa statistics were used to assess agreement. Median patient age was 1 year (interquartile range, 1–5), 39% had single‐ventricle lesions, and 37% were in the cardiac intensive care unit. Although 92% of parents reported understanding their child's prognosis “extremely well” or “well,” 28% of physicians thought parents understood the prognosis only “a little,” “somewhat,” or “not at all.” Better parent‐reported prognostic understanding was associated with greater preparedness for their child's medical problems (odds ratio, 4.7; 95% CI, 1.4–21.7, P=0.02). There was poor parent–physician agreement in assessing functional class, symptom burden, and likelihood of limitations in physical activity and learning/behavior; on average, parents were more optimistic. Many parents (47%) but few physicians (6%) expected the child to have normal life expectancy.ConclusionsParents and physicians caring for children with advanced heart disease differed in their perspectives regarding prognosis and disease burden. Physicians tended to underestimate the degree of parent‐reported symptom burden. Parents were less likely to expect limitations in physical activity, learning/behavior, and life expectancy. Combined interventions involving patient‐reported outcomes, parent education, and physician communication tools may be beneficial.

Prevalence of hypertension among school going adolescent boys in Najafgarh, Delhi, India

Hypertension is a global epidemic. Hypertension has become an increasingly important medical problem in children and adolescents. Evidence shows that hypertension begins in childhood and its associated risk factors like obesity, unhealthy eating habits also emerge in children of school going age. To study the prevalence of hypertension among school going adolescent boys in Najafgarh, Delhi and to find out the factors associated with hypertension among them. A cross-sectional study was planned in which a self-administered questionnaire was used to collect information from the study participants. A total of 600 adolescent boys of 9th to 12th classes from four different schools in Delhi, were included in the study over a period of 12 months. Blood pressure, height, weight and waist circumference were measured for all children. Data was analyzed using SPSS software version 21.0 and for qualitative data analysis a chi-square (χ2) test was used. The mean age of study subjects was 15.1 years. The majority of the study subjects, 372 (62%), were in the age group of 14-16 years. Among the study subjects, 44 (7.3%) had pre-hypertension and 26 (4.3%) had hypertension. Hypertension was significantly higher in those with a family history of hypertension and who were overweight/obese. The prevalence of hypertension was significantly high among adolescents of Delhi. Obesity and family history of hypertension were identified as important risk factors prevalent in the study population.

Medical problems in children with Down syndrome

Background: Down syndrome (DS) is a major cause of mental retardation of prenatal origin and has several associated co-morbidities involving cardiovascular system, respiratory, endocrine system, hematological, gastrointestinal, musculoskeletal, eye and ear defects, immunological changes and neurological system. This study was conducted to identify the common medical problems in children with Down syndrome and the morbidity associated with these conditions. The objective of the present study was to find out the occurrence of different medical problems in children with DS.Methods: 42 children with a phenotype of Down syndrome in the age group of 0-12 years attending the outpatient, inpatient and Down syndrome Clinic of the Institute of Child Health, Kottayam during the study period were included in the study by purposive sampling. Demographic details were entered, and Pediatric Clinical Examination was performed by the investigator himself to identify the medical problems. Old medical reports were reviewed, and data entered into a proforma and statistically analysed.Results: Out of the 42 children with DS, 22 were males. 15 (35.7%) were less than 1 year, 20 (48.3%) children 1-5 years and 7 (16.1%) children 5-12 years of age. Mean age of the study group was 1.78±0.51 years. Mean age of their mothers at the time of conception was 30.6±5.8 years. 26 (57%) children with Down syndrome had a medical problem during the neonatal period which required hospitalization. Almost all systems are affected and craniofacial features, developmental delay and hypotonia were universal. Various forms of congenital heart diseases were observed in 67% and hypothyroidism in 23.8%.Conclusions: Down syndrome is a common genetic disorder with multisystem involvement. Congenital heart diseases, hypothyroidism and recurrent respiratory infections were the common medical problems identified in this study.

Reducing hospital admissions of healthy children with functional constipation: a quality initiative

Functional constipation (FC) is a common medical problem in children, with minimal risk of long-term complications. We determined that a large number of children were being admitted to our children’s...

Effectiveness of Health Education on Knowledge of Mothers of Under Five Children Regarding Management of Children Suffering from Pyrexia

Fever is a commonest medical problem in children for which mothers to seek immediate medical care and the parents experience "fever phobia". The study was aimed to assess the mothers' knowledge and effectiveness of health education on mother's knowledge on the management of children suffering from pyrexia. Data was collected from the mothers at pediatric ward, Krishna Hospital and Medical Research Center, Karad, Maharashtra, India. The study design was one group pre-test, post-test design. Forty mothers of children suffering from pyrexia were the samples selected by non-probability purposive sampling technique. The pre-test was conducted on the 1<sup>st</sup> day by administering structured knowledge questionnaire and health education was delivered on management of children suffering from pyrexia. Post-test was conducted on the 7<sup>th</sup> day. Descriptive and inferential statistics were used for analysis. Results show that 11.2 was the mean pre-test value and 20.8 was the mean post-test value. The paired t-test value was 11.097, (p<0.0001) showing a significant gain in the mothers knowledge on management of children suffering from pyrexia. Chi-square test result shows that there was a significant association of knowledge scores of mothers with monthly family income ( χ<sup>2</sup> = 11.039, p<0.05), source of health information ( χ<sup>2</sup> = 17.861, p<0.05). The study concludes that the health education regarding management of children suffering from pyrexia was effective in improving the knowledge of mothers and thus health education interventions should be targeted to mothers to manage children suffering from pyrexia effectively.

Effectiveness of Health Education on Knowledge of Mothers of Under Five Children Regarding Management of Children Suffering from Pyrexia

Fever is a commonest medical problem in children for which mothers to seek immediate medical care and the parents experience "fever phobia". The study was aimed to assess the mothers' knowledge and effectiveness of health education on mother's knowledge on the management of children suffering from pyrexia. Data was collected from the mothers at pediatric ward, Krishna Hospital and Medical Research Center, Karad, Maharashtra, India. The study design was one group pre-test, post-test design. Forty mothers of children suffering from pyrexia were the samples selected by non-probability purposive sampling technique. The pre-test was conducted on the 1<sup>st</sup> day by administering structured knowledge questionnaire and health education was delivered on management of children suffering from pyrexia. Post-test was conducted on the 7<sup>th</sup> day. Descriptive and inferential statistics were used for analysis. Results show that 11.2 was the mean pre-test value and 20.8 was the mean post-test value. The paired t-test value was 11.097, (p<0.0001) showing a significant gain in the mothers knowledge on management of children suffering from pyrexia. Chi-square test result shows that there was a significant association of knowledge scores of mothers with monthly family income ( χ<sup>2</sup> = 11.039, p<0.05), source of health information ( χ<sup>2</sup> = 17.861, p<0.05). The study concludes that the health education regarding management of children suffering from pyrexia was effective in improving the knowledge of mothers and thus health education interventions should be targeted to mothers to manage children suffering from pyrexia effectively.

Cinematic magnetic resonance enterography for non-organic abdominal pain in infants and children.

Recurrent non-organic abdominal pain is the most commonly diagnosed medical problem in children. However, excluding small bowel disease remains a challenge. We evaluated our exclusion criteria for organic small intestinal diseases in pediatric patients with recurrent non-organic abdominal pain using cinematic magnetic resonance (cine-MR) enterography. The non-intestinal organic (non-IO) group as classified by the Rome III criteria system and the intestinal organic (IO) group consisted of 81 and 19 patients, with 35 and 12 male and 46 and 7 female patients with an age range of 5-18 and 4-15 years (average 10.5 and 10.5 years), respectively. Cine-MR enterography was performed by dynamically balanced first-field-echo imaging with thick-slice water-selective excitation without breath holding. In our original small intestinal motility test, cine-MR enterography was taken at three different times (fasting state [P1], immediately after [P2] and 30 min after [P3] drinking liquid material), with images taken sequentially for 5 min at each time-point to evaluate the motion of water in the gastrointestinal tract. Positive findings for organic intestinal problems were concluded when persistent visible intestinal loops appeared in both the P1 and P2 phases. Cine-MR enterography showed 6/81 (7.4%) and 18/19 (94.7%) (P < 0.01) positive cases of organic intestinal problems in the non-IO and IO groups, respectively. Positive and negative predictive values of this examination were 78.3% and 97.4%, respectively. The unique capabilities of cine-MR enterography technology in this clinical setting render it an important additional diagnostic tool when specific disease management issues must be addressed.

Consumption of energy-dense, nutrient-poor foods and hypertension in obese children

Background Obesity has become an increasingly important medicalproblem in children. Obesity-induced hypertension in childhoodshould be considered as a chronic medical condition that is likelyto require long-term management of dietary patterns, especially forenergy-dense, nutrient-poor (EDNP) food consumption.Objective To examine the contribution ofEDNP foods to dailyenergy and macronutrient intakes and to examine the relationshipbetween intake of EDN P foods and the prevalence of hypertensionin children.Methods Four hundred and forty children were randomly selectedto participate. Weight and height were measured with precisionelectronic scales and fixed microtoise, respectively. Blood pressure(BP) measurements were performed by standard procedure. A24-hour dietary recall was obtained by a trained interviewer todetermine the intake of EDNP foods, which were clas sified to 4major groups: visible fat, sweeteners, desserts, or salty snacks.The difference in mean was evaluated using paired Ttest.Logistic models were fitted to assess for an association betweenhypertension and the various characteristics.Results The proportion of children who were overweight (includingobese) was 23 .2%. The prevalence of elevated BP was 10.5%, similarin boys and girls, with most of them having isolated elevated sys to lieBP. There was a relationship between BP and body mass index(BMI) in all children. Approximately 27% of total daily energyintake was contributed by all EDNP foods. Of the EDNP foodsubgroups examined, dessert and sweeteners contributed nearly20% of total daily energy intake. In the highest one-third of subjectswho consumed EDNP food, these foods provided 49% of total dailycarbohydrate intake and 34% of total daily fat intake.Conclusion Eating patterns ofEDNP foods provide 49% of totaldaily carbohydrate intake and 34% of total daily fat intake. ThisEDNP food is independently associated with hypertension inchildren.

Mothers’ knowledge, perception and management of fever in children

Objective – Fever is a common medical problem in children which often prompts mothers to seek immediate medical care. The aim of this study was to survey mothers about their knowledge, perception and management of fever in their children. Patients and methods – The study involved 240 mothers who brought febrile children to Afshar Hospital in Yazd, Iran. An assessment of the mothers’ knowledge, perception and management of fever in their children through answers to a structured questionnaire were the focus of this study. Results – In this study, twenty-one percent of the mothers used a liquid crystal forehead thermometer. Forty-six percent treated febrile children with acetaminophen or ibuprofen. Fifty-eight percent of mothers perceived a risk of convulsions in children with fever if it is untreated. Fifty-five percent of mothers think that teething causes fever. Conclusion – Most mothers perceive that fever is harmful and dangerous for children. Also, their knowledge is poor and the temperature is not measured accurately. Mothers’ misconceptions about fever reflect the lack of health education in our city

Prevalence of multidrug resistant pathogens in children with urinary tract infection: A retrospective analysis

Urinary tract infection (UTI) is one of the commonest medical problems in children. It can distress the child and may cause kidney damage. Prompt diagnosis and effective treatment can prevent complications in the child. But treatment of UTI in children has now become a challenge due to the emergence of multidrug resistant bacteria.

Clinical approach to quality of life in children with end-stage renal disease

Quality of life in addition to various medical problems in children with end-stage renal disease (ESRD) should be objectively assessed to accomplish normal growth and development during childhood. However, unfortunately, studies of quality of life (QoL) in children with ESRD have been not popular yet and there are only fewer suitable assessment tools compared with adults. Recently, disease-specific modules to evaluate QoL in children with chronic disease such as ESRD have been developed. This review was made to introduce these QoL instruments for children and help the clinical application of them.

子どものめまい: 小児起立性調節障害を中心に

Dizziness is not an uncommon medical problem in children. When a child develops various physical symptoms in addition to dizziness, clinicians should include orthostatic dysregulation (OD) in their diagnosis. OD is composed of four different subsets, instantaneous orthostatic hypotension (INOH), postural tachycardia syndrome (POTS), neurally-mediated syncope and delayed orthostatic hypotension, and the former two are dominant. INOH involves dysfunction of the high-pressure system in the neural baroreflex pathway, and the low-pressure system in the case of POTS. Children with OD show a decrease in cerebral blood flow compared with unaffected children, and this might be associated with the mechanism responsible for dizziness. Further studies are anticipated in relation to OD and vestibular function.

A Call for Action: Recognizing and Treating Medical Problems of Children with Autism

The care of children with autism requires attention to medical problems which they may develop. Significant subsets of children with autism have intestinal inflammation, digestive enzyme abnormalities, metabolic impairments, oxidative stress, mitochondrial dysfunction, and immune problems which range from immune deficiency to hypersensitivity to autoimmunity. The author works within a paradigm that views autism as a body wide, multi-system disorder. Behavioral symptoms may be signs of underlying pain in children with communication problems and require attention to underlying pathology rather than relying on behavioral measures to extinguish the behaviors. Opportunities for improving quality of life and autistic symptoms are found by using a combination of detailed histories, physical exams and laboratory evaluations to uncover clues about underlying medical issues that need to be treated. The current prevalence of autism and the suffering of the children and families involved call for action by primary care physicians working in collaboration with researchers, specialists and parents if these children are to receive appropriate medical care. [N A J Med Sci. 2012;5(3): 180-184.]