Older Children Research Articles

NEUROLEPTIC MALIGNANT SYNDROME IN A 10-MONTH-OLD EX-PRETERM INFANT WITH DELIRIUM

In recent times, atypical antipsychotics are increasingly being used in the neonatal intensive care unit (NICU) for the management of neonatal delirium. As the recognition of delirium in NICU infants increases, caution should be exercised with use of antipsychotics for management, given associated adverse effects. Neuroleptic malignant syndrome (NMS) is a rare adverse drug reaction associated with exposure to anti-dopaminergic medications. Most reported cases of NMS in pediatric patients have been in older children on antipsychotic medications. We present a case of a 10-month-old former preterm infant who developed clinical signs suggestive of neuroleptic malignant syndrome after exposure to olanzapine for treatment of delirium. Our case report details the clinical course of this infant, delves into the condition, and outlines some useful lessons for the clinician in the identification and management of this rare but life-threatening adverse effect.

Quantifying Removal Torque for Application in a New Child‐Resistant and Senior Friendly Package

ABSTRACTChild resistant packaging (CRP) can effectively reduce the access of children under the age of 5 years old when used correctly. Adults over the age of 65 years commonly struggle to open many kinds of CRP and choose to leave the packages open. The goals of this work were (1) to design a testing system to accurately measure an individuals' ability to apply removal toque to a closure, (2) determine the ranges of torque both older adults and children can apply to a standard closure and (3) determine the effectiveness of a novel CRP to reduce the torque generation of children. A custom hand‐held torque test system was created and used to obtain torque data. In total, 49 participants were tested, 25 children and 24 adults. All participants were tested using three variations of a new type of CRP, which varied the amount of functional surface area (FSA) available to the user and a control. The novel CRP theoretically can be ‘tuned’ by changing the FSA available, impacting the torque individuals are able to exert. All CRP treatments and the control resulted in significantly different removal torques between groups. The difference was largest when the available FSA was between 50% and 80%. Results suggest the new design has the potential to permit older adults to easily open containers while reducing access of children. This new cap system capitalized on a need to understand that a specific, limited region needs to be gripped for opening—and most children tended to just spin the outer cap without applying an isolated torque.

Development of mathematical competence of 5–6-year-old children in Polish preschool education institutions

ABSTRACT This study addresses the topic of developing mathematical competence of children aged 5–6 years old in Polish preschools. A survey was conducted to examine the methods employed in the mathematical education of preschool children, the effectiveness of these methods, and the relationship between the development of mathematical competence of preschool children and their overall growth and development. The responses from the survey of teachers of pre-school education and parents were analysed to determine whether the mathematical competence of older preschool children is adequately shaped in accordance with their developmental possibilities and whether the mathematical education provided in kindergarten sufficiently prepares children to start learning mathematics in the ‘school way’.

You Do You[Tube]!The multifaceted roles of online video viewing in the lives of U.S. children

Guided by uses and gratifications theory, the current project invited parents (N = 358) to submit YouTube videos (N = 973) recently viewed by their children aged 0 to 8. Parents rated each video for its perceived impact on their child, while coders evaluated each video for its content. Results indicated that in-depth educational lessons were rare in these videos, and potentially harmful depictions were common (e.g., physical aggression). Despite these issues, parents reported that these videos often evoked children's joy, fostered social bonding, and allowed children to explore niche interests. Some patterns varied by age, such that older (vs. younger) children viewed fewer educational videos, and they experienced fewer emotional gratifications from viewing. However, older children also viewed more videos with peers, and parents reported that those experiences facilitated peer bonding. Collectively, these findings replicate some concerning patterns found in previous research while also hinting at positive aspects of YouTube exposure that are neglected in discourse about children's experiences online.

Sharing Stories Versus Explaining Facts: Comparing African American Children's Microstructure Performance Across Fictional Narrative, Informational, and Procedural Discourse.

Both fictional oral narrative and expository oral discourse skills are critical language competencies that support children's academic success. Few studies, however, have examined African American children's microstructure performance across these genres. To address this gap in the literature, the study compared African American children's microstructure productivity and complexity across three discourse contexts: fictional narratives, informational discourse, and procedural discourse. The study also examined whether there were age-related differences in microstructure performance by discourse type. Participants were 130 typically developing African American children, aged 59-95 months old, enrolled in kindergarten through second grades in a Midwestern U.S. public school district. Wordless children's books were used to elicit fictional narratives, informational, and procedural discourse. Indicators of microstructure performance included measures of productivity (i.e., number of total words and number of different words) and complexity (i.e., mean length of communication unit and complex syntax rate). The effects of genre and age on microstructure performance were assessed using linear mixed-effects regression models. Children produced longer discourse and used a greater diversity of words for their fictional stories compared to their informational or procedural discourse. Grammatical complexity was greater for fictional narratives and procedural discourse than informational discourse. Results showed greater productivity and complexity among older children compared to younger children, particularly for fictional and informational discourse. African American children exhibit variation in their microstructure performance by discourse context and age. Understanding this variation is key to providing African American children with support to maximize their oral language competencies.

Respiratory pathogen analysis in pediatric inpatients unraveled the infection pattern of Mycoplasma pneumoniae post the COVID-19 pandemic.

To counteract the COVID-19 pandemic, nonpharmaceutical interventions (NPIs) were implemented globally, exerting a profound influence on a wide spectrum of infectious diseases, encompassing respiratory tract infections (RTIs). Subsequent to the easing of NPIs, China experienced a significant outbreak of Mycoplasma pneumoniae (MP). Over a decade from 2015 to 2024, our study scrutinized 12 common infectious diseases among pediatric children. Etiologically diagnostic data and clinical outcome metrics of children with RTIs, tested for 13 pathogens, were analyzed to evaluate changes during and after the pandemic compared to pre-pandemic periods, with a notable emphasis on age profile and coinfection patterns of MP. Among 57,471 hospitalized children, 23,178 were diagnosed with infectious diseases. Under NPIs, most respiratory infections declined compared to pre-pandemic levels, rebounding by 69.64% in 2023. While the infection rate of common respiratory pathogens decreased, cases of respiratory syncytial virus increased during the period of extensive NPI implementation. In 2023, pediatric intensive care unit durations for these pathogens increased, suggesting greater severity of illness compared to 2019. MP exhibited the highest infection rate (31.38% average), with a notable outbreak post-pandemic due to severity increase in <3 year olds and rise among older children. NPIs reduced MP coinfections and mitigated their severity, while exerting a significant influence on bacterial coinfections with MP over the span of 5 years, in contrast to their impact on viral pathogens. NPIs effectively curb transmission of respiratory infections by most pathogens, resulting in increased average age of MP infections and altered patterns of coinfection post-pandemic.

Children interstitial lung disease: Assessment and management.

Diffuse parenchymal lung diseases or children interstitial lung disease (chILD) in pediatrics are a heterogenous group of more than 200 rare diseases with an incidence and prevalence around 8.2 and 46.4 cases/million, respectively, higher than previously recognized, probably related to a greater understanding and increased clinical awareness of these diseases. Children under 2 years of age account for 40%-60% of cases. Diseases presenting before the age of 2 years are mainly of genetic origin or associated with disorders of lung development and are very different from those of older children and adults. In 10%-20% of cases, a genetic cause is found, and in approximately 12%, no cause (undefined chILD) is found after performing all diagnostic tests. A multidisciplinary approach in an expert center is essential for diagnosis and treatment. Tests to be performed after lung computed tomography include serological and other blood tests, bronchoscopy and bronchoalveolar lavage, genetic studies and lung biopsy. Although no approved specific treatment for most cases of chILD exists, an improved understanding of the pathophysiology of many of these diseases is facilitating the development of new treatments.

Multi-echo Acquisition and Thermal Denoising Advances Precision Functional Imaging.

The characterization of individual functional brain organization with Precision Functional Mapping has provided important insights in recent years in adults. However, little is known about the ontogeny of inter-individual differences in brain functional organization during human development. Precise characterization of systems organization during periods of high plasticity is likely to be essential for discoveries promoting lifelong health. Obtaining precision fMRI data during development has unique challenges that highlight the importance of establishing new methods to improve data acquisition, processing, and analysis. Here, we investigate two methods that can facilitate attaining this goal: multi-echo (ME) data acquisition and thermal noise removal with Noise Reduction with Distribution Corrected (NORDIC) principal component analysis. We applied these methods to precision fMRI data from adults, children, and newborn infants. In adults, both ME acquisitions and NORDIC increased temporal signal to noise ratio (tSNR) as well as the split-half reliability of functional connectivity matrices, with the combination helping more than either technique alone. The benefits of NORDIC denoising replicated in both our developmental samples. ME acquisitions revealed longer and more variable T2* relaxation times across the brain in infants relative to older children and adults, leading to major differences in the echo weighting for optimally combining ME data. This result suggests ME acquisitions may be a promising tool for optimizing developmental fMRI, albeit application in infants needs further investigation. The present work showcases methodological advances that improve Precision Functional Mapping in adults and developmental populations and, at the same time, highlights the need for further improvements in infant specific fMRI.

Correlation between screen time and physical activity to student’s physical fitness

The development of electronic media may increase screen time (ST) duration, cause students to develop sedentary habits, and decrease their physical activity (PA). Lately, this has been thought to be the cause of the problem of low physical fitness (PF) among students. This study aimed to analyze the correlation between screen time, physical activity, and students' physical fitness. The design of this study was correlational, with a total of 88 subjects in grades 4 and 5 at Primary Laboratoy School (Labschool) Unesa 1. The sampling technique was simple random sampling. Nusantara students' physical fitness test (TKPN) was employed to assessed physical fitness, screen time-based sedentary behaviour questionnaire to assessed sedentary behaviour, and physical activity questionnaires for older children to assessed physical activity level. Data were collected in alignment with the physical education schedule for each class. Multinomial logistic regression was employed for data analysis. Findings revealed a significant simultaneous correlation among sedentary time (ST), physical activity (PA), and physical fitness (PF) (p = 0.017). However, partial analysis indicated no significant correlation between ST and PF (p = 0.517), while PA demonstrated a significant correlation with PF (p = 0.013). The results of the descriptive analysis showed that 73.9% of participants had very poor levels of physical fitness, and 43.18% of participants had low physical activity levels, with an average daily screen time duration of 3.03 hours. Participants accessed electronic media mostly to play games on smartphones, with an average of 2.28 hours. This study concluded that screen time was not directly affecting physical fitness but could reduce physical activity and student fitness. Despite screen time having no direct impact on physical fitness, this study recommends continuing to monitor screen time duration and increasing physical activity levels to mitigate potential risks associated with excessive screen use.

Impact of International Classification of Functioning, Disability and Health personal factors on outcomes following lower limb orthopaedic surgery in children with cerebral palsy: a systematic review

Purpose To investigate impact of International Classification of Functioning, Disability and Health (ICF) personal factors on pain, function, or quality of life following lower limb orthopaedic surgery in children with cerebral palsy (CP). Materials and methods Systematic review of prospective studies of lower limb orthopaedic surgery in children with CP reporting relationships between ICF personal factors, and pain, function, or quality of life. Results Eight prospective studies reporting various orthopaedic procedures (median follow-up 2.1 years) were eligible, but not sufficiently homogenous for meta-analysis. Functional outcomes most reported (n = 6), then pain (n = 3) and quality of life (n = 1). Personal factors were age (n = 3), sex (n = 4), child education (n = 1), and co-morbidities (n = 1). Older children had lower function (p < 0.01), and children in “special education” greater improvement in function compared to those in “regular” education (p = 0.001) post-single-event multi-level surgery (SEMLS). Age and sex not associated with function, pain, or quality of life post-single-joint procedures (p > 0.05), except females with higher pain intensity (p = 0.019) and lower function (p = 0.018) post-Schanz procedure. No association between sex and function post-SEMLS (p > 0.05). Conclusions Further prospective cohort studies are needed to understand the influence of personal factors identified in this review and investigate the effect of other personal factors on pain, quality of life, and function.

Clinical characteristics and serum 25-hydroxyvitamin D levels in children with febrile seizures in China

The aim of this study was to evaluate the serum level of 25-hydroxyvitamin D (25(OH)D) in children with febrile seizures (FS) in Luzhou, Sichuan Province, China, and in particular its association with gender and age. This should inform possible strategies for supplementation with vitamin D, and hence for prevention of FS in the local pediatric population. The Febrile seizures group consisted of 747 children hospitalized with FS at the Southwest Medical University Affiliated Hospital from January 2020 to January 2024. The healthy control group was comprised of 750 children aged from 0 to 8 years who underwent health checkups during this period. The serum 25(OH)D level was analyzed in relation to gender and age to explore its association with FS. The median serum vitamin D level in the FS group (28.8 ng/mL; IQR 21.64, 33.64) was significantly lower than in the healthy control group (37.51 ng/mL; IQR 31.05, 37.51). The incidence of vitamin D deficiency in the FS group was 10.8%, which was significantly higher than in the healthy control group (P < 0.05). In addition, the serum vitamin D level in children with FS varied in different age groups, with significantly lower levels observed in older children (P < 0.05). ROC curve analysis revealed that a serum vitamin D level of 35.28 ng/mL showed 60.0% sensitivity and 84.7% specificity for predicting FS (P < 0.05). In this study cohort, the serum vitamin D level in children with FS was at the lower limit of the physiological range, and significantly lower than in healthy children. Furthermore, this level decreased with age in children with FS. Regular supplementation with vitamin D for 6 months after birth and outdoor sun exposure for more than 2 h per day can improve the serum vitamin D level in children with FS.

Field-based physical fitness assessment in preschool children in China

BackgroundPhysical fitness in the preschool years is considered a marker of current and future health. Therefore, understanding physical fitness levels of preschool children is necessary. Furthermore, the use of field-based methods to measure physical fitness is essential for assessing children in authentic venues such as schools. Hence, the main purpose of this study was to describe the physical fitness of Chinese preschool children across field-based methods considering a statement of confidence intervals for reference in physical fitness in each age and genders.MethodsA total of 619 children (296 boys and 323 girls) aged 3–6 years old from China participated in the present study. Physical fitness was measured using the Chinese National Physical Fitness Measurement (CNPFM-Pre) battery, which included the tennis ball throw (upper-limb muscular strength), standing long jump (lower-limb muscular strength), shuttle run test (speed-agility), double-leg timed hop (coordination), sit-and-reach (flexibility), and balance beam test (dynamic balance).ResultsThe results revealed significant differences in gender for standing long jump (SLJ; η2 = 0.012, p = 0.007), tennis ball throw (TT; η2 = 0.081, p < 0.001), sit-and-reach (SR; η2 = 0.114, p < 0.001), and one-legged stance test (OST; η2 = 0.037, p < 0.001). Age had positive effects on all physical fitness performance tests, as the shuttle run test (η2 = 0.672, p < 0.001), SLJ (η2 = 0.513, p < 0.001), TT (η2 = 0.394, p < 0.001), double-legged timed hop test (DTH; η2 = 0.445, p < 0.001), SR (η2 = 0.069, p < 0.001), balance beam test (BBT; η2 = 0.367, p < 0.001), and OST (η2 = 0.336, p < 0.001). Older preschool children performed better than their younger counterparts in all the tests. No significant interactions between age groups and gender were found.ConclusionsThis study provided age- and gender-specific physical fitness performance data in Chinese preschool children. Gender differences in physical fitness tests performance already exists at the preschool age. All physical fitness component results increased with age in this cohort. These findings can help healthcare, physical education, and pediatric professionals understand the physical fitness development of preschool children at different ages and help design sports tasks for preschool boys and girls.

A scoping review of randomized controlled trials of parenting and family-based interventions for 10 – 17 year-olds with severe and persistent conduct problems

ABSTRACT Purpose A scoping review of randomized controlled trials (RCTs) of parenting and family-based interventions that aim to reduce severe and persistent conduct problems among 10–17 year-olds. The review also examined feasibility for conducting a network meta-analysis of common therapy elements measured by RCTs. Materials and methods The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA- ScR). Searches were conducted in ERIC, PsycINFO, and MEDLINE without limits on publication year, language or publication country. Study methodological quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for RCTs. Results Twenty-five eligible RCTs were identified. The studies trialed nine interventions, with Multisystemic Therapy (MST) being the most evaluated (N = 10), followed by Functional Family Therapy (FFT, N = 4), and Treatment Foster Care Oregon (TFCO, N = 3). Only 10 of the 25 RCTs revealed treatment effect on conduct problems, including 6 of 9 MST, 1 of 4 FFT and all 3 TFCO trials. Discussion Surprisingly few RCTs of parenting and family-based interventions have been carried out exclusively with this population. Available data suggests that MST and FFT have uncertain effectiveness for reducing severe and persistent conduct problems. While the quality of the reviewed studies was generally high, only two reported substantive data on common therapy elements. Conclusion There is need for more RCTs of parenting and family-based interventions delivered for older children and adolescents with severe and persistent conduct problems. Future RCTs should systematically measure common therapy elements with a view to advancing intervention science.

Factors influencing valproic acid trough levels in epileptic children.

In this study, we aimed to assess main factors influencing the Valproic Acid (V.Acid) plasma trough levels (C0) and to determine their degree of influence on V.Acid C0 in children with epilepsy who had Therapeutic Drug Monitoring (TDM). We conducted an observational study in the Department of Clinical Pharmacology including patients with generalized seizures' epilepsy aged between two and 18 years. Only the children that had benefited from at least two V.Acid C0 determinations were included. First, we assessed daily dose optimization, performed by the practitioners. Then we divided our population into two groups: group A with a final V.Acid C0 in the therapeutic range (TR) and group B with a final V. Acid C0 outside the TR to find out factors influencing V.Acid C0 journey. We included 805 patients (2537 V.Acid C0). The median age was 6.24 years and the sex ratio (M/F) was 1.45. The median V.Acid normalized daily dose was 27.27mg/kg/day and the median V.Acid C0 was 57µg/mL. The children's first V.Acid C0 was in the TR in 59.4% and V.Acid daily dose optimization was performed by the practitioners in 72.3%. Comparing GroupA and B, we found that age and the number of V.Acid C0 determinations increases the chance to reach the TR by respectively 3.79% and 7.39%. Older children who benefit from higher number of performed V.Acid C0 were more likely to reach the TR. In children who beneficiate from a TDM of V.Acid, close follow-up is mandatory to reach and maintain therapeutic V.Acid C0.

Epidemiology of acute childhood poisoning in pediatric emergencies in Western Mexico.

The increase in the production of substances to enhance the quality of life, the biodiversity of the different ecosystems in Mexico, and the unique characteristics of pediatric patients, contribute to intoxications within this population. Analytical retrospective study of admissions to pediatric emergency care due to poisoning in < 16-year-old (2016 to 2020). Included variables were age, gender, type of toxic substance, exposure characteristics, and the season of the year. Frequencies, percentages, range, average and standard deviation were obteined. In the bivariate análisis, the Chi square test was used. A p-value < 0.05 was considered statistically significant. Over 5 years, there were 459 cases, with a prevalence of 3.16%. No gender predominance was observed. The most common was caused by venomous animals (28.5%), followed by medication ingestion (27.6%). Only 5% of cases were suicide attempts, the rest were accidental (95%). Children up to 5 years old were more commonly by medication ingestion, hydrocarbons, or household products (p = 0.03, p = 0.0001), while the causes in older children were contact with venomous animals and ingestion of stimulants drugs (alcohol, amphetamines, cannabis, cocaine) (p = 0.0001, p = 0.006). Intoxication with quaternary ammonium herbicides was lethal in all cases. Children under the age of 5 are more susceptible to intoxication from common household products. Older kids tend to be more frequently a combination of stimulants drugs.

Prediction by Young Autistic Children from Visual and Spoken Input.

Recent theoretical accounts suggest that differences in the processing of probabilistic events underlie the core and associated traits of autism spectrum disorder (ASD). These theories hypothesize that autistic individuals are differentially impacted by disruptions in probabilistic input relative to neurotypical peers. According to this view, autistic individuals assign disproportionate weight to prediction errors such that novel input is overweighted relative to the aggregation of prior input; this is referred to as 'hyperplasticity' of learning. Prediction among autistic individuals has primarily been examined in nonverbal, visual contexts with older children and adults. The present study examined 32 autistic and 32 cognitively-matched neurotypical (NT) children's ability to generate predictions and adjust to changes in predictive relationships in auditory stimuli using two eye gaze tasks. In both studies, children were trained and tested on an auditory-visual cue which predicted the location of a reward stimulus. In Experiment 1 the cue was non-linguistic (instrumental sound) whereas in Experiment 2 the cue was linguistically-relevant (speaker gender). In both experiments, the cue-reward contingency was switched after the first block of trials, and predictive behavior was evaluated across a second block of trials. Results: Analyses of children's looking behavior revealed similar performance in both groups on the non-linguistic task (Exp. 1). In the linguistically-relevant task (Exp. 2), predictive looking was less disrupted by the contingency switch for autistic children than NT children. Results suggest that autistic children may demonstrate hyperplastic learning in linguistically-relevant contexts, relative to NT peers.

Методика «Схематизация» в цифровом формате для оценки уровня развития наглядно-образного мышления старших дошкольников

&lt;p&gt;The development of imaginative thinking is one of the main tasks of educational work with preschoolers, because it allows the child to be successful in preschool activities, where the most favorable conditions for the formation of age new achievements are formed. The need for diagnostic tests to determine the level of imaginative thinking of preschoolers is related both to the need to assess the effectiveness of educational work with children, and to identify the level of development of the child. The most informative and reliable results of the assessment of cognitive processes are provided by the use of standardized test. In Russian psychology, there is only one such test - "Schematization" (author R.I. Bardin). This test was created and standardized at the end of the last century and its psychometric characteristics and assessment standards need to be updated for a modern sample. The article presents the results of the re-standarization of this test. The experimental sample of the study consisted of N = 2425 children of senior preschool age: children 5-6 years old (M = 66 months; SD = 3.09 months; n = 974) and 6-7 years old (M = 77 months; SD = 3.21 months; n = 1451). For psychometric verification, confirmatory factor analysis, Cronbach's alpha and McDonald's omega coefficients, Spearman correlation coefficient, Mann-Whitney U criterion and two-factor analysis of variance were used. The norms were calculated using percentile normalization. The obtained results showed the conformity of the test with psychometric requirements and allowed us to determine the current norms for the development of imaginative thinking of older preschool children.&lt;/p&gt;

PDOC-11 A STUDY TO DETERMINE THE TREATMENT OUTCOMES OF GANGLIONEUROBLASTOMA IN PEDIATRIC CANCER PATIENTS AT AIC KIJABE HOSPITAL IN KENYA

Abstract BACKGROUND Ganglioneuroblastoma is one of neurogenic tumors characterized by an interval spectrum of differentiation with elements of both malignant neuroblastoma and benign ganglioneuroma. They are mostly diagnosed by the first decade of life with median age at diagnosis of 22-48 months. OBJECTIVES The main objective of this study is to determine treatment outcome of ganglioneuroblastoma in pediatric cancer patients at AIC Kijabe Hospital. METHODOLOGY This is a retrospective study where children diagnosed with ganglioneuroblastoma at AICKH over a period of three years have been assessed. Inclusion criteria included children from ages 0-14 years diagnosed with ganglioneuroblastoma. Data was entered in a questionnaire and was analyzed using descriptive statistical methods. Children were evaluated based on histologic tissue diagnosis, staging scans, risk stratification and monitored along the course of treatment that included during surgery, chemotherapy and radiotherapy and followed up in one year post treatment for recurrence. RESULTS Ganglioneuroblastoma constituted 1.3 % of all childhood malignancies diagnosed compared to the more common variant neuroblastoma with an incidence of 8-10%, mainly predominated in the males. More than 75% had remission after one-year follow up, those who died was as a result of other factors not related to the disease. Surgery and combination chemotherapy regimen COJEC administered yielded benefits in the treatment outcome. Radiotherapy was considered in high-risk tumors. CONCLUSIONS Ganglioneuroblastoma is commoner in older children with a median age of 3-4 years with incidence noted more in male with thoracic type tends to be a common presentation. The disease was noted to be rare after 10 years of age and generally has a good overall survival and prognosis compared to neuroblastoma.

Characteristics and Treatment Outcome of Pediatric Diabetic Ketoacidosis in Mekong Delta, Vietnam: A 5-Year Retrospective Study

Background Diabetic ketoacidosis (DKA), a critical and potentially fatal complication resulting from a lack of insulin, presents with elevated blood sugar, acid-base imbalance, and increased ketone bodies. Objectives Our research was designed to assess the clinical manifestations, laboratory findings, and outcomes of treatment in children diagnosed with DKA over a span of five years in the Mekong Delta region of Vietnam. Methods This study retrospectively analyzed pediatric cases of diabetic ketoacidosis treated at a major pediatric center in the Mekong Delta between 2017 and 2021. Results Diabetic ketoacidosis was more common in older children aged 11 – 16 years (66.7%), and females (70%). The majority of cases had not been diagnosed with previous diabetes (60%) and no history of diabetic ketoacidosis (90%). In univariate analysis, female gender (OR, 13.0; 95% CI, 1.4 – 124.3; p=0.026), previous diabetes diagnosis (OR, 7.8; 95% CI, 1.5 – 41.2; p=0.016), precipitating factors (OR, 10.1; 95% CI, 1.1 – 97.0; p=0.045), tachypnea (OR, 5.5; 95% CI, 1.1 – 26.4; p=0.033), Kussmaul breathing (OR, 5.4; 95% CI, 1.1 – 26.0; p=0.036), serum potassium level (OR, 3.5; 95% CI, 1.2 – 10.4; p=0.027), and anion gap (OR, 1.6; 95% CI, 1.8 – 2.3; p=0.003) were associated factors with severe DKA. All cases in our study had a 100% survival rate. Anion gap was an independent factor associated with severe diabetic ketoacidosis after adjustment multivariate analysis. Conclusion: Female, younger age, precipitating factors, tachypnea, Kussmaul’s breathing, and relevant laboratory findings, including increased anion gap, should be considered to ensure successful management in pediatric diabetic ketoacidosis. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1112-1119

Reasons for encounter in video contacts at a Danish out-of-hours primary care service: a questionnaire study

ObjectiveTo investigate reasons for encounter in telephone triage contacts to an out-of-hours primary care service for which general practitioners (GPs) use video consultations (video contact), overall and stratified for patient...