A systematic review of state-of-the-art Laryngeal Electromyography in pediatric populations and meta-analysis of recovery prediction in vocal cord paralysis.

Developing gene therapies involving gene editing is a rapidly evolving field with large potential implications for improving health for both rare and common diseases. Ensuring that these technologies are developed safely, efficiently, and fairly is essential. To better understand the ethical considerations and regulatory requirements and challenges with gene therapies involving gene editing that may advance precision health. Through a multistakeholder workshop and subsequent engagements, multiple ethical and regulatory barriers to developing and implementing gene therapies involving gene editing were identified. Eight major themes emerged that warrant careful consideration, including (1) objectives (treatment, risk reduction, and enhancement) for the intervention; (2) competing interests of safety, equity, and desire for research efficiencies; (3) unique aspects of gene editing related to rare and ultrarare genetic conditions; (4) considerations in the pediatric population; (5) regulatory requirements and ethics oversight; (6) challenges with long-term follow-up and data sharing; and (7) communication. To promote the safe, efficient development of gene therapies involving gene editing that will reach their full potential, all stakeholders will have to undertake an unprecedented degree of collaboration. However, this will be essential to ensure that these interventions are effective, ethically sound, and patient-centered.

Dengue fever is a mosquito-borne viral illness caused by the dengue virus, primarily transmitted by Aedes aegypti mosquitoes. It remains a major public health concern in tropical and subtropical regions worldwide. Clinical presentations range from mild febrile illness to severe complications such as Dengue Haemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS). In recent years, atypical manifestations, including cardiac involvement, have been recognised. The present case report focuses on a nine-year-old male child from a dengue-endemic area who presented with a high-grade fever, myalgia, abdominal pain, and vomiting. Laboratory findings revealed thrombocytopenia and elevated haematocrit levels, meeting the criteria for dengue with warning signs. During the course of the illness, the child was found to have Mobitz type 1 Atrioventricular (AV) block (Wenckebach phenomenon) on an Electrocardiogram (ECG). This cardiac conduction abnormality, though rare in the paediatric population, was transient and resolved spontaneously without the need for intervention. The patient was managed conservatively with close monitoring, fluid management, and supportive care, ultimately making a full recovery. A repeat ECG showed normalisation of the cardiac rhythm. The present case underscores the importance of recognising cardiac complications in dengue fever, even in children, as they may be self-limiting yet clinically significant. Early detection and vigilant monitoring of warning signs, including electrocardiographic changes, can aid in preventing potential morbidity. Clinicians should maintain a high index of suspicion for such atypical manifestations in dengue cases, especially during outbreaks.

Development of an ELISA using recombinant Dengue NS1 constructs to measure antibody titers and predict dengue disease outcome in a pediatric population in India.

Human adenoviruses (HAdVs) are important respiratory pathogens that circulate globally and frequently cause outbreaks, particularly among pediatric populations. Despite their clinical relevance, recent data on genome-wide evolution and recombination of circulating HAdVs in Korea remain limited. In this study, we characterized the epidemiological dynamics and genomic evolution of HAdVs detected in Gwangju, South Korea, between 2023 and 2025. Molecular epidemiological surveillance of respiratory samples was conducted, followed by phylogenetic and whole-genome sequencing analyses. Adenovirus positivity increased sharply during an outbreak from August to October 2023, with pediatric cases predominating. Phylogenetic analysis identified eight genotypes from species B and C, with genotype B114 as the principal outbreak strain. Whole-genome sequencing revealed recombination events in both species, involving antigenic, replication, and packaging regions. These findings indicate that circulating HAdVs undergo continuous genome-wide recombination, resulting in genotype-specific outbreaks that are not fully captured by capsid-based classification alone. Our study highlights the importance of whole-genome approaches for understanding adenovirus evolution and provides insights into the genomic diversity underlying recent outbreaks.

Introduction: The oral cavity is one of the most vital components of the human body, playing a key role in digestion and communication. Stomatitis (Mukhapaka) is a common inflammatory condition of the oral mucosa frequently encountered in the paediatric population. It is characterised by symptoms such as pain, ulceration, and excessive salivation, which often interfere with daily activities such as eating and speaking. In Ayurveda, this condition is associated with the vitiation of Pitta and Kapha doshas. Need of the study: Due to contemporary dietary habits, irregular meal timings, night-time wakefulness, and improper oral hygiene practices, children are increasingly prone to inflammatory oral disorders. Although modern medicine utilises antibiotics and antiinflammatory drugs for treatment, there remains a need for an affordable, safe, and effective Ayurvedic therapeutic approach. Classical Ayurvedic texts mention Krushna Jeerakadi Yoga and Mrudvikadi Lotion as effective treatments; however, their relative efficacy has not yet been established through clinical trials. Aim: To assess the comparative effectiveness of an altered dosage form of Krushna Jeerakadi Yoga (Lotion) and Mrudvikadi Lotion in paediatric patients suffering from Mukhapaka (Stomatitis). Material and Methods: The present study will be a randomised controlled interventional clinical scheduled to be conducted from June 2025 to June 2026 involving 60 children aged 5-16 years diagnosed with Mukhapaka. Participants will be randomly divided into two groups of 30 each. Group A will receive Mrudvikadi Lotion (control group), while Group B will receive the altered dosage form of Krushna Jeerakadi Yoga Lotion (trial group) for seven days. Clinical evaluation will be conducted on the 3rd, 5th, and 7th days, with a final assessment on the 14th day. Outcomes will be measured using the World Health Organisation (WHO) Stomatitis (oral mucositis) Grading Scale along with symptom-relief parameters.

Efficacy, immunogenicity, and safety of a cell culture-derived quadrivalent influenza vaccine compared with a non-influenza vaccine in infants and children across five influenza seasons: a phase 3, multinational, observer-blind, randomised controlled trial.

mRNA-based COVID-19 vaccination and risk of autoimmune diseases in the pediatric population.

Background: Influenza remains a major cause of hospitalization and severe complications in children worldwide, particularly in young children and those with underlying health conditions. Objectives: This study compared pulmonary and extrapulmonary complications, therapeutic interventions, and outcomes in pediatric patients with influenza A and B admitted to Mardani Azari Pediatric Educational and Therapeutic Center, Tabriz, Iran, during 2022–2023. Methods: A retrospective observational study was conducted among 226 hospitalized children aged up to 15 years with PCR-confirmed influenza. Demographic, clinical, and laboratory data were collected and analyzed using parametric and nonparametric statistical tests. Results: Among the 226 patients, 169 (74.8%) had influenza A, predominantly H3N2 subtype, and 57 (25.2%) had influenza B. The mean age was 4.51±7.64 years with no significant age or sex differences between groups. Pneumonia was the most common pulmonary complication and was significantly more frequent in influenza A patients, particularly among H3N2 cases. Air trapping occurred more frequently in influenza B patients. Extrapulmonary complications were rare, with sinusitis and otitis being the most common; otitis was significantly more prevalent in influenza B cases. No significant differences were found between groups regarding length of hospital stay, inflammatory markers, or mortality rates, although influenza A was associated with a slightly higher mortality rate (9.5% vs. 7.0%). Conclusions: While both influenza A and B infections caused notable morbidity, influenza A, especially H3N2, was associated with more severe pulmonary complications. These findings highlight the importance of early recognition, appropriate management, and routine vaccination to reduce influenza-related morbidity and mortality in pediatric populations.

Pediatric firearm-related injuries are rising, reflecting an ongoing public health concern and burden on the health care system. However, studies examining regional gunshot wound (GSW) trends among children are scarce. We evaluated upper-limb injuries from GSWs at our state's sole level-1 trauma center over 8 years. We hypothesize there would be an increase in upper limb ballistic injuries in our pediatric population and that understanding these trends may lead to improved supportive care and interventions aimed at mitigating future occurrences. A retrospective chart review of pediatric patients (age <18) referred for GSW-related injuries to the upper extremity from 2016 to 2023 was conducted. Data collected included patient demographics, injury characteristics, fracture locations, surgical management, and long-term complications. Trends and disparities were analyzed. Of the 296 total patients with nonfatal pediatric firearm injuries, 58 patients sustained GSW-related to the upper limb (19.6%). Forty-two of these 58 patients (68.9%) had fractures. Most patients were men (79.3%) and Hispanic/Latino (65.5%) with a mean age of 15.2 years (range 6-17 years). The phalanx (n = 11) and humerus (n = 10) were the most commonly fractured bones. 62.1% (n = 36) of patients required operative management, 20 of which involved fracture fixation. Antibiotic administration was noted in 86.2% of patients, predominantly cefazolin. We observed primary sequelae, which included 15 nerve injuries and 42 fractures. Documented soft tissue infections occurred in 9.4% of patients. Over 37% of patients lived in impoverished areas. Pediatric gunshot injuries remain a notable concern with broad implications for medical care and public health. We identified a total of 296 pediatric patients with nonfatal firearm-related injuries in 8 years, 58 of which involved injuries to the upper limb. Orthopedic surgeons have a role in recognizing this epidemic, improving treatment protocols, and providing guidance for practical improvements in education in injury prevention. IV (case series).

Multi-level surgery for obstructive sleep apnoea in syndromic and non-syndromic paediatric patients - A systematic review and meta-analysis.

Advances in the understanding of pediatric sleep bruxism: A narrative review of recent literature.

Childhood trauma assessed using the childhood trauma questionnaire and its influence on pediatric mood disorders and self-harm: a systematic review and meta-analysis.

Peanut oral immunotherapy at a single academic medical center using a volume-based approach with store-purchased peanut products.

Pediatric coronary MR angiography with a two-minute scan using de-aliasing regularization based compressed sensing.

Health-Related Quality of Life in Children With Migraine: A Tertiary Care Center Experience.

Vitamin E in the management of oral mucositis: Systematic review with meta-analysis of randomized clinical trials.

Medial Patellofemoral Ligament Reconstruction Using Autograft vs Allograft in Pediatric Patients: A Systematic Review and Meta-Analysis.

Parenteral nutrition (PN) represents a critical therapeutic approach for patients unable to meet nutritional needs through oral or enteral routes. In recent years, the development of advanced PN formulations has accelerated, driven by improvements in lipid emulsion design, compound amino acid and micronutrient preparations, and multichamber bag (MCB) technologies. These innovations not only enhance safety, stability, and metabolic efficiency but also expand the capacity of PN to address increasingly complex clinical scenarios. Novel lipid emulsions derived from mixed-oil systems, structured triglycerides, and omega-3 polyunsaturated fatty acids provide both energy support and immunomodulatory effects. Advances in mixed micelles and nanoemulsion-based delivery systems have improved the solubility and chemical stability of labile vitamins and trace elements, whereas modern MCB systems reduce infection risk and simplify compounding procedures. Despite these advancements, significant challenges remain in translating laboratory progress into standardized clinical practice. Variability in formulation selection criteria, limited physicochemical stability in all-in-one systems, insufficient adaptability for pediatric and home parenteral nutrition populations, and inconsistencies in manufacturing quality and regulatory oversight all restrict broader clinical adoption. Moreover, the absence of unified evaluation standards for stability, compatibility, and clinical safety continues to hinder evidence-based optimization. This review summarizes the current progress and unresolved issues associated with advanced PN formulations, with particular focus on lipid emulsions, amino acids, vitamins, trace elements, and MCB technologies. Future directions include establishing multidimensional evaluation frameworks, promoting individualized and precision nutrition strategies, improving formulation processes, and strengthening global regulatory harmonization.

Pediatric patient volume in United States emergency departments: Differences in patient populations.