Health Problems In Children Research Articles

Early Detection and Intervention for Children's Mental Health Issues Using Machine Learning

The rise of mental health problems in children has created a need for early detection and intervention strategies. The routine method of diagnosing mental illness in child ren often relies on testing, which can lead to delays in treatment. Machine learning (ML) has become a powerful tool for analyzing complex data with the ability to identify subtle patterns associated with mental health. This article explores the potential of machine learning models for early detect ion of mental health problems in children, focusing on accuracy of facts, timeliness of intervention, and ethical considerations r elated to data privacy and algorithmic bias.

Behavioural interventions targeting the prevention and treatment of young children's mental health problems in low- and middle-income countries: a scoping review.

Globally, 10% of children and adolescents live with mental health problems and often lack high-quality care. Over 80% of people facing mental health issues reside in low- and middle-income countries (LMICs). Failing to address children's mental health may prolong these challenges into adulthood, impeding their chances for a healthy life. This scoping review aims to describe the types, implementation strategies, effectiveness, and gaps of existing interventions for preventing and treating mental health problems in early childhood (<10 years) in LMICs. The study employed a scoping review of experimental studies published 2007-2023. Major databases including PubMed, Embase, Web of Science, and PsycINFO were searched using key terms related to the population (children), intervention (mental and/or behavioural health programmes), and outcome (mental health problems). Three authors independently conducted search strategy, article screening, data extraction, and quality assessment. The findings were presented using descriptive analysis and narrative synthesis. Of 39 499 identified articles, 33 were included in the study, covering 7629 children and published between 2009-2022. Seventeen studies (51.5%) were from upper-middle-income countries, 13 (39.4%) were from lower-middle-income, and three (9.1%) were from low-income countries. Enrolment was community-based in 23 studies and health-facility based in 10 studies; the majority (79%) focused on children aged 3-8 years old. Almost two-third (63.6%) of studies were conducted in urban settings. Programmes encompassed various interventions such as parenting programmes (33.3%). A majority of studies (57.5%) employed group therapy for delivering the programme, with mental health professionals (21.2%) acting as the primary intervention providers. Interventions were primarily received by children (39.4%), followed by mothers/caregivers (33.3%). Most studies explored disruptive disorders (20 studies), social and behavioural problems (16 studies), and anxiety disorders (12 studies). Statistically significant intervention effects on child mental health outcomes were reported for 90% of published studies. Diverse behavioural programmes that improve the mental health of young children are available and effective in LMICs. Most interventions were delivered in urban settings and focus was on the use of health care professionals. Diverse intervention approaches, including parenting programmes and group therapy, were effective in addressing various mental health issues among young children.

School Ethnic Density and Mental Health Problems in Black, Latine, and White Preadolescent Children.

Previous studies suggest school ethnic density is associated with less internalizing problems in Black and Latine adolescents in high school. Here, we assessed associations between school ethnic density and internalizing, externalizing, and thought problems in Black, Latine, and White pre-adolescent children (mean age=9.9 years) in elementary school. We additionally examined if associations differed by family generational status. We analyzed baseline data from the Adolescent Brain and Cognitive Development Study (n=10, 076). We operationalized school ethnic density as a measure of racial and/or ethnic concordance. In models stratified by race and ethnicity, we used generalized estimating equation models to assess associations between proportions of school racial and/or ethnic concordance and the internalizing, externalizing, and thought problem subscales of the Child Behavior Checklist. We subsequently adjusted for family and neighborhood socioeconomic factors and tested for interactions with family generational status. For Black children, a higher proportion of Black students at schools was associated with less internalizing (β=-1.11, 95% Confidence Interval (CI): -2.82, -.13; p =.026) and thought problems (β=-.47, 95% CI: -.78, -.06; p =.026). For Latine children, a higher proportion of Latine students was associated with less thought problems, but only among children from immigrant families (β=-.65, 95% CI: -1.20, -.09; p =.023). For White children, an initial association between a higher proportion of White students and less externalizing problems disappeared after controlling for socioeconomic factors. We find protective associations between school ethnic density and mental health problems for Black children and Latine children from immigrant families.

How to Approach a Child About Concerns for Their Mental Health and Seeking Help: A Delphi Expert Consensus Study to Develop Guidelines on Mental Health First Aid for Supporting Children.

Adults who live or work with children are an important source of support and are gateways to professional help when a child is experiencing a mental health problem. This study aimed to develop consensus-based guidelines on how adults such as parents, educators or health professionals should approach a child aged 5-12 years to discuss concerns about the child's mental health and seek help. A Delphi consensus method with three rounds was used. Experts were recruited from six countries to form three panels: health professionals, educators and people with lived experience (parents and carers, and young people with mental health problems). Statements to be rated were sourced from an online search of websites designed for adults who live or work with children. Further suggestions for statements came from panellists. Statements that reached 80% consensus across all panels were included in the guidelines. 132 participants completed the Round 1 survey, reducing to 54 by Round 3. A total of 248 statements were presented to panel members, with 151 being endorsed and included in the guidelines. These guidelines represent the first recommendations developed for members of the public providing mental health first aid to children aged 5-12 years. Lived experience advocates (i.e. those with lived experience of a mental health problem in childhood and/or caregiving experience of raising a child with a mental health problem) were involved at two stages of this research: As part of the Advisory Group for the project and as expert panel members. Advisory Group members provided input into the conduct of the study and the content and design of the research outputs. Panel members provided their expertise to review every item to be included in the guidelines, proposed new items to be included, and reviewed and approved the finalised output documents.

Protective or limited? Maternal antibodies and RSV-associated lower respiratory tract infection in hospitalized infants aged 28-90 days.

Respiratory syncytial virus (RSV) is a major cause of severe health problems in newborns and young children. The protective role and limitations of serum maternal RSV antibodies in infants under 3 months remain controversial. A two-center prospective study from 2020 to 2023 recruited infants (n=286) admitted to the respiratory departments of two children's hospitals in southwestern and southeastern China during RSV epidemic. These infants were hospitalized with lower respiratory tract infections (LRTI). We evaluated the relationship between serum RSV Prefusion (Pre-F), postfusion (Post-F) IgG levels, subtype neutralizing antibodies, and the incidence of RSV infection, as well as the relationship between these maternal antibodies and severity of disease. Since this prospective study only included data from RSV epidemic, we retrospectively reviewed medical records from the Children's Hospital of Chongqing Medical University for the years 2019 to 2023 (n=3467) to analyze population characteristics during both RSV epidemic and non-epidemic periods, using the same inclusion and exclusion criteria. There were no significant differences in RSV Pre-F IgG, Post-F IgG, or RSV A or B neutralizing antibody levels between the RSV infected and non-infected groups during the epidemic. While RSV Pre-F IgG antibody was inversely correlated with disease severity, RSV Post-F IgG, and RSV A and B neutralizing antibodies did not show a similar correlation across the three illness severity categories. Additionally, there were no differences in age, gender, or illness severity distribution among hospitalized patients during epidemic and non-epidemic periods. Serum maternal antibody levels offer insufficient protection against RSV-associated LRTI in hospitalized infants aged 28 to 90 days.

Health of quilombola children as a challenge for the Sustainable Development Goals: a scoping review.

to map the literature on quilombola children's health and its relationship with the Sustainable Development Goals. a scoping review, which followed the JBI protocol and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Searches were conducted in the LILACS, BDENF, Web of Science, Scopus, MEDLINE databases and Google Scholar platform. The research protocol was registered in the Open Science Framework. eighteen articles out of 2,055 studies were selected as relevant for this study. The articles were grouped into four axes: Access to healthcare services; Nutritional aspects of quilombola children; Health problems of quilombola children; and Care for quilombola children. The relationship between these articles and SDGs 1, 3, 4, 6 and 10 was observed. the study provided an extremely important mapping of the theme of quilombola children's health and themes related to the Sustainable Development Goals.

Longitudinal Analysis of sFas, sFasL, and sE-selectin as Predictive Biomarkers for Chronic Kidney Disease Progression in Children: PROGRESS Study

Background: Chronic kidney disease (CKD) is a rare condition that causes significant health problems in children. Objectives: To evaluate changes in serum and urinary levels of soluble Fas (sFas), soluble Fas Ligand (sFasL), and soluble E-selectin (sE-selectin) over time in children with CKD and determine their potential as biomarkers for CKD progression. Methods: This longitudinal study was conducted as part of the PROGRESS study. A total of 117 patients with CKD and 56 healthy children were included. The CKD cohort underwent a 24-month prospective follow-up. Soluble Fas, sFasL, and sE-selectin levels were measured using the Luminex method at baseline, the 12th month, and the 24th month of the study. Results: At baseline, patients with CKD had significantly higher serum median levels of sFas, sFasL, and sE-selectin compared to the control group (8337 pg/mL vs. 3951 pg/mL, 68 pg/mL vs. 33 pg/mL, and 26460 pg/mL vs. 19801 pg/mL, respectively; P &lt; 0.0001 for all). Additionally, the CKD group showed significantly higher urinary ratios of sFas/Cr, sFasL/Cr, and sE-selectin/Cr compared to the control group (P &lt; 0.0001 for all). In the CKD group, median serum sFasL levels (68 pg/mL vs. 51 pg/mL) and urinary sFasL/Cr ratios (19 pg/mg vs. 14 pg/mg) significantly decreased at the 24th month compared to baseline (P &lt; 0.0001 for both). Similarly, serum sE-selectin median levels and urinary sE-selectin/Cr ratios showed significant decreases over time (P = 0.003 and P &lt; 0.0001, respectively). Baseline urinary sFas/Cr, sFasL/Cr, and sE-selectin/Cr ratios were highest in CKD stages 4 - 5 compared to stages 2, 3a, and 3b (P &lt; 0.0001, P &lt; 0.0001, and P = 0.007, respectively), while no significant differences were observed in baseline serum levels of sFas, sFasL, and sE-selectin across CKD stages (P &gt; 0.05). Baseline serum sFasL median levels were lower (P = 0.038), while baseline serum sFas median levels were higher (P = 0.045) in patients with rapid CKD progression compared to those without rapid progression. Urinary sFas/Cr, sFasL/Cr, and sE-selectin/Cr ratios positively correlated with all urinary HSP/Cr ratios (P &lt; 0.0001 for all). Conclusions: Our study highlights that CKD progression is a complex process involving sFas, sFasL, and sE-selectin; however, these biomarkers do not serve as predictors of CKD progression.

Silver Diamine Fluoride: Overcoming The Traditional Drill And Fill Technique In Children

Dental caries is a chronic, bacterial, multi-factorial dynamic process and remains a significant public health problem in children. Treatment of dental caries can be very challenging for the dentist, especially in young children. Silver Diamine Fluoride (SDF) offers a non-invasive alternative for managing dental caries in children, revolutionizing traditional drill and fill technique. Its unique properties, including antimicrobial activity, remineralization potential, and desensitizing effects, make it a versatile and effective agent for addressing carious lesions and improving oral health outcomes. Plenty of clinical evidence is available including many in-vivo and in-vitro studies that have demonstrated the successful use of SDF in preventive and curative aspects of clinical dentistry. While SDF offers significant benefits, dental professionals should carefully weigh the potential risks and benefits and adhere to recommended protocols to ensure safe and effective use. With the ongoing research and advancements in SDF, it continues to hold promise as a key component of preventive and restorative dentistry strategies aimed at improving oral health and reducing the burden of dental caries worldwide.

Association Between Residential Exposure to Road Traffic Noise and Psychological Health in Preschool Children.

Environmental noise pollution is one of the biggest concerns and the most important challenges in urban areas. Evidence from epidemiological studies shows that acoustic pollution can impact human health, and the effects may be stronger in susceptible and sensitive individuals. The objective of the study was to determine the individual exposure to road transport noise for preschool children in the residential environment and to assess its impact on children's psychological health. This is the first representative large-scale noise impact study in Lithuania aimed at the psychological health of children. A total of 1457 parent-child pairs were involved in the study. Residential exposure to environmental noise caused by road transport in Kaunas agglomeration, Lithuania was determined by applying geographic information systems and strategic noise mapping. A standardized Strengths and Difficulties Questionnaire (SDQ) was used to assess psychological health problems in children. Multivariate logistic regression analysis was used to determine the association between residential exposure to environmental noise caused by road transport and children's psychological health. The results of the study showed that the risk of hyperactivity and total scale difficulties increased statistically significantly up to 77% and up to 48%, respectively, in the highest noise (Lnight ≥ 50dB) exposure. The obtained results provide new knowledge about the relationship between road traffic noise in the residential environment and the psychological health of preschool children.

Evaluation of Dental Students' Knowledge and Attitudes About Early Childhood Caries

Background: Early childhood caries (ECC) causes serious and widespread oral health problems in children. This study aimed to evaluate the knowledge, attitudes and clinical practices of undergraduate dental students about ECC. Method: The study included 4th and 5th year dental intern students who were treating patients. A 16-question survey form was prepared using the literature and the questionnaire prepared with the online survey program was sent via Google Forms. Distributions were compared using Pearson Chi-square test. A significant difference was defined as 0.05. Results: When the awareness and knowledge levels about ECC were examined, 4th grade students had lower knowledge levels than 5th grade students. 5th grade students reported that they examined and diagnosed a higher rate of ECC cases. Conclusion: It is important to make clinical trainings more comprehensive and systematic for the prevention and treatment of ECC.

Breathing dirty air, struggling in school: The case of air pollution and Student Learning in Chile

AbstractAir pollution has been linked to various health problems in children, including respiratory and neurological issues. Existing research has also found that exposure to air pollution can affect children's cognitive ability and academic performance, with some studies showing a decrease in test scores and grade point averages associated with increased exposure to hazardous air pollution. This study examined the association between air pollution and children’s academic performance in Chile. This research addressed a critical gap in the literature by providing data from an understudied context and tracking children's academic performance at an individual level over time. We constructed a panel dataset that followed students from 1st to 8th grade and estimated their exposure to PM2.5, based on the distance of their school to air monitoring stations from elementary to middle school. We tracked students' academic performance using a longitudinal fixed-effects regression model to assess the relationship between their grade point average (GPA) and air pollution. The results revealed that, on average, an increase in the percentage of days exceeding different official air quality standards significantly affected students' annual GPA. The study also showed that academic performance among students from families with lower economic resources is disproportionately affected by air pollution. The findings underscore the pressing issue of environmental justice, highlighting that numerous students attend schools in the unhealthy environments of several Chilean cities that frequently bear the burden of socioeconomic disadvantage.

Educational inequalities and decomposition of the urban-rural disparities in maternal health care utilization in Ethiopia: further analysis of 2019 intermediate Ethiopian demography and health survey

IntroductionThe utilization of maternal health services is vital to prevent maternal and child health problems. However, there is limited evidence as to why rural women have lower utilization and educational inequality in maternal health services utilization in Ethiopia. Identifying the causes is the first step to achieving maternal and child health initiatives.ObjectiveThe objective of this study was to decompose the urban-rural disparities and educational inequalities in maternal health care utilization in Ethiopia.MethodsThe study used the 2019 Ethiopian Demography Health Survey. Blinder-Oaxaca decomposition and multivariate decomposition analyses were done on a weighted 3,926.7 women to see the urban-rural differences in maternal health service utilization by using Stata 17.0. For the educational inequality of maternal health service utilization, concentration curve and concentration index were used by using conindex. P value < 0.005 was used to declare association.Result84.89% of urban and 70.75% of rural residents use antenatal care and 73% of urban and 44% rural use institutional delivery. There was no urban-rural difference in postnatal care utilization. There was educational inequality in antenatal care (CIx 0.0926; p < 0.001), delivery care (CIx 0.2137; p < 0.001 and postnatal care (CIx 0.1272; p < 0.001) utilization in Ethiopia. 83.3% of antenatal care urban-rural difference was explained by women’s characteristics difference. Secondary (16.51%) and higher (23.01%) educational level difference of urban and rural women widening antenatal care utilization. Living regions (-1.33%) difference of urban and rural women mitigated antenatal care utilization. About 76.07% of the urban-rural difference in institutional delivery was explained by differences in the characteristics of women. Attending primary (3.76%), secondary (11.83%), and higher (8.44%) education, antenatal care (15.81%) difference of urban and rural women were widening institutional delivery utilization.ConclusionThe urban-rural disparity in antenatal care and delivery care utilization is significant in the country. There were educational inequalities in maternal health service utilization. Attending, Secondary, higher, educational levels widening antenatal care and institutional delivery care utilization. Living regions mitigated antenatal care utilization. Antenatal care utilization widening institutional delivery utilization. Special attention is needed for rural women to improve maternal health service utilization through health extension workers and the women’s developmental army.

Use of animals in clinical practices beyond animal-assisted therapy

In this article, we discussed the use ofanimals in clinical practice beyond animal-assistedtherapy to emphasize that it can benefit even morefrom animals in medicine. Animal-assisted therapyis a rehabilitation and treatment procedure that usestrained animals to help patients cope with certainsituations in a complementary way to othertherapeutic interventions. The studies showed thatmuch many animals, most commonly dogs andhorses, have been successfully used on mental healthproblems in both children and adults. We think thatmany animals such as horses, cats, birds and fishes can be successfully used as complementarytreatment in patients with various disorders such asmental disability, motor retardation, vision andhearing problems, as well as mental health problemsbecause the Quran foretold that animals could beused in the service of humans over 1,400 years ago.We recommend that health professionals shouldcooperate with veterinarians and conduct rando-mized controlled studies, including large seriesabout this subject.

Oral Health Related Quality of Life and Oral Hygiene Practice Patterns in 11-14 Year Old Children (Study at SMP PGRI 1 Cibinong, Bogor, West Java)

Background: According to RISKESDAS West Java in 2018, the prevalence of oral hygiene practices was only 5.9% in children aged 10-14 years, so the low rate will have an impact on oral health problems. Children's quality of life refers to children's well-being and satisfaction with their oral health conditions, as well as their psychosocial consequences. Some studies suggest that oral health problems in children have an impact on the dimensions of children's functioning, such as drinking difficulties, eating difficulties, speaking difficulties, and missing school. The purpose of this study was to explain the quality of life of children related to their oral health and oral hygiene practice patterns of children aged 11-14 years at SMP PGRI 1 Cibinong. Materials and Methods: The type of research used is a descriptive quantitative survey, with Proportional Stratified Random Sampling technique. The questionnaire consisted of 8 questions about oral hygiene practice patterns, and CPQ11-14 in the form of 38 questions about children's quality of life related to oral health. Results and Discussion: The results showed that OHRQoL (Oral Health Related Quality of Life) of children aged 11-14 years, the majority described their oral health condition as "quite good" with a prevalence of 104 students (33.33%). A frequent problem was food stuck between the teeth. Emotional well-being was generally stable, although some students occasionally felt frustrated regarding their oral health condition. The social impact of the majority of students did not feel difficulties in interacting with friends or family due to oral health problems. The results also showed that almost most of the respondents, 125 students (40.06%), had never visited a dentist. The majority of students reported brushing more than once a day (73.72%), but most students never used dental floss (77.56%). Conclusion: The respondents' OHRQoL was quite good, especially for never feeling frustrated with the condition of their teeth and their oral hygiene practice patterns were still lacking in the items of visiting the dentist and using dental floss.

Study on Clinical Features, Detection of Risk Factors and Causes of Anaemia in Children in a Tertiary Care Hospital of Bangladesh

Background: Anaemia is a common childhood health problem. Among the causes of anaemia besides the nutritional anaemia congenital hemoglobin disorder such as thalassemia and haemoglobinopathies has a great role which can be combated by increasing awareness in the population. Objective: To detect clinical features, common causes, risk factors of childhood anaemia and to make awareness among the population to prevent the deadly effects of anaemia in children as well as in the society. Methodology: A cross-sectional study was carried out at outpatient department of Delta Medical College and Hospital over a period of 3 years. Children aged between 6 months to eighteen years who visited outdoor for acute illness and were clinically pale and CBC supporting the condition were included. Children with malignancy and haemorrhagic diseases were excluded from the study. Total 200 cases were collected. Results: Among 200 cases 62.5% were male. Most vulnerable age group was 6 months to 2 years (63%). Most common cause of anaemia was iron deficiency anaemia (64.5%). Congenital haemoglobin disorder was the second most common cause (28%). Among haemoglobinopathies Hb E trait contributes (82.35%). Most common presentation of anaemic children was frequent attack of RTI. Low protein diet was the most common risk factor for iron deficiency anaemia. Under five years, males were more affected but thereafter females were more affected than male children. Among 200 cases only 32(15%) cases were malnourished. Most of the cases were term baby. Among inherited cases only one care giver had knowledge about thalassemia. Most cases came from lower middle class family (65%). Most common morphologic variant of anaemia was microcytic hypochromic anaemia (99%). RBC count was normal in iron deficiency anaemia. Conclusion: Besides iron deficiency anaemia, haemoglobinopathies and thalassemia have a great contribution in childhood anaemia. Family education, increased awareness, screening out of thalassemia and haemoglobinopathies carrier can combat this heath problem in children and can reduce social burden. Bangladesh J Child Health 2023; Vol 47 (2) : 89-94

Evaluation of a Parenting Program for Mothers With a Borderline Personality Disorder: A Multiple Baseline Single-Case Experimental Design Study.

Parents with borderline personality disorder (BPD) experience deficiencies in parenting skills leading to increased family burden, stress, mental health problems in children and even family violence. The present study evaluated a Dutch version of the parenting training based on Dialectical Behavior Therapy (DBT) for mothers with BPD. A multiple baseline single-case experimental design study was conducted with standardized and idiosyncratic assessments of parenting behavior and parental stress before, biweekly during, and after training. Participants (N = 10) were mothers with a BPD diagnosis with a child under the age of 6. Four participants discontinued the training. Among six training completers, clinically reliable improvements in parenting skills were most pronounced for inconsistent discipline, involvement, positive parenting and corporal punishment. Frequent, idiosyncratic assessments showed that for six mothers training had a positive effect on parenting skills, while for five mothers this effect was large. Overall, less improvement was found for parenting stress. DBT parenting training seems to have clinical value for mothers with BPD struggling with raising their children. Most prominent improvement was found in relation to mothers disciplining their child in a more consistent manner. The complexity and heterogeneity of mothers with BPD requires a more idiosyncratic, patient-centered approach. This study was registered (retrospectively) in ISRCTN (ID ISRCTN74447767). https://www.isrctn.com/ISRCTN74447767, March 2022.

PREVALENCE OF DRY EYE IN CHILDREN AGED 5 TO 15 YEARS AND ITS PATTERN WITH DURATION OF SCREEN TIME IN THE EASTERN PART OF BIHAR

Objectives: Dry eye disease (DED) is increasingly recognized as a significant health problem in children, particularly about screen time exposure. However, detailed epidemiological data on DED in young populations, especially in regions such as Eastern Bihar, are sparse. This study aims to assess the prevalence of DED among children aged 5–15 years and explore the relationship between the duration of screen time and the occurrence of DED. Methods: A cross-sectional study at M.G.M. Medical College and L.S.K. Hospital, Kishanganj, Bihar, examined 140 children with DED symptoms. Diagnostic tests such as tear film breakup time and Schirmer’s test were conducted during comprehensive ocular examinations. The association between DED prevalence and parental and self-reported screen usage was examined. Results: The prevalence of DED among the participants was 12.1%. There was a significant association between higher screen time and increased prevalence of DED, with the severity of symptoms correlating positively with a longer duration of screen exposure. Children with severe DED reported significantly more screen time compared to those with milder forms. Conclusion: The study confirms a notable prevalence of DED among children in Eastern Bihar, closely linked to excessive screen time. These findings highlight the need for public health strategies to manage screen exposure in children to prevent the onset of DED.

Diarrhoeagenic Escherichia Coli Isolated from Children with Acute Diarrhoea by Culture and Multiplex PCR in Tertiary Care Hospitals of Dhaka, Bangladesh

Background: Diarrhoeal diseases are a major childhood health problem and an important cause of morbidity and mortality, especially in developing countries. Objective: This study aimed to detect Diarrhoeagenic Escherichia coli (DEC) by detecting virulence genes (lt, st, bfp, and aat) and to determine the antimicrobial susceptibility pattern of all identified DEC isolates in fecal samples. Methodology: This cross-sectional study was carried out in the Department of Microbiology at Dhaka Medical College Hospital, Dhaka, Bangladesh and Dhaka Shishu Hospital, Dhaka, Bangladesh from July, 2012 to June, 2013 for around one year. Identification of Diarrhoeagenic Escherichia coli (DEC) in fecal samples from children under 5 years old was done by culture and standard biochemical tests. Virulence factor genes for DEC were detected by Polymerase Chain Reaction (PCR). Susceptibility to antimicrobial agents of all identified DEC isolates was observed by disc diffusion method. Results: Out of total 200 stool samples, E. coli was isolated in 130(65.0%). The prevalence of DEC was 52(40.0%) and the most common was enterotoxigenic Escherichia coli (55.8%) followed by enteropathogenic Escherichia coli (34.6%) and enteroaggregative Escherichia coli (26.9%). Among 52 DEC, 12(23.1%) contained more than one pathogenic genes of DEC in various combinations. Colistin, imipenem and amikacin were found to be the most effective against isolated DEC. Most of the strains were resistant to ampicillin, erythromycin, tetracycline and nalidixic acid. Conclusion: Differentiation between the Diarrhoeagenic Escherichia coli pathotypes is of great importance since they are involved in acute diarrhoeal diseases and may require specific antimicrobial chemotherapy. Bangladesh Journal of Medical Microbiology, January 2024;18(1):17-21

Addressing Physical Inactivity in Mexican Children: The Role of Parents and Their Physical Literacy

ABSTRACTIntroductionChildhood obesity and physical inactivity rates in Mexico are among the highest in the world. While parenting is a key factor in shaping children's physical activity behavior, there is a lack of research in this area, particularly in Mexico.ObjectiveThis qualitative study aims to better understand aspects of parenting relevant to children's physical engagement, including what parents understand by physical activity, how engaged they are and how important they find it, that is, their physical literacy.MethodsSeven focus group discussions were conducted with 43 caregivers of overweight primary school children. Inquiry topics included components of physical literacy (i.e., motivation, confidence, physical competence, knowledge and understanding, engagement in physical activity), parenting practices, role modeling, perception of children's physical activity, parental self‐efficacy and general parenting style.ResultsAlthough many participants stated that they were aware of their child's health problems and that they did not set a good example themselves, most could not overcome personal obstacles to exercise such as lack of time and energy. Most participants showed a knowledge gap about appropriate levels of physical activity or underestimated its importance. Several reported increased motivation after participating in the focus group discussion and developed their own ideas to deal with barriers or to support their children, such as engaging in physical activity together and introducing family routines.ConclusionFollowing a participatory approach, future studies should use these ideas to develop context‐sensitive group interventions. Empowering parents by considering their physical literacy in children's weight management could be a valuable addition to theory‐based strategies in research and practice.

Acute hepatitis in children: A wide clinical spectrum

Introduction: Acute hepatitis remains an important health problem in children. viral hepatitis particularly hepatitis A remains the most common cause. Nevertheless, other causes such as non A non B hepatitis and mixed infections like enteric fever are other causes particularly in developing countries like India. The spectrum of acute hepatitis is also varied with many atypical presentations in the form of fever along with icterus as presenting features. Use of lab parameters as prognostic markers for development of acute liver failure (ALF) needs further exploration as it can be used to identify patients who need better monitoring and may be the potential candidates for liver transplantation. In our study we have tried to find a possible association between liver enzyme values and number of children who develop ALF. Methods: Children between 1 and 15 years of age who presented with features of acute hepatitis were enrolled in the study after taking informed consent from their parents. Data was collected about their epidemiological and clinical characteristics in a predesigned study performa. Quantitative data were described as means and standard deviations and qualitative data were computed into frequency (No) and percentages (%). Chi-square (χ2) test was used to determine the statistical difference between the categorical variables, while means were compared using student’s t test. For all statistical analyses, p value &lt; 0.05 was adopted as level of significance. Results: We enrolled 68 patients of acute hepatitis. Most of them were males (78%) and majority were in 6 to 10 years age category. The most common clinical presentation was with abdominal pain followed by fever and icterus. Liver enzymes were raised to the tune of 10 to 20 times in the second week of illness. Serum bilirubin mean value was 5.3. Serum bilirubin values remained almost constant over 3 weeks period while liver enzymes showed a decline. 26% patients presented with ALF. Also, liver enzyme values in the second week showed a positive association with development of ALF with higher values associated with a higher chance of development of ALF. Conclusion: Hepatitis A was the most important cause of acute hepatitis in children and albeit early, a significant proportion of them develop features of ALF. Regular monitoring of liver enzymes can serve as a prognostic marker for development of ALF. It requires larger level studies to use liver enzymes as prognostic markers of ALF in paediatric patients.