To18 Years Research Articles

The ‘clinically significant’ bronchodilator responsiveness (BDR) in children: a comparative study between six definitions of scholarly societies and a mini-review

ABSTRACT Objective: To compare the percentages of children with and without airway obstruction (obstructive and non-obstructive groups, respectively) presenting a ‘clinically significant’ BDR according to the following definitions: GINA: FEV1 increase >12% predicted (∆Predicted), ATS/ERS: FEV1 increase ≥12% initial (∆Initial) and ∆FEV1 absolute (∆) ≥200 ml and/or ∆FVCInitial ≥12% and ∆FVC ≥200 ml, British thoracic society (BTS): ∆FEV1Initial ≥12%, National asthma education and prevention program (NAEPP): ∆FEV1Initial ≥12% and ∆FEV1 > 200 ml, Group of research on advances in pediatric pneumology: ∆FEV1Initial ≥12% or ∆PEFInitial ≥20%, and South African thoracic society (SATS): ∆FEV1Initial ≥12% or ∆FEV1 >200 ml and/or ∆FVCInitial ≥12% or ∆FVC >200 ml. Methods: This was a multicenter comparative study involving 278 children aged 6 to16 years: obstructive group (FEV1/FVC < lower-limit-of-normal, n = 116) and non-obstructive group (FEV1/FVC ≥ lower-limit-of-normal, n = 162). Spirometry was performed before/after a bronchodilator test. The Cochrane Q test was used to compare the percentage of responders according to the six definitions. Results: The percentages of responders among the obstructive [ranging from 51.72 (NAEPP) to 74.14% (SATS)] and the non-obstructive [ranging from 0.62 (NAEPP, BTS) to 8.64% (SATS)] groups were definition-dependent. Conclusion: In children, a ‘clinically significant’ BDR is definition-dependent.

Prevalence Of Physical Activity, Sedentary Behaviour And Unhealthy Dietary Habits Among Moroccan Adolescents

Adolescence represents a very crucial phase in the human life cycle. During this period adolescents develop individual lifestyle habits. as a result, and in the absence of data concerning the above characteristics, in the Beni Mellal-Khénifra region, we leaded a cross-sectional survey of growth ,food and hygiene behaviour conducted among a sample of 812 adolescents, including 404 boys attending school aged 13 to18 years, Furthermore, the objective of this study was also to verify among college students of the region the prevalence of moderate physical activity levels, unhealthy dietary habits and sedentary behaviour, in order to determine the risk factors related to the physical inactivity. The prevalence of physical activity was 36.08% (50.0% among boys and 22.06% among girls). Nearly 40% of these adolescents spend more than 2 hours a day in front of the screens. Unhealthy dietary habits are more frequent among adolescents and the majority of them consume Fried potatoes (fries and chips) Doughnuts/cake, Sugary drinks more than three times a week. These results show significant associations between physical activity, sedentary habits and some unhealthy dietary habits.

Factors Affecting the Prevalence of Skin Disorders among Human Immunodeficiency Virus (HIV) Infected Children in Aminu Kano Teaching Hospital (AKTH) Kano, Nigeria

Introduction: Among HIV infected children, skin disorders are vital as they give a clue to diagnosis of the HIV disease. Various factors are associated with occurrence of skin disorders among HIV infected children. Objectives: To determine the factors associated with prevalence of skin disorders among HIV infected children in Aminu Kano Teaching Hospital (AKTH) Kano, Nigeria. Materials and Methods: It was a cross-sectional study conducted to determine the factors affecting skin disorders among HIV infected children attending Paediatric Infectious Disease Clinic of Aminu Kano Teaching Hospital, Kano, Nigeria. A total of 223 HIV infected participants aged 6weeks to14 years were recruited for this study. Chi-square test or Fishers exact test where necessary were used to determine the difference between proportions of categorical variables and level of significance was set at 0.05. Multivariate analysis was used to further analyse significant relationships from the univariate analysis. The confidence level was set at 95% and a p-value less than 0.05 was considered statistically significant Results: There were 110 (49.3%) males and 113 females (50.7%). The male to female ratio was found to be 1:1.1. Seventy-eight percent (78%) of the children had skin disorder. A multivariate analysis showed that only age, social class and immune status were significantly associated with the occurrence of skin disorders. Conclusion: Among the HIV infected children, age, socioeconomic class and immune status were the factors found to determine the Prevalence of skin disorders.

Çocuk Yoğun Bakım Ünitesinde Takip Edilen Guillain Barre Sendromu Olguları; 3 Yıllık Deneyim

Objective: After the poliomyelitis eradicated, Guillain-Barre Syndrome (GBS) is the most common cause of acute flaccid paralysis in healthy child. It is one of the neuromuscular disorders required treatment to pediatric intensive care unit. Aim of this study is to present the three-year’s experience of caring for patients with GBS admitted the PICU in the university hospital. Materials and Methods: Patients who were admitted to the PICU with diagnosed GBS between March 2016 and March 2019 were evaluated retrospectively. Results: Twenty-two patients were diagnosed with GBS during study period. Seven of them needed PICU in 8 admissions, and they formed the study group. Four of them were female and 3 of them were male. They were 3 to12 years old. All of them were admitted in the PICU because of respiratory distress symptoms. The paralysis followed a nonspecific respiratory or gastrointestinal infection by 3 to 7 days, and ascending progress was present. Intravenous immunoglobulin infusion was administered in all patients. Five of them need to plasmapheresis and mechanical ventilator support. Stay to PICU length was 2 to 87 days and hospitalization length was 14 to 98 days. All of them were discharged, and became able to walk unaided. Conclusion: Our results show that PICU follow-up is very important in children with GBS. Although duration of mechanical ventilation, and hospitalization length is long, prognosis is good with effective management strategies.

Study of lipid profile in β thalassemia major pediatric patients with multiple blood transfusion and its correlation with serum ferritin level in tertiary care hospital in Kolkata

Background: β-Thalassemia major is associated with iron overload toxicity. This study was done to investigate lipid profile abnormality in β-Thalassemia major patients and to establish their correlation with serum ferritin. Another motto of this study was to signify deleterious effect of multiple blood transfusion and facilitate to understand how it will affect the lipid profile parameters changes so that we can also prevent early dyslipidemia induced complications like atherogenesis by early detection of lipid profile abnormality and also to establish derangement of lipid profile as an indirect evidence of iron overload.Methods: 102 nos. β-Thalassemia major paediatric patients with multiple blood transfusion (≥10) in age group of 6 to12 years admitted in pediatric ward of tertiary care hospital (NRSMCH) were enrolled. Serum ferritin level and lipid profile were investigated and their correlation were assessed.Results: Among 102 β-Thalassemia major pediatric (6 to 12 years) patients 55.88% were male and 66.67% were Hindu by religion and 69.61% children came from lower socio-economic class. The average value of number of previous blood transfusion was 42.79±7.510. The mean value of serum ferritin was 2263.53±833.904 ng/ml. The average value of serum total cholesterol, LDL and HDL were 153.84±5.428 mg/dl and 97.16±3.982 mg/dl and 29.45±4.445 mg/dl respectively and their correlation with serum ferritin were negative (r=-0.941 and r=-0.964 and r=-0.751 respectively). Average value of serum triglyceride and VLDL were 206.22±67.407 mg/dl and 36.16±3.385 mg/dl respectively and their correlation with serum ferritin were positive (r=+0.606 and r=+0.973 respectively).Conclusions: There was significant lipid profile derangement. As the serum ferritin level increases, serum total cholesterol, HDL, LDL decreases and serum triglyceride, VLDL level increases.

Prevalence and Pattern of Skin Disorders among Human Immuno Deficiency Virus (HIV) Infected Children in Aminu Kano Teaching Hospital (AKTH) Kano, Nigeria

Introduction: In HIV infected children, skin disorders are important as they serve as clue to diagnosis of the HIV disease. The Skin is one of the early systems affected by HIV/AIDS, which can affect almost all organs and systems in the body. Prevalence of skin disorders among HIV infected children is up to 90% in some studies. Objective: To determine the prevalence of skin disorders among HIV infected children attending paediatric infectious disease clinic in Aminu Kano Teaching Hospital Kano, Nigeria. Materials and Methods: A cross-sectional study was conducted to determine the prevalence of skin manifestations among HIV infected children attending paediatric infectious disease clinic of Aminu Kano Teaching Hospital, Kano, Nigeria. A total of 223 HIV infected participants aged 6weeks to14 years were recruited for this study. Results: The prevalence of skin disorders among HIV infected children was 78.0%. The leading categories were infections and infestations accounting for 55.1% then inflammatory skin disorders (20.6%) Dermatophytoses were the commonest specific skin disorders observed. Conclusion: Therefore, the prevalence of skin disorder among HIV infected children in Aminu Kano Teaching Hospital is high (78%). Infections and infestations were the commonest category found followed by inflammatory skin disorders.

Assessment of the Pregnancy Induced Hypertension and Gravida in Teen Age Girls at People Medical College Hospital Nawabshah Pakistan

Objectives: To assess of the pregnancy induced hypertension and gravida in teen age girls at People Medical College Hospital Nawabshah Pakistan.&#x0D; Methodology: This cross-sectional study was carried out on 200 pregnant women from Gynecology &amp; Obstetrics Department of Unit-1 and 2 People Medical College Hospital Nawabshah from January 2018 to December 2018. The sampling technique was convenience sampling. The frequency and association between the hypertension and Gravida were observed. Blood Pressure was taken by sphygmomanometer of mercury type B.P apparatus from 200 pregnant women and interviewed all the study subjects. A well designed and structured questionnaire (consist of age, gravida and hypertension related questions) was used for data collection and analyzed statistically. The data was analyzed statistically by SPSS Version 20.0.&#x0D; Results: The mean age of married teenage girls was 16.6 Years with SD ± 2.3 Years. The study results show that 23.5% of Teenage mothers were suffering from Pregnancy Induced Hypertension. 83% women participants were in the age group of 17 to 19 years. Majority 80.3% of marriages were in the age of 13 to16 years. 76% of women were in 1st and 2nd Gravida. Conclusion: One fourth of Teenage married girls are suffering from Pregnancy Induced Hypertension. The maternal age of 17-19 years has been found most common age group for pregnancy induced hypertension, more common in 1st and 2nd Gravida.

A study on the prevalence of ocular disorders among school going children in the age group of 5 to 12 years

The aim of this study is to assess the prevalence of various ocular disorders among school going children in the age group of 5 to12 years. : Vision screening is crucial for early detection of ocular disorders among young children thereby preventing the risk of uncorrectable dimunition of vision. Hence, our programme is planned as early detection of the causative factors in the childhood period and most effectively treat as early as possible.The purpose of the screening programme is to identify various ocular diseases in children like refractive errors, amblyopia, defective color vision, lid and adnexal disorders, vitamin A deficiency, allergic conjuctivitis, glaucoma, cataract and squint. Identification of such problems and its correction in early stage is crucial for their normal growth. A school based prospective cross sectional study design was adopted to examine children aged 5–12 years in randomly selected schools of Kollam district from January 2020 to March 2020. In this cross-sectional study, two Optometrist and two Ophthalmologist and other supportive staffs screened 3100 school children aged 5 to 12 years for vision and external eye examination. An Optometrist did the visual acuity testing and refraction. Detailed ophthalmic examination was done by an Ophthalmologist. The pattern of visual acuity, colour vision and ocular disorders were studied. Children needing further assessment were referred to the hospital and analysis of the data and data entry done using Microsoft office excel 2016 with Statistical software: R software (EZR 1.32).: A total number of 3100 students from 11 different schools were examined, 1570 of whom were males, and 1530 were females. The commonest eye disorder was refractive error 16.6% (514) in which most common was myopic astigmatism 78.2% (402) of which 322 were against the rule and 80 were with the rule astigmatism, followed by simple myopia 15.2%(78) simple hypermetropia 4.7%(25) and hypermetropic astigmatism 1.7%(9). Of these spectacles usage was found to be present only in 81.3% (418) students, rest 18.7%(96) were not aware of the refractive error. Next common eye disorder was allergic conjunctivitis 1.6%(49).Squint was present in 1.4%(42) children. Corneal opacity was present in 0.26%(8), defective color vision was there in 0.2%(6); lids and adnexal disorders 0.13%(4) and cataract 0.03%(1). There were no students with congenital anomalies, congenital glaucoma or Vitamin A deficiency. Uncorrected refractive error is the most common visual impairment found in school going children. There is a need to set up a regular school vision-screening programme to detect ocular disorders in order to prevent the burden on society on long term. Since most of this morbidity is either preventable or completely treatable, school screening is an effective method to reduce this burden.

Impact of Counseling on Quality of Life and Treatment Adherence for Acute Lymphoblastic Leukemia Children.

Aim: is to assess the impact of counseling on quality of life (QoL) and treatment adherence. Research designs: A quasi experimental research design. Settings: The study was conducted at the pediatric unit in National Cancer Institute affiliated to Cairo University. Subjects: A purposeful sample included (30) children newly diagnosed with “Acute Lymphoblastic Leukemia” in the initial diagnosis period and received chemotherapy treatment at the first day of induction phases their age start from 6 to18 years, and they been accompanying with their mothers and admitted to the previously mentioned setting. Tools: data collected was a structured interviewing questionnaire, Kids Screen-Scale to assess quality of life, pre and post counseling and Medication Adherence Scales to assess treatment adherence post counseling. Results: The study results revealed that there are a highly statistically significant difference on quality of life of children pre and post counseling, as well as children had high adherence to treatment post counseling. Conclusion: The counseling had a positive effect on children adherence to Acute Lymphoblastic Leukemia treatment, which lead to promote the quality of life. Recommendation: Recommendations: The study recommended the application of the counseling session for all Acute Lymphoblastic Leukemia children and their mothers to improve their adherence to treatment to promote their quality of life.

Associations of Dietary Intake on Biological Markers of Inflammation in Children and Adolescents: A Systematic Review.

Background: In children and adolescents, chronic low-grade inflammation has been implicated in the pathogenesis of co- and multi-morbid conditions to mental health disorders. Diet quality is a potential mechanism of action that can exacerbate or ameliorate low-grade inflammation; however, the exact way dietary intake can regulate the immune response in children and adolescents is still to be fully understood. Methods: Studies that measured dietary intake (patterns of diet, indices, food groups, nutrients) and any inflammatory biomarkers in children and adolescents aged 2 to19 years and published until November 2020 were included in this systematic review, and were selected in line with PRISMA guidelines through the following databases: Academic Search Complete, CINAHL, Global Health, Medline COMPLETE and Web of Science–Core Collection. A total of 53 articles were identified. Results: Results show that adequate adherence to healthful dietary patterns such as the Mediterranean diet, or food groups such as vegetables and fruit, or macro/micro nutrients such as fibre or vitamin C and E, are associated with decreased levels of pro-inflammatory biomarkers, mainly c-reactive protein (CRP), interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α), whereas adherence to a Western dietary pattern, as well as intake of food groups such as added sugars, macro-nutrients such as saturated fatty acids or ultra-processed foods, is associated with higher levels of the same pro-inflammatory biomarkers. Conclusions: This is the first systematic review examining dietary intake and biological markers of inflammation in both children and adolescents. A good quality diet, high in vegetable and fruit intake, wholegrains, fibre and healthy fats ameliorates low-grade inflammation, and therefore represents a promising therapeutic approach, as well as an important element for disease prevention in both children and adolescents.

Retrospective Study of Acute Pediatric Intoxication Cases by Household Products Presented to the Poison Control Center of Ain-Shams University Hospitals

Background: Acute poisoning in children is a crucial pediatric emergency and may be a worldwide problem.This study aims to acknowledge the incidence of acute poisoning by household products in children regardingdemographic factors, common clinical presentation and outcome of management.Methods: this is often a descriptive retrospective study conducted on patients admitted to the Poison ControlCentre of Ain-Shams University Hospital. The duration of the study was one year, from the beginning ofJanuary, 2016 till the top of December, 2016. the entire number of cases was 846 cases collected and analyzedregarding the demographic data, condition of poisoning, common clinical presentation, and managementplan. Data was analyzed using computer software package SPSS 15.Results: a complete of 846 cases were reviewed, the varied age groups involved ranged from but one year to18 years, with a mean age of 10.22 ± 6.83 years. Most cases were females (67 %), living in urban areas (52.4%) and therefore the majority of cases were accidental (74 %). the foremost common offending agent waspesticides (71%). Most of the patients were vitally stable on admission and therefore the commonest clinicalpresentation was gastrointestinal symptoms (31.3%). Most of cases received medical treatment within theinpatient wards (80.5%) and (96.7%) improved while (3.3 %) died.Conclusions: Acute poisoning by household products is common among adolescents and pre-school agechildren. Pesticides were liable for the bulk of cases. Supportive and symptomatic therapy is that the mainmethod for treatment.

Prevalence of H. pylori Infection in the Children having Recurrent Abdominal Pain

Background and objective: The stomach’s acidic environment is the growth site for Helicobacter pylori, a pathogenic Gram-negative bacterium with rod shape. The aim of this study is determination of the prevalence of Helicobacter pylori infection in the children having recurrent abdominal pain. Materials and methods: This cross-sectional study was carried out during 2018 in Sir Ganga Ra Hospital, Lahore. The sample was consisted of 200 participants among them the proportion of Helicobacter was 8% in patients with Recurrent Abdominal Pain. Results: The mean age of the patients was 12.43 ± 1.23 years. Mostly the age of the sample group was between 8 to16 years. The 4.23 ± 0.47 months was the mean time period of abdominal pain. Helicobacter pylori were found in 47% of patients. Conclusion: In paediatric population, Helicobacter pylori is very common with Recurrent Abdominal Pain. It is a severe problem in children and further study is recommended to explore the risk element associated with this increase trouble of Helicobacter pylori.

Pediatric Teleconsultation in the Context of the COVID-19 Pandemic

Three billion individuals worldwide are currently confined to fight the COVID-19 pandemic. In this context, since physical examinations are less present. Teleconsultation is the delivery of health care services using the phone, information or communication technology. In the current pandemic scenario, teleconsultation can supplement health-care delivery in the absence of in-person visit. Our study aimed to assess the efficiency and security of teleconsultation with only a smartphone to manage the flow of pediatric emergencies in Morocco. This prospective observational cohort study was conducted on the first 500 patients, who received a teleconsultation by contacting pediatricians by smartphone, using audio, videos or photos, during two months April and May 2020, the patients were calling from all Morocco. The average of age was 2 years and 4 months with extremes ranging from 4 days to 15 years. Gender: male-60.7% and female-39.3%. The communication type was written message-100%; Photos-15%; Voice mail-8%. Our attitude was give as Prescription-69%; Tips-43%; Specialist advice-15%; Emergencies-6%; Diet- 5%; Balance-5%; Consultation-4%; Radiological assessment-3%; Family treatment-1%. This study is the first to assess the utility of emergency pediatric teleconsultation with a simple smartphone application to manage emergency in a population with suddenly restrained access to pediatricians. This approach permitted us to preserve social distancing.

A study evaluating the perinatal outcomes in teenage pregnancy

Teenage pregnancy is one of the important social problems faced worldwide. It increases the risk of neonatal mortality and also significantly deteriorates the health of the mother. The most common complication in teenage pregnancy includes anemia, preterm delivery, intrauterine growth restriction, preeclampsia and depression in the mother and increased risk of congenital malformation, sepsis inadequate weight gain and failure to thrive due to lack of maternal care in the neonate. This study evaluates the postnatal complications in teenage pregnancy (less than or equal to19 years). Lack of awareness, attainment of early puberty and early marriage are the important causes for prevalence of teenage pregnancy in India. A cohort retrospective study was done in the Obstetrics and Gynaecology Department at Saveetha Medical College and Hospital during the period January-July 2020; which involved collection of data from 2011-2019. This study shows among the teenage pregnancies 82% of cases had normal vaginal delivery,14% were delivered by cesarean section and 4% by forceps delivery. But there was no significant association between mode of delivery and teenage pregnancy. Moreover, teenage pregnancies had higher incidence of vaginal delivery. Also, Immediate Complications such as anemia, postpartum hemorrhage, Premture rupture of membranes, placenta previa, abruption, neonatal death and IUGR were seen in 27% cases and late complications such as inadequate weight again and failure to thrive were present in 43%. Although most patients delivered through normal vaginal delivery the complications in teenage pregnancy was found to be relatively more than pregnancy in an adult. The study showed that teenage pregnancy is a high risk pregnancy and can be promoted by sex education and emphasizing the importance of contraception.

Early Maladaptive Schemas as Predictors Symptomatology among Victims and Non-Victims of Dating Violence

Este estudo investigou como os esquemas iniciais desadaptativos (EIDs) podem predizer o desenvolvimento de sintomas de depressão, ansiedade e estresse em uma aamostra alargada de adolescentes vítimas de violência no namoro. Um total de 525 adolescentes, de 14 a 19 anos de idade, oriundos da região metropolitana de Porto Alegre/RS, participaram no estudo. Os participantes foram divididos em dois grupos: Grupo de adolescentes vítimas (n = 396 adolescentes, 60,4% do sexo feminino, M = 16,67 anos de idade, DP = 1,18 anos) e não-vítimas (n = 129 adolescentes, 52,7% do sexo feminino, M = 16,50 anos de idade, DP = 1,23 anos). O Questionário de Esquemas para Adolescentes-Forma Breve, o Inventário de Conflitos nas Relações de Namoro na Adolescência e a Escala de Depressão, Ansiedade e Estresse para Adolescentes foram aplicados. Os resultados indicaram maior sintomatologia de depressão, ansiedade e sintomas de estresse entre as vítimas, em comparação com as não vítimas, e entre as meninas vítimas, em comparação com os meninos vítimas. Vítimas de violência no namoro apresentaram significativamente escores mais altos nos EIDs de Abandono, Desconfiança/abuso, Arrogo/grandiosidade, Autossacrifício, Busca por Aprovação, Negativismo/pessimismo e em Padrões Inflexíveis, quando comparadas ao grupo de não-vítimas. Para o grupo de vítimas do sexo feminino, regressões múltiplas indicaram que os EIDs explicam a variância dos sintomas de depressão (36%), ansiedade (28%) e estresse (26%). Para os adolescentes do sexo masculino, os EIDs também explicam a variância dos sintomas de depressão (43%), ansiedade (38%) e estresse (39%). Os resultados são discutidos a partir dos pressupostos da Terapia dos Esquemas. Implicações para políticas públicas e práticas de intervenção são consideradas.

ANALYSIS OF THE DEPENDENCE BETWEEN JUMPING TAKEOFF AND ANTHROPOMETRIC INDICATORS OF FEMALE FIGURE SKATERS

ABSTRACT Jump Elements in figure skating are an integral part of motor activity. One of the conditions for their good performance is great height and length. Criteria for this are the indicators of speed and power qualities. The aim of this research work is to analyze the relationship between anthropometric indicators and those for jumping takeoff of young female figure skaters of the basic level of training. Seventeen female skaters aged 10-14 years old (prepuberty) from ice skating clubs in Bulgaria voluntarily participated in the study. The age of the participants was 10 to14 years old, which is considered favorable for the development of speed and strength abilities. They were subjected twice to 8 anthropometric measurements and 5 different types of takeoff, conducted in office conditions. To achieve the goal of the survey, the following research methods were used: theoretical analysis and generalization of data in specialized scientific and methodological literature, pedagogical observation, pedagogical testing, anthropometric research methods and methods of mathematical statistics for processing the results of the study. The results showed significant intragroup dependences for the anthropometric and bio- mechanical parameters for all types of jumps takeoff in the first study and a decrease in the correlation coefficients in the second measurement. The maximum force in all types of jumps increases with increasing indicators of height, weight, length of the lower limbs, chest circumference, shoulder width, while the width of the pelvis does not affect the strength of the takeoff. The height of the jumps with the help of the arms depends on the width of the shoulders – r = 0.497, and for vertical jump with the hands on the hips – r = 0.664.

A study of pulmonary function tests in HIV infected children

Background: If untreated, HIV mortality will be high from the cause of acute respiratory infections in neonatal stage up to one year of age. Here, the study was conducted to determine the prevalence of spirometric abnormalities in HIV positive children. Methodology: A cohort of 20 children in the age group of 10 to18 years with a diagnosis of HIV was included. Spirometry measurements carried out to analyze the forced expiratory volume at one second (FEV1), forced vital capacity (FVC), FVC/FEV1 ratio, and forced expiratory flow 25% to 75% (FEF25-75) and pulse oximetry. The PFT data were analyzed in correlation with the age and blood parameters. Results: 20 HIV-infected participants with a mean age 15.5 years were recruited. 17 children were on antiretroviral therapy. The mean CD4 count was 496±235.22 (151-1088) cells/µl. Mean Hb% value observed was 9.96±2.5 and mean total leucocyte count was 3785±2087.37. We found mean FEV1 as 71.05±9.2, mean FVC as 71.6±8.5 and ratio FEV1/FVC as 98%±0.11. The total lung capacity was observed as 73%-117%. Conclusions: Clinicians evaluating HIV infected children with respiratory symptoms must first determine whether those symptoms are a result of common bacterial symptoms or opportunistic infections. Keywords: Antiretroviral therapy (ART); Chronic lung disease; HIV; Pulmonoray function test.

ESR1 gene polymorphism (rs827421) as a potential genetic marker for constitutional delay of growth and puberty in Egyptian adolescents

Constitutional delay of growth and puberty (CDGP) is a variant of normal pubertal timing and progress. It is the most common form of delayed puberty in both genders. The genetic director of CDGP is ill-understood despite the positive family history result noted in those patients. The current study aimed at assessing the role of estrogen receptor 1 (ESR1) gene variant (rs827421) in Egyptian adolescents with CDGP. A cross-sectional study with follow-up part was carried out on 6760 children aged 4 to15 years. The study focused generally on children aged 13–15 years in order to evaluate the prevalence of delayed puberty in relation to all ages in general and to their peers in specific. Assessment of serum TSH, FSH, and LH was conducted on all participants, along with the measurement of serum-free testosterone for males and estradiol for females. Genotyping of ESR1 (rs827421) was done to all subjects through the use of TaqMan discrimination assay by real-time PCR. ESR1 (rs827421) GG genotype and G allele were significantly dominant among CDGP adolescents in comparison with controls (OR = 25.67 and 6.90). As regards follow-up of testicular size, AA genotype was significantly associated with increased size in the right and left testis compared to other genotypes (P = 0.021 and 0.006, respectively). Moreover, AA genotype showed significantly higher Tanner stage in both males and females in comparison with other genotypes. Serum estradiol level was significantly higher in AA genotype group than other genotypes groups. ESR1 gene polymorphism can be considered a potential genetic marker for CDGP in both sexes in a sample of Egyptian adolescents.

Impact of distance on postoperative follow-up in patients of pediatric surgery: a retrospective review

ObjectiveCentralization of medical services in Canada has resulted in patients travelling long distances for healthcare, which may compromise their health. We hypothesized that children living farther from a children’s hospital...

Spectrum of pediatric heart disease in newly established cardiac center in South Punjab.

Objectives: To determine the spectrum of pediatric heart disease in a newly established cardiac centre in south Punjab. Study Design: Descriptive Observational Case Series. Setting: Department of Pediatric Cardiology of Cardiac Center Bahawal Victoria Hospital (BVH) Bahawalpur. Period: July 2019 to December 2019. Material &amp; Methods: All consecutive patients of any gender, age range from first day of life to18 years, diagnosed as having heart disease (congenital/ acquired) on Echocardiography were enrolled. Patients of isolated bicuspid aortic valve, premature neonates having PDA or those who already had device or surgical intervention done were excluded from the study. The spectrum of the heart diseases in children was assessed by categorizing them as having acquired, acyanotic and acyanotic heart defects. Results: A total of 624 patients were enrolled in the study on the basis of inclusion criteria. There were 56.7 % male (n=354) while 43.3% were female (n=270) with male to female ratio 1.3:1. Majority of the patients were of infant age group (66%, n=412). Congenital heart disease (CHD) was present in 87% of the patients (n=543) while 13% (n=81) had acquired heart disease (AHD). Acyanotic heart lesions were found in 73.1% of patients while cyanotic congenital heart diseases (CCHD) were 26.9 %. Ventricular septal defect (VSD) was the most common CHD (33%), followed by Atrial Septal defect (14.9%) and Patent ductus arteriosus (13.1%). TOF was the most common CCHD (10.1%) followed by TGA (7.4%). Among AHD, 55.6% were of Rheumatic heart disease (RHD) followed by Cardiomyopathy (27.2), pericardial effusion (8.6%) and infective endocarditis (4.9%). Conclusion: The VSD, ASD, PDA, TOF and TGA remain the most common CHD in descending order while RHD is the most common acquired heart disease in children at our centre.