Trematode induced ocular granuloma in children from South India

BackgroundThe pandemic of Coronavirus Disease 2019 (COVID-19) brings new challenges for pediatricians, especially in the differentiation with non-COVID-19 pneumonia in the peak season of pneumonia. We aimed to compare the clinical characteristics of pediatric patients with COVID-19 and other respiratory pathogens infected pneumonias.MethodsWe conducted a multi-center, cross-sectional study of pediatric inpatients in China. Based on pathogenic test results, pediatric patients were divided into three groups, including COVID-19 pneumonia group, Non-COVID-19 viral (NCV) pneumonia group and Non-viral (NV) pneumonia group. Their clinical characteristics were compared by Kruskal-Wallis H test or chi-square test.ResultsA total of 636 pediatric pneumonia inpatients, among which 87 in COVID-19 group, 194 in NCV group, and 355 in NV group, were included in analysis. Compared with NCV and NV patients, COVID-19 patients were older (median age 6.33, IQR 2.00-12.00 years), and relatively fewer COVID-19 patients presented fever (63.2%), cough (60.9%), shortness of breath (1.1%), and abnormal pulmonary auscultation (18.4%). The results were verified by the comparison of COVID-19, respiratory syncytial virus (RSV) and influenza A (IFA) pneumonia patients. Approximately 42.5%, 44.8%, and 12.6% of the COVID-19 patients presented simply ground-glass opacity (GGO), simply consolidation, and the both changes on computed tomography (CT) scans, respectively; the proportions were similar as those in NCV and NV group (p>0.05). Only 47.1% of COVID-19 patients had both lungs pneumonia, which was significantly lower than that proportion of nearly 80% in the other two groups. COVID-19 patients presented lower proportions of increased white blood cell count (16.5%) and abnormal procalcitonin (PCT) (10.7%), and a higher proportion of decreased lymphocyte count (44.0%) compared with the other two groups.ConclusionMajority clinical characteristics of pediatric COVID-19 pneumonia patients were milder than non-COVID-19 patients. However, lymphocytopenia remained a prominent feature of COVID-19 pediatric pneumonia.

ObjectiveThe number of children presenting with coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 infection is increasing, and we aimed to assess the clinical characteristics of pediatric patients with a definite epidemiological history during the early COVID-19 epidemic.MethodsRetrospective analysis was performed on the clinical data of children admitted to the fever ward of Xiangyang Central Hospital in Hubei province between January 1, 2020 and March 17, 2020. According to definite epidemiological history, patients with SARS-CoV-2 nucleic acid test (NAT) positive detection were grouped as confirmed cases, and patients with two consecutive negative NATs were grouped as suspected cases. We compared the clinical characteristics of the two groups.ResultsA total of 47 (47/127, 37%) cases had a definite epidemiological history, of which 32 (68.1%) were suspected, with a median age of 5.5 years (interquartile range [IQR]: 0.7–10.3), and 15 (31.9%) were confirmed, with a median age of 9 years (IQR: 4–14). Statistically significant differences in age, family cluster of infection, and numbers of patients with clinical symptoms and fever (P<0.05) were found between the two groups, but no statistically significant differences in leucocyte and lymphocyte counts were observed (P>0.05). Significant differences were found in the computed tomography (CT) manifestation of ground glass opacity (GGO) between the two groups (P<0.05).ConclusionChildren of older age and from family clusters of infection were more easily diagnosed as having COVID-19. GGO changes on chest CT was more likely in confirmed cases. Although obvious clinical manifestations increase our awareness of COVID-19, children without manifestations of fever or cough should not be ignored as they may be asymptomatic carriers.

ResumenIntroducción. La psoriasis pediátrica tiene una prevalencia del 0,5 al 4,1 %. Es más frecuente en el sexo femenino y predomina su variante vulgar o en placa. Se ha relacionado con comorbilidades como la obesidad y el síndrome metabólico, e incluso, con antecedentes familiares de psoriasis.Objetivo. Describir las características epidemiológicas y clínicas de los pacientes pediátricos con diagnóstico de psoriasis que consultaron a dermatólogos miembros de la Asociación Colombiana de Dermatología, de enero de 2017 a junio de 2022.Materiales y métodos. Se trata de un estudio descriptivo, retrospectivo y multicéntrico, en el cual se determinó la prevalencia de la psoriasis, y se describen las características clínicas, el método diagnóstico, los antecedentes personales y familiares, y los tratamientos en casos pediátricos. Las variables se analizaron con el programa Stata 13™. Resultados. De 26.870 pacientes pediátricos atendidos, 146 tuvieron diagnóstico de psoriasis (0,54% de prevalencia), con una relación entre mujeres y hombres de 1,5:1. La mediana de la edad de aparición fue de ocho años. La variante más común fue la vulgar (72,6 %), seguida de la guttata (6,85 %). El cuero cabelludo fue la localización más frecuente (55,48 %). Las comorbilidades más comunes fueron obesidad y enfermedad de Crohn (5,5 % cada una). En cuanto a antecedentes familiares, se reportaron 39 casos de psoriasis, 16 de diabetes mellitus y 7 de dislipidemia. El 78 % fueron reportados como leves, según el Psoriasis Area Severity Index (PASI). El 65 % de los pacientes recibió tratamiento tópico, el 18 %, sistémico y, el 2,7 %, fototerapia; en cuanto a tratamientos combinados, el 6 % recibió el tópico y sistémico, el 1,3%, el tópico más fototerapia, y el 0,68 % recibió la combinación de todos.Conclusiones. En la población evaluada, la variante de psoriasis pediátrica más frecuente fue la vulgar en su forma leve y, en la mayoría de los casos, el tratamiento fue tópico. La asociación ocasional con otras enfermedades sistémicas, como obesidad y síndrome metabólico, implica la necesidad de ampliar los estudios.

To report the incidence and clinical characteristics of paediatric patients presenting with diabetic ketoacidosis to the Emergency Department (ED) with new and pre-existing type 1 diabetes mellitus (T1DM). A ten-year retrospective data analysis was performed on children under 16 years presenting to the ED with T1DM from January 2010. Demographic and laboratory data were extracted to determine the rates of DKA. Comparative statistics were performed between age groups and pre-existing and newly diagnosed T1DM patients. A total of 196 children with T1DM were included. The mean age of the cohort was 9.3 ± 4.0 years, with female predominance (54%, p = 0.38). Most (60%) were newly diagnosed with T1DM, of which 38% presented in DKA. Amongst the total cohort, 43% presented in DKA.The older children accounted for 50% of the DKA presentations in the newly diagnosed cohort. Amongst the younger age group, 42% presented with severe DKA. There were higher rates of T1DM in areas of relative socioeconomic advantage. Children with T1DM presented with unacceptably high rates of DKA and posed a significant medical, psychosocial and financial burden on families and medical services. These findings suggest that a prospective public health campaign to reduce rates of DKA is warranted.

To evaluate thoracolumbar spine injury patterns, demographics, and clinical characteristics in pediatric patients following all-terrain vehicle-related trauma. A retrospective review of patients 0-17years old admitted to a level I trauma center following an ATV-related incident from 2004 to 2013 was performed. Thoracolumbar spine injury patterns, accident mechanism, driver/passenger status, and demographic and clinical data were compared between patients with and without a spine injury. Of 456 pediatric patients involved in ATV-related trauma, 36 sustained one or more thoracolumbar spine injuries (7.9%). These patients tended to be older, taller, heavier, and had a higher BMI. ATV rollover was the major statistically significant mechanism of injury to cause spine fractures (61%). Patients with spine injuries had twice the hospital length of stay compared with those without (4days vs. 2days, P = 0.003). Nonstructural spine injuries (A0) were the most common type of injury (49.1%), followed by wedge-compression fractures (A1) (41.1%). In patients with a thoracolumbar spine injury, there was a mean of 3.11 spine injuries per child. Four (10%) patients with thoracolumbar spine fractures also sustained a cervical spine fracture. Once a thoracolumbar spine injury has been detected in a patient, the entire spinal column should be scrutinized because there is a high likelihood for additional injuries throughout the spine. Younger pediatric patients (≤ 8years old) exhibit a spine fracture pattern distinct from that of older children who have a mature osseous-ligamentous complex.

BackgroundCOVID-19 infections have been described as asymptomatic or mild, with a low incidence of severe cases in children and adolescents who followed the basic hygiene measures. The objective of this study was to describe the clinical and epidemiological characteristics of our pediatric population during four waves of the COVID-19 pandemic from a private hospital.MethodsA retrospective observational study in patients under 15 years old with confirmed SARS-CoV-2 infection by real-time reverse transcription-polymerase chain reaction (RT-PCR) test from April 1, 2020 to April 30, 2022. Demographic, clinical, and therapy variables were examined, and the Chi-square test was used for comparisons.ResultsFrom 5,870 RT-PCR taken through the first two years of the pandemic, 1,371 tested positive, obtaining a positivity rate of 23.37%. Patients' median (IQR) age was 9.0 (7.0) years, and most were male (n = 705, 51.4%). The primary comorbidities were rhinitis (n = 239, 17.4%) and asthma (n = 172, 12.5%). Most cases were scholars (n = 568, 41.4%) during the fourth COVID-19 wave (n = 831, 60.6%). Almost all cases (88.2%) reported prior exposure to SARS-CoV-2-infected households. Six percent (n = 82) of the patients reported being vaccinated against SARS-CoV-2. Most participants (89.3%) received outpatient care, and 0.6% required hospitalization. Nine (0.6%) patients were diagnosed with Multisystemic Inflammatory Syndrome in Children (MIS-C). The second COVID-19 wave reported a higher frequency of anosmia and dysgeusia; the third wave reported fever and malaise, and the fourth wave reported cough, odynophagia, and vomiting (p < 0.05). The second wave reported no treatment (n = 23, 15.3%), while the third and fourth waves reported outpatient care and hospitalization (n = 367, 95.1%; and n = 4, 1.0%, respectively) (p = <0.001). Reinfection cases were frequent during the second wave (n = 8, 5.3%) (p=<0.001). Rhinorrhea, vomiting, and diarrhea were reported mainly by infants; fever by preschoolers; abdominal pain by scholars; and headache, odynophagia, anosmia, dysgeusia, myalgia, arthralgia, and malaise by adolescents (p < 0.05). Neither treatment nor reinfection showed age-related differences (p = 0.496 and p = 0.224, respectively).ConclusionThe study demonstrated a lower positive rate for SARS-CoV-2 in our hospital'The majority of cases in our study were outpatients who reported a mild infection with a favorable evolution based on symptomatic treatment.

Acute gastroenteritis is one of the most common causes of hospital admission in children. Treatment regimens differ depending on the pathogen. In our study, we aimed to evaluate the epidemiological and clinical features of pediatric patients whose gastrointestinal agents were detected by multiplex PCR. The study included 131 pediatric patients who were followed up at Eskişehir Osmangazi University, Pediatric Department between January 2018 and December 2021.Gastrointestinal pathogens were detected in stool samples by multiplex PCR. The epidemiological and clinical features were reviewed retrospectively. A total of 203 gastrointestinal pathogens were detected from the stool samples of 131 cases. Of these cases, 56% were male and 44% were female. The mean age was 66 (2-204) months. The most common symptoms were diarrhea, fever, vomiting and abdominal pain. The pathogen detection rate was 69% by multiplex PCR. A single pathogen was detected in 85 (65%) cases and multiple pathogens were detected in 46 (35%) cases. The most common pathogens were enteropathogenic Escherichia coli (EPEC, 23%), Clostridium difficile (21%), norovirus (17%), rotavirus (15%), salmonella (12%) and enterotoxigenic E. coli (ETEC, 11%). Stool culture was positive in 16 (12%) cases and microscopic examination positive in 17 (13%) cases. Probiotic treatment was given to 119 (92%) cases and antimicrobial treatment (metroinidazole, ceftriaxone, azithromycin and oral vancomycin) to 34 (26%) cases. Of the cases, 56 (42%) had chronic disease, 40 (30%) had a history of previous antibiotic use and 17 (13%) had a history of hospitalization in the intensive care unit. The sensitivity of the multiplex PCR in the detection of acute gastroenteritis agents is higher than stool microscopy, stool culture and stool antigen tests. However, due to the inability to distinguish between colonization, carrier state and pathogenicity, it should be evaluated together with other diagnostic tests and clinical findings in order to determine whether the determined agent is pathogenic or not and in the regulation of antimicrobial therapy.

Objective: To analyze the clinical characteristics of abnormal personality and conduct disorders (CDs) in pediatric patients with vasovagal syncope (VVS).Methods: In this study, we recruited patients diagnosed with VVS at Children's Heart Center from January 2018 to December 2020. Healthy children were recruited as controls. The Eysenck Personality Questionnaire-Child edition (EPQ-C) and Achenbach Child Behavior Checklist (CBCL) were used for the assessment.Results: One hundred and fifty-one VVS patients and 151 healthy controls were included in this study. Compared with the control group, patients in the VVS group had a higher incidence of abnormal personality and were more prone to suffer from CDs. Moreover, pediatric patients with VVS suffered more events of syncope recurrence if they had CDs.Conclusion: Abnormal personality and CDs are common clinical characteristics in pediatric patients with VVS.

Streptococcus pneumoniae (S. pneumoniae) is a major cause of pneumonia in pediatric health concerns. Effective vaccination strategies depend on understanding serotype distribution and its correlation with clinical manifestations. This study aims to describe the serotype distribution of Streptococcus pneumoniae strains at Hai Phong Children’s Hospital, Vietnam. Conducted at Hai Phong Children’s Hospital in Vietnam from November 2022 to September 2023, our cross-sectional study enrolled 428 pediatric pneumonia patients. Nasopharyngeal fluid specimens were collected to isolate S. pneumoniae by culture and confirmed by Real-time PCR. S. pneumoniae serotyping was performed by realtime PCR. Medical records provided symptom and medical history data. Out of 428 samples, 66.8% tested positive for S. pneumoniae. Among confirmed cases by real-time PCR, 82.6% were typeable, with predominant serotypes being 6A/B (16.4%), 19F (14.9%), 15B/C (11.4%), 19A (11.0%), and 15A/15F (7.8%). Notably, 70.7% of strains belonged to vaccine-covered serotypes. Cough (96.5%), tachypnea (78.7%), fever (56.1%), and wheezing (52.8%) were the most frequent symptoms. Notably, cough, tachypnea, wheezing, and chest indrawing (29.0%) significantly correlated with pneumococcal pneumonia. Positive S. pneumoniae cultures also correlated with chest X-ray findings. Our study reveals a high prevalence of S. pneumoniae in pediatric patients with pneumonia in Vietnam. Insights into serotype distribution, clinical characteristics of pneumonia cases offer valuable guidance for optimizing vaccination programs and enhancing disease management.

Background: The prevalence of alopecia areata in childhood is increasing yearly. Alopecia areata is often seen in daily practice among our patients, studies related to this disease are still limited and must be updated. This study aims to describe the clinical characteristics of pediatric patients diagnosed with alopecia areata at Prof. Dr. I.G.N.G. Ngoerah General Hospital Denpasar from 2021 to 2023. Purpose: This study is expected to be used for decision-making related to the management of alopecia areata in children. Method: This study is a quantitative descriptive study. The data used is secondary data from medical records with a cross-sectional design. The sample includes pediatric patients diagnosed with alopecia areata at Prof. Dr. I.G.N.G. Ngoerah General Hospital Denpasar from January 2021 to November 2023. Results: This study involved 18 patients with an average age of 10.33 ± 4.85 years. In 2021, there were 5 patients; in 2022, there were 6 patients; and in 2023, there were 7 patients. The genders of girls and boys were the same, with 9 patients for each. Hair loss is the most common clinical symptom, with a percentage of 100%. The highest onset occurs between 1–6 months at 44.44%. The most common dermoscopic findings is a black dot, which accounts for 38.89%. Conclusion: Alopecia in childhood is different from alopecia in adults. The clinical picture in children can vary, and sometimes with nail involvement. Children with alopecia areata need further evaluation for other comorbidities.

Despite the increasing recognition of cystic fibrosis (CF) in China, few cases have been reported in the Xinjiang Uyghur Autonomous Region (Xinjiang), which is located in China’s northwest with a diverse ethnic composition. This study aimed to describe the genotype and clinical phenotype of children with CF in Xinjiang. We recruited children diagnosed with CF at the Children’s Hospital of Xinjiang Uygur Autonomous Region between January 2012 and December 2025. The demographic data, imaging findings, laboratory test results, and genetic data were retrospectively reviewed. A total of 19 patients from 18 families were enrolled. The median age at diagnosis was 9.8 years. Among them, 15 (78.9%) were Uygur, 3 (15.8%) Kazakh, and 1 (5.3%) Mongolian. Fifteen distinct cystic fibrosis transmembrane conductance regulator (CFTR) mutations were identified, with c.1521_1523delCTT (p. F508del) being the most common (allele frequency: 36.1%). Mutations of c.1860T > G (p.H620Q), c.2991 G > C (p.L997F), del ex4-11, c.3254 A > G (p.H1085R), c.2619 + 1G > A, c.349 C > T (p.R117C), c.3909 C > G (p.N1303K), and c.1911delA > G (p.G637Hfs*26)—which have never been reported in Chinese populations—were observed. Bronchiectasis was observed in 84.2% of patients, with allergic bronchopulmonary aspergillosis noted in 36.8%. Pseudomonas aeruginosa (78.9%) and Staphylococcus aureus (47.4%) were the predominant pathogens. Additionally, 78.9% had pancreatic insufficiency, 21.1% had CF-related liver disease, 21.1% had Pseudo-Bartter syndrome, and 5.3% had diabetes. CF may be significantly underdiagnosed in Xinjiang, China. The genotypic spectrum in children with CF in this multiethnic region differs considerably from previous reports, mainly focusing on the Han population, with p.F508del as the most frequent CFTR mutation.

Objective: To determine the demographic and clinical characteristics of pediatric patients admitted to our hospital’s emergency department due to poisoning and to provide data that may inform preventive measures and contribute to national records. Methods: We retrospectively analyzed pediatric patients (0–18 years) admitted for poisoning between January 2023 and December 2024. Demographics, exposure characteristics, treatment, disposition, and outcomes were extracted from the hospital information system. Descriptive statistics were reported as frequencies (%) for categorical variables. Results: A total of 328 patients were analyzed. Males accounted for 51.5% of cases. The most common age group at presentation was 3–6 years (45.1%). The most frequent season of presentation was summer (37.8%). The most common cause of poisoning was drugs (60.4%), followed by food, corrosive substances, and carbon monoxide, respectively. The overall hospitalization rate was 53.7%, with 20.7% requiring intensive care unit (ICU) admission. Mortality was 2.2%. Conclusion: Childhood poisonings remain a preventable public health problem. Strengthening family education, safe storage practices, and standardized ED protocols can reduce morbidity and mortality.

BACKGROUNDTourette syndrome (TS) is a complex neurodevelopmental condition marked by tics, as well as a variety of psychiatric comorbidities, such as obsessive-compulsive disorders (OCDs), attention deficit hyperactivity disorder (ADHD), anxiety, and self-injurious behavior. TS might progress to treatment-refractory Tourette syndrome (TRTS) in some patients. However, there is no confirmed evidence in pediatric patients with TRTS.AIMTo investigate the clinical characteristics of TRTS in a Chinese pediatric sample. METHODSA total of 126 pediatric patients aged 6-12 years with TS were identified, including 64 TRTS and 62 non-TRTS patients. The Yale Global Tic Severity Scale (YGTSS), Premonitory Urge for Tics Scale (PUTS), and Child Behavior Checklist (CBCL) were used to assess these two groups and compared the difference between the TRTS and non-TRTS patients.RESULTSWhen compared with the non-TRTS group, we found that the age of onset for TRTS was younger (P < 0.001), and the duration of illness was longer (P < 0.001). TRTS was more often caused by psychosocial (P < 0.001) than physiological factors, and coprolalia and inappropriate parenting style were more often present in the TRTS group (P < 0.001). The TRTS group showed a higher level of premonitory urge (P < 0.001), a lower intelligence quotient (IQ) (P < 0.001), and a higher percentage of family history of TS. The TRTS patients demonstrated more problems (P < 0.01) in the “Uncommunicative”, “Obsessive-Compulsive”, “Social-Withdrawal”, “Hyperactive”, “Aggressive”, and “Delinquent” subscales in the boys group, and “Social-Withdrawal” (P = 0.02) subscale in the girls group. CONCLUSIONPediatric TRTS might show an earlier age of onset age, longer duration of illness, lower IQ, higher premonitory urge, and higher comorbidities with ADHD-related symptoms and OCD-related symptoms. We need to pay more attention to the social communication deficits of TRTS.

Gentamicin, an aminoglycoside antibiotic, remains an effective treatment for pneumonia, urinary tract infection, and neonatal sepsis empirically in pediatric practice. The pediatric guidelines recommended the gentamicin dosage regimen to be 4-7mg/kg in an extended interval of every 24 hours or 36 hours based on the subjects’ gestational age to reduce the risk of gentamicin accumulation resulting in nephrotoxicity. This study aimed to describe the demographic and clinical characteristics of pediatric patients who were 2 years old and below who were at risk of gentamicin-related nephrotoxicity. This was a descriptive study conducted on all under 2-year-old pediatric patients who were on 5mg/kg gentamicin extended interval regimens, had elevated blood gentamicin trough levels of above 1.0mg/L after 2 doses, and were at risk of nephrotoxicity. The subjects were categorized into 2 groups: the 24-hourly group and the 36-hourly group. The data on the demography, medication history, and blood investigation results were collected and analyzed. Out of the total 46 subjects who had elevated blood gentamicin trough levels, there were 32 (69.6%) subjects in the 24-hourly group and 14 (30.4%) in the 36-hourly group. 21 out of 32 subjects in the 24-hourly group were term babies whereas, all subjects in the 36-hourly group were preterm babies. Of all the 46 cases, gentamicin was served during the babies’ first week of life in 31 cases, and after the babies’ first week of life in 15 cases with 1 case of gentamicin being served to infants of 1 month old and above. It appeared that the incidence of gentamicin-related nephrotoxicity was slightly lower in the 36-hourly group than in the 24-hourly group. It is recommended to use the 5mg/kg 36 hourly regimens for neonates in their first week of life when indicated. Future study directions could focus on determining the risk factors for gentamicin-related nephrotoxicity among pediatric patients.

Introduction The clinical phenotype of severe acute asthma at the Paediatric Intensive Care Unit (PICU) is highly heterogeneous. However, current treatment is still based on a ‘one size fits all approach’. Areas covered We aim to give a comprehensive description of the clinical characteristics of paediatric patients with severe acute asthma admitted to the PICU and available immunological biomarkers, providing the first steps towards precision medicine for this patient population. A literature search was performed using PubMed for relevant studies on severe acute (pediatric) asthma. Expert opinion Omics technologies should be used to investigate the relationship between cellular molecules and pathways, and their clinical phenotypes. Inflammatory phenotypes might guide bedside decisions regarding the use of corticosteroids, neutrophil modifiers and/or type of beta-agonist. A next step towards precision medicine should be inclusion of these patients in clinical trials on biologicals.