Journal of Pediatric Perspectives
Volume:12 Issue: 124, Apr 2024

Based on the findings of previous studies, patients with severe Covid-19 have a much greater occurrence of coagulation abnormalities. Additionally, individuals who get this novel virus are susceptible to developing disseminated intravascular coagulation. The present study aimed to investigate the frequency of coagulation disorders in children with covid-19 who were hospitalized in Bandar Abbas Children's Hospital during 2020-2021.

This study was done retrospectively. The medical records of all children were checked with a definite diagnosis of Covid-19, based on positive PCR results. Age, gender and comorbidity status were obtained from the medical records of the patients. In addition, white blood cell count, blood platelet count, hemoglobin concentration, CRP, PT, PTT, INR, D-dimer and fibrinogen were checked. Data was analyzed using SPSS 22 software with a significance threshold of 0.05.

In this study 20.63% had coagulation abnormalities. The groups with and without coagulation disease exhibited a significant difference in the proportions of neutrophils and lymphocytes. Specifically, the coagulation disorder group had elevated levels of neutrophils and reduced levels of lymphocytes (P= 0.043, P= 0.041, respectively). The average D-dimer level and age in the group with coagulation disorder was significantly greater than those in the group without coagulation problem (P= 0.000, P=0.045).

According to the findings of this research, 20.63% of children who were definitively diagnosed with covid-19 had coagulation abnormalities. Only the alterations in D-dimer, lymphocyte, and neutrophil levels were shown to be substantially associated with coagulation disorders in this investigation. Specifically, in the group with coagulation disorders, there was an elevation in neutrophil count and a decrease in lymphocyte count.

Fetal Malnutrition (FM) is caused by inadequate formation of fat, subcutaneous tissues and muscle mass in the fetus, which is associated with several morbidities. Thus, accurate and timely diagnosis of FM is crucial in newborns. In this study, we aimed to compare the nutritional status (Fetal Malnutrition) of a newborn in Ghaem Hospital, Mashhad University of Medical Sciences, Iran, based on CANSCORE with anthropometric criteria. In this cross-sectional descriptive study, 367 neonates who were born from 2020 to 2021 in the maternity ward of Ghaem Hospital, Mashhad were evaluated in the first 24 to 48 hours of life. Demographic characteristics, anthropometric criteria and CANSCORE of neonates were recorded and analyzed using SPSS software (version 16). A p-value <0.05 was considered statistically significant. 367 neonates (54.8% females), with a mean gestational age of 38.7 ± 1.4 weeks, were studied. Mean anthropometric indices, including height, mid-arm circumference and head circumference were 50.05 ± 2.3 cm, 10.5 ± 1.1 cm, and 34.8 ± 1.5 cm, respectively. Average CANSCORE was 25.5 ± 1.9. The majority of the neonates were AGA (89.6%), while 6% were SGA. According to MAC/HC, BMI, and PI, 0%, 14.4% and 12.3% of newborns were malnourished, respectively. CANSCORE identified FM in 19.1% of neonates. A significant correlation between neonates’ weight (SGA, AGA, LGA) and CANSCORE was detected (p<0.001). Bivariate analysis with Pearson’s correlation showed a significant and positive relationship between all anthropometric indices and CANSCORE (p<0.05). CANSCORE is an accurate clinical tool for identifying FM in term newborns.

Autism Spectrum Disorder (ASD) is identified by a group of neurodevelopmental disorders. In view of the importance of, and demand for, novel behavioural interventions in autism disorder, a comprehensive evaluation of the outcomes of interventions for the ongoing impact of behavioral interventions in ASD is necessary.

A systematic search of the electronic databases including PubMed, Embase, Google Scholar, Scopus, Sciencedirect, Web of Science, and Biomed central were conducted to find evidence for the effectiveness of behavioral interventions in ASDs. The search strategy was based on exploring studies published in different global languages from the earliest to 2019 databases. In addition to the databases mentioned above, relevant studies were searched using forward and backward citation tracing.

In the present review, 48 Randomized Controlled Trials (RCTs), and 44 quasi-experimental articles matched the defined evaluation criteria. Eighty-three out of 93 studies were conducted in high-income countries, the results of which raised the challenges associated with acceptability of conducting those studies in low- and middle-income countries. The majority of those studies (93.5%) were classified as having either low or medium quality. From those studies, 32 studies used integrative programs, and 30 studies used social skills development interventions. The majority of the studies were based on integrative programs designed to foster social skills. The results of the study showed that social skills development interventions were effective in changing the desired outcomes. The results showed that, regardless of the study design and the type of intervention used, the possibility of success in interventions were greater in changing the participants' social skills.

There were inconsistent evidence on the effectiveness of interventions in providing changes in targeted outcomes. There is a need for further investigation in behavioral interventions for ASDs. Further research is needed to understand the effectiveness of other interventions and finding quality interventions to achieve more significant results.

Abdominal compartment syndrome can have devastating effects on abdominal visceral organs which eventually can progress to multi-organ dysfunction and death. Various medical and surgical conditions are known to progress to this complication. Abdominal compartment syndrome is now increasingly recognised as a complication of sepsis and Dengue shock syndrome. Life saving measures include reduction of intra-abdominal pressure and adequate support of dysfunctional organs.

Case report: 

We report the case of a 3-month-old infant with abdominal compartment syndrome due to severe dengue illness with multi organ failure with massive ascites. She had a dramatic recovery following abdominal decompression by therapeutic drainage of 300 ml of ascitic fluid.

The spectrum of abdominal compartment syndrome features may easily be thought to be part of capillary leak syndrome and the diagnosis of ACS could have been missed. Early recognition and aggressive treatment have been shown to significantly improve the outcome.

Tuberculosis is a very common disease in India with varied presentations. CNS Tuberculosis (TB) is the most severe form of TB in children and leads to mortality, if not treated timely and effectively (1).

Case report:

 A 7-year-old boy born out of a non-consanguineous marriage was admitted with a history of acute onset of extreme irritability, agitation and inability to recognize parents. Our patient presented with CNS TB and peripheral gangrene for which no cause could be ascertained clinically. We considered that the gangrene resulted from vasculitis secondary to tuberculosis infection based on the pathological presentation, radiographic changes and therapeutic response to ATT. The patient was treated with Antitubercular therapy (Isoniazid, Rifampicin, Pyrazinamide and Ethambutol) for 6 months, oral Prednisolone @ 2 mg/kg/day for 4 weeks with subsequent tapering to 1mg/kg/day for another 4 weeks and oral Aspirin @ 3 mg/kg/day for 6 months. He showed significant improvements with the above said management, with pain significantly decreased and range of motion improved after 2 weeks of starting treatment. He was discharged after 2 weeks. The child was followed up over a period of 2 years and there had been no reappearance of the above mentioned symptoms.

Overall, in this case, it was presumed that Mycobacterium tuberculosis infection was responsible for the neurological manifestations (CNS Tuberculosis) and it also induced the vasculitis process, ultimately causing gangrene and diminished pulsations of extremities.

Aarskog-Scott Syndrome (AAS), also known as facio-digital-genital dysplasia, is a rare syndrome mainly characterized by short stature, skeletal disorders and genitourinary dysmorphisms (1).

Case report:

 We present the case of two caucasian male twins affected by AAS and Patent Foramen Ovale (PFO). The AAS diagnosis was genetically confirmed by the homozygous mutation on the FGD1 gene on exon 6, variant c.1327 C>T p. (Arg443 Cys). Twins described in this report would have been at a higher risk of CHD because of three elements: they were affected by AAS, they were born after IVF, and they were twins. Despite having all these characteristics, only a PFO was detected. 2021 European position paper (22) asserts that after an incidental finding of a PFO, conventional flight or diving should not be denied. In professional divers and selected military pilots performing intensive high-altitude flight activities, a primary PFO percutaneous closure should be recommended.

A first echocardiography evaluation should be performed on a child presenting malformations because of possible involvement of the heart; nevertheless, we do not believe that AAS patients should undergo a mandatory cardiological follow-up. The larger PFOs or those with significant resting shunts should require a follow-up based on specific patient characteristics.