The Journal of Pediatric Academy

A Rare Case of Osteoblastoma of the Sacrum

Şule Çalışkan Kamış — 2024-11-11

Osteoblastoma (OB) is a rare bone tumor. It is classified as benign and represents about 1% of all bone neoplasms. While it typically occurs in the axial skeleton, sacral involvement is extremely rare. Despite its non-malignant nature, OB can be locally aggressive and may lead to considerable morbidity if not addressed in a timely manner. This report discusses a unique case of sacral, focusing on the clinical, radiological, and surgical features.
A 14-year-old male patient reported experiencing increasing pain in his left lower limb and lumbosacral region for two years. A magnetic resonance imaging (MRI) of the lumbosacral area identified a mass measuring 50x43 mm on the left side of the sacrum in T2-weighted images. Further evaluation with a positron emission tomography/computerized tomography (PET/CT) scan indicated a destructive bone lesion in the left sacrum, measuring 43x40 mm, with a soft tissue component and increased fluorodeoxyglucose (FDG) uptake (standardized uptake value maximum: 11). The patient underwent surgical excision by a neurosurgery team, and histopathological analysis confirmed the diagnosis of OB.
Although OB is a benign tumor, its location can cause significant symptoms, particularly in rare areas like the sacrum. Diagnostic imaging modalities such as MRI and PET/CT are crucial for identifying the tumor and planning surgical intervention. The elevated FDG uptake observed on PET/CT indicated a metabolically active lesion, reinforcing the need for surgical treatment.
Sacral OB is an exceptionally rare entity. This case underscores the need to include OB in the differential diagnosis of sacral lesions and illustrates the value of imaging in facilitating accurate diagnosis and management. Surgical resection remains the cornerstone of treatment, offering good clinical outcomes.

Retrospective Evaluation of the Complications and Risk Factors Related to Cardiac Catheterization: Single Center Experience

Pembe Soylu Üstkoyuncu — 2025-03-04

Cardiac catheterization is an invasive procedure that carries the risk of life-threatening complications. The aim of our study is to evaluate the risk factors and complications of cardiac catheterization procedures performed over a 14-year period at the Department of Pediatric Cardiology, Erciyes University Faculty of Medicine. Complications of 2265 cardiac catheterization procedures in 1880 different patients between September 16, 1995, and December 30, 2009, along with risk factors, were evaluated. Complications occurred in 169 (7.5%) of the 2265 cardiac catheterizations. One hundred and twenty-four (5.5%) were minor and 45 (2%) were major complications. Among 1880 patients, 6 patients (0.31%) died within the first 24 hours. A statistically significant difference was observed between the type of procedure and anesthesia used when comparing minor and major complications. The overall complication rate was 12.9% in patients under one year of age, 11.3% in the cyanotic heart disease group, 8.7% in therapeutic procedures, and 10.9% in patients with a body weight of less than 10 kg. Retrospective studies examining risk factors and complications in cardiac catheterization procedures will provide insights for prospective studies.

Effects of a School-based Multicomponent Intervention on the Behavior and Anthropometry of Overweight and Obese Children Aged 10-13 Years-a Randomized Control Trial

Tejaswini Manogna — 2025-03-05

Obesity is a growing concern in developing countries and is associated with significant mortality and morbidity in childhood. It is attributed to an interplay of environmental and genetic factors. There is a notable difficulty in addressing the various dimensions of managing obesity and hence a combination of interventions incorporating physical activity, education on healthy lifestyle and family involvement becomes a necessity. We aimed to evaluate the effects of a school-based multicomponent intervention (integrating health education, yoga, and parental involvement) on the anthropometric measures and healthy lifestyle behavior of obese and overweight children aged 10-13 years in Puducherry, India. The study included 120 overweight and obese children aged 10-13 years, in two randomly selected urban schools. The children were then randomized to intervention (60) and control (60) groups. The intervention group received health education classes, Yoga classes by certified yoga trainers and parental counseling for 3 months. The control group received routine counseling. Anthropometric measures such as body mass index (BMI), waist-to-hip ratio (WHR), and healthy lifestyle scoring in three domains (nutrition, physical activity levels, and screen time) were assessed pre- and post-intervention for both groups after 3 months. The intervention group showed significant reduction in BMI (p=0.017), WHR (p=0.003), and improvement in behavior scores of nutrition (p<0.001), physical activity (p<0.001), and reduced screen time (p<0.001) at 3 months post-intervention. No significant changes were observed in the control group on follow-up after 3 months. Thus, we conclude that a school-based multi faceted intervention is an effective program in combating childhood obesity. We recommend long-term follow-up studies on these interventions to discern the sustainable results of such interventions.

Acute Kidney Injury As A Consequence of Perinatal Asphyxia

Obaydur Rahman — 2025-03-14

Perinatal asphyxia (PNA) results in multiorgan damage including the kidney. The severity of kidney damage is related to the extent of central nervous system damage. This study aimed to determine the prevalence of acute kidney injury (AKI) in neonates with PNA and its association with hypoxic ischemic encephalopathy (HIE) staging. This cross-sectional study was conducted in the neonatal intensive care unit of the Institute of Child and Mother Health, Dhaka, from July 2020 to June 2021. A total of 100 neonates with PNA were included in this study. After careful history taking, examination, and appropriate investigations, HIE staging was done in each subject using the Sarnat and Sarnat method. Data were analyzed by statistical package for the social sciences, version 23. In this study, 45 (45.0%) neonates belonged to the postnatal age group ≤24 hours, and male patients were predominant (57.0%). Out of 100 neonates, 89.0% had HIE stage II and 11.0% had stage III. Among stage II HIE neonates, 9 (10.1%) had AKI and 80 (89.9%) did not have AKI. Among stage III HIE neonates, 5 (45.5%) had AKI and 6 (54.5%) did not have AKI. The difference was statistically significant (p<0.05). When HIE stage was higher in PNA patients, there was a higher possibility of developing AKI. Renal function alterations correlated with HIE severity. Therefore, AKI should be evaluated and properly managed among neonates with PNA.

Predictive Value of Maternal Systemic Inflammatory Markers in Treatment-Requiring Retinopathy of Prematurity

Çağatay Karaca — 2025-03-18

The aim of the study was to investigate the predictive value of maternal systemic inflammatory markers such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), systemic immune-inflammatory index (SII), platelet mass index (PMI) and mean platelet volume (mPV) in treatment-requiring retinopathy of prematurity (TR-ROP). In this retrospective study, 19 mothers whose preterm infants required treatment (intravitreal injection) for ROP were included in the TR-ROP group. Twenty-one mothers whose preterm infants did not require treatment for ROP were included in the control group. Birth weights (BWs) and gestational age (GA) were recorded. Maternal complete blood count samples obtained within 3 days before delivery were analyzed. Maternal NLR, PLR, LMR, SII, PMI and mPV data were calculated and statistically compared. All data were analyzed using statistical package for the social sciences, version 22.0 (SPSS, Chicago, IL, USA). There was no significant difference between the groups in terms of BW (p=0.108). The GA was significantly lower in the TR-ROP group compared to the control group [28 (24-33), 30 (27-32), p=0.04, respectively]. NLR, PLR, LMR and SII values were 5.9/4.2 (p=0.02), 143.8±26.3/123.1±36.2 (p=0.02), 2.06/3.01 (p=0.001), 1279/1040 (p=0.05) between the TR-ROP and control groups, respectively. In the TR-ROP group, when these values were corrected according to the GA in logistic regression analysis, the NLR, PLR, and SII were not statistically significant (p=0.11, p=0.83 and p=0.13), but there was an increase in the LMR [p=0.02, odds ratio=0.38 95% confidence interval (0.16-0.88)]. The relationship of maternal SII, PMI and mPV parameters with TR-ROP was shown for the first time in this study. Maternal LMR in the prenatal period may be helpful in predicting TR-ROP. Additional studies are needed before these conclusions can be applied to daily clinical practice.

Pediatric Hyperprolactinemia: Clinical Features, Diagnostic Groups, and Treatment Approaches

Emel Hatun Aytaç Kaplan — 2025-03-24

Hyperprolactinemia (HPRL) is a rare endocrinopathy in childhood caused by tumors, pituitary stalk interruption, and systemic diseases. In this retrospective study, we examined the clinical characteristics of pediatric patients with prolactin (PRL) elevation. The study examined 70 pediatric and adolescent patients with elevated PRL. The patients (52 female, 18 male; age range, 0.03-18) were divided into two groups: Physiological (n=46, 65.7%) and pathological (iatrogenic+sellar mass) (n=24, 34.3%) HPRL. Six patients (8.6%) were included in the pathological group due to iatrogenic causes and 18 patients (25.7%) due to a sellar mass. Subdiagnostic groups were found in the pathological group: 14 patients with prolactinoma (10 microadenomas; 4 macroadenomas), 6 patients with drug-induced HPRL, 2 patients with craniopharyngioma, 1 patient with dysgerminoma, and 1 patient with tuberculoma. Symptoms such as headache (p=0.004), galactorrhea (p=0.000), amenorrhea (p=0.037), and menstrual irregularity (p=0.037) were more common in the pathological group. Short stature and early thelarche complaints were more common in the physiological group (p=0.004, p=0.045, respectively). The presence of galactorrhea was significant in predicting pathological PRL elevation (p=0.002) (odds ratio=56.1%, 95% confidence interval=4.33-728.1). Twenty-seven point one percent (n=19) received cabergoline treatment, and 8.5% (n=6) received levothyroxine treatment. Three patients underwent surgical treatment for dysgerminoma and craniopharyngioma, respectively. The probability of detecting HPRL is high in the presence of galactorrhea. In prolactinoma, if there are significant pituitary compression symptoms, the disease can be controlled with medical treatment.

Ballantyne Syndrome-The Uncommon in Common Rh Isommunization

Dasari Varun Kumar — 2025-02-10