The Journal of Pediatric Academy

Hirschsprung Disease in a Female Infant: A Case Report

Alejandro Rojas-Urrea — 2024-12-31

Hirschsprung’s disease (HD) is a congenital disease characterized by the absence of ganglion cells in the intestinal muscularis nerve plexus. The segment most affected was the rectosigmoid colon (80%). The clinical manifestations are non-specific; the common signs include vomiting, abdominal distention, and defecation alterations in early-life another feasible alteration is anemia. Anorectal manometry and contrast enemas are also highly useful. We present the case of a 9-month-old female with refractory constipation who was diagnosed with HD. Some theories explain that there is dysregulation of the microecological balance and intestinal mucosa. Imaging diagnostic methods are useful tools for screening HD. The mortality rate of these conditions is between 2% and 5%; therefore, a group of qualified professionals is necessary for treatment and postsurgical care.

First Cases of Transplacental Transmission of Anaplasma spp. in Gabon: Cases Reports and Brief Review of the Literature

Lambert Mulakwa Morisho — 2024-11-11

Anaplasma spp. is an emerging human zoonosis, usually transmitted by tick bites. Human-to-human transmission is rare, and transplacental transmission is even less common. No cases of transplacental transmission have been previously reported. We report the cases of patients who were followed up for febrile syndrome diagnosed with maternal-fetal infection and treated with antibiotic therapy and hemodynamic correction. Investigation of the etiology revealed Anaplasma spp. in a neonatal infection. These cases prove that transplacental transmission of Anaplasma spp. is possible and that surveillance is important.

Retrospective Analysis of Transfusion-Related Adverse Reactions: A 15-Month Study of a Single Center’s Experience

Şule Çalışkan Kamış — 2024-09-09

The aim of this study was to evaluate transfusion-related adverse reactions (TRARs). In this study, all adverse reactions (ARs) related to blood/blood product transfusions conducted between 01.01.2022 and 31.03.2023 at the Health Sciences University Türkiye, Adana City Training and Research Hospital were evaluated. In total, 97,926 records of blood and blood component transfusions were evaluated during the study period. The distribution of blood components used was as follows: 57,066 (58.2%) red blood cell concentrates, 27,345 (28%) fresh frozen plasma, 12,282 (12.5%) pooled platelet concentrates, 564 (0.6%) apheresis platelet concentrates, and 669 (0.7%) cryoprecipitates. In total, 40 AR reports were associated with transfusions. The probability levels of the relationship degrees of reactions for these 40 cases were as follows: 2 cases; not likely (5%); 32 cases; likely (80%); 2 cases; highly likely (5%); and 4 cases, unassessable (10%). All unwanted reactions were acute, and there were no delayed reactions. No transfusion reaction (TR) leading to death occurred. Of the patients who developed reactions, 60% (n=24) were female, and 40% (n=16) were male. The ages of patients with unwanted reactions ranged from 2 to 86 years, with a median age of 33. Among the cases with unwanted reactions, 8 were children (20%) and 32 were adults (80%). In our study, the frequency of allergic TR was 8.1 per 100,000 children and 32.6 per 100,000 adults. A statistically significant difference in the distribution of blood component types among cases based on the types of unwanted reaction was observed (p=0.003).

Do Vitamin D Levels Play a Role in Urinary Tract Infection in Children?

Gökçe Mergan Çetiner — 2024-09-24

Previous studies have shown the protective effects of vitamin D supplementation against urinary tract infection (UTI). However, there are a few contradictory studies on the negative effect of vitamin D supplementation on UTI. Our objective was to establish whether there existed a relationship between serum vitamin D levels and UTIs in children. This study compared the serum 25-hydroxy vitamin D [25(OH)D] levels of children diagnosed with UTIs with those of healthy children (control group). We found a high rate of 25(OH)D deficiency in both the control and case groups (90% and 66.7%, respectively). Therefore, we added the laboratory parameters calcium, phosphate, and parathormone (PTH) to our analysis. We assessed the medical records of 60 patients diagnosed with UTIs and 20 healthy controls. The mean serum 25(OH)D level and PTH level were significantly higher in the patient group than in the control group. The PTH level was significantly lower in the acute pyelonephritis (APN) group than in the control group (p=0.016). Phosphate levels in the APN group were significantly lower than those in the control and cystitis groups (p=0.04, p=0.006 respectively). Because there was no correlation between 25(OH)D level and UTI, we concluded that 25(OH)D had no effect on UTI.

Detection of Neurological Complications by Cranial Ultrasound in Neonatal Sepsis: A Cross-sectional Study

Nadia Hossain — 2024-12-31

Neonates with sepsis are at risk of neurological complications. Cranial ultrasound (CUS) has been widely used in neonates for early detection of these intra-cranial abnormalities. It is a convenient, non-invasive, safe with no radiation exposure and quick imaging technique to visualize the neonatal brain parenchyma and ventricular system. To detect neurological complications in neonates with sepsis by CUS. This cross-sectional study was conducted in Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from June 2019 to September 2020. Inborn neonates with sepsis and inborn preterm neonates without sepsis satisfying the inclusion and exclusion criteria who were admitted into neonatal intensive care unit (NICU), BSMMU during study period were the study population. Among 110 neonates, 75 neonates with sepsis and 35 pre-term neonates without sepsis were assessed for eligibility. Among these 75 septic neonates 19 were excluded. Finally,56 septic neonates were analyzed. Out of them 21 (37.5%) neonates had abnormal neurological findings in CUS. Distribution of abnormal CUS findings were intraventricular hemorrhage (33%), features of meningitis (24%), hydrocephalus (14%), prominent lateral and third ventricles (10%), intracerebral hemorrhage (5%), features of ventriculitis (5%). Among 35 non-septic pre-term neonates, 5 were excluded due to guardians did not give consent to perform CUS. So, 30 non-septic pre-term neonates were analyzed, among them, 2 neonates (7%) had feature of intraventricular hemorrhage in CUS. Septic neonates with abnormal CUS findings, most of the neonates were male (71%), gestational age (34.57±3.043) weeks and birth weight (1985.2±684.132) gm. In babies with abnormal CUS, convulsion was significantly associated (p value 0.01). This study showed proven sepsis was significantly associated with abnormal CUS findings. The abnormal CUS findings in newborn with sepsis was 37.5%. So CUS may be an important investigatory modality in NICU for early detection of intracranial complications.

Variations of 25-Hydroxyvitamin D Levels During COVID-19 Pandemic and its Relation to Season, Sex and Age in Children

Sadiye Sert — 2024-12-31

We aimed to investigate variations in vitamin D levels (VDLs) during the coronavirus disease-19 pandemic and their relationship to season, sex, and age in otherwise healthy children and adolescents. We conducted a retrospective cross-sectional study at an outpatient pediatric clinic, which included 4,262 children aged 1-18 years. The study cohort was divided into three groups: Group 1 (pre-pandemic), Group 2 (pandemic), and Group 3 (post-pandemic). Vitamin D deficiency (VDD) was defined as a level below 12 ng/mL, insufficiency as a level between 12 and 20 ng/mL, and sufficiency as a serum level above 20 ng/mL. The pandemic cohort exhibited significantly lower VDLs compared with both the pre-pandemic and post-pandemic cohorts. Females had significantly lower VDLs than males. The prevalence of VDD was highest among adolescents. A significantly higher rate of VDD was observed in the pandemic group among the 6-11 and 12-18 age groups compared with both the pre-pandemic and post-pandemic groups. VDLs were significantly lower in spring and winter than in summer and autumn. Additionally, an inverse relationship was observed between age and VDLs. Our study revealed a significant prevalence of VDD in school-aged children and adolescents, with a notable decrease in VDLs observed during the pandemic compared with other time periods. Furthermore, our study highlighted the increased vulnerability of female adolescents to VDD.

Can Mean Platelet Volume be an Inflammatory Marker in Pediatric Diabetic Ketoacidosis?

Gül Trabzon — 2024-12-31

This study explores the association between mean platelet volume (MPV) and other hematological parameters in children with diabetic ketoacidosis (DKA), aiming to identify hematological changes and their implications for management and treatment strategies in pediatric type 1 diabetes mellitus (T1DM). In a retrospective, two-center analysis of 323 children, participants were categorized into three groups: DKA, T1DM without ketoacidosis, and healthy controls (95). Hematological parameters and HbA1c levels were collected. Blood pH levels classified DKA severity, and statistical analyses included One-way ANOVA, correlation tests, receiver operating characteristic curve analysis, and logistic regression to assess the predictive value of hematological parameters for DKA. No significant demographic differences were noted among the groups. Patients with DKA exhibited significantly lower MPV and higher neutrophil-to-lymphocyte ratio (NLR) compared with both patients with T1DM without ketoacidosis and healthy controls. Logistic regression showed MPV ≤9.35 and NLR ≥2.73 significantly increased DKA risk. This study demonstrated a significant relationship between DKA and altered hematological parameters (MPV and NLR) in pediatric patients, highlighting their potential as markers for early detection and risk assessment of DKA.