Pediatric Review: International Journal of Pediatric Research

Assessment of sexual assaults in pediatric settings at the Sourô Sanou University Hospital in Bobo-Dioulasso

Makoura Barro — 2024-09-24

Introduction: Sexual assault is a worldwide public health problem. It is one of the most appalling forms of child abuse. The aim is to take stock of sexual assaults in pediatric settings at the Souro Sanou University Hospital in Bobo-Dioulasso.

Methods: This was a descriptive, prospective study covering the period from 2013 to 2021. All children victims of sexual abuse aged between 0 and 15 years were included. Descriptive statistics were used

Results: we had a sample of 32 patients, 31 females. Mean age was 9.23 years. The children were most often abused during working hours (68.75%), outside the family environment (90.62%), by a single aggressor (78.125%) belonging to the victim's entourage (68.75%). For most of our victims, this was the first episode (87.5%), and genital contact was the most frequent form of sexual contact, with vaginal penetration in (71.87%) of cases. In half the cases, the assailant had used physical force; in 18.75% of cases, a knife was used, and in 6.25% of cases, the assailant was under the influence of drugs. Less than half the victims had consulted within 72 hours, and the genital examination revealed vulvar ulcerations in 37.5% of cases, and hymenal damage in 28.12%. HIV serology was carried out in all patients, 75% had hepatitis B serology and 62.5% had syphilitic serology. Pregnancy tests were performed in 7 patients. None of these tests came back positive.

Conclusion: Sexual assault of children, a very sensitive subject often hushed up, remains a reality in our country.

Frequency of Meningitis in Late Onset Neonatal Sepsis-A cross sectional descriptive study

Lubna Ahmed — 2024-09-30

Background: Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteraemia in the first month of life. It is responsible for about 30-50% of the total neonatal deaths in developing countries. Neonatal sepsis can be divided into two sub-types depending upon whether the onset of symptoms is within the first 72 hours of life (Early Onset Neonatal Sepsis) or after 72 hours of life (Late Onset Neonatal Sepsis). Meningitis is an important complication of late onset neonatal sepsis. Objectives: To observe characteristic of Cerebrospinal Fluid (CSF) findings in Late Onset Neonatal Sepsis. Methods: It was a cross sectional descriptive study carried out in Department of Neonatology SSMCMH, Dhaka. Duration of study was November 2019 to October 2020.Total 60 neonates fulfilling the inclusion criteria were included and subjected to detailed history, clinical examination followed by investigations. All babies with LONS underwent lumbar puncture and CSF was sent to laboratory for cytology, biochemistry and culture and sensitivity. Results: Among the 60 newborn studied, mean age of neonates was 12.45 ± 7.16 days with male to female ratio of 1.1:1. Frequency of Meningitis in babies with late onset sepsis was 21.7% (13 out of 60).Conclusion: Meningitis is commonly associated with late onset neonatal sepsis hence LP should be done as standard protocol in such neonates. This study demonstrated that frequency of meningitis in late onset neonatal sepsis was 21.7% (13/60).

Wilms Tumor Treatment Outcome in Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh

Md. Abdul Wohab — 2024-09-30

Background: Wilms tumor is the commonest renal malignancy in childhood. Survival in high-income countries is approximately 90%, whereas in low-income countries, it is less than 60%. This study assessed treatment outcomes of patients with Wilms tumor at Bangladesh Shishu Hospital & Institute.

Patients and Methods: We conducted a prospective study in all children diagnosed with Wilms tumor between July 2020 and July 2024. Total 30 patients of Wilms tumor were enrolled in our study, Data were collected such as treatment outcomes and various socio demographic and clinical characteristics and recorded in sheet.

Results: Of the 30 patients with Wilms tumor, 73.33% had event-free survival, 20% had relapsed, 6.67% died. Patients presented as follows-stage I (20%), II (25%), III (35%), IV (15%), or V (5%). The most likely treatment outcome in patients with low-stage (I to II) disease was event-free survival (100%), whereas in those with high-stage (III,IV and V) disease, it was 46.67%. No deaths or instances of progressive or relapsed disease were recorded among patients with low-stage disease. Stage of disease significantly affected treatment outcomes (P =0 .01) and event-free survival estimates (P < .001). Age at diagnosis, sex, duration of symptoms did not statistically significantly influence treatment outcomes or event-free survival estimates.

Conclusion: Survival of patients with Wilms tumor in Bangladesh is lower compared with that in high-income countries. Treatment abandonment is the most common cause of treatment failure. Stage of disease at diagnosis statistically significantly affects treatment outcomes and survival.

Stressors encountered by the parents due to planned surgery of the child

Akanksha Anjali — 2024-10-02

The child's surgery is a significant event in their life, affecting both the child and their parents. Parents face many difficulties as a result of their extreme anguish while witnessing their child in agony. In addition to the child's surgery, parental anxiety is a significant issue that might impact the child's recovery, post-operative care, mental health, and relationship with their parents. The health of the parent will likewise be impacted in the same manner as the child. In this review, discussion has been done over the stressors encountered by the parents due to planned surgery of the child, its effect on the child as well as parents, and strategies to reduce parental anxiety before surgery of the child.

Striking the Right Balance: A Review of Pre-procedural Fasting Protocols and their Impact on Pediatric Patients

Satyam Vada — 2024-10-02

Introduction: Preoperative fasting guidelines have evolved from Sir Joseph Lister's 1883 recommendations to more flexible protocols such as the 1999 American Society of Anaesthesiologists’ 6-4-2 rule and 2022 6-4-1 regimen. Despite these updates, outdated practices still lead to prolonged fasting and related complications. Aim: This scoping review evaluates current preoperative fasting protocols for Pediatric patients, assesses their impact on outcomes, and identifies areas for improvement to balance aspiration risks with the adverse effects of prolonged fasting. Methodology: An orderly search was conducted across PubMed, Scopus, Science Direct, etc., (up to June 10, 2024) using Boolean operators and keywords like "pre-procedural fasting," "protocols," "children," and "influencing factors" to select relevant studies based on inclusion criteria. Results: Prolonged fasting, sometimes up to 16 hours, causes discomfort and increases risks of hypotension, nausea, and hypoglycemia. Challenges include outdated practices, unpredictable surgical schedules, and communication gaps, leading to non-compliance and cancellations. Modern guidelines balance benefits and risks by incorporating a better understanding of gastric emptying and child comfort. Conclusion: Optimizing preoperative fasting for pediatric patients requires flexible protocols, enhanced family education, and improved healthcare team coordination. Continued research and a multidisciplinary approach are essential for refining practices, improving outcomes, and increasing satisfaction.

Factors Hindering Compliance with Exclusive Breastfeeding Practices Among Mothers: A Narrative Review

Priya Kadiyan — 2024-10-17

Introduction: Commencing a child's developmental path with the unparalleled advantages of exclusive breastfeeding establishes the cornerstone for optimal health. Despite understanding the importance of exclusive breastfeeding (EBF), many mothers still face challenges in adhering to it. The objective of this review is to thoroughly delineate the barriers to exclusive breastfeeding.

Methods: Searches were conducted using PubMed, Google Scholar, and manually to retrieve studies from 2014-2024. Using our inclusion criteria, we selected studies that described barriers to exclusive breastfeeding. Qualitative and quantitative studies and survey reports published in English were considered. The descriptors used in this study were: factors, determinants, causes, barriers, hindering, influencing, and exclusive breastfeeding. Thirty-two studies from various countries were included.

Result: Out of the 244 articles identified, 32 met the inclusion criteria. Most of the included studies were cross-sectional and were published between 2014 and 2024. Evidence indicates that breastfeeding support is crucial for extending both the duration and exclusivity of breastfeeding. Factors such as physiological issues, health-related barriers, and limitations within the healthcare system significantly impact exclusive breastfeeding practices. Interventions addressing these factors are essential for improving exclusive breastfeeding rates and enhancing maternal and child health outcomes.

Conclusion: Despite being widely practiced, exclusive breastfeeding (EBF) rates remain low due to challenges faced by many mothers. Addressing these barriers through targeted interventions during antenatal and postnatal education can help improve and sustain EBF practices.