Negative efficacy of antidepressants in pharmacotherapy of child and adolescent depression

Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines still recommend the use of antidepressants,especially specific serotonin re-uptake inhibitors.Previous studies have suggested that antidepressants have little therapeutic effect but many side effects,such as switching to mania,suicide,and non-suicidal self injury(NSSI),in the treatment of child and adolescent depression.In the process of developing guidelines,drug recommendations should not only focus on impro-ving symptoms,but they should also consider potential side effects.This review discusses the serious side effects of antidepressants,including switching to mania,suicide,and NSSI.

Association of preschool children behavior and emotional problems with the parenting behavior of both parents

BACKGROUND Parental behaviors are key in shaping children’s psychological and behavioral development,crucial for early identification and prevention of mental health issues,reducing psychological trauma in childhood.AIM To investigate the relationship between parenting behaviors and behavioral and emotional issues in preschool children.METHODS From October 2017 to May 2018,7 kindergartens in Ma’anshan City were selected to conduct a parent self-filled questionnaire-Health Development Survey of Preschool Children.Children’s Strength and Difficulties Questionnaire(Parent Version)was applied to measures the children’s behavioral and emotional performance.Parenting behavior was evaluated using the Parental Behavior Inventory.Binomial logistic regression model was used to analyze the association between the detection rate of preschool children’s behavior and emotional problems and their parenting behaviors.RESULTS High level of parental support/participation was negatively correlated with conduct problems,abnormal hyperactivity,abnormal total difficulty scores and abnormal prosocial behavior problems.High level of maternal support/participation was negatively correlated with abnormal emotional symptoms and abnormal peer interaction in children.High level of parental hostility/coercion was positively correlated with abnormal emotional symptoms,abnormal conduct problems,abnormal hyperactivity,abnormal peer interaction,and abnormal total difficulty scores in children(all P<0.05).Moreover,paternal parenting behaviors had similarly effects on behavior and emotional problems of preschool children compared with maternal parenting behaviors(all P>0.05),after calculating ratio of odds ratio values.CONCLUSION Our study found that parenting behaviors are associated with behavioral and emotional issues in preschool children.Overall,the more supportive or involved the parents are,the fewer behavioral and emotional problems the children experience;conversely,the more hostile or controlling the parents are,the more behavioral and emotional problems the children face.Moreover,the impact of fathers’parenting behaviors on preschool children’s behavior and emotions is no less significant than that of mothers’parenting behaviors.

The Development of a Feeding Coparenting Scale for Japanese Parents of Fifth- and Sixth-Grade Elementary School Children

Aim: Recently, the role of feeding coparenting has gained attention in the child eating research field. The Feeding Coparenting Scale (FCS), a measure of how caregivers interact with their partners when feeding their children was developed in the United States in 2019. However, there is no valid and reliable measure to assess feeding coparenting among caregivers of school-aged children in Japan. Therefore, this study aimed to develop a Japanese version of the FCS (FCS-J) questionnaire for caregivers with school-aged children. Methods: This was a web-based cross-sectional survey completed by caregivers of children aged 10-12 years. A preliminary survey using interviews and a web-based survey was conducted and found that the translated items of the FCS into Japanese were understandable to Japanese people. The developed survey was administered to parents of children at an elementary school. The reliability of the survey was assessed using both test-retest reliability and internal consistency analysis. Exploratory factor analysis was used to test construct validity, and known population validity was examined in relation to attributes, marital satisfaction, and feeding tasks. Results: Findings with 135 parents of school-aged children showed good internal reliability and validity of the FCS-J. The mean score for the overall FCS-J score was 46.2 (SD = 6.2), with Cronbach’s α of 0.72. For the subscales, Cronbach’s α ranged from 0.75 to 0.79. In sum, the present study’s results support the three-factor structure of the FCS in Japanese caregivers in Japan. Conclusions: The developed FCS-J was found to have a certain degree of reliability and validity. In this study, a Japanese version of the FCS-J was developed. .

Main focus of parents of children with attention deficit hyperactivity disorder and the effectiveness of early clinical screening

BACKGROUND Attention deficit hyperactivity disorder(ADHD)is a common mental and behavioral disorder among children.AIM To explore the focus of attention deficit hyperactivity disorder parents and the effectiveness of early clinical screening METHODS This study found that the main directions of parents seeking medical help were short attention time for children under 7 years old(16.6%)and poor academic performance for children over 7 years old(12.1%).We employed a two-stage experiment to diagnose ADHD.Among the 5683 children evaluated from 2018 to 2021,360 met the DSM-5 criteria.Those diagnosed with ADHD underwent assessments for letter,number,and figure attention.Following the exclusion of ADHD-H diagnoses,the detection rate rose to 96.0%,with 310 out of 323 cases identified.RESULTS This study yielded insights into the primary concerns of parents regarding their children's symptoms and validated the efficacy of a straightforward diagnostic test,offering valuable guidance for directing ADHD treatment,facilitating early detection,and enabling timely intervention.Our research delved into the predominant worries of parents across various age groups.Furthermore,we showcased the precision of the simple exclusion experiment in discerning between ADHD-I and ADHD-C in children.CONCLUSION Our study will help diagnose and guide future treatment directions for ADHD.

Knowledge and practice skills on home-based urinary catheter care among parents of under-five children with urinary catheter

Objectives:The objectives of this study were to assess the knowledge and practice skills on home-based urinary catheter care among parents of under-five children with urinary catheter.Materials and Methods:This cross-sectional study was conducted from June 1,2021,to September 11,2021,in a tertiary hospital in north India.Purposive sampling was used to select 50 participants.Three instruments were employed for data collection after fulfilling sample criteria;for baseline information demographic tool,knowledge questionnaires,and a practice checklist.Data were analyzed using descriptive and inferential statistics.Results:On assessment of 50 participants,the majority of parents aged above 30 years(74%).Most of the participants were male(82%),graduated(38%),and working in the private sector(58%).Similarly,two-thirds of participants were residing in a nuclear family(64%)with a single child 32(64%)and family income<5000 rupees per month(60%).The mean score of knowledge was 1.94±0.81 and that of practice skills was 1.98±0.85 on home-based care.Regression analysis showed that knowledge of parents was significantly associated with qualification(β:1.821,P=0.002).Similarly,association of practice skills of parents with gender(β:1.235,P=0.050)and qualification(β:1.889,P=0.00)was significant.Conclusion:The general findings of our study showed that parents’education and occupation played a significant role in a child’s care.Parental education and catheter care skills positively affect the child and reduce readmission rates.

Parents’s knowledge and awareness about hepatitis B can influence the vaccination of their children

BACKGROUND Birth-dose(Hep-BD)followed by three additional doses(Hep-B3)of hepatitis B virus(HBV)vaccine are key to eliminating HBV by 2030.Unfortunately,Hep-BD and Hep-B3 coverage in our country is poor.AIM To studied the parent’s knowledge and awareness about HBV infection,its prevention,consequences and vaccination.METHODS Parents of 6 months to 8 years old children were interviewed to assess their knowledge&awareness about hepatitis B,its transmission,prevention,illness caused by this,and vaccination.Eighteen close-ended questions were admini-stered,and responses were recorded as‘yes’,‘no’,or‘not sure’.HBV knowledge score was calculated based on the sum of correct answers.Each correct response scored one point and incorrect,missing or‘not sure’responses received no points.Categorical data are presented as number(%)and numerical data are expressed as median.Data were compared using Chi2 tests and level of significance was kept as P<0.05.RESULTS Parents(58.3%mothers)of 384 children(89.9%age<5 years;82%age-appropriately vaccinated)were included.Three hundred and twenty-two(83.9%)children were Hep-B3 vaccinated.94.3%,87.5%,and 29.2%parents knew about polio,tetanus,and hepatitis B vaccine.Overall,41.2%,15.8%,and 23%parents knew about hepatitis B transmission,consequences of infection,and prevention respectively.Only 7.6%parents knew about three-dose schedule of hepatitis B vaccination.Only 23%parents believed that vaccine could prevent HBV,15.7%knew that HBV affects liver.Parents of Hep-B3 vaccinated children were significantly more aware about HBV than the parents of unvaccinated children(P<0.05 for 17/18 questions).CONCLUSION The knowledge and awareness among the parents about hepatitis B is poor.The Increasing knowledge/awareness about HBV among parents may improve Hep-B3 vaccination coverage.

Exploring the Views of Parents of Children Following Telephone Advice from Nurses Working in a GP Out-of-Hours in Ireland

This paper focuses on parents’ use and experiences of general practitioner (GP) out-of-hours (OOHs) services in Ireland. The progress in the establishment of GP OOHs services is considered by the Health Service Executive (HSE) to be a highly significant quality initiative for patient care, and the health service as a whole. Outside of normal GP surgery hours, parents of children can call a dedicated telephone number, to have their urgent health concerns assessed and to be advised about the appropriate level of care. Experienced nurses, who are often based in a GP OOHs centre, assess the call over the telephone and provide advice to the callers. The spur for conducting this study arose from my personal and professional experience which, I believe, underscores the need for exploring and understanding parents’ views of GP OOHs services, in order to bring about change in nurses’ practice of delivering advice over the telephone. The overall aim of the study is to explore and understand the views of parents of children, aged two years and under, following telephone advice received from nurses in the context of a GP out-of-hours service. A qualitative, exploratory, and descriptive design was used to examine the views and experiences of parents of children aged two years and under, who used a GP out-of-hours service provider in Ireland. Nine parents who had received phone advice from a nurse were purposively sampled to take part in the study. Data were collected using semi-structured interviews by telephone. Data were transcribed and analysed thematically. Themes included parents’ perceptions of illness in children with the need to be heard, parents’ views about accessibility to GP OOHs, parents’ expectations that the service would offer guidance and reassurance, parents’ satisfaction with the nurse’s advice, and parents’ experiences of hospital emergency departments (EDs). Suggestions for improving the GP OOHs service were made across these themes. The suggestions include: higher staffing levels, wanting a quicker call back, preference for face-to-face assessment over telephone advice and a preference for a children’s area in the GP OOHs. The study revealed that parents are satisfied with the GP OOHs service and the parental decision-making model has the potential to provide an opportunity to continue the progress of the establishment of GP OOHs services in Ireland.

Studies on Endogenous Hormones and Nutritional Physiology Related to the Premature Senescence of Super-hybrid Rice Liangyoupeijiu and Its Parents at Late Growth Stage

The amount of root bleeding sap, contents of chlorophyl , nutrients and hormones in flag leaves of a super-hybrid rice cultivar Liangyoupeijiu （LYPJ） and its parents 9311 and Pei’ai 64S after heading were measured in this study. The re-sults revealed that compared with 9311, the chlorophyl content of LYPJ reduced more quickly after heading, and then kept at a lower level, which was an obvious characteristic of premature senescence. The other physiological indices of LYPJ af-ter heading except abscisic acid （ABA） content in leaf and root also maintained at a lower level than 9311, while al the physiological indices of the sterile line Pei＇ai 64S were lower than LYPJ. So it was speculated that the early-aging characteristic of LYPJ may be inherited from Pei’ai 64S. Al the leaf and root early-aging traits reduced for LYPJ and its parent lines after heading, their leaf and root aged grad-ual y, which indicated that the above-ground （leaf） and under-ground （root） parts cor-related to each other closely, but there was not absolute correlations between them judged from the data.

Global trends and hotspots of type 2 diabetes in children and adolescents:A bibliometric study and visualization analysis

BACKGROUND Epidemiological surveys indicate an increasing incidence of type 2 diabetes mellitus(T2DM)among children and adolescents worldwide.Due to rapid disease progression,severe long-term cardiorenal complications,a lack of effective treatment strategies,and substantial socioeconomic burdens,it has become an urgent public health issue that requires management and resolution.Adolescent T2DM differs from adult T2DM.Despite a significant increase in our understanding of youth-onset T2DM over the past two decades,the related review and evidence-based content remain limited.AIM To visualize the hotspots and trends in pediatric and adolescent T2DM research and to forecast their future research themes.METHODS This study utilized the terms“children”,“adolescents”,and“type 2 diabetes”,retrieving relevant articles published between 1983 and 2023 from three citation databases within the Web of Science Core Collection(SCI,SSCI,ESCI).Utilizing CiteSpace and VoSviewer software,we analyze and visually represent the annual output of literature,countries involved,and participating institutions.This allows us to predict trends in this research field.Our analysis encompasses co-cited authors,journal overlays,citation overlays,time-zone views,keyword analysis,and reference analysis,etc.RESULTS A total of 9210 articles were included,and the annual publication volume in this field showed a steady growth trend.The United States had the highest number of publications and the highest H-index.The United States also had the most research institutions and the strongest research capacity.The global hot journals were primarily diabetes professional journals but also included journals related to nutrition,endocrinology,and metabolism.Keyword analysis showed that research related to endothelial dysfunction,exposure risk,cardiac metabolic risk,changes in gut microbiota,the impact on comorbidities and outcomes,etc.,were emerging keywords.They have maintained their popularity in this field,suggesting that these areas have garnered significant research interest in recent years.CONCLUSION Pediatric and adolescent T2DM is increasingly drawing global attention,with genes,behaviors,environmental factors,and multisystemic interventions potentially emerging as future research hot spots.

Unraveling the landscape of pediatric pancreatic tumors:Insights from Japan

Pediatric pancreatic tumors,though rare,pose significant diagnostic and manage-ment challenges.The recent,22-year nationwide survey on pediatric pancreatic tumors in Japan by Makita et al offers valuable insights into this uncommon enti-ty,revealing striking geographical variations and questioning current treatment paradigms.This editorial commentary analyzes the study's key findings,inclu-ding the predominance of solid pseudopapillary neoplasms and their younger age of onset,which contrast sharply with Western data.It explores the implications for clinical practice and research,emphasizing the need for population-specific approaches to diagnosis and treatment.The revealed limited institutional expe-rience and surgical management patterns prompt a reevaluation of optimal care delivery for these complex cases,suggesting benefits of centralizing healthcare services.Furthermore,the commentary advocates for international collaborative studies to elucidate the genetic,environmental,and lifestyle factors influencing the development and progression of pediatric pancreatic tumors across diverse populations.It also outlines future directions,calling for advancements in precision medicine and innovative care delivery models to improve global patient outcomes.Unraveling Makita et al's findings within the broader landscape of pediatric oncology can stimulate further research and clinical advancements in managing pancreatic and other rare tumors in children.

Comparative study on emotional behavior and parental job stress of only-child and non-only-child preschool children

BACKGROUND Studies have revealed that Children's psychological,behavioral,and emotional problems are easily influenced by the family environment.In recent years,the family structure in China has undergone significant changes,with more families having two or three children.AIM To explore the relationship between emotional behavior and parental job stress in only preschool and non-only preschool children.METHODS Children aged 3-6 in kindergartens in four main urban areas of Shijiazhuang were selected by stratified sampling for a questionnaire and divided into only and nononly child groups.Their emotional behaviors and parental pressure were compared.Only and non-only children were paired in a 1:1 ratio by class and age(difference less than or equal to 6 months),and the matched data were compared.The relationship between children's emotional behavior and parents'job stress before and after matching was analyzed.RESULTS Before matching,the mother's occupation,children's personality characteristics,and children's rearing patterns differed between the groups(P<0.05).After matching 550 pairs,differences in the children's parenting styles remained.There were significant differences in children's gender and parents'attitudes toward children between the two groups.The Strengths and Difficulties Questionnaire(SDQ)scores of children in the only child group and the Parenting Stress Index-Short Form(PSI-SF)scores of parents were significantly lower than those in the non-only child group(P<0.05).Pearson’s correlation analysis showed that after matching,there was a positive correlation between children's parenting style and parents'attitudes toward their children(r=0.096,P<0.01),and the PSI-SF score was positively correlated with children's gender,parents'attitudes toward their children,and SDQ scores(r=0.077,0.193,0.172,0.222).CONCLUSION Preschool children's emotional behavior and parental pressure were significantly higher in multi-child families.Parental pressure in differently structured families was associated with many factors,and preschool children's emotional behavior was positively correlated with parental pressure.

The Relationship between Parental Stress and Child Conformity:The Mediating Role of Resilience

Background:In today’s society,parental stress has become a prevalent and significant issue,impacting not only parents’mental health but also potentially profoundly affecting children’s growth and education.This topic has garnered continuous attention from scholars.The present study aims to delve into the relationship between parental stress and children’s behavior,particularly focusing on children’s conformity and discipline development during crucial stages.This study aims to explore the relationship between parental stress,child conformity,and resilience,and further examines the mediating role of resilience in the relationship between parental stress and child conformity.Methods:We used three scales:the Parental Stress Scale,the Child Conformity Scale,and the Resilience Scale,to survey 890 elementary school students(aged 6–12)and their parents in the Beijing-Tianjin-Hebei region of China.We employed SPSS 26.0 software for data analysis,conducting descriptive statistics,correlation analysis,and mediation effect tests sequentially.In the mediation effect tests,we utilized structural equation modeling(SEM)and regression analysis to examine the mediation effects,ensuring the accuracy and scientific nature of our analysis.Results:Through descriptive statistics,correlation analysis,regression models,and mediation effect tests,we found that parental stress significantly negatively predicts child conformity,while resilience shows a significant positive prediction.Further mediation analysis indicates that resilience plays a partial mediating role between parental stress and child conformity,with the mediation effect accounting for 36.67%.Conclusion:These findings highlight the importance of the family environment on child behavior and provide valuable insights and recommendations for family education practices in the Beijing-Tianjin-Hebei region.Therefore,we suggest future research should further explore the complex relationships among parental stress,child conformity,and resilience,and examine regional differences to better promote children’s overall development.

Attachment Styles and Traumatic Responses: Exploring the Impact of Parental Interaction on Child Development and Coping Mechanisms

This article explores the intricate relationship between attachment styles formed during early childhood and the subsequent responses to traumatic events, particularly the death of a parent. Drawing on the theoretical framework of attachment theory and incorporating contemporary research, the paper discusses how parental interactions shape the neural circuitry of infants and children, influencing their ability to form secure or insecure attachments. These attachment styles, in turn, play a critical role in determining the child’s coping mechanisms when faced with trauma. This paper focuses on trying to understand how attachment theory is connected to the reaction to trauma with a highlight on the four major styles of attachments which are secure, anxious, avoidant, and disorganized to mention but a few, and how they influence stress and adversity in children. Attachment theory holds that human beings’ ability to form affectional bonds in infancy determines their patterns of relatedness across the life cycle. The type of attachment that is secure usually supports healthy adaptation and good coping mechanisms regardless of the trauma in the childhood of the child. While secure attachment mostly facilitates favorable trauma-related outcomes, anxious or avoidant attachment can exacerbate or alter the responses. The caregiving system that is avoidant attachment has implications of autonomous self-functioning which has features of suppression of the emotional response and poor search for emotional support during stress. From the principles of developmental psychology and trauma theory, the paper also focuses on the major significance of the child’s early caregivers’ interactions that define the resilience and vulnerability factor. This knowledge is therefore critical in designing specific interventions based on the improvement of coping behaviors and emotional regulatory systems of children who have been exposed to trauma. Finally, we have the synthesis of new knowledge about the role of secure attachment relationships as its fundamental element in shaping adaptive traumatization and psychological development. The article also delves into the physiological processes involved in emotional regulation and the role of cortisol in disrupting attachment. Finally, the implications of these findings for therapeutic interventions and the challenges of addressing prolonged grief and traumatic responses in clinical settings are considered.

Profile of Peanut Sensitization in Children Attending a Pneumo-Allergology Consultation at the Teaching Hospital Campus of Lomé, Togo

Introduction: Food allergies are on the constant increase worldwide. Among them is peanut allergy, which also affects children. The aim of this study was to determine the profile of peanut sensitization in children attending a pneumo-allergology consultation. Methods: This was a cross-sectional study, which ran from January 1, 2018, to December 31, 2022, on children sensitized to peanuts seen in pneumo-allergology consultations at the Teaching Hospital Campus of Lomé. Results: The sample included 137 children aged 3 months to 18 years. The frequency of peanut sensitization was 25.3%. The mean age of patients was 6.3 ± 4.3 years (minimum 6 months and maximum 18 years). The 6 months to 5 years age group was the most represented (43.1%). The sex ratio was 1.3. The main reasons for consultation were rhinorrhea (67.9%), sneezing (36.5%) and cough (35.8%). Allergic rhinitis was identified as a personal history in 75.2% of patients. Peanut allergy was manifested as rhinorrhea (62.5%), asthma (26.8%) and eczema (8.9%). The risk of onset of symptoms within 15 - 30 minutes was 1.87 times (p = 0.001, CI = [1.2 - 2.1]) for peanuts consumed in roasted form with shell. Severe clinical signs such as Quincke’s Edema and anaphylactic shock were found in 1.4% of cases. Conclusion: Peanut allergy was common in children. Severe clinical signs were rare.

Management of Acute Diarrhoea in Children Aged 0 - 59 Months in the Paediatric Ward of the Ratoma CMC (Guinea)

Introduction: Acute diarrhoea is a real public health problem worldwide and is responsible for considerable mortality in developing countries. The aim of this study was to evaluate the management of acute diarrhoea in children aged 0 - 59 months hospitalised in the paediatric ward of the Ratoma CMC. Material and Methods: This was a descriptive cross-sectional study lasting 6 months, from 01 July to 31 December 2023, including all children aged 0-59 months admitted for diarrhoea lasting no more than 14 days and whose parents agreed to take part in the study. Sociodemographic, clinical, therapeutic and evolutionary data were studied. Results: 79 children were seen for acute diarrhoea out of 330 consulted, i.e., a frequency of 23.9%. The age group 0 - 11 months was the most represented, at 54.4%. Males predominated: 62% with a sex ratio of 1.6. The average consultation time was 3 days, with extremes of 0 to 10 days. The number of bowel movements per day varied from 3 to 12. The stools were liquid in 82.27% of cases. All hospitalised children were dehydrated, with 68.4% suffering from moderate dehydration, 21.5% from mild dehydration and 10.1% from severe dehydration. Malaria was the condition most frequently associated with diarrhoea (27.8%). Malnutrition was found in only 2.5%. 82% of the children had received oral rehydration with ORS and 18% intravenous rehydration. Almost all the children (93.67%) had a favourable outcome. We recorded one case of death, a rate of 1.26%. Conclusion: Acute diarrhoea in children is one of the most frequent reasons for consultation in the paediatric department of the Ratoma CMC. Often accompanied by fever and vomiting, it is frequently observed in children aged 0 to 11 months, with a predominance of males. The overall management of acute diarrhoea in children involves improving people’s standard of living, combating faecal peril, drinking water consumption, promoting vaccination, the use of oral rehydration solutions and zinc, and training healthcare staff.

Large Conventional Osteosarcoma of the Proximal Humerus in a 13-Year-Old Child: Case Report

Introduction: Osteosarcoma is the most common primary malignant bone tumor in children. It is highly aggressive and has a poor prognosis. A late presentation modifies and makes difficult the management affecting the survival of children. We report the case of a large conventional osteosarcoma in a 13-year-old girl. Case Presentation: Adolescent girl admitted for painful swelling of the left shoulder with absolute functional impotence of the thoracic limb and severe anemia. The painful swelling was thought to have been caused by a minor trauma that had occurred six months previously. The patient’s general condition was poor, and she presented with a large, shiny, painful mass over the shoulder and upper 2/3 of the left arm, measuring 28 cm long by 28 cm wide and 57 cm in circumference, and a large fistulous axillary adenopathy. CT scan showed a tumour lesion of the left humerus with liver and lung metastases, raising suspicion of osteogenic osteosarcoma. The tumor was classified according to TNM staging: T2N1M1(a + b). Management was modified when uncontrolled bleeding developed. It consisted of an extended amputation of the left thoracic limb. Pathological analysis showed a high-grade conventional osteosarcoma. Quality improvement was obtained for thirty days, followed by the onset of dyspnea. The evolution was towards death at forty days post-operatively. Conclusion: Osteosarcoma is a highly aggressive cancer. Delayed treatment leads to a fatal outcome. Early diagnosis is one of the challenges to be met in order to improve survival.

Elbow Dislocation in Children: About Two Cases and Review of the Literature

Background: Elbow dislocations in pediatric patients are rare injuries. This is a therapeutic emergency because a delay in treatment can have disastrous consequences on the functional level of the upper limb. Objective: To present the management of elbow dislocation in children in cases of limited resources. Presentation of the Cases: These were 2 older male children aged 7 and 9 years old, admitted to the emergency room for painful functional impotence of the right elbow after a fall and landing on the right hand. Clinical and radiological examinations were in favor of posterior elbow dislocations. The reductions were carried out under sedation and immobilization in Jersey. According to Robert’s criteria, the functional result was excellent in both patients. Conclusion: Emergency reduction and immobilization whatever the means ensure an excellent functional prognosis even in cases of limited resources.

Management of Severely Malnourished Children Aged 6 - 59 Months Hospitalized in the Pediatric Ward of Kayanza Hospital/Burundi

The implementation of WHO guidelines has significantly reduced hospital mortality due to severe malnutrition. Nevertheless, severe acute malnutrition in children under five remains a major public health problem in all low-income countries and is little studied. The study aimed to assess the nutritional status and quality of management of severe acute malnutrition in children aged 06 to 59 months hospitalized in the pediatric ward of Kayanza Hospital. This is a prospective study with descriptive and analytical aims over 6 months from February 10 to July 9, 2023. All children aged 6 to 59 months admitted for severe acute malnutrition are included in this study. The results show that the most affected age group is 12 to 23 months (42.55%). Marasmus is the most common clinical form, at 70.2%. Housewives and mothers from rural areas are the most affected, with rates ranging from 69.14% to 91.49%. The study shows that the reasons for consultation are respectively: edema (29.78%), diarrhea (26.59%), vomiting (19.14%), and fever (14.89%). Dehydration and hypothermia were the main complications observed in 45.74% and 22.34% respectively. Medical treatment was provided by antibiotics (44.68%), artesunate (31.91%), and resomal (21.27%). Nutritional treatment consisted of F75 100% milk and F100 100% milk. Pathologies observed were: anemia 38.29%, malaria 37.23%, urinary tract infection 12.7%, measles 11.7%. The national protocol for integrated management of acute malnutrition (PCIMA) was followed. This study shows that 72.3% of children were successfully treated, with 9.5% dropping out and dying, and 8.5% not responding. We found that malnutrition remains a public health problem, affecting mostly children aged 12 to 24 months. The main complications or pathologies associated with malnutrition are diarrhea, malaria, and fever, and the majority of children suffer from marasmus.

Epidemiological, Clinical and Prognostic Profiles of Measles in Children in the Pediatric Ward of the University Hospital of Conakry

Introduction: Measles is a highly contagious viral infectious disease. It is one of the major causes of infant morbidity and mortality in developing countries. The general objective was to study the epidemiological, clinical and prognostic aspects of measles in the paediatric department of Conakry University Hospital. Methods: This was a prospective descriptive study lasting six months, from 01 October 2021 to 31 March 2022, in the paediatric wards of Conakry University Hospital. It included all patients aged between 0 and 15 years, received in consultation and/or hospitalised for measles and whose parents agreed to participate in the study. Results: Out of 3916 cases of paediatric pathology, we collected 380 cases of measles, i.e., 9.7%. The 0 - 4 age group was the most affected, accounting for 60.8%, with an average age of 26.6 ± 18.8 months and extremes of 3 months and 150 months. Females predominated in 53.2% of cases, with a sex ratio of 0.9. Non-vaccinated children accounted for 226 cases (59.5%). Fever was the most common clinical sign in the study (97.11%), followed by oculonasal catarrh (83.9%) and maculopapular lesions (82.1%). A notion of contagion was noted in 254 patients, i.e., a rate of 66.8%. The main complications were ocular in 229 cases (60.3%), pulmonary in 139 cases (36.6%) and digestive in 124 cases (32.6%). Malnutrition was noted in only 15 patients (3.93%). Treatment was symptomatic. The outcome was favourable in 92.3% of cases. We recorded 20 cases of death (5.3%) and 9 cases of escape (2.4%). Conclusion: Despite progress in the control and management of measles, much remains to be done to improve vaccination coverage with the aim of eradicating this disease.

Unraveling the Impact of Direct-Acting Antivirals on Hepatitis-Linked Cirrhosis: A Comprehensive Analysis of Fibrosis, Child Score, and Disease Progression

The treatment of hepatitis C has undergone a significant boom since the advent of direct acting antivirals (DAA). Indeed, the interferon-ribavirin combination that has been used to treat hepatitis C has a virological response in only 45% of cases with significant side effects. The advent of direct-acting antivirals has changed the prognosis of cirrhotic patients with hepatitis C. DAAs have ensured a sustained viral response in the majority of patients. Our work aims to see the evolution of hepatitis C patients at the cirrhosis stage under DAA. We conducted a retrospective study over 15 years (January 2009, January 2024) including all patients with post-viral cirrhosis C, whom we divided into two groups: group A, cirrhotic patients who received ribavirin and interferon, and group B, patients on DAA. From January 2009 to January 2024, we conducted a study of 182 patients with viral hepatitis C, including 102 cirrhotic patients. The mean age was 55 years. 66% of patients were initially treated with the ribavirin interferon combination, while 34% received direct-acting antivirals (DAAs). Since the introduction of DAAs, the most commonly used regimens have been sofosbuvir/daclatasvir with or without ribavirin and sofosbuvir/ledipasvir with or without ribavirin. Group A achieved sustained virological response (SVR) in 60% of cases, with notable side effects. In Group B, SVR was 98.18%, with improved tolerability and fewer side effects than previous treatments. Fifteen patients developed hepatocellular carcinoma (HCC), with a significantly lower mortality rate in those treated with DAAs compared with pegylated dual therapy (p: 0.001).