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.

Clinical and Epidemiological Aspects of Severe Acute Malnourished Children from 6 to 59 Months Hospitalized in a Secondary Hospital in Mali

Introduction: Malnutrition acts on the immune system and thus increases susceptibility to infections. Infections can weaken the body and cause malnutrition, so we speak of a vicious circle between malnutrition and infection. Objective: To study the clinical and epidemiological aspects of severe acute malnutrition in children aged 6 to 59 months. Methodology: This was a prospective and descriptive study extending from July 1, 2018 to June 30, 2019. All severely acute malnourished children aged 6 to 59 months were hospitalized at URENI whose parents or careers accepted their participation in the study. Results: Severe acute malnutrition was diagnosed in 398 of the 671 hospitalized children, i.e. 59.3%. The median age was 15.33 months (2 months - 59 months). The sex ratio was 1.03 (M = 50.8 F = 49.2). Eighty-seven percent of mothers were housewives. Parents were uneducated in 49.3% for mothers and 51.8% for fathers. Marasmus represented 93.5% of cases, children diagnosed with HIV+ represented 6.3% with exclusively HIV1 (100%). Pneumopathy was most frequently associated pathology with 33.4%. The duration of hospitalization was less than 7 days in 67.6% of cases and 93.3% of children had been successfully treated. The mortality rate was 4%. Conclusion: Malnutrition still remains a public health problem affecting mainly children aged 13 to 24 months, mainly from low-income families.

Blood Count Characteristics of Children Hospitalized in General Pediatrics at the Gabriel Touré Teaching Hospital

Objective: The main objective was to study the disturbances of the Blood Count of children hospitalized in the general pediatric of the Gabriel Touré teaching hospital. Methods: This was a prospective and descriptive study conducted from September 1 to November 30, 2018 in the general pediatrics department of the Gabriel Touré teaching hospital in Bamako. Data were collected on patient records using a survey sheet. Results: We collected 512 files of children out of 1030 admissions during the study period;the rate of completion of the blood count is 50%. The male sex was predominant with a sex ratio of 1.3. The majority of patients were under 5 years old (58%). The majority of fathers (56%) and mothers (64%) of children had no education;they are mainly farmers (61%) and housewives (88%). Pallor was the reason for consultation in 29% of patients and present in 60%. On blood count, anemia was present in 92% of patients, half of whom (50%) had severe anemia with a hemoglobin level below 7 g/dL. The anemia was mainly microcytic (72%) and hypochromic (66%). Hyperleukocytosis (62%), eosinophilia (68%) and basophilia (58%) were the abnormalities observed in the white line. Thrombocytopenia accounted for 40%. Severe malaria (53%) was the main discharge diagnosis and almost all patients (99%) were alive at discharge. Conclusion: The characteristics of anemia require a study of the complete blood count in healthy children with dosage of serum iron and ferritin for a better understanding of the phenomenon.

Norovirus Infection and Histo-blood Group Antigens in Children Hospitalized with Diarrhea in Lulong and Chenzhou in China

Norovirus （NOV） is a pathogen that commonly causes viral diarrhea in children. Studies indicate that NoV recognizes human histo-blood group antigens （HBGAs） as cell attachment factors. In order to explore the correlation between of NoV infection and HBGAs, a cross-sectional study was conducted in children less than five years old who were hospitalized with diarrhea in two areas of China between November 2014 and February 2015. Of the paired stool and saliva samples taken from 424 children,

Biological Markers of Undernutrition and Risk of Complications in Children Hospitalized at the Teaching Hospital of Brazzaville

Introduction: Undernutrition is a condition frequently encountered in pediatrics. It leads to an increased morbidity and mortality regardless of the underlying condition or other risk factors such as age. In countries with limited resources such as ours, the diagnosis of undernutrition is often limited to the clinical presentation, and the contribution of biology is not often taken into account. Objectives: To establish the relationship between anthropometric parameters and biological markers in the diagnosis and classification of undernutrition and to assess the risk of infectious complications during undernutrition in children. Materials and Methods: A cross-sectional study conducted in Brazzaville among undernourished children aged 1 - 59 months between October 2018 and April 2019. Clinical diagnosis was based on WHO growth charts. The CRP, orosomucoid, albumin and transthyretin were obtained using the Cobas c311 analyzer, which enabled the calculation of Prognostic Inflammatory and Nutritional Index (PINI). The comparison of the means of the biological markers used the Student’s t-test, the risk of infectious complications the chi-square. The correlation of the diagnostic value of Z-score weight/height and PINI was also investigated. The significance level was set at 0.05. Results: Of the 95 children enrolled 63 (66.3%) were clinically severely malnourished, including 26 acute (41.3%) and 37 chronic (58.7%). The PINI revealed severe undernutrition in 85 children (89.4%) including 50 acute (58.8%) and 35 chronic (41.2%). CRP and orosomucoid were statistically higher in severe acute undernutrition (p Conclusion: Anthropometric parameters have a front-line advantage for assessing and classifying undernutrition. However, biological markers of undernutrition with PINI should be systematized in the diagnosis and management of undernutrition.

Relationship between Authoritative Parenting Style and Preschool Children’s Emotion Regulation:A Moderated Mediation Model

An authoritative parenting style has been shown to promote children’s emotion regulation in European-American family studies.However,little is known about how sleep problems and the child’s sibling status in Chinese families affect this relationship.Based on family system theory,this study attempts to better understand the relationship between authoritative parenting style and emotion regulation.Mothers of preschool children in Chinese kindergartens completed questionnaires about their children’s sleep habits,their authoritative parenting styles,and children’s emotion regulation.A total of 531 children participated in this study.Results showed that authoritative parenting was positively associated with emotional regulation.Sleep problems mediated the effects of authoritative parenting style on emotion regulation.The child’s sibling status moderated the mediating effects of sleep problems in authoritative parenting and emotion regulation relationships.Specifically,the relationship between the authoritative parenting style and sleep problems was significant for only children,while birth order had no significant influence on the authoritative parenting style and sleep problems in two-child families.These findings suggest that a lowauthoritative parenting style predicts low emotion regulation through sleep problems,and this depends on the child’s sibling status,indicating that children without siblings may impair emotion regulation due to increased sleep problems.

Exploration of Child-friendly Urban Park Design Strategies Based on Child Behavioral Psychology

By studying the behavioral psychology and needs of children,this paper analyzes the essence of child-friendly parks from the perspective of children,and discusses the design principles and key points of child-friendly parks,so as to provide a practical basis for the construction of child-friendly cities.

Ten-year Etiologic Review of Chinese Children Hospitalized for Pediatric Cataracts

Purpose:Our aim was to obtain a better understanding of the etiologies and characteristics of pediatric cataracts treated at a single facility in China.Methods:.Medical records accrued over a 10-year period(from August, 2003 to July, 2013) at Shengjing Hospital of China Medical University were reviewed retrospectively,ide ntifying all patients treated for various subtypes of pediatric cataract..A database with 367 subjects under 14 years of age(598, including second-round surgeries) was generated.Results:.Of this cohort(n =367; males: 232, 63.2%; females: 135, 36.8%), 200 patients(54.5%) had bilateral cataracts,and 258(70.3%) were under 3 years of age. In all age groups and in all subtypes of pediatric cataract,.males were most commonly affected..Congenital cataract was the most prevalent subtype, accounting for 296 patients(80.7%). Most congenital cataracts were associated with other ocular or systemic abnormalities;.and in 48 patients(16.22%),.they were hereditary..Traumatic cataract was the most common subtype(85.92%) of acquired cataract. The few instances of cataracts due to steroids(n=3) or to metabolic disorders(n=2) occurred in males and involved both eyes.Conclusion: The majority of pediatric cataracts in this patient population were congenital in nature. A significant lag in ophthalmologic evaluation of Chinese infants was evident and should be addressed by educating both children and parents on risk factors for cataract development. Regular assessments are especially important in children subjected to long-term systemic steroid treatments.

The Epidemiology of Influenza in Children Hospitalized at the Hospital of Sikasso, Mali 2015-2019

Introduction: Influenza is an acute respiratory infectious disease, highly contagious due to influenza viruses. The objective of this work was to identify, understand the epidemiology of circulating strains and estimate disease transmission. Patients and Methods: The study was carried out in the pediatric department of the Sikasso Hospital. This was a prospective, longitudinal descriptive study over a five-year period (January 1, 2015 to December 31, 2019). She was interested in severe acute respiratory infections (SARI) for hospitalized patients in the pediatric department. Results: During the study period the prevalence of severe acute respiratory infections among hospitalized children was 21.85‰. The majority of cases were observed in 2019 with 58 cases, the sex ratio was 1.8. The age group from 0 to 1 was the most represented with 100 cases (48.30%) followed by 2 to 4 years 73 cases (35.24%) and 5 to 15 years 34 cases (16.46%). More than half of the patients lived in rural areas 129 (62.31%). Fever and cough were present in the majority of patients. No children had received influenza vaccination. In study 36 (17.39%) cases were positive for influenza A and B.

不同Child-Pugh分级肝硬化患者血清TSP-1、球蛋白/胆碱酯酶的表达水平差异及其疾病预后危险因素分析

目的分析不同Child-Pugh分级肝硬化患者血清凝血酶敏感蛋白-1(TSP-1)、球蛋白/胆碱酯酶的表达水平差异及其疾病预后危险因素。方法回顾性选取2020年2月至2023年2月新疆医科大学第一附属医院收治的70例肝硬化患者作为主要研究对象,根据Child-Pugh分级将其分为Child-Pugh A级组(n=20),Child-Pugh B级组(n=34),Child-Pugh C级组(n=16),另选取同期在本院进行体检的50名健康人群作为对照组。采用酶联免疫吸附试验法检测4组及肝硬化不同预后患者的血清TSP-1、球蛋白、胆碱酯酶、球蛋白/胆碱酯酶表达水平;采用双变量Spearman相关性检验血清TSP-1、球蛋白、胆碱酯酶、球蛋白/胆碱酯酶与肝硬化患者Child-Pugh分级和预后的相关性;建立多因素Logistic模型分析影响肝硬化患者预后的独立危险因素,并绘制受试者工作特征(ROC)曲线分析血清TSP-1、球蛋白/胆碱酯酶对肝硬化预后的预测价值。结果与对照组比较,Child-Pugh A级组、Child-Pugh B级组、Child-Pugh C级组患者的血清TSP-1、球蛋白、球蛋白/胆碱酯酶表达水平较高,血清胆碱酯酶表达水平较低;与Child-Pugh A级组患者比较,Child-Pugh B级组、Child-Pugh C级组患者的血清TSP-1、球蛋白、球蛋白/胆碱酯酶表达水平较高,血清胆碱酯酶表达水平较低;与Child-Pugh B级组比较,Child-Pugh C级组患者的血清TSP-1、球蛋白、球蛋白/胆碱酯酶表达水平较高,血清胆碱酯酶表达水平较低,差异均有统计学意义(P<0.05)。与预后良好组比较,预后不良组血清TSP-1、球蛋白、球蛋白/胆碱酯酶表达水平较高,血清胆碱酯酶表达水平较低,差异均有统计学意义(P<0.05)。肝硬化患者血清TSP-1、球蛋白/胆碱酯酶与Child-Pugh分级和预后均呈正相关(P<0.05)。多因素Logistic分析结果显示,Child-Pugh分级、TSP-1、球蛋白/胆碱酯酶均是影响肝硬化患者预后的独立危险因素(P<0.05)。血清TSP-1、球蛋白/胆碱酯酶与TSP-1+球蛋白/胆碱酯酶预测肝硬化患者预后的曲线下面积值分别为0.814、0.824、0.885。结论血清TSP-1、球蛋白/胆碱酯酶异常表达与肝硬化Child-Pugh分级及其预后均存在一定关联,可作为肝硬化患者的Child-Pugh分级及预后的辅助预测指标。

Percutaneous Coronary Intervention in Acute Coronary Syndromes at the Mother-Child University Hospital Luxembourg in Bamako

Introduction: Acute coronary syndromes (ACS) are a diagnostic and therapeutic emergency. Objective: Studying the feasibility, difficulties and results of coronary angioplasty in acute coronary syndromes at the Luxembourg Mother-Child University Hospital in Bamako. Patients and Methods: Cross-sectional, descriptive study with prospective recruitment over 18 months from September 2020 to February 2022. All patients aged at least 18 years old admitted for SCA and having undergone PCI during the study period were included. Result: We collected 249 patients for SCA, of whom 160 underwent angioplasty, either an angioplasty/SCA ratio of 0.64. The average age of the patients was 59.54 ± 11.62 with extremes of 32 and 92 years. The age group of 45 to 65 years was the most representative. The predominance was male, sex ratio of 2.4. The main cardiovascular risk factors were high blood pressure (58.23%) and diabetes (45.78%). Persistent ST-segment elevation on the electrocardiogram was present in 71.48%. The treatment time was more than 12 hours after the first medical contact in 95.5%. The approach was radial in 96.5% of cases. Coronarography was pathological in 91.16% of our patients. The lesions were tri-truncular in 34.13% with the anterior inter ventricular as culprit artery in 72% of cases. The majority of patients (64%) had undergone angioplasty with implantation of an active stent. Angioplasty was performed successfully in 98% and per procedural mortality was 1.87%. Only 6.45% of ACS with ST elevation benefited from primary angioplasty. Conclusion: Percutaneous coronary intervention is performed routinely in our center with satisfactory results. Difficulties exist, related to the diagnostic delay of ACS and the high cost of angioplasty.

A Comparative Study of Mandibular Fractures in Senegal: Children vs. Adults

Introduction: The commonest maxillofacial fractures involve the mandible. Age can be considered among influential factors. Aim of the Study: To compare mandibular fractures between children and adults from the beginning up to the treatment in Senegal. Patients and Method: A three-year retrospective study was conducted in a university hospital. The medical records of patients admitted for maxillofacial injuries were reviewed. Patient and injury-related variables including age, gender, etiology, average consultation delay, anatomic location of fracture and treatment were compared up to age of 15 and beyond that. Results: Considering 272 casualties, maxillofacial fractures were less frequent among children than adults (36.7% and 59.7%) and were mainly mandibular (90.1% and 91.4%). Male predilection (sex ratio of 2.4 and 4.9) was twice (2) as pronounced from the age of 16. The average consultation delay was two (2) times shorter for children. Road traffic accidents which predominated among children (33.9%) had comparable frequency (32.3%) although they were outnumbered by assault (37.6%) among adults. Fractures occurred mainly on the corpus (90.1% and 90.4%), particularly on parasymphysis (40.1%) up to the age of 15, whereas angle fractures increased (8.5% to 19.6%) and joint damage decreased afterwards. Intra-oral orthopedic procedures (91.2% and 92.6%) in which mandibular retention splints were more common (37.3%) up to the age of 15 then arch ligatures (49%) were then widely favored. Conclusion: Differences relating to the distribution of causes but also to the anatomic location on the corpus and to the choice of intra-oral orthopedic procedures within overall similarities between children and adults regarding the male predilection, the frequency of road traffic accidents, the mandibular injuries, but also the school therapeutic attitude consisting of favoring the orthopedic option.

Epidemiological, Clinical and Evolutionary Aspects of Human African Trypanosomiasis in Children in Nola

Background: Human African trypanosomiasis (HAT) occurs in three historical foci in the Central African Republic. Objective: To describe the morbi-mortality of childhood HAT in rural Central African Republic with the aim of early management. Methods: Descriptive and analytic cross-sectional study conducted from January 1, 2017 to March 30, 2018 at Nola prefectural hospital. This study was included all children seen as outpatients and/or hospitalized in the pediatric wards, in whom the diagnosis of HAT was confirmed. Statistical analysis was performed using Epi-info software. Results: Forty children were included from Bilolo (60%), Nola (30%) and Salo (10%). The sex ratio was 0.66 with a median age of 8.65 ± 12.48 years. Fever (82.5%), nocturnal insomnia (75%), daytime somnolence (67.5%), headache (65%), polyarthralgia (62.5%), convulsions 52.5% (n = 21), tremor (27.5%), trypanidism (7.5%) and delirium (2.5%) were the main functional signs. Examination signs were adenopathy (52.5%), paresthesia (30%), decreased cutaneous-abdominal reflexes (25%) and osteoarticular reflexes (17.5%), hyperesthesia (20%), extrapyramidal hypertonia (15%) and depression (2.5%). The children were in the lymphatic-blood phase in 65% of cases, and meningoencephalitis in 35%. Pentamidine was administered in 65% of cases. Four children died and 6 had neurological sequelae. There was an association between age under 5, Bilolo’s focus, the children’s history and the severity of the disease. Age under 5, gender, household, children’s activity, history and occurrence of sequelae were also associated. Conclusion: HAT remains a permanent threat to Central African children. Any clinical presentation combining long-term infectious signs and unexplained neurological or neuropsychological disorders must be treated with caution.

Rhabdomyosarcoma in Children: About 10 Cases

Introduction: Rhabdomyosarcoma (RMS) is a malignant soft-tissue tumor arising from striated muscle cells. It accounts for 60% - 70% of malignant mesenchymal tumors and 5% of pediatric cancers. Two-thirds of these cancers are diagnosed in children under 6 years of age, with a slight male predominance. Materials and Methods: This is a retrospective descriptive study of 10 cases of RMS collected in the pediatric hematology and oncology department of the Oujda university hospital, over a 5-year period, running from January 2018 to December 2022. Results: The median age at diagnosis was 3 years, with a sex ratio of 1. The mean time to diagnosis was 2 months. The most common site was the head and neck (50%), followed by the genitourinary tract (20%), the extremities (20%) and finally the abdomen (10%). The most frequent mode of discovery was a mass or swelling found in 90% of patients (all sites included), followed by exophthalmos in 30% of cases. At the diagnostic stage, CT scans were performed in 70% of cases and MRI in 5 patients (50%). Histological diagnosis was determined by immunohistochemical pathology in all our patients, with a predominance of embryonal (70%) versus alveolar (20%) and spindle cell types (10%). All patients underwent an extension workup, and a cervico-thoraco-abdominopelvic CT was performed in all patients (100%);MRI was performed in 2 patients (20%);lymph node involvement was present in 5 patients (50%). Metastases at the time of diagnosis were noted in only 1 patient (10%), who simultaneously presented with two metastatic sites;testicular and abdominal wall. Sixty percent of patients presented with advanced disease (high risk) and 40% with standard risk. Chemotherapy was used in all patients (100%), with upfront tumor resection performed in 40%. Fifty percent of patients received radiotherapy at a mean dose of 43 Gy, with the orbit the most frequently irradiated area (30%). All patients underwent CTscan and/or MRI and/or ultrasound surveillance. Follow-up during and after treatment was marked by complete remission in 8patients, loss of sight in one patient, and one patient died as a result of progressive disease. Conclusion: RMS is a malignant tumor of striated muscle. The epidemiological and clinical features of this tumor in our study are generally similar to those described in the literature. Management of these tumors requires multidisciplinary collaboration involving oncopediatric, radiologist, pediatric surgeon, pathologist and radiotherapist.

Traumatic Diaphragmatic Hernia in Children: A Case Report

Introduction: Traumatic diaphragmatic hernia is a rare condition in children complicating closed or penetrating trauma to the abdomen and thorax. We report the case of an 11-year-old girl with a traumatic diaphragmatic hernia. Case Presentation: An 11-year-old girl was seen in the paediatric surgery department for a thoracolumbar spine deformity and intermittent chest pain. These symptoms occurred after a domestic accident involving a fall from a low wall onto the thoracolumbar spine 5 months previously. The diagnosis was suggested by the presence of a left hemithoracic hydroaera and confirmed by a thoraco-abdominal CT scan. Surgical exploration revealed a linear rupture of the entire left hemi-diaphragm with herniation of the stomach, small intestine, cecum, transverse colon and omentum. We performed a double-layer suture of the diaphragmatic rupture with a non-absorbable suture without edge rejuvenation after the reduction of the hernia. The outcome was favourable with normal postoperative radiographs at one year follow-up. Conclusion: Traumatic diaphragmatic hernia, although uncommon and difficult to diagnose, is a condition that is relatively easy to manage surgically, even if it is discovered late. In all cases of trauma to the thoracolumbar spine, regular follow-up and repeat X-rays are necessary if pain persists.

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.

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. .

Early Nursing Intervention in Children with Viral Meningitis

Aim: To explore the effect of a WeChat peer education program in children with severe viral meningitis combined with respiratory failure. Design: Retrospective cohort study. Methods: Patients who had severe viral meningitis combined with respiratory failure, were admitted to the hospital from March 2017 to June 2018, and who received the WeChat-based nursing intervention were included. Patients who received routine nursing were used as controls. The family’s emotional state, self-care ability, and rehabilitation were analyzed. Results: There were 37 patients in the WeChat group (19 boys (51.3%) and 18 girls (48.7%);mean of 5.1 ± 2.4 years of age) and 37 controls (20 boys (54.1%) and 17 girls (45.9%);mean of 5.9 ± 2.4 years of age) (all P > 0.05). After nursing, improvements in the self-assessed anxiety score and self-assessed depression score were better in the WeChat group (anxiety: -29.2% vs. -20.3%, P = 0.015;depression: -25.2% vs. -15.4%, P = 0.009). After nursing, the improvements in the condition management ability scale and condition management difficulty scale scores were better in the WeChat group (ability: +80.5% vs. +44.4%. P = 0.001;difficulty: +58.4% vs. +37.8%, P = 0.003). After nursing, the improvement in the Fugl-Meyer score was better in the WeChat group (+138.0% vs. +53.0%, P Conclusion: Early nursing intervention combined with WeChat peer education can improve the emotional state of children with severe viral meningitis combined with respiratory failure and their caregivers. Impact: Viral meningitis is associated with a good prognosis, but central nervous system complications can be observed. Early intervention is the key to a good prognosis. Internet-based nursing and coaching can improve self-efficacy and care ability in patients with various conditions, as well as improve the emotional state of the children and their caregivers. The research might have an impact on any children’s hospital that deals with viral meningitis.

Special electromyographic features in a child with paramyotonia congenita: A case report and review of literature

BACKGROUND Paramyotonia congenita(PMC)stands as a rare sodium channelopaty of skeletal muscle,initially identified by Eulenburg.The identification of PMC often relies on electromyography(EMG),a diagnostic technique.The child’s needle EMG unveiled trains of myotonic discharges with notably giant amplitudes,alongside irregular wave trains of myotonic discharges.This distinctive observation had not surfaced in earlier studies.CASE SUMMARY We report the case of a 3-year-old female child with PMC,who exhibited la-ryngeal stridor,muffled speech,myotonia from birth.Cold,exposure to cool water,crying,and physical activity exacerbated the myotonia,which was relieved in warmth,yet never normalized.Percussion myotonia was observable in bilateral biceps.Myotonia symptoms remained unchanged after potassium-rich food consumption like bananas.Hyperkalemic periodic paralysis was excluded.Cranial magnetic resonance imaging yielded normal results.Blood potassium remained within normal range,while creatine kinase showed slight elevation.Exome-wide genetic testing pinpointed a heterozygous mutation on chromosome SCN4A:c.3917G>A(p.G1306E).After a six-month mexiletine regimen,symptoms alleviated.CONCLUSION In this case revealed the two types of myotonic discharges,and had not been documented in other studies.We underscore two distinctive features:Giant-amplitude potentials and irregular waves.

Prevalence of Children Vaccinated against Viral Hepatitis B in Brazzaville

Introduction: Viral hepatitis B (VHL) is a public health problem, particularly in sub-Sahara Africa. The aim of this study was to assess vaccination coverage against HBV in children in Brazzaville. Patients and Methods: This was a cross-sectional analytical study conducted in Brazzaville health centres from January to September 2019. It involved children aged between six months and six years who received a vaccination against HBV. Sampling was exhaustive and based on stratified sampling. Results: The overall prevalence of children vaccinated against HBV in Brazzaville was 96.2%. It was insufficient in the Talangai health district (79%). The pentavalent vaccine was administered to 97.7% of children, 85% of whom had received all three doses. The reasons for incomplete vaccination were parents’ ignorance of HVB (85.6%) and of vaccination (14.3%). Conclusion: Although the prevalence of vaccinated children is high in Brazzaville, it is still insufficient in some health districts, particularly Talangai, because parents are unaware of the disease and of vaccination. Pentavalent is the only vaccine available in the national vaccination programme, which is why an effective national vaccination policy needs to be put in place. .