Appendicitis combined with Meckel’s diverticulum obstruction, perforation, and inflammation in children: Three case reports

BACKGROUND Meckel’s diverticulum is a common congenital malformation of the small intestine,with the three most common complications being obstruction,per-foration,and inflammation.To date,only a few cases have been reported world-wide.In children,the clinical symptoms are similar to appendicitis.As most of the imaging features are nonspecific,the preoperative diagnosis is not precise.In addition,the clinical characteristics are highly similar to pediatric acute appendicitis,thus special attention is necessary to distinguish Meckel’s diver-ticulum from pediatric appendicitis.Patients with poor disease control should undergo laparoscopic exploration to avoid serious complications,including intestinal necrosis,intestinal perforation and gastrointestinal bleeding.CASE SUMMARY This report presents three cases of appendicitis in children combined with intestinal obstruction,which was caused by fibrous bands(ligaments)arising from the top part of Meckel's diverticulum,diverticular perforation,and diver-ticular inflammation.All three patients,aged 11-12 years,had acute appendicitis as their initial clinical presentation.All were treated by laparoscopic surgery with a favorable outcome.A complete dataset including clinical presentation,dia-gnostic imaging,surgical information,and histopathologic findings was also provided.CONCLUSION Preoperative diagnosis of Meckel’s diverticulum and its complications is challenging because its clinical signs and complications are similar to those of appendicitis in children.Laparoscopy combined with laparotomy is useful for diagnosis and treatment.

Nosocomial diarrhea in children:is astrovirus the leading pathogen?

Objective:To screen for the presence of mixed infection with rotavirus.Methods:The present study included 140 children aged less than 2 years with acute diarrhea.Fecal samples of all these patients were analyzed for the presence of astroviral antigen by enzyme immunoassay.Also 40 rotavirus positive fecal samples were screened for the presence of astrovirus.Results:In case of acute diarrhea in children the prevalence of astrovirus was around 34% (48/140).It was seen that even in rotavirus positive cases astrovirus co infection was 25% .Conclusions:Astrovirus is a growing problem which is often underrecognised.With the rotavirus vaccine licensure being imminent astrovirus will emerge out as the single most important cause of viral

History of Vitamin A Supplementation Reduces Severity of Diarrhea in Young Children Admitted to Hospital with Diarrhea and Pneumonia

Background: Although the role of vitamin A in childhood pneumonia in association with diarrhea is not fully proven, we did not find any published data demonstrating the impact of lack of vitamin A supplementation in under-five children who present with the co-morbidities of pneumonia and diarrhea. This study examined whether previous vitamin A supplementation was associated with reduced severity and duration of diarrhea and pneumonia for children presenting with both illnesses. Methods: All admitted children (n = 189) aged 0 - 59 months to the Special Care Ward of the Dhaka Hospital of icddr,b with diarrhea and radiological pneumonia from September-December 2007 were enrolled. We compared clinical features of the children who received (n = 96) and did not receive (n = 93) high potency capsule vitamin A supplementation during previous immunization according to EPI schedule. Results: In logistic regression analysis, after adjusting for potential confounders such as respiratory rate, lower chest wall in-drawing, severe wasting and systolic blood pressure, vitamin A non-supplemented children with pneumonia and diarrhea more often presented in their early infancy (95% CI 1.01 - 1.09), had duration of diarrhea for >4 days (95% CI 1.79 - 11.88), had clinical dehydration (95% CI 1.2 - 5.63), and more often required hospitalization for >7 days (95% CI 1.03 - 8.87). But, there was no significant difference in the clinical features of pneumonia, such as history of cough, respiratory rate, lower chest wall in-drawing, nasal flaring, head nodding, grunting respiration, cyanosis, and inability to drink between the groups. Conclusion: Lack of vitamin A supplementation in under-five children with radiological pneumonia and diarrhea is independently associated with young infancy, duration of diarrhea for >4 days, dehydration and hospitalization for >7 days which underscores the importance of routine supplementation of vitamin A in young infancy. However, lack of vitamin A supplementation did not influence any clinical signs of pneumonia.

Prevalence of diarrhea and associated risk factors among children under-five years of age in Eastern Ethiopia: A cross-sectional study

Diarrhea remains a major cause of mortality in children under 5 years of age in Sub-Saharan countries in Africa. Risk factors for diarrhea vary by context and have important implications for developing appropriate strategies to reduce the burden of the disease. The objective of this study was to assess the prevalence of diarrhea and associated risk factors among children un-der 5 years of age in Kersa district, located in Eastern Ethiopia. A community-based cross-sectional study was conducted among 1456 randomly selected households with at least one child under 5 years of age. A questionnaire and an observational check list were used for col-lecting information on socio-economic charac-teristics, environmental hygiene and behavioral practices, and occurrence of diarrhea among children under 5 years of age. Logistic regres-sion was used to calculate the adjusted odds ratio of 95% confidence interval. The two-week prevalence of diarrhea among children under 5 years of age was 22.5% (95% CI: 20.3-24.6). Improper refuse disposal practices (OR = 2.22, 95% CI: 1.20-4.03), lack of hand washing facilities (OR = 1.92, 95%CI: 1.29-2.86), living in rural area (OR = 1.81, 95% CI: 1.12-3.31), the presence of two or more siblings in a household (OR = 1.74, 95% CI: 1.33-2.28), and age of the child (OR= 2.25, 95% CI;1.5-3.36) were the major risk factors for diarrhea. This study demonstrated that diarrhea morbidity was relatively high among children under 5 years of age residing in Eastern Ethiopia. Efforts to reduce childhood diarrhea should focus on improving household sanitation, personal hygiene, and child birth spacing.

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,

Etiology of Diarrhea among Severely Malnourished Infants and Young Children: Observation of Urban-Rural Differences over One Decade in Bangladesh

There is inadequate information on the etiology of diarrhea in severely malnourished (SM) young children. Thus, the study aimed to determine the etiology of diarrhea among severely malnourished (z score ?3.00 SD) children in rural and urban Bangladesh. From the database (2000-2011) of Diarrheal Disease Surveillance Systems (DDSS) at rural Matlab and urban Dhaka hospitals of icddr,b, 2234 and 3109 under-5 children were found severely malnourished (underweight, stunted or wasted) respectively. Two comparison groups [moderately malnourished (MM) and well-nourished (WN)] were randomly selected in a ratio of 1:1:1. Children with all categories of SM were more likely to be infected with Vibrio cholerae (rural—11%;urban—15%), Shigella (16%;9%), Salmonella (1%;2%) and Campylobacter (3%;4%);and less likely to have rotavirus (25%;20%) compared to only one SM category. Isolation rate of Vibrio cholerae was significantly higher among SM both in rural and urban children (7%;13%) than those of MM (5%;10%) and WN (2%;8%) and lower for rotavirus (30%;31%), (34%;43%), (35%;47%) respectively (p 0.01). However, for Shigella it was only higher among rural SM children (11%) [MM (9%), and WN (8%) (p 0.01)]. The isolation rate of Salmonella in SM (2%) was similar to that in MM (2%;p = 0.72) but significantly higher than that in WN (1%;p 0.01) among urban children. Isolation rates of bacterial enteric pathogens were higher but rotavirus was lower in SM children in both rural and urban area with geographical heterogeneity.

The Treatment of Children's Diarrhea with Massage and Acupunture in 58 cases

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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.

Design of a Landscape Device for Children from the Perspective of Embodied Cognition in the New Era

In recent years,embodied cognition has ushered in a new research upsurge in the academic field,and has become a hot topic in the field of cognitive psychology.In this paper,from the perspective of embodied cognition,the interaction ways of a landscape device for children were discussed to achieve a more real and harmonious interaction between children and scenes.The research data of embodied cognition used by children was analyzed,and the drawbacks and breakthrough points of current landscape devices for children were discussed.The core characteristics of children’s growth period were extracted to establish children’s interaction model and summarize the interactive design methods of landscape devices for children.Embodied cognition has become the most intuitive way for children to know and understand the environment,and plays a pivotal role in children’s growth.Based on embodied cognition principle and interactive behavior mode,the interactive design of a landscape device for children was studied,and three interactive design modes,including simple and convenient interaction mode,multi-sensory interaction mode and game natural interaction mode were summarized.On the basis of this research,relevant design practice and research were carried out to bring a new vision to the design of children’s landscape.

Diarrhea Disease among Children under 5 Years of Age: A Global Systematic Review

Diarrhea diseases remain the second leading cause of death among children under five years globally. Nearly one in every five child deaths, about 1.6 million each year, are due to diarrhea. Further, diarrhea kills more young children than malaria, measles and Acquired Immunodeficiency Syndrome (AIDS) combined. As a result, better understanding of childhood diarrhea occurrence can perhaps help reduce associated morbidity and mortality rates. Therefore, this study conducted a global systematic review on occurrence of childhood diarrhea. The broad objective of this study was to review present and past researches on childhood diarrhea and most importantly for children under 5 years of age. The review focused on understanding the burden of diarrhea, causes of childhood diarrhea and solutions to the disease. A systematic literature review was conducted using the databases of PubMed, CINAHL, Web of Science and Google Scholar. Search key terms used were childhood diarrhea, risk factors and intervention practices. Journal articles and related reports were filtered and limited from 2005 to 2020. Sixty-one reports and articles that met inclusion criteria were used in this review. Review found that, childhood diarrhea imposes economic costs on the health system and families. Also, repeated bouts of diarrhea can lead to malnutrition, stunting and delayed brain growth later in life and can lead to stress and tension to the affected households. The dependence on open water sources which are often contaminated with fecal materials was found as the major cause of the rising prevalence of childhood diarrhea. Other important factors were poor hygienic practices and lack of sanitation facilities contribute to the spread of diarrhea diseases. Improvements in the quality of drinking water, sanitation facilities and hygiene practices especially in low and middle income countries have been suggested by many studies as an intervention to reduce childhood diarrhea.

Factors Influencing Preventive Behaviors of Mothers for Diarrhea in Children Aged 1-5 Years in Buol District, Indonesia

This study aims to determine the factors related with mothers＇ behaviors in preventing diarrhea in children aged 1-5 years inBuol District. This was a cross-sectional survey design with health belief model as the conceptual framework. A total of 300mothers were selected by using purposive sampling method based on criteria. Mothers were interviewed by using astructured questionnaire during October to November 2015. A chi-square （X^2） test was used to determine a significantassociation between independent variables and dependent variable. The finding showed that 68.3% of mothers hadgood behaviors in preventing diarrhea. The factors significantly related to mothers＇ behaviors included perceivedsusceptibility to diarrhea, perceived severity of diarrhea, perceived benefits of diarrhea prevention behaviors, and perceivedbarriers of diarrhea prevention behaviors CP 〈 .01, p 〈 .01, p 〈 .01, and p 〈 .01 respectively）. Further, mothers had highperception to comply with diarrhea prevention behaviors. Those who perceived that diarrhea prevention behaviors werehighly beneficial to their children had good behaviors in preventing diarrhea. However, taking certain actions must considernegative aspects.

On Translation of Children’s Literature Based on Reception Aesthetics:A Case Study of The Secret Garden

Grounded in reader-centered theories,Reception Aesthetics prioritizes the active engagement and acceptance of target readers.This study examines the translation of children’s literature through the lens of Reception Aesthetics,using Li Wenjun’s rendition of The Secret Garden as a case study.The objective is to scrutinize various aspects of the translation-including vocabulary,syntax,rhetorical devices,and cultural nuances-and to discern how the adaptation and application of diverse translation strategies cater to the aesthetic expectations.

Frequency of E.coli pathotypes in acute diarrhea of children and its related factorsat Beassat hospital,Sanandaj

Objective:Diarrhea is a leading cause of morbidity and mortality among children in developing countries.The bacterial pathogen most commonly associated with childhood diarrhea is Escherichia coli.A one-year prospective study was carried out in Sanandaj to determine the prevalence and roles of the different E.coli pathotypes in children less than five years of age with acute diarrhea.Methods:Rectal swab were collected prospectively from children with acute diarrhea and transported to the Department of Microbiology,School of Medicine, KUMS,Sanandaj during 2008.The study was approved by the institutional ethics committee.Results:During this study period,rectal swabs were investigated from a total of 466 children 1 to 144 months of age(mean, 29.97 months±S.D) with diarrhea.Among the children,191(41%,191/466) were girls,and 275 (59%,275/466) were boys.The age-specific incidence rates of acute diarrhea among children 13-24 and 1 - 12 months of age were 37.37%(37/99) and 26.26%(26/99),respectively,during the study period.A total of 99 strains of E.coli were detected.EPEC 59(59.59%) and EIEC 22(22.22%),were the most commonly found Escherichia coli strains detected in stools from children.Disk diffusion testing showed E.coli strains resistance to tetracycline(89.89%),chloramphenicol(88.88%),Ampicillin(79.79%),Amoxicillin (75.75%) and Ceficime(75.75%).Among risk factors like age,sex,haemoglubin,fathers and mothers education,food and weight of children only mother's education was significant(P =0.018).Conclusion: In most of the clinical laboratories in Iran,E.coli does not considered as an etiologic agent responsible for diarrhea. Results in this study revealed that E.coli should be considered as an etiologic agent causing acute diarrhea among children.We therefore,recommend the routine isolation and identification of E.coli strains in all the clinical laboratories in Sanandaj.Guidelines for appropriate use of antibiotics in Sanandaj need updating.

Reflections on Conducting Kindergarten Language Education Activities Based on Children’s Literature

In early childhood education,language education is a crucial component,yet in kindergarten teaching,there often exists issues such as“emphasis on knowledge and neglect of practice.”To address this problem,teachers need to incorporate children’s literature in a reasonable manner to create a conducive environment for language education for young children.This article analyzes and discusses the significance of integrating children’s literature into kindergarten language education activities,and proposes strategies for addressing the current issues in kindergarten language education activities and conducting them based on children’s literature.

Research on the Influence of Family Education on Children’s Behavioral Habits

Under the background of the all-round deepening of quality education,the cultivation of comprehensive quality has become the main theme of contemporary education reform.Good behavior and habits are of great significance to children’s future learning,growth,and development.Through literature review and other methods,this paper analyzes the current situation of children’s family education and the influence of family education on the cultivation of children’s behavioral habits and provides some strategies for cultivating children’s good behavioral habits in family education.

The Market Development of Children’s Go Training and the Difficulty and Countermeasure Analysis of Go Training

The children’s Go training market is experiencing vigorous growth but also faces several challenges.As the importance of Go in cultural education increases,the market expands,with growing demand and involvement from training and educational institutions.However,the market encounters difficulties such as a shortage of high-quality Go coaches,uniformity in training content and methods,and high training costs.To address these issues,measures can be taken to strengthen the team of Go coaches,diversify training content and methods,and optimize the training cost structure,thereby promoting the healthy development of the children’s Go training market.

A Study of Health Prescribing for Children with Tourette’s Disorders in Children’s Health Education Specialty Care Clinics

Objective:This study designs and implements the health prescription of children’s health education specialized nursing clinic based on the physical and mental characteristics of children with Tourette’s syndrome.Methods:Applying the evidence-based nursing model and nursing intervention theory based on the survey research by searching China Knowledge Network,Wanfang Database and Wipro Chinese Science and Technology Journal Database,the study collected the literature on the health prescription intervention research in children’s Tourette’s disorders health education in children’s health education of specialized nursing outpatient clinic for review and combined with the specialty characteristics to formulate“Children’s Tourette’s Disorder Health Education Prescription.”Results:Tourette’s syndrome in children is a common pediatric neurological disorder,mainly manifested as involuntary,rapid and repeated muscle twitching and vocal tics,which brings serious psychological pressure and life disturbance to the affected children.Conclusion:For children with Tourette’s syndrome,healthcare professionals should give enough care and understanding to the children and their parents,provide timely and effective health education to them,help them improve their bad behavioral habits,establish correct cognitive attitudes,enhance self-confidence,improve patient compliance,reduce the frequency of recurrence,reduce the incidence of complications and promote children’s physical and mental health development.

Research on Children’s Game Activity Design Strategies Based on Embodied Cognition Theory

Edutainment,in the kindergarten education stage,emphasizes the game as the basic activity and combines the content of education with the form of the game,thus it also forms the educational method of gamification teaching.Through investigation and analysis,it is found that the current kindergarten game activity design has the problem of improper combination of educational content and game form.The current kindergarten game activity design has problems such as stereotypes,children’s lack of active learning opportunities in activities,teachers’insufficient theoretical understanding,inappropriate teacher guidance methods,and so on.Embodied cognition theory attaches importance to the important role of the body in the development of cognition,provides new guidance for classroom teaching,and opens up a new path for classroom teaching reform.Based on the perspective of embodied cognition theory,the concept of body and mind integration should be adhered to in kindergarten teaching with games as the basic activity,experiential teaching situation should be created,children’s subjective experience should be respected,and games and interactions should be designed to promote children’s physical and mental participation,thus laying a foundation for the realization of children’s individual freedom,autonomy,and all-round development.Therefore,this paper aims at the existing problems in the current kindergarten gamification teaching and discusses the design strategy of children’s game activities based on embodied cognition theory.

Predictors of Meningitis in Under-Fifteen Children Attending an Intensive Care Unit of an Urban Large Diarrheal Disease Hospital in Bangladesh

Background: Data are lack on predicting features of meningitis in diarrheal children although the great clinical importance. Objective: To evaluate clinical and laboratory features in predicting meningitis in under-fifteen children having diarrheal illnesses. Methods: Children aged 1 month to 15 years, admitted in the ICU of the Dhaka Hospital of icddr, b between March 2011 and February 2012 with fever and seizure or altered consciousness and having LP done were enrolled into this analysis. Those children who had abnormal CSF findings [pleocytosis (normal range of leukocyte, 0 - 10/mm3) and/or elevated protein (normal range, 0.10 - 0.45 mg/dl) and low glucose (normal value, 60% of corresponding blood glucose)] were defined as meningitis. Comparison was made between children with (cases = 17) and without meningitis (controls = 66) from our study children. Data were retrospectively collected from SHEBA, an online database system of the Dhaka Hospital of icddr, b. Results: Death was significantly higher among the cases compared to the controls (29% vs. 3%, p = 0.003). In logistic regression analysis, after adjusting for potential confounders, cases frequently had hypoxemia (95% CI 1.55 - 21.93), absent peripheral pulse (95% CI 1.95 - 27.13) and neutrophilia (95% CI 1.13 - 17.00). Conclusion: Our data suggest that children with meningitis had higher case fatality rate. Simple independent predictors of meningitis such as hypoxemia, absent peripheral pulse, and neutrophilia may help clinicians to initiate early and prompt management in order to curve lifelong sequel due to meningitis and death in such patient population especially those in resource poor settings.

Health and Nutritional Status of Young Foster Children Attending a Diarrhea Treatment Hospital in Bangladesh

There is scarcity of evidence-based information about socio-demographic as well as ailment factors associated with foster children in Bangladesh. Thus the aim of the present study was to determine the socio-economic, health and nutritional status of young foster children in urban Dhaka. A total of 208 (1%;n = 208/28,948) under-5 foster children were enrolled in the Diarrheal Disease Surveillance System of icddr,b between 1993-2012. Randomly selected under-5 children (n = 624) with a ratio of 1:3 were extracted and constituted as comparison group. Forty-three percent (n = 90) foster children were male. Lack of formal schooling of mother was higher among foster children compared to non-foster children (52% vs. 35%;p < 0.001). Higher proportion of foster children suffered from some or severe dehy-dration (60% vs. 47%;p = 0.001) and often received intravenous saline (12% vs. 5%;p = 0.002) in comparison to non-foster children. Significantly lower proportion of foster children had rotavirus diarrhea (26% vs. 43%;p < 0.001). In multivariate analysis, foster children were 2 times (95% CI: 1.31-4.32) more likely to be stunted and 194 times (95% CI: 82.25-457.76) more likely to be non-breastfed. Infants aged 6-11 months were 8 times (95% CI: 3.70-15.50) more likely to be foster compared to older children and probability of fostering was 7 times (95% CI: 3.96-13.33) higher among mothers with a median age of 25 years. The findings of our study clearly demonstrate the existing health and nutritional problems of foster children. Therefore, appropriate health and nutrition interventions are critical for foster children in Bangladesh.