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Asploro Journal of Pediatrics and Child Health

ASJPCH

Asploro Journal of Pediatrics and Child Health

About this Journal

Asploro Journal of Pediatrics and Child Health (ASJPCH) is an international, peer-reviewed open access journal in which it addresses not only health related issues (disease, infection, genetic disorder, growth impairment etc.), but also aims to cover topics related to the physical, emotional and social well-being of children. Child psychology, behavioral aspects, societal apathy, exposure to the criminal and violent environment, parental negligence, and cultural background, are some of the factors that influence the development of a child; and any research related to these issues will be accepted for publication….

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Latest Papers

Abstract

Objective: To compare medication errors that reached pediatric and adult patients during hospitalization.

Methods: Observational, non-experimental, cross-sectional study from January 2011 to March 2015 at two community-based, teaching hospitals

Results: Over a 4-year period, there were 4.2 and 13.3 million doses dispensed in pediatrics and adults, respectively. Less than 0.25% of doses dispensed contributed to medication errors, with 9.6% of these medication errors reaching patients and 0.04% causing harm. There was no statistical difference in medication error rates based on doses dispensed, patient-days, admission rate, and severity. However, significantly more errors in the documentation and prescribing processes occurred in adults (21.9% vs 6.5% and 37.4% vs 29.8% respectively, p<.001) versus administration in pediatrics (42.5 vs 29.8% in adults, p <0.001). Errors in drug administration that occurred in pediatrics consisted of infusion devices, incorrect dose, the omission of medication, and time of administration. Pediatrics had higher medication errors related to electrolytes and total parenteral nutrition. Independent of age, there were more medication errors that caused harm in patients residing in the intensive care unit (5.5% of 769 vs 3.5% of 2800 patients, respectively, p =0.006).

Conclusion: While the prevalence of medication errors that reached patients and caused harm were similar between adults and pediatrics, the types of errors within the medication use process, class of drugs, and severity of the mediation errors varied between the groups. Given these differences, it is quintessential to develop population-specific medication safety programs aimed at addressing the needs of pediatric patients to enhance safe medication use.

Comparative Cross-Sectional Pharmacovigilance Study of Medication Errors in Children and Adults in Community-Based Hospitals
Comparative Cross-Sectional Pharmacovigilance Study of Medication Errors in Children and Adults in Community-Based Hospitals
Abstract

An umbilical cord hernia (UCH) is a form of abdominal wall defect, affecting 6 out of every 10,000 newborns. The persistence of urachus is an embryonic remnant that connects the bladder to the abdominal wall at the level of the umbilicus, being yet more uncommon. We reviewed the literature, searching in PubMed, under the terms “Hernia of umbilical cord”, “Congenital hernia of cord” and “Persistent Urachus”. Only a few similar cases of both pathologies associated described were found. Our main objective is to highlight the distinct clinical features, embryogenesis, prognosis and associated anomalies of two infrequent embryopathies. And to describe a infrequent case of both abnormalities presenting simultaneously.

UCH are often misdiagnosed with other abdominal wall deffects, such as omphalocele, umbilical hernias, gastroschisis and umbilical cord cysts. The normal cord insertion, adequate muscle development of the abdominal wall and a wall defect less than 5cm is what differentiates it from an omphalocele. UCH has a low morbidity overall, as it is not associated with other anomalies. The most frequently observed urachal malformations are the persistence of a urachus and urachal cyst. The prenatal diagnosis of patent urachus is made by ultrasound or magnetic resonance, being easily mistaken with abdominal wall defects, confirming the diagnosis with an ultrasound at birth. The persistence of urachus may resolve spontaneously, if not, surgical resolution is recommended. Similar to a UCH, a patent urachus shows little association with other malformations.

It is important to know the clinical presentation and the diagnostic perinatal methods employed for appropriate management and favorable results for both pathologies. This relies on knowing when to suspect possible associated anomalies and when complementary studies might be needed. It is also important to be aware that there is the possibility of a UCH and a patent urachus existing simultaneously.

Umbilical Cord Hernia Associated with a Patent Urachus: A Case Report
Umbilical Cord Hernia Associated with a Patent Urachus: A Case Report
Abstract

Aim: Aplastic anemia is a rare syndrome of bone marrow failure. There is a dearth of data on the clinical and demographic profile of pediatric patients with aplastic anemia in the Philippines. This study provides data on pediatric patients with aplastic anemia seen in the Philippine national tertiary hospital in an 8-year period.

Methods: Records of patients below 19 years of age diagnosed with aplastic anemia at the Philippine General Hospital from 2006 to 2013 were retrieved. Only patients with bone marrow examination results confirming the diagnosis of aplastic anemia were included. The patients’ clinical data and diagnostic results were presented using descriptive statistics.

Results: A total of 39 pediatric patients were diagnosed with aplastic anemia in the Philippine national tertiary hospital from 2006 to 2013. There were 25 males and 14 females. The median age was 13 years, and majority (66.7%) resided in urban dwellings. Thirteen patients had non-severe disease, 15 had severe, and 11 had very severe aplastic anemia. Majority (87.2%) were classified as idiopathic. Sixteen patients received cyclosporine (41.1%) and four received corticosteroids (10.2%). The rest received supportive therapy only. Seven patients died due to sepsis (18%), while the rest were lost to follow-up.

Conclusion: Management and long-term follow up of children with aplastic anemia in the Philippines need to be improved. Provision of financial and social support and the creation of a registry of aplastic anemia may improve the outcome of patients.

Clinical and Demographic Profile of Pediatric Patients with Aplastic Anemia Seen in the Philippine National Tertiary Hospital from 2006 to 2013
Clinical and Demographic Profile of Pediatric Patients with Aplastic Anemia Seen in the Philippine National Tertiary Hospital from 2006 to 2013
Author(s): Ale H*, Zapata CP, Castellano-Sanchez AA, Poppiti RJ, Brathwaite C, Escobar RA, Zapata CM, De Angulo GR
Abstract

Background: Hodgkin Lymphoma (HL) represents a disease of successful outcome due to advances in modern medicine. A significant percentage of patients respond very well to treatment, achieving relapse free survival. However, despite appropriate treatments as many as 20% of these patients die of this disease. Risk stratification allows therapy to be selected based on specific prognostic indicators.

Procedure: A retrospective cohort study containing 25 pediatric classical HL cases were evaluated from the files of Miami Children’s Hospital Department of Pathology. The study aimed to analyze tumor-associated macrophages via CD68 immunohistochemistry in tissue obtained at the time of diagnosis. It studied the prognostic value of CD68+ histiocytes against a patient’s response to treatment and survival rates, as a possible correlation of this biomarker with outcomes.

Results: Higher levels of CD68+ macrophages was strongly correlated with a significant probability of relapsing from complete response (P=0.005), along with a greater likelihood of death from lymphoma (P=0.024). Furthermore, survival analysis demonstrated a decreased progression-free survival (P=0.001) and disease specific survival (P=0.023) when the microenvironment showed elevation of these macrophages.

Conclusions: The presence of an increased expression of CD68+ macrophages was found to be associated with a worse prognosis in a pediatric patient with HL. This study, establishes a new use for CD68, as a reliable immunohistochemical marker in pediatric patients with equivalent predictor outcomes as those reported in adult cases. This biomarker helps to identify those pediatric patients at higher risk of treatment failure, and thus provide the basis for individualized patient treatment.

Significance of CD68 Tumor Infiltrating Macrophages in Pediatric Classical Hodgkin Lymphoma
Significance of CD68 Tumor Infiltrating Macrophages in Pediatric Classical Hodgkin Lymphoma

2-month-old had fever, decreasing urine output and progressing abdominal distension. His renal function showed mild deterioration from the normal limits and ultrasound abdomen showed right perinephric collection measuring 1.7x 0.8 cm (Panel A) with grade 1 hydronephrosis. Micturating cystourethrogram revealed extravasation of dye from right lower pelvicalyceal system and grade 5 vesicoureteral reflux (Panel B). His blood and urinary culture were sterile, however, he needed prophylactic broad-spectrum antibiotics, continuous urinary catheterization and percutaneous drainage of the ascites. His urinary electrolytes consistent with urinary ascites and cystoscopy revealed posterior urethral valve and irregular bladder which eventually required ablation of the valve. Urinoma secondary to the posterior urethral valve occur because of rupture of calyceal fornixes. Pelvicalyceal rupture secondary to posterior urethral valve resulting in urinary ascites was likely condition in this patient. His pelvicalyceal rupture improved without any intervention, renal function back to normal and percutaneous drainage catheter was removed.

An infant with fever, oliguria, and abdominal distension
An infant with fever, oliguria, and abdominal distension