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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

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
Abstract

Background: Newborns are the future generations and ensuring their healthy growth and development and all the activities regarding them must be the prime concern of societies. The Ethiopian government has used a combined efforts and interventions in health promotion, nutrition, and non-health sectors at different levels to reduce neonatal mortality but still has high neonatal mortality. The objective of this study was to assess the magnitude of neonatal mortality and associated factors among Neonates admitted in neonatal intensive care unit of Arba Minch general hospital.

Method: A cross sectional study was conducted from January, 01, 2015 to December, 31, 2017 G.C in Arba Minch General Hospital. Simple random sampling technique using computer generated random numbers was used to recruit the predetermined 332 samples. Data were collected using structured checklist and entered, coded, edited and cleaned using Epi-info version 7 and exported to SPSS version 23 for Windows. Crude and Adjusted Odd ratio, 95% CI and P-value were used to assess the strength of association and statistical significance. Variables which have p value <0.05 were declared as significant.

Results: The magnitude of neonatal mortality was 20.2%. The 5th minute APGAR score less than five (AOR:4.4; 95%CI: 1.98,9.65), Induced labor (AOR:2.7; 95%CI: 1.03,7.37), Duration of labor > 18 hour (AOR:2.6; 95%CI: 1.12,6.11), Time of rupture of membrane >12 hour (AOR:3.9; 95%CI: 1.5,9.87) and Birth order > (AOR:19.5; 95%CI: 6.84,55.45) were the independent factors which cause neonatal mortality.

Conclusion: The magnitude of neonatal mortality was high and the fifth minute APGAR score less than 5, Induced labor, Duration of labor more than or equal to 18 hours, Time of rupture of membrane more than or equal to 12 hours before delivery and being fifth or above birth order are the independent factors which cause neonates to die.

Fig-1_Age of Neonates at Admission in NICU at Arba Minch General Hospital, 2015-2017G.C (n=332)
Table-1: Maternal obstetrical factors of Neonatal mortality for Neonates admitted in NICU at Arba Minch General Hospital, 2015-2017G.C (n=332)
Author(s): Naja AS*, El Khatib H, Haber G, Eddine MN, Moussalem C, Rajab M, Saghieh S
Abstract

Arthrogryposis multiplex congenita is a rare, non-progressive congenital disorder characterized by multiple joint contractures associated with akinesia and connective tissue fibrosis that can be either generalized or limited to the upper and/or lower extremity. AMC is a group of conditions with varied etiologies including myopathic processes, neromuscular end-plates, connective tissue abnormalities, intra-uterine space limitation and vascular compromise, maternal factors, metabolic disturbances and neuropathic processes [2]. Neural tube defects including myelomeningocele have been identified as a cause of arthrogryposis in lower extremities [2]. We present, to the best of our knowledge, the first reported case in Lebanon of lower limb arthrogryposis due to lumbosacral myelomeningocele.

Lumbosacral Myelomeningocele.