American Journal of Pediatric Medicine and Health Sciences (2993-2149)
American Journal of Pediatric Medicine and Health Sciences (2993-2149) under U.S. ISSN Center - is an international, open-access, peer-reviewed online journal covering all aspects of the diagnosis, management, and prevention of disorders specific to children and adolescents, including pediatric oncology, pediatric cardiology, pediatric critical care, pediatric endocrinology, pediatric gastroenterology, hepatology and nutrition, pediatric hematology and hematological malignancies, obstetric and pediatric pharmacology, pediatric immunology, pediatric infectious diseases, pediatric nephrology, pediatric neurology, pediatric orthopedics, pediatric otolaryngology, pediatric pulmonology, pediatric surgery, pediatric urology and etc.
Maternal Serum Netrin-1 as a New Biomarker of Preeclampsia
Background: The netrin-1 serum is extensively expressed in various tissues such as renal tissues and placenta. It is predominantly implicated in cell migration development, cell adhesion and cell survival. Netrin-1 serum is also important in the formation of the placenta by enhancing the growth of cytotrophoblast and placental vapour development. Aim: To determine whether the use of serum netrin-1 levels measurement might be linked to preeclampsia or might be a biomarker of preeclampsia. Patients and Method: The case-control study was done in Alzahraa Teaching Maternity and Pediatrics Hospital / Najaf Governorate / Iraq, in the year period starting 1 st January 2024 to 1 st January 2025. The convenience sampling technique was used to recruit a total of 90 singleton pregnant women. The sample incorporated two groups whereby the case group comprised 45 pregnant women exposed to preeclampsia and the control group comprised of 45 healthy pregnant women (normotensive and never had any medical disease in their history). The serum netrin-1 was measured with the help of an Enzyme-Linked Immunosorbent Assay kit. Findings: The serum netrin-1 mean showed a significant difference that was found to be elevated at the case group (non-severe and severe preeclampsia) than in the control group. Besides, it was also more pronounced in patients with non-severe preeclampsia than in the control group (P-value=0.001). Moreover, it was much greater in the case of severe preeclampsia patients as compared to non-severe preeclampsia (P-value=0.019). There were also significant positive associations between serum netrin-1 and alanine transaminase, aspartate transaminase, blood urea, serum creatinine and negative significant association between serum netrin-1 and platelet count in case. The sensitivity, the specificity, and the accuracy of serum netrin-1 in the diagnosis of preeclampsia were 93.3, 80 and 86.6 respectively with a cut-off point of 698 pg/ml. Conclusion: Netrin-1 serum can be considered as a potential biomarker in the prediction and detection of preeclampsia.
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Ultrasound-Guided Versus Landmark Technique for Spinal Anesthesia: A Comparative Study of Success Rate, Procedure Time, and Complications
Background: Spinal anesthesia is extensively applied in lower abdominal and lower limb surgery; nonetheless, the traditional landmark technique is linked to the varying success rates and complications. Ultrasound guidance has been brought out as a possible tool of enhancing accuracy and clinical results. Aim: To compare the ultrasound-guided with the landmark methods of spinal anesthesia in terms of the first-attempt success rate, duration of the procedure, and complications. Methods: It was a prospective comparative study that was carried out over a period of one year in the Medical Research Teaching Hospital. One hundred and twenty adult patients who were to undergo elective surgeries under spinal anesthesia were divided equally between two groups; ultrasound-guided (n = 60) and landmark technique (n = 60). The first-attempt success rate was used as the primary outcome, and other secondary outcomes were the procedure time, the number of attempts, as well as the complications. Data analysis was done with SPSS 28 and p = 0.05 was used as the level of significance. Findings: The ultrasound group had a much higher success rate on the first attempt than the landmark group (86.7% vs 63.3% p = 0.003). The time spent at the procedure was also a lot less in the ultrasound group (3.8 +1.2 minutes vs 6.1 +2.0 minutes, p = 0.001). Also, ultrasound group experienced fewer needle attempts and reduced cases of complications, such as paresthesia, bloody tap, and failed block (p < 0.05). Conclusion: Ultrasound-guided spinal anesthesia is better and safer in comparison to the traditional landmark method, with a better success rate, shorter duration of a procedure, and less number of complications. It is advisable to incorporate it into the normal practice of anesthetic practice in case of resources.
Association between Periodontitis and Glycaemic Control Among Adults with Type 2 Diabetes in Ogun State, Nigeria: A Cross Sectional Study
Background: Periodontitis and type 2 diabetes mellitus (T2DM) share a bidirectional relationship mediated by chronic inflammation and immune dysregulation. Evidence from high income countries shows that periodontitis is associated with poorer glycaemic control, and that periodontal therapy can modestly reduce glycated haemoglobin (HbA1c) levels, but data from sub Saharan Africa remain scarce (Mauri Obradors et al., 2018; Sanz et al., 2018; Tsobgny Tsague et al., 2018; Simpson et al., 2022). This study assessed the association between periodontal status and glycaemic control among adults with T2DM attending public hospitals in Ogun State, Nigeria. Methods: A hospital based cross sectional study was conducted among adults with T2DM attending teaching and general hospitals in Ogun State. Sociodemographic, behavioural and clinical information was collected using interviewer administered questionnaires and medical records. Periodontal status was assessed using the 2018 case definition for periodontitis. Glycaemic control was determined using HbA1c, with poor control defined as HbA1c ≥ 7.0%. Multivariable logistic regression was used to examine the association between periodontitis and poor glycaemic control, adjusting for age, sex, body mass index (BMI), and duration of diabetes, smoking and oral hygiene practices. Results: A total of 234 participants were included; 142 (60.7%) had periodontitis. Poor glycaemic control was observed in 64.8% of participants with periodontitis compared with 41.3% of those without periodontitis. After adjustment for potential confounders, periodontitis remained significantly associated with poor glycaemic control (adjusted odds ratio [AOR] ≈ 2–3, 95% confidence interval not including 1). Conclusion: Periodontitis was independently associated with poor glycaemic control among adults with T2DM in Ogun State. Integrating periodontal screening, prevention and basic periodontal therapy into routine diabetes care in Nigerian public hospitals may improve metabolic outcomes and support holistic non communicable disease management.
Stigma and Discrimination Experienced by Individuals Living with Sickle Cell Disease in Lagos Metropolis, Nigeria
Introduction: Sickle cell disease (SCD) is a common inherited blood disorder in Nigeria, often accompanied by social stigma and discrimination. Misconceptions about its causes, inheritance, and management affect the psychosocial well-being of affected individuals. Objectives: This study assessed stigma and discrimination experienced by individuals living with SCD in Lagos Metropolis, Nigeria. Method of Analysis: A cross-sectional community-based survey was conducted among 600 adults using multistage cluster sampling. Data were collected with a semi-structured interviewer-administered questionnaire covering socio-demographics, knowledge and beliefs about SCD, attitudes, genotype awareness, personal contact with individuals with SCD, and stigmatizing behaviors. Descriptive statistics summarized the data, while chi-square tests assessed associations between variables. Results: Awareness of SCD was universal, with friends/relatives and radio/TV as primary information sources. Knowledge and genotype awareness were moderate, with only 55% knowing their genotype. Attitudes were generally positive, but 28% reported high social distance behaviors. Higher knowledge and favorable attitudes were significantly associated with lower social distance (χ² = 18.6, p < 0.001), while low personal contact and lack of genotype awareness predicted higher stigma (χ² = 15.4, p = 0.002). Conclusion: Despite high awareness, stigma and discriminatory behaviors toward individuals with SCD persist. Community education, genetic counseling, and promoting positive interactions are essential to reduce stigma and improve social inclusion.
Radiomonitoring at the Meat-Oriented Farm “Soatov Otabek” in the Amudarya District of the Republic of Karakalpakstan
This article presents the results of radiometric monitoring conducted at the meat-oriented agro-farm “Soatov Otabek,” located in the Amudarya district of the Republic of Karakalpakstan. Samples of soil, alfalfa, water bodies, and hay collected from the farm territory were analyzed under laboratory conditions. The levels of ionizing radiation and the presence of radioactive substances were determined. Based on the obtained results, the radiation status of the farm environment was evaluated and compared with established regulatory standards. The findings confirm the importance of radiomonitoring in ensuring environmental safety and the quality of livestock products.
Surgical Techniques and Treatment Results of Skin Graft Reconstruction in Post-Burn Elbow Contractures
Post-burn scar deformities and contractures affecting joint regions, particularly the elbow, represent a significant clinical problem due to their impact on both functional capacity and aesthetic appearance. These pathological changes often result in restricted range of motion, discomfort, and a noticeable decline in patients’ quality of life and daily activity levels. Among the available reconstructive methods, skin grafting remains one of the most reliable and widely used techniques for correcting such deformities. This study focuses on the surgical principles and technical nuances of skin grafting in the management of post-burn elbow deformities. Special attention is given to preoperative evaluation, including assessment of scar characteristics and tissue condition, as well as to the selection of appropriate grafting techniques. In addition, key aspects of postoperative care, rehabilitation, and complication prevention are discussed. The findings indicate that properly planned and executed skin grafting significantly improves joint mobility, restores functional performance, and enhances cosmetic outcomes. Furthermore, the integration of adjunctive methods, including physiotherapy and laser therapy, contributes to better long-term results and reduces the risk of recurrence.
Healthcare Financing Options for Under-Five Child Care and Their Implications for Primary Healthcare Utilization in Oyo State, Nigeria
Under-five morbidity and mortality remain major public health challenges in Nigeria. Timely utilization of primary healthcare (PHC) is essential for preventing and managing common childhood illnesses. Caregivers’ socio-demographic characteristics, education, and household income strongly influence PHC utilization. Out-of-pocket payments dominate healthcare financing, limiting timely utilization of PHC services, while enrolment in health insurance schemes remains low, particularly among informal and low-income households. Understanding how caregiver factors interact with financing methods is critical for improving PHC access and child health outcomes. This study assessed the relationship between caregivers’ healthcare financing options and PHC utilization for under-five children in Oyo State, Nigeria. A cross-sectional survey was conducted among caregivers of under-five children, collecting data on socio-demographics, income, health-seeking patterns, and financing options. Descriptive statistics and chi-square tests were employed to examine associations between variables. The mean age of caregivers was 31.0 years (SD ± 8.5), with 91.7% female and 77.5% married. Informal employment was predominant (56.2%), and the majority earned below ₦100,000 per month. Out-of-pocket payment was the most common financing method (44.5%). PHC utilization was suboptimal, with only 22.7% of caregivers seeking care from PHC facilities during child illness and 53.1% delaying care by more than five days. Socio-demographic characteristics, particularly age, education, and income, significantly influenced financing choices and uptake of PHC. (p<0.001). Expanding affordable insurance coverage, promoting caregiver-targeted health education, and strengthening PHC service delivery and governance are essential to enhance timely utilization and equitable access, contributing to improved child health and progress toward universal health coverage in Nigeria.
Presently Frequent Occurrence Of Cervical Pathologies And Their Causes.
Cervical pathologies are a group of diseases that are widespread among women of reproductive age. In recent years, the incidence of inflammatory diseases, dysplasia and cervical cancer has been increasing. This article analyzes the types, etiological factors, pathogenesis, risk factors and causes of their spread of cervical pathologies. The main etiological factors are human papillomavirus (HPV), early sexual life, polysexual intercourse, decreased immunity and lack of screening. Early diagnosis and preventive measures are important in reducing the incidence.
Assessment of Attitudes and Perceptions toward COVID-19 Vaccination among Community Health Workers in Training at Agency Schools, University College Hospital, Ibadan, Nigeria
Background: Community health workers play a critical role in the promotion of public health interventions, including vaccination. Their attitudes and perceptions toward COVID 19 vaccination can influence both personal uptake and advocacy within the wider community. This study assessed the awareness, attitudes, perceptions, and factors associated with COVID 19 vaccine acceptance among community health workers in training at Agency Schools, University College Hospital (UCH), Ibadan, Nigeria. Methods: A descriptive cross-sectional study was conducted among 200 trainees enrolled in the Primary Health Care Tutors and Community Health Officers Training Programmes. Data were collected using a structured self-administered questionnaire, capturing socio-demographic characteristics, knowledge, perception, attitude, vaccination status, and factors influencing vaccine acceptance. Descriptive statistics, frequencies, percentages, and chi-square tests were used to analyze associations between perception, attitude, and vaccine uptake. Results: The mean age of respondents was 32.1 ± 8.4 years, with a majority being female (65%) and of Yoruba ethnicity (80%). Awareness of COVID 19 and preventive measures, including vaccination, was high, with 98% demonstrating knowledge of transmission routes and 95% aware of vaccine side effects. Eighty-five percent had received at least one dose of the COVID 19 vaccine, and 83% completed the full vaccination schedule. Positive attitudes toward vaccination, including encouragement of peers, were observed in 95% of respondents. Misconceptions regarding vaccine safety and efficacy were minimal but present. Chi-square analysis indicated significant associations between both attitude and perception with vaccine acceptance (p < 0.05). Perceived factors influencing vaccine uptake included personal health considerations, peer influence, and access to vaccination information. Conclusion: Community health worker trainees at UCH Ibadan demonstrated high awareness and generally positive attitudes toward COVID 19 vaccination, which were strongly associated with uptake. Residual misconceptions highlight the need for continued educational interventions, peer advocacy, and transparent communication to sustain vaccine confidence. Strengthening these strategies within training programs can enhance both personal uptake and broader public health promotion.
Risk Factors Associated with Severe Dehydration in Children with Acute Diarrhea in Emergency Settings
Background: Acute diarrhea is a leading cause of emergency care to children hospital globally and it still makes a significant contribution to the under-five morbidity and mortality. The most life-threatening complication is severe dehydration that has to be identified and treated immediately. Knowledge of clinical and socioeconomic predictors in the emergency situation plays a crucial role in selecting prevention initiatives. Aim: To identify the prevalence and independent predictors of severe dehydration in children that report to emergency departments with acute diarrhea. Methods: It was a hospital-based analytical cross-sectional study that was done in three tertiary emergency departments that were based in pediatric units with a 12 months period. Four hundred and twenty children aged between 1-59 months old diagnosed with acute diarrhea underwent enrolment in consecutive sampling. The level of dehydration was categorized by the WHO. The sociodemographic and nutrition, clinical, and home-management variables were obtained by interviewing caregivers and examining these factors by the doctor. The logistic regression analysis showed the multivariate predictors of severe dehydration with adjusted odds ratio (AOR), and 95% confidence interval (CI) being evaluated. Aim: 128 children were found to have severe dehydration (30.5%). Independent predictors were lack of oral rehydration therapy (AOR = 3.82; 95% CI: 2.156788), later presentation >48 hours (AOR = 3.12; 95% CI: 1.885.16), stool frequency>8/day (AOR = 2.91; 95% CI: 1.704.98), moderate/severe malnutrition (AOR = 2.74; 95) Conclusion: In emergency departments in almost a third of cases of children with acute diarrhea, severe dehydration was found. The clinical severity indicators as well as modifiable home-care practices both posed a significant risk. Rehydration therapy at an early stage, breastfeeding and timely treatment are significant measures to decrease emergency complications and avoid death.
Pediatric Nutrition Determinants, Health Outcomes, and Public Health Implications
The importance of pediatric nutrition, however, is its impact on a child growth and development as well as subsequent immune health and long-term outcomes. Adequate consumption of macronutrients and micronutrients in early childhood is critical for healthy physical and cognitive development. Yet there are global disparities, with undernutrition and micronutrient deficiencies continuing to be major public health challenges alongside emerging childhood obesity. The latest epidemiological evidence shows malnutrition is a direct contributory factor in over 45% of all deaths among under-fives worldwide. Rapid dietary transitions and urbanization have simultaneously resulted in increasing prevalence of overweight and metabolic disorders in children. Both extremes of malnutrition undernutrition and overnutrition have long-term consequences such as compromised immunity, poorer education achievement and greater risk for non-communicable diseases in adulthood. This article summarizes current evidence on the determinants of nutritional status in children and adolescents, describes health outcomes associated with nutritional imbalance, and outlines preventive approaches at familial/community/policy levels. As we work to improve sustainable child health outcomes worldwide, reinforcing early-life nutritional interventions continues to be a critical factor.
Comparison between Traditional Surgery and Laparoscopic Surgery in the Treatment of Hernias in the Elderly
Hernia repair in older patients typically involves a number of complexities related to the effects of aging on the body as well as underlying medical issues. This research has compared and contrasted open term with laparoscopically performed hernia repairs while evaluating operative outcomes, short-term recovery periods, complication rates, and long-term results. The terminal ambit of surgical evaluations showed that laparoscopy took about 10 minutes longer on average (95 ± 20 min) than open procedures (85 ± 15 min) during the course of surgery; however, the amount of blood lost during laparoscopic repair was much less (60 ± 20 ml versus 120 ± 30 ml). Regarding early recovery from surgery, patients undergoing a laparoscopic repair were able to ambulate sooner (1.5 ± 0.4 days post-op) when compared with patients undergoing an open repair (2.5 ± 0.5 days post-op), and exhibited fewer pain complaints (VAS 3 ± 1 versus VAS 6 ± 1), and stayed in the hospital for less time (3 ± 0.8 days versus 5 ± 1 days). The incidence of postoperative complications was higher in patients who had an open repair; for example, there were greater instances of wound-related morbidity due to wound infections (8% vs 3%) and seromas (10% vs 4%) in the open repair group when compared with the laparoscopic group. Incidence rates of cardiopulmonary events were somewhat higher during the immediate post-operative period in the laparoscopic group (6% vs 5%), however, all cardiopulmonary events were associated with an early post-operative period only. Recurrence rates of hernia at longterm follow-up were similar (4% laparoscopic vs 5% open), but laparoscopic repair patients exhibited more optimal functional status and greater patient satisfaction (90% vs 75%). Patients who had laparoscopic repairs also experienced significantly less chronic pain than patients who had open repairs (5% vs 12%). In conclusion, laparoscopic hernia repair provided numerous advantages to elderly patients over open procedure including shorter recovery time, lower complication rates and better long-term quality of life while presenting comparable rates of hernia recurrence.
Antibiotic Resistance in Uzbekistan And Germany: A Comparative Investigation into Public Health Implications
This study sets out to investigate and contrast the prevalence of and health burden associated with antibiotic resistance in Uzbekistan and Germany, with a special emphasis on the public health implications in both countries. Comparing healthcare systems, antibiotic use and resistance rates, the study helps to identify that contribute to development of resistance. Data were from health authorities, hospital reports and literature with comparison of differences and similarities between the 2 countries. The results of the work offer valuable input to the worldwide problem of antibiotic resistance underlining that purpose-oriented measures and international collaboration for containment are urgently needed.
Obesity Prevalence and its Health Implications: A Cross-National Analysis of Uzbekistan and Germany
Obesity has become an increasing worldwide health problem associated with chronic diseases including cardiovascular disease, type 2 diabetes as well as several cancers. The current study aims to compare the prevalence of obesity and related health consequences between a low-middle income country (Uzbekistan) and a high-income nation (Germany). Germany: Germany has an established obesity epidemic, with more than 50% of adults overweight Uzbekistan: Rapid urbanization and changes in diet have led to an emerging obesity crisis in the country The analysis describes underlying factors such as SES, diet, PA, and urbanization. It assesses the impact of public health interventions in each country, too. Results It seems that in Germany many public health programs were launched but had only some—primarily among the socially challenged groups—success. In contrast, Uzbekistan is at an early phase of the obesity epidemic and needs focused prevention plans. This study recommends country-specific public health interventions in both countries to address the escalating obesity epidemic and its consequential health effects.
Clinical Features of Bronchial Asthma in Children
Identification of clinical forms of bronchial asthma in children in the presence of causally significant allergens and concomitant allergic diseases associated with rhinoconjunctival symptoms, seizures develop rapidly, often acquiring a severe course of the disease.When bronchial asthma was combined with rhinoconjunctival symptoms, seizures developed intensively, the disease was severe and serious complications were observed.
Mechanisms of Brain Adaptation in Post-Stroke Motor Recovery
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Exercise-Based Cardiac Rehabilitation: Impact on Myocardial Function measured by Global Longitudinal Strain
Measures of cardiovascular (CV) health and function are improved by exercise. However, it might be challenging to determine the short-term efficacy of an exercise intervention when conventional metrics steadily improve. Reductions in left ventricular global longitudinal strain (LVGLS) are a powerful predictor of future cardiac dysfunction and death. LVGLS is a very sensitive cardiac imaging tool that can identify myocardial dysfunction before more conventional assessments. Because of its sensitivity, LVGLS may provide a practical way to monitor the short-term impact of an exercise intervention on CV function, giving practitioners valuable data to enhance patient care in exercise environments. It's unknown, nevertheless, how exercise affects LVGLS. This systematic review and meta-analysis aimed to determine the effect exercise has on LVGLS across a range of populations. Included studies assessed LVGLS pre–post an exercise intervention (minimum 2 weeks) in adults 18 years and over, and were published in English from 2000 onwards. Study-level random-effects meta-analyses were performed using Stata (v16.1) to calculate summary standardized mean differences (SMD) and 95% confidence intervals (CI). 39 studies met selection criteria, with 35 included in meta-analyses (1765 participants). In primary analyses, a significant improvement in LVGLS was observed in populations with CV disease (SMD=0.59; 95% CI 0.16–1.02; p=0.01), however, no significant effect of exercise was observed in CV risk factor and healthy populations. In populations with CV disease, LVGLS could be used as an early biomarker to determine the effectiveness of an exercise regime before changes in other clinical measures are observed.
Utilizing Global Longitudinal Strain (GLS) to Guide Safe Exercise Prescription and Physical Rehabilitation in Pediatric BAV Patients
Bicuspid aortic valve (BAV) is one of the most common congenital heart defects in children and is frequently associated with progressive valvular dysfunction and aortopathy. Conventional assessment using left ventricular ejection fraction (LVEF) may fail to detect early myocardial impairment. Despite increasing clinical application of speckle tracking echocardiography (STE), limited pediatric evidence exists regarding the prognostic value of global longitudinal strain (GLS) for identifying subclinical left ventricular dysfunction and guiding early clinical decision-making in BAV patients. This study provides an analytical evaluation of recent pilot evidence assessing GLS in pediatric BAV patients, with emphasis on segmental strain abnormalities and phenotype-specific risk stratification through STE-derived measurements. The evidence indicates that GLS is more sensitive than LVEF in detecting subtle myocardial dysfunction even when global systolic performance appears preserved. Segmental strain reductions, particularly in inferior, anterior, and apical regions, were identified as early indicators of myocardial alteration. Integration of GLS into routine pediatric BAV assessment may enhance early risk stratification, support safe exercise prescription, and enable personalized monitoring strategies. Nevertheless, larger multi-center longitudinal investigations are necessary to validate GLS as a standardized prognostic marker in pediatric cardiology practice.
Cholesteatoma of the Pineal Region of the Brain
Pineal region cholesteatoma (intracranial epidermoid cyst) is a rare benign congenital lesion characterized by accumulation of keratinized epithelium. Due to its slow growth, the tumor may remain asymptomatic for a long period and becomes clinically evident after compression of surrounding brain structures and ventricular system. This article presents a clinical case diagnosed using MRI and treated surgically. Neuroimaging revealed a large cystic formation in the pineal region. Microsurgical removal of the lesion was performed successfully, and the postoperative period was without complications. Early radiological diagnosis and timely surgical intervention are essential for favorable outcomes. Long-term follow-up is recommended because recurrence may occur.
Health Risk Analysis and Source Apportionment of Polyaromatic Hydrocarbons in Water and Sediment in Aluu River
This study focuses on the health risk analysis and source apportionment of polyaromatic hydrocarbons in water and sediment in Aluu River. The objectives were to quantify and characterize PAH concentrations, determine the sources of these contaminants and the health risks associated with exposure to polycyclic aromatic hydrocarbons. Surface water and sediment samples were collected from multiple locations along the Aluu River using standard sampling protocols. PAHs were extracted and quantified using Gas Chromatography-Mass Spectrometry (GC-MS) methods. Source apportionment was conducted using principal component analysis (PCA), while ecological and human health risk assessments were performed using hazard quotient (HQ) and cancer risk (CR) models. PAHs were detected in both water and sediment, with total concentrations ranging from 3.33 to 6.41 µg/L in water and 22.33 to 31.00 µg/kg in sediments. High molecular weight PAHs (HPAHs) predominated, suggesting pyrogenic sources. Health risk assessments indicated elevated HQs for several carcinogenic PAHs such as chrysene, benzo[a]pyrene, and benzo[ghi]perylene. The total cancer risk from PAHs in surface water ranged from 0.039 to 0.090, significantly above the acceptable threshold (1.0 × 10⁻⁶), indicating potential long-term health concerns. Principal component analysis (PCA) identified distinct pollution sources for PAHs, including industrial discharge, combustion activities, and urban runoff. The findings demonstrate significant contamination of the Aluu River by PAHs, with sediment acting as a major sink for these pollutants. The dominance of high-risk carcinogenic PAHs, coupled with elevated health risk indices, indicates potential long-term ecological degradation and serious public health concerns for populations dependent on the river. Establishment of a long-term environmental monitoring program to track PAHs trends and evaluate effectiveness of mitigation strategies is recommended
Interrelation Between Inflammatory Periodontal Diseases and Bronchial Asthma: Pathogenetic Parallels and Treatment Tactics
The article examines the mechanisms of the relationship between bronchial asthma and chronic periodontitis. The authors analyze common immuno-inflammatory links of pathogenesis, the impact of inhalation therapy on oral health, and the clinical features of periodontitis progression in the context of comorbid pathology. Ways to optimize complex treatment based on an interdisciplinary approach are proposed.
Specificity of Immunity in Children Living in the South Aral Sea Region After Vaccination with Different Pneumococcal Vaccines
Two types of pneumococcal vaccines for children are registered in Uzbekistan: Prevenar-13 (Pfizer, USA), which contains capsular polysaccharides of thirteen pneumococcal serotypes conjugated with genetically engineered diphtheria toxoid, and 10-valent conjugate vaccine Pnevmosil (India). Until 2020, children were vaccinated with the 13-valent vaccine Prevenar-13, after 2020 - Pnevmosil-10. We conducted a study to assess the humoral immune response (IgG) to 15 pneumococcal CPS in ELISA in children with pneumonia, as well as in relatively healthy children. Analysis of the same sera showed a higher level of IgG in the post-vaccination period to the Prevenar-13 vaccine to a greater extent than to the 10-valent vaccine (1.3-2 times).
Integrating Artificial Intelligence, Machine Learning, and Molecular Sciences in Biomedical Research: Applications in Laboratory Medicine, Cancer Biology, and Public Health
Artificial intelligence (AI) and machine learning (ML) are rapidly transforming biomedical research, offering novel solutions to longstanding challenges in laboratory medicine, cancer biology, molecular sciences, drug discovery, and public health. These technologies enable the analysis of vast, complex datasets, facilitating pattern recognition, predictive modeling, and data integration at scales beyond human capability. In laboratory medicine, AI and ML enhance diagnostic accuracy, automate repetitive processes, reduce errors, and shorten turnaround times, while supporting decision-making through intelligent data interpretation. In cancer biology, machine learning models integrate genomic, proteomic, imaging, and clinical data to predict disease progression, therapeutic response, and patient outcomes, advancing precision oncology. Similarly, AI applications in molecular sciences, including molecular pathology and allergen classification, improve disease categorization and personalized treatment strategies. In drug discovery, AI accelerates compound screening, predicts drug-target interactions, and supports rational design of therapeutics, exemplified by technologies such as AlphaFold, which accurately models protein structures. Public health also benefits from AI-driven predictive modeling for outbreak detection, risk stratification, and resource optimization. Despite these advancements, challenges remain, including the need for high-quality, representative datasets, algorithm validation, ethical considerations, data privacy, and workforce training. Interdisciplinary collaboration among clinicians, researchers, data scientists, and policymakers is essential to ensure responsible and effective implementation. Looking forward, AI and ML are poised to redefine biomedical research, enabling data-driven insights, personalized medicine, and improved healthcare outcomes, provided that technical, ethical, and regulatory challenges are addressed.
Sepsis Disease and Treatment in Children
Sepsis in children remains a critical global health challenge and a leading cause of morbidity and mortality, particularly in neonatal and pediatric intensive care settings. It is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Early diagnosis and prompt treatment are crucial for improving survival outcomes and reducing long-term complications. This article reviews the etiology, pathophysiology, clinical manifestations, diagnostic criteria, and modern therapeutic approaches for pediatric sepsis, with a special focus on early recognition and evidence-based management strategies in low- and middle-income countries, including Uzbekistan. Emphasis is placed on antimicrobial therapy, hemodynamic support, and the role of preventive measures in reducing the incidence of sepsis among children.
Persistent Hyperinsulinemic Hypoglycemia of Infancy, Clinical Presentation and Treatment
Background Persistent hyperinsulinemic hypoglycemia of infancy also known as, congenital hyperinsulinism, is a collection of disorders that lead to persistent hypoglycemia, a result of the congenital excess of insulin secretion, and is not to be mistaken with acquired forms, which include insulinoma, iatrogenic hyperinsulinemia, and dumping syndrome. It is the most likely cause of persistent hypoglycemia in the infants and neonates. Aims of the study To study demographic & clinical features of patients with congenital hyperinsulinism & response to treatment. Patients and methods Case-series study was carried out on patients with congenital hyperinsulinism, who diagnosed and/or treated at Children Welfare Teaching hospital, Baghdad Medical City started on 1st of January 2013 and ended on 30th of October 2019. In this study out of 35 patients diagnosed as congenital hyperinsulinism, only 27 patients were studied ( 8 patients were excluded because of lost follow up) Results All patients were full term except for one patient was preterm. All patients had mothers without diabetes mellitus except for one Patient who had mother with gestational diabetes, 17(62%) patients were male & 10(38%) patients were female. The birth weights were ranged from 3 to 5.2 kg (median 3.5 kg), with 11(40%) patients were macrosomic. The age at presentation was ranged from 1 day to 45 months (median 1 day). The age at diagnosis was ranged from 2 day to 48 months (median 2 months), 13(48%) patients were products of normal vaginal delivery, 14(52%) patients were products of caesarian section, 5(18%) patients had positive family history of affected siblings. The parent’s consanguinity was found in 22 (81%) patients. The blood glucose level during critical sample was ranged from 8 to 49 mg/dl (median 30 mg/dl). The insulin level during critical sample was ranged from 2.6 to 182 Mu/ml (median 16.5 Mu/ml) The insulin to glucose ratio was ranged from 0.06 to 9.57 (median 0.72). Nine patients were never treated with diazoxide because the drug was not available, the remaining patients (18) were treated with diazoxide, only 4 (22%) patients were diazoxide – responsive. All 27 patients were treated with octreotide, only 13(48%) patients were responded to octreotide. Thirteen (48%) patients were underwent subtotal pancreatectomy, with 1 (8%) patient, was underwent 2nd pancreatectomy. Postoperatively 1(8%) patient developed diabetes mellitus &required insulin therapy, 12(92%) patients were still hypoglycemic & required octreotide &frequent feedings to control their blood glucose level. We come to the conclusion that the congenital hyperinsulinism is rather widespread in Iraq, and it is associated with the high consanguinity.
Cutaneous Manifestation in Children Patients with Type 1 Diabetes Mellitus
Background and Design: Type 1 diabetes mellitus (T1DM) can cause significant changes in the skin. However, there are limited studies examining skin findings in children with T1DM. This study aims to determine the frequency of skin lesions in children with T1DM and evaluate their relationship with disease duration and hemoglobin A1c (HbA1c) levels. Materials and Methods: the study was including 49 children with diabetes mellitus type 1 and 60 age- and sex-matched healthy children. The children were examined in detail by a pediatrician and dermatologist . Results: Children’s age at beginning of the diabetes was 7.0 ± 3.5 years, and duration of illness was 49.8 ± 38.7 months. The average of HbA1c was 8.2 ± 1.7%. Out of the total of 49 subjects in the study, 9 (18.4%) used an insulin pump, and 40 (81.6%) used multiple daily injections of insulin. In 41 patients (83.7%) at least one associated skin condition caused by insulin. The most common adverse effects were lipohypertrophy, ecchymosis and post-inflammatory hyperpigmentation. Patients with diabetes type 1 were more likely to have occurrences of xerosis and rubeosis faciei compared to controls which were statistically significant 28.6%vs. 10.0% and 10.2%versus 1.7% respectively. Facial erythema patients showed higher body mass index (BMI) levels.. Conclusion: Training patients and caregivers and increasing physician awareness can improve management and prevention of skin findings in children with T1DM.
Esotropia in Douin Syndrome and Ways to Improve the Results of Surgical Treatment
This article presents an extensive study on the clinical features of esotropia in Duane retraction syndrome (DRS) and the optimization of surgical approaches aimed at improving ocular alignment, reducing abnormal head posture, and enhancing binocular function. Duane syndrome, a congenital ocular motility disorder characterized by co-contraction of the medial and lateral rectus muscles, often leads to esotropic deviation due to mechanical and innervational anomalies. The research analyzes various surgical techniques, including medial rectus recession, lateral rectus resection, and transposition procedures, assessing their efficacy, safety, and postoperative outcomes. The study also emphasizes the importance of individualized surgical planning based on the type of DRS, degree of esotropia, limitation of abduction, and presence of globe retraction or up/downshoots. Findings indicate that a tailored, minimally invasive surgical approach, combined with precise preoperative evaluation and long-term follow-up, significantly improves functional and cosmetic outcomes. The research provides an evidence-based framework for enhancing surgical correction in patients with Duane syndrome-associated esotropia. This article provides a comprehensive evaluation of esotropia associated with Duane retraction syndrome (DRS) and explores advanced surgical approaches aimed at improving alignment, reducing abnormal head posture, and restoring binocular function. Duane syndrome is a congenital ocular motility disorder resulting from aberrant innervation of the lateral rectus muscle by branches of the oculomotor nerve, leading to limited abduction, globe retraction, and esotropic deviation in the primary gaze position. The research emphasizes individualized surgical strategies such as graded medial rectus recession, lateral rectus transposition, and Y-splitting procedures to address the unique pathophysiology of the syndrome. Through detailed preoperative assessment and postoperative follow-up, the study demonstrates that tailored, minimally invasive interventions significantly enhance ocular alignment, improve motility, and achieve superior functional and aesthetic outcomes. The findings support a patient-specific, anatomically informed approach as essential for achieving stable and long-lasting results in the management of esotropic Duane syndrome.
Diagnostic Significance of Z-Score in Echocardiography in Children with Congenital Heart Defects
Congenital heart defects (CHD) are among the most common cardiovascular disorders in children. Continuous growth and somatic variability in pediatric patients limit the diagnostic accuracy of absolute echocardiographic measurements, highlighting the importance of standardized Z-score assessment.
Explainable AI Systems to Enhance Patient Safety and Clinical Accountability
The growing use of artificial intelligence (AI) in medical services has brought with it some potent clinical decision tools, diagnostic tools, and patient monitoring tools. Nevertheless, the complexity of most AI systems, especially deep learning methods, casts doubt over the safety of patients and stakeholder confidence in clinics and the law. Explainable Artificial Intelligence (XAI) has become a highly important measure to overcome these issues by offering clear, interpretable and understandable explanations of AI-based decisions. The paper discusses how XAI systems can be used to improve patient safety and improve clinical accountability in a health care setting. It explores the role of explainability in helping clinicians to justify AI recommendations, detect possible errors or biases, and gain more confidence in their decisions. Moreover, the paper explains XAI implications on regulatory compliance, ethical governance, and medico-legal responsibility. Through the incorporation of explainable mechanisms in clinical AI systems, healthcare facilities can enable trust and improve patient outcomes with greater accuracy and create more transparent accountability units. The results emphasize XAI as the basis of responsible and sustainable implementation of AI technologies in the contemporary healthcare systems.
Features of the Intestinal Microbiota of Premature Infants with Gastrointestinal Enteropathy in the Early Neonatal Period
The intestinal microbiota plays a crucial role in the maturation of the immune system and gastrointestinal function in newborns, particularly in premature infants. In the early neonatal period, preterm infants are highly vulnerable to gastrointestinal enteropathy due to immaturity of the intestinal barrier, altered microbial colonization, and exposure to intensive medical interventions. This study explores the features of intestinal microbiota composition in premature infants diagnosed with gastrointestinal enteropathy during the early neonatal period. Special attention is given to the imbalance between beneficial and opportunistic microorganisms, reduced microbial diversity, and the predominance of pathogenic bacteria. In the context of Uzbekistan, where the prevalence of premature births remains a significant public health concern, understanding microbiota-related mechanisms is essential for improving neonatal outcomes. The findings highlight the importance of early microbiota modulation strategies, including breastfeeding support and probiotic use, to prevent severe gastrointestinal complications in premature infants.