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OBJECTIVES@#COVID-19, SARS-COV-2, Nasopharyngeal RT-PCR, Saliva RT-PCR, Children, 0- 18 years old.@*METHODOLOGY@#A metanalysis was done to synthesize the diagnostic accuracy of saliva RT-PCR compared to the nasopharyngeal RT-PCR in the detection of SARS-COV 2 in pediatric patients ages 0-18 years old. Five studies published from January to September 2021 were analyzed using the "midas" command of STATA14. MIDAS command is a comprehensive program of statistical and graphical routines for undertaking meta-analysis of diagnostic test performance in Stata. The index and reference tests (gold standard) are dichotomous. Primary data synthesis is performed within the bivariate mixed-effects regression framework focused on making inferences about average sensitivity and specificity. @*RESULTS@#The World Health Organization’s acceptable sensitivity and specificity for products used in COVID-19 diagnostics is ≥ 80% and ≥ 97% respectively. The results of this metanalysis showed the pooled sensitivity of Saliva RT-PCR as compared to the Nasopharyngeal RT-PCR is at 87% (81-92% at 95% CI) and the pooled specificity is at 97% (95% CI: 96-98%). @*CONCLUSION@#This metanalysis demonstrates that saliva can be used as an alternative specimen for SARS-COV-2 diagnostic testing in children. Aside from the acceptable pooled specificity and sensitivity, the use of saliva offers several advantages. However, the authors recommend to include more studies for future metanalysis research, to further increase sample size, and to include both symptomatic and asymptomatic pediatric age group participants. A future prospective research study comparing the two diagnostic modalities is likewise recommended.
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INTRODUCTION@#To determine the factors affecting prolonged hospitalization in children 6 months to 5 years diagnosed with severe pneumonia.@*METHODOLOGY@#The study was a retrospective chart review of patients aged 6 months to 5 years diagnosed with Severe Community Acquired Pneumonia and admitted at the Philippine Children’s Medical Center over a 24-month period from January 2018 to December 2019. Variables such as the age and gender of the child, immunization and socio-economic status as well as presence of hypoxemia, respiratory rate on admission, nutritional status and number of antibiotics were correlated with the duration of stay.@*RESULTS@#Younger age, low socioeconomic status and greater number of antibiotics used were found to be significantly associated with prolonged duration of hospital stay after controlling for other variables.@*CONCLUSION@#Findings in this study can help pediatricians to identify children with severe pneumonia who will likely need to be admitted for a prolonged period of time.
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@#<p><strong>BACKGROUND:</strong> Neonatal sepsis remains to be an important cause of neonatal morbidity and mortality and its diagnosis is difficult due to non-specific signs and symptoms that may mimic other infectious conditions. Blood culture, the gold standard in the diagnosis of sepsis, is limited by it being time-consuming and with high probability of false negative results.</p><p><strong>OBJECTIVE:</strong> To investigate the usefulness of the NLR as a predictor in the diagnosis of neonatal sepsis and early - onset neonatal sepsis (EOS).</p><p><strong>METHODS:</strong> Relevant publications from 2009 to 2019 that fulfilled the inclusion criteria were identified through electronic database search. Studies were analyzed and a meta- analysis was performed. The effect of NLR was calculated as a predictive factor for EOS. \</p><p><strong>RESULTS:</strong> Four observational studies were included with a total of 392 patients. Two studies were analyzed for EOS which included 242 patients. There is significant association between NLR and neonatal sepsis. The sensitivity and specificity of NLR to predict sepsis were 84.5% and 91%. The sensitivity and specificity of NLR to predict EOS were 71% and 66%.</p><p><strong>CONCLUSION:</strong> NLR is an acceptable tool in predicting neonatal sepsis and EOS but its usefulness is limited due to the presence of bias and heterogeneity in the studies included.</p><p><strong>RECOMMENDATIONS:</strong> Further studies, preferably local studies, to investigate and validate the usefulness of the NLR as a predictor of neonatal sepsis and EOS is recommended.</p>
Subject(s)
Humans , Male , Female , Neonatal Sepsis , Meta-AnalysisABSTRACT
@#<p><strong>BACKGROUND:</strong> Falls in the hospital are preventable. Prevention of fall requires cooperation from the health care provider, caregivers, as well as the hospital administration. This study was done to utilize standard reminders for fall to increase the awareness of health care providers of a tertiary hospital for children. <br /> <br /><strong>OBJECTIVES:</strong> To determine the effectiveness of the Patient Fall Prevention Reminder Checklist in increasing the awareness of health care providers of patients admitted at the Philippine Children's Medical Center. <br /> <br /><strong>METHODOLOGY:</strong> After obtaining permission to use an established Patient Fall Prevention Reminder checklist from the Intermountain Health Care (USA), participants were recruited after giving their informed consent. A pre-test was conducted to gauge the awareness and practices of the participants in preventing falls in the hospital. After the pre-test, the tool was introduced and discussed by the author to the participants. After 7 days, the participantswere followed up to take the post-test. Data collected were encoded then analyzed throughdescriptive statistics. <br /> <br /><strong>RESULTS:</strong> There were one hundred twenty-one (121) respondents with 42 males and 79 females. There is an increase in awareness in fall prevention amongthe residents and nurses, based on their pre and post-test examination results. The midwives had previous awareness in preventing falls even prior to the study. <br /> <br /><strong>CONCLUSIONS AND RECOMMENDATIONS:</strong> The checklist served as an effective tool in increasing the awareness of most study participants. We recommend the establishment of an institutionalized Fall Prevention Reminder Checklist at the Philippine Children's Medical Center for use by health care personnel.</p>
Subject(s)
Humans , Male , Female , Accidental FallsABSTRACT
@#<p style="text-align: center;"> </p><p style="text-align: justify;"><strong>BACKGROUND: </strong>Leukemia is the most common malignant neoplasm in childhood, with Acute Lymphoblastic Leukemia (ALL) comprising 71% of cases. Partients undergo intensive course of treatment and complications, making them at risk for psychosocial difficulties. The Pediatric Symptom Checklist (PSC) is a validated psychosocial screening tool for the identification of emotional, cognitive, and behavioral problems in children. It uses subscales to identify impairments in attention, internalizing, and externalizing behaviors.</p><p style="text-align: justify;"><strong>OBJECTIVE</strong><strong>: </strong>To screen the psychosocial status of pediatric patients with ALL using the PSC. It aimed to correlate a positive PSC score with factors such age, gender, and on-going chemotherapy.</p><p style="text-align: justify;"><strong>METHODS: </strong>The study design is cross-sectional. Participants were asked to answer the PSC which is a 35-item questionnaire. Total scores were calculated and interpreted based on set cut-off scores.</p><p style="text-align: justify;"><strong>RESULTS: </strong>A total of 87 patients with ALL were included in the study. The PSC was able to identify 16 patients (18%) with psychosocial problems. The patients had concerns related to the internalizing subscale, followed by attention and externalizing subscales. There was no association between age, sex, duration of diagnosis, and on-going chemotherapy with the presence of psychosocial issues in patients with ALL.</p><p style="text-align: justify;"><strong>CONCLUSIONS:</strong> In this study, the prevalence of psychosocial issues in patients with ALL is 16%. Screening patients using the PSC can help in the early detection of psychosocial issues among children with ALL. </p><p style="text-align: justify;"><strong>RECOMMENDATIONS: </strong>A separate study which focuses on both patients and families' psychosocial status is recommended to get an overall picture of the effect of cancer and its treatment. Screening in several points during the course chemotherapy can also be done in future studies.</p><p style="text-align: justify;"><strong> </strong></p>
Subject(s)
Humans , Male , Female , Cross-Sectional Studies , Problem Behavior , Precursor Cell Lymphoblastic Leukemia-LymphomaABSTRACT
BACKGROUND@#Among critically ill pediatric patients, a common complication experienced is nosocomial pneumonia. One field that garnered special interests as an alternative and promising way of preventing infection is the utilization of Probiotics. But whether it can prevent occurrence of ventilatorassociated pneumonia (VAP) among critically ill pediatric patients remains unclear.@*OBJECTIVES@#To determine whether probiotic supplementation will prevent the incidence of ventilatorassociated pneumonia among critically ill pediatric patients.@*METHODS@#Literature search was conducted in PubMed, MEDLINE, EMBASE, CINAHL, SciHub, Herdin, Google Scholar, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews to identify all relevant randomized controlled trials (RCTs) published between 1980 and 2016. The reviewers extracted data and reviewed the quality of the studies independently.@*RESULTS@#Three randomized controlled studies with a total of 327 pediatric patients admitted at the PICU were analyzed. Pooled analysis showed a statistically significant reduction in nosocomial pneumonia rates (odd ratio [OR] = 0.31, 95% CI 0.18 to 0.55, P< 0.0001, I 2 = 53%) and statistically significant difference was found regarding overall mortality (OR =0.51 , 95% CI 0.30 to 0.88, P = 0.01, I 2 = 0%) due to probiotics. However, no statistically significant difference was found between groups regarding duration of stay in the PICU (Mean Difference [MD] in days = 2.93, 95% CI 1.84 to 4.01, P < 0.00001, I2 = 97% ), and duration of stay in the hospital (MD = 4.33 days, 95% CI 2.85 to 5.81, P < .00001, I 2 = 97%).@*CONCLUSIONS AND RECOMMENDATIONS@#The use of probiotics was associated with statistically significant reduction in the incidence of VAP in critically ill children. However, larger and well-designed, multi-center, RCTs are needed to further establish the effects of probiotic in the pediatric population of critically ill children who are at risk of developing nosocomial infection.