Preterm Prelabour Rupture of Membrane (PPROM) in a Young Female in South-South Nigeria: A Clinical Case Report.

A 30-year-old in a second pregnancy presented with new-onset spontaneous vaginal discharge of clear liquid for two hours at a gestational age of 29 weeks + 6 days; no other symptoms were present. Movement aggravated vaginal fluid leakage. She appeared anxious but otherwise vitally stable. An immediate ultrasound scan revealed reduced liquor volume. Conservative management was followed by the surgical delivery of a live preterm neonate. The neonate was admitted to the Special Care Baby Unit and the mother was monitored post-surgically in the obstetric ward. Several studies have described the etiology, pathogenesis, and various approaches to the management of Preterm Prelabour Rupture of Membranes (PPROM); however, there is no single global guideline for managing this condition. There is a consensus that PPROM is a notable risk factor for preterm labor, and significantly impacts both maternal and neonatal morbidity, as well as neonatal mortality. We compared epidemiology across other countries to the statistics obtained from Nigeria as well as management guidelines. Studies have also described the advantages of conservative management over proactive surgical intervention in improving neonatal outcomes. Moreover, the management of PPROM is affected by healthcare resources in different countries and their national protocol, and the impact is significant in developing countries like Nigeria such as the age of fetal viability and the lack of a national protocol. This paper explores PPROM and an uncommon presentation of spontaneous PPROM in the South-South region of Nigeria with only drainage of liquor. This case exemplifies the management approaches of PPROM in an underserved community and the factors that affect the survival of neonates in these communities. The index patient was initially managed conservatively and subsequently delivered a live preterm neonate surgically with good APGAR (appearance, pulse, grimace, activity, and respiration) scores. We expect this case report to prompt a unifying guideline for managing PPROM cases while encouraging advanced research and financial support of PPROM screening and treatment in low-income countries.

Evaluation of Bronchiolitis in the Pediatric Population in the United States of America and Canada: A Ten-Year Review.

Bronchiolitis is a well-known viral infection among the pediatric population, significantly impacting hospitalization rates. The COVID-19 pandemic profoundly affected respiratory viral infections, including bronchiolitis, as various mitigation measures were implemented. In this study, we analyzed bronchiolitis cases during the pandemic and post-pandemic period, aiming to identify changes in management guidelines and their incidence and management over the last 10 years. Moreover, we explored the relationship between bronchiolitis and COVID-19, a virus that gained rapid notoriety worldwide. By analyzing data from pediatric populations in Canada and the USA, we sought to understand the role of varying seasons in the peak periods of bronchiolitis infections. The comprehensive review's results will provide valuable insights into bronchiolitis dynamics within the context of the COVID-19 pandemic. Our aim is to better comprehend the interplay between bronchiolitis, COVID-19, and seasonal variations, ultimately contributing to a deeper understanding of this respiratory viral infection and informing future management strategies. Furthermore, these findings can assist healthcare professionals in preparing for and responding to potential fluctuations in bronchiolitis cases in the post-pandemic era.

A Review of Acute Lymphocytic Leukemia (ALL) in the Pediatric Population: Evaluating Current Trends and Changes in Guidelines in the Past Decade.

Acute lymphocytic leukemia (ALL) is a commonly diagnosed cancer in children. Despite technological advancements to improve treatment and survival rates, there has been a steady increase in the incidence of ALL and treatment failures. This paper discusses the pathogenic interaction between genetic and environmental factors leading to childhood ALL. It evaluates the current treatment guidelines and notable obstacles leading to resistance, relapse, and treatment toxicities. The review evaluates a 10-year trend in the management guidelines of pediatric ALL through a systematic literature review of records from 2012 to 2023. Findings show that improvement in the five-year survival rates, notwithstanding rates of relapse and incurable diseases, is still high. Furthermore, several risk factors, including an interplay between genetic and environmental factors, are largely contributory to the outcome of ALL treatments and its overall incidence. Moreover, huge financial costs have remained a significant challenge in outcomes. There remains a need to provide individualized treatment plans, shared decision-making, and goals of care as parts of the management guidelines for the best possible outcomes. We expect that future advancements will increase overall survival rates and disease-free years.