Lymphatic malformations (LMs) are congenital defects, resulting from abnormal venous endothelial development. Most lesions present as superficial masses located in the head and neck region. Lymphatic malformations may cause significant complications: extensive expansion on surrounding tissues, airway obstruction, respiratory insufficiency or feeding difficulties. Treatment remains challenging; standard methods (surgery, sclerotherapy) might be ineffective. Therefore, sirolimus, due to its antitumoral and antiangiogenic effect, has been introduced an important systemic treatment option, especially for widespread, complicated, unresectable, or resistant lesions in patients with lymphatic malformations. This case series illustrates the clinical presentation of three neonates with head and neck congenital lymphatic malformations, who were treated with sirolimus. Information, such as prenatal data, postnatal findings (including imaging studies), children’s general condition during hospitalization, clinical course, treatment response, safety profile of the medication, and follow-up were analysed, described and compared with data found in the literature. Our findings confirm that sirolimus is a potential treatment for mixed-type lymphatic malformations, with encouraging clinical response rates and manageable side effects. Further characterisation of affected patients and lymphatic malformations, including definition of therapeutic ranges and a systematic evaluation of treatment results would allow better selection of candidates, with improved overall results. Further multicentre and ultimately randomised, studies on sirolimus treatment for lymphatic malformations, would be helpful for improved care and effective treatment options for this vulnerable pediatric population.
Abstract Background Congenital Cyanotic heart disease (CCHD) is a congenital defect of the heart that reduces the amount of oxygen delivered to the body. Coagulation is the physiological process of maintaining hemostasis in the body. Multiple coagulation and hematological abnormalities have been found in patients with CCHD that can lead to both bleeding tendency or/and thrombosis. Aim To assess the presence of certain hematological and coagulation abnormalities among pediatric patients with CCHD comparing them to normal control and assess for the presence of complications resulting from these abnormalities. Methods This analytical observational case control study included 76 patients (37 cases diagnosed with congenital cyanotic heart disease and 39 healthy control) with age ranged from 6 months to 13 years old who were following up in pediatric cardiology clinic in Cairo University Specialized Pediatric Hospital. Both cases and control were tested for PT, PTT, INR, CBC differential and D-dimer, the results of both groups were compared. Results Children with congenital cyanotic disease had a statistically significant higher values of PT, PTT, INR and D-dimer compared to healthy controls with P value 0.001, 0.004, < 0.001 and < 0.001 respectively. Also, there was a statistically significant increase in the Hb, HCT in cases when compared with the control group with a (p-value < 0.001). There was a statistically significant decrease in the platelet count in cases group versus control group with p = 0.001. Eight patients (22%) showed thrombocytopenia while three patients (8%) showed thrombocytosis. There was a statistically significant longer duration of cyanosis in patients who developed complications versus patients who didn’t develop complications (p value: 0.014). Conclusion Coagulation abnormalities, in the form of prolonged PT, PTT, INR, D –dimer, high hematocrit values and thrombocytopenia, were found in children with cyanotic heart disease compared to healthy individuals. These abnormalities make them more liable for thrombotic or bleeding complications. So, routine screening of coagulation abnormalities is recommended in these patients which may aid in management decisions while awaiting definitive surgeries.
Abstract Background The World Health Organization defines antimicrobial self‑medication as the use of antimicrobials without medical supervision. High antimicrobial self‑medication prevalence among children and adolescents in Sub‑Saharan Africa raises critical public health concerns. This systematic review synthesizes evidence on prevalence, determinants, and sources of antimicrobial self‑medication exclusively among children and adolescents under 18 years in Sub‑Saharan Africa. Main body Following PRISMA 2020 guidelines, we searched PubMed/MEDLINE, ScienceDirect, Europe PMC, and EBSCO Open Dissertations from January 2015 to June 30, 2025. Initial screening and data extraction were completed by December 2025. During the revision process, we performed an updated search on June 24, 2026, to capture recently published studies. Two reviewers independently screened records, assessed quality, and performed narrative synthesis. Thirteen studies met inclusion criteria. Antimicrobial self‑medication prevalence ranged from 21.9% to 92%, highest in Nigeria. Frequently self‑administered antibiotics included amoxicillin (11.4%–80.6%), ampicillin‑cloxacillin (10.3%–50.9%), penicillin (25%), and tetracycline (~ 20%); antimalarials included chloroquine (78%) and quinine (15%). Main sources were drugstores/pharmacies (up to 99.7%), pharmacy staff (70%), and leftover medications (21%). Key determinants were lower parental education, distance to healthcare over 5 km, and febrile symptoms (fever up to 85.1%, cough up to 80.5%). Conclusion Antimicrobial self‑medication increases antimicrobial exposure and represents a recognized contributor to antimicrobial resistance, though no included study directly measured resistance outcomes. Targeted public health interventions including caregiver health education and stricter enforcement of prescription‑only regulations are imperative. This review provides the first exclusive synthesis of antimicrobial self‑medication among Sub‑Saharan African children and adolescents, informing context‑specific interventions.
Abstract Introduction Hepatitis C virus (HCV) infection is a significant cause of morbidity and mortality in hemodialysis patients. hepatitis C virus infection is one of the most common blood-borne infections in Egypt. Objective To detect the prevalence of HCV infection and seroconversion among all hemodialysis in Assiut University Children’s Hospital Dialysis unit (ACUH). Methodology This study was Ambispective study. A total of 70 patients were included; the retrospective component includes patients who received hemodialysis between January 2018 and September 2023. the prospective component, covering October 2023 to October 2025. The study is conducted at the Children’s Dialysis Unit at AUCH. Results HCV seroconversion occurred in 28 (40.0%) patients. Seroconversion was associated with longer hemodialysis duration, with a progressive decline in HCV-free survival as dialysis duration increased. In Cox proportional hazards regression analysis, hemodialysis duration was the only independent predictor of HCV seroconversion in both univariable (HR = 0.721, 95% CI: 0.588–0.882, p = 0.002) and multivariable analyses (adjusted HR = 0.479, 95% CI: 0.294–0.779, p = 0.003). No significant independent associations were observed for CVC duration, history of blood transfusion, hemodialysis outside AUCH, or vascular access type. The annual incidence of seroconversion declined from 10.6% in 2018 to 5.0% in 2023, with no new cases recorded in 2024 or 2025, coinciding with the implementation and reinforcement of infection control measures. Conclusion HCV seroconversion remains a significant concern among paediatric hemodialysis patients; however, the incidence markedly declined due to effective infection control measures.
Oromotor dysfunction like drooling swallowing sucking and chewing, is a collection of disorders that primarily impact sensory inputs, motor outputs, and the coordination of movements related to activities. This systematic review aimed to summarize the current evidence of the effects of kinesio taping (KT) on oromotor dysfunction in cerebral palsy children. This review followed the PRISMA guidelines. A comprehensive search was conducted in PubMed, PEDro, Cochrane Library, Google Scholar and Embase for studies published in English between 2014 and 2025. Data was extracted by two independent reviewers and quality of included studies was assessed using PEDro scale. The level of evidence was classified according to modified sackett’s scale. 11 randomized control trials (RCTs) were included in this review. The mean PEDro score was 6.2 points. Analysis showed that KT has significant strong evidence on swallowing and sucking, and moderate evidence on drooling and chewing. The evidence of KT suggests strong effects on swallowing and sucking and moderate effects on drooling and chewing, however, these findings should be interpreted with cautions, particularly for sucking and chewing, due to the limited number of studies.
