Autism spectrum disorder (ASD) prevalence is increasing globally, including in low- and middle-income settings. Early screening is essential; however, screening tools require local validation. The Screening Tool for Autism in Toddlers and Young Children (STAT) has been incorporated into Vietnam’s Ministry of Health guidelines, yet its diagnostic performance has not been formally evaluated. This cross-sectional study validated the STAT among 86 children aged 24–36 months with language delay attending a tertiary pediatric hospital in Ho Chi Minh City between December 2022 and August 2023. STAT results were compared with DSM-5-based clinical diagnoses, the diagnostic reference standard. The STAT was administered by certified speech therapists, and STAT results were not disclosed to the child psychologist conducting the DSM-5-based diagnostic evaluation. Diagnostic accuracy indices and receiver operating characteristic (ROC) analysis were performed to evaluate diagnostic performance and explore alternative cut-off values. The findings showed a predominance of male children (65.1
Concealed Penis is a common pediatric condition in which a normally-sized penis is partially or completely hidden beneath the prepubic skin. This study aimed to assess long-term surgical outcomes using a framework consisting of objective and subjective tools. The mean postoperative Concealed Index (CI) after one year increased significantly from 0.35 ± 0.09 to 0.73 ± 0.15 (P < 0.001). No significant difference was observed between the mean immediate postoperative Index and the one-year follow-up Index (0.79 ± 0.09 vs. 0.73 ± 0.15, P > 0.05), indicating durable long-term outcomes. Regarding the modified Pediatric Penile Perception Score (mPPPS), 78.2
Mycoplasma pneumoniae (MP) is a major cause of pediatric respiratory infections, characterized by cyclical epidemics and age- and season-specific patterns. However, long-term epidemiological data spanning multiple epidemic cycles are limited. We conducted a 20-year retrospective study of children (< 18 years) hospitalized with respiratory tract infections and undergoing MP testing at Children's hospital of Soochow University from October 2005 to December 2025. MP infection was defined by positive PCR and/or serological evidence. Positivity was analyzed by age, sex, season, calendar period, and COVID-19 pandemic phase. Among 51,399 specimens, 16,086 were MP-positive (31.30
Abstract Background Esophagogastroduodenoscopy (EGD) is a crucial diagnostic tool. The ability to do diagnostic and therapeutic endoscopy is a key feature of the current era of gastroenterology. We aimed to evaluate the indications, diagnostic yields, and appropriateness of upper endoscopies carried out at Beni-Suef and Aswan University Hospitals. Methods Demographics and endoscopic information (indications, results, complications and histopathology) were gathered by retrospectively analyzing the files of patients who had upper endoscopies from January 2021 to December 2025, after obtaining research ethical committees approval. Results Our study included 400 patients from 1 to 18 years, with 52% females and a mean age of 7.91 ± 4.24 years. Abdominal pain/dyspepsia (46%) and vomiting (17.5%) were the most common indications for upper endoscopy. Abnormal endoscopic results were noted in 47.25%. The abnormal endoscopy group had substantially greater body mass index (BMI), height, weight, and age ( p < 0.001 for each). Abnormal pathology results were detected in 40.3% of cases. The frequency of normal endoscopy with abnormal histopathology was significantly higher in the Helicobacter pylori gastritis and/or duodenitis group (95% vs. 24.6%, p < 0.001). Age group of 6–12 years and abnormal endoscopy were predictive of abnormal histology. Conclusions Upper endoscopy in children had a sensitivity of 59.6% (95% CI, 51.7–67.2), specificity of 61.1% (95% CI, 54.6–67.3), positive predictive value of 50.8% (95% CI, 43.5–58.1), and negative predictive value of 69.2% (95% CI, 62.5–75.3) in identifying abnormal histopathology, so biopsy of normal-looking mucosa is essential. H. pylori derived most of the normal endoscopy/ abnormal-histology cases (95% vs. 24.6%, p < 0.001). Age group of 6–12 years was predictive of abnormal histology.
Abstract Objective Human milk is rich in bioactive nutrients essential for retinal development and visual maturation. Despite advances in the manufacture of formula milk to better simulate human milk, low-resource countries still rely on standard formula milk due its lower financial cost. Aim To assess visual function and retinal development in exclusively breastfed versus standard formula-fed healthy full-term infants aged 4 to 6 months. Subjects and methods This cross-sectional comparative study included 55 full-term infants aged 4 to 6 months; 25 were exclusively breastfed and 30 were standard formula-fed infants. Visual function and retinal development were examined using flash visual evoked potential (F-VEP) and flash electroretinogram (F-ERG). Results breastfed infants had significantly shorter F-VEP latency (123.68 ± 18.44 versus 150.63 ± 30.81; p-value 0.004) and higher amplitude of P2 wave (30.64 ± 23.94 versus 9.23 ± 9.95; p -value < 0.001) than formula-fed infants. Additionally, F-ERG a and b waves’ amplitudes were significantly higher in breastfed than formula-fed infants (11.96 ± 4.82 versus 8.00 ± 1.93; p-value 0.001 for a wave and 27.62 ± 10.58 versus 19.21 ± 6.81; p -value 0.003 for b wave). Effect size analysis showed a large difference in F-VEP parameters and F-ERG amplitudes between breastfed and formula-fed infants. Apart from significantly higher weight in breastfed than formula-fed infants, no significant difference was observed between both groups as regards socioeconomic and demographic characteristics. Conclusion Exclusive breastfeeding was associated with electrophysiological differences suggestive of more favorable retinal function and visual pathway maturation in early infancy.
To evaluate the relationship between H. pylori infection density and serum ammonia levels in pediatric patients with portal hypertension and to determine whether serum ammonia can serve as a non-invasive marker for high-grade infection. A cross-sectional study was conducted on 40 successive children with portal hypertension during surveillance upper gastrointestinal endoscopy at Ain Shams University Children's Hospital, Pediatric Hepatology Endoscopy Unit. Gastric biopsies were obtained for histopathological grading of H. pylori density (Grades 0–3) using the updated Sydney System as the primary reference standard; rapid urease testing was performed concurrently as a secondary diagnostic modality. Serum ammonia levels were measured and correlated with infection severity. Ammonia was measured in µg/dL and converted to µmol/L using the standard conversion factor of 0.5872 (NH3 molecular weight 17.03 g/mol). The cohort included 40 children with a mean age of 6.9 ± 3.4 years. The prevalence of H. pylori infection was 87.5
Neonatal sepsis (NS) continues to be a leading cause of illness and death in newborns. The lack of identifiable clinical indications and inconclusive blood cultures highlights the need for non-invasive biomarkers that can be relied on for early and accurate diagnosis. We aimed to assess reliability of salivary C-reactive protein (CRP), mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in the diagnosis of NS. A prospective case-control study was conducted on 80 patients; 40 with sepsis by history, clinical picture, laboratory findings and blood culture and 40 controls with no signs of sepsis. Since 1 patient out of 40 in the case group was culture-negative though had intense clinical indicators, so will define case group as “proven sepsis” (n = 39) and “clinical/suspected sepsis” (n = 1). For all patients laboratory analysis was performed [blood culture, complete blood count (CBC): neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), mean platelet volume (MPV) were calculated, serum and salivary C-reactive protein (CRP) analysis]. The diagnostic performance for many laboratory indicators was shown to be extremely significant by receiver operating characteristic curve analysis. Salivary CRP showed significant diagnostic value with an AUC of 0.817 at a cut-off of 3.015 mg/L, with 60
Persistent pneumonia in children, characterized by persistent respiratory symptoms and unresolved radiological abnormalities despite appropriate therapy, remains a significant diagnostic challenge. Flexible bronchoscopy allows direct airway visualization, bronchoalveolar lavage (BAL) sampling, and therapeutic intervention; however, data from low- and middle-income countries remain limited. To evaluate bronchoscopic findings, BAL microbiological profile, procedural safety, and the clinical impact of flexible bronchoscopy in children with persistent pneumonia. This retrospective observational study was conducted at a tertiary pediatric referral centre in Eastern India between January 2019 and December 2024. Children aged 1 month to 14 years with persistent pneumonia who underwent flexible bronchoscopy were included. Demographic characteristics, radiological findings, bronchoscopic abnormalities, BAL microbiology, multiplex respiratory polymerase chain reaction (PCR) results, therapeutic interventions, complications, and post-bronchoscopy management changes were analyzed. Seventy-five children were included (mean age 4.5 ± 3.2 years; 60
Abstract Background Pediatric esophageal atresia management has come a long way in recent years. Early diagnosis and better neonatal ICU and anesthesia have contributed to a steady decline in infant mortality. Aim of the study The present study aims to compare the outcome of thoracoscopic versus classic conventional open repair of tracheoesophageal fistula with esophageal atresia in neonates. Patients and methods The study was conducted at the Pediatric Surgery Department in Sohag University Hospitals and Cairo University during the duration from July 2022 to July 2024. The patients were divided into 2 groups: Group I (35 Patients): Conventional Open Repair group (COR) and Group II (20 Patients): Thoracoscopic Repair group (TR). The open thoracotomy group represented the conventional open practice in our institutions and included both intrapleural and extrapleural access. Results The thoracoscopic group required 105 min for the operation, while the open surgery group only needed 97 min. The two procedures were comparable regarding need of post-operative ventilation, early and late post-operative complications, 30-days morbidity and mortality in addition to re-intervention occurrence. Compared to the Open group, the thoracoscopic group maintained higher survival rates throughout the duration of the follow-up. At 180 days, 85% of patients in the thoracoscopic group survived, while 83% of those in the open group did not. Conclusions Thoracoscopic repair of type-C esophageal atresia with distal tracheoesophageal fistula was feasible in selected cardiorespiratorily stable neonates and provided expected access-related advantages. However, operative time was not shorter, and major postoperative outcomes were comparable to conventional open repair.
Abstract Background This study aimed to compare the impact of two enteral formulas with different nutritional compositions on nutritional status and gastrointestinal symptoms related to feeding intolerance in pediatric patients with chronic neurological disorders. Methods Thirty-four children with severe neurological disabilities under the age of 14 who had experienced percutaneous endoscopic gastrostomy placement were enrolled. Following six months of enteral feeding, we analyzed the nutritional outcomes and gastrointestinal symptoms of two groups: one received a casein polymeric formula, and the other was administered completely whey peptides. Results The percentage of weight gain was substantially higher with the whey-peptide protein than with the casein polymeric formula ( p = 0.031). Additionally, compared to patients who received the casein polymeric formula, those who received the whey-peptide formula demonstrated a significantly higher percentage of improvement in their ability to swallow ( p = 0.037). Conclusion These data suggest that enteral formula composition may influence nutritional and feeding-related outcomes in children with neurological disabilities receiving long-term gastrostomy feeding. However, because of the observational design and small sample size, these findings should be interpreted as exploratory and hypothesis-generating. Further larger studies are required to confirm these associations.
Abstract Background Intravenous cannulation is a painful procedure that causes significant pain, anxiety, fear, and poor cooperation among children. Resource-intensive pain management strategies are often difficult to implement in low-resource clinical settings. This study aimed to evaluate the effectiveness, feasibility, and acceptability of the counting technique in reducing pain during IV cannulation among children. Methods A parallel-group randomised controlled trial was conducted among children undergoing IV cannulation in a tertiary care hospital in India. Participants were randomly assigned in a 1:1 ratio to either the counting technique group or the standard care control group using a computer-generated randomisation sequence. The intervention involved guided counting during IV cannulation. Pain intensity was assessed using the Wong-Baker Faces Pain Scale immediately after the procedure. Feasibility and acceptability of the intervention were assessed among staff nurses involved with IV cannulation. Data were analysed using Stata 19BE. Result A total of 100 children were enrolled and randomised to the intervention and control groups. Results show that children in the intervention group demonstrated a lower pain score than the control group, although the result was statistically not significant (z = − 1.995, p = 0.057). On the other hand, nurses reported high acceptability (2.48 ± 0.35, range 1.6–3) and feasibility (3.94 ± 1.11, range 1–5) of counting techniques during IV cannulation. Conclusion The counting technique is a simple and resource-free, non-pharmacological intervention for procedural pain management in children. It can be used in situations where resources are scarce.
Abstract Background Interoception represents the brain’s ability to sense and interpret internal bodily signals, integrating cardiovascular, autonomic, and cortical processes to maintain homeostasis and shape emotional states. Cardiac interoception links physiological signals with affective experience. Mitral valve prolapse (MVP), a common valvular condition, is frequently associated with anxiety and autonomic dysfunction, yet its mechanisms remain poorly understood. Main body Altered valve mechanics in MVP may modify baroreceptor signaling and autonomic balance, potentially contributing to distorted afferent input and heightened interoceptive sensitivity, although direct evidence for this pathway in MVP patients is currently lacking. Experimental optogenetic studies in animal models demonstrate that cardiac afferent modulation can causally influence anxiety-related behaviors, providing mechanistic proof-of-concept rather than direct evidence in MVP. Brain–computer interfaces (BCIs) using heartbeat-evoked potentials are being explored as experimental tools for real-time assessment and closed-loop neurofeedback, though clinical translation remains preliminary. Conclusion Cardiac interoception offers a candidate, hypothesis-generating framework linking cardiac pathology and neuropsychiatric symptoms. Future work integrating circuit-level insights with BCI-based monitoring may help clarify whether earlier detection and personalized interventions can improve outcomes in MVP-related anxiety.
Perinatal iron deficiency (PNID) is known to have long term adverse effects on the hippocampus. Present study was conducted with an aim to determine if cord reticulocyte hemoglobin equivalent (RET-He) can be an early marker of hippocampal volume in infants at risk for PNID. In an observational study, cord RET-He, serum ferritin, hemoglobin (Hb) and other RBC parameters, and hippocampal volume in MRI at 72–96 h after birth in 20 neonates of anemic mothers (Hb < 10.0 g/dl), were compared with 18 neonates of non-anemic mothers (Hb > 11.0 g/dl). Except maternal Hb, the maternal and neonatal baseline characteristics were comparable in the two groups. Compared with neonates of non-anemic mothers, cord-blood RET-He was lower in neonates of anemic mothers (20.52 ± 2.81pg vs. 22.38 ±.44pg, p = 0.03). Other RBC parameters and serum ferritin were comparable. Neonatal right, left and combined hippocampal volumes were lower in the anemic group compared with the non-anemic group. Pearson correlations between all pairs showed relatively strong association between combined hippocampal volume and maternal Hb (correlation, 0.69; p < 0.001), driven primarily by two clusters, with maternal Hb above or below 10.0 g/dl, respectively. No clear association with neonatal hippocampal volumes for any other parameter (correlation, -0.25 to 0.25; p > 0.05) was observed. The left and right hippocampal volumes were highly correlated (correlation = 0.89) and generally gave same result, with a strong and significant association with maternal Hb but not any other parameter. Cord RET-He is an early marker of PNID in neonates.However, a correlation between RET-He and neonatal hippocampal size was not observed.A strong association between maternal anemia and neonatal hippocampal volume was observed.
Penile amputation is a rare urological emergency that requires prompt surgical intervention and comprehensive medical evaluation. Microsurgical replantation is considered the preferred approach when feasible; however, macroscopic repair may provide satisfactory outcomes in resource-limited settings. Reports of successful penile replantation in very young children remain exceedingly rare. A 4-year-old boy presented with near-complete penile amputation. Following initial resuscitation and stabilization, surgical re-implantation of the penis and urethral reconstruction were performed. Due to the unavailability of microscopic equipment, neurovascular anastomosis of the penile dorsal complex could not be carried out. A Foley catheter was maintained for a relatively prolonged period postoperatively for 20 days. Despite the absence of microsurgical repair, the patient demonstrated satisfactory early cosmetic appearance and normal voiding behavior during 38-month follow-up. This case suggests that macroscopic penile replantation may provide favorable cosmetic and urinary outcomes in selected pediatric patients when microsurgical facilities are unavailable. Prompt intervention and meticulous surgical reconstruction remain critical for achieving satisfactory results. However, longer-term objective functional evaluation into adolescence remains necessary.
Abstract Objectives This study aimed to compare the prevalence of gastrointestinal (GI) symptoms in children with autism spectrum disorder (ASD) and typically developing (TD) children. It also intended to determine whether inflammatory marker levels and adaptive behavior scores were related to GI symptoms in ASD children. Methods Fifty-six children with ASD aged 3–12 years and 40 age- and sex-matched TD children were included in this case-control study. ASD diagnosis was confirmed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and severity was assessed using the Childhood Autism Rating Scale (CARS). GI symptoms were evaluated using a standardized GI history questionnaire. The Vineland Adaptive Behavior Scales, Second Edition (VABS-II) was used to measure adaptive behavior. The enzyme-linked immunosorbent assay (ELISA) was used to measure the levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and C-reactive protein (CRP) in the serum. Results The age and gender of ASD children showed no statistically significant differences compared to the control group. Children with ASD experienced GI symptoms at a considerably higher rate than TD peers (83.9% vs. 60.0%, p = 0.008). Mean serum level of IL-6, TNF-α and CRP showed no statistically significant differences between the ASD group and the control group. Mean values of the adaptive behavior standard scores in ASD children were more deficient than those of TD children and this relation was statistically highly significant (P< 0.01). Correlation between the inflammatory markers’ levels and the age in ASD group was non- significant (P> 0.05). In ASD group, correlations between the general adaptive composite score, the adaptive behavior standard scores, and the total CARS score on one side and the age on the other side were not significant. In contrary, the motor standard score was the only variant that reported high positive significant correlation (P< 0.01) with the age. Children with ASD who experienced frequent vomiting or diarrhea had significantly higher TNF-α levels than those without these symptoms (P< 0.05). Linear regression analysis for TNF-α in autistic patients showed positive significance with diarrhea. In TD group, comparisons of the inflammatory markers with the diverse GI symptoms were not significant. Children with mild ASD had significantly lower CRP levels than children with moderate and severe ASD (P< 0.05). While linear regression analysis for prediction of inflammatory markers levels in ASD group in relation to the severity of the disease was non-significant. In ASD group, comparisons between the general adaptive composite score and the adaptive behavior standard scores in relation to GI symptoms were non-significant using non-parametric tests. Conclusion The prevalence of GI disturbances in ASD children was high. GI troubles were irrelevant to the poor adaptive behavior scores. The ASD severity could not be predicted by the levels of the inflammatory markers. TNF-α was found to be positively correlated with diarrhea.
Abstract Micronutrient deficiencies, commonly referred to as “hidden hunger,” remain a major public health and developmental challenge across Africa, disproportionately affect women of reproductive age, infants, and children under five. This narrative review synthesizes current evidence on the prevalence, determinants, health consequences, and intervention strategies related to deficiencies in iron, vitamin A, iodine, zinc, and folate in African populations. The review highlights that inadequate dietary diversity, food insecurity, infectious disease burdens, environmental constraints, and socioeconomic inequities are the key drivers of micronutrient malnutrition across the continent. These deficiencies contribute substantially to anemia, stunting, impaired cognitive development, weakened immune function, adverse pregnancy outcomes, and reduced economic productivity. Existing interventions including food fortification, biofortification, micronutrient supplementation, dietary diversification, nutrition sensitive agriculture, and improved food processing technologies have demonstrated important benefits; however, their effectiveness remains constrained by weak health systems, poor policy implementation and limited coverage. The review further emphasizes that the importance of integrated, multisectoral strategies that combine food system transformation, public health interventions, nutrition education, and strong governance frameworks to sustainably reduce micronutrient deficiencies. Addressing these gaps in Africa is essential for improving maternal and child health, strengthening human capital development, and advancing progress toward the Sustainable Development Goals across Africa.
Abstract Background Breastfeeding is a critical component of neonatal nutrition and maternal-infant bonding. However, breastfeeding practices remain suboptimal in many resource-poor settings including Nigeria. Objectives To determine the prevalence of breastfeeding confidence and exclusive breastfeeding among postpartum women; and to identify hospital breastfeeding support practices associated with breastfeeding confidence and exclusive breastfeeding, adjusting for maternal age, educational level, parity, mode of delivery, breastfeeding confidence, early initiation of breastfeeding, skin-to-skin contact, rooming-in practice, postnatal breastfeeding counselling and formula supplementation. Methods This was a hospital-based cross-sectional study conducted among 114 postpartum women attending postnatal and immunization clinics at the Federal Medical Centre, Umuahia, Southeast Nigeria in April, 2026. Participants were recruited consecutively using interviewer-administered structured questionnaires. Data collected included sociodemographic characteristics, obstetric history, hospital breastfeeding support practices, breastfeeding confidence assessed using the Breastfeeding Self-Efficacy Scale-Short Form, and exclusive breastfeeding practices. Data were analyzed using descriptive statistics, chi-square tests and multivariable logistic regression. Results The mean age of the respondents was 30.9 ± 5.8 years. The mean Breastfeeding Self-Efficacy Scale Score was 52.4 ± 9.1. High breastfeeding confidence was observed among 47.4% of respondents while 43.9% practiced exclusive breastfeeding. Early initiation of breastfeeding occurred among 48.2% of respondents, skin-to-skin contact among 44.7% and postnatal breastfeeding counselling among 58.8%. High breastfeeding confidence was significantly associated with early initiation of breastfeeding (p < 0.001), skin-to-skin contact (p < 0.001) and postnatal breastfeeding counselling (p < 0.001). Exclusive breastfeeding practice was significantly associated with high breastfeeding confidence (p < 0.001), early initiation of breastfeeding (p < 0.001) and postnatal counselling (p = 0.001). In exploratory adjusted analysis, high breastfeeding confidence (AOR = 4.2, 95% CI: 1.9–9.3), early initiation of breastfeeding (AOR = 2.5, 95% CI: 1.1–5.7) and postnatal breastfeeding counselling (AOR = 3.0, 95% CI: 1.3–6.8) were associated with maternal self-reported exclusive breastfeeding practice. Conclusions Breastfeeding confidence and exclusive breastfeeding practices among postpartum women were strongly associated with hospital breastfeeding support practices. Strengthening institutional breastfeeding support practices including early breastfeeding initiation, skin-to-skin contact, structured lactation counselling and reduction of unnecessary formula supplementation should be prioritized.
Abstract Background Congenital coronary artery anomalies (CAA) represent clinically important abnormalities due to their association with myocardial ischemia, arrhythmias, heart failure, and sudden cardiac death in children. They may be isolated findings or associated with congenital heart disease (CHD). The prevalence of CAAs is known to be higher in patients with CHD compared with the normal pediatric population. This study aims to determine the prevalence, types, and clinical implications of coronary artery anomalies in children with CHD by using multislice computed tomography (MSCT). It is a retrospective single-center study that included 102 pediatric patients (62 males and 40 females; mean age 60.3 ± 72.3 months) with echocardiographically confirmed congenital heart disease who were referred for cardiac MSCT. Coronary anatomy was assessed using ECG-gated MSCT with advanced image reconstruction techniques. Results Coronary artery anomalies were identified in 10 patients (9.8%). The majority of anomalies involved the right coronary artery (80%). The most frequent anomaly was the anomalous origin of the right coronary artery. Other anomalies included single coronary artery variants, a high-takeoff right coronary artery, an origin of the right coronary artery from the non-coronary sinus, a dual left anterior descending artery (type IV), and an anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). Two patients required coronary-related intervention. Electrocardiographic evidence of ischemia was documented in one patient with ALCAPA. Conclusion Coronary artery anomalies were relatively common among children with congenital heart disease in this cohort, with right coronary artery abnormalities representing the most frequent type. Multislice computed tomography enabled accurate assessment of coronary artery anatomy and provided valuable information for detecting and characterizing anomalies that may influence clinical management.
Continuous physiological monitoring in pediatric patients is crucial for the early identification of critical events such as cardiac arrhythmias, seizures, and sepsis. Wearable devices embedded with analytical algorithms offer a novel approach for non-invasive, continuous surveillance. Despite rapid technological advances, a comprehensive evaluation of their diagnostic accuracy, clinical effectiveness, safety, and acceptability in pediatric cohorts remains lacking. To systematically evaluate the diagnostic performance, clinical outcomes, safety, and usability of wearable continuous monitoring devices with integrated analytical algorithms in pediatric patients (neonates to adolescents), compared with standard monitoring methods or wearable devices without analytical integration. A systematic search of PubMed, Embase, Cochrane Library, Web of Science, and Scopus was conducted from inception through March 31, 2026. Eligible studies included randomized controlled trials, prospective and retrospective cohorts, and diagnostic accuracy investigations involving wearable devices with embedded analytical algorithms for continuous monitoring in pediatric populations. Independent dual reviewers performed study selection, data extraction, and risk of bias assessment. Diagnostic accuracy metrics were synthesized using bivariate random-effects models. Clinical outcomes were pooled using random-effects meta-analyses. Certainty of evidence was appraised using the GRADE framework. From 3,842 screened records, 24 studies enrolling 4,376 pediatric patients were included. Wearable analytical devices demonstrated a pooled sensitivity of 87.4
Congenital generalized lipodystrophy (CGL), or Berardinelli-Seip syndrome, is a rare autosomal recessive condition with near-complete lack of metabolically functional adipocytes since birth or in early infancy, leading to severe metabolic complications. The prevalence of CGL is less than 1 case per million births, and it occurs in four genetic types (CGL1-CGL4). CGL type 2 (mutations in the BSCL2 gene; OMIM #269700) is the most common subtype (70–80
