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.
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.
Copyright (c) 2026 American Journal of Pediatric Medicine and Health Sciences (2993-2149)
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.
Психосоматические Механизмы Как Фактор Прогрессирования Сердечно-Сосудистых Заболеваний
В данной статье изучено значение психосоматических факторов в течении сердечно-сосудистых заболеваний, осложнённых хронической сердечной недостаточностью. Исследование проведено на базе поликлиник города Самарканда с участием 290 пациентов, которые были распределены на две группы в зависимости от длительности заболевания. Наряду с клинико-инструментальными методами обследования психоэмоциональное состояние пациентов оценивалось с использованием шкал тревожности Спилбергера–Ханнина и депрессии Цунга. Результаты исследования показали, что у пациентов с длительностью заболевания более 5 лет значительно чаще выявлялись высокие уровни тревожности и депрессивные расстройства. В первой группе высокая тревожность была зарегистрирована у 78,1 % пациентов, депрессивные расстройства — у 68,0 %, тогда как во второй группе эти показатели составили 42,9 % и 38,4 % соответственно. Полученные данные свидетельствуют о тесной взаимосвязи между длительным течением сердечно-сосудистой патологии и нарастанием психоэмоционального дистресса.
Fatty Liver in a Group of Iraqi Children
The fatty liver disease (FLD) among children is increasingly being accepted as a severe comorbidity, which is often linked with metabolic and endocrine pathologies. The aim of the research was to characterize the clinical prognosis of a child group of patients with FLD and, more precisely, to evaluate the correlations between the metabolic control, liver injury biomarkers, and non-invasive fibrosis index. The study was performed as a cross-sectional study involving 39 children with FLD. The data obtained were demographic, comorbidity, primary diagnosis, and significant laboratory parameters (platelets, ALT, AST, and HbA1c). Also established was the AST to Platelet Ratio Index (APRI) as a non-invasive method for assessing hepatic fibrosis. In order to characterize data statistically, the descriptive statistics and Pearson correlation coefficients were employed to estimate the relationship among the clinical variables (age, BMI, laboratory values, and APRI scores). The comorbidity burden was also high (46.2 with diabetes being the most common and 41.0 with hypertension being the next most common). The most common first disease diagnosis was T1DM (53.8%). Lab data showed a median of 20 U/L of ALT and 21 U/L of AST, and AST has a great outlier skewness (1011.7 U/L). Mean haemoglobin was 9.08 (±3.61), and mean APRI was 0.32 (±0.45). Correlation analysis showed that there was a close correlation between ALT and APRI (r = 0.86). On the contrary, both ALT and APRI had linear relationships with HbA1c. Pediatric FLD in this group is mostly manifested in T1DM and major metabolic comorbidity. Liver injury severity and predicted risk of fibrosis occurrences, which are vigorously correlated with transaminase levels, do not seem to be closely associated with short-term glycemic regulation, assessed by HbA1c. These results indicate that FLD in children has a multifactorial etiology, and therefore, management should be more extensive than glycemic control, as it should involve overall metabolic and hepatic monitoring.
Fatty Liver Disease In Pediatric Patients
Errors and Complications During Endodontic Treatment
Endodontic treatment is a fundamental dental procedure aimed at preserving natural teeth affected by pulpal and periapical pathologies. Despite significant advancements in diagnostic tools, instrumentation systems, and treatment protocols, errors and complications during endodontic therapy remain prevalent and represent a major cause of treatment failure. This comprehensive scientific article analyzes the types, causes, clinical manifestations, and consequences of errors and complications occurring during various stages of endodontic treatment, including diagnosis, access cavity preparation, working length determination, cleaning and shaping, irrigation, obturation, and post-treatment restoration. Emphasis is placed on iatrogenic factors, anatomical complexities, operator-related variables, and material-related issues. Preventive strategies, modern technological solutions, and evidence-based management approaches are discussed in detail to enhance clinical outcomes and long-term tooth survival.
Workplace Ergonomics and its Influence on Dental Practitioners’ Productivity and Patient Care Quality
Workplace ergonomics is a critical determinant of the efficiency, productivity, and overall health of dental practitioners. Dentistry is inherently demanding, requiring sustained precision, prolonged static postures, repetitive movements, and high visual concentration. Poor ergonomic design in dental clinics not only increases the risk of musculoskeletal disorders among practitioners but also impacts the quality of patient care, procedural accuracy, and overall clinical performance. This article provides an in-depth review of workplace ergonomic principles, evaluates their influence on dental practitioners’ productivity and patient care quality, and explores evidence-based strategies to optimize clinical environments. It emphasizes the integration of ergonomic assessment, equipment design, workflow optimization, and practitioner education as essential components of sustainable dental practice.
Method of Comprehensive Treatment of Chronic Periodontitis in Chronic Leukemia
Chronic periodontitis represents a significant clinical challenge in patients diagnosed with chronic leukemia due to profound alterations in immune function, hematopoiesis, and tissue repair mechanisms. The coexistence of these two chronic conditions leads to mutual aggravation, where periodontal inflammation may exacerbate systemic complications, while leukemia-related immunosuppression accelerates periodontal tissue destruction. This article aims to evaluate the effectiveness of a comprehensive, multidisciplinary treatment approach for managing chronic periodontitis in patients with chronic leukemia. The proposed method integrates individualized periodontal therapy, systemic medical coordination, antimicrobial control, and supportive care tailored to hematological status. Clinical outcomes demonstrate that a structured and cautious therapeutic strategy can significantly improve periodontal health, reduce inflammatory burden, and enhance overall quality of life without increasing hematological risks. The findings support the necessity of close collaboration between dental professionals and hematologists when treating this vulnerable patient population. Chronic periodontal inflammation in individuals affected by chronic leukemia poses a complex clinical scenario due to altered immune responses, vascular fragility, and impaired tissue regeneration. The coexistence of these conditions increases the risk of rapid periodontal breakdown and systemic complications. This section presents an expanded overview of how an integrated therapeutic strategy aimed at controlling oral inflammation while maintaining systemic stability can lead to favorable clinical outcomes. Emphasis is placed on individualized care, risk reduction, and the importance of coordinated medical and dental management to ensure both oral and overall health improvement in this medically compromised population.
Assessment of the Healthfulness of School Environments in Government Secondary Schools in Ado Local Government Area, Ekiti State, Nigeria
Introduction: Healthful school environments are essential for student well-being and academic performance. In Southwest Nigeria, gaps in infrastructure, sanitation, and policy implementation compromise the quality of public secondary schools. Objective: This study assessed the healthful school environment of public secondary schools in Ado-Ekiti, focusing on school site, infrastructure, classroom standards, and staff awareness of environmental health practices. Method of Analysis: A descriptive cross-sectional survey was conducted among 300 teachers and administrative staff across 21 public secondary schools. Data were collected using structured questionnaires and analyzed using SPSS 25. Descriptive statistics and chi-square tests were employed. Results: Most schools (85.7%) were located near major roads, while only 17.7% were near rivers or streams, and 8% near waste disposal sites. Water facilities were available in 86.7% of schools, and emergency health services in 69.1%. Only 31.2% of schools had adequate gender-sensitive toilets, and 41.5% had safe recreational facilities. Classroom assessments showed 73.3% were well-ventilated, but only 13.3% had adequate lighting, and 33% had sufficient furniture. Less than half of staff (47.3%) had received training on environmental health, and only 39.7% participated in sanitation monitoring. Conclusion: Public secondary schools in Ado-Ekiti demonstrate partial compliance with healthful environment standards. Critical gaps in sanitation, classroom quality, recreational facilities, and staff training highlight the need for targeted infrastructure improvements, WASH interventions, and policy enforcement to promote safe and conducive learning environments.
Evaluating the Efficiency of Emergency Response System During Disaster Incidents in Niger State, Nigeria
Despite the presence of state emergency management agency in Niger State, there are still challenges in emergency response, which hinders the efficiency and effectiveness of disaster recovery. Without efficient response system, emergency agencies may struggle to make informed decisions, and coordinate response efforts effectively. The effectiveness of disaster recovery efforts during disaster incidents relies on the availability, accessibility, and utilization of accurate and timely response by emergency management agencies. Additionally, inadequate evaluation can lead to delays in disaster recovery, miscommunication among agencies, and ultimately hinder the achievement of disaster management goals. In recent time, disaster related risk have been exacerbated by climate change and this has impacted progress toward sustainable development. Although the Niger state government has worked assiduously to strengthen her disaster risk management strategy by establishing Niger State Emergency Management Agency (NSEMA). It is hitherto regrettable that such idea has not yielded such progress as event continue to threaten the existence, wellbeing and safety of the population. It is disheartening that the State has continually experience humanitarian emergency and catastrophes on an ever-increasing scale and frequency, and it has become so difficult for the affected persons and community to adsorb and recover from the impact created by these disasters. Therefore, it has been observed that disasters signal the failure of a society to adapt successfully to certain features of its natural and socially constructed environment in a sustainable fashion. In view of the foregoing ,the study concludes that there is need for the state to improve its effort at creating sustainable measures that will help protect its citizens from natural and man-made disasters and also have a walkable data base that can be used to assess the damage caused by disaster and proffer avoidable solutions proactively. The study suggested that the state government should as a matter of utmost urgency constitute a body of experts in disaster risk management for the purpose of mitigating the effect of this disasters that has become a recurring decima in the state.
Modern Approaches to the Diagnosis and Management of Dental Caries in Adult Patients
Dental caries continues to be one of the most prevalent oral health problems among adult populations worldwide, significantly impacting masticatory function, esthetics, and overall quality of life. Modern approaches to the diagnosis and management of dental caries emphasize early detection, minimally invasive intervention, and individualized preventive strategies to halt disease progression and preserve natural tooth structure. This study examines contemporary diagnostic modalities, including digital radiography, laser fluorescence, and transillumination techniques, alongside restorative strategies such as adhesive resin composites, glass ionomer cements, and selective caries removal. The integration of patient-centered preventive care, risk assessment models, and evidence-based restorative protocols was evaluated in adult patients presenting with varying severity of carious lesions. Results demonstrate that early diagnosis, combined with conservative restorative and preventive measures, significantly reduces lesion progression, enhances patient comfort, and promotes long-term oral health sustainability. The study underscores the importance of adopting modern, technology-assisted approaches in clinical dentistry to improve therapeutic outcomes and optimize patient satisfaction. Dental caries remains a predominant oral health challenge among adults, leading to structural tooth damage, functional impairment, and diminished quality of life if not properly addressed. Modern clinical dentistry emphasizes early detection, minimally invasive restorative techniques, and individualized preventive strategies to halt disease progression and maintain dental integrity. This study investigates the application of advanced diagnostic tools, including digital radiography, laser fluorescence, and fiber-optic transillumination, in identifying incipient lesions in adult patients. Furthermore, it evaluates the clinical efficacy of contemporary restorative materials, such as adhesive composite resins and glass ionomer cements, in conjunction with selective caries removal and risk-based preventive interventions. Findings reveal that integration of these modern approaches facilitates preservation of healthy dental tissues, improves restoration longevity, reduces postoperative complications, and enhances patient satisfaction. The study underlines the importance of combining technological innovations with evidence-based protocols to optimize therapeutic outcomes and support sustainable oral health practices in adults.
Cutaneous Manifestations in Pediatric Autoimmune Polyendocrinopathy–Candidiasis–Ectodermal Dystrophy (APECED)
Background: APECED is a rare monogenic autoimmune disorder resulting from mutations in the AIRE gene. It primarily affects children and manifests with a classic triad: chronic mucocutaneous candidiasis (CMC), hypoparathyroidism, and adrenal insufficiency. Dermatological features often present early, offering a crucial opportunity for diagnosis. Objectives: This study aimed to delineate the cutaneous features in a pediatric cohort with APECED, analyze the relationship of these cutaneous manifestations with systemic disease, and assess genotype-phenotype correlation. We also explored whether ectodermal features reflect a primary dysplasia or are secondary phenomena. Methods: Twelve children diagnosed with APECED underwent multidisciplinary evaluation, including dermatologic and endocrine assessments. Detailed clinical histories, physical examinations, and genetic testing were conducted. Cutaneous features were assessed with respect to disease progression, and statistical correlation was performed to identify significant relationships. Results: All 12 children exhibited CMC, with 75% also presenting with candidal onychomycosis or paronychia. Alopecia areata occurred in 33%, while vitiligo was noted in 17%. In 17% of cases, skin findings led to early diagnosis before endocrine failure. No direct correlation was observed between AIRE mutations and skin manifestations. Statistical analysis showed that CMC and onychomycosis were significantly associated with APECED progression (p < 0.01), while vitiligo showed no significant association. Conclusions: Skin manifestations, particularly CMC and nail involvement, are highly prevalent and often precede systemic features of APECED. Recognizing these signs early can prevent life-threatening complications. The term “ectodermal dystrophy” may be misleading, as these cutaneous features likely represent secondary changes.
Copyright (c) 2025 American Journal of Pediatric Medicine and Health Sciences (2993-2149)
Occupational Ergonomics in Dentistry: Prevention of Musculoskeletal Disorders among Dental Professionals
The prevalence of musculoskeletal disorders (MSDs) among dental professionals has become a significant occupational health concern worldwide. Dentistry involves prolonged static postures, repetitive fine motor movements, and sustained visual focus, which collectively contribute to cumulative musculoskeletal strain. This study explores the implementation of occupational ergonomics in dental settings as a preventive strategy for MSDs. By evaluating dental professionals across multiple clinical environments, we examine the effectiveness of ergonomic interventions—including posture training, adjustable chairs, optimized instrument placement, and workflow restructuring—on reducing physical strain and improving practitioner comfort. Our findings demonstrate a strong correlation between ergonomically optimized workplaces and lower incidences of musculoskeletal complaints, improved procedural efficiency, and enhanced long-term professional well-being. The research highlights the importance of integrating ergonomic principles into daily practice and professional education to mitigate occupational hazards and sustain a productive and healthy workforce in dentistry. This analytical work examines occupational strain experienced by dental professionals and evaluates preventive strategies aimed at minimizing work-related physical disorders. Daily clinical activities require sustained static postures, repetitive fine motor movements, and prolonged visual focus, which collectively contribute to cumulative physical overload. The analysis emphasizes how appropriate workplace adaptation, correct body mechanics, and evidence-based preventive measures significantly reduce the incidence and severity of musculoskeletal complaints. Attention is given to the interaction between practitioner posture, equipment design, and task organization. The findings demonstrate that systematic ergonomic integration enhances professional longevity, improves comfort during procedures, and supports consistent delivery of high-quality oral healthcare while reducing long-term disability risks.
The Role of Magnification Systems and Ergonomic Instruments in Modern Dental Practice
This study explores the significance of implementing magnification systems and ergonomically designed dental instruments in contemporary clinical practice. The research evaluates the impact of loupes, operating microscopes, and adaptive handpieces on procedural precision, practitioner comfort, and long-term occupational health. Findings indicate that these technologies enhance visualization, reduce musculoskeletal strain, improve fine motor control, and facilitate accurate clinical interventions. Integration of ergonomic principles and magnification tools contributes to increased efficiency, reduced fatigue, and superior patient outcomes, establishing a foundation for sustainable dental practice and professional longevity. This work underscores the importance of adopting these innovations as standard practice to ensure optimal care quality, practitioner well-being, and long-term clinical effectiveness. This study investigates the integration of advanced magnification systems and ergonomically designed dental instruments, emphasizing their transformative impact on clinical precision, practitioner comfort, and long-term professional health. By evaluating the application of loupes, operating microscopes, and ergonomically optimized handpieces across restorative, endodontic, and surgical procedures, the research demonstrates how enhanced visualization and instrument adaptation reduce cumulative musculoskeletal strain, improve fine motor control, and facilitate more accurate interventions. Observations reveal that such technological and ergonomic innovations contribute to increased efficiency, lower fatigue levels, and improved patient outcomes. The findings support the necessity of adopting magnification tools and ergonomic instruments as standard practice, highlighting their role in optimizing professional performance, sustaining practitioner health, and ensuring consistently high-quality dental care in contemporary clinical settings.
Age-Specific Pharmacoepidemiological Patterns of Antibiotic Use in the Treatment of Community-Acquired Pneumonia in Pediatric Patients
Community-acquired pneumonia remains one of the leading causes of morbidity and hospitalization among children worldwide. The selection of antibacterial therapy in pediatric populations is strongly influenced by age-related physiological characteristics, etiological variability, pharmacokinetic differences, and patterns of antimicrobial resistance. This article analyzes age-dependent pharmacoepidemiological trends in antibiotic prescribing for pediatric community-acquired pneumonia, emphasizing rational drug selection, dosing strategies, and safety considerations. By evaluating real-world prescribing practices and clinical outcomes across different pediatric age groups, this study highlights the importance of evidence-based antibiotic use to improve therapeutic effectiveness, reduce adverse effects, and limit the development of resistance. This review examines age-related patterns in antibacterial therapy for pediatric community-acquired pneumonia from a pharmacoepidemiological perspective. Emphasis is placed on how developmental physiology, pathogen distribution, prescribing behavior, and resistance trends interact to influence treatment choices across different childhood stages. By synthesizing clinical data and real-world prescription practices, the paper highlights critical determinants of therapeutic effectiveness and safety, while identifying gaps between recommended strategies and actual use. The analysis underscores the importance of tailoring antibiotic selection to age-specific needs in order to optimize outcomes and preserve antimicrobial efficacy.
Pharmacoepidemiological Assessment of Antibiotic Prescribing Practices for Community-Acquired Pneumonia in Children: Influence of Age and Pathogen Distribution
Community-acquired pneumonia remains one of the leading causes of morbidity in pediatric populations worldwide and continues to pose challenges related to optimal antimicrobial selection. This article provides a comprehensive pharmacoepidemiological evaluation of antibiotic prescribing practices in children with community-acquired pneumonia, with particular focus on the influence of patient age and pathogen distribution. By analyzing patterns of antibiotic use in relation to developmental physiology, epidemiological trends, and microbial etiology, the study aims to identify rational and irrational prescribing behaviors. The findings highlight critical discrepancies between clinical guidelines and real-world practice, emphasizing the need for age-adapted and pathogen-oriented antimicrobial strategies to improve therapeutic outcomes and limit resistance development. This work presents an in-depth pharmacoepidemiological evaluation of antibacterial prescribing patterns for pediatric community-acquired pneumonia, emphasizing how therapeutic decisions vary according to developmental stage and circulating infectious agents. By integrating population-level prescription data with age-related clinical characteristics, the analysis explores the balance between empirical treatment and targeted therapy. Particular attention is given to the consequences of spectrum selection, duration of use, and formulation choice on clinical recovery and antimicrobial safety. The synthesis demonstrates that inappropriate age-independent prescribing contributes to unnecessary exposure and fosters resistance, while rational, stratified approaches improve outcomes and preserve antimicrobial efficacy.
Impact of Metabolic Syndrome Components on Left Ventricular Diastolic Function in Hypertensive Patients: Cross-Sectional Study from Bukhara Region
The aim of this study was to evaluate the relationship between components of metabolic syndrome (MetS)—abdominal obesity, dyslipidaemia and impaired glucose metabolism—and left ventricular diastolic dysfunction (LVDD) in hypertensive patients. A cross-sectional sample of 190 adults with confirmed arterial hypertension, followed at a cardiology department in the Bukhara region between 2024 and 2025, was analysed. MetS was diagnosed according to International Diabetes Federation criteria using waist circumference, triglycerides, high-density lipoprotein cholesterol, blood pressure and fasting plasma glucose. Echocardiography was performed to assess LV diastolic function based on transmitral E/A ratio, E/e' index and left atrial size, and LVDD was graded from I to III.MetS was present in 60% of patients; in this group, both the prevalence and severity of LVDD were higher than in those without MetS (78% vs. 49%). The mean E/e' value increased stepwise with the number of MetS components (10.2±2.1 in patients with fewer than three components, 12.8±2.4 in those with three to four components and 15.1±2.9 in those with all five components). Positive correlations were observed between waist circumference, triglyceride levels and LVDD grade. These findings suggest that active identification and targeted treatment of MetS components in hypertensive patients are important for preserving LV diastolic function and slowing progression toward overt heart failure.
Age-Dependent CD45 Expression in Skeletal Muscle Following Injury in White Outbred Rats: An Immunohistochemical Study
Skeletal muscle injury triggers complex inflammatory and regenerative processes that vary with age. In this study, we evaluated the expression of CD45, a pan-leukocyte marker, in skeletal muscle of 3-, 6-, 9-, and 12-month-old white outbred rats following mechanical injury. Immunohistochemical staining using DAB chromogen and quantitative analysis with QuPath 0.4.0 revealed age-dependent differences in immune cell infiltration. Early neutrophil recruitment was observed across all ages, followed by macrophage-mediated tissue clearance and myoblast activation. Younger animals exhibited higher initial CD45 expression, whereas older rats showed delayed but sustained immune responses. Our results demonstrate that CD45-positive leukocytes play a pivotal role in muscle regeneration, coordinating inflammation, tissue repair, and remodeling.
Glial Tumors of the Brain: General Principles of Diagnosis and Treatment
Gliomas are the most common primary tumors of the central nervous system and represent a major medical and socio-economic problem due to their high incidence, malignant potential, and unfavorable prognosis. They account for up to 40–45% of all intracranial neoplasms and predominantly affect individuals of working age. Gliomas are characterized by infiltrative growth, absence of clear anatomical boundaries, high recurrence rates, and pronounced angiogenesis, especially in high-grade forms. This review summarizes current concepts of glioma classification based on tumor localization, histogenesis, and degree of malignancy according to the World Health Organization criteria. Modern diagnostic approaches, including advanced neuroimaging techniques, as well as contemporary surgical, radiotherapeutic, and chemotherapeutic treatment strategies, are discussed. Particular attention is paid to intraoperative technologies aimed at increasing the radicality and safety of tumor resection. Despite ongoing progress, the treatment of gliomas remains limited in effectiveness, highlighting the need for further research and development of novel therapeutic approaches in neuro-oncology.
Rare But Dangerous Complications of Coxsackie Virus Infection
Coxsackie viruses belong to the Enterovirus genus and are commonly associated with mild, self-limiting infections. However, in certain cases particularly among neonates, young children, and immunocompromised individuals these infections may result in rare but potentially life-threatening complications. This article reviews the clinical characteristics of Coxsackie virus types A and B, transmission pathways, and severe complications including myocarditis, meningitis, encephalitis, pancreatitis, hepatitis, and serious neonatal infections. The aim of the study is to highlight the clinical significance of these complications and emphasize the importance of early diagnosis and careful monitoring in high-risk populations.
The Clinical Importance of Glycemic Status in the Course and Outcomes of Acute Pyelonephritis in Patients with Diabetes Mellitus
Acute pyelonephritis represents a severe and potentially life-threatening infectious complication in patients with diabetes mellitus. The presence of chronic hyperglycemia alters immune function, disrupts microcirculation, and creates favorable conditions for rapid bacterial proliferation within the urinary tract. As a result, diabetic patients frequently experience a more aggressive disease course, higher rates of complications, and prolonged hospitalization. The present study aimed to comprehensively evaluate the impact of blood glucose levels on the clinical course, complication profile, and treatment outcomes of acute pyelonephritis in hospitalized patients with diabetes mellitus. A retrospective observational analysis was conducted involving 76 adult patients with diabetes mellitus who were treated for acute pyelonephritis at a tertiary care hospital between January and December 2024. Clinical data, laboratory findings, imaging results, and therapeutic interventions were analyzed with particular emphasis on glycemic status and insulin dependence. The results demonstrated that poor glycemic control was strongly associated with increased disease severity, higher incidence of renal abscess formation, and the need for invasive interventions. Insulin-dependent patients exhibited significantly higher blood glucose levels and a greater frequency of complications compared to non–insulin-dependent patients. Optimization of glycemic control during hospitalization was associated with improved clinical outcomes and reduced length of hospital stay. These findings underscore the critical importance of maintaining optimal blood glucose levels in diabetic patients with acute pyelonephritis and highlight glycemic control as a key modifiable factor in reducing complications and improving prognosis.
The Importance of Vitamin D in the Treatment of Rickets in Children - Modern Views
Rickets remains a significant metabolic bone disorder in children, primarily resulting from vitamin D deficiency and impaired mineralization of growing bones. Vitamin D plays a central role in calcium and phosphorus homeostasis, intestinal absorption of minerals, and normal skeletal development. This article provides a comprehensive overview of the importance of vitamin D in the treatment of rickets, with particular emphasis on its absorption, metabolic activation, and therapeutic effectiveness. The paper analyzes clinical and biochemical outcomes associated with vitamin D supplementation and highlights its role in restoring bone structure, preventing deformities, and improving overall growth parameters in affected children. Understanding the mechanisms underlying vitamin D action is essential for optimizing treatment strategies and preventing long-term complications of rickets. This work examines the therapeutic importance of vitamin D in the management of rickets, focusing on its physiological influence on mineral balance and skeletal recovery. Emphasis is placed on how adequate supplementation improves intestinal uptake of essential elements, supports proper bone formation, and accelerates clinical improvement in affected children. The analysis highlights the clinical relevance of timely intervention and demonstrates that appropriate correction of deficiency leads to measurable biochemical normalization and structural bone repair, reducing the risk of long-term deformities and functional limitations.
Pharmacoepidemiological Justification for the Use of Antibacterial Drugs in the Treatment of Community-Acquired Pneumonia in Children of Different Age Groups
Community-acquired pneumonia in children remains a significant cause of illness, hospitalization, and healthcare resource utilization worldwide. The rational selection of antibacterial drugs for its treatment requires not only clinical judgment but also a clear understanding of population-level drug use patterns, age-related differences in etiology, and safety considerations. Pharmacoepidemiology provides a scientific framework for analyzing real-world prescribing practices and outcomes, allowing clinicians to justify antibacterial choices based on effectiveness, safety, and resistance trends. This article presents a comprehensive pharmacoepidemiological justification for age-specific antibacterial therapy in pediatric community-acquired pneumonia, highlighting the importance of evidence-based decision-making to optimize treatment outcomes and minimize antimicrobial resistance. Pediatric community-acquired pneumonia represents a dynamic clinical challenge in which therapeutic decisions must balance individual patient needs with population-level safety and effectiveness. Evaluating antibacterial drug use through a pharmacoepidemiological lens allows for a deeper understanding of how age influences treatment outcomes, risk profiles, and patterns of clinical response. By analyzing real-world utilization data, it becomes possible to justify therapeutic choices that optimize recovery while limiting unnecessary exposure to broad-spectrum agents. This synthesis highlights the value of population-based evidence in guiding antibacterial strategies tailored to developmental stages, thereby supporting both clinical success and public health priorities.