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Chest pain in pediatric patients is a common concern in pediatric emergency departments (ED). In most cases, benign conditions are related to noncardiac causes, and only a minority of the cases are caused by heart disease. This research aimed to evaluate the causes and characteristics of chest pain among children in a pediatric emergency department. This retrospective study evaluated children younger than 14 years of age who presented to the emergency department of a general pediatric hospital in the Eastern area of Saudi Arabia with non-traumatic chest pain between 2017 and 2022. The data included socioeconomic information, physical examination findings, and the results of basic investigations, such as chest X-ray and electrocardiogram. The Chi-square test was performed to compare various etiologies, with a 5% significant level. The study evaluated 310 patients with a mean age of 9.1±2.7 years. The majority of children presenting with chest pain had normal physical examinations, except 3.3% who showed respiratory and cardiac findings. The diagnostic tests indicated pneumonia in 2.9% and arrhythmia in 2.1% of children. Most patients were discharged with a diagnosis of idiopathic or muscular chest pain. The majority of patients (95%) were treated symptomatically in outpatient settings, with just one patient requiring hospitalization. The most common cause of chest pain prompting a child to visit the ED was idiopathic chest pain. Therefore, this study highlights the significance of obtaining a comprehensive medical history and physical examination to reveal important clues and help avoid unnecessary tests. [ABSTRACT FROM AUTHOR]

Background: Lockdown was a unique experience that affected many aspects of life, particularly during the challenge of Ramadan fasting (RF). Studying this can increase understanding of the effects of lifestyle changes on quality of life (QoL) for children with type 1 diabetes (T1D) during RF. Methods: A cross-sectional study that assessed the effect of lockdown on lifestyle and QoL on fasting children living with T1D during Ramadan in the Middle East and North Africa region (2020-2021). We compared the child (self) and parent (proxy) reports using PEDQoL v3.0 disease specific questionnaire during lockdown and non-lockdown periods, and assessed correlations with lifestyle changes using regression and gap analyses. Results: A total of 998 reports from 499 children with T1D aged 8 to 18 years (study = 276, control = 223), and their parents during RF in lockdown and non-lockdown periods. Fathers were more involved in their children's care during lockdown (P =.019). Patients had better compliance with treatment (P =.002), a reversed sleep pattern (P =.033), increased food intake (P ⩽.001), and less exercise (P <.001). Children and parents perceived better QoL during lockdown (P ⩽.001) with no differences between their reports in "Diabetes Symptoms", "Treatment Adherence," and "Communication" domains. Self and proxy reports were different in all domains during non-lockdown (P = <.001-.009). In gap analysis, although not statistically significant, the gap was approximated between children's and parents' perceptions in all domains during lockdown. Conclusion: COVID-19 lockdown had a positive impact on QoL of children living with T1D during RF, possibly due to lifestyle changes and superior psychosocial family dynamics. [ABSTRACT FROM AUTHOR]

Introduction: Sensenbrenner syndrome, or cranioectodermal dysplasia (OMIM #218330), is a rare genetic condition inherited as an autosomal recessive with less than 70 reported cases worldwide. It results in multiorgan abnormalities along with ectodermal structural defects. No previous reported cases demonstrated primary hypothyroidism in a matter of Sensenbrenner syndrome. Case Presentation: Herein, we report a 6-year-old girl who suffered from progressive liver failure and end-stage renal disease secondary to Sensenbrenner syndrome, which was associated with severe primary hypothyroidism that completely recovered after a combined renal and liver transplant. Conclusion: For the first time in the literature, we report an association of Sensenbrenner syndrome with hypothyroidism that resolved after a combined renal and liver transplant. Such findings expand the clinical spectrum of this syndrome. However, a larger cohort is needed to confirm or exclude such an association. Our case highlights the importance of thyroid function monitoring in any patient with renal and liver failure prior to and after a hepatorenal transplant. [ABSTRACT FROM AUTHOR]

Objective: The main aim was to report the prevalence and severity of serious bacterial infections (SBI) in children with sickle cell disease at King Abdulaziz Hospital (KAH), Al Ahsa, Saudi Arabia, to aid in determining whether outpatient management of such cases is appropriate. Methods: We conducted a retrospective chart review of febrile children less than 14 years of age admitted with sickle cell disease 2005 through 2015. Results: During 320 admissions, 25 children had SBIs (8%) including pneumonia (n=11), osteomyelitis (n=8), bacteremia (n=3, all with Salmonella species) and UTI (n=3). All recovered uneventfully. Conclusion: It appears that in the current era, less than 10% of febrile children with sickle cell disease in our center are diagnosed with an SBI. Over 11 years, there were no sequelae or deaths from SBI. Given these excellent outcomes, outpatient ceftriaxone should be considered for febrile well-appearing children with sickle cell disease if they have no apparent source and parents are judged to be reliable. [ABSTRACT FROM AUTHOR]

Gonadal dysfunction is a well-known endocrine manifestation of Down syndrome (DS) in men. Herein, we report a case of a seven-year-old boy with DS who developed precocious puberty, presenting with a six-month history of frequent erections, sudden growth spurts, and adult odors. Clinical examination revealed stage 2 puberty, with pubic hair development at stage 2 based on Tanner staging and bilateral testicular volumes of 6 mm. Laboratory tests indicated elevated luteinizing hormone (LH) and follicle-stimulating hormone levels and advanced bone age. A pituitary MRI revealed normal pituitary morphology without any detectable masses. The patient was initially prescribed monthly triptorelin acetate (Decapeptyl) intramuscular injections at a dose of 3.75 mg. Following six months, the treatment was switched to triptorelin pamoate (Diphereline) at a dose of 11.25 mg administered intramuscularly every three months. At age 10, following a three-year course of gonadotropin-releasing hormone (GnRH) agonist therapy, the patient demonstrated a notable decrease in testicular size and a reduction in LH levels, with no reported side effects. Conclusively, our findings imply that idiopathic central precocious puberty in boys with DS can be effectively managed with triptorelin pamoate injections, and early intervention may help alleviate the psychosocial impact of this condition., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. The Research Ethics Committee at King Faisal University issued approval KFU-REC-2024-MAR-ETHICS2119. The manuscript was approved and follows the rules and regulations of the Institution Review Board in The Research Ethics Committee at King Faisal University in publishing patient information including confidentiality and consent for publication. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Al Noaim et al.)