Psychosocial Impact of Childhood Cancer on Patients and their Families

Background: The presence of cancer has a profound psychological impact on the quality of life of patients and their families, on family and social relationships, and on role functioning. Aim of the study: Assess the impact of childhood cancer on patients and their families. Subjects and methods: A Prospective questionnaire-based study, for 151 patients, had malignancy identified by tumor registry of Children Welfare Teaching Hospital. The information was taken from the parent(s) in the presence of the patient who sometimes answered some questions during the interview. Result: There was an interview with 151 families of children with cancer in the outpatient clinic. Sixty-two (41%) patients have leukemia while 89 (59%) have solid tumors. Boys were more than girls. Regarding patients, the mean age at the time of the interview was 10.2 years, while the mean age at diagnosis was 7.1 years. The majority of the parents accepted the diagnosis (89.4%), the rest of the parents (10.6%) were skeptical and tried to re-evaluate the condition elsewhere. More than one-half of the parents started to have quick temper (54%) after diagnosis. Most of them had sleep difficulties (83.2%) after diagnosis. Neglection of other siblings in the family was reported in more than one-half of the interviewed families (52.1%). Most of the parents lost their emotional control (69.2%) with the surrounding people after knowing the diagnosis. After an initial period of treatment, there was a decrease in the social activity of the families in 42% of cases. There was a high concern of the parents about the patient’s future marriage (69%), conception (62%), and career (52%). Conclusions: The establishment of a multidisciplinary cancer care team including social workers, teachers, psychologists, and others to support the child and family is seems to be mandatory during the whole period of treatment and thereafter.

Germ cell tumor: A seven-year experience Children Welfare Teaching Hospital

Background: Germ cell tumors are a rare heterogeneous group of cancers with high cure rates in the pediatric age group.Objectives: To study the clinical and pathological features in a group of patients with germ cell tumors and to evaluate their outcomes.Patients and methods: A record review was undertaken on a group of patients with germ cell tumor who were admitted to the Children Welfare Teaching Hospital in Baghdad during the years 2009 - 2015. Information on gender, age, clinical signs, pathological findings, treatment and overall survival rate were reviewed.Results: The patients had a mean age of 4.2 years (ranging from 1 month - 14 years). There were 45 girls and 16 boys. Abdominal pain was the most common presentation in 17 patients followed by a lower back mass in 16 patients. Primary sites included extra gonadal (sacrococcygeal 18, pelvis 5, vagina 4, gluteal 3, intra-cardiac, and one each for the mediastinum, orbit and rectum), and gonadal (18 ovarian and 9 testicular). After a mean period of follow-up of 42 months, the overall survival at 1 year was 59%.Conclusion: The prognosis of children with germ cell tumors is favorable, regardless the site and histopathology.

CONSTRUCTION OF COVID-19 PANDEMIC MANAGEMENT POLICY BASED ON THE WELFARE OF WOMEN AND CHILDREN

<p><em>The purpose of this study is to find out and analyze the construction of policies for handling the Covid-19 pandemic based on women and children's welfare and analyze the Government's role in realizing the policy for handling the Covid-19 pandemic. In order to realize the welfare of women and children. This study uses a qualitative method with a normative juridical approach. The results showed that the construction of welfare-based Covid-19 handling policies for women and children must be socialized to women and children. The socialization process to women and children is carried out in a way; love, appreciation, and love between family members. Socializing women and children in making a policy must encourage and enable women and children to collaborate as equal stakeholders in policies to handle Covid-19 during the pandemic. This policy has certain limitations, such as Human Rights, Good Governance, and Morality. Policies with these limitations will produce policies that guarantee freedom for women and children, protection for women and children, welfare for women and children, child development, all of which must be considered in the policy for handling Covid 19. </em></p><p><em> </em></p>

Physical Abuse in Its Extreme form Seen in a 12-Year-Old Female Adolescent

Background: Child abuse occurs very frequently in Nigeria with approximately 6 out of every 10 children experiencing some form of violence. An estimate of 1 in every 4 girls and 1 in every 10 boys have undergone some form of sexual violence. Unfortunately this human violation often elicits little or no attention particularly where the abuser happens to be a close relative. Case: A 12 year old female adolescent was admitted into the children emergency room of a Nigerian tertiary institution with high grade fever and bilateral painful leg swelling following physical abuse by her biological father. This was buttressed with the findings made on examination. Parenteral anti-inflammatory and antibiotics were administered with surgical drainage of the lesions. The mental state of the Patient was evaluated by the Psychological Medicine Experts /Psychiatrist and also had counselling sessions during the course of treatment and shortly before discharge. Patient responded well to treatment and was discharged to the care of the women and children welfare unit of the State Ministry of Women Affairs. Conclusion: This case report underscores the need for continuous awareness creation on the inherent dangers of child abuse for both the general public and the Health practitioners.

Nutritional Status of Under Five Years Children in Rangpur Cantonment

Introduction: Nutrition is an important factor because of its role in preventing disease and infant survival and growth. Malnutrition and diseases are interlinked with each other and a great problem in all countries of the developing world. Objectives: To assess the nutritional status of the under five year's children in Rangpur Cantonment. Materials and Methods: This descriptive cross-sectional study was done in Children Welfare Centre (CWC) of Combined Military Hospital (CMH), Rangpur from July to August 2018. A total of 50 under five years children were selected and a structured questionnaire was used keeping the focus on socioeconomic status, dietary habits, hygiene practices, and anthropometric indices of the children. Results: Out of 50 children, 60% were male and 40% were female. About 26% of children were in the 36 to 48 months of age group. About 50% were in the height group of >100 cm, 34.0% were in the height group of 91-100 cm, 16% were in the height group up to 90 cm, 48.0% were in the weight group of 12.1-16 kg, 34.0% were in the weight group of 16 kg, 10%were in the weight group of 10.1-12 kg and 8%were in the weight group below 10 kg. Conclusion: In this study, 20% of cases were stunted and 80% of cases were not stunted and no wasted case was found and the overall prevalence of malnutrition in the Rangpur cantonment was low. A further in-depth study is recommended to draw conclusive inferences. JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 168-170

Hemolysis in children with Glucose-6-Phosphate Dehydrogenase deficiency after ingestion of fava beans; facts predicting severity

Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an enzymatic disorder of red blood cells causes acute haemolysis after exposure to certain offending agents including ingestion of fava beans. This problem represents a major health issue for Iraqis, especially during the fava bean harvesting season. This study aimed to assess the demographic, clinical and biochemical characteristics as predictors of haemolysis after ingesting fava beans. Methods: A cross-sectional study was undertaken. A total of 57 patients with G6PD deficiency were recruited from the Emergency Department of Children Welfare Teaching Hospital, Medical City. Data were collected using a specially designed form. A purposive sampling method was used to recruit 57 patients 49 males and 8 females who were visiting the pediatric emergency department from March to May 2017 with a presentation of acute hemolytic episode of G6PD. Patients were classified into mild or severe haemolysis groups based on their haemoglobin level at the time of admission. Results: Younger age group patients tend to present with the severe form of hemolysis (3.59 years with a P value of 0.001). No significant gender susceptibility between both types of hemolysis. The urban area based living individuals tend to present with mild hemolysis while those from rural areas tends to present with more severe episodes of hemolysis (P value 0.001). There was a significant correlation between the type of fava bean ingestion (fresh or dried) and the severity of hemolysis, those who presented with more severe hemolysis usually had a history of ingestion of fresh type of fava bean. Eight individuals of severe type recorded previous episodes of hemolysis while three individuals of the mild type recorded previous episodes (P value 0.001). Family history of G6PD was significant in 88.2% of individuals with the severe form (P value 0.005). Conclusions: This study is aimed to report several factors that might predict the severity of hemolysis among patients with G6PD deficiency. Younger age, residence in a rural region, ingestion of fresh fava beans, and history of frequent hemolysis incidents are predictors of developing severe hemolysis among children admitted to the emergency room of Children Welfare Teaching Hospital in Medical City/Baghdad.

Practices in performing lumbar puncture procedure in the Children Welfare Teaching Hospital / Baghdad

Background: Lumbar puncture is a procedure that is frequently performed in the pediatric practice.Objective: To review some (patient, provider and technique- related) characteristics of lumbar puncture performed at the Children Welfare Teaching Hospital, Baghdad / Iraq.Methods: A descriptive cross-sectional study was conducted in the period from April to September, 2017. A self-prepared questionnaire was used to collect the data. It included 32 items, which were divided into three sections: Residents doctors' information (3 items), patient's information (2 items) and procedure’s information (27 items).Results: The total number of performed procedures was 103, of which 51 (49.5%) were performed in the oncology ward. About half (50, 48.6%) of the patients were preschool-aged. Lumbar puncture was indicated for diagnostic purposes in 52(50.5%) cases. Nearly two thirds (67, 65.9%) of the procedures was performed by senior residents (3rd/4th Board residents). A written consent was obtained in only one case, the couch sheet were not renewed in 92 (93.9%) cases, a drape were not used in 92 (93.9%) cases, sitting upright position was assumed in 90 (91.8%) cases, gloves were worn by the doctor in all cases, anesthesia was used in 47 (48%) cases, antiseptics were used in 97 (99%) cases ,one holder was noted in 93 (94.8%) cases ,SpinocanQuincke and 22 Gage needle type was used in 98 (100%) cases, one entry attempt per procedure was reported in 79 (80.6%) cases and no documentation in the patients’ notes was reported in any of the procedures.Conclusion: Lumbar puncture load was found in the oncology ward both for the patients and the residents. Safety was considered but was suboptimal in all wards.

Providing pediatric well-care and sick visits in the COVID-19 pandemic era: the recommendations of the Italian pediatric society

Pediatricians have observed a significant decrease in in-person child health visits during the COVID-19 pandemic. In the post lockdown period, the coronavirus trend remains positive in Italy but fears of a second wave have recently grown in Italy due to active hotbeds of contagion. The pandemic may negatively affect the care of pediatric patients and overall children welfare as it may present with severe signs and symptoms or it may complicate. The Italian Pediatric Society recommend to separate well visits from sick ones, to educate families and to promote hygienic strategies to provide an adequate pediatric assistance in case of a second pandemic wave.

Decrease of respiratory diseases in one social children welfare institute in Shanxi Province during COVID-19

Background To assess the impact of disinfection measures on the incidence of common diseases in children welfare institute during the epidemic of Corona Virus Disease 2019 (COVID-19), and provide a basis for the daily disinfection management of children welfare institute. Methods This study surveyed and analyzed common diseases among children under the age of 14 in one social children welfare institute in Shanxi Province from January to May in 2018–2020 by the year-on-year method. Results The prevalence rate of respiratory diseases in 2020 was a significantly negative growth compared with 2018 and 2019. There was no obvious pattern of changes in digestive diseases group. Conclusion In view of the above anti-epidemic measures, it indicates that the children gathering institutions should strengthen effective personal protection and public health management to reduce infectious disease among children.

KUALITAS KELEKATAN ANAK DENGAN PENGASUH DI LEMBAGA KESEJAHTERAAN SOSIAL ANAK (LKSA) AL-KAUTSAR LEMBANG KABUPATEN BANDUNG BARAT

Attachment refers to a relationship or emotional bonding that last for a long time, intertwined between individuals and attachment figures that are characterized by a desire to seek and maintain closeness to the attachment figures, especially in pressure time. This research aims to gain the empirical description about warmth of children to caregivers. The method in this research uses descriptive method with a quantitative approach. Sampling in this research is census, and data collection technique uses: 1) questionnaire, 2) interview, 3) observation, and 4) documentation study. As for the measuring instrument validity test uses face validity. Furthermore, the result analysed through quantitative and qualitative analysis. The result shows that the attachment quality of children to caregivers in Al-Kautsar’s Children Welfare Institution Lembang, West Bandung Regency is in moderate category. Therefore, it is necessary to make an improvement throught the proposed program which is EDUFAS (Education and Fun Sharing) “Improvement of The Attachment Quality of Children to Caregivers in Al-Kautsar’s Children Welfare Institution Lembang, West Bandung Regency”. Abstrak. Kualitas kelekatan (attachment) merujuk pada ikatan emosional yang bertahan dalam waktu yang lama, terjalin antara individu dengan figur lekatnya yang ditandai adanya keinginan untuk mencari dan memelihara kedekatan dengan figur lekat tersebut terutama pada saat-saat yang menekan. Penelitian ini bertujuan untuk mendapatkan gambaran empiris tentang kehangatan (warmth) anak dengan pengasuh. Metode penelitian yang digunakan dalam penelitian adalah metode kuantitatif dengan pendekatan deskriptif. Teknik penarikan sampel dalam penelitian ini adalah sensus, yaitu dengan jumlah responden sebanyak 38 anak. Teknik pengumpulan data yang digunakan adalah: 1) kuesioner, 2) wawancara tidak terstruktur, 3) observasi, dan 4) studi dokumentasi. Adapun uji validitas alat ukur menggunakan validitas muka (face validity). Selanjutnya hasil penelitian dianalisis menggunakan analisis kuantitatif dan kualitatif. Hasil penelitian menunjukkan bahwa kualitas kelekatan anak dengan pengasuh di Lembaga Kesejahteraan Sosial Anak Al-Kautsar Lembang Kabupaten Bandung Barat termasuk dalam kategori sedang. Begitu pula pada semua aspek dalam kualitas kelekatan termasuk dalam kategori sedang. Maka dari itu diperlukan upaya peningkatan melalui program yang diusulkan yaitu EDUFAS (Educating and Fun Sharing) “Peningkatan Kualitas Kelekatan Anak dengan Pengasuh di Lembaga Kesejahteraan Sosial Anak (LKSA) Al-Kautsar Lembang Kabupaten Bandung Barat”.