pediatric medicine
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Bone age is estimated in pediatric medicine for medical and legal purposes. In pediatric medicine, it aids in the growth and development assessment of various diseases affecting children. In forensic medicine, it is required to determine criminal liability by age, refugee age estimation, and child-adult discrimination. In such cases, radiologists or forensic medicine specialists conduct bone age estimation from left hand-wrist radiographs using atlas methods that require time and effort. This study aims to develop a computer-based decision support system using a new modified deep learning approach to accelerate radiologists' workflow for pediatric bone age estimation from wrist radiographs. The KCRD dataset created by us was used to test the proposed method. The performance of the proposed modified IncepitonV3 model compared to IncepitonV3, MobileNetV2, EfficientNetB7 models. Acceptably high results (MAE=4.3, RMSE=5.76, and R2=0.99) were observed with the modified IncepitonV3 transfer deep learning method.

On the basis of literature data and their own observations, Barabas and Tordau (Arch. F. Kind., Bd. 72) concluded that protein therapy in infancy can be applied only within narrow limits.

OBJECTIVE This report describes a quality improvement initiative to implement a pharmacist-led antimicrobial time-out (ATO) in a large, freestanding pediatric hospital. Our goal was to reach 90% ATO completion and documentation for eligible patients hospitalized on general pediatric medicine or surgery services. METHODS A multidisciplinary quality improvement team developed an ATO process and electronic documentation tool. Clinical pharmacists were responsible to initiate and document an ATO for pediatric medicine or surgery patients on or before the fifth calendar day of therapy. The quality improvement team educated pharmacists and physicians and provided ATO audit and feedback to the pharmacists. We used statistical process control methods to track monthly rates of ATO completion retrospectively from October 2017 through March 2018 and prospectively from April 2018 through April 2019. Additionally, we retrospectively evaluated the completion of 6 data elements in the ATO note over the final 12-month period of the study. RESULTS Among 647 eligible antimicrobial courses over the 19-month study period, the mean monthly documentation rate increased from 54.6% to 83.5% (p < 0.001). The mean ATO documentation rate increased from 32.8% to 74.2% (p < 0.001) for the pediatric medicine service and from 65.0% to 88.1% for the pediatric surgery service (p = 0.006). Among 302 notes assessed for completeness, 35.8% had all the required data fields completed. A tentative antimicrobial stop date was the data element completed least often (49.3%). CONCLUSIONS We implemented a pharmacist-led ATO, highlighting the role pharmacists play in antimicrobial stewardship. Additional efforts are needed to further increase ATO completion rates and to define treatment duration.

Objectives: To know the frequency of hypertension among children having acute kidney injury (AKI) at a tertiary care hospital. Study Design: Descriptive, cross-sectional study. Setting: Department of Pediatric Medicine, Nishtar Hospital, Multan, Period: 1st January to 31 December 2019. Material & Methods: A total of 718 children with AKI were included from department of Pediatric medicine, Nishtar Hospital, Multan. Once registered, study variables were noted along with systolic and diastolic blood pressure. Results: Of these 718 study cases, majority, 439 (61.1%) were male, 435 (61.0%) belonged to rural areas, 443 (61.7%) from poor socioeconomic status and 551 (76.7%) mothers were illiterate. Mean age was 4.33±2.56 years whereas mean body mass index was 23.58±3.17 kg/m2. Overall, family history of AKI was noted in 165 (23.0%) children. Hypertension was noted in 228 (31.8%) cases. Conclusion: Very high frequency of hypertension was seen in children presenting with AKI.

BHS (breath holding spell) are very successive & significant demonstrative difficulties in pediatric medicine. The obviously terrifying functions are generally basic in youngsters. Yet, at times BHS (breath holding spell) can be extremely upsetting by the guardians & the strategies on your own may not be adequate. Strong enhancements and piracetam are the two distinctive pharmacologic techniques those were utilized for giving BHS in kids. That go through such kind of study is driven in our assessment site and it is speculated to give a couple of results to investigate two healing schedules that are typically suggested for BHS in kids. An aggregate of 70 BHS (breath holding spell) cases are chosen into the examination of the 35 patients (A) stayed specified iron alone and 35 patients (B) that gives piracetam and oral iron. The examination gives the data to differentiate the ampleness of using piracetam and oral iron versus iron alone in kids with BHS (breath holding spell) in the outpatient division of PVS Hospital (P) Ltd, Calicut. The assessment contemplated that piracetam has all the reserves of being ensured and reasonable medicine for BHS. Piracetam despite oral iron in adolescents with BHS can reduce the repeat and earnestness of attacks than using iron alone, henceforth diminishing the difficulty of the agitated watchmen and misery by children.