Asian Journal of Pediatric Research

Subclinical Markers of Kidney Injury in Children with Congenital Solitary Kidney

Hakan Erdogan — 2026-07-29

Objective: Congenital solitary kidney (CSK) is generally associated with preserved renal function during childhood; however, early subclinical markers of renal injury may already be present. This study aimed to evaluate renal function, microalbuminuria, office blood pressure (OBP), and ambulatory blood pressure monitoring (ABPM) findings in children with CSK compared with healthy controls.

Methods: Thirty-nine children aged 5–18 years with CSK (25 with unilateral renal agenesis and 14 with multicystic dysplastic kidney) and 30 healthy age- and sex-matched children were enrolled. Renal function, 24-hour urinary microalbumin excretion, OBP, and ABPM parameters were evaluated and compared between the groups.

Results: Renal function parameters remained within the normal range and did not differ significantly between the groups. Twenty-four-hour urinary microalbumin excretion was significantly higher in children with CSK than in controls (18.2 ± 7.2 vs. 8.2 ± 4.7 mg/day, p=0.033). The prevalence of abnormal blood pressure was also significantly higher in the CSK group than in controls (p=0.024).

Conclusion: Children with congenital solitary kidney may exhibit early markers of subclinical renal injury despite preserved renal function. These findings support careful longitudinal follow-up to identify children who may be at increased risk of future renal and cardiovascular complications.

Association of Sociodemographic Factors with Adherence to Age-specific Guidelines for Pediatric Umbilical Hernia Repair: A Nationwide Inpatient Sample Analysis

Alaa Yasir Hussein — 2026-07-29

Background: Age-specific recommendations generally support observation of uncomplicated paediatric umbilical hernias because many close spontaneously during early childhood. Nevertheless, some children undergo repair earlier than recommended, and the demographic, clinical, and institutional factors associated with this timing remain incompletely characterised.

Aim: This study examined factors associated with umbilical hernia repair at 3 years of age or younger.

Methods: A retrospective cohort analysis was conducted using the 2023 Nationwide Inpatient Sample. Children aged 0–17 years who underwent umbilical hernia repair were identified using APR-DRG 228. Early repair was defined as surgery at 3 years of age or younger. Demographic, payer, admission, and severity variables were evaluated, and independent associations were estimated using multivariable logistic regression.

Results: Of 5,806 identified children, 5,512 met the study criteria, and 581 underwent early repair. Early repair was associated with residence in the lowest income quartile (adjusted odds ratio [aOR] = 1.87; 95% confidence interval [CI]: 1.45–2.41), Medicaid coverage (aOR = 1.62; 95% CI: 1.28–2.05), non-elective admission (aOR = 2.14; 95% CI: 1.69–2.71), and major or extreme illness severity (aOR = 1.93 and 2.67, respectively).

Conclusion: Early inpatient repair was associated with socioeconomic disadvantage, clinical urgency, and greater illness severity. These associations should be interpreted cautiously because administrative data do not establish the reasons for surgical timing or the clinical appropriateness of individual procedures.

A Comparative Study to Assess the Behavioral Problems among Pre-school Children of Working and Non-working Mothers at Selected Anganwadis of District Yamuna Nagar, Haryana, India

Taruna — 2026-08-01

Background: Behavioural problems may affect preschool children’s emotional, social, and cognitive development. Maternal employment status may influence supervision, caregiving, and parent–child interaction; therefore, early recognition is important.

Objectives: This study assessed and compared behavioural problems among preschool children of working and non-working mothers at selected Anganwadis in Yamuna Nagar district, Haryana, and examined associations with selected demographic variables.

Methodology: A descriptive comparative design was used. Sixty mothers (30 working and 30 non-working) with preschool children aged 3–6 years were selected through purposive sampling. Data were collected using a sociodemographic profile and the Strengths and Difficulties Questionnaire. Descriptive and inferential statistics were applied.

Results: Among children of non-working mothers, 70% had normal behavioural status, whereas 63.33% of children of working mothers were in the borderline category. The mean overall behavioural problem score was higher among children of working mothers (17.15 ± 3.64) than among those of non-working mothers (15.68 ± 3.57), but the difference was not statistically significant (p = .121). Hyperactivity/inattention scores were significantly higher among children of working mothers (p < .001), while prosocial behaviour scores were significantly higher among children of non-working mothers (p = .014). Behavioural problems were significantly associated with family income, maternal occupation, and duration of maternal care per day.

Conclusion: Most children had normal behavioural status, although borderline problems were more common among children of working mothers. Early screening and supportive caregiving may promote healthy behavioural development.

Childhood Cystic Fibrosis in the Era of Highly Effective Modulator Therapy: A Critical Narrative Review of Diagnosis, Multisystem Disease and Evolving Management

Stefan Bittmann — 2026-07-30

Cystic fibrosis (CF) is the most common life-limiting autosomal recessive disorder among populations of European ancestry, and the childhood years determine much of its long-term trajectory. The therapeutic landscape has been reshaped by cystic fibrosis transmembrane conductance regulator (CFTR) modulators, yet the paediatric evidence base has matured unevenly across the domains that matter most to affected children. This critical narrative review evaluates the strength, consistency and limitations of the literature on CF in childhood, spanning pathophysiology, newborn screening and diagnosis, early airway infection and structural lung disease, nutrition and gastrointestinal involvement, CF-related diabetes, CFTR modulator therapy, and mental health. Peer-reviewed studies, professional consensus guidelines and authoritative institutional sources were appraised for methodological quality and translated into a thematic synthesis rather than a study-by-study catalogue. The evidence most strongly supports early diagnosis through newborn screening, the predictive value of early neutrophilic inflammation and infection for structural lung disease, and the short-to-medium-term efficacy and tolerability of triple CFTR modulator therapy in children as young as two years. Confidence is weaker for long-term safety, for outcomes in children ineligible for or unable to access modulators, and for the neuropsychiatric effects attributed to these drugs, where observational signals and case reports remain difficult to disentangle from the psychological burden of chronic illness. Persistent gaps include the management of inconclusive screening results, the durability of modulator benefit initiated in early life, the evolving natural history of CF-related diabetes and pancreatic disease under modulator therapy, and equity of access across health systems. The review concludes that childhood CF is being transformed rather than solved, and that surveillance, nutritional and psychosocial frameworks developed in the pre-modulator era require deliberate re-evaluation rather than uncritical continuation.

Fibrous Dysplasia of the Posterior Mandible in a 5 Year- Old Child: A Rare Case Report

Vundela Rajashekar Reddy — 2026-07-30

Fibrous dysplasia is a rare, benign bone disorder where normal bone is replaced by fibro-osseous tissue, often associated with GNAS gene mutations. It typically presents in childhood and may involve craniofacial bones, leading to facial deformities. Around 90% of cases show maxillofacial involvement, especially in the maxilla and mandible. Facial deformities are the primary reasons the patients seek medical treatment. In some cases, it occurs alongside café-au-lait skin pigmentation and endocrine abnormalities, forming part of McCune-Albright syndrome. Diagnosis can be challenging due to non-specific symptoms like pain or swelling. Lesions tend to enlarge with growth, and ceases when the child reaches pubertal age with the remodelling of the bone seen during the adulthood. Taking the patient’s growing age and that the lesion ceases after puberty and also due to asymptomatic nature of the swelling into considerations, the treatment approach is palliative with regular follow ups.

This case report presents a rare pediatric instance of fibrous dysplasia with respect to the posterior mandible, focusing on the clinical features, diagnostic challenges, and the need for early recognition to ensure appropriate referral and management.