International Journal of Scientific Pediatrics

CARDIOVASCULAR DISORDERS IN CHILDREN WITH JUVENILE ARTHRITIS: THE IMPORTANCE OF INFLAMMATION ACTIVITY AND DISEASE DURATION

Nilufar Akhmedova — 2025-11-04

Relevance. Under the influence of progressive inflammatory activity, immunological disturbances, and pharmacological therapy, cardiovascular system damage in children with juvenile arthritis is considered one of the leading factors contributing to a poorer prognosis and increased risk of disability. The clinical manifestations of such disorders are often masked by the underlying disease, which leads to a delay in diagnosis. This highlights the necessity of a detailed investigation of cardiovascular abnormalities in this patient population. Objective. To assess the impact of inflammatory activity and disease duration of juvenile arthritis on the development of cardiovascular disorders in children. Materials and Methods. The study included 80 patients with JIA aged 2 to 17 years, divided into two groups: 50 with systemic-onset JIA and 30 with the articular form of the disease. Clinical, instrumental, and laboratory methods were applied. Statistical analysis of the data was performed using IBM SPSS Statistics v.26. Results. It was established that the frequency of cardiovascular disorders in children with systemic-onset JIA was higher than in those with the articular form. The following characteristic cardiovascular disorders were identified: chronic heart failure, myocardial remodeling, arrhythmias, conduction blocks, left ventricular hypertrophy, and decreased contractile function. A significant association was demonstrated between the frequency of these disorders, the severity of inflammatory activity, and disease duration. Conclusion. In children with systemic-onset JIA, cardiovascular disorders are more frequent compared to the articular form. The progression and high inflammatory activity of JIA are closely related to the development of structural and functional cardiac changes, including myocardial remodeling, conduction abnormalities, and valvular dysfunctions.

MULTIMODAL APPROACH TO DIAGNOSING POLYNEUROPATHIES OF VARIOUS ORIGINS IN CHILDREN

Kakhkhorali Gulomov — 2025-11-04

Background: Polyneuropathies in children pose diagnostic challenges due to their diverse etiologies, age-specific clinical presentations, and the need for specialized assessment techniques. A multimodal diagnostic approach, combining clinical evaluation, electrophysiology, laboratory studies, and imaging, is crucial for accurate diagnosis and management. Objective: To evaluate the effectiveness of a structured multimodal diagnostic approach in identifying pediatric polyneuropathies and determine the diagnostic yield of various modalities. Methods: A retrospective analysis was conducted on 85 pediatric patients (age range: 0-18 years) suspected of having polyneuropathy at Fergana Regional Children’s Multidisciplinary Medical Center. The diagnostic protocol included comprehensive clinical assessment, nerve conduction studies (NCS) and electromyography (EMG), targeted laboratory investigations, neuroimaging, and genetic testing when indicated. Results: Definitive diagnoses were established in 78 patients (91.8%). The most common etiologies were hereditary neuropathies (34.1%), immune-mediated inflammatory neuropathies (28.2%), and metabolic causes (15.3%). Nerve conduction studies had the highest diagnostic yield (89.4%), followed by targeted genetic testing (72.3% in hereditary cases) and laboratory investigations (68.2%). Conclusions: A structured multimodal approach significantly improves diagnostic accuracy in pediatric polyneuropathies. Early use of electrophysiological studies, combined with targeted laboratory and genetic testing, enables timely diagnosis and appropriate intervention.

ANALYSIS OF RISK FACTORS FOR THE TRANSFER OF LATENT TUBERCULOSIS INFECTION TO ACTIVE TUBERCULOSIS IN CHILDREN LIVING IN FAMILY TUBERCULOSIS FACTORIES

Dinara Adjablayeva — 2025-11-04

Relevance. According to the WHO definition, latent tuberculosis infection (LTBI) represents a state of persistence of Mycobacterium tuberculosis in the absence of clinical manifestations of the disease, which can only be detected through immunological tests. Experts estimate that about one-quarter of the world’s population is infected with LTBI, with a lifetime risk of reactivation ranging from 5% to 15%, particularly within the first five years after infection and predominantly during childhood. Within the framework of the global tuberculosis control strategy after 2015, special attention has been directed to the early detection and prevention of LTBI as a key element in reducing the incidence of new cases. However, to date, no “gold standard” exists for diagnosing and differentiating latent and active forms of tuberculosis in children. Objective. To study the anamnestic and social indicators of latent tuberculosis infection development and active tuberculosis course in children. Materials and Methods. A retrospective-prospective cohort study was conducted in accordance with the international STROBE standard. A total of 60 children were included and divided into two groups: Group 1 consisted of 40 children with latent tuberculosis infection, and Group 2 included 20 children with active tuberculosis. Results. It was established that the key social risk factors for tuberculosis activation were living in low-income, large, and single-parent families, poor housing conditions, low parental education, unemployment, and harmful habits. Among biological factors, low birth weight, perinatal CNS lesions, early childhood anemia, as well as concomitant chronic conditions (helminthic invasions, gastrointestinal and endocrine disorders, myopia, rheumatism) were identified. Epidemiological factors included contact with bacillary patients, lack of chemoprophylaxis, non-compliance with sanitary measures in households, living in families with HIV infection, and a history of COVID-19. Conclusions. Thus, the study confirmed the multifactorial nature of the risk of LTBI activation in children, where social, biological, and epidemiological components play a significant role. The authors emphasize the necessity of a comprehensive assessment of risk factors and their justified differentiation for latent and active tuberculosis forms, which has practical significance for prevention, early diagnosis, and rational monitoring of children in risk groups.

CARDIOVASCULAR SYSTEM STATUS IN CHILDREN OF PRIMARY SCHOOL AGE DEPENDING ON OVERWEIGHT

Salomat Khudaynazarova — 2025-11-04

Relevance. The problem of obesity in the population of children and adolescents is not only pediatric, but also a cardiological problem, since in children and adolescents with excess body weight, arterial hypertension, dyslipidemia, insulin resistance, and early signs of myocardial remodeling are significantly more frequently detected, which contributes to the formation of a high cardiovascular risk at a young age. In particular, in schoolchildren of different ages with metabolic syndrome, the likelihood of developing cardiovascular diseases is 14 times higher, and diabetes mellitus is 11 times higher compared to their peers without this syndrome. Purpose of the research. To study the features of the course of functional disorders of the cardiovascular system in children with excess body weight, depending on age (7-10 years). Materials and methods of research. The examination was conducted at the city adolescent center. The study involved 50 children with excess body weight and 30 children without excess body weight. The study involved 50 children with excess body weight and 30 children without excess body weight. Research results. In the main BMI group, excess body weight (+2 SD) was detected in 93.3% of boys and 94.2% of girls, and the risk of excess weight (+1 SD) was 6.7% of boys and 5.8% of girls, weight gain was observed, and growth was not observed in the control group. According to the study of parental questionnaires in the main group, it was revealed that heredity is complicated in children with various pathologies, among which cardiovascular system pathologies occurred in 72% (ischemic heart disease, arterial hypertension, those who had a heart attack at a young age), type 2 diabetes mellitus - in 16.7%, endocrine pathologies - in 42% (hypo- and hyperthyroidism, etc.). Among comorbidities, chronic tonsillitis occurred in 91.0% of children in the main group and 59.9% in the control group, anemia occurred in 78.2% of children in the 1st group and 39.9% in the 2nd group, which showed a significant value (p < 0.001), somatoform. Conclusion. In children with excess body weight, complaints of sleep disturbance, chest pain, shortness of breath during physical exertion, headache, and dizziness are registered significantly more often, which confirms the negative impact of obesity on the functional state of the cardiovascular system. According to ECG data, rhythm and conduction disorders were detected in such children, among which slowed AV conduction, rhythm driver migration, and extrasystole occur significantly more frequently. The nature of hemodynamic reactions to physical exertion in overweight children is determined by the predominance of the hyperdynamic type of blood circulation, while in their peers with normal body weight, the normotonic type is more common. The obtained results indicate that excess body weight in children is a significant factor in the formation of cardiovascular risk already in childhood and requires timely diagnosis, prevention, and correction.

INTEGRATING NEUROPHYSIOLOGICAL AND PARACLINICAL FINDINGS FOR DIFFERENTIAL DIAGNOSIS OF SUBACUTE SCLEROSING PANENCEPHALITIS IN PEDIATRIC PATIENTS

Shakhlo Saidazizova — 2025-11-04

Relevance. Subacute sclerosing panencephalitis (SSPE) remains a devastating progressive encephalopathy in children, caused by persistent measles virus infection. Accurate differential diagnosis requires integrating clinical, neurophysiological, and paraclinical data. Materials and methods.This study analyzed 180 pediatric SSPE patients treated at the Center for the Development of Professional Qualification of Medical Workers and the National Children’s Medical Center between 2019 and 2024. Data included demographics, vaccination status, disease severity, electroencephalography (EEG), and magnetic resonance imaging (MRI). Results: Characteristic EEG periodic complexes and MRI white-matter abnormalities strongly correlated with clinical stage and functional decline. Vaccination coverage was low (40%), highlighting persistent susceptibility to measles-related complications. Our findings confirm that combining EEG, MRI, and cerebrospinal fluid antibody testing increases diagnostic certainty and distinguishes SSPE from mimicking neurological conditions. Conclusion. Early recognition through multimodal assessment is essential for timely management, counseling, and trial enrollment. Strengthening vaccination strategies and standardized diagnostic protocols may reduce disease burden and improve outcomes.

OBESITY AND OVERWEIGHT AS EARLY PREDICTORS OF CARDIOVASCULAR DYSFUNCTION IN CHILDREN

Artur Popenkov — 2025-11-04

Relevance. Childhood overweight and obesity remain among the most pressing issues in pediatrics and public health. The rising prevalence of excess body weight in children is associated with lifestyle changes, reduced physical activity, and dietary habits. Pediatric obesity is linked not only to metabolic disorders but also to the early onset of cardiovascular abnormalities. Elevated body mass index (BMI) correlates with arterial hypertension and electrocardiographic (ECG) changes, which may serve as early predictors of cardiovascular diseases. Studying these associations in school-aged children is essential for developing preventive strategies. The purpose of the study is to assess the impact of overweight and obesity on blood pressure and electrocardiographic parameters in 7-year-old children. Materials and methods of the study. A cross-sectional study was conducted involving 120 children aged 7 years. Participants were divided into three groups: normal BMI (n=67), overweight (n=29), and obese (n=24). Anthropometric measurements were performed according to WHO standards, BMI and SDS were calculated, and arterial blood pressure was measured three times to determine systolic and diastolic values. Standard 12-lead ECG was performed for all participants. Statistical analysis included descriptive statistics, Student’s t-test, Mann–Whitney test, and correlation analysis (Pearson and Spearman). A p-value <0.05 was considered significant. Research results. Children with obesity demonstrated significantly higher systolic and diastolic blood pressure compared with children of normal weight (p<0.01). ECG analysis revealed that the frequency of functional cardiac abnormalities increased proportionally with higher BMI: 40.3% in normal-weight children versus 70.8% in obese children. The most common findings included early repolarization syndrome, sinus tachycardia, and nonspecific intraventricular conduction disturbances. A positive correlation was found between BMI and blood pressure (r=0.42; p<0.01), as well as between BMI and functional ECG abnormalities (r=0.36; p<0.05). Conclusion. Overweight and obesity in early school-aged children are associated with increased arterial blood pressure and a higher prevalence of functional ECG changes, which may serve as early predictors of cardiovascular pathology. These findings highlight the importance of routine monitoring of cardiovascular parameters in overweight children and emphasize the need for comprehensive preventive measures, including dietary modification and increased physical activity, starting from early childhood.

THE ONSET OF SCHIZOPHRENIA IN CHILDHOOD AND ADOLESCENCE AS AN UNFAVORABLE PROGNOSTIC INDICATOR (based on the results of an epidemiological study in the socio-economic conditions of the Fergana Valley of the Republic of Uzbekistan)

Shavkat Islamov — 2025-11-04

Relevance. Schizophrenia with onset in childhood and adolescence is one of the key unfavorable prognostic factors affecting the course and outcome of the disease. In the Fergana Valley, this problem is particularly relevant due to the high proportion of early onset cases. The aim of the study is to identify the characteristics of early-onset schizophrenia in the Fergana Valley, substantiate its prognostic significance, and establish priorities for early detection and prevention programs. Materials and methods. A retrospective analysis of 1087 cases of schizophrenia registered in the Fergana Valley between 1984 and 2024 was conducted. Patients were categorized by age of disease onset (under 20 years, 21-29, 30-39, 40 and older). Statistical methods were used to assess the influence of age and associated factors (heredity, exogenous triggers, schizoid premorbid personality) on the course of the disease. Results. Nearly 44% of cases had onset before age 20, a figure that has remained stable over 40 years. Early onset is associated with longer episodes, reduced quality of remission, and deterioration in social adaptation. Hereditary predisposition and schizoid premorbid personality are linked to a more severe course and incomplete remissions, while exogenous factors show a tendency towards improved prognosis. A statistically significant increase in cases with onset between ages 30-39 was noted. Conclusion. Early onset of schizophrenia is a persistent unfavorable prognostic indicator, necessitating the development of regional programs for early detection and comprehensive psychosocial support. Special attention should be given to patients with hereditary predisposition and schizoid premorbid personality. Modern treatment approaches contribute to improving the course of the disease; however, additional preventive measures are necessary.

CLINICAL FEATURES AND STRUCTURE OF CASES IN CHILDREN WITH CONGENITAL HEART DISEASE

Dilorom Akhmedova — 2025-11-04

Relevance. Congenital heart defects (CHD) represent the most common group of congenital developmental anomalies in children and remain one of the leading causes of neonatal and infant mortality. According to global statistics, the prevalence of CHD ranges from 6 to 10 cases per 1,000 live births. With the current advances in cardiac surgery and neonatology, timely diagnosis of clinical, laboratory, and instrumental parameters in children with CHD is of critical importance for determining prognosis, selecting optimal treatment strategies, and preventing complications. The purpose of the study. To assess the clinical manifestations, physical development, laboratory, and instrumental indicators in young children with congenital heart defects of varying severity. Materials and methods of the study. The study included 49 children with congenital heart defects who underwent examination and treatment at the Department of Cardiac Surgery, Tashkent Pediatric Medical Institute. The age of the patients ranged from several weeks to 3 years. All children underwent a comprehensive clinical and instrumental assessment, including medical history collection, physical examination, anthropometric measurements (height, weight, body mass index), laboratory tests (complete blood count, biochemical analysis, hemoglobin level, protein and electrolyte parameters), and instrumental methods such as electrocardiography (ECG), echocardiography (EchoCG), chest radiography, and abdominal ultrasound when indicated. The severity of heart failure was determined according to the Ross classification (Ross, 1992). Research results. The most common CHD among the examined children was ventricular septal defect (VSD), identified in 46.9% of patients. Ventricular septal defect and patent ductus arteriosus (PDA) were the next most frequent. Isolated defects were found in 51% of cases, while combined defects were observed in 47%, indicating a high prevalence of complex cardiac malformations in early childhood. Pulmonary hypertension (PH) was diagnosed in 57.1% of children, mainly in those with significant shunts and combined defects, underscoring the importance of early detection of elevated pulmonary artery pressure. Growth retardation was noted in most boys, likely associated with chronic hypoxia and reduced exercise tolerance. All patients exhibited anemia, reflecting impaired oxygen transport and compensatory adaptation to hypoxia. Congestive pulmonary changes were identified in 26.5% of cases, while gastrointestinal and urinary tract disorders were observed in 10.2% of children, indicating a systemic impact of cardiac pathology on somatic health. Conclusion. Young children with congenital heart defects demonstrate marked impairments in physical development, anemia, pulmonary hypertension, and a high frequency of combined cardiac defects. The degree of heart failure does not always correlate with the age at diagnosis, emphasizing the importance of a comprehensive approach to examination and follow-up. Timely detection of clinical, laboratory, and instrumental abnormalities helps to determine disease prognosis, plan surgical correction, and reduce the risk of complications.

THE ROLE OF PEPTIDE YY3-36 IN THE DEVELOPMENT OF METABOLIC SYNDROME IN CHILDREN WITH OBESITY

Lilya Garifulina — 2025-11-04

This article presents data from a study of peptide YY-36 in obese children, which plays a key role in the regulation of eating behavior. This peptide is synthesized by L-cells in the distal small and large intestines, enters circulation after meals, and is an anorexigenic hormone. The results of this study are recommended for widespread implementation in the practice of pediatricians, general practitioners, and pediatric endocrinologists. Study objective: To determine the contribution of peptide YY3-36 to the development of metabolic syndrome in children with obesity. Materials and methods: A total of 108 children with exogenous-constitutional obesity, abdominal fat distribution, and waist circumference greater than the 90th percentile for age and sex were examined. For comparative analysis, 76 children with normal body weight were examined. A comprehensive set of anthropometric, biochemical, and enzyme immunoassay studies was conducted, and serum peptide YY3-36 levels were determined. Based on the criteria for diagnosing metabolic syndrome, the frequency of metabolic syndrome, its various forms, and combinations were determined in children with abdominal obesity. Study results: When studying peptide YY3-36 levels in obese children, a significant decrease was found in children with abdominal obesity (72,13 pg/ml), which was significantly lower than in controls (105,39 pg/ml; p< 0.001). When determining the gender dependence of intestinal neuroregulatory peptide YY3-36 production, statistically lower levels were observed in boys compared to girls, indicating a more pronounced imbalance in peptide YY3-36 production in boys with visceral fat distribution. The study noted a tendency toward decreased YY3-36 peptide levels as children aged 16-18 years compared to children aged 10-15 years. No similar age-related dynamics were observed in children in the control group. The duration of obesity in children with abdominal obesity played a role in the production of intestinal neuroregulatory peptide. YY3-36 peptide levels progressively decreased with increasing duration of the disease, which was apparently associated with a gradually increasing eating disorder. The study demonstrated that all children with abdominal obesity had low YY3-36 peptide levels, indicating an eating disorder, which is one of the dominant factors in the development of metabolic syndrome in the entire sample of children, with the lowest values in children with complete metabolic syndrome. Currently, there is no interpretation of peptide YY3-36 levels for diagnosing pathological conditions, including metabolic syndrome, in children with obesity. Therefore, a threshold level for peptide YY3-36 was determined to assess the contribution of this hormone to the diagnosis of metabolic syndrome in children with abdominal obesity. In a study of the AUC-ROC of peptide YY3-36 levels, the AUC curve area reached sufficient diagnostic values at a threshold level ≤71,600, with a sensitivity of 84.2% and a specificity of 73.4%, demonstrating the good diagnostic accuracy of the AUC-ROC test (AUC = 0,856). Conclusions: The study suggests a significant contribution of abnormal peptide YY3-36 production to the development of abdominal obesity in children. The conducted work characterizes a significant decrease in the production of this food hormone in metabolic syndrome in children, the degree of pathology of which was greatest in boys with the full form of the syndrome.

MELKERSSON-ROSENTAL SYNDROME IN CHILDREN AS AN ORPHAN DISEASE: PREVALENCE, CLINICS AND TREATMENT METHODS

Farrukhbek Khamidov — 2025-11-04

In this article, the authors, referring to their own practice, cases from practice, present information about a rare syndrome in children - Melkersson-Rosenthal. Based on the results of their own clinical observation, instrumental and laboratory studies, the clinical and diagnostic criteria of the syndrome are described. Historical and modern literary data on the rare Melkersson-Rosenthal syndrome are provided. The authors argue that the disease begins during the transition from childhood to adolescence, and after treatment, the progression of the disease slows down, but does not stop, which requires close monitoring by both pediatricians and general practitioners.

THE ROLE OF SHORT-CHAIN FATTY ACIDS IN THE ASSESSMENT OF THE STATE OF INTESTINAL MICROBIOCENOSIS AND ITS DIAGNOSIS IN CHILDREN WITH CONGENITAL HEART DEFECTS

Shoira Agzamova — 2025-11-04

Annotation. Children with congenital heart defects constitute a highly susceptible cohort for the development of intestinal dysbiosis and epithelial barrier dysfunction. This athophysiological vulnerability stems from anomalous intestinal perfusion or hypoxemia, which manifests in conditions of low cardiac output or cyanosis. Disruption of gut microbiota eubiosis potentially exacerbates systemic inflammation, adversely affecting clinical outcomes in this patient group. Despite significant advancements in therapeutic strategies and survival rates for patients with congenital heart defects, the incidence of associated complications remains substantial, raising questions regarding the microbiome's role in the pathogenesis of inflammatory processes. Aim of the study: to analyze the characteristics, properties, mechanistic role, and diagnostic methods of short-chain fatty acids in assessing the state of the intestinal microbiocenosis in children with congenital heart defects, based on data from international and domestic research. Material and methods: a systematic literature review on the specified topic was conducted using electronic database resources including PubMed, Medline, eLibrary, Scopus, Web of Science, and Cochrane Library. Results and discussion: the obtained data provide a comprehensive understanding of the properties and composition of the intestinal microbiota in children with congenital heart defects. They emphasize the necessity of studying the microbiota not as an isolated organ, but as an integral system that supports interaction with all physiological systems of the body and plays a key role in maintaining homeostasis and adaptive reserves to changing internal and external environmental conditions. It has been determined that congenital heart defects remain the primary cause of child mortality, despite treatment advancements. In children with congenital heart defects, inflammation and low cardiac output are crucial pathophysiological factors exacerbating clinical outcomes. These conditions contribute to gut microbiome dysbiosis, leading to a decrease in the production of short-chain fatty acids such as acetate, propionate, and butyrate. As primary metabolites of beneficial microflora, they are critically important for maintaining intestinal homeostasis, including cell metabolism, barrier function, and systemic influence. The dysbiosis identified in children with these defects is caused by hypoxia, stress, antibiotics, and nutritional factors, which leads to a decrease in butyrate and propionate. Gas chromatography-mass spectrometry is an effective method for diagnosing short-chain fatty acids. A comprehensive assessment of the short-chain fatty acids profile in children with heart defects opens new avenues for improving diagnosis, prognosis, and optimizing therapeutic approaches aimed at correcting the microbiome and improving outcomes. Conclusions: potential interactions between congenital heart defects and the microbiome are illustrated, key signaling mechanisms are discussed, along with promising research directions and opportunities for the therapeutic translation of fundamental scientific data.