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Background Globally, febrile convulsions (FC) constitute a respected prevalence scale among pediatric population. This usually induces a high parental anxiety. Aim To investigate the local community diversity of perception as regards FC. Method A cross-sectional anonymous Arabic questionnaire-based study took place targeting the Saudi community. The study included parents with at least a child who underwent FC. Excluded, were those who have children with convulsions due to other causes rather than FC. Results Eight hundred participants have fulfilled the study inclusion criteria. Majority of them (84%) were mothers. While 10.9% had only one child diagnosed with FC. Participants believed that FC may induce brain damage (41.4%). Others expressed FC attacks to be life-threatening events (52.9%). They were convinced that FC is not related to epilepsy (40.2%). However, a respected percentage of participants denoted the importance of using oral protective devices during the attacks (41.4%). Overall, most study population (84%) had poor perception of the different aspects of FC. Conclusion Social perception of FC problems may be significantly related to the educational level and profession of the parents. The majority of the study subjects have poor perception as regards FC. Therefore, holistic socially oriented educational programs are needed to orient the population about the problem. They may be implemented via various approaches.

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.

Background: Coinfection with bacteria, fungi, and respiratory viruses has been described as a factor associated with more severe clinical outcomes in children with COVID-19. Such coinfections in children with COVID-19 have been reported to increase morbidity and mortality. Objectives: To identify the type and proportion of coinfections with SARS-CoV-2 and bacteria, fungi, and/or respiratory viruses, and investigate the severity of COVID-19 in children. Methods: For this systematic review and meta-analysis, we searched ProQuest, Medline, Embase, PubMed, CINAHL,Wiley online library, Scopus, and Nature through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for studies on the incidence of COVID-19 in children with bacterial, fungal, and/or respiratory coinfections, published from 1 December 2019 to 1 October 2022, with English language restriction. Results: Of the 169 papers that were identified, 130 articles were included in the systematic review (57 cohort, 52 case report, and 21 case series studies) and 34 articles (23 cohort, eight case series, and three case report studies) were included in the meta-analysis. Of the 17,588 COVID-19 children who were tested for co-pathogens, bacterial, fungal, and/or respiratory viral coinfections were reported ('n' = 1633, 9.3%). The median patient age ranged from 1.4 months to 144 months across studies. There was an increased male predominance in pediatric COVID-19 patients diagnosed with bacterial, fungal, and/or viral coinfections in most of the studies (male gender: 'n' = 204, 59.1% compared to female gender: 'n' = 141, 40.9%). The majority of the cases belonged to White (Caucasian) ('n' = 441, 53.3%), Asian (n = 205, 24.8%), Indian (n = 71, 8.6%), and Black (n = 51, 6.2%) ethnicities. The overall pooled proportions of children with laboratory-confirmed COVID-19 who had bacterial, fungal, and respiratory viral coinfections were 4.73% (95% CI 3.86 to 5.60, 'n' = 445, 34 studies, 'I2' 85%, 'p' < 0.01), 0.98% (95% CI 0.13 to 1.83, 'n' = 17, six studies, 'I2' 49%, 'p' < 0.08), and 5.41% (95% CI 4.48 to 6.34, 'n' = 441, 32 studies, I2 87%, 'p' < 0.01), respectively. Children with COVID-19 in the ICU had higher coinfections compared to ICU and non-ICU patients, as follows: respiratory viral (6.61%, 95% CI 5.06-8.17, 'I2' = 0% versus 5.31%, 95% CI 4.31-6.30, 'I2' = 88%) and fungal (1.72%, 95% CI 0.45-2.99, 'I2' = 0% versus 0.62%, 95% CI 0.00-1.55, 'I2' = 54%); however, COVID-19 children admitted to the ICU had a lower bacterial coinfection compared to the COVID-19 children in the ICU and non-ICU group (3.02%, 95% CI 1.70-4.34, 'I2' = 0% versus 4.91%, 95% CI 3.97-5.84, 'I2' = 87%). The most common identified virus and bacterium in children with COVID-19 were RSV ('n' = 342, 31.4%) and 'Mycoplasma pneumonia' ('n' = 120, 23.1%). Conclusion: Children with COVID-19 seem to have distinctly lower rates of bacterial, fungal, and/or respiratory viral coinfections than adults. RSV and 'Mycoplasma pneumonia' were the most common identified virus and bacterium in children infected with SARS-CoV-2. Knowledge of bacterial, fungal, and/or respiratory viral confections has potential diagnostic and treatment implications in COVID-19 children.

Objective: To evaluate the role of Vitamin-D and calcium supplementation on preoperative weight reduction in obese women before laparoscopic ventral hernia repair. Methods: This double-blind clinical trial was conducted at the affiliated health centers of King Faisal University, Al-Ahsa, Saudi Arabia from January 2021 to December 2021. It included forty-five obese women aged 24-56 years, with body mass index (BMI) of 34.0–48.0 kg/m2. They were randomly allocated into two groups; the Group-A (N=22) included obese women who received supplementation of 5000 IU cholecalciferol (Vitamin-D3), and 1000 mg calcium daily for 12 months, while the Group-B (N=23) received no treatment. Measurement of change in weight and BMI and comparison of their pre-operative weight reduction, laparoscopic operative time, and length of hospital stay was done. Results: There were no differences in patients’ biographic data between the two groups. During the study, Vitamin-D level in the patients increased and there was a significant positive association with weight loss. In group-A, the mean weight loss was 11.8±3.5 kg. At the end of first year, their BMI decreased from 36.1±1.6kg/m2 at baseline to 29.7±2.6 kg/m2, whereas in-group-B, the mean weight loss was 6.8±3.1 kg and their BMI decreased from 36.9±2.69kg/m2 at baseline to 32.7±0.93kg/m2. The operation time and the length of hospital stay were shorter in group-A (107 vs.128.min) and (3 vs. 5 days) respectively as compared to Group-B. Conclusion: Vitamin-D and calcium supplementation contributes to a remarkable weight reduction of preoperative obese female patients, which in turn is associated with significantly better outcome of laparoscopic repair of ventral hernia. doi: https://doi.org/10.12669/pjms.40.5.9047 How to cite this: AlMulhim SA, AlNaim MM, Khan AS, Memon AQ, AlArfaj HM, Al Abdulqader AA, et al. Weight reduction among females undergoing laparoscopic ventral hernia repair:  The role of Calcium and Vitamin D3. Pak J Med Sci. 2024;40(5):922-926.  doi: https://doi.org/10.12669/pjms.40.5.9047 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.