Introduction Intraventricular hemorrhage (IVH) is a common cause of morbidity and mortality in preterm neonates. IVH leads to complications such as posthemorrhagic hydrocephalus (PHH), which commonly occurs in neonates with a more severe degree of IVH. Hence, we aimed to evaluate the characteristics and outcomes of PHH in neonates with IVH. Methods We performed a systematic review of cases reported from January 1978 to December 2020 through the PubMed database, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the keywords 'intraventricular hemorrhage,' 'cerebral intraventricular hemorrhage,' and 'newborn.' A total of 79 articles were considered for analysis, and data on neonatal and maternal characteristics and outcomes were collected. The analysis was performed by using the chi(2) test, Wilcoxon rank-sum test, and multivariate logistic regression model. Results We analyzed a total of 101 IVH cases, 54.5% were male and 62.4% preterm. Thirteen point nine percent (13.9%) presented with grade I, 35.6% grade II, and grade III respectively, and 8% grade IV IVH. Among the 59 (58.4%) neonates with PHH, 33.6% had resolved PHH and 24.8% had unresolved. In adjusted regression analysis, we found that neonates with resolved PHH have lower odds of having neurodevelopmental delay (OR:0.15, 95%CI:0.03-0.74; p=0.02) and death (OR:0.9;95%CI:0.01-0.99; p=0.049) as compared to unresolved PHH. Conclusion Our study showed that neonates with resolved PHH have a statistically significant lower risk of neurodevelopmental delay (NDD) and mortality. Future studies should be planned to evaluate the role of treatment and its effect on outcomes in IVH neonates with PHH as a complication.

Primary immune regulatory disorders (PIRDs) constitute a subset of inborn errors of immunity and are characterized by lymphoproliferation, autoimmunity, malignancy, and infection. Unlike classical p

Prematurity refers to the birth of a baby before 37 completed weeks of pregnancy. This can be related to considerable parental anxiety and mental status changes. Anxiety can manifest as worrying thoughts, feelings of tension, and altered vital signs. This review aims to analyze the relationship between premature birth and parental anxiety, focusing on the emotional status of both mothers and fathers. The review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines. A search was undertaken in PubMed, PubMed Central, MEDLINE, and ScienceDirect. Screening of articles was carried out to find relevant and appropriate articles. Articles were then quality-checked before inclusion. Our analysis showed that mothers of preterm infants had greater symptoms of anxiety, and comorbid anxiety and depression, than mothers of term infants. Mothers of preterm infants 5 years after discharge showed long-term consequences of stress and anxiety, including inappropriate responses and reduced praise for their children. Mothers of preterm multiples were more likely to experience stress and anxiety than mothers of preterm singletons. Fathers of preterm infants experienced higher levels of stress than fathers of term infants, but fathers of preterm infants experienced less stress than mothers of preterm infants. These findings suggest that routine mental health screening and intervention should be undertaken for both mothers and fathers of preterm infants.

The COVID-19 pandemic resulted in the pause of medical clinical rotations. As a result, virtual rotations were implemented. These are a form of remote learning that seeks to mimic the clinical learning environment that students were already accustomed to. This article seeks to review the published literature to explore which specialties adapted this format, what are the advantages and disadvantages observed, determine what were the responsibilities and involvements of students participating in these rotations, how well these rotations substituted for in-person rotations, and to evaluate if there is a continued role for them after, outside of COVID-19. Virtual rotations have been developed in almost every specialty. These rotations have been developed from small centers to large universities, and are widespread throughout the United States, and in other countries as well. These rotations are targeted toward medical students, medical residents, and physician assistants and range in length from one to four weeks. Responsibilities and scope of interaction varied according to rotation; some rotations allowed patient interaction, and observation of procedures and surgeries, whereas some were purely didactic. A mixture of inpatient and outpatient involvements was seen. Advantages included saving money and time, more flexibility, increased diversity, and participation of international medical graduates. Virtual rotations participants have been invited for interviews at the participating institution's residency programs and have matched there. Disadvantages included lack of assessment of practical skills, inability to receive credit, and inability to obtain a letter of recommendation. Virtual rotations have proven to be a good substitute for in-person rotations, with most medical students seeing a need for the rotations in the future. Due to widespread development and acceptance of these rotations, it is likely that these rotations will continue.

Non-IgE immune-mediated gastrointestinal disorders constitute a heterogeneous group of enigmatic conditions that are on the rise. This category encompasses entities like food protein-induced enterocolitis syndrome (FPIES), food protein-induced allergic proctocolitis (FPIAP), and food protein-induced enteropathy (FPE). These are immune-mediated reactions to certain foods without the involvement of allergen-specific IgE in their pathogenesis. Eosinophilic esophagitis (EoE) is also included in this group, acknowledged for its mixed IgE and non-IgE-mediated characteristics. The diagnostic landscape is fraught with challenges, given the poorly understood nature of these disorders and their propensity to manifest with varying and overlapping clinical presentations, typically emerging in infancy with common potential triggers such as cow’s milk and soy. Presently, confirmatory testing for most of these conditions is limited and invasive, emphasizing the pivotal role of a thorough history and physical examination in reaching a diagnosis. Notably, there are limited guidelines for diagnosis and management for most of these disorders. This article elucidates the key distinctions among these disorders, provides an overview of existing diagnostic and therapeutic approaches, and addresses existing knowledge and research gaps. The considerable impact on the quality of life of non-IgE immune-mediated allergic disorders of the gastrointestinal tract, which can result in debilitating complications such as nutritional deficiencies, mental health disorders, and eating disorders, underscores the urgency for comprehensive exploration and management strategies.