Objective: To investigate the effect of Coronavirus disease 2019 (COVID‐19) measures on the hospitalization of patients with epilepsy and status epilepticus (SE).Methods: This interrupted time series design included data from the Thai Universal Coverage Scheme electronic database between January 2017 and September 2020. The monthly hospitalization rate of epilepsy and SE was calculated by the number of hospitalizations divided by the midyear population. Segmented regression fitted by ordinary least squares (OLS) was used to detect the immediate and overtime effects of COVID‐19 measures on the hospitalization rate.Results: During January 2017 and September 2020, the numbers of epilepsy and SE patients admitted to the hospital were 129 402 and 15 547 episodes, respectively. The monthly trend of the hospitalization rate in epilepsy decreased immediately after the COVID‐19 measure (0.739 per 100 000 population [95% CI: 0.219 to 1.260]). In particular, the number of children declined to 1.178 per 100 000 population, and the number of elderly individuals dropped to 0.467 per 100 000 population, while there was a nonstatistically significant change in SE.Significance: COVID‐19 measures reduced the hospital rate in epilepsy, particularly in children and adults. However, there was no change in SE patients.

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disorder common in children. Successful pediatric AD therapy requires parental assistance. Thus, evaluating parental knowledge, attitudes, and behaviors regarding childhood AD may lead to more educational recommendations to help children control AD in the future. This study examined parents’ knowledge, attitudes, and conduct concerning AD in families with and without children with AD. Method: The Pediatric Department, Faculty of Medicine, Khon Kaen University, Thailand, conducted a cross-sectional study from June to December 2023. Parents of children who visited the dermatology clinic with or without AD were asked to complete a Google form questionnaire. Results: A total of 372 parents answered a questionnaire about AD pathophysiology, knowledge, attitudes, and practices. The participants were 293 (78.8%) female participants and 79 (21.2%) male participants. The average age was 29.79 (SD 4.91). Most parents (319, 85.8%) did not work in the medical field, and more than half (228 instances, 61.29%) had children diagnosed with AD. Conclusions: Parents of children with AD understood AD causes and triggers better than parents of children without AD. But, “exposure to furry toys” that may contain dust and allergies and “infection” that may cause AD flare-ups were the most common triggers, regardless of the group. Appropriate information should be supplied because both the parents of children with AD and those of children without AD reported immediate food avoidance without confirmatory testing, which might lead to malnutrition. Clinicians and families handling patients with AD require further education.

(1) Background: Hospital-acquired malnutrition in pediatric patients leads to adverse outcomes. This study aimed to develop and validate a pediatric hospital-acquired malnutrition (PHaM) risk score to predict nutritional deterioration. (2) Methods: This was a derivative retrospective cohort study for developing a PHaM risk score. The study included data from children aged 1 month–18 years admitted to pediatric wards in four tertiary care hospitals for at least 72 h between December 2018 and May 2019. Data on pediatric patients’ characteristics, medical history, nutritional status, gastrointestinal symptoms, and outcomes were used for tool development. Logistic regression identified risk factors for nutritional deterioration, defined as a decline in BMI z-score ≥ 0.25 SD and/or ≥2% weight loss. A PHaM risk score was developed based on these factors and validated with an independent prospective cohort from July 2020 to March 2021. (3) Results: The study used a derivative cohort of 444 patients and a validation cohort of 373 patients. Logistic regression identified gastrointestinal symptoms, disease severity, fever, lower respiratory tract infection, and reduced food intake as predictors. The PHaM risk score (maximum 9 points) showed good discrimination and calibration (AUC 0.852, 95% CI: 0.814–0.891). Using a cut-off at 2.5 points, the scale had 63.0% sensitivity, 88.6% specificity, 76.1% positive predictive value, and 80.6% negative predictive value (NPV) when applied to the derivative cohort. The accuracy improved on the validation cohort, with 91.9% sensitivity and 93.0% NPV. (4) Conclusions: This PHaM risk score is a novel and probably effective tool for predicting nutritional deterioration in hospitalized pediatric patients, and its implementation in clinical practice could enhance nutritional care and optimize outcomes.

Background and objective: Lower respiratory tract infection (LRTI) is a leading cause of childhood hospitalization worldwide, with high-flow nasal cannula (HFNC) therapy commonly employed as a non-invasive respiratory support method. Determining early predictors of HFNC failure is crucial for timely intervention and reducing associated morbidity and mortality. Methods: We retrospectively reviewed the medical records of hospitalized children aged 1 month to 18 years with LRTI who received HFNC from January 2016 to December 2021. We aimed to evaluate predictive factors for HFNC failure and identify optimal cutoffs from the AUROC (AUROC). Results: One hundred and sixteen children with LRTI applied to HFNC were included in this study. Most of them (90.5%) were diagnosed with pneumonia as a principal diagnosis, and 68.9% had co-morbidities. Of those, 18 patients (15.5%) needed escalation to intubation and were defined as HFNC failure. The early predictive parameters associated with HFNC failure were pulse rate at 2 hours and SpO₂/FiO₂ ratio at 4 hours. AUROC analysis for the predictive parameter of HFNC failure showed cut-off values of S/F ratio at 4 hours after HFNC therapy was lower than 238 (AUC 0.89, 95%CI: 0.78–0.99). Conclusion: SpO2/FiO2 at 4 hours after initiating HFNC appeared to be a predicting value for early detected failure for HFNC therapy in children with LRTI. Close monitoring and swift management adjustments are recommended for children exhibiting these risk factors to enhance outcomes.

Pediatric anemia remains a significant public health challenge in Northeast Thailand, where hemoglobinopathies and nutritional deficiencies coexist. Early identification of children at risk of anemia is crucial to prevent developmental and health consequences. This study assessed the prevalence of children under five being at risk of anemia using Masimo Rad-67® with Rainbow DCI-mini Sensor, while evaluating the association between caregivers’ knowledge, attitudes, and practices on complementary feeding and childhood anemia. A clustered randomized cross-sectional study was conducted involving 2,000 child-caregiver pairs (aged 6 months to 5 years) in Northeast Thailand from September 2022 to March 2023. Non-invasive hemoglobin measurement was used, with anemia risk defined as spectrophotometry hemoglobin (SpHb) < 13.0 g/dL. Data collection included demographic characteristics, natal history, and feeding practices. Additionally, a survey was conducted to assess associated factors of anemia and caregivers’ attitudes, knowledge, and practices regarding complementary feeding. The study found a 36.9% prevalence of at-risk anemia. Key predictors included age under 24 months (adjusted OR 2.1, 95%CI 1.7–2.6), maternal thalassemia trait (adjusted OR 1.8, 95%CI 1.4–2.3), and wasting (adjusted OR 1.6, 95%CI 1.2–2.1). Iron supplementation was a protective factor. Despite 48.2% of children receiving iron supplementation per government policy, only 24.6% met the daily iron intake according to the Thai dietary reference intake. Gap in caregiver knowledge persisted, with 68.1% of caregivers having received education on iron deficiency anemia, and only 32% able to name iron-rich foods. Public health strategies should combine nutritional education targeting iron-rich complementary feeding, implementation of a thalassemia-integrated screening protocol, and proactive community surveillance programs to improve iron intake. Thai clinical trial registration: TCTR20221024002.

Epilepsy has a significant impact on individuals' lives, as well as on society and the economy, due to its unpredictable nature and the financial burden it places on those affected. Even though Thai citizens hold health benefits or health insurance, excess costs can occur; thus, this study aimed to describe the direct medical costs among hospitalized patients with epilepsy from both social and patient perspectives. Moreover, the factors associated with costs were investigated. This was a prevalence-based cost-of-illness study using data from the Thailand National Health Security Office database. Patients who were diagnosed with epilepsy (ICD-10 code G40) and admitted to the hospital in the fiscal year 2022 were included. Direct medical costs were reported from societal and patient perspectives. A generalized linear model with gamma distribution and log-link function was employed to investigate the factors influencing these costs. Among 31,635 epilepsy visits, the mean direct medical costs from a societal and patient perspective were 1,043.45 PPP-USD and 14.02 PPP-USD per visit, respectively. From a societal perspective, patients who underwent procedures experienced a substantial increase of 120.9% in costs compared to those without procedures, while hospital stays exceeding one week showed a significant 750.1% increase in costs compared to shorter stays. Furthermore, female sex, older age, and the presence of comorbidities or complications significantly increase costs. From the patient's perspective, those with comorbidities or complications during admission had a 56.0% increase compared to those without such conditions. Moreover, elderly patients, those who underwent procedures, and individuals with extended hospital stays were associated with increased costs. Factors influencing costs were hospital stay duration, comorbidities or complications, and types of procedures.