Актуальность. COVID-19 — это потенциально тяжёлое заболевание, вызываемое вирусом SARS-CoV-2. Известно, что из всех больных COVID-19 в России за 2020–2024 гг. до 15% составляли дети. Осложнённые формы COVID-19 у детей составили 1% всех случаев болезни. Как правило, такое течение болезни отмечалось у детей с тяжёлой сопутствующей патологией.

Описание клинического случая. Мальчик, 9 дней, от 2-й беременности, срочных родов путём кесарева сечения. Масса тела при рождении 3800 г, оценка по шкале Апгар 7/8 баллов. Привит по национальному календарю. Заболевание началось с разжиженного стула после каждого кормления и повышения температуры тела до 38°С. На 1-е сутки от начала болезни ребёнок был госпитализирован в инфекционный стационар. При поступлении состояние средней тяжести, дыхательная недостаточность 1–2 степени. При обследовании выявлен положительный ПЦР-тест на COVID-19, при КТ органов грудной клетки — двусторонняя полисегментарная пневмония. На 9-е сутки состояние больного ухудшилось, наросла одышка смешанного характера, появился цианоз носогубного треугольника при крике. При повторной КТ выявлен двусторонний пневмоторакс. Установлен дренаж по Бюлау, получено 53 мл воздуха, при повторной пункции — 40 мл. В течение следующих 2 сут нарастали проявления сердечно-лёгочной недостаточности, и было принято решение о переводе на ИВЛ. С целью восполнения факторов свертывающей системы крови и потерь эритроцитов проведены плазмо- и гемотрансфузии. Проводимая терапия — интерферон альфа-2b, цефекон-Д, смекта, лактазар, затем ампициллин сульбактам, дексаметазон, цефоперазон сульбактам, меропенем. При обтурации интубационной трубки мокротой произведена экстубация, дренаж был удалён. На фоне инфекции у ребёнка выявились симптомы перинатальной энцефалопатии смешанного генеза. На 33- и сутки от начала заболевания появилась положительная динамика, и для дальнейшего лечения больной был переведён в отделение патологии новорождённых.

Заключение. Лечение COVID-19 у новорождённых может стать сложной задачей в связи с возникновением осложнений, таких как пневмоторакс и дыхательная недостаточность. В связи с этим необходимы своевременная диагностика и индивидуальный подход к лечению новорождённых детей.

Relevance. Onychocryptosis (ingrown toenail) is one of the most common reasons for contacting a pediatric surgeon. Despite the improvement of surgical methods, the disease often recurs, affecting the child’s quality of life. The issues of etiology, pathogenesis and prevention of ingrown toenails in children remain relevant. Purpose: to determine the causal relationships between onychocryptosis and predisposing factors, identify risk groups among children, and develop preventive recommendations.

Materials and methods. The study conducted a retrospective analysis of twenty clinical cases of ingrown toenails in 9 to 17 years children who were hospitalized in the pediatric surgical department of the Multidisciplinary Clinic of the Tashkent Medical Academy for the period 2024. The medical history, clinical picture (according to the classification of A. Martinez-Nova), macroscopic anatomy of the nail plate (according to D.R. Kiriakis), the presence of orthopedic pathologies were studied. The treatment was performed using the Schmieden method of marginal resection of the nail plate.

Results. Analysis of the collected data allowed establishing the following risk factors of onychocryptosis in children: orthopedic foot pathologies (hallux valgus deformity, flat feet) — 50% of patients; anatomical features of the nail plate structure predisposing to ingrowth — 70%; overweight — 25%; hygiene disorders and wearing uncomfortable shoes – 30%. In addition, 6 patients had previously undergone surgical treatment for onychocryptosis, which confirms the high probability of recurrence. Surgical intervention was performed after the acute inflammatory process subsided and included marginal resection of the nail plate according to Schmieden without suturing, which minimized tissue injury and reduced the likelihood of reingrowth. In the postoperative period, patients reported moderate pain in the first hours after surgery, but in most cases did not require additional anesthesia. The average hospital stay is 3 days.

Conclusion. The results of the study allow identifying the criteria of the risk group. The main criteria are orthopedic pathologies of the lower extremities, features of the anatomical structure of the nail plate; secondary criteria are improper hygienic foot care, the presence of concomitant diseases. For prevention, it is necessary to identify children at risk, orthopedic correction and consultation patients with a predisposition with a podologist.

Relevance. Malnutrition remains a major public health issue affecting paediatric populations, particularly in low- and middle-income countries. It weakens the immune system, making children more susceptible to severe infections and prolonging recovery. Understanding the correlation between malnutrition and infectious disease severity is crucial for developing early screening strategies, improving the therapy interventions and reducing childhood mortality. This study provides evidence to support the integration of nutritional rehabilitation programs into infectious disease management in paediatric care settings. Purpose: this study aims to assess impact of malnutrition or infection severity, the duration of hospital stays, and the rate of complications among paediatric patients. It will compare mortality rates between malnourished and well-nourished children to delineate critical differences in clinical outcomes. By analyzing patient data, the studies seeks to identify specific nutritional deficiencies, such as protein, energy, malnutrition, and various micro nutrient deficits that exacerbate the course of infectious diseases. Ultimately, the findings will be used to provide evidence based recommendations for early nutritional interventions, thereby improving the management and prognosis of paediatric infectious diseases in this vulnerable population.

Materials and methods. A retrospective cohort study was conducted at a tertiary pediatric hospital over a three-year period (2022–2024), analyzing medical records of 6 months to 10 years children diagnosed with infectious diseases such as pneumonia, diarrhoea, sepsis, and tuberculosis, with documented nutritional status (assessed via weight-for-height, BMI, and MUAC). Patients with congenital immunodeficiencies, those receiving immunosuppressive therapy, or with incomplete records were excluded. Data collection encompassed anthropometric measurements, infection severity indicators (ICU admission, need for mechanical ventilation, and presence of sepsis), hospital stay duration, complications including secondary infections and multi-organ dysfunction syndrome, as well as mortality rates attributed to infectious disease complications. Statistical analyses were performed using chi-square tests for categorical variables, independent t-tests for continuous variables, and logistic regression to evaluate the impact of malnutrition on mortality risk, with significance level at p < 0.05.

Results.  In a retrospective analysis of five hundred pediatric patients (250 malnourished and 250 well-nourished) with a mean age of 3.2 years, common infectious diseases included pneumonia (38%), diarrhea (25%), sepsis (20%), tuberculosis (10%), and other infections (7%). Notably, malnourished children exhibited significantly higher rates of complications compared to their well-nourished counterparts, with sepsis progression observed in 42% versus 18% (p < 0.01), acute kidney injury in 18% versus 6% (p < 0.01), persistent diarrhea lasting more than 7 days in 25% versus 10% (p < 0.01), and severe pneumonia with respiratory failure in 30% versus 12% (p < 0.01). Furthermore, the overall mortality risk in the malnourished group was 4.2 times higher than in well-nourished patients, with the highest mortality rate (15%) occurring among children diagnosed with severe acute malnutrition (SAM) complicated by sepsis.

Conclusion. This study demonstrates a strong association between pediatric malnutrition and the severity, duration, and recovery of infectious diseases. Malnourished children had longer hospital stays, higher rates of complications, increased ICU admissions, and greater mortality risk compared to well-nourished peers.

Relevance. Severe infections and sepsis in pediatric patients are major causes of morbidity and mortality, particularly in critical care. Delayed recognition and inappropriate antimicrobial use worsen outcomes and drive antimicrobial resistance (AMR). Current diagnostics rely on clinical judgment and conventional biomarkers, which often lack specificity, leading to delayed intervention and increased ICU burden. This study evaluates a biomarker-driven approach to enhance early detection and targeted treatment of severe infections in pediatric intensive care. Purpose: to assess the efficacy of procalcitonin (PCT) and interleukin-6 (IL-6) in early diagnosis and severity stratification of severe infections and sepsis in pediatric ICU (PICU) patients. This study aims to establish a predictive model integrating biomarkers with clinical parameters to optimize early intervention and reduce ICU morbidity and mortality.

Materials and methods.  Study Design: Prospective cohort study (2020–2024) analyzing biomarker levels and clinical progression in pediatric ICU patients. Inclusion Criteria: Children (0–18 years) admitted with suspected severe infections, sepsis, or septic shock. Data Collected: PCT and IL-6 levels on admission and at 24, 48, and 72 hours. Blood cultures, inflammatory markers (CRP, WBC), and clinical severity scores (PELOD-2, SOFA-Pediatrics). Antibiotic escalation/de-escalation patterns, ICU stay, and mortality rates. Statistical Analysis: Correlation between biomarker kinetics, infection severity, and clinical outcomes, assessed using multivariate regression models.

Results. Elevated PCT (> 2 ng/mL) and IL-6 (> 150 pg/mL) strongly correlated with ICU admission and progression to septic shock (p < 0.001). Biomarker-driven diagnosis reduced antibiotic overuse by 37%, optimizing antimicrobial stewardship. Patients with persistently elevated IL-6 (> 72 hours) had a 4.2x higher risk of multiple organ dysfunction syndrome (MODS). Early risk stratification using PCT/IL-6 enabled targeted intervention, reducing ICU mortality by 21% (p = 0.003).

Conclusion. Biomarker-guided infection management significantly enhances early sepsis detection, antibiotic stewardship, and survival rates in pediatric critical care. This study provides strong evidence for integrating PCT and IL-6 into standardized sepsis protocols, potentially reshaping pediatric ICU guidelines worldwide. Implementing this approach could lead to earlier interventions and improved long-term outcomes.

Relevance. This study on post-streptococcal glomerulonephritis is highly relevant due to its impact on pediatric nephrology, public health, and clinical management. remains a significant cause of acute kidney injury in children, especially in resource-limited settings, and this study provides essential epidemiological data on its prevalence, clinical presentation, and outcomes. By identifying key risk factors such as severe hypertension, elevated serum creatinine, and low C3 levels, it facilitates early recognition of high-risk cases, enabling timely intervention and reducing complications. The aim of the study: the primary objectives of this study were to assess the clinical presentation, risk factors, and laboratory findings of  children and evaluate the prevalence of severe complications, such as hypertensive encephalopathy, pulmonary edema, and heart failure and  determine short-term and long-term renal outcomes, including persistent hypertension and provide recommendations for early diagnosis, effective management, and follow-up strategies to improve clinical outcomes in children.

Materials and methods. This retrospective cohort study analyzed medical records of two hundred fifty children diagnosed with post-streptococcal glomerulonephritis at a tertiary pediatric hospital between 2022 and 2024. 2–15 years children were confirmed through clinical, laboratory, and histopathological findings, and evidence of prior group A streptococcal infection were included, while those with pre-existing chronic kidney disease, congenital renal anomalies, or other glomerular diseases were excluded. Data collection focused on clinical features (hematuria, proteinuria, edema, hypertension, acute kidney injury), laboratory investigations (serum creatinine, complement levels, urinalysis), complications (seizures, pulmonary edema, hypertensive encephalopathy, congestive heart failure), and treatment approaches (fluid restriction, antihypertensives, diuretics, dialysis if needed). Outcome measures included hospital stay duration, recovery time, mortality, and long-term risks like hypertension. Statistical analysis involved descriptive statistics to summarize patient characteristics, chi-square tests to assess risk factors for severe PSGN, and multivariate logistic regression to identify predictors of complications, with significance set at p < 0.05.

Results. Among 250 patients with a mean age of 7.6 ± 2.8 years and a male-to-female ratio of 1.4:1, 68% had preceding pharyngitis and 32% had impetigo. The most common clinical findings included hematuria (94%), proteinuria (72%), edema (76%), hypertension (65%), and acute kidney injury (30%), while severe complications such as encephalopathy and heart failure occurred in 8% of cases. The mean hospital stay was 8.4 ± 3.1 days, 6.8% requiring dialysis, 12% needing ICU admission, and a mortality rate of 1.2%. Notable complications included hypertensive encephalopathy (5%), pulmonary edema (6%), congestive heart failure (4%), and dialysis-dependent AKI (7%). At a six-month follow-up, 12% had persistent hypertension, 8% had residual proteinuria, and 4% developed chronic kidney disease (Stage 2-3). Multivariate analysis identified severe hypertension (OR 3.2, p < 0.01), elevated serum creatinine > 1.5 mg/dL (OR 2.8, p < 0.01), and low C3 levels < 50 mg/dL (OR 2.1, p = 0.02) as significant risk factors for severe disease.

Conclusion. This study highlights that post-streptococcal glomerulonephritis remains a significant cause of acute kidney injury in children, with hypertension, hematuria, and edema being the most common clinical features. Risk factors for severe disease included severe hypertension, elevated serum creatinine, and low C3 levels. Clinically, early diagnosis and aggressive blood pressure control are essential to preventing complications, and long-term monitoring is necessary to detect and manage persistent hypertension. Public health strategies, such as improved hygiene and early antibiotic treatment, may help prevent in endemic regions. Overall, this study underscores the importance of early intervention, effective management, and follow-up care to improve outcomes in affected children.