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New onset ANCA-associated vasculitis in an adolescent during an acute COVID-19 infection: a case report
Daniel D. Reiff, Chloe G. Meyer, Brittany Marlin & Melissa L. Mannion
doi : 10.1186/s12887-021-02812-y
BMC Pediatrics volume 21, Article number: 333 (2021)
SARS-CoV-2 has been found to be exquisitely adept at triggering autoimmunity and multiple new onset autoimmune diseases have been described as a post-infectious complication of COVID-19 infection in the adult population. Less has been described in the pediatric population, as infections are more likely to be asymptomatic and less severe. This case reports a previously healthy adolescent patient with new onset antineutrophil cytoplasmic autoantibody-associated vasculitis (AAV) diagnosed in the setting of acute COVID-19 infection.
Concentration levels of serum 25-Hydroxyvitamin-D and vitamin D deficiency among children and adolescents of India: a descriptive cross-sectional study
Akif Mustafa & Chander Shekhar
doi : 10.1186/s12887-021-02803-z
BMC Pediatrics volume 21, Article number: 334 (2021)
Vitamin D is an essential micronutrient for the overall health and well-being of individuals. For strong musculoskeletal and neurological development of human body, vitamin D levels during childhood and adolescence have key importance. This is the first national-level study that analyzes the deficiency and concentration of serum 25-Hydroxyvitamin D [25(OH)D)] among Indian children and adolescents with respect to various demographic and socioeconomic characteristics.
Stress hyperglycemia as first sign of asymptomatic type 1 diabetes: an instructive case
Wei-De Wang, Chun-Hao Chu, Chiung-Hsi Tien, Shuo-Yu Wang, Shih-Yao Liu & Chien-Ming Lin
doi : 10.1186/s12887-021-02811-z
BMC Pediatrics volume 21, Article number: 335 (2021)
Stress hyperglycemia (SH) is considered a transient manifestation and routine diagnostic evaluation was thought to be unnecessary due to the lack of definite correlation with diabetes mellitus (DM). Although SH was usually benign and long-term treatment was superfluous, it might be the first sign of insulinopenic status such as type 1 DM (T1DM).
Paediatric preoperative sedation practices in tertiary maternity and children’s hospitals in China: a questionnaire survey
Bo Li, Huiyan Hou, Jie Bai, Mazhong Zhang, Shengde Li & Jijian Zheng
doi : 10.1186/s12887-021-02802-0
BMC Pediatrics volume 21, Article number: 336 (2021)
Preoperative anxiety is a common problem in the paediatric population, and several studies have reported that it is related to adverse events such as emergence delirium and postoperative psychological and behavioural changes. In recent years, increasing attention has been paid to paediatric preoperative anxiety in China. A variety of strategies, including sedatives, parental presence, and audio-visual interventions, have been used to relieve paediatric preoperative anxiety, but there is no well-recognised procedure for paediatric preoperative sedation. Therefore, this study aimed to investigate current paediatric preoperative sedation practices in tertiary children’s hospitals in China.
Concordance of skin test reactivity between indoor inhalant allergens among children with allergic respiratory disease
Prapasri Kulalert, Paskorn Sritipsukho, Sira Nanthapisal & Orapan Poachanukoon
doi : 10.1186/s12887-021-02800-2
BMC Pediatrics volume 21, Article number: 338 (2021)
In vitro studies have demonstrated cross-reactivity among indoor allergen proteins in children with allergic respiratory diseases. However, there are only few studies evaluating in vivo response. A skin prick test (SPT) with commercial indoor solutions is widely used in clinical practice. We aimed to evaluate SPT agreement in children with allergic respiratory disease between pairs of common indoor allergens.
Can large doses of glucocorticoids lead to Perthes? a case report and review of the literature
Guoming Chen, Tengyu Chen, Peng Zhang, Zhaoping Zhang, Ruilan Huang, Tao Chen, Wei He, Haibin Wang & Chi Zhou
doi : 10.1186/s12887-021-02755-4
BMC Pediatrics volume 21, Article number: 339 (2021)
Perthes disease (Legg-Calvé-Perthes, LCP) is a self-limited and non-systemic disease occurring in the femoral heads of children, which is mainly manifested as an ischemic necrosis of the femoral head epiphysis, leading to subchondral ossification injury of the femoral head.
Association between humidifier disinfectant exposure during infancy and subsequent neuropsychiatric outcomes during childhood: a nation-wide cross-sectional study
Ju Hee Kim, Sihyeong Park, Eun Kyo Ha, Dong Keon Yon, Seung Won Lee, Hyun Yong Koh & Man Yong Han
doi : 10.1186/s12887-021-02825-7
BMC Pediatrics volume 21, Article number: 340 (2021)
The purpose was to determine the association between infant exposure to humidifier disinfectant (HD) with neuropsychiatric problems in pre-school children.
Performing central venous catheters in neonates and small infants undergoing cardiac surgery using a wireless transducer for ultrasound guidance: a prospective, observational pilot study
Judith Schiefer, Paul Lichtenegger, Daniel Zimpfer, Doris Hutschala, Lorenz Kuessel, Alessia Felli, Stephan Hornykewycz, Peter Faybik & Eva Base
doi : 10.1186/s12887-021-02822-w
BMC Pediatrics volume 21, Article number: 341 (2021)
Neonates and small infants with congenital cardiac disease undergoing cardiac surgery represent major challenges facing paediatric anaesthesia and perioperative medicine. Aims.
Impact of antibiotic pretreatment on cultures in children with osteomyelitis and septic arthritis: a retrospective review
Amanda Lansell, Yasasvi Vasili, Parminder S. Suchdev, Janet Figueroa & Anjali Kirpalani
doi : 10.1186/s12887-021-02806-w
BMC Pediatrics volume 21, Article number: 342 (2021)
In the management of pediatric osteomyelitis or septic arthritis, delay in treatment may affect outcome, while receipt of antibiotics prior to culture may affect culture results. We aimed to determine if pathogen identification decreased in cultures that were pretreated with antibiotics.
Case report: risk of skin necrosis related to injectable vancomycin in critically ill newborn infants
Sixtine Gilliot, Mohamed Riadh Boukhris, Morgane Masse, Laurent Storme, Bertrand Décaudin, Pascal Odou & Kevin Le Duc
doi : 10.1186/s12887-021-02824-8
BMC Pediatrics volume 21, Article number: 343 (2021)
Vancomycin is commonly used as part of empiric antibiotic therapy in the preterm infants who develop signs and symptoms of infection. Although skin necrosis has been noted to occur following injection of vancomycin into a peripheral vein in an adult patient, this complication has not been previously described in a preterm infant.
The factors associated with transient hypothyroxinemia of prematurity
Aslan Yilmaz, Yavuz Ozer, Nesrin Kaya, Hande Turan, Hazal Cansu Acar, Oya Ercan, Yildiz Perk, Olcay Evliyaoglu & Mehmet Vural
doi : 10.1186/s12887-021-02826-6
BMC Pediatrics volume 21, Article number: 344 (2021)
Hypothyroxinemia is defined by low levels of thyroxine (T4) despite low or normal levels of thyroid-stimulating hormone (TSH). This study aimed to evaluate the factors associated with transient hypothyroxinemia of prematurity (THOP) in newborns admitted to the neonatal intensive care unit (NICU).
Aseptic meningitis, hepatitis and cholestasis induced by trimethoprim/sulfamethoxazole: a case report
J. A. A. van Asperdt & R. A. De Moor
doi : 10.1186/s12887-021-02820-y
BMC Pediatrics volume 21, Article number: 345 (2021)
Drug-induced aseptic meningitis is a rare, but challenging diagnosis, most commonly reported with nonsteoroidal anti-inflammatory drugs (NSAIDs) and antibiotics. Trimethoprim/sulfamethoxazole (TMP/SMX) is a sulfonamide that is widely used in clinical practice for the treatment and prophylaxis of various infections. The most common side effects associated with TMP/SMX are generally mild and self-limited, but serious side effects have been reported, including liver injury and aseptic meningitis.
Associations between study questionnaire-assessed need and school doctor-evaluated benefit of routine health checks: an observational study
Kirsi Nikander, Elina Hermanson, Tero Vahlberg, Minna Kaila, Tuire Sannisto & Silja Kosola
doi : 10.1186/s12887-021-02810-0
BMC Pediatrics volume 21, Article number: 346 (2021)
In Finland, school doctors examine all children at predetermined ages in addition to annual health checks by school nurses. This study explored the association of study questionnaire-assessed need for and school doctor-evaluated benefit of routine health checks conducted by doctors.
Prevalence and influencing risk factors of eczema among preschool children in Urumqi city: a cross-sectional survey
Haonan Shi, Guangsheng Wan, Tingting Wang, Jia Zhu, Lan Jiang, Shaowei Ma, Jian Yao, Zhe Yin, Murizhati Maimaiti & Huijuan Dong
doi : 10.1186/s12887-021-02819-5
BMC Pediatrics volume 21, Article number: 347 (2021)
Eczema is a chronic inflammatory disease associated with impaired quality of life. We identified indoor environmental risk factors, to provide strong evidence for the prevention and control of eczema in preschool children.
The reliability and validity of the Turkish version of the school-based asthma and allergy screening questionnaires
Mahmut Kilic, Ghaniya Ede & Tugba Uzuncakmak
doi : 10.1186/s12887-021-02823-9
BMC Pediatrics volume 21, Article number: 348 (2021)
Asthma is an important public health disease affecting children that may result in school absenteeism and hospitalization. This study aims to assess the validity, reliability, and diagnostic accuracy of the Turkish version of the asthma and allergy screening questionnaire.
Risk of hypertension in school-aged children with different parental risk: a longitudinal study from childhood to young adulthood
Parisa Amiri, Marjan Rezaei, Sara Jalali-Farahani, Mehrdad Karimi, Leila Cheraghi, Romina Esbati & Fereidoun Azizi
doi : 10.1186/s12887-021-02807-9
BMC Pediatrics volume 21, Article number: 352 (2021)
Although previous studies have shown the relationship between different parental factors and children’s blood pressure status, there is limited data on the cumulative effect of these factors. Considering parental socio-demographic, behavioral and cardio-metabolic characteristics, the current study aimed to distinguish parental risk clusters and their impact on the incidence of hypertension in school-age children over 13 years.
What is beyond Salmonella gastroenteritis? A case of acute pancreatitis complicating Salmonella infection in a child: a case report and literature review
Salwa Al Kaabi, Aysha Al Kaabi & Hasa Al Nuaimi
doi : 10.1186/s12887-021-02814-w
BMC Pediatrics volume 21, Article number: 353 (2021)
Salmonella infection presents itself in a wide variety of ways, ranging from mild self-limited illness to severe systemic disease with multiorgan involvement. Acute pancreatitis (AP) is a very rare complication that is associated with Salmonella infection, especially among the pediatric population.
Prevalence of bone fractures among children and adolescents with attention-deficit/hyperactivity disorder: a systematic review and meta-analysis
Hoda Seens, Shirin Modarresi, Joy C MacDermid, David M Walton & Ruby Grewal
doi : 10.1186/s12887-021-02821-x
BMC Pediatrics volume 21, Article number: 354 (2021)
Attention-deficit/hyperactivity disorder (ADHD) is a significant neurodevelopment disorder among children and adolescents, with 5?% prevalence. Bone fractures account for 25?% of accidents and injuries among all children and adolescents. Considering the characteristics of inattention, hyperactivity, and impulsivity in children with ADHD, it is critical to examine bone fractures among these children. The objective of our meta-analysis was to determine the prevalence of bone fractures among children and adolescents with ADHD.
Serum HMGB1 level is correlated with serum I-FABP level in neonatal patients with necrotizing enterocolitis
Ruyahan Huo, Heng Liu, Jing Chen, Hong Sheng & Li Miao
doi : 10.1186/s12887-021-02818-6
BMC Pediatrics volume 21, Article number: 355 (2021)
This study aims to investigate clinical significance of HMGB1 in neonatal patients with necrotizing enterocolitis (NEC).
The Pregnancy and EARly Life study (PEARL) - a longitudinal study to understand how gut microbes contribute to maintaining health during pregnancy and early life
Sarah Phillips, Rachel Watt, Thomas Atkinson, George M Savva, Antonietta Hayhoe & Lindsay J Hall on behalf of the PEARL study team
doi : 10.1186/s12887-021-02835-5
BMC Pediatrics volume 21, Article number: 357 (2021)
The early life period represents the first step in establishing a beneficial microbial ecosystem, which in turn affects both short and longer-term health. Changes during pregnancy influence the neonatal microbiome; through transmission of maternal microbes during childbirth, and beyond, through nutritional programming. However, in-depth exploration of longitudinal maternal-infant cohorts, with sampling of multiple body sites, complemented by clinical and nutritional metadata, and use of cutting-edge experimental systems are limited.
Spinal cord compression as tumor onset: an unusual case report of Hodgkin lymphoma in a teenager
Giulia Salomone, Milena La Spina, Giuseppe Belfiore, Gregoria Bertuna, Laura Cannav?, Stefano Catanzaro, Salvatore D’Amico, Mariaclaudia Meli, Andrea Musumeci, Lucia Salvatorelli, Maria Grazia Scuderi, Corrado Spatola, Mariella Valenzise, Andrea Di Cataldo & Giovanna Russo
doi : 10.1186/s12887-021-02834-6
BMC Pediatrics volume 21, Article number: 358 (2021)
Spinal cord compression (SCC) is an uncommon, severe complication of Hodgkin lymphoma (HL), occurring in 0.2% of cases at the onset and in 6% during disease progression. We present a teenager with SCC with clinical onset of HL; her pre-existing neurological abnormalities covered the presence of an epidural mass, which could have misled us.
Translation and validation of the German version of the Young Spine Questionnaire
Luana Nyir?, Tobias Potthoff, Mette Hobaek Siegenthaler, Fabienne Riner, Petra Schweinhardt & Brigitte Wirth
doi : 10.1186/s12887-021-02804-y
BMC Pediatrics volume 21, Article number: 359 (2021)
Back pain in childhood and adolescence increases the risk for back pain in adulthood, but validated assessment tools are scarce. The aim of this study was to validate the Young Spine Questionnaire (YSQ) in a German version (G-YSQ) in children and adolescents.
Physical growth and neurodevelopment during the first year of life: a cohort study of the Japan Environment and Children’s Study
Masafumi Sanefuji, Yuri Sonoda, Yoshiya Ito, Masanobu Ogawa, Vlad Tocan, Hirosuke Inoue, Masayuki Ochiai, Masayuki Shimono, Reiko Suga, Ayako Senju, Satoshi Honjo, Koichi Kusuhara, Shouichi Ohga & Japan Environment and Children’s Study Group
doi : 10.1186/s12887-021-02815-9
BMC Pediatrics volume 21, Article number: 360 (2021)
The association between a slower physical growth and poorer neurodevelopment has been established in infants born preterm or small for gestational age. However, this association is inconsistent in term-born infants, and detailed investigations in infancy, when intervention is most beneficial for improving outcomes, are lacking. We therefore examined this association separately by sex during the first year of life in term-born infants.
Effect of acute and chronic liver diseases on the thyroid function in children
Gihan M. Bebars, Madeha A. Sayed, Lamia Hamdy & Reem A. Abdel Aziz
doi : 10.1186/s12887-021-02816-8
BMC Pediatrics volume 21, Article number: 361 (2021)
Thyroid hormones modulate hepatic function through regulation of basal metabolic rate in addition; the liver metabolizes the thyroid hormones and regulates their endocrine effects.
Tinea capitis in an immigrant pediatric community; a clinical signs-based treatment approach
Riad Kassem, Yahel Shemesh, Orna Nitzan, Maya Azrad & Avi Peretz
doi : 10.1186/s12887-021-02813-x
BMC Pediatrics volume 21, Article number: 363 (2021)
Tinea capitis is a common cutaneous infection of the scalp and hair follicles, typically diagnosed by direct examination and culture. Treatment with oral antifungals is usually withheld until mycology results are available. In Israel, African refugee children demonstrate higher susceptibility to Tinea capitis and generally fail to undergo follow-up evaluations.
Trends in food insecurity rates at an academic primary care clinic: a retrospective cohort study
Kimberly Montez, Callie L. Brown, Arvin Garg, Scott D. Rhodes, Eunyoung Y. Song, Alysha J. Taxter, Joseph A. Skelton, Laurie W. Albertini & Deepak Palakshappa
doi : 10.1186/s12887-021-02829-3
BMC Pediatrics volume 21, Article number: 364 (2021)
Healthcare organizations are increasingly screening and addressing food insecurity (FI); yet, limited data exists from clinic-based settings on how FI rates change over time. The objective of this study was to evaluate household FI trends over a two-year period at a clinic that implemented a FI screening and referral program.
Cortisol concentration affects fat and muscle mass among Polish children aged 6–13 years
Paulina Pruszkowska-Przybylska, Aneta Sitek, Iwona Rosset, Marta Sobalska-Kwapis, Marcin S?omka, Dominik Strapagiel, El?bieta ??dzi?ska & Niels Morling
doi : 10.1186/s12887-021-02837-3
BMC Pediatrics volume 21, Article number: 365 (2021)
Cortisol is a steroid hormone acting as a stress hormone, which is crucial in regulating homeostasis. Previous studies have linked cortisol concentration to body mass and body composition.
Estimating the burden of pediatric HIV in an ‘A’ category district in India: an epidemiological study
Anju Sinha, Reynold Washington, Rajeev Sethumadhavan, Rajaram Subramanian Potty, Shajy Isac, Vasantha Thavraj & Ravindra Mohan Pandey
doi : 10.1186/s12887-021-02836-4
BMC Pediatrics volume 21, Article number: 366 (2021)
India lacks epidemiological information on the disease burden of pediatric HIV. The National AIDS Control Program (NACP) estimates the numbers of HIV-positive children as a proportion of adult persons living with HIV. A third of HIV-positive children die before their first birthday and a half before they reach their second birthday. The early detection of HIV is crucial for the prevention of morbidities, growth delays, and death among HIV-positive children.
Walking onset: a poor predictor for motor and cognitive skills in healthy preschool children
Nadine Messerli-Bürgy, Tanja H. Kakebeeke, Andrea H. Meyer, Amar Arhab, Annina E. Zysset, Kerstin Stülb, Claudia S. Leeger-Aschmann, Einat A. Schmutz, Susi Kriemler, Jardena J. Puder, Simone Munsch & Oskar G. Jenni
doi : 10.1186/s12887-021-02828-4
BMC Pediatrics volume 21, Article number: 367 (2021)
The onset of walking is thought to be an indicator of early development. However, evidence is mixed and clear data on this relationship at preschool age is missing. The study aimed at investigating if walking onset and motor and cognitive development in preschool children are related.
A pilot feasibility study of gabapentin for managing pain in children with dystonic cerebral palsy
Adrienne Harvey, Mary-Clare Waugh, James Rice, Giuliana Antolovich, Lisa Copeland, Francesca Orsini, Adam Scheinberg, Clare McKinnon, Megan Thorley, Felicity Baker, George Chalkiadis & Kirsty Stewart
doi : 10.1186/s12887-021-02847-1
BMC Pediatrics volume 21, Article number: 368 (2021)
Gabapentin is often used to manage pain in children with dystonic cerebral palsy, however the evidence for its effectiveness in this population is limited. The primary objective of this feasibility pilot study was to assess the factors which might impact on a future randomised controlled trial including the ability to recruit and retain participants, assess adherence/compliance to the prescribed intervention, and ability to complete all outcome assessments. The secondary objective was to gather preliminary evidence for the effectiveness of gabapentin at reducing pain, improving comfort and reducing dystonia in children with dystonic cerebral palsy.
Barriers, facilitators and solutions for active inclusive play for children with a physical disability in the Netherlands: a qualitative study
L. van Engelen, M. Ebbers, M. Boonzaaijer, E. A. M. Bolster, E. A. H. van der Put & M. A. T. Bloemen
doi : 10.1186/s12887-021-02827-5
BMC Pediatrics volume 21, Article number: 369 (2021)
Children with physical disabilities (PD) are less physically active than typically developing peers. The most important contributor to physical activity for primary school-aged children is outside play and therefore this should be part of every child’s life. However, children with PD experience multiple barriers to participation in playgrounds. Despite recent improvements in the accessibility of Dutch playgrounds, the participation of children with PD has not increased. This study aims to explore facilitators, barriers and solutions influencing the participation of children with PD in Dutch outdoor playgrounds, from parents’ and professionals’ perspectives.
Neonatal rebound hyperkalemia associated with ritodrine alone: a case report
Keita Osumi, Kenichi Suga, Masashi Suzue, Ryuji Nakagawa & Shoji Kagami
doi : 10.1186/s12887-021-02840-8
BMC Pediatrics volume 21, Article number: 370 (2021)
Betamimetics have been used for tocolysis extensively in the past, and one of them, ritodrine is widely used in Japan. Various adverse events have been reported for this agent, including newborn hypoglycemia and hypokalemia, as well as maternal hypokalemia and rebound hyperkalemia; however, cases of neonatal rebound hyperkalemia are not described in the literature.
Unusual intramuscular locations as a first presentation of hydatid cyst disease in children: a report of two cases
Ruba A. Khasawneh, Ziyad M. Mohaidat, Rawand A. Khasawneh, Sohaib B. Zoghoul & Yousef M. Henawi
doi : 10.1186/s12887-021-02843-5
BMC Pediatrics volume 21, Article number: 371 (2021)
Hydatid disease is an endemic disease in many countries of the world including the Middle East. It mainly affects the liver and lungs. Intramuscular hydatid disease is rarely reported in children. Such uncommon localization of hydatid cyst may pose difficulties in the clinical and radiological diagnosis; hence affecting patient’s management and outcome even in endemic areas.
Multiple anatomic sites of infarction in a pediatric patient with M. pneumoniae infection, a case report
Devon W. Hahn, Claire E. Atkinson & Matthew Le
doi : 10.1186/s12887-021-02845-3
BMC Pediatrics volume 21, Article number: 372 (2021)
Although M. pneumoniae (M. pneumoniae) infections have been associated with various extrapulmonary manifestations, there have been very few documented cases of thrombotic events in pediatrics, and none to our knowledge with such extensive involvement as the patient described here. We aim to contribute to the urgency of discovering the mechanism of the coagulopathy associated with M. pneumoniae infections.
Impact of very preterm birth and post-discharge growth on cardiometabolic outcomes at school age: a retrospective cohort study
Jungha Yun, Young Hwa Jung, Seung Han Shin, In Gyu Song, Young Ah Lee, Choong Ho Shin, Ee-Kyung Kim & Han-Suk Kim
doi : 10.1186/s12887-021-02851-5
BMC Pediatrics volume 21, Article number: 373 (2021)
Adverse metabolic outcomes later in life have been reported among children or young adults who were born as preterm infants. This study was conducted to examine the impact of very preterm/very low birth weight (VP/VLBW) birth and subsequent growth after hospital discharge on cardiometabolic outcomes such as insulin resistance, fasting glucose, and systolic and diastolic blood pressure (BP) among children at 6–8 years of age.
Protocol of the Snuggle Bug/Acurrucadito Study: a longitudinal study investigating the influences of sleep-wake patterns and gut microbiome development in infancy on rapid weight gain, an early risk factor for obesity
Megan E. Petrov, Nana Jiao, Sarada S. Panchanathan, Elizabeth Reifsnider, Dean V. Coonrod, Li Liu, Rosa Krajmalnik-Brown, Haiwei Gu, Laurie A. Davidson, Robert S. Chapkin & Corrie M. Whisner
doi : 10.1186/s12887-021-02832-8
BMC Pediatrics volume 21, Article number: 374 (2021)
Overweight, obesity, and associated comorbidities are a pressing global issue among children of all ages, particularly among low-income populations. Rapid weight gain (RWG) in the first 6?months of infancy contributes to childhood obesity. Suboptimal sleep-wake patterns and gut microbiota (GM) have also been associated with childhood obesity, but little is known about their influences on early infant RWG. Sleep may alter the GM and infant metabolism, and ultimately impact obesity; however, data on the interaction between sleep-wake patterns and GM development on infant growth are scarce. In this study, we aim to investigate associations of infant sleep-wake patterns and GM development with RWG at 6?months and weight gain at 12?months. We also aim to evaluate whether temporal interactions exist between infant sleep-wake patterns and GM, and if these relations influence RWG.
Postoperative results of ventilation tube insertion: a retrospective multicenter study for suggestion of grading system of otitis media with effusion
Chan Il Song, Byung Chul Kang, Chol Ho Shin, Yun Suk An, Tae Su Kim, Hyun Woo Lim, Hyun Joon Shim, Myung Hoon Yoo & Joong Ho Ahn
doi : 10.1186/s12887-021-02855-1
BMC Pediatrics volume 21, Article number: 375 (2021)
In otitis media with effusion (OME), it is important to know when to surgically intervene and when careful monitoring is more appropriate. This study aimed to visualize and classify the clinical manifestations of OME and the correlation between the new grading system and postoperative results after ventilation tube insertion (VTI).
