Hypertension by&nbsp;<a href="http://www.nyphotographic.com/">Nick Youngson</a>&nbsp;<a href="https://creativecommons.org/licenses/by-sa/3.0/">CC BY-SA 3.0</a>&nbsp;<a href="https://pix4free.org/">Pix4free</a>As parents, we often worry about our children's health and well-being, from ensuring they eat healthy foods to getting&nbsp;the best medical attention that we can afford whenever they are ill. But have you ever considered their blood pressure?&nbsp;While&nbsp;hypertension is often thought of as a condition that affects adults, it can also impact children and adolescents, and its prevalence is on the&nbsp; rise.&nbsp;<h2 style="margin-left:0cm;">How common is hypertension in children?</h2>Although less common than in adults, hypertension in children is increasingly recognized as a significant health issue.&nbsp;It can result from underlying conditions, such as kidney disease or heart abnormalities, or develop as primary hypertension, often linked to obesity, poor diet, and lack of physical activity. Increased rates of childhood obesity have contributed to a rise in hypertension among children.&nbsp;A&nbsp;<a href="https://www.sciencedirect.com/science/article/pii/S2589537021005101">review&nbsp;</a>of studies on hypertension in Africa finds that about 7% of African children are hypertensive and that the number is rising due to an increase in the number of children who are overweight or obese.&nbsp;<h2 style="margin-left:0cm;">Types of hypertension in children</h2>Hypertension could be primary or secondary.&nbsp;Primary hypertension, or essential hypertension, is&nbsp;a condition of high blood pressure&nbsp;in which the cause is unknown.&nbsp;Primary hypertension runs in families and is the most&nbsp;common type of&nbsp;hypertension in children.&nbsp;Secondary&nbsp;hypertension&nbsp;is high blood pressure with a known cause, such as renal disease, heart disease, or endocrine disorders.&nbsp;<h2 style="margin-left:0cm;">What are the causes of hypertension in children?</h2>There are many genetic, environmental, lifestyle, and medical&nbsp;factors responsible for hypertension in children.&nbsp;They include:<ul><li>Having a hypertensive parent</li><li>Obesity</li><li>Poor diet</li><li>Sedentary lifestyle</li><li>Chronic medical conditions like diabetes, kidney disease, and sleep apnea</li><li>Medications, including NSAIDs, steroids, and over-the-counter cold remedies</li></ul><h2>Signs and symptoms of hypertension in children?</h2>Here are some signs&nbsp;that may suggest your child has hypertension:<ul><li>Headaches</li><li>Fatigue</li><li>Dizziness</li><li>Blurry vision</li><li>Chest pain</li><li>Difficulty breathing</li><li>Blood in urine</li></ul>It is important to note that many children with&nbsp;hypertension do not experience any symptoms,&nbsp;so regular blood pressure checks are essential for early detection and treatment.<h2 style="margin-left:0cm;">How can you know if your child has hypertension?</h2>Diagnosing hypertension in children requires multiple blood pressure measurements taken over time and a thorough evaluation of&nbsp;your child’s medical history, family history, and physical exam.&nbsp;The diagnostic criteria for&nbsp;hypertension in&nbsp;children use average blood pressure values for age, sex, and height. The doctor must measure a child’s blood pressure multiple times to establish a diagnosis of hypertension.<h2 style="margin-left:0cm;">Management of hypertension in children</h2>Management depends on the severity of the condition, the age of the child, and any underlying medical conditions. It also involves several approaches:<ul><li style="text-align:justify;">Lifestyle changes</li></ul>Adjusting a child’s diet and exercise habits is key. Reducing their sodium intake, increasing fruits and vegetables, encouraging regular physical activity, and helping them manage weight are essential to controlling blood pressure. These changes are often the first step in treating primary hypertension.<ul><li style="text-align:justify;">Medications</li></ul>If lifestyle changes are not enough, a child will need medications. Blood pressure-lowering drugs, such as ACE inhibitors, beta-blockers, or calcium channel blockers, are commonly used. Medication use depends on the child’s age, the severity of the hypertension, and individual health needs.<ul><li style="text-align:justify;">Treatment of underlying conditions</li></ul>For secondary hypertension, managing the root cause, such as kidney disease or hormonal disorders, is essential. Treating these underlying conditions helps to control high blood pressure and prevent complications like organ damage or stroke in the long term.<ul><li style="text-align:justify;">Specialist care</li></ul>A doctor should always supervise paediatric hypertension management, preferably a specialist such as a paediatrician or paediatric cardiologist. A specialist will ensure treatment is tailored to the child’s condition and adjusted for optimal care.<h2 style="margin-left:0cm;">How to protect your child from having hypertension</h2><ul><li>Encourage kids to have a salt- and&nbsp;fibre-free, fruit- and vegetable-rich, well-balanced diet. Avoid&nbsp;consuming processed and packaged foods that are heavy in added sugars, saturated fats, and salt. Instead of noodles, biscuits, chips, and fries, try fruits, nuts, dairy, milk, and whole grain meals.</li><li>Set aside at least an hour each day for kids to play or move about. Outdoor games, sports, dancing, and other physical pursuits fall into this category.</li><li>Regular blood pressure checks at well-child visits can help&nbsp;detect hypertension early on and enable early intervention.&nbsp;Get a home blood pressure monitor and then take the child to the hospital for regular checks.</li><li>Limit the time children spend on screens and encourage other activities that promote physical activity and social interaction.</li><li>Encourage children to develop healthy coping mechanisms such as meditation, deep breathing, or other relaxation techniques.</li></ul>Hypertension affects children and adults, and&nbsp;they have similar prevention strategies.&nbsp;By encouraging good practices from a young age, you can reduce your child's risk of hypertension and improve their general health and well-being.

Poor diet, obesity, and genetics are causing a rise in childhood hypertension, leading to lifelong health risks.

Hypertension in Children

Children's Health

<a href="https://www.freepik.com/free-ai-image/portrait-adorable-newborn-baby_66108984.htm#fromView=search&amp;page=3&amp;position=17&amp;uuid=a59ddb6d-4d72-41b9-a5e1-b0ec18ec572d">Image by freepik</a><h2>Introduction</h2>Do you know that, according to a&nbsp;<a href="https://www.researchgate.net/publication/228478123_Neonatal_jaundice_Prevalence_and_associated_factors_as_seen_in_Federal_Medical_Centre_Abakaliki_Southeast_Nigeria">report</a>, 35% of all NICU admissions were made for Neonatal Jaundice? A global survey estimates that each year,&nbsp;<a href="https://www.njcponline.com/article.asp?issn=1119-3077;year=2016;volume=19;issue=1;spage=1;epage=17;aulast=Olusanya#:~:text=every%20year%2C%20roughly-,1.1%20million%20babies,-would%20develop%20severe">1.1 million newborns</a> experience severe jaundice, with the bulk of those cases occurring in sub-Saharan Africa and South Asia. In Africa, particularly in West Africa, neonatal jaundice is the major condition that affects and kills newborns. Hence, it requires priority attention from the international community. In these areas, newborn mortality due to jaundice complications occurred in almost 75% of cases. There are a lot of misconceptions about neonatal jaundice in developing countries, and it is imperative we talk about it. Nigeria is one of the nations with one of the highest neonatal mortality rates, with almost one-third (32%) of the estimated 1 million children under the age of five who pass away each year dying during the newborn period. Between 5 and 14% of these neonatal deaths, severe neonatal jaundice (SNNJ) is to blame. The prevalence of neonatal jaundice in Africa is partially caused by a genetic predisposition brought on by a high prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency, system flaws, and delays in the care of newborns who have jaundice. Infants with severe neonatal jaundice who survive develop varying neurological problems, including sensory-neural hearing loss, language processing issues, and cerebral palsy, now known as a kernicterus spectrum disorder (KSD). Nigeria and the entire of Africa have insufficient research on the prevalence and regional characteristics linked to newborn jaundice. However, we have put together some pertinent information regarding neonatal jaundice as it concerns us in West Africa. Let’s go on this ride, shall we?<h2>Outlook of Neonatal Jaundice in Low and Middle-Income Countries</h2>Numerous studies conducted throughout the years have identified newborn jaundice as a significant cause of infant morbidity and mortality. It has been challenging to compare jaundice across different regions due to the absence of standardised guidelines for the care and classification of the condition in low- and middle-income nations.The high prevalence of acute bilirubin encephalopathy (ABE) or kernicterus in low- and middle-income countries (LMICs) has been linked to three levels of delay in the pathway to care for neonates with neonatal jaundice. Specifically, a delay in seeking care, a delay in showing up at the proper facility, and a delay in receiving sufficient and appropriate care at a medical facility. Due to these delays, bilirubin levels can rise to risky levels, and the newborn's brain is exposed to high bilirubin levels over an extended period, which results in both acute and chronic neurotoxicity. In many LMICs, parents of newborns who fail to seek immediate and appropriate care for a sick newborn outside the home setting may do so due to poverty, a lack of access to medical care, sociocultural perceptions and practices related to newborn illness, such as the use of traditional medicine, and living in rural areas.&nbsp;In Nigeria and Africa as a whole, septicemia and prematurity were the main aetiological causes of NNJ. Significantly more outborn than inborn babies experienced substantial bilirubinemia, septicemia, and contact with clothing contaminated by naphthalene balls. Also, unbooked women were more likely to use herbal pregnancy remedies than mothers of unborn children.<h2>What is Jaundice</h2>Jaundice is defined as the yellowish discolouration of the skin and sclera (the white part of the eye) due to high levels of a pigment known as bilirubin in the skin and mucous membranes. Neonatal Jaundice, aka NNJ, is jaundice in a neonate (a child 28 days old and less). Neonatal jaundice is one of the most prevalent illnesses that require medical attention in newborns. It is a liver condition that causes the yellowing of a newborn baby’s skin and eyes. 60% of term and 80% of preterm newborns experience neonatal jaundice worldwide. Neonatal jaundice occurs because of an imbalance between bilirubin production and its removal from the bloodstream. The mother assists in the placenta's function throughout pregnancy to help the foetus excrete its bilirubin. Following delivery, the infant must self-adjust and eliminate blood bilirubin. Bilirubin is a by-product of the breakdown of haemoglobin(a pigment in red blood cells). Because newborns have more red blood cells, which also have a short lifespan and an immature liver, there’s usually an imbalance in the rate at which bilirubin is produced and removed from the bloodstream. It is important to know that when this pigment (bilirubin) crosses the barrier separating the blood from the brain, it causes what we call bilirubin encephalopathy or kernicterus.&nbsp; Kernicterus results in permanent brain damage in which the child will have a delay in development, stiffness of the body, and affectation of social interaction. Kernicterus specifically happens in the first 14 days of a newborn (as the blood-brain barrier is most easily penetrated at this time). It is important to know that the damage to the brain is permanent, and no treatment can reverse it. The child can only be managed to limit challenges and complications.&nbsp;<h2>How do I know my child has jaundice?</h2><ul><li>Baby’s skin becomes more yellow.</li><li>The skin on the baby’s abdomen, arms, or legs looks yellow</li><li>The whites of the baby’s eyes look yellow</li><li>Baby seems listless, sick, or is difficult to awaken</li><li>Baby isn’t gaining weight or is feeding poorly</li><li>Baby makes high-pitched cries.</li></ul><h2>Jaundice: What Could Be the Cause?</h2>The appearance of jaundice in a newborn could be a result of certain factors. Below are some of the common causes of jaundice.<ul><li>Hyperbilirubinemia (excess bilirubin): An excessive amount of bilirubin in the blood results in a condition called hyperbilirubinemia. When red blood cells, which carry oxygen throughout the body, are broken down, bilirubin, a yellow material, is created. The bilirubin is transported to the liver by the bloodstream. Bilirubin is transformed by the liver so that it can be eliminated from the body in feces. However, if there is too much bilirubin in the blood or the liver is unable to eliminate it, it will produce jaundice.</li><li>Internal bleeding (hemorrhage): Red blood cell disintegration and the subsequent release of unconjugated bilirubin into the bloodstream can cause jaundice. Therefore, this breakdown of blood cells outside of blood vessels (extravascular hemolysis) will lead to an increase in the amount of unconjugated bilirubin presented to the liver cells (hepatocyte). Thus, unconjugated bilirubin will build up in plasma, increasing total and indirect bilirubin if the hepatocyte's capacity to absorb and conjugate this bilirubin is exceeded.&nbsp;</li><li>Infection in baby’s blood (sepsis): Sepsis is a condition in which there is both an infection and a systemic inflammatory reaction. Jaundice is one of the many symptoms of sepsis. When the body fights an infection due to sepsis, among other reactions, cytokines are released. The regulation of bilirubin by our body is interfered with by these cytokines, which are also the cause of inflammation in sepsis. As a result, bilirubin cannot be properly processed by our bodies, which causes a buildup and jaundice or yellowing of the skin. Both the drugs used to treat sepsis or direct liver damage from sepsis can result in jaundice.</li><li>Incompatibility between the mother’s blood and the baby’s blood: While a mother is pregnant, it is possible for her red blood cells to enter the placenta or fetus. When this happens, the mother's blood cells produce antibodies that can target the newborn's blood cells, resulting in jaundice.</li><li>Liver malfunction Inflammation, various issues involving the liver cells, or clogged bile ducts may all be associated with high levels of bilirubin. In newborns, the early symptoms of liver illness frequently include jaundice.</li><li>Biliary atresia: The flow of bile from the liver to the gut is obstructed in infants who have biliary atresia. The newborn develops jaundice as a result of the bile becoming trapped inside the liver. Babies' trapped bile can damage and scar their livers very quickly (cirrhosis). This typically leads to liver failure, and jaundice often develops in infants with biliary atresia between the ages of 3 and 6 weeks.</li></ul><h2>Myths and Truths Surrounding the Treatment of Neonatal Jaundice in Africa&nbsp;</h2>People are wrongly informed about treatment options regarding neonatal jaundice. Some of the myths and truths about jaundice are listed below.<h3 style="margin-left:0in;">Myths</h3>In Africa, some of the myths and wrong narratives or pieces of advice prevalent and surrounding the treatment of neonatal jaundice include:<ul><li>Putting the child under sunlight&nbsp;</li><li>Putting breast milk in the eyes</li><li>Giving any form of traditional medications</li><li>Giving any form of oral (mouth) medications.</li><li>Wearing yellow clothes causes jaundice.</li><li>Unripe pawpaw/leaf cures jaundice.</li><li>Abidec/ampiclox drops cure/prevent jaundice.</li><li>Untreated malaria in pregnancy causes jaundice.&nbsp;</li></ul><h3 style="margin-left:0in;">Truths</h3>The perfect advice to parents and health workers of every sort is to always make sure to refer newborns with jaundice or suspected case of jaundice to a paediatrician.&nbsp; In doing so, you could just be guaranteeing a normal life!&nbsp;<h2>How Long Does Jaundice Last In A Baby?</h2>If your baby is fed formula, jaundice usually goes away within two weeks. In breastfed babies, it can last longer, up to three weeks or more. If your baby's jaundice persists beyond three weeks, it's best to speak to your healthcare provider.<h2>What Jaundice Treatment Options Are Available?</h2>At birth, jaundice can be discovered by running an SB (serum bilirubin) test. Clinically, jaundice can be discovered in a neonate between 1 and 7 days of birth. The treatment option to be used is dependent on the level of the bilirubin as measured in the lab. In some cases, no intervention is required. The mother would just be counselled to go home, continue breastfeeding and come back for a recheck later. In situations where bilirubin levels are still high after a recheck, the paediatrician decides on any of the following treatment options:<ul><li>Phototherapy: This is a medical treatment that uses a specific type of light, which is not sunlight. It is commonly used to treat newborn jaundice by helping the liver to break down and eliminate bilirubin from the baby's blood. Any level above 15 mg/dL or more calls for immediate phototherapy within the first 72hrs after birth.</li><li>Exchange Blood Transfusion: In some cases, when a person has a serious case of jaundice, or when phototherapy hasn't been effective, a procedure known as a complete blood transfusion or an exchange transfusion may be necessary. The process involves the gradual removal of the individual's blood and replacing it with fresh donor blood or plasma to counteract the high levels of bilirubin in their blood.</li></ul><h2>Complication Of Jaundice</h2>The major/most worrisome complication of jaundice is kernicterus. Kernicterus causes irreversible (permanent) brain damage.&nbsp;<h2>What is the way forward?</h2>To considerably lower newborn morbidity and mortality, social factors that affect health must be taken into consideration. These factors are at the heart of the problems that underlie both of these outcomes. Furthermore, to reduce the prevalence of severe neonatal jaundice, there is a need for continuous education of the general public on the importance of routine antenatal observation of pregnancy and delivery in competent healthcare facilities.In conclusion, always follow the doctor’s recommendation when your child has jaundice. Also, the best thing you can do for your newborn who is jaundiced is to make sure they are getting enough breastmilk. Do not listen to old wives’ fables of alternate methods of ‘curing’ jaundice. Remember, it is your baby and therefore, it is your responsibility to give the best care.

Do you know that, according to a report, 35% of all NICU admissions were made for Neonatal Jaundice? A global survey estimates that each year, 1.1 million newborns experience severe jaundice, with the bulk of those cases occurring in sub-Saharan Africa and South Asia. In Africa, particularly in West Africa, neonatal jaundice is the major condition that affects and kills newborns.

Jaundice in Newborns

David is a bright and active eight-year-old boy who loved playing in the compound and discovering new things around him. One day, while playing with his toys under the shade of a tree in front of his house, he suddenly fell to the ground and started shaking uncontrollably.His mom was terrified and quickly called out for help. The neighbours came together, and one of them offered his bike. David’s father quickly got on the bike, and with the help of his mother and a neighbour, they carefully placed David on the bike. With David held between his parents, they rushed to the clinic, hoping he would get better soon.At the clinic, the doctors ran a series of tests before diagnosing David with a seizure disorder, often referred to as epilepsy.&nbsp; This meant that he would be at risk for future seizures. For&nbsp;David and&nbsp;his family, this diagnosis was life-changing.&nbsp;If you have a child like David, this article will help you learn about seizure disorders in children and how to manage&nbsp;similar cases.&nbsp; It provides an overview of seizure disorders in paediatrics, including the definition of seizures, common causes, diagnosis, and treatment options. Additionally, it provides coping strategies for parents and caregivers to manage seizures in children and ensure their safety.<h1 style="margin-left:0cm;">What is a seizure?</h1>A seizure is a disorder in which brain cells malfunction and transmit electrical impulses involuntarily, resulting in symptoms that impact other areas of the brain and body. In this case, seizures often cause loss of consciousness and abnormal movements, usually immediately.&nbsp;It can result in unexpected, abrupt changes in a child's movements, sensations, cognition, and&nbsp;behaviour. Neurons in the child's brain may&nbsp;freeze excessively during a seizure,&nbsp;resulting in odd feelings, emotions, or behaviours. The seizure may be minor or severe, lasting between a few seconds and several minutes.Paediatric seizure disorder&nbsp;occurs in approximately 4 to 10 out of every 1,000 children.<h2 style="margin-left:0cm;">Causes of seizure disorders in children</h2>Several possible causes of seizure disorder in&nbsp;children may include the following:<ul><li>Genetic factors - some forms of epilepsy may be inherited.</li><li>Brain injury or damage - can occur during birth from infections, head injuries, or strokes.</li><li>Brain malformations - when the brain does not develop properly before birth.</li><li>Infections - such as meningitis, encephalitis, or abscesses in the brain.</li><li>Metabolic disorders - including low blood sugar, electrolyte imbalances, or kidney or liver failure.</li><li>Brain tumours - both benign and malignant&nbsp;tumours can cause seizures.</li><li>Febrile seizures - which occur during high fever in young children.</li><li>Unknown causes - in some cases, no&nbsp;specific cause of the seizure disorder can be&nbsp;identified.</li></ul><h2 style="margin-left:0cm;">Types of seizure disorders</h2>A seizure can come in different forms, depending on the cause and the part of the brain affected. The common types include:<ul><li>Generalised seizures&nbsp;</li></ul>They affect the entire brain and can render a child unconscious. They can be atonic or tonic-clonic seizures if they affect the child’s muscles and movement or absence seizures if the child just stares into space or blanks out for a few seconds. Absence seizures were once called petit mal&nbsp;seizures.<ul><li>Focal or partial seizures</li></ul>These seizures might originate in one&nbsp;specific location and result in a limited range of symptoms. If the child does not lose consciousness, the seizure could be simplepartial seizures. Complex partial seizures result in altered consciousness.<h2 style="margin-left:0cm;">Symptoms of a seizure in children&nbsp;</h2>The symptoms of a seizure vary depending on the type. Common symptoms include:<ul><li>Abnormal movements:&nbsp;The seizure may include jerking or twitching the arms, legs, or face.</li><li>Loss of consciousness: The child may appear to&nbsp;stare blankly, become unresponsive or confused, or even fall to the ground.</li><li>Convulsions:&nbsp;The severity of convulsion can range from mild to severe and can include shaking stiffness, and loss of muscle control.</li><li>Change in mood or&nbsp;behaviour: Children may experience sudden changes in mood or&nbsp;behaviour,&nbsp;and may become irritable, aggressive, or anxious.</li><li>Changes in sensations: Children may complain of hearing unusual sounds or seeing&nbsp;flashing lights.</li><li>Loss of bladder or bowel control:&nbsp;A child with a seizure may find it difficult to hold her pee or poop.</li></ul><h2 style="margin-left:0cm;">Diagnosis of seizures in children</h2><figure class="image"><img src="https://tenbadgers-myhealthvoice.s3.eu-central-1.amazonaws.com/image_7ae6bc1cca_eb49f243f9.webp"></figure><a href="https://www.freepik.com/free-ai-image/man-working-as-paediatrician_262780334.htm#fromView=search&amp;page=1&amp;position=0&amp;uuid=3751e076-8a39-4cda-8e30-00aa555908bf">Image by freepik</a>Seizures in children combine medical history, physical exam, neurological assessment, and diagnostic testing.&nbsp;<ul><li>Medical history: The doctor will&nbsp;ask about the child's symptoms and medical history from the parents or other primary caregivers</li><li>Neurological assessment.&nbsp;This involves a comprehensive neurological examination comprising tests for nerve and sensory functions, gait and balance, etc.&nbsp;</li></ul><h2 style="margin-left:0cm;">Management options for seizure disorders</h2>The primary goal of treatment of&nbsp;a seizure disorder is to stop the seizure and, if it can’t be stopped, to control or reduce the frequency and severity of the seizure. These goals may be achieved through:&nbsp;<ul><li>Anti-seizure drugs: Anti-seizure drugs are the mainstay of treatment for children with seizure disorders. The drugs reduce the abnormal electrical activity in the brain.&nbsp;</li><li>Nutritional therapy:&nbsp;There have been reports of some epileptic children experiencing fewer seizures while following a high-fat, low-carb ketogenic diet.</li><li>Cognitive-behavioural therapy (CBT) is a&nbsp;form of treatment that can be used with other therapies to help children with seizure disorders manage their disease's emotional and psychological aspects.</li><li>Vagus nerve stimulation (VNS)&nbsp;is a noninvasive medical procedure that involves implanting a device beneath the skin of the chest and connecting it to the vagus nerve in the neck. VNS stimulates the brain with electrical impulses, which lessen the frequency and intensity of seizures.</li><li>Surgery: For kids with seizure disorders, surgery may occasionally be advised to remove the portion of the brain producing the seizures&nbsp;without causing greater harm to the healthy brain tissue.</li></ul><h2 style="margin-left:0cm;">Coping strategies for parents and caregivers of children&nbsp; having a seizure disorder</h2>Having a child with a seizure disorder can be challenging and stressful for a parent or caregiver.&nbsp; To help you cope, try:<ul><li>Working closely with a paediatric neurologist to create a personalised treatment plan for children with seizure disorders. Identifying and addressing any sign of seizure disorder early can improve treatment outcomes and reduce the risk of complications.</li><li>Ask for help:&nbsp;Connect with other parents and caregivers&nbsp;whose children have similar challenges. Join a support group, attend seminars or conferences, or consult a therapist or&nbsp;counsellor who focuses on helping families dealing with seizure disorders.</li><li>Make self-care a priority: Make time for leisurely pursuits like reading, jogging, and&nbsp;socialising with friends. These activities can help you unwind. When you need a break, take one, and if you require assistance, ask friends or family for assistance.</li><li>Create an action plan for seizures: Consult with your child's doctor to create an action plan that&nbsp;specifies what to do during a seizure. If you have a strategy, you may feel more prepared and&nbsp;confident in controlling your child's seizures.</li><li>Create a safe space for your child.&nbsp;This may entail clearing your child's room of sharp or harmful things, setting up safety equipment like bed rails or epilepsy helmets, and instructing other family members and caregivers on handling seizures.</li></ul>

Early diagnosis and treatment can ease the burden of seizures, but reducing stigma is just as important.

Hypertension in Children

Jaundice in Newborns

Seizure Disorders in Children