جستجوی مقالات مرتبط با کلیدواژه « Failure to Thrive » در نشریات گروه « پزشکی »

Failure to thrive (FTT) is a common developmental disorder in infants. Although the improvement effect of zinc supplementation in these patients was reported in some past studies, the results were conflicting. Accordingly, this study investigates the effect of zinc supplementation on factors related to growth in infants with FTT by conducting a meta-analysis.

Medline, Web of Science, and Scopus databases were comprehensively searched to find randomized controlled trials investigating the effect of zinc on growth-related factors in infants with FTT. Eligible studies were extracted after screening their relevant information. The pooled effect size was estimated as a weighted mean difference with a 95% confidence interval (CI) using the random effect model method.

Out of 85 reviewed papers, 4 studies were eligible to enter this review. The present meta-analysis revealed that zinc supplementation in infants with FTT led to a significant increase in weight (weighted mean difference (MD)=-0.25 kg; 95% CI, 0.02%-0.49%), weight-for-age Z-score (weighted MD=0.16; 95% CI, 0.03%, 0.28%), and height-for-age Z-score (weighted MD=0.15, 95% CI, 0.001%, 0.30%), compared to control groups. In contrast, zinc supplementation had no significant effect on height and insulin-like growth factor 1 serum level.

The findings of the current meta-analysis indicated the effectiveness of zinc supplementation in improving the developmental status of infants with FTT; however, due to the small number of included trials, it was impossible to draw definitive conclusions, and conducting randomized controlled trials with larger sample size and higher sensitivity is needed.

Failure to thrive (FTT) is defined as delaying or stopping a child’s growth and mightlead to more serious complications, such as reduced learning ability, mental or physical disability, and mortality.

The present study aimed to assess the prevalence of growth retardation in children under 5 years of age and its risk factors.

This cross-sectional study was conducted on all 2038 children admitted to Ali Ebne Abitalib and Ali Asghar hospitals in Zahedan, Iran, in 2016. The samples entered the study basedoncensus sampling, andthe children’s height, weight, andothergrowth indices were measured. The children with confirmed growth retardation were recognized as the case group. Other children were regarded as controls. The parents’ characteristics were recorded in a list provided for this purpose. Data analysis was performed with SPSS software (version 20) using logistic regression with an error level of 0.05.

Of all children, 52.6% were male. The mean age of the total patients was 17.6 ± 4.14 months. The prevalence of children with growth failure was 747 patients (36.6%). In this study, the prevalence of short stature was significantly associated with factors such as parental height, low household level of education, high patients’ birth order, dry feeding, low birth weight, place of residence, and presence of background disease (P < 0.05). Nevertheless, the prevalence of short stature was not significantly associated with gender, age, polygamy status, age of complementary feeding, and gestational age (P > 0.05).

The present study concluded that the prevalence of FTT was high due to socioeconomic factors in the studied society. Parental short stature, education, nutrition, low birth weight, and residence in rural areas were the most significant factors.

  Bartter syndrome (BS) is a salt losing tubulopathy due to impairment of the transport mechanisms at the thick ascending limb of the Henle’s loop. The aim of this study was to report the clinical course of patients with BS.

  Patients with BS were followed from 1996 to 2020 and enrolled to a systematic protocol to confirm primary BS by evaluating the metabolic derangements, nephrolithiasis and nephrocalcinosis. Treatment was based on standard guidelines. Comparisons were made between data at baseline and at the last visit.

  A total of 13 patients (7 males) with primary BS were analyzed. Two patients had a mutation of the KCNJ1 gene. Age at diagnosis was 3 ± 4.5 years and the follow-up period was 11.19 ± 6.76 years. Metabolic alkalosis was initially detected in 76.92% and remained stable at the last visit (P > .05). Hypokalemia was present in 61.5% of patients at diagnosis, but sustained in 38.46% at the last visit (P < .05). Urine calcium level was 13.3 ± 9.6 mg/ kg/d at the first visit, and significantly reduced to 3.7 ± 2.0 mg/ kg/d at the last visit (P < .05). Nephrocalcinosis was detected by first kidney ultrasonography in 53.8% of patients. Kidney function was preserved, with a glomerular filtration rate of 120.1 ± 28.7 mL/min/ 1.73m2 at last visit. Growth was completely recovered in 71.42% and partially improved in 14.28% of patients after treatment, respectively. All patients received indomethacin and potassium chloride salts.

Long-term follow-up of this cohort of BS showed favorable outcomes after treatment resulting in metabolic normalization and growth catch-up in most patients.

We presented an 18-month old female patient known as failure-to-thrive (FTT) with poor weight gain during the first postpartum weeks. After 20 days of birth, she manifested lethargy, fatigue, fever, and diarrhea and was admitted to the hospital with acute colitis and rectovaginal fistula. She was later fixed for the fistula and underwent upper gastrointestinal (GI) endoscopy, abdominopelvic sonography and colonoscopy and was eventually diagnosed with very-early-onset inflammatory bowel disease (VEO-IBD).

Food protein-induced enterocolitis syndrome (FPIES), is a non-IgE mediated food allergy presenting in infants younger than 12 months. Diagnostic delay may occur due to overlapping clinical symptoms with several conditions. Here, we present two cases of FPIES, mistakenly diagnosed and treated as Bartter syndrome. This study aims to emphasize the several features of this syndrome that may mimic other diagnoses and sometimes leading to near-death events due to delay in the diagnosis and improper treatment. The first patient was a 30-month-old boy with multiple episodes of profuse vomiting and diarrhea within 1 hour after breastfeeding, beginning from the first month of life progressing to hypokalemia and metabolic alkalosis at the age of 5 months leading to the diagnosis of Bartter syndrome. The second patient had a history of unremitting diarrhea which had been started soon after his first breastfeeding followed by biliary vomiting on the 7th day of life. He was treated in another hospital for neonatal sepsis, however, without an appropriate response to treatment. To conclude, despite the current belief on the rarity of FPIES, it is a more prevalent disease than expected with various non-specific manifestations imitating other conditions which may result in diagnostic delay and sometimes fatalities. To shed light on the importance of the physicians’ awareness of this syndrome, these two cases are presented here as examples of FPIES imitating other disorders.

The first stage of Universal Health Coverage (UHC) was founded Iran to achieve better access to needed health services.

The aim of present study was to illustrate the prevalence rate of malnutrition’s subtypes in under 5‑year old children after UHC in comparison with before that. Settings and Design: In a cross‑sectional study in 2018, anthropometric indices of 970 under 5 years old children in rural and small towns of Isfahan province were gathered from their health files by cluster randomized sampling method.

Children whose weight for age, height for age, and weight for height were lower than ‑2SD based on Z score, were marked as underweight, stunting, and wasting, respectively. Children, whose weight for age was upper than +2SD, were marked as overweight. Statistical Analysis Used: The T‑test, Chi‑square, and logistic regression tests were used for determination of association between malnutrition’s subtypes and demographic variables.

A total of 78 (8.04%) of under 5 years old children were wasting, 74 (7.63%) were underweight, and 82 (8.45%) were stunting. Also, 12 (1.23%) of the children from the same group were overweight.

The prevalence rate of underweight and stunting in under 5 years old children were less than before UHC implementation period. The prevalence rate of overweight children below 5 in Isfahan province’s villages and small towns was low.

non-celiac gluten sensitivity (NCGS) is a condition characterized by gastrointestinal and extra-intestinal symptoms which triggered by ingestion of Gluten contained compounds i.e., wheat, rye, and barley, in subjects without celiac disease or wheat allergy.

hereby we present five children and adolescents with final diagnosis of NCGS. All patients had failure to thrive and abdominal pain. Following gluten free diet, clinical symptoms reduced and we detected significant weight and height gain after 1 month of diet.

relationship between failure to thrive and NCGS is still unknown, hence according to mentioned cases, NCGS may be one of the main causes of FTT, which can be prevented by gluten free diets.

 The congenital intestinal web is a rare cause of small bowel obstruction classified as Type I intestinal atresia. The second portion of the duodenum is the most prevalent site for these webs, whereas the jejunal web is rare.

 Herein, we present a very uncommon late presentation of the jejunal web in an 18-month-old girl complaining of chronic recurrent vomiting, constipation, and failure to thrive (FTT). After thorough investigations, the diagnosis was confirmed by the small bowel follow-through. The surgical procedure resulted in a significant improvement in her quality of life, given the subsequent increase in her weight and height.

 Vomiting that occurs at any age is pathologic and requires careful history taking, thorough clinical examination, and evaluation, especially in patients treated with proton pump inhibitors such as omeprazole for a long time a diagnosis of GERD without any response. In these patients, gastrointestinal abnormalities, including complete or incomplete obstructions such as malrotation and web, should be made in the differential diagnosis.

Failure to thrive (FTT) is a global problem and one of the most common health problems in childhood that involves many other social, economic, and cultural factors. Considering the adverse effects of FTT in the future of children, we studied FTT and its related factor in children under the age of 2 years in Bojnurd (the capital city of North Khorasan province, Iran).

This study was a Retrospective cohort study on 1000 health records, born in 2008-2013. Stratified sampling method was applied and the data were collected using a checklist in the health centers. Finally, data were analyzed using Chi-square, Multiple logistic regression, and independent t-test in SPSS19 software. Significant level was set at 5%.

Incidence of FTT was calculated as 443 children (44.3%) in the children's first two years of life. A significant relationship was observed between FTT in children and head circumference disorders at birth (p=0.001), maternal age at delivery (p=0.01), mother's education level (OR=0.4   CI95% [0.2-0.8]  p=0.012), type of delivery (OR=0.5 CI95% [0.4-0.7]   p<0.001), unspecified gestational age (OR=3.6   CI95% [1.3-10.08   p=0.015]), and pregnancy under the age of 18 (OR=2.4   CI95% [1.1-5.3]  p=0.02). 

Considering the high incidence of FTT in children, increasing awareness about timely feeding, promoting households' health, preventing and controlling infectious diseases should be improved.

Bartter syndrome (BS) is a rare metabolic disorder causing defect in sodium and chloride absorption in the thick ascending limb of Henle’s loop and increased urinary loss of sodium chloride (Na), chloride (Cl), and prostaglandins. We present the case of a 1-year-old girl with BS presenting with vomiting, poor feeding, and agitation. Physical examination revealed muscle weakness, developmental delay, and failure to thrive. Laboratory investigations revealed hypokalemia, metabolic alkalosis, hyponatremia, and hypokalemia. Urinary investigations revealed raised urinary chloride, sodium, potassium, and calcium levels. Renal ultrasound revealed a renal calculus in the lower calyx of the right kidney with hydronephrosis. The basic defect in BS is the loss of one of the transporters involved in sodium reabsorption in the thick ascending limb on the Henle’s loop or apical K channel. BS is characterized by severe hypokalemia, metabolic alkalosis, hyponatremia, hypochloremia, and hyperaldosteronism. In BS, increased urinary loss of sodium, potassium, and chloride is observed.

Lead is a strong and stable toxin, harmful especially to children, pregnant women, and the elderly. Nearly 27% of children aged under 5 years suffer from failure to thrive (FTT). Due to the probable harmful effects of lead poisoning on children’s growth, in this study we aimed to assess the blood lead level in children with unexplained failure to thrive. This analytic cross-sectional study was performed on 200 children under 2 years of age who were referred to Ghaem hospital, a referral hospital in Mashhad city-Iran. The participants were divided into two equal groups, one with unexplained FTT (group A), and children with normal weight (group B). Baseline characteristics were obtained by a research-made questionnaire. Blood samples were taken by the hospital nurses who were blind to the study groups. Blood lead level was measured by atomic absorption spectrophotometric method (Perkin Elmer 3030). The mean ± standard deviation (SD) of blood lead level in FTT group and control group were 7.3±3.32 µg/dL and 6.37±5.93 µg/dL, respectively. Blood lead level was significantly higher in FTT group than control group (P=0.001). Baseline Charactistics (such as hgender, parental educational level, gestational age, and socio-economic status of the family) were not significantly different between the two groups (P>0.05). The results of our study revealed that blood lead level was higher in children with FTT. So Lead poisoning may be a potential cause of unexplained FTT. So, measuring blood lead level can be useful in diagnostic workup of patients with FTT.

Febrile seizure is the most common seizure disorder in childhood. Anemia or failure to thrive can predispose children to Febrile seizure by affecting the nervous system function. The current study investigates the association between febrile seizures and Anemia or failure to thrive.
This case-control study was performed on 307children 6 months to 6 years old age hospitalized at the Ali Asghar children`s Hospital from 2011 to 2014 divided into two groups: a case group including 158 children with febrile seizures and a control group including 149 febrile children without seizure. The amount of Hgb, Hct, RBC count, MCV, MCH, and MCHC was recorded and weight-for-age and weight-for-height was calculated based on the WHO Z-Score charts.The date were compared between two groups.
There were no differences regarding age and sex between the groups. Statistically significant differences were found regarding the mean RBC count between the case group (4.38×106 ± 0.72×106) and the control group (4.24×106 ± 0.84×106) (p=0.013), as well as about the mean MCV that was 78.73 ± 0.97 and 76.78 ± 1.00 in the case and control groups respectively(p=0.005). Anemia was seen in 28.5% of the case and 42.3% of control group which was statistically significant (p=0.012). There was not statistically significant difference regarding failure to thrive between two groups.
in children with febrile seizures anemia was lower comparing with febrile children without seizure. Moreover, there was not any association between failure to thrive and febrile seizures.

Failure to thrive is one of the most important health problems of children around the word and in developing countries. This study aimed at investigating factors associated with failure to thrive among the children aged 3 to 72 months in Jahrom city of southern Iran.
This case-control study comprised of 250 children aged 3 to 72 months. The case group included children with growth curves below the third percentile in more than one measurement and children above the third percentile with failure to gain weight or with weight loss during at least 1 month. The control group was selected from children with normal growth rate. The case and control groups were matched in terms of age and gender. The chi-square test and logistic regression method were applied for analysis of data using the SPSS 17 software.
Failure to thrive in children was significantly associated with factors, such as lower level of mother's education (OR = 4.29, %95 CI = 1.80 - 10.25, P Failure to thrive causes serious complications in children later in their lives. With regards to the relatively high prevalence of this problem among children aged under 6 years of age, it is therefore deemed necessary, as an important health problem, to identify factors associated with this disorder, improve pre-pregnancy care, promote women’s education level, and train parents to consider appropriate nutrition of children and healthy pregnancy.

Malnutrition and inflammation are considered risk factors of morbidity, hospitalization, and mortality in chronic kidney disease (CKD) children. The aim of this study was to determine the prevalence and severity of failure to thrive (FTT) in children with moderate to severe CKD.
This cross-sectional study was conducted in 84 children with CKD (30 female, 54 males) aged 2-16 years old from June 2014 to June 2015.The inclusion criteria were eGFR less than 90 ml/min/1.73m2, being healthy in the month before the visit, and lack other chronic diseases except CKD. Anthropometric data including the body mass index, height, weight, and mid upper arm circumference were collected. Protein wasting energy was scored and the severity of failure to thrive was estimated using Gomez and Jelliffe classifications. P-values less than 0.05 were considered significant
Glomerulopathy and hereditary tubulopathy were the main causes of underlying disease. About 79% of CKD children had FTT and the rate increased with a decline in the renal function (p-value0.05). A quarter of the patients with FTT were classified as no PWE and vice versa.
The majority of the children with moderate to severe chronic kidney disease had failure to thrive and protein wasting energy. There was no correlation between inflammatory markers and the severity of CKD or the presence of failure to thrive.

Back ground: Failure to thrive (FTT) is a condition of poor weight gain in early childhood. Low appetite which is associated with FTT interacts with increasing caloric intake as the main treatment for FTT. Phytochemicals in herbal remedies could alter appetite more than the expected effects of other nutrients. This review aimed to assess the effective and safe herbal appetizer for children with FTT according to Traditional Persian Medicine (TPM).
By searching through main pharmaceutical books of Persian medicine during 8th –18th centuries (A.D.), the herbal remedies as appetizer were determined. We searched Phytochemical and pharmacological activities of these herbs in PubMed, Scopus, ISI and Google scholar databases, since 1950 to15 december2016.
Findings: Overall, 42 herbs were found. Among these herbs, only 11 herbs were prescriptible for children. Improving of feed intake, growth performance, weight gain and gastro- esophageal protection were the most reported activities.
Natural remedies Prepared from these herbs may be useful for enhancing appetite especially for FTT in children. Additional well-designed studies are needed to investigate the safety and efficacy of them.

Growth retardation following malnutrition is prevalent among patients with congenital heart diseases (CHDs). This study was designed to evaluate failure to thrive (FTT) and delay in bone age in children with CHDs who were referred to our hospital and subsequently to determine their relation with cyanosis and the pulmonary artery pressure.
We enrolled 120 consecutive patients who were referred to Rajaie Cardiovascular, Medical, and Research Center for cardiac catheterization or surgical correction. Growth parameters, comprising height (cm), weight (kg), and head circumference (cm), were measured by an experienced nurse. Bone age was evaluated by taking an anteroposterior wrist X-ray and reported by a radiologist, who was not aware of the exact cardiac diagnosis. The pulmonary artery pressure was measured during cardiac catheterization or surgical correction.
Bone growth retardation, FTT, short stature, and microcephaly were seen in 46.6%, 43.7%, 29.4%, and 5.1% of the patients, correspondingly. There was a significant relationship between the presence of cyanosis and delayed bone age, particularly when O2 saturation was less than 75% (P According to our results, delayed bone age and growth retardation are common findings in children with CHDs. The presence of cyanosis and/or pulmonary hypertension may further deteriorate these conditions and should be promptly managed. (Iranian Heart Journal 2017; 18(3):35-41)

Malnutrition and failure to thrive (FTT) is a delay or a halt in children’s growth, which leads to serious compilations if it is left untreated. Malnutrition due to its prevalence is the most important nutritional disease in developing countries and has the most prevalence among infants and preschool children. This study aimed at rating and determining the effective factors of malnutrition incidence and growth delay among 0 to 24 months children.
To identify children under 2 years of age, we referred to health centers and health stations in the city of Shahroud (Northeast of Iran) in 2015. Using cluster sampling, 706 children were surveyed.
Anthropometric indices with international reference standards were compared. The values obtained for less than 2 standard deviations as stunting, underweight, wasting, and FTT were defined. All statistical analyses were performed using SPSS software with significance level set at 0.05.
The results indicated the existence of malnutrition in the region. Based on the findings, the percentage of underweight, wasting, stunting and ratio of head circumference with age was determined to be 1.7%, 5.4%, 9.5%, and 8.6%, respectively; and considering the category of growth disorder, Type 1, 2, and 3 were, respectively, 1.7%, 5.2% and 3.1%. Factors affecting malnutrition included age, birth weight, birth spacing, and the mother’s BMI at child birth.
Tracking the status of children with growth disorder and malnutrition, offering appropriate interventions, considering the nutrition status of mothers during pregnancy, and providing appropriate nutritional counseling are of prime importance to attend to this problem.

Celiac disease (CD), considered as a common chronic and genetic diseases that caused by hypersensitivity to gluten. Failure to thrive (FTT), is one of three major clinical features of CD during childhood. The current study aimed to determine the prevalence of celiac disease in children with unexplained FTT in South West of Iran.
This cross‑sectional study was conducted on 433 children 9-month to 6 years old that diagnosed as unexplained FTT referred to Abuzar Children's Hospital, Ahvaz, South West of Iran, in 2014. In this study, we examined the serum levels of anti-transglutaminase antibody (anti-tTG) in children with unexplained FTT. Data were analyzed using SPSS version 16.0 software.
The results showed that the prevalence of CD in children with unexplained FTT in was 8.8%. The mean scores of children's anti-tTG serum levels in both gender and age groups, showed no significant difference (P> 0.05).
At current study, the prevalence of CD in children with FTT was 8.8%. Since the CD is an important cause of unexplained FTT in children, the early screening and diagnosis and dietary management can be decrease the risk for long-term complications in these children.