Journal of Comprehensive Pediatrics
Volume:7 Issue: 2, May 2016

There is a large amount of data on the prevalence and risk factors of speech and language delay from the West, but relatively scanty data from India..
The aim of this study was to assess the prevalence and risk factors of speech and language delay in children less than three years old, using the Langauge Evaluation Scale Trivandrum (LEST 0-3)..
A descriptive, cross sectional study was conducted in the under-five clinic of our institute, on a sample of 200 children, less than three years old. Language was assessed using Language Evaluation Scale Trivandrum (LEST 0-3) and development in other domains was assessed using the Trivandrum Development Screening Chart (TDSC). The Home Screening Questionnaire (HSQ) was used to assess the home environment. Various biological and environmental risk factors were analyzed..
The prevalence of speech and language delay was found to be 27%. In univariate analysis, parameters found to be significantly associated with speech and language delay were male gender, poor home environment (score ≤ 19 in the Home Screening Questionnaire) and family history of speech and language delay. In multivariate analysis, poor home environment (CI = 0.20 - 0.80, P = 0.01) and positive family history (CI = 0.09 - 0.72, P = 0.01) were significant risk factors. There was a significant association between delay in TDSC and speech delay. However, TDSC alone had a low sensitivity of 33% in detecting speech and language delay..
Prevalence of speech and language delay is high (27%) in children less than three years of age attending the Under-Five clinic for at-risk children. Negative home environment and family history of speech and language disorders are significant risk factors for speech and language delay. The strong association of speech delay with delay in TDSC reemphasizes the need for a complete developmental assessment in any child with speech delay. The TDCS alone fails to detect significant number of cases of speech delay, showing the need to perform a separate speech screening test..

Tachycardia-induced cardiomyopathy (TIC) is a ventricular dysfunction secondary to chronic and persistent tachycardia that can regress partially or completely following heart rate normalization. Paroxysmal atrial tachycardia and permanent junctional reciprocating tachycardia are two types of frequent arrhythmias that can cause cardiomyopathy in children..
A 12-year-old child with obesity (body mass index > 26.8) was admitted with fatigue, pallor and tachypnea to the clinic. He had palpitation for the past 24 hours. On the cardiac auscultation, holosystolic 2/6 murmur was heard in the apex as well as gallop rhythm. Electrocardiogram revealed heart rate of 150 - 160 bpm and negative P waves in II, III and AVF leads. The echocardiography revealed dilated cardiomyopathy with an ejection fraction of 30%..
Diagnosis of tachycardia-induced cardiomyopathy in children is important, since appropriate treatment improves the prognosis. Every child with recurrent and persistent palpitation with the first episode of congestive heart failure should be evaluated for tachycardia- induced cardiomyopathy..

The national program of neonatal screening was performed in 2005 in Iran. According to the studies, the outbreak of congenital hypothyroidism (CH) was one in every 670 live births in 2011. The prevalence of the disease in the world is 1 in 3000. The mean prevalence of this disease in Iran is estimated to be 1 in 1,000, which indicates a high prevalence of the disease in Iran..
This study was conducted to investigate the prevalence of congenital hypothyroidism among neonates in the Najmiyeh hospital in Tehran, Iran..
Patients and This cross-sectional study was conducted from 2011 to 2014. Most heel blood samples were taken between three and seven days of birth. Thyroid stimulating hormone (TSH) was tested using the enzyme-linked immunosorbent assay method. Neonates with abnormal screening results (TSH > 10 mIU/L, Free T4 A total of 11427 infants were screened. Of 399 re-called subjects (re-call rate = 3%), 57 cases were detected with CH, a CH prevalence of 1:200 (the female:male ratio of 1:1.5)..
The prevalence of CH in our center is high. These results emphasize the importance of the congenital screening program..

Non-attendance in clinics has major economic impact in the national health service. Literature review indicates that main reason for non-attendance is forgetfulness and reminders reduce the non-attendance rate (NAR)..
We aimed to evaluate the NAR at the paediatric outpatient clinics after implementation of telephone reminders..
Patients and NAR was reviewed for 6 months (February-July 2013) and compared with the NAR for similar duration in 2014 (before and after implementation of telephone reminders). Within 2014 data, comparison was also made for patients who confirmed attendance during telephone reminders versus those left a voice message and patients who were not contactable..
Total number of patients in 6 months were 4156 [2674 follow-up (F/U), 1482 New] in 2013 and 4732 [3100 F/U, 1632 New] in 2014. Overall NAR in 2014 was significantly lower (5.1%) than in 2013 (P = Our results validate that telephonic confirmation of clinic appointment plays a significant role in reducing the NAR in paediatric out-patient clinic setting..

Urinary tract infection (UTI) is the second most common bacterial infection in infancy and childhood with peaking in infancy and toilet training..
The current study aimed to investigate UTI in patients with diarrhea..
Patients and This case-control study was conducted on 200 participants, 100 were patients with acute gastroenteritis and the other 100 were controls who referred to the clinic for routine checkup. UTI was defined as two positive urine cultures with > 105 cfu/mL. If white blood cells were more than 10/mm3 in un-centrifuged urine it would be considered pyuria and more than one microorganism in 10 oil immersion fields as bacteriuria. Analysis was conducted using SPSS ver. 16 with application of chi-square test and 0.05 as significant levels..
The distribution of these 200 children were 115 (57.5%) and 85 (42.5%) for females and males respectively. The gender and age distribution in case and control groups showed non-significant association. In urine culture it was observed that 27 individuals were positive and there were seven healthy children. The number of children with positive urine culture was higher than that of their counterparts significantly (P = 0.0001). Relationship between urine culture and age groups showed that the number of participants with positive urine culture was higher in children with age of two months to two years but it was not significant (P = 0.54)..
It was demonstrated that, considerable percentage of UTI existed in the gastroenteritis diseases. Early treatment of UTI in patients would reduce UTI complications..

Tracheal bronchus or pig bronchus is a rare congenital lung anomaly .In this condition, an ectopic bronchus arises from the lateral wall of the trachea, more commonly from right side. Although pig bronchus is usually asymptomatic, however in some patients it is presented with recurrent pneumonia and segmental atelectasis..
The patient was a five-month-old female referred to the clinic because of pneumonia with inappropriate response to antibacterial treatment and previous history of recurrent pneumonia. On chest X-ray, she had reduced volume right lung with mediastinal shift to the right side. Thorax computed tomography scan (CT scan) revealed pneumonitis. On bronchoscopy, there was no foreign body, but purulent exudates and fibrin were observed in her right lung and possibility of tracheal bronchus was not proposed. Although axial views of CT scan did not determine any anatomic anomaly, the coronal view reconstruction of her first CT scan revealed tracheal bronchus above the carina on the right side. The images of axial cuts of CT scan re-inspect one more time; it was interesting that it had some evidence of tracheal bronchus..
Recurrent pneumonia in right upper lobe sensitized physicians about the possibility of congenital anomalies particularly tracheal bronchus and coronal view reconstruction of CT scan should be requested..