Journal of Comprehensive Pediatrics
Volume:8 Issue: 1, Feb 2017

Context: The premature newborns are prone to develop both early onset and late onset neonatal sepsis. The major causes of this phenomenon rely on the immaturity of the immune system, which has reduced capability to respond adequately to pathogens.
Evidence Acquisition: Titles and abstracts of previous papers were scanned before reading the full-text, in order to retrieve appropriate information. The databases used for searching were PubMed, Cochrane, and Embase for articles published before 1st of July, 2016. Secondary search for articles cited in reference lists were identified by the primary search. This review focused on neonatal sepsis incidence and the associated immune response with regards to microRNAs of human milk as a new microelement that enables regulation of innate immunity functions.
Since human milk is a valuable source of microRNAs, a better understanding of its content will open a new therapeutic avenue for the clinical management of infectious diseases affecting premature newborns. The variation in miRNAs quantity in human milk needs to be considered. Mother’s milk can have different amounts of miRNAs and the identification of a microMilk batch richer of miRNAs can be a nutrition intervention method for modulating innate immunity in clinical management of premature newborns.
Routine translation of the microMilk concept for neonatal intensive care unit (NICU), in the management of premature newborns could be a way of defending premature newborns and Very Low Birth Weight (VLBW) infants from both early and late sepsis.

Children with nephrotic syndrome are prone to hypercoagulation disorders and thromboembolism. Of these patients, intracardiac thrombus is the most serious and life-threatening complication, which is detectable by echocardiography and can be successfully treated with plasminogen activator. This review deals with the very rare occurrence of intracardiac thrombi in children with nephrotic syndrome.

Various strategies have been suggested for the treatment of neonatal respiratory distress syndrome (NRDS).
Nowadays, most of the high-risk pregnancies are successfully ended although they normally result in the delivery of premature and preterm neonates. The rate of NRDS increases in these neonates, which consequently demands for more interventions to save them.
This was a case-control study in which, 52 neonates of 27 - 32 weeks’ gestation and birth weight 1000 - 3000 g were treated with Curosurf (a natural surfactant) and NCPAP (Nasal continuous positive airway pressure) as the case group. The control group consisted of 52 matched neonates untreated with surfactant and NCPAP.
Studying 6 common NRDS-induced complications (pneumothorax, pulmonary hemorrhage, chronic lung disease, intra-ventricular hemorrhage, sepsis and patent ductus arteriosus) showed that there were no significant differences between the case and control groups (P > 0.05). Also, there were no significant differences in mortality and ventilator usage rates and duration of hospitalization (P > 0.05). In total, 9 neonates in the case group (17%) and 16 in the control group (30%) died consequently.
The results showed that surfactant therapy had no significant effect on mortality and ventilator usage rates, duration of hospitalization, and NRDS-induced complications.

Autosomal recessive polycystic kidney disease (ARPKD) is a heterogeneous inherited disorder most commonly seen in childhood. The presentation is usually a palpable large mass in the flank or abdomen appearing at infancy or birth, leading to electrolyte abnormalities, pulmonary hypoplasia, oligohydramnious and the Potter’s syndrome. The survival rate of this disease is 70%. Multiple mutations of the polycystic kidney and hepatic disease 1 (PKHD1) are known that can cause ARPKD. On the other hand, mutations in PKHD1 have also been identified in about 30% of children with congenital hepatic fibrosis (the Caroli’s syndrome) without any evidence of kidney involvement. Based on this evidence, not everyone with PKHD1 mutations will present with ARPKD. Recent studies have shown that nongenetic factors, including environmental exposures had a significant effect on manifestations of ARPKD. The present study aimed at investigating the possible link between ARPKD and its epidemiologic factors, hypothesizing that these epidemiologic conditions would influence the incidence of ARPKD.
The present study aimed at evaluating a possible link between the ARPKD and its epidemiologic factors.
In this case-control study, children with ARPKD referred to Amirkabir hospital in Arak city, Iran, were compared with noninfected children. Examinations, interviews, and questionnaires were performed to collect data and the disease was diagnosed by a physician.
The results of this study showed no significant relationship between epidemiological factors such as age, place of residence for families, sex, family education/occupation/ income, body mass index, stunted growth, slow growth, good growth, milk intake, water intake, failure to thrive and ARPKD.
Based on our findings, epidemiological factors did not have a significant effect on the occurrence of ARPKD. 

The current study aimed at determining asthenopia prevalence and its associated factors in a population of high school students.
In the current cross sectional study, samples were selected from high school students (range, 12 to 18 years) in Kermanshah city, Iran, through stratified cluster sampling. Any person with at least 1 symptom was considered to have asthenopia.
Of the 1070 selected samples, 1040 participated, and examinations were completed for 901 students. The prevalence of asthenopia was 49.4% (45.7 to 53.2). The prevalence of asthenopia was 62.8% (51.9 to 73.8) and 47.7% (43.8 to 51.7) in males and females, respectively (P = 0.013). Asthenopia prevalence increased from 21.4% in 12-year-old to 63.9% in 18-year-old cases (P The prevalence of asthenopia in this student population was high. Since asthenopia can interfere with near-work, its treatment merits high importance in school-age children.

Prenatal mortality and morbidity increase after 40 weeks of gestation. The current study aimed at comparing maternal and neonatal outcomes between term and postterm pregnancies.
The current prospective cohort study was performed on 1180 singleton, cephalic fetus, and uncomplicated pregnancy cases admitted for labor. Pregnant mothers were divided into 3 groups. Group 1 included 750 cases in 38 to 40 weeks, group 2 included 250 cases in 40 to 41 weeks, and group 3 included 180 cases in over 41 weeks of gestation. Prenatal outcomes were recorded as: fetal distress, meconium passage, meconium aspiration, fetal weight ≥ 4 kg, Apgar score in 1 and 5 minutes, neonatal intensive care unit (NICU) admission, maternal infection, postpartum hemorrhage, and the rate of cesarean section.
There were significant differences in the rate of fetal distress (P Late-term and postterm births are associated with higher rates of fetal and neonatal morbidity and maternal risks compared to pregnancy termination before 40 weeks of gestation, and earlier birth induction is recommended in such cases.

Pseudoachondroplasia is a rare type of short-limbed skeletal dysplasia. It is usually found as an autosomal dominant inheritable disorder. Children are normal at birth and they present developmental delay in walking by the age of 2, an abnormal waddling gait or deformities of the lower limb. Diagnosis is based on characteristic clinical and radiological findings. This study reports on a 6-year-old boy with classical features of pseudoachondroplasia.

Oxalate nephropathy is a rare cause of renal failure. Primary Hyperoxaluria (PH) is due to glyoxylate metabolism disorders with specific hepatic enzyme deficiencies. Secondary hyperoxaluria is caused by increased intestinal absorption, excessive dietary intake or excessive intake of oxalate precursors. This study reports on a 4-month-old male with high serum creatinine level, low serum sodium and calcium, high uric acid, and low urine specific gravity. Sonography showed calcification of medullary papilla (nephrocalcinosis). In kidney biopsy, many polarizing intra-tubular and interstitial calcium oxalate crystals, mild patchy lymphocytic infiltration, and interstitial fibrosis were noted. Despite supportive therapies and correction of fluid and electrolyte abnormalities, the patient gradually became oliguric progressing to anuria, and was placed on peritoneal dialysis.