Journal of Pediatrics Review
Volume:8 Issue: 4, Oct 2020

Context: 

Jaundice is a common problem and the most common risk factor for hospitalization during the neonatal period.

The prevention of neonatal hyperbilirubinemia would not be possible without identifying its predisposing risk factors. The present systematic review study aims to determine the risk factors of neonatal jaundice.
Data Sources:  Databases including Science Direct, Cochrane Library, Web of Science (ISI), PubMed, and Google Scholar were searched to identify all eligible papers concerning the risk factors of neonatal hyperbilirubinemia.

Study Selection:

 This systematic review was performed to review the causes and risk factors of neonatal hyperbilirubinemia. Finally, 18 articles were defined as eligible for further review.

Data Extraction: 

The keywords included neonates, jaundice, hyperbilirubinemia, and risk factors. The inclusion criteria were studies determining jaundice risk factors, while papers with only published abstracts were excluded.

A total of 18 eligible articles (3 retrospective, 4 prospective, 10 cross-sectional, and 1 historical cohort) out of 421 retrieved articles were included in this review. The etiologic causes for neonatal jaundice were ABO incompatibility (24.6%), infection (including UTI and sepsis) (13.7%), G6PD deficiency (9.4%), Rh incompatibility (7%), and cephalohematoma (2.9%), while, known predisposing factors for neonatal jaundice included unknown (33.2%), low birth weight (30.9%), hyperbilirubinemia in siblings (22.7%), prematurity (20.1%), and infant of diabetic mother (6.7%).

According to our review with considering the studies, the etiologic causes for neonatal jaundice are ABO incompatibility, infection (including UTI and sepsis), G6PD deficiency, Rh incompatibility, and cephalohematoma. While, known predisposing factors for neonatal jaundice include low birth weight, hyperbilirubinemia in siblings, prematurity, and infant of diabetic mother.

Context: 

Different studies have been done so far on drug safety and efficacy in children with refractory nephrotic syndrome (NS). Ofatumumab might be an effective drug for this syndrome; however, the long-term effects and cost-effectiveness of ofatumumab treatment have not been comprehensively assessed.

This study aims to perform a systematic review of the efficacy and safety of ofatumumab in children with difficult-to-treat NS.

Study Selection: 

An electronic literature search was conducted to identify appropriate studies. The search key terms were as follows: (“nephrotic syndrome” OR “minimal change disease” OR “focal segmental glomerulosclerosis” OR “membranous”) AND (“Ofatumumab” or “CD20” or “Arzerra” or “HuMax-CD20”).

Data Extraction: 

Data were extracted from the articles according to the selection criteria by two independent reviewers.

A total of 83 potentially relevant articles were identified. Thirty-two articles were removed due to duplication. Then 26 more articles were excluded because they were book sections and review papers and therefore not relevant. Another 14 items were removed after reviewing the full text of selected papers because the topics did not fit our study subject. Finally, 11 studies were selected in our systematic review. The benchmark considered to assess the efficacy of ofatumumab in children with nephrotic syndrome in most of the studies was a complete remission rate.

In conclusion, our systematic review showed that ofatumumab may be an effective drug in refractory NS treatment in children and could bring down the use of steroids and immunosuppressants. However, further large randomized trials are suggested.

Context: 

Although positive outcomes of breastfeeding on both mothers and infants are well documented, few studies have investigated the spiritual aspects of breastfeeding. This study conducted a narrative review of the research on spiritual and religious beliefs for breastfeeding.

Evidence acquisition: 

All papers from 2000 to 2018 about the study subject were searched in the international databases. The measured outcome included different breastfeeding behaviors in mothers with different religions.

In this study, 69 related studies were reviewed and finally 9 articles were selected. One article was about the influence of breastfeeding on the spiritual status of mothers and 8 articles were about the effect of religious beliefs on different breastfeeding behaviors.

The results of this review showed that spirituality can influence the management of breastfeeding behavior. More attention should be paid to spirituality interventions to acknowledge the high priority in breastfeeding because it may allow public health officials to more effectively promote breastfeeding policies.

Context: 

Warts are benign cutaneous and mucosal growths caused by human papillomavirus. Warts are the most common skin diseases seen by pediatric dermatologists. Warts are often self-limited, especially in children, but some lesions are not resolved despite repeated treatments and referred to as recalcitrant warts.

Evidence acquisition: 

Electronic databases such as Google Scholar, PubMed, and Scopus were searched during 2000-2018 and a review was conducted for articles published in English on pediatric warts by focusing on recalcitrant warts.

If warts are asymptomatic and being in a location that causes no cosmetic or other problems, observation is the ideal management course. Most parents and children prefer treatment for their warts. There are three modalities of treatment: medical, surgical, and immunotherapy.

Treatment of warts is a therapeutic challenge that depends on the patient’s age and the type of warts. Despite treatment according to evidence-based guidelines, a significant proportion of warts are failed to respond. This condition is an unsolved problem in practice. The management for treating these lesions has remained unclear and a wide range of the second line of treatments has been developed.

Context: 

Persian medicine (PM) scientists such as Avicenna (980‑1037 AD) believed that maintaining health without exercise is impossible. So they have written about special rules and various techniques for the exercise of different groups of people including children. This study aimed to express the PM views about the exercise in children.

Evidence Acquisition: 

Among the most important references of PM in childrenchr('39')s subjects, six books from different centuries were selected. Relevant keywords were used to extract related data. Also, PubMed, Science Direct, and Google Scholar databases were searched up to July 2019 to find common views on physical activity and exercise in children. The extracted materials were thoroughly studied to summarize and categorize to find the main themes.

According to PM, exercise is a broad concept, including massage of the upper and lower limbs from the first hours of life, physical activity like crying for feeding and playing, passive movements such as cradle shaking and swinging, and proper and frequent experience of mental states and five senses such as winning/losing, enjoying, listening to music and looking at fine writings. The intensity of exercise varies in different children. Vigorous exercise in children changes the body composition, results in weakness, or impairs the growth and development. So, according to Avicenna, exercise must be planned individually.

It seems that the principles of PM can help design available, different, enjoyable, and user-friendly exercises for children of all ages.

Appendicitis could be a rare complication of Salmonella Typhi infection.

we present a 13-year-old girl with typhoid fever with histology-proven acute appendicitis as a rare complication of Salmonella Typhi infection. The patient was admitted to the hospital with the chief complaints of fever, abdominal pain, diarrhea, and vomiting for more than one week. A brief review of relevant literature was also performed to explore more this rare cause of a common emergency surgical procedure.

In all cases with typhoid fever with persistent diarrhea and vomiting, localized abdominal pain, probable acute appendicitis should be considered as an important complication.

Congenital lacrimal sac fistula is a rare anomaly of the lacrimal system in which, an epithelium-lined lacrimal tract is connected to the skin through a fistula. In most cases, it usually presents as an asymptomatic unilateral lesion located inferolateral to the medial canthus. Several studies reported that congenital lacrimal sac fistulas may be associated with systemic anomalies like Down syndrome, renal agenesis, etc. However, in this case, we aimed to report a patient with isolated bilateral congenital lacrimal sac fistula and its surgical management.

A previously healthy 17 years old female presented with the complaint of intermittent watery discharge from her left eye since a few months ago. Physical examination revealed a small orifice in the skin at about 4 mm from the medial canthus on the medial side in both eyes without any signs of inflammation. Probing and irrigation in the left eye disclosed communication with the puncta and nose. Surgical repair was carried out through fistulectomy which successfully controlled the patient’s lacrimation.

Recent advances in surgical techniques have shown better rates of success in relieving the patient’s lacrimation through fistulectomy than the simple excision methods. Our experience with the case presented here demonstrates that this lacrimal system anomaly can be treated successfully by surgical intervention.

Exposure to house dust mites is an important cause of asthma among children. The main asthma-causing mites found in homes are Dermatophagoides farinae and Dermatophagoides. pteronyssinus. Der f1 or Der p1 are allergens of the mentioned mites. This study aimed to assess the levels of Der p1, and Der f1 in the homes of families that had a case of childhood asthma in a northern city of Iran and to determine the association between indoor house environment and the level of mites allergens present there.

Dust samples were collected from bedrooms of 91 homes of families that had cases of childhood asthma. Families filled a questionnaire about demographical characteristics and the indoor condition of their living environment. The levels of Der f1 and Der p1 were measured by enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed in SPSS 24 and a P value less than 0.05 was considered significant.

we found that Der p1 was more prevalent than Der f1 among samples. The mean concentration of Der p1 concentration was 271.35 ng/g (9 times greater than the concentration of Der f1). When the indoor environment status was evaluated, it was found that keeping pets and having old carpets are associated with Der f1 (P<0.05). However, no significant association was found between Der p1 and the indoor conditions of the home.

Our study showed that Der p1 level is higher than Der f1 level in the houses of children with asthma. We suggest removing carpets and pets from the house.

The breastfeeding process is as vital for the mother as it is for the baby. Therefore, the weaning is a difficult decision for both parties.

In this study, it is aimed to determine the traditional and non-traditional methods that mothers use to wean their babies.

The descriptive type of study was conducted between 15 May 2018 and 15 October 2018 on 1,124 women with healthy children between years of age 2-5 the Primary Health Care Center in Kocaeli province in Turkey. The data was collected using a “Questionnaire Form” prepared by the researchers.

In the findings of the methods used in weaning, it was determined that 31.8% of mothers (n:358) applied a substance to the nipple, which is said to create a frightening effect for the baby.  14.5% of mothers (n:164) were found to apply a substances on the nipple, in order to leave a bitter taste in the mouth of the baby and reduce the desire to suck the nipple. Another method used to wean is to apply something that creates a repulsive effect on the nipple; this method was used by 12.3% of mothers (n:139).  The percentage of women who failed to perform on the first attempt was 11.38% (n:128). The reasons for re-starting breastfeeding were the method to wean not working (21.1%; n:27), the influence of relatives to abandon weaning (6.2%; n:8), and the baby crying too much (89.1%; n:11).
 

In the study, it was determined that some of the mothers used the traditional method for weaning and the majority of the babies of the mothers who used the traditional method responded by crying. In line with these findings; Training and counseling on breastfeeding is recommended to mothers who are breastfeeding by nurses.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus with highly contagious that affects all ages such as children. Any age, including infancy, could be affected by the pandemic.