Journal of Comprehensive Pediatrics
Volume:12 Issue: 1, Feb 2021

Context:

 Necrotizing enterocolitis (NEC), as a life-threatening gastrointestinal tract disease, is associated with high rates of morbidity and mortality. Extensive inflammation, progressive hemorrhagic necrosis, and overwhelming infection of the gut are reasons why NEC is known as a devastating disease in premature infants. Almost 45% of affected preterm infants die, and those who survive suffer from multiple complications. Human milk, the best food for newborns, plays a significant role in supporting the immune system. Both mother’s own milk (MOM) and donor human milk (DHM) are particularly important in the prevention and lessening of the severity of NEC. Evidence Acquisition: We searched PubMed, Elsevier, and Google Scholar databases for articles that investigated the correlation between NEC and human milk. Then all data were accessed about their relevancy to this current subject.

In summary, the purpose of this article is to firstly review the protective role of breast milk components against NEC, and secondly discussing the correlation between human milk and NEC in clinical studies. Human milk bio-components, including Lactoferrin, oligosaccharides, maternal soluble IgA, epidermal growth factor, transforming growth factor, prebiotic, probiotics, and antioxidants, have a protective effect against NEC. However, the importance of these components in donor human milk and the formula is underestimated.

Human milk, as the first-choice of nutritional source, comprises a wide diversity of copious bio-components, which dwindle the risk and severity of NEC in many ways. The exact mechanisms are still unclear, the evidence strongly point out that human milk is superior to any other nutrition concerning protecting the gastrointestinal tract from NEC.

 The phenomena of transformation from the intrauterine environment to independent breathing proceeds successfully in 90% of newborns. However, timely resuscitation is crucial for the 10% remaining.

 We investigated the neonate resuscitation (NR) status, predisposing factors, and outcomes.

 This retrospective descriptive research was conducted at Al-Zahra hospital (Guilan-Iran) between April 2018 to March 2019. During the study period, all files of born neonates were reviewed, and relevant maternal and neonate information was extracted and analyzed.

 A total of 4,850 files were reviewed, and the data from 2,131 complete ones were analyzed. Among them, 14.1% needed resuscitation, 10.2% basic interventions, while 3.9% required advanced interventions. Neonate resuscitation outcome was significantly associated with gestational age (in less than 32 gestation weeks, 84.9% of neonates needed resuscitation) (P < 0.001), meconium staining of amniotic fluid (in 38.3% of cases whose amniotic fluid was stained with meconium, resuscitation was required) (P < 0.001), mode of delivery (in cesarean delivery, 18.7% of infants were resuscitated) (P < 0.001), birth weight (49.3% of infants weighing less than 2,500 grams needed resuscitation) (P < 0.001), multiple pregnancies (in multiple pregnancies, 66.1% resuscitation was needed (P < 0.001), Apgar score at minute 1 and 5 (in infants with an Apgar score below 7 in minute 1, 57.7% and in infants with an Apgar score below 7 in minute 5, 90.8% of neonates needed resuscitation) (P < 0.001).

 Screening pregnant women for early detection of high-risk cases and attendance of a skilled NR team at the time of delivery results in better outcomes.

 In the contemporary century, the media has played a significant role in educating communities.

 The purpose of this research is to investigate the role of national media programs in the prevention of childhood cancer.

 Participants in this research study included ordinary people, parents of children with cancer, and pediatric oncologists. The study was performed for six months (2017) in Bahrami and Mahak hospitals. Participants were asked questions about the role of the media in the prevention of childhood cancer, and their answers were recorded in a questionnaire.

 The results showed that, while ordinary people evaluate the role of national media programs, their simplicity and comprehensibility in the prevention of childhood cancer as desirable, parents of children with cancer consider this program’s comprehensibility as low. Physicians also considered the influence of the contents of radio and television programs as low but their simplicity as desirable.

 Our study confirmed the effectiveness of national media programs in the prevention of childhood cancer. The level of education of parents was effective in understanding media education in the prevention of childhood cancer.
 

 Reducing infant mortality in the whole world is one of the millennium development goals.The aim of this study was to determine the factors related to infant mortality using data mining algorithms.

 This population-based case-control study was conducted in eight provinces of Iran. A sum of 2,386 mothers (1,076 cases and 1,310 controls) enrolled in this study. Data were extracted from health records of mothers and filled with checklists in health centers. We employed several data mining algorithms such as AdaBoost classifier, Support Vector Machine, Artificial Neural Networks, Random Forests, K-nearest neighborhood, and Naïve Bayes in order to recognize the important predictors of infant death; binary logistic regression model was used to clarify the role of each selected predictor.

 In this study, 58.7% of infant mortalities occurred in rural areas, that 55.6% of them were boys. Moreover, Naïve Bayes and Random Forest were highly capable of predicting related factors among data mining models. Also, the results showed that events during pregnancy such as dental disorders, high blood pressure, loss of parents, factors related to infants such as low birth weight, and factors related to mothers like consanguineous marriage and gap of pregnancy (< 3 years) were all risk factors while the age of pregnancy (18 - 35 year) and a high degree of education were protective factors.

 Infant mortality is the consequence of a variety of factors, including factors related to infants themselves and their mothers and events during pregnancy. Owing to the high accuracy and ability of modern modeling compared to traditional modeling, it is recommended to use machine learning tools for indicating risk factors of infant mortality.

Urinary tract infection (UTI) is the second most common infection in children. Parents’ lack of awareness and information about UTIs ultimately leads to delayed referral for treatment, which raises many concerns in parents.

The research aimed to evaluate the parental awareness of UTIs in infants and children and related demographic factors.

In this cross-sectional analytical study, 270 parents who had a child or infant with UTIs referring to the Nephrology Clinic of Mohammad Kermanshahi Hospital in Kermanshah, Iran, in 2018 were selected by a convenience sampling method. To analyze the data, the chi-square test and Fisher's exact test were used.

According to the results, the parental awareness of the symptoms of UTIs in children was moderate, and the overall score on the awareness of complications, treatment, prevention, and diagnosis of UTIs in children was high. There were statistically significant relationships between the parental age and knowledge of UTI treatment in children, between paternal education and treatment and diagnosis and the total score of knowledge on UTIs in children, and between maternal education and awareness of the symptoms and how to prevent UTIs. Further, there was a statistical relationship between the children’s history of UTIs and the awareness of how to diagnose and treat UTIs in children (P < 0.05).

Given the results, educational programs must be promoted to raise parents' awareness of UTIs in infants and children, especially UTI symptoms in lower educated, elderly parents whose other children have not had any history of UTIs.

 Nasal septal hematoma (NSH) is a complication of nasal trauma, which its emergency treatment is drainage of hematoma. Delayed treatment may result in necrosis of the nasal cartilage and saddle nose deformity.

 Here, we reported a 15-year-old girl presented with NSH associated with a dental local anesthetic injection, which led to nasal septum necrosis.

 Computerized tomography (CT) scanning was performed to determine the hematoma size and existence of other complications.

 Malignant peripheral nerve sheath tumor (MPNST) is a type of connective tissue cancer, which may also have genetic backgrounds. More than half of patients have neurofibromatosis. The treatment of this tumor is a combination of surgery, radiotherapy, and chemotherapy. As usual, the tumor may be present anywhere with several manifestations.

 A 4-year old boy presented with sweating and pain in the right forearm that was diagnosed with MPNST developed in the paravertebral region after laboratory and radiographic evaluation.

 The patient was treated successfully and followed up for one year without any complications.

Teething is a physiological process, which usually does not cause problems. A variety of symptoms are ascribed to infant teething, despite little evidence to support such belief. The wrong beliefs and misconceptions about the symptoms of teething may present serious risks to infants.

This study aims for determination of the mothers' attitude about the symptoms and signs of infants teething.

Data collection was done using a questionnaire, containing demographic information of the respondents as well as a number of 20 questions about the signs and symptoms of teething. In this study, 220 questionnaires were completed by mothers having 6 - 30 months’ children, with at least one deciduous tooth.

The mean age of the mothers was 28.26 ± 5.10 years old. Mean of the first deciduous tooth eruption in them was 7.16 ± 1.60 month. All mother associated, at least, one symptom with teething. In this study, mothers' beliefs were as follows: gum rubbing (91%), biting objects (86%), restlessness and irritability (84%), fever (75%), drooling (70%), and diarrhea (62%).

Regarding that symptoms such as fever, diarrhea, and restlessness and irritability are attributed to teething, this can distract parents from serious illnesses, leading to diagnosis and treatment delay.

 To investigate the epidemiology, clinical features, and treatment of hospitalized pediatric cases of preseptal and orbital cellulitis in a central university hospital in Zahedan, Iran.

 Retrospective study of children/adolescents admitted to a central university hospital with orbital and preseptal cellulitis from 2016 to 2018.

 Forty patients, including 29 cases of preseptal cellulitis and 11 cases of orbital cellulitis, were included in the study. The prevalence of orbital and preseptal cellulitis was approximately the same in both sexes. Mean age was 2.86 ± 0.56 years (ranges 12 days to 13 years) in patients with orbital cellulitis and 2.82 ± 0.67 years (range, 2 months to 8 years) in patients with preseptal cellulitis. The most common clinical and paraclinical findings were edema of the eyelids and increased ESR, respectively. Sinusitis is the most common underlying cause, which was present in 63.63% of cases of orbital cellulitis and 34.48% of cases of preseptal cellulitis. The most frequent antibiotics used in this study were ceftriaxone, cloxacillin, and vancomycin.

 The most common clinical and paraclinical findings were edema of the eyelids and increased ESR, respectively. Sinusitis is the most common underlying cause. Timely treatment of sinusitis may prevent orbital and preseptal cellulitis.