Journal of Comprehensive Pediatrics
Volume:13 Issue: 1, Feb 2022

Cancer is one of the most common causes of death in children. The aim of this study was to evaluate the effect of parents’ education on the prevention of leukemia in children.

This study was a survey performed in Mahak and Bahrami hospitals in 2019. Checklists were completed in two groups of parents, those who had a child with leukemia and those who had a healthy child. Data were analyzed by SPSS statistical software.

In this study, 365 individuals in the healthy group and 81 in the cancer group participated. More than sixty percent (62.3%) were females. The highest frequency of age in both groups was 31 - 40 years. The highest frequency of parents’ education in the healthy group was associate degree and bachelor (about 51%) and in the cancer group, lowers than associate degree (about 73%). There was a significant relationship between parents’ education and the prevalence of leukemia in children (P < 0.05).

Based on the study, parents’ higher education can be effective in preventing the development of leukemia in children.

Bronchiolitis is a lower respiratory tract infection and one of the major health concerns and hospitalization factors in infants.

This study aimed to address inconsistencies in treating this disease.

This study is a double-blind clinical trial investigating the effect of salbutamol, epinephrine, and 5% inhaled hypertonic saline on treating infants with bronchiolitis referred to the Taleghani Pediatrics Hospital in Gorgan, Iran, during 2019 - 2020. The clinical results of the treatments and hospitalization stay were also evaluated.

In this study, the study sample encompassed 18 girls and 39 boys. There was no significant difference between the three groups regarding age, gender, parental literacy level, and history of allergies. Salbutamol and epinephrine, in comparison to hypertonic saline, were effective in shortening patients' hospital stay (P = 0.004). Moreover, there was a significant difference between the oxygen saturation of in the patients 48 h after treatment in the salbutamol and epinephrine groups compared to the saline group (P = 0.001).

In comparison to hypertonic saline, salbutamol and epinephrine can be selected to treat children with acute bronchiolitis since they can shorten hospital stay improve O2 saturation, and decrease treatment costs imposed on the health care system and families.

This study aimed to evaluate the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) as diagnostic adjunct tests for early-onset neonatal sepsis (EOS).

This prospective cross-sectional study included 80 full-term neonates with confirmed EOS and 80 healthy newborns. All examinations were done 24 hours after birth. Neonatal sepsis (NS) was characterized as a positive blood culture with symptoms of infection. Positive diagnostic indicators, including I/T ratio > 0.2, total leukocytes [WBCs] of either 5109/L or > 15109/L, thrombocytopenia [150,000/mm3], CRP > 1 mg/dL, and procalcitonin >0.5 ng/mL were considered as NS.

As the predictors of EOS, the sensitivity of NLR and PLR was 67% and 70%, and their specificity was 99% and 73%, respectively. Also, positive predictive value (PPV) of NLR and PLR was 98% and 72%, respectively. We found a weak correlation between platelets and sepsis, Strong correlation between WBCs and PLR with sepsis, and a moderate correlation among the ratio of immature to total neutrophil counts (I/T ratio), all of which were significant. Besides, concerning NLR with sepsis, we found an inverse correlation between lymphocytes and sepsis.

PLR and NLR are important predictive markers for EOS (PPV of NLR and PLR was 98% and 72%, respectively). Moreover, leukocytosis, thrombocytopenia, high c-reactive protein (CRP), high procalcitonin, and positive blood culture were correlated with the risk of NS. NLR and PLR showed more specificity than CRP and procalcitonin.

Pulmonary interstitial glycogenosis (PIG) is a kind of children’s interstitial lung disease (ChILD). This is exclusively limited to neonates and infants. Often, PIG is diagnosed in the lung biopsy in a short time after birth (usually < 6 months). Most cases of PIG in infants are symptomatic within the first days to weeks of life. PIG expresses itself with diverse clinical symptoms such as tachypnea and hypoxia and may lead to acute respiratory failure in neonates.

In this case report study, we presented a 1.5-year-old boy with the chief complaint of stage 4 clubbing in fingers and toes. Mild chest deformity was observed in his physical exam. No evidence of respiratory and cardiac complications was observed. Initial lab tests and further specific studies were normal. His parents did not mention the history of any diseases in this patient. His chest X-ray (CXR) showed hyperinflated lungs, diffuse bilateral interstitial infiltration, and hazy opacities. Ground glass opacities (GGO) and interlobular septal thickening and cystic changes with reversed halo sign in both lungs were observed in his chest computerized tomography (CT). Finally, pulmonary biopsy showed a high level of glycogen-laden mesenchymal cells in the interstitium of alveoli, and vimentin-positive interstitial infiltration in lung parenchyma confirmed the PIG diagnosis.

The new manifestation of PIG, which has been reported in this case, can be beneficial for future diagnoses of PIG.

In 1994, the mandatory iodized salt consumption became a law in Iran, and since then, almost all people have routinely and effectively received iodine. This study aimed to compare the iodine sufficiency among Iranian students in 1996 and 2017. We used Iran’s health ministry national data on urinary iodine among 8- to 10-year-old students. A total 13,389 and 2,917 urine samples were examined for monitoring in 2017 and 1996, respectively. The median urinary iodine (MUI) excretion of samples was 18.26 µg/dL in 2017 and 20.5 µg/dL in 1996. Based on the urinary iodine index (< 10 μg/dL), 14.53% and 19.61% of students had iodine deficiency (ID) in 1996 and 2017, respectively, which mild, moderate, and severe insufficiency was 8.83%, 2.3%, and 3.43% in 1996 and 14.86%, 3.72% and 1.01% in 2017. So, the main achievement of this national program was the reduction in severe ID rate during these years (3.43% vs. 1.01%).

Early-onset neonatal sepsis (EOS) is a systemic infection that occurs within the first week of life.

This study investigated the association of serum vitamin D levels in pregnant women and their neonates with the prevalence of EOS.

This case-control study was performed among 50 term/late pre-term neonates admitted to our NICU due to EOS, alongside 50 healthy neonates matched for gestational age range and sex. Maternal and neonatal serum vitamin D levels were measured. The criteria for diagnosing EOS included any/combination of: respiratory, cardiovascular, hemodynamic, neurological, gastrointestinal, body temperature, or metabolic signs. For sepsis cases, CBC, CRP, blood type, blood culture, chest X ray, and in some cases, and CSF analysis and culture were tested. Mothers’ clinical history was collected.

Each group included 30 (60%) male and 20 (40%) female neonates. Birth weight averages were 2772 ± 667 and 3215 ± 349 grams in the case and control groups, respectively (P < 0.001). The mean serum vitamin D levels were 49.75 ± 25.53 and 56.41 ± 18.17 nmol/L in the case and control groups, respectively. The control group mothers had a significantly higher vitamin D level (68.24 nmol/L versus 55.01 in mothers of sepsis cases, p=0.005) and showed a correlation with the vitamin D levels of their neonates (R = 0.731, P < 0.001), while the data failed to show a correlation between vitamin D level in mothers and their neonates in the sepsis group (R = 0.241, P = 0.115). C-section delivery was more prevalent among the sepsis cases (P < 0.001).

Early-onset neonatal sepsis is associated with vitamin D deficiency in neonates and their mothers, low birth weight, and being delivered by C-section.

The bowel management program (BMP) promotes independence and self-sufficiency in children, helping them to integrate into the community. It also enhances their sense of well-being and provides them with a high-quality life.

This study aimed to determine the effect of BMP on quality of life (QOL) in children with fecal incontinence in Mofid Children’s Hospital in Tehran, Iran from 1 February, 2019 to 1 February, 2020.

The target population of this clinical trial was all individuals with an age range of 4 - 18 years referred to the gastrointestinal and surgical clinic of Mofid Children’s Hospital due to fecal incontinence. A total of 100 subjects with fecal incontinence participated in the study and were randomly divided into two groups of intervention and control. To collect data, two questionnaires, including the Demographic Characteristics Questionnaire and the Quality of Life in Children Questionnaire were used.

There was a significant difference between the two groups after the intervention (P < 0.05), indicating that the bowel management training program improved the QOL in children. The results also showed a significant increase in all the related aspects in the intervention group, with the highest increase observed in social (P < 0.001) and physical (P < 0.001) aspects. However, in the control group, the increase was meaningful only in the emotional sense (P = 0.002). Accordingly, the scores in the emotional aspect decreased notably after one month.

The BMP is an effective way for treating fecal incontinence and improving the QOL in children. Hence, this program is highly recommended to be carried out in comprehensive gastrointestinal centers.

The usual intake of fish products is not common in Iranian mothers.

Regarding the significant effect of this nutrient material on neonatal outcomes, we aimed to evaluate the breast milk docosahexaenoic acid (DHA) level in mothers with preterm delivery.

This cross-sectional study was done in 67 mothers with gestational age lower than 36 weeks during 2018 - 2019. Breast milk samples of 5 - 10 milliliters were evaluated by gas chromatography for DHA level. Then, the correlation between the breast milk DHA levels and neonatal outcomes was assessed.

A total of 67 mothers were eligible in the study. The mean gestational age and birth weights were 31.54 ± 4.44 weeks and 1707.85 ± 595.83 g, respectively. The mean DHA, as a percentage of total breast milk fatty acids, was 0.29 ± 0.0127%. Statistical analysis showed no significant relationship between the breast milk DHA level and gestational age, birth weight, maternal age, delivery mode, neonatal growth index, and neonatal complications. The relationship between the intake of food materials rich in DHA and breast milk level was not statistically significant.

We concluded that the breast milk DHA level of mothers with preterm delivery was acceptable, although it revealed no significant correlation with maternal factors and neonatal outcomes.

This study aims to determine the effects of vitamin D administration throughout pregnancy on the level of vitamin D in cord blood, neonatal anthropometric measurements, and Apgar score.

This study was designed as a retrospective analytic study. The intervention group comprised 40 pregnant women who were prescribed vitamin D supplementation during their pregnancy, according to the recommendations of the Turkish Ministry of Health General Directorate of Mother and Child Health and Family Planning (MCHFP) and their infants, while the control group comprised 40 pregnant women without vitamin D supplementation and their infants. After exclusion criteria were applied, a total of 60 pregnant women and their babies (28 with supplementation, 32 without) were included in the final analyses.

Final analyses were conducted on 28 pregnant women and their infants as the intervention group and 32 pregnant women and their infants as the control group. The cord blood vitamin D values of the intervention group were significantly higher compared to controls (X2 = 25.71, P = 0.000). Vitamin D use throughout the pregnancy was observed to significantly increase vitamin D levels in the cord blood compared to those without supplementation. Vitamin D levels were categorized as normal in the cord blood of 53.6% of the pregnant women using vitamin D and 3.1% of the pregnant women not using vitamin D. However, there was no difference between the two groups in terms of neonatal anthropometric measurements and Apgar scores.

Although cord blood 25(OH) vitamin D levels were significantly higher in the intervention group, there was no difference in neonatal outcomes. The fact that cord blood vitamin D levels were lower than 30 ng/mL in all samples suggests that the adequacy of the vitamin D supplementation recommended by TR Ministry of Health MCHFP during pregnancy should be discussed.

Coarctation of the aorta (CoA) is a congenital heart defect. Due to the narrowing of the descending aorta, blood flow mainly reduces after the stenosis, and CoA can occur at any region in the thoracic and abdominal aorta. Cardiac surgeons and cardiologists are familiar with postoperative complications of CoA; however, there are also some other complications that have not been reported to date.

The present study investigated three cases of CoA undergoing reconstructive surgery. Nevertheless, a couple of days after the surgery, they manifested symptoms suspected of cerebral infarction. Ischemic infarction was observed after performing brain computed tomography. Additionally, we discuss possible pathophysiology and reasons that can lead to this problem.

In this case report, we presented three cases of CoA patients who underwent reconstructive surgery and manifested cerebral infarction as an adverse effect of the reconstructive surgery