Caspian Journal of Pediatrics
Volume:8 Issue: 1, Mar 2022

Chronic Kidney Disease-Mineral Bone Disorder (CKD-MBD) is characterized by hypocalcemia, hyperphosphatemia and abnormal vitamin D (VD) metabolism resulting in high parathyroid hormone secretion. The objective of the study was to determine VD status in children with CKD-MBD and the effect of cholecalciferol therapy in these children.

This quasi-experimental study was conducted at the Department of Pediatrics, National Institute of Child Health, (NICH), Karachi, during 2016-2017. The sample size was 81. VD deficient and insufficient patients were supplemented with oral cholecalciferol and response was assessed by vitamin D (25-OHD), serum calcium, phosphorus and parathyroid hormone (PTH) levels after 3 months.

Fifty (61.70%) were males and 31(38.30%) females. The mean age was 8.06±4.01 years with a majority (70.37%) above 5 years. The mean height was 125.85±25.38 centimeters. The mean disease duration was 2.37±1.38 years. The majority of patients had CKD stage III (56.80%), followed by stage IV (24.7%) and stage II (18.5%). Most patients were insufficient (85.2%) and others were deficient (14.8%) in VD status. The mean serum 25-OHD, PTH, Calcium and Phosphorus levels before therapy and after supplementation were 16.98±4.24 ng/ml and 39.34±9.08 ng/ml, 105.11±26.40 pg/ml and 90.82±24.92 pg/ml, 8.92±0.77 mg/dl and 9.32±0.76 mg/dl, 3.61±0.37 mg/dl and 4.07±0.38 mg/dl, respectively. The P-value was <0.05.

VD supplementation has increased serum calcium and serum 25-OHD levels and suppressed phosphate and PTH levels, which may halt the MBD and thereby improve the outcome of CKD. Therefore, early supplementation with cholecalciferol therapy is recommended for all children with CKD.

Social class, hygiene, and feeding behavior determine the status of nutrition in children during the first 1000 days of life. This study aimed to evaluate the association of the above factors with the need for admission to nutrition rehabilitation.

This prospective study was conducted in the Nutritional Rehabilitation Centre (NRC) of a secondary care center from April 2019 to March 2020. Convenience sampling was applied for the selection of study participants. Information about all the children suffering from severe acute malnutrition (SAM) was collected and documented, such as age, gender, social class, hand washing habits, breastfeeding, age of starting complementary feeding, anthropometry, and medical complications.

During the study period, 398 children with SAM were admitted to NRC. Moreover, 71.86% (n=286) of children were from 7 to 24 months and 88.43% (n= 352) of the children belonged to the families with upper/lower and lower socioeconomic status. Poor hand washing habits were seen in 36.18% (n=144) of families. The mean weight gain per child during a hospital stay was 8.3 gm/kg/day.

Inadequate complementary feeding practices and poor hygiene are the most common preventable causes leading to malnutrition and the majority of admissions to the NRC occurring before the age of two years.

This study aimed to estimate the prevalence of very low birth weight (VLBW) as well as to identify various maternal factors associated with VLBW among newborns delivered at a tertiary care teaching institute.

A hospital-based retrospective case-control study was done at the neonatal intensive care unit of GITAM Institute of medical sciences and research, Visakhapatnam from January 2019 to December 2021. Data were collected from a total of 250 mothers who delivered babies weighing <1.5 kilograms as cases, and age-matched 250 mothers who had babies weighing >2.5 kilograms as controls. Multiple factors that influenced VLBW were analyzed. These factors were maternal, neonatal and delivery factors.

The prevalence of VLBW babies was 2.5%. VLBW was high in babies of mothers from lower to lower-middle-class (68%), babies born to mothers with parity 4 or more (39.6%), anemic mothers (P<0.0001), preterm babies (62%) (P<0.0001), born through cesarean delivery (65.6%). Also, VLBW proportion was lower among babies born to mothers who took folic acid (IFA) tablets compared to others, (P<0.0001).

Several factors like illiteracy status of mothers, number of living children, increased parity, inadequate consumption of IFA tablets, anemia during pregnancy were found to be associated with low consumption of eggs, milk and fruits as well as less weight gain during pregnancy. Most of these factors are modifiable and can be managed easily by providing adequate antenatal care.

The level of fasting blood sugar (FBS) must be regularly monitored in diabetic patients. As unlike blood, saliva sampling is a noninvasive technique, saliva glucose was evaluated in controlled and uncontrolled type 1 diabetes mellitus (T1DM) children in this study.

In this cross-sectional study, 40 uncontrolled T1DM and 40 controlled T1DM children were enrolled. The FBS and stimulated and unstimulated saliva glucose were assayed by the GOD-POP method and analyzed by unpaired Student’s t-test.

Serum and stimulated saliva glucose levels were higher in the uncontrolled T1DM than that in the controlled T1DM. However, there was no significant difference in unstimulated saliva between the two groups. Serum glucose had a positive correlation with unstimulated (r=0.403; p<0.001) and stimulated (r=0.232; p=0.005) salivary glucose levels. The stimulated and unstimulated salivary flow rate was significantly lower in uncontrolled T1DM.

Stimulated salivary glucose level similar to serum was higher in uncontrolled T1DM than controlled T1DM children. Therefore, it may be helpful to monitor T1DM patients.

Beta-thalassemia is an autosomal recessive hemoglobinopathy that is thought to be the most common genetic mutation. Complications of iron overload and treatment processes are the most common cause of pain in these patients. Children with chronic diseases like thalassemia deal with a lot of pain during the diagnosis process, treatment and management of their disease. The aim of the present study was to evaluate pain in patients with thalassemia major.

The present descriptive-analytical study was performed on 211 patients with beta-thalassemia major, referred to Ali Asghar Clinic in Zahedan in 2017. A brief pain inventory (BPI) questionnaire was used to collect patients’ information analyzed using Chi-square t-test and Pearson correlation coefficient.

The mean pain intensity was 1.72±2.60 and 2.15±3.33 in patients ≤15 years and >15 years, respectively (p=0.011). The mean pain intensity was 2.37±1.49 and 3.52±2.33 in patients receiving oral and injectable iron chelators, respectively (p=0.004). However, no significant relationship was found between pain intensity with gender and presence of cardiomyopathy.

Since the mean pain intensity is associated with increasing age and type of iron depletion, it is recommended that at the beginning of diagnosis the necessary training on proper disease control and periodic examinations for timely diagnosis and treatment of complications of the disease.

Intraventricular hemorrhage (IVH) is an important cause of death and lifelong neurological complications in premature and very low birth weight infants. The aim of this study was to assess the frequency of IVH and its severity in infants admitted to a referral center for high-risk pregnancies and their short-term outcomes.

This retrospective cross-sectional study was conducted in an academic hospital for high-risk pregnancies over the period between Jan 2011 and Mar 2018. All premature (<34wk) and very low birth weight (<1500gr) infants diagnosed with IVH through brain ultrasound were included in the study. All infants’ information such as gestational age, birth weight, grade of IVH (I-IV) and outcome at the time of discharge was recorded and then analyzed.

Out of 2563 eligible infants admitted to the intensive care unit, 138 neonates (5.38%) were diagnosed with IVH. The mean gestational age and the birth weights were 29.97± 2.89 weeks and 1084± 327.71 grams, respectively. Male to female ratio was 2.53 to 1. The frequencies of IVH grades included: 106 (76.81%) with grade I, 23 (16.67%) with grade II, 7 (5.07%) with grade III, and 2 (1.45%) with grade IV. Four cases (2.9%) underwent ventriculoperitoneal shunt and three of them died.

In this study, the frequency of IVH was higher compared to that of developed countries; however, severe IVH (grades three and four) had a relatively low frequency.

Multiple disabilities are associated with attention deficit hyperactivity disorder (ADHD), some with single disabilities, while others involve multiple deficits, while others display no specific impairments. This study aimed to examine how coping skills training affects emotional self-regulation in inclusive children with attention deficit hyperactivity disorder (ADHD).

In this study, a quasi-experimental design was used with pretests, post-tests and a control group. From October to December 2019, all pediatric ADHD patients attended the Armaghan Pediatric Clinic of the Razi psychiatric hospital in district 4 of Tehran, Iran. Totally, 28 of them were chosen for the study using a purposive sampling method. Both groups were randomly divided into two experimental (n=14) and control (n=14) groups. The experimental group received 12 ninety-minute sessions of therapy once a week, while the control group did not receive treatment. The study instruments were a questionnaire on demographic features and the Emotion Regulation Questionnaire (ERQ). For data analysis, SPSS 21 was used to conduct an analysis of covariance (ANCOVA).

Twenty-eight children aged seven to twelve were evaluated for ADHD (mean = 8.13, SD = 1.20) whose diagnoses met diagnostic criteria. The results revealed that coping skills training made significant changes in emotion regulation at the post-test stage (P < 0.001).

The findings of this study demonstrated that coping skills training for children with ADHD resulted in improved emotional self-regulation.

Anxiety is one of the most prevailed childhood disorders. Children's anxiety affects all areas of their communication and even academic performance.  However, it seems that most children's diseases are influenced by parents’ cognitive and behavioral aspects. This study investigated the correlation between parental self-cohesion and parental self-control with children's anxiety.

The method of this research was descriptive-correlational. The statistical population of 16,670 second grade primary school female students in Karaj, of whom 390 parents [Mother] were selected using Cochran's formula using multi-stage cluster sampling in 2021. March et al.’s questionnaire on children's anxiety, Ghorbani et al.’s questionnaire on parental self-control and Tangney et al.’s questionnaire on self-control were used in this study. Data were analyzed using Pearson correlation and stepwise regression.

The results showed that there was a negative correlation between parental self-cohesion and parental self-control with children's anxiety [p<0.001]. Specifically, there was a significant negative correlation between parental self- cohesion (0.25) and parental self-control (0.19) with children's anxiety.

This study indicated that there was a correlation between parental self-cohesion and parental self-control with children's anxiety. The present study emphasizes the role of cognitive and communication factors in the family environment on children's anxiety.

The incidence of patent ductus arteriosus (PDA) has been increased significantly over the last two decades, due to an increase in the survival rate of premature infants. The present case report used an amplatzer ventricular septal defect (VSD) for a large PDA closure.

The present report describes a two-year-old girl with poor weight gain, failure to thrive and recurrent infection, referred to the Rafsanjan Ali Ibn Abi Talib Hospital. But in most examinations, a form of congenital heart disease was diagnosed and treated. The present case had a large PDA whose diameter was equal to the diameter of the aorta. This large PDA was not identified in the previous transthoracic echocardiography which was performed by several cardiologists. It was successfully occluded using the amplatzer muscular VSD closure device.

Amplatzer VSD occluder device because of its wider waist is recommended to close a large PDA.

COVID-19 is a new respiratory infection caused by the Coronavirus, which the World Health Organization (WHO) declared a global pandemic in 2019. The clinical course of the infection in children differs from adults. With a variety of presentations, COVID-19 poses a great diagnostic challenge for physicians. Here, we present a child with COVID-19, who presented with fever and periorbital edema.

A 3-year-old boy came into the hospital with periorbital edema and fever. He had no respiratory and gastrointestinal symptoms, his laboratory tests revealed only hypoalbuminemia and he had no prior history of any other diseases. His nasopharyngeal swab PCR came back positive for Covid-19.

Fever and periorbital edema are rare manifestations of COVID-19 in infected children, further medical research is required to find the cause of this problem. Finding the scientific explanation for this complication can lead to better insight for diagnosis and even reveal possible effective treatments.