Journal of Comprehensive Pediatrics
Volume:13 Issue: 2, May 2022

The provision of facilities to achieve better living conditions for patients with cystic fibrosis (CF) is of particular importance. Smoking is one of the known factors that aggravate CF. However, the effects of exposure to secondhand smoke (consumed by parents) if not consumed by the individual him/herself are not very evident.

This study aimed to evaluate the quality of life in patients with CF based on a history of smoking in parents.

This cross-sectional analytical study was conducted on 100 patients with CF referred to the National Research Institute of Tuberculosis and Lung Diseases in Tehran, Iran, who were admitted in 2019 - 2021, using convenience sampling. After measuring height and weight, body mass index (BMI) was calculated, and the relationship between these factors (including a family history of smoking, pulmonary function tests, and BMI) with the quality of life of these patients was assessed. The data collection tool was a questionnaire. Data analysis was performed using SPSS software (version 20). The independent t-test and Pearson correlation test were used in this study, with a significance level of 0.05.

There was no statistically significant difference in the quality of life of the patients in the two groups whose parents were smokers and nonsmokers; however, physical and social functions and disease severity were lower in the smoking family group than in the other group (P > 0.05). In this study, there was no significant relationship between the quality of life of patients with CF in physical, emotional, and social functions and disease severity with a family history of smoking (P > 0.05); nevertheless, the quality of life was lower in patients whose fathers were smokers. In the present study, there was no significant relationship between patients’ quality of life in the smoking family group with the number of daily consumption of tobacco (cigarettes) in those around and the duration of family smoking (year).

The findings of this study showed that smoking reduces the quality of life of patients with CF. Therefore, the need for the attention of parents and relatives of patients with CF to increase patients’ quality of life is seriously felt. There was no statistically significant relationship between smoking in patients with CF and reduced quality of life in this study; however, it is suggested to perform this study on a larger sample and in different cities in patients with CF and compare the results.

Depending on the level of care and the availability of pediatric intensive care unit (PICU) facilities, the mortality rate of acutely ill children varies in PICUs. Referral of patients from other medical centers, admission during working or off-work hours, and nosocomial infections are the most important risk factors for the high mortality rates in PICUs.

The present study aimed to investigate the characteristics and factors related to the risk of mortality in pediatric patients admitted to the PICU of a pediatric hospital in Qazvin, Iran.

This cross-sectional study was performed on children admitted to the PICU of a pediatric hospital in Qazvin, Iran, between June 2017 and June 2020. During this period, a total of 1504 children, aged one month to 13 years, were admitted to the PICU, and 106 cases expired. The patients’ clinical data (ie, demographic characteristics, underlying disease, cause of death, and length of hospital stay) was extracted from their medical records. A prolonged length of stay was defined as more than 28 days of PICU admission.

A total of 106 children, with a mean age of 3.89 ± 3.23 years, expired during the study, with 41 (38.7%) cases being male. Among the investigated cases, 61 (57%) were < 2 years, 18 (17%) were 2 - 5 years old, and 27 (26%) were≥ 6 years. In these patients, sepsis (13/82, 15.85%) and pneumonia (10/82, 12.19%) were the main causes of death. Other mortalities (14/106) were due to infectious diseases (gastroenteritis, influenza, and coronavirus disease) and non-infectious diseases (aspiration, anaphylaxis, and electrocution). The majority of children with a prolonged length of stay were < 2 years (17/23, 74%). The length of PICU stay was shorter in children with a lower weight percentile (P = 0.016).

Following infectious diseases, congenital abnormalities and genetic disorders were the most common causes of pediatric mortality. Chronically ill children were more likely to be underweight and develop nutritional disorders, leading to the deterioration of their condition.

Choking is one of the most common types of unintentional injury that results in the death of children aged under 14 years.

This study aimed to assess the effect of providing mothers with video education on their awareness of choking hazards as well as methods of administering first aid to children aged between 6 months to 8 years.

In this quasi-experimental study conducted from October to April 2021 in Dezful city of Iran, 110 mothers were divided into intervention and control groups by adopting convenience sampling method. The education program was run by offering two video presentations. Participants in both groups were asked to complete two questionnaires in order to evaluate their knowledge about first aid for choking children before and 30 days after the intervention. Data were analyzed based on frequency and Wilcoxon test using SPSS 16 software.

Mothers were found to have a very limited knowledge about the issues, including the right age for beginning chewing and smashing solid food in children, the most common food resulting in choking, and the best way to assess the risk of an object leading to choking of a child under the age of four. Furthermore, 10.9% of the mothers in the intervention group, as well as 12.7% of them in the control group were discovered to adopt Heimlich maneuver when facing the choking accident. The given percentages reached 67.3% and 16.4% in the intervention and control groups, respectively, after providing the mothers with proper training. Only 16.4% of mothers in the intervention group and 18.2% of them in the control group demonstrated the required knowledge of opening the airway in infants before the intervention. After offering the video education, however, this knowledge was increased by 68.5% and 20% in the intervention group and control group, respectively. Their knowledge of the risk factors for choking in control group (P = 0.000) and intervention group (P = 0.001) was significant before and after offering the video education; regarding the methods of administering first aid for choking children, however, the result was significant only in the intervention group (P = 0.000).

Educating mothers may have improved their knowledge about the risk factors as well as the methods of dealing with choking children.

Acute diarrhea in children with an annual prevalence of about 2 billion episodes accounts for 1.9 million deaths in developing countries. According to the World Health Organization (WHO), only 35% of children with diarrhea receive proper treatment for dehydration; hence, the detection of appropriate interventions enables us to prevent mortality and decrease the morbidity rate.

This prospective randomized clinical trial was conducted from September 2018 to May 2019 in the Pediatric Gastroenterology Ward at the Mofid Children’s Hospital, where 95 children were hospitalized with non-exudative acute gastroenteritis and moderate to severe dehydration. Among these patients, 53 children were administered intravenous (IV) fluid therapy and oral rehydration solution (ORS), and 42 children received IV rehydration and ORS plus Racecadotril (ORS+R). Daily bowel movements and their consistency were recorded at admission, 24 hours, and 48 hours after hospitalization. All data were analyzed by SPSS software version 25.

There was no statistically meaningful difference between the intervention and control groups in terms of age, gender, and weight. According to the statistical analysis, the dehydration severity was same in both groups, and no difference was revealed between the two groups regarding fever and vomiting. All laboratory findings were similar in both groups at the time of admission. Although the average duration of diarrhea was shorter in the racecadotril group than in the control group, there was no statistically significant difference between the two groups. The results indicated a rapid decline in the number of bowel movements by the first and second days after beginning of the treatment in both groups; however, no statistically meaningful difference was noticed. The present results indicated no significant difference between the two groups regarding the recovery rate in the first 24 hours of treatment. Moreover, although the recovery rate of children treated for 48 hours was faster in the racecadotril+ORS group than in the oral rehydration group, no significant difference was revealed.

There was no meaningful relationship between the administration of racecadotril with the duration of diarrhea, the frequency of diarrhea, and the recovery rate in the first and second days after treatment. However, in 24 and 48 hours after treatment, there were a decrease in the number of watery stools and an increase in solid stools; hence, further studies with larger sample sizes and more accurate measurements determining factors affecting acute diarrhea and differentiating different types of diarrhea are recommended to further illustrate the role of racecadotril on the treatment of diarrhea in children

Functional constipation as a common disorder in children, may be induce by psychiatric disorders. The present study aimed to evaluate and compared anxiety disorders in children with and without functional constipation.

This case-control study was conducted on 200 children (100 cases with functional constipation and 100 children without functional constipation) aged 15 - 8 years. The participants’ age and gender were evaluated and compared in two groups. Moreover, the Spence Children Anxiety Scale (SCAS) (parent form) for children was completed. Finally, the collected data were analyzed using SPSS software version 24.

Of 200 evaluated cases in the case and control groups, there were 46 (46.0%) and 59 (59.0%) males, respectively (P = 0.113). The mean ± SD of age in total, the case, and the control groups were 7.51 ± 1.91, 7.61 ± 0.91, and 7.41 ± 2.49 years, respectively (P = 0.585). Furthermore, SCAS in the case group was significantly higher (33.06 ± 14.4 vs. 24.8 ± 14.9, P = 0.001). Furthermore, the mean of separation anxiety disorder (P = 0.001), generalized anxiety (P = 0.003), and obsessive-compulsive disorder (OCD) were significantly higher in the functional constipation group (P = 0.001).

Anxiety was higher in children with functional constipation than in children without functional constipation (ie, control group), among which separation anxiety, generalised anxiety, and OCD were significantly different in the two groups

Scimitar syndrome is a rare congenital condition that is usually presented in two major types, the infantile type as a severe condition with a poor outcome (median age: 2 months) and the adult type with a better condition and good outcome. It also has a wide spectrum of clinical presentations, from being asymptomatic in the adult type to cardiac and respiratory failure and pulmonary hypertension in the infantile type.

In this case report, we present a 43-day-old female case referred to Taleghani Children Hospital, Gorgan, Iran, with respiratory symptoms. In a physical examination, the case had a grade II/VI murmur, dextrocardia, and respiratory distress. In evaluations, the patient had severe stenosis proximal to the left common carotid artery after its origin. The heart and mediastinum were displaced to the right side, and the thoracic aorta was normal in size and orientation. bovine type of supra-aortic arch branches in the left-sided aortic arch, hypoplasia of the right upper lobe with severe hypoplasia of the right lower lobe were seen as well. There was sequestration adjacent to the right lower lobe with a dual feeder artery directly from the abdominal aorta and celiac branch and dual draining veins. Partial anomalous pulmonary venous connection was detected in the neck, and mediastinal computed tomography (CT) angiography with reconstructed views.. Bronchoscopy revealed right main bronchus hypoplasia and right lower lobe hypoplasia. Then, with the help of angiography, scimitar syndrome diagnosis was confirmed for the patient.

Although scimitar syndrome is an uncommon condition, it has serious complications and poor outcomes in some patients. It is necessary to be aware of this rare congenital condition and use helpful methods, such as CT angiography and angiography, to confirm the diagnosis.

Lowe syndrome (LS) is a very uncommon syndrome that causes the death of young patients due to kidney diseases. This narrative review aimed to assess the clinical manifestations of LS, mainly the novel investigations of LS, to provide an update on the clinical manifestations improving the misdiagnosis of LS.

For this narrative review, the articles from several sources, including Scopus, Google Scholar, Embase, Web of Science, PubMed, and the Directory of Open Access Journals, were used.

This syndrome is heredity and a multiple system disorder with the three main symptoms of renal tubular dysfunction, mental retardation, and cataracts. Other features include growth retardation, behavioral problems, stereotypical behavior, areflexia, severe muscular hypotonia, intellectual disability, nontender joint swelling, subcutaneous nodules, potassium loss, sodium loss, renal dysfunction, aminoaciduria, bicarbonaturia, and low-molecular-weight proteinuria. An X-linked recessive pattern inherits this syndrome. The hereditary transmission of this syndrome is X-linked recessive.

It is essential to investigate the diverse clinical manifestations of LS. The prognosis and severity of the disease have not yet been determined. It is recommended to perform extensive general studies on the prevalence, diagnosis, and management of this syndrome.

Nonalcoholic fatty liver disease (NAFLD) is the most frequent form of liver disease in children, defined as the infiltration of fat into more than 5% of liver cells with metabolic syndrome consisting of dyslipidemia, insulin resistance, and obesity.

This study aimed to assay the effect of metformin or vitamin E on ultrasonographic grade and biochemical findings of children and adolescents with NAFLD.

This clinical trial was performed on 150 non-diabetic obese children with NAFLD in the age range of 10 to 14 in Qazvin, Iran, during 2018 - 2019. The participants were randomly assigned to three groups: Group 1 was treated with metformin at a dose of 500 mg twice daily for three months; group 2 received vitamin E at a dose of 400 units twice daily; and group 3 received a placebo. In addition, all the three groups were given the same proper diet and advised to increase their physical activity. SPSS software version 23 was used to analyze the data.

After the intervention, in groups receiving metformin and vitamin E, the grades of fatty liver decreased significantly (P < 0.05), and the decrease was more significant in the group receiving metformin.

Insulin resistance is one of the critical factors in the development of nonalcoholic fatty liver disease. By reducing insulin resistance with drug treatment, desirable results can be achieved.