Journal of Comprehensive Pediatrics
Volume:13 Issue: 3, Aug 2022

Trichorhinophalangeal syndrome (TRPS) is a sporadic autosomal dominant disorder with approximately 200 reported cases worldwide. We aimed to report a 15-year-old girl with TRPS type 1 (TRPS1) and the second reported case with a rare non-ossifying fibroma (NOF) in the distal part of her left femur.

We introduce a 15-year-old girl who presented to the outpatient rheumatology clinic at 17 Shahrivar Children's Hospital, Rasht, Iran, with the chief complaint of osteoarticular pain and bone deformities. She had sparse hair, a recession of the fronto-temporal hairline, and unusually thick eyebrows at the medial and abnormal sparseness of the lateral margins. Physical examination of the limbs revealed short fingers and toes with proximal interphalangeal (PIP) ulnar deviation of the second and third fingers in both hands. Shortness of the fourth fingers, especially in the right hand, and the swelling of the PIP joints of both hands were prominent. Genetic analysis showed deletion mutation in the TRPS1 gene in chromosome 8q24 compatible with TRPS1.

Several symptoms and signs, including distinctive craniofacial features and ectodermal and skeletal abnormalities, are used for proper TRPS diagnosis. A correct and on-time diagnosis is essential to perform supportive care for the patient to prevent morbidities. Bone lesions, such as NOF1, can also be presented in TRPS1 patients and may be correlated with TRPS1 mutation. Further investigations are required on the association of the TRPS gene with NOF bone lesions.

The penile aged-matched value should be determined to define abnormal penile length.

The purpose of this study was to establish novel reference values and flaccid penis length cut-off points for prepubertal children aged 6 - 15 years.

In this study, 300 micropenis children were studied. In order to assess the diagnostic test power, 300 healthy boys were also evaluated as a control group. All children were divided into ten age groups (60 boys in each group). In order to obtain a non-stretched penile length (NSPL) cut-off point, stretched penile length (SPL) and NSPL mean values were separately calculated for each age group. We subtracted these two values to get the mean difference, which was subtracted from the standard SPL cut-off point to obtain the NSPL cut-off point for each age group. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were defined to assess diagnostic test power.

NSPL cut-off point for the age groups of 6 - 7, 7 - 8, 8 - 9, 9 - 10, 10 - 11, 11 - 12, 12 - 13, 13 - 14, 14 - 15, and 15 - 16 years was 2.8, 2.9, 2.9, 3.8, 3.9, 4.4, 4.2, 4.8, 6.6, and 8.1 cm, respectively. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of NSPL were 100% (95% CI, 98.53 - 100.00), 94.66% (95% CI, 89.77 - 96.28), 7.25% (95% CI, 4.64 - 11.16), 100%, and 97.33% (95% CI, 91.09 - 99.59), respectively. The AUC was 0.82, showing that the diagnostic power of the test was good.

This study aimed to attain precise reference values of flaccid penis measurement for children. It seemed that the flaccid method is less observer-dependent, more tolerable, and repeatable. It should be mentioned that this new method does not replace the standard SPL method, while utilizing two reference values together can help to detect the size of the penis more accurately, especially in children. The new cut-off point can be used by all primary care practitioners and pediatric nurses as a reference for prepubertal boys to prevent misdiagnosis or overdiagnosis of micropenis.

Childhood overweight and obesity are public health concerns. It is essential to examine the prevalence of overweight and obesity for effective planning and efficient use of resources in the health system.

The present study’s objective was to investigate the prevalence of overweight and obesity in children aged 8 to 12 years in Tehran, Iran.

In this cross-sectional study, 829 primary school children in Tehran were included. An investigator administered a checklist to collect the relevant data, and anthropometric measurements were performed using standard procedures. We used the World Health Organization’s (WHO) child growth standards to assess overweight and obesity among children. The Chi-square test was used to analyze categorical variables, and statistical significance was confirmed at P < 0.05.

Of the students, 366 (44.1%) were boys, and 463 (55.9%) were girls. The prevalence of overweight and obesity were 20.6% and 14.6%, respectively. The prevalence of obesity was higher among boys than among girls (19.4% vs. 10.8%); the highest prevalence of obesity was observed among 9-year-old children. No relationship was identified between the type of school and the prevalence of obesity (P = 0.33).

Childhood overweight and obesity were relatively prevalent among 8 - 12-year-old children. So, obesity should be considered a serious health problem in Tehran, requiring more care and interventions to prevent an epidemic of obesity among Iranian children.

Breastfeeding benefits both mother and newborn and plays a significant role in controlling chronic diseases. Fathers' breastfeeding attitude and paternal breastfeeding self-efficacy, which means that their ability to help their partner breastfeed the newborn, appear to be among the factors that affect women’s breastfeeding.

This correlational descriptive study investigates paternal breastfeeding self-efficacy and its relationship with Infant and young child feeding practice three months postpartum.

This study was performed in 2019 on 206 fathers. Fathers waited for the mother and baby outside the postpartum ward and filled out the paternal breastfeeding self-efficacy scale and demographic information questionnaire in the hospital. Three months after delivery, mothers were called and asked about Infant and young child feeding practices. The SPSS software version 23 was used for statistical analysis by the Spearman’s test, independent t-test, Pearson’s correlation coefficient, chi-squared test, and analysis of variance.

In the present study, 5.8% of Iranian children used formula feeding at three months of age, 74.3% were exclusively breastfed, and 19.9% received both formula feeding and breast milk. Fathers who participated in antenatal classes had a higher paternal breastfeeding self-efficacy score than the others (P = 0.003). The results showed a significant relationship between paternal cooperation in prenatal care and paternal breastfeeding self-efficacy score (P = 0.001). No correlation was found between paternal breastfeeding self-efficacy scores and infant feeding practices three months after delivery (P = 0.99).

Fathers' attendance in antenatal classes and paternal cooperation in prenatal care can increase paternal breastfeeding self-efficacy.

In this study, we aimed to evaluate the accuracy of echocardiography compared to plain radiography in determining the appropriate line tip position of peripherally-inserted central catheters (PICC). Also, we aimed to evaluate the relationship between independent predictors (chronological age, birth weight, gestational age, and gender) and related complications with PICC line tip position.

In this prospective observational study, which was performed in the neonatal intensive care units of teaching hospitals affiliated with Iran University of Medical Sciences in 2019, 50 out of 96 neonates were non-randomly selected based on inclusion criteria. The radiographic and echocardiographic tests were simultaneously performed, and the data were analyzed.

The findings of this study showed that there was an agreement between radiography and echocardiography in determining the PICC line tip position in 43 neonates (86%). The sensitivity and specificity of echocardiography in determining the ectopic position of the catheter were 81% and 77%, respectively. In 32 neonates (64%), a second radiograph prevented the following line manipulation using echocardiography. In addition, there was no significant relationship between independent predictors (chronological age, birth weight, gestational age, and gender) and PICC line complications.

The results of the present study showed that echocardiography was a useful tool for determining the position of the catheter’s tip in LBW neonates. It also minimizes radiation exposure on subsequent radiographs and obviates the need for additional radiographs following catheter manipulation by echocardiography.

Distinguishing between seizure and neurally mediated syncope is challenging because of similar consequences and medical history. A head-up tilt test (HUTT) is a non-invasive, simple, and easy test to distinguish between epilepsy and syncope besides detailed history taking.

This study aimed to differentiate between epileptic events and reflex syncope (any different type of syncope) using the head-upright tilt test.

We studied 59 patients (37 boys and 22 girls) between 4 to 18 years old (mean age, 10.5±3.7 years) with a previous diagnosis of seizure who did not respond well to treatment. All patients underwent HUTT, and the test was positive in 26 patients. There were no significant differences in sex, age, provocative factors, associated syndrome, and family history between negative and positive groups.

There was a history of actual syncope in 26.9% of the positive tilt test group compared to 15.15% of the negative test group. Also, there was a positive family history of syncope in the positive tilt test group. Among 26 patients with a positive tilt test, 17 were diagnosed with vasovagal syncope (VVS) vasodepressor type and 9 with mixed type. Antiepileptic drugs were tapered for patients diagnosed with VVS, and they did not show any seizures after 18 ± 6 months of follow-up. Overemphasizing positive family history and inattention to history taking are 2 crucial factors leading to the misdiagnosis of epilepsy.

Our study showed that HUTT is a non-invasive test that can be useful, especially for early and proper diagnosis in children with refractory epilepsy.

Fecal incontinence (FI) is a stressful condition for children and their parents that may affect the patient’s psychological well-being. Evaluating the patients’ psychological status may help physicians manage the disease effectively.

This study aimed to assess the emotional and behavioral disturbances in children with FI who were referred to the pediatric gastroenterology clinic in Mofid Children’s Hospital from April 2021 to 2022.

This cross-sectional study included children (over four years old) with chronic constipation and fecal incontinence. The diagnosis of chronic constipation and FI were made according to Rome-IV criteria. The Child Behavior Checklist (CBCL) evaluated patients’ emotional, behavioral, and social problems.

One hundred one patients with a mean age of 7.96 years were enrolled in the study; 67.32% were males. According to CBCL, 12% (12 patients) indicated emotional and behavioral problems, with CBCL scores in the clinical or at-risk range. We detected anxious/depressed problems in five (4.95%), withdrawn/depressed problems in eight (7.92%), somatic complaints in seven (6.93%), social problems in eight (7.92%), thought problems in nine (8.91%), attention problems in seven (6.93%), rule-breaking behavior in two (1.98%), and aggressive behavior in nine (8.91%) patients. The risk of internalizing and externalizing disorders was reported in four (3.96%) and five (4.95%) patients. Also, eight (7.92%) and seven (6.93%) patients had clinical symptoms of internalizing and externalizing disorders, respectively. There was no significant relationship between patients’ age and gender with the CBCL scores in any subscales. However, there was a significant difference in the total score among the age groups (P = 0.04).

The relatively high prevalence of emotional, behavioral, and social problems in our study corroborates the importance of psychological screening of children with FI during the treatment process.

The number of reports of the extrapulmonary manifestations of the coronavirus disease 2019 (COVID-19) is increasing in the literature. The neurological manifestations of COVID-19 in pediatric patients, however, are not well studied. Acute transverse myelitis is among the neurological manifestations usually reported with viral infections. However, the development of transverse myelitis in pediatric patients following COVID-19 is extremely rare. We report a case of acute transverse myelitis in a previously healthy 11 years old female patient with COVID-19 who was asymptomatic before the onset of weakness.