Journal of Pediatrics Review
Volume:10 Issue: 2, Apr 2022

The prevalence of childhood obesity has been on an increasing trend in the world during the past decades, with studies in Iran showing different and inconsistent prevalence rates. 

This study was done to determine the prevalence of obesity in children through a meta-analysis approach.

This study was done to determine the prevalence of obesity in children through a meta-analysis approach from January 2000 to January 2021. Articles related to the subject were obtained by searching Scopus, ScienceDirect, SID, Magiran, Barakat Knowledge Network System, Medline (PubMed), and Google Scholar databases. The heterogeneity of the studies was evaluated using the I2 index and the data were analyzed by Comprehensive Meta-analysis software. 

In a study on 2,637,912 individuals aged 2-15 years, the overall prevalence of obesity in Iranian children was 11.4% (95% CI: 9.4-13.7%) based on a meta-analysis. Also, in order to investigate the effects of potential factors (sample size and year of study) on the heterogeneity of obesity prevalence in Iranian children, meta-regression was used. It was reported that the prevalence of obesity in Iranian children decreased and increased with increasing sample size and increasing years of the study, respectively, and both were significantly different from each other (P<0.05).

Considering the high prevalence of obesity in Iranian children, it is necessary for health policymakers to take effective educational measures.

Preterm delivery is one of the main causes of newborn mortality, signifying the inequality of conditions in receiving the necessary prenatal care. 

The present systematic review was conducted to investigate the relationship between preterm delivery and socio-structural determinants of health with an emphasis on occupation, education, and income in Iranian society based on the World Health Organization model.

In this systematic review, all observational articles published from 2000 to November 2021 were examined by searching the international and Persian databases of Scopus, PubMed, Google Scholar, Web of Science, Embase, ProQuest, Cochrane, IranDoc, and SID. Keywords were extracted through the MESH. The articles were searched using English and Persian keywords of occupation, education, income, social and economic status, and preterm delivery and appropriate operators, such as AND, OR, as well as a combination of the search strategy of each database, and all related articles were collected.

In the initial search, 1456 articles were found, and a total number of 17 articles were finally included in the study, of which 12 articles were on occupation, ten articles on education, four studies on income, two studies on socio-economic status, seven studies on occupation, and eight studies on education. All studies on income and socio-economic status had shown a statistically significant relationship between these structural determinants and preterm delivery. 

Preterm delivery is a prevalent problem with critical complications in Iran and there is a significant relationship between structural determinants and preterm delivery. Appropriate interventions, such as life skills training, self-care, and prenatal care can help mitigate pregnancy outcomes.

In recent years, the number of emergencies in hospitals has increased. Hospitals are one of the main assets for successful disaster management. One of the significant challenges in a disaster is the evacuation of training wards. There are anatomical and physiological differences between adults and children that make children more vulnerable to accidents and disasters. Rapid transfer of sick children on a large scale has always been challenging in this respect. 

This study pursued the goal to determine the challenges of emergency evacuation in specialized hospitals for children and neonates.

Searching online databases, such as Google Scholar, PubMed, Scopus, and Web of Science was done from December 1 to December 20, 2021. The keywords used for the search were based on Medical Subject Headings (MESH) and were combined with other keywords, including evacuation, disaster, pediatric, and patient transfer. All English language studies consistent with the study goal (emergency evacuation challenges in specialized hospitals for children and neonatal) were included in this study.

Out of 2,145 studies, the full text of 11 studies was finally reviewed. The measures taken during natural disasters are divided into three levels: local, state, and national. Emergency evacuation challenges are also divided into five categories: communication, training, transportation, equipment and energy, and management.

This study provided essential perspectives for developing appropriate intervention strategies for the managers and policymakers of health care systems to better prepare in case of natural disasters breaking out in children and neonatal wards.

Growth impairment is a common problem in Chronic Kidney Disease (CKD) children. Approximately 40% of children with CKD have a reduced final height. Growth impairment affects school attendance, duration of hospitalization, adult height, and even risk of death. 

Various studies have shown that patients with moderate to severe growth failure have higher mortality rates (three folds) than those with normal growth. This narrative review aimed to define the management of growth in pediatric chronic renal failure.

This study was conducted through a literature search with the keywords of chronic renal failure, kidney transplant, Glomerular Filtration Rate (GFR) combined with growth, short stature, and growth hormone using PubMed, Scopus, Web of Sciences, Cochrane, and Embase databases.

Growth impairment in children with CKD occurs due to diverse etiologies, such as uremia, anemia, metabolic acidosis, etc. It becomes more prominent in GFR<75 ml/min/1.73 m2. Growth hormone (GH) therapy seems to be a safe and effective therapeutic modality consequent to the correction of associated metabolic disturbances.

This study indicated that pretransplant GH therapy in children with CKD and its temporary discontinuation at kidney transplantation up to one year after transplantation leads to improved growth velocity. Therefore, it seems that considering GH therapy in children with CKD is mandatory.

The incidence of autism is increasing day to day and it has increased significantly in the last decade. There have been many studies on the treatment of Autism Spectrum Disorder (ASD) in children. 

The  aim of this study was  to design  a treatment model for  children under  three years of age with  autism disorder  using  comprehensive look at the existing patterns.

eight databases ,inculding Scopus, Science Direct, Medline, Google Scholar, Magiran, SID, Iranmedex, pubmed and Cochran databases were independently searched by two researchers MeSH and relevant  keywords regarding autism and children under 3 years  We included the studies published in different regions of Iran from 2010-2019 .diagnostic, screening and treatment intervention studies with focused on treatment patterns were reviewed. analyses guideline was used to design this study.

A total of 46 articles were collected from which 16 diagnostic, screening and 22 treatment intervention and  18 articles were treatment model. The collected results were assessed in the intervention,. In general, treatment models  with emphasis on improvement social  interactions and communication were structured and  unstructured . some models was used  to specific age groups(adolescence and youth) , or all age groups. The oldest model was developed in 1980 and the newest pattern in 2015. Models with more flexibility also allow for continuous evaluation and improvement.

A review of articles shows that therapeutic models in which the active participation of parents, more interaction and freedom of action of the child are considered in the design, improve symptoms more. Models with more flexibility also allow for continuous evaluation and improvement. However, it is suggested that a standard treatment model be designed for children under the age of three that can be evaluated and can be upgraded.

Langerhans cell histiocytosis (LCH) is an uncommon hematological disorder-affecting infant and young child. LCH is a rare disorder of the reticuloendothelial system associated with proliferation of Langerhans cells and mature eosinophils. LCH can involve any bone, but the most common are pelvis, ribs, skull, long bones, vertebra, and facial bones. In this article, we report a case of LCH in a 15-months-old child involving the scapula and round shape swelling on left scapula with no erythema or tenderness and normal passive range of motion of shoulder and also aggressive periosteal reaction led to the diagnosis of LCH. This patient undergone surgery and received chemotherapy with no complications or any recurrence after two years follow up The purpose of reporting this case is to discuss clinical and radiological and histopathology features of LCH and role of doctors in diagnosing and managing such lesions.

Thyroid disorder is one of the main endocrine problems in childhood. In children with thyroid disorders, goiter is common. 

In this mini-review, the authors aimed to present total insights on goiter in children. 

This is a mini-review about total insights on goiter in children. This review included articles assessing goiter in children. Web of Science, PubMed, and Google Scholar were investigated to find appropriate articles regarding goiter in children from 1988 to 2021. The keywords were thyroid, goiter, hyperthyroidism, hypothyroidism, and thyroid nodule. The authors included all study types assessing the pathophysiology, evaluation, and treatment of goiter in childhood. 

Through taking the medical history and performing a physical examination, clinicians can differentiate types of goiter, including diffuse or nodular toxic or non-toxic, which can present themselves in euthyroid, hypothyroid, and hyperthyroid states. When taking a medical history, clinicians have to ask patients about their food intake, place of residence, and nutrient deficiencies to abstain from goitrogens. Diverse treatment methods are required for goiter in euthyroidism, hypophyroidism, and hyperthyroidism. In patients with euthyroidism, whenever there is iodine deficiency, a history of irradiation to the neck, or Hashimoto’s disease, suppressive therapy is needed. Both clinical and subclinical hypothyroidism need levothyroxine. Besides, in hyperthyroidism, antithyroid drugs, iodine therapy, or surgery are needed. Both clinical and subclinical hypothyroidism need levothyroxine.

In hyperthyroidism, antithyroid drugs, iodine therapy, or surgery are needed. Based on the importance of managing goiter in children, clinicians have to consider food intake, vitamin deficiency, and iodine status in these patients.

Antimonial compounds are the most common choice for the treatment of cutaneous Leishmaniosis (CL). Antimonial toxicities are common and cardiac toxicity is one of them, which leads to the electrocardiogram (ECG) changes. In this study, ECG changes in a patient with CL, who received systemic glucantime, were evaluated. 

A 7-year-old girl was admitted to Amir-Kabir Hospital with the complaint of skin lesions (CL) on her left leg from ten months ago. The patient had received glucantime (10-20mg/kg/day) as a treatment for two 15-day periods and unfortunately, she had not responded to the treatment. Due to the cardiac side effects of glucantime, cardiology consultation was requested and an ECG was performed for the patients during the administration of treatment for the third time. Several ECG changes were detected, including first-degree block, right bundle branch block (RBBB), and QTc prolongation. The cardiologist stopped the treatment with glucantime to improve the ECG changes, and an ECG was taken every week. Even though prolonged QT interval and RBBB improved after a month, the first-degree block was present for ten months.

ECG monitoring is necessary prior to and during the treatment with this drug. Moreover, RBBB has not been commonly reported in other studies. Thus, it should be considered as one of the cardiac side effects of glucantime and needs more attention.

Thalassemia is one of the most prevalent genetic disorders globally, and infections are one of the major causes of death in these patients. Various studies have attributed the increased susceptibility to bacterial infections in thalassemia patients to changes in their immunological status. 

This research aimed to measure serum levels of immunoglobulins (Igs) in Thalassemia Major (TM) patients and in the control group. 

The study included forty TM patients (20 splenectomized and 20 non-splenectomized) and 20 healthy participants (the control group). Three groups were matched for age and gender. Mean serum levels of immunoglobulins (IgG, IgA and IgM) were measured for all individuals by ELISA. P<0.05 was considered the significance level. 

Increased serum IgG and IgA levels and significantly reduced serum IgM levels were observed in the splenectomized patients compared to the non-splenectomized ones. A comparison of the study groups revealed that serum IgG and IgA levels in the splenectomized patients and the mean serum IgM and IgG levels in the non-splenectomized patients were higher than those of the healthy participants. The mean serum IgM levels in the splenectomized patients and the mean serum IgG levels in the non-splenectomized patients were lower than those of the control group.

The results showed that splenectomy could change the immunological status of thalassemia patients. Nevertheless, the exact mechanism for this change was not clear. Studying the serum levels of immunoglobulins might be useful in determining the severity of infections in TM patients.

Pediatric Intensive Care Unit (PICU) admitted patients are considered as a nutritionally high-risk population, for whom optimum energy and nutrient delivery is an important treatment strategy preventing organ dysfunction and subsequently poor clinical outcomes. 

The present study aimed to investigate the nutritional adequacy indices and their probable relations to clinical outcomes in critically ill children.

This project was a retrospective cross-sectional study carried out at the Akbar Children’s Hospital, Mashhad, Iran. All critically ill children with PICU stay >48 hours during May-June 2019 were enrolled. Age, gender, medical diagnosis, nutritional status, energy and protein requirements and deliveries, and clinical outcomes of patients were extracted.

Seventy-one patients were included, among whom 39 subjects (54.9%) were male. The prevalence of malnutrition was 45.3% and 52.4% in PICU patients with surgical and non-surgical underlying diseases, respectively. There were significant associations between the nutritional status of the patients (upon the PICU admission time), infection, and mortality rate. Mean±SEM values of the estimated energy requirement and delivered energy were 85.7±1.6 and 68.3±2.1 kcal/kg/d, respectively. In addition, the estimated protein requirement and protein delivery were 2.5±0.08 and 1.8±0.03 gr/kg/d, respectively. Energy intake had a negative association with infection rate and lower protein delivery was negatively associated with prolonged duration of mechanical ventilation.

Significant associations were found between energy/protein delivery and some clinical outcomes. The findings indicated the necessity of immediate further studies on the efficacy of different nutritional interventions as well as monitoring of optimal nutrition support barriers in critically ill children.