Journal of Pediatrics Review
Volume:11 Issue: 1, Jan 2023

Neonatal hypoglycemia is the most common metabolic abnormality affecting newborns and contributes to increased morbidity and mortality. 

The present systematic review and meta-analysis aim to explore the prevalence and risk factors associated with neonatal hypoglycemia in Iran.

A systematic search was performed in Iranian and international databases, including SID, MagIran, Barakat Knowledge Network System, PubMed, Scopus, Web of Science, and the Google Scholar search engine searched for relevant articles using valid keywords. The search process was updated until September 28, 2021. Data were analyzed using STATA software, version 14, and the significance level for all tests was considered P<0.05. 

In 14 reviewed articles with a sample size of 18217, the prevalence of hypoglycemia in Iranian newborns was 29% [95%CI: 21%, 37%, P=0.0001] (64% in boys and 37% in girls). The hypoglycemia prevalence was 67% in infants born via cesarean section compared to 24% in vaginally delivered infants. The lowest and highest prevalence of neonatal hypoglycemia was observed in Mashhad (12%) and Arak (53%), respectively. The most common risk factors for neonatal hypoglycemia in Iran were infant prematurity (61%), septicemia (45%), respiratory distress syndrome (RDS) (26%), small for gestational age (SGA) (26%), maternal diabetes (21%), hypocalcemia (19%), intrauterine growth restriction (IUGR) (9%) and perinatal asphyxia (8%).

Neonatal hypoglycemia is very common in Iran, affecting nearly one-third of Iranian newborns. The prevalence of hypoglycemia in boys was almost twice as high as that in girls and 2.5 times higher in infants born by cesarean section than in infants delivered vaginally. Furthermore, prematurity was reportedly the most common risk factor for neonatal hypoglycemia in Iran.

Guillain-Barre syndrome (GBS) is an immune-mediated polyneuropathy and a common cause of acute ascending weakness in children. 

This study aims to report long-term disability and poor outcome predictors of GBS in children. Medline (via Pubmed), Embase, Cochrane Library, Web of Science, and Scopus database was searched for relevant studies until April 2022, with a designated search strategy, using MeSH terms and free keywords.

Studies evaluating functional outcomes of GBS in children with at least one year of follow-up were included. All studies achieved acceptable quality for inclusion. After selecting studies based on inclusion criteria, data were extracted based on a modified standardized Joanna Briggs Institute (JBI) data extraction tool, and the methodological quality of studies were reviewed using the Joanna Briggs Institute (JBI) critical appraisal tool.

Fourteen studies were included in this systematic review consisting of 1141 patients (647 males, 466 females, and 28 unclassified). Follow-up duration varied from one year to 11 years. The prevalence of the GBS subtype was as follows, acute inflammatory demyelinating polyneuropathies (AIDP) 46.6%, acute motor axonal neuropathy (AMAN) 30.2%, acute motor and sensory axonal neuropathy (AMSAN) 6.8% and Miller fisher 6.1%. The most commonly reported poor outcome after at least one year of follow-up was walking disabilities and gait disorders. Motor deficits and weakness, sensory complaints, including pain or paresthesia and fatigue were other prevalent residual symptoms. Axonal form of GBS was the most reported poor outcome predictor, followed by Hughes disability score >3, a delay in independent walking, artificial ventilation, and rapid progression of symptoms.

Despite the good prognosis of GBS in children, they could suffer long-term sequels, especially in walking abilities and gait. The axonal form is considered a crucial poor predictive factor.

More than half of reproductive-age women experience dysmenorrhea, which can reduce their quality of life. The treatment options for dysmenorrhea are medications and alternative therapies. The tendency to use alternative therapies, such as hypnotherapy has increased. 

This study aimed to carry out a narrative review to evaluate the effect of hypnosis on dysmenorrhea in adolescents. 

EMBASE, Web of Science, Scopus, Google Scholar, PubMed, Cochrane library ProQuest and clinicaltrials.gov were searched up to 2021 using the following keywords “dysmenorrhea”, “hypnosis”. The quality of studies was assessed by Cochrane collaboration’s tool and the risk of bias in the non-randomized studies of interventions (ROBINS-I) tool.

Nine studies with a sample size of 5203 participants were included. The hypnosis intervention similar to drug therapy was effective in reducing the intensity of dysmenorrhea and improving the women’s quality of life. Dysmenorrhea pain scores in hypnosis and drug therapy groups were significantly lower than those at baseline, but pain scores in the drug therapy group were significantly lower than in the hypnosis group.

Hypnosis can provide lasting pain relief compared to NSAIDs. Therefore, it is recommended that hypnosis as a complementary or alternative therapy reduce the intensity of dysmenorrhea in adolescents.

Type 1 diabetes mellitus (T1DM) is one of the chronic diseases that timely and correct management affects the outcome of these patients. COVID-19 is an acute respiratory infection that has created a disproportionate situation for individuals and healthcare systems. The resulting pandemic is associated with delayed presentation of patients as well as increased frequency and severity of acute complications. 

This review study aims to investigate the incidence, initial presentation, frequency, and severity of diabetic ketoacidosis (DKA) as well as changes in demographic findings, such as age and sex in newly diagnosed T1DM children and adolescents during the COVID-19 pandemic. 

The search was conducted in different databases, using the keywords: T1DM, COVID-19, pediatrics, and incidence to find the related articles published in English from December 31, 2019, to March 3, 2022.

There is no clear evidence for increase in the incidence of T1DM and the frequency and severity of DKA in female and younger people during the pandemic compared to the pre-pandemic period. Further studies with larger sample sizes are needed to better understand the role of pandemic on disease incidence and acute complications.

To reduce the incidence of DKA and speed up the diagnosis of T1DM during the pandemic, people should be informed about their symptoms.

Early childhood caries (ECC) is one of the multifactorial, acute, and progressive types of tooth decay. Some salivary biomarkers are associated with this disease. 

The data we used in our review were searched from articles published between 1950 to 2021 and using early childhood caries (ECC), children, saliva, salivary biomarkers, salivary characteristics, salivary minerals, cytokines, total antioxidant capacity (TAC) and nitric oxide (NO) as keywords, collected from official web pages (Scopus, PubMed, Embase and Google scholar) and documents published from different international institutions. 

The search was limited to articles published in the English language. After the abstract screening, the full text of 194 relevant studies was reviewed. Finally, 101 relevant studies were selected.

Cytokines with the potential to affect ECC include interleukin (IL)-1 (IL-1β), IL-6, IL-8, IL-10, IL-12, tumor necrosis factor-alpha (TNFα), a soluble cluster of differentiation (sCD)14-cluster of differentiation 14 (CD14), CD63 and vascular endothelial growth factor (VEGF). The minerals associated with the ECC are calcium (Ca), phosphate (PO43-), fluoride (F), magnesium (Mg), iron (Fe), and lead (Pb). 

Some characteristics of saliva that seem to concern ECC include salivary pH, salivary total protein, salivary total lipid, salivary buffering capacity, and saliva flow rate. Other vital factors observed to have significant effects on the ECC process involve total antioxidant capacity (TAC) and nitric oxide (NO).

The World Health Organization (WHO), as the international authority on public health and water quality, directs and monitors global efforts to prevent the transmission of waterborne diseases and advises governments on the development of health-based goals and regulations. 

This review study aims to investigate the management methods, including control, prevention, and treatment of gastrointestinal (GI) diseases in children in the Middle East caused by contaminated water through WHO.

For this purpose, Scopus, Google scholar, PubMed, SID, Irandoc, and up-to-date databases were searched without time limitation. Keywords included contaminated water, pediatric, GI diseases, and WHO. In this study, the full text of various articles in Persian and English was used. After removing duplicate articles and articles that did not fit the topic of the study, 54 articles were finally selected.

Based on the findings, the WHO has reported that diarrhea, polio, hepatitis A, and cholera are the most common GI infectious diseases caused by contaminated water in children in the Middle East. The present reports of waterborne disease represent only a small proportion of the total number of cases of this disease in the population. In some areas, it has been shown that investments in water and wastewater supply by responsible institutions can provide a net economic gain by reducing negative health impacts and healthcare costs.

The results of this study indicate that most of the diseases caused by contaminated water affect children, due to low ability to observe personal hygiene and the state of the child’s immune system, which often leads to the death of children. The lack of diagnosis and insufficient prevalence of these diseases in some Middle Eastern countries, followed by the lack of attention to the prevention and control of waterborne diseases, threatens the health policies of these countries. International organizations, especially the WHO and the united nations children’s fund, play a vital role in addressing and controlling this problem.

With the global spread of COVID-19, many families have experienced the physical or psychological effects of the disease, which has had a profound impact on children.

Given that most studies have assessed the effects of COVID-19 on physical health, this study reviews the psychological and psychosomatic aspects of the disease and possible solutions to improve the condition of children and adolescents regardless of physical problems and complications of COVID-19.

The data employed in our narrative review were searched for English documents published between 2019 and 2022 in EMBASE, Web of Science, Scopus, Google Scholar, and PubMed databases. Keywords included Mental health, Grief, Anxiety, depression, Children, and COVID-19. After screening the abstracts, the full text of 70 related studies was reviewed, and finally, 52 relevant surveys were selected.

Among the most important issues are the irreparable effects of losing a parent or the death of a loved one due to this disease (loss and grief) and a wide range of other disorders, such as feelings of fear, anxiety, depression, sleep problems, and post-traumatic stress disorder. However, the destructive effects of prolonged school closures and turning to social media without parental supervision and adequate infrastructure for children cannot be ignored.

Children’s reactions to stress are different, such as overdependence, anxiety, withdrawal, anger, bedwetting, etc. Long-term quarantine and its consequences have increased anxiety and depression, sleep disorders, and nutritional problems in children and adolescents. Therefore, children need a safe and supportive environment, guidance, and help to express their fear and sadness.

To end the new COVID-19 pandemic, most of the world’s population needs to be immune to the virus, protecting individuals from infection, and ultimately ensuring herd immunity at the population level. A variety of COVID-19 vaccines have been developed worldwide for adults and children over the age of 12 years, and the effectiveness of the vaccine in preventing symptomatic diseases and hospitalization is being studied. One of the major obstacles to COVID-19 vaccination that has emerged along with the global immunization program is vaccine hesitation or disapproval. The World Health Organization (WHO) has reported vaccine hesitation as one of the 10 global health threats of 2019. This is also related to COVID-19.The present review, explore the current evidence on COVID-19 vaccination platforms and vaccination efficacy, safety, and adverse effects among strategic sub-populations, including elderly people, people with chronic disease (diabetes, cancer), pregnant and lactating women, children, youth, and vaccination willingness or hesitancy among the target population.

Distraction is a technique that has had positive effects on reducing children’s pain in painful interventions, such as venipuncture, and replacing the burn dressing. Based on the available data, very few articles exist about the application of this technique when suturing children. 

This study was designed to determine the effect of distraction by watching cartoons on the level of pain during preparation before suturing children in the emergency ward.

This study is a randomized controlled trial. The research population included all children aged 3-12 years who were referred to the emergency ward of Bu Ali Sina Hospital in Sari City, Iran. Forty-three subjects were selected from each group. In the intervention group, playing cartoons on the tablet was initiated from the time of placing the child on the bed for suturing, and continued until the end of the anesthetic injection, and this time was recorded. In the control group, the suturing was performed conventionally. The behavioral reactions of both groups were measured twice based on the pain behavioral reactions scale. The first time was when the child was placed on the bed and before cleaning for the anesthetic agent, while the second time was observed and recorded by the researcher immediately after injecting the anesthetic agent.

The comparison of mean pain before injecting the anesthetic agent (after playing the cartoon) showed a significant difference between the intervention and control groups based on Mann-Whitney test (P=0.0001). The comparison of mean pain immediately after termination of anesthetic injection also showed a significant difference in both the intervention and control groups based on the Mann-Whitney test (P=0.0001). Based on the results of the present research, the pain in the intervention group was less before the anesthetic injection and less in the control group immediately after the injection.

The results suggested that distraction from watching cartoons has a positive effect on reducing the pain of preparation before suturing children. Therefore, this technique can be used in emergency departments.

Bronchiolitis is common in children under 2 years of age and is a leading cause of hospitalization in infants and children. Children with bronchiolitis are generally well-appearing and active despite being tachypneic or hypoxic. 

This study aims to identify the predictors of hypoxia in children with bronchiolitis, as well as to find the average duration of oxygen requirement and hospitalization in children with hypoxia.

A total of 65 children between the age group of 1 month to 2 years with bronchiolitis were included in the study. Data were collected retrospectively from case records and prospective cases were consecutively enrolled. Oxygen saturation was monitored in all hospitalized children. An oxygen saturation (SpO2)<92% was considered hypoxia. The relationship between presenting clinical features and subsequent development of hypoxia was assessed using the Pearson chi-square test.

The presenting features of bronchiolitis in our study were cough, fever, tachypnea, increased work of breathing, and wheezing. Cough was the most common symptom and fever was the least common symptom. A total of 59.3% of children with a cough had hypoxia. Of the 23 children who had a fever, 52.1% of them had hypoxia. Among 51 children with tachypnea, 68.6% had hypoxia (P=0.001). Among 57 children whose respiratory work was increased, 68% of children had hypoxia (P=0.000); 71.8% of children with wheezing had hypoxia (P=0.05).

Our study shows that in children with bronchiolitis, the presence of tachypnea, increased work of breathing and wheezing increases the risk of developing hypoxia. Identifying these predictors of hypoxia can help as a guide for deciding on the need for hospitalization in children with bronchiolitis.