Journal of Pediatrics Review
Volume:12 Issue: 2, Apr 2024

Non-adherence to treatment is a major worldwide concern for healthcare providers. This is especially important in chronic diseases where patients have to follow the prescribed treatment for a long time. Adherence to the treatment of patients with chronic diseases in developed countries is at an average of 50%, and this rate is lower in developing countries. Despite many studies on non-adherence to treatment, it has remained an unresolved issue for the past four decades. On the other hand, commonly used interventions and practices have not successfully improved adherence to prescribed treatments in patients with chronic diseases. Moreover, the available theories of adherence have little explanatory power to justify this issue.

Divergent findings reported in the literature on the impact of acupressure on improvement in mothers’ anxiety during labor and consequently on birth outcomes. However, there is no existing meta-analysis on this issue.

This systematic review assesses the effect of acupressure and auriculotherapy on anxiety during labor, neonatal outcomes, and maternal-fetal attachment.

The Cochrane central register of controlled trials, MEDLINE/PubMed, ISI, and Scopus online databases were searched by two researchers up to January 2023. The quality of studies was assessed based on the Jade scale.

Nine studies were included in the systematic review and meta-analysis. Acupressure significantly decreased anxiety compared to touching (standardized mean difference=-3.29; P<0.001; I2=8%; P=0.295; the fixed effect model) and routine care (standardized mean difference=-1.08; confidence interval=-2.46 to 0.30; P=0.12; I2=96.19%; P<0.001). Maternal-fetal attachment was higher in both groups who received acupressure and auriculotherapy compared to the control group (P<0.001). Meanwhile, auriculotherapy did not impact neonatal outcomes, such as newborns’ weight and Apgar score.

Acupressure was an effective tool to improve anxiety during labor and it consequently improved fetal oxygenation.

The rate of neonatal jaundice is increasing. Due to the complications associated with phototherapy, researchers have consistently sought alternative methods, including herbal remedies.

In this study, we conduct a systematic review and meta-analysis to investigate the impact of Purgative manna consumption on the serum bilirubin levels of neonates.

In this systematic review and meta-analysis, we conducted an online search on various databases, including Barakat Gostar, scientific information database (SID), Magiran, IranDoc, PubMed, Scopus, Web of Science, Cochrane and the Google Scholar search engine, without time restrictions, up to July 20, 2023. Data analysis was performed using the STATA software, version 14. Meanwhile, the significance level was considered P<0.05.

We examined 12 clinical trial articles, involving a total of 1557 neonates. Before the intervention, there was no statistically significant difference in the bilirubin levels of neonates between the two groups (standardized mean difference [SMD]=-0.02; 95% confidence interval [CI], -0.12%, 0.09%; P=0.473). After Cotoneaster consumption, the serum bilirubin levels of the intervention group decreased (SMD=-3.50; 95% CI, -5.76%, -1.24%; P=0.000). Following phototherapy, the bilirubin levels of the control group also decreased (SMD=-2.14; 95% CI, -4.01%, -0.27%; P=0.000). After the intervention, at 12 h (SMD=-0.45; 95% CI, -0.80%, -0.10%; P=0.000), 24 h (SMD=-0.63; 95% CI, -1%, -0.26%; P=0.000), 36 h (SMD=-0.95; 95% CI, -1.69%, -0.20%; P=0.000), 48 h (SMD=-0.62; 95% CI, -0.92%, -0.31%; P=0.000), and 72 h (SMD=-0.84; 95% CI, -1.40%, -0.29%; P=0.000) post-intervention, the bilirubin levels of neonates in the Cotoneaster group were lower compared to the control group.

Cotoneaster consumption is more effective than phototherapy alone in reducing the bilirubin levels of neonates.

Congenital hypothyroidism (CH) is one of the most prevalent endocrine disorders in children. According to the literature, there is a high prevalence of other anomalies and syndromes in infants diagnosed with CH.

This study finds the prevalence of concurrent anomalies and the prevalence of each one.

This was a systematic review study based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA). The research question was the comparison of children with and without CH in terms of having extra-thyroidal congenital anomalies. A systematic literature search through PubMed, Science Direct, Scopus, and the Web of Science databases was done using the following key words: Congenital hypothyroidism, birth defects, congenital anomalies.

From the 655 initially retrieved articles, 24 articles remained, and 4 additional references were found by reviewing the references of the final articles. Finally, 28 articles were selected. The prevalence of extra-thyroidal anomalies ranged from 5% to 50% in girls and from 4% to 80% in boys. Meanwhile, 20% of the permanent CH patients and 13% of the patients with transient CH had extra-thyroidal congenital malformations. Cardiac anomalies were more prevalent in girls (female to male ratio=1.6 [0.7 to 5.5]), and urogenital anomalies were more reported in boys. Most of the studies did not report the association between non-thyroidal anomalies and thyroid stimulating hormone, gender, etiology of CH, and transient and permanent CH.

Congenital anomalies are more common in CH patients compared with the general population, even in the absence of congenital syndromes or chromosomal abnormalities. The most common anomalies are cardiac, craniofacial, urogenital, and nervous system.

Improper use of standards for measurement instruments can impact the accuracy of study results. 

This study systematically reviews the Instruments for measuring pain intensity during venous catheter insertion in preschool children.

In this systematic review, conducted from October 2023 to January 2023, an open search was carried out for articles in domestic databases, such as scientific information database (SID), MagIran, and Iran Medex, and international databases, including PubMed, CINAHL, Web of Science, and Scopus using the following keywords: Preschool period, pain intensity, cannulation, vein removal, pain scale, pain relief, pain perception, and pain sensation. The objective of this search was to examine the measurement tools utilized to assess pain intensity during venipuncture in preschool-aged children without a time restriction. Duplicate articles were excluded, and other studies meeting the inclusion criteria were reviewed. Articles were assessed by two researchers, and any discrepancies were resolved by a third author.

Among all the reviewed studies, 21 articles that were conducted between 2001 and 2023 met the inclusion criteria. The tools utilized in these studies to assess pain intensity during venous catheter insertion in preschool children included face, legs, activity, cry, and consolability (FLACC), Wong-Baker, Oucher scale, visual analog scale, and Poker Chip scale. The Wong-Baker instrument was a self-assessment, FLACC were assessed by both the researcher and a reviewer, Oucher was a self-assessment, the visual analog scale was assessed by parents and reviewers, and the Poker Chip scale was a self-assessment.

Researchers who do not adhere to tool standards often opt to utilize tools based on the methods of other studies or their requirements, which could potentially impact the outcomes of their studies

Identifying affecting and predictive factors of steroid-sensitive nephrotic syndrome’s (SSNS's) outcome may greatly benefit the proper management of SSNS patients. 

The current systematic review comprehensively reviews all available evidence on the risk factors of SSNS relapse in children and adolescents. 

An extensive search was conducted on the electronic databases of Medline, Embase, Web of Science, and Scopus until February 18, 2024. Studies investigating the risk factors of relapse were included in this systematic review.

A total of 11 articles were included. Age, gender, and laboratory variables, such as serum creatinine and serum protein are not risk factors for relapse in these studies. Possible associations were reported for risk factors, such as the number of relapses and response time. Overall, the studies reported conflicting results on the value of relapse risk factors.

Although factors, such as hematuria, hypertension, time from treatment to response, and number of relapses have been proposed as possible risk factors for relapse, no conclusion can be reached due to the heterogeneity of studies. Future studies should have more conforming designs to make comparisons more reliable.

Legg-calve-perthes disease (LCPD) is an idiopathic condition affecting children’s hip joints, causing bone tissue death and deformity. Typically, occurring between ages 2 to 15 years, LCPD is influenced by genetic and environmental factors. The disease progresses through distinct stages including necrosis, fragmentation, re-ossification, and remodeling.

This study aims to perform a a comprehensive review of diagnosis, management and current treatment options of LCPD.

A literature review focusing on the etiology, diagnosis and treatment of LCPD was conducted. The inclusion criteria were studies reporting clinical or preclinical findings. The research team performed a refined search on PubMed to gather relevant information.

This article highlights key aspects of LCPD management, encompassing etiology, diagnostic modalities, and various treatment strategies. The primary goals of treatment are to preserve normal hip joint function, prevent deformities and mitigate the risk of long-term complications. The Steinberg classification system categorizes LCPD into six stages based on size, morphology, and gross changes. Diagnosis and staging are typically performed using conventional radiography, with magnetic resonance imaging playing a crucial role in early prognosis.

The study evaluates various diagnostic and therapeutic approaches, encompassing both non-surgical interventions and surgical procedures. Treatment methods are compared based on patient-specific factors, such as physical condition, age, and timing of intervention to provide a comprehensive understanding of the strengths and limitations of each approach.

This study assesses the vaginal button battery insertion in a child with attention deficit hyperactivity disorder (ADHD). 

For the literature review, online databases, such as Google Scholar and PubMed were searched with the following keywords: “Vaginal battery” OR “vaginal button battery” OR “vaginal battery insertion” AND “girl.” The search process considered articles in English with no publication year limitation. The included studies were published from 2005 until 2023. 

We presented an eight-year-old, second-grade elementary school girl with ADHD and a history of methylphenidate consumption, referred to the general educational hospital in north Iran with the chief complaint of inserting a vaginal foreign body (VFB). On the night of the event. The child removed a small disc battery of her toys and inserted it into her vagina. Then, she told this to her parents and was referred to the hospital. The psychiatrist’s assessment showed no psychiatric disorder, except for ADHD. The patient’s abdomen was soft in physical examination and had a rebound tenderness complaint. Also, the entrance of the vagina was erythematosus, and vaginal discharge was seen. The primary assessment by pelvic radiography indicated a round button buttery in the upper segment of the rectum. In the surgery room, a gynecologist gently removed the button battery from the wall by rectal examination and milking from the upper under general anesthesia. The patient was febrile in the follow-up for 48 h and discharged with good general health without fever and severe psychiatric symptoms. In the review section of this study, case reports conducted regarding the insertion of battery in the vagina as a VFB in girls were searched and reported. Overall, 15 case reports were included in the literature review.

Interdisciplinary cooperation among pediatric clinicians and gynecology specialists in dealing with cases of VFB associated with a wide range of emotional and behavioral disorders, such as ADHD should be considered.

Type 1 diabetes mellitus (T1DM) is an autoimmune disorder characterized by the destruction of insulin-producing beta cells in the pancreas, leading to insulin deficiency. 

This study determines the frequency of T1DM-specific auto-antibodies, namely glutamic acid decarboxylase, islet cell cytoplasmic, insulinoma-associated-2/tyrosine phosphatase, and insulin autoantibody. 

This prospective cross-sectional study was conducted from March 2019 to December 2020. Registered T1DM patients under 18 years of age who visited the Diabetes Clinic of Bu Ali Sina Hospital in Sari City, Iran, were included. The autoantibody, clinical, and biochemistries profile of each participant was recorded.

A total of 190 children diagnosed with T1DM were included in the study. The mean age of the patients was 13.14±0.36 years. Based on the mono test, the highest prevalence was seen in islet cell cytoplasmic (104 [66.67%]). Also, based on multiple tests, islet cell cytoplasmic+glutamic acid decarboxylase had the highest prevalence (135 [49.63%]). Patients with positive insulinoma-associated-2/tyrosine phosphatase and islet cell cytoplasmic compared to negative insulinoma-associated-2/tyrosine phosphatase and islet cell cytoplasmic had higher age at diabetes onset (8.93±4.11 vs 7.73±4.33, P=0.02; 8.8±4.22 vs 6.81±4.1, P=0.01), receptively. The HbA1c level at T1DM onset in patients with positive insulin autoantibody was lower than negative insulin autoantibody (7.84±1.82 vs 9.41±2.35, P=0.0009). There was a significant difference in hyperglycemia with positive and negative insulinoma-associated-2/tyrosine phosphatase, in which the chance of positive insulinoma-associated-2/tyrosine phosphatase was 54% lower in hyperglycemia than in euglycemia (odd ratio=0.46 [0.22-0.96], confidence interval=95%, P=0.04).

The islet cell cytoplasmic and islet cell cytoplasmic + glutamic acid decarboxylase had the most prevalence in T1DM patients in Northern Iran.

According to previous reports, between 2%-5% of multiple sclerosis (MS) cases occur before the age of 16 years. 

This study aims to investigate the clinical and epidemiological features of MS in Iranian children to provide diagnostic criteria for policymakers and physicians.

This study objectives are achieved in two phases. The first phase was conducted and the second phase is underway. The first phase was performed in one year to design and finalize a pediatric MS registry software. For this reason, all variables and registration methods were determined. The second phase which has been started since 2016 consists of a routine data registry in the national phase. The project information, including all cases, epidemiological, clinical, and diagnostic factors is being reported based on different geographical areas of Iran.

We registered 932 cases with MS since 2017, of whom 74.4% were girls. There was no significant difference in mean age between girls and boys with MS (mean difference=0.73 years, P=0.133). Most of the children who were diagnosed were between the ages of 15 to 18 years (52.4%).

The registry for MS in children in Iran can improve the knowledge of health policymakers on the incidence of MS in children throughout the country, the first and most common symptoms of MS in children, raising physicians’ awareness about early diagnosis and treatment that consequently reduce the economic, psychological, and psychological burden of the disease.