Setila Dalili, Afagh Hassanzadeh Rad, Omid Salkhori, Shayan Dabbaghi, M. Karambin, H. Badeli, Shahin Koohmanaee
Background: Recent studies in humans show that increased uric acid predicts hyperinsulinemia and obesity. Objectives: Our study aimed to investigate whether hyperuricemia and insulin levels predict hypertension in obese children. Methods: This analytical cross-sectional study was conducted on the records of 161 obese children aged 5 to 15 years old based on the defined inclusion criteria. Children's blood pressure, height, weight, FBS (fasting blood sugar), HDL (high-density lipoprotein), LDL (low-density lipoprotein), TG (triglyceride), HbA1c (hemoglobin A1c), urine albumin, creatinine, insulin levels, and uric acid were measured. Data were analyzed by SPSS software. The significance level was considered P < 0.05. Results: According to the data obtained from this study, the mean of SBP (systolic blood pressure) and DBP (diastolic blood pressure) in obese children with hyperuricemia was higher than in obese children without hyperuricemia. The average insulin in obese children and hypertension was higher than in obese children without hypertension, especially in males and the age group of 5 - 10 years. The levels of cholesterol and LDL in hypertensive males were higher than in those with hyperuricemia. HDL was higher in children without hyperuricemia than in children with hyperuricemia. The strongest predictors of uric acid were age (P < 0.001, B = 0.183), HbA1c (P = 0.014, B = 0.255), and cholesterol (P = 0.03, B = -0.007), respectively. Conclusions: Based on this study, there is a relationship between uric acid levels and parameters such as obesity and blood pressure, and the findings showed that increased uric acid predicts hyperinsulinemia and obesity. Therefore, this study indicates that physicians and healthcare workers should consider the level and state of uric acid.
{"title":"Potentials of Hyperuricemia and Insulin Levels in Predicting Hypertension in Obese Children: A Cross-Sectional Study","authors":"Setila Dalili, Afagh Hassanzadeh Rad, Omid Salkhori, Shayan Dabbaghi, M. Karambin, H. Badeli, Shahin Koohmanaee","doi":"10.5812/jcp-139577","DOIUrl":"https://doi.org/10.5812/jcp-139577","url":null,"abstract":"Background: Recent studies in humans show that increased uric acid predicts hyperinsulinemia and obesity. Objectives: Our study aimed to investigate whether hyperuricemia and insulin levels predict hypertension in obese children. Methods: This analytical cross-sectional study was conducted on the records of 161 obese children aged 5 to 15 years old based on the defined inclusion criteria. Children's blood pressure, height, weight, FBS (fasting blood sugar), HDL (high-density lipoprotein), LDL (low-density lipoprotein), TG (triglyceride), HbA1c (hemoglobin A1c), urine albumin, creatinine, insulin levels, and uric acid were measured. Data were analyzed by SPSS software. The significance level was considered P < 0.05. Results: According to the data obtained from this study, the mean of SBP (systolic blood pressure) and DBP (diastolic blood pressure) in obese children with hyperuricemia was higher than in obese children without hyperuricemia. The average insulin in obese children and hypertension was higher than in obese children without hypertension, especially in males and the age group of 5 - 10 years. The levels of cholesterol and LDL in hypertensive males were higher than in those with hyperuricemia. HDL was higher in children without hyperuricemia than in children with hyperuricemia. The strongest predictors of uric acid were age (P < 0.001, B = 0.183), HbA1c (P = 0.014, B = 0.255), and cholesterol (P = 0.03, B = -0.007), respectively. Conclusions: Based on this study, there is a relationship between uric acid levels and parameters such as obesity and blood pressure, and the findings showed that increased uric acid predicts hyperinsulinemia and obesity. Therefore, this study indicates that physicians and healthcare workers should consider the level and state of uric acid.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":"88 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138997957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Behmadi, A. Dehvari, N. Bakhshani, Abdolbaset Vahedi Tabas, Hirad Houjaghani
Background: Cognitive development during childhood has significant implications for an individual's cognitive functioning throughout life. Perinatal and postnatal factors may influence this function. Objectives: In this study, we aimed to investigate the relationship between perinatal and postnatal factors and cognitive development in healthy toddlers aged 18 – 22 months. Methods: In this retrospective cross-sectional study, we examined 50 toddlers born between March 2015 and March 2016 at a teaching hospital in Zahedan, Iran. This study focused on perinatal and neonatal risk factors based on the results of the Bayley-3 test. Data were analyzed using Mann–Whitney U, Kruskal–Wallis, and Pearson correlation coefficient tests. Results: Analysis revealed significant correlations between several perinatal factors and subsequent cognitive performance in toddlers. Greater maternal chronological age at the time of parturition, higher levels of mother's attained education, increased neonatal weight at delivery, augmented body weight in the toddler phase, as well as the documented occurrence of neonatal hyperbilirubinemia within the initial postpartum period, demonstrated meaningful associations with enhanced cognitive functioning as assessed during the toddler stage of development. Conclusions: Based on the results, it is advised that pregnancy commences at a maternal age that circumvents risks of very young childbearing. Offspring growth should be closely tracked, and neonatal jaundice promptly treated, as these perinatal factors impact cognitive performance. Giving priority to these factors improves a child's chances of healthy cognitive development, which is essential for success in life.
{"title":"The Relationship Between Perinatal and Postnatal Factors and Cognitive Development of Healthy Toddlers","authors":"R. Behmadi, A. Dehvari, N. Bakhshani, Abdolbaset Vahedi Tabas, Hirad Houjaghani","doi":"10.5812/jcp-140234","DOIUrl":"https://doi.org/10.5812/jcp-140234","url":null,"abstract":"Background: Cognitive development during childhood has significant implications for an individual's cognitive functioning throughout life. Perinatal and postnatal factors may influence this function. Objectives: In this study, we aimed to investigate the relationship between perinatal and postnatal factors and cognitive development in healthy toddlers aged 18 – 22 months. Methods: In this retrospective cross-sectional study, we examined 50 toddlers born between March 2015 and March 2016 at a teaching hospital in Zahedan, Iran. This study focused on perinatal and neonatal risk factors based on the results of the Bayley-3 test. Data were analyzed using Mann–Whitney U, Kruskal–Wallis, and Pearson correlation coefficient tests. Results: Analysis revealed significant correlations between several perinatal factors and subsequent cognitive performance in toddlers. Greater maternal chronological age at the time of parturition, higher levels of mother's attained education, increased neonatal weight at delivery, augmented body weight in the toddler phase, as well as the documented occurrence of neonatal hyperbilirubinemia within the initial postpartum period, demonstrated meaningful associations with enhanced cognitive functioning as assessed during the toddler stage of development. Conclusions: Based on the results, it is advised that pregnancy commences at a maternal age that circumvents risks of very young childbearing. Offspring growth should be closely tracked, and neonatal jaundice promptly treated, as these perinatal factors impact cognitive performance. Giving priority to these factors improves a child's chances of healthy cognitive development, which is essential for success in life.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":"30 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139254941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Many clinicians have used the Apgar scoring system to evaluate newborn babies at the first minutes of birth. Expanded and combined Apgar have been introduced due to the interventions done for babies in the first minutes of life. This study evaluates the predicting values of combined Apgar scores in short-term neonatal outcomes. Methods: A diagnostic test was conducted on alive preterm and term babies without major anomalies between October 2021 and August 2022. Infants with congenital heart disease, congenital metabolic disorders, and those transferred to another hospital were excluded. Demographic data, feeding volume, conventional, expanded, and combined Apgar scores were assessed at 5 minutes of birth and recorded. The area under the receiver operating characteristic (ROC) curve was used to determine the sensitivity and specificity of the combined Apgar score to predict short-term outcomes (need to admission, duration of hospitalization, and oral feeding progression). Results: Of 599 babies (339 boys and 260 girls) with a mean gestational age of 35.3 ± 3.8 weeks (25 - 42 weeks), 280 (46.7%) babies were admitted. As the average Apgar score decreased, progression to full oral feeding was associated with longer delay. The area under the ROC curve for the Combined Apgar score was 80% and 55% in correlation with the need for admission and duration of hospitalization, respectively. Conclusions: This study showed that the 5th-minute combined Apgar score is a good predictor of the need for admission and oral feeding progression but does not seem suitable for predicting the duration of hospitalization.
{"title":"Assessing the Effectiveness of the Combined Apgar Scoring System in Predicting the Short-Term Outcomes of Newborns","authors":"Samira Pournajaf, Zahra Akbarian, Hemmat Gholinia Ahangar, Nesae Bozorgnezhad, Mohsen Haghshenas Mojaveri","doi":"10.5812/jcp-138666","DOIUrl":"https://doi.org/10.5812/jcp-138666","url":null,"abstract":"Background: Many clinicians have used the Apgar scoring system to evaluate newborn babies at the first minutes of birth. Expanded and combined Apgar have been introduced due to the interventions done for babies in the first minutes of life. This study evaluates the predicting values of combined Apgar scores in short-term neonatal outcomes. Methods: A diagnostic test was conducted on alive preterm and term babies without major anomalies between October 2021 and August 2022. Infants with congenital heart disease, congenital metabolic disorders, and those transferred to another hospital were excluded. Demographic data, feeding volume, conventional, expanded, and combined Apgar scores were assessed at 5 minutes of birth and recorded. The area under the receiver operating characteristic (ROC) curve was used to determine the sensitivity and specificity of the combined Apgar score to predict short-term outcomes (need to admission, duration of hospitalization, and oral feeding progression). Results: Of 599 babies (339 boys and 260 girls) with a mean gestational age of 35.3 ± 3.8 weeks (25 - 42 weeks), 280 (46.7%) babies were admitted. As the average Apgar score decreased, progression to full oral feeding was associated with longer delay. The area under the ROC curve for the Combined Apgar score was 80% and 55% in correlation with the need for admission and duration of hospitalization, respectively. Conclusions: This study showed that the 5th-minute combined Apgar score is a good predictor of the need for admission and oral feeding progression but does not seem suitable for predicting the duration of hospitalization.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":"9 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135042489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: There are important cognitive issues in patients with epilepsy, which can be referred to as impairment in executive functions such as attention. Objectives: This research aims to compare the effectiveness of computer-based cognitive rehabilitation programs and task-oriented cognitive rehabilitation programs on attention in children with epilepsy in Tehran. Methods: The present research was a semi-experimental study with a pre-test and post-test design with a control group. The statistical population of the study included all children with epilepsy who were referred to the neurology clinic of Mofid Children's Hospital in 2021. Using the purposeful sampling method, 45 eligible children were included in the study and were randomly divided into 2 experimental groups and 1 control group (15 people in each group). The Integrated Visual and Auditory Continuous Performance Test (IVA2) of Sohlberg and Mateer (2001) was used for data collection. The experimental groups underwent the intervention of the computerized cognitive rehabilitation program of the Cambridge Neuropsychological Test (1980) (12 sessions of 45 minutes) and the task-oriented cognitive rehabilitation program (12 sessions of 45 minutes). The control group did not receive any intervention. SPSS 20 software was used for data analysis. Univariate covariance analysis (ANCOVA) was performed using a significance level of 0.05. Results: The results demonstrated that both computer-based cognitive rehabilitation programs and task-based cognitive rehabilitation were effective in increasing the attention of epileptic children in Tehran (P < 0.001). There was no significant difference between the effectiveness of computer-based cognitive rehabilitation programs and task-based cognitive rehabilitation in increasing the attention of epileptic children (P = 0.67). Conclusions: It can be concluded that computer-based and task-oriented cognitive rehabilitation programs can be used to increase attention and executive functions in children with epilepsy.
{"title":"Comparing the Effectiveness of Computer-Based and Task-Oriented Cognitive Rehabilitation Programs on Epileptic Children’s Attention in Tehran","authors":"Asie Khaleghi, Farah Naderi, Reza Joharifard, Mohsen Javadzadeh","doi":"10.5812/jcp-137309","DOIUrl":"https://doi.org/10.5812/jcp-137309","url":null,"abstract":"Background: There are important cognitive issues in patients with epilepsy, which can be referred to as impairment in executive functions such as attention. Objectives: This research aims to compare the effectiveness of computer-based cognitive rehabilitation programs and task-oriented cognitive rehabilitation programs on attention in children with epilepsy in Tehran. Methods: The present research was a semi-experimental study with a pre-test and post-test design with a control group. The statistical population of the study included all children with epilepsy who were referred to the neurology clinic of Mofid Children's Hospital in 2021. Using the purposeful sampling method, 45 eligible children were included in the study and were randomly divided into 2 experimental groups and 1 control group (15 people in each group). The Integrated Visual and Auditory Continuous Performance Test (IVA2) of Sohlberg and Mateer (2001) was used for data collection. The experimental groups underwent the intervention of the computerized cognitive rehabilitation program of the Cambridge Neuropsychological Test (1980) (12 sessions of 45 minutes) and the task-oriented cognitive rehabilitation program (12 sessions of 45 minutes). The control group did not receive any intervention. SPSS 20 software was used for data analysis. Univariate covariance analysis (ANCOVA) was performed using a significance level of 0.05. Results: The results demonstrated that both computer-based cognitive rehabilitation programs and task-based cognitive rehabilitation were effective in increasing the attention of epileptic children in Tehran (P < 0.001). There was no significant difference between the effectiveness of computer-based cognitive rehabilitation programs and task-based cognitive rehabilitation in increasing the attention of epileptic children (P = 0.67). Conclusions: It can be concluded that computer-based and task-oriented cognitive rehabilitation programs can be used to increase attention and executive functions in children with epilepsy.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135041860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Celiac disease (CD) treatment is based on life-long adherence to a gluten-free diet (GFD). Some patients with CD experience persistent symptoms despite adhering to a GFD. This condition is defined as a nonresponsive CD. Objectives: The present study aimed to investigate the prevalence and cause of persistent symptoms in pediatric patients with CD adhering to a GFD in Sistan and Baluchestan province, southeastern Iran. Methods: This descriptive cross-sectional study was conducted on 112 patients with CD selected from all diagnosed CD patients receiving a GFD for 6 months and newly diagnosed cases studied within one year. Gastrointestinal (GI) and extraintestinal (EI) symptoms were recorded on a questionnaire at the onset and during treatment. Data were analyzed by SPSS16 software, independent t-test, univariate t-test, and analysis of variance (ANOVA). Results: A total of 46.43% of our sample were boys, and 53.57% were girls (mean age = 82 ± 4.43 months). Abdominal pain and constipation symptoms were reported more frequently at the time of diagnosis and following one year of treatment. The most commonly observed EI symptoms at the time of diagnosis and during treatment were weight loss and growth failure, respectively. The percentage of treatment non-response in patients with a positive family history was significantly greater than in those with a negative family history. Conclusions: The results showed that GFD had a significant effect on the reduction of GI and non-GI symptoms, but the effect of this regime on insignificant symptoms, particularly at older ages, is negligible.
{"title":"Evaluating the Frequency and Cause of Persistent Symptoms in Pediatric Patients with Celiac Disease Adhering to a Long-Term Gluten-Free Diet","authors":"Manijeh khalili, Mojgan Sadeghi Zarchi, Alireza Teimouri, Alireza Ansari-Moghaddam, Raheleh Rafaiee","doi":"10.5812/jcp-138752","DOIUrl":"https://doi.org/10.5812/jcp-138752","url":null,"abstract":"Background: Celiac disease (CD) treatment is based on life-long adherence to a gluten-free diet (GFD). Some patients with CD experience persistent symptoms despite adhering to a GFD. This condition is defined as a nonresponsive CD. Objectives: The present study aimed to investigate the prevalence and cause of persistent symptoms in pediatric patients with CD adhering to a GFD in Sistan and Baluchestan province, southeastern Iran. Methods: This descriptive cross-sectional study was conducted on 112 patients with CD selected from all diagnosed CD patients receiving a GFD for 6 months and newly diagnosed cases studied within one year. Gastrointestinal (GI) and extraintestinal (EI) symptoms were recorded on a questionnaire at the onset and during treatment. Data were analyzed by SPSS16 software, independent t-test, univariate t-test, and analysis of variance (ANOVA). Results: A total of 46.43% of our sample were boys, and 53.57% were girls (mean age = 82 ± 4.43 months). Abdominal pain and constipation symptoms were reported more frequently at the time of diagnosis and following one year of treatment. The most commonly observed EI symptoms at the time of diagnosis and during treatment were weight loss and growth failure, respectively. The percentage of treatment non-response in patients with a positive family history was significantly greater than in those with a negative family history. Conclusions: The results showed that GFD had a significant effect on the reduction of GI and non-GI symptoms, but the effect of this regime on insignificant symptoms, particularly at older ages, is negligible.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":"209 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135872028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Noor Mohammad Noori, Saeedeh Yaghoubi, Gholamreza Soleimani, Tahereh Boryri, Alireza Teimouri, Sahar Safapour Moghadam, Seyed Hosein Soleimanzadeh Mousavi
Background: The majority of children affected by coronavirus disease 2019 (COVID-19) are thought to be asymptomatic, with a lower mortality rate than adults. Objectives: The aim of this study was to evaluate risk factors associated with mortality in children with COVID-19. Methods: In this study, all patients were under 19 years of age, and their COVID-19 was confirmed by RT-PCR analysis. Primary data were related to underlying diseases, clinical and laboratory information, mortality, or safe discharge. The recorded data were analyzed using SPSS software (version 18), taking into account the significance level of < 0.05. Results: Of the 183 children enrolled in the study, the mortality rate was 13.67%. The major risk factors for death were clinical manifestations involving central nervous system (CNS) diseases (P = 0.006), platelet (PLT) count (P = 0.020), lactate dehydrogenase (LDH) (P < 0.001), alanine transaminase (ALT) (P = 0.033), erythrocyte sedimentation rate (ESR) (P < 0.001), and C-reactive protein (CRP) (P < 0.001) as laboratory measurements, and cardiovascular disease (CVD) was the underlying disease with an odds ratio of 10.94. Conclusions: The study concluded that the factors associated with death were laboratory measures, such as CRP, ESR, hemoglobin, and liver enzymes, and potential diseases, such as cardiovascular and central nervous system diseases.
{"title":"Impacted Factors on Death in Children with COVID-19","authors":"Noor Mohammad Noori, Saeedeh Yaghoubi, Gholamreza Soleimani, Tahereh Boryri, Alireza Teimouri, Sahar Safapour Moghadam, Seyed Hosein Soleimanzadeh Mousavi","doi":"10.5812/jcp-137674","DOIUrl":"https://doi.org/10.5812/jcp-137674","url":null,"abstract":"Background: The majority of children affected by coronavirus disease 2019 (COVID-19) are thought to be asymptomatic, with a lower mortality rate than adults. Objectives: The aim of this study was to evaluate risk factors associated with mortality in children with COVID-19. Methods: In this study, all patients were under 19 years of age, and their COVID-19 was confirmed by RT-PCR analysis. Primary data were related to underlying diseases, clinical and laboratory information, mortality, or safe discharge. The recorded data were analyzed using SPSS software (version 18), taking into account the significance level of < 0.05. Results: Of the 183 children enrolled in the study, the mortality rate was 13.67%. The major risk factors for death were clinical manifestations involving central nervous system (CNS) diseases (P = 0.006), platelet (PLT) count (P = 0.020), lactate dehydrogenase (LDH) (P < 0.001), alanine transaminase (ALT) (P = 0.033), erythrocyte sedimentation rate (ESR) (P < 0.001), and C-reactive protein (CRP) (P < 0.001) as laboratory measurements, and cardiovascular disease (CVD) was the underlying disease with an odds ratio of 10.94. Conclusions: The study concluded that the factors associated with death were laboratory measures, such as CRP, ESR, hemoglobin, and liver enzymes, and potential diseases, such as cardiovascular and central nervous system diseases.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":"212 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135462926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Toddlers are consuming more energy-dense, nutrient-poor foodstuffs in discordance with international dietary guidelines. Limited data are available on the dietary habits of children in Jordan. Objectives: This study aimed primarily at assessing the local validity of the NutricheQ tool in reflecting the nutritional risk status of 12- to 36-month-old toddlers in Jordan. Methods: This national, multicentre, observational validation study analyzed the data of healthy 12- to 36-month-old toddlers who were identified and prospectively enrolled during a routine clinic visit. After providing written informed consent, the parents or legal guardians of toddlers were asked to (a) complete a food intake diary form (FIDF) over three days (two weekdays and one weekend day); and (b) to answer the NutricheQ questionnaire completed by the physician during a single outpatient visit, as part of the case report form (CRF). Results: Out of 213 Jordanian toddlers, 31 (14.6%) were at low nutritional risk; 145 (68.1%) (95% confidential interval (CI): 61.5 - 74.0) were at moderate nutritional risk, and 37 (17.4%) (95% CI: 12.8 - 23.1) were at an increased nutritional risk. The average nutritional intake of the toddlers did not meet the daily intake of the main nutrients recommended across all food categories, with a default daily intake of vitamin A, vitamin D, fiber, and iodine and an excess daily intake of protein and iron. NutricheQ-predicted risk categories significantly correlated with meat intake and the number of weekly servings of fruits and cooked vegetables. Conclusions: NutricheQ is a valid tool to predict nutritional risk among toddlers in Jordan.
{"title":"Local Validation of NutricheQ, a Study in Jordan","authors":"Mofeed Abdelqader, Sameer Abdo, Maisa Jallad, Maha Muhtaseb, Shawqi Amerah, Qais Azar, Nabeel Fararjeh, Bashar Khasawneh, Furat Kreshan, Ayman Obeid, Mohammad Rawashdeh, Manar Shawbkeh, Suleimman Al-Sweedan","doi":"10.5812/jcp-137522","DOIUrl":"https://doi.org/10.5812/jcp-137522","url":null,"abstract":"Background: Toddlers are consuming more energy-dense, nutrient-poor foodstuffs in discordance with international dietary guidelines. Limited data are available on the dietary habits of children in Jordan. Objectives: This study aimed primarily at assessing the local validity of the NutricheQ tool in reflecting the nutritional risk status of 12- to 36-month-old toddlers in Jordan. Methods: This national, multicentre, observational validation study analyzed the data of healthy 12- to 36-month-old toddlers who were identified and prospectively enrolled during a routine clinic visit. After providing written informed consent, the parents or legal guardians of toddlers were asked to (a) complete a food intake diary form (FIDF) over three days (two weekdays and one weekend day); and (b) to answer the NutricheQ questionnaire completed by the physician during a single outpatient visit, as part of the case report form (CRF). Results: Out of 213 Jordanian toddlers, 31 (14.6%) were at low nutritional risk; 145 (68.1%) (95% confidential interval (CI): 61.5 - 74.0) were at moderate nutritional risk, and 37 (17.4%) (95% CI: 12.8 - 23.1) were at an increased nutritional risk. The average nutritional intake of the toddlers did not meet the daily intake of the main nutrients recommended across all food categories, with a default daily intake of vitamin A, vitamin D, fiber, and iodine and an excess daily intake of protein and iron. NutricheQ-predicted risk categories significantly correlated with meat intake and the number of weekly servings of fruits and cooked vegetables. Conclusions: NutricheQ is a valid tool to predict nutritional risk among toddlers in Jordan.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dadang Hudaya Somasetia, F. Meilyana, A. Widiasta, D. Rachmadi
Background: Sepsis-associated acute kidney injury (SA-AKI) is an acute kidney injury in the presence of sepsis without other significant contributing factors explaining acute kidney injury (AKI). Circulating syndecan-1, angiopoietin-2, and urinary neutrophil gelatinase-associated lipocalin levels can potentially cause neglected AKI to become acute kidney disease (AKD) and even chronic kidney disease (CKD). Therefore, studying its levels in the early phase of AKI is important, especially in SAAKI. Objectives: This study aims to analyze the levels of syndecan-1, angiopoietin-2, and urine neutrophil gelatinase-associated lipocalin (uNGAL) as other modalities that might detect AKI earlier in children with SAAKI. Methods: This study enrolled 23 children between one month and 18 years with sepsis. Blood samples were collected from all patients at the baseline, 12, 24, and 48 hours after admission to assess serum creatinine, syndecan-1, angiopoietin-2, and a urine sample was collected to measure uNGAL levels. We used the Wilcoxon signed-rank test to compare each biomarker with the time of measurement and the Mann-Whitney test to compare the levels of biomarkers with the incidence of SA-AKI. Results: The highest median value for uNGAL was 78.30 (3.20 - 24098.40) in the 12th-hour measurement; for syndecan was 2.92 (0.06 - 83.00) in the baseline measurement, slightly decreased and continued to increase up to 48 hours, and for Ang-2 was 4159.60 (17.60 - 226428.00) in the 12th-hour measurement. The incidence of SA-AKI based on the pediatric risk-injury-failure-loss-end stage (pRIFLE) criteria were that five children (21.7%) had AKI in the risk/injury phase at baseline, 24-hour, 48-hour observations, and also six children (26.1%) at 12-hour observation. Conclusion: There was an increase in levels of syndecan-1 and ang-2 in children with severe sepsis, especially in the first 24 hours.
{"title":"Endothelial Injury in Paediatric Sepsis-associated Acute Kidney Injury","authors":"Dadang Hudaya Somasetia, F. Meilyana, A. Widiasta, D. Rachmadi","doi":"10.5812/jcp-137916","DOIUrl":"https://doi.org/10.5812/jcp-137916","url":null,"abstract":"Background: Sepsis-associated acute kidney injury (SA-AKI) is an acute kidney injury in the presence of sepsis without other significant contributing factors explaining acute kidney injury (AKI). Circulating syndecan-1, angiopoietin-2, and urinary neutrophil gelatinase-associated lipocalin levels can potentially cause neglected AKI to become acute kidney disease (AKD) and even chronic kidney disease (CKD). Therefore, studying its levels in the early phase of AKI is important, especially in SAAKI. Objectives: This study aims to analyze the levels of syndecan-1, angiopoietin-2, and urine neutrophil gelatinase-associated lipocalin (uNGAL) as other modalities that might detect AKI earlier in children with SAAKI. Methods: This study enrolled 23 children between one month and 18 years with sepsis. Blood samples were collected from all patients at the baseline, 12, 24, and 48 hours after admission to assess serum creatinine, syndecan-1, angiopoietin-2, and a urine sample was collected to measure uNGAL levels. We used the Wilcoxon signed-rank test to compare each biomarker with the time of measurement and the Mann-Whitney test to compare the levels of biomarkers with the incidence of SA-AKI. Results: The highest median value for uNGAL was 78.30 (3.20 - 24098.40) in the 12th-hour measurement; for syndecan was 2.92 (0.06 - 83.00) in the baseline measurement, slightly decreased and continued to increase up to 48 hours, and for Ang-2 was 4159.60 (17.60 - 226428.00) in the 12th-hour measurement. The incidence of SA-AKI based on the pediatric risk-injury-failure-loss-end stage (pRIFLE) criteria were that five children (21.7%) had AKI in the risk/injury phase at baseline, 24-hour, 48-hour observations, and also six children (26.1%) at 12-hour observation. Conclusion: There was an increase in levels of syndecan-1 and ang-2 in children with severe sepsis, especially in the first 24 hours.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44192750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shahin Koohmanaee, Arash Bakhshi, Shayan Pourkazem, B. Motamed
Context: Hypothyroidism describes an endocrine disorder that occurs when the thyroid gland cannot secrete adequate thyroid hormones. Congenital hypothyroidism refers to a lack of thyroid hormone among newborns. Evidence Acquisition: The ISI Web of Sciences, Scopus, PubMed, and Google Scholar databases were reviewed for relevant articles published from 2000 to 2022. Results: Congenital hypothyroidism, occurring in approximately one in 2,000 to one in 4,000 newborns, ranks among the most frequent causes of intellectual disability that can be prevented. The screening of newborns, confirmation assessments, interpretation of thyroid function tests accurately, prompt and therapeutic treatment, and regular follow-up contribute to a very good neurocognitive outcome later in life. Since the timely diagnosis of congenital hypothyroidism is critical in preventing mental retardation, clinicians must be kept abreast of this disorder and educate nursing and medical students regarding accurate interpretations of diagnostic testing and the recognition of associated symptoms. Most newborns with congenital hypothyroidism present no symptoms, even though their TSH or T4 levels are likely to have fluctuated significantly. As a result, congenital hypothyroidism was rarely detected in newborns before the introduction of neonatal screenings. Conclusions: We provide an overview of the etiology, epidemiology, manifestation, diagnosis, and treatment of congenital hypothyroidism based on the latest studies.
{"title":"Diagnosis and Management of Congenital Hypothyroidism: An Updated Overview","authors":"Shahin Koohmanaee, Arash Bakhshi, Shayan Pourkazem, B. Motamed","doi":"10.5812/jcp-138532","DOIUrl":"https://doi.org/10.5812/jcp-138532","url":null,"abstract":"Context: Hypothyroidism describes an endocrine disorder that occurs when the thyroid gland cannot secrete adequate thyroid hormones. Congenital hypothyroidism refers to a lack of thyroid hormone among newborns. Evidence Acquisition: The ISI Web of Sciences, Scopus, PubMed, and Google Scholar databases were reviewed for relevant articles published from 2000 to 2022. Results: Congenital hypothyroidism, occurring in approximately one in 2,000 to one in 4,000 newborns, ranks among the most frequent causes of intellectual disability that can be prevented. The screening of newborns, confirmation assessments, interpretation of thyroid function tests accurately, prompt and therapeutic treatment, and regular follow-up contribute to a very good neurocognitive outcome later in life. Since the timely diagnosis of congenital hypothyroidism is critical in preventing mental retardation, clinicians must be kept abreast of this disorder and educate nursing and medical students regarding accurate interpretations of diagnostic testing and the recognition of associated symptoms. Most newborns with congenital hypothyroidism present no symptoms, even though their TSH or T4 levels are likely to have fluctuated significantly. As a result, congenital hypothyroidism was rarely detected in newborns before the introduction of neonatal screenings. Conclusions: We provide an overview of the etiology, epidemiology, manifestation, diagnosis, and treatment of congenital hypothyroidism based on the latest studies.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49319625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Hashemian, Rasool Poorjamal, M. Asgharzadeh, Saeid Sadatmansouri, M. Shahrokhi
Background: Vitamin D is a multifunctional hormone essential in the immune system. Vitamin D deficiency may increase the disease burden in patients with COVID-19. Objectives: We investigated the effect of vitamin D administration as an adjunctive therapy on treating children with COVID-19. Methods: Children with confirmed or probable COVID-19 who were admitted to 17th Shahrivar Hospital in Rasht from October 2022 to April 2023 were selected by random sampling method. They were divided into two groups by random blocks: the intervention group with vitamin D administration and the placebo-controlled group. The patient data were recorded and analyzed, including age, sex, and the required clinical and laboratory information, including the time required to recover from fever and respiratory distress and the length of hospitalization. Results: In this study, 60 patients (30 in each group) were evaluated. At the beginning of hospitalization, fever was significantly more observed in the intervention group (90% vs. 53.3%, P = 0.002). The average time required to recover from fever and respiratory distress was less in the intervention group, although this difference was not significant between the two groups (P = 0.591 and P = 0.192, respectively). The hospitalization duration was also similar in both groups, and no complications or death were observed in the two groups. Conclusions: Administering vitamin D at a dose of 1000 IU daily showed no significant efficacy for recovering children with COVID-19. Further studies are suggested to investigate the high dose of vitamin D supplementation in treating children with COVID-19.
{"title":"Efficacy of Vitamin D as Adjuvant Therapy for Treatment of Hospitalized Children with COVID-19: A Randomized Clinical Trial","authors":"H. Hashemian, Rasool Poorjamal, M. Asgharzadeh, Saeid Sadatmansouri, M. Shahrokhi","doi":"10.5812/jcp-138083","DOIUrl":"https://doi.org/10.5812/jcp-138083","url":null,"abstract":"Background: Vitamin D is a multifunctional hormone essential in the immune system. Vitamin D deficiency may increase the disease burden in patients with COVID-19. Objectives: We investigated the effect of vitamin D administration as an adjunctive therapy on treating children with COVID-19. Methods: Children with confirmed or probable COVID-19 who were admitted to 17th Shahrivar Hospital in Rasht from October 2022 to April 2023 were selected by random sampling method. They were divided into two groups by random blocks: the intervention group with vitamin D administration and the placebo-controlled group. The patient data were recorded and analyzed, including age, sex, and the required clinical and laboratory information, including the time required to recover from fever and respiratory distress and the length of hospitalization. Results: In this study, 60 patients (30 in each group) were evaluated. At the beginning of hospitalization, fever was significantly more observed in the intervention group (90% vs. 53.3%, P = 0.002). The average time required to recover from fever and respiratory distress was less in the intervention group, although this difference was not significant between the two groups (P = 0.591 and P = 0.192, respectively). The hospitalization duration was also similar in both groups, and no complications or death were observed in the two groups. Conclusions: Administering vitamin D at a dose of 1000 IU daily showed no significant efficacy for recovering children with COVID-19. Further studies are suggested to investigate the high dose of vitamin D supplementation in treating children with COVID-19.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48007343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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