Setila Dalili, Shahin Koohmanaee, A. Hassanzadeh Rad, Zahra Khalatbari, Reza Bayat, M. Shahrokhi
Background: Obesity is one of the causes of insulin resistance. Although it has been speculated that nettle is probably a safe treatment for insulin resistance, considering the shortage of evidence on its effects, we aimed to assess the effect of nettle extract on insulin resistance and metabolic parameters in obese children. Methods: In this paralleled-randomized controlled clinical trial, 64 children aged 12-18 years with obesity were randomly divided into two groups. The intervention group received nettle syrup twice a day for 12 weeks in addition to a specific diet, and the control group followed the diet alone. Demographic characteristics and metabolic results, and lipid profile were checked. Data were analyzed by IBM SPSS Statistics Version 24.0, and a P-value < 0.05 indicated statistical significance. Results: The results showed that most patients in the groups were girls. In the inter-group analyses, results showed significant differences in terms of FBS (P = 0.043), LDL (P = 0.023), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (P = 0.025) after eight weeks. Although FBS (P = 0.044) had a significant difference in the 12th week and was higher in the intervention group, it was still in the normal range. Conclusions: This study revealed that administering nettle syrup can be helpful for patients with obesity with no significant adverse effects, and it considerably reduced LDL, T-Chol, and HOMA-IR. Despite our promising results, further multicenter studies with larger sample sizes in this age group can be beneficial to confirm our results.
背景：肥胖是引起胰岛素抵抗的原因之一。尽管有人猜测荨麻可能是治疗胰岛素抵抗的安全药物，但考虑到缺乏有关其疗效的证据，我们旨在评估荨麻提取物对肥胖儿童胰岛素抵抗和代谢参数的影响。方法：在本平行随机对照临床试验中，64名12-18岁肥胖儿童被随机分为两组。除了特定的饮食外，干预组每天接受两次荨麻糖浆，持续12周，对照组单独接受饮食。对人口统计学特征、代谢结果和脂质状况进行了检查。数据采用IBM SPSS Statistics Version 24.0进行分析，P值<0.05表示具有统计学意义。结果：结果显示，两组患者中大多数是女孩。在组间分析中，结果显示8周后FBS（P=0.043）、LDL（P=0.023）和胰岛素抵抗稳态模型评估（HOMA-IR）（P=0.025）存在显著差异。尽管FBS（P=0.044）在第12周有显著差异，并且在干预组中更高，但仍在正常范围内。结论：本研究表明，服用荨麻糖浆对肥胖患者有帮助，没有显著的不良反应，并显著降低了LDL、T-Chol和HOMA-IR。尽管我们的结果很有希望，但在这个年龄段进行更多样本量的多中心研究可能有利于证实我们的结果。
{"title":"Can Nettle Extract Affect Insulin Resistance and Metabolic Parameters in Obese Children? A Paralleled- Randomized Controlled Clinical Trial","authors":"Setila Dalili, Shahin Koohmanaee, A. Hassanzadeh Rad, Zahra Khalatbari, Reza Bayat, M. Shahrokhi","doi":"10.5812/jcp-138234","DOIUrl":"https://doi.org/10.5812/jcp-138234","url":null,"abstract":"Background: Obesity is one of the causes of insulin resistance. Although it has been speculated that nettle is probably a safe treatment for insulin resistance, considering the shortage of evidence on its effects, we aimed to assess the effect of nettle extract on insulin resistance and metabolic parameters in obese children. Methods: In this paralleled-randomized controlled clinical trial, 64 children aged 12-18 years with obesity were randomly divided into two groups. The intervention group received nettle syrup twice a day for 12 weeks in addition to a specific diet, and the control group followed the diet alone. Demographic characteristics and metabolic results, and lipid profile were checked. Data were analyzed by IBM SPSS Statistics Version 24.0, and a P-value < 0.05 indicated statistical significance. Results: The results showed that most patients in the groups were girls. In the inter-group analyses, results showed significant differences in terms of FBS (P = 0.043), LDL (P = 0.023), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (P = 0.025) after eight weeks. Although FBS (P = 0.044) had a significant difference in the 12th week and was higher in the intervention group, it was still in the normal range. Conclusions: This study revealed that administering nettle syrup can be helpful for patients with obesity with no significant adverse effects, and it considerably reduced LDL, T-Chol, and HOMA-IR. Despite our promising results, further multicenter studies with larger sample sizes in this age group can be beneficial to confirm our results.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44369243","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}
Pub Date : 2023-08-20DOI: 10.5812/compreped-135359
M. Varzeshnejad, F. Najari, Maryam Khoshnood Shariati, Naeeme Taslimi Taleghani, Maryam Mahdizadeh-Shahri, A. Naseh
Background: Neonatal and pediatric health have a great share in global health programs. However, the neonatal mortality rate still shows unacceptable figures and statistics worldwide. Objectives: To investigate the timing and causes of neonatal death. Methods: In this retrospective descriptive study conducted in neonatal care units of Mahdiyeh Hospital in Tehran, Iran, the census sampling method was used to include all the medical records of the expired neonates during 2015-2020. Neonatal and maternal demographics and health complications were recorded. Descriptive statistics such as mean, standard deviation, frequency, and associations were analyzed to compare factors recorded as causes of neonatal death and its timing. A P-value of < 0.05 was considered significant. Results: Out of 24049 live births, 755 neonates had expired (3.1%). The expired neonates' average birth weight was 1616 ± 905 grams, and 35.9% weighed under 1000 grams. Most (80.8%) expired neonates were preterm (30.9 ± 4.8 gestational weeks), and the most common causes of neonatal death were prematurity (23.6%), congenital anomaly (19.9%), respiratory distress syndrome or RDS (19.5%), sepsis (13.2%), and asphyxia (7%). Most (60.7%) neonates died between the second and seventh days of birth. The following conditions were associated with an early-period neonatal death rather than a later-period: multiple births (OR = 2.8), normal vaginal delivery (OR = 2.03), low-birth-weight, diabetic mothers, neonatal heart disease, neonatal neurological diseases, RDS, asphyxia, familial marriage, and intrauterine growth restriction (IUGR) (P < 0.05). Being male (P = 0.005) or being multiple births (P < 0.0001) were associated with a higher risk of death. While 57% of mothers delivered through Cesarean section, among the expired neonates, 66.9% were delivered through Cesarean section. In expired neonates, Apgar scores were low in the first (5.71) and fifth (7.27) minutes of birth. Conclusions: Our study showed that prematurity, congenital anomaly, RDS, sepsis, and asphyxia were the most prevalent causes of death among expired neonates, respectively. Preterm birth and low birth weight were prevalent among expired neonates. Conducting regular similar studies periodically is important to identify, manage, and reduce neonatal mortality rates as an indicator of health promotion in the country.
{"title":"Causes, Timing, and Factors Related to Neonatal Death: A Descriptive Study","authors":"M. Varzeshnejad, F. Najari, Maryam Khoshnood Shariati, Naeeme Taslimi Taleghani, Maryam Mahdizadeh-Shahri, A. Naseh","doi":"10.5812/compreped-135359","DOIUrl":"https://doi.org/10.5812/compreped-135359","url":null,"abstract":"Background: Neonatal and pediatric health have a great share in global health programs. However, the neonatal mortality rate still shows unacceptable figures and statistics worldwide. Objectives: To investigate the timing and causes of neonatal death. Methods: In this retrospective descriptive study conducted in neonatal care units of Mahdiyeh Hospital in Tehran, Iran, the census sampling method was used to include all the medical records of the expired neonates during 2015-2020. Neonatal and maternal demographics and health complications were recorded. Descriptive statistics such as mean, standard deviation, frequency, and associations were analyzed to compare factors recorded as causes of neonatal death and its timing. A P-value of < 0.05 was considered significant. Results: Out of 24049 live births, 755 neonates had expired (3.1%). The expired neonates' average birth weight was 1616 ± 905 grams, and 35.9% weighed under 1000 grams. Most (80.8%) expired neonates were preterm (30.9 ± 4.8 gestational weeks), and the most common causes of neonatal death were prematurity (23.6%), congenital anomaly (19.9%), respiratory distress syndrome or RDS (19.5%), sepsis (13.2%), and asphyxia (7%). Most (60.7%) neonates died between the second and seventh days of birth. The following conditions were associated with an early-period neonatal death rather than a later-period: multiple births (OR = 2.8), normal vaginal delivery (OR = 2.03), low-birth-weight, diabetic mothers, neonatal heart disease, neonatal neurological diseases, RDS, asphyxia, familial marriage, and intrauterine growth restriction (IUGR) (P < 0.05). Being male (P = 0.005) or being multiple births (P < 0.0001) were associated with a higher risk of death. While 57% of mothers delivered through Cesarean section, among the expired neonates, 66.9% were delivered through Cesarean section. In expired neonates, Apgar scores were low in the first (5.71) and fifth (7.27) minutes of birth. Conclusions: Our study showed that prematurity, congenital anomaly, RDS, sepsis, and asphyxia were the most prevalent causes of death among expired neonates, respectively. Preterm birth and low birth weight were prevalent among expired neonates. Conducting regular similar studies periodically is important to identify, manage, and reduce neonatal mortality rates as an indicator of health promotion in the country.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41360116","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}
Introduction: Hypertriglyceridemia (HTG) and diabetic ketoacidosis (DKA) are complications of uncontrolled diabetes that may result in significant mortality or morbidity. Hypertriglyceridemia is a rare complication in children, and we report a case of hypertriglyceridemia in a child 12 years old with Diabetic Ketoacidosis. Case Presentation: We report the case of a 12-year-old patient who was referred to our center with polydipsia, polyuria, lethargy, and weakness. On admission, serum glucose was 300 mg/dL, hemoglobin A1c level was 10.7%, plasma triglyceride (TG) was very high, 13520 mg/dL, and cholesterol was 980 mg/dL. He had DKA with hypertriglyceridemia and acute pancreatitis. Conclusions: Insulin and fresh frozen plasma (FFP) injection is a safe, effective therapy for hypertriglyceridemia in DKA and rapidly lowers dangerously high triglyceride levels and prevents untoward complications.
{"title":"A Case of Hypertriglyceridemia in a Child 12 Years Old with Diabetic Ketoacidosis","authors":"Leyla Katebi","doi":"10.5812/jcp-135978","DOIUrl":"https://doi.org/10.5812/jcp-135978","url":null,"abstract":"Introduction: Hypertriglyceridemia (HTG) and diabetic ketoacidosis (DKA) are complications of uncontrolled diabetes that may result in significant mortality or morbidity. Hypertriglyceridemia is a rare complication in children, and we report a case of hypertriglyceridemia in a child 12 years old with Diabetic Ketoacidosis. Case Presentation: We report the case of a 12-year-old patient who was referred to our center with polydipsia, polyuria, lethargy, and weakness. On admission, serum glucose was 300 mg/dL, hemoglobin A1c level was 10.7%, plasma triglyceride (TG) was very high, 13520 mg/dL, and cholesterol was 980 mg/dL. He had DKA with hypertriglyceridemia and acute pancreatitis. Conclusions: Insulin and fresh frozen plasma (FFP) injection is a safe, effective therapy for hypertriglyceridemia in DKA and rapidly lowers dangerously high triglyceride levels and prevents untoward complications.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46000568","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}
Pub Date : 2023-07-23DOI: 10.5812/compreped-133658
S. Sadeghi-bojd, E. Zarifi, Motahare Alisofi, Saeideh Sarhadi
Background: Nephrotic syndrome (NS) is a common disease in children with many consequences for their health, particularly when the disease is severe, accompanied by frequent recurrences, and must be treated with high-dose, long-term corticosteroids. Objectives: We aimed to determine the effect of birth weight on complete response to corticosteroids in children with NS. Methods: Two hundred and ninety-two children with NS aged 1 - 18 years were included in the present cross-sectional study. The children followed up from 2010 to 2021 at Ali-Ibn-e-Abitaleb Hospital, Zahedan, Iran. Data were obtained by reviewing medical records for results and completing a parental self-reported questionnaire for birth-related information. For the analysis, SPSS 23 was applied with P < 0.05 as a significance level. Results: In the steroid-resistant (28.9%) group, low birth weight (LBW) was significantly higher than in the steroid-sensitive (10.5%) group (P = 0.001). A two-way logistic regression report showed that birth weight (P = 0.04, OR = 0.58, 95% CI: 0.34 - 0.99) and number of recurrences (P = 0.001, OR = 4.60, 95% CI: 2.91 - 7.27) were both significantly associated with the development of steroid resistance. Conclusions: In patients with NS, there was a significant association between LBW, higher relapse rates, steroid resistance, and thus poorer patient outcomes.
{"title":"The Prevalence of Low Birth Weight in Children with Nephrotic Syndrome","authors":"S. Sadeghi-bojd, E. Zarifi, Motahare Alisofi, Saeideh Sarhadi","doi":"10.5812/compreped-133658","DOIUrl":"https://doi.org/10.5812/compreped-133658","url":null,"abstract":"Background: Nephrotic syndrome (NS) is a common disease in children with many consequences for their health, particularly when the disease is severe, accompanied by frequent recurrences, and must be treated with high-dose, long-term corticosteroids. Objectives: We aimed to determine the effect of birth weight on complete response to corticosteroids in children with NS. Methods: Two hundred and ninety-two children with NS aged 1 - 18 years were included in the present cross-sectional study. The children followed up from 2010 to 2021 at Ali-Ibn-e-Abitaleb Hospital, Zahedan, Iran. Data were obtained by reviewing medical records for results and completing a parental self-reported questionnaire for birth-related information. For the analysis, SPSS 23 was applied with P < 0.05 as a significance level. Results: In the steroid-resistant (28.9%) group, low birth weight (LBW) was significantly higher than in the steroid-sensitive (10.5%) group (P = 0.001). A two-way logistic regression report showed that birth weight (P = 0.04, OR = 0.58, 95% CI: 0.34 - 0.99) and number of recurrences (P = 0.001, OR = 4.60, 95% CI: 2.91 - 7.27) were both significantly associated with the development of steroid resistance. Conclusions: In patients with NS, there was a significant association between LBW, higher relapse rates, steroid resistance, and thus poorer patient outcomes.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45457325","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}
B. Zargaran, M. Naghibi, F. Akhavein, Hassan Mottaghi Moghaddam Shahri
Background: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. Patients with repaired TOF (rTOF) expose to moderate to severe pulmonary regurgitation (PR), right ventricular (RV) dysfunction, and RV failure. Although cardiac magnetic resonance (CMR) provides details of RV function and structure, an electrocardiogram (ECG) is accessible and inexpensive. Objectives: We aimed to assess the correlation between clinical symptoms and ECG parameters with CMR findings. Methods: This cross-sectional study assessed the patients with rTOF who underwent CMR between May 2020 and September 2022 in Imam Reza Hospital. The signs and symptoms of rTOF were assessed, and a pediatric cardiologist interpreted ECG parameters. We considered CMR findings, clinical symptoms, and ECG parameters with CMR findings in rTOF. In addition, fragmented QRS (fQRS), the additional spikes within the QRS complex, was used to indicate conduction disturbance due to myocardial scar or fibrosis. Data were analyzed by SPSS version 18. Results: Among 42 patients with rTOF, 20 patients were male. Although the QT correction (QTc) had a significant correlation with CMR parameters, fQRS showed a positive correlation with right ventricular ejection fraction (RVEF) less than 47% (OR 2.06, 95% CI 1.45 - 2.93; P-value = 0.005), right ventricular end-diastolic volume (RVEDV) more than 150 mL/m2 (OR 4.4, 95% CI 2.03 - 9.5; P-value = 0), and right ventricular end-systolic volume (RVESV) more than 80 mL/m2 (OR 2.83, 95% CI 1.59 - 5.04; P-value = 0). We found a murmur in the clinical examination of 64.3% of patients. Our results showed that tachycardia and tachypnea were the most common signs in these patients. Surgery at a young age was significantly correlated to lower ascending aortic volume, right pulmonary artery size, left pulmonary artery size, right atrium and left atrium volume, and main pulmonary artery flow. Conclusions: Compared to other ECG parameters, fQRS could strongly predict RVESV, RVEDV, and RVEF as the right heart indexes. Besides, repair surgery at a younger age reduces the possibility of needing pulmonary valve replacement surgery at older ages. Therefore, clinicians should consider these issues in patients.
{"title":"Comparison and Validity of Fragmented QRS (fQRS) Against Cardiac Magnetic Resonance (CMR) in Predicting Right Heart Function in Tetralogy of Fallot Patients After Reconstructive Surgery","authors":"B. Zargaran, M. Naghibi, F. Akhavein, Hassan Mottaghi Moghaddam Shahri","doi":"10.5812/jcp-136258","DOIUrl":"https://doi.org/10.5812/jcp-136258","url":null,"abstract":"Background: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. Patients with repaired TOF (rTOF) expose to moderate to severe pulmonary regurgitation (PR), right ventricular (RV) dysfunction, and RV failure. Although cardiac magnetic resonance (CMR) provides details of RV function and structure, an electrocardiogram (ECG) is accessible and inexpensive. Objectives: We aimed to assess the correlation between clinical symptoms and ECG parameters with CMR findings. Methods: This cross-sectional study assessed the patients with rTOF who underwent CMR between May 2020 and September 2022 in Imam Reza Hospital. The signs and symptoms of rTOF were assessed, and a pediatric cardiologist interpreted ECG parameters. We considered CMR findings, clinical symptoms, and ECG parameters with CMR findings in rTOF. In addition, fragmented QRS (fQRS), the additional spikes within the QRS complex, was used to indicate conduction disturbance due to myocardial scar or fibrosis. Data were analyzed by SPSS version 18. Results: Among 42 patients with rTOF, 20 patients were male. Although the QT correction (QTc) had a significant correlation with CMR parameters, fQRS showed a positive correlation with right ventricular ejection fraction (RVEF) less than 47% (OR 2.06, 95% CI 1.45 - 2.93; P-value = 0.005), right ventricular end-diastolic volume (RVEDV) more than 150 mL/m2 (OR 4.4, 95% CI 2.03 - 9.5; P-value = 0), and right ventricular end-systolic volume (RVESV) more than 80 mL/m2 (OR 2.83, 95% CI 1.59 - 5.04; P-value = 0). We found a murmur in the clinical examination of 64.3% of patients. Our results showed that tachycardia and tachypnea were the most common signs in these patients. Surgery at a young age was significantly correlated to lower ascending aortic volume, right pulmonary artery size, left pulmonary artery size, right atrium and left atrium volume, and main pulmonary artery flow. Conclusions: Compared to other ECG parameters, fQRS could strongly predict RVESV, RVEDV, and RVEF as the right heart indexes. Besides, repair surgery at a younger age reduces the possibility of needing pulmonary valve replacement surgery at older ages. Therefore, clinicians should consider these issues in patients.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48953849","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}
Pub Date : 2023-07-13DOI: 10.5812/compreped-133639
Shahla Ansari Damavandi, S. Sayyahfar, N. Ashayeri, Maryam Shamspour, M. Jafari, S. Salahi
Background: Patients with beta-thalassemia (BT) are more prone to infections than others, especially when they have some risk factors. Some reports showed the lower severity of Coronavirus disease 2019 (COVID-19) infection in this population. Objectives: In this study, we aimed to determine the serological status of COVID-19 in BT patients. Methods: This cross-sectional study was conducted in September 2020-February 2021 at Ali-Asghar Children's Hospital, Iran. All major and intermedia β-thalassemia patients dependent on blood transfusion were enrolled in this study. Demographic information, including age, gender, thalassemia type, history of splenectomy, and blood type, were recorded in a checklist. Moreover, the patients were asked about their exposure to COVID-19, and the related symptoms, such as cough, fever, headache, and anosmia, in the last six months. The enrolled cases were examined for anti-COVID-19 IgM and IgG to determine the serological status against this virus. Results: The positive IgG and IgM tests against COVID-19 were in 35.7% (25/70) and 20% (14/70) of cases, respectively, while 42.9% (30/70) were either IgM- or IgG-positive. Among the serologically positive cases, six had a history of at least one symptom suspicious of COVID-19. These six included one fever, two coughs, one anosmia, one dyspnea, and one cough and anosmia. Only one of the patients was hospitalized (1%) with fever and dyspnea. No Intensive Care Unit admission or mortality was reported. Conclusions: It seems that COVID-19 is more likely to be mild or asymptomatic in patients with BT.
{"title":"COVID-19 Serological Status in Beta-thalassemia Patients in Iran: A Retrospective Descriptive Study","authors":"Shahla Ansari Damavandi, S. Sayyahfar, N. Ashayeri, Maryam Shamspour, M. Jafari, S. Salahi","doi":"10.5812/compreped-133639","DOIUrl":"https://doi.org/10.5812/compreped-133639","url":null,"abstract":"Background: Patients with beta-thalassemia (BT) are more prone to infections than others, especially when they have some risk factors. Some reports showed the lower severity of Coronavirus disease 2019 (COVID-19) infection in this population. Objectives: In this study, we aimed to determine the serological status of COVID-19 in BT patients. Methods: This cross-sectional study was conducted in September 2020-February 2021 at Ali-Asghar Children's Hospital, Iran. All major and intermedia β-thalassemia patients dependent on blood transfusion were enrolled in this study. Demographic information, including age, gender, thalassemia type, history of splenectomy, and blood type, were recorded in a checklist. Moreover, the patients were asked about their exposure to COVID-19, and the related symptoms, such as cough, fever, headache, and anosmia, in the last six months. The enrolled cases were examined for anti-COVID-19 IgM and IgG to determine the serological status against this virus. Results: The positive IgG and IgM tests against COVID-19 were in 35.7% (25/70) and 20% (14/70) of cases, respectively, while 42.9% (30/70) were either IgM- or IgG-positive. Among the serologically positive cases, six had a history of at least one symptom suspicious of COVID-19. These six included one fever, two coughs, one anosmia, one dyspnea, and one cough and anosmia. Only one of the patients was hospitalized (1%) with fever and dyspnea. No Intensive Care Unit admission or mortality was reported. Conclusions: It seems that COVID-19 is more likely to be mild or asymptomatic in patients with BT.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48611030","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}
Pub Date : 2023-07-01DOI: 10.5812/compreped-136807
H. Al-Oran, A. AL-Sagarat, Faris A. Alsaraireh, Deema Mahasneh
Background: Family-centered care (FCC) is widely accepted as a care model and is a basic core principle of pediatric nursing. Objectives: This study aims to investigate pediatric nurses’ perceptions and practices toward FCC in selected governmental hospitals and assess the relationship between age, academic level, and pediatric nurses’ perceptions. Methods: This cross-sectional study was carried out on 102 pediatric nurses. A survey containing socio- demographic information sheet and an FCC questionnaire will be distributed to pediatric nurses from January 2022 to March 2022. Results: The findings show that the overall mean score of the pediatric nurses toward FCC is 3.38 ± 0.10, indicating modest perceptions and practices toward FCC. The dimension stipulating “Family is the constant” has the highest score (3.56 ± 0.78), while the dimension stipulating “Parent-to-parent support” has the lowest score (3.26 ± 0.86). Besides, there are no correlations between participants’ age, academic level, and overall FCC. Conclusions: This study gives insight into FCC employed in designing policies and interventions in several healthcare settings in Jordan. Importantly, such insights might raise positive perceptions and practice among pediatric nurses toward FCC.
{"title":"A Cross-Sectional Study of Pediatric Nurses’ Perceptions and Practices of Family-Centered Care in Governmental Pediatric Setting","authors":"H. Al-Oran, A. AL-Sagarat, Faris A. Alsaraireh, Deema Mahasneh","doi":"10.5812/compreped-136807","DOIUrl":"https://doi.org/10.5812/compreped-136807","url":null,"abstract":"Background: Family-centered care (FCC) is widely accepted as a care model and is a basic core principle of pediatric nursing. Objectives: This study aims to investigate pediatric nurses’ perceptions and practices toward FCC in selected governmental hospitals and assess the relationship between age, academic level, and pediatric nurses’ perceptions. Methods: This cross-sectional study was carried out on 102 pediatric nurses. A survey containing socio- demographic information sheet and an FCC questionnaire will be distributed to pediatric nurses from January 2022 to March 2022. Results: The findings show that the overall mean score of the pediatric nurses toward FCC is 3.38 ± 0.10, indicating modest perceptions and practices toward FCC. The dimension stipulating “Family is the constant” has the highest score (3.56 ± 0.78), while the dimension stipulating “Parent-to-parent support” has the lowest score (3.26 ± 0.86). Besides, there are no correlations between participants’ age, academic level, and overall FCC. Conclusions: This study gives insight into FCC employed in designing policies and interventions in several healthcare settings in Jordan. Importantly, such insights might raise positive perceptions and practice among pediatric nurses toward FCC.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46229924","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}
Pub Date : 2023-06-26DOI: 10.5812/compreped-136019
Shokouh Hamidifar, N. Moazzen, H. Ahanchian
Context: Atopic dermatitis is among the most common chronic diseases in children, with increasing prevalence. Objectives: This study evaluated the relationship between the microbial composition of nasal nares and atopic dermatitis severity. Study Selection: This meta-analysis included all types of studies (experimental and observational) on nasal colonization of pediatrics (age ≤ 19 years old) with a diagnosis of AD confirmed by a physician. The following search strategy was used in the databases: Atopic dermatitis AND (nasal OR nares). Results: Twenty-two studies were included in our analysis. Nine studies compared the odds of S. aureus nasal colonization between AD pediatrics and non-AD healthy controls. In 13 studies, there was no control group. Subgroup analysis was performed on eight studies regarding AD severity in pediatrics with positive nasal colonization of S. aureus. Pooled analysis showed that S. aureus was colonized in 38% of the pediatrics with mild AD, 50% with moderate AD, and 22% with severe AD. The random-effects model showed that the odds of nasal colonization of S. aureus were significantly higher in AD pediatrics than in non-AD healthy controls (OR: 2.52; 95% CI (1.60, 3.97); I2 = 72%). Conclusions: The nasal cavity of pediatric AD patients was more colonized with Staphylococcus aureus than in healthy children. More studies on children with severe AD are needed to accurately prove the role of S. aureus colonization in the severity of atopic dermatitis.
{"title":"Relationship Between Nasal Cavity Microbial Colonization and Atopic Dermatitis Severity: A Systematic Review and Meta-analysis","authors":"Shokouh Hamidifar, N. Moazzen, H. Ahanchian","doi":"10.5812/compreped-136019","DOIUrl":"https://doi.org/10.5812/compreped-136019","url":null,"abstract":"Context: Atopic dermatitis is among the most common chronic diseases in children, with increasing prevalence. Objectives: This study evaluated the relationship between the microbial composition of nasal nares and atopic dermatitis severity. Study Selection: This meta-analysis included all types of studies (experimental and observational) on nasal colonization of pediatrics (age ≤ 19 years old) with a diagnosis of AD confirmed by a physician. The following search strategy was used in the databases: Atopic dermatitis AND (nasal OR nares). Results: Twenty-two studies were included in our analysis. Nine studies compared the odds of S. aureus nasal colonization between AD pediatrics and non-AD healthy controls. In 13 studies, there was no control group. Subgroup analysis was performed on eight studies regarding AD severity in pediatrics with positive nasal colonization of S. aureus. Pooled analysis showed that S. aureus was colonized in 38% of the pediatrics with mild AD, 50% with moderate AD, and 22% with severe AD. The random-effects model showed that the odds of nasal colonization of S. aureus were significantly higher in AD pediatrics than in non-AD healthy controls (OR: 2.52; 95% CI (1.60, 3.97); I2 = 72%). Conclusions: The nasal cavity of pediatric AD patients was more colonized with Staphylococcus aureus than in healthy children. More studies on children with severe AD are needed to accurately prove the role of S. aureus colonization in the severity of atopic dermatitis.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49588174","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}
Pub Date : 2023-05-24DOI: 10.5812/compreped-136461
Seyyedeh Azade Hoseini Nouri, M. Zarkesh
Context: Hyperbilirubinemia is a common cause for diagnostic work-up and therapeutic intervention in neonates and needs a convenient, quick, and safe treatment modality. Phototherapy is the most common treatment for neonatal jaundice; however, complementary treatment is still needed. Despite the identification of the enzymatic pathways of bilirubin catabolism, few pharmacological interventions have been found to be effective in reducing bilirubin, along with traditional phototherapy. This review was conducted to evaluate recent pharmacotherapies as adjuvants to phototherapy for the treatment of neonatal indirect hyperbilirubinemia (IHB). Evidence Acquisition: This study was carried out through a literature search with the keywords of Infant, Newborn, and Indirect Hyperbilirubinemia, combined with Drug Therapy, in PubMed, Scopus, International Statistical Institute, Web of Science, Cochrane, and Embase databases. This study included relevant articles (i.e., randomized controlled trials, observational studies, guidelines, and reviews) written in English and published between 2012 - 2022. Results: This narrative review first assessed the relevant articles to define IHB and its etiology. Then, the efficacy and side effects of recent pharmacologic agents as adjuvants to phototherapy were discussed. Additionally, this study reviewed the efficacy and safety of drugs prescribed to neonates to prevent jaundice. Conclusions: The best drug for adjuvant pharmacotherapy, in addition to phototherapy, for neonatal jaundice has not still been identified. The use of probiotics, prebiotics, synbiotics, and ursodeoxycholic acid (UDCA) in adjuvant to phototherapy has been recently increasing, and beneficial results were observed in most studies. The use of agar, charcoal, fibrate, and phenobarbital had a minor therapeutic role in recent years. There were conflicting results about the efficacy of herbal agents in neonatal jaundice. The use of intravenous immunoglobulin (IVIG), metalloporphyrin, and albumin is also limited to severe or immune-related IHB cases. The prescription of the aforementioned drugs sometimes had different results. Therefore, further research in this regard is necessary.
背景:高胆红素血症是新生儿诊断检查和治疗干预的常见原因，需要一种方便、快速、安全的治疗方式。光疗是新生儿黄疸最常见的治疗方法;然而，补充治疗仍然是必要的。尽管已经确定了胆红素分解代谢的酶促途径，但除了传统的光疗外，很少有药物干预能够有效地降低胆红素。这篇综述是为了评价最近的药物治疗作为辅助光疗治疗新生儿间接高胆红素血症(IHB)。证据获取:本研究通过检索PubMed、Scopus、International Statistical Institute、Web of Science、Cochrane、Embase等数据库的文献，检索关键词为Infant、neonatal、Indirect Hyperbilirubinemia, combined with Drug Therapy。本研究纳入了2012 - 2022年间发表的英文相关文章(即随机对照试验、观察性研究、指南和综述)。结果:这篇叙述性综述首先评估了相关文章来定义IHB及其病因。并对近年来光疗辅助药物的疗效及副作用进行了综述。此外，本研究回顾了新生儿预防黄疸药物的有效性和安全性。结论:新生儿黄疸除光疗外，辅助药物治疗的最佳药物仍未确定。近年来，益生菌、益生元、合成菌和熊去氧胆酸(UDCA)在辅助光疗中的应用越来越多，并且在大多数研究中观察到有益的结果。近年来，琼脂、木炭、贝特酸盐和苯巴比妥的治疗作用较小。关于中药治疗新生儿黄疸的疗效，目前的研究结果存在矛盾。静脉注射免疫球蛋白(IVIG)、金属卟啉和白蛋白也仅限于严重或免疫相关的IHB病例。上述药物的处方有时会产生不同的结果。因此，这方面的进一步研究是必要的。
{"title":"Recent Advances in Adjuvant Pharmacotherapy for Neonatal Indirect Hyperbilirubinemia: A Narrative Review","authors":"Seyyedeh Azade Hoseini Nouri, M. Zarkesh","doi":"10.5812/compreped-136461","DOIUrl":"https://doi.org/10.5812/compreped-136461","url":null,"abstract":"Context: Hyperbilirubinemia is a common cause for diagnostic work-up and therapeutic intervention in neonates and needs a convenient, quick, and safe treatment modality. Phototherapy is the most common treatment for neonatal jaundice; however, complementary treatment is still needed. Despite the identification of the enzymatic pathways of bilirubin catabolism, few pharmacological interventions have been found to be effective in reducing bilirubin, along with traditional phototherapy. This review was conducted to evaluate recent pharmacotherapies as adjuvants to phototherapy for the treatment of neonatal indirect hyperbilirubinemia (IHB). Evidence Acquisition: This study was carried out through a literature search with the keywords of Infant, Newborn, and Indirect Hyperbilirubinemia, combined with Drug Therapy, in PubMed, Scopus, International Statistical Institute, Web of Science, Cochrane, and Embase databases. This study included relevant articles (i.e., randomized controlled trials, observational studies, guidelines, and reviews) written in English and published between 2012 - 2022. Results: This narrative review first assessed the relevant articles to define IHB and its etiology. Then, the efficacy and side effects of recent pharmacologic agents as adjuvants to phototherapy were discussed. Additionally, this study reviewed the efficacy and safety of drugs prescribed to neonates to prevent jaundice. Conclusions: The best drug for adjuvant pharmacotherapy, in addition to phototherapy, for neonatal jaundice has not still been identified. The use of probiotics, prebiotics, synbiotics, and ursodeoxycholic acid (UDCA) in adjuvant to phototherapy has been recently increasing, and beneficial results were observed in most studies. The use of agar, charcoal, fibrate, and phenobarbital had a minor therapeutic role in recent years. There were conflicting results about the efficacy of herbal agents in neonatal jaundice. The use of intravenous immunoglobulin (IVIG), metalloporphyrin, and albumin is also limited to severe or immune-related IHB cases. The prescription of the aforementioned drugs sometimes had different results. Therefore, further research in this regard is necessary.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46623868","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}
Pub Date : 2023-05-24DOI: 10.5812/compreped-134561
N. Rochmah, Yuni Hisbiyah, R. Perwitasari, Jeny Rosaningrum, Garindra Wicaksono, N. P. Kusumastuti, Mahendra Tri Arif Sampurna, I. K. A. Utamayasa, M. Faizi
Background: Type 1 Diabetes Mellitus (T1DM) is a chronic disease that requires complicated therapies. The coronavirus disease 2019 (COVID-19) pandemic has caused lockdown restrictions, compromising access to medical care, including T1DM management. Poor medication adherence may affect the quality of life (QoL) and glycemic control. Objectives: This study analyzed the association among QoL, medication adherence, and glycemic control in T1DM patients during the COVID-19 pandemic. Methods: This study recruited T1DM patients aged 5 - 18 who regularly visited the pediatric endocrinology outpatient clinic. The PedsQL 3.2 and the diabetes management questionnaire (DMQ) were used to measure QoL and medication adherence. In addition, glycemic control was measured based on HbA1c levels. All data were analyzed using SPSS version 17, and correlations between variables were analyzed using Spearman or Pearson correlation tests. Results: Twenty-five children and adolescents with a mean age of 141.1 months (± 36.7) were included in this study. The mean HbA1c level was 10.7 mg/dL (± 2.4). Around 19 (76%) participants had already experienced diabetic ketoacidosis (DKA). There was no significant correlation between QoL and medication adherence or HbA1c level (P = 0.220, r = - 0.254; P = 0.753, and r = - 0.066, respectively). Conclusions: Our study’s QoL and medication adherence of T1DM children was relatively good even though the HbA1c was still high. However, numerous factors affect QoL and medication adherence in T1DM children other than HbA1c level.
背景:1型糖尿病(T1DM)是一种需要复杂治疗的慢性疾病。2019年冠状病毒病(COVID-19)大流行导致封锁限制，影响了获得医疗服务，包括T1DM管理。不良的药物依从性可能影响生活质量(QoL)和血糖控制。目的:本研究分析新冠肺炎大流行期间T1DM患者生活质量、药物依从性和血糖控制之间的关系。方法:本研究招募年龄在5 - 18岁、定期到儿科内分泌科门诊就诊的T1DM患者。采用PedsQL 3.2和糖尿病管理问卷(DMQ)测量患者的生活质量和药物依从性。此外，根据HbA1c水平测量血糖控制。所有数据均采用SPSS version 17进行分析，变量之间的相关性采用Spearman或Pearson相关检验进行分析。结果:25例儿童和青少年纳入本研究，平均年龄为141.1个月(±36.7)。平均HbA1c水平为10.7 mg/dL(±2.4)。大约19名(76%)参与者已经经历过糖尿病酮症酸中毒(DKA)。生活质量与服药依从性、HbA1c水平无显著相关性(P = 0.220, r = - 0.254;P = 0.753, r = - 0.066)。结论:本研究中T1DM患儿在HbA1c仍较高的情况下，生活质量和药物依从性较好。然而，除HbA1c水平外，还有许多因素影响T1DM儿童的生活质量和药物依从性。
{"title":"Quality of Life, Medication Adherence, and Glycemic Control in Type 1 Diabetes Mellitus Children with Basal Bolus Regimen During COVID-19 in Limited Resources Setting","authors":"N. Rochmah, Yuni Hisbiyah, R. Perwitasari, Jeny Rosaningrum, Garindra Wicaksono, N. P. Kusumastuti, Mahendra Tri Arif Sampurna, I. K. A. Utamayasa, M. Faizi","doi":"10.5812/compreped-134561","DOIUrl":"https://doi.org/10.5812/compreped-134561","url":null,"abstract":"Background: Type 1 Diabetes Mellitus (T1DM) is a chronic disease that requires complicated therapies. The coronavirus disease 2019 (COVID-19) pandemic has caused lockdown restrictions, compromising access to medical care, including T1DM management. Poor medication adherence may affect the quality of life (QoL) and glycemic control. Objectives: This study analyzed the association among QoL, medication adherence, and glycemic control in T1DM patients during the COVID-19 pandemic. Methods: This study recruited T1DM patients aged 5 - 18 who regularly visited the pediatric endocrinology outpatient clinic. The PedsQL 3.2 and the diabetes management questionnaire (DMQ) were used to measure QoL and medication adherence. In addition, glycemic control was measured based on HbA1c levels. All data were analyzed using SPSS version 17, and correlations between variables were analyzed using Spearman or Pearson correlation tests. Results: Twenty-five children and adolescents with a mean age of 141.1 months (± 36.7) were included in this study. The mean HbA1c level was 10.7 mg/dL (± 2.4). Around 19 (76%) participants had already experienced diabetic ketoacidosis (DKA). There was no significant correlation between QoL and medication adherence or HbA1c level (P = 0.220, r = - 0.254; P = 0.753, and r = - 0.066, respectively). Conclusions: Our study’s QoL and medication adherence of T1DM children was relatively good even though the HbA1c was still high. However, numerous factors affect QoL and medication adherence in T1DM children other than HbA1c level.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47417685","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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