Pub Date : 2023-05-19DOI: 10.5812/compreped-136054
Narges Lashkarbolouk, Mahdi Mazandarani, Ali Ahani Azari, Lobat Shahkar
Introduction: Chronic granulomatous disease (CGD) is a primary hereditary immunodeficiency condition caused by a defect in the nicotinamide adenine dinucleotide phosphate (NADP) oxidase complex. Recurrent infections and inflammatory complications with a narrow bacterial and fungal spectrum characterize CGD. Acute inflammatory and infectious complications are vexing and fatal for them. Therefore, managing CGD with prophylactic antibiotics and antifungal agents is essential. Case Presentation: We present a 23-month-old infant with a chief complaint of recent lymphadenopathy diagnosed with CGD. Two months later, she was hospitalized with uncontrolled fever and lung involvement while receiving prophylactic treatment with trimethoprim/sulfamethoxazole. A mass-like consolidation was seen in her radiography evaluation. Based on the biopsy and bronchoalveolar lavage (BAL) pathology report, pulmonary mucormycosis was confirmed. Two weeks after starting the standard treatment regimen with amphotericin B, the patient’s symptoms improved. She was discharged in good general condition with oral voriconazole and trimethoprim/sulfamethoxazole and referred to do hematopoietic stem cell transplantation (HSCT). Conclusions: Mucormycosis in CGD is not a common infection and usually infects patients with impaired cell-mediated immunity, hematological malignancies, steroid treatment, and diabetes. Patients with CGD are vulnerable when treated with a high dose of immunosuppressant medications. In our case report, the patient was infected with mucormycosis despite not receiving immunosuppressant medications and having no history of hematologic malignancies or diabetes. Our patient also had a mass-like consolidation in her radiological result, a rare feature of pulmonary mucormycosis involvement in CGD patients.
{"title":"An Unusual Presentation of Pulmonary Mucormycosis as a “Mass-like” Consolidation in an Infant with Chronic Granulomatous: A Case Report Study","authors":"Narges Lashkarbolouk, Mahdi Mazandarani, Ali Ahani Azari, Lobat Shahkar","doi":"10.5812/compreped-136054","DOIUrl":"https://doi.org/10.5812/compreped-136054","url":null,"abstract":"Introduction: Chronic granulomatous disease (CGD) is a primary hereditary immunodeficiency condition caused by a defect in the nicotinamide adenine dinucleotide phosphate (NADP) oxidase complex. Recurrent infections and inflammatory complications with a narrow bacterial and fungal spectrum characterize CGD. Acute inflammatory and infectious complications are vexing and fatal for them. Therefore, managing CGD with prophylactic antibiotics and antifungal agents is essential. Case Presentation: We present a 23-month-old infant with a chief complaint of recent lymphadenopathy diagnosed with CGD. Two months later, she was hospitalized with uncontrolled fever and lung involvement while receiving prophylactic treatment with trimethoprim/sulfamethoxazole. A mass-like consolidation was seen in her radiography evaluation. Based on the biopsy and bronchoalveolar lavage (BAL) pathology report, pulmonary mucormycosis was confirmed. Two weeks after starting the standard treatment regimen with amphotericin B, the patient’s symptoms improved. She was discharged in good general condition with oral voriconazole and trimethoprim/sulfamethoxazole and referred to do hematopoietic stem cell transplantation (HSCT). Conclusions: Mucormycosis in CGD is not a common infection and usually infects patients with impaired cell-mediated immunity, hematological malignancies, steroid treatment, and diabetes. Patients with CGD are vulnerable when treated with a high dose of immunosuppressant medications. In our case report, the patient was infected with mucormycosis despite not receiving immunosuppressant medications and having no history of hematologic malignancies or diabetes. Our patient also had a mass-like consolidation in her radiological result, a rare feature of pulmonary mucormycosis involvement in CGD patients.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44989440","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 : 2023-05-18DOI: 10.5812/compreped-135095
F. Imanzadeh, Beheshteh Olang, A. Sayyari, N. Dara, K. Khatami, A. Hosseini, Maryam Kazemi Aghdam, M. Khalili, M. Hajipour, Zahra Fazeli Farsan, Negar Imanzadeh, Ayeh Yaraghi, Tahereh Hatami, S. Mohammadi
Background: Non-alcoholic fatty liver disease (NAFLD) occurs with the pathological accumulation of fat in the liver and is one of the most common liver disorders worldwide among adults and even children. Obesity is a risk factor for NAFLD. Objectives: Considering the increasing prevalence of obesity in Iran and worldwide, this study was conducted to determine the prevalence of NAFLD and its related factors in overweight and obese students of schools in Tehran, Iran. Methods: This cross-sectional study was performed on 115 overweight and obese students [body mass index (BMI) ≥ 25] with an age range of 7 - 17 years. Eligible individuals were classified into two groups with and without NAFLD. Liver ultrasonography and measurement of serum parameters, including fasting blood sugar, lipid profile, and liver enzymes, were performed. Next, the demographic and anthropometric characteristics were compared between the two groups. Results: Out of 115 studied students, 71 subjects were boys (61.7%). The results showed that the mean BMI in patients with fatty liver was significantly higher than in individuals without fatty liver (P = 0.03). According to our findings, the mean total cholesterol in NAFLD patients was significantly higher than in the group without NAFLD (P = 0.008). The univariate logistic regression model results for measuring factors related to fatty liver in students showed a significant positive correlation between male gender, BMI, total cholesterol, aspartate aminotransferase, and alanine aminotransferase. Conclusions: NAFLD is a substantial problem in school children and correlates with elevated BMI. Therefore, the measurement of BMI can be used as a useful predictor and screening tool for NAFLD in school children.
{"title":"Prevalence and Related Factors for Non-alcoholic Fatty Liver Disease in Obese Students","authors":"F. Imanzadeh, Beheshteh Olang, A. Sayyari, N. Dara, K. Khatami, A. Hosseini, Maryam Kazemi Aghdam, M. Khalili, M. Hajipour, Zahra Fazeli Farsan, Negar Imanzadeh, Ayeh Yaraghi, Tahereh Hatami, S. Mohammadi","doi":"10.5812/compreped-135095","DOIUrl":"https://doi.org/10.5812/compreped-135095","url":null,"abstract":"Background: Non-alcoholic fatty liver disease (NAFLD) occurs with the pathological accumulation of fat in the liver and is one of the most common liver disorders worldwide among adults and even children. Obesity is a risk factor for NAFLD. Objectives: Considering the increasing prevalence of obesity in Iran and worldwide, this study was conducted to determine the prevalence of NAFLD and its related factors in overweight and obese students of schools in Tehran, Iran. Methods: This cross-sectional study was performed on 115 overweight and obese students [body mass index (BMI) ≥ 25] with an age range of 7 - 17 years. Eligible individuals were classified into two groups with and without NAFLD. Liver ultrasonography and measurement of serum parameters, including fasting blood sugar, lipid profile, and liver enzymes, were performed. Next, the demographic and anthropometric characteristics were compared between the two groups. Results: Out of 115 studied students, 71 subjects were boys (61.7%). The results showed that the mean BMI in patients with fatty liver was significantly higher than in individuals without fatty liver (P = 0.03). According to our findings, the mean total cholesterol in NAFLD patients was significantly higher than in the group without NAFLD (P = 0.008). The univariate logistic regression model results for measuring factors related to fatty liver in students showed a significant positive correlation between male gender, BMI, total cholesterol, aspartate aminotransferase, and alanine aminotransferase. Conclusions: NAFLD is a substantial problem in school children and correlates with elevated BMI. Therefore, the measurement of BMI can be used as a useful predictor and screening tool for NAFLD in school children.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48475263","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 : 2023-05-17DOI: 10.5812/compreped-136499
Hoda Atef Abdelsattar Ibrahim, Gihan Fouad Ahmed, Khaled Mohamed Abdelhamid ElKhashab, A. Amin, Aya Farag Attia Elsebaey, Enas Sayed Abbas
Background: Growing evidence suggests a higher occurrence of overweight and obesity in children diagnosed with phenylketonuria (PKU), yet the exact cause is still unknown. Objectives: The objective is to address the prevalence of overweight and obesity in children with PKU. Methods: In our cross-sectional study, we included 47 children with PKU who were receiving care at the nutritional clinic of the National Nutrition Institute. We conducted anthropometric assessments, which involved measuring weight, height, and BMI. Additionally, we performed biochemical evaluations, including measurements of fasting total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, very low-density lipoprotein (VLDL) cholesterol, and triglycerides. Moreover, we assessed fasting blood sugar levels. Results: In the study group, 57.44% were males, and 42.55% were females, with no significant gender difference observed. Malnourished children exhibited significantly higher phenylalanine (PHE) levels. Most participants (n = 26, 55.3%) were overweight or obese. A positive and significant correlation (rs = 0.6, P = 0.01) was found between PHE levels and fasting blood sugar levels. Conclusions: Children with PKU have a high prevalence of overweight and obesity, emphasizing the importance of obesity screening in this population.
背景:越来越多的证据表明，在诊断为苯丙酮尿症(PKU)的儿童中，超重和肥胖的发生率更高，但确切的原因尚不清楚。目的:目的是解决超重和肥胖的患病率儿童PKU。方法:在我们的横断面研究中，我们纳入了47名在国家营养研究所营养诊所接受治疗的PKU儿童。我们进行了人体测量评估，包括测量体重、身高和身体质量指数。此外，我们进行了生化评估，包括空腹总胆固醇(TC)、低密度脂蛋白(LDL)胆固醇、高密度脂蛋白(HDL)胆固醇、极低密度脂蛋白(VLDL)胆固醇和甘油三酯的测量。此外，我们还评估了空腹血糖水平。结果:研究组中男性占57.44%，女性占42.55%，性别差异无统计学意义。营养不良儿童苯丙氨酸(PHE)水平明显升高。大多数参与者(n = 26, 55.3%)超重或肥胖。PHE水平与空腹血糖水平呈显著正相关(rs = 0.6, P = 0.01)。结论:PKU患儿超重和肥胖的患病率较高，强调了在这一人群中进行肥胖筛查的重要性。
{"title":"Prevalence of Overweight and Obesity in Children Diagnosed with Phenylketonuria","authors":"Hoda Atef Abdelsattar Ibrahim, Gihan Fouad Ahmed, Khaled Mohamed Abdelhamid ElKhashab, A. Amin, Aya Farag Attia Elsebaey, Enas Sayed Abbas","doi":"10.5812/compreped-136499","DOIUrl":"https://doi.org/10.5812/compreped-136499","url":null,"abstract":"Background: Growing evidence suggests a higher occurrence of overweight and obesity in children diagnosed with phenylketonuria (PKU), yet the exact cause is still unknown. Objectives: The objective is to address the prevalence of overweight and obesity in children with PKU. Methods: In our cross-sectional study, we included 47 children with PKU who were receiving care at the nutritional clinic of the National Nutrition Institute. We conducted anthropometric assessments, which involved measuring weight, height, and BMI. Additionally, we performed biochemical evaluations, including measurements of fasting total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, very low-density lipoprotein (VLDL) cholesterol, and triglycerides. Moreover, we assessed fasting blood sugar levels. Results: In the study group, 57.44% were males, and 42.55% were females, with no significant gender difference observed. Malnourished children exhibited significantly higher phenylalanine (PHE) levels. Most participants (n = 26, 55.3%) were overweight or obese. A positive and significant correlation (rs = 0.6, P = 0.01) was found between PHE levels and fasting blood sugar levels. Conclusions: Children with PKU have a high prevalence of overweight and obesity, emphasizing the importance of obesity screening in this population.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47159532","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 : 2023-05-03DOI: 10.5812/compreped-136070
Hoda Atef Abdelsattar Ibrahim, R. Gamal, Mona Mohsen, A. Amin, Yasmeen AbdElSalam, M. Aziz
Background: In February 2020, a novel coronavirus caused a pandemic affecting children and adults with different presentations and outcomes. Objectives: The current study aimed to provide descriptive values regarding the clinical and laboratory profiles of children suspected of coronavirus disease 2019 (COVID-19). This purpose was achieved by studying all presentations, whether clinical or laboratory, typical or atypical, of suspected COVID-19-affected children at the peak of the third wave in a large tertiary hospital. Methods: This cross-sectional study enrolled 404 children with suspected COVID-19 who were tested in the Emergency Room of Abu El-Reesh Japanese Hospital, Cairo, Egypt, during the study period, which was from March 2021 to the end of October 2021. According to age, the patients were divided into four groups, including those under 2 years, the early childhood group (2 - 6 years), the late childhood group (6 - 12 years), and those over 12 years. The enrolled cases met the diagnostic criteria for COVID-19 according to the Egyptian Ministry of Health protocol. Results: In this study, 58 out of 404 tested children were positive for COVID-19 (14%), with a higher male predominance (n = 230/404, or 56.9% of the study group). The median age of the study participants was 1.6 years. Out of all presentations, the non-respiratory ones predominated and had the upper hand. It represented 62.9% (254/404) of the total presentations of the enrolled children. Among the non-respiratory manifestations, gastrointestinal ones were predominant (n = 63). Thrombocytopenia, leucopenia, and pancytopenia were significantly higher in children with non-respiratory manifestations than in those with respiratory manifestations. Conclusions: Children might have atypical manifestations of COVID-19 infections. The non-respiratory system could predominate in children. Thrombocytopenia could be a laboratory marker for COVID-19 infection, especially in those with predominant non-respiratory manifestations. Respiratory manifestations in children could be a guide for other systemic affections.
{"title":"Pediatric Dilemma of the Third Wave Pandemic of COVID-19 in A Tertiary Care Hospital for Children","authors":"Hoda Atef Abdelsattar Ibrahim, R. Gamal, Mona Mohsen, A. Amin, Yasmeen AbdElSalam, M. Aziz","doi":"10.5812/compreped-136070","DOIUrl":"https://doi.org/10.5812/compreped-136070","url":null,"abstract":"Background: In February 2020, a novel coronavirus caused a pandemic affecting children and adults with different presentations and outcomes. Objectives: The current study aimed to provide descriptive values regarding the clinical and laboratory profiles of children suspected of coronavirus disease 2019 (COVID-19). This purpose was achieved by studying all presentations, whether clinical or laboratory, typical or atypical, of suspected COVID-19-affected children at the peak of the third wave in a large tertiary hospital. Methods: This cross-sectional study enrolled 404 children with suspected COVID-19 who were tested in the Emergency Room of Abu El-Reesh Japanese Hospital, Cairo, Egypt, during the study period, which was from March 2021 to the end of October 2021. According to age, the patients were divided into four groups, including those under 2 years, the early childhood group (2 - 6 years), the late childhood group (6 - 12 years), and those over 12 years. The enrolled cases met the diagnostic criteria for COVID-19 according to the Egyptian Ministry of Health protocol. Results: In this study, 58 out of 404 tested children were positive for COVID-19 (14%), with a higher male predominance (n = 230/404, or 56.9% of the study group). The median age of the study participants was 1.6 years. Out of all presentations, the non-respiratory ones predominated and had the upper hand. It represented 62.9% (254/404) of the total presentations of the enrolled children. Among the non-respiratory manifestations, gastrointestinal ones were predominant (n = 63). Thrombocytopenia, leucopenia, and pancytopenia were significantly higher in children with non-respiratory manifestations than in those with respiratory manifestations. Conclusions: Children might have atypical manifestations of COVID-19 infections. The non-respiratory system could predominate in children. Thrombocytopenia could be a laboratory marker for COVID-19 infection, especially in those with predominant non-respiratory manifestations. Respiratory manifestations in children could be a guide for other systemic affections.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43065696","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 : 2023-04-11DOI: 10.5812/compreped-134897
Maryam Saeedi, Kayvan Mirnia, Razieh Sangsari, Zeynab Jannatmakan, Vahid Ziaee
Introduction: Immune dysregulation happens after exposure to corona virus disease-2019 (COVID-19) and affects many organs. It is confirmed with a positive COVID-19 test history, fever, and the involvement of 2 or more organs, but it is hard to diagnose in neonates. Case Presentation: There were 2 Persian neonates admitted to the Neonatal Intensive Care Unit or neonatal ward of the Children’s Medical Center, Tehran, Iran, with sepsis in this case presentation. The trunk and extremities were affected by macular rashes in both cases. COVID-19 tests in both cases were negative, but both of their mothers were affected by COVID-19 before delivery. In both cases, systemic and macular rashes responded to corticosteroids. Conclusions: Macular rash can present multisystem inflammatory disease in neonates. Neonates with a positive history of COVID-19 in parents or relatives should be considered for this syndrome.
{"title":"Neonatal Multisystem Inflammatory Syndrome Associated with COVID-19 Exposure in Two Cases from Iran","authors":"Maryam Saeedi, Kayvan Mirnia, Razieh Sangsari, Zeynab Jannatmakan, Vahid Ziaee","doi":"10.5812/compreped-134897","DOIUrl":"https://doi.org/10.5812/compreped-134897","url":null,"abstract":"Introduction: Immune dysregulation happens after exposure to corona virus disease-2019 (COVID-19) and affects many organs. It is confirmed with a positive COVID-19 test history, fever, and the involvement of 2 or more organs, but it is hard to diagnose in neonates. Case Presentation: There were 2 Persian neonates admitted to the Neonatal Intensive Care Unit or neonatal ward of the Children’s Medical Center, Tehran, Iran, with sepsis in this case presentation. The trunk and extremities were affected by macular rashes in both cases. COVID-19 tests in both cases were negative, but both of their mothers were affected by COVID-19 before delivery. In both cases, systemic and macular rashes responded to corticosteroids. Conclusions: Macular rash can present multisystem inflammatory disease in neonates. Neonates with a positive history of COVID-19 in parents or relatives should be considered for this syndrome.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134993709","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 : 2023-04-10DOI: 10.5812/compreped-132915
M. Zarkesh, Seyyedeh Azade Hoseini Nouri, Manijeh Tabrizi, Esfandiar Nazari, Atbin Latifi, Sadroddin Mahdipour, E. Kazemnezhad leili
Background: Gestational diabetes mellitus (GDM) can cause diastolic dysfunction and asymmetric ventricular septal hypertrophy in infants of gestational diabetic mothers (IGDMs). Ventricular thickness can affect QT interval and other QT parameters. Objectives: This study aimed to evaluate and compare the duration of QT, corrected QT (QTc), QT dispersion (QTD), and echocardiographic indices in two groups of neonates of mothers with and without GDM. Methods: In this case-control study, 76 term neonates were enrolled. The case group (n = 38) included IGDM, and the control group (n = 38) included neonates born to healthy mothers. The QT, QTD, and QTc were calculated based on electrocardiographic results. Ejection fraction (EF), interventricular septal thickness at the end of diastole (IVSTD), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), and left ventricular posterior wall thickness (LVPWT) were evaluated by performing echocardiography, and the two groups were compared regarding them. Data were analyzed using SPSS version 21. Results: In this study, neonates' mean age and weight were 4.18 ± 1.3 days and 3418.16 ± 549.24 grams, respectively. As for the gender of neonates, 68.4% in the case group and 47.4% in the control group were female. The two groups had no significant difference regarding age, weight, and sex (P > 0.05). Minimum QTc (QTc min) was significantly higher in the case group (P = 0.046). Considerably lower EF and higher IVSTD were found in the case group (P = 0.011 and P = 0.05 respectively). In univariate analysis, echocardiographic parameters were not the predictors of QTD (P > 0.05); in multivariate analysis, however, QTD was significantly correlated with LVEDD (P = 0.001) and LVESD (P = 0.015). Conclusions: A higher proportion of septal hypertrophy was detected in IGDMs compared to infants of the healthy mothers without any correlation with ECG indices. This involvement was accompanied by relatively decreased EF verified by echocardiography. Most ECG findings, including QTD values, had no linear relationship with echocardiographic parameters except for LVEDD and LVESD.
{"title":"Is There Any Correlation Between QT Dispersion and Echocardiographic Indices in Term Neonates with and Without Maternal Gestational Diabetes Mellitus?","authors":"M. Zarkesh, Seyyedeh Azade Hoseini Nouri, Manijeh Tabrizi, Esfandiar Nazari, Atbin Latifi, Sadroddin Mahdipour, E. Kazemnezhad leili","doi":"10.5812/compreped-132915","DOIUrl":"https://doi.org/10.5812/compreped-132915","url":null,"abstract":"Background: Gestational diabetes mellitus (GDM) can cause diastolic dysfunction and asymmetric ventricular septal hypertrophy in infants of gestational diabetic mothers (IGDMs). Ventricular thickness can affect QT interval and other QT parameters. Objectives: This study aimed to evaluate and compare the duration of QT, corrected QT (QTc), QT dispersion (QTD), and echocardiographic indices in two groups of neonates of mothers with and without GDM. Methods: In this case-control study, 76 term neonates were enrolled. The case group (n = 38) included IGDM, and the control group (n = 38) included neonates born to healthy mothers. The QT, QTD, and QTc were calculated based on electrocardiographic results. Ejection fraction (EF), interventricular septal thickness at the end of diastole (IVSTD), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), and left ventricular posterior wall thickness (LVPWT) were evaluated by performing echocardiography, and the two groups were compared regarding them. Data were analyzed using SPSS version 21. Results: In this study, neonates' mean age and weight were 4.18 ± 1.3 days and 3418.16 ± 549.24 grams, respectively. As for the gender of neonates, 68.4% in the case group and 47.4% in the control group were female. The two groups had no significant difference regarding age, weight, and sex (P > 0.05). Minimum QTc (QTc min) was significantly higher in the case group (P = 0.046). Considerably lower EF and higher IVSTD were found in the case group (P = 0.011 and P = 0.05 respectively). In univariate analysis, echocardiographic parameters were not the predictors of QTD (P > 0.05); in multivariate analysis, however, QTD was significantly correlated with LVEDD (P = 0.001) and LVESD (P = 0.015). Conclusions: A higher proportion of septal hypertrophy was detected in IGDMs compared to infants of the healthy mothers without any correlation with ECG indices. This involvement was accompanied by relatively decreased EF verified by echocardiography. Most ECG findings, including QTD values, had no linear relationship with echocardiographic parameters except for LVEDD and LVESD.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43568644","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 : 2023-04-10DOI: 10.5812/compreped-135106
N. A. Risan, Dea Aprilianti Permana, A. Widiasta, Mia Milanti Dewi, D. Hilmanto
Introduction: Nephrotic syndrome (NS) is characterized by swelling, proteinuria, hypoalbuminemia, or hyperlipidemia. The incidence of NS depends on the country and ethnicity and is highest in Asia than in Europe. Nephrotic syndrome can cause complications such as arterial thromboembolism (ATE) due to a hypercoagulable state. Case Presentation: We encountered a 9-year-old boy with NS and infarct stroke, which was treated with corticosteroid and low molecular weight of heparin with clinical improvement. Conclusions: We recommend that all NS children with high platelet levels perform thromboelastography (TEG) examination and use prophylactic anticoagulation with monitoring of bleeding risk during therapy.
{"title":"Successful Therapy of Infarct Stroke with Nephrotic Syndrome in Children: A Rare Case Report","authors":"N. A. Risan, Dea Aprilianti Permana, A. Widiasta, Mia Milanti Dewi, D. Hilmanto","doi":"10.5812/compreped-135106","DOIUrl":"https://doi.org/10.5812/compreped-135106","url":null,"abstract":"Introduction: Nephrotic syndrome (NS) is characterized by swelling, proteinuria, hypoalbuminemia, or hyperlipidemia. The incidence of NS depends on the country and ethnicity and is highest in Asia than in Europe. Nephrotic syndrome can cause complications such as arterial thromboembolism (ATE) due to a hypercoagulable state. Case Presentation: We encountered a 9-year-old boy with NS and infarct stroke, which was treated with corticosteroid and low molecular weight of heparin with clinical improvement. Conclusions: We recommend that all NS children with high platelet levels perform thromboelastography (TEG) examination and use prophylactic anticoagulation with monitoring of bleeding risk during therapy.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43292392","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 : 2023-04-09DOI: 10.5812/compreped-134763
P. Rohani, Mehrnaz Rezghi, F. Imanzadeh, Sharareh Kamfar, M. Hajipour
Background: Portal hypertension (PH) refers to a clinical syndrome characterized by an elevation in the pressure gradient between the portal and hepatic veins. It is necessary to identify the underlying causes to manage this disorder effectively. Objectives: This study aimed to investigate the etiology, clinical manifestations, and endoscopic findings in children with PH. Methods: This analytic cross - sectional study was performed on patients (< 18 years) with PH who were referred to the Pediatric Gastroenterology Clinic of Mofid Children’s Hospital in Tehran, Iran, within 2014 - 2020. The demographic details of the patients were collected from their medical records. Clinical manifestations, age at diagnosis, family history, and endoscopic findings were also recorded. Results: A total of 102 patients participated in this study. The subjects’ mean age was 6.81 ± 4.46 years. The results revealed that 50 (49.0%) and 46 (45%) cases had PH due to extrahepatic and intrahepatic diseases, respectively. Autoimmune hepatitis and portal vein thrombosis were the most common etiology of intrahepatic and extrahepatic PH, respectively. Based on the endoscopic analysis, esophageal varices were the most common findings (95.8%) observed in patients with PH. Conclusions: Extrahepatic diseases were the most prevalent PH etiology in children referred to the Pediatric Gastroenterology Clinic of Mofid Children’s Hospital.
{"title":"Etiology, Presenting Features, and Endoscopic Findings of Portal Vein Hypertension in Children","authors":"P. Rohani, Mehrnaz Rezghi, F. Imanzadeh, Sharareh Kamfar, M. Hajipour","doi":"10.5812/compreped-134763","DOIUrl":"https://doi.org/10.5812/compreped-134763","url":null,"abstract":"Background: Portal hypertension (PH) refers to a clinical syndrome characterized by an elevation in the pressure gradient between the portal and hepatic veins. It is necessary to identify the underlying causes to manage this disorder effectively. Objectives: This study aimed to investigate the etiology, clinical manifestations, and endoscopic findings in children with PH. Methods: This analytic cross - sectional study was performed on patients (< 18 years) with PH who were referred to the Pediatric Gastroenterology Clinic of Mofid Children’s Hospital in Tehran, Iran, within 2014 - 2020. The demographic details of the patients were collected from their medical records. Clinical manifestations, age at diagnosis, family history, and endoscopic findings were also recorded. Results: A total of 102 patients participated in this study. The subjects’ mean age was 6.81 ± 4.46 years. The results revealed that 50 (49.0%) and 46 (45%) cases had PH due to extrahepatic and intrahepatic diseases, respectively. Autoimmune hepatitis and portal vein thrombosis were the most common etiology of intrahepatic and extrahepatic PH, respectively. Based on the endoscopic analysis, esophageal varices were the most common findings (95.8%) observed in patients with PH. Conclusions: Extrahepatic diseases were the most prevalent PH etiology in children referred to the Pediatric Gastroenterology Clinic of Mofid Children’s Hospital.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44831743","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 : 2023-04-04DOI: 10.5812/compreped-130982
N. Goel, Vikas Kashyap, I. Saini, Shobha Sharma, Ashutosh Kumar Singh
Introduction: Periodic fever syndrome (PFS) is a rare monogenic autoinflammatory disease group. The innate immune system abnormalities have a characteristic onset and spontaneous inflammation without any infectious or autoimmune trigger. It differs from autoimmune disorders (e.g., systemic lupus erythematosus (SLE)) occurring due to a defect in the adaptive immune system with auto-antibodies. Case Presentation: The clinical features of three patients presented with a periodic pattern of fever and a different constellation of symptoms were investigated. The final diagnosis of Periodic fever syndrome was reached based on standard diagnostic criteria and genetic testing. All three cases were observed to present with recurrent fever episodes at an interval of 6 - 12 weeks, 3 - 4 weeks, and one month, respectively. The first patient, presenting with a diffuse erythematous plaque-like lesion along the calf with severe calf pain and tenderness with signs of meningeal irritation, was diagnosed with a tumor necrosis factor receptor-associated periodic fever syndrome (TRAPS) like phenotype. The genetic panel was negative in this case. The second patient presenting with recurrent pharyngitis, cervical adenitis, and tonsillitis unresponsive to antibiotics was diagnosed with periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome. The last patient presenting with recurrent monoarthritis, hepatosplenomegaly, and a positive Mediterranean fever (MEFV) gene mutation was diagnosed with familial Mediterranean fever (FMF). All three patients had normal growth and development. Conclusions: Although periodic fever syndrome was an uncommon entity, it was recommended that this syndrome should be considered when a patient presented with recurring fever episodes with a characteristic constellation of symptoms.
{"title":"Periodic Fever in Children: A Report of Three Unusual Cases","authors":"N. Goel, Vikas Kashyap, I. Saini, Shobha Sharma, Ashutosh Kumar Singh","doi":"10.5812/compreped-130982","DOIUrl":"https://doi.org/10.5812/compreped-130982","url":null,"abstract":"Introduction: Periodic fever syndrome (PFS) is a rare monogenic autoinflammatory disease group. The innate immune system abnormalities have a characteristic onset and spontaneous inflammation without any infectious or autoimmune trigger. It differs from autoimmune disorders (e.g., systemic lupus erythematosus (SLE)) occurring due to a defect in the adaptive immune system with auto-antibodies. Case Presentation: The clinical features of three patients presented with a periodic pattern of fever and a different constellation of symptoms were investigated. The final diagnosis of Periodic fever syndrome was reached based on standard diagnostic criteria and genetic testing. All three cases were observed to present with recurrent fever episodes at an interval of 6 - 12 weeks, 3 - 4 weeks, and one month, respectively. The first patient, presenting with a diffuse erythematous plaque-like lesion along the calf with severe calf pain and tenderness with signs of meningeal irritation, was diagnosed with a tumor necrosis factor receptor-associated periodic fever syndrome (TRAPS) like phenotype. The genetic panel was negative in this case. The second patient presenting with recurrent pharyngitis, cervical adenitis, and tonsillitis unresponsive to antibiotics was diagnosed with periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome. The last patient presenting with recurrent monoarthritis, hepatosplenomegaly, and a positive Mediterranean fever (MEFV) gene mutation was diagnosed with familial Mediterranean fever (FMF). All three patients had normal growth and development. Conclusions: Although periodic fever syndrome was an uncommon entity, it was recommended that this syndrome should be considered when a patient presented with recurring fever episodes with a characteristic constellation of symptoms.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47074519","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 : 2023-04-03DOI: 10.5812/compreped-134297
M. Kashaki, Zohreh Mohammadi, A. Mazouri, E. Norouzi
Background: Vitamin D levels lower than 20 ng/mL are defined as vitamin D deficiency and levels between 20 and 30 ng/mL are defined as insufficient vitamin D. Due to the high prevalence of vitamin D deficiency in premature infants and the need for obtaining optimal treatment methods, we compared the serum levels of vitamin D before and fifteen days after administration of the drug orally and by injection. Methods: In this randomized clinical trial, 90 premature infants with gestational age < 37 weeks were admitted to NICU of Shahid Akbarabadi Hospital, with concomitant vitamin D deficiency and insufficiency entered the study and randomly received oral (with oral drops of 1,000 units daily for 15 days) or injectable (a single dose of 15,000 units intramuscularly) vitamin D supplement and followed on the 16th day after drug administration by measuring 25 (OH) D, calcium, phosphorus, and serum alkaline phosphatase (ALP). Results: In this study, the gestational age of the patients was 29.39 ± 2.42 weeks, and their average birth weight was 1,208.45 ± 238.98 grams. There was no significant difference between the two groups that received the drug, and they were similar. The level of vitamin D in premature infants suffering from vitamin D deficiency was equal to 13.20 ± 6.37 ng/dL. There was no significant difference between the serum levels of ALP, phosphorus, and calcium in the patients of the injection and oral groups before and after the intervention (P-value > 0.05). Although there was no significant difference between the serum vitamin D levels in the two groups before the intervention, its level in the oral group was significantly higher than in the injection group after the intervention (P-value = 0.006). However, none of the treatment methods independently changed the effectiveness of the treatment (P-value = 0.073). Conclusions: The results of our study showed that, in premature infants with vitamin D deficiency or insufficiency, administration of vitamin D orally or by injection significantly increases the serum concentration of 25 (OH) D3 to sufficient levels safely, and both treatment routes can be used in practice.
{"title":"Comparison of the Effect of Oral Versus Parenteral Vitamin D on Serum Levels of Vitamin D in Premature Infants with Vitamin D Deficiency","authors":"M. Kashaki, Zohreh Mohammadi, A. Mazouri, E. Norouzi","doi":"10.5812/compreped-134297","DOIUrl":"https://doi.org/10.5812/compreped-134297","url":null,"abstract":"Background: Vitamin D levels lower than 20 ng/mL are defined as vitamin D deficiency and levels between 20 and 30 ng/mL are defined as insufficient vitamin D. Due to the high prevalence of vitamin D deficiency in premature infants and the need for obtaining optimal treatment methods, we compared the serum levels of vitamin D before and fifteen days after administration of the drug orally and by injection. Methods: In this randomized clinical trial, 90 premature infants with gestational age < 37 weeks were admitted to NICU of Shahid Akbarabadi Hospital, with concomitant vitamin D deficiency and insufficiency entered the study and randomly received oral (with oral drops of 1,000 units daily for 15 days) or injectable (a single dose of 15,000 units intramuscularly) vitamin D supplement and followed on the 16th day after drug administration by measuring 25 (OH) D, calcium, phosphorus, and serum alkaline phosphatase (ALP). Results: In this study, the gestational age of the patients was 29.39 ± 2.42 weeks, and their average birth weight was 1,208.45 ± 238.98 grams. There was no significant difference between the two groups that received the drug, and they were similar. The level of vitamin D in premature infants suffering from vitamin D deficiency was equal to 13.20 ± 6.37 ng/dL. There was no significant difference between the serum levels of ALP, phosphorus, and calcium in the patients of the injection and oral groups before and after the intervention (P-value > 0.05). Although there was no significant difference between the serum vitamin D levels in the two groups before the intervention, its level in the oral group was significantly higher than in the injection group after the intervention (P-value = 0.006). However, none of the treatment methods independently changed the effectiveness of the treatment (P-value = 0.073). Conclusions: The results of our study showed that, in premature infants with vitamin D deficiency or insufficiency, administration of vitamin D orally or by injection significantly increases the serum concentration of 25 (OH) D3 to sufficient levels safely, and both treatment routes can be used in practice.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48914452","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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