Pub Date : 2023-03-17DOI: 10.5812/compreped-134122
Yuni Hisbiyah, A. Endaryanto, Bagus Setyoboedi, W. Deakandi, N. Rochmah, M. Faizi
Background: The coronavirus disease-19 (COVID-19) pandemic has significantly affected healthcare systems. Down syndrome (DS) is a chronic disease caused by trisomy of chromosome 21 which is associated with a variety of medical problems such as autoimmune thyroid disease (AITD) that necessitate comprehensive routine treatment. During the COVID-19 pandemic, there was an increasing an unavailability, which became an impediment to chronic disease patients’ drug consumption. Objectives: The purpose of this study was to examine the barriers to medication adherence faced by DS patients during the COVID-19 pandemic. Methods: An observational analytic study was conducted from January to July 2021 among parents of DS patients who registered in the pediatric endocrinology outpatient clinic of Dr. Soetomo General Hospital. Inclusion criteria include: The parents of DS with AITD patients aged 1 - 18 years who came to the pediatric endocrinology polyclinic, routinely took oral medication before March 2020, can fill out questionnaire forms independently, and signed the informed consent. Exclusion criteria were parents of DS patients who did not take regular medication, or started treatment after March 2020. Data were collected and analyzed using the Wilcoxon comparison test Results: There are 31 DS patients responded and completed the questionnaires. Adherence to hospital visits in DS with AITD patients before and during the COVID-19 pandemic showed significant differences (P = 0.001). The main barriers to follow-up visits during the pandemic were lockdown protocol which made travel difficult (28%). The compliance for taking medication was still high although 13 (41.9%) obtained the medicine without a prescription. Conclusions: Changes in terms of medication adherence during the pandemic have highlighted the importance of improving DS patient’s access to healthcare. Shifting medication counseling to the nearest primary health care provider with supervision from a tertiary referral specialist appears to be a reasonable and potentially cost-effective strategy in improving treatment adherence especially in a pandemic setting.
{"title":"Medication Adherence in Children with Down Syndrome with Autoimmune Thyroid Disease During the Covid-19 Pandemic: Indonesian Study","authors":"Yuni Hisbiyah, A. Endaryanto, Bagus Setyoboedi, W. Deakandi, N. Rochmah, M. Faizi","doi":"10.5812/compreped-134122","DOIUrl":"https://doi.org/10.5812/compreped-134122","url":null,"abstract":"Background: The coronavirus disease-19 (COVID-19) pandemic has significantly affected healthcare systems. Down syndrome (DS) is a chronic disease caused by trisomy of chromosome 21 which is associated with a variety of medical problems such as autoimmune thyroid disease (AITD) that necessitate comprehensive routine treatment. During the COVID-19 pandemic, there was an increasing an unavailability, which became an impediment to chronic disease patients’ drug consumption. Objectives: The purpose of this study was to examine the barriers to medication adherence faced by DS patients during the COVID-19 pandemic. Methods: An observational analytic study was conducted from January to July 2021 among parents of DS patients who registered in the pediatric endocrinology outpatient clinic of Dr. Soetomo General Hospital. Inclusion criteria include: The parents of DS with AITD patients aged 1 - 18 years who came to the pediatric endocrinology polyclinic, routinely took oral medication before March 2020, can fill out questionnaire forms independently, and signed the informed consent. Exclusion criteria were parents of DS patients who did not take regular medication, or started treatment after March 2020. Data were collected and analyzed using the Wilcoxon comparison test Results: There are 31 DS patients responded and completed the questionnaires. Adherence to hospital visits in DS with AITD patients before and during the COVID-19 pandemic showed significant differences (P = 0.001). The main barriers to follow-up visits during the pandemic were lockdown protocol which made travel difficult (28%). The compliance for taking medication was still high although 13 (41.9%) obtained the medicine without a prescription. Conclusions: Changes in terms of medication adherence during the pandemic have highlighted the importance of improving DS patient’s access to healthcare. Shifting medication counseling to the nearest primary health care provider with supervision from a tertiary referral specialist appears to be a reasonable and potentially cost-effective strategy in improving treatment adherence especially in a pandemic setting.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46474017","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 : 2023-03-14DOI: 10.5812/compreped-132383
Mahshid Maleki, M. Hashemi, M. Zamanian, M. Shayganfard, P. Yousefichaijan
Background: Functional constipation (FC) is a common problem in childhood worldwide. This disorder can lead to various physical and behavioral problems and ultimately reduce the quality of life. Sleep disorders are also among the complaints of patients with FC. Objectives: In this study, we aimed to investigate the prevalence of sleep disorders in children with chronic FC. Methods: This cross-sectional study was conducted on 140 children aged 5 to 12 with chronic FC referred to the specialized pediatrics clinic of Amirkabir Hospital of Arak, Iran. The functional constipation was diagnosed based on Rome ΙV criteria. Children and their parents were requested to complete the Children’s Sleep Habits Questionnaire (CSHQ). Data analysis was performed in SPSS version 22 using the chi-square and Mann-Whitney tests to find significant associations at the significance level of 5%. Results: The mean (SD) age of the participants was 7.36 ± 1.6, and most participants were boys (65.7%). The prevalence of sleep disorders in children with chronic FC was 62.9% (95% CI: 54.5 - 70.2). Sleep resistance and sleep apnea were the most common minor sleep disorders. The prevalence of sleep disorders was significantly higher in girls (81.3%) than in boys (53.3%) with chronic FC (P = 0.001). There was no significant difference in the prevalence of sleep disorders in children with chronic FC aged 5 to 8 and 9 to 12. Conclusions: In the present study, the results showed that the prevalence of sleep disorders in children with chronic FC was significant, and it was higher compared to other studies conducted on healthy children, and also it was found that girls had a significantly higher rate of sleep disorders than boys.
{"title":"The Prevalence of Sleep Disorders Among Children with Chronic Functional Constipation, a Study in Arak, Iran","authors":"Mahshid Maleki, M. Hashemi, M. Zamanian, M. Shayganfard, P. Yousefichaijan","doi":"10.5812/compreped-132383","DOIUrl":"https://doi.org/10.5812/compreped-132383","url":null,"abstract":"Background: Functional constipation (FC) is a common problem in childhood worldwide. This disorder can lead to various physical and behavioral problems and ultimately reduce the quality of life. Sleep disorders are also among the complaints of patients with FC. Objectives: In this study, we aimed to investigate the prevalence of sleep disorders in children with chronic FC. Methods: This cross-sectional study was conducted on 140 children aged 5 to 12 with chronic FC referred to the specialized pediatrics clinic of Amirkabir Hospital of Arak, Iran. The functional constipation was diagnosed based on Rome ΙV criteria. Children and their parents were requested to complete the Children’s Sleep Habits Questionnaire (CSHQ). Data analysis was performed in SPSS version 22 using the chi-square and Mann-Whitney tests to find significant associations at the significance level of 5%. Results: The mean (SD) age of the participants was 7.36 ± 1.6, and most participants were boys (65.7%). The prevalence of sleep disorders in children with chronic FC was 62.9% (95% CI: 54.5 - 70.2). Sleep resistance and sleep apnea were the most common minor sleep disorders. The prevalence of sleep disorders was significantly higher in girls (81.3%) than in boys (53.3%) with chronic FC (P = 0.001). There was no significant difference in the prevalence of sleep disorders in children with chronic FC aged 5 to 8 and 9 to 12. Conclusions: In the present study, the results showed that the prevalence of sleep disorders in children with chronic FC was significant, and it was higher compared to other studies conducted on healthy children, and also it was found that girls had a significantly higher rate of sleep disorders than boys.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41400214","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 : 2023-03-11DOI: 10.5812/compreped-132106
A. Omidi, M. Firoozi, M. Khabazkhoob, T. von Schoen-Angerer, Nasrin Mehrnoosh, M. Rassouli
Background: Nausea and vomiting are among the most common side effects of chemotherapy, and despite using pharmaceutical treatments, no desired outcome has yet been achieved in this regard. Therefore, using non-pharmacological techniques has been recommended. Objectives: The present study examined the effect of overshadowing on chemotherapy-induced nausea and vomiting in children with leukemia. Methods: In this clinical trial study, participants were 70 children aged 3 - 18 years admitted to the Oncology Department of Mofid hospital in Tehran, Iran, and were randomly assigned to two intervention and control groups. A flavored candy was given to each child in the intervention group 10 minutes before the start of chemotherapy. This process was repeated during three rounds of chemotherapy. The severity of nausea was measured with the Baxter Animated Retching Faces Scale. The frequency of vomiting was measured using a checklist in both groups 10 minutes before and immediately after chemotherapy. The data were analyzed with SPSS software (version 25). Results: The data revealed no statistically significant difference in the severity of nausea in the first and second chemotherapy rounds between the intervention and control groups (P > 0.05). However, there was a significant difference in the third chemotherapy round between the two groups (P < 0.05). The severity of nausea and frequency of vomiting in three chemotherapy rounds was not significant (P > 0.05). Conclusions: The results indicated that overshadowing was not effective in reducing the severity of nausea and frequency of vomiting. Further studies are needed to determine the potential effects of this technique on gastrointestinal symptoms, including nausea and vomiting.
{"title":"Effectiveness of Overshadowing by Flavored Candies in Management of Chemotherapy-Induced Nausea and Vomiting in Children with Leukemia: A Randomized Trial","authors":"A. Omidi, M. Firoozi, M. Khabazkhoob, T. von Schoen-Angerer, Nasrin Mehrnoosh, M. Rassouli","doi":"10.5812/compreped-132106","DOIUrl":"https://doi.org/10.5812/compreped-132106","url":null,"abstract":"Background: Nausea and vomiting are among the most common side effects of chemotherapy, and despite using pharmaceutical treatments, no desired outcome has yet been achieved in this regard. Therefore, using non-pharmacological techniques has been recommended. Objectives: The present study examined the effect of overshadowing on chemotherapy-induced nausea and vomiting in children with leukemia. Methods: In this clinical trial study, participants were 70 children aged 3 - 18 years admitted to the Oncology Department of Mofid hospital in Tehran, Iran, and were randomly assigned to two intervention and control groups. A flavored candy was given to each child in the intervention group 10 minutes before the start of chemotherapy. This process was repeated during three rounds of chemotherapy. The severity of nausea was measured with the Baxter Animated Retching Faces Scale. The frequency of vomiting was measured using a checklist in both groups 10 minutes before and immediately after chemotherapy. The data were analyzed with SPSS software (version 25). Results: The data revealed no statistically significant difference in the severity of nausea in the first and second chemotherapy rounds between the intervention and control groups (P > 0.05). However, there was a significant difference in the third chemotherapy round between the two groups (P < 0.05). The severity of nausea and frequency of vomiting in three chemotherapy rounds was not significant (P > 0.05). Conclusions: The results indicated that overshadowing was not effective in reducing the severity of nausea and frequency of vomiting. Further studies are needed to determine the potential effects of this technique on gastrointestinal symptoms, including nausea and vomiting.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41703323","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 : 2023-03-11DOI: 10.5812/compreped-135110
H. Hashemian, Mohammad Ali Esfandiari, Setila Dalili
Context: Infectious diseases are still one of the main causes of morbidity and mortality in children, especially in developing countries. In various studies, the weight of children has been found to be influential in the risk of occurrence of these diseases or their severity, and sufficient information on this matter can be important in improving the management and prognosis of patients. This study aimed to determine the impact of being underweight or obese on the risk of infection in children Evidence Acquisition: The ISI Web of Sciences, Scopus, PubMed, and Google Scholar databases were reviewed for relevant articles published from 2010 to 2022. The keywords used included: Infections, Body Mass Index, obesity, thinness, underweight, and child. Results: Studies show that underweight children are associated with an increased risk of various parasitic, viral, and bacterial infections or their severity. Being overweight and obese have received less attention, but they have been shown to be effective in some respiratory and urinary infections in children. Conclusions: According to obtained results, being underweight or obese has been linked to an increased risk of various parasitic, viral, and bacterial infections or their severity in children. Therefore, determining the weight of children, even in emergency cases, and considering it, along with other initial evaluations of children with infection, can be effective in improving the management and prognosis of these children.
{"title":"Childhood Body Mass Index (BMI) and the Risk of Infection: A Narrative Review","authors":"H. Hashemian, Mohammad Ali Esfandiari, Setila Dalili","doi":"10.5812/compreped-135110","DOIUrl":"https://doi.org/10.5812/compreped-135110","url":null,"abstract":"Context: Infectious diseases are still one of the main causes of morbidity and mortality in children, especially in developing countries. In various studies, the weight of children has been found to be influential in the risk of occurrence of these diseases or their severity, and sufficient information on this matter can be important in improving the management and prognosis of patients. This study aimed to determine the impact of being underweight or obese on the risk of infection in children Evidence Acquisition: The ISI Web of Sciences, Scopus, PubMed, and Google Scholar databases were reviewed for relevant articles published from 2010 to 2022. The keywords used included: Infections, Body Mass Index, obesity, thinness, underweight, and child. Results: Studies show that underweight children are associated with an increased risk of various parasitic, viral, and bacterial infections or their severity. Being overweight and obese have received less attention, but they have been shown to be effective in some respiratory and urinary infections in children. Conclusions: According to obtained results, being underweight or obese has been linked to an increased risk of various parasitic, viral, and bacterial infections or their severity in children. Therefore, determining the weight of children, even in emergency cases, and considering it, along with other initial evaluations of children with infection, can be effective in improving the management and prognosis of these children.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44614117","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 : 2023-02-07DOI: 10.5812/compreped-133596
A. Hassanzadeh Rad, Soodeh Salehi, Shohreh Maleknejad, Amirhossein Fakhre Yaseri
Context: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease in children, with an increased incidence of overweight and obesity. Currently, no food and drug administration is approved for treating NAFLD in children; however, antioxidants such as vitamins are the safest options for managing this disease. Regarding the unknown aspects of managing NAFLD, this review provides an overview of the latest evidence on the association of vitamins A, B, C, D, and E with NAFLD in children and adolescents. Evidence Acquisition: In this narrative review, we searched and extracted relevant English publications from the Web of Science, PubMed, Scopus, and Google Scholar using keywords such as non-alcoholic fatty liver disease, NAFLD, children, pediatric, Vitamin A, Vitamin B, Vitamin C, Vitamin D, and Vitamin E. Results: The level of vitamins A, B, C, D, and E in children with NAFLD has been linked to the disease’s prognosis and severity. Conclusions: Regarding previous studies on this issue, measuring vitamins in children with NAFLD seems logical.
背景：非酒精性脂肪肝（NAFLD）是儿童中最常见的慢性肝病，超重和肥胖的发病率增加。目前，没有批准任何食品和药物管理机构用于治疗儿童NAFLD；然而，维生素等抗氧化剂是治疗这种疾病最安全的选择。关于管理NAFLD的未知方面，本综述概述了维生素A、B、C、D和E与儿童和青少年NAFLD相关的最新证据。证据获取：在这篇叙述性综述中，我们使用非酒精性脂肪肝、NAFLD、儿童、儿科、维生素A、维生素B、维生素C、维生素D和维生素E等关键词，从Web of Science、PubMed、Scopus和Google Scholar中搜索并提取了相关英文出版物，NAFLD儿童的E与疾病的预后和严重程度有关。结论：关于先前关于这个问题的研究，测量NAFLD儿童的维生素似乎是合乎逻辑的。
{"title":"The Latest Evidence on the Association Between Vitamins and Non-alcoholic Fatty Liver Disease in Childhood","authors":"A. Hassanzadeh Rad, Soodeh Salehi, Shohreh Maleknejad, Amirhossein Fakhre Yaseri","doi":"10.5812/compreped-133596","DOIUrl":"https://doi.org/10.5812/compreped-133596","url":null,"abstract":"Context: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease in children, with an increased incidence of overweight and obesity. Currently, no food and drug administration is approved for treating NAFLD in children; however, antioxidants such as vitamins are the safest options for managing this disease. Regarding the unknown aspects of managing NAFLD, this review provides an overview of the latest evidence on the association of vitamins A, B, C, D, and E with NAFLD in children and adolescents. Evidence Acquisition: In this narrative review, we searched and extracted relevant English publications from the Web of Science, PubMed, Scopus, and Google Scholar using keywords such as non-alcoholic fatty liver disease, NAFLD, children, pediatric, Vitamin A, Vitamin B, Vitamin C, Vitamin D, and Vitamin E. Results: The level of vitamins A, B, C, D, and E in children with NAFLD has been linked to the disease’s prognosis and severity. Conclusions: Regarding previous studies on this issue, measuring vitamins in children with NAFLD seems logical.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45320951","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: Low birth weight among preterm neonates is a crucial public health problem worldwide. Objectives: The study aimed to assess if massage therapy and coconut oil application could affect weight gain in premature neonates. Method: A double-blind, randomized controlled trial (RCT) was conducted in neonatal intensive care units (NICU) of two educational hospitals affiliated with Shahid Beheshti University of Medical Sciences, Tehran, Iran, from September 2019 to April 2021. Massage therapy, alongside applying coconut oil to the skin for five days, versus massage therapy with tepid water, was considered an intervention. Demographic data, weight gain, and serum triglycerides (TG) levels were the outcomes. First, oil was tested on the baby’s wrist skin. If there was no skin reaction or side effects, massage therapy was started using fingertips in 3 steps, and each step lasted for five minutes. Results: The study included 94 neonates with a gestational age of fewer than 37 weeks who were randomly assigned to three groups: body massage with coconut oil group (n = 33), body massage without oil (n = 30), and control group (n = 31) who did not receive any intervention. Fifty-one cases (54.3%) were male. The mean gestational age of all patients was 32.5 ± 2.24 weeks (range of 27 to 36.6), birth weight was 1769.04 ± 472.8 grams (range of 800 to 2780 grams), serum triglycerides levels before and after intervention in all patients were 0.87 ± 0.43 and 1.14 ± 0.50 mmol/L respectively (or 77.04 ± 39.7 and 100.94 ± 44.7 mg/dL respectively) (P = 0.44). The five-day average weight gains based on the groups included: coconut oil: 49.24 ± 94.32 grams, tepid water: 27.16 ± 65.79 grams, control: 26.29 ± 77.09 grams, P = 0.49. There were no statistically significant differences among all groups for weight gain and change in serum TG levels. Conclusions: Massage therapy, alongside applying coconut oil to the skin for five days, could not increase weight and serum TG levels in premature neonates. Further studies with long-term intervention and a larger sample size are recommended.
{"title":"Effectiveness of Massage Therapy with and Without Oil on Neonatal Weight and Serum Triglycerides: A Randomized Clinical Trial","authors":"A. Naseh, Neda Massomi, Narges Gholami, Shirin Mohamadi, Zahra Khodagholi, Elahe Rastkar Mehrabani","doi":"10.5812/compreped-130416","DOIUrl":"https://doi.org/10.5812/compreped-130416","url":null,"abstract":"Background: Low birth weight among preterm neonates is a crucial public health problem worldwide. Objectives: The study aimed to assess if massage therapy and coconut oil application could affect weight gain in premature neonates. Method: A double-blind, randomized controlled trial (RCT) was conducted in neonatal intensive care units (NICU) of two educational hospitals affiliated with Shahid Beheshti University of Medical Sciences, Tehran, Iran, from September 2019 to April 2021. Massage therapy, alongside applying coconut oil to the skin for five days, versus massage therapy with tepid water, was considered an intervention. Demographic data, weight gain, and serum triglycerides (TG) levels were the outcomes. First, oil was tested on the baby’s wrist skin. If there was no skin reaction or side effects, massage therapy was started using fingertips in 3 steps, and each step lasted for five minutes. Results: The study included 94 neonates with a gestational age of fewer than 37 weeks who were randomly assigned to three groups: body massage with coconut oil group (n = 33), body massage without oil (n = 30), and control group (n = 31) who did not receive any intervention. Fifty-one cases (54.3%) were male. The mean gestational age of all patients was 32.5 ± 2.24 weeks (range of 27 to 36.6), birth weight was 1769.04 ± 472.8 grams (range of 800 to 2780 grams), serum triglycerides levels before and after intervention in all patients were 0.87 ± 0.43 and 1.14 ± 0.50 mmol/L respectively (or 77.04 ± 39.7 and 100.94 ± 44.7 mg/dL respectively) (P = 0.44). The five-day average weight gains based on the groups included: coconut oil: 49.24 ± 94.32 grams, tepid water: 27.16 ± 65.79 grams, control: 26.29 ± 77.09 grams, P = 0.49. There were no statistically significant differences among all groups for weight gain and change in serum TG levels. Conclusions: Massage therapy, alongside applying coconut oil to the skin for five days, could not increase weight and serum TG levels in premature neonates. Further studies with long-term intervention and a larger sample size are recommended.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43229052","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 : 2023-01-28DOI: 10.5812/compreped-132834
S. Ahmadipour, M. Rostami Nejad, Saba Soleimani, Golnaz Mahmoudvand, K. Anbari, A. Karimi Rouzbahani
Background: The close relatives of patients with celiac disease (CD), particularly their siblings, are known to be at a higher risk for CD development. Objectives: Our aim was to determine the prevalence of CD in siblings of confirmed CD patients in Lorestan province, Iran, in 2020. Methods: In this cross-sectional study, anti-tissue transglutaminase (tTG) antibody levels were measured in 140 siblings of children with CD. Duodenal biopsies were taken to confirm the diagnosis in those with positive serological tests. The subjects’ demographic and clinical data were recorded into a pre-designed questionnaire, and the collected data were analyzed by SPSS software version 22 at a significance level of 0.05. Results: Twelve out of 140 subjects (8.6%) tested positive for tTG IgA, eight of them (66.7%) were girls, and most of them (75%) were ≤ 15 years old. Half of the newly diagnosed patients were in the Marsh IIIc category. The Marsh grading had no significant relationship with the serum levels of tTG IgA antibodies (P = 0.319). The most common gastrointestinal symptom was bloating (66.7%), and the most common extraintestinal symptoms were anemia (58.3%) and dental and oral diseases (58.3%). Conclusions: We found a high prevalence (8.6%) of CD among the siblings of children with confirmed CD. Since the early diagnosis of CD can lead to better management, particularly in pediatrics, it is recommended screen patients’ family members as soon as the diagnosis of CD is confirmed.
{"title":"Celiac Disease Screening in the Siblings of Pediatric Patients with a Confirmed Diagnosis: A Cross-sectional Study","authors":"S. Ahmadipour, M. Rostami Nejad, Saba Soleimani, Golnaz Mahmoudvand, K. Anbari, A. Karimi Rouzbahani","doi":"10.5812/compreped-132834","DOIUrl":"https://doi.org/10.5812/compreped-132834","url":null,"abstract":"Background: The close relatives of patients with celiac disease (CD), particularly their siblings, are known to be at a higher risk for CD development. Objectives: Our aim was to determine the prevalence of CD in siblings of confirmed CD patients in Lorestan province, Iran, in 2020. Methods: In this cross-sectional study, anti-tissue transglutaminase (tTG) antibody levels were measured in 140 siblings of children with CD. Duodenal biopsies were taken to confirm the diagnosis in those with positive serological tests. The subjects’ demographic and clinical data were recorded into a pre-designed questionnaire, and the collected data were analyzed by SPSS software version 22 at a significance level of 0.05. Results: Twelve out of 140 subjects (8.6%) tested positive for tTG IgA, eight of them (66.7%) were girls, and most of them (75%) were ≤ 15 years old. Half of the newly diagnosed patients were in the Marsh IIIc category. The Marsh grading had no significant relationship with the serum levels of tTG IgA antibodies (P = 0.319). The most common gastrointestinal symptom was bloating (66.7%), and the most common extraintestinal symptoms were anemia (58.3%) and dental and oral diseases (58.3%). Conclusions: We found a high prevalence (8.6%) of CD among the siblings of children with confirmed CD. Since the early diagnosis of CD can lead to better management, particularly in pediatrics, it is recommended screen patients’ family members as soon as the diagnosis of CD is confirmed.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71259183","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 : 2023-01-22DOI: 10.5812/compreped-131292
N. Noori, Alireza Teimouri, M. Khalili
Background: Celiac disease is a hereditary digestive disease in children associated with an autoimmune disorder of the small intestine. This study aimed to study aortic stiffness in children with celiac disease compared with controls and assess the effects of a gluten-free diet on aortic stiffness parameters. Methods: This case-control study was conducted on 114 children with celiac disease and 57 healthy volunteers. Children with celiac disease comprised three groups: Gluten-free diet (GFD)-responsive, GFD-nonresponsive, and newly diagnosed. Systolic and diastolic diameters of the ascending aorta were recorded by M-mode echocardiography. Data were analyzed using SPSS 20. Study data had free distribution and nonparametric tests were applied for the analysis. The tests were Mann-Whitney U and Kruskal-Wallis with P value < 0.05as the significance level. Results: Aortic strain (11.15 ± 7.47 vs. 13.78 ± 6.95, P = 0.002) and aortic distensibility (6.98 ± 5.03 vs. 8.33 ± 5.13, P = 0.037) were lower in celiac disease (CD) while pressure strain elastic modulus (410.60 ± 247.45 vs. 330.71 ± 216.94, P = 0.012) and aortic strain β index (1.79 ± 0.62 vs. 1.44 ± 0.51, P < 0.001) were higher. The aortic strain significantly differed between control and response to GFD (P = 0.026), control and new diagnosis (P < 0.001), response to GFD and new diagnosis (P = 0.003), and no response to GFD and new diagnosis (P < 0.001) groups. The aortic strain β index differed significantly between control and response to GFD (P ≤ 0.001), control and new diagnosis (P < 0.001), response to GFD and no response to GFD (P = 0.035), response to GFD and new diagnosis (P = 0.002), and no response to GFD and new diagnosis (P < 0.001) groups. Aortic distensibility significantly differed between control and new diagnosis (P < 0.001), response to GFD and new diagnosis (P = 0.037), and no response to GFD and new diagnosis (P = 0.021) groups. Pressure strain elastic modulus significantly differed between control and new diagnosis (P < 0.001), response to GFD and new diagnosis (P = 0.037), and no response to GFD and new diagnosis (P = 0.021) groups. Conclusions: The present study concluded that the elasticity parameters will change due to celiac disease. Gluten-free diet had no significant effect on aortic stiffing measures except the ASβ index.
{"title":"Effect of Gluten-Free Diet on Aortic Elasticity in Children with Celiac Disease","authors":"N. Noori, Alireza Teimouri, M. Khalili","doi":"10.5812/compreped-131292","DOIUrl":"https://doi.org/10.5812/compreped-131292","url":null,"abstract":"Background: Celiac disease is a hereditary digestive disease in children associated with an autoimmune disorder of the small intestine. This study aimed to study aortic stiffness in children with celiac disease compared with controls and assess the effects of a gluten-free diet on aortic stiffness parameters. Methods: This case-control study was conducted on 114 children with celiac disease and 57 healthy volunteers. Children with celiac disease comprised three groups: Gluten-free diet (GFD)-responsive, GFD-nonresponsive, and newly diagnosed. Systolic and diastolic diameters of the ascending aorta were recorded by M-mode echocardiography. Data were analyzed using SPSS 20. Study data had free distribution and nonparametric tests were applied for the analysis. The tests were Mann-Whitney U and Kruskal-Wallis with P value < 0.05as the significance level. Results: Aortic strain (11.15 ± 7.47 vs. 13.78 ± 6.95, P = 0.002) and aortic distensibility (6.98 ± 5.03 vs. 8.33 ± 5.13, P = 0.037) were lower in celiac disease (CD) while pressure strain elastic modulus (410.60 ± 247.45 vs. 330.71 ± 216.94, P = 0.012) and aortic strain β index (1.79 ± 0.62 vs. 1.44 ± 0.51, P < 0.001) were higher. The aortic strain significantly differed between control and response to GFD (P = 0.026), control and new diagnosis (P < 0.001), response to GFD and new diagnosis (P = 0.003), and no response to GFD and new diagnosis (P < 0.001) groups. The aortic strain β index differed significantly between control and response to GFD (P ≤ 0.001), control and new diagnosis (P < 0.001), response to GFD and no response to GFD (P = 0.035), response to GFD and new diagnosis (P = 0.002), and no response to GFD and new diagnosis (P < 0.001) groups. Aortic distensibility significantly differed between control and new diagnosis (P < 0.001), response to GFD and new diagnosis (P = 0.037), and no response to GFD and new diagnosis (P = 0.021) groups. Pressure strain elastic modulus significantly differed between control and new diagnosis (P < 0.001), response to GFD and new diagnosis (P = 0.037), and no response to GFD and new diagnosis (P = 0.021) groups. Conclusions: The present study concluded that the elasticity parameters will change due to celiac disease. Gluten-free diet had no significant effect on aortic stiffing measures except the ASβ index.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43346348","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 : 2023-01-21DOI: 10.5812/compreped-129495
S. A. Tabatabaee, S. Sadat Mansouri, Mohammadreza Azangou Khyavy, Hasti Zarfeshani, G. Khanbabaee, Fatemeh Abdollah Gorji, N. Farahbakhsh, Saeid Sadr, F. Alaei
Background: Cystic fibrosis (CF) is a multisystem disease presenting different manifestations, including the involvement of the respiratory and gastrointestinal tract. Patients may be at risk for micronutrient depletion, particularly during illness and infection. However, the relationship between micronutrient depletion and pulmonary involvement is not established well. Objectives: This study aimed to determine the relationship between serum levels of calcium, phosphorus, magnesium, zinc, copper, selenium, and vitamin D with the severity of pulmonary involvement in patients with CF. Methods: This cross-sectional study was performed on 84 patients with CF referred to Mofid Children’s Hospital, Tehran, Iran, in 2017. The collected data included demographic and anthropometric information. Laboratory evaluations included magnesium, copper, zinc, selenium, complete blood cell count (CBC), and vitamin D levels. The severity of pulmonary involvement was determined based on the Brasfield scoring system (BSS). Pearson correlation coefficient, t test, χ2 test, or Fisher exact test was used for analyses. Results: The mean age of the children was 6.8 ± 3.5 years, and 36 patients (43%) were female. Based on the z score, 53 patients (63%) were malnourished. The severity of pulmonary involvement was mild in 25 patients (30%), moderate in 39 patients (46%), and severe in 20 patients (24%). The percentages of deficiency related to vitamin D, zinc, copper, and selenium were 56%, 38%, 32.1%, and 21.4%, respectively. Among trace elements, there was a statistically significant relationship between the severity of pulmonary involvement according to BSS and serum copper (P = 0.007 and r = -0.229) and selenium deficiency (P < 0.001 and r = -0.418). There was a significant relationship between malnutrition and vitamin D deficiency in patients (P = 0.034, r = 0.231). Conclusions: Serum copper concentration might affect respiratory function in CF patients. Selenium supplements should be added to patients’ diets. However, further interventional studies are required to investigate the possible causal relationships.
背景:囊性纤维化(CF)是一种多系统疾病，表现多样，包括累及呼吸道和胃肠道。患者可能有微量营养素缺乏的危险，特别是在患病和感染期间。然而，微量营养素缺乏与肺部受累之间的关系尚未得到很好的确定。目的:本研究旨在确定CF患者血清钙、磷、镁、锌、铜、硒和维生素D水平与肺受累严重程度之间的关系。方法:本横断面研究对2017年伊朗德黑兰Mofid儿童医院的84例CF患者进行了研究。收集的数据包括人口统计和人体测量信息。实验室评估包括镁、铜、锌、硒、全血细胞计数(CBC)和维生素D水平。根据Brasfield评分系统(BSS)确定肺部受累的严重程度。采用Pearson相关系数、t检验、χ2检验或Fisher精确检验进行分析。结果:患儿平均年龄为6.8±3.5岁，女性36例(43%)。根据z评分，53例(63%)患者营养不良。肺部受累的严重程度为轻度25例(30%)，中度39例(46%)，重度20例(24%)。维生素D、锌、铜和硒缺乏症的比例分别为56%、38%、32.1%和21.4%。微量元素中，肺受累程度与血清铜(P = 0.007, r = -0.229)与硒缺乏(P < 0.001, r = -0.418)之间存在显著相关。患者营养不良与维生素D缺乏之间存在显著相关性(P = 0.034, r = 0.231)。结论:血清铜浓度可能影响CF患者的呼吸功能。应在患者的饮食中添加硒补充剂。然而，需要进一步的介入研究来调查可能的因果关系。
{"title":"The Association of Serum Elements’ Levels with the Severity of Pulmonary Involvement in Cystic Fibrosis Patients","authors":"S. A. Tabatabaee, S. Sadat Mansouri, Mohammadreza Azangou Khyavy, Hasti Zarfeshani, G. Khanbabaee, Fatemeh Abdollah Gorji, N. Farahbakhsh, Saeid Sadr, F. Alaei","doi":"10.5812/compreped-129495","DOIUrl":"https://doi.org/10.5812/compreped-129495","url":null,"abstract":"Background: Cystic fibrosis (CF) is a multisystem disease presenting different manifestations, including the involvement of the respiratory and gastrointestinal tract. Patients may be at risk for micronutrient depletion, particularly during illness and infection. However, the relationship between micronutrient depletion and pulmonary involvement is not established well. Objectives: This study aimed to determine the relationship between serum levels of calcium, phosphorus, magnesium, zinc, copper, selenium, and vitamin D with the severity of pulmonary involvement in patients with CF. Methods: This cross-sectional study was performed on 84 patients with CF referred to Mofid Children’s Hospital, Tehran, Iran, in 2017. The collected data included demographic and anthropometric information. Laboratory evaluations included magnesium, copper, zinc, selenium, complete blood cell count (CBC), and vitamin D levels. The severity of pulmonary involvement was determined based on the Brasfield scoring system (BSS). Pearson correlation coefficient, t test, χ2 test, or Fisher exact test was used for analyses. Results: The mean age of the children was 6.8 ± 3.5 years, and 36 patients (43%) were female. Based on the z score, 53 patients (63%) were malnourished. The severity of pulmonary involvement was mild in 25 patients (30%), moderate in 39 patients (46%), and severe in 20 patients (24%). The percentages of deficiency related to vitamin D, zinc, copper, and selenium were 56%, 38%, 32.1%, and 21.4%, respectively. Among trace elements, there was a statistically significant relationship between the severity of pulmonary involvement according to BSS and serum copper (P = 0.007 and r = -0.229) and selenium deficiency (P < 0.001 and r = -0.418). There was a significant relationship between malnutrition and vitamin D deficiency in patients (P = 0.034, r = 0.231). Conclusions: Serum copper concentration might affect respiratory function in CF patients. Selenium supplements should be added to patients’ diets. However, further interventional studies are required to investigate the possible causal relationships.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45483097","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 : 2023-01-20DOI: 10.5812/compreped-132384
F. Torabi, M. Hashemi, M. Zamanian, M. Shayganfard, P. Yousefichaijan
Background: Functional constipation (FC) is a common disease in children. This disease can cause many behavioral and mental problems and ultimately reduce the quality of life. Reciprocally, psychological factors can play a role in the development and persistence of FC. Objectives: In this study, we aimed to determine the prevalence of social anxiety in children with chronic FC in Arak city, Iran. Methods: In this cross-sectional study, 200 children between 10 - 17 years with chronic FC referred to Amirkabir Hospital in Arak, Iran, which is a specialized center, were enrolled. This study was done in 2022, and the participants' disease was diagnosed based on Rome ΙV criteria. The Social Anxiety Scale for Adolescents (SASA) was completed by children under the guidance and supervision of their parents. Statistical analyses were performed in SPSS 22 using the Chi-square test and independent sample T-test. Results: The participants’ mean age (SD) was 13.43 ± 1.54 years. The prevalence of social anxiety was estimated at 67.5% (95%CI: 60.6 - 73.4), of whom 70% had moderate anxiety, and 30% had severe anxiety. There was no significant difference in the prevalence of social anxiety between the age groups (P = 0.167). The prevalence of social anxiety was significantly higher in girls (74.8%) than in boys (59.8%) (P = 0.034). Also, girls showed a significantly higher prevalence of severe social anxiety than boys (P = 0.023). Conclusions: In this study, the prevalence of social anxiety was found to be considerably high in children with chronic FC. There was no significant difference between different age groups in terms of the prevalence of social anxiety; however, the prevalence and severity of this disease were significantly higher in girls than in boys.
{"title":"The Prevalence of Social Anxiety in Children with Chronic Functional Constipation","authors":"F. Torabi, M. Hashemi, M. Zamanian, M. Shayganfard, P. Yousefichaijan","doi":"10.5812/compreped-132384","DOIUrl":"https://doi.org/10.5812/compreped-132384","url":null,"abstract":"Background: Functional constipation (FC) is a common disease in children. This disease can cause many behavioral and mental problems and ultimately reduce the quality of life. Reciprocally, psychological factors can play a role in the development and persistence of FC. Objectives: In this study, we aimed to determine the prevalence of social anxiety in children with chronic FC in Arak city, Iran. Methods: In this cross-sectional study, 200 children between 10 - 17 years with chronic FC referred to Amirkabir Hospital in Arak, Iran, which is a specialized center, were enrolled. This study was done in 2022, and the participants' disease was diagnosed based on Rome ΙV criteria. The Social Anxiety Scale for Adolescents (SASA) was completed by children under the guidance and supervision of their parents. Statistical analyses were performed in SPSS 22 using the Chi-square test and independent sample T-test. Results: The participants’ mean age (SD) was 13.43 ± 1.54 years. The prevalence of social anxiety was estimated at 67.5% (95%CI: 60.6 - 73.4), of whom 70% had moderate anxiety, and 30% had severe anxiety. There was no significant difference in the prevalence of social anxiety between the age groups (P = 0.167). The prevalence of social anxiety was significantly higher in girls (74.8%) than in boys (59.8%) (P = 0.034). Also, girls showed a significantly higher prevalence of severe social anxiety than boys (P = 0.023). Conclusions: In this study, the prevalence of social anxiety was found to be considerably high in children with chronic FC. There was no significant difference between different age groups in terms of the prevalence of social anxiety; however, the prevalence and severity of this disease were significantly higher in girls than in boys.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47135189","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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