Pub Date : 2022-02-20DOI: 10.5812/compreped.112148
Farnaz Naserly, M. Fallahi, S. Tajalli, M. Kazemian, M. Hajipour, Beheshteh Olang, Shamsollah Noripour
Background: The usual intake of fish products is not common in Iranian mothers. Objectives: Regarding the significant effect of this nutrient material on neonatal outcomes, we aimed to evaluate the breast milk docosahexaenoic acid (DHA) level in mothers with preterm delivery. Methods: This cross-sectional study was done in 67 mothers with gestational age lower than 36 weeks during 2018 - 2019. Breast milk samples of 5 - 10 milliliters were evaluated by gas chromatography for DHA level. Then, the correlation between the breast milk DHA levels and neonatal outcomes was assessed. Results: A total of 67 mothers were eligible in the study. The mean gestational age and birth weights were 31.54 ± 4.44 weeks and 1707.85 ± 595.83 g, respectively. The mean DHA, as a percentage of total breast milk fatty acids, was 0.29 ± 0.0127%. Statistical analysis showed no significant relationship between the breast milk DHA level and gestational age, birth weight, maternal age, delivery mode, neonatal growth index, and neonatal complications. The relationship between the intake of food materials rich in DHA and breast milk level was not statistically significant. Conclusions: We concluded that the breast milk DHA level of mothers with preterm delivery was acceptable, although it revealed no significant correlation with maternal factors and neonatal outcomes.
{"title":"Breast Milk Docosahexaenoic Acid and Neonatal Outcome in Preterm Infants: A Cross-sectional Study","authors":"Farnaz Naserly, M. Fallahi, S. Tajalli, M. Kazemian, M. Hajipour, Beheshteh Olang, Shamsollah Noripour","doi":"10.5812/compreped.112148","DOIUrl":"https://doi.org/10.5812/compreped.112148","url":null,"abstract":"Background: The usual intake of fish products is not common in Iranian mothers. Objectives: Regarding the significant effect of this nutrient material on neonatal outcomes, we aimed to evaluate the breast milk docosahexaenoic acid (DHA) level in mothers with preterm delivery. Methods: This cross-sectional study was done in 67 mothers with gestational age lower than 36 weeks during 2018 - 2019. Breast milk samples of 5 - 10 milliliters were evaluated by gas chromatography for DHA level. Then, the correlation between the breast milk DHA levels and neonatal outcomes was assessed. Results: A total of 67 mothers were eligible in the study. The mean gestational age and birth weights were 31.54 ± 4.44 weeks and 1707.85 ± 595.83 g, respectively. The mean DHA, as a percentage of total breast milk fatty acids, was 0.29 ± 0.0127%. Statistical analysis showed no significant relationship between the breast milk DHA level and gestational age, birth weight, maternal age, delivery mode, neonatal growth index, and neonatal complications. The relationship between the intake of food materials rich in DHA and breast milk level was not statistically significant. Conclusions: We concluded that the breast milk DHA level of mothers with preterm delivery was acceptable, although it revealed no significant correlation with maternal factors and neonatal outcomes.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71259271","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 : 2022-02-15DOI: 10.5812/compreped.117569
Shiva Hojjati, Leila Khanali Mojen, A. Hosseini, Ahmad Khaleghnejad Tabari, Siamak Afaghi, L. Mohajerzadeh, F. Rahimi, Azam Shirinabadi Farahani, Hadis Ashrafizadeh
Background: The bowel management program (BMP) promotes independence and self-sufficiency in children, helping them to integrate into the community. It also enhances their sense of well-being and provides them with a high-quality life. Objectives: This study aimed to determine the effect of BMP on quality of life (QOL) in children with fecal incontinence in Mofid Children’s Hospital in Tehran, Iran from 1 February, 2019 to 1 February, 2020. Methods: The target population of this clinical trial was all individuals with an age range of 4 - 18 years referred to the gastrointestinal and surgical clinic of Mofid Children’s Hospital due to fecal incontinence. A total of 100 subjects with fecal incontinence participated in the study and were randomly divided into two groups of intervention and control. To collect data, two questionnaires, including the Demographic Characteristics Questionnaire and the Quality of Life in Children Questionnaire were used. Results: There was a significant difference between the two groups after the intervention (P < 0.05), indicating that the bowel management training program improved the QOL in children. The results also showed a significant increase in all the related aspects in the intervention group, with the highest increase observed in social (P < 0.001) and physical (P < 0.001) aspects. However, in the control group, the increase was meaningful only in the emotional sense (P = 0.002). Accordingly, the scores in the emotional aspect decreased notably after one month. Conclusions: The BMP is an effective way for treating fecal incontinence and improving the QOL in children. Hence, this program is highly recommended to be carried out in comprehensive gastrointestinal centers.
{"title":"Evaluating the Effect of Bowel Management Training Program on Quality of Life in Children with Fecal Incontinence","authors":"Shiva Hojjati, Leila Khanali Mojen, A. Hosseini, Ahmad Khaleghnejad Tabari, Siamak Afaghi, L. Mohajerzadeh, F. Rahimi, Azam Shirinabadi Farahani, Hadis Ashrafizadeh","doi":"10.5812/compreped.117569","DOIUrl":"https://doi.org/10.5812/compreped.117569","url":null,"abstract":"Background: The bowel management program (BMP) promotes independence and self-sufficiency in children, helping them to integrate into the community. It also enhances their sense of well-being and provides them with a high-quality life. Objectives: This study aimed to determine the effect of BMP on quality of life (QOL) in children with fecal incontinence in Mofid Children’s Hospital in Tehran, Iran from 1 February, 2019 to 1 February, 2020. Methods: The target population of this clinical trial was all individuals with an age range of 4 - 18 years referred to the gastrointestinal and surgical clinic of Mofid Children’s Hospital due to fecal incontinence. A total of 100 subjects with fecal incontinence participated in the study and were randomly divided into two groups of intervention and control. To collect data, two questionnaires, including the Demographic Characteristics Questionnaire and the Quality of Life in Children Questionnaire were used. Results: There was a significant difference between the two groups after the intervention (P < 0.05), indicating that the bowel management training program improved the QOL in children. The results also showed a significant increase in all the related aspects in the intervention group, with the highest increase observed in social (P < 0.001) and physical (P < 0.001) aspects. However, in the control group, the increase was meaningful only in the emotional sense (P = 0.002). Accordingly, the scores in the emotional aspect decreased notably after one month. Conclusions: The BMP is an effective way for treating fecal incontinence and improving the QOL in children. Hence, this program is highly recommended to be carried out in comprehensive gastrointestinal centers.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47537269","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 : 2022-02-11DOI: 10.5812/compreped.115378
N. Mahmoud, Mohammed Abdelhakeem, H. Mohamed, Gamal Baheeg
Background: This study aimed to evaluate the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) as diagnostic adjunct tests for early-onset neonatal sepsis (EOS). Methods: This prospective cross-sectional study included 80 full-term neonates with confirmed EOS and 80 healthy newborns. All examinations were done 24 hours after birth. Neonatal sepsis (NS) was characterized as a positive blood culture with symptoms of infection. Positive diagnostic indicators, including I/T ratio > 0.2, total leukocytes [WBCs] of either 5109/L or > 15109/L, thrombocytopenia [150,000/mm3], CRP > 1 mg/dL, and procalcitonin >0.5 ng/mL were considered as NS. Results: As the predictors of EOS, the sensitivity of NLR and PLR was 67% and 70%, and their specificity was 99% and 73%, respectively. Also, positive predictive value (PPV) of NLR and PLR was 98% and 72%, respectively. We found a weak correlation between platelets and sepsis, Strong correlation between WBCs and PLR with sepsis, and a moderate correlation among the ratio of immature to total neutrophil counts (I/T ratio), all of which were significant. Besides, concerning NLR with sepsis, we found an inverse correlation between lymphocytes and sepsis. Conclusions: PLR and NLR are important predictive markers for EOS (PPV of NLR and PLR was 98% and 72%, respectively). Moreover, leukocytosis, thrombocytopenia, high c-reactive protein (CRP), high procalcitonin, and positive blood culture were correlated with the risk of NS. NLR and PLR showed more specificity than CRP and procalcitonin.
{"title":"Validity of Platelet to Lymphocyte Ratio and Neutrophil to Lymphocyte Ratio in Diagnosing Early-onset Neonatal Sepsis in Full-term Newborns","authors":"N. Mahmoud, Mohammed Abdelhakeem, H. Mohamed, Gamal Baheeg","doi":"10.5812/compreped.115378","DOIUrl":"https://doi.org/10.5812/compreped.115378","url":null,"abstract":"Background: This study aimed to evaluate the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) as diagnostic adjunct tests for early-onset neonatal sepsis (EOS). Methods: This prospective cross-sectional study included 80 full-term neonates with confirmed EOS and 80 healthy newborns. All examinations were done 24 hours after birth. Neonatal sepsis (NS) was characterized as a positive blood culture with symptoms of infection. Positive diagnostic indicators, including I/T ratio > 0.2, total leukocytes [WBCs] of either 5109/L or > 15109/L, thrombocytopenia [150,000/mm3], CRP > 1 mg/dL, and procalcitonin >0.5 ng/mL were considered as NS. Results: As the predictors of EOS, the sensitivity of NLR and PLR was 67% and 70%, and their specificity was 99% and 73%, respectively. Also, positive predictive value (PPV) of NLR and PLR was 98% and 72%, respectively. We found a weak correlation between platelets and sepsis, Strong correlation between WBCs and PLR with sepsis, and a moderate correlation among the ratio of immature to total neutrophil counts (I/T ratio), all of which were significant. Besides, concerning NLR with sepsis, we found an inverse correlation between lymphocytes and sepsis. Conclusions: PLR and NLR are important predictive markers for EOS (PPV of NLR and PLR was 98% and 72%, respectively). Moreover, leukocytosis, thrombocytopenia, high c-reactive protein (CRP), high procalcitonin, and positive blood culture were correlated with the risk of NS. NLR and PLR showed more specificity than CRP and procalcitonin.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47293942","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 : 2021-12-31DOI: 10.5812/compreped.108667
Fariba Hadi, Hasan Eftkhar, A. Djazayery, S. Mazloomzadeh
Background: Exclusive breastfeeding (EBF), especially during the first six months of life, is one of the primary health indicators in infants. Objectives: The present study intended to describe the frequency of EBF in infants and its determinants until six months after birth. Methods: This longitudinal study was conducted on 673 mother-newborn pairs visiting obstetrics and gynecology departments of two main hospitals in Zanjan. Information on the frequency of EBF up to six months, socio-demographic and reproductive information, and attitudes of mothers towards breastfeeding was gathered using questionnaires. Data were analyzed using chi-square test and logistic regression in SPSS. Results: The proportion of neonates who were receiving EBF at discharge was 95.7%. The EBF proportions in the second week, the first, fourth, and sixth months were 95%, 88.1%, 80.7%, and 77.3%, respectively. The multivariate analysis of data indicated that living in urban areas (P = 0.02), lower education of mothers (P = 0.008), having more than three years of birth interval (P = 0.006), no experience of breastfeeding in mothers (P = 0.01), no prior decision for breastfeeding in mothers (P < 0.0001), and use of artificial nipples (P = < 0.0001) were independently associated with non-EBF. Conclusions: In this study, despite a high proportion of EBF at discharge, we found that the proportion of EBF reduced during six months. The determinants of non-EBF at six months, including urban and less educated mothers, highlight a need to promote awareness regarding EBF and perform interventions for women at a greater risk for early breastfeeding cessation.
{"title":"Exclusive Breast Feeding and Its Determinants in Infants Born in Zanjan Hospitals: A Longitudinal Study","authors":"Fariba Hadi, Hasan Eftkhar, A. Djazayery, S. Mazloomzadeh","doi":"10.5812/compreped.108667","DOIUrl":"https://doi.org/10.5812/compreped.108667","url":null,"abstract":"Background: Exclusive breastfeeding (EBF), especially during the first six months of life, is one of the primary health indicators in infants. Objectives: The present study intended to describe the frequency of EBF in infants and its determinants until six months after birth. Methods: This longitudinal study was conducted on 673 mother-newborn pairs visiting obstetrics and gynecology departments of two main hospitals in Zanjan. Information on the frequency of EBF up to six months, socio-demographic and reproductive information, and attitudes of mothers towards breastfeeding was gathered using questionnaires. Data were analyzed using chi-square test and logistic regression in SPSS. Results: The proportion of neonates who were receiving EBF at discharge was 95.7%. The EBF proportions in the second week, the first, fourth, and sixth months were 95%, 88.1%, 80.7%, and 77.3%, respectively. The multivariate analysis of data indicated that living in urban areas (P = 0.02), lower education of mothers (P = 0.008), having more than three years of birth interval (P = 0.006), no experience of breastfeeding in mothers (P = 0.01), no prior decision for breastfeeding in mothers (P < 0.0001), and use of artificial nipples (P = < 0.0001) were independently associated with non-EBF. Conclusions: In this study, despite a high proportion of EBF at discharge, we found that the proportion of EBF reduced during six months. The determinants of non-EBF at six months, including urban and less educated mothers, highlight a need to promote awareness regarding EBF and perform interventions for women at a greater risk for early breastfeeding cessation.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45281353","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 : 2021-12-21DOI: 10.5812/compreped.115193
A. Naseh, Azade Shabani, Hanieh Ghane
Background: Early-onset neonatal sepsis (EOS) is a systemic infection that occurs within the first week of life. Objectives: This study investigated the association of serum vitamin D levels in pregnant women and their neonates with the prevalence of EOS. Methods: This case-control study was performed among 50 term/late pre-term neonates admitted to our NICU due to EOS, alongside 50 healthy neonates matched for gestational age range and sex. Maternal and neonatal serum vitamin D levels were measured. The criteria for diagnosing EOS included any/combination of: respiratory, cardiovascular, hemodynamic, neurological, gastrointestinal, body temperature, or metabolic signs. For sepsis cases, CBC, CRP, blood type, blood culture, chest X ray, and in some cases, and CSF analysis and culture were tested. Mothers’ clinical history was collected. Results: Each group included 30 (60%) male and 20 (40%) female neonates. Birth weight averages were 2772 ± 667 and 3215 ± 349 grams in the case and control groups, respectively (P < 0.001). The mean serum vitamin D levels were 49.75 ± 25.53 and 56.41 ± 18.17 nmol/L in the case and control groups, respectively. The control group mothers had a significantly higher vitamin D level (68.24 nmol/L versus 55.01 in mothers of sepsis cases, p=0.005) and showed a correlation with the vitamin D levels of their neonates (R = 0.731, P < 0.001), while the data failed to show a correlation between vitamin D level in mothers and their neonates in the sepsis group (R = 0.241, P = 0.115). C-section delivery was more prevalent among the sepsis cases (P < 0.001). Conclusions: Early-onset neonatal sepsis is associated with vitamin D deficiency in neonates and their mothers, low birth weight, and being delivered by C-section.
{"title":"Association Between Maternal and Neonatal Serum Vitamin D Levels and the Incidence of Early-Onset Sepsis","authors":"A. Naseh, Azade Shabani, Hanieh Ghane","doi":"10.5812/compreped.115193","DOIUrl":"https://doi.org/10.5812/compreped.115193","url":null,"abstract":"Background: Early-onset neonatal sepsis (EOS) is a systemic infection that occurs within the first week of life. Objectives: This study investigated the association of serum vitamin D levels in pregnant women and their neonates with the prevalence of EOS. Methods: This case-control study was performed among 50 term/late pre-term neonates admitted to our NICU due to EOS, alongside 50 healthy neonates matched for gestational age range and sex. Maternal and neonatal serum vitamin D levels were measured. The criteria for diagnosing EOS included any/combination of: respiratory, cardiovascular, hemodynamic, neurological, gastrointestinal, body temperature, or metabolic signs. For sepsis cases, CBC, CRP, blood type, blood culture, chest X ray, and in some cases, and CSF analysis and culture were tested. Mothers’ clinical history was collected. Results: Each group included 30 (60%) male and 20 (40%) female neonates. Birth weight averages were 2772 ± 667 and 3215 ± 349 grams in the case and control groups, respectively (P < 0.001). The mean serum vitamin D levels were 49.75 ± 25.53 and 56.41 ± 18.17 nmol/L in the case and control groups, respectively. The control group mothers had a significantly higher vitamin D level (68.24 nmol/L versus 55.01 in mothers of sepsis cases, p=0.005) and showed a correlation with the vitamin D levels of their neonates (R = 0.731, P < 0.001), while the data failed to show a correlation between vitamin D level in mothers and their neonates in the sepsis group (R = 0.241, P = 0.115). C-section delivery was more prevalent among the sepsis cases (P < 0.001). Conclusions: Early-onset neonatal sepsis is associated with vitamin D deficiency in neonates and their mothers, low birth weight, and being delivered by C-section.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49633910","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 : 2021-12-12DOI: 10.5812/compreped.111394
N. Seyyedirad, Ali Ahani Azari, Lobat Shahkar
Introduction: Pulmonary interstitial glycogenosis (PIG) is a kind of children’s interstitial lung disease (ChILD). This is exclusively limited to neonates and infants. Often, PIG is diagnosed in the lung biopsy in a short time after birth (usually < 6 months). Most cases of PIG in infants are symptomatic within the first days to weeks of life. PIG expresses itself with diverse clinical symptoms such as tachypnea and hypoxia and may lead to acute respiratory failure in neonates. Case Presentation: In this case report study, we presented a 1.5-year-old boy with the chief complaint of stage 4 clubbing in fingers and toes. Mild chest deformity was observed in his physical exam. No evidence of respiratory and cardiac complications was observed. Initial lab tests and further specific studies were normal. His parents did not mention the history of any diseases in this patient. His chest X-ray (CXR) showed hyperinflated lungs, diffuse bilateral interstitial infiltration, and hazy opacities. Ground glass opacities (GGO) and interlobular septal thickening and cystic changes with reversed halo sign in both lungs were observed in his chest computerized tomography (CT). Finally, pulmonary biopsy showed a high level of glycogen-laden mesenchymal cells in the interstitium of alveoli, and vimentin-positive interstitial infiltration in lung parenchyma confirmed the PIG diagnosis. Conclusions: The new manifestation of PIG, which has been reported in this case, can be beneficial for future diagnoses of PIG.
{"title":"Unusual Presentation of Pulmonary Interstitial Glycogenosis: A Case Report Study","authors":"N. Seyyedirad, Ali Ahani Azari, Lobat Shahkar","doi":"10.5812/compreped.111394","DOIUrl":"https://doi.org/10.5812/compreped.111394","url":null,"abstract":"Introduction: Pulmonary interstitial glycogenosis (PIG) is a kind of children’s interstitial lung disease (ChILD). This is exclusively limited to neonates and infants. Often, PIG is diagnosed in the lung biopsy in a short time after birth (usually < 6 months). Most cases of PIG in infants are symptomatic within the first days to weeks of life. PIG expresses itself with diverse clinical symptoms such as tachypnea and hypoxia and may lead to acute respiratory failure in neonates. Case Presentation: In this case report study, we presented a 1.5-year-old boy with the chief complaint of stage 4 clubbing in fingers and toes. Mild chest deformity was observed in his physical exam. No evidence of respiratory and cardiac complications was observed. Initial lab tests and further specific studies were normal. His parents did not mention the history of any diseases in this patient. His chest X-ray (CXR) showed hyperinflated lungs, diffuse bilateral interstitial infiltration, and hazy opacities. Ground glass opacities (GGO) and interlobular septal thickening and cystic changes with reversed halo sign in both lungs were observed in his chest computerized tomography (CT). Finally, pulmonary biopsy showed a high level of glycogen-laden mesenchymal cells in the interstitium of alveoli, and vimentin-positive interstitial infiltration in lung parenchyma confirmed the PIG diagnosis. Conclusions: The new manifestation of PIG, which has been reported in this case, can be beneficial for future diagnoses of PIG.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42534623","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 : 2021-12-04DOI: 10.5812/compreped.109377
S. Amiri, S. Farhang, M. Shekari Khaniani, Sima Mansouri Derakhshan, Aziz Zadfattah, Zahra Mohammadi Bina, Fatemeh Ghazipour, Narges Sardari, Habibeh Barzegar, Leila Mehdizadeh Fanid
Background: Drug treatment is one of the most important treatments for attention deficit hyperactivity disorder (ADHD). The DRD4 gene is a transporter and receptor coding gene of dopamine and is one of the most important genes under investigation in the disorder and etiology of ADHD. In this study, the association between rs3758653 C/T and VNTR exon 3 repetition polymorphisms of the DRD4 gene and the effects of methylphenidate were investigated in patients with ADHD disorder consuming methylphenidate. Methods: The descriptive-analytical study was performed on 122 patients (5 - 18 years old) with ADHD who were treated with methylphenidate. DNA was extracted using salting out method. Subsequently, the rs3758653 polymorphism in the 5'UTR region of DRD4 gene was genotyped by PCR-RFLP method, and the VNTR fragment in exon III of DRD4 gene was investigated by electrophoresis gel on acrylamide gel method. After eight weeks from the start of drug treatment with methylphenidate, the intensity of symptoms was evaluated using the Conners scale. Finally, all data from questionnaires and information that were resulted from laboratory findings were analyzed using ANOVA and repeated measure analysis. Results: Of the 122 patients under study, 15 patients (12.3%) were responded to the drug treatment, and 107 patients (87.7%) were not responded. The significant differences were not revealed in genotype, and allele frequencies of between rs3758653 (C/T) and exon III 3'VNTR repeats polymorphisms of the DRD4 gene and responder and non-responder of ADHD groups to the drug treatment. Conclusions: The results showed that the reduction of ADHD symptoms with drug treatment is not related to DRD4 sub-types in patients with ADHD.
{"title":"Analysis of Association Between the Effects of Methylphenidate and DRD4 Gene Polymorphisms in Patients with Attention Deficit Hyperactivity Disorder","authors":"S. Amiri, S. Farhang, M. Shekari Khaniani, Sima Mansouri Derakhshan, Aziz Zadfattah, Zahra Mohammadi Bina, Fatemeh Ghazipour, Narges Sardari, Habibeh Barzegar, Leila Mehdizadeh Fanid","doi":"10.5812/compreped.109377","DOIUrl":"https://doi.org/10.5812/compreped.109377","url":null,"abstract":"Background: Drug treatment is one of the most important treatments for attention deficit hyperactivity disorder (ADHD). The DRD4 gene is a transporter and receptor coding gene of dopamine and is one of the most important genes under investigation in the disorder and etiology of ADHD. In this study, the association between rs3758653 C/T and VNTR exon 3 repetition polymorphisms of the DRD4 gene and the effects of methylphenidate were investigated in patients with ADHD disorder consuming methylphenidate. Methods: The descriptive-analytical study was performed on 122 patients (5 - 18 years old) with ADHD who were treated with methylphenidate. DNA was extracted using salting out method. Subsequently, the rs3758653 polymorphism in the 5'UTR region of DRD4 gene was genotyped by PCR-RFLP method, and the VNTR fragment in exon III of DRD4 gene was investigated by electrophoresis gel on acrylamide gel method. After eight weeks from the start of drug treatment with methylphenidate, the intensity of symptoms was evaluated using the Conners scale. Finally, all data from questionnaires and information that were resulted from laboratory findings were analyzed using ANOVA and repeated measure analysis. Results: Of the 122 patients under study, 15 patients (12.3%) were responded to the drug treatment, and 107 patients (87.7%) were not responded. The significant differences were not revealed in genotype, and allele frequencies of between rs3758653 (C/T) and exon III 3'VNTR repeats polymorphisms of the DRD4 gene and responder and non-responder of ADHD groups to the drug treatment. Conclusions: The results showed that the reduction of ADHD symptoms with drug treatment is not related to DRD4 sub-types in patients with ADHD.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45154134","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 : 2021-11-21DOI: 10.5812/compreped.116602
N. Mahmoud
Background: Extubation readiness is assessed by spontaneous breathing trials (SBTs); however, there is a lack of universally agreed protocols for their accurate performance and reporting in pediatric intensive care units (PICUs). Objectives: We aimed to evaluate extubating bundles, including modified SBT, in predicting successful extubation in critically-ill children with planned extubation. Method: This prospective cross-sectional study was based on the collection of data from 150 critically-ill children admitted to the PICU at Minia University Hospital. From January 2019 to June 2020, those children admitted to the PCIU and subjected to mechanical ventilation (MV), and extubation were enrolled. When the clinical team decided a child was ready for extubation based on the extubating bundle, a modified SBT (10 min) was used. It was started with switching to the CPAPPS mode, followed by PS zero, and maintaining the original PEEP for 3 min. Finally, PS was kept at 5 - 8 cm H2O, and the original PEEP was maintained for the remaining 7 min (total period of 10 min). Results: The extubation bundle with modified SBT could predict extubation success with 89% sensitivity and 89.9% positive predictive value (PPV). There were no significant differences in age, weight, gender, and length of intubation between children with failed SBT and those who were successfully extubated. In 41 cases, SBT failure occurred in 3 ‐ 5 min, while nine cases showed failure in 6 ‐ 10 min. Conclusions: Extubation bundle with modified SBT before elective extubation is indicated for children. Guidelines for extubation among critically-ill children are needed to reduce unnecessary exposure to mechanical ventilation's adverse effects. Further multicenter research is required to enhance outcomes and decline the burden of these patients.
{"title":"Predicting Successful Extubation Rate Using Modified Spontaneous Breathing Trial in PICUs","authors":"N. Mahmoud","doi":"10.5812/compreped.116602","DOIUrl":"https://doi.org/10.5812/compreped.116602","url":null,"abstract":"Background: Extubation readiness is assessed by spontaneous breathing trials (SBTs); however, there is a lack of universally agreed protocols for their accurate performance and reporting in pediatric intensive care units (PICUs). Objectives: We aimed to evaluate extubating bundles, including modified SBT, in predicting successful extubation in critically-ill children with planned extubation. Method: This prospective cross-sectional study was based on the collection of data from 150 critically-ill children admitted to the PICU at Minia University Hospital. From January 2019 to June 2020, those children admitted to the PCIU and subjected to mechanical ventilation (MV), and extubation were enrolled. When the clinical team decided a child was ready for extubation based on the extubating bundle, a modified SBT (10 min) was used. It was started with switching to the CPAPPS mode, followed by PS zero, and maintaining the original PEEP for 3 min. Finally, PS was kept at 5 - 8 cm H2O, and the original PEEP was maintained for the remaining 7 min (total period of 10 min). Results: The extubation bundle with modified SBT could predict extubation success with 89% sensitivity and 89.9% positive predictive value (PPV). There were no significant differences in age, weight, gender, and length of intubation between children with failed SBT and those who were successfully extubated. In 41 cases, SBT failure occurred in 3 ‐ 5 min, while nine cases showed failure in 6 ‐ 10 min. Conclusions: Extubation bundle with modified SBT before elective extubation is indicated for children. Guidelines for extubation among critically-ill children are needed to reduce unnecessary exposure to mechanical ventilation's adverse effects. Further multicenter research is required to enhance outcomes and decline the burden of these patients.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48016303","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 : 2021-11-21DOI: 10.5812/compreped.113199
F. Farnaghi, Marjaneh Abbasi Ghadi, L. Gachkar, Hossein Hassanian Moghaddam
Background: Opioid poisoning is common and fatal childhood poisoning in Iran with nonspecific, hidden, vague, and misleading clinical manifestations in some cases. Objectives: The aim of this study was to investigate and emphasize pruritus, as a neglected and helpful symptom in this important poisoning. Methods: In this cross-sectional study, one hundred pediatrics patients (< 14 years) with opioid poisoning who were referred to Loghman Hakim Hospital, Tehran-Iran, from April 2018 to April 2019 were enrolled the study. Demographic data including age, sex, type of poisoning, clinical manifestations including pruritus, its onset, location, duration, and therapy, also laboratory findings including complete blood count (CBC) and Eosinophilia recorded in patient-specific information forms. The collected data were analyzed using SPSS 21 software. Results: The patients’ mean age was 43.4 ± 31.4 months. Fifty-seven (57%) of them were male. Fifty-two (52%) of them reported Pruritus that in 84% observed in face. In 31% of children, itching resulted in skin scratches. The most common clinical manifestations were CNS depression (93%), respiratory suppression (68%), vomiting (52%), pruritus (52%), and meiosis (51%). There was no significant relationship between pruritus and gender, age, laboratory findings, family history of addiction, and allergy. Pruritus had a significant difference with Respiratory suppression (apnea, bradypnea, cyanosis), meiosis, vomiting, and redness of the skin (P-value: 0.05, 0.003, 0.009, and 0.002, respectively). Pruritus was controlled by naloxone in all of our patients. Conclusions: According to the results of the present study, pruritus is a common and helpful clinical manifestation in children with opioid poisoning that helps the physician for correct diagnosis, especially in hidden clinical scenarios.
{"title":"Pruritus, as a Neglected Symptom, in Opioid Poisoning in Children","authors":"F. Farnaghi, Marjaneh Abbasi Ghadi, L. Gachkar, Hossein Hassanian Moghaddam","doi":"10.5812/compreped.113199","DOIUrl":"https://doi.org/10.5812/compreped.113199","url":null,"abstract":"Background: Opioid poisoning is common and fatal childhood poisoning in Iran with nonspecific, hidden, vague, and misleading clinical manifestations in some cases. Objectives: The aim of this study was to investigate and emphasize pruritus, as a neglected and helpful symptom in this important poisoning. Methods: In this cross-sectional study, one hundred pediatrics patients (< 14 years) with opioid poisoning who were referred to Loghman Hakim Hospital, Tehran-Iran, from April 2018 to April 2019 were enrolled the study. Demographic data including age, sex, type of poisoning, clinical manifestations including pruritus, its onset, location, duration, and therapy, also laboratory findings including complete blood count (CBC) and Eosinophilia recorded in patient-specific information forms. The collected data were analyzed using SPSS 21 software. Results: The patients’ mean age was 43.4 ± 31.4 months. Fifty-seven (57%) of them were male. Fifty-two (52%) of them reported Pruritus that in 84% observed in face. In 31% of children, itching resulted in skin scratches. The most common clinical manifestations were CNS depression (93%), respiratory suppression (68%), vomiting (52%), pruritus (52%), and meiosis (51%). There was no significant relationship between pruritus and gender, age, laboratory findings, family history of addiction, and allergy. Pruritus had a significant difference with Respiratory suppression (apnea, bradypnea, cyanosis), meiosis, vomiting, and redness of the skin (P-value: 0.05, 0.003, 0.009, and 0.002, respectively). Pruritus was controlled by naloxone in all of our patients. Conclusions: According to the results of the present study, pruritus is a common and helpful clinical manifestation in children with opioid poisoning that helps the physician for correct diagnosis, especially in hidden clinical scenarios.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42664135","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 : 2021-11-17DOI: 10.21203/rs.3.rs-1066325/v1
M. Saeedi, K. Mirnia, Razieh Sangsari, Zeinab Jannat Makan, V. Ziaee
Introduction:Immune dysregulation following exposure to Covid-19 results in MIS-N (Multi-system Inflammatory Syndrome in Neonates). MIS-N affects various systems in the body and is diagnosed with a positive history of PCR test, positive serologic test, and a history of contact with those vectors of COVID-19 infection. This case series aimed to differentiate from possible misdiagnosis about MIS-N.Case Presentation:Both cases are term neonates with positive serology of COVID -19 and the 2nd case with a mother's positive history of Covid-19 PCR at 30 weeks of pregnancy. The first case was admitted with diarrhea, dehydration, fever for three days, and rash on the 3rd day of hospitalization. We admitted the 2nd case on the 22nd day of birth with a cough, rashes on the head, palms, and soles for two days. Both cases responded to corticosteroid treatment that confirmed MIS-N. Finally, we discharged them with a stable and normal condition in follow-ups.Conclusions:In inflammatory syndromes, especially in delayed phases of COVID cytokine storms, the mortality and morbidity caused by infections diminish with proper interventions and inhibited cytokine cascade inflammations.
{"title":"Neonatal Multi-System Inflammatory Syndrome Associated With Covid-19 Exposure in Two Cases From Iran","authors":"M. Saeedi, K. Mirnia, Razieh Sangsari, Zeinab Jannat Makan, V. Ziaee","doi":"10.21203/rs.3.rs-1066325/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-1066325/v1","url":null,"abstract":"\u0000 Introduction:Immune dysregulation following exposure to Covid-19 results in MIS-N (Multi-system Inflammatory Syndrome in Neonates). MIS-N affects various systems in the body and is diagnosed with a positive history of PCR test, positive serologic test, and a history of contact with those vectors of COVID-19 infection. This case series aimed to differentiate from possible misdiagnosis about MIS-N.Case Presentation:Both cases are term neonates with positive serology of COVID -19 and the 2nd case with a mother's positive history of Covid-19 PCR at 30 weeks of pregnancy. The first case was admitted with diarrhea, dehydration, fever for three days, and rash on the 3rd day of hospitalization. We admitted the 2nd case on the 22nd day of birth with a cough, rashes on the head, palms, and soles for two days. Both cases responded to corticosteroid treatment that confirmed MIS-N. Finally, we discharged them with a stable and normal condition in follow-ups.Conclusions:In inflammatory syndromes, especially in delayed phases of COVID cytokine storms, the mortality and morbidity caused by infections diminish with proper interventions and inhibited cytokine cascade inflammations.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67950205","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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