Journal of Pediatrics Review
Volume:2 Issue: 2, Apr 2014

Numerous methods for repair of hypospadias have been introduced. The technique of Tubularized Incised Plate urethroplasty has gained widespread acceptance. In the classical method of Tubularized Incised Plate urethroplasty, to divert urine flow and preventing urethral stenosis, a stent was used, but its necessity is questionable for some surgeons. In this paper we systematically compared the results of operations in different studies. Searching the databases such as PubMed, SCOPUS, and Google Scholar was done and articles found from January 1994 to September 2013 were included. Then articles about the impact of use or non-use of urinary catheters on surgical outcomes were analyzed. By reviewing 168 studies related to repair of hypospadias with TIP, we selected 11 studies that met our inclusion criteria which did not use a stent. A total of 708 children had urethroplasty using the TIP method without stent. The overall complication rate such as meatal stenosis and fistula compared with stents was not significant. It could tell us that at least in some cases especially in distal types, use of stent can be avoided, because its least benefit would be reduction of bladder spasm and urinary tract infections.

Rotavirus is one of the most common etiologic agent of severe acute diarrhea in infants and children which results in high mortality and morbidity globally. Prophylactic strategies are required to prevent acute rotavirus diarrhea. Recently, the beneficial effect of probiotic therapy in control of rotavirus diarrhea was noted in many investigations. This systematic review investigated the prophylactic effect of Lactobacillus rhamnosus GG on the incidence of acute rotavirus diarrhea in infants and children. Databases including PubMed, Cochrane Controlled Trial Register (CCTR), Google Scholar, Science direct and Ovid (Wolters Kluwer health) were searched for articles and reviews from 1980–2013. Reviewers selected randomized clinical trials that met the study inclusion criteria. The outcome measures included incidence of rotavirus diarrhea, duration of diarrhea, and hospital stay. The search results included three trials with 1043 eligible patients. The results indicated that the use of Lactobacillus rhamnosus GG compared with placebo significantly affected the incidence of rotavirus diarrhea without influencing the duration of hospital stay. Some studies signified the role of Lactobacillus rhamnosus GG in preventing acute rotavirus diarrhea; however we did not find sufficient trials with certain method to evaluate this influence.

Hypothermia is an important cause of neonatal morbidity and mortality especially in low-income settings. To control this problem in countries such as Iran a full knowledge of the situation is of great importance. A review was performed both in Persian and English, including international databases. Totally 934 articles were reviewed and finally five articles were selected. The incidence of neonatal hypothermia in different parts of Iran was reported between 7.48 to 53.3 percent. The prevalence of neonatal hypothermia is a matter of concern and further studies are needed to determine this prevalence in all parts of Iran. Furthermore, performing more etiological investigations are recommended.

Rare bleeding disorders (RBDs) are a heterogeneous group of disorders including different types of coagulation factor deficiencies. The disorders are inherited in an autosomal recessive manner with different frequencies varying from 1:500000 to 1:2000000. Patients affected with RBDs are presented with a wide spectrum of clinical manifestations ranging from mild to life threatening bleeding diathesis. These disorders are usually present in regions with high rate of parental consanguinity. Despite the rare incidence of RBDs, it is necessary for physicians to be aware of these disorders. Here we aim to have a comprehensive review on general features and also the recent advances in understanding of RBDs. MEDLINE and Web of Science databases searched for English sources from 1990 to 2014, using the following keywords: rare bleeding disorder, rare inherited disorder, factor deficiency, structure, function, epidemiology, manifestations, laboratory analysis, diagnosis, mutation, treatment, management and also all the factor deficiencies which are considered as RBD. Knowledge towards RBDs is increasing, however, most of published data are limited to small group of populations or case reports. Therefore, there are still several questions on these rare disorders which need to be clarified through large prospective studies.

Pneumonia is the leading cause of mortality in young children worldwide. Early diagnosis and empiric antibacterial therapy is an important strategy to improve outcome. The World Health Organization (WHO) has developed case management guidelines to reduce pneumonia-related deaths through early diagnosis and antibiotic treatment. For management purpose, pneumonia is subclassified by its severity. Children with simple pneumonia, pneumonia with chest wall in-drawing or pneumonia with danger signs (convulsion, cyanosis, inability to drink, abnormal sleepiness). Pneumonia with danger signs requires hospitalization and parenteral antibiotics, whereas children who only have fast breathing (tachypnea) can be treated at home with oral antibiotics. Later, these strategies were incorporated into the Integrated Management of Childhood Illnesses (IMCI), and the protocol was adopted by several developing countries. Despite the proven benefit of this program in reducing pneumonia-related deaths, there has been some concern about the specificity of the WHO and the IMCI guidelines, leading to unnecessary use of antibiotic for children with tachypnea, who were categorized as pneumonia. There is a necessity to improve the IMCI case management of childhood pneumonia because of overlap with other lower respiratory tract illnesses. This review outlines current guidelines for childhood pneumonia management in developing countries and identifies challenges for improvement in management in a variety of settings.

Asthma is a chronic inflammatory airway disorder and the most common chronic disease among children characterized by frequent and chronic cough, wheezing, and dyspnea. Asthma is defined as an inflammatory process in response to T- Helper 2 cells. Vitamin E as a Lipid soluble vitamin; containing 4 isomers α, β, γ, б, with α- tocopherol as the most important isomer is an important defensive agent against epithelial tissue damages caused by antioxidants in human. The results of animal studies showed vitamins C and E cause decreased and modulation of pulmonary responses to oxidant agents such as O3 or NO2. A few studies showed an association between reduced intake of vitamin E by mothers during pregnancy and wheezing in children aged 2 years old. Some studies showed significant declines in serum vitamin E level in asthmatic children compared to non-asthmatic. However, in another study no significant relationship was observed between serum level of vitamin E and risk of asthma. There are controversies on the effect of vitamin E in children with asthma. This study aimed to investigate the role of vitamin E in children with asthma.

Respiratory syncytial virus infection in immunocompromised patients, especially those with defects in cell mediated immunity is associated with high morbidity and mortality. Lymphocytopenia is an important factor associated with progression of upper to lower respiratory tract infection. The only licensed antiviral treatment for RSV available currently is ribavirin, although additional immunomodulatory therapies may also play a beneficial role. The use of ribavirin in immunocompromised patients with lower respiratory tract infection has some evidence for efficacy in reducing mortality. We report two cases of pre-transplant patients with acute myeloid leukaemia who were considered for ribavirin treatment for RSV upper respiratory tract infection and review the published literature on this. The use of ribavirin in immunocompromised patients with RSV upper respiratory tract infection to reduce the risk of progression to lower respiratory tract infection is unclear. In patients with Respiratory syncytial virus upper respiratory tract infection detected in the pre-haematopoetic stem cell transplant stage, delay of transplantation remains the most effective method of reducing morbidity and mortality.

Background and Successful treatment of Helicobacter pylori infection causes not only eradication of pathogen, but also prevents the associated diseases such as peptic ulcer, gastric carcinoma and lymphoma. The aim of this study was to evaluate the efficacy of 7 days triple therapy as a lowest drug resistance, shortest duration and fewer numbers of drugs in children. The target population was 22 children <15 years with peptic disease complaints. The inclusion criteria were: positive endoscopic finding, inflammatory evidence in gastric biopsy and presence of Helicobacter pylori in gastric mucosa. Two pieces from incisura and body of gastric mucosa were taken and stained with Gimsa. Helicobacter pylori positive patients were treated with omeprazol, clarithromycin and amoxicillin for 7 days. One month later, all cases were evaluated by repeated endoscopy or Urea Breath Test and H pylori eradication were assessed. Data was gathered and analyzed with SPSS software, and McNamara''s and Chi-Square test were performed. Nineteen patients were studied including twelve boys, 26.3% 2-6 years and the rest older than 6 years. The most common clinical presentations and endoscopic findings were chronic abdominal pain (74%) and nodularity (47.4%), respectively. The per-protocol and intention-to-treat H. pylori eradication rates were 84.2% and 76%, respectively in seven days triple therapy regimen. Seven days triple therapy successfully eradicated H pylori in children.