Journal of Pediatrics Review
Volume:7 Issue: 4, Oct 2019

Musculoskeletal pain is very common among students and adolescents. The present systematic review and meta-analysis study aimed to determine the prevalence of musculoskeletal pain among Iranian children and adolescents. All articles on the prevalence of musculoskeletal disorders in Iranian adolescents were searched in the Google Scholar, four Iranian databases and five international English-language databases using the keywords of “pain”, “musculoskeletal disorders”, “low back pain”, “adolescents”, “students”, and a combination of these keywords. The obtained data were analyzed by Comprehensive Meta-Analysis (CMA) software. The findings showed that out of 9 studies found in this systematic review and meta-analysis, 6 articles were about low back pain, 6 articles about neck pain, and 3 articles about shoulder pain, respectively. According to the findings, 25.4% (95% CI: 19.0 to 33.0) of the children experienced pain; the prevalence rates of low back pain, knee pain, and the shoulder pain were 26.2% (95% CI: 14.3 to 43.0), 22% (95% CI: 14.5 to 32.0), and 29.3% (95% CI: 20.1 to 40.7) in Iranian adolescents, respectively. Considering the high prevalence of pain among Iranian adolescents, it is necessary to carry out appropriate interventions for pain prevention among this age group.

Congenital Hypothyroidism (CH) is the most common endocrine disorder and causes of preventable mental retardation in children. We aimed to review the reported CH-related risk factors systematically. In this review, all types of human studies on the risk factors related to the occurrence or high rate of CH were included. An electronic search was conducted in international and national electronic databases. The following keywords were used: “Congenital Hypothyroidism” AND “risk factor”. In this review, 373 papers (from PubMed: 199; Scopus: 36; ISI: 53, SID: 55, Ovid: 11; Science Direct: 19) were identified through electronic database search. A total of 98 articles were assessed for their eligibility, from which 60 qualified articles were selected for final evaluation. Most of the studies have cross-sectional, case-control, and prospective design. The current review was conducted and reported following the PRISMA (preferred reporting items for systematic reviews and meta-analyses) statement. Reported risk factors for transient CH were as follows; iodine deficiency and excess, prematurity, advanced maternal age, male gender, retinopathy of prematurity, twin pregnancy, maternal autoimmune thyroid disease, intrauterine growth retardation, and cesarean delivery. Reported risk factors for permanent CH with dysgenesis of the thyroid gland were as follows; female gender, familial history of CH, birth in geographical areas with a high rate of the disease, advanced maternal age, ethnicity (Caucasians), but not seasonality. Reported risk factors for permanent CH with dyshormonogenesis were a familial history of CH and origin of both parents from the high-risk geographical region. By using this information, we could plan more etiologic studies to investigate the pathogenesis of the disorder, design interventional studies for the known modifiable risk factors to reduce the rate of CH in our region. Also, for risk factors with limited evidence, more studies should be performed.

Asthma is a chronic inflammatory disorder of the respiratory system in children. Immunoglobulin E (IgE) has an important role in allergic disorders like asthma. This study aimed to review the association between maternal serum IgE and the incidence of childhood asthma. Three researchers searched all articles in PubMed, Scopus, Google, and Embase databases related to maternal serum IgE, cord blood IgE, childhood asthma, and its incidence. We used keywords such as “maternal IgE, cord blood IgE, relation, association, childhood asthma, and child allergy”.  We found a few related articles on maternal IgE, cord blood IgE, and childhood asthma. In total, we reviewed 11 articles. Parental atopy and allergy are the most important predictive factors for children’s allergies, like asthma. IgE levels were higher in children whose mothers had higher IgE levels. Total IgE level was significantly higher in boys, compared to girls.  Increased maternal and cord blood IgE may be a predictive factor for the development of childhood asthma. More data are required to clarify this relationship.

Orofacial clefts are among the most common congenital birth malformations in the oral and maxillofacial area. Lip reconstruction or cheiloplasty is a critical issue for these patients when they are around three months old. Presurgical Nasoalveolar Molding (NAM) has become part of the treatment protocol in many cleft centers to improve the treatment outcome. This procedure is commonly employed to reduce the alveolar segments into proper alignment and improve nasal symmetry in patients with cleft lip and palate. This article aims to review the value of this technique as part of the treatment protocol for infants born with cleft lip and palate. In this review, the electronic databases of ISI, PubMed, and Google Scholar were searched. Articles published from 2000 to 2018 were retrieved and underwent “abstract” and “full-text” appraisal. The following keywords were used: “Nasoalveolar Molding”, “cleft lip and palate”, “presurgical orthopedics”, and “nasal stent”. Presurgical NAM can reduce the severity of the initial cleft deformity, wherein the bony segments are slowly moved to a more favorable position, lessening the amount of surgical correction needed to bring the lip segments together, while simplifying the surgical approach for the nose. By using presurgical NAM, the primary surgical repair of the lip and nose is performed under minimal tension, thereby reducing scar formation and improving the esthetic results. Also, the frequent surgical intervention to achieve the desired esthetic results can be avoided by this technique.

Netherton Syndrome (NS) is a rare hereditary autosomal recessive disorder with ichthyosiform cutaneous lesions, specific hair shaft defect, and atopic diathesis. The incidence of NS is estimated to be approximately 1 in 200000. The objective of this case report is to present NS in a patient with severe eczema atopic dermatitis-like eruption. A 41-month-old boy was referred to the clinic of Allergy and Immunology, Hazrat Rasoul Hospital with generalized erythema, and scaling cutaneous lesions. The patient underwent clinical examinations and laboratory analysis. His laboratory data revealed only an elevated IgE level with a leukocyte count of 7800/μL containing 10% eosinophil. His hair shaft indicated classic trichorrhexis invaginata (Bamboo hair). Based on the clinical and laboratory findings, he was diagnosed with NS. A brief review was also done related to this case. This case was reported because of the severity of the disorder and other differential diagnoses in severe and refractory atopic dermatitis-like eruptions. The importance of the case is related to other differential diagnoses, especially with early onset disorders at neonatal age.

The real risk of Sudden Cardiac Death (SCD) in Asymptomatic Wolff-Parkinson-White (AWPW) syndrome is still unclear, and the literature is controversial about the best management strategy. Usually, SCD has been reported as the first event in asymptomatic or undiagnosed infants with AWPWs. So adequate risk stratification is warranted to prevent the occurrence of life-threatening arrhythmias in these patients. However, none of the available diagnostic tests is satisfactory to predict SCD. We report two cases of AWPW syndrome in infants that experienced SCD as their first clinical manifestation. AWPW syndrome in infants is not rare. It is also a challenging condition that implies a very weak but real risk of SCD, which is very difficult to ascertain with current diagnostic methods. In this article, we review the literature about these cases and discuss the adequate management of these patients.

We aimed to determine the epidemiology of anaphylaxis to bee stings in the rural areas of Gorgan City, Iran.  Anaphylaxis is a severe, life-threatening, diffuse or systemic hypersensitivity reaction with rapidly progressive problems such as airway (throat or laryngeal edema) or bronchospasm, tachypnea and hypotension .The systemic response to bee stings is 1% in children and 3% in adults. Anaphylaxis due to bee stings is very dangerous in many cases, and may even be fatal at the initial stage. In this cross-sectional study, we analyzed some of the epidemiological characteristics of the study participants, such as demographic information, bee type, the cause of anaphylaxis, the time of bee sting, the onset of symptoms of anaphylaxis after a bee sting, the number of bee stings, symptoms during anaphylaxis, and therapeutic and prophylactic measures. In total, 201 patients were diagnosed with anaphylaxis caused by bee stings. Of these, 129(64%) were male, and 72(36%) were female with the Mean±SD age of 34.33±32 and 35.25±34 years, respectively. Anaphylaxis incidents occurred in 108 men, and 103 women out of 100000; 169 of whom were adults and 46 were children. Anaphylaxis occurred in 105(52.2%) cases in <5 minutes after being stung (very severe attack) and in 94(46.8%) cases, between 5-60 minutes after being stung (rapid attack) (P=0.45). The patients’ involved organs were skin (85.6%), respiratory system (78.6%), cardiovascular system (35.8%), nervous system (17.4%), and gastrointestinal tract (10.9%). Among these stings, 78(38.8%), 107(53.2%), and 16(8%) occurred indoors, outdoors, and at home, respectively (P=0.05). 7(9.5%) children and 67(39.6%) adults had hypotensive symptoms (P=0.05). Ninety five percent of cases have been stung for <10 times, and 80% of those who have experienced more than 10 stings experienced severe anaphylactic attacks (P=0.003). Case finding was successful through the rural health network. To obtain accurate epidemiological data on the prevalence of anaphylaxis due to bee stings, an anaphylaxis registry and healthcare service packages are recommended. In this integrated model, a service package, including raising awareness and the knowledge of people, and treatment for anaphylaxis can be employed.

Publishing study protocols have been recently growing due to their substantial benefits. Such advantages include increasing the research transparency, reducing the selective reporting of outcomes, and preventing the unnecessary duplications of research. This paper explained the rationale and methods of a policy analysis study on newborn mortality in Iran. The study objectives are identifying the risk factors of neonatal mortality in Iran, identifying the experiences of successful countries in this area, analyzing the policies of reducing neonatal mortality in Iran, analyzing the policies of reducing neonatal mortality in the high-burden provinces of neonatal mortality in Iran.  This study consists of four steps; each corresponds to one aim of the study. The steps are as follows: a systematic review of the risk factors of neonatal mortality in Iran, a comparative study of policymaking to reduce neonatal mortality in successful countries, the analysis of policies of reducing neonatal mortality in Iran using policy models, and developing policy options for reducing the neonatal mortality in the high-burden provinces.  This study is designed for analyzing the policies of reducing neonatal mortality in Iran. The results may provide recommendations for the provinces with high rates of neonatal mortality. The study will identify the advantages, disadvantages, and defects of the existing policies. As a result, we would be able to develop proper plans to further reduce neonatal mortality. Moreover, the findings and methods of this study can help other countries, especially the developing ones, in reducing their neonatal mortality. The data could also be beneficial in other healthcare areas, including under-five mortality and maternal mortality.