Caspian Journal of Pediatrics
Volume:8 Issue: 2, Sep 2022

Childhood obesity is one of the major national health concerns. World Health Organisation (WHO) recommends Body mass index (BMI) as the standard epidemiological measurement of obesity. The BMI is not quite independent of stature, especially at the younger ages. Hence, an alternative tool like arm-circumference-to-height ratio (AHtR) is necessitated. The aim of this study was to evaluate the accuracy of AHtR as an alternate tool to identify overweight and obesity in children aged 5-12 years.

This study was conducted in the Paediatrics Out-Patient Department of a tertiary care teaching center over 12 months (June 2020-May 2021) in Puducherry, India. Children between 5-12 years were included using the convenience sampling method. Their height, weight and mid-upper arm circumference (MUAC) were noted. BMI, AHtR, BMI-z scores and MUAC-z scores were calculated. All variables were analyzed in SPSS 23.0. Receiver operating characteristic (ROC) curve analysis was served to identify the age and gender-specific AHtR cut-offs to identify overweight and obesity.

This study was conducted on 1169 children (623 (53.2%)=boys and 546 (46.7%)=girls). The accuracy levels of AHtR for obesity were determined by area under curve (AUC) which was 0.962 for boys (cut-off=0.155) and 0.949 for girls (cut-off=0.175) between 5-12 years of age. BMI (kappa=0.605 and p<0.01) and MUAC (kappa=0.631 and p<0.01) significantly correlated with AHtR across all age groups.

AHtR is a simple, inexpensive, reliable, and accurate index to detect overweight and obesity in 5-12-year-old children. It serves as a useful alternative tool for BMI.

Loss of hearing is a non-visible disability (NVD) and the second most common congenital pathology. Apart from hearing loss, further disability in these domains has been reported like development of language, speech, cognition, and other evolving domains. These can be prevented by early identification and intervention. The aim of this study was to assess the outcomes of neonatal hearing screening programs in hospitals.

This retrospective study was conducted at the Department of Paediatrics and Neonatology. The records of 426 newborns who underwent hearing screening from Jan 2020 to Jan 2021 were analyzed. All healthy newborns underwent first screening between 48-72 hours with transient evoked otoacoustic emission (TEOAE) test, and babies admitted to NICU were screened once the condition stabilized. OAE and brainstem evoked response audiometry (BERA) results were considered outcome variables. The results of the OAE and BERA were expressed as passed or failed (referred). The coGuide software, V.1.03 was used for statistical analysis.

Totally, 221 out of 426 (51.88%) neonates were males, and appropriate for gestational age (AGA) babies' proportion was 381 out of 426 (89.44%) cases. Among the 37 preterm deliveries, 31(86.11%) were delivered during 34-37 weeks. Out of 426 neonates, 28(6.57%) had some risk factors. OAE-1 was referred in 30 neonates (7.04%), OAE-2 was referred in 10% (3 out of 30) and BERA was referred in 33.33% (1 out of 3).

The frequency of hearing loss among screened babies confirmed by BERA was 0.23% (1 out of 426). Neonatal hearing screening in hospitals can aid in the early diagnosis of hearing impairment thereby enabling appropriate and timely intervention.

Intestinal atresia is a life-threatening problem requiring early active intervention. The aim of the study was to compare management outcomes between Duodenal-Atresia (DA) and Jejunoileal-Atresias (JIA). The secondary objective was to analyse tapering enteroplasty versus end-to-end anastomosis in JIA.

Retrospective descriptive analysis of patients operated between  Mar 2015 to Feb 2020 in a tertiary-care Paediatric Surgery unit of Armed Forces Medical College Pune ,India. The data was obtained from the hospital records, operation theatre notes, discharge summary, and follow-up notes. Additional data was obtained by a telephonic conversation with the parents. Data were analysed with SPSS version 26 with appropriate statistical tools.

Forty-eight neonates were included (DA=23; JIA=25).There were 18 (37.5%) males and 30 (62.5%) females.The mean age, mean birth weight, and time to feed were statistically significant and better in JIA compared to DA. A total of 45% of newborns had associated anomalies. The primary surgery performed in patients with DA was Kimura's duodenoduodenostomy, while Resection-anastomosis with or without tapering enteroplasty was performed in JIA patients. In the subgroup analysis of JIA, the length of hospital stay in the tapering enteroplasty was statistically significant compared to resection anastomosis.(p=0.048). The average weight gain and survival in Jejunoileal-atresia at six months is statistically significant compared to Duodenal-atresia

The management of intestinal atresias is challenging and requires a dedicated team in a specialized neonatal intensive-care unit. Intensive investigation of other congenital anomalies associated with the condition is equally critical, and in the subgroup analysis of JejunoIlial -atresia, the patients undergoing tapering enterostomy showed better survival compared to resection and end to end anastomosis only.

Vitamin D deficiencies are highly prevalent globally, but the correlation between serum alkaline phosphatase and vitamin D3 deficiency among Indian children is seldom investigated. To describe the correlation of vitamin D3 levels and serum alkaline phosphatase levels among children admitted with malnutrition to the pediatric wards of a tertiary care center.

This descriptive observational study was conducted among 250 malnourished children aged between 1–14-years, attending the outpatient department of a rural tertiary care center in Faridabad, Haryana. The study was conducted from February 2019 to March 2020. A detailed history was taken using a questionnaire administered to the parents/guardians of the enrolled children. Demographic data, serum alkaline phosphatase, and vitamin D3 levels were used for analysis. The collected data was transferred and analyzed in coGuide software.

The mean age of children was 6.32 ± 4.15 years (range 1-14 years). More than half (64.50%) of all malnourished children were males. Mean serum alkaline phosphatase levels were 226.95 ± 169.39 u/l (range 89 - 2341), and the mean serum vitamin D3 levels were 19.79 ± 11.99 ng/ml (range 5.49 to 69.53 ng/ml). A weak negative correlation between serum alkaline phosphate (U/L) and serum vitamin D3(ng/ml) (rs: -0.105, P : 0.118) was observed.

 There was a negative correlation between serum alkaline phosphate and serum vitamin D3. As vitamin D3 levels were low in malnourished children, active surveillance and aggressive management is the need of the hour.

Thrombocytopenia (NTP) is one of the most common neonatal hematological disorders. The causes of neonatal NTP are very various, leading to large differences in the clinical profile of the affected neonates. Therefore, the aim of this study was to investigate the characteristics, clinical diagnoses and short-term outcomes of neonatal NTP in Bahrami Children's Hospital, Iran.

This descriptive retrospective cross-sectional study was conducted on all neonates admitted to the neonatal intensive care unit (NICU) of Bahrami Children's Hospital in 2017-2019. The infants diagnosed with neonatal NTP, defined as a platelet count of <150000 on at least 2 occasions, were retrospectively evaluated. Data on patients' NTP and short-term outcomes were reported. Incomplete medical records were excluded from the study.

Out of 2000 neonates, 210 patients were diagnosed with neonatal NTP with a prevalence of 10.5%. Totally, 60% and 71.4% of infants were premature and underweight, respectively. Moreover, 30 and 20.9% of infants had premature and severe NTP, respectively. The most common clinical diagnosis was sepsis (68.1%). The mean length of stay in NICU was 12.3±9.5 days. Additionally, 20.9% of infants had at least one episode of severe hemorrhage, received a platelet transfusion, and 10.4% of infants expired during their NICU stay.

The prevalence of neonatal NTP was 10.5%. Despite the relatively high prevalence of preterm birth, low-birth weight and sepsis, the majority of our neonates recovered. Prospective studies are recommended to investigate the role of each predisposing factor in the development and outcome of neonatal NTP.

Sleep disorder is complex comorbidity in children with attention-deficit/hyperactivity disorder (ADHD), and there is generally a reciprocal effect between them. Considering its adverse consequences on children and their families, the aim of this study was to investigate the frequency of sleep disorders in children with ADHD and the relationship between the sleep problems and mental health of their parents.

In this cross-sectional study, 100 ADHD children aged 4-12 years were selected using simple and available sampling method among all children referred to the Pediatric Psychiatric Clinic of Yahyanejad Hospital during 2020.  The data were collected using a demographic questionnaire, Children’s Sleep Habits Questionnaire (CSHQ) for children and Depression Anxiety Stress Scale-21(DASS-21) for both parents completed by the same researcher through interview method. A value of p<0.05 was statistically considered significant.

One hundred 4-12-year-old children with a mean age of 7.72±2.31 years participated in this study. The mean CSHQ for ADHD children was 54.07±6.29. The most common sleep disorders were bedtime resistance (92%), sleep duration (69%) and sleep anxiety (64%). There was relationship between CSHQ score with depression (R=0.31, P=0.002), anxiety (R=0.26, P=0.008) and stress (R=0.23, P=0.02) in mothers.

Bedtime resistance was the most common complaint of ADHD children. Moreover, sleep problems in children were related to depression, stress and anxiety in their mothers.

Emotion regulation and separation anxiety are some of the problems faced by elementary-school students. This study aimed to investigate the effectiveness of cognitive-behavioral play therapy (CBPT) on emotion regulation and separation anxiety of elementary-school children in Isfahan.

This quasi-experimental study was conducted using a pretest-posttest design with a control group. The statistical population included all male elementary-school students in Isfahan, Iran in 2020. Using the convenience sampling method, 30 students were selected and divided into experimental and control groups (n= 15 per group). The experimental group underwent eight sessions (one 30-minute group session per week) of CBPT, while the control group received no intervention. The research tools included the Cognitive Emotion Regulation Questionnaire (CERQ) and the Separation Anxiety Assessment Scale-Parent version (SAAS-P). Data were analyzed using the analysis of covariance in SPSS 22 software.

The participants included 30 elementary-school students, aged 9.12±1.35 years old. The mean ± SD of the post-test scores of emotion regulation and separation anxiety in the CBPT group was 58.26±1.96 and 45.26±1.08 and was 52.26±1.96 and 76.33±2.67 for the control group. The results indicated that CBPT improved emotion regulation and reduced separation anxiety in elementary-school students (P= 0.001).

 It can thus be concluded that play therapy with a cognitive-behavioral approach can mitigate anxiety and improve emotion regulation in elementary-school students.

 Youth is a sensitive time, and the habits acquired during this period last a lifetime. Today's generation wastes their time with smartphones and other electronic media, which prevents them from focusing on academic and other healthy activities. The aim of the present study was to investigate the problem of screen time and academic performance.

This was a community-based descriptive cross-sectional study conducted among 301 adolescents aged 10 to 18 years between January 2020 and December 2021. A pilot-tested semi-structured questionnaire was used to elicit responses using the interview method, focusing on basic demographic information and screen time. This pilot study was conducted on healthy adolescents attending the pediatric clinic of the Department of Pediatrics at GMH in Rewa, and the same questionnaires were then used in the sampled schools in Rewa County (M.P.)

In the present study, 106 children (35%) belonged to the early adolescent age group, 174 (58%) to the middle adolescent age group, and 21(7%) to the late adolescent age group. The average percentage of the participants’ grades was 74.6%. It was found that the average percentage of grades obtained decreased with increasing screen time. Sixty-three (20.9%) children with screen time of > 3 hours per day achieved an average grade of 62.1%, while those who did not use screen media achieved an average grade of 88.4%. This is statistically significant with a p-value of < 0.001.

 Adolescents spending 3 hours per day in front of a computer screen may decrease their academic performance

The prevalence of childhood obesity and overweight and its rising trend in recent decades have taken a worrying form. Since obesity at this age lays the foundation for obesity in adulthood and entails consequences, and also in view of the extensive studies conducted that have yielded different results, the present meta-analysis study related to the prevalence of obesity in Iranian children was conducted to provide a credible result for planners.

All cross-sectional studies on the prevalence of obesity in Ian were extracted from national and international databases such as Scopus, Iranmedex, SID, Magiran, and PubMed in October 2021. Moreover, the random effect model with 95% confidence level was used to analyze the data and obtain summary effect.

This study included 42 articles that met the inclusion criteria. According to the studies, the prevalence of obesity and overweight in Iranian children was 10.32% and 12.48%, respectively.

The present meta-analysis study indicated that the prevalence of obesity in this country is increasing and the rate is higher in girls than in boys. Changing lifestyles and promotion of poor nutrition in modern society have necessitated the planning and implementation of intervention programs for this age group at the family, school, and social levels.

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare but well-described cardiac anomaly with a frequency of 0.25 - 0.5% among all cardiac anomalies. It is associated with a high mortality rate (90%) in infants (within 1 year of birth) due to inadequate collateral circulation development. However, if good collateral circulation to the left side of the heart is established, the patient may survive into adulthood without complications.

 The present report describes an unusual case of a 14-year-old boy who was incidentally diagnosed with ALCAPA and was completely asymptomatic with normal left ventricular ejection fraction. The patient was treated with conservative medical therapy and recommended for regular clinical follow-up.

Although our patient’s parents were not convinced about surgical repair, he could be further treated with conservative medical therapy. However, surgical repair should be performed in all cases of ALCAPA to prevent the progression of ischemia, arrhythmia, congestive heart failure, and even sudden death.

Subcutaneous fat necrosis (SFN) of the newborn is a rare form of panniculitis. It usually occurs in perinatal stress and is usually complicated by metabolic disorders such as hypercalcemia. While the number of cases reported worldwide has increased, there are very few cases from Nigeria.

 We report the case of a Nigerian newborn admitted at 25 hours of life with macrosomia (birth weight of 4.7 kg) and perinatal asphyxia. On the fourth day of life, she developed reddened to dark, tender areas on the back (20 x 15 cm) and back of the arms, suggestive of SFN with elevated serum calcium. The baby received oral frusemide with the resolution of hypercalcemia by the 4th month of life.

Panniculitis, as a form of subcutaneous fat necrosis should be considered in a neonate with a history of perinatal asphyxia and macrosomia, which requires measurement of serum calcium levels.