Journal of Pediatrics Review
Year:2019 | Volume:7 | Issue:1 (13)|Papers Count:8

Context: Due to the dissatisfaction with the conventional therapeutic methods to control the infantile colic, the mothers are developing interest in herbal medicines.Objectives: The present study is a systematic review with meta-analysis which was conducted to evaluate the effect of herbal medicines in the treatment of infantile colic.Data Sources: A systematic electronic search was performed on the databases of the MEDLINE, Scopus and the Cochrane Central Register Trials inception up to July 2018 to assess the effectiveness of herbal medicines in the treatment of infantile colic. No determined limitation was considered and the measured outcome was the duration of crying time.Study Selection: Six studies assessed the effect of herbal medicine on colic infantile Data Extraction: The data extraction and quality assessment of the trials were performed by two separate individuals based on standardized predefined checklist.Results: Five studies investigated the effect of prepared herbal medicines containing phytoestrogens on the infantile colic, the colic improvement score, and the number of night waking times. The compounds containing phytoestrogens decreased the duration of crying time compared to placebo (SMD=-0.536; 95% CI=-0.848 to 0.224; P=0.001). Heterogeneity was moderate but not statistically significant (I2=56%; P=0.07). Moreover, one study measured the colic improvement score and the number of night wakings whose results showed a significant decrease in the parameters. To sum up, the phytoestrogens could significantly improve the infantile colic. Four trials studied the effect of compounds containing fennel, as their results indicated a significant improvement in the duration of crying time compared to control group (SMD=O.712; 95% CI=-1.005 to 0.420; P<0.001). Heterogeneity was 0% among the studies. The SMD of compounds containing fennel alone reduced the duration of crying time to less than -0.6 (95% CI= -0.940 to -0.456; P<0.001). Heterogeneity was moderate but not statistically significant (I2=0%; P=0.669).Conclusions: Fennel and compounds containing phytoestrogens had a significant positive effect on the duration of crying time. Mentha piperita was shown to possess higher efficacy than simethicone in reducing daily colic duration. Further trials should be conducted with larger sample size and longer treatment duration.

Context: Immunological reactions against proteins found in cow’s milk (casein and whey proteins) are called Cow’s Milk Protein Allergy (CMPA). CMPA has systemic as well as oral symptoms. Also, any casein-containing products used for preventive and therapeutic purposes in dentistry may trigger this allergy. The objective of this compilation is to reveal the importance of CMPA in dentistry by adhering to the literature.Evidence Acquisition: A literature search was done using PubMed, with focus on articles published in the last 10 years. Searched terms included the following: cow’s milk protein allergy, child, pathogenesis, prevention, management, and dentistry. Results: Oral allergy syndrome and dental erosion caused by gastroesophageal reflux were observed in 40% of patients with CMPA that were detected by the dentists. Conclusions: Pediatric dentists should be aware of CMPA and pediatricians should be given support in definitive diagnosis of CMPA.

Context: Asthma, characterized by airway inflammation, is a common chronic disease of childhood. Cytokines and chemokines could be used in the diagnosis, treatment, and management of asthma severity in children. In this review, we have explained the application of cytokines and chemokines as biomarkers in pediatric asthma.Evidence Acquisition: All related articles were separately searched by two researchers using the following keywords in PubMed, Scopus, and Embase databases: Cytokine biomarkers, chemokines biomarkers, and children asthma. Articles published from 2000 to 2017 were investigated in the research, and 28 articles were included in the final analysis for this review. Results: About cytokines, serum Interleukin 4 (IL-4) level is a marker of the presence of asthma, and IL-13 is a key cytokine involved in the manifestation of asthma symptoms. High IL-13 concentration and number of IL-13+ cells in the bronchial submucosa specimens are characteristic of severe asthma. Serum IL-5 concentration 3.1 times in children with severe asthma. IL-17 is involved in airway obstruction. IFN-γ gene polymorphism (+874A/T) in children elevates susceptibility to asthma. TGFB1 polymorphisms are considered as indicators of asthma severity. IL-26 plays an important role in asthma severity. IP-10 may be a useful inflammatory marker of asthma severity. High periostin level has been identified in pediatric asthma. PDGF level, which is high in asthma patients, plays an important role in bronchial fibrosis. About chemokines, plasma TARC concentration may be a useful biomarker of airway inflammation and asthma severity in children. Studies have supported the association between high serum RANTES levels and severe airway obstruction in children. CXCR4 levels are high in pediatric asthma and are associated with disease severity. Conclusions: A wide range of cytokines and chemokines may play important roles in asthma severity in pediatric patients. Therefore, several studies have recommended the use of multiple molecular biomarkers, such as cytokines, for determining asthma severity in children.

Context: The present study aimed at developing a conceptual co-relational model of personal and environmental factors affecting mobility in children with CP.Evidence Acquisition: This perspective article describes a path model for mobility in children with CP. A conceptual framework for the model was supported by the relevant literature, and published papers on the personal and environmental factors affecting mobility in children with CP were reviewed. A literature search was performed using PubMed, SCOPUS and Google Scholar on papers published from 1970 to 2016.Results: From the initial 228 articles related to personal and environmental factors for children with cerebral palsy, 72 articles met the inclusion criteria. Different factors, affecting the mobility, directly and indirectly, were analyzed based on available evidence. Conclusions: If contributing factors that lead to changes in basic motor abilities are identified and subjected to manipulation, the identified determinants that can be optimized through interventions might enhance long-term results of mobility.

Introduction: Half of all fractures of the elbow and almost 30% of all limb fractures occur in children under the 7 years of age, supracondylar humerus fracture being the most common. Neurological complications associated with supracondylar humerus fractures in children such as Anterior Interosseous Nerve (AIN) syndrome are well known.Cases Presentation: Thirty-three children with humeral supracondylar fracture were admitted to the orthopedic surgery centers at Imam Hospital in Sari, north of Iran from November 2014 to November 2016. Of them, four cases had AIN syndrome. The treatment of fracture involved closed reduction with percutaneous pinning, open reduction, and pin fixation. Conclusions: According to the only motor (no sensory) dysfunction of AIN and by deceiving children using the third finger to flex the second one, underestimation of AIN syndrome in supracondylar fracture of the humerus can be expected. So, the physician should be more careful about physical examination in supracondylar fracture of humerus beside to vascular state.

Introduction: Treacher Collins Syndrome (TCS) is an inherited and rare, autosomal dominant condition of craniofacial malformation with varying degrees of penetrance and expression that has been described extensively in the scientific literature with more than 250 cases reported. We presented a 7-year-old boy with TCS. The etiology, clinical features, differential diagnosis and treatment planning have been discussed. In addition, we also reviewed 10 varied cases of TCS.Case Presentation: Syndromic appearance of abnormal orbits, eyes, ear, and facial bones, along with normal physical and dental development and intelligence quotient were observed in a 7-year old boy referred to the Pediatric Department of Babol Dental School. The patient had no family history of any syndrome, and after reviewing his complete medical records and diagnosing oral and dental problems, the treatment plan was devised. Due to the high risk of caries in the patient, he was followed up every three months. Conclusions: Early detection, treatment and particular attention to every case of TCS can reduce disease symptoms. Psychological consultation can improve the quality of life for these patients.

Background: Methylmalonate-semialdehyde Dehydrogenase Deficiency (MMSDHD) is an uncommon autosomal recessive disorder. MMSDH is an enzyme encoded by the protein coding gene ALDH6A1 in humans.Case Presentation: We present a 4-year-old boy with elevated liver enzymes, 3-hydroxyisobutyric aciduria (MMSDHD) and cardiac symptoms. He had a mutated ALDH6A1 gene, c.184c>G (p.Pro62Ala).Conclusions: This is one of the rare case reports in the world and the first one in Iran that reports MMSDHD with cardiac disease.

Background: Several studies have developed sex-specific reference percentile curves for body fat percentage in children to be adopted in clinical surveys.Objectives: This study aimed to develop acceptable percentile curves for body fat percentage in children in Babol, North of Iran, to assess childhood obesity.Methods: Body fat percentile charts were created using bioelectrical impedance analysis of 7 to 11 years old schoolchildren from rural and urban parts of Babol. The obtained percentile charts were then smoothed.Results: The findings showed that the mean fat percentages differed between boys and girls. The 50th percentile curve was slightly higher for boys of 7-11 years, with a peak fat percentage of 22.50% at 11 years of age, whereas the mean fat percentage increased with age in 7 to 9 years old girls (16.8%-22.05%), reduced slightly from 9 years of age, and then peaked at 25.5% at 11 years.Conclusions: This study provided reference curves for body fat percentage in the North Iranian children, who were found to have significantly high body fat percentage. It may be useful to further prepare national reference values and cut-off points for body fat percentage as a predictor of childhood obesity.