Journal of Pediatrics Review
Year:2024 | Volume:12 | Issue:1|Papers Count:10

Since Alan Turing proposed the concept of using computers for intelligent simulation of behavior and critical thinking, artificial intelligence has progressed in various fields. In medicine, artificial intelligence is used in three subfields: Machine learning (ML), deep learning (DL), and computer vision. Considering the increasing use of artificial intelligence in pediatric oncology and cancer treatment, there is a need for studies and research projects specifically focused on pediatric oncology. In oncology, especially childhood malignancies, artificial intelligence can help doctors as a new tool.

Background: Gavage feeding is associated with adverse effects, such as irritations in the mouth, hyperactivity, problems in gag reflex, bradycardia, and the parents’ unacceptance. Accordingly, it is essential to undertake a comprehensive review of the effects of breast milk and other pleasant odors that may reduce the transition time from gavage to oral feeding in preterm infants. Objectives: Aim of review is to compare of effects of breast milk and other pleasant odors with the control group on the transition from gavage to oral feeding in preterm infants. Methods: In this systematic review, online English databases, such as PubMed, Scopus, ISI Web of Science, and Cochrane Library were systematically searched without any time limitation up to February 10, 2022. The modified Jadad scale was also used to assess the quality of the articles. The inclusion criteria comprised all clinical trials evaluating the effect of aromatherapy on odors on the transition from gavage to oral feeding in preterm infants. Results: 8 studies were assessed with the effects of aroma inhalation on the transition from gavage to oral feeding. Meta-analysis of these studies showed that preterm infants transitioned from tube feeding (gavage) to oral feeding earlier in the groups stimulated by pleasant odors (standardized mean difference [SMD]=₋0. 47, 95% CI, ₋0. 64%, ₋0. 3%, heterogeneity, P=0. 32,I2=13%, 8 trials) and odor of breast milk (SMD=₋0. 61, 95% CI, ₋0. 64%, ₋0. 31%, heterogeneity, P=0. 85, I2=0%, 6 trials) in comparison to the control group. Conclusions: Our meta-analysis supports using breast milk and other pleasant odors as a safe and noninvasive way of reducing the transition time from gavage to oral feeding in preterm infants. Health providers should use effective and family-friendly interventions to care for their premature infants.

Background and Objectives: Failure to thrive (FTT) is a common developmental disorder in infants. Although the improvement effect of zinc supplementation in these patients was reported in some past studies, the results were conflicting. Accordingly, this study investigates the effect of zinc supplementation on factors related to growth in infants with FTT by conducting a meta-analysis. Methods: Medline, Web of Science, and Scopus databases were comprehensively searched to find randomized controlled trials investigating the effect of zinc on growth-related factors in infants with FTT. Eligible studies were extracted after screening their relevant information. The pooled effect size was estimated as a weighted mean difference with a 95% confidence interval (CI) using the random effect model method. Results: Out of 85 reviewed papers, 4 studies were eligible to enter this review. The present meta-analysis revealed that zinc supplementation in infants with FTT led to a significant increase in weight (weighted mean difference (MD)=-0. 25 kg,95% CI, 0. 02%-0. 49%), weight-for-age Z-score (weighted MD=0. 16,95% CI, 0. 03%, 0. 28%), and height-for-age Z-score (weighted MD=0. 15, 95% CI, 0. 001%, 0. 30%), compared to control groups. In contrast, zinc supplementation had no significant effect on height and insulin-like growth factor 1 serum level. Conclusions: The findings of the current meta-analysis indicated the effectiveness of zinc supplementation in improving the developmental status of infants with FTT,however, due to the small number of included trials, it was impossible to draw definitive conclusions, and conducting randomized controlled trials with larger sample size and higher sensitivity is needed.

Background and Objectives: The global COVID-19 pandemic has significantly impeded children’s vaccination programs, endangering the public’s health. Concerns have risen about the impact on vaccination coverage rates and the need for effective strategies to overcome such obstacles. Accordingly, this study investigates the effects of COVID-19 on the worldwide trend of childhood immunization. Methods: The Web of Science database was comprehensively searched from January 2020 to July 2023. The English keywords were TS=([“SARS-CoV-2” OR “COVID-19” OR “coronavirus”) AND (“pediatric immunization” OR “childhood vaccination” OR “vaccine coverage”]). The two authors of this research independently assessed each study that satisfied the inclusion criteria. The preferred reporting items for systematic reviews and meta-analyses checklist guided the systematic review process, and VOSviewer software was used for bibliometric analysis. Results: The initial search yielded 624 articles, leaving 62 articles for analysis. The most frequent keyword searches were COVID-19 (n=37, total link strength=78). The US was the most productive country in terms of articles (n=19, citations=411). Furthermore, visualization mapping showed that “the journal of vaccine” was the top source with a total link strength of 1560 and citations of 139. The disruptions were multifaceted and resulted from various factors, such as changes in vaccination coverage rates, vaccine hesitancy, missed or delayed vaccinations, catch-up immunization efforts, and disruptions to routine immunization programs. Declines in vaccination coverage were observed for various vaccines, including measles, polio, and diphtheria-tetanus-pertussis. Conclusions: The results showed the critical need for action to minimize the COVID-19 pandemic’s negative effects on childhood immunization. Policymakers and healthcare providers should prioritize restoring and strengthening immunization services, addressing vaccine hesitancy, and implementing catch-up vaccination programs.

Background and Objectives: During the COVID-19 pandemic, school closures, and home quarantine measures resulted in a myriad of mental health challenges for teenagers, notably heightened levels of stress and anxiety, with far-reaching implications. Against this backdrop, the current study identifies the factors associated with anxiety and fear among adolescent girls during both the COVID-19 pandemic and the subsequent post-pandemic period. Methods: This study conducted a comprehensive review using related keywords, such as anxiety, fear, phobia, adolescent, teenager, teen, coronavirus, corona, and COVID-19. Specifically, articles with Iranian affiliations were investigated in PubMed, Science Direct, Google Scholar, and SID databases from July 19 to August 26, 2023. Results: A comprehensive analysis of 16 studies revealed significant associations between various factors and the level of COVID-19 anxiety among teenagers. Specifically, factors such as effective communication skills, robust social support networks, mindfulness practices, resilience, and optimistic attitudes mitigated COVID-19 anxiety levels. Conversely, factors such as insomnia, excessive exposure to news updates, and prolonged periods of quarantine were associated with heightened COVID-19 anxiety levels among teenagers. Conclusions: Adolescents have exhibited psychological vulnerability amidst the COVID-19 pandemic, particularly manifesting symptoms of anxiety and fear. The reviewed studies primarily focused on elucidating the associations between various factors and anxiety levels. Hence, future research endeavors are encouraged to delve into investigating efficacious methodologies fortifying these associations and bolstering beneficial factors. This approach is vital for averting the deleterious consequences of anxiety in the post-COVID-19 era.

Background and Objectives: Septic arthritis is an uncommon condition in neonates. It is a serious disorder, especially because of the possibility of sequelae, if not identified and treated early. In addition, due to the rarity of this condition in neonates and the paucity of signs and symptoms, the diagnosis of septic arthritis is more difficult in older children. The published literature is limited to case series, which is why the purpose of this systematic review is to provide a comprehensive summary of neonatal septic arthritis based on the existing literature. This study identifies the changing trends over time, specifically focusing on intravenous cannulation as a major risk factor that led to the undertaking of the study. Methods: The preferred reporting items for systematic reviews and meta-analyses protocol guidelines were used in this study. Three search engines were used for 239 articles. A total of 26 studies were screened in full text, of which 16 articles underwent quantitative analysis. Due to limited data and heterogeneous reporting, the data were summarized descriptively. Results: The total number of babies and joints studied was 307 and 313, respectively, of which the proportion of male babies was mentioned in 12 case series, accounting for 136(228) (60% [42%-71%]) subjects. The most common presenting symptoms were swelling at the involved joint, erythema, and decreased range of motion in variable order. The most common site of involvement was the hip joint (42%), followed by the knee joint (27%). Staphylococcus aureus (40%) was the most commonly cultured pathogen, followed by Klebsiella (18%). Antibiotics were reported in only 12% (38 babies) of the cases. Open surgery was performed on 16% of the 49 babies. The rest of the babies responded to joint aspiration and irrigation, with or without immobilization. Prompt laboratory and radiographic evaluations could help reduce delays in diagnosis and improve outcomes. Blood and tissue cultures were positive in most of the cases. Previous culture reports for the same unit guide the addition of empirical antibiotics. Conclusions: In our case series, the majority of the babies were premature. The most common joint involved is the hip joint. The most common underlying cause is sepsis and catheterization. Intravenous canulation is also a major risk factor because of the continuity of metaphysis and epiphysial vessels. The most common presenting symptom is local signs. Unexplained fever and irritability make it better to look for a local examination of joints. Follow-up is mandatory as a long-term sequel is more.

Background: Spinal muscular atrophy (SMA) is a neuromuscular disorder that is highly frequent in children. This leads to serious health challenges for children of different severity levels. Orem’s self-care deficit nursing theory helps parents get involved in their child’s care, leading to better outcomes and healthcare experiences. Accordingly, this case study examines the effectiveness of applying Orem’s self-care nursing theory to a child with SMA and his parents. Case Presentation: This study used Orem’s self-care deficit nursing theory to treat particular self-care deficiencies relating to mobility, eating, swallowing, and respiratory function in a 3-year-old child with SMA type I. The researcher recognized the patient’s lack of self-care and created a tailored plan for self-management training. The initial steps were to understand the patient’s needs, organize the implementation, and create the educational system. The final phase entailed implementing the self-care program and assessing its success. The following methods were used to gather the data: Structured interviews and surveys on Orem’s theory and self-care ability. A 60-min educational intervention was broken up into four in-person sessions. This study illustrates the useful application of theories in illness management. This theory was used to identify deficiencies in movement, feeding, swallowing, and respiratory function. Nursing interventions focused on neuromuscular deficits, while educational interventions enhanced parents’ awareness. Conclusions: This case study investigates the usefulness of Orem’s theory in controlling SMA, empowering parents, emphasizing patient-centered care, and the possible advantages of nursing theories in treating chronic diseases.

Context: Childhood pre-obesity and obesity rates have been rapidly growing worldwide over the past decades. Copper homeostasis is gaining increasing attention in the physiopathology of obesity. Strong evidence indicates that a disturbance of copper homeostasis plays an important role in the development of obesity and its related comorbidities. Under physiological conditions, copper plays a significant role in regulatory, immunologic, and antioxidant functions resulting in protection against inflammation and oxidative stress, and consequently against the known comorbidities of obesity. Nevertheless, despite the growing body of research, information about copper status in obesity, particularly in childhood obesity, is scarce. Evidence Acquisition: This brief narrative review examines the latest data published in the last five years using various databases, such as PubMed, Scopus, Unpaywall (COBISS), and EBSCO to emphasize the major current findings in research related to this topic. Results: The most recent studies have yielded strong evidence in support of altered copper status in childhood obesity,nevertheless. Conclusions: Further studies are needed to clarify the role of copper in the physiopathology of childhood obesity.

Background and Objectives: Postpartum depression (PPD) is a subtype of major depressive disorder, which is correlated with having an infant with cleft lip and palate (CL/P). Since there is a dearth of research in this regard, this study compares mothers of infants with CL/P and mothers of normal infants in terms of PPD and suicidal thoughts. Methods: This descriptive-analytical study was conducted on 50 mothers of children with CL/P and 50 mothers of normal children who had recently given birth and presented to the Research Center of Cranial Deformities, Isfahan University of Medical Sciences, Isfahan City, Iran, from September 2020 and 2021. The Edinburgh postnatal depression scale was used to assess PPD. Results: The mean PPD score was 15. 42±4. 77 (range=5-24) and 10. 3±6. 7 (range=0-29) in mothers of children with CLP and those with normal children, respectively. The frequency of PPD was significantly higher among the mothers of CLP children, compared to mothers of normal children (χ2=25. 25, P<0. 005). No difference was reported between the mothers with PPD and those without it in terms of educational level (χ2=0. 36, P=0. 83), occupational status (χ2=0. 13, P=0. 71), or parity (P=0. 93). Having suicidal thoughts had no significant correlation with having CL/P children (P=0. 11). Conclusions: The PPD score and frequency of PPD were higher among mothers of children with CLP, compared with mothers of normal children,however, the frequency of suicidal thoughts was not significantly different between the two groups. Educational level, occupational status, and parity were not correlated with PPD or suicidal thoughts.

Background: The prevalence of short stature was reported high in thalassemia major patients. It causes mental and social problems for them. As different cut-off points for growth retardation are suggested in these patients, it is desirable to find a careful cut-off age using statistical analysis to help patients before it is too late. Methods: Data from 803 thalassemia major patients was extracted from questionnaires completed in person by the operator. They contained demographic data, family, medical, and drug history. Height and weight measurements were conducted by only one device. The mean age was 20±7 years and there were 420 females in the sample. Children (<20 years of age) constituted 47% of the participants. Patients who reported a major risk factor for osteoporosis were omitted from this study. The SPSS software, version 16 was used for the statistical analysis Results: Short stature was found in 32% of patients. Being 10 to 11 years old or above increased the risk of short stature, 28. 5 and 21. 4 times, respectively compared to younger patients (P<0. 001). On the other hand, after 7 years of age up to 18 years of age, similar to 10 years of age and 11 years of age, increases the risk of short stature. Also being 27 years old and 30 years old and above increases the risk of short stature 1. 4 and 1. 7 times, respectively, compared to younger patients (P=0. 042 and <0. 018, respectively). Conclusions: Awareness of short stature and monitoring it in thalassemic patients should be done in their childhood. Accordingly, being 7 years old or above increases the risk of short stature,therefore, we suggest the start of monitoring as early as 5 years of age.