Journal of Pediatrics Review
Year:2019 | Volume:7 | Issue:2 (14)|Papers Count:7

Context: Preterm and low-birth weight are of the most common causes of mortality and criticaldisabilities in newborns. Although advances in neonatal care improved survival and quality oflife in the developed countries, mortality and morbidity due to prematurity are still high in thedeveloping and underdeveloped countries such countries in Eastern Mediterranean Region (EMR). Objective: The study aimed at evaluating mortality and morbidity among Very Low Birth Weight(VLBW) and Very Preterm (VP) neonates in EMR. Data Sources: A systematic search was conducted in CINAHL, Cochrane Library, Current Contents, Database of Abstracts of Reviews of Effects (DARE), Google Scholar, PubMed, PsycINFO, ThomsonReuters, Scientific Information Database (SID), and Medical Library (MedLib) as well as regionalWHO database to detect relevant studies published from 1996 to 2016. Study Selection: English Language Literature From EMR countries, which reporting outcomes ofVLBW and VP were considered. Finally, 32 full text articles were included. Data Extraction: Data on VLBW and VP outcomes including mortality, and short-and long-termmorbidities were extracted. Results: Meta-analysis results of prevalence of mortality among VLBW newborns was obtainedas 32. 0%, which was different from Asian and African countries (23% vs. 55%). Pooled odds ratioof mortality among VLBW newborns was estimated as 2. 41. The most prevalent comorbidity inVLBW and VP newborns were allocated to septicemia and Neurodevelopmental Delay (NDD), andthe rarest belonged to Periventricular Leukomalacia (PVL) and Necrotizing Enterocolitis (NEC). Themain limitation of the current study was lack of relevant studies and adequate sample size. Conclusions: It seems that indicators in EMR should be evaluated independently in Asianand African countries. Septicemia, as relatively curable cause of morbidity, is the mostprevalent comorbidity among VLBW infants.

Context: Premature rupture of membrane is a serious complication in pregnancy and responsible forone third of preterm labors associated with the neonatal and delivery outcomes. Objective: The current study aimed at investigating the risk factors of premature rupture ofmembrane on delivery and neonatal implications. Data Sources: The articles on the databases, including PubMed, Cochrane Library, ISI and GoogleScholar up to 2017 were searched to conduct the current study. The keywords used were “ prematurerupture of membrane” , “ neonatal, ” “ risk factors” , “ maternal” , and “ delivery” . Study Selection: The inclusion criteria were articles on the relationship between maternal riskfactors and Premature Rupture of Membrane (PROM), neonatal outcomes of PROM, the deliveryoutcomes of PROM, the study of mothers and infants, English and Persian language articles, andsufficient information on the PROM. The articles investigating amniotomy or the ones that only theirabstracts were available were excluded from the study. Data Extraction: The data extracted from the above mentioned databases were fed with the followingtitles in the Excel software: Authors’ names and surnames, year of study, type of study, place of study, case group, control group, maternal risk factors, delivery outcomes, neonatal outcomes of PROM, and the results of the study. Results: Out of 90 articles, 15 articles were finalized including one prospective study, five crosssectionalpapers, six retrospective articles, and three historical cohort studies. Maternal risk factorsincluded age; parity; education; occupation; diabetes; blood pressure; cervical length along withabortion history; history of infection, upper urinary tract infection, and sexually transmitted diseases. Moreover, delivery complications were cesarean section, oligohydramnios, chorioamnionitis, andplacental abruption. Neonatal complications included prematurity, respiratory distress syndrome, asphyxia, infection, meningitis, sepsis, pneumonia, perinatal mortality, patent arterial duct, necrotizing enterocolitis, IVH, pulmonary hypoplasia, hyperbilirubinemia, and antibiotic intake. Conclusions: Based on the results of the current study, the most important risk factors for PROM were diabetes and maternal hypertension associated with neonatal and maternal complications. Infection was the most important maternal and neonatal complication.

Context: Supraglottic Airway Devices (SADs) are applied in airway management of pediatricemergency conditions. Objective: This review study aimed to examine the literature regarding pediatric supraglotticairway devices, to introduce the optimal devices in terms of Oropharyngeal Leak Pressure(OLP), risk of insertion failure on the first attempt and risk for blood staining of the device. Data Sources: An electronic search was conducted on MEDLINE, EMBASE, CINAHL andPubMed databases. We also searched the Cochrane database (CENTRAL) and Web ofScience up to July 1, 2017. Study Selection: Of 112 potential studies, the full texts of 53 articles were available, in which15 were duplicated and omitted, accordingly. Papers which did not directly discuss SADs werealso excluded. In total, 30 papers were identified related to the children supraglottic devices. Data Extraction: The current review was conducted and reported in accordance with thePreferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Results: The LMA ProSeal may be the best supraglottic airway device for children due to its highoropharyngeal leakage pressure and low risk of insertion failure. It seems that i-gel is a veryfunctional tool as well. Conclusions: Further research is recommended to investigate the most appropriate supraglotticairway in diverse clinical situations and various conditions among children.

Context: The current review article considered the latest published papers on reducing unnecessary head Computed Tomography (CT) scans in pediatric patients, to pave the way for further surveys. Evidence Acquisition: The papers were selected through Google Scholar and PubMed. We searched “ reducing unnecessary head CT scan in pediatric patients” with related keywords compatible with MeSH system in accordance with the search strategy. Original articles and systematic reviews published after 2010 were included. Other types of manuscripts such as a letter to editor, editorial reviews, case series, etc. were excluded. The title and abstract of the eligible articles were assessed in terms of relevance to our topic. The full text of final selected papers were studied by the investigators. Furthermore, a critical appraisal was performed in an expert panel to summarize it and make it applicable. Results: The extracted manuscripts have addressed this issue by various strategies. The findings could be categorized as follows: observation period, focused history taking, protocol and guideline development, implementation of validated clinical prediction rules, and blood-based decision making by assessing neuro-biomarker levels. Conclusions: Most of the reviewed articles were focused on clinical findings to discover the minimum or low risk category of the pediatric patients with blunt head trauma. Other articles attempted on facilitating the use of available clinical prediction rules in this regard. Also, the measurement of serum biomarker levels has been considered; however, their widely application in practice is not well supported by evidence yet.

Context: Scabies is a common infestation in children. Treatment of scabies in infants and children is a therapeutic challenge. Many prescribed drugs for adults cannot be used in children because of their side effects and safety profile. This review article studied the treatment of scabies in children and infants. Evidence Acquisition: In this review, electronic databases, including Google Scholar, PubMed, Cochrane and Scopus were searched based on the following MeSH terms: Scabies, Pediatric and Children. We included all articles related to scabies in children published from 2008 to 2018. Duplicated and irrelevant studies and abstracts were excluded. Results: The management of scabies is focused on identification and treatment of cases and household contacts. We briefly discussed the clinical presentation of scabies with the currently used topical and oral treatments for this infestation. Topical treatments are effective and the most effective treatment is permethrin. Other treatment options may be less effective, poorly tolerated, or with adverse effects. Conclusions: Scabies is prevalent in children and causes considerable morbidity. Because of its complications, scabies should be managed properly in accordance with the guidelines.

Introduction: Primordial dwarfism is a rare class of genetic disorders, characterized by intrauterine growth retardation, short stature at birth and growth deficiency that persist throughout life. This disorder is caused by various mechanisms such as chromosomal abnormalities, molecular changes and mutation of genes that result in developmental defects, facial dysmorphism and skeletal abnormalities in fetus. Primordial dwarfism includes 5 specific subtypes that their descriptions vary from one type to another. This study aimed to report 7 cases of primordial dwarfism as the first case series study and literature review of this disorder in Iran. Case Presentations: This study presented primordial dwarfism patients and summarized clinical findings of 7 cases who referred to Pediatric endocrine wards in Imam Reza Hospital, from June 2016 to September 2017. The cases suffered from severe growth retardation and clinical features of this disorder that were not explained by other disorders. We also conducted a literature review about primordial dwarfism on Google Scholar, Medline, and PubMed to compare our results with other reports. Seven patients (5 females and 2 males) aged between 18 months and 12 years were identified, during the study. The most prevalent referring symptoms were growth retardation, presenting in all cases. Other clinical signs and symptoms included intrauterine growth retardation, low birth weight, specific clinical features such as microcephaly, narrow face, high pitch voice, prominent nose, etc. Biochemical and imaging studies were performed to rule out other diseases that can cause growth retardation. The diagnosis of primordial dwarfism was made based o clinical presentation. Conclusions: This review will provide an overview of the clinical aspects and different subtypes of primordial dwarfism disorder and draw the attention of clinicians for diagnose and further evaluations of this disorder.

Background: Anterior crossbite is a frequent malocclusion in patients with Unilateral Cleft Lip and Palate (UCLP). Several studies have investigated the effects of orthognathic surgery or orthopedic treatment on correction of this malocclusion. Only few studies evaluated the effect of conventional orthodontic treatment on growing patients Objective: The present study investigated significant changes of facial profile as well as the underlying hard tissue following conventional orthodontic treatment in growing subjects with UCLP. Methods: Lateral cephalograms of 32 non-syndromic children with UCLP (15 boys, 17 girls) with the Mean± SD age of 10. 91± 2. 00 years were retrospectively collected. All patients had complete orthodontic records before and after treatments, indicating the acceptable treatment results, in respect of the degree of overbite, overjet, maximum intercuspation occlusion and facial profile. Cephalometric measurements represented dentoskeletal and soft tissue profile before and after treatments were evaluated, and significant changes were assessed by paired t test. Onesample t test was used to analyze significant differences between these measurements and the clinical norm. Results: The initial characteristics of the UCLP patients were skeletal class III maxillary retrusion with relative mandibular prognathism, retroclination of the incisors, negative overjet, and increased overbite and concave facial profile. After conventional orthodontic treatment, maxillary arch expansion and class III elastic traction, the acceptable overbite and overjet were achieved by proclination of the upper incisors. Significant changes of the soft tissue profile due to facial growth and treatment included increase in facial convexity, nose length, nose depth, columellar length, soft tissue face height ratio, upper and lower lip lengths and upper lip protrusion. The soft tissue profile was acceptable after the treatment, compared to the clinical norm. Conclusions: The early correction of the anterior crossbite with maxillary arch expansion and class III traction could improve the soft tissue facial profile of patients with UCLP.