Journal of Pediatrics Review
Year:2019 | Volume:7 | Issue:3 (15)|Papers Count:7

Context: The use of ciprofloxacin is contraindicated in children due to safety concerns. Animal studies have revealed that ciprofloxacin can be associated with arthropathy (joint toxicity) in juvenile animals; however, this potential side effect has not been proven in children. Many clinicians still prescribe ciprofloxacin when there is no suitable alternative. In many developing countries, access to the newer generation of antibiotics is either limited or expensive. Therefore, ciprofloxacin is an available and cost-effective alternative that can save lives when necessary. Objective: This study aimed to systemically review the published studies about the safety profile of using ciprofloxacin in children. Data Sources: All relevant studies published from 1990 to 2018 in the Cochrane library, Trip database, ScienceDirect, PubMed, and Google Scholar were collected. Study Selection: We have only considered clinical trials, which included the following keywords: “ ciprofloxacin” , “ children under 18 years” , and “ arthropathy” . Data Extraction: The collected data were analyzed by Comprehensive Meta-Analysis software (CMA. 2). We used random or fixed-effect methods based on the heterogeneity of the results. The heterogeneity was checked by I2 index and tau-squared. The publication bias was evaluated by the Begg’ s test. Results: The obtained data indicated no increased risk of arthropathy after ciprofloxacin use in children on a short-term basis, in comparison to placebo or other antibiotics. Conclusions: Ciprofloxacin is potentially a safe alternative to be used in children under 18 years old when there is no better alternative.

Context: Dental enamel is the hardest and highly mineralized structure in human body. However, Developmental Enamel Defects (DEDs) may occur due to an interplay between multiple factors ranging from genetic inadequacy to environmental insults. Primary enamel defects provoke the local or systemic insults that the child might undergo pre-, peri-and post-natally. Several gene mutations and environmental factors, including systemic illnesses have already been identified that can permanently imprint enamel damage. The DED may appear as enamel hypoplasia or hypomineralization. Clinically, DED often presents problems of aesthetics and stained defects, tooth sensitivity, susceptibility to dental caries, erosion and tooth wear. Evidence Acquisition: An electronic search was conducted on PubMed, Cochrane, ScienceDirect and Clinical Key databases with the focus on articles published since 2000. The following keywords were applied: “ Developmental Enamel Defect (DED)” , “ Enamel hypoplasia” , and “ Primary teeth” . Results: Managing the enamel defects involves early diagnosis and aesthetic rehabilitation of defective enamel, while maintaining its form and function. This should involve close cooperation between the paediatricians and the paediatric dentists, so that preventive regimens can be institutionalised at the earliest. Conclusions: Despite our understanding of DED, further research is required to establish accurate clinical diagnosis and successful treatment of such enamel defects.

Context: Smoking in adolescence is a worldwide health problem. Understanding the prevalence of smoking and its clinical correlates in adolescent inpatients is useful for mental health staff to plan effective programs to reduce its detrimental consequences. In this study, we investigated the prevalence and correlates of cigarette smoking and its sociodemographic and clinical correlates. We performed a narrative review of cigarette smoking prevalence among adolescents as well as a descriptive study in inpatient adolescents in Iran. Evidence Acquisition: This was a multicentric, cross-sectional, and hospital-based survey. In total, 82 patients (male/female: 66. 9% vs. 33. 1%) were consecutively recruited from 5 child and adolescent inpatient psychiatric wards of Iran. The study data were collected from patients, their family members and patients’ medical records. The descriptive statistics, Pearson’ s chi-squared test, and univariate logistic regression analyses were employed to analyze the obtained data. Additionally, we added a narrative review to understand the prevalence rate of smoking and its clinical correlates in adolescent inpatients. Results: The prevalence rate of smoking was 30% in our study sample (24. 5% in boys and 39. 5 % in girls). There was a significant association between smoking with family size, history of suicide attempt, physical illness, drug misuse in patients, and alcohol or drug misuse in family members. The prevalence of mood disorders in the nonsmokers and smokers were 37. 5% and 62. 5%, respectively. Overall, 26. 6% of the subjects had a history of suicide attempt of whom, 52. 9% were smokers. Conclusions: Results of this study about the association between smoking with family size, history of suicide attempt, physical illness, drug misuse, and other related factors, call for both careful screening of smoking and specially designed integrated psychiatric/smoking treatments in these patients.

Context: Tetralogy of Fallot (TOF) is one of the most important congenital heart diseases that its prognosis can be improved by surgery. However, Right Ventricular (RV) function may be disrupted because of pulmonary regurgitation and other preoperative and intraoperative factors. Access to a simple and reproducible diagnostic index of RV function is important. Echocardiographic index of Right Ventricular Myocardial Performance (RVMPI) has been used as a simple and noninvasive method for the assessment of RV function. Evidence Acquisition: This article review was conducted utilizing PubMed, Web of Science, Scopus and Google Scholar databases with the keywords of “ Right Ventricle (RV)” , “ Myocardial Performance Index (MPI)” , and “ Tetralogy of Fallot (TOF) repair or correction” . Results: RVMPI as a non-geometric echocardiographic index was compared with other echocardiographic indices, QRS duration in ECG, Cardiac Magnetic Resonance (CMR) findings, and exercise capacity in the pediatric and adult studies. Conclusions: This narrative review suggested that RVMPI, especially the tissue Doppler-derived has been used as a useful index of RV function in the follow-up of the repaired TOF patients. However, more research, including systematic reviews are necessary to determine the potential implication of RVMPI in the assessment of RV dysfunction.

Introduction: Anesthetic medications are frequently used in medical procedures to prevent pain and undesired sensations. Local anesthetic agents are widely used in the form of ointment, gel, cream, drop or spray in minor surgical or in-house pain relieving procedures in children and adults. Case Presentation: A 16-month-old boy ingested an unknown amount of lidocaine and became lethargic after about 15 minutes. After a while, he experienced a generalized tonic-clonic seizure and loss of consciousness. He needed a short course of intubation and mechanical ventilation. A short literature review was also performed on local anesthetic intoxication. Conclusions: Safe-seeming local anesthetic agents can cause life-threatening complications, especially when used at home without enough medical knowledge or supervision.

Introduction: Common Variable Immunodeficiency (CVID) is one of the primary immunodeficiencies that its patients can develop its symptoms since infancy till senility; however, it usually manifests between the age of 15 and 40 years. It is characterized by low antibody levels and recurrent infections. Individuals with CVID are more prone to autoimmune diseases and malignancy. Case presentation: We presented a 17-year-old girl with a documented CVID, who was treated with intravenous immunoglobulin and prophylactic antibiotics. She suffered from CVID from the age of 13 to the study time. She was hospitalized due to illness, fever, and severe dyspnea. Her chest X-ray revealed cardiomegaly; thus, high-resolution thorax CT scan and echocardiography were performed which revealed pericardial effusion. No underlying autoimmune diseases were detected in our assessments. Significant clinical, radiographic and physiological improvements were achieved after conducting an appropriate therapy. The patient was followed for two years and showed no clinical and laboratory findings in respect to autoimmune diseases. In our case, the pericardial effusion was present without any evidence of autoimmunity. Conclusions: Cardiac manifestation and complications are rare in CVID patients in the absence of an autoimmune disease; however, they should be considered.

Background: Metabolic Syndrome (MetS) predisposes the human body to a variety of chronic diseases. Objectives: This study, for the first time, aimed to assess the effects of Fermented Camel Milk (FCM), a functional dairy food, on the obesity measures and blood pressure of adolescents with MetS. Methods: This was a crossover, randomized, double-blind trial. We enrolled overweight or obese adolescents, aged 11-18 years, meeting the diagnostic criteria for MetS. We randomly assigned the study participants to receive FCM 250 mL per day for 8 weeks, followed by a 4-week washout, then, consuming Diluted Cow Yogurt (DCY) 250 mL per day for 8 weeks, or the reverse sequence. General and abdominal obesity measures consisting of weight, Body Mass Index (BMI), BMI z-score, Waist Circumference (WC), Hip Circumference (HC), waist to height ratio and Systolic and Diastolic Blood Pressure (SBP, DBP) were measured before and after each of the 4 periods. A three-day food record and physical activity questionnaire were completed before each period. Statistical analyses were performed using Minitab and SPSS considering the significance level of 0. 05. Results: Twenty-four participants with the Mean± SD age of 13. 77± 1. 87 years (age range: 10. 45-16. 25 years) (58% girls) completed the study. It resulted in nonsignificant mean changes (increase or decrease) in weight of-0. 67 kg (95%CI:-1. 97; 0. 61; P=0. 28), BMI (-0. 10 kg/m2, 95%CI:-0. 65; 0. 45; P=0. 70), BMI z-score of-0. 06 (95%CI:-0. 33; 0. 19; P=0. 59), WC of-1. 10 cm (95%CI:-3. 22; 1. 01; P=0. 29), and HC of-0. 12 cm (95%CI:-2. 04; 1. 79; P=0. 89) by FCM consumption in comparison to DCY. The study also resulted in non-significant mean reduction in DBP of-4. 45 mm Hg (95%CI:-10. 04; 1. 12; P=0. 11). Conclusions: According to some positive impacts of FCM on obesity measures and blood pressure, we suggest conducting further studies to validate the clinical impacts of fermented camel milk.