Journal of Pediatrics Review
Year:2019 | Volume:70 | Issue:4 (16)|Papers Count:7

Context: Orofacial clefts are one of the most common congenital birth malformations in the oral and maxillofacial area. Lip reconstruction or cheiloplasty is an important issue for these patients, and is performed around three months of age. Presurgical nasoalveolar molding have become part of the treatment protocol in many cleft centers to improve the treatment outcome and commonly employed to reduce the alveolar segments into proper alignment and to improve nasal symmetry in patients with cleft lip and palate The aim of this article is to review the value of this technique as part of the treatment protocol for infants born with cleft lip and palate. Evidence Acquisition: In this review, the electronic databases ISI, PubMed, and Google Scholar were searched. Articles published from 2000 to 2018 were retrieved and underwent abstract and full-text appraisal. The following search terms were used: “ nasoalveolar molding” , “ cleft lip and palate” , “ presurgical orthopedics” , and “ nasal stent” . Results: Presurgical nasoalveolar molding can reduce the severity of the initial cleft deformity, wherein the bony segments are slowly moved to a more favorable position, lessening the amount of surgical correction that is needed to bring the lip segments together while simplifying the surgical approach for the nose. Conclusions: The primary surgical repair of the lip and nose heals under minimal tension, thereby reducing scar formation and improving the esthetic result. Frequent surgical intervention to achieve the desired esthetic results can be avoided by presurgical nasoalveolar molding.

Introduction: The real risk of sudden cardiac death (SCD) in asymptomatic Wolff-Parkinson-White syndrome (AWPWS) is still not well known, and controversial literature is found about the best management strategy. Most worrisome is that SCD has been reported as the first event in asymptomatic or undiagnosed AWPWS infants. So adequate risk stratification to prevent the occurrence of life-threatening arrhythmias is warranted in these patients, but none of the available tests for this is a good option. Case report: We report 2 cases of AWPW infants that experienced SCD as the first clinical manifestation. Conclussion: AWPWS in infants is a non-rare and challenging condition that implies a very low but real risk of SCD, which is very difficult to determine accurately with diagnostic methods currently available. In this article we review the literature about the subject andand discuss about the adequate management of these patients.

Introduction: Netherton Syndrome (NS) is a rare hereditary autosomal recessive disorder with ichthyosiform cutaneous lesions, specific hair shaft defect and atopic diathesis. The incidence of Netherton syndrome is estimated to be approximately 1 in 200, 000. The objective of this case report is to illustrate the Netherton Syndrome in a patient with severe eczema atopic dermatitislike eruption. Case presentation: A 41-month old boy referred to the clinic of Allergy and Immunology, Hazrat Rasoul Hospital with generalized erythema and scaling cutaneous lesions. The patient underwent clinical examinations and laboratory analysis. Laboratory data revealed only an elevated IgE level, leukocyte count was 7800/μ l with 10% eosinophil, and his hair shaft indicated classic trichorrhexis invaginata (Bamboo hair). Based on the clinical and laboratory findings, N. S was diagnosed. A brief review was also done related to this case. Conclusion: The case was reported because of the severity of the disorder and other differential diagnoses in severe and refractory atopic dermatitis-like eruptions. The importance of the case is related to other differential diagnoses, especially with early onset disorders at neonatal age.

Objective: To determine the epidemiology of anaphylaxis to a bee's sting in the rural areas of Gorgan city. Methods: In this cross sectional study, we analyzed some of the epidemiological characteristics of the study participants such as demographic information, bee type, cause of anaphylaxis, time of bee sting, onset of symptoms of anaphylaxis after a bee sting, number of bee stings, symptoms during anaphylaxis, and therapeutic and prophylactic measures. Results: 201 patients were diagnosed with anaphylaxis caused by a bee sting. Of these, 129 (64%) were male and 72 (36%) were female with an average age of 34. 33 (32) and 35. 25 (34) years respectively. Anaphylaxis incidents occur in 108 men and 103 women out of 100, 000, 169 of which are adults and 46 are children. Anaphylaxis occurred in 105 cases (52. 2%) less than five minutes after being stung (very severe attack) and in 94 cases (46. 8%) between 5-60 minutes after being stung (rapid attack) (p = 0. 45). The patients' organs involved were skin (85. 6%), respiratory system (78. 6%), cardiovascular system (35. 8%), nervous system (17. 4%) and gastrointestinal tract (10. 9%). Among these stings, 78 (38. 8%), 107 (53. 2%) and 16 (8%) took place indoors, outdoors and at home respectively (P=0. 05). Seven (9. 5%) children and sixty seven (39. 6%) adults had hypotensive symptoms (P= 0. 05). Ninty five percent of cases have been stung less than 10 times, and 80% of those who have experienced more than 10 stings had severe anaphylactic attacks (P = 0. 003). Conclusion: Based on our study, case finding was successful through the rural health network. In order to obtain accurate epidemiological information on the prevalence of anaphylaxis due to bee stings, an anaphylaxis registry and healthcare service packages are recommended. In this integrated model, a service package, including raising awareness and knowledge of people, and treatment for anaphylaxis can be employed.

Context: Congenital hypothyroidism (CH) is the most common endocrine disorder and causes of preventable mental retardation in children. Objectives: We aimed to systematically review the reported congenital hypothyroidism (CH) related risk factors. Data Sources: In this systematic review, all types of human studies studying the risk factors related to the occurrence or high rate of CH were included. An electronic search was conducted in international national electronic databases. The following keywords were used; ( “ Congenital Hypothyroidism” [Mesh] AND “ risk factor” [Mesh]). Study Selection: In this review, 373 papers (PubMed: 199; Scopus: 36; ISI: 53, SID: 55, Ovid: 11; Science Direct: 19) were identified through electronic database search. 98 articles assessed for eligibility, from which 60 qualified articles were selected for final evaluation. Most of the studies have cross sectional, case control and prospective design, respectively. Data Extraction: The current review was conducted and reported in accordance with the Preferred Reporting Items for systematic reviews and meta-analyses (PRISMA) statement. Results: Reported risk factors for transient CH were as follows; iodine deficiency and excess, prematurity, advances maternal age, male gender, retinopathy of prematurity, twin pregnancy, maternal autoimmune thyroid disease, intrauterine growth retardation and cesarean delivery. Reported risk factors for permanent CH with dysgenesis of thyroid gland were as follows; female gender, familial history of CH, birth in geographical areas with high rate of the disease, advanced maternal age, ethnicity (Caucasians) but not seasonality. Reported risk factors for permanent CH with dyshormonogenesis were familial history of CH and origin of both parents from the high risk geographical region. Conclusions: Using the data we could plan more etiologic studies to investigate the pathogenesis of the disorder, design interventional studies for the known modifiable risk factors to reduce the rate of CH in our region. In addition for risk factors with limited evidences more studies should be performed.

Context: Asthma is chronic inflammatory disorder of the respiratory system in childhood. IgE has an important role in allergic disorders such as asthma. The aim of this study is to review the association between maternal serum IgE and incidence of childhood asthma. Evidence Acquisition: Three researchers searched all articles in PubMed, Scopus, Google and Embase databases related to maternal serum IgE, cord blood IgE, childhood asthma and incidence using key words such as maternal IgE, cord blood IgE, relation, association, childhood asthma, child allergy. Results: We found a few related articles on the topic of maternal IgE, cord blood IgE, and childhood asthma. We reviewed 11 articles for this study. Parental atopy and allergy are more important predictive factors for children’ s allergies such as asthma. IgE levels was higher in children whose mothers had higher IgE levels. Total IgE level was significantly higher in boys compared to girls. Conclusions: Increasing maternal and cord blood IgE may be a predictive factor for development of children asthma. More data is needed to clearify this relation.

Context: Musculoskeletal pain is one of the most important pains among students and adolescents. Objectives: the aim of the present study is to determine the prevalence of musculoskeletal pain among Iranian Children and adolescents through systematic review and meta-analysis. Data Sources, Study Selection, and Data Extraction: all articles on prevalence measurement of musculoskeletal disorders in Iranian adolescents were searched in the Google Scholar search engine, four Iranian databases and five international English-language databases using the keywords of Pain, Musculoskeletal disorders, Low back pain, Adolescents, Students, and a combination of these keywords. Data was analyzed by comprehensive meta-analysis (CMA) software. Results: The findings showed that out of 9 studies included in this systematic review and meta-analysis, 6 article about LBP, 6 article about neck pain, and 3 article about shoulder pain, respectively. According to the findings, 25. 4 %( 95% CI: 19. 0 to 33. 0) of the children experienced pain, the prevalence of LBP, knee pain, and the shoulder pain was 26. 2(95% CI: 14. 3 to 43. 0), 22% (95% CI: 14. 5 to 32. 0), and 29. 3% (95% CI: 20. 1 to 40. 7) in Iranian adolescents, respectively. Conclusion: Considering the high prevalence of pain among Iranian adolescents, it is necessary to carry out appropriate interventions for pain prevention in this age group.