Fat loss in thawed breast milk: Comparison between refrigerator and warm water

Objective

To compare the fat loss between refrigerator and warm water thawed breast milk.

Design

Experimental.

Setting

Tertiary-care pediatric university hospital.

Participants

Ninety samples of expressed breast milk were collected from mothers with singleton babies of a gestational age 32?C42 weeks.

Main Outcome Measures

Fat content in fresh breast milk (FM); thawed breast milk by refrigeration (RM); and thawed breast milk by warm water (WM).

Results

The mean (SD) total fat content in FM, RM and WM were 2.98 (0.97), 2.76 (0.99) and 2.66 (0.88) g/100 mL, respectively. The mean difference (SD) of the total fat in FM declined significantly after the frozen milk was thawed by refrigeration or warm water at ?0.22 (0.50) g/100 mL (P=0.0001) and ?0.32 (0.45) g/100 mL (P<0.0001), respectively. The mean (SD) total fat loss of frozen breast milk thawed by refrigeration was less than thawing in warm water at 0.094 (0.38) g/100 mL (P=0.02).

Conclusion

The fat loss of thawed breast milk by refrigeration was significantly less than placing it in warm water.     

Fat-Soluble Antioxidant Vitamins,Iron Overload and Chronic Malnutrition in β-Thalassemia Major

Objective

To assess the antioxidant vitamins A (retinol) and E (α-tocopherol) levels, iron status and growth retardation in children with β-thalassemia major in Odisha, an eastern state of India.

Methods

Forty three children aged 1–15 y diagnosed with β-thalassemia major (28 males and 15 females) and 42 age-matched healthy controls (22 males and 20 females) were studied. β-thalassemia was detected by using Bio-rad variant assay. Measurement of blood hemoglobin (Hb), hematocrit, serum vitamins (A and E) and ferritin was carried out by standard methods.

Results

Mean hemoglobin (6.60?±?1.84 vs. 11.8?±?2.29 g/dL, p?<?0.01), serum retinol (28.0?±?17.67 vs. 54.4?±?36.56 μg/dL, p?<?0.001) and α-tocopherol (0.2?±?0.34 vs. 1.1?±?0.82 mg/dL, p?<?0.001) were significantly lower in children with thalassemia compared with control group, however, serum ferritin (storage iron) was elevated in thalassemia patients (553.7?±?176.80 vs. 57.3?±?40.73 ng/mL, p?<?0.001). Vitamin E had significantly correlated with hemoglobin and hematocrit values in the patients. Growth retardation in terms of stunting (79 % vs. 24 %, p?<?0.0001) and thinness (32.6 % vs. 9.5 %, p?<?0.05) was significantly higher in thalassemic children compared with normal children.

Conclusions

This study shows that children with β-thalas-semia major are in a state of oxidative stress of hyperfer-ritinemia with deprived antioxidant vitamins (A and E) and poor growth status suggesting a possible need for reduction in iron overload and additional antioxidant supplementation.     

Does Mesenchymal Stem Cell Population in Umbilical Cord Blood Vary at Different Gestational Periods?

Objective

To identify and quantitatively determine Mesenchymal stem cells (MSCs) in the umbilical cord blood (UCB) of neonates born at different gestational periods.

Methods

UCB was collected at birth in neonates of three different gestational groups. The mononuclear cells (MNCs) were phenotypically analyzed by flow cytometer.

Results

The yield of total MNCs did not differ much with gestation; the average values were 22.6?±?6.48?×?106 cells/ml. The MSCs were significantly higher in the lower gestation group. These were 0.0219?±?0.012 %, 0.0044?±?0.003 % and 0.0022?±?0.003 % in 28 to 31 wk, 32 to 35 wk and >36 wk, respectively (P?=?0.00). There was a significant inverse correlation between the gestational age and the presence of MSCs with a correlation co-efficient of ?0.54 (P?=?0.0001).

Conclusions

The MSCs population was significantly higher in infants born at lesser gestation than those born at term gestation.     

Topiramate and Propranolol for Prophylaxis of Migraine

Objective

To compare efficacy and safety of topiramate (TPM) and propranolol for migraine prophylaxis in children.

Methods

In a parallel single-blinded randomized clinical trial, 5–15 y-old referred migraineurs to Pediatric Neurology Clinic of Shahid Sadoughi Medical Sciences University, Yazd, Iran from May through October 2011, were evaluated. Patients were distributed into two groups, 50 of whom were treated with 3 mg/kg/d of topiramate (TPM) and another group of 50, were treated with 1 mg/kg of propranolol for 3 mo. Primary endpoints were efficacy in reduction of monthly frequency, severity, duration and headache related disability. Secondary outcome was clinical side effects.

Results

Fifty two girls and 48 boys with mean age of 10.34?±?2.31 y were evaluated. Monthly frequency, severity and duration of headache decreased with TPM, from 13.88?±?8.4 to 4.13?±?2.26 attacks, from 6.32?±?1.93 to 2.8?±?2.12, and from 2.36?±?1.72 to 0.56?±?0.5 h, respectively. Monthly frequency, severity and duration of headache also decreased with propranolol from 16.2?±?6.74 to 8.8?±?4.55 attacks, from 6.1?±?1.54 to 4.8?±?1.6 and from 2.26?±?1.26 to 1.35?±?1.08 h, respectively. Pediatric Migraine Disability Assessment score reduced from 31.88?±?9.72 to 9.26?±?7.21 with TPM and from 33.08?±?8.98 to 23.64?±?9.88 with propranolol. Transient mild side effects were seen in 18 % of TPM and in 10 % of propranolol (P?=?0.249) groups.

Conclusions

Topiramate is more effective than propranolol for pediatric migraine prophylaxis.     

Evaluation of the impact of organ-specific dose reduction on image quality in pediatric chest computed tomography

Background

Organ-specific dose reduction significantly reduces the radiation exposure of radiosensitive organs.

Objective

The purpose of this study was to assess the impact of a novel organ-specific dose reduction algorithm on image quality of pediatric chest CT.

Materials and methods

We included 28 children (mean age 10.9?±?4.8 years, range 3–18 years) who had contrast-enhanced chest CT on a 128-row scanner. CT was performed at 100 kV using automated tube current modulation and a novel organ-specific dose-reduction algorithm (XCare?; Siemens, Forchheim, Germany). Seven children had a previous chest CT performed on a 64-row scanner at 100 kV without organ-specific dose reduction. Subjective image quality was assessed using a five-point scale (1-not diagnostic; 5-excellent). Contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were assessed in the descending aorta.

Results

Overall mean subjective image quality was 4.1?±?0.6. In the subgroup of the seven children examined both with and without organ-specific dose reduction, subjective image quality was comparable (score 4.4?±?0.5 with organ-specific dose reduction vs. 4.4?±?0.7 without it; P?>?0.05). There was no significant difference in mean signal-to-noise ratio and contrast-to-noise ratio with organ-specific dose reduction (38.3?±?10.1 and 28.5?±?8.7, respectively) and without the reduction (35.5?±?8.5 and 26.5?±?7.8, respectively) (P?>?0.05). Volume computed tomography dose index (CTDI_vol) and size-specific dose estimates did not differ significantly between acquisitions with the organ-specific dose reduction (1.7?±?0.8 mGy) and without the reduction (1.7?±?0.8 mGy) (P?>?0.05).

Conclusion

Organ-specific dose reduction does not have an impact on image quality of pediatric chest CT and can therefore be used in clinical practice to reduce radiation dose of radiosensitive organs such as breast and thyroid gland.     

Usefulness of Pulsed Wave Tissue Doppler Imaging in Assessment of Left Ventricular Functions in Children with Beta-Thalassemia Major

Objective

To evaluate the changes in the LV systolic and diastolic function in children with beta-thalassemia major (β-TM) using pulsed wave tissue doppler (TD) echocardiography.

Methods

Clinical, conventional echo doppler and pulsed wave tissue doppler imaging parameters were compared in 40 beta-thalassemia major patients (mean age, 6.52?±?3.5 y) and 25 age and sex matched normal subjects (mean age, 6.5?±?2.7 y).

Results

There were no significant statistical differences between mean fractional shortening (FS) and ejection fraction (EF) of left ventricle (LV) of the patients and control group. Children with beta-thalassemia had significantly lower E′ wave velocities measured at the left ventricular septal annulus (8.1?±?3.3 vs. 13?±?2.5, P?<?0.001), lateral margin of the mitral annulus (9.1?±?5.4 vs. 13.3?±?2.5, P?<?0.001) and lateral margin of the tricuspid annulus (9.3?±?3.9 vs. 13.3?±?2.5, P?<?0.001) when compared to the control group. Furthermore children with beta-thalassemia had significantly lower E′/A′ wave ratio at the left ventricular septal annulus (0.76?±?0.34 vs. 1.36?±?0.23), lateral margin of the mitral annulus (0.83?±?0.17 vs. 1.28?±?0.22), and lateral margin of the tricuspid annulus ((0.90?±?0.27 vs. 1.26?±?0.23, (P?<?0.05) when compared to the control group.

Conclusions

This study showed that patients with beta-thalassemia major and normal conventional echo doppler parameters had statistically significant changes detected by pulsed wave tissue doppler imaging.     

Clinical and Echocardiographic Outcome in Patients Receiving Carvedilol for Treatment of Dilated Cardiomyopathy

Objective

To determine outcome of children receiving carvedilol in addition to other standard drug therapy for treatment of dilated cardiomyopathy.

Methods

Children receiving carvedilol for treatment of dilated cardiomyopathy with moderate to severe ventricular dysfunction were included into the study. Data on history, clinical examination and investigations were obtained and detailed echocardiography findings were recorded for the initial and all subsequent visits.

Results

Thirty-three children, mean age 26?±?30 mo (range 7 mo to 138 mo) were enrolled. Carvedilol was initiated at a mean dose of 0.14?±?0.03 mg/kg/d and the maintenance dose was 0.46?±?0.14 mg/kg/d. At a follow up of 6–90 mo (mean of 28?±?23 mo), functional class using Ross classification for pediatric heart failure improved from 2.7 to 1.3. The left ventricular ejection fraction rose from a basal value of 22 %?±?7 % (10–40 %) to 42 %?±?15 % (15–65 %) (p?<?0.0001). Similarly, left ventricular fractional shortening increased significantly from 16?±?6 % (8–34 %) to 21?±?7 % (10–44 %) (p?<?0.0001). One patient deteriorated and died of refractory heart failure. Carvedilol was discontinued in two more patients temporarily due to bronchospasm during respiratory infection.

Conclusions

The present study suggests that improvement in ventricular function and clinical symptoms is seen on oral carvedilol added to standard drug therapy in pediatric patients with dilated cardiomyopathy and moderate to severe ventricular dysfunction. The drug is well tolerated with minimal side effects but close monitoring is required as it may worsen heart failure and bronchospasm.     

Effect of Oil Massage on Growth in Preterm Neonates Less than 1800 g: A Randomized Control Trial

Objective

To study the effect of oil massage on growth in preterm babies less than 1800 g.

Methods

This randomised controlled trial was conducted in Neonatal intensive care unit of a level II hospital. Neonates with birth weight?<?1800 g, gestation?<?35 wk and?<?48 h of age at enrolment were included in the studies. Eligible neonates were randomized to one of the two groups (a) Oil massage along with standard care of low birth weight (b) Standard care of low birth weight without massage. Weight, length and head circumference was measured in the two groups at 7 d intervals. Serum triglyceride levels were measured at enrolment and at completion of study. Primary outcome variable was weight gain at 28 d after enrolment.

Results

A total of forty-eight neonates were randomisd to either oil massage group (n?=?25) or standard care of low birth weight without massage group (n?=?23). Mean (SD) weight of babies in the two groups was 1466.4?±?226.8 g in oil massage group and 1416.6?±?229.9 g in the control group. At 28 d, weight gain in the oil massage group (476.76?±?47.9 g) was higher compared to the control group (334.96?±?46.4 g) (p?<?0.05). At 7 d, less weight loss (7.80?±?9.8 g) was observed in babies in oil massage group compared to control group (21.52?±?19.4 g) (p?=?0.003). However, there was no significant difference in serum triglycerides and other anthropometric parameters.

Conclusions

Oil application has a potential to improve weight gain and cause less weight loss in first 7 d in low birth weight neonates     

Hyperbilirubinemia in Healthy Newborns Born to Immigrant Mothers from Southeastern Asia Compared to Italian Ones

Objective

To compare the characteristics of jaundice and hyperbilirubinemia in the newborn population of both immigrant and Italian mothers.

Methods

The authors studied a group of 1,680 infants born at “A. Gemelli” hospital during 1 y. All were with appropriate weight for gestational age, weighting more than 2,500 g, born to low-risk pregnancy. Maternal ethnicity, clinically evident jaundice (that is total serum bilirubin (TSB)?>?7 mg/dL), hyperbilirubinemia (TSB?>?12 mg/dL), the duration of hospital stay and their need of phototherapy were evaluated.

Results

In infants born to Asian mothers, hyperbilirubinemia was significantly more frequent (48.8 % vs. 26.5 %, p?=?0.003) and they reached mean TSB peak significantly later (86.5?±?38.5 vs. 74.5?±?20.6 h, P?=?0.0001) compared with Italian infants. The average length of hospitalization of infants of Asian and Latin American mothers is significantly longer compared to Italian newborns (4.5?±?1.9 vs. 3.6?±?1.1, p <0.0001 and 4.2?±?1.6 vs. 3.6?±?1.1, p?=?0.0004). With regard to the use of phototherapy, and to its duration, there are no significant differences between the populations studied.

Conclusions

Having studied all infants at low risk, the greater length of hospitalization is due to later peak and the higher frequency of jaundice in newborns of immigrant mother, especially in Asia. Therefore, as it happens to the Italian newborns, it would be desirable to build forecasting nomograms in these populations, to reduce the length of hospitalization and facilitate protected discharge.     

Prevalence and Predictors of Decreased Glomerular Filtration Rate in Tibetan Children with Congenital Heart Disease

Objectives

To assess the prevalence of decreased glomerular filtration rate (GFR) in Tibetan children with congenital heart disease (CHD) and its associated risk factors.

Methods

A total of 207 Tibetan children attending authors’ center for treatment of CHD from May 2012 through November 2012, were included in the study. GFR was estimated with the Schwartz formula (eGFR).

Results

The mean eGFR was 104.3?±?16.6 mL/min/1.73 m², and decreased in 21 children (10.1 %). In the cyanotic category, eGFR was decreased only in severely cyanotic individuals. In the acyanotic category with left ventricular overload, children with decreased eGFR were younger, more commonly lived in areas above 4,700 m, and had higher left ventricular internal dimensions indexed by body surface areas (LVID/BSA) (53.8?±?6.9 vs. 40.1?±?6.8 mm/m², P?P?P?2 (sensitivity: 75.0 %, specificity: 93.9 %). In the remaining category, decreased eGFR was only observed in those living above 4,700 m.

Conclusions

One tenth of Tibetan children with CHD had decreased eGFR. The risk factors included severe cyanosis, younger age, living above 4,700 m and higher LVID/BSA.     

Serum Fructosamine and Retinopathy of Prematurity

Objective

To determine whether serum fructosamine which is a good marker for detecting hyperglycemia during the previous 2 to 3 wk in infants could predict the development of retinopathy of prematurity in very low birth weight infants.

Methods

One hundred sixty seven premature infants who had a birth weight of <1500 g and a gestational age of less than 32 wk were investigated in the present study. Blood glucose was measured at the bedside and infants were recorded as hyperglycemic if their mean blood glucose levels were higher than 150 mg/dL. Serum corrected fructosamine level was obtained from the cord blood at birth and after the first month of life. The infants’ eyes were examined by ophthalmologists to detect retinopathy of prematurity at the gestational age of 32 wk or at four wk after birth, whichever came first.

Results

Corrected fructosamine was 319.6?±?59.6 and 272.8?±?50.6 mmol/l for group1 on 1^st and 30^th day respectively; 320?±?61.7 and 268.2?±?47.3 mmol/l for groups 2?+?3 on 1^st and 30^th day respectively which did not differ between groups (p?=?0.766 and p?=?0.665), whereas duration of hyperglycemia was 1.69?±?1.1 day in group 1 compared with 3.05?±?2.4 day in groups 2?+?3 which was significantly different (p?=?0.019). The multivariate regression analysis indicated that the duration of hyperglycemia in days was significantly correlated with the development of retinopathy of prematurity (OR 3.26; 95% CI 1.09–9.80; p?=?0.035).

Conclusions

Although the duration of hyperglycemia may contribute to the development of retinopathy of prematurity, serum corrected fructosamine does not have a good predictive value in developing retinopathy of prematurity in very-low-birth-weight (VLBW) infants.     

Estimation of radiation dose and risk to children undergoing cardiac catheterization for the treatment of a congenital heart disease using Monte Carlo simulations

Background

Children diagnosed with congenital heart disease often undergo cardiac catheterization for their treatment, which involves the use of ionizing radiation and therefore a risk of radiation-induced cancer.

Objective

The purpose of this study was to calculate the effective and equivalent organ doses (H_T) in those children and estimate the risk of exposure-induced death.

Materials and methods

Fifty-three children were divided into three groups: atrial septal defect (ASD), ventricular septal defect (VSD) and patent ductus arteriosus (PDA). In all procedures, the exposure conditions and the dose-area product meters readings were recorded for each individual acquisition. Monte Carlo simulations were run using the PCXMC 2.0 code and mathematical phantoms simulating a child's anatomy. The H_T values to all irradiated organs and the resulting E and risk of exposure-induced death values were calculated.

Results

The average dose-area product values were, respectively, 40?±?12 Gy·cm² for the ASD, 17.5?±?0.7 Gy·cm² for the VSD and 9.5?±?1 Gy·cm² for the PDA group. The average E values were 40?±?12, 22?±?2.5 and 17?±?3.6 mSv for ASD, VSD and PDA groups, respectively. The respective estimated risk of exposure-induced death values per procedure were 0.109, 0.106 and 0.067%.

Conclusion

Cardiac catheterizations in children involve a considerable risk for radiation-induced cancer that has to be further reduced.     

Serum Procalcitonin in Septic Meningitis

Objective

To evaluate the role of serum procalcitonin (PCT) in diagnosis of septic meningitis in children and its efficacy in differential diagnosis.

Methods

The study included 40 children of septic meningitis admitted in pediatric ward with fever, headache, vomiting and seizure, up to 14 y of age. The diagnosis of septic meningitis was based on clinical features; physical examination, blood and cerebrospinal fluid (CSF) cytochemical findings, gram’s stain and bacterial culture. Fifteen cases of aseptic meningitis admitted during same period were also included in the study, and 15 children with normal CSF were taken as control. Serum PCT was measured by ELISA Kit.

Results

Serum PCT level was significantly higher in children with septic meningitis than those with aseptic meningitis or in controls (p?<?0.001). In culture and gram’s stain positive 7 cases, serum procalcitonin was significantly elevated (24,768.21?±?6,567.45 pg/mL) than aseptic meningitis(14,451.24?±?4,266.15 pg/mL) (p?<?0.001). Further its level was found significantly elevated in partially treated septic meningitis as compared to aseptic meningitis cases (p?<?0.001). At optimum cut off value of ≥ 5,000 pg/mL, based on area under ROC curve, PCT showed sensitivity, specificity, positive predictive value and negative predictive value of 98.5 %, 93.5 %, 98.6 % and 93.3 % respectively. Serum PCT with cut off level of 15,000 pg/ml showed sensitivity, specificity, PPV and NPV of 92 %, 67 %, 91.4 % and 71.4 % respectively for the differentiation of septic from aseptic meningitis.

Conclusions

Serum PCT may be used as diagnostic marker for septic meningitis and its differentiation from aseptic meningitis.     

Body Temperature Changes of Newborns Under Fluorescent Versus LED Phototherapy

Objective

To determine changes in body temperature (BT) of hyperbilirubinemic newborns under conventional phototherapy with fluorescent lamps and light emitting diodes (LED) at different irradiances.

Methods

Otherwise healthy newborn infants >34 wk gestational age (GA) hospitalized for indirect hyperbilirubinemia, requiring phototherapy in the first 10 d of life were enroled. Infants who received conventional phototherapy with fluorescent lamps (10–15 μW/cm²/nm irradiance) were defined as group 1, LED phototherapy of 26–60 μW/cm²/nm irradiance as group 2, and LED phototherapy of 60–120 μW/cm²/nm irradiance as group 3. Primary outcome measure was mean BT which was defined as arithmetical mean of axillary BT measured at 2 h intervals during the first day of phototherapy.

Results

Thirty patients were enroled in each group. Mean birth weight and GA of the total cohort was 2800?±?530 g and 36.6?±?2 wk, respectively. Baseline demographic variables and serum total bilirubin levels were similar among groups. Mean BT was 36.7?±?0.1 °C in group 1, 36.6?±?0.2 °C in group 2, 37.7?±?0.2 °C in group 3. Mean BT was higher in group 3 compared to group 1 (p?<?0.001) and group 2 (p?<?0.001). Group 1 and group 2 had similar mean BT measurements (p?=?0.09). During phototherapy all the patients in group 3 had at least one BT measurement ≥37.5 °C and 77 % had BT ≥38 °C. Only one patient in group 2 had BT?≥?37.5 °C which was also ≥38 °C. During phototherapy all BT measurements were <37.5 °C in group 1.

Conclusions

LED phototherapy of ≥60 μW/cm²/nm intensity significantly increases BT in hyperbilirubinemic newborns.     

Pediatric chest CT at 70 kVp: a feasibility study in 129 children

Background

Before introducing 70-kVp settings in the low-kilovoltage strategies for pediatric examinations, it was mandatory to demonstrate, at similar dose levels, an equivalence of image quality at 70 kVp and 80 kVp.

Objective

To assess image quality of chest CT examinations acquired at 70 kVp in comparison with standard scanning at 80 kVp.

Materials and methods

We prospectively evaluated 129 children with a 70-kVp scanning protocol (group 1). All scanning parameters were kept similar to those usually selected for pediatric standard 80-kVp protocols, except the milliamperage increased by a factor of 1.6 to maintain comparable radiation dose. Image quality of group 1 examinations was compared to that of a paired population scanned at 80 kVp (group 2). The noninferiority hypothesis was fixed at 10% of the mean level of image noise.

Results

There was no significant difference in the mean dose length product (DLP) and the volume computed tomography dose index (CTDI_vol) between the groups (DLP: 20.5?±?5.8 mGy.cm [group 1] vs. 19.7?±?7.6 mGy.cm [group 2]; P?=?0.06) (CTDI_vol: 0.8?±?0.1 mGy [group 1] vs. 0.8?±?0.18 mGy [group 2]; P?=?0.94). The mean of differences in image noise between group 1 and group 2 examinations was ?1.38 (?2.59; ?0.18), verifying the noninferiority hypothesis. Subjective image quality did not significantly differ between group 1 and group 2 examinations (P?=?0.18).

Conclusion

At equivalent radiation dose levels, 70-kVp protocols provide similar image quality to that achievable at 80 kVp.     

A Comparative Study on Reliability of Point of Care Sodium and Potassium Estimation in a Pediatric Intensive Care Unit

Objective

To compare sodium and potassium levels in children as done with Blood Gas Analyzer (BGA) at point of care testing in pediatric ICU vs. that done in laboratory electrolyte analyzer.

Methods

This prospective method comparison study was done from February to April 2012 in Pediatric ICU of tertiary care hospital at Delhi. Sixty consecutive patients were tested during the period. Paired blood samples for venous blood gas to be tested on BGA and serum electrolytes to be tested on auto-analyzers (AA) were taken as per standard technique. Data was collected and 59 paired samples were analyzed for sodium and potassium levels. They were analyzed according to CLSI document EP15-A2 using ACB method comparison software.

Results

Mean sodium measured on the BGA was 132.8?±?12.2 mmol/L where as measured by AA was 141.5?±?11.1 mmol/L. The mean difference between the two was ?8.76 mmol/L (p?<?0.001). The difference was statistically significant in all three subgroups of hypernatremia, isonatremia and hyponatremia (p?<?0.001). Potassium level in BGA was 3.53?±?0.81 mmol/L and AA was 4.28?±?1.05 mmol/L. The mean difference between the BGA and AA was ?0.75 mmol/L (p?<?0.0001). The difference was statistically significant in patients with normokalemia and hyperkalemia (p?<?0.0001). The difference was non significant in patients with hypokalemia (p?=?0.051).

Conclusions

Blood gas analyzers underestimates Na?+?and K?+?values if sampling is done using liquid sodium heparin and if all other potential pre-analytical errors of testing are taken care of. The Bland Altman’s analysis in the present study showed a significant systematic bias and very wide limits of agreement for both sodium and potassium, which is not clinically acceptable.     

Treatment of Iron Deficiency Anemia in Children: A Comparative Study of Ferrous Ascorbate and Colloidal Iron

Objective

To compare the efficacy of ferrous ascorbate and colloidal iron in the treatment of iron deficiency anemia in children.

Methods

Eighty one children, aged 6 mo to 12 y, were screened for iron deficiency anemia (IDA) and those diagnosed with IDA were randomized to receive ferrous ascorbate or colloidal iron for a period of 12 wk, such that each child received elemental iron 3 mg/kg body weight/d. Increase in hemoglobin (Hb) level was the primary outcome measure. Assessment was performed at baseline, wk 4, wk 8 and wk 12.

Results

Of 81 children screened, 73 were included in the study. The mean rise in Hb at the end of the 12 wk was significantly higher in ferrous ascorbate group than the colloidal iron group [3.59?±?1.67 g/dl vs. 2.43?±?1.73 g/dl; P?<?0.01]. Significantly higher proportion of children receiving ferrous ascorbate (64.86 % vs. 31.03 %; P?<?0.01) became non-anemic in comparison to colloidal iron.

Conclusions

Ferrous ascorbate provides a significantly higher rise in hemoglobin levels in comparison to colloidal iron. The study supports the use of ferrous ascorbate in the pediatric age group, providing evidence for its role as an efficient oral iron supplement in the treatment of iron deficiency anemia.     

The Association Between Vitamin D Status and Recurrent Wheezing

Objective

To investigate association between vitamin D status and recurrent wheezing in infants.

Methods

Thirty infants with recurrent wheezing and 45 healthy, similar aged infants without any history of acute or chronic illness were included in the study. The clinical features of infants were recorded and serum 25-hydroxyvitamin D [25(OH)D] levels were measured. Data analysis was performed using SPSS 13 package program.

Results

The mean value of 25 (OH) D vitamin levels were 22.1?±?8.9 IU/L and 18.8?±?11 IU/L for the control and recurrent attack group respectively. Seventy-three percent of subjects with recurrent wheezing had vitamin D levels in the deficient range (<20 ng/ml) and 48.9 % had vitamin D levels under?<?20 ng/ml in the control group. The percentage of insufficient vitamin D levels (<30 ng/ml) were 90 and 77.8 for the patient and control group respectively. Eight patients had extremely deficient vitamin D (<10 ng/ml) levels. There was no statistical significance between the groups in terms of the distribution of 25 (OH)D level.

Conclusions

The present study did not demonstrate significant association between vitamin D status and recurrent wheezing in the infants.     

Computed tomography measurements of the normal and the pathologic cochlea in children

Background

Radiological investigation is frequently undertaken to assess the aetiology of sensorineural hearing loss (SNHL).

Objective

To establish the CT measurements of the normal cochlea in children and to determine radiological criteria correlated with SNHL.

Materials and methods

A retrospective study of temporal bone CT performed in 159 children, age range from 3 days to 16 years between February 1999 and July 2004. A control group (n?=?88) comprised children without SNHL; the SNHL group comprised 71 children. The width of the second turn of the cochlea (CW), the cochlear height (CH), and the width of the bony canal for the cochlear nerve (WCN) were measured on a reference plane containing the modiolus, the posterior semicircular canal, the footplate, and the stapes arch.

Results

Width of the canal measurements ≤1.7 mm or ≥2.5 mm supported the diagnosis of SNHL with a specificity of 97% and 91%, respectively. Cochlear width was found to be significantly smaller in the SNHL group (5.61?±?0.51 mm) than in the control group (5.75?±?0.31 mm, P?<?0.02), a size <5.4 mm being highly suggestive of SNHL with a specificity of 90%. No significant variations of all measurements were found with age.

Conclusion

Appropriate measurements of WCN and CW are highly correlated with SNHL.     

Evaluation of carotid intima-media thickness, a marker of subclinical atherosclerosis, in children with cerebral palsy

Background

Respiratory and cardiovascular diseases are the most common causes of death in children with cerebral palsy.

Objective

To evaluate sonographic carotid intima-media thickness, an early marker of atherosclerosis, in children with cerebral palsy and in healthy controls.

Materials and methods

One hundred children with cerebral palsy (65 boys), mean age 6.2 (SD, 2.1) years, and 35 age-matched and sex-matched healthy controls were included. Common carotid artery intima-media thickness was measured sonographically. Differences between patients and controls were evaluated with an independent samples t-test.

Results

Age, sex distribution and levels of serum lipids were comparable between patients and controls. Average, right and left carotid artery intima-media were thicker in patients compared with controls (mean ± SD, 0.61?±?0.13 mm vs 0.40?±?0.03 mm; 0.61?±?0.14 mm vs 0.40?±?0.03 mm; 0.61?±?0.13 mm vs 0.40?±?0.03 mm, respectively; all P?Conclusion Carotid intima-media is sonographically thicker in children with cerebral palsy compared with healthy controls, which may express an increased risk of atherosclerotic diseases.