Open Access Original Research Article

Study of Vitamin D Receptor Levels in Children with Immune Thrombocytopenic Purpura

Eman Abd Elkhalek Elnady, Ibrahim Mohamed Badraia, Adel Abd El-Haleim Hagag, Sarah Amr Hamam

Asian Journal of Pediatric Research, Page 1-6
DOI: 10.9734/ajpr/2021/v7i230209

Background: Vitamin D, affecting many tissues and organs of the body. It exerts many of its effects through contact with Vitamin D receptor (VDR) It Is Important especially in immune system; Immune thrombocytopenia is one of the most common causes of symptomatic thrombocytopenia in children.

Aim: The main objective of our study was to study vitamin D receptor level in children with immune thrombocytopenic purpura and effect of vitamin D supplementation upon the response of the thrombocytopenia to conventional therapy of ITP.

Subjects and Methods: This is a case control study which included 30 ITP children, who would be attendants to Hematology and Oncology Unit, Pediatric Department, Tanta University Hospital in Egypt. This study would include also 30 apparently healthy children matched in age and sex as a control group. The duration of the study ranges from 6 to 12 months, for all patients and controls the following were done: complete blood count, bone marrow aspiration, serum level of Vitamin D receptors, serum calcium level, serum phosphorus level, serum alkaline phosphatase level and serum parathyroid hormone level.

Results: the results revealed that mean ± SD of Vitamin D receptors in case group is 132.43 ± 14.58 and there was statistical difference between groups regarding Vitamin D receptor. There was statistical difference between platelets count and Serum total Ca (mg/dl) with negative correlation, while there was no statistical difference between platelets count and Vitamin D receptor. There was statistically significant difference in platelets count in patient with ITP before and after conventional treatment and platelets count in patient with ITP under conventional treatment plus vitamin D supplementation.

Conclusion: VD receptors elevation is very common in ITP. Supplementing VD might diminish recurrence. Further research is needed.

Open Access Original Research Article

The Effect of Oral Motor Therapy on Feeding Difficulties and Eating Behaviors in Younger ASD Children

Heena Khan, Sheeba Parveen, Amitabh Dwivedi

Asian Journal of Pediatric Research, Page 7-18
DOI: 10.9734/ajpr/2021/v7i230210

Background: A variety of feeding difficulties like aversion of food, food selectivity, complete food refusal are the most common problems reported by the Parents of ASD children. Every parent of ASD children struggles to manage their child’s feeding routine as well as undesirable mealtime behaviours, which can cause parental concern and poor family dynamics.

Aim: 1) The aim of this study is to analyze the effect of dedicated oral motor work in children with ASD who presented with feeding difficulty. 2) To determine parental concerns related to feeding behavior shown by their child and assess whether an additional home program in parallel with oral motor work by an Occupational Therapist would provide any benefits.

Methods: This is a pre and post study where a total number of 18 ASD children at the age of 2-4 year old were participated and selected through BPFAS, out of which 15 copies were considered to be concerned with the oral motor and feeding difficulties of the child. Therefore, 15 participants who were facing feeding difficulties with their children were recruited. Concerned Participants were further assessed by Occupational therapist with the help of ‘The com deall Oro-motor assessment scale for toddlers’.

Results: According to The Com Deall Oral-motor assessment scale, some changes observed in the oral motor skills and When parental concern is considered via home plan including mealtime strategies with oral motor activities, the post intervention result showed decrease in Total problem score as well as in Total frequency score.

Conclusion: The study concluded that continuous structured direct oral motor work as well as addressing parental concerns via home programs is helpful for the ASD children and gives better understanding of feeding difficulties to their parents. Also, some changes have been seen in oral motor skills through continuous practice of oral motor activities by the therapist.

Open Access Original Research Article

Functional Abdominal Pain of Children: Therapy with Bacillus Coagulans GBI-30, 6086 and Insight into Its Probiotic Properties

Vishnu Kumar Tandon, Trayambak Dutta, R. Ezhil Arasan

Asian Journal of Pediatric Research, Page 19-27
DOI: 10.9734/ajpr/2021/v7i230211

Background: Probiotics are effective in the treatment of functional gastrointestinal disorders in adults but there is lack of enough clinical evidence in children.

Aim: To evaluate effectiveness of Bacillus Coagulans GBI-30, 6086 along with digestive enzymes in the treatment of childhood functional abdominal pain (FAP).

Methods: Children with FAP, based on the Rome IV criteria (n = 95, aged 5-16 years), received Bacillus Coagulans GBI-30, 6086 along with digestive enzymes from a commercially available preparation - Tummysoft® for three weeks. Treatment response was assessed by improvement in the Quality of Life in Reflux and Dyspepsia Questionnaire (QOLRAD) score and Global Overall Symptom (GOS) scale.

Results: Patients diagnosed with FAP upon receiving a 3-week treatment with Bacillus Coagulans GBI-30, 6086 along with digestive enzymes, registered statistically significant improvement in both QOLRAD (Baseline, 30.27 ± 5.95; 10th Day: 108.39 ± 7.06; 21st day: 173.71 ± 6.71, P=0.00) and GOS scale (Baseline, 3.10 ± 0.37; 10th Day: 2.15 ± 0.73; 21st day: 1.00 ± 0.00, P = 0) signifying the efficacy of the probiotic in FAP.

Conclusion: Bacillus Coagulans GBI-30, 6086 along with digestive enzymes from a commercially available preparation - Tummysoft® was found to be effective in the treatment of childhood functional abdominal pain (FAP).

Open Access Original Research Article

Assessment of Right Ventricular Function and Structure in Children with Idiopathic Dilated Cardiomyopathy

Drahem Mansour Ahmed El-Fiky, Shimaa Basyony El-Nemr, Osama Abd Rab El-Rasoul Tolba, Waleed Ahmed El-Shahaby

Asian Journal of Pediatric Research, Page 28-38
DOI: 10.9734/ajpr/2021/v7i230212

Background: Dilated cardiomyopathy (DCM) refers to dilating the ventricles and dysfunction of their systolic functions (predominantly the left ventricle) with or without congestive heart failure. In children, it is the most common form of heart muscle disease. We aimed to evaluate the right ventricular functions and structure using speckling tracking echocardiography in children with dilated cardiomyopathy and correlate this parameter with other echocardiographic findings.

Methods: This observational Case-Control Study was carried out on 75 subjects. They were subdivided into two groups: Group 1: 50 patients with dilated cardiomyopathy Group 2: 25 healthy children matched for age and sex. Patients were evaluated by M-mode echocardiography, Transthoracic 2DE Examination (TTE), Tissue Doppler Examination (TDE) and Speckling Tracking Technique.

Results: Left ventricle (LV) and right ventricle (RV) systolic dysfunction was evidenced by a significant decrease of mitral and tricuspid annular systolic velocities and a significant decrease of LV and RV global systolic strain and a significant decrease of LV and RV Ejection fraction (EF). LV and RV diastolic dysfunction were evidenced by a significant decrease of mitral and tricuspid annular diastolic velocities (E’/A’) and a significant increase of LV and RV Myocardial Perfusion Imaging (MPI). LV and RV global strains were significantly reduced in comparison to controls, suggesting that the dilated cardiomyopathy is a diffuse disease.

Conclusion: In DCM patients, RV had significant systolic and diastolic dysfunction mainly elicited by the Tissue Doppler imaging (TDI) beside LV affection secondary to the interventricular interaction. TDI and 2D-STE add value to interpreting the findings and the dependency of RV systolic and diastolic functions on each other in DCM patients.

Open Access Original Research Article

Evaluation of Nutrient Composition in Breast Milk of Breast Feeding Mothers in Urban and Sub-Urban Subjects in Rivers State

Ikewuchi Catherine Chidinma, Kalaotaji Glory Biambo, Jonathan Nyebuchi, Amadi Chikadibia Fyneface, Nwika Goodnews

Asian Journal of Pediatric Research, Page 39-44
DOI: 10.9734/ajpr/2021/v7i230213

The human breast milk is considered to be the perfect food for infants, specifically adapted to their needs. Changes in lifestyle and environment may impact on breast milk composition. This study was aimed at comparing the nutrients composition in breast milk in postpartum women in urban and sub-urban areas in Rivers State. The cross-sectional study was conducted among 59 postpartum subjects between 0 and 10days of child delivery in each group. Sampling was done through a simple random sampling method. Human breast milk was collected by means of a manual breast pump for the analysis of carbohydrate, protein and lipid using ClegAnthrone Method, Kjedahl Method and Soxhelt Extraction Method respectively. The results revealed that carbohydrate level was 6.1±0.5% in urban group and 5.0±0.1% in sub-urban group which was statistically significant (t-value=2.2; p-value=0.04). Protein level was 3.5±0.6% in urban group and 3.9±0.3% in sub-urban group which was statistically non-significant (t-value=0.6; p-value=0.57).  Lipid level was 6.1±0.5% and 5.0±0.1% in urban and sub-urban groups respectively which was statistically non- significant (t-value=1.2; p-value=0.27). This study has revealed that differences in settlements (urban and sub-urban) have no impact on breast milk composition except in carbohydrate.