World journal of clinical pediatrics最新文献

{"title":"Multimodal distraction reduces intravenous cannulation pain and anxiety in preschoolers: Controlled prospective study.","authors":"Leana Phebe Wilson, Zubair Khan, Pushparaj Nilkanth Patil, Rajesh G Konnur, Nagarajan Sriram","doi":"10.5409/wjcp.v15.i1.111388","DOIUrl":"10.5409/wjcp.v15.i1.111388","url":null,"abstract":"<p><strong>Background: </strong>Hospitalization and intravenous (IV) procedures are known to provoke significant pain and anxiety in preschool children, potentially leading to long-term psychological distress. Despite growing evidence supporting distraction techniques, practical, low-cost interventions suited for resource-limited settings remain underutilized.</p><p><strong>Aim: </strong>To determine the effectiveness of a nurse-led multimodal distraction intervention - comprising balloon blowing, art therapy, and kaleidoscope use - in reducing pain and anxiety during IV therapy among hospitalized preschool children.</p><p><strong>Methods: </strong>A posttest-only controlled observational study was conducted at Shri Vinoba Bhave Civil Hospital, India. A total of 600 hospitalized preschoolers (aged 3-6 years) were randomly allocated to either an experimental group (<i>n</i> = 300; distraction intervention) or control group (<i>n</i> = 300; routine care). Pain was measured using the Wong-Baker FACES Pain Rating Scale, and anxiety was assessed using the Visual Analogue Anxiety Scale. The distraction intervention included daily 5-minute sessions: (1) Pre-procedure familiarization (balloon/art); (2) Intra-procedure distraction (kaleidoscope and balloon blowing); and (3) Post-procedure relaxation. Outcomes were evaluated on day 3. Data were analyzed using independent <i>t</i>-tests and correlation analysis.</p><p><strong>Results: </strong>Children in the experimental group had significantly lower pain scores [mean ± SD (3.07 ± 1.39)] than the control group (8.80 ± 1.01) (<i>t</i> = 58.56, <i>P</i> < 0.00001). Anxiety levels were also reduced in the experimental group (5.85 ± 1.56 mm) compared to controls (9.39 ± 0.73 mm) (<i>t</i> = 35.55, <i>P</i> < 0.00001). A moderate positive correlation was found between pain and anxiety in both groups (experimental: <i>r</i> = 0.67; control: <i>r</i> = 0.66; <i>P</i> < 0.05). Significant associations were also found between pain levels and variables such as age, IV site, cannula size, and medication type (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>This study demonstrates that a simple, low-cost, nurse-led multimodal distraction strategy can significantly reduce pain and anxiety in preschool children undergoing IV therapy. Its ease of use and scalability make it highly suitable for immediate integration into pediatric care, especially in low-resource healthcare settings.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"111388"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of the extensively hydrolyzed formulas in the management of infantile colic: A systematic review and meta-analysis.","authors":"Konstantinos Dodos, Tsampika-Vasileia Kalamara, Stylianos Xinias, Antigoni Mavroudi, Dorothea Kapoukranidou, Antigoni Sarantaki, Athina Diamanti, Vasiliki E Georgakopoulou","doi":"10.5409/wjcp.v15.i1.111066","DOIUrl":"10.5409/wjcp.v15.i1.111066","url":null,"abstract":"<p><strong>Background: </strong>Infantile colic (IC) is a common, self-limiting condition marked by excessive, unexplained crying. Evidence on the use of extensively hydrolyzed formulas (eHFs) as a dietary intervention remains fragmented.</p><p><strong>Aim: </strong>To systematically review and meta-analyze the effectiveness of eHFs in managing symptoms of IC.</p><p><strong>Methods: </strong>A comprehensive literature search of MEDLINE, Cochrane and Web of Science databases (1980-2025) identified randomized controlled trials and crossover studies assessing the efficacy of eHF in infants diagnosed with IC based on Wessel's or ROME III criteria. Studies were included if they involved infants ≤ 6 months old on partial or exclusive formula diets, and were excluded if the diagnosis was unclear. Data were synthesized qualitatively and through meta-analysis using odds ratios (OR) and 95% confidence intervals (CI).</p><p><strong>Results: </strong>Six studies met the inclusion criteria, with a total of 340 infants across intervention and comparator arms. In all studies, eHF significantly reduced crying duration and colic symptoms compared to regular formula or dicyclomine. The meta-analysis showed a pooled OR of 4.8 (95%CI: 2.53-9.11, <i>P</i> < 0.05). Secondary outcomes such as stool consistency and parental quality of life were variably reported but tended to favor eHF.</p><p><strong>Conclusion: </strong>eHF appear significantly more effective than standard formulas and pharmacologic comparators in reducing colic-related symptoms. These findings support eHF as a viable dietary intervention for IC, though larger, well-controlled trials are warranted to confirm long-term outcomes.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"111066"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of bilirubin albumin ratio and total serum bilirubin for predicting neurological dysfunction in newborns: A meta-analysis.","authors":"Nabeel Ahmad, Uzair Ahmed, Ghulam Mohy Ud Din, Mavia Habib, Muhammad Shaheer Luqman, Muhammad Talha, Muneeb Saifullah, Ikra Rana","doi":"10.5409/wjcp.v15.i1.112088","DOIUrl":"10.5409/wjcp.v15.i1.112088","url":null,"abstract":"<p><strong>Background: </strong>Bilirubin-induced neurologic dysfunction (BIND) remains a serious complication of severe neonatal hyperbilirubinemia, especially in resource-limited settings. While total serum bilirubin (TSB) is widely used for risk stratification, the bilirubin/albumin (B/A) ratio has been proposed as a surrogate for free bilirubin, the neurotoxic fraction.</p><p><strong>Aim: </strong>To compare the diagnostic accuracy of the B/A ratio <i>vs</i> TSB for predicting acute BIND in neonates.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of observational studies evaluating the B/A ratio and TSB for predicting BIND in neonates (≥ 35 weeks' gestational age). Data sources included PubMed, EMBASE, Cochrane Central, and Google Scholar. Pooled standardized mean difference (SMD), sensitivity, specificity, and heterogeneity (<i>I</i> ²) were calculated using a bivariate random-effects model. Meta-regression was used to assess whether biomarker type (B/A <i>vs</i> TSB) explained performance differences. The risk of bias was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool.</p><p><strong>Results: </strong>Five studies involving a total of 1022 neonates were included, with a male-to-female ratio of approximately 57:40. The SMD for B/A ratio was 1.71 (95%CI: 1.00-2.41, <i>P</i> < 0.0001), and for TSB it was 1.68, both showing strong associations with BIND. Meta-regression revealed no significant difference in predictive value between the two biomarkers (<i>P</i> = 0.96).</p><p><strong>Conclusion: </strong>Both TSB and the B/A ratio are comparably effective in predicting BIND. While the B/A ratio may provide incremental value in specific clinical contexts, current evidence supports continued reliance on TSB for routine risk stratification.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"112088"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beliefs, attitudes, knowledge, and behaviours of physical therapists towards pediatric complex regional pain syndrome.","authors":"Ranya Moutafakir, Oriana Denise Strilinsky-Pérez, Jesús Zamora-Tortosa, Julia Raya-Benítez, Ángela Benítez-Feliponi, Marie Carmen Valenza, María Granados-Santiago","doi":"10.5409/wjcp.v15.i1.110584","DOIUrl":"10.5409/wjcp.v15.i1.110584","url":null,"abstract":"<p><strong>Background: </strong>Pediatric complex regional pain syndrome (CRPS) is a debilitating chronic condition that affects the quality of life and psychosocial development of children and adolescents. Despite increasing recognition, significant diagnostic and therapeutic challenges persist, partly due to the lack of clinical criteria tailored to the pediatric population.</p><p><strong>Aim: </strong>To evaluate current diagnostic and therapeutic practices in pediatric CRPS, identifying barriers to timely intervention and gaps in provider knowledge.</p><p><strong>Methods: </strong>Physiotherapists who had treated at least one pediatric CRPS case in the past two years were surveyed. The online questionnaire included 40 questions divided into three sections: Professional knowledge, therapeutic approaches, and personal perceptions. Data were analyzed using descriptive statistics and <i>χ</i> ² tests.</p><p><strong>Results: </strong>Most participants worked in private clinics (71%) and collaborated with other healthcare professionals. About 53% had specific training in pediatric pain, while 40% had training in CRPS. Only 13% had received training in cognitive-behavioral therapy (CBT). The use of the Budapest criteria was limited, primarily applied during the diagnostic suspicion phase. The most common therapeutic strategies included mirror therapy (40%) and relaxation techniques (80%). The main reported challenges were the lack of specific clinical guidelines (60%) and insufficient professional training (47%).</p><p><strong>Conclusion: </strong>Physical therapists are key contributors to multidisciplinary diagnosis and play a central role in managing pediatric CRPS in most cases, adopting a collaborative and largely non-pharmacological approach. However, the absence of standardized clinical guidelines limits treatment consistency. The development of pediatric-specific protocols and enhanced training in psychological therapies such as CBT is recommended.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"110584"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of dual-targeted therapy in children with inflammatory bowel disease: Retrospective cohort study.","authors":"Tatiana Gabrusskaya, Natalia Ulanova, Elena Shilova, Natalia Volkova, Sofia Kilina, Elena Kornienko, Mikhail Kostik","doi":"10.5409/wjcp.v15.i1.111093","DOIUrl":"10.5409/wjcp.v15.i1.111093","url":null,"abstract":"<p><strong>Background: </strong>There is a limited number of studies on the efficacy and safety of dual-targeted therapy (DTT) in children with inflammatory bowel diseases (IBD); the latest reports focus on the combination of biological drugs with Janus kinase inhibitors (JAKI).</p><p><strong>Aim: </strong>To evaluate the efficacy and safety of DTT in children with IBD.</p><p><strong>Methods: </strong>This retrospective cohort study included 18 IBD patients, aged 2-17 years, with 13 (72%) having Crohn's disease (CD) and 5 (28%) having ulcerative colitis, who were treated with DTT. In two children, two different combinations of DTT were used sequentially. The data on clinical and laboratory changes were assessed at the beginning of DTT and at three months (M3) and six months (M6). Fecal calprotectin and endoscopy were evaluated at baseline and M6.</p><p><strong>Results: </strong>A total of 20 courses of DTT in 18 patients were included in the analysis: (1) 12 (60%) were treated with JAKI and vedolizumab; (2) 6 (30%) with JAKI and ustekinumab; and (3) 2 (10%) with JAKI and adalimumab. Clinical remission was achieved in 9/20 (45%) and 13/20 (68%) DTT courses in patients within M3 and M6, respectively. In contrast, laboratory and endoscopic remission (ER) were achieved in 8/20 (40%) and 9/17 (53%) patients, respectively, within M6. Perianal lesions and upper gastrointestinal tract involvement were negatively associated with the efficacy of the DTT in CD patients. Children with early onset of the disease are more likely to achieve ER compared with those with later onset: 8/11 (73%) <i>vs</i> 1/6 (17%), respectively. Side effects were reported in 6/20 (30%) of cases, and 5/6 (83.3%) were considered non-serious.</p><p><strong>Conclusion: </strong>A DTT may be considered for children with refractory IBD. This strategy was shown to be most effective among children with a very early onset of the disease.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"111093"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal consequences of cesarean section birth: A systematic review of short- and long-term effects in infancy and beyond.","authors":"Mohammed Al-Beltagi, Salman Alzayani, Nermin Kamal Saeed, Adel Salah Bediwy, Archana Prabu Kumar, Hosameldin A Bediwy, Reem Elbeltagi","doi":"10.5409/wjcp.v15.i1.111501","DOIUrl":"10.5409/wjcp.v15.i1.111501","url":null,"abstract":"<p><strong>Background: </strong>Cesarean section (C-section) delivery rates are rising globally, raising concern about their potential long-term health consequences on offspring. Emerging evidence suggests that C-section, by bypassing the physiological and microbial exposures of vaginal birth, may adversely affect neonatal gastrointestinal (GI) development and immune regulation.</p><p><strong>Aim: </strong>To evaluate the short- and long-term gastrointestinal outcomes in infants born <i>via</i> C-section, compared to those born vaginally.</p><p><strong>Methods: </strong>A systematic literature search was conducted across PubMed, Scopus, and Web of Science for studies published from inception to 2024. Studies were included if they reported gastrointestinal outcomes among C-section-born infants and included a vaginal delivery comparison group. Outcomes of interest included short-term disorders (infantile colic, gastroesophageal reflux, constipation, dyschezia, and functional gastrointestinal disorders) and long-term conditions (inflammatory bowel disease, food allergies including cow's milk protein allergy, celiac disease, and microbiota dysbiosis). Data extraction and synthesis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</p><p><strong>Results: </strong>C-section -born infants demonstrated a higher risk of several short-term GI disturbances, including infantile colic, reflux, and constipation. These outcomes were consistently associated with early gut microbiota dysbiosis, characterized by reduced microbial diversity and delayed colonization by <i>Bifidobacteria</i> and <i>Bacteroides</i>. Long-term associations with C-section included a modest increase in the risk of Crohn's disease, cow's milk protein allergy, and food sensitization, while the links with ulcerative colitis and celiac disease were inconsistent. Breastfeeding, probiotic/synbiotic supplementation, and limited antibiotic exposure emerged as protective modifiable factors.</p><p><strong>Conclusion: </strong>C-section delivery is associated with a higher risk of adverse gastrointestinal outcomes in infancy and childhood, driven in part by early-life gut microbial disruption. Preventive strategies targeting microbial restoration and immune modulation, particularly breastfeeding and probiotic interventions, may help mitigate these risks. Clinicians should be aware of these associations to guide personalized care and parental counseling, particularly in elective C-section deliveries.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"111501"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cow's milk protein allergy in infants: Clinical presentations and outcomes.","authors":"Fareed Khdair Ahmad, Mohammad R Alkayid, Tahani M Ahmad, Reem H Hadidi, Riad M Rahhal","doi":"10.5409/wjcp.v15.i1.109301","DOIUrl":"10.5409/wjcp.v15.i1.109301","url":null,"abstract":"<p><strong>Background: </strong>Cow's milk protein allergy (CMPA) is the most common food allergy in infants, with significant clinical, nutritional, and economic consequences. In Jordan, the Ministry of Health (MoH) provides specialized formulas for affected infants; however, local data on clinical presentation, treatment duration, costs, and breastfeeding barriers are scarce.</p><p><strong>Aim: </strong>To evaluate the clinical manifestations and outcomes of infants diagnosed with CMPA in a public hospital in Jordan and to assess treatment costs and maternal breastfeeding barriers.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 38 infants aged < 1 year diagnosed with CMPA at a MoH tertiary hospital in Salt, Jordan, between 2020 and 2023. Data were collected from medical records and caregiver phone interviews. Infants who were exclusively breastfed or received mixed formulas (extensively hydrolyzed formula and amino acid-based formula) were excluded. Statistical analysis included descriptive statistics and Fisher's exact test to determine associations between breastfeeding barriers and maternal factors.</p><p><strong>Results: </strong>Constipation (47.4%) and diarrhea (44.7%) were among the most frequent symptoms. One-third of the infants had coexisting food allergies, and elevated liver enzyme levels or isolated jaundice was noted in 21%. The average treatment duration was 13.89 months, with a mean cost of JD 1802 ($2523) per child. Maternal perception of milk insufficiency (36.8%) was the most reported breastfeeding barrier. Maternal employment, but not education (<i>P</i> = 0.22), was significantly associated with breastfeeding challenges (OR = 7.20, <i>P</i> = 0.03).</p><p><strong>Conclusion: </strong>CMPA in Jordanian infants was associated with delayed diagnosis, high treatment costs, and significant breastfeeding barriers, particularly among employed mothers. These findings highlight the need for improved awareness, earlier diagnosis, and supportive policies to promote breastfeeding and reduce the disease burden.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"109301"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and neonatal determinants of newborn sepsis: A case-control study in resource-limited settings.","authors":"Mohd Asif Qureshi, Mangla Sood, Pratima Thakur, Ishaan Sood","doi":"10.5409/wjcp.v15.i1.111423","DOIUrl":"10.5409/wjcp.v15.i1.111423","url":null,"abstract":"<p><strong>Background: </strong>Neonatal sepsis continues to remain a serious threat, with multiple maternal and neonatal risk factors. Understanding these determinants will empower clinicians in comparable settings to apply targeted interventions, ultimately reducing newborn morbidity and mortality.</p><p><strong>Aim: </strong>To assess maternal and infant risk factors, the aim is to develop evidence-based strategies for preventing neonatal sepsis.</p><p><strong>Methods: </strong>A total of 453 neonates and their mothers were enrolled, of which 146 were cases. Clinical, demographic, and obstetric data were analyzed including maternal infection history, delivery conditions, neonatal characteristics, and respiratory support requirements. Statistical associations were assessed using multivariable logistic regression analysis to determine independent risk factors.</p><p><strong>Results: </strong>Male sex (adjusted odd ratio [AOR] = 1.9; 95% confidence interval [CI]: 1.03-3.5), forceps-assisted vaginal delivery (AOR = 3.4; 95%CI: 1.1-14.9), fewer than four antenatal care visits (AOR = 2.9; 95%CI: 1.4-6.5), prolonged labor > 24 hours (AOR = 6.2; 95%CI: 2.8-17), rupture of membranes > 18 hours (AOR = 3.0; 95%CI: 1.6-6.8), and maternal urinary tract infection (AOR = 3.5; 95%CI: 2.4-29.4) significantly increased neonatal sepsis risk. Unclean vaginal examinations (AOR = 4.2; 95%CI: 1.6-11) and foul-smelling amniotic fluid (AOR = 10.3; 95%CI: 1.9-56.4) were among the strongest risk factors. Among neonatal factors prematurity (AOR = 4.3; 95%CI: 2.8-6.6), low birth weight ≤ 1500 g (AOR = 3.6; 95%CI: 2.2-5.7), birth asphyxia (AOR = 4.3; 95%CI: 2.4-7.6), and small-for-gestational-age status (AOR = 2.1; 95%CI: 1.1-4) were significant predictors. Respiratory support showed a strong correlation, with surfactant administration (AOR = 9.7; 95%CI: 4.1-22.9), continuous positive airway pressure) (AOR = 15.4; 95%CI: 9.4-25.1), and invasive ventilation (AOR = 53; 95%CI: 12.7-89) as the highest risk factors. Extended newborn intensive care unit stays (> 7 days: AOR = 38.9; > 15 days: AOR = 30) further elevated the likelihood of sepsis, likely due to nosocomial exposure.</p><p><strong>Conclusion: </strong>The findings highlight the importance of enhanced prenatal care, timely labor management, strict hygiene protocols, and focused neonatal monitoring to reduce neonatal sepsis incidence. Addressing modifiable risk factors, including maternal infections and respiratory interventions, could significantly improve neonatal outcomes in resource-limited settings.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"111423"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional constipation in Thai infants and toddlers: The role of genetic-gut-brain interaction and fiber supplementation.","authors":"Kanticha Chatpermporn, Thitima Ngoenmak, Busara Charoenwat, Atchariya Chanpong, Hansa Sriphongphankul, Nipaporn Hanpitakpong, Palittiya Sintusek","doi":"10.5409/wjcp.v15.i1.111828","DOIUrl":"10.5409/wjcp.v15.i1.111828","url":null,"abstract":"<p><strong>Background: </strong>Functional constipation (FC) is a global burden, and data on its prevalence based on Rome IV diagnostic criteria in young children, particularly after the coronavirus disease 2019 era, are limited.</p><p><strong>Aim: </strong>To determine the prevalence of FC in Thai infants and toddlers using the Rome IV criteria and identify associated factors.</p><p><strong>Methods: </strong>The Thai version of the Rome IV Diagnostic Questionnaire for Pediatric Functional Gastrointestinal Disorder (R4PDQ-Toddler) was developed and then officially approved by the Rome Foundation. Guardians of children aged 6-48 months from six hospitals in five regions in Thailand were surveyed between August 2023 and September 2024. The questionnaire collected demographic data, the R4PDQ-Toddler gathered defecation data, and factors potentially associated with FC were recorded.</p><p><strong>Results: </strong>A total of 1874 guardians participated, yielding a high response rate of 98.1%. The mean age of the children was 20.3 months ± 11.4 months, and 53.5% were male. The prevalence of FC was 16.1% [95% confidence interval (CI), 14.5%-17.8%]. Painful or hard bowel movements (81.5%), large-diameter stools (77.5%), and excessive stool retention (72.2%) were the most common symptoms. Factors independently associated with FC were age > 1 year [adjusted odds ratio (aOR), 3.36; 95%CI: 2.29-4.94], a first-degree relative with a history of constipation (aOR: 2.48; 95%CI: 1.85-3.35), fiber supplementation (aOR: 7.85; 95%CI: 3.56-17.30), and exposure to stressful family events (aOR: 1.41; 95%CI: 1.03-1.92).</p><p><strong>Conclusion: </strong>FC is prevalent in Thai infants and toddlers. Older age, family history, fiber supplementation, and stress are key factors, highlighting genetic, dietary, and gut-brain influences that need further investigations.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"111828"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of omega-3 fatty acid supplementation on heart rate variability.","authors":"Hoda Atef Abdelsattar Ibrahim, Kamal Gouda Kamal, Mohamed Khaled Ali Mohamed Ali Zid, Albraa Ashraf Hamad, Ayesha Kuraishi, Marwa Taha","doi":"10.5409/wjcp.v15.i1.116331","DOIUrl":"10.5409/wjcp.v15.i1.116331","url":null,"abstract":"<p><strong>Background: </strong>Obesity and overweight are major public health challenges and are associated with autonomic imbalance and decreased heart rate variability (HRV), a non-invasive indicator of cardiovascular risk. Omega-3 polyunsaturated fatty acids have shown cardioprotective effects and may modulate autonomic function. Nevertheless, the effect of omega-3 supplementation on HRV in individuals who are overweight or obese remains unclear.</p><p><strong>Aim: </strong>To study the effect of omega-3 supplementation on HRV in overweight and obese individuals and to explore the heterogeneity across different study designs.</p><p><strong>Methods: </strong>In accordance with PRISMA guidelines, a systematic review and meta-analysis were conducted. PubMed, Science Citation Index, and Scopus were searched for randomized controlled trials (RCTs) assessing the impact of oral omega-3 supplementation on HRV in overweight or obese participants. Primary outcomes were the impacts of omega-3 supplementation on time-domain HRV indices [root mean square of successive differences (RMSSD), standard deviation of normal-to-normal intervals (SDNN), and percentage of successive normal-to-normal intervals differing by more than 50 milliseconds (pNN50%)], and frequency-domain indices [high-frequency (HF) power, low-frequency (LF) power, and LF/HF ratio].</p><p><strong>Results: </strong>Four RCTs (<i>n</i> = 134 participants) met the inclusion criteria. Two trials compared pre- <i>vs</i> post- omega-3 supplementation, and two compared omega-3 with placebo on HRV in overweight and obese children and adults. In the within-subject analyses, omega-3 supplementation was associated with a significant increase in RMSSD [mean difference (MD) = -11.69 milliseconds, 95%CI: -18.50 to -4.87, <i>P</i> = 0.0008), SDNN (MD = -26.13 milliseconds, 95%CI: -35.84 to -16.42, <i>P</i> < 0.00001), and pNN50% (MD = -9.45, 95%CI: -14.27 to -4.64, <i>P</i> = 0.0001). Between-group comparisons showed that omega-3 supplementation had no significant effect on HF power, LF power, or the LF/HF ratio.</p><p><strong>Conclusion: </strong>Omega-3 supplementation represents a promising and low-cost strategy for enhancing autonomic balance and potentially reducing cardiovascular risk in overweight and obese populations, as it improves time-domain HRV measures.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"116331"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}