International Journal of Pediatrics
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Acceptance rate14%
Submission to final decision69 days
Acceptance to publication19 days
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Journal Citation Indicator0.690
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Role of Adenotonsillectomy and Tonsillectomy in Children with Down Syndrome Who Develop Obstructive Sleep Apnea by Obesity as a Risk Factor

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 Journal profile

International Journal of Pediatrics provides a forum for pediatricians who diagnose and treat disorders in infants, children, and adolescents. Studies relate to pediatric subspecialities including adolescent medicine, cardiology, critical care etc.

 Editor spotlight

Chief Editor, Dr Alessandro Mussa, is based in the Department of Public Health and Pediatrics at the University of Torino, Italy.

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Do you think there is an emerging area of research that really needs to be highlighted? Or an existing research area that has been overlooked or would benefit from deeper investigation? Raise the profile of a research area by leading a Special Issue.

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Research Article

Comparison of Airway Pressure Release Ventilation to High-Frequency Oscillatory Ventilation in Neonates with Refractory Respiratory Failure

Background. Airway pressure release ventilation (APRV) is a relatively new mode of ventilation in neonates. We hypothesize that APRV is an effective rescue mode in infants failing conventional ventilation and it is comparable in survival rates to rescue with high-frequency oscillatory ventilation (HFOV). Methods. This is a 6-year retrospective cohort study of infants that failed synchronized intermittent mandatory ventilation (SIMV) and were rescued with either APRV or HFOV. For comparison, we divided infants into two groups (28-37 and >37 weeks) based on their corrected gestational age (CGA) at failure of SIMV. Results. Ninety infants were included in the study. Infants rescued with APRV () had similar survival rates to those rescued with HFOV ()—28-37 weeks CGA (APRV 78% vs. HFOV 84%, ) and >37 weeks CGA (APRV 76% vs. HFOV 72%, ). Use of APRV was not associated with an increase in pneumothorax (APRV 0% and HFOV 10%, , in 28-37 weeks CGA, and APRV 0% and HFOV 4%, , in >37 weeks CGA). Conclusion. APRV can be effectively used to rescue infants with refractory respiratory failure on SIMV. When compared to HFOV, rescue with APRV is not associated with an increase in mortality or pneumothorax.

Research Article

Indications and Yield of Pediatric Endoscopy in Bahrain: A Tertiary Center Experience

Background and Objectives. Gastrointestinal (GI) endoscopy is a medical field that has been evolving in the last decades. Innovative advances in pediatric endoscopy led to more accurate diagnosis of various GI diseases. This study aimed to assess the appropriateness of endoscopic procedures’ indications and to evaluate the diagnostic and therapeutic yield of pediatric GI endoscopy, considering the limitations to access this facility. Material and Methods. Retrospective, cross-sectional, and analytical chart review was performed for children who underwent GI endoscopy at Salmaniya Medical Complex, Bahrain, from 1995 to 2020. Demographic data, endoscopic indications, and findings were collected and compared. Results. Of 1,111 patients, 1,101 (99.1%) were included in the study. 589 (53.6%) patients were males. Median age at the time of endoscopy was 8 (interquartile range 3, 11) years. 1534 endoscopies were performed (1193 upper GI endoscopies (UGIE) and 341 colonoscopies) in 1296 sessions. The mean number of endoscopies per year was procedures with 81.4% reduction noted after coronavirus pandemic (). Ratio between UGIE to colonoscopy was 3.5 : 1. Median number of endoscopies per patient was one, ranging from one to eight procedures. 1153 (89%) sessions were diagnostic, and 143 (11.0%) were therapeutic. Main endoscopic indication was chronic abdominal pain (451 (40.9%) patients) followed by upper GI bleeding (302 (27.4%) patients). Overall positive yield was 68.1% (716/1052 procedures). Endoscopic yield varies according to the type of procedure (). Colonoscopy alone gave a higher yield (82.6%, 38/46 procedures) compared to combined procedures (75.4%, 141/187) and UGIE alone (65.6%, 537/819). Conclusions. This study emphasizes a careful selection of the type of endoscopic procedures, based on the expected endoscopic yield, to diagnose and treat pediatric GI diseases. In patients with chronic abdominal pain, endoscopy should be reserved as a second-line tool to avoid unnecessary use of invasive procedures.

Research Article

Effects of Phototherapy on the Serum Magnesium Level in Neonates with Indirect Hyperbilirubinemia: A Prospective Cohort Study

Objectives. Neonatal jaundice or hyperbilirubinemia is one of the common findings in neonatal medicine. Severe disease can cause neurological damage and even Kernicterus. Magnesium ion is the most important N-methyl-D-aspartate receptor antagonist. The most commonly used treatment for jaundice is phototherapy, but the effect of phototherapy on serum magnesium is less investigated. In this study, we aim to investigate the effects of phototherapy on total serum magnesium levels in icteric neonates. Methods. This prospective cohort study was carried out on 160 neonates with jaundice referring to the Besat Hospital of Hamadan. Based on the bilirubin level, newborns were divided into three subgroups of mild, moderate, and severe disease which were subjected to single, double, and intensive phototherapy, respectively. Serum bilirubin and magnesium levels were measured before and after phototherapy and compared using parametric tests. Results. Subjects have a mean intrauterine age of 38.8 weeks and a jaundice onset age of 3.8 days. In all groups, serum magnesium levels were within the normal range before phototherapy. After phototherapy, on the other hand, the most reduction of total serum magnesium was in the double phototherapy group, which was (). The change in serum magnesium level was not significant in the single phototherapy () and intensive phototherapy () groups (). Conclusion. In the present study, serum magnesium did not increase significantly before the treatment in three groups. After treatment, a significant reduction was seen in the double phototherapy group.

Review Article

Effect of Massage Therapy for the Treatment of Neonatal Jaundice: A Systematic Review and Dose-Response Meta-analysis

Background. The effectiveness of massage therapy in the treatment of neonatal jaundice has been established in previous literature, but how much the level of massage can reduce the mean of bilirubin in neonates with jaundice is a question that has been addressed in this review. Methods. Four electronic databases, including Cochrane, PubMed, Scopus, and Web of Science, were searched for relevant literature. For the dose-response association between massage therapy and treatment of neonatal icterus, we conducted a meta-analysis using the random-effects model. For any level of intervention, we calculated the overall mean difference (MD) with 95% confidence intervals (CI). Results. Twenty studies were included in our meta-analysis. There was a positive and significant increasing dose-response trend between massage therapy and the mean reduction of bilirubin in neonates with hyperbilirubinemia as follows: <50 minutes massage during the experiment -0.36 (95% CI: -0.67, -0.06; %), 50-60 minutes massage during the experiment -0.41 (95% CI: -0.95, 0.13; %), and ≥101 minutes massage during the experiment -1.20 (95% CI: -1.63, -0.78; %). The heterogeneity across studies was mild to moderate. Conclusions. The presence of a dose-response relationship favors the causal relationship between massage therapy and reduction of neonatal jaundice.

Research Article

Analysis of Fluid Balance as Predictor of Length of Assisted Mechanical Ventilation in Children Admitted to Pediatric Intensive Care Unit (PICU)

Background. Ventilator-associated lung injury (VALI) is a devastating complication of assisted mechanical ventilation (AMV) and is one of the root causes of prolonged AMV. Many strategies were made to decrease the effect of the same. This study is conducted to determine the association of prolonged AMV with fluid balance and pediatric index of mortality 2 (PIM2) score. Methods. This prospective observational study was carried out in a PICU of a tertiary care centre over a period of 12 months. Patient’s fluid balance was calculated by tabulating fluid input-output over initial 48 hours of AMV. The PIM2 score on admission was documented. The association between qualitative variables was assessed by a chi-square test. Comparison of quantitative data measured between cases with duration of and <7 days was done using the Mann–Whitney test. Correlation between quantitative data was done by using the Pearson product moment correlation. Results. Out of 40 patients, 27 patients who had ≥15% positive fluid balance required prolonged mechanical ventilation. Similarly, 27 patients with required prolonged AMV. On applying the Pearson chi-square test, we found a significant association between positive fluid balance and prolonged mechanical ventilation ( (<0.05)). Likewise, a statistically significant association was found between PIM2 score and prolonged ventilation ( (<0.05)). Conclusion. There is a significant association of prolonged AMV with positive fluid balance (>15%) and PIM2 score (>5). By strict maintenance of fluid balance with appropriate intervention, the length of AMV and PICU stay can be decreased.

Research Article

The Effectiveness of Synbiotic on the Improvement of Clinical Symptoms in Children with Eosinophilic Esophagitis

Background. Eosinophilic esophagitis (EoE) is an allergic inflammatory disorder of the esophagus. Today, probiotics are included as adjuvant therapy in the treatment of allergic diseases. The aim of this study was to assess the effect of synbiotic on clinical symptom improvement in EoE patients. Methods. This study is designed by a double-blind, placebo-controlled clinical trial with two parallel groups, which was performed on 30 children with eosinophilic esophagitis. All participants were children aged 6 months to 15 years. Both groups received the same treatment (elimination diet, topical steroid, and proton pump inhibitor). A synbiotic (KidiLact) was added to the medication regimen of 15 patients (case), while the next 15 patients received a placebo (control). Severity and frequency of symptoms were assessed with a checklist derived from a validated scoring tool in both groups before and after 8 weeks of treatment. Results. There was a significant reduction in the severity score of chest pain and poor appetite ( value < 0.05) in the case group taking probiotics, while nausea and poor appetite were the only symptoms with a significant reduction in the frequency score after intervention in this group. Conclusion. Probiotics can be used as adjuvant treatment for patients with EoE. Improvement in the severity of chest pain and poor appetite and reduction in the frequency of nausea and poor appetite in these patients can be seen.

International Journal of Pediatrics
 Journal metrics
See full report
Acceptance rate14%
Submission to final decision69 days
Acceptance to publication19 days
CiteScore-
Journal Citation Indicator0.690
Impact Factor-
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Article of the Year Award: Outstanding research contributions of 2020, as selected by our Chief Editors. Read the winning articles.