General Pediatrics

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Original Article
General Pediatrics
Effect of 2–6 weeks of systemic steroids on bone mineral density in children
Athira Kuniyil, Somdipa Pal, Namrita Sachdev, Tribhuvan Pal Yadav
Clin Exp Pediatr. 2022;65(5):254-261.   Published online November 18, 2021
Question: Does steroid use for 2–6 weeks in children affect bone mineral content (BMC) or density (BMD)?
Finding: Steroid use for 2–6 weeks significantly decreased BMC and BMD of the whole body, total body less the head, lumbar spine, and distal radius. A significant negative correlation was observed among BMD, duration, and cumulative dose.
Meaning: Steroid use for 2–6 weeks in children negatively affected BMC and BMD.
Clinical note
General Pediatrics
Diabetic ketoacidosis in children induced by coronavirus disease 2019 (COVID-19) diabetic ketoacidosis post-COVID-19 in children
Neha Thakur, Narendra Rai
Clin Exp Pediatr. 2022;65(4):209-210.   Published online November 30, 2021
Original Article
General Pediatrics
Early initiation of breastfeeding and factors associated with its delay among mothers at discharge from a single hospital
J. Jenifer Florence Mary, R. Sindhuri, A. Arul Kumaran, Amol R. Dongre
Clin Exp Pediatr. 2022;65(4):201-208.   Published online October 18, 2021
Background: According to the National Family Health Survey– 4, in India, 78.9% of deliveries occur in institutions, although only 42.6% of new mothers initiate breastfeeding within 1 hour of delivery.
Purpose: To estimate the proportion of early initiation of breastfeeding (EIBF) among new mothers at discharge from a tertiary care hospital and identify the determinants of delayed initiation of breastfeeding among...
Gross motor dysfunction and balance impairments in children and adolescents with Down syndrome: a systematic review
Preyal D. Jain, Akshatha Nayak, Shreekanth D. Karnad, Kaiorisa N. Doctor
Clin Exp Pediatr. 2022;65(3):142-149.   Published online June 11, 2021
Question: What are the primary motor and balance dysfunctions in children with Down syndrome?
Finding: These individuals have gross delays, altered balance, and inefficient compensatory mechanisms.
Meaning: Neuromuscular and musculoskeletal impairments due to the chromosomal abnormality lead to developmental delay. These children also exhibit poor balance with greater instability and inefficient compensatory mechanisms including altered center of pressure displacement and trunk stiffening that predisposes them to falls.
Effect of maternal and child factors on stunting: partial least squares structural equation modeling
Agus Santosa, Essa Novanda Arif, Dinal Abdul Ghoni
Clin Exp Pediatr. 2022;65(2):90-97.   Published online May 4, 2021
Question: What effects do maternal and child factors have on stunting? Are there significant indicators of stunting?
Finding: Child and maternal factors had 49.8% and 30.3% effects on stunting, respectively. The primary child factor was infant formula dose, while the primary maternal factor was nutritional status.
Meaning: More attention to nutritional status during pregnancy and ensuring the appropriate dose of infant formula at ages 6–24 months can prevent stunting.
Review Article
General Pediatrics
A new perspective on cholesterol in pediatric health: association of vitamin D metabolism, respiratory diseases, and mental health problems
Jeana Hong
Clin Exp Pediatr. 2022;65(2):65-72.   Published online December 9, 2021
∙ Pediatric dyslipidemia is associated with several health problems besides cardiovascular diseases.
∙ There is a direct association between pediatric dyslipidemia and low serum vitamin D levels, asthma, and mental health problems regardless of body mass index.
∙ More large-scale nationally representative studies are needed to establish the appropriate cutoff points for the definition of dyslipidemia that is a prerequisite for further epidemiological studies in the Korean pediatric population.
Original Article
General Pediatrics
Global relationship between parent and child obesity: a systematic review and meta-analysis
Ju Suk Lee, Mi Hyeon Jin, Hae Jeong Lee
Clin Exp Pediatr. 2022;65(1):35-46.   Published online March 29, 2021
Question: Are parent and child obesity correlated worldwide?
Finding: Overweight and obese status of parents and children were significantly associated worldwide. The association between parent and child obesity was stronger in Asia than in Europe and the Middle East, and in high-income than in middle- and low-income countries.
Meaning: Childhood obesity is highly influenced by parental weight status, indicating that parents could play an important role in its prevention.
Editorial
General Pediatrics
Is it time to add point-of-care ultrasound education to pediatric residency curriculum?
Shin Ae Yoon
Clin Exp Pediatr. 2022;65(1):33-34.   Published online October 12, 2021
Growing point-of-care ultrasound (POCUS) use in pediatric patients has led to the need for POCUS education for pediatric residents. Recent experimental studies have suggested that POCUS education improves self-rated POCUS confidence and comfort in pediatric resident training. Considering the effective and sustainable POCUS education curriculum in pediatric resident training, simulation-based education would be a solution.
Original Article
General Pediatrics
Efficacy of probiotics for managing infantile colic due to their anti-inflammatory properties: a meta-analysis and systematic review
Reza Shirazinia, Ali Akbar Golabchifar, Mohammad Reza Fazeli
Clin Exp Pediatr. 2021;64(12):642-651.   Published online April 12, 2021
Question: Do probiotics reduce colic symptoms?
Finding: Probiotics reduced colic symptoms in colicky infants probably due to the anti-inflammatory properties.
Meaning: Probiotics may be an effective and less noxious way to manage infantile colic.
Risk factors for childhood pneumonia: a case-control study in a high prevalence area in Indonesia
Vivi Ninda Sutriana, Mei Neni Sitaresmi, Abdul Wahab
Clin Exp Pediatr. 2021;64(11):588-595.   Published online March 15, 2021
Question: Is the incidence of childhood pneumonia influenced by breastfeeding and basic immunization status?
Finding: Exclusive breastfeeding and complete basic immunization status have an effect in limiting the incidence of childhood pneumonia.
Meaning: While exclusive breastfeeding and complete basic immunization the Expanded Program on Immunization status are important factors for reducing the incidence of childhood pneumonia, indoor air pollution was also a significant risk factor.
Letter to the Editor
General Pediatrics
Skipping breakfast is associated with lifestyle habits among Japanese pupils
Jun Kohyama
Clin Exp Pediatr. 2021;64(8):433-435.   Published online November 4, 2020
Question: Breakfast is important; however, adolescents are increasingly skipping it.
Finding: Skipping breakfast is independently associated with sleepiness, physical inactivity, dinner irregularity, screen time on school days, poor academic performance, after-school activity, and decreased sleep duration before school day.
Meaning: Reducing screen time on school days, after-school activity, and irregular dinner habits might decrease breakfast skipping, resulting in decreased sleepiness and improved academic performance.
Hyperinflammatory syndrome in children during the coronavirus disease 2019 pandemic in sub-Himalayan region
Seema Sharma, Shikha Verma, Isha Bhatia, Ravinder Singh, Mohit Bajaj, Milap Sharma
Clin Exp Pediatr. 2021;64(7):370-372.   Published online May 11, 2021
Question: Is there an increase in patients with hyperinflammatory syndrome during the coronavirus disease 2019 pandemic?
Finding: We found 10 patients with hyperinflammatory syndrome with poor outcome during a period of 2 months in a single tertiary care centre.
Meaning: Pediatricians who come across patients with muco cutaneous manifestations and multiorgan involvement should consider hyperinflammatory syndrome. Early recognition and prompt treatment of such patients may result in promising outcome.
Original Article
General Pediatrics
Significance of the tethered maxillary frenulum: a questionnaire-based observational cohort study
Sody A. Naimer, Ariel Israel, Aviezer Gabbay
Clin Exp Pediatr. 2021;64(3):130-135.   Published online September 7, 2020
Question: Does a tethered maxillary frenulum in the newborn result in breastfeeding difficulty or other oral symptomatology?
Finding: The analysis of subjects with a tethered maxillary frenulum surveyed beyond a mean 5-year follow-up did not reveal an increase in oral issues versus those of a random agematched control group.
Meaning: These data demonstrate no need to intervene upon the diagnosis of a tethered maxillary frenulum.
Review Article
General Pediatrics
Association between maternal smoking during pregnancy and risk of bone fractures in offspring: a systematic review and meta-analysis
Erfan Ayubi, Saeid Safiri, Kamyar Mansori
Clin Exp Pediatr. 2021;64(3):96-102.   Published online February 5, 2020
Question: What is the effect of maternal smoking during pregnancy (MSDP) on the risk of bone fractures in the offspring?
Finding: After the adjustment for misclassification, MSDP may be associated with a 27% increased risk of bone fracture in the offspring (pooled odds ratio, 1.27; 95% confidence interval, 1.00–1.62; I2=0%; P=0.537)
Meaning: Preventive measures and health education programs should be designed and implemented to encourage women to stop smoking, especially during.
Clinical features, diagnosis, and outcomes of multisystem inflammatory syndrome in children associated with coronavirus disease 2019
Ji Hee Kwak, Soo-Young Lee, Jong-Woon Choi; the Korean Society of Kawasaki Disease
Clin Exp Pediatr. 2021;64(2):68-75.   Published online December 30, 2020
Hundreds of cases of children and adolescents with hyperinflammatory responses such as Kawasaki disease have been reported amid the coronavirus disease 2019 (COVID-19) pandemic, leading to coining of the new term COVID-19–associated multisystem inflammatory syndrome in children. In this review article, we introduce the illness and describe its case definitions, epidemiology, pathogenesis, clinical features, treatments, and outcomes.
Editorial
General Pediatrics
Why should we be concerned about early menarche?
Hae Sang Lee
Clin Exp Pediatr. 2021;64(1):26-27.   Published online July 13, 2020
· Early menarche is associated with several health problems in later life.
· Early menarche can be caused by environmental factors such as increased subcutaneous fat, a high body mass index, and sugar-sweetened beverages as well as genetic factors.
· Health education can prevent early menarche by aiming to reduce the consumption of fructose, high concentrations of which are present in sugar-sweetened beverages.
Original Article
General Pediatrics
Efficacy of conservative treatment of perianal abscesses in children and predictors for therapeutic failure
Lars Boenicke, Johannes Doerner, Stefan Wirth, Hubert Zirngibl, Mike Ralf Langenbach
Clin Exp Pediatr. 2020;63(7):272-277.   Published online May 15, 2020
Background: The optimal management of perianal abscess in children is controversial.
Purpose: To evaluate the efficiency of conservative treatment of perianal abscess in children and identify parameters that predict therapy failure. Methods: All cases of children younger than 14 years of age with perianal abscesses between 2001–2016 were evaluated. Results: Of the 113 enrolled patients, 64 underwent subsequent surgery for advanced disease (primary...
Ability of children to perform touchscreen gestures and follow prompting techniques when using mobile apps
Savita Yadav, Pinaki Chakraborty, Arshia Kaul, Pooja, Bhavya Gupta, Anchal Garg
Clin Exp Pediatr. 2020;63(6):232-236.   Published online February 5, 2020
Background: Children today get access to smartphones at an early age. However, their ability to use mobile apps has not yet been studied in detail.
Purpose: This study aimed to assess the ability of children aged 2–8 years to perform touchscreen gestures and follow prompting techniques, i.e., ways apps provide instructions on how to use them. Methods: We developed one mobile app...
Letter to the Editor
General Pediatrics
Effectiveness of comprehensive hand hygiene module on preschool children in Klang Valley, Malaysia
Mohd Dzulkhairi Mohd Rani, Nurul Azmawati Mohamed, Tengku Zetty Maztura Tengku Jamaluddin, Zarini Ismail, Shalinawati Ramli, Habibah Faroque, Farishah Nur Abd Samad, Abdul Rasyid Ariffien, Aisyah Ar Redha Che Amir Farid, Ilina Isahak
Clin Exp Pediatr. 2020;63(3):115-116.   Published online February 5, 2020
Perspective
General Pediatrics
Integrative care for children with medical complexity
Jung Lee, Min Sun Kim, Hee Young Shin
Clin Exp Pediatr. 2020;63(2):32-33.   Published online November 14, 2019
Systematic review and meta-analysis
General Pediatrics
The maternal prepregnancy body mass index and the risk of attention deficit hyperactivity disorder among children and adolescents: a systematic review and meta-analysis
Ensiyeh Jenabi, Saied Bashirian, Salman Khazaei, Zohreh Basiri
Clin Exp Pediatr. 2019;62(10):374-379.   Published online June 14, 2019
Background: Attention deficit hyperactivity disorder (ADHD) symptoms have a major impact on individuals, families, and society. Therefore identification risk factors of ADHD are a public health priority.
Purpose: This is meta-analysis evaluated the association between maternal prepregnancy body mass index and the risk of ADHD among the resulting offspring. Methods: The search identified studies published through December 2018 in the PubMed, Web...
Original Article
General Pediatrics
Prevalence of hyperuricemia and its association with metabolic syndrome and cardiometabolic risk factors in Korean children and adolescents: analysis based on the 2016–2017 Korea National Health and Nutrition Examination Survey
Jung Hyun Lee
Clin Exp Pediatr. 2019;62(8):317-323.   Published online June 24, 2019

Purpose: Investigating the prevalence of hyperuricemia and its association with metabolic syndrome (MetS) and cardiometabolic risk factors (CMRFs) in Korean children and adolescents. Methods: This cross-sectional survey used data from the 7th Korea National Health and Nutrition Examination Survey (2016–2017); 1,256 males and females aged 10–18 years were included. Hyperuricemia was defined as serum uric acid levels were >6.6 mg/dL at...
Current use of safety restraint systems and front seats in Korean children based on the 2008–2015 Korea National Health and Nutrition Examination Survey
Seom Gim Kong
Clin Exp Pediatr. 2018;61(12):381-386.   Published online September 19, 2018

Purpose: The use of proper safety restraint systems by children is vital for the reduction of traffic accident-related injury and death. This study evaluated the rates of use of safety restraint systems and front seats by Korean children. Methods: Based on data from the National Health and Nutrition Examination Survey from 2008 to 2015, I investigated the frequencies of safety restraint...
Use of child safety seats during transportation of newborns
Seon Hyuk Kim, Sung Won Park, Yeon Kyung Lee, Sun Young Ko, Son Moon Shin
Clin Exp Pediatr. 2018;61(8):253-257.   Published online August 15, 2018

Purpose: Child safety seats (CSS) are critical for the protection of children, in case of motor vehicle accidents. Although the national legislation mandates that all newborns must be placed in an appropriately installed CSS during transportation, people often do not perceive the importance of CSS and do not use it as recommended. The purpose of this survey was to understand...
Review Article
General Pediatrics
The 2017 Korean National Growth Charts for children and adolescents: development, improvement, and prospects
Jae Hyun Kim, Sungha Yun, Seung-sik Hwang, Jung Ok Shim, Hyun Wook Chae, Yeoun Joo Lee, Ji Hyuk Lee, Soon Chul Kim, Dohee Lim, Sei Won Yang, Kyungwon Oh, Jin Soo Moon; for the Committee for the Development of Growth Standards for Korean Children and Adolescents, the Committee for School Health and Public Health Statistics; the Committee for School Health and Public Health Statistics; the Korean Pediatric Society, and Division of Health and Nutrition Survey; Korea Centers for Disease Control and Prevention
Clin Exp Pediatr. 2018;61(5):135-149.   Published online May 28, 2018

Growth charts are curves or tables that facilitate the visualization of anthropometric parameters, and are widely used as an important indicator when evaluating the growth status of children and adolescents. The latest version of the Korean National Growth Charts released in 2007 has raised concerns regarding the inclusion of data from both breastfed and formula-fed infants, higher body mass index...

Original Article
General Pediatrics
Sudden unexpected cardio-respiratory arrest after venipuncture in children
Goun Jeong, Son Moon Shin, Nam Su Kim, Young Min Ahn
Clin Exp Pediatr. 2018;61(4):108-113.   Published online April 23, 2018
Purpose

This study aimed to investigate the clinical and socioenvironmental characteristics of sudden cardiorespiratory arrest after venipuncture in children.

Methods

We conducted a retrospective email-based survey of all members of the Korean Pediatric Society. The questionnaire included items on patient demographics, socioenvironmental circumstances of the venipuncture, type of cardiorespiratory arrest, symptoms and signs, treatment, prognosis, and presumed cause of the arrest.

Results

Fourteen patients were...

Review Article
General Pediatrics
Quality improvement in pediatric care
Moon Sung Park
Clin Exp Pediatr. 2018;61(1):1-5.   Published online January 22, 2018

We often overlook the importance of several safety issues such as identification of patients, timeout procedure, hand hygiene, handoff communication, and many others. This ignorance, along with many other issues, leads to medical error being ranked as a third leading cause of death in the U.S. Consequently, quality improvement (QI) has become one of the major subjects in healthcare despite...

Original Article
General Pediatrics
Sleep problems in children and adolescents at pediatric clinics
Dong Soon Kim, Cho Long Lee, Young Min Ahn
Clin Exp Pediatr. 2017;60(5):158-165.   Published online May 31, 2017
Purpose

To investigate the frequency of childhood sleep problems at pediatric clinics in Seoul and Gyeonggi provinces.

Methods

Children (n=936) and their parents who visited 5 primary and 1 secondary pediatric outpatient clinics were invited to complete a Pediatric Sleep Questionnaire.

Results

Among patients, 901 (96.3%) answered questionnaires in sufficient detail for evaluation. The participant's mean age was 4.35±3.02 years (range, 0–18 years). The male...

The correlation of depression with Internet use and body image in Korean adolescents
Chang Hoon Lim, Eun Ji Kim, Jong Hyun Kim, Jue Seong Lee, Yoon Lee, Sang Hee Park
Clin Exp Pediatr. 2017;60(1):17-23.   Published online January 24, 2017
Purpose

To examine the correlation of depression with Internet use and body image perception, and to analyze the risk factors of depression in a total of 920 students in Seoul, Korea.

Methods

Students were recruited by contacting school principals and teachers and were encouraged to fill out a self-report questionnaire designed specifically for this study in July of 2008.

Results

Female participants had an increased...

Case Report
General Pediatrics
Accidental ingestion of E-cigarette liquid nicotine in a 15-month-old child: an infant mortality case of nicotine intoxication
An Deok Seo, Dong Chan Kim, Hee Joon Yu, Min Jae Kang
Clin Exp Pediatr. 2016;59(12):490-493.   Published online December 31, 2016

Electronic cigarettes are novel tobacco products that are frequently used these days. The cartridge contains liquid nicotine and accidental poisoning, even with a small oral dose, endangers children. We present here a mortality case of a 15-month-old child who ingested liquid nicotine mistaking it for cold medicine. When the emergency medical technicians arrived, she was found to have pulseless electrical...

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