ABSTRACT
Purpose@#The impact of coronavirus 2019 (COVID-19) on gastrointestinal (GI) endoscopy procedures in adults has been reported, with a drastic reduction in the number of procedures.However, there are no sufficient data regarding the impact on pediatric GI endoscopy. Here, we aimed to report that impact in the Asia-Pacific region. @*Methods@#A questionnaire-based internet survey was conducted from June to November 2021 among pediatric endoscopy institutions in the Asia-Pacific region, with each institution providing a single response. Overall, 25 questions focused on the impact of the number of procedures conducted, the usage of personal protective equipment (PPE), and endoscopy training programs during the pandemic. @*Results@#A total of 162 institutions across 13 countries in the Asia-Pacific region participated in the study, and 133 (82.1%) institutions underwent procedure changes since the emergence of COVID-19. The number of esophagogastroduodenoscopy and ileocolonoscopy procedures decreased in 118/133 (88.7%) and 112/133 (84.2%) institutions, respectively. Endoscopy for patient with positive COVID-19 in an emergency or urgent cases still carried out in 102/162 (62.9%) institutions. Screening of COVID-19 for all patients before endoscopy was done across 110/162 (67.9%) institutions. PPE recommendations varied among institutions.Pediatric gastrointestinal endoscopy training programs were discontinued in 127/162 (78.4%) institutions. @*Conclusion@#This study reports the impact of the COVID-19 pandemic on pediatric gastrointestinal endoscopy in the Asia-Pacific region. There has been a significant reduction in the number of endoscopic procedures and relevant training programs.
ABSTRACT
PURPOSE: The risk of cardiovascular disease (CVD) has been shown to be associated with systemic inflammation in obese adults with metabolic syndrome (MetS). The aims of this study were to evaluate the prevalence of MetS and its relation to inflammatory markers in obese Thai children. METHODS: A cross-sectional study was conducted. Children with history of endogenous obesity, chronic diseases, drug ingestion, and any acute illness within 2 weeks prior to enrollment were excluded. Their fasting blood glucose (FBG) levels, oral glucose tolerance tests, insulin, lipid profiles, and selected inflammatory markers, including interleukin-6, tumor necrosis factor-alpha, and high-sensitivity C-reactive protein (hs-CRP) levels, were tested. RESULTS: In this study, 58 obese Thai children (female, 20; male, 38) with a mean body mass index z score of 5.1±2.2 were enrolled. The prevalence of MetS and prediabetes was 31% and 17.2%, respectively. None of the children had diabetes. FBG levels, 2-hour glucose levels, and lipid profiles were not statistically different between those with and without MetS. However, obese children with MetS had higher insulin levels and homeostasis model assessment of insulin resistance values. Elevated hs-CRP levels were found in 69% of the cases, although it was not statistically different between the 2 groups. CONCLUSION: We described a substantial prevalence of MetS in Thai obese children. Regardless of MetS status, two-thirds of the obese children had elevated hs-CRP level, indicating subtle ongoing inflammatory process. This chronic inflammation feasibly predisposes them to CVD in the future, even in children without MetS.
Subject(s)
Adult , Child , Humans , Male , Asian People , Blood Glucose , Body Mass Index , C-Reactive Protein , Cardiovascular Diseases , Chronic Disease , Cross-Sectional Studies , Eating , Fasting , Glucose , Glucose Tolerance Test , Homeostasis , Inflammation , Insulin , Insulin Resistance , Interleukin-6 , Obesity , Pediatric Obesity , Prediabetic State , Prevalence , Tumor Necrosis Factor-alphaABSTRACT
Abstract Objective To evaluate electrolyte disturbances in children presenting with acute diarrhea at a tertiary care center, and identify any possible risk factors.Methods This was a retrospective study. Children who were admitted to the pediatric ward due to acute diarrhea were enrolled into this study. The inclusion criteria consisted of 1 month-5 year old children with a history of acute diarrhea (more than 3 loose stools per day or mucus bloody stool) that had a duration of less than 14 days. The patients were assessed clinically by degrees of dehydration. Serum electrolytes were evaluated in all cases.Results Fifty-three patients were included. The mean age was 19.4 months. One half of the patients developed moderate dehydration, whereas, 28.3% and 22.6% had mild and severe dehydra-tion, respectively. Metabolic acidosis, noted in 54.7%, was the most common electrolyte abnormality. Isonatremic dehydration comprised 73.6% of the cases, whereas, 17% and 9.4% presented with hyponatremic and hypernatremic dehydration, respectively. The younger children were predisposed to develop electrolyte abnormalities, particularly metabolic acidosis and hypernatremia. (p
ABSTRACT
Although regurgitation or vomiting can be a functional GI disorder during infancy, patients should be spontaneously resolved before 18 months of age. Thus, children with chronic vomiting, particularly in association with poor weight gain, should be considered for investigation of any possible of intestinal obstruction. Herein, we report a child, presening with chronic non- bilious vomiting, abdominal distension, and failure to thrive, who had been treated initially as GERD and was diagnosed finally as gastric volvulus with diaphragmatic hernia.