Evaluation of the Relationship Between Environmental Factors, Nutrition, and Metabolic Changes in Children Diagnosed With Autism in North Cyprus: A Case-Control Study.

Introduction Autism spectrum disorder (ASD) is a set of neurodevelopmental disorders characterized by deficits in social behaviors and nonverbal interactions. The disorder is believed to be multifactorial regarding etiopathology. This study aimed to investigate the possible risk factors associated with the development of autism in the prenatal and postnatal periods. Methods We conducted an unmatched case-control study composed of 56 autistic cases and 85 control children in North Cyprus. Cases recruited were previously diagnosed by a pediatric psychiatrist as being on the autistic spectrum. Parental questionnaires were distributed, and the collected data were analysed using Statistical Package for the Social Sciences (SPSS) version 24 (IBM Corp, Armonk, NY). Binary logistic regression was used to compute the adjusted odds ratios (aOR), adjusted for possible confounders. Results Our results showed increased odds of developing ASD in mothers with mental disorders such as depression and anxiety (aOR 6.99; 95% CI 1.94 - 25.24), mothers with medical conditions such as Hashimoto's thyroiditis (aOR 2.68; 95% CI 1.06 - 6.78), mothers using aluminum-containing anti-acids (aOR 2.34; 95% CI 1.012 - 5.39), mothers exposed to loud noises during pregnancy (aOR 2.66; 95% CI 1.005 - 7.034), mothers with ≥ two previous miscarriages (aOR 4.19; 95% CI 1.17 -14.97), neonates with birth weight <2500 grams (aOR 4.19; 95% CI 1.16 - 14.84), male gender neonates (aOR 3.26; 95% CI 1.31 - 8.90), and neonates exposed to MRI or CT scan during the first year of life (aOR 6.94; 95% CI 1.15 - 42.07). Decreased odds of ASD development were observed in mothers using multivitamins during pregnancy (aOR 0.35; 95% CI 0.13 - 0.97), mothers consuming slight amounts of baking powder during pregnancy (aOR 0.235; 95% CI 0.09 - 0.60), mothers with threatened abortion (aOR 0.35; 95% CI 0.12 - 0.98), and neonates taking iron supplementation during the first six months of life (aOR 0.38; 95% 0.16 - 0.91). Conclusion There were various maternal and neonatal factors associated with ASD development in North Cyprus. Although there is some evidence to suggest that exposure to specific factors during prenatal or postnatal periods may increase the risk of ASD, there is insufficient evidence that implicates a specific factor for autism etiology. Future studies are recommended to be performed on larger scales to support further the factors associated with ASD development.

Homeopathy for childhood and adolescence ailments: systematic review of randomized clinical trials.

OBJECTIVE: To assess the evidence of any type of therapeutic or preventive intervention testing homeopathy for childhood and adolescence ailments. METHODS: Systematic literature searches were conducted through January 2006 in MEDLINE, EMBASE, AMED, CINAHL, Cochrane Central, British Homeopathic Library, ClinicalTrials.gov, and the UK National Research Register. Bibliographies were checked for further relevant publications. Studies were selected according to predefined inclusion and exclusion criteria. All double-blind, placebo-controlled randomized clinical trials of any homeopathic intervention for preventing or treating childhood and adolescence ailments were included. According to the classification of the World Health Organization, the age range defined for inclusion was 0 to 19 years. Study selection, data extraction, and assessment of methodological quality were performed independently by 2 reviewers. RESULTS: A total of 326 articles were identified, 91 of which were retrieved for detailed evaluation. Sixteen trials that assessed 9 different conditions were included in the study. With the exception of attention-deficit/hyperactivity disorder and acute childhood diarrhea (each tested in 3 trials), no condition was assessed in more than 2 double-blind randomized clinical trials. The evidence for attention-deficit/hyperactivity disorder and acute childhood diarrhea is mixed, showing both positive and negative results for their respective main outcome measures. For adenoid vegetation, asthma, and upper respiratory tract infection each, 2 trials are available that suggest no difference compared with placebo. For 4 conditions, only single trials are available. CONCLUSION: The evidence from rigorous clinical trials of any type of therapeutic or preventive intervention testing homeopathy for childhood and adolescence ailments is not convincing enough for recommendations in any condition.

Asymptomatic pons tuberculoma in an infant with miliary tuberculosis.

Miliary tuberculosis is caused by the hematogenous spread of Mycobacterium tuberculosis and consists of 1.5% of all tuberculosis cases. It is seen mostly in infants because of the immature immune system, and central nervous system CNS involvement is not rare. Tuberculomas are rarely seen in the localized form of CNS tuberculosis, and only 4% are localized in the brain stem. We report a 4.5-month-old infant who deteriorated during follow-up with the diagnosis of cytomegalovirus pneumonia, and afterwards received the diagnosis of miliary tuberculosis. Although the baby had no neurologic abnormality and cerebrospinal fluid findings were normal, cranial MRI revealed contrast enhanced nodular lesions in pons, cerebellum, and right parietal region. The case is presented to intensify the importance of CNS investigation even if the patient with miliary tuberculosis has no neurologic finding.

Asymptomatic pons tuberculoma in an infant with miliary tuberculosis.

Miliary tuberculosis is caused by the hematogenous spread of Mycobacterium tuberculosis and consists of 1.5% of all tuberculosis cases. It is seen mostly in infants because of the immature immune system, and central nervous system (CNS) involvement is not rare. Tuberculomas are rarely seen in the localized form of CNS tuberculosis, and only 4% are localized in the brain stem. We report a 4.5-month-old infant who deteriorated during follow-up with the diagnosis of cytomegalovirus pneumonia, and afterwards received the diagnosis of miliary tuberculosis. Although the baby had no neurologic abnormality and cerebrospinal fluid findings were normal, cranial MRI revealed contrast enhanced nodular lesions in pons, cerebellum, and right parietal region. The case is presented to intensify the importance of CNS investigation even if the patient with miliary tuberculosis has no neurologic finding.