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Raza J.,National Institute of Child Health | Mazen I.,National Research Center of Egypt
Endocrine Development | Year: 2014

Disorders of sex development are complex disorders with atypical chromosomal, gonadal or anatomical sex. Decision making in relation to sex assignment has been perceived as extremely disturbing and difficult for families and healthcare professionals. This is mainly due to a general paucity of information about the condition, lack of advanced diagnostic settings, and an exaggerated feeling of stigma and shame associated with genital abnormalities. Lack of accurate healthcare information and reporting results in poor knowledge about the exact incidence and impact of these disorders in resource-poor countries. Lack of neonatal screening facilities for congenital adrenal hyperplasia often results in delayed diagnosis of these disorders and perhaps a higher number of deaths, especially in male children who lack ambiguity of genitalia. Technically more sophisticated investigations are often not available or affordable, posing further difficulties in establishing a diagnosis. Limited resources also include the lack of availability of adequately trained personal. Thus, the establishment of the recommended and necessary multidisciplinary team is often hard to accomplish in these countries. This seriously compromises the ability to manage these children properly. Finally, countries in places like Southeast and Far East Asia and sub-Saharan Africa are often accompanied with their unique cultural and social issues, filled with myths and misconceptions, which worsens the already complex situation. Thus, a huge limitation exists in dealing with these children with disorders that are complex to diagnose and manage, even in countries with advanced and well-equipped medical facilities. © 2014 S. Karger AG, Basel.

Couples who wish to get pregnant may want to avoid caffeine because it's associated with an increased risk of miscarriage, a new study from the National Institutes of Health (NIH) suggests. For women, drinking more than two caffeinated drinks daily before getting pregnant was associated with a 74 percent higher risk of a miscarriage, according to the study published today (March 24) in the journal Fertility and Sterility. But women's caffeine consumption wasn't the only factor: Among couples in which the male partner drank more than two caffeinated beverages daily before conception, there was a 73 percent higher risk of a miscarriage, according to the study. [6 Myths About Miscarriage] "Our findings indicate that the male partner matters, too," Germaine Buck Louis, the director of Intramural Population Health Research at the National Institute of Child Health and Development and lead author on the study, said in a statement. "Male pre-conception consumption of caffeinated beverages was just as strongly associated with pregnancy loss as females'," Buck Louis said. The study included 501 couples in Michigan and Texas who had stopped using contraception and were trying to become pregnant. The couples were instructed to keep daily journals of their lifestyle behaviors, including smoking cigarettes and drinking alcohol and caffeinated beverages, according to the study. Couples who got pregnant within a year continued in the study until they gave birth or experienced a miscarriage, according to the study. Of the 344 couples who became pregnant, 98 experienced a miscarriage, according to the study. Women 35 and older were nearly twice as likely to miscarry as women younger than 35, according to the study. In addition to the caffeine findings, the researchers also found that women who took a daily multivitamin before and during pregnancy were less likely to have a miscarriage. Women who took a daily multivitamin before getting pregnant were 55 percent less likely to miscarry, according to the study. And women who continued to take the multivitamin during early pregnancy had a 79 percent lower miscarriage risk, according to the study. The protective effect from the multivitamin may come from the folate and vitamin B6 found in a multivitamin, both of which have been linked to decreased risk of miscarriage, according to the study. The study only showed an association between caffeine intake and miscarriage, and did not prove cause and effect. Previous studies have shown similar results, although the potential mechanism is still unknown, according to the study. The authors did note, however, that the findings of the study do not necessarily mean that drinking decaf instead of regular coffee is safer, as the study did not include information on decaffeinated drinks, they wrote. Couples may want to limit their caffeine intake to fewer than three daily beverages, and women should continue to to be advised to take daily multivitamins before and during pregnancy, the researchers wrote in their conclusion. Copyright 2016 LiveScience, a Purch company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Vandenplas Y.,Vrije Universiteit Brussel | Alarcon P.,National Institute of Child Health
Beneficial Microbes | Year: 2015

Regurgitation, constipation, excessive crying/fussiness, infantile colic and gassiness are frequent GI manifestations in young infants and result in numerous visits to paediatricians and in many cases in unnecessary change of formulas. The aim of this study was to offer paediatricians consensus based and simple algorithms for the management of the most frequent GI symptoms in infants. Paediatric gastroenterologists processed practical algorithms to assist general practitioners and general paediatricians. Four such practice recommendations were developed, based on the in 2013 published algorithms after an updated literature review. These algorithms cannot be considered as an 'evidence based guideline'. To date, these algorithms are the result of a consensus based on the available literature and the algorithms published in 2013. © 2014 Wageningen Academic Publishers.

Nordahl H.,Copenhagen University | Krolner R.,University of Southern Denmark | Pall G.,National Institute of Child Health | Currie C.,University of Edinburgh | Andersen A.,University of Southern Denmark
Journal of Adolescent Health | Year: 2011

Purpose: Indicators such as country of birth and language spoken at home have been used as proxy measures for ethnic background, but the validity of these indicators in surveys among school children remains unclear. This study aimed at comparing item response and studentparent agreement on four questions about country of birth and language spoken at home in three European countries. Methods: We analyzed data from the Health Behaviour in School-aged Children (HBSC) ChildParent Validation Study 2005, including 486 matched studentparent pairs from Denmark, Hungary, and Scotland. Selected items from the internationally standardized HBSC questionnaire were completed by 11-year-old students and their parents. We examined item response and studentparent agreement on the four HBSC Ethnic Background Indicators: the student's country of birth, mother's country of birth, father's country of birth, and language usually spoken at home. Results: All item response rates were high for both students (>92%) and parents (>96%). The percent studentparent agreement was high on all four items (>97%). The strength of agreement ranged from good to excellent for all items indicated by the kappa value (between.60 and 1.00). Results were robust across countries. Conclusions: Our findings suggest that students as young as 11 years are able to provide valid responses to four simple questions about country of birth and language spoken at home. The four HBSC Ethnic Background Indicators can be useful in epidemiologic studies on identification of subgroups that may receive unequal prevention services or in assessment of how risk factors, symptoms, and diseases may differ by ethnic background among school children. © 2011 Society for Adolescent Health and Medicine. All rights reserved.

Shams S.,National Institute of Child Health
Pakistan Paediatric Journal | Year: 2012

Objective: to find frequency of low birth weight (LBW) and maternal factors associated with it. Place of Study Department of Obstetrics and Gynaecology, Sir Syed Hospital (Private Teaching Hospital) of Sir Syed College of Medical and Dental Sciences for Girls, Karachi. Methods and materials: A cross-sectional hospital based study, was undertaken in the department of Obstetrics and Gynaecology of a private teaching hospital in Karachi (PK) over a period of 2 years on 832 singleton live births. Data of 832 mothers and their newborns was collected at the time of delivery either from mothers or their close attendants Results: Of 832 babies, 95.3% were term, 4.7% preterm and mean birth weight was 2900 ± 500 gm. There were 52.5% males and 47.5% females. 99 were LBW having frequency of rate 11.98%. In LBW babies, 60 were term and 39 preterm (52 males and 47 females). Statistics revealed, lack of antenatal care (p value = 0.0139), parity more than 1, anaemia (Haemoglobin less than 10gm %), Pregnancy induced hypertension (maternal BP systolic > 140mm of Hg and diastolic > 90mm of Hg), antepartum haemorrhage Urinary Tract Infection in mothers were significant risk factors (p value(s) = 0.0000) while sex of baby and maternal age were not significant risk factors for LBW. Conclusion: Our findings indicate that parity, anaemia (Haemoglobin less than 10 gm %), PIH, APH, UTI and lack of antenatal care in mothers were highly significant factors for LBW.

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