Background: Obesity, particularly in the upper part of the body, is a major health problem. Measuring the neck circumference (NC) and wrist circumference (WrC) is a relatively new method of differentiating between normal and abnormal fat distributions. This study aimed to evaluate the association of NC, hip circumference (HC), and WrC with different phenotypes of obesity and their metabolic status.Methods: In this multi-centric cross-sectional study, 4,200 students aged 7–18 years were selected from 30 provinces in Iran in 2014 by using a multistage cluster random sampling method. Metabolic syndrome (MetS) was defined based on the ATP III criteria modified for the pediatric age group. The subjects were classified into four groups according to their weight and metabolic status: metabolically healthy obese (MHO), metabolically non-healthy non-obese (MNHNO), metabolically non-healthy obese (MNHO), and metabolically healthy non-obese (MHNO).Results: Significant but different associations of NC, HC, and WrC with obesity phenotypes were documented in the entire population. Significant but different associations of NC, HC, and WrC with metabolic phenotypes were also found in the entire population. In the multinomial logistic regression, the association of the different obesity phenotypes with the study anthropometric indices increased significantly with increasing NC, WrC, and HC. Also, per one unit increment in NC, HC, and WrC, the odds of MHO, MNHNO, and MNHO increased compared to that of the MHNO phenotype.Conclusion: In children and adolescents, HC, NC, and WrC are significantly associated with obesity phenotypes and their metabolic status, and these metrics are suggested to be innovative, low-cost, and alternative tools for assessing them in different age and sex pediatric age groups.
Background:The aim of the study was to compare the serum zinc level and eating behaviors in 2–8-year-old children with and without arbitrarily zinc supplementation.Materials and Methods:This case–control study was conducted from December 2015 to December 2017 in Isfahan, Iran. The case group consisted of seventy children, aged 2–8 years, who have received zinc supplement without physician prescription; the controls were an equal number of age-matched children who did not receive any supplement. The serum zinc level was measured, and eating behaviors were identified using Children's Eating Behavior Questionnaire (CEBQ).Results:There was no significant difference in serum zinc level between two groups (P = 0.18). Some differences in CEBQ subscales were identified between the groups studied. In the control group, the subscale of enjoyment of food was higher than the case group (P < 0.001). In the case group, the subscales of food fussiness and satiety responsiveness were higher than controls (P < 0.001).Conclusion:In this study, serum zinc levels were not significantly different between the two groups, and arbitrarily zinc supplementation does not play an important role in improving anorexia subscales.
Background: The early determination and treatment of lung exacerbation have a significant role in increasing the health and quality of life in patients with cystic fibrosis. The Multiple-breath washout (MBW) technique was used to discriminate between health and disease of the lungs recently, however, its role in the prediction of upcoming exacerbation is not clear .This study aims to clarify this ambiguity. Methods: We recruited 60 clinically stable children with cystic fibrosis who were coming to the CF clinic for periodic care. In addition to the routine pulmonary function tests (PFT), we performed MBW technique for all subjects as an annual assessment. Subsequently, in the follow-up period, we admitted all patients who had experienced exacerbation within two weeks after the MBWT for proper antimicrobial therapy. During admission, we reevaluated the PFT results of hospitalized subjects and compared them with the PFT results of subjects who had no exacerbation. Results: Overall 55 subjects finished the trial; 18 cases (32.7%) were hospitalized and 37 patients (67.3%) were not hospitalized. The LCI5% variable had no significant difference between hospitalized and non-hospitalized groups. The median of the LCI2.5% in the hospitalized group (13.26) was greater than in the non-hospitalized group(7.82), this difference was statistically significant (P = 0.0001). The mean value of M2 /M0 in hospitalized patients (16.31) was greater than in non-hospitalized patients (5.97) and this difference was statistically significant (P = 0.0001). Conclusion: Our study outcomes had a valuable ability to predict exacerbation, however, this hypothesis requires further studies with larger sample sizes.
: The patient was an 11-year-old boy who was referred to our emergency department with a chief complaint of dry cough and shortness of breath. He was diagnosed with asthma when he was three years old and was treated with inhalers as needed. On physical examination, he had respiratory distress and biphasic wheezing. The patient was initially managed as an asthma attack; however, he did not respond to the treatment completely. After a pulmonology consult, he underwent a spirometry test, which was compatible with an obstructive pattern. He was a candidate for fiberoptic bronchoscopy, which revealed findings in favor of vocal cord dysfunction (VCD) and adult-onset laryngomalacia. As part of the management of VCD, we referred him to a psychiatric clinic, evaluating for psychological problems as aggravating factors. We found that he suffered from psychological disorders, including somatic symptoms disorders and mild to moderate depression. The patient was treated for his psychiatric problems. He responded to the treatment well, and the cough and dyspnea attacks resolved gradually after a few months.
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