Vitamin D deficiency in patients with cystic fibrosis: a systematic review and meta-analysis.

AIM: Vitamin D is a prominent modulator of immunity and respiratory function. It plays a vital role in respiratory diseases such as cystic fibrosis (CF). S. However, there is a dearth of information on patients with CF. The purpose of the meta-analysis is to highlight the importance of following the existing guidelines regarding maintenance of Vitamin D serum levels in patients with CF. METHODS: The systematic search was conducted without utilizing any time or language limitations in original database from the beginning until March 2022. The meta-analysis was performed using a random-effects model. Heterogeneity was determined by I2 statistics and Cochrane Q test. RESULTS: Pooled analysis using the random-effects model of the 8 case-control studies with 13 effect sizes revealed that the serum 25-OH-vitamin D in participants with cystic fibrosis was significantly lower than controls in pediatrics and adolescences (WMD: - 3.41 ng/ml, 95% CI - 5.02, - 1.80, p = < 0.001) and adults (WMD: - 2.60 ng/ml, 95% CI - 4.32, - 0.89, p = 0.003). Based on data from 12 studies (21 effect sizes) with a total of 1622 participants, the prevalence of vitamin D levels of 20-30 ng/ml in CF patients was 36% among pediatrics/adolescents and 63% among adults. In addition, 27% of pediatric/adolescent CF patients and 35% of adult CF patients had vitamin D levels of below 20 ng/ml. CONCLUSIONS: As a result, according to the existing guidelines, our results proved the need to pay attention to the level of vitamin D in these patients.

Clinical Efficacy of Persian Medicine Diet Combined with Western Medicine-Based Diet on Proteinuria in Pediatric Nephrotic Syndrome: A Randomized Controlled Clinical Trial.

Introduction: Nephrotic syndrome (NS) is a common chronic kidney disorder during childhood. The most important characteristic of this disease is proteinuria. The Persian medicine (PM) has important dietary recommendations for strengthening the kidney function and treatment of this disease. The aim of this study was to investigate the effect of a diet including PM recommendations and general principles of Western medicine. Materials and Methods: Twenty children with nephrotic syndrome were randomly divided into intervention and control groups and monitored for one month. The control group received a diet based on the general principles of Western medicine. In the intervention group, in addition to the Western medicine diet, dietary recommendations of PM were also prescribed including the pomegranate (Cydonia oblonga mill.), quince (Cydonia oblonga mill.), and whole grains (wheat and barley). A 24-hour dietary questionnaire was applied and anthropometric and biochemical indices including spot urine protein (proteinuria), albumin (Alb), urea, creatinine (Cr), total cholesterol (TC), and triglyceride (TG) were measured before and after the study. Results: The amount of protein intake reduced significantly in the diet of both groups but the differences between the two groups were not significant. Proteinuria reduced significantly in both the Western and PM groups; however, proteinuria was significantly lower in the Persian medicine group compared to the control group. TC and Cr levels reduced significantly in the intervention group, although the changes were not significant compared to the control group. Conclusion: The results of this study showed that adding dietary recommendations of the Persian medicine to the general rules of the Western medicine diet reduced proteinuria and improved the combat against nephrotic syndrome.

Traditional, complementary and alternative medicine in children constipation: a systematic review.

OBJECTIVES: This review aims to evaluate the efficacy and safety of complementary and alternative medicine methods for constipation in the pediatric population. EVIDENCE ACQUISITION: Medical literature search was performed in several databases for a variety of Traditional, Complementary and Alternative Medicine in childhood constipation. Databases included Web of Science, Scopus, Embase, Cochrane Library, PubMed, ScienceDirect, Google scholar and a number of Persian databases including IranDoc, Magiran and SID. No time limitation was determined. Clinical trials or case series that had evaluated the effectiveness of CAM therapies in functional constipation of 1-18 year old children were included. Papers not in English or Persian language were excluded. Related articles were screened independently by two reviewers according to their titles and abstracts. A data extraction form was filled in for each eligible paper. Quality assessment of eligible documents was also performed. RESULTS: 30 studies were included, comprising 27 clinical trials and 3 case series. Ten documents were on herbal medicine, nine on traditional medicine, ten on manual therapies and one on homeopathy. Except for two herbal and one reflexology interventions, all studies reported positive effects on childhood constipation, with the majority being statistically significant. As the number of studies in each method was limited, we could not perform a meta-analysis. CONCLUSION: The scarcity of research on the efficacy and safety of different types of complementary and alternative medicine methods in children with constipation necessitates conducting more studies in each field. Graphical abstract.

Effect of sweet almond syrup versus methylphenidate in children with ADHD: A randomized triple-blind clinical trial.

BACKGROUND AND PURPOSE: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common health disorders among children. Some patients do not respond to methylphenidate or cannot tolerate its side effects. Sweet almond syrup as a Persian Medicine preparation has been used for many years. This study aims to evaluate the efficacy and safety of sweet almond for ADHD children. MATERIALS AND METHODS: Fifty children aged 6-14 years with ADHD were recruited to the study. The participants were randomly assigned to two groups to receive either methylphenidate or sweet almond syrup. The outcomes were assessed using the Parent and Teacher ADHD Rating Scale every two weeks for 8 weeks. RESULTS: Results showed that the two treatments had similar effects on symptom reduction in ADHD children. No significant differences were observed between the two groups (F=2.3, df=1, p=0.13, F=0.57, df=1, p=0.47). CONCLUSION: Sweet almond may be an effective treatment for ADHD children.

Prevention and treatment of constipation in children from the perspective of Iranian traditional medicine.

Constipation is one of the most common complaints of children and a common cause of referrals to pediatricians. Numerous reasons for this disease have been mentioned in the Iranian traditional medicine (ITM). It is believed that this disorder is mostly due to the lack of consideration of the six essential principles (Setteh-ye-Zarurieah), which are necessary to maintain health and prevent disease. In this descriptive study we collected and classified the concepts related to the topic by reviewing reliable ITM text books. Scientific databases were also searched for the most commonly used herbs in the treatment of constipation. The results showed that, from the perspective of ITM, the first step in treating constipation in children is making lifestyle changes. This includes giving appropriate training in the six essential principles, and making modification in existing habits where necessary. In the next steps, using some herbal remedies for topical or oral administration is recommended. On the other hand, a few clinical trials have been done concerning the effects of herbal medicines on pediatric constipation. Therefore, ITM's preventive and curative strategies can provide an efficient and cost-effective way to address constipation in children. This study can serve as a preface to performing clinical studies in this field.