Impact of omega-3 supplementation on children and adolescents patients with cystic fibrosis: A systematic review and meta-analysis of randomized-controlled trials.

OBJECTIVE: Clinical trial research have provided evidence that omega-3 may have larger potential benefits for treating cystic fibrosis (CF). This study's objective was to assess the impact of three supplementation on pediatric CF patients. METHODS: Scopus, PubMed/Medline, Web of Science, Cochrane, and Embase databases were searched from commencement until July 20, 2022 using standard keywords to identify all randomized controlled studies (RCTs) examining the effects of omega-3 supplementation on young patients with CF. The eligible studies were subjected to a random-effects model meta-analysis. RESULTS: A meta-analysis of 12 the eligible studies was performed. Findings of the study showed that omega-3 supplementation significantly increased the levels of docosahexaenoic acid (weighted mean [WMD]: 2.06%, 95% confidence interval [CI]: 1.29, 2.82, p < 0.001) and eicosapentaenoic acid (WMD: 0.32%, 95% CI: 0.15, 0.48, p < 0.001) as well as decreased arachidonic acid (WMD: -0.78%, 95% CI: -1.50, -0.05, p = 0.035) and C-receptive protein (CRP) (WMD: -3.76 mg/L, 95% CI: -7.42, -0.10, p = 0.044) especially when used in higher doses and for a longer period of time compared to the control group. However, no significant effect was observed on other factors including forced expiratory volume 1, forced vital capacity as well as anthropometric parameters. In addition, high heterogeneity was reported for all fatty acids, but heterogeneity was low and nonsignificant for other variables. CONCLUSION: The finding showed that in pediatric patients with CF, omega-3 supplementation showed benefits only in plasma fatty acid profile and serum CRP.

Impact of Omega-3 supplementation on homocysteine levels in humans: A systematic review and meta-regression analysis of randomized controlled trials.

AIMS: Although some evidence suggests that omega-3 polyunsaturated fatty acids (PUFAs) supplementation influences enzymes involved in forming homocysteine (Hcy) and improving hyperhomocysteinemia, these findings are still contradictory in humans. The aim of this systematic and meta-analysis study was to investigate the effects of omega-3 supplementation on Hcy using existing randomized controlled trials (RCTs). DATA SYNTHESIS: Available databases, including PubMed/MEDLINE, Web of Science, Scopus, Cochrane Library, and Embase, were searched to find relevant RCTs up to June 2021. The effect size was expressed as weighted mean difference (WMD) and 95% confidence interval (CI). CONCLUSION: A total of 20 RCT studies with 2676 participants were included in this article. Our analyses have shown that omega-3 supplementation significantly reduced plasma Hcy levels (WMD: 1.34 µmol/L; 95% CI: 1.97 to -0.72; P < 0.001) compared to the control group. The results of subgroup analysis showed that omega-3 supplementation during the intervention <12 weeks and with a dose ≥3 gr per day causes a more significant decrease in Hcy levels than the intervention ≥12 weeks and at a dose <3 gr. In addition, omega-3 supplements appear to have more beneficial effects in individuals with high levels of normal Hcy. This meta-analysis showed that omega-3 supplementation significantly improved Hcy. However, further studies are needed to confirm the findings.

Therapeutic actions in a 2-month-old child with teratoma and duodenal malrotation accompaniment.

Introduction: and importance: A mature mediastinal teratoma is a rare type of tumor that can contain fully developed tissues and it is usually considered benign, more common in female and may require surgical removal. The most common locations for teratomas are the tailbone (coccyx), ovaries, and testicles, but in this case, the teratoma was located in the mediastinum. Case presentation: Furthermore, intestinal malrotation could potentially lead the patient to gastrointestinal (GI) obstruction and PO intolerance. Here, we present a 2-month-old patient with considerable manifestation of GI intolerance due to intestinal malrotaion accompanied by mature mediastinal teratoma. Clinical discussion: An evaluation of malrotation should be part of every upper GI tract examination in pediatric patients, particularly newborns and infants. Conclusion: Finally, in this case, surgical intervention could enhance both malrotation and mediastinal teratoma.

Extraintestinal manifestation of inflammatory bowel disease and associated factors in pediatric patients.

OBJECTIVE: Extraintestinal manifestations in irritable bowel disease (IBD), Crohn's disease and ulcerative colitis are reported in different system of the body. We aimed to investigate the factors determining disease severity and evaluate extraintestinal manifestations in patients with irritable bowel disease based on disease activity scoring system. METHODS: This cross-sectional study was conducted on all patients with irritable bowel disease referred to clinic and gastroenterology ward of (XXX). Medical history, gastrointestinal complications and incidence of extraintestinal manifestations were recorded. Disease severity in ulcerative colitis was rated based on PUCAI (Pediatric Ulcerative Colitis Activity Index) score and in Crohn's disease was calculated based on PCDAI (Pediatric Crohn's Disease Activity Index) score. RESULTS: Of 73 children included in our study, 54.80% were diagnosed with ulcerative colitis and 45.20% were diagnosed with Crohn's disease. The most prevalent symptom was weight loss (81.81%), diarrhea (72.72%) and abdominal pain (69.69%) in Crohn's diseases and bloody diarrhea (80%), abdominal pain (77.5%) and weight loss (57.5%) in ulcerative colitis. The average of PCDAI score was 43.44 and PUCAI score was 35.62. The most prevalent extraintestinal manifestation of the disease was arthritis in 7 Crohn's disease patients (21.21%) and 5 patients (12.5%) with ulcerative colitis, oral plague in 5 patients (15.15%) with Crohn's disease and erythema nodosum in 2 patients (6.06%) with Crohn's disease. CONCLUSION: The severity of oral plaque was positively associated with the severity of the disease. There was no significant association among other parameters. Scoring systems, to determine the extraintestinal manifestation, should be standardized based on the scoring outcomes.

Infected urchus cyst in a teenage girl.

We report the case of a 16-year-old girl who complained of stomach discomfort. She's been on medical therapy for roughly 6 months after being diagnosed with Crohn's disease. Magnetic resonance enterography confirmed the diagnosis of an infected urachal cyst, and she eventually had surgery. The removed material had a significant chronic inflammatory and foreign body type granulomatous response, according to histology. Because urachal cyst is an uncommon disease, early identification requires a high level of suspicion, and urachal cyst should be included in the differential diagnosis.