Prevalence, risk factors and parental perceptions of gastroesophageal reflux disease in Asian infants in Singapore

INTRODUCTION@#Infant gastroesophageal reflux disease (GERD) is a significant cause of concern to parents. This study seeks to describe GERD prevalence in infants, evaluate possible risk factors and assess common beliefs influencing management of GERD among Asian parents.@*METHODS@#Mother-infant dyads in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO) cohort were prospectively followed from preconception to 12 months post-delivery. GERD diagnosis was ascertained through the revised Infant Gastroesophageal Reflux Questionnaire (I-GERQ-R) administered at 4 time points during infancy. Data on parental perceptions and lifestyle modifications were also collected.@*RESULTS@#The prevalence of infant GERD peaked at 26.5% at age 6 weeks, decreasing to 1.1% by 12 months. Infants exclusively breastfed at 3 weeks of life had reduced odds of GERD by 1 year (adjusted odds ratio 0.43, 95% confidence interval 0.19-0.97, P=0.04). Elimination of "cold or heaty food" and "gas producing" vegetables, massaging the infant's abdomen and application of medicated oil to the infant's abdomen were quoted as major lifestyle modifications in response to GERD symptoms.@*CONCLUSION@#Prevalence of GERD in infants is highest in the first 3 months of life, and the majority outgrow it by 1 year of age. Infants exclusively breastfed at 3 weeks had reduced odds of GERD. Cultural-based changes such as elimination of "heaty or cold" food influence parental perceptions in GERD, which are unique to the Asian population. Understanding the cultural basis for parental perceptions and health-seeking behaviours is crucial in tailoring patient education appropriately for optimal management of infant GERD.

Serum hydrogen sulfide levels in children with benign infantile convulsions associated with mild gastroenteritis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the changes and significance of serum hydrogen sulfide (H2S) levels in children with benign infantile convulsions associated with mild gastroenteritis (BICE).</p><p><b>METHODS</b>Forty-two hospitalized children diagnosed with BICE were recruited to the observation group, and 46 children admitted due to acute gastroenteritis alone were recruited to the control group. Serum H2S levels were measured by a spectrophotometer.</p><p><b>RESULTS</b>The serum H2S level in the observation group was significantly lower than in the control group (28±12 μmol/L vs 45±10 μmol/L; P<0.01). The patients with a number of convulsions greater than or equal to two had significantly lower serum H2S levels than those with a number less than two (P<0.05). The number of convulsions was negatively correlated with serum H2S level in BICE patients (r=-0.485, P=0.001). When a convulsion exceeded 5 minues in duration, the duration was negatively correlated with serum H2S level (r=-0.736, P=0.004).</p><p><b>CONCLUSIONS</b>The reduction in endogenous H2S level might be one of the causes of convulsions in BICE patients. The degree of reduction in H2S level is associated with the number of convulsions and the duration of convulsion (when it exceeds 5 minues). Further investigation is needed to determine the clinical significance of these results.</p>