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BACKGROUND: Every year, 14 million babies are born with low birth weight (LBW) and/or intrauterine growth restriction (IUGR) in developing countries. In Sudan, 15-25% of all newborns are born with LBW, with half being Term-LBW. The importance of nutrition in the first 1000 days of life has been well demonstrated. Evidence links IUGR to various health and developmental disorders, and intrauterine programming of the hypothalamic-pituitary-adrenal (HPA) axis has been strongly suggested as a possible mechanism. Sudan has been listed among the lowest four countries regarding food security which has a massive impact on maternal and infant health. HYPOTHESIS: We hypothesize that infants who suffer from intrauterine growth retardation will have exaggerated physiological and behavioural responses to physical stressors. OBJECTIVES: To compare T-LBW with T-NBW on (a) Salivary cortisol level at rest and after a physical stressor and (b) Behavioural response to physical stressors. METHODS: Hospital-based matched case-control study. Cases were 65 T-LBW neonates, and controls were 67 T-NBW neonates matched for age 4-6 hours, gestational age, and mode of deliverymeasurements: Anthropometry, salivary samples for cortisol before and after heel prick, and behavioural ratings. RESULTS: Compared with controls, the IUGR neonates were lighter, shorter, and thinner (p <0.0001) and had lower basal cortisol levels (p <0.03). Following stressors, IUGR neonates had lower (p >0.0001) and inhibited cortisol response (p <0.02), and cried less vigorously (p <0.0001). All anthropometric measures were significantly and positively correlated with behavioural responses and pre- and post-stress cortisol levels. Stunting was more strongly associated with behavioural inhibition than wasting. CONCLUSION: The severity of intrauterine growth retardation correlated with behavioral and physiological inhibition, which can lead to the development of mismatch diseases such as allergies, autoimmune diseases, and conjunctive disorders.
RESUMO
BACKGROUND: Obstructive sleep apnea (OSA) affects 1% to 5% of all children, with the most significant prevalence between ages 2 and 8. Correlations between OSA and Adenoid hypertrophy (AH) have been well-demonstrated in children. If untreated, OSA can cause growth impairment, neuro-cognitive and behavioral problems, and cardiovascular complications. Allergy was reported to be a vital risk factor for AH, among other inflammatory processes mentioned. OBJECTIVES: To demonstrate that the combination of nasal steroids and ani leukotriene reduces the number of adenectomies in children with OSA and adenoid hypertrophy in Saudi children.To demonstrate the positive Correlation between allergic sensitization and OSA caused by adenoid hypertrophy Methods: This retrospective study included 60 children with moderate/severe OSA attending a Pediatric Allergy Clinic in Saudi Arabia diagnosed using Sleep-Related Breathing Disorder Scale (pediatrics-related items). We had children with adenoid hypertrophy confirmed by soft neck tissue x-ray or both; children who suffer from obesity were excluded. Sensitization was defined as positive specific IgE and/or skin prick for food and/or inhaled allergens; allergic comorbidities were enumerated. RESULTS: Combination of nasal steroid and anti-leukotriene reduces adenectomy by 58.3 % in children with OSA caused by AH. 71.7% of Them were sensitized to inhaled food or both allergens. CONCLUSION: Anti-inflammatory treatment with a combination of nasal steroids and anti-leukotriene remarkably reduces the adenectomy rate in children with OSA caused by AH. Our findings suggest that allergic sensitization, regardless of the allergen, increases children's susceptibility to AH through the inflammatory process. This may be why nasonex and montelukast are effective treatments for OSA in children with AH.
RESUMO
BACKGROUND: As health care organizations strive to improve health care access, quality, and costs, they have implemented patient-facing eHealth technologies such as personal health records to better engage patients in the management of their health. In the Kingdom of Saudi Arabia, eHealth is also growing in accordance with Vision 2030 and its National Transformation Program framework, creating a roadmap for increased quality and efficiency of the health care system and supporting the goal of patient-centered care. OBJECTIVE: The aim of this study was to investigate the adoption of the personal health record of the Ministry of National Guard Health Affairs (MNGHA Care). METHODS: A cross-sectional survey was conducted in adults visiting outpatient clinics in hospitals at the Ministry of National Guard Health Affairs hospitals in Riyadh, Jeddah, Dammam, Madinah, and Al Ahsa, and primary health care clinics in Riyadh and Qassim. The main outcome measure was self-reported use of MNGHA Care. RESULTS: In the sample of 546 adult patients, 383 (70.1%) reported being users of MNGHA Care. MNGHA Care users were more likely to be younger (P<.001), high school or university educated (P<.001), employed (P<.001), have a chronic condition (P=.046), use the internet to search for health-related information (P<.001), and use health apps on their mobile phones (P<.001). CONCLUSIONS: The results of this study show that there is substantial interest for the use of MNGHA Care personal health record with 70% of participants self-reporting use. To confirm these findings, objective data from the portal usage logs are needed. Maximizing the potential of MNGHA Care supports patient engagement and is aligned with the national eHealth initiative to encourage the use of technology for high-quality, accessible patient-centered care. Future research should include health care provider perspectives, incorporate objective data, employ a mixed-methods approach, and use a theoretical framework.