Risk Factors of Recurrent Wheezing in Children Under 5 Years of Age.

Objective: To identify risk factors which may lead to the occurrence of recurrent wheezing in children under five years of age. Material and Method: A cross-sectional study was conducted in children under 5 years old at the Out Patient Department at Naresuan University Hospital, from October 2013 to October 2014. Fifty-five children who had signs and symptoms of recurrent wheezing were assigned to the study group, whereas another fifty-five children matching on age and sex with the case who had no symptoms of recurrent wheezing were assigned to the control group. All of the parents completed the given questionnaires. Descriptive data analysis were statistically conducted to understand the characteristics of the study groups. The risk factors were analysed using both bivariate and multivariate statistical analyses which included all the important predictors with a statistically significant level of p<0.05. Results: Mean age in the study group was 36.1 months and in the control group 25.0 months. The mean weights and heights showed no difference between the case and control groups. Bivariate analysis showed that upper respiratory tract infection [odds ratio (OR) 7.273; 95% confidence interval (CI) 2.277-23.232)], lower respiratory tract infection (OR 5.332; 95% CI 2.326-12.225), passive smoking (OR 2.368; 95% CI 1.094-5.129), and day care center attendance (OR 2.590; 95% CI 1.168-5.745) were the risk factors of recurrent wheezing. Multivariate logistic regression analysis indicate that lower respiratory tract infection [adjusted odds ratios (aOR) 0.241; 95% CI 0.088-0.659] was the most important risk factor leading to recurrent wheezing. Conclusion: Lower respiratory tract infection, upper respiratory tract infection, passive smoking and day care center attendance were found to be risk factors of recurrent wheezing in children under five years of age, with lower respiratory tract infection being the most risk. Targeted surveillance of these risk factors should reduce the incidence of recurrent wheezing. This is especially important for high risk patients such as asthma patients.

Effects of Domperidone on QT Interval in Children with Gastroesophageal Reflux Disease.

BACKGROUND: Domperidone has been widely used in children with gastroesophageal reflux disease (GERD). Studies on the effects of domperidone on corrected QT interval (QTc) in young children are limited. Our aim was to study the effect of domperidone on the repolarization abnormalities assessed by electrocardiogram (ECG) in young children. METHODS: ECG was performed in children <2 years of age before and after taking domperidone orally 0.3 mg/kg three times/day for at least a 1 week period. Each ECG was reviewed and QT, RR, and Tpeak to Tend intervals (TpTe) were measured to calculate the QTc and TpTe/QT ratio. RESULTS: A total of 22 patients (12 male) with a median age of 8.5 months (1-24 months) were enrolled. Most patients (59.1%) were under 1 year of age. The median baseline QTc (410 milliseconds, 350-450 milliseconds) was not significantly different from the QTc after taking domperidone (410 milliseconds, 320-560 milliseconds), p = 0.159. Only two patients showed a QTc increase ≥450 milliseconds. The baseline TpTe interval and TpTe/QT (105 milliseconds, 60-170 milliseconds and 0.27 milliseconds, 0.15-0.43 milliseconds) were significantly greater than the TpTe interval and TpTe/QT in children after taking domperidone (90 milliseconds, 60-140 milliseconds and 0.22 milliseconds, 0.15-0.29 milliseconds), p = 0.001 and 0.004, respectively. CONCLUSIONS: Our data demonstrate that domperidone treatment over a short-term period in children <2 years of age did not lengthen QTc significantly; however, QTc increased ≥450 milliseconds in two patients with concomitant lansoprazole. Routine baseline and follow-up ECG may not be necessary in each individual case receiving only domperidone.

Reliability and validity of thai version ROME III questionnaire for children with functional gastrointestinal disorders.

BACKGROUND: The ROME III diagnostic questionnaireforpediatric functional gastrointestinal disorders (FGIDs) is widely accepted as an essential tool for the diagnosis ofFGIDs in children and as a research tool. However, the questionnaire has not been translated into Thai. OBJECTIVE: To transpose the ROME III diagnostic questionnaire and to determine its validity and reliability in the Thai cultural setting. MATERIAL AND METHOD: The original English ROME III diagnostic questionnaire, composed of 71 items, was translated into Thai following permission from the ROME foundation. The ROME III questionnaire, Thai version was then translated back to English by a bi-lingual expert. The original English and the back-translation versions were compared and the validity was analyzed using Index ofl Item-Objective Congruence (IOC). Finally, the Thai questionnaire was tested with 50 healthy school-children aged four to 15 years old who had no serious illness. The questionnaire was answered by parents for children aged four to 10 years, and self-answered by children aged over 10 years. The reliability was evaluated by Cronbach's alpha coefficient. RESULTS: Item to item comparison between the original English and the back-translation versions valued by IOC was 0.94, which indicated high validity. The Cronbach's alpha coefficient of the overall 71 items was 0.98, which indicated high reliability. Moreover the alpha of reliability for self-report and parent-report was 0.96 and 0.97 respectively. CONCLUSION: The ROME III diagnostic questionnaire in Thai is valid and reliable for the diagnosis of FGIDs in Thai children.