Efficiency of the sublingual route in treating B12 deficiency in infants

Objective:To evaluate the efficiency of the sublingual route for the treatment of vitamin B12 deficiency in infants.Background:Vitamin B12 deficiency is common in children. In breastfed infants, the main reason is maternal B12 deficiency. Parenteral administration is commonly prescribed. However, patient compliance is not satisfactory due to repeated painful parenteral applications. It is also known that the oral route is efficient in high doses. In recent years, the sublingual route has been tried. This route stands out due to its easy applicability and low cost. However, there are few efficacy studies in infants for the sublingual route.Materials and methods:The study included 49 infants aged 6–12 months. All infants with marginal or deficient B12 levels (<300 pg/mL) were incidentally detected and treated with sublingual methylcobalamin. Each dose was 1000 μg and administered once a day in the first week, every other day in the second week, twice a week in the third week, and once a week in the last week. Serum vitamin B12 levels were measured before and after the treatment. Paired Sample T-Test was used to compare variables.Results:All infants had normal physical development and had no hematological or neurological issues. It was learned from the parents that the infants tolerated treatment well, and no side effects related to the treatment, such as vomiting or rash, were observed. Before and after the treatment, the mean vitamin B12 levels were 199±57 pg/mL and 684±336 pg/ml, respectively. The difference between the means was statistically significant (p<0.001).Conclusion:According to the study, it seems possible to treat vitamin B12 deficiency via a sublingual route in infants. In addition, methylcobalamin can be an alternative to the commonly used cyanocobalamin

Infants infected with SARS-CoV-2 and newborns born to mother diagnosed with COVID-19: clinical experience

Background Almost every day, new information about the COVID-19 pandemic continues to emerge. COVID-19 presents a mild clinical picture in children. However, how it goes in newborns and pregnant is still entirely unclear. Aims To present the clinical course of SARS-CoV-2 positive newborns and outcomes of babies born to mothers diagnosed with COVID-19. Methods The present cohort-study examined two groups. The first group includes fourteen newborns born to mothers diagnosed with COVID-19. The second group evaluates twelve newborns infected with SARS-CoV-2. Results Fourteen infants born to mothers diagnosed with COVID-19 were not infected with SARS-CoV-2. They had no symptoms and pathological laboratory findings. Additionally, forty-one newborns suspected of COVID-19 were evaluated, and 12 of them were detected to be infected with SARS-CoV-2. The most common symptoms were feeding intolerance (vomiting or refusing to feed, 58%), cough (50%), elevated fever (42%), and respiratory distress (42%). Conclusion We did not come across any signs of vertical SARS-CoV-2 transmission. COVID-19 diagnosed newborns entirely healed with conservative treatment

UP-TO DATE APPROACH TO ACUTE BRONCHIOLITIS

Acute viral bronchiolitis is a very common disease of infancy, characterized by the respiratory distress caused usually by Respiratory Syncytial Virus (RSV). Lungs are diffusely affected and no spasm occurs in bronchial smooth muscles. High fever is unusual. Following rhinorrhea and coughing; prolonged expirium, tachypnea and respiratory distress occur. Diffuse wheezing is typical. Because of the risk of hypoxemia oxygen saturation must be closely followed and oxygen support should be provided if necessary. Patients are under the risk of dehydratation owing to insufficient oral intake. The diagnosis of acute bronchiolitis is based on the clinical findings, so laborotary studies are unnecessary. The main steps of the treatment are maintaining sufficent oxygenation, securing the liquid and electrolyte balance and drug therapy. Nebulized adrenalin can be partially helpful by reducing the airway edema. Nebulized salbutamol may be tried although its effect is questionable because of the absence of bronchospasm. However, it should not be continued if there is no benefit. The benefits of inhaled and oral corticosteroids are controversial. Antibiotics are unnecessary. The preventive measures include general infectious precautions, hand washing, environmental hygienic precautions, use of a mask if necessary, withholding sick kids from school, continuation of breastfeeding and preventing passive smoking. RSV vaccine is not available yet