The prevalence of zinc deficiency in morbidly obese patients before and after different types of bariatric surgery

Background: The prevalence of obesity is considered to be increased worldwide. Lack of mineral elements is one of the essential side effects of bariatric surgery as a trending treatment for obesity. We aimed to assess zinc deficiency among morbidly obese patients before and following different types of bariatric surgical procedures. Methods: In the present retrospective cohort study, 413 morbidly obese patients (body mass index (BMI) � 40 kg/m2 or BMI � 35 kg/m2 with a complication or risk factor, e.g., diabetes mellitus) were enrolled who received bariatric surgery, aged between 18 and 65 years old, and had a negative history of active consumption of alcohol and illicit drugs. Patients were assigned into three groups of bariatric surgeries: mini-gastric bypass, Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy (SG). We recorded baseline clinical and demographic characteristics and zinc serum levels during the preoperative and postoperative follow-up periods at three, six, and 12 months after the operation. Results: All patients with a mean age of 40.57 ± 10.63 years and a mean preoperative BMI of 45.78 ± 6.02 kg/m2 underwent bariatric surgery. 10.2 of the bariatric patients experienced zinc deficiency before the surgery, and 27.1 at 1 year after the surgery. The results showed that 27.7 of mini-gastric bypass patients, 29.8 of RYGB, and 13.3 of SG experienced zinc deficiency 12 months following surgery. We observed no statistical differences in the preoperative and postoperative zinc deficiency between different types of surgeries. Conclusion: A high prevalence of preoperative zinc deficiency among morbidly obese patients who underwent bariatric surgery was observed, which increased during the postoperative periods. We recommend assessing zinc serum levels and prescribing zinc supplements before the bariatric operation to alleviate the prevalence of zinc deficiency after the operation. © 2021, The Author(s)

The Effect of Synbiotic Supplementation on Growth Parameters in Mild to Moderate FTT Children Aged 2�5 Years

Synbiotic (probiotic bacteria and prebiotic) has beneficial effects on the gastrointestinal tract. This study was designed to investigate the effect of synbiotic supplementation on the growth of mild to moderate failure to thrive (FTT) children. A randomized, triple-blind, placebo-controlled trial was conducted involving 80 children aged 2�5 years with mild to moderate FTT, who were assigned at random to receive synbiotic supplementation (109 colony-forming units) or placebo for 30 days. The weights, height, and BMI were recorded in a structured diary, and the questionnaires were completed to monitor the numbers of infection episodes, gastrointestinal problems, admission to hospital, and appetite improvement during the study. Sixty-nine children completed the study. There were no differences in the demographic characteristic between the two groups. The mean weight was similar at baseline. After 30 days of intervention, the mean weight of the participants in the synbiotic group increased significantly than those in the placebo group (600 ± 37 vs. 74 ± 32 g/month P 0.000). BMI changes in synbiotic and placebo group were 0.44 and 0.07 kg/m2, and that the differences among the two groups were significant.(P 0.045) Furthermore, the height increment in synbiotic and placebo group was 0.41 and 0.37 cm respectively with no significant difference (P 0.761). Administration of 30-day synbiotic supplementation may significantly improve weight and BMI in Iranian children with mild to moderate FTT, but there is no effect on the height in this study. Further studies should be designed to found out the effect of synbiotic on growth parameters in undernourished and well-nourished children. © 2019, Springer Science+Business Media, LLC, part of Springer Nature

The Effect of Synbiotic Supplementation on Growth Parameters in Mild to Moderate FTT Children Aged 2–5 Years

Synbiotic (probiotic bacteria and prebiotic) has beneficial effects on the gastrointestinal tract. This study was designed to investigate the effect of synbiotic supplementation on the growth of mild to moderate failure to thrive (FTT) children. A randomized, triple-blind, placebo-controlled trial was conducted involving 80 children aged 2–5 years with mild to moderate FTT, who were assigned at random to receive synbiotic supplementation (109 colony-forming units) or placebo for 30 days. The weights, height, and BMI were recorded in a structured diary, and the questionnaires were completed to monitor the numbers of infection episodes, gastrointestinal problems, admission to hospital, and appetite improvement during the study. Sixty-nine children completed the study. There were no differences in the demographic characteristic between the two groups. The mean weight was similar at baseline. After 30 days of intervention, the mean weight of the participants in the synbiotic group increased significantly than those in the placebo group (600 ± 37 vs. 74 ± 32 g/month P 0.000). BMI changes in synbiotic and placebo group were 0.44 and 0.07 kg/m2, and that the differences among the two groups were significant.(P 0.045) Furthermore, the height increment in synbiotic and placebo group was 0.41 and 0.37 cm respectively with no significant difference (P 0.761). Administration of 30-day synbiotic supplementation may significantly improve weight and BMI in Iranian children with mild to moderate FTT, but there is no effect on the height in this study. Further studies should be designed to found out the effect of synbiotic on growth parameters in undernourished and well-nourished children. © 2019, Springer Science+Business Media, LLC, part of Springer Nature

Evaluation of Efficacy and Safety of Propranolol for Pediatric Migraine Prophylaxis

Introduction: Migraine is the most frequent and most important headache in childhood. Therefore, prophylactic therapy should be exerted in children with frequent or disabling headaches. The purpose of this study was to evaluate efficacy and safety of propranolol for children’s migraine prophylaxis. Methods: In this quasi- experimental study, monthly frequency, severity and duration of headache, migraine disability and side effects of fifty migrainous children were evaluated who were treated with 1mg/kg/day of propranolol for three months and referred to Pediatric Neurology Clinic of Shahid Sadoughi Medical Sciences University, Yazd, Iran from April 2011. Results: Twenty seven (54%) girls and 23(46%) boys with mean age of 10.68± 2.35 years were evaluated. Monthly frequency, severity and duration of headache decreased with treatment, from 16.2±6.74 to 8.88±4.54 attacks, from 6. 1±1.54 to 4.18±1.61, and from 2.2±1.36 to 1.08±1.08 hours, respectively. Pediatric Migraine Disability Assessment score reduced with TPM from 33.08±8.98 to 23.64 ± 9.88. (p<0.05). Transient side effects were seen in 10%(N=5) of the patients including mild hypotension in three and drowsiness in two children. Conclusion: Propranolol is partially effective and safe for pediatric migraine prophylaxis

Comparing the Growth Pattern of the First 5-Year Life in Children with Congenital Hypothyroidism in Yazd According to Growth Pattern of Normal Children of World Health Organization in 2014: A Cohort Study

Abstract Introduction: Congenital hypothyroidism is regarded as one of the major preventable and treatable causes of physical disorders. Therefore, the present study aimed to study the growth pattern of first 5-year life in children with congenital hypothyroidism in Yazd according to growth pattern of healthy children of World Health Organization (WHO). Methods: This descriptive retrospective cohort study was performed on all the infants born within 2006- 2008, that had been diagnosed as a patient by a screening program. After taking inclusion and exclusion criteria into account, growth pattern of the infants' height, weight and head circumference within first 5-year of life was compared to that of normal children of WHO in terms of age and sex in 3,15,50,85, 97 percentiles. Results: The study results revealed that pattern growth of height, weight and head circumference within girl patients was developed parallel with the growth pattern of healthy girls of WHO. Within the boys, linear pattern growth after 36 months, weight growth after 9 months and head circumference growth at 24 months was similar to the growth pattern of healthy boys of WHO. Conclusions: The growth pattern in children with congenital hypothyroidism will develop towards normal growth pattern after treatment and medical care continuation