Clinical and Experimental Pediatrics

Original Article

Gastroenterology

Efficacy and safety of carbon dioxide versus room-air insufflation in pediatric colonoscopy: a randomized controlled trial

Ajay Aravind, Ujjal Poddar, Anshu Srivastava, Moinak Sen Sarma

Clin Exp Pediatr. 2025;68(8):594-600. Published online March 11, 2025

CO₂ insufflation has been used instead of air insufflation to reduce postprocedure pain and discomfort in adults; however, adequately powered studies in children are scarce. This randomized controlled trial of 200 children showed that CO₂ insufflation reduces postprocedure pain and discomfort during pediatric colonoscopy with no signs of CO₂ retention. CO₂ insufflation is safe and causes less pain in children.

DOI: https://doi.org/10.3345/cep.2024.02012

Somatic symptom severity during acute illnesses among children with functional gastrointestinal disorders

Rattanachart Sirinil, Anundorn Wongteerasut

Clin Exp Pediatr. 2025;68(8):587-593. Published online March 11, 2025

Functional gastrointestinal disorders (FGIDs) are associated with various somatic symptoms measured using a visual analogue scale and the Children’s Somatic Symptoms Inventory-24 questionnaire. Children with FGIDs exhibited more significant somatic symptoms than controls during acute illnesses. Gastrointestinal (GI) and non-GI manifestations are significantly more common in children with FGIDs.

DOI: https://doi.org/10.3345/cep.2024.01795

Critical Care Medicine

Serum amyloid A and proadrenomedullin as early markers in critically ill children with sepsis

Nagwan Y. Saleh, Wafaa M. Abo El Fotoh, Mona S. Habib, Salem E. Deraz

Clin Exp Pediatr. 2025;68(8):578-586. Published online February 26, 2025

Question: Are serum amyloid A (SAA) and proadrenomedullin (proADM) levels early markers in critically ill children with sepsis?
Finding: This prospective case-control study included 65 critically ill children with sepsis admitted to the pediatric intensive care unit and 31 controls. SAA and proADM levels were significantly higher in patients versus controls.
Meaning: SAA and proADM are promising biomarkers for diagnosing and predicting outcomes in pediatric sepsis.

DOI: https://doi.org/10.3345/cep.2024.01928

Neurology

Establishing an induced pluripotent stem cell bank using urine cells from pediatric patients with neurogenetic diseases

Hien Bao Dieu Thai, WonWoo Jung, Sol Choi, Woo Joong Kim, JangSup Moon, ByungChan Lim

Clin Exp Pediatr. 2025;68(8):569-577. Published online April 1, 2025

Crossref 1

Question: What can be used to create a reliable supply of somatic cells for induced pluripotent stem cells (iPSCs) generation and standardize procedures for building an iPSC bank for researching pediatric neurogenetic disorders?
Findings: Noninvasively acquired urine cells are a desirable cell source for iPSC reprogramming.
Meaning: An iPSC bank can be created from diverse patient cell sources and offer a useful resource for translating research results into clinical therapy for pediatric neurogenetic disorders.

DOI: https://doi.org/10.3345/cep.2024.01830

Editorial

Other

Beyond the eye: a multidisciplinary perspective on managing pediatric myopia

Eoi Jong Seo

Clin Exp Pediatr. 2025;68(8):566-568. Published online July 18, 2025

Myopia is a growing global public health concern because of its association with irreversible vision loss such as myopic traction maculopathy, rhegmatogenous retinal detachment, and glaucoma. The effective prevention of myopia in childhood requires a multidisciplinary approach that integrates ophthalmologic care with lifestyle, nutrition, and sleep interventions. Early detection through regular visual screening in schools and primary care settings and timely ophthalmology referrals are critical to preventing high myopia.

DOI: https://doi.org/10.3345/cep.2025.00955

Review Article

Other

Myopia: a review of current concepts, association with nonophthalmological conditions, and treatment strategy in children and adolescents

Yeon Woong Chung

Clin Exp Pediatr. 2025;68(8):554-565. Published online April 1, 2025

Crossref 2

Myopia is a major ophthalmological disorder with increasing prevalence worldwide, particularly in East Asia. Evidence indicates that its development involves complex interactions between genetic and environmental factors. Body stature, sleep patterns, and nutritional status significantly influence the progression of myopia during childhood and adolescence. Its treatment and prevention strategies include optical correction, atropine therapy, increased outdoor activity, decreased near work, and regular retinal monitoring.

DOI: https://doi.org/10.3345/cep.2025.00115

Letter to the Editor

General Pediatrics

Debate around and impact of digital screen time and media parenting on children’s development

Gowda Parameshwara Prashanth

Clin Exp Pediatr. 2025;68(7):551-553. Published online March 11, 2025

DOI: https://doi.org/10.3345/cep.2025.00073

Perspective

Gastroenterology

Metabolic dysfunction-associated steatotic liver disease in children: a practical update based on Indian Society of Pediatric Gastroenterology, Hepatology and Nutrition (ISPGHAN) 2024 guidelines

Ankit Agrawal, Arghya Samanta

Clin Exp Pediatr. 2025;68(7):546-550. Published online May 12, 2025

DOI: https://doi.org/10.3345/cep.2025.00157

Original Article

Neonatology (Perinatology)

Evaluation of total serum bilirubin thresholds for discontinuing phototherapy in jaundiced neonates: a randomized study

Ajay Kumar, Nidhi Jain

Clin Exp Pediatr. 2025;68(7):539-545. Published online February 26, 2025

Question: What are the outcomes of jaundiced neonates when phototherapy is discontinued at 2 different total serum bilirubin (TSB) thresholds?
Findings: The study involved 80 neonates, comparing a recommended TSB threshold and a lower threshold for phototherapy discontinuation. Results showed a 14.3% reinstitution rate of treatment, with no adverse outcomes.
Meaning: Careful posttreatment monitoring is essential when discontinuing phototherapy, and future research should consider updated guidelines like those from the American Academy of Pediatrics.

DOI: https://doi.org/10.3345/cep.2024.01249

Incidence of neural tube defects in tertiary care university hospital in Bangladesh

Ismat Jahan, Arif Hossain, Shah Nizam Uddin Shaon, Sadeka Choudhury Moni, Mohammad Kamrul Hassan Shabuj, Sanjoy Kumer Dey, Mohammad Abdul Mannan, Mohammod Shahidullah

Clin Exp Pediatr. 2025;68(7):530-538. Published online April 1, 2025

Question: What is the burden of neural tube defects (NTDs) in a tertiary care neonatal intensive care unit in Bangladesh?
Finding: The overall incidence of NTD was 6.4 (range, 4.59–11.2) per 1,000 live births, and the meningomyelocele complex was the most frequent location.
Meaning: The high incidence of NTD found in a leading tertiary care multidisciplinary referral hospital in Bangladesh may not reflect that of the wider population.

DOI: https://doi.org/10.3345/cep.2024.01578

Hematology

Treatment and clinical outcomes of pediatric autoimmune hemolytic anemia: real-world single-center data from Korea

Young Dai Kwon, Eun Sun Jung, Yeon Jung Lim

Clin Exp Pediatr. 2025;68(7):522-529. Published online April 16, 2025

Question: Can pediatric autoimmune hemolytic anemia (AIHA) be effectively managed using first-line steroids?
Finding: In this single-center study, pediatric patients with AIHA achieved normal hemoglobin levels within 16.5 days (range, 9.0–22.0 days) of first-line steroid treatment and maintained effective responses for 2 months.
Meaning: These outcomes highlight the efficacy of steroid treatment in pediatric versus adult AIHA and underscore the need for multicenter trials to establish standardized treatment guidelines.

DOI: https://doi.org/10.3345/cep.2024.02026

Genetics and Metabolism

Role of microRNA-498 and microRNA-410 in neonatal hypoxic-ischemic encephalopathy

Eman Salah Eldeen Arafat, Hasnaa Hesham Abotaleb, Dina Abdel Razek Midan, Abdel Hamid Abdo Ismail, Zeinab Sabri Abouzouna

Clin Exp Pediatr. 2025;68(7):512-521. Published online February 26, 2025

Question: Is it role of microRNA-410 (miRNA-410) and microRNA-498 (miRNA-498) in neonatal hypoxic-ischemic encephalopathy (HIE)?
Findings: miRNA-498 and miRNA-410 can be auxiliary diagnostic and prognostic tools for neonatal HIE.
Meaning: we can use miRNA-498 and miRNA-410 as markers and indicator for HIE.

DOI: https://doi.org/10.3345/cep.2024.01669

Neonatology (Perinatology)

Characterization of gut microbiota in very low birth weight infants with versus without bronchopulmonary dysplasia

Anucha Thatrimontrichai, Manapat Praditaukrit, Gunlawadee Maneenil, Supaporn Dissaneevate, Kamonnut Singkhamanan, Komwit Surachat

Clin Exp Pediatr. 2025;68(7):503-511. Published online February 26, 2025

Web of Science 2 Crossref 2

Question: Does the gut microbiota differ between very low birth weight (VLBW) infants with versus without bronchopulmonary dysplasia (BPD)?
Finding: Common respiratory pathogens were notably elevated in the BPD group, whereas anaerobic and butyrate-producing taxa, key components of postbiotics, were dominant in the non-BPD group.
Meaning: In gut-lung communication, the interplay between the intestinal and respiratory systems may implicate pro- and postbiotics in VLBW infants with BPD.

DOI: https://doi.org/10.3345/cep.2024.01718

Pulmonology

Clinical course of children with postinfectious bronchiolitis obliterans with versus without comorbid bronchopulmonary dysplasia

Lamia Medghoul, Julien Grosjean, Christophe Marguet, Hortense Petat

Clin Exp Pediatr. 2025;68(7):497-502. Published online April 1, 2025

Question: Postinfectious bronchiolitis obliterans (PIBO) is a chronic respiratory disease that typically develops in children after a severe respiratory infection. Bronchopulmonary dysplasia (BPD) is often comorbid in patients with PIBO.
Finding: Corticosteroid pulse therapy effectively manages PIBO with or without comorbid BPD, significantly reducing exacerbations and decreasing the daily requirement for inhaled corticosteroids.
Meaning: Therapeutic effects of corticosteroid pulses are rapid and sustained over time, in both groups.

DOI: https://doi.org/10.3345/cep.2025.00122

Nonlinear association between neutrophil-to-lymphocyte ratio and asthma in children and adolescents in the United States: a cross-sectional study

Chuhan Cheng, Liyan Zhang

Clin Exp Pediatr. 2025;68(7):489-496. Published online March 11, 2025

Crossref 2

Question: Is there a nonlinear relationship between neutrophil-to-lymphocyte ratio (NLR) and asthma in children and adolescents?
Finding: NLR showed a nonlinear association with asthma, with an NLR threshold of 2.23 identifying individuals at higher risk.
Meaning: An NLR<2.23 may serve as a potential biomarker for asthma risk assessment and management in pediatric populations, thereby offering a simple tool for the early identification of at-risk individuals.

DOI: https://doi.org/10.3345/cep.2024.01844

Editorial

Neonatology (Perinatology)

Intermittent sigh breaths during high-frequency oscillatory ventilation among newborn infants

Ga Won Jeon

Clin Exp Pediatr. 2025;68(7):486-488. Published online April 16, 2025

Intermittent sigh breaths during high-frequency oscillatory ventilation can improve ventilation and oxygenation by enhancing lung recruitment. Although research on this approach in newborn infants is limited, some published studies suggest that sigh breaths are generally applied at a rate of 2–3 breaths/min with an inspiratory time of 0.5–1 second and pressure of current mean airway pressure + 5 cmH₂O (maximum, 30 cmH₂O).

DOI: https://doi.org/10.3345/cep.2025.00549

Review Article

Immunology

NLRP3 inflammasome: a key player in neonatal brain injury

Cagla Kiser, Ilkcan Ercan, Defne Engur, Sermin Genc

Clin Exp Pediatr. 2025;68(7):475-485. Published online April 1, 2025

Hypoxic-ischemic encephalopathy is the major cause of neonatal brain injury. NOD-like receptor family pyrin domain containing 3 inflammasome activation leads to neuroinflammation, which significantly affects newborn mortality. The establishment of preventive and therapeutic strategies against brain damage requires a thorough understanding of the mechanisms underlying neuroinflammation and inflammasome activation in the neonatal brain.

DOI: https://doi.org/10.3345/cep.2024.01935

Clinical Note

General Pediatrics

Aplasia cutis congenita with unique vascular malformation and cranial hypoplasia: a case in a preterm infant

Yasufumi Sakata, Natsumi Fujii, Sadahiro Nomura, Yoshihiro Azuma, Hiroki Hamano, Hidenobu Kaneyasu, Seigo Okada, Kazumasa Takahashi, Shunji Hasegawa

Clin Exp Pediatr. 2025;68(6):472-474. Published online March 11, 2025

DOI: https://doi.org/10.3345/cep.2024.01998

Original Article

Neonatology (Perinatology)

Differential roles of interleukin-6 and adrenomedullin in early diagnosis and mortality predictions in late-onset neonatal sepsis

Emilly Henrique dos Santos, Gabriel Acca Barreira, Mariana Okay Saippa, Maria Carolina Pires Cruz, Karen Alessandra Rodrigues, Ronaldo Arkader, Thelma Suely Okay

Clin Exp Pediatr. 2025;68(6):463-471. Published online December 23, 2024

Web of Science 2 Crossref 2

Question: Can adrenomedullin (ADM) or interleukin-6 (IL-6) detect late-onset neonatal sepsis (LOS) at admission (area under the curve [AUC]>0.90) as an early diagnostic marker?
Finding: Only IL-6 consistently distinguished survivors from nonsurvivors (AUC>0.90) on admission and antibiotic treatment days 3 and 7. C-reactive protein level identified infections from day 3 but failed to predict outcomes (AUC<0.70).
Meaning: IL-6 level can improve LOS diagnosis and prognosis.

DOI: https://doi.org/10.3345/cep.2024.01543

Nephrology (Genitourinary)

COVID-19 vaccine hesitancy among parents of children with systemic lupus erythematosus

Karnchanit Sausukpaiboon, Nuanpan Penboon, Pornpimol Rianthavorn

Clin Exp Pediatr. 2025;68(6):454-462. Published online February 3, 2025

Web of Science 1 Crossref 2

Question: What is the acceptance rate for coronavirus disease 2019 vaccination among parents of children with systemic lupus erythematosus (SLE)?
Finding: One-third of parents were hesitant to vaccinate their child. Parental willingness to vaccinate themselves, older patient age, and belief in the vaccine's potency were associated with vaccine acceptance.
Meaning: These findings highlight the need for targeted interventions to improve vaccine acceptance among parents of children with SLE.

DOI: https://doi.org/10.3345/cep.2024.01340

Oncology

Prognostic role of mid-regional pro-adrenomedullin in predicting infection in pediatric cancer with febrile neutropenia

Seham M. Ragab, Sara Mahmoud El-Deeb, Ahmed Saeed, Asmaa A. Mahmoud

Clin Exp Pediatr. 2025;68(6):445-453. Published online January 13, 2025

Web of Science 1 Crossref 1

· Infection remains a leading cause of death in febrile neutropenia (FN).
· Mid-regional pro-adrenomedullin (MR-ProADM) levels are higher among patients with FN and a bacterial infection.
· A longer FN duration and hospital stay length as well as elevated C-reactive protein, procalcitonin, and MR-ProADM levels are significant risk factors for mortality.

DOI: https://doi.org/10.3345/cep.2024.01620

Hematology

Impact of Xmn1 polymorphism on hydroxyurea therapy in children with HbE-β non-transfusion dependent thalassemia: a cohort study

Saheli Roy, Paramita Bhattacharya, Atanu Kumar Dutta, Mrinal Kanti Das

Clin Exp Pediatr. 2025;68(6):437-444. Published online February 3, 2025

Question: Does the T allele of Xmn1 polymorphism favorably influence hydroxyurea efficacy in children of Eastern descent with fetal hemoglobin (HbE)-β nontransfusion dependent thalassemia (NTDT)?
Finding: Decrease in transfusion requirement and increase in height following hydroxyurea therapy was noted in both groups, however, change in CT was more critical than that in CC genotype.
Meaning: T allele of Xmn1 polymorphism favorably influences hydroxyurea efficacy in children with HbE-β NTDT.

DOI: https://doi.org/10.3345/cep.2024.01284

Editorial

Neurology

Screen time and neurodevelopment in preschoolers: addressing a growing concern in pediatric practice

Soongang Park, Hyewon Woo

Clin Exp Pediatr. 2025;68(6):434-436. Published online January 13, 2025

· Excessive screen time in preschoolers is associated with neurodevelopmental delays, particularly during the early years of life.
· Parental supervision and national guidelines are critical in mitigating the negative impacts of excessive screen time and fostering healthy media habits in preschoolers.

DOI: https://doi.org/10.3345/cep.2024.01536

Review Article

Other

Peripheral nerve sheath tumors in the head and neck in patients with APC gene deletion mutations: a case report and scoping review of the literature

Koral M. Blunt, Monirah Albathi, Miriam Conces, Tendy Chiang

Clin Exp Pediatr. 2025;68(6):428-433. Published online January 13, 2025

In this report, we describe our experience with a patient with an APC-related genetic syndrome who presented with a rare palatal lesion with characteristics of a schwannoma. We discuss the role of immunohistochemical staining in discerning the differential diagnosis.

DOI: https://doi.org/10.3345/cep.2024.01375

Endocrinology

Impact of hematopoietic stem cell transplantation on growth outcomes in mucopolysaccharidosis: a systematic review

Farzaneh Abbasi, Asal Khalili Dehkordi, Reihaneh Mohsenipour

Clin Exp Pediatr. 2025;68(6):417-427. Published online March 11, 2025

Hematopoietic stem cell transplantation (HSCT) enhances the growth outcomes of pediatric patients with mucopolysaccharidosis, with early intervention leading to improved height, weight, and body mass index. However, achieving a standard adult height remains uncommon among these patients, even in cases of early HSCT. Growth hormone therapy provides short-term benefits but does not address long-term height deficits. Pubertal development is generally normal; however, precocious puberty and pubertal arrest may occur.

DOI: https://doi.org/10.3345/cep.2024.01725

Critical Care Medicine

Protocolized sedation may reduce ventilation and sedation requirements in the pediatric intensive care unit: a systematic review and meta-analysis

Ambrus Szemere, Alíz Fazekas, Anna Réka Sebestyén, Rani Ezzeddine, Veronika Upor, Marie Anne Engh, Péter Hegyi, Zsolt Molnár, Klára Horváth

Clin Exp Pediatr. 2025;68(6):406-416. Published online February 19, 2025

Protocolized sedation may reduce ventilation requirements, pediatric intensive care unit length of stay, and sedative exposure. However, it may increase the likelihood of unplanned extubation, highlighting the importance of incorporating preventive measures to mitigate this risk.

DOI: https://doi.org/10.3345/cep.2024.01711

Allergy

Eosinophil-derived neurotoxin levels can predict allergic disease development and atopic march in children

Zak Callaway, Chang-Keun Kim

Clin Exp Pediatr. 2025;68(6):398-405. Published online February 3, 2025

· Allergic march occurs in a subset of children, beginning with atopic dermatitis and progressing to food allergies, allergic rhinitis, and/or asthma. Its early diagnosis is important to slowing its progression.
· Eosinophil-derived neurotoxin (EDN), an excellent biomarker of eosinophil activity, is often elevated in allergic diseases.
· EDN levels have been used to predict allergic disease development and diagnose, treat, and monitor allergic diseases.

DOI: https://doi.org/10.3345/cep.2024.01382

Clinical Note

Gastroenterology

Abdominal pain in a young girl: a twist in the tale

Upasana Ghosh, Ankit Agrawal, Umesh Shukla, Vikas Jain, Deeksha Bhalla

Clin Exp Pediatr. 2025;68(5):395-397. Published online March 11, 2025

· Chronic abdominal pain caused by a gastric trichobezoar is extremely rare among children.
· An indentable epigastric mass is characteristic and upper gastrointestinal endoscopy is diagnostic of a gastric trichobezoar.
· Symptomatic large trichobezoars usually require surgery.
· Neuropsychiatric disorders are often associated with gastric trichobezoar, making a psychiatric evaluation of paramount importance.

DOI: https://doi.org/10.3345/cep.2024.01949

Original Article

General Pediatrics

The role of serum zinc and selenium levels in etiology of febrile seizures

Yavuz Ataş, Hatice Gamze Poyrazoğlu

Clin Exp Pediatr. 2025;68(5):388-394. Published online January 13, 2025

Zinc may play a key role in preventing febrile seizures by increasing the seizure threshold and reducing oxidative stress. Incorporating zinc supplements into treatment could help protect children from the adverse effects of febrile seizures and improve their overall outcomes.

DOI: https://doi.org/10.3345/cep.2024.01410

Infection

Enteric pathogens implicated in acute infectious diarrhea among young children in resource-limited region with rapidly growing population: a hospital-based cross-sectional study

Aseel Mahmood Ibrahim Al-Mashahedah, Randa Mohammed Dhahi

Clin Exp Pediatr. 2025;68(5):379-387. Published online December 23, 2024

Question: What are the most common enteric pathogens in acute diarrhea among children younger than 5 years of age, and which age group is most susceptible?
Finding: Bacteria were the most common causative microorganisms of diarrhea, followed by viruses, parasites, and fungi. The 1–2-year age group was the most commonly affected.
Meaning: There is a need to formulate preventive strategies targeting children exposed to enteric pathogens to limit diarrhea.

DOI: https://doi.org/10.3345/cep.2024.01333

Cited By 31	Neurodevelopmental outcomes of preterm infants
Cited By 29	Long COVID in children and adolescents: prevalence, clinical manifestations, and management strategies
Cited By 27	Gut microbiota affects brain development and behavior
Cited By 24	Association of gut microbiota with obesity in children and adolescents
Cited By 24	Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: a systematic review and meta-analysis

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