Summary: Childhood obesity represents a significant public health concern, imposing a substantial burden on the healthcare system. Furthermore, weight‐loss programs often exhibit reduced effectiveness in adults who have a history of childhood obesity. Therefore, early intervention against childhood obesity is imperative. Presently, the primary method for diagnosing childhood obesity relies on body mass index (BMI), yet this approach has inherent limitations. Leptin, a satiety hormone produced by adipocytes, holds promise as a superior tool for predicting both childhood and subsequent adulthood obesity. In this review, we elucidate the tools employed for assessing obesity in children, delve into the biological functions of leptin, and examine the factors governing its expression. Additionally, we discuss maternal and infantile leptin levels as predictors of childhood obesity. By exploring the relationship between leptin levels and weight loss, we present leptin as a potential indicator of the effectiveness of obesity interventions.

Propofol and sevoflurane are two of the most commonly used anaesthetics for paediatric surgery. Data from some clinical trials suggest that postoperative pain incidence is lower when propofol is used for maintenance of anaesthesia compared with sevoflurane, although this is not clear. This meta-analysis compared postoperative pain following maintenance of anaesthesia with propofol or sevoflurane in paediatric surgeries. PubMed Medline, Embase, Scopus, Web of Science and Cochrane Library were searched for randomised controlled trials (RCTs) that compared postoperative pain between sevoflurane and propofol anaesthesia in children. After quality assessment, a meta-analysis was carried out using bias-adjusted inverse heterogeneity methods, heterogeneity using I² and publication bias using Doi plots. In total, 13 RCTs with 1174 children were included. The overall synthesis suggested nearly two-fold higher odds of overall postoperative pain in the sevoflurane group compared with the propofol group (odds ratio [OR] 1.88, 95% confidence interval [CI] 1.12-3.15, I²=58.2%). Further, children in the sevoflurane group had higher odds of having higher pain scores (OR 3.18, 95% CI 1.83-5.53, I²=20.9%), and a 60% increase in the odds of requiring postoperative rescue analgesia compared with propofol (OR 1.60, 95% CI 0.89-2.88, I²=58.2%). Children maintained on inhalational sevoflurane had higher odds of postoperative pain compared with those maintained on propofol. The results also suggest that sevoflurane is associated with higher odds of needing postoperative rescue analgesia compared with propofol. The protocol for this systematic review and meta-analysis was registered on the International Prospective Register of Systematic Reviews (PROSPERO) with registration ID CRD42023445913.

Background and Objective: Estimates of the prevalence of the autism spectrum disorder (ASD) in the Middle East and North Africa (MENA) region are not readily available, amid a lack of recent evidence. In this study, we estimated the prevalence of ASD in the MENA region by synthesising evidence from published studies in the region. Methods: In this systematic review and meta-analysis, we searched PubMed, EMBASE, Scopus, and CINAHL databases for studies which assessed ASD prevalence in the MENA region. Risk of bias was assessed using the Newcastle Ottawa scale. A bias-adjusted inverse variance heterogeneity meta-analysis model was used to pool prevalence estimates from included studies. Cochran’s Q statistic and the I ² statistic were used to assess heterogeneity, and publication bias assessed using funnel and Doi plots. Results: A total of 3075 studies were identified, 16 studies of which met the inclusion criteria and involved 3,727,731 individuals. The studies were published during the period 2007-2022, and included individuals from Iran, Oman, Libya, Egypt, Kingdom of Saudi Arabia (KSA), Lebanon, United Arab Emirates (UAE), Bahrain and Qatar. Estimates of ASD prevalence ranged from 0.01% in Oman during the period June 2009-December 2009, to a high of 2.51% in the Kingdom of Saudi Arabia during the period December 2017-March 2018. The pooled prevalence of ASD was 0.13% (95% CI: 0.01% – 0.33%), with significant heterogeneity (I ² = 99.8%). For Iran, the only country with multiple analysable studies, an overall prevalence of 0.06% (95% CI: 0.00 – 0.19, I2=97.5%, n= 6 studies) was found. A review of data from countries with repeated studies suggested that the prevalence of ASD is increasing. Conclusion: Estimates of the prevalence of ASD vary widely across the MENA region, from 0.01% in Oman to 2.51% in Saudi, with an overall prevalence of 0.13%. Existing data suggests a trend towards increasing prevalence in the region. More and better-quality research is needed to provide up to date ASD prevalence estimates. Registration: The protocol for this systematic review and meta-analysis was registered on the International Prospective Register of Systematic Reviews (PROSPERO) with registration ID CRD42024499837.

Blood product transfusion in major burned pediatric patients: A case-control study - Turkish Journal of Surgery

Background and Objectives: The etiology of autism spectrum disorder (ASD) is poorly understood, with sparse data from the Middle East and North Africa (MENA) region, which has a unique climate and socio-epidemiological setting. This research investigated the developmental (early life) risk factors associated with ASD in the MENA region. Methods: In this systematic review and meta-analysis, we searched for observational studies, which carried out adjusted analyses for ASD risk factors in the MENA region, in PubMed, Embase, Scopus, and CINAHL databases. We analyzed associations between ASD and factors related to conception, inheritance, maternal morbidity during pregnancy and adverse pregnancy outcomes. After study quality assessment, meta-analyses for each risk factor were carried out using the bias-adjusted inverse variance heterogeneity model. Heterogeneity was assessed using I ² and publication bias using Doi and funnel plots. Results: The systematic review included 19 case control studies from eight countries within the MENA region. In overall synthesis, male sex (OR=3.27, 95% CI: 2.39-4.48, I2 = 40.9%), family history of ASD (OR=2.98, 95% CI: 0.51-17.31, I2 = 85.0%), and consanguinity (OR= 1.77, 95% CI: 1.38-2.28, I2 = 57.1%) were associated with ASD. Although with limited studies, a review of the literature showed some possible associations between ASD and gestational diabetes, gestational hypertension, macrosomia, NICU admission, respiratory distress syndrome, cesarean delivery, gestational age, and older maternal age. Conclusion: These findings confirm the association between male sex, family history of ASD and consanguinity with ASD, potentially suggesting some inherited mechanism in the etiology of ASD in the MENA region. Some maternal co-morbidities during pregnancy and adverse pregnancy outcomes may contribute to ASD risk in the MENA region, although more studies are needed in the region. Registration: The protocol for this systematic review and meta-analysis is registered on the International Prospective Register of Systematic Reviews (PROSPERO) with registration ID CRD42024499837.